Yasushi Ikuta

A HER2/NEU‐derived peptide, a Kd‐restricted murine tumor rejection antigen, induces HER2‐specific HLA‐A2402‐restricted CD8+ cytotoxic T lymphocytes

We have identified an H‐2Kd‐binding peptide, HER2p780 (PYVSRLLGI), derived from murine HER2/neu (HER2), that can induce HER2‐specific murine cytotoxic T lymphocytes (CTL). Weekly vaccination of BALB/c mice by syngeneic dendritic cells pulsed with HER2p780 peptide, entirely common to murine and human HER2, suppressed growth of pretransplanted HER2‐expressing syngeneic tumors. A HER2‐expressing human cancer cell line SKOV3 transfected with murine H‐2Kd cDNA could also be lysed by HER2p780‐specific murine CTLs, indicating that human HER2‐expressing cancer cells can process and present the cognate peptide in the context of H‐2Kd. Since H‐2Kd and HLA‐A2402 molecules have similar anchor motifs, the possibility of inducing HER2‐specific CTL activity with HER2p780 in HLA‐A2402 individuals was examined. CD8+ CTL clones specific for HER2‐expressing cancer cell lines were established from peripheral blood lymphocytes with HLA‐A2402 by repeatedly sensitizing with peptide‐pulsed autologous dendritic cells as well as peripheral blood mononuclear cells. Detailed analysis of their specificity revealed that the cytotoxicity of CTL clones is specific for the cognate peptide with HLA‐A2402 restriction. The results suggest that HER2p780 is a unique peptide that may function as a tumor rejection antigen peptide in HLA‐A2402 individuals, as it was directly proven here to function in a murine tumor system. Int. J. Cancer 87:553–558, 2000.

Surgical Treatment for Lung Cancer in Octogenarians

PurposeWe conducted this study in order to determine how we should perform the surgical treatment for clinical stage I non-small cell lung cancer (NSCLC) in octogenarians.MethodsThirty-three octogenarians with clinical stage I NSCLC participated in this study. They were retrospectively divided into two groups: one group of 11 patients who underwent a lymph node dissection (ND group), and one group of 22 patients who did not undergo this procedure (ND0 group). We analyzed the surgical invasiveness, morbidity, mortality, and survival in both groups.ResultsThe morbidity rate in the ND group (45%) was higher than that in the ND0 group (23%); however, the difference was no statistically significant (P = 0.1805). There was no significant difference in the overall survival rates of the two groups (P = 0.1647), and the median survival time of the ND0 group (76 months) was slightly longer than that of the ND group (26 months). There was no significant difference in local recurrence rate between the two groups (9.1% vs 4.5%, P = 0.6059).ConclusionWe thus conclude that a limited operation without lymph node dissection might be the best surgical treatment for carefully selected octogenarians with clinical stage I NSCLC.

Chromosome 8 numerical aberrations in stage II invasive ductal carcinoma: correlation with patient outcome and poor prognosis.

Aberrations in chromosome 8 are common in breast cancer. However, the relationship between numerical aberrations of chromosome 8 and clinical behavior (especially prognosis) in breast cancer is not well understood. In this study, a total of 40 specimens of stage II invasive ductal carcinomas (IDCs) was analyzed by fluorescence in situ hybridization (FISH) with a chromosome 8 centromere-specific probe and DNA flow cytometry (stage IIA: 20 cases; stage IIB: 20 cases). All cases were followed for at least 5.7 yr (mean: 7.5 yr; median: 7.7 yr) after surgery or until death. Single (loss), double, and triple or more signals (gain) of chromosome 8 were found in 7.6±3.5% (range: 2–16%; median: 7%), 53.7±13.2% (range: 25–81%, median: 53%), and 38.7±13.2% (range: 17–65%, median: 38%), respectively, of tumors. The frequencies of chromosome 8 gain and disomy correlated with patient outcome (respectively p<0.05 and p<0.01). When median ratios of chromosome 8 loss, disomy, and gain were used as the cutoff values, the survival curves revealed that patients in the low-frequency group survived significantly longer than those in the high-frequency group for chromosome 8 gain (p<0.05), and patients in the high-frequency group survived significantly longer than those in the low-frequency group for chromosome 8 disomy (p<0.05). Poor prognosis was not associated with age, tumor size, lymph node metastasis, histologic type, TNM stage, estrogen-receptor status, progesterone-receptor status, or DNA ploidy. Our results suggest that the frequencies of chromosome 8 gain and disomy is a potentially useful parameter for predicting prognosis of stage II IDCs.

Pulmonary Tractotomy for a Patient with Traumatic Penetrating Lung Injury: Report of a Case

We report a case of traumatic hemopneumothorax caused by penetrating lung injury in a 26-year-old man. The patient underwent emergency thoractomy, which revealed hemorrhage in the lingular segment of the left lung. We found the bleeding point and controlled the hemorrhage using pulmonary tractotomy by inserting a linear stapler into the stab wound in the pulmonary parenchyma. The original technique of pulmonary tractotomy was performed for complete through-and-through injury by dividing the bridge of lung tissue between the aortic clamps. We were able to apply this procedure safely to stop bleeding from a stab wound that did not go through the lung. Thus, pulmonary tractotomy is an effective damage-control operation for the lung with obvious advantages over major lung resection.

Wound retraction technique in video-assisted thoracoscopic surgery for a morbidly obese patient

高度の肥満は胸腔鏡手術を困難にする要因の一つである．今回我々は高度肥満患者における胸腔鏡手術において，厚い皮下脂肪組織を開排するためにウーンドリトラクター（Applied Medical, USA）を使用した．患者の胸壁を薄くすることにより，胸腔鏡デバイスの操作性が向上した．

TWO CASES OF ELASTOFIBROMA DORSI

症例は58歳と60歳の男性．ともに右肩甲骨下部の腫瘤と疼痛を訴え来院した．いずれの症例でも肩甲骨下に弾性硬，境界不明瞭な腫瘤を触知した．胸部CTで低吸収域の腫瘤，胸部MRIでT1強調像・T2強調像ともに高信号域と低信号域が混在する腫瘤がみられた．発生部位と画像所見より弾性線維腫と診断し，腫瘤摘出術を施行した．病理組織は膠原繊維の増生と，elastic van Gieson stainで黒褐色に染まる弾性線維を認めたため，最終的に弾性線維腫と診断された．ともに疼痛は消失し，術後10カ月・5カ月再発はみられていない．