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PubMed1995

Endoscopic US of the gastrointestinal tract with endoscopic, radiographic, and pathologic correlation.

Endoscopic ultrasonography (US) makes it possible to evaluate the layers of the wall of the gastrointestinal tract, as well as surrounding structures. The authors have used endoscopic US to evaluate the gastrointestinal tract in 160 patients. In the esophagus, endoscopic US is useful in staging esophageal carcinoma, planning radiation therapy ports, and locating and characterizing esophageal masses. Endoscopic US of the esophagus is also used to identify varices and evaluate the results of therapy. Applications of endoscopic US in the stomach include staging of gastric carcinoma, localization and characterization of nonmucosal gastric masses, detection and evaluation of gastric varices, and evaluation of gastric lymphoma. In the pancreas, endoscopic US is used for detecting pancreatic masses; staging pancreatic, distal common bile duct, and ampullary carcinoma; and evaluation biliary tract obstruction. Applications of endoscopic US in the rectum include localization and characterization of nonmucosal lesions and local staging of rectal carcinoma.

Digestive System Diseases↗
PubMed1999

Evaluation of a 10-minute comprehensive MR imaging examination of the upper abdomen.

PURPOSE: To determine whether a 10-minute magnetic resonance (MR) imaging examination of the upper abdomen provides sufficiently comprehensive information to replace a longer MR protocol. MATERIALS AND METHODS: Images obtained with selected breathing-independent and breath hold MR sequences, with 2 minutes of total acquisition time and an estimated 10 minutes of total study time, in consecutive MR examinations of the upper abdomen in 72 patients (age range, 23-87 years) were retrospectively reviewed in a blinded fashion by two separate interpreters. Determination was made of major and minor findings, and the two separate retrospective interpretations and the prospective clinical interpretation were correlated by using kappa statistics. Surgical and clinical findings were also correlated with imaging findings. RESULTS: In 61 patients, all major and minor findings were identical in the original clinical interpretation and the two retrospective readings. In 66 patients, the major findings were identical in these three readings. Close agreement was present between the two separate retrospective readings and the prospective clinical interpretation (kappa = 0.49-1.00). CONCLUSION: The findings suggest that the diagnostic information provided by a shortened MR imaging protocol that includes breath-hold and breathing-independent sequences is in close agreement with lengthier MR protocols. The advantages of a shortened protocol include increased patient throughput and decreased study cost.

Abdomen↗
PubMed1998

Port site recurrences after laparoscopic surgery. A review.

Port site metastasis has been a surprising event after laparoscopic procedures in cancer patients. No clear data exist about this phenomenon. The aim of this study is to summarize current epidemiologic knowledge about the risk of this complication. A review of all case reports about port site recurrences was undertaken. To date, 164 cases of port site metastases after videoscopic procedures have been reported in 90 papers. We found 108 cases of implantation after laparoscopy for digestive tumors, 23 after thoracoscopy, 29 after gynecological and 4 after urological laparoscopy. Analysis of the current literature confirms that laparoscopy is associated with abdominal cell mobilization to the trocars and instruments. Also low-staged and highly differentiated tumors have been reported to cause post-laparoscopy tumor seeding. The temporary data of the CAE registry 'port site metastases' (Workgroup for Surgical Endoscopy of the German Society of Surgery) are also reported. The analysis of 80 histologically confirmed cases of port site recurrence shows a particular frequency after laparoscopic cholecystectomy for unsuspected gallbladder cancer (n = 59). Postoperative specimen examination revealed a T1 carcinoma in 9 cases (15%), T2 carcinoma in 33 (21%), T3 in 3 (5%) and T4 in 1 case (1.7%). The mean time to clinical tumor relapse was 6 months. Similar patterns were found in a lower number of port site metastases after laparoscopy for colon cancer (n = 2) and for other cancers (n = 9). Clinical evidence that laparoscopy with CO2 pneumoperitoneum can enhance tumor dissemination is given. Port site metastases seem to be secondary to multiple factors including the gas used, local trauma, tumor manipulation, biologic properties of the tumor, and individual surgical skills.

Colorectal Neoplasms↗
PubMed1991

Serum sialyl-Tn antigen levels in patients with digestive cancers.

