The clinicopathology of our series of patients (n = 486) with early gastric cancer was reviewed with special reference to metastasis to the regional lymph nodes. The incidence of lymph node metastasis was 15.8% (19/120) in patients with the protruded type of carcinoma and 11.7% (42/360) in patients with the depressed type of carcinoma. It was especially high in carcinomas of the IIa + IIc type of the former group. The incidence of lymph node involvement was higher in the group with larger tumors (greater than 30 mm) than in the group with smaller tumors (less than or equal to 30 mm). Metastatic lesions were detected in as many as 25.0% (16/64) of the cases with large tumors (greater than or equal to 50 mm); however, of the 46 cases with small tumors (less than 10 mm), 1 case had metastases to the nodes of group 1. There were 4 cases of m-cancer with metastasis to group 1 lymph nodes. Skip metastasis to group 2 lymph nodes was discovered in 4 cases. From these results, we feel that the standard operation for early gastric cancer is R2-gastrectomy including the complete removal of group 1 and 2 lymph nodes. R1-gastrectomy or local resection is thought to be sufficient for m-cancer with a lesion smaller than 10 mm in maximum diameter.

Adenocarcinoma↗

PubMedDate not supplied

A clinical evaluation of various tumor markers for the diagnosis of pancreatic cancer.

Many substances that are widely used as tumor markers for detecting pancreatic cancer are discussed. Some are good indicators, but some are not. Among them, CA 19-9 and SPan-1 have higher sensitivity and specificity for diagnosis of pancreatic cancer. However, these markers are neither tumor-specific nor pancreatic-cancer-specific. Accurate understanding of the measurement of serum tumor markers makes it possible for them to be useful adjunctive tools for detecting pancreatic cancer, even in small cancers, and for monitoring patients after treatment.

Antigens, Neoplasm↗

PubMedDate not supplied

Effect of fat emulsion in patients with liver disorders.

The effect of fat emulsion in preoperative patients (n = 17) with liver disorders was studied by liver-function tests, intraoperative liver biopsy specimens, intravenous fat tolerance tests, and serum fatty acid analyses. There was no difference between liver-function tests before and after the administration of fat emulsion. Before the administration of fat emulsion, the levels of serum lipids were relatively low, and serum fatty acid patterns were abnormal. However, after the administration of fat emulsion, serum lipid levels increased, and serum fatty acid patterns became nearly normal. There was a significant correlation between the total fat intake and serum linoleic acid change before and after the administration of fat emulsion. From this equation, the total fat intake required for a normal range of serum linoleic acid was calculated to be 7 g/kg fat. These results suggest that the administration of fat emulsion improves serum fatty acid patterns without a deterioration of liver function in preoperative patients with liver disorders, but total intake of 10% fat emulsion greater than 70 ml/kg might induce higher serum fatty acids than in healthy control subjects and cause overload in these patients.

Adult↗

PubMedDate not supplied

Gastric carcinoma in young adults in Japan.

Forty-nine cases of young adults with carcinoma of the stomach were reviewed. The occurrence of this tumor had a percentage rate of 2.7 of the total of 1767 Japanese patients with stomach carcinoma, with a male to female ratio of 1.0:0.88. The most common complaint observed was epigastric pain (45.7%). In the majority of patients, the period from the onset of symptoms to the time of diagnosis was over two years (49%). Thirty-nine out of 49 patients had resection of the stomach and a consequent operation was curative in 55.1% of them. The overall 5-year survival rate was 26.8%. However, the 5-year survival rate for the curative operation was 42.6% particularly in early gastric carcinoma without any serosal invasion and no patients died from carcinoma of the stomach. These results indicate that early diagnosis is very important to improve the curing rate of this disease in young adults.

Adolescent↗