Hirotomo Kanayama

Carcinoembryonic Antigen in Gastric Cancer Patients

Carcinoembryonic antigen (CEA) levels were determined in 252 gastric cancer patients. In patients with resectable cancer, the preoperative CEA values and CEA positivity rates were 2.4 +/- 1.5 ng/ml and 7.7% for stage I, 24.9 +/- 72.0 ng/ml and 10.0% for stage II, 21.6 +/- 84.1 ng/ml and 17.9% for stage III, and 6.3 +/- 8.4 ng/ml and 27.1% for stage IV cancers, respectively. In patients with nonresectable cancers, the CEA value was 83.0 +/- 235.5 ng/ml, the CEA positivity rate was 47.8%. Overall, of 252 patients with primary gastric cancer, 47(18.7%) were positive for CEA. In patients with cancer recurrence, the CEA value averaged 41.8 +/- 101.8 ng/ml, the positivity rate was 63%. This rate increased as the cancer stage increased; it was highest in gastric cancer patients with liver metastasis. In 4 of 13 patients with recurrence, an elevation in CEA was observed about 4.8 months before the clinical detection of cancer recurrence. Our results suggest that in gastric cancer patients, the preoperative and periodic postoperative assay of CEA levels has predictive value in determining cancer stage, progression and recurrence.

The effects of total-body hyperthermia combined with anticancer drugs on immunity in advanced cancer patients.

As total‐body hyperthermia (TBHT) therapy may lead to a reduction in the immune response of cancer patients because of the immediate effect of heat on lymphocytes, the authors studied the immunity of advanced cancer patients receiving combined TBHT and anticancer chemotherapy. A decrease was found in their lymphocyte blastogenesis, skin reactions to PPD and PHA, lymphocyte rosette formation, IgG, and C3c component. These parameters returned to their pretreatment levels at 1 week after completion of TBHT therapy. This result indicates that there is no necessity for giving special consideration to a reduction of cell‐mediated immunity in TBHT therapy.

Immunosuppressive factor from the spleen in gastric cancer patients.

The spleens of gastric cancer patients were examined to determine whether this organ releases an immunosuppressive factor. Compared to serum from peripheral blood, serum from splenic venous blood of advanced gastric cancer patients had greater suppressive activity to normal lymphocyte responses to phytohemagglutinin (PHA); it also contained significantly more immune complexes. Furthermore, the supernatant from spleen cell cultures from advanced gastric cancer patients significantly suppressed normal lymphocyte responses to PHA. This immunosuppressive activity was enhanced when the supernatant was from cultures of separated nonadherent subpopulations. These observations were not detected in patients with early gastric cancer. The blastogenic response to PHA and the percentage of T‐cells among spleen cells was not affected by the cancer stage. These results suggest that the spleen of patients with advanced gastric cancer participates in the induction of serum immunosuppressive factors, possibly due to a change in splenic lymphocyte subsets. Cancer 56: 1963‐1966, 1985.

Experimental Study of Antitumor Effect of Methyl-B12

We examined the antitumor effect of vitamin B12 (methyl-B12) using C3H/He, C57BL/6 and BALB/C mice for animals and MH134 hepatoma ascites cells, Lewis lung cancer cells and Ehrlich ascites tumor cells for tumor cells. At 1.0-10 micrograms/ml, methyl-B12 enhanced PHA- and Con-A-induced lymphocyte blastoformation of C3H/He mice. The growth of MH134 tumors on the backs of C3H/He mice were suppressed by the 7-day administration of 50 or 100 micrograms/day i.p. and their survival was longer than that of untreated mice. However, methyl-B12 administration did not positively affect the survival of C3H/He mice that had been irradiated with 60Co 300 R on the day before tumor cell inoculation. The growth of Ehrlich ascites tumor cells inoculated into BALB/C mice was also reduced at 17 and 19 days after tumor inoculation by administration of methyl-B12 50 micrograms/day i.p. and the mice survived longer than the untreated mice.

