acid-phosphatase and Soft-Tissue-Neoplasms

Response criteria and the reporting of results in clinical trials on drug therapy of stage D prostate cancer were evaluated by examination of studies listed in the Index Medicus 1980-1984. During this 5-year period, 70 studies (51 phase II and 16 phase III) were listed, comprising 3184 evaluable patients. Among 346 patients reported as having evaluable disease according to the WHO criteria, 198 had well-defined evaluable disease. A variety of response criteria were used, the NPCP criteria being the most frequent. Only three studies included solely patients with evaluable disease according to the WHO criteria. Reporting of results was often inadequate. The value of the most frequently used response parameters such as acid phosphatase, bone scan, per-rectal ultrasound, CT scan, bone pain and performance status is discussed. A system to standardise the reporting of results is proposed.

Topics: Acid Phosphatase; Bone Neoplasms; Clinical Trials as Topic; Drug Evaluation; Humans; Liver Neoplasms; Male; Pain Management; Prognosis; Prostatic Neoplasms; Radiography; Radionuclide Imaging; Soft Tissue Neoplasms

Evaluation of response to systemic therapy in metastatic prostate cancer is often difficult because of the infrequency of nonbony indicator lesions. The authors previously described a set of response criteria for Phase II and III studies which can be applied in patients with only bony disease. They have retrospectively evaluated response to Adriamycin (doxorubicin) and (5-fluorouracil) 5-FU in 38 patients with measurable soft tissue and visceral disease, using their response criteria for acid phosphatase and clinical status and standard definitions of response. No correlation was attempted for bone disease. Agreement between the results obtained with each system was good. Using this system of evaluating response, patients with metastatic prostate cancer with bone-dominant disease are eligible for Phase II and III studies.

Topics: Acid Phosphatase; Aged; Bone Neoplasms; Clinical Trials as Topic; Doxorubicin; Drug Evaluation; Fluorouracil; Humans; Male; Middle Aged; Prognosis; Prostatic Neoplasms; Soft Tissue Neoplasms

Seventy-two patients with advanced prostatic carcinoma without previous endocrine therapy were treated with an oral nonsteroidal antiandrogen, flutamide. Sixty-three patients (87.5%) had a favorable response, and 9 patients showed no response. Flutamide appears to be a safe antiandrogen, usually effective in the management of patients with advanced prostatic cancer who have had no prior endocrine therapy.

Topics: Acid Phosphatase; Adenocarcinoma; Adult; Aged; Anilides; Bone Neoplasms; Clinical Trials as Topic; Flutamide; Humans; Hydronephrosis; Male; Middle Aged; Prostatic Neoplasms; Soft Tissue Neoplasms; Urination Disorders

NKX3.1 is a prostatic tumor suppressor gene located on chromosome 8p. Although most studies have shown that staining for NKX3.1 protein is positive in the majority of primary prostatic adenocarcinomas, it has been shown to be downregulated in many high-grade prostate cancers, and completely lost in the majority of metastatic prostate cancers (eg, in 65% to 78% of lesions). A recent study showed that NKX3.1 staining with a novel antibody was highly sensitive and specific for high-grade prostatic adenocarcinoma when compared with high-grade urothelial carcinoma. This raised the question that this antibody may perform better than earlier used antibodies in metastatic prostate tumors. However, the sensitivity and specificity for prostate carcinomas for this antibody in metastatic lesions was not determined. Although prostate-specific antigen (PSA) and prostatic-specific acid phosphatase (PSAP) are excellent tissue markers of prostate cancer, at times they may be expressed at low levels, focally, or not at all in poorly differentiated primary and metastatic prostatic adenocarcinomas. The purpose of this study was to determine the performance of NKX3.1 as a marker of metastatic adenocarcinoma of prostatic origin. Immunohistochemical staining against NKX3.1, PSA, and PSAP was carried out on a tissue microarray (TMA) (0.6-mm tissue cores) of hormone naïve metastatic prostate adenocarcinoma specimens from lymph nodes, bone, and soft tissue. To determine the specificity of NKX3.1 for prostatic adenocarcinoma, we used TMAs that contained cancers from various sites including the urinary bladder, breast, colon, salivary gland, stomach, pancreas, thyroid, and central nervous system, and standard paraffin sections of cancers from other sites including the adrenal cortex, kidney, liver, lung, and testis. Overall 349 nonprostatic tumors were evaluated. Any nuclear staining for NKX3.1 was considered positive and the percentage of cells with nuclear staining and their mean intensity level were assessed visually. Sensitivity was calculated by considering a case positive if any TMA core was positive. The sensitivity for identifying metastatic prostatic adenocarcinomas overall was 98.6% (68/69 cases positive) for NKX3.1, 94.2% (65/69 cores positive) for PSA, and 98.6% (68/69 cores positive) for PSAP. The specificity of NKX3.1 was 99.7% (1/349 nonprostatic tumors positive). The sole positive nonprostatic cancer case was an invasive lobular carcinoma of the breast. NKX3.1 seems

