2025/04/02 更新

写真a

イワムロ マサヤ
岩室 雅也
IWAMURO Masaya
所属
学術研究院医療開発領域 助教
職名
助教
外部リンク

学位

  • 博士(医学) ( 岡山大学大学院医歯薬学総合研究科 )

研究キーワード

  • 消化管リンパ腫

  • 消化器内視鏡

  • 幹細胞

研究分野

  • ライフサイエンス / 消化器内科学

所属学協会

 

論文

  • Analysis of painful situations during unsedated esophagogastroduodenoscopy. 国際誌

    Hiromitsu Kanzaki, Sakiko Kuraoka, Takuya Satomi, Shotaro Okanoue, Kenta Hamada, Yoshiyasu Kono, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada, Motoyuki Otsuka

    Endoscopy international open   12 ( 11 )   E1267-E1276   2024年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background and study aims Although esophagogastroduodenoscopy (EGD) is a widely used technique, the procedure is often associated with discomfort. This study aimed to analyze painful situations, their frequency, and factors associated with patient discomfort during EGD. Patients and methods This prospective observational study included patients scheduled to undergo EGD. Seven endoscopists recruited patients scheduled for EGD screening or surveillance. Each endoscopist enrolled 20 patients, performing 10 EGD procedures using ultraslim endoscopes and 10 with standard-sized endoscopes. Data regarding painful situations and frequency were collected using specialized buttons pressed by the patients during EGD. A survey about overall discomfort was conducted after the procedure. Results We analyzed data from 140 patients. Esophageal insertion and duodenal observation were associated with the highest incidence of pressing the pain button, accounting for 59.3% and 40.7% of the cases, respectively. The factor associated with pressing the pain button during esophageal insertion was endoscopist experience (< 10 years). In contrast, younger age and female sex were the factors associated with pressing the pain button during duodenal observation. In the post-procedure survey, 63.6% of patients reported discomfort. Factors associated with patient discomfort included pressing the pain button during esophageal insertion (odds ratio [OR]: 2.84, P = 0.01) and previous painful EGD experience (OR: 2.41, P = 0.03). Concusions This study provides objective data on painful situations, their frequency, and related factors during EGD. Further research and interventions focusing on pain reduction during endoscopic procedures are warranted. The results of this study will help endoscopists manage painful situations and potentially improve skills.

    DOI: 10.1055/a-2401-6804

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  • Clinical Significance of Prior Ramucirumab Use on the Effectiveness of Nivolumab as the Third-Line Regimen in Gastric Cancer: A Multicenter Retrospective Study. 国際誌

    Yuka Obayashi, Shoichiro Hirata, Yoshiyasu Kono, Makoto Abe, Koji Miyahara, Masahiro Nakagawa, Michihiro Ishida, Yasuhiro Choda, Kenta Hamada, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Motoyuki Otsuka

    Drugs - real world outcomes   2024年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND OBJECTIVE: Because vascular endothelial growth factor inhibition has been suggested to improve immune cell function in the cancer microenvironment, we examined whether using ramucirumab (RAM) before nivolumab usage is more effective in advanced gastric cancer. METHODS: This was a multicenter retrospective observational study. We analyzed patients who received nivolumab monotherapy as the third-line regimen for unresectable advanced or recurrent gastric cancer between October 2017 and December 2022. They were divided into the RAM (RAM-treated) group and the non-RAM (non-treated) group according to the RAM usage in the second-line regimen. The primary outcome was to compare the overall survival after nivolumab administration in the third-line regimen between the RAM and non-RAM groups. RESULTS: Fifty-two patients were included in the present study: 42 patients in the RAM group and ten patients in the non-RAM group. The median overall survival was significantly longer in the RAM group than in the non-RAM group (8.5 months vs 6.9 months, p < 0.05). In the RAM group, patients without peritoneal metastasis had significantly better median overall survival than those with peritoneal metastasis (23.8 months vs 7.7 months, p = 0.0033). Multivariate Cox-proportional hazards analyses showed that the presence of peritoneal metastasis (hazard ratio, 2.4; 95% confidence interval 1.0-5.7) alone was significantly associated with overall survival in the RAM group. CONCLUSIONS: The use of RAM prior to nivolumab monotherapy may contribute to prolonged survival in patients with gastric cancer, especially those without peritoneal metastasis.

