Inhibitory effect of a serine protease inhibitor, FOY-305 on the invasion and metastasis of human pancreatic cancers

We examined the inhibitory effect of a serine protease inhibitor, FOY-305, on the invasion and metastasis of human pancreatic cancers. The in vitro matrigel invasion assay showed that the invasiveness of Capan-1 human pancreatic cancer cells was inhibited by FOY-305 treatment in a dose-dependent manner at concentrations greater than 100 nM. Intrasplenic injection of Capan-1 cells in nude mice resulted in frequent metastases to liver, however, its incidence was significantly decreased by FOY-305 treatment. These findings suggest that a serine protease inhibitor, FOY-305 can inhibit tumor invasion and metastasis by blocking the serine protease-mediated activation cascade.

[A case of rectal cancer with lymph node metastasis (N4) successfully treated with low-dose cisplatin and UFT]

A 65-year-old man was admitted to our hospital due to the swelling of bilateral inguinal lymph nodes and anal discomfort. Sigmoidoscopy revealed a type-1 tumor of the lower rectum which was histologically diagnosed as a poorly-differentiated adenocarcinoma, and inguinal lymph node biopsy showed metastatic adenocarcinoma. An abdominal CT scan revealed swelling of the paraaortic lymph nodes. After a full explanation of the treatment options, the patient chose chemotherapy. Treatment by intravenous infusion of 7.5 mg/body/day of cisplatin for 5 days a week and oral administration of 600 mg/day of UFT was carried out. After 4 weeks of treatment, the primary tumor and swelling of the paraaortic lymph nodes had disappeared, and there was a 61% reduction in the inguinal lymph nodes. Four months later, the primary lesion recurred but vanished again following the same treatment regimen for 6 weeks. The patient has been in good health for over 9 months with no adverse effects from the chemotherapy.

[A case of small cell carcinoma of the stomach with multiple liver and lung metastases successfully treated by combined chemotherapy with cisplatin and etoposide]

We experienced a case of small cell carcinoma of the stomach in which chemotherapy had been markedly effective. A 54-year-old man was admitted to our hospital complaining of hematemesis. Gastric endoscopy showed a type 2 tumor at the lesser curvature of the cardia of the remnant stomach. Total gastrectomy, splenectomy and D2 lymph node dissection were performed. Histopathologically, the tumor was diagnosed as a small cell carcinoma with findings of t 2 n 1 in stage II, and conclusive curability was A. A month after the operation, CT-scan revealed multiple liver and lung metastases, so the patient was treated by combined chemotherapy with cisplatin and etoposide called PVP for three courses every four weeks for small cell lung cancer, which resulted in remarkable reduction of metastases (96% in the liver and 81% in the lung). This result suggests that PVP chemotherapy is effective in the treatment of small cell carcinoma of the stomach as well as the lung.

Bafilomycin A1 induces apoptosis in the human pancreatic cancer cell line Capan-1

Bafilomycin A1, a specific inhibitor of vacuolar type H(+)-ATPase, can inhibit the growth of a variety of cultured cells in a dose-dependent manner, but its mechanism is unclear. The aim of this study was to examine whether bafilomycin A1 inhibits the growth of Capan-1 human pancreatic cancer cells through apoptosis. The effect of bafilomycin A1 on tumour growth in vitro and in vivo was examined using an MTT assay and an in vivo tumour model. The presence or absence of apoptosis was determined by morphology and DNA analysis of tumour cells. The concentration of bafilomycin A1 for 50 per cent inhibition of cell viability during 72 h by the MTT assay was 5 nm. In DNA analysis, a ladder of fragmented DNA was detected in Capan-1 cells treated with bafilomycin A1 at concentrations greater than 10 nm for 24 h. Nude mice bearing a xenografted Capan-1 cell line tumour received 4 weeks of bafilomycin A1 (1.0 mg/kg per day). This treatment significantly inhibited tumour growth compared with controls after 21 days (P < 0.05). Histopathological examination of tumour cells in the treated group demonstrated signs of apoptosis with chromatin condensation and cell shrinkage. These observations suggest that bafilomycin A1 inhibits the growth of Capan-1 human pancreatic cancer cells through apoptosis.

