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Volume 36, Issue 4
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[in Japanese], [in Japanese]1996 Volume 36 Issue 4 Pages 339-340
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (188K) -
Yutaka Nishigaki, Yoshinobu Ohsaki, Syuji Yamaguchi, Toshiyuki Ogasa, ...1996 Volume 36 Issue 4 Pages 341-349
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSNorthern blot analyses detected parathyroid hormone related protein (PTHrP) messenger RNA in a variety of lung cancers. PTHrP is broken into small fragments by proteases. Among these fragments, C-terminal fragment (C-PTHrP) is stable and measurable in urine. Therefore, we measured C-PTHrP in the urine from 21 primary lung cancer patients (11 adenocarcinoma, 4 squamous cell carcinoma, 5 small cell carcinoma, 1 sarcoma) and 8 normal subjects by RIA using antibody directed against PTHrP Cterminal (109-141). We measured C-terminal and N-terminal (1-34) (N-PTHrP) in the serum from the same subjects. Average urinary C-PTHrP/urine creatinine ratio was 8.41±5.5710-1 pmol/mg·creatinine (mean±SD) in the lung cancer patients comparing 5.18±1.85 in the normal subjects. The difference was statistically significant (p=-0.027). Serum C-PTHrP and N-PTHrP levels were not significantly increased in the lung cancer patients (p=0.052). From these results, we concluded that lung cancer patients had higher C-PTHrP levels in the urine than normal subjects. Measurement of C-PTHrP has a potential role as a tumor marker in lung cancer patients, especially in non-small lung cancers.View full abstractDownload PDF (893K) -
Masao Umemoto, Yukihito Saitoh, Hiroji Imamura, Seibun Yonezu, Takashi ...1996 Volume 36 Issue 4 Pages 351-358
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe investigated the perioperative complications in 39 patients who received preoperative induction therapy for treatment of lung cancer (16 squamous cell carcinoma, 12 adenocarcinoma, 1 large cell carcinoma, and 10 small cell carcinoma). The patients were 36 males and 3 females, and their mean age was 61.5 years. Preoperative complications, such as paresthesia (sensory abnormalities), electrocardiographic abnormalities, and pulmonary embolism were observed in a single case.
Intraoperative and postoperative complications developed in 64.1% of these cases, in contrast to the control group (a series of 100 patients treated surgically for lung cancer during the same period) where the incidence of these complications was only 26%.Moreover, in the preoperative induction therapy group, there was one operative mortality, and two late postoperative mortalities due to pulmonary embolism, and three due to empyema, while no treatment-related fatalities occurred in the control group.
We think that in the preoperative induction therapy group, the complications or their preliminary states were subclinically present, and they must be tackled during the intraoperative and postoperative care. It is also necessary to investigate this induction therapy not only from the aspect of the therapeutic efficacy but also from that of adverse actions. The evaluation of this induction therapy has not been settled yet, and we think that it should be considered carefully in addition to the selection of the patientsView full abstractDownload PDF (934K) -
Katsuo Usuda, Yasuki Saito, Satomi Takahashi, Gunji Okaniwa, Masashi H ...1996 Volume 36 Issue 4 Pages 359-364
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe examined the validity of our diagnostic criteria of synchronous multiple lung cancer and intrapulmonary metastasis in 115 patients with intrapulmonary multiple lesions who underwent pulmonary resection. Our criteria for synchronous multiple lung cancer were cancers physically distinct and separate, and which meet the following requirement a, b or c.
(a) different histology
or similar histology but in different segments, lobes, or lungs, if:
(b) cancers with in situ components, e.g. a roentgenographically occult squamous cell carcinoma
(c) nO or n1 cancers with two intrapulmonary lesions and no extrapulmonary metastasis
The 5-year-survival rate of 58 patients with synchronous multiple lung cancer was 45%, which was significantly better than that (4%) of 57 patients with intrapulmonary metastasis. In the patients with synchronous multiple lung cancer, the 5-year-survival rate of (c) was 54%, which was significantly better than the 2-year-survival rate (0%) of (a), and which was also better than the 5-year-survival rate (43%) of (b). Prognosis of patients with n0 or n1 lung cancers with 2 intrapulmonary lesions and no extrapulmonary metastasis was good, and surgical treatment is justified. They should be treated as synchronous multiple lung cancers, not as intrapulmonary metastasis, from a therapeutic point of view.View full abstractDownload PDF (608K) -
Noboru Ishii, Masayoshi Okada, Satoru Okada, Noriaki Tubota1996 Volume 36 Issue 4 Pages 365-373
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn 78 patients with non-small cell lung cancer who underwent surgery in a cooperative randomized controlled trial, surgical specimens of tumor tissue were examined histologically. The efficacy of postoperative OK-432 (Su-strain streptococcal preparation) therapy was determined in terms of its effect on the survival rate. In the histological study, tumor tissues were examined to determine the degree of lymphocyte infiltration and whether there was shared antigenicity with Su-strain streptococci. An anti-Su antibody was used to detect common antigenicity.
