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| 1 | Liver metastasis is the only independent prognostic factor in AFP-producing gastric cancer显示文摘AIM:To investigate differences between common gastric cancer andα-fetoprotein(AFP)-producing gastric cancer according to the presence or absence of liver metastasis.METHODS:Between 1997 and 2011,1299 patients underwent gastrectomy for gastric cancer(GC)at our institute and their hospital records were reviewed retrospectively.Patients were immunohistochemically divided into two groups:23 patients(1.8%)with AFPproducing GC and 1276 patients(98.2%)without it.RESULTS:AFP-producing GC patients had a significantly higher incidence of deeper tumors,venous invasion,lymphatic invasion,lymph node metastasis,and liver metastasis and a poorer prognosis(P<0.005)than those without AFP-producing GC.However,multi-variate analysis revealed that AFP-positivity was not an independent prognostic factor.The prognosis of AFPproducing GC was similar to that of AFP-non producing GC according to the presence or absence of liver metastasis.Concerning recurrence,47.8%of patients(11/23)with AFP-producing GC and 20.0%of patients(256/1276)without AFP-producing GC exhibited recurrence.Liver metastasis[90.9%(10/11)]was the most prevalent in AFP-producing GC patients.Multivariate analysis revealed that liver metastasis was the only independent prognostic factor in AFP-producing GC(HR=17.6,95%CI:2.1-147.1;P=0.0081).CONCLUSION:AFP-producing GC is similar to common GC without liver metastasis,which should be specifically targeted in an effort to improve the prognosis of AFP-producing GC patients. | Shoji Hirajima Shuhei Komatsu Daisuke Ichikawa Takeshi Kubota Kazuma Okamoto Atsushi Shiozaki Hitoshi Fujiwara Hirotaka Konishi Hisashi Ikoma Eigo Otsuji | 2013 | World Journal of Gastroenterology2013，19，36： | 33 |
| 2 | 亚热带山地亮叶水青冈林的群落分类及物种组成与更新显示文摘水青冈属(Fagus)约有11种,我国有5种。亮叶水青冈(Faguslucida)是我国间断分布于亚热带高海拔山地的主要落叶树种。近年来亮叶水青冈林受砍伐严重,为了保护残存的林地,作者采用Braun-Blanquet(1964)、Fujiwara(1987)的植物社会学方法,对分布于中国亚热带山地的南山、梵净山、宽阔水、八大公山4地域的亮叶水青冈林进行了植被的比较研究。根据37个样方调查的资料,区分出3个群丛6个亚群丛。比较3个群丛的物种组成、生活型结构发现,位于南山的毛玉山竹–亮叶水青冈群丛(Yushaniobasihirsuto–Fagetumlucidae)及位于梵净山与宽阔水的大箭竹–亮叶水青冈群丛(Sinarundinariochungii–Fagetumlucidae),其常绿落叶阔叶混交林的特征明显;而八大公山的箭竹–亮叶水青冈群丛(Sinarundinarionitido–Fagetumlucidae),其落叶阔叶林的特征较显著。南山与八大公山的亮叶水青冈林立木结构分析结果表明,前者呈“L”型分布,林窗的存在使亮叶水青冈可以保持更新,密集的竹子是妨碍其自然更新的主要因素;后者呈“Λ”状分布,尽管林下竹子稀疏,自然更新却严重不良,其原因尚待继续定点观测分析。 | 汪正祥 雷耘 Kazue Fujiwara 刘林翰 薛跃规 | 2006 | 生物多样性2006，14，1： | 28 |
| 3 | Risk factors for bleeding after endoscopic mucosal resection显示文摘AIM: To clarify the risk factors for bleeding after endoscopic mucosal resection (EMR).METHODS: A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Bleeding requiring endoscopic treatment was defined as bleeding after EMR. Odds ratios (OR) with 95% confidence intervals (CI), calculated by logistic regression with multivariate adjustments for covariates,were the measures of association.RESULTS: Of the 297 patients, 57 (19.2%) patients with bleeding after EMR were confirmed. With multivariate adjustment, the cutting method of ENR, diameter, and endoscopic pattern of the tumor were associated with the risk of bleeding after ENR. The multivariate-adjusted OR for bleeding after EMR using endoscopic aspiration mucosectomy was 3.07 (95%CI, 1.59-5.92) compared with strip biopsy. The multiple-adjusted OR for bleeding after EMR for the highest quartile (16-50 mm) of tumor diameter was 5.63 (95%CI, 1.84-17.23) compared with that for the lowest (4-7 mm). The multiple-adjusted OR for bleeding after EM R for depressed type of tumor was 4.21 (95%CI, 1.75-10.10) compared with elevated type.CONCLUSION: It is important to take tumor characteristics (tumor size and endoscopic pattern) and cutting method of EMR into consideration in predicting bleeding after ENR. | Masatsugu Shiba Kazuhide Higuchi Kaori Kadouchi Ai Montani Kazuki Yamamori Hirotoshi Okazaki Makiko Taguchi Tomoko Wada Atsushi Itani Toshio Watanabe Kazunari Tominaga Yoshihiro Fujiwara Tomoshige Hayashi Kei Tsumura Tetsuo Arakawa | 2005 | World Journal of Gastroenterology2005，11，46： | 25 |
