[A case of long remission for about 5 years as an outpatient with second-line chemotherapy of weekly PTX after palliative distal gastrectomy for pStage IV advanced gastric cancer].

A 59-year-old man underwent palliative distal gastrectomy for Stage IV advanced gastric cancer with cytological and histopathological peritoneal dissemination. After surgery, he began to receive chemotherapy by S-1 oral administration as an outpatient. About one year and 9 months after surgery, cartinomatous peritonitis grew, and severe obstruction of gastrojejunostomy and dilatation of residual stomach were detected by CT tomography. Then, second-line chemotherapy by weekly paclitaxel(PTX)was started. After one course of weekly PTX was completed, he was feeling better gradually with obvious improvement of carcinomatous peritonitis, which was revealed by sequential CT tomography examinations. Weekly PTX chemotherapy has been continued successfully for 43 courses, and he remains alive today with a good QOL, about 5 years after surgery. He is an outpatient with only a grade 2 or less complication of peripheral neuropathy.

Successive cultures of mature hepatocytes for hepatocyte autotransplantation to assist liver function after liver resection for cancer.

We developed a method for the rapid successive cultures of adult rat mature hepatocytes on plastic dishes while avoiding viral transformation or co-culture with other cell lines. This method also allows for culturing adult human mature hepatocytes up to the secondary culture. These can be expected to provide a good source for hepatocyte autotransplantation, and, combined with the previously reported methods for the transplantation of hepatocytes into the spleen, a promising option for the support of liver function after liver resection for cancer without the need for immunosuppressive agents.

Clinical implication of anti-p53 antibodies and p53-protein in pancreatic disease.

p53 gene mutations play an important role in the pathogenesis of pancreatic carcinomas. Anti-p53 antibodies and p53 protein have been detected in the sera of patients with pancreatic carcinomas. However, very little is known about the clinical significance of these p53 antibodies. We investigated the relationship between anti-p53 antibodies and the presence of p53 protein in cancer cells and the serum, as well as other clinical factors. Anti-p53 antibodies were detected in 19 (23%) of 82 pancreatic-duct-cell carcinomas, and in one (5%) of 21 cases of chronic pancreatitis. However, no antibodies were detected in mucin-producing tumors or in islet-cell tumors of the pancreas. The anti-p53 antibodies were detected in both early and advanced stages. In those patients undergoing surgical resection for pancreatic duct-cell carcinomas, the prognosis of patients who were negative for the anti-p53 antibodies was better than patients who were positive. Of the 11 cases that were positive for anti-53 antibodies, 8 (73%) were also positive for the immunohistochemical expression of p53 protein in cancer cells. However, there was no significant correlation between the presence of anti-p53 antibodies and the serum p53 protein levels. These results suggest that the benefits of measuring the anti-p53 antibody titier as a screening test to detect pancreatic carcinoma are limited, but the presence of anti-p53 antibodies predicts a poor prognosis for postoperative pancreatic carcinoma patients.

Expression of cyclooxygenase-2 in primary and remnant gastric carcinoma: comparing it with p53 accumulation, Helicobacter pylori infection, and vascular endothelial growth factor expression.

BACKGROUND AND OBJECTIVES: Cyclooxygenase-2 (COX-2) expression may contribute to the synthesis of prostanoids, which have been related to carcinogenesis and tumor progression. It is well known that the gastric remnant is at greater risk of the development of gastric cancer than is the whole stomach; incidence rates for gastric cardia adenocarcinoma are rising in the United States and Europe. Our objective was to determine the involvement of COX-2 in primary and remnant gastric cancer tissues as well as in adjacent noncancerous mucosa. METHODS: We investigated the expression of COX-2 in 91 human gastric cancer tissue and adjacent noncancerous mucosa samples (40 remnant gastric cancer, 37 gastric cardia cancer, and 14 gastric corpus and antrum cancer), using immunohistochemistry. In addition, p53 expression, Helicobacter pylori infection, and vascular endothelial growth factor in the tissues were evaluated by immunohistochemical staining and compared with COX-2 expression. RESULTS: There were no significant differences in clinicopathological data in the gastric cancer tissues. There was a significant relation between the expression of COX-2 and p53 in gastric cancer tissues (P = 0.0048). However, vascular endothelial growth factor expression and Helicobacter pylori infection showed no correlation with the expression of COX-2. In the case of adjacent noncancerous mucosa, the positive rate of COX-2 expression was significantly higher in the remnant gastric cancers (75.0%) than in the primary gastric cancers (25.5%) (P < 0.0001). CONCLUSIONS: This information may help in the analysis of the carcinogenesis of gastric cancer; there is also a possibility that the COX-2 selective inhibitor to the remnant gastric cancer has a chemopreventive effect.