Nihon Gan Chiryo Gakkai shi最新文献

Frozen samples of normal gastric tissue (n = 80), gastric adenocarcinoma (n = 80), lymphnode metastases (n = 17) and liver metastases (n = 2) were investigated immunohistochemically for determination of fibronectin (FN) and laminin (LM). On monoclonal antibody, FN was seen in the gland basement membrane, scattered tissue and the vessel basement membrane in normal gastric tissue. On polyclonal antibody, FN was seen in the gland surface cells, the stomach gland cells and some portions of muscle fiber cells in normal gastric tissue, too. On both monoclonal and polyclonal antibody, LM was seen in the gland basement membrane, the vessel basement membrane, the vessel endothelial cells, and the fibroblast in normal gastric tissue. But on polyclonal antibody, LM staining in gland basement membrane was thicker than monoclonal antibody. These demonstrated that the monoclonal antibody was superior to the polyclonal antibody in specificity. In gastric adenocarcinoma, FN was not seen in the carcinoma gland basement membrane but in the tissue around the carcinoma. These suggested that FN had a share in the malignant transformation and the fibrous tissue formation. LM was seen in the carcinoma gland basement membrane in eighteen of thirty-six well-differentiated adenocarcinomas and two of fourteen moderately-differentiated adenocarcinomas. Well-differentiated adenocarcinoma were divided into two groups; a LM-positive group, and LM-negative group. These two groups were then compared for vein eroding, and lymph-node metastases, and the differences between the two groups found to be slight and not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

A double-blind, placebo-controlled, cross-over clinical trial of recombinant human granulocyte colony-stimulating factor (rG-CSF), produced by Chinese hamster ovary cells, was conducted in 46 patients receiving intensive chemotherapy for non-Hodgkin's lymphoma. Each patient received 2 cycles of CHOP therapy. rG-CSF (2 micrograms/kg/day) or its placebo was given subcutaneously to each patient for 14 days from 2 days after initiation of the chemotherapy, in a cross-over fashion. rG-CSF significantly increased the absolute neutrophil counts (ANC) at nadir, and reduced the number of days with ANC less than 1,000/mm3 and also the number of days for recovery to ANC greater than or equal to 2,000/mm3. Bone marrow examination showed a significant increase in the number of myeloid cells after rG-CSF treatment. 12 infective episodes were observed during placebo cycles, while 6 infective episodes were observed during rG-CSF cycles. No serious side effects were observed. We concluded that rG-CSF was effective in neutropenia induced by intensive chemotherapy for non-Hodgkin's lymphoma.

It has been well known that Sizofiran (SPG) cultured from the Schizophyllum commune Fries activates the macrophages and induces the cytotoxic lymphocytes in some cancers. In this study, we observed electronmicroscopically the macrophages around the cancer tissue from the patients with uterine cervical cancer after the treatment with SPG. At the same time, their immune responses were also examined by analyzing lymphocyte subsets, ADCC and NK activity in peripheral blood. A considerable number of erratic macrophage with well developed Golgi apparatus, endoplasmic reticulum and mitochondria were found in the uterine cervical cancer tissue from the patients treated with SPG under radiotherapy. Simultaneously, we identified the lysosome granules with a bright filament structure which appeared to be specific for SPG. In the immune responses evaluated by analyses of peripheral blood, the number of CD 16+ cells and NK activity significantly increased in the patients treated with SPG as compared with non-treated group. The present results indicate that SPG-immunotherapy combined with radiotherapy not only induces the cytotoxic activity of macrophage but also augments NK activity in the patients with uterine cervical cancer.