| 4 | Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy显示文摘AIM: To re-evaluate the recent clinicopathological features of remnant gastric cancer (RGC) and to develop desirable surveillance programs. METHODS: Between 1997 and 2008, 1149 patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery, Kyoto Prefectural University of Medicine, Japan. Of these, 33 patients underwent gastrectomy with lymphadenectomy for RGC. Regarding the initial gastric disease, there were 19 patients with benign disease and 14 patients with gastric cancer. The hospital records of these patients were reviewed retrospectively. RESULTS: Concerning the initial gastric disease, the RGC group following gastric cancer had a shorter interval [P < 0.05; gastric cancer vs benign disease: 12 (2-22) vs 30 (4-51) years] and were more frequently reconstructed by Billroth-Ⅰ procedure than those following benign lesions (P < 0.001). Regarding reconstruction, RGC following Billroth-Ⅱ reconstruction showed a longer interval between surgical procedures [P < 0.001; Billroth-Ⅱ vs Billroth-Ⅰ: 32 (5-51) vs 12 (2-36) years] and tumors were more frequently associated with benign disease (P < 0.001) than those following Billroth-Ⅰ reconstruction. In tumor location of RGC, after Billroth-Ⅰ reconstruction, RGC occurred more frequently near the suture line and remnant gastric wall. After Billroth-Ⅱ reconstruction, RGC occurred more frequently at the anastomotic site. The duration of follow-up was significantly associated with the stage of RGC (P < 0.05). Patients diagnosed with early stage RGC such as stage Ⅰ-Ⅱ tended to have been followed up almost every second year. CONCLUSION: Meticulous follow-up examination and early detection of RGC might lead to a better prognosis. Based on the initial gastric disease and the procedure of reconstruction, an appropriate follow-up interval and programs might enable early detection of RGC. | Shuhei Komatsu Daisuke Ichikawa Kazuma Okamoto Daito Ikoma Masahiro Tsujiura Yukihisa Nishimura Yasutoshi Murayama Atsushi Shiozaki Hisashi Ikoma Yoshiaki Kuriu Masayoshi Nakanishi Hitoshi Fujiwara Toshiya Ochiai Yukihito Kokuba Eigo Otsuji | 2012 | World Journal of Gastroenterology2012，18，22： | 25 |
| 5 | 日本人未破裂脑动脉瘤出血的危险性:对日本医生发表文献的系统研究显示文摘 | Morita A Fujiwara S Hashi K 赵刚 | 2005 | 中国微侵袭神经外科杂志2005，10，7： | 20 |
| 6 | Importance of adequate immunosuppressive therapy for the recovery of patients with 'life-threatening' severe exacerbation of chronic hepatitis B显示文摘AIM: Hepatitis B virus (HBV) re-activation often occurs spontaneously or after withdrawal of immunosuppressive therapy in patients with chronic hepatitis B. Severe exacerbation, sometimes developing into fulminant hepatic failure, is at high risk of mortality. The efficacy of corticosteroid therapy in 'clinically severe' exacerbation of chronic hepatitis B has not been well demonstrated. In this study we evaluated the efficacy of early introduction of high-dose corticosteroid therapy in patients with lifethreatening severe exacerbation of chronic hepatitis B.METHODS: Twenty-two patients, 14 men and 8 women,were defined as 'severe' exacerbation of chronic hepatitis B using uniform criteria and enrolled in this study. Eleven patients were treated with corticosteroids at 60 mg or more daily with or without anti-viral drugs within 10 d after the diagnosis of severe disease ('early high-dose'group) and 11 patients were either treated more than 10 d or untreated with corticosteroids ('non-early high-dose'group).RESULTS: Mean age, male-to-female ratio, mean prothrombin time (PT) activity, alanine transaminase (ALT)level, total