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Biomedical subjects

Y Maehara

Publications and source records attributed to Y Maehara.

At least 145 records · Page 8Linked to original sources
PubMed1995

Complete response of transverse colon carcinoma to S1, a new chemotherapy agent: report of a case.

A complete response to a new chemotherapeutic agent, S1, was achieved in a 64-year-old Japanese man with advanced transverse colon cancer. S1 is a combination of the agents tegafur, 5-chloro-2,4-dihydroxypyridine, and oxonic acid. Because the patient was considered to be a high operative risk due to his poor general condition, S1 was administered at 100 mg/day for 5 days/week over 12 weeks. However, as the serum carcinoembryonic antigen level continued to gradually increase, partial resection of the transverse colon was finally performed. Histopathological study of the resected specimen showed mucin pools in the colon wall with no residual viable cancer cells. No perioperative complications were recognized and the patient is now leading a normal life 6 months after his operation without any signs of recurrence.

Adenocarcinoma↗
PubMed1995

Effectiveness of extended lymphadenectomy in noncurative gastrectomy.

PURPOSE: We examined the efficacy of extended lymph node dissection for prolonging survival in macroscopically or histologically proven incurable gastric cancer. PATIENTS AND METHODS: We analyzed clinico-pathologic data on 119 patients with serosally invasive gastric cancer who underwent noncurative gastrectomy, with respect to the relation between the extent of lymphadenectomy and survival benefit. RESULTS: The 5-year survival rate was significantly higher among patients treated with extensive lymphadenectomy (R2/3) compared to simple gastrectomy (R1). Extensive lymphadenectomy significantly prolonged survival time even after noncurative gastrectomy in cases where there was no evidence of hepatic metastasis, peritoneal seeding, or extensive nodal metastasis beyond the tertiary lymph node, and regardless of the extent of direct invasion to adjacent organs. CONCLUSIONS: Gastrectomy combined with extended lymphadenectomy and/or resection of adjacent organs is recommended for gastric cancer patients without distant metastasis, even when the operation is histologically noncurative. Gastrectomy and perioperative intensive chemotherapy are called for when patients have distant metastasis.

Adenocarcinoma↗
PubMed1995

A simple classification of lymph node level in gastric carcinoma.

BACKGROUND: Because insufficient lymph node examination can cause erroneous listing of earlier-nodal-stage gastric carcinoma (stage migration phenomenon), surgical results must be evaluated based on a highly accurate examination of the dissected lymph nodes. To establish a simple and useful classification of lymph node level, we analyzed the frequency and distribution of lymph node metastasis by using curatively treated node-positive gastric carcinoma. PATIENTS AND METHODS: Various clinicopathologic data were analyzed with reference to the degree of lymph node metastasis by using 240 patients with curatively resected node-positive gastric carcinoma. The cases were divided into the following three groups: 142 with positive level I (perigastric) nodes, 71 with positive level II (intermediate) nodes, and 27 with positive level III (distant) nodes, irrespective of the location of tumors. RESULTS: The level of lymph node metastasis clearly correlated with the survival of patients, with the 5-year survival rates for level I, II, and III cases being 67%, 35%, and 26%, respectively (P < 0.01). The degree of lymph node metastasis was determined by the number of positive nodes (P < 0.01), the depth of invasion (P < 0.01), the size of tumors (P < 0.01), and the location of tumors (P < 0.05). CONCLUSION: This simple classification of lymph node level (level I, II, and III) is useful for the evaluation and prediction of surgical results in gastric carcinoma.

Arteries↗
PubMed1995

Lymphatic invasion and potential for tumor growth and metastasis in patients with gastric cancer.

BACKGROUND: Lymph node metastasis is a risk factor for the occurrence of peritoneal dissemination and liver metastasis in patients with gastric cancer. METHODS: We analyzed data on 324 patients with serosally invasive gastric cancer with respect to the relation between lymphatic invasion and potential for tumor growth and metastasis. All these patients were curatively treated in the Department of Surgery II, Kyushu University. RESULTS: Lymphatic invasion was evident in 214 patients, in whom vascular invasion was more frequent and the rate of lymph node metastasis was higher compared with patients with no lymphatic invasion. There was no difference in tumor size. The type of recurrence varied, and the prognosis was poor in patients with lymphatic invasion. The DNA ploidy pattern was higher, and the levels of proliferating cell nuclear antigen labeling and argyrophilic nucleolar organizer regions count were significantly higher in tumor tissues with lymphatic invasion than in those without invasion. CONCLUSIONS: Gastric cancers with characteristics of lymphatic invasion have higher proliferating activities, and metastases to distant organs are likely.

