研究者詳細 - 柳井　広之

論文 - 柳井　広之

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超音波内視鏡下穿刺吸引細胞診(EUS-FNA)が有用であった胃粘膜下腫瘍の一例

本山由紀子, 井上博文, 今井みどり, 松岡博美, 藤田勝, 市村浩一, 柳井広之

日本臨床細胞学会岡山支部会誌 31 34 - 37 2012年12月

記述言語：日本語出版者・発行元：岡山県臨床細胞学会

70代女。30年前に他院で胃噴門部大彎の粘膜下腫瘍を認められ、以来、年に一度の経過観察が行われていた。今回、CT検査で噴門部大彎腫瘤と胃体上部大彎腫瘤を認められ、精査目的で当院に紹介された。超音波検査を行ったところ、噴門部腫瘤は内部エコーがほぼ均一の低エコー像であるのに対し、体上部腫瘤は内部エコーが不均一な低〜等エコー像であったため、それぞれの腫瘤についてEUS-FNAを施行した。結果、噴門部腫瘤は核密度の低い緻密な細胞集塊で、核はクロマチン分布がほぼ均等・淡染性で長紡錘形を呈し、比較的整った配列を示した。体上部腫瘤は、噴門部腫瘤に比べて核密度の高い細胞集塊で、核形は主に楕円形〜紡錘形であり、一部に円形を呈する細胞もみられ、小型の核小体が観察されたが、明らかな核分裂像は認めなかった。両腫瘤間の最も顕著な相違点は核密度であり、体上部腫瘤の細胞所見からはGISTが強く示唆され、噴門部腫瘤はGIST以外の間葉系腫瘍である可能性が考えられた。組織学的検査により、噴門部腫瘤は平滑筋腫、体上部腫瘤はGISTと診断された。

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Clinicopathological characteristics of human epidermal growth factor receptor 2-positive Barrett's adenocarcinoma 査読

Takehiro Tanaka, Atsushi Fujimura, Koichi Ichimura, Hiroyuki Yanai, Yasuharu Sato, Katsuyohi Takata, Hiroyuki Okada, Seiji Kawano, Shunsuke Tanabe, Tadashi Yoshino

WORLD JOURNAL OF GASTROENTEROLOGY 18 ( 43 ) 6263 - 6268 2012年11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：BAISHIDENG PUBL GRP CO LTD

AIM: To compare the clinicopathological characteristics of human epidermal growth factor receptor 2 (HER2)-positive and HER2-negative Barrett's adenocarcinoma in Japan.
METHODS: We performed immunohistochemical analysis of HER2 in 30 samples taken from patients with Barrett's adenocarcinoma and dual color in situ hybridization in cases showing 2+ reactions. We compared the clinicopathological characteristics of HER2-positive and HER2-negative patients.
RESULTS: HER2 positivity was identified in 8 (27%) carcinoma samples. We found that HER2 expression was associated with p53 overexpression (100% vs 52.6% in pT1 tumor; 100% vs 54.5% in all stage tumor, P < 0.05) and protruding lesions at the early disease stage. There was no association between the mucin phenotype of the carcinomas and prognosis. HER2 expression and low clinical stage were unexpectedly different between Barrett's adenocarcinoma patients and gastric cancer patients, but the macroscopic features may be associated with earlier diagnosis in these patients.
CONCLUSION: Our results suggest that HER2-positive Barrett's adenocarcinomas are associated with p53 overexpression and lesion protrusion at the early disease stage. (C) 2012 Baishideng. All rights reserved.

