1. Pathology Division

Research in the Pathology Division has been focused on the molecular and cellular mechanisms of carcinogenesis and cancer progression, especially invasion and metastasis. Studies on the clinicopathological significance of genetic alterations in carcinogenesis in each organ were continued. Much progress was made in the understanding of how cancer cells dissociate and invade, through analysis of the cadherin cell adhesion system.

Pathology of Multistage Carcinogenesis and Multiple Genetic Alterations

In the liver of patients suffering from chronic active hepatitis or cirrhosis, increased cell proliferative activity was shown to be an important feature of early neoplastic lesions, and to be useful as a marker for diagnosis of those lesions.(1) This abnormally induced cell proliferation may be the mechanism underlying the accumulation of genetic and chromosomal aberrations leading to cancer progression. In a nodule-in-nodule lesion of hepatocellular carcinoma representing cancer progression, involvement of p53 mutation in this process was clearly demonstrated.(2)
In breast cancer, loss of heterozygosity (LOH) on the long arm of chromosome 16 occurred frequently regardless of the degree of tumor spread or phenotype.(3) Because LOH was not detected in benign proliferative lesions, it was suggested that LOH on 16q was useful for differential diagnosis in intracystic papillary tumors between low-grade papillary carcinoma and papilloma.(4) Mutation of the p53 tumor-suppressor gene was detected selectively in breast cancers with a high histologic grade of atypia irrespective of the site and type of the mutations.(5) However, such site and type of mutations were shown to influence the manner of accumulation of mutant p53 protein in cancer cell nuclei; mis-sense point mutations and in-frame deletions generally gave rise to nuclear accumulation of p53 protein, whereas non-sense point mutations and frameshift deletions gave rise to loss of the protein expression.(5)
In adenocarcinoma of the uterine cervix, mutation of the p53 gene occurred preferentially in patients in advanced clinical stages and those with poorer differentiation, whereas genomic integration of human papillomavirus DNA type 16 or 18 was more frequent in patients in early clinical stages and those with good differentiation.(6) Amplification of the c-erbB-2 gene was also associated with advanced stages and poorer prognosis of adenocarcinoma of the uterine cervix.(7) Similar studies on gastric cancer and skin cancers were also performed.(8,9)

Alterations of Cadherin Cell Adhesion System in Cancer

The E-cadherin-mediated cell adhesion system acts as an "invasion suppressor" system, which is widely considered to be inactivated when the expression of E-cadherin is reduced and/or heterogeneous. The molecular mechanisms responsible for dysfunction of this system in cancers were further investigated. In stomach cancer cell lines lacking tight cell-cell adhesion, mutations of the E-cadherin gene resulting in an mRNA splicing error, and loss of the wild-type allele of the E-cadherin locus, which was assigned to chromosome 16q22-23, were found.(10) A point mutation of the E-cadherin gene was detected in invasive lobular carcinomas of the breast with allele loss on chromosome 16, indicating that dysfunction of E-cadherin could be caused by the two-hit mechanism.(11) Frequent reduced expression of alpha-catenin was observed in scirrhous carcinomas of the stomach and breast.(12) mRNA deletion of beta-catenin was found to disrupt the interaction between E-cadherin and alpha-catenin in stomach cancer cell lines.(13) Various mechanisms of inactivating the E-cadherin-mediated cell adhesion and "invasion suppressor" system in cancers were clarified.(14,15)
Kinases which participate in tyrosine phosphorylation of the members of this system were examined and the c-erbB-2 product was found to be associated with the E-cadherin-catenin complex.(16) This is the first evidence indicating interaction between oncogene products and cell-cell adhesion molecules. Direct association between an APC tumor-suppressor gene product and gamma-catenin (plako-globin) was also found.(17) These findings suggested the possibility that this system is involved in the signaling pathway connecting cell adhesion and cell growth.

Diagnostic Pathology

Members of the Pathology Division contributed a great deal to the diagnostic pathology practice in the hospital.(18-20) The basic studies described above were all performed with ideas and materials obtained through the diagnostic pathology practice. A rare case of adenomyoepithelial adenosis of the breast, which showed histo-pathological features of malignant progression, was reported.(21) A cell line producing a large amount of anti-diuretic hormone was established from a patient with human small cell lung cancer with SIADH syndrome.(22)


List of papers from this division
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