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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 | 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 |
| 3 | MRCP and MRI findings in 9 patients with autoimmune pancreatitis显示文摘瞄准:为了评估磁性的回声 cholangiopancreatography (MRCP ) ,与磁性的回声(先生) 一起的调查结果在自体免疫的胰腺炎(AIP ) 想象病人。方法:有 AIP 的九个病人经历了 MRI, MRCP,内视镜后退 cholangiopancreatography (ERCP ) ,计算断层摄影术,和 ultrasonography。在类固醇治疗前后拿的 MRCP 和先生图象被考察并且与另外的成像形式相比。AIP 盒子的 MRCP 调查结果与有胰的头的癌的 10 个盒子的那些相比。结果:在 MRCP 上,在 ERCP 上注意的主要的胰腺的管的缩小的部分没被设想,当主要的胰腺的管的非包含的片断被设想时。近似的主要的胰腺的管的在上游的膨胀的度比在胰腺的癌的情况下看温和。更低的胆汁管的狭窄或阻塞在 8 个病人被检测。先生图象在 T1 加权的先生图象上与减少的信号紧张显示出胰的增大, T2 加权的先生图象上的增加的信号紧张,并且,在 3 个病人,低亚硫酸钠强烈像囊的边界。在类固醇治疗以后,以前没设想主要的胰腺的管的部分被看见,与胆汁管狭窄的改进一起。胰腺的增大减少了,并且 T1 加权、 T2 加权的先生图象上的反常信号紧张成为了 isointense。结论:MRCP 不能区分从与胰腺的癌看见的主要的胰腺的管的狭窄与 AIP 看见的主要的胰腺的管的不规则的变窄。然而,与在 T1 加权、 T2 加权的先生图象上显示出反常信号紧张的胰腺的增大的先生成像一起的 MRCP 调查结果在支持 AIP 的诊断是有用的。 | Terumi Kamisawa Pong-Yui Chen Yuyang Tu Hitoshi Nakajima Naoto Egawa Kouji Tsuruta Atsutake Okamoto Noriko Kamata | 2006 | World Journal of Gastroenterology2006,12,18: | 23 |
| 4 | 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 |
| 5 | 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 |
| 6 | Usefulness of biopsying the major duodenal papilla to diagnose autoimmune pancreatitis:A prospective study using IgG4-immunostaining显示文摘瞄准:检验组织学并且免疫从自体免疫的胰腺炎(AIP ) 的主要十二指肠的乳头状的小突起拿的活体检视标本的组织化学的调查结果病人们。方法:在有 AIP 的 3 个病人并且 5 个控制病人的 resected 胰的主要十二指肠的乳头状的小突起[胰腺的癌(n = 3 ) 并且长期的含酒精的胰腺炎(n = 2 )] 免疫用 anti-CD4-T 房间, CD8-T 房间和 IgG4 抗体被染色。与怀疑的视神经乳头炎与 AIP 和 5 个控制病人从 2 个病人的主要十二指肠的乳头状的小突起拿的钳活体检视标本有希望地在组织化学地检验的十二指肠镜检查和免疫期间被拿。结果:包括许多 CD4 积极或 CD8 积极的 T 淋巴细胞和 IgG4 积极的血浆房间(>or=10/HPF ) 的中等或严重的 lymphoplasmacytic 渗入,与 AIP 在所有 3 个病人的主要十二指肠的乳头状的小突起被观察。一样的调查结果也在与 AIP 从 2 个病人的主要十二指肠的乳头状的小突起拿的活体检视标本,但是在控制被检测,仅仅有一些(<or=3/HPF ) 渗入主要十二指肠的乳头状的小突起的 IgG4 积极的血浆房间。结论:IgG4 积极的血浆房间的丰富的渗入明确地与 AIP 在病人的主要十二指肠的乳头状的小突起被检测。尽管这是初步的研究,从主要十二指肠的乳头状的小突起拿的活体检视标本的 IgG4-immunostaining 可以支持 AIP 的诊断。 | Terumi Kamisawa Yuyang Tu Hitoshi Nakajima Naoto Egawa Kouji Tsuruta Atsutake Okamoto | 2006 | World Journal of Gastroenterology2006,12,13: | 13 |
| 7 | 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 |
| 8 | Pancreatic cancer with a high serum IgG4 concentration显示文摘Differentiation between autoimmune pancreatitis and pancreatic cancer is sometimes difficult. It has been reported that serum IgG4 concentrations are significantly elevated and particularly high (>135 mg/dL) in autoimmune pancreatitis. Measurement of serum IgG4 has become a useful tool for differentiating between autoimmune pancreatitis and pancreatic cancer. However, we present a 74-year-old female with a markedly elevated serum IgG4 (433 mg/dL) who underwent pancreaticoduodenectomy for pancreatic cancer. Elevated serum IgG4 levels continued after the resection. On histology, adenocarcinoma of the pancreas accompanied with moderate lymphoplasmacytic infiltration infiltrated the lower bile duct and duodenum, but there were no findings of autoimmune pancreatitis. Although a small metastasis was detected in one parapancreatic lymph node, regional lymph nodes were swollen. Abundant IgG4-positive plasma cells infiltrated the cancerous areas of the pancreas, but only a