上嶋 一臣(ウエシマ カズオミ)
医学科 | 特命准教授 |
Last Updated :2024/09/14
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肝癌の診断と治療
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J-Global ID
研究キーワード
- 全身薬物療法 肝動注化学療法 化学療法 肝細胞癌
現在の研究分野(キーワード)
肝癌の診断と治療
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論文
- Tomoko Aoki; Naoshi Nishida; Yutaka Kurebayashi; Kazuko Sakai; Masahiro Morita; Hirokazu Chishina; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Kazuomi Ueshima; Yasunori Minami; Masakatsu Tsurusaki; Takuya Nakai; Michiie Sakamoto; Kazuto Nishio; Masatoshi KudoLiver cancer 13 3 285 - 305 2024年06月INTRODUCTION: Immunotherapy is becoming a promising approach for unresectable-hepatocellular carcinoma (HCC); the anti-tumor response is affected by the tumor microenvironment (TME). Although Wnt/β-catenin mutations are reported to cause non-inflamed phenotype, their role on TME remains controversial. We aimed to clarify the heterogeneity of immunophenotype in HCC with Wnt/β-catenin mutations. METHODS: This study includes 152 resected HCCs; mutations in the catenin beta-1, adenomatous polyposis coli, or AXIN1, or AXIN2 genes were defined as Wnt/β-catenin mutations. With hierarchical cluster analyses, TME was classified into inflamed or non-inflamed classes based on the gene expressions associated with T-cell activation. Expression profiles of molecules related to cell differentiation and biliary-stem cell markers were compared between the TME classes to investigate whether differences in tumor traits were associated with TME. RESULTS: Forty of 152 (26.3%) HCCs carried the Wnt/β-catenin mutations. Of these, 33 were classified as non-inflamed (33/40, 82.5%) and 7 as inflamed (7/40, 17.5%). Non-inflamed class was characterized by low number of CD3+, CD4+, and CD8+ cells on immunostaining, and high mRNA expressions of AXIN2 and GLUL, which are involved in the canonical Wnt/β-catenin signaling and hepatocyte differentiation, respectively. Non-inflamed tumors showed higher enhancement on the hepatobiliary-phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) compared to inflamed tumors. HCCs classified as inflamed class are revealed to have high numbers of CD3+, CD4+, and CD8+ tumor infiltrating lymphocytes on immunostaining. This class is associated with increased expression of anti-epithelial cell adhesion molecule and FOXM1 accompanied by upregulation of genes related to interferon-gamma signaling, dendritic cell migration, regulatory T cells, and myeloid-derived suppressor cell activation and recognized as low enhancement nodule on Gd-EOB-DTPA-enhanced MRI. CONCLUSION: Heterogeneity of tumor traits and TME was observed in HCC with Wnt/β-catenin mutation. The potential was indicated that tumor traits and TME are determined not only by the activation of the HNF4A but also by FOXM1, both of which are downstream transcription factor of the Wnt/β-catenin signaling pathway.
- Tomoko Aoki; Masatoshi Kudo; Kazuomi Ueshima; Masahiro Morita; Hirokazu Chishina; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Yasunori Minami; Masakatsu Tsurusaki; Naoshi NishidaLiver cancer 13 1 56 - 69 2024年02月INTRODUCTION: Programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) signaling blockade is the most effective strategy for the treatment of immune evading hepatocellular carcinoma (HCC). While immune checkpoint inhibitor has revolutionized the concept of cancer treatment, it has also led to unexpected tumor growth. Regulatory T cells express PD-1 and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) receptors, which are proliferated and activated by antibody binding, and their ratio to CD8+ T cells is altered, which is one of the causes for hyper progressive disease (HPD). We examined the frequency of HPD in anti-PD-1/PD-L1 monotherapy and combination therapy with vascular endothelial growth factor (VEGF) antibody and anti-CTLA-4 antibodies. METHODS: This was a prospective and retrospective cohort study which enrolled 198 patients with unresectable HCC from January 2015 to December 2021 at the Kindai University Hospital. Fifty-eight patients received anti-PD-1/PD-L1 monotherapy, 119 patients combination with VEGF antibody, and 21 patients combination with anti-CTLA-4 antibody. We defined HPD as tumor growth rate (TGR) ratio ≥4, ΔTGR ≥40%, and tumor growth kinetics ratio ≥4. RESULTS: The HPD rate was 10.3% (6/58) in anti-PD-1/PD-L1 monotherapy, 1.7% (2/119) in combination with VEGF antibody, and 4.8% (1/21) in combination with anti-CTLA-4 antibody (p = 0.034). The odds ratio for HPD in the combined anti-CTLA-4 antibody group was 0.433 (95% confidence interval [CI]: 0.05-3.83) when compared to the anti-PD-1/PD-L1 monotherapy group and 2.93 (95% CI: 0.25-33.79) when compared to the combined VEGF antibody group. CONCLUSION: The frequency of HPD in unresectable HCC compared to anti-PD-1/PD-L1 monotherapy was decreased with the combination with anti-VEGF antibody and not increased with anti-CTLA-4 antibody. Anti-PD-1/PD-L1 combined with anti-CTLA-4 antibody is now available in real-world and needs to be further validated with accumulated clinical practice.
- 萩原 智; 上嶋 一臣; 西田 直生志; 依田 広; 三長 孝輔; 南 康範; 田北 雅弘; 青木 智子; 盛田 真弘; 千品 寛和; 松原 卓哉; 大丸 直哉; 稲村 昇; 工藤 正俊肝臓 64 11 567 - 574 (一社)日本肝臓学会 2023年11月症例は30代男性.幼少期に完全大血管転位III型に対してFontan手術が施行され,近医に定期的に通院していた.20XX年7月腹部USで多発肝腫瘤を指摘され当院紹介受診となった.造影CTにて最大13cmの多発肝細胞癌と判明した(BCLC stage B).画像上は門脈圧亢進所見や明らかな肝形態異常を認めなかったが,肝生検でCongestive Hepatic Fibrosis Score 3であり,実際には線維化の進展を認めていた.肝内多発のため外科手術やRFAの適応外であった.また最大径の腫瘍は肝外に突出しており,腹腔内破裂の危険性もあることから,まずTACEを施行した.再発に応じて各種抗癌剤治療を行い,生存中である.画像上は肝線維化を示唆する所見はなかったが,Fontan術後の特殊な循環動態では,肝線維化が進展している可能性があり,本症例を通して肝癌サーベイランスの重要性を再考する.(著者抄録)
- 萩原 智; 上嶋 一臣; 西田 直生志; 依田 広; 三長 孝輔; 南 康範; 田北 雅弘; 青木 智子; 盛田 真弘; 千品 寛和; 松原 卓哉; 大丸 直哉; 稲村 昇; 工藤 正俊肝臓 64 11 567 - 574 (一社)日本肝臓学会 2023年11月症例は30代男性.幼少期に完全大血管転位III型に対してFontan手術が施行され,近医に定期的に通院していた.20XX年7月腹部USで多発肝腫瘤を指摘され当院紹介受診となった.造影CTにて最大13cmの多発肝細胞癌と判明した(BCLC stage B).画像上は門脈圧亢進所見や明らかな肝形態異常を認めなかったが,肝生検でCongestive Hepatic Fibrosis Score 3であり,実際には線維化の進展を認めていた.肝内多発のため外科手術やRFAの適応外であった.また最大径の腫瘍は肝外に突出しており,腹腔内破裂の危険性もあることから,まずTACEを施行した.再発に応じて各種抗癌剤治療を行い,生存中である.画像上は肝線維化を示唆する所見はなかったが,Fontan術後の特殊な循環動態では,肝線維化が進展している可能性があり,本症例を通して肝癌サーベイランスの重要性を再考する.(著者抄録)
- 青木 智子; 上嶋 一臣; 工藤 正俊肝臓クリニカルアップデート 9 2 154 - 158 医学図書出版(株) 2023年10月
- 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊肝臓 64 10 514 - 516 (一社)日本肝臓学会 2023年10月カボザンチニブは血管内皮増殖因子受容体や肝細胞増殖因子受容体(MET)を標的とする分子標的薬であり、主に腫瘍増殖抑制を期待する薬剤として使用されている。今回、肺転移により症状増悪した肝細胞癌患者(50歳代男性)に対して、FoundationOne CDxがん遺伝子パネル検査によりMET遺伝子増幅を確認したうえでカボザンチニブを投与し、著明な腫瘍縮小が認められたので報告した。
- 肝細胞癌に対するアテゾリズマブ・ベバシズマブの初回投与直後に急速に発症し増悪した急性呼吸窮迫症候群の一剖検例南 康範; 松原 卓也; 盛田 真弘; 千品 寛和; 青木 智子; 田北 雅弘; 萩原 智; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正敏肝臓 64 Suppl.3 A873 - A873 (一社)日本肝臓学会 2023年10月
- Ken Kamata; Hajime Imai; Hisakazu Matsumoto; Yukitaka Yamashita; Takao Kato; Katsuhisa Nishi; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Tomoko Hyodo; Sung‐Woon Im; Akane Hara; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Kazuomi Ueshima; Yasutaka Chiba; Mamoru Takenaka; Tomohiro Watanabe; Masayuki Kitano; Masatoshi KudoJGH Open 7 9 659 - 666 2023年09月Abstract Background and Aim A multicenter, open‐label randomized Phase II trial was conducted to determine whether low‐dose gemcitabine plus nab‐paclitaxel (GnP) could improve tolerability and show equivalent efficacy to the standard‐dose GnP for elderly patients with metastatic pancreatic cancer. Methods Consecutive patients aged ≥65 years with metastatic pancreatic cancer who presented at one of four Japanese referral centers between November 2016 and January 2021 were enrolled. The 60 patients were randomly assigned to low‐ or standard‐dose groups with a 1:1 ratio. Patients in the low‐dose GnP group received gemcitabine at a dose of 250 mg/m2 and nab‐paclitaxel at 125 mg/m2. Results Low‐dose GnP significantly decreased the rate of cases requiring dose reduction (16.7% vs 63.3%). The response rate (36.7% vs 33.3%) and progression‐free survival (7.3 vs 8 months) were comparable between the low‐ and standard‐dose groups as determined by independent review. The difference in the median overall survival between the two groups was not significant (7.9 vs 12 months). The proportion of patients with hematologic and non‐hematologic treatment‐related adverse events was comparable between the two groups. Conclusion Low‐dose GnP had an equivalent efficacy to conventional therapy; however, it did not reduce adverse events.
- 肝細胞癌Intermediate stageに対する治療戦略 Intermediate stage HCCに対する集学的治療とclinical CR&drug-free strategy青木 智子; 上嶋 一臣; 工藤 正俊肝臓 64 Suppl.2 A560 - A560 (一社)日本肝臓学会 2023年09月
- カボザンチニブ投与による腫瘍の著明な縮小、腫瘍マーカーの低下を認めたMET遺伝子増幅を伴う肝細胞癌の1例八田 寛朗; 萩原 智; 上嶋 一臣; 大丸 直哉; 松原 卓哉; 盛田 真弘; 千品 寛和; 田北 雅弘; 南 康範; 依田 広; 渡邉 智裕; 西田 直生志; 工藤 正俊日本消化器病学会近畿支部例会プログラム・抄録集 119回 99 - 99 日本消化器病学会-近畿支部 2023年09月
- Masatoshi Kudo; Kazuomi Ueshima; Issei Saeki; Toru Ishikawa; Yoshitaka Inaba; Naoki Morimoto; Hiroshi Aikata; Nobukazu Tanabe; Yoshiyuki Wada; Yasuteru Kondo; Masahiro Tsuda; Kazuhiko Nakao; Takanori Ito; Tetsuya Hosaka; Yusuke Kawamura; Teiji Kuzuya; Shunsuke Nojiri; Chikara Ogawa; Hironori Koga; Keisuke Hino; Masafumi Ikeda; Michihisa Moriguchi; Takashi Hisai; Kenichi Yoshimura; Junji Furuse; Yasuaki AraiLIVER CANCER 2023年06月Background:Transarterial chemoembolization (TACE) is the standard treatment for unresectable intermediate-stage hepatocellular carcinoma (HCC), but recurrence after TACE is common. The present phase II, prospective, multicenter, single-arm trial, the TACTICS-L trial, investigated the efficacy and safety of TACE plus lenvatinib (LEN), a drug that more strongly promotes vascular normalization and has a better ORR than sorafenib (jRCTs031180074). Patients and Methods:Participants were patients with HCC who had not previously received systemic therapy, hepatic arterial infusion chemotherapy, or immunotherapy, and who were ineligible for resection or percutaneous ablation therapy. LEN was to be administered 14-21 days before the first TACE, stopped 2 days before TACE, and resumed 3 days after TACE. Key inclusion criteria were unresectable HCC, Child-Pugh A liver function, 0-2 prior TACE sessions, tumor size <= 10 cm, number of tumors <= 10, and ECOG performance status 0-1. Key exclusion criteria were vascular invasion and extrahepatic spread. The primary endpoint was PFS by RECICL, and secondary endpoints were time to untreatable progression, objective response rate (ORR), OS, and safety. Results:A total of 62 HCC patients were enrolled in this trial. The median age was 72 years, 77.4% of patients were men, and 95.2% had PS 0. The primary endpoint of median PFS was 28.0 months (95% CI 25.1-31.0) after a minimum 24 months of follow-up. The secondary endpoint of median OS was not reached (95% CI 35.5 months-NR). LEN-TACE achieved a high response rate and high CR rate (4 weeks after the first TACE: ORR 79.0%, CR rate 53.2%; best response: ORR 88.7%, CR rate 67.7%) by RECICL. Exploratory subgroup analyses showed that the characteristics of responders/nonresponders (ORR and CR) were similar, and that LEN-TACE would be effective in all subgroups, including the population in whom TACE alone would be less likely to be curative (e.g., patients with the nonsimple nodular type or a high tumor burden). The relative dose intensity of LEN before the first TACE was important for achieving higher CR/ORR by LEN-TACE. No new safety concerns were observed. Conclusion:The results of this trial provide encouraging evidence supporting the efficacy and favorable safety profile of LEN-TACE in patients who are ineligible for locoregional therapy.
- Kiyoshi Hasegawa; Nobuyuki Takemura; Tatsuya Yamashita; Takeyuki Watadani; Masaki Kaibori; Shoji Kubo; Mitsuo Shimada; Hiroaki Nagano; Etsuro Hatano; Hiroshi Aikata; Hiroko Iijima; Kazuomi Ueshima; Kazuyoshi Ohkawa; Takuya Genda; Kaoru Tsuchiya; Takuji Torimura; Masafumi Ikeda; Junji Furuse; Masaaki Akahane; Satoshi Kobayashi; Hideyuki Sakurai; Atsuya Takeda; Takamichi Murakami; Utaroh Motosugi; Yutaka Matsuyama; Masatoshi Kudo; Ryosuke TateishiHepatology research : the official journal of the Japan Society of Hepatology 53 5 383 - 390 2023年05月The 5th version of the Clinical Practice Guidelines for Hepatocellular Carcinoma was revised by the Japan Society of Hepatology, according to the methodology of evidence-based medicine and partly to the Grading of Recommendations Assessment, Development and Evaluation system, which was published in October 2021 in Japanese. In addition to surveillance-diagnostic and treatment algorithms, a new algorithm for systemic therapy has been created, as multiple drugs for hepatocellular carcinoma can be currently selected. Herein, new or revised algorithms and evidence on which the recommendations are based are described. This article is protected by copyright. All rights reserved.
- Naoshi Nishida; Tomoko Aoki; Masahiro Morita; Hirokazu Chishina; Masahiro Takita; Hiroshi Ida; Satoru Hagiwara; Yasunori Minami; Kazuomi Ueshima; Masatoshi KudoCancers 15 8 2023年04月Cholangiocarcinoma (CCA) is a refractory cancer; a majority of CCAs represents a non-inflamed tumor phenotype that should be resistant to treatment, including immune checkpoint inhibitors (ICIs). In this study, we aimed to understand the molecular characteristics associated with non-inflamed CCAs. The genetic/epigenetic status of 36 CCAs was obtained from the Cancer Genome Atlas (PanCancerAtlas). CCAs were classified based on immune class using hierarchical clustering analysis of gene expressions related to tumor-infiltrating lymphocytes. The associations between immune class and genetic/epigenetic events were analyzed. We found that the tumors with alterations in FGFR2 and IDH1/2 had a "non-inflamed" tumor phenotype. A significant association was observed between the non-inflamed group and the downregulation of genes involved in antigen presentation (p = 0.0015). The expression of antigen-presenting machineries was inversely correlated with their DNA methylation levels, where 33.3% of tumors had an upregulation/low-methylation pattern, and 66.7% of tumors had a downregulation/high-methylation pattern. All tumors in the "inflamed" group exhibited an upregulation/low-methylation pattern. In contrast, 24 of 30 tumors in the non-inflamed group represent the downregulation/high-methylation pattern (p = 0.0005). Methylation with downregulation of antigen-presenting machineries is associated with the "non-inflamed" tumor phenotype of CCAs. This evidence provides important insights for developing new strategies for treating CCA.
- Masahiro Morita; Naoshi Nishida; Tomoko Aoki; Hirokazu Chishina; Masahiro Takita; Hiroshi Ida; Satoru Hagiwara; Yasunori Minami; Kazuomi Ueshima; Masatoshi KudoCancers 15 8 2023年04月Recently, the therapeutic combination of atezolizumab and bevacizumab was widely used to treat advanced hepatocellular carcinoma (HCC). According to recent clinical trials, immune checkpoint inhibitors (ICIs) and molecular target agents are expected to be key therapeutic strategies in the future. Nonetheless, the mechanisms underlying molecular immune responses and immune evasion remain unclear. The tumor immune microenvironment plays a vital role in HCC progression. The infiltration of CD8-positive cells into tumors and the expression of immune checkpoint molecules are key factors in this immune microenvironment. Specifically, Wnt/β catenin pathway activation causes "immune exclusion", associated with poor infiltration of CD8-positive cells. Some clinical studies suggested an association between ICI resistance and β-catenin activation in HCC. Additionally, several subclassifications of the tumor immune microenvironment were proposed. The HCC immune microenvironment can be broadly divided into inflamed class and non-inflamed class, with several subclasses. β-catenin mutations are important factors in immune subclasses; this may be useful when considering therapeutic strategies as β-catenin activation may serve as a biomarker for ICI. Various types of β-catenin modulators were developed. Several kinases may also be involved in the β-catenin pathway. Therefore, combinations of β-catenin modulators, kinase inhibitors, and ICIs may exert synergistic effects.
- 竹村 信行; 建石 良介; 山下 竜也; 渡谷 岳行; 海堀 昌樹; 久保 正二; 島田 光生; 永野 浩昭; 波多野 悦朗; 相方 浩; 飯島 尋子; 上嶋 一臣; 大川 和良; 玄田 拓哉; 土谷 薫; 鳥村 拓司; 池田 公史; 古瀬 純司; 赤羽 正章; 小林 聡; 櫻井 英幸; 武田 篤也; 村上 卓道; 本杉 宇太郎; 松山 裕; 工藤 正俊; 長谷川 潔肝臓 64 3 109 - 121 (一社)日本肝臓学会 2023年03月2021年に肝癌診療ガイドラインの改訂が行われた.肝細胞癌の診断にEOB-MRIが多く用いられるようになったため,サーベイランスアルゴリズムにおいて超音波で結節が検出された後にまずEOB-MRIを撮像するアルゴリズムが追加された.治療アルゴリズムにおいては,3cm以内の単発肝細胞癌に対する治療推奨が切除と焼灼療法が同等に推奨されることになり,また,脈管侵襲陽性肝細胞癌に対しては,まず切除が推奨され,切除不能例に対して薬物療法,次いで肝動注化学療法ならびにTACEが推奨されることとなった.前回の改訂後に,肝細胞癌に対する薬物療法の選択肢が大幅に増えたため,従来の治療アルゴリズムを補完する形で,新たに薬物療法アルゴリズムが作成された.また,前版では弱く推奨されないとされていた薬物療法とTACEの併用療法が,今回の改訂で行うことを考慮しても良いとの弱い推奨に変更がなされた.(著者抄録)
- Masatoshi Kudo; Tomoko Aoki; Kazuomi Ueshima; Kaoru Tsuchiya; Masahiro Morita; Hirokazu Chishina; Masahiro Takita; Satoru Hagiwara; Yasunori Minami; Hiroshi Ida; Naoshi Nishida; Chikara Ogawa; Tetsu Tomonari; Noriaki Nakamura; Hidekatsu Kuroda; Atsushi Takebe; Yoshifumi Takeyama; Masaaki Hidaka; Susumu Eguchi; Stephen L. Chan; Masayuki Kurosaki; Namiki IzumiLIVER CANCER 12 4 321 - 338 2023年02月Introduction: Atezolizumab plus bevacizumab therapy is extremely effective in the treatment of intermediate-stage hepatocellular carcinoma (HCC), with a response rate of 44%, as reported in the IMbrave150 trial. When tumor shrinkage is obtained, achieving complete response (CR) is possible in many cases using curative conversion with resection, ablation, or super selective transarterial chemoembolization (TACE) with curative intent. This concept, i.e., curative conversion by combining systemic therapy and locoregional therapy, has not been reported before. This multicenter proof-of-concept study was conducted to show the value of curative conversion in immunotherapy-treated intermediate-stage HCC meeting TACE-unsuitable criteria.Methods: This study included 110 consecutive Child-Pugh A patients who received atezolizumab plus bevacizumab as first-line treatment for unresectable and TACE-unsuitable intermediate-stage HCC at seven centers in Japan. CR rate, drug-free rate, time to CR, change in liver function, efficacy in positron emission tomography (PET)-positive HCC, progression-free survival (PFS), and overall survival (OS) were assessed in patients who achieved CR using resection, ablation, super selective TACE with curative intent following atezolizumab plus bevacizumab or atezolizumab plus bevacizumab alone.Results: Clinical or pathological CR was achieved in 38 patients (35%) (median observation period: 21.2 months). The modalities of curative conversion in 35 patients were as follows: resection, 7; ablation, 13; and superselective TACE, 15. Three patients achieved clinical CR with atezolizumab plus bevacizumab therapy alone. Among the 38 CR patients, 25 achieved drug-free status. PFS was not reached, and three patients experienced recurrence after reaching CR. Regarding OS, there were no deaths in any of the CR patients. The albumin-bilirubin score did not deteriorate after locoregional therapy or resection. Of seven PET-positive patients who achieved CR with atezolizumab plus bevacizumab followed by curative conversion, five achieved drug-free status.Discussion/Conclusion: The achievement of CR rate by curative conversion in patients treated with atezolizumab plus bevacizumab as the preceding therapy for unresectable and TACE-unsuitable intermediate-stage HCC was 35%. Overall, 23% of patients achieved drug-free status and no recurrence was observed from this patient subgroup with CR and drug free status. Thus, achieving CR and/or drug-free status should be a therapeutic goal for patients with intermediate-stage HCC without vascular invasion or extrahepatic spread.
- Naoshi Nishida; Masatoshi Kudo; Takafumi Nishimura; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Naosuke Yokomichi; Takeshi Nagasaka; Ajay GoelPLOS ONE 18 1 2023年01月
- Masatoshi Kudo; Richard S Finn; Shukui Qin; Kwang-Hyub Han; Kenji Ikeda; Ann-Lii Cheng; Arndt Vogel; Francesco Tovoli; Kazuomi Ueshima; Hiroshi Aikata; Carlos López López; Marc Pracht; Zhiqiang Meng; Bruno Daniele; Joong-Won Park; Daniel Palmer; Toshiyuki Tamai; Kenichi Saito; Corina E Dutcus; Riccardo LencioniJournal of hepatology 78 1 133 - 141 2023年01月BACKGROUND & AIMS: Validated surrogate endpoints for overall survival (OS) are important for expediting the clinical study and drug-development processes. Herein, we aimed to validate objective response as an independent predictor of OS in individuals with unresectable hepatocellular carcinoma (HCC) receiving systemic anti-angiogenic therapy. METHODS: We investigated the association between objective response (investigator-assessed mRECIST, independent radiologic review [IRR] mRECIST and RECIST v1.1) and OS in REFLECT, a phase III study of lenvatinib vs. sorafenib. We conducted landmark analyses (Simon-Makuch) of OS by objective response at 2, 4, and 6 months after randomization. RESULTS: Median OS was 21.6 months (95% CI 18.6-24.5) for responders (investigator-assessed mRECIST) vs. 11.9 months (95% CI 10.7-12.8) for non-responders (hazard ratio [HR] 0.61; 95% CI 0.49-0.76; p <0.001). Objective response by IRR per mRECIST and RECIST v1.1 supported the association with OS (HR 0.61; 95% CI 0.51-0.72; p <0.001 and HR 0.50; 95% CI 0.39-0.65; p <0.001, respectively). OS was significantly prolonged for responders vs. non-responders (investigator-assessed mRECIST) at the 2-month (HR 0.61; 95% CI 0.49-0.76; p <0.001), 4-month (HR 0.63; 95% CI 0.51-0.80; p <0.001), and 6-month (HR 0.68; 95% CI 0.54-0.86; p <0.001) landmarks. Results were similar when assessed by IRR, with both mRECIST and RECIST v1.1. An exploratory multivariate Cox regression analysis identified objective response by investigator-assessed mRECIST (HR 0.55; 95% CI 0.44-0.68; p <0.0001) and IRR-assessed RECIST v1.1 (HR 0.49; 95% CI, 0.38-0.64; p <0.0001) as independent predictors of OS in individuals with unresectable HCC. CONCLUSIONS: Objective response was an independent predictor of OS in individuals with unresectable HCC in REFLECT; additional studies are needed to confirm surrogacy. Participants achieving a complete or partial response by mRECIST or RECIST v1.1 had significantly longer survival vs. those with stable/progressive/non-evaluable disease. GOV NUMBER: NCT01761266. IMPACT AND IMPLICATIONS: This analysis of data taken from a completed clinical trial (REFLECT) looked for any link between objective response and overall survival time in individuals with unresectable HCC receiving anti-angiogenic treatments. Significantly longer median overall survival was found for responders (21.6 months) vs. non-responders (11.9 months). Overall survival was also significantly longer for responders vs. non-responders (based on objective response status at 2, 4, and 6 months) in the landmark analysis. Our results indicate that objective response is an independent predictor of overall survival in this setting, confirming its validity as a rapid marker of efficacy that can be applied in phase II trials; however, further validation is required to determine is validity for other systemic treatments (e.g. immunotherapies), or as a surrogate of overall survival.
- Andrea Casadei-Gardini; Margherita Rimini; Masatoshi Kudo; Shigeo Shimose; Toshifumi Tada; Goki Suda; Myung Ji Goh; Andre Jefremow; Mario Scartozzi; Giuseppe Cabibbo; Claudia Campani; Emiliano Tamburini; Francesco Tovoli; Kazuomi Ueshima; Tomoko Aoki; Hideki Iwamoto; Takuji Torimura; Takashi Kumada; Atsushi Hiraoka; Masanori Atsukawa; Ei Itobayashi; Hidenori Toyoda; Naoya Sakamoto; Takuya Sho; Wonseok Kang; Jürgen Siebler; Markus Friedrich Neurath; Valentina Burgio; Stefano CascinuLiver cancer 11 6 527 - 539 2022年12月INTRODUCTION: In the REFLECT trial, lenvatinib was found to be noninferior compared to sorafenib in terms of overall survival. Here, we analyze the effects of lenvatinib in the real-life experience of several centers across the world and identify clinical factors that could be significantly associated with survival outcomes. METHODS: The study population was derived from retrospectively collected data of HCC patients treated with lenvatinib. The overall cohort included western and eastern populations from 23 center in five countries. RESULTS: We included 1,325 patients with HCC and treated with lenvatinib in our analysis. Median OS was 16.1 months. Overall response rate was 38.5%. Multivariate analysis for OS highlighted that HBsAg positive, NLR >3, and AST >38 were independently associated with poor prognosis in all models. Conversely, NAFLD/NASH-related etiology was independently associated with good prognosis. Median progression-free survival was 6.3 months. Multivariate analysis for progression-free survival revealed that NAFLD/NASH, BCLC, NLR, and AST were independent prognostic factors for progression-free survival. A proportion of 75.2% of patients suffered from at least one adverse effect during the study period. Multivariate analysis exhibited the appearance of decreased appetite grade ≥2 versus grade 0-1 as an independent prognostic factor for worse progression-free survival. 924 patients of 1,325 progressed during lenvatinib (69.7%), and 827 of them had a follow-up over 2 months from the beginning of second-line treatment. From first-line therapy, the longest median OS was obtained with the sequence lenvatinib and immunotherapy (47.0 months), followed by TACE (24.7 months), ramucirumab (21.2 months), sorafenib (15.7 months), regorafenib (12.7 months), and best supportive care (10.8 months). CONCLUSIONS: Our study confirms in a large and global population of patients with advanced HCC, not candidates for locoregional treatment the OS reported in the registration study and a high response rate with lenvatinib.
- Satoru Hagiwara; Naoshi Nishida; Hiroshi Ida; Kazuomi Ueshima; Yasunori Minami; Masahiro Takita; Tomoko Aoki; Masahiro Morita; Hirokazu Chishina; Yoriaki Komeda; Akihiro Yoshida; Ah-Mee Park; Masako Sato; Akira Kawada; Hajime Nakano; Hiroshi Nakagawa; Masatoshi KudoScientific Reports 12 1 6100 - 6100 2022年12月Abstract Liver damage affects the prognosis of patients with erythropoietic protoporphyria (EPP). However, there is no radical cure for EPP patients with severe liver damage. This study aims to investigate the effectiveness of phlebotomy in patients with severe liver damage. We examined seven patients diagnosed with EPP and liver damage between 2010 and 2020. Of the 7 cases, phlebotomy was performed in 3 cases with severe hepatic disorder, and the improvement effect of hepatic disorder was observed in all cases. In addition, as an additional study, we also investigated the mechanism by which liver damage becomes more severe. Liver biopsy samples were stained with hematoxylin and eosin and immunohistochemistry was used to examine the expression of adenosine triphosphate-binding transporter G2 (ABCG2). Liver biopsies were performed in 3 of 7 patients with EPP. Of these three patients, ABCG2 expression was low in two patients, especially in the protoporphyrin (PP) deposition area. Two patients with reduced ABCG2 expression subsequently developed severe liver damage. However, the causal relationship between the decreased expression of ABCG2 and the exacerbation of liver damage has not been directly proved, and further investigation is required in the future. This study demonstrated the effectiveness of phlebotomy in EPP patients with severe liver damage.
- Hideki Iwamoto; Takashi Niizeki; Hiroaki Nagamatsu; Kazuomi Ueshima; Joji Tani; Teiji Kuzuya; Kazuhiro Kasai; Youhei Kooka; Atsushi Hiraoka; Rie Sugimoto; Takehiro Yonezawa; Satoshi Tanaka; Akihiro Deguchi; Shigeo Shimose; Tomotake Shirono; Miwa Sakai; Hiroyuki Suzuki; Etsuko Moriyama; Hironori Koga; Takuji Torimura; Takumi Kawaguchi; New Fp Study Group; Kurume Liver Cancer Study Group Of JapanCancers 14 19 2022年10月BACKGROUND: Systemic treatments are recommended for advanced hepatocellular carcinoma (HCC) in preserved liver function. However, their effects are unsatisfactory in some tumor conditions, particularly macrovascular invasion (MVI) including major portal vein tumor thrombus (PVTT). We compared the efficacy of hepatic arterial infusion chemotherapy (HAIC) regimens New-FP and sorafenib for various tumor conditions in preserved liver function. METHODS: We retrospectively collected the data of 1709 patients with HCC who were treated with New-FP or sorafenib. Survival was assessed after propensity score matching. Subgroup analyses were conducted: cohort 1 (no MVI or extrahepatic spread (EHS)), cohort 2 (MVI only), cohort 3 (EHS only), cohort 4 (MVI and EHS), and cohort 5 (major PVTT). RESULTS: The New-FP group had a longer median survival time (MST) than the sorafenib in the whole analysis (18 vs. 9 months; p < 0.0001). New-FP demonstrated a longer MST compared with sorafenib in cohort 2 and cohort 4. In cohort 5, the MST of the New-FP group was 16 months, while that of sorafenib was 6 months (p < 0.0001). For major PVTT-HCC, the response rate of New-FP was 73.0%. The MST of patients who achieved complete response with New-FP was 59 months. CONCLUSIONS: HAIC using New-FP is promising for patients with MVI- and major PVTT-HCC in preserved liver function.
- Yasunori Minami; Tomoko Aoki; Hirokazu Chishina; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoCancers 14 19 2022年10月BACKGROUND: The treatment of the hepatitis C virus (HCV) has reduced the risk of hepatocellular carcinoma (HCC)-related mortality. Many patients with advanced HCC have achieved longer survival through systemic chemotherapy. However, survivors of HCC may develop liver cancer during and after treatment. Therefore, the present study investigated prognostic factors for survival in patients with HCV-related HCC in the new era of molecular targeted therapy. METHODS: A total of 359 patients with HCV-related HCC treated with first-line chemotherapy were reviewed. A Cox proportional hazards model and Kaplan-Meier curve were used to identify prognostic factors associated with survival outcomes. RESULTS: The median follow-up duration was 16.0 months (range, 1.0-115.7) and the median duration of first-line systemic therapy was 3.73 months (range, 0.7-86.9). The achievement of a sustained virological response (SVR) (p < 0.001), albumin-bilirubin (ALBI) grade II/III (p < 0.001), Barcelona Clinic Liver Cancer (BCLC) stage C (p = 0.005), extrahepatic spread (p < 0.001), baseline AFP (alpha-fetoprotein) level ≥ 90 (p = 0.038), baseline DCP (des-γ-carboxy prothrombin) level ≥ 500 (p < 0.001), and a fibrosis-4 (FIB-4) index ≥ 4 (p = 0.003) were identified as prognostic factors for overall survival. CONCLUSIONS: The achievement of SVR was most strongly associated with overall survival. Other factors, such as the BCLC stage, extrahepatic spread, baseline tumor marker (AFP/DCP) levels, ALBI grade, and FIB-4 index need to be considered in the management of patients with HCV-related HCC.