bilirubin level, positivity of HBeAg, mean IgMHBc titer, and mean HBV DNA polymerase activity did not differ between the two groups. Ten of 11 patients of the 'early high-dose' group survived, while only 2 of 11 patients of the 'non-early high-dose' group survived (P<0.001). During the first 2 wk after the introduction of corticosteroids, improvements in PT activities and total bilirubin levels were observed in the 'early high-dose'group. Both ALT levels and HBV DNA polymerase levels fell in both groups.CONCLUSION: The introduction of high-dose corticosteroid can reverse deterioration in patients with 'clinically lifethreatening' severe exacerbation of chronic hepatitis B,when used in the early stage of illness. | Keiichi Fujiwara Osamu Yokosuka Hiroshige Kojima Tatsuo Kanda Hiromitsu Saisho Hiroyuki Hirasawa Hiroshi Suzuki | 2005 | World Journal of Gastroenterology2005，11，8： | 20 |
| 7 | Akt inhibitor shows anticancer and radiosensitizing effects in malignant glioma cells by inducing autophagy显示文摘 | Fujiwara K Iwado E Mills GB Sawaya R Kondo S Kondo Y | 2007 | 中国神经肿瘤杂志2007，5，4： | 20 |
| 8 | Lifestyle-related disease in Crohn’s disease: Relapse prevention by a semi-vegetarian diet显示文摘AIM: To investigate whether semi-vegetarian diet (SVD) has a preventive effect against relapse of Crohn’s disease (CD) in patients who have achieved remission,who are a high-risk group for relapse.METHODS: A prospective,single center,2-year clinical trial was conducted.Twenty-two adult CD patients who achieved clinical remission either medically (n = 17) or surgically (n = 5) and consumed an SVD during hospitalization were advised to continue with an SVD and avoid known high-risk foods for inflammatory bowel disease.The primary endpoint was clinical relapse defi ned as the appearance of active symptoms of CD.Kaplan-Meier survival analysis was used to calculate the cumulative proportion of patients who had a relapse.A 2-year analysis of relapse rates of patients who followed an SVD and those who did not (an omnivorous diet group) was undertaken.RESULTS: SVD was continued by 16 patients (compliance 73%).Remission was maintained in 15 of 16 patients (94%) in the SVD group vs two of six (33%)in the omnivorous group.Remission rate with SVD was 100% at 1 year and 92% at 2 years.SVD showed signif icant prevention in the time to relapse compared to that in the omnivorous group (P = 0.0003,log rank test).The concentration of C-reactive protein was normal at the f inal visit in more than half of the patients in remission who were taking an SVD,who maintained remission during the study (9/15;60%),who terminated follow-up (8/12;67%),and who completed 2 years follow-up (7/10;70%).There was no untoward effect of SVD.CONCLUSION: SVD was highly effective in preventing relapse in CD. | Mitsuro Chiba Toru Abe Hidehiko Tsuda Takeshi Sugawara Satoko Tsuda Haruhiko Tozawa Katsuhiko Fujiwara Hideo Imai | 2010 | World Journal of Gastroenterology2010，16，20： | 17 |
| 9 | Quality of ulcer healing in gastrointestinal tract:Its pathophysiology and clinical relevance显示文摘In this paper,we review the concept of quality of ulcer healing(QOUH) in the gastrointestinal tract and its role in the ulcer recurrence.In the past,peptic ulcer disease(PUD) has been a chronic disease with a cycle of repeated healing/remission and recurrence.The main etiological factor of PUD is Helicobacter pylori(H.pylori),which is also the cause of ulcer recurrence.However,H.pylori-negative ulcers are present in 12%-20% of patients;they also recur and are on occasion intractable.QOUH focuses on the fact that mucosal and submucosal structures within ulcer scars are incompletely regenerated.Within the scars of healed ulcers,regenerated tissue is immature and with distorted architecture,suggesting poor QOUH.The abnormalities in mucosal regeneration can be the basis for ulcer recurrence.Our