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Biomedical subjects

K Sasajima

Publications and source records attributed to K Sasajima.

At least 55 records · Page 3Linked to original sources
PubMed1990

Prognostic significance of intramural metastasis in patients with esophageal carcinoma.

Clinicopathologic data on 201 patients who underwent surgical resection of esophageal squamous cell carcinoma, with or without intramural metastasis (IM), were analyzed to determine the significance of IM for patient prognosis and survival. In 24 (11.9%) patients IM was observed. There was one (1.4%) in 74 cases in Stage 0, I, or II, and 23 (18.1%) in 127 cases in Stage III or IV, based on the new pTNM classification. There was a statistically significant Cox-Mantel test difference in the percentage survival curves of the patients, both in all stages (P less than 0.01) and in only Stages III and IV (P less than 0.05), as a function of the presence or absence of IM. Lymph node metastasis and distant organ metastasis were observed in 22 (91.7%) and seven (29.2%) of the 24 patients, respectively, with IM and in 111 (62.7%) and 13 (7.3%) of the 177 patients without IM. For both types of metastasis, the incidence was significantly lower in the patients without IM (P less than 0.01). Seventy percent of IM on the proximal side was detected during preoperative clinical examination. These data indicate that the presence of IM is an important factor for preoperative and postoperative evaluation of the prognosis of patients with esophageal squamous cell carcinoma.

Adult↗
PubMed1990

Assessment of adventitial involvement of esophageal carcinoma by endoscopic ultrasonography.

The adventitial involvement (AI) of esophageal squamous cell carcinoma in 20 patients was analyzed by endoscopic ultrasonography (EUS) and computed tomography (CT). The findings were compared with the histologic evidence of tumor invasion in the resected specimens. AI was detected as an irregularity or interruption of the third layer of the esophageal wall on ultrasound examination. The overall accuracy in the assessment of depth of tumor invasion by EUS and CT scan was 80% and 68%, respectively. EUS diagnosed AI in 17 patients and detected direct tumor invasion of either the aorta, trachea or pericardium in 7 of them. In 4 patients who had severe stenotic lesions, EUS underestimated the depth of tumor invasion when compared to the histologic findings. Overall, these results, show that EUS when combined with CT scanning is a useful means of preoperatively evaluating tumor invasion in patients with esophageal carcinoma.

Adult↗
PubMed1990

Differential effects of cigarette smoke condensate and its fractions on cultured normal and malignant human bronchial epithelial cells.

The differential effects of cigarette smoke condensate (CSC) and its fractions (neutral, basic, and acidic fractions) on proliferation and squamous differentiation of normal human bronchial epithelial (NHBE) cells versus human lung carcinoma cells were investigated. CSC, and the neutral and acidic fractions inhibited cellular proliferation more than the basic fraction. When compared to the acidic and basic fractions, CSC and the neural fraction were more effective in causing squamous differentiation of NHBE cells and inhibiting specific binding of phorbol dibutyrate (PDBU). There were no significant changes in ionized cytosolic calcium concentration when NHBE cells were treated with CSC. In contrast to the normal epithelial cells, neither HUT-292 nor the 3 other carcinoma cell lines examined showed marked squamous morphological changes when exposed to either CSC or its fractions and the carcinoma cells were more resistant to their inhibiting effects on cellular proliferation. These results are consistent with the hypothesis that differential effects of tobacco smoke components on cellular proliferation may allow clonal expansion of preneoplastic and neoplastic human bronchial epithelial cells during lung carcinogenesis.

Bronchi↗
PubMed1990

Mucoepidermoid carcinoma of the esophagus: report of two cases and review of the literature.

The clinicopathological manifestation of mucoepidermoid carcinoma of the esophagus are reported in two cases. Barium swallow and endoscopy revealed infiltrating and constricting appearances. The tumors were grossly indurated, with or without ulceration. Histologically, the tumors were composed of a mixture of glandular cells which contained signet ring cells and squamous cells. In two cases, the tumor cells invaded into the adventitia, with lymph node metastasis. Two patients died of wide-spread metastasis within 1 year after operation. Our results and previous reports suggest that mucoepidermoid carcinoma of the esophagus is extremely aggressive and has a poor prognosis.

Carcinoma↗
PubMed1990

Serum neuron-specific enolase as a marker of small-cell carcinoma of the esophagus.

