We previously reported the beneficial effects of combination therapy of interferon (IFN)-a/5-fluorouracil (FU) for advanced hepatocellular carcinoma (HCC) with tumour thrombi in the major portal branches. This report describes the results of longer follow-up and includes more than double the number of patients relative to the original report, and evaluates the role of IFN-a/type 2 interferon receptor (IFNAR2) expression on the response to the combination therapy. The study subjects were 55 patients with advanced HCC and tumour thrombi in the major branches of the portal vein (Vp3 or 4). They were treated with at least two courses of IFN-a/5-FU without major complication. In the 55 patients, 24 (43.6%) showed objective response (eight (14.5%) showed complete response, 16 (29.1%) partial response), four (7.3%) showed no response, and 27 (49.1%) showed progressive disease. Immunohistochemically, IFNAR2 expression was detected in nine out of 13 (69.2%) patients. There was significant difference in the time-to-progression survival (P ¼ 0.0002) and the overall survival (Po0.0001) between IFNAR2-positive and -negative cases. There was a significant correlation between IFNAR2 expression and response to IFN-a/5-FU combination therapy in univariate analysis (P ¼ 0.0070). IFN-a/5-FU combination therapy is a promising modality for advanced HCC with tumour thrombi in the major portal branches and could significantly depend on IFNAR2 expression.

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The purpose of this study was to define the indications and limitations of endoscopic resection (ER) of early gastric carcinoma (EGC). Over the 15 year period from 1978 to 1992, 308 early cancers were resected endoscopically either through a single operative intervention or in stages. Of 266 lesions resected in a single step, 222 (85%) entered remission. Forty-four cases had either residual or recurrent lesions. The size, histology and location affected the curability; 89% of Type IIa lesions less than 2 cm were resected curatively, while only 50% of those larger than 2 cm were resected completely. In Type IIc, 83% of lesions less than 1 cm and 57% of those greater than 1 cm were excised completely by ER. In Type IIc, curative ER was possible in 85% of differentiated carcinomas and 43% of undifferentiated carcinomas. The rate of incomplete resection was higher for lesions of the anterior or posterior wall, than for those of the lesser curvature. Semiserial sections of the resected specimens made at 2 mm intervals, indicated that, if the positive margin was confined to one section, cure may be possible by the burning effect. Follow-up showed that there was no single case undergoing endoscopic resection which subsequently died of gastric carcinoma. The lesions that are suitable for ER comprise Type IIa EGC of less than 2 cm in diameter, and Type IIc differentiated adenocarcinoma of less than 1 cm. Lesions in which the entire margin is difficult to observe by front-view endoscopy should be smaller than defined by the above criteria.

Our study showed that the expression of VEGF and Ang-2 correlated with MVD. Strong Ang-2 expression and/or high nuclear expression of HIF-1alpha is a significant predictive factor for recurrence after curative resection in HCC patients.

Objective To investigate the association between body mass index (BMI) and radiographic joint damage (using the Ratingen Score [RS]) in early rheumatoid arthritis (RA). Methods The study was carried out in 767 patients with early RA. Standard clinical data, RS, and BMI were evaluated at baseline and after 3 years. Multivariate logistic regression analyses were performed in rheumatoid factor (RF)–positive and RF‐negative patients to determine the influence of BMI (<25 versus ≥30 kg/m2) on considerable joint damage (RS ≥7) after 3 years, adjusting for sex, age, disease duration, and disease activity (using the Disease Activity Scale in 28 joints [DAS28]). Results Patients of normal weight already had significantly more joint damage at study entry than obese patients (mean RS 4.5 versus 2.4; P = 0.004) and experienced significantly more progression than obese patients (RS 3.4 versus 1.3; P = 0.011). At 3 years, their RS score was twice as high as that of the obese patients (7.5 versus 3.7; P < 0.001). Multivariate regression analyses in both serologic groups revealed significantly higher odds of RS ≥7 in RF‐positive patients of normal weight than in RF‐positive obese patients (odds ratio [OR] 3.3), but not in RF‐negative patients. Male sex (OR 1.6), osteoporosis (OR 2.0), C‐reactive protein levels >15 mg/liter versus <5 mg/liter (OR 2.6), and disease activity (DAS28 ≥5.1 versus <3.2; OR 1.9) were independently associated with RS ≥7. Conclusion BMI provides a risk estimate of joint damage in RA patients. Further studies are needed to elucidate the association between BMI, RF, and joint damage in RA and the possible role of adipose tissue.