Neurotrophin-3 expression in human pancreatic cancers

Some neurotrophic factors stimulate process outgrowth in peripheral and/or central nerve fibres. There is no published report that has focused on the expression of neurotrophic factors in human pancreatic cancer except basic fibroblast growth factor. This study was therefore designed to examine the mRNA and protein levels of neurotrophin-3 (NT-3), which is one of the representative neurotrophic factors. The mRNA level for NT-3 was first investigated in eight pancreatic cancers and two samples of normal pancreas, using reverse transcription-polymerase chain reaction (RT-PCR). NT-3 protein expression was then studied in 47 human pancreatic cancers, using a monoclonal antibody against human NT-3 protein. There was a notable difference in the level of NT-3 mRNA between normal and pancreatic carcinoma tissues, with no evident difference in the expression of the beta-actin gene. Immunohistochemically, 34 of 47 pancreatic cancers (72 per cent) were mildly to markedly immunoreactive for NT-3 in the cytoplasma. Immunoreactivity was usually more pronounced at the infiltrative margins of the tumours. These observations suggest that pancreatic carcinoma overexpresses NT-3.

Neurotrophin-3 expression in human pancreatic cancers

Some neurotrophic factors stimulate process outgrowth in peripheral and/or central nerve fibres. There is no published report that has focused on the expression of neurotrophic factors in human pancreatic cancer except basic fibroblast growth factor. This study was therefore designed to examine the mRNA and protein levels of neurotrophin-3 (NT-3), which is one of the representative neurotrophic factors. The mRNA level for NT-3 was first investigated in eight pancreatic cancers and two samples of normal pancreas, using reverse transcription-polymerase chain reaction (RT-PCR). NT-3 protein expression was then studied in 47 human pancreatic cancers, using a monoclonal antibody against human NT-3 protein. There was a notable difference in the level of NT-3 mRNA between normal and pancreatic carcinoma tissues, with no evident difference in the expression of the beta-actin gene. Immunohistochemically, 34 of 47 pancreatic cancers (72 per cent) were mildly to markedly immunoreactive for NT-3 in the cytoplasma. Immunoreactivity was usually more pronounced at the infiltrative margins of the tumours. These observations suggest that pancreatic carcinoma overexpresses NT-3.

Lymphatic flow and neural plexus invasion associated with carcinoma of the body and tail of the pancreas

BACKGROUND

Lymph node status and neural plexus invasion are the most important prognostic factors that may be amenable to surgery for carcinoma of the body and tail of the pancreas. The pattern of lymphatic spread and neural plexus invasion were evaluated by analysis of various clinicopathologic factors.

METHODS

Twenty patients with carcinoma of the body and tail of the pancreas underwent pancreatectomy with systemic regional lymph node dissection at Kanazawa University Hospital. A precise evaluation of their lymph node involvement and neural plexus invasion was determined.

RESULTS

Sixteen of 20 patients (80%) had lymph node involvement. The lymph nodes with a high metastatic rate were those along the splenic artery (50%), the inferior body lymph nodes (35%), the lymph nodes around the common hepatic artery (25%), and the paraaortic lymph nodes (20%). There was no relationship between tumor size, histologic type, and lymph node involvement. Plexus invasion was observed in 14 patients (70%). The most frequent site was the splenic plexus, but between 15% and 20% of the patients had celiac or superior mesenteric plexus invasion. There was no relationship between tumor size, histologic type, and neural plexus invasion.

CONCLUSIONS

Based on these results, extended lymphadenectomy including the paraaortic lymph nodes, celiac lymph nodes, and superior mesenteric lymph nodes may improve the prognosis for patients with carcinoma of the body and tail of the pancreas. Extrapancreatic neural plexus dissection, especially of the celiac plexus and superior mesenteric plexus, also is necessary.

Lymphatic flow and neural plexus invasion associated with carcinoma of the body and tail of the pancreas

BACKGROUND

Lymph node status and neural plexus invasion are the most important prognostic factors that may be amenable to surgery for carcinoma of the body and tail of the pancreas. The pattern of lymphatic spread and neural plexus invasion were evaluated by analysis of various clinicopathologic factors.

METHODS

Twenty patients with carcinoma of the body and tail of the pancreas underwent pancreatectomy with systemic regional lymph node dissection at Kanazawa University Hospital. A precise evaluation of their lymph node involvement and neural plexus invasion was determined.

RESULTS

Sixteen of 20 patients (80%) had lymph node involvement. The lymph nodes with a high metastatic rate were those along the splenic artery (50%), the inferior body lymph nodes (35%), the lymph nodes around the common hepatic artery (25%), and the paraaortic lymph nodes (20%). There was no relationship between tumor size, histologic type, and lymph node involvement. Plexus invasion was observed in 14 patients (70%). The most frequent site was the splenic plexus, but between 15% and 20% of the patients had celiac or superior mesenteric plexus invasion. There was no relationship between tumor size, histologic type, and neural plexus invasion.

