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The patient was a woman in her 80s. Operative treatment was performed for papillary thyroid cancer(pT3N0M0)13 years ago. A follow-up CT scan 1 year ago revealed a skin, lung, and lymph node metastasis. At the same time, a tumor with a size of 24 mm was initially observed in the tail of the pancreas, which was considered to be pancreatic metastasis of thyroid papillary cancer and was followed up. Only the pancreatic lesions tended to gradually increase, although other lesions did not increase. Therefore, the patient was referred to our department. It was difficult to diagnose preoperatively. Thus, diagnostic and therapeutic laparoscopic distal pancreatectomy with splenectomy was performed. The pathological diagnosis was dedifferentiated liposarcoma. Postoperatively, a Grade B pancreatic fistula was observed, but the patient recovered conservatively and was discharged on postoperative day 55. Primary liposarcoma of the pancreas is extremely rare, and few cases have been reported. Primary liposarcoma of the pancreas is very difficult to diagnose preoperatively by only diagnostic imaging.

Background/aim We investigated the relationship between the expression of natural killer group 2, member D ligands (NKG2DLs) and the antitumor effects of protein-bound polysaccharide-K (PSK). Materials and methods PSK was administered to evaluate its effectiveness against tumor growth. The expression of Rae-1 and H60 were analyzed in multiple cell lines. Results PSK showed the highest antitumor effects in mice implanted with cells expressing neither Rae-1 nor H60. PSK had little antitumor effect in mice implanted with cells expressing both Rae-1 and H60. A correlation between the expression of NKG2DLs and the antitumor effect of PSK was observed. After PSK administration, INF-γ production in CD8+ T cells increased in mice with cells expressing neither Rae-1 nor H60, but did not change in mice implanted with cells expressing both Rae-1 and H60. Conclusion We demonstrated that the expression of NKG2DLs affects tumor immunity and the efficacy of immuno therapy in tumor-bearing mouse model.

We report a case of heterochronic cervical esophageal cancer with a subcutaneous abscess successfully treated using chemoradiation. A 68-year-old man underwent esophagectomy for middle thoracic esophageal cancer 13 years ago. In April 2015, upper gastrointestinal endoscopy revealed advanced residual cervical esophageal cancer. Enhanced CT showed a massive tumor with a subcutaneous abscess, and the tumor had invaded the left internal jugular vein and the 8th cervical spine. We firstly performed abscess drainage and administered antibiotics. After the inflammation decreased, we started chemora- diation. Chemotherapy consisted of 70mg/m / 2 cisplatin(day 1)and 700 mg/m2 5-FU(days 1-5)combined with almost 60 Gy radiotherapy(1.8 Gy/day, 5 days/week, days 1-49). We administered cisplatin and 5-FU only once because renal dys- function occurred. Consequently, we changed the regimen to weekly 100mg/m2 paclitaxel administration(day 1). After 2 months, a clinical complete response(CR)was obtained and we stopped chemotherapy. Eight months after chemotherapy cessation, the patient shows no sign of recurrence. These results suggest that chemoradiation is an effective treatment for cervical esophageal cancer with a subcutaneous abscess.

症例は40歳代男性．大腸癌検診で便潜血反応陽性を指摘され，大腸内視鏡検査で虫垂開口部に粘膜下腫瘍様の隆起性病変を認めた．CTエンテロクリーシスで憩室を伴った虫垂嚢腫が描出されたため，腹腔鏡下盲腸部分切除術が施行され，病理組織学的に仮性憩室を伴った虫垂粘液嚢胞腺腫と診断された．虫垂嚢胞腺腫に憩室を伴っており,それが術前にCTで明瞭に描出されている稀な症例を経験したので文献的考察を加えて報告する．

