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The worldwide increase in cancer mortality demands a practical and effective chemopreventive approach to this problem. Using animal bioassay, the authors demonstrated protocatechuic acid (PCA, 3,4-dihydroxybenzoic acid), a simple and antioxidative phenolic acid present in fruits, vegetables, and nuts, to be an efficacious agent in reducing the carcinogenic action of 4-nitroquinoline 1-oxide in oral cavity, N-methyl-N-nitrosourea in glandular stomach, azoxymethane in colon, and diethylnitrosamine in liver. PCA exerts its chemopreventive action partly through inhibition of cell proliferation induced by carcinogens in the target organs. The prospect of this agent as chemopreventive against human cancer warrants a thorough investigation, such as dose-dependent efficacy and its potential toxicity at an effective dose level in other species of animals. Considering its promising anticarcinogenic potency, proliferation biomarkers, including tissue and blood polyamine levels, might eventually be useful in assessing the possible role of PCA intake in high risk populations for cancers of these organs.

Modifying effects of dietary exposure of seven naturally occurring products on the development of colonic aberrant crypt foci (ACF) induced by azoxymethane (AOM) were investigated in male F344 rats. The effects of these compounds on proliferation biomarkers such as the number of silver-stained nucleolar organizer region protein, ornithine decarboxylase activity, and polyamine concentration in the colon were also estimated. The naturally occurring products tested included four terpenoids (rebaudioside A, oleanolic acid, costunolide, and soyasaponin A2), one flavonoid (liquiritin), and two isocoumarins (phyllodulcin and hydrangenol). Animals were given 3 weekly s.c. injections of AOM (15 mg/kg body weight) to induce ACF. These rats were fed the diet containing 200 ppm of each test chemical for 5 weeks, starting 1 week before the first dosing of AOM. All rats were sacrificed 2 weeks after the last AOM injection to estimate their modulatory effects on the occurrence of ACF and the cell proliferation biomarkers in the colon. In groups of rats given AOM and hydrangenol, oleanolic acid, or costunolide, the frequencies of ACF/colon were significantly lower than that of AOM alone (P < 0.05, P < 0.005, and P < 0.05, respectively). In groups of rats given AOM and costunolide and those treated with AOM and soyasaponin A2, both ornithine decarboxylase activity and polyamine concentration of the colonic mucosal tissue were significantly decreased compared with those in rats given AOM alone (P < 0.05 and P < 0.001 for costunolide and P < 0.001 and P < 0.05 for soyasaponin A2, respectively). In groups of rats given AOM and liquiritin, oleanolic acid, or costunolide, the numbers of silver-stained nucleolar organizer regions/nucleus were significantly lower than that of AOM alone (P < 0.05, P < 0.01, and P < 0.05, respectively). Costunolide decreased four AOM-induced biomarkers, such as the frequencies of ACF/colon, ornithine decarboxylase activity, polyamine concentration level, and silver-stained nucleolar organizer region number in the colon. These results indicate that, among the test chemicals, costunolide has blocking effects against rat colon carcinogenesis and is a possible chemopreventive agent against colon tumorigenesis. Also, the short-term model described here could be a very useful prescreening tool for chemopreventive agents against colon cancer.

Modifying effects of costunolide, a constituent of oriental medicines, on intestinal carcinogenesis were examined in a rat model using azoxymethane (AOM). A total of 115 male F344 rats, 6 weeks old, were divided into four groups. Group 1 (30 rats) was fed a diet containing costunolide at a concentration of 0.02% for 4 weeks during which time three s.c. injections of AOM (15 mg/kg) were applied, and then kept on a basal diet until the end of the experiment (33 weeks). Group 2 (30 rats) was given AOM as in group 1 and fed the basal diet throughout, without costunolide. Group 3 (25 rats) was administered costunolide at the start of the experiment, but not given the carcinogen. Group 4 (30 rats) received the basal diet alone throughout the experiment and served as a control. Intestinal tumors were seen in groups 1 and 2, their incidence in group 1 (17%) being significantly lower than in group 2 (50%) (P < 0.05). Furthermore, the number of aberrant crypt foci/cm2 of colon in rats of group 1 at the termination of the experiment was significantly smaller than in group 2 (P < 0.01). BrdU labelling indices of S-phase mucosal cells in the colon of rats in group 1 were significantly lower than those in group 2 (3.9 +/- 3.1 vs. 9.1 +/- 4.5, P < 0.005). The present results suggest that the natural sesquiterpene contained in plants which have been used as oriental drugs, could be a promising chemopreventive agent for human intestinal neoplasia.