DOI： 10.3748/wjg.v18.i43.6263

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Carcinosarcoma of the Gallbladder Manifesting as Cholangitis Due to Hemobilia 査読

Hiroshi Sadamori, Hiroyasu Fujiwara, Takehiro Tanaka, Hiroyuki Yanai, Daisuke Satoh, Takahito Yagi, Toshiyoshi Fujiwara

JOURNAL OF GASTROINTESTINAL SURGERY 16 ( 6 ) 1278 - 1281 2012年6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：SPRINGER

Carcinosarcomas of the gallbladder are rare tumors that are characterized by malignant epithelial and mesenchymal components, and preoperative diagnosis of carcinosarcoma of the gallbladder remains difficult.
We recently encountered a case of carcinosarcoma of the gallbladder with osteoid and chondroid differentiation, manifesting as cholangitis due to hemobilia.
Preoperative computed tomography and magnetic resonance imaging indicated the cause of cholangitis and provided qualitative information regarding the two components of the tumor.

DOI： 10.1007/s11605-012-1836-3

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The clinical impact of pathological review on selection the treatment modality for localized prostate cancer in candidates for brachytherapy monotherapy 査読

Ryo Kishimoto, Takashi Saika, Kensuke Bekku, Hiroyuki Nose, Fernando Abarzua, Yasuyuki Kobayashi, Motoo Araki, Hiroyuki Yanai, Yasutomo Nasu, Hiromi Kumon

WORLD JOURNAL OF UROLOGY 30 ( 3 ) 375 - 378 2012年6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：SPRINGER

To evaluate the impact of pathological review by pathologist with genitourinary expertise (PGU) on treatment modality of localized prostate cancer, we analyzed Gleason grade (GG) migration and the final treatment decision in a cohort of patients designated for permanent prostate brachytherapy (PPB).
From February 2005 to July 2010, a total of 247 patients with localized prostate cancer diagnosed by local community hospitals were referred to our hospital for PPB monotheray. All pathologic slides of prostate biopsies were reviewed by a single PGU. Patients ultimately selected their treatment modality from our recommendations based on the review. Indication for PPB monotherapy was the NCCN classification of patients as good or intermediate risk. In addition, patient with Primary GG 4 was regarded as unadapted case.
Six cases were reinterpreted as no cancer (2.4%). GG change occurred in 94 cases (38.1%) of which 77 (81.9%) were upgraded and 17 (18.1%) downgraded. Of the total 247 patients, 86 (34.8%) changed therapies and 30 (12.1%) did so based on the pathologic slide review.
Pathological review of biopsy specimens is mandatory for the determination of treatment modality especially in candidates for monotherapy of permanent prostate brachytherapy.

DOI： 10.1007/s00345-011-0738-4

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Gene therapy for prostate cancer - Research and development of a new immuno-gene therapy

Katsumi Sasaki, Ryuta Tanimoto, Shin Ebara, Hiromi Kumon, Yasutomo Nasu, Masami Watanabe, Haruki Kaku, Hiroyuki Yanai

Nishinihon Journal of Urology 74 ( 4 ) 197 - 202 2012年4月

記述言語：日本語掲載種別：研究論文（国際会議プロシーディングス）

We have performed three clinical studies for prostate cancer at Okayama University Hospital. In the first study (Suicide gene therapy using adenovirus vector (ADV) expressing herpes simplex virus-thymidine kinase gene and Ganciclovir), 9 castration-resistant prostate cancer (CRPC) patients without metastasis were treated from 2001 to 2005, demonstrating the safety profile and some clinical responses. In the second study (Immunogene therapy using ADV expressing the Interleukin-12 gene), 10 CRPC patients with or without metastasis were treated from 2008, demonstrating the safety profile and some immuno-clinical responses. The latest study (Gene therapy creating cancer vaccine using ADV expressing reduced expression in immortalized cells
REIC/Dkk-3 gene, which mediates simultaneous induction of cancer-selective apoptosis and augmentation of anti-tumor immunity), was initiated in Jan., 2011. The study category includes 2 groups: A, CRPC
and B, newly diagnosed high-risk localized cancer with indication for surgical resection (Neo-adjuvant). Four CRPC patients and 9 neo-adjuvant patients have been entered into the study with an excellent safety profile. Patients treated with the intermediate vector dose demonstrated modest clinical and/or immunological effects, and an increased vector dose showed remarkable immuno-pathological effects. Ad/REIODkk-3, a revolutionary gene-based medicine creating a cancer vaccine, could be a promising treatment option for prostate cancer.

