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1.
Gan To Kagaku Ryoho ; 48(8): 1049-1051, 2021 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-34404074

RESUMO

The rate of aging in Japan has currently exceeded 28.1%. Moreover, it is expected that the rate of aging will continue to increase in the future. Under these circumstances, the opportunities to treat breast cancer in the super-elderly individuals are elevating. Here, we summarized and examined the cases who were 85 years or above in age and diagnosed with breast cancer at our hospital during the last 10 years. There were 29 cases(30 breasts), who were all female, with an average age of 89.6 years. Dementia coexisted in 17 cases, and an enlarged mass was the trigger for the discovery in most cases. For breast cancer in super-elderly females, it is necessary to treat it in the right proportion. Moreover, it is considered that the treatment policy should be decided considering the presence or absence of dementia and comorbidities. Also, the treatment regime should be decided upon full consultation with the surroundings, such as family members and long-term care facilities.


Assuntos
Neoplasias da Mama , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Comorbidade , Feminino , Hospitais , Humanos , Japão/epidemiologia
2.
Gan To Kagaku Ryoho ; 48(7): 955-957, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34267035

RESUMO

The case involved a 51-year-old woman who was diagnosed with Stage Ⅰ right breast cancer(cT1, N0, M0). Partial resection of the right breast and sentinel lymph node biopsy were performed. The histological type was found to be Stage Ⅰ triple-negative medullary carcinoma with pT1c, pN0(sn), and M0. A pituitary tumor was diagnosed after discharge. After removal of the pituitary tumor, whole-breast irradiation was performed. Subsequently, chemotherapy was started. Approximately 5 months after surgery, redness and swelling of the right breast were observed. Inflammatory breast cancer recurrence could not be ruled out by imaging, and skin biopsy was performed. No malignant findings were observed, and the symptoms were considered to indicate radiation recall dermatitis caused by chemotherapy. When chemotherapy was discontinued, the redness of the right breast improved.


Assuntos
Neoplasias da Mama , Neoplasias Inflamatórias Mamárias , Radiodermatite , Axila , Neoplasias da Mama/cirurgia , Feminino , Humanos , Neoplasias Inflamatórias Mamárias/diagnóstico , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Radiodermatite/diagnóstico , Radiodermatite/etiologia , Biópsia de Linfonodo Sentinela
3.
J Surg Case Rep ; 2020(10): rjaa296, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33072250

RESUMO

Conventional jejunal reconstruction procedures for large duodenal defects include jejunal serosal patch repair and duodenojejunostomy and have some risks of postoperative complications. The pedicled jejunal flap is used for reconstruction following laryngopharyngectomy, esophagectomy and other gastrointestinal surgeries. We report two cases of successful closure of duodenal defects after partial duodenectomies by pedicled jejunal flap reconstruction. Case 1: A 72-year-old man was diagnosed with gastrointestinal stromal tumor by esophagogastroduodenoscopy (EGD), endoscopic ultrasound-guided fine needle aspiration biopsy and computed tomography (CT). Case 2: A 63-year-old woman was diagnosed with early duodenal cancer using EGD and CT. Partial duodenectomy and pedicled jejunal flap reconstruction were performed in both patients. A part of the jejunum was formed into a pedicled flap to fit the duodenal defect and duodenojejunal anastomosis was performed. The patients did not report any postoperative gastrointestinal symptoms or abnormal findings during follow-up EGD or upper gastrointestinal radiography.

4.
J Anus Rectum Colon ; 4(2): 79-84, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32346646

RESUMO

Objectives: In recent years, CapeOX therapy for patients with colorectal cancer is widely used. We previously reported that a multidisciplinary approach decreases the worsening of adverse events and increases patient satisfaction. In this study, we conducted a multicenter, prospective, observational study to evaluate the incidence of adverse events, health-related quality of life (HRQOL) of the patient, and efficacy of a management (intervention) according to the support system (SMILE study). Methods: As the interventional method, the following more than one method was carried out in each institute, 1: support with telephone, 2: dosing instruction by a pharmacist, 3: skin care instruction by a nurse, and 4: patient instruction by a doctor. The primary endpoint was the incidence of hand-foot syndrome (HFS) of more than grade 2. The secondary endpoint was the HRQOL evaluation and efficacy. The questionnaire (HADS) was administered before the start of the chemotherapy and in 1, 2, 4, 5, and 8 courses to evaluate quality of life (QOL). Results: From April 2011 to September 2012, 80 patients were enrolled from 14 sites, and all patients were the subjects of analysis. The demographic background was as follows: man/woman: 46/34, age median: 63 (36-75), and management interventional method 1/2/3/4: 36/68/73/78. The overall percentage of HFS that exceeded grade 2 within 6 months was 16.3%. It was 11.1% with the telephone support group and 20.5% without the telephone support group (p = 0.26). Conclusions: A multi-professional telephone support may reduce the deterioration of HFS. Further study which includes larger cohort is needed in the future.

