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Sugano K, Spechler SJ, El-Omar EM, McColl KEL, Takubo K, Gotoda T, Fujishiro M, Iijima K, Inoue H, Kawai T, Kinoshita Y, Miwa H, Mukaisho KI, Murakami K, Seto Y, Tajiri H, Bhatia S, Choi MG, Fitzgerald RC, Fock KM, Goh KL, Ho KY, Mahachai V, O'Donovan M, Odze R, Peek R, Rugge M, Sharma P, Sollano JD, Vieth M, Wu J, Wu MS, Zou D, Kaminishi M, Malfertheiner P. Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction. Gut 2022; 71:1488-1514. [PMID: 35725291 PMCID: PMC9279854 DOI: 10.1136/gutjnl-2022-327281] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/03/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE An international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ. DESIGN Clinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations.A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement. Two rounds of voting and amendments were completed before the meeting at which clinical questions and consensus were finalised. RESULTS Twenty eight clinical questions and statements were finalised after extensive amendments. Critical consensus was achieved: (1) definition for the GOJ, (2) definition of the GOJZ spanning 1 cm proximal and distal to the GOJ as defined by the end of palisade vessels was accepted based on the anatomical distribution of cardiac type gland, (3) chemical and bacterial (Helicobacter pylori) factors as the primary causes of inflammation, metaplasia and neoplasia occurring in the GOJZ, (4) a new definition of Barrett's oesophagus (BO). CONCLUSIONS This international consensus on the new definitions of BO, GOJ and the GOJZ will be instrumental in future studies aiming to resolve many issues on this important anatomic area and hopefully will lead to better classification and management of the diseases surrounding the GOJ.
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Affiliation(s)
- Kentaro Sugano
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Stuart Jon Spechler
- Division of Gastroenterology, Center for Esophageal Diseases, Baylor University Medical Center, Dallas, Texas, USA
| | - Emad M El-Omar
- Microbiome Research Centre, St George & Sutherland Clinical Campuses, School of Clinical Medicine, Faculty of Medicine & Health, Sydney, New South Wales, Australia
| | - Kenneth E L McColl
- Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Kaiyo Takubo
- Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takuji Gotoda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Haruhiro Inoue
- Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Takashi Kawai
- Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan
| | | | - Hiroto Miwa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Kobe, Japan
| | - Ken-ichi Mukaisho
- Education Center for Medicine and Nursing, Shiga University of Medical Science, Otsu, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Oita University Faculty of Medicine, Yuhu, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisao Tajiri
- Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | | | - Myung-Gyu Choi
- Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea
| | - Rebecca C Fitzgerald
- Medical Research Council Cancer Unit, Hutchison/Medical Research Council Research Centre, University of Cambridge, Cambridge, UK
| | - Kwong Ming Fock
- Department of Gastroenterology and Hepatology, Duke NUS School of Medicine, National University of Singapore, Singapore
| | | | - Khek Yu Ho
- Department of Medicine, National University of Singapore, Singapore
| | - Varocha Mahachai
- Center of Excellence in Digestive Diseases, Thammasat University and Science Resarch and Innovation, Bangkok, Thailand
| | - Maria O'Donovan
- Department of Histopathology, Cambridge University Hospital NHS Trust UK, Cambridge, UK
| | - Robert Odze
- Department of Pathology, Tuft University School of Medicine, Boston, Massachusetts, USA
| | - Richard Peek
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Massimo Rugge
- Department of Medicine DIMED, Surgical Pathology and Cytopathology Unit, University of Padova, Padova, Italy
| | - Prateek Sharma
- Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Jose D Sollano
- Department of Medicine, University of Santo Tomas, Manila, Philippines
| | - Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Friedrich-Alexander University Erlangen, Nurenberg, Germany
| | - Justin Wu
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Duowu Zou
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Peter Malfertheiner
- Medizinixhe Klinik und Poliklinik II, Ludwig Maximillian University Klinikum, Munich, Germany,Klinik und Poliklinik für Radiologie, Ludwig Maximillian University Klinikum, Munich, Germany
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2
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Saito Y, Kodashima S, Matsuda T, Matsuda K, Fujishiro M, Tanaka K, Kobayashi K, Katada C, Horimatsu T, Muto M, Ohtsuka K, Oda I, Kato M, Kida M, Hoteya S, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Kato M, Haruma K, Fujimoto K, Iishi H, Ogata H, Uemura N, Kaminishi M, Tajiri H, Inoue H. Current status of diagnostic and therapeutic colonoscopy in Japan: The Japan Endoscopic Database Project. Dig Endosc 2022; 34:144-152. [PMID: 33774877 DOI: 10.1111/den.13980] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/23/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The Japan Endoscopy Database Project was initiated to develop the world's largest endoscopy data repository. This study describes the first phase of the colonoscopy project in Japan. METHODS Data were aggregated offline by integrating information from the endoscopy database software from January 2015 through March 2017. The study population included all patients who underwent colonoscopy at eight centers. RESULTS A total of 31,395 patients who underwent 38,497 colonoscopy procedures were registered. The majority of procedures were performed for screening (n = 14,156), followed by fecal immunochemical test positivity (n = 3960), abdominal symptoms (n = 3864), post-colorectal surgery surveillance (n = 3431), post-endoscopic treatment surveillance (n = 3757), thorough pre-treatment examination (n = 2822), and therapeutic purposes (n = 6507). In the screening group, advanced cancers, early cancers, and adenomas were diagnosed endoscopically in 2.1%, 1.3%, and 28.7% of cases, respectively, while in the fecal immunochemical test-positive group, they were diagnosed in 2.5%, 1.9%, and 41.6% of cases, respectively. The incidence of complications was 0.177% and 0.152% in the screening and fecal immunochemical test-positive groups, respectively. The therapeutic procedures included 1446 cold forceps polypectomy procedures, 4770 cold snare polypectomy procedures, 368 hot biopsies, 2998 hot snare polypectomy procedures, 9775 endoscopic or piecemeal endoscopic mucosal resections, and 1660 endoscopic submucosal dissections. A total of 173 procedure-related complications (0.82%) occurred in 21,017 therapeutic procedures performed in 15,744 patients. CONCLUSIONS The first phase of the Japan Endoscopy Database Project established the proportions of the diagnostic and therapeutic colonoscopy procedures, and complication rates in real-world settings.
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Affiliation(s)
- Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroyasu Iishi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Haruhiko Ogata
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Haruhiro Inoue
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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3
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Uchida S, Suzuki K, Matsunaga T, Takamochi K, Teruya M, Kaminishi M. Extended double sleeve lobectomy combined with thoracic wall resection to treat a huge lung cancer. Multimed Man Cardiothorac Surg 2021; 2021. [PMID: 34927400 DOI: 10.1510/mmcts.2021.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 58-year-old man came to our hospital with numbness of the left arm, fatigue, and fever. A huge solid mass with necrotic changes located in the left upper lobe was noted on the computed tomography scan. The tumor directly invaded the extrathoracic wall, the left main pulmonary artery, and the superior segment of the lower lobe. To avoid pneumonectomy, a combination of an extended double sleeve lobectomy and thoracic wall resection was performed. The postoperative course was uneventful. The patient has survived without any recurrence for 6 months postoperatively.
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Affiliation(s)
- Shinsuke Uchida
- Department of General Thoracic Surgery, Juntendo University Hospital, Japan
| | - Kenji Suzuki
- Department of Cardiovascular Surgery Nippon Medical School Tokyo Japan
| | - Takeshi Matsunaga
- Division of General Thoracic Surgery, Showa General Hospital, Tokyo, Japan
| | - Kazuya Takamochi
- Division of General Thoracic Surgery, Showa General Hospital, Tokyo, Japan
| | - Masanori Teruya
- Division of General Thoracic Surgery, Showa General Hospital, Tokyo, Japan
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4
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Ohta M, Maekawa S, Imazu H, Hatao F, Okumura Y, Kiyonaga H, Sawada Y, Inamori M, Seto Y, Masaki T, Kakuma T, Kasama K, Inomata M, Kitagawa Y, Kaminishi M, Kitano S. Endoscopic intragastric balloon therapy for 15 years in Japan: Results of nationwide surveys. Asian J Endosc Surg 2021; 14:401-407. [PMID: 33084236 DOI: 10.1111/ases.12881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/28/2020] [Accepted: 10/11/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Endoscopic intragastric balloon (IGB) placement has been performed in Japan since 2004. The nationwide surveys were repeatedly carried out to confirm the effectiveness and safety of IGB in Japan. We herein present the accumulated results. METHODS Twenty-six Japanese endoscopists personally imported products of the BioEnterics Intragastric Balloon (BIB)/Orbera system after completing the training courses in Japan. Mail surveys were posted to them every 2 years from 2010. This study included the accumulated data of the six surveys, and excluded data from non-Japanese patients and the Orbera365 data. RESULTS Between 2004 and 2019, 399 obese Japanese patients underwent IGB treatment using the BIB/Orbera system. The incidence rates of early removal of IGB within 1 week and complications due to IGB were 4.8% and 6.1%, respectively. The average percent excess weight loss (%EWL) and percent total weight loss (%TWL) at IGB removal were 46.6% and 11.5%, and successful weight loss, defined as %EWL ≥ 25% or %TWL ≥ 10%, was achieved in 65.6% or 54.5% of the patients, respectively. Multivariate analyses revealed that older age and larger saline filling volume were independent predictors of successful weight loss. At 1 year after IGB removal, successful weight loss defined by the %EWL and %TWL was maintained in 44.7% and 34.1% of the patients, respectively. CONCLUSION IGB therapy using the BIB/Orbera system has been safely and effectively performed in Japan. The successful weight loss may be associated with older age and larger saline filling volume.
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Affiliation(s)
- Masayuki Ohta
- Global Oita Medical Advanced Research Center for Health, Oita University, Oita, Japan
| | - Satoshi Maekawa
- Department of Gastroenterology and Hepatology, Nagano Matsushiro General Hospital, Nagano, Japan
| | | | - Fumihiko Hatao
- Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | | | | | - Yukio Sawada
- Sawada Hepatology & Gastroenterology Clinic, Takarazuka, Japan
| | - Masahiko Inamori
- Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, University of Tokyo, Tokyo, Japan
| | - Takayuki Masaki
- Department of Endocrinology, Rheumatology and Nephrology, Oita University Faculty of Medicine Metabolism, Oita, Japan
| | | | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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5
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Kaminishi M. Congratulatory note to the 100th Congress of the Japan Gastroenterological Endoscopy Society: JGES, past and future. Dig Endosc 2021. [PMID: 34187096 DOI: 10.1111/den.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Michio Kaminishi
- The University of Tokyo, Tokyo, Japan.,Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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6
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Kato M, Tanaka K, Kida M, Ryozawa S, Matsuda K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Katada C, Kobayashi K, Hoteya S, Horimatsu T, Kodashima S, Matsuda T, Muto M, Yamamoto H, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. Multicenter database registry for endoscopic retrograde cholangiopancreatography: Japan Endoscopic Database Project. Dig Endosc 2020; 32:494-502. [PMID: 31361923 DOI: 10.1111/den.13495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/26/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM Few studies have reported on a national, population-based endoscopic retrograde cholangiopancreatography (ERCP) database. Hence, in 2015, we established a multicenter ERCP database registry, the Japan Endoscopic Database (JED) Project in preparation for a nationwide endoscopic database. The objective the present study was to evaluate this registry before the establishment of a nationwide endoscopic database. METHODS From 1 January 2015 to 31 March 2017, we collected and analyzed the ERCP data of all patients who underwent ERCP in four participating centers in the JED Project based on the JED protocol. RESULTS Four centers carried out 4104 ERCP on 2173 patients. Data entry of ERCP information (age, 100%; gender, 100%; American Society of Anesthesiologists Physical Status Classification System, 74.5%; scope, 92.7%; time to ERCP, 100%; antithrombotic drug information, 55.0%; primary selective common bile duct [CBD] cannulation methods, 73.0%; number of attempts at primary selective CBD cannulation, 67.6%; overall selective CBD cannulation methods, 68.9%; ERCP procedure time, 66.3%; fluoroscopy time, 65.1%; adverse events, 74.9%; serum amylase levels 1 day post-ERCP, 36.5%) was accurately extracted from the four centers. Success rate of CBD cannulation by level of ERCP difficulty was 98.5%, 99.0%, and 96.4% in grades 1, 2, and 3, respectively. Complication rate by overall selective CBD cannulation method was 5.6%, 7.6%, and 10.5% in the contrast-assisted technique, guidewire-assisted technique, and cross-over method, respectively. CONCLUSION Data from this evaluation of the JED Project, a multicenter ERCP database registry, suggest the feasibility of establishing a nationwide ERCP database and its challenges.
