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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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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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Endoscopic submucosal dissection for colorectal neoplasms:A review

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World Journal of Gastroenterology 2014年第43期20卷 16153-16158页

作者： Taku Sakamoto Genki Mori Masayoshi Yamada Yuzuru Kinjo Eriko So Seiichiro Abe Yosuke Otake Takeshi Nakajima takahisa matsuda Yutaka Saito Endoscopy Division National Cancer Center Hospital

The introduction of colorectal endoscopic submucosal dissection(ESD)has expanded the application of endoscopic treatment,which can be used for lesions with a low metastatic potential regardless of their *** has the advantage of achieving en bloc resection with a lower local recurrence rate compared with that of piecemeal endoscopic mucosal ***,in the past,surgery was indicated in patients with large lesions spreading to almost the entire circumference of the rectum,regardless of the depth of invasion,as endoscopic resection of these lesions was technically ***,a prime benefit of ESD is significant improvement in the quality of life for patients who have large rectal *** the other hand,ESD is not as widely applied in the treatment of colorectal neoplasms as it is in gastric cancers owing to the associated technical difficulty,longer procedural duration,and increased risk of *** diversify the available endoscopic treatment strategies for superficial colorectal neoplasms,endoscopists performing ESD need torecognize its indications,the technical issues involved in its application,and the associated *** review outlines the methods and type of devices used for colorectal ESD,and the training required by endoscopists to perform this procedure.

关键词： Colorectum Endoscopic submucosal dissection Short-term outcomes Training indication for endoscopic treatment

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Effectiveness of narrow-band imaging magnification for invasion depth in early colorectal cancer

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World Journal of Gastroenterology 2010年第14期16卷 1727-1734页

作者： Masakatsu Fukuzawa Yutaka Saito takahisa matsuda Toshio Uraoka Takao Itoi Fuminori Moriyasu Division of Endoscopy National Cancer Center Hospital Tokyo 1040045 Japan Division of Gastroenterology and Hepatology Tokyo Medical University Tokyo 1600023 Japan Department of Endoscopy Okayama University Hospital Okayama 7008558 Japan Microvasculature

AIM: To evaluate the surface microvascular patterns of early colorectal cancer (ECC) using narrow-band imaging (NBI) with magnification and its effectiveness for invasion depth diagnosis. METHODS: We studied 112 ECC lesions [mucosal/ submucosal superficial (m/sm-s), 69; sm-deep (sm-d), 43] ≥ 10 mm that subsequently underwent endoscopic or surgical treatment at our hospital. We compared microvascular architecture revealed by NBI with magnification to histological findings and then to magnifi- cation colonoscopy pit pattern diagnosis. RESULTS: Univariate analysis indicated vessel density: non-dense (P < 0.0001); vessel regularity: negative (P < 0.0001); caliber regularity: negative (P < 0.0001); vessel length: short (P < 0.0001); and vessel meandering: positive (P = 0.002) occurred significantly more often with sm-d invasion than m/sm-s invasion. Multivariate analysis showed sm-d invasion was independently associated with vessel density: non-dense[odds ratio (OR) = 402.5, 95% confidence interval (CI): 12.4-13 133.1] and vessel regularity: negative (OR = 15.9, 95% CI: 1.2-219.1). Both of these findings when combined were an indicator of sm-d invasion with sensitivity, specificity and accuracy of 81.4%, 100% and 92.9%, respectively. Pit pattern diagnosis sensitivity, specificity and accuracy, meanwhile, were 86.0%, 98.6% and 93.8%, respectively, thus, the NBI with magnification findings of non-dense vessel density and negative vessel regularity when combined together were comparable to pit pattern diagnosis. CONCLUSION: Non-dense vessel density and/or negative vessel regularity observed by NBI with magnification could be indicators of ECC sm-d invasion.