Cell Division↗
PubMed1995

Effect of lymph node dissection on the prognosis in patients with node-negative early gastric cancer.

BACKGROUND: Our objective was to evaluate the long-term benefit of R2/3 lymph node dissection compared with that of R1, even in node-negative cases. METHODS: We analyzed clinicopathologic data on 373 surgically treated patients with early gastric cancer and without microscopic nodal involvement. RESULTS: Five- and 10-year survival rates for patients treated with R2/3 gastrectomy were 97.3% and 95.4%, respectively. These values were significantly higher than the 90.1% and 81.1% noted for R1 gastrectomy (p < 0.01). Although no difference was found in morbidity and mortality, the incidence of death from a recurrence of the gastric cancer was significantly higher in patients treated with R1 gastrectomy than those with R2/3. Multivariate analysis with the Cox's proportional hazard model revealed patients' age and R2/3 gastrectomy to be independent prognostic factors in patients with node-negative early gastric cancer. CONCLUSIONS: These data show that prophylactic lymph node dissection can potentially prolong the survival time of patients with node-negative early gastric cancer by preventing a recurrence of the gastric cancer.

Age Factors↗
PubMed1995

A tumour-associated cell-surface glycoprotein accompanying p53 overexpression and higher growth potential for gastric cancer.

Tumour-associated cell-surface glycoprotein is associated with tumour progression in gastric cancer. We investigated the biological significance of tumour-associated cell-surface glycoprotein, determined by the binding of Helix pomatia agglutinin (HPA), with regard to survival time and to the malignant potential of cancer cells in serosally invasive gastric cancer in 119 patients. HPA was positively stained in 75 of 119 patients (63.0%) with gastric cancer with serosal invasion. In patients with HPA-positive tissue, the tumour was larger than in HPA-negative cases and was frequently located in the middle third of the stomach. The incidence of lymph node metastasis was higher than in patients with HPA-negative tissue. There were no differences between the cases staining negatively and positively with HPA with respect to the other factors examined. Gastric cancer tissues with HPA-positive staining revealed a higher positive rate of abnormal p53 staining and a higher concentration of proliferating cell nuclear antigen (PCNA) labelling. The survival time of the patients with HPA positive staining was shorter than for those whose tissues were HPA negative. Thus, tumour-associated cell-surface glycoprotein is apparently closely related to the malignant potential of serosally invasive gastric cancer.

Aged↗
PubMed1995

Correlation between sialyl Tn antigen and lymphatic metastasis in patients with Borrmann type IV gastric carcinoma.

The expression of sialyl Tn (STn) antigen in 180 patients with Borrmann type IV gastric carcinomas was examined immunohistochemically. The rate of positive STn staining was 32% (57/180) for the primary tumours, and this positive staining correlated well with tumour extension, lymph node metastasis (P < 0.05) and peritoneal dissemination (P < 0.01). One-third (5/15) of patients with positive STn-staining cancer cells had a high level of serum STn. Lesions with positive STn staining were related to a lower survival rate for the patients (P < 0.05). Proliferative activity of the tumour, as measured by proliferating nuclear antigen (PCNA) labelling percentage and argyrophilic nucleolar organiser region (AgNOR) count, was significantly higher (41.5 +/- 13.0%, 3.78 +/- 0.98) in the STn-positive group than in the STn-negative group (34.2 +/- 13.2%, 3.48 +/- 0.85) (P < 0.01, P < 0.05 respectively). Estimating STn antigen may be useful for predicting the likelihood of lymph node metastasis or peritoneal dissemination and the clinical prognosis for patients with Borrmann type IV gastric carcinoma.

Adult↗
PubMed1995

Cyclosporin A and FK506 reverse anthracycline resistance by altering the cell cycle.

