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Biomedical subjects

O Doi

Publications and source records attributed to O Doi.

At least 55 records · Page 3Linked to original sources

Lymphoepithelioma-like carcinoma of the lung: analysis of two cases for Epstein-Barr virus infection.

Lymphoepithelioma-like carcinoma, which is an uncommon histological type of epithelial tumor, has been described as being closely associated with Epstein-Barr virus (EBV) infection in organs other than the lung. Recently, we experienced two surgically resected cases of pulmonary tumors mimicking lymphoepithelioma-like carcinoma. Both cases contained EBV DNA genomes as shown by polymerase chain reaction (PCR) using EBV DNA-specific primers, one positive for EBV DNA in virtually all cancer cells, and the other showing positive hybridization in a small number of cancer cells by in situ hybridization (ISH) using digoxigenin-labeled olignucletide probes for each of EBV DNA for EBV DNA. EBV-encoded RNA-1 (EBER-1) was typically detected in one case. These results are highly suggestive of EBV-associated tumors in one of the current cases, although in the other case, no such close association was determined. It seems that lymphoepithelioma-like pulmonary carcinoma, which seems extremely unusual, may be closely associated with EBV infection in tumorigenesis.

Adenocarcinoma↗

p53 immunostaining in combined type small cell lung cancer. Brief report.

Abnormalities of the p53 oncogene in lung cancer have recently been reported to be more frequent in small cell lung cancer (SCLC) than in non-small cell lung cancer (non-SCLC), but their status in combined type SCLC is as yet unknown. In this study, immunohistochemical analysis using a polyclonal antibody against p53 protein was performed in 12 surgically resected specimens of combined type SCLC. Immunoreactivity of the p53 protein was found in 5 (42%) of the 12 cases, and the immunostaining pattern of the p53 protein in areas of the non-small cell carcinoma type was the same as in those of the small cell carcinoma type. Thus, it seems that the incidence of p53 abnormalities in combined type SCLC is slightly lower than in ordinary type SCLC. It is also suggested that abnormalities of the p53 oncogene in this histological type may not be a specific event related to the morphological difference between small cell carcinoma and non-small cell carcinoma.

Aged↗

[Development of new in vitro chemosensitivity test using collagen gel droplet embedded culture and its clinical usefulness].

We developed a new in vitro assay for chemosensitivity test using collagen gel droplet embedded culture and image analysis. In this in vitro assay, we successfully minimized the cancer cell number required for culture to approximately 3-10 x 10(3) cells for each 30 microliters collagen gel droplet, obtained the sufficient growth of cancer cells using serum-free medium while suppressing the growth of fibroblastic cells, and measured the volume of cancer cells by eliminating the contaminating fibroblastic cells by an image processing technique. Anticancer effects of the in vitro assay showed a very good correlation with those of in vivo nude mouse assay using human cancer cell lines. The success rates of the in vitro assay for 141 surgical specimens of primary lung cancers and for 65 of primary breast cancers were 89 and 80%, respectively. The accumulated in vitro assay response rates of MMC, CDDP, VDS and VP-16 for primary lung cancers and of MMC, 5-FU and ADR for primary breast cancers were similar to the respective clinical response rates. These results suggest that this in vitro chemosensitivity test may be practically useful for clinical applications.

Animals↗

[Relationship between intraoperative pleural lavage cytology and recurrence in pleural cavity after resection of lung metastasis from colorectal cancer].

Seventeen patients with lung metastases from colorectal cancer underwent intraoperative pleural lavage cytology immediately after thoracotomy from August 1988 to December 1994. Patients with pleural effusion and/or dissemination were excluded. The median followup period was 34 months (range 3-52 months). Of the 17 patients, 13 were cytologically negative (76%, group A) and 4 were positive (24% group B). Recurrence rate in the pleural cavity was 25% (1/4) in group B and 0% (0/13) in group A. The three-year survival rate was 0% in group B and 78% in group A, respectively. These results indicate that intraoperative pleural lavage cytology is useful in the assessment of prognosis, and locoregional therapy should be considered for cytology positive group.

Colorectal Neoplasms↗

[A case of pulmonary tumorlet with tuberculoma misdiagnosed as small cell lung carcinoma by transbronchial lung biopsy].

A 59-year-old woman was picked up by chest X-ray findings. Her CT scan film showed a tumor shadow in the upper lobe of the left lung, and by transbronchial lung biopsy, she was diagnosed as a small cell lung carcinoma. Lobectomy was performed, but the lesion was diagnosed as tuberculoma by frozen section. Furthermore, on postoperative histological examination, a minute lesion of tumorlet, which was histologically identical to that preoperatively detected by transbronchial lung biopsy was found in the adjacent tissues of the tuberculoma. Pulmonary tumorlet is clinically a rare lesion, but the diagnosis and treatment for small-sized tumor or tumor-like lesion may be carefully done, taking into account the existence or co-existence of tumorlet lesion.

