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Objective : This study aimed to determine the detection rate of cancer by target site in MRI-TRUS fusion pros)tate biopsy. Methods : This study included 370 prostate biopsy cases at the first time with PSA levels below 20 ng/ml who underwent targeted biopsy (TB) in addition to systematic biopsy (SB) at Hiroshima University Hospital. MRI was evaluated based on PI-RADS version 2 and cases with category 3 or higher were considered for biopsy. The association with the detection of clinically significant (CS) cancer by site was analyzed. Results : The case-specific cancer positivity rates were 70.0 % and 59.7 % in SB+TB and TB, respectively, while the positivity rates of clinically significant cancer were 56.8 % and 53.0 %, respectively. Cancer detection rates of TB were 72.3 % and 35.7 % in the peripheral zone (PZ) and the transition zone (TZ), with pros)tate cancer detected more frequently in the PZ (p < 0.001). The detection rates of clinically significant cancers in PI-RADS category 3, 4, and 5 regions by site were 18.9 %, 64.9 %, and 97.4 % in PZ and 10.1 %, 38.2 %, and 57.6 % in TZ, respectively. Lesions in PI-RADS category 4 and 5 in PZ were detected more frequently than those in PI-RADS category 3 (p < 0.001). Conclusion : The detection rate of CS prostate cancer in the TZ tends to be lower than that in the PZ, regardless of PI-RADS category in all sites. PI-RADS category 3 lesions in TZ had low cancer detection rates and the indication for targeted biopsy should be carefully considered. [ABSTRACT FROM AUTHOR]

The cumulative incidence of secondary cancers in childhood cancer survivors at 20 years after treatment is 2-5%, which is 3-20 times higher than in the general population. Risk factors include radiation therapy, alkylating agents, platinum drugs, and topoisomerase Ⅱ inhibitors. A retrospective cohort study of 15 pediatric oncology hospitals in Japan revealed that the time to development of a second cancer varies from 5 years or less for hematologic tumors, 10 years or less for bone/soft tissue tumors, approximately 10 years for brain tumors, and 15-20 years for thyroid and adult-type cancers. Some secondary cancers have a poor prognosis. Primary prevention of secondary cancers is the same as in the general population, and early detection and treatment are important. The key points of consensus on secondary cancers by the North American Children's Oncology Group guidelines and the International Guideline Harmonization Group were presented. In the future, it will be important to share information on the benefits and risks of cancer screening with childhood cancer survivors and their families.

Objectives: Most cancer control measures in the workplace have limited supporting evidence. This study aimed to identify highly effective cancer control measures, based on a survey by the Corporate Action to Promote Cancer Control., Methods: The firms and organizations that responded to the web survey were included. The questionnaire comprised five cancer (stomach, lung, colorectal, breast, and cervical) screening rates and their countermeasures to promote cancer control. We conducted a non-hierarchical cluster analysis according to the degree of the measures and compared the screening rates among each group using an analysis of variance. Then, we performed two multiple regression analyses with the mean screening rates for stomach/lung/colorectal cancer and breast/cervical cancer as dependent variables, the implementation of each countermeasure as an independent variable, and the size and industry as control variables., Results: We obtained responses from 704 firms and organizations. The three groups classified by cluster analysis were defined as active, moderate, and negative. For all cancer screenings, the main effects were significant, and multiple comparisons revealed that the difference between the active and negative groups (ts > 3.30, ps < .01, Hedges' ds > 0.73) and the moderate and negative groups (ts > 3.70, ps < .01, Hedges' ds > 0.88) were significant. For the four cancers other than lung, the difference between the active and moderate groups was not significant (ts < 0.21, ps < .84, Hedges' ds < 0.02), and for lung, the difference was significant, but the effect size was small. The multiple regression analyses revealed that "distribution of colorectal cancer test kits to all subjects" (β = 0.14) was significant for stomach, lung, and colorectal cancer, while "financial supports for cancer screening" (β = 0.24), "screening as part of employment" (β = 0.18), and "careful screening of female subjects" (β = 0.17) were significant for breast and cervical cancer, respectively., Conclusions: We identified effective countermeasures for cancer control in the workplace, and these measures will help increase cancer screening rates.

