Shinji Iwamoto

Expression of Cell-Cycle Regulator p27 Is Correlated to the Prognosis and ER Expression in Breast Carcinoma Patients

Cell cycle inhibitor p27 is variously expressed in breast carcinoma. A possible association between the expression of p27 and the prognosis of breast carcinoma remains to be elucidated. We investigated the expression of p27 and cyclin D1 in a retrospective series of 216 breast carcinomas immunohistochemically. Expression of p27 (p27 LI) ranged from 0 to 93.6% (median 62.4%). There was a positive association between p27 LI and cyclin D1 (p < 0.01) and between p27 LI and ER (p < 0.0001). In the combination study of p27 LI and cyclin D1 expression, the patients classified as low p27 LI/cyclin D1 negative had a poorer prognosis than those in other categories. p27 was identified as an independent prognostic factor by the multivariate Cox proportional hazard model with a relative risk of death of disease of 4.1 (p < 0.05; vs. high p27 LI compared to the median). Assessment of p27 expression and examination of both p27 LI and cyclin D1 expression may identify breast carcinoma patients who would benefit from adjuvant therapy.

Regression of lymph node metastases by immunotherapy using autologous breast tumor-lysate pulsed dendritic cells: report of a case.

Abstract A 50-year-old woman was diagnosed as having stage IV breast cancer with bilateral supraclavicular lymph node metastasis resistant to CAF therapy. She received immunotherapy using autologous tumor lysate-pulsed dendritic cells (DCs). Four cycles of DC injection into the right supraclavicular lymph nodes resulted in regression of bilateral supraclavicular lymphogenous metastasis. Histological studies revealed an accumulation of CD45+ T lymphcytes in the regressive lymph nodes. This case suggests that immunotherapy with DCs may be a safe and promising approach for the treatment of advanced breast cancer.

DIFFERENTIAL DIAGNOSIS OF VON MEYENBURG COMPLEX FROM DIFFUSE LIVER METASTASIS IN THE PRESENCE OF ADVANCED GASTRIC CANCER

von Meyenburg complexは胆管性過誤腫性病変といわれている.今回われわれは進行胃癌の術前検索にて,びまん性肝転移との鑑別診断を必要としたvon Meyenburg complexの1例を経験したので,報告する.症例は59歳,女性.進行胃癌の術前検索の腹部超音波検査, CT検査にて肝臓の両葉に多発する小結節性の腫瘤性病変を認め,多発性肝転移との鑑別は難しかった.そこで, MRI, MRCPへと検査にて精査をすすめたところ,肝内の胆管系との交通がない多発する小嚢胞を確認し,典型的なvon Meyenburg complexと診断した.さらに診断精度を上げるために, FDG-PET検査も追加したところ, FDGの集積は認めず,肝転移は否定した.術中の肝臓の肉眼判定では,肝表面に5mm大の濃緑色調を呈する嚢胞性病変が散在しており, von Meyenburg complexの術中診断を下した.病理学的な確定診断を得るべく肝生検を行ったが,採取部位と大きさが不適切であり,今後の反省課題として残った.