Low nutritional prognostic index correlates with poor survival in patients with stage IV colorectal cancer following palliative resection of the primary tumor

BACKGROUND

We retrospectively investigated the prognostic significance of various clinicopathological factors and preoperative nutritional status to select patients with stage IV colorectal cancer (CRC) who will have a poor prognosis after palliative resection of the primary tumor.

METHODS

A total of 100 stage IV CRC patients who underwent palliative resection were enrolled. Various clinicopathological factors and Onodera's prognostic nutritional index (OPNI) were evaluated to identify any possible relationship with the prognosis.

RESULTS

At the time of the analysis, 83 patients had died, and the median survival time was 21 months. Of the 100 patients, 24 had primary tumor-related symptoms such as obstruction or bleeding. No significant correlation was noted between the OPNI and various clinicopathological factors. The multivariate analysis of patients without primary tumor-related symptoms revealed that the OPNI was an independent prognostic factor. The overall survival of the low-OPNI group was significantly worse than that of the high-OPNI group.

CONCLUSIONS

This retrospective study suggested that patients with a low OPNI may not be candidates for palliative resection, because it provides no survival benefit to these patients.

[A case of desmoid tumor and advanced sigmoid colon cancer with liver metastasis in familial adenomatous polyposis (FAP)]

We report on a 30-year-old man with familial adenomatous polyposis (FAP ) who developed advanced sigmoid colon cancer with desmoid tumors. The patient initially presented with melena. FAP advanced sigmoid colon cancer was diagnosed following a laparoscopy-assisted proctocolectomy in 2007. A computed tomography (CT) scan, conducted 7 months later, revealed a tumor around the branch of the common iliac artery. We diagnosed sigmoid colon cancer recurrence and attempted treatment by surgical removal. However, there were many smooth tumors within the patient's abdomen, which were diagnosed as desmoid tumors using rapid intraoperative pathological diagnosis. Although the patient was administered a COX-2 inhibitor and tamoxifen after surgery, the tumor grew. Dacarbazine (DTIC) and doxorubicin (DOX) were subsequently administered to the patient, and after 4 courses, the tumor was reduced by 60% and stable disease (SD) was achieved. In 2009, a CT scan indicated sigmoid colon cancer recurrence in the liver. The patient underwent a left hepatic lobectomy by laparoscopy-assisted surgery. To date, 4 years and 6 months after surgery, we have been unable to find new disease or desmoid tumor growth.

Abstract 3606: The effect of PGE2 receptor inhibitor on the microenviroment of scirrhous gastric cancer

Introduction: Prostaglandins and cyclooxygenase2 have been suggested to play an important role for the proliferation and migration of cancer cells. But Prostaglandins (PG) have been suggested to affect cancer cells in various directions. For example, PGF2α and PGD2 has been demonstrated to have anti-tumor effects against some types of cancer cells. But PGE2 has been demonstrated to promote the proliferation and migration of cancer. Therefore, the investigation of the involvement of PG signals for cancer in lower level of arachidonic acid cascade is very important. The aim of this study is to investigate the effects of PGE2 and PGE2 receptor inhibitor (EP2 inhibitor) on the growth-interaction between cancer cells and fibroblasts.

Methods: Three human gastric cancer cell lines (OCUM-2M, OCUM-2MD3, OCUM-12) and a human gastric fibroblast (CAF45) cell line were used in this study. Serum-free conditioned medium (SF-CM) from CAF-45 stimulated with PGE2 or EP2 inhibitor was prepared and used in study. Cell proliferation was studied by MTT assay and cell count in the presence or absence of CAF45. Cell migration was studied by wound healing assay in the presense or absence of SF-CM. In vivo study, We examined the effect of EP2 inhibitor on subcutaneous and orthotopically transplanted tumors.

