ABSTRACT
BACKGROUND: Helicobacter pylori infection is a well-established risk factor for gastric cancer and has been linked to other gastrointestinal diseases, including pancreatic and biliary tract cancers; however, the relevance of enterohepatic non-H. pylori helicobacters to the pathophysiology of these diseases remains unclear. MATERIALS AND METHODS: We estimated the prevalence of two enterohepatic non-H. pylori helicobacters (Helicobacter hepaticus and Helicobacter bilis) in the framework of a hospital-based case-control study involving 121 patients with biliary tract cancer, pancreatic cancer, or other gastrointestinal diseases. Bile and blood samples were collected from the patients undergoing endoscopic retrograde cholangiopancreatography. The presence of H. bilis, H. hepaticus, and other Helicobacter spp. was examined using bacterial culture, PCR-based detection, and serological tests. RESULTS: Culture of Helicobacter spp. from biliary brush samples was unsuccessful. Approximately 13.0% (15/115) of the bile samples collected from patients with a variety of gastrointestinal cancers, including pancreatic and biliary tract cancers, tested positive for one of the enterohepatic non-H. pylori helicobacter species as determined by PCR. Specifically, H. bilis and H. hepaticus DNA were detected in 11 and 4 bile samples, respectively. Approximately 20%-40% of the patients tested positive for serum non-H. pylori helicobacter IgG antibodies. The seroprevalence of H. bilis and H. hepaticus in the patients without evidence of H. pylori infection appeared to be higher in the pancreatic cancer group than in the control group. CONCLUSION: Our findings suggest a role for Helicobacter spp., especially H. bilis and H. hepaticus, in the etiology of pancreatic and biliary tract cancers.
Subject(s)
Biliary Tract Neoplasms , Helicobacter Infections , Helicobacter pylori , Helicobacter , Biliary Tract Neoplasms/epidemiology , Case-Control Studies , Helicobacter Infections/epidemiology , Humans , Prevalence , Seroepidemiologic StudiesABSTRACT
BACKGROUND: The prophylactic administration of itraconazole (ITCZ) is effective for preventing mycotic infections during chemotherapy in patients with hematologic malignancies. However, fungal infections can occur when the ITCZ does not reach an effective concentration. METHODS: We conducted a prospective study to monitor the plasma concentration of ITCZ and hydroxyl-ITCZ (OH-ITCZ) weekly and to verify whether the day 3 plasma concentration of ITCZ could predict the subsequent acquisition of an effective plasma concentration. RESULTS: A total of 39 patients who underwent 66 courses of chemotherapy were assessed in this study. An effective plasma concentration was achieved on day 7 in 34 of 63 patients (54%) and on day 14 in 35 of 59 patients (59%). A univariate analysis revealed that age, type of chemotherapy, and the body surface area were significantly associated with a high plasma concentration of ITCZ + OH-ITCZ. A linear regression analysis extracted the body surface area and the type of chemotherapy as significant factors. An receiver operating characteristic curve analysis revealed a day 3 plasma ITCZ + OH-ITCZ concentration of >656 ng/mL led to a plasma concentration that exceeded the minimum effective level on day 7; the sensitivity and specificity were 62% and 93%, respectively. CONCLUSIONS: This study showed that the measurement of the day 3 plasma concentration could lead to a better outcome in patients receiving chemotherapy for hematologic malignancies.
Subject(s)
Hematologic Neoplasms/blood , Itraconazole/blood , Itraconazole/therapeutic use , Mycoses/drug therapy , Administration, Oral , Adult , Aged , Aged, 80 and over , Antifungal Agents/blood , Female , Hematologic Neoplasms/complications , Humans , Male , Middle Aged , Mycoses/etiology , Pharmaceutical Solutions/therapeutic use , Prospective Studies , Young AdultABSTRACT
A 52-year-old man underwent abdominoperineal resection of the rectum, a partial hepatectomy, and intrahepatic arterial infusion chemotherapy for rectal cancer and liver metastases in 2001. Due to recurrent liver metastases, additional hepatectomies were performed in 2003 and 2005. He then underwent radiofrequency ablation therapy and systemic chemotherapies with mFOLFOX6 and FOLFORI. In July 2007, positron emission tomography (PET) and computed tomography (CT) revealed a high level of (18)F-fluorodeoxyglucose (FDG) accumulation in the liver. After 6 cycles of chemotherapy with bevacizumab plus mFOLFOX6, the FDG accumulation disappeared. The multidisciplinary therapy was effective, yielding long term survival of over 8 years.
Subject(s)
Adenocarcinoma/pathology , Adenocarcinoma/therapy , Liver Neoplasms/secondary , Rectal Neoplasms/pathology , Rectal Neoplasms/therapy , Combined Modality Therapy , Humans , Male , Middle AgedABSTRACT
A 66-year-old male was admitted to our hospital because of dyspnea in 2007. Cancerous pleural effusion and gastric cancer was diagnosed, and the chemotherapy consisted of S-1 + DOC was started for Stage IV gastric cancer. In 2009, lung cancer was found. The chemotherapy was changed to CDDP + CPT-11. This chemotherapy was effective for both lung and gastric cancers. Operation was performed for both tumors in 2010, and the pathological diagnosis revealed that gastric cancer was pStage I, Cur A, and the lung cancer was pStage IA, R0. Pathologic histology inspection of both tumors was judged to be effective for the chemotherapy prior to resection.
