2025/04/16 更新

写真a

イノクチ トシヒロ
井口 俊博
INOKUCHI Toshihiro
所属
学術研究院異分野融合教育研究領域(腸健康) 助教(特任)
職名
助教(特任)

学位

  • 医学博士 ( 2014年3月   岡山大学 )

  • 博士(医学) ( 岡山大学 )

 

論文

  • Acetic Acid-Indigo Carmine Chromocolonoscopy for Proximal Serrated Lesions: A Randomized, Three-Arm Colonoscopy Study. 国際誌

    Hideaki Kinugasa, Sakiko Hiraoka, Sayo Kobayashi, Minoru Matsubara, Teruya Nagahara, Reiji Higashi, Kensuke Takei, Masayasu Ohmori, Takashi Nakamura, Takao Tsuzuki, Shouichi Tanaka, Ryosuke Hirai, Junki Toyosawa, Yuki Aoyama, Yasushi Yamasaki, Toshihiro Inokuchi, Masahiro Takahara, Takehiro Tanaka, Toshiharu Mitsuhashi, Motoyuki Otsuka

    The American journal of gastroenterology   2025年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: Aggressive colorectal cancer (CRC) frequently originates from serrated lesions (SLs), particularly in the proximal colon, which are challenging to detect using standard screening colonoscopy. Although duplicate examinations or chromocolonoscopies are recommended for detecting proximal SLs, evidence from randomized trials is limited. We evaluated the effectiveness of tandem colonoscopy with an acetic acid-indigo carmine mixture (AIM) for detecting SLs in the proximal colon compared to white-light imaging (WLI) and indigo carmine (IC). METHODS: This three-arm, multicenter, randomized controlled trial involving nine institutions enrolled patients undergoing colonoscopy and assigned them randomly to the WLI, IC, or AIM group. The primary outcomes were the SL-detection rate (SDR) of proximal lesions during the second examination (SDR2nd) and SL additional rate (SAR). Secondary outcomes included the detection and additional rates of other polyps, factors contributing to SAR, and complications. RESULTS: Between 2021 and 2024, 1,319 participants with 1,267 polyps were included in the analysis. With AIM, the SDR2nd and SAR were significantly higher compared to WLI or IC (WLI vs. AIM: 2.7% vs. 14.0%, p<.001; IC vs. AIM: 7.9% vs. 14.0%, p=.002, and WLI vs. AIM: 22.4% vs. 69.3%, p<.001; IC vs. AIM: 45.8% vs. 69.3%, p=.001). AIM conferred a higher adenoma-detection rate (ADR)2nd than with WLI (10.5% vs. 24.7%; p<.001) and was an independent factor for SAR (odds ratio [95% confidence interval]: 7.79 [3.76-17.08]). No major adverse events were observed. CONCLUSIONS: AIM significantly improved proximal colon SDRs and outperformed WLI and IC. The relationship between SDR and CRC incidence warrants further investigation.

    DOI: 10.14309/ajg.0000000000003411

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  • Diagnostic accuracy and cut-off values of serum leucine-rich alpha-2 glycoprotein for Crohn's disease activity in the small bowel.

    Muneyori Okita, Kento Takenaka, Fumihito Hirai, Shinya Ashizuka, Hideki Iijima, Shigeki Bamba, Toshimitsu Fujii, Kenji Watanabe, Yosuke Shimodaira, Hisashi Shiga, Sakiko Hiraoka, Toshihiro Inokuchi, Takeshi Yamamura, Ryo Emoto, Shigeyuki Matsui

    Journal of gastroenterology   2025年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Small bowel (SB) lesions in Crohn's disease (CD) are often asymptomatic despite being highly active. Fecal calprotectin (FC) is the most widely used biomarker of CD activity, but its drawbacks include a large intra-individual sample variability and the burden of collecting stool samples. Meanwhile, serum leucine-rich alpha-2 glycoprotein (LRG) has recently attracted attention as a biomarker that can address the limitations of FC. This study determined the diagnostic accuracy of LRG and its cut-off values for diagnosing CD activity in SB. METHODS: This was a retrospective, multi-center study of CD patients undergoing retrograde balloon-assisted endoscopy. For ileal- and ileocolonic-type patients with a colon SES-CD score of 0, we estimated the receiver operating characteristic curve of LRG and determined the cut-off value to achieve a target sensitivity level of 80%. RESULTS: Among 285 patients with SB lesions, LRG had an area under the curve (AUC) of 0.72 (95% CI 0.67-0.78) with a sensitivity of 80.2% and specificity of 47.2% for a cut-off value of 10.5 when diagnosing endoscopic remission (modified SES-CD ≤ 3), while it had an AUC of 0.72 (95% CI 0.65-0.78) with a sensitivity of 81.2% and specificity of 46.2% for a cut-off value of 10.1 when diagnosing complete ulcer healing (modified SES-CD ≤ 1). CONCLUSION: LRG was effective for diagnosing CD activity in SB, specifically with cut-off values of 10.5 and 10.1 for endoscopic remission and complete ulcer healing, respectively. A future prospective validation study will assess its clinical utility.

