Well-differentiated Cases Research Articles

Cytokeratin expression in hepatocellular carcinoma: An immunohistochemical study

Normal human hepatocytes express cytokeratins no. 8 and 18, whereas bile duct cells contain the same cytokeratins and, in addition, cytokeratins no. 7 and 19. This cytokeratin pattern is believed to be preserved during neoplastic transformation. Thirty-four cases of hepatocellular carcinoma (11 well differentiated, 16 moderately differentiated, 7 poorly differentiated) were studied on frozen sections using monoclonal antisera directed against individual cytokeratins no. 7, 8, 18, and 19 in an immunoperoxidase procedure. In 17 of 34 cases, tumor cells showed only reactivity with monoclonals anticytokeratin no. 8 and 18. However, 17 of 34 cases showed an aberrant pattern in that a variable number of tumor cells were stained with anticytokeratins no. 7 and/or 19 in addition to no. 8 and 18. Only three of 11 well-differentiated cases displayed an unexpected cytokeratin pattern, whereas an aberrant pattern was present in all seven of seven poorly differentiated cases. These results are in conflict with previously published data obtained by two-dimensional gel electrophoresis and immunohistochemistry. They indicate that the cytokeratin pattern might not always be preserved during neoplastic transformation. The implication of this finding for the differential diagnosis of metastatic gastrointestinal carcinomas is discussed.

Stage I endometrial carcinoma: A review of 140 patients primarily treated by surgery only

One hundred patients with stage Ia and 40 patients with stage Ib endometrial carcinoma had hysterectomy and bilateral salpingo-oophorectomy performed as the only primary treatment. Sixty-two percent of the patients had well-differentiated tumors, 31% moderately differentiated, and 7% undifferentiated tumors. Information on myometrial invasion was not available. The overall 5-year survival was 0.92 and the 5-year survival by tumor grade 0.96, 0.90, and 0.80 for patients with grade 1, 2, and 3 tumors, respectively. Survival rates decreased significantly with increased tumor dedifferentiation. Prognosis was not affected by enlargement of the uterine cavity or by higher patient age. Of 7 cases of isolated vaginal or pelvic recurrence, 4 could by controlled by irradiation therapy. These results compared to reported results of combined therapy suggest, that in well-differentiated cases—the majority of stage I endometrial cancers—combined therapy of surgery and irradiation presents no advantage over simple hysterectomy.