Results: In proliferation, PGE2 significantly stimulated the proliferation and migration of cancer cells. PGE2 significantly stimulated the proliferation and migration of cancer cells co-cultured with CAF45 or SF-CM more in comparison with single culture. EP2 inhibitor significantly decreased the proliferation and migration of cancer cells, EP2 inhibitor significantly decreased the proliferation migration of cancer cells co-cultured with CAF-45 or SF-CM more in comparison with single culture. In vivo study, EP2 inhibitor significantly suppressed the subcutaneous tumor in nude mice and suppressed orthotopic tumor growth and lymph node metastasis.

Conclusion: PGE2 is associated with progression of gastric cancer. PGE2 receptor inhibitors might be promising anti-cancer drug for gastric carcinoma.

Citation Format: Tatsunari Fukuoka, Masakazu Yashiro, Hiroshi Takeda, Takayuki Maruyama, Hiroaki Kasashima, Go Masuda, Haruhito Kinoshita, Tamami Morisaki, Katsunobu Sakurai, Masatsune Shibutani, Sadaaki Yamazoe, Kenjiro Kimura, Hisashi Nagahara, Takahiro Toyokawa, Ryosuke Amano, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Hiroshi Otani, Kiyoshi Maeda, Masaichi Ohira, Kosei Hirakawa. The effect of PGE2 receptor inhibitor on the microenviroment of scirrhous gastric cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3606. doi:10.1158/1538-7445.AM2014-3606

Abstract 1081: Extent of intranodal macrophage correlates with lymph node metastasis of gastric cancer

Background

Tumor-associated macrophages (TAM) plastically change their polarity to M2macrophages (M2Mϕ) in the tumor microenvironment. It has been reported correlation of tumor-infiltrating TAM with lymphangiogenesis and lymph node (LN) metastasis of several types of cancer including gastric cancer (GC). However, It is not sufficiently elucidated that the role of intranodal TAM on tumor progression of GC. The purpose of this study was to examine the distribution of intranodal TAM in draining LNs and the association of M2Mϕ with spreading LN metastasis of GC.

Methods

We assessed regional LN specimens from 49 patients with GC who are composed of pathologically diagnosed 31 node-positive and 18 node-negative cases. All specimens were examined by immunohistochemistry staining of cytokeratin AE1/AE3 antibodies for tumor cells and CD163 antibodies for M2Mϕ. The distributions of intranodal macrophages were analyzed by calculating the number of M2Mϕ according to the region of the cancer location. PBMC harvested from blood samples of healthy subjects were ascertained to be differentiated into M1, M2a and M2cMϕ by appropriate cytokines. Vascular endothelial growth factor-C (VEGF-C) concentrations of Mϕ supernatants were detected to compare the ability of lymphangiogenesis.

Results

The number of M2Mϕ infiltrating in the LNs with metastasis were significantly higher than that of normal LNs (p<0.0001). In the histopathological examination, stage and degree of LN metastasis positively correlated with the number of intranodal M2Mϕ. The number of intranodal M2Mϕ was decreased distant from the primary tumor. Importantly, M2Mϕ increased at LNs along root of the left gastric artery and gastroepiploic arteries in patients with node positive. The VEGF-C levels of the M2Mϕ culture supernatants were significantly higher than that of control Mϕ. The result of flow cytometer revealed that M2a and M2c cultured from PMBC expressed CD163.

Conclusion

The number of intranodal M2Mϕ significantly associated with LN metastasis and progression of GC. Moreover, M2Mϕ infiltrated into LNs prior to formation of metastasis. The findings indicated that M2Mϕ might migrate into LNs by chemotactic activity of primary tumor. Our results suggested that molecules associated with M2Mϕ could be one of the new biomarkers for LN metastasis of GC.

Citation Format: Yukie Go, Hiroaki Tanaka, Mao Tokumoto, Yoshihiro Okita, Masatsune Shibutani, Sadaaki Yamazoe, Katsunobu Sakurai, Hisashi Nagahara, Kenjiro Kimura, Takahiro Toyokawa, Ryosuke Amano, Naoshi Kubo, Kazuya Muguruma, Hiroshi Otani, Masakazu Yashiro, Kiyoshi Maeda, Masaichi Ohira, Kosei Hirakawa. Extent of intranodal macrophage correlates with lymph node metastasis of gastric cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1081. doi:10.1158/1538-7445.AM2014-1081

Abstract 3924: Establishment and characterization of two cell lines of anaplastic pancreatic cancer

Background: Anaplastic pancreatic cancer is a rare malignancy with a poor prognosis. As a whole, pancreatic cancer is a devastating prognosis but its therapeutic strategy has not still well developed. Thus, new models are needed to research its biology.

