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1 G-CSF 産生胃癌の既報告 38 例の解析 Key words G-CSF はじめに granulocyte-colony stimulating factor G-CSF Robinson G-CSF G-CSF Obara G-CSF G-CSF autocrine growth PubMED 方法 Morstyn G-CSF G-CSF G-CSF Shimamura G-CSF G-CSF. kda G-CSF G-CSF PubMed gov/pubmed CRPG-CSFCEACA- R staging Kaplan- Meier. Coxlead time bias R IBM SPSS Statistics Subscription IBM Armonk NY 結果.

2 表 1 List of the literatures reporting cases of G-CSF producing gastric cancer Author Year Language Source of reference Obara English Cancer ; : Saeki Japanese Gan-no-Rinsho ; : Oda Japanese Naika ; : Aimoto Japanese Nihon Shokakigeka Gakkai Zasshi ; : Tojo Japanese Hiroshima Shimin Byoin Ishi ; : Yoda Japanese Nihon Rinshogeka Gakkaishi Zasshi ; : Kanaji Japanese Ehime Igaku ; : Mizumori Japanese Rinsho-to-Kenkyu ; : Akutsu Japanese Nihon Shokakigeka Gakkai Zasshi ; : Nasu Japanese Nihon Rinshogeka Gakkaishi Zasshi ; : Fujita Japanese Nihon Rinshogeka Gakkaishi Zasshi ; : Endo English Gastric Cancer ; : - DOI :./s - --y Yokoyama English Gastric Cancer ; : - DOI :./s - -- Hashimoto Japanese Nihon Rinshogeka Gakkaishi Zasshi ; : Okada Japanese Nihon Rinshogeka Gakkaishi Zasshi ; : Eto Japanese Nihon Shokakigeka Gakkai Zasshi ; : Uji Japanese Nihon Shokakigeka Gakkai Zasshi ; : Ishii Japanese Nihon Shokakibyo Gakkai Zasshi ; : Takada Japanese Nihon Rinshogeka Gakkai Zasshi ; : Sato Japanese Nihon Shokakigeka Gakkai Zasshi ; : Yamano English Japanese Journal of Clinical Oncology ; : - DOI :./jjco/hym Fujikawa Japanese Nihon Rinshogeka Gakkai Zasshi ; : Kawaguchi English International Journal of Clinical Oncology ; : - DOI :./s - -- Sunami Japanese Nihon Shokakigeka Gakkai Zasshi ; : Mori English Medical Science Monitor ; : Murase Japanese Nihon Rinshogeka Gakkai Zasshi ; : Shiraishi Japanese Nihon Rinshogeka Gakkai Zasshi ; : Kudou Japanese Nihon Rinshogeka Gakkai Zasshi ; : Watanabe Japanese Nihon Rinshogeka Gakkai Zasshi ; : Hiraoka Japanese Tama Symposium Journal of Gastroenterology ; : Uematsu Japanese Progress of Digestive Endoscopy ; : Saito Japanese Japanese Journal of Cancer Chemotherapy ; : Oshima Japanese Nihon Rinshogeka Gakkai Zasshi ; : Miyamoto Japanese Nihon Shokakibyo Gakkai Zasshi ; : Matsushita Japanese Japanese Journal of Cancer Chemotherapy ; : Tsuruta English Oncology Letters ; : - DOI :./o.. Moro English Surgical Case Reports ; : DOI :./s cm. cm CRP, /,, /. / dl.. / dl G-CSF. / / / poorly differentiated adenocarcinoma tubular adenocarcinoma adenosquamous cell carcinoma squamous cell carcinomag-csf. R

3 Age year old Characteristics Mean.median. Number of Patients Hazard ratio CI p value.... Gender Male. Clinical Presentation Anorexia Primary tumor size 表 2 Univariate analysis of the reported 38 patients with G-CSF producing gastric cancer Female... Fatigue Epigastralgia Weight decrease Others Mean. cm median. cm cm. cm... Serosal invasion of primary tumor Absent. Present... Lymph node metastasis Absent. Present... Distant Metastasis Absent. Present... WBC before oncologic treatment Mean, / median, /., /..., / CRP before oncologic treatment Mean. / dl median. / dl CEA before oncologic treatment Mean. / ml median. / ml. / dl.. / dl.... / ml.. / ml... G-CSF before oncologic treatment Mean. / median. /. /... / Histology most dominant Differentiated Undifferentiated.... Squamous cell or adenosquamous Neuroendocrine carcinoma Anti G-CSF antibody stain Negative. Positive... Resection Complete Rresection. Not R resection... No resection BSC Chemotherapy Absent. including adjuvant chemotherapy Present... Hazard ratio and p value were calculated using a COX proportional hazard regression model. BSC ; best supportive care