- 消化器癌に対する薬物療法 複合免疫療法時代における切除不能肝細胞癌に対するconversion療法青木 智子; 上嶋 一臣; 工藤 正俊日本消化器病学会近畿支部例会プログラム・抄録集 117回 51 - 51 日本消化器病学会-近畿支部 2022年10月
- Kazuomi Ueshima; Atsushi Komemushi; Takeshi Aramaki; Hideki Iwamoto; Shuntaro Obi; Yozo Sato; Toshihiro Tanaka; Kiyoshi Matsueda; Michihisa Moriguchi; Hiroya Saito; Miyuki Sone; Takuji Yamagami; Yoshitaka Inaba; Masatoshi Kudo; Yasuaki AraiLiver cancer 11 5 407 - 425 2022年09月Hepatocellular carcinoma is one of the leading causes of cancer-related death both in Japan and globally. In the advanced stage, hepatic arterial infusion chemotherapy (HAIC) is one of the most commonly used treatment options for liver cancer in Japan, and implantation of a catheter system (called a port system) in the body is a treatment method that has evolved mainly in Japan. The Guideline Committee of the Japanese Society of Interventional Radiology and the Japanese Society of Implantable Port Assisted Treatment jointly published clinical practice guidelines for HAIC with a port system to ensure its appropriate and safe performance in Japanese in 2018. We have written an updated English version of the guidelines with the aim of making this treatment widely known to experts globally. In this article, the evidence, method, indication, treatment regimen, and maintenance of the system are summarized.
- Shohei Komatsu; Kazuomi Ueshima; Masahiro Kido; Kaori Kuramitsu; Daisuke Tsugawa; Hiroaki Yanagimoto; Hirochika Toyama; Yonon Ku; Masatoshi Kudo; Takumi FukumotoJournal of hepato-biliary-pancreatic sciences 30 3 303 - 314 2022年09月AIM: Sorafenib was previously considered a first-line treatment for hepatocellular carcinoma (HCC) patients with macroscopic portal vein tumor thrombus (PVTT). This case-matched analysis was performed to evaluate the best first-line treatment for HCC in patients with macroscopic PVTT. METHODS: The HCC patients with Vp2 (PVTT invaded into a second-order portal branch), Vp3 (first-order portal branch), and Vp4 (main trunk or contralateral portal vein) PVTT who underwent hepatectomy and those treated with sorafenib were included. Treatment results were compared between the two modalities for each PVTT category, and a propensity analysis was performed for patients with Vp3 and Vp4 (Vp3/4). RESULTS: The median survival times (MSTs) of patients with Vp2, Vp3, and Vp4 PVTT who underwent hepatectomy were 21.4, 13.6, and 14.9 months, respectively; the MSTs for those with Vp2, Vp3, and Vp4 PVTT who received sorafenib treatment were 6.9, 5.5, and 3.6 months, respectively, with a significant difference. In a propensity-matched cohort of patients with Vp3/4 PVTT (36 patients in each), the MST of patients who underwent hepatectomy (15.1 months) was significantly better than the patients treated with sorafenib (4.5 months). CONCLUSION: Hepatectomy can be associated with prolonged survival in HCC patients with macroscopic PVTT.
- Satoru Hagiwara; Takeshi Yoshida; Naoshi Nishida; Hiroshi Ida; Kazuomi Ueshima; Yasunori Minami; Masahiro Takita; Tomoko Aoki; Masahiro Morita; Hirokazu Cishina; Yoriaki Komeda; Akihiro Yoshida; Hidetoshi Hayashi; Kazuhiko Nakagawa; Masatoshi KudoHepatology research : the official journal of the Japan Society of Hepatology 52 10 888 - 892 2022年07月AIM: We report a rare case of immune-related cholangitis in which the natural course could be demonstrated. CASE PRESENTATION: Eight courses of pembrolizumab maintenance therapy were given as first-line treatment for squamous cell lung cancer; however, the patient was subsequently hospitalized due to a rapid increase in hepatobiliary enzymes. On endoscopic ultrasound, the common bile duct was dilated to 11 mm, and the wall, throughout its length from the papilla, was thickened. Endoscopic retrograde cholangiopancreatography showed no obvious stenosis in the lower bile duct; however, a parapapillary diverticulum was found, and papillary incision and bile duct plastic stent insertion were carried out. However, the liver disorder did not improve and overt jaundice appeared subsequently; therefore, an immune-related cholangitis was suspected, and prednisolone (PSL) 35 mg/day was introduced from day 59 of admission. Following PSL initiation, a decrease in serum bilirubin level was observed; however, significant decrease was not observed in alkaline phosphatase. Given the history of recurrent infectious cholangitis, magnetic resonance cholangiopancreatography was carried out on day 70 of admission. The intrahepatic bile duct showed stenosis and dilated findings, which was considered to be a factor for repeated infectious cholangitis. CONCLUSION: No previous case reports have described the changes and progression in bile duct images in immune-related adverse events. Therefore, this case is noteworthy for considering the progression of immune-related cholangitis.
- Masatoshi Kudo; Kazuomi Ueshima; Masafumi Ikeda; Takuji Torimura; Nobukazu Tanabe; Hiroshi Aikata; Namiki Izumi; Takahiro Yamasaki; Shunsuke Nojiri; Keisuke Hino; Hidetaka Tsumura; Teiji Kuzuya; Norio Isoda; Michihisa Moriguchi; Hajime Aino; Akio Ido; Naoto Kawabe; Kazuhiko Nakao; Yoshiyuki Wada; Sadahisa Ogasawara; Kenichi Yoshimura; Takuji Okusaka; Junji Furuse; Norihiro Kokudo; Kiwamu Okita; Philip James Johnson; Yasuaki AraiLiver cancer 11 4 354 - 367 2022年07月Introduction: Several clinical trials comparing the efficacy and safety of transarterial chemoembolization (TACE) plus molecular-targeted agents versus TACE alone revealed no clinical benefits in progression-free survival (PFS) or overall survival (OS). Here, we report the final OS analysis from the TACTICS trial, which previously demonstrated significant improvement in PFS with TACE plus sorafenib in patients with unresectable hepatocellular carcinoma (HCC) (NCT01217034). Methods: Patients with unresectable HCC were randomized to a TACE plus sorafenib group (N = 80) or a TACE alone group (N = 76). Patients in the combination treatment group received sorafenib 400 mg once daily for 2-3 weeks before TACE, followed by 800 mg once daily during on-demand conventional TACE sessions until time to untreatable progression. In this trial, TACE-specific PFS was used. TACE-specific PFS is defined as the time from randomization to progressive disease (PD) or death from any cause, and PD was defined as untreatable progression, caused by the inability of a patient to further receive or benefit from TACE for reasons that include intrahepatic tumor progression (25% increase vs. baseline) according to response evaluation criteria in cancer of the liver, the detection of extrahepatic spread, vascular invasion, or transient deterioration of liver function to Child-Pugh C after TACE. Results: At the cut-off date of July 31, 2020, 131 OS events were observed. The median OS was 36.2 months with TACE plus sorafenib and 30.8 months with TACE alone (hazard ratio [HR] = 0.861; 95% confidence interval [CI], 0.607-1.223; p = 0.40, ΔOS, 5.4 months). The updated PFS was 22.8 months with TACE plus sorafenib and 13.5 months with TACE alone (HR = 0.661; 95% CI, 0.466-0.938; p = 0.02). Post-trial treatments with active procedures/agents were received by 47 (58.8%) patients in the TACE plus sorafenib group and 58 (76.3%) in the TACE alone group (p = 0.01). In post hoc analysis, PFS and OS benefit were shown in HCC patients with tumor burden beyond up-to-7 criteria. Conclusions: In TACTICS trial, TACE plus sorafenib did not show significant OS benefit over TACE alone; however, clinical meaningful OS prolongation and significantly improved PFS was observed. Thus, the TACE plus sorafenib can be considered a choice of treatment in intermediate-stage HCC, especially in patients with high tumor burden. Trial Registration: NCT01217034.
- Satoru Hagiwara; Naoshi Nishida; Hiroshi Ida; Kazuomi Ueshima; Yasunori Minami; Masahiro Takita; Tomoko Aoki; Masahiro Morita; Hirokazu Cishina; Yoriaki Komeda; Akihiro Yoshida; Hidetoshi Hayashi; Kazuhiko Nakagawa; Masatoshi KudoHepatology Research 52 9 754 - 761 2022年05月AIM: The risk of hepatitis B virus (HBV) reactivation with immune checkpoint inhibitors (ICIs) is an important issue that has not yet been fully investigated. ICI is also expected to have an antiviral effect on HBV due to its immune tolerance inhibitory effect. We herein investigated the risk of HBV reactivation and the antiviral effect of ICI administration. METHODS: This study included 892 patients on ICIs between September 2014 and May 2021 at our hospital. The frequency of HBV reactivation and antiviral effects were investigated. RESULTS: Among the 892 patients who underwent ICI, 27 were hepatitis B surface antigen (HBsAg) positive. HBV reactivation was evaluated in 24 cases, among which 4.1% (1/24) had HBV reactivation. Nucleic acid analog prophylaxis was not administered to patients with reactivation. In a study of 15 cases, the amount of HBsAg decreased from baseline; 2.18 ± 0.77 log to 48 weeks later; 1.61 ± 1.38 log (p = 0.17). Forty-eight weeks after the start of ICI, disappearance of HBsAg was observed in two out of 15 cases (13.3%), and one case each with and without nucleic acid analog. CONCLUSION: In rare cases, HBsAg-positive patients may be reactivated by ICI administration. On the other hand, when ICI is administered, it is expected to have an antiviral effect on HBV due to its immune tolerance inhibitory effect, and future drug development is expected.
- Masatoshi Kudo; Kazuomi Ueshima; Shin Nakahira; Naoshi Nishida; Hiroshi Ida; Yasunori Minami; Takuya Nakai; Hiroshi Wada; Shoji Kubo; Kazuyoshi Ohkawa; Asahiro Morishita; Takeo Nomi; Koji Ishida; Shogo Kobayashi; Makoto Umeda; Masakatsu Tsurusaki; Yasutaka Chiba; Kenichi Yoshimura; Kazuko Sakai; Kazuto NishioJOURNAL OF CLINICAL ONCOLOGY 40 4 2022年02月
- Kazuomi Ueshima; Toru Ishikawa; Issei Saeki; Naoki Morimoto; Hiroshi Aikata; Nobukazu Tanabe; Yoshitaka Inaba; Yoshiyuki Wada; Yasuteru Kondo; Masahiro Tsuda; Kazuhiko Nakao; Masafumi Ikeda; Michihisa Moriguchi; Takanori Ito; Masahiro Kobayashi; Hironori Koga; Keisuke Hino; Yoshiyuki Suzuki; Kenichi Yoshimura; Masatoshi KudoJOURNAL OF CLINICAL ONCOLOGY 40 4 2022年02月
- Masatoshi Kudo; Masafumi Ikeda; Kazuomi Ueshima; Michiie Sakamoto; Shuichiro Shiina; Ryosuke Tateishi; Kazuhiro Nouso; Kiyoshi Hasegawa; Junji Furuse; Shiro Miyayama; Takamichi Murakami; Tatsuya Yamashita; Norihiro KokudoHepatology research : the official journal of the Japan Society of Hepatology 52 4 329 - 336 2022年01月Response Evaluation Criteria in Solid Tumors (RECIST) is inappropriate to assess the direct effects of treatment on hepatocellular carcinoma (HCC) by locoregional therapies, such as radiofrequency ablation or transarterial chemoembolization. Therefore, establishment of response evaluation criteria solely devoted to HCC is needed in clinical practice, as well as in clinical trials of HCC treatment, such as systemic therapies, which cause necrosis of the tumor. Response Evaluation Criteria in Cancer of the Liver (RECICL) was revised in 2021 by the Liver Cancer Study Group of Japan based on the 2019 version of RECICL, which was commonly used in Japan. The major revised points of the RECICL 2021 is inclusion of RECIST 1.1 and modified RECIST as response evaluation criteria in systemic therapy for HCC. We hope this new treatment response criteria, RECICL, proposed by the Liver Cancer Study Group of Japan will benefit the HCC treatment response evaluation in the setting of daily clinical practice and clinical trials as well, not only in Japan, but also internationally This article is protected by copyright. All rights reserved.
- Kazuomi UeshimaNihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 119 5 414 - 422 2022年
- Masatoshi Kudo; Robert Montal; Richard S Finn; Florian Castet; Kazuomi Ueshima; Naoshi Nishida; Philipp K Haber; Youyou Hu; Yasutaka Chiba; Myron Schwartz; Tim Meyer; Riccardo Lencioni; Josep M LlovetClinical cancer research : an official journal of the American Association for Cancer Research 28 16 3443 - 3451 2021年12月PURPOSE: Due to the increased number of sequential treatments used for advanced HCC, there is a need for surrogate endpoints of overall survival (OS). We analyze if objective response (OR) is an independent predictor and surrogate endpoint of OS. EXPERIMENTAL DESIGN: A systematic review of randomized clinical trials (RCTs) in advanced HCC published between 2010 and 2020 was conducted to explore OS surrogacy of OR by RECIST and mRECIST. In parallel, RCTs exploring the impact of OR on OS in a time-dependent multivariate analysis were integrated in a meta-analysis. RESULTS: Out of 65 RCTs identified in advanced HCC, we analyzed 34 studies including 14,056 patients that reported OS and OR by either RECIST (n=23), mRECIST (n=5) or both (n=6). When exploring surrogacy, the trial-level correlation between OR odds ratio and OS hazard ratio was R=0.677 by mRECIST and R=0.532 by RECIST. Meta-analysis of five RCT assessing predictors of survival in multivariate analysis found that patients with OR by mRECIST presented a pooled HR for OS of 0.44 (95% CI, 0.27-0.70, p<0.001) compared with non-responders. Responses to atezolizumab-bevacizumab had a greater impact on OS than tyrosine-kinase inhibitor responses. CONCLUSIONS: OR-mRECIST is an independent predictor of OS in patients with advanced HCC. Although correlation of OR-mRECIST and OS is better than with OR-RECIST, the level of surrogacy is modest. Thus, it can be used as endpoint in proof-of-concept phase II trials, but the data does not support its use as a primary endpoint of phase III investigations assessing systemic therapies.
- Satoru Hagiwara; Naoshi Nishida; Kazuomi Ueshima; Yasunori Minami; Yoriaki Komeda; Tomoko Aoki; Masahiro Takita; Masahiro Morita; Hirokazu Chishina; Akihiro Yoshida; Hiroshi Ida; Masatoshi KudoCells 10 11 2021年11月The incidence of hepatocellular carcinoma (HCC) related to non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. We analyzed 16 surgically resected HCC cases in which the background liver was pathologically diagnosed as NAFLD. Specimens with Brunt classification grade 3 or higher were assigned as the fibrotic progression group (n = 8), and those with grade 1 or lower were classified as the non-fibrosis progression group (n = 8). Comprehensive mutational and methylome analysis was performed in cancerous and noncancerous tissues. The target gene mutation analysis with deep sequencing revealed that CTNNB1 and TP53 mutation was observed in 37.5% and TERT promoter mutation was detected in 50% of cancerous samples. Furthermore, somatic mutations in non-cancerous samples were less frequent, but were observed regardless of the progression of fibrosis. Similarly, on cluster analysis of methylome data, status for methylation events involving non-cancerous liver was similar regardless of the progression of fibrosis. It was found that, even in cases of non-progressive fibrosis, accumulation of gene mutations and abnormal methylation within non-cancerous areas were observed. Patients with NAFLD require a rigorous liver cancer surveillance due to the high risk of HCC emergence based on the accumulation of genetic and epigenetic abnormalities, even when fibrosis is not advanced.
- Tomoko Aoki; Naoshi Nishida; Kazuomi Ueshima; Masahiro Morita; Hirokazu Chishina; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Yasunori Minami; Akira Yamada; Keitaro Sofue; Masakatsu Tsurusaki; Masatoshi KudoLiver cancer 10 6 615 - 628 2021年11月Introduction: Immune checkpoint inhibitors (ICIs) are promising agents for the treatment of hepatocellular carcinoma (HCC). However, the establishment of noninvasive measure that could predict the response to ICIs is challenging. This study aimed to evaluate tumor responses to ICIs using the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI), which was shown to reflect Wnt/β-catenin activating mutation. Methods: A total of 68 intrahepatic HCC nodules from 18 patients with unresectable HCC and Child-Pugh class A liver function who received anti-programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) monotherapy were enrolled in this study. All patients had viable intrahepatic lesions evaluable using the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI within the 6 months prior to the treatment. The relative enhancement ratio was calculated, and the time to nodular progression (TTnP) defined as 20% or more increase in each nodule was compared between higher or hypo-enhancement HCC nodules. Then, the progression-free survival (PFS) and objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) were compared between patients with and without HCC nodules with higher enhancement on hepatobiliary phase images. Results: The median PFS was 2.7 (95% confidence interval [CI]: 1.4-4.0) months in patients with HCC nodules with higher enhancement (n = 8) and 5.8 (95% CI: 0.0-18.9) months in patients with hypointense HCC nodules (n = 10) (p = 0.007). The median TTnP of HCC nodules with higher enhancement (n = 23) was 1.97 (95% CI: 1.86-2.07) months and that of hypointense HCC nodules (n = 45) was not reached (p = 0.003). The ORR was 12.5% (1/8) versus 30.0% (3/10); the disease control rate was 37.5% (3/8) versus 70.0% (7/10), respectively, in patients with or without higher enhancement intrahepatic HCC nodules. Conclusion: The TTnP on HCC nodules with higher enhancement and the median PFS in patients who carried higher enhancement intrahepatic HCC nodules were significantly shorter than those in hypointense HCC nodules with anti-PD-1/PD-L1 monotherapy. The intensity of the nodule on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI is a promising imaging biomarker for predicting unfavorable response with anti-PD-1/PD-L1 monotherapy in patients with HCC.
- Yasunori Minami; Masahiro Morita; Hirokazu Chishina; Tomoko Aoki; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoUltrasound in medicine & biology 47 10 2930 - 2935 2021年10月Developments in image fusion technology made it possible to visualize the ablative margin on ultrasound (US). The purpose of the present study was to assess the ablative area of radiofrequency ablation for hepatocellular carcinoma and compare it with the ablative hyperechoic zone with a non-enhanced area on contrast-enhanced US/contrast-enhanced computed tomography (CEUS/CECT) in the same cross-section. This retrospective study included 25 patients with 27 hepatocellular carcinomas. The long and short dimensions of the ablative hyperechoic zone were measured using B-mode US, and those of the non-enhanced area were assessed with CEUS/CECT on the same cross-section measured with B-mode US, using image fusion techniques. The technical effectiveness of ablation with an adequate ablative margin in a single session was determined in all patients. The long and short dimensions of the ablative hyperechoic zone ranged between 15.0 and 40.7 mm (mean: 27.3 ± 6.9 mm) and between 14.0 and 33.0 mm (mean: 23.3 ± 5.8 mm), respectively. R values for the long and short dimensions were 0.99 and 0.98, respectively, between B-mode US and CEUS, and 0.96 and 0.92, respectively, between B-mode US and CECT. The ablative hyperechoic zone may be regarded as a necrotic lesion after radiofrequency ablation.
- Masahiro Morita; Naoshi Nishida; Kazuko Sakai; Tomoko Aoki; Hirokazu Chishina; Masahiro Takita; Hiroshi Ida; Satoru Hagiwara; Yasunori Minami; Kazuomi Ueshima; Kazuto Nishio; Yukari Kobayashi; Kazuhiro Kakimi; Masatoshi KudoLiver Cancer 10 4 380 - 393 2021年07月Introduction: Although immune checkpoint inhibitors (ICIs) have been considered as promising agents for the treatment of advanced hepatocellular carcinoma (HCC), previous clinical trials revealed that the response to anti-programmed cell death protein 1 (anti-PD-1) monotherapy was as low as 20%. Identifying subgroups that respond well to ICIs is clinically important. Here, we studied the prognostic factors for anti-PD-1 antibody treatment based on the molecular and immunological features of HCC. Methods: Patients who were administered anti-PD1 antibody for advanced HCC at Kindai University Hospital were included. Clinicopathological backgrounds and antitumor responses were examined in 34 cases where tumor tissues before treatment were available. Transcriptome analysis was performed using 40 HCC samples obtained from surgical resection, and immune status was compared between 20 HCCs with activating mutations in β-catenin and those without the mutations using transcriptome-based immunogram. Results: Univariate analysis showed that the disease control rate was significantly better in patients with α-fetoprotein < 400 ng/mL, negative for β-catenin/glutamate synthetase (GS) staining, high combined positive score (CPS) of programmed death-ligand 1 (PD-L1), and increased infiltration of CD8+ cells in tumor tissues. Among them, negative staining of β-catenin/GS, CPS of PD-L1 ≥ 1, and high degree of CD8+ tumor-infiltrating lymphocytes (TILs) were significantly associated with longer survival in both progression-free survival (PFS) and overall survival (OS). The combination of these factors well stratified the survival of the patients on anti-PD-1 antibody in both PFS and OS (p < 0.0001 and p = 0.0048 for PFS and OS, respectively). In addition, the immunogram revealed that tumor-carrying mutations in β-catenin showed downregulation of immune-related genes, especially in those related to priming and activation by dendritic cells, interferon-γresponse, inhibitory molecules, and regulatory T cells. Discussion/Conclusion: The combined score including Wnt/β-catenin activation, CPS of PD-L1, and degree of CD8+ TILs in HCC is informative for predicting the response to ICI in HCC cases. Constitutive activation of β-catenin can induce an immune cold phenotype with downregulation of immune-related genes, and immunohistochemistry-based evaluation is beneficial for identifying the subgroup that shows a good response to ICI.
- Masatoshi Kudo; Yusuke Kawamura; Kiyoshi Hasegawa; Ryosuke Tateishi; Kazuya Kariyama; Shuichiro Shiina; Hidenori Toyoda; Yasuharu Imai; Atsushi Hiraoka; Masafumi Ikeda; Namiki Izumi; Michihisa Moriguchi; Sadahisa Ogasawara; Yasunori Minami; Kazuomi Ueshima; Takamichi Murakami; Shiro Miyayama; Osamu Nakashima; Hirohisa Yano; Michiie Sakamoto; Etsuro Hatano; Mitsuo Shimada; Norihiro Kokudo; Satoshi Mochida; Tetsuo TakeharaLiver cancer 10 3 181 - 223 2021年06月The Clinical Practice Manual for Hepatocellular Carcinoma was published based on evidence confirmed by the Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma along with consensus opinion among a Japan Society of Hepatology (JSH) expert panel on hepatocellular carcinoma (HCC). Since the JSH Clinical Practice Guidelines are based on original articles with extremely high levels of evidence, expert opinions on HCC management in clinical practice or consensus on newly developed treatments are not included. However, the practice manual incorporates the literature based on clinical data, expert opinion, and real-world clinical practice currently conducted in Japan to facilitate its use by clinicians. Alongside each revision of the JSH Guidelines, we issued an update to the manual, with the first edition of the manual published in 2007, the second edition in 2010, the third edition in 2015, and the fourth edition in 2020, which includes the 2017 edition of the JSH Guideline. This article is an excerpt from the fourth edition of the HCC Clinical Practice Manual focusing on pathology, diagnosis, and treatment of HCC. It is designed as a practical manual different from the latest version of the JSH Clinical Practice Guidelines. This practice manual was written by an expert panel from the JSH, with emphasis on the consensus statements and recommendations for the management of HCC proposed by the JSH expert panel. In this article, we included newly developed clinical practices that are relatively common among Japanese experts in this field, although all of their statements are not associated with a high level of evidence, but these practices are likely to be incorporated into guidelines in the future. To write this article, coauthors from different institutions drafted the content and then critically reviewed each other's work. The revised content was then critically reviewed by the Board of Directors and the Planning and Public Relations Committee of JSH before publication to confirm the consensus statements and recommendations. The consensus statements and recommendations presented in this report represent measures actually being conducted at the highest-level HCC treatment centers in Japan. We hope this article provides insight into the actual situation of HCC practice in Japan, thereby affecting the global practice pattern in the management of HCC.
- Kazuomi Ueshima; Masatoshi Kudo; Takeharu Yamanaka; Hiroshi Aikata; Tatsuya Yamashita; Masafumi Ikeda; Ryosuke Tateishi; Michihisa Moriguchi; Atsushi Hiraoka; Kaoru Tsuchiya; Sadahisa Ogasawara; Satoshi Mochida; Shiro Miyayama; Kiyoshi Hasegawa; Kenichi Yoshimura; Tetsuo TakeharaJOURNAL OF CLINICAL ONCOLOGY 39 15 2021年05月
- Satoru Hagiwara; Tomohiro Watanabe; Masatoshi Kudo; Kosuke Minaga; Yoriaki Komeda; Ken Kamata; Masatomo Kimura; Hidetoshi Hayashi; Kazuhiko Nakagawa; Kazuomi Ueshima; Yasunori Minami; Tomoko Aoki; Masahiro Takita; Masahiro Morita; Hirokazu Cishina; Hiroshi Ida; Ah-Mee Park; Naoshi NishidaScientific reports 11 1 9242 - 9242 2021年04月Immune checkpoint inhibitors (ICIs) targeting programmed cell death 1 (PD-1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) are widely used to treat advanced metastatic cancers. Neutralisation of PD-1 or CTLA-4 by ICIs results in immune-related adverse events (irAEs). The clinicopathological features of twelve patients with hepatic irAEs were evaluated and compared to those of ten patients with autoimmune hepatitis (AIH) or graft-versus-host disease (GVHD). No significant difference was seen in serum levels of transaminases, whereas serum levels of IgG and anti-nuclear antibody were higher in patients with AIH than in those with GVHD or hepatic irAEs. Inflammation was limited to the liver lobes in patients with GVHD or hepatic irAEs, whereas patients with AIH exhibited both portal and lobular inflammation. Immunohistochemical analyses revealed a predominant infiltration of CD8+ T cells and defective accumulation of regulatory T cells (Tregs) expressing forkhead box p3 (FOXP3) in the lobular areas of patients with hepatic irAEs and GVHD. In contrast, periportal lesions of patients with AIH were characterised by an infiltration of CD4+ T cells, CD8+ T cells, CD20+ B cells, and FOXP3+ Tregs. Overall, the activation of CD8+ T cells in the absence of activation of Tregs potentially underlies the immunopathogenesis of hepatic irAEs.
- Satoru Hagiwara; Naoshi Nishida; Kazuomi Ueshima; Akihiro Yoshida; Yasunori Minami; Masatoshi KudoHepatology research : the official journal of the Japan Society of Hepatology 51 7 767 - 774 2021年04月AIM: Both entecavir (ETV) and tenofovir alafenamide fumarate (TAF) are widely used to treat chronic hepatitis B (CHB) in Japan. However, it remains unclear whether the efficacy of TAF in decreasing the hepatitis B surface antigen (HBsAg) level, and its safety, are superior to those of ETV. This study aimed to report the long-term effects and safety of 96-week ETV and TAF treatment in patients with CHB. METHODS: A prospective comparative observational study was undertaken on the following two groups: patients with CHB who received continuous ETV (n = 32) and patients with CHB who were switched from ETV to TAF upon request (n = 48). The HBsAg, urinary β2-microglobulin (β2MG)/creatinine (Cr), urinary N-acetyl-β-D-glucosaminidase (NAG)/Cr, and serum alanine aminotransferase (ALT) levels, estimated glomerular filtration rate (eGFR), and bone mineral density (lumbar spine and femur) at 96 weeks were compared. RESULTS: The two groups did not significantly differ with respect to mean age, male / female patient ratio, or rate of hepatitis B e antigen-positive status. The mean changes in serum HBsAg level and eGFR at 96 weeks were not significantly different between the two groups. The β2MG/Cr and NAG/Cr levels at 96 weeks were similar between the two groups. Additionally, the bone mineral density of the lumbar spine and femur as well as the serum ALT did not significantly differ. CONCLUSIONS: When compared with patients who received continuous ETV, those who were introduced to TAF after ETV showed similar effects in terms of the decrease in HBsAg level and safety.
- Yasunori Minami; Tomohiro Minami; Kazuomi Ueshima; Yukinobu Yagyu; Masakatsu Tsurusaki; Takuya Okada; Masatoshi Hori; Masatoshi Kudo; Takamichi MurakamiCancers 13 6 2021年03月BACKGROUND: We investigate the feasibility of image fusion application for ablative margin assessment in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) and possible causes for a wrong initial evaluation of technical success through a side-by-side comparison. METHODS: A total of 467 patients with 1100 HCCs who underwent RFA were reviewed retrospectively. Seventeen patients developed local tumor progressions (LTPs) (median size, 1.0 cm) despite initial judgments of successful ablation referring to contrast-enhanced images obtained in the 24 h after ablation. The ablative margins were reevaluated radiologically by overlaying fused images pre- and post-ablation. RESULTS: The initial categorizations of the 17 LTPs had been grade A (absolutely curative) (n = 5) and grade B (relatively curative) (n = 12); however, the reevaluation altered the response categories to eight grade C (margin-zero ablation) and nine grade D (existence of residual HCC). LTP occurred in eight patients re-graded as C within 4 to 30.3 months (median, 14.3) and in nine patients re-graded as D within 2.4 to 6.7 months (median, 4.2) (p = 0.006). Periablational hyperemia enhancements concealed all nine HCCs reevaluated as grade D. CONCLUSION: Side-by-side comparisons carry a risk of misleading diagnoses for LTP of HCC. Overlay fused imaging technology can be used to evaluate HCC ablative margin with high accuracy.
- Hideki Iwamoto; Takashi Niizeki; Hiroaki Nagamatsu; Kazuomi Ueshima; Takako Nomura; Teiji Kuzuya; Kazuhiro Kasai; Yohei Kooka; Atsushi Hiraoka; Rie Sugimoto; Takehiro Yonezawa; Akio Ishihara; Akihiro Deguchi; Hirotaka Arai; Shigeo Shimose; Tomotake Shirono; Masahito Nakano; Shusuke Okamura; Yu Noda; Naoki Kamachi; Miwa Sakai; Hiroyuki Suzuki; Hajime Aino; Norito Matsukuma; Satoru Matsugaki; Kei Ogata; Yoichi Yano; Takato Ueno; Masahiko Kajiwara; Satoshi Itano; Kunitaka Fukuizumi; Hiroshi Kawano; Kazunori Noguchi; Masatoshi Tanaka; Taizo Yamaguchi; Ryoko Kuromatsu; Atsushi Kawaguchi; Hironori Koga; Takuji Torimura; New Fp Study Group; Kurume Liver Cancer Study Group Of JapanCancers 13 4 2021年02月BACKROUND: Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with molecular targeted agents such as sorafenib. We investigated whether New-FP (fine-powder cisplatin and 5-fluorouracil), a hepatic arterial infusion chemotherapy regimen, is more favorable than sorafenib as an initial treatment for locally progressed HCC. METHODS: To avoid selection bias, we corrected the data from different facilities that did or did not perform New-FP therapy. In total, 1709 consecutive patients with HCC initially treated with New-FP or sorafenib; 1624 (New-FP, n = 644; sorafenib n = 980) were assessed. After propensity score matching (PSM), overall survival (OS) and prognostic factors were assessed (n = 344 each). Additionally, the patients were categorized into four groups: cohort-1 [ (without macrovascular invasion (MVI) and extrahepatic spread (EHS)], cohort-2 (with MVI), cohort-3 (with EHS), and cohort-4 (with MVI and EHS) to clarify the efficacy of each treatment. RESULTS: New-FP prolonged OS than sorafenib after PSM (New-FP, 12 months; sorafenib, 7.9 months; p < 0.001). Sorafenib treatment, and severe MVI and EHS were poor prognostic factors. In the subgroup analyses, the OS was significantly longer the New-FP group in cohort-2. CONCLUSIONS: Local treatment using New-FP is a potentially superior initial treatment compared with sorafenib as a multidisciplinary treatment in locally progressed HCC without EHS.
- Kazuko Sakai; Toshiharu Sakurai; Marco A De Velasco; Tomoyuki Nagai; Takaaki Chikugo; Kazuomi Ueshima; Yurie Kura; Takayuki Takahama; Hidetoshi Hayashi; Kazuhiko Nakagawa; Masatoshi Kudo; Kazuto NishioFrontiers in oncology 11 763468 - 763468 2021年Immune checkpoint inhibitors (ICIs) have become the standard of care for several cancers. However, ICI therapy has also been associated with various immune-related adverse events (irAEs). Clinical manifestations of immune-related colitis resemble those of inflammatory bowel diseases such as ulcerative colitis (UC). The composition of the bowel microflora is thought to influence the development of inflammatory bowel disease and irAE colitis. We profiled the gene expressions and microbe compositions of colonic mucosa from patients with solid cancers receiving anti-PD-L1 antibody treatment; we then compared the expression profiles associated with irAE colitis with those associated with UC. The pathway enrichment analysis revealed functional similarities between inflamed regions of irAE colitis and UC. The common enriched pathways included leukocyte extravasation and immune responses, whereas non-inflamed mucosa from patients with irAE colitis was distinct from patients with UC and was characterized by the recruitment of immune cells. A similarity between the microbiota profiles was also identified. A decreased abundance of Bacteroides species was observed in inflamed regions from both irAE colitis and UC based on a microbiota composition analysis of 16S rDNA sequencing. Pathways associated with molecule transport systems, including fatty acids, were enriched in inflamed and non-inflamed irAE colitis and inflamed UC, similar to Piphillin-inferred KEGG pathways. While UC is characterized by local regions of inflammation, ICI treatment extends to non-inflammatory regions of the colonial mucosa where immune cells are reconstituted. This analysis of the similarity and heterogeneity of irAE colitis and UC provides important information for the management of irAE colitis.
- Tomoko Aoki; Masatoshi Kudo; Kazuomi Ueshima; Masahiro Morita; Hirokazu Chishina; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Yasunori Minami; Masakatsu Tsurusaki; Naoshi NishidaCancers 12 10 2020年10月Although programmed cell death protein 1 (PD-1)/PD-ligand 1 (PD-L1) blockade is effective in a subset of patients with hepatocellular carcinoma (HCC), its therapeutic response is still unsatisfactory. Alternatively, the potential impact of the lenvatinib in patients who showed tumor progression on PD-1/PD-L1 blockade is unknown. In this work, we evaluated the safety and efficacy of lenvatinib administration after PD-1/PD-L1 checkpoint blockade. The outcome and safety of lenvatinib administered after PD-1/PD-L1 blockade failure was analyzed retrospectively in 36 patients. Tumor growth was assessed every 4-8 weeks using modified Response Evaluation Criteria in Solid Tumors. The mean relative dose intensity of lenvatinib was 87.6% and 77.8% in patients receiving a starting dose of 8 (interquartile range (IQR), 77.5-100.0) mg and 12 (IQR, 64.4-100.0) mg, respectively. Since lenvatinib therapy initiation, the median progression-free survival was 10 months (95% confidence interval (CI): 8.3-11.8) and the median overall survival was 15.8 months (95% CI: 8.5-23.2). The objective response rate was 55.6%, and the disease control rate was 86.1%. No particular safety concerns were observed. Lenvatinib demonstrated considerable antitumor effects with acceptable safety in patients with progressive and unresectable HCC when administered right after PD-1/PD-L1 blockade failure.
