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The clinical signifi cance of circulating tumor cells in gastrointestinal cancer

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Journal of Cancer Metastasis and Treatment 2015年第1期1卷 130-137页

作者： Masaaki Iwatsuki Junji Kurashige Takatsugu Ishimoto Keisuke Kosumi Yoshifumi Baba yasuo sakamoto Yuji Miyamoto Naoya Yoshida Masayuki Watanabe Hideo Baba Department of Gastroenterological Surgery Graduate School of Medical SciencesKumamoto University1-1-1 HonjoChuo-kuKumamoto 860-8556Japan Department of Gastroenterological Surgery Esophageal Cancer DivisionCancer Institute Hospital of Japanese Foundation for Cancer Research3-8-31 AriakeKoto-kuTokyo 135-8550Japan

Circulating tumor cells(CTCs)are originated from the primary tumor lesion into the blood stream.CTCs could lead to recurrence of gastrointestinal(GI)cancers,even after a curative resection and colonizing in the distant organs to facilitate tumor distant metastasis;however,it has been challenging in clinic to detect CTCs for a long time,such as detection methodology or molecular markers for identifi cation of CTCs.This review discussed the recent technical advances and biomarkers in the detection of CTCs and the molecular mechanism of CTC in cancer progression and metastasis.Moreover,novel concepts,such as cancer stem cells and epithelial-mesenchymal transition,could lead to CTCs and tumor progression and metastasis.Nevertheless,the involvement of CTCs varies greatly among cancer types in the GI and much remains to be learned.Thus,further study will provide more insightful information from a clinical and translational viewpoint to use CTCs for cancer early diagnosis or prediction of tumor recurrence and investigation of tumor progression and metastasis as well.

关键词： Cancer stem cells circulating tumor cells epithelial-mesenchymal transition gastrointestinal cancer tumor progression and metastasis

Factors associated with the overall survival of elderly patients with hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第16期18卷 1926-1932页

作者： Hideki Fujii Yoshito Itoh Naoki Ohnishi Masafumi sakamoto Tohru Ohkawara Yoshihiko Sawa Koichi Nishida yasuo Ohkawara Kanji Yamaguchi Masahito Minami Takeshi Okanoue Department of Internal Medicine Aiseikai Yamashina HospitalKyoto 602-8566Japan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of MedicineGraduate School of Medical ScienceKyoto 602-8566Japan Hepatology Center Saiseikai Suita HospitalOsaka 564-0013Japan

AIM:To identify the factors associated with overall survival of elderly patients with hepatocellular carcinoma(HCC).METHODS:A total of 286 patients with HCC(male/female:178/108,age:46-100 years),who were diagnosed and treated by appropriate therapeutic procedures between January 2000 and December 2010,were enrolled in this study.Patients were stratified into two groups on the basis of age:Elderly(≥ 75 years old) and non-elderly(< 75 years old).Baseline clinical characteristics as well as cumulative survival rates were then compared between the two groups.Univariate and multivariate analyses were used to identify the factors associated with prolonged overall survival of patients in each group.Cumulative survival rates in the two groups were calculated separately for each modified Japan Integrated Stage score(mJIS score) category by the Kaplan-Meier method.In addition,we compared the cumulative survival rates of elderly and non-elderly patients with good hepatic reserve capacity(≤ 2 points as per mJIS).RESULTS:In the elderly group,the proportion of female patients,patients with absence of hepatitis B or hepatitis C viral infection,and patients with coexisting extrahepatic comorbid illness was higher(56.8% vs 31.1%,P < 0.001;27.0% vs 16.0%,P = 0.038;33.8% vs 22.2%,P = 0.047;respectively) than that in the nonelderly group.In the non-elderly group,the proportion of hepatitis B virus(HBV)-infected patients was higher than that in the elderly group(9.4% vs 0%,P = 0.006).The cumulative survival rates in the elderly group were 53.7% at 3 years and 32.9% at 5 years,which were equivalent to those in the non-elderly group(55.9% and 39.4%,respectively),as shown by a log-rank test(P = 0.601).In multivariate analysis,prolonged survival was significantly associated with the extent of liver damage and stage(P < 0.001 and P < 0.001,respectively),but was not associated with patient age.However,on individual evaluation of factors in both groups,stage was significantly(P < 0.001) associated with prolonged survival.Regarding mJIS scor

关键词：中老年生存期患者肝癌肝功能损害肝炎病毒治疗程序病毒感染

Factors Predicting the Relapse of Radiation-Induced Organizing Pneumonia after Breast-Conserving Therapy