The modifying effect of dietary exposure to protocatechuic acid (PCA) on the development of azoxymethane (AOM)-induced colonic aberrant crypt foci (ACF) was investigated in male F344 rats. The effects of PCA feeding on the silver-stained nucleolar organizer regions protein (AgNORs) count in the colonic epithelial cells and on the ornithine decarboxylase (ODC) activity in the colonic mucosa were also estimated. Animals were given weekly s.c. injections of AOM (15 mg/kg body weight) for 3 weeks to induce ACF. These rats were fed diet containing 1000 or 2000 ppm PCA for 5 weeks, starting one week before the first dosing of AOM. All rats were killed 2 weeks after the last AOM injection, to measure the number of ACF, ODC activity, and AgNORs count per nucleus in the colon. In rats given AOM and PCA, the frequency of ACF/colon was significantly decreased compared with that in rats given AOM alone (P < 0.005 at 1000 and P < 0.05 at 2000 ppm). ODC activity in the colon of rats given AOM and PCA at both doses was also significantly lower than that of rats treated with AOM alone (P < 0.05). Similarly, the mean AgNORs count in rats fed PCA was significantly smaller than that of rats treated with AOM alone (P < 0.0001). Treatment with PCA alone did not affect these three biomarkers. These results provide further evidence that PCA could be a chemopreventive agent against rat colon carcinogenesis.

An autopsy case of an 83-year-old Japanese woman with pancreatic cancer with significantly elevated serum alpha-fetoprotein levels is reported. The pancreatic tumor was a mucinous cystadenocarcinoma with multiple metastasis to the liver. The immunohistochemistry for alpha-fetoprotein revealed positive reactivity in the cytoplasm of cancer cells in the primary and liver metastatic lesions. The current case is the first reported in which mucinous cystadenocarcinoma of the pancreas produced alpha-fetoprotein.

The modifying effects of three doses of dietary protocatechuic acid (PCA) given the initiation and postinitiation phases of oral carcinogenesis initiated with 4-nitroquinoline 1-oxide (4-NQO) were investigated in male F344 rats. At 6 weeks of age, rats were divided into experimental and control groups and fed the diet containing PCA at various doses of 0 g/kg diet (basal diet alone), 0.5 g/kg diet (500 ppm), 1 g/kg diet (1000 ppm), and 2 g/kg diet (2000 ppm). At 7 weeks of age, all animals except PCA alone and control groups were given 4-NQO (20 ppm) in the drinking water for 8 weeks to induce oral cancer. Seven days after the 4-NQO exposure, groups of animals fed the PCA diets were switched to the basal diet and continued on this diet until the end of the study. Starting 1 week after the end of 4-NQO exposure, the groups given 4-NQO and a basal diet were switched to the diets containing PCA and maintained on these diets for 22 weeks. The other groups consisted of rats given 2000 ppm PCA alone or untreated rats. All animals were necropsied at the termination of the experiment (week 32). The incidences of tongue neoplasms and preneoplastic lesions, polyamine levels in the tongue tissue, and cell proliferation activity estimated by bromodeoxyuridine-labeling index and by morphometric analysis of silver-stained nucleolar organizer regions' protein were compared among the groups. Feeding of PCA at all doses during initiation or postinitiation phase significantly decreased the development of tongue neoplasms (squamous cell papilloma and carcinoma) and preneoplasia (hyperplasia and dysplasia) (P < 0.05). There were no such lesions in rats treated with 2000 ppm PCA alone or those in an untreated control group. Dietary administration of PCA also caused significant decreases in the labeling index of bromodeoxyuridine and the number and area of silver-stained nucleolar organizer regions per cell nucleus, known as cell proliferation indices, of the tongue squamous epithelium (P < 0.05). In addition, PCA exposure during either initiation or postinitiation phase decreased polyamine levels in the oral mucosa (P < 0.05). These results clearly indicated that PCA inhibited rat oral carcinogenesis in both initiation and postinitiation phases, when administered in these respective phases together with or following treatment with 4-NQO, and such inhibition might be related to suppression of cell proliferation by PCA.