5.
Gan To Kagaku Ryoho ; 46(1): 139-141, 2019 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-30765667

RESUMO

A 56-year-old man was admitted to our hospital because abdominal CT showed wall thickening of the ascending colon. Colonoscopyshowed type 4 colon cancer, diagnosed as poorlydifferentiated adenocarcinoma bybiopsy , with circumferential stenosis. Enhanced CT after admission also showed obstructive ileus and lymphadenopathy leading to a paraaortic lesion, but no other distant metastases were seen. Right hemicolectomywas performed. Histological examination showed poorlydifferentiated adenocarcinoma extending from the hepatic flexure to the terminal ileum, with marked invaded vessels and stromal fibrosis, which was diagnosed as type 4 colon cancer of scirrhous and lymphangiosis types. On the 10th postoperative day, he developed lymphangitis carcinomatosa. Intensive treatment including steroid therapy was not effective, and he died of respiratory failure on the 26th day. Type 4 colon cancer is rare and has very poor prognosis. We report a case and literature review.


Assuntos
Adenocarcinoma , Neoplasias do Colo , Linfangite , Adenocarcinoma/complicações , Colo Ascendente , Neoplasias do Colo/complicações , Humanos , Linfangite/etiologia , Masculino , Pessoa de Meia-Idade
6.
Gan To Kagaku Ryoho ; 45(13): 2327-2329, 2018 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-30692453

RESUMO

We encountered a case of type 4 gastric cancer with esophageal invasion that responded to neoadjuvant chemotherapy containing S-1 and oxaliplatin(SOX)followed by surgery, which could be curative resection. A 46-year-old man was referred to our hospital because of abnormal upper gastrointestinal series findings. He was diagnosed with type 4 advanced gastric cancer with esophageal invasion, cT4b(diaphragm)N2M0, Stage ⅢC, and 3 courses of neoadjuvant SOX therapy were administered. Adverse events were minor. After NAC, the primary lesion and lymph nodes showed marked reductions on CT; total gastrectomy and subtotal thoracic esophagectomy were performed. The pathological response to NAC was evaluated as Grade 2 in the primary tumor and Grade 3 in the lymph node; overall, NAC showed considerable antitumor effects. The final diagnosis was ypT3N0M0P0CY0H0, StageⅡA, and was judged as curatively resected. Currently, we are continuing to administer adjuvant chemotherapy containing S-1.


Assuntos
Terapia Neoadjuvante , Neoplasias Gástricas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino , Combinação de Medicamentos , Esôfago/patologia , Gastrectomia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Oxaliplatina/administração & dosagem , Ácido Oxônico/administração & dosagem , Ácido Oxônico/uso terapêutico , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Tegafur/administração & dosagem , Tegafur/uso terapêutico
7.
Gan To Kagaku Ryoho ; 43(7): 879-83, 2016 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-27431633

RESUMO

Regional lymph node recurrence without distant metastasis after the initial treatment of breast cancer is a relatively rare event. The optimal management for regional lymph node recurrence is poorly understood. We retrospectively evaluated 21 patients who developed regional lymph node recurrence between January 1, 2003 and December 31, 2014. The median interval between regional lymph node recurrence and distant metastasis was 1.0 years(range, 0.4 to 2.5 years). On followup, 15 cases(71.4%)were found to eventually develop distant metastases. Median follow-up time after lymph node recurrence was 1.8 years(range, 0.4 to 20.3 years). The 2-year survival rate after regional lymph node recurrence was 65.5%. The mean distant-disease-free interval was 2.2 years in patients with estrogen receptor(ER)-positive tumor(n=10)and 0.7 years in patients with ER-negative tumor(n=11). The distant-disease-free interval after regional lymph node recurrence was significantly shorter in patients with ER-negative tumor than in patients with ER-positive tumor(p=0.008). The 2-year survival rate after regional lymph node recurrence was significantly lower in patients with ER-negative tumor(33.3%)than in patients with ER-positive tumor(100%, p=0.016). This study revealed that regional lymph node recurrence after initial treatment is associated with an increased risk of distant metastasis and death and ER-negative tumors are indicative of a poor prognosis.


