Biomedical subjects

I Fujimoto

Publications and source records attributed to I Fujimoto.

At least 19 recordsLinked to original sources

PubMed1995

Survival rates of childhood cancer patients in Osaka, Japan, 1975-1984.

Survival rates for childhood cancers were analyzed with a total of 2,209 cases who were registered in a population-based cancer registry in Osaka, Japan in 1975-1984. These cases were reclassified according to Birch's classification and the survival rate of each diagnostic group was calculated by Kaplan-Meier methods. Death certificate-only cases, which amounted to 3.9% of all incidence, were excluded from the calculation. The five-year cumulative survival rate for both sexes was 46% for all cancer children. Among 12 major diagnostic groups, the most favorable survival was seen in retinoblastoma (87.5%), followed by renal tumors, epithelial neoplasms, and gonadal and germ-cell tumors. The outcome was unfavorable in leukemias, sympathetic nervous system tumors, hepatic tumors and malignant bone tumors. Comparing the survival in 1975-1979 with that in 1980-1984, the rate for all childhood cancer rose from 41% to 51%. Improvement in survival was also observed in 4 groups; acute lymphocytic leukemia, acute non-lymphocytic leukemia, non-Hodgkin's lymphoma and osteosarcoma. One attributable factor for the rise of survival was proved to be improvement of medical treatment by Cox's hazard model analysis. Comparison of survival rates in Osaka with those in England and the U.S. revealed that the prognosis for acute lymphocytic leukemia and acute non-lymphocytic leukemia was less favorable in Osaka than in England and the U.S.

Adolescent↗

PubMed1995

[Effects of long-term administration of tamoxifen on vaginal epithelium and complications of endometrial lesions in breast cancer patients].

The effects of tamoxifen (TAM) on 56 postoperative breast cancer patients who were orally administered TAM and followed up at Cancer Institute Hospital from 1989 to 1992 were studied retrospectively. The maturation index (MI) and karyopyknotic index (KPI) were employed to investigate the effects of TAM on vaginal epithelial cells cytologically, and the patients were also monitored for complications. The results were as follows. (1) The relationship between the duration of TAM therapy and the changes in MI and KPI were analyzed. It was found that, for the MI, intermediate cells (IMT) increased and superficial cells (ST) decreased during TAM administration for up to 4 years, but when the TAM therapy was continued for longer than 4 years, IMT showed a gradual decrease and ST increased gradually. The KPI values showed similar changes. (2) Studies of the endometrium (26 cases) revealed a tendency for few of the long-term administration cases to show a picture of atrophy. Of the total of 56 patients, endometrial lesions were observed in five cases (8.9%), consisting of endometrial cancer in three and cystic glandular hyperplasia in two. The mean duration of TAM administration to these five patients was 54 (+/- S.D.26.8) months. These data indicate that long-term oral administration of TAM involves the possibility of having an estrogenic effect on the vaginal epithelium and the uterine endometrium.

Administration, Oral↗

PubMed1995

[Clinical and pathological study of 24 patients with fallopian tube malignancy].

Clinical and pathological analyses were carried out in 24 patients with fallopian tube malignancy. The results are as follows: 1. Twenty-three patients had adenocarcinoma (well differentiated 11, moderately 6, poorly 6) and one patient had MMT (Müllerian mixed tumors). 2. There were 11 cases in stage I, 4 in stage II, 8 in stage III and 1 in stage IV according to Dodson's classification. 3. Atypical genital bleeding was the most common symptom, whereas 12.5% of patients had no symptoms. 4. Positive rates in cytology were 25.0% in cervico-vaginal smear and 55.0% in endometrial aspiration cytology. 5. The overall 5-year survival rate is 60.0%. The 5-year survival rates for stage I/II and stage III/IV were 88.9% and 16.7%, respectively. 6. The relapse rate of 16 patients treated with complete surgery was 25.0% (well differentiated 11.1%, moderately 0%, poorly 75.0%). Based on these observation, it is likely that patients with stage I/II have a good prognosis, however, patients with poorly differentiated adenocarcinoma have a high relapse rate, indicating that intensive adjuvant chemotherapy would be necessary in these cases. Cytologic examination, particularly endometrial aspiration cytology, is an effective method to use in detecting cases with fallopian tube malignancy early.

