研究者詳細 - 赤穂　宗一郎

論文 - 赤穂　宗一郎

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【膵・胆道癌の発生・進展メカニズムを探る】膵癌の薬剤耐性メカニズム

寺澤裕之, 堤康一郎, 原田圭, 服部直, 菊池達也, 小幡泰介, 佐藤亮介, 織田崇志, 松三明宏, 宮本和也, 藤井佑樹, 赤穂宗一郎, 内田大輔, 松本和幸, 堀口繁, 大塚基之

胆と膵 45 ( 8 ) 801 - 806 2024年8月

記述言語：日本語出版者・発行元：医学図書出版(株)

膵癌は予後不良な難治癌であるが,その一因として薬剤耐性があげられる。薬剤耐性のメカニズムとして,標的治療が難しいKRAS変異の存在やエピジェネティック機構などの遺伝子変異や薬物代謝の変化,転移・浸潤を促進するEMT,膵癌に特徴的な間質成分の多い腫瘍微小環境,さらにnon-coding RNAによる遺伝子発現の調整などがあり,それらが複合的に影響していると考えられている。この複雑な薬剤耐性メカニズムのさらなる解明がその克服において重要である。(著者抄録)

【膵・胆道癌の発生・進展メカニズムを探る】膵癌の薬剤耐性メカニズム

寺澤裕之, 堤康一郎, 原田圭, 服部直, 菊池達也, 小幡泰介, 佐藤亮介, 織田崇志, 松三明宏, 宮本和也, 藤井佑樹, 赤穂宗一郎, 内田大輔, 松本和幸, 堀口繁, 大塚基之

胆と膵 45 ( 8 ) 801 - 806 2024年8月

記述言語：日本語出版者・発行元：医学図書出版(株)

膵癌は予後不良な難治癌であるが,その一因として薬剤耐性があげられる。薬剤耐性のメカニズムとして,標的治療が難しいKRAS変異の存在やエピジェネティック機構などの遺伝子変異や薬物代謝の変化,転移・浸潤を促進するEMT,膵癌に特徴的な間質成分の多い腫瘍微小環境,さらにnon-coding RNAによる遺伝子発現の調整などがあり,それらが複合的に影響していると考えられている。この複雑な薬剤耐性メカニズムのさらなる解明がその克服において重要である。(著者抄録)

Methylation analysis of DCC gene in saliva samples is an efficient method for non-invasive detection of superficial hypopharyngeal cancer. 国際誌

Ryosuke Hirai, Hideaki Kinugasa, Shumpei Yamamoto, Soichiro Ako, Koichiro Tsutsumi, Makoto Abe, Koji Miyahara, Masahiro Nakagawa, Motoyuki Otsuka

British journal of cancer 2024年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Advances in upper gastrointestinal endoscopic technology have enabled early detection and treatment of hypopharyngeal cancer. However, in-depth pharyngeal observations require sedation and are invasive. It is important to establish a minimally invasive and simple evaluation method to identify high-risk patients. METHODS: Eighty-seven patients with superficial hypopharyngeal cancer and 51 healthy controls were recruited. We assessed the methylation status of DCC, PTGDR1, EDNRB, and ECAD, in tissue and saliva samples and verified the diagnostic accuracy by methylation analyses of their promoter regions using quantitative methylation-specific PCR. RESULTS: Significant differences between cancer and their surrounding non-cancerous tissues were observed in the methylation values of DCC (p = 0.003), EDNRB (p = 0.001), and ECAD (p = 0.043). Using receiver operating characteristic analyses of the methylation values in saliva samples, DCC showed the highest area under the curve values for the detection of superficial hypopharyngeal cancer (0.917, 95% confidence interval = 0.864-0.970), compared with those for EDNRB (0.680) and ECAD (0.639). When the cutoff for the methylation values of DCC was set at ≥0.163, the sensitivity to detect hypopharyngeal cancer was 82.8% and the specificity was 90.2%. CONCLUSIONS: DCC methylation in saliva samples could be a non-invasive and efficient tool for early detection of hypopharyngeal cancer in high-risk patients.

DOI： 10.1038/s41416-024-02654-2

MicroRNA-34a-5p: A pivotal therapeutic target in gallbladder cancer. 国際誌

Takashi Oda, Koichiro Tsutsumi, Taisuke Obata, Eijiro Ueta, Tatsuya Kikuchi, Soichiro Ako, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Hironari Kato, Hiroyuki Okada, Ryota Chijimatsu, Motoyuki Otsuka

Molecular therapy. Oncology 32 ( 1 ) 200765 - 200765 2024年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

Gallbladder cancer incidence has been increasing globally, and it remains challenging to expect long prognosis with the current systemic chemotherapy. We identified a novel nucleic acid-mediated therapeutic target against gallbladder cancer by using innovative organoid-based gallbladder cancer models generated from KrasLSL-G12D/+; Trp53f/f mice. Using comprehensive microRNA expression analyses and a bioinformatics approach, we identified significant microRNA-34a-5p downregulation in both murine gallbladder cancer organoids and resected human gallbladder cancer specimens. In three different human gallbladder cancer cell lines, forced microRNA-34a-5p expression inhibited cell proliferation and induced cell-cycle arrest at the G1 phase by suppressing direct target (CDK6) expression. Furthermore, comprehensive RNA sequencing revealed the significant enrichment of gene sets related to the cell-cycle regulators after microRNA-34a-5p expression in gallbladder cancer cells. In a murine xenograft model, locally injected microRNA-34a-5p mimics significantly inhibited gallbladder cancer progression and downregulated CDK6 expression. These results provide a rationale for promising therapeutics against gallbladder cancer by microRNA-34a-5p injection, as well as a strategy to explore therapeutic targets against cancers using organoid-based models, especially for those lacking useful genetically engineered murine models, such as gallbladder cancer.