关键词： Colorectal neoplasms Narrow-band imaging Microvasculature

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Endoscopic submucosal dissection for large laterally spreading tumors involving the ileocecal valve and terminal ileum

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World Journal of Gastroenterology 2012年第3期18卷 291-294页

作者： Gustavo Kishimoto Yutaka Saito Hajime Takisawa Haruhisa Suzuki Taku Sakamoto Takeshi Nakajima takahisa matsuda National Cancer Center Hospital Endoscopy Division 5-1-1 Tsukiji Chuo-ku Tokyo 104-0045 Japan

Endoscopic submucosal dissection is a challenging technique that enables en-bloc resection for large colorectal tumors, as laterally spreading tumors, particularly difficult, if the ileocecal valve and terminal ileum is involved. Herein, we report on one of 4 cases. The procedures, using a bipolar needle knife (B-Knife) to reduce the perforation risk and carbon dioxide instead of conventional air insufflation for patient comfort, achieved curative resections without any complications.

关键词： Ileocecal valve Colorectal neoplasms Lat- erally spreading tumor Endoscopic mucosal resection Endoscopic submucosal dissection Bipolar current needle knife B-Knife IT-Knife

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Assessment of the validity of the clinical pathway for colon endoscopic submucosal dissection

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World Journal of Gastroenterology 2012年第28期18卷 3721-3726页

作者： Takaya Aoki Takeshi Nakajima Yutaka Saito takahisa matsuda Taku Sakamoto Takao Itoi Yassir Khiyar Fuminori Moriyasu Endoscopy Division National Cancer Center Hospital Tokyo 104-0045 Japan Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo 160-0023 Japan

AIM: To determine the effective hospitalization period as the clinical pathway to prepare patients for endoscopic submucosal dissection (ESD). METHODS: This is a retrospective observational study which included 189 patients consecutively treated by ESD at the National Cancer Center Hospital from May 2007 to March 2009. Patients were divided into 2 groups; patients in group A were discharged in 5 d and patients in group B included those who stayed longer than 5 d. The following data were collected for both groups: mean hospitalization period, tumor site, median tumor size, post-ESD rectal bleeding requiring urgent endoscopy, perforation during or after ESD, abdominal pain, fever above 38 ℃, and blood test results positive for inflammatory markers before and after ESD. Each parameter was compared after data collection. RESULTS: A total of 83% (156/189) of all patients could be discharged from the hospital on day 3 postESD. Complications were observed in 12.1% (23/189) of patients. Perforation occurred in 3.7% (7/189) of patients. All the perforations occurred during the ESD procedure and they were managed with endoscopic clipping. The incidence of post-operative bleeding was 2.6% (5/189); all the cases involved rectal bleeding. We divided the subjects into 2 groups: tumor diameter ≥ 4 cm and < 4 cm; there was no significant difference between the 2 groups (P = 0.93, χ 2 test with Yates correction). The incidence of abdominal pain was 3.7% (7/189). All the cases occurred on the day of the procedure or the next day. The median white blood cell count was 6800 ± 2280 (cells/μL; ± SD) for group A, and 7700 ± 2775 (cells/μL; ± SD) for group B, showing a statistically significant difference (P = 0.023, t-test). The mean C-reactive protein values the day after ESD were 0.4 ± 1.3 mg/dL and 0.5 ± 1.3 mg/dL for groups A and B, respectively, with no significant difference between the 2 groups (P = 0.54, t -test). CONCLUSION: One-day admission is sufficient in the absence of compl

关键词： Clinical pathway Colon Complication Endoscopic submucosal dissection Hospitalization period Rectum

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Magnifying colonoscopy as a non-biopsy technique for differential diagnosis of non-neoplastic and neoplastic lesions

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World Journal of Gastroenterology 2006年第9期12卷 1416-1420页

