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ABSTRACT: The aim of this study was to elucidate the significance of a novel staging criterion, a five-point scoring system (FPSS), determined by five histopathological factors of colorectal carcinoma. These factors included depth of invasion, lymph node metastasis, lymphatic invasion, venous invasion and histopathological tumor type. In total, 357 patients with colorectal carcinoma who had had been treated by surgical resection were investigated. One point was assigned to each of the five aforementioned tumor-related pathological factors. The FPSS score was determined by an aggregate of the points. A significant difference was observed between the survival of patients with FPSS scores of 0 and 1, and 2 and 3 (P=0.0002); and FPSS scores of 2 and 3, and 4 and 5 (P<0.0001). We demonstrate that the FPSS is a convenient criterion for stratifying the prognosis of patients with colorectal carcinoma.
Oncology letters 03/2013; 5(3):978-982. · 0.11 Impact Factor
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ABSTRACT: Unilateral multicentric cancer of the breast containing a tumor with a specific histopathological type is comparatively rare. We, herein, report a case of an unilateral multicentric cancer of the breast containing two separate tumors diagnosed as a papillo-tubular carcinoma and an invasive lobular carcinoma. In addition to the difference in histological type, these two tumors also had different patterns of expression of hormonal receptors reflecting the cellular aggressiveness. Therfore, these tumors may be formed through multicentric tumorigenesis.
Oncology letters 01/2013; 5(1):333-335. · 0.11 Impact Factor
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ABSTRACT: The aim of the present study was to analyze the effect of the prolongation of operative time (OT) on the prognosis of patients with gastric carcinoma. In total, 330 patients with gastric carcinoma were enrolled. Correlation of OT with clinicopathological features including the prognosis of the patients were analyzed. Although tumors of patients for whom the OT was longer proved to be at a significantly more advanced stage of disease and univariate analysis demonstrated that the prognosis of these patients was significantly unfavorable, tumor stage was the only factor independently associated with worse prognosis for the patients based on multivariate analysis. Duration of OT was not an independent prognostic indicator. However, OT is dependent on the surgical procedure to treat tumor progression of gastric carcinoma.
Oncology letters 07/2012; 4(1):119-122. · 0.11 Impact Factor
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ABSTRACT: We experienced a rare case of a pedunculated polyp of the appendix, which had been incidentally found by preventive appendectomy performed when providing surgical treatment for rectal carcinoma. A pathological investigation of this polypoid lesion demonstrated branches of fibro-muscular stalks connecting with the lamina muscularis covered by a hyperplastic mucosa, which proved to be consistent with the features of hamartoma. The patient had no external characteristics of Peutz-Jeghers syndrome, including mucocutaneous pigmentation and gastrointestinal polyposis, observed by endoscopy. This case is considered to be a Peutz-Jeghers type polyp of the appendix with a pedunculated form, which is very rare.
Surgery Today 05/2012; · 1.22 Impact Factor
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ABSTRACT: Body mass index (BMI) has been suggested to provide clinicopathological information in tumor development and progression in patients with gastric carcinoma.
The correlation of BMI with clinicopathological features and operation-related factors was analyzed in 308 patients with gastric carcinoma who had undergone distal or total gastrectomy.
There was no significant correlation of obesity, indicated by a high value of BMI, with tumor-related factors including survival, or with operation-related factors. On the other hand, more advanced tumors and worse preoperative nutritional and immunological conditions were found in patients with a lower value of BMI.
BMI might be a representation of the physical condition brought about by the extent of tumor progression rather than a factor influencing the factors related to gastric carcinoma.
Surgery Today 04/2012; 42(10):945-9. · 1.22 Impact Factor
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ABSTRACT: The effects of preoperative lipiodolization (LPD) for large hepatocellular carcinoma (HCC) are controversial.
A retrospective review was undertaken for 137 patients with initial solitary resectable HCC ≥ 5 cm who underwent hepatic resection between 1995 and 2008. Forty-two patients underwent preoperative LPD, and clinical data and prognosis were compared to those of patients without preoperative LPD (n=95).