few IgG4-positive plasma cells were detected in the noncancerous areas. Pancreatic cancer cells were not immunoreactive for IgG4. An abundant infiltration of IgG4-positive plasma cells was detected in the swollen regional lymph nodes and in the duodenal mucosa. We believe that the serum IgG4 level was elevated in this patient with pancreatic cancer as the result of an IgG4-related systemic disease that had no clinical manifestations other than lymphadenopathy. | Terumi Kamisawa Pong Yui Chen Yuyang Tu Hitoshi Nakajima Naoto Egawa Kouji Tsuruta Atsutake Okamoto Tsunekazu Hishima | 2006 | World Journal of Gastroenterology2006,12,38: | 10 |
| 9 | Post-hepatectomy survival in advanced hepatocellular carcinoma with portal vein tumor thrombosis显示文摘AIM: To analyze hepatocellular carcinoma(HCC) patients with portal vein tumor thrombosis(PVTT) using the tumor-node-metastasis(TNM) staging system.METHODS: We retrospectively analyzed 372 patients with HCC who underwent hepatectomy between 1980 and 2009.We studied the outcomes of HCC patients with PVTT to evaluate the American Joint Committee on Cancer TNM staging system(7th edition) for stratifying and predicting the prognosis of a large cohort of HCC patients after hepatectomy in a single-center.Portal vein invasion(vp) 1 was defined as an invasion or tumor thrombus distal to the second branch of the portal vein,vp2 as an invasion or tumor thrombus in the second branch of the portal vein,vp3 as an invasion or tumor thrombus in the first branch of the portal vein,and vp4 as an invasion or tumor thrombus in the portal trunk or extending to a branch on the contralateral side.RESULTS: The cumulative 5-year overall survival(5yr OS) and 5-year disease-free survival(5yr DFS) rates of the 372 patients were 58.3% and 31.3%,respectively.The 5yr DFS and 5yr OS of vp3-4 patients(n = 10) were 20.0%,and 30.0%,respectively,which was comparable with the corresponding survival rates of vp1-2 patients(P = 0.466 and 0.586,respectively).In the subgroup analysis of patients with macroscopic PVTT(vp2-4),the OS of the patients who underwent preoperative transarterial chemoembolization was comparable to that of patients who did not(P = 0.747).There was a significant difference in the DFS between patients with stage Ⅰ HCC and those with stage Ⅱ HCC(5yr DFS 39.2% vs 23.1%,P < 0.001); however,theDFS for stage Ⅱ was similar to that for stage Ⅲ(5yrD FS 23.1% vs 13.8%,P = 0.330).In the subgroup analysis of stage Ⅱ-Ⅲ HCC(n = 148),only alpha-fetoprotein(AFP) > 100 mg/dL was independently associated with DFS.CONCLUSION: Hepatectomy for vp3-4 HCC results in a survival rate similar to hepatectomy for vp1-2.AFP stratified the stage Ⅱ-Ⅲ HCC patients according to prognosis. | Yusuke Yamamoto Hisashi Ikoma Ryo Morimura Katsutoshi Shoda 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 Gastroenterology2015,21,1: | 9 |