We investigated the effect of cyclosporin A (CsA) or FK506 on the cytotoxicity of anthracyclines against a human laryngeal cancer cell line, KB cells, and a multi-drug resistance cell line, VJ-300 cells. CsA and FK506 enhanced the cytotoxicity of anthracyclines, especially in the VJ-300 cells. The intracellular concentrations of epirubicin (EPIR), daunomycin (DM), adriamycin (ADM) and THP-adriamycin (THP) were increased by the addition of CsA or FK506 in VJ-300, but not in KB cells. The intracellular accumulation of EPIR was most increased when CsA or FK506 was concomitantly administered with the drug. We also asked whether CsA or FK506 might influence the cycle of KB or VJ-300 cells. The population of cells in each phase of the cell cycle was little changed in both KB and VJ-300 cells when 0.3 microM ADM was administered for 24 h. Both CsA and FK506 significantly increased the ADM-induced accumulation of VJ-300 cells in G2M phase, in comparison with findings with KB cells. Thus, the reversal of MDR by CsA or FK506 is related to increased intracellular concentrations of cytotoxic drugs and, as a result, the increased G2M accumulates in MDR cells. Among of antrhacyclines, EPIR was most effective when concomitantly combined with CsA or FK506 in VJ-300 cells.

Antibiotics, Antineoplastic↗
PubMed1995

Long-term survival after resection for advanced gastric carcinoma.

Although several prognostic indicators for gastric carcinoma have been reported, characteristics of long-term survivors with advanced gastric carcinoma have not yet been clarified. We compared clinicopathologic features of 54 patients who survived for >10 years after resection for advanced gastric carcinoma with those of 72 patients who died of recurrence. Long-term survivors were characterized by small tumor size (6.2 cm vs. 8.1 cm, p < 0.01), negative serosal invasion (50% vs. 32%, p < 0.05), few lymph node metastases (fewer than seven) (89% vs. 56%, p < 0.01), limited lymph node metastases (nO, nl) (89% vs. 40%, p < 0.01), and earlier stage (I or II) (50% vs. 16%, p < 0.01). These results indicate that small tumor size, negative serosal invasion, and fewer than seven positive nodes were the predictors of long-term survival after resection for advanced gastric carcinoma.

Adenocarcinoma↗
PubMed1995

Neural invasion in gastric carcinoma.

AIMS: To determine whether neural invasion in advanced gastric cancer is of clinicopathological significance. METHODS: The study population comprised 121 cases of primary advanced gastric carcinoma. Two paraffin wax embedded blocks taken from the central tissue slice in each primary tumour were used. For definitive recognition of neural invasion, immunostaining for S-100 protein was applied to one slide; the other slide was stained with haematoxylin and eosin. RESULTS: Neural invasion was recognised in 34 of 121 (28%) primary gastric carcinomas. There were significant differences in tumour size, depth of tumour invasion, stage, and curability between patients with and without neural invasion. The five year survival rates of patients with and without neural invasion were 10 and 50%, respectively. Multivariate analysis, however, demonstrated that neural invasion was not an independent prognostic factor. CONCLUSIONS: Neural invasion could be an additional useful factor for providing information about the malignant potential of gastric carcinoma. This may be analogous to vessel permeation which is thought to be important, but is not an independent prognostic factor.

Carcinoma↗
PubMed1995

Lymph-node metastases: efficacy for detection with helical CT in patients with gastric cancer.

PURPOSE: To determine the efficacy of helical computed tomography (CT) in the detection of lymphadenopathy in patients with gastric cancer. MATERIALS AND METHODS: Helical CT (5-mm section thickness, 5-mm/sec table incrementation) was performed in 58 patients (39 men, 19 women; mean age, 63.8 years) with gastric cancer; 1,082 lymph nodes (138 positive, 944 negative for metastasis) were resected at surgery. Findings at CT and resection were compared. Sensitivity for detecting lymph nodes was evaluated according to nodal size and presence of metastasis. RESULTS: Seven (1.1%) of 649 lymph nodes 1-4 mm, 160 (45.1%) of 355 nodes 5-9 mm, and 56 (72%) of 78 nodes larger than 9 mm were detected at CT. For nodes of at least 5 mm, sensitivity for detecting metastasis-positive nodes (79 [75.2%] of 105 nodes) was higher than that for detecting metastasis-negative nodes (137 [41.8%] of 328; P < .01). Differences between positive and negative nodes in CT attenuation (110 HU +/- 25 vs 66 HU +/- 32) and short-to-long axis ratios (0.81 +/- 0.15 vs 0.57 +/- 0.15; P < .001) were significant. CONCLUSION: Helical CT is effective for detection of metastatic lymphadenopathy from gastric cancer. CT attenuation and lymph-node configuration aid in diagnosis of malignant adenopathy.

