Faculty Profiles - YANAI Hiroyuki

Papers - YANAI Hiroyuki

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腎移植後の尿細胞診で6ヶ月以上持続するDecoy細胞陽性所見はBKウイルス腎症の発症予測に有効である

関戸崇了, 荒木元朗, 吉永香澄, 丸山雄樹, 定平卓也, 西村慎吾, 和田耕一郎, 渡部昌実, 渡邉豊彦, 田邊克幸, 竹内英実, 和田淳, 柳井広之, 那須保友

移植 56 ( Supplement ) s441 - s441 2021

Language：Japanese Publisher：一般社団法人日本移植学会

【目的】腎移植後患者において、尿細胞診のDecoy細胞陽性所見の持続期間とBKウイルス腎症 (BKVN)発症予測の関連性を検討した。【方法】対象は2012年05月から2020年07月までに当院で腎移植を行った121例。尿細胞診は、腎移植後6ヶ月間は1ヶ月毎、その後の6ヶ月は1から2ヶ月毎、以降は1から3ヶ月毎に行なっている。BKVN発症予測に最適な陽性持続期間をAUC曲線にて解析し、その最適な陽性期間の持続の有無で患者を2群に分け、BKVN発症率を比較検討した。SV40免疫染色の有効性も併せて比較検討した。【結果】尿検体数は計2,534検体、SV40免疫染色は計2,241検体であった。BKVN発症予測に最適な陽性持続期間は6ヶ月であった（AUC = 0.819）。Decoy細胞陽性が6ヶ月以上持続した（decoy≧6M）群および持続が6ヶ月未満であった（decoy<6M）群に分け、decoy≧6M群 47例、SV40<6M群 74例であった。decoy ≧6M群はdecoy <6M群に比べ、BKVNの発症率は有意に高かった（5 vs 0, p=0.008）。decoy細胞によるBKVN発症予測の感度、特異度、陽性的中率、陰性的中率はそれぞれ100%, 64%, 11%, 100%であり、SV40免疫染色は感度、陰性的中率は同等で、特異度は68%, 陽性的中率は12%であった。【結語】6ヶ月以上のDecoy細胞陽性持続の所見はBKVN発症予測に有用である可能性が示唆された。SV40免疫染色追加に伴うBKVN発症予測精度はごくわずかに向上した。

DOI： 10.11386/jst.56.supplement_s441

Impact of HER2 expression on EGFR-TKI treatment outcomes in lung tumors harboring EGFR mutations: A HER2-CS study subset analysis. Reviewed International journal

Kadoaki Ohashi, Kiichiro Ninomiya, Hiroshige Yoshioka, Akihiro Bessho, Takuo Shibayama, Keisuke Aoe, Nobuhisa Ishikawa, Toshiyuki Kozuki, Haruyuki Kawai, Shoichi Kuyama, Seigo Miyoshi, Kazunori Fujitaka, Hideto Obata, Yukari Tsubata, Yoshikazu Awaya, Masaaki Inoue, Koji Inoue, Naokatsu Horita, Hiroyuki Yanai, Katsuyuki Hotta, Katsuyuki Kiura

