Biomedical subjects

S Moriguchi

Publications and source records attributed to S Moriguchi.

At least 19 recordsLinked to original sources

PubMed1992

Prophylactic lymph node dissection in patients with advanced gastric cancer promotes increased survival time.

BACKGROUND: There is no consensus of opinion regarding the efficacy of lymph node dissection. METHODS: Data were analyzed from 452 patients with advanced gastric cancer who underwent curative resection in the Department of Surgery II, Kyushu University Hospital, between 1970 and 1985, with special reference to the lymph node metastasis. RESULTS: Metastatic lesions were evident in the dissected lymph nodes of 300 of 452 (66.4%) patients. Survival time for patients without lymph node metastasis was longer than for those with it (P less than 0.01). In patients without lymph node metastasis, the tumor was smaller, serosal invasion was less prominent, tumor growth was less infiltrating, and the tumor stage was, therefore, less advanced. Lymphatic involvement was found in 38.9% of the patients with no evidence of lymph node metastasis. CONCLUSIONS: Because the postoperative mortality rate is low in patients with lymph node dissection, the authors advocate prophylactic lymph node dissection to prevent a recurrence.

Aged↗

PubMed1992

Immobilization of protein ligands with methyl vinyl ether-maleic anhydride copolymer.

Methyl vinyl ether-maleic anhydride copolymer (MMAC) is a water-insoluble polymer with an acid anhydride group which reacts with amino groups of ligands to form stable amide bonds. MMAC was used to immobilize protein ligands on two kinds of supports, the wells of plastic microtitre plates for enzyme-linked immunosorbent assay and related methods, and gels for affinity adsorbents. The wells were first coated with MMAC and then allowed to react with proteins. The immobilization of proteins by this method was efficient and occurred in a dose-dependent manner. Shodex Et123, a gel having amino groups, was incubated with MMAC, and then the activated Shodex was used to immobilize high concentrations of proteins. Concanavalin A-Shodex thus obtained had high affinities and was successfully used for the high-performance liquid affinity chromatography of sugar derivatives on a short column.

Chromatography, High Pressure Liquid↗

PubMed1992

Signet ring cell carcinoma of the stomach.

Between 1965 and 1985, 51 of 1500 patients (3.4%) with gastric cancer who had gastric resection had signet ring cell gastric cancer. Patients with this form of cancer tended to be younger and female; the tumors were smaller and involved the stomach body, serosal invasion was less prominent, and lymph node metastases were less likely to be present. Early mucosal and submucosal cancer was present in 54.9% of the patients with the signet ring cell and in 24.6% with other types of gastric cancer. In 15.7% of patients with signet ring cell cancer, a noncurative resection was performed. The 5-year survival rate was 74.5% for patients with signet ring cell cancer and 52.4% for those with other types of gastric cancer (P less than 0.01). In patients with signet ring cell gastric cancer, the lesion is less extensive; thus, these patients probably can expect a longer survival time.

Adenocarcinoma, Mucinous↗

PubMed1992

Predictors of lymph node metastasis in early gastric cancer.

Data were analysed on 396 patients with early gastric cancer who underwent resection in this department; special reference was made to lymph node metastasis. Metastases were present in the dissected lymph nodes of 47 patients (11.9 per cent). The survival rate for patients with metastasis to lymph nodes was lower than for those without such metastasis (P less than 0.05). Lymph node metastasis was associated with larger tumour, a higher incidence of submucosal invasion, a higher rate of lymphatic vessel involvement, an advanced stage of disease and a non-curative resection rate of 6.4 per cent. Multivariate analysis showed that the independent risk factors for lymph node metastasis in patients with early gastric cancer were large tumour size, lymphatic vessel involvement and invasion into the submucosal layer. In patients with these risk factors, lymph node dissection and postoperative adjuvant therapy should be performed in an attempt to prevent recurrence in the form of lymph node metastasis.