Biopsy↗

Surgery for brain metastases from nonsmall cell lung carcinomas and tissue cultures from the resected specimens.

Between 1978 and 1989, 44 patients underwent 44 thoracotomies and 55 craniotomies for nonsmall cell lung carcinoma (NSCLC) and its brain metastases. Patients ages ranged from 20 to 75 years. There were no intraoperative mortalities. The 2-, 3-, and 5-year survival rates following the initial craniotomy were 23%, 10%, and 10%, respectively. Patient survival did not differ with respect to solitary or multiple metastases or the sequence of surgery for primary lesion and brain metastases. Moreover, there was no significant difference in survival between patients treated by surgery alone and those receiving surgery followed by whole brain radiotherapy. After 1985, in vitro tissue culture was attempted using freshly resected specimens of brain metastases obtained from 30 consecutive cases. Of those specimens, nine (30%) were successfully established as permanent cell lines. Eight of those cell lines revealed DNA-aneuploid pattern on flow cytometric analysis. The remaining cell line was not analyzed. Karyotype analysis was also performed in eight of nine established cell lines. Two adenocarcinoma cell lines showed the presence of +3p- chromosome, and three showed +7q- chromosome as recurrent chromosomal abnormalities. These findings provide new evidence concerning the presence of 3p- and/or 7q- marker chromosomes in certain adenocarcinoma cell lines established from brain metastases. The prognosis was poorer in the group with in vitro tumor growth than that in the group showing no in vitro tumor growth. These cell lines established from brain metastases may be useful materials not only for studying the biological characteristics and chemo-sensitivity testing, but also for estimating prognoses after resection of brain metastases.

Adult↗

Prognostic significance of pS2 protein expression in pulmonary adenocarcinoma.

In the present study, pS2 protein expression in pulmonary adenocarcinoma was investigated on paraffin-embedded sections obtained from 170 patients. 28 (16%) patients showed varying degrees of pS2 protein expression in the cytoplasm of tumour cells, as detected by immunohistochemical staining with anti-pS2 protein antibody. There was a significant association between pS2 protein expression and larger tumour size, and the acinar or bronchiolo-alveolar subtype. However, no significant correlations between pS2 protein status and the other clinicopathological factors, i.e. T-factor, N-factor, stage and histological differentiation, were shown. In contrast to breast cancer, patients with pS2-positive pulmonary adenocarcinomas had a significantly worse prognosis than those with pS2-negative pulmonary adenocarcinomas; this was true for stage I patients, as well as for all patients. Multivariate analysis showed that pS2 protein expression was a discriminating variable in overall survival. These findings suggest that pS2 protein status is a possible prognostic indicator in pulmonary adenocarcinoma.

Adenocarcinoma↗

Differentiation of a Ewing's sarcoma cell line towards neural and mesenchymal cell lineages.

Two different pathways of differentiation were investigated in Ewing's sarcoma (ES) cell line, designated CADO-ES1, which has been established in our laboratory. This cell line was induced to differentiate and display a neural phenotype when treated with dibutyryl cyclic adenosine monophosphate or when cultured in serum-free medium (HB101). In these in vitro differentiation studies, two different phenotypes were demonstrated by light and electron microscopy. One phenotype, present in a major portion of the cell population, had long neurites in which microtubules were ultrastructurally demonstrated. The other one, present in a minor portion of the cell population, consisted of flat cells with many short processes. After differentiation in serum-free medium, tumorigenicity in nude mice or colony-forming efficiency in soft agar was strongly depressed. In the cells, N-myc, c-fos and c-src genes were not amplified, and although c-myc was amplified by up to 2-fold, depending on the culture conditions, this appeared to be unrelated to the changes of phenotype. When tumor cells were transplanted into nude mice, cartilage was formed. The cartilage was immunoreactive with the antibody for HLA-ABC, indicating that it was derived from the tumor cells, not from mouse tissue.

Animals↗

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↗

Surgical treatment of brain metastases of lung cancer: retrospective analysis of 89 cases.