Lung cancer (Amsterdam, Netherlands) 150 83 - 89 2020.12

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

OBJECTIVES: Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are standard treatment for EGFR-mutated non-small-cell lung carcinoma (NSCLC); however, a biomarker to predict their efficacy has not been established. Although human epidermal growth factor receptor-2 (HER2) aberrations constitute a potential mechanism for acquired resistance to EGFR-TKIs, the impact of HER2 on EGFR-TKI treatment outcomes has not been systematically evaluated. In this post-hoc subgroup study, we examined the impact of HER2 on the effect of EGFR-TKIs in patients with NSCLC harboring EGFR mutations. MATERIALS AND METHODS: Of 1126 patients with NSCLC enrolled into a prospective cohort study (HER2-CS study), we analyzed data of 356 (32 %) patients with EGFR-mutant tumors. HER2 protein expression levels were determined by immunohistochemistry (IHC) with the gastric cancer criteria. Patients were divided either to an HER2-P group (HER2-IHC2+/3+) or an HER2-N group (HER2-IHC0/1+). We primarily assessed differences in the time-to-treatment failure (TTF) of EGFR-TKI between the groups. RESULTS: The HER2 scoring was as follows: IHC0 (n = 76, 21 %), IHC1+ (n = 199, 56 %), IHC2+ (n = 72, 20 %), and IHC3+ (n = 9, 3 %). The patients' demographics were similar in the HER2-P and HER2-N groups. The HER2-P group showed a significantly shorter EGFR-TKI TTF than the HER2-N group (hazard ratio [HR]: 1.657, 95 % confidence interval [CI]: 1.076-2.552; median: 13.3 vs. 19.1 months). The magnitude of the negative impact of TTF was especially dependent on performance status (PS). HER2 expression significantly deteriorated the TTF in the subgroup with PS 2 (HR: 5.497, 95 % CI: 1.510-20.02), but not in that with better PS (HR: 1.437, 95 % CI: 0.899-2.298) (pinteraction = 0.015). CONCLUSION: In the current cohort, HER2 protein expression in EGFR-mutant NSCLC may have a negative impact on the effect of EGFR-TKIs, the effect of which was PS dependent.

DOI： 10.1016/j.lungcan.2020.09.024

What Are the Results of Resection of Localized Dedifferentiated Liposarcomas in the Extremities? Reviewed

Eiji Nakata, Toshiyuki Kunisada, Joe Hasei, Ryuichi Nakahara, Hiroyuki Yanai, Tomohiro Toji, Hirofumi Inoue CT, Toshifumi Ozaki

Clinical Orthopaedics & Related Research 478 ( 11 ) 2550 - 2561 2020.11

Fibrosis or Necrosis in Resected Lymph Node Indicate Metastasis Before Chemoradiotherapy in Lung Cancer Patients. Reviewed International journal

Yuta Takahashi, Junichi Soh, Kazuhiko Shien, Hiromasa Yamamoto, Masaomi Yamane, Katsuyuki Kiura, Susumu Kanazawa, Hiroyuki Yanai, Shinichi Toyooka

Anticancer research 40 ( 8 ) 4419 - 4423 2020.8

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

BACKGROUND/AIM: The histological features of lymph nodes (LNs) treated by chemoradiotherapy (CRT) in non-small cell lung cancer (NSCLC) have not been well studied. The purpose of this study was to evaluate the histological findings of LNs affected by CRT. PATIENTS AND METHODS: Among 107 clinically N2 NSCLC patients who underwent induction CRT followed by surgery from 1999 to 2017, 24 patients who received pathological evaluation of mediastinal LN before CRT were enrolled in this study. Postoperatively, we histologically reviewed all resected LNs (n=117) of the station evaluated before CRT. RESULTS: Fibrosis and/or necrosis were observed in all investigated LN stations. Histological observation of fibrosis and/or necrosis in the resected LNs after CRT indicated the presence of LN metastasis before CRT. CONCLUSION: The metastatic LNs that responded to CRT showed specific histological features, which enabled us to know the accurate clinical stage of the patient even though cancer cells were not found in the post-treated LNs.