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Affiliation(s)
- Masayuki Kato
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyohito Tanaka
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Kida
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shomei Ryozawa
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Yutaka Saito
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ichiro Oda
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Chikatoshi Katada
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyonori Kobayashi
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shu Hoteya
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahiro Horimatsu
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shinya Kodashima
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahisa Matsuda
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Manabu Muto
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hironori Yamamoto
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ryuichi Iwakiri
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroaki Miyata
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hisao Tajiri
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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7
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Niikura R, Yamada A, Fujishiro M, Tanaka K, Matsuda K, Saito Y, Ohtsuka K, Oda I, Katada C, Kato M, Kida M, Kobayashi K, Hoteya S, Horimatsu T, Kodashima S, Matsuda T, Muto M, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Shinozaki T, Tajiri H, Koike K. The Effects of Direct Oral Anticoagulants, Warfarin, Aspirin and Thienopyridine on the Performance of Immunochemical, Faecal, Occult Blood Tests. Digestion 2020; 100:117-126. [PMID: 30408803 DOI: 10.1159/000494251] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/01/2018] [Indexed: 02/04/2023]
Abstract
AIM To clarify whether antithrombotic drugs affect diagnosis using the immunochemical faecal occult blood test -(iFOBT) of colorectal neoplasia. METHODS Using the Japan Endoscopy Database from 8 centres between 2015 and 2017, we analyzed data about patients who were iFOBT positive and had received direct oral anticoagulants (DOAC), warfarin, aspirin or thienopyridine. One-to-one matching-analogue propensity score weighted analyses were performed to compare the positive predictive value (PPV) of all neoplasms, invasive and non-invasive colorectal cancers and adenomas between drug users and non-users. All neoplasms included invasive and non-invasive colorectal cancer, and adenomas. RESULTS We analyzed 197 DOAC users and 196 non-users, 153 warfarin users and 153 non-users, 408 aspirin users and 415 non-users, and 97 thienopyridine users and 97 non-users. No significant differences were observed in the PPV for all neoplasms (56.67 vs. 50.43%), invasive cancer (4.32 vs. 3.53%), non-invasive cancer (15.58 vs. 15.56%) or adenoma (53.13 vs. 48.09%) between the DOAC user and non-user groups. No significant differences were observed in the PPV for all neoplasia, invasive and non-invasive cancer, or adenoma between warfarin, aspirin and thienopyridine use and non-users. CONCLUSIONS DOAC, warfarin, aspirin and thienopyridine use did not decrease the PPVs of the iFOBT used to evaluate all colorectal neoplasia.
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Affiliation(s)
- Ryota Niikura
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsuo Yamada
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroaki Miyata
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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8
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Katada C, Horimatsu T, Muto M, Tanaka K, Matsuda K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Kato M, Kida M, Kobayashi K, Hoteya S, Kodashima S, Matsuda T, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. Current status of esophageal endoscopy including the evaluation of smoking and alcohol consumption in Japan: an analysis based on the Japan endoscopy database. Esophagus 2019; 16:174-179. [PMID: 30519821 DOI: 10.1007/s10388-018-0650-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/20/2018] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim was to investigate the current status of esophageal endoscopy, including the evaluation of smoking and alcohol consumption, in Japan. METHODS A total of 47,441 patients who underwent 69,748 sessions of esophageal endoscopy were registered in the Japan Endoscopy Database between January 2015 and March 2017. The study variables were as follows: (1) methods for monitoring the esophagus and the time required for monitoring and (2) the status of smoking and alcohol consumption in patients with esophageal cancer and head and neck cancer. RESULTS Image-enhanced endoscopy was performed in 10.6%, Lugol chromoendoscopy in 4.1%, and magnifying endoscopy in 3.2%. The mean time required for gastrointestinal endoscopy was 10 min 58 s. The mean examination times in patients with or without monitoring of the head and neck were 10 min 51 s and 11 min 13 s, respectively. In 57.0% of the patients with esophageal cancer, the head and neck were monitored at the time of gastrointestinal endoscopy. The proportion of current smokers (esophageal cancer: 16.8-4.7%; head and neck cancer: 24.3-9.3%) and addicted drinkers (esophageal cancer: 52.3-40.8%; head and neck cancer: 50.2-47.3%) were lower at the second or subsequent endoscopy than at the initial endoscopy. CONCLUSIONS The new strategy for esophageal endoscopy has led to an evolutionary change in Japan. The patients with esophageal cancer and head and neck cancer who underwent a second or subsequent endoscopy had lower incidences of smoking and alcohol consumption, although the incidences remained high.
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Affiliation(s)
- Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan. .,Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, 252-0374, Japan.
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroaki Miyata
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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9
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Yoshizawa N, Yamaguchi H, Kaminishi M. Differential diagnosis of solitary gastric Peutz-Jeghers-type polyp with stomach cancer: a case report. Int J Surg Case Rep 2018; 51:261-264. [PMID: 30219660 PMCID: PMC6139994 DOI: 10.1016/j.ijscr.2018.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/21/2018] [Accepted: 09/03/2018] [Indexed: 12/20/2022] Open
Abstract
We experienced a giant Peutz-Jeghers-type polyp in the stomach without features of Peutz-Jeghers syndrome. Solitary Peutz-Jeghers-type polyps of the stomach are extremely rare. We found only 10 reports describing solitary gastric PJ polyps. We present the patient with a comprehensive literature review.
Introduction Solitary Peutz-Jeghers-type polyps of the stomach are extremely rare. They are defined as unique polyps that are not associated with Peutz-Jeghers syndrome (PJS). Presentation of Case A 37-year-old woman presented at our hospital with anemia and epigastric discomfort. Esophagogastroduodenoscopy to determine the cause of anemia revealed a 5 × 6-cm pedunculated polypoid tumor at the greater curvature of the upper gastric body. Pathological examination of a biopsy specimen confirmed a Group 1 hyperplastic polyp. Computed tomography revealed neither lymph node swelling nor distant metastasis. A malignant component of the polypoid tumor was difficult to deny because of its size. The patient underwent local resection of the stomach. Her postoperative course was uneventful. A pathological examination of the surgical specimen revealed a Peutz-Jeghers-type, hamartomatous polyp containing an enlarged crypt with hyperplastic foveolar epithelium and smooth muscle proliferating into the lamina propria. No atypical cells were found in the overlying epithelium. Based on these findings, we performed colonoscopy and capsule endoscopy of the intestine. No polyps were found in the intestine or colon. She had no family history of any type of tumor and no mucocutaneous pigmentation. Discussion There were only 10 reports of solitary gastric Peutz-Jeghers polyps published to date. Although most of them did not have atypical cells, one case has proliferative component. A few reports have described relationship with malignant tumor. Conclusion Solitary gastric PJ-type polyps are rare. Careful follow-up should be recommended and further studies are needed to evaluate cancer risk of solitary gastric PJ-type polyps.
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Affiliation(s)
- Nao Yoshizawa
- Department of Gastroenterological Surgery, Showa General Hospital, Japan.
| | - Hirokazu Yamaguchi
- Department of Gastroenterological Surgery, Showa General Hospital, Japan
| | - Michio Kaminishi
- Department of Gastroenterological Surgery, Showa General Hospital, Japan
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10
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Kodashima S, Tanaka K, Matsuda K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Katada C, Kato M, Kida M, Kobayashi K, Hoteya S, Horimatsu T, Matsuda T, Muto M, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. First progress report on the Japan Endoscopy Database project. Dig Endosc 2018; 30:20-28. [PMID: 28885724 DOI: 10.1111/den.12963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/31/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM The Japan Endoscopy Database (JED) Project was started to develop the world's largest endoscopic database, capture the actual performance of endoscopic practice, and standardize the terminology and fundamental items needed for a clinical and research registry. This paper presents a progress report on the first phase of this project undertaken at eight endoscopic centers in Japan. METHODS The list of data items to be collected was drafted by the MSED-J (Minimal Standard Endoscopic Database) subcommittee. These items were aggregated offline by integrating data from two endoscopic filing systems between July 2015 and December 2015. The study population included all patients who underwent esophagogastroduodenoscopy or colonoscopy at all eight centers, patients who underwent enteroscopy at five of the eight centers, and patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at four of the eight centers. RESULTS Data collected in this phase included 61 070 endoscopic procedures, of which 40 475 were esophagogastroduodenoscopies, 215 were enteroscopies, 19 204 were colonoscopies, and 1176 were ERCPs. Frequencies of complications were 0.68% for esophagogastroduodenoscopy, 0% for enteroscopy, 0.43% for colonoscopy, and 13.34% for ERCP. In addition, we obtained various data including Helicobacter pylori infection status, past history of endoscopy in patients who underwent enteroscopy or colonoscopy, and degree of difficulty of ERCP, although the frequencies of reporting were sometimes low, with some items <20%. CONCLUSION Results of the first phase suggest that the JED project can provide vast quantities of useful data about endoscopic procedures.
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Affiliation(s)
- Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroaki Miyata
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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11
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Matsuda K, Tanaka K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Katada C, Kato M, Kida M, Kobayashi K, Hoteya S, Horimatsu T, Kodashima S, Matsuda T, Muto M, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. Design paper: Japan Endoscopy Database (JED): A prospective, large database project related to gastroenterological endoscopy in Japan. Dig Endosc 2018; 30:5-19. [PMID: 28905472 DOI: 10.1111/den.12964] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/05/2017] [Indexed: 02/08/2023]
Abstract
The advent of electronic medical records brought image filing systems to many hospitals, as well as electronic endoscopic medical records. However, data integration among multiple different vendors has not yet been accomplished. We start the Japan Endoscopic Database (JED) Project endorsed by Japan Gastroenterological Endoscopy Society (JGES) from January 2015. The purposes of this project are as follows: (i) developing the world's largest endoscopic database generated from daily use of the reporting system; (ii) capturing the actual performance of endoscopic practice in Japan; and (iii) standardizing the terminology and fundamental items for registry of clinical studies. Moreover, the JED project has the potential to automatically collect data about adverse events, competency and evaluation of residents, and actual numbers of procedures on a nationwide scale, certification for the specialty board system, and so on. We believe that this design paper will be helpful not only for future nationwide research but also for international research (UMIN000016093).
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Affiliation(s)
- Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan.,JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan.,JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Mitsuhiro Fujishiro
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan.,JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan.,JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Hiroaki Miyata
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | | | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
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12
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Tanabe S, Hirabayashi S, Oda I, Ono H, Nashimoto A, Isobe Y, Miyashiro I, Tsujitani S, Seto Y, Fukagawa T, Nunobe S, Furukawa H, Kodera Y, Kaminishi M, Katai H. Gastric cancer treated by endoscopic submucosal dissection or endoscopic mucosal resection in Japan from 2004 through 2006: JGCA nationwide registry conducted in 2013. Gastric Cancer 2017; 20:834-842. [PMID: 28205058 DOI: 10.1007/s10120-017-0699-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 01/29/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Japanese Gastric Cancer Association (JGCA) initiated a new nationwide gastric cancer registry in 2008 and reported the treatment outcomes of patients with primary gastric cancer who underwent surgical therapy in 2001 and 2003. However, the outcomes of endoscopic therapy have not been reported yet. METHODS The JGCA conducted a retrospective nationwide registry in 2013 to investigate the short-term and long-term outcomes of endoscopic mucosal resection or endoscopic submucosal dissection in patients with gastric cancer treated from January 2004 through December 2006. This registry used a computerized database with terminology in accordance with the JGCA classification (13th and 14th editions) and the Japanese Gastric Cancer Treatment Guidelines from 2010. RESULTS Accurate data on 12,647 patients were collected from 126 participating hospitals and analyzed. The treatment procedure was endoscopic submucosal dissection in 81% of the patients and endoscopic mucosal resection in 19%. En bloc and R0 resections were achieved in 89% and 79% of the patients respectively. The total proportion of patients who underwent curative resection was 69.2%; 43.8% of patients underwent curative resection for absolute indication lesions, and 25.4% underwent curative resection for expanded indication lesions. Emergency surgery was performed to treat bleeding or perforation in very few patients (0.3% and 0.4% respectively). The 5-year follow-up rate after endoscopic resection was 70%. The 5-year overall survival rate was 91.6% in patients with absolute indications and 90.3% in patients with expanded indications after curative resection and 86.5% in patients who underwent noncurative resection. The 5-year disease-specific survival rates were 99.9%, 99.7%, and 98.7% in patients with absolute indications who underwent curative resection, patients with expanded indications who underwent curative resection, and patients who underwent noncurative resection respectively. CONCLUSION Endoscopic resection of gastric cancer resulted in favorable short-term and long-term outcomes nationwide in Japan. Further efforts to increase the follow-up rate are needed.
