[Show abstract][Hide abstract] ABSTRACT: A 74-year-old man underwent total gastrectomy for gastric cancer, when the histopathological diagnosis was Stage IB gastric cancer. Twenty-three months later, he underwent two courses of TS-1 + CDDP followed by a partial hepatectomy for hepatic metastasis in S5. Histopathological findings revealed the primary gastric cancer to be alpha-fetoprotein (AFP) producing gastric cancer. Thirty-three months after the gastrectomy (or five months after hepatectomy) a tumor in the right lung (S3) was found on a chest CT scan, for which paclitaxel (PTX) was ineffective. Forty-four months after the gastrectomy, he underwent pulmonary resection for the lung metastasis. The histopathological diagnosis was pulmonary metastasis of AFP-producing gastric cancer. Fifty-three months after gastrectomy (or 25 months after hepatectomy or 10 months after pulmonary resection), he had transcatheter arterial embolization (TAE) combined with radiofrequency ablation (RFA) for hepatic metastasis in S8. Thereafter he has been followed in our outpatient clinic, and as of 120 months after resection of the primary gastric cancer, he is alive without recurrence.
Preview · Article · Jan 2015 · Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
[Show abstract][Hide abstract] ABSTRACT: Introduction
Intestinal metastasis from gastric cancer is rare, although the most common cause of secondary neoplastic infiltration of the colon is gastric cancer. However, little data is available on recurrence or death in patients with gastric cancer surviving >5 years post-gastrectomy. Here we report two cases of lower intestinal metastasis from gastric cancer >5 years after primary resection and discuss with reference to the literature.
Presentation of Case: Case 1: A 61-year-old man with a history of total gastrectomy for gastric cancer 9 years earlier was referred to our hospital with constipation and abdominal distention. We diagnosed primary colon cancer and subsequently performed extended left hemicolectomy. Histological examination revealed poorly differentiated adenocarcinoma resembling the gastric tumor he had 9 years earlier. The patient refused postoperative adjuvant chemotherapy and remained alive with cancerous peritonitis and skin metastases as of 17 months later. Case 2: A 46-year-old woman with a history of total gastrectomy for gastric cancer 9 years earlier presented with constipation. She also had a history of Krukenberg tumor 3 years earlier. We diagnosed metastatic rectal cancer and subsequently performed low anterior resection and hysterectomy. Pathological examination revealed poorly differentiated tubular adenocarcinoma, resembling the gastric tumor. The patient remained alive without recurrence as of 17 months later.
We found 19 reported cases of patients with resection of colon metastases from gastric cancer. Median disease-free interval was 74 months.
Resection of late-onset colorectal recurrence from gastric cancer appears worthwhile for selected patients.
Full-text · Article · Oct 2014 · International Journal of Surgery Case Reports
[Show abstract][Hide abstract] ABSTRACT: During breast cancer screening at our hospital's screening center, a 66-year-old woman was found to have a tumor based on palpation and mammography examinations. She subsequently visited our department for the first time. Palpation indicated a tumor approximately 25 mm in size in the upper inner quadrant of the right breast. Mammography revealed a category 4 tumor approximately 20 mm in size without a distinct border in the right M-I. Ultrasound showed an intracystic tumor with a solid inner component in the right upper inner quadrant. Needle biopsy was performed under ultrasonography guidance, and metaplastic cancer, ER0%, PgR0%, HER2(-) was diagnosed. There was no evidence suggestive of distant metastases or axillary lymph node metastases, and mastectomy of the left breast and sentinel lymph node biopsy were performed. The histopathological diagnosis was spindle cell carcinoma of the breast. This case of spindle cell carcinoma of the breast that was visualized on ultrasonography as an intracystic tumor is reported.
No preview · Article · Jan 2014 · Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
[Show abstract][Hide abstract] ABSTRACT: This report proposes a concept for the standardization of immunohistochemical evaluation. Immunohistochemical staining has several problems associated with the sensitivity of the technical process and standardization of the assessment of potent staining. We provided data focusing on this concept through immunostaining for CD154 in non-small cell lung cancer (NSCLC). We used two types of anti-CD154 antibody as primary antibodies in immunohistochemical staining, as previously reported. Western blot analysis confirmed strong CD154 expression in the cultured cell line PC10, but not in LK2. We also assessed CD154 expression in SCID mouse xenografts of these cell lines. SCID xenograft data on western blot analysis were consistent with those of cultured cell lines. These xenografts could thus be used as positive or negative tissue controls for CD154 immunostaining. Primary antibodies should therefore be confirmed as recognizing target lesions, while control tissue specimens should be objectively confirmed as having target products using another experimental method. Our method would allow results to be unified at more than one laboratory and could act as an objective control assessment method in immunohistochemistry.
[Show abstract][Hide abstract] ABSTRACT: CD40 and CD154 are associated with lymphocyte signaling pathways and they are also expressed in some malignant neoplasms, but the significance in pancreatic cancer is unknown.
Eighty pancreatic cancer specimens were stained immunohistochemically, and the results were correlated with the patients' clinicopathologic features. Subsequently, in vitro analysis of CD40-CD154 signaling was performed.
