Biomedical subjects

H Kuwano

Publications and source records attributed to H Kuwano.

At least 55 records · Page 3Linked to original sources

PubMed2001

Clinical significance of soluble form of HLA class I molecule in Japanese patients with pancreatic cancer.

In recent studies a soluble form of human leukocyte antigen class I (sHLA-I) has been found in blood, urine, ascitic fluid, and various other tissues. Research has been focused on the role of sHLA-I in the induction of immunotolerance in organ transplantation. To examine the role of sHLA-I in the immune system of patients with malignancy, we examined serum sHLA-I levels in patients with pancreatic, biliary, hepatic malignancy, and other diseases. We examined sHLA-I levels in the sera of patients with pancreatic cancer (n = 19), benign biliary disease and chronic pancreatitis (n = 20), hepatocellular carcinoma (n = 51), gallbladder cancer (n = 6), cholangiocellular carcinoma (n = 6), and in normal controls (n = 22), using enzyme-linked immunosorbent assay (ELISA). In patients with pancreatic cancer we also analyzed the relationship between sHLA-I and CA19-9, and the specificity and sensitivity of sHLA-I. When patients with acute or chronic hepatitis were excluded from analysis, the mean sHLA-I level in patients with pancreatic cancer was significantly higher than that of normal controls (p < 0.01) and patients with benign disease (p < 0.01), hepatocellular carcinoma (p < 0.01), gallbladder cancer (p < 0.05), and cholangiocarcinoma (p < 0.05). We determined a serum sHLA-I cutoff level for normal controls of 2000 ng/ml; serum levels of sHLA-I were higher than the cutoff in ten patients with pancreatic cancer, and serum levels of CA19-9 were lower than 37 IU/l in 9 of 14 patients; sensitivity and specificity were 88.2% and 85.5%, respectively. Serum levels of sHLA-I in pancreatic cancer patients were higher than in the other diseases, although we found that pancreatic cancer cell lines did not produce the sHLA-I. The evaluation of serum sHLA-I levels could have clinical significance in pancreatic cancer.

Biomarkers↗

PubMed2001

Pyloric relaxation regulated via intramural neural pathway of the antrum.

Current information about pyloric relaxation is not sufficient. For this reason, our study aimed at measuring pyloric relaxation correctly and determining the role of the intrinsic and extrinsic neural pathway in pyloric relaxation. Five groups of dogs were used: five dogs had an intact gastrointestinal tract (control group); five dogs had transection and reanastomosis of the antrum 3 cm proximal to the pylorus (antral transection group); five dogs had extrinsic pyloric denervation (denervation group); five dogs had transection and reanastomosis of the antrum with extrinsic pyloric ring denervation (transection with denervation group); and five dogs had truncal vagotomy (vagotomy group). Gastropyloroduodenal motility was recorded by a strain-gauge force transducer in conscious dogs. In the control and denervation groups, pyloric relaxation was observed only during phase III of the interdigestive migrating motor complex. In the antral transection, transection with denervation, and vagotomy groups, pyloric relaxation was not observed in either the interdigestive or the postprandial state. The frequency of pyloric contractions increased in these groups in comparison with the control group. In conclusion, the results suggest that pyloric relaxation occurred during phase III to expel undigested particles from the stomach and that descending antral intramural pathways play an important role in the control of pyloric relaxation.

Animals↗

PubMed2001

Sinusoidal endothelial cell injury by superoxide anion and iron in the Propionibacterium acnes-pretreated and lipopolysaccharide-stimulated rat liver.

AIMS/BACKGROUND: We attempted to measure the generation of superoxide anion, examine its site of release and determine its pathological role in Propionibacterium acnes-lipopolysaccharide-induced liver injury in the rat. METHODS: The P. acnes-pretreated (16 mg/kg i.v.) rat liver was perfused with buffer containing lipopolysaccharide (2.5 microg/ml). Chemiluminescence enhanced with Cypridina luciferin analog, MCLA, and reduction of nitro blue tetrazolium were used for detecting superoxide anion. Leakage of enzymes and release of cytokines into the perfusate, and histological specimens were also examined. RESULTS: Superoxide dismutase-inhibitable chemiluminescence peaked at 30 min of lipopolysaccharide infusion and blue formazan precipitate was histochemically deposited mainly on hepatic macrophages. Purine nucleoside phosphorylase (PNP) activity in the perfusate, as a marker of sinusoidal endothelial cell injury, reached its maximum at 50 min and aspartate aminotransferase (AST) activity, as a marker of hepatocyte injury, reached a plateau at 90 min. Simultaneous treatment with superoxide dismutase and deferoxamine mesylate significantly suppressed the leakage of PNP and AST. Release of tumor necrosis factor-alpha and growth-related oncogene/cytokine-induced neutrophil chemoattractant-1 lagged behind PNP leakage. Light microscopy showed destruction of the sinusoids followed by hepatocyte necrosis. Electron microscopy revealed adherence of hepatic macrophages to sinusoidal endothelial cells. CONCLUSION: These results indicate that superoxide anion released from hepatic macrophages may induce sinusoidal endothelial cell injury via interaction with iron in the P. acnes-lipopolysaccharide-treated liver.