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Primary Gleason grade 4 impact on biochemical recurrence after permanent interstitial brachytherapy in Japanese patients with low- or intermediate-risk prostate cancer 査読

Tatsuya Uesugi, Takashi Saika, Kohei Edamura, Hiroyuki Nose, Makoto Kobuke, Shin Ebara, Fernand Abarzua, Norihisa Katayama, Hiroyuki Yanai, Yasutomo Nasu, Hiromi Kumon

International Journal of Radiation Oncology Biology Physics 82 ( 2 ) e219 - e223 2012年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

Purpose: To reveal a predictive factor for biochemical recurrence (BCR) after permanent prostate brachytherapy (PPB) using iodine-125 seed implantation in patients with localized prostate cancer classified as low or intermediate risk based on National Comprehensive Cancer Network (NCCN) guidelines. Methods and Materials: From January 2004 to December 2009, 414 consecutive Japanese patients with clinically localized prostate cancer classified as low or intermediate risk based on the NCCN guidelines were treated with PPB. The clinical factors including pathological data reviewed by a central pathologist and follow-up data were prospectively collected. Kaplan-Meier and Cox regression analyses were used to assess the factors associated with BCR. Results: Median follow-up was 36.5 months. The 2-, 3-, 4-, and 5-year BCR-free rates using the Phoenix definition were 98.3%, 96.0%, 91.6%, and 87.0%, respectively. On univariate analysis, the Gleason score, especially primary Gleason grade 4 in biopsy specimens, was a strong predicting factor (p &lt
0.0001), while age, initial prostate-specific antigen (PSA) level, T stage, and minimal dose delivered to 90% of the prostate volume (D90) were insignificant. Multivariate analysis indicated that a primary Gleason grade 4 was the most powerful prognostic factor associated with BCR (hazard ratio = 6.576, 95% confidence interval, 2.597-16.468, p &lt
0.0001). Conclusions: A primary Gleason grade 4 carried a worse BCR prognosis than the primary grade 3 in patients treated with PPB. Therefore, the indication for PPB in patients with a Gleason sum of 4 + 3 deserves careful and thoughtful consideration. © 2012 Elsevier Inc.

DOI： 10.1016/j.ijrobp.2011.04.018

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Prostatic stromal tumor of uncertain malignant potential (STUMP) with unrecognized growth pattern 査読

Soichiro Fushimi, Tetsuya Ogino, Ken Aoki, Junya Itakura, Toshihiro Ito, Tadashi Oeda, Hiroyuki Yanai, Akihiro Matsukawa

PATHOLOGY INTERNATIONAL 62 ( 1 ) 69 - 71 2012年1月

心臓原発malignant fibrous histiocytoma(MFH)の十二指腸転移の1例

沼田紀史, 中川昌浩, 岡本良一, 東玲治, 平尾謙, 小川恒由, 大江啓常, 植木亨, 高田晋一, 松浦博夫, 柳井広之, 水野元夫

胃と腸 2012年

小細胞癌成分を含む食道癌肉腫の1切除例

田辺俊介, 白川靖博, 前田直見, 大原利章, 野間和広, 櫻間教文, 柳井広之, 山辻知樹, 猶本良夫, 藤原俊義

岡山医学会雑誌 124 ( 2 ) 145 - 148 2012年

記述言語：日本語出版者・発行元：岡山医学会

We experienced a case of esophageal carcinosarcoma with a component of small cell carcinoma. The patient was a 73-year-old man. We administered chemotherapy of CDDP+VP-16, and performed an operation after 2 courses of this chemotherapy. Subtotal esophagectomy and reconstruction with the small intestine was performed. More than three years after resection, he remains alive and recurrence-free. There are few cases of esophageal carcinosarcoma and small cell carcinoma. We report this rare case herein.