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Open Journal of Radiology 2015年第3期5卷 159-169页

作者： Yukinori Okada Shingo sakamoto Tatsuyuki Abe Mio Shinozaki Hiromichi Gomi Yoshihide Kanemaki Shin Matsuoka yasuo Nakajima Department of Radiology St. Marianna University School of Medicine Kawasaki Japan Department of Radiology Breast and Imaging Center St. Marianna University School of Medicine Kawasaki Japan

We investigated the factors predicting radiation-induced organizing pneumonia (RIOP) relapse after tangential breast irradiation. The participants included 23 patients diagnosed with RIOP at the St. Marianna University School of Medicine Hospital between January 2008 and March 2015. Relapse was defined as the appearance of new lesions on diagnostic images during follow-up or after commencing treatment. The relapse-free survival rate and the following 9 parameters were compared between patients with and without RIOP relapse: 1) age (less than vs. equal to or more than the median);2) white blood cell count (less than vs. equal to or more than the median);3) C-reactive protein (CRP) level at the time of RIOP diagnosis (less than normal, more than normal/ less than borderline, and more than borderline);4) boost irradiation (yes vs. no);5) maximum lung depth on linacgraphy (less than vs. equal to or more than the median);6) hormone therapy (yes vs. no);7) chemotherapy (yes vs. no);8) RIOP ratio in the whole lung (less than vs. equal to or more than the median) at the time of RIOP diagnosis;and 9) use of corticosteroids (yes vs. no). The Kaplan-Meier method was used for statistical analysis, with relapse as the cutoff. The follow-up period spanned the date of RIOP onset to May 30, 2015. The level of significance for 2-sided tests was p < 0.05. Relapse was evident in 14 patients (60.8%). The relapse-free survival rate was significantly greater in the normal CRP group (less than 0.30 mg/dl) than in the abnormal CRP group (more than 0.36 mg/dl) (p = 0.044) and in the normal/borderline CRP group (less than 0.36 mg/dl) than in the high CRP group (more than 0.70 mg/dl) (p < 0.01). The CRP level at RIOP onset may be a useful predictor of relapse after breast-conserving therapy.We investigated the factors predicting radiation-induced organizing pneumonia (RIOP) relapse after tangential breast irradiation. The participants included 23 patients diagnosed with RIOP at the St. Marianna University School of Medicine Hospital betwee

关键词： Radiation-Induced Organizing Pneumonia Breast-Conserving Therapy Tangential Irradiation C-Reactive Protein

Case of autoimmune hepatitis with markedly enlarged hepatoduodenal ligament lymph nodes

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World Journal of Gastroenterology 2013年第11期19卷 1834-1840页

作者： Hideki Fujii Naoki Ohnishi Kazuho Shimura Masafumi sakamoto Tohru Ohkawara Yoshihiko Sawa Koichi Nishida yasuo Ohkawara Tatsuro Kobata Kanji Yamaguchi Yoshito Itoh Department of Internal Medicine Aiseikai Yamashina HospitalShichouno-choTakehanaYamashinakuKyoto 602-8086Japan Department of Gastroenterology and Hepatology Uji Tokushukai HospitalKyoto 611-0042Japan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of MedicineGraduate School of Medical ScienceKyoto 602-8566Japan

Autoimmune hepatitis(AIH) is a necroinflammatory liver disease of unknown etiology.The disease is characterized histologically by interface hepatitis,biochemically by increased aspartate aminotransferase and alanine aminotransferase levels,and serologically by increased autoantibodies and immunoglobulin G levels.Here we discuss AIH in a previously healthy 37-year-old male with highly elevated serum levels of soluble interleukin-2 receptor and markedly enlarged hepatoduodenal ligament lymph nodes(HLLNs,diameter,50 mm).Based on these observations,the differential diagnoses were AIH,lymphoma,or Castleman's disease.Liver biopsy revealed the features of interface hepatitis without bridging fibrosis along with plasma cell infiltration which is the typical characteristics of acute AIH.Lymph node biopsy revealed lymphoid follicles with inflammatory lymphocytic infiltration;immunohistochemical examination excluded the presence of lymphoma cells.Thereafter,he was administered corticosteroid therapy:after 2 mo,the enlarged liver reached an almost normal size and the enlarged HLLNs reduced in size.We could not find AIH cases with such enlarged lymph nodes(diameter,50 mm) in our literature review.Hence,we speculate that markedly enlarged lymph nodes observed in our patient may be caused by a highly activated,humoral immune response in AIH.

