シガケン ヒガシオウミ イリョウケン ニオケル キュウセイキ ビョウイン カラ ハッシンスル ガン チイキ イリョウ レンケイ ノ ココロミ

平成24 年から29 年まで、滋賀県東近江医療圏のがん診療連携支援病院である東近江総合医療センター外科と、地域医療者の連携協働により実践した在宅支援型包括的がん診療を報告する。連携開始時にカンファレンスで在宅療養支援の具体的な方法を決定した。個々の患者・家族の期待に応える在宅支援チーム、予期し難い病状変化への対応など、患者・家族・医療者全員の安心を担保した地域がん医療連携体制の構築は、地域中核病院の主導により実践可能であることが示された。また、共有すべき患者情報を掘り下げた連携ツールの必要性が明確になり、滋賀県がん緩和ケア地域連携クリニカルパスの開発に寄与した

Clinical implications of DLL4 expression in gastric cancer

BACKGROUND: Delta-like ligand 4 (DLL4)-Notch signaling plays a key role in tumor neovascular development and angiogenesis during tumor growth. The clinical significance of DLL4 expression in gastric cancer has not been clarified. METHODS: Gastric cancer cell lines and 180 gastric cancer patients were enrolled. DLL4 expression in gastric cancer cells and stroma was identified and evaluated immunohistochemically. The association between DLL4 and clinicopathological factors was also assessed. RESULTS: DLL4 expression was identified in the cellular membrane and cytoplasm of gastric cancer cells by immunoblotting and immunohistochemical staining. DLL4 positivity in cancer cells and stroma was found in 88 (48%) and 41 (22%) of the 180 gastric cancer patients respectively. Both cancer and stromal DLL4 expression significantly correlated with more advanced tumor depth, nodal involvement, and lymphatic and venous invasion. A strongly positive association between cancerous and stromal DLL4 expression was identified (p < 0.01). Both cancerous and stromal DLL4 expression were prognostic markers in gastric cancer as determined by univariate analysis. CONCLUSIONS: Cancerous and stromal DLL4 expression was found in 48% and 22% in gastric cancer, and significantly affected postoperative clinical outcomes. Cancerous and stromal DLL4 expression may be an effective target of anti-DLL4 treatment in gastric cancer

Significance of Twist expression and its association with E-cadherin in esophageal squamous cell carcinoma

in esophageal squamous cell carcinom