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World Journal of Gastroenterology 2014年第4期20卷 1119-1122页

作者： Osamu Dohi Moyu Dohi Ken inoue Yasuyuki Gen Masayasu Jo kazuhiko Tokita Department of Gastroenterology and Hepatology North Medical Center Kyoto Prefectural University of Medicine

A 63-year-old woman was referred to our hospital for further examination because of an incidental finding of early gastric *** submucosal dissection(ESD)was successfully performed for complete resection of the *** the first post-ESD day,the patient suddenly complained of abdominal pain after an episode of *** computed tomography(CT)showed delayed perforation after *** patient was conservatively treated with an intravenous proton pump inhibitor and *** the fifth post-ESD day,CT revealed a gastric wall abscess in the gastric *** revealed a gastric fistula at the edge of the post-ESD ulcer,and pus was found flowing into the *** intradrainage stent and an extradrainage nasocystic catheter were successfully inserted into the abscess for endoscopic transgastric *** the procedure,the clinical symptoms and laboratory test results improved *** months later,a follow-up CT scan showed no collection of ***,the intradrainage stent was *** the gastric wall abscess recurred 2 wk after stent removal,it recovered soon after endoscopic transgastric ***,after stent removal and oral antibiotic treatment for 1 mo,no recurrence of the gastric wall abscess was found.

关键词： Gastric wall abscess Transgastric drainage Delayed perforation Endoscopic submucosal dissection Early gastric cancer

Adult case of an omphalomesenteric cyst resected by laparoscopic-assisted surgery

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World Journal of Gastroenterology 2006年第5期12卷 825-827页

作者： Fumi Sawada Rie Yoshimura Kenichi Ito kazuhiko Nakamura Hajime Nawata Kazuhiro Mizumoto Shuji Shimizu Takahiro inoue Takashi Yao Masazumi Tsuneyoshi Atushi Kondo Naohiko Harada Department of Medicine and Bioregulatory Science Department of Surgery and Oncology Department of Anatomic Pathology Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582FukuokaJapan Department of Gastroenterology Aso Iizuka HospitalIizuka 820-8505FukuokaJapan Department of Gastroenterology Fukuoka Higashi Medical CenterKoga 811-3195FukuokaJapan

This report describes an extremely rare adult case of an omphalomesenteric cyst resected by laparoscopicassisted surgery. A 29-years-old Japanese man was referred and admitted to Kyushu University Hospital because of an abdominal mass and an elevated serum CEA （carcinoembryonic antigen） level （21.3 ng/mL） in August 2001. Abdominal CT and US demonstrated a cystic mass with septum and calcification. Laparoscopy showed a large mass to be attached to his abdominal wall, measuring 110 mm × 70 mm× 50 mm and filled with mucus. The mass was resected by laparoscopicassisted surgery. The histological findings of its wall showed fibromuscular tissue, adipose tissue, calcification, and an intestinal structure. It was finally diagnosed to be an omphalomesenteric cyst.

关键词： Omphalomesenteric cyst Laparoscopicassisted surgery

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Message from Chairs

Message from Chairs

Comparing Oncotype DX Recurrence Score Categories with Immunohistochemically Defined Luminal Subtypes

7th Workshop on RTL and High Level Testing

作者： kazuhiko Iwasaki Tomoo inoue Michiko inoue

＜正＞Welcome to the seventh Workshop on RTL and High Level Testing （WRTLT’06）. The workshop has been held annually to provide an international forum for discussing and exchanging ideas and implementation experienc...

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Journal of Cancer Therapy 2016年第3期7卷 223-231页

作者： Yoshio Mizuno Hiromi Fuchikami Naoko Takeda Junichi Yamada Yuko inoue Hiroshi Seto kazuhiko Sato Department of Breast Oncology Tokyo-West Tokushukai Hospital Tokyo Japan inoue Ladies Clinic Tokyo Japan Department of Clinical Pathology Tokyo-West Tokushukai Hospital Tokyo Japan Seto Hospital Saitama Japan

