はじめに: stage IV大腸癌の予後因子を臨床病理学的に検討した. 方法: stage IV大腸癌161症例を対象とし臨床病理学的検討を行い予後規定因子を解析した. 結果: 根治度はB37例 (23.0%), C110例 (68.3%), 不明14例 (8.7%) で, 非治癒因子数は単独111例 (68.9%), 複数50例 (31.1%) であった. 単独因子症例の内訳は肝転移64例 (57.7%), 腹膜転移21例 (18.9%) の順で多かった. 多変量解析を行った結果, 独立した予後規定因子として根治度, 組織型, 深達度, 非治癒因子数, リンパ管侵襲の5因子が抽出された. 5年以上生存した13例はすべて非治癒因子数が単独, かつ高または中分化腺癌症例で, 1例 (肝転移に対し異時的肝切除施行) を除き根治度Bであった. 考察: 予後不良とされるstage IV大腸癌においても, 非治癒因子数が単独の高または中分化腺癌症例に対して積極的な転移巣切除を行い根治度Bが得られれば長期生存が期待できると思われた.

10.5833/jjgs.39.529

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Citations (2)

8 Association of pharmacokinetics of axitinib with treatment outcome and adverse events in advanced renal cell carcinoma patients

European Urology Supplements (2015)

Naoyuki Tsuchiya R. Igarashi Naoko Suzuki-Honma Nobuhiro Fujiyama Shintaro Narita

Axitinib

10.1016/s1569-9056(15)60011-2

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Neuroendocrine cell differentiation of poorly differentiated colorectal adenocarcinoma correlates with liver metastasis

International Journal of Oncology (2006)

Seiichi Shinji Zenya Naito Toshiyuki Ishiwata Noritake Tanaka Kiyonori Furukawa

Poorly differentiated (PD) adenocarcinoma often retains the capacity for neuroendocrine (NE) cell differ-entiation; however, it is difficult to distinguish the NE cell differentiation by routine hematoxylin and eosin staining. It is important to detect the presence of NE cell differentiation in advanced colorectal carcinomas because these carcinomas have been shown to produce distant metastasis at the time of diagnosis and to have a particularly poor prognosis. In this study, the characteristics of PD adenocarcinoma with NE cell differentiation and its biological metastatic mechanisms were investigated. Forty-eight of 2204 colorectal cancer patients, diagnosed as having PD adenocarcinoma (2.2%) were enrolled in this study. Immunohistochemical analysis was performed with anti-chromogranin A anti-synaptophysin, anti-CD34, anti-D2-40, and anti-VEGF antibodies. The clinicopathological factors for PD adenocarcinoma with NE cell differentiation were compared with those for PD adenocarcinoma without NE cell differentiation. Microvessel density (MVD) was assessed using immunostained slides with anti-CD34 antibody and vascular endothelial growth factor (VEGF) expression in PD adenocarcinoma with NE cell differentiation was confirmed by in situ hybridization. By immunohistochemical staining for chromogranin A and synaptophysin, NE cell differentiation was detected in eight of 48 patients (16.7%) with PD adenocarcinoma. The frequency of liver metastasis at the time of diagnosis was significantly higher in patients having PD adenocarcinoma with NE cell differentiation (p=0.03). Moreover, MVD and VEGF expression level tended to be higher in patients having PD adenocarcinoma with NE cell differentiation (p=0.13 and 0.068, respectively). NE cell differentiation in PD adenocarcinoma may produce liver metastasis through microvessel formation in the tumor induced by VEGF. In PD colorectal adenocarcinoma, immunohistochemical analysis of NE markers is important for establishing the presence of NE cell differentiation and further study is necessary to evaluate the effectiveness of anti-angiogenic drugs to PD adenocarcinoma with NE cell differentiation.

Chromogranin A

Neuroendocrine differentiation

10.3892/ijo.29.2.357

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Citations (30)

Cytochrome P45O2E1 (CYP2E1) genetic polymorphism in a case-control study of gastric cancer and liver disease

Pharmacogenetics (1995)

