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Miura E, Emoto K, Abe T, Hashiguchi A, Hishida T, Asakura K, Sakamoto M. Establishment of artificial intelligence model for precise histological subtyping of lung adenocarcinoma and its application to quantitative and spatial analysis. Jpn J Clin Oncol 2024:hyae066. [PMID: 38757929 DOI: 10.1093/jjco/hyae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/04/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The histological subtype of lung adenocarcinoma is a major prognostic factor. We developed a new artificial intelligence model to classify lung adenocarcinoma images into seven histological subtypes and adopted the model for whole-slide images to investigate the relationship between the distribution of histological subtypes and clinicopathological factors. METHODS Using histological subtype images, which are typical for pathologists, we trained and validated an artificial intelligence model. Then, the model was applied to whole-slide images of resected lung adenocarcinoma specimens from 147 cases. RESULT The model achieved an accuracy of 99.7% in training sets and 90.4% in validation sets consisting of typical tiles of histological subtyping for pathologists. When the model was applied to whole-slide images, the predominant subtype according to the artificial intelligence model classification matched that determined by pathologists in 75.5% of cases. The predominant subtype and tumor grade (using the WHO fourth and fifth classifications) determined by the artificial intelligence model resulted in similar recurrence-free survival curves to those determined by pathologists. Furthermore, we stratified the recurrence-free survival curves for patients with different proportions of high-grade components (solid, micropapillary and cribriform) according to the physical distribution of the high-grade component. The results suggested that tumors with centrally located high-grade components had a higher malignant potential (P < 0.001 for 5-20% high-grade component). CONCLUSION The new artificial intelligence model for histological subtyping of lung adenocarcinoma achieved high accuracy, and subtype quantification and subtype distribution analyses could be achieved. Artificial intelligence model therefore has potential for clinical application for both quantification and spatial analysis.
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Affiliation(s)
- Eisuke Miura
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Katsura Emoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
- Department of Diagnostic Pathology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Tokiya Abe
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Akinori Hashiguchi
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
- School of Medicine, International University of Health and Welfare, Chiba, Japan
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Suzuki T, Hishida T, Suzuki S, Okubo Y, Masai K, Kaseda K, Asakura K, Emoto K, Asamura H. Clinicopathological predictors of postoperative long-term myasthenic status in resected thymoma with myasthenia gravis. Surg Today 2024:10.1007/s00595-024-02806-0. [PMID: 38416144 DOI: 10.1007/s00595-024-02806-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/22/2023] [Indexed: 02/29/2024]
Abstract
PURPOSE Surgical patients with thymoma and myasthenia gravis (MG) must have their MG status and oncological outcomes critically monitored. We aimed to identify clinicopathological predictors of the postoperative MG status. METHODS We conducted a retrospective review of 40 consecutive surgical patients with MG-related thymomas between 2002 and 2020. The quantitative myasthenia gravis score (QMGS) and Myasthenia Gravis Foundation of America post-intervention status (MGFA-PIS) were used to evaluate postoperative MG status. RESULTS All patients underwent extended total thymectomy. The most common WHO type was type B2 (32%), while 65% of patients had type B1-B3 and 35% had type A-AB thymomas. Eleven patients (28%) achieved controlled MG status in MGFA-PIS 6 months after surgery. This controlled status was observed more frequently in type A-AB than in B1-B3 (57% vs. 12%, p = 0.007). In a multivariate analysis, WHO type (A-AB or B1-B3) was an independent predictor of worsening episodes of MG based on the QMGS (Type B1-B3, hazard ratio: 3.23, 95% confidence interval: 1.12-9.25). At the last follow-up, 23 patients (58%) achieved controlled MG status. The 5-year overall survival rate of all patients was 93.7%. CONCLUSION The WHO type of thymoma is an informative predictor of postoperative MG status in patients with MG-related thymoma.
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Affiliation(s)
- Takahiro Suzuki
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Yu Okubo
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Kyohei Masai
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Kaoru Kaseda
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Katsura Emoto
- Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
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Masai K, Nakai T, Okubo Y, Kaseda K, Hishida T, Asakura K. Nuss procedure for the treatment of pectus excavatum with dyspnea following oropharyngeal cancer surgery: a case report. J Surg Case Rep 2024; 2024:rjad714. [PMID: 38250131 PMCID: PMC10799248 DOI: 10.1093/jscr/rjad714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Pectus excavatum (PE) causes cardiopulmonary dysfunction depending on the degree and form of the depression. The patient was a 74-year-old woman with a history of PE. Fourteen years ago, a total glossolaryngectomy was performed for oropharyngeal cancer. Two years later, the patient gradually experienced difficulty in breathing. Computed tomography (CT) revealed severe PE and right main bronchial stenosis. We performed a Nuss procedure for PE repair to surgically release the stenosis of the right main bronchus. Postoperative chest CT showed improvement in the sternal depression and right main bronchial stenosis. Furthermore, shortness of breath was relieved postoperatively. Oropharyngeal cancer surgery may cause tracheal support disruption, leading to leftward shift and severe stenosis of the right main bronchus due to sternum depression. This is an important report regarding respiratory distress caused by a combination of PE and post-oropharyngeal cancer surgery.
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Affiliation(s)
- Kyohei Masai
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Taketo Nakai
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yu Okubo
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kaoru Kaseda
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
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4
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Hayashi K, Kitago M, Abe Y, Yagi H, Hasegawa Y, Hori S, Tanaka M, Nakano Y, Asakura K, Masugi Y, Kitagawa Y. Long-term survival after surgical resection for bone metastasis from pancreatic cancer: A case report. Medicine (Baltimore) 2023; 102:e35856. [PMID: 37986361 PMCID: PMC10659668 DOI: 10.1097/md.0000000000035856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/09/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Pancreatic cancer (PC) is highly malignant and metastatic; however, bone metastases are rare. Although the effectiveness of conversion surgery for distant metastases of PC has been reported in a few cases, there are no reports on surgical resection for bone metastases. Here, we report a case of long-term survival after resection of bone metastasis from PC. PATIENT CONCERNS A 60-year-old woman underwent pancreaticoduodenectomy after neoadjuvant chemoradiotherapy for pancreatic head cancer. At 28 months after surgery, multiple lung metastases from PC were diagnosed, and chemotherapy was administered. After 59 months, chemotherapy was terminated because all target lesions had disappeared on imaging. DIAGNOSIS At 77 months after the initial surgery, bone metastasis in the left 9th rib was detected by positron emission tomography/computed tomography, which was performed due to elevated carbohydrate antigen 19-9 levels. INTERVENTIONS Chemotherapy was readministered as the initial treatment. Subsequently, due to the long-term well-controlled status of the recurrence site and the absence of other metastases, thoracoscopic-assisted partial resection of the left 9th rib was performed 128 months following pancreaticoduodenectomy. Pathological examination revealed adenocarcinoma metastasis from PC. OUTCOMES The patient is currently alive without recurrence 44 months after resection for bone metastasis and 172 months after the initial surgery. CONCLUSION Surgical resection may be favorable in patients with bone metastasis of PC that is well-controlled with chemotherapy.
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Affiliation(s)
- Koki Hayashi
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Hiroshi Yagi
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Yasushi Hasegawa
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Shutaro Hori
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Masayuki Tanaka
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Yutaka Nakano
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Keisuke Asakura
- Department of Thoracic Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Yohei Masugi
- Department of Pathology, Keio University School of Medicine, Shinjukusss, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Shinjuku, Japan
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Oka N, Masai K, Okubo Y, Kaseda K, Hishida T, Asakura K. Combined Ravitch and Nuss procedure for pectus excavatum with dyspnea following scoliosis repair. J Surg Case Rep 2023; 2023:rjad618. [PMID: 37965534 PMCID: PMC10641290 DOI: 10.1093/jscr/rjad618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023] Open
Abstract
Pectus excavatum (PE) is often associated with scoliosis and can elicit cardiovascular disturbances under rare conditions. Here we report a patient who was treated with a combined Ravitch and Nuss procedure for PE with dyspnea following scoliosis repair to improve her symptoms. The patient was a 49-year-old woman with a history of PE and scoliosis. Right inferior pulmonary vein stenosis was caused by posterior spinal fusion for scoliosis prior to the PE repair. We could safely correct the chest wall deformity and treat dyspnea by performing a modified Ravitch repair in combination with the Nuss procedure.
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Affiliation(s)
- Naoyuki Oka
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kyohei Masai
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yu Okubo
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kaoru Kaseda
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Masai K, Okubo Y, Kaseda K, Hishida T, Asakura K. Combined Ravitch and Nuss procedure for patients with severe pectus excavatum: technique and initial results. J Surg Case Rep 2023; 2023:rjad576. [PMID: 37942345 PMCID: PMC10629864 DOI: 10.1093/jscr/rjad576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/01/2023] [Indexed: 11/10/2023] Open
Abstract
The Nuss procedure for pectus excavatum (PE) is both less invasive and very simple compared to the Ravitch procedure. However, it may be difficult to perform the Nuss procedure in cases of severe PE. Therefore, we developed a Combined Ravitch and Nuss (CRN) procedure and examined its effectiveness in patients with severe PE. Nine patients with severe PE underwent the CRN procedure. Data on patient characteristics and perioperative results were collected retrospectively. The median Haller index (HI) was 15.4 (range, 6.3-29.3). No significant intraoperative adverse events were noted. Postoperatively, marked improvements in HI were seen in all cases (3.29, range, 2.72-4.96). Two surgical site infections on the shallow layer and one wound seroma occurred. No recurrences were observed during the observation period. Our novel CRN procedure is useful for achieving adequate and sustainable sternal elevation with less invasiveness for patients with severe PE.