Adenocarcinoma↗

PubMed1994

Allelotype of uterine cancer by analysis of RFLP and microsatellite polymorphisms: frequent loss of heterozygosity on chromosome arms 3p, 9q, 10q, and 17p.

Cancers in which mutations have been identified in putative tumor suppressor genes, such as the TP53 gene, the retinoblastoma (RBI) gene, the adenomatous polyposis coli (APC) gene, and the Wilms tumor (WTI) gene, frequently show loss of the corresponding allele on the homologous chromosome. To identify locations of tumor suppressor genes involved in uterine cancer, we examined loss of heterozygosity (LOH) by using genomic probes detecting RFLPs in 35 uterine cancers at 29 loci throughout the genome, and with highly informative microsatellite markers in 21 uterine cancers at nine putative or known tumor suppressor gene loci. High frequencies of allelic loss found at loci on 3p (71%), 9q (38%), 10q (35%), and 17p (35%) suggest that tumor suppressor genes involved in uterine carcinogenesis exist in these regions. There were no significant differences in frequencies of LOH between cancers of the uterine cervix and cancers of the uterine endometrium at any of the loci tested.

Adenocarcinoma↗

PubMed1994

Combined assay of serum levels of CA125 and CA19-9 in endometrial carcinoma.

Serum levels of CA125 and CA19-9 were examined in 225 cases with endometrial carcinoma before treatment and 32 cases with recurrent endometrial carcinoma. The positive rates in the 225 cases were 27.1% for CA125, 24.0% for CA19-9, and 38.7% for the combined assay. The serum levels of both CA125 and CA19-9 significantly increased with surgical staging. The presence of lymph node metastasis and extrauterine spread exhibited a marked influence on the serum levels of both CA125 and CA19-9. Myometrial invasion and vessel permeation also increased serum levels of CA125, whereas peritoneal cytology and adnexal metastasis exhibited no influence on CA125 levels or CA19-9 levels. Twenty-five of 33 cases who showed either more than 100 U/ml of CA125 level or more than 100 U/ml of CA19-9 level were classified as surgical stage III or IV. The combined assay demonstrated a 71.9% positive rate at the time of detection of the recurrence (65.6% for CA125, 43.7% for CA19-9). In 34.4% of the 32 recurrent cases, elevated levels of the tumor markers were the first sign of recurrence. These data indicate that the use of CA19-9 in combination with CA125 is noteworthy in the management of patients with endometrial carcinoma.

Adult↗

PubMed1994

Prevalence of second generation antibody to hepatitis C virus among voluntary blood donors in Osaka, Japan.

To clarify the demographic characteristics of the prevalence of hepatitis C virus (HCV) infection in Osaka, Japan, where hepatocellular carcinoma is common, we investigated the screening data of antibody to HCV (anti-HCV, DAINABOTHCVPHA, second generation assay) in 197,600 voluntary blood donors residing in Osaka. The study found that age-standardized prevalence of anti-HCV was significantly higher than that of HBsAg (2.25 cf 0.86 percent among males, P < 0.001; 2.17 cf 0.55 percent among females, P < 0.001. It was much higher in the blood donors aged 55-64 years than in those aged 16-54 years (8.49 cf 1.32 percent among males, P < 10(-5); 7.26 cf 1.42 percent among females, P < 10(-5)). The prevalence of anti-HCV among males was significantly higher than that of females in the younger (25-34 years) generations (1.02 to 1.49 percent cf 0.71 to 1.13 percent, P < 0.05). A similar tendency was observed in the prevalence of high-titer (> or = 2(12)) anti-HCV. The number of coinfection (both HBsAg and anti-HCV seropositive) was very small, and it was not statistically different from the expected number.

Adolescent↗

PubMed1994

Primary liver cancer incidence-rates related to hepatitis-C virus infection: a correlational study in Osaka, Japan.