症例は17歳男性．10歳時から時々血便を認めていたため，17歳時に近医で下部消化管内視鏡検査を施行された．肛門縁に接して，ほぼ全周性に白色顆粒状隆起の集簇からなる腫瘍を認め，生検の結果serrated adenoma（SA）と診断された．CT，PETでは直腸以外に病変はなく，腫瘍マーカーの上昇は認めなかった．下部直腸に限局するSAと診断し，経肛門的粘膜下層切除術を施行した．病理組織診断は中等度異型のSAであり，術後８日で退院した．非常に稀な若年発症の下部直腸Serrated adenoma を経験し，経肛門的切除術を施行することにより肛門機能を温存した治療が可能であった．

The use of hepatectomy for the treatment of liver metastasis from gastric cancer has been controversial. We report a case of metachronous liver metastasis from gastric cancer, which we successfully treated with hepatectomy. A 59-year-old man underwent laparoscopy-assisted total gastrectomy with D1 plus lymphadenectomy for gastric cancer. The histopathological findings revealed that the tumor was a well-differentiated tubular adenocarcinoma, T2(MP), N1(#1 2/3), M0, fStage II, according to the 14th edition of the Japanese Classification of Gastric Carcinoma. TS-1 was administered as adjuvant chemo- therapy for 1 year after the operation. About 5 years after the gastrectomy, a recurrent tumor was detected in S5/8-7 of the liver. Although chemotherapy with TS-1 plus Lentinan was administered, the liver tumor increased in size. Percutaneous transhepatic portal embolization was performed to improve liver function followed by resection of the right lobe of the liver. Paclitaxel plus doxifluridine (5'-DFUR) was administered for 6 months as adjuvant chemotherapy. No recurrence was observed for 17 months after hepatectomy.

Previously, we showed that expression of nm23-H1 is associated inversely with sensitivity to cisplatin in human oesophageal squamous cell carcinoma (OSCC). The present study was undertaken to investigate the association of nm23-H1 expression with cisplatin-induced DNA damage in OSCC using antisense nm23-H1 transfectants. YES-2/AS-12, an antisense nm23-H1-transfected OSCC cell line, showed significantly reduced expression of intracellular nm23-H1 protein compared with that in parental YES-2 cells and YES-2/Neo transfectants. Surface expression of nm23-H1 protein was not observed in any of the three cell lines. PCR analysis for DNA damage demonstrated that YES-2/AS-12 cells were more resistant to nuclear and mitochondrial DNA damage by cisplatin than were YES-2/Neo cells. In addition, mitochondrial membrane potentials and DNA fragmentation assays confirmed that YES-2/AS-12 was more resistant than YES-2/Neo to apoptosis induced by cisplatin. In contrast, YES-2/AS-12 was more sensitive to ouabain, a selective inhibitor of Na+, K+-ATPase, than YES-2 and YES-2/Neo. Pre-treatment with ouabain resulted in no differences in cisplatin sensitivity between the three cell lines examined. Intracellular platinum level in YES-2/AS-12 was significantly lower than that in YES-2 and YES-2/Neo following incubation with cisplatin, whereas ouabain pre-treatment resulted in no differences in intracellular platinum accumulations between the three cell lines. Our data support the conclusion that reduced expression of intracellular nm23-H1 in OSCC cells is associated with cisplatin resistance via the prevention of both nuclear and mitochondrial DNA damage and suggest that it may be related to Na+, K+-ATPase activity, which is responsible for intracellular cisplatin accumulation. © 2000 Cancer Research Campaign

Cytologic examination of peritoneal lavage fluid is a useful predictor of peritoneal recurrence in gastric cancer. However, this technique is not overly sensitive and requires special abilities in the cytologist. In this study, telomerase activity was used to detect free cancer cells in peritoneal lavage fluid from patients with gastric cancer. In the first part, 12 lavage-fluid samples obtained from 12 patients with gastric cancer were analysed using the conventional telomeric repeat amplification protocol (TRAP) assay. Three of five patients with early gastric cancer had positive telomerase activity. These false-positive results may have been due to lymphocyte contamination. Furthermore, polymerase chain reaction inhibitors were also detected in the lavage-fluid samples. Therefore, we developed a novel method for elimination of haematopoietic cell and Taq polymerase inhibitors to increase the accuracy of the TRAP assay using immunomagnetic beads, which bind to most normal and neoplastic human epithelial cells. Telomerase activity was found in 10 of 20 (50%) lavage-fluid samples from patients with serosal or subserosal invasion. Cytologic examination was positive in nine of 20 (45%) samples. Both the telomerase activity and cytology were negative in all 14 patients without serosal or subserosal invasion. These results suggest that the TRAP assay combined with immunomagnetic beads might be useful for detection of free cancer cells in the peritoneal space in gastric cancer without the aid of an experienced cytologist. © 2000 Cancer Research Campaign

