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| 1 | Endoscopic Kyoto classification of Helicobacter pylori infection and gastric cancer risk diagnosis显示文摘Recent advances in endoscopic technology allow detailed observation of the gastric mucosa.Today,endoscopy is used in the diagnosis of gastritis to determine the presence/absence of Helicobacter pylori(H.pylori)infection and evaluate gastric cancer risk.In 2013,the Japan Gastroenterological Endoscopy Society advocated the Kyoto classification,a new grading system for endoscopic gastritis.The Kyoto classification organized endoscopic findings related to H.pylori infection.The Kyoto classification score is the sum of scores for five endoscopic findings(atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness with or without regular arrangement of collecting venules)and ranges from 0 to 8.Atrophy,intestinal metaplasia,enlarged folds,and nodularity contribute to gastric cancer risk.Diffuse redness and regular arrangement of collecting venules are related to H.pylori infection status.In subjects without a history of H.pylori eradication,the infection rates in those with Kyoto scores of 0,1,and≥2 were 1.5%,45%,and 82%,respectively.A Kyoto classification score of 0 indicates no H.pylori infection.A Kyoto classification score of 2 or more indicates H.pylori infection.Kyoto classification scores of patients with and without gastric cancer were 4.8 and 3.8,respectively.A Kyoto classification score of 4 or more might indicate gastric cancer risk. | Osamu Toyoshima Toshihiro Nishizawa Kazuhiko Koike | 2020 | World Journal of Gastroenterology2020，26，5： | 44 |
| 2 | Clinical outcomes and risk factors for perforation in gastric endoscopic submucosal dissection: A prospective pilot study显示文摘AIM: To evaluate clinical outcomes and risk factors for endoscopic perforation during endoscopic submucosal dissection (ESD) in a prospective study. METHODS: We investigated the clinical outcomes and risk factors for the development of perforation in 98 consecutive gastric neoplasms undergoing ESD regarding. Demographic and clinical parameters including patient-, tumor-, and treatment-related factors, clinical parameters, and duration of hospital stay were analyzed for risk factors for perforation. In subgroup analysis, we also compared the clinical outcomes between perforation and 'silent' free air without endoscopically visible perforation detected only by computed tomography.RESULTS: Perforation was identified in 8.2% of patients. All patients were managed conservatively by the administration of antibiotics. The mean procedure time was significantly longer in patients with endoscopic perforation than in those without. According to the receiver-operating characteristic analysis, the resulting cutoff value of the procedure time for perforation was 115 min (87.5% sensitivity, 56.7% specificity). Prolonged procedure time (≥ 115 min) was associated with an increased risk of perforation (odds ratio 9.15; 95%CI: 1.08-77.54; P = 0.04). Following ESD, body temperature and C-reactive protein level were significantly higher in patients with perforation than in those without (P = 0.02), whereas there was no difference between these patient groups on the starting day of oral intake or of hospitalization. In subgroup analysis, the post-ESD clinical course was not different between endoscopic perforation and silent free air. CONCLUSION: Only prolonged procedure time (≥ 115 min) was significantly associated with perforation. The clinical outcomes of perforation are favorable and are comparable to those of patients with or without silent free air. | Jiro Watari Toshihiko Tomita Fumihiko Toyoshima Jun Sakurai Takashi Kondo Haruki Asano Takahisa Yamasaki Takuya Okugawa Hisatomo Ikehara Tadayuki Oshima Hirokazu Fukui Hiroto Miwa | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，6： | 17 |
