研究者詳細 - 安井　和也

論文 - 安井　和也

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Regulatory T cells induce a suppressive immune milieu and promote lymph node metastasis in intrahepatic cholangiocarcinoma. 査読国際誌

Daisuke Konishi, Yuzo Umeda, Kazuhiro Yoshida, Kunitoshi Shigeyasu, Shuya Yano, Tomohiro Toji, Sho Takeda, Ryuichi Yoshida, Kazuya Yasui, Tomokazu Fuji, Kazuyuki Matsumoto, Hiroyuki Kishimoto, Hiroyuki Michiue, Fuminori Teraishi, Hironari Kato, Hiroshi Tazawa, Hiroyuki Yanai, Takahito Yagi, Ajay Goel, Toshiyoshi Fujiwara

British journal of cancer 127 ( 4 ) 757 - 765 2022年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Emerging evidence indicates that immunogenicity plays an important role in intrahepatic cholangiocarcinoma (ICC). Herein, we systematically evaluated the clinical relevance of immunogenicity in ICC. METHODS: Highly immunogenic ICCs identified in the public dataset and the Cancer Immunome Atlas (TCIA) were assessed to determine the prognostic impact of immunogenicity in ICC and key components after curative resection. We also investigated the clinical relevance of the immune milieu in ICC. RESULTS: Using the Gene Expression Omnibus dataset 89749 and TCIA, we identified CD8+/forkhead box P3 (FoxP3)+ tumour-infiltrating lymphocytes (TILs), T-cell immunoglobulin and mucin domain 3 (TIM-3) and human leukocyte antigen-A (HLA-A) in highly immunogenic ICCs. Immunohistochemical analysis of the in-house cohort showed that intratumoral FoxP3+ TILs correlated with CD8+ TILs (P = 0.045, Fisher's exact test) and that high FoxP3+/CD8+ ratio (FCR) was an important marker for poor survival (P < 0.001, log-rank test). Furthermore, the FCR was higher in tumour-free lymph nodes in ICCs with lymph node metastases than in those without lymph node metastases (P = 0.003, Mann-Whitney U test). CONCLUSIONS: FCR should be considered an important biomarker that represents the immune environment of ICC based on its potentially important role in tumour progression, especially lymph node metastasis.

DOI： 10.1038/s41416-022-01838-y

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Prognostic Value of the Regional Lymph Node Station in Pancreatic Neuroendocrine Tumor. 査読国際誌

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Anticancer research 42 ( 5 ) 2797 - 2801 2022年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIM: Little is known regarding the impact of lymph node dissection on survival benefit after curative resection for pancreatic neuroendocrine tumor (PNET). This study aimed to evaluate the efficacy of lymph node dissection based on tumor location of PNET. PATIENTS AND METHODS: A retrospective study, including 50 patients with surgical resection for PNET between 2004 and 2020, was performed. The efficacy index (EI) was calculated by multiplication of the incidence of lymph node metastasis (LNM) at the station and the 5-year survival rate of patients with LNM at the station. RESULTS: In the pancreatic head tumors, the peri-pancreatic head and superior mesenteric artery lymph node stations had high EI of 13.3 and 25, respectively. In contrast, other stations, including stations 8 and 12, had zero EI. In the pancreatic body and tail tumors, only the splenic artery lymph node station had a survival benefit from lymph node dissection with an EI of 6.7. CONCLUSION: The extent of lymph node dissection for PNET should be decided based on the efficacy of lymph node dissection in accordance with tumor location. Our findings may be helpful in determining the extent of lymph node dissection required.

DOI： 10.21873/anticanres.15760

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ステレオタイプ・スレットという問題とニュースレターの果たす役割

竹原裕子, 溝尾妙子, 小林純子, 坂本美咲, 新田薫, 工藤由里絵, 安井和也, 菊池覚次, 黒田新士, 吉田龍一, 岡崎幹生, 杉本誠一郎, 枝園忠彦, 小谷恭弘, 豊岡伸一, 笠原真悟, 藤原俊義, 土井原博義

日本外科学会定期学術集会抄録集 122回 SP - 6 2022年4月

ステレオタイプ・スレットという問題とニュースレターの果たす役割

日本外科学会定期学術集会抄録集 122回 SP - 6 2022年4月

肝胆膵領域における再生医療研究の最前線ベーラー大学における膵全摘自家膵島移植200例の検討

熊野健二郎, 藤智和, 金平典之, 佐藤博紀, 高木弘誠, 安井和也, 吉田一博, 吉田龍一, 楳田祐三, 八木孝仁, 藤原俊義, Bashoo Naziruddin

日本外科学会定期学術集会抄録集 122回 WS - 7 2022年4月

Surgical resection of mixed neuroendocrine-non-neuroendocrine neoplasm in the biliary system: a report of two cases. 査読国際誌