Purpose: We have established and characterized 2 anaplastic cancer cell lines (OCUP-A1 and OCUP-A2) for revealing tumor worsening factors and the mechanism of dedifferentiation.

Methods: We researched the present studies by comparing with established 2 cell lines and well-known pancreatic cancer cell lines. In vitro proliferation, migration and invasion assays was examined in each cell lines under normoxia and hypoxia by CellPlayer™ 96-Well Kinetic Cell Proliferation, Migration and Invasion Assays. Furthermore,as assessment of chemosensitivity, IC50 values against 5Fu and gemcitabine ware measured by MTT assay. As In vivo assays, the growth of the xenografts in each cell lines was also measured for a month. The immunohistochemistry (IHC) of E-cadherin and vimentin for primary tumors and the xenografts was performed to confirm the induction of epitherial-mesenchymal transition (EMT).

Result: Both OCUP-A1 and OCUP-A2 were pleomorphic cells derived from ascites of anaplastic pancreatic cancer patients. The doubling time of OCUP-A1 and OCUP-A2 was 30.9 h and 20.4 h, respectively. In migration and invasion assays, relative wound density in new 2 cell lines ranged from 47.1 % to 98.1 % at 48 hours. The values were not so different from that of other cell lines. Interestingly, although a large part of OCUP-A1 is spindle shape in normoxia, the subpopulation with polygonal structure has increased in hypoxia. Furthermore, OCUP-A1 rapidly proliferated in hypoxia. The IC50 values of gemcitabine for OCUP-A1 and OCUP-A2 were 8.77 nM and 4.90 nM, respectively. And the values of 5-Fu for OCUP-A1 and OCUP-A2 were 48.5 μM and 14.8μM, respectively. Chemosensitivity of 2 established cell lines was not superior to other cell lines. The xenografts of OCUP-A1 and OCUP-A2 more rapidly increased than other cell lines (MIAPaCa2 and Panc-1). In IHC, the E-cadherin expression was reduced and the vimentin expression was enhanced in both specimens.

Conclusion: We established 2 anaplastic pancreatic cancer cell lines. It was suspected that these cell lines would have aggressive characters affected by TME and EMT.

Citation Format: Kotaro Miura, Kenjiro Kimura, Ryosuke Amano, Sadaaki Yamazoe, Keiichiro Hirata, Masatsune Shibutani, Katsunobu Sakurai, Hisashi Nagahara, Takahiro Toyokawa, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Hiroshi Otani, Masakazu Yashiro, Kiyoshi Maeda, Masaichi Ohira, Kosei Hirakawa. Establishment and characterization of two cell lines of anaplastic pancreatic cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3924. doi:10.1158/1538-7445.AM2014-3924

Abstract 3612: Effect of cancer associated fibroblast on gastric cancer cells under hypoxia

Background:

Cancer-associated fibroblasts (CAF) have been suggested to be associated with the scirrhous gastric cancer (SGC) progression. SGC have a heterogeneously hypoxic environment which has been currently considered to be associated with aggressive tumor phenotypes cancer. Stromal cell-derived factor (SDF)-1 and C-X-C chemokine receptor type 4 (CXCR4) form an important chemokine/receptor pair, and are supposed to be up-regulated by hypoxia inducible factor-1 (HIF-1). The aim of our study was to clarify the effect of hypoxic environment on the CAF and CXCR4/SDF-1 axis in SGC.

Experimental Design:

Proliferation of SGC cells grown in monoculture and co-culture with CAF under hypoxia. SGC and CAF expression level of CXCR4 and SDF-1 under hypoxia were examined by RT-PCR and ELISA. Proliferation and migration of SGC cells with SDF-1 or hepatocyte growth factor (HGF) or conditioned medium from CAF under hypoxia, furthermore, added c-Met inhibitor or CXCR4 inhibitor.