| 3 | Helicobacter pylori infection in subjects negative for high titer serum antibody显示文摘AIM To investigate the clinicopathological features of the patients testing negative for high titer serum antiHelicobacter pylori(H. pylori) antibody.METHODS The antibody titers were measured using antigens derived from Japanese individuals. ^(13)C-urea breath test-positive individuals were defined as having H. pylori infection. We investigated the demographic characteristics, laboratory data, endoscopic findings including Kyoto classification of gastritis, and histology in negative-high titer patients without H. pylori eradication therapy. Kyoto classification consisted of scores for gastric atrophy, intestinal metaplasia, enlarged folds, nodularity, and redness.RESULTS Of the 136 subjects enrolled, 23(17%) had H. pylori infection. Kyoto classification had an excellent area under the receiver operating characteristics curve(0.886, 95% confidence interval: 0.803-0.968, P = 3.7 × 10^(-20)) for predicting H. pylori infection with a cutoff value of 2. Further, Kyoto classification, H. pylori density, and neutrophil activity had high accuracies(89.7%, 96.3%, and 94.1%, respectively). Kyoto classification was independent of the demographic and laboratory parameters in multivariate analysis.CONCLUSION Endoscopic Kyoto classification of gastritis is a useful predictor of H. pylori infection in negative-high titer antibody patients. | Osamu Toyoshima Toshihiro Nishizawa Masahide Arita Yosuke Kataoka Kosuke Sakitani Shuntaro Yoshida Hiroharu Yamashita Keisuke Hata Hidenobu Watanabe Hidekazu Suzuki | 2018 | World Journal of Gastroenterology2018，24，13： | 9 |
| 4 | Serum anti-Helicobacter pylori antibody titer and its association with gastric nodularity,atrophy,and age:A cross-sectional study显示文摘AIM To clarify the role of serum anti-Helicobacter pylori(H. pylori) antibody titers in gastric cancer.METHODS In this cross-sectional study, the effect of patients' baseline characteristics and endoscopic findings on their serum antibody titers were assessed. We evaluated consecutive patients who underwent esophagogastroduodenoscopy and their first evaluation for H. pylori infection using a serum antibody test. We excluded patients with a history of eradication therapy. The participants were divided into four groups according to their E-plate serum antibody titer. Patients with serum antibody titers < 3, 3-9.9, 10-49.9, and ≥ 50 U/m L were classified into groups A, B, C, and D, respectively. RESULTS In total, 874 participants were analyzed with 70%, 16%, 8.7%, and 5.1% of them in the groups A, B, C, and D, respectively. Patients in group C were older than patients in groups A and B. Gastric open-type atrophy, intestinal metaplasia, enlarged folds, diffuse redness, and duodenal ulcers were associated with a high titer. Regular arrangements of collecting venules, fundic gland polyps, superficial gastritis, and gastroesophageal reflux disease were related to a low titer. Multivariate analysis revealed that nodularity(P = 0.0094), atrophy(P = 0.0076), and age 40-59 years(vs age ≥ 60 years, P = 0.0090) were correlated with a high serum antibody titer in H. pylori-infected patients. Intestinal metaplasia and atrophy were related to age ≥ 60 years in group C and D.CONCLUSION Serum antibody titer changes with age, reflects gastric mucosal inflammation, and is useful in predicting the risk of gastric cancer. | Osamu Toyoshima Toshihiro Nishizawa Kosuke Sakitani Tadahiro Yamakawa Yoshiyuki Takahashi Nobutake Yamamichi Keisuke Hata Yasuyuki Seto Kazuhiko Koike Hidenobu Watanabe Hidekazu Suzuki | 2018 | World Journal of Gastroenterology2018，24，35： | 9 |
