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Clinicopathological features of small T1 colorectal cancers

World Journal of Clinical Cases 2021年第33期9卷 10088-10097页

作者： Yuki Takashina shin-ei kudo Katsuro Ichimasa Yuta Kouyama Kenichi Mochizuki Yoshika Akimoto Yasuharu Maeda Yuichi Mori Masashi Misawa Noriyuki Ogata Toyoki kudo Tomokazu Hisayuki Takemasa Hayashi Kunihiko Wakamura Naruhiko Sawada Toshiyuki Baba Fumio Ishida Kazunori Yokoyama Mitsuru Daita Tetsuo Nemoto Hideyuki Miyachi Digestive Disease Center Showa University Northern Yokohama HospitalYokohama 224-8503Japan Department of Gastroenterology Nikko Kinen HospitalMuroran 051-8501Japan Clinical Effectiveness Research Group Institute of Health and SocietyUniversity of OsloOslo 0001Norway Department of Pathology Showa University Nothern Yokohama HospitalYokohama 224-8503Japan

BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the *** To clarify the clinicopathological features of small T1 colorectal *** Of 32025 colorectal lesions between April 2001 and March 2018,a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size:a small group(<10 mm)and a large group(≥10 mm).We compared clinicopathological factors including lymph node metastasis(LNM)between the two *** The incidence of small T1 cancers was 10.1%(116/1152).The percentage of initial endoscopic treatment in small group was significantly higher than in large group(<10 mm 74.1%vs≥10 mm 60.2%,P<0.01).In the surgical resection cohort(n=798),the rate of LNM did not significantly differ between the two groups(small 12.3%vs large 10.9%,P=0.70).In addition,there were also no significant differences between the two groups in pathological factors such as histological grade,vascular invasion,or lymphatic *** Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers,the requirement for additional surgical resection should be determined according to pathological findings,regardless of tumor size.

关键词： Colorectal neoplasms Lymphatic metastasis Biological phenomena Polyps Colorectal cancers

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Small invasive colon cancer with adenoma observed by endocytoscopy: A case report

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World Journal of Gastrointestinal Endoscopy 2020年第9期12卷 304-309页

作者： Yoshika Akimoto shin-ei kudo Katsuro Ichimasa Yuta Kouyama Masashi Misawa Tomokazu Hisayuki Toyoki kudo Tetsuo Nemoto Digestive Disease Center Showa University Northern Yokohama HospitalYokohama 224-8503Japan Department of Pathology Showa University Northern Yokohama HospitalYokohama 224-8503Japan

Endocytoscopy is a next-generation endoscopic system that facilitates real-time histopathologic endoscopic diagnosis of colorectal lesions by virtue of its 520×maximum *** SUMMARY We present the case of a 63-year-old man with sigmoid colon cancer who was regularly referred for follow-up colonoscopy after endoscopic resection of T1 rectal *** revealed a 12 mm reddish polyp,including a depression and a flat area in the sigmoid *** observation showed unclear gland formation and agglomeration of distorted nuclei(depression),suggesting a submucosal invasive(T1)*** the flat area,slitlike smooth lumens and regular pattern of fusiform nuclei were found,suggesting an *** the basis of these endocytoscopic findings,we predicted this lesion as T1 cancer(depression)with adenoma(flat area)and performed endoscopic resection corresponding to the final histopathological *** We could perform an optical diagnosis of T1 sigmoid cancer with adenoma by using endocytoscopy before treatment.

关键词： Endocytoscopy T1 colorectal cancer Adenoma Optical diagnosis Case report

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Congenital tracheoesophageal fistula successfully diagnosed by CT esophagography

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World Journal of Gastroenterology 2006年第9期12卷 1476-1478页

作者： Koichi Nagata Yoshito Kamio Tamaki Ichikawa Mitsutaka Kadokura Akihiko Kitami Shungo Endo Haruhiro Inoue shin-ei kudo Digestive Disease Center Showa University Northern Yokohama Hospital 35-1 Chigasaki-chuoTsuzuki-kuYokohama 224-8503 Japan Respiratory Disease Center Showa University Northern Yokohama Hospital 35-1 Chigasaki-chuoTsuzuki-kuYokohama 224-8503Japan Department of Radiology Showa University Northern Yokohama Hospital 35-1 Chigasaki-chuoTsuzuki-kuYokohama 224-8503Japan Digestive Disease Center Showa University Northern Yokohama Hospital 35-1 Chigasaki-chuoTsuzuki-kuYokohama 224-8503Japan

Tracheoesophageal 管(TEF ) 或 bronchoesophageal 管可能对损伤先天、煽动性、肿瘤，或第二等。先天的 TEF 或 bronchoesophageal 管通常与食道的闭锁被联系并且乐意地在幼年期被诊断。但是如果它没与食道的闭锁被联系，它可以坚持直... 详细信息