Assuntos
Neoplasias da Mama/cirurgia , Recidiva Local de Neoplasia/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/química , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Humanos , Metástase Linfática , Mastectomia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/química , Recidiva Local de Neoplasia/mortalidade , Receptores de Estrogênio/análise , Estudos Retrospectivos
8.
Gan To Kagaku Ryoho ; 43(12): 2453-2455, 2016 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-28133352

RESUMO

We report a case of a gastrointestinal stromal tumor(GIST)that originated in the anal canal. A 70's woman with a subcutaneous tumor reaching from the anal canal was referred to our hospital. After a thorough examination, the tumor was resected percutaneously in the jackknife position. Histopathological examination showed proliferation of spindle-shaped tumor cells arranged in irregular bundles. Immunohistochemical staining showed that the tumor was positive for c-kit and CD34, and negative for a-SMA and S-100, so the tumor was diagnosed as GIST. As a-SMA-positive smooth muscle cells were seen around the tumor, we suspected that this tumor originated from the internal sphincter muscle.


Assuntos
Neoplasias do Ânus/patologia , Tumores do Estroma Gastrointestinal , Idoso , Antineoplásicos/uso terapêutico , Neoplasias do Ânus/tratamento farmacológico , Neoplasias do Ânus/genética , Neoplasias do Ânus/cirurgia , Quimioterapia Adjuvante , Feminino , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/genética , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Mesilato de Imatinib/uso terapêutico , Mutação , Proteínas Proto-Oncogênicas c-kit/genética
9.
BMC Gastroenterol ; 15: 114, 2015 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-26463667

RESUMO

BACKGROUND: Emphysematous cholecystitis is a severe variant of acute cholecystitis caused by anaerobic bacteria. Although intraperitoneal air as a complication has been described in association with emphysematous cholecystitis, pneumoretroperitoneum arising from emphysematous cholecystitis is extremely rare. Herein, we describe a rare case of pneumoretroperitoneum arising from emphysematous cholecystitis that was successfully treated with emergency surgery. CASE PRESENTATION: An 84-year-old male was transported to the Emergency Department of our hospital for acute abdomen. Computed tomography revealed acute cholecystitis accompanied by emphysematous change. Computed tomography also revealed massive pneumoretroperitoneum complicated with pneumobilia and gas in the hepatoduodenal ligament. Clinical findings fulfilled the diagnostic criteria for systemic inflammatory response syndrome and sepsis. Emergency surgery was carried out with a diagnosis of both emphysematous cholecystitis and gastrointestinal perforation. Intraoperative findings revealed acute gangrenous cholecystitis and pneumoretroperitoneum presenting with an odor-free foamy abscess along the loose connective tissue behind the ascending colon and mesocolon. No evidence of gastrointestinal perforation was found during surgery. Therefore, cholecystectomy and lavage drainage were performed. Bacterial culture examination isolated a single species of anaerobe, Klebsiella pneumoniae, which was considered to be the cause of emphysematous cholecystitis, pneumobilia, and pneumoretroperitoneum. CONCLUSIONS: Emphysematous cholecystitis should be considered as a possible cause of pneumoretroperitoneum. The present case is the first report of massive pneumoretroperitoneum extending to the dorsal side of the ascending mesocolon as a complication of emphysematous cholecystitis.


Assuntos
Colecistite Enfisematosa/complicações , Infecções por Klebsiella/complicações , Klebsiella pneumoniae , Retropneumoperitônio/etiologia , Sepse/complicações , Idoso de 80 Anos ou mais , Colecistectomia , Colecistite Enfisematosa/microbiologia , Colecistite Enfisematosa/cirurgia , Humanos , Infecções por Klebsiella/microbiologia , Masculino , Lavagem Peritoneal , Doenças Raras/etiologia , Doenças Raras/cirurgia , Retropneumoperitônio/cirurgia , Sepse/microbiologia
10.
Int Surg ; 100(3): 431-5, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25785323

RESUMO

Laparoscopic hernia repair has become popular due to its rapid recovery time, fewer postoperative complications, and less chronic pain compared with conventional approaches. Currently, laparoscopic hernia repair is also used for more complex pathogenesis, including extra-anatomic bypass surgery for femoral artery. To the best of our knowledge, cases of inguinal hernia after femoral arterial bypass are extremely rare. We report the case of a 77-year-old Japanese man who was diagnosed with inguinal hernia after a previous left external iliac artery-right common femoral artery bypass. We used a hybrid laparoscopic and anterior approach, and the procedure was completed successfully without perioperative complications. A laparoscopic approach is useful for the diagnosis and treatment of inguinal hernia after extra-anatomic bypass surgery for femoral artery. While complicated, the addition of anterior reinforcement should be considered in cases of insufficient preperitoneal repair using transabdominal preperitoneal patch plasty.


Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Laparoscopia/métodos , Complicações Pós-Operatórias/cirurgia , Enxerto Vascular , Idoso , Artéria Femoral/cirurgia , Hérnia Inguinal/etiologia , Humanos , Artéria Ilíaca/cirurgia , Masculino
11.
Gan To Kagaku Ryoho ; 42(12): 1533-6, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26805087

RESUMO

In our institution, placement of a self-expanding metallic stent (SEMS) for obstructive colorectal cancer to avoid emergency operations, namely as a bridge to surgery (BTS), was introduced in April 2012. Here, we assess the efficacy and safety of pre-operative SEMS placement for treatment of Stage Ⅳ obstructive colorectal cancer. We analyzed a total of 44 cases of Stage Ⅳ colorectal cancer, which consisted of 13 obstructive cases that were surgically resected following SEMS placement as BTS (BTS group), and 31 cases that were resected in elective operations without pre-operative SEMS placement (Ope group), from April 2012 to August 2014. None of the patients had any adverse events during the SEMS procedure or after SEMS placement, and all patients of BTS group could undergo the planned operations after sufficient decompression. In the postoperative period, 1 patient of BTS group (7.7%) had anastomosis bleeding, but no other complications, including anastomosis leakage, were observed in BTS group. However more progressive primary tumors were resected in BTS group (p=0.0115), there were no significant differences for post-operative course between the 2 groups; this indicated avoiding high-risk emergency operations contributed to adequate short-term outcomes in BTS group comparable to those in Ope group. SEMS placement as BTS could be performed safely for Stage Ⅳ obstructive colorectal cancer cases, and was 1 of the effective strategies for local treatment.


Assuntos
Neoplasias Colorretais/patologia , Obstrução Intestinal/terapia , Stents Metálicos Autoexpansíveis , Adulto , Idoso , Neoplasias Colorretais/complicações , Feminino , Humanos , Obstrução Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Complicações Pós-Operatórias , Resultado do Tratamento
12.
Gan To Kagaku Ryoho ; 42(12): 2115-7, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26805282

RESUMO

We report a case of ascending colon cancer with right extra iliac lymph node metastases. A 60s-year-old woman underwent right hemicolectomy with lymph node dissection in July 2011. Pathological diagnosis was T4 (SE), N1 (2/42), M0, stage ⅢA. Adjuvant chemotherapy with tegafur/uracil was administered after the operation for 6 months. One year after the operation, the serum carcinoembryonic antigen (CEA) level was gradually increasing. Three years after the operation, positron emission tomography-computed tomography (PET-CT) delineated a 3 cm mass with an abnormal signal on the right lower abdominal side of the external iliac vessels. The diagnosis was an isolated remnant tumor in the right extra iliac vessels area from the primary ascending colon cancer. Other recurrent lesions were not found; therefore, resection of this mass was performed. Pathological findings confirmed lymph node metastases from the ascending colon cancer. This type of metastasis is extremely rare, and more case reports are needed to determine the mechanism behind these metastases.


Assuntos
Colo Ascendente/patologia , Neoplasias do Colo/patologia , Linfonodos/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Colo Ascendente/cirurgia , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/secundário , Feminino , Humanos , Excisão de Linfonodo , Metástase Linfática , Prognóstico , Tegafur/administração & dosagem , Uracila/administração & dosagem
13.
Gan To Kagaku Ryoho ; 42(12): 2166-8, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26805299

RESUMO

A 70s-year-old man was referred to our hospital because of sigmoid colon cancer. Computed tomography (CT) revealed a large mass in the right lobe of the liver and small masses in Couinaud segments Ⅳ and Ⅵ. We started systemic chemotherapy with mFOLFOX6 and panitumumab. After 6 courses of the treatment, the size and number of the liver metastases was remarkably reduced on CT. We performed a simultaneous laparoscopic resection for the primary tumor and synchronous liver metastases. The postoperative course was uneventful and he had no signs of recurrence 12 months after surgery.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias do Colo Sigmoide/tratamento farmacológico , Neoplasias do Colo Sigmoide/patologia , Idoso , Anticorpos Monoclonais/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Fluoruracila/administração & dosagem , Humanos , Laparoscopia , Leucovorina/administração & dosagem , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Masculino , Compostos Organoplatínicos/administração & dosagem , Panitumumabe , Neoplasias do Colo Sigmoide/cirurgia , Resultado do Tratamento
14.
Gan To Kagaku Ryoho ; 42(12): 2330-3, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26805354