    DOI: 10.1007/s40801-024-00460-z

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  • Long-term outcomes of endoscopic resection of superficial esophageal squamous cell carcinoma in late-elderly patients. 査読 国際誌

    Katsunori Matsueda, Seiji Kawano, Keisuke Fukui, Shoichiro Hirata, Takuya Satomi, Shoko Inoo, Kenta Hamada, Yoshiyasu Kono, Masaya Iwamuro, Yoshiro Kawahara, Motoyuki Otsuka

    Journal of gastroenterology and hepatology   2024年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIM: As the population ages, the number of elderly patients with superficial esophageal squamous cell carcinoma (ESCC) is increasing. We aimed to clarify the indications for endoscopic resection (ER) in late-elderly patients with ESCC in terms of life expectancy. METHODS: Patients aged ≥75 years who underwent ER for ESCC at our institution from January 2005 to December 2018 were enrolled. Clinical data, including the Eastern Cooperative Oncology Group performance status, American Society of Anesthesiologists physical status (ASA-PS), Charlson comorbidity index, and prognostic nutritional index (PNI), were collected at the time of ER. The main outcome measure was overall survival (OS). RESULTS: Two hundred eight consecutive patients were enrolled. The patients' median age was 78 years (range, 75-89 years). The 5-year follow-up rate was 88.5% (median follow-up period, 6.6 years). The 5-year OS rate was 79.2% (95% confidence interval [CI], 72.2-84.8), and 5-year net survival standardized for age, sex, and calendar year was 1.04 (95% CI, 0.98-1.09). In the multivariate analysis, an ASA-PS of 3 (hazard ratio, 2.45; 95% CI, 1.16-5.17) and PNI of <44.0 (hazard ratio, 2.73; 95% CI, 1.38-5.40) were independent prognostic factors. When neither of these factors was met, the 5-year OS rate was 87.8% (95% CI, 80.0-92.9), and 5-year net survival was 1.08 (95% CI, 1.02-1.14). CONCLUSIONS: ER for ESCC in late-elderly patients may improve life expectancy. ER is recommended in patients with a good ASA-PS and PNI.

    DOI: 10.1111/jgh.16764

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  • Rates and risk factors of bleeding after gastric endoscopic submucosal dissection with continuous warfarin or 1-day withdrawal of direct oral anticoagulants. 国際誌

    Shoichiro Hirata, Kenta Hamada, Masaya Iwamuro, Hirokazu Mouri, Koji Miyahara, Takao Tsuzuki, Kenji Yamauchi, Sayo Kobayashi, Sakuma Takahashi, Ryuta Takenaka, Shinichiro Hori, Masafumi Inoue, Tatsuya Toyokawa, Mamoru Nishimura, Shuhei Ishiyama, Jiro Miyaike, Ryo Kato, Minoru Matsubara, Naoko Yunoki, Hiromitsu Kanzaki, Yoshiro Kawahara, Hiroyuki Okada, Hideki Ishikawa, Motoyuki Otsuka