Results:

The proliferation that co-culture of SGC cells with CAF was significantly increased under hypoxia. The expression level of CXCR4 mRNA was significantly increased under hypoxia in all of SGC cells. SDF-1 concentration level was significantly increased under hypoxia. The proliferation of SGC cells with SDF-1 and CAF was significantly increased. The proliferation of SGC cells with CAF was inhibited by CXCR4 inhibitor under hypoxia. The migration of SGC cells with HGF and CAF was significantly increased. The migration of SGC cells with CAF was inhibited by c-Met inhibitor.

Conclusion:

CAF might up-regulate the proliferation and migration of SGC cells under hypoxia, in comparison with that under normoxia. CXCR4/SDF-1 axis might play an important role for the proliferation of SGC cells under hypoxia.

Citation Format: Haruhito Kinoshita, Masakazu Yashiro, Go Masuda, Hiroaki Kasashima, Tamami Morisaki, Tatsunari Fukuoka, Masatune Shibutani, Sadaaki Yamazoe, Katsunobu Sakurai, Hisashi Nagahara, Kenjiro Kimura, Takahiro Toyokawa, Ryosuke Amano, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Hiroshi Otani, Kiyoshi Maeda, Masaichi Ohira, Kosei Hirakawa. Effect of cancer associated fibroblast on gastric cancer cells under hypoxia. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3612. doi:10.1158/1538-7445.AM2014-3612

Effects of surgical intervention on disease activity of rheumatoid arthritis: cases of surgery for rheumatoid arthritis of the lower limbs treated with biologics

OBJECTIVES

In order to verify combination therapy with drugs and surgery for rheumatoid arthritis (RA), we evaluated changes in clinical outcome affected by surgical intervention in the patient treated with biologics and investigated the effects of surgery on disease activity.

METHODS

Fifty-five lower limb joint surgeries were performed in 48 patients under biological therapy. DAS28-ESR, modified Health Assessment Questionnaire (mHAQ) score, PtGA and serum CRP were examined just before surgery, at 6 months and at 12 months after surgery. A kind of suitable medication and its dose were investigated.

RESULTS

Preoperative DAS28-ESR significantly decreased from 3.71 ± 1.19 (mean ± SD) to 3.37 ± 1.22 at 6 months and to 3.24 ± 1.05 at 12 months postoperatively. mHAQ score did not change, but, PtGA and serum CRP improved. In 43 (78.2%) patients in whom no change or decrease in medication during the follow-up period, excluding the effect of drugs, DAS28-ESR also decreased significantly from 3.53 ± 1.17 to 3.16 ± 1.16 at 6 months, and to 3.16 ± 0.98 at 12 months.

CONCLUSIONS

Lower limb surgery performed under biological therapy enhances the effects of not only improving joint function but also of ameliorating systemic disease activity.

Prognostic value of preoperative inflammation-based prognostic scores in patients with stage IV colorectal cancer who undergo palliative resection of asymptomatic primary tumors

BACKGROUND

The need for palliative resection of asymptomatic primary tumor in patients with unresectable metastatic colorectal cancer (CRC) is still controversial. In order to identify predictors of survival after palliative resection, we investigated the correlations between clinicopathological factors, preoperative Glasgow prognostic score (GPS) and neutrophil-to-lymphocyte ratio (NLR), and survival.

PATIENTS AND METHODS

A total of 94 patients were enrolled in the present study. The prognostic value of the clinicopathological factors, GPS and NLR were analyzed retrospectively.

RESULTS

A multivariate analysis revealed that both the GPS and NLR were independent predictors of survival along with the preoperative Eastern Cooperative Oncology Group performance status (PS) and extent of distant metastasis. We classified the patients using a combination of these factors, and categorized them into three risk groups. The median survival time was five months in the high-risk group, compared to 21.5 months in the intermediate-risk group and 37 months in the low-risk group.

