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Appropriate leucine-richα-2 glycoprotein cut-off value for Japanese patients with ulcerative colitis

World Journal of Clinical Cases 2023年第32期11卷 7753-7760页

作者： Masanao Yamazato Shunichi Yanai Tomofumi Oizumi Makoto Eizuka Shun Yamada Yosuke Toya Noriyuki Uesugi tamotsu sugai Takayuki Matsumoto Division of Gastroenterology and Hepatology Department of Internal MedicineIwate Medical UniversityYahaba 028-3695Japan Division of Molecular Diagnostic Pathology Iwate Medical UniversityYahaba 028-3695Japan

BACKGROUND It has been suggested that serum leucine-richα-2 glycoprotein(LRG)could be a novel monitoring biomarker for the assessment of disease activity in inflammatory bowel *** particular,the relationship between LRG levels and the endoscopically assessed activity of ulcerative colitis(UC)has become a matter of *** To clarify appropriate LRG cut-off values for the prediction of endoscopic and histologic remission in Japanese patients with *** This was a cross-sectional,single-center,observational study of Japanese patients with *** 213 patients with UC,in whom LRG was measured from September 2020 to February 2022,we recruited 30 patients for whom a total colonoscopy and measurements of LRG and C-reactive protein(CRP)were performed on the same *** retrospectively analyzed correlations between the LRG and CRP levels and endoscopic indices,including the Mayo endoscopic subscore and UC endoscopic index of *** Correlations between the LRG values and the Mayo endoscopic subscore or UC endoscopic index of severity were significant(r=0.754,P<0.0001;r=0.778,P<0.0001,respectively).There were also significant correlations between CRP levels and Mayo endoscopic subscore or UC endoscopic index of severity(r=0.599,P=0.0005;r=0.563,P=0.0012,respectively),although the correlation coefficients were higher for *** LRG cutoff value for predicting endoscopic remission was 13.4μg/mL for a Mayo endoscopic subscore of 0[area under the curve(AUC):0.871;95%confidence interval(CI):0.744-0.998],and 13.4μg/mL for an UC endoscopic index of severity of 0 or 1(AUC:0.904;95%CI:0.792-1.000).CONCLUSION LRG may be a surrogate marker for endoscopic activity in UC,with a cut-off value of around 13.4μg/mL for endoscopically inactive disease.

关键词： Ulcerative colitis Leucine-rich alpha-2 glycoprotein C-reactive protein Japanese patients

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New application of endocytoscope for histopathological diagnosis of colorectal lesions

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World Journal of Gastrointestinal Endoscopy 2022年第8期14卷 495-501页

作者： Fumihiro Inoue Daizen Hirata Mineo Iwatate Santa Hattori Mikio Fujita Wataru Sano tamotsu sugai Hiroshi Kawachi Kazuhito Ichikawa Yasushi Sano Gastrointestinal Center and Institute of Minimally-invasive Endoscopic Care(i-MEC) Sano HospitalKobe 655-0031HyogoJapan Molecular Diagnostic Pathology Iwate Medical University School of MedicineShiwa-gun 028-3694IwateJapan Department of Pathology Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKoto 135-8550TokyoJapan Department of Pathology Noda HospitalNoda 270-0237ChibaJapan

BACKGROUND The endocytoscope with ultra-high magnification(x 520)allows us to observe the cellular structure of the colon epithelium during colonoscopy,known as virtual *** hypothesized that the endocytoscope could directly observe colorectal histopathological specimens and store them as endocyto-pathological images by the endoscopists without a microscope,potentially saving the burden on *** To assess the feasibility of endocyto-pathological images taken by an endoscopist as adequate materials for histopathological *** Three gastrointestinal pathologists were invited and asked to diagnose 40 cases of endocyto-pathological images of colorectal *** case contained seven endocyto-pathological images taken by an endoscopist,consisting of one loupe image,three low-magnification images,and three ultra-high magnification *** participants chose hyperplastic polyp or low-grade adenoma for 20 cases of endocyto-pathological images(10 hyperplastic polyps,and 10 Low-grade adenomas in conventional histopathology)in study 1 and high-grade adenoma/shallow invasive cancer or deep invasive cancer for 20 cases[10 tumor in situ/T1a and 10 T1b]in study *** investigated the agreement between the histopathological diagnosis using the endocyto-pathological images and conventional histopathological *** Agreement between the endocyto-pathological and conventional histopathological diagnosis by the three gastrointestinal pathologists was 100%(95%CI:94.0%–100%)in studies 1 and *** interobserver agreement among the three gastrointestinal pathologists was 100%,and theκcoefficient was 1.00 in both *** Endocyto-pathological images were adequate and reliable materials for histopathological diagnosis.

