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Serum manganese superoxide dismutase and thioredoxin are potential prognostic markers for hepatitis C virus-related hepatocellular carcinoma

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World Journal of Gastroenterology 2011年第44期17卷 4890-4898页

作者： Tsutomu Tamai Hirofumi Uto Yoichiro Takami Kouhei Oda Akiko Saishoji Masashi Hashiguchi Kotaro Kumagai takeshi kure Seiichi Mawatari Akihiro Moriuchi Makoto Oketani Akio Ido Hirohito Tsubouchi Department of Digestive and Lifestyle Related Diseases Human and Environmental SciencesHealth ResearchKagoshima University Graduate School of Medical and Dental Sciences

AIM:To evaluate the clinical significance of oxidative stress markers in patients with hepatitis C virus(HCV)related hepatocellular carcinoma(HCC).METHODS:Sixty-four consecutive patients who were admitted to Kagoshima University Medical and Dental Hospital were enrolled in this retrospective *** patients had chronic liver disease(CLD) due to infection with *** patients with HCV-related HCC,34 with HCV-related CLD without HCC(non-HCC),and 20 healthy volunteers(HVs) were *** associations between serum manganese superoxide dismutase(MnSOD) and thioredoxin(TRX) levels and clinical parameters or patient prognosis were analyzed over a mean follow-up period of 31.7 ***:The serum MnSOD levels were significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.03) or HVs(P < 0.001).Similarly,serum TRX levels were also significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.04) or HVs(P < 0.01).However,serum levels of MnSOD and TRX were not correlated in patients with *** patients with HCC,the overall survival rate(OSR) was lower in patients with MnSOD levels ≥ 110 ng/mL than in patients with levels < 110 ng/mL(P = 0.01),and the OSR tended to be lower in patients with TRX levels < 80 ng/mL(P = 0.05).In addition,patient prognosis with HCC was poorest with serum MnSOD levels ≥ 110 ng/mL and serum TRX levels < 80 ng/***,a multivariate analysis using a Cox proportional hazard model and serum levels of five factors(MnSOD,prothrombin time,serum albumin,serum α-fetoprotein(AFP),and serum des-γ-carboxy prothrombin) revealed that MnSOD levels ≥ 110 ng/mL(risk ratio:4.12,95% confidential interval:1.22-13.88,P = 0.02) and AFP levels ≥ 40 ng/mL(risk ratio:6.75;95% confidential interval:1.70-26.85,P < 0.01) were independent risk factors associated with a poor patient ***:Serum MnSOD and TRX levels are potential clinical biomarkers that predict patient prognosis in

关键词： Oxidative stress Manganese superoxide dismutase Thioredoxin Hepatitis C virus Hepatocellular carcinoma

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High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1487-1496页

作者： Nao Furuya Atsushi Yamaguchi Naohiro Kato Syuhei Sugata Takuro Hamada takeshi Mizumoto Yuzuru Tamaru Ryusaku Kusunoki Toshio Kuwai Hirotaka Kouno Kazuya Kuraoka Yoshiyuki Shibata Sho Tazuma takeshi Sudo Hiroshi Kohno Shiro Oka Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Gastroenterology Hiroshima University HospitalHiroshima 734-8551HiroshimaJapan Department of Pathology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Surgery National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan

BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination ***,it can be diagnosed by pancreatic juice cytology from indirect *** previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic *** revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD ***,course observation was *** 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic *** performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology *** performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade *** parenchyma invasion was not observed,and curative resection was *** High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.