Adult↗
PubMed1995

Glutathione S transferase Pi is a powerful indicator in chemotherapy of human lung squamous-cell carcinoma.

We immunohistochemically investigated the expression of glutathione S transferase pi (GST- pi) and clarified the correlation between GST-pi and the results of chemosensitivity testing on the tissue of primary human squamous-cell carcinoma of the lung. The expression of GST-pi was evaluated in 105 cases and their level of chemosensitivity was estimated by the in vitro succinate dehydrogenase inhibition test for cisplatin, Adriamycin, cyclophosphamide, mitomycin C, vindesine and fluorouracil. Tumors in which 25% and more of the cells stained for GST-pi were classified as having a high GST-pi expression, while those tumors demonstrating less than 25% of the cells staining for GST-pi were considered to have a low expression GST-pi. The percentage of high GST-pi was 52% (53 of 105) while that of low GST-pi was 48% (52 of 105). No significant correlation between the expression of GST-pi and clinicopathologic factors was observed, while no significant difference in the survival of the two groups was found either. An increase in succinate dehydrogenase activity was recognized in the high-GST-pi group compared with the low-GST-pi group for each anticancer drug; however, no statistical significance was seen except for cisplatin. In the cases with adjuvant combination chemotherapy using cisplatin after a complete resection, all cases demonstrating a relapse were associated with a high GST-pi. These findings thus indicate that an overexpression of GST-pi is related to the resistance to cisplatin in human lung squamous-cell carcinoma. It is therefore important to select carefully the optimal anticancer drug for high-GST-pi cases.

Aged↗
PubMed1995

[DNA ploidy pattern and p53 overexpression in gastric cancer].

DNA ploidy pattern was determined by flow cytometry and p53 overexpression was investigated immunohistochemically in 145 primary gastric cancers. Aneuploid patterns were found in 78 (65%) and diploid patterns in 67 (46%). Metastasising to lymph nodes was observed more frequently in cases with aneuploid tumors, as compared to those with diploid tumors (p < 0.01). DNA ploidy patterns were related to overexpression of p53. The incidences of overexpression of p53 in aneuploid tumors and diploid ones were 65% and 33%, respectively (p < 0.05). Thus, we suggest that gastric carcinomas with the aneuploid pattern have mutation of tumor suppressor gene p53 and high potential to metastasize to lymph nodes.

Cell Cycle↗
PubMed1995

[Cytophotometrically determined DNA content, mitotic index and proliferative activity clinical gastric cancer].

1) Analyses of cytophotometrically determined DNA content and mitotic index (MI) using histologic sections were carried out in 37 advanced gastric carcinomas. According to the linear regression analysis, there were statistically significant correlations of MI with DNA variants such as the peak value, the mean value and the frequency of cells with values exceeding 4c or 6c (%-over 4c or 6c). When the mean MI was calculated according to the %-over 4c or 6c, there were better correlations of higher MI with increased hyperaneuploid levels. 2) Measurement of DNA content and MI were examined in each layer of 46 tumors with serosal invasion. The mitotic counting analysis revealed a significantly higher value in the serosa, compared with findings in the mucosa. Similarly, the deeper the layer, the higher the %-over 6c. This tendency was evident in cases of an undifferentiated type adenocarcinoma. 3) The relationship between DNA ploidy and tumor invasion was studied in 254 tumors. The frequency of aneuploidy increased with invasion into the deeper layers. Especially in cases of the undifferentiated type, aneuploid carcinoma was free at the stage confined to the mucosa, while the rate was 47% for serosal carcinoma. Thus, abnormal DNA fractions appear to be indicative of tumors with a high mitotic activity and a propensity for growing downward rapidly in the gastric wall.

