Tatsuo Munehisa

RADIOIMMUNODETECTION OF CANCER USING ANTIBODIES TO α-FETOPROTEIN AND CARCINOEMBRYONIC ANTIGEN

This study reports the use of radiolabeled antibody to AFP and CEA for the detection and localization of AFP- or CEA-producing tumors. Thirty-one patients received 131I-labeled anti-AFP or anti-CEA antibodies. Photoscans were taken at 24 and 48 hours after injection of radioantibodies. In three of six patients with CEA-producing tumors, radioimmunodetection with anti-CEA antibody showed positive scans. In AFP-producing tumors, 7 of 15 patients had positive findings on immunoscintigraphy using polyclonal anti-AFP antibody, and two of nine patients had positive findings when monoclonal antibodies were used. Analysis of radioantibody in the blood after injection showed both complex and free antibody with immunoreactivity in the circulation, and smaller complexes were seen to form after administration of monoclonal antibodies.

Radioimmunodetection of Cancer Using Radiolabeled Antibodies to α-Fetoprotein

Abstract The tumor imaging using radiolabeled antobodies to α-Fetoprotein (AFP) was undertaken in 27 patients with various AFP producing tumors. In 7 of 15 patients (47%), positive images were obtained using polyclonal antibody and 4 positive and 3 doubtful images were obtained in 12 patients using 4 monoclonal antibodies. The tumor/serum ratios of AFP showed high levels in positive cases, and all monoclonal antibodies could bind to AFP in 7 patients with various primary tumor sites in vitro.

A case report of hepatocellular carcinoma who has survived for 10 years.

3回の摘出術と2回の肝動脈塞栓術(TAE)により10年8カ月生存している肝細胞癌の1例を報告した.症例は62歳の女性,1971年肝生検で肝硬変と診断.1973年10月血中AFP上昇のため当科入院.HBs抗原,HBe抗原ともに陽性.血管造影で腫瘍膿染像をみとめ,摘出術施行,右葉後上区域の3.5cm大の肝癌を摘出した.非癌部は乙型肝硬変であった.6年10カ月後に肝癌の再発がみられ,やはり右葉後上区域にて2.0cm大の肝癌を摘出.さらに10カ月後に肝癌が出現,右葉後下区域より1.0cm大の肝癌を摘出した.組織学的には,3回ともtrabeculartypeであった.さらに1年8カ月後肝癌が出現,TAEを2回施行し外来通院中である.本例の肝癌発生様式は,多中心性と思われるが,血中AFPの厳重なfollowにより3回もの肝癌摘出術に成功し,10年以上の生存をみているため報告した.

Clinicopathological Studies of Minute Hepatocellular Carcinoma. Analysis of 7 Cases

肝細胞癌の早期診断はきわめて難しい.著者らは細小肝細胞癌7例を経験したので,その臨床病理学的特徴につき述べる.7例中6例は診断時自覚症状は軽微であった.臨床所見中変形し増大する肝腫に注目する必要がある.血中AFPは5例が陽性で診断に役立ち,とくに経時的な追跡測定が重要である.特異的診断法ではないが,HBs抗原,アルカリホスファターゼ,総コレステロール,LDH, LAP,トランスアミナーゼ解離が有用な例があった.肝動脈造影は有力な診断法で5例にTumor stainがみられた.AFP陰性,肝動脈造影でTumor stainがみられない2例中1例は腫瘤の吸引細胞診で診断がついた.組織型は全例索状型であった.非癌部組織は全例肝硬変または肝線維症で,肝細胞癌の治療上の問題点につき述べた.術後4年生存している1例では,肝シンチグラム,肝動脈造影で切除部は修復されており,肝硬変でも再生するこ とを示していると考えられた.