Objectives　The purpose of the study is to compare the results of doctor sampling and self-collection of specimens in the same examinee for cervical cytopathology and human papillomavirus (HPV) testing.Methods　Patients who have undergone cervical cancer screening at the four clinics affiliated with the Association for Preventive Medicine of Japan and who consented to participate were included in the study. Approximately one month after undergoing cervical cancer screening at the clinic, we tested a method of self-collection by mailing a Kato-type self-collection container to the participants. We evaluated the results of cytopathology and HPV testing obtained by self-collection and doctor sampling in the same patients. We used the χ 2 test and κ analysis for the evaluation of the results.Results　A total of 134 health checkup participants each underwent both doctor sampling and self-collection. The positive rate of cytology was 6.0% in doctor sampling and 2.2% for self-collection, but there was no evidence in statistical significance (P>0.05). However, cervical duct lining membrane cells could not be detected by self-collection. The positive rate of HPV testing in both doctor sampling and self-collection was the same at 14.2%. However, HPV18 type was positive only in one case by self-collection.Conclusion　The results of this study suggest that it is necessary to proceed with studies by self-collection, and introduce the applications of liquid cytopathology and its combined uses with HPV testing.

Purpose: The purpose of this study was to evaluate the differences in the organ doses and the effective doses using three types of automated organ dose estimation software for low-dose computed tomography (CT) screening for lung cancer and to evaluate the correlations between each dose and size-specific dose estimates (SSDEs)., Methods: Seventy-two adults who underwent low-dose CT screening for lung cancer were included, and the organ doses and the effective doses were calculated using each of automated organ dose estimation software. We evaluated differences between software for the organ doses and the effective doses and the correlations between each dose and SSDEs., Results: Differences in organ doses and effective doses were observed among the software. The organ doses showed a strong correlation (r=0.833-0.995) with SSDEs for organs within the scan range. The effective doses showed a strong correlation (r=0.830-0.970) with SSDEs, although there were significant differences among the software., Conclusion: Although the organ doses and the effective doses differed between software, it may be possible to estimate them from SSDEs by using linear regression equations.

Weight loss during cancer chemotherapy affects the continuation of treatment; therefore, it is important to maintain and improve nutritional status. Additionally, appropriate fluid and electrolyte replacement is essential for maintaining life. This study included 100 patients who underwent outpatient chemotherapy in April 2021. The degree of dehydration was assessed based on serum osmolality, and the possibility of screening was examined by a hidden dehydration check sheet. Hidden dehydration was noted in 38 patients and dehydration in 6 patients. The incidence of pancreatic cancer was significantly lower than that of lung cancer. In the hidden dehydration check sheet, 51 patients were found to present with high possibility of hidden dehydration and required consultation to a medical professional. The serum osmolality of the results was not significantly different. During outpatient cancer chemotherapy, a certain percentage of patients present with hidden dehydration. To detect dehydration at an early stage, serum osmolality should be actively measured and continuous diet counseling, including confirmation of food and fluid intake, is required.

Objective　This study aimed to promote the application of mammography (MMG) screening without performing a clinical breast examination (CBE). It examined population-based screening data, including history taking findings, to elucidate the status of breast cancer cases, detected solely by CBE, and to reveal the factors associated with breast cancer. Through this, it explored alternative methods for evaluating breast cancer cases, undetected by MMG, when CBE is omitted.Methods　The linked anonymized data from women, who underwent breast cancer screening in 2014, 2016, or 2017, were prepared. The data were obtained from the Nishinomiya City database. Breast cancer, undetected by MMG, were defined as breast cancer cases diagnosed by close examination based on CBE only (MMG findings were category 2 or lower, with no abnormalities). To assess the quality of breast cancer screening, process indices were calculated for the overall population, and for patients indicated for close examination based on CBE but not MMG. The association of breast cancer with each factor was statistically analyzed (χ 2 test, etc.).Results　In total, 13,504 women underwent breast cancer screening. Close examination was required in 1,247 women (9.2%). Breast cancer was diagnosed in 44 women (3.5%), including four, who had breast cancer undetected by MMG. All of the process indices satisfied the acceptable values. Three of the four women with breast cancer, undetected by MMG, noticed a lump. Breast cancer was significantly associated with "subjective symptoms". The presence of a "lump" and "nipple discharge" were significantly more common in breast cancer patients.Conclusion　Three of the four breast cancer cases, undetected by MMG screening, had a subjective symptom (lump). There was a significant association between subjective symptoms (lump and nipple discharge) and breast cancer. To avoid missing breast cancer, undetected by MMG alone, these symptoms should be especially evaluated in women to compensate for the omission of a CBE. This can be achieved by encouraging women experiencing symptoms to seek consult, performing a thorough history-taking and observation, engaging in multidisciplinary collaboration (communication from medical staff to physicians), and promoting breast awareness.