| 10 | Malignancies associated with intraductal papillary mucinous neoplasm of the pancreas显示文摘AIM: As intraductal papillary mucinous neoplasm (IPMN)has a favorable prognosis, associated malignancies have potential significance in these patients. We examined the incidence and characteristics of pre-existing, coexisting and subsequent malignancies in patients with IPMN. METHODS: Seventy-nine cases of IPMN were diagnosed by detection of mucous in the pancreatic duct during endoscopic retrograde pancreatography. Histological diagnosis was confirmed in 30 cases (adenoma (n = 19)and adenocarcinoma (n = 11). Other primary malignancies associated with IPMN, occurring in the prediagnostic or postdiagnostic period, were investigated. Postdiagnostic follow-up period was 3.3±0.5 years (range, 0.2-20 years).RESULTS: Other 40 malignancies occurred in 28 patients (35%). They were found before (n = 15), at (n = 19) and after (n = 6) the diagnosis of IPMT. Major associated malignancies were gastric cancer (n = 12), colonic cancer (n = 7), esophageal cancer (n = 4), pulmonary cancer (n = 4), and independent pancreatic cancer (n = 3).Pancreatic cancer was synchronous with IPMN in two patients and metachronous in one (3 years after diagnosis of IPMN). Thirty-one lesions were treated surgically or endoscopically. Fourteen patients died of associated cancers. Development of other malignancies was related to age (71.9±8.2 vs66.8±9.3, P<0.05), but not to gender or site of the tumor.CONCLUSION: IPMN is associated with a high incidence of other malignancies, particularly gastric and colonic cancers. Common genetic mechanisms between IPMN and other associated malignancies might be present. Clinicians should pay attention to the possibility of associated malignancies in preoperative screening and follow-up of patients with IPMN. | Terumi Kamisawa Yuyang Tu Naoto Egawa Hitoshi Nakajima Kouji Tsuruta Atsutake Okamoto | 2005 | World Journal of Gastroenterology2005,11,36: | 8 |
| 11 | Clinicopathological characteristics of clinical early gastric cancer in the upper-third stomach显示文摘AIM: To elucidate the clinicopathological characteristics of clinically early gastric cancer in the upper-third stomach and to clarify treatment precautions.METHODS: A total of 683 patients with clinical early gastric cancer were enrolled in this retrospective study, 128 of whom had gastric cancer in the upper-third stomach(U group). All patients underwent a double contrast barium examination, endoscopy, and computed tomography(CT), and were diagnosed preoperatively based on the findings obtained. The clinicopathological features of these patients were compared with those of patients with gastric cancer in the middle- and lower-third stomach(ML group). We also compared clinicopathological factors between accurate-diagnosis and under-diagnosis groups in order to identify factors affecting the accuracy of a preoperative diagnosis of tumor depth.RESULTS: Patients in the U group were older(P = 0.029), had a higher ratio of males to females(P = 0.015), and had more histologically differentiated tumors(P = 0.007) than patients in the ML group. A clinical under-diagnosis occurred in 57 out of 683 patients(8.3%), and was more frequent in the U group than in the ML group(16.4% vs 6.3%, P < 0.0001). Therefore, the rates of lymph node metastasis and lymphatic invasion were slightly higher in the U group than in the ML group(P = 0.071 and 0.082, respectively). An under-diagnosis was more frequent in histologically undifferentiated tumors(P = 0.094) and in those larger than 4 cm(P = 0.024). The