DOI： 10.1016/j.omton.2024.200765

MicroRNA-451a inhibits gemcitabine-refractory biliary tract cancer progression by suppressing the MIF-mediated PI3K/AKT pathway. 国際誌

Taisuke Obata, Koichiro Tsutsumi, Eijiro Ueta, Takashi Oda, Tatsuya Kikuchi, Soichiro Ako, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Hironari Kato, Hiroyuki Okada, Motoyuki Otsuka

Molecular therapy. Nucleic acids 34 102054 - 102054 2023年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Gemcitabine is an effective chemotherapeutic agent for biliary tract cancers (BTCs), including gallbladder cancer (GBC) and cholangiocarcinoma (CCA). However, few other effective agents are currently available, particularly for GEM-refractory BTCs. We previously identified microRNA-451a (miR-451a) as a potential therapeutic target in GBC. To elucidate the antineoplastic effects of miR-451a and its underlying mechanisms, we transfected miR-451a into GBC, gemcitabine-resistant GBC (GR-GBC), and gemcitabine-resistant CCA (GR-CCA) cell lines. Furthermore, mimicking in vivo conditions, tumorigenic GBC organoids and three-dimensional (3D) cell culture systems were employed to investigate the anti-proliferative effects of miR-451a on BTCs, and its effect on stem cell properties. We found that miR-451a significantly inhibited cell proliferation, induced apoptosis, and reduced chemoresistant phenotypes, such as epithelial-mesenchymal transition, in both GBC and GR-GBC. The principal mechanism is probably the negative regulation of the phosphatidylinositol 3-kinase/AKT pathway, partially accomplished by directly downregulating macrophage migration inhibitory factor. The Gene Expression Omnibus database revealed that miR-451a was the most significantly downregulated microRNA in CCA tissues. The introduction of miR-451a resulted in similar antineoplastic effects in GR-CCA. Furthermore, miR-451a reduced cell viability in 3D spheroid models and tumorigenic GBC organoids. These findings suggest that the supplementation of miR-451a is a potential treatment strategy for GEM-refractory BTCs.

DOI： 10.1016/j.omtn.2023.102054

医学生は、学内演習でもコミュニケーションにおける成長を自覚するのかコロナ禍での挑戦

三好智子, 川端崇義, 猪田宏美, 小崎吉訓, 越智可奈子, 赤穂宗一郎, 座間味義人, 伊野英男, 成瀬恵治, 松川昭博

医学教育 54 ( Suppl. ) 285 - 285 2023年7月

胆嚢オルガノイドを用いた発癌モデルより同定したmiR-34a-5p補充による胆嚢癌治療の開発

織田崇志, 堤康一郎, 小幡泰介, 菊池達也, 松三明宏, 宮本和也, 森本光作, 寺澤裕之, 藤井佑樹, 山崎辰洋, 赤穂宗一郎, 内田大輔, 松本和幸, 堀口繁, 加藤博也, 大塚基之

日本消化器病学会雑誌 120 ( 臨増総会 ) A328 - A328 2023年3月

ウィズコロナ下の学生ワクチン接種実習における岡山大学の工夫と課題について

小崎吉訓, 越智加奈子, 赤穂宗一郎, 三好智子, 山口貴子, 伊野英男, 松川昭博, 伊達勲

医学教育 53 ( Suppl. ) 141 - 141 2022年7月

医学科1年生における手指衛生指導の実践と課題

越智可奈子, 三好智子, 小崎吉訓, 赤穂宗一郎, 小山敏広, 山下範之, 伊野英男, 松川昭博, 伊達勲

医学教育 53 ( Suppl. ) 185 - 185 2022年7月

情熱にあふれた入学者を求む!夏休み高校生メディカルスクール開講とその成果

三好智子, 小崎吉訓, 越智可奈子, 赤穂宗一郎, 山下範之, 山口貴子, 犬飼恭二, 物部和彦, 伊野英男, 伊達勲

医学教育 53 ( Suppl. ) 144 - 144 2022年7月

Modified line-assisted complete closure of the defect after gastric endoscopic full-thickness resection: a pilot study in porcine models. 国際誌

Yasushi Yamasaki, Masayasu Ohmori, Junki Toyosawa, Soichiro Ako, Hiroyuki Okada

Endoscopy international open 10 ( 5 ) E609-E615 2022年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background and study aims Closure after endoscopic full-thickness resection (EFTR) is challenging. We previously developed a simple endoscopic closure method: line-assisted complete closure (LACC). We performed a pilot study using porcine models to evaluate the feasibility of modified LACC after gastric EFTR. Patients and methods Six live pigs were included. EFTR (greater curvature of the gastric antrum [n = 3] and anterior wall of the gastric body [n = 3]) was performed under general anesthesia and the defect after EFTR was closed by modified LACC. The pigs were observed until postoperative day 4 (Day 4). The closure site was endoscopically evaluated and the presence or absence of peritonitis and fluid leakage was evaluated. The outcomes were the success rate of modified LACC on the day of the procedure, maintenance of defect closure, presence of peritonitis or leakage, and clinical course. Results Once complete closure was successfully achieved in all cases, maintenance of closure on Day 4 was not achieved. However, there was neither peritonitis nor fluid leakage. The defect was completely covered by surrounding tissues on Day 4 and the clinical course was good in all cases. Conclusions The feasibility of modified LACC after gastric EFTR was demonstrated in porcine models. Further improvement is needed to maintain defect closure.

DOI： 10.1055/a-1785-8589

Fever and electrocoagulation syndrome after colorectal endoscopic submucosal dissection for patients with immunosuppressants and steroids. 国際誌

Shumpei Yamamoto, Hideaki Kinugasa, Yasushi Yamasaki, Mami Hirai, Soichiro Ako, Kensuke Takei, Shoko Igawa, Eriko Yasutomi, Shohei Oka, Masayasu Ohmori, Toshihiro Inokuchi, Keita Harada, Sakiko Hiraoka, Kazuhiro Nouso, Takehiro Tanaka, Hiroyuki Okada

DEN open 2 ( 1 ) e83 2022年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: Transient fever and electrocoagulation syndrome after colorectal endoscopic submucosal dissection (ESD) remain a challenge. The aim of this study was to assess the risk factors of post-ESD fever and post-ESD coagulation syndrome (PECS), focusing on the involvement of immunosuppressive drugs and steroids (IM). METHODS: This retrospective analysis included 510 patients who underwent colorectal ESD at Okayama University Hospital from 2015 to 2020. The incidence rate, clinical outcome, and factors associated with post-ESD fever and PECS were investigated. RESULTS: Post-ESD fever and PECS occurred in 63 patients (12.4%) and 43 patients (8.4%), respectively. In multivariate analysis, the American Society of Anesthesiologists Physical Status ≥3, the use of immunosuppressants or prednisolone ≥5mg (IM group), and injury to muscle layer/perforation were significantly associated with post-ESD fever. In PECS, IM group, tumors located on the right side, treatment time ≥60 min, injury to the muscle layer, and multiple lesions were independent risk factors. Both post-ESD fever and PECS improved conservatively in the IM group, and no serious complication was observed. CONCLUSIONS: The use of IM was a risk factor for both post-ESD fever and PECS. However, there were no serious complications in colorectal ESD for patients taking IM.