studies have shown that persistence of macrophages in the regenerated area plays a key role in ulcer recurrence.Our studies in a rat model of ulcer recurrence have indicated that proinflammatory cytokines trigger activation of macrophages,which in turn produce increased amounts of cytokines and chemokines,which attract neutrophils to the regenerated area.Neutrophils release proteolytic enzymes that destroy the tissue,resulting in ulcer recurrence.Another important factor in poor QOUH can be deficiency of endogenous prostaglandins and a deficiency and/or an imbalance of endogenous growth factors.Topically active mucosal protective and antiulcer drugs promote high QOUH and reduce inflammatory cell infiltration in the ulcer scar.In addition to PUD,the concept of QOUH is likely applicable to inflammatory bowel diseases including Crohn's disease and ulcerative colitis. | Tetsuo Arakawa Toshio Watanabe Tetsuya Tanigawa Kazunari Tominaga Yasuhiro Fujiwara Kenichi Morimoto | 2012 | World Journal of Gastroenterology2012，18，35： | 16 |
| 10 | Optimal duration of the early and late recurrence of hepatocellular carcinoma after hepatectomy显示文摘AIM: To determine the best cut-off value between the early and late recurrence periods after the initial recurrence of hepatocellular carcinoma(HCC).METHODS: The clinical records of 404 patients who underwent macroscopic curative hepatectomy for HCC between 1980 and 2010 were retrospectively examined. We divided the 252 patients experienced a recurrence of HCC into two groups, the early and late recurrence groups using the 'minimum P-value' approach. Factors for early recurrence were investigated using all 404 patients, and factors related to late recurrence were investigated in the patients who were confirmed to be recurrence free at the end of the early recurrence period.RESULTS: For the 252 patients who experienced a recurrence, the optimal cut-off value for differentiating early and late recurrence based on the overall survival after initial recurrence was 17 mo(5-year overall survival after initial recurrence: 15.4% vs 36.3%, P = 0.000018). Cox proportional hazard analysis identified early recurrence(P = 0.003) as one of the independent prognostic factors associated with overall survival after initial recurrence. A logistic regression model showed that an alpha-fetoprotein level > 100 ng/m L(P < 0.001), multiple HCC(P < 0.001), serosal invasion(P = 0.031), and microvascular invasion(P = 0.012) were independent factors associated with early recurrence, whereas the only independent factor related to late recurrence was liver cirrhosis(P = 0.002).CONCLUSION: Seventeen months after hepatectomy is a useful cut-off value between early and late recurrence of HCC based on the prognosis and different etiologies. | Yusuke Yamamoto Hisashi Ikoma Ryo Morimura Hirotaka Konishi Yasutoshi Murayama Shuhei Komatsu Atsushi Shiozaki Yoshiaki Kuriu Takeshi Kubota Masayoshi Nakanishi Daisuke Ichikawa Hitoshi Fujiwara Kazuma Okamoto Chouhei Sakakura Toshiya Ochiai Eigo Otsuji | 2015 | World Journal of Gastroenterology2015，21，4： | 14 |
| 11 | Risk factors to predict severe postoperative pancreatic fistula following gastrectomy for gastric cancer显示文摘AIM:To allow the identification of high-risk postoperative pancreatic fistula(POPF)patients with special reference to the International Study Group on Pancreatic Fistula(ISGPF)classification.METHODS:Between 1997 and 2010,1341 consecutive patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery,Kyoto Prefectural University of Medicine,Japan.Based on the preoperative diagnosis,total or distal gastrectomy and sufficient lymphadenectomy was performed,mainly according to the Japanese guidelines for the treatment of gastric cancer.Of these,35 patients(2.6%)were diagnosed with Grade B or C POPF according to the ISGPF classification and were treated intensively.The