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Publications (2)5.67 Total impact

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    ABSTRACT: Presence of minute cancer cell dissemination in peritoneal lavage fluid detected by reverse transcription polymerase chain reaction (RT-PCR) has been reported to be a reliable predictor of the prognosis in several kinds of cancers, but has not been determined in pancreatic cancer. Peritoneal lavage fluid was harvested just after a laparotomy in 83 patients with adenocarcinoma of the pancreas. Half of the fluid was examined by cytology and the remaining half was used to measure carcinoembryonic antigen/beta-2-microglobulin (beta2M) mRNA expression. Patients were followed after surgery to evaluate its clinical significance. Among 83 patients, 3 were cytologically positive (CY+), while 23 were positive by RT-PCR (PCR+). Seventy-one patients underwent a surgical resection whereas 12 were unresectable. Because 2 were CY+ among the 71 operated patients, the remaining 69 CY- patients were further investigated. Among those 69 patients, PCR+ was observed in 15 patients, whose incidence of postoperative peritoneal recurrence was significantly higher than that in PCR- patients (21% vs 4% at 3 years; P = .039). Moreover, both the recurrence-free rate in the abdominal cavity (peritoneal or local recurrence, excluding liver metastases) and the overall survival rate were better in PCR- patients than PCR+ patients (78% vs 33%, P = .0045 and 67% vs 46%, P = .0151). A multivariate analysis revealed positive lymph node metastases (hazard ratio; 5.18) and positive RT-PCR (hazard ratio; 3.65) were independent prognostic factors. The RT-PCR-based cancer cell detection was an independent prognostic factor in patients with resectable adenocarcinoma of the pancreas and had close association with local or peritoneal recurrence.
    Surgery 08/2009; 146(5):888-95. · 3.37 Impact Factor
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    ABSTRACT: The significance of dissecting the lateral pelvic lymph node (LN) for lower rectal cancer remains controversial. We detected the lateral sentinel node (SN) by indocyanine green (ICG) and micrometastases using carcinoembryonic antigen (CEA)-specific reverse transcriptase-polymerase chain reaction (RT-PCR). Twenty-five patients who underwent curative surgery with a dissection of the lateral pelvic LNs between 2003 and 2005 were examined. We investigated the existence of lateral SNs and any associations between pathological metastases and micrometastases by RT-PCR. Lateral SNs were detected in 7 (28%) of the 25 patients. The number of lateral SNs was 13 LNs, or 1.9 nodes per case. Of the 25 cases, 7 had lateral LN metastases based on pathological examinations in dissected lateral LNs. Three cases had massive lateral LN swelling by pre-operative pelvic CT and the SNs were not detected in them. The SNs were detected in two cases and were negative based on pathological examinations and positive according to a genetic diagnosis. SNs were detected in one case, which was positive based on pathological examinations and a genetic diagnosis. SN was not detected in one case. There were five SNs in which CEA was positive by RT-PCR, though only one of them was positive based on pathological examinations. No SNs were observed that were negative based on a genetic diagnosis, but were positive according to the pathological diagnosis. We detected the lateral SNs using ICG. The sensitivity of identifying lateral LN metastasis was improved by the use of a genetic diagnosis. However, the detection rate was still low, therefore we need to develop a new method for detecting SNs.
    Oncology Reports 11/2008; 20(4):745-50. · 2.30 Impact Factor