[Case of double cancer (uterus and paranasal sinus)--additional report].
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Biomedical subjects
Publications and source records attributed to S Oda.
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In 323 of 1,620 patients with gastric cancer, the lesion was > or = 10 cm in maximum diameter. Studies were done with respect to clinicopathologic features and the prognosis. Patients with tumors > or = 10 cm were younger and women patients were more numerous compared to those with tumors < 10 cm. Tumors were more advanced and noncurative resection was usually done for these patients. A multivariate analysis showed that serosal invasion, liver metastasis, lymph node metastasis, operative curability, tissue differentiation, and extended lymph node dissection to be independent prognostic factors. This retrospective study showed that patients with a larger tumor are at an increased risk for tumor advancement and that they will benefit from curative resection and extended lymph node dissection.
Deficient repair of nucleotide mismatches in the genome is considered a major factor in tumorigenesis. Such deficiency is evidenced by alterations in dinucleotide repeats of microsatellite sequences, specifically microsatellite instability (MSI) or replication errors. We investigated the frequency of MSI in human gliomas in terms of patient outcome. Frequency of MSI was estimated by examining five loci on chromosomes 2, 5, 10, 11, and 13 in 31 gliomas using high-resolution fluorescent microsatellite analysis. MSI was found at all loci in only 2 malignant gliomas (6.5%). MSI was detected at the D10S197 locus in 3 of 11 glioblastomas (27.2%) and 4 of 8 anaplastic astrocytomas (50%), while no MSI was detected in low-grade gliomas. Among patients with anaplastic astrocytoma, the 4 with MSI at D10S197 died from local recurrence less than 18 months after surgery, while 3 of the patients without MSI survived for more than 20 months. MSI at D10S197 may be a prognostic marker for patients with anaplastic astrocytomas.
Angiogenesis has an important role in the growth and metastasis of solid tumors. Several angiogenic factors have been identified, one being platelet-derived endothelial cell growth factor (PD-ECGF), which is identical to thymidine phosphorylase (dThdPase). We investigated the activity of dThdPase in 84 samples of 42 human gastric cancers, by liquid chromatography. The dThdPase activity significantly correlated to the microvessel density assessed by immunostaining to CD-31 antigen (P<0.05). Expression of dThdPase has an important role in the promotion of angiogenesis in human gastric cancer.
Four murine MoAbs, KM191(IgM), KM206(IgM), KM230(IgG1) and KM231(IgG1), against human gastric cancer were generated using mice which underwent tolerance treatment to stomach tissues. They exhibited very similar high reactivities to stomach adenocarcinoma cells and low reactivities to normal cells in both membrane binding assay and immunohistochemical analysis. Their antigens were neuraminidase and protease sensitive and existed as macromolecules (1,000Kd) in body fluids. Binding of each antibody was inhibited by the others and KM231 showed the highest binding avidity. When they were used to detect the antigens shed in ascitic fluids and pleural effusions of cancer patients, KM231 allowed the most efficient detection of the antigen. The above results indicated that the four MoAbs bound to closely related epitopes on the same antigen and that the nature of its high binding avidity enabled KM231 to show the greatest efficiency in the detection of the antigen in body fluids. KM231 was applied to serum diagnosis and gave high positive percentages in pancreatic cancer(86%), hepatocarcinoma(87%), gall bladder cancer(50%), and gastric cancer(34%), whereas in healthy persons (0%) and benign diseases except for hepatitis(29%) the percentages were low. KM231 was similar to NS19-9, but quite different from NS19-9 in the high positive percentages of hepatocarcinoma in serum diagnosis.
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Lymph node metastasis is a risk factor for the occurrence of peritoneal dissemination and liver metastasis in patients with gastric cancer. We analysed data on 893 Japanese patients with serosally invasive gastric cancer, with respect to the relation between lymph node metastasis and peritoneal dissemination or liver metastasis. All these patients were treated in our clinics. Lymph node metastasis was evident in 746 patients, and in these patients the tumors were larger, lymphatic and vascular involvement were prominent and rates of peritoneal dissemination and liver metastasis were higher. In 147 patients with no evidence of lymph node metastasis, peritoneal dissemination was seen in 3.4% of cases and there was no liver metastasis. In cases of peritoneal dissemination and in those with liver metastasis, the rate of lymphatic involvement was higher than when there was vascular involvement. Peritoneal dissemination and liver metastasis are likely to be concomitant with lymph node metastasis in cases of serosally invasive gastric cancer. It seems apparent that lymphatic spread leads to peritoneal dissemination and liver metastasis in patients with gastric cancer.
BACKGROUND/AIMS: The natural history of gastric cancer, as to how an early gastric cancer develops into an advanced lesion, is still an open question. In this study, we focused on the gastric cancer invading the muscularis propria, and analyzed the relationship between gross appearance and the biological characteristics of gastric cancer. MATERIALS AND METHODS: One hundred and forty six patients with gastric cancer invading the muscularis propria (pm) were studied with special reference to the macroscopic appearance of the primary tumor; Borrmann type vs. EGC type (advanced gastric cancer simulating early gastric cancer), and to the biologic characteristics such as p53 expression and mitotic activity. RESULTS: Borrmann type comprised 59.6% (87/146) and EGC type comprised 40.4% (59/146) of the cases. Borrmann type cancer was located more commonly in the antral region (71.3%), tended to grow expansively, and had higher rate of vascular vessel invasion and lymph node metastasis. The type of recurrence varied, and the prognosis was poor in patients with Borrmann type cancer. Incidence of p53 overexpression in Borrmann type cancer was 44.1% (15/34), and significantly higher than 25.8% (8/31) in EGC type cancer. Proliferating activity measured by MIB-1 labeling percentage was also higher in Borrmann type (49.8 +/- 11.6 vs. 38.9 +/- 10.9). CONCLUSIONS: These results suggest that Borrmann type and EGC type pm gastric cancers are distinct in their inherent biological nature, and possibly represent the advanced form of penetrating growth (Pen) type and superficially-spreading growth (Super) type, respectively, of early gastric cancers.
More than 20 years have passed since policies for dealing with intractable diseases have been instituted in Japan. This study was carried out to clarify which factors tend to promote a patient's subjective satisfaction with his or her quality of life. The subjects were 62 male and 51 female patients with Parkinson's disease. Their average age was 68.8 years. The results were as follows: 1. Patients placed more importance on trying to understand the pathophysiology of the disease than trying to improve their better-life with the disease. 2. Most male patients received care from a family member, whereas most female patients received care from a non-family member. 3. Multiple logistic regression analysis indicated that a) patients who understand how to improve their better-life with Parkinson's Disease are four times more satisfied(on-a subjective basis)than patients who do not understand how to improve their better-life, and b) patients who have a supportive caregiver are twice as satisfied as those who do not. These findings suggest that, in order to increase the subjective satisfaction of Parkinson's disease patients, it is important for them to have a supportive caregiver and to help them understand how to improve their better-life.