Hiromi Tanemura

Spread of colorectal cancer micrometastases in regional lymph nodes by reverse transcriptase-polymerase chain reactions for carcinoembryonic antigen and cytokeratin 20

Background and Objectives: Lymph node metastasis is known as a significant predictor of prognosis in colorectal cancer patients. Recently, reverse transcriptase polymerase chain reaction (RT‐PCR) has been applied to detecting micrometastasis. To assess the risk of recurrence and accurately determine the spread of tumor cells, we examined lymph node micrometastases in a series of colorectal cancer patients.

Facilitation of Tumor Metastasis by Operative Stress and Participation of Cell-Mediated Immunity

5-week-old syngeneic female SD rats were inoculated subcutaneously at the dorsal flank with 200 mg of a metastasizing rats mammary tumor, MRMT-1. A significantly higher incidence of lung metastasis was observed in the cases in which tumor excision on day 14 was accompanied by 30 min laparotomy than in the cases of simple tumor excision. PHA lymphoblastogenesis on day 17 was significantly lower in the cases of tumor excision plus laparotomy on day 14 than in the cases of simple tumor excision. Winns assay using splenocytes revealed a postoperative enhanced suppressor activity in the cases undergoing laparotomy stress. Possible participation of the raised suppressor activity to facilitation of metastasis was discussed.

Malignant lymphoma occurring in the residual stomach following gastrectomy: plus discussion based on the literature in Japan

Abstract.Malignant lymphoma of the remnant stomach was diagnosed in a 53-year-old man 8 years after gastrectomy for a perforated gastric ulcer. Endoscopic examination demonstrated protruding lesions spreading over the entire residual stomach, and biopsy revealed malignant lymphoma. Rectal cancer was diagnosed simultaneously. The residual stomach was completely excised, with splenectomy, in parallel with low anterior resection of the rectum. Histological studies revealed that the lesion in the residual stomach was a lymphoma of the diffuse, large-cell type, according to the Lymphoma–Leukemia Study Group (LSG) classification, with positivity for CD20 and CD45RA, leading to a diagnosis of B-cell lymphoma. Helicobacter pylori microorganisms were found on the luminal surface of the tumor. Despite postoperative chemotherapy, the patient died of disseminated lymphoma 34 months later. Although malignant lymphoma occurring in the residual stomach following gastrectomy is rare, particular attention should be given to the possible presence of a malignant tumor when examining the residual stomach following gastrectomy.

Venous invasion in cancer of the stomach. With a special reference to method of histological examination.

臨床病理学的に種々の点で近似した2群の胃癌, A群235例, B群115例の切除胃について静脈侵襲を検索した. 病理組織学的検査は, A群で平均1.7枚, B群で3.8枚の組織片について, ビクトリアブルー-ヘマトキシリン・エオジン染色, 第VIII因子関連抗原およびラミニン染色を行い検索した. 癌が粘膜層のみに限局している症例を除くと, 静脈侵襲はA群48.3%, B群56.0%に認められ, 癌の深達度, リンパ管侵襲およびリンパ節転移の程度に平行して増加し, これらとの間に正の相関が認められたが, 組織型ではとくに有意差は認められなかった. ビクトリアブルー-ヘマトキシリン・エオジン染色は静脈の識別に, 基底膜染色は小静脈の判別に有用であるが, 細静脈とリンパ管の鑑別には内皮細胞染色が必要であった. また, 検索は腫瘍中心部および末梢部より採取した組織片, 少なくとも4個について行うのが適切と思われた.

CLINICOPATHOLOGICAL STUDIES ON THE EARLY GASTRIC CANCERS : ESPECIALLY ON THE DEGREE OF THEIR SUBMUCOSAL INVASION

早期胃癌 (192例) のうち粘膜下浸潤 (sm) 胃癌 (68例) の粘膜下層 (sm層) への浸潤程度を新たにsm1, sm2, sm3の3段階に分類し, 早期胃癌の臨床病理学的検討を行い, 以下の結果を得た.(1) sm層への浸潤程度が強くなるほどリンパ節転移率, 脈管侵襲陽性率が高率となった.(2) sm2～3と判定された症例は組織型ではpor, tub2に, 肉眼病型では混合型 (IIc+IIa), 占居部位ではA領域のものに頻度が高い傾向がみられた.(3) sm胃癌再発死亡5例中4例は脈管侵襲陽性のsm2～3例であり, 再発様式は肝転移2例, 腹膜再発, リンパ節再発, 不明が各1例ずつみられた.早期胃癌の術式や術後補助療法の決定に当っては, sm層への浸潤程度をも考慮する必要性があると推察された.