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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 *** 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 *** and multivariate analyses were used to identify the factors associated with prolonged overall survival of patients in each *** survival rates in the two groups were calculated separately for each modified Japan Integrated Stage score(mJIS score) category by the Kaplan-Meier *** 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 *** 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 ***,on individual evaluation of factors in both groups,stage was significantly(P < 0.001) associ

关键词： Age Hepatocellular carcinoma Liver damage Stage Survival

Relationships of early esophageal cancer with human papillomavirus and alcohol metabolism

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World Journal of Gastroenterology 2020年第39期26卷 6047-6056页

作者： Masaki Inoue Yuichi Shimizu Marin Ishikawa Satoshi Abiko yoshihiko Shimoda Ikko Tanaka Sayoko Kinowaki Masayoshi Ono Keiko Yamamoto Shoko Ono Naoya sakamoto Department of Gastroenterology and Hepatology Graduate School of Medicine and Faculty of MedicineHokkaido UniversitySapporoHokkaido 060-0808Japan of Endoscopy Hokkaido University HospitalSapporoHokkaido 060-8648Japan Department of Cancer Pathology Hokkaido University Graduate School of MedicineSapporoHokkaido 060-0808Japan Department of Gastroenterology Hokkaido University HospitalSapporoHokkaido 060-8648Japan Department of Gastroenterology and Hepatology Hakodate Municipal HospitalHakodateHokkaido 041-8680Japan

BACKGROUND It is well known that an alcohol consumption habit together with inactive heterozygous aldehyde dehydrogenase-2(ALDH2)is an important risk factor for the development of esophageal squamous cell carcinoma(ESCC).It remains controversial whether human papillomavirus(HPV)infection contributes to the occurrence/development of *** has been no study in which the relationship between ESCC and HPV in addition to alcohol dehydrogenase-1B(ADH1B)and ALDH2 genotypes was *** To evaluate relationships between HPV infection and development of esophageal cancer,particularly early esophageal cancer,based on ADH1B/ALDH2 *** We conducted an exploratory retrospective study using new specimens,and we enrolled 145 patients who underwent endoscopic resection for superficial ESCC and had been observed for more than two years by both physical examination and endoscopic examination in Hokkaido University *** was collected to analyze genetic polymorphisms of ADH1B/*** performed in situ hybridization for resected specimens to detect HPV by using an HPV type 16/18 *** HPV was detected in 15(10.3%)of the 145 patients with ***-positive rates in inactive ALDH2*1/*2 and ALDH2*1/*1+*2/*2 were 10.8%and 9.8%,respectively(P=1.00).HPV-positive rates in slow-metabolizing ADH1B*1/*1 and ADH1B*1/*2+*2/*2 were 12.0%and 10.0%,respectively(P=0.72).HPV-positive rates in the heavy or moderate alcohol consumption group and the light or rare consumption group were 11.1%and 8.7%,respectively(P=0.68).HPV-positive rates in the heavy smoking group and the light or no smoking group were 11.8%and 8.3%,respectively(P=0.59).The 3-year incidence rates of secondary ESCC or head and neck cancer after initial treatment in the HPV-positive and HPVnegative groups were 14.4%and 21.4%(P=0.22),*** In the present situation,HPV status is considered to be less important than other risk factors,such as alcohol consumption,smoking habit,AD

关键词： Human papillomavirus Esophageal squamous cell carcinoma Early esophageal cancer Alcohol dehydrogenase-1B Aldehyde dehydrogenase-2 Endoscopic resection

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 *** disease is characterized histologically by interface hepatitis,biochemically by increased aspartate aminotransferase and alanine aminotransferase levels,and serologically by increased autoantibodies and immunoglobulin G *** 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 *** biopsy revealed the features of interface hepatitis without bridging fibrosis along with plasma cell infiltration which is the typical characteristics of acute *** node biopsy revealed lymphoid follicles with inflammatory lymphocytic infiltration;immunohistochemical examination excluded the presence of lymphoma ***,he was administered corticosteroid therapy:after 2 mo,the enlarged liver reached an almost normal size and the enlarged HLLNs reduced in *** could not find AIH cases with such enlarged lymph nodes(diameter,50 mm) in our literature ***,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