- Masatoshi Kudo; Manabu Morimoto; Michihisa Moriguchi; Namiki Izumi; Tetsuji Takayama; Hitoshi Yoshiji; Keisuke Hino; Takayoshi Oikawa; Tetsuhiro Chiba; Kenta Motomura; Junko Kato; Kentaro Yasuchika; Akio Ido; Takashi Sato; Daisuke Nakashima; Kazuomi Ueshima; Masafumi Ikeda; Takuji Okusaka; Kazuo Tamura; Junji FuruseCancer science 111 10 3759 - 3769 2020年10月A previous randomized phase 2 study of hepatocellular carcinoma revealed that the c-Met inhibitor tivantinib as second-line treatment significantly prolonged progression-free survival in a subpopulation whose tumor samples highly expressed c-Met (MET-high). Accordingly, this phase 3 study was conducted to evaluate the efficacy of tivantinib as a second-line treatment for Japanese patients with MET-high hepatocellular carcinoma. This randomized, double-blind, placebo-controlled study was conducted at 60 centers in Japan. Hepatocellular carcinoma patients with one prior sorafenib treatment and those with MET-high tumor samples were eligible for inclusion. Registered patients were randomly assigned to either the tivantinib or placebo group at a 2:1 ratio and were treated with twice-a-day oral tivantinib (120 mg bid) or placebo until the discontinuation criteria were met. The primary endpoint was progression-free survival while the secondary endpoints included overall survival and safety. Between January 2014 and June 2016, 386 patients provided consent, and 195 patients were randomized to the tivantinib (n = 134) or placebo (n = 61) group. Median progression-free survival was 2.8 (95% confidence interval: 2.7-2.9) and 2.3 (1.5-2.8) mo in the tivantinib and placebo groups, respectively (hazard ratio = 0.74, 95% confidence interval: 0.52-1.04, P = .082). Median overall survival was 10.3 (95% confidence interval: 8.1-11.6) and 8.5 (6.2-11.4) mo in the tivantinib and placebo group, respectively (hazard ratio = 0.82, 95% confidence interval: 0.58-1.15). The most common tivantinib-related grade ≥3 adverse events were neutropenia (31.6%), leukocytopenia (24.8%), and anemia (12.0%). This study did not confirm the significant efficacy of tivantinib as a second-line treatment for Japanese patients with MET-high hepatocellular carcinoma. (NCT02029157).
- Kazuomi Ueshima; Sadahisa Ogasawara; Masafumi Ikeda; Yutaka Yasui; Takeshi Terashima; Tatsuya Yamashita; Shuntaro Obi; Shinpei Sato; Hiroshi Aikata; Takumi Ohmura; Hidekatsu Kuroda; Takamasa Ohki; Kengo Nagashima; Yoshihiko Ooka; Masahiro Takita; Masayuki Kurosaki; Kazuaki Chayama; Shuichi Kaneko; Namiki Izumi; Naoya Kato; Masatoshi Kudo; Masao OmataLiver cancer 9 5 583 - 595 2020年09月Background: Prior to the approval of sorafenib, hepatic arterial infusion chemotherapy (HAIC) was offered to patients with advanced hepatocellular carcinoma (HCC) in East Asia, particularly Japan. According to the Japanese guidelines, HAIC is recommended as one of the treatment options in patients without extrahepatic metastasis (EHM). Methods: The present cohort study compared the use of HAIC and sorafenib on outcomes of patients with advanced HCC. Consecutive patients with advanced HCC who received HAIC or sorafenib as a first-line systemic therapy were enrolled from 10 Japanese institutions. The primary outcomes were overall survival (OS) in patients with macrovascular invasion (MVI), but without EHM, and OS in patients without both MVI and EHM. Results: Between 2009 and 2016, 2,006 patients were enrolled (541 HAIC patients, 1,465 sorafenib patients). After propensity score matching, the OS of patients with MVI but without EHM was significantly longer in the HAIC group compared with the sorafenib group (10.1 vs. 9.1 months for the HAIC and sorafenib groups, respectively; n = 170 for each group; hazard ratio [HR] 0.668; 95% confidence interval [95% CI] 0.475-0.935; p = 0.018). There was no significant difference in OS between patients without both MVI and EHM (12.2 vs. 15.4 months for the HAIC and sorafenib groups, respectively; n = 76 in each cohort after propensity score matching; HR 1.227; 95% CI 0.699-2.155; p = 0.475). Conclusion: HAIC is a potential front-line treatment choice in a subpopulation of patients with advanced HCC with MVI but without EHM.
- Masatoshi Kudo; Kazuomi Ueshima; Masafumi Ikeda; Takuji Torimura; Nobukazu Tanabe; Hiroshi Aikata; Namiki Izumi; Takahiro Yamasaki; Shunsuke Nojiri; Keisuke Hino; Hidetaka Tsumura; Teiji Kuzuya; Norio Isoda; Kohichiroh Yasui; Hajime Aino; Akio Ido; Naoto Kawabe; Kazuhiko Nakao; Yoshiyuki Wada; Osamu Yokosuka; Kenichi Yoshimura; Takuji Okusaka; Junji Furuse; Norihiro Kokudo; Kiwamu Okita; Philip James Johnson; Yasuaki AraiGut 69 8 1492 - 1501 2020年08月OBJECTIVE: This trial compared the efficacy and safety of transarterial chemoembolisation (TACE) plus sorafenib with TACE alone using a newly established TACE-specific endpoint and pre-treatment of sorafenib before initial TACE. DESIGN: Patients with unresectable hepatocellular carcinoma (HCC) were randomised to TACE plus sorafenib (n=80) or TACE alone (n=76). Patients in the combination group received sorafenib 400 mg once daily for 2-3 weeks before TACE, followed by 800 mg once daily during on-demand conventional TACE sessions until time to untreatable (unTACEable) progression (TTUP), defined as untreatable tumour progression, transient deterioration to Child-Pugh C or appearance of vascular invasion/extrahepatic spread. Co-primary endpoints were progression-free survival (PFS), which is not a conventional one but defined as TTUP, or time to any cause of death plus overall survival (OS). Multiplicity was adjusted by gatekeeping hierarchical testing. RESULTS: Median PFS was significantly longer in the TACE plus sorafenib than in the TACE alone group (25.2 vs 13.5 months; p=0.006). OS was not analysed because only 73.6% of OS events were reached. Median TTUP (26.7 vs 20.6 months; p=0.02) was also significantly longer in the TACE plus sorafenib group. OS at 1 year and 2 years in TACE plus sorafenib group and TACE alone group were 96.2% and 82.7% and 77.2% and 64.6%, respectively. There were no unexpected toxicities. CONCLUSION: TACE plus sorafenib significantly improved PFS over TACE alone in patients with unresectable HCC. Adverse events were consistent with those of previous TACE combination trials. TRIAL REGISTRATION NUMBER: NCT01217034.
- Naoshi Nishida; Kazuko Sakai; Masahiro Morita; Tomoko Aoki; Masahiro Takita; Satoru Hagiwara; Yoriaki Komeda; Mamoru Takenaka; Yasunori Minami; Hiroshi Ida; Kazuomi Ueshima; Kazuto Nishio; Masatoshi KudoLiver cancer 9 4 426 - 439 2020年08月Background and Aim: Immune checkpoint inhibitors are promising agents for the treatment of hepatocellular carcinomas (HCC) refractory to conventional therapies. To enhance the efficacy of this treatment, immunological and molecular characteristics of HCC with programmed cell death ligand 1 (PD-L1) should be explored. Methods: Clinical backgrounds, PD-L1 expression, and the amount of CD8+ tumor-infiltrating mononuclear cells (TIMCs) were analyzed in 154 HCCs. The expression of 3 stem cell markers and co-inhibitory receptors on tumor cells and TIMCs, respectively, were examined by immunohistochemical analysis. Somatic mutations in the 409 cancer-associated genes and TERT promoter were determined; HCCs were classified based on the presence of gene alterations affecting the 8 oncogenic pathways. The results were validated using the dataset from the Cancer Genome Atlas. Results: The expression of PD-L1 in the HCCs was positively correlated with progressive tumor features, the presence of cytokeratin 19 (CK19), Sal-like protein 4 (SALL4), and the mutations of genes involving the phosphatidyl inositol 3-kinase (PI3K)-Akt pathway. Although CD8+ cells were densely infiltrated in PD-L1-positive tumors, these TIMCs frequently expressed multiple co-inhibitory receptors. However, a subset of PD-L1-positive tumors characterized by activating mutations of the PI3K-Akt pathway showed a low degree of TIMCs. Conversely, PD-L1-negative HCCs were associated with mutations in the β-catenin pathway and a small number of TIMCs, although the expression of co-inhibitory receptors was rare. Conclusions: PD-L1-positive HCCs frequently showed an inflamed phenotype with stem cell features; a subset of PD-L1-positive HCCs with mutations in the PI3K-Akt pathway showed a non-inflamed phenotype. In HCCs with dense infiltration of TIMCs, CD8+ cells expressed multiple co-inhibitory receptors, suggesting T cell exhaustion. On the other hand, PD-L1-negative HCCs showed mutations leading to β-catenin activation and exhibited a non-inflamed background. These characteristics should be taken into consideration for developing novel combination therapies using immune checkpoint inhibitors.
- Yasunori Minami; Tomohiro Minami; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoHepatology research : the official journal of the Japan Society of Hepatology 50 1 67 - 74 2020年01月AIM: To retrospectively investigate the potential benefit of ultrasound-ultrasound (US-US) overlay fusion guidance for local controllability of radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC). METHODS: Patients (n = 101) with 121 HCCs (mean ± SD, 1.8 ± 0.7 cm) who underwent RFA guided by US-US overlay fusion were included in the retrospective study. By overlaying pre/postoperative US, the tumor image could be projected onto the ablative hyperechoic zone. The ablative margin could thereby be evaluated three-dimensionally during the RFA procedure. As a control group, all 325 patients with 453 HCCs who underwent conventional RFA during the same study period were selected. RESULTS: The total number of RF needle insertions per tumor for ablation was significantly more in the US overlay fusion group (mean 1.9 vs. 1.2; P < 0.01). The technical success rates of ablation after a single session were 100% (101/101) and 96.6% (314/325) for the US overlay fusion group and the control group, respectively. For early assessment of RFA response, 5-mm safety margins were achieved in 89.3% (108/121) and 47.0% (213/453) of nodules in the US overlay fusion group and the control group, respectively (P < 0.01). During the follow-up period (median 19 months), the 2-year local tumor progression rates were 0.8% (1/121) and 6.0% (27/453) in the US overlay fusion group and the control group, respectively (P = 0.022, log-rank test). CONCLUSIONS: US-US overlay fusion guidance can be highly effective for safety margin achievement in RFA for HCC, providing a lower risk of local tumor progression.
- Masahiro Morita; Chikara Ogawa; Akina Omura; Teruyo Noda; Atsushi Kubo; Toshihiro Matsunaka; Hiroyuki Tamaki; Mitsushige Shibatoge; Hiroshi Seno; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Naoshi Nishida; Masatoshi KudoInternal medicine (Tokyo, Japan) 59 4 471 - 477 2020年Objective The usefulness of contrast-enhanced ultrasonography (CEUS) for making decisions in the treatment of liver abscess is unknown. Methods We evaluated the internal blood flow in the arterial-predominant phase by CEUS using Sonazoid® in 21 patients. The stain area rate was evaluated in maximum parting plane of abscess in CEUS. Patients were divided into two groups: the vascular phase enhancement (VE) group, in which ≥50% of the abscess cavity was enhanced (12 patients), and the vascular phase non-enhancement (VNE) group, in which <50% of the abscess cavity was enhanced (9 patients). The rate of patients who were cured by conservative treatment alone was examined in both groups. The defect rate of all liver abscesses in the post-vascular phase was also evaluated. Results In the VE group, improvement by conservative treatment alone was obtained in 11 out of 12 patients (91.7%), while in the VNE group, improvement by conservative treatment alone was obtained in only 1 out of 9 patients (11.1%), a significant difference (p<0.001). In the VE group, one patient did not improve with conservative treatment alone because the abscess ruptured near the liver surface. In the VE group, the abscess size was smaller than in the VNE group. By examining the defect rate in the post-vascular phase, it was found that 16 out of 21 patients (76.2%) showed 71% or more defects. Conclusion The enhancement rate in the arterial-predominant phase of CEUS was considered useful for determining the treatment approach for liver abscess.
- Masatoshi Kudo; Kazuomi Ueshima; Yasutaka Chiba; Sadahisa Ogasawara; Shuntaro Obi; Namiki Izumi; Hiroshi Aikata; Hiroaki Nagano; Etsuro Hatano; Yutaka Sasaki; Keisuke Hino; Takashi Kumada; Kazuhide Yamamoto; Yasuharu Imai; Shouta Iwadou; Chikara Ogawa; Takuji Okusaka; Fumihiko Kanai; Yasuaki AraiLiver cancer 8 6 505 - 519 2019年11月Objective: In SILIUS (NCT01214343), combination of sorafenib and hepatic arterial infusion chemotherapy did not significantly improve overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC) compared with sorafenib alone. In this study, we explored the relationship between objective response by mRECIST and OS in the sorafenib group, in the combination group, and in all patients in the SILIUS trial. Methods: Association between objective response and OS in patients treated with sorafenib (n = 103) or combination (n = 102) and all patients (n = 205) were analyzed. The median OS of responders was compared with that of non-responders. Landmark analyses were performed according to objective response at several fixed time points, as sensitivity analyses, and the effect on OS was evaluated by Cox regression analysis with objective response as a time-dependent covariate, with other prognostic factors. Results: In the sorafenib group, OS of responders (n = 18) was significantly better than that of non-responders (n = 78) (p < 0.0001), where median OS was 27.2 (95% CI, 16.0-not reached) months for responders and 8.9 (95% CI, 6.5-12.6) months for non-responders. HRs from landmark analyses at 4, 6, and 8 months were 0.45 (p = 0.0330), 0.37 (p = 0.0053), and 0.36 (p = 0.0083), respectively. Objective response was an independent predictor of OS based on unstratified Cox regression analyses. In the all patients and the combination group, similar results were obtained. Conclusions: In the SILIUS trial, objective response by sorafenib assessed by mRECIST is an independent prognostic factor for OS in patients with HCC.
- Kudo Masatoshi; Ueshima Kazuomi; Chan Stephen L; Minami Tomohiro; Chishina Hirokazu; Aoki Tomoko; Takita Masahiro; Hagiwara Satoru; Minami Yasunori; Ida Hiroshi; Takenaka Mamoru; Sakurai Toshiharu; Watanabe Tomohiro; Morita Masahiro; Ogawa Chikara; Wada Yoshiyuki; Ikeda Masafumi; Ishii Hiroshi; Izumi Namiki; Nishida NaoshiHEPATOLOGY 70 133A - 134A 2019年10月 [査読有り]
- Satoru Hagiwara; Naoshi Nishida; Hiroshi Ida; Kazuomi Ueshima; Yasunori Minami; Masahiro Takita; Yoriaki Komeda; Masatoshi KudoJournal of medical virology 91 10 1804 - 1810 2019年10月Tenofovir alafenamide (TAF) is a newly developed prodrug of tenofovir (TFV). We divided 48 chronic hepatitis B patients who had taken entecavir (ETV) for ≥2 years into two groups: the ETV continuation (n = 24) and the TAF switching (n = 24) groups, and compared the antiviral effects and safety until 48 weeks after the start of the study. There were no significant differences in the alterations in the serum levels of HBs antigen (HBsAg) level between the ETV continuation and the TAF switching groups at 24 or 48 weeks. We also examined the effect of baseline HBsAg level on the decrease of HBsAg during the treatment; in the TAF switching group, the decrease of HBsAg level at 48 weeks was more significant in patients with low baseline HBsAg (<800 IU/mL) than those with high baseline HBsAg ( >800 IU/mL) (change of HBsAg; - 0.029 vs - 0.132 for high and low baseline HBsAg, respectively, P = .007). Also, the effect on renal function was found to be comparable between the TAF switch group and the ETV continuation group. In this study, switching from ETV to TAF may represent higher efficacy for a decrease of HBsAg than a continuation of ETV among the patients with low baseline HBsAg level.
- Masatoshi Kudo; Masafumi Ikeda; Kazuomi Ueshima; Michiie Sakamoto; Shuichiro Shiina; Ryosuke Tateishi; Kiyoshi Hasegawa; Junji Furuse; Shiro Miyayama; Takamichi Murakami; Tatsuya Yamashita; Norihiro KokudoHepatology research : the official journal of the Japan Society of Hepatology 49 9 981 - 989 2019年09月Response Evaluation Criteria in Solid Tumors (RECIST) is inappropriate to assess the direct effects of treatment on hepatocellular carcinoma (HCC) by locoregional therapies, such as radiofrequency ablation and transarterial chemoembolization. Therefore, establishment of response evaluation criteria solely devoted to HCC is needed in clinical practice, as well as in clinical trials of HCC treatment, such as systemic therapies, which cause necrosis of the tumor. Response Evaluation Criteria in Cancer of the Liver (RECICL) was revised in 2019 by the Liver Cancer Study Group of Japan based on the 2015 version of RECICL, which was commonly used in Japan. The major revised points of the RECICL 2019 are as follows: (i) CEA and CA19-9 have been newly added as tumor markers that should be recorded for use as criteria in the response evaluation for intrahepatic cholangiocarcinoma; (ii) the criteria now state that the details of molecular targeted therapy should be specified; and (iii) specific methods for overall evaluation are now described. Also, as an assessment of overall TE4 requires that TE4 is achieved in all nodules (even non-target lesions), the same calculation methods described above are used. We hope this new treatment response criteria, RECICL, proposed by the Liver Cancer Study Group of Japan will benefit the HCC treatment response evaluation in the setting of daily clinical practice and clinical trials as well, not only in Japan, but also internationally.
- Masatoshi Kudo; Kazuomi Ueshima; Stephan Chan; Tomohiro Minami; Hirokazu Chishina; Tomoko Aoki; Masahiro Takita; Satoru Hagiwara; Yasunori Minami; Hiroshi Ida; Mamoru Takenaka; Toshiharu Sakurai; Tomohiro Watanabe; Masahiro Morita; Chikara Ogawa; Yoshiyuki Wada; Masafumi Ikeda; Hiroshi Ishii; Namiki Izumi; Naoshi NishidaCancers 11 8 2019年07月Although transcatheter arterial chemoembolization (TACE) is the standard of care for intermediate-stage hepatocellular carcinoma (HCC), this is a largely heterogeneous disease that includes a subgroup of patients who do not benefit from TACE. The treatment strategy for this subgroup of patients currently remains an unmet need in clinical practice. Here, we performed a proof-of-concept study that lenvatinib may be a more favorable treatment option over TACE as an initial treatment in intermediate-stage HCC patients with large or multinodular tumours exceeding the up-to-seven criteria. This proof-of-concept study included 642 consecutive patients with HCC initially treated with lenvatinib or conventional TACE (cTACE) between January 2006 and December 2018. Of these patients, 176 who received lenvatinib or cTACE as an initial treatment and met the eligibility criteria (unresectable, beyond the up-to-seven criteria, no prior TACE/systemic therapy, no vascular invasion, no extrahepatic spread and Child-Pugh A liver function) were selected for the study. Propensity score matching was used to adjust for patient demographics. After propensity-score matching, the outcome of 30 patients prospectively treated with lenvatinib (14 in clinical trials, one in an early access program and 15 in real world settings) and 60 patients treated with cTACE as the initial treatment was compared. The change of albumin-bilirubin (ALBI) score from baseline to the end of treatment were -2.61 to -2.61 for 30 patients in the lenvatinib group (p = 0.254) and -2.66 to -2.09 in the cTACE group (p < 0.01), respectively. The lenvatinib group showed a significantly higher objective response rate (73.3% vs. 33.3%; p < 0.001) and significantly longer median progression-free survival than the cTACE group (16.0 vs. 3.0 months; p < 0.001). Overall survival was significantly longer in the lenvatinib group than in the cTACE group (37.9 vs. 21.3 months; hazard ratio: 0.48, p < 0.01). In patients with large or multinodular intermediate-stage HCC exceeding the up-to-seven criteria with Child-Pugh A liver function, who usually do not benefit from TACE, lenvatinib provides a more favorable outcome than TACE.
- Kazuomi Ueshima; Naoshi Nishida; Satoru Hagiwara; Tomoko Aoki; Tomohiro Minami; Hirokazu Chishina; Masahiro Takita; Yasunori Minami; Hiroshi Ida; Mamoru Takenaka; Toshiharu Sakurai; Tomohiro Watanabe; Masahiro Morita; Chikara Ogawa; Atsushi Hiraoka; Philip Johnson; Masatoshi KudoCancers 11 7 2019年07月BACKGROUND: This study investigated the impact of baseline liver function according to the Child-Pugh score and ALBI (albumin-bilirubin) grade on the outcomes of patients with unresectable hepatocellular carcinoma treated with lenvatinib. METHODS: A total of 82 lenvatinib treated patients were included. The correlations of baseline liver function according to the Child-Pugh score and ALBI grade with treatment outcomes, including objective response rate per mRECIST (modified Response Evaluation Criteria in the Solid Tumor), time to treatment failure, treatment duration, and likelihood of treatment discontinuation due to adverse events, were assessed in patients with hepatocellular carcinoma treated with lenvatinib. Patients were divided into four groups: (1) Child-Pugh score 5 and ALBI grade 1 (group 1), (2) Child-Pugh score 5 and ALBI grade 2 (group 2), (3) Child-Pugh score 6 (group 3), and (4) Child-Pugh score ≥7 (group 4). Univariate and multivariate analyses were performed to identify the factors contributing to the objective response rate and likelihood of discontinuation due to adverse events. Results: Among the 82 patients analyzed, group 1 had the highest objective response rate (57.1%) and the lowest likelihood of treatment discontinuation because of adverse events (11.1%) among the four groups (p < 0.05 and p < 0.05). Multivariate analysis identified ALBI grade 1 and baseline AFP level <200 ng/mL as the significant predictors of a high objective response rate (p < 0.05 and p < 0.01), and confirmed that patients with ALBI grade 1 had the lowest probability of treatment discontinuation due to adverse events (p < 0.01). Conclusions: Patients with Child-Pugh score of 5 and ALBI grade 1 predicted a higher response rate and lower treatment discontinuation due to adverse events by lenvatinib treatment.
- Masatoshi Kudo; Kazuomi Ueshima; Yukio Osaki; Masashi Hirooka; Yasuharu Imai; Kazunobu Aso; Kazushi Numata; Masayuki Kitano; Takashi Kumada; Namiki Izumi; Yasukiyo Sumino; Chikara Ogawa; Kohei AkazawaLiver cancer 8 4 271 - 280 2019年07月Background: Current practice guidelines recommend the use of ultrasound (US) as an initial surveillance tool for hepatocellular carcinoma (HCC) in patients with liver cirrhosis. Patients with liver cirrhosis, however, frequently have coarse liver parenchyma, masking the presence of tiny nodules during B-mode US. Contrast-enhanced US (CEUS) with Sonazoid has a long-lasting, stable Kupffer phase, which makes it possible to scan the entire liver to depict small lesions. In addition, defect reperfusion imaging (reinjection imaging) enables to determine whether the detected nodule is HCC or not. This prospective, multicenter, randomized, controlled trial was conducted to demonstrate the usefulness of Kupffer phase surveillance in the detection of small HCC compared to B-mode US. Methods: A total of 23 institutions joined this study. In total, 656 patients with hepatitis B- or C-related liver cirrhosis were randomized either to the B-mode US surveillance group (n = 313) or the Kupffer phase CEUS with Sonazoid surveillance group (n = 309). The primary endpoint was the maximum size of HCC at the time of the first detection. Secondary endpoints included time to HCC detection, number of tumors, and Barcelona Clinic Liver Cancer stage at the first detection, and sensitivity, specificity, and accuracy of each method in the diagnosis, and the cumulative detection rate of HCC. Results: The mean HCC size at the first detection was significantly smaller in the CEUS (13.0 ± 4.1 mm; n = 28) than in the B-mode US group (16.7 ± 4.1 mm; n = 26) (p = 0.011). Of the 38 patients with HCV cirrhosis diagnosed with HCC by US alone, mean tumor size at the first detection was significantly smaller in the 20 patients diagnosed by CEUS alone than in the 18 diagnosed by B-mode US alone (12.7 ± 3.1 vs. 17.6 ± 7.0 mm, p = 0.012). In contrast, among the 16 patients with HBV cirrhosis diagnosed by US alone, mean tumor size at the first detection was similar in the 8 patients diagnosed by CEUS alone and the 8 diagnosed by B-mode US (13.6 ± 6.0 vs. 14.5 ± 2.7 mm, p = 0.715). Conclusion: Kupffer phase CEUS surveillance with Sonazoid is extremely useful for the early detection and confirmation of HCC using a reinjection technique. Kupffer phase CEUS with Sonazoid contrast combined with the reinjection technique is, therefore, recommended as first-line screening tool for HCC in patients with liver cirrhosis, especially those with very coarse liver parenchyma.
- Masatoshi Kudo; Kazuomi Ueshima; Osamu Yokosuka; Sadahisa Ogasawara; Shuntaro Obi; Namiki Izumi; Hiroshi Aikata; Hiroaki Nagano; Etsuro Hatano; Yutaka Sasaki; Keisuke Hino; Takashi Kumada; Kazuhide Yamamoto; Yasuharu Imai; Shouta Iwadou; Chikara Ogawa; Takuji Okusaka; Fumihiko Kanai; Kohei Akazawa; Ken-Ichi Yoshimura; Philip Johnson; Yasuaki AraiThe lancet. Gastroenterology & hepatology 3 6 424 - 432 2018年06月BACKGROUND: Hepatic arterial infusion chemotherapy plus sorafenib in phase 2 trials has shown favourable tumour control and a manageable safety profile in patients with advanced, unresectable hepatocellular carcinoma. However, no randomised phase 3 trial has tested the combination of sorafenib with continuous arterial infusion chemotherapy. We aimed to compare continuous hepatic arterial infusion chemotherapy plus sorafenib with sorafenib alone in patients with advanced, unresectable hepatocellular carcinoma. METHODS: We did an open-label, randomised, phase 3 trial (SILIUS) at 31 sites in Japan. Eligible patients were aged 20 years or older, with advanced hepatocellular carcinoma not suitable for resection, local ablation, or transarterial chemoembolisation; Eastern Cooperative Oncology Group (ECOG) performance status 0-1; Child-Pugh score 7 or lower; and adequate bone marrow, liver, and renal function. Patients were randomly assigned (1:1) via an interactive web response system with a computer-generated sequence to receive 400 mg sorafenib orally twice daily or 400 mg sorafenib orally twice daily plus hepatic arterial infusion chemotherapy (cisplatin 20 mg/m2 on days 1 and 8 and fluorouracil 330 mg/m2 continuously on days 1-5 and 8-12 of every 28-day cycle via an implanted catheter system). The primary endpoint was overall survival. The primary efficacy analysis comprised all randomised patients (the intention-to-treat population), and the safety analysis comprised all randomised patients who received at least one dose of study treatment. This trial is registered with ClinicalTrials.gov, number NCT01214343. FINDINGS: Between Nov 4, 2010, and June 10, 2014, 206 patients were randomly assigned (103 to the sorafenib group, 103 to the sorafenib plus hepatic arterial infusion chemotherapy group). One patient in the sorafenib plus hepatic arterial infusion chemotherapy group withdrew after randomisation. Median overall survival was similar in the sorafenib plus hepatic arterial infusion chemotherapy (n=102) and sorafenib monotherapy (n=103) groups (11·8 months [95% CI 9·1-14·5] vs 11·5 months [8·2-14·8]; hazard ratio 1·009 [95% CI 0·743-1·371]; p=0·955). Grade 3-4 adverse events that were more frequent in the sorafenib plus hepatic arterial infusion chemotherapy group than in the sorafenib monotherapy group included anaemia (15 [17%] of 88 vs six [6%] of 102), neutropenia (15 [17%] vs one [1%]), thrombocytopenia (30 [34%] vs 12 [12%]), and anorexia (12 [14%] vs six [6%]). INTERPRETATION: Addition of hepatic arterial infusion chemotherapy to sorafenib did not significantly improve overall survival in patients with advanced hepatocellular carcinoma. FUNDING: Japanese Ministry of Health, Labour and Welfare.
- Yasunori Minami; Tomohiro Minami; Satoru Hagiwara; Hiroshi Ida; Kazuomi Ueshima; Naoshi Nishida; Takamichi Murakami; Masatoshi KudoEuropean radiology 28 5 1986 - 1993 2018年05月OBJECTIVES: To assess the clinical feasibility of US-US image overlay fusion with evaluation of the ablative margin in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). METHODS: Fifty-three patients with 68 HCCs measuring 0.9-4.0 cm who underwent RFA guided by US-US overlay image fusion were included in this retrospective study. By an overlay of pre-/postoperative US, the tumor image could be projected onto the ablative hyperechoic zone. Therefore, the ablative margin three-dimensionally could be shown during the RFA procedure. US-US image overlay was compared to dynamic CT a few days after RFA for assessment of early treatment response. Accuracy of graded response was calculated, and the performance of US-US image overlay fusion was compared with that of CT using a Kappa agreement test. RESULTS: Technically effective ablation was achieved in a single session, and 59 HCCs (86.8 %) succeeded in obtaining a 5-mm margin on CT. The response with US-US image overlay correctly predicted early CT evaluation with an accuracy of 92.6 % (63/68) (k = 0.67; 95 % CI: 0.39-0.95). CONCLUSION: US-US image overlay fusion can be proposed as a feasible guidance in RFA with a safety margin and predicts early response of treatment assessment with high accuracy. KEY POINTS: • US-US image overlay fusion visualizes the ablative margin during RFA procedure. • Visualizing the margin during the procedure can prompt immediate complementary treatment. • US image fusion correlates with the results of early evaluation CT.
- Satoru Hagiwara; Naoshi Nishida; Tomohiro Watanabe; Hiroshi Ida; Toshiharu Sakurai; Kazuomi Ueshima; Masahiro Takita; Yoriaki Komeda; Norihiro Nishijima; Yukio Osaki; Masatoshi KudoAntiviral therapy 23 6 513 - 521 2018年BACKGROUND: Although the efficacy of combination therapy with lamivudine or tenofovir and pegylated interferon (PEG-IFN) has been reported in patients with chronic hepatitis B (CHB), the long-term effect of the combination based on the observation of clinical course remains to be clarified. We previously reported the efficacy of combination therapy with entecavir (ETV) and PEG-IFN. Here, we investigated the long-term effect of this combination in patients with CHB. METHODS: We administered both ETV and PEG-IFN-α2a or -2b simultaneously to 26 patients with HBV genotype C infection. Treatment was continued for 48 weeks followed by 24 weeks of observation period; we examined the virological and biochemical responses. We also analysed characteristics related to the post-treatment relapse. Finally, we investigated the long-term therapeutic effects. RESULTS: Average reduction of intra-hepatic cccDNA level was 1.2 log copies/μg at the completion of administration. Pretreatment hepatitis B surface antigen (HBsAg) level with more than 3.5 log U/ml was identified as a predictive factor for relapse. Furthermore, the cumulative rates of HBsAg-negative patients at 1, 3 and 5 years after the completion of administration were 3.8, 8.4 and 15%, respectively (mean follow-up period: 4.8 years). CONCLUSIONS: Baseline HBsAg level with more than 3.5 log U/ml is a useful predictor for relapse 24 weeks after the completion of administration in patients treated with combination therapy. Combination with ETV and PEG-IFN could be an option for treatment of CHB patients especially in those with baseline HBsAg levels of less than 3.5 log U/ml.
- S. Kobayashi; K. Ueshima; M. Moriguchi; T. Takayama; N. Izumi; H. Yoshiji; K. Hino; T. Oikawa; T. Chiba; K. Motomura; J. Kato; K. Yasuchika; A. Ido; J. Kinoshita; T. Sato; M. Ikeda; T. Okusaka; M. Kudo; K. Tamura; J. FuruseANNALS OF ONCOLOGY 28 2017年09月
- Tadaaki Arizumi; Kazuomi Ueshima; Mina Iwanishi; Tomohiro Minami; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Hiroshi Ida; Yoriaki Komeda; Mamoru Takenaka; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoLiver cancer 6 3 227 - 235 2017年06月AIM/BACKGROUND: The ultimate aim of any treatment for hepatocellular carcinoma (HCC) is to improve overall survival (OS); however, the clinical significance of time to progression (TTP) after transarterial chemoembolization (TACE) is unclear. This retrospective study examined the association between OS and the newly defined time to TACE progression (TTTP) to assess whether TTTP can be an alternative to OS in HCC patients with Barcelona Clinic Liver Cancer (BCLC) stage B. METHODS: Between January 2006 and December 2013, 592 patients with HCC (BCLC B1, n = 118; BCLC B2, n = 170) underwent TACE. TTTP was then redefined as time to progression from the first image taken after TACE. The relationship between TTTP and OS was then examined based on survival time. RESULTS: Survival analysis revealed significant differences in the OS of patients with BCLC B1 and those with BCLC B2 (median OS: 42.3 months, 95% confidence interval [CI] 34.4-50.7; and 29.3 months, 95% CI 26.1-37.6, respectively, p = 0.0348). The median TTTP values were 9.5 months (95% CI 7.0-10.9) and 5.3 months (95% CI 4.6-6.7), respectively (p = 0.0078). There was a moderate positive correlation between OS and TTTP for both B1 (R2 = 0.6563, p = 0.0045) and B2 (R2 = 0.6433, p = 0.0052) substages. There was also a positive correlation between OS and TTTP for the combined B1 and B2 substages (R2 = 0.6590, p = 0.0024). CONCLUSIONS: There was a moderate correlation between the TTTP and OS of patients with HCC after TACE therapy, where the patients with short TTTP represented short OS, indicating that TTTP is an alternative parameter for survival analysis of HCC patients with BCLC stage B tumors who undergo TACE.
