Monitoring of cancer patients via next-generation sequencing of patient-derived circulating tumor cells and tumor DNA.

Liquid biopsy of circulating tumor cells (CTC) and circulating tumor DNA (ctDNA) is gaining attention as a method for real-time monitoring in cancer patients. Conventional methods based upon epithelial cell adhesion molecule (EpCAM) expression have a risk of missing the most aggressive CTC subpopulations due to epithelial-mesenchymal transition and may, thus, underestimate the total number of actual CTC present in the bloodstream. Techniques utilizing a label-free inertial microfluidics approach (LFIMA) enable efficient capture of CTC without the need for EpCAM expression.

Disentangling the prognostic heterogeneity of stage III colorectal cancer through histologic stromal categorization.

Background: Growing evidence suggests the importance of stroma in determining cancer biology and recent studies have identified that genes closely associated with poor prognosis subtypes of colorectal cancer are expressed by the stroma rather than epithelial cancer cells. We aimed to clarify the prognostic value of the novel histologic classification of desmoplastic reaction in stage III colorectal cancer.

Methods: A pathologic review was conducted for 466 stage III colorectal cancer patients in a single Japanese institution (1999-2006).

FOSL1 immunohistochemistry clarifies the distinction between desmoplastic fibroblastoma and fibroma of tendon sheath.

Aims: Although desmoplastic fibroblastoma (DFB) and fibroma of tendon sheath (FTS) are well-established entities, they may show overlapping clinicopathological features. In addition, cytogenetic data showing a shared 11q12 rearrangement in a small number of cases suggest a close link between these entities. A recent microarray study revealed up-regulation of FOSL1 mRNA in DFBs with 11q12 rearrangement.

Basic principles and practice of gastric cancer screening using high-definition white-light gastroscopy: Eyes can only see what the brain knows.

Endoscopic diagnosis of gastrointestinal tumors consists of the following processes: (i) detection; (ii) differential diagnosis; and (iii) quantitative diagnosis (size and depth) of a lesion. Although detection is the first step to make a diagnosis of the tumor, the lesion can be overlooked if an endoscopist has no knowledge of what an early-stage 'superficial lesion' looks like. In recent years, image-enhanced endoscopy has become common, but white-light endoscopy (WLI) is still the first step for detection and characterization of lesions in general clinical practice.

Adenocarcinoma of the pigmented ciliary epithelium.

Adenocarcinoma of the pigmented ciliary epithelium is an exceptionally rare eye tumour, with only a few cases reported to date. We encountered such a case in a 50-year-old woman who reported seeing floaters in her right eye. Fundus examination and MRI revealed an elevated lesion located in the ciliary body compressing the lens.

Successful balloon-occluded retrograde transvenous obliteration for bleeding duodenal varices using cyanoacrylate.

A 76-year-old woman with hepatitis C cirrhosis presented with tarry stools and hematemesis. An endoscopy demonstrated bleeding duodenal varices in the second portion of the duodenum. Contrast-enhanced computed tomography revealed markedly tortuous varices around the wall in the duodenum.

Assessment of the interface between retroperitoneal fat infiltration of pancreatic ductal carcinoma and the major artery by multidetector-row computed tomography: surgical outcomes and correlation with histopathological extension.

Background: Precise assessment of retroperitoneal invasion is clinically important to allow the achievement of negative margin resections.

Methods: The clinical records of 132 patients who underwent macroscopic curative pancreaticoduodenectomy for invasive ductal carcinoma of the pancreas between 2004 and 2008 were retrospectively examined. The clinicopathological factors, including retroperitoneal fat infiltration classified into four groups by multidetector-row computed tomography (MDCT), were analyzed.

Is celiac axis resection justified for T4 pancreatic body cancer?

Background: The clinical impact of the distal pancreatectomy with en-bloc celiac axis resection for locally advanced pancreatic body cancer remains unclear.

Methods: We reviewed the records of 13 patients who underwent distal pancreatectomy-celiac axis resection between 1991 and 2009, 58 patients who underwent distal pancreatectomy for pancreatic body cancer involving major vessels, the extrapancreatic neural plexus or other organs (T4 according to the Japanese stage classification) between 1991 and 2009, and 24 patients with unresectable locally advanced pancreatic cancer without distant metastases (unresectable group) between 2001 and 2009. The clinicopathologic factors and overall survival among the 3 groups were compared.

Preoperative identification of intraoperative blood loss of more than 1,500 mL during elective hepatectomy.

Background: Despite recent advances in surgical techniques, hepatectomies remain one of the most hemorrhagic procedures in abdominal surgery. It is important to identify preoperatively patients who are at high risk of suffering massive intraoperative blood loss.

Methods: The clinical records of 251 patients who underwent an elective hepatectomy for liver tumors between September 2007 and December 2009 were reviewed retrospectively.

A rare case of poorly differentiated endocrine cell carcinoma of the stomach with signet ring cell differentiation.

There have been few reports of the dual differentiation of different cell types within the same gastric tumor. Here, we report a rare case of poorly differentiated endocrine cell carcinoma with an associated differentiated signet ring cell population arising in the stomach. The histological appearance of the tumor by light microscopy matched the phenotype of endocrine cell carcinoma and signet ring cell differentiation with mucinous lakes.