| 5 | Histological diagnosis of gastric submucosal tumors: A pilot study of endoscopic ultrasonography-guided fine-needle aspiration biopsy vs mucosal cutting biopsy显示文摘AIM: To compare the usefulness of endoscopic ultrasonography-guided fine-needle aspiration biopsy(EUS-FNAB) without cytology and mucosal cutting biopsy(MCB) in the histological diagnosis of gastric submucosal tumor(SMT).METHODS: We prospectively compared the diagnostic yield, feasibility, and safety of EUS-FNAB and those of MCB based on endoscopic submucosal dissection. The cases of 20 consecutive patients with gastric SMT ≥1 cm in diameter. who underwent both EUS-FNAB and MCB were investigated.RESULTS: The histological diagnoses were gastrointestinal stromal tumors(n = 7), leiomyoma(n =6), schwannoma(n = 2), aberrant pancreas(n = 2), and one case each of glomus tumor, metastatic hepatocellular carcinoma, and no-diagnosis. The tumors' mean size was 23.6 mm. Histological diagnosis was made in 65.0% of the EUS-FNABs and 60.0% of the MCBs, a nonsignificant difference. There were no significant differences in the diagnostic yield concerning the tumor location or tumor size between the two methods. However, diagnostic specimens were significantly more frequently obtained in lesions with intraluminal growth than in those with extraluminal growth by the MCB method(P = 0.01). All four SMTs with extraluminal growth were diagnosed only by EUSFNAB(P = 0.03). No complications were found in either method.CONCLUSION: MCB may be chosen as an alternative diagnostic modality in tumors showing the intraluminal growth pattern regardless of tumor size, whereas EUSFNAB should be performed for SMTs with extraluminal growth. | Hisatomo Ikehara Zhaoliang Li Jiro Watari Masato Taki Tomohiro Ogawa Takahisa Yamasaki Takashi Kondo Fumihiko Toyoshima Tomoaki Kono Katsuyuki Tozawa Yoshio Ohda Toshihiko Tomita Tadayuki Oshima Hirokazu Fukui Ikuo Matsuda Seiichi Hirota Hiroto Miwa | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，14： | 7 |
| 6 | Endoscopic diagnosis for colorectal sessile serrated lesions显示文摘BACKGROUND Hyperplastic polyps are considered non-neoplastic, whereas sessile serrated lesions(SSLs) are precursors of cancer via the ‘‘serrated neoplastic pathway’’. The clinical features of SSLs are tumor size(> 5 mm), location in the proximal colon, coverage with abundant mucus called the ‘‘mucus cap’’, indistinct borders, and a cloud-like surface. The features in magnifying narrow-band imaging are varicose microvascular vessels and expanded crypt openings. However, accurate diagnosis is often difficult.AIM To develop a diagnostic score system for SSLs.METHODS We retrospectively reviewed consecutive patients who underwent endoscopic resection during colonoscopy at the Toyoshima endoscopy clinic. We collected data on serrated polyps diagnosed by endoscopic or pathological examination. The significant factors for the diagnosis of SSLs were assessed using logistic regression analysis. Each item that was significant in multivariate analysis was assigned 1 point, with the sum of these points defined as the endoscopic SSL diagnosis score. The optimal cut-off value of the endoscopic SSL diagnosis score was determined by receiver-operating characteristic curve analysis.RESULTS Among 1288 polyps that were endoscopically removed, we analyzed 232 diagnosed as serrated polyps by endoscopic or pathological examination. In the univariate analysis, the location(proximal colon), size(> 5 mm), mucus cap, indistinct borders, cloud-like surface, and varicose microvascular vessels were significantly associated with the diagnosis of SSLs. In the multivariate analysis, size(> 5 mm;P = 0.033), mucus cap(P = 0.005), and indistinct borders(P = 0.033) were independently associated with the diagnosis of SSLs. Size > 5 mm, mucus cap, and indistinct borders were assigned 1 point each and the sum of these points was defined as the endoscopic SSL diagnosis score. The receiver-operating characteristic curve analysis showed an optimal cut-off score of 3, which predicted pathological SSLs with 75% sensitivity, 80% specificity, and 78.4% accuracy. The pathological SSL rate for an endoscopic SSL diagnosis score of 3 was significantly higher than that for an endoscopic SSL diagnosis score of 0, 1, or 2(P < 0.001).CONCLUSION Size > 5 mm, mucus cap, and indistinct borders were significant endoscopic features for the diagnosis of SSLs. Serrated polyps with these three features should be removed during colonoscopy. | Toshihiro Nishizawa Shuntaro Yoshida Akira Toyoshima Tomoharu Yamada Yoshiki Sakaguchi Taiga Irako Hirotoshi Ebinuma Takanori Kanai Kazuhiko Koike Osamu Toyoshima | 2021 | World Journal of Gastroenterology2021，27，13： | 7 |