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Affiliation(s)
- Satoshi Tanabe
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Shigeki Hirabayashi
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Ichiro Oda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Ono
- Endoscopy Division, Shizuoka Cancer Center, Shizuoka, Japan
| | - Atsushi Nashimoto
- Department of Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yoh Isobe
- Department of Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Isao Miyashiro
- Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | | | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Takeo Fukagawa
- Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Souya Nunobe
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Tokyo, Japan
| | | | - Yasuhiro Kodera
- Department of Surgery, Nagoya University School of Medicine, Nagoya, Japan
| | | | - Hitoshi Katai
- Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan
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13
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Yamashita H, Seto Y, Takenaka R, Okuma K, Kiritooshi T, Mori K, Yamada K, Fukuda T, Kaminishi M, Abe O, Nakagawa K. Survival comparison between radical surgery and definitive chemoradiation in 267 esophageal squamous cell carcinomas in a single institution: A propensity-matched study. PLoS One 2017; 12:e0177133. [PMID: 28486551 PMCID: PMC5423615 DOI: 10.1371/journal.pone.0177133] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 04/21/2017] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To compare radical surgery with definitive chemoradiation (CRT) for esophageal squamous cell carcinoma using propensity score (PS) matching at our single institution. MATERIALS AND METHODS A total of 386 consecutive, surgically treated and 243 CRT-treated cases between 2001 and 2014 were analyzed. PS was calculated using multivariable analysis (logistic regression) for pairs of variables such as treatment time, age, sex, primary tumor location, clinical stage, and clinical T- and N-stage for patients after excluding clinical T4 and M1 cases. According to PS, 133 surgically-treated and 134 CRT-treated cases were selected randomly by software. RESULTS The patients' median age was 68 years in the CRT group and 71 years in the surgery group. Clinical stage II-III, T3, N0 (according to the 7th American Joint Committee on Cancer-2009), and upper plus middle thoracic esophageal disease were seen in 68%, 44%, 54%, and 59%, respectively, in the CRT group and 64%, 47%, 55%, and 64%, respectively, in the surgery group. The 3- and 5-year overall survival was 47.1% and 34.0% in the CRT group and 68.3% and 54.4% in the surgery group (p = 0.0019). The 3- and 5-year progression-free survival was 45.3% and 38.8% in the CRT group and 61.1% and 54.4% in the surgery group (p = 0.022). CONCLUSION CRT may be inferior to surgery in survival, although a selection bias for patients selected for a non-operative approach cannot be excluded, especially since surgery is the standard of care at this institution. A prospective randomized clinical trial will be necessary to draw a definite conclusion.
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Affiliation(s)
- Hideomi Yamashita
- Department of Radiology, University of Tokyo Hospital, Tokyo, Japan
- * E-mail:
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, University of Tokyo Hospital, Tokyo, Japan
| | | | - Kae Okuma
- Department of Radiology, University of Tokyo Hospital, Tokyo, Japan
| | | | - Kazuhiko Mori
- Department of Gastrointestinal Surgery, Mitui Memorial Hospital, Tokyo, Japan
| | - Kazuhiko Yamada
- Department of Gastrointestinal Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Fukuda
- Department of Gastrointestinal Surgery, Saitama Cancer Center, Saitama, Japan
| | - Michio Kaminishi
- Department of Gastrointestinal Surgery, Showa General Hospital, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, University of Tokyo Hospital, Tokyo, Japan
| | - Keiichi Nakagawa
- Department of Radiology, University of Tokyo Hospital, Tokyo, Japan
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Terabe F, Aikou S, Aida J, Yamamichi N, Kaminishi M, Takubo K, Seto Y, Nomura S. Columnar Metaplasia in Three Types of Surgical Mouse Models of Esophageal Reflux. Cell Mol Gastroenterol Hepatol 2017; 4:115-123. [PMID: 28593183 PMCID: PMC5453905 DOI: 10.1016/j.jcmgh.2017.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/24/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Esophageal adenocarcinoma develops in the setting of gastroesophageal reflux and columnar metaplasia in distal esophagus. Columnar metaplasia arising in gastroesophageal reflux models has developed in rat; however, gastroesophageal reflux models in mice have not been well-characterized. METHODS One hundred thirty-five C57Bl/6J mice aged 8 weeks old were divided into the following operations: esophagogastrojejunostomy (side-to-side) (EGJ), esophageal separation and esophagojejunostomy (end-to-side) (EJ), and EJ and gastrectomy (end-to-side) (EJ/TG). The animals were euthanized after 40 weeks and the histology of the junction was examined. Immunohistochemistry for p53, PDX-1, and CDX-2 was performed. RESULTS Metaplasia developed in 15/33 (45.5%) of EGJ, 0/38 (0%) of EJ, and 6/39 (15.4%) of EJ/TG (P < .05) and dysplasia developed 7/33 (21.2%) of EGJ, 0% of EJ, and 1/39 (2.6%) of EJ/TG. p53 was positive in all of the dysplastic regions, 12/15 (80%) metaplasias in the EGJ model, and 1/6 (16.7%) metaplasia in the EJ/TG model. CDX-2 was positive in all cases of metaplasias, but decreased in some cases of dysplasia. PDX-1 was positive in 7/8 (88%) cases of dysplasia and in 15/21 (71%) cases of metaplasia (P < .05). CONCLUSIONS The EGJ model, which causes reflux of gastric acid and duodenal content, developed metaplasia and dysplasia most frequently. No metaplasia developed in the EJ model in which gastric juice and duodenal content mixed before reflux. Thus, duodenal contents alone can induce columnar metaplasia and dysplasia; however, the combination of gastric acid with duodenal content reflux can cause metaplasia and dysplasia more efficiently.
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Affiliation(s)
- Fabio Terabe
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Susumu Aikou
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Aida
- Department of Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Nobutake Yamamichi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Kaiyo Takubo
- Department of Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sachiyo Nomura
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Correspondence Address correspondence to: Sachiyo Nomura, MD, PhD, Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyu-ku, Tokyo, Japan 113-8655.fax: +81-3-5800-9734.Department of Gastrointestinal SurgeryGraduate School of MedicineThe University of Tokyo7-3-1, Hongo, Bunkyu-kuTokyoJapan 113-8655
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Hiki N, Mimura Y, Ogawa T, Kojima J, Hatao F, Kaminishi M. Pathophysiological relevance of the CD14 receptor in surgical patients: biological activity of endotoxin is regulated by the CD14 receptor. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/09680519010070060101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Endotoxins (lipopolysaccharides, LPSs) are potent bacterial poisons, and they are always present in the intestine in considerable numbers. Stress, such that as a resulting from multiple injuries, burns, hypovolemia, hypoxia, intestinal ischemia, and surgery can lead to a breakdown of the gut barrier, allowing endotoxins to enter the systemic circulation via translocation. However, estimating the biological activity of translocated circulating endotoxins and identification of the mechanisms regulating their biological activities remain complex problems. CD14 has been found to exist as a soluble protein in the serum and as a glycosylphosphatidylinositol (GPI)-anchored protein of myeloid lineage cells. It plays key roles in both LPS-induced activation and in LPS internalization by cells. In this article, we outline: (i) the biological activity of circulating endotoxin; and (ii) the role of membrane and/or soluble CD14 regulating the bioactivity of circulating endotoxin in a human model of postoperative endotoxemia.
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Affiliation(s)
- Naoki Hiki
- Department of Surgery, University of Tokyo, Tokyo, Japan,
| | | | | | - Junichi Kojima
- Department of Surgery, University of Tokyo, Tokyo, Japan
| | - Fumihiko Hatao
- Department of Surgery, University of Tokyo, Tokyo, Japan
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16
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Ito D, Teruya M, Hata S, Kobayashi K, Kaminishi M. Transverse carcinoma after Miles operation: a case in which preoperative evaluation was assisted by computed tomographic colonography. World J Surg Oncol 2016; 14:118. [PMID: 27094762 PMCID: PMC4837561 DOI: 10.1186/s12957-016-0872-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 04/12/2016] [Indexed: 01/18/2023] Open
Abstract
Background There were only few case reports in which CTC was performed in patients with colostomy. Case Presentation A 68-year-old man was admitted with right abdominal pain and bloody stool that had been present for 2 weeks prior to admission. His medical history included abdominoperineal rectal resection with permanent sigmoid stoma (Miles operation). Colonoscopy showed a sub-occlusive tumor in the transverse colon but provided no information about the proximal colon. Thus, computed tomographic colonography (CTC) was planned to assist our examination of the proximal colon under sigmoid colostomy. CTC revealed the apple core sign in the hepatic flexure, without any evident tumor in the proximal colon. Therefore, we performed transverse colectomy and lymph node dissection, preserving a part of the ascending colon and Bauhin valve. Conclusion CTC examination can be an effective means of preoperatively evaluating the proximal colon in patients with occlusive tumor. Further, CTC examination was technically feasible through a sigmoid stoma.
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Affiliation(s)
- Daisuke Ito
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan.
| | - Masanori Teruya
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan
| | - Shojiro Hata
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan
| | - Kaoru Kobayashi
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan
| | - Michio Kaminishi
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan
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17
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Shimizu A, Hata S, Kobayashi K, Teruya M, Kaminishi M. Intraoperative air leak test was useful for the detection of a small biliary fistula: A rare case of non-parasitic hepatic cysts with biliary communication. Int J Surg Case Rep 2015; 16:1-6. [PMID: 26398333 PMCID: PMC4643437 DOI: 10.1016/j.ijscr.2015.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 09/14/2015] [Indexed: 11/16/2022] Open
Abstract
Non-parasitic hepatic cysts with biliary communication are extremely rare. Overlooking of the communication site may lead to postoperative bile leakage. Air leak test was useful for the detection of the small biliary communication.
Introduction Symptomatic non-parasitic hepatic cysts with biliary communication are rare and no standard treatment has been established yet. Careful attention should be paid to avoidance of postoperative bile leakage during surgical treatment. Presentation of case We report the case of a 74-year-old man who visited our department complaining of right upper abdominal pain and elevated serum levels of the liver enzymes. Computed tomography revealed hepatic cysts including a large one measuring 16 cm in diameter in Segments IV and VIII. Percutaneous drainage of the cyst revealed bile-staining of the cyst fluid. Endoscopic retrograde cholangiography demonstrated the presence of a cyst–biliary communication. We performed open deroofing of the cyst. During the operation, the biliary fistula was invisible, however, air injection into the bile duct through the stump of the cystic duct caused release of air bubbles from the cyst cavity, which allowed us to detect the small biliary orifice and repair it successfully by suture. Discussion We utilized the intraoperative air leak test, which has previously been reported to be effective for preventing postoperative bile leakage in patients undergoing hepatectomy to detect of a small cyst–biliary communication in a case undergoing non-parasitic hepatic cyst surgery. Conclusion An intraoperative air leak test may be a useful test during surgical treatment of non-parasitic hepatic cysts with biliary communication.
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Affiliation(s)
- Atsushi Shimizu
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan.
| | - Shojiro Hata
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan
| | - Kaoru Kobayashi
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan
| | - Masanori Teruya
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan
| | - Michio Kaminishi
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan
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Ito D, Kaneko S, Morita K, Seiichiro S, Teruya M, Kaminishi M. Cecal volvulus caused by endometriosis in a young woman. BMC Surg 2015; 15:77. [PMID: 26099803 PMCID: PMC4477618 DOI: 10.1186/s12893-015-0063-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 06/10/2015] [Indexed: 12/14/2022] Open
Abstract
Background Cecal volvulus is relatively rare. Moreover, to the best of our knowledge, a case of cecal volvulus caused by endometriosis has not yet been reported. Case presentation A 41-year-old woman was admitted to our hospital with a 14-day history of subacute intermittent right lower quadrant abdominal pain. Simple abdominal radiography and abdominal computed tomography findings were suggestive of sigmoid volvulus, and she underwent an emergency colonoscopy. Following colonoscopic reduction, the patient’s symptoms resolved quickly, and elective laparoscopic surgery was scheduled 2 weeks after admission. Intraoperative examination revealed a significantly distended cecum and ascending colon, which was twisted around a short rope-like adhesion that connected the cecum and the mesentery of the transverse colon, whereas the sigmoid colon was neither twisted nor extended. We laparoscopically performed an ileocecal resection. The postsurgery histopathological examination revealed the presence of endometrial tissue in the short rope-like adhesion. This finding confirmed that cecal volvulus in this patient was caused by endometriosis. Conclusion Cecal volvulus should be considered in relatively young women who present with atypical right lower abdominal pain. Whenever possible, secondary factors should be evaluated preoperatively, especially in relatively young patients.
