Masayoshi Tokunaga,* Charles E. Land,t Yoshiko Uemura,* Takahiro Tokudome,* Sadao Tanaka,t and Ei... more Masayoshi Tokunaga,* Charles E. Land,t Yoshiko Uemura,* Takahiro Tokudome,* Sadao Tanaka,t and Eiichi Sato§ From the Department of Pathology, * Kagoshima City Hospital, Kagoshima, Japan; Radiation Epidemiology Branch,t National ...
We show clear evidence for direct infection of various human epithelial cells by Epstein-Barr vir... more We show clear evidence for direct infection of various human epithelial cells by Epstein-Barr virus (EBV) in vitro. The successful infection was achieved by using recombinant EBV (Akata strain) carrying a selective marker gene but without any other artificial operations, such as introduction of the known EBV receptor (CD21) gene or addition of polymeric immunoglobulin A against viral gp350 in culture. Of 21 human epithelial cell lines examined, 18 became infected by EBV, as ascertained by the detection of EBV-determined nuclear antigen (EBNA) 1 expression in the early period after virus exposure, and the following selection culture easily yielded a number of EBV-infected clones from 15 cell lines. None of the human fibroblasts and five nonhuman-derived cell lines examined was susceptible to the infection. By comparison, cocultivation with virus producers showed approximately 800-fold-higher efficiency of infection than cell-free infection did, suggesting the significance of direct c...
Aim of this study is to find subgroup of early gastric cancer with lymph node metastasis for whic... more Aim of this study is to find subgroup of early gastric cancer with lymph node metastasis for which successive further surgical operation is needed after endoscopic resection. A total of 559 lesions of early gastric cancer, which had undergone curative gastrectomy, were enrolled in this study. We retrospectively investigated 10 clinicopathological factors predictive of lymph node metastasis by univariate and multivariate analysis. We showed the frequency of lymph node metastasis of subgroups in combination of independent factors selected by multivariate analysis. Lymph node metastases were detected in 57 lesions (10.2%). Univariate analysis revealed that lesion size > 30 mm, undifferentiated components, sm massive invasion, lymphatic invasion and venous invasion were factors significantly correlated with lymph node metastasis. By multivariate analysis, risk factors for lymph node metastasis were lesion size > 30 mm, undifferentiated components, sm massive invasion, and lymphati...
To determine the indication for endoscopic submucosal dissection, we retrospectively analyzed the... more To determine the indication for endoscopic submucosal dissection, we retrospectively analyzed the results of strip biopsies for early gastric cancer. We studied 374 lesions of 360 patients with early gastric cancer. The resection results were classified into complete local resection and incomplete resection. The relations among the resection results and maximum tumor diameter, tumor location, and 1-year recurrence were analyzed. Complete local resection was achieved by strip biopsy for 206 of the 374 lesions (55.1%). For the 168 lesions with incomplete resection, local recurrence was found in 22. The rate of complete local resection in strip biopsy was significantly low, and the rate of local recurrence was significantly high for lesions exceeding 2 cm in diameter as well as for lesions of the cardiac part and the angular part of the lesser curvature. Our strip biopsy results suggest that endoscopic submucosal dissection is needed for early gastric cancer lesions larger than 2 cm in...
World journal of gastroenterology : WJG, Jan 7, 2015
To investigate the utility of photodynamic diagnosis (PDD) using 5-aminolevulinic acid (5-ALA) to... more To investigate the utility of photodynamic diagnosis (PDD) using 5-aminolevulinic acid (5-ALA) to detect gastric/colorectal tumors. This prospective single-center study investigated inter-subject variability in patients with early-stage gastric/colorectal tumor indicated for endoscopic resection. Subjects were patients with gastric or colorectal tumors who had undergone endoscopic resection between November 2012 and November 2013. Selection criteria included age 20-80 years, either sex, and provision of informed consent. Patients were orally administered 20 mg/kg of 5-ALA enteric-coated capsules (SBI ALApromo Co., Tokyo, Japan). Administration of 5-ALA was followed by endoscopic resection of gastric or colorectal tumors, and the resected specimens were examined using a video autofluorescence processor and a fluorescence endoscope (SAFE-3000 and EB-1970AK, respectively; Pentax, Tokyo, Japan). The primary endpoint was the presence of fluorescence in tumors. Endoscopic, macroscopic, an...