medianfollow-up period after surgery was 56 mo(range, 1-186 mo). Overall, survival and disease-specific survival rates were significantly lower in the U group than in the ML group(P = 0.016 and 0.020, respectively). However, limited operation-related cancer recurrence was not detected in the U group in the present study.CONCLUSION: Clinical early gastric cancer in the upper-third stomach has distinguishable characteristics that increase the risk of a clinical under-diagnosis, especially in patients with larger or undifferentiated tumors. | Daisuke Ichikawa Shuhei Komatsu Toshiyuki Kosuga Hirotaka Konishi Kazuma Okamoto Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji | 2015 | World Journal of Gastroenterology2015,21,45: | 6 |
| 12 | Claudin 1 mediates tumor necrosis factor alpha-induced cell migration in human gastric cancer cells显示文摘AIM:To investigate the role of claudin 1 in the regulation of genes involved in cell migration and tumor necrosis factor alpha(TNF-α)-induced gene expression in human gastric adenocarcinoma cells.METHODS:Knockdown experiments were conducted with claudin 1 small interfering RNA(si RNA),and theeffects on the cell cycle,apoptosis,migration and invasion were analyzed in human gastric adenocarcinoma MKN28 cells.The gene expression profiles of cells were analyzed by microarray and bioinformatics.RESULTS:The knockdown of claudin 1 significantly inhibited cell proliferation,migration and invasion,and increased apoptosis.Microarray analysis identified 245genes whose expression levels were altered by the knockdown of claudin 1.Pathway analysis showed that the top-ranked molecular and cellular function was the cellular movement related pathway,which involved MMP7,TNF-SF10,TGFBR1,and CCL2.Furthermore,TNFand nuclear frctor-κB were the top-ranked upstream regulators related to claudin 1.TNF-αtreatment increased claudin 1 expression and cell migration in MKN28 cells.Microarray analysis indicated that the depletion of claudin1 inhibited 80%of the TNF-α-induced m RNA expression changes.Further,TNF-αdid not enhance cell migration in the claudin 1 si RNA transfected cells.CONCLUSION:These results suggest that claudin 1 is an important messenger that regulates TNF-α-induced gene expression and migration in gastric cancer cells.A deeper understanding of these cellular processes may be helpful in establishing new therapeutic strategies for gastric cancer. | Atsushi Shiozaki Hiroki Shimizu Daisuke Ichikawa Hirotaka Konishi Shuhei Komatsu Takeshi Kubota Hitoshi Fujiwara Kazuma Okamoto Daisuke Iitaka Shingo Nakashima Yoshito Nako Mingyao Liu Eigo Otsuji | 2014 | World Journal of Gastroenterology2014,20,47: | 6 |
| 13 | Histological mixed-type as an independent prognostic factor in stageⅠgastric carcinoma显示文摘AIM: To evaluate the clinicopathological features of mixed-type gastric cancer and their influence on prognosis of mixed-type stageⅠgastric cancer.METHODS: We analyzed 446 patients who underwent curative gastrectomy for stageⅠgastric cancer between 1999 and 2009. The patients were divided into two groups: those with differentiated or undifferentiated cancer(non-mixed-type, n = 333) and those with a mixture of differentiated and undifferentiated cancers(mixed-type, n = 113).RESULTS: The overall prevalence of mixed-type gastric cancer was 25.3%(113/446). Compared with patients with non-mixed-type gastric cancer, those with mixedtype gastric cancer tended to be older at onset(P = 0.1252) and have a higher incidence of lymph node metastasis(P = 0.1476). They also had significantly larger tumors(P < 0.0001), more aggressive lymphatic invasion(P = 0.0011), and deeper tumor invasion(P < 0.0001). In addition, they exhibited significantly worse overall survival rates than did patients with non-mixedtype gastric cancer(P = 0.0026). Furthermore, mixedtype gastric cancer was independently associated with a worse outcome in multivariate analysis [P = 0.0300, hazard ratio = 11.4(1.265-102.7)].CONCLUSION: Histological mixed-type of gastric cancer contributes to malignant outcomes and highlight its usefulness as a prognostic indicator in stageⅠgastric cancer. | Shuhei Komatsu Daisuke Ichikawa Mahito Miyamae Hiroki Shimizu Hirotaka Konishi Atsushi Shiozaki Hitoshi Fujiwara Kazuma Okamoto Mitsuo Kishimoto Eigo Otsuji | 2015 | World Journal of Gastroenterology2015,21,2: | 6 |
| 14 | Clinical characteristics of hepatoduodenal lymph node metastasis in gastric cancer显示文摘AIM: To assess the clinical features of hepatoduodenal lymph node(HDLN) metastasis and to clarify the optimal indication of HDLN dissection.METHODS: We investigated a total of 276 patients who underwent gastrectomy with extended lymphadenectomy,including HDLN dissection,for gastric cancer between 1999 and 2012. Of these,26 patients(9.4%) had HDLN metastasis. First,we investigated the clinicopathological characteristics,their perioperative clinical outcomes,such as postoperative complications,and prognostic outcomes between patients with and without HDLN metastasis. Second,we detected the prognostic factors,particularly in patients with HDLN metastasis. Third,we assessed the therapeutic value of HDLN dissection to determine its optimal indication.RESULTS: The five-year overall survival rate of the patients with HDLN metastasis was 29%. Univariate and multivariate logistic regression analyses revealed that the tumour location(the middle or lower stomach [P = 0.005,OR = 5.88(95%CI: 1.61-38.1)] and p T category [T3 or T4,P = 0.017,OR = 4.45(95%CI: 1.28-21.3)] were independent risk factors for HDLNmetastasis. Cox proportional hazard analysis identified p N3 as an independent poor prognostic factor in the patients with HDLN metastasis [P = 0.021,HR = 5.17(95%CI: 1.8-292)]. For patients who underwent radical HDLN dissection,HDLN metastasis was a prognostic indicator in p N3 gastric cancer(P < 0.0001),but not p N1-2(P = 0.602). Furthermore,the index of therapeutic value of HDLN dissection for gastric cancer in the middle or lower stomach and the upper stomach was 3.4 and 0.0,respectively.CONCLUSION: We suggest that HDLN dissection should be indicated for p N1 or p N2 gastric cancers located at the middle or lower stomach. | Taisuke Imamura Shuhei Komatsu Daisuke Ichikawa Toshiyuki Kosuga Kazuma Okamoto Hirotaka Konishi Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji | 2015 | World Journal of Gastroenterology2015,21,38: | 4 |