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Affiliation(s)
- Kyohei Masai
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582, Japan
| | - Yu Okubo
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582, Japan
| | - Kaoru Kaseda
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582, Japan
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Suzuki S, Asakura K, Okui M, Izawa N, Sawafuji M, Sakamaki H, Shigenobu T, Tajima A, Oka N, Masai K, Kaseda K, Hishida T, Yasuda H, Fukunaga K, Asamura H. Prognostic factors affecting survival in patients with non-small cell lung cancer treated with salvage surgery after drug therapy: a multi-institutional retrospective study. World J Surg Oncol 2023; 21:290. [PMID: 37715273 PMCID: PMC10503184 DOI: 10.1186/s12957-023-03177-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/09/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND The prevalence of salvage surgeries after drug therapy for non-small cell lung cancer (NSCLC) has risen, mainly due to recent progress in molecular-targeted drugs and immune checkpoint inhibitors for NSCLC. While the safety and effectiveness of salvage surgery after drug therapy for NSCLC have been studied, its indications remain unclear. We aimed to identify the prognostic factors affecting survival in patients with advanced-stage (stages III-IV) NSCLC treated with salvage surgery after drug therapy. METHODS A retrospective investigation was conducted on patients who received salvage surgery after drug therapy at four hospitals between 2007 and 2020. Salvage surgery was defined as surgery after drug therapy for local progression, tumor conversion to resectable status, and discontinuation of prior drug therapy owing to serious complications. RESULTS Thirty-two patients received cytotoxic agents alone (n = 12 [38%]), tyrosine kinase inhibitors (TKIs; n = 16 [50%]), or immune checkpoint inhibitors (n = 4 [13%]) as prior drug therapy. In 11 (34%) and 21 (66%) patients, the clinical stage before treatment was III or IV, respectively. The median initial and preoperative serum carcinoembryonic antigen (CEA) levels were 10.2 (range, 0.5-1024) ng/mL and 4.2 (range, 0.6-92.5) ng/mL, respectively. Among the patients, 28 (88%) underwent lobectomy, 2 (6%) underwent segmentectomy, and 2 (6%) underwent wedge resection. Complete resection of the primary lesion was accomplished in 28 (88%) patients. Postoperative complications were documented in six (19%) patients. Mortality rates were 0% at 30 days and 3% at 90 days post-operation. The 5-year overall survival rate stood at 66%, while the 5-year progression-free survival rate was 21%. Multivariate analyses showed that prior TKI therapy and preoperative serum CEA level < 5 ng/mL were prognostic factors influencing overall survival (hazard ratio [95% confidence interval]: 0.06 [0.006-0.68] and 0.03 [0.002-0.41], respectively). The 5-year overall survival in the 11 patients with both favorable prognosticators was 100%. CONCLUSIONS In this study, prior TKI therapy and preoperative serum CEA level < 5 ng/mL were favorable prognostic factors for overall survival in patients with NSCLC treated with salvage surgery. Patients with these prognostic factors are considered good candidates for salvage surgery after drug therapy.
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Affiliation(s)
- Shigeki Suzuki
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
- Department of General Thoracic Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
| | - Masayuki Okui
- Department of General Thoracic Surgery, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Naoko Izawa
- Department of General Thoracic Surgery, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Makoto Sawafuji
- Department of General Thoracic Surgery, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Hiroyuki Sakamaki
- Department of General Thoracic Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan
| | - Takao Shigenobu
- Department of General Thoracic Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan
| | - Atsushi Tajima
- Department of General Thoracic Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan
| | - Naoyuki Oka
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Kyohei Masai
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Kaoru Kaseda
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinanomachi, Shinjyuku-ku, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinanomachi, Shinjyuku-ku, Tokyo, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
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Oka N, Masai K, Okubo Y, Kaseda K, Hishida T, Emoto K, Asakura K. [Clinicopathological Features and Imaging Characteristics of Pulmonary Mucosa-associated Lymphoid Tissue Lymphoma]. Kyobu Geka 2023; 76:623-628. [PMID: 37500551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease. We report seven cases of pulmonary MALT lymphoma. CASES Chest computed tomography (CT) revealed various morphological features, including a solitary mass, a solid nodule, and ground-glass opacity. Multiple nodules were observed in one patient. However, the tumor margins were ill-defined in all seven cases, and air bronchograms were identified in five cases. The solitary mass was found to extend along the pulmonary lymphatic vessels. Six patients underwent R0 resection, while one underwent an open lung biopsy. Histopathological findings in all seven cases showed lymphoepithelial lesions. Regarding their immunohistological findings, all patients were diagnosed with pulmonary MALT lymphoma. Two patients received postoperative chemotherapy with rituximab. The progression-free survival time was 52 (range, 22-122) months. Postoperative course was uneventful in all patients. CONCLUSION MALT lymphoma is characterized by an ill-defined margin, air bronchogram, and tumor extension along the pulmonary lymphatic vessels, all of which aid in diagnosis. MALT lymphoma is a low-grade lymphoma, and the prognosis is favorable. Therefore, follow-up examination without treatment can be one of the therapeutic options if patients are diagnosed with pulmonary MALT lymphoma.
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Affiliation(s)
- Naoyuki Oka
- Division of Thoracic Surgery, Keio University, Tokyo, Japan
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Ebisudani T, Hamamoto J, Togasaki K, Mitsuishi A, Sugihara K, Shinozaki T, Fukushima T, Kawasaki K, Seino T, Oda M, Hanyu H, Toshimitsu K, Emoto K, Hayashi Y, Asakura K, Johnson TA, Terai H, Ikemura S, Kawada I, Ishii M, Hishida T, Asamura H, Soejima K, Nakagawa H, Fujii M, Fukunaga K, Yasuda H, Sato T. Genotype-phenotype mapping of a patient-derived lung cancer organoid biobank identifies NKX2-1-defined Wnt dependency in lung adenocarcinoma. Cell Rep 2023; 42:112212. [PMID: 36870059 DOI: 10.1016/j.celrep.2023.112212] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/06/2023] [Accepted: 02/16/2023] [Indexed: 03/05/2023] Open
Abstract
Human lung cancer is a constellation of tumors with various histological and molecular properties. To build a preclinical platform that covers this broad disease spectrum, we obtained lung cancer specimens from multiple sources, including sputum and circulating tumor cells, and generated a living biobank consisting of 43 lines of patient-derived lung cancer organoids. The organoids recapitulated the histological and molecular hallmarks of the original tumors. Phenotypic screening of niche factor dependency revealed that EGFR mutations in lung adenocarcinoma are associated with the independence from Wnt ligands. Gene engineering of alveolar organoids reveals that constitutive activation of EGFR-RAS signaling provides Wnt independence. Loss of the alveolar identity gene NKX2-1 confers Wnt dependency, regardless of EGFR signal mutation. Sensitivity to Wnt-targeting therapy can be stratified by the expression status of NKX2-1. Our results highlight the potential of phenotype-driven organoid screening and engineering for the fabrication of therapeutic strategies to combat cancer.
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Affiliation(s)
- Toshiki Ebisudani
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Junko Hamamoto
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kazuhiro Togasaki
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Akifumi Mitsuishi
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kai Sugihara
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Taro Shinozaki
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takahiro Fukushima
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kenta Kawasaki
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takashi Seino
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Mayumi Oda
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hikaru Hanyu
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kohta Toshimitsu
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Katsura Emoto
- Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yuichiro Hayashi
- Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Todd A Johnson
- Laboratory for Cancer Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Hideki Terai
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Shinnosuke Ikemura
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Ichiro Kawada
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Makoto Ishii
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kenzo Soejima
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hidewaki Nakagawa
- Laboratory for Cancer Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Masayuki Fujii
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Koichi Fukunaga
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hiroyuki Yasuda
- Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Toshiro Sato
- Department of Organoid Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.
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Nagata T, Minami Y, Muramatsu Y, Asakura K, Katamine M, Katsura A, Kinoshita D, Ako J. High thrombotic risk is associated with higher prevalence of suboptimal stent results in patients with high bleeding risk. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Shorter duration of dual antiplatelet therapy after drug-eluting stent implantation is required in patients with high bleeding risk (HBR) irrespective of the presence of concomitant high thrombotic risk (HTR). The prevalence of post-stent suboptimal findings in patients with HBR remains unclear.
Purpose
To clarify the prevalence of post-stent suboptimal findings assessed by optical coherence tomography (OCT) in patients with HBR according to the presence of HTR.
Methods
A total of 607 consecutive patients with stable coronary disease, who underwent OCT imaging of the culprit lesion were included. HBR was defined based on the Academic Research Consortium for High Bleeding Risk (ARC-HBR). HTR was defined as lesions with diffuse long (≧60 mm), treated with more than three stents, chronic total occlusion or diffuse long lesion (≧32 mm) in patients with diabetes mellitus. Post-stent suboptimal OCT criteria was defined as minimum stent area (MSA) <4.5 mm2, edge dissection and stent malapposition.
Results
The prevalence of HBR was 55.8%. The prevalence of HTR was significantly higher in patients with HBR than in those without HBR (35.0 vs. 26.6%, p=0.028) (Figure A). Among patients with HBR, the prevalence of post-stent suboptimal OCT criteria was significantly higher in patients with HTR than in those without HTR (86.2 vs. 64.7%, p<0.001), mainly due to the higher prevalence of MSA <4.5 mm2 (Figure B) in patients with HTR.
Conclusions
HTR was associated with a higher prevalence of post-stent suboptimal findings among patients with HBR. The present results may suggest the importance of optimal stenting in patients with HBR, particularly in those with concomitant HTR.
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Affiliation(s)
- T Nagata
- Kitasato University School of Medicine , Sagamihara , Japan
| | - Y Minami
- Kitasato University School of Medicine , Sagamihara , Japan
| | - Y Muramatsu
- Kitasato University School of Medicine , Sagamihara , Japan
| | - K Asakura
- Kitasato University School of Medicine , Sagamihara , Japan
| | - M Katamine
- Kitasato University School of Medicine , Sagamihara , Japan
| | - A Katsura
- Kitasato University School of Medicine , Sagamihara , Japan
| | - D Kinoshita
- Kitasato University School of Medicine , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine , Sagamihara , Japan
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11
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Sakata R, Chu PS, Kawaida M, Emoto K, Sakurai M, Nishida R, Asakura K, Morikawa R, Taniki N, Kataoka K, Kanai T, Nakamoto N. Concurrent de novo Thymoma-associated Paraneoplastic Type 1 Autoimmune Hepatitis and Pure Red Cell Aplasia after Thymectomy: A Case Report and Literature Review. Intern Med 2023; 62:243-249. [PMID: 35705275 PMCID: PMC9908397 DOI: 10.2169/internalmedicine.9743-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The precise manipulation of immune tolerance is the holy grail of immunotherapies for both autoimmunity and cancer immunity. Thymomas are well known to be associated with autoimmune diseases. The exact mechanism by which autoreactivity is induced after thymectomy remains to be elucidated. We herein present the case of a 50-year-old lady with concurrent de novo type 1 autoimmune hepatitis (AIH) and pure red cell aplasia (PRCA), 1 month after undergoing a successful total thymectomy for combined squamous cell carcinoma and thymoma (Masaoka stage II). Corticosteroids yielded short-term effects for both AIH and PRCA. Literature on thymoma-associated AIH, an extremely rare immune-related comorbidity, was also reviewed.