hospital records of these patients were reviewed retrospectively.RESULTS:Of 35 patients with severe POPF,17(49%)and 18(51%)patients were classified as Grade B and C POPF,respectively.From several clinical factors,the severity of POPF according to the ISGPF classification was significantly correlated with the duration of intensive POPF treatments(P=0.035).Regarding the clinical factors to distinguish extremely severe POPF,older patients(P=0.035,65 years≤vs<65 years old)and those with lower lymphocyte counts at the diagnosis of POPF(P=0.007,<1400/mm3vs 1400/mm3≤)were significantly correlated with Grade C POPF,and a low lymphocyte count was an independent risk factor by multivariate analysis[P=0.045,OR=10.45(95%CI:1.050-104.1)].CONCLUSION:Caution and intensive care are required for older POPF patients and those with lower lymphocyte counts at the diagnosis of POPF. | Shuhei Komatsu Daisuke Ichikawa Kingo Kashimoto Takeshi Kubota Kazuma Okamoto Hirotaka Konishi Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji | 2013 | World Journal of Gastroenterology2013，19，46： | 13 |
| 12 | Clinical utility of the platelet-lymphocyte ratio as a predictor of postoperative complications after radical gastrectomy for clinical T2-4 gastric cancer显示文摘AIM To identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors. METHODS Three-hundred and twelve patients with previously untreated clinical T2-4 gastric cancer who underwent a D2 standard gastrectomy(distal gastrectomy or total gastrectomy) were included in the analysis.Correlations between 21 parameters that can be determined by preoperative routine blood tests and clinically relevant postoperative complications(grade Ⅱ or higher according to the Clavien-Dindo classification) were evaluated. The optimal cutoff values and clinical significance of the selected markers were further evaluated by subgroup analyses according to age, body mass index, operative procedure and clinical disease stage.RESULTS Sixty-six patients(21.1%) experienced grade Ⅱ or higher postoperative complications. The plateletlymphocyte ratio(PLR, total lymphocyte count/platelet count × 100) exhibited the highest area under the curve value(0.639) for predicting postoperative complications among the 21 parameters, and the optimal cutoff value was determined to be 0.71(sensitivity = 70%, specificity = 56%). In the univariate analysis, the odds ratio of a low PLR for the occurrence of postoperative complications was 2.94(95%CI: 1.66-5.35, P < 0.001), and a multivariate binomial logistic analysis involving other potential risk factors identified a low PLR as an independent risk factor for postoperative complications(OR = 3.32, 95%CI: 1.82-6.25, P < 0.001). In subgroups classified according to age, body mass index, operative procedure and clinical disease stage, the low PLR group exhibited an increased incidence of postoperative complications. CONCLUSION The preoperative PLR is a simple and useful predictor of complications after curative gastrectomy in patients with clinical T2-4 gastric cancer. | Kenichi Inaoka Mitsuro Kanda Hiroaki Uda Yuri Tanaka Chie Tanaka Daisuke Kobayashi Hideki Takami Naoki Iwata Masamichi Hayashi Yukiko Niwa Suguru Yamada Tsutomu Fujii Hiroyuki Sugimoto Kenta Murotani Michitaka Fujiwara Yasuhiro Kodera | 2017 | World Journal of Gastroenterology2017，23，14： | 13 |
