Biomedical subjects

H Inaji

Publications and source records attributed to H Inaji.

At least 73 records · Page 4Linked to original sources

PubMed1992

Surgical treatment for chest wall recurrence of breast cancer.

From 1977 to 1987, 23 patients with isolated chest wall recurrence, excluding sternal metastasis, from breast cancer underwent full thickness chest wall resection. The 5-year survival rate after chest wall resection was 48% but the 5-year relapse-free survival rate was 26%. Mediastinal metastasis was proved histologically at the time of chest wall resection in 7 patients, and survival period with mediastinal involvement was significantly (P less than 0.01) shorter than that with no mediastinal involvement (n = 16). In 17 patients with a long disease-free interval (DFI greater than or equal to 24 months), survival was longer than in 6 patients with a short DFI (less than 24 months). For the selected patients without mediastinal involvement and long DFI, surgical treatment for chest wall recurrence of breast cancer should play a significant role in improving the quality of life, and even in prolonging the survival rate.

Breast Neoplasms↗

PubMed1992

Evaluation of an improved dot-immunobinding assay for carcinoembryonic antigen determination in nipple discharge in early breast cancer: results of a multicenter study.

We have previously reported carcinoembryonic antigen (CEA) measurement in nipple discharge to be a useful adjunct in the diagnosis of non-palpable breast cancer. We have now developed a "microdot-immunobinding assay" using a specially constructed device to screen efficiently large numbers of patients with nipple discharge for non-palpable breast cancer. The method is as follows: a sample of nipple discharge is placed on a solid phase monoclonal anti-CEA antibody and, if CEA is present in the discharge, it will be detected by a second monoclonal anti-CEA antibody conjugated with alkaline phosphatase. The use of bromochloroindolyl phosphate as a chromogen results in a stable color reaction that can be semiquantitatively analyzed with the naked eye. CEA levels determined by this microdot assay correlated well with those determined using the earlier Elmotec assay. To determine the accuracy of the method, a collaborative study involving 11 institutes in Japan was organized. The CEA levels in nipple discharges from 77 patients undergoing surgery, 44 of whom were diagnosed as having breast cancer, were assayed. The results were that 17 of the 23 patients with palpable breast cancer, and 16 of the 21 patients with non-palpable breast cancer exhibited CEA values > 400 ng/ml, a cut-off value determined in a previous study. The overall accuracy (78%) of this test for diagnosing non-palpable breast cancer was higher than that obtained from ductography or cytology. The system may thus be of use in the screening of early breast cancer.

Breast Neoplasms↗

PubMed1992

[Co-operative clinical evaluation of 5'-DFUR tablets for breast cancer at 31 institutions].

A phase II study of 5'-deoxy-5-fluorouridine (5'-DFUR) tablets for breast cancer was done at 31 institutions in Japan. Forty-five patients were registered and 44 of them were eligible for the study. Of the 40 patients whose results could be evaluated, 11 (28%) responded (four complete responses and seven partial responses). Side effects, such as diarrhea, anorexia, leukocytopenia, and liver dysfunction were observed in 24 of the 44 patients. The side effects were mild and transient. 5'-DFUR is a promising drug for breast cancer treatment, and its tablet form makes chemotherapy easier for the patient.

Administration, Oral↗

PubMed1992

[Breast preserving operation for early breast cancer--clinical implications and biological aspects of residual tumor].

Among the 93 surgical specimens of stage I breast cancer treated by breast preserving operation, surgical margins were less than 10mm in 23 (25%) cases because of intraductal spread. Such tumors with extensive intraductal component, however, were frequently positive for estrogen receptor (ER). Possible risk factors for local failure have been studied in an attempt to exclude high-risk patients not suitable for breast preserving operation. The results so far obtained suggest that biological markers such as c-erb B-2 or PS2 proteins may provide useful informations to select patients who are most likely to recur. In addition, adjuvant endocrine therapy may be recommended for the patients treated by breast preserving operation.

Aged↗

PubMed1992

[Adjuvant chemotherapy therapy of breast cancer].

Six to 12 cycles of CMF is regarded as the standard regimen for adjuvant chemotherapy for breast cancer, producing 10-20% increase in survival for premenopausal and node-positive patients. Tamoxifen combined with CMF has induced an additional reduction in recurrence rate only in postmenopausal patients. Oral administration of 5-FU or its derivatives combined with tamoxifen for as long as 1-2 years is the regimen most widely used in Japan for considerable improvement in survival. But it needs further evaluation in comparison with CMF, and in ultimate duration of treatment and better combination with other drugs. Adjuvant chemotherapy for node-negative patients is advocated in the U.S., where the recurrence rate is as high as 30%. Only 10% of Japanese n0 patients undergo recurrence. Therefore, adjuvant therapy should be given only to high-risk patients.