Osaka, Japan, has one of the highest, primary liver cancer (PLC) incidence-rates in the world, although hepatitis-B virus (HBV) is not endemic. This paper addresses the question of whether the PLC-incidence variation within Osaka Prefecture is due to differences in the prevalence of hepatitis-C virus (HCV) infection. The screening data of antibody to HCV (anti-HCV) and of hepatitis-B virus antigen (HBsAg) in 111,069 male blood-donors, and the incidence data of male PLC obtained from the Osaka Cancer Registry were examined. In a multiple-weighted regression analysis, the age-standardized incidence rate of PLC in the 61 counties within Osaka was correlated significantly with the age-standardized prevalence of anti-HCV with adjustment for that of HBsAg (regression coefficient [RC] = 7.26, P < 0.0001). This finding was consistent with the relationship between the PLC incidence rate and the prevalence of high-titer (> or = 2(12)) anti-HCV (RC = 11.18, P < 0.0001). There was significant association between the prevalence of HBsAg and the PLC incidence rate with adjustment for that of anti-HCV (RC = 7.08, P = 0.018). These findings suggest that the PLC-incidence variation within Osaka is correlated with the geographic pattern of HCV infection as well as that of HBV infection among the residents.

Adolescent↗

PubMed1994

Incidence of childhood cancer in Osaka, Japan, 1971-1988: reclassification of registered cases by Birch's scheme using information on clinical diagnosis, histology and primary site.

In 1971-1988, 4,021 malignant tumors occurring among children under 15 years of age were registered in the Osaka Cancer Registry, a population-based registry which covers Osaka Prefecture, Japan. These patients were reclassified into 12 diagnostic groups by Birch's scheme using information on clinical diagnosis, histology and primary site. The annual age-standardized incidence rate for childhood cancer per million children was 130.3 for males and 104.9 for females in 1971-88. Comparing the incidence rates for both sexes in 1981-88 with those in 1971-80 in Osaka, we observed a significant decrease of acute non-lymphocytic leukemia (ANLL) and a significant increase of all cancers, acute lymphocytic leukemia, non-Hodgkin lymphoma, sympathetic nervous system tumors, soft-tissue sarcomas, and gonadal and germ-cell tumors. Age-standardized incidence rates in around 1971-80 of the above-mentioned diagnostic groups were compared among 4 population-based registries; Osaka, Miyagi (Japan), SEER (U.S.), and the National Registry of Childhood Tumors (England and Wales). Rates for ANLL and gonadal and germ-cell tumors were higher and those for other diagnostic groups were lower in Osaka, especially for Hodgkin's disease. Thus, in 1980-88 in Osaka, rates for Hodgkin's disease remained low and rates for gonadal and germ-cell tumors increased, though rates for other cancers appeared to resemble the levels in caucasian populations. The incidence of childhood cancer in Japan was estimated according to the diagnostic groups in Birch's scheme.

Adolescent↗

PubMed1994

Incidence of second primary cancers in Osaka residents, Japan, with special reference to cumulative and relative risks.

This study was conducted to examine the incidence rates and cumulative risks of second primary cancers in Osaka and to compare the observed number of second primary cancers with the expected number calculated using cancer incidence rates among Osaka residents. Study subjects were all reported cases aged 0-79 who were first diagnosed as having a first primary cancer between 1966-86. Incidence of second primary cancer among the study subjects was examined through to the end of 1989. The total number of study subjects was 217,307. During the follow-up period (mean duration: 3.7 years), second primary cancers developed in 5,071 patients (2.3%). Incidence of synchronous (interval < 3 months) and metachronous (interval > or = 3 months) second primary cancers increased in the later years. Incidence rates of second primary cancers were significantly associated with gender (male), age and calendar year at diagnosis of the first cancer. Based on the incidence rates, cumulative risk of developing metachronous second primary cancer was calculated. The ten-year cumulative risk was estimated as 10% for those who developed their first cancer during their sixties in 1978-83. The observed number of second primary cancers (including synchronous) was compared with the expected number. The ratios of observed-to-expected numbers were generally lower than 1.0 among those who developed their first cancer in 1966-77, while these ratios were higher than 1.0 among those who developed their first cancer in 1978-86. The ratios were much higher than 1.0 among those who developed their first cancer in their childhood and youth. Patients who had developed cancer of the colon, larynx, lung, bladder, or breast (female) showed significantly higher risk of developing second primary cancer during the period 1-4 years after diagnosis of the first cancer.