| 13 | Visualizing the hepatic vascular architecture using superb microvascular imaging in patients with hepatitis C virus: A novel technique显示文摘AIM: To identify the hepatic vascular architecture of patients with hepatitis C virus(HCV) using superb microvascular imaging(SMI) and investigate the use of SMI in the evaluation of liver fibrosis.METHODS: SMI was performed in 100 HCV patients. SMI images were classified into five types according to the vascular pattern, and these patterns were compared with the fibrosis stage. Moreover, the images were analyzed to examine vascularity by integrating the number of SMI signals in the region of interest ROI [number of vascular trees(VT)]. The number of VT, fibrosis stage, serum parameters of liver function, and CD34 expression were investigated.RESULTS: There was a significant difference between SMI distribution pattern and fibrosis stage(P < 0.001). The mean VT values in each of the fibrosis stages were as follows: 26.69 ± 7.08 in F0, 27.72 ± 9.32 in F1, 36.74 ± 9.23 in F2, 37.36 ± 5.32 in F3, and 58.14 ± 14.08 in F4. The VT showed excellent diagnostic ability for F4 [area under the receiver operator characteristic(AUROC): 0.911]. The VT was significantly correlated with the CD34 labeling index(r = 0.617, P < 0.0001).CONCLUSION: SMI permitted the detailed delineation of the vascular architecture in chronic liver disease. SMI appears to be a reliable tool for noninvasively detecting significant fibrosis or cirrhosis in HCV patients. | Hidekatsu Kuroda Tamami Abe Keisuke Kakisaka Yudai Fujiwara Yuichi Yoshida Akio Miyasaka Kazuyuki Ishida Hideaki Ishida Tamotsu Sugai Yasuhiro Takikawa | 2016 | World Journal of Gastroenterology2016，22，26： | 12 |
| 14 | Chemotherapy as a component of multimodal therapy for gastric carcinoma显示文摘局部地先进的胃的癌症的预后仍然保持差,并且几多,包含外科,化疗,和放射的形式策略在临床的试用被测试了。独自与外科在治疗上测试手术后的辅助化疗的利益的阶段 III 试用几乎没在幸存上揭示很少影响,与在西方的国家的一些小试用的例外。从探索手术后的 chemoradiation 的美国的大试用是在这个范畴的第一主要成功。从日本试用的结果建议有口头的 fluoropyrimidines 的中等化疗可能对更少进展(T2 阶段) 是有效的癌症,尽管另一确定的试用被需要证明这,指。调查者最近转到 neoadjuvant 化疗,并且一些有希望的结果从阶段 II trials using 被报导了活跃的药联合。在 2005,测试在前和手术后的化疗的大阶段 III 试用为将切除证明了它的幸存利益有能力的胃的癌症。因为病理学的完全的反应的率被认为影响这策略的治疗结果,进一步增加病理学的完全的反应的发生的 neoadjuvant chemoradiation 能是突破,并且分阶段执行测试这策略的 III 研究在不久的将来可以被保证。 | Yasuhiro Kodera Michitaka Fujiwara Masahiko Koike Akimasa Nakao | 2006 | World Journal of Gastroenterology2006，12，13： | 12 |
| 15 | Radiofrequency ablation as treatment for pulmonary metastasis of colorectal cancer显示文摘Radiofrequency ablation(RFA)causes focal coagulation necrosis in tissue.Its first clinical application was reported in 2000,and RFA has since been commonly used in both primary and metastatic lung cancer.The procedure is typically performed using computed tomography guidance,and the techniques for introducing the electrode to the tumor are simple and resemble those used in percutaneous lung biopsy.The most common complication is pneumothorax,which occurs in up to 50%of procedures;chest tube placement for pneumothorax is required in up to 25%of procedures.Other severe complications,such as pleural effusion requiring chest tube placement,infection,and nerve injury,are rare.The local efficacy depends on tumor size,and local progression after RFA is not rare,occurring in 10%or more of patients.The local progression rate is particularly high for tumors>3 cm.Repeat RFA may be used to treat local progression.Short-to mid-term survival after RFA appears promising and is approximately 85%-95%at 1 year and 45%-55% at 3 years.Long-term survival data are sparse.Better survival may be expected for patients with small metastasis,low carcinoembryonic antigen levels,and/or no extrapulmonary metastasis.The notable advantages of RFA are that it is simple and minimally invasive;preserves pulmonary function;can be repeated;and is applicable regardless of previous treatments.Its most substantial limitation is limited local efficacy.Although surgery is still the method of choice for treatment with curative intent,the ultimate application of RFA may be to replace metastasectomy for small metastases.Randomized trials comparing RFA with surgery are needed. | Takao Hiraki Hideo Gobara Toshihiro Iguchi Hiroyasu Fujiwara Yusuke Matsui Susumu Kanazawa | 2014 | World Journal of Gastroenterology2014，20，4： | 12 |