Aged↗

PubMed1992

[New factors of possible prognostic value in breast cancer].

Over the past 10 years, we have witnessed a variety of potential prognostic factors of breast cancer including proliferative rate, ploidy, growth factor receptors, oncogenes and cathepsin D production. Some of these variables seem to predict the prognosis of the patients but the available data are conflicting and call for carefully conducted quality-control studies to analyze intra- and interlaboratory variations. In this review, we provided a framework from which prognostic factor information can be used directly to make treatment decisions.

Breast Neoplasms↗

PubMed1991

Breast cancer with bone-only metastases. Visceral metastases-free rate in relation to anatomic distribution of bone metastases.

The medical records of 82 patients with breast cancer with bone-only metastases were reviewed. According to the distribution of the metastases by bone scan at the time they were first documented, the patients were divided into three groups: Group A (patients who had bone metastases exclusively cranial to the lumbosacral junction), Group B (patients who had bone metastases exclusively caudal to the junction), and Group C (patients who had bone metastases both cranial and caudal to the junction). Group A had a significantly higher visceral metastases-free rate than Groups B or C. Serial bone scans and radiographs of Group A patients revealed that bone lesions cranial to the junction rarely developed into visceral metastases and that bone lesions extending caudal to the junction frequently developed into visceral metastases. These results indicate that the presence of bone metastases caudal to the lumbosacral junction is predictive of visceral metastases.

Adult↗

PubMed1991

Immunohistochemical, ultrastructural and biochemical studies of an amylase-producing breast carcinoma.

We describe a breast cancer with ectopic production of amylase, found in the patient's serum, urine and in the tumour. Clinically, serum amylase levels reflected both the progression of the disease and regression induced by various therapies. Using agarose gel electrophoresis and a wheat protein inhibitor assay, the predominant serum amylase appeared to be identical to pancreatic-type isoenzyme. However, the action mode analysis using a new fluorogenic substrate revealed that the serum contained non-salivary, non-pancreatic amylase. The tumour had microscopic features of invasive ductal carcinoma with some argyrophilic differentiation. The component cells stained positively for amylase, and ultrastructurally numerous secretory granules were seen.

Adult↗

PubMed1991

The partial characterization and clinical evaluation of pancreas cancer-associated antigen from the ascites fluid of a patient with pancreatic cancer.

Monoclonal antibodies against pancreas cancer-associated antigen (PCAAp) were produced by established hybridoma cells. Two monoclonal antibodies, 3F1 and 3B6, were selected and these two monoclonal antibodies were found immunohistologically to react strongly with cancer cells and intraductal mucin-like products in well-differentiated pancreatic cancer tissues, but weakly, if at all, with gastric, colorectal and other cancers and at all not with normal adult or fetal pancreatic tissue. PCAAp is usually expressed in normal colonic mucosa (PCAAc), but the two monoclonal antibodies scarcely reacted with normal colonic mucosa. A sandwich enzyme immunoassay was developed to measure circulating PCAAp. Thirty-two normal subjects and 271 patients comprised of 210 with malignant disease and 61 with benign disease were surveyed. The cut-off value of PCAAp levels in the 32 normal subjects was 2.06 micrograms/ml, being the mean + 2SD, while PCAAp levels of more than this were observed in 72 per cent of the patients with pancreatic cancers, 65 per cent of those with bile duct cancers, 60 per cent of those with hepatomas, 0-30 per cent of those with other malignant diseases, and 10 per cent of those with benign hepatobiliary diseases. The susceptibility of isolated PCAAp and PCAAc to various enzymes and chemical reagents were also studied. The results of this study suggest that the assay for PCAAp might be useful in the diagnosis of pancreatic cancer.

Adult↗

PubMed1991

Changes in hematologic parameters during treatment with medroxyprogesterone acetate for breast cancer.

To elucidate the etiology of the thrombogenic effects of high-dose medroxyprogesterone acetate (MPA) in the treatment of breast cancer, hematologic parameters were sequentially assessed in 12 patients receiving MPA 800 mg p.o. daily for 6 months as adjuvant hormone therapy after mastectomy. The results were as follows. (1) Coagulation system: levels of factor VII and fibrinogen decreased significantly, whereas factors II and IX increased significantly, with a shortened activated partial thromboplastin time. (2) Fibrinolytic system: plasminogen and alpha 2-plasmin inhibitor-plasmin complex increased, whereas fibrinogen degradation products remained low. (3) Anticoagulation system: antithrombin III increased significantly. (4) These changes were most marked after 2 or 4 weeks of MPA treatment, and returned to the pretreatment level one month after discontinuation of treatment. (5) No patients in this study developed thromboembolic disease during or after MPA administration. These results indicate that MPA may induce a hypercoagulable state, but this state does not directly lead to the development of thrombosis.