- Yasunori Minami; Masahiro Takita; Masakatsu Tsurusaki; Yukinobu Yagyu; Kazuomi Ueshima; Takamichi Murakami; Masatoshi KudoHepatology research : the official journal of the Japan Society of Hepatology 47 3 E113-E119 2017年03月AIM: To investigate whether plain cone-beam computed tomography (CT) immediately after conventional transcatheter arterial chemoembolization (c-TACE) can help to predict tumor response semiquantitatively in patients with hepatocellular carcinoma (HCC). METHODS: Analysis was carried out retrospectively on 262 targeted HCCs in 169 patients treated with c-TACE. Dynamic CT was performed at baseline and 1-4 months after c-TACE. Receiver-operating characteristic curve analysis was undertaken to evaluate whether voxel values of cone-beam CT could predict a complete response and to identify the cut-off value. Final tumor response assessment and early prediction using the retention pattern of iodized oil, the cut-off value of the density, and the combination of the cut-off density value and retention pattern of iodized oil in HCCs on postprocedural cone-beam CT were compared. RESULTS: Complete response was obtained in 72.9% of lesions. According to the pattern of iodized oil uptake, the sensitivity, specificity, and accuracy for predicting complete response were 85.9%, 70.4%, and 81.7%, respectively by excellent uptake on cone-beam CT. The area under the curve was 0.86 with the optimal cut-off at a voxel value of 200.13. According to not only the density but also the homogeneity of iodized oil retention, the sensitivity, specificity, and accuracy values for predicting complete response were 86.4%, 95.8%, and 88.9%, respectively. The predictive accuracy was significantly better than that of the pattern of iodized oil retention only (P = 0.019). CONCLUSION: The combination of density and visual estimate of homogeneity is superior to either alone in predicting tumor response of c-TACE in HCC patients.
- Kazuomi Ueshima; Masatoshi KudoJournal of Japanese Society of Gastroenterology 114 9 1621 - 1628 2017年 [査読有り]
- Kwok WY; Hagiwara S; Nishida N; Watanabe T; Sakurai T; Ida H; Minami Y; Takita M; Minami T; Iwanishi M; Chishina H; Kono M; Ueshima K; Komeda Y; Arizumi T; Enoki E; Nakai T; Kumabe T; Nakashima O; Kondo F; Kudo MOncology 92 Suppl 1 16 - 28 2017年
- Satoru Hagiwara; Naoshi Nishida; Tomohiro Watanabe; Toshiharu Sakurai; Hiroshi Ida; Yasunori Minami; Masahiro Takita; Tomohiro Minami; Mina Iwanishi; Hirokazu Chishina; Kazuomi Ueshima; Yoriaki Komeda; Tadaaki Arizumi; Masatoshi KudoOncology 92 Suppl 1 3 - 9 2017年INTRODUCTION: Recently, the treatment of chronic hepatitis C has markedly advanced. A phase III clinical study of combination therapy with sofosbuvir (SOF) and ledipasvir (LDV) was conducted in Japan, and the additive therapeutic effects were reported. In this study, we report the results of treatment in our hospital. METHODS: Of 147 patients with chronic type C liver disease who had consulted our hospital since September 2015 and received SOF/LDV therapy, in 91 subjects a sustained virological response of 12 weeks (SVR12) could be evaluated. RESULTS: In all 91 patients, end treatment response was achieved. Subsequently, recrudescence was noted in 1 before the completion of treatment (week 12); an SVR12 was achieved in 90 patients (99%). The following adverse reactions were observed in 3 patients (3.3%): bradycardia, paroxysmal atrial fibrillation, and heart failure with QT prolongation, which were associated with heart disease. CONCLUSION: A favorable SVR was achieved by SOF/LDV therapy even in elderly patients, those with liver cirrhosis, or those having undergone radical treatment of liver cancer. Furthermore, a high tolerance was demonstrated, but adverse reactions associated with the heart may appear in patients with heart disease as an underlying disease; strict management during treatment is necessary.
- Masashi Kono; Yasunori Minami; Mina Iwanishi; Tomohiro Minami; Hirokazu Chishina; Tadaaki Arizumi; Yoriaki Komeda; Toshiharu Sakurai; Masahiro Takita; Norihisa Yada; Hiroshi Ida; Satoru Hagiwara; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoOncology 92 Suppl 1 29 - 34 2017年OBJECTIVE: To compare contrast tissue harmonic imaging (THI) with low mechanical index (MI) and conventional contrast harmonic imaging (CHI) with respect to lesion visibility of hepatocellular carcinoma (HCC). METHODS: One hundred and twenty-five patients (84 men and 41 women, age range 39-94 years, mean age 74 years) with 100 naïve HCCs and 30 lesions after radiofrequency ablation (RFA) for HCC were evaluated. One hundred and four patients had liver cirrhosis of Child-Pugh class A, and the remaining 21 had Child-Pugh class B cirrhosis. The lesion conspicuity and intratumoral echogenicity during the postvascular phase were compared using conventional CHI and contrast THI with low MI. RESULTS: The MI values ranged from 0.20 to 0.30 on conventional CHI and from 0.30 to 0.35 on contrast THI. Regarding HCC lesion conspicuity, contrast THI with low MI was clearer in 79 lesions (60.8%), equal in 34 lesions (26.2%), and less clear in 17 lesions (13.1%) when compared with conventional CHI. The lesion conspicuity with contrast THI was significantly better than that with conventional CHI (p < 0.01). All of the postablative lesions were well delineated in patients who received RFA. CONCLUSION: Low-MI contrast THI was superior to conventional CHI with respect to lesion visibility of HCCs and might offer good imaging for the guiding of RFA.
- Wing Yee Kwok; Satoru Hagiwara; Naoshi Nishida; Tomohiro Watanabe; Toshiharu Sakurai; Hiroshi Ida; Yasunori Minami; Masahiro Takita; Tomohiro Minami; Mina Iwanishi; Hirokazu Chishina; Masashi Kono; Kazuomi Ueshima; Yoriaki Komeda; Tadaaki Arizumi; Eisuke Enoki; Takuya Nakai; Tsutomu Kumabe; Osamu Nakashima; Fukuo Kondo; Masatoshi KudoOncology 92 Suppl 1 16 - 28 2017年The patient was a 20-year-old male in whom a hepatic hypervascular mass accompanied by intratumoral hemorrhage was detected on examination for epigastric pain. Based on the enlargement of the mass and diagnostic imaging, hepatocellular adenoma (HCA) was suspected and hepatectomy was performed. The lesion was diagnosed as malignant transformation of β-catenin-activated HCA. There are only few reports of cases with malignant transformation of HCA in Japan; it is necessary to accumulate cases to investigate it.
- Norihisa Yada; Toshiharu Sakurai; Tomohiro Minami; Tadaaki Arizumi; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoOncology 92 Suppl 1 10 - 15 2017年OBJECTIVE: In order to evaluate the influence of liver inflammation on liver stiffness measurement (LSM) by the simultaneous use of shear wave and strain imaging (combinational elastography), shear wave and strain imaging were compared before and after initial therapy for autoimmune hepatitis (AIH). METHODS: Nine AIH patients initially treated with steroid were enrolled. Transient elastography and real-time tissue elastography were performed just before and 1 month after the start of initial steroid treatment. Blood samples, LSM, and the liver fibrosis index (LFI) were compared. RESULTS: Aspartate aminotransferase (p = 0.002) and alanine aminotransferase (ALT) (p = 0.015) were significantly decreased after initial treatment. The LSM was 15.5 ± 9.6 kPa at baseline, decreasing to 7.2 ± 2.3 kPa after initial treatment p = 0.034). The LFI was 1.67 ± 0.67 at baseline and 1.61 ± 0.66 after initial treatment; no significant change in LFI was recognized (p = 0.842). Between ΔALT and ΔLSM, a significant regression equation could be calculated as follows: ΔALT = -0.55 + 0.654 × ΔLSM. CONCLUSIONS: Combinational elastography was useful in evaluating not only the degree of liver fibrosis, but also the degree of liver inflammation in AIH.
- Yasuko Umehara; Satoru Hagiwara; Naoshi Nishida; Toshiharu Sakurai; Hiroshi Ida; Yasunori Minami; Masahiro Takita; Tomohiro Minami; Hirokazu Chishina; Kazuomi Ueshima; Yoriaki Komeda; Tadaaki Arizumi; Tomohiro Watanabe; Masatoshi KudoDigestive diseases (Basel, Switzerland) 35 6 548 - 555 2017年OBJECTIVE: It is a generally accepted fact that eradication of hepatitis virus C inhibits the subsequent development of hepatocellular carcinoma (HCC). On the contrary, a significant population of patients developed HCC despite sustained virological responses (SVRs) to interferon (IFN) therapy. METHODS: A total of 415 patients with chronic hepatitis C, who were treated at our hospital between 2004 and 2014, were enrolled for this study. We examined the risk factors for HCC development after IFN therapy. RESULTS: After analyzing various clinical parameters, it was concluded that a serum albumin (ALB) level <4.0 g/dL and the presence or absence of SVR achievement were risk factors for the development of HCC. When analyzing pre- and posttreatment factors, only a serum ALB level <4.0 g/dL was considered a significant risk factor. The presence or absence of liver fibrosis progression was not identified as a risk factor. CONCLUSIONS: In patients with a serum ALB level <4.0 g/dL before IFN therapy, hepatic carcinogenesis after SVR achievement need to be considered. Furthermore, the serum ALB level may be more useful than the degree of fibrosis for the prediction of HCC after SVR in chronic hepatitis C.
- Masashi Kono; Naoshi Nishida; Satoru Hagiwara; Tomohiro Minami; Hirokazu Chishina; Tadaaki Arizumi; Kosuke Minaga; Ken Kamata; Yoriaki Komeda; Toshiharu Sakurai; Mamoru Takenaka; Masahiro Takita; Norihisa Yada; Hiroshi Ida; Yasunori Minami; Kazuomi Ueshima; Tomohiro Watanabe; Masatoshi KudoDigestive diseases (Basel, Switzerland) 35 6 556 - 564 2017年BACKGROUND AND AIMS: Direct-acting antivirals (DAAs) dramatically improve the sustained virological response (SVR) of chronic hepatitis C (CHC) patients. However, continuous liver damage after SVR may be a risk of hepatocellular carcinoma (HCC). We clarified pretreatment characteristics related to sustained liver damage after SVR. METHODS: A total of 286 CHC patients were treated with an interferon-free DAA regimen. Among them, 250 patients achieved SVR for 12 weeks after the end of treatment (SVR12); these individuals were classified based on α-fetoprotein (AFP) and alanine transaminase (ALT) levels posttreatment. Baseline characteristics significantly associated with AFP >5 ng/mL and ALT level ≥20 IU/L after SVR were clarified using multivariate analyses. RESULTS: Among the pretreatment factors examined, serum AFP values and the presence of fatty liver (FL) were significantly associated with abnormal AFP (p < 0.0001) and ALT levels 12 weeks after SVR12 (SVR24; p = 0.0109). For 126 patients who showed an increase in baseline AFP level, FL, fibrosis-4 (FIB-4) index, and albumin levels before treatment were related to abnormal AFP at SVR24 (p = 0.0005, 0.0232, and 0.0400 for FL, FIB-4 index, and albumin, respectively). Similarly, for 150 patients with abnormal baseline ALT levels, FL was associated with an ALT level ≥ 30 IU/L after SVR (p = 0.0430). CONCLUSIONS: High FIB-4 index, low albumin level, and FL before DAA treatment were associated with a risk of sustained liver damage with AFP and ALT elevation after SVR; patients with these factors should be carefully monitored for emergence of HCC.
- Hiroshi Ida; Satoru Hagiwara; Masashi Kono; Tomohiro Minami; Hirokazu Chishina; Tadaaki Arizumi; Masahiro Takita; Norihisa Yada; Yasunori Minami; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoDigestive diseases (Basel, Switzerland) 35 6 565 - 573 2017年BACKGROUND: Interferon-based antiviral therapies against hepatitis C virus (HCV) infection have been shown to reduce the incidence of hepatocellular carcinoma (HCC) in patients with sustained viral response (SVR). Recently, direct-acting antivirals (DAAs) have been proven to be much more effective in achieving SVR than interferon-based therapies. However, whether DAAs can efficiently prevent the occurrence of HCC after SVR remains controversial. To clarify this issue, we analyzed the clinical features of patients in whom HCC developed after achievement of SVR with DAAs for chronic HCV infection. SUMMARY: Among patients who achieved SVR with daclatasvir and asunaprevir (n = 100), HCC developed in 17 patients (HCC group; n = 17) and did not develop in 83 patients (non-HCC group; n = 83) during a mean observation period of 15 months. A multivariate Cox proportional hazards analysis identified past history of HCC and male sex as significant risk factors for the emergence of HCC after DAAs. Sixteen cases with HCC after DAAs were in the very early or early stage (16/17, 94.1%), and one case was in the advanced stage (1/17, 5.9%) with portal venous tumor thrombus. Radiofrequency ablation and/or transarterial chemoembolization were performed in most cases as curative therapy (16/17, 94.1%). Key Messages: SVR by DAAs did not completely prevent the occurrence of HCC. However, even if HCC did develop after SVR, curative anticancer therapy was applicable in most cases.
- Tadaaki Arizumi; Tomohiro Minami; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Hiroshi Ida; Kazuomi Ueshima; Ken Kamata; Kosuke Minaga; Yoriaki Komeda; Mamoru Takenaka; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoDigestive diseases (Basel, Switzerland) 35 6 583 - 588 2017年BACKGROUND: Tumors classified based on the Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) are heterogeneous in nature. Previously, the Kinki criterion was proposed for a more precise subclassification of tumors in BCLC-stage B. However, tumors in sub-stage B2 include various size and number of HCCs even with the Kinki criteria, which could lead to heterogeneity for overall survival (OS). In this study, we assessed how the size and number of tumors affect the OS and time to progression (TTP) in patients with Kinki criteria stage B2 tumors and treated with transarterial chemoembolization (TACE). METHODS: Of 906 HCC patients treated with TACE at Kindai University Hospital, 236 patients with HCC considered as Kinki criteria stage B2 were examined. They were classified into the following 4 groups according to the maximum tumor diameter and number of tumors: B2a group, tumor size ≤6 cm and total number of tumors ≤6; B2b group, size ≤6 cm and number >6; B2c group, size >6 cm and number ≤6; and B2d group, size >6 cm and number >6. The OS and TTP of patients in each group were compared. RESULTS: There were 131 patients (55.5%) in the B2a group, 58 (24.6%) in the B2b group, 41 (17.4%) in the B2c group, and 6 (0.03%) in the B2d group. Comparison of the survivals revealed that the median OS was 2.8 years (95% CI 2.0-3.5) in the B2a group, 2.8 years (95% CI 2.0-3.3) in the B2b group, 1.9 years (95% CI 0.8-4.0) in the B2c group, and 2.3 years (95% CI 1.2-ND [no data]) in the B2d group, respectively (p = 0.896). The median TTP in B2a, B2b, B2c, and B2d sub-substage HCC were13.2, 12.1, 13.8, and 11.5 months, respectively (p = 0.047). The median TTP in B2a + B2c sub-substage patients was longer than that in B2b + B2d sub-substage HCC patients (14.0 months and 10.4 months; p = 0.002). CONCLUSION: No significant differences were observed in the OS among HCC patients subclassified based on the maximum tumor diameter and tumor number in Kinki criteria stage B2. Consequently, Kinki criteria stage B2 HCC is a homogeneous subgroup in terms of OS prediction. However, shorter TTP in B2b+B2c sub-substage HCC patients than that in B2a + B2c sub-substage HCC patients suggests that different treatment strategy, such as systemic therapy with targeted agents instead of TACE, may be suitable to preserve the liver function.
- Tadaaki Arizumi; Tomohiro Minami; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Hiroshi Ida; Kazuomi Ueshima; Ken Kamata; Kosuke Minaga; Yoriaki Komeda; Mamoru Takenaka; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoDigestive diseases (Basel, Switzerland) 35 6 589 - 597 2017年BACKGROUND: Transarterial chemoembolization (TACE) is recommended for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage B. However, because of the heterogeneity of HCC in BCLC stage B; various subclassification systems have been proposed to predict the prognosis of patients. Previously, we proposed the Kinki criteria for precise classification of HCC cases in BCLC stage B. In this study, we compared the time to TACE refractoriness in HCC patients with Kinki criteria substages B1 and B2-HCC. SUMMARY: Between January 2006 and December 2013, 592 HCC patients (substage B1, n = 118; substage B2, n = 170) underwent TACE. Time to progression under TACE treatment was defined as the time to untreatable progression (TTUP). TTUP and changes in liver function were analyzed in patients with substages B1 and B2-HCC. The median TTUP was 25.7 months (95% CI 19.3-37.3) and 16.4 months (95% CI 13.1-20.2) in patients with substage B1-HCC and substage B2-HCC, respectively (p = 0.0050). In patients with substage B2-HCC, median Child-Pugh scores after the first TACE session was significantly different from those after third and fifth TACE sessions (first-third, p = 0.0020; first-fifth, p = 0.0008). Key Message: TACE refractoriness occurred earlier in patients with substage B2-HCC than those with substage B1-HCC; deterioration of liver function with repeated TACE was more obvious in HCC cases with stage-B1 tumor. Shorter TTUP and impaired liver function due to repeated TACE could be responsible for the shorter survival in patients with substage B2-HCC.
- Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoDigestive diseases (Basel, Switzerland) 35 6 611 - 617 2017年OBJECTIVES: Previously, no therapeutic agent has been known to improve the overall survival compared with placebo in patients with hepatocellular carcinoma (HCC), who have progressed after sorafenib. In this patient population, regorafenib was first demonstrated to confer a survival benefit in the RESORCE trial, and subsequently it was approved as a second-line treatment for patients with advanced HCC. An open-label expanded access program (EAP) of regorafenib was implemented for compassionate use. We investigated the efficacy and safety of regorafenib based on our experience of the RESORCE trial and the EAP. METHODS: Data from 5 patients from the RESORCE trial and 6 from the EAP were analyzed retrospectively. All patients had tolerated prior sorafenib and were progressing during sorafenib treatment. RESULTS: The median progression-free survival was 9.2 months (95% CI 2.3-16.1). One patient achieved a partial response and 7 achieved stable disease. The objective response rate was 9.1%, and the disease control rate was 72.7%. No treatment-associated mortalities were observed. Grade 3 hypophosphatemia was observed in 2 patients, grade 2 anorexia was observed in 5 patients, and grade 3 neutropenia was observed in 2 patients. Grade 2 and grade 3 thrombocytopenia were observed in 2 and 3 patients, respectively. All treatment-related adverse events were improved by reduction or interruption of regorafenib. Five patients showed decreased serum albumin levels. CONCLUSION: Sorafenib and regorafenib sequential therapy presents a safe and effective treatment option for patients with advanced HCC.
- Chikara Ogawa; Masahiro Morita; Akina Omura; Teruyo Noda; Atsushi Kubo; Toshihiro Matsunaka; Hiroyuki Tamaki; Mitsushige Shibatoge; Akemi Tsutsui; Tomonori Senoh; Takuya Nagano; Kouichi Takaguchi; Joji Tani; Asahiro Morishita; Hirohito Yoneyama; Tsutomu Masaki; Akio Moriya; Masaharu Ando; Akihiro Deguchi; Yasutaka Kokudo; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Naoshi Nishida; Masatoshi KudoOncology 93 Suppl 1 113 - 119 2017年OBJECTIVE: To determine the relationship between treatment outcomes and hand-foot syndrome (HFS), and the relationship between survival rate and post-progression treatment after sorafenib therapy. METHODS: The study assessed 314 patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib at 5 general hospitals in Kagawa Prefecture, Japan. RESULTS: At the start of sorafenib therapy, 23.6% of the patients had HCC of a Child-Pugh class other than A. The initial sorafenib dose was 800 mg in 9.2% of the patients and 400 mg in 64.3%. Time to progression was 129 days (95% CI: 87.3-170.7) and the median overall survival (OS) was 392 days (95% CI: 316.0-468.0). The OS of the patients with Child-Pugh class A HCC was significantly better than that of the patients with Child-Pugh class B HCC (p < 0.0001). The survival curves for Child-Pugh class A-5 points and class A-6 points were significantly different, with that for class A-5 points being better (p < 0.0001). A significant difference was observed between the patients who exhibited HFS and those who did not, with the former exhibiting a better survival rate (p < 0.001). In addition, the survival rate of the patients who received post-progression treatment after sorafenib therapy was significantly better than that of the patients who did not (p < 0.001). CONCLUSION: In sorafenib therapy, patients with HFS and those who received post-progression treatment exhibited good OS.
- T. Arizumi; K. Ueshima; M. Iwanishi; H. Chishina; M. Kono; M. Takita; S. Kitai; T. Inoue; N. Yada; S. Hagiwara; H. Ida; Y. Minami; T. Sakurai; N. Nishida; M. Kitano; M. KudoDIGESTIVE DISEASES 35 6 625 - 626 2017年
- T. Arizumi; K. Ueshima; M. KudoJOURNAL OF HEPATOLOGY 66 1 S620 - S620 2017年
- Arizumi T; Ueshima K; Iwanishi M; Minami T; Chishina H; Kono M; Takita M; Kitai S; Inoue T; Yada N; Hagiwara S; Minami Y; Ida H; Sakurai T; Kitano M; Nishida N; Kudo MDigestive diseases (Basel, Switzerland) 34 6 671 - 678 2016年 [査読有り]
- Nishida N; Kono M; Minami T; Chishina H; Arizumi T; Takita M; Yada N; Ida H; Hagiwara S; Minami Y; Ueshima K; Sakurai T; Kudo MDigestive diseases (Basel, Switzerland) 34 6 632 - 639 2016年 [査読有り]
- Minami Y; Minami T; Chishina H; Kono M; Arizumi T; Takita M; Yada N; Hagiwara S; Ida H; Ueshima K; Nishida N; Kudo MDigest Dis 34 6 687 - 691 2016年 [査読有り]
- Takita M; Iwanishi M; Minami T; Kono M; Chishina H; Arizumi T; Yada N; Hagiwara S; Minami Y; Ida H; Ueshima K; Naoshi N; Kudo MDigest Dis 34 6 654 - 658 2016年 [査読有り]
- Chishina H; Hagiwara S; Nishida N; Ueshima K; Sakurai T; Ida H; Minami Y; Takita M; Kono M; Minami T; Iwanishi M; Umehara Y; Watanabe T; Komeda Y; Arizumi T; Kudo MDig Dis 34 6 659 - 664 2016年
- Hagiwara S; Nishida N; Watanabe T; Sakurai T; Ida H; Minami Y; Takita M; Minami T; Iwanishi M; Chishina H; Ueshima K; Komeda Y; Arizumi T; Kudo MDig Dis 34 6 620 - 626 2016年
- Norihisa Yada; Toshiharu Sakurai; Tomohiro Minami; Tadaaki Arizumi; Masahiro Takita; Satoru Hagiwara; Hiroshi Ida; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoDIGESTIVE DISEASES 34 6 650 - 653 2016年Objective: We have reported about real-time tissue elastography (RTE), which displays relative strain by measuring the relative distortion of the tissue, and found this information to be useful for diagnosing liver fibrosis. However, its use in predicting hepatocellular carcinoma has not been reported as yet. Here, we investigated RTE to predict liver carcinogenesis in patients with chronic hepatitis C virus (HCV) infection. Methods: We enrolled 160 patients with chronic HCV, who were followed up for 39.9 +/- 22.9 weeks (median). They underwent RTE and then ultrasounds every 3-6 months. Results: Respective cumulative liver cancer incidences for years 1, 2, 3, 4, and 5 were, for the entire cohort: 2.0, 5.6, 8.8, 13.1, and 23.9%; for those whose liver fibrosis index (LFI) was <= 2.0: 0.0, 0.0, 0.0, 0.0, and 0.0%; for those whose LFI was 2-2.8:0.0, 7.4, 7.4, 13.2 and 19.9%; and for those whose LFI was >2.8: 12.9, 12.9, 21.7, 31.4, and 31.4% (p = 0.011; log-rank test). Conclusions: Measurements of LFI by strain imaging can effectively predict liver cancer risk in patients with chronic HCV infection. (C) 2016 S. Karger AG, Basel
- Tomoyuki Nagai; Tokuzo Arao; Kazuto Nishio; Kazuko Matsumoto; Satoru Hagiwara; Toshiharu Sakurai; Yasunori Minami; Hiroshi Ida; Kazuomi Ueshima; Naoshi Nishida; Kazuko Sakai; Nagahiro Saijo; Kanae Kudo; Hiroyasu Kaneda; Daisuke Tamura; Keiichi Aomatsu; Hideharu Kimura; Yoshihiko Fujita; Seiji Haji; Masatoshi KudoDigestive Diseases 34 6 702 - 707 2016年Background: Epithelial-mesenchymal transition (EMT) is considered to play a critical role in cancer progression and metastasis. However, the impact of EMT on the prognosis of hepatocellular carcinoma (HCC) is still elusive. In this study, we examined the relationship between the expression of EMT markers and recurrence-free survival (RFS) and overall survival (OS) in HCC patients after hepatic resection. Summary: The mRNA expression of 15 genes related to EMT was assessed by quantitative real-time polymerase chain reaction in cancerous tissues from 72 patients who underwent hepatic resection of HCC between January 2005 and December 2010 at our hospital. The upregulation of TWIST and the downregulation of tight junction protein ZO-1 (TJP1) were significantly associated with shorter RFS as well as OS. Increased levels of TWIST and decreased levels of TJP1 should be predictive markers for poor prognosis in patients with HCC after hepatectomy; those could serve as potential biomarkers for the treatment of HCC. Key Messages: A low level of TJP1 and high level of TWIST expression were prognostic factors predicting HCC after hepatic resection.
- Masatoshi Kudo; Kazuomi Ueshima; Shoji Kubo; Michiie Sakamoto; Masatoshi Tanaka; Iwao Ikai; Junji Furuse; Takamichi Murakami; Masumi Kadoya; Norihiro KokudoHepatology research : the official journal of the Japan Society of Hepatology 46 1 3 - 9 2016年01月The Response Evaluation Criteria in Solid Tumors (RECIST) is inappropriate to assess the direct effects of treatment on hepatocellular carcinoma (HCC) by locoregional therapies such as radiofrequency ablation (RFA) and transarterial chemoembolization (TACE). Therefore, establishment of response evaluation criteria solely devoted to HCC is needed urgently in clinical practice as well as in clinical trials of HCC treatment, such as molecular-targeted therapies, which cause necrosis of the tumor. The Response Evaluation Criteria in Cancer of the Liver (RECICL) was revised in 2015 by the Liver Cancer Study Group of Japan based on the 2009 version of RECICL, which was commonly used in Japan. Major revised points of the RECICL 2015 is to define the target lesions of two lesions per organ or three lesions per liver, up to a maximum of five lesions. The second revised point is that setting the timing at which the overall treatment response has been changed. The third point is that the definition of treatment effect 1 has been changed to more than 50% tumor enlargement, excluding the area of necrosis after treatment. Overall evaluation of treatment response has been amended to make it possible to evaluate the overall response including extrahepatic lesions by systemic therapy, which is similar to RECIST or modified RECIST. We hope this new treatment response criteria, RECICL, proposed by the Liver Cancer Study Group of Japan will benefit HCC treatment response evaluation in the setting of daily clinical practice and clinical trials, not only in Japan, but also internationally.
- M. Kudo; K. Ueshima; O. Yokosuka; S. Obi; N. Izumi; H. Aikata; H. Nagano; E. Hatano; Y. Sasaki; K. Hino; T. Kumada; K. Yamamoto; Y. Imai; S. Iwadou; C. Ogawa; T. Okusaka; Y. Arai; F. Kanai; K. AkazawaJOURNAL OF HEPATOLOGY 64 S209 - S210 2016年
- Tadaaki Arizumi; Kazuomi Ueshima; Tomohiro Minami; Masashi Kono; Hirokazu Chishina; Masahiro Takita; Satoshi Kitai; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Toshiharu Sakurai; Naoshi Nishida; Masatoshi KudoLiver cancer 4 4 253 - 62 2015年12月BACKGROUND AND AIMS: Patients with intermediate-stage hepatocellular carcinoma (HCC) refractory to transcatheter arterial chemoembolization (TACE) are considered to be candidates for sorafenib. The aim of this study was to evaluate the superiority of conversion of treatment to sorafenib on overall survival (OS) for cases refractory to TACE. METHODS: This was a retrospective cohort study carried out on 497 patients with HCC who were treated with TACE therapy at our hospital between January 2008 and December 2013. Fifty-six patients were diagnosed as refractory to TACE during their clinical course and they were divided into two cohorts, (1) those who switched from TACE to sorafenib and (2) those who continued TACE. The overall survival (OS) after the time of being refractory to TACE was evaluated between the two groups. RESULTS: After refractoriness to TACE therapy was confirmed, 24 patients continued with TACE (TACE-group) and 32 patients underwent treatment conversion to sorafenib (sorafenib-group). The median OS was 24.7 months in the sorafenib-group and 13.6 months in the TACE-group (p=0.002). CONCLUSIONS: Conversion to sorafenib significantly improves the OS in patients refractory to TACE therapy with intermediate-stage HCC. Administration of sorafenib is therefore recommended in such circumstances of TACE treatment failure.
- Kazuomi Ueshima; Masatoshi Kudo; Masatoshi Tanaka; Takashi Kumada; Hobyung Chung; Satoru Hagiwara; Tatsuo Inoue; Norihisa Yada; Satoshi KitaiLiver cancer 4 4 263 - 73 2015年12月We conducted a phase I/II study in patients with advanced hepatocellular carcinoma (HCC) to determine the recommended dose, as well as the safety and efficacy, of combination therapy of sorafenib with hepatic arterial infusion chemotherapy (HAIC) using low dose cisplatin (CDDP) and 5-fluorouracil (5FU). Cohorts consisting of 3-6 patients with HCC received an escalated dose of CDDP and 5-FU until a maximum-tolerated dose was achieved. The treatment regimen was as follows: oral administration of sorafenib (400 mg twice daily for 28 days) combined with HAIC using CDDP (14-20 mg/m(2), on days 1 and 8) and 5-FU (170-330 mg/m(2), continuously on days 1-5 and 8-12) via an implanted catheter system). Each treatment cycle consisted of 28 days and three cycles of combination therapy. At the end of the first cycle, adverse events were evaluated and future dose escalation was determined. Eighteen patients with advanced HCC were enrolled. Dose-limiting toxicity was observed in two patients from cohort 1 (erythema multiforme and grade 4 thrombocytopenia) and in one patient from cohort 2 (erythema multiforme). Seven of the 18 patients achieved a partial response, seven showed stable disease, two were diagnosed as progressive disease, and two were not assessable. The response rate was 38.9% and the disease control rate was 77.8%. The time-to-progression was 9.7 months and the 1-year survival rate was 88.2%. Oral administration of 400 mg of sorafenib twice daily, 20 mg/m(2) of intra-arterial infusion of CDDP, and 5-FU at 330 mg/m(2) are the recommended doses for combination therapy, which was well tolerated and efficacious. This combination therapy may be a promising treatment for patients with advanced HCC. A large prospective randomized multicenter study (ClinicalTrials.gov Identifier NCT01214343) is ongoing.
- Naoshi Nishida; Mina Iwanishi; Tomohiro Minami; Hirokazu Chishina; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Hiroshi Ida; Satoru Hagiwara; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Masayuki Kitano; Masatoshi KudoDigestive diseases (Basel, Switzerland) 33 6 708 - 14 2015年10月OBJECTIVES: Triple therapy using peg-interferon, ribavirin and simeprevir (PEG-IFN/RBV/SMV) has reportedly resulted in high-sustained virological response (SVR) rates in patients with chronic hepatitis C (CHC), especially in naïve cases and relapsers to prior PEG-IFN/RBV therapy. Here, we retrospectively analyzed the antiviral response associated with a triple regimen, in the context of early reduction of viral load during treatment. METHODS: Forty-six CHC patients with HCV genotype 1b were treated with PEG-IFN/RBV/SMV triple therapy: 20 were naïve cases, 12 were relapsers and 14 were non-responders to prior PEG-IFN/RBV therapy. We evaluated rapid virological response (RVR), complete early virological response (EVR), viral clearance at the end of the treatment (EOT) and at 12 weeks after the EOT (SVR12). In addition, we quantified the serum HCV-RNA on the 1st day and the 7th day after initiating treatment. RESULTS: Multivariate analysis revealed that response to prior treatment was identified as an independent factor for achieving SVR12 after triple therapy (p = 0.0005). The achievement of serum HCV-RNA <2 log(10) IU/ml on day 7, RVR, EVR and EOT were associated with SVR12 (p = 0.0050, p = 0.0002, p = 0.0009 and p = 0.0002, respectively). CONCLUSIONS: Rapid decline of HCV is a predictive factor for the achievement of SVR12, even in antiviral triple therapy with PEG-IFN/RBV/SMV. An extended treatment period should be applied for patients who show detectable serum HCV-RNA at week 4.
- Masatoshi Kudo; Tadaaki Arizumi; Kazuomi Ueshima; Toshiharu Sakurai; Masayuki Kitano; Naoshi NishidaDigestive diseases (Basel, Switzerland) 33 6 751 - 8 2015年10月Intermediate stage hepatocellular carcinoma (HCC) is a very heterogeneous tumor in terms of tumor size (>3 cm ∼ over 10 cm), tumor number (4 ∼ over 20) and liver function (Child-Pugh score 5-9). However, transarterial chemoembolization is the only recommended treatment option according to the Barcelona Clinic Liver Cancer (BCLC) staging. Bolondi's subclassification of BCLC B stage is feasible; however, there are several weak points. Therefore, by modifying Bolondi's subclassification, we have proposed a more simplified subclassification, Kinki criteria. The Kinki criteria consist of 2 factors: liver function (Child-Pugh score 5-7 or 8, 9) and tumor status (Beyond Milan and within up-to-7 criteria; IN and OUT). The Kinki criteria classifies BCLC B stage from B1 (Child-Pugh score 5-7 and within up-to-7), B2 (Child-Pugh score 5-7 and beyond up-to-7) and B3 (Child-Pugh score 8, 9 and any tumor status). These criteria are simple and easy to apply to clinical practice. Therefore, these criteria will stratify the heterogeneous population of BCLC B group patient well and give the treatment indication according to each substage. These criteria should be further validated both retrospectively and prospectively.
- Tadaaki Arizumi; Kazuomi Ueshima; Mina Iwanishi; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Satoshi Kitai; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Hiroshi Ida; Yasunori Minami; Toshiharu Sakurai; Naoshi Nishida; Masayuki Kitano; Masatoshi KudoDigestive diseases (Basel, Switzerland) 33 6 728 - 34 2015年10月OBJECTIVES: Sorafenib has become a standard therapy for advanced hepatocellular carcinoma following the demonstration of significant increase in progression-free survival as well as overall survival (OS) in the 2-phase III trials. We examined efficacy and adverse events (AEs) in patients treated with sorafenib over a 6-year period since approval in Japan. METHODS: Two hundred and forty-one patients treated with sorafenib at the Kinki University Hospital were retrospectively analyzed clinically for the factors related to survival periods, tumor response evaluated by the Response Evaluation Criteria In Cancer of the Liver (RECICL) and AEs. RESULTS: OS was 14.3 months. According to the RECICL, the objective response and disease control rates were 18.6% (43 of 241) and 61.1% (137 of 241), respectively. AEs were seen in 77.3% (187 of 241), with Grade 3 or higher in 23.6% (57 of 241). The most frequent AE was hand-foot skin reaction in 109 patients (45.0%), and 28 patients (11.8%) showed Grade 3 or higher. Significant factors contributing to the OS were treatment duration (p = 0.0204), up-to-7 criteria (p = 0.0400), increase of Child-Pugh score (p = 0.0008) and tumor response determined by the RECICL (p = 0.0007). CONCLUSION: Based on the analysis, using many cases at a single center, we concluded that continuation of treatment with sorafenib for ≥90 days without decrease of liver function was critical if tumor response was determined as stable disease or higher.
