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Objectives: This study was designed to examine the immunohistochemical expression of bcl-2, p53, and proliferating cell nuclear antigen (PCNA) and the relation of this expression to clinicopathological characteristics and prognosis in renal cell carcinoma (RCC)., Methods: The expression of bcl-2, p53 protein, and PCNA was studied by immunohistochemical methods in paraffin-embedded nephrectomy specimens from 53 patients whose clinicopathological data had already become clear., Results: The expression of the bcl-2 protein was recognized in 34 cases (64%); the expression of the p53 protein, however, was seen in only 1 case. Bcl-2 positivity was not associated with any pathological parameters or prognosis. If the percentage of PCNA-positive cancer cells as compared to the total amount of cancer cells was defined as a labeling index (LI), a high PCNA LI number correlated significantly with a high T category, high grade, venous invasion, and shortened survival. Among the conventional pathological parameters, the T category, nuclear grade, and venous invasion had the most significant effect on prognosis. A multivariate analysis in the parameters of PCNA, T category, nuclear grade, and venous invasion demonstrated that only nuclear grade had a significant effect on prognosis., Conclusions: The inhibitory effect of the bcl-2 gene on apoptosis related to tumor development is not clear, and the expression of the p53 protein is uncommon in RCC. PCNA seems to be a good objective and quantitative marker of the biological malignant potential in RCC, although the assessment of malignant potential in combination with conventional pathological parameters is indispensable.

Background/aims: This study was designed to assess the correlation of interleukin 6 (IL-6) with jaundice reduction by percutaneous transhepatic cholangio-drainage (PTCD) for obstructive jaundice., Methodology: We measured serum and bile IL-6 concentrations by enzyme linked immuno-sorbent assay before and after PTCD in 26 patients with obstructive jaundice. The patients were divided into two groups according to their bilirubin decrease rate., Results: Serum IL-6 levels measured before and after PTCD in the slowly decreasing bilirubin group ("poor" group) were significantly higher than those of the rapidly decreasing bilirubin group ("good" group). Measures of bile IL-6 in the "poor" group remained high from 3 to 14 days after PTCD in comparison with the "good" group., Conclusions: These results suggest that circulating IL-6, as well as IL-6 in the bile, may be involved in the pathogenesis of obstructive jaundice, and play an important role in preventing the resolution of obstructive jaundice after PTCD.

The aim of this study was to evaluate the correlation between tumor necrosis factor alpha (TNF alpha) and jaundice reduction by percutaneous transhepatic cholangio-drainage (PTCD) in patients with obstructive jaundice. Thirty patients who had undergone PTCD were divided into two groups: those with rapidly decreasing bilirubin (the fast group; n = 21) and those with slowly decreasing bilirubin (the slow group; n = 9). We compared clinical features before PTCD between groups. We also compared serum and bile TNF alpha before and after PTCD in the fast group with those in the slow group. The rate of patients with recurrence of malignancy in other organs involved in the etiology of obstructive jaundice was significantly higher in the slow group than in the fast group. Before and after PTCD, serum and bile TNF alpha were significantly higher in the slow group than in the fast group. These results suggest that TNF alpha may play an important role in the protracted recovery from obstructive jaundice after PTCD.

Thirteen patients with advanced gastric cancer treated by palliative radiotherapy were retrospectively analyzed. The radiation sites were abdominal cavities in 8 cases, superficial masses in 5 and lung metastasis in one. The purposes were to diminish mass size in 5 cases, to relieve pain in 3 and to reduce stenosis in 6. The total doses were more than 40 Gy in 10 patients. In 2 cases, the intracavitary irradiation was performed using 192Ir. In one case, radiation had to be stopped at the dose of 22.5 Gy because of poor general condition. Partial response was obtained in 6 of 12 cases (RP, 50%). The sites of responders were superficial lesions in 4 and hepatic hilar mass in 2, which were given intracavitary as well as external radiation. Pain relief was achieved in all patients suffering from it. One of 3 cases with esophageal stenosis showed marked improvement in swallowing. Two patients showed a decrease in the levels of tumor markers. Five patients had side effects of more than grade 2. Two of them were grade 3, one thrombocytopenia and one diarrhea. The median survival time of all cases was 9 months, and 5 patients could shift to home care. These results suggest that palliative radiotherapy could be one of the most useful locoregional therapies for advanced gastric cancer, in the aspect of improvement of patient's QOL.

Eighteen patients with gastric cancer with peritoneal metastasis were treated with methotrexate/5-fluorouracil sequential therapy. In four patients, a partial response was obtained and in another four, symptomatic relief was obtained by the therapy. As side effects, BM suppression was seen in 9 and GI symptoms in 6 patients. Intraaortic, low-dose and 3-hour-interval procedure are recommended in the therapy.