Animals↗

PubMed2001

Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer.

BACKGROUND: A secure lymphadenectomy in a laparoscopically assisted gastrectomy performed for gastric cancer is required because of the high prevalence of lymph node metastasis. A surgical technique for laparoscopic gastrectomy with lymph node dissection and reconstruction using a conventional circular stapler is reported. METHODS: Forty-nine laparoscopically assisted gastrectomies with lymphadenectomy (47 distal and two total gastrectomies) were performed using devices for retraction of the stomach and laparoscopic ligation of arteries, which were developed to ensure secure dissection of lymph nodes. Reconstruction by Billroth I or intestinal interposition using a conventional circular stapler was performed through a small incision through which the specimen was removed. When submucosal invasion was suspected (n = 16), the lymph nodes along with the common hepatic artery were also dissected through the same incision. RESULTS: The operations were performed without serious complication. None was converted to laparotomy, and there were no deaths. Metastatic lymph nodes were seen in perigastric nodes and nodes along the left gastric artery in five cases. In five of the 49 patients the macroscopic diagnosis of depth of invasion was underestimated. CONCLUSION: A technique of laparoscopic gastrectomy with lymph node dissection for early invasive gastric cancer is described. A definitive answer concerning the appropriate level of lymph node dissection and the role of laparoscopic gastrectomy in the treatment of more advanced gastric cancer remains to be defined.

Adult↗

PubMed2001

Results of bowel plication in addition to primary anastomosis in patients with jejunal atresia.

BACKGROUND/PURPOSE: Disturbed intestinal transit (DIT) associated with bowel dilation occurs in some postoperative patients with jejunal atresia. Bowel plication (BP) has been introduced to prevent the DIT, but the long-term results of BP are unclear. METHODS: The authors reviewed the preoperative and operative records and postoperative clinical courses (for 2.3 to 7.0 years; mean period, 3.7 years) of 19 jejunal atresia patients, 4 of whom had undergone additional BP with primary anastomosis after dilated bowel resection or tapering jejunoplasty at neonatal surgery. The degree of DIT was evaluated by the clinical symptoms, weight gain, whether reoperation was performed, and duration from the operation to receiving an oral feeding volume of at least 130 mL/kg/d. The patients then were assigned 4 grades (0 to 3). To determine the presence or absence of bowel dilation at the BP site, the plain abdominal x-rays were reviewed. RESULTS: (1) Within 2 months after surgery, 4 patients without BP underwent operation because of severe DIT. The degree of postoperative DIT in patients who had received additional BP at neonatal surgery was less than that in patients without BP (mean grade, 0.50 v. 2.08). (2) The preoperative clinical features, operative method, and postoperative weight gain were almost similar in patients with and without BP. (3) On abdominal x-ray the bowel dilation remained 6 to 12 months after the operation, but was not observed over 1 year after the operation. CONCLUSIONS: In this preliminary study, the addition of BP after tapering jejunoplasty or resection of dilated bowel may be effective in preventing early postoperative DIT. Further study is necessary to evaluate the long-term results of additional BP at neonatal surgery. J Pediatr Surg 36:1752-1756.

Anastomosis, Surgical↗

PubMed2001

An easy method for the intraluminal administration of peppermint oil before colonoscopy and its effectiveness in reducing colonic spasm.