Ayano Tamaki, Yuma Tani, Hiroki Sato, Ryuichi Yoshida, Kazuya Yasui, Shigeru Horiguchi, Takashi Kuise, Yuzo Umeda, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kosei Takagi, Takahito Yagi, Toshiyoshi Fujiwara

Surgical case reports 8 ( 1 ) 38 - 38 2022年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Mixed neuroendocrine-non-neuroendocrine neoplasm (MINEN) is a rare disease and there is scarce literature on its diagnosis, treatment, and prognosis. We encountered two unusual cases of MINEN in the biliary tract, one in the ampulla of Vater and the other in the distal bile duct. In this report, we describe the clinical course of these two cases in detail. CASE PRESENTATION: Case 1: A 69-year-old woman presented with a chief complaint of epigastric pain. When endoscopic sphincterotomy and retrograde biliary drainage were performed for gallstone pancreatitis, an ulcerated lesion was found in the ampulla of the Vater. Based on the biopsy results, the lesion was diagnosed as the ampulla of Vater carcinoma and subtotal stomach-preserving pancreatoduodenectomy (SSPPD) was performed. Postoperative histopathological examination revealed the coexistence of adenocarcinoma and neuroendocrine carcinoma components, consistent with the diagnosis of MINEN. In addition, lymph node metastasis was found on the dorsal side of the pancreas and the metastatic component was adenocarcinoma. Adjuvant chemotherapy with etoposide and cisplatin was administered for 6 months, and presently the patient is alive without recurrence 64 months after surgery. Case 2: A 79-year-old man presented with a chief complaint of anorexia. Cholangiography showed severe stenosis of the distal bile duct. A biopsy was conducted from the stenotic lesion and it revealed the lesion to be adenocarcinoma. A diagnosis of distal bile duct carcinoma was made, and SSPPD was performed. Histopathological examination revealed the coexistence of adenocarcinoma and neuroendocrine carcinoma components, and the tumor was confirmed as MINEN of the distal bile duct. No adjuvant chemotherapy was administered due to the poor performance status. 7 months later, the patient was found to have a liver metastasis. CONCLUSION: We experienced two valuable cases of biliary MINEN. To identify better treatments, it is important to consider the diversity of individual cases and to continue sharing a variety of cases with different presentations.

DOI： 10.1186/s40792-022-01386-w

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移植I 葛西術後減黄不良患児に対する肝移植時期の検討

藤智和, 金平典行, 佐藤博紀, 高木弘誠, 安井和也, 熊野健二郎, 吉田一博, 吉田龍一, 楳田祐三, 八木孝仁

日本小児外科学会雑誌 58 ( 1 ) 124 - 124 2022年2月

Acute acalculous cholecystitis caused by SARS-CoV-2 infection: A case report and literature review. 査読国際誌

Hana Futagami, Hiroki Sato, Ryuichi Yoshida, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

International journal of surgery case reports 90 106731 - 106731 2022年1月

記述言語：英語

BACKGROUND: Emerging data indicate that gastrointestinal disorders, in addition to pulmonary dysfunction, are also hallmarks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. CASE PRESENTATION: A 42-year-old man with maintenance hemodialysis developed high fever and dyspnea. He was positive for SARS-CoV-2 and was diagnosed with pneumonia. After treatment for SARS-CoV-2, his respiratory condition improved. However, he developed right upper quadrant pain with elevated inflammatory markers (white blood cells, 21,160/μL; c-reactive protein, 163.9 mg/L) on the 13th day. Abdominal computed tomography revealed acute acalculous cholecystitis. Percutaneous transhepatic gallbladder drainage (PTGBD) was performed together with antibiotic therapy, which resulted in improvement of symptoms. Laparoscopic cholecystectomy was performed 36 days after PTGBD. CONCLUSION: We report a rare case of acute acalculous cholecystitis (AAC) following pneumonia caused by SARS-CoV-2 infection. We also conducted a literature search to characterize SARS-CoV-2-related cholecystitis. Infection with SARS-CoV-2 is an important trigger for AAC, and appropriate therapeutic alternatives should be cautiously selected according to individual cases.

