Search

胸部X線上, 肺野末梢の腫瘤状陰影を呈する279例に経皮肺穿刺生検を299回施行した.悪性腫瘍182例中165例 (90.7%) に陽性所見を得た.得られた穿刺細胞像は, 原発性肺癌では, 喀痰細胞診や経気管支的擦過細胞診などの剥離細胞像と異なる所見もあり, 詳細に検討した.組織診との一致率は81.1%であった.転移性肺腫瘍では, 穿刺細胞診より大腸癌や腎癌の一部で原発巣推定可能な所見を得た.また, 陰性例19例 (延べ21回) についての検討を行い, その原因としては, 壊死物質しか得られなかったこと, 腫瘤の位置による手技的困難なことが考えられた.合併症については, 気胸21例 (7.0%), 血痰10例 (3.3%), 胸壁播種2例 (1.0%) であった.

肝細胞癌102例に対する肝切除術と肝動脈塞栓術 (TAE) の治療療成績を検討した.肝切除38例の累積生存率は1年85.9%, 2年78.6%, 3年66.0%, 4年32.6%で, TAE64例では1年61.8%, 2年33.7%, 3年25.8%, 4年25.8%であった.肝切除群においてHr1以上切除群とHrS以下切除群との間には予後・再発率に有意差はなかった.肝硬変併存Ts症例において, 肝切除群の累積生存率は1年90.2%, 2年84.8%, 3年60.3%, 4年30.2%で, TAE群では1年81.6%, 2年48.1%, 3年以上生存は0であり, 3年以上生存を得るためには縮小手術ででも腫瘍を切除すべきと考えられた.

Experiments have been made to study the phosphorus distribution between liquid iron and the CaO-SiO2-FeOx slag equilibrated in a magnesia crucible in the temperature range 1550° to 1650°C. The phosphorus distribution ratio (P2O5)/[P] increased with increasing CaO content and decreasing temperature. The maximum value of the distribution ratio was found to be present near the slag composition saturated with the tricalcium silicate and the magnesio wustite phases. The experimentally determined phosphorus content in metal disagrees with the phosphorus contents estimated from the treatments proposed by Balajiva et al., Turkdogan and Pearson, and Healy over the present range of slag compositions, except by Flood and Grjotheim.

世界各地で産出する堆積性およびグアノ起源リン鉱石30試料について, 非破壊γ線スペクトロメトリ, α線スペクトロメトリおよび放射化分析によって, ウラン系列核種および232Thの含有量を測定した。その結果, ウランおよびトリウムの含有量は, 堆積性リン鉱石の方がグアノ起源リン鉱石よりも大きいことが確かめられた。また, リン鉱石において, ウラン系列核種の放射平衡は必ずしも成立していないことを明らかにし, 非平衡を生じる原因について考察した。

Experiments have been made to study the phosphorus distribution between liquid iron and the CaO-SiO2-FeOx slag equilibrated in a magnesia crucible in the temperature range 1550° to 1650°C. The phosphorus distribution ratio (P2O5)/[P] increased with increasing CaO content and decreasing temperature. The maximum value of the distribution ratio was found to be present near the slag composition saturated with the tricalcium silicate and the magnesio wustite phases. The experimentally determined phosphorus content in metal disagrees with the phosphorus contents estimated from the treatments proposed by Balajiva et al., Turkdogan and Pearson, and Healy over the present range of slag compositions, except by Flood and Grjotheim.

More than 95% of the apparent cathepsin D activity in the lysosomes of porcine adrenal cortex was due to a genuine cathepsin D that has a molecular weight of 42,800 +/- 800 (mean +/- standard deviation of the mean in 5 runs) as determined by Sephadex G-100 column chromatography. On CM-Sephadex C-50 column chromatography at pH 6.9, the enzyme was resolved into five peaks which were termed Fractions D1 through D5 in order of their elution from the column. Fraction D4 and Fraction D5 together constituted more than 70% of the total cathepsin D, and were purified through chromatographic procedures to constant specific activities. The content of lysosomal cathepsin D was estimated to be about 1% of the total cellular protein. On isoelectric focusing, Fraction D4 was resolved into one major band with pI of 7.34 (termed Form D4-1) and one minor band of 7.20 (Form D4-2), while Fraction D5 gave one major band with pI of 7.50 (Form D5-1) and two minor ones of 7.37 (Form D5-2) and of 7.20 (Form D5-3). All of these 5 bands were enzymatically active. On SDS-polyacrylamide gel electrophoresis, both Form D4-1 and Form D5-1 dissociated into three subunits with molecular weights of 27,400 +/- 500 (termed Subunit A), 24,600 +/- 400 (Subunit B) and 13,800 +/- 600 (Subunit C) (mean +/- standard deviation of the mean in 16 determinations). The three subunits all contained carbohydrates.