DOI： 10.21873/anticanres.14447

術者の立ち位置を交互に変換した腹腔鏡下前立腺全摘除術の手術成績

長谷川泰久, 松崎信治, 村田大城, 上野剛志, 宮本克利, 久留優子, 岩根亨輔, 金岡隆平, 柳井広之, 三田耕司, 水谷雅巳

泌尿器科紀要 66 ( 8 ) 251 - 257 2020.8

Language：Japanese Publisher：泌尿器科紀要刊行会

2013年2月〜2018年7月に単一術者が立ち位置を1例ずつ左右交互に変えて執刀した腹腔鏡下前立腺全摘除術(LRP)184例の治療成績を後方視的に検証した。全症例の平均年齢は69.9±5.4歳、観察期間は平均44.8±17.3ヵ月であり、D'Amico分類では低リスク26例(14.1%)、中リスク45例(24.5%)、高リスク113例(61.4%)であった。陰茎海綿体神経温存は82例(44.6%)に、術前ホルモン療法は10例(5.4%)に施行した。手術時間は平均203.5±45.5分、尿込み出血量は平均437.6±428.3ml、尿道カテーテル留置期間は平均5.0±3.7日であり、周術期合併症はClavien-Dindo分類でIIIaを1例(0.5%)、IIIbを2例(1.1%)に認めた。切除断端陽性(RM1)は41例(23.6%)に認め、術者の立ち位置から遠方となるサイドの断端陽性が29例(70.7%)と高率であった。前立腺特異抗原非再発率は5年で81.4%、尿禁制回復は12ヵ月で84.8%であった。術者の立ち位置による手術成績への影響は認めなかった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01269&link_issn=&doc_id=20200902470001&doc_link_id=http%3A%2F%2Fhdl.handle.net%2F2433%2F254167&url=http%3A%2F%2Fhdl.handle.net%2F2433%2F254167&type=%8B%9E%93s%91%E5%8Aw%81F%8B%9E%93s%91%E5%8Aw%8Aw%8Fp%8F%EE%95%F1%83%8A%83%7C%83W%83g%83%8A&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80028_3.gif

鑑別に苦慮した成人型顆粒膜細胞腫の1例

大槻花穂, 坪井有加, 長尾良太, 田中高志, 正岡佳久, 平木隆夫, 柳井広之, 金澤右

臨床放射線 65 ( 6 ) 593 - 597 2020.6

Language：Japanese Publisher：金原出版(株)

症例は40歳代前半女性で、腹痛の精査目的で施行されたCT検査で左卵巣に4cm大の腫瘤を認め、当院婦人科に紹介となった。骨盤部MRIでは左卵巣から外方性に発育した約4.2cm大の充実性腫瘤を認めた。辺縁はほぼ平滑で境界明瞭、内部はT2強調像でやや低信号で拡散低下を示していた。Dynamic MRIでは漸増性に子宮筋層と同程度の造影効果を認めた。子宮内膜に肥厚は認めなかった。臨床、画像所見から腫瘤の鑑別として悪性リンパ腫や性索間質性腫瘍が挙げられた。左付属器切除術が施行され、術中迅速病理組織検査で成人型顆粒膜細胞腫と診断され、腹式単純子宮全摘術、右付臓器切除術、大網切除術が追加された。腫瘍細胞は比較的均一でN/C比は高く、円形または楕円形の核の一部に核溝がみられ、成人型顆粒膜細胞腫と診断された。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01565&link_issn=&doc_id=20200629120014&doc_link_id=10.18888%2Frp.0000001264&url=https%3A%2F%2Fdoi.org%2F10.18888%2Frp.0000001264&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Intracranial Mesenchymal Chondrosarcoma Lacking the Typical Histopathological Features Diagnosed by HEY1-NCOA2 Gene Fusion. Reviewed

Atsuhito Uneda, Kazuhiko Kurozumi, Atsushi Fujimura, Atsunori Kamiya, Takanori Hirose, Hiroyuki Yanai, Isao Date

NMC case report journal 7 ( 2 ) 47 - 52 2020.4

Language：English

Intracranial mesenchymal chondrosarcoma (MCS) is a rare neoplasm. The diagnosis of MCS is confirmed by the presence of a biphasic pattern on histological examination, comprising undifferentiated small round cells admixed with islands of well-differentiated hyaline cartilage; however, a differential diagnosis may be challenging in some cases. A 28-year-old woman with a 2-month history of headache was referred to our hospital. Radiologic studies showed an extra-axial lobulated mass composed of calcified and uncalcified areas occupying the left middle fossa. Surgical resection was planned, but her headache suddenly worsened before her planned hospital admission and she was admitted as an emergency. Radiologic studies showed an acute hemorrhage in the uncalcified part of the mass. The mass was resected via the left zygomatic approach after embolization of the feeder vessels. The most likely histopathological diagnosis was MCS. However, the typical bimorphic pattern was not identified in our surgical samples; each undifferentiated area and well-differentiated area was observed separately in different tissue specimens, and no islands of well-differentiated hyaline cartilage were identified within the undifferentiated areas in the same specimen. Molecular assays confirmed the presence of HEY1-NCOA2 fusion. IRF2BP2-CDX1 fusion and IDH1/2 mutations were negative. The final diagnosis of MCS was made based on the presence of HEY1-NCOA2 gene fusion. MCS should be included in the differential diagnosis when radiologic studies show an extra-axial lobulated mass with calcification. Furthermore, molecular demonstration of HEY1-NCOA2 gene fusion may help make a precise diagnosis of MCS, especially in surgical samples lacking the typical histopathological features.