Objective. Patients with gastroenteropancreatic neuroendocrine carcinoma (NEC) have a poor progno... more Objective. Patients with gastroenteropancreatic neuroendocrine carcinoma (NEC) have a poor prognosis. Platinum-based combination chemotherapy is commonly used as first-line treatment; however, the role of salvage chemotherapy remains unknown. This study aimed to analyze the efficacy and safety of amrubicin monotherapy in patients with platinum-refractory gastroenteropancreatic NEC. Methods. Among 22 patients with advanced gastroenteropancreatic NEC, 10 received amrubicin monotherapy between September 2007 and May 2014 after failure of platinum-based chemotherapy. The efficacy and toxicity of the treatment were analyzed retrospectively. Results. Eight males and two females (median age, 67 years (range, 52-78)) received platinum-based chemotherapy, including cisplatin plus irinotecan (n = 7, 70%), cisplatin plus etoposide (n = 2, 20%), and carboplatin plus etoposide (n = 1, 10%) before amrubicin therapy. Median progression-free survival and overall survival after amrubicin therapy were 2.6 and 5.0 months, respectively. Two patients had partial response (20% response rate), and their PFS were 6.2 months and 6.3 months, respectively. Furthermore, NEC with response for amrubicin had characteristics with a high Ki-67 index and receipt of prior chemotherapy with cisplatin and irinotecan. Grade 3-4 neutropenia and anemia were observed in four and five patients, respectively. Conclusion. Amrubicin monotherapy appears to be potentially active and well-tolerated for platinum-refractory gastroenteropancreatic NEC.
ABSTRACT The use of white or color tunable LEDs (light-emitting diodes), which can replace a larg... more ABSTRACT The use of white or color tunable LEDs (light-emitting diodes), which can replace a large light source apparatus and light-guiding fiber bundle, enable the miniaturization of the whole endoscope system and remove constraints on the design of its shape. We have developed a novel white LED for a new experimental prototype LED-illuminated gastrointestinal endoscope having the color rendering in the clinically important red range at around 600 nm.
Hyperspectral imaging (HSI) is a new technology that obtains spectroscopic information and render... more Hyperspectral imaging (HSI) is a new technology that obtains spectroscopic information and renders it in image form. This study examined the difference in the spectral reflectance (SR) of gastric tumors and normal mucosa recorded with a hyperspectral camera equipped with HSI technology and attempted to determine the specific wavelength that is useful for the diagnosis of gastric cancer. A total of 104 gastric tumors removed by endoscopic submucosal dissection from 96 patients at Yamaguchi University Hospital were recorded using a hyperspectral camera. We determined the optimal wavelength and the cut-off value for differentiating tumors from normal mucosa to establish a diagnostic algorithm. We also attempted to highlight tumors by image processing using the hyperspectral camera's analysis software. A wavelength of 770 nm and a cut-off value of 1/4 the corrected SR were selected as the respective optimal wavelength and cut-off values. The rates of sensitivity, specificity, and ac...
We determined comparative efficacy of i-Scan for detection and diagnosis of gastric cancer. Ten p... more We determined comparative efficacy of i-Scan for detection and diagnosis of gastric cancer. Ten patients diagnosed with early gastric cancer based on histopathological findings were analyzed. White light and i-Scan moving images recorded from these patients in twin mode were separated into white light and i-Scan. Twelve endoscopists (three different skill levels) blinded to patient information evaluated the images. Correlation between demarcation accuracy and lesion brightness on still images was investigated. No significant differences were found in diagnostic accuracy between white light and i-Scan moving images for tumor detection rate (91.7% versus 90.8%, P = 0.777). Diagnostic accuracy of tumor size was comparable between novice and experienced endoscopists for i-Scan moving images (65.7% versus 71.1%, P = 0.528), whereas it was significantly lower for white light moving images (41.2% versus 79.5%, P = 0.019). Tumor demarcation accuracy was significantly better with white light...