Anorectal malignant melanoma(AMM)is a relatively rare disease with an extremely poor prognosis. We experienced a case of this disease detected by colorectal cancer screening and report it here with a literature review. Our 67-year-old female patient was referred to the Department of Gastroenterology at our hospital for a thorough examination of the gastrointestinal tract after an abnormal fecal occult blood count(+/+ on 2 occasions)was noted during a colorectal cancer screening. Lower gastrointestinal endoscopy revealed a small easily bleeding lesion near the anal verge for which endoscopic mucosal resection was performed. A histopathological examination revealed a primary malignant melanoma of the rectum, and the patient underwent abdominoperineal rectal amputation. According to the rules for the treatment of T1b (1,200 μm), N0, P0, H0, M(-), StageⅠ, Cur A colorectal cancer. A histopathological examination of the resected specimen showed no remnant tumor cells. About 2 years have passed since the surgery, and the patient is still alive without recurrence. Considering its characteristics, patients with AMM will require further careful follow-up. Here we summarize our experience diagnosing and treating a case of early-stage AMM.

Objectives　We investigated the participation and detection rates of cervical lesions in cervical screening non-attenders offered HPV (human papillomavirus) self-sampling with cytology triage.Methods　From 2016 to 2018, HPV self-sampling was routinely offered as an option, along with cytology, to all non-attenders in Ebetsu City, Japan. The primary endpoints were ≥CIN2 and ≥CIN3 detection rates, and secondary endpoints were abnormal cytology rates and follow-up compliance.Results　Overall, recall invitations were mailed to 6,116 non-attenders, with a response rate of 15.9% (cytology: 6.5%, HPV testing: 9.4%). Of the responders to undergo HPV self-sampling, 11.7% had a positive result and were referred to cytology triage. Moreover, ≥CIN2 and ≥CIN3 detection rates were 1.7% and 0.9%, respectively, in the HPV self-sampling group, and 1.0% and 0.8%, respectively, in the cytology group, showing no statistically significant differences. In those who underwent cytology triage following an HPV positive test, ≥CIN2 and ≥CIN3 detection rates were 23.8% and 11.9%, respectively, which was significantly higher than those who only underwent cytology alone.Conclusion　HPV self-sampling followed by cytology triage is highly effective at detecting high grade disease in non-attenders. Thus, multi-municipality-based studies to standardize processes involving this method are warranted. Furthermore, HPV self-sampling could be a promising method for inviting non-attenders who have difficulty undergoing cervical screening in the COVID-19 pandemic era.

The Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, has been conducting mass screening of oral cancer using oral abrasion cytology by oral surgeons in eastern Shimane prefecture for public awareness and its early detection. As a result, 3(0.09%)cases of oral cancer were identified. Case 1: The patient was diagnosed with well-differentiated squamous cell carcinoma in the floor of the mouth(pT1N0M0, Stage Ⅰ)after undergoing Matsue city oral cancer screening in 2016. Case 2: The patient underwent oral cancer screening in Izumo city in 2018 and was diagnosed with verrucous carcinoma in the back of the tongue(pT1N0M0, Stage Ⅰ). Case 3: The patient was diagnosed with highly differentiated squamous cell carcinoma of the palate(pT1N0M0, Stage Ⅰ)after undergoing the Izumo city oral cancer screening in 2019. Awareness of oral cancer is important, and cancer screening by oral surgeons using cytology is highly useful and should be continued in the future.