Topics: Acid Phosphatase; Adenocarcinoma; Antibody Specificity; Biomarkers, Tumor; Bone Neoplasms; Cell Differentiation; Homeodomain Proteins; Humans; Immunohistochemistry; Lymph Nodes; Male; Neoplasms, Unknown Primary; Predictive Value of Tests; Prostate-Specific Antigen; Prostatic Neoplasms; Protein Tyrosine Phosphatases; Sensitivity and Specificity; Soft Tissue Neoplasms; Tissue Array Analysis; Transcription Factors

Osteoclast-like giant cells (GCs) in giant cell tumors (GCTs) are thought to derive from a monocyte-macrophage lineage. Microphthalmia transcription factor (MITF) is necessary for osteoclast gene expression and tartrate-resistant acid phosphatase (TRAP) activation; c-Kit plays a role in regulation of MITF.. To gain insight into the differentiation of GCTs of bone (GCTBs) and GCTs tendon sheath (GCTTSs) by investigating immunohistochemical staining for c-Kit, MITF, TRAP, and HAM-56 in the GCs and stroma.. Immunoreactivity for CD117 (c-Kit), MITF, TRAP, and HAM-56 was studied in 35 GCTBs, 15 GCTTSs, and 5 foreign-body GC controls.. Across tumors, MITF and TRAP but not c-Kit were generally expressed in GCs; TRAP was variably expressed in stromal cells. The MITF was expressed more consistently in stromal cells of GCTTSs than GCTBs (P < .001). The GCTBs showed more intense MITF stromal (P < .001) and TRAP GC staining (P = .04) than GCTTSs. HAM-56 staining by stromal cells was associated with MITF stromal staining (r2 = 0.6, P < .001).. Results suggest that MITF and TRAP are expressed during osteoclast differentiation and that a proportion of mononuclear cells in GCTs express the macrophage marker HAM-56. Both GCTBs and GCTTSs show similar patterns of immunohistochemical expression.

Topics: Acid Phosphatase; Adolescent; Adult; Aged; Antibodies, Monoclonal; Bone Neoplasms; Connective Tissue; DNA-Binding Proteins; Female; Giant Cell Tumors; Humans; Isoenzymes; Male; Microphthalmia-Associated Transcription Factor; Middle Aged; Neoplasm Recurrence, Local; Osteoclasts; Proto-Oncogene Proteins c-kit; Soft Tissue Neoplasms; Tartrate-Resistant Acid Phosphatase; Tendons; Transcription Factors

Histological examination of 38 nodular formations extirpated from the site of vaccine administration to cats disclosed 25 cases of sarcoma and 13 of granuloma. Average age of the cats bearing sarcoma was 8.75 years whereas granuloma occurred at average age of 1.9 year. This age-relationship of the lesions, as well as their similar morphologic features indicated a progression of chronic inflammatory changes to tumors. Similar tumors were diagnosed in one cat with "posttraumatic ocular sarcoma" and in the uterus of female-cat with long-standing pyometra. These two cats were 15 and 8 years old, respectively. Experimental study of local reaction 21 days after administration of commercial, lipid-adjuvanted vaccine revealed in young cats (age 9 months) a reaction to immunogen, whereas in old animals (age 10 to 15 years) there was a reaction to foreign material. The data suggest that chronic inflammation and age-related immunodeficiency are instrumental in pathogenesis of the vaccine-associated sarcoma.