DOI： 10.1002/deo2.83

【Liquid biopsyは膵癌の診断・治療をどう変えるか?】膵癌診断・治療においてliquid biopsyは腫瘍マーカーを凌駕するか?

衣笠秀明, 能祖一裕, 加藤博也, 赤穂宗一郎, 岡田裕之

胆と膵 43 ( 1 ) 77 - 81 2022年1月

記述言語：日本語出版者・発行元：医学図書出版(株)

次世代シークエンサーとデジタルPCRの登場はliquid biopsyをめざましく進歩させた。従来法の生検と異なり、非侵襲的にリアルタイムで情報取得が可能であり、近年もっとも注目されている手法である。しかし、本邦の膵癌ガイドラインにおいて、膵癌診断法のひとつとして腫瘍マーカーがあげられているものの、liquid biopsyに関しては明記されていない。診断、フォローアップ、予後予測、治療効果予測などに関して、liquid biopsyの有用性が相次いで報告されており、その活躍の場は今後ますます増えてくると思われる。しかし、liquid biopsyが腫瘍マーカーを凌駕する側面はあるものの、簡便なモニタリングとして腫瘍マーカーが役立つ場面も多い。現状においては、liquid biopsyと腫瘍マーカーを融合し、おのおのの利点を組み合わせながら診断、フォローアップ、予後予測、治療効果予測の精度を高めていくべきと考える。(著者抄録)

Statins Inhibit Inflammatory Cytokine Production by Macrophages and Acinar-to-Ductal Metaplasia of Pancreatic Cells. 国際誌

Soichiro Ako, Yaroslav Teper, Linda Ye, James Sinnett-Smith, Oscar J Hines, Enrique Rozengurt, Guido Eibl

Gastro hep advances 1 ( 4 ) 640 - 651 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIMS: Animal data show that the presence of an oncogenic Kras mutation in pancreatic acinar cells leads to acinar-to-ductal metaplasia (ADM), pancreatic intraepithelial neoplasia (PanIN), and pancreatic ductal adenocarcinoma (PDAC). Inflammatory macrophages play an important role in the formation of ADMs and transition to PanINs. Epidemiologically, statins are associated with a reduced risk of PDAC. We investigated whether statins inhibit inflammatory cytokine production in macrophages and whether this leads to reduced ADM formation. METHODS: The efficacy of statins on inflammatory cytokine production in 2 macrophage cell lines was measured by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. The effect of macrophage-conditioned medium on ADM in primary pancreatic acinar cells was investigated. Mouse pancreatic tissue samples were analyzed for macrophage numbers, cytokine levels, and neoplastic/dysplastic area. RESULTS: Lipophilic statins prevented inflammatory cytokine production in Raw264.7 and J774A.1 cells stimulated by lipopolysaccharide. The inhibitory effect of statins was mediated by inhibition of mevalonate and geranylgeranyl pyrophosphate synthesis and disruption of the actin cytoskeleton but not by a reduction in intracellular cholesterol. Treatment of macrophages with lipophilic statins also blocked ADM formation of primary pancreatic acinar cells. Furthermore, oral administration of simvastatin was associated with a reduction in the number of intrapancreatic macrophages, decreased inflammatory cytokine levels in the pancreas, and attenuated ADM/PanIN formation in mice. CONCLUSION: Our data support the hypothesis that statins oppose early PDAC development by their effects on macrophages and ADM formation. The inhibitory actions of statins on macrophages may collaborate with direct inhibitory effects on transformed pancreatic epithelial cells, which cumulatively may reduce early PDAC development and progression.

DOI： 10.1016/j.gastha.2022.04.012

Plasma KRAS mutations predict the early recurrence after surgical resection of pancreatic cancer. 国際誌

Soichiro Ako, Hironari Kato, Kazuhiro Nouso, Hideaki Kinugasa, Hiroyuki Terasawa, Hiroshi Matushita, Saimon Takada, Yosuke Saragai, Sho Mizukawa, Shinichiro Muro, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Daisuke Nobuoka, Ryuichi Yoshida, Yuzo Umeda, Takahito Yagi, Hiroyuki Okada

Cancer biology & therapy 22 ( 10-12 ) 1 - 7 2021年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The technique to analyze circulating tumor DNA (ctDNA) in body fluid (so-called "liquid biopsy") is recently developed. AIMS: Our aim was to assess the utility of liquid biopsy for predicting progression of pancreatic ductal adenocarcinoma (PDAC) after surgical resection or chemotherapy. METHODS: A total of 72 patients with PDAC were retrospectively enrolled for this study, 33 treated surgically and 39 given chemotherapy, either FOLFIRINOX (oxaliplatin/irinotecan/fluorouracil/leucovorin) or gemcitabine plus nab-paclitaxel. Prior to treatment, patients were screened for the presence of KRAS mutations (G12D and G12V) in plasma using droplet digital polymerase chain reaction, and outcomes were compared. RESULTS: KRAS mutations were identified in plasma samples of 12 patients (36%) underwent surgical resection. Patients with plasma KRAS mutations had significantly shorter disease-free survival (DFS) and overall survival (p < .01 and p = .01, respectively). Of 10 clinical variables analyzed, plasma KRAS mutation was the factor predictive of DFS in multivariate analysis (RR = 3.58, 95% CI: 1.36-9.60; p = .01). Although 12 patients (31%) given chemotherapy tested positive for plasma KRAS mutations, there was no demonstrable relation between plasma KRAS mutations and progression-free survival (PFS) or overall survival (OS) (p = .35 and p = .68, respectively). CONCLUSIONS: In patients with PDAC, detection of KRAS mutations in plasma proved independently predictive of early recurrence after surgical resection but did not correlate with PFS following chemotherapy.