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Affiliation(s)
- Rie Sakata
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
- Postgraduate Medical Education Center, Keio University Hospital, Japan
| | - Po-Sung Chu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Miho Kawaida
- Division of Diagnostic Pathology, Keio University School of Medicine, Japan
| | - Katsura Emoto
- Division of Diagnostic Pathology, Keio University School of Medicine, Japan
| | - Masatoshi Sakurai
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Risa Nishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Japan
| | - Rei Morikawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Nobuhito Taniki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Keisuke Kataoka
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Nobuhiro Nakamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
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12
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Matsuzaki J, Kato K, Oono K, Tsuchiya N, Sudo K, Shimomura A, Tamura K, Shiino S, Kinoshita T, Daiko H, Wada T, Katai H, Ochiai H, Kanemitsu Y, Takamaru H, Abe S, Saito Y, Boku N, Kondo S, Ueno H, Okusaka T, Shimada K, Ohe Y, Asakura K, Yoshida Y, Watanabe SI, Asano N, Kawai A, Ohno M, Narita Y, Ishikawa M, Kato T, Fujimoto H, Niida S, Sakamoto H, Takizawa S, Akiba T, Okanohara D, Shiraishi K, Kohno T, Takeshita F, Nakagama H, Ota N, Ochiya T. Prediction of tissue-of-origin of early stage cancers using serum miRNomes. JNCI Cancer Spectr 2022; 7:6847090. [PMID: 36426871 PMCID: PMC9825310 DOI: 10.1093/jncics/pkac080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/02/2022] [Accepted: 10/17/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Noninvasive detection of early stage cancers with accurate prediction of tumor tissue-of-origin could improve patient prognosis. Because miRNA profiles differ between organs, circulating miRNomics represent a promising method for early detection of cancers, but this has not been shown conclusively. METHODS A serum miRNA profile (miRNomes)-based classifier was evaluated for its ability to discriminate cancer types using advanced machine learning. The training set comprised 7931 serum samples from patients with 13 types of solid cancers and 5013 noncancer samples. The validation set consisted of 1990 cancer and 1256 noncancer samples. The contribution of each miRNA to the cancer-type classification was evaluated, and those with a high contribution were identified. RESULTS Cancer type was predicted with an accuracy of 0.88 (95% confidence interval [CI] = 0.87 to 0.90) in all stages and an accuracy of 0.90 (95% CI = 0.88 to 0.91) in resectable stages (stages 0-II). The F1 score for the discrimination of the 13 cancer types was 0.93. Optimal classification performance was achieved with at least 100 miRNAs that contributed the strongest to accurate prediction of cancer type. Assessment of tissue expression patterns of these miRNAs suggested that miRNAs secreted from the tumor environment could be used to establish cancer type-specific serum miRNomes. CONCLUSIONS This study demonstrates that large-scale serum miRNomics in combination with machine learning could lead to the development of a blood-based cancer classification system. Further investigations of the regulating mechanisms of the miRNAs that contributed strongly to accurate prediction of cancer type could pave the way for the clinical use of circulating miRNA diagnostics.
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Affiliation(s)
- Juntaro Matsuzaki
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan,Division of Pharmacotherapeutics, Keio University Faculty of Pharmacy, Minato-ku, Tokyo, Japan
| | - Ken Kato
- Department of Head and Neck, Esophageal Medical Oncology and Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kenta Oono
- Preferred Networks, Inc, Chiyoda-ku, Tokyo, Japan
| | - Naoto Tsuchiya
- Laboratory of Molecular Carcinogenesis, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | - Kazuki Sudo
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Akihiko Shimomura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Sho Shiino
- Department of Breast Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Takayuki Kinoshita
- Department of Breast Surgery, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Hiroyuki Daiko
- Department of Esophageal Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Takeyuki Wada
- Department of Gastric Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hitoshi Katai
- Department of Gastric Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiroki Ochiai
- Department of Colorectal Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiroyuki Takamaru
- Endoscopy Division, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Seiichiro Abe
- Endoscopy Division, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Narikazu Boku
- Department of Head and Neck, Esophageal Medical Oncology and Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Shunsuke Kondo
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hideki Ueno
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kazuaki Shimada
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Keisuke Asakura
- Department of Thoracic Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Naofumi Asano
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Mitsuya Ishikawa
- Department of Gynecology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiroyuki Fujimoto
- Department of Urology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Shumpei Niida
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiromi Sakamoto
- Department of Biobank and Tissue Resources, Fundamental Innovative Oncology Core, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | - Satoko Takizawa
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan,Toray Industries, Inc, Kamakura, Kanagawa, Japan
| | - Takuya Akiba
- Preferred Networks, Inc, Chiyoda-ku, Tokyo, Japan
| | | | - Kouya Shiraishi
- Division of Genome Biology, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | - Takashi Kohno
- Division of Genome Biology, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | - Fumitaka Takeshita
- Department of Translational Oncology, Fundamental Innovative Oncology Core, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | | | | | - Takahiro Ochiya
- Correspondence to: Takahiro Ochiya, PhD, Department of Molecular and Cellular Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan (e-mail: )
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13
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Asakura K, Minami Y, Nagata T, Katamine M, Katsura A, Kinoshita D, Ako J. Higher triglyceride level is associated with the higher prevalence of layered plaque in nonculprit coronary plaques. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The impact of the high triglyceride (TG) level on the characteristics of coronary plaque in nonculprit lesion remains to be elucidated.
Purpose
To clarify the association between the TG level and the characteristics of nonculprit coronary plaque in patients with stable coronary disease using optical coherence tomography (OCT).
Methods
A total of 531 consecutive patients who underwent OCT imaging of the nonculprit lesion were included. Patients were classified into either the higher TG group (non-fasting TG ≥150 mg/dL, n=197) or the lower TG group (non-fasting TG <150 mg/dL, n=334). The morphologies of nonculprit plaque assessed by OCT were compared between the two groups.
Results
The median (interquartile range) of TG in the two groups was 193.0 (168.0–244.0) mg/dL and 95.0 (75.0–120.0) mg/dL, respectively. The prevalence of layered plaque was significantly higher in the higher TG group than the lower TG group (40.1 vs. 27.5%, p=0.004), whereas the prevalence of other plaque components was comparable between the two groups (Figure 1). The prevalence of layered plaque was significantly higher in the higher TG group than in the lower TG group among patients with diabetes mellitus (DM) (44.2 vs. 28.7%, p=0.037) although it was comparable between the two groups among patients without DM (Figure 2).
Conclusion
A higher TG level was associated with a higher prevalence of layered plaque in nonculprit plaques in patients with stable coronary disease, particularly in patients with DM. The present results may partly explain the impact of TG on the progression of coronary plaque and the increased incidence of recurrent events in patients with coronary artery disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Asakura
- Kitasato University School of Medicine , Kanagawa , Japan
| | - Y Minami
- Kitasato University School of Medicine , Kanagawa , Japan
| | - T Nagata
- Kitasato University School of Medicine , Kanagawa , Japan
| | - M Katamine
- Kitasato University School of Medicine , Kanagawa , Japan
| | - A Katsura
- Kitasato University School of Medicine , Kanagawa , Japan
| | - D Kinoshita
- Kitasato University School of Medicine , Kanagawa , Japan
| | - J Ako
- Kitasato University School of Medicine , Kanagawa , Japan
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14
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Suzuki T, Hishida T, Yano K, Imoto T, Oka N, Maeda C, Okubo Y, Masai K, Kaseda K, Asakura K, Emoto K, Asamura H. EP07.03-007 Clinicopathological Analyses for Predicting Recurrence After Complete Resection of Thymoma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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15
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Yanagihara T, Shimohira M, Inoue M, Nakayama K, Tamura M, Nakatsuka S, Hattori H, Emoto K, Yokota K, Okuda K, Nakanishi R, Kaseda K, Maeda C, Asakura K, Hiwatashi A. Hemoptysis after coil embolization for pulmonary arteriovenous malformation: Histopathological confirmation of bronchial epithelium extension. Radiol Case Rep 2022; 17:2101-2105. [PMID: 35469299 PMCID: PMC9034289 DOI: 10.1016/j.radcr.2022.03.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/13/2022] [Indexed: 11/24/2022] Open
Abstract
Coil embolization is widely performed for pulmonary arteriovenous malformations (PAVMs). We describe herein 2 cases of hemoptysis during long-term follow-up after coil embolization for PAVMs. For both cases, lobectomy was performed and histopathological examinations revealed chronic inflammation and bronchial epithelium extension into the sac of the PAVM. In addition, we performed a systematic review of previous reports of hemoptysis after embolization for PAVMs.
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16
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Suzuki T, Asakura K, Egawa T, Kawauchi M, Okubo Y, Masai K, Kaseda K, Hishida T, Asamura H. Double stapling method for closure of intraoperative alveolar air leakage adjacent to the staple line: a randomized experimental study on ex vivo porcine lungs. J Thorac Dis 2022; 14:2045-2052. [PMID: 35813731 PMCID: PMC9264071 DOI: 10.21037/jtd-21-1960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/07/2022] [Indexed: 11/13/2022]
Abstract
Background Alveolar air leakage from a pleural defect around the staple line is one of the complications after wedge resection of the lung. An intraoperative closure of the pleural defect by suturing can cause additional pleural rupture due to tension of the pleura adjacent to staple lines. Therefore, we have introduced a novel closure method for pleural defect adjacent to the staple line, named the double stapling method. This study compared the efficacy of two closure methods; the double stapling method and conventional suturing method with pledgets using ex vivo porcine lungs. Methods The double stapling method involves closing the pleural defect by suturing the two parallel staple lines at both sides of the pleural defect. This method was developed to distribute the pleural tension around the needle holes of suturing. As a model of pleural defect adjacent to the staple line after wedge resection, wedge resection of the caudal lobe of left porcine lungs was performed, and a superficial square pleural defect (10 mm × 10 mm) adjacent to the staple line was made by scalpel. The defect was closed using the following two methods: (I) suturing with pledgets (n=10); and (II) double stapling method (n=10). The lobe was inflated in water at an airway pressure of 20, 25, and 30 cmH2O; closure success or failure was judged by the absence or presence of air leakage. Results The closure success was confirmed in 2 (20%) out of 10 cases in the suturing with pledgets group and 9 (90%) out of 10 in the double stapling method group (P=0.007). In 4 out of 10 cases in the suturing with pledgets group, new pleural clefts longer than 3 mm were created around the needle holes of suturing. Conclusions Ex vivo experiments have suggested the superiority of the double stapling method for the intraoperative closure of alveolar air leakage adjacent to the staple line after wedge resection, compared to conventional suturing with the pledget method.
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Affiliation(s)
- Takahiro Suzuki
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takumi Egawa
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Kawauchi
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yu Okubo
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kyohei Masai
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kaoru Kaseda
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
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17
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Katamine M, Minami Y, Nagata T, Asakura K, Katsura A, Kinoshita D, Hashimoto T, Ako J. High sensitivity C-reactive protein is associated with vulnerable characteristics in non-culprit plaques in patients with ST-segment elevation myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Higher level of high sensitivity C-reactive protein (hsCRP) is associated with an increased risk of recurrent cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI). However, the association between hsCRP and the characteristics of non-culprit plaques in patients with STEMI remains to be elucidated.
Purpose
To clarify the morphological characteristics of non-culprit plaque in patients with STEMI according to the hsCRP levels using optical coherence tomography (OCT).
Methods
A total of 79 non-culprit plaques in 76 consecutive patients with STEMI, who underwent OCT imaging of the non-culprit plaques in a culprit vessel were included. The characteristics of non-culprit plaques assessed by OCT were compared between the higher hsCRP group (hsCRP ≥ 0.16 mg/dL, 38 plaques in 38 patients) and the lower hsCRP group (hsCRP < 0.16 mg/dL, 41 plaques in 38 patients).
Results
The prevalence of plaque with macrophage (63.2 vs. 31.7%, p = 0.006), plaque with large lipid (maximal lipid arc > 180 °) (57.9 vs. 31.7%, p = 0.018), healed plaque (50.0 vs. 26.8%, p = 0.045) and cholesterol crystal (18.4 vs. 2.4%, p = 0.045) was significantly higher in the higher hsCRP group than in the lower hsCRP group (Figure). In a multivariate analysis, the higher hsCRP was independently associated with the presence of plaque with macrophage (Odds ratio [OR], 3.031; 95% confidence interval [CI]: 1.112-8.264, p = 0.030), plaque with large lipid (OR, 2.897; 95% CI: 1.122-7.478, p = 0.026) and healed plaque (OR, 2.666; 95% CI: 1.030-6.896, p = 0.040).
