Faculty Profiles - IWAMURO Masaya

Papers - IWAMURO Masaya

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Scoring systems for differentiating gastrointestinal stromal tumors and schwannomas from leiomyomas in the stomach. Reviewed International journal

Shotaro Okanoue, Masaya Iwamuro, Takehiro Tanaka, Takuya Satomi, Kenta Hamada, Hiroyuki Sakae, Makoto Abe, Yoshiyasu Kono, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Medicine 100 ( 40 ) e27520 - e27520 2021.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

ABSTRACT: There is no practical predictive model for the diagnosis of gastrointestinal stromal tumors (GISTs). To establish a practical predictive model for the diagnosis of subepithelial lesions in the stomach, we reviewed patients with GISTs (n = 89), schwannomas (n = 7), and leiomyomas (n = 28).The tumor was more frequently found along the gastric cardia in the leiomyoma group (57.1%) than in the GIST/schwannoma group (2.1%, P < .01). Contrast enhancement (57.3% vs 0%, P < .01) and intra-tumoral necrosis (34.4% vs 0.0%, P < .01) were more frequently observed in the GIST/schwannoma group than in the leiomyoma group. On endoscopic ultrasonography, 58.3% of GISTs/schwannomas showed uneven echogenicity, whereas the echogenicity was uneven in 21.4% of leiomyomas (P < .01). There were no differences between the tumor color and the presence or absence of ulcer formation, tumor bleeding, irregularity of the tumor margin, cystic spaces, and hyperechoic spots between the 2 groups. Based on these results, we developed a 2-step diagnostic algorithm for GISTs/schwannomas. The first step comprises 1 endoscopic feature: a cardiac or non-cardiac location. Tumors with a cardiac location were judged as leiomyomas and those with a non-cardiac location were judged as GISTs/schwannomas, with 96.9% sensitivity and 57.1% specificity for GIST/schwannoma diagnosis. The second step comprises a combination of endoscopic (non-cardiac location), radiologic (positive contrast enhancement and intra-tumoral necrosis), and endosonographic (uneven echogenicity) features for a total of 4 points. We assigned 1 point to each feature. Tumors with scores of 2 to 4 were judged as GISTs/schwannomas, with 81.3% sensitivity and 92.9% specificity for GIST/schwannoma diagnosis.Our predictive model will be a practical guide for the management of gastric subepithelial lesions.

DOI： 10.1097/MD.0000000000027520

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Clinical characteristics and course of sporadic non-ampullary duodenal adenomas: A multicenter retrospective study. International journal

Hiromitsu Kanzaki, Kazuhiro Matsueda, Masahiro Nakagawa, Tomoki Inaba, Masahiro Takatani, Ryuta Takenaka, Masao Yoshioka, Atsushi Imagawa, Masafumi Inoue, Seiyuu Suzuki, Jun Tomoda, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Okada

Medicine 100 ( 39 ) e27382 2021.10

Language：English Publishing type：Research paper (scientific journal)

ABSTRACT: Sporadic non-ampullary duodenal adenoma (SNADA) is a rare disease, and therefore, its clinical characteristics have not been comprehensively investigated. Furthermore, owing to the high complication rates and severity of endoscopic resection, treatment strategies vary among facilities. In the present study, we aimed to clarify the clinical characteristics and course of SNADA.We extracted clinical and histological records of SNADA cases diagnosed in 11 hospitals between September 1999 and August 2014. The patients were divided into "no-resection" and "resection" groups based on the initial treatment approach. We investigated the long-term outcome of the "no-resection" group and treatment results of the "resection" group, with particular interest in endoscopic resection.Overall, 299 patients were diagnosed with SNADA. The median age at diagnosis was 67 years (range, 31-88 years), with approximately twice as many men as women. The median tumor size was 8.0 mm (2-60 mm). In total, 161 patients were initially selected for no-resection and 138 underwent resection. Age >70 years and the presence of either severe illness or poor performance status were significantly related to opting for no-resection. In the no-resection group, 101 patients underwent endoscopic follow-up for at least 1 year. During the observational period (2.5 ± 2.2 years), 27 lesions (27%) disappeared following cold forceps biopsy, and 13 lesions (14%) presented lateral growth. Four lesions (4%) changed to mucosal carcinoma, 3 were treated endoscopically, and 1 was surgically resected. Nineteen patients died; however, no one died of duodenal carcinoma. In the endoscopic resection group, en bloc resection was achieved in 78% of patients. However, the complication rate for perforation was 7%, and endoscopic submucosal dissection was associated with a 36% perforation rate.With the low incidence of cancer development and no disease specific death, the strategy of initially not performing resection could be considered especially for the older adults, poor-prognosis patients, or small lesions.