关键词： Pancreatic cancer Pancreatic intraepithelial neoplasm High-grade pancreatic intraepithelial neoplasm Magnetic resonance cholangiopancreatography Carcinoma in situ Case report

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Safety and efficacy of self-expandable metallic stents in malignant small bowel obstructions

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World Journal of Gastroenterology 2016年第40期22卷 9022-9027页

作者： Akiyoshi Tsuboi Toshio Kuwai Tomoyuki Nishimura Sumio Iio takeshi Mori Hiroki Imagawa Toshiki Yamaguchi Atsushi Yamaguchi Hirotaka Kouno Hiroshi Kohno Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer Center

In this report, we present 3 cases of malignant small bowel obstruction, treated with palliative care using endoscopic self-expandable metallic stent(SEMS) placement, with the aim to identify the safety and efficacy of this procedure. Baseline patient characteristics, procedure methods, procedure time, technical and clinical success rates, complications, and patient outcomes were obtained. All 3 patients had pancreatic cancer with small bowel strictures. One patient received the SEMS using colonoscopy, while the other 2 patients received SEMS placement via double balloon endoscopy using the through-the-overtube technique. The median procedure time was 104 min. The technical and clinical success rates were 100%. Post-treatment, obstructive symptoms in all patients improved, and a low-residue diet could be tolerated. All stents remained within the patients until their deaths. The median overall survival time(stent patency time) was 76 d. SEMS placement is safe and effective as a palliative treatment for malignant small bowel obstruction.

关键词： Self-expandable metallic stents Malignant small bowel obstructions Endoscopy Case report Pancreatic cancer

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Transmembrane serine protease 4 expression in the prognosis of radical resection for biliary tract cancer

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2555-2564页

作者： Yoshiyuki Shibata takeshi Sudo Sho Tazuma Naoki Tanimine Takashi Onoe Yosuke Shimizu Atsushi Yamaguchi Kazuya Kuraoka Shinya Takahashi Hirotaka Tashiro Department of Surgery National Hospital Organization Kure Medical Center and Chugoku Cancer CenterHiroshima 737-0023Japan Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterHiroshima 737-0023Japan Department of Diagnostic Pathology National Hospital Organization Kure Medical Centerand Chugoku Cancer CenterHiroshima 737-0023Japan Department of Surgery Graduate School of Biochemical and Health ScienceHiroshima UniversityHiroshima 734-8551Japan

BACKGROUND Recent advancements in biliary tract cancer(BTC)treatment have expanded beyond surgery to include adjuvant therapy,yet the prognosis remains *** prognostic biomarkers could enhance the assessment of patients who have undergone radical resection for *** To determine transmembrane serine protease 4(TMPRSS4)utility as a prognostic biomarker of radical resection for *** Medical records of patients who underwent radical resection for BTC,excluding intrahepatic cholangiocarcinoma,were retrospectively *** associations between TMPRSS4 expression and clinicopathological factors,overall survival,and recurrence-free survival were *** Among the 85 patients undergoing radical resection for BTC,46(54%)were *** TMPRSS4-positive group exhibited significantly higher preoperative carbohydrate antigen 19-9(CA19-9)values and greater lymphatic invasion than the TMPRSS4-negative group(P=0.019 and 0.039,respectively).Postoperative overall survival and recurrence-free survival were significantly worse in the TMPRSS4-positive group(median survival time:25.3 months vs not reached,P<0.001;median survival time:28.7 months vs not reached,P=0.043,respectively).Multivariate overall survival analysis indicated TMPRSS4 positivity,pT3/T4,and resection status R1 were independently associated with poor prognosis(P=0.032,0.035 and 0.030,respectively).TMPRSS4 positivity correlated with preoperative CA19-9 values≥37 U/mL and pathological tumor size≥30 mm(P=0.016 and 0.038,respectively).CONCLUSION TMPRSS4 is a potential prognostic biomarker of radical resection for BTC.