CONCLUSIONS

Based on these results, extended lymphadenectomy including the paraaortic lymph nodes, celiac lymph nodes, and superior mesenteric lymph nodes may improve the prognosis for patients with carcinoma of the body and tail of the pancreas. Extrapancreatic neural plexus dissection, especially of the celiac plexus and superior mesenteric plexus, also is necessary.

[A new strategy for the therapy of pancreatic cancer by proton pump inhibitor]

Bafilomycin A1 is a specific inhibitor of vacuolar type proton pump (V-ATPase). This study was designed to examine the effect of bafilomycin A1 on the growth of Capan-1 human pancreatic cells which overexpress V-ATPase. Nude mice bearing a xenografted tumor of Capan-1 cell line were treated for 4 weeks with bafilomycin A1 (1.0 mg/kg/day). This treatment inhibited tumor growth, which was significantly reduced as compared with controls after 21 days (p < 0.05). However, there were no significant differences in body weights between groups. Microscopically, a large number of tumor cells in the treated group showed signs of apoptosis. These findings suggest that apoptosis induced by bafilomycin A1 was the event involved in suppression of tumor growth in vivo.

[Inhibitory effect of FOY-305 on liver metastasis of the pancreatic cancer]

The potential for hepatic metastasis in nude mice was studied by the intrasplenic implantation method with five human pancreatic cancer cell lines, Capan-1, BxPC-3, AsPC-1, Panc-1, and MIAPaCa-2, especially in relation to serine protease expression, including urokinase-type plasminogen activator and pancreatic trypsinogen 1 (cationic form). The inhibitory effect of a serine protease inhibitor agent, FOY-305, on hepatic metastasis was also a assessed. As a result, the potential for hepatic metastasis was well correlated with expression of pancreatic trypsinogen 1 in these cell lines, and the incidence of metastasis was significantly decreased by FOY-305. These findings suggest that pharmacologic inhibition of serine protease activity may be a new strategy for the therapy of pancreatic cancer metastasis.

Expression of 16 kDa proteolipid of vacuolar-type H(+)-ATPase in human pancreatic cancer

Recent studies have shown that bafilomycin A1-sensitive vacuolar-type H(+)-ATPase (V-ATPase) plays important roles in cell growth and differentiation. However, there is no published study that has focused on the expression of V-ATPase in human tumour tissues. This study was designed to examine the mRNA and protein levels for the 16 kilodalton (kDa) proteolipid of V-ATPase in human pancreatic carcinoma tissues. We first investigated the mRNA level for V-ATPase in six cases of invasive pancreatic cancers and two normal pancreases, using reverse transcription-polymerase chain reaction technique. Then, we examined immunohistochemically the level of V-ATPase protein in 49 pancreatic cancers and ten benign cystic neoplasms of the pancreas, using antisera raised against the 16 kDa proteolipid. There was a notable difference in the level of V-ATPase mRNA between normal and pancreatic carcinoma tissues, with no evident difference in the expression of the beta-actin gene. Immunohistochemically, 42 out of 46 invasive ductal cancers (92%) displayed a mild to marked immunoreactivity for V-ATPase in the cytoplasm, whereas neither non-invasive ductal cancers nor benign cystic neoplasms expressed detectable immunoreactive proteins. These findings suggest that the overexpression of V-ATPase protein is characteristic of invasive pancreatic tumours. V-ATPase may play some crucial roles in tumour progression.

[Candidiasis in the field of gastroenterological surgery]

Postoperative candidiasis in the gastroenterological surgery has an increasing tendency with poor prognosis particularly in generalized cases. Candida is difficult to be specified as infectious agent only by culture findings, and has a problem on rapidity and sensitivity. Furthermore, also as for the time starting antifungal treatment, the start after the blood culture has given positive result is problematic. We analyzed the present state of candidiasis in our department and studied its background factors. Totaling of 4,424 samples from all of bacterial and fungal culture tests performed at our department for recent 9 years revealed detection of Candida with the incidence of 24%. The incidence was about 2.5 times increased in the former half of the period as compared with the later half of the period. The background factors were intravenous hyperalimentation, major operations (long operative time, insertion of many drains), splenectomy, pancreatectomy, intensive chemotherapy, radiation therapy, hyperthermia therapy, aging, continuous use of steroids, etc. Then, we determined concentrations of beta-D-glucan, a fungal component, and evaluated the results since it is being applied to early diagnosis of candidiasis. We performed early antifungal treatment before confirmation of positive culture finding in high risk group of candidiasis and obtained effective results.