DOI： 10.1097/MD.0000000000027382

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Diffuse Esophageal Wall Thickening Due to Lymphoma. Reviewed

Masaya Iwamuro, Ken-Ichi Matsuoka, Takehiro Tanaka, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 60 ( 19 ) 3179 - 3180 2021.10

家族性大腸腺腫症の胃病変の形質発現と内視鏡的特徴の検討

小橋真由, 岩室雅也, 亀高大介, 岡上昇太郎, 里見拓也, 濱田健太, 榮浩行, 安部真, 河野吉泰, 神崎洋光, 川野誠司, 河原祥朗, 田中健大, 岡田裕之

Gastroenterological Endoscopy 63 ( Suppl.2 ) 2023 - 2023 2021.10

上部消化管内視鏡診療の新技術 Flow Cytometryのための内視鏡下生検材料からの簡易リンパ球分離方法

岩室雅也, 田中健大, 岡田裕之

Gastroenterological Endoscopy 63 ( Suppl.2 ) 1968 - 1968 2021.10

上部消化管内視鏡診療の新技術 Flow Cytometryのための内視鏡下生検材料からの簡易リンパ球分離方法

岩室雅也, 田中健大, 岡田裕之

Gastroenterological Endoscopy 63 ( Suppl.2 ) 1968 - 1968 2021.10

家族性大腸腺腫症の胃病変の形質発現と内視鏡的特徴の検討

小橋真由, 岩室雅也, 亀高大介, 岡上昇太郎, 里見拓也, 濱田健太, 榮浩行, 安部真, 河野吉泰, 神崎洋光, 川野誠司, 河原祥朗, 田中健大, 岡田裕之

Gastroenterological Endoscopy 63 ( Suppl.2 ) 2023 - 2023 2021.10

Desquamative esophagitis followed by esophageal cancer in a stem cell transplant recipient. Reviewed International journal

Masaya Iwamuro, Nobuharu Fujii, Shunsuke Tanabe, Hiroyuki Okada

Gastrointestinal endoscopy 2021.9

胃気腫症の5例の臨床的特徴に関する検討 Reviewed

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

日本消化器病学会雑誌 118 ( 9 ) 851 - 858 2021.9

【消化管の希少疾患-診療の現状】Gastric adenocarcinoma and proximal polyposis of the stomach(GAPPS)の臨床病理学的特徴

川野誠司, 赤穂宗一郎, 倉岡紗樹子, 小橋真由, 岡上昇太郎, 里見拓也, 濱田健太, 安部真, 河野吉泰, 神崎洋光, 岩室雅也, 河原祥朗, 岡田裕之

消化器・肝臓内科 10 ( 3 ) 290 - 295 2021.9

Two Types of Polyp Shape Observed in the Stomach of Patients with Peutz-Jeghers Syndrome. Reviewed

Masaya Iwamuro, Tatsuya Toyokawa, Kazuhiro Matsueda, Shinichiro Hori, Masao Yoshioka, Yuki Moritou, Takehiro Tanaka, Motowo Mizuno, Hiroyuki Okada

Acta medica Okayama 75 ( 4 ) 471 - 477 2021.8

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

The characteristics of gastric polyps in patients with Peutz-Jeghers (PJ) syndrome (PJS) have not been fully investigated. The objective of this study was to reveal the endoscopic and pathologic findings of gastric polyps in patients with PJS. We reviewed 11 patients with PJS treated at 6 institutions, and summarized the endo-scopic and pathologic features of their gastric polyps. The polyps were mainly classified into 2 types: (i) soli-tary or sporadic polyps > 5 mm, reddish in color with a sessile or semi-pedunculated morphology (n = 9); and (ii) multiple sessile polyps ≤ 5 mm with the same color tone as the peripheral mucosa (n = 9). Patients who underwent endoscopic mucosal resection for polyps > 5 mm were diagnosed with PJ polyps (n = 2), whereas those who underwent biopsy were diagnosed with hyperplastic polyps. Polyps ≤ 5 mm were pathologically diagnosed as fundic gland polyps or hyperplastic polyps. This study revealed that patients with PJS present with 2 types of polyps in the stomach. Endoscopic mucosal resection of polyps > 5 mm seems necessary for the pathologic diagnosis of PJ polyps.