Radical excision, a common oral cancer treatment, produces variable postoperative results depending on the specialized tissues involved and the extent of the cancer. Furthermore, the material selected for reconstruction also influences functional outcomes. Oral dysfunction due to postoperative tissue loss is more common with advanced cancer; therefore, early detection and treatment are important. To improve oral cancer awareness and early detection, mass oral cancer screenings led by maxillofacial surgeons in cooperation with the Shimane prefecture and local dental associations were conducted. We describe the mass screening methods and describe a case of tongue cancer that was detected and treated as a result of our screening efforts.

Objectives　The purpose of this study was to assess the situation of regional cancer screening of individuals in Sapporo city through an independent survey and to identify groups with low cancer screening rates.Methods　We conducted a self-administered questionnaire survey on 3,000 men aged 40 to 69 years and 4,000 women aged 20 to 69 years living in Sapporo (response rate = 32.4%). The contents of the survey were quoted from the health slips of the Comprehensive Survey of Living Conditions related to cancer screening, as well as basic and cancer-related attributes. We analyzed the relationship between cancer screening participation rate, basic attributes, and cancer-related attributes using the χ 2 test or logistic regression analysis.Results　The screening rates recorded in this study for gastric, colon, and lung cancers were 67.4%, 59.2%, and 66.1%, respectively in men, and 48.7%, 47.7%, and 53.4%, respectively in women. The screening rates were 52.7% and 56.1% for uterine and breast cancers, respectively.　The participation rate of non-working individuals and those who had National Health Insurance was significantly lower for all cancer types among both men and women. Regarding attributes and cancer screening, the odds ratio of working to non-working individuals was 3.00 to 3.09 in men and 1.41 to 2.46 in women. The odds ratio of non-National Health Insurance individuals was 3.47 to 4.26 in men and 1.47 to 2.52 in women. In addition, there was a significant association between awareness and rates of Sapporo city cancer screening in both men and women, with the exception of stomach cancer screening in women. Furthermore, the odds ratio of awareness was 1.41 to 1.74 in men and 1.24 to 1.48 in women.Conclusion　The cancer types with screening rate below 50% were gastric and colon cancers in women. In men, the screening rate for gastric, colon, and lung cancers exceeded 50%. The cancer-screening rate was found to be low among both non-working men and women, those with national health insurance, or those who do not recognize the Sapporo city cancer screening (regional screening). The characteristics of the group with low participation status in Sapporo city, which was the only parameter not reported in the Comprehensive Survey of Living Conditions, has been clarified.

Post-transplant lymphoproliferative disorder (PTLD) usually develops with systemic symptoms, such as fever, generalized lymphadenopathy, and elevation in the lactate dehydrogenase level. Here, we present the case of a 65-year-old female patient with PTLD localized to the colon; the patient only had mild diarrhea without systemic symptoms. She had myelodysplastic syndrome and was treated with cord blood transplantation (CBT). She had a past medical history of sigmoid colon cancer treated with colonosectomy and adjuvant chemotherapy. After CBT, she achieved complete remission and was discharged after 60 days. Further, 79 days after CBT, she presented with abdominal pain. Computed tomography scan revealed adhesive ileus. The abdominal pain was resolved in 1 day with conservative treatment, however, mild diarrhea persisted. Therefore, we performed colonoscopy and found multiple ulcerative lesions in the upper colon. A pathological examination revealed PTLD. Furthermore, elevation of EBV-DNA in the blood was also confirmed. There was no detectable lesion on positron emission tomography-computed tomography (PET-CT) outside the colon; thus, we diagnosed PTLD localized into the colon that was successfully treated with rituximab. Our present experience suggests that it might be important to perform endoscopy and monitoring of EBV-DNA for early detection of PTLD, especially localized in the gastrointestinal tract.

