Shinkan Tokudome

A Case‐Control Study of Gastric Cancer and Diet in Northern Kyushu, Japan

A case‐control study of gastric cancer was done in a rural area of northern Kyushu, Japan, in relation to dietary habits especially focusing on the relationship with the consumption of broiled fish. The study was based upon 139 cases of newly diagnosed gastric cancer at a single institution, 2,574‐ hospital controls and 278 controls sampled randomly from the residents of the study area (with sex and year of birth matched). No association was observed between the consumption of broiled fish and gastric cancer risk whether three types of broiled fish (raw fish, dried fish and salted fish) were analyzed separately or as a single category. However, consistently in the comparisons with both sets of controls, the risk of gastric cancer was inversely related with the consumption of fruits and positively associated with cigarette smoking. A decreased risk of gastric cancer was also noted among those with high consumption of green tea (10 or more cups per day).

Smoking and mortalities from cancer, coronary heart disease and stroke in male Japanese physicians

SummaryA cohort of 5,477 male Japanese physicians was studied to examine the relationship between smoking habits and mortalities from cancer, coronary heart disease (CHD) and stroke over 12.7 years. The logistic regression analysis based on proportional hazard models was used for statistical assessment. The risks of both lung cancer and CHD were strongly associated with smoking habits in terms of the number of cigarettes smoked per day, inhalation level and age at starting to smoke. These associations were not influenced by the effect of drinking habits. However, the risk increment of lung cancer due to cigarette smoking was fairly small as compared with the data from other studies of male Caucasians. A statistically significant association was observed between upper aerodigestive cancer and cigarette smoking. But this relationship became insignificant after adjustment for drinking habits, and the risk of heavy smokers was drastically reduced. No clear association was noted between smoking and mortalites from gastric cancer and stroke.

Tissue copper content in primary and metastatic liver cancers.

Tissue copper contents in 38 primary and 45 metastatic hepatic malignancies and 15 control livers were analyzed by atomic absorption spectro‐photometry. The average copper content of 15 control livers was 23.1 ± 13.0 μg/g dry weight (μg/gdw). The copper content of five cholangiocellular carcinomas (CCCs) and 45 metastatic cancers was almost equal to the control level. Thirty three hepatocellular carcinomas (HCCs) contained a larger amount of copper (61.5 ± 76.8 μg/gdw) than the control livers (p < 0.05), but the copper content of HCCs showed a considerably wide variation. The average copper content of nine minute HCCs (126 ± 112 μg/gdw) was significantly (p < 0.05) higher than that of 24 large HCCs (37.2 ± 39.9 μg/gdw). Histologically, orcein and paramethylaminobenzylidene rhodalne positive granules were seen in eight and four of nine minute HCCs, respectively. These granules were also found in some large HCCs, but were never found in CCCs and metastatic cancers. It was concluded that these excessive accumulations of copper and copper‐binding proteins might present a helpful finding to distinguish some cases of HCC, especially small HCC, from CCCs, metastatic cancers and hypertrophic regenerative nodules of cirrhotic livers. The significance and possible pathogenesis of these copper accumulations in HCCs require further studies.

Risk of Adult T-cell Leukemia Developing Individuals with HTLV-I Infection

We examined the risk of ATL developing among anti-HTLV-I antibody-positive residents of Goto Island, an ATL-endemic area in Japan. In the period from 1986 to 1990, a total of 1,221 residents aged 40 or over were followed. The crude incidence rates for ATL (with 95% confidence intervals) were 577 per 100,000 (53-2,052) for males and 205 per 100,000 (19-755) for females, rates three to five times higher than those given in previous reports. The different levels of risk in various districts imply that there are risk factor(s) for ATL peculiar to the endemic area.

Alcohol and cancer in male Japanese physicians

SummaryThe relationship between alcohol and sitespecific cancers was investigated in a follow-up study of 5,139 male Japanese physicians. Information on drinking habits was obtained by mail questionnaire in 1965, and cancer deaths over 12.7 years were analyzed with drinking habits classified into five categories; nondrinker, ex-drinker, occasional drinker, and daily drinker whose intake of alcohol was equivalent to less than 2 or 2 and morego ofsake (1go sake≃27 ml alcohol). Both age and smoking habits were taken into account in the calculation of death rates based on man-years at risk. Logistic regression analysis was also performed on cummulative mortality data. Upper aerodigestive cancer was strongly associated with alcohol consumption, giving some confidence in the validity of the present study. Excluding ex-drinkers, the risk of stomach cancer and liver cancer was gradually increased from nondrinkers to daily drinkers with lower intake of alcohol, but no further increase was noted for daily drinkers with larger consumption. Logistic regression did not show any significant associations between drinking habits and these two cancers, but the number of deaths from liver cancer was still small. Not paticular patterns were observed for cancers of the large bowel and lung.

