The current prospective randomized study was designed to compare the effects of intracavitary (i.c.) chemotherapy vs immunotherapy vs immunochemotherapy for malignant effusion. Between 1992 and 1995, a total of 42 patients with malignant effusion were registered, and 41 patients were eligible for statistical analysis. The primary diseases of the eligible patients included 27 gastric, four colorectal, four pancreatic, three lung, two liver and one oesophageal cancers. The patients with malignant effusion were randomly assigned into one of three i.c. therapeutic regimens: chemotherapy alone with weekly injection of anticancer agents (ACAs: cisplatin, mitomycin-C, adriamycin, etc.) (Group A, n = 13); immunotherapy alone with weekly injection of streptococcal preparation OK-432 (Group B, n = 14); or immunochemotherapy with ACAs and OK-432 (Group C, n = 14). The response of the effusion, patient survival and the kinetics of cytokines in the effusion were compared. There were no differences in the patients' backgrounds. The side-effects of the regimens included pain, anorexia, fever, leucopenia and anaemia and there were no differences in their incidence among the three groups. One patient died after cisplatin (CDDP) administration in Group A. Cytologic examination revealed that tumour cells in the effusion disappeared in 23% of Group A cases, 36% of Group B cases and 36% of Group C cases. The malignant effusion did not disappear in any of the Group A cases; however, the effusion disappeared in 29% of Group B cases and 43% of Group C cases ( P = 0.03, Group A vs Group C). Furthermore, the 50% survival period was 1.6 months for Group A, 2.4 months for Group B and 3.5 months for Group C. The 6-month survival rate was 7% for Group A, 6% for Group B and 34% for Group C, and the 1-year survival rate was 0%, 0% and 17% respectively ( P = 0.048, Group A vs Group C by the log-rank test). The analysis of the cytokine kinetics revealed a prominent increase in the level of interleukin-6 in the effusion in Group C. These results suggest that i.c. immunochemotherapy with OK-432 and ACAs may be more beneficial than i.c. chemotherapy alone or immunotherapy alone. © 1999 Cancer Research Campaign

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The tumor growth fraction as assessed by PCNA immunostaining is an independently significant predictor for survival of patients with TCC of the bladder.

Recently, inhibition of absorbed cholesterol has been reported to reduce the recurrence of vascular events in patients with acute coronary syndrome. However, the effect of absorbed cholesterol on atherosclerosis in healthy subjects remains unclear. In the present study, we investigated the relationship between cholesterol synthesis and absorption biomarkers, and vascular elasticity or morphological changes in healthy subjects. Methods: Among 580 subjects who underwent a complete medical checkup between 2012 and 2015, 256 healthy subjects (male/female: 161/95; mean age, 55 10 years) who did not receive any medication were included in the present study. We measured blood pressure, heart rate, blood glucose level, lipid parameters, lathosterol level (cholesterol synthesis marker), and campesterol level (cholesterol absorption marker). We then analyzed the relationship between these measured values and vascular elasticity (cardio-ankle vascular index [CAVI]) or carotid arterial plaque score (CAPS). Results: The CAVI and CAPS significantly correlated with the campesterol-tolathosterol ratio (CAVI; r=-0.20, p=0.015; CAPS; r=-0.16, p=0.023). Multivariate analysis of conventional atherosclerotic factors and campesterol-to-lathosterol ratio for CAVI and CAPS as the objective variables showed that age, systolic blood pressure, low-density lipoprotein-to-high-density lipoprotein ratio, and campesterol-to-lathosterol ratio were the significant determining factors for CAVI, and age and campesterol-to-lathosterol ratio were the determining factors for CAPS. Discussion: We found that absorbed cholesterol is closely related to vascular elasticity and morphological changes, and that a higher balance of absorption could induce favorable effects on atherosclerosis in healthy subjects. These findings might propose new nutritional guidance for healthy subjects.

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