Adult↗

PubMed1994

Case-control study for lung cancer and cigarette smoking in Osaka, Japan: comparison with the results from Western Europe.

In order to clarify the relation between cigarette smoking and lung cancer, a case-control study was conducted. The case series consisted of 1,376 lung cancer patients (1,082 males and 294 females) who were newly diagnosed and admitted to eight hospitals in Osaka during 1986-88. Smoking histories were compared with those of 2,230 controls (1,141 males and 1,089 females) admitted to the same hospitals during the same period without established smoking-related diseases. Odds ratios of current smoker versus nonsmoker were 18.1, 1.9, 21.4, and 3.8 for squamous, adeno, small, and large cell carcinoma, respectively, for males, and 9.7, 1.3, 12.1, 3.7, respectively, for females. Compared to the results from previous studies in Japan, the magnitude of the odds ratios for squamous and small cell carcinoma is approaching the level of Western Europe in the late 1970s. Population attributable risk of exsmokers has also been increasing to the level of Western Europe. Among male current smokers, smoking intensity, such as number of cigarettes per day or fraction smoked per cigarette, seemed to have a slightly greater influence on squamous cell carcinoma than adenocarcinoma, while factors associated with the spread of cigarette smoke, such as inhalation, seemed to have greater influence on adenocarcinoma. The difference in the distribution of these smoking characteristics between Japan and Western Europe could not fully explain the difference in lung cancer incidence and distribution of histologic types between the two areas.

Adenocarcinoma↗

PubMed1994

Cumulative risk of hepatocellular carcinoma in hepatitis C virus carriers: statistical estimations from cross-sectional data.

The probability of developing hepatocellular carcinoma (HCC) among hepatitis C virus (HCV) carriers during their life-time is unknown. This paper addresses the estimation of the cumulative risk of HCC among HCV carriers using cross-sectional data. Age-specific prevalences of HCV carriers among the general population were estimated according to 5-year age group, based on the data of 2nd-generation anti-HCV assay in blood donors resident in Osaka (33,226 males and 29,054 females). Seropositivity of anti-HCV among 422 HCC cases, and the Osaka Cancer Registry data on HCC were used in the estimations of 5-year age-specific incidence rates of HCV-linked HCC. Using these data, the cumulative risk, i.e., the probability of contracting HCC within the following 15 years in 50-year-old HCV carriers, was estimated as 28% for males and 6% for females.

Carcinoma, Hepatocellular↗

PubMed1994

Interhospital differences in cancer survival: magnitude and trend in 1975-1987 in Osaka, Japan.

This study addresses the disparity in cancer survival rates among hospitals in Osaka, Japan. Using data from the Osaka Cancer Registry, four-year survival rates for stomach cancer patients (n = 8,845) diagnosed in 1976, 1981 and 1986, and lung cancer (n = 9,795) and breast cancer patients (n = 7,377) diagnosed in 1975-77, 1980-82 and 1985-87 were calculated according to four hospital categories (teaching hospitals, large hospitals: 400 + beds excluding teaching hospitals, medium-size hospitals: 150-399 beds, and small hospitals: 20-149 beds). Cox's proportional hazards model was employed with adjustment for sex, age, clinical stage at diagnosis, and treatment status. Stomach and lung cancer patients treated in large, medium-size and small hospitals showed significantly higher risks of death than those treated in teaching hospitals in 1975-87. Interhospital differences in breast cancer survival appeared to increase in 1975-87, whereas those in stomach and lung cancer survivals decreased during the same period.

Breast Neoplasms↗

PubMed1994

[Role of population-based cancer registry in cancer epidemiology--epidemiological studies in the Cancer Registration Scheme in Osaka, Japan].