Hepatocellular carcinoma among HBsAg positive blood donors in Fukuoka, Japan

In order to examine the association between hepatitis B virus carriage and hepatocellular carcinoma, 3765 HBsAg positive blood donors were followed from 1977 to 1983 in Fukuoka, Japan. The observed number of deaths was compared with the expected deaths calculated by applying cause-, sex- and age-specific death rates for Fukuoka in 1980 to sex- and age-specific population at risk of the subjects. Among 2595 male blood donors, mortality from liver cancer (or hepatocellular carcinoma) was specifically elevated compared with the general population, where the observed, expected deaths and O/E were 15, 2.07 and 7.25, respectively (P less than 0.001). This relative risk was assumed to be underestimated partly because of a healthy donor effect. Neither the HBsAg titer nor the HBeAg-Ab system was related to the risk. Relative risk and population attributable risk % in Japan and various countries were estimated.

Follow-up of asymptomatic HTLV-I carriers among blood donors in Kyushu, Japan

We examined mortality from adult T-cell leukemia/lymphoma (ATL/ATLL) and other diseases alleged to be associated with human T-lymphotropic virus type I (HTLV-I) among anti-HTLV-I antibody-positive blood donots in Kyushu, Japan. During 1984–87, a total of 3,991 blood donors aged 40 years or over were followed from the date of donation to the date of death or the end of the study. Crude mortality rates from ATL (with 95 percent confidence intervals) were 68 per 100,000 (13–202) for males and 36 per 100,000 (3–132) for females. The rates were underestimated by approximately 50 percent because of self-selection and short observation periods. Neither death rates from other cancers not death rates from all cancers were elevated.

Prevalence of HTLV-I-associated myelopathy among HTLV-I carriers in Saga, Japan.

Surveying the disease by sending questionnaires to all physicians of the Saga Medical Association, we tabulated 19 definite cases of HTLV-I-associated myelopathy (7 males and 12 females) as of January 31, 1988. The population at risk of HTLV-I carriers was estimated by applying sex- and age-specific anti-HTLV-I antibody-positive rates among blood donors at the Saga Red Cross Blood Center in the fiscal year of 1986 to the population of Saga Prefecture in 1982. The crude prevalence rates among HTLV-I carriers from 20 to 69 years of age per 100,000 were 65.7 for males and 86.9 for females, respectively. The summary prevalence rates with 95% confidence intervals were 46.5 (14.3-97.3) for males and 74.9 (35.3-129.2) for females. There was no remarkable difference in the age-specific prevalence rates in either sex. The crude and summary rates among females were higher than those among males, but the difference was not statistically significant.

INTER‐ and INTRA‐PATHOLOGIST VARIABILITY IN HISTOLOGIC DIAGNOSES OF LUNG CANCER

To estimate variability and reliability in histologic diagnosis (Dx) of lung cancers, lung cancer preparations were divided into eight equal sets and diagnosed independently by an eight‐man pathology panel. Majority Dx (Dx affirmed by more than 4 panelists) was regarded as the consensus Dx of each cancer. The consensus rate of each panelist ranged from 78.8% to 96.1% with an average of 89.4%. The consensus rates were not significantly different among the panelists. Relatively high inter‐pathologist agreement was observed in squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. However, regarding large cell carcinoma, there was occasional disagreement among the panelists. Forty‐seven cancers were reexamined by the same panelists, with no preliminary announcement, 7 months after the first examination to study the intra‐pathologist agreement. The rate of the intra‐pathologist agreement ranged from 76.6% to 93.3%. Dx of large cell carcinoma was the most intra‐changeable. It was concluded that the histologic Dx of large cell carcinoma was the most inter‐ and intra‐changeable, and the most frequent dissenting Dx from it was poorly differentiated squamous cell carcinoma. ACTA PATHOL. JPN. 37:1053–1060, 1987.

Concomitant carriage of hepatitis B virus and human T-lymphotropic virus type I among blood donors in Kitakyushu, Japan

The seroprevalence of hepatitis B surface antigen (HBsAg) by gender and age and of human T-lymphotropic virus type I (HTLV-I), and their concomitant carriage was examined among blood donors at the Kitakyushu Red Cross Blood Centre in the fiscal year of 1988. The positive rates of HBsAg among males were consistently higher than those of females; the peaks were detected in male donors aged 30-39 years and in females aged 40-49 years. Declining seropositive rates in individuals aged 50 years or over were observed for both genders. Self-selection due to chronic HBV infection may partly account for such tendencies. On the other hand, the prevalence rates of anti-HTLV-I antibodies among males were uniformly lower than those of females, which must be attributable to male-to-female transmission of HTLV-I via sexual contact. Elevated positive rates in proportion to age were noted for both genders, which may be explained in part by birth cohort effect. The seropositive rates of HBsAg among HTLV-1 carriers were not statistically different from those of non-HTLV-I carriers. Conversely, the prevalence of antibodies to HTLV-I was unrelated to the status of seropositivity of HBsAg.