RESUMO

A man in his 70s was referred to our hospital with anorexia, weight loss, and constipation. After examination by computed tomography (CT), magnetic resonance imaging (MRI), and colonoscopy, he was diagnosed as having a locally advanced rectal cancer with abscess formation. Because CT and MRI indicated that the tumor had invaded the seminal vesicle, prostate, and sacrum, we diagnosed it as an unresectable tumor. We treated the abscesses around the tumor by sigmoid colostomy with administration of antibiotics. After control of the infection, the patient received systemic chemotherapy with capecitabine/oxaliplatin (XELOX) plus bevacizumab (BV). After the 5th courses of XELOX plus BV, the primary tumor showed a tendency to shrink, but invasion to the neighboring organs was still seen. Therefore, we treated him with chemoradiotherapy (CRT) using S-1. After completion of CRT with no significant adverse effects, the tumor invasion to the neighboring organs disappeared, and we performed a low anterior resection 9 weeks later. Pathological findings revealed that the tumor had shrunk remarkably and it was resected curatively, although a few tumor cells remained in the subserosal layer of the ulcerative scar caused by the CRT. His postoperative course was uneventful, and he underwent adjuvant chemotherapy with S-1 for 3 months after discharge. To date, no disease recurrence has been detected. We report a case of locally advanced rectal cancer, which was curatively resected following chemoradiotherapy, along with a short literature review.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia , Neoplasias Retais/terapia , Idoso , Colostomia , Humanos , Masculino , Invasividade Neoplásica , Prognóstico , Neoplasias Retais/patologia
15.
Int J Oncol ; 25(3): 631-9, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15289864

RESUMO

Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) ligands inhibit the growth of PPAR-gamma expressing cancer cells through terminal differentiation. However, there are few studies examining the effect of a PPAR-gamma ligand on metastatic potential of cancer cells in an animal model and the underlying molecular mechanisms. We have recently developed a rectal cancer xenograft animal model in which anti-tumor and anti-metastatic efficacy of agents can be evaluated. This study was designed to examine whether a representative PPAR-gamma ligand, thiazolidinedione (TZD), could inhibit growth and metastasis of PPAR-gamma positive HT-29 human colon cancer cells through the induction of terminal differentiation. TZD caused G1 arrest in association with a marked increase in p21Waf-1, Drg-1, and E-cadherin expression. In untreated cancer cells, fluorescence immunostaining demonstrated beta-catenin in the nucleus and/or cytoplasm; in TZD-treated cancer cells, beta-catenin localization shifted to the plasma membrane, in association with increased E-cadherin at this site and reduced tyrosine phosphorylation of beta-catenin. In addition, TZD completely inhibited lymph node and lung metastases in the xenograft animal model, and TZD inhibited growth of primary xenografts by 40%. These results suggest that TZD can function as a cytostatic anti-cancer agent to inhibit growth and metastasis of HT-29 colon cancer cells through differentiation-promoting effects. These effects involve not only modulation of the E-cadherin/beta-catenin system, but also up-regulation of Drg-1 gene expression.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias do Colo/tratamento farmacológico , PPAR gama/agonistas , Tiazolidinedionas/uso terapêutico , Animais , Antineoplásicos/farmacologia , Caderinas/análise , Caderinas/genética , Caderinas/metabolismo , Ciclo Celular/efeitos dos fármacos , Proteínas de Ciclo Celular/genética , Proteínas de Ciclo Celular/metabolismo , Diferenciação Celular , Membrana Celular/química , Membrana Celular/metabolismo , Membrana Celular/ultraestrutura , Neoplasias do Colo/patologia , Inibidor de Quinase Dependente de Ciclina p21 , Proteínas do Citoesqueleto/análise , Proteínas do Citoesqueleto/metabolismo , Células HT29 , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Espaço Intracelular/química , Espaço Intracelular/metabolismo , Ligantes , Linfonodos/patologia , Camundongos , Metástase Neoplásica , Transplante de Neoplasias , Proteína do Retinoblastoma/metabolismo , Tiazolidinedionas/farmacologia , Transativadores/análise , Transativadores/metabolismo , Ensaios Antitumorais Modelo de Xenoenxerto , beta Catenina
16.
Int J Cancer ; 112(1): 135-42, 2004 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-15305385

