[Clinical significance of pyrimidine nucleoside phosphorylase (PyNPase) in breast cancer].

To clarify the clinical significance of pyrimidine nucleoside phosphorylase (PyNPase) activity in breast cancer, we examined the possible correlation of PyNPase activity to clinicopathological features and prognosis in twenty-one patients with primary breast cancer from April 2000 to December 2001. Flow signals of tumors were analyzed by Power Doppler sonography (PDUS), and maximal velocity (V(max)) was calculated. PyNPase activity of resected specimens was assayed by ELISA method. PyNPase activities in resected cancerous tissue were 156.9+/-63.5 unit/mg (mean+/-SD), which were significantly higher than that in normal tissue (19.0+/-18.1 unit/mg, p<0.0001). PyNPase activity was positively correlated with tumor size (r=0.496, p=0.026) and V(max) (r=0.498, p=0.021). The disease free survival rate was significantly lower in the high PyNPase activity group than in the low PyNPase activity group. In overall survival rate, there was no significant difference between the high and low PyNPase activity groups. In the multivariate analysis, PyNPase activity was an independent predictor of postoperative recurrence (p=0.032). We suggest that PyNPase activity is associated with progression and proliferation of breast cancer, and that it may be useful for prediction of the prognosis.

Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer.

BACKGROUND: Sentinel lymph node biopsy using a vital dye is a convenient and safe method to assess lymph node status in breast cancer. However, intensive training is necessary to obtain a satisfactory detection rate and to avoid false-negative results. This paper presents a novel method using indocyanine green fluorescence imaging to detect sentinel lymph nodes. METHODS: Fluorescence images were obtained using a charge coupled device camera with a cut filter as the detector, and light emitting diodes at 760 nm as the light source. When indocyanine green was injected around the areola, subcutaneous lymphatic channels draining from the areola to the axilla were visible by fluorescence within a few minutes. The sentinel lymph node was then dissected by fluorescence navigation. RESULTS: Sentinel lymph node biopsy using the present method was performed on eighteen patients. Subcutaneous lymphatics were detectable by fluorescence in all patients, and sentinel nodes were successfully identified in 17 of 18 cases (detection rate:94%). It was possible to detect the lymphatic channels and nodes receiving indocyanine green with higher sensitivity by the fluorescence signal than by the green color. CONCLUSION: Sentinel node biopsy guided by indocyanine green fluorescence imaging is a promising technique for further clinical exploration.

Preoperative assessment of hepatic function: Utility of a new convenient two-compartment model analysis using galactosyl human serum albumin scintigraphy.

BACKGROUND AND AIM: Preoperative hepatic function was evaluated using technetium-99 m-diethylenetriaminepenta-acetic acid-galactosyl-human serum albumin (Tc-GSA) and a scintillation camera to detect hepatic Tc-GSA uptake by the asialoglycoprotein receptor. METHODS: Sixty-two preoperative patients with liver cancer, including hepatocellular and cholangiocellular carcinomas, were studied, using two-parameter two-compartment model analysis. This model is simpler than either the three- or five-compartment model, both of which are accurate but which require complicated analysis and enormous calculation. The parameters k1 and k2 represented the transfer rate constant from the blood to the liver and from the liver to the blood, respectively. We calculated k1, k2, and k1/k2 from time-radioactivity curves of the heart and liver as well as VLmg, which represented the maximal amount of Tc-GSA in the liver. RESULTS: The results were compared to those of conventional liver function analysis using Tc-GSA (the index of blood clearance (HH15) and the receptor index (LHL15)) or indocyanine green (ICGR15). Both HH15 and LHL15 were significantly correlated with k1, k1/k2, and VLmg. In addition, they closely correlated with the results of ICGR15 and some serum hepatic function tests (aspartate aminotransferase, choline esterase, albumin, platelet). The pathological grading for liver cirrhosis also correlated with k1, k1/k2, and VLmg. From a clinical point of view, VLmg had a significant correlation with the Child-Pugh score. CONCLUSIONS: These results suggest that this new compartment analysis will be useful in evaluating liver function, as it is accurate, simple and convenient.