Topics: Acid Phosphatase; Alkaline Phosphatase; Animals; Carboxylesterase; Cat Diseases; Cats; Female; Immunocompromised Host; Immunoenzyme Techniques; Inflammation; Male; Sarcoma; Soft Tissue Neoplasms; Vaccination

Although "giant cell tumor of soft parts" has traditionally been considered a single entity as reflected in the original term "malignant giant cell tumor of soft parts (MGCT)" and later by the term "malignant fibrous histiocytoma, giant cell type" the degree of atypia and mitotic activity varies in this group, suggesting biologic heterogeneity. The clinicopathologic features of 31 tumors meeting the traditional criteria of MGCT but having only mild to moderate nuclear atypia are presented. Patients with these tumors (19 females; 12 males) ranged in age from 14 to 84 years (mean, 40 years) and presented with masses of involving either superficial (n = 16) or deep (n = 13) soft tissue. Most occurred on the arm or hand (n = 16) and ranged in size from 0.7 to 6.5 cm (mean, 2.1 cm). The tumors consisted of sheets and nodules of rounded mononuclear cells that blended with spindled cells and benign osteoclastic giant cells. Pleomorphic giant cells were absent. Osteoid was noted in 10 cases, but features typically associated with tenosynovial giant cell tumors (such as dense stromal hyaline, siderophages, and xanthoma cells) were nearly always absent. Mitotic figures ranged from 1-10/10 HPF (mean, 2-3/10 high-powered field), and angiolymphatic invasion was present in 10 cases. Necrosis was absent, however. The mononuclear cells expressed CD68, tartrate-resistant acid phosphatase, and smooth muscle actin, but lacked CD45, S100 protein, desmin, and lysozyme, an immunophenotypic profile identical to that of giant cell tumor of bone. Follow-up information in 19 patients (mean, 3 yrs; median, 1-7 yrs) indicated recurrences in four patients, but none developed metastasis. This behavior contrasts significantly with the high-grade behavior traditionally associated with MGCT of soft parts. These giant cell tumors can be consistently recognized by the lack of cytologic atypia even in the face of mitotic activity and vascular invasion. Although their long term metastatic risk is not fully defined, we propose they be termed "giant cell tumors of low malignant potential" and regarded as the soft tissue analogue of giant cell tumor of bone. The term "malignant giant cell tumor of soft parts" or giant cell malignant fibrous histiocytoma should be restricted to histologically high-grade lesions.

Topics: Acid Phosphatase; Actins; Adolescent; Adult; Aged; Aged, 80 and over; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Female; Giant Cell Tumors; Humans; Immunohistochemistry; Isoenzymes; Male; Middle Aged; Muscle, Smooth; Soft Tissue Neoplasms; Tartrate-Resistant Acid Phosphatase

Effect of chemotherapy for relapse of prostatic cancer was evaluated with new response criteria, in which four objective parameters including the prostate, bone metastasis, soft tissue metastasis and the serum acid phosphatase level estimated by radioimmunoassay or enzyme immunoassay were judged separately and then summarized to evaluate the response as complete response (CR), partial response (PR), stable and progressive disease (PD). Eighty-two patients were included in the study. Rate of PR and stable were 19% and 27%, respectively, and these two groups showed longer survival than those with PD. Evaluation of prostate and bone showed tendency to be discrepant with total judgement. Evaluation of soft tissues and prostatic acid phosphatase reflected the effect of chemotherapy. Chemotherapy often improved subjective symptoms but the effect did not parallel the total judgement in many cases. Factors influencing response of chemotherapy were mode of pretreatment, performance status, age, number of affected areas and clinical stage, but the grade at initial treatment was not correlated to response. The new criteria used in this study was valid for evaluation of response in prostatic cancer.

Topics: Acid Phosphatase; Aged; Aged, 80 and over; Antineoplastic Agents; Bone Neoplasms; Drug Evaluation; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Prostatic Neoplasms; Soft Tissue Neoplasms

Topics: Acid Phosphatase; Carcinoma, Basal Cell; Clinical Enzyme Tests; Diagnosis, Differential; Fibrosarcoma; Histiocytoma, Benign Fibrous; Humans; Liposarcoma; Rhabdomyosarcoma; Soft Tissue Neoplasms; Tartrates