DOI： 10.1080/15384047.2021.1980312

コロナ禍における医学科1年次行動科学I〜社会におけるコミュニケーション〜の実施とアウトカム

三好智子, 小崎吉訓, 越智可奈子, 吉田登志子, 山根正修, 赤穂宗一郎, 伊野英男, 大塚愛二, 松川昭博

医学教育 52 ( Suppl. ) 122 - 122 2021年7月

医学科1年生における行動科学授業「コロナ禍での医学生生活を考える」コロナ禍での入学の現状と課題

越智可奈子, 三好智子, 小崎吉訓, 赤穂宗一郎, 吉田登志子, 山根正修, 伊野英男, 大塚愛二, 松川昭博

医学教育 52 ( Suppl. ) 147 - 147 2021年7月

Direct Effects of Lipopolysaccharide on Human Pancreatic Cancer Cells. 国際誌

Roxanne L Massoumi, Yaroslav Teper, Soichiro Ako, Linda Ye, Elena Wang, O Joe Hines, Guido Eibl

Pancreas 50 ( 4 ) 524 - 528 2021年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: Obesity, a risk factor for pancreatic adenocarcinoma (PDAC), is often accompanied by a systemic increase in lipopolysaccharide (LPS; metabolic endotoxemia), which is thought to mediate obesity-associated inflammation. However, the direct effects of LPS on PDAC cells are poorly understood. METHODS: The expression of toll-like receptor 4, the receptor for LPS, was confirmed in PDAC cell lines. AsPC-1 and PANC-1 cells were exposed to LPS, and differential gene expression was determined by RNA sequencing. The activation of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) pathway by LPS in PDAC cells was assessed by Western blotting. RESULTS: The expression of toll-like receptor 4 was confirmed in all PDAC cell lines. The exposure to LPS led to differential expression of 3083 genes (426 ≥5-fold) in AsPC-1 and 2584 genes (339 ≥5-fold) in PANC-1. A top canonical pathway affected by LPS in both cell lines was PI3K/Akt/mTOR. Western blotting confirmed activation of this pathway as measured by phosphorylation of the ribosomal protein S6 and Akt. CONCLUSIONS: The exposure of PDAC cells to LPS led to differential gene expression. A top canonical pathway was PI3K/Akt/mTOR, a known oncogenic driver. Our findings provided evidence that LPS can directly induce differential gene expression in PDAC cells.

DOI： 10.1097/MPA.0000000000001790

Evaluation of Local Recurrence of Pancreatic Cancer by KRAS Mutation Analysis Using Washes from Endoscopic Ultrasound-Guided Fine-Needle Aspiration. 国際誌

Kazuyuki Matsumoto, Hironari Kato, Kazuhiro Nouso, Soichiro Ako, Hideaki Kinugasa, Shigeru Horiguchi, Yosuke Saragai, Saimon Takada, Shuntaro Yabe, Shinichiro Muro, Daisuke Uchida, Takeshi Tomoda, Hiroyuki Okada

Digestive diseases and sciences 65 ( 10 ) 2907 - 2913 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIMS: The sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosing the recurrence of pancreatic cancer is usually low because of difficulties in obtaining adequate samples for pathological examinations. We evaluated the efficacy of highly sensitive KRAS mutation analysis using EUS-FNA washes to detect cancer recurrence. METHODS: Nineteen consecutive patients with suspected pancreatic cancer recurrence after surgical resection were enrolled. All underwent EUS-FNA, and samples were obtained for pathological examination. After the first session, the inside of the FNA needle was washed with saline for DNA extraction. KRAS mutations were examined using digital droplet PCR (dPCR). RESULTS: The median needle puncture number used to obtain adequate pathological samples was two (range 1-6). In ten patients pathologically diagnosed with malignant pancreatic cancer, nine patients tested positive for a KRAS mutation. All patients who were not diagnosed with a malignant pancreatic cancer tested negative for a KRAS mutation. About half of surgically resected primary cancers (9/19) showed double KRAS mutations (G12V and G12D); however, all but one wash sample showed a single KRAS mutation, G12D. After including one patient who showed a malignant recurrence during follow-up, the sensitivities of a pathological diagnosis and KRAS analysis to detect recurrence were 90.9% and 81.8%, respectively. CONCLUSIONS: KRAS mutation analysis of needle wash samples using dPCR is a new methodology for the diagnosis of the local recurrence of pancreatic cancer. The diagnostic ability of dPCR with a one-time needle wash sample was comparable to a pathological diagnosis with multiple samplings.

DOI： 10.1007/s10620-019-06006-6

Ballvalve syndromeを契機に診断されたGAPPS (Gastric Adenocarcinoma and Proximal Polyposis of the Stomach)一例とその家系の検討

赤穂宗一郎, 川野誠司, 岡上昇太郎, 里見拓也, 岡本雄貴, 大林由佳, 馬場雄己, 濱田健太, 榮浩行, 安部真, 神崎洋光, 岩室雅也, 河原祥朗, 田中健太, 岡田裕之

Gastroenterological Endoscopy 62 ( Suppl.2 ) 2101 - 2101 2020年10月

Gastric Adenocarcinoma and Proximal Polyposis of the Stomach Occurring With Ball Valve Syndrome. 国際誌

Soichiro Ako, Seiji Kawano, Hiroyuki Okada

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 20 ( 2 ) e12-e13 2020年7月

Human Telomerase Reverse Transcriptase Gene Promoter Mutation in Serum of Patients with Hepatocellular Carcinoma. 国際誌

Soichiro Ako, Kazuhiro Nouso, Hideaki Kinugasa, Hiroshi Matsushita, Hiroyuki Terasawa, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Mari Mandai, Hideki Onishi, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Shinichi Fujioka, Tetsushige Mimura, Hiroyuki Okada

Oncology 98 ( 5 ) 311 - 317 2020年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Mutations in the human telomerase reverse transcriptase (hTERT) gene promoter have been reported in hepatocellular carcinoma (HCC); however, analyses of these mutations in liquid biopsies have been technically difficult because of the high GC content of the regions of interest within this promoter. We evaluated the feasibility and prognostic value of hTERT promoter mutations identified in circulating cell-free DNA (cfDNA) from the serum of patients with HCC. OBJECTIVE: A cohort of HCC patients (n = 36) who were curatively treated by surgical resection between June 2003 and September 2014 were enrolled in this study. METHODS: The presence of hTERT promoter mutations in cfDNA from the patients' serum was analyzed via modified droplet digital polymerase chain reaction, and associations were sought between specific promoter mutations and patients' disease-free survival (DFS). RESULTS: The G>A hTERT mutation at -124 bp was detected in the serum of 25 patients (69%). Although no marked differences were observed between the characteristics of the serum mutation-positive and serum mutation-negative patient groups, the DFS of patients with the mutation was significantly shorter than that of the serum mutation-negative patients (p = 0.02). Among 18 clinicopathologic and background liver factors examined, the presence of the -124 bp G>A mutation was an independent and significant predictor of patients' DFS (hazard ratio = 3.01, 95% confidence interval 1.11-10.5, p = 0.03) in multivariate analyses. CONCLUSIONS: The -124 bp G>A hTERT promoter mutation was observed in the serum of 69% of HCC patients who underwent surgical resection and was an independent predictor of disease progression in HCC.