BACKGROUND: Systemic administration of a cholinergic blocking agent or glucagon is used to reduce spasms, but it is inconvenient and sometimes causes side effects. This study is an evaluation of the intracolonic administration of peppermint oil during colonoscopy for the control of colonic spasm. METHODS: Each patient in the treated group (n = 409) was given approximately 200 mL of the solution (a mixture of 8 mL of peppermint oil and 0.2 mL of Tween 80 per 1 L of water with 0.04% indigo carmine) by using a hand pump attached to the accessory channel of the colonoscope. Changes in patient posture were made to distribute the solution. The patients in the control group (n = 36) were given the solution without peppermint oil. RESULTS: A satisfactory spasmolytic effect was seen in 88.5% of the treated patients and in 33.3% of those in the control group (p<0.0001). No adverse effect was observed. The mean time to onset was 21.6 +/- 15.0 seconds, and the effect continued for at least 20 minutes. In patients with irritable bowel syndrome, efficacy was significantly lower (p < 0.0001). CONCLUSIONS: The intraluminal administration of peppermint oil by using a hand pump is a simple, safe, and convenient alternative to the systemic injection of a cholinergic blocking agent or glucagon during colonoscopy.

Adult↗

PubMed2001

Clinical studies of enteritis caused by methicillin-resistant Staphylococcus aureus.

OBJECTIVE: To study the clinical features of methicillin-resistant Staphylococcus aureus (MRSA) enteritis in our surgical ward. DESIGN: Retrospective study. SETTING: Teaching hospital, Japan. SUBJECTS: 16 men and 1 woman who developed MRSA enteritis from January 1995 to October 1999. MAIN OUTCOME MEASURES: Causes and treatments. RESULTS: The underlying diseases were as follows: gastric cancer (n = 13), colorectal cancer (n = 2), recurrent cancer (n = 1) and bowel obstruction following gastrectomy (n = 1). 16 patients were operated on. Two cases were treated with histamine H2 receptor blockers. The mean age of patients was 65 years (range 50-80). In 13 cases MRSA enteritis developed within 6 days of operation. 10 strains of MRSA were isolated from stools, 8 from gastric juice, and 3 from intra-abdominal exudate. 10 patients were treated with vancomycin given through a nasogastric tube and 2 through a nasogastric tube and by drip intravenous infusion. 15 patients survived and 2 died. CONCLUSIONS: Patients who are given broad-spectrum antibiotics and whose gastric secretion is reduced are at high risk of MRSA enteritis. In the surgical ward, early diagnosis, treatment, and isolation are essential for patients with MRSA enteritis.

Aged↗

PubMed2001

Effect of duodenectomy on gastric motility and gastric hormones in dogs.

OBJECTIVE: To test the hypothesis that the duodenum is required to coordinate interdigestive insulin secretion with gastrointestinal motility and to determine whether duodenectomy alters the interdigestive cycles of plasma motilin and insulin levels and their relations to insulin secretion and motility. METHODS: Adult mongrel dogs were chronically implanted with force transducers in the stomach, duodenum, and upper jejunum to monitor contractile activity. Eight healthy mongrel dogs were divided into control and duodenectomized dogs. Insulin secretion, gastrointestinal motility, and plasma concentrations of motilin during the interdigestive period were measured in normal and duodenectomized dogs. RESULTS: After duodenectomy, no obvious phase III contractions were seen in the gastric antrum, but migrating phase III contractions were seen in the upper jejunum. The plasma motilin concentration did not fluctuate as it does in normal dogs, and remained low. After duodenectomy, insulin secretory cycles were not coordinated with either cycles of interdigestive motility or the plasma concentration of motilin. Exogenous motilin administration stimulated endogenous insulin release significantly compared with saline-treated controls. The contractile response of the stomach to exogenous motilin after duodenectomy was similar to that of intact dogs. CONCLUSIONS: Duodenectomy disrupts the relation between cycles of both interdigestive gastrointestinal motility and insulin secretion. These effects of duodenectomy may be attributable to interruption of the duodenopancreatic neural connections, hormonal abnormalities, or loss of vagus-sensitive humoral factors. The duodenum, which stores motilin, seems to play an important role in the relations between gastric migrating motor complexes and the concomitant increase of insulin secretion in fasted dogs. The mechanism responsible for the effect of motilin in both duodenectomized and normal dogs may involve a cholinergic pathway.

Animals↗

PubMed2001

Clinical characteristics of acute hemorrhagic rectal ulcer.