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Affiliation(s)
- Daisuke Ito
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan.
| | - Susumu Kaneko
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan
| | - Kouji Morita
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan
| | | | - Masanori Teruya
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan
| | - Michio Kaminishi
- Department of Gastrointestinal Surgery, Showa General Hospital, 8-1-1, Hanakoganei, Kodaira, Tokyo, 187-8510, Japan
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Obara K, Haruma K, Irisawa A, Kaise M, Gotoda T, Sugiyama M, Tanabe S, Horiuchi A, Fujita N, Ozaki M, Yoshida M, Matsui T, Ichinose M, Kaminishi M. Guidelines for sedation in gastroenterological endoscopy. Dig Endosc 2015; 27:435-449. [PMID: 25677012 DOI: 10.1111/den.12464] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/06/2015] [Indexed: 12/12/2022]
Abstract
Recently, the need for sedation in gastrointestinal endoscopy has been increasing. However, the National Health Insurance Drug Price list in Japan does not include any drug specifically used for the sedation. Although benzodiazepines are the main medication, their use in cases of gastrointestinal endoscopy has not been approved. This has led the Japan Gastrointestinal Endoscopy Society to develop the first set of guidelines for sedation in gastrointestinal endoscopy on the basis of evidence-based medicine in collaboration with the Japanese Society for Anesthesiologists. The present guidelines comprise 14 statements, five of which were judged to be valid on the highest evidence level and three on the second highest level. The guidelines are not intended to strongly recommend the use of sedation for gastrointestinal endoscopy, but rather to indicate the policy as to the choice of appropriate procedures when such sedation is deemed necessary. In clinical practice, the final decision as to the use of sedation should be made by physicians considering patient willingness and physical condition.
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Affiliation(s)
| | - Ken Haruma
- The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Atsushi Irisawa
- The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuru Kaise
- The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takuji Gotoda
- The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Satoshi Tanabe
- The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Akira Horiuchi
- The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naotaka Fujita
- The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Makoto Ozaki
- The Japanese Society of Anesthesiologists, Tokyo, Japan
| | | | | | - Masao Ichinose
- The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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Ito D, Miki K, Seiichiro S, Hata S, Kobayashi K, Teruya M, Kaminishi M. Clinical and computed tomography findings of appendiceal diverticulitis vs acute appendicitis. World J Gastroenterol 2015; 21:3921-3927. [PMID: 25852277 PMCID: PMC4385539 DOI: 10.3748/wjg.v21.i13.3921] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 09/11/2014] [Accepted: 10/21/2014] [Indexed: 02/07/2023] Open
Abstract
AIM: To study the clinical features and computed tomography (CT) findings of appendiceal diverticulitis vs acute appendicitis.
METHODS: We retrospectively reviewed the records of 451 patients who had undergone appendectomy in our institution from January 2007 to September 2012. Patient demographics, clinical features, pathological findings, and surgical outcomes were analyzed. We also compared preoperative CT images of 25 patients with appendiceal diverticulitis with those of 25 patients with acute appendicitis.
RESULTS: Among 451 patients, 44 (9.7%) were diagnosed to have appendiceal diverticulitis and 398 (86.9%) to have acute appendicitis. Patients with appendiceal diverticulitis were older (59 vs 37 years, P < 0.001) and had a longer duration of the illness (4.0 d vs 1.0 d, P < 0.001). Perforation rates in patients with appendiceal diverticulitis were higher (68% vs 27%, P < 0.001). The appendix could be visualized in only 13 patients (52%) among the appendiceal diverticulitis cases, but in all acute appendicitis cases. CT findings suggestive of appendiceal diverticulitis included the absence of fluid collection in the appendix (84% vs 12%, P < 0.001), absence of appendicolith (92% vs 52%, P = 0.005), and formation of abscess (68% vs 16%, P < 0.001). Appendiceal diverticula were identified in 6 patients (24%).
CONCLUSION: Among patients who had undergone appendectomy, 9.7% had appendiceal diverticulitis. Patients with appendiceal diverticulitis had different clinical features and CT findings from patients with acute appendicitis.
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Ito D, Hata S, Seiichiro S, Kobayashi K, Teruya M, Kaminishi M. Amebiasis presenting as acute appendicitis: Report of a case and review of Japanese literature. Int J Surg Case Rep 2014; 5:1054-7. [PMID: 25460473 PMCID: PMC4275826 DOI: 10.1016/j.ijscr.2014.10.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 10/02/2014] [Accepted: 10/09/2014] [Indexed: 11/16/2022] Open
Abstract
The overall mortality rate reported in the studies in Japan (25%) is considerably higher than that reported in a systematic review conducted of similar studies in other countries (3.3%). Japan is a low-risk area for amebiasis, and many physicians fail to consider amebiasis in the differential diagnosis of acute appendicitis. In all of the cases, the diagnosis occurred only after surgery. It is important to conduct further examinations, including those for amebiasis, when appendectomy does not resolve acute appendicitis.
INTRODUCTION Outside of these high-risk regions, acute amebic appendicitis is considerably rarer and the mortality rate is much higher than with non-amebic appendicitis. PRESENTATION OF CASE A 31-year-old woman presented with fever and right lower abdominal pain with no history of traveling abroad or sexual infection. Computed tomography revealed a dilated appendix and thickened cecal and ascending colon walls. She underwent an appendectomy for appendicitis. Owing to a lack of symptom resolution, we performed a pathologic examination of the appendix again that revealed multiple Entamoeba histolytica trophozoites; the serum amebic antibody was positive. She was treated postoperatively with metronidazole for amebiasis and discharged on postoperative day 12. DISCUSSION The mortality rate and frequency of severe postoperative intraabdominal complications were higher in the Japanese literature (1995–2013) (25% and 33%, respectively) than in other developed countries (3.3% and 19.4%, respectively). Japan is a low-risk area for amebiasis; many physicians fail to consider amebiasis in the differential diagnosis of acute abdomen. It is important to conduct further examinations, including those for amebiasis, when appendectomy does not resolve acute appendicitis. CONCLUSION We report a case of acute amebic appendicitis in a 31-year-old woman and review the ages at presentation, causative factors, treatments, and outcomes of 11 cases reported in Japan between 1995 and 2013.
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Affiliation(s)
- Daisuke Ito
- Department of Gastrointestinal Surgery, Showa General Hospital, Tokyo, Japan.
| | - Shojirou Hata
- Department of Gastrointestinal Surgery, Showa General Hospital, Tokyo, Japan
| | | | - Kaoru Kobayashi
- Department of Gastrointestinal Surgery, Showa General Hospital, Tokyo, Japan
| | - Masanori Teruya
- Department of Gastrointestinal Surgery, Showa General Hospital, Tokyo, Japan
| | - Michio Kaminishi
- Department of Gastrointestinal Surgery, Showa General Hospital, Tokyo, Japan
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Kobayashi T, Kawakamil M, Hara Y, Shioiri S, Yasuno M, Teruya M, Kaminishi M. Combined evaluation of the Glasgow prognostic score and carcinoembryonic antigen concentration prior to hepatectomy predicts postoperative outcomes in patients with liver metastasis from colorectal cancer. Hepatogastroenterology 2014; 61:1359-1362. [PMID: 25436311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIMS Little is known about the ability of the inflammation-based Glasgow prognostic score (GPS). METHODOLOGY 106 patients who underwent curative resection for colorectal liver metastasis (CRLM) were analyzed. Patients with an elevated Creactive protein concentration (>10 mg/L) and hypoalbuminemia (<35 g/L) at admission were assigned a GPS 2, those with only 1 of these biochemical abnormalities were assigned a GPS 1, and those without either abnormality were assigned a GPS 0. RESULTS Multivariate analysis showed that 2 variables, carcinoembryonic antigen (CEA) concentration > 30 ng/mL and a GPS 1 or 2, were independently prognostic of survival. Patients were classified into 3 groups on the basis of these 2 variables. Patients with GPS 1 or 2 and CEA concentration > 30 ng/mL were assigned a new score of 2, those with either 1 factor were assigned a new score of 1, and those with neither factors were assigned a new score of 0. The 5-year overall survival rates of new scores of 0, 1, 2 were 71.5%, 31.6%, and 0%, respectively (P < 0.0001). CONCLUSIONS This simple staging system may be able to identify a subgroup of patients who are eligible for curative resection but show poor prognosis.
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Sato Y, Imamura H, Kaizaki Y, Koizumi W, Ishido K, Kurahara K, Suzuki H, Fujisaki J, Hirakawa K, Hosokawa O, Ito M, Kaminishi M, Furuta T, Chiba T, Haruma K. Management and clinical outcomes of type I gastric carcinoid patients: retrospective, multicenter study in Japan. Dig Endosc 2014; 26:377-84. [PMID: 24188531 DOI: 10.1111/den.12197] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 09/27/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Type I gastric carcinoids (TIGC) are associated with chronic atrophic gastritis (CAG) with hypergastrinemia and hyperplasia of enterochromaffin-like cells. Several treatment options are currently available for these tumors including total gastrectomy, partial resection, antrectomy, endoscopic resection and endoscopic surveillance. The present study evaluated different treatment approaches and clinical outcomes of patients with TIGC in Japan. METHODS Between 1991 and 2011, 82 patients with TIGC were identified at multicenter institutions in Japan. Patient demographics, tumor size, depth of invasion, vessel involvement, treatment approach, Helicobacter pylori infection, serum gastrin level, recurrence-free survival (RFS) and disease-specific survival (DSS) were analyzed. RESULTS Median age of all patients at the time of diagnosis was 56 years (range, 24-79 years). There were 44 males and 38 females. Patients underwent endoscopic surveillance (n=25), endoscopic resection (n=41) or surgical resection (n=16). Intramucosal invasion was found in 19 patients, submucosal invasion in 44 patients and muscularis propria invasion in one patient. Tumor diameter was ≤ 10 mm in 71 patients, 11-20mm in five patients and ≥ 21 mm in five patients. None of the patients showed rapidly growing tumors, local recurrence or metastasis. The median (range) follow-up period was 7(0-20) years. RFS was 97.6% and DSS was 100% in all the patients. CONCLUSION The prognosis of TIGC patients treated by different modalities in Japan is favorable regardless of the generational change of management for TIGC.
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Affiliation(s)
- Yuichi Sato
- Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Hirabayashi S, Kosugi S, Isobe Y, Nashimoto A, Oda I, Hayashi K, Miyashiro I, Tsujitani S, Kodera Y, Seto Y, Furukawa H, Ono H, Tanabe S, Kaminishi M, Nunobe S, Fukagawa T, Matsuo R, Nagai T, Katai H, Wakai T, Akazawa K. Development and external validation of a nomogram for overall survival after curative resection in serosa-negative, locally advanced gastric cancer. Ann Oncol 2014; 25:1179-84. [PMID: 24669009 DOI: 10.1093/annonc/mdu125] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Few nomograms can predict overall survival (OS) after curative resection of advanced gastric cancer (AGC), and these nomograms were developed using data from only a few large centers over a long time period. The aim of this study was to develop and externally validate an elaborative nomogram that predicts 5-year OS after curative resection for serosa-negative, locally AGC using a large amount of data from multiple centers in Japan over a short time period (2001-2003). PATIENTS AND METHODS Of 39 859 patients who underwent surgery for gastric cancer between 2001 and 2003 at multiple centers in Japan, we retrospectively analyzed 5196 patients with serosa-negative AGC who underwent Resection A according to the 13th Japanese Classification of Gastric Carcinoma. The data of 3085 patients who underwent surgery from 2001 to 2002 were used as a training set for the construction of a nomogram and Web software. The data of 2111 patients who underwent surgery in 2003 were used as an external validation set. RESULTS Age at operation, gender, tumor size and location, macroscopic type, histological type, depth of invasion, number of positive and examined lymph nodes, and lymphovascular invasion, but not the extent of lymphadenectomy, were associated with OS. Discrimination of the developed nomogram was superior to that of the TNM classification (concordance indices of 0.68 versus 0.61; P < 0.001). Moreover, calibration was accurate. CONCLUSIONS We have developed and externally validated an elaborative nomogram that predicts the 5-year OS of postoperative serosa-negative AGC. This nomogram would be helpful in the assessment of individual risks and in the consideration of additional therapy in clinical practice, and we have created freely available Web software to more easily and quickly predict OS and to draw a survival curve for these purposes.