作者： Shigeharu Kato Kuang I Fu Yasushi Sano Takahiro Fujii Yutaka Saito takahisa matsuda Ikuro Koba Shigeaki Yoshida Takahiro Fujimori Division of Gastrointestinal Oncology and Digestive Endoscopy National Cancer Center Hospital East KashiwaChiba 277-8577Japan Division of Gastrointestinal Oncology and Digestive Endoscopy National Cancer Center Hospital East KashiwaChiba 277-8577Japan Department of Surgical and Molecular PathologyDokkyo University School of Medicine880 KitakobaysashiMibuShimotugaTochigi 321-0293Japan Division of Endoscopy National Cancer Center Hospital TsukijiTokyo 104-0045Japan Department of Surgical and Molecular Pathology Dokkyo University School of Medicine 880 KitakobaysashiMibuShimotugaTochigi 321-0293Japan

AIM： To clarify whether mucosal crypt patterns observed with magnifying colonoscopy are feasible to distinguish non-neoplastic polyps from neoplastic polyps. METHODS： From June 1999 through March 2000, 180 consecutive patients with 210 lesions diagnosed with a magnifying colonoscope （CF-200Z, Olympus Optical Co., Ltd., Tokyo, Japan） were enrolled. Magnification and chromoendoscopy with 0.2% indigo-carmine dye was applied to each lesion for mucosal crypt observation. Lesions showing types Ⅰ and Ⅱ crypt patterns were considered non-neoplastic and examined histologically by biopsy, whereas lesions showing types Ⅲ to Ⅴ crypt patterns were removed endoscopically or surgically. The correlation of endoscopic diagnosis and histologic diagnosis was then investigated. RESULTS： At endoscopy, 24 lesions showed a type Ⅰ or Ⅱ pit pattern, and 186 lesions showed type Ⅲ to Ⅴ pit patterns. With histologic examination, 26 lesions were diagnosed as non-neoplastic polyps, and 184 lesions were diagnosed as neoplastic polyps. The overall diagnostic accuracy was 99.1% （208/210）. The sensitivity and specificity were 92.3% （24/26） and 99.8% （184/186）, respectively. CONCLUSION： Magnifying colonoscopy could be used as a non-biopsy technique for differentiating neoplastic and non-neoplastic polyps.

关键词： Non-biopsy technique Magnifying colonoscopy Indigo-carmine dye spraying Pit Pattern

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Endoscopic diagnosis of cytomegalovirus gastritis after allogeneic hematopoietic stem cell transplantation

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World Journal of Gastroenterology 2010年第23期16卷 2907-2912页

作者： Yasuo Kakugawa Masahiro Kami takahisa matsuda Yutaka Saito Sung-Won Kim Takahiro Fukuda Shin-ichiro Mori Tadakazu Shimoda Ryuji Tanosaki Daizo Saito Division of Endoscopy National Cancer Center Hospital(Japan) Division of Exploratory Research Institute of Medical ScienceUniversity of Tokyo Division of Hematopoietic Stem Cell Transplantation National Cancer Center Hospital(Japan) Clinical Laboratory Division National Cancer Center Hospital(Japan)

AIM:To clarify the endoscopic and clinical findings of cytomegalovirus(CMV) gastritis after allogeneic hematopoietic stem cell transplantation(allo-SCT).METHODS:Between 1999 and 2005,523 patients underwent allo-SCT at our hospital,and 115 of these patients with gastrointestinal symptoms underwent ***:CMV gastritis was diagnosed pathologically in seven patients(1.3%) with the other 108 patients serving as *** of the seven patients developed positive CMV antigenemia,and five complained of abdominal *** of abdominal pain preceded CMV antigenemia in four of the f ive *** examination showed oozing(n=2),erosion(n=6),and redness(n=5) in the seven patients with CMV gastritis,while the control patients showed oozing(n=3),erosion(n=24),and redness(n=100).Erosion and oozing were more frequently documented in patients with CMV gastritis compared with the controls,and the differences were statistically significant(P=0.0012 and 0.029,respectively).CMV inclusion bodies were documented in 12 of 14 biopsy specimens obtained from erosive lesions,while they were identif ied in 4 of 15 biopsy specimens obtained from lesions other than erosions(P=0.0025).CONCLUSION:This study suggests that erosion and oozing,as well as abdominal pain,are useful indicators in the diagnosis of CMV gastritis following allo-SCT.

