E2F target score is associated with cell proliferation and survival of patients with hepatocellular carcinoma.

BACKGROUND: E2F target genes are essential for the cell cycle. A score that quantifies its activity is expected to reflect the aggressiveness and prognosis of hepatocellular carcinoma. METHODS: Cohorts of hepatocellular carcinoma patients (total n = 655) from The Cancer Genome Atlas, GSE89377, GSE76427, and GSE6764 were analyzed. The cohorts were divided into high versus low by the median. RESULTS: All the Hallmark cell proliferation-related gene sets were consistently enriched in hepatocellular carcinoma with high E2F targets score, and E2F score was associated with grade, tumor size, American Joint Committee on Cancer staging, proliferation score, and MKI67 expression, as well as with less abundance of hepatocytes and stromal cells. E2F targets enriched DNA repair, mTORC1 signaling, glycolysis, and unfolded protein response gene sets and were significantly associated with the higher intratumoral genomic heterogeneity, homologous recombination deficiency, and progression of hepatocellular carcinoma. On the other hand, there was no relationship between E2F targets and mutation rates or neoantigens. High E2F hepatocellular carcinoma did not enrich any of the immune-response-related gene sets but was associated with high infiltration of Th1, Th2 cells, and M2 macrophage; however, there was no difference in cytolytic activity. In both early (I and II) and late (III and IV) stages of hepatocellular carcinoma, a high E2F score was associated with worse survival and was an independent prognostic factor for overall and disease-specific survival in patients with hepatocellular carcinoma. CONCLUSION: The E2F target score, associated with cancer aggressiveness and worse survival, could be used as a prognostic biomarker in patients with hepatocellular carcinoma.

Tomato Juice Consumption Could Improve Breast Skin Adverse Effects of Radiotherapy in Breast Cancer Patients.

BACKGROUND/AIM: We investigated the beneficial effects of drinking tomato juice (TJ) rich in antioxidant carotenoids on irradiated skin following radiotherapy (RT) in breast cancer patients. PATIENTS/METHODS: Twenty-three patients agreed to drink TJ (160 g/day for six months) after the completion of RT. Early and late adverse events (AEs) of irradiated skin were evaluated according to the Common Terminology Criteria for AEs and the European Organization for Research and Treatment of Cancer Global Cosmetic Rating System, respectively. RESULTS: With regard to early AEs, acute radiodermatitis of grade 1 was observed in most patients (22/23) at the end of RT. However, the grade of radiodermatitis rapidly changed to 0, 1 month after RT and starting TJ consumption. With regard to late AEs, most patients were in good or excellent dermal condition. CONCLUSION: TJ consumption could help in relieving and recovering from early AEs and decreasing the severity of late AEs of irradiated skin.

Influence of anticoagulants and storage temperatures on blood counts and mitotic index of blood samples collected for cytogenetic biodosimetry.

PURPOSE: In order to establish suitable protocols of blood culture to obtain sufficient numbers of metaphases for dicentric chromosome assay (DCA), we have examined the effect of storage temperature, storage time, and anticoagulant type. MATERIALS AND METHODS: Peripheral blood was collected from five healthy donors with lithium heparin and ethylenediaminetetraacetic acid dipotassium salt (EDTA-2K). These samples were irradiated with X-rays at 3 Gy or sham; the samples were further divided into groups that were either stored at room temperature (RT) or 5.2 ± 1.0 °C. After 6, 24, 48, 72, and 168 h of storage, both blood counts and the mitotic index (MI) were analyzed. RESULTS: Heparinized blood samples stored under cold conditions exhibited low white blood cell, lymphocyte, and platelet counts. EDTA-treated blood samples did not show such obvious changes in cell counts. After 6 h of storage, heparinized blood samples stored at RT had MI of 21.5-29.3%. Similar MI was obtained in the EDTA-washed group stored for 6, 24, 48, and 72 h. CONCLUSIONS: Our study confirms that heparinized blood samples should be stored at RT to get sufficient metaphases for DCA, and that EDTA blood samples also can be used for blood culture after washing and storage under 5.2 ± 1.0 °C.

Repeated Small Bowel Obstruction Caused by Chestnut Ingestion without the Formation of Phytobezoars.

A small number of cases of small bowel obstruction caused by foods without the formation of phytobezoars have been reported. Repeated small bowel obstruction due to the ingestion of the same food is extremely rare. We present the case of 63-year-old woman who developed small bowel obstruction twice due to the ingestion of chestnuts without the formation of phytobezoars. This is the first reported case of repeated small bowel obstruction caused by chestnut ingestion. Careful interviews are necessary to determine the meal history of elderly patients and psychiatric patients.

