Nobukuni Terata

Expression of sialyl-Tn antigen is correlated with survival time of patients with gastric carcinomas.

Expression of sialyl-Tn antigen (STN) was examined by an immunohistochemical method in 85 primary gastric carcinomas. The STN expression occurred in 53 (62.4%) cancers, and the positive staining was correlated with degree of gastric wall and lymph vessel invasion, lymph node metastasis, and stage of tumour. Five-year survival rates of patients with STN-positive cancers (47.2%) were significantly lower than those with STN-negative cancers (84.4%) (P < 0.01), and patients with STN-positive cancers at stage III and stage IV had a worse prognosis. In the cancers with serosal invasion, patients with STN-positive cancer disclosed a significantly poorer prognosis than those with STN-negative cancers (P < 0.01). Therefore, it is suggested that a careful follow-up study and intensive postoperative therapy are needed for patients with advanced gastric cancers with positive STN expression.

Expression of Hla-Class II Antigen in Gastric Carcinomas: Its relationship to histopathological grade, lymphocyte infiltration and five-year survival rate

To investigate whether the expression of HLA-DR antigen in gastric carcinomas is associated with the survival rate, we studied 70 cases of gastric carcinoma using a monoclonal antibody. Forty-seven cases (67%) stained positively, including 31 differentiated carcinomas, and 16 undifferentiated carcinomas. A close correlation was found between expression of HLA-DR antigen and differentiation of the tumor cells. Marked lymphocyte infiltration was seen in the HLA-DR antigen positive cancers. In advanced gastric cancers, the 5-year survival rate of patients with HLA-DR antigen positive cancers was significantly higher (67.5%) than that of patients with HLA-DR antigen negative cancers (40%). The data suggest that the expression of HLA-DR antigen in gastric carcinomas may reflect the degree of tumor cell differentiation, and influence the host immune response and prognosis.

Expression of HLA-DR and urokinase-type plasminogen activator in stage IV gastric cancer

Abstract:Background.Some patients with stage IV gastric cancer have a long survival. Host immune response and proteolytic activity in the primary tumor may be associated with outcome in these patients. The purpose of this study was to assess prognostic factors in patients with stage IV far advanced gastric cancer.Methods.Findings in 26 patients who underwent resection of stage IV gastric cancer were retrospectively analyzed for clinicopathological variables, and for the immunohistochemical expression of human leukocyte antigen (HLA)-DR as an index of host immune response and for expression of urokinase type-plasminogen activator (u-PA) as an index of proteolytic activity in the tumor.Results.Of the 13 clinicopathological and immunohistochemical variables tested by univariate analysis surgical curability, lymph node metastasis, HLA-DR expression, and u-PA expression had a significant influence on survival after surgery. Multivariate analysis showed that surgical curability, HLA-DR expression, and u-PA expression independently influenced survival. Patients positive for HLA-DR expression [HLA-DR (+)] and regative for u-PA expression [u-PA (−)] had the best survival: 25-month median survival and 25% 5-year survival rate. Patients who were HLA-DR (+) and u-PA (+), or HLA-DR (−) and u-PA (−) had a median survival of 10 months, a 1-year survival rate of 46.2%, and a 2-year survival rate of 7.7%. HLA-DR (−) and u-PA (+) patients had the worst survival: 4.5-month median survival and 0% 1-year survival.Conclusions.These findings suggest that host immune response and proteolytic activity in the primary tumor may determine malignant potential, and that the combination of positive-HLA-DR and negative-u-PA expression in cancer cells may be a predictor of prolonged survival in stage IV gastric cancer patients.

The Induction of Enhanced Antitumor Effect against a Nonimmunogenic Tumor by Highly Immunogenic Variants Obtained by Mutagen Treatment

Nonimmunogenic 1767‐3 fibrosarcoma was treated with the mutagen N‐methyl‐N′‐nitro‐N‐nitrosoguanidine, and stable variant cell clones (M‐clones) were obtained that were able to elicit an immunological rejection response in syngenic C3H mice. Mice immunized with some M‐clones were protected against a challenge from the original nonimmunogenic fibrosarcoma. Furthermore, when spleen cells of immunized syngenic mice were restimulated in vitro with M‐clones, cytotoxic T lymphocytes (CTL) were obtained that were able to lyse not only M‐clones but also the original nonimmunogenic tumor. These in vivo and in vitro results demonstrate the immunogenicity of M‐clones and the existence of a singular antigenic specificity between the original nonimmunogenic tumor and M‐clones. For the purpose of application of this mutagen treatment to cancer therapy, we combined it with lymphokine‐activated killer (LAK) adoptive immunotherapy (AIT). With interleukin 2 and in vitro stimulation with highly immunogenic variant clones, we tried to induce transfer cells that had not only nonspecific LAK cells but also CTL with specific immunity against the original nonimmunogenic tumor. Successful results were obtained in the LAK AIT models. These findings indicate that an immunotherapy of human cancers that are thought to be weakly or nonimmunogenic may be possible by the application of this approach to LAK AIT.

Sialyl-Tn Antigen as a Predictor of Survival Time for Patients with Gastric Carcinoma

Expression of sialyl-Tn antigen (STN) was examined by a immunohistochemical method in 85 primary gastric carcinomas. The STN expression occured in 53(62.3%) cancers, and the positive staining was correlated with tumor penetration, lymph nodes metastasis, and stages. Five-year survival rate for patients with STN-positive cancers(47.2%) were significantly lower than those with STN-negative cancers(84.4%,P<0.01),and patients with STN-positive cancers at stage III and stage IV had a worse prognosis. Therefore, it is suggested that a careful follow-up study and intensive post-operative therapy are needed for patients with advanced gastric carcers with positive STN expression.

Ripstein operation for rectal prolapse.

われわれは最近6年間に9例の完全直腸脱に対し, Ripstein手術を施行し, 良好な結果を得ている. 症例は男性3例, 女性6例, 年齢は41歳から79歳, 平均61歳. 直腸脱出を訴えて来院した症例が多く, 病悩期間は2ヵ月～20年と種々で, 脱出直腸の長さは17cmにおよぶものも認めた. その他には便通異常6例, 出血4例, 疼痛3例であり, またほぼ全例に肛門括約筋緊張低下を認めた. Ripstein手術は, 経腹腔的に腹膜翻転部を切離後, 直腸を授動し, メッシュにて仙骨に挙上固定する術式である. 手術成績は, 術後6年を経過した症例もあるが, 再発は1例もなく, 2例に軽度の便通異常を認めるが, 全例に高い満足が得られている.

Analysis of oncological surgery using the experimental neoplasms.

Strain-2モルモットのLine-10肝細胞癌を用いて, 手術切除と癌化学療法 (MFC) の組みあわせ方について検討した. 切除後のMFCの全身投与では, ヒトの常用量 (1/2MFC: 3週間) では治癒に至らしめられず, LD50量ではじめて1/6匹に治癒を認めたが, 免疫能の荒廃があった. 至適量の局注であれぼ, 早い時期の腫瘍は治癒させられ, しかも治癒動物で抗腫瘍性の免疫能が誘導された. MFC局注後に切除すれば, それぞれの単独にくらべ治癒率が向上し, 局注と切除の間隔はわずか3時間でも良好な成績が得られる. さらに動物実験の成績と臨床の成績の解離について, とくに腫瘍の抗原性の面から解析した.