Serum levels of beta-Sm (a component of human seminal plasma) were measured in patients with breast cancer or mastopathy by RIA method. 9.4 +/- 9.5 ng/ml in control healthy adult women and 11.7 +/- 15.7 ng/ml in 8 patients with mastopathy were observed. Whereas, in 30 patients with breast cancer including 28 pre-operation and 2 recurrence 64.5 +/- 52.3 ng/ml were observed. Especially, high levels of beta-Sm (135.8 and 182.3 ng/ml) in the recurrence were detected. Each case of 8 post-operation was below 50 ng/ml. Fifty-seven percent of patients with breast cancer including pre-operation and recurrence were showed over 50 ng/ml. In histological typing, the beta-Sm levels of papillotubular carcinoma were higher than that of scirrhous carcinoma. In tubular carcinoma, 45% of stage I, 67% of stage II and 100% of stage III, IV and recurrence cases were over 50 ng/ml. The evidence suggests that serum levels of beta-Sm is useful for the diagnosis of breast cancer.

A comparison of the results of clinical diagnosis and ultrasound (US) and CT examinations was carried out in 43 patients who underwent radical neck dissection. We examined the site, size, depth and other features of lymph nodes which were unable to be detected by physical examination. US and CT proved superior to conventional clinical examination in detecting metastatic nodes. US and CT revealed that the disease in seven necks (12%) was not N1 but N2b, while in six of nine necks it changed from N0 to N positive. The features of metastatic lymph nodes on US and CT were clarified, and it was found that the detection of cervical metastatic nodes by a combination of US and CT is the most reliable method for assessing metastasis from tumors of the oral cavity.

We investigated the clinical effects and toxicity of chemotherapy with Cisplatin (CDDP) for head and neck cancer as the third joint research project of the Tokai Meeting for Head and Neck Tumors. The cases were examined at the cooperating institutions from September 1986 to March 1988. The subjects were 93 cases consisting of 66 patients (intravenous infusion: 47 cases; intraarterial infusion: 19 cases) of PP therapy (CDDP + PEP), 16 cases of PF therapy (CDDP + 5-FU) and 11 cases of PPV therapy (CDDP + PEP + VCR). The regimens of PP therapy were: CDDP 50-100 mg/body x 1 day, PEP 5 mg/body x 5 days (i.v.), and CDDP 10-20 mg/body x 5 days, PEP 5-10 mg/body x 5 days (i.a.). In the regimen of PF therapy, CDDP 80-100 mg/body x 1 day and 5-FU 750-1,000 mg/body x 5 days were administered. In the regimen of PPV therapy, CDDP 80-100 mg/body x 1 day, PEP 5 mg/body x 5 days and VCR 1 mg/body x 1 day were administered. As a rule, two courses of each of the regimens were performed. The total dose of CDDP in intraarterial infusion of PP therapy was significantly less than in intravenous infusion. The major results were as follows: 1) Total response rate was 57.0% on the average, and this was not significantly different among the regimens. 2) The response rate of intraarterial infusion of PP therapy was as high as that for intravenous infusion in spite of the lower CDDP dose. 3) The response rate of oral cavity was significantly higher than that of nasal cavity and paranasal sinuses. 4) In the squamous cell carcinoma, the response rate of the well differentiated type was significantly higher than that of the poorly differentiated type. 5) The leukocyte counts significantly decreased with the intravenous infusion of PP therapy, PF therapy and PPV therapy. 6) The platelet counts significantly decreased with PPV therapy. 7) There were no significant changes with time with Ccr and PaO2 of PP therapy. 8) The frequency of toxicities such as nausea and vomiting was high in the intravenous infusion of PP therapy, PF therapy and PPV therapy. However, the frequency of toxicity was low in the intraarterial infusion of PP therapy.

Sixty-eight patients with endobronchially invading recurrence of esophageal cancer after resective surgery were treated with radiotherapy from 1966 to 1988. The mean interval between resective surgery and diagnosis of recurrence was 11.1 months, that was significantly shortened in a3 group. The dose of radiation for recurrence ranged from 2 to 70.3 Gy, with a mean dose of 42.6 Gy. The mean survival time after treatment of recurrence was 4.9 months. The dose of radiation was found to have a positive correlation with survival time. The cause of death was bleeding in 20 patients, and respiratory failure in 36. High dose of radiation was thought to induce high incidence of bleeding. The results indicated that external beam radiotherapy with conventional fractionation was not so much effective for the recurrence.

