Ohtsubo K, Mouri H, Sakai J, Akasofu M, Yamaguchi Y, Watanabe H, Gabata T, Motoo Y, Okai T, Sawabu N
Department of Internal Medicine and Medical Oncology, Kanazawa University, Japan.
J Clin Gastroenterol. 1998 Dec;27(4):357-60. doi: 10.1097/00004836-199812000-00018.
We report an 83-year-old man with pancreatic body cancer of 4.5 cm in diameter. Peripheral leukocyte count was 15,700/microl and the serum concentration of granulocyte-colony stimulating factor (G-CSF) was 123 pg/ml (normal, 6.0-21.9 pg/ml) on admission. Furthermore, not only K-ras codon 12 (GGT --> GAT) but also p53 at codon 247 (CGG --> CCG) mutations were identified in the pancreatic juice aspirated endoscopically. We performed chemotherapy with two courses of 5-fluorouracil, pirarubicin hydrochloride, and mitomycin-C, resulting in no beneficial effect. After the second course the patient developed interstitial pneumonia, probably caused by anticancer drugs, and died 4 months after the tumor was detected. In the autopsy tissue, the tumor macroscopically occupied the pancreas body and was 7 x 6 x 5 cm in size. Histopathologic diagnosis of the tumor was poorly differentiated adenosquamous carcinoma. Immunohistochemical staining of the autopsy tissue showed that pancreatic cancer cells were positive for G-CSF. This is the first case report of G-CSF-positive pancreatic cancer confirmed by immunohistochemistry.
我们报告了一名83岁的男性，患有直径4.5厘米的胰体癌。入院时外周白细胞计数为15,700/微升，血清粒细胞集落刺激因子（G-CSF）浓度为123皮克/毫升（正常范围为6.0 - 21.9皮克/毫升）。此外，在内镜下抽吸的胰液中不仅检测到K-ras密码子12（GGT --> GAT）突变，还检测到密码子247处的p53（CGG --> CCG）突变。我们用两疗程的5-氟尿嘧啶、盐酸吡柔比星和丝裂霉素-C进行化疗，但未取得有益效果。第二疗程后，患者发生间质性肺炎，可能由抗癌药物引起，在肿瘤被发现4个月后死亡。尸检组织中，肿瘤肉眼可见占据胰体，大小为7×6×5厘米。肿瘤的组织病理学诊断为低分化腺鳞癌。尸检组织的免疫组化染色显示胰腺癌细胞G-CSF呈阳性。这是首例经免疫组化证实的G-CSF阳性胰腺癌病例报告。
