26 results on '"Oka, S"'
Search Results
2. # 1142 Long-term prognosis of patients who underwent endoscopic resection for esophageal squamous cell carcinoma reaching or invading beyond the muscularis mucosae
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MIWATA, T, OKA, S, TANAKA, S, YOSHIFUKU, Y, KAGEMOTO, K, SANOMURA, Y, URABE, Y, TORU, HIYAMA, and CHAYAMA, K
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- 2015
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3. Gastrointestinal: Kaposiʼs sarcoma coexistent with Cytomegalovirus (CMV) infection
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Nagata, N, Iizuka, T, and Oka, S
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- 2011
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4. CLINICAL USEFULNESS OF DES-GAMMA-CARBOXY PROTHROMBIN AND LECTIN-REACTIVE ALPHA-FETOPROTEIN IN SMALL HEPATOCELLULAR CARCINOMA
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Yamamoto, K., Kato, M., Kurosawa, K., Tsuda, N., Oka, S., Shimizu, K., Komori, M., Nishimura, Y., Michida, T., Kaneko, A., Yuki, N., and Ikeda, M.
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- 2000
5. PROBLEMS IN DIAGNOSIS AND TREATMENT OF PROBABLE CASES OF AUTOIMMUNE HEPATITIS.
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Kaneko, A., Kato, M., Tsuda, N., Oka, S., Shimizu, K., Komori, M., Nishimura, Y., Michida, T., Yuki, N., Yamamoto, K., Kurosawa, K., and Ikeda, M.
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- 2000
6. Evaluation of the maximal excretion rate of indocyanin green as a prognostic indicator in patients undergoing biliary decompression for obstructive jaundice
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IZAWA, K., primary, SASAKI, M., additional, TOMIOKA, T., additional, OKA, S., additional, SEGAWA, T., additional, YAMAGUCHI, T., additional, TSUNODA, T., additional, and KANEMATSU, T., additional
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- 1993
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7. Nationwide multicenter study on adverse events associated with a patency capsule: Additional survey of appropriate use of patency capsule study.
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Omori T, Ohmiya N, Watanabe K, Hirai F, Nakamura M, Kitamura K, Ozeki K, Oka S, Kawano S, Handa O, Kawai M, Ninomiya K, Sagawa T, Wakamatsu T, Araki A, Koike Y, Kato S, Hashimoto S, Mannami T, Nakaji K, Tanaka S, and Matsui T
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- Humans, Retrospective Studies, Prospective Studies, Abdominal Pain etiology, Capsule Endoscopy adverse effects, Intestinal Obstruction epidemiology, Intestinal Obstruction etiology, Polymers, Xylenes
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Background and Aim: The PillCam patency capsule (PC) without a radio frequency identification tag was released to preclude retention of the small bowel capsule endoscope (CE) in Japan in 2012. We conducted a multicenter study to determine tag-less PC-related adverse events (AEs)., Methods: We first conducted a retrospective survey using a standardized data collection sheet for the clinical characteristics of PC-related AEs among 1096 patients collected in a prospective survey conducted between January 2013 and May 2014 (Cohort 1). Next, we retrospectively investigated additional AEs that occurred before and after Cohort 1 within the period June 2012 and December 2014 among 1482 patients (Cohort 2)., Results: Of the 2578 patients who underwent PC examinations from both cohorts, 74 AEs occurred among 61 patients (2.37%). The main AEs were residual parylene coating in 25 events (0.97%), PC-induced small bowel obstruction, suspicious of impaction, in 23 events (0.89%), and CE retention even after patency confirmation in 10 events (0.39%). Residual parylene coating was significantly associated with Crohn's disease (P < 0.01). Small bowel obstruction was significantly associated with physicians with less than 1 year of experience handling the PC and previous history of postprandial abdominal pain (P < 0.01 and P < 0.03, respectively). CE retention was ascribed to erroneous judgment of PC localization in all cases., Conclusions: This large-scale multicenter study provides evidence supporting the safety and efficiency of a PC to preclude CE retention. Accurate PC localization in patients without excretion and confirmation of previous history of postprandial abdominal pain before PC examinations is warranted (UMIN000010513)., (© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2024
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8. Long-term outcomes of patients with obscure gastrointestinal bleeding after negative capsule endoscopy.
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Hirata I, Tsuboi A, Matsubara Y, Sumioka A, Takasago T, Tanaka H, Yamashita K, Takigawa H, Kotachi T, Yuge R, Urabe Y, and Oka S
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- Humans, Recurrence, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage therapy, Time Factors, Retrospective Studies, Endoscopy, Gastrointestinal, Capsule Endoscopy adverse effects, Hemostasis, Endoscopic
- Abstract
Background and Aim: Although small-bowel capsule endoscopy (CE) is widely used for obscure gastrointestinal bleeding (OGIB), long-term outcomes for OGIB patients after negative CE remain unclear. Herein, we defined negative CE as P0 (no bleeding potential) or P1 (less likely to bleed), based on the P classification using CE. We aimed to clarify long-term outcomes of patients with OGIB after negative CE., Methods: This single-center observational study enrolled 461 consecutive patients with OGIB who underwent CE from March 2014 to October 2021 and were followed up for >1 year. We examined rebleeding rates and predictive factors., Results: Two hundred and twenty-four (49%) patients had P0, and 237 (51%) had P1 findings. Rebleeding occurred in 9% and 16% of patients in the P0 and P1 groups, respectively. Two patients in the P0 group and 15 in the P1 group showed rebleeding from the small bowel. The rate of small-bowel rebleeding was significantly lower in the P0 group than that in the P1 group (1% vs 6%, P = 0.002), as was the cumulative rebleeding rate (P = 0.004). In the multivariate analysis, history of endoscopic hemostasis (hazard ratio [HR] = 15.958, 95% confidence interval [CI]:4.950-51.447, P < 0.001) and P1 CE findings (HR = 9.989, 95% CI: 2.077-48.030, P = 0.004) were independently predicted small-bowel rebleeding., Conclusions: OGIB with P0 CE findings rarely showed rebleeding from the small bowel. Rebleeding may occur in patients with OGIB. Patients with history of endoscopic hemostasis for small-bowel lesions or P1 CE findings should be followed up intensively., (© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2024
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9. Comparison of clinical utility of deep learning-based systems for small-bowel capsule endoscopy reading.