| 16 | Validation of the chinese version of the EORTC QLQ-CR29 in patients with colorectal cancer显示文摘AIM To assess the validity and reliability of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal Cancer 29(EORTC QLQ-CR29) in Chinese patients with colorectal cancer(CRC). METHODS From March 2014 to January 2015, 356 patients with CRC from four different hospitals in China were enrolled in the study, and all patients self-administered the EORTC QLQ-CR29 and the quality of life core questionnaire(EORTC QLQ-C30). Evaluation of the scores was based on the Karnofsky Performance Scale(KPS). The reliability and validity of the questionnaires were assessed by Cronbach's α coefficient, the Spearman correlation test and Wilcoxon rank sum test.RESULTS The EORTC QLQ-CR29 showed satisfactory reliability(α > 0.7), although the urinary frequency and blood and mucus in stool dimensions had only moderate reliability(α = 0.608). The multitrait scaling analyses showed good convergent(r > 0.4) and discriminant validity. Significant differences were obtained for each item in the different KPS subgroups(KPS ≤ 80; KPS > 80). body image and most single-item dimensions showed statistically significant differences in patients with a stoma compared with the rest of the patients. CONCLUSION The EORTC QLQ-CR29 exhibits high validity and reliability in Chinese patients with CRC, and can therefore be recommended as a valuable tool for the assessment of quality of life in these patients. | Jin-bo Lin Lei Zhang Dong-Wen Wu Zhou-Huan xi xue-Jun Wang Yun-Shou Lin Wakana Fujiwara Jing-Ru Tian Min Wang Peng Peng Ai Guo Zhen Yang Le Luo Ling-Ya Jiang Qia-Qia Li xue-Ying Zhang Yun-Feng Zhang Hou-Wei xu bing Yang xun-Lin Li Yi-xiong Lei | 2017 | World Journal of Gastroenterology2017，23，10： | 12 |
| 17 | Molecular diagnosis and therapy for occult peritoneal metastasis in gastric cancer patients显示文摘To apply an individualized oncological approach to gastric cancer patients,the accurate diagnosis of disease entities is required.Peritoneal metastasis is the most frequent mode of metastasis in gastric cancer,and the tumor-node-metastasis classification includes cytological detection of intraperitoneal cancer cells as part of the staging process,denoting metastatic disease.The accuracy of cytological diagnosis leaves room for improvement;therefore,highly sensitive molecular diagnostics,such as an enzyme immunoassay,reverse transcription polymerase chain reaction,and virusguided imaging,have been developed to detect minute cancer cells in the peritoneal cavity.Molecular targeting therapy has also been spun off from basic research in the past decade.Although conventional cytologyis still the mainstay,novel approaches could serve as practical complementary diagnostics to cytology in near future. | Shunsuke Kagawa Kunitoshi Shigeyasu Michihiro Ishida Megumi Watanabe Hiroshi Tazawa Takeshi Nagasaka Yasuhiro Shirakawa Toshiyoshi Fujiwara | 2014 | World Journal of Gastroenterology2014，20，47： | 11 |
| 18 | Surgical treatment of hepatocellular carcinoma with severe intratumoral arterioportal shunt显示文摘We report a case of hepatocellular carcinoma (HCC) that caused a severe arterioportal shunt (APS). A 49-year-old man was admitted to hospital due to esophagogastric variceal hemorrhage and HCC, and underwent endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS). He was then referred to our hospital. Abdominal computed tomography revealed a lowdensity lesion in the posterior segment of the liver and an intratumoral APS, which caused portal hypertension. Although the patient underwent EVL, EIS, Hassab’s operation, and transcatheter arterial embolization for APS, he vomited blood due to rupture of esophagogastric varices. Right hepatectomy was performed for the treatment of HCC and APS, although the indocyanine green retention value at 15 min after intravenous injection was poor (30%). The patient’s postoperative course was uneventful. Eventually, APS disappeared and the esophagogastric varices improved. | Hiromichi Ishii Teruhisa Sonoyama Shingo Nakashima Hiroyuki Nagata Atsushi Shiozaki Yoshiaki Kuriu Hisashi Ikoma Masayoshi Nakanishi Daisuke Ichikawa Hitoshi Fujiwara Kazuma Okamoto Toshiya Ochiai Yukihito Kokuba Chohei Sakakura Eigo Otsuji | 2010 | World Journal of Gastroenterology2010，16，25： | 11 |
