CD-DST ホウ オ モチイタ ニュウガン INTRINSIC SUBTYPES ニ オケル コウガンザイ カンジュ セイ シケン ノ ケントウ

乳癌の個別化治療が進む中で,依然としてエストロゲンレセプター (ER) やHER2遺伝子の発現状況と化学療法の薬剤感受性との関係には不明な点が多い.今回我々はCollagen gel Droplet embedded culture Drug Sensitivity Test (CD-DST法) を用いた抗癌剤感受性試験を行い,乳癌のsubtypeと薬剤感受性の関係について検討を行った.対象は乳癌患者60例59検体で,5-FUは34検体,epirubicinは35検体,paclitaxelは29検体で抗癌剤感受性の評価が可能であった.5-FU,epirubicin,paclitaxelいずれの薬剤においてもHER2発現状況と抗癌剤感受性との間に有意な相関は認められなかった.ERの発現を認めるホルモン陽性乳癌ではepirubicinに対する薬剤感受性が有意に低下し,5-FU,paclitaxelに対しても感受性が低い傾向が認められた.術前化学療法施行例では抗癌剤感受性試験の評価可能率が低下する事が判明した.CD-DST法は今後の乳癌化学療法を選択する上で,有用となりうる可能性が示唆された.Breast cancer is classified into four subtypes according to estrogen receptor (ER) and human epidermal growth factor receptor 2( HER2) expression. The biological subtypes have a spectrum of clinical, pathologic, and molecular features. Here, we investigated the correlation between the breast cancer subtype and chemosensitivity using the collagen gel droplet embedded culture drug sensitivity test (CD-DST). The response to 5-fluorouracil( 5-FU) was examined in 34 specimens;the response to epirubicin, in 35; and the response to paclitaxel, in 29. HER2 overexpression was not significantly correlated to the chemotherapeutic response to 5-FU, epirubicin, or paclitaxel. ER-positive breast cancer was significantly less sensitive to epirubicin and tended to be refractory to 5-FU and paclitaxel. The evaluation rate of the anti-drug sensitivity test was significantly lower in the group that received neoadjuvant chemotherapy. CD-DST could be useful in choosing anti-cancer drug agents for breast cancer patients

Efficacy of octreotide against chylothorax following lateral neck dissection for thyroid cancer: A case report

Introduction: Postsurgical chylothorax is a rare complication of cervical dissection for thyroid cancer. We report that octreotide, a synthetic analog of somatostatin, is effective in treating chylothorax after thyroid carcinoma surgery. Presentation of case: The patient was a 48-year-old woman who presented to our institution complaining of a left anterior cervical mass. We diagnosed this as thyroid papillary carcinoma and performed a subtotal excision of the thyroid gland with left cervical lymph node dissection. The patient developed dyspnea, and a chest X-ray revealed bilateral chylothorax on Day 4 post-surgery. Octreotide was administered since bilateral chylothorax was noted. A marked decrease in chyle effusion was noted just 3 days after starting octreotide, and after a total of 9 days of treatment, there were no further signs of chylous effusion. Discussion: Octreotide is effective against postsurgical chylothorax; however, if there are no signs of improvement, we believe surgical treatment should be considered. Conclusion: Octreotide should be administered first to treat postsurgical chylothorax before surgical treatment is considered