- Naoshi Nishida; Mina Iwanishi; Tomohiro Minami; Hirokazu Chishina; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Hiroshi Ida; Satoru Hagiwara; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Masayuki Kitano; Masatoshi KudoDigestive diseases (Basel, Switzerland) 33 6 745 - 50 2015年10月OBJECTIVES: Several studies revealed that the proportion of hepatocellular carcinoma (HCC) without hepatitis virus infection (NBNC-HCC) is increasing. On the other hand, epigenetic alterations are reportedly responsible for HCC development. Here, we identified HCC risk factors that are associated with DNA methylation in the background liver tissue of NBNC-HCC patients. METHODS: We performed methylation analysis in 37 pairs of virus-positive and 22 pairs of NBNC-HCC and non-cancerous livers using a HumanMethylation450 BeadChip array. After the selection of differentially methylated CpGs (DM-CpGs) in cancerous and non-cancerous livers, we analyzed DNA methylation of DM-CpGs within the adjacent non-cancerous liver tissue that is affected by specific HCC risk factors. RESULTS: A total of 38,331 CpGs were selected as DM-CpGs using the following criteria: difference of β-value between HCC and non-cancerous liver ≥0.15 and false discovery rate (FDR) q < 1.0E-12. We subsequently selected the DM-CpGs that had methylation differences with the background liver tissue (that has FDR q < 0.35). Among the virus-positive patients, the type of hepatitis virus was mostly associated with differences in methylation within the background liver tissues. However, we found that background methylation patterns were most significantly associated with aging in NBNC patients. Interestingly, age-related methylation differences in DM-CpGs were also observed in NBNC-HCC tissues. CONCLUSIONS: Hepatitis viruses affect the methylation profiles within background liver tissues. However, difference in background methylation was mostly associated with age in NCBC-HCC patients; some age-related methylation events could contribute to emergence of NBNC-HCC in elderly individuals.
- Kiwamu Okita; Namiki Izumi; Kenji Ikeda; Yukio Osaki; Kazushi Numata; Masafumi Ikeda; Norihiro Kokudo; Kazuho Imanaka; Shuhei Nishiguchi; Shunsuke Kondo; Yoichi Nishigaki; Susumu Shiomi; Kazuomi Ueshima; Norio Isoda; Yoshiyasu Karino; Masatoshi Kudo; Katsuaki Tanaka; Shuichi Kaneko; Hisataka Moriwaki; Masatoshi Makuuchi; Takuji Okusaka; Norio Hayashi; Yasuo Ohashi; Hiromitsu KumadaJournal of gastroenterology 50 6 667 - 74 2015年06月BACKGROUND: This study examined the effects of peretinoin, an acyclic retinoid, on the survival of patients with hepatitis C virus-related hepatocellular carcinoma (HCC) who had completed curative therapy and participated in a randomized, placebo-controlled trial. METHODS: This study was an investigator-initiated retrospective cohort study. Subjects were all patients who were administered the investigational drug (peretinoin 600 mg/day, peretinoin 300 mg/day, or placebo) in the randomized trial. Survivals between the groups were compared using the log-rank test, and hazard ratios were estimated by Cox regression. RESULTS: Survey data were collected from all patients (n = 392) who participated in the randomized trial, all of whom were then divided into the peretinoin 600 mg/day (n = 132), peretinoin 300 mg/day (n = 131), and placebo (n = 129) groups. At the median follow-up of 4.9 years, 5-year cumulative survival rates for patients in the 600 mg/day, 300 mg/day, and placebo groups were 73.9, 56.8, and 64.3 %, respectively. Comparison of overall survival among patients classified as Child-Pugh A revealed that survival of the 600 mg/day group (n = 105) was significantly longer than that of the placebo group (n = 108) (hazard ratio 0.575, 95 % CI 0.341-0.967; P = 0.0347). CONCLUSIONS: Administration of 600 mg/day peretinoin to patients with hepatitis C virus-related HCC who have completed curative therapy may improve survival for those classified as Child-Pugh A, for whom liver function is relatively stable.
- Toshiharu Sakurai; Norihisa Yada; Tomohiro Watanabe; Tadaaki Arizumi; Satoru Hagiwara; Kazuomi Ueshima; Naoshi Nishida; Jun Fujita; Masatoshi KudoCancer science 106 4 352 - 8 2015年04月Most hepatocellular carcinomas (HCCs) develop in the context of chronic liver inflammation. Oxidative stress is thought to play a major role in the pathogenesis of HCC development. In this study, we examined whether cold-inducible RNA-binding protein (Cirp) controls reactive oxygen species (ROS) accumulation and development of HCC by using murine models of hepatocarcinogenesis and human liver samples. Cirp expression, ROS accumulation, and CD133 expression were increased in the liver of tumor-harboring mice. Cirp deficiency reduced production of interleukin-1β and interleukin-6 in Kupffer cells, ROS accumulation, and CD133 expression, leading to attenuated hepatocarcinogenesis. Thioacetamide treatment enhanced hepatic expression of CD133 and phosphorylated signal transducer and activator of transcription 3 (STAT3), which was prevented by treatment with the antioxidant butylated hydroxyanisole. Intriguingly, the risk of human HCC recurrence is positively correlated with Cirp expression in liver. Cirp appears to play a critical carcinogenic function and its expression might be a useful biomarker for HCC risk prediction.
- Shigeru Yutani; Kazuomi Ueshima; Kazumichi Abe; Atsushi Ishiguro; Junichi Eguchi; Satoko Matsueda; Nobukazu Komatsu; Shigeki Shichijo; Akira Yamada; Kyogo Itoh; Tetsuro Sasada; Masatoshi Kudo; Masanori NoguchiJournal of immunology research 2015 473909 - 473909 2015年Objective. To evaluate safety and immune responses of personalized peptide vaccination (PPV) for hepatitis C virus- (HCV-) positive advanced hepatocellular carcinoma (HCC). Patients and Methods. Patients diagnosed with HCV-positive advanced HCC were eligible for this study. A maximum of four HLA-matched peptides were selected based on the preexisting IgG responses specific to 32 different peptides, which consisted of a single HCV-derived peptide at core protein positions 35-44 (C-35) and 31 peptides derived from 15 different tumor-associated antigens (TAAs), followed by subcutaneous administration once per week for 8 weeks. Peptide-specific cytotoxic T lymphocyte (CTL) and IgG responses were measured before and after vaccination. Results. Forty-two patients were enrolled. Grade 3 injection site skin reaction was observed in 2 patients, but no other PPV-related severe adverse events were noted. Peptide-specific CTL responses before vaccination were observed in only 3 of 42 patients, but they became detectable in 23 of 36 patients tested after vaccination. Peptide-specific IgG responses were also boosted in 19 of 36 patients. Peptide-specific IgG1 responses to both C-35 and TAA-derived peptides could be potentially prognostic for overall survival. Conclusion. Further clinical study of PPV would be warranted for HCV-positive advanced HCC, based on the safety and strong immune induction.
- Norihisa Yada; Toshiharu Sakurai; Tomohiro Minami; Tadaaki Arizumi; Masahiro Takita; Satoru Hagiwara; Kazuomi Ueshima; Hiroshi Ida; Naoshi Nishida; Masatoshi KudoOncology 89 Suppl 2 53 - 9 2015年OBJECTIVE: The aim of this study was to prospectively assess the usefulness of the reliability index, namely the percentage of the net amount of effective shear wave velocity (VsN). METHODS: One hundred and sixty-eight patients with chronic liver disease, who underwent ultrasound elastography, were consecutively enrolled. Shear wave measurement (SWM), FibroScan, virtual touch quantification, and shear wave elastography were performed for all patients, and the variations in the measurement results were compared with VsN. The absolute average value of the difference between SWM_Vs and Vs measured using other elastography devices is termed |ΔVs|. VsN was classified into three groups: ≥50, <50, and 0 (failure measurement). In these groups, there was a significant difference in abdominal circumference, body mass index, the distance between the ultrasound probe surface and the liver, and |ΔVs|. When the distance between the ultrasound probe surface and the liver was >2 cm, VsN tended to be significantly lower (p < 0.001). RESULTS: When VsN was <50, |ΔVs| became high, and there was variation in the results between each device. CONCLUSIONS: The results of this study show that VsN is a useful value to decide whether Vs is appropriate or not.
- Tadaaki Arizumi; Kazuomi Ueshima; Mina Iwanishi; Tomohiro Minami; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Satoshi Kitai; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Hiroshi Ida; Yasunori Minami; Toshiharu Sakurai; Naoshi Nishida; Masayuki Kitano; Masatoshi KudoOncology 89 Suppl 2 4 - 10 2015年OBJECTIVE: Transarterial chemoembolization (TACE) is recommended as a first-line therapy for hepatocellular carcinoma (HCC) patients ineligible for curative therapy and without portal invasion. The Assessment for Retreatment with TACE (ART) scoring system was recently proposed for identifying patients who would not show sufficient survival benefit from repeated TACE. We reevaluated the performance of ART in HCC patients treated in Japan, where selective TACE is commonly used. METHODS: Between 2000 and 2013, 988 patients with HCC underwent TACE at Kinki University Hospital, and 627 received ≥2 sessions of TACE. Seventy-six patients who underwent ≥2 TACE sessions within 90 days were investigated for their performance of the ART score in the context of overall survival (OS). RESULTS: Only 12% (76/627) of patients underwent ≥2 TACE sessions within 90 days. Of those, 52 patients showed a low ART score (0-1.5), and 24 had a high ART score (≥2.5); the median OS was 20.2 and 37.6 months, respectively (p = 0.8207). CONCLUSION: The ART scoring system did not demonstrate a sufficiently predictive impact on OS among the patients who underwent ≥2 TACE sessions within 90 days. Application of the ART score should be carefully considered because differences in TACE procedures and post-TACE treatment can affect the results while evaluating OS.
- Yasunori Minami; Tomohiro Minami; Hirokazu Chishina; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Masakatsu Tsurusaki; Yukinobu Yagyu; Kazuomi Ueshima; Naoshi Nishida; Takamichi Murakami; Masatoshi KudoOncology 89 Suppl 2 27 - 32 2015年OBJECTIVE: To investigate whether balloon-occluded transcatheter arterial chemoembolization (b-TACE) can produce a more dense accumulation of iodized oil in various stages of hepatocellular carcinoma (HCC), from single to uncountable, to overcome inferior local control. MATERIALS AND METHODS: We studied 27 patients with HCC, including single to uncountable multiple lesions, who underwent b-TACE between August 2013 and April 2015. Dynamic CT was performed at baseline and 1-3 months after b-TACE. The treatment effect (TE) after b-TACE was evaluated using the Response Evaluation Criteria in Cancer of the Liver (RECICL) proposed by the Liver Cancer Study Group of Japan. RESULTS: In the countable HCC group, contrast-enhanced CT demonstrated RECICL TE4 in 43.8% (14/32), TE3 in 12.5% (4/32), TE2 in 37.5% (12/32), and TE1 in 6.3% (2/32) of patients. For the TACE-naïve cohort, the objective response rate was 52.9%. The objective response rate was 60% for the previously TACE-treated cohort. In the uncountable multiple HCC group, the objective response rate was 0% (0/10), with progressive disease in 90% (9/10) of patients. CONCLUSION: Our observations suggested that b-TACE did not reduce the efficacy of retreatment for HCC with an insufficient outcome from conventional TACE, but it could not improve the efficacy of treatment for uncountable multiple HCCs.
- Tadaaki Arizumi; Kazuomi Ueshima; Mina Iwanishi; Tomohiro Minami; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Satoshi Kitai; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Hiroshi Ida; Yasunori Minami; Toshiharu Sakurai; Masayuki Kitano; Naoshi Nishida; Masatoshi KudoOncology 89 Suppl 2 47 - 52 2015年INTRODUCTION: Barcelona Clinic Liver Cancer (BCLC) stage B, an intermediate stage, includes various conditions of hepatocellular carcinoma (HCC). This heterogeneity of the patients with intermediate-stage HCC makes it difficult to predict their survival rates. In the present study, we examined the validity of the modified Bolondi classification (Kinki criteria) as a subclassification of patients with BCLC stage B HCC. METHODS: Of 906 patients who underwent conventional transarterial chemoembolization at Kinki University Hospital, 753, who met the inclusion criteria, were examined. Of these 753 patients, 425 (56.4%) with BCLC stage B were subclassified using the Kinki criteria to examine the survival rate. RESULTS: According to the Kinki criteria, 158 (37.2%) were subclassified into subclass B1, 236 (55.5%) into B2, and 31 (7.3%) into B3. The comparison of the survival rates showed that the median overall survival was 3.9 years (95% CI, 3.2-4.6) in the BCLC subclass B1 group, 2.5 years (95% CI, 2.2-3.1) in the B2 group, and 1.1 years (95% CI, 0.6-1.5) in the B3 group (p < 0.001). CONCLUSION: When the BCLC stage B patients were subclassified according to the Kinki criteria, survival curves were stratified with significant differences, suggesting that the Kinki criteria were suitable for the subclassification of the intermediate-stage HCC patients.
- Tadaaki Arizumi; Kazuomi Ueshima; Haruhiko Takeda; Yukio Osaki; Masahiro Takita; Tatsuo Inoue; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Toshiharu Sakurai; Naoshi Nishida; Masatoshi KudoJournal of gastroenterology 49 12 1578 - 87 2014年12月BACKGROUND: To test the hypothesis that use of the response evaluation criteria in cancer of the liver (RECICL), an improved evaluation system designed to address the limitations of the response evaluation criteria in solid tumors 1.1 (RECIST1.1) and modified RECIST (mRECIST), provides for more accurate evaluation of response of patients with hepatocellular carcinoma (HCC) to treatment with sorafenib, a molecularly targeted agent, as assessed by overall survival (OS). METHODS: The therapeutic response of 156 patients with advanced HCC who had been treated with sorafenib therapy for more than 1 month was evaluated using the RECIST1.1, mRECIST, and RECICL. After categorization as showing progressive disease (PD), stable disease (SD), or objective response, the association between OS and categorization was examined using the Kaplan-Meier method to develop survival curves. The 141 cases categorized as PD or SD by the RECIST1.1, but objective response by the mRECIST and RECICL, were further analyzed for determination of the association between OS and categorization. RESULTS: Only categorization using the RECICL was found to be significantly correlated with OS (p = 0.0033). Among the patients categorized as SD or PD by the RECIST1.1, reclassification by the RECICL but not the mRECIST was found to be significantly associated with OS and allowed for precise prediction of prognosis (p = 0.0066). CONCLUSIONS: Only the use of the RECICL allowed for identification of a subgroup of HCC patients treated with sorafenib with improved prognosis. The RECICL should, therefore, be considered a superior system for assessment of therapeutic response.
- Masatoshi Kudo; Osamu Matsui; Namiki Izumi; Hiroko Iijima; Masumi Kadoya; Yasuharu Imai; Takuji Okusaka; Shiro Miyayama; Kaoru Tsuchiya; Kazuomi Ueshima; Atsushi Hiraoka; Masafumi Ikeda; Sadahisa Ogasawara; Tatsuya Yamashita; Tetsuya Minami; Koichiro YamakadoLiver cancer 3 3-4 458 - 68 2014年10月The Clinical Practice Guidelines for the Management of Hepatocellular Carcinoma proposed by the Japan Society of Hepatology was updated in June 2014 at a consensus meeting of the Liver Cancer Study Group of Japan. Three important items have been updated: the surveillance and diagnostic algorithm, the treatment algorithm, and the definition of transarterial chemoembolization (TACE) failure/refractoriness. The most important update to the diagnostic algorithm is the inclusion of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging as a first line surveillance/diagnostic tool. Another significant update concerns removal of the term "lipiodol" from the definition of TACE failure/refractoriness.
- Masatoshi Kudo; Tadaaki Arizumi; Kazuomi UeshimaHepatology (Baltimore, Md.) 59 6 2424 - 5 2014年06月
- Nishida Naoshi; Yada Norihisa; Chishina Hirokazu; Arizumi Tadaaki; Takita Masahiro; Kitai Satoshi; Inoue Tatsuo; Hagiwara Satoru; Minami Yasunori; Ueshima Kazuomi; Sakurai Toshiharu; Kudo MasatoshiHEPATOLOGY 60 758A 2014年 [査読有り]
- Naoshi Nishida; Takafumi Nishimura; Takuya Nakai; Hirokazu Chishina; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Masatoshi KudoDigestive diseases (Basel, Switzerland) 32 6 658 - 63 2014年OBJECTIVE: To clarify the progression pattern of abnormal DNA methylation during the development of hepatocellular carcinoma (HCC) using a comprehensive methylation assay. METHODS: We used an Infinium HumanMethylation450 BeadChip array that can analyze >485,000 CpG sites distributed throughout the genome for a comprehensive methylation study of 117 liver tissues consisting of 59 HCC and 58 noncancerous livers. Altered DNA methylation patterns during tumor progression were also analyzed. RESULTS: We identified 38,330 CpG sites with significant differences in methylation levels between HCCs and noncancerous livers (DM-CpGs) using strict criteria. Of the DM-CpGs, 92% were hypomethylated and only 3,051 CpGs (8%) were hypermethylated in HCC. The DM-CpGs were more prevalent within intergenic regions with isolated CpGs. In contrast, DM-CpGs that were hypermethylated in HCC were predominantly located within promoter regions and CpG islands (p < 0.0001). The association between methylation profiles of DM-CpGs and tumor size was statistically significant, especially in hepatitis C virus (HCV)-positive cases (p = 0.0001). CONCLUSIONS: We clarified the unique characteristics of DM-CpGs in human HCCs. The stepwise progression of alterations in DNA methylation was a common feature of HCV-related hepatocarcinogenesis.
- Masashi Kono; Tatsuo Inoue; Masatoshi Kudo; Hirokazu Chishina; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Kazuomi Ueshima; Naoshi Nishida; Takamichi MurakamiDigestive diseases (Basel, Switzerland) 32 6 670 - 7 2014年OBJECTIVE: The purpose of this study was to evaluate the risk factors for local recurrence with radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) measuring ≤2 cm. METHODS: This study involved 234 patients with 274 HCCs measuring ≤2 cm who had undergone RFA as the initial treatment. The mean tumor diameter was 1.478 cm. The median follow-up period was 829 days. We evaluated the post-RFA cumulative local recurrence rate and analyzed the risk factors contributing to clinical outcomes. RESULTS: Cumulative local recurrence rates were 9, 19 and 19% at 1, 2 and 3 years, respectively. Among the 145 cases with a complete safety margin (SM) after RFA, only 4 developed local tumor recurrence and the cumulative rates of local tumor recurrence at 1, 2 and 3 years were 2, 3 and 3%, respectively. Among the 129 cases with incomplete SM, local tumor recurrence developed in 34 and the cumulative rates of local tumor progression at 1, 2 and 3 years were 14, 36 and 36%, respectively. In multivariate analysis, significant risk factors were tumor location (liver surface), irregular gross type and SM <5 mm. CONCLUSION: Even with HCC measuring ≤2 cm, location and gross type of tumor should be carefully evaluated before RFA is performed.
- Tadaaki Arizumi; Kazuomi Ueshima; Hirokazu Chishina; Masashi Kono; Mashiro Takita; Satoshi Kitai; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Toshiharu Sakurai; Naoshi Nishida; Masatoshi KudoDigestive diseases (Basel, Switzerland) 32 6 705 - 10 2014年BACKGROUND: Sorafenib is a molecular-targeting agent showing improved overall survival (OS) for advanced hepatocellular carcinoma (HCC). Although tumor dormancy, characterized by stable tumor status or stable disease (SD) without tumor regression, is a unique feature of sorafenib treatment, the contribution of SD to OS remains debatable. This study aimed to clarify the correlation between SD periods and OS in patients with HCC treated with sorafenib. METHODS: From May 2009 to January 2013, 269 patients with advanced-stage HCC were treated with sorafenib at the Kinki University Hospital. The antitumor response of sorafenib was evaluated in 158 patients using the modified Response Evaluation Criteria in Solid Tumors, and patients with SD were divided into two subgroups according to the median duration of SD: short SD (<3 months) and long SD (≥3 months). The relationship between the duration of SD and OS was analyzed among patients with complete (CR) and partial response (PR), and long and short SD using the Kaplan-Meier method. RESULTS: The median OS was 5.7 months in the short SD, 20.8 months in the long SD and 17.9 months in the CR + PR group. Although the duration of OS was significantly longer in the long SD group than the short SD group, no difference in OS was detected between the patients with CR + PR and patients with long SD. The impact of long SD on OS could be as strong as that of CR + PR. CONCLUSION: Achievement of long SD is one of the important goals for improving survival in patients with HCC treated with sorafenib.
- Tadaaki Arizumi; Kazuomi Ueshima; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Satoshi Kitai; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Toshiharu Sakurai; Naoshi Nishida; Masatoshi KudoDigestive diseases (Basel, Switzerland) 32 6 733 - 9 2014年BACKGROUND: Sorafenib is a multikinase inhibitor targeting Raf and protein tyrosine kinases, which are involved in cell growth and tumor angiogenesis. Sorafenib administration induces temporary inhibition of tumor growth and a decrease in arterial blood flow in a considerable number of hepatocellular carcinoma (HCC) patients. We retrospectively evaluated the association between decreased blood flow and the overall survival (OS) of HCC patients after the initiation of sorafenib therapy. PATIENTS AND METHODS: Therapeutic responses of 158 advanced HCC patients with hypervascular tumors who had received sorafenib for more than 1 month were analyzed. To assess their therapeutic response, patients underwent radiological evaluation before and every 4-6 weeks after the initiation of sorafenib treatment. After the classification of patients into three groups based on the change in arterial enhancement during treatment (no change, decrease and disappearance), the OS of each group was compared using the Kaplan-Meier method. RESULTS: Statistically significant differences in OS were observed among the three groups (p < 0.001). A decrease or disappearance of arterial enhancement was significantly associated with improved OS compared to patients with no change in arterial enhancement; the median OS was 19.9 months (95% confidence interval, CI, 16.4-24.5 months) and 6.0 months (95% CI, 4.0-8.8 months), respectively (p < 0.001). However, there was no difference in OS between the decrease and disappearance groups (p = 0.88). CONCLUSION: We conclude that decreased arterial enhancement during sorafenib treatment was associated with the longest OS and could therefore reflect an effective response.
- Naoshi Nishida; Hirokazu Chishina; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Masatoshi KudoDigestive diseases (Basel, Switzerland) 32 6 740 - 6 2014年OBJECTIVES: DNA methylation-dependent transcriptional inactivation of tumor suppressor genes (TSGs) is critical for the pathogenesis of hepatocellular carcinoma (HCC). This study identifies potential TSGs in HCCs using methylation profiling and pharmacological unmasking of methylated TSGs. METHODS: Methylation profiling was performed on 22 pairs of HCCs and their corresponding noncancerous liver tissues using the Infinium HumanMethylation27 BeadChip. We also determined the gene reexpression after treatment with 5-aza-2'-deoxycytidine (5-Aza-dC) and trichostatin A (TSA) in 5 HCC cell lines. RESULTS: We selected CpGs that exhibited a significant increase in methylation in HCC tissues compared with that of the noncancerous control group. Two hundred and thirteen CpGs on different gene promoters with a mean difference in the β value ≥0.15 and a value of p < 0.05 were selected. Of the 213 genes, 45 genes were upregulated in 3 or more HCC cell lines with multiplier value of differences ≥2.0 after 5-Aza-dC and TSA treatment. CONCLUSIONS: We identified several potential TSGs that participate in transcription inactivation through epigenetic interactions in HCC. The results of this study are important for the understanding of functionally important epigenetic alterations in HCC.
- Masatoshi Kudo; Osamu Matsui; Namiki Izumi; Masumi Kadoya; Takuji Okusaka; Shiro Miyayama; Koichiro Yamakado; Kaoru Tsuchiya; Kazuomi Ueshima; Atsushi Hiraoka; Masafumi Ikeda; Sadahisa Ogasawara; Tatsuya Yamashita; Tetsuya MinamiOncology 87 Suppl 1 22 - 31 2014年In the 2010 version of the Japan Society of Hepatology (JSH) consensus-based treatment algorithm for the management of hepatocellular carcinoma (HCC), transarterial chemoembolization (TACE) failure/refractoriness was defined assuming the use of superselective lipiodol TACE, which has been widely used worldwide and particularly in Japan, and areas with lipiodol deposition were considered to be necrotic. However, this concept is not well accepted internationally. Furthermore, following the approval of microspheres, an embolic material that does not use lipiodol, in February 2014 in Japan, the phrase 'lipiodol deposition' needed to be changed to 'necrotic lesion or viable lesion'. Accordingly, the respective section in the JSH guidelines was revised to define TACE failure as an insufficient response after ≥2 consecutive TACE procedures that is evident on response evaluation computed tomography or magnetic resonance imaging after 1-3 months, even after chemotherapeutic agents have been changed and/or the feeding artery has been reanalyzed. In addition, the appearance of a higher number of lesions in the liver than that recorded at the previous TACE procedure (other than the nodule being treated) was added to the definition of TACE failure/refractoriness. Following the discussion of other issues concerning the continuous elevation of tumor markers, vascular invasion, and extrahepatic spread, descriptions similar to those in the previous version were approved. The revision of these TACE failure definitions was approved by over 85% of HCC experts.
- Tadaaki Arizumi; Kazuomi Ueshima; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Satoshi Kitai; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Toshiharu Sakurai; Naoshi Nishida; Masatoshi KudoOncology 87 Suppl 1 32 - 6 2014年BACKGROUND: Transcatheter arterial chemoembolization (TACE) failure or refractoriness is an indication for sorafenib therapy in patients with advanced hepatocellular carcinoma. The study evaluated the validity of the definition of TACE failure or refractoriness as proposed by the Liver Cancer Study Group of Japan (LCSGJ) through a retrospective analysis of sorafenib treatment. METHODS: Out of 265 patients with advanced hepatocellular carcinoma who were treated with sorafenib at our hospital, 45 experienced TACE failure or refractoriness and were included in this study and retrospectively analyzed. RESULTS: Multivariate analysis only identified the number of ineffective TACE procedures performed before starting sorafenib treatment as significant factors. Overall survival (OS) after starting sorafenib was statistically longer in patients treated with ≤2 consecutive ineffective TACE procedures before sorafenib administration than in patients treated with ≥3 consecutive ineffective TACE procedures (p < 0.005). This result matched the LCSGJ criteria. CONCLUSION: In patients treated with sorafenib, OS was extended with ≤2 consecutive ineffective TACE procedures compared to that with ≥3 consecutive ineffective TACE procedures. Thus, if tumors are uncontrolled, TACE should not be repeated. The result of this study supports the definition of TACE failure or refractoriness proposed by the LCSGJ.
- Tomohiro Minami; Yasunori Minami; Hirokazu Chishina; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Tatsuo Inoue; Satoru Hagiwara; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoOncology 87 Suppl 1 55 - 62 2014年PURPOSE: The purpose of this study was to evaluate the usefulness of the combination guidance of contrast-enhanced US (CEUS) and fusion imaging in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) with poor conspicuity on B-mode US and CEUS/fusion imaging. MATERIALS AND METHODS: We conducted a retrospective cohort study, which included 356 patients with 556 HCCs that were inconspicuous on B-mode US. A total of 192 patients with 344 HCCs, 123 patients with 155 HCCs, and 37 patients with 57 HCCs underwent RFA under CEUS guidance, fusion imaging guidance, and the combination of CEUS and fusion imaging guidance. RESULTS: The average number of treatment sessions was 1.1 (range: 1-2) in the CEUS guidance group, 1.1 (range: 1-2) in the fusion imaging guidance group, and 1.1 (range: 1-3) in the combination of CEUS and fusion imaging guidance group. Treatment analysis did not reveal significantly more RFA treatment sessions in the combination guidance group than in the other groups (p = 0.97, Student's t test). During the follow-up period (1.1-85.3 months, mean ± SD, 43.2 ± 59.5), the 3-year local tumor progression rates were 4.9, 7.2, and 5.9% in the CEUS guidance group, the fusion imaging guidance group, and the combination guidance group, respectively (p = 0.84, log-rank test). CONCLUSION: In spite of selection bias, session frequency and local tumor progression were not different under the combination guidance with CEUS and fusion imaging in RFA. The combination of fusion imaging and CEUS guidance in RFA therapy is an effective treatment for HCC with poor conspicuity on B-mode US and CEUS/fusion imaging.
- Masahiro Takita; Satoru Hagiwara; Masatoshi Kudo; Masashi Kouno; Hirokazu Chishina; Tadaaki Arizumi; Satoshi Kitai; Norihisa Yada; Tatsuo Inoue; Yasunori Minami; Kazuomi UeshimaOncology 87 Suppl 1 110 - 7 2014年BACKGROUND: Telaprevir-based antiviral therapy has been the primary treatment for chronic hepatitis C genotype 1 at a high viral load since November 2011. On the other hand, a number of patients have been reported to require withdrawal from or reduced doses of drugs due to side effects, such as eruptions, anemia, and renal dysfunction. In addition, as hepatitis C patients are growing older, it is imperative to investigate the tolerability of triple combination therapy for elderly patients. SUBJECTS AND METHODS: The study subjects comprised 35 patients who received telaprevir combination therapy after November 2011. They were divided into group A (age: <65 years; n = 21) and group B (age: ≥65 years; n = 14) in order to compare the treatment completion rate, sustained virological response at week 24 (SVR24), and adverse events between the groups. RESULTS: The treatment completion rate was 82.8% (29/35) in all subjects, 90.4% (19/21) in group A, and 78.5% (11/14) in group B. The rate was lower in group B but without a significant difference between the groups (p = 0.804). The SVR24 rate was 88.5% (31/35) in all subjects, 90.4% (19/21) in group A, and 85.7% (12/14) in group B, without a significant difference between the groups (p = 0.161). CONCLUSION: Although the incidence of anemia was higher in group B, there was no significant difference in the treatment completion or SVR24 rate between the groups. Telaprevir combination therapy is suggested to be tolerable for elderly hepatitis C patients.
- Norihisa Yada; Toshiharu Sakurai; Tomohiro Minami; Tadaaki Arizumi; Masahiro Takita; Tatsuo Inoue; Satoru Hagiwara; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoOncology 87 Suppl 1 118 - 23 2014年OBJECTIVE: To investigate the relationship between tissue elasticity before and after antiviral therapy and shear wave as well as strain elastography. METHODS: FibroScan and real-time tissue elastography were performed before and after antiviral therapy for chronic hepatitis C, and treatment efficacy and elastographic findings were comparatively analyzed. Elasticity was evaluated by measuring liver stiffness (LS) in kilopascals using FibroScan, and the liver fibrosis index (LFI) was assessed by real-time tissue elastography. RESULTS: LS and LFI correlated well before and after therapy (r = 0.567, p = 0.003 and r = 0.576, p = 0.002, respectively). In the group without a sustained virological response (SVR), LS increased in 4 of 5 patients. Patients with an increase in both LS and LFI were all in the non-SVR group (3/3, 100%). In addition, LS increased in all patients except 1 in the non-SVR group (4/5, 80%). In the SVR group, both LS and LFI decreased in all patients except 1 (18/19, 94.7%). In the patient with an increase in LS despite achieving SVR, LS decreased quickly after alcohol cessation. CONCLUSIONS: With a few exceptions, SVR improved LS. All patients with an increase in LFI were in the non-SVR group, even though LFI decreased in 2 patients. Our findings suggest that an LFI increase indicates lack of treatment efficacy with antiviral therapy. LFI may be useful for the assessment of treatment efficacy in patients with worsening of LS despite achieving SVR with antiviral therapy.
- Nishida Naoshi; Kudo Masatoshi; Arizumi Tadaaki; Takita Masahiro; Kitai Satoshi; Yada Norihisa; Inoue Tatsuo; Hagiwara Satoru; Minami Yasunori; Sakurai Toshiharu; Ueshima Kazuomi; Nagasaka Takeshi; Goel AjayHEPATOLOGY 58 1065A - 1066A 2013年10月 [査読有り]
- Satoru Hagiwara; Masatoshi Kudo; Yukio Osaki; Hiroo Matsuo; Tadashi Inuzuka; Akihiro Matsumoto; Eiji Tanaka; Toshiharu Sakurai; Kazuomi Ueshima; Tatsuo Inoue; Norihisa Yada; Naoshi NishidaJournal of medical virology 85 6 987 - 95 2013年06月The ideal approach to treat chronic hepatitis B remains controversial. This pilot study aimed to evaluate the effectiveness of peginterferon (PEG-IFN) α-2b and entecavir hydrate (ETV) as a combination therapy for patients with chronic hepatitis B, particularly in the context of virological response and the reduction of intrahepatic covalently closed circular DNA (cccDNA). A total of 17 patients with hepatitis B virus (HBV) genotype C were enrolled in this study. All subjects were treated with this combination therapy for 48 weeks and observed for an additional 24 weeks. All patients underwent liver biopsy before and after the therapy period. Changes in cccDNA levels and liver histology were monitored between biopsies. Among the 11 patients who exhibited pre-therapy hepatitis B e antigen (HBeAg), 8 (73%) showed evidence of HBeAg seroconversion by the end of the follow-up period. Serum HBV DNA levels decreased by 5.2 and 3.3 log copies/ml (mean) by the end of the therapy and follow-up periods, respectively. In addition, intrahepatic cccDNA decreased significantly to 1.4 log copies/µg (mean) by the end of the therapy period. Among the 11 patients who did not experience viral relapse, only 2 (18%) exhibited high levels of cccDNA (>4.5 log copies/µg) by the end of the treatment period. In contrast, all relapsed subjects exhibited significantly higher levels of cccDNA than subjects who did not relapse (P = 0.027). The combination regimen is a promising approach to treat chronic hepatitis B and may achieve significant reduction in serum HBV DNA and intrahepatic cccDNA. Wiley Periodicals, Inc.