Cancer can develop in the operated stomach after partial gastrectomy and in the reconstructed gas... more Cancer can develop in the operated stomach after partial gastrectomy and in the reconstructed gastric tube after surgery for esophageal cancer. It is considered that endoscopic therapy is more safe and suitable for the early gastric cancer developed in such stomach than operation. We investigated the efficacy of endoscopic submucosal dissection (ESD) for cancer of the operated stomach. Subjects were 669 gastric cancer patients who underwent ESD: 22 patients (23 lesions) had surgically altered gastric anatomy, whereas 647 patients (727 lesions) had normal gastric anatomy. In the altered gastric anatomy group, 13 patients, 6 patients, and 3 patients had previously undergone distal gastrectomy, gastric tube reconstruction, and proximal gastrectomy, respectively. Rates of complete en bloc resection and curative resection were compared between the two groups. Influence of an anastomotic site and/or a suture line on ESD outcomes was examined in the altered gastric anatomy group. The rate ...
World journal of gastrointestinal endoscopy, Jan 16, 2012
Basaloid squamous carcinoma (BSC) of the esophagus is a rare esophageal tumor. A 79-year-old man ... more Basaloid squamous carcinoma (BSC) of the esophagus is a rare esophageal tumor. A 79-year-old man with a history of proximal gastrectomy for gastric adenocarcinoma in 2000 was followed-up by esophagogastroduodenoscopy (EGD) annually. In June 2010, EGD revealed a new protruding lesion in the cervical esophagus. The small lesion was approximately 5 mm in size. A biopsy specimen showed poorly differentiated squamous cell carcinoma. We performed endoscopic mucosal resection using a cap-fitted endoscope (EMRC). The histological diagnosis of the endoscopically resected specimen was BSC and the invasion depth was limited to the muscularis mucosae. Horizontal and vertical margins were negative. We report the case of superficial BSC in the cervical esophagus successfully resected by EMRC.
Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology, 2011
Infliximab is widely used in the treatment of inflammatory bowel disease, but despite its good cl... more Infliximab is widely used in the treatment of inflammatory bowel disease, but despite its good clinical efficacy and tolerance, drug-induced autoimmune disorders have been reported as adverse reactions and are a matter of concern. Here we report a patient with ulcerative colitis who developed drug-induced lupus erythematosus after infliximab treatment. While this is a rare complication of infliximab, early diagnosis and successful management are essential.
We performed a photodynamic therapy for local recurrence after chemoradiotherapy for esophageal c... more We performed a photodynamic therapy for local recurrence after chemoradiotherapy for esophageal cancer. The patient was a 60s man, who presented dysphasia. Esophagoscopy, CT and FDG-PET revealed an advanced esophageal cancer with mediastinal lymph node metastasis. He rejected a surgical treatment and underwent chemoradiotherapy, then achieved CR once. Subsequent FDG-PET, however, showed slightly FDG uptake at primary focus of the esophagus. Endoscopic biopsy specimen from Lugol's unstained lesion of the esophagus revealed squamous cell carcinoma, and he was diagnosed as a recurrence of the esophageal cancer. He underwent chemotherapy again, but the recurrent lesion enlarged. Because the control of the metastatic lesion was excellent and the recurrent lesion was considered as a superficial cancer, he was performed photodynamic therapy. Two months after photodynamic therapy, the esophagoscopy and FDG-PET showed no findings of the recurrence of the esophageal cancer. It was suggest...
