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Yonenaga Y, Yokoyama S. Isolated liver metastasis detected 11 years after the curative resection of rectal cancer: A case report. World J Clin Cases 2021; 9:8923-8931. [PMID: 34734076 PMCID: PMC8546816 DOI: 10.12998/wjcc.v9.i29.8923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/06/2021] [Accepted: 08/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The duration of surveillance after curative resection of colorectal cancer (CRC) is generally 5 years. The overall incidence of recurrence more than 5 years after surgery for CRC in Japan has been reported to be 0.6%. Moreover, it is rare for CRC to have metachronous liver metastasis more than 10 years after surgery. Here, we present a case of liver metastasis detected 11 years after the curative resection of rectal cancer.
CASE SUMMARY A 72-year-old man was referred to our hospital after a liver tumor was detected by abdominal ultrasonography at another hospital. He had undergone surgery for rectal cancer 11 years previously. Contrast-enhanced computed tomography (CT) showed a tumor with a diameter of approximately 8 cm in the posterior segment, which was weakly and gradually enhanced. 18F-fluorodeoxyglucose-positron emission tomography/CT showed an abnormally high uptake on the tumorous lesion, which showed that the tumor appeared to spread convexly along the intrahepatic bile ducts. Intrahepatic cholangiocarcinoma was therefore diagnosed, and he had an extended right posterior sectionectomy and regional lymph node dissection. Histopathological examination showed that the tumor was a moderately differentiated adenocarcinoma and showed the same pathological characteristics as the rectal cancer. Immunohistological examination showed that the cancer cells of both the liver tumor and rectal cancer were positive for cytokeratin (CK) 20 and weakly positive for CK 7. These findings were consistent with the liver metastasis from the rectal cancer.
CONCLUSION It is possible that a liver tumor is metastatic in a patient with a previous history of CRC, even if it was more than 10 years earlier.
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Affiliation(s)
- Yoshikuni Yonenaga
- Department of Surgery, Ako City Hospital, Ako 678-0232, Hyogo, Japan
- Department of Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama 640-8558, Wakayama, Japan
| | - Satoshi Yokoyama
- Department of Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama 640-8558, Wakayama, Japan
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Yonenaga Y, Ichimiya M, Uyama S. [Multiple Intussusceptions Caused by Small Intestinal Metastases of the Nasal Cavity from Malignant Melanoma-A Case Report]. Gan To Kagaku Ryoho 2021; 48:89-91. [PMID: 33468731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 77-year-old woman, who underwent surgery for malignant melanoma of the nasal cavity 15 months prior and radiation and interferon-β therapy for local recurrence, presented with epigastric discomfort. PET-CT examination showed multiple intussusceptions due to small intestinal tumors. Four intussusceptions were detected during laparotomy, and she underwent partial resection of the small intestine. Pathological findings revealed small intestinal metastases that originated from malignant melanoma. Following administration of nivolumab, local recurrence disappeared, and she was well. Because the prognosis of malignant melanoma with systemic metastases has improved due to the administration of new drugs, such as nivolumab, the incidence of indications for surgery for metastatic melanomas of the gastrointestinal tract is expected to increase.
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Yonenaga Y, Nio M, Yata Y, Higashide S. [A Case of Alcoholic Liver Disease Presenting as Prominent Accumulation of Ascites Associated with Liver Damage Due to CapeOX]. Gan To Kagaku Ryoho 2017; 44:801-803. [PMID: 28912413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 75-year-old man with rectal cancer had consumed an average of6 6 g of alcohol per day for 47 years. However, his liver function was within normal limits and his Child-Pugh classification was A before initiation of therapy. He underwent neoadjuvant chemoradiation and a low anterior resection. The patient then received CapeOX as an adjuvant therapy. During the fourth cycle of CapeOX, computed tomography(CT)showed massive ascites. The chemotherapy was discontinued and treatment including a diuretic agent was initiated. The ascites gradually decreased and 8 months after the discontinuation of CapeOX, CT showed neither the presence ofascites nor recurrence ofthe cancer or metastasis. When a patient has a history ofexcessive alcohol intake, even iftest results for liver function are within normal limits, we should be aware ofthe hepatic toxicity ofCapeOX.