关键词： Cancer Colon Endocytoscopy Histopathology Specimen

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Practical fecal calprotectin cut-off value for Japanese patients with ulcerative colitis

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World Journal of Gastroenterology 2018年第38期24卷 4384-4392页

作者： Jun Urushikubo Shunichi Yanai Shotaro Nakamura Keisuke Kawasaki Risaburo Akasaka Kunihiko Sato Yosuke Toya Kensuke Asakura Takahiro Gonai tamotsu sugai Takayuki Matsumoto Division of Gastroenterology Department of Internal Medicine School of Medicine Iwate Medical University Division of Molecular Diagnostic Pathology Department of Pathology School of Medicine Iwate Medical University

AIM To determine appropriate fecal calprotectin cut-off values for the prediction of endoscopic and histologic remission in Japanese patients with ulcerative colitis(UC). METHODS We performed a cross-sectional observational study of 131 Japanese patients with UC and measured fecal calprotectin levels by fluorescence enzyme immunoassay. The clinical activity of UC was assessed with the partial Mayo score(PMS). Relapse was defined as increase of PMS by 2 points or more in stool frequency or rectal bleeding subscore. The endoscopic and histologic activities of UC were evaluated in 50 patients within a 2-mo period from fecal sampling. Endoscopic activity was determined by Mayo endoscopic subscore, Rachmilewitz endoscopic index, and ulcerative colitis endoscopic index of severity. The histologic grade of inflammation was evaluated with biopsy specimens obtained from the endoscopically most severely inflamed site, according to the scheme by Matts grade and Riley's *** Fecal calprotectin levels varied from 1-20783 μg/g. There was a significant correlation between the partial Mayo score and fecal calprotectin levels(r = 0.548, P < 0.001). In 50 patients who underwent colonoscopy with biopsy, levels were significantly correlated with the Mayo endoscopic subscore(r = 0.574, P < 0.001), Rachmilewitz endoscopic index(r = 0.628, P < 0.001), ulcerative colitis endoscopic index of severity(r = 0.613, P < 0.001), Riley's histologic score(r = 0.400, P = 0.006), and Matts grade(r = 0.586, P < 0.001). Receiver-operating characteristic analyses identified the best cut-off value for the prediction of endoscopic remission as 288 μg/g, with an area under the curve of 0.777 or 0.823, while that for histologic remission was 123 or 125 μg/g, with an AUC of 0.881 or 0918, respectively. Of the 131 study patients, 88 patients in clinical remission were followed up 6 mo. During the follow-up period, 19 patients relapsed. The best fecal calprotectin cut-off value for predicting relapse

关键词： Ulcerative colitis Remission Mucosal healing Colonoscopy Histology Biomarker Feces Calprotectin

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Association between white opaque substance under magnifying colonoscopy and lipid droplets in colorectal epithelial neoplasms

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World Journal of Gastroenterology 2017年第47期23卷 8367-8375页

作者： Keisuke Kawasaki Makoto Eizuka Shotaro Nakamura Masaki Endo Shunichi Yanai Risaburo Akasaka Yosuke Toya Yasuko Fujita Noriyuki Uesugi Kazuyuki Ishida tamotsu sugai Takayuki Matsumoto Division of Gastroenterology Department of Internal MedicineIwate Medical University Department of Diagnostic Pathology Iwate Medical University Kaiunbashi Endoscopy Clinic

AIM To examine the association between white opaque substance(WOS) and histologically verified lipiddroplets in colorectal epithelial *** We reviewed colonoscopy records at our institution from 2014 to 2016 and identified cases of endoscopically or surgically resected colorectal epithelial neoplasms observed by magnifying narrow-band imaging(M-NBI) colonoscopy. Immunohistochemistry was used to stain tumors with a monoclonal antibody specific to adipophilin as a marker of lipids. The expression and distribution of adipophilin were compared between WOS-positive and WOS-negative lesions and among tumors classified by histologic type and depth of *** Under M-NBI colonoscopy, 81 lesions were positive for WOS and 48 lesions were negative for WOS. The rate of adipophilin expression was significantly higher in WOS-positive lesions(95.1%) than in WOS-negative lesions(68.7%)(P = 0.0001). The incidence of deep adipophilin expression was higher in WOS-positive lesions(24.7%) than in WOS-negative lesions(4.2%)(P = 0.001). The incidence of deep expression was predominant among cancers with massive submucosal invasion(62.5%) compared to adenoma(7.2%) and high-grade dysplasia or cancers with slight submucosal invasion(12.7%)(P = 0.0001).CONCLUSION The distribution of lipid droplets may be closely associated with the visibility of WOS under M-NBI colonoscopy, and with histologic grade and depth of tumor invasion.