We examined the effect of interleukin-15 (IL-15) gene transfer into tumour cells on the host's anti-tumour response. In BALB/c mice IL-15 producing Meth-A cells (Meth-A/IL-15) underwent complete rejection, in a response characterized by massive infiltration of CD4+ T-cells and neutrophils. In contrast, Meth-A cells transfected with vector alone (Meth-A/Neo) grew rapidly. Moreover, rechallenged parental cells also were rejected in association with CD8+ T-cell infiltration. However, in nude mice there was no drastic difference between Meth-A/IL-15 and Meth-A/Neo cells. These results demonstrate that IL-15-secreting tumour cells can stimulate local and systemic T-cell-dependent immunity and therefore may have a potential role in cancer therapy. © 1999 Cancer Research Campaign

Recently, nm23-H1, an anti-metastasis gene, has been reported to correlate with sensitivity to chemotherapeutic agents including cisplatin in human breast and ovarian carcinoma cells. The aim of this study was to evaluate a role for nm23-H1 in responsiveness to cisplatin-based chemotherapy in patients with oesophageal squamous cell carcinoma (OSCC). The expression of nm23-H1 protein was examined immunohistochemically in 32 eligible patients with OSCC who underwent adjuvant chemotherapy with cisplatin, etoposide, and 5-fluorouracil after tumour resection. Fifteen (46.9%) of 32 patients were positive for nm23-H1 staining and 17 (53.1%) were negative. Both disease-free survival and overall survival rates of nm23-H1-negative patients were significantly shorter than in nm23-H1-positive patients (P < 0.01 for both). There was no significant difference in clinicopathologic characteristics between nm23-H1-positive and nm23-H1-negative groups. Multivariate analysis also showed that nm23-H1 expression was the most significant factor for overall survival of OSCC patients included in this study (P = 0.0007). To further study the role of nm23-H1, a human OSCC cell line (YES-2) was transfected with a plasmid containing a fragment of the nm23-H1 cDNA in an antisense orientation. Reduced expression of nm23-H1 protein in the antisense-transfected (AS) clones was found by Western blot analysis as compared to wild-type YES-2 and YES-2/Neo (clone transfected with the neomycin resistance gene alone). MTT (3-(4,5-dimethyl-2-thiazol)-2,5-diphenyl-2H tetrazolium bromide) assay showed that reduced expression of the nm23-H1 protein in AS clones was consistent with the degree of increased resistance to cisplatin but not etoposide or 5-fluorouracil. These data support the conclusion that reduced expression of nm23-H1 may be associated with resistance to cisplatin, suggesting the value of nm23-H1 expression as a prognostic marker for OSCC patients who are to undergo cisplatin-based chemotherapy. © 1999 Cancer Research Campaign

We report a case of ascending colon cancer successfully treated for synchronous liver metastases with mFOLFOX6 after a resection of the primary tumor. A 79-year-old woman was diagnosed as having an ascending colon cancer with synchronous liver metastases. After right hemicolectomy, she was treated with mFOLFOX6. A partial response was observed after the fifth course and CEA decreased to a normal range (8 ng/mL). A complete response was observed after the ninth course and the treatment finished at the twelfth course. Sequentially, she was treated with UFT/LV/PSK after three courses of FOLFIRI regimen. The patient is alive without recurrence.