Conclusions
Higher level of hsCRP is associated with a higher prevalence of vulnerable characteristics in non-culprit plaques in patients with STEMI. The present results may partly explain the pathogenesis of an increased incidence of recurrent cardiovascular events in patients with STEMI. Abstract Figure.
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Affiliation(s)
- M Katamine
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Minami
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Nagata
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Asakura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - A Katsura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - D Kinoshita
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Hashimoto
- Kitasato University School of Medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Sagamihara, Japan
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18
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Hirozane T, Nakayama R, Yamaguchi S, Mori T, Asano N, Asakura K, Kikuta K, Kawaida M, Sasaki A, Okita H, Nakatsuka S, Ito T. Recurrent malignant peripheral nerve sheath tumor presenting as an asymptomatic intravenous thrombus extending to the heart: a case report. World J Surg Oncol 2022; 20:8. [PMID: 34996471 PMCID: PMC8742394 DOI: 10.1186/s12957-021-02473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022] Open
Abstract
Background Malignant peripheral nerve sheath tumor (MPNST) is a rare soft tissue sarcoma mainly treated via surgical resection. Herein, we report a case of MPNST wherein a massive tumor thrombus extended to the major veins and heart. Case presentation A 39-year-old female with a history of neurofibromatosis type 1 developed MPNST from the right radial nerve. In addition to adjuvant chemotherapy, she underwent wide tumor resection and concomitant radial nerve resection, followed by postoperative radiotherapy. Histological evaluation revealed marked venous invasion. The 2-year follow-up CT revealed an asymptomatic recurrent tumor thrombus extending from the right subclavian vein to the heart. An urgent life-saving operation was performed to ligate the base of the right subclavian vein and remove the entire intravenous thrombus that extended to the right ventricle. The remaining tumor in the right subclavian vein increased in size 3 months after thrombectomy. After confirming the absence of any metastatic lesions, the patient underwent extended forequarter amputation to achieve surgical remission. One year later, a new metastasis to the right diaphragm was safely resected. The patient remains alive without any evidence of disease 2 years after the extended forequarter amputation. Conclusions In cases of a previous history of microscopic venous invasion, recurrence can occur as a massive tumor thrombus that extends to the great vessels. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-021-02473-2.
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Affiliation(s)
- Toru Hirozane
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Robert Nakayama
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Sayaka Yamaguchi
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomoaki Mori
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naofumi Asano
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazutaka Kikuta
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Division of Musculoskeletal Oncology and Orthopedic Surgery, Tochigi Cancer Center, Tochigi, Japan
| | - Miho Kawaida
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Aya Sasaki
- Department of Pathology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Hajime Okita
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Seishi Nakatsuka
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Tsutomu Ito
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
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Kaseda K, Asakura K, Nishida R, Okubo Y, Masai K, Hishida T, Inoue M, Yashiro H, Nakatsuka S, Jinzaki M, Asamura H. Feasibility and safety of percutaneous cryoablation under local anesthesia for the treatment of malignant lung tumors: a retrospective cohort study. J Thorac Dis 2022; 14:4297-4308. [PMID: 36524096 PMCID: PMC9745531 DOI: 10.21037/jtd-22-830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/09/2022] [Indexed: 11/09/2022]
Abstract
Background In our institution, computed tomography (CT)-guided percutaneous cryoablation has been performed in patients with malignant lung tumors under local anesthesia. This study aimed to examine the feasibility and safety of percutaneous cryoablation for the treatment of malignant lung tumors. Methods From July 2002 to December 2016, 227 patients (56 with primary lung cancer and 171 with metastatic lung tumor) underwent percutaneous cryoablation for the treatment of malignant lung tumors using a cryosurgical unit at our institution. Demographic factors, duration of post-treatment hospitalization, and adverse event and mortality rates were retrospectively investigated in 366 treatment sessions targeting 609 lesions. Results The median diameter of the targeted tumor was 1.3 cm. All the cryoablation procedures were completed under local anesthesia, and the median duration of post-treatment hospitalization was two days. Adverse events (grade 2 or higher) were observed in 79 sessions (21.6%), with pneumothorax being the most common. In five sessions (1.4%), patients had grade 3 adverse events. There was no 30-day mortality; however, there were two 60-day mortality (0.5%) due to acute exacerbation of interstitial pneumonia. In multivariate analysis, independent predictors of adverse events were comorbid interstitial pneumonia [odds ratio (OR) =2.20; 95% confidence interval (CI): 1.04-4.64] and no history of pulmonary resection on the treated side (OR =3.04; 95% CI: 1.65-5.62). Conclusions Cryoablation is a feasible and safe treatment for malignant lung tumors with acceptable adverse event rates. However, the mortality risk in patients with comorbid interstitial pneumonia should be fully recognized.
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Kobayashi AK, Nakagawa K, Nakayama Y, Ohe Y, Yotsukura M, Uchida S, Asakura K, Yoshida Y, Watanabe SI. Salvage Surgery Compared to Surgery After Induction Chemoradiation Therapy for Advanced Lung Cancer. Ann Thorac Surg 2021; 114:2087-2092. [PMID: 34843695 DOI: 10.1016/j.athoracsur.2021.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/03/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Salvage surgery is performed for selected patients with relapses of locally advanced lung cancer after definitive chemoradiation therapy (CRT), and seems to be effective. To date, the feasibility of such salvage surgery, particularly anatomical pulmonary resection, has not been fully evaluated. To assess the feasibility of salvage surgery after definitive CRT, we compared clinical outcomes of surgery after definitive CRT to those of surgery after induction CRT. METHODS Medical records of patients who underwent surgery from January 2000 to January 2018 were reviewed. We compared patients with salvage anatomical pulmonary resection after definitive CRT to patients with surgery after induction CRT in terms of perioperative and long-term outcomes. RESULTS Twenty-three patients underwent salvage surgery after definitive CRT for locally advanced lung cancer (salvage group) and 36 underwent surgery after induction CRT for cN2-stage III non-small cell lung cancer (induction CRT group). The surgical procedures in the salvage group were 2 segmentectomies, 13 lobectomies, 1 bi-lobectomy and 7 pneumonectomies, and those in the induction CRT group were 34 lobectomies and 2 bi-lobectomies. There was no 30-day or 90-day mortality in either group. The 5-year overall survival was 44.7% for the salvage group and 58.6% for the induction CRT group. The 5-year progression-free interval was 42.2% for the salvage group and 47.7% for the induction CRT group. CONCLUSIONS Salvage anatomical pulmonary resection after definitive CRT for locally advanced lung cancer is feasible with acceptable morbidity and prognosis in highly selected patients.
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Affiliation(s)
- Aki K Kobayashi
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masaya Yotsukura
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Shinsuke Uchida
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Keisuke Asakura
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
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21
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Sugiura T, Uesaka K, Okamura Y, Ito T, Yamamoto Y, Ashida R, Ohgi K, Otsuka S, Nakagawa M, Aramaki T, Asakura K. Major hepatectomy with combined vascular resection for perihilar cholangiocarcinoma. BJS Open 2021; 5:6342603. [PMID: 34355240 PMCID: PMC8342931 DOI: 10.1093/bjsopen/zrab064] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/31/2021] [Indexed: 12/14/2022] Open
Abstract
Background Hepatectomy with vascular resection (VR) for perihilar cholangiocarcinoma (PHCC) is a challenging procedure. However, only a few reports on this procedure have been published and its clinical significance has not been fully evaluated. Methods Patients undergoing surgical resection for PHCC from 2002–2017 were studied. The surgical outcomes of VR and non-VR groups were compared. Results Some 238 patients were included. VR was performed in 85 patients. The resected vessels were hepatic artery alone (31 patients), portal vein alone (37 patients) or both (17 patients). The morbidity rates were almost the same in the VR (49.4 per cent) and non-VR (43.8 per cent) groups (P = 0.404). The mortality rates of VR (3.5 per cent) and non-VR (3.3 per cent) were also comparable (P > 0.999). The median survival time (MST) was 45 months in the non-VR group and 36 months in VR group (P = 0.124). Among patients in whom tumour involvement was suspected on preoperative imaging and whose carbohydrate antigen 19-9 (CA19-9) value was 37 U/ml or less, MST in the VR group was significantly longer than that in the non-VR group (50 versus 34 months, P = 0.017). In contrast, when the CA19-9 value was greater than 37 U/ml, MST of the VR and non-VR groups was comparable (28 versus 29 months, P = 0.520). Conclusion Hepatectomy with VR for PHCC can be performed in a highly specialized hepatobiliary centre with equivalent short- and long-term outcomes to hepatectomy without VR.
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Affiliation(s)
- T Sugiura
- Division of Hepato-Biliary-Pancreatic Surgery
| | - K Uesaka
- Division of Hepato-Biliary-Pancreatic Surgery
| | - Y Okamura
- Division of Hepato-Biliary-Pancreatic Surgery
| | - T Ito
- Division of Hepato-Biliary-Pancreatic Surgery
| | - Y Yamamoto
- Division of Hepato-Biliary-Pancreatic Surgery
| | - R Ashida
- Division of Hepato-Biliary-Pancreatic Surgery
| | - K Ohgi
- Division of Hepato-Biliary-Pancreatic Surgery
| | - S Otsuka
- Division of Hepato-Biliary-Pancreatic Surgery
| | - M Nakagawa
- Division of Plastic and Reconstructive Surgery
| | - T Aramaki
- Division of Diagnostic Radiology, Shizuoka Cancer Centre, Shizuoka, Japan
| | - K Asakura
- Division of Diagnostic Radiology, Shizuoka Cancer Centre, Shizuoka, Japan
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22
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Hishida T, Masai K, Kaseda K, Asakura K, Asamura H. Debulking surgery for malignant tumors: the current status, evidence and future perspectives. Jpn J Clin Oncol 2021; 51:1349-1362. [PMID: 34254145 DOI: 10.1093/jjco/hyab107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/22/2021] [Indexed: 11/14/2022] Open
Abstract
Debulking surgery, also called cytoreductive surgery, is a resection of the tumor as much as possible and an intended incomplete resection for unresectable malignant tumors. Since the most important principle in surgical oncology is complete R0 resection, debulking surgery goes against the basic principle and obscures the concept of operability. However, debulking surgery has been advocated for various types of advanced malignant tumors, including gynecological cancers, urological cancers, gastrointestinal cancers, breast cancers and other malignancies, with or without adjuvant therapy. Positive data from randomized trials have been shown in subsets of ovarian cancer, renal cell carcinoma, colorectal cancer and breast cancer. However, recent trials for renal cell carcinoma, colorectal cancer and breast cancer have tended to show controversial results, mainly according to the survival improvement of nonsurgical systemic therapy alone. On the other hand, debulking surgery still has a therapeutic role for slow-growing and borderline malignant tumors, such as pseudomyxoma peritonei and thymomas. The recent understanding of tumor heterogeneity and clonal evolution responsible for malignancy and drug resistance indicates that select patients may obtain prolonged survival by the synergistic effect of debulking surgery and novel systemic therapy. This review aimed to describe the current status and evidence of debulking surgery in a cross-organ manner and to discuss future perspectives in the current era with advances in systemic therapy.