肺癌切除例481例に対し術前後のCEA値の変動を測定した.術前10.1ng/ml以上の高値症例では有意に予後不良であった.術前CEA陽性例のうち術後に正常化しなかった症例の予後は不良で, 術後2ヶ月以内に正常化しなければ, ほぼ2年以内に再発死した.術後CEAが正常化した後に再発する場合, 約半数の症例でCEAの再上昇が先行しており再発治療を考えるうえでのすぐれた指標であると思われた

A 27-year-old man with acute lymphocytic leukemia (ALL) received a bone marrow transplant (BMT). On day 27, he developed erythematous maculopapular lesions all over his body. This rash improved within a month. Histological findings were obtained comparing those of the graft versus host reaction (GVHR). Five months later, he developed macular lesions on his body, clinically suggestive of lichen planus. Histologically, it was also compatible with lichen planus. He exhibited the grade I changes of acute GVHR described in Lerner's classification, and lichen planus-like eruptions as the chronic form.

Introduction It is not determined whether the continuous use of epidermal growth factor receptor ( EGFR ) tyrosine kinase inhibitors (TKI) is reasonable for patients with activating EGFR mutations, who have progressed with the drug. Methods We retrospectively analyzed the data from 2002 to 2010 of consecutive patients who had advanced non–small-cell lung cancer (NSCLC) harboring activating EGFR mutations and showed radiological disease progression after EGFR-TKI treatment as the first-line or second-line setting. We classified them into two groups: continuous EGFR-TKI and switching to chemotherapy, and compared the clinical outcomes. Multivariate analysis for survival was performed including age, sex, Eastern Cooperative Oncology Group performance status (0–1/ 2–4), brain metastasis, EGFR mutations (deletions in exon 19 versus L858R), continuous EGFR-TKI (yes/no), and initiation of EGFR-TKI (first versus second). Results A total of 551 NSCLC patients were screened for EGFR mutations in the period, and 186 patients had activating EGFR mutations. To explore the potential use of EGFR-TKI beyond progressive disease (PD), 64 patients were selected and analyzed. There were 13 men and 51 women, and median age was 65.5 years (range, 42–86). Among them, 31 patients had deletions in exon 19, and 33 had point mutation of L858R in exon 21. Thirty-nine patients were continuing EGFR -TKI beyond PD; 25 patients were switched to cytotoxic chemotherapy alone. The median overall survival was 32.2 months in the patients continuing EGFR -TKI, and 23.0 months in the patients switching to chemotherapy, presenting a significant difference between the two groups ( p = 0.005). Cox analysis showed that continuous EGFR-TKI after PD (hazards ratio 0.42, 95% confidence interval: 0.21–0.83, p = 0.013) was associated with improved survival. Conclusion Continuous use of EGFR-TKI beyond PD may prolong overall survival compared with switching to cytotoxic chemotherapy in patients with activating EGFR mutations. A prospective study will be needed to confirm our results.

BackgroundPerformance status (PS) is an important factor in determining survival outcome in non-small cell lung cancer (NSCLC) but is generally confounded by stage, age, gender, and smoking status. We investigated the prognostic significance of PS taking into account these important factors.MethodsRetrospective analysis of registry database of the National Hospital Study Group for Lung Cancer (NHSGLC) between1990 and 2005. Univariate analysis was performed using Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards model to identify independent prognostic factors.ResultsA total of 26,957 patients with NSCLC were analyzed of which 12,613 patients (46.8%) had World Health Organization (WHO) PS = 0, 8,137 patients were never smokers (30.2%), and most of them were females (72.7%). The majority of PS = 0 patients presented with stage I disease (56.9%). Patients with PS = 0 constituted the group with the highest proportion of never smokers (36.7%). There was a significant difference in the median overall survival (OS) between patients with PS = 0 and PS = 1 (51.5 months versus 15.4 months, respectively; p < 0.0001) and among patients with various PS within individual American Joint Committee on Cancer stage (all p values

The concentrations of 238U, 234U, 226Ra and 210Pb in 4 crystalline apatlte samples from different localities were determined by means of nondestraetive γ-ray spectrometry and α-ray spectrometry. The data obtained indicate that 234U and 226Ra are in radioactive equilibrium with the parent 238U The 210Pb/238U activity ratios are clearly smaller than unity. Release of 222Rn from apatites after crystallization was shown to be responsible for the 238U-210Pb disequilibrium.