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Yokoyama S, Ueno K, Higashide Y, Noma A, Okishio Y, Masuda M, Miyamoto T, Kamimura R, Hosokawa S, Yonenaga Y, Ito D, Ichimiya M, Yamashita Y, Uyama S, Harb SEIG. Short- and long-term outcomes after pancreaticoduodenectomy following total gastorectomy: Report of case series and literature review. Int J Surg Case Rep 2016; 30:118-121. [PMID: 28012325 PMCID: PMC5192014 DOI: 10.1016/j.ijscr.2016.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/13/2016] [Accepted: 11/13/2016] [Indexed: 12/01/2022] Open
Abstract
Pancreaticoduodenectomy (PD) following gastrectomy (TG) should be considered challenging even currently although its procedure and clinical value have been being standardized. Short- and long-term outcomes as well as standard reconstruction method following these procedures remain unclear. In order to clarify these issues, we reviewed worldwide English literature and 4 of our own cases of PD for patients with previous TG. In cases of PD following TG, previously-made Y-limb should not be used for reconstruction following PD because of probable cause of previously-made Y-limb for ALS. Long-term outcomes of PD after TG seemed unsatisfactory notably in cases of pancreatic cancer and thus application of PD for patients with previous TG should be carefully decided until reasonable explanation for this dismal outcome is obtained.
Purpose Pancreaticoduodenectomy (PD) following gastrectomy (TG) should be considered challenging even currently although its procedure and clinical value have been being standardized. Short- and long-term outcomes as well as standard reconstruction method following these procedures remain unclear. In order to clarify these issues, we reviewed worldwide English literature and 4 of our own cases of PD for patients with previous TG. Methods Clinicopathological variables of 11 cases of PD for patients with previous TG were evaluated. Seven of these 11 were abstracted from a review of worldwide English literature and 4 of 11 were our own cases. Results 3 cases was reconstructed using Y-limb made in previous TG and afferent loop syndrome (ALS) was observed in 2 of 3, in these cases whereas no cases of ALS were found in cases reconstructed using newly-made Y-limb. In cases where PD was indicated for cancer, early cancer death, defined as death related to cancer recurrence observed within 2 years after PD, was observed in 6 of 9 cases. Notably in cases of pancreatic cancer recurrent cancer was diagnosed within 1 year after PD in 5 of 7 cases and 4 of these patients died of pancreatic cancer soon after recurrence. Conclusion In cases of PD following TG, previously-made Y-limb should not be used for reconstruction following PD because of probable cause of previously-made Y-limb for ALS. Long-term outcomes of PD after TG seemed unsatisfactory notably in cases of pancreatic cancer and thus application of PD for patients with previous TG should be carefully decided until reasonable explanation for this dismal outcome is obtained.
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Affiliation(s)
- Satoshi Yokoyama
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan.
| | - Kohei Ueno
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Yasuhiro Higashide
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Atsushi Noma
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Yuko Okishio
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Mitsuru Masuda
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Takumi Miyamoto
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Ryo Kamimura
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Shinichi Hosokawa
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Yoshikuni Yonenaga
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Daisuke Ito
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Masato Ichimiya
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Yoshito Yamashita
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Shiro Uyama
- Department of Surgery, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan
| | - Shady EIGhazly Harb
- Department of General Surgery, Faculty of Medicine, Cairo University, Al-Saray Street, El Manial, Cairo 11956, Egypt
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Yonenaga Y, Kushihata F, Watanabe J, Tohyama T, Inoue H, Sugita A, Takada Y. Localized 18F-fluorodeoxyglucose uptake at the pancreatic head during remission phase of autoimmune pancreatitis: A case report. Oncol Lett 2016; 12:1801-1805. [PMID: 27602112 PMCID: PMC4998295 DOI: 10.3892/ol.2016.4815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 03/15/2016] [Indexed: 01/14/2023] Open
Abstract
Autoimmune pancreatitis (AIP) is a unique form of pancreatitis, histopathologically characterized by dense lymphoplasmacytic infiltration and fibrosis of the pancreas with obliterative phlebitis. AIP is associated with a good response to steroid therapy. Differentiation between AIP and pancreatic cancer to determine a preoperative diagnosis is often challenging, despite the use of various diagnostic modalities, including computed tomography (CT), magnetic resonance imaging and endoscopic retrograde cholangiopancreatography. It has been reported that 18F-fluorodeoxyglucose (18F-FDG)-positron emission tomography (PET)/CT may be a useful tool for distinguishing between the two diseases. In the present case report, a 71-year-old male patient presented with a well-circumscribed, solitary, nodular and homogenous 18F-FDG uptake at the pancreatic head, while receiving maintenance steroid therapy in the remission phase of AIP; preoperatively, the patient had been strongly suspected of having pancreatic cancer. Pathological examination revealed post-treatment relapse of AIP. The present case highlights the diagnostic and management difficulties with AIP in the remission phase. In certain cases, it remains challenging to differentiate the two diseases, even using the latest modalities.