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Affiliation(s)
| | | | | | | | - Hisao Asamura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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23
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Hong H, Hahn S, Matsuguma H, Inoue M, Shintani Y, Honda O, Izumi Y, Asakura K, Asamura H, Isaka T, Lee K, Choi YS, Kim YT, Park CM, Goo JM, Yoon SH. Pleural recurrence after transthoracic needle lung biopsy in stage I lung cancer: a systematic review and individual patient-level meta-analysis. Thorax 2021; 76:582-590. [PMID: 33723018 DOI: 10.1136/thoraxjnl-2020-216492] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 02/26/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Conflicting results exist regarding whether preoperative transthoracic biopsy increases the risk of pleural recurrence in early lung cancer. We conducted a systematic, patient-level meta-analysis to evaluate the risk of pleural recurrence in stage I lung cancer after percutaneous transthoracic lung biopsy. METHODS A systematic search of OVID-MEDLINE, Embase and the Cochrane Database of Systematic Reviews was performed through October 2018. Eligible studies were original articles on the risk of pleural recurrence in stage I lung cancer after transthoracic biopsy. We contacted the corresponding authors of eligible studies to obtain individual patient-level data. We used the Fine-Gray model for time to recurrence and lung cancer-specific survival and a Cox proportional hazards model for overall survival. RESULTS We analysed 2394 individual patient data from 6 out of 10 eligible studies. Compared with other diagnostic procedures, transthoracic biopsy was associated with a higher risk for ipsilateral pleural recurrence, which manifested solely (subdistribution HR (sHR), 2.58; 95% CI 1.15 to 5.78) and concomitantly with other metastases (sHR 1.99; 95% CI 1.14 to 3.48). In the analysis of secondary outcomes considering a significant interaction between diagnostic procedures and age groups, reductions of time to recurrence (sHR, 2.01; 95% CI 1.11 to 3.64), lung cancer-specific survival (sHR 2.53; 95% CI 1.06 to 6.05) and overall survival (HR 2.08; 95% CI 1.12 to 3.87) were observed in patients younger than 55 years, whereas such associations were not observed in other age groups. DISCUSSION Preoperative transthoracic lung biopsy was associated with increased pleural recurrence in stage I lung cancer and reduced survival in patients younger than 55 years.
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Affiliation(s)
- Hyunsook Hong
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seokyung Hahn
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Haruhisa Matsuguma
- Divisions of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan
| | - Masayoshi Inoue
- Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
| | - Osamu Honda
- Department of Radiology, Kansai Medical University, Moriguchi, Osaka, Japan
| | - Yotaro Izumi
- Department of General Thoracic Surgery, Saitama Medical University, Saitama Medical Center, Kawagoe, Saitama, Japan
| | - Keisuke Asakura
- Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Hisao Asamura
- Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Tetsuya Isaka
- Department of Respiratory Surgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Kyungjong Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Soo Choi
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soon Ho Yoon
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Suzuki T, Hishida T, C. M, Matsuda K, Nakagomi T, Omura S, Tanaka H, Masai K, Kaseda K, Asakura K, Asamura H. P26.07 Video-Assisted Thoracoscopic Surgery for Stage I Thymoma: Short-Term Outcomes and Appropriate Indications. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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25
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Suzuki S, Asakura K, Masai K, Kaseda K, Hishida T, Asamura H. Four cases of completion lobectomy for locally relapsed lung cancer after segmentectomy. World J Surg Oncol 2021; 19:47. [PMID: 33573659 PMCID: PMC7879527 DOI: 10.1186/s12957-021-02165-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/03/2021] [Indexed: 11/18/2022] Open
Abstract
Background Although completion lobectomy is the treatment of choice for local recurrence of non-small cell lung cancer after segmentectomy, few cases have been reported. We report four patients who underwent completion lobectomies for staple line recurrence after segmentectomy for stage I non-small cell lung cancer. Case presentation Three women aged 65, 82, and 81 years underwent completion lower lobectomy after superior segmentectomy of the same lobe for local recurrence of stage I non-small cell lung cancer. A 67-year-old man, who had a tumor recurrence on the staple line after apical segmentectomy with superior mediastinal nodal dissection for stage I non-small cell lung cancer, underwent completion right upper lobectomy. These four patients underwent segmentectomy because of comorbidities or advanced age. Local recurrence was confirmed by computed tomography-guided needle biopsy. The interval between the two operations was 37, 39, 41, and 16 months, respectively. Although minimal hilar adhesion was seen for the three completion lower lobectomies, tight adhesions after apical segmentectomy made completion right upper lobectomy quite difficult to dissect, which led to injury of the superior pulmonary vein. No recurrence was recorded after completion lobectomies for 62, 70, 67, and 72 months, respectively. Conclusions Although completion lobectomy is one of the most difficult modes of resection, among several completion lobectomies, completion lower lobectomy after superior segmentectomy without superior mediastinal nodal dissection was relatively easy to perform because of fewer hilar adhesions. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-021-02165-x.
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Affiliation(s)
- Shigeki Suzuki
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Kyohei Masai
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kaoru Kaseda
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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26
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Sunohara T, Imamura H, Goto M, Fukumitsu R, Matsumoto S, Fukui N, Oomura Y, Akiyama T, Fukuda T, Go K, Kajiura S, Shigeyasu M, Asakura K, Horii R, Sakai C, Sakai N. Neck Location on the Outer Convexity is a Predictor of Incomplete Occlusion in Treatment with the Pipeline Embolization Device: Clinical and Angiographic Outcomes. AJNR Am J Neuroradiol 2021; 42:119-125. [PMID: 33184073 DOI: 10.3174/ajnr.a6859] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/11/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE With the increasing use of the Pipeline Embolization Device for the treatment of aneurysms, predictors of clinical and angiographic outcomes are needed. This study aimed to identify predictors of incomplete occlusion at last angiographic follow-up. MATERIALS AND METHODS In our retrospective, single-center cohort study, 105 ICA aneurysms in 89 subjects were treated with Pipeline Embolization Devices. Patients were followed per standardized protocol. Clinical and angiographic outcomes were analyzed. We introduced a new morphologic classification based on the included angle of the parent artery against the neck location: outer convexity type (included angle, <160°), inner convexity type (included angle, >200°), and lateral wall type (160° ≤ included angle ≤200°). This classification reflects the metal coverage rate and flow dynamics. RESULTS Imaging data were acquired in 95.3% of aneurysms persistent at 6 months. Complete occlusion was achieved in 70.5%, and incomplete occlusion, in 29.5% at last follow-up. Multivariable regression analysis revealed that 60 years of age or older (OR, 5.70; P = .001), aneurysms with the branching artery from the dome (OR, 10.56; P = .002), fusiform aneurysms (OR, 10.2; P = .009), and outer convexity-type saccular aneurysms (versus inner convexity type: OR, 30.3; P < .001; versus lateral wall type: OR, 9.71; P = .001) were independently associated with a higher rate of incomplete occlusion at the last follow-up. No permanent neurologic deficits or rupture were observed in the follow-up period. CONCLUSIONS The aneurysm neck located on the outer convexity is a new, incomplete occlusion predictor, joining older age, fusiform aneurysms, and aneurysms with the branching artery from the dome. No permanent neurologic deficits or rupture was observed in the follow-up, even with incomplete occlusion.
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Affiliation(s)
- T Sunohara
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
| | - H Imamura
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - M Goto
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - R Fukumitsu
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - S Matsumoto
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Fukui
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Y Oomura
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - T Akiyama
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - T Fukuda
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Go
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - S Kajiura
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - M Shigeyasu
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Asakura
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - R Horii
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - C Sakai
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Sakai
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
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Kato A, Minami Y, Asakura K, Katamine M, Katsura A, Muramatsu Y, Sato T, Kakizaki R, Hashimoto T, Meguro K, Shimohama T, Ako J. Plaque erosion is associated with less systemic atherosclerosis than other plaque types of acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previous studies have demonstrated that plaque erosion is associated with less atheromatous plaque at both culprit and non-culprit lesion than other plaque types of acute coronary syndrome (ACS). However, the status of systemic atherosclerosis in patients with plaque erosion remains to be elucidated.
Purpose
To clarify if plaque erosion is associated with less systemic atherosclerosis than other plaque types of ACS.
Methods
A total of 239 consecutive patients with ACS who underwent optical coherence tomography (OCT) imaging of the culprit lesion were enrolled. Patients were classified into either plaque erosion (PE, n=45) or non-plaque erosion (non-PE, n=194) including plaque rupture and calcified nodule based on OCT findings of the culprit lesions. The status of systemic atherosclerosis was assessed by the findings of carotid echography, the severity of aortic arch calcification (AAC; grade 0–3) on chest X-ray, brachial-ankle pulse wave velocity (baPWV) and ankle-brachial pressure index (ABPI).
Results
The maximum intima media thickness (IMT) was significantly thinner in the PE group than in the non-PE group (1.9±0.8 vs. 2.3±0.9 mm, p=0.023) (Panel A). The prevalence of heterogeneous plaque and calcified plaque was significantly lower in the PE group than in the non-PE group (25.0 vs. 50.4%, p=0.010, 18.8 vs. 38.5%, p=0.037, respectively). The prevalence of AAC grade was significantly different between the two groups with a tendency toward lower AAC grade in the PE group than the non-PE group (Panel B). The mean baPWV (1588.1±420.6 vs. 1686.5±363.5 cm/sec, p=0.186) and ABPI (1.1±0.1 vs. 1.1±0.1, p=0.270) was comparable between the two groups.
Conclusion
Plaque erosion was associated with less atherosclerosis in carotid artery and aortic arch than non-plaque erosion. These findings may help further clarify the distinct pathophysiology of plaque erosion.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Kato
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Minami
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Asakura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - M Katamine
- Kitasato University School of Medicine, Sagamihara, Japan
| | - A Katsura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Muramatsu
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Sato
- Kitasato University School of Medicine, Sagamihara, Japan
| | - R Kakizaki
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Hashimoto
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Shimohama
- Kitasato University School of Medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Sagamihara, Japan
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Hashimoto T, Minami Y, Asakura K, Katamine M, Kato A, Katsura A, Muramatsu Y, Sato T, Kameda R, Meguro K, Shimohama T, Ako J. Lower levels of low-density lipoprotein cholesterol are associated with lower prevalence of thin-cap fibroatheroma in statin-treated patients with coronary artery disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lowering low-density lipoprotein cholesterol (LDL-C) with statins slows progression of atherosclerotic plaques and reduces cardiovascular events. The 2019 European Society of Cardiology guideline for the management of dyslipidaemias recommends the absolute LDL-C treatment target as <55mg/dL for very high-risk patients, <70 mg/dL for high-risk patients and <100 mg/dL for moderate-risk patients. However, the difference in plaque composition of coronary lesions according to these LDL-C levels remains to be elucidated.