Background: At the 13th St Gallen International Breast Cancer Conference in 2013, a new definition of luminal A-like and luminal B-like breast cancer was proposed, involving the expression of estrogen receptor (ER), progesterone receptor (PgR), and Ki-67. We examined the rate of concordance between the risk groups using the Oncotype DX recurrence score (RS) and the previous and newly proposed luminal subtypes with the standardized Ki-67 assessment. Method: The relationship between a previously and newly proposed, immunohistochemically defined luminal A and B subtype with the Oncotype DX RS of 41 cases of T1-2 N0-1 M0 (ER positive, HER2 negative) breast cancer was assessed. We first classified the patients into the previously defined luminal A and B subtypes, according to the level of Ki-67 as either “low” (<14%) or “high” (≥14%), as assessed by local pathologists. Next, to consider the necessity for standardizing Ki-67 measurement methods, we re-examined Ki-67 with a central review. By introducing PgR positivity (≥20%), we classified these patients to newly proposed luminal subtypes and compared them with the risk groups stratified by Oncotype DX RS. Results: In the previously proposed luminal subtypes, the concordance rate between luminal A and the low RS category was 76.5% according to local pathologists and 90.1% by central review, whereas the rate between luminal B and the intermediate to high RS category was 46.7% and 45.8%, respectively. In newly proposed luminal subtypes, the concordance rate between luminal A and low RS category was 100% and between the luminal B and intermediate to high RS category was 53.6%. Conclusions: Although this study was based on a retrospective chart review of a small sample size, the newly proposed luminal subtypes including addition of PgR positivity with the standardized Ki-67 assessment appeared to improve the concordance rate especially between luminal A and low RS category.

关键词： Breast Cancer Oncotype DX Ki-67 Standardized Assessment

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios alone or combined with prostate-specific antigen for the diagnosis of prostate cancer and clinically significant prostate cancer

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Asian Journal of Urology 2023年第2期10卷 158-165页

作者： Sat Prasad Nepal Takehiko Nakasato Takashi Fukagai Yoshio Ogawa Yoshihiro Nakagami Takeshi Shichijo Jun Morita Yoshiko Maeda kazuhiko Oshinomi Tsutomu Unoki Tetsuo Noguchi Tatsuki inoue Ryosuke Kato Satoshi Amano Moyuru Mizunuma Masahiro Kurokawa Yoshiki Tsunokawa Sou Yasuda Department of Urology Department of MedicineShowa University School of Medicine1-5-8 HatanodaiShinagawa-kuTokyoJapan

Objective:We evaluated whether the blood parameters before prostate biopsy can diagnose prostate cancer(PCa)and clinically significant PCa(Gleason score[GS]7)in our ***:This study included patients with increased prostate-specific antigen(PSA)up to 20 ng/*** associations of neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)alone or with PSA with PCa and clinically significant PCa were ***:We included 365 patients,of whom 52.9%(193)had PCa including 66.8%(129)with GS of≥*** density(PSAD)and PSA had better the area under the curve(AUC)of 0.722 and 0.585,respectively with pZ0.001 for detecting PCa compared with other blood *** combined with PLR(PsPLR)and PSA with NLR(PsNLR)had better AUC of 0.608 and 0.610,respectively with p<0.05,for diagnosing GS≥7 population,compared with PSA,free/total PSA,NLR,PLR,and PsNPLR(PSA combined with NLR and PLR).NLR and PLR did not predict PCa on multivariate *** GS≥7 cancer detection,in the multivariate analysis,separate models with PSA and NLR(Model 1:PsNLRþbaseline parameters)or PSA and PLR(Moder 2:PsPLRþbaseline parameters)were *** parameters comprised age,digital rectal exam-positive lesions,PSA density,free/total PSA,and magnetic resonance *** 2 containing PsPLR was statistically significant(odds ratio:2.862,95% confidence interval:1.174-6.975,p=0.021)in finding aggressive *** predictive accuracy of Model 2 was increased(AUC:0.734,p<0.001)than that when only baseline parameters were used(AUC:0.693,p<0.001).Conclusion:NLR or PLR,either alone or combined with PSA,did not detect ***,the combined use of PSA with PLR could find the differences between clinically significant and insignificant PCa in our retrospective study limited by the small number of samples.