Objectives: With the advent of high-resolution chest imaging systems and lung cancer screening programs, the number of patients diagnosed with multiple primary lung cancers is increasing. For the treatment of multiple lung cancers, a surgical procedure that preserves the lung function while ensuring curability is required. We herein report the surgical strategy and outcomes of synchronous multiple lung cancer., Subjects: The subjects were 83 patients with synchronous multiple lung cancer who received surgical resection between January 2010 and March 2020. Cases within the same lobe were excluded, and only cases with two or more lobes involved were included in this study., Results: The study enrolled 39 male and 44 female patients, and the mean age was 67.8 years old. Sixty-five patients had cancers within a unilateral lobe, and all had undergone surgery for one term. Eighteen patients had cancers in bilateral lobes, and 17 of them received secondary surgery for more advanced cancer. Bilobectomy was performed in 9 patients( 10.8%), consisting of 5 upper-middle lobectomies, 3 middle-lower lobectomies, and 1 right middle lobectomy with left lower lobectomy. Seventy-four patients (89.2%) underwent combination surgery with sublobar resection, such as segmentectomy and partial resection. Pneumonectomy was not performed in any patients. The histologic type was adenocarcinoma in 78 patients (94.0%), and 37 patients (47.4%) had adenocarcinoma in situ. Regarding the most advanced pathological stage, 57 patients( 68.7%) were stage≤Ⅰ, and 26( 31.3%) were stage≥Ⅱ. Postoperative complications were observed in 29 patients( 34.9%), and persistent pulmonary fistula of ≥7 days after the surgery was the most common, being observed in 16 patients. Operative death within 30 days after surgery occurred in 2 patients( 2.4%)[ due to pneumonia in 1 and cerebral infarction in 1]. None of the patients required home oxygen therapy after surgery. Recurrence occurred in 20 patients;14 of these had pathological stage ≥Ⅱ, 11 had lymph node metastases, and 2 had pleural dissemination. The recurrence patterns were metastasis to other organs, pleural dissemination, or lymph node metastasis;no local recurrence was observed. The mean recurrence-free survival was 32.4 months, and the five-year survival rate was 84.8%. On comparing outcomes according to the most advanced pathological stage, the five-year survival rate for stage ≤Ⅰdisease was 94.9%, and that for stage ≥Ⅱ disease was 61.7%, showing a significantly better prognosis for stage ≤Ⅰdisease (p<0.001)., Conclusions: Selecting an appropriate operative procedure for synchronous multiple lung cancer renders the prognosis equivalent to that of single cancer. Surgical treatments, including sublobar resection, are thus deemed important.

The prognosis for advanced lung cancer is still poor, even though various therapeutic methods such as molecular targeted therapeutics and immunotherapy have become available. Early detection is still important in the treatment of lung cancer, and the role of lung cancer screening is very essential. The current lung cancer screening system in Japan has many problems. Although low-dose chest computed tomography (CT) screening has appeared as a new screening modality, there are still many things to be studied and improved. In this article, the outline of the current system of lung cancer screening in Japan is presented, and then the problems in the system and future prospects are described.

Background: In the field of breast screening using mammography, announcing to the examinees whether they are dense or not has not been deprecated in Japan. One of the reasons is a shortage of objectivity estimating their dense breast. Our aim is to build a system with deep learning algorithm to calculate and quantify objective breast density automatically., Material and Method: Mammography images taken in our institute that were diagnosed as category 1 were collected. Each processed image was transformed into eight-bit grayscale, with the size of 2294 pixels by 1914 pixels. The "base pixel value" was calculated from the fatty area within the breast for each image. The "relative density" was calculated by dividing each pixel value by the base pixel value. Semantic segmentation algorithm was used to automatically segment the area of breast tissue within the mammography image, which was resized to 144 pixels by 120 pixels. By aggregating the relative density within the breast tissue area, the "breast density" was obtained automatically., Result: From each but one mammography image, the breast density was successfully calculated automatically. By defining a dense breast as the breast density being greater than or equal to 30%, the evaluation of the dense breast was consistent with that by a computer and human (76.6%)., Conclusion: Deep learning provides an excellent estimation of quantification of breast density. This system could contribute to improve the efficiency of mammography screening system.

