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Present laparoscopic surgery for colorectal cancer in Japan

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World Journal of Clinical Oncology 2016年第2期7卷 155-159页

作者： Takeo Sato masahiko watanabe Department of Surgery Kitasato University School of Medicine

In many clinical studies,laparoscopic surgery(LS) for colon cancer has been shown to be less invasive than open surgery(OS) while maintaining similar ***,there are no significant differences between LS and OS in long-term ***,LS has been accepted as one of the standard treatments for colon *** the treatments of rectal cancer as well,LS has achieved favorable outcomes,with many reports showing long-term outcomes comparable to those of ***,the magnification in laparoscopy improves visualization in the pelvic cavity and facilitates precise manipulation,as well as providing excellent educational *** these reasons,rectal cancer has seemed to be well indicated for LS,as has been colon *** indication for LS in the treatment of locally advanced rectal cancer,which is relatively unresectable(e.g.,cancer invading other organs),remains an open *** recent years,new techniques such as singleport and robotic surgery have begun to be introduced for ***,various clinical studies in our country as well as in most Western countries have demonstrated that LS,with these new techniques,are gradually showing long-term outcomes.

关键词： Laparoscopic surgery Colorectal cancer Colectomy Total mesorectal excision Randomized controlled trial Robotic surgery Single-port surgery

Optimal treatment for Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction: A retrospective cohort study with long-term follow-up

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World Journal of Gastroenterology 2017年第15期23卷 2723-2730页

作者： Kei Hosoda Keishi Yamashita Hiromitsu Moriya Hiroaki Mieno masahiko watanabe Department of Surgery Kitasato University School of Medicine

AIM To determine the optimal treatment strategy for Siewert type Ⅱ and?Ⅲ?adenocarcinoma of the esophagogastric *** We retrospectively reviewed the medical records of 83 patients with Siewert type?Ⅱ?and?Ⅲ?adenocarcinoma of the esophagogastric junction and calculated both an index of estimated benefit from lymph node dissection for each lymph node(LN) station and a lymph node ratio(LNR: ratio of number of positive lymph nodes to the total number of dissected lymph nodes). We used Cox proportional hazard models to clarify independent poor prognostic factors. The median duration of observation was 73 *** Indices of estimated benefit from LN dissection were as follows, in descending order: lymph nodes(LN) along the lesser curvature, 26.5; right paracardial LN, 22.8; left paracardial LN, 11.6; LN along the left gastric artery, 10.6. The 5-year overall survival(OS) rate was 58%. Cox regression analysis revealed that vigorous venous invasion(v2, v3)(HR = 5.99; 95%CI: 1.71-24.90) and LNR of > 0.16(HR = 4.29, 95%CI: 1.79-10.89) were independent poor prognostic factors for *** LN along the lesser curvature, right and left paracardial LN, and LN along the left gastric artery should be dissected in patients with Siewert type?Ⅱ?or?Ⅲ?adenoca rcinoma of the esophagogastric junction. Patients with vigorous venous invasion and LNR of > 0.16 should be treated with aggressive adjuvant chemotherapy to improve survival outcomes.

关键词： Adenocarcinoma of the esophagogastric junction Lymph node ratio Venous invasion Lymph node dissection Prognostic factor

Trend in gastric cancer:35 years of surgical experience in Japan

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World Journal of Gastroenterology 2011年第29期17卷 3390-3397页

作者： Keishi Yamashita Shinichi Sakuramoto Masayuki Nemoto Tomotaka Shibata Hiroaki Mieno Natsuya Katada Shiroh Kikuchi masahiko watanabe Department of Surgery Kitasato University School of MedicineKitasato 1-15-1Minami-kuSagamiharaKanagawa 252-0374Japan

AIM:To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East ***:A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the surgical unit in Kitasato University Hospital,to determine the trend in gastric cancer requiring ***:Gastric cancer requiring surgical resection increased in our hospital,but the incidence adjusted for population was constant during the observed ***,the ratio of diffuse type/intestinal type gastric cancer was unexpectedly unchanged,and that of advanced/early gastric cancer(EGC)was,however,markedly reduced,while the actual incidence of potentially curative advanced gastric cancer tended to *** incidence of EGC requiring surgery tended to increase as a whole,which is consistent with increased prevalence of endoscopic *** a result,overall survival and mortality of gastric cancer requiring gastric resection has recently markedly ***:In Japan,planned interventions may improve surgical gastric cancer mortality,but an unexpected trend of persistent existence of intestinal type cancer suggests the need for more robust medical intervention.

