Taiji Hase

Evaluation of multi skin test in colorectal cancer patients and effects of serum immunosuppressive factor and cytokine production of peripheral mononuclear cells.

Decreased skin reactions using five kinds of recall antigens correlate d with the stage of colorectal cancer. Immunosuppressive factors in the serum (IS index) increased with the progression of the stage in cancer patients, but interleukin (IL)-I and IL-2 production in peripheral mononuclear cells (PBMC) did not correlate with the advance of the disease. In patients with low immunosuppressive factors, the score of skin reactions was significantly higher than that in patients with high immunosuppressive factors. Increased serum immunosuppressive factors seem to reduce skin reactions in the patients. Furthermore, significant difference in skin reaction score was observed between patients with high IL-1 production of PBMC and patients with low IL-1 production of PBMC. These results suggest that skin reaction might be controlled by serum immunosuppressive factors and IL-1 production of PBMC, and that the score of skin reaction using multirecall antigens is a useful parameter to learn the host immunity in colorectal cancer.

Hepatic sinusoidal obstruction associated with S-1 plus cisplatin chemotherapy for highly advanced gastric cancer with paraaortic lymph node metastases: report of a case

A 56-year-old man who was diagnosed with gastric cancer with multiple paraaortic lymph node metastases was treated with S-1 plus cisplatin. The spleen gradually enlarged during the therapeutic courses. After the 6th course of therapy, the primary gastric lesion and paraaortic lymphadenopathies disappeared. He underwent a curative resection, including a distal gastrectomy with regional and paraaortic lymph node dissections. Irregularly distributed congestion of the liver was noted during the surgery. Histological examinations revealed residual cancer cells in 3 regional lymph nodes and no cancer cells in the primary site and paraaortic lymph nodes. Hepatic sinusoidal obstruction syndrome (SOS) was also confirmed histologically. This is the first report of a case with SOS after S-1 plus cisplatin therapy. S-1 plus cisplatin therapy can cause SOS, although it is a promising preoperative chemotherapy for highly advanced gastric cancer.

TWO CASES OF MUCINOUS CYSTADENOCARCINOMA OF THE APPENDIX

虫垂粘液嚢胞腺癌は比較的稀な疾患である.従来,その発見は破裂による腹膜偽粘液腫であることが多かった.しかし最近の画像診断の発達とともに未破裂の状態で発見されることが多くなった. われわれは最近,虫垂粘液嚢胞腺癌の2症例を経験した. 1例は62歳女性で術前に超音波,CT検査およびMRI検査などで確診を得て,一部盲腸を含めた虫垂切除術を行い良好な結果を得た. 2例目は80歳男性でイレウス症状著明にて第4病日に緊急手術を施行した未破裂の虫垂粘液嚢胞腺癌であった.回腸に一部浸潤し,これが原因で腸閉塞症状を惹起していた症例であった.本症例は術後3日目に肺炎を合併,気管切開,人工呼吸器装着などにより,術後1.5カ月後にはほぼ回復し,経口摂取も一時可能になったが,その後再び肺炎を発症し,術後93日目に死亡した.以上2例につき若干の考察を加え報告した.