Showing papers by "Toshio Onitsuka published in 2010"

Prognostic Significance of Tumour Marker Index Based on Preoperative CEA and CYFRA 21-1 in Non-small Cell Lung Cancer

Abstract: Background: Prognostic impact of tumour marker index (TMI) based on preoperative serum carcinoembryonic antigen (CEA) and CYFRA 21-1 in non-small cell lung cancer (NSCLC) was examined using patients with a follow- up period more than 5 years. Patients and Methods: Two hundred and ninety-three consecutive NSCLC patients were reviewed retrospectively, and any patients with follow-up periods less than 5 years were omitted. Results: The 5-year survival of the patients with normal and high serum CEA levels was 71.52% and 48.41%, respectively (p<0.0001). The 5-year survival of the patients with a high serum CYFRA 21-1 level was 39.66%, which was significantly poorer compared with that of the patients with a normal serum CYFRA 21-1 level (66.95%, p<0.0001). There was a 5-year- survival rate of 72.28% in patients with a TMI less than or equal to 1.0 compared to only 37.08% in patients with a TMI greater than 1.0 (p<0.0001). Both univariate and multivariate analyses indicated the independent prognostic impact of TMI. Conclusions: TMI may be useful for predicting the prognosis of NSCLC patients. In addition to TNM staging, the best predictor of outcome of non-small cell lung cancer (NSCLC), several previous reports have indicated that preoperative elevated serum carcinoembryonic antigen (CEA) and CYFRA 21-1 levels are associated with very poor survival rates following surgical resection in NSCLC (1-7). In contrast, other studies have found that an elevated preoperative CEA and/or CYFRA 21-1 level has no prognostic value (8-10). The majority of these authors performed their analyses with the calculated cumulative survival rate, which can occasionally be confounded by those patients with a short follow-up

Postoperative serum C-reactive protein levels in non-small cell lung cancer patients.

Abstract: Purpose: The significance of the postoperative serum C-reactive protein (CRP) level as a prognosis indicator was evaluated in patients with non-small cell lung cancer (NSCLC). Patients and Methods: A total of 276 patients who had undergone a curative resection of NSCLC were retrospectively reviewed. Results: The overall and disease-specific survival rates in the postoperative CRP/high group (≥ 0.5 mg/dL at 30 days postoperation: n = 130) were significantly lower than those in the postoperative CRP/low group (< 0.5 mg/dL at 30 days postoperation: n = 146). However, based on a multivariate analysis, the postoperative CRP level was not among the unfavorable indicators regarding survival. The patients were divided into two groups, namely, the preoperative CRP/low group (n = 231) and the CRP/high group (n = 45). The proportion of the postoperative CRP/low group (60.2%) in the preoperative CRP/low group was significantly lower than that in the preoperative CRP/low group (15.6%; p <0.0001). No significant difference was observed in the disease-specific survival rates in the postoperative CRP/high group and the postoperative CRP/low group in either the preoperative high/group or low/group. Conclusions: The overall and disease-specific survival rates in the postoperative CRP/high group were significantly lower than that in the postoperative CRP/low group. This difference may be associated with the relationship between the pre- and postoperative CRP levels. (Ann Thorac Cardiovasc Surg 2010; 16: 85–90)

Acute massive pulmonary thromboembolism treated with percutaneous cardiopulmonary support perioperatively

Abstract: A 57-year-old female was transferred to our hospital because of sudden dyspnea. She was hypotensive and hypoxic. Acute massive pulmonary thromboembolism was detected by echocardiography and computed tomography (CT). Before the operation, she fell into severe shock and needed cardiopulmonary resuscitation. We applied percutaneous cardiopulmonary support (PCPS), and performed emergency open embolectomy under total cardiopulmonary bypass. Because of the right ventricular failure, she could not be weaned from total cardiopulmonary bypass. PCPS was required again and used continuously during postoperative management. Her cardiopulmonary state improved gradually. PCPS was stopped at 6 days after surgery, and she was extubated at 14 days after surgery. PCPS was very useful for resuscitation and stabilization of the cardiopulmonary function for acute massive pulmonary thromboembolism perioperatively.

Undifferentiated carcinoma (non-small cell type) with lymphoid stroma of the esophagus

Abstract: 症例は67歳，男性．検診で施行された上部消化管内視鏡検査で胸部中部食道に隆起性病変が指摘され当科に入院となった．内視鏡検査にて切歯より35cmの部位に立ち上がりの急峻な隆起性病変を認め，同部位からの生検にてgroup V，adenocarcinomaと診断された．中部食道腺癌の診断にて食道亜全摘術および2群リンパ節郭清が施行された．病理組織所見にて比較的均一な細胞が索状または敷石状に配列し，多くは大型の核と明瞭な核小体を有する腫瘍細胞が充実性発育を呈していた．また間質にはlymphoid stromaの形成も散見された．診断は食道未分化癌とされ，免疫染色にてchromograninA，NSEとも陰性であったため非小細胞型となった．食道原発未分化癌の中でも非小細胞型未分化癌は特にまれとされ，さらにlymphoid stromaを伴った症例であることも興味がもたれるところである．食道非小細胞型未分化癌の本邦報告例の臨床病理学的検討も加えて報告する．