Kamachi H

Luminal membrane expression of mesothelin is a prominent poor prognostic factor for gastric cancer

Background:Mesothelin is expressed in various types of malignant tumour, and we recently reported that expression of mesothelin was related to an unfavourable patient outcome in pancreatic ductal adenocarcinoma. In this study, we examined the clinicopathological significance of the mesothelin expression in gastric cancer, especially in terms of its association with the staining pattern.Methods:Tissue specimens from 110 gastric cancer patients were immunohistochemically examined. The staining proportion and intensity of mesothelin expression in tumour cells were analysed, and the localisation of mesothelin was classified into luminal membrane and/or cytoplasmic expression.Results:Mesothelin was positive in 49 cases, and the incidence of mesothelin expression was correlated with lymph-node metastasis. Furthermore, luminal membrane staining of mesothelin was identified in 16 cases, and the incidence of luminal membrane expression was also correlated with pT factor, pStage, lymphatic permeation, blood vessel permeation, recurrence, and poor patient outcome. Multivariate analysis showed that luminal membrane expression of mesothelin was an independent predictor of overall patient survival.Conclusion:We described that the luminal membrane expression of mesothelin was a reliable prognostic factor in gastric cancer, suggesting the functional significance of membrane-localised mesothelin in the aggressive behaviour of gastric cancer cells.

Effectiveness of using ultrasonically activated scalpel in combination with radiofrequency dissecting sealer or irrigation bipolar for hepatic resection.

BACKGROUND/AIMS Many kinds of transection devices have been developed but there are very few reports on the effectiveness of using ultrasonically activated scalpel with a hook blade in combination with a thermo-coagulating device for hepatectomy. METHODOLOGY We studied 533 consecutive patients who underwent hepatectomy for primary disease and for living- related liver transplantation (LRLT) donors preformed using ultrasonically activated scalpel with a hook blade along with a saline-linked radiofrequency dissecting sealer (TL group, n=215) or bipolar cautery with a saline-irrigation system (IB group, n=318). Intraoperative blood loss, operative time, postoperative laboratory data collected over a week and the incidence of postoperative complications were analyzed in accordance with the pre-existing liver conditions. RESULTS The median operative time required to perform partial hepatectomy and hemihepatectomy in liver tumor cases was found to be significantly shorter in the TL group than in the IB group. There was no significant difference in the amount of blood loss between the 2 groups. Postoperative laboratory data was favorable and the overall complication rate after hepatectomy was 9.01%. CONCLUSIONS Ultrasonically activated scalpel with a hook blade used in combination with a thermo-coagulation device yielded favorable intra and postoperative outcomes.