| 15 | Development of ulcerative colitis during the course of rheumatoid arthritis: Association with selective IgA deficiency显示文摘有风湿性关节炎(RA ) 的 29 年的历史的一个 56 岁的女人进入医院,抱怨高发烧,腹的疼痛和严重流血腹泻。结肠镜检查与从直肠延长到远侧的横向的冒号的自发的流血、弥漫的侵蚀和溃疡揭示了脆、水肿的粘膜。直肠的活体检视的组织病理学说的调查结果与 ulcerative (UC ) 兼容。作为有严重活跃左边的 UC 被诊断,她成功地被对待,静脉内的甲基氢化尼松由氢化尼松和 leukocytapheresis 列在后面。实验室测试揭示了低浆液和口水 IgA 层次,它可能在 UC 的发展起一个作用。到我们的知识,这是发生在 RA 的功课期间的 UC 的第一个盒子,由选择 IgA 缺乏伴随了。 | Yuki Asada Hajime Isomoto Saburo Shikuwa Chun Yang Wen Eiichiro Fukuda Masaru Miyazato, Kenta Okamoto Takashi Nakamura Hitoshi Nishiyama Yohei Mizuta Kiyoshi Migita Masahiro Ito Shigeru Kohno | 2006 | World Journal of Gastroenterology2006,12,32: | 2 |
| 16 | Adipocyte-Derived Plasma Protein, Adiponectin, Suppresses Lipid Accumulation and Class A Scavenger Receptor Expression in Human Monocyte-Derived Macrophages显示文摘 | Noriyuki Ouchi Shinji Kihara Yukio Arita Makoto Nishida Akifumi Matsuyama Yoshihisa Okamoto Masato Ishigami Hiroshi Kuriyama Ken Kishida Hitoshi Nishizawa Kikuko Hotta Masahiro Muraguchi Yasukazu Ohmoto Shizuya Yamashita Tohru Funahashi Yuji Matsuzawa | 2001 | Circulation: Journal of the American Heart Association2001,,8: | 2 |
| 17 | Surgical Outcomes of Gastrectomy for Elderly Patients with Gastric Cancer显示文摘 | Hiroki Takeshita Daisuke Ichikawa Shuhei Komatsu Takeshi Kubota Kazuma Okamoto Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji | 2013 | World Journal of Surgery2013,,12: | 2 |
| 18 | Adipocyte-Derived Plasma Protein, Adiponectin, Suppresses Lipid Accumulation and Class A Scavenger Receptor Expression in Human Monocyte-Derived Macrophages显示文摘 | Noriyuki Ouchi Shinji Kihara Yukio Arita Makoto Nishida Akifumi Matsuyama Yoshihisa Okamoto Masato Ishigami Hiroshi Kuriyama Ken Kishida Hitoshi Nishizawa Kikuko Hotta Masahiro Muraguchi Yasukazu Ohmoto Shizuya Yamashita Tohru Funahashi Yuji Matsuzawa | 2001 | Circulation: Journal of the American Heart Association2001,,8: | 2 |
| 19 | Differences of the Lymphatic Distribution and Surgical Outcomes Between Remnant Gastric Cancers and Primary Proximal Gastric Cancers显示文摘 | Shuhei Komatsu Daisuke Ichikawa Kazuma Okamoto Daito Ikoma Masahiro Tsujiura Atsushi Shiozaki Hitoshi Fujiwara Yasutoshi Murayama Yoshiaki Kuriu Hisashi Ikoma Masayoshi Nakanishi Toshiya Ochiai Yukihito Kokuba Eigo Otsuji | 2012 | Journal of Gastrointestinal Surgery2012,,3: | 2 |
| 20 | Sclerosing cholecystitis associated with autoimmune pancreatitis显示文摘瞄准:与自体免疫的胰腺炎(AIP ) 在病人评估胆囊的组织病理学说、放射学的调查结果。方法:19 个 AIP 病人的胆囊的放射学的调查结果回顾地被考察。8 个 AIP 病人的 Resected 胆囊组织学地被检验,免疫与 anti-IgG4 抗体被染色。控制为征兆的胆石由胆囊 resected 组成了(n = 10 ) 并且那些为胰腺的癌在胰头十二指肠切除术期间搬迁了(n = 10 ) ,以及额外的肝的胆汁管和胰为胰腺的癌由胰头十二指肠切除术搬迁了(n = 10 ) 。结果:胆囊墙变厚被超声检测或与 AIP 在 10 个病人计算了断层摄影术(3 严重并且 7 中等) ;在这些病人,额外的肝的胆汁管的严重狭窄也被注意。组织学地,胆囊变厚在 8 中的 6 个被检测(75%) 有 AIP 的病人;4 个盒子与纤维变性有透壁 lymphoplasmacytic 渗入,并且 2 个盒子有基于 mucosal 的 lymphoplasmacytic 渗入。与稠密的纤维变性和弥漫的 lymphoplasmacytic 渗入的额外的肝的胆汁管墙的可观的透壁的变厚在 7 个病人被检测。Immunohistochemically, IgG4 积极的浆细胞的严重或中等的渗入在所有 8 个病人的胆囊,胆汁管,和胰被检测,但是没在控制被检测。结论:胆囊墙与纤维变性和 IgG4 积极的血浆房间的丰富的渗入变厚经常与 AIP 在病人被检测。我们建议一个新术语的使用,致硬化的胆汁,为这些盒子,那被象致硬化的胰腺炎或致硬化的胆管炎的一样的机制在 AIP 导致。 | Terumi Kamisawa Yuyang Tu Hitoshi Nakajima Naoto Egawa Kouji Tsuruta Atsutake Okamoto Shinichirou Horiguchi | 2006 | World Journal of Gastroenterology2006,12,23: | 2 |