The validity of predicting prognosis by the number of lymph node metastases in node-positive colon cancer

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Open Journal of Gastroenterology 2013年第4期3卷 217-222页

作者： Kiichi Sugimoto Masaya Kawai Kazuhiro Takehara yoshihiko Tashiro Shinya Munakata Kiichi Nagayasu Koichiro Niwa Shun Ishiyama Hiromitsu Komiyama Makoto Takahashi Yutaka Kojima Michitoshi Goto Yuichi Tomiki Kazuhiro sakamoto Department of Coloproctological Surgery Faculty of Medicine Juntendo University Tokyo Japan

Background: We examined the possibility of predicting prognosis by the number of lymph node metastases. Methods: Two hundred and forty nine patients with lymph node metastases who underwent curative surgery for colon cancer were enrolled in this study. We calculated cancer-specific survival according to the number of lymph node metastases. Results: There was a tendency toward better rates of cancer-specific survivals among the patients with 1 LNM, compared with those with 2 LNM (p = 0.07). When comparing cancer-specific survival between the patients with 1, 2-3 and 4 or more lymph node metastases, cancer-specific survival was well stratified (p i.e., the patients with 1, 2 and 3 and 4 or more lymph node metastases. This study was in favor of the TNM classification in which N category is classified by the number of lymph node metastases.

关键词： Colon Cancer Lymph Node Metastasis Stage Classification TNM Classification Prognostic Factors

Prognostic factors after palliative resection for colorectal cancer with incurable synchronous liver metastasis

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Open Journal of Gastroenterology 2013年第5期3卷 259-266页

作者： Kiichi Sugimoto Kazuhiro sakamoto Yuichi Tomiki Michitoshi Goto Yutaka Kojima Hiromitsu Komiyama Makoto Takahashi Yukihiro Yaginuma Shun Ishiyama Koichiro Niwa Kiichi Nagayasu Shingo Ito Masaya Kawai Kazuhiro Takehara yoshihiko Tashiro Shinya Munakata Department of Coloproctological Surgery Faculty of Medicine Juntendo University Tokyo Japan

Purpose: With the improvements in newer chemotherapeutic agents, there is currently no consensus regarding the validity of palliative resection of the primary tumor for colorectal cancer with incurable distant metastasis. We retrospectively analyzed prognostic factor in patients with colorectal cancer accompanied by incurable synchronous liver metastasis. Methods: 82 patients with incurable synchronous liver metastases, who underwent primary tumor resection alone, were enrolled. Results: The multivariate analysis revealed that the presence of ascites (P = 0.001, Hazard ratio = 2.96) and differentiation (P = 0.003, Hazard ratio = 3.68) were found to be significant independent prognostic factors. The median survival time among the patients with ascites was 4.8 months and that among the patients with poorly-differentiated or mucinous adenocarcinoma, or signet ring cell carcinoma (high grade differentiation) was 1.4 months, respectively. Conclusion: The presence of ascites and differentiation were prognostic factors in the patients with incurable liver metastases. Therefore, because prognosis is generally poor after primary tumor resection in the patients with ascites or high grade differentiation, the introduction of systemic chemotherapy with alleviation of symptoms related to the primary tumor should be taken into account as one of the therapeutic strategies.