Serum levels of sialyl-Tn antigen (STN) were measured using a one-step radioimmunoassay kit in 257 patients with digestive cancers, 121 patients with benign digestive diseases, and in 64 healthy controls. With 45 U/ml regarded as the cutoff value, the positive rates of serum STN in digestive cancers were as follows: pancreas 40.0%, stomach 28.1, colon and rectum 27.8, biliary tract 25.0, liver 7.1, and esophagus 0%. In benign digestive diseases, the positive rate of STN was low (4.1%). In gastric and colorectal cancers, simultaneous measurements of STN and carcinoembryonic antigen (CEA) revealed that the positive rates of STN, CEA, and STN and/or CEA were 28, 42, and 55%, respectively. There was no significant correlation between STN and CEA in these cancers. STN may be a useful serum marker for digestive cancers, especially gastric and colorectal cancers.

Antigens, Neoplasm↗
PubMed1985

Trends in cancer mortality in Italy, 1955-1978.

Trends in age-specific and age-standardized cancer death certification rates in Italy from 1955 to 1978 were analyzed. In males total cancer mortality rates increased in all age groups. However, when respiratory and other tobacco-related neoplasms were excluded, death certification rates were roughly stable up to age 64. Moderate decreases in overall cancer mortality have been apparent at younger ages (35-44) since the early 1970's. In females, all the age-specific and the age standardized, under-65 death certification rates decreased; the downward trends were more pronounced (-18.5%) in the younger age group considered (35-44 years). Respiratory cancer mortality increased sharply in males: lung cancer death rates reached a plateau in the early 1970's in the 35-44-year age group, but increased at all subsequent ages. In females, the increase in lung cancer mortality was about 50% in the 45-54 and 55-64-year age groups, but no upward trend was evident in younger women. Other tobacco-related cancers (mouth or pharynx, larynx, esophagus, pancreas, kidney and bladder) also rose considerably. In both sexes, gastric cancer mortality dropped about 50% below age 65, but mortality rates from cancer of the stomach were still considerably higher than in other Western countries. Likewise, mortality from cancer of the (cervix) uteri decreased markedly, mostly in younger age groups. Upward trends in death certification rates were evident for cancers of the bowel (colon and rectum, about 50% in males, and 35% in females below age 65), and of the breast in females. However, these trends have levelled off since the late 1960's, at least in the younger age groups. Certified death rates from cancer of the skin (melanoma) increased over all the periods considered in the young of both sexes. Cancer mortality rates showed marked increases in older (greater than or equal to 65) males, but this can be partially explained in terms of better case ascertainment and more accurate death certification.

Adult↗
PubMed1994

Trial of sequential trimetrexate, fluorouracil, and high-dose leucovorin in previously treated patients with gastrointestinal carcinoma.

PURPOSE: Trimetrexate (TMTX) is a dihydrofolate reductase inhibitor, which, like methotrexate (MTX), has been shown to potentiate fluorouracil (FU) cytotoxicity by increasing phosphoribosylpyrophosphate (PRPP) levels. We investigated the safety and efficacy of a sequential TMTX/FU/leucovorin (LV) combination. PATIENTS AND METHODS: Forty-one patients with advanced gastrointestinal carcinoma (mostly colorectal) received variable doses of TMTX followed 24 hours later by FU/LV (500 mg/m2 of each drug). Almost all patients had received previous chemotherapy. The initial 19 patients were treated on a 3-week-on/1-week-off schedule without any significant toxicity; the remaining patients were treated for 6 consecutive weeks followed by a 2-week rest period. TMTX was escalated in 30-mg/m2 increments from 20 to 110 mg/m2 in separate patient cohorts. When the 110-mg/m2 dose of TMTX was reached, the FU dose was escalated from 500 mg/m2 to 600 mg/m2. RESULTS: The partial response (PR) rate in assessable patients with colorectal cancer (all previously treated) was 20% (seven of 35; 95% confidence interval, 7% to 33%), and with other gastrointestinal cancers was one of four patients. Median survival has not been reached with a median follow-up of 13.5 months. The maximum-tolerated dose (MTD) was 110 mg/m2 for TMTX, 500 mg/m2 for FU, and 500 mg/m2 for LV on a 6-weeks-on/2-weeks-off cycle. The principal toxicities were grade 3 or 4 diarrhea, which occurred in 17% of patients, and hypersensitivity reactions, which occurred in 26% of patients. CONCLUSION: TMTX can be administered at maximal doses in combination with FU and LV without increasing toxicity. The PR rate of 20% in advanced colorectal carcinoma patients previously treated with chemotherapy is encouraging and merits further study.

Adult↗
PubMed2004

Phase I trial of intratumoral injection of an adenovirus encoding interleukin-12 for advanced digestive tumors.