A population-based cancer registration scheme started in three areas in Japan in the 1950s solely for studying cancer incidence in their respective areas. Soon thereafter, several prefectural governments started their own schemes as part of their cancer control programs, effectively expanding the aims of cancer registration: to clarify cancer facts, to elevate the medical care for cancer patients, and to plan and evaluate cancer control programs. The Osaka Cancer Registry (OCR) started in 1962, and has been using epidemiological methods as a tool in constructing its registration scheme, as well as analyzing and utilizing registry data. This report deals with the results obtained in the OCR, classifying these results into four activities of epidemiology. 1. Clarifying cancer facts (descriptive epidemiology): The OCR has been observing incidence, medical care for cancer patients, distribution of cases by clinical stage, and the 5-year relative survival rate, and has estimated the prevalence rate, cured-case rate, and future incidence into the 21st century. Population-based data on histology and multiple cancers collected at the OCR have also contributed to the new approaches in cancer epidemiology. 2. Research on risk factors (analytical epidemiology): The OCR developed a computerized record-linkage system in 1970. This not only made registry work more effective and reliable, but many cohort studies were able to be conducted with relatively little effort and highly reliable results. The cancer case file in the OCR has been linked with the newly prepared data file of the study group, and cancer incidence among the study group has been observed. Finally, cancer risks of possible causal factors in that group have been estimated quantitatively. 3. Evaluation of control programs: Secondary prevention programs (early detection) have been conducted in Japan as major cancer control programs, because effective risk factors were not previously defined. OCR data have been used for estimating sensitivity and specificity of screening tests for various cancers, as well as for evaluating the effect of clinical work on improving survival and on decreasing cancer deaths. 4. Planning future cancer control programs: The OCR has reported on the probable rapid increase of cancer incidence in the 21st century, especially of elderly cancer cases, and cancer cases with poor survival. To control these difficult problems, new cancer programs should be urgently designed and implemented. The authors have recommended that programs be prepared by cancer site, and have already presented a detailed program for lung cancer control.

Cohort Studies↗

PubMed1994

[Pelvic lymph node metastasis in endometrial cancer].

Various factors associated with pelvic lymph node metastasis were analysed in 393 cases with stage I endometrial cancer treated with extended total hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. The results are as follows. 1. The positive rates for lymph node metastasis and the relapse rate in 393 cases were 8.4% and 12.5%, respectively. 2. Myometrial invasion, tumor size, vessel permeation, cervical involvement, peritoneal cytology and adnexal metastasis were significant factors for lymph node metastasis. 3. Internal iliac nodes were the most common metastatic sites for cases with a single node metastasis, whereas external iliac nodes were the most common in all cases with lymph node metastasis. 4. The relapse rate for cases with single node metastasis was 40%, while the relapse rate for cases with three or more metastatic lymph nodes was 70%. 5. The relapse rate for 33 cases with lymph node metastasis was 54.5% and all of the relapse cases showed distant recurrence, whereas the relapse rate for 360 cases without lymph node metastasis was only 8.6%. It is therefore considered that pelvic lymphadenectomy is important in detecting high-risk patients and to reduce the relapse rate. Cytotoxic chemotherapy seems to be more adequate as adjuvant therapy for cases with lymph node metastasis.

Adult↗

PubMed1994

[Recurrent endometrial cancer after complete surgery].

Between 1974 and 1991, 576 patients with endometrial cancer were treated with complete surgery. 1. The overall relapse rate was 14.4%. No recurrence was observed in surgical stage Ia, whereas 56.8% relapse was noted in stage IIIc. 2. The relapse rate in cases with adenocarcinoma was 13.0%. The relapse rate increased with poorer differentiation. Five of 6 cases with serous adenocarcinoma developed recurrence. 3. Myometrial invasion, size of tumor, vessel permeation, cervical involvement, adnexal metastasis and lymph node metastasis were significant factors for relapse. 4. Distant recurrence was noted in 63.9% of recurrent cases and 28.9% developed pelvic recurrence. The most common recurrent sites were lung, peritoneal cavity, and para-aortic lymph node in distant relapse and vaginal vault and parametrium in pelvic relapse. 5. The time to relapse ranged between 106 days and 5,518 days after complete surgery. Thirty one point three % of the recurrent cases manifested relapse within the first year, 60.2% within 2 years and 93.9% within 5 years. The mean time to relapse was 561 days. It was concluded that adjuvant therapy for cases with adnexal metastasis, lymph node metastasis, cervical involvement, adenocarcinoma (G3), and serous adenocarcinoma should be established urgently.

Adenocarcinoma↗

PubMed1994

[Trends of lung cancer incidence and its prognosis in Osaka, Japan].

