Showing papers by "Tsutomu Kasugai published in 2001"
TL;DR: The purpose of the present study was to evaluate whether the combination of dye and radioisotope would improve the detection rate of sentinel nodes (SN) and the diagnostic accuracy of axillary lymph node status over dye alone in patients with breast cancer.
Abstract: Background
The purpose of the present study was to evaluate whether the combination of dye and radioisotope would improve the detection rate of sentinel nodes (SN) and the diagnostic accuracy of axillary lymph node status over dye alone in patients with breast cancer.
Methods
Sentinel node biopsy (SNB) was performed in stages I or II breast cancer patients with clinically negative nodes using dye alone (indocyanine green) or a combination of dye and radioisotope (99mTc-radiolabelled tin colloid).
Results
SNB guided by dye alone was performed in 93 patients and SNB guided by a combination of dye and radioisotope was performed in 138 patients. The detection rate of SN was significantly (P = 0.006) higher in the combination group (94.9%) than in the dye alone group (83.9%). The sensitivity, specificity, and overall accuracy of SNB in the diagnosis of axillary lymph node status were 100, 100, and 100%, respectively, for the combination group, and 81.0, 100, and 94.9%, respectively, for the dye alone group. There were no false negatives in the combination group, but four false negatives (19.0%) in the dye alone group. The combination method was significantly superior to the dye alone method for sensitivity (P = 0.011) and accuracy (P = 0.018).
Conclusions
The addition of a radioisotope to the dye in SNB increases the detection rate of SNs in breast cancer patients, and SNs detected by the combination method predict the axillary lymph node status with greater accuracy than those detected by the dye alone method. J. Surg. Oncol. 2001;76:95–99. © 2001 Wiley-Liss, Inc.
113 citations
TL;DR: In this article, the authors evaluated the usefulness of gamma probe and ultrasonographically-guided fine-needle aspiration biopsy in the pre-operative detection of sentinel node (SN) metastasis in breast cancer patients.
Abstract: Aim The purpose of the present study was to evaluate the usefulness of gamma probe and ultrasonographically-guided fine-needle aspiration biopsy (FNAB) in the pre-operative detection of sentinel node (SN) metastasis in breast cancer patients. Methods Sentinel node biopsy (SNB) was performed in patients with stage I or II breast cancer with clinically negative nodes using dye and radio-isotope. Axillas of 60 patients in whom a hot spot was detected by gamma probe were examined by ultrasonography. Pre-operative diagnosis of SN metastasis by gamma probe and ultrasonographically-guided FNAB was compared with the histological results of SN. Results The sensitivity, specificity and overall accuracy of ultrasonography in the diagnosis of SN metastasis were 50.0%, 92.1% and 76.7%, respectively. SNs were visualized by ultrasonography in 29 of 60 patients. Of 14 patients with positive results by ultrasonography, four had positive and two had negative cytology. The combination of ultrasonography and ultrasonographically-guided FNAB for visualized nodes had a sensitivity of 78.5%, specificity of 93.3% and overall accuracy of 86.2%. Blind FNAB in the hot spot was not useful in the detection of SN metastasis in patients whose SNs failed to be detected by ultrasonography. Conclusions Gamma probe and ultrasonographically-guided FNAB is a potentially useful method for pre-operative detection of SN metastasis. In patients with positive SNs, SNB is not indicated and complete axillary lymph-node dissection can be performed as a primary procedure.
62 citations
TL;DR: The loss of CA11 expression in gastric tissues may play an important role in gastrics carcinogenesis, and this suggests that the novel human gene referred to as CA11 should be considered for further study.
Abstract: To reveal the implication in gastric cancer pathogenesis of the novel human gene referred to as CA11, which was recently isolated by a differential display technique using normal gastric mucosa and gastric cancer tissue, we examined CA1 1 expression in 50 primary gastric cancers and also introduced the CAl 1 gene into gastric cancer cells. RNA dot blot analysis against various human organs and developmental stages demonstrated that CA1 1 was intensively expressed especially in normal stomach tissue. Northern blot analysis showed that expression of the CA11 1 gene in cancer tissue was down-regulated compared with normal tissue. Semi-quantitative RT-PCR also demonstrated that CA1 gene expression was decreased in 41 out of 50 (82%) of the gastric cancer tissues, when compared with normal stomach tissues, while no relationship was found between CA1 1 expression and various clinicopathological characteristics including histological type, depth of invasion, lymph node metastasis, and clinical stage. Immunohistochemical analysis with anti CA1 1 antibody showed that CA11-positive staining was observed in the surface regions of normal gastric epithelium, but was found faintly or not at all in cancer tissues. CA11 transfected MKN28 cells also displayed a marked decrease in the number of colony formations when compared to double normal controls. These findings suggest that the loss of CA1 expression in gastric tissues may play an important role in gastric carcinogenesis.