Immunosuppressive acidic protein (IAP) in gastric cancer patients

Immunosuppressive acidic protein (IAP) in the serum from peripheral, splenic and regional venous blood of gastric cancer patients was assayed. Peripheral venous blood was collected before, and for several months after the surgery. The IAP values of peripheral venous blood, increased with advancing cancer stage; in patients at the same cancer stage, the IAP values of venous blood draining from the cancer lesion were the highest. In curatively operated patients, the IAP values increased during the first postoperative month and decreased thereafter. In patients with non-resectable cancer and in patients subjected to palliative surgery, these values remained high; they increased sharply just before death. Determination of the serum IAP values in gastric cancer patients may be useful in estimating the immunological state of gastric cancer patients and for monitoring the postoperative immunological, status.

Does preoperative radiation for thoracic esophageal cancer promote intramural lymphatic invasion

Between 1976 and 1983, 43 patients with carcinoma of the thoracic esophagus underwent esophagectomy in the Department of Surgery, Tottori University. Of these 43, 22 received a total dose of 30 to 40 Gy of Co60 (2 Gy/day) preoperatively: 21 were not given preoperative irradiation treatments. The spread of intramural lymphatic cancer invasion into the esophageal wall was compared in these two groups. The preoperatively irradiated patients manifested a significantly lower rate of lymphatic cancer invasion and the depth of invasion tended to be less than in the non-irradiated patients. However, in preoperatively irradiated subjects, the horizontal cancer spread into the extra-radiation field anal to the cancer site was greater than in the other group. In addition, a significantly higher intra-abdominal lymph node metastasis rate was found in the irradiated group than in the non-irradiated group. Our findings suggest that patients with thoracic esophageal cancer who are treated with preoperative radiotherapy must be carefully monitored for the occurrence of intramural lymphatic cancer invasion and distant lymph node metastasis.

Circulating immune complexes in gastric cancer patients and their effect on lymphocyte mitogenesis (the first report)

Immune complexes (IC) were measured in 66 gastric cancer patients, using the 3.5 percent polyethylene glycol (PEG) precipitation method. Preoperatively, the IC values in patients with advanced gastric cancer (stages III and IV) were significantly higher than in normal subjects (p<0.01). In the presence of 3.5 percent PEG-precipitated IC from sera of gastric cancer patients, the mitogen respones of normal peripheral blood lymphocytes was inhibited; the PHA response revealed a significant negative correlation with the concentration of IC (p<0.01). Our data suggest that IC may be a major serum factor exerting immunosuppressive effect in cancer hosts.

A Case of Splenic Inflammatory Pseudotumor with Radial Hypodese Zone on T2-weighted MRI in the Spleen-Review of the Japanese Literature-

MRI, T2強調像にて放射状の低信号を呈する炎症性偽腫瘍 (IPT) の1例を経験したので報告する. 症例は51歳の男性で, 健診にて, USで脾に境界不明瞭で不均一な低エコーの腫瘍を指摘され入院した. 愁訴はなく, 末梢血検査所見では指摘すべき異常はなく, CEAやCA19-9も正常であった. 腹部CT検査で脾内に不均一な低吸収域を認め, 遅延相で造影効果が認められた. MRI検査ではT1強調像で不均一な低信号が認められ, ガドリニウム負荷後に遅延相で造影効果が認められた. 我々の症例では, 特にMRI, T2強調像にて放射状の低信号を呈した. 脾原発腫瘍の診断のもとに摘脾術を施行した. 脾臓の重量は116gで, 腫瘍の大きさは, 3.5×3.5×2.5cmであった. 病理組織学的にIPTと診断され, MRI, T2強調像にて放射状の低信号, を呈した部位に豊富な繊維組織の増生を認めた. 術前に, 悪性腫瘍とIPTを鑑別するのは困難である. 本邦報告例の臨床像所見を検討し報告した.

Effect of regional or distant lymph node removal and of splenectomy on immunologic responses in Ehrlich tumor-bearing mice

To study the role of regional (RLN) and distant (DLN) lymph nodes and of the spleen in the regulation of tumor immunity, we monitored tumor growth in mice subjected to lymph node removal or splenectomy. We found that tumor growth was facilitated when RLN were removed before or soon after tumor inoculation and that RLN removal after extirpation of the immunizing tumor decreased the host resistance to a subsequent challenge. When splenectomy preceded tumor inoculation, tumor growth was not affected, however, marked growth inhibition was observed when splenectomy was performed 5 days after tumor inoculation. Furthermore, splenectomy combined with extirpation of the immunizing tumor increased the host resistance to a subsequent challenge. We conclude from these studies that RLN or the spleen may be of immunologic importance in the host’s tumor resistance.