DOI： 10.1159/000506135

Utility of liquid biopsy using urine in patients with pancreatic ductal adenocarcinoma. 国際誌

Hiroyuki Terasawa, Hideaki Kinugasa, Soichiro Ako, Mami Hirai, Hiroshi Matsushita, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Hironari Kato, Kazuhiro Nouso, Hiroyuki Okada

Cancer biology & therapy 20 ( 10 ) 1348 - 1353 2019年

記述言語：英語掲載種別：研究論文（学術雑誌）

In recent years, liquid biopsy for blood and body fluid in cancer patients has attracted attention. However, there have been few reports of liquid biopsy focusing on urine of pancreatic ductal adenocarcinoma (PDAC). In 56 patients with PDAC, DNA was extracted from urine and plasma prior to treatment, and KRAS mutations were analyzed with droplet digital PCR to examine the mutation detection rate. Our study showed that KRAS mutations were found in 27 cases (48%) in urine and 27 cases (48%) in plasma. The detection rate of urine KRAS mutations varied by renal functions. The rates were 70% (14/20) and 36% (13/36) in the creatinine clearance rate (CCr) < 70 mL/min group and in the CCr ≥ 70 mL/min group, respectively (P = .024). Whereas, no influence of the CCr was observed in the detection rates of plasma KRAS mutations. The rates were 50% (10/20) and 47% (17/36) in cases with the CCr < 70 mL/min group and the CCr ≥ 70 mL/min group, respectively. Although the sample size was small, this study clearly indicated a new possibility of less invasive urine liquid biopsy in PDAC patients.

DOI： 10.1080/15384047.2019.1638685

[Metachronous intraductal papillary mucinous carcinoma five years after cholecystectomy for gallbladder cancer in a patient with pancreaticobiliary maljunction]. 査読

Ikeda A, Matsumoto K, Kato H, Tanaka N, Ako S, Muro S, Uchida D, Tomoda T, Horiguchi S, Okada H

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 116 ( 3 ) 241 - 248 2019年

Transcatheter Arterial Chemoembolization to Reduce Size of Hepatocellular Carcinoma before Radiofrequency Ablation.

Soichiro Ako, Shinichiro Nakamura, Kazuhiro Nouso, Chihiro Dohi, Nozomu Wada, Yuki Morimoto, Yasuto Takeuchi, Tetsuya Yasunaka, Kenji Kuwaki, Hideki Onishi, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada

Acta medica Okayama 72 ( 1 ) 47 - 52 2018年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

Transcatheter arterial chemoembolization (TACE) is often performed before radiofrequency ablation (RFA) for the treatment of early-stage hepatocellular carcinoma (HCC). TACE prior to RFA can expand the ablated area and reduce the tumor size, facilitating complete ablation. However, the factors correlated with size reduction remain uncertain. The aim of this study was to identify the factors associated with size reduction by TACE and develop a formula to predict the reduction rate. A total of 100 HCC patients treated with TACE followed by RFA at least 20 days later were enrolled. The tumor size was measured at the time of TACE and RFA, and correlations between the reduction rate and 13 clinical factors were examined. A formula to predict the reduction rate was built using the factors obtained by the analysis. Reduction in the tumor size was observed in 69 nodules, and the median reduction rate was 16.2%. A multivariate regression analysis revealed that a large tumor size (p< 0.01) and a long interval between the therapies (p= 0.01) were factors for a high tumor reduction rate, with tumor size more strongly related to the degree of reduction. A size reduction of more than 10% can be expected by waiting 20 days after TACE when the size of the tumor at TACE is over 25 mm in diameter. The tumor size.

DOI： 10.18926/AMO/55662

Liquid biopsy of bile for the molecular diagnosis of gallbladder cancer. 国際誌

Hideaki Kinugasa, Kazuhiro Nouso, Soichiro Ako, Chihiro Dohi, Hiroshi Matsushita, Kazuyuki Matsumoto, Hironari Kato, Hiroyuki Okada

Cancer biology & therapy 19 ( 10 ) 934 - 938 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Tissue sampling of gallbladder cancer (GBCa) is challenging because of the anatomy of the gallbladder. The aim of this study is to investigate the possibility of diagnosing GBCa patients by performing a liquid biopsy of bile in addition to current diagnostic methods. METHODS: Thirty patients with GBCa were enrolled in this study. Cytological examination was performed in all patients. Using next generation sequencing (NGS), DNA isolated from the bile and tumor tissue was analyzed for mutations in 49 oncogenes. We also compared these mutations with cytology results. RESULTS: 57.1% of DNA samples from tumor tissue were positive for a mutation. In these patients, 87.5% of the bile circulating tumor DNA (ctDNA) samples had the same mutation. The concordance rate between bile ctDNA and tissue DNA samples was 85.7%, and the mutation frequencies detected in ctDNA were approximately half of what was detected in tumor tissue DNA. On the other hand, the sensitivity of the cytological and bile ctDNA analyses was 45.8% and 58.3%, respectively. The concordance rate between cytology and bile ctDNA analyses was 87.5%. CONCLUSIONS: Mutated tumor DNA could be detected in bile by NGS. Liquid biopsy of bile might help us to diagnose GBCa because of higher sensitivity and positive predict value compared to cytology with ERCP.