- Norihisa Yada; Satoru Hagiwara; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Naoshi Nishida; Masatoshi KudoGASTROENTEROLOGY 144 5 S1041 - S1041 2013年05月0
- Tokuzo Arao; Kazuomi Ueshima; Kazuko Matsumoto; Tomoyuki Nagai; Hideharu Kimura; Satoru Hagiwara; Toshiharu Sakurai; Seiji Haji; Akishige Kanazawa; Hisashi Hidaka; Yukihiro Iso; Keiichi Kubota; Mitsuo Shimada; Tohru Utsunomiya; Masashi Hirooka; Yoichi Hiasa; Yoshikazu Toyoki; Kenichi Hakamada; Kohichiroh Yasui; Takashi Kumada; Hidenori Toyoda; Shuichi Sato; Hiroyuki Hisai; Teiji Kuzuya; Kaoru Tsuchiya; Namiki Izumi; Shigeki Arii; Kazuto Nishio; Masatoshi KudoHepatology (Baltimore, Md.) 57 4 1407 - 15 2013年04月UNLABELLED: The response rate to sorafenib in hepatocellular carcinoma (HCC) is relatively low (0.7%-3%), however, rapid and drastic tumor regression is occasionally observed. The molecular backgrounds and clinico-pathological features of these responders remain largely unclear. We analyzed the clinical and molecular backgrounds of 13 responders to sorafenib with significant tumor shrinkage in a retrospective study. A comparative genomic hybridization analysis using one frozen HCC sample from a responder demonstrated that the 11q13 region, a rare amplicon in HCC including the loci for FGF3 and FGF4, was highly amplified. A real-time polymerase chain reaction-based copy number assay revealed that FGF3/FGF4 amplification was observed in three of the 10 HCC samples from responders in which DNA was evaluable, whereas amplification was not observed in 38 patients with stable or progressive disease (P = 0.006). Fluorescence in situ hybridization analysis confirmed FGF3 amplification. In addition, the clinico-pathological features showed that multiple lung metastases (5/13, P = 0.006) and a poorly differentiated histological type (5/13, P = 0.13) were frequently observed in responders. A growth inhibitory assay showed that only one FGF3/FGF4-amplified and three FGFR2-amplified cancer cell lines exhibited hypersensitivity to sorafenib in vitro. Finally, an in vivo study revealed that treatment with a low dose of sorafenib was partially effective for stably and exogenously expressed FGF4 tumors, while being less effective in tumors expressing EGFP or FGF3. CONCLUSION: FGF3/FGF4 amplification was observed in around 2% of HCCs. Although the sample size was relatively small, FGF3/FGF4 amplification, a poorly differentiated histological type, and multiple lung metastases were frequently observed in responders to sorafenib. Our findings may provide a novel insight into the molecular background of HCC and sorafenib responders, warranting further prospective biomarker studies.
- Kenji Fujimoto; Michio Kato; Masatoshi Kudo; Norihisa Yada; Tsuyoshi Shiina; Kazuomi Ueshima; Yukinori Yamada; Tetsushi Ishida; Masayoshi Azuma; Masaru Yamasaki; Keiji Yamamoto; Norio Hayashi; Tetsuo TakeharaOncology 84 Suppl 1 3 - 12 2013年It has been established that the long-term infection of chronic hepatitis C leads to the increased risk of hepatic fibrosis and hepatocellular carcinoma. Currently, histological diagnosis by invasive and painful liver biopsy is the gold standard for evaluating the hepatic fibrosis stage. Because of a side effect or patient inability to cope with the pain, it is difficult to assess the fibrosis stage frequently using liver biopsy. Recently, instead of liver biopsy, many articles have been published showing the usefulness of ultrasound elastography to evaluate the stage of hepatic fibrosis. We also reported the usefulness of real-time tissue elastography (RTE) for liver fibrosis staging in 2007. However, in our previous report, fibrosis classification was performed manually and the number of patients involved was also small. In the current study, the fibrosis staging is performed automatically using software by characterizing the elastography images. We have also increased the number of patients from 64 to 310. Thus, the aim of this study is to increase objectivity by using a newly developed automatic analysis method. We obtain the Liver Fibrosis Index (LFI), which is calculated from image features of RTE images, using multiple regression analysis performed on clinical data of 310 cases as the training data set. The correlation coefficient obtained between the LFI and the stage of hepatic fibrosis was r = 0.68, and significant differences exist between all stages of fibrosis (p < 0.001). Our new method seems promising since it has the ability to diagnose fibrosis even in the presence of inflammation.
- Tatsuo Inoue; Masatoshi Kudo; Kinuyo Hatanaka; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Toshiharu Sakurai; Kazuomi Ueshima; Naoshi NishidaOncology 84 Suppl 1 51 - 7 2013年OBJECTIVE: Contrast-enhanced ultrasonography (CEUS) with Sonazoid® and dynamic computed tomography (CT) were used to evaluate radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Local recurrence rate was used as the gold standard of evaluation. METHODS: From January 2007 to December 2011, 86 HCCs from 70 patients were treated with RFA. CEUS with Sonazoid and dynamic CT were then used to evaluate the effect of RFA. For CEUS and dynamic CT, effects were classified as follows: (1) complete ablated response with safety margin >5 mm (CRSM+); (2) complete ablated response but with safety margin <5 mm (CRSM-); (3) incomplete, residual tumor detected after treatment. RESULTS: CEUS judged 33 cases as CRSM+, while dynamic CT identified 49 cases. None of these 33 cases from the CEUS group had local recurrences, while dynamic CT had 1 case. CEUS judged 49 cases as CRSM-, compared to 34 cases with dynamic CT. Of these, 9 cases of CEUS and 8 cases of dynamic CT showed local recurrences. Two cases diagnosed as 'incomplete' by CEUS and dynamic CT had recurrences within 1 year. CONCLUSION: CEUS can be used to assess the efficacy of RFA for HCC, with the potential to reduce the number of CT scans required for confirmation.
- Naoshi Nishida; Tadaaki Arizumi; Masahiro Takita; Tomoyuki Nagai; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Hiroshi Ida; Masatoshi KudoOncology 84 Suppl 1 82 - 7 2013年OBJECTIVES: Hepatocellular carcinoma (HCC) is one of the common cancers worldwide. Accurate diagnosis of tumor progression is critical for the appropriate management of HCC. Here, we established a sensitive assay to detect and quantify tumor-derived DNA in the serum of HCC patients. METHODS: Aberrant methylation of the APC gene was quantified in 23 HCC patients and 8 healthy volunteers using 100 µl of serum. For sensitive detection and accurate quantification of tumor DNA, we combined seminested polymerase chain reaction (PCR) with TaqMan PCR, which could amplify the APC gene regardless of the methylation status and detect the methylated and unmethylated sequences separately. The ratio of methylated to unmethylated sequences was quantified. RESULTS: The methylated APC gene was detected in all HCC patients examined, but no healthy volunteers showed amplification of methylated sequences in serum. HCC patients with portal vein thrombosis showed a significantly higher methylated to unmethylated APC gene ratio in serum than those without portal vein thrombosis (p = 0.0029). CONCLUSIONS: Considering the strong association between the ratio of the methylated to unmethylated APC sequences in serum and the presence of portal vein thrombosis, methylation status of APC sequences could be a promising marker for improving HCC management.
- Naoshi Nishida; Masatoshi Kudo; Takafumi Nishimura; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Naosuke Yokomichi; Takeshi Nagasaka; Ajay GoelPloS one 8 9 e72312 2013年Global DNA hypomethylation is a characteristic feature of cancer cells that closely associates with chromosomal instability (CIN). However, the association between these characteristics during hepatocarcinogenesis remains unclear. Herein, we determined the relationship between hypomethylation and CIN in human hepatocellular carcinoma (HCC) by analyzing 179 HCCs, 178 matched non-tumor livers and 23 normal liver tissues. Hypomethylation at three different repetitive DNA (rDNA) sequences and hypermethylation of 12 CpG loci, including 11 tumor suppressor gene (TSG) promoters, were quantified using MethyLight or combined bisulfite restriction analysis. Fractional allelic loss (FAL) was used as a marker for CIN, calculated by analyzing 400 microsatellite markers. Gains and losses at each chromosome were also determined using semi-quantitative microsatellite analysis. The associations between rDNA hypomethylation and FAL, as well as between TSG hypermethylation and FAL were investigated. Significantly more hypomethylation was observed in HCC tissues than in normal liver samples. Progression of hypomethylation during carcinogenesis was more prominent in hepatitis C virus (HCV)-negative cases, which was in contrast to our previous reports of significantly increased TSG methylation levels in HCV-positive tumors. Absence of liver cirrhosis and higher FAL scores were identified as independent contributors to significant hypomethylation of rDNA in HCC. Among the chromosomal alterations frequently observed in HCC, loss of 8p, which was unique in the earliest stages of hepatocarcinogenesis, was significantly associated with hypomethylation of rDNA by multivariable analysis (p=0.0153). rDNA hypomethylation was also associated with a high FAL score regardless of tumor differentiation (p=0.0011, well-differentiated; p=0.0089, moderately/poorly-differentiated HCCs). We conclude that DNA hypomethylation is an important cause of CIN in the earliest step of HCC, especially in a background of non-cirrhotic liver.
- Toshiharu Sakurai; Masatoshi Kudo; Tomohiro Watanabe; Katsuhiko Itoh; Hiroaki Higashitsuji; Tadaaki Arizumi; Tatsuo Inoue; Satoru Hagiwara; Kazuomi Ueshima; Naoshi Nishida; Manabu Fukumoto; Jun FujitaDigestive diseases (Basel, Switzerland) 31 5-6 440 - 6 2013年OBJECTIVE: Mild hypothermia (32-33°C) shows protective effects in patients with brain damage and cardiac arrest. Although cold-inducible RNA-binding protein (CIRP) contributes to the protective effects of hypothermia through extracellular signal-regulated kinase activation in fibroblasts, the effects of hypothermia in the liver remain unclear. METHODS: We analysed the effects of cold temperature on fulminant hepatitis, a potentially fatal disease, using the D-galactosamine (GalN)/lipopolysaccharide (LPS) and concanavalin (con) A-induced hepatitis models in mice. After GalN/LPS administration and anaesthesia, mice in the hypothermia group were kept at 25°C and those in control group were kept at 35°C. After concanavalin A (con A) administration, the mice in the hypothermia group were placed in a chamber with an ambient temperature of 6°C for 1.5 h. RESULTS: Hypothermia attenuated liver injury and prolonged survival. Activation of c-Jun N-terminal kinase and Akt, which are involved in reactive oxygen species (ROS) accumulation, was suppressed by low temperature. Hypothermia significantly decreased oxidized protein levels, and treatment with N-acetyl-L-cysteine, an antioxidant, attenuated GalN/LPS-induced liver injury. In con A-induced hepatitis, CIRP expression was upregulated and Bid expression was downregulated, resulting in decreased apoptosis of hepatocytes in the hypothermia group. CONCLUSIONS: These data suggest that hypothermia directly protects hepatocytes from cell death via reduction of ROS production in fulminant hepatitis.
- Naoshi Nishida; Tadaaki Arizumi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Masatoshi KudoDigestive diseases (Basel, Switzerland) 31 5-6 459 - 66 2013年Chronic hepatitis C (CHC) triggers oxidative stress and contributes to the emergence of hepatocellular carcinoma (HCC). We previously reported that tumor suppressor gene (TSG) methylation is a critical factor during the early stages of hepatocarcinogenesis. In this study, we clarify the association between oxidative stress and epigenetic alterations during hepatocarcinogenesis. We examined DNA oxidation and methylation profiles in 128 liver biopsy samples from CHC patients. The DNA oxidation and methylated TSG numbers were quantified using immunohistochemical analysis of 8-hydroxydeoxyguanosine (8-OHdG) and quantitative PCR for 11 TSGs, respectively. The quantitative chromatin immunoprecipitation-PCR (ChIP-qPCR) assay in HepG2 and fetal liver Hc cells treated with H2O2 was used to quantify trimethyl-H3K4, acetylated-H4K16 (an active chromatin marker), trimethyl-H3K27 (a repressive chromatin marker) and 8-OHdG. We analyzed 30 promoters of 25 different TSGs by qPCR. The high levels of 8-OHdG was the only variable that was significantly associated with the increased number of methylated TSGs in CHC (p < 0.0001). The ChIP-qPCR revealed that after H2O2 treatment of the cell lines, the 8-OHdG-bound promoters showed a modification from an active chromatin (trimethyl-H3K4 and acetylated-H4K16 dominant) to a repressive chromatin (trimethyl-H3K27 dominant) status. We conclude that oxidative stress alters the chromatin status, which leads to abnormal methylation of TSGs, and contributes to hepatocarcinogenesis in CHC patients.
- Nagai Tomoyuki; Kazuomi Ueshima; Hayaishi Sosuke; Takita Masahiro; Kitai Satoshi; Yada Norihisa; Inoue Tatsuo; Hagiwara Satoru; Minami Yasunori; Nishida Naoshi; Kudo MasatoshiJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 27 225 2012年12月 [査読有り]
- Kazuomi Ueshima; Masatoshi KudoNihon rinsho. Japanese journal of clinical medicine 70 Suppl 8 457 - 62 2012年11月
- Tatsuo Inoue; Masatoshi Kudo; Mina Komuta; Sosuke Hayaishi; Taisuke Ueda; Masahiro Takita; Satoshi Kitai; Kinuyo Hatanaka; Norihisa Yada; Satoru Hagiwara; Hobyung Chung; Toshiharu Sakurai; Kazuomi Ueshima; Michiie Sakamoto; Osamu Maenishi; Tomoko Hyodo; Masahiro Okada; Seishi Kumano; Takamichi MurakamiJournal of gastroenterology 47 9 1036 - 47 2012年09月BACKGROUND: We aimed to evaluate gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for the detection of hepatocellular carcinomas (HCCs) and dysplastic nodules (DNs) compared with dynamic multi-detector row computed tomography (MDCT), and to discriminate between HCCs and DNs. METHODS: Eighty-six nodules diagnosed as HCC or DNs were retrospectively investigated. Gd-EOB-DTPA-enhanced MRI and dynamic MDCT were compared with respect to their diagnostic ability for hypervascular HCCs and detection sensitivity for hypovascular tumors. The ability of hepatobiliary images of Gd-EOB-DTPA-enhanced MRI to discriminate between these nodules was assessed. We also calculated the EOB enhancement ratio of the tumors. RESULTS: For hypervascular HCCs, the diagnostic ability of Gd-EOB-DTPA-enhanced MRI was significantly higher than that of MDCT for tumors less than 2 cm (p = 0.048). There was no difference in the detection of hypervascular HCCs between hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI (43/45: 96%) and dynamic MDCT (40/45: 89%), whereas the detection sensitivity of hypovascular tumors by Gd-EOB-DTPA-enhanced MRI was significantly higher than that by dynamic MDCT (39/41: 95% vs. 25/41: 61%, p = 0.001). EOB enhancement ratios were decreased in parallel with the degree of differentiation in DNs and HCCs, although there was no difference between DNs and hypovascular well-differentiated HCCs. CONCLUSION: The diagnostic ability of Gd-EOB-DTPA-enhanced MRI for hypervascular HCCs less than 2 cm was significantly higher than that of MDCT. For hypovascular tumors, the detection sensitivity of hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was significantly higher than that of dynamic Gd-EOB-DTPA-enhanced MRI and dynamic MDCT. It was difficult to distinguish between DNs and hypovascular well-differentiated HCCs based on the EOB enhancement ratio.
- Minami Yasunori; Hatanaka Kinuyo; Arizumi Tadaaki; Hayaishi Sosuke; Takita Masahiro; Kitai Satoshi; Yada Norihisa; Inoue Tatsuo; Hagiwara Satoru; Ueshima Kazuomi; Nishida Naoshi; Kudo MasatoshiGASTROENTEROLOGY 142 5 S1002 2012年05月 [査読有り]
- Inoue Tatsuo; Arizumi Tadaaki; Kitai Satoshi; Yada Norihisa; Hagiwara Satoru; Minami Yasunori; Sakurai Toshiharu; Ueshima Kazuomi; Nishida Naoshi; Kudo MasatoshiGASTROENTEROLOGY 142 5 S1002 2012年05月 [査読有り]
- Nishida Naoshi; Kudo Masatoshi; Arizumi Tadaaki; Hayaishi Sosuke; Takita Masahiro; Kitai Satoshi; Yada Norihisa; Inoue Tatsuo; Hagiwara Satoru; Minami Yasunori; Ueshima Kazuomi; Sakurai Toshiharu; Nagasaka Takeshi; Goel AjayGASTROENTEROLOGY 142 5 S910 - S911 2012年05月 [査読有り]
- Sakurai Toshiharu; Hagiwara Satoru; Inoue Tatsuo; Ueshima Kazuomi; Matsui Shigenaga; Nishida Naoshi; Kashida Hiroshi; Kudo MasatoshiGASTROENTEROLOGY 142 5 S452 2012年05月 [査読有り]
- Satoru Hagiwara; Masatoshi Kudo; Hobyung Chung; Kazuomi Ueshima; Tatsuo Inoue; Seiji Haji; Tomohiro Watanabe; Ah-Mee Park; Hiroshi Munakata; Toshiharu SakuraiHepatology research : the official journal of the Japan Society of Hepatology 42 4 394 - 400 2012年04月AIM: Hepatocellular carcinoma (HCC) ranks as the third leading cause of cancer deaths worldwide. Hepatic resection is the mainstay of curative treatment for early stage HCC. Although c-Jun N-terminal kinase (JNK) activation contributes to hepatocyte proliferation and HCC development in mice, the extent of involvement of JNK in human HCC development is unknown. The aim of this study is to assess the predictive value of JNK for postoperative recurrence in HCC. METHODS: From April 2005 to March 2008, 159 patients underwent curative resection for HCC. From the 159 patients, 20 patients each matched for age, gender and etiology were registered as three groups: (i) without recurrence (no recurrence group), (ii) with recurrence within one year after surgery (early recurrence group), and (iii) with recurrence at one year or more after surgery (late recurrence group) (a cross-sectional control study). We investigated factors contributing to postoperative early and late phase recurrence. RESULTS: Multivariate analysis using a Logistic regression model showed that JNK activity in non-cancerous liver tissue was correlated with postoperative late recurrence. (P = 0.02, odds ratio; 5.79, 95% confidence interval [CI]; 1.33-25.36). CONCLUSIONS: JNK activity in non-cancerous liver tissue is considered as a reliable predictive biomarker for post-operative recurrence in HCC.
- Satoru Hagiwara; Toshiharu Sakurai; Shinichi Nishina; Kaoru Tanaka; Masafumi Ikeda; Kazuomi Ueshima; Yasunori Minami; Tatsuo Inoue; Norihisa Yada; Satoshi Kitai; Masahiro Takita; Tomoyuki Nagai; Sousuke Hayaishi; Tadaaki Arizumi; Ah-Mee Park; Hiroshi Munakata; Naoshi Nishida; Masatoshi KudoDigestive diseases (Basel, Switzerland) 30 6 541 - 6 2012年OBJECTIVE: A number of studies have reported reactivation of hepatitis B during intensive immunosuppressive therapy such as cases of hematological malignancy, whereas little has been reported for characteristics of reactivation triggered by chemotherapy for solid cancer. METHODS: A total of 130 patients underwent chemotherapy for treatments of common solid cancer between May 2011 and May 2012 at Kinki University Hospital. Among them, 27 patients were suspected for a past infection of hepatitis B virus (HBV), showing positive for hepatitis B core antibody or surface antibody but negative for hepatitis B surface antigen, and were eligible for this study. RESULTS: Hepatitis B reactivation was observed in 2 of 27 cases (7.4%). The duration between the start of chemotherapy and increase of serum HBV load was 30 days in both cases. CONCLUSIONS: We reported the 2 cases of hepatitis B reactivation receiving chemotherapy for solid cancer in terms of patterns and characteristics of reactivation. Accumulation of such cases will help in clarifying the clinical importance of hepatitis B reactivation during treatment of solid malignancies.
- Naoshi Nishida; Tadaaki Arizumi; Sosuke Hayaishi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toshiharu Sakurai; Iwao Ikai; Masatoshi KudoDigestive diseases (Basel, Switzerland) 30 6 547 - 53 2012年OBJECTIVES: A unique causative aspect of hepatocellular carcinoma (HCC) is a gender difference in its incidence. To determine the specific factors that contribute to a male predominance, we analyzed the clinicopathological factors, and genetic and epigenetic alterations of HCCs in male and female patients. METHODS: We retrospectively analyzed three cohorts of patients: the first cohort consisted of 547 patients identified with the first event of HCC, the second cohort included 176 HCC patients, and the third 127 patients with chronic hepatitis C (CHC). RESULTS: Male patients were found to have HCC more frequently than female patients in cases of non-cirrhotic liver (p = 0.0030 by the χ(2) test), especially in hepatitis C-positive cases. However, there were no gender-specific differences in the genetic and epigenetic alterations of cancer-related genes. Deposition of iron was more severe in male CHC patients than in female patients. CONCLUSIONS: Male patients with CHC develop HCC more frequently when they have a non-cirrhotic liver than do female patients. This gender difference could be, at least partially, attributed to a different degree of iron deposition, which contributes to the development of HCC in the absence of liver cirrhosis in men with CHC.
- Satoru Hagiwara; Toshiharu Sakurai; Masahiro Takita; Kazuomi Ueshima; Yasunori Minami; Tatsuo Inoue; Norihisa Yada; Satoshi Kitai; Tomoyuki Nagai; Sousuke Hayaishi; Tadaaki Arizumi; Naoshi Nishida; Masatoshi KudoDigestive diseases (Basel, Switzerland) 30 6 561 - 7 2012年OBJECTIVE: Increasing evidence suggests the efficacy of maintenance therapy with interferon (IFN) for chronic hepatitis C (CHC) in reducing the risk of hepatocellular carcinoma (HCC). The aim of this study was to determine clinical characteristics on the risk of occurrence of HCC in CHC patients receiving maintenance IFN therapy. METHODS: A total of 55 patients were treated in a single center with PEG-IFNα-2a monotherapy for CHC and evaluated for variables predictive of the occurrence of HCC. RESULTS: The cumulative incidences of HCC were 0.092, 0.117 and 0.161 at 3, 5 and 7 years, respectively. Serum ALT level (>40 IU/l) in the 6th month after commencement of IFN therapy and BMI >25 were associated with shorter time-to-HCC emergence using multivariate analysis (relative risk 16.034, p = 0.01 for ALT >40 IU/l; relative risk 6.020, p = 0.026 for BMI >25, respectively). The IL28B SNP was extracted as a significant factor for the occurrence of HCC. CONCLUSIONS: Maintenance therapy with the use of long-term low-dose PEG-IFNα-2a is effective for preventing HCC occurrence irrespective of the IL28B SNP, at least for a subset of CHC patients. The initial response of serum ALT levels and BMI provides a prognostic value for determining the risk of developing HCC later in life.
- Masatoshi Kudo; Kazuomi Ueshima; Tadaaki ArizumiDigestive diseases (Basel, Switzerland) 30 6 609 - 16 2012年To evaluate the efficacy of sorafenib monotherapy, we enrolled 188 patients with hepatocellular carcinoma (HCC) who had undergone sorafenib monotherapy during a 3-year period from May 2009 to June 2012. Median overall survival was 15.6 months, and the 1- and 2-year survival rate was 54.4 and 32.2%, respectively, showing a relatively favorable treatment outcome. In addition, outcome was more favorable in earlier TNM stages. HCC patients with stage IVB had a better outcome than those with stage IVA, indicating the involvement of vascular invasion had poor prognosis. Outcome was more favorable in patients with Child-Pugh class A than in those with Child-Pugh class B. Patients in the long-term treatment group, who received sorafenib for ≥90 days, also showed a favorable outcome compared with those in the short-term treatment group, in which the administration period was <90 days. Multivariate analysis revealed treatment duration as a significant prognostic factor. Furthermore, patients who received post-sorafenib treatment had a better outcome than those who did not.
- Sakurai Toshiharu; Kudo Masatoshi; Ueshima Kazuomi; Matsui Shigenaga; Kashida Hiroshi; Karin MichaelGASTROENTEROLOGY 140 5 S927 2011年05月 [査読有り]
- Satoru Hagiwara; Masatoshi Kudo; Kazuomi Ueshima; Hobyung Chung; Mami Yamaguchi; Masahiro Takita; Seiji Haji; Masatomo Kimura; Tokuzo Arao; Kazuto Nishio; Ah-Mee Park; Hiroshi MunakataJournal of gastroenterology 46 2 212 - 21 2011年02月BACKGROUND: Combination therapy with the oral fluoropyrimidine anticancer drug S1 and interferon is reportedly effective for the treatment of advanced hepatocellular carcinoma (HCC), but selection criteria for this therapy have not been clarified. In this study, we attempted to identify factors predicting the effectiveness of this combination therapy. METHODS: Pathological specimens of HCC were collected before treatment from 31 patients with advanced HCC who underwent S1+ pegylated-interferon (PEG-IFN) α-2b therapy between January 2007 and January 2009. In these pathological specimens, the expression levels of CD133, thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), and interferon-receptor 2 (IFNR2) proteins were determined by Western blot assay. The presence or absence of p53 gene mutations was determined by direct sequencing. The relationships between these protein expression levels and the response rate (RR), progression-free survival (PFS), and overall survival (OS) were evaluated. RESULTS: The CD133 protein expression level was significantly lower in the responder group than in the nonresponder group. Comparing the PFS and OS between high- and low-level CD133 expression groups (n = 13 and 18, respectively) revealed that both parameters were significantly prolonged in the latter group. The expression levels of TS, DPD, and IFNR2 protein and the presence of p53 gene mutations did not correlate with the RR. CONCLUSIONS: CD133 was identified as a predictor of the therapeutic effect of S1+ PEG-IFN α-2b therapy against advanced HCC.
- Kazuomi Ueshima; Masatoshi Kudo; Masahiro Takita; Tomoyuki Nagai; Chie Tatsumi; Taisuke Ueda; Satoshi Kitai; Emi Ishikawa; Norihisa Yada; Tatsuo Inoue; Satoru Hagiwara; Yasunori Minami; Hobyung Chung; Toshiharu SakuraiDigestive diseases (Basel, Switzerland) 29 3 321 - 5 2011年OBJECTIVE: The purpose of this study was to evaluate the role of des-γ-carboxyprothrombin (DCP) as a marker for the efficacy of sorafenib therapy for hepatocellular carcinoma (HCC). METHODS: Patients with advanced HCC treated with sorafenib were retrospectively evaluated, focusing on DCP levels and clinical characteristics. RESULTS: 50 patients with advanced HCC were treated with sorafenib alone. In 25 of these patients, the serum levels of DCP were evaluated twice (pretreatment and within 2 weeks after starting therapy). The time to progression was significantly longer in patients in whom the DCP level at 2 weeks after starting sorafenib was ≥2-fold higher than the pretreatment levels, as compared with patients without an increase in DCP (p = 0.0296). CONCLUSIONS: The serum level of DCP is a surrogate marker for tissue hypoxia and can be a predictive marker to assess the tumor response to sorafenib therapy.
- Sosuke Hayaishi; Hobyung Chung; Masatoshi Kudo; Emi Ishikawa; Masahiro Takita; Taisuke Ueda; Satoshi Kitai; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Kazuomi UeshimaDigestive diseases (Basel, Switzerland) 29 3 326 - 32 2011年BACKGROUND: It has been reported that branched-chain amino acid (BCAA) supplementation can improve nutritional status and prevent liver-related complications in patients with decompensated cirrhosis. We investigated the effects of oral BCAA supplementation on the incidence of hepatocellular carcinoma (HCC) and liver-related events in patients with compensated and decompensated cirrhosis. METHODS: We enrolled 211 patients with cirrhosis including 152 patients with Child-Pugh A cirrhosis, but no history of HCC. Of these, 56 received oral administration of 12 g/day BCAA for ≥6 months (BCAA group), and 155 were followed-up without BCAA treatment (control group). The HCC occurrence and event-free survival rates were compared between the two groups. We used a propensity score analysis to overcome selection bias of this retrospective analysis. RESULTS: The HCC occurrence rate was significantly lower and event-free survival rate was significantly higher in the BCAA group than in the control group. Multivariate analyses showed BCAA supplementation was significantly associated with reduced incidence of HCC (hazard ratio (HR) 0.416, 95% confidence interval (CI) 0.216-0.800, p = 0.0085). BCAA supplementation also reduced the incidence of liver-related events in patients with Child-Pugh A cirrhosis, although the difference did not reach statistical significance (HR 0.585, 95% CI 0.336-1.017, p = 0.0575). CONCLUSIONS: Oral BCAA supplementation is associated with reduced incidence of HCC in patients with cirrhosis and seems to prevent liver-related events in patients with Child-Pugh A cirrhosis.
- Masahiro Takita; Satoru Hagiwara; Tadaaki Arizumi; Sousuke Hayaishi; Taisuke Ueda; Satoshi Kitai; Norihisa Yada; Tatsuo Inoue; Yasunori Minami; Hobyung Chung; Kazuomi Ueshima; Toshiharu Sakurai; Masatoshi KudoDigestion 84 Suppl 1 56 - 61 2011年BACKGROUND: Pegylated interferon (PEG-IFN) plus ribavirin therapy is the current standard treatment for chronic hepatitis C (CHC) genotype 1 with high viral load. A common genetic variation near the IL28B gene has been found to affect the response to PEG-IFN plus ribavirin therapy for CHC. The aims of this study were to analyze the association between the rs8099917 genotype and treatment response in a cohort study of CHC. METHODS: This study evaluated clinical and laboratory parameters retrospectively in a cohort of 122 patients with chronic hepatitis C with genotype 1 and a high viral load who received PEG-IFN plus ribavirin therapy. We carried out univariate and multivariate statistical analyses of parameters and clinical responses. RESULTS: Sixty-three of 122 patients (51.6%) had sustained virological responses (SVRs). Patients with the rs8099917 genotype TT achieved significantly higher SVR rates (p < 0.01). Univariate analysis revealed that SVRs were associated with BMI, fibrosis, albumin, total cholesterol, PEG-IFN dose, ribavirin dose and the rs8099917 genotype. Multivariate analysis revealed that the rs8099917 genotype (odds ratio 7.434, 95% CI 2.278-24.257, p = 0.001) and total PEG-IFN dose (odds ratio 7.162, 95% CI 1.565-18.15, p = 0.007) were significant factors. CONCLUSIONS: The rs8099917 genotype and total PEG-IFN dose were associated with SVR in patients with hepatitis C virus genotype 1.
- Junji Furuse; Takuji Okusaka; Shuichi Kaneko; Masatoshi Kudo; Kohei Nakachi; Hideki Ueno; Tatsuya Yamashita; Kazuomi UeshimaCancer science 101 12 2606 - 11 2010年12月S-1, an oral fluoropyrimidine derivative, has been shown to be clinically effective against various solid tumors, and preclinical studies have demonstrated activity against hepatocellular carcinoma. We conducted a phase I/II study in patients with advanced hepatocellular carcinoma to examine the pharmacokinetics, recommended dose, safety and efficacy of S-1. In phase I, the administered dose of S-1 was approximately 64 mg/m(2) per day in three patients (level 1) and approximately 80 mg/m(2) per day in six patients (level 2). There was no dose-limiting toxicity at level 1, but two patients had dose-limiting toxicity at level 2 (grade 3 anorexia and grade 2 rash requiring eight or more consecutive days of rest). The recommended dose was finally estimated to be 80 mg/m(2) per day. There were no significant differences in the pharmacokinetics of S-1 between patients with Child-Pugh A and those with B. In phase II, five of 23 patients (21.7%) had partial responses. The median progression-free survival and overall survival were 3.7 and 16.6 months, respectively. The most common toxicities of grade 3 or 4 were elevated serum aspartate aminotransferase levels, hypochromia and thrombocytopenia. In conclusion, S-1 showed an acceptable toxicity profile and promising antitumor activity for hepatocellular carcinoma, warranting further evaluation in randomized clinical trials.
- Tatsuo Inoue; Yasunori Minami; Hobyung Chung; Sousuke Hayaishi; Taisuke Ueda; Chie Tatsumi; Masahiro Takita; Satoshi Kitai; Kinuyo Hatanaka; Emi Ishikawa; Norihisa Yada; Satoru Hagiwara; Kazuomi Ueshima; Masatoshi KudoOncology 78 Suppl 1 94 - 101 2010年07月PURPOSE: To confirm the safety and effectiveness of techniques to assist radiofrequency ablation (RFA) for difficult cases, we retrospectively evaluated successful treatment rates, early complications and local tumor progressions. PATIENTS AND METHODS: Between June 1999 and April 2009, a total of 341 patients with 535 nodules were treated as difficult cases. Artificial pleural effusion assisted ablation was performed on 64 patients with 82 nodules. Artificial ascites-assisted ablation was performed on 11 patients with 13 nodules. Cooling by endoscopic nasobiliary drainage (ENBD) tube-assisted ablation was performed on 6 patients with 8 nodules. When the tumors were not well visualized with conventional B-mode ultrasonography (US), contrast-enhanced US-assisted ablation with Levovist or Sonazoid or virtual CT sonography-assisted ablation was performed. Contrast-enhanced US-assisted ablation was performed on 139 patients with 224 nodules and virtual CT sonography-assisted ablation was performed on 121 patients with 209 nodules. RESULTS: In total, complete ablation was achieved in 514 of 535 (96%) nodules in difficult cases. For RFA with artificial pleural effusion, artificial ascites and ENBD, complete response was confirmed in all cases. For contrast-enhanced US- and CT sonography-assisted ablation, complete response was 95%. Early complications were recognized in 24 cases (4.5%). All cases recovered with no invasive treatment. Local tumor recurrence was investigated in 377 nodules of 245 patients, and 69 (18%) nodules were positive. Tumor recurrences in each assisted technique were 14.7% in artificial pleural effusion cases, 7% in artificial ascites, 12.5% in ENBD tube cases, 31% in virtual CT sonography, and 8.5% in contrast-enhanced US. CONCLUSION: Although local tumor progression needs to be carefully monitored, assisted techniques of RFA for difficult cases are well tolerated and expand the indications of RFA.