The effect on colon and liver carcinogenicity in rats of a single X-irradiation exposure given either before or after methylazoxymethanol (MAM) acetate was studied in ACI/N rats of both sexes. A single dose of X-irradiation (3 Gy) was administered either 3 months before or after three weekly s.c. injections of MAM acetate (25 mg/kg body weight). At 365 days after the start, the incidence and multiplicity of MAM acetate-induced intestinal tumors were enhanced by X-irradiation either prior to or after the MAM acetate treatment. In addition, X-irradiation before MAM acetate increased the incidence of hepatocellular foci in either sex. In females, X-irradiation either before or after MAM acetate exposure decreased intestinal tumorigenesis. These findings suggest an apparent synergism of these agents in intestinal carcinogenesis of male rats.

The modifying effects of dietary administration of D,L-alpha-difluoromethylornithine (DFMO) during initiation or postinitiation phase on the hepatocarcinogenesis initiated by diethylnitrosamine (DEN) were investigated in male F344 rats. A total of 129 animals were divided into seven groups. Groups 1-5 were given the drinking water containing 40 ppm DEN for 5 weeks, starting at 7 weeks of age. Groups 2 and 3 were fed the diets mixed with 500 and 1000 ppm DFMO, respectively, for 7 weeks, starting at 6 weeks of age. Groups 4 and 5 were given the diets containing 500 and 1000 ppm DFMO, respectively, starting 1 week after DEN exposure and maintained on these diets until the end of the study (Week 32). Rats in group 6 were fed the DFMO diet (1000 ppm) alone during the experiment. Group 7 served as an untreated control. At the end of the study, the incidences of liver cell foci (resistant iron accumulation or positive for glutathione S-transferase placental form) and hepatocellular neoplasms along with polyamine levels in the liver were measured. Also, morphometric analysis of silver-stained nucleolar organizer regions proteins as cell proliferation activity in liver cells was performed. The mean incidences and areas of foci in rats given DEN and DFMO in groups 2-5 were significantly lower than those of group 1 (P < 0.01). The frequencies of liver cell tumors in group 3 (50%), 4 (24%), and 5 (45%) were significantly reduced compared to that of group 1 (100%) (P < 0.01). The multiplicities of neoplasms in group 2 (1.15/rat), 3 (0.65/rat), 4 (0.35/rat), and 5 (0.95/rat) were significantly smaller than that of group 1 (3.34/rat) (P < 0.001). Although the polyamine levels of liver tissues among the groups showed no clear differences among the groups, the number and area of silver-stained nucleolar organizer regions proteins/nucleus in rats given DEN and DFMO (groups 2-5) were significantly lower than those of group 1. These results indicate that the feeding of DFMO during the initiation or postinitiation stage clearly inhibited DEN-induced rat hepatocarcinogenesis and that such inhibition may be due to alteration in cell proliferation activity caused by DFMO.

The modifying effects of dietary administration of the plant phenolic antioxidants caffeic acid (CA), ellagic acid (EA), chlorogenic acid (CGA) and ferulic acid (FA) during the initiation phase on 4-nitroquinoline-1-oxide (4-NQO)-induced tongue carcinogenesis and on the number and area of silver-stained nucleolar organizer region proteins (AgNORs), a new cell proliferation marker, of the tongue squamous epithelium were investigated in male F344 rats. Rats were fed the diet containing 500 p.p.m. CA, 400 p.p.m. EA, 250 p.p.m. CGA or 500 p.p.m. FA for 7 weeks. One week after the commencement of the diets, 4-NQO (20 p.p.m.) was administered in the drinking water for 5 weeks. Feeding of four phenolic compounds significantly reduced the incidences of tongue neoplasms (squamous cell papilloma and carcinoma) and preneoplastic lesions (hyperplasia and dysplasia) by 32 weeks, and rats fed CA or EA had no tongue neoplasms. The number and area of AgNORs per nucleus were decreased significantly by dietary treatment with these four phenolics. Thus, CA, EA, CGA and FA inhibited the tongue carcinogenesis induced by 4-NQO when they were administered concurrently with the carcinogen. These results might suggest possible application of these natural substances for cancer chemoprevention in tongue in addition to other tissues (skin, lung, liver and esophagus).

