| Co-Investigator(Kenkyū-buntansha) |
AIKOU Takashi 鹿児島大学, 大学院・医歯学総合研究科, 教授 (60117471)
NATSUGOE Shoji 鹿児島大学, 大学院・医歯学総合研究科, 教授 (70237577)
ISHIGAMI Sumiya 鹿児島大学, 医学部・歯学部附属病院, 助教 (90325803)
KITAZONO Masaki 鹿児島大学, 医学部・歯学部附属病院, 助教 (30398276)
松本 正隆 鹿児島大学, 医学部・歯学部附属病院, 助教 (40398293)
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| Budget Amount *help |
¥19,240,000 (Direct Cost: ¥14,800,000、Indirect Cost: ¥4,440,000)
Fiscal Year 2009: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2008: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Fiscal Year 2007: ¥15,470,000 (Direct Cost: ¥11,900,000、Indirect Cost: ¥3,570,000)
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| Research Abstract |
(1) Circulating tumor cells in blood detected by CellSearch System in gastric cancer The purposes of this study are to evaluate CTCs of peripheral blood (PB) and portal vein blood (PV) with gastric cancer patients using CellSearch System (CSS), and to investigate the relation of the recurrence. 【Methods】 In 50 patients with T1-3 gastric cancer, PB was collected 10ml before the gastrectomy, and PV was collected 10ml during operation. 【Results】CTCs were detected in 18% from PB, 24% from PV and 28% from PB and/or PV. CTCs were found in 8% with T1, 26% with T2, 44% with T3. Detection rate of CTCs were correlated with the results of Stage (p=0.007), vessel invasion (p=0.008), lymphatic invasion (p=0.007) and lymph node metastasis (p=0.01). The recurrences were detected in 11 patients (78.5%) with CTCs, and there was statistically significant difference in over all survival between patients with or without CTCs (p=0.0049). 【Conclusions】The identification of CTCs is very useful to follow up a
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fter operation and to perform the adjuvant chemotherapy in gastric cancer.
(2)-1 The utility of rapid diagnosis of lymph node metastasis in gastric cancer using a multiplex real-time RT-PCR assay
The purpose of this study was to evaluate the utility of a prototype RT-PCR assay run on the SmartCycler^[○!R] that enables the rapid diagnosis of lymph node metastasis in gastric cancer within 40 minutes. The purpose of this study was to verify the utility of the SmartCycler^[○!R] as compared to conventional RT-PCR using the LightCycler^[○!R]. 【Patients and methods】47 overt metastatic lymph nodes from 8 patients with advanced gastric cancer and 22 benign lymph nodes from patients without malignant tumor who received surgery were obtained with informed consent. We examined the metastatic lymph nodes by RT-PCR using multiple markers using CEA and CK19 by the LightCycler^[○!R] and SmartCycler^[○!R]. 【Results】 In the singlex assay, the sensitivity of CEA and CK19 was 91.5% and 70.2% in the LightCycler^[○!R], and 97.9% and 95.7% in the prototype assay system, respectively. In the multiplex assay, the sensitivity was 91.5% in the LightCycler^[○!R] system and 97.9% in the SmartCycler^[○!R], respectively. 【Conclusion】Rapid diagnosis for lymph node metastasis using RT-PCR by the SmartCycler^[○!R] has equally high precision for detecting lymph node metastasis as the conventional LightCycler^[○!R]. In this study the SmartCycler^[○!R] is advantageous for the diagnosis of lymph node metastasis in gastric cancer when run with the prototype assay.
(2)-2 Utility of the GeneSearch BLN Assay for Rapid Evaluation of Sentinel Lymph Nodes in Breast Cancer
Our goal was to evaluate the clinical application of the Breast Lymph Node (BLN) assay, a real-time RT-PCR assay for SLN metastases, by comparing this test with routine pathological examination. 【Methods】One hundred seventeen patients with breast cancer underwent breast surgery with SLN biopsy. Each SLN was cut in half along the plane of the longest dimension. Half of each node was examined by the BLN assay's 2 markers, mammaglobin (MG) and cytokeratin 19 (CK19), and the other half was examined by hematoxylin and eosin staining (HE) and immunohistochemical staining (IHC) for pancytokeratins. 【Results】A total of 204 SLNs were obtained from 117 patients. HE identified metastases in 31 SLNs (15.2%), and IHC detected metastases in 6 SLNs ; 40 SLNs from 32 patients were positive for metastasis by the BLN assay. The assay results correlated with the pathological diagnoses by HE and IHC (p<0.001). BLN Assay sensitivity compared with pathological findings classified according to TNM was 95.7% for macrometastases, 60.0% for micrometastases, and 55.6% for isolated tumor cells. 【Conclusion】The 2-marker BLN assay has performance comparable to, and analyzes more tissue than, routine pathological examination. Therefore, clinical intraoperative use of the BLN assay for SLNs may result in reduction of the second surgery for axillary lymph node dissections. Less
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