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ABSTRACT: The most serious complaints after total gastrectomy are alkaline esophagitis and postalimentary syndrome. We have performed ileocolon interposition as a gastric substitution which uses the ileocecal valve to prevent bile reflux. The ileocolon segment consists of 7 cm of terminal ileum and 10 cm of coecum and ascending colon on a vascular pedicle. This isolated segment is rotated upwards between the esophagus and the duodenum. To evaluate the function of the ileocolon as a gastric substitute, Barium X rays, O-GTT and gastric emptying time (99Tc EDTA) were examined. Barium X-rays showed that the air at the coecal portion looks like a gastric fornix and there is no barium reflux into the esophagus even in the supine position. Likewise, there were no complaints from patients of symptoms of reflux esophagitis. In case of Rouxen-Y reconstructions, blood sugar level after O-GTT show oxyhyperglycemia. Those in ileocolon interposition rose rapidly, but almost to the same degree as in normal subjects. The appearance of the gastric emptying curve using Tc-DTPA in case of ileocolon interposition shows that there is good reservoir function.
Nippon Geka Gakkai zasshi 07/1997; 98(6):549-54.
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ABSTRACT: The human genes MAGE-1 and MAGE-3 encode tumor rejection antigens recognized on melanoma cells by cytotoxic T lymphocytes (CTL). These antigens are potentially useful as targets for specific immunotherapy. Expression of MAGE genes in some malignant tumors has been reported, but MAGE gene expression in colorectal carcinomas has not been studied adequately. Therefore, we studied MAGE-1,2,3, and 4 a/4 b expression at the mRNA level, in 40 cases of surgery for colorectal carcinoma, using the reverse transcription polymerase chain reaction (RT-PCR). MAGE-1,2,3, and 4 a/4 b genes were expressed in 3 (7.5%), 6 (15.0%), 13 (32.5%), and 5 (12.5%), respectively, of these 40 cases. A total of 19 of the 40 samples (47.5%) expressed at least one of the MAGE genes. The relationships between clinicopathologic factors and MAGE gene expression were also examined. The frequency of lymph node metastasis was significantly higher in MAGE-3-positive than in MAGE-3-negative cases (p < 0.05). All these cases classified as Duke's D expressed the MAGE-3 gene. This rate of expression was significantly higher than that for all other the Duke's classifications together (p < 0.05). Our findings suggest that MAGE-specific immunotherapy against colorectal carcinomas may be feasible.
Japanese Journal of Clinical Immunology 04/1997; 20(2):95-101.
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ABSTRACT: In a recent 14-year period from December 1978 to December 1993, 180 patients with breast cancer were treated at the hospital, and out of these 180 patients, 38 patients (21.1%) who had a recurrent breast cancer were clinically evaluated. The first recurrence occurred in the local skin in 13 patients, regional lymph node in 1, bone in 13, lung in 4, liver in 4 and in other areas in 3. Histologically, the incidence of scirrhous carcinoma recurrence was higher than that of papillotubular carcinomas. There was no recurrence in mucinous carcinomas. The frequency of recurrence became higher in accordance with TNM classification, namely, 6.7% in Stage I, 23.7% in Stage II, 37.5% in Stage IIIa, and 47.1% in Stage IIIb cancers. An increasing tendency in the recurrence rate was also noted with an increase of tumor diameter or lymph node metastasis. Otherwise, there was no difference in cumulative survival after recurrence between TNM classification. There were no correlations between the estrogen receptor and incidence of recurrence or 5-year survival rate. The disease free interval (DFI) was less than 2 years in about 60% of the recurrent cases. DFI of bone metastasis was longer than for the other sites of recurrence. The survival rate increased according to prolongation of DFI. After through evaluation of these results, one should pay close attention to follow-up after mastectomy.
Gan to kagaku ryoho. Cancer & chemotherapy 08/1996; 23(8):1049-54.
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ABSTRACT: We have already reported that a combination of TNF-alpha and immunogenic variant was effective for immunotherapy of nonimmunogenic tumor. Immunogenic variants (A2 and A7) were obtained from nonimmunogenic fibrosarcoma (parent cell: 1767-3) by mutagen treatment with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). In this study, we studied about the possibility of TNF-alpha gene immunotherapy for nonimmunogenic tumor. We established two types of TNF-alpha producing cell lines. One is TNF-alpha producing nonimmunogenic variant (1767 TR 2), and another is TNF-alpha producing immunogenic variant (A7 TR3). We compared them about the ability of producing specific immunity against parent tumor. TNF-alpha producing immunogenic variant (A7TR3) could induce strong specific immunity to parental cell compared to TNF-alpha producing nonimmunogenic variant (1767TR2). Immunogenicity of tumor is very important when we want to perform TNF-alpha gene immunotherapy against cancer.
Japanese Journal of Clinical Immunology 03/1996; 19(1):69-79.
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Nippon Geka Gakkai zasshi 04/1994; 95(3):209.
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ABSTRACT: To investigate whether the expression of HLA-DR antigen in gastric carcinomas is associated with the survival rate, we studied 70 cases of gastric carcinoma using a monoclonal antibody. Forty-seven cases (67%) stained positively, including 31 differentiated carcinomas, and 16 undifferentiated carcinomas. A close correlation was found between expression of HLA-DR antigen and differentiation of the tumor cells. Marked lymphocyte infiltration was seen in the HLA-DR antigen positive cancers. In advanced gastric cancers, the 5-year survival rate of patients with HLA-DR antigen positive cancers was significantly higher (67.5%) than that of patients with HLA-DR antigen negative cancers (40%). The data suggest that the expression of HLA-DR antigen in gastric carcinomas may reflect the degree of tumor cell differentiation, and influence the host immune response and prognosis.