Acinic cell carcinoma(ACC)is an invasive malignancy primarily characterized by proliferation of tumor cells that resemble acinar cells of the salivary glands and pancreas. ACC of the mammary glands is rare. We report a case of primary ACC of the breast. Two masses were revealed in the left mammary gland of a 57-year-old woman who visited our hospital through screening mammography. The lesions were identified as synchronous multiple breast carcinoma of 2 different histological types; ACC and tubulolobular carcinoma. For treatment, left mastectomy and sentinel lymph node biopsy were performed, followed by postoperative chemotherapy and endocrine therapy. Hematoxylin-eosin staining of ACC revealed abundant acinar- like structures formed by tumor cells with prominent eosinophilic granules in the cytoplasm. Immunostaining was positive for S-100 protein, α1-antichymotrypsin, α1-antitrypsin, and lysozyme. The tumor cells were negative for estrogen, progesterone, and HER2 receptors, which indicated that they had a triple-negative phenotype. Although primary ACC of the breast is regarded as low-grade triple-negative breast carcinoma with a favorable prognosis, further accumulation of cases may be needed to elucidate the biological features of ACC and investigate appropriate therapeutic strategies.

Treatment of oral cancer is based on radical resection and reconstructive surgery. Surgery causes impairment of maxillofacial morphology and function, including chewing and eating difficulties, and dysarthria. It is necessary to restore the maxillofacial morphology and function by reconstructive surgery and use of prostheses. Therefore, early detection and treatment are required to reduce these disabilities associated with oral cancers. Here, we report a case of oral cancer that was detected early by our oral cancer mass screening program in Izumo, Japan, in 2019. A 73-year-old woman presented with a reddish ulcerative region in the palate. Cytological screening indicated positive-suspected low squamous intraepithelial neoplasia (LSIL). The patient was diagnosed as squamous cell carcinoma of the palate(cT1N0M0, StageⅠ)in our hospital. We performed radical resection of the palate tumor and immediate reconstruction using a vascularized radial forearm flap. The clinical course was good and oral function was fully restored. It is important for oral surgeons to publicize and raise awareness of oral cancer, and to continue oral cancer mass screening programs.

We experienced a case of early gastric cancer. A 69-year-old woman with a thick gastric wall, thickened folds, and undifferentiated cancer cells in biopsy was diagnosed with scirrhous gastric cancer. The patient underwent total gastrectomy for scirrhous gastric cancer and was found to have only an early gastric cancer lesion located on the upper gastric wall. The thick wall diagnosed before surgery was diagnosed as angiodysplasia occupying the submucosal layer.

To screen colorectal cancers, fecal occult blood test(FOBT), conducted to detect occult blood present in the feces, has been shown to reduce colorectal cancer mortality in many large-scale colorectal cancer screening programs. However, the sensitivities of FOBT for early-stage colon cancer, colon cancer located at the right colon and colorectal adenoma tend to be low. Additionally, some colorectal cancers which could not detect by repeated FOBT screening are actually existed. Beyond those disadvantages, FOBT is the most promised colorectal cancer screening tool for large-scale cohort. To overcome the weak points of FOBT to screen colorectal tumors, the strategy for capturing and recovering tumor-derived DNA in feces has been developed and applied for clinical usage. In this study, we summarized the series of strategies for capturing and recovering fecal tumor-derived DNA to screen colorectal neoplasia.

Early detection and resection of cancer is the most effective in the treatment of solid cancer. Development of a new cancer detection method is expected to become a breakthrough to solve various problems for early detection. It has been reported that there is the specific odors of cancer by using bio olfaction such as dogs, and it has been recognized that there is the odors of cancer. Cancer cells acquire malignant traits as a result of metabolic changes originating from genetic mutation. The cancer specific odorous substances may be considered to be the end products of their metabolic changes. Omics researches such as genomics, proteomics, and metabolomics have been extensively performed to comprehensively analyze changes in DNA, RNA, protein, metabolism and its products specific to cancer for the purpose of developing a new cancer detection marker. It is thought that the research on the odor of cancer is also on the line of omics research. It is difficult to identify cancer-specific odorants buried in various environmental substances. However, it is expected that human will be able to acquire the technology, from the fact that they can be recognized by biological olfaction. We are continuing the research with the dream that identification of the odorous substances as a new cancer detection marker and sensor development for it will lead to the happiness of colleagues in the world.