Seven patients with Stage III-IV ovarian carcinoma were treated with oral etoposide. The patients received a dose of 25 or 50 mg/day/body for every day or 21 consecutive days every one months. Four patients received this treatment as second line chemotherapy, two as initial chemotherapy and one as maintenance chemotherapy. One of 6 patients with measurable tumor had complete response, one had partial response and four had no changes. One patient with embryonal carcinoma, who received this treatment as maintenance chemotherapy is in no relapse for 2 years and 2 months. Leucopenia with a WBC under 3,000/mm3 was seen in 3 cases. Oral mucositis occurred in 2 cases, hair loss and gastrointestinal toxicities in 1 case. This method of oral administration is effective, tolerated and convenient for advanced ovarian carcinoma and recurrence following prior, vigorous chemotherapy in a outpatient clinic.

Clinical efficacy of a new preparation of peplomycin emulsion in hydroxypropylcellulosum (HPC-PEP) was studied in 26 patients to compared with that in 14 patients administered with 60 mg of PEP in 20 ml saline (S-PEP). The HPC-PEP was a mixture of 90 mg PEP suspended in 30 ml of 1% HPC. Both of preparations were retained in the bladder cavity over an hour after the instillation. Intravesical instillation was performed once for the patients with HPC-PEP, and 10 times repeatedly for the patients with S-PEP. A clinical evaluation was made on the basis of cytoscopic finding and cytology one week after the final instillation. According to the degree of tumor reduction, the results were classified into "disappearance", "greater than 50% reduction," and "no alteration or further growth" of primary tumor, which were referred respectively to "complete response (CR)", "partial response (PR)" and "not changed (NC)". The rates of CR and response were 27 and 73% respectively for the HPC-PEP administered patients, which were significantly higher than those of 8 and 43% respectively for the patients with S-PEP. In terms of configuration and number of tumor, intravesical HPC-PEP treatment was found to be superior to intravesical S-PEP treatment. In HPC-PEP treatment, a series of untoward symptoms such as bladder irritability and leukopenia was encountered at a frequency of 8%, which is much less than those seen in the S-PEP treatment. These clinical date suggest that HPC-PEP treatment against the superficial bladder tumors is superior to conventional S-PEP instillation in terms of administration frequency and potent doses available to tumor reduction.

From 1966 through 1988, 124 patients with non-Hodgkin's lymphoma of the Waldeyer's ring were treated. Seventy patients were male, and 54 were female. Age ranged from 5 to 81 years with a median value of 53 years. Pathological slides were reviewed and reclassified according to the Working Formulation. Diffuse large cell type was most common (53%). Since 1981, CHOP has been incorporated into the treatment including stage I and II patients. During these 22 years, new imaging modalities have developed, and an upstage rate by using those modalities has increased from 5% to 9%. In order to make the comparison meaningful, we used clinical stage determined at the day of the first visit. Fifty-one patients were clinical stage I, 64 were stage II, seven were stage III, and two were stage IV. B symptom was seen in 8 patients. Relapse developed in 45 patients (41%) out of 111 who achieved complete remission, and distant relapse was most frequent (89%). Salvage therapy was successful in only three patients of the 45 relapsed patients. Overall 5-year freedom from relapse (FFR) were 38% for the patients treated until 1980, and 69% for the patients treated thereafter (p less than 0.01). Addition of CHOP to radiotherapy has increased 5-year FFR of the stage II patients from 31% to 81% (p less than 0.01). In stage I, 5-year FFR was 71% in the patients treated with CHOP and radiotherapy, and it was 27% treated without CHOP. But the difference has no statistical significance, and we can not rule out the presence of selection bias.(ABSTRACT TRUNCATED AT 250 WORDS)