Six rhabdomyosarcomas were assessed by means of a battery of enzyme histochemical methods. The reactions were compared with those of a small number of other tumours belonging to the small-cell tumour category. Four of the rhabdomyosarcomas were positive for myophosphorylase and acetylcholinesterase. Myoblasts were strongly reactive for adenosine triphosphatase at alkaline pH and after acid pre-incubation, whereas the small undifferentiated neoplastic cell of the four alveolar rhabdomyosarcomas showed also discernible cytoplasmic reaction, but only after acid pre-incubation. Other tumour categories revealed positive staining for adenosine triphosphatase with acid pre-incubation but the degree of reaction was minimal by comparison. Other enzyme reactions were variable and, generally, did not distinguish between different tumour categories. It is concluded that enzyme histochemistry has a potential role in the diagnostic evaluation of the small cell tumour and should be included in the growing list of special techniques that may assist the pathologist confronted with this problem.

Topics: Acetylcholinesterase; Acid Phosphatase; Adenosine Triphosphatases; Alkaline Phosphatase; Child; Child, Preschool; Diagnosis, Differential; Female; Histocytochemistry; Humans; Infant; Leucyl Aminopeptidase; Male; Neoplasms; Rhabdomyosarcoma; Soft Tissue Neoplasms

Histochemical staining for three hydrolytic enzymes were performed in 35 bone tumours and 43 soft tissue tumours, malignant as well as benign. Osteosarcoma, intra-osseous as well as extra-osseous, revealed characteristic rich staining for alkaline phosphatase, no matter how dedifferentiated the tumour was. Haemangioendothelioma (and normal endothelium), too, showed strong reaction for alkaline phosphatase whereas haemangiopericytoma did not. Alkaline phosphatase furthermore was found in slight to moderate amounts in fibrous proliferations. All other tumours examined were negative. Acid phosphatase was found in almost every tumour investigated except Ewing sarcoma and chondromyxoid fibroma. However, high activity was characteristic of giant cell tumours and malignant fibrous histiocytoma. The inhibition of acid phosphatase by tartrate was complete except in osteosarcoma and giant cell tumours, where only a partial inhibition was seen. There were non-specific esterase reactions in a variety of tumours, but very strong reactions were characteristic of malignant fibrous histiocytoma and giant cell tumours. The reaction could be completely inhibited by the addition of fluoride. In an era of increasing application of immunohistologic techniques in surgical pathology it might be of value to remember that simple enzyme histochemical stainings may provide helpful diagnostic features in the classification of bone and soft tissue tumours.

Topics: Acid Phosphatase; Alkaline Phosphatase; Bone Neoplasms; Carboxylesterase; Carboxylic Ester Hydrolases; Histocytochemistry; Humans; Soft Tissue Neoplasms

The acid phosphatase in the cells of bone and soft parts tumors, and of other tumorous conditions in our Department of Orthopedic Surgery in Kumamoto University Medical School from mid-1979 through mid-1983 were analysed by light microscopic and electron microscopic histochemical studies and their inhibition studies. The histochemical and their inhibiting studies of acid phosphatase by azo dye method in the cells of bone and soft parts tumors and of other tumorous conditions were undertaken in order to characterize them with a view to providing helpful diagnostic features. The acid phosphatase in some giant cells and tumor cells of several kinds of tumors, whose reaction against inhibitors was different from that of lysosomal acid phosphatase, was observed. In the giant cells of giant cell tumor of bone, acid-para-nitrophenyl phosphatase was demonstrated by the method of Miyayama , et al. using sodium-para-nitrophenyl phosphate as a substrate. In addition, the fine structural localization of acid phosphatase in giant cell tumor of bone was studied by Gomori's method and by the method of Miyayama , et al. By Gomori's method, acid phosphatase activity was demonstrated in lysosome, secondary lysosome-like organelles and the digestive vacuoles in the giant cells. In the stromal cells, that activity was demonstrated in lysosomes. By the method of Miyayama , et al., acid para-nitrophenyl phosphatase was demonstrated in the Golgi complex and the cisternae of the rough endoplasmic reticulum in the giant cell. Therefore, in the giant cells and the tumor cells of some kinds of tumors, non-lysosomal acid phosphatase besides lysosomal acid phosphatase was recognized. The demonstration of non-lysosomal acid phosphatase was a useful tool for the differential diagnosis of tumors and tumorous conditions in bone and soft parts.

