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| 1 | Role of 18F-fluorodeoxyglucose positron emission tomography imaging in surgery for pancreatic cancer显示文摘AIM: To evaluate the role of positron emission tomo-graphy using 18F-fluorodeoxyglucose (FDG-PET) in the surgical management of patients with pancreatic cancer, including the diagnosis, staging, and selection of patients for the subsequent surgical treatment.METHODS: This study involved 53 patients with proven primary pancreatic cancer. The sensitivity of diagnosing the primary cancer was examined for FDG-PET, CT, cytological examination of the bile or pancreatic juice, and the serum levels of carcinoembrionic antigens (CEA) and carbohydrate antigen 19-9 (CA19-9). Next, the accuracy of staging was compared between FDG-PET and CT. Finally, FDG-PET was analyzed semiquantitatively using the standard uptake value (SUV). The impact of the SUV on patient management was evaluated by examining the correlations between the SUV and the histological findings of cancer.RESULTS: The sensitivity of FDG-PET, CT, cytological examination of the bile or pancreatic juice, and the serum levels of CEA and CA19-9 were 92.5%, 88.7%, 46.4%, 37.7% and 69.8%, respectively. In staging, FDG-PET was superior to CT only in diagnosing distant disease (bone metastasis). For local staging, the sensitivity of CT was better than that of FDG-PET. The SUV did not correlate with the pTNM stage, grades, invasions to the vessels and nerve, or with the size of the tumor. However, there was a statistically significant difference (4.6 ± 2.9 vs 7.8 ± 4.5, P = 0.024) in the SUV between patients with respectable and unresectable disease.CONCLUSION: FDG-PET is thus considered to be useful in the diagnosis of pancreatic cancer. However, regarding the staging of the disease, FDG-PET is not considered to be a sufficiently accurate diagnostic modality. Although the SUV does not correlate with the patho-histological prognostic factors, it may be useful in selecting patients who should undergo subsequent surgical treatment. | Hisao Wakabayashi Yoshihiro Nishiyama Tsuyoshi Otani Takanori Sano Shinichi Yachida Keiichi Okano Kunihiko Izuishi Yasuyuki Suzuki | 2008 | World Journal of Gastroenterology2008，14，1： | 16 |
| 2 | Management of a large mucosal defect after duodenal endoscopic resection显示文摘Duodenal endoscopic resection is the most difficult type of endoscopic treatment in the gastrointestinal tract(GI) and is technically challenging because of anatomical specificities. In addition to these technical difficulties, this procedure is associated with a significantly higher rate of complication than endoscopic treatment in other parts of the GI tract. Postoperative delayed perforation and bleeding are hazardous complications, and emergency surgical intervention is sometimes required. Therefore, it is urgently necessary to establish a management protocol for preventing serious complications. For instance, the prophylactic closure of large mucosal defects after endoscopic resection may reduce the risk of hazardous complications. However, the size of mucosal defects after endoscopic submucosal dissection(ESD) is relatively large compared with the size after endoscopic mucosal resection, making it impossible to achieve complete closure using only conventional clips. The over-the-scope clip and polyglycolic acid sheets with fibrin gel make it possible to close large mucosal defects after duodenal ESD. In addition to the combination of laparoscopic surgery and endoscopic resection, endoscopic full-thickness resection holds therapeutic potential for difficult duodenal lesions and may overcome the disadvantages of endoscopic resection in the near future. This review aims to summarize the complications and closure techniques of large mucosal defects and to highlight some directions for management after duodenal endoscopic treatment. | Shintaro Fujihara Hirohito Mori Hideki Kobara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Tsutomu Masaki | 2016 | World Journal of Gastroenterology2016，22，29： | 10 |