| 7 | Narrow pelvic inlet plane area and obesity as risk factors for anastomotic leakage after intersphincteric resection显示文摘BACKGROUND Intersphincteric resection(ISR)has been increasingly used as the ultimate sphincter-preserving procedure in extremely low rectal cancer.The most critical complication of this technique is anastomotic leakage.The incidence rate of anastomotic leakage after ISR has been reported to range from 5.1%to 20%.AIM To investigate risk factors for anastomotic leakage after ISR based on clinicopathological variables and pelvimetry.METHODS This study was conducted at Department of Colorectal Surgery,Japanese Red Cross Medical Center,Tokyo,Japan,with a total of 117 patients.We enrolled 117 patients with extremely low rectal cancer who underwent laparotomic and laparoscopic ISRs at our hospital.We conducted retrospective univariate and multivariate regression analyses on 33 items to elucidate the risk factors for anastomotic leakage after ISR.Pelvic dimensions were measured using threedimensional reconstruction of computed tomography images.The optimal cutoff value of the pelvic inlet plane area that predicts anastomotic leakage was determined using a receiver operating characteristic(ROC)curve.RESULTS We observed anastomotic leakage in 10(8.5%)of the 117 patients.In the multivariate analysis,we identified high body mass index(odds ratio 1.674;95%confidence interval:1.087-2.58;P=0.019)and smaller pelvic inlet plane area(odds ratio 0.998;95%confidence interval:0.997-0.999;P=0.012)as statistically significant risk factors for anastomotic leakage.According to the receiver operating characteristic curves,the optimal cutoff value of the pelvic inlet plane area was 10074 mm2.Narrow pelvic inlet plane area(≤10074 mm2)predicted anastomotic leakage with a sensitivity of 90%,a specificity of 85.9%,and an accuracy of 86.3%.CONCLUSION Narrow pelvic inlet and obesity were independent risk factors for anastomotic leakage after ISR.Anastomotic leakage after ISR may be predicted from a narrow pelvic inlet plane area(≤10074 mm2). | Akira Toyoshima Toshihiro Nishizawa Eiji Sunami Ryuji Akai Takahiro Amano Akiyoshi Yamashita Shin Sasaki Takeshi Endo Yoshihiro Moriya Osamu Toyoshima | 2020 | World Journal of Gastrointestinal Surgery2020，12，10： | 4 |
| 8 | Diagnosis of small intramucosal signet ring cell carcinoma of the stomach by non-magnifying narrow-band imaging: A pilot study显示文摘AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been treated with endoscopic submucosal dissection(ESD) and 14 randomly selected whitish gastric ulcer scars(control). The strength and shape of the SRCs and whitish scars by NM-NBI and white-light imaging(WLI) were assessed with Image J(NIH, Bethesda).RESULTS: NM-NBI findings of SRC showed a clearly isolated whitish area amid the brown color of the surrounding normal mucosa. The NBI index, which indicates the potency of NBI for visualizing SRC, was significantly higher than the WLI index(P = 0.001), indicating SRC was more clearly identified by NM-NBI. Although the NBI index was not significantly different between SRCs and controls, the circle(C)-index, as an index of circularity of tumor shape, was significantly higher in SRCs(P = 0.001). According to the receiveroperating characteristic analysis, the resulting cut-off value of the circularity index(C-index) for SRC was 0.60(85.7% sensitivity, 85.7% specificity). Thus a lesion with a C-index ≥ 0.6 was significantly more likely to be an SRC than a gastric ulcer scar(OR = 36.0; 95%CI: 4.33-299.09; P = 0.0009).CONCLUSION: Small isolated whitish round area by NM-NBI endoscopy is a useful finding of SRCs which is the indication for ESD. | Jiro Watari Toshihiko Tomita Hisatomo Ikehara Masato Taki Tomohiro Ogawa Takahisa Yamasaki Takashi Kondo Fumihiko Toyoshima Jun Sakurai Tomoaki Kono Katsuyuki Tozawa Yoshio Ohda Tadayuki Oshima Hirokazu Fukui Seiichi Hirota Hiroto Miwa | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，12： | 4 |