DOI： 10.4044/joma.124.145

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卵巣明細胞腺癌Ia期に対する病理組織学的観点からの考察

松尾勇児, 宮原陽, 本田律生, 大竹秀幸, 田代浩徳, 柳井広之, 森谷卓也, 片渕秀隆

日本婦人科腫瘍学会雑誌 30 ( 2 ) 129 - 134 2012年

Thallium-201 Scintigraphy Is an Effective Diagnostic Modality to Distinguish Malignant From Benign Soft-Tissue Tumors 査読

Naoaki Kawakami, Toshiyuki Kunisada, Shuhei Sato, Yuki Morimoto, Masato Tanaka, Tsuyoshi Sasaki, Shinsuke Sugihara, Hiroyuki Yanai, Susumu Kanazawa, Toshifumi Ozaki

CLINICAL NUCLEAR MEDICINE 36 ( 11 ) 982 - 986 2011年11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：LIPPINCOTT WILLIAMS & WILKINS

Background: The aim of this study is to evaluate whether thallium-201 (201-Tl) scintigraphy can differentiate malignant from benign soft-tissue tumors.
Methods: Between April 1995 and December 2005, 192 patients with soft-tissue tumors (85 malignant and 107 benign) underwent 201-Tl scintigraphy before treatment. Isotope uptake was used as a proxy for tumor-to-background ratio (TBR). The accuracy of TBR on early and delayed imaging was evaluated using the Mann-Whitney U and chi(2) tests.
Results: There was a statistically significant difference in mean TBR on early and delayed imaging of malignant and benign soft-tissue tumors (124% +/- 109% vs. 22% +/- 42%, and 82% +/- 83% vs. 12% +/- 25%, P < 0.0001). A TBR cutoff of 20% indicated the probability of malignancy on early and delayed imaging (82% sensitivity and 77% specificity; 82% sensitivity and 84% specificity, P < 0.0001). Well-differentiated liposarcomas showed low isotope accumulation, while pigmented villonodular synovitis and giant cell tumors of the tendon sheath showed high isotope accumulation.
Conclusions: Thallium-201 scintigraphy can distinguish malignant from benign tumors with relatively high accuracy. With the exception of low grade liposarcomas and locally aggressive benign tumors, 201-Tl scintigraphy may be an effective diagnostic modality to differentiate malignant from benign soft-tissue tumors.

DOI： 10.1097/RLU.0b013e3182177407

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Primary Germinoma in the Medulla Oblongata-Case Report 査読

Takao Yasuhara, Tomotsugu Ichikawa, Yasuyuki Miyoshi, Kazuhiko Kurozumi, Tomoko Maruo, Hiroyuki Yanai, Isao Date

NEUROLOGIA MEDICO-CHIRURGICA 51 ( 4 ) 326 - 329 2011年4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：JAPAN NEUROSURGICAL SOC

A 27-year-old woman presented with a case of primary medulla oblongata germinoma manifesting as sleep apnea, aspiration pneumonia, and left hemiparesis. Magnetic resonance (MR) imaging revealed a dorsal mass in the medulla oblongata with heterogeneous enhancement by gadolinium (Gd). Emergent biopsy and foramen magnum decompression with C1 laminectomy were performed because of rapid worsening of her symptoms. The histological diagnosis was germinoma. Subsequently she received chemoradiation therapy with subsequent amelioration of her neurological deficits and disappearance of enhancement on MR imaging with Gd. Primary medulla oblongata germinoma is rare and difficult to diagnose preoperatively. However, correct diagnosis and subsequent adequate chemoradiation therapy is possible by understanding the common characteristics of the disease. Germinoma should be included in the differential diagnosis of midline medullary lesion in young patients, and biopsy should be considered.