We monitored the changes in serum neuron-specific enolase (NSE) level in two patients with esophageal small-cell carcinoma (SCC) during the course of treatment by chemotherapy or surgery, with radiation. Serum NSE levels at diagnosis were 18.5 and 58.0 ng/ml. In both cases, after treatment the serum NSE level decreased to within normal range (less than 10.0 ng/ml), concurrent with reduction in the size of the tumor. However, with relapse of the disease, the serum NSE increased to 24.3 and 200.0 ng/ml, respectively. One patient died of lung and skin metastases 4 months after surgery; the other, who developed brain metastasis, was treated again with chemotherapy by the same regimen. The serum NSE level decreased to 13.0 ng/ml, and the symptoms improved. These results indicate that there is a correlation between serum NSE level and remission or relapse of the disease after treatment in patients with SCC of the esophagus, as with SCC of the lung.

Aged↗
PubMed1990

[Immunohistochemical study on epidermal growth factor and its receptor in human pancreatic carcinoma].

We investigated immunohistochemical expressions of the epidermal growth factor (EGF) and the epidermal growth factor receptor (EGFR) in 25 cases of pancreatic carcinoma, including 13 cases of metastatic lymph nodes. EGF and EGFR were stained mainly in the cytoplasm and on the surface of some pancreatic carcinoma cells, with positive rates of 18/25 (72%) and 9/25 (36%) respectively. In all cases EGFR was noted only when EGF was also detected. EGF and EGFR were stained frequently in differentiated types. In metastatic lymph nodes, EGF and EGFR were found in 54% and 15% respectively, and they were detected only when they were also noted in the same patient's primary lesions. EGF and EGFR were found more frequently in Stages III and IV than in Stage II. These results emphasize that EGF and EGFR may promote both the proliferation and the differentiation of human pancreatic carcinoma cells, as in other sites.

Adult↗
PubMed1990

Preoperative assessment of the length of the stomach for esophageal substitution.

This method is easily applied and useful for the estimation of the actual length of the gastric tube in situations of reconstruction after subtotal esophagectomy. The actual length of the gastric tube was almost identical to that of the stomach which was measured from the preoperative roentgenogram. In the end, a safe reconstruction by this approach will decrease the operative mortality rate caused by the leakage of the anastomosis.

Adult↗
PubMed1989

Polypoid squamous cell carcinoma of the esophagus.

Since 1971, 111 patients with esophageal carcinoma have undergone esophagectomy at the affiliated hospitals of Nippon Medical School. Of the 101 patients with ordinary squamous cell carcinoma, seven (7%) had intraluminal polypoid masses, endoscopically, and radiologically. The criteria used to select cases were as follows: (1) a size greater than 3 cm, (2) an intraluminal polypoid or pedunclated tumor, and (3) absence of wall construction and ulceration. Four of the seven polypoid cases have survived more than 5 years. One has lived more than 3 years. The 5-year survival rate of those patients with the polypoid type was 71%, but it was only 11% for the other types (P less than 0.05). Age, sex, size or location of the tumor, histologic grade, or lymph node metastasis did not affect survival. Only the incidence of adventitial involvement was significantly lower for the polypoid type. These results indicate that polypoid-type squamous cell carcinoma of the esophagus has a fairly good prognosis after surgery.

Aged↗
PubMed1989

Morphological heterogeneity of esophageal carcinoma.

To clarify the morphological heterogeneity of esophageal carcinoma, the adenocarcinomatous, basaloid, and sarcoma-like components of 178 esophageal carcinomas were studied with regard to histopathology, mucin histochemistry, immunohistochemistry, and ultrastructure. Adenocarcinomatous components with mucicarminophilic cells and/or glandular structures, basaloid components, and sarcoma-like components were found in 55 lesions (30.9%), 17 lesions (9.3%), and five lesions (2.8%) respectively. Carcinoembryonic antigen staining was positive in 52 lesions (29.2%), secretory component staining was positive in 15 (8.4%), and lactoferrin staining was positive in 12 (6.7%). Eight intraepithelial carcinomas were found to have no adenocarcinomatous components, and two intramucosal carcinomas had adenocarcinomatous components in the invasive portions. These findings strongly suggest that the adenocarcinomatous components do not arise from the ductal epithelium, but occur during the process of invasion. There were no significant clinicopathological differences between the carcinomas with adenocarcinomatous components and those without. Ultrastructurally, the adenocarcinomatous components were seen to possess intracellular microcysts, intercellular lumina, and bundles of tonofilaments, having features of both glandular and squamous epithelia. On the basis of the concept that the basaloid components are histological variants of squamous cell carcinoma and that sarcoma-like components arise from mesenchymal metaplasia of squamous cell carcinoma, it is possible that the three components may originate from the squamous component. The present study thus demonstrated a high incidence of histological variation among esophageal carcinomas.

Adult↗
PubMed1989

Immunohistochemical localization of Na+, K+-ATPase in human normal and malignant pancreatic tissues.