关键词： Cytomegalovirus gastritis Hematopoietic stem cell transplantation Cytomegalovirus antigenemia Esophagogastroduodenoscopy Graft-versus-host disease

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Primary signet-ring cell carcinoma of the colon at early stage: A case report and a review of the literature

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World Journal of Gastroenterology 2006年第21期12卷 3446-3449页

作者： Kuang-I Fu Yasushi Sano Shigeharu Kato Hiroki Saito Atsushi Ochiai Takahiro Fujimori Yutaka Saito takahisa matsuda Takahiro Fujii Shigeaki Yoshida Division of Gastrointestinal Oncology and Digestive Endoscopy National Cancer Center Hospital East KashiwaChiba 277-8577Japan Department of Surgical and Molecular PathologyDokkyo University School of Medicine880 KitakobaysashiMibuShimotugaTochigi 321-0293Japan Division of Gastrointestinal Oncology and Digestive Endoscopy National Cancer Center Hospital East KashiwaChiba 277-8577Japan Division of Pathology National Cancer Center East Research Institute Chiba 277-8577Japan Department of Surgical and Molecular Pathology Dokkyo University School of Medicine 880 KitakobaysashiMibuShimotugaTochigi 321-0293Japan Division of Endoscopy National Cancer Center Hospital TsukijiTokyo 104-0045Japan

A 67-year-old man, who had undergone surgery to resect multiple gastric cancers 4 years ago, visited our hospital for surveillance colonoscopy. Colonoscopy revealed a discolored, 7-mm in diameter, flat-elevated lesion with central depression in the transverse colon near the splenic flexure. Although the findings of endoscopy and barium enema were suggestive of submucosal invasion, the patient chose to undergo endoscopic mucosal resection. Pathological examination of the resected specimen revealed signet-ring cell carcinoma and a positive surgical margin. A second operation was performed, and no residual tumor or metastasis to lymph nodes was found in the resected specimens. Primary colorectal cancers composed of signet-ring cell carcinoma detected and treated at an early stage are extremely rare. We present a case and review the literature.

关键词： Signet-ring cell carcinoma Early colorectal cancer Endoscopic mucosal resection

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A laterally-spreading tumor in a colonic interposition treated by endoscopic submucosal dissection

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World Journal of Gastroenterology 2010年第3期16卷 392-394页

作者： Hideaki Bando Hiroaki Ikematsu Kuang-I Fu Yasuhiro Oono Takashi Kojima Keiko Minashi Tomonori Yano takahisa matsuda Yutaka Saito Kazuhiro Kaneko Atsushi Ohtsu Department of Gastrointestinal Oncology & Endoscopy National Cancer Center Hospital EastKashiwanoha 6-5-1KashiwaChiba 277-8577Japan Department of Gastroenterology Juntendou University Nerima Hospital Endoscopy Division National Cancer Center Hospital

Herein we describe an early colonic carcinoma which developed in a colonic interposition 14 years after surgery for esophageal cancer, which was successfully treated by endoscopic submucosal dissection (ESD). An 80-year-old man underwent colonic interposition between the upper esophagus and stomach after surgery for an early esophageal squamous cell carcinoma in 1994. He received a surveillance endoscopy, and a laterally-spreading tumor of granular type, approximately 20 mm in size, was identified in the colonic interposition. An endoscopic biopsy revealed moderately differentiated adenocarcinoma histologically, however, we diagnosed the lesion as an intramucosal carcinoma based on the endoscopic findings. The lesion was safely and completely removed en bloc by ESD using a bipolar knife. Histologically, the lesion was an intramucosal moderately differentiated adenocarcinoma in a tubular adenoma.

关键词： Colonic interposition Early colonic carc inoma Endoscopic submucosal dissection

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