关键词： Biliary tract cancer Biomarker Prognosis Radical resection Transmembrane serine protease 4

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Endoscopic submucosal dissection for early esophageal neoplasms using the stag beetle knife

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World Journal of Gastroenterology 2018年第15期24卷 1632-1640页

作者： Toshio Kuwai Toshiki Yamaguchi Hiroki Imagawa Ryoichi Miura Yuki Sumida takeshi Takasago Yuki Miyasako Tomoyuki Nishimura Sumio Iio Atsushi Yamaguchi Hirotaka Kouno Hiroshi Kohno Sauid Ishaq Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer Center Department of Gastroenterology DGH SGU WI Birmingham City University

AIM To determine short-and long-term outcomes of endoscopic submucosal dissection(ESD) using the stag beetle(SB) knife, a scissor-shaped *** Seventy consecutive patients with 96 early esophageal neoplasms, who underwent ESD using a SB knife at kure Medical Center and Chugoku Cancer Center, Japan, between April 2010 and August 2016, were retrospectively evaluated. Clinicopathological characteristics of lesions and procedural adverse events were assessed. Therapeutic success was evaluated on the basis of en bloc, histologically complete, and curative or non-curative resection rates. Overall and tumor-specific survival, local or distant recurrence, and 3-and 5-year cumulative overall metachronous cancer rates were also *** Eligible patients had dysplasia/intraepithelial neoplasia(22%) or early cancers(squamous cell carcinoma, 78%). The median procedural time was 60 min and on average, the lesions measured 24 mm in diameter, yielding 33-mm tissue defects. The en bloc resection rate was 100%, with 95% and 81% of dissections deemed histologically complete and curative, respectively. All procedures were completed without accidental incisions/perforations or delayed bleeding. During follow-up(mean, 35 ± 23 mo), no local recurrences or metastases were observed. The 3-and 5-year survival rates were 83% and 70%, respectively, with corresponding rates of 85% and 75% for curative resections and 74% and 49% for noncurative resections. The 3-and 5-year cumulative rates of metachronous cancer in the patients with curative resections were 14% and 26%, *** ESD procedures using the SB knife are feasible, safe, and effective for treating early esophageal neoplasms, yielding favorable short-and long-term outcomes.

关键词： Neoplasms Stag beetle knife Esophageal Endoscopic submucosal dissection Outcome measures

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Gastric and enteric anisakiasis successfully treated with Gastrografin therapy: A case report

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World Journal of Gastrointestinal Endoscopy 2018年第3期10卷 69-73页

作者： Hiroki Fujikawa Toshio Kuwai Toshiki Yamaguchi Ryoichi Miura Yuki Sumida takeshi Takasago Yuki Miyasako Tomoyuki Nishimura Sumio Iio Hiroki Imagawa Atsushi Yamaguchi Hirotaka Kouno Hiroshi Kohno Department of Gastroenterology National Hospital OrganizationKure Medical Center and Chugoku Cancer Center

We report a case of a 59-year-old woman who was diagnosed with gastric and small intestinal anisakiasis, which was successfully treated with endoscopic extraction and Gastrografin therapy. She was admitted to our hospital with epigastric pain and vomiting one day after eating raw fish. She exhibited tenderness in the epigastrium without obvious rebound tenderness or guarding. Computed tomography (CT) demonstrated segmental edema of the intestinal wall with proximal dilatation and a small number of ascites. Because enteric anisakiasis was suspected based on the patient's history of recent raw fish consumption and abdominal CT, we performed gastroscopy and confirmed that nine Anisakis larvae were attached to the gastric mucosa. All of the Anisakis larvae were extracted via endoscopy, and the patient was diagnosed with gastric and enteric anisakiasis. Additionally, in the hospital, we performed ileography twice using Gastrografin, which led to shortened hospital stay. Based on the clinical results of this case, we suggest that Gastrografin therapy is a safe, convenient, and useful method to extract enteric Anisakis larvae.