Shunji Kato Masahiko Onda Norio Matsukura Akira Tokunaga Takashi Tajiri

Cytochrome P4502E1 (CYP2E1) activates carcinogenic N-nitrosamines, benzene, urethane and other low molecular weight compounds. This enzyme is also inducible by ethanol, and metabolizes alcohol. A restriction fragment length polymorphism (RFLP) using the Rsa I restriction enzyme has been identified in the CYP2E1 transcription regulatory region; recent studies suggest that this polymorphism may affect gene expression. We investigated the frequency of the Rsa I RFLP in a Japanese population in relation to gastric cancer and liver disease susceptibiliy. The frequency of this polymorphism was determined in 150 gastric cancer, 16 hepatocellular cancer, 48 liver cirrhosis and 203 benign gastric disease (controls) patients. This preliminary study shows no association of the specific genotype with gastric cancer in all subjects (odds ratio=1.04, 95% CI=0.74-3.08 for the heterozygote and 0.57, 95% CI=0.22-1.50 for the homozygous rare allele, respectively). To further confirm this lack of association, an age and gender matched case-control study should be performed. Separately, there was no association of the Rsa I RFLP with hepatocellular carcinoma (p =0.911), but there was a suggested difference between the non-viral associated liver cirrhosis patients and control patients. Thus, this polymorphism may be related to ethanol metabolism and consequential liver diseases in a Japanese population.

Liver Cancer

ALDH2

Liver disease

10.1097/00008571-199512001-00016

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A Case of Double Pylorus Due to the Repeated Gastric Ulcer

Nihon Ika Daigaku Igakkai Zasshi (2006)

Takeshi Okuda Shunji Kato Teruo Kiyama Takashi Mizutani Itsuro Fujita

A 70-year-old woman visited our hospital for evaluation of epigastric pain. She had been treated for a gastric ulcer by her home doctor with H2-receptor antagonist or PPI for 30 years. An upper GI series revealed a gastroduodenal fistula from the lesser curvature to the prepyloric region and the duodenal bulb. Eighteen months later, endoscopic examination revealed a double pylorus without additional changes.

Duodenal bulb

Epigastric pain

Upper gastrointestinal series

10.1272/manms.2.213

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86 Comparison of the clinical outcome and systemic inflammatory marker levels between standard laparoscopic surgery and reduced port surgery for living donor nephrectomy

European Urology Supplements (2015)

Ryusei Yamamoto M. Saito Takaaki Inoue S. Narita Naoyuki Tsuchiya

Benchmark (surveying)

Continuous variable

10.1016/s1569-9056(15)60088-4

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1136 Pharmacokinetics in the early period after sunitinib treatment predict adverse events and clinical outcome of patients with advanced renal cell carcinoma

European Urology Supplements (2014)

K. Takayama Naoyuki Tsuchiya Shintaro Narita Takaaki Inoue Mitsuru Saito

10.1016/s1569-9056(14)61116-7

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Preoperative Oral Immune-Enhancing Nutritional Supplementation Corrects Th1/Th2 Imbalance in Patients Undergoing Elective Surgery for Colorectal Cancer

Diseases of the Colon & Rectum (2006)

Akihisa Matsuda Kiyonori Furukawa Hideaki Takasaki Hideyuki Suzuki Hayato Kan

Recent studies have shown that the type 1/2 CD4+ T cell (Th1/Th2) balance shifts toward Th2 dominance in cancer-bearing state or by surgical stress. Perioperative immunonutrition is reported to improve the outcome in patients with gastrointestinal cancer. This study was designed to investigate whether preoperative immunonutrition corrects the impaired Th1/Th2 balance in the perioperative period.Thirty-six patients with colorectal cancer were prospectively divided into two groups as follows: preoperative oral intake supplementation with a formula enriched with arginine, omega-3 fatty acids and ribonucleic acid for five days (supplemented group; n = 19); and (control group; n = 17). Blood sampling was performed before supplementation, on the morning of surgery, and 3, 7, and 14 days postoperatively. The proportions of CD4+ T cells producing intracellular cytokines (interferon-gamma and interleukin-4) were measured by flow cytometry.In the preoperative period, the proportions of CD4+ T cells producing interleukin-4 significantly decreased and Th1/Th2 ratio significantly increased on the morning of surgery compared with those before supplementation. In the postoperative period, the proportions of CD4+ T cells producing interferon-gamma in both groups maintained the preoperative level. The proportions of CD4+ T cells producing interleukin-4 in the control group showed a gradual increase from the preoperative level, which implies Th2 dominant shift. In contrast, the supplemented group maintained the preoperative level of Th1/Th2 ratio.Preoperative immunonutrition corrects impaired Th1/Th2 balance in both cancer-bearing state and the postoperative period. This correction may be one of the important determinants of the clinical benefits of immunonutrition.

Gastrointestinal cancer

Colorectal Surgery

Surgical stress

Preoperative care

10.1007/s10350-005-0292-5

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Citations (59)