Long-term recurrence-free survival in a patient with primary hepatic carcinosarcoma: case report with a literature review.

A 72-year-old man was found to have a 40 mm mass in liver segment VIII during follow-up abdominal ultrasonography for type C viral hepatitis. Abdominal ultrasound showed a well-defined mass containing a cystic component, and computed tomographic hepatic arteriography showed heterogeneous enhancement except for cystic necrosis. Under a pre-operative diagnosis of atypical hepatocellular carcinoma (HCC), partial resection of liver segment VIII was performed.

Efficacy of a hepatectomy and a tumor thrombectomy for hepatocellular carcinoma with tumor thrombus extending to the main portal vein.

Introduction: Hepatocellular carcinoma (HCC) with major portal tumor thrombus has been considered to be a fatal disease. A thrombectomy remains the only therapeutic option that offer a chance of complete tumor removal avoiding acute portal vein obstruction. However, the efficacy of tumor thrombectomy in addition to hepatectomy has not been well evaluated.

CT colonography - towards applications for colorectal cancer screening.

Three-dimensional (3D) imaging of the large intestine is globally called computed tomography colonography (CTC). CTC has been intensively investigated for application in colorectal cancer screening in Western countries and with the advent of multi-slice CT (MSCT), which provides effective high resolution in 3D CT images, the diagnostic use of CT for colorectal lesions has become a concept widely accepted throughout the world. Computer-aided detection (CAD) for colorectal polyps using digital CT image data and digital pre-processing are also advancing in the West.

Clinicopathological characteristics of intrahepatic cholangiocellular carcinoma presenting intrahepatic bile duct growth.

Background: Intrahepatic cholangiocellular carcinoma (ICC) presenting intraductal growth (IG) has distinct clinicopathological features with a favorable prognosis. The mass-forming (MF) plus IG type of ICC has not been previously investigated.

Methods: One hundred forty-four patients with ICC underwent surgical resections and were classified according to the macroscopic type.

Reconstruction of hepatic venous tributaries using a Y-shaped left portal vein graft harvested from a resected left liver.

Hepatic vein resection and reconstruction after major hepatectomy is a technically feasible but controversial procedure. Reported autologous vein grafts include the great saphenous, external iliac vein, superficial femoral, gonadal, left renal and inferior mesenteric veins. The procedures required to obtain these grafts, however, are associated with a risk of postoperative morbidity such as edema of the lower leg.

Role of the width of the surgical margin in a hepatectomy for small hepatocellular carcinomas eligible for percutaneous local ablative therapy.

Background: There is intense clinical interest to determine whether a wide surgical margin is required to improve postoperative recurrence after locoregional therapy for small hepatocellular carcinomas (HCCs).

Methods: From 1996 to 2003, 117 patients with small HCCs, and also matching the criteria for local ablation therapy (up to 3 nodules
Results: The number of tumors and the surgical margin status were independent factors influencing the disease-free survival.

Role of medial pancreatectomy in the management of intraductal papillary mucinous neoplasms and islet cell tumors of the pancreatic neck and body.

Background/aim: Medial pancreatectomy has been applied as a safe and effective alternative in benign diseases located in the pancreatic neck or body. However, the role of this procedure remains controversial. We investigate outcomes using this method in 14 patients.

Role of a hepatectomy for the treatment of large hepatocellular carcinomas measuring 10 cm or larger in diameter.

Background: A curative hepatectomy is the mainstay of effective treatment for small hepatocellular carcinoma (HCC), but the treatment of large HCC remains challenging.

Materials And Methods: The possible prognostic factors were retrospectively analyzed in 85 patients with large HCC (> or = 10.0 cm) who all underwent a hepatectomy for HCC between 1988 and 2004.

[Ovarian cancer].

The current standard treatment for advanced ovarian cancer is primary debulking surgery (PDS) followed by postsurgical chemotherapy. We can expect a better prognosis in cases of optimal debulking (residual disease<1 cm). Unfortunately, optimal debulking in the PDS can be achieved in only about 40% of stage III/IV ovarian cancers as a rule.

Two distinct pathways of tumorigenesis of adenocarcinomas of the esophagogastric junction, related or unrelated to intestinal metaplasia.

It is still uncertain whether intestinal metaplasia (IM) of the esophagogastric junction (EGJ) plays a role in the development of adenocarcinoma of the esophagogastric junction (AEGJ). The purpose of the present study was to clarify the relationship between AEGJ and IM in Japanese patients. Forty-eight AEGJ, <3 cm and centered within 1 cm of the EGJ, were investigated.

Prevalence of FOXP3+ regulatory T cells increases during the progression of pancreatic ductal adenocarcinoma and its premalignant lesions.

Purpose: Antitumor immune response changes drastically during the progression of cancers. Established cancers often escape from the host immune system, although specific immune surveillance operates in the early stages of tumorigenesis in murine models. CD4+CD25+ regulatory T cells (TR) play a central role in self-tolerance and suppress effective antitumor immune responses.

Signet-ring cell carcinoma of the urinary bladder associated with transitional cell carcinoma of the right ureter.

We report on a case of a 72-year-old male with vesical signet-ring cell carcinoma containing a transitional cell carcinoma (TCC) component. It was associated with pure TCC of the right ureter. No other microscopic changes were found in the bladder.