DOI： 10.2176/nmc.51.326

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Long-Term Effect of External Beam Radiotherapy of Optic Disc Hemangioma in a Patient with von Hippel-Lindau Disease 査読

Toshihiko Matsuo, Kengo Himei, Kouichi Ichimura, Hiroyuki Yanai, Soichiro Nose, Tetsushige Mimura, Yasuyuki Miyoshi, Tomoyasu Tsushima

ACTA MEDICA OKAYAMA 65 ( 2 ) 135 - 141 2011年4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：OKAYAMA UNIV MED SCHOOL

An 18-year-old woman with a 2-year history of hypertension and headache was diagnosed with noradrenal in-secreting bilateral adrenal pheochromocytomas with paragangliomas in the background of von Hippel-Lindau disease with family histories and a missense mutation, 712C to T (Arg167Trp) in the VHL gene. She had optic disc hemangioma in the left eye which gradually enlarged and caused serous retinal detachment on the macula in one year. Low-dose external beam radiation (20 Gy) was adminisitered to the left eye using a lens-sparing single lateral technique. She underwent craniotomy for cerebellar hemangioblastoma at the age of 22 years and total pancreatectomy for multiple neuroendocrine tumors at the age of 24 years. In the 6-year follow-up period after the radiotherapy, the optic disc hemangioma gradually reduced in size and its activity remained low, allowing good central vision to be maintained. External beam radiation is recommended as a treatment option for the initial therapy for optic disc hemangioma.

DOI： 10.18926/AMO/45273

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性索間質性腫瘍（分類不能型）の１例

乗金精一郎, 上者郁夫, 笹井信也, 井田健太郎, 加地充昌, 柳井広之, 金澤右

臨床放射線 56 ( 13 ) 1855 - 1859 2011年

耳下腺上皮筋上皮癌の一例

那須篤子, 井上博文, 藤田勝, 濱田香菜, 松岡博美, 今井みどり, 田中健大, 市村浩一, 柳井広之, 吉野正

日本臨床細胞学会岡山支部会誌 30 40 - 42 2011年

記述言語：日本語出版者・発行元：岡山県臨床細胞学会

80歳代男。頸部エコーで右耳下腺内に不整形腫瘤を認め、穿刺吸引細胞診を施行した。壊死物を伴う嚢胞内容を背景に、シート状ないし管状配列を示す小型で細胞質に乏しい上皮細胞集塊、小集塊〜散在性に出現する大型裸核状筋上皮細胞を認め、筋上皮細胞が粘液球を取り囲む構造がみられた。筋上皮細胞の核は裸核状で大型、不整形、クロマチン細顆粒状で、大型核小体を認めた。以上より腺様嚢胞癌と推定したが、組織学的に腫瘍は嚢胞内に上皮細胞と筋上皮細胞が明瞭な二層構造を示して乳頭状あるいは充実性に増生していたことから上皮筋上皮癌と診断した。腫瘍細胞には腺腔形成、偽腺腔形成を認めた。免疫組織化学的に上皮細胞はEMA陽性、筋上皮細胞はα-smooth muscle actin、p63陽性、偽腺腔、基底膜様物質がType IV collagen陽性であった。

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放射線療法が奏効した,H. pylori陰性胃MALTリンパ腫の1例

胃と腸 46 ( 9 ) 1300 - 1303 2011年

神経内分泌分化した汗腺癌の1例

池田佳寿子, 大塚正樹, 山崎修, 岩月啓氏, 岩谷佳代子, 柳井広之, 森下佳子

Skin Cancer 26 ( 2 ) 153 - 156 2011年

記述言語：日本語出版者・発行元：The Japanese Skin Cancer Society

69歳，男性。初診の1年前から左頬部に結節を自覚。徐々に増大してきたため，当院を紹介受診した。左頬部に23×20mm，ドーム状に隆起する淡い弾性硬の紅色腫瘤を認めた。組織学的には，真皮全層にわたり，淡明な類円形～多角形細胞が充実性胞巣状に増生しており，少数の核分裂像や個細胞壊死を認めた。免疫染色では，pan keratin・EMA・vimentin・CAM5.2・GCDFP15・chromogranin A・CD56が陽性で，S100・CEA・CK7・CK20が陰性であった。一部でムチン産生性であった。PET－CT，CTで明らかなリンパ節転移・遠隔転移は認められなかった。神経内分泌分化した汗腺癌と診断し，腫瘍切除およびセンチネルリンパ節生検を施行し，リンパ節転移が認められたため，頸部リンパ節郭清と放射線療法を追加した。リンパ節郭清後6ヵ月，リンパ節転移・遠隔転移は認められていない。

