Studies on adjuvant therapies for prevention of hepatic matastasis after resection of pancreatic cancer

由于经常出现肝转移，胰腺癌患者的术后病程是充分的。手术联合辅助治疗是改善预后的唯一途径，但可能会增加发病率和死亡率。为了明确胰十二指肠切除术（PD）的安全性、加放疗时的安全性以及/或肝转移的分子机制，我们分析了以下问题。(1)由于猴的排泄道解剖结构与人相似，猴的PD可作为了解和评价术前、术中及术后放疗影响的有用模型。我们已经为猴子建立了标准的PD技术。(2)临床应用肝功能测定，使用甲美二酮对PD术前患者进行肝功能测定。(3)为了解肝转移的分子机制，对28例原发性胰腺癌和16例原发性胰腺癌的肝转移结节进行E-cadherin （E-cad）和α -catenin （α -cat）蛋白的表达分析。我们发现，E-cad和α -cat的表达状态没有显著的预测价值，尽管在这种细胞-细胞相互作用系统完整的病例中，似乎有更高的肝转移倾向。

Postoperative course of the patient with Pancreatic carcinoma is in sufficient, because of the frequent presentation of liver metastasis. Combination of operation and adjuband therapy is only the way for improving the prognosis, however, morbidity and mortality rate may increase. In order to clarify the safes of pancreatico duodenectomy (PD), when radiation therapy is added, and/or the molecular mechanisms of liver metastasis, following issues were analyzed. (1) Because anatomy of eliminatory tract of monkey is similar to those of human, PD for monkey should be a useful model to know and evaluate the in fluence of pre-, intea- and post-operative radiation therapy. We have established the standard PD technique for monkey. (2) We clinically applied liver function assay test, using Trimethadione, for the preoperative patient of PD.(3) Intending to know the molecular mechanisms of liver metastasis, twenty-eight primary pancreatic carcinomas and liver metastatic nodules from 16 or them were analyzed for E-cadherin (E-cad) and alpha-catenin (alpha-cat) protein expression. We found that the status of the E-cad and alpha-cat expression has no significant predictive value, even though there seem to be a higher tendency to liver metastasis for cases with integrity of such cell-cell interaction system.