Eito Ikeda

Molecular detection of disseminated cancer cells in the peripheral blood and expression of sialylated antigens in colon cancers

To improve the survival rate of patients with colon cancer, liver metastases must be eradicated in a clinically occult state. This study was designed to find a predictor for potential liver metastases or micrometastases in colon cancer.

Comparative study of CEA staining in gastric and colorectal cancer tissues.

SummaryExpression of CEA was studied in tissue sections from 140 cases of gastric and 54 cases of colorectal carcinoma by the immunoperoxidase technique. In some cases of gastric cancer, the intensity of CEA staining was compared with the CEA concentration by radioimmunoassay, and the intensity of the CEA staining was related to CEA concentration. CEA was more strongly positive in colorectal carcinomas than in gastric carcinomas. The intensity of the CEA staining was stronger in differentiated gastric and colorectal carcinomas than in anaplastic ones. No relationship was seen between the expression of CEA and the extent of disease in gastric or colorectal carcinoma. The CEA expression was related to the location of tumors in colorectal carcinomas, but not in gastric carcinomas.

Detection of gastric cancer by a combination of tissue polypeptide antigen (TPA), lipidbound sialic acid (LBSA) and carcinoembryonic antigen (CEA)

SummaryIn this study, the clinical significance of the tumor markers, tissue polypeptide antigen (TPA) and lipid-bound sialic acid (LBSA) in conjunction with carcinoembryonic antigen CEA, was tested in 52 gastric cancer patients. The incidence of elevated serum levels of these 3 markers was as follows: 63% (33/52) for TPA; 40% (21/52) for LBSA; 21% (11/52) for CEA. In a combination assay using all three tumor markers, 37 out of 52 gastric cancer patients (71%) showed a positive combination assay, while 5 out of 20 normal subjects (25%) showed a positive combination assay. In a discriminant analysis of the resulting data, 18 out of 52 gastric cancer patients (35%) were classified correctly based on an analysis of CEA alone. Furthermore, 25 out of 52 gastric cancer patients (48%) and all 20 normal subjects (100%) were classified correctly based on an analysis of all three variables.Our data suggest that TPA and LBSA are more sensitive than CEA as markers of gastric cancer, and that the simultaneous measurement of TPA and LBSA in conjunction with CEA is more useful in cancer detection than the measurement of CEA alone.

Immunoreactive carcinoembryonic antigen in gastric juice in patients with gastric cancer

To clarify the significance of immunoreactive carcinoembryonic antigen in gastric juice (gastric CEA) from gastric cancer patients, we studied the gastric CEA in comparison with cancer progress, histologic types of tumors, staining, for CEA and extent of intestinal metaplasia. The gastric CEA levels from patients with other gastric diseases, i.e., gastric ulcer, duodenal ulcer and chronic gastritis were also investigated. The mean gastric CEA level from gastric cancer patients was significantly higher than from gastric or duodenal ulcer patients, but there was no significant difference between levels in patients with gastric cancer and in those with chronic gastritis. The gastric CEA levels from cancer patients increased with progression of the cancer. The differentiated carcinomas showed significantly higher gastric CEA levels than the poorly differentiated carcinomas. Positive CEA tumors showed significantly higher gastric CEA levels than did the negative CEA tumors. The tumors with diffuse intestinal metaplasia revealed high gastric CEA levels. Determination of gastric CEA levels is considered to be useful for screening of gastric cancer.

Bleeding Meckel’s diverticulum diagnosed with99mTc-pertechnetate

The diagnosis of bleeding Meckel’s diverticulum in an 11 year old boy, an 8 year old girl and a 2 1/2 year old boy, was established preoperatively using99mTc-pertechnetate. These abdominal scannings were of value in the management of patients with rectal bleeding after ruling out other disorders by hematologic tests, usual radiologic studies and endoscopic examinations. To reduce ambiguities, the scanning was performed with the child in a fasting state and a nasogastric tube was led into the stomach to minimize volume and flow of radioactive gastric juice into the intestinal tract. Based on our experiences and review of reported cases, applicability of the scanning in the management of patients with Meckel’s diverticulum is discussed.

