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Treatment of gastric remnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knife

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World Journal of Gastroenterology 2008年第16期14卷 2550-2555页

作者： Shoji Hirasaki Hiromitsu Kanzaki Minoru Matsubara Kohei Fujitav shuji matsumura Seiyuu Suzuki Second Department of Internal Medicine Sumitomo Besshi Hospital

AIM: To evaluate the effectiveness of endoscopic submucosal dissection using an insulation-tipped diathermic knife (IT-ESD) for the treatment of patients with gastric remnant cancer. METHODS: Thirty-two patients with early gastric cancer in the remnant stomach, who underwent distal gastrectomy due to gastric carcinoma, were treated with endoscopic mucosal resection (EMR) or ESD at Sumitomo Besshi Hospital and Shikoku Cancer Center in the 10-year period from January 1998 to December 2007, including 17 patients treated with IT-ESD. Retrospectively, patient backgrounds, the one-piece resection rate, complete resection (CR) rate, operation time, bleeding rate, and perforation rate were compared between patients treated with conventional EMR and those treated with IT-ESD. RESULTS: The CR rate (40% in the EMR group vs 82% in the IT-ESD group) was significantly higher in the IT-ESD group than in the EMR group; however, the operation time was significantly longer for the IT- ESD group (57.6 ± 31.9 min vs 21.1 ± 12.2 min). No significant differences were found in the rate of underlying cardiopulmonary disease (IT-ESD group, 12% vs EMR group, 13%), one-piece resection rate (100% vs 73%), bleeding rate (18% vs 6.7%), and perforation rate (0% vs 0%) between the two groups. CONCLUSION: IT-ESD appears to be an effective treatment for gastric remnant cancer post distal gastrectomy because of its high CR rate. It is useful for histological confirmation of successful treatment. Thelong-term outcome needs to be evaluated in the future.

关键词： Remnant stomach Distal gastrectomy Gastric cancer Endoscopic mucosal resection Insulationtipped diathermic knife

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Minute signet ring cell carcinoma occurring in gastric hyperplastic polyp

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World Journal of Gastroenterology 2007年第43期13卷 5779-5780页

作者： Shoji Hirasaki Seiyuu Suzuki Hiromitsu Kanzaki Kohei Fujita shuji matsumura Eiji Matsumoto Department of Internal Medicine Sumitomo Besshi Hospital 3-1 Ohji-cho Niihama 792-8543 Japan

We describe a 45-year-old woman with minute signet ring cell carcinoma occurring in a gastric hyperplastic polyp. A biopsy specimen obtained from the gastric hyperplastic polyp revealed signet ring cell carcinoma. Endoscopic mucosal resection (EMR) was performed to confirm the diagnosis. Histological examination of the EMR specimen revealed focal signet ring cell carcinoma in the hyperplastic polyp. There are few cases of gastric hyperplastic polyp associated with signet ring cell carcinoma.

关键词： Minute gastric cancer Signet ring cell Endoscopic mucosal resection

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Alpha-fetoprotein before and after pegylated interferon therapy for predicting hepatocellular carcinoma development

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World Journal of Hepatology 2015年第19期7卷 2220-2228页

作者： Yasuto Takeuchi Fusao Ikeda Toshiya Osawa Yasuyuki Araki Kouichi Takaguchi Youichi Morimoto Noriaki Hashimoto Kousaku Sakaguchi Tatsuro Sakata Masaharu Ando Yasuhiro Makino shuji matsumura Hiroki Takayama Hiroyuki Seki Shintarou Nanba Yuki Moritou Tetsuya Yasunaka Hideki Ohnishi Akinobu Takaki Kazuhiro Nouso Yoshiaki Iwasaki Kazuhide Yamamoto Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine Dentistry and Pharma- ceutical Sciences Department of Molecular Hepatology Okayama University Graduate School of Medicine Dentistry and Pharma- ceutical Sciences Department of Internal Medicine Okayama Saiseikai General Hospital Department of Internal Medicine Hiroshima City Hospital Department of Internal Medicine Kagawa Prefectural Central Hospital Department of Internal Medicine Kurashiki Central Hospital Department of Internal Medicine Mihara Red Cross hospital Department of Internal Medicine Fukuyama City Hospital Department of Internal Medicine National Hospital Organization Fukuyama Clinical Center Department of Internal Medicine Mitoyo General Hospital Department of Gastroenterology National Hospital Organization Iwakuni Clinical Center Department of Internal Medicine Sumitomo Besshi Hospital Department of Gastroenterology Tsuyama Central Hospital Health Service Center Okayama University

AIM: To investigate factors that accurately predict hepatocellular carcinoma(HCC) development after antiviral therapy in chronic hepatitis C(CHC) patients. METHODS: CHC patients who received pegylated interferon and ribavirin were enrolled in this cohort study that investigated the ability of alpha-fetoprotein(AFP) to predict HCC development after interferon(IFN) therapy. RESULTS: Of 1255 patients enrolled, 665 developed sustained virological response(SVR) during mean follow-up period of 5.4 years. HCC was occurred in 89 patients, and 20 SVR patients were included. Proportional hazard models showed that HCC occurred in SVR patients showing AFP ≥ 5 ng/m L before therapy and in non-SVR patients showing AFP ≥ 5 ng/m L before and 1 year after therapy besides older age, and low platelet counts. SVR patients showing AFP ≥ 5 ng/m L before therapy and no decrease in AFP to < 5 ng/m L 1 year after therapy had significantly higher HCC incidence than non-SVR patients showing AFP ≥ 5 ng/m L before therapy and decreased AFP(P = 0.043). AFP ≥ 5 ng/m L before therapy was significantly associated with low platelet counts and high values of alanine aminotransferase(ALT) in stepwise logistic regression analysis. After age, gender, platelet count, and ALT was matched by propensity score, significantly lower HCC incidence was shown in SVR patients showing AFP < 5 ng/m L before therapy than in those showing AFP ≥ 5 ng/m ***: The criteria of AFP < 5 ng/m L before and 1 year after IFN therapy is a benefical predictor for HCC development in CHC patients.

关键词： Hepatitis C virus Interferon Hepatocellular carcin

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