眞嶋 浩聡

異時性に内分泌細胞癌小細胞型と扁平上皮癌の多発を認めた稀な食道癌の1例を経験したので報告する．症例は62歳，男性．嚥下時つかえ感を主訴に施行した内視鏡検査で胸部食道に2型腫瘍を認め，生検で内分泌細胞癌小細胞型と診断された．CTでは気管膜様部浸潤，リンパ節転移などを認め，cStage IVa（T4N3M0）と診断され，肺小細胞癌に準じてCDDP，CPT-11による化学療法と放射線療法を併用した．化学療法計11コース終了後，CT，内視鏡検査では腫瘍，リンパ節腫脹が消失し，完全奏効であったが，腹部食道に表面隆起型扁平上皮癌を認め，内視鏡的粘膜下層剥離術を施行した（moderately to poorly differentiated squamous cell carcinoma，pT1a（MM），ly0，v0，pHM0，pVM0）．内分泌細胞癌の診断から現在まで，3.5年間無再発生存中である．

Pancreatic acinar cells are used to study regulated exocytosis. We investigated the role of interferon regulatory factor-2 (IRF2) in exocytosis in pancreatic acinar cells.<br /> Pancreas tissues from Irf2⁺/⁺, Irf2⁺/⁻), and Irf2⁻/⁻ mice were examined by microscopy, immunohistochemical, and immunoblot analyses; amylase secretion was quantified. We also compared salivary glands and pancreatic islets of Irf2⁻/⁻ mice with those of Irf2⁺/⁻ mice. To examine the effects of increased signaling by type I interferons, we studied pancreatic acini from Irf2⁻/⁻Ifnar1⁻/⁻ mice. The effect of IRF2 on amylase secretion was studied using an acinar cell line and a retroviral system. We studied expression of IRF2 in wild-type mice with cerulein-induced pancreatitis and changes in pancreatic tissue of Irf2⁻/⁻ mice, compared with those of Irf2⁺/⁻ mice.<br /> Irf2⁻/⁻ pancreas was white and opaque; numerous and wide-spread zymogen granules were observed throughout the cytoplasm, along with lack of fusion between zymogen granules and the apical membrane, lack of secretagogue-stimulated amylase secretion, and low serum levels of amylase and elastase-1, indicating altered regulatio