- Kazuomi Ueshima; Masatoshi Kudo; Masahiro Takita; Tomoyuki Nagai; Chie Tatsumi; Taisuke Ueda; Satoshi Kitai; Emi Ishikawa; Norihisa Yada; Tatsuo Inoue; Satoru Hagiwara; Yasunori Minami; Hobyung ChungOncology 78 Suppl 1 148 - 53 2010年07月BACKGROUND: Although hepatic arterial infusion chemotherapy (HAIC) using low-dose 5-fluorouracil (5-FU) and cisplatin (low-dose FP) is commonly used for advanced hepatocellular carcinoma (HCC) with vascular invasion in Japan, few reports have investigated the efficacy and safety of this approach. We investigated the efficacy and toxicity of HAIC using low-dose FP for patients with advanced HCC as a phase II trial. METHODS: Low-dose FP consisted of a continuous arterial infusion of 5-FU (250-500 mg/day, 5 days/week, for the first 2 weeks) and cisplatin (10 mg/day, 5 days/week, for the first 2 weeks). Then, 5-FU (1,000 mg/body for 5 h) and cisplatin (10 mg/body) were administered once weekly. RESULTS: In these patients treated with low-dose FP, the response rate was 38.5%, the median time to progression was 4.1 months (95% CI 2.1-6.1 months) and the median survival time was 15.9 months (95% CI 9.8-22.0 months). The most frequent adverse events were myelosuppression such as neutropenia or thrombocytopenia. CONCLUSIONS: HAIC using low-dose FP is an effective treatment option for locally advanced HCC. However, it is not well tolerated hematologically because of potent pancytopenia and poor hepatic reserve. Therefore, this regimen should be performed carefully with regular monitoring of hematological function.
- Masatoshi Kudo; Kazuomi UeshimaOncology 78 Suppl 1 154 - 66 2010年07月Sorafenib, a molecular-targeted agent that inhibits tumor cell proliferation and angiogenesis by inhibiting RAF serine-threonine kinase and VEGF, PDGF, Flt-3, c-Kit receptor tyrosine kinase, was approved in Europe and North America in 2007 and in Japan on May 20, 2009. In the 10 months since its approval, sorafenib has been prescribed for more than 3,700 patients with advanced hepatocellular carcinoma (HCC), and its efficacy has been confirmed in many cases. According to the consensus statements of the Japan Society of Hepatology in 2010, sorafenib is recommended for advanced HCC with extrahepatic spread or major vascular invasion such as invasion of the 1st branch of the portal vein or the main portal branch of the portal vein in patients with Child-Pugh A liver function. In addition to that, transcatheter arterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) refractory HCC patients with Child-Pugh A liver function are also candidates of sorafenib monotherapy as a second-line treatment option. To date, 15 cases with complete remission (CR) to sorafenib in metastatic advanced HCC patients have been reported in Japan, an event that is rarely reported in other countries. Of the 90 cases treated by ourselves, 2 achieved CR. Factors indicating systemic cancer spread, including multiple liver lesions, lymph node metastases, adrenal metastases, lung metastases and vascular invasion, were completely absent in both cases of CR by 2 and 1 year, respectively. Similarly, three tumor markers (AFP, PIVKA-II, and AFP-L3) completely returned to normal values. Although cases of CR are rare, it seems that there might be racial differences in terms of gene mutations. Clinical trials for other molecular-targeted agents, including sunitinib, brivanib, or linifanib, are ongoing and their outcomes are eagerly awaited. According to a subanalysis of the SHARP study, it is expected that sorafenib in combination with resection, ablation, TACE or HAIC will markedly prolong the overall survival in early-, intermediate- and advanced- stage HCCs.
- Yasunori Minami; Masatoshi Kudo; Kinuyo Hatanaka; Satoshi Kitai; Tatsuo Inoue; Satoru Hagiwara; Hobyung Chung; Kazuomi UeshimaLiver international : official journal of the International Association for the Study of the Liver 30 5 759 - 64 2010年05月AIM: Conventional contrast harmonic sonography has the technical problem of a short enhancement time during targeting of hepatic malignancies for radiofrequency (RF) ablation. This study investigated the effectiveness of contrast harmonic sonographic guidance using perfluorocarbon microbubbles (Sonazoid) during RF ablation of hepatic malignancies. MATERIALS AND METHODS: Nodules were detected on contrast-enhanced computed tomography, but could not be resolved clearly by B-mode sonography. Sixty-six patients (51 men, 15 women; mean age, 65.8 years) with 108 hepatic malignancies were enrolled. Fifty-one patients with hepatocellular carcinoma and 15 patients with liver metastases were treated by RF ablation guided by contrast harmonic sonography using perfluorocarbon microbubbles for a target lesion identified as a defect image after the administration of contrast medium. RESULTS: The maximal diameters of all tumours ranged from 0.7 to 3.5 cm (mean +/- SD, 1.7 cm +/- 0.9) on sonography. Complete tumour necrosis was achieved by a single session of RF ablation in 62 (94%) of the 66 patients, while two sessions were required for the remaining four (6%) patients. The average number of treatment sessions was 1.1 +/- 0.3. In the post-vascular phase, 105 (97%) of a total of 108 malignant hepatic tumours were depicted as a defect with a margin. Clinical courses have been satisfactory without any signs of local tumour progression during 1-12 months of follow-up (mean, 4.3 months). CONCLUSION: Using perfluorocarbon microbubbles, contrast harmonic sonographic-guided RF ablation is an efficient approach for guiding further ablation of hepatic malignancies that are not clearly demarcated by B-mode sonography.
- Taisuke Ueda; Hobyung Chung; Masatoshi Kudo; Emi Ishikawa; Sousuke Hayaishi; Chie Tatsumi; Tatsuo Inoue; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Kazuomi UeshimaIntervirology 53 1 55 - 9 2010年OBJECTIVE: The extension of treatment duration has been proposed in late virological responders with hepatitis C virus (HCV) genotype 1 and high viral load. However, the effectiveness of extended treatment in patients whose serum HCV RNA become undetectable later than 24 weeks of treatment (ultra-late virological responder; ULVR) has not yet been determined. METHODS: A total of 130 patients infected with HCV genotype 1 and who had high viral load were treated with pegylated interferon (PEG-IFN) and ribavirin (RBV) combination therapy. We retrospectively analyzed 10 ULVR who received extended combination treatment beyond 48 weeks. RESULTS: The duration of the combination treatment for ULVR ranged between 59 and 119 weeks, and the mean duration was 80 weeks. Although the majority of ULVR were older female patients (> or = 60 years) with factors related to poor therapeutic response, 8 patients (80%) achieved sustained virological response (SVR). The SVR rate correlated well with the duration of the treatment. Five ULVR achieved SVR when treatment was continued until serum HCV RNA remained undetectable for longer than 48 weeks. CONCLUSION: The extended duration of PEG-IFN and RBV combination treatment is a possible strategy to improve treatment response in HCV genotype 1 infection, even for ULVR.
- Norihisa Yada; Masatoshi Kudo; Hobyung Chung; Sosuke Hayaishi; Masahiro Takita; Taisuke Ueda; Chie Tatsumi; Kinuyo Hatanaka; Satoshi Kitai; Emi Ishikawa; Tatsuo Inoue; Satoru Hagiwara; Kazuomi UeshimaIntervirology 53 1 60 - 5 2010年OBJECTIVES: We investigated the significance of serum ferritin levels in pegylated interferon (PEG-IFN) and ribavirin (RBV) combination therapy for chronic hepatitis C (CHC) and examined its correlation with serum alanine aminotransferase (ALT) levels during therapy and response to the therapy. METHODS: A total of 175 patients with CHC received the combination therapy. Correlations between serum ferritin levels and serum ALT levels at 12 and 24 weeks of therapy were examined. Differences in serum ferritin levels during therapy between patients with sustained viral response (SVR) and non-SVR were also examined. RESULTS: Only 24 (13.7%) and 20 (11.4%) patients showed elevated serum ALT levels (> or = 70 IU/l) at 12 and 24 weeks of therapy, respectively. There was no correlation between serum ferritin levels and ALT levels. Ninety-five (54.3%) of 175 patients achieved SVR. Serum ferritin levels increased dramatically in both SVR and non-SVR groups after starting the therapy and were significantly higher in the SVR group throughout the therapy. CONCLUSIONS: Serum ferritin level increases during PEG-IFN and RBV combination therapy; however, it did not correlate with either serum ALT level or the total dose of RBV. Higher serum ferritin levels during combination therapy appear to be associated with favorable therapeutic response.
- Chie Tatsumi; Masatoshi Kudo; Kazuomi Ueshima; Satoshi Kitai; Emi Ishikawa; Norihisa Yada; Satoru Hagiwara; Tatsuo Inoue; Yasunori Minami; Hobyung Chung; Kiyoshi Maekawa; Kenji Fujimoto; Michio Kato; Akiko Tonomura; Tsuyoshi Mitake; Tsuyoshi ShiinaIntervirology 53 1 76 - 81 2010年OBJECTIVE: The aim of this study was to investigate liver fibrosis using non-invasive Real-time Tissue Elastography (RTE) and transient elastography (FibroScan) methods. METHODS: RTE, FibroScan and percutaneous liver biopsy were all performed on patients with chronic liver disease, particularly hepatitis C, to investigate liver fibrosis. RESULTS: FibroScan and RTE were compared for fibrous liver staging (F stage), which was pathologically classified using liver biopsy. In FibroScan, significant differences were observed between F1/F3 and F2/F4, but no such differences were observed between F1/F2, F2/F3 and F3/F4. In RTE, significant differences were observed between F1/F2, F2/F3 and F2/F4. But for F3/F4, no significant differences were observed. CONCLUSION: FibroScan and RTE correlated well with F staging of the liver. In particular RTE was more successful than FibroScan in diagnosing the degree of liver fibrosis.
- Emi Ishikawa; Masatoshi Kudo; Yasunori Minami; Kazuomi Ueshima; Satoshi Kitai; Kazuki UedaInternal medicine (Tokyo, Japan) 49 12 1123 - 6 2010年Cronkhite-Canada syndrome (CCS) is a rare, noninherited gastrointestinal polyposis syndrome associated with characteristic ectodermal abnormalities. Here, we report a case of Cronkhite-Canada syndrome with cecal intussusception relieved by colonoscopy. A 52-year-old man who was diagnosed as CCS pathologically two years previously presented abdominal pain and sub fever-up. Physical examination revealed the palpable mass sized approximate 10 cm in diameter in the upper abdominal site, in addition to the symptoms of alopecia, absent fingernails and toenails. However, abdominal wall rigidity and rebound tenderness were never expressed. Abdominal plain CT showed concentric circles from the ascending to the middle of the transverse colon, and a tumor in the lumen at the middle of the transverse colon. Colonoscopic reduction was performed first because we diagnosed it as intussusception due to CCS polyps without peritoneal irritation, and his symptoms were improved dramatically after careful reduction. Therefore, he was able to undergo the laparoscopic ascending colectomy as scheduled.
- Tatsuya Yamashita; Shuichi Kaneko; Junji Furuse; Takuji Okusaka; Masatoshi Kudo; Kohei Nakachi; Masafumi Ikeda; Kazuomi UeshimaHEPATOLOGY 48 4 949A - 949A 2008年10月
- Hobyung Chung; Masatoshi Kudo; Shunsuke Takahashi; Satoru Hagiwara; Yasuhiro Sakaguchi; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toyokazu Fukunaga; Takashi MatsunagaJournal of gastroenterology and hepatology 23 3 445 - 52 2008年03月BACKGROUND AND AIM: Although various staging systems for hepatocellular carcinoma (HCC) have been developed in recent years, there is no worldwide consensus which staging system is best. The aim of the present study was to compare the performance of the currently developed three staging systems: the Japan integrated staging (JIS) score, new Barcelona Clinic Liver Cancer (BCLC) staging classification, and the Tokyo score. METHODS: A total of 290 consecutive patients with HCC before initial treatment at Kinki University between January 1999 and December 2001 were included. The patients were stratified according to the three staging systems, and the performance of the staging systems was compared using survival time as the only outcome measure. RESULTS: There were significant differences between all stages in the JIS score, while no significant difference was found between stages C and D in the BCLC staging classification and between all the scores, except between scores 0 and 1 and 2 and 3 in the Tokyo score. For all patients (n = 290), the radical treatment group (n = 208) and the non-radical treatment group (n = 82), the likelihood ratio chi(2)-test showed the highest value, and the Akaike information criterion value was lowest in the JIS score. CONCLUSION: The JIS score provided the best prognostic stratification in a Japanese cohort of HCC patients who were mainly diagnosed at early stages and treated with radical therapies.
- Shunsuke Takahashi; Hobyung Chung; Satoshi Kitai; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Masatoshi KudoLiver international : official journal of the International Association for the Study of the Liver 28 3 414 - 5 2008年03月
- Chie Tatsumi; Masatoshi Kudo; Kazuomi Ueshima; Satoshi Kitai; Shunsuke Takahashi; Tatsuo Inoue; Yasunori Minami; Hobyung Chung; Kiyoshi Maekawa; Kenji Fujimoto; Tonomura Akiko; Mitake TakeshiIntervirology 51 Suppl 1 27 - 33 2008年OBJECTIVE: The aim of this study was to investigate the accuracy of noninvasive tests, e.g. serum fibrotic markers, transient elastography and real-time tissue elastography, in the diagnosis of hepatic fibrosis, and to determine whether they can replace liver biopsy. METHODS: 119 patients with chronic liver disease were included in this study. Serum fibrotic markers including hyaluronic acid, type IV collagen, type IV collagen 7S domain and type III procollagen-N-peptide were measured. Aspartate aminotransferase (AST) and platelet counts were also measured to calculate the AST to platelet ratio index (APRI). Liver stiffness was measured using FibroScan and real-time tissue elastography. RESULTS: The fibrotic stage, determined by histopathological diagnosis of a liver biopsy sample, did not correlate as well with serum fibrotic markers although it was useful to diagnose liver cirrhosis. However, the stage of hepatic fibrosis correlated well with liver stiffness measured by FibroScan. FibroScan was also a much better predictor of liver cirrhosis than APRI. Furthermore, the levels of liver strain measured by real-time tissue elastography correlated well with liver stiffness (p < 0.05). CONCLUSION: Serum fibrotic markers and FibroScan are useful for distinguishing liver cirrhosis (F4) from chronic hepatitis (F1-F3). In addition, real-time tissue elastography is a novel and promising method to determine the stage of hepatic fibrosis.
- Kinuyo Hatanaka; Masatoshi Kudo; Yasunori Minami; Taisuke Ueda; Chie Tatsumi; Satoshi Kitai; Shunsuke Takahashi; Tatsuo Inoue; Satoru Hagiwara; Hobyung Chung; Kazuomi Ueshima; Kiyoshi MaekawaIntervirology 51 Suppl 1 61 - 9 2008年OBJECTIVE: To clarify the value of contrast-enhanced harmonic ultrasonography (US) with Sonazoid, a second-generation US contrast agent, in the differential diagnosis of liver tumors compared to dynamic CT. METHODS: A total of 249 hepatic nodules in 214 patients were studied; these included 177 hepatocellular carcinomas (HCCs), 42 liver metastases, 20 liver hemangiomas, 6 dysplastic nodules and 4 focal nodular hyperplasias (FNHs). After the injection of Sonazoid, nodules were scanned using real-time contrast-enhanced harmonic US in the vascular phases, i.e. the early and late vascular phases, and the Kupffer phase. RESULTS: Six enhancement patterns were identified to be significant for the differential diagnosis of hepatic tumors. In HCCs, the presence of intratumoral vessels supplied from the periphery and fast washout (sensitivity, 96.6%; specificity, 94.4%) were the most typical characteristics. In metastases, the presence of rim-like enhancement with peripheral tumor vessels (sensitivity, 88.1%; specificity, 100%) was the typical pattern. In hemangiomas, the presence of intratumoral hypoperfusion images with globular or cotton wool-like pooling, which continue to the late vascular phase (sensitivity, 90.0%; specificity, 99.6%), was typical. In dysplastic nodules, the presence of portal enhancement without arterial supply in the early vascular phase and the presence of intratumoral uptake in the Kupffer phase (sensitivity, 83.3%; specificity, 100%) were the most typical patterns. In FNHs, the presence of a spoke-wheel pattern in the early vascular phase with dense staining in the late vascular phase, and positive uptake within the nodule in the Kupffer phase (sensitivity, 100%; specificity, 100%) were the most typical patterns. CONCLUSION: Contrast-enhanced harmonic US with Sonazoid allowed intimate vascular and Kupffer imaging and, therefore, is useful for the differential diagnosis of hepatic tumors.
- Satoshi Kitai; Masatoshi Kudo; Yasunori Minami; Kazuomi Ueshima; Hobyung Chung; Satoru Hagiwara; Tatsuo Inoue; Emi Ishikawa; Shunsuke Takahashi; Yutaka Asakuma; Seiji Haji; Yukio Osaki; Hiroko Oka; Toshihito Seki; Hiroshi Kasugai; Yo Sasaki; Takashi MatsunagaIntervirology 51 Suppl 1 86 - 94 2008年OBJECTIVES: The Japan Integrated Staging (JIS) score has been reported to have good stratification ability in patients with hepatocellular carcinoma (HCC). However, the JIS score could not estimate malignant grade of HCC. The aim of this study was to evaluate the performance of a new staging system: the biomarker combined JIS (bm-JIS) which includes three tumor markers: alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive AFP and des-gamma-carboxy prothrombin with the conventional JIS score. METHODS: A total of 1,924 HCC patients were included in this study. We compared their overall survival, the stratification ability and suitability as a prognostic model according to the bm-JIS score and the conventional JIS score. RESULTS: There were significant differences between the survival curves for all bm-JIS scores. For the conventional JIS scores of 0, 1, 2 and 3, the survival curves differed greatly according to the bm-JIS score (p < 0.0001). The independent homogenizing ability and the stratification value of the JIS score and the bm-JIS score determined by the likelihood ratio test using the Cox proportional hazard regression model showed the bm-JIS score to have a higher value(chi2 = 717.348) than the JIS score (chi2 = 668.91). CONCLUSIONS: The bm-JIS score showed superior stratification ability and thus was found to be a better predictor of the prognosis than the conventional JIS score, especially for the patients with good prognosis.
- Emi Ishikawa; Masatoshi Kudo; Yasunori Minami; Kazuomi Ueshima; Hobyung Chung; Sosuke Hayaishi; Kiyoshi MaekawaInternal medicine (Tokyo, Japan) 47 22 1977 - 9 2008年A 60-year-old woman with polycystic kidney presented with intracystic hemorrhage; renocolic fistula was diagnosed by contrast-enhanced. The patient was admitted due to hematuria, pyuria and pneumaturia. Abdominal B-mode ultrasonography showed that this renal cyst had thickened walls and debris-like internal echo. Truagent Detection, a power Doppler imaging mode, could depict intracystic color signals after Levovist injection by real-time scan. Enhanced spots had increased in the cyst, and were shown as minimal intracystic hemorrhage in real-time. The case of polycystic kidney with renocolic fistula is rare, however contrast-enhanced ultrasonography could successfully identify the site of minute bleeding.
- Tatsuo Inoue; Masatoshi Kudo; Kinuyo Hatanaka; Syunsuke Takahashi; Satoshi Kitai; Taisuke Ueda; Emi Ishikawa; Satoru Hagiwara; Yasunori Minami; Hobyung Chung; Kazuomi Ueshima; Kiyoshi MaekawaOncology 75 Suppl 1 48 - 54 2008年PURPOSE: To evaluate the usefulness of vascular phase images of contrast-enhanced ultrasonography (CE-US) with Sonazoid for hepatocellular carcinomas (HCCs), a retrospective, comparative study was conducted of images of HCCs obtained by CE-US and superparamagnetic iron oxide (SPIO) magnetic resonance imaging (MRI) and evaluated qualitatively and quantitatively. METHODS: Seventy-seven patients with 88 HCCs who received CE-US and SPIO-MRI were reviewed. The ratio of the echogenicity of the tumor and nontumor areas was calculated with postvascular phase CE-US (postvascular phase ratio). The ratio of the intensity of the nontumor to tumor areas on SPIO-enhanced MRI (SPIO intensity index) was also calculated. The Pearson correlations were calculated for all values between the postvascular phase ratio and SPIO intensity index for quantitative comparison. These images were also compared qualitatively for the detection rate of the tumors. RESULTS: The sensitivities of CE-US and SPIO-MRI in detecting tumors were 98 and 95%, respectively (nonsignificant, chi(2) test). The postvascular phase ratio correlated with the SPIO intensity index for HCCs (Pearson r = 0.803, p < 0.05). The image conformity of the result from the liver parenchymal phase CE-US and SPIO-MRI was 92%. Dedifferentiation spots of nodule-in-nodule HCCs were detected in 4 (80%) of 5 on postvascular phase images of CE-US, and in 2 (40%) of 5 on SPIO-MRI (nonsignificant, chi(2) test). CONCLUSIONS: Postvascular phase images of CE-US with Sonazoid appear promising as an alternative to SPIO-enhanced MRI. Further study cases are needed to confirm the usefulness of postvascular phase images of CE-US compared to SPIO-MRI for the detection of dedifferentiation foci in hepatic tumors.
- Shunsuke Takahashi; Masatoshi Kudo; Hobyung Chung; Tatsuo Inoue; Emi Ishikawa; Satoshi Kitai; Chie Tatsumi; Taisuke Ueda; Tomoyuki Nagai; Yasunori Minami; Kazuomi UeshimaOncology 75 Suppl 1 91 - 8 2008年OBJECTIVE: This study was undertaken to assess the prognostic predictor in patients with hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). METHODS: This study retrospectively evaluated clinical outcomes in a cohort of 179 Child-Pugh stage A cirrhotic patients who received curative RFA for naive HCC within Milan criteria. The median follow-up period was 40.5 months. RESULTS: The cumulative survival rate was significantly lower in patients with prothrombin induced by vitamin K absence or antagonist II (PIVKA-II) > or =100 mAU/ml compared with PIVKA-II <100 mAU/ml (58.0 vs. 84.0% at 5 years; p < 0.001). The cumulative recurrence-free survival rates were significantly lower in patients with PIVKA-II > or =100 mAU/ml compared with PIVKA-II <100 mAU/ml (12.1 vs. 16.9% at 5 years; p < 0.032). The cumulative rate of maintaining period within Milan criteria was significantly lower in patients with PIVKA-II > or =100 mAU/ml compared with PIVKA-II <100 mAU/ml (34.1 vs. 55.6% at 5 years; p < 0.001). Cox regression analysis showed that low serum albumin (<3.5 g/dl; p = 0.002, RR 3.75, CI 1.64-8.56), a high level of PIVKA-II (> or =100 mAU/ml; p = 0.04, RR 3.15, CI 1.45-6.87), and multiple nodules (p = 0.021, RR 2.61, CI 1.15-5.91) were independently significant mortality risk factors. CONCLUSION: In patients with Child-Pugh stage A HCC, the PIVKA-II level is the best prognostic predictor after curative RFA.
- Yu Xia; Masatoshi Kudo; Yasunori Minami; Kinuyo Hatanaka; Kazuomi Ueshima; Hobyung Chung; Satoru Hagiwara; Tatsuo Inoue; Emi Ishikawa; Satoshi Kitai; Shunsuke Takahashi; Chie Tatsumi; Taisuke Ueda; Sosuke Hayaishi; Kiyoshi MaekawaOncology 75 Suppl 1 99 - 105 2008年BACKGROUND: The purpose of this study was to investigate if Sonazoid-enhanced harmonic ultrasonography (US) could be used to evaluate the responses of hepatocellular carcinomas (HCCs) to treatment with transcatheter arterial chemoembolization (TACE). PATIENTS AND METHODS: Forty-three HCCs that had been treated by TACE were evaluated by Sonazoid-enhanced harmonic US and dynamic computed tomography (CT) approximately 1 week after their treatment. The detection rates of residual tumor blood supply using the two modalities were compared. Two months after chemoembolization, 16 of the 43 HCCs, which had no additional local treatment, were followed up with dynamic CT. The results of contrast-enhanced harmonic US and dynamic CT 1 week after chemoembolization were analyzed and compared with follow-up dynamic CT results. RESULTS: The detection rates of positive enhancement with Sonazoid-enhanced harmonic US and dynamic CT 1 week after TACE were 25 (58.1%) of 43 lesions and 17 (39.5%) of 43 lesions, respectively. Sonazoid-enhanced harmonic US was significantly more sensitive than dynamic CT in depicting the residual tumor blood supply to HCCs 1 week after TACE (p < 0.01; chi(2) test). The Sonazoid-enhanced harmonic US results of the 16 lesions 1 week after chemoembolization were consistent with the follow-up results of dynamic CT 2 months after chemoembolization. CONCLUSIONS: Sonazoid-enhanced harmonic US appears to be a highly sensitive and accurate modality for evaluating responses of HCCs shortly after TACE.
- Kazuomi Ueshima; Masatoshi Kudo; Tomoyuki Nagai; Chie Tatsumi; Taisuke Ueda; Shunsuke Takahashi; Kinuyo Hatanaka; Satoshi Kitai; Emi Ishikawa; Tatsuo Inoue; Satoru Hagiwara; Yasunori Minami; Hobyung ChungOncology 75 Suppl 1 106 - 13 2008年PURPOSE: There are currently no effective treatments for patients with advanced hepatocellular carcinoma (HCC) with vascular invasion or extrahepatic metastases. We evaluated the efficacy and safety of combination therapy with S-1 and pegylated interferon (PEG-IFN)-alpha for advanced HCC. METHODS: A total of 22 patients received combination therapy with S-1 and PEG-IFN. One cycle of the combination therapy consists of oral S-1 (80 mg/m(2)) administration and subcutaneous PEG-IFN injection (PEG-IFN-alpha-2a 90 microg weekly or PEG-IFN-alpha-2b 50 microg weekly) for 4 weeks with 1- to 2-week intervals. RESULTS: One patient was evaluated as complete response, 6 as partial response, 8 as stable disease, and 6 as progressive disease. One patient was not evaluable because therapy had to be discontinued as a result of jaundice. The median survival time was 15.3 months (95% CI: 4.4-26.2 months). The 1- and 2-year survival rates were 54.9 and 36.6%, respectively. The overall response rate was 31.8% and the disease control rate was 68.2%. Grade 3 neutropenia (18.2%), leukopenia (9.1%), anemia (9.1%), and thrombocytopenia (18.2%) were observed. Grade 4 toxicities were not observed. CONCLUSION: Combination therapy with S-1 and PEG-IFN is effective and feasible, and is therefore a promising regimen for advanced HCC.
- Hobyung Chung; Masatoshi Kudo; Shunsuke Takahashi; Satoru Hagiwara; Yasuhiro Sakaguchi; Tatsuo Inoue; Yasunori Minami; Kazuomi Ueshima; Toyokazu FukunagaHepatology research : the official journal of the Japan Society of Hepatology 37 Suppl 2 S210-5 2007年09月Several staging systems have been developed to classify patients with hepatocellular carcinoma (HCC), however, there is no consensus on which of these is the most useful and reliable. In this review article, currently available integrated staging systems taking into account both liver function and tumor progression are presented, and their characteristics and applicability for current HCC patients, many of whom are diagnosed in the early stage of the disease and treated by curative therapy, are discussed. Based on the original andsubsequent validation studies of these staging systems, we recommend that further validation studies of staging systems for HCC should focus on the revised Barcelona Clinic Liver Cancer (BCLC) staging classification, Japan Integrated Staging (JIS) score and Tokyo score.
- Kinuyo Hatanaka; Masatoshi Kudo; Toyokazu Fukunaga; Kazuomi Ueshima; Hobyung Chung; Yasunori Minami; Yasuhiro Sakaguchi; Satoshi Hagiwara; Akio Orino; Yukio OsakiIntervirology 50 1 24 - 31 2007年OBJECTIVE: To clarify the frequency and trends of both HBsAg and HCVAb negative hepatocellular carcinoma (NonBNonC-HCC) in all HCC, to clarify the etiology of NonBNonC-HCC, and to elucidate the clinical characteristics of NonBNonC-HCC compared with those of HBsAg-positive HCC (B-HCC) and HCVAb-positive HCC (C-HCC). METHODS: A total of 2,542 patients with HCC examined at three institutions between 1991 and 2004 were categorized based on their serum viral antigen/antibody positivities, and compared between groups for the etiology, annual trend of the incidence, and clinical characteristics. RESULTS: For the etiology, C-HCC was most prevalent, followed by B-HCC, NonBNonC-HCC, and both HBsAg and HCVAb-positive HCC (BC-HCC) in order. For survival, C-HCC had the most favorable prognosis, followed by NonBNonC-HCC, and B-HCC patients had the poorest prognosis in the three groups (C-HCC, B-HCC, and NonBNonC-HCC). In tumor-node metastasis (TNM) stages I+II, however, NonBNonC-HCC patients took the most favorable clinical course. The incidence of NonBNonC-HCC in all HCC was 5-8% from 1991 to 1998, and has increased to 10-12% since 1999. Additionally, the incidence of HBcAb-positive HCC in NonBNonC-HCC declined each year. Among NonBNonC-HCC patients, the morbidity of diabetic complications was significantly higher in HBcAb-negative patients than in HBcAb-positive patients. CONCLUSION: Although the incidence of NonBNonC-HCC among all HCC has an increasing trend recently, the incidence of HBcAb-positive HCC in NonBNonC-HCC has a tendency of decreasing. This fact suggest its etiology might be changing from occult HBV related HCC to unknown etiology such as nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) related HCC. The prognosis of NonBNonC-HCC was fairly good if the HCC was found in its early stage.
- Shunsuke Takahashi; Masatoshi Kudo; Hobyung Chung; Tatsuo Inoue; Miki Nagashima; Satoshi Kitai; Chie Tatsumi; Yasunori Minami; Kazuomi Ueshima; Toyokazu Fukunaga; Seiji HajiDigestive diseases (Basel, Switzerland) 25 4 303 - 9 2007年BACKGROUND: This study was undertaken to assess the outcome of potentially curative therapy for early-stage hepatocellular carcinoma (HCC) in patients with Child-Pugh stage A cirrhosis as well as to investigate the impact of low-dose interferon (IFN) therapy after curative therapy on survival. METHODS: This study retrospectively evaluated clinical outcomes in a cohort of 224 Child-Pugh stage A cirrhotic patients who received either resection (53 cases) or radiofrequency ablation (RFA: 171 cases) for HCC within Milan criteria. Thirty patients were treated with low-dose maintenance IFN therapy after initial curative therapy. The median follow-up period was 36.7 months. RESULTS: The 5-year survival rate of all patients was 74.9%, with similar rates for the resection and RFA groups (70.4 vs. 76.8%; p = 0.561). The 5-year HCC recurrence rate was higher in the RFA group than the resection group (85.3 vs. 73.2%; p = 0.012). The maintenance IFN-treated group maintained their liver function within Child-Pugh stage A for a significantly longer time (median time 36.9 vs. 32.2 months; p = 0.0025). CONCLUSION: The 5-year outcomes of resection and RFA in patients with Child-Pugh stage A cirrhosis and early stage HCC were comparable with liver transplantation. Low-dose, long-term maintenance IFN therapy after curative therapy was significantly beneficial on survival.
- Shunsuke Takahashi; Masatoshi Kudo; Hobyung Chung; Tatsuo Inoue; Emi Ishikawa; Satoshi Kitai; Chie Tatsumi; Taisuke Ueda; Yasunori Minami; Kazuomi Ueshima; Seiji HajiOncology 72 Suppl 1 98 - 103 2007年OBJECTIVE: This study was undertaken to assess the outcome of potentially curative radiofrequency ablation (RFA) therapy for early-stage hepatocellular carcinoma (HCC) in patients with Child-Pugh stage A cirrhosis. METHODS: This study retrospectively evaluated clinical outcomes in a cohort of 171 Child-Pugh stage A cirrhotic patients who received RFA for naïve HCC within the Milan criteria. The median follow-up period was 36.7 months. RESULTS: Cumulative survival rates estimated by the Kaplan-Meier method for all patients were 98.8, 91.1 and 76.8% at 1, 3 and 5 years, respectively. Cumulative probabilities of local tumor recurrence at 1, 2 and 3 years were 9.0, 14.1 and 17.7%, respectively. Cumulative survival rates in patients without local tumor recurrence were 96.6, 94.6 and 84.4% at 1, 3 and 5 years, respectively, compared with patients with local tumor recurrence (96.6, 74.8 and 42.1% at 1, 3 and 5 years, respectively; p = 0.0002). Cox regression analysis showed that low serum albumin (p = 0.009, RR 3.04, CI 1.32-6.98), high range of PIVKA-II (prothrombin induced by vitamin K absence or agonist II) (p = 0.025, RR 2.57, CI 1.13-5.89), with multiple (less than 3) nodules (p = 0.021, RR 2.61, CI 1.15-5.91), and with local tumor recurrence (p = 0.004, RR 3.62, CI 1.51-8.69) were significant risk factors for death. CONCLUSION: Initial complete response of curative RFA therapy in patients with Child-Pugh stage A cirrhosis and early-stage HCC is associated with improved survival. Therefore, clinicians should aim to achieve complete ablation of all detectable HCC nodules with adequate safety margins.
- Masatoshi Kudo; Yasuhiro Sakaguchi; Hobyung Chung; Kinuyo Hatanaka; Satoru Hagiwara; Emi Ishikawa; Shunsuke Takahashi; Satoshi Kitai; Tatsuo Inoue; Yasunori Minami; Kazuomi UeshimaOncology 72 Suppl 1 132 - 8 2007年OBJECTIVE: To assess whether low-dose, long-term maintenance interferon (IFN) therapy inhibits recurrence after complete ablation of hepatocellular carcinoma (HCC) and improves patient survival. METHODS AND PATIENTS: From June 1999 through May 2006, a total of 127 HCC cases that met the requirements of both tumor diameter 3 cm or less, and number of tumors three or fewer, were curatively treated by radiofrequency ablation therapy (RFA). Among them, 43 patients received three million IU of IFN-alpha2b twice per week or pegylated IFN-alpha2a 90 microg once per week or once per 2 weeks without discontinuation (IFN maintenance group). The remaining 84 patients, whose sex, age, and platelet counts were randomly matched to those of the IFN maintenance group, did not receive IFN treatment (control group). RESULTS: Cumulative first, second, and third recurrence rates were significantly reduced in the IFN maintenance group compared with the control group by Kaplan-Meier estimate. The 5-year survival rate was 66% for the control group and 83% for the IFN maintenance group (p = 0.004). Multivariate analysis using the Cox proportional hazards model identified IFN maintenance therapy as an independent risk factor for survival, and the risk ratio was 0.21 (95% CI: 0.05-0.73). In conclusion, low-dose, long-term maintenance IFN therapy after curative RFA therapy of HCC significantly inhibits recurrence, and consequently improves patient survival.