Surgical results of the LPD group, such as surgical time, surgical blood loss, and the mortality and morbidity rate were statistically equal to those of the nonLPD group. The disease-free and overall survival of the LPD group were significantly better than those of the nonLPD group, and early tumor recurrence within 1-year of the LPD group was significantly lower than that of the nonLPD group. According to the multivariate analysis, the absence of preoperative LPD was an independent poor prognostic factor of patients with hepatic resection for HCC ≥ 5 cm.
Preoperative LPD suppressed early tumor recurrence and improved patient survival after hepatic resection for HCC ≥ 5 cm.
Journal of Surgical Oncology 03/2012; 106(4):498-503. · 2.10 Impact Factor
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ABSTRACT: The aim of this study is to certify a rationality of Pathological Prognostic Score (PPS) in determining the prognosis of patients with colorectal carcinoma.
Three hundred and thirty-one patients with colorectal carcinoma, which had been treated by surgical resection, were enrolled. One point was added for each element among four tumor-related pathological factors of depth of tumor, lymph node metastasis, venous invasion, and lymphatic invasion. PPS was determined by an aggregate of the points.
There existed a significant difference both between survivals of patients with PPS 0 or 1 and 2 or 3 (P = 0.0005) and between survivals of patients with PPS 2 or 3 and 4 (P < 0.0001).
PPS could be an easy and useful criteria to stratify prognosis of patients with colorectal carcinoma.
Journal of Surgical Oncology 02/2012; 106(3):243-7. · 2.10 Impact Factor
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ABSTRACT: Preoperative assessments regarding a patient's immunological and nutritional condition are required to predict the outcomes of patients with malignant tumors. The aim of the current study was to clarify the significance of Onodera's prognostic nutritional index (OPNI), which can simply account for the immunological and nutritional conditions, in patients with colorectal carcinoma.
The correlations of the preoperative OPNI value with clinicopathological features were examined in 219 patients with colorectal carcinoma who had been surgically treated.
Not only the tumor stage (P = 0.028) and venous invasion (P = 0.002), but also an OPNI of less than 40 (P = 0.002) were found to be independently correlated with a worse prognosis of patients with colorectal carcinoma.
The preoperative OPNI can be used as a simple prognostic indicator in colorectal carcinoma.
Surgery Today 12/2011; 42(6):532-5. · 1.22 Impact Factor
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ABSTRACT: Hitherto, biliary intraepithelial neoplasia (BilIN) has been described in chronic biliary disease but rarely in non-biliary liver cirrhosis (LC). Intraepithelial neoplasia of the pancreas shows alterations in the expression of cell cycle and mucin core proteins. The aim of this study was to evaluate BilIN and reactive biliary lesions in biliary disease and non-biliary LC.
BilIN was found in 51% (33 of 65) of liver tissue cases of biliary disease, and in 11% (34 of 310) of the LC group. Immunohistologically, MUC5AC, an 'early phase' protein, and Ki67, reflecting 'late phase' expression, were identified with increasing degrees of dysplasia in both groups, but that expression was significantly higher in the biliary disease group. 'Early phase' cell cycle proteins, p16 (decrease) and p21 (increase) altered in both biliary and LC groups with increasing degrees of dysplasia.
We found BilIN in the large bile ducts of hepatitis B virus- and hepatitis C virus-related LC as well as in cases related to a biliary aetiology. The LC group was significantly less likely to show changes in the expression of MUC5AC and proliferative activity than the biliary group. Alterations in p16 and p21 reflected increasing degrees of dysplasia in both groups.
Histopathology 11/2011; 59(5):867-75. · 3.08 Impact Factor
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ABSTRACT: Primary neuroendocrine carcinoma (NEC) of the breast appears to be a rare neoplasm. Due to the limited number of the cases, a definitive therapeutic option for the disease has not yet been established. We herein report the case of a 57-year-old female patient with primary NEC of the breast who underwent a surgical resection and for whom the suitable adjuvant therapy is now being considered.