Tracheoesophageal 管(TEF ) 或 bronchoesophageal 管可能对损伤先天、煽动性、肿瘤，或第二等。先天的 TEF 或 bronchoesophageal 管通常与食道的闭锁被联系并且乐意地在幼年期被诊断。但是如果它没与食道的闭锁被联系，它可以坚持直到成人生活。一些理论被建议了在诊断解释这延期。我们在场有先天的 TEF 的一个 70 岁的人的一个盒子。TEF 被 multidetector 排 CT esophagography 成功地诊断。

关键词：先天性气管疾病食管疾病 CT检查内窥镜

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Microvasculature of the esophagus and gastroesophageal junction: Lesson learned from submucosal endoscopy

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World Journal of Gastrointestinal Endoscopy 2016年第19期8卷 690-696页

作者： Roberta Maselli Haruhiro Inoue Haruo Ikeda Manabu Onimaru Akira Yoshida Esperanza Grace Santi Hiroki Sato Bu'Hussain Hayee shin-ei kudo Digestive Disease Center Showa University Northern Yokohama Hospital Department of "Paride Stefanini" Surgical Umberto I° General HospitalSapienza University of Rome King's College Hospital NHSFT

Advanced therapeutic endoscopy,in particular endoscopic mucosal resection,endoscopic submucosal dissection,per-oral endoscopic myotomy,submucosal endoscopic tumor resection opened a new era where direct esophageal visualization is *** these information with advanced diagnostic endoscopy,the esophagus is organized,from the luminal side to outside,into five layers(epithelium,lamina propria with lamina muscularis mucosa,submucosa,muscle layer,adventitia).A specific vascular system belonging to each layer is thus visible: Mucosa with the intra papillary capillary loop in the epithelium and the sub-epithelial capillary network in the lamina propria and,at the lower esophageal sphincter(LES) level with the palisade vessels; submucosa with the drainage vessels and the spindle veins at LES level; muscle layer with the perforating vessels; periesophageal veins in *** structures are particularly important to define endoscopic landmark for the gastro-esophageal junction,helpful in performing submucosal therapeutic endoscopy.

关键词：微脉管系统食道的解剖 Submucosal 内视镜检查法每口头的内视镜的肌切开术先进成像

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In vivo gastric mucosal histopathology using endocytoscopy

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World Journal of Gastroenterology 2015年第16期21卷 5002-5008页

作者： Hiroki Sato Haruhiro Inoue Haruo Ikeda Chiaki Sato Chainarong Phlanusittepha Bu'Hussain Hayee Esperanza Grace R Santi Yasutoshi Kobayashi shin-ei kudo Digestive Disease Center Showa UniversityNorthern Yokohama Hospital Department of Gastroenterology King’s College Hospital NHS Foundation TrustLondon SE5 9RSUnited Kingdom Department of Gastroenterology De La Salle University Medical Center Kobayashi Internal Medicine Clinic

AIM:To study the ability of endocytoscopy to identify normal gastric mucosa and to exclude Helicobacter pylori(***) ***:Endocytoscopic examination of the gastric corpus and antrum was performed in 70 consecutive *** biopsy specimens were also obtained from the assessed region and multiple *** tests were *** normal endocytoscopy patterns of the corpus and antrum were divided into the normal pit-dominant type(n-Pit) or the normal papilladominant type(n-Pap), respectively characterized as either regular pits with capillary networks or round, smooth papillary structures with spiral *** the other hand, normal mucosa was defined as mucosa not demonstrating histological abnormalities, including inflammation and ***:The sensitivity and specificity of n-Pit for normal mucosa in the gastric corpus were 94.4%and 97.1%,respectively,whereas those of n-Pap for normal mucosa in the antrum were 92.0%and 86.7%,*** positive predictive values of n-Pit and n-Pap for ***-negative tissue were 88.6%and 93.1%,respectively,and their negative predictive values for ***-negative tissues were 42.9%and41.5%,*** inter-observer agreement for determining n-Pit and n-Pap for normal mucosa were0.857 and 0.769,respectively,which is considered ***:N-Pit and n-Pap,seen using EC,are considered useful predictors of normal mucosa and theabsence of *** infection.