DOI： 10.1080/15384047.2018.1456604

A case of liver capillary hemangioma with cystic lesions 査読

Soichiro Ako, Ryuichi Kita, Eriko Iguchi, Yorimitsu Koshikawa, Haruhiko Takeda, Tadashi Inuzuka, Jun Nakajima, Fumihiro Matsuda, Tetsuro Ishikawa, Azusa Sakamoto, Shinichiro Henmi, Sumio Saito, Hiroki Nishikawa, Toru Kimura, Yukio Osaki, Akiko Wakasa, Osamu Nakashima

Acta Hepatologica Japonica 59 ( 3 ) 187 - 193 2018年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Japan Society of Hepatology

Hepatic capillary hemangioma is a rare hepatic benign tumor which composed of the aggregation of capillary vessels. Because of the difficulty of diagnosis, there are some reports diagnosed by surgical resection. We reported the case of liver capillary hemangioma with cystic lesions which was diagnosed by single level dynamic CT and fine-needle targeted biopsy. A patient was female in the sixties. Screening examination by magnetic resonance imaging (MRI) pointed out the tumor in the 6th segment of liver. Contrast enhanced CT revealed that tumor was strongly enhanced in the arterial phase. Washout pattern was observed at equilibrium phase. Single level dynamic CT during hepatic arteriography showed spotted enhanced followed to enhanced homogeneously, which might reveal the characteristic of capillary vessels in the tumor. The tumor tissue obtained by fine-needle biopsy showed the aggregation of capillary vessels positively immuno-stained with CD34 and factor VIII, that lead to diagnose hepatic capillary hemangioma.

DOI： 10.2957/kanzo.59.187

Comparing reduced-dose sodium phosphate tablets to 2 L of polyethylene glycol: A randomized study. 国際誌

Soichiro Ako, Koji Takemoto, Eriko Yasutomi, Chihiro Sakaguchi, Mayu Murakami, Tomoko Sunami, Shohei Oka, Hamada Kenta, Noriko Okazaki, Yuki Baba, Yasushi Yamasaki, Toshiyuki Asato, Daisuke Kawai, Ryuta Takenaka, Hirohumi Tsugeno, Sakiko Hiraoka, Jun Kato, Shigeatsu Fujiki

World journal of gastroenterology 23 ( 24 ) 4454 - 4461 2017年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: To compare the tolerability and quality of bowel cleansing between 2 L polyethylene glycol (PEG) and reduced-dose sodium phosphate (NaP) tablets as a preparation for colonoscopy. METHODS: Two hundred patients were randomly assigned to the PEG or NaP groups at the same ratio. The NaP group patients took 30 tablets with 2 L of clear liquid, while the PEG group patients took 2L of PEG. Tolerability was assessed by a questionnaire about taste, volume, and the overall impression. The bowel cleansing quality was evaluated by colonoscopists. RESULTS: Although NaP showed better tolerability in terms of taste, volume and overall impression (P < 0.01, P < 0.01 and P = 0.02, respectively), the overall cleansing quality was better in the PEG group (P < 0.01). A subgroup analysis, stratified by sex and age, indicated that NaP was associated with better tolerability and equivalent bowel cleansing quality in females of < 50 years of age. CONCLUSION: Despite the better tolerability, the use of 30 NaP tablets with 2 L of clear liquid should be limited due to its lower cleansing quality; however, in certain cases the regimen may deserve consideration, particularly in cases involving young women.

DOI： 10.3748/wjg.v23.i24.4454

Application of radiofrequency ablation for the treatment of intermediate-stage hepatocellular carcinoma. 国際誌

Kazuhiro Nouso, Kazuya Kariyama, Shinichiro Nakamura, Ayano Oonishi, Akiko Wakuta, Atsushi Oyama, Soichiro Ako, Chihiro Dohi, Nozomu Wada, Yuki Morimoto, Yasuto Takeuchi, Kenji Kuwaki, Hideki Onishi, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada

Journal of gastroenterology and hepatology 32 ( 3 ) 695 - 700 2017年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIM: Transcatheter arterial chemoembolization (TACE) is a standard therapy for the treatment of intermediate-stage hepatocellular carcinoma (HCC). In this study, we tried to elucidate the possibility of using radiofrequency ablation (RFA) as an alternative treatment of intermediate-stage HCC. METHODS: Among 246 patients who were initially diagnosed with intermediate-stage HCC, 76 who were treated with TACE (TACE group) and 91 who were treated with RFA (RFA group) were enrolled in this study. The risk for survival was analyzed with the Cox Proportional Hazard Model, and the survival rates were compared using propensity score matching. RESULTS: About half (50.6%) of the intermediate-stage HCC patients in the RFA group were diagnosed with Barcelona Clinic Liver Cancer substage-B1 (BCLC-B1) compared with only 19.7% of the patients in the TACE group. Survival of the RFA group was longer than that of TACE group in patients with BCLC-B1 and BCLC-B2. In contrast, no difference between groups was observed in patients with BCLC-B3/4. Multivariate analysis revealed that large tumor size (>30 mm, hazard ratio = 1.685, P = 0.043), high des-γ-carboxyprothrombin (>100 mAU/mL, hazard ratio = 1.920, P = 0.012), and TACE group (hazard ratio = 1.896, P = 0.016) were significant risk factors for survival. Overall 3-year survival of the patients in the RFA group (69.5%) was significantly longer than that of patients in the TACE group (51.5%) after propensity score matching (P = 0.032). No significant adverse events were observed in either group. CONCLUSIONS: RFA was useful for the treatment of less advanced intermediate-stage HCC and could be an alternative to TACE in selected cases.