| 3 | Reduction effect of bacterial counts by preoperative saline lavage of the stomach in performing laparoscopic and endoscopic cooperative surgery显示文摘AIM:To investigate the effects of gastric lavage with2000 mL of saline in laparoscopic and endoscopic cooperative surgery.METHODS:Twenty two patients who were diagnosed with a gastric gastrointestinal stromal tumor were enrolled.In former term,irrigations of the stomach were conducted whenever it was necessary,not systematically(Non systemic lavage group).In latter term,the stomach was thoroughly cleaned with 2000 mL of saline using an endoscope with a water jet,and Duodenal balloon occlusion was conducted to prevent refluxedbile and pancreatic juice(Systemic lavage+balloon occlusion group).The gastric wall was sprayed with 20mL of distilled water,and 20 mL of gastric juice was collected in a sterile tube and submitted for culture.20mL of ascites was also collected from the laparoscopic ports and submitted for culture.We compared WBC,CRP,BT between two groups,and verify the reduction effect of bacterial counts in Systemic lavage+balloon occlusion group.RESULTS:WBC count before,1 d after,and 3 d after laparoscopic and endoscopic cooperative surgery(LECS)were 5060(95%CI:4250-9640),12140(6050-14110),and 6910(5320-12520)in Non systemic lavage group,4400(3660-7620),8910(6480-10980),and 5950(4840-7860)in Systemic lavage+balloon occlusion group.Significant differences between two groups at the day after LECS(P=0.029)and the 3 d after LECS(P=0.042).CRP levels in Non systemic lavage group and in Systemic lavage+balloon occlusion group were significantly different at the day after LECS(P=0.005)and the 3 d after LECS(P=0.028).BTs(℃)in Non systemic lavage group and in Systemic lavage+balloon occlusion group were also significantly different at the day after LECS(P=0.004)and the 3 d after LECS(P=0.006).In a logarithmic comparison,bacterial load before gastric lavage,after lavage,and ascites culture were 6.08(95%CI:4.04-6.97),0.48(0-0.85),and 0.21(0-0.56).The bacterial counts before and after gastric lavage were significantly suppressed(P=0.007),but no significant difference between gastric juice culture after lavage and ascites(P=0.154).CONCLUSION:Pre-LECS lavage with 2000 mL of saline exhibited a bacteria-reducing effect equivalent to disinfectants and obtained favorable results in terms of clinical symptoms and data. | Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Joji Tani Hisaaki Miyoshi Asahiro Morishita Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，42： | 9 |
| 4 | Circulating tumor DNA as a liquid biopsy target for detection of pancreatic cancer显示文摘Most pancreatic cancer patients present with advanced metastatic disease, resulting in extremely poor 5-year survival, mainly because of the lack of a reliable modality for early detection and limited therapeutic options for advanced disease. Therefore, there is a need for minimally-invasive diagnostic tools for detecting pancreatic cancer at an early stage, when curative surgery and also novel therapeutic approaches including precision medicine may be feasible. The 'liquid biopsy' addresses these unmet clinical needs based on the concept that simple peripheral blood sampling and detection of circulating tumor DNA(ct DNA) could provide diagnostic information. In this review, we provide an overview of the current status of bloodbased tests for diagnosis of pancreatic cancer and the potential utility of ct DNA for precision medicine. We also discuss challenges that remain to be addressed in developing practical ct DNA-based liquid biopsy approaches for early diagnosis of pancreatic cancer. | Erina Takai Shinichi Yachida | 2016 | World Journal of Gastroenterology2016，22，38： | 8 |