Purpose
To investigate plaque morphologies according to LDL-C levels in statin-treated patients with coronary artery disease (CAD).
Methods
A total of 685 consecutive statin-treated patients with CAD, who underwent optical coherence tomography (OCT) imaging of culprit lesions were enrolled. The prevalence of vulnerable compositions in culprit plaques evaluated by OCT was compared among the groups of patients classified by LDL-C levels (<55, 55–70, 70–100, ≥100 mg/dL).
Results
LDL-C levels <55 mg/dL, <70 mg/dL and <100 mg/dL were observed in 6.3%, 21.8% and 63.9% of patients, respectively. The prevalence of thin-cap fibroatheroma was significantly different among the groups (P=0.014, Figure) with a trend toward lower prevalence in the lower two LDL-C groups than in the higher two LDL-C groups. A gradient with lower prevalence of thrombus in lower LDL-C groups was observed, although the statistical significance was not demonstrated (Figure). There was no significant difference in the prevalence of macrophage or cholesterol crystal among the groups.
Conclusions
Lower LDL-C level was associated with a trend toward lower prevalence of thin-cap fibroatheroma and thrombus in statin-treated patients with CAD.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Hashimoto
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - Y Minami
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - K Asakura
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - M Katamine
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - A Kato
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - A Katsura
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - Y Muramatsu
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - T Sato
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - R Kameda
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - T Shimohama
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
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Katamine M, Minami Y, Asakura K, Kato A, Katsura A, Sato T, Muramatsu Y, Hashimoto T, Kameda R, Meguro K, Shimohama T, Ako J. Higher level of high sensitivity C-reactive protein is associated with more fibrocalcific plaque and longer lesion in patients with acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The association between the level of high sensitivity C-reactive protein (hsCRP) and coronary plaque characteristics in patients with acute coronary syndrome (ACS) remains to be elucidated.
Purpose
To clarify the morphological characteristics of culprit lesion in patients with ACS according to the hsCRP levels using optical coherence tomography (OCT).
Methods
A total of 215 consecutive patients with ACS, who underwent OCT imaging of culprit lesions were included. The patients were classified into either the higher hsCRP group (hsCRP ≥0.14 mg/dL, n=108) or the lower hsCRP group (hsCRP <0.14 mg/dL, n=107) according to the median preprocedural hsCRP level. The morphological characteristics of culprit lesion assessed by OCT were compared between the two groups.
Results
The higher hsCRP group had higher prevalence of insulin therapy (14 vs. 6%, p=0.037) and current smoker than the lower hsCRP group (37 vs. 18%, p=0.002). The prevalence of long lesion (≥25 mm, 67 vs. 53%, p=0.041) and fibrocalcific plaque (53 vs. 33%, p=0.003) was significantly higher in the higher hsCRP group than in the lower hsCRP group (Figure). On the other hand, the prevalence of plaque rupture (36 vs. 46%, p=0.174) and lipid-rich plaque (47 vs. 64%, p=0.011) was rather lower in the higher hsCRP group than in the lower hsCRP group (Figure). In a multivariate analysis, fibrocalcific plaque (odds ratio [OR]: 2.098, 95% confidence interval [CI]: 1.125–3.913, p=0.019), lesion length (mm, OR: 1.036, 95% CI: 1.010–1.061, p=0.004) and current smoker (OR: 2.757, 95% CI: 1.388–5.476, p=0.003) was independently associated with higher hsCRP level.
Conclusions
ACS patients with high hsCRP levels had more fibrocalcific plaque and longer lesion than those with low hsCRP levels. The association between high hsCRP levels and vulnerable characteristics of culprit plaque was not demonstrated.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Katamine
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Minami
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Asakura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - A Kato
- Kitasato University School of Medicine, Sagamihara, Japan
| | - A Katsura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Sato
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Muramatsu
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Hashimoto
- Kitasato University School of Medicine, Sagamihara, Japan
| | - R Kameda
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Shimohama
- Kitasato University School of Medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Sagamihara, Japan
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Mauriello F, Ariga-Miwa H, Paone E, Pietropaolo R, Takakusagi S, Asakura K. Transfer hydrogenolysis of aromatic ethers promoted by the bimetallic Pd/Co catalyst. Catal Today 2020. [DOI: 10.1016/j.cattod.2019.06.071] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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31
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Takada N, Asakura K, Sugiyama S. Developing and validating the Japanese version of professional attitude scale for nurses. Int Nurs Rev 2020; 68:24-33. [PMID: 33047308 PMCID: PMC8247416 DOI: 10.1111/inr.12627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 11/28/2022]
Abstract
Aim We developed and psychometrically tested the Japanese version of the Professional Attitude Scale for Nurses (PASN‐J). Background Nurses must recognize the importance of their professionalism; therefore, it is critical to quantitatively measure nurses’ professional attitudes. Introduction This instrument validation study was designed to generate an itemized scale and examine its content validity/psychometric testing using a sample of Japanese nurses. Methods Based on a trait approach focusing on the characteristic traits of the nursing profession, a 59‐item draft scale was generated. During November 2017, 2657 nurses from 29 facilities in Japan were surveyed. The questionnaire included demographics, the 59‐item draft scale, and a self‐report scale of nurses’ professional behaviour and nursing practice ability. Using exploratory and confirmatory factor analyses, we evaluated the construct, criterion‐related, concurrent, and known‐groups validity, and reliability of the PASN‐J. Results Data from 1716 participants were analysed. The analyses yielded a 38‐item, 3‐factor scale that adequately fit the data. PASN‐J scores were positively correlated with nurses’ professional behaviour and nursing practice ability. Conclusion The 38‐item PASN‐J has good reliability and validity, making it useful for measuring the current condition of nursing professionalism and evaluating nursing education. Implications for Nursing and Health Policy: This scale can evaluate nursing education and promote nurses’ professionalism. The PASN‐J will help identifying the elements of undergraduate nursing education that require further emphasis. Additionally, the PASN‐J could facilitate the development of nursing policies to promote professional development in nurses. Ultimately, evaluating nursing education with the PASN‐J enhances nurses’ professional attitudes and subsequently improves their quality of nursing, nursing efficiency and patient outcomes.
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Affiliation(s)
- N Takada
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - K Asakura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - S Sugiyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Uchida S, Yoshida Y, Ohe Y, Nakayama Y, Motoi N, Kobayashi A, Asakura K, Nakagawa K, Watanabe SI. Trimodality therapy for superior sulcus tumour: experience of a single institution over 19 years. Eur J Cardiothorac Surg 2020; 56:167-173. [PMID: 30689794 DOI: 10.1093/ejcts/ezy480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/11/2018] [Accepted: 12/17/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Induction chemoradiotherapy followed by surgery is the standard treatment for superior sulcus tumours (SSTs). However, the protocols, chemotherapy agents and cycles used as well as the mode and intensity of radiotherapy vary between institutions. Thus, the objective of the study was to investigate the effects of trimodality therapy on the outcomes of patients with SSTs. METHODS Sixty patients with SSTs were enrolled between January 1999 and December 2017. Induction therapy consisted primarily of 2 cycles of mitomycin-vindesine-cisplatin or cisplatin-vinorelbine delivered concurrently to the tumour with 40-45 Gy of radiation. Surgery was performed 2-6 weeks after completion of induction therapy. RESULTS Fifty-four (90%) patients underwent radical surgical resection. Complete pathological resection was achieved in 44 patients (81%). There was no 30-day mortality. After a median follow-up of 57.0 months, 19 (35%) patients experienced recurrence, and 8 (15%) patients showed brain metastasis. A pathological complete response (PCR) was observed in 12 (22%) patients. The 5-year survival rate for the entire population (n = 54) was 69% (95% confidence interval 55-81%). The survival rate was better for patients who underwent complete resection than for those who underwent incomplete resection (73% vs 51%, P = 0.46). A better survival rate was evident in patients with PCR than in those without PCR (92% vs 62%, P = 0.12). CONCLUSIONS Trimodality therapy for SSTs was efficacious and associated with favourable outcomes, with acceptable morbidity and mortality. PCR in patients with resected SSTs reveals promising long-term survival prospects with the trimodality therapy.
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Affiliation(s)
- Shinsuke Uchida
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Noriko Motoi
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Aki Kobayashi
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Keisuke Asakura
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
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33
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Kaseda K, Hishida T, Masai K, Asakura K, Hayashi Y, Asamura H. Clinicopathological and prognostic features of operable non-small cell lung cancer patients with diabetes mellitus. J Surg Oncol 2020; 123:332-341. [PMID: 33002203 DOI: 10.1002/jso.26243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/17/2020] [Accepted: 09/19/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to investigate the clinicopathological and prognostic features of operable non-small cell lung cancer (NSCLC) patients with diabetes mellitus (DM). METHODS A total of 1231 surgically resected NSCLC patients were retrospectively reviewed. Clinicopathological characteristics were compared between patients with DM (DM group, n = 139) and those without DM (non-DM group, n = 1092). The clinical factors associated with postoperative complications and prognostic factors were identified. RESULTS The DM group had distinct clinicopathological features. No significant differences in histological invasiveness or stage were found. The presence and control status of DM were independent predictors of postoperative complications. No significant differences in recurrence-free survival or cancer-specific survival were observed; however, the DM group had worse overall survival (OS). The DM group had a higher number of deaths from other diseases than the non-DM group, and these patients had significantly higher postoperative hemoglobin A1c levels than patients with cancer-related death. CONCLUSION The presence and control status of preoperative DM are useful predictors of both postoperative complications and OS in operable NSCLC patients. Concomitant diabetes-related complications have a negative effect on long-term survival in diabetic NSCLC patients, and long-term glycemic control is important to prolong OS.
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Affiliation(s)
- Kaoru Kaseda
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kyohei Masai
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | - Hisao Asamura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
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Yotsukura M, Asamura H, Suzuki S, Asakura K, Yoshida Y, Nakagawa K, Sakurai H, Watanabe SI, Motoi N. Histological and prognostic data on surgically resected early-stage lung adenocarcinoma. Data Brief 2020; 31:105785. [PMID: 32551350 PMCID: PMC7287229 DOI: 10.1016/j.dib.2020.105785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 11/03/2022] Open
Abstract
This article presents supplementary data for the research article by Yotsukura et al. entitled "Prognostic impact of cancer-associated active fibroblasts and invasive architectural patterns on early-stage lung adenocarcinoma" [1], which presented the postoperative prognosis for early-stage lung adenocarcinoma categorized according to histological findings. We included data of 1,032 resected cases of lung adenocarcinoma, which consisted of pathological stage IA invasive cancer and adenocarcinoma in situ resected at National Cancer Center Hospital, Tokyo, Japan, between 2007 and 2012. A pathological review was performed to assess total tumor size, size of invasion, histological subtype, lymphovascular invasion, and presence of cancer-associated active fibroblast (CAF). Tumor recurrence and overall survival were retrospectively recorded. Of the included cases, 166 (16.1%), and 866 (83.9%) were adenocarcinoma in situ and pathological stage IA, respectively. Pathological stage IA adenocarcinoma was further classified based on the histologial subtype and the presence of CAF. This data set may be useful for analyzing the postoperative prognosis of early-stage lung adenocarcinoma, in combination with detailed pathological findings including size of invasion, histological subtype, and presence of CAF.
