The expression of blood group antigens A, B, and H, as well as sialylated and nonsialylated forms of Lewis(a) and Lewis(x), was studied using immunohistochemical methods in normal and tumor tissues in the following cohort of patients: 51 patients with primary breast carcinoma, 13 with metastatic lymph node lesions, and 16 with benign tumors of the breast. As a control, normal tissue was obtained from a similar group of 22 patients with breast cancer. The noncancerous tissues expressed the same A/B/H antigens as the patients' red blood cells and also usually expressed Lewis-related antigens. Seventy-six percent of primary carcinomas failed to express the appropriate A/B/H antigens, and in one blood group A patient the tumor tissue expressed B antigen. In the metastatic lesions, Lewis(a)/sialyl Lewis(a) expression was reduced when compared with the primary tumors, but Lewis(x)/sialyl Lewis(x) antigens were still expressed. These results suggest a possible relationship between the metastatic behavior of the tumor and expression of the blood group antigens.

Surgical treatment for metastatic lesions from lung cancer is seldom performed. We have treated three patients with a unilateral adrenal metastasis with adrenalectomy. Simultaneous resection of primary lung cancer and adrenal metastasis was performed in two cases. This is the first report of such surgical management. Adrenalectomy after lung resection was done in the third case. Two of the patients are alive and well more than 5 years after adrenalectomy. These cases are presented, and the literature is reviewed.

Mutations in either of two recently identified genes, BRCA1 and BRCA2, are thought to be responsible for approximately two-thirds of all cases of autosomaldominantly inherited breast cancer. To examine the nature and frequency of BRCA1 and BRCA2 mutations in Japanese families exhibiting a high incidence of breast cancer, we screened 78 unrelated families in this category for mutations of these two genes. Examining the entire coding sequences as well as exon-intron boundaries of both genes by polymerase chain reaction (PCR) single-strand conformation polymorphism (SSCP) and multiplex-SSCP analysis, we identified possible disease-causing alterations in BRCA1 among affected members of 15 families and in BRCA2 in another 14 families. In 15 of those 29 families, the affected individuals carried missense mutations, although most germline mutations reported worldwide have been deletions or nonsense mutations. Our results, indicating that missense mutations of BRCA1 and BRCA2 tend to predominate over frameshifts or nonsense mutations in Japanese breast cancer families, will contribute significantly to an understanding of mammary tumorigenesis in Japan, and will be of vital importance for future genetic testing. pattern of inheritance of breast cancer were evaluated. For each family, a pedigree was prepared on the basis of a family member known to be affected. Key wordsOccurrence of cancer within each pedigree was confirmed by obtaining medical records and pathology reports for all available family members whether living or deceased. The criteria for selecting "breast cancer families" for this study were as follows: (a) at least three first-degree family members with breast cancer or (b) two or more first-degree family members with breast cancer, either early-onset, bilateral, or accompanied by a history of primary cancer(s) of other organs. Blood samples were obtained from affected family members through the aforementioned Societies. Genomic DNAs were extracted from fresh blood under standard protocols (Kunkel et al. 1977). Mutation screening SSCP-analysis.The entire coding sequences of BRCA1 and BRCA2, and associated exon-intron boundary sequences, were examined by PCR-SSCP analysis. The PCR primers used for PCR-SSCP analysis have been described elsewhere (Katagiri et al. 1996b, Miki et al. 1996.Each genomic DNA (50␣ ng) was amplified in a reaction mixture containing 10 ml of 1 ϫ PCR buffer (25␣ mM TAPS, 50␣ mM KCl, 2␣ mM MgCl 2 , and 1␣ mM β-mercaptoethanol), 20␣ mM dNTPs, 5␣ pmol primers, 2␣ mCi of α[ 32 P]dCTP (3000␣ Ci/mmol, 10␣ mCi/ml), and 0.5 units of Taq polymerase (Boehringer Mannheim, Mannheim, Germany). PCR conditions were 1 cycle at 94°C for 2␣ min, then 30 cycles at 94°C for 30␣ s, 60°C for 30␣ s, and 72°C for 30␣ s with final elongation at 72°C for 5␣ min. Each reaction mixture was diluted with 50␣ ml of 95% formamide dye and 20␣ mM ethylenediaminetetraacetic acid (EDTA), incubated at 85°C for 5␣ min, and electrophoresed in a 6% polyacrylamide gel containing 5% glycerol and 0.5 ϫ 90␣ mM Trisborat...

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Background: Hand-foot syndrome (HFS) is a common side effect that has a high occurrence rate with capecitabine (Cape) chemotherapy. However, little is known about the risk factors of developing HFS under the Cape regimen. Our aim was to examine these risk factors. Methods: A univariate analysis was used to determine the risk factors associated with developing HFS, and we calculated the effect sizes between the patients who developed HFS compared to those who did not. Results: Of the 52 patients enrolled in our research, 24 (46.2%) developed HFS. This group was significantly associated with hemoglobin (Hb) values (p < 0.001), and the effect size (1.21) was more than moderate. The receiver operating characteristic curve analysis confirmed 12 mg/dl Hb as the best diagnostic cut-off value for developing HFS. The sensitivity and specificity were 75.5 and 88.2%, respectively. Patients who had Hb values of 12 or below who developed HFS had longer median times without HFS compared to patients with high Hb values (115 vs. 75 days, p = 0.30, hazard ratio = 1.42, 95% CI 0.73-2.76) and a greater area under the Kaplan-Meier curves (p < 0.05). Conclusion: This research suggests that the Hb value is an important factor for developing HFS.