The modifying effect of dietary protocatechuic acid (PCA) given during the initiation phase or the postinitiation phase on liver carcinogenesis induced by diethylnitrosamine (DEN) was studied in male F344 rats. At 6 weeks of age, rats were divided into experimental and control groups and fed the diets containing 500 and 1000 ppm PCA or the basal diet. At 7 weeks of age, all animals except PCA alone and control groups were given DEN at 40 ppm in the drinking water for 5 weeks to induce liver cell neoplasms. Seven days after the DEN exposure, groups of animals fed the PCA diets and continued on these diets until the end of the study. All animals were necropsied during the 37 weeks after the start of the experiment in order to determine the incidences of preneoplastic liver cell foci and neoplasms. Hepatic ornithine decarboxylase activity was also measured in all animals at the termination of the study. Dietary PCA administered at both doses during the initiation phase significantly inhibited the incidence of altered hepatocellular foci resistant for iron accumulation or those positive for glutathione S-transferase placental form and the liver cell tumor incidence and multiplicity. Similarly, the numbers of liver cell foci and neoplasms and tumor multiplicity were significantly reduced in groups fed the PCA diets at the postinitiation stage of carcinogenesis. Hepatic ornithine decarboxylase activity was reduced in DEN-treated animals fed the PCA diets compared to those given DEN alone. Although the precise mechanisms of PCA-induced inhibition of hepatocarcinogenesis remain to be elucidate, it is likely that the inhibitory effects during the initiation and postinitiation phases may be due to alteration in hepatic ornithine decarboxylase activity under the present experimental condition.

Cell kinetics and activity of ornithine decarboxylase (ODC) were studied during the process of 1-hydroxyanthraquinone (1-HA)-induced intestinal carcinogenesis in rats. Starting at 6 weeks of age, a total of 37 male ACI/N rats were divided into two groups and treated as follows: group I (18 rats) received diet containing 1% 1-HA for 12 months; group II (19 rats) was given the basal diet alone. Sub-groups of 5-7 rats were sequentially killed at 4, 8 and 12 months for evaluation of the length, cell numbers and 5-bromo-2'-deoxyuridine (BrDU) labeling indices of large bowel crypts together with ODC activity. All kinetic and ODC data indicated increased DNA synthesis and proliferation at all time points. Morphological observation of the intestines also revealed melanosis, crypt abscesses and erosion, becoming more pronounced with length of exposure to the anthraquinone. The data thus suggest that cell proliferation in the crypts of the cecum or colon is important for 1-HA-induced intestinal carcinogenesis.

A case of gastric antral vascular ectasia confined to the antrum in an elderly Japanese male patient is described. The condition is a cause of blood loss and chronic iron deficiency anemia, particularly in the elderly. The clinical, endoscopic, and pathologic findings, which were contrasted with other hyperplastic or gastric vascular abnormalities, are described.

We report a rare case of gastric collision tumor (carcinoid and adenocarcinoma) with gastritis cystica profunda that developed in a 49-year-old Japanese man. Early gastric cancer (moderately differentiated tubular adenocarcinoma) was present at the edge of an ulcer in the posterior wall of the upper gastric body. In addition, a carcinoid tumor was found adjacent to adenocarcinoma. This tumor displayed ribbonlike or trabecular patterns, and numerous constituent cells were positive for the argyrophil reaction with Grimelius' stain and serotonin. Electron microscopic features of this tumor confirmed typical carcinoid. There was no merged appearance between both tumors, suggesting collision-type tumor.