Adult↗

PubMed1991

[Tumor markers. Personal experience--screening of breast cancer by determining CEA in nipple discharge].

Secondary prevention, detection and treatment at an early stage, may be the only means of controlling breast cancer. This is rational behind screening for breast cancer. We have previously reported that CEA measurement in nipple discharge is a useful adjunct in the diagnosis of nonpalpable breast cancer. As an extension, a dot-immunobinding assay was developed to screen a large number of patients with nipple discharge for nonpalpable breast cancer. This article is a review of the current status of CEA assay in nipple discharge for mass screening of breast cancer. False positive and negative cases will be also described.

Adult↗

PubMed1990

[Combination therapy with 5'DFUR and MPA as a second line treatment for advanced/recurrent breast cancer].

As a second line therapy after failure to previous therapies, a combination therapy with MPA 1,200 mg po and 5'DFUR 1,200 mg po daily was given to 31 patients with recurrent breast cancer. At a median follow up period of 18 months, the overall response rate was 42%. The response rates for bone and visceral lesions were still good for the second line therapy. Patients previously exposed to tamoxifen (24 patients), 5-FU or its derivatives (21) and/or adriamycin (18) had response rates of 42%, 33%, 33%, respectively. The median duration of response in responders was 10 months. The overall median survival for the entire series was 9 months after start of the treatment. Thirteen (81%) of 16 patients with bone lesions were relieved from their bone pain. It is of special interest that the pain relief was also obtained in 7 out of 10 NC/PD patients with bone lesions, resulting in much improvement of their performance status. Side effects included obesity 52%, edema of the leg 35%, diarrhea 16% and so on. One patient developed venous thrombosis of her lower extremities and 4 were suspected to have the same condition. Fifty-five % of the patients underwent dose reduction of MPA at the 5th month of treatment in a median. This combination therapy is useful for recurrent disease even in late stages, so long as close observation is made for the occurrence of thrombosis.

Adult↗

PubMed1990

Inability of medroxyprogesterone acetate to down regulate estrogen receptor level in human breast cancer.

The influence of medroxyprogesterone acetate (MPA) on estrogen receptor (ER) and progesterone receptor (PR) levels was studied in 20 postmenopausal patients with ER-positive and PR-positive primary breast cancers. Each patient underwent drill biopsy and subsequently mastectomy. The drill biopsy and surgical specimens were assayed for the total ER and PR levels (cytosolic plus nuclear fraction) by enzyme immunoassay. Between the drill biopsy and mastectomy, ten patients received no treatment (control group) and the other ten patients were given MPA (1200 mg/day) for 7 days. In the control group, the total ER and PR levels of the surgical specimens decreased by 68.2 +/- 7.3% and 60.7 +/- 8.4%, respectively, taking the receptor values of the drill biopsy specimens as 100%, although no treatment was given preoperatively. This decrease seems to be attributable to the receptor degradation due to damages occurring during mastectomy. In the MPA group, the total ER and PR levels of the surgical specimens decreased by 64.2 +/- 8.0% and 23.3 +/- 7.6%, respectively. The decrease in PR, but not ER, was statistically significant between the control and MPA groups (P less than 0.01). These results demonstrate that MPA down regulates PR but not ER in human breast cancer and challenge the conventional idea, extrapolated from the results on the endometrium and endometrial cancer, that MPA antagonizes endogenous estrogens by down regulating ER.

Antineoplastic Agents↗

PubMed1989

Enzyme immunoassay of estrogen and progesterone receptors in drill biopsy specimens from breast cancer.

We have applied enzyme immunoassay (EIA) to the detection of estrogen and progesterone receptors (ER and PR, respectively) in small samples obtained by drill biopsy of primary breast cancers. Thirty patients with breast cancer underwent drill biopsy of the tumors just before mastectomy. Both the drill biopsy and surgical specimens were assayed for ER and PR in the cytosol and nuclear fractions by EIA. ER and PR in the cytosol fraction (ERc and PRc, respectively) of the drill biopsy specimens (DBS) correlated very well with those of the surgical specimens (SS): ERc (DBS) = 1.02 X ERc (SS) + 3.85 fmol/mg protein (r = 0.958) and PRc (DBS) = 1.05 X PRc (SS) + 3.87 fmol/mg protein (r = 0.958). ER and PR in the nuclear fraction (ERn and PRn, respectively) of the drill biopsy specimens also correlated very well with those of the surgical specimens: ERn (DBS) = 1.02 X ERn (SS) + 59.18 fmol/mg DNA (r = 0.932) and PRn (DBS) = 0.98 X PRn (SS) + 54.28 fmol/mg DNA (r = 0.898). These results demonstrate that EIA for ER and PR of the drill biopsy specimens is a very useful method for the estimation of the receptor status of breast cancers.