DOI： 10.1111/jgh.13586

Utility of serum DNA as a marker for KRAS mutations in pancreatic cancer tissue 査読

Soichiro Ako, Kazuhiro Nouso, Hideaki Kinugasa, Chihiro Dohi, Hiroshi Matushita, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada

PANCREATOLOGY 17 ( 2 ) 285 - 290 2017年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：ELSEVIER SCIENCE BV

Background/Objectives: The detection of cancer-specific DNA in peripheral blood, known as a liquid biopsy, has been reported recently. Most such studies have used plasma as a sample; however, whether or not serum can be used as effectively is unclear. We attempted to clarify suitable samples for detecting KRAS mutations in circulating DNA in the blood of pancreatic cancer patients using droplet digital polymerase chain reaction (PCR).
Methods: DNA was extracted from the tissue, plasma, and serum of 40 pancreatic cancer patients. The presence of KRAS mutations G12D, G12V, and G12R was analyzed by droplet digital PCR.
Results: The amount of DNA isolated from the serum was much higher than that from plasma (1.0-to 42.0-fold). At least 1 KRAS mutation was observed in 93% of cancer tissues, whereas we detected the mutations in only 48% of the serum and plasma DNA samples. The G12D mutation was the most prevalent of the three mutations, followed by the G12V mutation. The presence of the G12D KRAS mutation in the plasma, serum, or tissue did not correlate to the overall survival; however, the prognosis of the patients with a KRAS mutation at G12V in the plasma or serum was significantly poorer than that of the patients without the mutation (P < 0.01).
Conclusions: Serum and plasma were found to be good materials for detecting cancer-specific DNA in the peripheral blood and the presence of KRAS mutations in blood-derived DNA may be used as a prognostic biomarker for patients with pancreatic cancer. (C) 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.

DOI： 10.1016/j.pan.2016.12.011

A case of gastric volvulus treated by balloon endoscopy

Soichiro Ako, Ryuta Takenaka, Yasufumi Yamasaki, Daisuke Kawai, Koji Takemoto, Akihiko Taira, Hirofumi Tsugeno, Shigeatsu Fujiki

Gastroenterological Endoscopy 57 ( 6 ) 1361 - 1366 2015年6月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Japan Gastroenterological Endoscopy Society

A 63-year-old man was admitted to our hospital for vomitus niger. Chest X-ray showed elevation of the left diaphragm, and computerized tomography revealed that the stomach was extended and rotated on the short axis. Therefore, the diagnosis was gastric volvulus. Because of the extension of the stomach, the upper gastrointestinal endoscopy, which we routinely use, was not able to reach the duodenum. By using balloon endoscopy we were able to reach the third portion of the duodenum, and to fix the volvulus with the balloon. We had success with the noninvasive treatment, and were able to avoid surgical treatment. Balloon endoscopy should be considered as one of the options to treat gastric volvulus.

The effect of long-term supplementation with branched-chain amino acid granules in patients with hepatitis C virus-related hepatocellular carcinoma after radiofrequency thermal ablation. 国際誌

Hiroki Nishikawa, Yukio Osaki, Eriko Iguchi, Yorimitsu Koshikawa, Soichiro Ako, Tadashi Inuzuka, Haruhiko Takeda, Jun Nakajima, Fumihiro Matsuda, Azusa Sakamoto, Shinichiro Henmi, Keiichi Hatamaru, Tetsuro Ishikawa, Sumio Saito, Akihiro Nasu, Ryuichi Kita, Toru Kimura

Journal of clinical gastroenterology 47 ( 4 ) 359 - 66 2013年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

GOALS: To elucidate whether long-term supplementation with branched-chain amino acid (BCAA) granules improves overall survival (OS) and recurrence-free survival (RFS) after radiofrequency thermal ablation (RFA) in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC)≤3 cm in diameter with up to 3 nodules and a serum albumin level before RFA of ≤3.5 g/dL. BACKGROUND: Whether BCAA treatment after curative RFA for patients with HCV-related HCC improves OS and RFS remains unclear. STUDY: We compared the OS rate and the RFS rate between the BCAA group (n=115) and the control group (n=141). We also examined factors contributing to OS and RFS. RESULTS: The 1 and 3 years OS rates after RFA were 94.0% and 70.0%, respectively, in the BCAA group, and 94.0% and 49.8%, respectively, in the control group (P=0.001). The corresponding RFS rates 1 and 3 years after RFA were 61.8% and 28.0%, respectively, in the BCAA group, and 52.0% and 12.0%, respectively, in the control group (P=0.013). In the multivariate analysis, in terms of OS, BCAA treatment, and serum albumin level of ≥3.4 g/dL, and in terms of RFS, age 70 years or older, BCAA treatment, and a serum albumin level of ≥3.4 g/dL were significant independent factors, respectively. CONCLUSIONS: BCAA treatment may improve OS and RFS after RFA in patients with HCV-related HCC≤3 cm in diameter with up to 3 nodules and a serum albumin level before RFA of 3.5 g/dL.

DOI： 10.1097/MCG.0b013e31826be9ad

[A case of diffuse cystic malformation in which submucosal tumor-like advanced gastric cancer was identified during 10-year follow-up].

Soichiro Ako, Takehiko Tsumura, Yoshihiro Okabe, Akira Sekikawa, Takashi Kanesaka, Tomoko Wakasa, Masayuki Shintaku, Takanori Maruo, Toru Kimura, Yukio Osaki

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 109 ( 11 ) 1910 - 9 2012年11月

記述言語：日本語掲載種別：研究論文（学術雑誌）

A 66-year-old man with giant gastric folds had been followed up since February 2000. In March 2010, a submucosal tumor of 35mm was identified with endoscopy and a low echoic mass was identified with endoscopic ultrasonography. After histologic diagnosis by endosonography-guided fine needle aspiration biopsy, he underwent a total gastrectomy. Histologic examination of the resected specimen revealed a tumor 20mm in diameter consisting of well-to-moderately differentiated tubular adenocarcinoma in the thickened wall of the gastric greater curvature, which contained small cystic lesions in the lamina propria. Immunohistochemical staining showed thick gastric wall consisting of not only multiple cysts but also smooth muscle, elastic and collagen fibers. The histologic diagnosis was advanced gastric cancer accompanied by diffuse cystic malformation (DCM). Although it is a rare condition, DCM should be considered in the differential diagnosis of giant gastric folds and as a pre-cancerous lesion.