DOI： 10.2176/nmccrj.cr.2019-0123

Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion-matched biopsy specimens. Reviewed International journal

Yuki Maruyama, Takuya Sadahira, Motoo Araki, Yosuke Mitsui, Koichiro Wada, Acosta Gonzalez Herik Rodrigo, Kazuaki Munetomo, Yasuyuki Kobayashi, Masami Watanabe, Hiroyuki Yanai, Toyohiko Watanabe, Yasutomo Nasu

Molecular and clinical oncology 12 ( 4 ) 384 - 389 2020.4

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

The present study investigated the concordance between Gleason scores assigned to prostate biopsy specimens by outside pathologists and a urological pathology expert, and determined the risk of upgrading between opinion-matched Gleason grade group (GGG) 1 biopsy specimens and radical prostatectomy specimens. Between January 2012 and May 2018, 733 patients underwent robot-assisted radical prostatectomy. Patients whose original biopsy specimens from outside hospitals were reviewed by a urological pathology expert Okayama University Hospital were included. Patients who had received neoadjuvant hormonal therapy were excluded. Logistic regression analysis was used to identify predictors of upgrading among GGG 1 diagnoses. A total of 403 patients were included in the present study. Agreement in GGG between initial and second-opinion diagnoses was present in 256 cases (63.5%). Although opinion-matched cases improved concordance between biopsy and prostatectomy specimen GGG compared with single-opinion cases (initial, 35.2%; second-opinion, 36.5%; matched, 41.4%), 71% (56/79) of cases classified as GGG 1 were upgraded after prostatectomy. Multivariate analysis revealed that prostate-specific antigen density and Prostate Imaging Reporting and Data System version 2 score were significant predictors of upgrading (odds ratio, 1.10; P=0.01; and odds ratio, 1.88; P=0.03, respectively). In conclusion, the GGG concordance rate between needle-core biopsy and radical prostatectomy specimens was higher in opinion-matched cases; however, 71% of opinion-matched GGG1 cases were upgraded after robot-assisted radical prostatectomy. Urologists should propose treatment strategies or further biopsy rather than active surveillance for patients with GGG1 and a high PSAD and/or PI-RADS score.

DOI： 10.3892/mco.2020.1996

Juvenile Granulosa Cell Tumor with an Unusual Clinical Course: A Late-onset and Late Recurrent Case. Reviewed

Thar Htet San, Yoko Ota, Soichiro Fushimi, Masayoshi Fujisawa, Hiroyuki Yanai, Hiroko Toda, Tadayoshi Kunitomo, Keisuke Kodama, Akihiro Matsukawa

Acta medica Okayama 74 ( 2 ) 159 - 163 2020.4

Language：English

Juvenile granulosa cell tumors (JGCTs) are rare ovarian tumors with overall good prognoses. They differ from adult granulosa cell tumors (AGCTs), which are well known for late recurrence. Most JGCTs (～97%) occur in individuals <30 years old. We report a recurrent JGCT in a 40-year-old woman 5 years after initial presentation. The histological appearance and lack of 402C>G missense point mutation of FOXL2 gene (characteristic of AGCT but absent in JGCT) allowed differentiation from AGCT. This is the first comprehensive report of JGCT with late recurrence. Although rare, late recurrence of JGCT can occur; long-term surveillance is suggested.