DOI： 10.18926/AMO/62399

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一目瞭然!目で診る症例 Invited

岩室雅也, 田中健大, 岡田裕之

日本内科学会雑誌 110 ( 8 ) 1685 - 1687 2021.8

Isolation of lymphocytes from the human gastric mucosa. Invited Reviewed International journal

Masaya Iwamuro, Takahide Takahashi, Natsuki Watanabe, Hiroyuki Okada

World journal of methodology 11 ( 4 ) 199 - 207 2021.7

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

Flow cytometry is widely used for lymphocyte immunophenotyping in clinical settings. However, few studies have applied it for analyzing lymphocytes of the gastric mucosa. This review offers an overview of methodologies for isolating lymphocytes from the human stomach. Previously reported articles were reviewed, focusing on procedures for isolating human gastric mucosal lymphocytes. Helicobacter pylori-associated peptic diseases and gastric cancer are two major subjects of research in this field. Enzymatic dissociation, mechanical dissociation, or a combination of the two have been used to isolate lymphocytes from the stomach. Intra-epithelial and lamina propria lymphocytes were separately isolated in several studies. We also summarize the history and present trends in analyzing lymphocytes in patients with gastric disease.

DOI： 10.5662/wjm.v11.i4.199

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Squamous Metaplasia of the Stomach Associated with Lymphoma Infiltration. Reviewed

Masaya Iwamuro, Nobuharu Fujii, Takehiro Tanaka, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 60 ( 14 ) 2229 - 2234 2021.7

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

We herein report a patient who presented with follicular lymphoma. Although the stomach was initially intact, mucosal redness and multiple erosions appeared in the gastric body owing to infiltration of the follicular lymphoma cells. Subsequently, a slightly depressed, white area lacking gastric mucosal structure was detected in the lesser curvature of the gastric cardia and body, where lymphoma cell infiltration was also pathologically observed beneath the stratified squamous epithelium. This case indicated that, although infrequent, prolonged mucosal injury owing to lymphoma infiltration can cause squamous metaplasia in the stomach.

DOI： 10.2169/internalmedicine.6271-20

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女性に発症した食道扁平上皮癌の臨床病理学的特徴に関する検討

小橋真由, 川野誠司, 倉岡紗樹子, 岡上昇太郎, 里見拓也, 濱田健太, 安部真, 河野吉泰, 神崎洋光, 岩室雅也, 河原祥朗, 田邊俊介, 藤原俊義, 田中健大, 岡田裕之

日本高齢消化器病学会誌 24 ( 1 ) 186 - 186 2021.7

Two Cases of Endometriosis in the Cecum Detected by Contrast-enhanced Computed Tomography with Air/Carbon Dioxide Insufflation. Reviewed

Masaya Iwamuro, Takehiro Tanaka, Yuusaku Sugihara, Keita Harada, Sakiko Hiraoka, Yoshitaka Kondo, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 60 ( 11 ) 1697 - 1701 2021.6

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

We herein report two patients with endometriosis in the cecum. Both patients presented with a protruding, subepithelial tumor on colonoscopy and were diagnosed with cecal endometriosis after surgical resection. It is notable that the cecal lesions were not initially identified on computed tomography (CT), while CT colonography with air/carbon dioxide insufflation resulted in the detection of the cecal tumor. These cases highlight the possibility of false-negative results on conventional CT in patients with cecal endometriosis. We consider CT colonography with air/carbon dioxide insufflation useful for detecting cecal tumors in such cases.

DOI： 10.2169/internalmedicine.6418-20

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Laminin-411 and -511 Modulate the Proliferation, Adhesion, and Morphology of Gastric Cancer Cells. Reviewed International journal

Masaya Iwamuro, Hidenori Shiraha, Atsushi Oyama, Daisuke Uchida, Shigeru Horiguchi, Hiroyuki Okada

Cell biochemistry and biophysics 79 ( 2 ) 407 - 418 2021.6

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

Laminins (Ln), a type of extracellular matrix glycoprotein, are key regulators of cellular behavior. Recent work revealed that in various tumor cell lines, laminin isoforms influence specific responses, such as cell anchorage, survival, proliferation, migration, organization, and specialization. The contribution of laminin isoforms to the function of gastric cancer cells, however, remain unclear. Here, we revealed that in gastric cancer, laminin isoforms Ln411, Ln421, Ln511, and Ln521 promote cellular proliferation; Ln511 and Ln521 increase cell cytoplasmic volume; Ln511 hampers invadopodia formation in some cells, Ln511 enables prompt adhesion of cells to plates, and Ln411 and Ln511 do not alter the gastric cancer stem cell markers CD44 and Lgr5. These results indicate that Ln411 and Ln511 dynamically modulate the proliferation, adhesion, and morphology of gastric cancer cells in different ways that are independent of stem cell properties. In particular, Ln511 showed a high affinity for gastric cancer cells. Our observations broaden the possible options for controlling cancer cell progression and metastasis by modulating laminin-integrin interactions.