4 S-... Kaplan-Meier.. Cox hazard. CI.. Survival rate Overall survival Time(month) 図 1 Kaplan Meier survival curve of the reported 38 cases with G-CSF producing gastric cancer. 表 3 Univariate analysis of the patients with R0 resection(n=20) Characteristics Number of Patients Hazard ratio CI p value Age year old Mean.median Gender Male. Female.. -. Primary tumor size Mean. cm median. cm cm. cm... Serosal invasion of primary tumor Absent. Present... Lymph node metastasis Absent. Present... Distant Metastasis Absent. Present... WBC before oncologic treatment Mean, / median, /, /., /... CRP before oncologic treatment Mean. / dl median. / dl. / dl.. / dl... CEA before oncologic treatment Mean. / ml median. / ml. / ml.. / ml... G-CSF before oncologic treatment Mean. / median. /. /... / Histology most dominant Differentiated Undifferentiated.... Squamous cell or adenosquamous Neuroendocrine carcinoma Anti G-CSF antibody stain Negative. Positive... Adjuvant chemotherapy Absent. Present... Hazard ratio and p value were calculated using a COX proportional hazard regression model

5 Survival rate 図 2 p. R hazard. CI..p. R R Kaplan-Meier R. R.. R R p hazard. CI..p. R CEA / ml hazard. CI..p. G-CSF / hazard. CI..p. G-CSF p. 考 Overall survival Patients with R0 resection(n=20) Patients without R0 resection(n=18) Time(month) G-CSF G-CSF G-CSF G-CSF undifferentiated adenocarcinoma squamous cell carcinoma adenosquamous cell carcinoma G-CSF 察 Kaplan Meier survival curves of the patients according to achievement of R0 resection.... R G-CSF rapid growth lead time bias UICC stage lead time bias G-CSF R.. R. ganjoho.jp StageStage UICC TNM.. G-CSFG-CSF R hazard. CI..p. CEA hazard. CI..p. G-CSF p.p.p. G-CSF G-CSF autocrine growth factor site-reduction surgery Cur A palliative R. R G-CSF

6 cstagepet- CTFDG R G-CSF S-CDDP T-mab IRI PTX S- over diagnosis IRI CDDP S-CDDP G-CSF G-CSF G-CSF WBC G-CSF WBC まとめ G-CSF G-CSF R R CEAG-CSF publication bias evidence 文献 Demetri G. D. et al : Granulocyte colony-stimulating factor and its receptor. Blood :,. Robinson W. A. : Granulocytosis in neoplasia. ANN N Y Acad Sci :,. Obara T. et al : A case of gastric carcinoma associated with excessive granulocytosis. Production of a colony stimulating factor by the tumor. Cancer :,. Tachibana M. et al : Autocrine growth of transitional cell carcinoma of the bladder induced by granulocyte-colony stimulating factor. Cancer Res :,. Morstyn G. et al : Hematopoietic growth factors : a review. Cancer Res :,. Shimamura K. et al : Establishment of specific monoclonal antibodies against recombinant human granulocyte colony-stimulating factor hg-csf and their application for immunoperoxidase staining of paraffinembedded sections. J Histochem Cytochem :,. Horii A. et al : Granulocyte colony stimulating factorproducing tongue carcinoma. Head Neck :,. Matsumoto K. et al : Granulocyte colony-stimulating factor-producing upper urinary tract carcinoma: Systematic review of cases reported in Japan. Clin Oncol :,. Izumo W. et al : Granulocyte-colony stimulating factorproducing gallbladder carcinoma-include analysis all case reports: A case report. Int J Surg Case Rep :,. Kitani M. et al : Radical esophagectomy for a -yearold woman with granulocyte colony-stimulating factorproducing esophageal squamous cell carcinoma: a case report. World J Surg Oncol :,. Matsumoto M. et al : A pleomorphic carcinoma of the lung producing multiple cytokines and forming a rapidly progressive mass-like opacity. BMC Cancer :,. Granulocyte-colony stimulating factor. Tsuburaya A. et al : Neoadjuvant chemotherapy with S- and cisplatin followed by D gastrectomy with para-aortic lymph node dissection for gastric cancer with extensive lymph node metastasis. Br J Surg :,. Tsuruta N. et al : Systemic chemotherapy with

7 pronounced efficacy and neutropenia in a granulocytecolony stimulating factor-producing advanced gastric neuroendocrine carcinoma. Oncol Lett :,. Granulocytecolony stimulating factor :,. G-CSF :,. G-CSF :,.

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