To examine the relationship of growth pattern of colorectal carcinoma with mucin property and cellular proliferation of transitional mucosa (TM), 49 lesions of colorectal carcinomas invading to the muscularis propria were studied. Growth patterns were classified as polypoid growth (PG), non-polypoid growth (NPG), or intermediate type basically according to Shimoda's classification. Mucin property of TM was examined using HID-AB staining. Cellular proliferation was assessed from PCNA staining. NPG carcinomas were smaller in size, found in younger age, and more often to have lymphnode metastasis than PG carcinoma. Mucin property of TM significantly correlated with growth pattern of carcinoma ; sulphomucin dominance in TM was found in 5 out of 12 PG carcinomas where as it was found in only 1 out of 22 NPG carcinomas. In addition, none of the 8 carcinomas whose TM showed a sulphomucin dominance had lymphnode metastasis. However cellular proliferation in TM did not differ by the growth pattern of carcinoma or the mucin property of TM. Preoperative assessment of the growth pattern of lesions and the mucin property of TM appears to be useful for predicting lymphnode metastasis of colorectal carcinomas invading to the muscularis propria.
Between 1986 and 1994, 66 patients with unresectable liver metastases from colorectal cancer were treated by repeated hepatic arterial infusion chemotherapy employing an implantable port system. In this study, 44 patients who received intermittent hepatic arterial infusion of high dose 5-FU (1000mg/m2) were analysed according to a response rate, survival rates, developments of extrahepatic lesions, periods of hepatic arterial infusion, and the rates at home. Two cases (4.5%) achieved a complete response (CR) and 27 cases (61.4%) a partial response (PR). The overall one-year and two-year survival rates were 56.7% and 37.8% respectively. The 50% survival time for all patients was 17.2 months. During the course of observation, extrahepatic lesions developed in 16 of the 39 patients (41.0%) and many responders died due to deterioration of extrahepatic lesions. The over all rates at home were more than 85%. Hepatic a rterial infusion of the 5-FU at 1000mg/m2 every week showed a high response rate in colorectal cancer patients with hepatic metastases, and the responders showed a low rate of death due to the hepatic metastases. However, in many patients the prognosis-determining-factor was extrahepatic lesions. Thus, countermeasures were necessary for extrahepatic lesions.
Partial splenic embolization (PSE) was performed on fifty cases with liver cirrhosis underwent no therapy. We evaluated changes of platelet count, ICGR15, GPT and Child-Pugh score which were significantly recovered by PSE. About liver cirrhosis before PSE, K.ICG, GPT, Alb, platelet count and splenic volume were selected as total characteristic factors by principal component analysis. We showed predicting formulas after PSE by multiple regression analysis between five factors selected by principal component analysis and platelet count, HPT, PT, Alb, ICGR15, K.ICG, GOT, GPT and Child-Pugh score after PSE. In conclusion, it is suggested that PSE is useful for recovering of platelet count and liver function. We made it possible to estimate therapeutic effect by predicting formulas before PSE.