Quantitative analysis of factors in recurrence of hepatocellular carcinoma.
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Biomedical subjects
Publications and source records attributed to T Monna.
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The effectiveness of BRM (biological response modifier) for primary liver cancer was investigated in a prospective randomized and well controlled study. The protocol consisted of 3 groups: 1) Tegafur oral administration only, 2) OK-432 i.v. plus Tegafur, and 3) PSK oral application plus Tegafur. One hundred seventy-two Japanese patients were entered. The results revealed that BRM addition was more effective than Tegafur therapy alone with regard to tumor regression and the results of clinical examinations, but that there was no difference in subjective symptoms between the use of BRM and the other regimes. As to prognosis, patients given PSK survived longer than those given Tegafur alone, but OK-432 group had the same survival rate as the other two groups as a whole. The relationship among the three groups with regard to survival time, was similar to that of their respective total efficacies. Between the three groups, there was a significant difference in the incidence of adverse effects. The difference was sustained with the occurrence of fever symptoms as a result of OK-432 stimulation, with and BRM therapy decreased the gastro-intestinal side effects in comparison with the control group.
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Mouse interferon (alpha + beta) given to mice by intraperitoneal injection suppressed both the accumulation of putrescine and stimulation of DNA synthesis in liver caused by partial hepatectomy. The suppression of DNA synthesis was completely reversed by exogenous putrescine. The same results were obtained when core 2',5'-oligoadenylate instead of interferon was given to partially hepatectomized mice. These results suggest that interferon inhibits putrescine formation through elevating the 2',5'-oligoadenylate level and thus inhibits DNA synthesis in the regenerating liver.
Histopathological liver changes resembling primary biliary cirrhosis were induced in an experimental animal model. A special strain of rabbit received an antigen prepared from scrapings of bovine gallbladder mucosa. Eventually, 47 out of 84 antigen-treated rabbits displayed histopathological liver features resembling those of chronic non-suppurative destructive cholangitis as seen in humans. In addition, granuloma formation, ductular proliferation and fibrosis were seen in some cases. However, advanced lesions consistent with micronodular cirrhosis have not been found. Lymphocytes seemed to play an important role triggering early pathogenetic mechanisms, judging from the presence of lymphocytes invading the basement membrane of the affected bile ducts. Furthermore, we observed by electron microscopy that the epithelial cells of the involved bile ducts revealed both mitochondrial swelling and dilatation of endoplasmic reticulum cisternae. In summary, our experimental animal model offers interesting possibilities regarding the study of pathogenesis and development of primary biliary cirrhosis.
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A nationwide survey using questionnaires was carried out concerning lupoid hepatitis and related diseases (518 cases) during the 8-year period from January, 1975 to December, 1982. The following results were obtained. A total of 253 cases of autoimmune hepatitis, consisting of 97 lupoid hepatitis and 156 lupoid type CAH, were reported. Autoimmune hepatitis was overwhelmingly predominant in females, while male cases of B type CAH with a gamma-globulin level of more than 2 g/dl significantly outnumbered female CAH cases of the same type. The liver function tests at the first examination demonstrated that transaminases, total bilirubin, ICG (R15) and gamma-globulin were increased, and ChE was decreased in lupoid hepatitis. Lupoid type CAH showed a close similarity with lupoid hepatitis rather than to the nLnB type or B type with regard to liver function. Of the 289 patients who could be followed up, 280 cases (97%) received steroid hormones, and 247 (85%) received no another drug. Immunosuppressive treatment was also performed in 40% of the HBs antigen-positive cases of B type CAH. The efficacy was about 90% in the lupoid hepatitis group as well as in the lupoid type CAH group. It was no greater than approximately 70% in any other group. Analysis of survival revealed the following: 1) The cumulative survival rates of autoimmune hepatitis was lowest among the different types of CAH. 2) Patients who had a high serum level of total bilirubin tended to die sooner than those who had a low level. There was no correlation between the cumulative survival rate and serum gamma-globulin concentration or antinuclear antibody titer. 3) The duration of steroid hormone therapy and the total dosage of immunosuppressants were thought to be important factors affecting the prognosis of autoimmune hepatitis.
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