Topics: Acid Phosphatase; Bone Neoplasms; Giant Cell Tumors; Histocytochemistry; Humans; Osteosarcoma; Soft Tissue Neoplasms

The results of clinical examination, skeletal X-ray, bone scan and phosphatase determinations in serum were analyzed in 30 patients with metastatic prostatic cancer prior to and during anti-androgenic treatment. Bone scan revealed skeletal metastases in all 30 patients, whereas X-ray showed bone metastases in only 22 patients. Radiological pseudoprogression and scintigraphic flair reaction were relatively frequent findings during the first 3-8 months of effective hormone therapy. Later on progressive changes on X-ray and bone scan were well related to clinical progression of the disease and indicated a poor prognosis in the individual patient. Soft tissue metastases most often responded well to the initial hormone treatment, but regrew only rarely during later disease progression. Changes of the radioimmunologically determined prostatic acid phosphatase seemed most often to indicate the presence of advanced disease and subsequent disease progression. Second line treatment of hormone-unresponsive prostatic cancer is at best palliative and has not been proved to prolong the survival in most of the patients. In routine clinical practice, the need for such second line therapy is dependent on the patient's symptoms and not on the early detection of progressive changes on X-ray, bone scan or blood tests. Therefore it seems unnecessary to perform these examinations regularly in hormone-treated asymptomatic patients with advanced prostatic cancer unless the patient is entered into a clinical research program.

Topics: Acid Phosphatase; Alkaline Phosphatase; Bone and Bones; Bone Neoplasms; Castration; Diethylstilbestrol; Follow-Up Studies; Humans; Lymphatic Metastasis; Male; Prostatic Neoplasms; Radiography; Radionuclide Imaging; Soft Tissue Neoplasms

The ultrastructural findings in 17 cases of malignant fibrous histiocytoma (MFH) are described. The tumors consisted of fibroblast-like cells and histiocyte-like cells in different proportions in different cases. Intermediate, undifferentiated, xanthomatous and multinucleated giant cells were also identified. In 12 of 17 cases myofibroblasts were evident. Acid phosphatase activity was detected cytochemically in the Golgi zone, endoplasmic reticulum and lysosomes (GERL) mainly within histiocyte-like cells, in three cases. These observations indicate that the GERL of the tumor cells are engaged in th formation of lysosomes. The polymorphic cellular composition, including undifferentiated cells, lends support to the concept that the MFH originates from a primitive multipotent undifferentiated mesenchymal cell.

Topics: Acid Phosphatase; Adult; Aged; Endoplasmic Reticulum; Female; Fibroblasts; Golgi Apparatus; Histiocytes; Histiocytoma, Benign Fibrous; Humans; Lysosomes; Male; Microscopy, Electron; Middle Aged; Soft Tissue Neoplasms

A clinicopathologic study of 130 cases of malignant fibrous histiocytoma (MFH) of the soft tissues is reported. This malignant neoplasm principally of middle and late adults occurred most often in the proximal portions of the extremities (48%) including the thigh and buttocks (35%). MFH may be subclassified into common (storiform and pleomorphic), myxoid, xanthogranulomatous, and giant cell types, the common type being accounted for 100 cases (77%) of the series. The prognosis was more favorable in patients with storiform and myxoid tumors than in patients with pleomorphic or other type tumors, the overall relative five-year survival rate being 48%. The depth of the tumor also affected prognosis with a significantly lower survival rate in deeply situated tumors. The rate of local recurrence of the tumor was 48%. Because of incomplete informations, metastasis was confirmed in only 26 patients and was most frequently to the lung (73%). In addition, electron microscopic, histochemical and tissue culture findings in limited cases are presented, concerning the histogenesis of the MFH.

Topics: Acid Phosphatase; Adolescent; Adult; Aged; Arm; Child; Female; Histiocytoma, Benign Fibrous; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Soft Tissue Neoplasms; Thigh

Topics: Acid Phosphatase; Adolescent; Adult; Bone Neoplasms; Child; Child, Preschool; Female; Fibrosarcoma; Fibrous Dysplasia of Bone; Giant Cell Tumors; Humans; Infant; Isoenzymes; Male; Middle Aged; Osteosarcoma; Sarcoma, Ewing; Soft Tissue Neoplasms