关键词： White opaque substance Adipophilin Magnifying narrow-band imaging Colorectal neoplasm Magnifying endoscopy

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Case of gastric neuroendocrine carcinoma showing an interesting tumorigenic pathway

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World Journal of Clinical Cases 2017年第11期5卷 397-402页

作者： Noriyuki Uesugi Ryo Sugimoto Makoto Eizuka Yasuko Fujita Mitsumasa Osakabe Keisuke Koeda Takashi Kosaka Shunichi Yanai Kazuyuki Ishida Akira Sasaki Takayuki Matsumoto tamotsu sugai Department of Diagnostic Molecular Pathology School of MedicineIwate Medical University Department of Surgery School of MedicineIwate Medical University Division of Gastroenterology Department of Internal MedicineSchool of MedicineIwate Medical University

Here, we report a case of gastric neuroendocrine carcinoma showing an interesting tumorigenic pathway. A 57-year-old Japanese woman presented with epigastric tenderness, and distal gastrectomy was performed. In the surgical specimen, histologically, the tumor tissue was composed of three subtypes of tumor components showing different histological architecture and cellular atypia, diagnosed as neuroendocrine tumor(NET) G2, NET G3, and neuroendocrine carcinoma(NEC) components. Immunohistochemically, the Ki-67-positive rates of NET G2, NET G3, and NEC components were 6.5%, 99.5% and 88.1%, respectively. Although allelic imbalance(AI) on chromosomes 1p, 3p, 8q, TP53, 18q and 22 q was commonly found in all components, AI of 4p was found in NET G3 and NEC components(but not in the NET G2 component). In contrast, AIs of 5q and 9p were found in only the NEC component. Thus, we showed the progression from NET G2 to NEC, via NET G3, within the same tumor.

关键词： stomach neuroendocrine tumor G2 neuroendocrine tumor G3 neuroendocrine carcinoma

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Visualizing the hepatic vascular architecture using superb microvascular imaging in patients with hepatitis C virus: A novel technique

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World Journal of Gastroenterology 2016年第26期22卷 6057-6064页

作者： Hidekatsu Kuroda Tamami Abe Keisuke Kakisaka Yudai Fujiwara Yuichi Yoshida Akio Miyasaka Kazuyuki Ishida Hideaki Ishida tamotsu sugai Yasuhiro Takikawa Division of Hepatology Department of Internal Medicine Iwate Medical University School of Medicine Department of Molecular Diagnostic Pathology Iwate Medical University Center of Diagnostic Ultrasound Akita Red Cross Hospital

AIM: To identify the hepatic vascular architecture of patients with hepatitis C virus(HCV) using superb microvascular imaging(SMI) and investigate the use of SMI in the evaluation of liver ***: SMI was performed in 100 HCV patients. SMI images were classified into five types according to the vascular pattern, and these patterns were compared with the fibrosis stage. Moreover, the images were analyzed to examine vascularity by integrating the number of SMI signals in the region of interest ROI [number of vascular trees(VT)]. The number of VT, fibrosis stage, serum parameters of liver function, and CD34 expression were ***: There was a significant difference between SMI distribution pattern and fibrosis stage(P < 0.001). The mean VT values in each of the fibrosis stages were as follows: 26.69 ± 7.08 in F0, 27.72 ± 9.32 in F1, 36.74 ± 9.23 in F2, 37.36 ± 5.32 in F3, and 58.14 ± 14.08 in F4. The VT showed excellent diagnostic ability for F4 [area under the receiver operator characteristic(AUROC): 0.911]. The VT was significantly correlated with the CD34 labeling index(r = 0.617, P < 0.0001).CONCLUSION: SMI permitted the detailed delineation of the vascular architecture in chronic liver disease. SMI appears to be a reliable tool for noninvasively detecting significant fibrosis or cirrhosis in HCV patients.

关键词： Superb microvascular imaging Number of vascular trees Chronic liver disease Ultrasound Liver fibrosi

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Clinical Impact of Endoscopic Submucosal Dissection for Early Gastric Cancer

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Journal of Cancer Therapy 2013年第1期4卷 61-67页

作者： Takashi Kosaka Masaki Endo Yousuke Toya Tomomi Mizutani Yukito Abiko Norihiko Kudara Masaaki Inomata Toshimi Chiba Yasuhiro Takikawa Kazuyuki Suzuki tamotsu sugai Department of Diagnostic Pathology Iwate Medical University School of Medicine Morioka Japan. Department of Gastroenterology and Hepatology Iwate Medical University School of Medicine Morioka Japan

Aim: The aim of this study was to examine the safety and efficacy of endoscopic submucosal dissection (ESD) for early gastric cancer based on approximately 10 years’ experience. Methods: Endoscopic submucosal dissection was performed in 1272 patients with early gastric cancer (1657 lesions). We examined en bloc resection rate, curative resection rate, local recurrence rate, procedure time, and complications. Results: The overall en bloc resection rate was 98.6% for all lesions treated by ESD. The median procedure time of the operation was 54.3 minutes (range 5 - 632 min). The incidence of positive horizontal and vertical margins was 3.8% and 4.0%, respectively. The incidence was 2.5% each for perforation and postoperative bleeding. There were no deaths related to ESD. Local recurrence was observed in 10 lesions (0.06%). Conclusion: Since the procedure time and incidence of complications have been reduced, endoscopic submucosal dissection has been considered a standard treatment for early gastric cancer.

关键词： Endoscopic Submucosal Dissection ESD Gastric Cancer

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