DOI： 10.1007/s12013-021-00972-3

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Endoscopic resection is a suitable initial treatment strategy for oxyntic gland adenoma or gastric adenocarcinoma of the fundic gland type. Reviewed International journal

Masaya Iwamuro, Chiaki Kusumoto, Masahiro Nakagawa, Sayo Kobayashi, Masao Yoshioka, Tomoki Inaba, Tatsuya Toyokawa, Shinichiro Hori, Shouichi Tanaka, Kazuhiro Matsueda, Takehiro Tanaka, Hiroyuki Okada

Scientific reports 11 ( 1 ) 7375 - 7375 2021.4

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

The aim of this study was to reveal the histological features of oxyntic gland adenomas and gastric adenocarcinoma of the fundic-gland type (GA-FG). We retrospectively examined the histological features of 126 lesions of oxyntic gland adenoma and/or GA-FG in 116 patients. The prevalence of oxyntic gland adenomas and GA-FG was approximately equal. The majority of the lesions were resected by endoscopic mucosal resection using a diathermic snare (EMR, n = 42) or endoscopic submucosal dissection (ESD, n = 72). Histologically, there were no lesions with invasion at the level of the muscularis propria or deeper, and lymphovascular invasion was present in 1.6%. Of the ESD and EMR specimens, there were no lesions that were positive for vertical margins. Among the eight GA-FG patients with deep (≥ 500 μm) submucosal invasion, six were treated with endoscopic resection alone, and no recurrence was documented. No patients died of the disease during the median follow-up period of 14.5 months. In conclusion, all lesions were confined to the mucosa or submucosa and were negative for vertical margins. Lymphovascular invasion was present in only 1.6% of the patients. Thus, we believe that endoscopic resection is a suitable initial treatment method for oxyntic gland adenoma and GA-FG.

DOI： 10.1038/s41598-021-86893-w

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Risk Factors for Gastric Cancer after the Eradication of Helicobacter pylori Evaluated Based on the Background Gastric Mucosa: A Propensity Score-matched Case-control Study.

Yuka Obayashi, Seiji Kawano, Hiroyuki Sakae, Makoto Abe, Yoshiyasu Kono, Hiromitsu Kanzaki, Masaya Iwamuro, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Yanai, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 60 ( 7 ) 969 - 976 2021.4

Language：English Publishing type：Research paper (scientific journal)

Objective The eradication of Helicobacter pylori (H. pylori) reduces the risk for gastric cancer (GC) development, but it cannot prevent GC completely. We investigated the risk factors of early GC development after the eradication of H. pylori, based on the histological characteristics of gastric mucosa. Methods Sixty-one patients who underwent endoscopic submucosal dissection for early GC after successful H. pylori eradication (Group A) and 122 patients without developing a gastric neoplasm over 3 years after successful H. pylori eradication (Group B) were analyzed. We compared the histological findings of the patients enrolled in Group A and Group B before and after the propensity score-matching. Results Comparing the characteristics of two the groups, Group A consisted predominantly of males, had significantly more elderly patients, and the years after successful eradication tended to be longer. We performed score matching for these three factors to reduce the influence of any confounding factors. After matching, the scores of inflammation for Group A (n=54) was significantly higher than those of Group B (n=54) at the greater curvature of the antrum, the lesser curvature of the corpus, and the greater curvature of the corpus. According to a multivariate analysis, inflammation of the greater curvature of the antrum and lesser curvature of the corpus were found to be independent risk factors. The risk ratio and 95% CI were 5.92 (2.11-16.6) (p<0.01), and 3.56 (1.05-13.2) (p=0.04), respectively. Conclusion A continuous high level of inflammation of the background gastric mucosa may be a risk factor for gastric cancer onset after H. pylori eradication.

DOI： 10.2169/internalmedicine.5486-20

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Peutz-Jeghers症候群の11例における胃病変に関する検討

里見拓也, 岩室雅也, 豊川達也, 森藤由記, 松枝和宏, 堀伸一郎, 吉岡正雄, 田中健大, 川野誠司, 岡田裕之

Gastroenterological Endoscopy 63 ( Suppl.1 ) 936 - 936 2021.4

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Papers - IWAMURO Masaya