Female↗

PubMed1992

Quality of life after gastrectomy in patients with carcinoma of the stomach.

One hundred and fifty patients without recurrence of disease after R2 gastrectomy for carcinoma of the stomach were interviewed to determine their quality of life after surgery. Patients ate less and weighed less but most appeared to be well adjusted and had an optimistic attitude regarding their physical state. There was no evidence of a diminished quality of life in those who had undergone distal partial gastrectomy. These patients had a higher overall food tolerance, body-weight and performance status compared with those treated by total gastrectomy. Considering the satisfactory outcome and the sustained quality of life, radical R2 gastrectomy may be the treatment of choice for carcinoma of the stomach.

Body Weight↗

PubMed1992

Postoperative chemotherapy for patients with advanced gastric cancer.

The relationship between postoperative chemotherapy and survival time after gastric resection in patients with advanced gastric cancer was examined by retrospectively reviewing data on 916 patients treated in our clinics between 1965 and 1985. Of these patients, 738 were treated postoperatively with antitumor drugs. Postoperative chemotherapy was more often prescribed for those in the advanced stages of malignancy. Univariate analysis revealed that the survival time of patients given postoperative chemotherapy was shorter than for those not receiving chemotherapy, but there was no statistical significance. Multivariate analysis using the Cox regression analysis adjusted for sex, age, and other covariants indicated that operative curability, liver metastasis, serosal invasion, lymph node metastasis, peritoneal dissemination, and tumor size were the important prognostic factors. There was no correlation with postoperative chemotherapy. Our findings rule out any relationship between postoperative chemotherapy and length of survival time for patients with advanced gastric cancer undergoing gastric resection.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1992

Multivariate analysis of postoperative complications after esophageal resection.

To determine the contributing factors for eight postoperative complications after esophagectomy through a right thoracoabdominal approach, a multivariate analysis was carried out on preoperative and intraoperative variables in 141 patients with thoracic esophageal cancer. Although postoperative complications occurred in 125 patients, only 7 died of such complications. The multivariate analysis indicated that the retrosternal route was a significant factor predisposing to postoperative atelectasis. Age, preoperative arterial oxygen tension, and volume transfused were significant factors predisposing to postoperative hypoxemia, whereas age, routes other than the intrathoracic route, and volume transfused were significant factors predisposing to prolonged respiratory support. In addition, preoperative total serum bilirubin level and volume transfused were significant factors predisposing to postoperative hyperbilirubinemia; preoperative serum creatinine level was a significant contributing factor for postoperative renal insufficiency; and sex, antesternal route, and substituted colon were significant contributing factors for anastomotic leakage. There were no significant factors predisposing to postoperative pneumonia and liver dysfunction. These significant factors should be taken into consideration not only during perioperative management but also when choosing the operative procedures and extending the surgical indication for esophagectomy through a right thoracoabdominal approach.

Age Factors↗

PubMed1992

Risk factors which predict pattern of recurrence after curative surgery for patients with advanced gastric cancer.

The objective of the study was to define risk factors for peritoneal dissemination and haematogenous metastasis after curative resection of patients with an advanced gastric cancer. In retrospective analyses of 405 patients, 168 died of a tumour recurrence. Patients who died of gastric cancer were more likely to have large, invasive tumours which had spread throughout the stomach, metastasized to lymph nodes, and vessel invasion by gastric cancerous cells (P < 0.01 or P < 0.05). Of the 168 deaths, 60 (35.7%) were secondary to haematogenous recurrence, 53 (31.5%) were related to peritoneal dissemination, and 19 (11.3%) were related to a local recurrence. To determine the independent risk factors related to peritoneal dissemination and haematogenous metastasis, multivariate analyses using a stepwise logistic model suggested that serosal invasion (P < 0.01, relative risk = 2.57) and Borrmann type 4 (P < 0.01, relative risk = 1.95) were the greatest risk factors for peritoneal dissemination. The presence of lymph node metastasis (P < 0.01, relative risk = 2.62) and presence of vessel invasion by cancerous cells (P < 0.05, relative risk = 1.59) were the greatest risk factors for a haematogenous metastasis.

