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Pyloric-gland metaplasia may be an origin of cancer and intestinal metaplasia with possible CDX2 expression

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Gastroenterology Report 2021年第4期9卷 370-373,I0003页

作者： Kazuyoshi Yagi atsunori tsuchiya Satoru Hashimoto Taisuke Kato Osamu Onodera Shuji Terai Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalNiigataJapan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan Department of System Pathology for Neurological Disorders Brain Science BranchBrain Research InstituteNiigata UniversityNiigataJapan Department of Neurology Brain Research InstituteNiigata UniversityNiigataJapan

Introduction The majority of cases of gastric cancer are thought to develop due to chronic inflammation from Helicobacter pylori(***)infection leading to intestinal metaplasia,termed the intestinal metaplasia–dysplasia–cancer sequence[1].Chronic inflammation from *** infection causes mucin core protein 6-positive(MUC6t)pyloric-gland metaplasia;however,its origin is *** MUC6t pyloric-gland metaplasia is similar to spasmolytic polypeptide-expressing metaplasia in mouse studies[2–4].

关键词：肠上皮化生幽门腺 Helicobacter CDX2

Spontaneous regression of hepatocellular carcinoma: A mini-review

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World Journal of Gastroenterology 2017年第21期23卷 3797-3804页

作者： Akira Sakamaki Kenya Kamimura Satoshi Abe atsunori tsuchiya Masaaki Takamura Hirokazu Kawai Satoshi Yamagiwa Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

Spontaneous tumor regression is an extremely rare phenomenon in the oncology field. However, there are several case reports resulted in the regression of hepatocellular carcinoma(HCC) and the accumulation of clinical information and analyses of the mechanism can contribute to the development of a novel therapy. For this purpose, we have carefully reviewed 23 cases of spontaneously regressed HCC published in recent 5 years and our case. The information regarding the tumor size, tumor marker, treatments, etc., have been summarized. The mechanism of spontaneous regression has been discussed to date and presumed to be due to many factors, including hypoxia and immunological reactions. In this careful review of the 24 cases based on the clinical information, hypoxia, systemic inflammation, and both upon spontaneous regression were seen in 3, 8, and 4 cases, respectively amo ng t he 15 c as e s f or w hic h t he inf o r mat io n regarding the proposed mechanisms are available. Recent development of immunotherapeutic approaches in oncology shows promising results, therefore, accumulation of additional cases and analysis of mechanisms underlying the spontaneous regression of HCC are essential and could lead to the development of a new generation of immunotherapies including antibodies directed against immune reactions.

关键词： Spontaneous regression Hepatocellular carcinoma Immunological reaction Immunotherapy Hypoxia

Improved survival for hepatocellular carcinoma with portal vein tumor thrombosis treated by intra-arterial chemotherapy combining etoposide,carboplatin,epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil:A pilo

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World Journal of Gastroenterology 2007年第41期13卷 5465-5470页

作者： Toru Ishikawa Michitaka Imai Hiroteru Kamimura atsunori tsuchiya Tadayuki Togashi Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Tomoteru Kamimura Department of Gastroenterology and Hepatology Saiseikai Niigata Second HospitalNiigata 950-1104Japan

AIM： To investigate the poor prognosis of HCC with PVTT, we evaluated the efficacy by a new combination chemotherapy for advanced hepatocellular carcinoma （HCC） with portal vein tumor thrombus （PVTT）. METHODS： From 2002 to 2007, a total of 10 consecutive patients with Stage IVA HCC accompanied by PVTT were studied prospectively to examine the efficacy of treatment by intra-arterial infusion of a chemotherapeutic agents consisting of etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil. RESULTS： The mean course of chemotherapy was 14.4 （range, 9-21） too. One patient showed complete response （CR） with disappearance of HCC and PVI-F after treatment, and the two patients showed partial response （PR）, response rate （CR ＋ PR/All cases 30%）. The median survival time after the therapy was 457.2 d. The one-year survival rate was 70%. Adverse reactions were tolerable.CONCLUSION： Although the prognosis of most patients with Stage IVA HCC by PVTT is poor, our combination chemotherapy may induces long-term survival and is an effective treatment and produced anti-tumor activity with tolerable adverse effects in patients for advanced Stage IVA HCC accompanied by PVTT.