Acta Oncologica 02/1994; 33(2):187-90. · 3.33 Impact Factor
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ABSTRACT: Postoperative adjuvant locoregional chemotherapy was performed on patients who underwent hepatic resection for metastatic colorectal cancer. To prevent recurrence in the residual liver after hepatic resection. 7 patients received intra-hepato-arterial infusion of MMC, 5-fluorouracil (5-FU), doxorubicin + Lipiodol emulsion. Sixteen cases did not receive such treatment. The 1-, 2- and 3-year cumulative disease free rates were 100, 80 and 40% in the patients with this adjuvant chemotherapy, against 61.4, 54.6 and 28.1% in those without this locoregional therapy, respectively. The 1-, 2- and 3-year cumulative survival rates were 100, 100 and 60% in the TAI-E group, and 73.7, 63.3 and 63.3% in the patients without TAI-E, respectively. Postoperative adjuvant locoregional chemotherapy is considered effective to prevent the recurrence of metastatic colorectal cancer in the residual liver after hepatectomy.
Gan to kagaku ryoho. Cancer & chemotherapy 09/1993; 20(11):1535-7.
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ABSTRACT: EAP therapy was performed on 30 cases of advanced or recurrent gastric cancer between September 1987 and July 1991. The clinical responses of 15 trial patients were evaluated. The overall response rate was 40.0% (CR, one case; PR 5 cases). The results were thus not as favorable as that reported by Preusser et al. On the contrary, with such a poor response rate, this treatment did not lead to a prolonged life span (mean survival time; 5.6 months, median survival time; 4 months). Side effects, such as myelosuppression, appetite loss, nausea, vomiting, liver dysfunction, renal dysfunction, and alopecia, were also observed. Myelosuppression was a dose-limiting factor. The rhG-CSF proved in 4 cases to be a clinically useful tool against the neutropenia induced by this treatment. It may be concluded that EAP should be given to the following selected patients: (1) those whose condition is not so far advanced: (2) those who have not received many other forms of treatment; and (3) those in excellent general physical condition.
Gan to kagaku ryoho. Cancer & chemotherapy 05/1993; 20(5):611-6.
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ABSTRACT: Expression of sialyl-Tn antigen (STN) was examined by an immunohistochemical method in 85 primary gastric carcinomas. The STN expression occurred in 53 (62.4%) cancers, and the positive staining was correlated with degree of gastric wall and lymph vessel invasion, lymph node metastasis, and stage of tumour. Five-year survival rates of patients with STN-positive cancers (47.2%) were significantly lower than those with STN-negative cancers (84.4%) (P < 0.01), and patients with STN-positive cancers at stage III and stage IV had a worse prognosis. In the cancers with serosal invasion, patients with STN-positive cancer disclosed a significantly poorer prognosis than those with STN-negative cancers (P < 0.01). Therefore, it is suggested that a careful follow-up study and intensive postoperative therapy are needed for patients with advanced gastric cancers with positive STN expression.
European Journal of Cancer 01/1993; 29A(13):1820-3. · 5.54 Impact Factor
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ABSTRACT: Nonimmunogenic 1767-3 fibrosarcoma was treated with the mutagen N-methyl-N'-nitro-N-nitrosoguanidine, and stable variant cell clones (M-clones) were obtained that were able to elicit an immunological rejection response in syngenic C3H mice. Mice immunized with some M-clones were protected against a challenge from the original nonimmunogenic fibrosarcoma. Furthermore, when spleen cells of immunized syngenic mice were restimulated in vitro with M-clones, cytotoxic T lymphocytes (CTL) were obtained that were able to lyse not only M-clones but also the original nonimmunogenic tumor. These in vivo and in vitro results demonstrate the immunogenicity of M-clones and the existence of a singular antigenic specificity between the original nonimmunogenic tumor and M-clones. For the purpose of application of this mutagen treatment to cancer therapy, we combined it with lymphokine-activated killer (LAK) adoptive immunotherapy (AIT). With interleukin 2 and in vitro stimulation with highly immunogenic variant clones, we tried to induce transfer cells that had not only nonspecific LAK cells but also CTL with specific immunity against the original nonimmunogenic tumor. Successful results were obtained in the LAK AIT models. These findings indicate that an immunotherapy of human cancers that are thought to be weakly or nonimmunogenic may be possible by the application of this approach to LAK AIT.
Japanese journal of cancer research: Gann 12/1988; 79(11):1247-53.
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ABSTRACT: We retrospectively analyzed 116 patients who underwent resection of stage IV gastric cancer to investigate the prognostic factors responsible for long-term survival. Statistically significant clinicopathological differences between patients surviving 3 years or more (n = 9) and those surviving less than 3 years (n = 107) were observed in regard to macroscopic type, curability of surgery, lymph node metastasis and blood vessel invasion. These four variables also had a statistically significant influence on survival by univariate analysis. Multivariate analysis revealed that no residual tumor (R0) surgery was a significantly beneficial factor for long-term survival. However, no patients with the diffusely infiltrative type of tumor survived for more than 2 years even if they underwent R0 surgery. Patients without the diffusely infiltrative type who underwent R0 surgery had better survival rates: a 27.3% and 13.6%, 3 and 5 year survival rate, respectively. In conclusion, R0 surgery contributes to long-term survival even in stage IV gastric cancer, and some patients with the not diffusely infiltrative type, in particular, may receive a survival benefit by R0 surgery.
International surgery 83(4):283-6. · 0.36 Impact Factor