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Affiliation(s)
- S Hirabayashi
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata
| | - S Kosugi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata
| | - Y Isobe
- Department of Surgery, National Hospital Organization Tokyo Medical Center, Tokyo
| | - A Nashimoto
- Department of Surgery, Niigata Cancer Center Hospital, Niigata
| | - I Oda
- Endoscopy Division, National Cancer Center Hospital, Tokyo
| | - K Hayashi
- Department of Surgery, Yamagata Prefectural Kahoku Hospital, Yamagata
| | - I Miyashiro
- Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka
| | - S Tsujitani
- Center for Clinical and Translational Research, National Center for Global Health and Medicine, Tokyo
| | - Y Kodera
- Department of Surgery II, Nagoya University School of Medicine, Nagoya
| | - Y Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo
| | - H Furukawa
- Department of Surgery, Kinki University Faculty of Medicine, Osaka
| | - H Ono
- Endoscopy Division, Shizuoka Cancer Center Hospital, Shizuoka
| | - S Tanabe
- Department of Gastroenterology, Kitasato University East Hospital, Sagamihara
| | - M Kaminishi
- Department of Surgery, Showa General Hospital, Tokyo
| | - S Nunobe
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Tokyo
| | - T Fukagawa
- Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - R Matsuo
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata
| | - T Nagai
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata
| | - H Katai
- Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - T Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata
| | - K Akazawa
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata
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Fujishiro M, Kaminishi M, Hiki N, Oda I, Fujisaki J, Uedo N, Kaise M, Tanabe S, Iguchi M, Matsuhashi N, Nomura S, Tajiri H, Yahagi N, Suzuki H. Efficacy of spraying l-menthol solution during endoscopic treatment of early gastric cancer: a phase III, multicenter, randomized, double-blind, placebo-controlled study. J Gastroenterol 2014; 49:446-54. [PMID: 23800946 DOI: 10.1007/s00535-013-0856-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 06/15/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND The topical antispasmodic agent l-menthol is useful for inhibiting gastric peristalsis during diagnostic upper gastrointestinal endoscopy. However, it remains unclear whether l-menthol is similarly effective during therapeutic endoscopy, thereby improving treatment outcomes in a clinical setting. METHODS A total of 83 patients scheduled to undergo endoscopic treatment at 8 Japanese referral centers were randomly assigned to receive l-menthol or placebo. The degree of gastric peristalsis (peristaltic score: grade 1-5) was assessed by an independent committee. The primary outcome was the proportion of subjects in whom no or mild peristalsis (grade 1 or 2) was maintained throughout endoscopic treatment. Secondary outcomes were the duration of sustained response and the incidence of adverse drug reactions. RESULTS The proportion of patients with no or mild peristalsis was significantly higher in the l-menthol group (85.4 %, 95 % confidence intervals 70.8-94.4: 35/41 subjects) than in the placebo group (39.0 %, 24.2-55: 16/41; P < 0.001). The sustained response rates in the l-menthol and the placebo were, respectively, 90.0 and 39.6 % 30 min post-dose, and 79.9 and 35.7 % at the completion of the resection. The sustained response rates were significantly higher in the l-menthol group than in the placebo group (P < 0.001, log-rank test). The incidence of adverse drug reactions did not differ significantly between the two groups (P = 1.000). CONCLUSIONS During gastric endoscopic submucosal dissection, spraying l-menthol on the gastric mucosa significantly suppressed peristalsis, with minimal adverse drug reactions as compared with placebo. l-menthol solution might be useful for therapeutic endoscopy.
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Affiliation(s)
- Mitsuhiro Fujishiro
- Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,
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26
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Aikou S, Aida J, Takubo K, Yamagata Y, Seto Y, Kaminishi M, Nomura S. Columnar metaplasia in a surgical mouse model of gastro-esophageal reflux disease is not derived from bone marrow-derived cell. Cancer Sci 2013; 104:1154-61. [PMID: 23734763 DOI: 10.1111/cas.12213] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 05/20/2013] [Accepted: 06/01/2013] [Indexed: 12/20/2022] Open
Abstract
The incidence of esophageal adenocarcinoma has increased in the last 25 years. Columnar metaplasia in Barrett's mucosa is assumed to be a precancerous lesion for esophageal adenocarcinoma. However, the induction process of Barrett's mucosa is still unknown. To analyze the induction of esophageal columnar metaplasia, we established a mouse gastro-esophageal reflux disease (GERD) model with associated development of columnar metaplasia in the esophagus. C57BL/6 mice received side-to-side anastomosis of the esophagogastric junction with the jejunum, and mice were killed 10, 20, and 40 weeks after operation. To analyze the contribution of bone marrow-derived cells to columnar metaplasia in this surgical GERD model, some mice were transplanted with GFP-marked bone marrow after the operation. Seventy-three percent of the mice (16/22) showed thickened mucosa in esophagus and 41% of mice (9/22) developed columnar metaplasia 40 weeks after the operation with a mortality rate of 4%. Bone marrow-derived cells were not detected in columnar metaplastic epithelia. However, scattered epithelial cells in the thickened squamous epithelia in regions of esophagitis did show bone marrow derivation. The results demonstrate that reflux induced by esophago-jejunostomy in mice leads to the development of columnar metaplasia in the esophagus. However, bone marrow-derived cells do not contribute directly to columnar metaplasia in this mouse model.
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Affiliation(s)
- Susumu Aikou
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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27
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Miki K, Matsui Y, Teruya M, Kaminishi M, Kokudo N. Index of convexity: A novel liver function index using Tc-GSA scintigraphy. World J Gastroenterol 2013; 19:92-96. [PMID: 23326168 PMCID: PMC3542746 DOI: 10.3748/wjg.v19.i1.92] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 10/20/2012] [Accepted: 11/15/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the clinical usefulness of a newly developed index, the “index of convexity (IOC)”, for evaluating liver functional reserve using technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (Tc-GSA scintigraphy).
METHODS: In total, 349 patients underwent Tc-GSA scintigraphy. Dynamic planner images were obtained, and time activity curves of the liver and heart were generated and analyzed. Our focus was on the convex shape of the liver accumulation curve. We developed a method for evaluating the extent of convexity and calculated an index that we named the IOC. Clearance index and receptor index were also calculated. The correlations between each GSA index with other liver function tests and liver histopathology were evaluated.
RESULTS: Among the 3 indices generated by Tc-GSA, the IOC had the highest correlation with all other liver function tests (indocyanine green R15, albumin, prothrombin time, cholinesterase level, platelet count, and total bilirubin level). IOC can also differentiate between normal liver, chronic hepatitis, and liver cirrhosis with highest F ratio among GSA indices as determined by one-way analysis of variance. Receiver operating characteristic analysis demonstrated high diagnostic performance of IOC in the diagnosis of cirrhosis.
CONCLUSION: IOC is a very simple and reliable index for assessing liver functional reserve, which may prove to be useful in combination with the indocyanine green test for preoperative assessment of hepatic resection.
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Nashimoto A, Akazawa K, Isobe Y, Miyashiro I, Katai H, Kodera Y, Tsujitani S, Seto Y, Furukawa H, Oda I, Ono H, Tanabe S, Kaminishi M. Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry. Gastric Cancer 2013; 16:1-27. [PMID: 22729699 PMCID: PMC3549249 DOI: 10.1007/s10120-012-0163-4] [Citation(s) in RCA: 347] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 04/30/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Japanese Gastric Cancer Association (JGCA) started a new nationwide gastric cancer registration in 2008. METHODS From 208 participating hospitals, 53 items including surgical procedures, pathological diagnosis, and survival outcomes of 13,626 patients with primary gastric cancer treated in 2002 were collected retrospectively. Data were entered into the JGCA database according to the JGCA classification (13th edition) and UICC TNM classification (5th edition) using an electronic data collecting system. Finally, data of 13,002 patients who underwent laparotomy were analyzed. RESULTS The 5-year follow-up rate was 83.3 %. The direct death rate was 0.48 %. UICC 5-year survival rates (5YEARSs)/JGCA 5YEARSs were 92.2 %/92.3 % for stage IA, 85.3 %/84.7 % for stage IB, 72.1 %/70.0 % for stage II, 52.8 %/46.8 % for stage IIIA, 31.0 %/28.8 % for stage IIIB, and 14.9 %/15.3 % for stage IV, respectively. The proportion of patients more than 80 years old was 7.8 %, and their 5YEARS was 51.6 %. Postoperative outcome of the patients with primary gastric carcinoma in Japan have apparently improved in advanced cases and among the aged population when compared with the archival data. Further efforts to improve the follow-up rate are needed. CONCLUSIONS Postoperative outcome of the patients with primary gastric carcinoma in Japan have apparently improved in advanced cases and among the aged population when compared with the archival data. Further efforts to improve the follow-up rate are needed.
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Affiliation(s)
- Atsushi Nashimoto
- Department of Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuo-ku, Niigata, 951-8566 Japan
| | - Kohei Akazawa
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yoh Isobe
- Department of Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Isao Miyashiro
- Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Hitoshi Katai
- Department of Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Kodera
- Department of Surgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Shunichi Tsujitani
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | | | - Ichiro Oda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Ono
- Endoscopy Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Satoshi Tanabe
- Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa, Japan
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Yamagata Y, Aikou S, Fukushima T, Kataoka H, Seto Y, Esumi H, Kaminishi M, Goldenring JR, Nomura S. Loss of HGF activator inhibits foveolar hyperplasia induced by oxyntic atrophy without altering gastrin levels. Am J Physiol Gastrointest Liver Physiol 2012; 303:G1254-61. [PMID: 23064758 PMCID: PMC4888532 DOI: 10.1152/ajpgi.00107.2012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Spasmolytic polypeptide/trefoil family factor 2 expressing metaplasia (SPEM) is induced by oxyntic atrophy and is known as a precancerous or paracancerous lesion. We now have sought to determine whether hepatocyte growth factor (HGF) influences the development of SPEM and oxyntic atrophy. DMP-777, a parietal cell ablating reagent, was administered to HGF activator (HGFA)-deficient mice and wild-type mice. Gastric mucosal lineage changes were analyzed in the DMP-777 treatment phase and recovery phase. Both wild-type and HGFA knockout mice showed SPEM, and there was no difference in SPEM development. However, after cessation of DMP-777, HGFA-deficient mice showed delayed recovery from SPEM compared with wild-type mice. Foveolar cell hyperplasia and the increase in proliferating cells after parietal cell loss were reduced in HGFA-deficient mice. The HGFA does not affect emergence of SPEM. However, the absence of HGFA signaling causes a delay in the recovery from SPEM to normal glandular composition. HGFA also promotes foveolar cell hyperplasia and mucosal cell proliferation in acute oxyntic injury.
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Affiliation(s)
- Yukinori Yamagata
- 1Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan;
| | - Susumu Aikou
- 1Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan;
| | - Tsuyoshi Fukushima
- 2Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan;
| | - Hiroaki Kataoka
- 2Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan;
| | - Yasuyuki Seto
- 1Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan;
| | - Hiroyasu Esumi
- 3Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Japan;
| | | | - James R. Goldenring
- 5Nashville Veterans Affairs Medical Center and the Departments of Surgery and Cell and Developmental Biology, Epithelial Biology Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Sachiyo Nomura
- 1Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan;
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Affiliation(s)
- Michio Kaminishi
- Japan Gastroenterological Endoscopy Society, Showa General Hospital, Tokyo, Japan
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Hiki N, Kaminishi M, Yasuda K, Uedo N, Kobari M, Sakai T, Hiratsuka T, Ohno K, Honjo H, Nomura S, Yahagi N, Tajiri H, Suzuki H. Multicenter phase II randomized study evaluating dose-response of antiperistaltic effect of L-menthol sprayed onto the gastric mucosa for upper gastrointestinal endoscopy. Dig Endosc 2012; 24:79-86. [PMID: 22348831 DOI: 10.1111/j.1443-1661.2011.01163.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM Peppermint oil solution was found to be effective for reducing gastric spasm during upper gastrointestinal endoscopy. The aim of the present study was to assess whether the gastric peristalsis-suppressing effect is dose-dependently induced by L-menthol, the major constituent of peppermint oil, and to determine the recommended dose of an L-menthol preparation. METHODS In this phase II, multicenter, double-blind, dose-response study, 131 eligible patients were randomly assigned to receive 20 mL of 0.4% L-menthol (n = 32), 0.8% L-menthol (n = 35), 1.6% L-menthol (n = 30), or placebo (n = 34). The primary efficacy measure was the proportion of subjects with no peristalsis in two time periods, 75 to 105 s after treatment and immediately before the completion of endoscopy. RESULTS The peristalsis-suppressing effect of L-menthol increased dose dependently (5.6%, 32.0%, 47.4% and 52.9% in the 0%, 0.4%, 0.8% and 1.6% groups, respectively: P < 0.001, one-tailed Cochran-Armitage trend test). As compared with the placebo group, the proportion of subjects with no peristalsis after administration was significantly higher in the 0.8% group (P = 0.015) and 1.6% group (P = 0.009). Adverse events in the L-menthol dose groups occurred with similar frequencies in the placebo group. CONCLUSION L-menthol suppresses peristalsis in a dose-dependent manner, and the dose-response reaches a plateau at 0.8% L-menthol. Further Phase III studies are needed to establish the superiority of 0.8% L-menthol over placebo.