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Aoki T, Yamada A, Oka S, Tsuboi M, Kurokawa K, Togo D, Tanino F, Teshima H, Saito H, Suzuki R, Arai J, Abe S, Kondo R, Yamashita A, Tsuboi A, Nakada A, Niikura R, Tsuji Y, Hayakawa Y, Matsuda T, Nakahori M, Tanaka S, Kato Y, Tada T, and Fujishiro M
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- Humans, Retrospective Studies, Intestine, Small diagnostic imaging, Intestine, Small pathology, Neural Networks, Computer, Capsule Endoscopy methods, Deep Learning
- Abstract
Background and Aim: Convolutional neural network (CNN) systems that automatically detect abnormalities from small-bowel capsule endoscopy (SBCE) images are still experimental, and no studies have directly compared the clinical usefulness of different systems. We compared endoscopist readings using an existing and a novel CNN system in a real-world SBCE setting., Methods: Thirty-six complete SBCE videos, including 43 abnormal lesions (18 mucosal breaks, 8 angioectasia, and 17 protruding lesions), were retrospectively prepared. Three reading processes were compared: (A) endoscopist readings without CNN screening, (B) endoscopist readings after an existing CNN screening, and (C) endoscopist readings after a novel CNN screening., Results: The mean number of small-bowel images was 14 747 per patient. Among these images, existing and novel CNN systems automatically captured 24.3% and 9.4% of the images, respectively. In this process, both systems extracted all 43 abnormal lesions. Next, we focused on the clinical usefulness. The detection rates of abnormalities by trainee endoscopists were not significantly different across the three processes: A, 77%; B, 67%; and C, 79%. The mean reading time of the trainees was the shortest during process C (10.1 min per patient), followed by processes B (23.1 min per patient) and A (33.6 min per patient). The mean psychological stress score while reading videos (scale, 1-5) was the lowest in process C (1.8) but was not significantly different between processes B (2.8) and A (3.2)., Conclusions: Our novel CNN system significantly reduced endoscopist reading time and psychological stress while maintaining the detectability of abnormalities. CNN performance directly affects clinical utility and should be carefully assessed., (© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2024
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10. Correlation between serum pro-inflammatory cytokine levels and the prognosis of the patients with acute liver failure.
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Murakami S, Uchida T, Imamura M, Suehiro Y, Namba M, Fujii Y, Uchikawa S, Teraoka Y, Fujino H, Ono A, Nakahara T, Murakami E, Okamoto W, Yamauchi M, Kawaoka T, Miki D, Hayes CN, Tsuge M, Ohira M, Ohdan H, and Oka S
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- Humans, Middle Aged, Cytokines, Interleukin-4, Interleukin-8, Prognosis, Hepatic Encephalopathy, Liver Failure, Acute diagnosis, Liver Failure, Acute etiology, Liver Failure, Acute surgery
- Abstract
Background and Aim: The prognosis of acute liver failure (ALF) remains poor, and liver transplantation is an alternative treatment option. Assessing the prognosis of ALF is important in determining treatment strategies. Here, we investigated clinical factors including serum pro-inflammatory cytokine levels that are associated with the prognosis of ALF., Methods: Sixty-six patients who developed ALF were enrolled in this study. Serum concentrations of 12 pro-inflammatory cytokines were measured on admission. The prognosis and factors associated with survival and development of hepatic coma were analyzed., Results: Of 66 patients, 4 patients underwent liver transplantation, and 49 patients were rescued without liver transplantation, while the remaining 13 patients died. Serum concentrations of interleukin (IL)-1β, IL-4, IL-6, IL-8, IL-13, TNF, IFN -γ, IP-10, and G-CSF were significantly elevated in ALF patients. IL-4 and IL-8 levels were higher in patients who underwent liver transplantation or died than in rescued patients. Multivariable analysis identified age ≥ 55 years and IL-4 ≥ 1.2 pg/mL on admission as independent factors for mortality. Serum IL-8 levels were higher in patients with hepatic coma, and prothrombin-international normalized ratio ≥ 3.5 and IL-8 ≥ 77.2 pg/mL on admission were associated with development of hepatic coma after admission., Conclusion: Serum levels of several pro-inflammatory cytokines were elevated in ALF patients. IL-4 and IL-8 were correlated with survival and development of hepatic coma after admission, respectively. Measurement of serum pro-inflammatory cytokines seems to be useful for the management of ALF., (© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2023
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11. Linked color imaging provides enhanced visibility with a high color difference in upper gastrointestinal neoplasms.