关键词： Hepatocellular carcinoma Portal vein tumor thrombus Intra-arterial regional chemotherapy

Successful treatment of multiple lung metastases of hepatocellular carcinoma by combined chemotherapy with docetaxel, cisplatin and tegafur/uracil

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World Journal of Gastroenterology 2009年第14期15卷 1779-1781页

作者： atsunori tsuchiya Michitaka Imai Hiroteru Kamimura Tadayuki Togashi Kouji Watanabe Kei-ichi Seki Toru Ishikawa Hironobu Ohta Toshiaki Yoshida Tomoteru Kamimura Department of Gastroenterology Saiseikai Niigata Second Hospital NishiKu Teraji 280-7 Niigata 950-1104 Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Science Niigata University 1-757 Asahimachi-dori Chuo-ku Niigata 951-8510 Japan

We report the successful treatment of multiple lung metastases after hepatic resection for hepatocellular carcinoma (HCC) with combined docetaxel, cisplatin (CDDP), and enteric-coated tegafur/uracil (UFT-E). A 68-year-old man was diagnosed with multiple lung metastases of HCC 7 mo after partial hepatectomy for HCC. Oral UFT-E was given daily and docetaxel and CDDP were given intra-arterially (administered just before the bronchial arteries) every 2 wk via a subcutaneous injection port. One month after starting chemotherapy, levels of tumor marker, protein induced by vitamin K absence(PIVKA--), decreased rapidly,and after a further month, chest X-ray and computed tomography revealed the complete disappearance of multiple liver metastases. Two years after the combined chemotherapy, HCC recurred in the liver and was treated but no pulmonary recurrence occurred. In the absence of a standardized highly effective therapy, this combined chemotherapy with docetaxel, CDDP and UFT-E may be an attractive option for multiple lung metastases of HCC.

关键词： Hepatocellular carcinoma Docetaxel Lungmetastasis Cisplatin

Comparison of a new aspiration needle device and the Quick-Core biopsy needle for transjugular liver biopsy

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World Journal of Gastroenterology 2006年第39期12卷 6339-6342页

作者： Toru Ishikawa Hiroteru Kamimura atsunori tsuchiya Tadayuki Togashi Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Noriko Ishihara Tomoteru Kamimura Deptartments of Gastroenterology Saiseikai Niigata Second Hospital Niigata Japan Deptartments of Pathology Saiseikai Niigata Second Hospital Niigata Japan

AIM: To evaluate sample adequacy, safety, and needle passes of a new biopsy needle device compared to the Quick-Core biopsy needle for transjugular liver biopsy in patients affected by liver disease. METHODS: Thirty consecutive liver-disease patients who had major coagulation abnormalities and/or relevant ascites underwent transjugular liver biopsy using either a new needle device (18 patients) or the Quick-Core biopsy needle (12 patients). The length of the specimens was measured before fixation. A pathologist reviewed the histological slides for sample adequacy and pathologic diagnoses. The two methods’ specimen adequacy and complication rates were assessed. RESULTS: Liver biopsies were technically successful in all 30 (100%) patients, with diagnostic histological core specimens obtained in 30 of 30 (100%) patients, for an overall success rate of 100%. With the new device, 18 specimens were obtained, with an average of 1.1 passes per patient. Using the Quick-Core biopsy needle, 12 specimens were obtained, with an average of 1.8 passes per patient. Specimen length was significantly longer with the new needle device than with the Quick- Core biopsy needle (P < 0.05). The biopsy tissue was not fragmented in any of the specimens with the new aspiration needle device, but tissue was fragmented in 3 of 12 (25.0%) specimens obtained using the Quick-Core biopsy needle. Complications included cardiac arrhythmia in 3 (10.0%) patients, and transient abdominal pain in 4 (13.3%) patients. There were no cases of subcapsular hematoma, hemoperitoneum, or sepsis, and there was no death secondary to the procedure. In particular, no early or delayed major procedure-related complications were observed in any ***: Transjugular liver biopsy is a safe and effective procedure, and there was significant difference in the adequacy of the specimens obtained using the new needle device compared to the Quick- Core biopsy needle. Using the new biopsy needle device, the specimens

关键词： Liver disease Biopsy-interventional procedures Transjugular biopsy

Small extracellular vesicles and liver diseases:From diagnosis to therapy

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World Journal of Hepatology 2022年第7期14卷 1307-1318页

作者： atsunori tsuchiya Kazuki Natsui Yui Ishii Yohei Koseki Nobutaka Takeda Kei Tomiyoshi Fusako Yamazaki Yuki Yoshida Shuji Terai Division of Gastroenterology and Hepatology Niigata University Medical and Dental HospitalNiigata 951-8510Japan Department of Gastroenterology and Hepatology Niigata UniversityNiigata 951-8510Japan

