Basic and clinical study of adjuvant therapy for preventaion of liver metastasis of pancreatic cancer after surgical therapy

Liver metastasis of pancreatic cancer after pancreas resection is the most critical problem even now。Effective adjuvant therapy combined with surgical therapy is required for increase the survival length of the patients after pancreas resection。The prupose of this study was investigation of four ways to develop the adjuvant therapy.1：Arterial embolization method using fibrin glue to prevent pressing cancer cell into portal vein by surgical manipulation。2：Histopathological study of adjuvant irradiation to pancreas and clinical evaluation of adjuvant irradiation。3：Analysis of E-Cadherin DNA·mRNA of pancreas cancer cell which participates in invasion and metastasis.4：New liver function test which is useful for prediction of liver injury by ischemy during surgery or by anticancer drug infusion into the hepatic artery.Results：1：We determined conditions of fibrinogen and thrombin which could be injeted into small vessels。And we confirmed the fibrin glue without aprotinin in dog supra mesentric artery lysed in several hours because of plasmin like substance comtaminated in fibrin.The fibrin glue should be safe and effective in clinical use。2：Intra operative and post operative radiation therapy was not effective to inhibit liver metastasis after surgery but could slightly increase patient survival length。Study of pre-operative radiation method using japanese monkey is still on the way.Clinical traial of the pre-operative irradiation was started，however it takes several years to estimate the effectiveness。3：Four of 19 human pancreatic cancer cell lines expressed no E-Cadherin mRNA and one showed markedly reduced expression.This may explaine a molecular mechanism of invasive tendency of pancreatic cancer.4：We developed a new liver function test using trimethadione and have examined another new test using caffein。

Liver metastasis of pancreatic cancer after pancreas resection is the most critical problem even now. Effective adjuvant therapy combined with surgical therapy is required for increase the survival length of the patients after pancreas resection. The prupose of this study was investigation of four ways to develop the adjuvant therapy. 1 : Arterial embolization method using fibrin glue to prevent pressing cancer cell into portal vein by surgical manipulation. 2 : Histopathological study of adjuvant irradiation to pancreas and clinical evaluation of adjuvant irradiation. 3 : Analysis of E-Cadherin DNA ・ mRNA of pancreas cancer cell which participates in invasion and metastasis. 4 : New liver function test which is useful for prediction of liver injury by ischemy during surgery or by anticancer drug infusion into the hepatic artery.Results : 1 : We determined conditions of fibrinogen and thrombin which could be injeted into small vessels. And we confirmed the fibrin glue without aprotinin in dog supra mesentric artery lysed in several hours because of plasmin like substance comtaminated in fibrin. The fibrin glue should be safe and effective in clinical use. 2 : Intra operative and post operative radiation therapy was not effective to inhibit liver metastasis after surgery but could slightly increase patient survival length. Study of pre-operative radiation method using japanese monkey is still on the way. Clinical traial of the pre-operative irradiation was started, however it takes several years to estimate the effectiveness. 3 : Four of 19 human pancreatic cancer cell lines expressed no E-Cadherin mRNA and one showed markedly reduced expression. This may explaine a molecular mechanism of invasive tendency of pancreatic cancer. 4 : We developed a new liver function test using trimethadione and have examined another new test using caffein.