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Affiliation(s)
- Masaya Yotsukura
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.,Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.,Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shigeki Suzuki
- Department of Thoracic Surgery, Sagamihara Kyodo Hospital, 2-8-18, Hashimoto, Midori-ku, Sagamihara, Kanagawa Prefecture 252-5188, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Hiroyuki Sakurai
- Division of Respiratory Surgery, Nihon University School of Medicine, 30-1 Oyaguchikamimachi, Itabashi-ku, Tokyo 173-8610, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Noriko Motoi
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.,Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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Yotsukura M, Asamura H, Suzuki S, Asakura K, Yoshida Y, Nakagawa K, Sakurai H, Watanabe SI, Motoi N. Prognostic impact of cancer-associated active fibroblasts and invasive architectural patterns on early-stage lung adenocarcinoma. Lung Cancer 2020; 145:158-166. [PMID: 32450494 DOI: 10.1016/j.lungcan.2020.04.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Invasion is a crucial indicator of the prognosis in lung adenocarcinoma. The 2015 WHO classification of lung tumors defined invasion of adenocarcinoma mainly by the presence of non-lepidic histological subtypes including papillary, acinar, micropapillary and solid patterns, and the presence of cancer-associated active fibroblasts (CAF). In this study, we focused specifically on early-stage lepidic adenocarcinoma with CAF to evaluate its prognostic significance. METHODS We included 1032 resected cases of lung adenocarcinoma, which consisted of pathological stage IA invasive cancer and adenocarcinoma in situ (AIS). Invasive adenocarcinoma was classified into two subgroups according to the type of invasion, INV-1 and INV-2. We defined INV-1 as adenocarcinoma of a non-lepidic histological subtype with or without CAF, and INV-2 as lepidic adenocarcinoma with CAF. The clinicopathological characteristics and prognosis were retrospectively analyzed. RESULTS Included cases were classified into 696 (67.4 %) INV-1, 170 (16.5 %) INV-2, and 166 (16.1 %) AIS. The estimated 5-year recurrence-free probabilities of INV-1, INV-2, and AIS were 92.9 %, 100 %, and 100 %, respectively (p < 0.001). Although there were significant differences between INV-1 and INV-2 in terms of gender (more males in INV-1, p = 0.039), smoking habit (more smokers in INV-1, p = 0.046), and lymphovascular invasion (more invasion in INV-1, p < 0.001), there was no difference between AIS and INV-2. CONCLUSION The presence of CAF is not always associated with a worse prognosis, and therefore it does not seem appropriate to include the presence of CAF alone in diagnostic criteria for invasion in early-stage lung adenocarcinoma.
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Affiliation(s)
- Masaya Yotsukura
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shigeki Suzuki
- Department of Thoracic Surgery, Sagamihara Kyodo Hospital, 2-8-18, Hashimoto, Midori-ku, Sagamihara, Kanagawa Prefecture 252-5188, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Hiroyuki Sakurai
- Division of Respiratory Surgery, Nihon University School of Medicine, 30-1, Oyaguchikamimachi, Itabashi-ku, Tokyo 173-8610, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Noriko Motoi
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
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Kobayashi AK, Horinouchi H, Nakayama Y, Ohe Y, Yotsukura M, Uchida S, Asakura K, Yoshida Y, Nakagawa K, Watanabe SI. Salvage surgery after chemotherapy and/or radiotherapy including SBRT and proton therapy: A consecutive analysis of 38 patients. Lung Cancer 2020; 145:105-110. [PMID: 32422344 DOI: 10.1016/j.lungcan.2020.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/02/2020] [Accepted: 04/14/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Local recurrence after definitive chemoradiation therapy, chemotherapy or radiotherapy with curative intent is often seen in patients with advanced non-small cell lung cancer. We evaluated the feasibility of salvage pulmonary resection after definitive non-surgical treatments and the postoperative morbidity and mortality rates. METHODS We retrospectively analyzed the characteristics and medical courses of patients who had undergone salvage pulmonary resections after local relapse or progression between January 2000 and March 2018 at the National Cancer Centre Hospital, Tokyo, Japan. All the candidates were evaluated, and curability by surgical resection was assessed by a multidisciplinary tumor board. RESULTS A total of 38 patient received salvage surgery: 26 of the patients were men, and the median age was 64.5 years (range, 20-78 years). Among these 38 patients, salvage lung resection was performed after chemoradiotherapy in 23 patients, after chemotherapy in 9 patients, and after radiotherapy with curative intent in 6 patients. The surgical resection methods were as follows: 26 lobectomies (2 bilobectomy, 15 right upper, 5 right lower, 1 right middle, 2 left lower and 1 left upper), 8 pneumonectomies (5 left and 3 right), and 4 segmentectomies. A complete resection (R0 resection) was achieved in 35 cases (92.1 %). Postoperative complications were observed in 3 patients (prolonged air leakage, bronchopleural fistula and surgical site infection in 1 patient each). No postoperative deaths occurred within 30 days after surgery. CONCLUSION Along with better outcomes after definitive chemoradiotherapy, chemotherapy, and radiotherapy, the frequency of salvage surgery has been increasing in recent years. Salvage pulmonary resections after definitive non-surgical treatments with curative intent are feasible with an acceptable morbidity rate and oncological outcomes in thoroughly assessed patients.
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Affiliation(s)
- Aki K Kobayashi
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Hidehito Horinouchi
- Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Yuko Nakayama
- Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masaya Yotsukura
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shinsuke Uchida
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Keisuke Asakura
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Asakura K, Kadota T, Matsuzaki J, Yoshida Y, Yamamoto Y, Nakagawa K, Takizawa S, Aoki Y, Nakamura E, Miura J, Sakamoto H, Kato K, Watanabe SI, Ochiya T. A miRNA-based diagnostic model predicts resectable lung cancer in humans with high accuracy. Commun Biol 2020; 3:134. [PMID: 32193503 PMCID: PMC7081195 DOI: 10.1038/s42003-020-0863-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 02/19/2020] [Indexed: 01/17/2023] Open
Abstract
Lung cancer, the leading cause of cancer death worldwide, is most frequently detected through imaging tests. In this study, we investigated serum microRNAs (miRNAs) as a possible early screening tool for resectable lung cancer. First, we used serum samples from participants with and without lung cancer to comprehensively create 2588 miRNAs profiles; next, we established a diagnostic model based on the combined expression levels of two miRNAs (miR-1268b and miR-6075) in the discovery set (208 lung cancer patients and 208 non-cancer participants). The model displayed a sensitivity of 99% and specificity of 99% in the validation set (1358 patients and 1970 non-cancer participants) and exhibited high sensitivity regardless of histological type and pathological TNM stage of the cancer. Moreover, the diagnostic index markedly decreased after lung cancer resection. Thus, the model we developed has the potential to markedly improve screening for resectable lung cancer. Asakura, Kadota et al. demonstrate the diagnostic potential of serum microRNAs for resectable lung cancer. Their diagnostic model based on the combined expression levels of two miRNAs predicts resectable lung cancer with 99% sensitivity, regardless of histological types and pathological stages of cancer, suggesting its promising, diagnostic utility.
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Affiliation(s)
- Keisuke Asakura
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tsukasa Kadota
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Juntaro Matsuzaki
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yusuke Yamamoto
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Satoko Takizawa
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Toray Industries, Inc. 6-10-1 Tebiro, Kamakura city, Kanagawa, 248-0036, Japan
| | - Yoshiaki Aoki
- Dynacom Co., Ltd., World Business Garden E25, 2-6-1 Nakase, Mihama-ku, Chiba city, Chiba, 261-7125, Japan
| | - Eiji Nakamura
- Dynacom Co., Ltd., World Business Garden E25, 2-6-1 Nakase, Mihama-ku, Chiba city, Chiba, 261-7125, Japan
| | - Junichiro Miura
- Dynacom Co., Ltd., World Business Garden E25, 2-6-1 Nakase, Mihama-ku, Chiba city, Chiba, 261-7125, Japan
| | - Hiromi Sakamoto
- Department of Biobank and Tissue Resources, National Cancer Center Research Institute, Tokyo, 104-0045, Japan
| | - Ken Kato
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takahiro Ochiya
- Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. .,Institute of Medical Science, Tokyo Medical University, Tokyo, 160-0023, Japan.
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Makino H, Tanaka A, Asakura K, Koezuka R, Tochiya M, Ohata Y, Tamanaha T, Son C, Shimabara Y, Fujita T, Miyamoto Y, Kobayashi J, Hosoda K. Addition of low-dose liraglutide to insulin therapy is useful for glycaemic control during the peri-operative period: effect of glucagon-like peptide-1 receptor agonist therapy on glycaemic control in patients undergoing cardiac surgery (GLOLIA study). Diabet Med 2019; 36:1621-1628. [PMID: 31335979 DOI: 10.1111/dme.14084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2019] [Indexed: 01/20/2023]
Abstract
AIM To test the hypothesis that the addition of a glucagon-like peptide-1 receptor agonist that can decrease glucose levels without increasing the hypoglycaemia risk will achieve appropriate glycaemic control during the peri-operative period. METHODS We studied 70 people with Type 2 diabetes who underwent elective cardiac surgery. Participants were randomized to either an insulin-alone or an insulin plus liraglutide 0.6 mg/day group. We evaluated average M values, which indicated the proximity index of the target glucose level from day 1 to day 10. RESULTS The average M value in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (liraglutide plus insulin 5.8 vs insulin-alone 12.3; P < 0.001). The frequency of insulin dose modification in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (odds ratio 0.19, 95% CI 0.08-0.49; P < 0.001). The frequency of hypoglycaemia in the liraglutide plus insulin group tended to be lower than that in the insulin-alone group (odds ratio 0.57, 95% CI 0.15-2.23; P = 0.21). CONCLUSIONS The results of this study showed that the addition of low-dose liraglutide to insulin achieved lower M values than insulin alone, suggesting that the addition of low-dose liraglutide may achieve better glycaemic control during the peri-operative period. (Clinical trials registry no.: UMIN 000008003).
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Affiliation(s)
- H Makino
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - A Tanaka
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - K Asakura
- Department of, Data Science, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - R Koezuka
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - M Tochiya
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Ohata
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - T Tamanaha
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - C Son
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Shimabara
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - T Fujita
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Miyamoto
- Department of, Preventive Cardiology, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - J Kobayashi
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - K Hosoda
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
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Masai K, Kaseda K, Asakura K, Hishida T, Asamura H. WS05.03 How to Perform a Proper Systematic Nodal Dissection in Lung Cancer Surgery. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Migita S, Simodai-Yamada S, Asakura K, Mukaiyama T, Okumura Y, Hao H. P2805Initial pathological responses of third-generation everolimus-eluting stents implantation: comparison with second-generation everolimus-eluting stents. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Third-generation drug-eluting stent (3rd DES) is commonly used now in percutaneous coronary intervention, and it has not only thinner struts, easier delivery than second-generation drug-eluting stent (2nd DES), but also abluminal biodegradable polymer. Clinical superiority of 3rd DES has been demonstrated compared to 1st and 2nd DESs. However, pathological response after 3rd DES implantation remains unclear.