[A case of carcinomatous cardiac tamponade caused by breast cancer treated with instillations of OK-432 and mitomycin C].

The patient was a 36-year-old female who had undergone Auchincloss operation for left breast cancer at another hospital when 29 years old. Three years ago she was transferred from another hospital to our department complaining of dyspnea. Under the diagnosis of cardiac tamponade, we treated her with pericardial drainage and systemic chemotherapy (intravenous dosage of trastuzumab and vinorelbine: VNR), and then pericardial effusion disappeared. Further medical treatment was continued on an outpatient basis. One year later, cardiac tamponade developed again. We performed echo-guided pericardiocentesis and removed 600 mL of bloody effusion. The cytology of the effusion showed class V. Pericardial effusion recurred, so we instilled OK-432 and mitomycin C (MMC) twice. After that the cytology diagnosis became negative, and the heart shadow in chest X-P reduced. The pericardial effusion has never occurred until now. We also gave her systemic chemotherapy (intravenous dosage of trastuzumab)and endocrine therapy (peroral administration of medroxyprogesterone acetate). She made a remarkable recovery with these treatments and could go back to work.

[A case of nonresected gastric cancer with peritoneal dissemination effectively treated by S-1/DOC and PTX/ CDDP combination chemotherapy with good QOL].

We performed combination chemotherapy in the outpatient clinic on a 47-year-old man with nonresected gastric cancer accompanied by peritoneal dissemination. At first we administered S-1/DOC combination chemotherapy. Afterwards a rise of tumor marker (CEA) occurred accompanying taste disorder and edema of the lower limbs, so we changed to combination chemotherapy for PTX/CDDP. Since the only side effect was numbness, the patient was treated on an outpatient basis while working. The case achieved good QOL by these combination chemotherapy methods for 1 year 10 months post exploratory laparotomy.

[A case of metastasis to the diaphragm from ascending colon cancer].

We reported a case of metastatic tumor to the diaphragm discovered by rising CEA after operation of ascending colon cancer. A 72-year-old female underwent right hemicolectomy on January 2005. After discharge, she received adjuvant chemotherapy by S-1, but a rise of CEA was shown. Based on exploratory findings, laparotomy was done with the diagnosis of metastasis to the liver(S7). A tumor was present in the right diaphragm, and contacted the liver(S7). Partial resection of the right diaphragm was performed. The removed specimen revealed the same histological findings of the last operated ascending colon. Metastasis to the diaphragm is very rare, especially a solitary one as in this case. Etiologically speaking, the tumor cells might be absorbed or have strayed into peritoneal stomata of the diaphragm.

[A Case of advanced gastric cancer successfully treated with TS-1/low-dose CDDP as neoadjuvant chemotherapy].

TS-1 was introduced into the treatment of advanced or recurrent gastric cancer cases. Along with independent administration of TS-1, a high antitumor effect has been reported in combination with various anticancer agents. We report a patient with gastric cancer successfully treated with TS-1 and low-dose CDDP as neoadjuvant chemotherapy. The patient was a 46-year-old man who was diagnosed as type 3 gastric cancer with suspected invasion of the pancreas. Histopathological findings demonstrated the degeneration of cancer cells and fibrosis in the primary tumor. The changes against neoadjuvant chemotherapy were judged to be Grade 3. The treatment was completed without adverse events. TS-1 and low-dose CDDP therapy can be one of the effective methods as neoadjuvant chemotherapy without remarkable toxicity.

[A case of a nonresected gastric cancer with peritoneal dissemination maintained on TS-1 and docetaxel combination chemotherapy with good QOL].

In general, treatment for gastric cancer with peritoneal dissemination or recurrent gastric cancer is outside the scope of surgery. The efficacy of new anti-cancer drugs such as TS-1 system was revealed in a controlled study by comparing treatment with non-treatment groups. We performed chemotherapy of TS-1 and docetaxel (TXT) in the outpatient clinic on a 72-year-old nonresected gastric cancer patient accompanied by peritoneal dissemination. Although no killer cell effect was recognized, the patient clinically achieved good QOL by this method for one year and seven months. In conclusion, we reported a treatment method for nonresected gastric cancer, which was treated only on an outpatient basis. The course of this case closely resembled the tumor dormancy therapy performed by Takahashi et al.