[Type 4 advanced gastric cancer responding to histological complete response after neoadjuvant S-1 combined with CDDP therapy-report of a case].

A 75-year-old man with type 4 advanced gastric cancer was referred to our hospital. We diagnosed the tumor as cStage III B(cT4a, cN2, cM0)gastric cancer. We selected neoadjuvant S-1 combined with CDDP therapy for him. After 2 courses of chemotherapy, the extension of the gastric wall improved. After an additional 2 courses of chemotherapy, the primary tumor revealed a partial response(PR), judged from a barium meal study and upper GI endoscopic findings, and a total gastrectomy with lymph node dissection was performed. The pathological specimens showed no cancer cells in the gastric wall and lymph nodes, so the histological effect was judged as Grade 3.

[A case of advanced gastric cancer with tumor embolus in the portal vein successfully treated with S-1 and CDDP therapy].

A 50-year-old man with advanced gastric cancer and a tumor embolus in the portal vein was referred to our hospital. We diagnosed the tumor as cStage III B (cT3, cN2, cH0, P0, M0) gastric cancer, and selected neoadjuvant S-1 (80 mg/m2) and CDDP (60 mg/m2) therapy for him. After 2 courses of chemotherapy, the embolus in the portal vein disappeared. After additional chemotherapy, the primary tumor and regional lymph node revealed a partial response (PR), and judging from the results from the barium meal study, upper GI endoscopic findings and CT scan, a total gastrectomy with lymph node dissection was performed.

[Investigation of epiphora following S-1 therapy].

We report the frequency of lacrimal passage disorder and the outcomes of treatment. This retrospective study was performed on 55 cases that were treated with S-1 for at least 1 month. We asked patients about ocular symptoms. An ophthalmic surgeon examined all patients and diagnosed lacrimal passage disorder in 6 of 55 patients (12. 5%). The mean dose of S- 1 was 10, 300 mg, and the average period to onset of lacrimal passage disorder was 5. 7 months. The causes of epiphora included occlusion/stenosis of lacrimal canaliculus, occlusion of lacrimal puncta and stenosis of nasolacrimal duct. Lacrimal surgery was performed in all 6 patients and epiphora improved. Lacrimal passage disorder may result from systemic treatment of patients with S-1. Symptoms of lacrimal passage disorder improved with early detection and treatment by insertion of a silicone tube.

[A case of granulocyte-colony stimulating factor producing gastric cancer].

We report a case of granulocyte-colony stimulating factor producing gastric cancer with multiple liver metastases. A 68-year-old woman who complained of epigastralgia visited our hospital. Upper gastrointestinal endoscopic examination revealed a type-2 gastric cancer. The laboratory data at admission indicated leukocytosis (35,900/microl) and a high level of serum granulocyte-colony stimulating factor (61 pg/mg). Granulocyte-colony stimulating factor producing gastric cancer was diagnosed by immunohistochemistry of biopsy specimen. Since we detected multiple liver metastases, chemotherapy was performed. Granulocyte-colony stimulating factor-producing gastric cancer is relatively rare and we summarize previous reports.

PPP1R3 gene (protein phosphatase 1) alterations in colorectal cancer and its relationship to metastasis.

The PPP1R3 gene is located on chromosome 7q31, and encodes protein phosphatase 1 (regulatory 3). It has been reported that the inactivation of various phosphatase proteins causes abnormalities in cell division and cell growth systems. We analyzed alterations in the PPP1R3 gene and its relationship to tumor progression and metastasis. Deletion mutants of exons containing mutations were prepared and assayed for intranuclear transcription activity. SSCP analysis of PPP1R3 showed abnormal patterns in 6 (12%) of the 50 colorectal cancers. DNA sequencing of the 6 samples showing abnormal SSCP patterns confirmed point mutations in exon 4 in 4 samples, and in exon 1 in 2 samples. PPP1R3 gene alterations correlated with lymph node and liver metastases. Enhancement of luciferase activity by the full PPP1R3 gene was confirmed. However, when point mutation-containing exon 1 or 4 deletion mutants were examined for luciferase activity, enhancement of activity was decreased in the exon 1 deletion mutants, while no enhancement of the activity was noted in the exon 4 deletion mutants. These findings suggest that protein phosphatase 1 (regulatory 3) protein is involved in intracellular processes in some colorectal cancers and may play a role in metastasis.