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Volume 27, Issue 6
Displaying 1-12 of 12 articles from this issue
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Nobuyuki Hara, Mitsuo Ohta, Akira Motohiro, Jun Miyake, Sadanori Takeo ...1987 Volume 27 Issue 6 Pages 615-623
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSOf 46 patients with stage III small cell carcinoma of the lung, 9 underwent surgical resection, 36 were treated with combination chemotherapy and radiotherapy and 1 with radiotherapy alone. For surgically treated patients the overall 3-year survival rate was 29.6% with a median survival time (MST) of 16 months. Long-term survival (>3 years) was achieved only by patients with T3 primary tumor, without lymph node (N1 and N2) metastases. In a recent trial, we performed resection (adjuvant surgery) in 3 patients with N2 disease who showed a good response to combination chemotherapy prior to surgery and continuation of the same chemotherapy regimen postoperatively. However, all patients had distant recurrence of disease. The response rate in 37 non-operated patients was 81% with 14 cases of complete (38%) and 16 partial (43%) response. The survival of all patients was 37.7% at 1 year, 18.4% at 2 years and 7% at 3 years, with MST of 9 months. Patients achieving a complete response had relatively good survival, resulting in a 23% 3 year survival with an MST of 21 months. However, where a partial response to therapy was achieved, the MST was 11 months whereas with no measurable response it was only 4 months.
In conclusion, surgical resection for stage III disease seems to offer no better benefit in terms of survival even if adjuvant chemotherapy is used postoperatively. We consider that it is desirable to achieve complete remission with combination chemotherapy and radiotherapy, particularly for stage III with N2 disease, rather than surgical resection.View full abstractDownload PDF (3211K) -
Noriaki Iwahashi, Shinsuke Tamura, Junji Fujii, Souji Shimomura, Kenji ...1987 Volume 27 Issue 6 Pages 625-631
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to evaluate the usefulness of serum lipid-bound sialic acid as a lung tumor marker, this compound was determined in 42 patients with lung cancer, 17 patients with CRP (+) benign diseases and 20 patients with CRP (-) benign diseases. The assay method used for serum lipid bound sialic acid was that developed by Katopodis and Stock. Serum lipid bound sialic acid concentrations of patients with lung cancer and CRP (+) benign deseases were 28.4 ± 16.5mg/d1 and 22.2 ± 13.6mg/dl, respectively, which was significantly higher than that of patients with CRP (-) benign diseases, 15.2 ± 8.6mg/dl (P<0.001 and P<0.05, respectively). The positive rate in the detection of lung cancer was 57.1%. Efficiency percentage for the diagnosis of lung cancer was 55.9% with CRP (+) and 62.0% with CRP (-) benign diseases, respectively. No significant difference was observed in serum lipid-bound sialic acid value between cell types and clinical stage. The positive rate increased to 81.6% when combined with the serum carcinoembryonic antigen value. These results indicated that though serum lipid bound sialic acid is not specific for the diagnosis of cancer, it can be of help for the diagnosis of lung cancer.View full abstractDownload PDF (728K) -
Tadayuki Akaishi, Tetsuo Shimizu, Sokichi Onodera, Masahiro Fujita, Ei ...1987 Volume 27 Issue 6 Pages 633-644
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSN-Methyl-N'-nitrosoguanidine (NMNG) is a potent carcinogen for mammals. We have used it to induce tracheobronchial cancer in rabbits, and here report the method and the histopathological changes observed in the tracheobronchial trees of the rabbits.
Under pentobarbital anesthesia, MNNG, dissolved in distilled water, was instilled through a flexible broncho fiberscope. Animals were divided into three groups according to the amount of MNNG and the site of the instillation. Group 1 was given 1 mg of MNNG in the right posterior lobe bronchus once a week, 10 times. Group 2 was given 0.5 mg of MNNG 20 times in the upper trachea once a week. Group 3 was given 1 mg of MNNG 10 times at the same site as Group 2.
Tracheobronchial squamous cell carcinoma developed in 2 of 9 rabbits in Group 1, 4 of 8 in Group 2 and 8 of 11 in Group 3. Associated lesions such as bronchitic changes, goblet cellhyperplasia, basal cell hyperplasia, squamous metaplasia and dysplasia of the tracheobronchial trees were observed with high frequency. Among these changes, we concentrated our attention upon dysplasia, the frequency of which was increased in proportion to the duration of the experiment and was greater in the rabbits with cancer than without. In general, multifocal lesions of dysplasia was observed, and the phenomenon was prominent especially in the rabbits with cancer.