| 9 | Personalized immunotherapy in cancer precision medicine显示文摘With the significant advances in cancer genomics using next-generation sequencing technologies,genomic and molecular profilingbased precision medicine is used as a part of routine clinical test for guiding and selecting the most appropriate treatments for individual cancer patients.Although many molecular-targeted therapies for a number of actionable genomic alterations have been developed,the clinical application of such information is still limited to a small proportion of cancer patients.In this review,we summarize the current status of personalized drug selection based on genomic and molecular profiling and highlight the challenges how we can further utilize the individual genomic information.Cancer immunotherapies,including immune checkpoint inhibitors,would be one of the potential approaches to apply the results of genomic sequencing most effectively.Highly cancer-specific antigens derived from somatic mutations,the so-called neoantigens,occurring in individual cancers have been in focus recently.Cancer immunotherapies,which target neoantigens,could lead to a precise treatment for cancer patients,despite the challenge in accurately predicting neoantigens that can induce cytotoxic T cells in individual patients.Precise prediction of neoantigens should accelerate the development of personalized immunotherapy including cancer vaccines and T-cell receptor-engineered T-cell therapy for a broader range of cancer patients. | Kazuma Kiyotani Yujiro Toyoshima Yusuke Nakamura | 2021 | Cancer Biology & Medicine2021，18，4： | 3 |
| 10 | Mucosal-incision assisted biopsy for suspected gastric gastrointestinal stromal tumors显示文摘To evaluate the diagnostic yield of the procedure, mucosal-incision assisted biopsy (MIAB), for the histological diagnosis of gastric gastrointestinal stromal tumor (GIST), we performed a retrospective review of the 27 patients with suspected gastric GIST who underwent MIAB in our hospitals. Tissue samples obtained by MIAB were sufficient to make a histological diagnosis (diagnostic MIAB) in 23 out of the 27 patients, where the lesions had intraluminal growth patterns. Alternatively, the samples were insufficient (non-diagnosticMIAB) in remaining 4 patients, three of whom had gastric submucosal tumor with extraluminal growth patterns. Although endoscopic ultrasound and fine needle aspiration is the gold standard for obtaining tissue specimens for histological and cytological analysis of suspected gastric GISTs, MIAB can be used as an alternative method for obtaining biopsy specimens of lesions with an intraluminal growth pattern. | Eikichi Ihara Hiroshi Matsuzaka Kuniomi Honda Yoshitaka Hata Yorinobu Sumida Hirotada Akiho Tadashi Misawa Satoshi Toyoshima Yoshiharu Chijiiwa Kazuhiko Nakamura Ryoichi Takayanagi | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，4： | 3 |
| 11 | Enlarged folds on endoscopic gastritis as a predictor for submucosal invasion of gastric cancers显示文摘BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;however,evaluating invasion depth based on endoscopic background gastritis remains unclear.AIM To investigate predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis.METHODS Patients with gastric cancer detected on esophagogastroduodenoscopy at Toyoshima Endoscopy Clinic were enrolled.We analyzed the effects of patient and tumor characteristics,including age,sex,body mass index,surveillance endoscopy within 2 years,current Helicobacter pylori infection,the Kyoto classification,and Lauren’s tumor type,on submucosal tumor invasion and curative endoscopic resection.