关键词： Histology Age factors Clinical classification Prognosis Disease progression Gastric cancer

Macroscopic appearance of TypeⅣand giant Type Ⅲ is a high risk for a poor prognosis in pathological stage Ⅱ/Ⅲ advanced gastric cancer with postoperative adjuvant chemotherapy

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World Journal of Gastrointestinal Oncology 2017年第4期9卷 166-175页

作者： Keishi Yamashita Akira Ema Kei Hosoda Hiroaki Mieno Hiromitsu Moriya Natsuya Katada masahiko watanabe Department of Gastrointestinal Surgery Kitasato University School of MedicineKanagawa 252-0374Japan

AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage Ⅱ/Ⅲ(p Stage Ⅱ/Ⅲ) gastric *** One hundred and seventy-two advanced gastric cancer(defined as pT2 or beyond) patients with p Stage Ⅱ/Ⅲ who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival(RFS)(35.7%) and overall survival(OS)(34%) than an average risk appearance(P = 0.0003 and P < 0.0001, respectively). A high-risk macroscopic appearance was significantly associated with the 13^(th) Japanese Gastric Cancer Association(JGCA) pT(P = 0.01), but not with the 13^(th) JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13^(th) JGCA p Stage(P < 0.0001)and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified highrisk macroscopic appearance(P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS) as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13^(th) JGCA stage in p Stage Ⅱ/Ⅲ advanced gastric cancer.

关键词： Macroscopic feature Gastric cancer Type Ⅳ Giant type Ⅲ Stage Ⅱ/Ⅲ

Early gastric cancer frequently has high expression of KKLC-1, a cancer-testis antigen

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World Journal of Gastroenterology 2017年第46期23卷 8200-8206页

作者： Nobue Futawatari Takashi Fukuyama Rui Yamamura Akiko Shida Yoshihito Takahashi Yatsushi Nishi Yoshinobu Ichiki Noritada Kobayashi Hitoshi Yamazaki masahiko watanabe Department of Surgery Sagamihara National Hospital Division of Biomedical Research Kitasato University Medical Center Department of Surgery School of MedicineKitasato University Department of Surgery Kitasato University Medical Center Second Department of Surgery School of MedicineUniversity of Occupational and Environmental Health Department of Pathology Kitasato University Medical Center

AIM To assess cancer-testis antigens(CTAs) expression in gastric cancer patients and examined their associations with clinicopathological *** Eighty-three gastric cancer patients were evaluated in this study. Gastric cancer specimens were evaluated for the gene expression of CTAs, Kitakyushu lung cancer antigen-1(KK-LC-1), melanoma antigen(MAGE)-A1, MAGE-A3 and New York esophageal cancer-1(NYESO-1), by reverse transcription PCR. Clinicopathological background information, such as gender, age, tumor size, macroscopic type, tumor histology, depth of invasion, lymph node metastasis, lymphatic invasion, venous invasion, and pathological stage, was obtained. Statistical comparisons between the expression of each CTA and each clinicopathological background were performed using the χ2 test. RESULTS The expression rates of KK-LC-1, MAGE-A1, MAGE-A3, and NY-ESO-1 were 79.5%, 32.5%, 39.8%, and 15.7%, respectively. In early stage gastric cancer specimens, the expression of KK-LC-1 was 79.4%, which is comparable to the 79.6% observed in advanced stage specimens. The expression of KK-LC-1 was not significantly associated with clinicopathological factors, while there were considerable differences in the expression rates of MAGE-A1 and MAGE-A3 with vs without lymphatic invasion(MAGE-A1, 39.3% vs 13.6%, P = 0.034; MAGE-A3, 47.5% vs 18.2%, P = 0.022) and/or vascular invasion(MAGE-A1, 41.5% vs 16.7%, P = 0.028; MAGE-A3, 49.1% vs 23.3%, P = 0.035) and, particularly, MAGE-A3, in patients with early vs advanced stage(36.5% vs 49.0%, P = 0.044), respectively. Patients expressing MAGE-A3 and NYESO-1 were older than those not expressing MAGE-A3 and NY-ESO-1(MAGE-A3, 73.7 ± 7.1 vs 67.4 ± 12.3, P = 0.009; NY-ESO-1, 75.5 ± 7.2 vs 68.8 ± 11.2, P = 0.042). CONCLUSION The KK-LC-1 expression rate was high even in patients with stage I cancer, suggesting that KK-LC-1 is a useful biomarker for early diagnosis of gastric cancer.