Localization of Na+, K+-ATPase in the human pancreas was investigated immunohistochemically using rabbit antisera against Na+, K+-ATPase of the human kidney. The reaction product existed only on the luminal surfaces of both centroacinar and ductal cells in normal pancreatic tissue, whereas in chronic pancreatitis the localization of Na+, K+-ATPase was found frequently on the luminal surfaces of both centroacinar and ductal cells, and on the basolateral surfaces of some ductal cells. However, in acinar cells, the distribution of Na+,K+-ATPase was not detected in either the normal pancreas or chronic pancreatitis. In pancreatic carcinoma tissues, Na+,K+-ATPase existed very rarely in malignant cells. These results indicate that Na+,K+-ATPase is immunohistochemically localized on the membranes of centroacinar and ductal cells of the human pancreas, and that the antigenicity of Na+,K+-ATPase in pancreatic carcinoma cells differs from that in normal cells.

Chronic Disease↗
PubMed1988

Multiple organ failure without sepsis following surgical treatment of advanced gastric carcinoma.

Two patients, a 58-year-old male and a 41-year-old female, who had poorly differentiated adenocarcinoma with signet ring cells of the stomach, developed progressive multiple organ failure following their surgical treatment, even though they did not have any direct surgical complications. Their abdominal explorations revealed primary gastric tumors with deep infiltration and metastases to the regional lymph nodes. Their clinical courses were characterized by acute renal failure and respiratory distress associated with disseminated intravascular coagulation. Histopathological examination at autopsy revealed diffuse cortical necrosis of the kidneys and marked congestion, edema, and hemorrhage with or without alveolar fibrosis of the lungs. Fibrin thrombi in the lesions of the kidneys and lungs strongly suggested the existence of disseminated intravascular coagulation. It is likely that the widely spreading cancer cells themselves produced the subclinical background for disseminated intravascular coagulation, which appeared to play an important role in the development of the multiple organ failure.

Adenocarcinoma, Mucinous↗
PubMed1988

Rapid growth of a pseudosarcoma of the esophagus.

The growth of a pseudosarcoma of the esophagus was observed chronologically by serial esophagography. Esophagograms taken 12 and 6 months prior to diagnosis showed no abnormalities. At diagnosis, the tumor in the lower esophagus had a polypoid and nodular surface with a stalk, and it was approximately 3 cm in diameter. Four months later, the tumor had increased in size to 4 cm in diameter. The tumor was 5 cm in length and incarcerated into the stomach with an elongated stalk at operation. The growth curve was linear on semilogarithmic paper; its doubling time was calculated as 2.2 months. The surgical specimen showed squamous cell carcinoma and spindle cell sarcoma-like elements that comprised the greater part of the tumor. The sarcoma-like elements had metastasized to the abdominal lymph nodes. These findings confirm that this polypoid tumor grows rapidly.

Aged↗
PubMed1988

Oat cell carcinoma of the esophagus with multiple differentiation.

We report an esophageal oat cell carcinoma with multiple differentiation in a 75-year-old man who had a flat lesion with nodular projections in the middle third of the esophagus. Most of the resected tumor consisted of small round cells that contained neurosecretory granules, tonofilaments, and desmosomes. The tumor cells invaded only into the submucosa with extensive intraepithelial spreading. Foci of adenoid cystic, glandular, and squamous differentiation were found in some areas, and had continuity with the intraepithelial spreading carcinoma. Transition was also found. These findings suggest that the small cells had a propensity to undergo further adenoid cystic, glandular, and squamous differentiation.

Aged↗
PubMed1987

Intraductal spread of esophageal squamous cell carcinoma.

In order to determine the pathways of tumor dissemination in esophageal carcinoma, 175 lesions of squamous cell carcinoma of the esophagus were studied histopathologically and by electron microscope in relation to the intraepithelial spread and involvement of the esophageal glands by the carcinoma. The study compared vessel invasion and lymph node metastasis. Intraepithelial spread was seen in 111 lesions (63%) and gland duct involvement in 33 lesions (19%). Gland duct involvement was observed in 30% of the lesions positive for intraepithelial spread. In the intramucosal carcinomas, gland duct involvement was observed in 24%. Even in a very small carcinoma 7 X 5 mm in size, ductal spread was detected. This carcinoma did not reach the submucosa through stromal invasion. Patients with intramucosal carcinoma showed low incidence (20%) of lymphatic and/or blood vessel invasion and no incidence of lymph node metastasis. Examination by electron microscope showed that the cancer cells of the intraepithelial spread entered the duct by raising the normal ductal epithelium in the ductal cavity although the basal lamina was retained. Normal gland duct cells and cancer cells were either attached with desmosomes directly or were separated by degenerated epithelial cells. A high incidence of ductal involvement of the esophageal glands was seen in squamous cell carcinoma of the esophagus, indicating its possible importance as a route to the deep tissue in the early stage of this carcinoma.