| 5 | Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth显示文摘Gastric hamartomatous inverted polyps(GHIP)are difficult to diagnose accurately because of inversion into the submucosal layer.GHIP are diagnosed using the pathological characteristics of the tumor,including the fibroblast cells,smooth muscle,nerve components,glandular hyperplasia,and cystic gland dilatation.Although Peutz-Jeghers syndrome,juvenile polyposis,and Cowden disease are hereditary,it is rare to encounter 2 cases of monostotic and asymptomatic gastric hamartomas.The pathogeneses of hamartomatous inverted polyps and inverted hyperplastic polyps remain controversial because of the paucity of reported cases.There are 3 hypotheses regarding the pathogenesis of complete gastric inverted polyps.Based on our experience with 2 successive,rare GHIP cases,we affirm the hypothesis that after a hamartomatous change occurs in the submucosal layer,some of these components are exposed to the gastric mucosa and,consequently,form a hypertrophic lesion.In Case 1,our hypothesis explains why a tiny hypertrophic change was first detected on the top of the submucosal tumor using a detailed narrow band imaging-magnified endoscopy.There was no confirmation that the milky white mucous and calcification structures were exuding directly from the biopsy site like Case 1,and in Case 2 the presence of this mucous was indirectly confirmed during an endoscopic submucosal dissection(ESD).Regarding the pathogenesis of GHIP,a submucosal hamartomatous change may occur prior to the growth of hypertrophic portions.An en bloc resection using ESD is recommended for treatment. | Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，19： | 7 |
| 6 | Familial pancreatic cancer: Concept, management and issues显示文摘Familial pancreatic cancer (FPC) is broadly defined as two first-degree-relatives with pancreatic cancer (PC) and accounts for 4%-10% of PC. Several genetic syndromes, including Peutz-Jeghers syndrome, hereditary pancreatitis, hereditary breast-ovarian cancer syndrome(HBOC), Lynch syndrome, and familial adenomatous polyposis (FAP), also have increased risks of PC, but the narrowest definition of FPC excludes these known syndromes. When compared with other familial tumors, proven genetic alterations are limited to a small proportion (<20%) and the familial aggregation is usually modest. However, an ethnic deviation (Ashkenazi Jewish>Caucasian) and a younger onset are common also in FPC. In European countries, 'anticipation' is reported in FPC families, as with other hereditary syndromes; a trend toward younger age and worse prognosis is recognized in the late years. The resected pancreases of FPC kindred often show multiple pancreatic intraepithelial neoplasia (Pan IN) foci, with various K-ras mutations, similar to colorectal polyposis seen in the FAP patients. As with HBOC patients, a patient who is a BRCA mutation carrier with unresectable pancreatic cancer (accounting for 0%-19% of FPC patients) demonstrated better outcome following platinum and Poly (ADP-ribose) polymerase inhibitor treatment. Western countries have established FPC registries since the 1990 s and several surveillance projects for highrisk individuals are now ongoing to detect early PCs. Improvement in lifestyle habits, including non-smoking, is recommended for individuals at risk. In Japan, the FPC study group was initiated in 2013 and the Japanese FPC registry was established in 2014 by the Japan Pancreas Society. | Hiroyuki Matsubayashi Kyoichi Takaori Chigusa Morizane Hiroyuki Maguchi Masamichi Mizuma Hideaki Takahashi Keita Wada Hiroko Hosoi Shinichi Yachida Masami Suzuki Risa Usui Toru Furukawa Junji Furuse Takamitsu Sato Makoto Ueno Yoshimi Kiyozumi Susumu Hijioka Nobumasa Mizuno Takeshi Terashima Masaki Mizumoto Yuzo Kodama Masako Torishima Takahisa Kawaguchi Reiko Ashida Masayuki Kitano Keiji Hanada Masayuki Furukawa Ken Kawabe Yoshiyuki Majima Toru Shimosegawa | 2017 | World Journal of Gastroenterology2017，23，6： | 5 |
| 7 | Immunohistochemically Detected Expression of 3 Major Genes (CDKN2A/p16, TP53, and SMAD4/DPC4) Strongly Predicts Survival in Patients With Resectable Pancreatic Cancer显示文摘 | Minoru Oshima Keiichi Okano Shinobu Muraki Reiji Haba Takashi Maeba Yasuyuki Suzuki Shinichi Yachida | 2013 | Annals of Surgery2013，，2： | 4 |