关键词： Colorectal Carcinoma Liver Metastasis Primary Tumor Resection Palliative Resection Systemic Chemotherapy Postoperative Morbidity

Stratifying the risk of lymph node metastasis in undifferentiated-type early gastric cancer

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World Journal of Gastroenterology 2015年第9期21卷 2683-2692页

作者： Yukiko Asakawa Masahiko Ohtaka Shinya Maekawa Mitsuharu Fukasawa Yasuhiro Nakayama Tatsuya Yamaguchi Taisuke Inoue Tomoyoshi Uetake Minoru sakamoto Tadashi Sato yoshihiko Kawaguchi Hideki Fujii Kunio Mochizuki Masao Hada Toshio Oyama Tomotaka Yasumura Kosaku Omata Atsushi Nishiyama Keiichi Naito Hideo Hata Yoshiaki Haba Kazuyuki Miyata Haruhisa Saitoh Yoichi Yamadera Kazuo Miura Akira Kawaoi Tohru Abe Hajime Tsunoda Yuji Honda Masayuki Kurosaki Nobuyuki Enomoto First Department of Internal Medicine Faculty of MedicineUniversity of YamanashiYamanashi 409-3898Japan First Department of Surgery Faculty of MedicineUniversity of YamanashiYamanashi 409-3898Japan Department of Pathology Faculty of MedicineUniversity of YamanashiYamanashi 409-3898Japan Department of Surgery Yamanashi Prefectural Central HospitalYamanashi 400-8506Japan Department of Pathology Yamanashi Prefectural Central HospitalYamanashi 400-8506Japan Department of Surgery Social Insurance Yamanashi HospitalYamanashi 400-0025Japan Department of Pathology Social Insurance Yamanashi HospitalYamanashi 400-0025Japan Department of General Surgery Kofu Kyoritsu HospitalYamanashi 400-0034Japan Department of Pathology Kofu Kyoritsu HospitalYamanashi 400-0034Japan Department of Surgery Kofu Municipal HospitalYamanashi 400-0832Japan Department of Pathology Kofu Municipal HospitalYamanashi 400-0832Japan Department of Surgery Yamanashi Kosei HospitalYamanashi 405-0033Japan Department of Surgery Kanoiwa General HospitalYamanashi 405-0018Japan Department of Pathology Kanoiwa General HospitalYamanashi 405-0018Japan Department of Surgery Social Insurance Kajikazawa HospitalYamanashi 400-0601Japan Department of Surgery Kofu National HospitalYamanashi 400-0006Japan Department of Surgery Fujiyoshida Municipal Medical CenterYamanashi 403-0005Japan Division of Gastroenterology and Hepatology Musashino Red Cross HospitalTokyo 180-0023Japan

AIM:To study how lymph node metastasis(LNM) risk is stratified in undifferentiated-type early gastric cancer(undiff-EGC) dependent on combinations of risk ***:Five hundred and sixty-seven cases with undiff-EGC undergoing gastrectomy with lymphadenectomy were examined *** clinicopathological factors of patient age,location,size,an endoscopic macroscopic tumor form,ulceration,depth,histology,lymphatic involvement(LI) and venous involvement(VI),LNM risk was examined and stratified by conventional statistical analysis and datamining ***:LNM was positive in 44 of 567 cases(7.8%).Univariate analysis revealed > 2 cm,protrusion,submucosal(sm),mixed type,LI and VI as significant prognostic factors and > 2 cm and LI-positive were independent factors by multivariate *** preoperatively evaluable factors excluding LVI,sm and > 2 cm were independent *** to the depth and size,cases were categorized into the low-risk group [m and ≤ 2 cm,0%(LNM incidence)],the moderaterisk group(m and > 2 cm,5.6%; and sm and ≤ 2 cm,6.0%),and the high-risk group(sm and > 2 cm,19.3%).On the other hand,LNM occurred in 1.4% in all LI-negative cases,greatly lower than 28.2% in all LI-positive cases,and LNM incidence was low in LInegative cases even in the moderate- and high-risk ***:LNM-related factors in undiff-EGC were depth and size preoperatively while those were LI and size *** these factors,LI was the most significantly correlated factor.

关键词： Undifferentiated-type early gastric cancer Lymph n