研究者詳細 - 小倉　淳司

Antitumor Effects of Deep Ultraviolet Irradiation for Pancreatic Cancer 国際誌

Yamazaki, K; Kokuryo, T; Yamaguchi, J; Sunagawa, M; Ogura, A; Watanabe, N; Onoe, S; Miyata, K; Mizuno, T; Uehara, K; Igami, T; Yokoyama, Y; Ebata, T; Nagino, M

ANTICANCER RESEARCH 43 巻 ( 2 ) 頁： 621 - 630 2023年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Anticancer Research

Background/Aim: Deep ultraviolet (DUV) light spans within the 250 nm to 350 nm invisible wavelength range. Although it strongly damages various cells, the efficacy of DUV irradiation on pancreatic cancer cells has never been clarified. The purpose of this study was to reveal the antitumor effects of DUV irradiation on pancreatic cancer cells. Materials and Methods: Human pancreatic cancer cell lines were eradicated with DUV or ultraviolet A (UVA) for 5 s. Several angiogenesis-related proteins were studied in cancer cells after DUV irradiation using a protein antibody array. A subcutaneous xenograft model was established by inoculation of pancreatic cancer cells into mice. Tumors in this model were irradiated with DUV or UVA once or twice for two weeks. Tumor volumes in these groups (DUV×1: one irradiation, DUV×2: two irradiations, and untreated) were analyzed one week after the second irradiation. Results: DUV irradiation significantly changed the cytomorphology of pancreatic cancer cells. In addition, DUV irradiation induced apoptosis on pancreatic cancer cells more strongly than UVA irradiation and no irradiation. Interestingly, lower expression of thrombospondin 1 (TSP1) and tissue inhibitor of metalloproteinase 1 (TIMP1) was identified after DUV treatment. The tumor volume in the DUV-treated groups (DUV×1 and DUV×2) was smaller than that in the untreated group. Conclusion: Further investigations are required to reveal the precise mechanisms of the antitumor effects of DUV irradiation and to facilitate its clinical application as a new therapy for pancreatic cancer. Overall, DUV irradiation can be potentially used as a therapeutic option of pancreatic malignancy.

DOI： 10.21873/anticanres.16198

Current status of transanal total mesorectal excision for rectal cancer and the expanding indications of the transanal approach for extended pelvic surgeries 国際誌

下部進行直腸癌における術前化学療法後の側方リンパ節縮小の意義の検討

小倉淳司, 上原圭, 村田悠記, 神原祐一, 小池佳勇, 三品拓也, 小林龍太郎, 宮田一志, 水野隆史, 山口淳平, 國料俊男, 梅田晋一, 服部憲史, 中山吾郎, 横山幸浩, 小寺泰弘, 江畑智希

日本大腸肛門病学会雑誌 76 巻 ( 2 ) 頁： 184 - 184 2023年2月

免疫チェックポイント阻害薬により病理学的完全奏功が得られたMSI-High大腸癌腹壁限局播種再発・小腸間膜リンパ節転移の1例

小林龍太朗, 上原圭, 小倉淳司, 村田悠記, 鳥居直矢, 深田浩志, 神原祐一, 梅田晋一, 服部憲史, 中山吾郎, 尾上俊介, 宮田一志, 山口淳平, 水野隆史, 伊神剛, 横山幸浩, 小寺泰弘, 江畑智希

日本大腸肛門病学会雑誌 76 巻 ( 2 ) 頁： 248 - 248 2023年2月

Uehara, K; Ogura, A; Murata, Y; Sando, M; Mukai, T; Aiba, T; Yamamura, T; Nakamura, M

DIGESTIVE ENDOSCOPY 35 巻 ( 2 ) 頁： 243 - 254 2023年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Digestive Endoscopy

Transanal total mesorectal excision (taTME) has been rapidly accepted as a promising surgical approach to the distal rectum. The benefits include ease of access to the bottom of the deep pelvis linearly over a short distance in order to easily visualize the important anatomy. Furthermore, the distal resection margins can be secured under direct vision. Additionally, a two-team approach combining taTME with a transabdominal approach could decrease the operative time and conversion rate. Although taTME was expected to become more rapidly popularized worldwide, enthusiasm for it has stalled due to unfamiliar intraoperative complications, a lack of oncologic evidence from randomized trials, and the widespread use of robotic surgery. While international registries have reported favorable short- and medium-term outcomes from taTME, a Norwegian national study reported a high local recurrence rate of 9.5%. The characteristics of the recurrences included rapid, multifocal growth in the pelvis, which was quite different from recurrences following traditional transabdominal TME; thus, the Norwegian Colorectal Cancer Group reached a consensus for a temporary moratorium on the performance of taTME. To ensure acceptable baseline quality and patient safety, taTME should be performed by well-trained colorectal surgeons. Although the appropriate indications for taTME remain controversial, the transanal approach is extremely important as a means of goal setting in difficult TME cases and as an aid to the transabdominal approach in various types of extended pelvic surgeries. The benefits in transanal lateral lymph node dissection and pelvic exenteration are presented herein.

DOI： 10.1111/den.14464

A Case Report of Localized Peritoneal Disseminated Recurrence of Microsatellite Instability-High Colorectal Cancer with Pathologic Complete Response after Immune Checkpoint Inhibitor Therapy

Nishimura M., Uehara K., Ogura A., Murata Y., Kobayashi R., Mizuno T., Miyata K., Yokoyama Y., Ebata T.

