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| 1 | Utility of linked color imaging for endoscopic diagnosis of early gastric cancer显示文摘BACKGROUND Linked color imaging(LCI) is a method of endoscopic imaging that emphasizes slight differences in red mucosal color.AIM To evaluate LCI in diagnostic endoscopy of early gastric cancer and to compare LCI and pathological findings.METHODS Endoscopic images were obtained for 39 patients(43 lesions) with early gastric cancer. Three endoscopists evaluated lesion recognition with white light imaging(WLI) and LCI. Color values in Commission Internationale de l'Eclairage(CIE)1976 L*a*b* color space were used to calculate the color difference(ΔE) between cancer lesions and non-cancer areas. After endoscopic submucosal dissection,blood vessel density in the surface layer of the gastric epithelium was evaluated pathologically. The identical region of interest was selected for analyses of endoscopic images(WLI and LCI) and pathological analyses.RESULTS LCI was superior for lesion recognition(P < 0.0001), and ΔE between cancer and non-cancer areas was significantly greater with LCI than WLI(29.4 vs 18.6, P <0.0001). Blood vessel density was significantly higher in cancer lesions(5.96% vs4.15%, P = 0.0004). An a* cut-off of ≥ 24 in CIE 1976 L*a*b* color space identified a cancer lesion using LCI with sensitivity of 76.7%, specificity of 93.0%, and accuracy of 84.9%.CONCLUSION LCI is more effective for recognition of early gastric cancer compared to WLI as a result of improved visualization of changes in redness. Surface blood vessel density was significantly higher in cancer lesions, and this result is consistent with LCI image analysis. | Toshihisa Fujiyoshi Ryoji Miyahara Kohei Funasaka Kazuhiro Furukawa Tsunaki Sawada Keiko Maeda Takeshi Yamamura Takuya Ishikawa Eizaburo Ohno Masanao Nakamura Hiroki Kawashima Masato Nakaguro Masahiro Nakatochi Yoshiki Hirooka | 2019 | World Journal of Gastroenterology2019，25，10： | 12 |
| 2 | In vivo histological diagnosis for gastric cancer using endocytoscopy显示文摘AIM To examine usefulness of virtual biopsy using endocytoscopy by comparing the in vivo endocytoscopic and histopathological images of gastric cancers.METHODS Endocytoscopy was performed in 30 patients with early gastric cancer. Of these, 26 patients showed well differentiated adenocarcinomas, while 4 patients showed poorly differentiated adenocarcinomas(including one signet ring cell carcinoma). Cancerous and non-cancerous areas were observed after double staining with 0.05% crystal violet and 0.1% methylene blue. The endocytoscopic images obtained were evaluated by an expert endoscopist and an expert pathologist without knowledge of patient clinical data, and endocytoscopic and histopathological diagnoses were compared.RESULTS The endocytoscopic images of the cancerous area were assessed as evaluable in 25(83.3%) and 27(90%) patients by endoscopist A and pathologist B, respectively, and those of the non-cancerous area as evaluable in 28(93.3%) and 23(76.7%) patients by the endoscopist and pathologist, respectively. The sensitivity, specificity, and diagnostic accuracy of gastric cancer diagnosis using evaluable endocytoscopic images were 88.0% and 92.9%, and 90.6% by endoscopist A, and 88.9% and 91.3%, and 90.0% by pathologist B, respectively. Evaluation of the diagnostic concordance rate between the endoscopist and the pathologist by inter-observer agreement calculation revealed no significant difference between the two observers. The inter-observer agreement(κ-value) for endocytoscopic diagnosis was 0.745. CONCLUSION Endocytoscopy is useful for the differentiation of cancerous from non-cancerous gastric mucosa, making it a promising tool for virtual biopsy. | Issei Tsurudome Ryoji Miyahara Kohei Funasaka Kazuhiro Furukawa Masanobu Matsushita Takeshi Yamamura Takuya Ishikawa Eizaburo Ohno Masanao Nakamura Hiroki Kawashima Osamu Watanabe Masato Nakaguro Akira Satou Yoshiki Hirooka Hidemi Goto | 2017 | World Journal of Gastroenterology2017，23，37： | 5 |