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Affiliation(s)
- Yoshikuni Yonenaga
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan; Department of Surgery, Nagahama City Hospital, Nagahama, Shiga 526-8580, Japan
| | - Fumiki Kushihata
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Jota Watanabe
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Taiji Tohyama
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Hitoshi Inoue
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Atsuro Sugita
- Pathology Division, Ehime University Hospital, Toon, Ehime 791-0295, Japan
| | - Yasutsugu Takada
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
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Yonenaga Y, Kurosawa M, Mise M, Yamagishi M, Higashide S. Pancreatic-type Acinar Cell Carcinoma of the Stomach Included in Multiple Primary Carcinomas. Anticancer Res 2016; 36:2855-64. [PMID: 27272797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/04/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND/AIM Pancreatic-type acinar cell carcinoma (ACC) in the stomach is extraordinarily rare. We pathologically examined two cases with multiple primary carcinomas, including gastric tumors. PATIENTS AND METHODS Gastric cancer specimens were examined by immunostaining and electron microscopy. RESULTS Both cases had cancer cells with acinar patterns, resembling pancreatic ACC. The cancer cells in the first case were positive for exocrine markers, including chymotrypsin, lipase and alpha-1 antichymotrypsin (ACT), as well as neuroendocrine markers, including chromogranin A and synaptophysin. The cancer cells in the second case were positive for chymotrypsin and alpha-1 ACT, while being slightly positive for chromogranin A and synaptophysin. Ultrastructurally, cancer cells contained zymogen granules in both cases. The final diagnosis was pancreatic mixed acinar-neuroendocrine carcinoma and pure pancreatic ACC, respectively. CONCLUSION We confirmed two cases with gastric pancreatic-type ACC included in multiple primary carcinomas. This type of double cancer has not been reported previously.
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Affiliation(s)
| | - Manabu Kurosawa
- Department of Diagnostic Pathology, Nagahama City Hospital, Nagahama, Japan
| | - Masahiro Mise
- Department of Surgery, Nagahama City Hospital, Nagahama, Japan
| | - Miki Yamagishi
- Department of Nursing, Nagahama City Hospital, Nagahama, Japan
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Morimoto T, Yata Y, Nio M, Yonenaga Y, Hanaki K, Mise M, Higashide S, Kanda Y, Noda H. [A Case of Squamous Cell Carcinoma of the Esophagus with Achalasia -- Conversion from Chemoradiotherapy to Surgery]. Gan To Kagaku Ryoho 2016; 43:447-449. [PMID: 27220791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The patient was a 67-year-old woman with achalasia and squamous cell carcinoma(SCC)of the esophagus. She presented with a difficulty in swallowing. The cancer was on the surface of the esophagus. The patient initially received systemic chemotherapy with 5-FU and cisplatin, and radiation therapy. The difficulty in swallowing persisted due to insufficiency of radiation treatment caused by achalasia. Therefore, we shifted the treatment plan from chemoradiotherapy to surgery. Endoscopic examination performed before surgery showed that there was no obvious cancer in the esophagus. We resected the esophagus routinely. On the specimen, no cancer cells were detected upon macroscopic and microscopic examinations; metastasis was not detected in the lymph node. Achalasia is a recognized risk factor for esophageal SCC. In the treatment of superficial SCC, no difference of therapeutic effect was observed between surgery and chemoradiation. However, for the treatment of certain cases of SCC with achalasia, including the treatment of achalasia itself, surgery can be the preferred option of treatment.