The records of 89 patients who underwent surgery for solitary or multiple parenchymal brain metastases of lung cancer at the Osaka Center for Adult Diseases between 1978 and 1990 were reviewed with follow up until March 1992. The aim of this retrospective analysis was to identify prognostic features that were associated with a favourable outcome. The benefits of brain tumour surgery were evaluated in terms of the cause of death (brain metastasis, tumour in another organ, or treatment related) as well as the postoperative changes in functional state indicated by the Karnofsky scale. The overall mean survival time was 11.6 months, and the one and two year survival rates were 24% and 8%. The brain lesion itself was the cause of death in only 19% of the patients; the other 81% died of systemic disease. Functional state improved after surgical excision of the brain tumour in 36%, remained unchanged in 53%, and worsened in 11%. These data suggest that surgical intervention is beneficial for patients with parenchymal brain metastases. Variables significantly associated with a favourable prognosis included surgical excision of the primary lesion, adenocarcinoma as the histological diagnosis, the use of adjuvant treatment, especially chemotherapy, a preoperative score of over 80% on the Karnofsky scale, and metastasis confined to the brain with no extracranial metastatic foci or residual primary tumour. Additional but non-significant contributors to a good prognosis included age under 65 or 70 years, early tumour stage (stage 1), curative lung cancer surgery, a single metastatic brain tumour (v multiple lesions), a solid tumour (v cystic), and a supratentorial location of the brain metastasis. The disease free interval and the cerebrospinal fluid cytology were not significant prognostic factors. On the basis of these findings, it is concluded that the surgical removal of brain metastases of lung cancer should be undertaken if the primary tumour has already been removed whether or not there are extracranial metastases, and that postoperative chemotherapy should generally be given.

Activities of Daily Living↗

Pleural invasion by peripheral bronchogenic carcinoma: assessment with three-dimensional helical CT.

PURPOSE: To evaluate the potential role of three-dimensional (3D) computed tomography (CT) in assessment of pleural invasion by peripheral bronchogenic carcinoma. MATERIALS AND METHODS: Twenty-four-second helical CT scans were obtained during a single breath hold in 42 consecutive patients with peripheral bronchogenic carcinoma. Conventional two-dimensional (2D) images and 3D reconstruction images were reviewed independently by three blinded observers, who reached a decision by consensus. All patients underwent surgical resection of the tumor, and CT findings were correlated with the findings in pathologic specimens. RESULTS: Twelve patients had visceral pleural invasion, five had parietal pleural invasion, and 25 had no evidence of pleural invasion. Visceral pleural invasion was identified on 2D CT images in two patients and on 3D reconstructions in 11. Parietal pleural invasion was identified on 2D CT images in two patients and on 3D reconstructions in three. CONCLUSION: 3D reconstruction imaging is superior to conventional 2D CT in assessment of pleural invasion by peripheral bronchogenic carcinoma.

Carcinoma, Bronchogenic↗

Lung cancer found in a patient with absence of the inferior vena cava associated with a left superior vena cava.

A patients with anomalies of the main systemic veins developed lung cancer. In this patient, the large hemiazygos vein emptied into the left superior vena cava which communicated with the right atrium through the coronary sinus. The cancer was located in the right upper lobe and directly invaded the mediastinum. Fortunately, because of the absence of a right superior vena cava in the normal position, the tumor was completely resected by sleeve upper lobectomy without necessitating angioplastic procedures.

Aged↗

Aggressive pulmonary metastasectomy for soft tissue sarcomas.

BACKGROUND: To evaluate the efficacy of aggressive pulmonary metastasectomy for treating soft tissue sarcomas, the clinical data on the surgical management of 23 patients with extensive pulmonary metastases from soft tissue sarcomas were reviewed. METHODS: Between January 1973 and April 1991, 9 male patients and 14 female patients were treated. Their ages ranged from 13-68 years (median, 42 years). Twenty-one patients (91%) had bilateral and multiple metastases, and two patients had solitary metastasis. The number of resected metastatic nodules ranged from 1-110 (mean, 30.5). As an initial surgical approach, median sternotomy was used on 18 patients and lateral thoracotomy on 5 patients. Eleven patients underwent two or more explorations for recurrent metastases using lateral thoracotomy. The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was adopted in 10 patients since 1986. RESULTS: The actuarial 2-year and 5-year survival rates after the first pulmonary resection were 49.7% and 24.8%, respectively. Histologic type (alveolar soft part sarcoma versus synovial sarcoma, P < 0.025), histologic grade (G1 and G2 versus G3, P < 0.01), and metastatic localization (subpleural versus extrapleural, P < 0.005) were the most significant prognostic factors for aggressive pulmonary metastasectomy of soft tissue sarcomas. Application of laser surgery, absence of local recurrences, and absence of extrapulmonary metastases before pulmonary resection also correlated with better prognosis with borderline significance. CONCLUSIONS: Aggressive pulmonary metastasectomy for soft tissue sarcomas is a recommended procedure, even in the case of extensive metastases. The combination of median sternotomy and Nd:YAG laser-assisted surgery is a useful technique, especially in bilateral multiple pulmonary metastases.

Adolescent↗

Long-term results of postoperative intrathoracic chemo-thermotherapy for lung cancer with pleural dissemination.

