Keiko Suzuki

Diabetes mellitus may be associated with hepatocarcinogenesis in patients with chronic hepatitis C.

It is unknown whether diabetes mellitus is a risk factor of the hepatocarcinogenesis in patients with chronic hepatitis C. Three hundred eleven anti-hepatitis C virus (HCV) -positive patients who had undergone liver biopsies were studied. Patients with histologically proven cirrhosis or withdrawing within 12 months were excluded. Thus, the remaining 279 patients were followed-up for 65.9 ± 29.4 months until the occurrence of hepatocellular carcinoma (HCC). During the observation period, HCC developed in 13 patients. Diabetes, age, sex, habitual alcohol intake, history of blood transfusion, serum α-fetoprotein level, histological findings, HCV genotype, viral load, and interferon therapy were assessed as potential risk factors. The Cox proportional hazard model identified that diabetes mellitus, histological staging, and age were independently associated with the occurrence of HCC. With multivariate analysis, only diabetes mellitus and age were associated with the occurrence of HCC. Diabetes mellitus may be associated with hepatocarcinogenesis in patients with chronic hepatitis C.

A case of primary mediastinal seminoma treated with chemotherapy and surgery.

才男性, 嚥下障害, 呼吸困難を主訴に来院した縦隔原発seminomaの症例を経験した.血清βHCG値は12ng/mlと軽度上昇を示した.左鎖骨上窩リンパ節転移, 両肺門に及ぶ巨大腫瘍のためCisplatin, Vinblastine/Etoposide, Bleomycinによる化学療法を4コース施行した.その後の手術による切除標本内にviableな腫瘍細胞は見出し得なかった.予後不良と思われる進行縦隔原発seminoma例に対しては化学療法による治療が必要と考える.