PURPOSE: To evaluate the feasibility and safety of intratumoral injection of an adenoviral vector encoding human interleukin-12 genes (Ad.IL-12) and secondarily, its biologic effect for the treatment of advanced digestive tumors. PATIENTS AND METHODS: Ad.IL-12 was administered in doses ranging from 2.5 x 10(10) to 3 x 10(12) viral particles, to seven cohorts of patients with advanced pancreatic, colorectal, or primary liver malignancies. Patients were thoroughly assessed for toxicity, and antitumor response was evaluated by imaging techniques, tumor biopsy, and hypersensitivity skin tests. Patients with stable disease and no serious adverse reactions were allowed to receive up to 3 monthly doses of Ad.IL-12. RESULTS: Twenty-one patients (nine with primary liver, five with colorectal, and seven with pancreatic cancers) received a total of 44 injections. Ad.IL-12 was well tolerated, and dose-limiting toxicity was not reached. Frequent but transient adverse reactions, including fever, malaise, sweating, and lymphopenia, seemed to be related to vector injection rather than to transgene expression. No cumulative toxicity was observed. In four of 10 assessable patients, a significant increase in tumor infiltration by effector immune cells was apparent. A partial objective remission of the injected tumor mass was observed in a patient with hepatocellular carcinoma. Stable disease was observed in 29% of patients, mainly those with primary liver cancer. CONCLUSION: Intratumoral injection of up to 3 x 10(12) viral particles of Ad.IL-12 to patients with advanced digestive malignancies is a feasible and well-tolerated procedure that exerts only mild antitumor effects.

Adenoviridae↗
PubMed1991

Frequency and spectrum of mutations at codons 12 and 13 of the c-K-ras gene in human tumors.

The frequency of point mutations at codons 12 and 13 of the c-K-ras gene has been determined in a panel of more than 400 human tumors. Mutant c-K-ras genes were detected in about 75% of adenocarcinomas of the pancreas (n = 84); 40% of adenomas (n = 72) and carcinomas (n = 244) of the colon end rectum; 30% of carcinomas of the bile duct (n = 19); 25% of carcinomas of the lung (n = 92), and in lower frequency in other carcinomas, including liver, stomach, and kidney. No mutations were found in carcinomas of the breast, prostate, esophagus, and gall bladder, among others. Comparative analysis of the spectrum of mutations show that while G to A transitions were the most frequent mutations in pancreatic and colo-rectal tumors, G to T transversions were more prevalent in lung carcinomas. The aspartic acid mutation at codon 13 (GGC----GAC) was relatively frequent in colo-rectal tumors but rare in pancreatic and lung carcinomas. The differences in the mutation spectrum of the c-K-ras gene in cancers of the gastrointestinal and respiratory tracts are suggestive of differential exposure to genotoxic agents.

Base Sequence↗
PubMed1993

Establishment and characterization of a feline large granular lymphoma cell line expressing interleukin 2 receptor alpha-chain.

A feline large granular lymphocyte (LGL) cell line was established from a cat with an alimentary-form lymphoma. This cell line, designated as FGL, had many large azurophilic granules in the cytoplasm, which were typical to LGL cells. Proviral genome of feline leukemia virus was detected in the chromosomal DNA of FGL cells, and reverse transcriptase activity was also demonstrated in the culture supernatant. Furthermore, we found expression of interleukin 2 (IL-2) receptor alpha-chain on the cell surface of FGL and its natural killer activity against human erythroblastic leukemia cell line, K562.

Animals↗
PubMed2001

Malignant fibrous histiocytoma (MFH) cells and macrophages/histiocytes have a common antigen recognized by a monoclonal antibody risen against a rat MFH-derived cloned cell line.

A monoclonal antibody (B9) was generated by using a rat malignant fibrous histiocytoma (MFH)-derived cloned cell line (MT-8) as the immunogen. Immunohistochemically, B9 reacted specifically with a cytoplasmic antigen of MT-8 cells. Furthermore, B9 immunolabeled another MFH-derived cloned cells (MT-9) and histiocytic sarcoma cells, as well as macrophages/histiocytes in normal and diseased tissues of rats. These findings suggest the presence of a common antigen recognized by B9 between MFH cells and macrophages/histiocytes. This suggests that MFH cells may express histiocytic nature.

Animals↗
PubMed2006

Value of preoperative upper endoscopy in patients undergoing laparoscopic gastric bypass.