The effect of pegylated interferon-alpha2b and ribavirin combination therapy for chronic hepatitis C infection in elderly patients. 国際誌

Hiroki Nishikawa, Eriko Iguchi, Yorimitsu Koshikawa, Soichiro Ako, Tadashi Inuzuka, Haruhiko Takeda, Jun Nakajima, Fumihiro Matsuda, Azusa Sakamoto, Sinichiro Henmi, Keiichi Hatamaru, Tetsuro Ishikawa, Sumio Saito, Ryuichi Kita, Toru Kimura, Yukio Osaki

BMC research notes 5 135 - 135 2012年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The clearance of hepatitis C virus infection by interferon therapy significantly reduces the incidence of hepatocellular carcinoma and death in elderly chronic hepatitis patients. However, there are few reports concerning the efficacy and safety of pegylated interferon-alpha2b plus ribavirin combination therapy in elderly patients. The aims of the present study were to examine the effect and safety of pegylated interferon-alpha2b plus ribavirin combination therapy in 427 patients with chronic hepatitis C infection. We compared the rates of sustained virological response--defined as the absence of detectable hepatitis C virus in serum 24 weeks after the treatment ended--and the treatment discontinuation rate between 319 younger patients aged < 65 years and 108 elderly patients aged ≥ 65 years. We also examined the factors contributing to a sustained virological response. RESULTS: There was no significant difference in the sustained virological response rate between younger patients and elderly patients according to their hepatitis C virus genotype (41.5% (100/241) and 40.7% (35/86) for genotype 1; P = 0.899, 89.7% (70/78) and 86.4% (19/22) for genotype 2; P = 0.703, respectively). There was also no significant difference in the treatment discontinuation rate between the two age groups (10.3% (33/319) and 13.9% (15/108), respectively; P = 0.378). There were no serious adverse events requiring hospitalization. The factors contributing significantly to a sustained virological response in elderly patients were gender, hepatitis C virus genotype, platelet count, and the presence of a rapid or early virological response (undetectable hepatitis C virus in serum at weeks 4 or 12 of treatment, respectively). However, upon multivariate analysis, the presence of an early virological response was the only significant factor (odds ratio: 0.115, 95% confidence interval: 0.040- 0.330, P < 0.001). CONCLUSIONS: The efficacy and safety of pegylated interferon-alpha2b plus ribavirin combination therapy in elderly patients are not always inferior to those in younger patients. Obtaining an early virological response may be essential to achieve a sustained virological response in elderly patients with chronic hepatitis C infection.

DOI： 10.1186/1756-0500-5-135

【細胆管細胞癌】細胆管癌成分を有し濃染する胆管細胞癌の1例

喜多竜一, 原田憲一, 若狭明子, 井口恵里子, 赤穂宗一郎, 竹田治彦, 犬塚義, 中島潤, 石川哲郎, 坂本梓, 木村達, 大崎往夫, 中沼安二

Liver Cancer 17 ( 2 ) 82 - 91 2011年11月

記述言語：日本語出版者・発行元：(株)アークメディア

症例は75歳女性で、C型肝硬変で近医フォロー中、腹部USで肝S8に3cm大の腫瘤、CT等の血流画像で多血性を認め、肝細胞癌(HCC)疑いで紹介入院した。検査ではトランスアミナーゼの軽度高値を認めるが、肝予備能は保たれていた。HCV抗体陽性、HBVは既感染パターン、腫瘍マーカーはCA19-9のみ軽度高値であった。腹部USで径3.5cmの低エコー結節を認め、CTでは淡い低信号、dynamic CTでは早期相で高吸収、後期相で低吸収を呈し、MRIではT1強調で低信号、T2強調で高信号、拡散強調で高信号、EOB肝細胞相で辺縁不整の低信号を呈した。HCC、混合型肝癌疑いで手術切除を行った。切除標本は白色、辺縁やや不整で被覆を有さず、顕微鏡的には境界明瞭で著明なリンパ球、形質細胞浸潤とリンパ濾胞形成を伴い、胆管類似の腫瘍細胞が不明瞭な管状〜充実性の増殖を示した。免疫染色で腫瘍組織全体にスリット状〜不規則分枝状の血管増生を認め、EMAは癌病変の腺腔内部に陽性を示した。

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J02969&link_issn=&doc_id=20111122170003&doc_link_id=%2Fab8livec%2F2011%2F001702%2F003%2F0082-0091%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8livec%2F2011%2F001702%2F003%2F0082-0091%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

State of the Art 粘液産生胆管内乳頭状腺癌の1例

松田史博, 岡部純弘, 赤穂宗一郎, 越川頼光, 竹田治彦, 犬塚義, 中島潤, 金坂卓, 恵荘裕嗣, 坂本梓, 邊見慎一郎, 金秀基, 石川哲朗, 齊藤澄夫, 波多野貴昭, 西川浩樹, 関川昭, 津村剛彦, 喜多竜一, 圓尾隆典, 木村達, 大崎往夫, 若狭朋子

肝胆膵画像 13 ( 3 ) 318 - 321 2011年5月

記述言語：日本語出版者・発行元：(株)医学書院

66歳女。検診で肝腫瘤を指摘され当科紹介となった。腹部USで肝左様に境界明瞭、辺縁に帯状の高エコー像、内部に不整形の低エコー領域を有し一部石灰化を伴う腫瘍を認め、ソナゾイド造影では辺縁高エコー部位にのみ流入を認めた。腹部CTでは肝S4に造影で濃染される乳頭状隆起を伴う嚢胞性腫瘍を認め、胆管外側枝は拡張していた。腹部MRIではT2強調像でS4に内部に不均一な低信号と高信号が混在する腫瘍を認めた。ERCPで乳頭開口部は軽度開大しており、通常の胆管造影では左肝管付近に陰影欠損を認め、末梢は描出されず、バルーン造影では拡張した内側枝を認め、IDUSでは腫瘍内に高エコーで丈の高い乳頭状隆起がみられた。S4を主体とする粘液産生胆管内乳頭状腫瘍と診断し、一部がS8まで進展していたため拡大肝左葉切除術、右後枝-小腸吻合、Roux-en Y再建術を施行した。病理学的所見で胆管内に乳頭状に発育する腫瘍を認め、腫瘍細胞の形態は膵胆管上皮型、低異型度の乳頭状腺癌であった。MUC染色ではMUC1陽性、MUC2、MUC5ACは陰性で、MIB-index 4.3%であった。

DOI： 10.11477/mf.1428100400

胃ESD後の人工胃潰瘍治癒に対する前向き比較検討 PPI 8週vs.PPI 4週後レバミピド4週vs.PPI 1週+レバミピド8週投与の比較

今川敦, 藤木茂篤, 赤穂宗一郎, 関博之, 井口俊博, 友田健, 窪田淳一, 竹本浩二, 柘野浩史, 平良明彦, 竹中龍太

Gastroenterological Endoscopy 51 ( Suppl.2 ) 2191 - 2191 2009年9月

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