    DOI: 10.1007/s00535-025-02223-1

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  • Changes of leucine-rich alpha 2 glycoprotein could be a marker of changes of endoscopic and histologic activity of ulcerative colitis. 国際誌

    Yuki Aoyama, Sakiko Hiraoka, Eriko Yasutomi, Toshihiro Inokuchi, Takehiro Tanaka, Kensuke Takei, Shoko Igawa, Keiko Takeuchi, Masahiro Takahara, Junki Toyosawa, Yasushi Yamasaki, Hideaki Kinugasa, Jun Kato, Hiroyuki Okada, Motoyuki Otsuka

    Scientific reports   15 ( 1 )   5248 - 5248   2025年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Leucine-rich alpha 2 glycoprotein (LRG) is one of the serum biomarkers for disease activity of ulcerative colitis (UC). We focused on the correlation between the changes of LRG and the changes of endoscopic and histologic activity of UC, in comparison to the changes of fecal calprotectin (Fcal), fecal immunochemical test (FIT), and C-reactive protein (CRP). Seventy-nine patients with two or more colonoscopies were enrolled, and 123 paired colonoscopies and 121 paired biopsies were examined. With regard to the change of endoscopic/histologic activity between the preceding and subsequent colonoscopy, there was improvement (n = 29/45), unchanging (n = 63/36), and worsening (n = 31/40). The correlations between the changes of marker levels and endoscopic/histologic activity were Fcal; r = 0.50/0.39 and FIT; r = 0.41/0.40, LRG; r = 0.42/0.40 and CRP; r = 0.22/0.17. Furthermore, when the correlation between the changes of LRG levels and the changes of endoscopic/histological activity was compared with those of other markers, the correlation of LRG tended to be superior to those of CRP (CRP vs. LRG; p = 0.08/0.01). LRG is equivalent to fecal markers and superior to CRP, when inferring changes in disease activity of UC based on changes in its level.

    DOI: 10.1038/s41598-025-89615-8

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  • Short- and longer-term learning effects from virtual scale endoscopy videos: a useful tool for colorectal lesion size estimation (with video). 国際誌

    Ryosuke Hirai, Hideaki Kinugasa, Mikako Ishiguro, Junki Toyosawa, Yuki Aoyama, Shoko Igawa, Yasushi Yamasaki, Toshihiro Inokuchi, Masahiro Takahara, Seiji Kawano, Sakiko Hiraoka, Motoyuki Otsuka

    Gastrointestinal endoscopy   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 AIMS: Accurate assessment of colorectal polyp size is crucial for determining treatment and surveillance policies. However, visual estimation of lesion diameter is often inaccurate, making simple and effective educational tools essential. We aimed to evaluate the learning effects of virtual scale endoscopy (VSE). METHODS: Thirty-three endoscopists first watched pre-learning videos for SET1. They then estimated the diameters of 20 lesions and referred to instructional videos with VSE for self-study. Subsequently, they watched the post-learning videos for SET2 and estimated the lesion diameters. The error between the estimated and correct lesion sizes of both sets was compared. To evaluate longer-term learning effects, participants answered SET3 and SET4, which consisted of the same questions as SET2 and SET1, respectively, 2-3 months later without watching the instructional video for SET2. RESULTS: The error in the participants' estimation of the correct lesion diameter improved from SET1 to SET2 (34.7 mm ± 6.6 vs. 30.7 mm ± 7.7; p = 0.048), with a significant learning effect and error improvement specifically among non-experts (35.2 mm ± 5.3 vs. 30 mm ± 6.8; p = 0.028). In the SET3 and SET4, participants' errors indicated that the learning effect was well maintained (SET2 vs. SET3; 30.7 mm ± 7.7 vs. 28.6 mm ± 7.2; p = 0.1, and SET1 and SET4: 34.7 mm ± 6.6 vs. 31.7 mm ± 7.1; p = 0.025). CONCLUSIONS: VSE videos are a valuable learning tool for estimating lesion diameter, particularly for novice endoscopists, both in the short- and longer-term.