BACKGROUND: Acute hemorrhagic rectal ulcer (AHRU) occurs suddenly with painless, massive, fresh rectal bleeding in elderly, bed-ridden patients who have a serious primary disease. There have been several reports on AHRU in Japan, but in Western countries, there have been none. We examined the clinical characteristics of four cases, and we report on AHRU in Western countries. STUDY: The medical records and endoscopic findings in four patients with AHRU seen during a 3-year period were reviewed. The diagnosis of AHRU was established by clinical symptoms, endoscopic examination, and other methods. RESULTS: All of the patients were elderly and bed-ridden and all had sudden onset of massive, fresh rectal bleeding without pain. Sigmoidoscopic examination of all patients showed a shallow or irregular bleeding ulcer in the lower rectum. In three cases, the clinical course was uneventful. In the other case, massive, fresh rectal bleeding recurred but transanal ligation was effective. CONCLUSIONS: When painless, massive, fresh rectal bleeding occurs in elderly and bed-ridden patients, it is important to carefully examine the lower rectum, as there is a strong possibility of AHRU.

Aged↗

PubMed2001

Intestinal motility in an in vivo rat model of intestinal ischemia-reperfusion with special reference to the effects of nitric oxide on the motility changes.

BACKGROUND: To clarify the relation between intestinal ischemia-reperfusion (IR) and dysmotility, the authors investigated changes in the motility pattern in the duodenum and jejunum in an in vivo rat model of IR when artery- (and vein-) fed jejunum was clamped transiently. The authors also studied the effect of nitric oxide on the motility changes in this model by means of the administration of L-NAME (N(G)-nitro-L-arginine methyl ester) or S-methylisothiourea sulfate (SMT). MATERIALS AND METHODS: A force transducer was sutured onto the serosal side of the duodenum or jejunum. After a 3-to 4-day recovery period, contractions were recorded during periods of preischemia, ischemia (60 minutes), and reperfusion (90 minutes). An intestinal IR was produced by clamping and releasing the mesenteric artery and vein with artery forceps. RESULTS: In the jejunum, there was a prolongation in the duration of contraction and there were decreases in the number of contractions (NC) during the IR. When treated with L-NAME, no decrease in the NC was observed during the 45 to 90 minutes after reperfusion. S-methylisothiourea sulfate did not affect the IR-induced motility changes significantly. In the duodenum, there was a prolongation in the duration of contraction and a decrease in the NC and AC only during the reperfusion. L-NAME or S-methylisothiourea sulfate inhibited the decreases in the NC during the reperfusion. CONCLUSIONS: Intestinal IR causes motility changes in the ischemic site during the IR and in the nonischemic site during the reperfusion. The IR-induced motility changes partly depend on nitric oxide production.

Animals↗

PubMed2001

Dermoid cyst of the colon.

Dermoid cysts are benign cystic teratomas lined by skin and epidermal appendages. We report a dermoid cyst occurring in a 26-year-old female whose chief complaint was irregular vaginal bleeding. Abdominal magnetic resonance image demonstrated a space-occupying lesion in the right lower abdomen. The mass showed hyperintensity on the T2 image and the signal was homogeneous for the interior. During abdominal surgery we made the diagnosis of subserous tumor of the colon and resected the ileocecal portion of the colon. The tumor measured 5.4 x 4.8 x 3.5 cm and was soft and elastic. On cross section, a unilocular cyst filled with atheromatous material was found. Pathological examination revealed a dermoid cyst. In the view of this diagnosis, a simple excision would have been an adequate treatment.

Adult↗

PubMed2001

Mechanism of growth inhibition by tungsten in Acidithiobacillus ferrooxidans.