Surgery Today 06/2011; 41(6):829-31. · 1.22 Impact Factor
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ABSTRACT: Portal venous invasion is one of the most important prognostic factors after surgical resection of hepatocellular carcinoma. Microscopic portal venous invasion can be evaluated histologically. We examined 280 hepatocellular carcinomas with microscopic portal venous invasion (n = 125) or without it (n = 155) for 3 characteristics: the number of invaded portal vessels, the maximum number of invading carcinoma cells, and the farthest distance from the tumor. Univariate analysis of overall and disease-free survival revealed that the number of invaded portal vessels and the number of invading carcinoma cells were poor prognostic factors. Therefore, we classified patients with microscopic portal venous invasion into 2 groups: a high-microscopic portal venous invasion group, in which there were multiple invaded portal venous vessels (≥2) and more than 50 invading carcinoma cells (n = 57), and a low-microscopic portal venous invasion group, in which microscopic portal venous invasion was observed but with invasion of only a single portal venous vessel or fewer than 50 invading carcinoma cells (n = 68). The high-microscopic portal venous invasion group showed significantly higher α-fetoprotein levels, larger tumor size, and higher frequencies of poorly differentiated histology, capsule infiltration, and intrahepatic metastasis compared with the low-microscopic portal venous invasion group (P = .0496, P < .0001, P = .0431, P = .0180, and P = .0012, respectively). The high-microscopic portal venous invasion group showed poorer overall survival and disease-free survival rates than the low-microscopic portal venous invasion group (P = .0004 and P = .0003), and the high-microscopic portal venous invasion group was an independent prognostic factor for disease-free survival (P = .0259). We proposed a new definition for classifying microscopic portal venous invasion and documented the necessity of definite histologic evaluation of it.
Human pathology 04/2011; 42(10):1531-8. · 3.03 Impact Factor
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ABSTRACT: Preoperative elevation of serum C-reactive protein (CRP) is a prognostic indicator for some malignant tumors. We investigated the clinicopathologic importance of an elevated preoperative serum CRP value in gastric carcinoma patients.
We studied the relationship between the preoperative serum CRP value and clinicopathologic characteristics in 204 patients who underwent curative resection of gastric carcinoma.
The patients with preoperative CRP elevation had significantly poorer survival than those without CRP elevation (P < 0.0001). According to multivariate analysis, the factors independently associated with an unfavorable prognosis were a high preoperative CRP value (P = 0.024), lymphatic invasion (P = 0.017) and advanced tumor stage (P = 0.016).
Preoperative serum CRP elevation can be an independent prognostic indicator in patients with gastric carcinoma.
Surgery Today 04/2011; 41(4):510-3. · 1.22 Impact Factor
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ABSTRACT: We met a 61-year-old woman who had been suffering from dyspnea due to pleuritis carcinomatosa derived from recurrent breast cancer for which no former chemotherapy had been effective. Capecitabine mono-therapy could exert a drastic anticancer effect for lymphangiosis carcinomatosa causing more severe symptoms of dyspnea. This therapeutic option could be selected for patients with recurrent breast cancer for which the first- or second-line chemotherapy could not provide a sufficient anti-cancer efficacy and possibly serve to sustain the life quality of the patients.
Gan to kagaku ryoho. Cancer & chemotherapy 03/2011; 38(3):427-9.
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ABSTRACT: Accurate preoperative imaging is an important aspect of patient evaluation before liver transplantation for hepatocellular carcinoma (HCC) because the size and number of tumors are indicators of posttransplant prognosis. This study aimed to evaluate the preoperative detectability of HCC and clarify the role of preoperative assessment on prognosis after living donor liver transplantation (LDLT).