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Yonenaga Y, Kushihata F, Inoue H, Watanabe J, Tohyama T, Sugita A, Takada Y. Sarcoidosis manifesting as hepatic and splenic nodules mimicking ovarian cancer metastases: A case report. Oncol Lett 2015; 10:2166-2170. [PMID: 26622813 PMCID: PMC4579816 DOI: 10.3892/ol.2015.3566] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 06/05/2015] [Indexed: 12/15/2022] Open
Abstract
The current study presents a case of sarcoidosis manifesting as hepatic and splenic nodules, which was difficult to differentiate from ovarian cancer metastases. A 24-year-old female, who was previously diagnosed with right ovarian cancer and underwent surgery at the age of 21, was found to have two nodules in the spleen revealed by contrast-enhanced computed tomography (CT). 18F-fluorodeoxyglucose positron emission tomography/CT revealed two abnormal high uptake lesions in the spleen and one abnormal high uptake lesion in the liver. Under a diagnosis of hepatic and splenic metastases from right ovarian cancer, a laparoscopic splenectomy and partial hepatectomy were performed. Histopathological examination showed that a large number of non-caseating epithelioid cell granulomas formed these nodules, which was compatible with sarcoidosis. This case indicates that it is difficult to distinguish sarcoidosis from metastatic disease even using the latest modalities, and that laparoscopic surgery is a minimally invasive and useful tool for forming a differential diagnosis.
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Affiliation(s)
- Yoshikuni Yonenaga
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan ; Department of Surgery, Nagahama City Hospital, Nagahama, Shiga 526-8580, Japan
| | - Fumiki Kushihata
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Hitoshi Inoue
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Jota Watanabe
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Taiji Tohyama
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Atsuro Sugita
- Pathology Division, Ehime University Hospital, Toon, Ehime 791-0295, Japan
| | - Yasutsugu Takada
- Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
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Watanabe E, Koizumi Y, Hirooka M, Ochi H, Tada F, Ishihara T, Tokumoto Y, Abe M, Yonenaga Y, Tohyama T, Takada Y, Hiasa Y, Onji M. Hepatocellular carcinoma in a chronic hepatitis C patient 15 years after achieving a sustained virological response. ACTA ACUST UNITED AC 2012. [DOI: 10.2957/kanzo.53.763] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mori A, Doi R, Yonenaga Y, Nakabo S, Yazumi S, Nakaya J, Kono F, Manabe T, Uemoto S. Xanthogranulomatous cholecystitis complicated with primary sclerosing cholangitis: report of a case. Surg Today 2010; 40:777-82. [PMID: 20676864 DOI: 10.1007/s00595-009-4138-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 05/07/2009] [Indexed: 01/06/2023]
Abstract
Patients with primary sclerosing cholangitis (PSC) are at an increased risk for biliary tract carcinoma. The preoperative diagnosis of a biliary tract tumor as a malignancy is difficult, even using new modalities such as multidetector computed tomography (MD-CT), magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiography (ERC), and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET). Surgery is considered to be first line of treatment when these examinations suggest the presence of malignancy in the biliary tract, depending on both the curability of the cancer and the impaired liver function due to PSC. The management of gallbladder masses in patients with PSC remains problematic due to difficulties with the precise diagnosis and adequate surgery. Xanthogranulomatous cholecystitis (XGC) is a type of chronic cholecystitis, and sometimes coexists with gallbladder cancer. It is very difficult to make a preoperative diagnosis differentiating these two diseases. This report presents the case of a patient with XGC, who had been suspected of having gallbladder cancer before surgery, because the tumorous lesion emerged within a year and showed a focally increased uptake by FDG-PET during the follow up for PSC for years. This is the first case of XGC discovered during treatment for PSC.