This model has wide applications, such as in studies on cytological changes during carcinogenesis and on treatment for cancer.View full abstractDownload PDF (18891K) -
Takehiko Fujisawa, Hisami Yamakawa, Hiroaki Saitoh, Toshitaka Ogawa, Y ...1987 Volume 27 Issue 6 Pages 645-652
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe treated 6 cases of spontaneous pneumothorax associated with primary lung cancerduring the past 15 years in our institute. Although the frequency was very low (0.6%), the average age was only 54 years old, which is a little younger than the average age of overall primary lung cancer cases, all were males and squamous cell carcinomas predominated. The mechanisms of spontaneous pneumothorax consisted of check-valve and bronchopleural fistula, however, these differ in terms of their mechanisms of development. These results enabled us to propose a new classification of spontaneous pneumothorax associated with primary lung cancer.View full abstractDownload PDF (9207K) -
Yasushi Matsushima, Masanori Tachibana, Mitsuaki Sakonji, Kouichi Hase ...1987 Volume 27 Issue 6 Pages 653-661
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSFifteen small nodules of the lung were studied in terms of diagnostic approaches and their value. The average size of the tumors was 9.5 mm by 8.2 mm. Of the 15 cases, 9 were benign tumors and 6 were adenocarcinomas. Clinical data (ESR, CRP, tumor markers, scintigram etc.) did not provide diagnostic information. Analysis of X ray findings (plain, tomogram, bronchography, PAG, CT etc.) was valuable for diagnosis in more than half of these cases. A definitive diagnosis was made cytologically and/or pathologically in 4 cases out of 6 carcinomas and in 1 granuloma. In 3 cases which could be diagnosed by TBLB, sections of bronchi more than 1.5 mm in width were recognized in the tumor. Reconstruction of these carcinomas using the method of tracing the tumor slice showed that one carcinoma seemed to originate from a daughter branch, and some of them had communication with a bronchus. Our results suggested that analysis of X-ray findings is valuable in the diagnosis of small nodules of the lung, and that there is a necessity for new approaches to reach peripheral bronchi and small nodules in the lung field. In certain cases open lung biopsy is necessary for definitive diagnosis from the point of view of trying to save lung cancer patients.View full abstractDownload PDF (8870K) -
Masahiko Kurata, Ryuhei Tateishi, Akira Yamamoto, Hideo Morino, Kenji ...1987 Volume 27 Issue 6 Pages 663-670
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe disease-free rate of 50 resected cases of peripheral small adenocarcinoma of the lung (tumor diameter, 2.0 cm or less) treated at 7 hospitals in Osaka from January 1977 to December 1981 was studied.
The 5-year disease-free rate of the 33 cases in the nO group was 77.3%, while the rates for the n1 and n2 groups were markedly lower at 40.0% and 34.7%, respectively. The combined 5-year disease-free rate for all 50 cases was 63.8%. Lymph node metastasis was found in approximately one third of all cases, and n2 cases were more than twice as common as n1 cases, with n2 cases making up one fourth of the total number of cases.
The disease-free rate was also found to be markedly lower in T2 or T3 groups and in parietal p2 or p3 groups. The histopathological findings showed a markedly lower disease-free rate in cases which had a large number of mitotic figures and in cases in which there was no lymphocytic infiltration.
he 5-year disease-free rate for 12 cases in which the tumor diameter was 1.5 cm or smaller was 55.6%, showing no significant difference from the rate for cases with a tumor diameter of 1.6 -2.0 cm.View full abstractDownload PDF (869K) -
Keiko Kuriyama, Akiyoshi Kajita, Yasusada Fujino, Ken Kodamd, Osamu Do ...1987 Volume 27 Issue 6 Pages 671-678
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo demonstrate peripheral small lung cancer in detail, 7 patients were examined by CT (GE 9800scanner) using 1.5 mm scan. These patients had early lung cancer (5 papillary adenocarcinomas, 1 squamous-cell carcinoma, 1 large-cell carcinoma) seen on chest radiographs including one patient with double primary lung cancers. CT images were examined by extended scale (window width; 1500H, level;-600H). All lesions were surgically resected and histopathological specimens were sliced transversely to correlate with thin-section CT images.
In thin-section CT images, findings suggesting malignancy, such as spiculation (86%), lobulation (100%), and retraction of the overlying visceral pleura (71%), convergence of peripheral bronchi and vessels toward the tumor (100%) were well demonstrated. CT images with extended scales could demonstrate that 2 papillary adenocarcinomas had peripheral fluffy zones. This finding was compatible with the observation of tumor cells spread on the alveolar walls in the pathologic specimen.
