Shinya Iida

FDG-PET/CT in the diagnosis of recurrent breast cancer

Background An advantage of PET/CT has been demonstrated for diagnosis of several tumor entities. In patients with breast cancer, early diagnosis and accurate restaging of recurrence after surgery is important for selection of the most appropriate therapeutic strategy. Purpose To evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using 18F-fluorodeoxyglucose (FDG), for follow-up of patients with suspected recurrent breast cancer. Material and Methods Forty-seven patients with suspected recurrent breast cancer underwent PET/CT. The PET and PET/CT images were interpreted without knowledge of the results of other diagnostic modalities, and compared with each other with reference to the final diagnosis. Results Twenty-five (53%) patients suffered tumor recurrence. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT were 96%, 91%, 92%, 95%, and 94%, respectively. In comparison with PET, PET/CT had a higher sensitivity and accuracy (96% vs. 80% and 94% vs. 81%, respectively). The difference in diagnostic accuracy between PET/CT and PET was significant (P < 0.05). Conclusion The present findings indicate that PET/CT is an accurate, sensitive and reliable modality for screening and detection of breast cancer recurrence. PET/CT appears to be an effective surveillance tool, as it is able to cover the whole body in a single procedure and shows good performance.

Comparative Study between DNA Copy Number Aberrations Determined by Quantitative Microsatellite Analysis and Clinical Outcome in Patients with Stomach Cancer

Purpose: We detected the relative DNA copy numbers (RCNs) at target loci in patients with stomach cancer with quantitative microsatellite analysis. We additionally clarified the relationship between DNA copy number aberrations and the clinical outcome of the patients. Experimental Design: Fresh frozen samples were obtained from 30 patients who had undergone surgery for stomach cancer. Seven microsatellite loci in chromosomes 8q, 16q, and 20q and one gene-specific locus (ZNF217) were selected as the target loci. The DNA copy number was obtained relatively to a pooled reference consisting of six microsatellite primer sets selected from the regions where few aberrations have been reported in comparative genomic hybridization analysis. On the basis of the TaqMan PCR system, the internal probes used were carrying donor (6-carboxyfluorescein) and acceptor (6-carboxytetramethylrhodamine) fluorescent molecules complementary to CA repeats in the microsatellite markers and to one gene-specific oligomer in the gene-specific marker. Results: Chromosome 8q gain, 20q gain, and 16q loss were detected in 18 (60.0%), 8 (26.7%), and 13 (43.3%) cases, respectively. Gains in the RCNs of D8S1801 and D8S1724 were most frequently found (36.7%). There was a significant correlation between the loss of D16S3026 and reduced survival duration (P = 0.0158), and the simultaneous aberrations of D8S1801 gain and D16S3026 loss (double marker positive) was significantly associated with reduced survival duration (P = 0.0008). According to Cox proportional hazards model, the double marker positive was a significant and independent factor indicating an unfavorable prognostic factor (relative risk, 17.176; 95% confidence interval, 2.782–106.026; P = 0.0022). Conclusion: RCN aberrations in tumor tissues determined by quantitative microsatellite analysis enable identification of the prognostic factors that correlate with clinical outcome of the patients with stomach cancer.

Correlation of c-erbB-2 with invasion and metastasis in human gastric cancer

Recently, metastatic tumors of human gastric .)cancer have been reported to show a high incidence of c-erbB-2 amplification ] . This study was designed to examine the correlation of expression of c-erbB-2 protein in primary site with nodal involvement in resected human gastric cancer. C-erbB-2 was stained immunohistochemically with formalin-fixed and paraffin embedded specimens of 203 gastric cancers using anti-c-erbB-2 polyclonal antibody (Triton Bioscience Inc.) by the method of Hsu et al.. A cell line of gastric cancer, MKN-7, was used as a positive control. Twenty six of the 203 (12.8%) specimens showed positive reactiQn. Immunohistochemical staining was confined mainly to the cell membrane. The expression of c-erbB-2 correlated with the depth of invasion, histologic type and amount of stromal tissue. Six of 89 (6.7%) early cancers and 20 of 114 (17.5%) advanced cancers showed positive reaction (P< 0.05). Twelve of 2a (50%) papillary adenocarcinomas (pap), 8 of 83 (9.6%) tubular adenocarinomas (tub), 4 of 68 (5.9%) poorly differentiated adenocarinomas (por), 2 of 26 (7.7%) signetring cell carcinomas (sig), and no cases of mucinous adenocarcinoma are positive for c-erbB-2. The positive incidence in pap was found to be significantly higher than in other types (P<0.OI). Four of 46 (8.7%) scirrhous types and 16 of 68 (23.5%) non-scirrhous types showed a positive reaction (P<0.05). The p

Abstract 3187: Utility of serum p53 antibodies in patients with various types of malignant tumors

sitivity in metastatic lymph nodes was found more frequently than in primary sites (Table) iirespective of the presence or absence of c-erbB-2 in primary sites. Thirty four of 38 (89.5%) metastatic nodes in pap, 37 of 60 (61.7%) in tub, 3~ of 96 (35.4%) in por and 3 of 20 (15%) in sig showed a positive reaction (Table). The positive incidence in metastatic lymph nodes was significantly higher in pap and tub than in others. Results suggest that expression of c-erbB-2 is related to invasion and lymph node metastasis of gastric cancer, especially in differentiated adenocacinoma.