Symposium (I): Immuno-biochemical diagnosis of hepatoma

About 80% of hepatoma associate with liver cirrhosis and hepatoma is found in about 50% of liver cirrhosis. This is the characteristic feature of cirrhosis and hepatoma in Japan. This study is carried out to investigate HB antigen, which is now considered as one of the causative agents of hepatoma, AFP and hepatoma ALP, these are specific markers of hepatoma, and putrescine, which may reflect the malignancies, in chronic hepatitis, liver cirrhosis and hepatoma. Methods : The analysis of HB antigen and antibodies were carried out by Dr. Mayumi, Jichi Univ., using reverse passive hemagglutination (RPHA) (HBsAg), PHA (anti-HBs), IAHA (anti-HBc). AFP was determined by RIA and SRID. Hepatoma ALP was studied by polyacrylamide disc electrophoresis. Serum putrescine was determined by high speed liquid chromatography, using fluotescamine labelled putreseine, separated from the serum by deproteinization and CMC chromatography procedures. Results : 1) About 50% of the cases with hepatoma are shown to be closely related with HB virus infection. The mean survival age of cirrhotics with positive HBsAg is 49-year-old and the association of hepatoma is 100~ Otherwise, the mean age of survival of cirrhotics with negative HBsAg is 59-year-old and these cirrhotics associated with hepatoma in 69% cases. 2) Hepatoma ALP was observed in 31% of the cases with hepatoma. This is uniquely found in hepatoma, and not found in other diseases. Hepatoma ALP was observed even in the case of hepatoma with negative AFP test. This suggests that the combination of Hepatoma ALP and AFP tests may be useful for the diagnosis of hepatoma. 3) Serum levels of AFP continuously exceeding 400 ng/ml were observed in 70% of the cases with hepatoma. About 3% of cirrhotics showed the elevated levels of serum AFP exceeding 400 ng/ml, but these were only transiently. AFP levels higher than 400 ng/ml are strongly suggestive of the presence of hepatoma. 4) Serum putrescine level was high in one case with hepatoma. This test is not specific for hepatoma, but the elevation of serum putrescine is considered to be suggestive of the presence of malignancies. Further investigations are undergoing.

Clinical and Pathological Liver Abnormalities in Alcoholics

清酒換算毎日3合(80g)以上,期間10年以上の常飲者34例をA群(肝硬変・前硬変,17例),B群(非硬変,17例、に分け臨床病理的に検討した.臨床的事項:理学的に肝腫,黄疸,クモ状血管腫,腹水ともA群に圧倒的に多い.肝機能ではBSP, TTT, ZST, AL-PともにA群に異常例が多く又,A群でGOT>GPTの傾向がある.飲酒量・持続期間と肝組織像との比較では清酒換算8合(200g)以上,期間15年以上の常飲者にA群に入る例が多い.病理的事項:電顕的に肝細胞胞体基質内に160Aのperiodicityを有す「あみの目状」の結晶構造がみられたことは注目される.また,経時的肝生検により,徐々に進行し最終的に壊死後性肝硬変の完成をみた例を経験したが,アルコールによる壊死後性肝硬変の成立に示唆を与えるものと考えられる.

Hepatoma and liver cirrhosis in nagasaki area

were taken a f t e r in t ravenous admin is t ra t ions of 200 microcuries of l~ colloidal gold in 16 pat ients wi th chronic hepati t is , 11 wi th precirrhosis , and 21 wi th cirrhosis , and sizes of f ronta l as well as lateral project ing areas of these organs were compared. Both hepatic and splenic sizes were unchanged in chronic hepat i t is pat ients whose course remained s tat ionary, whereas splenic sizes were increased in chronic active hepatitis. In pa t ien ts with precirrhosis , e i ther increased or unchanged splenic sizes were observed, and the fluctuations of hepatic sizes were seen. While increases of splenic sizes concomitant with decreases of hepatic sizes were often seen in pat ients with compensated stage of cirrhosis , hepatic sizes were tended to decrease and splenic sizes were remained constant in pat ients wi th te rmina l stage of cirrhosis. Al though the n u m b e r of pat ients studied was small , we feel the findings on serial scintiphotogr phies of the l iver and the spleen in pat ients wi th chronic diffuse hepatic diseases are significant and w a r r a n t fu r the r invest igat ion wi th gamma camera.