Biopsy↗

PubMed1989

Influence of tamoxifen-medroxyprogesterone sequential therapy on estrogen and progesterone receptor contents of breast cancer.

The influence of tamoxifen (TAM) and medroxyprogesterone acetate (MPA) sequential administration on the estrogen receptor (ER) and progesterone receptor (PR) contents of breast cancer was studied in 68 patients with operable breast cancer. TAM was used as a primer of PR induction in order to enhance the effects of MPA. Half of the patients (n = 34) were preoperatively treated with TAM (20 mg/day for 7 days) and sequentially with MPA (1200 mg/day for 17 (median) days). ER and PR of surgical specimens were assayed by enzyme immunoassay and the results were compared with those obtained from the other half of the patients (n = 34), who had not received any treatment before surgery. TAM-MPA treatment significantly lowered PR in the cytosol regardless of the menopausal status. On the other hand, TAM-MPA treatment significantly lowered ER in the cytosol only in the postmenopausals but not in the premenopausals. These results demonstrate that reduction of ER provoked by TAM-MPA treatment is dependent on menopausal status.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1989

[Analysis of prognostic factors in patients with locally advanced breast cancer treated with intra-arterial infusion chemotherapy as an induction therapy].

A retrospective analysis was undertaken on a series of 75 patients with locally advanced breast cancer treated with intraarterial infusion chemotherapy as an induction therapy. Several parameters were tested as to possible prognostic variables. Of these, only histological assessment of local response influenced survival; patients with good histological response had a better prognosis than those with poor response (77% versus 47% survival at 5 years). Thus, histological effect appeared to be an important prognostic factor in this treatment strategy.

Adult↗

PubMed1989

[A comparison of two doses of tamoxifen in patients with advanced breast cancer: 20 mg/day versus 40 mg/day].

In order to establish the optimal dose of Tamoxifen in the treatment of advanced breast cancer, a randomized trial comparing 40 mg/day to 20 mg/day was conducted. Thirty-four patients were entered in the study, and the results were as follows: 1) The response rates of 40 mg/day and 20 mg/day were 35.3% and 23.5%, respectively, without any significant difference between them. 2) The response rate in relation to metastatic sites were also similar at the two dose levels. 3) There was no significant difference in the median duration of response, either. 4) Among nine patients, one PR and three NC case were observed with subsequent increase of the dosage to 40 mg/day after 20 mg/day. The conclusion from this study was that 20 mg/day of Tamoxifen was suitable as an initial dosage for the treatment of advanced breast cancer. But, in certain cases who failed to respond, a dose-escalation to 40 mg/day appeared to be effective.

Adult↗

PubMed1989

Evaluation of dot-immunobinding assay for carcinoembryonic antigen determination in nipple discharge as an adjunct in the diagnosis of early breast cancer. Research Group for Carcinoembryonic Antigen in Nipple Discharge.

We have previously reported carcinoembryonic antigen (CEA) measurement in nipple discharge to be a useful adjunct in the diagnosis of non-palpable breast cancer. As an extension, a dot-immunobinding assay was developed to screen a large number of patients with nipple discharge for non-palpable breast cancer. The principle is as follows. CEA bound to a solid phase monoclonal anti-CEA antibody is detected by a second monoclonal anti-CEA antibody conjugated with horseradish peroxidase. The use of tetramethylbenzidine as a chromogen results in a stable color reaction that can be semiquantitively analyzed by the naked eye. The CEA levels determined by this dot assay correlated well with CEA levels determined using the former Elmotec assay. To determine whether or not the method could also be feasible in the detection of non-palpable breast cancer, a collaborative study from 12 Japanese institutes was organized. The CEA levels in nipple discharges from 155 patients were assayed. Thirteen of 30 patients with palpable breast cancer and 22 of 30 patients with non-palpable breast cancer exhibited CEA values higher than 400 ng/ml, a cut-off value determined using 89 benign controls. The specificity (91%) and sensitivity (73%) of this test were higher than those of mammography or cytology. The incidence of elevated CEA levels in nipple discharge correlated significantly with the incidence of intratumoral antigen expression. Thus, the system could prove useful in screening for early breast cancer.

Body Fluids↗