Molecular Biological Degree of Tumor Malignancy and Its Clinical Significance in Gallbladder Carcinoma

Masami Tabata, Yoshifumi Ogura, Masayoshi Ido, Koji Takahashi, Takashi Noguchi, Yoshifumi Kawarada, Ryuji Mizumoto

First Department of Surgery, Mie University School of Medicine

The molecular biological degree of tumor malignancy and its clinical significance were examined in 72 resected cases of gallbladder carcinoma. The nuclear DNA ploidy pattern was measured using flow cytometry, and immunohistochemical staining of cancer cells was performed by the avidin-biotin peroxidase complex (ABC) method for the following factors: proliferating cell nuclear antigen (PCNA), c-erbB-2, c-myc, K-ras, p53, fibronectin, laminin and tenascin. Patients with aneuploid and/or K-ras-positive tumors showed a significantly higher incidence of advanced carcinoma and a significantly lower survival rate than those with diploid and/or K-rasnegative tumors. In patients with depth of cancer invasion to the subserosal layer or more, expression of K-ras provided more significant prognostic information than histopathological factors. All patients who had tumors that were aneuploid and PCNA-positive, c-myc-positive and p53-positive, or tenascin-positive and fibronectin-negative died of tumor recurrence within 2 years. Moreover, the PCNA labeling index and the expression of extracellular matrix were considerted to be valuable indicators of the time and mode of tumor recurrence after radical resection.

Key words
gallbladder carcinoma, molecular biological degree of tumor malignancy, prognostic factor

Reprint requests
Masami Tabata First Department of Surgery, Mie University School of Medicine
2-174 Edobashi, Tsu, 514 JAPAN

Accepted
June 14, 1993

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