关键词： Atrophy Endocytoscopy Gastric mucosa Helicobacter pylori In vivo histopathology

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Endocytoscopic narrow-band imaging efficiency for evaluation of inflammatory activity in ulcerative colitis

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World Journal of Gastroenterology 2015年第7期21卷 2108-2115页

作者： Yasuharu Maeda Kazuo Ohtsuka shin-ei kudo Kunihiko Wakamura Yuichi Mori Noriyuki Ogata Yoshiki Wada Masashi Misawa Akihiro Yamauchi Seiko Hayashi Toyoki kudo Takemasa Hayashi Hideyuki Miyachi Fuyuhiko Yamamura Fumio Ishida Haruhiro Inoue Shigeharu Hamatani Digestive Disease Center Showa University Northern Yokohama Hospital Department of Gastroenterology and Hepatology Tokyo Medical and Dental University Hospital Endoscopy Center Showa Hospital Department of Pathology Showa University Northern Yokohama Hospital

AIM:To assess the efficacy of endocytoscopic narrowband imaging(EC-NBI)for evaluating the severity of inflammation in ulcerative colitis(UC).METHODS:This retrospective study was conducted at a single tertiary care referral *** included UC patients who underwent colonoscopy with endocytoscopy from July 2010 to December *** was performed,and the images were evaluated by assessing visibility,increased vascularization,and the increased calibers of capillaries and were classified as Obscure,Visible or *** was indicative of inactive disease,while Visible and Dilated were indicative of acute *** study received Institutional Review Board *** primary outcome measures included the diagnostic ability of EC-NBI to distinguish between active and inactive UC on the basis of histological *** conventional endoscopic images were classified according to the Mayo endoscopic score.A score of 0 or 1 indicated inactive disease,whereas a score of 2 indicated active ***:Fifty-two patients were *** was a strong correlation between the EC-NBI findings and the histological assessment(r=0.871,P<0.01).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of EC-NBI for diagnosing acute inflammation were 84.0%,100%,87.1%,100%,and 92.3%,respectively,while those for the Mayo endoscopic score were 100%,40.7%,100%,61.0%,and 69.2%,*** with conventional endoscopy,EC-NBI was superior in diagnostic specificity,negative predictive value,and accuracy(P<0.001,P=0.001 and P=0.047,respectively).CONCLUSION:The EC-NBI finding of capillaries in the rectal mucosa was strongly correlated with histological inflammation and aided in the differential diagnosis between active and inactive UC.

关键词： Endosytoscopy Narrow-band imaging Magnified endosc

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Endocytoscopic visualization of squamous cell islands within Barrett's epithelium

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World Journal of Gastrointestinal Endoscopy 2013年第4期5卷 174-179页

作者： Nicholas Eleftheriadis Haruhiro Inoue Haruo Ikeda Manabu Onimaru Akira Yoshida Toshihisa Hosoya Roberta Maselli shin-ei kudo Digestive Disease Center Showa University Northern Yokohama Hospital

AIM: To study the endocytoscopic visualization of squamous cell islands within Barrett's epithelium. METHODS: Endocytoscopy (ECS) has been studied in the surveillance of Barrett's esophagus, with controversial results. In initial studies, however, a soft catheter type endocytoscope was used, while only methylene blue dye was used for the staining of Barrett's mucosa. Integrated type endocytoscopes (GIF-Q260 EC, Olympus Corp, Tokyo, Japan) have been recently developed, with the incorporation of a high-power magnifying endocytoscope into a standard endoscope together with narrow-band imaging (NBI). Moreover, double staining with a mixture of 0.05% crystal violet and 0.1% of methylene blue (CM) during ECS enables higher quality images comparable to conventional hematoxylin eosin histopathological ***: In vivo endocytoscopic visualization of papillary squamous cell islands within glandular Barrett's epithelium in a patient with long-segment Barrett's esophagus is reported. Conventional white light endoscopy showed typical long-segment Barrett's esophagus, with small squamous cell islands within normal Barrett's mucosa, which were better visualized by NBI endoscopy. ECS after double CM staining showed regular Barrett's esophagus, while higher magnification (×480) revealed the orifices of glandular structures better. Furthermore, typical squamous cell papillary protrusion, classified as endocytoscopic atypia classification (ECA) 2 according to ECA, was identified within regular glandular Barrett's mucosa. Histological examination of biopsies taken from the same area showed squamous epithelium within glandular Barrett's mucosa, corresponding well to endocytoscopic findings. CONCLUSION: To our knowledge, this is the first report of in vivo visualization of esophageal papillary squamous cell islands surrounded by glandular Barrett's epithelium.

