title: A case of squamous cell carcinoma of the head and neck producing granulocyte-colony stimulating factor with marked leukocytosis.
abstract: In squamous cell carcinoma of the head and neck (SCCHN), tumor cells have been shown to secrete detectable amounts of various cytokines, such as interleukin (IL)-6, IL-10, and transforming growth factor (TGF)-beta. These tumor-derived factors might be responsible for promoting malignancy. Here, we describe a SCCHN patient with tumor produced G-CSF and characterized by marked leukocytosis. In this 45-year-old man, severe leukocytosis developed in parallel with aggressive tumor growth. G-CSF production by the tumor was confirmed by immunohistochemistry (IHC). Serum G-CSF levels were elevated. The leukocyte counts and the blood G-CSF level decreased following a course of radiotherapy. Tumor cells were also positive for G-CSF receptor, suggesting autocrine growth regulation by G-CSF. Moreover, the tumor cells were also investigated by IHC with anti-p53, anti-P-glycoprotein (P-gp), anti-thymidylate synthase (TS), and anti-dihydropyrimidine dehydrogenase (DPD), which molecules are thought to contribute the acquisition of therapeutic resistance. The tumor cells were positively stained for TS and DPD, but neither p53 nor P-gp. These results suggest that a variety of molecules may be responsible for acquisition of high malignancy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi 371-8511, Japan. toyodami@showa.gunma-u.ac.jp
authors.forename: Minoru
authors.initials: M
authors.lastname: Toyoda
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chikamatsu
authors.forename: Koichi
authors.initials: K
authors.lastname: Sakakura
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Takahashi
authors.forename: Motoaki
authors.initials: M
authors.lastname: Miyashita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimamura
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Furuya
mesh_terms: D000038:Abscess / Q000473:pathology; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy; D003937:Diagnosis, Differential; D042943:Dihydrouracil Dehydrogenase (NADP) / Q000378:metabolism; D018450:Disease Progression; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D006801:Humans; D007964:Leukocytosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D010166:Palliative Care; D011879:Radiotherapy Dosage; D013363:Submandibular Gland / Q000473:pathology; D013365:Submandibular Gland Neoplasms / Q000473:pathology / Q000532:radiotherapy; D013940:Thymidylate Synthase / Q000378:metabolism; D014057:Tomography, X-Ray Computed
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D042943:Dihydrouracil Dehydrogenase (NADP); D013940:Thymidylate Synthase