Yoshinori Inagaki

A study on recurrent patterns of hepatoma in the remnant liver.

過去12年間に経験した108例の肝細胞性肝癌に対して53例の肝切除を行い, 肝切除後の再発形式がどのような因子によるものかを検討した.再発症例は23例, 60.5%と再発率は高率で, 再発形式には断端, 孤立性および多発性再発の3つに分類された.再発までの期間は孤立性および多発性再発はそれぞれ1,000±667,566±511日で差はなかったが, 再発確認後の生存期間はそれぞれ472±237,238±130日となり, 多発性再発群が短かった.再発危険因子としての被膜形成とその浸潤の有無, 脈管浸潤の有無, Stage分類, 腫瘍径, 肝硬変の程度, Edmondson分類, および術前集学的治療の有無により再発形式を予測できなかった.多発性再発を予測できると考えられた因子としてはHBs抗原の存在 (38.5%), AFP値の肝切除後の減少率の低値 (52.5%) および術前原発巣が複数の場合が考えられた.

Abnormality of serum immunoglobulins in chronic liver disease-immune complex like substances, abnormaly basic γ-globulin, secretory IgA and anti-DNA antibody

1) Serum secretory IgA was reduced in chronic liver disease while it was increased in obstructive jaundice. 2) Serum anti-dsDNA antibody was slightly increased in chronic liver disease, especially it was significantly increased in lupoid hepatitis in which its titer paralelled with the course of disease activity. 3) Serum Clq binding activity, Clq binding inhibition activity and polyclonal rheumatoid factor binding inhibition activity were increased in chronic liver disease and their disease activity was correlated with concentration of macromolecular immune complexes which were fractionated with sucrose density gradient ultracentrifugation. 4) Abnormally basic y-globulin which was dominantly found in chronic hepatitis B sera was determined to be monomeric IgG. I t was increased in aggravation of the disease but has no correlation with Clq binding monomeric IgG. 5) Liver membrane specific lipoprotein (LP-1), Espinosas liver specific antigen (LSA), Nerenbergs hepatorenal antigen (HRA) and Tamm-Horsfall glycoprotein (THGP) had positive charge, and LP-2 and F-antigen did negative charge. 6) Human liver cell membrane fraction could not be obtained by the method of Ray or aqueous two phase polymer system which have been used for rat liver.