Background: The infiltration of lymphocytes in tumor tissue has been associated with a good prognosis for patients with hepatocellular carcinoma (HCC). The purpose of the present study was to ...estimate the correlation between mRNA expression of chemokines and tumor‐infiltrating lymphocytes in HCC.
Methods: A total of 44 HCC were examined. Immunohistochemical staining was performed using antibodies to CD4, CD8, CD68, and L‐26. The mRNA expression of each chemokine was investigated: regulated upon activation normal T‐cell expressed and secreted (RANTES), interleukin‐8 (IL‐8), epithelial‐derived neutrophil attractant‐78 (ENA78), interferon‐inducible protein‐10 (IP‐10), monokine induced by interferon‐γ (Mig), and interferon‐γ in HCC were quantified via a real‐time polymerase chain reaction assay. Chemokine proteins of Mig and IP‐10 were examined by immunohistochemistry.
Results: The mean number of infiltrating lymphocytes in HCC was 136.9 ± 32.9/0.25 mm2. Of these infiltrating lymphocytes, CD8‐positive T lymphocytes were those predominantly seen around the tumor cells. The mean mRNA expression (copies/103 glyceraldehyde‐3‐phosphate dehydrogenase GAPDH mRNA) of the following chemokines was determined to be follows: 3.0 ± 1.9 copies/103 GAPDH mRNA, RANTES; 9.2 ± 4.9 copies/103 GAPDH mRNA, IL‐8; 44.6 ± 24.4 copies/103 GAPDH mRNA, ENA78; 215.7 ± 93.9 copies/103 GAPDH mRNA, IP‐10; 77.3 ± 38.5 copies/103 GAPDH mRNA, Mig; and 1.7 ± 0.4 copies/103 GAPDH mRNA, interferon‐γ. Significant close correlations were observed between the number of infiltrating lymphocytes in these HCC and the expression of Mig and IP‐10 mRNA. In the immunostaining, expression of Mig and IP‐10 proteins was found only in the HCC cells in the high‐infiltration group.
Conclusions: Some chemokines induced by interferon‐γ, such as Mig and IP‐10, may promote lymphocyte recruitment to HCC and may thus play important roles in cancer immunology.
It is important to identify useful tumor markers for the prediction of postoperative outcomes in patients with pancreatic carcinoma (PC).
A retrospective study was performed in 87 patients who ...underwent surgical resection for PC. Preoperative levels of tumor markers such as carbohydrate antigen 19-9 (CA19-9) and duke pancreatic monoclonal antigen type 2 (DUPAN-2) were estimated and analyzed in relation to disease-specific survival (DSS).
The CA19-9 level did not correlate with the DUPAN-2 level (R=-0.057). Prognosis correlated with CA19-9 levels, and patients with 185 U/mL or lower CA19-9 level showed significantly better DSS than patients with 186-U/mL or higher CA19-9 level (P=0.015). Patients with 151- to 800-U/mL DUPAN-2 level showed significantly worse DSS than patients with 801-U/mL or higher DUPAN-2 level (P=0.0023), so the prognosis was reversely related to the DUPAN-2 level. Patients with increased levels of both CA19-9 and DUPAN-2 showed significantly worse DSS than the patients without elevated levels (P<or=0.0023). The independent predictors of poor DSS (hazards ratio, 95% confidence interval) were the following: non-well-differentiated adenocarcinoma (2.35, 1.28-4.53), invasion of the portal vein (2.57, 1.47-4.47), and increased levels of both CA19-9 and DUPAN-2 (3.01, 1.72-5.32).
The increased levels of both CA19-9 and DUPAN-2 closely reflect prognosis in patients with PC.
We report a patient in whom two pulmonary resections were performed for lung metastasis after hepatic resection of hepatocellular carcinoma (HCC). A 56-year-old Japanese man with an 8-year history of ...chronic liver disease was admitted with elevated serum alpha-fetoprotein (AFP) and a liver tumor that had been detected by ultrasonography. Computed tomography showed a 6-cm tumor in the medial segment of the liver, and partial resection of the medial segment was performed. Thirty-six months after the first operation, pulmonary resection was performed for a solitary metastasis in the left lung. Fifty-one months after the second operation, a solitary metastatic tumor was detected in the right lung, without any evidence of recurrence or other metastatic foci, and thoracoscopic partial resection of the right lung was performed as the third operation. The patient is alive 36 months after the second pulmonary resection, has a normal AFP value, and shows no signs of recurrent or metastatic foci. Repeat pulmonary resection for metastasis from HCC resulted in long-term survival in this patient.
