Takayuki Itoh

Invasive thymoma with paraneoplastic retinopathy

A 60-year-old man was admitted for progressive visual loss in both eyes. He was diagnosed with retinopathy and chest computed tomography revealed an invasive thymoma. In western blot analysis, serum autoantibodies against recoverin, photoreceptor-specific calcium-binding protein, and heat shock cognate protein 70 which were identified as the cause of cancer-associated retinopathy (CAR). Immunofluorescence staining showed that thymoma cells also expressed recoverin. These observations strongly suggested that similar pathogenesis of CAR was involved in the presented case.

Usefulness of the high sensitivity PIVKA-II measurement method in diagnosis of hepatocellular carcinoma: A comparison with the conventional method

Abstract We investigated a new PIVKA-II assay kit (Eizai, ED-008) that incorporates the use of an improved secondary antibody compared with the conventional EIA method, and is highly sensitive to PIVKA-II (sensitivity: 0,0125 AU/ml). Using this new kit, we measured plasma PIVKA-II levels in 76 subjects in whom the conventional PIVKA-II assay was negative (≤ 0.0625 AU/ml). There were 30 patients with HCC, 14 patients with liver cirrhosis (six with α-fetoprotein ≥ 50 ng/ml), 11 patients with chronic active hepatitis C, 11 patients with chronic inactive hepatitis C, and ten healthy volunteers. The new assay kit detected PIVKA-II (≥ 0.0125 AU/ml) in 11 patients with HCC (36.7%), and one patient with liver cirrhosis (7.1%), but was negative in the patients with chronic active or inactive hepatitis C and the controls. Among the 11 HCC patients positive for PIVKA-II, the plasma α-fetoprotein level was greater than 100 ng/ml in two patients (18.2%), while it was above this level in three of the 19 patients negative for PIVKA-II. The mean size of the main tumor in the patients positive and negative for PIVKA-II was 2.16 + 0.87 cm and 2.62 + 1.50 cm, respectively, with no significant difference between the groups (P = 0.47). However, in seven patients positive for PIVKA-II, the tumor size was less than 2 cm. This assay also showed a high specificity for HCC (0.98). We concluded that this assay may allow PIVKA-II to be used as a more effective indicator of HCC.