International journal of gastrointestinal cancer, 2006
With the development of endoscopic submucosal dissection, an expansion of the criteria for local ... more With the development of endoscopic submucosal dissection, an expansion of the criteria for local treatment was suggested for lesions with ulcerous changes or undifferentiated-type adenocarcinoma. To determine the efficacy of endoscopic ultrasonography for such lesions, we retrospectively analyzed factors that influenced accurate diagnosis by endoscopic ultrasonography of the depth of tumor invasion. We investigated 267 gastric adenocarcinomas for which histopathological results were obtained by endoscopic mucosal resection or gastrectomy. The lesions were divided into four groups by histological type and the presence of ulcerous changes. Five clinicopathological factors were assessed for their possible associations with incorrect diagnosis. The positive predictive value (PPV) for cancer limited within the mucosa (endoscopic ultrasonography, EUS-M) and cancer invaded into the submucosal layer (EUS-SM) were 88.0% (125 of 142 lesions) and 60.0% (30 of 50 lesions), respectively. The les...
Epstein-Barr virus (EBV) has been detected in about 10% of gastric carcinoma cases worldwide, and... more Epstein-Barr virus (EBV) has been detected in about 10% of gastric carcinoma cases worldwide, and a high prevalence of EBV involvement in gastric remnant carcinoma has been reported recently. Details of the background remnant stomach of EBV-positive lesions, however, have not been well clarified. We screened 17 consecutive gastric remnant carcinoma lesions resected surgically. To detect EBV, we used in situ hybridization (ISH) for EBV-encoded small RNA1 (EBER-1) and we compared the clinicopathologic feature between EBV-positive and -negative gastric remnant carcinoma cases. EBV was detected in 41.8% (7 of 17) of the lesions by EBER-1 ISH. All 7 EBV-positive lesions developed in the anastomotic site had undergone Billroth-II reconstruction excess 20 years previously (mean 26.4 years). Histologically, all EBV-positive lesions were poorly differentiated adenocarcinomas with intense lymphocyte infiltration. In the adjacent mucosa of carcinomas, moderate or marked intestinal metaplasia w...
Masayoshi Tokunaga,* Charles E. Land,t Yoshiko Uemura,* Takahiro Tokudome,* Sadao Tanaka,t and Ei... more Masayoshi Tokunaga,* Charles E. Land,t Yoshiko Uemura,* Takahiro Tokudome,* Sadao Tanaka,t and Eiichi Sato§ From the Department of Pathology, * Kagoshima City Hospital, Kagoshima, Japan; Radiation Epidemiology Branch,t National ...
We show clear evidence for direct infection of various human epithelial cells by Epstein-Barr vir... more We show clear evidence for direct infection of various human epithelial cells by Epstein-Barr virus (EBV) in vitro. The successful infection was achieved by using recombinant EBV (Akata strain) carrying a selective marker gene but without any other artificial operations, such as introduction of the known EBV receptor (CD21) gene or addition of polymeric immunoglobulin A against viral gp350 in culture. Of 21 human epithelial cell lines examined, 18 became infected by EBV, as ascertained by the detection of EBV-determined nuclear antigen (EBNA) 1 expression in the early period after virus exposure, and the following selection culture easily yielded a number of EBV-infected clones from 15 cell lines. None of the human fibroblasts and five nonhuman-derived cell lines examined was susceptible to the infection. By comparison, cocultivation with virus producers showed approximately 800-fold-higher efficiency of infection than cell-free infection did, suggesting the significance of direct c...
Aim of this study is to find subgroup of early gastric cancer with lymph node metastasis for whic... more Aim of this study is to find subgroup of early gastric cancer with lymph node metastasis for which successive further surgical operation is needed after endoscopic resection. A total of 559 lesions of early gastric cancer, which had undergone curative gastrectomy, were enrolled in this study. We retrospectively investigated 10 clinicopathological factors predictive of lymph node metastasis by univariate and multivariate analysis. We showed the frequency of lymph node metastasis of subgroups in combination of independent factors selected by multivariate analysis. Lymph node metastases were detected in 57 lesions (10.2%). Univariate analysis revealed that lesion size > 30 mm, undifferentiated components, sm massive invasion, lymphatic invasion and venous invasion were factors significantly correlated with lymph node metastasis. By multivariate analysis, risk factors for lymph node metastasis were lesion size > 30 mm, undifferentiated components, sm massive invasion, and lymphati...