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Affiliation(s)
- Akira Mori
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Li X, Yonenaga Y, Seki T. Shortened ALK1 regulatory fragment maintains a specific activity in arteries feeding ischemic tissues. Gene Ther 2009; 16:1034-41. [DOI: 10.1038/gt.2009.53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Suzuki R, Yonenaga Y, Lan F, Seki T. An enhancer region of the ALK1 gene resides in its intron 2. FASEB J 2009. [DOI: 10.1096/fasebj.23.1_supplement.634.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Rumi Suzuki
- Department of PhysiologyMedical College of GeorgiaAugustaGA
| | | | - Fei Lan
- Department of PhysiologyMedical College of GeorgiaAugustaGA
| | - Tsugio Seki
- Department of PhysiologyMedical College of GeorgiaAugustaGA
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13
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Yonenaga Y, Mori A, Fujimoto A, Nagayama S, Tachibana T, Onodera H, Uemoto S. The administration of naked plasmid DNA into the liver induces antitumor innate immunity in a murine liver metastasis model. J Gene Med 2007; 9:299-307. [PMID: 17397091 DOI: 10.1002/jgm.1013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Gene therapy is a promising strategy against advanced cancer; however, the safety of viral vectors and the effectiveness of non-viral vectors have not yet been established. Recently, a hydrodynamics-based procedure was reported to be an effective and safe method to deliver and transduce DNA into the liver. Herein, we propose a strategy for liver metastasis by a hydrodynamics-based procedure to deliver naked non-coding plasmid DNA (pDNA) into the liver as an immunocompetent organ. METHODS AND RESULTS Mice received a rapid intravenous (i.v.) injection of naked pDNA in a large volume of saline (0.1 ml/g body weight). The single administration of a naked non-coding pDNA by the hydrodynamics-based procedure before tumor cell inoculation strongly suppressed liver metastasis formation. However, the usual i.v. injection (200 microl/body) of the same dose of naked pDNA could not suppress liver metastasis formation. Following the methylation of CpG sequences within the pDNA using CpG methylase, injection of the methylated pDNA by the hydrodynamics-based procedure could not suppress liver metastasis formation. Gadolinium chloride pretreatment did not interfere with this antitumor effect, but anti-asialo GM1 antiserum treatment did. These findings indicated that natural killer (NK) cells, not Kupffer cells, were involved in this antitumor effect. The NK cytotoxic activities of liver mononuclear cells were strongly enhanced after receiving a naked pDNA by the hydrodynamics-based procedure. CONCLUSIONS These observations suggest that unmethylated CpG motifs in pDNA stimulated immune cells, resulting in the activation of NK cells in the liver to suppress liver metastases in a murine model.
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Affiliation(s)
- Yoshikuni Yonenaga
- Department of Surgery, Graduate School of Medicine Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan.
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14
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Fujimoto A, Onodera H, Mori A, Nagayama S, Yonenaga Y, Tachibana T. Tumour plasticity and extravascular circulation in ECV304 human bladder carcinoma cells. Anticancer Res 2006; 26:59-69. [PMID: 16475680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND The concepts of vasculogenic mimicry and mosaic vessels have been proposed as novel modes of tumour neovascularisation. However, the presence and significance of these types of neovascularisation remain unclear. MATERIALS AND METHODS ECV304 human bladder carcinoma cells were used to determine how tumour cells take part in tumour neovascularisation. RESULTS Subcutaneous ECV304 xenografts in mice showed various vessel types, including angiogenic vessels, tumour cell-related vessels and extracellular matrix networks. A tracer experiment demonstrated perfusion of beads in these structures. ECV304 cells, cultured on collagen I gels, formed tube networks with expressions of several endothelial-related markers. In coculture models of ECV304 cells and human umbilical vein endothelial cells, the two cells collaborated to form sprouts or networks. CONCLUSION ECV304 cells possess an endothelial character which confers the ability to mimic and collaborate with vascular endothelial cells and facilitates the acquisition of tumour microcirculation.