58 citations
TL;DR: It is suggested that ER-β (ER-β2) plays a more important role than ER-α in pancreatic cancers, and, on the contrary, ER- β1 mRNA variant expression was significantly (P<0.01) lower in pancreatIC cancers than in ER-positive and ER-negative breast cancers.
27 citations
TL;DR: A case in which peritoneal carcinomatosis had once developed after resection of primary pancreatic ACC but it was successfully cured by an intraperitoneal administration of CDDP is reported, suggesting that pancreaticACC may be very sensitive to cisplatin, if it can efficiently reach the cancer cells.
Abstract: Acinar cell carcinoma (ACC) is an uncommon malignant tumor of the pancreas and it remains unclear how best to treat such tumors, especially at an advanced stage or after disease relapse. We report a 15-year survivor after successful resection of locally advanced ACC of the pancreatic head with en bloc resection of the common hepatic artery. Nine years after surgery, she developed massive bloody ascites containing many cancer cells of acinar cell origin. A volume of 2,000 mL of ascites was aspirated and 20 mg of cisplatin was injected into the peritoneal cavity biweekly. After this treatment had been repeated four times at our outpatient clinic, the ascites disappeared without the appearance of any adverse side effects. The patient was alive 6 years after chemotherapy and had shown no signs of disease relapse. These observations suggested that pancreatic ACC may be very sensitive to cisplatin, if it can efficiently reach the cancer cells. Intraperitoneal cisplatin administration is, therefore, worth performing for treatment of the peritoneal seeding ACC. Acinar cell carcinomas of the pancreas are uncommon neoplasms, accounting for 1–2% of all cases of exocrine pancreatic tumors (1). The overall 5-year survival rate was reported to be as low as 6% by Klimstra and 0% by Cubilla (2,3), and no optimal treatment strategy for ACC has yet been determined. The liver is the most common site of distant metastasis from pancreatic ACC. Some recent reports suggested a good response rate of liver metastases of ACC to intra-arterial chemotherapy with a combination of 5-fluorouracil (5-FU) and cisplatin (CDDP) (4,5). Peritoneal spreading is less common than liver metastasis in pancreatic ACC, and there have been no previous reports of active or successful treatment for this condition. However, we report a case in which peritoneal carcinomatosis had once developed after resection of primary pancreatic ACC but it was successfully cured by an intraperitoneal administration of CDDP. These findings have important implications for the future of ACC treatment, especially at advanced stages or after cancer recurrence.
25 citations
TL;DR: This study evaluated whether benign pancreatic cysts are a precancerous condition as reflected by K‐ras mutation in pancreatic juice, and whether this mutation might be an early event in Pancic oncogenesis.
Abstract: Background: We detected benign pancreatic cysts in more than half of 12 cases of in situ pancreatic cancer. A few investigators, having detected K-ras mutation in pancreatic juice before the clinical diagnosis of pancreatic cancer, have suggested that this mutation might be an early event in pancreatic oncogenesis. Therefore, in the present study, we evaluated whether benign pancreatic cysts are a precancerous condition as reflected by K-ras mutation in pancreatic juice.
Methods: Pancreatic juice was collected through endoscopic cannulation of the pancreatic duct. Analysis of the mutations was performed using the polymerase chain reaction–preferential homoduplex formation assay.
Results: The frequencies and types of K-ras point mutations and the rate of multiplicity of K-ras mutations in patients with benign pancreatic cyst were the same as those with pancreatic cancer.
Conclusions: Multiple K-ras codon 12 mutations in the pancreatic juice of patients with benign pancreatic cysts are present as frequently as those with pancreatic cancer. These results indicate that patients with benign cysts may be at a high-risk for the development of pancreatic cancer.
3 citations