In the patients with lymphocyte infiltration of tumor tissue, post-operative OK-432 therapy achieved a significant prolongation of survival. In the patients with shared tumor antigenicity, use of OK-432 was also effective, although an improvement was not significant.
The extent of intratumor lymphocyte infiltration before OK-432 therapy was more closely associated with the prolongation of survival than the presence of shared antigenicity. In addition, because lymphocyte infiltration can be easily assessed by hematoxylin-eosin staining, it can be used as an indicator for selecting patients to be treated with OK-432.View full abstractDownload PDF (7716K) -
Kouzo Yamada, Mutsumi Kondou, Yuji Katou, Fumihiro Oshita, Ikuo Nomura ...1996 Volume 36 Issue 4 Pages 375-384
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSFive cases of resected small lung cancer less than 6 mm in diameter were examined retrospectively to evaluate their clinical features and roentgeno-pathological correlations.
The five patients consisted of two males and three females with well-differentiated adenocarcinoma. Abnormal shadows were detected on all CT screenings but the plain chest X-ray images were negative in all cases. The conventional CT images revealed airdensity lesions in all cases. The thin-section CT images, however, revealed air-density lesions with irregular margins in three and vascular involvement in all cases.
We conclude that small lung cancers showed specific characteristics on the thin-section CT images. The thin-section CT is useful in differentiating small lung cancers by revealing internal air spaces, irregular margins and vascular involvement.View full abstractDownload PDF (14883K) -
Kazushige Hayakawa, Yoshihiro Saito, Yuko Nakayama, Susumu Katano, Mas ...1996 Volume 36 Issue 4 Pages 385-392
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSResults of treatment of 347 patients with inoperable or unresectable non-small cell lung cancer (NSCLC) who received radical radiation therapy (RT) from 1964 through 1989 were compared according to the period of treatment because equipment and methods changed. The overall 2- and 5-year survival rates were 33% and 15% for patients in the recent period (1976-1989) as compared with 24% and 10% for patients in the previous period (1964-1975), respectively. The survival curves of the recent period patients were superior to those of the earlier group. The 5-year survival for squamous cell carcinoma was 7% in the early period and 18% in the recent period, and the 2-year local progression rate was only 36% for recent period patients, which was significantly lower than the 83% for the earlier group. These differences were statistically significant. In patients with non-squamous cell carcinoma, however, there was no significant difference between the two periods in terms of survival rate. Our results suggested that, in NSCLC patients treated with RT, the recent improvement in treatment results was due to the improvement of local control of squamous cell carcinoma in patients who were favorable candidates for radical RT.View full abstractDownload PDF (970K) -
Tetsu Nakamura, Yoshiharu Ohno, Masahiro Endo, Arata Motoyama, Kazuhik ...1996 Volume 36 Issue 4 Pages 393-399
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo compare the detectability of brain metastases from lung cancer, both CT and MRI were performed on all patients. Thirty-two lung cancer patients with brain metastases admitted from December 1990 to June 1994 were examined by CT and MRI using contrast enhancement. Six radiologists individually evaluated CT and MRI films for brain metastases. In 3 of 32 cases, multiple small metastatic lesions which could not be detected on CT were detected on MRI. In 29 of the 32 cases, 56 metastatic lesions were detected on CT, whereas 103 lesions were detected on MRI. There were no lesions that were detected only by CT and were not detected by MRI. MRI was superior to CT for determining small lesions less than 9 mm and inferior tentorial lesions. As a result, we consider that CT is not sufficiently effective for detecting brain metastases of lung cancer, and that MRI is now indispensable.View full abstractDownload PDF (5817K) -
Chieko Anzai, Kouichi Sano, Satoshi Kumazaki, Teruo Ishihara1996 Volume 36 Issue 4 Pages 401-407
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe studied the clinical features of 5 cases of lung cancer complicated by leukoencephalopathy associated with intrathecal methotrexate. Subjects included 2 men and 3 women with a mean age of 53.6. Four cases were adenocarcinoma and one was small cell lung cancer.