DOI： 10.18926/AMO/58275

Recurring radiation-induced angiosarcoma of the breast that was treated with paclitaxel chemotherapy: a case report. Reviewed International journal

Yoko Suzuki, Kohei Taniguchi, Minami Hatono, Yukiko Kajiwara, Yuko Abe, Kengo Kawada, Takahiro Tsukioki, Mariko Kochi, Keiko Nishiyama, Takayuki Iwamoto, Hirokuni Ikeda, Tadahiko Shien, Naruto Taira, Masahiro Tabata, Hiroyuki Yanai, Hiroyoshi Doihara

Surgical case reports 6 ( 1 ) 25 - 25 2020.1

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

BACKGROUND: Angiosarcoma of the breast is very rare and can be divided into primary and secondary angiosarcoma. Radiation-induced angiosarcoma (RIAS) is classified as secondary angiosarcoma. Diagnosis of RIAS is difficult due to its rarity, and the interpretation of pathological imaging is complicated. In the National Comprehensive Care Network (NCCN) guidelines, the first choice of treatment is surgery with negative margins. Adjuvant radiotherapy (RT) for close soft tissue margins should be considered. Preoperative or adjuvant chemotherapy of nonmetastatic disease is not recommended for angiosarcoma. We report a case of RIAS, which was impossible to diagnose with core needle biopsy (CNB) but was diagnosed by excisional biopsy. The patient was then administered adjuvant chemotherapy using conjugated paclitaxel (PTX). CASE PRESENTATION: A 62-year-old woman noticed a tumor in her right breast. She had a history of right breast cancer and had undergone breast-conserving surgery, RT, and tamoxifen therapy 8 years previously. CNB, which was performed twice, was inconclusive. The tumor was surgically excised and pathological analysis yielded a diagnosis of angiosarcoma. She then underwent a right mastectomy. One month after she underwent right mastectomy, a nodule reappeared on the skin of her right breast, and excisional biopsy revealed recurrence of angiosarcoma. A few weeks later another nodule reappeared near the post-operative scar and excisional biopsy revealed recurrence of angiosarcoma. We assumed that surgical therapy was insufficient because the patient experienced relapse of angiosarcoma after complete mastectomy. After the second recurrence, we treated her with systemic chemotherapy using PTX. There was no evidence of recurrence 8 months after chemotherapy. CONCLUSION: Although angiosarcoma is difficult to diagnose, many patients have a poor prognosis. Therefore, prompt treatment intervention is desired. Moreover, there is little evidence regarding adjuvant therapy of angiosarcoma since it is a rare disease. We consider that adjuvant therapy helped to effectively prevent recurrence in the patient after complete excision.

DOI： 10.1186/s40792-020-0790-7

Differentiation of Small (≤ 4 cm) Renal Masses on Multiphase Contrast-Enhanced CT by Deep Learning. Reviewed International journal

Tanaka T, Huang Y, Marukawa Y, Tsuboi Y, Masaoka Y, Kojima K, Iguchi T, Hiraki T, Gobara H, Yanai H, Nasu Y, Kanazawa S

AJR. American journal of roentgenology 214 ( 3 ) 1 - 8 2020.1

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

OBJECTIVE. This study evaluated the utility of a deep learning method for determining whether a small (≤ 4 cm) solid renal mass was benign or malignant on multiphase contrast-enhanced CT. MATERIALS AND METHODS. This retrospective study included 1807 image sets from 168 pathologically diagnosed small (≤ 4 cm) solid renal masses with four CT phases (unenhanced, corticomedullary, nephrogenic, and excretory) in 159 patients between 2012 and 2016. Masses were classified as malignant (n = 136) or benign (n = 32). The dataset was randomly divided into five subsets: four were used for augmentation and supervised training (48,832 images), and one was used for testing (281 images). The Inception-v3 architecture convolutional neural network (CNN) model was used. The AUC for malignancy and accuracy at optimal cutoff values of output data were evaluated in six different CNN models. Multivariate logistic regression analysis was also performed. RESULTS. Malignant and benign lesions showed no significant difference of size. The AUC value of corticomedullary phase was higher than that of other phases (corticomedullary vs excretory, p = 0.022). The highest accuracy (88%) was achieved in corticomedullary phase images. Multivariate analysis revealed that the CNN model of corticomedullary phase was a significant predictor for malignancy compared with other CNN models, age, sex, and lesion size. CONCLUSION. A deep learning method with a CNN allowed acceptable differentiation of small (≤ 4 cm) solid renal masses in dynamic CT images, especially in the corticomedullary image model.