Cause of Death↗

PubMed1992

Prognosis for surgically treated gastric cancer patients is poorer for women than men in all patients under age 50.

From 1965 to 1983, 1031 patients (689 men and 342 women) with advanced gastric cancer underwent gastric resection in our department. A retrospective study was done with special reference to the sex of the patients. The age, tumour size and location, Borrmann type, and histology were considered as the sex-related associations. The survival rate of women under age 50 years was lower than that of men, with a significant difference (P less than 0.01), and the 10-year survival rate was 39.2% for the men and 29.3% for the women. A multivariate analysis showed that the operative curability (relative risk: 2.11), lymph node metastasis (relative risk: 1.37), depth of invasion (relative risk: 1.30) and tumour size (relative risk: 1.05), all significant prognostic factors, differed between the men and women under age 50 years, and the survival rate for women was lower. Thus, early detection of gastric cancer is crucial to improve the survival of women under age 50 years. Postoperative chemotherapy may be considered for those with an advanced gastric cancer.

Adult↗

PubMed1992

Nutritional factors and cellular immune responses.

Nutritional factors affect the immune response to infection and cancer in the elderly as well as young children. We studied the effects of lower and higher intake of food or nutrients on the immune cells of macrophage-lymphocytes series in the lung of rats. In rats of all ages taking voluntary exercise, a well balanced diet that contains adequate protein (20-40%) is crucial for maintenance of high levels of immune response. In addition, extra amounts of vitamins A and E activated the function of alveolar macrophages, which are probably stimulated by fat soluble vitamins coming into the lung via the lymphatic route from the intestine, and will be especially important in preventing pulmonary infection and cancer.

Animals↗

PubMed1992

Enhanced phagocytosis of rat alveolar macrophages by intravenous infusion of an arginine-enriched solution.

Phagocytosis of rat alveolar macrophages (AM) was enhanced by the infusion of arginine-rich solution for 7 days. The enhancement of phagocytosis by arginine-rich solution was due to not the difference in the distribution of AM subpopulations (I to IV) but the difference in phagocytic activity of AM in fraction IV. In the process of phagocytosis, there were no significant differences in the stages of migration, attachment, and digestion between control and arginine-rich solutions, although AM from fraction IV of rats infused with arginine-rich solution showed significantly higher ingestion of opsonized sheep red blood cells (SRBC) compared to that of control group. Furthermore, the production of macrophage-activating factor (MAF) from rat splenocytes was higher in arginine-rich group than that of control group. AM from fraction IV of rats fed a stock diet had a higher arginase activity and showed a significant increase of phagocytosis following in vitro incubation with L-arginine (25 and 50 mM) for 24 h. From these results, the enhanced phagocytosis of AM by arginine-rich solution may be due to the increased phagocytosis of AM from fraction IV, in which the higher sensitivity of AM from fraction IV to arginine and the higher production of MAF from splenocytes following the infusion of arginine-rich solution participate.

Amino Acids↗

PubMed1992

Trends in survival rates in Japanese patients with advanced carcinoma of the stomach.