We investigated the usefulness of screening for colorectal cancer (CRC) using immunological fecal occult blood test (FOBT) in 472 scheduled inpatients (median age, 68.6 years) who underwent screening for CRC via FOBT (single stool sample) at our hospital. The recall rate for further examination was 26.6% (126/472), and the rate of patients who underwent further examination was only 34.9% (44/126). The overall colorectal neoplasm detection rate, overall CRC detection rate, and positive predictive value for CRC in inpatients were 5.5% (26/472), 1.4% (7/472), and 5.5% (7/126), respectively, which were higher than those of population-based screening for CRC. Screening for CRC using FOBT in inpatients is a non-invasive and efficient method to detect latent CRC.

Endoscopic treatments, including endoscopic mucosal resection or endoscopic submucosal dissection, are well accepted as standard treatments for early gastric cancers. However, there are few studies evaluating the safety and efficacy of this approach for early gastric cancers in patients aged over 80 years, and the post-treatment prognosis remains unclear. Here, we retrospectively analyzed the medical records and evaluated the safety and efficacy of endoscopic treatment for early gastric cancers in patients aged over 80 years (group A) compared with non-elderly patients aged 65-79 years (group B) and under 65 years (group C). In this study, we enrolled 53 patients (mean age, 82 years) in group A, 217 patients (mean age, 73 years) in group B, and 89 patients (mean age, 60 years) in group C who received endoscopic treatment at Kyoto University Hospital between 2001 and 2010. The incidence of treatment-related complications including aspiration pneumonia, bleeding, and perforation was 19% (10/53) in group A, 9.7% (21/217) in group B, and 6.7% (6/89) in group C, respectively. In particular, only the incidence of aspiration pneumonia was significantly higher in group A [11% (6/53) ] than in the other two groups [1.8% (4/217) in group B and 1.1% (1/89) in group C]. There was no significant difference in the curative resection rate and recurrence rate including metachronous lesions among the three groups. In group A, the median survival calculated using the Kaplan-Meier method was 8.0 years, and the 5-year survival rate was 73%. No gastric cancer-related deaths were observed in all groups. In conclusion, endoscopic treatment for early gastric cancers may contribute to an improvement in life expectancy, even among patients aged over 80 years, provided an experienced gastroenterologist selects the appropriate patients based on not only the endoscopic findings for the lesion but also the severity of any comorbidities. However, it is noteworthy that our elderly group aged over 80 years had a high risk of developing aspiration pneumonia.

Purpose and Methods: External radiotherapy of target regions using high-energy beams leads to excessive exposure along with individual variation in therapeutic and adverse effects. However, high-precision radiotherapy utilizes 3D-multi detector computed tomography to confirm both target position and administer radiation dose. To install the individual bioinformation in the radiotherapy plan (particularly, radiosensitivity into the target region and/or the around normal tissue), the investigation of biomarkers, which are able to estimate their radiosensitivity was performed. The aim of this investigation is to screen for suitable radiosensitivity biomarkers using the human colorectal cancer-derived HCT 116 cell line., Results: We found that cell damage and micronucleus frequency significantly increased dose dependently after exposure to 6 Gy X-irradiation (1 Gy/min). In contrast, total RNA concentration (69.8-85.2 ng/ml) remained stable in the cell culture supernatant despite radiation dose variation. Additionally, 52 specific micro RNAs were detected after exposure to 6 Gy X-irradiation., Conclusion: These results suggest that radiosensitivity, including extent of cellular damage in target or normal tissue, can be indirectly estimated by monitoring the expression of micro RNAs.

A 69-year-old woman was referred to our department for refractory cystitis. Incomplete emptying of the bladder was observed, and symptoms did not improve after medication. Clean intermittent catheterization was initiated. Two years after introduction of catheterization, a mass in the bladder dome was detected by routine abdominal ultrasonography. She was diagnosed with malignant tumor of the bladder diverticulum based on cystoscopy, computed tomography, and magnetic resonance imaging. Partial cystectomy and lymph node dissection was performed following transurethral resection of the bladder tumor. Histopathology revealed squamous cell carcinoma and no signs of lymph node metastasis. She is alive and recurrence-free 28 months after surgery.