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Dohi O, Ono S, Kawada K, Kitamura S, Hatta W, Hori S, Kanzaki H, Murao T, Yagi N, Sasaki F, Hashiguchi K, Oka S, Katada K, Shimoda R, Mizukami K, Suehiro M, Takeuchi T, Katsuki S, Tsuda M, Naito Y, Kawano T, Haruma K, Ishikawa H, Mori K, and Kato M
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- Humans, Light, Esophagus pathology, Narrow Band Imaging methods, Image Enhancement methods, Color, Stomach Neoplasms pathology
- Abstract
Background and Aim: The aim of this post-hoc analysis in a randomized, controlled, multicenter trial was to evaluate the visibility of upper gastrointestinal (UGI) neoplasms detected using linked color imaging (LCI) compared with those detected using white light imaging (WLI)., Methods: The visibility of the detected UGI neoplasm images obtained using both WLI and LCI was subjectively reviewed, and the median color difference (ΔE) between each lesion and the surrounding mucosa according to the CIE L*a*b* color space was evaluated objectively. Multivariate logistic regression analysis was performed to identify factors associated with neoplasms that were missed under WLI and detected under LCI., Results: A total of 120 neoplasms, including 10, 32, and 78 neoplasms in the pharynx, esophagus, and stomach, respectively, were analyzed in this study. LCI enhanced the visibility 80.9% and 93.6% of neoplasms in pharynx/esophagus and stomach compared with WLI, respectively. LCI also achieved a higher ΔE of enhanced neoplasms compared with WLI in the pharynx/esophagus and stomach. The median WLI ΔE values for gastric neoplasms missed under WLI and later detected under LCI were significantly lower than those for gastric neoplasms detected under WLI (8.2 vs 9.6, respectively). Furthermore, low levels of WLI ΔE (odds ratio [OR], 7.215) and high levels of LCI ΔE (OR, 22.202) were significantly associated with gastric neoplasms missed under WLI and later detected under LCI., Conclusion: Color differences were independently associated with missing gastric neoplasms under WLI, suggesting that LCI has an obvious advantage over WLI in enhancing neoplastic visibility., (© 2022 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2023
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12. Novel endoscopic ultrasonography classification for assured vertical resection margin (≥500 μm) in colorectal endoscopic submucosal dissection.
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Kamigaichi Y, Oka S, Tanino F, Yamamoto N, Tamari H, Shimohara Y, Nishimura T, Inagaki K, Okamoto Y, Tanaka H, Yamashita K, Arihiro K, and Tanaka S
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- Humans, Japan
- Abstract
Background and Aim: The risk of local recurrence might be low in pT1 colorectal carcinoma with a tumor vertical margin (VM) ≥500 μm. We investigated the relationship between endoscopic ultrasonography (EUS) findings and VM in cases with colorectal endoscopic submucosal dissection (ESD) categorized as Type 2B according to the Japan NBI Expert Team (JNET) classification., Methods: We analyzed 179 JNET Type 2B colorectal tumors resected by ESD at Hiroshima University Hospital from January 2010 to May 2021. The distance from the tumor invasive front to the muscle layer on EUS was defined as the tumor-free distance (EUS-TFD) and classified as Type I (EUS-TFD ≥1 mm) and II (<1 mm). We investigated the relationship between EUS-TFD and VM and analyzed the predictive factors for VM ≥500 μm., Results: EUS-TFD Type I was diagnosed in 133 (74.3%) lesions: VM ≥500 μm (114, 85.7%); VM <500 μm (19, 14.3%); and VM positive (VM1) (0, 0%). Type II was diagnosed in 46 (25.7%) lesions: VM ≥500 μm (14, 30.5%); VM <500 μm (22, 47.8%); and VM1 (10, 21.7%). In the EUS-TFD Type I cases, 84.5% and 87.8% were protruded and superficial types; whereas for Type II cases, these were 38.9% and 25%, respectively. EUS-TFD classification (Type I), scope operability (good), submucosal invasion depth (<2000 μm), histology at the deepest invasive portion (favorable), and degree of fibrosis (F0/F1) were significant predictors of VM ≥500 μm., Conclusions: In JNET Type 2B lesions, EUS-TFD classification is a novel diagnostic indicator to predict VM ≥500 μm in ESD preoperatively., (© 2022 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2022
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13. Development of multi-class computer-aided diagnostic systems using the NICE/JNET classifications for colorectal lesions.
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Okamoto Y, Yoshida S, Izakura S, Katayama D, Michida R, Koide T, Tamaki T, Kamigaichi Y, Tamari H, Shimohara Y, Nishimura T, Inagaki K, Tanaka H, Yamashita K, Sumimoto K, Oka S, and Tanaka S
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- Artificial Intelligence, Humans, Sensitivity and Specificity, Colonoscopes, Colorectal Neoplasms diagnostic imaging, Diagnosis, Computer-Assisted
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Background and Aim: Diagnostic support using artificial intelligence may contribute to the equalization of endoscopic diagnosis of colorectal lesions. We developed computer-aided diagnosis (CADx) support system for diagnosing colorectal lesions using the NBI International Colorectal Endoscopic (NICE) classification and the Japan NBI Expert Team (JNET) classification., Methods: Using Residual Network as the classifier and NBI images as training images, we developed a CADx based on the NICE classification (CADx-N) and a CADx based on the JNET classification (CADx-J). For validation, 480 non-magnifying and magnifying NBI images were used for the CADx-N and 320 magnifying NBI images were used for the CADx-J. The diagnostic performance of the CADx-N was evaluated using the magnification rate., Results: The accuracy of the CADx-N for Types 1, 2, and 3 was 97.5%, 91.2%, and 93.8%, respectively. The diagnostic performance for each magnification level was good (no statistically significant difference). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CADx-J were 100%, 96.3%, 82.8%, 100%, and 96.9% for Type 1; 80.3%, 93.7%, 94.1%, 79.2%, and 86.3% for Type 2A; 80.4%, 84.7%, 46.8%, 96.3%, and 84.1% for Type 2B; and 62.5%, 99.6%, 96.8%, 93.8%, and 94.1% for Type 3, respectively., Conclusions: The multi-class CADx systems had good diagnostic performance with both the NICE and JNET classifications and may aid in educating non-expert endoscopists and assist in diagnosing colorectal lesions., (© 2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2022
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14. Heterogeneous distribution of Fusobacterium nucleatum in the progression of colorectal cancer.