DOI： 10.5227/skincancer.26.153

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その他リンク： http://search.jamas.or.jp/link/ui/2012038271

子宮体部clear cell adenocarcinomaの2例

那須篤子, 井上博文, 藤田勝, 松岡博美, 今井みどり, 大森昌子, 田中健大, 市村浩一, 柳井広之, 吉野正

日本臨床細胞学会岡山支部会誌 29 15 - 16 2010年12月

記述言語：日本語出版者・発行元：岡山県臨床細胞学会

症例1は59歳女で、出血持続の内膜細胞診classVで紹介となった。細胞所見は出血性背景の中に淡明な胞体を有する腫瘍細胞が孤立散在性から小集塊状、シート状に認められた。核は円形から一部不整形、大小不同を伴い、クロマチン細顆粒状・密で、著明な核小体と核縁肥厚が観察された。また、hobnail様構造も認めた。組織所見は淡明な胞体を有した乳頭状〜腺管増殖を示し、明細胞腺癌clear cell adenocarcinomaと診断し、一部にendometrioid adenocarcinoma像も認めた。症例2は71歳女で、不正出血のclassIVで紹介となった。細胞所見は壊死性背景の中に明るく豊富な細胞質を有する腫瘍細胞がシート状に認められた。核は円形から類円形、大小不同を伴い、クロマチン細顆粒状で、著明な核小体が確認された。また、ライト緑好性、オレンジG好性の基底膜様物質も認められた。組織所見は、一部に扁平上皮への分化を示す腫瘍細胞が管状〜充実性に増殖し、endometrioid adenocarcinoma G2相当像を認めた。明るい胞体を有する細胞の充実性増殖を認め、clear cell adenocarcinomaの成分が合併し、ER染色では類内膜腺癌で強陽性、明細胞腺癌で弱陽性、P53は明細胞腺癌で高陽性率が高かった。

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肺腫瘍の病理小円形細胞腫瘍を中心に

田中健大, 藤田勝, 松岡博美, 今井みどり, 井上博文, 那須篤子, 市村浩一, 柳井広之, 吉野正

日本臨床細胞学会岡山支部会誌 29 1 - 3 2010年12月

α-fetoprotein-producing endometrial adenocarcinoma without an obvious hepatoid component 査読

Junichi Kodama, Noriko Seki, Hiroyuki Yanai, Tomoyuki Kusumoto, Keiichiro Nakamura, Atsushi Hongo, Yuji Hiramatsu

Oncology Letters 1 ( 2 ) 243 - 245 2010年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

Endometrial carcinomas producing α-fetoprotein (AFP) are extremely rare. We report a case of AFP-producing, Grade 2 endometrioid adenocarcinoma without an obvious hepatoid component. A 59-year-old multiparous woman presented with abdominal swelling. The serum level of AFP was 1292.8 ng/ml. Magnetic resonance images of the pelvis showed a markedly enlarged uterus, with a tumor growing exophytically within the endometrial cavity. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The histopathological examination demonstrated a Stage IIA, Grade 2 endometrioid adenocarcinoma without an obvious hepatoid component. The endometrioid adenocarcinoma cells were partly positive for AFP immunoreactivity. The patient received adjuvant chemotherapy and was disease-free 60 months after the operation. This case confirms the existence of AFP-producing endometrioid adenocarcinomas without hepatoid features.

DOI： 10.3892/ol_00000043

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