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Affiliation(s)
- Akihisa Fujimoto
- Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
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Onodera H, Mori A, Nagayama S, Fujimoto A, Tachibana T, Yonenaga Y, Tsuruyama T. Fas/CD95 signaling rather than angiogenesis or proliferative activity is a useful prognostic factor in patients with resected liver metastases from colorectal cancer. Int J Colorectal Dis 2005; 20:477-84. [PMID: 15846499 DOI: 10.1007/s00384-004-0708-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2004] [Indexed: 02/04/2023]
Abstract
BACKGROUND The selection of resective therapy for colorectal hepatic metastases remains controversial. The aim of this study is to investigate the prognostic factors for patients with resected liver metastases from colorectal cancer by analyzing not only clinicopathological factors but also recent immunohistological markers. METHODS Eighty-five patients underwent hepatic resection for metastatic colorectal cancer over the past 20 years. Fas/CD95 expression, microvessel density, and proliferating cell nuclear antigen (PCNA) proliferative activity were assessed with immunohistochemical methods in addition to the clinicopathological factors. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards model, both univariately and multivariately. RESULTS Univariate and multivariate analyses revealed that the number of metastases, Fas/CD95 expression, and postoperative carcinoembryonic antigen doubling time (CEADT) were significant prognostic indicators, whereas the mode of hepatic resection, chemotherapy, and other clinicopathological factors had no influence on survival. Fas/CD95 index correlated with postoperative CEADT (p=0.039), number of metastases (p=0.018), and survival (p=0.023). CONCLUSIONS Our study confirmed the number of metastases and CEADT as prominent prognostic factors after hepatic resection for metastatic colorectal cancer. These two factors reflect the degree of Fas/CD95 signaling rather than angiogenesis or cancer growth rate.
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Affiliation(s)
- Hisashi Onodera
- Department of Surgery and Surgical Basic Science, Kyoto University, 54 Shogoin Kawara cho, Sakyo ku, Kyoto, 606-8507, Japan.
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Yonenaga Y, Mori A, Onodera H, Yasuda S, Oe H, Fujimoto A, Tachibana T, Imamura M. Absence of smooth muscle actin-positive pericyte coverage of tumor vessels correlates with hematogenous metastasis and prognosis of colorectal cancer patients. Oncology 2005; 69:159-66. [PMID: 16127287 DOI: 10.1159/000087840] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2004] [Accepted: 04/14/2005] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Immature microvessels, which are not covered by pericytes, are irregular and leaky. We hypothesized that tumor cells can penetrate immature microvessels more easily than mature microvessels. In this study, we investigated the maturation of angiogenesis by the immunohistochemical staining of colorectal cancer specimens and determined the correlation between the microvessel count or the maturity of microvessels and clinicopathological variables. METHODS Ninety-two surgical specimens from our department were used. Double immunostaining of endothelial cells with anti-CD34 antibody and pericytes with anti-alpha-smooth muscle actin antibody was performed. The microvessel density (MVD) and microvessel pericyte coverage index (MPI) as an index of microvessel maturation were evaluated. RESULTS The MVD showed a significant positive correlation with tumor size, depth of invasion and Dukes' stage. The MPI showed a significant positive correlation with the histological differentiation of the tumor tissues and distant metastasis at the time of operation. The high MVD group (> or =26.0, n = 50) tended to have a poorer prognosis than the low MVD group (<26.0, n = 42) (p = 0.097). Next, the 50 patients in the high MVD group were classified into two subgroups of high MPI (> or =78.1%, n = 25) and low MPI (<78.1%, n = 25). MPI showed a significant negative correlation with hematogenous metastasis, and the low MPI group demonstrated a significantly poorer survival than the high MPI group (p = 0.040). CONCLUSIONS These findings demonstrate that immature neovascularization was observed in poorly differentiated tumors and was correlated with metastasis, resulting in a poorer prognosis. Taken together, not only microvessel density but also vascular maturation were crucial factors for colorectal cancer patients.
