A case of asynchronous multiple cancers including quadruple colon cancers, gastric cancer, and lung cancer is described. The patient, a 57-year-old man, was diagnosed at the age of 46 in 1986 with early gastric cancer. In 1993, double ascending colon cancers, and in 1995 left lung cancer were found and surgically treated. Double sigmoid colon cancers were revealed in 1997, and all carcinomas were resected radically. No sign of recurrence or metastasis has been detected since the last operation. This patient has multiple polys in the residual colon and stomach, and takes Sulindac to control growth of sporadic polyps. Replication errors in DNA, which may play an important role in development of multiple primary cancers, were observed in thia case. The patient should be considered to have an increased risk of an additional primary cancer.
Forty-three resected materials of invasive ductal adenocarcinoma of the pancreas were examined for the expression of p 53 protein and the cell proliferating activity in comparison with the clinicopathological factors and prognosis. Anti-p 53 antibody (DO-7) and anti-Ki-67 antibody (MIB-1) were used as the primary antibody. Although a univariate analysis revealed significant variants including pancreatic cut end (pw). and p 53 protein expression (p<0.05), none of these were independent prognostic indicator according to a multivariate analysis. With regard to the clinicopatholigical factors, p 53 protein expression was significantly associated with tumor size (ts), arterial invasion (a), venous invasion (v), intrapancreatic nerve invasion (ne), lymph node metastasis, invasion to the dissected pancreatic tissue (ew), and pw (p<0.05). Furthermore, p 53 expression was correlated with the cell proliferating activity (p=0.039). With regard to the recurrent pattern, p 53 protein expression was associated with the recurrence as hepatic metastasis (p=0.041). As a result, while the significance of p 53 protein expression was not important as a prognostic indicator, the involvement of p53 protein expression with the local progression, proliferating activity, and hepatic metastasis was suggested in invasive ductal adenocarcinoma of the pancreas.
UNLABELLED Concomitant treatment with 5-fluorouracil (5-FU) and Leucovorin (LV) is positioned as the standard chemotherapy against colorectal cancer. We noted the action of LV to enhance the effect of biochemical modulation by 5-FU, and made an attempt at home chemotherapy with UFT + LV by oral administration, in consideration to the convenience of patients. SUBJECTS The subjects of this study were 24 post-operative patients who had been assessed with Dukes D and curability C colorectal cancer with measurable metastatic lesions and who could tolerate chemotherapy. METHODS 1 course of treatment consisted of 2 weeks of UFT at 300-400 mg/m2/day and LV at 15 mg/body/day followed by 2 weeks of drug withdrawal. The administration was conducted for 4 courses or more as the target. Unless serious adverse reaction occurred, dose increase of UFT was allowed. RESULTS The efficacy rate in the 22 patients who were assessable was 22.7%. There were 11 NC patients, accounting for half (50%) of the subjects. This home chemotherapy is expected to become an alternative chemotherapy against colorectal cancer in the future, because the treatment does not require hospitalization and has less impact on the QOL of patients.
Matrix metalloproteinase 7 (MMP-7) plays an important role in vessel invasion and metastasis in human colorectal cancer.The significance of MMP-7, laminin and type IV collagen expression in human colorectal cancer was investigated by immunohistochemical assay, and the correlation with liver metastasis was analyzed.In a synchronous metastasis group, 26 of 36 cases (72%) showed positive staining of MMP-7: There were 32 cases (89%) in the lymph channel and 28/32 cases (87%) in the vessels, and 17/34 cases (50%) showed a positive rate of laminin. In the metachronous metastasis group, 14 of 30 cases (47%) showed positive staining of MMP-7: There were 19 cases (63%) in the lymph channel and 13/19 cases (69%) in the vessels, and 17/30 cases (57%) showed a positive rate of laminin. In the control group, which was a 5-year disease-free group, despite there being no significant clinicopathological factors compared with the other two groups, 17 of 37 cases (51%) showed positive staining of MMP-7: There were 12 cases (37%) in the lymph channel and 6 cases (18%) in the vessels, and 2/31 cases (5%) showed a positive rate of laminin. The expression of type IV collagen attenuated in 19 out of 32 cases (59%) in Group S, 10 out of 19 cases (53%) in Group M, and 14 out of 37 cases (38%) in Group C, with no significant differences among the groups. Thus, the metastatic groups were significantly higher than the control group in terms of expression of laminin and MMP-7 in the lymph channel.These findings suggest that laminin and the expression of MMP-7 in the lymph channel is a useful parameter for predicting liver metastasis.
A 46-year-old man was admitted to the hospital because of abdominal distention, upper abdominal pain, and fever. There were previous histories of undergoing operations twice for intestinal obstruction, though details were lacked. Preoperative abdominal x-ray film, CT scan, and barium enema study revealed megacolon covering from the transverse to descending colon, and a tumorous shadow in the colonic mesentery at its oral side. A laparotomy was performed, when remarkable dilatation covering from the transverse to descending colon was seen and deep ulcer lesion was palpated at the hepatic flexure of the transverse colon. A partial resection of the colon including the ulcer was performed. On histopathological study of the resected material, the ulcer revealed findings of non-specific ulcer. It was concluded that the ulcer in this case was simple ulcer originated in the vicinity of megacolon due to some unknown mechanisms. The patient was discharged without any serious problems after the operation, and is followed on an ambulant basis.The etiology of simple ulcer has been still controversial. And there has been no another case of simple ulcer associated with megacolon other than our case as far as we could review. This uncommon case together with some bibliographical comments is presented.
Background: An association between periodontal disease and metabolic syndrome based on cross‐sectional and case‐control studies was recently reported, but their causal relationship has not been fully clarified. The objective of this cohort study is to investigate the association between periodontal disease and changes in metabolic‐syndrome components to accumulate evidence of the causal relationship between the two conditions. Methods: The study subjects consisted of 1,023 adult employees (727 males and 296 females; mean age: 37.3 years) who underwent medical and dental checkups between 2002 and 2006 and in whom all metabolic‐syndrome components were within the standard values in 2002. The association between the presence of periodontal pockets and the positive conversion of metabolic‐syndrome components was investigated using multiple logistic‐regression analysis, odds ratios (ORs), and 95% confidence intervals (CIs). Results: The presence of periodontal pockets was associated with a positive conversion of one or more metabolic components during the 4‐year observation period (OR: 1.6; 95% CI: 1.1 to 2.2). The ORs for a positive conversion of one component and two or more components were 1.4 (95% CI: 1.0 to 2.1) and 2.2 (95% CI: 1.1 to 4.1), respectively, and the difference was significant for two or more positive components. Of the metabolic‐syndrome components, positive conversions of blood pressure and the blood‐lipid index were significantly associated with the presence of periodontal pockets. Conclusion: The presence of periodontal pockets was associated with a positive conversion of metabolic‐syndrome components, suggesting that preventing periodontal disease may prevent metabolic syndrome.