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Atrophy was characterized by non-reddish and low mucosa.Intestinal metaplasia was detected as patchy whitish or grayish-white flat elevations,forming an irregular uneven surface.An enlarged fold referred to a fold width≥5 mm in the greater curvature of the corpus.Nodularity was characterized by goosebump-like multiple nodules in the antrum.Diffuse redness was characterized by uniform reddish nonatrophic mucosa in the greater curvature of the corpus.RESULTS A total of 266 gastric cancer patients(mean age,66.7 years;male sex,58.6%;mean body mass index,22.8 kg/m2)were enrolled.Ninety-three patients underwent esophagogastroduodenoscopy for surveillance within 2 years,and 140 had current Helicobacter pylori infection.The mean Kyoto score was 4.54.Fifty-eight cancers were diffuse-type,and 87 cancers had invaded the submucosa.Multivariate analysis revealed that low body mass index(odds ratio 0.88,P=0.02),no surveillance esophagogastroduodenoscopy within 2 years(odds ratio 0.15,P<0.001),endoscopic enlarged folds of gastritis(odds ratio 3.39,P=0.001),and Lauren’s diffuse-type(odds ratio 5.09,P<0.001)were independently associated with submucosal invasion.Similar results were obtained with curative endoscopic resection.Among cancer patients with enlarged folds,severely enlarged folds(width≥10 mm)were more related to submucosal invasion than mildly enlarged folds(width 5-9 mm,P<0.001).CONCLUSION Enlarged folds of gastritis were associated with submucosal invasion.Endoscopic observation of background gastritis as well as the lesion itself may help diagnose the depth of cancer invasion. | Osamu Toyoshima Shuntaro Yoshida Toshihiro Nishizawa Akira Toyoshima Kosuke Sakitani Tatsuya Matsuno Tomoharu Yamada Takashi Matsuo Hayato Nakagawa Kazuhiko Koike | 2021 | World Journal of Gastrointestinal Endoscopy2021，13，9： | 2 |
| 12 | Endoscopy-based Kyoto classification score of gastritis related to pathological topography of neutrophil activity显示文摘BACKGROUND Endoscopy-based Kyoto classification for gastritis and pathological topographic distribution of neutrophil infiltration are correlated with gastric cancer risk.AIM To investigate the association between Kyoto classification and the topographic distribution of neutrophil activity.METHODS Kyoto classification score,ranging from 0 to 8,consisted of atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Neutrophil activity was scored according to the updated Sydney System using biopsy samples obtained from the greater curvature of the corpus and the antrum.The participants were divided into four categories,inactive stomach,antrumpredominant gastritis,pangastritis,and corpus-predominant gastritis,based on the topographic distribution of neutrophil activity.Effects of sex,age,body mass index,drinking habit,smoking habit,family history of gastric cancer,serum Helicobacter pylori(H.pylori)antibody,and Kyoto score on topography of neutrophil infiltration were analyzed.RESULTS A total of 327 patients(comprising 50.7%women,with an average age of 50.2 years)were enrolled in this study.H.pylori infection rate was 82.9%with a mean Kyoto score of 4.63.The Kyoto score was associated with the topographic distribution of neutrophil activity.Kyoto scores were significantly higher in the order of inactive stomach,antrum-predominant gastritis,pangastritis,and corpuspredominant gastritis(3.05,4.57,5.21,and 5.96,respectively).Each individual score of endoscopic findings(i.e.,atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness)was correlated with the topographic distribution of neutrophil activity.On multivariate analysis,the Kyoto score,age,and serum H.pylori antibody were independently associated with the topographic distribution of neutrophil activity.CONCLUSION The Kyoto classification score was associated with the topographic distribution of neutrophil activity. | Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Yoshiki Sakaguchi Yousuke Nakai Hidenobu Watanabe Hidekazu Suzuki Chizu Tanikawa Koichi Matsuda Kazuhiko Koike | 2020 | World Journal of Gastroenterology2020，26，34： | 2 |