Japanese Journal of Gastroenterological Surgery 56 巻 ( 4 ) 頁： 221 - 228 2023年

記述言語：日本語出版者・発行元：Japanese Journal of Gastroenterological Surgery

Use of immune checkpoint inhibitors (ICIs) has recently been recommended for treatment of unresectable or recurrent colorectal cancer with a microsatellite instability-high (MSI-H) status. We report a case of recurrent sigmoid colon cancer that was treated with ICIs followed by radical resection. One year after primary resection, the patient was diagnosed with localized peritoneal metastasis invading the left lower abdominal wall. The tumor presented as RAS/BRAF wild-type and was treated with FOLFIRI+panitumumab as 1st line chemotherapy. After shrinkage was observed, the patient was referred to our department for possible resection. Treated with ipilimumab plus nivolumab was used for further disease control of the borderline resectable tumor. However, interim imaging showed a slight increase in tumor size, so radical surgery (abdominal wall tumor resection+lymph node dissection+fascia lata abdominal wall reconstruction) was performed after three courses of ICI treatment. The pathological results showed a complete response, and the patient is now under observation with neither adjuvant therapy nor recurrence.

DOI： 10.5833/jjgs.2022.0056

Renal Dysfunction after Rectal Cancer Surgery: A Long-term Observational Study

CiNii Research

Sando, M; Uehara, K; Li, YY; Ogura, A; Murata, Y; Mizuno, T; Yatsuya, H; Ebata, T

JOURNAL OF THE ANUS RECTUM AND COLON 7 巻 ( 3 ) 頁： 176 - 185 2023年

がん遺伝子パネル検査の二次的所見として生殖細胞系列にBRCA1病的バリアントが検出された盲腸癌同時性多発肝転移の1例

野中有紀子, 上原圭, 小倉淳司, 村田悠記, 小林龍太朗, 森川真紀, 畠山未来, 森田真未, 横山幸浩, 江畑智希

日本大腸肛門病学会雑誌 76 巻 ( 6 ) 頁： 443 - 446 2023年

記述言語：日本語出版者・発行元：日本大腸肛門病学会

症例は75歳女性で，倦怠感を主訴に精査し，盲腸癌，切除不能多発肝転移，腹膜播種と診断された．コンパニオン遺伝子検査結果ではRAS変異型（KRAS G12V），BRAF V600E野生型，microsatellite stableで，FOLFOX+bevacizumab療法を導入した．がん遺伝子パネル検査を行ったところ，生殖細胞系列にBRCA1病的バリアントが検出され，遺伝性乳癌卵巣癌症候群と診断され，本人および家族に対して遺伝カウンセリングを行った．がん遺伝子パネル検査の普及により，期せずして生殖細胞系列に二次的所見が得られ，遺伝性疾患の診断に繋がる機会は増えると予測される．このことは説明同意文書には必ず記載があるものの，患者側のみならず医療者側も認識に乏しい場合は少なくなく，今一度，患者への十分な説明を肝に銘じ，遺伝カウンセリングの体制を整えることが極めて重要である．

DOI： 10.3862/jcoloproctology.76.443

CiNii Research

Minimum radial margin in pelvic exenteration for locally advanced or recurrent rectal cancer 国際誌

Aiba, T; Uehara, K; Tsuyuki, Y; Ogura, A; Murata, Y; Mizuno, T; Yamaguchi, J; Kokuryo, T; Yokoyama, Y; Ebata, T

EJSO 48 巻 ( 12 ) 頁： 2502 - 2508 2022年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：European Journal of Surgical Oncology

Purpose: The aim of this study was to clarify the suitable radial margin (RM) for favourable outcomes after pelvic exenteration (PE), focusing on the discrepancy between the concepts of circumferential resection margin (CRM) and traditional R status. Methods: Seventy-three patients with locally advanced (LARC, n = 24) or locally recurrent rectal cancer (LRRC, n = 49) who underwent PE between 2006 and 2018 were retrospectively analysed. Patients were histologically classified into the following 3 groups; wide RM (≥1 mm, n = 45), narrow RM (0–1 mm, n = 10), and exposed RM (n = 18). The analysis was performed not only in the entire cohort but also in each disease group separately. Results: The rates of traditional R0 (RM > 0 mm) and wide RM were 75.3% and 61.6%, respectively, resulting in the discrepancy rate of 13.7% between the two concepts. Preoperative radiotherapy was given in 12.3%. In the entire cohort, the local recurrence and overall survival (OS) rates for narrow RMs were significantly worse than those for wide RMs (p < 0.001 and p = 0.002), but were similar to those for exposed RMs. In both LARC and LRRC, RM < 1 mm resulted in significantly worse local recurrence and OS rates compared to the wide RMs. Multivariate analysis showed that RM < 1 mm was an independent risk factor for local recurrence in both LARC (HR 15.850, p = 0.015) and LRRC (HR 4.874, p = 0.005). Conclusions: Narrow and exposed RMs had an almost equal impact on local recurrence and poor OS after PE. Preoperative radiotherapy might have a key role to ensure a wide RM.

DOI： 10.1016/j.ejso.2022.06.015