The advent and long-term use of tyrosine kinase inhibitors in molecular target therapy for chronic myeloid leukemia have resulted in a marked improvement of treatment outcomes. This has changed'the algorithm of the laboratory process for the diagnosis and therapeutic monitoring of chronic myeloid leukemia. It includes defining the molecular typing of BCR-ABL1 to establish the diagnosis, and a quantitative and/or high- sensitivity assay for minimal residual disease to evaluate the treatment response. Along with improved long-term survival outcomes, new issues have arisen regarding the best index to use for the improved clinical outcomes, such as treatment-free remission. To this end, clinical and laboratory monitoring of CML patients has been investigated. Novel methodologies and technologies have been applied to improve decision-making on patient care, tailoring the treatment to the individual characteristics of each patient, including an early index for the treatment response and deeper molecular response to realize treatment-free survival, and BCR-ABLI kinase domain mutation screening for refractory disease. In response to the advancement and applications of these emerging technologies, proper laboratory practice with the quality assurance of testing is expected. [Review].

We reported a case of early gastric cancer with submucosal heterotopic gastric glands.A 62-year-old woman presented with poor appetite, weight loss, and epigastric pain.Endoscopy examination identified giant gastric folds and a gastric ulcer on the posterior wall of the upper-middle stomach.Biopsy specimen analysis showed adenocarcinoma.We preoperatively diagnosed the lesion as type II c-like advanced cancer and performed a total gastrectomy.Pathologically, the lesion was diagnosed as gastric cancer(non-solid type poorly differentiated adenocarcinoma)located in the mucosal layer and accompanied by submucosal heterotopic gastric glands.Submucosal gastric gland heterotopia is a relatively rare disease, and it is difficult to diagnose the glands before surgery is performed.However, endoscopic ultrasonography helps to demonstrate diffuse cystic lesion preoperatively.It is often associated with multiple gastric cancers.Therefore, we must diagnose and treat the disease with great care.

We treated an 82-year-old man with early gastric cancer using endoscopic submucosal resection.Ultrasonography, which was performed to screen for metastasis, revealed hepatocellular carcinoma, and the tumor was curatively resected.Ultrasonography can be considered a useful examination tool to detect double cancer, even in cases of early cancer.

Colitis complicating inflammatory bowel disease is gradually increasing in Japan. Although the postoperative cancer in ulcerative colitis is rare, careful postoperative follow up is nec- essary. Anorectal cancer including cancer of anal fistulae in Crohn's disease is the most common cancer in Japan and our original cancer surveillance program in which biopsy for anorectal lesion is performed for longstanding anal lesion (more than 10 years) is suggested to be effective for the detection of early cancer.

Despite the recent advancement of the treatment including endoscopic resection, surgery, and systemic chemotherapy, mortality rate of colorectal cancer(CRC) has been increasing in Japan. Therefore, the strategy for CRC should be focused to both the early diagnosis by efficient screening and prevention. The screening using fecal occult blood test and subsequent total colonoscopy has been recognized as a gold standard of CRC screening, however, the checkup rate of these examinations is still very low in Japan. It is considered to be important to improve this checkup rate and now, the new modalities, such as computed tomographic colonography or capsule colon endoscopy, are expected to be involved in the clinical practice of CRC screening.

Amino acids are present in the blood. In healthy people, the concentrations of these amino acids in the blood are maintained at stable levels. However, different diseases disturb the balance of amino acids in the blood in different ways. AminoIndex® is a service that uses the latest medical technology to measure the concentration of amino acids in the blood to check a person's health and detect various diseases. It is now possible to conduct an AminoIndex® Cancer Screening (AICS®) test that can detect cancer from early stages. The AICS® measures the concentrations of amino acids in the blood and statistically analyzes the differ- ences in the balance of amino acid concentrations between healthy people and those with cancer. As a result, we can simultaneously screen for certain types of cancer. Currently, the test can screen for gastric cancer, lung cancer, colorectal cancer, prostate cancer (in males), breast cancer (in females), and uterine/ovarian cancer* (in females). The application of AminoIndex® technology will spread through the fields of medicine, such as in the treat- ment of metabolic syndrome. (*The uterine/ovarian cancer test determines the overall risk of having any of the three cancers: cervical cancer, endometrial cancer, and ovarian cancer, and can not determine the individual risk of having each cancer.) [Review].