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Performance of 18-fluoro-2-deoxyglucose positron emission tomography for esophageal cancer screening

World Journal of Gastroenterology 2017年第15期23卷 2743-2749页

作者： masau sekiguchi Takashi Terauchi Yasuo Kakugawa Naoki Shimada Yutaka Saito Takahisa Matsuda Cancer Screening Center National Cancer Center HospitalTokyo Endoscopy Division National Cancer Center HospitalTokyo Division of Screening Technology Center for Public Health SciencesNational Cancer CenterTokyo Department of Diagnostic Radiology National Cancer Center HospitalTokyo Department of Nuclear Medicine Cancer Institute HospitalJapanese Foundation for Cancer Research Department of Radiological Technology Radiological Diagnosis National Cancer Center HospitalTokyo

AIM To evaluate the performance of 18-fluoro-2-deoxyglucose positron emission tomography(FDG-PET) for esophageal cancer(EC) *** We retrospectively analyzed the data of consecutive asymptomatic individuals who underwent FDG-PET and esophagogastroduodenoscopy(EGD) simultaneously for cancer screening at our institution from February 2004 to March 2013. In total, 14790 FDG-PET and EGD procedures performed for 8468 individuals were included in this study, and the performance of FDGPET for EC screening was assessed by comparing the results of FDG-PET and EGD, considering the latter as the *** Thirty-two EC lesions were detected in 28 individuals(31 squamous cell carcinomas and 1 adenocarcinoma). The median tumor size was 12.5 mm, and the depths of the lesions were as follows: Tis(n = 12), T1a(n = 15), and T1b(n = 5). Among the 14790 FDG-PET procedures, 51 examinations(0.3%) showed positive findings in the esophagus; only 1 was a true-positive finding. The screen sensitivity, specificity, positive predictive value, and negative predictive value of FDGPET for ECs were 3.6%(95%CI: 0.1-18.3), 99.7%(95%CI: 99.6-99.7), 2.0%(95%CI: 0.0-10.4), and 99.8%(95%CI: 99.7-99.9), respectively. Of the 50 FDG-PET false-positive cases, 31 were observed in the lower esophagus, and gastroesophageal reflux disease was observed in 17 of these 31 *** This study is the first to clarify the FDG-PET performance for EC screening. Based on the low screen sensitivity, FDG-PET is considered to be difficult to use as a screening modality for ECs.

关键词： Cancer screening Esophageal cancer Esophagogastroduodenoscopy Positron emission tomography Screen sensitivity

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Endoscopic reduction of colocolonic intussusception due to metastatic malignant melanoma:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5816-5820页

作者： Kengo Kasuga Taku Sakamoto Hiroyuki Takamaru masau sekiguchi Masayoshi Yamada Naoya Yamazaki Taiki Hashimoto Toshio Uraoka Yutaka Saito Endoscopy Division National Cancer Center HospitalTokyo 104-0045Japan Cancer Screening Center National Cancer Center HospitalTokyo 104-0045Japan Department of Dermatologic Oncology National Cancer Center HospitalTokyo 104-0045Japan Division of Diagnostic Pathology National Cancer Center HospitalTokyo 104-0045Japan Department of Gastroenterology and Hepatology Gunma University Graduate School of MedicineMaebashi 371-8511GunmaJapan

BACKGROUND Intussusception rarely causes intestinal obstruction in *** malignant melanoma is the main cause of intussusception of the small intestine among ***,malignant melanoma rarely causes intussusception of the ***,emergent surgery is usually performed for such ***,we report a case of a patient with colocolonic intussusception caused by a malignant melanoma,for which endoscopic reduction and elective surgery were *** SUMMARY The patient was a 64-year-old woman who underwent multiple surgeries and received chemotherapy and immunotherapy for a malignant *** immunotherapy,she had abdominal pain,diarrhea,and bloody *** examination and laboratory studies did not reveal any findings that warranted emergent *** tomography revealed intussusception in the descending colon without intestinal necrosis and *** was reduced endoscopically,and elective surgery was *** This report suggests that endoscopic reduction and elective surgery constitute a treatment option for colocolonic intussusception of metastatic malignant melanomas.

关键词： Metastatic malignant melanoma Intussusception Colon Nonsurgical management Endoscopic reduction Case report

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Dehiscence following successful endoscopic closure of gastric perforation during endoscopic submucosal dissection

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World Journal of Gastroenterology 2012年第31期18卷 4224-4227页

作者： masau sekiguchi Haruhisa Suzuki Ichiro Oda Shigetaka Yoshinaga Satoru Nonaka Makoto Saka Hitoshi Katai Hirokazu Taniguchi Ryoji Kushima Yutaka Saito Endoscopy Division National Cancer Center HospitalTokyo 104-0045Japan Gastric Surgery Division National Cancer Center HospitalTokyo 104-0045Japan Pathology Division National Cancer Center HospitalTokyo 104-0045Japan

Gastric perforation is one of the most serious complications that can occur during endoscopic submucosal dissection(ESD).In terms of the treatment of such perforations,we previously reported that perforations immediately observed and successfully closed with endoclips during endoscopic resection could be managed *** now report the first case in our medical facility of a gastric perforation during ESD that was ineffectively treated conservatively even after successful endoscopic *** December 2006,we performed ESD on a recurrent early gastric cancer in an 81-year-old man with a medical history of laparotomy for cholelithiasis.A perforation occurred during ESD that was immediately observed and successfully closed with endoclips so that ESD could be continued resulting in an en-bloc *** conservative management was conducted following ESD,however,an endoscopic examination five days after ESD revealed dehiscence of the perforation requiring an emergency laparotomy.