In Japan, the number of obese patients has been gradually increasing, and the morbidly obese patients who are refractory to conventional therapies such as diet and behavior therapy are also ...increasing year by year. Now, endoscopic intragastric balloon placement and laparos-copic bariatric surgery have been generally performed as endoscopic treatments for morbid obesity in the world. The intragastric balloon placement which has become a safe therapy can induce the weight loss of 12-15 kg for six months and improve comorbidities such as diabetes and hypertension. Laparoscopic adjustable gastric banding which is one of the typical laparos-copic bariatric operations can also reduce the weight and improve the comorbidities more certainly. Although both procedures will be popular in the field of treatments for Japanese obese patients in the near future, the collaboration of bariatric physicians and endoscopists including endoscopic surgeons is essential.
進行性大腸癌に対する抗癌剤のオキサリプラチン（OX）は肝類洞障害を生じ，時に門脈圧亢進症を伴う．本研究ではOXを使用した大腸癌患者86症例に対しOX使用前後の造影CT所見と採血データの後方的な比較を行った．使用前と比較し使用後のCTでは31症例に脾腫，20症例に側副血行路を認め，そのうち1例で静脈瘤に対し加療を要した．症例群を画像所見によって分類し肝類洞障害の指標であるaspartate ...aminotransferase to platelet ratio indexを治療前後で比較すると，脾腫と側副血行路が共に出現した群のみで有意な上昇を認め，強い肝障害が示唆された．造影CTは治療効果判定に加え肝障害を類推し，conversion therapyとしての肝転移巣切除の適応判断の一助となり得る可能性がある．
Bariatric surgery is the only treatment that can provide effective long-term weight loss for morbid obesity. However, animal models of bariatric surgery have not yet been well established. The aims ...of this study were to establish an obese rat model of gastric banding and to determine whether the model would replicate the procedure of human gastric banding in terms of weight loss and metabolic parameters.
27 male Zucker fatty rats were divided into 3 groups: the sham-operated control, gastric banding, and diet treatment groups. They were followed for 8 weeks after surgery, and their body weight change, cumulative food intake and metabolic parameters were examined.
For the sham-operated control, gastric banding, and diet treatment groups, the mean body weights were 644 +/- 28 g, 511 +/- 77 g, and 339 +/- 15 g; % change of weight at 8 weeks after operaion were +63.7 +/- 8.3%, +33.2 +/- 20%, -12.0 +/- 2.0%, respectively. Absolute weekly food intake amounts were 233.8 +/- 38.1 g, 157.3 +/- 64 g, 80 g, and cumulative food intakes were 1862 +/- 111 g, 1258 +/- 375 g and 640 g, respectively. The gastric banding rats showed significant decreases in weight gain, % change of weight, absolute weekly food intake, and cumulative food intake compared to sham-operated control rats (P < 0.05). The banding group also had lower levels of all metabolic parameters compared with controls (P < 0.01), and these levels were equal to those of the diet-treated group.
The present study provides a new animal model of gastric banding using obese rats. This model may be useful in research on the biochemical and molecular mechanisms of morbid obesity.
Splenopneumopexy, which was developed in Japan, has been recognized as an effective surgical procedure in patients with Budd-Chiari syndrome. We report the case of a 72-year-old woman with ...Budd-Chiari syndrome and prominent hepatic encephalopathy. She was treated by splenopneumopexy 19 years previously at our institute. Recently, during a follow-up visit, she experienced disorientation and unconsciousness. Flapping tremor was also recognized, and electroencephalography demonstrated a triphasic wave. In computed tomography and angiography imagings, the inferior vena cava was obstructed and the portopulmonary shunt placed by splenopneumopexy was remarkably dilated. There were no other major collaterals of the portal venous system. These findings showed that the hepatic encephalopathy was caused by the change in the portopulmonary shunt. Because hepatic encephalopathy can appear after splenopneumopexy, long-term follow-up may be necessary in patients with Budd-Chiari syndrome who are treated by splenopneumopexy.
A 53-year-old woman admitted for abnormal metabolic activity in the left lateral hepatic segment detected by 18F-fluorodeoxyglucose positron emission tomography had a history of cholecystolithiasis, ...choledocolithiasis, and acute pancreatitis. Abdominal enhanced computed tomography showed a ring-like enhanced tumor lesion 3cm in diameter in segment S3 of the liver, necessitating left lateral segmentectomy based on a preoperative diagnosis of cholangiocellular carcinoma. Macroscopically, the tumor, a yellowish white hard mass in the resected specimen, was considered cholangiocellular carcinoma. Postoperative pathological examination showed, however, that the lesion was not tumorous and had only fibrosis and proliferation of inflammatory cells and fibroblasts, leading to a diagnosis of granulomatous abscess. It is thus important to consider granulomatous abscess as a differential diagnosis of cholangiocellular carcinoma in a patient who has a history of biliary tract surgery.
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