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Relationship between therapeutic efficacy of arterial infusion chemotherapy and expression of P-glycoprotein and p53 protein in advanced hepatocellular carcinoma

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World Journal of Gastroenterology 2006年第6期12卷 868-873页

作者： MasahideAkimoto MasaharuYoshikawa MasaakiEbara TsunenobuSato HiroyukiFukuda HiromitsuSaisho fukuo kondo Department of Medicine and Clinical Oncology Chiba UniversitySchool of Medicine1-8-1 InohanaChuo-kuChiba CityChiba 260-0856 Japan Department of Molecular Pathology Chiba UniversitySchool of MedicineChiba Japan

AIM： To investigate the relationship between the chemotherapeutic drug efficacy and the expression of P-glycoprotein （PGP） and p53 protein in advanced hepatocellular carcinoma （HCC）. METHODS： The study was conducted on 41 patients with advanced HCC who were treated by repeated arterial infusion chemotherapy. Biopsy specimens from the tumor were collected before the start of treatment in all the patients, and the specimens were stored frozen until immunohistochemical staining, which was performed after the start of treatment, to detect PGP and p53 protein expressions. Twenty of the fortyone patients were treated with an anthracycline drug （epirubicin hydrochloride; anthracycline group）, and the remaining 21 were treated with a non-anthracycline drug （mitoxantrone hydrochloride in 11 patients and carboplatin in 10 patients; non-anthracycline group）. The relationship between the chemotherapeutic efficacy and the results of immunostaining were compared between the two groups. RESULTS： Before the start of the treatment, PGPpositive rate was 90.2% （strongly-positive, 36.6%） and p53 protein-positive rate was 34.1% （strongly-positive, 19.5%）. In the anthracycline group, the response rate was 40.0%. The number of patients showing poor response to the treatment was significantly larger in the patients with strongly positive PGP expression （P= 0.005）, and their prognoses were poor （P= 0.001）. in the nonanthracycline group, the response rate was 42.9%,and there was no significant relationship between the chemotherapeutic drug efficacy and the PGP or p53 protein expression. When only the data from the 11 patients treated with anthraquinone drug, mitoxantrone, were analyzed, however, the number of patients who showed poor response to treatment was significantly higher among the p53-positive patients （P= 0.012）, irrespective of the survival outcome. CONCLUSION： The chemotherapeutic efficacy with an anthracycline drug for advanced HCC can be predicted by immunohistochemical a

关键词： Arterial infusion chemotherapy Hepatocellularcarcinoma P-glycoprotein p53 protein

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Resected case of eosinophilic cholangiopathy presenting with secondary sclerosing cholangitis

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World Journal of Gastroenterology 2009年第11期15卷 1394-1397页

作者： Fumihiko Miura Takehide Asano Hodaka Amano Masahiro Yoshida Naoyuki Toyota Keita Wada Kenichiro Kato Tadahiro Takada Junichi Fukushima fukuo kondo Hajime Takikawa Department of Surgery Teikyo UniversitySchool of MedicineTokyo173-8605Japan Department of Pathology Teikyo UniversitySchool of MedicineTokyo173-8605Japan Department of Medicine Teikyo University School of MedicineTokyo173-8605Japan

Eosinophilic cholangiopathy is a rare condition characterized by eosinophilic infiltration of the biliary tract and causes sclerosing cholangitis. We report a patient with secondary sclerosing cholangitis with eosinophilic cholecystitis. A 46-year-old Japanese man was admitted to our hospital with jaundice. Computed tomography revealed dilatation of both the intrahepatic and extrahepatic bile ducts, diffuse thickening of the wall of the extrahepatic bile duct, and thickening of the gallbladder wall. Under the diagnosis of lower bile duct carcinoma, he underwent pyloruspreserving pancreatoduodenectomy and liver biopsy. On histopathological examination, conspicuous fibrosis was seen in the lower bile duct wall. In the gallbladder wall, marked eosinophilic infiltration was seen. Liver biopsy revealed mild portal fibrosis. He was diagnosed as definite eosinophilic cholecystitis with sclerosing cholangitis with unknown etiology. The possible etiology of sderosing cholangitis was consequent fibrosis from previous eosinophilic infiltration in the bile duct. The clinicopathological findings of our case and a literature review indicated that eosinophilic cholangiopathy could cause a condition mimicking primary sclerosing cholangitis （PSC）. Bile duct wall thickening in patients with eosinophilic cholangitis might be due to fibrosis of the bile duct wall. Eosinophilic cholangiopathy might be confused as PSC with eosinophilia.

关键词： Eosinophilc cholangiopathy Primarysclerosing cholangitis Secondary sclerosing cholangitis Obstructive jaundice

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