| 3 | Modified docetaxel, cisplatin and capecitabine for stage Ⅳ gastric cancer in Japanese patients: A feasibility study显示文摘AIM To evaluate the feasibility of chemotherapy including fluoropyrimidine, platinum and taxane with modified dosages for unresectable gastric cancer in Japanese patients.METHODS We performed a feasibility study of a modified docetaxel, cisplatin and capecitabine (DCX) regimen for stage Ⅳ gastric cancer. In particular, 30 or 40 mg/m^2 of docetaxel on day 1, 60 mg/m^2 of cisplatin on day 1, and 2000 mg/m^2 of capecitabine for 2 wk were administered every three weeks.RESULTS Three patients were treated with modified DCX(m DCX) with 30 mg/m^2 docetaxel, and five patients were treated with this regimen with 40 mg/m^2 docetaxel. Grade 3 or 4 neutropenia was observed in six of the eight patients; no patients exhibited febrile neutropenia. Partial response was achieved in four of the eight patients. Three patients underwent gastrectomy, which achieved R0 resection without residual tumors in dissected lymph nodes. In one of these three patients, resected specimens revealed pathological complete response in the primary lesion and in lymph nodes.CONCLUSION m DCX was well tolerated by Japanese patients with stage Ⅳ gastric cancer. This regimen might be useful for allowing gastric cancer patients with distant lymph node metastasis to undergo conversion surgery. | Osamu Maeda Ayumu Matsuoka Ryoji Miyahara Kohei Funasaka Yoshiki Hirooka Masahide Fukaya Masato Nagino Yasuhiro Kodera Hidemi Goto Yuichi Ando | 2017 | World Journal of Gastroenterology2017，23，6： | 4 |
| 4 | Azathioprine is essential following cyclosporine for patients with steroid-refractory ulcerative colitis显示文摘AIM: To evaluate long-term prognosis following cyclosporine treatment by examining the rate of surgery avoidance among cyclosporine responders.METHODS: We retrospectively reviewed clinical records for 29 patients diagnosed with severe steroid-refractory ulcerative colitis in our hospital from August 1997 to August 2008 and treated with cyclosporine by continuous intravenous infusion.All patients were treated with intravenous corticosteroids for more than 5 d prior to cyclosporine therapy.Administration was continued for up to 21 d under serum monitoring to maintain cyclosporine levels between 400 and 600 ng/mL.Clinical activity was assessed before and after cyclosporine therapy using the clinical activity index score,with a reduction of ≥ 5 considered to indicate a response.Among responders,we defined cases not requiring surgery for more than 5 years as exhibiting long-term efficacy of cyclosporine.Factors considered to be possibly predictive of long-term efficacy of cyclosporine were sex,age,disease duration,clinical activity index score,C-reactive protein level,hemoglobin level,disease extent,endoscopic findings,and clinical course.RESULTS: Cyclosporine was not discontinued due to side effects in any patient.Nineteen(65.5%) of 29 patients were considered responders.A statistically significant(P = 0.004) inverseas sociation wa s observed between an endoscopic finding of 'mucosal bleeding' and responsive cases.Fifteen(9 males,6 females) of these 19 patients were followed for 5 years or more,of whom 9(60%) exhibited long-termefficacy of cyclosporine.Of the 10 non-responders,9(90%) underwent surgery within 6 mo of cyclosporine therapy.None of the following factors had a significant impact on the long-term efficacy of cyclosporine: sex,age,duration of disease,clinical activity index score,C-reactive protein level,hemoglobin level,extent of disease,endoscopic findings,or clinical course.In contrast,a significant association was observed for maintenance therapy with azathioprine after cyclosporine therapy(P = 0.0014).CONCLUSION: Maintenance therapy with azathioprine might improve the long-term efficacy of continuously infused cyclosporine for severe steroid-refractory ulcerative colitis patients. | Nobuyuki Miyake Takafumi Ando Kazuhiro Ishiguro Osamu Maeda Osamu Watanabe Yutaka Hirayama Keiko Maeda Kazuhiro Morise Masanobu Matsushita Kazuhiro Furukawa Kohei Funasaka Masanao Nakamura Ryoji Miyahara Naoki Ohmiya Hidemi Goto | 2015 | World Journal of Gastroenterology2015，21，1： | 3 |
| 5 | Contrast-enhanced endoscopic ultrasonography in digestive diseases显示文摘 | Yoshiki Hirooka Akihiro Itoh Hiroki Kawashima Eizaburo Ohno Yuya Itoh Yosuke Nakamura Takeshi Hiramatsu Hiroyuki Sugimoto Hajime Sumi Daijiro Hayashi Naoki Ohmiya Ryoji Miyahara Masanao Nakamura Kohei Funasaka Masatoshi Ishigami Yoshiaki Katano Hidemi Got | 2012 | Journal of Gastroenterology2012，，10： | 2 |
| 6 | Contrast-enhanced endoscopic ultrasonography in digestive diseases显示文摘 | Yoshiki Hirooka Akihiro Itoh Hiroki Kawashima Eizaburo Ohno Yuya Itoh Yosuke Nakamura Takeshi Hiramatsu Hiroyuki Sugimoto Hajime Sumi Daijiro Hayashi Naoki Ohmiya Ryoji Miyahara Masanao Nakamura Kohei Funasaka Masatoshi Ishigami Yoshiaki Katano Hidemi Got | 2012 | Journal of Gastroenterology2012，，10： | 2 |
| 7 | Usefulness of H elicobacter pylori eradication for precancerous lesions of the gastric remnant显示文摘 | Masatoshi Sakakibara Takafumi Ando Kazuhiro Ishiguro Osamu Maeda Osamu Watanabe Yutaka Hirayama Kazuhiro Morise Keiko Maeda Masanobu Matsushita Kazuhiro Furukawa Kohei Funasaka Masanao Nakamura Ryoji Miyahara Hidemi Goto | 2014 | J Gastroenterol Hepatol2014，，： | 1 |
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