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Affiliation(s)
- Yoshikuni Yonenaga
- Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Abstract
Although radiation enteritis is a well-recognized sequel of therapeutic irradiation, the standard surgical method is not universally agreed upon. Not only the short-term effect but also the long-term effect after a surgical intervention has been fairly well reported. To reassess the surgical therapy for radiation enteritis, we retrospectively analyzed 48 patients (5 males and 43 females, mean age 58.6 years) who had been operated on in our department. These patients were divided into two types according to the time of surgery or the clinical manifestation, and operative methods were analyzed. Patient's status such as bowel movement, body weight, and serum albumin value after surgery were analyzed, together with the patients survival. Our surgical methods were small intestinal resection for the intestinal obstruction, and pull-through reconstruction for proctitis. Two patients died of multiple organ failure caused by perforated peritonitis irrespective of emergent operation. Although the overall morbidity was 21.7%, there was no leakage when bowels were anastomosed. Overall survival after radiation-related complication in patients without previous neoplastic disease recurrence was 89%, 79%, and 69%, at 1, 3, and 5 years after surgery, respectively. Bowel motility, serum albumin level, and body weight recovered gradually soon after the operation and reached satisfactory levels within 6 months. Our analysis showed that small bowel injury should be treated by generous resection of the affected bowel followed by careful anastomosis of the disease-free ends, while rectal resection is best dealt with by restorative proctectomy. This may provide a good quality of life and minimize major postoperative complications such as leakage.
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Affiliation(s)
- Hisashi Onodera
- Department of Surgery & Surgical Basic Science, Kyoto University, 54 Shogoin Kawara cho, Sakyo ku, Kyoto 606-8507, Japan
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Fujimoto A, Onodera H, Mori A, Isobe N, Yasuda S, Oe H, Yonenaga Y, Tachibana T, Imamura M. Vascular endothelial growth factor reduces mural cell coverage of endothelial cells and induces sprouting rather than luminal division in an HT1080 tumour angiogenesis model. Int J Exp Pathol 2005; 85:355-64. [PMID: 15566432 PMCID: PMC2517531 DOI: 10.1111/j.0959-9673.2004.00404.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) plays a central role in tumour angiogenesis. In a mouse intramuscular tumour model using VEGF-transfected HT1080 human fibrosarcoma, we investigated the morphological features and patterns of remodelling in size-matched tumours. Compared with the control tumours (C group), the VEGF-transfected tumours (V group) showed vigorous neovascularization with larger vessels. Fenestrations and disruptions of endothelia were specific to the V group. Three types of vascular remodelling, i.e. sprouting, luminal division and intussusceptive microvascular growth, were present in both groups. Morphometric analyses revealed that mural cell coverage of the endothelial cells was significantly smaller in the V group compared with that in the C group (V group, 28.2 +/- 18.6%; C group, 41.6 +/- 21.1%; P < 0.0001). To determine the prevalence of remodelling patterns, the occurrences of abluminal and luminal processes on endothelial cell surfaces were quantified. Abluminal processes are defined as cytoplasmic protrusions of the abluminal membrane of endothelial cells, which can vary from tiny spurs to solid sprouts of the cell. On the other hand, luminal processes are defined as intraluminal protrusions of the endothelial cell membrane, including various membranous changes from filiform processes to rather thick cytoplasmic bulges. An abluminal process is thought to represent an initial morphological change in sprouting type angiogenesis, and a luminal process to be a sign of implementation of luminal division. The frequency of abluminal processes was significantly higher in the V group than in the C group (V group, 0.243 +/- 0.138/microm; C group, 0.114 +/- 0.101/microm; P < 0.0001). In contrast, the number of luminal processes on the endothelial cells per micrometre was statistically comparable between the groups (V group, 0.285 +/- 0.252/microm; C group, 0.309 +/- 0.236/microm, P = 0.381). These results indicate that sprouting is the main mode of VEGF-induced tumour angiogenesis.