CONCLUSION

Sub-classification based on the GPS, NLR, PS and extent of distant metastasis can classify patients into three independent groups. There may be no survival benefits associated with palliative resection in the high-risk group.

[A case of locally advanced pancreatic cancer with hepatic artery invasion treated with neoadjuvant chemoradiotherapy]

A 64-year-old man with a high serum level of cancer antigen 19-9 (CA19-9) was diagnosed with pancreatic head cancer by computed tomography. Because the tumor was found to have directly invaded the hepatic artery for long segment on laparotomy, we diagnosed it as an unresectable locally advanced pancreatic cancer. Radiation therapy( 50.4 Gy/28 Fr) with gemcitabine( GEM)( 1,000 mg/m2 on days 1, 8, and 15, every 4 weeks) for 3 courses was administered. Subsequently, additional systemic chemotherapy with GEM( 800 mg/m2 on days 1 and 15, every 3 weeks) and S-1( 100 mg/body on days 1-14, every 3 weeks) was administered for 4 courses. After the treatment, the main tumor shrunk without distant metastasis. Thus, we performed pancreaticoduodenectomy with resection of the common hepatic artery. An end-to-end microvascular anastomosis was made between the left gastric artery and the right hepatic artery. Pathological examination revealed that > 90% of the tumor cells had disappeared and confirmed a negative margin status (R0). Eight months postoperatively, the patient is healthy and shows no signs of recurrence.

Breaking down lignin to high-value chemicals: the conversion of lignocellulose to vanillin in a gene deletion mutant of Rhodococcus jostii RHA1

The aromatic polymer lignin represents a possible renewable source of aromatic chemicals, if biocatalytic routes for lignin breakdown can be developed. The availability of a genome sequence for Rhodococcus jostii RHA1, a bacterium that breaks down lignin, has allowed the application of a targeted pathway engineering strategy to lignin breakdown to produce vanillin, a valuable food/flavor chemical. A gene deletion strain of R. jostii RHA1 in which the vanillin dehydrogenase gene had been deleted, when grown on minimal medium containing 2.5% wheat straw lignocellulose and 0.05% glucose, was found to accumulate vanillin with yields of up to 96 mg/L after 144 h, together with smaller amounts of ferulic acid and 4-hydroxybenzaldehyde.

Regulation of the KstR2 regulon of Mycobacterium tuberculosis by a cholesterol catabolite

Cholesterol catabolism is widespread in actinobacteria and is critical for Mycobacterium tuberculosis (Mtb) virulence. Catabolism of steroid nucleus rings C and D is poorly understood: it is initiated by the CoA thioesterification of 3aα-H-4α(3'-propanoate)-7aβ-methylhexahydro-1,5-indanedione (HIP) by FadD3, whose gene is part of the KstR2 regulon. In Mtb, genes of this regulon were upregulated up to 30- and 22-fold during growth on cholesterol and HIP, respectively, versus another minimal medium. In contrast, genes involved in degrading the cholesterol side-chain and nucleus rings A and B were only upregulated during growth on cholesterol. Similar results were obtained in Rhodococcus jostii RHA1. Moreover, the regulon was not upregulated in a ΔfadD3 mutant unable to produce HIP-CoA. In electrophoretic mobility shift assays, HIP-CoA relieved the binding of KstR2(Mtb) to each of three KstR2 boxes: CoASH, HIP and a related CoA thioester did not. Inspection of the structure of KstR2(RHA1) revealed no obvious HIP-CoA binding pocket. The results establish that Mtb can catabolize the entire cholesterol molecule and that HIP-CoA is an effector of KstR2. They further indicate that KstR2 specifically represses the expression of the HIP degradation genes in actinobacteria, which encode a lower pathway involved in the catabolism of multiple steroids.