    Journal of gastroenterology and hepatology   2024年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIM: The 2017 Japanese guidelines recommend continuing warfarin therapy during the perioperative period or discontinuing direct oral anticoagulants (DOACs) only on the day of endoscopic submucosal dissection for early gastric cancer. However, their safety has not been sufficiently explored. This study aimed to validate this management method. METHODS: This retrospective, multicenter study analyzed the characteristics and outcomes of patients who underwent gastric endoscopic submucosal dissection between July 2017 and June 2019. The patients were categorized according to the use of warfarin or DOACs. RESULTS: Among the 62 eligible patients, 53 (85%) were male (median age, 76 years). Warfarin was used in 10 patients (16%) and DOACs in 52 patients (84%). Fourteen patients taking DOACs (27%) used concomitant antiplatelet agents, with seven patients (13%) continuing treatment at the time of the endoscopic procedure. No postprocedural bleeding occurred in patients receiving warfarin (0%), whereas 10 cases (19%) of bleeding occurred in patients receiving DOACs: rivaroxaban, 0% (0/22); dabigatran, 0% (0/2); edoxaban, 43% (6/14); and apixaban, 29% (4/14). The type of anticoagulant (P < 0.01) and continuation of antiplatelet therapy (P = 0.02) were risk factors for postprocedural bleeding in patients receiving DOACs. Intraprocedural bleeding requiring transfusion or symptomatic thromboembolic events were not reported. CONCLUSIONS: Continuous warfarin therapy is preferred. DOAC withdrawal 1 day before a procedure is associated with a high bleeding rate, which may differ for different types of anticoagulants. The continuation of antiplatelet medications in patients receiving DOACs carries a high risk of bleeding and is a future challenge.

    DOI: 10.1111/jgh.16757

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  • Vonoprazan-Associated Mucosal Redness: A Report of Two Cases. 国際誌

    Masaya Iwamuro, Yoshiyasu Kono, Takehiro Tanaka, Seiji Kawano, Nobumasa Ikeda

    Cureus   16 ( 10 )   e71325   2024年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Vonoprazan, a potassium-competitive acid blocker, is effective at treating acid-related gastrointestinal disorders but has been linked to gastric mucosal redness, a novel condition. This report describes two cases of vonoprazan-associated mucosal redness. Case 1 involved a 73-year-old woman who developed longitudinal erythema and mild mucosal changes after starting vonoprazan seven years ago. Case 2 involved a 70-year-old man who exhibited significant erythema and atrophic gastritis after seven months of treatment. In both cases, the pathological findings included hemorrhage in the superficial mucosa, highlighting that microhemorrhage may be the corresponding pathological finding for vonoprazan-associated mucosal redness.

    DOI: 10.7759/cureus.71325

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MISC

  • 左心耳閉鎖術前後の抗血栓療法に伴う消化管出血に関する検討

    河野吉泰, 濱田健太, 安部真, 神崎洋光, 岩室雅也, 川野誠司, 河原祥朗, 岡田裕之

    日本消化管学会雑誌(CD-ROM)   6 ( Supplement (CD-ROM) )   2022年

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  • 胃癌と非癌粘膜の白色球状外観(white globe appearance)の差異に関する検討

    岩室雅也, 田中健大, 榮浩行, 安部真, 河野吉泰, 神崎洋光, 川野誠司, 河原祥朗, 岡田裕之

    Gastroenterological Endoscopy (Web)   64 ( 1 )   2022年

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  • チエノピリジン服用者における胃内視鏡的粘膜下層剥離術(ESD)の後出血リスクの検討

    平井亮佑, 川野誠司, 稲生祥子, 倉岡紗樹子, 岡上昇太郎, 里見拓也, 濱田健太, 河野吉泰, 神崎洋光, 岩室雅也, 河原祥朗, 岡田裕之

    Gastroenterological Endoscopy (Web)   64 ( Supplement1 )   2022年

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  • 若年者におけるヘリコバクターピロリ除菌治療による腸内細菌叢の変化についての検討

    岡上昇太郎, 後藤和義, 倉岡紗樹子, 稲生祥子, 里見拓也, 濱田健太, 河野吉泰, 神崎洋光, 岩室雅也, 川野誠司, 河原祥朗, 横田憲治, 岡田裕之

    日本ヘリコバクター学会学術集会プログラム・抄録集   28th   2022年

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  • 医療系学部教育でのIPE(Inter-professional Education:多職種連携教育)の実践を通した患者中心の医療の経験