DOI： 10.2214/AJR.19.22074

Pilot evaluation of a HER2 testing in non-small-cell lung cancer. Reviewed International journal

Hotta K, Yanai H, Ohashi K, Ninomiya K, Nakashima H, Kayatani H, Takata M, Kiura K

Journal of clinical pathology 73 ( 6 ) 353 - 357 2019.12

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

AIMS: HER2-positivity pattern in the specimens of immunohistochemistry (IHC) and ﬂuorescence in situ hybridisation (FISH) has been hardly reported in non-small-cell lung cancer (NSCLC). METHODS: We evaluated the characteristics of HER2-positivity pattern in formalin-ﬁxed parafﬁn-embedded samples using IHC and FISH in 15 patients enrolled in a larger prospective cohort study to survey a HER2-positive NSCLC. RESULTS: As for the immunostaining pattern, most specimens (79%) demonstrated incomplete or mixed-typed membranous immunoreactivity with heterogeneity, resembling that observed in gastric cancer rather than breast cancer. Concordance between IHC-positivity and FISH-positivity was 87.5% according to the criteria for breast cancer scoring system. On application of the gastric cancer scoring system to the examined tumours, the IHC score increased in the seven (43.8%) specimens, and the concordance between IHC positivity and FISH positivity rose to 93.8%. CONCLUSIONS: In our pilot series, the pattern of IHC reactivity closely resembled that observed in gastric cancer rather than breast cancer. TRIAL REGISTRATION NUMBER: 000017003.

DOI： 10.1136/jclinpath-2019-206204

整形外科外来の出張細胞診にて胞巣状軟部肉腫を疑った1例

實平悦子, 今井みどり, 松岡博美, 井上博文, 那須篤子, 山口祐菜, 松岡昌志, 都地友紘, 柳井広之

岡山県臨床細胞学会誌 38 44 - 47 2019.12

Language：Japanese Publisher：岡山県臨床細胞学会

【はじめに】胞巣状軟部肉腫(以下ASPS)は、若年成人の下肢、上肢、頭頸部に好発する比較的まれな悪性軟部腫瘍である。今回、我々は出張細胞診でASPSを推定が可能であった症例を経験したので細胞像と臨床所見について報告する。【症例】10歳代女性。学校入学時検診の胸部X線検査にて異常陰影を指摘され、当院受診。MRI検査で、右大腿部に約10cm大の腫瘤を認め、質的診断目的にて整形外科外来で腫瘍生検が施行された。出張細胞診で行ったヘマカラー染色では、類円形核を有する異型細胞が孤立散在性に豊富に出現していた。腫瘍細胞の核は著明な核小体を1から数ヶ所有し、細胞質は淡く裸核状に見られるものもあった。パパニコロウ染色にて大型の異型細胞集塊を認め、集塊の周りに間質細胞の核が付着しているように見られた。孤立性に出現している細胞の細胞質は豊富でライトグリーンに好性で微細顆粒状であった。細胞質の辺縁は明瞭な細胞や境界不明瞭な細胞も混在していた。核クロマチンは、粗顆粒状で著明な核小体を認めた。PAS反応にてジアスターゼ抵抗性の針状結晶は認めなかった。病理組織像では、血管性の隔壁に囲まれた胞巣状の比較的均一な好酸性細胞が見られた。細胞質は顆粒状で、PAS反応は細胞質に陽性であった。免疫組織染色にてTFE3が核に陽性であったことよりASPSと診断された。【まとめ】出張細胞診で、豊富な類円形細胞と、若年の女性で肺に転移巣があるという臨床所見より、ASPSの推定が可能であった症例を経験した。(著者抄録)

Fumarate hydratase(FH)欠損腎細胞癌によるリンパ節転移に対して、イピリムマブ+ニボルマブ併用療法が奏功した一例

関戸崇了, 高本篤, 小林泰之, 三井將雄, 和田里章吾, 窪田理沙, 岩田健宏, 枝村康平, 佐古智子, 荒木元朗, 渡邉豊彦, 柳井広之, 那須保友

西日本泌尿器科 81 ( 増刊 ) 151 - 151 2019.10

Evaluation of the Usefulness and Convenience of the Kyoto Classification of Gastritis in the Endoscopic Diagnosis of the Helicobacter pylori Infection Status. Reviewed International journal