BACKGROUND: To overcome the poor prognosis of lung cancer with pleural dissemination, the authors developed postoperative intrathoracic chemo-thermotherapy (PICT). In this report, they present the long-term results for 31 consecutive patients who underwent resection, followed by PICT for lung cancer with pleural dissemination between April 1985 and December 1991. METHODS: Among the patients, there were 26 cases of adenocarcinoma, 3 cases of squamous cell carcinoma, and 1 case each of large and adenosquamous cell carcinoma. Twenty-four of these patients had an initial diagnosis of pleural involvement at thoracotomy. The other seven patients had massive malignant effusion at the time of the initial diagnosis. PICT was started between days 10 to 14 postoperatively. When possible, three courses of this procedure were administered at intervals of 5-7 days. RESULTS: The 5-year cumulative and 5-year local relapse-free survival rates were 24.6% and 76.3%, respectively. The 3-year and 5-year cumulative survival rates for 14 patients without mediastinal lymph node involvement were 68.4% and 42.7%, respectively. Those rates for 17 patients with mediastinal lymph node involvement were 22.7% and 0%, respectively. The 3-year survival rate in the former group was significantly better than that in the latter group. CONCLUSIONS: These results strongly suggest that in patients with pleural dissemination, PICT may be beneficial for regional disease control and improvement of survival, particularly for patients without mediastinal lymph node involvement.

Adenocarcinoma↗

cis-diamminedichloroplatinum (CDDP) therapy for brain metastasis of lung cancer. I. Distribution within the central nervous system after intravenous and intracarotid infusion.

The distribution of cis-diamminedichloroplatinum (CDDP) was studied in 23 patients undergoing surgical resection of brain tumors metastatic from lung cancer. CDDP (100 mg/m2) was administered intravenously (i.v.) or intra-arterially (IA) at the time of surgery, and various fluids and tissues were sampled for measurement of drug concentration. Comparison of the two routes of administration disclosed that the plasma level was slightly lower after IA than after i.v. infusion, whereas there was no difference between the two routes in terms of drug diffusion into the brain tissue adjacent to the tumor. However, IA administration resulted in an intratumoral drug concentration twice as high as that achieved with i.v. infusion. The tumor:plasma and tumor:adjacent brain ratios of drug concentration after IA injection were also twice those measured after i.v. administration. The distribution pattern of CDDP is characteristic of water-soluble agents. All patients experienced tolerable nausea and vomiting. Creatinine clearance was moderately reduced in ten cases, but no serious renal toxicity was observed. Seizures occurred postoperatively in nine patients. Infrequent side effects were myelosuppression, ototoxicity, and postoperative intracranial bleeding. All adverse effects disappeared with conservative treatment or no intervention.

Aged↗

cis-diamminedichloroplatinum (CDDP) therapy for brain metastasis of lung cancer. II: Clinical effects.

Parenchymal brain tumors, which were metastases of primary lung cancer, were surgically removed from 25 patients. During the operation, patients were administered (intravenous or intracarotid) 100 mg/sq m of cis-diamminedichloroplatinum (CDDP) and postoperatively, they received intravenous CDDP at 3-month intervals for 1 year. The results of this mode of treatment were compared with those obtained in 25 patients who underwent the same surgery but received other anticancer agents and in 39 patients who received no postoperative chemotherapy. Patients in the CDDP-treated group survived much longer than both of the other treatment groups. In the CDDP, but not in the other two groups, survival was significantly longer in patients who had undergone resection of their lung tumors than in those who had not. The stage of lung cancer was not found to significantly influence survival time among CDDP-treated patients. Brain metastasis was the cause of death in 12% of the patients who received CDDP, in 16% those treated with other drugs, and in 26% of those who received no chemotherapy. The incidence of local and remote intracranial tumor recurrence, including meningeal carcinomatosis, was similar in the three groups. However, the mean interval from resection of the metastatic brain tumor to local or remote recurrence was longer in the CDDP-treated group than in the other two groups, and the 2-year-survival rate was significantly higher after CDDP administration. These results suggest that CDDP may be useful in the therapy of metastatic brain tumors derived from lung cancer.

Brain Neoplasms↗

Successful surgery of malignant fibrous histiocytoma in the lung with gross extension into the right main pulmonary artery.

We report on successful surgical treatment of a 49-year-old female suffering from malignant fibrous histiocytoma which arose from the lower lobe of the right lung with gross extension into the right main pulmonary artery, mimicking pulmonary thromboembolism. With the aid of a percutaneous cardiopulmonary support system, right pneumonectomy with resection of the right main pulmonary artery and reconstruction of the pulmonary artery was performed. Surgical management and the unique clinicopathological features of this case are discussed.

Diagnosis, Differential↗