Abstract 4054: Significance of CXCR4/SDF-1 axis expression in gastric cancer under hypoxic enviroment

Background: Various types of solid tumors, including gastric cancer, have a heterogeneously hypoxic environment which has been currently considered to be associated with aggressive tumor phenotypes cancer. Stromal cell-derived factor (SDF)-1 and C-X-C chemokine receptor type 4 (CXCR-4) form an important chemokine/receptor pair, and are supposed to be up-regulated by hypoxia inducible factor-1 (HIF-1). Although the chemokine signaling is associated with malignant potential of various carcinomas, few studies have addressed the expression and function of CXCR4 and SDF-1 under hypoxia in gastric cancer. The aim of our study was to clarify the significance of CXCR4 and SDF-1 under hypoxia in gastric carcinoma by evaluating the expression of a hypoxic marker, a carbonic anhydrase 9 (CA-9).

Experimental Design: A total of 297 patients who had undergone a resection of the primary tumor and were confirmed histologically to have sporadic gastric cancer were enrolled in this study. Expressions of CXCR4, SDF-1, and CA-9, were assessed by immunohistochemistry. We examined the association between the expression levels of CXCR4, SDF-1, and CA-9 and clinicopathologic variables of patients with gastric cancers. Furthermore, using three diffuse-type gastric cancer cell lines, OCUM-2M, OCUM-2MD3, and OCUM-12, expression level of CXCR4 and SDF-1 in hypoxia (1% O2) were examined by RT-PCR.

Results: CA-9 expression was found in 48% (143/297) of gastric cancers, CXCR4 was 47% (141/297), and SDF-1 was 41% (122/297). The CA9 expression was significantly correlated with CXCR4 expression and SDF-1. The CA9 expression level was significantly high in cases diffuse-type carcinoma (p=0.028). The prognosis for CA-9-positive patients was significantly poorer than that of CA-9-negative patients (p<0.001,log-rank). The CXCR4 expression level was significantly correlated with lymph node metastasis (p<0.001), and with higher stages (p<0.001). The SDF-1 expression level was significantly higher with lymph node metastasis(p<0.001), and with higher stages (p<0.001). The prognosis for CXCR4-positive patients was significantly poorer than that of CXCR4-negative patients (p<0.001, log-rank). The prognosis for SDF-1-positive patients was significantly poorer than that of SDF-1-negative patients (p=0.008, log-rank). The expression level of CXCR4 mRNA was significantly increased by hypoxia, in comparison with that in normoxia in all of gastric cancer cells.

Conclusion: CXCR4/SDF-1 expression of gastric cancer cells might be regulated with by hypoxic condition. CXCR4/SDF-1 axis might play an important role for the progression of diffuse-type gastric carcinoma with hypoxic environment.

Citation Format: Haruhito Kinoshita, Masakazu Yashiro, Tamami Morisaki, Tatsunari Fukuoka, Tsuyoshi Hasegawa, Toshiki Hirakawa, Naoki Aomatsu, Katsunobu Sakurai, Kenjiro Kimura, Hisashi Nagahara, Takahiro Toyokawa, Ryosuke Amano, Eiji Noda, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Hiroshi Otani, Kiyoshi Maeda, Masaichi Ohira, Kosei Hirakawa. Significance of CXCR4/SDF-1 axis expression in gastric cancer under hypoxic enviroment. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4054. doi:10.1158/1538-7445.AM2013-4054

Abstract 3995: Antitumor effect of prostaglandin D2 by peroxisome proliferator-activated receptor gamma (PPARγ)-dependent pathway in gastric carcinoma

Introduction: Prostaglandin D2 (PGD2) has been demonstrated to have not only physiological responses but also anti-tumor effects against some types of cancer cells such as a lung cancer. PGD2 act through two major receptors, DP1 and DP2 of chemoattractant receptor-like molecule on the Th2 cell. Recently, some papers reported that PGD2 may act through PPARγ, suggesting that the effects of PGD2 are involved in either PGD2 dependent or independent pathway. PGD2 metabolite, 15-deoxy-Δ12 14-PGJ2, activates peroxisome proliferator-activated receptor γ (PPARγ) which induces growth inhibition of various cells. PPARγ is expressed in various types of cancers including gastric cancer. Since the role of PGD2 on gastric cancer cells is still unknown, this study is aimed to investigate the effect of PGD2 signalings on the proliferation of gastric cancer cells.

