Homotypic Adhesion through Carcinoembryonic Antigen Plays a Role in Hepatic Metastasis Development

We established a cell line with high metastatic potential to the liver (LS-LM4) after four successive repetitions of splenic injection of liver-metastatic cells in SCID mice. This cell line strongly expressed CEA and showed increased homotypic adhesion as compared with the parent cell line (LS174T). To examine the role of CEA in the increased homotypic adhesion, LS-LM4 cells were treated with anti-CEA antibody and subjected to an in vitro adhesion and aggregation assay. Further, to study the role of CEA in the hepatic metastasis of cells with high metastatic potential, LS-LM4 cells were treated with anti-CEA antibody, and the inhibition of hepatic metastasis after splenic injection in vivo was examined. There was a 62% decrease in the homotypic adhesion of anti-CEA antibody-treated (100 μg/ml) LS-LM4 cells under a Ca²⁺-free condition as compared with the control ( P <0.01). Anti-CEA antibody (100 μg/ml) inhibited cell aggregation under a Ca²⁺-free condition ( P <0.05). Treatment with anti-E-cadherin antibody (60 μ/ml) plus anti-CEA antibody (100 μg/ml) inhibited cell aggregation more potently than anti-E-cadherin antibody treatment alone in the presence of Ca²⁺. In vivo , there was a 75% decrease in the number of hepatic metastatic nodules in the G125 anti-CEA antibody-treated group as compared with the control group ( P <0.01). Similarly, there was a 40% decrease in the diameter of metastatic nodules and there was a 90% decrease in total tumor volume of hepatic metastasis in the G125 anti-CEA antibody-treated group as compared with the control ( P <0.01). These results suggest that increased metastatic potential to the liver is at least partly due to increased homotypic binding mediated by CEA.     

全胸膜混合射线照射治疗恶性胸水的初步报告

目的研究６０Ｃｏ和电子线匹配作全胸膜放射治疗胸膜转移伴恶性胸水。方法２５例恶性胸水患者接受治疗。其中肺癌伴恶性胸水２０例，乳腺癌术后胸膜转移伴胸水３例，恶性胸腺瘤术后胸膜转移伴胸水２例。６０Ｃｏ野包括全肺，中央铅块屏蔽，屏蔽处照射电子束，计算中平面胸膜受量，１００％等剂量线为２Ｇｙ，常规照射１５次。可见肿瘤局部加量２０Ｇｙ／１０ＦＸ。中平面约２／３肺组织受量＜５０％。同时接受３～６个疗程化疗。结果２５例恶性胸水完全控制１７例，部分控制７例，总有效率９６％。２２例可见肿瘤３例完全消退，１７例部分消退。经随访，１例无瘤生存１４个月，２例１２个月，１６例４～１１个月。６例死亡，中位生存期９个月。胸水复发４例，总控制率为８０．０％。照射后患者血象较前下降，急性放射性食管炎（Ⅰ～Ⅱ级）１１例，２例胸膜明显增厚伴纤维化。结论６０Ｃｏ和电子线混合照射全胸膜临床上安全且具有较好的疗效     

CYFRA21—1,CEA联合测定对癌性胸水的诊断价值

检测１１８例胸水ＣＹＦＲＡ２１－１和ＣＥＡ浓度以及ＡＤＡ活性。其中癌性不６７例，结核性胸水４０例，其它良性渗漏液１１例。ＣＹＦＲＡ２１－１对癌胸水的敏感度为６２．６％，特异度为９０．２％，ＣＥＡ的敏感度为５５．２％，特异度为１００％。联合测定ＣＹＦＲＡ２１－１和ＣＥＡ对癌性胸水的敏感度可提高到８５．１％，其临床应用值值得重视。     

低剂量粒—巨噬细胞集落刺激因子在肺癌化疗中的应用

３１例肺癌患者大剂量化疗４０例次，采用配对法分成加用低剂量粒－巨噬细胞集落刺激因子（ＧＭ－ＣＳＦ）的治疗组及不加用的对照组（二组均为２０例次）。结果表明，低剂量ＧＭ－ＣＳＦ明显缩短化疗所致白细胞低下的时间：治疗组为１４．５±９．４９天，对照组为１９．４±８．８５天（Ｐ＝０．０２），同时提高白细胞下降最低值：治疗组为３．３５×１０９／Ｌ±１．３７×１０９／Ｌ，对照组为２．９×１０９／Ｌ±１．１８×１０９／Ｌ。低剂量ＧＭ－ＣＳＦ的主要不良反应为发热（８０％）及肌痛、骨痛（１０％）。结果提示：低剂量ＧＭ－ＣＳＦ能支持癌症患者的大剂量化疗及连续化疗     