BACKGROUND: Preoperative evaluation of patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGBP) has included esophagogastroduodenoscopy (EGD) with little data to substantiate its use. METHODS: A retrospective analysis was conducted of patients from Feb 04 to Mar 05 who underwent preoperative EGD and subsequently LRYGBP. RESULTS: 169 patients underwent EGD prior to surgery. Their mean age was 41.1 years (range 14-66), mean BMI 49.7 (range 35-78), and 82% were females. There were no complications from EGD. Significant findings in patients at EGD included gastric ulceration in 3 (2%), duodenal ulcer in 1 (0.7%), Barrett's esophagus in 2 (1.3%), and a GI stromal tumor (GIST) in 1 (0.7%). EGD revealed hiatal hernias in 56 (35.2%), esophagitis in 28 (17%), Schatzki's ring in 5 (3%), gastritis in 43 (27%), gastric polyps in 8 (5%), and duodenitis in 9 (6%). 53 patients (33.3%) had a negative EGD. Ulcer and severe gastritis, esophagitis, and duodenitis diagnosed preoperatively were treated medically before surgery. 9 hiatal hernias were repaired intraoperatively. The patient with the GIST underwent laparoscopic near-total gastrectomy and gastric bypass, while 1 patient with an antral polyp underwent laparoscopic partial gastrectomy in addition to the LRYGBP. CONCLUSION: EGD is essential for diagnosis of GI diseases including tumors, ulcers, and hiatal hernias that alter the medical and surgical management of patients undergoing gastric bypass.

Adolescent↗
PubMed1989

Spontaneous tumors in F-344/Jcl rats.

The age-related incidence of spontaneously occurring neoplastic and non-neoplastic lesions in untreated F-344/Jcl rats, used as controls in carcinogenicity testing, were studied from the histological examination of tissues from 469 males and 354 females. The incidence of spontaneous tumors was 83.2% in the males and 71.2% in the females. The most common neoplasms were leukemia (males: 24.3%, females: 24.0%), pituitary adenoma (males: 16.0%, females: 45.2%), pheochromocytoma (males: 14.7%, females: 7.3%), testicular interstitial cell tumor (males: 79.1%), and uterine endometrial stromal polyp(females: 16.4%). The incidence of other tumors of almost all the organs and/or tissues was low. Non-neoplastic lesions generally increased with advancing age of the animals.

Age Factors↗
PubMedDate not supplied

[Endoscopic resection of the digestive tract mucosa].

The endoscopic resection of the mucosa of the digestive tract (ERM) is a set of techniques that have as their end the remotion of the mucosa for the diagnosis and treatment of localized diseases. The technique consists of the elevation of the mucosa with a submucosa injection of liquid or with suction in the interior of a transparent overtube. The procedure is indicated in the treatment of incipient malignant tumors of the esophagus, stomach, and colon, with a success rate that vacillates between 60 and 95%. An indispensable condition is the precise selection of patients through endoscopy and high-frequency endoscopic ultrasound. Other indications are the resection of flat and sessile polyps, the biopsies of submucosa tumors, and the taking of biopsies of great volume for the study of infiltrating and inflammatory neoplastic diseases. Based on the literature, principally descriptive and not comparative, the treatment of incipient digestive tract carcinomas with ERM has encountered serious difficulties in the Western world because of the rarity of the diagnosis, the scarce availability of endoscopic ultrasound, and lack of information of long-term results. On the other hand, in the diagnostic field of mucosa diseases, and in the treatment of polyps, its utility is evident. In conclusion, ERM is added to the new endoscopic techniques for the obtaining of specimens of great volume and for the resection of sessile polyps. In the treatment of malignant tumors, ERM should be used with caution.

Animals↗
PubMed1999

[Surgical treatment of pulmonary metastases from digestive organs and management of malignant pleural effusions].

This article summarizes the indications for surgical treatment of pulmonary metastases from carcinomas of the digestive organs, mainly the colon and rectum. Survival rats after pulmonary metastasectomy from colorectal carcinomas range from 24% to 43% at 5 years, and from 20% to 34% at 10 years. However, the survival benefit after metastasectomy from other organs appears questionable. Survival analysis after metastasectomy from colorectal carcinomas shows that patients with fewer metastatic tumors with smaller diameters, complete resection of metastatic foci, no lymph node involvement, no history of extrapulmonary metastases, longer disease-free interval, and a lower serum CEA level at thoracotomy have a better prognosis. Prospective studies are needed to determine which factors are statistically significant for survival. Management of malignant pleural effusions commonly includes thoracenthesis and tube thoracostomy drainage, followed by the instillation of various anticancer drugs or sclerosing agents. The application of biological agents such as interleukin-2 and interferons is an experimental treatment under investigation. Thoracoscopy using video-assisted techniques is a new approach for the diagnosis and treatment of malignant pleural effusions.

Colorectal Neoplasms↗