All cases underwent systemic chemotherapy. Three cases with brain metastasis received cranial irradiation. For leptomeningeal carcinomatosis, all cases received intrathecal injection of methotrexate, cytosine arabinoside and predonisolone once a week (the mean total dose of MTX was 105mg). Two patients received cranial irradiation. Leukoencephalopathy was diagnosed at an average of 10.6 months after the diagnosis of leptomeningeal carcinomatosis, and they survived for an additional average of 4.6 months. For diagnosis of leukoencephalopathy, MRI was more useful than CT.
In conclusion, leukoencephalopathy was a serious adverse effect of the leptomeningeal carcinomatosis therapy. However, there is no therapy at the present time. Periodic CT scanning and MRI are mandatory for early stage detection and prevention of this complication.View full abstractDownload PDF (5279K) -
Kikuo Nakano, Takehiko Hiramoto, Kazuhiko Kumagai, Yuji Tukamoto, Mako ...1996 Volume 36 Issue 4 Pages 409-415
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTreatment results of patients aged 75 years or older (elderly group) with non-small cell lung cancer were compared with those of patients aged 74 years or younger (younger group). In patients with stage III disease, radiotherapy alone resulted in a median survival of 11.5 months in the younger group and 5.5 months in the elderly group. There was a significant difference in survival rate between the two groups (P=0.0008). Moreover, the elderly group patients more frequently died of pneumonia and radiation pneumonitis than the younger group patients. However, results of radiotherapy were similar in the two groups of patients with stage I and II disease. Accordingly, these findings suggested that radiotherapy is an appropriate treatment modality for elderly lung cancer patients, but that individualized radiotherapy is needed for those with locally advanced stage.View full abstractDownload PDF (673K) -
Naomi Taniguchi, Tetsuo Sakai, Masanori Shimada, Takeshi Ishizaki, Tsu ...1996 Volume 36 Issue 4 Pages 417-423
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 70-year-old man was admitted to our hospital with dyspnea. Chest X-ray film showed left pleural effusion. Histological examination of the pleural biopsy specimen revealed poorly differentiated adenocarcinoma. Carcinomatous pleuritis was diagnosed. Chest Xray on the second day after admission showed a remarkable increase of left pleural effusion and the volume of drained pleural effusion was reached about 12 liter during five days after tube thoracostomy. Despite the tube drainage method, dyspnea did not improve and the patient died two weeks after admission before chemotherapy could be initiated. During hospitalization, the white blood cell count rose to 27, 800/mm3 without any evidence of bacterial infection. Levels of granulocyte colony stimulating factor (GCSF) in both serum and pleural effusion were high, indicating that the tumor cells produced G-CSF, but immunohistochemical examination of the tumor cells did not show any positive staining for and G-CSF monoclonal antibody. Carcinomatous pleuritis in this case had an unusual character, perhaps related to the leukocytosis.View full abstractDownload PDF (5529K) -
Katsuyasu Yamada, Masayuki Nishio, Kimihide Yoshida, Kenji Akita, Taka ...1996 Volume 36 Issue 4 Pages 425-430
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe report two cases of non-small cell lung Cancer (NSCLC) with tonsillar metastasis. One case was diagnosed as adenocarcinoma and the other as squamous cell carcinoma.
Case 1, in 51-year-old woman, whose chief complaint was coughing, adenocarcinoma was diagnosed in transbroncheal lung biopsy (TBB). Because of metastasis to the pancreas, spleen, and adrenal gland, we diagnosed T4N2M1, Stage N disease and started combination chemotherapy including Carboplatin (CBDCA), Adriamycin (ADR), and Etoposide (VP-16). During treatment, the patient suffered a sore throat due to left palatine tonsillar metastasis.
Case 2, TBB yielded a diagnosis of squamous cell carcinoma in 68-year-old man whose chief complaint was bloodysputum. Disease was diagnosed T3N3M1, Stage N because of adrenal, cerebral, and subcutaneous metastasis, and he was subsequently treated with a combination chemotherapy of Cisplatin (CDDP), Mitomycin C (MMC), and Vindesine (VDS). After one course of the therapy he had an abnormal sensation in the oral cavity due to left tonsillar metastasis.