DOI： 10.1016/j.ijscr.2021.106731

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Prognostic Value of the Regional Lymph Node Station in Pancreatoduodenectomy for Ampullary Carcinoma. 査読国際誌

Kosei Takagi, Yasuo Nagai, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Tomokazu Fuji, Kenjiro Kumano, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

In vivo (Athens, Greece) 36 ( 2 ) 973 - 978 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIM: The optimal extent of lymph node dissection for ampullary carcinoma is controversial. The aim of this study was to investigate the efficacy of lymph node dissection for ampullary carcinoma. PATIENTS AND METHODS: Between 2000 and 2020, a total of 75 patients undergoing radical resection for ampullary carcinoma were included. The efficacy index (EI) was calculated by multiplication of the frequency of lymph node metastasis (LNM) at the station and the 5-year survival rate of patients with metastasis at the station. RESULTS: Out of 75 patients, 14 had LNM. The EI for the peri-pancreatic head (station 13 and 17) and superior mesenteric artery (station 14) lymph node were 4.4 and 3.5, respectively. Whereas the peri-gastric (station 5 and 6), common hepatic artery (station 8), and liver hilum (station 12) lymph node stations had zero EI. Although the number of patients with the station 16 dissected was small (9%), the para-aortic (station 16) lymph nodes had the highest EI of 14.3 despite being distant lymph nodes. CONCLUSION: We identified the distribution of LNM and survival benefit of lymph node dissection for ampullary carcinoma. Our results suggest that the optimal extent of lymph node dissection for ampullary carcinoma could be reconsidered.

DOI： 10.21873/invivo.12789

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Concordance of acquired mutations between metastatic lesions and liquid biopsy in metastatic colorectal cancer. 査読国際誌

Fumitaka Taniguchi, Akihiro Nyuya, Toshiaki Toshima, Kazuya Yasui, Yoshiko Mori, Makoto Okawaki, Hiroyuki Kishimoto, Yuzo Umeda, Toshiyoshi Fujiwara, Hiroaki Tanioka, Yoshiyuki Yamaguchi, Ajay Goel, Takeshi Nagasaka

Future science OA 7 ( 10 ) FSO757 2021年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Aim: To evaluate whether PCR-reverse sequence-specific oligonucleotide can examine the concordance between liquid biopsy and metastatic lesions with acquired resistance. Materials & methods: We examined acquired mutations in chemoresistant lesions and blood obtained from four patients with RAS wild-type metastatic colorectal cancer who underwent treatment with anti-epidermal growth factor receptor antibodies. Results: In one patient, metastatic lesions harbored diverse acquired mutations in KRAS in all seven metastases; the two acquired mutations were detectable in blood collected after the patient acquired resistance. None of the other patients exhibited liquid biopsy mutations, except one, with a BRAF mutation confirmed in primary tumor and peritoneal dissemination. Conclusion: Liquid biopsy based on PCR-reverse sequence-specific oligonucleotide is a successful procedure for capturing acquired mutations with precise information on the RAS mutational spectrum.

DOI： 10.2144/fsoa-2021-0059

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Multiple Hepatolithiasis Following Hepaticojejunostomy Successfully Treated with Left Hemihepatectomy and Double Hepaticojejunostomy Reconstruction. 査読

Yasuo Nagai, Kosei Takagi, Takashi Kuise, Yuzo Umeda, Ryuichi Yoshida, Kazuhiro Yoshida, Kazuya Yasui, Takahito Yagi, Toshiyoshi Fujiwara

Acta medica Okayama 75 ( 6 ) 735 - 739 2021年12月

記述言語：英語

Surgical intervention for hepatolithiasis following hepaticojejunostomy (HJ) has rarely been reported. Herein, we present a case of post-HJ multiple hepatolithiasis treated with left hemihepatectomy with double HJ reconstruction. A 72-year-old woman who had undergone HJ for iatrogenic bile duct injury developed repeated cholangitis due to complicated hepatolithiasis accompanied by an atrophied left hepatic lobe and HJ stricture. Since endoscopic intervention was unsuccessful, the patient underwent left hemihepatectomy with HJ re-anastomoses of the common hepatic duct and left hepatic duct (double HJ technique). The double HJ technique with hepatectomy can be a useful option for treating complicated hepatolithiasis following HJ.

DOI： 10.18926/AMO/62814

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【conversion surgeryのすべて切除不能を切除可能に!】切除不能大腸癌肝転移に対するconversion surgery

楳田祐三, 高木弘誠, 藤智和, 吉田一博, 安井和也, 吉田龍一, 八木孝仁, 藤原俊義

消化器外科 44 ( 13 ) 1897 - 1913 2021年12月

腹腔鏡下右葉系系統的肝切除の定型化腹腔鏡下肝後区域切除の定型化

楳田祐三, 藤智和, 高木弘誠, 吉田一博, 安井和也, 野間和広, 黒田新士, 吉田龍一, 八木孝仁, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) PD2 - 3 2021年12月

ロボット肝胆膵手術のコツとピットフォールロボット支援下膵切除術のコツとピットフォール

高木弘誠, 楳田祐三, 吉田龍一, 吉田一博, 藤智和, 熊野健二郎, 安井和也, 佐藤博紀, 八木孝仁, 藤原俊義

日本内視鏡外科学会雑誌 26 ( 7 ) PD1 - 5 2021年12月

Technique of vessel-skeletonized parenchyma-sparing hepatectomy for the oncological treatment of bilobar colorectal liver metastases. 査読国際誌

