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Brown slits for colorectal adenoma crypts on conventional magnifying endoscopy with narrow band imaging using the X1 system

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World Journal of Gastroenterology 2022年第24期28卷 2748-2757页

作者： Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Hidenobu Watanabe Nariaki Odawara Kosuke Sakitani toru arano Hirotoshi Takiyama Hideyuki Kobayashi Hirofumi Kogure Mitsuhiro Fujishiro Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalChiba 286-8520Japan Department of Pathology Pathology and Cytology Laboratory JapanTokyo 166-0003Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastroenterology Sakitani Endoscopy ClinicChiba 275-0026Japan Department of Gastroenterology The Fraternity Memorial HospitalTokyo 130-8587Japan Department of Surgical Oncology The University of TokyoTokyo 113-8655Japan Department of Internal Medicine Umegaoka Ekimae ClinicTokyo 154-0022Japan

BACKGROUND Accurate diagnosis of colorectal premalignant polyps,including adenomas,is vital in clinical *** To investigate the diagnostic yields of novel findings of brown slits for *** Patients who underwent colonoscopy at the Toyoshima Endoscopy Clinic were *** sized≥5 mm suspected of adenomas or clinically significant serrated polyps were included in the *** defined the surface structures of colorectal polyps,which were brown curves inside and along the tubular glands identified using a combination of a new X1 system(Olympus Corporation)and a conventional magnifying colonoscope with non-staining narrow band imaging(NBI),as brown *** brown slits corresponded to slit-like lumens on endocytoscopy and histological crypt openings of an *** evaluated the diagnostic performance of brown slits for *** A total of 108 Lesions from 62 patients were *** average age was 60.4 years and 41.9%were *** mean polyp size was 7.45±2.83 ***-seven lesions were positive for brown *** diagnosis comprised 59 low-grade tubular adenomas,16 sessile serrated lesions,and 33 hyperplastic *** 59 adenomas,56(94.9%)were positive for brown *** 16 sessile serrated lesions,0(0%)was positive for brown *** 33 hyperplastic polyps,1(3.0%)was positive for brown *** sensitivity,specificity,and accuracy of brown slits for adenoma were 94.9%,98.0%,and 96.3%,*** positive predictive value and negative predictive value of brown slits for adenoma were also excellent for 98.2%,and 94.1%,*** Brown slits on conventional magnifying endoscopy with non-staining NBI using the X1 system were useful for diagnosing colorectal *** new endoscopy system could be examined using new standards.

关键词： Adenoma Colonoscopy Narrow band imaging Magnifying endoscopy X1 Serrated polyp Colorectal neoplasm Endocytoscopy

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Assessment of disease progression in patients with transfusion-associated chronic hepatitis C using transient elastography

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World Journal of Gastroenterology 2012年第12期18卷 1385-1390页

作者： Ryota Masuzaki Ryosuke Tateishi Haruhiko Yoshida toru arano Koji Uchino Kenichiro Enooku Eriko Goto Hayato Nakagawa Yoshinari Asaoka Yuji Kondo Tadashi Goto Hitoshi Ikeda Shuichiro Shiina Masao Omata Kazuhiko Koike Department of Gastroenterology Graduate School of MedicineThe University of Tokyo Department of Clinical Laboratory The University of Tokyo Hospital Yamanashi Prefectural Hospital Organization

METHODS： Between December 2006 and June 2008, a total of 524 transfusion-associated HCV-RNA positive patients with or without HCC were enrolled, Liver stiffness was obtained noninvasively by using Fibroscan （Echosens, Paris, France）, The date of blood transfusion was obtained by interview, Duration of infection was derived from the interval between the date of bloodtransfusion and the date of liver stiffness measurement （LSM）. Patients were stratified into four groups based on the duration of infection （17-29 years; 30-39 years; 40-49 years; and 50-70 years）. The difference in liver stiffness between patients with and without HCC was assessed in each group. Multiple linear regression analysis was used to determine the factors associated with liver stiffness.RESULTS： A total of 524 patients underwent LSM. Eight patients were excluded because of unsuccessful measurements. Thus 516 patients were included in the current analysis （225 with HCC and 291 without）. The patients were 244 men and 272 women, with a mean age of 67.8 ±9.5 years. The median liver stiffness was 14.3 kPa （25.8 in HCC group and 7.6 in non HCC group）. The patients who developed HCC in short duration of infection were male dominant, having lower platelet count, with a history of heavier alcohol consumption, showing higher liver stiffness, and receiving blood transfusion at an old age. Liver stiffness was positively correlated with duration of infection in patients without HCC （r = 0.132, P = 0.024） but not in patients with HCC （r = -0.103, P = 0.123）. Liver stiffness was significantly higher in patients with HCC than in those without in each duration group （P 〈 0.0001）. The factors significantly associated with high liver stiffness in multiple regression were age at blood transfusion （P 〈 0.0001）, duration of infection （P = 0.0015）, and heavy alcohol consumption （P = 0.043）CONCLUSION： Although liver stiffness gradually increases over time, HCC develops in patients with high stiffness value regardle

关键词： Transfusion-associated hepatitis C Transientelastography Hepatocellular carcinoma Liver stiffness Ultrasonography Liver fibrosis

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Impact of looping on premalignant polyp detection during colonoscopy

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World Journal of Gastrointestinal Endoscopy 2022年第11期14卷 694-703页

作者： Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Tatsuya Matsuno toru arano Ryo Kondo Kazunori Kinoshita Yuki Yasumi Yosuke Tsuji Mitsuhiro Fujishiro Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan Department of Obstetrics and Gynecology Seijo Kinoshita HospitalTokyo 157-0066Japan Department of Internal Medicine Yasumi HospitalMorioka 028-4125Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan

BACKGROUND The presence of premalignant polyps on colonoscopy is an indicator of metachronous colorectal *** during colonoscopy is associated with old age,female sex,and colonoscopy insertion ***,the clinical significance of looping is not fully *** aimed to clarify the effect of looping on colorectal premalignant polyp *** To assess the effects of looping on premalignant polyp detection using logistic regression *** We retrospectively investigated patients who underwent colonoscopy at Toyoshima Endoscopy Clinic between May,2017 and October,*** the clinic’s endoscopy database,we extracted data on patient age,sex,endoscopist-assessed looping,colonoscopy duration,endoscopist experience,detection rate,and number of premalignant *** We assessed 12259 patients(mean age,53.6 years;men,50.7%).Looping occurred in 54.3%of the *** and severe looping were noted in 4399 and 2253 patients,*** detection rates of adenomas,advanced adenomas,high-risk adenomas,clinically significant serrated polyps(CSSPs),and sessile serrated lesions(SSLs)were 44.7%,2.0%,9.9%,8.9%and 3.5%,*** mean numbers of adenomas and SSLs were 0.82 and 0.04,*** detection rates of adenomas,high-risk adenomas,and CSSPs increased with looping severity(all P<0.001).The number of adenomas increased with looping severity(P<0.001).Multivariate analyses found that detection of adenomas,high-risk adenomas,and CSSPs was associated with severe looping(P<0.001,P<0.001,and P=0.007,respectively)regardless of age,sex,time required for colonoscope insertion and withdrawal,and endoscopist *** Looping severity was independently associated with high detection rates of premalignant ***,looping may predict the risk of metachronous colorectal *** should carefully examine the colorectum of patients with looping.

关键词： Looping Colorectal polyp Colonoscopy Adenoma Serrated polyp Colorectal neoplasm

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