    三好智子, 三好智子, 岩室雅也, 花山宜久, 小川弘子, 小比賀美香子, 名倉弘哲, 大塚文男

    医学教育   53 ( 6 )   2022年

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共同研究・競争的資金等の研究

  • 消化器がん幹細胞標的療法としての遺伝子治療開発

    研究課題/領域番号:23K07438  2023年04月 - 2026年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    白羽 英則, 岩室 雅也, 大西 秀樹, 堀口 繁, 内田 大輔, 竹内 康人

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    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

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  • 潰瘍性大腸炎患者における直腸リンパ球の表面発現に基づいた治療効果予測法の確立

    研究課題/領域番号:22K07962  2022年04月 - 2025年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    岩室 雅也, 白羽 英則, 高原 政宏

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

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  • 咽頭表在癌内視鏡治療後潰瘍に対する扁平上皮細胞シートによる再生医療的治療法の開発

    研究課題/領域番号:15K10808  2015年04月 - 2018年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    堀 圭介, 岡田 裕之, 河原 祥朗, 高木 章乃夫, 岩室 雅也, 木股 敬裕, 小野田 友男, 金井 信雄, 安部 真

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    配分額:4810000円 ( 直接経費:3700000円 、 間接経費:1110000円 )

    医療用内視鏡分野の発展により、内視鏡補助下の早期の咽頭癌に対する経口的切除が広く行われる様になってきた。切除後早期合併症の予防、治癒後瘢痕形成による機能障害を予防する為、咽頭に対する扁平上皮細胞シート移植の臨床応用への基盤となる動物モデル(ミニブタモデル)での移植実験を行った。ワークスペースが限られる咽頭内腔における細胞シート移植の為、咽頭領域に扁平上皮細胞シートを運搬する新規移植デバイスを3Dプリンターにより作成した。移植群、対照群を比較した実験において、移植群において有意な創傷治癒の促進効果を確認し、今後の臨床応用に向け、非臨床POCを取得した。

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  • 肝癌における癌悪性化シグナルを標的とした新規治療法の確立

    研究課題/領域番号:15K08999  2015年04月 - 2018年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    白羽 英則, 桑木 健志, 大西 秀樹, 中村 進一郎, 能祖 一裕, 岩室 雅也, 堀口 繁, 竹内 康人

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    配分額:4810000円 ( 直接経費:3700000円 、 間接経費:1110000円 )

    肝癌におけるNotchシグナル活性化と癌悪性化メカニズムの関連性を検討した。Notchシグナルの阻害剤であるγ-secretase inhibitor (GSI)は、単独では培養肝癌細胞の細胞増殖にほとんど影響を与えなかったが、抗癌剤の細胞増殖抑制作用を倍増させた。肝がんの化学療法においてNotchシグナル制御を行う事が抗癌剤耐性化抑制に寄与する可能性が示唆された。抗癌剤耐性化の克服により化学療法の必要な肝がん患者の予後を改善できる可能性がある。

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  • 消化器癌における新規癌関連遺伝子REICの機能解析と臨床応用に関する研究

    研究課題/領域番号:15K09001  2015年04月 - 2018年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    加藤 博也, 内田 大輔, 白羽 英則, 那須 保友, 堤 康一郎, 松下 浩志, 岩室 雅也

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    肝細胞癌、胆道癌の細胞株における実験で、REIC遺伝子の導入による癌細胞特異的なアポトーシスが誘導されることが証明された。また肝細胞癌手術検体を用いた免疫組織染色では、癌部でのREIC発現が低下していることが証明された。
    膵癌細胞株にヒトPBMCとREIC蛋白を加えることで、PBMCの樹状細胞への分化誘導を促進し、CTLの活性化を介した腫瘍免疫誘導効果をもたらすことが証明された。
    これらの結果をもとに、肝癌に対するREIC遺伝子導入治療の医師主導治験が開始された。

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担当授業科目

  • 消化器系(臓器・系別統合講義) (2024年度) 特別  - その他