Eighty-one patients who underwent LDLT for HCC accompanied by liver cirrhosis were reviewed. A total of 149 nodules were pathologically diagnosed as HCCs. The pathologic findings were correlated with preoperative results from contrast-enhanced computed tomography, magnetic resonance imaging, and computed tomography with angiography.
The detectability of small HCCs (<1 cm) and well-differentiated HCCs was significantly reduced. Forty-six of 81 cases were preoperatively judged to meet the Milan criteria, although 16 of these failed to meet the criteria according to postoperative pathologic examination. However, recurrence-free survival in the 16 cases was similar to that in the 30 cases who met the criteria.
The preoperative diagnostic accuracy of radiologic imaging for small-sized, well-differentiated HCCs requires improvement. However, these undetected HCCs have little effect on prognosis after LDLT, and current imaging modalities therefore provide acceptable methods of preoperative LDLT evaluation.
Transplantation 03/2011; 91(5):570-4. · 4.00 Impact Factor
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ABSTRACT: To clarify the role of DNA polymerase delta in tumor progression, we examined the expression of its main catalytic subunit p125 encoded by POLD1 in hepatocellular carcinoma (HCC) and human HCC cell lines.
We examined the expression of p53 and p125 in HCC by using immunohistochemistry and Western blotting. Characteristic changes observed in human HCC cell lines after transfection were examined.
Immunohistochemical examination revealed positive staining of p125 in HCC cell nuclei, but few positively stained cells were observed in noncancerous tissues (p < 0.0001). p125 expression in specimens significantly correlated with cellular differentiation (p = 0.0048) and the degree of vascular invasion (p = 0.0401). It also significantly correlated with abnormal p53 expression. In vivo studies showed that p125 was upregulated in mutant p53-transfected HepG2 cells, which had more invasive potential than did control cells. Furthermore, the expression and invasive potential were reduced by the silencer sequence for POLD1.
These findings suggest that the DNA polymerase delta catalytic subunit p125 induced by mutant type p53 plays an important role in tumor invasion, which leads to a poorer prognosis in HCC.
Oncology 03/2011; 79(3-4):229-37. · 2.27 Impact Factor
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ABSTRACT: Colorectal perforation is a life-threatening disease with high mortality and morbidity. The correct and prompt diagnosis and accurate judgment of severity are necessary. We retrospectively investigated 30 patients with colorectal perforation to assess predictors of mortality and severity, and evaluated the usefulness of computed tomography (CT) for the initial diagnosis. The severity of peritonitis was assessed using clinical factors and Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) scores. Abdominal free air was detected by CT in 92% of patients with colorectal perforation, whereas only 36.6% showed evidence of abdominal free air by conventional radiography. The perforation site was correctly diagnosed in 14 of 25 cases (56%). Overall mortality was 16.7%. Survivors were younger than nonsurvivors, and POSSUM physiological and mortality scores were significantly lower for survivors compared with nonsurvivors. The amount of intraperitoneal soiling by large bowel content determined disease severity in terms of the need for postoperative respiratory management. In conclusion, CT is necessary for precise diagnosis, and the POSSUM score is helpful for the evaluation of disease mortality and severity.
Fukuoka igaku zasshi = Hukuoka acta medica 03/2011; 102(3):56-65.
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ABSTRACT: The significance of the Glasgow prognostic score (GPS), an inflammation-based prognostic score, as an indicator of aggressiveness in gastric carcinoma has not been investigated fully.
Two hundred thirty-two patients with gastric carcinoma were enrolled. Patients who had both an elevated C-reactive protein (>1.0 mg/dL) and hypoalbuminemia (<3.5 g/dL) were allocated a traditional GPS (TGPS) of 2. Patients who had one of these abnormal values were allocated a TGPS of 1, and patients who had neither were allocated a TGPS of 0.
There existed a significant difference between the survival of adjacent groups of patients when examined using the TGPS (P = .05 for TGPS 0 vs 1 and P = .006 for TGPS 1 vs 2). Multivariate analysis based on TGPS demonstrated that TGPS (P = .020) and tumor stage (P = .0007) proved to be independent prognostic indicators for worse prognosis.