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Yamamoto S, Kinugasa H, Hirai M, Terasawa H, Yasutomi E, Oka S, Ohmori M, Yamasaki Y, Inokuchi T, Harada K, Hiraoka S, Nouso K, Tanaka T, Teraishi F, Fujiwara T, and Okada H
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- Humans, Ki-67 Antigen, Proto-Oncogene Proteins B-raf, Proto-Oncogene Proteins p21(ras) genetics, Adenoma, Colorectal Neoplasms microbiology, Fusobacterium nucleatum
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Background and Aim: Fusobacterium nucleatum (Fn) is involved in colorectal cancer (CRC) growth and is a biomarker for patient prognosis and management. However, the ecology of Fn in CRC and the distribution of intratumoral Fn are unknown., Methods: We evaluated Fn and the status of KRAS and BRAF in 200 colorectal neoplasms (118 adenomas and 82 cancers) and 149 matched adjacent normal mucosas. The differentiation status between "surface" and "deep" areas of cancer tissue and matched normal mucosa were analyzed in 46 surgical samples; the Ki-67 index was also evaluated in these samples., Results: Fusobacterium nucleatum presence in the tumor increased according to pathological stage (5.9% [adenoma] to 81.8% [stage III/IV]), while Fn presence in normal mucosa also increased (7.6% [adenoma] to 40.9% [stage III/IV]). The detection rates of Fn on the tumor surface and in deep areas were 45.7% and 32.6%, while that of normal mucosa were 26.1% and 23.9%, respectively. Stage III/IV tumors showed high Fn surface area expression (66.7%). Fn intratumoral heterogeneity (34.8%) was higher than that of KRAS (4.3%; P < 0.001) and BRAF (2.2%; P < 0.001). The Ki-67 index in Fn-positive cases was higher than that in negative cases (93.9% vs 89.0%; P = 0.01)., Conclusions: Fusobacterium nucleatum was strongly present in CRC superficial areas at stage III/IV. The presence of Fn in the deep areas of adjacent normal mucosa also increased. The intratumoral heterogeneity of Fn is important in the use of Fn as a biomarker, as Fn is associated with CRC proliferative capacity., (© 2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2021
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15. Automatic detection of blood content in capsule endoscopy images based on a deep convolutional neural network.
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Aoki T, Yamada A, Kato Y, Saito H, Tsuboi A, Nakada A, Niikura R, Fujishiro M, Oka S, Ishihara S, Matsuda T, Nakahori M, Tanaka S, Koike K, and Tada T
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- Area Under Curve, Humans, Intestine, Small metabolism, ROC Curve, Retrospective Studies, Sensitivity and Specificity, Blood diagnostic imaging, Blood metabolism, Capsule Endoscopy methods, Deep Learning, Intestine, Small diagnostic imaging, Intestine, Small pathology, Neural Networks, Computer
- Abstract
Background and Aim: Detecting blood content in the gastrointestinal tract is one of the crucial applications of capsule endoscopy (CE). The suspected blood indicator (SBI) is a conventional tool used to automatically tag images depicting possible bleeding in the reading system. We aim to develop a deep learning-based system to detect blood content in images and compare its performance with that of the SBI., Methods: We trained a deep convolutional neural network (CNN) system, using 27 847 CE images (6503 images depicting blood content from 29 patients and 21 344 images of normal mucosa from 12 patients). We assessed its performance by calculating the area under the receiver operating characteristic curve (ROC-AUC) and its sensitivity, specificity, and accuracy, using an independent test set of 10 208 small-bowel images (208 images depicting blood content and 10 000 images of normal mucosa). The performance of the CNN was compared with that of the SBI, in individual image analysis, using the same test set., Results: The AUC for the detection of blood content was 0.9998. The sensitivity, specificity, and accuracy of the CNN were 96.63%, 99.96%, and 99.89%, respectively, at a cut-off value of 0.5 for the probability score, which were significantly higher than those of the SBI (76.92%, 99.82%, and 99.35%, respectively). The trained CNN required 250 s to evaluate 10 208 test images., Conclusions: We developed and tested the CNN-based detection system for blood content in CE images. This system has the potential to outperform the SBI system, and the patient-level analyses on larger studies are required., (© 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2020
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16. Potential of Helicobacter pylori-uninfected signet ring cell carcinoma to invade the submucosal layer.
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Yorita N, Ito M, Boda T, Kotachi T, Nagasaki N, Abuduwaili M, Hata K, Hiyama Y, Oka S, Yoshihara M, Kitadai Y, Tanaka S, and Chayama K
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- Humans, Japan, Neoplasm Invasiveness, Gastric Mucosa pathology, Gastritis microbiology, Gastritis pathology, Helicobacter Infections, Helicobacter pylori, Stomach Neoplasms pathology
- Abstract
Background and Aim: The typical histology of Helicobacter pylori-uninfected gastric cancer is signet ring cell carcinoma (SRCC) localized in the mucosal layer, but the potential of these SRCCs to invade the submucosal layer is unclear. This study aimed to investigate the clinicopathological characteristics of SRCC in H. pylori-uninfected patient and its prevalence in diffuse-type gastric cancer (DGC) within Japan., Methods: We enrolled consecutive pure DGC patients diagnosed with the disease either localized in the mucosal layer or with submucosal invasion. H. pylori infection was investigated, and the patients were divided into three groups according to histological types: pure SRCC, SRCC with poorly differentiated adenocarcinoma (PDA), and pure PDA., Results: Of the 345 pure DGC patients, 132 (38%), 127 (37%), and 86 (25%) had pure SRCC, SRCC with PDA, and pure PDA histologies, respectively. The prevalence of H. pylori infection and the SM ratio were significantly lower in the pure SRCC group than other groups (P < 0.01). Twenty-two (6.4%) patients, including two with submucosal invasion, were negative for H. pylori and had mucosal SRCC component in the cancer lesions. Of the 259 SRCC cases (pure SRCC or SRCC + PDA), H. pylori-uninfected cases had different clinicopathological characteristics compared with H. pylori-positive cases. Particularly, the ratio of patients with submucosal invasive SRCC was significantly lower in the H. pylori-uninfected gastric cancer group than in those with H. pylori infection., Conclusion: Helicobacter pylori-uninfected gastric cancer is not rare among pure DGC patients in Japan. SRCC in patients without H. pylori infection is less likely to be invasive., (© 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2019
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17. Clinical significance of small-bowel villous edema in patients with liver cirrhosis: A capsule endoscopy study.