Purpose
Pathological study of coronary artery after 3rd DES implantation have not been reported as far as we have referred to the previous studies. This study aimed to examine the initial tissue response after 3rd DES and 2nd DES implantation within one year.
Methods
Using specimens obtained by autopsy, we compared the histology between 3rd DES (n=3, 8 histological sections) and 2nd DES (n=6, 41 histological sections) lesions within 1 year after stent implantation to evaluate early tissue reaction. Stent segments were fixed with 10% buffered formalin and embedded in plastic, followed by hematoxylin–eosin, Masson's trichrome and elastica van Gieson. Ratio of covered stent struts by neointima was calculated. The thickness of neointima and the area of fibrin deposition were morphometrically evaluated. The degree of inflammation around struts was examined semi-quantitatively (score 0–3).
Results
The ratio of covered struts and thickness of neointima of 3rd DES were 0.84±0.04 and 68.2±10.3μm, while those of 2nd DES were 0.69±0.05 and 30.4±4.8μm respectively. The inflammation score was similar between two groups (1.00±0.14 vs. 1.02±0.16). The area of fibrin deposition around the struts was larger in 3rd DES compared with 2nd DES (1276.6±490.3μm2 vs. 658.0±173.4μm2). These results suggest that the 3rd DES may obtain prompt as well as rich covering of struts in the initial term after DES implantation. Although the biological feature of the polymers in 3rd and 2nd DESs is different, the inflammatory responses after both 3rd and 2nd DESs implantation were similar, at least within one year after deployment. The degree of inflammation was mild, less than approximately 50 inflammatory cells (score 1) around the struts.
Conclusions
Our pathological analysis showed advanced healing process in 3rd DES compared with 2nd DES lesions in the viewpoint of strut coverage by neointima. Observation of long-term pathological response may be required to evaluate the superiority of bioabsorbable polymer in 3rd DES.
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Affiliation(s)
- S Migita
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
| | - S Simodai-Yamada
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
| | - K Asakura
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
| | - T Mukaiyama
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
| | - Y Okumura
- Nihon University, Division of Cardiology, Department of Medicine, Tokyo, Japan
| | - H Hao
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
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Matsuda K, Kaseda K, Masai K, Asakura K, Hishida T, Asamura H. EP1.18-16 Surgery for Locally Advanced Lung Cancer Invading the Spine After Chemoradiotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Asakura K, Kadota T, Matsuzaki J, Yoshida Y, Nakagawa K, Asamura H, Watanabe S, Ochiya T. P1.11-10 Serum MicroRNA Biomarkers for Screening of Resectable Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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43
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Asakura K, Yoshida Y, Sakurai H, Nakagawa K, Motoi N, Watanabe SI. Prognostic Impact of Tumor Doubling Time in Patients with Metachronous Lung Cancer. World J Surg 2019; 43:3259-3266. [PMID: 31506713 DOI: 10.1007/s00268-019-05162-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Good prognosis following surgery for metachronous lung cancer has been reported. However, prognostic factors have not been fully investigated. The purpose of this study was to identify the preoperative predictor of survival in metachronous lung cancer. METHODS Patients who underwent a second pulmonary resection for metachronous lung cancer at our institution between 2000 and 2014 were analyzed. RESULTS A retrospective chart review identified 86 eligible patients (of 6213; 1.4%). The 5-year overall survival was 77%. All 86 cancers met Martini and Melamed's criteria for second primary cancer. However, on pathological examination based on morphological concordance between the initial and metachronous cancer, 73 (85%) cases were diagnosed as second primary cancer and 13 (15%) as a possible recurrent tumor. The 5-year overall survivals were 82% for second primary cancers and 52% for possible recurrent tumors. Tumor doubling time > 180 days (p < 0.001), pathological diagnosis of second primary cancer (p = 0.013), pathological stage IA (p = 0.016), interval between resections > 2 years (p = 0.040), and consolidation/tumor diameter ratio ≤ 0.5 (p = 0.045) were associated with superior overall survival. Multivariate Cox regression analysis identified tumor doubling time > 180 days as the only independent predictor of overall survival (hazard ratio 3.600, 95% confidence interval 1.226-10.338; p = 0.0196). CONCLUSIONS Surgical resection for metachronous lung cancer is effective and feasible. Particularly, a tumor doubling time > 180 days is associated with superior survival in patients with metachronous lung cancer.
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Affiliation(s)
- Keisuke Asakura
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. .,Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroyuki Sakurai
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Division of Respiratory Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Noriko Motoi
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Abstract
Intravenous immunoglobulin (IVIG) is widely used for treatment of autoimmune neurological disorders and is currently in clinical trials as a therapy for multiple sclerosis. We have previously demonstrated that certain mouse monoclonal antibodies of the IgM isotype, promote significant remyelination when administered to mice with chronic Theiler's murine encephalomyelitis virus-induced demyelinating disease. These IgM antibodies bind to antigens expressed on oligodendrocytes. We now demonstrate that polyclonal human IgG (IVIG) and polyclonal human IgM also promote remyelination in this system. Although both polyclonal human IgG and IgM promote remyelination, IgM is more potent Polyclonal human IgM also differs from human IgG in its ability to bind strongly to antigens expressed in the CNS and by oligodendrocytes. We propose that polyclonal IgG and polyclonal IgM may function to promote remyelination by different mechanisms. IVIG may function based on its immunomodulatory activity, while the activity of IgM is critically dependent upon its reactivity with CNS antigens. This possibility has clear relevance to the use of antibodies as a therapy for multiple sclerosis, suggesting that combined treatment with antibodies exerting immunomodulatory activity, in concert with antibodies that function through direct binding to CNS antigens, may synergize to enhance the efficacy of the therapy.
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Affiliation(s)
- A Bieber
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
- Department of Immunology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
| | - K Asakura
- Department of Neurology, Nagoya University, School of Medicine, Nagoya, Japan
| | - A Warrington
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
- Department of Immunology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
| | - SV Kaveri
- Institut National de la Santé et de la Recherche Medicate (INSERM) U430, Paris, France
| | - M Rodriguez
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
- Department of Immunology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
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Kaseda K, Asakura K, Kazama A, Ozawa Y. Correction to: Prognostic significance of preoperative plasma D-dimer level in patients with surgically resected clinical stage I non-small cell lung cancer: a retrospective cohort study. J Cardiothorac Surg 2019; 14:114. [PMID: 31221171 PMCID: PMC6587265 DOI: 10.1186/s13019-019-0935-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
- Kaoru Kaseda
- Department of Thoracic Surgery, Sagamihara Kyodo Hospital, 2-8-18 Hashimoto, Midori-ku, Sagamihara, Kanagawa, 252-5188, Japan.
| | - Keisuke Asakura
- Department of Thoracic Surgery, Sagamihara Kyodo Hospital, 2-8-18 Hashimoto, Midori-ku, Sagamihara, Kanagawa, 252-5188, Japan
| | - Akio Kazama
- Department of Pathology, Sagamihara Kyodo Hospital, 2-8-18 Hashimoto, Midori-ku, Sagamihara, Kanagawa, 252-5188, Japan
| | - Yukihiko Ozawa
- Yuai Clinic, 1-6-2 Kitashinyokohama, Kohoku-Ku, Yokohama, Kanagawa, 223-0059, Japan
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Asakura K. Predictor of cardiopulmonary complication after pulmonary resection. J Thorac Dis 2019; 11:S404-S407. [PMID: 30997232 DOI: 10.21037/jtd.2018.11.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Suzuki M, Hishida T, Asakura K, Asamura H. WT1 peptide-based immunotherapy for refractory thymic epithelial malignancies. Mediastinum 2019; 3:12. [PMID: 35118240 PMCID: PMC8794358 DOI: 10.21037/med.2019.04.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 04/08/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Mikito Suzuki
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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48
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Uchida S, Watanabe SI, Yoshida Y, Kobayashi A, Asakura K, Nakagawa K. Aberrant mediastinal trunk of pulmonary artery. J Surg Case Rep 2019; 2019:rjy359. [PMID: 30697409 PMCID: PMC6344918 DOI: 10.1093/jscr/rjy359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/16/2018] [Accepted: 12/22/2018] [Indexed: 11/24/2022] Open
Abstract
Anatomic variations of the pulmonary artery (PA) cause vascular injuries and result in critical mistakes. Here we report the first case of lung cancer with a fissureless left upper lobectomy, an aberrant mediastinal trunk of the lingular and basal segments of the PA. A 65-year-old man was referred to our hospital with a solid mass on the left upper lobe. A fissureless left upper lobectomy was performed due to severe incomplete lobulation. Intraoperative findings showed an extremely rare anatomic variation (left A5+A8+A9b) that arose as a common trunk from the left main PA. To prevent intraoperative injury, it is essential to consider the unexpected mediastinal inferior branch and perform a surgical procedure such as fissureless lobectomy upon encountering incomplete lobulation.
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Affiliation(s)
- Shinsuke Uchida
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Aki Kobayashi
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Keisuke Asakura
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
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Wakui M, Kawai K, Mizushima T, Nishime C, Serizawa A, Suemizu H, Asakura K, Yamauchi Y, Hayashida T, Suematsu M, Murata M. Fatty Acid β-Oxidation-dependent and -independent Responses and Tumor Aggressiveness Acquired Under Mild Hypoxia. Anticancer Res 2018; 39:191-200. [PMID: 30591458 DOI: 10.21873/anticanres.13097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The present study assessed whether and how tumor cells undergoing hypoxia contribute to disease progression after moving to areas with different oxygen conditions. MATERIALS AND METHODS Human colorectal carcinoma HCT116 cells cultured under mild hypoxia were subjected to in vivo experiments using transfer to immunodeficient murine recipients and to in vitro experiments using pharmacological inhibition of fatty acid β-oxidation (FAO). RESULTS Bone involvement and hepatic metastases were accelerated in transfer models of hypoxically cultured HCT116 cells. Hypoxic HCT116 cells exhibited FAO-dependent glycogen synthesis. FAO-dependent and -independent induction of gene expression also occurred under hypoxia. The distribution of glucose transporter 1 expression compared with heme oxygenase 1 expression in HCT116 cell spheroids seemed consistent with differential dependence of hypoxic expression of these molecules on FAO. CONCLUSION These results provide insights into the contribution of hypoxia to tumor progression and the relevance of FAO.
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Affiliation(s)
- Masatoshi Wakui
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Kawai
- Central Institute for Experimental Animals, Kawasaki, Japan
| | | | | | - Akihiko Serizawa
- Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Japan
| | | | - Keisuke Asakura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshikane Yamauchi
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Tetsu Hayashida
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Suematsu
- Department of Biochemistry, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuru Murata
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
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Uchida S, Yoshida Y, Asakura K, Nakagawa K, Watanabe S. P3.01-102 Potential Predictors of Unexpected Readmission After Lung Resection. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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