关键词： Cancer-testis antigen Kitakyushu lung cancer antigen-1 Melanoma antigen-A1 Melanoma antigen-A3 Gastric cancer New York esophageal cancer-1 Clinicopathological factor early stage

Cancer/testis antigen, Kita-Kyushu lung cancer antigen-1 and ABCD stratification for diagnosing gastric cancers

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World Journal of Gastroenterology 2020年第4期26卷 424-432页

作者： Akiko Shida Takashi Fukuyama Nobue Futawatari Haruki Ohmiya Yoshinobu Ichiki Tetsuro Yamashita Yatsushi Nishi Noritada Kobayashi Hitoshi Yamazaki masahiko watanabe Yoshihito Takahashi Division of Pathology Kitasato UniversitySagamiharaKanagawa 252-0374Japan Division of Biomedical Research Kitasato University Medical CenterKitamotoSaitama 364-8501Japan Division of Surgery Toho UniversityOhashi Medical CenterMegurokuTokyo 153-8515Japan Department of Biological Chemistry and Food Sciences Faculty of AgricultureIwate UniversityMoriokaIwate 020-8505Japan Division of Surgery Kitasato University Medical CenterKitamotoSaitama 364-8501Japan Division of Pathology Kitasato University Medical CenterKitamotoSaitama 364-8501Japan Division of Surgery Kitasato UniversitySagamiharaKanagawa 252-0374Japan

BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(***)]is effective for the classification of individuals at risk of developing gastric cancer(GC).The Kita–Kyushu lung cancer antigen-1(KK-LC-1)is a Cancer/Testis antigen frequently expressed in *** To evaluate the effectiveness of KK-LC-1 and ABCD stratification in the diagnosis of *** We analyzed the gene expression of KK-LC-1 in surgical specimens obtained from GC *** levels of serum PG I/PG II and IgG against *** were *** to their serological status,the patients were classified into the four groups of the ABCD *** Of the 77 examined patients,63(81.8%)expressed *** IgG titers of *** and PG II were significantly higher in patients expressing KK-LC-1 than those measured in patients not expressing KK-LC-1(P=0.0289 and P=0.0041,respectively).The expression of KK-LC-1 in group C[PG method(+)/*** infection(+)]was as high as 93.9%***-LC-1 was also detected in group A[-/-].CONCLUSION The KK-LC-1 expression in GC was associated with *** infection and atrophic status,so that,KK-LC-1 may be a useful marker for the diagnosis of GC.

关键词： Gastric cancer Tumor antigen Cancer/testis antigen Kita–Kyushu lung cancer antigen-1 Helicobacter pylori Early detection of cancer

Mobile Schwannoma of the Cauda Equina for Which Intraoperative Myelography Was Useful in Locating

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Surgical Science 2017年第4期8卷 184-190页

作者： Hiroki Kasama Eiren Toh Joji Mochida masahiko watanabe Department of Orthopaedic Surgery Tokai University Hachioji Hospital Tokyo Japan Yamato Orthopaedic Clinic Kanagawa Japan Department of Orthopaedic Surgery Ebina General Hospital Kanagawa Japan Department of Orthopaedic Surgery Tokai University School of Medicine Kanagawa Japan

We report on a case of a mobile schwannoma of the cauda equina. The patient was a 24-year-old woman who visited our hospital with the chief complaints of low back pain and numbness of the right leg. A tumor was noted from the L2 midbody level to the L3 upper endplate on preoperative MRI and myelogram. During the surgery, a right L2 hemilaminectomy was performed, and the dura was incised, but no tumor was founded in the surgical field, and this was noted as a missing tumor. Intraoperative myelography showed that the tumor had moved to the adjacent vertebra on the caudal side. Myelography applied again to the caudal side of the mobile tumor. Then, the tumor had moved upward, and could be excised without an additional laminectomy.