RESUMO

Capecitabine (N4-pentyloxycarbonyl-5'-deoxy-5-fluorocytidine) is a new fluoropyrimidine carbamate, which is converted to 5-fluorouracil (5-FU) by 3 sequential steps of enzyme reactions. We investigated the possibility of using capecitabine to prevent metastasis with a metastasis model of gastrointestinal cancer developed by the intrarectal injection of green fluorescent protein (GFP)-expressing colon cancer HT-29 cells (HT-29-GFP) into nude mice. Lung and lymph node metastasis in the HT-29-GFP rectal xenograft was assessed through both observation of GFP fluorescence and quantification of metastasis by amplification of a cancer-related human DNA by TaqMan PCR. Furthermore, for each organ, we examined mRNA levels of cancer-specific thymidine phosphorylase (dThdPase), which is an essential enzyme for capecitabine activation, by the quantitative RT-PCR method. Capecitabine inhibited the HT-29-GFP xenograft growth by 60.8% and 43.8% in the subcutaneous and rectal xenograft models, respectively. Furthermore, it inhibited both lung and lymph node metastasis by 99.9%. dThdPase expression in the tumor cells of both the rectal xenograft and metastatic lung tumor cells was upregulated by 10.0- and 24.3-fold that in the HT-29-GFP cells in vitro, respectively. These results indicated that capecitabine might effectively inhibit or suppress metastasis via upregulation of dThdPase expression. Capecitabine administration might be highly expected to reduce metastasis and improve survival of patients with gastrointestinal cancers.


Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Neoplasias do Colo/tratamento farmacológico , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapêutico , Neoplasias Gastrointestinais/prevenção & controle , Neoplasias Gastrointestinais/secundário , Neoplasias Retais/tratamento farmacológico , Animais , Capecitabina , Neoplasias do Colo/patologia , Fluoruracila/análogos & derivados , Proteínas de Fluorescência Verde , Humanos , Proteínas Luminescentes/metabolismo , Neoplasias Pulmonares/prevenção & controle , Neoplasias Pulmonares/secundário , Metástase Linfática/prevenção & controle , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , RNA Neoplásico/genética , RNA Neoplásico/metabolismo , Neoplasias Retais/patologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Timidina Fosforilase/genética , Timidina Fosforilase/metabolismo , Transplante Heterólogo
17.
Oncology ; 64(4): 416-22, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12759540

RESUMO

OBJECTIVE: Expression of vascular endothelial growth factor (VEGF)-D by tumors is associated with metastasis to lymph nodes in mice. However, there are few reports concerning the clinical significance of VEGF-D protein in human carcinoma. METHODS: After confirming production of VEGF-D by eight colorectal carcinoma cell lines, we investigated relationships between the expression of VEGF-D protein, lymph node metastasis and postoperative survival in 83 colorectal carcinoma patients. mRNA levels in cell lines were evaluated using the real-time reverse transcriptase-polymerase chain reaction, and protein was detected by Western blotting in cell lines and by immunohistochemistry in resected tissues using an antibody recognizing the processed form of the molecule. RESULTS: Immunohistochemistry showed VEGF-D-positive staining in 26 of the 83 carcinomas (31%). There was a significant relationship between the presence of VEGF-D protein and the incidence of lymph node metastasis (p < 0.01). Multivariate logistic regression analysis revealed that VEGF-D protein expression was an independent factor affecting lymph node metastasis (p < 0.01). Nonetheless, the presence or absence of VEGF-D protein had no significant impact on the survival of the patients (p = 0.15). CONCLUSION: These results suggest that the expression of VEGF-D protein could be useful in predicting the nodal status of colorectal carcinoma patients.


Assuntos
Biomarcadores Tumorais/análise , Carcinoma/química , Carcinoma/patologia , Neoplasias Colorretais/química , Neoplasias Colorretais/patologia , Fatores de Crescimento Endotelial/análise , Linfonodos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Western Blotting , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Neoplasias Hepáticas/secundário , Modelos Logísticos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Peritoneais/secundário , Valor Preditivo dos Testes , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sobrevida , Células Tumorais Cultivadas , Fator D de Crescimento do Endotélio Vascular
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