Sakae H, Iwamuro M, Okamoto Y, Obayashi Y, Baba Y, Hamada K, Gotoda T, Abe M, Kono Y, Kanzaki H, Kawano S, Kawahara Y, Tanaka T, Yanai H, Okada H

Digestion 101 ( 6 ) 1 - 8 2019.9

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

BACKGROUND/AIMS: The Kyoto Classification of Gastritis was published in 2014. Although this classification is now widely used in Japan, its usefulness and convenience have not been sufficiently evaluated. This study aimed to evaluate the usefulness and convenience of this classification in the endoscopic diagnosis of Helicobacter pylori infection. METHODS: We made a test for the endoscopic diagnosis of H. pylori infection comprising 30 cases who had representative endoscopic features of non-, active, or inactive gastritis. Thirty-eight participants took the test before and after a brief mini-lecture on the Kyoto Classification of Gastritis. Eighteen participants took the test again 3 months later. We investigated the accuracy before, just after, and 3 months after the mini-lecture. RESULTS: The accuracy of endoscopists after the lecture was significantly improved in comparison to before the lecture (77.6 vs. 83.3%). Medical students also showed significantly improved accuracy after the lecture (56.7 vs. 71.7%). Among endoscopists, this improvement was maintained after 3 months. Before the lecture, the accuracy of diagnosing non-gastritis was 90.3%; it tended to be further improved 3 months later (96.5%). A >10% point increase was observed in diagnosing active (72.7-83.3%) and inactive gastritis (73.2-84.3%) at 3 months after the lecture in comparison to before the lecture. CONCLUSION: A brief mini-lecture on the Kyoto Classification of Gastritis improved the accuracy in the endoscopic diagnosis of gastritis, indicating that understanding this classification is useful for the prompt diagnosis of H. pylori infection during esophagogastroduodenoscopy.

DOI： 10.1159/000502573

Metastatic ureteral tumor arising from gastrointestinal cancer: A report of two cases

Kasumi Kawamura, Motoo Araki, Takuya Sadahira, Yuki Maruyama, Yosuke Mitsui, Shingo Nishimura, Atsushi Takamoto, Koichiro Wada, Ryuta Tanimoto, Morito Sugimoto, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu, Hiroyuki Yanai

Nishinihon Journal of Urology 81 ( 4 ) 461 - 466 2019.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The West Japan Urological Association

We report two cases where gastrointestinal cancer gave rise to a metastatic ureteral tumor. Case one was a 64-year-old man who was operated on for descending colon cancer in September, 2007. In 2014, he was referred to our hospital because computed tomography (CT) scan showed a tumor of the right ureter. Ureteroscopic biopsy showed a metastatic ureteral tumor arising from descending colon cancer. The patient underwent open tumor resection. Transurethral resection of a bladder tumor (TUR- BT) was required three times for treatment of tumor recurrence from the ureteral stump in an effort to control gross hematuria Case two was a 62-year-old man who underwent pylorus-preserving gastrectomy for gastric cancer in December, 2014. Follow-up CT showed right hydronephrosis and thickening of the right ureteral wall in 2017. Selective urine cytology of the right ureter revealed urothelial carcinoma, class V. Ureteroscopic biopsy of the right ureter revealed invasive urothelial carcinoma. The patient underwent retroperitoneal laparoscopic nephroureterectomy. Histological examination revealed the right ureteral tumor to be metastasis of gastric cancer.