| 8 | Endoscopic management of a rare granulation polyp in a colonic diverticulum显示文摘There are many case reports on colon diverticula that cause irritable bowel syndrome,constipation,bleeding,diverticulitis,stricture due to multiple recurrences of diverticulitis,and perforation.However,few articles have examined neoplasms that arise from a diverticulum,such as adenoma and adenocarcinoma,and there have been no reports of granulation polyps that arise from a colon diverticulum after recurrent diverticulitis.We observed a rare granulation polyp that arose from a diverticulum as a result of repeated episodes of local diverticulitis.Narrow band imaging magnified colonoscopy was very useful to diagnose the polyp as a granulation polyp because of the absence of a pit pattern on the surface of the polyp.We successfully resected the polyp using endoscopic mucosal resection.We inverted the diverticulum,and the resected stalk of the polyp was used to close the diverticulum with an over-thescope clip.If a granulomatous polyp could arise from a diverticulum,differential diagnosis between a colon neoplasm and a granulomatous polyp would not only be difficult but also necessary for suitable endoscopic treatment. | Hirohito Mori Takaaki Tsushimi Hideki Kobara Noriko Nishiyama Shintaro Fujihara Tae Matsunaga Maki Ayagi Tatsuo Yachida Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，48： | 3 |
| 9 | Genomic alterations in pancreatic cancer and their relevance to therapy显示文摘Pancreatic cancer is a highly lethal cancer type, for which there are few viable therapeutic options. But, with the advance of sequencing technologies for global genomic analysis, the landscape of genomic alterations in pancreatic cancer is becoming increasingly well understood. In this review, we summarize current knowledge of genomic alterations in 12 core signaling pathways or cellular processes in pancreatic ductal adenocarcinoma, which is the most common type of malignancy in the pancreas, including four commonly mutated genes and many other genes that are mutated at low frequencies. We also describe the potential implications of these genomic alterations for development of novel therapeutic approaches in the context of personalized medicine. | Erina Takai Shinichi Yachida | 2015 | World Journal of Gastrointestinal Oncology2015，7，10： | 2 |
| 10 | Current Innovations in Endoscopic Therapy for the Management of Colorectal Cancer: From Endoscopic Submucosal Dissection to Endoscopic Full-Thickness Resection显示文摘 | Shintaro Fujihara Hirohito Mori Hideki Kobara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Asahiro Morishita Kunihiko Izuishi Tsutomu Masaki Hirotoshi Kobayashi | 2014 | BioMed Research International2014，，： | 2 |
| 11 | The patterns and dynamics of genomic instability in metastatic pancreatic cancer显示文摘 | Campbell PJ Yachida S Mudie LJ | 2010 | Nature2010，467，7319： | 1 |
| 12 | Sessile serrated adenomas and classical adenomas:an epigenetic perspective on premalignant neoplastic lesions of the gastrointestinal tract显示文摘 | Dhir M Yachida S Neste L | | 0，，08： | 1 |
| 13 | Distant metastasis occurs late during the genetic evolution of pancreatic cancer显示文摘 | Yachida S Jones S Bozic I | 2010 | Nature2010，467，7319： | 1 |
| 14 | Panoramic view system for extracting key sentences based on viewpoints and application to a search engine显示文摘 | Sunayama W Yachida M | 2005 | Journal of Network and Computer Applications2005，28，2： | 1 |
| 15 | The patterns and dynamics of genomic instability in metastatic pancreatic cancer显示文摘 | Campbell P J Yachida S Mudie L J Stephens P J Pleasance E D Stebbings L A | 2010 | Nature2010，467，： | 1 |
| 16 | Long - term survival after resection for small cell carcinoma of the esophagus 显示文摘 | YACHIDA S MATSUSHITA K USUKI H | 2001 | Ann Thorac Surg2001，72，2： | 1 |
| 17 | The patterns and dynamics of genomic instability in metastatic pancreatic cancer显示文摘 | Campbell PJ Yachida S Mudie LJ | 2010 | Nature2010，467，7319： | 1 |
| 18 | Genet-ic and epigenetic alterations of familial pancreatic cancers显示文摘 | Brune K Hong SM Li A Yachida S Abe T Griffith M | 2008 | CancerEpidemiol Biomarkers Prev2008，17，： | 1 |
| 19 | Validation of risk assessment scoring systems for an audit of elective surgery for gastrointestinal cancer in elderly patients : an audit显示文摘 | Wakabayashi H Sano T Yachida S | 2007 | Int J Surg2007，5，5： | 1 |
| 20 | Face detection from color images using a fuzzy pattern matching method显示文摘 | Wu H Chen Q Yachida M | 1999 | IEEE Transaction on Pattern Analysis and Machine Intelligence1999，22，6： | 1 |
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