Materials and Methods: Three human gastric cancer cell lines, OCUM-2M, OCUM-12, and MKN-74, were used. Effect of PGD2 or PPARγ antagonist on the proliferation of cancer cells was examined by MTT assay.

The expression level of PGD2 receptor, DP1 and DP2, and PPARγ of gastric cancer cells was examined by RT-PCR. The effect of PGD2 on cell cycle was examined with PI staining by flowcytometry.

Results: PGD2 significantly decreased the proliferation of OCUM-2M and MKN-74 cells at a dose-dependent manner, but not that of OCUM-12. PGD2 receptors, DP1 and DP2, were not expressed in 3 gastric cancer cell lines while PPARγ was expressed in OCUM-2M and MKN-74. BADGE, a PPARγ antagonist, significantly suppressed the growth-inhibitory effects of PGD2 on OCUM-2M and MKN-74 cells. PGD2 increased G0/G1 phase of cancer and decereased G2/M phase.

Conclusion: PGD2 decreased the proliferation of gastric cancer cells through PPARγ dependent pathway. PGD2 might be a promising therapeutic agent for gastric cancer with PPARγ expression.

Citation Format: Tatsunari Fukuoka, Masakazu Yashiro, Hiroshi Takeda, Takayuki Maruyama, Haruhito Kinoshita, Tamammi Morisaki, Tsuyoshi Hasegawa, Toshiki Hirakawa, Naoki Aomatsu, Katsunobu Sakurai, Kenjiro Kimura, Hisashi Nagahara, Takahiro Toyokawa, Ryosuke Amano, Eiji Noda, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Hiroshi Otani, Kiyoshi Maeda, Masaichi Ohira, Kosei Hirakawa. Antitumor effect of prostaglandin D2 by peroxisome proliferator-activated receptor gamma (PPARγ)-dependent pathway in gastric carcinoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3995. doi:10.1158/1538-7445.AM2013-3995

Procalcitonin is a specific marker for detecting bacterial infection in patients with rheumatoid arthritis

OBJECTIVE

Rheumatoid arthritis (RA) is a chronic inflammatory disease accompanied by many complications, and serious infections are associated with many of the advanced therapeutics used to treat it. We assessed serum procalcitonin (PCT) levels to distinguish bacterial infection from other complications in patients with RA.

METHODS

One hundred eighteen patients experiencing an RA flare, noninfectious complication of RA or its treatment, nonbacterial infection, or bacterial infection were studied. Serum PCT concentrations were determined with a chemiluminescent enzyme immunoassay.

RESULTS

All patients experiencing an RA flare showed negative PCT levels (≤ 0.1 ng/ml; n = 18). The PCT level was higher in the bacterial infection group (25.8% had levels ≥ 0.5 ng/ml) than in the other 3 groups (0.0-4.3% had levels ≥ 0.5 ng/ml) and the difference was significant among groups (p = 0.003). Conversely, no statistically significant difference was observed among the groups with C-reactive protein (CRP) concentration ≥ 0.3 mg/dl (p = 0.513), white blood cell (WBC) count > 8500/mm(3) (p = 0.053), or erythrocyte sedimentation rate (ESR) > 15 mm/h (p = 0.328). The OR of high PCT level (≥ 0.5 ng/ml) for detection of bacterial infection was 19.13 (95% CI 2.44-149.78, p = 0.005). Specificity and positive likelihood ratio of PCT ≥ 0.5 ng/ml were highest (98.2% and 14.33, respectively) for detection of bacterial infection, although the sensitivity was low (25.8%).

CONCLUSION

Serum PCT level is a more specific marker for detection of bacterial infection than either CRP, ESR, or WBC count in patients with RA. High PCT levels (≥ 0.5 ng/ml) strongly suggest bacterial infection. However, PCT < 0.5 ng/ml, even if < 0.2 ng/ml, does not rule out bacterial infection and physicians should treat appropriately.