Extracellular vesicles(EVs),especially small EVs(sEVs)derived from liver cells,have been the focus of much attention in the normal physiology and pathogenesis of various diseases affecting the *** are approximately 100 nm in size,enclosed within lipid bilayers,and are very *** lipids,proteins,and nucleic acids,including miRNAs,contained within these vesicles are known to play important roles in intercellular *** mini-review summarizes the application of ***,liver diseases and the related diagnostic markers are described,and the current active status of miRNA research in diagnosis of hepatocellular carcinoma(HCC)is ***,the biodistribution and pharmacokinetics of sEVs are described,and the liver is highlighted as the organ with the highest accumulation of ***,the relationship between sEVs and the pathogenesis of liver disorders is described with emphesis on the current active status of miRNA research in HCC recurrence and ***,the possibility of future therapy using sEVs from mesenchymal stem(stromal)cells for cirrhosis and other diseases is described.

关键词： Small extracellular vesicles Liver cirrhosis Hepatocellular carcinoma Mesenchymal stem cells

Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis

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World Journal of Gastroenterology 2010年第23期16卷 2918-2925页

作者： Akihiko Osaki Tomoyuki Kubota Takeshi Suda Masato Igarashi Keisuke Nagasaki atsunori tsuchiya Masahiko Yano Yasushi Tamura Masaaki Takamura Hirokazu Kawai Satoshi Yamagiwa Toru Kikuchi Minoru Nomoto Yutaka Aoyagi Department of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata University Department of Homeostatic Regulation and Development Graduate School of Medical and Dental SciencesNiigata University Department of Laboratory Medicine Niigata University Medical and Dental Hospital

AIM:To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis(NASH).METHODS:In total 26 patients,23 NASHs and 3 normal controls were enrolled in this *** was staged based on Brunt *** a region of interest(ROI),a shear wave was evoked by implementing an acoustic radiation force impulse(ARFI),and the propagation velocity was quantif ***:Shear wave velocity(SWV) could be reproducibly quantified at all ROIs in all subjects except for 4 NASH cases,in which a reliable SWV value was not calculated at several *** average SWV of 1.34 ± 0.26 m/s in fibrous stage 0-1 was significantly slower than 2.20 ± 0.74 m/s and 2.90 ± 1.01 m/s in stages 3 and 4,respectively,but was not significantly different from 1.79 ± 0.78 m/s in stage *** a cutoff value was set at 1.47 m/s,receiver operating characteristic analysis showed significance to dissociate stages 3 and 4 from stage 0-1(P=0.0092) with sensitivity,specificity and area under curve of 100%,75% and 94.2%,*** addition,the correlation between SWV and hyaluronic acid was significant(P<0.0001),while a tendency toward negative correlation was observed with serum albumin(P=0.053).CONCLUSION:The clinical implementation of ARFI provides noninvasive repeated evaluations of liver stiffness at an arbitrary position,which has the potential to shed new light on NASH management.

关键词： Nonalcoholic steatohepatitis Ultrasound Liver stiffness measurement Shear wave velocity Acoustic radiation force impulse

Rational arrangement of measuring shear wave speed in the liver

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World Journal of Gastroenterology 2019年第20期25卷 2503-2513页

作者： Takeshi Yokoo Tsutomu Kanefuji Takeshi Suda Itsuo Nagayama Takahiro Hoshi Satoshi Abe Shinichi Morita Hiroteru Kamimura Kenya Kamimura atsunori tsuchiya Masaaki Takamura Kazuyoshi Yagi Shuji Terai Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life Niigata University School of MedicineNiigataNiigata 951-8122Japan Division of Gastroenterology and Hepatology Niigata Tokamachi HospitalTokamachiNiigata 948-0065Japan Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalMinami UonumaNiigata 949-7302Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan

BACKGROUND Shear wave speed has been widely applied to quantify a degree of liver fibrosis. However, there is no standardized procedure, which makes it difficult to utilize the speed universally. AIM To provide procedural standardization of shear wave speed measurement. METHODS Point shear wave elastography (pSWE) was measured in 781 patients, and twodimensional shear wave elastography (2dSWE) was measured on the same day in 18 cases. Regions-of-interest were placed at 12 sites, and the median and robust coefficient-of-variation (CVR) were calculated. A residual sum-of-square (Σdi2) was computed for bootstrap values of 1000 iterations in 18 cases with each assumption of 1 to 12 measurements. The proportion of the Σdi2 (%Σdi2) was calculated as the ratio of Σdi2 to pSWE after converting it based on the correlation between pSWE and 2dSWE. RESULTS The CVR showed a significantly broader distribution in the left lobe (P < 0.0001),and the smallest CVR in the right anterior segment that covered 95% cases was 40.4%. pSWE was significantly higher in the left lobe than in the right lobe (1.63 ± 0.78 m/s vs 1.61 ± 0.78 m/s, P = 0.0004), and the difference between the lobes became further discrete when the subjects were limited to the cases with a CVR less than 40.4% in any segment (1.76 ± 0.80 m/s vs 1.70 ± 0.82 m/s, P < 0.0001). The highest values of the CVR in every 0.1 m/s interval were plotted in convex upward along pSWE and peaked at 1.93 m/s. pSWE and 2dSWE were significantly correlated (P < 0.0001, r = 0.95). In 216000 resamples from 18 cases, the %Σdi2 of 12 sites was 8.0% and gradually increased as the acquisition sites decreased to reach a significant difference with a %Σdi2 of 7 sites (P = 0.027). CONCLUSION These data suggest that shear wave speed should be measured at 8 or more sites of spreading in both lobes.

关键词： Liver stiffness Ultrasound Shear wave elastography Acoustic radiation force impulse Heterogeneity

Factors predicting aggressiveness of non-hypervascular hepatic nodules detected on hepatobiliary phase of gadolinium ethoxybenzyl diethylene-triamine-pentaacetic-acid magnetic resonance imaging

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World Journal of Gastroenterology 2015年第15期21卷 4583-4591页

作者： Tsutomu Kanefuji Toru Takano Takeshi Suda Kouhei Akazawa Takeshi Yokoo Hiroteru Kamimura Kenya Kamimura atsunori tsuchiya Masaaki Takamura Hirokazu Kawai Satoshi Yamagiwa Hidefumi Aoyama Minoru Nomoto Shuji Terai Deparatment of Gastro-enterology and Hepatology Uonuma Institute of Community Medicine Niigata University Medical and Dental Hospital 4132 Urasa Minami--Uonuma Department of Radiation Oncology Graduate School of Medical and Dental Sciences Niigata University Niigata Department of Medical Informatics Graduate School of Medical and Dental Sciences Niigata University Niigata Department of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University Niigata

AIM: To establish a prognostic formula that distinguishes non-hypervascular hepatic nodules(NHNs) with higher aggressiveness from less hazardous one. METHODS: Seventy-three NHNs were detected in gadolinium ethoxybenzyl diethylene-triamine-pentaaceticacid magnetic resonance imaging(Gd-EOB-DTPA-MRI) study and confirmed to change 2 mm or more in size and/or to gain hypervascularity. All images were interpreted independently by an experienced, board-certified abdominal radiologist and hepatologist; both knew thatthe patients were at risk for hepatocellular carcinoma development but were blinded to the clinical information. A formula predicting NHN destiny was developed using a generalized estimating equation model with thirteen explanatory variables: age, gender, background liver diseases, Child-Pugh class, NHN diameter, T1-weighted imaging/T2-weighted imaging detectability, fat deposition, lower signal intensity in arterial phase, lower signal intensity in equilibrium phase, α-fetoprotein, des-γ-carboxy prothrombin, α-fetoprotein-L3, and coexistence of classical hepatocellular carcinoma. The accuracy of the formula was validated in bootstrap samples that were created by resampling of 1000 iterations. RESULTS: During a median follow-up period of 504 d, 73 NHNs with a median diameter of 9 mm(interquartile range: 8-12 mm) grew or shrank by 68.5%(fifty nodules) or 20.5%(fifteen nodules), respectively, whereas hypervascularity developed in 38.4%(twenty eight nodules). In the fifteen shrank nodules, twelve nodules disappeared, while 11.0%(eight nodules) were stable in size but acquired vascularity. A generalized estimating equation analysis selected five explanatories from the thirteen variables as significant factors to predict NHN progression. The estimated regression coefficients were 0.36 for age, 6.51 for lower signal intensity in arterial phase, 8.70 or 6.03 for positivity of hepatitis B virus or hepatitis C virus, 9.37 for des-γ-carboxy prothrombin, and-4.05 for fat d

关键词： Hepatocellular carcinoma Magnetic resonanceimaging Ethoxybenzyl moiety Non-hypervascular hepaticnodule Fate prediction