To determine the indication for endoscopic submucosal dissection, we retrospectively analyzed the... more To determine the indication for endoscopic submucosal dissection, we retrospectively analyzed the results of strip biopsies for early gastric cancer. We studied 374 lesions of 360 patients with early gastric cancer. The resection results were classified into complete local resection and incomplete resection. The relations among the resection results and maximum tumor diameter, tumor location, and 1-year recurrence were analyzed. Complete local resection was achieved by strip biopsy for 206 of the 374 lesions (55.1%). For the 168 lesions with incomplete resection, local recurrence was found in 22. The rate of complete local resection in strip biopsy was significantly low, and the rate of local recurrence was significantly high for lesions exceeding 2 cm in diameter as well as for lesions of the cardiac part and the angular part of the lesser curvature. Our strip biopsy results suggest that endoscopic submucosal dissection is needed for early gastric cancer lesions larger than 2 cm in...
World journal of gastroenterology : WJG, Jan 7, 2015
To investigate the utility of photodynamic diagnosis (PDD) using 5-aminolevulinic acid (5-ALA) to... more To investigate the utility of photodynamic diagnosis (PDD) using 5-aminolevulinic acid (5-ALA) to detect gastric/colorectal tumors. This prospective single-center study investigated inter-subject variability in patients with early-stage gastric/colorectal tumor indicated for endoscopic resection. Subjects were patients with gastric or colorectal tumors who had undergone endoscopic resection between November 2012 and November 2013. Selection criteria included age 20-80 years, either sex, and provision of informed consent. Patients were orally administered 20 mg/kg of 5-ALA enteric-coated capsules (SBI ALApromo Co., Tokyo, Japan). Administration of 5-ALA was followed by endoscopic resection of gastric or colorectal tumors, and the resected specimens were examined using a video autofluorescence processor and a fluorescence endoscope (SAFE-3000 and EB-1970AK, respectively; Pentax, Tokyo, Japan). The primary endpoint was the presence of fluorescence in tumors. Endoscopic, macroscopic, an...
Objective. Patients with gastroenteropancreatic neuroendocrine carcinoma (NEC) have a poor progno... more Objective. Patients with gastroenteropancreatic neuroendocrine carcinoma (NEC) have a poor prognosis. Platinum-based combination chemotherapy is commonly used as first-line treatment; however, the role of salvage chemotherapy remains unknown. This study aimed to analyze the efficacy and safety of amrubicin monotherapy in patients with platinum-refractory gastroenteropancreatic NEC. Methods. Among 22 patients with advanced gastroenteropancreatic NEC, 10 received amrubicin monotherapy between September 2007 and May 2014 after failure of platinum-based chemotherapy. The efficacy and toxicity of the treatment were analyzed retrospectively. Results. Eight males and two females (median age, 67 years (range, 52-78)) received platinum-based chemotherapy, including cisplatin plus irinotecan (n = 7, 70%), cisplatin plus etoposide (n = 2, 20%), and carboplatin plus etoposide (n = 1, 10%) before amrubicin therapy. Median progression-free survival and overall survival after amrubicin therapy were 2.6 and 5.0 months, respectively. Two patients had partial response (20% response rate), and their PFS were 6.2 months and 6.3 months, respectively. Furthermore, NEC with response for amrubicin had characteristics with a high Ki-67 index and receipt of prior chemotherapy with cisplatin and irinotecan. Grade 3-4 neutropenia and anemia were observed in four and five patients, respectively. Conclusion. Amrubicin monotherapy appears to be potentially active and well-tolerated for platinum-refractory gastroenteropancreatic NEC.