Yuzo Umeda, Takeshi Nagasaka, Kosei Takagi, Ryuichi Yoshida, Kazuhiro Yoshida, Tomokazu Fuji, Tatsuo Matsuda, Kazuya Yasui, Kenjiro Kumano, Hiroki Sato, Takahito Yagi, Toshiyoshi Fujiwara

Langenbeck's archives of surgery 407 ( 2 ) 685 - 697 2021年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: To aid in the oncological management of multiple bilobar colorectal liver metastases (CRLMs), we describe a new surgical procedure, VEssel-Skeletonized PArenchyma-sparing Hepatectomy (VESPAH). STUDY DESIGN: Of 152 patients with CRLMs treated with hepatectomy, 33 patients had multiple bilobar liver metastases (≥8 liver metastases); their surgical procedures and clinical outcomes were retrospectively summarized and compared between those who underwent VESPAH and those who underwent major hepatectomy (Major Hx). RESULTS: Of the 33 patients, 20 patients were resected by VESPAH (the VESPAH group) and 13 patients by major hepatectomy (Major Hx group). The median number of CRLMs was 13 (range, 8-53) in the VESPAH group and 10 (range, 8-41) in the Major Hx group (P=0.511). No operative mortality nor severe morbidity was observed in either group. The VESPAH group showed earlier recovery of remnant liver function after surgery than the Major Hx group; the incidence of grade B/C post hepatectomy liver failure was 5% in the VESPAH group and 38% in the Major Hx group, P=0.048). Intrahepatic tumor recurrence was confirmed in 14 (70%) and 7 (54%) patients in the VESPAH and Major Hx groups, respectively (P=0.416). There was no significant difference in median overall survival (OS) after hepatectomy between the two groups; the median OS was 47 months in the VESPAH group and 33 months in the Major Hx group (P=0.481). The VESPAH group showed the higher induction rate of adjuvant chemotherapy within 2 months after surgery (P=0.002) and total number of repeat hepatectomy for intrahepatic recurrence (P=0.060) than the Major Hx group. CONCLUSIONS: VESPAH enables us to clear surgical navigation by hepatic vessel skeletonization and may enhance patient tolerability of not only adjuvant chemotherapy but also repeat hepatectomies during the patients' lifetimes.

DOI： 10.1007/s00423-021-02373-9

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情熱・努力を継続できる外科教育外科マネージメントセンターによる情熱のある外科医教育・育成システム

菊地覚次, 吉田龍一, 黒田新士, 野間和広, 安井和也, 笠原真悟, 豊岡伸一, 土井原博義, 藤原俊義

日本外科学会雑誌 122 ( 6 ) 680 - 682 2021年11月

Pectoralis major and serratus anterior muscle flap for diaphragmatic reconstruction. 査読国際誌

Toshiyuki Watanabe, Hiroshi Matsumoto, Ryuichi Yoshida, Kazuya Yasui, Takahito Yagi, Yoshihiro Kimata

The Annals of thoracic surgery 114 ( 1 ) e51-e54 2021年10月

記述言語：英語

The reconstruction of diaphragmatic defects after chondrosarcoma resection is challenging. In diaphragmatic reconstruction with chest wall defects, strong chest wall reconstruction and diaphragmatic flexibility are important to avoid interference with respiration. The artificial material, Gore-Tex, is used as the first choice, but it has infection-, exposure-, and durability-related drawbacks. As an alternative method using artificial material, we present our new alternative technique for diaphragmatic reconstruction using a reversed-combined pectoralis major and serratus anterior muscle flap.

DOI： 10.1016/j.athoracsur.2021.08.067

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生体肝移植ドナー肝切除成熟段階となった開腹手技

楳田祐三, 高木弘誠, 藤智和, 吉田一博, 安井和也, 熊野健二郎, 佐藤博紀, 吉田龍一, 八木孝仁, 藤原俊義

日本臨床外科学会雑誌 82 ( 増刊 ) S586 - S586 2021年10月

先天性胆道拡張症術後46年目に発生し根治切除が可能であった肝門部胆管癌の1例

吉田龍一, 野田卓男, 安井和也, 佐藤博紀, 楳田祐三, 吉田一博, 藤智和, 熊野健二郎, 高木弘誠, 金平典之, 納所洋, 谷本光隆, 八木孝仁, 藤原俊義

日本膵・胆管合流異常研究会プロシーディングス 44 42 - 43 2021年8月

膵・胆管合流異常に対する術後中長期的な経過観察の検討

熊野健二郎, 藤智和, 金平典之, 佐藤博紀, 高木弘誠, 安井和也, 吉田一博, 吉田龍一, 楳田祐三, 八木孝仁, 藤原俊義

日本膵・胆管合流異常研究会プロシーディングス 44 36 - 36 2021年8月

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