关键词： Enteric anisakiasis Gastrografin Ileus Endoscopic extraction Anisakis larvae

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Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan

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World Journal of Gastroenterology 2010年第40期16卷 5084-5091页

作者： Yutaka Suzuki Seryna Tamez Akihiko Murakami Akihiko Taira Akihiro Mizuhara Akira Horiuchi Chie Mihara Eiji Ako Hirohito Muramatsu Hitoshi Okano Hitoshi Suenaga Kazuaki Jomoto Junya Kobayashi Katsunari Takifuji Kazuhiro Akiyama Koh Tahara Koji Onishi Makoto Shimazaki Masami Matsumoto Masashi Ijima Masato Murakami Masato Nakahori Michiaki Kudo Michio Maruyama Mikako Takahashi Naohiro Washizawa Shigeru Onozawa Satoshi Goshi Satoyoshi Yamashita Shigeki Ono Shin Imazato Shinji Nishiwaki Shuichirou Kitahara Takao Endo Takao Iiri takeshi Nagahama Takuto Hikichi Tatsuya Mikami Tetsuo Yamamoto Tetsushi Ogawa Tomoko Ogawa Tomoyuki Ohta Toshifumi Matsumoto Toshiroh Kura Tsutomu Kikuchi Tsuyoshi Iwase Tsuyotoshi Tsuji Yukio Nishiguchi Mitsuyoshi Urashima Department of Surgery International Universi-ty of Health and Welfare Hospital Department of Molecular Epidemiology Jikei University School of Medicine Endoscopy Unit Iwate prefectural Central Hospital Department of Internal Medicine Tsuyama Chuo Hospital Department of Surgery Higashi Washi-nomiya Hospital Digestive Disease Center Showa Inan General Hospital Department of Neurology Ebina Medical Sup-port Center Department of Surgery Sumitomo Hospital Department of Gastroenterology Kiyota Hospital Department of Gastroenterology Okano Clinic Department of Geriatrics Hitachikoh Hospital Department of Internal Medicine Jomoto Gastroenteric and Internal Medical Clinic Department of Surgery Fujiyoshida Munici-pal Hospital 2nd Department of Surgery Wakayama Medical University Hospital Department of Surgery Tokatsu-clinic Hospital Department of Surgery Kure Kyosai Hospital Department of Internal Medicine Matsue Sei-kyo Genaral Hospital Department of Gastroenterology Hirano General Hospital Department of Internal Medicin Nara Prefectural Gojo Hospital Department of Internal Medicine Isesaki Mu-nicipal Hospital Department of Internal Medicine Muraka-mi Memorial Hospital Digestive Endoscopy Center Sendai Kousei Hospital Department of Surgery Onishi Hospital Department of Surgery Tokyo Metropoli-tan Ohkubo Hospital Department of Internal Medicine Tsuruoka Kyoritsu Hospital Nutritional Therapy Center Toho Uni-versity Omori Medical Center Home Care Department Kameda Medical Hospital Endoscopic Treatment Center Japan Labour Health and Welfare Organization Niigata Rousai Hospital Department of Gastroenterology and Hepatology Social Insurance Shimonoseki Welfare Hospital Department of Gastroenterology Ako City Hospital Percutaneous Endoscopic Gastrostomy Center Oita Kensei Hospital Department of Internal Medicine Nishimino Kosei Hospital Department of Pediatric Surgery Nagano Red Cross Hospital Department of Internal Medicine Sapporo Shirakaba-dai hospital Department of Gastroenterology Tachikawa

AIM: To examine the long term survival of geriatric patients treated with percutaneous endoscopic gastrostomy (PEG) in Japan. METHODS: We retrospectively included 46 Japanese community and tertiary hospitals to investigate 931 consecutive geriatric patients (≥ 65 years old) with swallowing difficulty and newly performed PEG between Jan 1st 2005 and Dec 31st 2008. We set death as an outcome and explored the associations among patient’s characteristics at PEG using log-rank tests and Cox proportional hazard models. RESULTS: Nine hundred and thirty one patients were followed up for a median of 468 d. A total of 502 deaths were observed (mortality 53%). However, 99%, 95%, 88%, 75% and 66% of 931 patients survived more than 7, 30, 60 d, a half year and one year, respectively. In addition, 50% and 25% of the patients survived 753 and 1647 d, respectively. Eight deaths were considered as PEG-related, and were associated with lower serum albumin levels (P = 0.002). On the other hand, among 28 surviving patients (6.5%), PEG was removed. In a multivariate hazard model, older age [hazard ratio (HR), 1.02; 95% confidence interval (CI), 1.00-1.03; P = 0.009], higher C-reactive protein (HR, 1.04; 95% CI: 1.01-1.07; P = 0.005), and higher blood urea nitrogen (HR, 1.01; 95% CI: 1.00-1.02; P = 0.003) were significant poor prognostic factors, whereas higher albumin (HR, 0.67; 95% CI: 0.52-0.85; P = 0.001), female gender (HR, 0.60; 95% CI: 0.48-0.75; P < 0.001) and no previous history of ischemic heart disease (HR, 0.69; 95% CI: 0.54-0.88, P = 0.003) were markedly better prognostic factors. CONCLUSION: These results suggest that more than half of geriatric patients with PEG may survive longer than 2 years. The analysis elucidated prognostic factors.