ABSTRACT The use of white or color tunable LEDs (light-emitting diodes), which can replace a larg... more ABSTRACT The use of white or color tunable LEDs (light-emitting diodes), which can replace a large light source apparatus and light-guiding fiber bundle, enable the miniaturization of the whole endoscope system and remove constraints on the design of its shape. We have developed a novel white LED for a new experimental prototype LED-illuminated gastrointestinal endoscope having the color rendering in the clinically important red range at around 600 nm.
Hyperspectral imaging (HSI) is a new technology that obtains spectroscopic information and render... more Hyperspectral imaging (HSI) is a new technology that obtains spectroscopic information and renders it in image form. This study examined the difference in the spectral reflectance (SR) of gastric tumors and normal mucosa recorded with a hyperspectral camera equipped with HSI technology and attempted to determine the specific wavelength that is useful for the diagnosis of gastric cancer. A total of 104 gastric tumors removed by endoscopic submucosal dissection from 96 patients at Yamaguchi University Hospital were recorded using a hyperspectral camera. We determined the optimal wavelength and the cut-off value for differentiating tumors from normal mucosa to establish a diagnostic algorithm. We also attempted to highlight tumors by image processing using the hyperspectral camera's analysis software. A wavelength of 770 nm and a cut-off value of 1/4 the corrected SR were selected as the respective optimal wavelength and cut-off values. The rates of sensitivity, specificity, and ac...
We determined comparative efficacy of i-Scan for detection and diagnosis of gastric cancer. Ten p... more We determined comparative efficacy of i-Scan for detection and diagnosis of gastric cancer. Ten patients diagnosed with early gastric cancer based on histopathological findings were analyzed. White light and i-Scan moving images recorded from these patients in twin mode were separated into white light and i-Scan. Twelve endoscopists (three different skill levels) blinded to patient information evaluated the images. Correlation between demarcation accuracy and lesion brightness on still images was investigated. No significant differences were found in diagnostic accuracy between white light and i-Scan moving images for tumor detection rate (91.7% versus 90.8%, P = 0.777). Diagnostic accuracy of tumor size was comparable between novice and experienced endoscopists for i-Scan moving images (65.7% versus 71.1%, P = 0.528), whereas it was significantly lower for white light moving images (41.2% versus 79.5%, P = 0.019). Tumor demarcation accuracy was significantly better with white light...
Cancer can develop in the operated stomach after partial gastrectomy and in the reconstructed gas... more Cancer can develop in the operated stomach after partial gastrectomy and in the reconstructed gastric tube after surgery for esophageal cancer. It is considered that endoscopic therapy is more safe and suitable for the early gastric cancer developed in such stomach than operation. We investigated the efficacy of endoscopic submucosal dissection (ESD) for cancer of the operated stomach. Subjects were 669 gastric cancer patients who underwent ESD: 22 patients (23 lesions) had surgically altered gastric anatomy, whereas 647 patients (727 lesions) had normal gastric anatomy. In the altered gastric anatomy group, 13 patients, 6 patients, and 3 patients had previously undergone distal gastrectomy, gastric tube reconstruction, and proximal gastrectomy, respectively. Rates of complete en bloc resection and curative resection were compared between the two groups. Influence of an anastomotic site and/or a suture line on ESD outcomes was examined in the altered gastric anatomy group. The rate ...
World journal of gastrointestinal endoscopy, Jan 16, 2012
Basaloid squamous carcinoma (BSC) of the esophagus is a rare esophageal tumor. A 79-year-old man ... more Basaloid squamous carcinoma (BSC) of the esophagus is a rare esophageal tumor. A 79-year-old man with a history of proximal gastrectomy for gastric adenocarcinoma in 2000 was followed-up by esophagogastroduodenoscopy (EGD) annually. In June 2010, EGD revealed a new protruding lesion in the cervical esophagus. The small lesion was approximately 5 mm in size. A biopsy specimen showed poorly differentiated squamous cell carcinoma. We performed endoscopic mucosal resection using a cap-fitted endoscope (EMRC). The histological diagnosis of the endoscopically resected specimen was BSC and the invasion depth was limited to the muscularis mucosae. Horizontal and vertical margins were negative. We report the case of superficial BSC in the cervical esophagus successfully resected by EMRC.
Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology, 2011
Infliximab is widely used in the treatment of inflammatory bowel disease, but despite its good cl... more Infliximab is widely used in the treatment of inflammatory bowel disease, but despite its good clinical efficacy and tolerance, drug-induced autoimmune disorders have been reported as adverse reactions and are a matter of concern. Here we report a patient with ulcerative colitis who developed drug-induced lupus erythematosus after infliximab treatment. While this is a rare complication of infliximab, early diagnosis and successful management are essential.
We performed a photodynamic therapy for local recurrence after chemoradiotherapy for esophageal c... more We performed a photodynamic therapy for local recurrence after chemoradiotherapy for esophageal cancer. The patient was a 60s man, who presented dysphasia. Esophagoscopy, CT and FDG-PET revealed an advanced esophageal cancer with mediastinal lymph node metastasis. He rejected a surgical treatment and underwent chemoradiotherapy, then achieved CR once. Subsequent FDG-PET, however, showed slightly FDG uptake at primary focus of the esophagus. Endoscopic biopsy specimen from Lugol's unstained lesion of the esophagus revealed squamous cell carcinoma, and he was diagnosed as a recurrence of the esophageal cancer. He underwent chemotherapy again, but the recurrent lesion enlarged. Because the control of the metastatic lesion was excellent and the recurrent lesion was considered as a superficial cancer, he was performed photodynamic therapy. Two months after photodynamic therapy, the esophagoscopy and FDG-PET showed no findings of the recurrence of the esophageal cancer. It was suggest...
International journal of gastrointestinal cancer, 2006
With the development of endoscopic submucosal dissection, an expansion of the criteria for local ... more With the development of endoscopic submucosal dissection, an expansion of the criteria for local treatment was suggested for lesions with ulcerous changes or undifferentiated-type adenocarcinoma. To determine the efficacy of endoscopic ultrasonography for such lesions, we retrospectively analyzed factors that influenced accurate diagnosis by endoscopic ultrasonography of the depth of tumor invasion. We investigated 267 gastric adenocarcinomas for which histopathological results were obtained by endoscopic mucosal resection or gastrectomy. The lesions were divided into four groups by histological type and the presence of ulcerous changes. Five clinicopathological factors were assessed for their possible associations with incorrect diagnosis. The positive predictive value (PPV) for cancer limited within the mucosa (endoscopic ultrasonography, EUS-M) and cancer invaded into the submucosal layer (EUS-SM) were 88.0% (125 of 142 lesions) and 60.0% (30 of 50 lesions), respectively. The les...
Epstein-Barr virus (EBV) has been detected in about 10% of gastric carcinoma cases worldwide, and... more Epstein-Barr virus (EBV) has been detected in about 10% of gastric carcinoma cases worldwide, and a high prevalence of EBV involvement in gastric remnant carcinoma has been reported recently. Details of the background remnant stomach of EBV-positive lesions, however, have not been well clarified. We screened 17 consecutive gastric remnant carcinoma lesions resected surgically. To detect EBV, we used in situ hybridization (ISH) for EBV-encoded small RNA1 (EBER-1) and we compared the clinicopathologic feature between EBV-positive and -negative gastric remnant carcinoma cases. EBV was detected in 41.8% (7 of 17) of the lesions by EBER-1 ISH. All 7 EBV-positive lesions developed in the anastomotic site had undergone Billroth-II reconstruction excess 20 years previously (mean 26.4 years). Histologically, all EBV-positive lesions were poorly differentiated adenocarcinomas with intense lymphocyte infiltration. In the adjacent mucosa of carcinomas, moderate or marked intestinal metaplasia w...
Uploads
Papers by Jun Nishikawa