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Affiliation(s)
- Naoki Hiki
- Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
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Kaminishi M, Niwa H. Past, present, and future of the Korea-Japan Joint Symposium on Gastrointestinal Endoscopy. Clin Endosc 2011; 44:1-5. [PMID: 22741105 PMCID: PMC3363048 DOI: 10.5946/ce.2011.44.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 09/14/2011] [Accepted: 09/16/2011] [Indexed: 11/14/2022] Open
Abstract
We herein discuss the history, the present situation, and the future prospects of Korean Society of Gastrointestinal Endoscopy (KSGE) and Japan Gastroenterological Endoscopy Society (JGES). Through the symposiums, endoscopy medicine in both countries has developed and matured remarkably, and Korea and Japan have taken a leadership position in this field. In the future, we continuously challenge to advance the symposium further, to hold international sessions, to develop the new KSGE journal Clinical Endoscopy and the JGES journal Digestive Endoscopy through friendly competition. Through those above, we will share useful information with the world and provide leadership in the field of endoscopy medicine.
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Aikou S, Ohmoto Y, Gunji T, Matsuhashi N, Ohtsu H, Miura H, Kubota K, Yamagata Y, Seto Y, Nakajima A, Goldenring JR, Kaminishi M, Nomura S. Tests for serum levels of trefoil factor family proteins can improve gastric cancer screening. Gastroenterology 2011; 141:837-845.e1-7. [PMID: 21699780 PMCID: PMC3163741 DOI: 10.1053/j.gastro.2011.05.040] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 05/12/2011] [Accepted: 05/20/2011] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Improving methods for early detection of gastric cancer could reduce mortality. Measurements of serum pepsinogen levels have been used for screening in Japan without satisfactory levels of sensitivity or specificity. Trefoil factor family (TFF) proteins (TFF1, TFF2, and TFF3) are small and stable molecules secreted by the mammalian gastrointestinal tract. Foveolar hyperplasia, spasmolytic polypeptide (TFF2)-expressing metaplasia, and intestinal metaplasia are histologic changes observed in patients with atrophic gastritis; they express TFF1, TFF2, and TFF3, respectively. We investigated whether serum levels of TFF can be used as markers for gastric cancer screening. METHODS Serum was collected from 183 patients with gastric cancer and 280 healthy individuals without cancer. Serum levels of anti-Helicobacter pylori immunoglobulin G, pepsinogen I, pepsinogen II, TFF1, TFF2, and TFF3 were measured by enzyme-linked immunosorbent assay and associated with gastric cancer. RESULTS Using a cutoff of 3.6 ng/mL, the level of TFF3 was significantly increased in serum samples from patients with cancer (odds ratio, 18.1; 95% confidence interval, 11.2-29.2); using this test, patients with cancer were identified with 80.9% sensitivity and 81.0% specificity. The test for TFF3 had a significantly higher odds ratio than that for pepsinogen. A test for the combination of TFF3 and pepsinogen had better results than the test for only pepsinogen. CONCLUSIONS Serum levels of TFF3 are a better marker of gastric cancer than pepsinogen; a test for the combined levels of serum pepsinogen and TFF3 could improve gastric cancer screening.
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Affiliation(s)
- Susumu Aikou
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo
| | | | | | | | - Hiroshi Ohtsu
- Department of Clinical Trial Data Management, Graduate School of Medicine, University of Tokyo
| | - Hirona Miura
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo
| | - Kensuke Kubota
- Department of Gastroenterology, School of Medicine, Yokohama City University
| | - Yukinori Yamagata
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo
| | - Atsushi Nakajima
- Department of Gastroenterology, School of Medicine, Yokohama City University
| | - James R Goldenring
- Nashville VA Medical Center and the Departments of Surgery and Cell and Developmental Biology, Epithelial Biology Center, Vanderbilt University School of Medicine
| | | | - Sachiyo Nomura
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo
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Hiki N, Kaminishi M, Tanabe S, Fujisaki J, Yoshino J, Iguchi M, Kobayashi H, Ashida K, Kawabe T, Kawano T, Nomura S, Yahagi N, Tajiri H, Suzuki H. An open-label, single-arm study assessing the efficacy and safety of L: -menthol sprayed onto the gastric mucosa during upper gastrointestinal endoscopy. J Gastroenterol 2011; 46:873-82. [PMID: 21559772 DOI: 10.1007/s00535-011-0395-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 03/02/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS The results of a phase III, placebo-controlled study demonstrated that endoscopic direct spraying of L: -menthol onto the gastric mucosa effectively suppressed gastric peristalsis in the study patients. The aim of the study reported here was to determine whether the anti-peristaltic effect of an L: -menthol preparation facilitates endoscopic examinations in a clinical setting. METHODS This was a multicenter, open-label, single-arm trial in which the study cohort comprised patients in whom L: -menthol was likely to be used to facilitate endoscopic examination in clinical settings. The primary outcome was the proportion of subjects with no peristalsis (Grade 1) after treatment and at the end of endoscopy (defined as the complete suppression of gastric peristalsis). This variable was assessed according to the level of anti-Helicobacter pylori immunoglobulin G (IgG) antibody, pepsinogen test results, whether sedation was performed, and whether subjects were considered unsuitable for the use of conventional antispasmodics. RESULTS Of the 119 enrolled subjects, data from 112 were included in the primary efficacy analysis. Gastric peristalsis was completely suppressed in 37.5% of the patients [42/112 patients; 95% confidence interval (CI) 28.5-47.1]. Subgroup analyses revealed that the rate of peristalsis suppression was significantly higher in patients with elevated levels of anti-H. pylori IgG antibody (26/44, 59.1%; 95% CI 43.2-73.7); P < 0.001] and positive pepsinogen test results (21/35, 65.6%; 95% CI 46.8-81.4; P < 0.001]. There was no significant difference according to sedation (17/52, 32.7%; 95% CI 20.3-47.1; P = 0.434) or whether subjects were considered unsuitable for use of conventional antispasmodic agents (14/28, 50.0%; 95% CI 30.6-69.4; P = 0.12]. CONCLUSION These findings are comparable to those of the phase III placebo-controlled study and provide further evidence that endoscopic direct spraying of L: -menthol effectively suppresses gastric peristalsis during upper gastrointestinal endoscopy.
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Affiliation(s)
- Naoki Hiki
- Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
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Tsuchida Y, Hatao F, Fujisawa M, Murata T, Kaminishi M, Seto Y, Hori M, Ozaki H. Neuronal stimulation with 5-hydroxytryptamine 4 receptor induces anti-inflammatory actions via α7nACh receptors on muscularis macrophages associated with postoperative ileus. Gut 2011; 60:638-47. [PMID: 21115544 PMCID: PMC3071096 DOI: 10.1136/gut.2010.227546] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The main symptom of postoperative ileus (POI) is an intestinal motility disorder in which monocytes/macrophages and neutrophils play crucial roles. Prokinetic 5-hydroxytryptamine 4 receptor (5-HT₄R) agonists and dopamine receptor antagonists are potential therapeutic agents for directly ameliorating the motility disorder associated with POI. AIM To determine the effects of the 5-HT₄R agonists mosapride citrate (MOS) and CJ-033466 on intestinal smooth muscle contractility relative to immune reactions after POI. METHODS Intestinal manipulation (IM) was applied to the rat distal ileum. Both MOS (0.3 and 1 mg/kg, s.c.) and CJ-033466 (1 mg/kg, s.c.) were administered to the animals before and after IM. At 24 h after IM, isolated intestinal smooth muscle contractile activity in vitro, gastrointestinal transit in vivo, inflammatory mediator expression and leucocyte infiltration were measured. RESULTS After IM, ileal circular muscle contractility in vitro and gastrointestinal transit in vivo were reduced and the number of macrophages and neutrophils increased in the inflamed muscle layer, resulting in the induction of inflammatory mediators such as interleukin 1 β (IL-1β), IL-6, tumour necrosis factor α (TNFα), monocyte chemoattractant protein 1 (MCP-1) and inducible nitric oxide synthase (iNOS). Both MOS and CJ-033466 significantly attenuated not only the intestinal motility dysfunction but also the leucocyte infiltration and inflammatory mediator expression after IM. The autonomic ganglionic blocker hexamethonium (1 mg/kg, i.p.) and the α7-nicotinic acetylcholine receptor (α7nAChR) antagonist methyl lycaconitine citrate (0.087 mg/kg, i.p.) blocked MOS-mediated ameliorative actions. Immunohistochemically, α7nAChR is expressed by monocytes/macrophages but not by neutrophils in the inflamed intestine. CONCLUSION Stimulating the 5-HT₄R accelerates acetyl choline (ACh) release from cholinergic myenteric neurons, which subsequently activates α7nAChR on activated monocytes/macrophages to inhibit their inflammatory reactions in the muscle layer. In addition to their gastroprokinetic action, 5-HT₄R agonists might serve as novel therapeutic agents for POI characterised by anti-inflammatory potency.
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Affiliation(s)
- Yasuaki Tsuchida
- Department of Veterinary Pharmacology, The University of Tokyo, Bunkyo-ku, Tokyo 113-8657, Japan.
| | - Fumihiko Hatao
- Department of Metabolic Care and Gastrointestinal Surgery Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiko Fujisawa
- Department of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Takahisa Murata
- Department of Veterinary Pharmacology, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Michio Kaminishi
- Department of Metabolic Care and Gastrointestinal Surgery Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuyuki Seto
- Department of Metabolic Care and Gastrointestinal Surgery Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masatoshi Hori
- Department of Veterinary Pharmacology, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Ozaki
- Department of Veterinary Pharmacology, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
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Kubota K, Tatsutomi Y, Kitajima M, Mafune KI, Ohta K, Yoshida M, Suwa T, Kuroda J, Hiki N, Seto Y, Kaminishi M. Physiological evaluation of residual stomach motility after local resection in conscious dogs. Surg Today 2011; 41:680-7. [PMID: 21533941 DOI: 10.1007/s00595-010-4329-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Accepted: 01/04/2010] [Indexed: 01/25/2023]
Abstract
PURPOSE To investigate the phenomenon of remnant gastric motility and emptying after local resection. METHODS Fifteen dogs were divided into three groups: a control (CONT) group, a group that underwent local resection of the greater (GREAT) curvature, and a group that underwent resection of the lesser (LESS) curvature. We conducted a strain gauge force transducer study, a [(13)C]octanoic acid breath test ((13)C-OBT), and a mosapride citrate effect test. Based on these results, we worked out the receptive relaxation (RR), motility index (MI), and postprandial period (PP) in the postprandial state, and the frequency, duration, and MI of phase III in the fasted state. The half emptying time (T (1/2)) of (13)C-OBT was also calculated. The MI was compared according to the mosapride effect test results. RESULTS Postprandial RR, antro-pyloro-duodenal coordination, and fasting contractions were maintained in all three groups. Receptive relaxation was significantly shorter in the LESS group than in the other groups. Motility index was significantly lower in both treatment groups than in the CONT group. The PP was significantly longer in the GREAT group than in the other two groups. The (13)CO(2) excretion curves did not differ significantly among the groups. The duration of phase III was remarkably less in the treatment groups than in the CONT group, and MI was significantly lower in the LESS group than in the other groups in the fasted state. The MI increased remarkably after mosapride administration in the CONT group, showing no differences in other objective groups. CONCLUSION Gastric function was maintained after gastric local resection, although its motility decreased.