Cell growth of three hundred iron-oxidizing bacteria isolated from natural environments was inhibited strongly by 0.05 mM, and completely by 0.2 mM of sodium tungstate (Na2WO4), respectively. Since no great difference in the level of tungsten inhibition was observed among the 300 strains tested, the mechanism of inhibition by Na2WO4 was studied with Acidithiobacillus ferrooxidans strain AP19-3. When resting cells of AP19-3 were incubated in 0.1 M beta-alanine-SO4(2-) buffer (pH 3.0) with 0.1 mM Na2WO4 for 1 h, the amount of tungsten bound to the cells was 12 microg/mg protein. The optimum pH for tungsten binding to the resting cells was 2 to approximately 3. Approximately 2 times more tungsten bound to the cells at pH 3.0 than at pH 6.0. The tungsten binding was specifically inhibited by sodium molybdenum. However, copper, nickel, cadmium, zinc, manganese, cobalt, and vanadate did not disturb tungsten binding to the resting cells. The iron-oxidizing activity of AP19-3 was inhibited 24, 62, and 77% by 1, 5, and 10 mM of Na2WO4, respectively. Among the components of iron oxidation enzyme system, iron:cytochrome c oxidoreductase activity was not inhibited by 10 mM of Na2WO4. In contrast, the activity of cytochrome c oxidase purified highly from the strain was inhibited 50 and 72%, respectively, by 0.05 and 0.1 mM of Na2WO4. The amounts of tungsten bound to plasma membrane, cytosol fraction, and a purified cytochrome c oxidase were 8, 0.5, and 191 microg/mg protein, respectively. From the results, the growth inhibition by Na2WO4 observed in A. ferrooxidans is explained as follows: tungsten binds to cytochrome c oxidase in plasma membranes and inhibits cytochrome c oxidase activity, and as a results, the generation of energy needed for cell growth from the oxidation of Fe2+ is stopped.

Culture Media↗

PubMed2000

Circulating soluble Fas ligand in patients with gastric carcinoma.

BACKGROUND: The Fas/Fas ligand (FasL) system is involved in cancer cell death induced by the immune system. Most of the tumors may escape the host immune attack by imitating themselves as immune-privileged sites by overexpressing FasL. FasL is synthesized as a membrane-bound protein that can be cleaved to the soluble isoform (sFasL). The objectives of this work were to determine whether the serum concentrations of sFasL in patients with gastric carcinoma were correlated with clinicopathologic features and survival rates. METHODS: The authors examined the circulating sFasL concentration in 43 healthy people and 166 primary gastric carcinoma patients at the time of diagnosis by enzyme linked immunoadsorbent assay. The results were categorized by clinical and histopathologic variables. RESULTS: The serum sFasL levels of healthy subjects were all less than 0.1 ng/mL. Among the 166 gastric carcinoma patients, the median concentration of sFasL was 0.04 ng/mL. There were no significant differences between the healthy controls and the gastric carcinoma patients group (P = 0.738). The sFasL levels were significantly increased in patients with gastric carcinoma in a manner reflective of the disease stages such as the depth of tumor invasion, lymph node metastasis, and distant metastasis. The authors determined the cutoff value (0.08 ng/mL) as a 90th percentile of healthy controls. The survival analysis demonstrated that patients with high sFasL levels had a worse prognosis than those with low levels (P < 0.001). Multivariable analysis confirmed that the sFasL concentration was an independent prognostic indicator of overall survival (P = 0.041). CONCLUSIONS: Our results indicated that sFasL concentrations could not be a new marker for early detection of gastric carcinoma but a prognostic tumor marker for the assessment of the progression of advanced gastric carcinoma.

Adult↗

PubMed2000

A novel model for invasion of cancer cells using the submucosal layer of the human stomach.

An in vitro model for studying the invasion mechanism of cancer cells was established using the submucosal layer of the human stomach. Submucosa prepared from a surgical specimen was maintained in an organ culture. The cytoarchitecture of the cultured submucosa remained well preserved; viability remained for over 2 weeks. When human gastric cancer cell lines MKN45, MKN74, and Kato III were seeded onto the submucosal slices, cancer cells of MKN45 and KATO III invaded the submucosa 3 days after inoculation. However, MKN74 cells were not seen in the submucosal slices. Our invasion model, which mimics the in vivo conditions of the submucosa of human stomach, may make it possible to analyze actual events of human gastrointestinal malignant cell invasion in normal submucosa in vitro. The usefulness of our invasion model lies in the choice of the submucosal layer of the human stomach as the host tissue. The histarchitecture of the submucosal slices indicates that the model has potential for studies of the mechanism of interactions between carcinoma cells and host tissue similar to interactions that may occur in vivo. Moreover, this method allows the continuous microscopic observation of cells within the living submucosa. Using this model, a novel approach to controlling the local invasion of tumor cells may lead to a promising, radical cure for these intractable neoplasms. Our model system is an in vitro model that is facile, inexpensive, and experimentally manipulative.

Adult↗

PubMed2000

Expression of Ets-1 angiogenesis-related protein in gastric cancer.