消化器癌による転移性尿管腫瘍の2例

河村香澄, 荒木元朗, 定平卓也, 丸山雄樹, 光井洋介, 西村慎吾, 高本篤, 和田耕一郎, 谷本竜太, 杉本盛人, 小林泰之, 渡部昌実, 渡辺豊彦, 那須保友, 柳井広之

西日本泌尿器科 81 ( 4 ) 461 - 466 2019.8

Language：Japanese Publisher：西日本泌尿器科学会

消化器癌を原発とする転移性尿管腫瘍の2例を経験したため報告する。【症例1】64歳、男性。2007年9月、下行結腸癌に対して下行結腸切除術を施行した。2014年、術後のCTで右尿管腫瘍を指摘され当科へ紹介となった。右尿管鏡検査時の生検病理結果より下行結腸癌の尿管転移と診断し、開腹腫瘍摘出術を行った。術後4ヵ月の時点で肝転移を認めたためTS-1 120mg内服療法を14ヵ月行い、様々な変更を経て現在はXELIRI + Bevacizumab療法8コース目を行っている。肝転移は緩徐に増大中である。【症例2】62歳、男性。2014年12月、多発胃癌に対して幽門側胃切除術、胆嚢摘出術およびRoux-en-Y再建術を施行し、術後TS-1 100mg内服療法を1年間行った。2017年、CTで右水腎症と尿管壁肥厚を指摘され、右尿管鏡検査を行うも狭窄が強く組織は採取できず、検査時の分腎尿細胞診はclass IVであった。再施行した右尿管鏡検査において狭窄尾側を生検したところ浸潤性尿路上皮癌の診断であったため、後腹膜鏡下右腎尿管摘除術を施行した。右尿管は腹膜およびS状結腸と著しく癒着し、漿膜ごと摘除した。病理結果は胃癌の右尿管転移であった。術後weekly PTX 100mgを開始したが骨転移の出現や腹膜転移の進行を認め、PTX + Ramucirumab 1コース施行した後に抗PD-1抗体180mgを5コース行ったが全身状態は徐々に悪化した。術後7ヵ月で緩和療法に移行し、術後11ヵ月で永眠された。転移性尿管腫瘍は術前生検しても診断が難しい場合がある。予後不良な疾患であり、悪性疾患の既往のある尿管腫瘍は転移性尿管腫瘍も鑑別に挙げる必要がある。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01004&link_issn=&doc_id=20190823210008&doc_link_id=%2Fer9niuro%2F2019%2F008104%2F008%2F0461-0466%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fer9niuro%2F2019%2F008104%2F008%2F0461-0466%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

A Comprehensive Review of Ovarian Serous Carcinoma. Reviewed

Hatano Y, Hatano K, Tamada M, Morishige KI, Tomita H, Yanai H, Hara A

Advances in anatomic pathology 2019.7

High-grade glioneuronal tumor with an ARHGEF2-NTRK1 fusion gene. Reviewed

Kazuhiko Kurozumi, Yoshiko Nakano, Joji Ishida, Takehiro Tanaka, Masatomo Doi, Junko Hirato, Akihiko Yoshida, Kana Washio, Akira Shimada, Takashi Kohno, Koichi Ichimura, Hiroyuki Yanai, Isao Date

Brain tumor pathology 36 ( 3 ) 121 - 128 2019.7

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

Here, we report a highly unusual case of high-grade glioneuronal tumor with a neurotrophic tropomyosin receptor kinase (NTRK) fusion gene. A 13-year-old girl presented with headache and vomiting and MRI detected two cystic lesions bilaterally in the frontal areas with surrounding edema. The left larger tumor was removed by left frontal craniotomy. The tumor was diagnosed as a high-grade glioneuronal tumor, unclassified. Methylation profiling classified it as a diffuse leptomeningeal glioneuronal tumor (DLGNT) with low confidence. This tumor showed genotypes frequently found in DLGNT such as 1p/19q codeletion without IDH mutation and, however, did not have the typical DLGNT clinical and histological features. RNA sequencing identified an ARHGEF2 (encoding Rho/Rac guanine nucleotide exchange factor 2)-NTRK1 fusion gene. The presence of recurrent NTRK fusion in glioneuronal tumors has an important implication in the clinical decision making and opens up a possibility of novel targeted therapy.

DOI： 10.1007/s10014-019-00345-y

Cavernous hemangioma of the rib mimicking a chondrosarcoma: Diagnostic value of delayed phase MRI Reviewed

T. Tanaka, Y. Masaoka, S. Sugimoto, T. Iguchi, T. Hiraki, H. Yanai, S. Kanazawa

Diagnostic and Interventional Imaging 100 ( 7-8 ) 455 - 457 2019.7

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