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Affiliation(s)
- Keisuke Kubota
- Department of Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
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Hiki N, Kaminishi M, Yasuda K, Uedo N, Honjo H, Matsuhashi N, Hiratsuka T, Sekine C, Nomura S, Yahagi N, Tajiri H, Suzuki H. Antiperistaltic effect and safety of L-menthol sprayed on the gastric mucosa for upper GI endoscopy: a phase III, multicenter, randomized, double-blind, placebo-controlled study. Gastrointest Endosc 2011; 73:932-41. [PMID: 21353674 DOI: 10.1016/j.gie.2010.12.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 12/12/2010] [Indexed: 02/08/2023]
Abstract
BACKGROUND GI peristalsis during GI endoscopy commonly requires intravenous or intramuscular injection of antispasmodic agents, which sometimes cause unexpected adverse reactions. OBJECTIVE Our ultimate goal was to evaluate whether the antiperistaltic effect of L-menthol-based preparations facilitates endoscopic examinations in a clinical setting. DESIGN Multicenter, randomized, double-blind, placebo-controlled study. SETTING Six Japanese referral centers. PATIENTS AND INTERVENTION A total of 87 patients scheduled to undergo upper GI endoscopy were randomly assigned to receive 160 mg of L-menthol (n=45) or placebo (n=42). Both treatments were sprayed endoscopically on the gastric mucosa. The degree of gastric peristalsis was assessed by an independent committee. MAIN OUTCOME MEASUREMENTS The proportion of subjects with no peristalsis 90 to 135 seconds after administration and at the end of the endoscopic examination (complete suppression of gastric peristalsis). Other outcomes were the proportion of subjects with no or mild peristalsis (adequate suppression of gastric peristalsis) and the ease of intragastric observation as evaluated by the endoscopist who performed the procedure. RESULTS Gastric peristalsis was completely suppressed in 35.6% (21.9, 51.2) of the L-menthol group compared with only 7.1% (1.5, 19.5) of the placebo group (P<.001). In the L-menthol group, 77.8% (62.9, 88.8) (35/45 subjects) of the subjects had no or mild peristalsis at the completion of endoscopy. Minor peristalsis interfered with intragastric examination in only 1 of these 35 patients (2.9%). The incidence of adverse events did not differ significantly between the groups (P=.512). LIMITATION Small sample size. CONCLUSIONS During upper GI endoscopy, L-menthol sprayed on the gastric mucosa significantly suppresses peristalsis with minimal adverse drug reactions compared with placebo. ( CLINICAL TRIAL REGISTRATION NUMBER NCT00742599.).
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Affiliation(s)
- Naoki Hiki
- Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, and Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Ueda T, Volinia S, Okumura H, Shimizu M, Taccioli C, Rossi S, Alder H, Liu CG, Oue N, Yasui W, Yoshida K, Sasaki H, Nomura S, Seto Y, Kaminishi M, Calin GA, Croce CM. Relation between microRNA expression and progression and prognosis of gastric cancer: a microRNA expression analysis. Lancet Oncol 2009; 14:1233-42. [PMID: 20022810 DOI: 10.1016/s1470-2045(13)70464-9] [Citation(s) in RCA: 197] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Analyses of microRNA expression profiles have shown that many microRNAs are expressed aberrantly and correlate with tumorigenesis, progression, and prognosis of various haematological and solid tumours. We aimed to assess the relation between microRNA expression and progression and prognosis of gastric cancer. METHODS 353 gastric samples from two independent subsets of patients from Japan were analysed by microRNA microarray. MicroRNA expression patterns were compared between non-tumour mucosa and cancer samples, graded by diffuse and intestinal histological types and by progression-related factors (eg, depth of invasion, metastasis, and stage). Disease outcome was calculated by multivariable regression analysis to establish whether microRNAs are independent prognostic factors. FINDINGS In 160 paired samples of non-tumour mucosa and cancer, 22 microRNAs were upregulated and 13 were downregulated in gastric cancer; 292 (83%) samples were distinguished correctly by this signature. The two histological subtypes of gastric cancer showed different microRNA signatures: eight microRNAs were upregulated in diffuse-type and four in intestinal-type cancer. In the progression-related signature, miR-125b, miR-199a, and miR-100 were the most important microRNAs involved. Low expression of let-7g (hazard ratio 2.6 [95% CI 1.3-4.9]) and miR-433 (2.1 [1.1-3.9]) and high expression of miR-214 (2.4 [1.2-4.5]) were associated with unfavourable outcome in overall survival independent of clinical covariates, including depth of invasion, lymph-node metastasis, and stage. INTERPRETATION MicroRNAs are expressed differentially in gastric cancers, and histological subtypes are characterised by specific microRNA signatures. Unique microRNAs are associated with progression and prognosis of gastric cancer. FUNDING National Cancer Institute.
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Affiliation(s)
- Tetsuya Ueda
- Department of Molecular Virology, Immunology, Ohio State University, Columbus, OH 43210, USA
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Ueda T, Volinia S, Okumura H, Shimizu M, Taccioli C, Rossi S, Alder H, Liu CG, Oue N, Yasui W, Yoshida K, Sasaki H, Nomura S, Seto Y, Kaminishi M, Calin GA, Croce CM. Relation between microRNA expression and progression and prognosis of gastric cancer: a microRNA expression analysis. Lancet Oncol 2009; 11:136-46. [PMID: 20022810 DOI: 10.1016/s1470-2045(09)70343-2] [Citation(s) in RCA: 662] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Analyses of microRNA expression profiles have shown that many microRNAs are expressed aberrantly and correlate with tumorigenesis, progression, and prognosis of various haematological and solid tumours. We aimed to assess the relation between microRNA expression and progression and prognosis of gastric cancer. METHODS 353 gastric samples from two independent subsets of patients from Japan were analysed by microRNA microarray. MicroRNA expression patterns were compared between non-tumour mucosa and cancer samples, graded by diffuse and intestinal histological types and by progression-related factors (eg, depth of invasion, metastasis, and stage). Disease outcome was calculated by multivariable regression analysis to establish whether microRNAs are independent prognostic factors. FINDINGS In 160 paired samples of non-tumour mucosa and cancer, 22 microRNAs were upregulated and 13 were downregulated in gastric cancer; 292 (83%) samples were distinguished correctly by this signature. The two histological subtypes of gastric cancer showed different microRNA signatures: eight microRNAs were upregulated in diffuse-type and four in intestinal-type cancer. In the progression-related signature, miR-125b, miR-199a, and miR-100 were the most important microRNAs involved. Low expression of let-7g (hazard ratio 2.6 [95% CI 1.3-4.9]) and miR-433 (2.1 [1.1-3.9]) and high expression of miR-214 (2.4 [1.2-4.5]) were associated with unfavourable outcome in overall survival independent of clinical covariates, including depth of invasion, lymph-node metastasis, and stage. INTERPRETATION MicroRNAs are expressed differentially in gastric cancers, and histological subtypes are characterised by specific microRNA signatures. Unique microRNAs are associated with progression and prognosis of gastric cancer. FUNDING National Cancer Institute.
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Affiliation(s)
- Tetsuya Ueda
- Department of Molecular Virology, Immunology, Ohio State University, Columbus, OH 43210, USA
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Miyoshi-Imamura T, Kakinuma S, Kaminishi M, Okamoto M, Takabatake T, Nishimura Y, Imaoka T, Nishimura M, Murakami-Murofushi K, Shimada Y. Unique Characteristics of Radiation-Induced Apoptosis in the Postnatally Developing Small Intestine and Colon of Mice. Radiat Res 2009; 173:310-8. [DOI: 10.1667/rr1905.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- T. Miyoshi-Imamura
- Genetic Counseling Program, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo, 112-8610, Japan
| | - S. Kakinuma
- Experimental Radiology for Children's Health Research Group, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - M. Kaminishi
- Experimental Radiology for Children's Health Research Group, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - M. Okamoto
- Experimental Radiology for Children's Health Research Group, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - T. Takabatake
- Experimental Radiology for Children's Health Research Group, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Y. Nishimura
- Experimental Radiology for Children's Health Research Group, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - T. Imaoka
- Experimental Radiology for Children's Health Research Group, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - M. Nishimura
- Experimental Radiology for Children's Health Research Group, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - K. Murakami-Murofushi
- Genetic Counseling Program, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo, 112-8610, Japan
| | - Y. Shimada
- Experimental Radiology for Children's Health Research Group, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
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Oka D, Yamashita S, Tomioka T, Nakanishi Y, Kato H, Kaminishi M, Ushijima T. The presence of aberrant DNA methylation in noncancerous esophageal mucosae in association with smoking history: a target for risk diagnosis and prevention of esophageal cancers. Cancer 2009; 115:3412-26. [PMID: 19472401 DOI: 10.1002/cncr.24394] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Esophageal squamous cell carcinomas (ESCCs) tend to have multiple primary lesions, and it is believed that they arise from background mucosae with accumulation of genetic/epigenetic alterations. In this study, the objective was to elucidate the effects of smoking and drinking on the accumulation of epigenetic alterations in background mucosae. METHODS Genes that are silenced in human ESCCs were searched for by treating 3 ESCC cell lines with the demethylating agent, 5-aza-2'-deoxycytidine and performing oligonucleotide microarrays. Methylation levels were analyzed by quantitative methylation-specific polymerase chain reaction analysis of 60 ESCCs and their corresponding background mucosae. RESULTS Forty-seven genes were identified as methylation-silenced in at least 1 of the 3 ESCC cell lines, and 14 of those genes (claudin 6 [CLDN6]; G protein-coupled receptor 158 [GPR158]; homeobox A9 [HOXA9]; metallothionein 1M [MT1M]; neurofilament, heavy polypeptide 200 kDa [NEFH]; plakophilin 1 [PKP1]; protein phosphatase 1, regulatory [inhibitor] subunit 14A [PPP1R14A]; pyrin domain and caspase recruitment domain containing [PYCARD]; R-spondin family, member 4 [RSPO4]; testis-specific protein, Y-encoded-like 5 [TSPYL5]; ubiquitin carboxyl-terminal esterase L1 [UCHL1]; zinc-finger protein 42 homolog [ZFP42]; zinc-finger protein interacting with K protein 1 homolog [ZIK1]; and zinc-finger and SCAN domain containing 18 [ZSCAN18]) were used as markers. In the background mucosae, methylation levels of 5 genes (HOXA9, MT1M, NEFH, RSPO4, and UCHL1) had significant correlations with smoking duration (rho=.268; P=.044; rho=.405; P=.002; rho=.285; P=.032; rho=.300; P=.024; and rho=.437; P=.001, respectively). In contrast, an inverse correlation between PYCARD methylation levels and alcohol intake was observed (rho=-.334, P=.025) among individuals with the inactive aldehyde dehydrogenase 2 (ALDH2) genotype. CONCLUSIONS The current results suggested that ESCCs developed from an epigenetic field for cancerization, which was induced by exposure to carcinogenic factors, such as tobacco smoking. The epigenetic field defect will be a novel target for risk diagnosis and prevention of ESCCs.
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Affiliation(s)
- Daiji Oka
- Carcinogenesis Division, National Cancer Center Research Institute, Tokyo, Japan
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Aikou S, Fukushima Y, Ogawa M, Nozaki K, Saito T, Matsui T, Goldenring JR, Kaminishi M, Nomura S. Alterations in gastric mucosal lineages before or after acute oxyntic atrophy in gastrin receptor and H2 histamine receptor-deficient mice. Dig Dis Sci 2009; 54:1625-35. [PMID: 19507031 DOI: 10.1007/s10620-009-0832-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Accepted: 04/30/2009] [Indexed: 12/22/2022]
Abstract
Spasmolytic polypeptide (SP/TFF2)-expressing metaplasia (SPEM) is induced by oxyntic atrophy and is known as a precancerous or paracancerous lesion. We seek to determine whether the gastrin receptor or H(2) histamine receptor influence the development of SPEM. DMP-777 was administered to gastrin receptor and/or H(2) receptor-deficient mice and wild-type mice. Gastric mucosal lineage changes were analyzed. The mucosa from double knockout mice and H(2) receptor knockout mice contained elevated numbers of dual TFF2 and intrinsic factor immunoreactive cells even before DMP-777 treatment. All genotypes of mice showed SPEM after 7-day treatment. In all types of knockout mice, the number of TFF2 immunoreactive cells remained elevated after cessation of treatment. The H(2) receptor and gastrin receptor do not affect emergence of SPEM. However, it is suggested that the absence of H(2) receptor signaling causes a delay in the maturation of chief cells from mucous neck cells.
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Affiliation(s)
- Susumu Aikou
- Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Niwa T, Saito H, Imajoh-ohmi S, Kaminishi M, Seto Y, Miki Y, Nakanishi A. BRCA2 interacts with the cytoskeletal linker protein plectin to form a complex controlling centrosome localization. Cancer Sci 2009; 100:2115-25. [PMID: 19709076 DOI: 10.1111/j.1349-7006.2009.01282.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The breast cancer susceptibility gene (BRCA2) is localized mainly in the nucleus where it plays an important role in DNA damage repair. Some BRCA2 protein is also present in the centrosome. Here, we demonstrate that BRCA2 interacts with plectin, a cytoskeletal cross-linker protein, and that this interaction controls the position of the centrosome. Phosphorylation of plectin by cyclin-dependent kinase 1/cyclin B (CDK1/CycB) kinase has been reported to abolish its cross-linking function during mitosis. Here, we induced phosphorylation of plectin in prepared fractions of HeLa cells by adding activated CDK1/CycB kinase. Consequently, there was significant dissociation of the centrosome from the nuclear membrane. Plectin has six homologous ankyrin-like repeat domains (termed PLEC M1-M6). Using a pull-down assay, we found that GST-PLEC M1 and a GST-C-terminal region fusion protein (which comprised PLEC M6, along with an adjacent vimentin site) interacted with BRCA2. Since each PLEC module exhibits high homology to the others, the possibility of all six domains participating in this interaction was indicated. Moreover, when PLEC M1 was overexpressed in HeLa cells, it competed with endogenous plectin and inhibited the BRCA2-plectin interaction. This inhibitory effect resulted in dissociation of the centrosomes from the nucleus and increased the rate of micronuclei formation which may lead to carcinogenesis. In addition, when either BRCA2 or plectin was suppressed by the appropriate siRNA, a similar change in centrosomal positioning was observed. We suggest that the BRCA2-plectin interaction plays an important role in the regulation of centrosome localization and also that displacement of the centrosome may result in genomic instability and cancer development.