关键词： Blood parameter Gleason score Neutrophil-tolymphocyte ratio Platelet-tolymphocyte ratio Prostate cancer

The Reliability of Assessment of Ki-67 Expression on Core Needle Biopsy and the Surgical Specimens of Invasive Breast Cancer: Comparison of Local Pathologists’ Assessment and Central Review

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Journal of Cancer Therapy 2012年第5期3卷 841-845页

作者： Yoshio Mizuno Tsuneo Natori Naoko Takeda Junichi Yamada Hiroaki Abe Yuko inoue Hiroshi Seto kazuhiko Sato Clinical Testing Business Testing Division Special Reference Laboratories Inc. Tokyo Japan Department of Breast Oncology Tokyo-West Tokushukai Hospital Tokyo Japan Department of Clinical Pathology Tokyo-West Tokushukai Hospital Tokyo Japan inoue Ladies Clinic Tokyo Japan Seto Hospital Saitama Japan

Purpose: The aim of this study was to assess the reliability of Ki-67 expression on core needle biopsy (CNB) and the surgical specimens of invasive breast cancer. We examined the concordance rate of Ki-67 expressions, hormone receptors, and human epidermal growth factor receptor 2 (HER2) status from a CNB with from a surgery in invasive breast cancer. Methods: A retrospective study was conducted on a clinical database of patients who underwent surgery for early breast cancer. Of these, 193 patients who underwent CNB before the surgery were enrolled. A cut-off value of 20% was used for Ki-67-positive criteria. Expression of estrogen receptor (ER), progesterone receptor (PgR), and HER2 were examined and compared with that of Ki-67. To evaluate discordance between the pathologists’ earlier assessments, we re-examined Ki-67 expression among the Ki-67 discordant group in a central laboratory. Results: The concordance rate for Ki-67 expression between the two specimen types was 77.7%, which was significantly lower than that for ER, PgR, and HER2 expression (95.9%, 88.1%, and 91.6%, respectively). The concordance rate for re-examined Ki-67 expression among the Ki-67 discordant group improved to 93.8% and was not significantly different from that for the other receptors. Conclusion: The concordance rate for Ki-67 expression between biopsy and surgical specimens was significantly lower than that for ER, PgR, and HER2 expressions, but re-examination of Ki-67 expression in a central laboratory revealed no significant difference among the receptors, suggesting the need for standard pathological assessment of Ki-67 expression for clinical use as a predictive marker of breast cancer.

关键词： Ki-67 CNB Concordance Rate Standard Assessment

Standardized Assessment of Ki-67 in Breast Cancer Patients Using Virtual Slides and an Automated Analyzer in Comparison to Central/Local Pathological Assessments

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Journal of Cancer Therapy 2014年第2期5卷 141-146页

作者： Yoshio Mizuno Hiromi Fuchikami Tsuneo Natori Naoko Takeda Yuko inoue Junichi Yamada Hiroaki Abe Hiroshi Seto kazuhiko Sato Clinical Testing Business Testing Division SRL Inc. Tokyo Japan Department of Breast Oncology Tokyo-West Tokushukai Hospital Tokyo Japan Department of Clinical Pathology Tokyo-West Tokushukai Hospital Tokyo Japan inoue Ladies Clinic Tokyo Japan Seto Hospital Tokorozawa Japan

Purpose: To standardize the methods to measure Ki-67, there is an interest in automating the assessment of Ki-67. Therefore, we reviewed the possibility of introducing an automated analyzer to standardize the Ki-67 evaluation method. Methods: We retrospectively reviewed a clinical database of patients who underwent surgery for early breast cancer at Tokyo-West Tokushukai Hospital. Among them, those who underwent preoperative core needle biopsy (CNB) were enrolled. The concordance rates of estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2), and Ki-67 by local pathologists were reviewed (valuations made by local pathologists), and nonmatching cases (from August 2008 to October 2011) were reassessed both by central review and using an automated analyzer with virtual slides. The results were compared with the evaluations made by local pathologists, and we reexamined the concordance rate by using central review and the automated analyzer. Results: The concordance rate of Ki-67 evaluations made by local pathologists in the preoperative CNB and surgical specimens was 78.7% in 287 cases pathologically assessed from October 2008 to March 2013. This rate was significantly lower (p < 0.01) than that of ER (95.6%), PgR (88.5%), and HER2 (91.6%). Reassessment of the 37 cases of nonmatching Ki-67 values from 2008 to October 2011 using central review and an automated analyzer resulted in clear improvement in matching of 22 (92.1%) and 24 (93.1%) of 37 cases, respectively. Conclusion: The concordance rate of Ki-67 in preoperative CNB and surgical specimens was lower than that of other biological markers;however, they were nearly equal by reassessment using central review and an automated analyzer.