Selective axillary node dissection differed from the arm lymph flow oriented by 3D-CT lymphography.

Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL Background: Circulating anti-p53 antibody(p53-Ab) in blood can be detected in various cancers. Serum p53-Ab has been applied as a tumor marker in clinical practice. We studied the clinical significance of p53-Ab in patients with esophageal, colorectal, and breast carcinoma. Methods: p53-Ab in serum was measured with Enzyme-linked immunosorvent assay (ELISA) before treatment in 51 patients with esophageal carcinoma, 54 patients with colorectal carcinoma, and 84 patients with breast carcinoma. clinical and pathological features of these cancers The association between clinicopathological factors of these cancers and the level of p53-Ab in serum was evaluated. Results: Twenty-one(41%) of 51 patients with esophageal cancer, 23 (42%) of 54 with colorectal cancer, and 26 (30%) of 84 with breast cancer were diagnosed as p53-Ab positive according to the Manufactures cut-off value. p53-Abs in serum were observed in all these cancer patients with earlier stage. Positive p53-Ab cases in esophageal, colorectal, and breast cancer in stage I were 33%, 25%, and 35%, respectively. There was no correlation between the positive cases and the age, sex, lymph node metastases, distant metastases, or tumor stage. Conclusion: This study showed that p53-Ab in serum was frequently detected in patients with esophageal, colorectal, and breast cancer. p53-Ab can be a promising tumor marker for the early detection of these cancers. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3187. doi:10.1158/1538-7445.AM2011-3187

Percutaneous and laparoscopic approaches of radiofrequency ablation treatment for liver cancer

CTRC-AACR San Antonio Breast Cancer Symposium: 2008 Abstracts Abstract #1012 Background: In early breast cancer, the presence of metastasis in axillary lymph nodes is an important factor in prognosis and further treatment. However, axillary node dissection causes many complications such as contracture of the shoulder joint, lymph edema, and paralysis of the upper extremities. Sentinel node (SN) biopsy provides us an information about no need to dissect axillary nodes for node-negative patients. But on node-positive patients, the conventional axillary node dissection has been performed. 3D-CT lymphography (LG) can show the precise individual lymphatic flow not only from the tumor to SN but also from SN to venous angle, which means breast lymphatic channel. We applied 3D-CT LG to distinguish them from the arm channel to avoid any arm complications. Materials and Methods: 3D-CT LG was performed on the day before the surgery to mark SN on the skin. Above the tumor and near the areola, 2 ml of Iopamidol was injected subcutaneously. A 16-channel multidetector-row helical CT images were taken at 1 min after injection for SN detection, and at 3 and 5 min for observing advancement of lymph flow into venous angle. They were reconstructed to produce a 3D image of lymph ducts and lymph nodes by shaded volume rendering method. SN biopsy and axillary node sampling were performed by dye-stain method using endoscopy. Results: We performed SN biopsy with 3D-CT LG in 146 patients. 3D-CT LG showed periareolar circular lymph ducts and complicated radial breast subcutaneous lymph ducts flow. They were connected to make a network. It clearly showed the precise lymphatic flow from the tumor to SN. 3D-CT lymphography can show sentinel lymph node at only one minute after injection. But following up to 3 minutes and 5 minutes after injection, we can follow the lymph ducts beyond SN into the second and the third nodes toward the venous angle with complex plexus. It shows five beads-like grouped nodes beyond SN. Detection rate was 100% for SN; 80.1% for the third group; and 30.1% for the fifth group. The position of SN and the other groups of axillary nodes were identified by their surrounding anatomical architecture of pectoral muscles and vascular systems, such as axillary vein, lateral thoracic artery, and thoracodorsal artery. Under the endoscopic technique, we can observe the dye-stained nodes in 63.3% of the second group and in 47.9% of the third group detected by 3D-CT LG. SN metastasis was positive in 40 patients, and only SN metastasis was found in 21 patients (52.5%) among them. Any skip metastasis beyond second and third nodes was not observed. Under the direct view, we can distinguish and the axillary node drained from the breast, guided by 3D-CT LG and dye-stain, in 40 patients with SN metastasis, and sample them selectively. Conclusions: By 3D-CT LG, we can recognize the accurate and more precise lymph flow, and their positional relations to surrounding anatomical architecture. It helps us easily to pursuit lymph flow and to remove SN and the axillary nodes from the breast selectively. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1012.