| 13 | Kyoto classification in patients who developed multiple gastric carcinomas after Helicobacter pylori eradication显示文摘BACKGROUND Endoscopic Kyoto classification predicts gastric cancer risk;however,the score in the patients with primary gastric cancer after Helicobacter pylori(H.pylori)eradication therapy is unknown.AIM To elucidate the Kyoto classification score in patients with both single gastric cancer and multiple gastric cancers developed after H.pylori eradication.METHODS The endoscopist recorded the Kyoto classification at the endoscope and the Kyoto classification score at the time of the first diagnosis of gastric cancer after H.pylori eradication.The score was compared between single gastric cancer group and multiple gastric cancers group.RESULTS The Kyoto score at the time of diagnosis of 45 cases of gastric cancer after H.pylori eradication was 4.0 points in average.The score was 3.8 points in the single gastric cancer group,and 5.1 points in the multiple gastric cancers group.The multiple group had a significantly higher score than the single group(P=0.016).In the multiple gastric cancers group,all the patients(7/7)had 5 or higher Kyoto score,while in single gastric cancer group,the proportion of patients with a score of 5 or higher was less than half,or 44.7%(17/38).CONCLUSION Patients diagnosed with gastric cancer after H.pylori eradication tended to have advanced gastritis.In particular,in cases of multiple gastric cancers developed after H.pylori eradication,the endoscopic Kyoto classification score tended to be 5 or higher in patients with an open type atrophic gastritis and the intestinal metaplasia extended to the corpus. | Kosuke Sakitani Toshihiro Nishizawa Akira Toyoshima Shuntaro Yoshida Tatsuya Matsuno Tomoharu Yamada Masatoshi Irokawa Yoshiyuki Takahashi Yousuke Nakai Osamu Toyoshima Kazuhiko Koike | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，9： | 2 |
| 14 | Analysis of circulating tumor cells derived from advanced gastric cancer显示文摘 | Kosei Toyoshima Akira Hayashi Masahide Kashiwagi Naoko Hayashi Masaaki Iwatsuki Takatsugu Ishimoto Yoshifumi Baba Hideo Baba Yoshikazu Ohta | 2015 | Int. J. Cancer2015，，4： | 2 |
| 15 | Generation of Pluripotent Stem Cells from Neonatal Mouse Testis显示文摘 | Mito Kanatsu-Shinohara Kimiko Inoue Jiyoung Lee Momoko Yoshimoto Narumi Ogonuki Hiromi Miki Shiro Baba Takeo Kato Yasuhiro Kazuki Shinya Toyokuni Megumi Toyoshima Ohtsura Niwa Mitsuo Oshimura Toshio Heike Tatsutoshi Nakahata Fumitoshi Ishino Atsuo Ogura T | 2004 | Cell2004，，7： | 2 |
| 16 | Effect of soaking and gaseous treatment on GABA content in germinated brown rice显示文摘 | Noriko Komatsuzaki Kikuichi Tsukahara Hidechika Toyoshima Tadanao Suzuki Naoto Shimizu Toshinori Kimura | 2005 | Journal of Food Engineering2005，，2： | 2 |
| 17 | Risk factors for first acute myocardial infarction attack assessed by cardiovascular disease registry data in Aichi Prefecture显示文摘 | Kondo Y Toyoshima H Yatsuya H | 2007 | Nagoya J Med Sci2007，69，34： | 1 |
| 18 | Genomic organization and chro- mosome localization of the newly identified human heparanase gene 显示文摘 | Dong J Kukula AK Toyoshima M | 2000 | Gene2000，25，3： | 1 |
| 19 | Transmission-blocking Activity of a Chitinase Inhibitor and Activation of Malarial Parasite Chitinase by Mosquito Protease显示文摘 | Shahabuddin M Toyoshima T Aikawa M | 1993 | Proc Natl Acad Sci USA1993，90，9： | 1 |
| 20 | Mutualalignment errors due to the variation of wavefront aberrations in a free space laser communication link 显示文摘 | M Toyoshima N Takahashi | 2001 | Optical Society of America2001，9，11： | 1 |
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