关键词： Autoimmune hepatitis Humoral immune response Hepatoduodenal ligament lymph nodes Corticosteroid Hepatomegaly

Malignant lymphoma in the ileum diagnosed by double-balloon enteroscopy

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World Journal of Gastroenterology 2007年第24期13卷 3388-3391页

作者： Kazuko Beppu Taro Osada Akihito Nagahara Naoto sakamoto Tomoyoshi Shibuya Masato Kawabe Takeshi Terai Toshifumi Ohkusa Tatsuo Ogihara Nobuhiro Sato Toshiki Kamano yasuo Hayashida Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine 2-1-1 Hongo Bunkyo-ku Tokyo 113-8421 Japan Department of Coloproctological Surgery Juntendo University School of Medicine dicine 2-1-1 Hongo Bunkyo-ku Tokyo 113-8421 Japan Department of General Medicine Juntendo University School of Medicine 2-1-1 Hongo Bunkyo-ku Tokyo 113-8421 Japan

A 73-year old man presented with abdominal pain. A tumor with central ulceration was observed in the ileum using double-balloon enteroscopy. Histological findings of the biopsy specimens were consistent with malignant lymphoma. Double-balloon enteroscopy confirmed the diagnosis of a malignant lymphoma tumor which was surgically resected. The patient is still in complete remission now.

关键词：淋巴瘤诊断治疗方法症状

Quantitative Assessment of Air Trapping Using Inspiratory and Expiratory Low-Dose Computed Tomography

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Open Journal of Medical Imaging 2015年第4期5卷 199-203页

作者： Yuki Saito Shin Matsuoka Tsuneo Yamashiro Shoichiro Matsushita Akiyuki Kotoku Kunihiro Yagihashi Hayato Tomita Shingo sakamoto Shinji Saruya yasuo Nakajima Department of Radiology St. Marianna University School of Medicine Kawasaki Japan Department of Radiology Graduate School of Medical Science University of the Ryukyus Nishihara Japan

Objective: The purpose of this study was to evaluate the effect of radiation dose reduction on the quantification of air trapping on expiratory CT. Materials and methods: This study was conducted as a retrospective evaluation of inspiratory and expiratory CT studies performed in routine clinical practice before and after alteration of the scanning protocol for expiratory CT at our institute. Eighty-six patients who had a clinical diagnosis of chronic obstructive pulmonary disease (COPD) and underwent inspiratory and expiratory CT and pulmonary function testing (PFT) were included. For the quantitative analysis, CT scans were obtained at six evenly spaced levels from the lung apices to the bases. The area of segmented lung without emphysema between -500 to -950 HU was obtained from the summation of six slices. The relative area between -900 and -950 HU for the area of the segmented lung (RA900-950) was calculated on both the inspiratory and expiratory scans. Comparisons of the RA-change between the standard-dose group (200 mA) and the low-dose group (80 mA) were performed by Mann-Whitney U test. Results: There was no significant difference between the standard-dose group and the low-dose group in the mean RA-change, and RA-change in both the standard-dose and low-dose groups correlated significantly with the results of PFT. In addition, there were no prominent differences in the correlation coefficients between the two groups. Conclusions: Low-dose CT could evaluate air trapping objectively and was not inferior to standard-dose CT for this purpose.

关键词： Chronic Obstructive Pulmonary Disease Emphysema Air Trapping Computed Tomography Quantification

Optimal Minimum Number of CT Slices Required to Measure Cross Sectional Areas of Small Pulmonary Vessels

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Open Journal of Medical Imaging 2015年第2期5卷 71-77页

作者： Shingo sakamoto Shoichiro Matsushita Akiyuki Kotoku Hayato Tomita Yuki Saito Shinji Saruya Shin Matsuoka Tsuneo Yamashiro Atsuko Fujikawa Kunihiro Yagihashi yasuo Nakajima Department of Radiology St. Marianna University School of Medicine Kawasaki Japan Department of Radiology Graduate School of Medical Science University of the Ryukyus Nishihara Japan

The cross-sectional area (CSA) of small pulmonary vessels can be quantified by CT, which is a reliable method of evaluating vascular alterations in such vessels. However, the optimal number of slices required for accurate quantitation remains unknown. We evaluated relationships among all slices at 10-mm interval and all slices at 3-cm interval, 6-cm interval, and 3-slices and found the closest correlation (0.939) between all slices at 10-mm intervals and 3-cm intervals. Thus, all slices at 3-cm intervals are suitable for accurately measuring CSA.

关键词： Computed Tomography Cross-Sectional Area Pulmonary Vessels Quantitative Analysis