Immunohistochemical analysis of tumor cells showed that 29 patients (36.3%) were positive for CD40, and 17 patients (21.3%) had very high CD154 expression. The survival of patients who had very high CD154 expression was significantly better than that of others (P = 0.0198). Univariate and multivariate analysis revealed that very high CD154 expression in cancer cells was not an independent, favorable prognostic factor (risk ratio, 0.493; P = 0.0224). On in vitro proliferation assay, the growth of PK-45P and KP-4 cells was blocked by CD40 and CD154 blocking antibodies. Moreover, on in vitro cytokine assay, Th-2 cytokines from PK-45P and SUIT-2 were blocked by CD40 or CD154 blocking antibody.
These results suggest that the CD40-CD154 interaction would correlate with cell proliferation and secretion of cytokines in PDAC cells, and CD154 overexpression could be a favorable prognostic factor in PDAC patients.
No preview · Article · Mar 2011 · Journal of Surgical Oncology
[Show abstract][Hide abstract] ABSTRACT: Over-expression of eIF4E indicates a poor prognosis in different tumors. In the present study, we investigated the frequency of eIF4E, 4E-BP1 and phosphorylated 4E-BP1 expression in PDAC cell lines, gastric carcinoma (GC) cell lines and human embryonic pancreatic cells, as well as gene therapy using translation repressor gene 4E-BP1 in combination with the mTOR inhibitor rapamycin. We also assessed the significance of eIF4E expression in 80 PDAC cases. Combination therapy of adenovirus vector-delivered 4E-BP1 gene and rapamycin was administered to determine their growth inhibition effect in vitro and in vivo in mice. Our study revealed that all PDAC cell lines, GC cell lines and human embryonic pancreas-derived cells expressed the 25-kDa eIF4E protein (MIAPaca-2 cells also expressed the 13-kDa protein 4E-BP1). The 80 PDAC specimens showed a heterogeneous pattern of eIF4E staining. No significant correlation between eIF4E expression and TNM classification was found. Adenovirus vectors Ad-4E-BP1 and Ad-GFP efficiently showed transgenic expression with hyperphosphorylation of 4E-BP1; however, insignificant growth inhibition of the PDAC and GC cell lines was observed. Combination therapy with rapamycin significantly inhibited proliferation and tumor growth in vitro as well as in vivo. Therefore, combination of Ad 4E-BP1 and rapamycin may be a more effective adjuvant therapy.
Full-text · Article · Jun 2009 · International Journal of Oncology
[Show abstract][Hide abstract] ABSTRACT: CD40 and its ligand, CD154, play a regulatory role in several signaling pathways among lymphocytes. Recently, it was reported that CD40 is expressed in several malignant tumors. However, the clinical impact of CD40 expression in nonsmall cell lung cancer has not been studied widely.
One hundred twenty-nine surgical specimens of nonsmall cell lung cancer were assessed immunohistochemically for CD40 and CD154 expression, and that expression was correlated with patients' clinicopathologic parameters and outcome. Subsequently, in vitro analysis of CD40-CD154 signaling was performed.
Immunohistochemical staining of tumor cells confirmed that 67 patients (51.9%) were positive for CD40, and 76 patients (58.9%) were positive for CD154. The survival of patients who had tumors that were negative for CD40 was significantly better than the survival of patients who had tumors that were positive for CD40 (P = .0004). Multivariate analysis using a Cox regression model indicated that CD40 expression in cancer cells is an independent, unfavorable prognostic factor (risk ratio, 1.855; P = .0403). By using an in vitro juxtacrine growth factor assay, the growth of LK2 cells (CD40-positive/CD154-negative) was accelerated by CD154-positive cancer cells, such as PC10 cells (CD40-negative/CD154-positive), by a juxtacrine mechanism.
The current results suggested that CD40 expression in tumors is associated with a poor prognosis and that the juxtacrine interaction of CD40-CD154 among cancer cells facilitates the development of malignant potential in nonsmall cell lung cancer.
[Show abstract][Hide abstract] ABSTRACT: CD4/8 status has been previously reported to be a critical factor in the prognosis of oesophageal squamous cell carcinoma (OSCC). In the current study, we investigated the effect of regulatory T cells (Treg; Foxp3+ lymphocytes) on the status of CD4+ and CD8+ T cells in 122 patients with OSCC. Immunohistochemical analysis of Treg was performed using an antibody against Foxp3. The survival rate for low Foxp3 patients was significantly lower than for high Foxp3 patients (P=0.0028 by log-rank test), but Foxp3 status did not significantly correlate with prognosis in CD4/8(+/+) patients or CD4/8(+/-) or (-/+) patients (P=0.5185 and 0.8479, respectively, by log-rank test). We also found that Foxp3 status correlated with CD4/8 status (P=0.0002 by chi2 test) and that the variance of CD8/CD4 ratio in patients with low Foxp3 was larger than in patients with high Foxp3 (P<0.0001 by F-test). Thus, the results do not support the idea that Treg suppress anti-tumour immunity in patients with OSCC. Rather, the CD8/CD4 ratio and CD4/8 status appear to be critical factors in anti-tumour immunity. Furthermore, Treg numbers correlate with both the CD8/CD4 ratio and the CD4/8 status, suggesting that Treg number is not a factor to predict patient's survival in OSCC.
Full-text · Article · Apr 2008 · British Journal of Cancer