Our results suggest that thin-section CT may have a significant clinical role in diagnosing peripheral small lung cancer by demonstrating malignant favoring findings, especially when a histopathological specimen for making definitive daignosis of lung cancer is not available beforeoperation.View full abstractDownload PDF (9767K) -
Ryuta Aogauchi, Noriaki Tsubota, Noboru Ishii, Sakan Maeda, Taketoshi ...1987 Volume 27 Issue 6 Pages 679-686
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSFifty lung cancers were removed at thoracotomy from 50 patients (18 squamous cell carcinomas, 21 adenocarcinomas, 6 large cell carcinomas, 3 small cell carcinomas, 1 adenosquamous cell carcinomas, 1 pulmonary blastoma) and tested for chemosensitivity by colony-forming assay. Colony-forming efficiencies ranged from 1.0×10-5 to 9.4×10-4. Of tumor specimens 37 (74%) formed 5 or more colonies, of which 22 (44%) formed more than 30 colonies in plates without drugs.
Factors affecting cell growth were investigated. The rate of colony formation was lower in well differentiated carcinoma, patients with prior chemotherapy, and with primary tumors. The rate of colony formation was higher in the order of NO, N1 and N2.
The in vitro sensitivity to 5FU was higher than that seen in the clinical cases. We thought this was because the standard concentration of 5FU (1.0μg/ml in continuous exposure) was possibly higher. Adenocarcinoma was most sensitive to 5FU, and small cell carcinoma which is generally considered to be sensitive to drugs, was not sensitive to most drugs.
Although a high correlation between the colony-forming assay and the clinical response of tumors to chemotherapy has been reported, there might be some problems such as low plating efficiency, when using the colony-forming assay for routine examinations.View full abstractDownload PDF (2770K) -
Shigeharu Moriyama, Hiroshi Date, Keijiro Miyake, Yoshiaki Miyai, Hide ...1987 Volume 27 Issue 6 Pages 687-692
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThis paper reports a 64 year-old male patient with pulmonary carcinoma, associatedwith an intracavitary aspergillus infection. To our knowledge, only 22 cases with such a combination have been reported in the literature. Routine chest X-ray rentogenogram showed a thin-walled cavity in the middle field of the left lung, but the patient had no symptom and no significantly abnormal laboratory finding, except for a slight acceleration of ESR. Sputum cytology and transbronchial brushing, however, revealed malignant cells, but no hyphae were detected. The surgical specimen, obtained by left lingual segmentectomy and S3 partial resection, revealed mycetoma of aspergillus in the cavity of a moderately differentiated squamous cell carcinoma.View full abstractDownload PDF (8765K) -
Toshiro Yonei, Taisuke Ohnoshi, Isao Takahashi, Shunkichi Hiraki, Hiro ...1987 Volume 27 Issue 6 Pages 693-700
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of acute myelogenous leukemia (AML) developing during complete remission ofsmall cell carcinoma was reported. A 51-year-old female case was diagnosed as small cell lung cancer in September, 1982. Complete remission of the disease was achieved in November, 1982 with alternating chemotherapy and chest irradiation of 40 Gy. She received monthly maintenance chemotherapy thereafter. Severe and persistent thrombocytopenia developed 22 months after the initiation of chemotherapy. Simultaneously, a small number of myeloblasts ere detected in the peripheral blood. Bone marrow examination revealed hypercellular marrow containing 4.2% myeloblasts and 25.6% promyelocytes with Auer rods. The hematologic findings were compatible with refractory anemia with excess blasts (RAEB) in transformation. She developed overt AML in April, 1985. She failed to respond to antileukemic therapy and died 7 months after onset of overt leukemia. An autopsy revealed no residual small cell carcinoma either at the primary site or in other organs. The risk of second malignancy following radiotherapy and long-term chemotherapy in small cell carcinoma is discussed.View full abstractDownload PDF (5051K) -
Takayoshi Tashiro, Jun Goto, Yoichiro Goto, Hideaki Shigeno, Masaru Na ...1987 Volume 27 Issue 6 Pages 701-706
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 44-year-old man with silicosis complained of cough. A chest roentogenogram showed diffuse miliary shadows in both lungs. Fiberoptic bronchoscopy revealed a nodular tumor in the left main bronchus. The tumor, 5×6×4mm in size, was located mainly in the submucosal area of the bronchus, and was composed of acini lined by well-differentiated mucous-secreting cells and distended acini lined by flattened epithelium without nuclear atypism.
A diagnosis of mucous gland adenoma was made. Mucous gland adenoma is one of the rarest epithelial tumors of the lung. It arises from the mucous gland of the larger bronchi and projects into the lumen as a polypoid mass. It is believed to be a benign tumor, but a few cases of malignant change are reported.View full abstractDownload PDF (6933K) -
1987 Volume 27 Issue 6 Pages 707-728
Published: October 20, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3151K)
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