Ectopic gastrointestinal variceal bleeding with portal hypertension

Massive gastrointestinal bleeding from gastrointestinal varices is one of the most serious complications in patients with portal hypertension. However, if no bleeding point can be detected by endoscopy in the predilection sites of gastrointestinal varices, such as the esophagus and stomach, ectopic gastrointestinal variceal bleeding should be considered as a differential diagnosis. Herein, we report a case of ectopic ileal variceal bleeding in a 57-year-old woman, which was successfully diagnosed by multi-detector row CT (MDCT) and angiography and treated by segmental ileum resection. To date, there have been no consensus for the treatment of ectopic ileal variceal bleeding. This review was designed to clarify the clinical characteristics of patients with ectopic ileal variceal and discuss possible treatment strategies. From the PubMed database and our own database, we reviewed 21 consecutive cases of ileal variceal bleeding diagnosed from 1982 to 2017. MDCT and angiography is useful for the rapid examination and surgical resection of an affected lesion and is a safe and effective treatment strategy to avoid further bleeding.

BENEFITS AND LIMITATIONS OF AN OMENTAL PEDICLE FLAP FOR THE TREATMENT OF EMPYEMA

目的)膿胸に対する有茎性大網法につき,有用性,限界を検討する.方法)閉鎖困難な有瘻性症例,大きな腔を有するが十分な筋肉弁を作成困難な症例,菌陰性化しない症例,胸郭成形術を避けたい症例を有茎性大網法の適応とし,有茎性大網法を行った膿胸10例につき,背景因子,術式,術式選択理由,治療成績,腹部合併症を検討した.結果)全例一度治癒退院したが,醸膿胸膜が遺残した2例が,晩期再発した.有瘻性症例,菌陰性化しない症例,腔遺残した症例,一期的手術も成功率が高かった.腹部合併症は軽度であった.結論)瘻孔閉鎖が成功しやすい,非耐性菌であれば菌陰性化を要さない,腔遺残しても治癒率が高いなどの利点から膿胸治療上有茎大網法は成功率が高く有用である.一方,膿胸壁残存症例で晩期再発を認めた.限界を理解した上で適応,治療手順を考え,有茎性大網法を施行することが重要である.

Immunoassessment of patients with gastric cancer. Using leukocyte migration inhibition (LMI) test

SummaryLeukocytes from patients with gastric, colorectal or benign gastrointestinal disease, as well as those from normal control subjects, were tested by the leukocyte migration inhibition test (LMIT), using five different allogeneic 3 M KC1 extracts of gastric cancer extracts. In LMIT with a single tumor extract, a pathological MI was found in 48% of 79 gastric cancer patients, a significantly higher figure than in the three other groups of patients (4–21 %). In the panel mode of LMIT, that is, testing each blood sample with five different tumor extracts, 62/79 (79%) of patients with gastric cancer showed a positive reaction. Positive reactivity was significantly higher in patients with gastric cancer than in patients in the other groups and the frequency was higher F in stage IV cases than in stage I-III cases, although the differences were not significant. In addition, the frequency of the positive reaction was unrelated to the degree of differentiation in adenocarcinoma. Positive reactivity increased in inverse proportion to the degree of nuclear grade (NG) (84% in NG I, 80% in NG II and 64% in NG III), but the correlation was not statistically significant.

Studies on effect of carcinoembryonic antigen on leucocyte migration inhibition test in patients with colorectal cancer

SummaryLeucocyte migration inhibition test (LMIT) is a useful method to detect tumor associated antigens (TAA) in cancer patients. Carcinoembryonic antigen (CEA) is one of the best tumor markers for gastrointestinal cancer, and especially for colorectal cancer patients, who show high plasma CEA level frequently. In this study, we performedLMIT in 71 colorectal cancer patients with 3 M KC1 extracts of cancer tissues and measured concentration of CEA in the plasma and the extracts of cancer tissue simultaneously. Although CEA in colorectal cancer extracts was individually varied from low to high in concentration, the levels of CEA had no relation toLMI reactivity. In addition, theLMI reactivity of colorectal cancer patients did not relate to the plasmaCEA level of the corresponding patient.The results suggest that some antigens which induce leucocyte migration inhibition factor (LMIF) to lymphocytes from colorectal cancer patients might be different substances from CEA.