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Otani I, Oka S, Tanaka S, Tsuboi A, Kunihara S, Nagaoki Y, Aikata H, and Chayama K
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- Adult, Aged, Aged, 80 and over, Edema etiology, Edema pathology, Female, Humans, Hypertension, Portal etiology, Intestinal Diseases etiology, Intestinal Diseases pathology, Male, Middle Aged, Young Adult, Capsule Endoscopy, Edema diagnosis, Intestinal Diseases diagnosis, Intestine, Small pathology, Liver Cirrhosis complications
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Background and Aim: The relationship between the presence of villous edema (VE) in portal hypertensive enteropathy and clinical factors remains unclear. The aim of this study was to reveal the clinical factors related to VE in patients with liver cirrhosis (LC), and investigate the clinical significance of VE., Methods: Between February 2009 and September 2016, 363 consecutive patients with LC underwent capsule endoscopy for diagnosing portal hypertensive enteropathy at Hiroshima University Hospital. We evaluated the relationship between the presence of VE and patients' clinical characteristics, findings of esophagogastroduodenoscopy and computed tomography, and survival time., Results: Villous edema was observed in 131 patients (36%), and severe lesions were found in 71 (20%). The presence of VE was significantly greater in patients with Child-Pugh classification B or C, esophageal varices, portal hypertensive gastropathy (PHG), ascites, portal vein thrombosis (PVT), and splenomegaly. In multivariate analysis, Child-Pugh class B or C, esophageal varices, PVT, and splenomegaly were significant predictive factors for the presence of VE. Severe VE was significantly greater in patients with Child-Pugh class B or C, serum albumin level ≤ 3.2 mg/dL, PHG, and PVT. In multivariate analysis, PHG, Child-Pugh class B or C, PVT, were significant predictive factors for severe VE., Conclusions: Clinical factors related to portal hypertension were significantly correlated with VE. In particular PVT was correlated with the appearance and exacerbation of VE. Periodic capsule endoscopy in LC patients may lead to early detection of portal hypertension and PVT., (© 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2018
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18. Clinical significance and validity of the subclassification for colorectal laterally spreading tumor granular type.
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Shigita K, Oka S, Tanaka S, Sumimoto K, Hirano D, Tamaru Y, Ninomiya Y, Asayama N, Hayashi N, Nagata S, Arihiro K, and Chayama K
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- Adenocarcinoma classification, Adenocarcinoma surgery, Adenoma classification, Adenoma surgery, Aged, Aged, 80 and over, Colonoscopy methods, Colorectal Neoplasms classification, Colorectal Neoplasms surgery, Coloring Agents, Female, Humans, Indigo Carmine, Japan, Male, Middle Aged, Neoplasm Invasiveness, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Adenocarcinoma pathology, Adenoma pathology, Colorectal Neoplasms pathology, Cytoplasmic Granules pathology, Terminology as Topic
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Background and Aim: Colorectal laterally spreading tumor granular type (LST-G) is generally divided into two subtypes based on morphology. Here, we retrospectively investigated the clinical significance of a concrete, objective LST-G subclassification., Methods: This study examined 636 consecutive cases that were resected endoscopically or surgically. LST-G was subclassified as follows: Type 1, a lesion with homogenous uniform granules with uniform (<5 mm) nodules; Type 2, a lesion with granules and small nodules (≥5 mm, <10 mm); or Type 3, a lesion accompanied by large nodules (≥10 mm). For the validation study, 194 images were compiled from 97 cases investigated using conventional colonoscopy and chromoendoscopy with indigo carmine dye spraying. Images were distributed in a randomized order to students without prior endoscopy experience, less-experienced endoscopists (LEE group), and highly experienced endoscopists (HEE group). Diagnostic accuracy and interobserver agreement were then evaluated., Results: There was no submucosal invasion in Type 1 lesions. The incidence of deep submucosal invasive carcinoma was higher for Type 3 lesions than for Type 2 lesions. Interobserver agreement was good in each group. Diagnostic accuracy was higher in the HEE group than in the student and LEE groups. Chromoendoscopy had a higher accuracy rate than conventional colonoscopy in the LEE and HEE groups (LEE, 0.74 vs 0.69, P < 0.05; HEE, 0.84 vs 0.78, P < 0.05)., Conclusions: This subclassification of LST-G according to the diameters of granules and nodules was both useful for choosing therapeutic strategies in the clinical setting and universally applicable., (© 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2016
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19. Major predictors of portal hypertensive enteropathy in patients with liver cirrhosis.