| 19 | Impact of obesity on the surgical outcome following repeat hepatic resection in Japanese patients with recurrent hepatocellular carcinoma显示文摘AIM: To evaluate the impact of obesity on the posto- perative outcome after hepatic resection in patients with hepatocellular carcinoma (HCC). METHODS: Data from 328 consecutive patients with primary HCC and 60 patients with recurrent HCC were studied. We compared the surgical outcomes between the non-obese group (body mass index: BMI < 25 kg/m2) and the obese group (BMI ≥ 25 kg/m2). RESULTS: Following curative hepatectomy in patients with primary HCC, the incidence of postoperative complications and the long-term prognosis in the non- obese group (n = 240) were comparable to those in the obese group (n = 88). Among patients with recurrent HCC, the incidence of postoperative complications after repeat hepatectomy was not significantly different between the non-obese group (n = 44) and the obese group (n = 16). However, patients in the obese group showed a significantly poorer long-term prognosis than those in the non-obese group (P < 0.05, five-yearsurvival rate; 51.9% and 92.0%, respectively). CONCLUSION: Obesity alone may not have an adverse effect on the surgical outcomes of patients with primary HCC. However, greater caution seems to be required when planning a repeat hepatectomy for obese patients with recurrent HCC. | Tohru Utsunomiya Masahiro Okamoto Toshihumi Kameyama Ayumi Matsuyama Manabu Yamamoto Megumu Fujiwara Masaki Mori Shiomi Aimitsu Teruyoshi Ishida | 2008 | World Journal of Gastroenterology2008，14，10： | 10 |
| 20 | Prognostic value of postoperative complication for early recurrence after curative resection of hepatocellular carcinoma显示文摘Background: Postoperative complications may adversely affect oncological outcomes. The aim of this study was to evaluate the impact of postoperative complications on early-phase recurrence after curative resection for hepatocellular carcinoma(HCC).Methods: We included 145 HCC patients who underwent initial and curative resection between January2004 and December 2013. Postoperative complications of grade III or higher based on Clavien–Dindo classification were defined as clinically relevant postoperative complications. Recurrence within two years after hepatectomy was defined as early-phase recurrence.Results: Thirty-eight patients(26%) developed postoperative complications. The only predictive factor for postoperative complication was longer operative duration(P = 0.037). The disease-specific survival rate of patients with complication was lower than that of patients without complications(P = 0.015). Earlyphase recurrence was observed in 20/38(53%) patients who suffered postoperative complications and36/107(34%) patients with no complications, which was statistically significant(P = 0.039). Multivariate analysis identified four factors contributing to early-phase recurrence: high serum AFP level(P = 0.042),multiple tumors(P < 0.001), poor differentiation(P = 0.036) and presence of postoperative complication(P = 0.039).Conclusions: Postoperative complication is an independent prognostic factor for early-phase recurrence after curative resection of HCC. Close observation of patients with postoperative complications may be a necessary treatment strategy for HCC. | Masataka Amisaki Hiroaki Saito Naruo Tokuyasu Teruhisa Sakamoto Soichiro Honjo Yoshiyuki Fujiwara | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，4： | 10 |
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