The Ets-1 transcription factor plays important roles in invasiveness and angiogenesis. Using automated immunodetection, we investigated Ets-1 expression and tumor microvessel density (MVD) in relation to the clinical significance of gastric cancer. The MVD of Ets-1-positive tumors was higher than that of Ets-1-negative tumors, but the difference was insignificant. The survival rate of patients with high-MVD tumors was significantly poorer than those with low-MVD tumors, and the survival rate of patients with Ets-1-positive tumors was significantly poorer than that of those with negative ones. These results indicate that Ets-1 expression is a useful marker for predicting the outcome for patients with gastric cancer.

Adenocarcinoma↗

PubMed2000

Association of DNase I phenotype 2 with colorectal carcinoma risk in Japanese populations.

We have already demonstrated a significant association of deoxyribonuclease I (DNase I; EC3.1.21.1) polymorphism with liver disease and gastric carcinoma. The aim of this study was to determine whether DNase I polymorphism is closely related to the incident of colorectal carcinoma. We have found a close statistical association between colorectal carcinoma and a high frequency of DNase I phenotype 2 in Japanese populations. However, there was no significant difference in the phenotype distribution between a group of patients with benign diseases and controls. These findings suggest that DNase I phenotype 2 may be potentially useful for identifying patients who are at risk of harboring or developing colorectal carcinoma.

Adult↗

PubMed2000

Expression of ets-1 transcription factor is correlated with penetrating tumor progression in patients with squamous cell carcinoma of the esophagus.

BACKGROUND: The Ets-1 transcription factor is proposed to play a role in tumor invasion. To evaluate the biologic significance of Ets-1 in the progression of squamous cell carcinoma of the esophagus, the authors investigated Ets-1 expression in tumors from 90 patients using immunohistochemical procedures. METHODS: The Ets-1 positive ratio (Ets-1 ratio) was determined in the center and deep margin areas of invasive sites and in the center and outer edge areas of intraepithelial spread contiguous with invasive disease. RESULTS: Ets-1 expression was heterogeneous within tumor tissue. The Ets-1 ratio was significantly higher at invasive sites compared with intraepithelial spread sites, and at deep margin areas compared with center areas (P < 0.0001 and P < 0.05, respectively, by two-way analysis of variance). No differences were noted in the Ets-1 ratio at the deep margin areas at each depth of invasion. Investigating the Ets-1 ratio at deep margin areas in each pathologic phenotype, the ratio of the small nest type was found to be higher than that of the large nest type (P < 0.0001). CONCLUSIONS: The authors propose that Ets-1 plays an important role in penetrating tumor progression, even very early in the invasive process (especially in the case of infiltrative invasive type tumors) at the deep margin areas of invasive sites in patients with squamous cell carcinoma of the esophagus.

Aged↗

PubMed2000

Mutation and expression of the metastasis suppressor gene KAI1 in esophageal squamous cell carcinoma.

BACKGROUND: KAI1/CD82, a tumor metastasis suppressor gene, is correlated inversely with the progression and invasion of several tumors. It also has been reported that the KAI1 gene is related to the tumor suppressor gene p53. This study was performed to clarify the correlation between KAI1/CD82 expression and clinicopathologic characteristics and p53 expression in patients with esophageal squamous cell carcinoma (ESCC). The authors also investigated mutation of the KAI1 gene coding region to determine whether this may reduce KAI1 expression in ESCC. METHODS: Using immunohistochemistry with anti-KAI1 polyclonal antibody and monoclonal antibody against p53, KAI1/CD82 and p53 expression were detected in 55 patients with ESCC who had undergone surgery. The authors examined the KAI1 gene mutation in 22 patients with ESCC by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis and DNA sequencing. RESULTS: KAI1/CD82 expression was positive in 36 of 55 patients (65.5%). There was a significant inverse correlation between KAI1/CD82 expression and regional lymph node metastasis (P = 0.0045), distant metastasis (P = 0.0092), the number of lymph node metastases (P = 0.0019), and pathologic stage (P = 0.0046). The survival rates of KAI1/CD82 negative patients were poorer than those of positive patients (P = 0. 024). The correlation between KAI1 positive and p53 positive tumors was not statistically significant. None of the 22 patients with ESCC showed mutation of the KAI1 gene by PCR-SSCP. In one patient, there was polymorphism in the SSCP assay and DNA sequencing. CONCLUSIONS: The authors demonstrated immunohistochemically that the expression of KAI1 protein appeared to be correlated with lymph node metastasis. Mutation does not seem to be a mechanism for dysregulation of the KAI1 protein in ESCC.

Adult↗