From 1965 to 1985, 1,150 patients underwent gastrectomy for carcinoma of the stomach invading beyond the submucosa. One thousand, one hundred and forty-one patients were studied for five years or longer. The patients were classified into two groups--those treated from 1965 to 1974 (n = 622) and those treated from 1975 to 1985 (n = 519). In the more recent group, there was a significant increase in the number of patients more than 70 years of age, in the number of female patients, of carcinomas present in the upper two-thirds of the stomach, in tumors exceeding 10 centimeters and diffusely infiltrative type and in early cancer-simulating type of advanced carcinoma in gross appearance and in undifferentiated type adenocarcinomas in histology. Although differences in the incidence of patients treated by radical procedures, such as extensive lymph node dissection and combined resection of adjacent organs, were not statistically significant, the incidence for those who underwent total gastrectomy was significantly increased. The over-all long term survival rate remained unchanged during 1965 to 1985 (five year survival rate of 31.3 versus 32.8 per cent). However, there was a significantly longer survival period for patients who underwent total gastrectomy (five year survival rate of 22.9 versus 28.3 per cent) (p less than 0.05). Much of the improvement can be attributed to an increase in the detection of relatively small advanced carcinomas and of advanced carcinomas of the stomach simulating early carcinoma in the upper one-third of the stomach. Therefore, we emphasize the need to diagnose advanced carcinoma of the stomach when the lesion is in an earlier stage of disease.

Adenocarcinoma↗

PubMed1992

Gastric carcinoma invading muscularis propria and macroscopic appearance.

From 1965 to 1983, 1362 patients with primary gastric cancer and no other evidence of a malignancy underwent gastric resection in the Second Department of Surgery, Kyushu University. Of these, 117 patients (8.6%) with gastric cancer invading the muscularis propria (pm) were studied clinicopathologically with special reference to the macroscopic appearance: Borrmann type cancer or advanced gastric cancer simulating early gastric cancer (AGC simulating EGC). The Borrmann type cancer comprised 62.4% (73/117) of cases and the AGC simulating EGC comprised 37.6% (44/117). The survival rate for patients with the Borrmann type cancer was lower than in cases of AGC simulating EGC (P less than 0.01). The 10-year survival rate was 82.6% for patients with AGC simulating EGC and 60.5% for those with Borrmann type cancer. A multivariate analysis showed that operative curability and lymph node metastasis are significant prognostic factors and these events differed between the Borrmann type cancer and AGC simulating EGC and the survival rate for patients with the Borrmann type cancer was less favorable. Our findings show that the lymph node dissection is important for the operative curability of pm gastric cancer with the Borrmann type. Postoperative chemotherapy is required in cases of a non-curative resection.

Adult↗

PubMed1992

Prediction of survival time after curative surgery for advanced gastric cancer.

This study was carried out to define independent prognostic factors influencing survival time and to examine the survival time of patients with advanced gastric cancer treated by curative resection. Six hundred and forty-eight patients were identified of whom 275 patients died of tumor recurrence during follow-up. Univariate analysis using Mantel-Cox analysis, indicated that tumor size, tumor location, gross appearance, degree of gastric wall invasion, lymph node metastasis and operative procedures were significant factors related to survival time (P less than 0.01 to P less than 0.05). Multivariate analysis using the Cox proportional hazard model adjusted for sex, age and other factors, suggested that tumor size (P less than 0.01, relative risk = 1.79), degree of gastric wall invasion (P less than 0.01, rr = 1.24) and lymph node metastasis (P less than 0.01, rr = 2.39) were the most independent prognostic factors statistically, although these three prognostic factors were inter-related. When the tumor is less than 5 cm and there is no serosal invasion or lymph node metastasis, then a longer survival time can be expected (88.7% at 5-years). If the tumor size exceeds 10 cm and there is invasion into neighboring structures and lymph node metastases, then survival time will be short (11.9% at 4-years).

Analysis of Variance↗

PubMed1992

Lower survival rate for patients with carcinoma of the stomach of Borrmann type IV after gastric resection.

Between 1965 and 1985, 194 of 1,113 patients (17.4 percent) with advanced carcinoma of the stomach who underwent gastric resection had Borrmann type IV carcinoma of the stomach, a macroscopically evident and diffusely spreading tumor. These patients tended to be younger and female and to have larger tumors that involved the entire stomach, as compared with patients with other types of carcinomas. Tissues were commonly undifferentiated, serosal invasion was prominent with infiltrative growth and high rates of metastasis to the lymph nodes and peritoneal dissemination were evident. In most instances, the disease was advanced; therefore, total gastrectomy was performed upon 82.0 percent of the patients and a palliative resection was done in 64.4 percent. The survival rate was lower than for patients with carcinoma of the stomach of other types (p less than 0.01). A multivariate analysis indicated that curative resection is an independent favorable prognostic event, while other factors are dependent covariates. Early detection of this carcinoma is crucial to extend survival time of patients with Borrmann type IV carcinoma of the stomach. Aggressive postoperative chemotherapy should be considered when a noncurative resection is done.