The preoperative measurement of an inflammation-based prognostic score can demonstrate a strict stratification for the prognosis of patients with gastric carcinoma.
American journal of surgery 02/2011; 201(2):186-91. · 2.36 Impact Factor
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ABSTRACT: Diaphragmatic involvement is relatively uncommon in patients undergoing a hepatectomy for hepatocellular carcinoma (HCC). The aim of this study was to evaluate the short- and long-term surgical impacts of HCC with gross diaphragmatic involvement in patients undergoing an en bloc resection of the diaphragm.
Between 1990 and 2007, 911 patients with HCC underwent a hepatectomy at our institution. Twenty-seven patients (3.0%) had had gross involvement of the diaphragm. Thirteen patients (1.4%) had undergone an en bloc resection of the diaphragm, and 14 (1.5%) had received only a blunt dissection. The short-term surgical impacts (surgical morbidity and mortality) and long-term surgical impacts (overall and disease-free survival) were compared between the groups.
In patients with an en bloc resection of the diaphragm as compared with those who received a blunt dissection, the values of total bilirubin and the indocyanine green retention rate at 15 min were significantly better (P < 0.01 and P = 0.04, respectively), and the rate of positivity for the hepatitis B antigen was significantly higher (P = 0.02). The positive rates of microscopic fibrocapsular invasion (P = 0.03), microscopic vascular invasion (P = 0.04), and Ki-67 immunostaining (P = 0.04) were significantly higher in patients with an en bloc resection of the diaphragm. There were no significant differences in the short-term and long-term surgical impacts between the groups.
An en bloc resection of the diaphragm in patients with gross diaphragmatic involvement of HCC is therefore justified, since there are no significant differences in short- or long-term surgical impacts in comparison with the patients receiving blunt dissection.
Surgery Today 01/2011; 41(1):101-6. · 1.22 Impact Factor
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ABSTRACT: Significance of serum appearance of anti-p53 antibody in breast cancer has not been discussed fully.
The relationship between serum appearance of anti-p53 antibody and the clinicopathological features was investigated on the basis of the data of 42 women with breast cancer who had been treated with surgical resection.
The proportion of tumors with histological grade 3 was significantly higher among tumors with serum appearance of anti-p53 antibody (P = 0.020). The proportion of triple negative tumors was also significantly higher among tumors with serum appearance of anti-p53 antibody (P = 0.003).
Preoperative appearance of anti-p53 antibody in sera can be correlated with the incidence of triple negative breast cancer and could therefore help identify tumors with aggressive potential.
Breast Cancer 12/2010; 19(1):11-5. · 1.36 Impact Factor
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ABSTRACT: Mallory bodies (MBs) and hyaline globules (HGs) are recognized as hepatocellular cytoplasmic inclusions in liver diseases. We reviewed 123 intrahepatic cholangiocarcinomas (ICCs) and encountered 16 cases (13.0%) in which cancer cells had MB-type inclusions and/or HG-type inclusions, both of which are positive for p62 and ubiquitin. The HG type was present in all 16 cases, and 5 cases contained the MB type. Of 16 patients, 12 had chronic liver disease that was related to alcoholic abuse in 4, hepatitis B surface antigen-positive in 3, and hepatitis C virus antibody-positive in 8. Viral infection and liver cirrhosis were more common in ICCs with p62+ inclusions (P = .0004 and P = .0199, respectively). Of 16 ICCs, 15 with hyaline inclusions had a peripheral tumor location (P = .0052). On ultrastructural examination, the MB type had an electron-dense fibrillar appearance, while the HG type appeared as rounded masses of granular materials. Our results suggest that intracytoplasmic hyaline bodies occasionally can be found in cholangiocarcinoma with chronic liver disease related to viral hepatitis or alcoholic intake.
American Journal of Clinical Pathology 09/2010; 134(3):457-65. · 2.60 Impact Factor