Metastatic tonsillar tumors from lung cancer are uncommon, especially tonsillar metastasis of squamous cell carcinoma of the lung.View full abstractDownload PDF (8379K) -
Masaharu Inagaki, Mamoru Yamada, Teizo Taya, Reiko Fukuda, Miwako Noza ...1996 Volume 36 Issue 4 Pages 431-436
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 73-year-old man with a Brinkmann Index 1500, was admitted to our hospital because of bloody sputum and an abnormal shadow on chest X-ray film. The chest X-ray film and chest CT film showed a tumor shadow (diameter 3.8cm) in the distant portion of right S9 and interstitial changes. Sputum cytology revealed adenocarcinoma, and percutaneous needle cytology revealed small cell carcinoma. After 1 course of preoperative chemotherapy, right lower lobectomy and R2a lymph node dissection were performed. Histologic examination of the resected lower lobe showed interstitial pneumonia in the peripheral region of the entire lobe, small cell carcinoma of the S9 peripheral tumor, with intrapulmonary metastases. Bronchiolo-alveolar carcinoma was revealed in around of the tumor in S9 to 56. No lymph node metastasis was demonstrated. Although the two tumors were in contact, we made a diagnosis of multiple primary lung cancer, because of the lack of apparent continuity in the histologic findings of both tumors.View full abstractDownload PDF (9662K) -
Yoshiyuki Abe, Yoshiro Oshika, Eiichiro Ota, Masayuki Iwasaki, Hiroshi ...1996 Volume 36 Issue 4 Pages 437-441
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 45-year-old male was admitted for the further examination of an abnormal shadowon his chest X-ray. Thoracic CT scan revealed a 6 cm mass shadow invading the diaphragm. Preoperative transbronchial lung biopsy indicated pulmonary adenocarcinoma. He underwent right lower lobectomy, partial resection of the diaphragm, and dissection of regional lymph nodes on October 19, 1992. The tumor, located in S9 and S10, measured 52×43 mm. Microscopic examination showed a biphasic growth pattern ofpapillary carcinoma and spindle cell sarcoma with rhabdoid cells. Immunohistochemical study revealed epithelial marker positive- and mesenchymal marker negative-tumor cells in both the above elements. The pathological diagnosis was “false” carcinosarcoma of the lung, with intrapulmonary metastasis (T4NOMO, stage IIIB). He is now being treated by chemotherapy for multiple intrapulmonary metastasis.View full abstractDownload PDF (7208K) -
Naoki Hosen, Kiyoshi Komuta, Seigo Kitada, Shinichirou Iida, Keiji Mae ...1996 Volume 36 Issue 4 Pages 443-448
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe pharmacokinetics of intravenously administrated carboplatin (CBDCA) and etoposide (VP-16) were studied in a patient with small cell lung carcinoma (T1N0M0, Stage I) receiving regular hemodialysis for chronic renal failure. The patient was treated with carboplatin at 300mg/m2 on day 1 and etoposide at 50mg/m2 on day 1 and day 3 via intravenous drip infusion for 1 hour. Hemodialysis was performed 2 hours after the start of administration for 4 hours. The pharmacokinetic results revealed that similar pharmacokinetic curves to those of patients with normal renal function were obtained using this regimen. No severe side effects were observed. These observations suggest that this regimen is a safe and useful chemotherapy regimen against malignant disease in patients undergoing regular hemodialysis.View full abstractDownload PDF (4530K) -
Shoji Oura, Takeo Sakurai, Goro Yoshimura, Takeshi Tamaki, Teiji Umemu ...1996 Volume 36 Issue 4 Pages 449-453
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 68-year-old man presented with severe back pain. He had an abnormal chest X-rayfilm shadow that was seen to invade the 3rd thoracic vertebral body on chest CT. Aspiration cytology of the right supraclavicular lymph node suggested adenocarcinoma. We diagnosed this as lung carcinoma with invasion to the vertebra (T4N3M0), and treated the patient with two bronchial arterial infusions of an anticanceragent (BAI) for pain control. Although BAI therapy brought him marked pain regression in each time, he complained again of severe back pain, accompanied by remarkable elevation of CEA levels soon after completion of the 2nd BAI therapy. Therefore, we treated him with morphine for pain control. As the severity of his pain required urgent elevation of the morphine dosage, we treated him with pamidronate (30mg/body i.v. 6 times), which relieved his severe pain and enabled good pain control with less than half of the prior dosage of morphine until he died. His consciousness was clear until just before his death. His serum CEA levels had also decreased remarkably.View full abstractDownload PDF (3573K) -
1996 Volume 36 Issue 4 Pages 455-474
Published: August 20, 1996
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (2943K)
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