The time required to count signals in the detection of HER-2/neu gene amplification in breast cancer by fluorescence in situ hybridization (FISH) has been a problem. To assess whether the amount of time necessary for counting could be reduced, image analysis using computer software (Win ROOF) was tested. Five photographs from each FISH sample were arranged into ten composite photographs. All ten composite photographs were necessary when using the conventional method of manual counting. However, using only four of the composite photographs and the image analysis method, the 60 necessary nucleus numbers could be measured, and a constant ratio of HER-2/neu / CEP 17 was obtained. In all 58 samples used, in the presence or absence of HER-2/neu gene amplification, there was agreement in counts between the conventional and image analysis methods, and a good correlation of r=0.961 (p<0.001) was obtained. Using the image analysis method, the necessary scoring time was reduced, particularly when the HER-2/neu gene had been amplified, where it was completed in about 1/4 of the time normally required. These results indicate that this image analysis method can be applied when using FISH in other areas of research, and may increase the speed of examination.

A 75-year-old man underwent partial resection of the small intestine for GIST in January 2000. A recurrent tumor revealed in the intra pelvic space was removed by two operations, and imatinib (400 mg/day) was given after the third operation. As successive administration was not able to be continued due to side effects such as anorexia and fatigue, the recurrent tumor enlarged. After imatinib was given at 200 mg/day, the defecation trouble was improved and the tumor decreased partially on CT image. His partial response has continued over one year. Mutation analysis revealed deletion and point mutation in exon 11 of c-kit gene. Low-dose imatinib administration should be considered in case of side effects at the standard dose.

We present a pediatric case of acute lymphoblastic leukemia (ALL) with chromosomal translocation 1;19 lacking E2A-PBX1 chimeric transcripts. On admission, the patient showed remarkable splenomegaly. Laboratory findings demonstrated that WBC was 12900/microl with blasts 61.5%. Bone marrow examination revealed 1282 X 10(3)/microl of the nucleated cell count with 95.5% lymphoblasts. Surface marker analysis showed an early pre-B lineage immunophenotype (CD10+, CD19+, CD34+, surface Ig-). Although G-banding chromosomal analysis showed 46,XY,der(19)t(1;19)(q23;p13), E2A-PBX1 chimeric transcripts and E2A gene rearrangement were not detected with the polymerase chain reaction method and Southern blot analysis, respectively. The patient was assigned to high-risk ALL according to the criteria of the Japan Association of Childhood Leukemia Study. His clinical response to prednisolone monotherapy for the initial 7 days and subsequent multidrug chemotherapy was excellent, and he achieved complete remission on day 15, which has lasted for more than 30 months. We reviewed the bibliography of the clinical and biological features of 17 children with t(1;19)+E2A-PBX1- ALL including this case. The two prominent characteristics included an early pre-B immunophenotype (11/13) and hyperdiploid (>50 chromosomes) chromosome abnormality (8/14). However, there was substantial heterogeneity in the demographic features and prognosis. Further accumulation of such patients will facilitate the determination of the appropriate treatment for childhood t(1;19)+E2A-PBX1- ALL.