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Aoyama T, Oka S, Aikata H, Igawa A, Nakano M, Naeshiro N, Yoshida S, Tanaka S, and Chayama K
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- Adult, Aged, Aged, 80 and over, Female, Gastrointestinal Diseases pathology, Humans, Liver Cirrhosis complications, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Capsule Endoscopy, Gastrointestinal Diseases diagnosis, Gastrointestinal Diseases etiology, Hypertension, Portal complications, Hypertension, Portal diagnosis
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Background and Aim: Portal hypertensive enteropathy (PHE) is acknowledged as a source of bleeding, and predicting its presence has become more important. We assessed PHE using capsule endoscopy (CE) and investigated factors that may predict its presence, including portosystemic shunts (PSs)., Methods: We analyzed data from 134 consecutive patients with liver cirrhosis, from February 2009 to September 2013. All patients had undergone dynamic computed tomography and esophagogastroduodenoscopy before CE examination. The frequencies and types of PHE lesions, and the relationships between the presence of PHE and patients' clinical characteristics were evaluated. The distribution of the lesions was also determined., Results: PHE was found in 91 (68%), erythema in 70 (52%), erosions in 25 (19%), angioectasia in 24 (18%), villous edema in 18 (13%), and varices in 10 (7%) patients. Most lesions were located in the jejunum. The clinical characteristics associated with the presence of PHE were a Child-Pugh grade of B or C (P = 0.0058), and the presence of PSs (P < 0.0001), ascites (P = 0.0017), portal thrombosis (P = 0.016), esophageal varices (P = 0.0017), and portal hypertensive gastropathy (P = 0.0029). The presence of PSs was an independent predictor of PHE (odds ratio [OR]: 3.15; 95% confidence interval [CI]: 1.27-7.95). Among the shunt types, left gastric vein (OR: 5.31; 95% CI: 1.97-17.0) and splenorenal shunts (OR: 4.26; 95% CI: 1.29-19.4) were independent predictors of PHE., Conclusion: PSs, especially left gastric vein and splenorenal shunts, appear to reliably predict the presence of PHE., (© 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)
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- 2015
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20. Is small-bowel capsule endoscopy effective for diagnosis of esophagogastric lesions related to portal hypertension?
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Aoyama T, Oka S, Aikata H, Nakano M, Watari I, Naeshiro N, Yoshida S, Tanaka S, and Chayama K
- Subjects
- Adult, Aged, Aged, 80 and over, Esophageal and Gastric Varices epidemiology, Female, Humans, Hypertension, Portal epidemiology, Male, Middle Aged, Retrospective Studies, Capsule Endoscopy statistics & numerical data, Esophageal and Gastric Varices diagnosis, Esophageal and Gastric Varices etiology, Hypertension, Portal complications, Hypertension, Portal diagnosis
- Abstract
Background and Aim: Effectiveness of capsule endoscopy (CE) for screening the small bowel in patients with portal hypertension (PHT) has been reported. However, few reports discuss CE detection of specific esophagogastric lesions related to PHT. Thus, we assessed whether CE is useful for detecting such lesions., Methods: One hundred nineteen consecutive patients with PHT comprised the study group. All had undergone esophagogastroduodenoscopy (EGD) prior to CE. The diagnostic yield of CE for esophageal varices (EVs), gastric varices (GVs), and portal hypertensive gastropathy (PHG) was evaluated. In addition, diagnostic yield in relation to form, location of the varices, grade, and extent of PHG was evaluated., Results: EVs were found by EGD in 71 patients. The overall diagnostic yield of CE for EVs was 72% (51/71). The diagnostic yield was significantly greater for F2/F3 EVs than for F1 EVs (87% vs 61%, P = 0.03). The diagnostic yield was significantly greater for Lm/Ls EVs than for Li EVs (85% vs 55%, P = 0.01). The diagnostic yield was significantly greater for locus superior/locus medialis EVs than for locus inferior EVs (85% vs 55%, P = 0.01). GVs were found by EGD in 29 patients. Only one case was detected by CE. PHG was found by EGD in 35 patients. The diagnostic yield of CE for PHG was 69% (24/35). There was no difference in diagnostic yield between cases of severe and mild PHG (82% vs 63%, P = 0.44). Diagnostic yield of CE for PHG in the gastric body was significantly greater than that in the fundus (100% vs 48%, P = 0.0009)., Conclusion: CE is reliable for diagnosis of F2/F3 and/or Lm/Ls EVs and of PHG in the gastric body., (© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)
- Published
- 2014
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21. Clinicopathologic features of hyperplastic/serrated polyposis syndrome in Japan.
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Miwata T, Hiyama T, Oka S, Tanaka S, Shimamoto F, Arihiro K, and Chayama K
- Subjects
- Adult, Aged, Aged, 80 and over, Colonoscopy, Colorectal Neoplasms etiology, Female, Humans, Intestinal Mucosa pathology, Intestinal Mucosa surgery, Intestinal Polyposis complications, Intestinal Polyposis pathology, Intestinal Polyposis surgery, Male, Middle Aged, Retrospective Studies, Risk, Surveys and Questionnaires, Syndrome, Young Adult, Intestinal Polyposis diagnosis
- Abstract
Background and Aim: Hyperplastic/serrated polyposis syndrome (HPS) is a condition characterized by multiple hyperplastic/serrated colorectal polyps. The risk of colorectal cancer (CRC) is increased in HPS. The clinicopathologic characteristics of HPS in Japanese patients are unknown. The aim of this study is to clarify the clinicopathologic features of HPS in Japanese patients., Methods: We retrieved records of patients diagnosed with HPS between April 2008 and March 2011 from the endoscopy database of Hiroshima University Hospital. In addition, we mailed a questionnaire to the hospital's 13 affiliated hospitals in July 2012. Data collected from the database and questionnaires included patient age, sex, number of hyperplastic/serrated polyps and tubular adenomas, size of the largest polyp, polyp location, resection for polyps, coexistence of HPS with CRC, and the diagnostic criterion met., Results: Of the 73,608 patients who underwent colonoscopy, 10 (0.014%) met the criteria for HPS. The mean age of these patients was 58.3 years, and 6 (60%) were men. No subjects had a first-degree relative with HPS. Four (40%) HPS patients had more than 30 hyperplastic/serrated polyps, and average size of the largest polyp was 19 mm. Three (30%) HPS patients had coexistence of HPS with CRC. In these 3 patients, polyps were observed throughout the colorectum., Conclusions: Although HPS was a rare condition in the overall study population, patients with the disease may have high risk of CRC. HPS should be diagnosed correctly and followed up carefully., (© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)
- Published
- 2013
- Full Text
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22. Clinical outcomes of endoscopic submucosal dissection for early gastric cancer in patients with chronic kidney disease.