关键词： Early gastric cancer Endoscopic closure Endoscopic submucosal dissection Gastric perforation Laparotomy

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Management and associated factors of delayed perforation after gastric endoscopic submucosal dissection

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World Journal of Gastroenterology 2015年第44期21卷 12635-12643页

作者： Haruhisa Suzuki Ichiro Oda masau sekiguchi Seiichiro Abe Satoru Nonaka Shigetaka Yoshinaga Takeshi Nakajima Yutaka Saito Endoscopy Division National Cancer Center Hospital

AIM: To identify the actual clinical management and associated factors of delayed perforation after gastric endoscopic submucosal dissection(ESD).METHODS: A total of 4943 early gastric cancer(EGC) patients underwent ESD at our hospital between January 1999 and June 2012. We retrospectively assessed the actual management of delayed perforation. In addition, to determine the factors associated with delayed perforation, after excluding 123 EGC patients with perforations that occurred during the ESD procedure, we analyzed the following clinicopathological factors among the remaining 4820 EGC patients by comparing the ESD cases with delayed perforation and the ESD cases without perforation: age, sex, chronological periods, clinical indications for ESD, status of the stomach, location, gastric circumference, tumor size, invasion depth, presence/absence of ulceration, histological type, type of resection, and procedure ***: Delayed perforation occurred in 7(0.1%) cases. The median time until the occurrence of delayed perforation was 11 h(range, 6-172 h). Three(43%) of the 7 cases required emergency surgery, while four were conservatively managed without surgical intervention. Among the 4 cases with conservative management, 2 were successfully managed endoscopically using the endoloop-endoclip technique. The median hospital stay was 18 d(range, 15-45 d). There were no delayed perforation-related deaths. Based on a multivariate analysis, gastric tube cases(OR = 11.0; 95%CI: 1.7-73.3; P = 0.013) were significantly associated with delayed ***: Endoscopists must be aware of not only the identified factors associated with delayed perforation, but also how to treat this complicationeffectively and promptly.

关键词： Early gastric cancer Endoscopic submucosal dissect

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Successful endoscopic closure of a colonic perforation one day after endoscopic mucosal resection of a lesion in the transverse colon

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World Journal of Clinical Cases 2016年第8期4卷 238-242页

作者： Kazuya Inoki Taku Sakamoto masau sekiguchi Masayoshi Yamada Takeshi Nakajima Takahisa Matsuda Yutaka Saito Endoscopy Division National Cancer Center HospitalTokyo Cancer Screening Division Research Center for Cancer Prevention and Screening National Cancer Center HospitalTokyo

A 73-year-old man underwent endoscopic mucosal resection(EMR) of a 20-mm flat elevated lesion on the transverse colon. The morning after the procedure, he started to have severe right upper quadrant pain after his first meal. A computed tomography scan revealed free air and a stomach filled with food. He was diagnosed to have delayed post-EMR intestinal perforation. He underwent emergent colonoscopy and clipping of the perforated site. He was discharged 8 d after the endoscopic closure without the need for surgical intervention. The meal was not the cause of the colon transversum perforation.

关键词： Colonoscopy Colorectal tumors Endoscopic surgical procedure Emergencies Intestinal perforation

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Fatal submucosal invasive gastric adenosquamous carcinoma detected at surveillance after gastric endoscopic submucosal dissection

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World Journal of Gastroenterology 2015年第14期21卷 4385-4390页

作者： Akinori Shirahige Haruhisa Suzuki Ichiro Oda masau sekiguchi Genki Mori Seiichiro Abe Satoru Nonaka Shigetaka Yoshinaga Shigeki Sekine Ryoji Kushima Yutaka Saito Takeo Fukagawa Hitoshi Katai Endoscopy Division National Cancer Center Hospital Pathology Division National Cancer Center Hospital Department of Clinical Laboratory Medicine and Diagnostic Pathology Shiga University of Medical Science Gastric Surgery Division National Cancer Center Hospital

An 80-year-old man was under annual surveillance esophagogastroduodenoscopy after endoscopic submucosal dissection(ESD) for early gastric cancer(EGC).Two years after the initial ESD, a 0-Ⅱc type metachronous EGC lesion, 8 mm in size, without an ulcer scar, was found in the gastric *** estimated tumor depth was up to the mucosa, and biopsy revealed well and poorly differentiated *** was performed for this lesion and en bloc resection with negative margins was *** examination revealed an adenosquamous carcinoma 8 mm in size invading the deep submucosal layer(1600 μm), with lymphovascular invasion, consistent with the diagnosis of non-curative *** gastrectomy was recommended for this patient; however, two months after the ESD, preoperative computed tomography revealed multiple liver metastases, and the patient was considered as an unsuitable candidate for surgical *** chemotherapy was therefore started; however, the patient died of gastric cancer 27 mo after the second *** gastric adenosquamous carcinoma localized to the mucosa and submucosa is extremely rare and its clinical behavior is not well *** present report is very significant in that it underscores the distinct possibility of gastric adenosquamous carcinoma being very aggressive and fatal even when detected at an early cancer.

关键词： Early gastric cancer Endoscopic submucosal dissect

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