Female↗

PubMed1991

Prognostic significance of argyrophilic nucleolar organizer regions in esophageal carcinoma.

The argyrophilic nucleolar organizer region (AgNOR) of 100 cancer cells from biopsy specimens of esophageal squamous cell carcinomas in 98 surgically treated cases was examined, using a silver colloid staining technique on biopsy specimens. The number of AgNOR per nucleus (AgNOR number) was higher in the more advanced groups with regard to the length of the tumor (P less than 0.01), the depth of penetration (P less than 0.05), and lymph node metastasis (P less than 0.01). The survival of the patients with a high AgNOR number (greater than or equal to 6) was significantly poorer than those with either a medium range AgNOR number (4 less than or equal to-less than 6) (P less than 0.05) or a low AgNOR number (less than 4) (P less than 0.01). In the multivariate analysis including conventional clinicopathological factors, the AgNOR number was found to be one of the independent and significant variables (P less than 0.01). Because the AgNOR method is simple and can be applied to paraffin-embedded sections, the AgNOR number may provide potential benefit in the pretherapeutic assessment of malignant potentiality in esophageal carcinoma.

Adult↗

PubMed1991

Clinicopathologic features and prognostic significance of duodenal invasion in patients with distal gastric carcinoma.

Clinicopathologic features and prognostic significance of duodenal invasion were studied in a retrospective study on 593 patients who underwent gastrectomy for adenocarcinoma in the antrum. The patients were grouped into three, according to the histologic extent of duodenal invasion: Group A (80 patients), obvious invasion beyond the pyloric ring; Group B (61 patients), invasion up to the pyloric ring; and Group C (452 patients), no evidence of duodenal invasion. Five-year survival rates in Groups A, B, and C were 7.9%, 31.6%, and 57.6%, respectively (P less than 0.001). Cox's regression analysis showed that duodenal invasion is an independent prognostic factor in cases of a gastric antrum carcinoma. Gastric cancer with duodenal invasion (Groups A and B) most often was infiltrative and the incidence of serosal invasion, lymphatic and vascular invasion, and lymph node metastasis was high. Duodenal invasion was direct through submucosal or subserosal layers or through submucosal lymphatics.

Adenocarcinoma↗

PubMed1991

Splenectomy does not correlate with length of survival in patients undergoing curative total gastrectomy for gastric carcinoma. Univariate and multivariate analyses.

The relationship between splenectomy and survival time after curative total gastrectomy for advanced gastric cancer was examined by reviewing retrospectively data on 252 patients treated in our clinics between 1965 and 1985. One hundred three patients (40.9%) did not undergo splenectomy and 149 (59.1%) did. In patients subjected to splenectomy, advanced stages of the malignancy were more frequent and metastasis was noticed in 8.1% of splenic hilar lymph nodes and in 10.1% of the lymph nodes associated with the splenic artery. A univariate analysis revealed that the survival time of patients with splenectomy was significantly less than those for whom splenectomy was not done (P less than 0.05). In a subgroup of our patients stratified to adjust for the stage of disease, there was no significant difference between the survival rates. Subsequently, multivariate analysis using the Cox regression analysis adjusted for sex, age, and other covariates indicated that serosa invasion, lymph node metastasis, and tumor size were the most important prognostic factors, and there was no correlation whatever with splenectomy. Our findings rule out any relationship between splenectomy and length of survival time in patients undergoing curative total gastrectomy for advanced gastric cancer.

Carcinoma↗