- Author
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Numata N, Oka S, Tanaka S, Higashiyama M, Sanomura Y, Yoshida S, Arihiro K, and Chayama K
- Subjects
- Aged, Aged, 80 and over, Female, Gastrointestinal Hemorrhage prevention & control, Humans, Male, Postoperative Hemorrhage prevention & control, Prognosis, Renal Insufficiency, Chronic therapy, Risk, Stomach Neoplasms pathology, Gastric Mucosa surgery, Gastrointestinal Hemorrhage etiology, Gastroscopy methods, Postoperative Hemorrhage etiology, Renal Dialysis adverse effects, Renal Insufficiency, Chronic complications, Stomach Neoplasms surgery
- Abstract
Background and Aim: Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric cancer (EGC), and the number of ESD performed for EGC in patients with chronic kidney disease (CKD) is increasing. Although patients undergoing hemodialysis tend to bleed and are at high risk for cardiovascular disease, the effectiveness and safety of ESD for EGC in patients with CKD in particular have not been established. The aim of this study was to evaluate the effectiveness and potential adverse effects of ESD for EGC in patients with CKD undergoing hemodialysis., Methods: Sixty-three consecutive CKD patients in whom 79 EGCs were treated by ESD between October 2004 and January 2012; 15 of the 63 patients were hemodialysis patients. Complete en bloc resection rate and ESD-related complications in hemodialysis patients versus non-hemodialysis patients were evaluated., Results: The complete en bloc resection rate was 100% (15/15) in the hemodialysis patients and 87.5% (56/64) in the non-hemodialysis patients, respectively. The post-ESD bleeding rate was 33% (5/15) and 9% (6/64), respectively (P < 0.05). Perforation occurred only in non-hemodialysis patients; the incidence was 5% (3/64). Two ESD-related deaths occurred among hemodialysis patients (13%, 2/15); femoral artery infarction triggered post-ESD bleeding in one of these two patients, and alveolar hemorrhage occurred in the other., Conclusion: Hemodialysis poses a risk of post-ESD bleeding. We must understand this risk and provide countermeasures for post-ESD bleeding in hemodialysis patients., (© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)
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- 2013
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23. Quantitative identification of mucosal gastric cancer under magnifying endoscopy with flexible spectral imaging color enhancement.
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Miyaki R, Yoshida S, Tanaka S, Kominami Y, Sanomura Y, Matsuo T, Oka S, Raytchev B, Tamaki T, Koide T, Kaneda K, Yoshihara M, and Chayama K
- Subjects
- Aged, Female, Humans, Logistic Models, Male, Predictive Value of Tests, Probability, ROC Curve, Sensitivity and Specificity, Software, Color, Diagnosis, Computer-Assisted methods, Gastroscopy methods, Image Enhancement methods, Stomach Neoplasms diagnosis, Stomach Neoplasms pathology
- Abstract
Background and Aim: Magnifying endoscopy with flexible spectral imaging color enhancement (FICE) is clinically useful in diagnosing gastric cancer and determining treatment options; however, there is a learning curve. Accurate FICE-based diagnosis requires training and experience. In addition, objectivity is necessary. Thus, a software program that can identify gastric cancer quantitatively was developed., Methods: A bag-of-features framework with densely sampled scale-invariant feature transform descriptors to magnifying endoscopy images of 46 mucosal gastric cancers was applied. Computer-based findings were compared with histologic findings. The probability of gastric cancer was calculated by means of logistic regression, and sensitivity and specificity of the system were determined., Results: The average probability was 0.78 ± 0.25 for the images of cancer and 0.31 ± 0.25 for the images of noncancer tissue, with a significant difference between the two groups. An optimal cut-off point of 0.59 was determined on the basis of the receiver operating characteristic curves. The computer-aided diagnosis system yielded a detection accuracy of 85.9% (79/92), sensitivity for a diagnosis of cancer of 84.8% (39/46), and specificity of 87.0% (40/46)., Conclusion: Further development of this system will allow for quantitative evaluation of mucosal gastric cancers on magnifying gastrointestinal endoscopy images obtained with FICE., (© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)
- Published
- 2013
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24. Management of T1 colorectal carcinoma with special reference to criteria for curative endoscopic resection.