One hundred and seventy-four patients with small cell lung cancer (SCLC) treated with combination chemotherapy, with or without chest radiation, were analyzed. Fourteen patients (8%) survived for 3 years or more. Three-year disease-free survival continued for 12 of the 101 patients (12%) with limited disease, and one of 75 (1%) with extensive disease (P less than 0.05). Patients' sex and performance status were not important in achieving long-term survival. All disease-free survivors, except two who could not be evaluated, achieved a complete response. Although the treatment programs had some influence on the long-term survival rates (P less than 0.05), thoracic radiation did not have significant impact on long-term survival. Three of the 13 patients (23%) developed second malignancies and died, and one of these patients also suffered from a progressive neurologic deterioration with dementia. Two other patients died free of SCLC. Consequently, eight have remained alive and free of disease. The last relapse was observed at 1.5 years from beginning of treatment. The disease-free survival may offer the hope of cure of SCLC. However, the survivors are at an increased risk of developing late complications including second malignancies and neurologic abnormalities. Therefore, careful follow-up will be necessary.

After stratification for the extent of disease, previously untreated patients with small cell lung cancer randomized to receive therapy with the four-drug combination of cyclophosphamide, oncovin, nimustine hydrochloride (ACNU), and procarbazine (CONP) every four weeks (continuous regimen) or to receive CONP alternating with the three-drug combination of etoposide (VP-16), adriamycin and cisplatin (VAD) at four-week intervals (alternating regimen). Sixty-nine patients were entered in the study. Of 34 evaluable patients receiving the continuous regimen, six (17.6%) achieved complete response (CR) and 16 (47.1%) achieved partial response (PR). Of 31 evaluable patients receiving the alternating regimen, 10 (32.3%) achieved CR, and 16 (51.6%) achieved PR. There was a tendency in favor of the alternating regimen in CR and over-all response rates (0.05 less than p less than 0.1). There were no significant differences between the regimens in response duration or survival. The projected median survival times were 9.2 months and 9.4 months for the continuous and alternating regimens, respectively. One patient receiving the continuous regimen and three receiving the alternating regimen have been living for more than two years. The major toxicity was myelosuppression in both regimens. One patient died of hemorrhage due to thrombocytopenia during induction with CONP, and one patient died of cisplatin-induced renal failure. We conclude that alternating non-cross resistant chemotherapy leads to improved CR and response rates, but does not improve survival.

For determining the value of carcinoembryonic antigen (CEA) levels in diagnosis of malignant tumors of the lung, the CEA levels in 187 specimens of pleural fluid and sera obtained simultaneously from patients with pleural fluid were measured. In all 70 patients with benign diseases, the CEA levels in the effusions were less than the cut-off value of 5 ng/ml (mean +/- SD: 1.44 +/- 1.01 ng/ml). In contrast, in 88 of 117 patients (75.2%) with malignant diseases, the CEA levels in the effusions were over 5 ng/ml (25.3 +/- 24.5 ng/ml) and in 58 of the 117 patients (50.4%), the CEA levels in the serum were values of 5 ng/ml or more (11.9 +/- 18.4 ng/ml). There was a significant correlation between the CEA levels in the effusions and in the sera. The CEA levels in effusions in patients with malignant lung tumors were usually much higher than those in their sera. The incidence of CEA levels of 5 ng/ml or more in both the serum and effusion was highest in the patients with adenocarcinoma. These data indicate that determination of the CEA level in effusions, when done in combination with cytological examinations, may have additional value in diagnosis of lung cancer.

Cetuximab, an antibody directed against the epidermal growth factor receptor, is an effective clinical therapy for patients with colorectal, head and neck, and non-small cell lung cancer, particularly for those with KRAS and BRAF wild-type cancers. Treatment in all patients is limited eventually by the development of acquired resistance, but little is known about the underlying mechanism. Here, we show that activation of ERBB2 signaling in cell lines, either through ERBB2 amplification or through heregulin up-regulation, leads to persistent extracellular signal-regulated kinase 1/2 signaling and consequently to cetuximab resistance. Inhibition of ERBB2 or disruption of ERBB2/ERBB3 heterodimerization restores cetuximab sensitivity in vitro and in vivo. A subset of colorectal cancer patients who exhibit either de novo or acquired resistance to cetuximab-based therapy has ERBB2 amplification or high levels of circulating heregulin. Collectively, these findings identify two distinct resistance mechanisms, both of which promote aberrant ERBB2 signaling, that mediate cetuximab resistance. Moreover, these results suggest that ERBB2 inhibitors, in combination with cetuximab, represent a rational therapeutic strategy that should be assessed in patients with cetuximab-resistant cancers.