关键词： Ki-67 Core Needle Biopsy Concordance Rate Virtual Slides Automated Analyzer Standardized Assessment

Intraoperative Open-Cavity Implant for Accelerated Partial Breast Irradiation Using High-Dose Rate Multicatheter Brachytherapy in Japanese Breast Cancer Patients: A Single-Institution Registry Study

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Journal of Cancer Therapy 2012年第5期3卷 822-830页

作者： kazuhiko Sato Yoshio Mizuno Masahiro Kato Takahiro Shimo Jun Kubota Naoko Takeda Yuko inoue Hiroshi Seto Tomohiko Okawa Department of Breast Oncology Tokyo-West Tokushukai Hospital Tokyo Japan Department of Radiation Oncology Tokyo-West Tokushukai Hospital Tokyo Japan Health Evaluation Center Utsunomiya Memorial Hospital Tochigi Japan inoue Ladies Clinic Tokyo Japan Seto Hospital Saitama Japan

Background: Previous research has compared the efficacies of accelerated partial breast irradiation (APBI) and wholebreast irradiation (WBI). APBI immediately after surgery may provide more benefit after intraoperative insertion of catheters. Although balloon catheter-based APBI is available in the US, it is difficult in Japanese women, who have relatively small breasts. With the applicators being implanted during tumor removal, APBI can be started immediately after surgery. The aim of this study was to assess the safety and efficacy of APBI using the intraoperative open-cavity implant technique. Method: Patients (age≥40 years) with invasive breast cancer (diameter≤3 cm) were enrolled. Before lumpectomy, the insertion of applicators and delivery doses were simulated by computed tomography (CT). After confirmation of free margins and negative sentinel nodes (SNs) using frozen section analysis, applicators were inserted. Postoperative CT-based dose distribution analysis was performed using dose-volume histograms. APBI was started on the day of surgery, delivering 32 Gy in 8 fractions over the following 5-6 days, and it covered a distance of 2 cm from tumor margins. This observational study was approved by the institutional review board of our hospital. Results: From October 2008 to July 2012, 157 women (160 lesions) were enrolled (age 55.0 years, <40:9, SN+: 25, for patients’ request). The mean number of applicators used was 6.4 (2-15) and mean planning target volume was 35.8 cm3 (6.5-137.1 cm3). All radiotherapy-related toxicities were mild. However, 12 patients (7.5%) experienced wound breakdown because of surgical site infection. Two patients developed ipsilateral breast tumor recurrence (1 marginal, 1 at a distant site). Conclusions: Despite the small number of participants and a short follow-up period, our results suggest that this technique could be helpful in establishing clinical safety and efficacy.

关键词： Breast Cancer Partial Breast Irradiation Multicatheter Brachytherapy

Sentinel-Node-Driven Personalized Radiation Techniques Ranging from Partial Breast Irradiation to Regional Nodal Radiation after Breast-Conserving Surgery

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Journal of Cancer Therapy 2013年第7期4卷 49-55页

作者： kazuhiko Sato Yoshio Mizuno Hiromi Fuchikami Masahiro Kato Takahiro Shimo Jun Kubota Naoko Takeda Yuko inoue Hiroshi Seto Tomohiko Okawa Department of Breast Oncology Tokyo-West Tokushukai Hospital Tokyo Japan Department of Radiation Oncology Tokyo- West Tokushukai Hospital Tokyo Japan Health Evaluation Center Utsunomiya Memorial Hospital Tochigi Japan inoue Ladies Clinic Tokyo Japan Seto Hospital Saitama Japan

Background: Breast-conserving surgery (BCS) followed by whole breast irradiation (WBI) has become the standard of care for treating patients with early-stage breast cancer. Recently, various radiation techniques followed by BCS have been reported. We have been investigating “personalized radiotherapy after BCS” ranging from accelerated partial breast irradiation (APBI) to WBI with regional nodal irradiation (RNI) based on the axillary node status. In this study, we compared different cohorts that received personalized radiotherapy. Method: Of 317 consecutive patients who underwent BCS followed by radiotherapy since November 2007, 187 who received APBI and 122 who received WBI were analyzed. Results: The local-only recurrence rate was 1.1% in the APBI group and 3.3% in the WBI group, and the regional-only recurrence rate was 1.1% for APBI and 0.8% for WBI. Conclusions: The clinical efficacy of APBI for local control after BCS was comparable to that of WBI ± RNI. Although this study was based on a small number of patients with a short follow-up period, the feasibility of breast-conserving therapy using multicatheter brachytherapy to achieve acceptable clinical outcomes was demonstrated.

关键词： Breast Cancer Personalized Radiotherapy Sentinel Node Partial Breast Irradiation Regional Nodal Radition