- Author
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Nakadoi K, Tanaka S, Kanao H, Terasaki M, Takata S, Oka S, Yoshida S, Arihiro K, and Chayama K
- Subjects
- Adenocarcinoma pathology, Adenocarcinoma secondary, Adult, Aged, Aged, 80 and over, Colorectal Neoplasms pathology, Humans, Intestinal Mucosa pathology, Lymphatic Metastasis, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Patient Selection, Risk Factors, Adenocarcinoma surgery, Colorectal Neoplasms surgery, Endoscopy, Gastrointestinal methods
- Abstract
Background and Aim: In guidelines 2010 for the treatment of colorectal cancer from the Japanese Society for Cancer of the Colon and Rectum (JSCCR), the criteria for identifying curable T1 colorectal carcinoma after endoscopic resection were well/moderately differentiated or papillary histologic grade, no vascular invasion, submucosal invasion depth less than 1000 µm and budding grade 1 (low grade). We aimed to expand these criteria., Methods: A total of 499 T1 colorectal carcinomas, resected endoscopically or surgically, were analyzed. Relationships between clinicopathologic findings and lymph node metastasis were evaluated., Results: Lymph node metastasis was found in 41 (8.22%) of the 499 cases. The incidence of lymph node metastasis was significantly higher in lesions featuring poorly differentiated/mucinous adenocarcinoma, submucosal invasion ≥ 1800 µm, vascular invasion, and high-grade tumor budding than in other lesions. Multivariate logistic regression analysis showed all of these variables to be independent risk factors for lymph node metastasis. When cases that met three of the JSCCR 2010 criteria (i.e. all but invasion < 1000 µm) were considered together, the incidence of lymph node metastasis was only 1.2% (3/249, 95% confidence interval: 0.25-3.48%), and there were no cases of lymph node metastasis without submucosal invasion to a depth of ≥ 1800 µm., Conclusions: Even in cases of colorectal carcinoma with deep submucosal invasion, the risk of lymph node metastasis is minimal under certain conditions. Thus, even for such cases, endoscopic incisional biopsy can be suitable if complete en bloc resection is achieved., (© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.)
- Published
- 2012
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25. Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm.
- Author
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Terasaki M, Tanaka S, Oka S, Nakadoi K, Takata S, Kanao H, Yoshida S, and Chayama K
- Subjects
- Adenocarcinoma pathology, Adenoma pathology, Adult, Aged, Aged, 80 and over, Colon injuries, Colonoscopy, Colorectal Neoplasms pathology, Female, Follow-Up Studies, Humans, Intestinal Perforation etiology, Intraoperative Complications etiology, Male, Middle Aged, Postoperative Hemorrhage etiology, Retrospective Studies, Time Factors, Treatment Outcome, Adenocarcinoma surgery, Adenoma surgery, Colorectal Neoplasms surgery, Intestinal Mucosa surgery, Neoplasm Recurrence, Local pathology
- Abstract
Background and Aims: Colorectal laterally spreading tumors (LST) > 20 mm are usually treated by endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR). Endoscopic piecemeal mucosal resection (EPMR) is sometimes required. The aim of our study was to compare the outcomes of ESD and EMR, including EPMR, for such LST., Methods: A total of 269 consecutive patients with a colorectal LST > 20 mm were treated endoscopically at our hospital from April 2006 to December 2009. We retrospectively evaluated the complications and local recurrence rates associated with ESD, hybrid ESD (ESD with EMR), EMR, and EPMR., Results: ESD and EMR were performed successfully for 89 and 178 LST, respectively: 61 by ESD; 28 by hybrid ESD; 70 by EMR; and 108 by EPMR. Between-group differences in perforation rates were not significant. Local recurrence rates in cases with curative resection were as follows: 0% (0/56) in ESD; 0% (0/27) in hybrid ESD; 1.4% (1/69) in EMR; and 12.1% (13/107) in EPMR; that is, significantly higher in EPMR. No metastasis was seen at follow up. The recurrence rate for EPMR yielding ≥ three pieces was significantly high (P < 0.001). All 14 local recurrent lesions were adenomas that were cured endoscopically., Conclusions: As for safety, ESD/hybrid ESD is equivalent to EMR/EPMR. ESD/hybrid ESD is a feasible technique for en bloc resection and showed no local recurrence. Although local recurrences associated with EMR/EPMR were seen, which were conducted based on our indication criteria, all local recurrences could obtain complete cure by additional endoscopic treatment., (© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.)
- Published
- 2012
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26. Frequent somatic mutations of mitochondrial DNA in traditional serrated adenomas but not in sessile serrated adenomas of the colorectum.
- Author
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Shimomura T, Hiyama T, Oka S, Tanaka S, Yoshihara M, Shimamoto F, and Chayama K
- Subjects
- Adenoma pathology, Adult, Aged, Aged, 80 and over, Carcinoma pathology, Colonic Polyps pathology, Colorectal Neoplasms pathology, DNA Mutational Analysis, Genetic Markers, Humans, Hyperplasia, Japan, Middle Aged, Adenoma genetics, Biomarkers, Tumor genetics, Carcinoma genetics, Colonic Polyps genetics, Colorectal Neoplasms genetics, DNA, Mitochondrial, Mutation
- Abstract
Background and Aim: Serrated adenomas (SAs), recently subdivided into traditional SAs (TSAs) and sessile SAs (SSAs), are recognized as a distinct form of neoplasia of the colorectum. One of the characteristics of SAs is hypermaturation of the gland epithelium due to the low extent of cell loss by apoptosis. Mutations of mitochondrial DNA (mtDNA) are closely associated with abnormality in apoptosis. We therefore examined mtDNA mutations in colorectal lesions including hyperplastic polyps (HPs), SSAs, TSAs, and carcinomas., Methods: Examined were 25 HPs, 32 SSAs, 19 TSAs, and 138 carcinomas. The D310 region of the mtDNAs was examined by microsatellite assay., Results: mtDNA mutations were detected in none of 25 (0%) HPs, one of 32 (3%) SSAs, six of 19 (32%) TSAs, and eleven of 133 (8%) carcinomas (five of the 138 carcinomas were not informative). The frequency of mtDNA mutations in the TSAs was significantly higher than that in the HPs, SSAs, and carcinomas (P = 0.004, P = 0.008, and P = 0.009, respectively). The frequency of mtDNA mutations in carcinomas was not significantly higher than that in HPs and SSAs (P = 0.14 and P = 0.28, respectively)., Conclusion: Our data suggest that mtDNA mutations may play an important role in the development of TSAs and could be used as a genetic marker to aid in the diagnosis of colorectal lesions., (© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.)
- Published
- 2011
- Full Text
- View/download PDF
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