    DOI: 10.1016/j.gie.2024.10.038

    PubMed

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  • 増大号 炎症性腸疾患2024 主題 炎症性腸疾患の内科治療 基本治療薬(5-ASA製剤,副腎皮質ステロイド,チオプリン製剤)

    平岡 佐規子, 石黒 美佳子, 豊澤 惇希, 青山 祐樹, 井川 翔子, 竹内 桂子, 山崎 泰史, 井口 俊博, 衣笠 秀明, 髙原 政宏, 大塚 基之, 金谷 信彦, 近藤 喜太, 田中 健大

    胃と腸   59 ( 10 )   1453 - 1461   2024年10月

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    出版者・発行元:株式会社医学書院  

    DOI: 10.11477/mf.1403203745

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MISC

  • 【高齢者潰瘍性大腸炎の現状】高齢者潰瘍性大腸炎の内科的治療とその見極め

    井口 俊博, 高原 政宏, 平岡 佐規子

    日本消化器病学会雑誌   119 ( 11 )   992 - 1003   2022年11月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

    近年,高齢潰瘍性大腸炎(UC)患者数が増加しており,特に若年発症して長期経過を追っている高齢UC症例と異なり,高齢になって新規に発症したUCは治療に難渋する症例が少なくない.また年齢だけで高齢者の全身状態を判断することはできず,症例によって脆弱性やリスクが異なるため,注意が必要である.現在使用できる治療薬はいずれも高齢者を対象とした試験を経ず保険収載されており,リアルワールドデータを基に有効性,安全性の判断をせざるを得ない.高齢者特有の併存疾患の管理,ポリファーマシーと相互作用,認知症,身体機能低下,易感染状態などのリスクを考慮し,重篤な状態になる前に常に早期介入を心掛ける必要がある.(著者抄録)

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J01118&link_issn=&doc_id=20221116250003&doc_link_id=10.11405%2Fnisshoshi.119.992&url=https%3A%2F%2Fdoi.org%2F10.11405%2Fnisshoshi.119.992&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

  • 手技の解説 クローン病におけるダブルバルーン内視鏡下逆行性造影の実際

    井口 俊博, 川野 誠司, 平岡 佐規子

    Gastroenterological Endoscopy   64 ( 10 )   2308 - 2316   2022年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

    クローン病患者の7割以上が小腸病変を有するとされ,小腸病変のモニタリングとその制御は患者のQOLに直結する.従ってクローン病診療では,全小腸を高精度でかつ手軽に,そして低侵襲にモニタリングすることが求められるが,残念ながらすべてを兼ね備えた検査やマーカーは未だ存在しない.ダブルバルーン内視鏡検査は,クローン病小腸病変に対するモニタリング検査の1つとして,また時に内視鏡的拡張術目的に広く使用されている.当科ではダブルバルーン内視鏡検査の際に通常の観察に加えて先端バルーンを拡張させて逆行性造影を行い,それまでは難しかった深部小腸の評価をルーチンで行っている.本稿では,クローン病小腸病変に対するダブルバルーン内視鏡下逆行性造影の手順やコツを解説する.(著者抄録)

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  • クローン病患者の内視鏡活動性と活動性の変化を予測するバイオマーカーは?

    井口 俊博, 平岡 佐規子, 豊澤 惇希, 竹井 健介, 青山 祐樹, 井川 翔子, 竹内 桂子, 山崎 泰史, 衣笠 秀明, 高原 政宏, 原田 馨太, 岡田 裕之

    日本消化器病学会雑誌   119 ( 臨増大会 )   A750 - A750   2022年10月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 【潰瘍性大腸炎内科診療の新時代】日常診療に有用な潰瘍性大腸炎のバイオマーカー

    青山 祐樹, 平岡 佐規子, 井口 俊博, 竹井 健介, 井川 翔子, 竹内 桂子, 高原 政宏

    医学と薬学   79 ( 11 )   1461 - 1468   2022年10月

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    記述言語:日本語   出版者・発行元:(株)自然科学社  

    J-GLOBAL

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  • 消化管疾患と性差 女性IBD患者における月経周期と腹部症状との関わりを探る

    井口 俊博, 平岡 佐規子, 青山 祐樹, 竹井 健介, 井川 翔子, 竹内 桂子, 高原 政宏, 近藤 喜太

    日本高齢消化器病学会誌   25 ( 1 )   144 - 144   2022年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本高齢消化器病学会  

    J-GLOBAL

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共同研究・競争的資金等の研究

  • 免疫学的便潜血検査自宅測定による潰瘍性大腸炎患者のセルフマネジメントの構築

    研究課題/領域番号:23K11871  2023年04月 - 2027年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    平岡 佐規子, 高原 政宏, 井口 俊博

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    配分額:3250000円 ( 直接経費:2500000円 、 間接経費:750000円 )

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担当授業科目

  • 消化器・肝臓内科学(基本臨床実習) (2024年度) 特別  - その他

  • 消化器・肝臓内科学(基本臨床実習) (2023年度) 特別  - その他

  • 消化器系(臓器・系別統合講義) (2023年度) 特別  - その他

  • 消化器・肝臓内科学(基本臨床実習) (2022年度) 特別  - その他

  • 消化器系(臓器・系別統合講義) (2022年度) 特別  - その他

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