关键词： Percutaneous endoscopic gastrostomy Enteral nutrition Comorbidity Survival Risk factor

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胃癌预防亚太地区共识指南

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胃肠病学 2008年第4期13卷 231-240页

作者： Kwong Ming Fock Nick Talley Paul Moayyedi Richard Hunt takeshi Azuma Kentaro Sugano Shu Dong Xiao Shiu Kum Lam Khean Lee Goh Tsutomu Chiba Naomi Uemura Jae G Kim Nayoung Kim Tiing Leong Ang Varocha Mahachai Hazel Mitchell Abdul Aziz Rani Jyh Ming Liou Ratha-korn Vilaichone Jose Sollanor 钱本余 Changi General Hospital Singapore Mayo Clinic College of Medicine Rochester USA McMaster University Medical Center Ontario Canada University of Fukui Fukui Jichi Medical University Tochigi Shanghai Institrte of Digestive Disease Shanghai University of Hong Kong Hong Kong University of Malaya Kuala Lumpur Malaysia Kyoto University Kyoto kure Kyousai General Hospital Kure Japan Chung Ang University College of Medicine Seoul National University College of Medicine Seoul Korea Chulalongkorn University Hospital Bangkok University of New South Wales Sydney New South Wales Australia University of Indonesia Jakarta Indonesia National Taiwan University Hospital Taipei China Thammasat University Hospital Pathumthani Thailand University of Santo Tomas Manila Philippines

背景与目的:胃癌是亚太地区的主要健康负担之一,但对其预防策略尚缺乏共识。本共识会议旨在评价预防胃癌的策略。方法:多学科专家组应用德尔菲(Delphi)法制订共识条文,提呈相关数据,对证据等级、推荐强度以及共识水平予以分级。结果:幽... 详细信息

背景与目的:胃癌是亚太地区的主要健康负担之一,但对其预防策略尚缺乏共识。本共识会议旨在评价预防胃癌的策略。方法:多学科专家组应用德尔菲(Delphi)法制订共识条文,提呈相关数据,对证据等级、推荐强度以及共识水平予以分级。结果:幽门螺杆菌(***)感染是非贲门胃腺癌必要但非充分的致病因子。盐的高摄入与胃癌强烈相关。新鲜果蔬对胃癌具有预防作用,但维生素和其他饮食补充并不能预防胃癌。***感染中的宿主-细菌相互作用导致不同类型的胃炎和胃酸分泌,从而决定疾病结局。胃癌阳性家族史是一个重要的危险因素。低血清胃蛋白酶原反映胃萎缩程度,可作为检出胃癌高危人群的标志物。***筛查和治疗被推荐作为减少高危人群胃癌危险性的一种策略,该策略在萎缩性胃炎发生前实施最为有效,但并不排除对胃癌高危人群的内镜监测。对胃癌低危人群不推荐行***筛查。***感染的一线治疗应遵循国家治疗指南。结论:高危人群中***筛查和根除策略可能会减少胃癌的发生率,本共识根据现有证据予以推荐。

关键词：癌指南幽门螺杆菌预防

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