Adult↗
PubMed1987

Effects of tumor promoters and cocarcinogens on growth and differentiation of cultured human esophageal epithelial cells.

The acute effects of 12-O-tetradecanoylphorbol-13-acetate [(TPA) CAS: 56937-68-9], T-2 toxin (CAS: 21259-20-1), capsaicin (CAS: 404-86-4), cigarette smoke condensate (CSC), and ethanol (CAS: 3807-77-0) were examined in secondary cultured human esophageal epithelial cells in serum-free LHC-8 medium. Effects were evaluated by morphology and measurement of clonal growth rate (population doublings per day), cross-linked envelope (CLE) formation, and the enzymatic activities of ornithine decarboxylase (ODC) and plasminogen activator (PA). All compounds tested were inhibitory to clonal growth; concentrations causing 50% growth inhibition were estimated as 10 nM TPA, 6 nM T-2 toxin, 40 microM capsaicin, 8 micrograms CSC/ml, 540 mM ethanol, and 0.8 microgram CSC/ml with 220 mM ethanol. None of the compounds tested induced CLE formation, although calcium ionophore (A23187) could induce CLE in at least 60% of the cells. TPA (10 and 100 nM) decreased the ODC activity of cells, and capsaicin (100 microM) induced ODC by 220%. TPA (1-100 nM) and capsaicin (100 microM) also induced PA activity. Slight increases in ODC activity by CSC (10 micrograms/ml), CSC (1 microgram/ml) with ethanol, and T-2 toxin (1 nM) were observed, but PA activity was not affected by these compounds. The results indicated that the response of human esophageal epithelial cells to TPA is both similar to and different from that reported for human epidermal and bronchial cells in vitro. Enhancement of PA activity and decrease in ODC by TPA are found in all three human epithelial cell types. However, these changes are not associated in esophageal cells with increased CLE formation as reported in studies with the use of bronchial and epidermal epithelial cells. The results from these acute studies provide the basis for designing in vitro carcinogenesis investigations using these agents.

Capsaicin↗
PubMed1985

Light and electron microscopic studies of perineural invasion by esophageal carcinoma.

Light and electron microscopic findings on perineural invasion by human esophageal squamous cell carcinoma are reported. Perineural invasion was observed histologically in 30 of a total of 129 cases (23%) of esophageal squamous cell carcinoma and in 11 of the 24 cases (46%) in which tumors infiltrated other organs by passing through the esophageal adventitial layer. Electron microscopic observation showed that the perineurium of peripheral nerves was completely surrounded by carcinoma cells and that marked degeneration and loss of perineural cells occurred. Irregularly thickened basal laminae were detected in the perineurium. For nerves incompletely surrounded by carcinoma tissue, the free portion of the perineurium revealed degenerative findings similar to those for completely surrounded nerves. Cytoplasmic projections of the leading margin of the invading cancer tissue were located in the degenerated perineurium, contained many lysosomes, and were not always surrounded by basal laminae. These observations suggest that invading carcinoma tissue actively contributes to the degeneration of the perineural sheath and that the special pattern of carcinoma tissue surrounding the peripheral nerves results from infiltration along the degenerated sheath of the perineurium.

Aged↗
PubMed1984

Junctions between intraepithelial carcinoma and non-neoplastic tissue of the esophagus. Light and electron microscopic studies.

This report describes light and electron microscopic observations in 11 patients with intraepithelial carcinomas concomitant with invasive squamous cell carcinomas of the esophagus. The junctions between the intraepithelial carcinomas and non-neoplastic tissues were examined using an electron microscope. Vertical sections through the basal laminae revealed intraepithelial carcinomas with bulky outgrowths and simple replacement histological patterns. The bulky outgrowths contained many pseudopodial cytoplasmic projections from the tumor cells through the basal laminae, while the simple replacement patterns included rare small breaks in the basal laminae. Horizontal sections parallel to the basal laminae showed that the cells of the poorly differentiated squamous cell carcinoma were readily distinguishable from the non-neoplastic cells in the surface layer of the esophageal epithelia and distinctly smaller and darker than the normal prickle cells. At most of the junctions, mesenchymal cells, degenerated cells, and amorphous material separated the tumor cells from the non-neoplastic epithelial cells. However, tumor cells were occasionally attached directly to normal epithelial cells with well-developed desmosomes. Ductal involvement of the carcinomas was found in the submucosal esophageal gland proper. The tumor cells invaded between the ductal cells and basal laminae, and neoplastic cells were also directly attached to the benign ductal cells by poorly-developed desmosomes. The host-tumor junctions in the intraepithelial carcinomas of the human esophagus consisted of basal laminae with hemidesmosomes and pseudopodial projections, mesenchymal cell accumulations and direct attachments with desmosomes.

Carcinoma↗