Lung cancer incidence figures in Japan were estimated as 30,000 for males and 11,000 for females for 1989 and represented the second and the fifth leading site of cancer, respectively, according to the Research Group for Population-based Cancer Registration in Japan. It is also estimated that lung cancer will steadily increase in the future. In relative frequencies of the major histological types, squamous cell carcinoma showed a decreasing trend, while small as well as large cell carcinomas showed an increasing trend in Osaka. In the distribution of clinical staging, the proportion of localized cases accounted for only 20% of the lung cancers in 1990. Five-year relative survival rates for lung cancer were 11.3% for all patients and 43.0% for localized cases in Osaka in 1984-1986. The rates were reported as 13.5% and 36.6% for total patients and localized cases, respectively, among caucasians from the SEER Program, a NCI project including 10 population-based cancer registries in the US. No noticeable difference was observed between Japan and the US. To control lung cancer in Japan it is considered vitally important and urgent to develop (1) new examination methods for diagnosing lung cancer in the earlier stage, (2) an efficient and effective cessation campaign for cigarettes smoking and (3) non-smoking based education.

Carcinoma, Squamous Cell↗

PubMed1993

Risk factors for hepatocellular carcinoma among patients with chronic liver disease.

BACKGROUND AND METHODS: To detect potentially curable cases of hepatocellular carcinoma, outpatients with chronic hepatitis or compensated liver cirrhosis who were seen at the Center for Adult Diseases (Osaka, Japan) were examined periodically by means of ultrasonography and measurement of serum alpha-fetoprotein. Risk factors for hepatocellular carcinoma were identified with a Cox proportional-hazards model. RESULTS: A total of 917 patients, 40 to 69 years old, were registered from May 1987 to March 1991. By the end of September 1991, liver cancer had developed in 54. The three-year cumulative risk of liver cancer was 12.5 percent for 240 patients with liver cirrhosis at enrollment and 3.8 percent for 677 patients with chronic hepatitis. Cox regression analysis showed that the risk of liver cancer was increased almost sevenfold in patients with hepatitis B surface antigen (rate ratio, 6.92; 95 percent confidence interval, 2.92 to 16.39) and fourfold in patients with hepatitis C antibody (rate ratio, 4.09; 95 percent confidence interval, 1.30 to 12.85). A high alpha-fetoprotein value at enrollment was also a risk marker for liver cancer. CONCLUSIONS: Patients with hepatitis C virus infection have a greatly increased risk of liver cancer. Further studies are required to clarify the roles of other risk factors, including drinking and smoking habits.

Adult↗

PubMed1993

Lung cancer incidence rate for male ex-smokers according to age at cessation of smoking.

Lung cancer incidence rate after the cessation of smoking was assessed for male ex-smokers according to the age at cessation, using the results from a case-control study for ex-smoker versus continuing smoker, and the lung cancer incidence rate function for continuing smoker estimated from Japan Vital Statistics and the "Six-prefectural Cohort Study" in Japan. This hospital-based case-control study consisted of 776 lung cancer cases (553 current smokers and 223 ex-smokers) and 772 controls (490 current smokers and 282 ex-smokers) who started smoking at ages 18-22. The odds ratio of developing lung cancer for ex-smokers compared to continuing smokers according to years since the cessation of smoking was estimated for four age groups (55-64, 60-69, 65-74 and 70-79). Given that the number of years since cessation of smoking is the same, reduction of the odds ratio appeared to be greater for the younger age group than for the older age group, reflecting the shorter period of exposure for the younger age group. Lung cancer incidence rate (per 100,000) was assumed to be expressed by the following function; 1.7 x 10(-5) x (age -24.3) for continuing smokers and 0.15 x 10(-5) x (age) for nonsmokers. Lung cancer incidence rate among ex-smokers according to years since cessation was then estimated to be the above function multiplied by the odds ratio from the case-control study for each age group. In contrast to the greater reduction of the odds ratio among younger ex-smokers, reduction of the incidence rate, in terms of rate difference, was considerably greater for older ex-smokers due to a high incidence rate of lung cancer for older continuing smokers. This indicates that the absolute magnitude of reduction of the lung cancer incidence rate after cessation of smoking is greater for older ex-smokers, although the relative magnitude of reduction is greater for younger ex-smokers.

Age Factors↗