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Affiliation(s)
- Takayoshi Niwa
- Department of Endocrine Surgery and Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Shioiri T, Muroi M, Hatao F, Nishida M, Ogawa T, Mimura Y, Seto Y, Kaminishi M, Tanamoto KI. Caspase-3 is activated and rapidly released from human umbilical vein endothelial cells in response to lipopolysaccharide. Biochim Biophys Acta Mol Basis Dis 2009; 1792:1011-8. [PMID: 19559790 DOI: 10.1016/j.bbadis.2009.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 06/16/2009] [Accepted: 06/17/2009] [Indexed: 12/25/2022]
Abstract
Endothelial cell injury/dysfunction is considered to play a critical role in the pathogenesis of severe sepsis and septic shock. Although it is considered that endothelial cell apoptosis is involved in endothelial injury/dysfunction, physiological involvement remains ambiguous since the induction of apoptosis requires the inhibition of endogenous apoptosis inhibitors. Here we show that caspase-3 activation, a biological indicator of apoptosis, is observed in response to lipopolysaccharide (LPS) stimulation even under the influence of endogenous apoptosis inhibitors, and that activated caspase-3 is rapidly released from human umbilical vein endothelial cells (HUVEC). In the presence of cycloheximide (CHX), an increase in intracellular caspase-3/7 activity in response to LPS was not detected in HUVEC up to 24 h following stimulation even in the presence of LPS-binding protein (LBP), soluble CD14 and soluble MD-2, whereas the decrease in cell viability and increase in release of the cellular enzyme lactate dehydrogenase (LDH) were observed in a soluble CD14/LBP-dependent manner. On the other hand, even in the absence of CHX, a significant increase in caspase-3/7 activity and a cleaved caspase-3 fragment with a slight increase in LDH release was observed in culture supernatants in response to LPS. This increase in caspase-3/7 activity was observed even when LDH release was undetected. These results indicate that caspase-3 is activated by LPS under physiological conditions and suggest that HUVEC escape from cell death by rapidly releasing activated caspase-3 into extracellular space. Failure of this escape mechanism may result in endothelial injury/dysfunction.
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Affiliation(s)
- Toshikazu Shioiri
- Research Institute of Pharmaceutical Sciences, Musashino University, 1-1-20 Shinmachi, Nishitokyo-shi, Tokyo 202-8585, Japan
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Yoshizawa N, Yamaguchi H, Yamamoto M, Shimizu N, Furihata C, Tatematsu M, Seto Y, Kaminishi M. Gastric carcinogenesis by N-Methyl-N-nitrosourea is enhanced in db/db diabetic mice. Cancer Sci 2009; 100:1180-5. [PMID: 19432903 DOI: 10.1111/j.1349-7006.2009.01157.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In 2005, a Japanese epidemiological study showed that increase in plasma glucose levels is a risk factor for gastric cancer. However, no animal model has hitherto shown any association between diabetes mellitus and neoplasia in the stomach. Diabetic (db/db) mice have obese and diabetic phenotypes, including hyperglycemia, because of disruption of the leptin receptor. In the present study, effects of hyperglycemia and/or hyperinsulinemia on the development of proliferative lesions were therefore examined in db/db mice given N-methyl-N-nitrosourea (MNU). A total of 120 mice were assigned to four groups: Group A, 40 db/db mice with MNU; Group B, 40 + /db mice with MNU; Group C, 30 misty (wild-type) mice with MNU; Group D, 10 db/db mice without MNU. MNU was given at 60 ppm in drinking water for 20 weeks. Subgroups of animals were sacrificed at weeks 21 and 30 and blood samples were collected to measure glucose, insulin, leptin, and adiponectin concentrations. The removed stomachs were fixed in formalin, and embedded in paraffin for histological examination and immunohistochemistry. At week 30 in Groups A, B, C and D, hyperplasia was observed in 100, 79, 57, and 0%, and dysplasia in 91, 43, 71, and 0%, respectively. Adenocarcinomas and pepsinogen-altered pyloric glands (PAPG), putative preneoplastic lesions, were observed only in Group A, at an incidence of 45%. The serum levels of insulin and leptin were also elevated in Group A. Gastric carcinogenesis by MNU was enhanced in db/db mice, possibly in association with hyperinsulinemia and hyperleptinemia.
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Affiliation(s)
- Nao Yoshizawa
- Department of Gastrointestinal Surgery, The University of Tokyo, Tokyo 113-8655, Japan.
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Ushiku T, Uozaki H, Shinozaki A, Ota S, Matsuzaka K, Nomura S, Kaminishi M, Aburatani H, Kodama T, Fukayama M. Glypican 3-expressing gastric carcinoma: distinct subgroup unifying hepatoid, clear-cell, and alpha-fetoprotein-producing gastric carcinomas. Cancer Sci 2009; 100:626-32. [PMID: 19243386 DOI: 10.1111/j.1349-7006.2009.01108.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Gypican-3 (GPC3) has been recognized as an oncofetal protein in hepatic neoplasms and yolk sac tumors. To characterize a distinct subgroup of gastric carcinoma (GC) expressing GPC3 (GPC3-GC), primary and metastatic GC tissues were evaluated by immunohistochemistry with special focus on their related entities: hepatoid, clear-cell, and alpha-fetoprotein-producing GC. GPC3-GC was defined as focal GPC3-GC when 10-49% of neoplastic cells were positive, and as diffuse GPC3-GC when more than 50% of cells were positive. Among 926 GC cases, 101 (11%) were GPC3-GC, of which 45 were diffuse and 56 were focal GPC3-GC. Specific histological patterns, such as the hepatoid and clear-cell patterns, were frequently observed in diffuse GPC3-GC (38 and 49%, respectively) and in focal GPC3-GC (4 and 25%, respectively), whereas these patterns were extremely rare in GPC3-negative GC. Immunoreactive alpha-fetoprotein was only identified in GPC3-GC (38% of diffuse and 14% of focal GPC3-GC). Both diffuse and focal GPC3-GC showed nodal metastasis more frequently (67 and 55%, respectively) than GPC3-negative GC (34%), and the diffuse GPC3-GC had significantly more T2-4 and M1 stage cases. GPC3 immunostaining was present in 57 out of 61 nodal metastases (93%) and in all four liver metastases examined. Importantly, diffuse GPC3 expression was observed in the liver metastasis, even if the primary tumor was focal GPC3-GC. GPC3-GC is a distinctive group of GC, which unifies hepatoid, clear-cell, and alpha-fetoprotein-producing GC. GPC3 is expected to be a target of forthcoming immunotherapy for a patient bearing this specific type of GC.
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Affiliation(s)
- Tetsuo Ushiku
- Department of Pathology and Diagnostic Pathology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Terada K, Okochi-Takada E, Akashi-Tanaka S, Miyamoto K, Taniyama K, Tsuda H, Asada K, Kaminishi M, Ushijima T. Association between frequent CpG island methylation and HER2 amplification in human breast cancers. Carcinogenesis 2009; 30:466-71. [PMID: 19168584 DOI: 10.1093/carcin/bgp021] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The presence of frequent methylation of CpG islands (CGIs), designated as the CpG island methylator phenotype in some cancers, is associated with distinct clinicopathological characteristics, including gene amplification, in individual tumor types. Amplification of HER2 in human breast cancers is an important prognostic and therapeutic target, but an association between HER2 amplification and frequent CGI methylation is unknown. To clarify the association, we here quantified methylation levels of promoter CGIs of 11 genes, which are unlikely to confer growth advantage to cells, in 63 human breast cancers. The number of methylated genes in a cancer did not obey a bimodal distribution, and the 63 cancers were classified into those with frequent methylation (n = 16), moderate methylation (n = 26) and no methylation (n = 21). The incidence of HER2 amplification was significantly higher in the cancers with frequent methylation (11 of 16) than in those with no methylation (2 of 21, P = 0.001). Also, the number of methylated genes correlated with the degree of HER2 amplification (r = 0.411, P = 0.002). Correlation analysis with clinicopathological characteristics and methylation of CDKN2A, BRCA1 and CDH1 revealed that frequent methylation had significant correlation with higher nuclear grades (P = 0.001). These showed that frequent methylation had a strong association with HER2 amplification in breast cancers and suggested that frequent methylation can be a determinant of various characteristics in a fraction of human breast cancers.
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Affiliation(s)
- Kotoe Terada
- Carcinogenesis Division, National Cancer Center Research Institute, Tokyo, Japan
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Yamashita H, Nakagawa K, Yamada K, Kaminishi M, Mafune K, Ohtomo K. A single institutional non-randomized retrospective comparison between definitive chemoradiotherapy and radical surgery in 82 Japanese patients with resectable esophageal squamous cell carcinoma. Dis Esophagus 2008; 21:430-6. [PMID: 19125797 DOI: 10.1111/j.1442-2050.2007.00793.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This retrospective study was conducted to compare the treatment results between radical surgery and definitive chemoradiotherapy for resectable squamous cell carcinoma of the esophagus. Between June 2000 and May 2005, 82 consecutive patients were selected for this study in which 33 were treated with chemoradiotherapy and 49 with surgery. The patients in the chemoradiotherapy (CRT) group received 2-4 cycles of 5-fluorouracil (1000 mg/m(2)/day, day 1-4, continuous) combined with cisplatin (75 mg/m(2), day 1, bolus) plus 50.4 Gy of radiation, while those in the surgery group were treated by an esophagectomy with radical node dissection. Eighteen surgical patients received postoperative chemotherapy. The baseline clinical TNM stage was similar between the two groups. With a median follow-up period of 36 months (range: 23-84 months) with 47 survivors (57%), the 3-year overall survival rates (P = 0.22) and disease-free survival rates (P = 0.16) were 48% and 44% in the chemoradiotherapy group versus 65% and 59% in the surgery group, and lacked statistical significance. This non-randomized study on patients with resectable squamous cell carcinoma of the esophagus showed that chemoradiotherapy could result in survival comparable with conventional surgery in spite of selection bias of patients. There is a trend toward improved survival with surgery versus definitive CRT.
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Affiliation(s)
- H Yamashita
- Department of Radiology, University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.
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Kurabayashi R, Takubo K, Aida J, Honma N, Poon SSS, Kammori M, Izumiyama-Shimomura N, Nakamura KI, Tsuji EI, Matsuura M, Ogawa T, Kaminishi M. Luminal and cancer cells in the breast show more rapid telomere shortening than myoepithelial cells and fibroblasts. Hum Pathol 2008; 39:1647-55. [PMID: 18656239 DOI: 10.1016/j.humpath.2008.04.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 04/03/2008] [Accepted: 04/04/2008] [Indexed: 11/24/2022]
Abstract
Critically shortened, dysfunctional telomeres may play a role in the genetic instabilities commonly found in cancer. We analyzed 30 surgical specimens of invasive breast carcinoma from women aged 34 to 91 years and estimated telomere lengths as telomere-to-centromere ratio values in the 5 different cell types comprising breast tissue in order to clarify telomere length variations within and between individuals using our tissue quantitative fluorescence in situ hybridization method. We obtained 3 novel findings. (1) In corresponding normal tissues, telomere length decreased in the order myoepithelial cells > normal-appearing fibroblasts > luminal epithelial cells, and telomere lengths were characteristic in these 3 cell types within each individual. (2) As expected, cancer cells had significantly shorter telomeres than myoepithelial cells (P < .0001) and normal-appearing fibroblasts (P = .0161), but there was no significant difference in telomere length between luminal cells and cancer cells (P = .6270). (3) Fibroblasts adjacent to cancer had longer telomeres than normal-appearing fibroblasts distant from cancer (P < .0001). This study, which represents the first reported assessment of telomere length variations in the 5 cell types comprising breast tissue within and between individuals, revealed that normal luminal epithelial cells and cancer cells had the shortest telomeres. Our new findings indicate that telomeres of background luminal cells are as short as those of cancer cells. Tissue quantitative fluorescence in situ hybridization, applicable to analysis of individual cells in tissue sections, is considered to be a powerful technique with considerable promise for studies in oncology.
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Affiliation(s)
- Rie Kurabayashi
- Division of Metabolic Care and Endocrine Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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