Peritoneal carcinomatosis(PC),the dissemination of cancer cells throughout the lining of the abdominal cavity,is the second most common presentation of colon cancer distant metastasis.Despite remarkable advances in cy...Peritoneal carcinomatosis(PC),the dissemination of cancer cells throughout the lining of the abdominal cavity,is the second most common presentation of colon cancer distant metastasis.Despite remarkable advances in cytotoxic chemotherapy and targeted therapy for colon cancer over the last 15 years,it has been repeatedly shown that these therapies remain ineffective for colon cancer PC.Recently,there has been a rapid accumulation of reports that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy(CRS-HIPEC) prolongs the life of colon cancer PC patients.Here,we will review the clinical presentation,the mechanisms of disease progression,and current treatment options for colon cancer PC,with a focus on the benefits and limitations of CRSHIPEC.展开更多
AIM： To investigate the immunological repertoire in the peritoneal cavity of gastric cancer patients. METHODS： The peritoneal cavity is a compartment in which immunological host-tumor interactions can occur. However...AIM： To investigate the immunological repertoire in the peritoneal cavity of gastric cancer patients. METHODS： The peritoneal cavity is a compartment in which immunological host-tumor interactions can occur. However, the role of lymphocytes in the peri- toneal cavity of gastric cancer patients is unclear. We observed 64 patients who underwent gastrectomy for gastric cancer and 11 patients who underwent lapa-roscopic cholecystectomy for gallstones and acted as controls. Lymphocytes isolated from both peripheral blood and peritoneal lavage were analyzed for surface markers of lymphocytes and their cytokine production by flow cytometry. CD4＋CD25h＋gh T cells isolated from the patient＇s peripheral blood were co-cultivated for 4 d with the intra-peritoneal lymphocytes, and a cytokine assay was performed. RESULTS： At gastrectomy, CCR7-CD45RA- CD8＋ effector memory T cells were observed in the peritoneal cavity. The frequency of CD4＋ CD25 h＋ghT ceils in both the peripheral blood and peritoneal cavity was elevated in patients at advanced stage [control vs stage IV in the peripheral blood： 6.89 （3.39-10.4） vs 15.34 （11.37-19.31）, P 〈 0.05, control vs stage IV in the peri- toneal cavity： 8.65 （5.28-12.0） vs 19.56 （14.81-24.32）, P 〈 0.05]. On the other hand, the suppression was restored with CD4＋ CD25h＋QhT cells from their own pe- ripheral blood. This study is the first to analyze lympho- cyte and cytokine production in the peritoneal cavity in patients with gastric cancer. Immune regulation at ad- vanced stage is reversible at the point of gastrectomy. CONCLUSION： The immunological milieu in the peri- toneal cavity of patients with advanced gastric cancer elicited a Th2 response even at gastrectomy, but this response was reversible.展开更多
基金Supported by NIH grants,No.R01CA160688(to Takabe K)and No.T32CA085159-10(to Terracina KP)
文摘Peritoneal carcinomatosis(PC),the dissemination of cancer cells throughout the lining of the abdominal cavity,is the second most common presentation of colon cancer distant metastasis.Despite remarkable advances in cytotoxic chemotherapy and targeted therapy for colon cancer over the last 15 years,it has been repeatedly shown that these therapies remain ineffective for colon cancer PC.Recently,there has been a rapid accumulation of reports that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy(CRS-HIPEC) prolongs the life of colon cancer PC patients.Here,we will review the clinical presentation,the mechanisms of disease progression,and current treatment options for colon cancer PC,with a focus on the benefits and limitations of CRSHIPEC.
基金Supported by Grant-in-Aid for Scientific Research(C),No.22591459
文摘AIM： To investigate the immunological repertoire in the peritoneal cavity of gastric cancer patients. METHODS： The peritoneal cavity is a compartment in which immunological host-tumor interactions can occur. However, the role of lymphocytes in the peri- toneal cavity of gastric cancer patients is unclear. We observed 64 patients who underwent gastrectomy for gastric cancer and 11 patients who underwent lapa-roscopic cholecystectomy for gallstones and acted as controls. Lymphocytes isolated from both peripheral blood and peritoneal lavage were analyzed for surface markers of lymphocytes and their cytokine production by flow cytometry. CD4＋CD25h＋gh T cells isolated from the patient＇s peripheral blood were co-cultivated for 4 d with the intra-peritoneal lymphocytes, and a cytokine assay was performed. RESULTS： At gastrectomy, CCR7-CD45RA- CD8＋ effector memory T cells were observed in the peritoneal cavity. The frequency of CD4＋ CD25 h＋ghT ceils in both the peripheral blood and peritoneal cavity was elevated in patients at advanced stage [control vs stage IV in the peripheral blood： 6.89 （3.39-10.4） vs 15.34 （11.37-19.31）, P 〈 0.05, control vs stage IV in the peri- toneal cavity： 8.65 （5.28-12.0） vs 19.56 （14.81-24.32）, P 〈 0.05]. On the other hand, the suppression was restored with CD4＋ CD25h＋QhT cells from their own pe- ripheral blood. This study is the first to analyze lympho- cyte and cytokine production in the peritoneal cavity in patients with gastric cancer. Immune regulation at ad- vanced stage is reversible at the point of gastrectomy. CONCLUSION： The immunological milieu in the peri- toneal cavity of patients with advanced gastric cancer elicited a Th2 response even at gastrectomy, but this response was reversible.
