Hideaki Kurioka

Elevated expression levels of NCOA3, TOP1, and TFAP2C in breast tumors as predictors of poor prognosis

Amplification of DNA in certain chromosomal regions plays a crucial role in the development and progression of human malignancies, specifically when protooncogenic target genes within those amplicons are overexpressed. Comparative genomic hybridization studies have revealed frequent amplification at 20q in primary breast tumors. The aim of the current study was to identify specific genes in the 20q amplicon that were likely to have clinical significance.

Phase I/II Study of a Combination of S-1 and Weekly Paclitaxel in Patients with Advanced or Recurrent Gastric Cancer

Objective: A phase I study of weekly intravenous paclitaxel combined with a fixed dose of S-1, a dihydropyrimidine-dehydrogenase-inhibitory oral fluoropyrimidine, was conducted for patients with advanced or recurrent gastric cancer (ARGC). Endpoints of this study were to examine the toxicity profile of this regimen and to determine the recommended dose (RD) of paclitaxel. Methods: S-1 was fixed at a dose of 80 mg/m2 per day and was administered for 2 weeks (days 1–14) followed by a 2-week rest. Two dose levels of paclitaxel (level 1: 60 mg/m2, level 0: 50 mg/m2) were studied. Paclitaxel was infused over 1 h on days 1, 8, and 15. Plasma sampling was performed to characterize the pharmacokinetics and pharmacodynamics of paclitaxel in some patients. Fifteen patients were enrolled (6 patients in level 1, and 9 patients in level 0). Dose-limiting toxicities were defined as grade 4 hematological (including grade 3 febrile neutropenia) and grade 3 non-hematological (except anorexia, nausea, vomiting and depilation) toxicities. Results: Three of 6 patients in level 1 developed grade 4 neutropenia or grade 3 febrile neutropenia, and 1 of them also showed grade 3 diarrhea, which settled the maximum-tolerated dose at this level. At level 0, 2 of 9 patients developed grade 4 neutropenia or grade 3 febrile neutropenia, and the RD of paclitaxel for this protocol was set at this level. Pharmacologic studies demonstrated the persistence of significant serum paclitaxel levels over 24 h after drug administration at both levels. Objective responses according to Response Evaluation Criteria in Solid Tumors were observed in 3 of 6 patients who had measurable disease. Conclusion: A combination of S-1 and weekly paclitaxel was feasible and well tolerated, and is suggested to produce a worthwhile response in ARGC. These results warrant further investigation, and a phase II study has already been started.

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.

Intra-abdominal desmoid tumor mimicking lymph node recurrence after gastrectomy for gastric cancer

immunocompromised because of lymphoma and its specific treatment with high dose steroids. This may have resulted in a low specific immune response to viral antigens and a weak cytotoxic T lymphocyte (CTL) response. The CTL response is responsible for the destruction of virally infected hepatocytes and subsequent viral clearance. Such a weak response may facilitate chronic evolution, as we observed. In conclusion, prolonged hepatitis E may be seen in specific populations, including immunocompromised patients.

Predictive value of the time-intensity curves on dynamic contrast- enhanced magnetic resonance imaging for lymphatic spreading in breast cancer

PurposeDynamic contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a promising diagnostic modality in various breast cancer treatments. However, little is known about the correlation between the pattern of time to signal intensity curves (TIC) on the CE-MRI and clinicopathologic features. This study was designed to investigate these correlations and evaluate the predictive value of TIC on CE-MRI in order to identify high-risk patients.MethodsBetween 2001 and 2003, 101 lesions were evaluated to detect malignancy on CE-MRI in 101 women who were suspected of having breast tumors based on either clinical findings or conventional imaging studies. Moreover, the clinicopathologic findings were compared with the pattern of TIC for the 69 surgically treated malignant lesions.ResultsIn detecting malignancy, the sensitivity, specificity, and accuracy were 78.7%, 88.5%, and 81.2%, respectively, in the 101 breast lesions. Especially for the 69 surgically treated malignant lesions, in comparison with breast cancer tumors with the benign pattern of TIC, the breast cancer tumors with a malignant pattern were found more frequently in lymphatic invasion (P < 0.01) and lymph node metastasis (P < 0.005), although no statistical correlation regarding the histological type, tumor size, vascular invasion, extensive intraductal component, hormone receptor status, or pathological stage was noted between the two groups. According to a logistic regression model, lymph node metastasis was found to be a significant independent variable.ConclusionThe pattern of TIC could be used to predict lymphatic spreading associated with lymph node metastasis prior to surgery as well as to detect malignancy. Therefore, a more detailed evaluation should be made to identify the presence of lymphatic spreading in patients with a malignant pattern of TIC.

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.