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Affiliation(s)
- Akihisa Fujimoto
- Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, 54-Shogoin Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
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Yasuda S, Arii S, Mori A, Isobe N, Yang W, Oe H, Fujimoto A, Yonenaga Y, Sakashita H, Imamura M. Hexokinase II and VEGF expression in liver tumors: correlation with hypoxia-inducible factor 1 alpha and its significance. J Hepatol 2004; 40:117-23. [PMID: 14672622 DOI: 10.1016/s0168-8278(03)00503-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND/AIMS We analyzed the expressions of hexokinase II (HK II), a key enzyme in glycolysis, and VEGF in hepatocellular carcinoma (HCC) and metastatic liver cancer in relation to tumor vascularity, and the participation of hypoxia-inducible factor-1 (HIF-1) was studied. METHODS A real-time quantitative reverse transcription-polymerase chain reaction was performed to examine the HK II and VEGF mRNA expression. Expression of HIF-1 alpha and HK II protein, and microvessel density (MVD) were examined immunohistochemically. RESULTS MVD was significantly higher in HCCs than in metastatic liver cancers, and VEGF mRNA expression was positively correlated only with MVD of HCCs. HK II mRNA expression was significantly higher in metastatic liver cancers, however, some cases of HCC pretreated with transcatheter arterial embolization (TAE) showed marked HK II mRNA expression. Both HIF-1 alpha and HK II protein expressions were co-localized in the cancer cells near necrosis, and the intensity of HIF-1 alpha protein expression was significantly correlated with HK II mRNA expression in both tumors. CONCLUSIONS These results suggest that, in metastatic liver cancers, glycolysis induced by HIF-1 is the predominant energy source under the hypoxic environment and, at least in some TAE-pretreated HCC cases, cancer cells obtain energy for growth by switching the metabolic profile to glycolysis through HIF-1.
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Affiliation(s)
- Seiichi Yasuda
- Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, 54-Shogoin Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan.
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Yamada S, Mito T, Tanahashi S, Kubo H, Yonenaga Y, Watanabe R, Takahata K, Yanagi N, Sakamoto M, Nishimura A, Motojima O, Yamamoto J. Characteristics of a dc 75 kA power supply in the superconducting magnet test facilities. Fusion Engineering and Design 1993. [DOI: 10.1016/0920-3796(93)90044-i] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yonenaga Y, Arimura K, Suehara M, Arimura Y, Osame M. Electroencephalographic abnormalities in human T-cell lymphotropic virus type I-associated myelopathy. Arch Neurol 1989; 46:513-6. [PMID: 2712748 DOI: 10.1001/archneur.1989.00520410047022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Thirty-six patients with human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy were studied by electroencephalogram. Twenty-two of 36 patients showed mild to moderate electroencephalographic abnormalities, ranging from poor organization or slowing of the background activity to theta bursts and/or spikes. None of these abnormalities were considered specific for HTLV-I-associated myelopathy. These electroencephalographic abnormalities had no apparent relationship to duration or severity of illness, nor to HTLV-I antibody titers in the cerebrospinal fluid. We document electroencephalographic changes in HTLV-I-associated myelopathy. Our data are consistent with previous reports describing the fact that involvement of regions above the spinal cord may exist in HTLV-I-associated myelopathy.
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Affiliation(s)
- Y Yonenaga
- Third Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan
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Yonenaga Y. [Perpectives on the cytogenetics of Brazilian mammals (author's transl)]. Rev Bras Pesqui Med Biol 1977; 10:431-3. [PMID: 609779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Yonenaga Y, Kasahara S, Almeida EJ, Peracchi AL. Chromosomal banding patterns in Akodon arviculoides (2n=14),Akodon sp.(2n=24 and 25), and two male hybrids with 19 chromosomes. Cytogenet Cell Genet 1975; 15:388-99. [PMID: 1225498 DOI: 10.1159/000130538] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Chromosomal polymorphism resulting from two pericentric inversions in Akodon arviculoides (2n=14) has been described (YONENAGA, 1972a). In this paper the banding patterns are presented and identification of the inverted segments of the autosomal pairs 2 and 3 is made. The karyotype of Akodon sp., which varies in diploid number (2n-24 and 25), is described and shown to be due to the presence of a small submetacentric chromosome in the 2n=25 individuals. The karyotypes of two 2n=19 males studied show that they are hybrids between Akodon arviculoides (2n=14) and Akodon sp. (2n=24).
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Yonenaga Y. Chromosomal polymorphism in the rodent Akodon arviculoidesssp. (2n=14) resulting from two pericentric inversions. Cytogenet Genome Res 1972. [DOI: 10.1159/000130215] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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