免疫组织化学在纤维支气管镜活检诊断及鉴别诊断中的应用

运用免疫组织化学技术对51例纤维支气管镜咬检组织中的角蛋白（KER）及癌胚抗原（CEA）进行检测，并设5例正常支气管粘膜肺组织作对照。结果正常支气管粘膜肺组织均呈CEA阴性，而癌组织的阳性率为62％；各型肺癌的可疑组与确诊组的阳性率及染色强度均无差异；鳞状细胞癌（鳞癌）KER染色的阳性率及染色强度均与腺癌有显著差异；小细胞癌KER染色阳性率为90％。作者认为在纤支镜咬检组织的诊断中CEA染色可用于肿瘤的定性诊断；而KER检测对鳞癌与腺癌的鉴别有一定帮助；小细胞癌KER染色的高阳性率支持其与其他非小细胞癌共同起源于干细胞的说法。     

Irinotecan as second-line treatment for unresectable liver metastases of colon cancer

A 53-year-old woman had shown repeated, partial responses to chemotherapy for large, multiple liver metastases of sigmoid colon cancer. After a partial response to 5-fluorouracil plus leucovorin therapy, an 89.7% reduction of the 5-fluorouracil-resistant metastatic tumor was achieved by giving CPT-11 (irinotecan) at a dose of 100 mg/body per week. We suggest that CPT-11 should be recommended as an effective second-line treatment for unresectable liver metastases of colon cancer, after 5-fluorouracil-based chemotherapy.     

Incidence of nodal metastasis around the superior border of the pancreas based on number of metastatic perigastric nodes

Received for publication on Jul. 17, 1998; accepted on Oct. 14, 1998     

Metastasis to the iris in squamous cell lung cancer

A 72-year-old Japanese woman, suffering from squamous cell lung cancer with brain metastasis, underwent 2 courses of combination chemotherapy, consisting of cisplatin and vindesine. Although both the primary tumor and the brain metastasis regressed markedly, she developed left ocular pain with blurred vision. An abnormal mass was found in the left iris, and cytologic examination of the aqueous aspirate revealed a few malignant cells, which, when examined by electron microscopy, were considered to be derived from squamous cell carcinoma of the lung.     

Assessment of vascularity in breast carcinoma by computer-assisted video analysis (CAVA) and its association with axillary lymph node status

Case-control methodology was used to evaluate the significance of vascularity in small breast carcinomas with regard to the presence or absence of axillary lymph node metastases. Vascularity was assessed in 32 axillary node positive primary breast tumours (LN+ve) less than 2 cm in size and compared with 56 control axillary node negative primary tumours (LN–ve), which were matched for histological type and grade and tumour size. This study design employed computer-assisted video analysis (CAVA) to assess the total blood vessel perimeter (BVP), total blood vessel area (BVA), and total blood vessel density (BVD) throughout a tissue section that encompassed an entire cross section of the tumour and its immediate periphery. The BVA and BVD in these tumours were not significantly different between LN+ve and LN–ve groups. The LN–ve carcinomas had, on average, a significantly (P < 0.05) higher total BVP (3355 µm/mm²) than LN+ve tumours (2771 µm/mm²). 'Hot spot' areas were also independently assessed by two pathologists and the same areas measured by CAVA. A strong correlation (P < 0.001) between the two methods of assessment of BVD of the neovascular 'hot spots' was found; however, no association with axillary lymph node metastasis was found using either method of assessment. In conclusion, vascularity assessed by either blood vessel density or blood vessel size in primary invasive breast cancers less than 2 cm in diameter showed no association with axillary lymph node metastasis; in fact a negative association was found with total BVP of whole tumour sections and BVD in 'hot spots' using CAVA. Further, this study has established a computer-assisted method of quantifying vascularity in solid neoplasms and is a positive step towards a standardised approach to this diverse and methodologically variable area.