关键词： Endocytoscopy Barrett’s esophagus Surveillance Endocytoscopic atypia classification Crystal violet Methylene blue Hematoxylin eosin stain

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Practical Use of Gemcitabine and Cisplatin Combination Therapy as First-Line Treatment for Japanese Patients with Advanced Biliary Tract Cancer

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Journal of Cancer Therapy 2013年第6期4卷 1068-1073页

作者： Hisato Kawakami Isamu Okamoto Wataru Okamoto Masayuki Takeda shinya Ueda Toshihiro kudo shin-ichi Nishina Yasuhito Fujisaka Masaki Miyazaki Junji Tsurutani Takayasu Kurata Kazuhiko Nakagawa Department of Medical Oncology Faculty of Medicine Kinki University Osaka Japan

Gemcitabine and cisplatin combination therapy (GC) is accepted as a standard treatment for advanced biliary tract cancer (BTC). However, little information is available regarding such treatment in the clinical practice setting in Japan. We retrospectively examined the clinical data of patients with unresectable or recurrent BTC who received GC as first-line treatment. The regimen consisted of cisplatin (25 mg/m2) and gemcitabine (1000 mg/m2) administered intravenously on days 1 and 8 of repeated 3-week cycles. Twenty patients were analyzed. A total of 148 cycles of GC was administered, with a median of 8 and a range of 1 to 18 cycles. Treatment delay and dose reduction were noted in 35 (24%) and 41 (28%) of the 148 cycles, respectively. The major adverse events of grade 3 or 4 included neutropenia (50%), leukopenia (45%), anemia (30%), and thrombocytopenia (15%). Nonhematologic toxicities included nausea (10%), appetite loss (10%), and fatigue (10%). Median progression-free and overall survival times were 6.9 and 12.3 months, respectively. Gallbladder cancer showed a significantly higher response rate than did other types of BTC (chi-squaretest, P = 0.002). GC was thus effective and well tolerated as first-line chemotherapy for Japanese patients with advanced BTC in the clinical practice setting.

关键词： Gemcitabine Cisplatin Chemotherapy Biliary Tract Cancer

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Attention-Deficit/Hyperactivity Disorder in Adults with High-Functioning Pervasive Developmental Disorders in Japan

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Open Journal of Psychiatry 2014年第4期4卷 372-380页

作者： Yasuko Takanashi Hirobumi Mashiko Hirohide Yokokawa Yoko Kawasaki Shuntaro Itagaki Hiromichi Ishikawa Norihiro Miyashita Yasuaki Hayashi Asako kudo Kentaro Oga Rieko Matsuura shin-Ichi Niwa Department of Neuropsychiatry Fukushima Medical University School of Medicine Fukushima Japan Fukushima General Health and Welfare Center Fukushima Japan Department of Public Health Fukushima Medical University School of Medicine Fukushima Japan Department of General Medicine Juntendo University School of Medicine Tokyo Japan Musasino Child Development Clinic Tokyo Japan Hanawakousei Hospital Fukushima Japan Landic Nihonbashi Clinic Tokyo Japan Hoshigaoka Hospital Fukushima Japan Surugadai Nihon University Hospital Tokyo Japan Shiba Clinic Tokyo Japan

Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.

关键词： Adults Attention-Deficit/Hyperactivity Disorder (ADHD) High-Functioning Pervasive Developmental Disorders (PDD) Self-Report

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Influence of the safety and diagnostic accuracy of preoperative endoscopic ultrasound-guided fine-needle aspiration for resectable pancreatic cancer on clinical performance

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World Journal of Gastroenterology 2014年第13期20卷 3620-3627页

作者： Taiki kudo Hiroshi Kawakami Masaki Kuwatani Kazunori Eto Shuhei Kawahata Yoko Abe Manabu Onodera Nobuyuki Ehira Hiroaki Yamato shin Haba Kazumichi Kawakubo Naoya Sakamoto Department of Gastroenterology and Hepatology Hokkaido University Graduate School of MedicineSapporo 060-8638Japan

AIM:To evaluate the safety and diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)in a cohort of pancreatic cancer ***:Of 213 patients with pancreatic cancer evaluated between April 2007 and August 2011,82were thought to have resectable pancreatic cancer on the basis of cross-sectional imaging *** these,54 underwent EUS-FNA before surgery(FNA+group)and 28 underwent surgery without preoperative EUSFNA(FNA-group).RESULTS:All 54 lesions were visible on EUS,and all54 attempts at FNA were technically *** diagnostic accuracy according to cytology and histology findings was 98.1%(53/54)and 77.8%(42/54),respectively,and the total accuracy was 98.1%(53/54).One patient developed mild pancreatitis after EUS-FNA but was successfully treated by conservative *** severe complications occurred after *** the FNA+and FNA-groups,the median relapse-free survival(RFS)was 742 and 265 d,respectively(P=0.0099),and the median overall survival(OS)was1042 and 557 d,respectively(P=0.0071).RFS and OS were therefore not inferior in the FNA+*** data indicate that the use of EUS-FNA did not influence RFS or OS,nor did it increase the risk of peritoneal ***:In patients with resectable pancreatic cancer,preoperative EUS-FNA is a safe and accurate diagnostic method.

关键词： Pancreatic cancer Diagnosis Biopsy Endo-scopic ult

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