Adenocarcinoma↗
PubMed1995

Clinicopathologic characteristics and outcome of adenocarcinoma of the human gastric cardia in comparison with carcinoma of other regions of the stomach.

BACKGROUND: Carcinoma arising in the cardioesophageal junction is a distinct clinical entity compared with tumors located in other regions of the stomach. This study was done to analyze the biologic characteristics of carcinoma of the gastric cardia compared with other gastric carcinomas. STUDY DESIGN: Clinicopathologic features and postoperative prognosis of 68 cases of carcinoma of the cardia were evaluated, in comparison with findings of tumors in other regions of the stomach. RESULTS: From 1975 to 1992, 68 (6.5 percent) of 1,042 patients with carcinoma of the stomach had adenocarcinoma of the cardia. Carcinoma of the cardia was characterized by a more advanced stage compared with carcinoma of other regions of the stomach. The incidence of early stage carcinoma (limited to the submucosal layer) was 11.8 percent in the cardia, 15.8 percent in the upper one-third, and 42.2 percent in the remaining middle and lower thirds of the stomach. When compared to carcinoma in other regions of the stomach, tumors of the cardia had a significantly poorer prognosis and there was a higher incidence of lymph node and hepatic metastasis. The five-year survival rates in patients with adenocarcinoma in the cardia, the upper one-third, and the remaining middle and lower thirds of the stomach were 35.3, 43.7, and 61.9 percent, respectively. Especially for patients with stage II and stage III disease, the prognosis was significantly worse with adenocarcinoma of the cardia than with carcinomas of the other regions of the stomach. CONCLUSIONS: Early detection is crucial to improve the survival of patients with carcinoma of the gastric cardia. Extended dissection of lymph nodes and aggressive postoperative chemotherapy in an attempt to prevent hepatic metastasis are highly recommended.

Adenocarcinoma↗
PubMed1995

[A late phase II trial of l-leucovorin and 5-fluorouracil in advanced colorectal cancer. l-Leucovorin and 5-FU Study Group (Japan Western Group)].

A multicentral cooperative study was conducted to evaluate the clinical efficacy and toxicity of l-Leucovorin (l-LV) and 5-fluorouracil (5-FU) in advanced colorectal cancer. The administration schedule was a two-hour intravenous infusion of l-LV (250 mg/m2) and an intravenous bolus injection of 5-FU (600 mg/m2), given one hour after the beginning of the l-LV infusion. Sixty-four patients were treated weekly for six weeks followed by two-weeks rest, and then evaluated for response. Complete response and partial response were obtained in 21 patients (32.8%). The median survival time was 12.8 months. The most prominent side effects were anorexia (57.8%), nausea and vomiting (56.3%), diarrhea (48.4%) and myelosuppression such as leucopenia (54.7%), thrombocytopenia (18.8%) and decreased hemoglobin (40.6%). These side effects, however, were within permissible levels. Severe toxicity was prevented by discontinuance of the treatment. From the present study, l-LV and 5-FU combination therapy seems to be a very promising and useful treatment for patients with advanced colorectal carcinoma.

Adult↗
PubMed1995

[Comparison of CAF plus MPA with CAF plus TAM for advanced or recurrent breast cancer--Kyushu CAFT Study Group of Advanced or Recurrent Breast Cancer].

A multi-center randomized comparison study of CAF + TAM therapy (Arm A) and CAF + MPA therapy (Arm B) in advanced or recurrent breast cancer was conducted at 37 institutions in Kyushu. Out of 119 registered cases, 114 were eligible and 76 were evaluable. The response rate was 42% (15/36) in Arm A and 58% (23/40) in Arm B. In the comparison of side effects, nausea/vomiting and anorexia were significantly less and moon face and body weight gain were significantly more in Arm B. Leucocytopenia was significantly inhibited in Arm B compared with Arm A, which indicated the myeloprotective effect of MPA. These results indicated that CAF + MPA therapy (Arm B) may be more advantageous than CAF + TAM therapy (Arm A) in advanced or recurrent breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