关键词： Mobile Tumor Schwannoma Intraoperative Myelography Cauda Equina

CB_1 Cannabinoid Receptor-Dependent and-Independent Inhibition of Depolarization-Induced Calcium Influx in Oligodendrocytes

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神经损伤与功能重建 2009年第1期4卷 48-59页

作者： SUSANA MATO ELENA ALBERDI CATHERINE LEDENT masahiko watanabe CARLOS MATUTE Department of Neuroscience Neurotek-University of the Basque CountryTechnological Park CIBERNED Department of NeuroscienceUniversity of the Basque Country Institut de Recherche Interdisciplinaire en Biologie Humaine et Moleculaire Free University of Brussels Department of Anatomy Hokkaido University School of Medicine

Ca2+稳态平衡的调节在少突胶质细胞功能和存活中起重要作用。大麻素CB1和CB2受体在许多细胞中调节Ca2+水平和/或K+电流。本文利用培养的少突胶质细胞中,通过增高细胞外K+浓度(50 mM诱导膜去极化,研究大麻素复合物在此过程引发钙内流中... 详细信息

Ca2+稳态平衡的调节在少突胶质细胞功能和存活中起重要作用。大麻素CB1和CB2受体在许多细胞中调节Ca2+水平和/或K+电流。本文利用培养的少突胶质细胞中,通过增高细胞外K+浓度(50 mM诱导膜去极化,研究大麻素复合物在此过程引发钙内流中的作用。CB2受体激动剂ACEA导致去极化诱导的少突胶质细胞胞浆的Ca2+瞬变表达浓度依赖性抑制,最大效应为(94±3)%,半效应浓度(EC50)为(1.3±0.03)μM。这种作用可被CB2/CB2激动剂CP55、940、内源性大麻素类AEA和2-AG所模拟,但是CB2受体选择性激动剂J WH133没有作用。CB2受体拮抗剂AM251(1μM)也可减少细胞外高K+诱导的Ca2+反应,但不能防止ACEA(3μM)诱发的抑制效应。然而,ACEA和AEA减少去极化诱导的Ca2+瞬变的能力在CB2受体敲除小鼠和经百日咳毒素预处理的少突胶质细胞中明显降低。内流性K+通道阻断剂BaCl2(300μM)和CsCl2(1 mM)降低电压诱导的Ca2+内流并部分阻断ACEA的抑制效应。本文表明,大麻素抑制少突胶质细胞中去极化诱导的Ca2+瞬变是通过包括PTX-敏感的Gi/o蛋白和阻断K+内流通道的CB2受体依赖性和非依赖性机制。

关键词：大麻素类 CB2受体少突胶质细胞离子通道钙髓鞘化

Efficacy of Modified Expansive Open-Door Laminoplasty for Cervical Myelopathy

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Surgical Science 2012年第12期3卷 568-571页

作者： Eiren Toh Yukihiro Yamamoto Daisuke Sakai Masato Sato masahiko watanabe Joji Mochida Department of Orthopaedic Surgery Tokai University Hachioji Hospital Tokyo Japan Department of Orthopaedic Surgery Tokai University School of Medicine Kanagawa Japan

Objectives: Expansive open-door laminoplasty is used widely for the treatment of cervical spondylosis and Ossification of the Posterior Longitudinal Ligament (OPLL). We have developed a unique modification of the surgical procedure to keep the lamina expanded, with the aim of preventing reclosure of the vertebral arch. To examine the effectiveness of and problems associated with the modified expansive open-door laminoplasty technique developed at our institution by evaluating the surgical outcomes. Methods and Materials: Fifty-six patients (46 men and 10 women) underwent the modified expansive open-door laminoplasty and were followed up for at least 1 year. Thirty-eight had Cervical Spondylotic Myelopathy (CSM) and 18 had OPLL. The patients were 34 to 89 years of age (mean: 60.9 years). The severity of myelopathy was evaluated according to the Japanese Orthopaedic Association’s scoring system. Surgical outcomes were evaluated using Hirabayashi’s system for determining recovery rate. In the radiographic analysis, the following angles were measured before and after surgery: lordosis angle and Range of Motion (ROM) at C2 - C7 on lateral radiographs, and opening angle on computerized tomography (CT). The presence and absence of axial pain and postoperative C5 palsy were also evaluated. Results: The rate of JOA score improvement was about 60%, the lordosis angle observed on lateral radiographs was maintained. ROM decreased after surgery in both the CSM and OPLL groups, and the extent of the decrease was similar to that in previous reports. The opening angle of the lamina was 62°- 65° on post-operative CT. Axial pain was reported by 34% of patients. Conclusions: Our modified procedure produced satisfactory postoperative outcomes based on the clinical data and imaging findings for both CSM and OPLL. The advantage of this procedure is that it avoids potential complications associated with bone grafts or implants.

关键词： Cervical Myelopathy Surgical Treatment Middle and Lower Cervical Spine