MISC
- 青木智子; 西田直生志; 紅林泰; 坂井和子; 萩原智; 上嶋一臣; 南康範; 坂元亨宇; 西尾和人; 工藤正俊 日本消化器病学会雑誌(Web) 121 2024年
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- B型慢性肝炎患者に対するTAFの効果および安全性の検討萩原 智; 盛田 真弘; 千品 寛和; 青木 智子; 田北 雅弘; 南 康範; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊 肝臓 64 (Suppl.1) A425 -A425 2023年04月
- 高アンモニア血症に対するレボカルニチン自体の効果について萩原 智; 盛田 真弘; 千品 寛和; 青木 智子; 田北 雅弘; 南 康範; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊 肝臓 64 (Suppl.1) A432 -A432 2023年04月
- 切除不能HCCに対するABC conversion療法と造影超音波によるclinical CRの補助診断青木 智子; 南 康範; 依田 広; 千品 寛和; 田北 雅弘; 萩原 智; 上嶋 一臣; 鶴崎 正勝; 西田 直生志; 工藤 正俊 超音波医学 50 (Suppl.) S598 -S598 2023年04月
- 【肝胆膵がん治療の進歩2023】肝細胞がん Intermediate stageに対するTACEと薬物療法の併用療法青木 智子; 上嶋 一臣; 工藤 正俊 腫瘍内科 31 (2) 159 -163 2023年02月
- 青木 智子; 上嶋 一臣; 工藤 正俊 画像診断 43 (3) 270 -276 2023年02月
- 土谷薫; 工藤正俊; 上嶋一臣; 加藤直也; 山下竜也; 下瀬茂男; 沼田和司; 児玉裕三; 田中靖人; 黒田英克; 伊藤心二; 相方浩; 平岡淳; 森口理久; 大西秀樹; 井戸章雄; 高口浩一; 小笠原定久; 山本紘司; 池田公史 肝臓 64 (Supplement 3) 2023年
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- 上嶋 一臣; 工藤 正俊 肝臓クリニカルアップデート 8 (1) 12 -16 2022年07月
- 非代償性肝硬変による直腸静脈瘤出血に対して内視鏡的組織接着剤注入術を施行した1例加藤 弘樹; 松井 繁長; 田北 雅弘; 上中 大地; 今村 瑞貴; 原 茜; 野村 健司; 瀬海 郁衣; 高田 隆太郎; 河野 匡志; 正木 翔; 永井 知行; 本庶 元; 米田 頼晃; 上嶋 一臣; 渡邉 智裕; 西田 直生志; 辻 直子; 樫田 博史; 工藤 正俊 日本消化器内視鏡学会近畿支部例会プログラム・抄録集 108回 89 -89 2022年06月
- 非代償性肝硬変による直腸静脈瘤出血に対して内視鏡的組織接着剤注入術を施行した1例加藤 弘樹; 松井 繁長; 田北 雅弘; 上中 大地; 今村 瑞貴; 原 茜; 野村 健司; 瀬海 郁衣; 高田 隆太郎; 河野 匡志; 正木 翔; 永井 知行; 本庶 元; 米田 頼晃; 上嶋 一臣; 渡邉 智裕; 西田 直生志; 辻 直子; 樫田 博史; 工藤 正俊 日本消化器内視鏡学会近畿支部例会プログラム・抄録集 108回 89 -89 2022年06月
- 上嶋 一臣 日本消化器病学会雑誌 119 (5) 414 -422 2022年05月
- 上嶋 一臣 内科 129 (4) 872 -874 2022年04月
- 【肝・胆・膵がんの薬物療法2022 update】肝細胞がん TACE不応、TACE不適の概念は、どのくらい受け入れられているのか?上嶋 一臣 腫瘍内科 29 (3) 282 -289 2022年03月
- 肝動注リザーバー療法に関するガイドライン米虫 敦; 上嶋 一臣; 新槇 剛; 岩本 英希; 小尾 俊太郎; 佐藤 洋造; 田中 利洋; 松枝 清; 森口 理久; 稲葉 吉隆; 齋藤 博哉; 曽根 美雪; 山上 卓士; 日本IVR学会, リザーバー研究会, 肝動注リザーバー療法に関するガイドライン作成委員会, 日本IVR学会ガイドライン委員会 日本インターベンショナルラジオロジー学会雑誌 36 (2) 203 -218 2022年03月
- 西田 直生志; 上嶋 一臣; 工藤 正俊 日本消化器病学会雑誌 119 (臨増総会) A41 -A41 2022年03月
- 上嶋 一臣; 田北 雅弘; 工藤 正俊 日本消化器病学会雑誌 119 (臨増総会) A79 -A79 2022年03月
- 免疫チェックポイント阻害剤をめぐる諸問題 免疫チェックポイント阻害剤投与後に発現した肝障害の臨床的、病理学的検討萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 116回 79 -79 2022年02月
- 上・下腸間膜動静脈奇形に伴う門脈圧亢進からの難治性腹水及び循環血液量低下に伴う血圧低下に対し血管内治療(IVR)にて改善しえた1例上原 広樹; 田北 雅弘; 杉森 啓伸; 岡井 夏輝; 野村 健司; 盛田 真弘; 千品 寛和; 青木 智子; 萩原 智; 依田 広; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 116回 88 -88 2022年02月
- 南康範; 青木智子; 千品寛和; 田北雅弘; 萩原智; 依田広; 上嶋一臣; 西田直生志; 工藤正俊 日本肝がん分子標的治療研究会プログラム・抄録集 26th 2022年
- 大丸直哉; 田北雅弘; 浦瀬篤史; 千品寛和; 青木智子; 萩原智; 依田広; 上嶋一臣; 鶴崎正勝; 鶴崎正勝; 西田直生志; 工藤正俊 リザーバー&ポート研究会プログラム・抄録集 46th 2022年
- 工藤 正俊; 池田 公史; 上嶋 一臣; 坂元 亨宇; 椎名 秀一朗; 建石 良介; 能祖 一裕; 長谷川 潔; 古瀬 純司; 宮山 士朗; 村上 卓道; 山下 竜也; 國土 典宏; 日本肝癌研究会肝癌治療効果判定基準作成委員会 肝臓 62 (12) 823 -829 2021年12月
- 工藤 正俊; 池田 公史; 上嶋 一臣; 坂元 亨宇; 椎名 秀一朗; 建石 良介; 能祖 一裕; 長谷川 潔; 古瀬 純司; 宮山 士朗; 村上 卓道; 山下 竜也; 國土 典宏; 日本肝癌研究会肝癌治療効果判定基準作成委員会 肝臓 62 (12) 823 -829 2021年12月
- Segmental arterial mediolysis(SAM)に伴う肝動脈瘤破裂に対して肝動脈塞栓術を施行した1例加藤 弘樹; 千品 寛和; 瀬海 郁衣; 盛田 真弘; 青木 智子; 田北 雅弘; 萩原 智; 南 康範; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊 肝臓 62 (Suppl.3) A824 -A824 2021年11月
- 上嶋 一臣 肝臓クリニカルアップデート 7 (1) 25 -28 2021年10月
- 上嶋 一臣 日本インターベンショナルラジオロジー学会雑誌 36 (1) 59 -63 2021年09月
- 【TACE再考】TACE不適例への薬物早期導入(TACE sequential治療) SORA-TACE sequential治療(TACTICS)上嶋 一臣; 工藤 正俊 肝胆膵 83 (3) 417 -423 2021年09月
- 【TACE再考】TACE不適例への薬物早期導入(TACE sequential治療) TACE不適例に対するアテゾ・ベバ治療の効果青木 智子; 上嶋 一臣; 西田 直志生; 工藤 正俊 肝胆膵 83 (3) 435 -443 2021年09月
- Gd-EOB-DTPA-enhanced MRI肝細胞相で高信号の肝細胞癌は、PD-1/PD-L1療法への一次耐性を反映し予後不良である青木 智子; 上嶋 一臣; 盛田 真弘; 千品 寛和; 田北 雅弘; 萩原 智; 南 康範; 依田 広; 鶴崎 正勝; 西田 直生志; 工藤 正俊 肝臓 62 (Suppl.2) A552 -A552 2021年09月
- 【TACE再考】Intermediate stage肝癌の新たな治療戦略 薬剤先行投与によるconversion治療工藤 正俊; 青木 智子; 上嶋 一臣; 西田 直生志 肝胆膵 83 (3) 475 -483 2021年09月
- 【ここまできた肝細胞癌の薬物療法:2021 update】免疫療法の動向 WNT/β-catenin変異のimaging biomarkerとしてのEOB-MRI青木 智子; 西田 直生志; 上嶋 一臣; 祖父江 慶太郎; 鶴崎 正勝; 工藤 正俊 肝胆膵 83 (2) 209 -218 2021年08月
- 上嶋 一臣; 工藤 正俊 肝胆膵 83 (2) 237 -242 2021年08月
- Masatoshi Kudo; Kazuomi Ueshima; Shin Nakahira; Naoshi Nishida; Hiroshi Ida; Yasunori Minami; Takuya Nakai; Hiroshi Wada; Shoji Kubo; Kazuyoshi Ohkawa; Asahiro Morishita; Takeo Nomi; Koji Ishida; Shogo Kobayashi; Makoto Umeda; Masakatsu Tsurusaki; Yasutaka Chiba; Kenichi Yoshimura; Kazuko Sakai; Kazuto Nishio JOURNAL OF CLINICAL ONCOLOGY 39 (15) 2021年05月
- 青木 智子; 上嶋 一臣; 工藤 正俊 消化器外科 44 (6) 855 -861 2021年05月
- 肝癌における薬物療法の診療体系 薬物療法と局所療法の位置づけ上嶋 一臣 日本消化器病学会雑誌 118 (臨増総会) A112 -A112 2021年03月
- 肝癌における薬物療法の診療体系 切除不能肝細胞癌に対するアテゾリズマブ+ベバシズマブ併用療法の経験(IMbrave150試験より)青木 智子; 上嶋 一臣; 工藤 正俊 日本消化器病学会雑誌 118 (臨増総会) A114 -A114 2021年03月
- 肝予備能の評価法:検体検査と画像検査 切除不能肝細胞癌へのレンバチニブ療法におけるFIB-4 index、ALBI scoreの有用性青木 智子; 上嶋 一臣; 工藤 正俊 日本消化器病学会雑誌 118 (臨増総会) A118 -A118 2021年03月
- 石川達; 上嶋一臣; 佐伯一成; 森本直樹; 相方浩; 田邊暢一; 稲葉吉隆; 和田幸之; 近藤泰輝; 津田政広; 中尾一彦; 池田公史; 森口理久; 葛谷貞二; 小林正宏; 古賀浩徳; 日野啓輔; 鈴木義之; 吉村健一; 工藤正俊 日本肝がん分子標的治療研究会プログラム・抄録集 24th 2021年
- Masatoshi Kudo; Kazuomi Ueshima; Masafumi Ikeda; Takuji Torimura; Hiroshi Aikata; Namiki Izumi; Takahiro Yamasaki; Keisuke Hino; Teiji Kuzuya; Norio Isoda; Kohichiroh Yasui; Hajime Aino; Akio Ido; Naoto Kawabe; Kazuhiko Nakao; Yoshiyuki Wada; Kenichi Yoshimura; Takuji Okusaka; Junji Furuse; Yasuaki Arai JOURNAL OF CLINICAL ONCOLOGY 39 (3) 2021年01月
- 上嶋一臣 日本臨床腫瘍学会学術集会(CD-ROM) 18th S269 -S269 2021年
- 上嶋一臣 医学と薬学 78 (4) 365 -370 2021年
- 青木智子; 上嶋一臣; 工藤正俊 日本消化器病学会雑誌(Web) 118 2021年
- 青木智子; 西田直生志; 上嶋一臣; 祖父江慶太郎; 鶴崎正勝; 工藤正俊 肝胆膵 83 (2) 209 -218 2021年
- 上嶋一臣 日本消化器病学会雑誌(Web) 118 2021年
- 青木智子; 上嶋一臣; 工藤正俊 日本消化器病学会雑誌(Web) 118 2021年
- 工藤正俊; 青木智子; 上嶋一臣; 西田直生志 肝胆膵 83 (3) 475 -483 2021年
- 上嶋一臣; 工藤正俊 肝胆膵 83 (3) 417 -423 2021年
- 青木智子; 上嶋一臣; 西田直生志; 工藤正俊 肝胆膵 83 (3) 435 -443 2021年
- 青木 智子; 南 康範; 鶴崎 正勝; 盛田 真弘; 南 知宏; 千品 寛和; 田北 雅弘; 萩原 智; 依田 広; 上嶋 一臣; 松井 繁長; 西田 直生志; 樫田 博史; 工藤 正俊 日本門脈圧亢進症学会雑誌 26 (4) 244 -248 2020年11月
- 進歩する化学療法時代に注意すべき肝細胞癌の遠隔転移吉田 早希; 青木 智子; 上嶋 一臣; 盛田 真弘; 千品 寛和; 田北 雅弘; 萩原 智; 南 康範; 依田 広; 鶴崎 正勝; 西田 直生志; 工藤 正俊 肝臓 61 (Suppl.3) A924 -A924 2020年11月
- 家村 郁衣; 青木 智子; 上嶋 一臣; 盛田 真弘; 千品 寛和; 田北 雅弘; 萩原 智; 南 康範; 依田 広; 鶴崎 正勝; 西田 直生志; 工藤 正俊 肝臓 61 (Suppl.3) A946 -A946 2020年11月
- 進行肝癌に対する免疫チェックポイント阻害薬後レンバチニブ療法の画像評価青木 智子; 依田 広; 盛田 真弘; 南 知宏; 田北 雅弘; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊 超音波医学 47 (Suppl.) S167 -S167 2020年11月
- 鑑別診断において造影超音波が有用であった多血性の肝内胆管癌の1例盛田 真弘; 南 康範; 青木 智子; 田北 雅弘; 萩原 智; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊 超音波医学 47 (Suppl.) S275 -S275 2020年11月
- トルバプタン不応の難治性腹水に対する腹腔-静脈シャント(デンバーシャント)の有用性青木 智子; 南 康範; 鶴崎 正勝; 盛田 真弘; 南 知宏; 千品 寛和; 田北 雅弘; 萩原 智; 依田 広; 上嶋 一臣; 松井 繁長; 西田 直生志; 樫田 博史; 工藤 正俊 日本門脈圧亢進症学会雑誌 26 (4) 244 -248 2020年11月
- 【肝細胞癌治療のパラダイムチェンジ-進化する薬物療法2020 Update Part II-(分子標的治療)】レンバチニブ REFLECT試験のサブ解析上嶋 一臣; 工藤 正俊 肝胆膵 81 (5) 835 -840 2020年11月
- 【肝細胞癌治療のパラダイムチェンジ-進化する薬物療法2020 Update Part II-(分子標的治療)】レンバチニブ REFLECT試験のサブ解析上嶋 一臣; 工藤 正俊 肝・胆・膵 81 (5) 835 -840 2020年11月
- 【肝細胞癌治療のパラダイムチェンジ-進化する薬物療法2020 Update Part II-(分子標的治療)】レンバチニブ 切除不能肝細胞癌へのPD-1/PD-L1療法不応後二次治療として投与したレンバチニブ逐次治療の有効性青木 智子; 上嶋 一臣; 鶴崎 正勝; 工藤 正俊 肝・胆・膵 81 (5) 874 -880 2020年11月
- 吉田 早希; 青木 智子; 上嶋 一臣; 盛田 真弘; 千品 寛和; 田北 雅弘; 萩原 智; 南 康範; 依田 広; 鶴崎 正勝; 西田 直生志; 工藤 正俊 肝臓 61 (Suppl.3) A924 -A924 2020年11月
- 難治性腹水に対するデンバーシャント術の試み家村 郁衣; 青木 智子; 上嶋 一臣; 盛田 真弘; 千品 寛和; 田北 雅弘; 萩原 智; 南 康範; 依田 広; 鶴崎 正勝; 西田 直生志; 工藤 正俊 肝臓 61 (Suppl.3) A946 -A946 2020年11月
- 上嶋一臣 日本癌治療学会学術集会(Web) 58回 SY10 -3 2020年10月
- 【肝細胞癌治療のパラダイムチェンジ-進化する薬物療法2020 Update Part I-(免疫療法)】免疫チェックポイント阻害剤による単剤治療 ニボルマブのChild-Pugh Bにおける有効性・安全性上嶋 一臣 肝胆膵 81 (4) 667 -670 2020年10月
- 消化器癌化学療法の進歩と課題 切除不能進行肝癌に対する免疫チェックポイント阻害薬不応後の二次治療を見据えて青木 智子; 萩原 智; 上嶋 一臣; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 113回 54 -54 2020年10月
- 吉田 早希; 南 康範; 盛田 真弘; 青木 智子; 田北 雅弘; 萩原 智; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 113回 103 -103 2020年10月
- 消化器癌化学療法の進歩と課題 切除不能進行肝癌に対する免疫チェックポイント阻害薬不応後の二次治療を見据えて青木 智子; 萩原 智; 上嶋 一臣; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 113回 54 -54 2020年10月
- 鑑別診断に造影超音波が有用であった多血性の肝内胆管癌の1例吉田 早希; 南 康範; 盛田 真弘; 青木 智子; 田北 雅弘; 萩原 智; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 113回 103 -103 2020年10月
- 【肝細胞癌治療のパラダイムチェンジ-進化する薬物療法2020 Update Part I-(免疫療法)】免疫チェックポイント阻害剤による単剤治療 ニボルマブのChild-Pugh Bにおける有効性・安全性上嶋 一臣 肝・胆・膵 81 (4) 667 -670 2020年10月
- 上嶋 一臣 臨床消化器内科 35 (8) 801 -805 2020年07月
- 青木 智子; 上嶋 一臣; 工藤 正俊 日本消化器病学会雑誌 117 (臨増総会) A52 -A52 2020年07月
- 大塚 康生; 青木 智子; 南 知宏; 田北 雅弘; 萩原 智; 南 康範; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊 日本消化器病学会雑誌 117 (臨増総会) A291 -A291 2020年07月
- 西尾 和人; 坂井 和子; 櫻井 俊治; 上嶋 一臣; 永井 知行; 林 秀敏; 川上 尚人; 高濱 隆幸; 武田 真幸; 中川 和彦 肺癌 60 (2) 165 -165 2020年04月
- 肝癌に対する分子標的治療および免疫治療 進行肝癌に対する免疫チェックポイント阻害薬不応後のレンバチニブ療法の有効性の検討青木 智子; 上嶋 一臣; 工藤 正俊 肝臓 61 (Suppl.1) A85 -A85 2020年04月
- B型慢性肝炎患者(CH-B)に対する,ETVとTAFの前向き比較観察研究萩原 智; 盛田 真弘; 青木 智子; 田北 雅弘; 南 康範; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊 肝臓 61 (Suppl.1) A423 -A423 2020年04月
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- 上嶋 一臣; 工藤 正俊 臨床消化器内科 35 (3) 333 -336 2020年02月
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- トルバプタンの治療効果における予測因子の検討千品 寛和; 井上 達夫; 南 知宏; 河野 匡志; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊 日本消化器病学会雑誌 112 (臨増総会) A364 -A364 2015年03月
- 工藤 正俊; 上嶋 一臣; 久保 正二; 坂元 亨宇; 田中 正俊; 猪飼 伊和夫; 古瀬 純司; 村上 卓道; 角谷 眞澄; 國土 典宏 肝臓 56 (3) 116 -121 2015年03月 [査読有り]
- 上嶋 一臣; 工藤 正俊 日本臨床 73 (増刊1 最新肝癌学) 737 -742 2015年01月
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- 上嶋 一臣 The liver cancer journal : 季刊学術雑誌 6 (4) 248 -252 2014年12月
- 金子 周一; 能祖 一裕; 池田 公史; 上嶋 一臣 The Liver Cancer Journal 6 (3) 155 -163 2014年09月
- B-modeで描出困難な肝癌に対するFusion imaging+造影USガイドでのラジオ波焼灼術南 知宏; 南 康範; 千品 寛和; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊 肝臓 55 (Suppl.2) A605 -A605 2014年09月
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- 上嶋 一臣; 工藤 正俊 腫瘍内科 13 (5) 637 -641 2014年05月
- T. Arizumi; K. Ueshima; H. Chishina; M. Takita; S. Kitai; T. Inoue; N. Yada; S. Hagiwara; Y. Minami; T. Sakurai; N. Nishida; M. Kudo JOURNAL OF HEPATOLOGY 60 (1) S253 -S253 2014年04月
- plain cone-beam CTによる肝動脈塞栓術の定量的治療効果予測南 康範; 南 知宏; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊; 柳生 行伸; 村上 卓道 日本消化器病学会雑誌 111 (臨増総会) A275 -A275 2014年03月
- 上嶋 一臣; 工藤 正俊 日本臨床 72 (増刊2 最新がん薬物療法学) 391 -396 2014年02月
- 上嶋 一臣; 工藤 正俊 医学のあゆみ 248 (2) 138 -140 2014年01月
- 上嶋一臣; 工藤正俊 肝胆膵 68 (3) 459 -463 2014年
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- 肝のう胞に対するオレイン酸モノエタノールアミン注入療法の検討田北 雅弘; 有住 忠晃; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊 肝臓 54 (Suppl.2) A614 -A614 2013年09月
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- ヒト肝癌に認められるゲノムワイドな脱メチル化と染色体不安定性の関連西田 直生志; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 櫻井 俊治; 上嶋 一臣; 工藤 正俊 肝臓 54 (Suppl.1) A149 -A149 2013年04月
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- PEG-IFNα2a少量長期療法における発癌リスク因子の検討 IL28B遺伝子多型との関連も含めて萩原 智; 櫻井 俊治; 上嶋 一臣; 南 康範; 井上 達夫; 矢田 典久; 北井 聡; 田北 雅弘; 永井 知行; 有住 忠晃; 田中 梨絵; 西田 直生志; 工藤 正俊 肝臓 54 (Suppl.1) A372 -A372 2013年04月
- 肝血管筋脂肪腫の3例田中 梨絵; 南 康範; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊 超音波医学 40 (Suppl.) S573 -S573 2013年04月
- 上嶋 一臣; 工藤 正俊 The Liver Cancer Journal 5 (1) 24 -31 2013年03月
- 肝血管筋脂肪腫の3例田中 梨絵; 上嶋 一臣; 千品 寛和; 有住 忠晃; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 西田 直生志; 工藤 正俊 日本消化器病学会雑誌 110 (臨増総会) A342 -A342 2013年02月
- 上嶋 一臣; 工藤 正俊 臨牀と研究 90 (2) 216 -221 2013年02月
- 上嶋一臣; 工藤正俊 癌と化学療法 40 (8) 995 -997 2013年
- 工藤正俊; 上嶋一臣 肝臓 54 (Supplement 2) 2013年
- 上嶋 一臣; 工藤 正俊 肝・胆・膵 65 (6) 1302 -1306 2012年12月
- 上嶋 一臣; 工藤 正俊 日本臨床 70 (増刊8 分子標的薬) 457 -462 2012年11月
- 樫田 博史; 上嶋 一臣; 矢田 典久 消化器内視鏡 24 (11) 1772 -1773 2012年11月
- 症例(肝がん) HBV陽性Vp4肝細胞癌の一例上嶋 一臣; 田北 雅弘; 工藤 正俊 日本癌治療学会誌 47 (3) 799 -799 2012年10月
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- 肝細胞癌に対するラジオ波焼灼療法の治療効果判定における造影超音波検査の有用性の検討 造影CTとの比較井上 達夫; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊 肝臓 53 (Suppl.2) A724 -A724 2012年09月
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- 上嶋 一臣; 工藤 正俊 最新医学 67 (9月増刊) 2220 -2229 2012年09月
- 田中 克明; 池田 健次; 山崎 隆弘; 永松 洋明; 上嶋 一臣 肝臓 53 (8) 463 -485 2012年08月
- 【ウイルス肝炎・肝癌制圧の分子基盤】肝癌制圧への治療の開発状況上嶋 一臣; 工藤 正俊 BIO Clinica 27 (8) 748 -751 2012年08月
- 田中 克明; 池田 健次; 山崎 隆弘; 永松 洋明; 上嶋 一臣 肝臓 53 (8) 463 -485 2012年08月
- 有住 忠晃; 上嶋 一臣; 竹田 治彦; 大崎 往夫; 萩原 智; 井上 達夫; 北井 聡; 矢田 典久; 櫻井 俊治; 西田 直生志; 工藤 正俊 肝臓 53 (6) 344 -347 2012年06月
- 奥坂 拓志; 加藤 弥菜; 荒井 保明; 上嶋 一臣 The Liver Cancer Journal 4 (2) 89 -97 2012年06月
- 有住 忠晃; 上嶋 一臣; 早石 宗右; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 櫻井 俊治; 西田 直生志; 工藤 正俊 The Liver Cancer Journal 4 (2) 138 -139 2012年06月
- 上嶋 一臣; 工藤 正俊 腫瘍内科 9 (6) 651 -658 2012年06月
- 上嶋 一臣; 工藤 正俊 肝・胆・膵 64 (5) 669 -675 2012年05月
- 上嶋 一臣; 工藤 正俊 肝・胆・膵 64 (5) 697 -700 2012年05月
- Tadaaki Arizumi; Kazuomi Ueshima; Masatoshi Kudo GASTROENTEROLOGY 142 (5) S979 -S979 2012年05月
- Brivanib上嶋 一臣; 工藤 正俊 肝胆膵 64 (5) 669 -675 2012年05月
- 肝癌診療ガイドラインの活用と改訂への提案 肝癌診療ガイドラインにおける治療アルゴリズムの妥当性 実臨床への展開とその問題点上嶋 一臣; 南 康範; 工藤 正俊 肝臓 53 (Suppl.1) A109 -A109 2012年04月
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- T. Arizumi; K. Ueshima; M. Kudo JOURNAL OF HEPATOLOGY 56 S273 -S273 2012年04月
- Tomoyuki Nagai; Tokuzo Arao; Kazuko Matsumoto; Kazuko Sakai; Kanae Kudo; Hiroyasu Kaneda; Daisuke Tamura; Keiichi Aomatsu; Hideharu Kimura; Yoshihiko Fujita; Satoru Hagiwara; Toshiharu Sakurai; Kazuomi Ueshima; Seiji Haji; Masatoshi Kudo; Kazuto Nishio CANCER RESEARCH 72 2012年04月
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- 体外式超音波穿刺用コンベックスプローブEUP-B715の使用経験矢田 典久; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 井上 達夫; 萩原 智; 南 康範; 上嶋 一臣; 工藤 正俊 超音波医学 39 (2) 201 -201 2012年03月
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- HCCのカテーテル治療の最前線 分子標的薬とTACE・動注化学療法の併用療法の現状上嶋 一臣; 工藤 正俊 日本医学放射線学会学術集会抄録集 71回 S84 -S84 2012年02月
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- Tatsuo Inoue; Masatoshi Kudo; Arizumi Tadaaki; Sousuke Hayaishi; Masahiro Takita; Satoshi Kitai; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Kazuomi Ueshima; Masahiro Okada; Hyodo Tomoko; Takamichi Murakami HEPATOLOGY 54 899A -899A 2011年10月
- Tatsuo Inoue; Masatoshi Kudo; Kinuyo Hatanaka; Yasunori Minami; Kazuomi Ueshima; Arizumi Tadaaki; Masahiro Takita; Satoshi Kitai HEPATOLOGY 54 902A -902A 2011年10月
- 肝血管肉腫の2例有住 忠晃; 萩原 智; 大本 俊介; 早石 宗右; 上田 泰輔; 田北 雅弘; 北井 聡; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊 肝臓 52 (Suppl.2) A680 -A680 2011年09月
- 肝細胞癌におけるTJP-1とTwist発現の肝癌切除後の予後への影響(Impact of TJP-1 and TWIST expression on post-operative prognosis in hepatocellular carcinoma)永井 知行; 荒尾 徳三; 松本 和子; 工藤 可苗; 木村 英晴; 藤田 至彦; 萩原 智; 櫻井 俊治; 上嶋 一臣; 土師 誠二; 工藤 正俊; 西尾 和人 日本癌学会総会記事 70回 368 -368 2011年09月
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- 上嶋 一臣; 工藤 正俊 外来癌化学療法 2 (2) 86 -91 2011年06月
- 超音波定量診断技術の新展開 Real-time Tissue Elastographyの肝疾患テクスチャ解析外村 明子; 元木 満; 三竹 毅; 藤本 研治; 加藤 道夫; 辰巳 千栄; 矢田 典久; 上嶋 一臣; 工藤 正俊; 椎名 毅 超音波医学 38 (3) 306 -306 2011年05月
- K. Ueshima; M. Kudo; M. Tanaka; T. Kumada; T. Sakurai; H. Chung; S. Hagiwara; Y. Minami; T. Inoue; N. Yada; S. Kitai; M. Takita; S. Hayaishi JOURNAL OF CLINICAL ONCOLOGY 29 (15) 2011年05月
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- Tomoyuki Nagai; Tokuzo Arao; Kazuko Matsumoto; Kanae Kudo; Satoru Hagiwara; Toshiharu Sakurai; Kazuomi Ueshima; Seiji Haji; Masatoshi Kudo; Kazuto Nishio CANCER RESEARCH 71 2011年04月
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- 上嶋 一臣; 土師 誠二; 早石 宗右; 上田 泰輔; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 鄭 浩柄; 櫻井 俊治; 工藤 正俊 新薬と臨牀 59 (12) 2409 -2410 2010年12月
- 上嶋 一臣; 工藤 正俊 The Liver Cancer Journal 2 (4) 284 -290 2010年12月
- 上嶋 一臣; 工藤 正俊 肝臓 51 (11) 681 -683 2010年11月
- Kazuomi Ueshima; Masatoshi Kudo HEPATOLOGY 52 (4) 1182A -1183A 2010年10月
- 非閉塞性腸管虚血を発症した悪性リンパ腫の一例宮田 剛; 井上 達夫; 有住 忠晃; 早石 宗右; 上田 泰輔; 辰巳 千栄; 田北 雅弘; 北井 聡; 石川 恵美; 矢田 典久; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊 日本消化器病学会雑誌 107 (臨増大会) A828 -A828 2010年09月
- 造影エコーによる肝細胞癌の診断能、Gd-EOB-MRI、Dynamic CTとの比較検討井上 達夫; 畑中 絹世; 早石 宗右; 上田 泰輔; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊 肝臓 51 (Suppl.2) A564 -A564 2010年09月
- 線維化進行C型肝炎患者における脾摘後のインターフェロン導入における問題点 好中球数の変化について鄭 浩柄; 上田 泰輔; 早石 宗右; 田北 雅弘; 北井 聡; 畑中 絹代; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 工藤 正俊; 土師 誠二 肝臓 51 (Suppl.2) A600 -A600 2010年09月
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- Kinuyo Hatanaka; Hobyung Chung; Masatoshi Kudo; Seiji Haji; Yasunori Minami; Kiyoshi Maekawa; Sousuke Hayaishi; Tomoyuki Nagai; Masahiro Takita; Kanae Kudo; Taisuke Ueda; Chie Tatsumi; Satoshi Kitai; Emi Ishikawa; Norihisa Yada; Tatsuo Inoue; Satoru Hagiwara; Kazuomi Ueshima Oncology 78 Suppl 1 (4) 53 -9 2010年07月
- 肝細胞癌の分子標的探索と臨床応用 HCCに対するソラフェニブの治療効果予測について上嶋 一臣; 工藤 正俊 肝臓 51 (Suppl.1) A32 -A32 2010年04月
- Real-time Tissue Elastographyによる非侵襲的肝線維化評価法は炎症の影響を受けない藤本 研治; 外村 明子; 辰巳 千栄; 石田 哲士; 上嶋 一臣; 三竹 毅; 山本 佳司; 椎名 毅; 工藤 正俊; 加藤 道夫 肝臓 51 (Suppl.1) A346 -A346 2010年04月
- 組織エラストグラフィーの現況と展望 慢性肝疾患におけるReal-time Tissue Elastographyの精度の検討藤本 研治; 外村 明子; 辰巳 千栄; 石田 哲士; 上嶋 一臣; 三竹 毅; 椎名 毅; 工藤 正俊; 加藤 道夫 超音波医学 37 (Suppl.) S168 -S168 2010年04月
- びまん性肝疾患のUltrasound Functional Imaging C型慢性肝疾患患者に対する非侵襲的肝線維化評価の有用性に関する検討矢田 典久; 辰巳 千栄; 上嶋 一臣; 藤本 研治; 加藤 道夫; 椎名 毅; 外村 明子; 三竹 毅; 工藤 正俊 超音波医学 37 (Suppl.) S280 -S280 2010年04月
- 【消化器がん化学療法看護完全マスターBOOK 分子標的薬と従来型抗がん剤のケア 副作用 治療のしくみがやさしくわかる!】こう変わった!こう変わる!肝がん化学療法上嶋 一臣; 工藤 正俊 消化器外科Nursing (2010臨時増刊) 128 -129 2010年02月
- 前川清; 工藤正俊; 畑中絹世; 井上達夫; 鄭浩柄; 上嶋一臣; 石川原; 土師誠二; 佐藤隆夫 モダンフィジシャン 30 (8) 1113 -1118 2010年
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- 上硲 俊法; 鍋島 紀滋; 米田 俊貴; 長尾 泰孝; 上嶋 一臣; 井上 達夫 日本内科学会雑誌 98 (6) 1401 -1408 2009年06月
- C型慢性肝炎の外来フォローアップのポイント上嶋 一臣 日本内科学会雑誌 98 (6) 1404 -1405 2009年06月
- Kenji Fujimoto; Chie Tatsumi; Kazuomi Ueshima; Tsuyoshi Shiina; Akiko Tonomura; Tsuyoshi Mitake; Keiji Yamamoto; Masatoshi Kudo; Michio Kato GASTROENTEROLOGY 136 (5) A835 -A835 2009年05月
- びまん性肝疾患の超音波による評価 肝疾患におけるReal-time Tissue Elastography(第4報)藤本 研治; 辰巳 千栄; 上嶋 一臣; 外村 明子; 三竹 毅; 金 栄浩; 山本 佳司; 椎名 毅; 工藤 正俊; 加藤 道夫 超音波医学 36 (Suppl.) S204 -S204 2009年04月
- 分枝鎖アミノ酸顆粒製剤による肝硬変患者の予後に与える影響に関する検討早石 宗右; 石川 恵美; 辰巳 千栄; 上田 泰輔; 高橋 俊介; 北井 聡; 矢田 典久; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊 肝臓 50 (Suppl.1) A206 -A206 2009年04月
- 進行肝細胞癌に対するS-1、ペグインターフェロン併用療法の有用性矢田 典久; 上嶋 一臣; 早石 宗右; 永井 知行; 田北 雅弘; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 石川 恵美; 井上 達夫; 南 康範; 鄭 浩柄; 工藤 正俊 肝臓 50 (Suppl.1) A275 -A275 2009年04月
- 特異な経過をたどったアルコール性肝硬変に合併した肝細胞癌の一例早石 宗右; 鄭 浩柄; 辰巳 千栄; 永井 知行; 上田 泰輔; 高橋 俊介; 北井 聡; 石川 恵美; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 上嶋 一臣; 工藤 正俊 肝臓 50 (Suppl.1) A292 -A292 2009年04月
- 進行肝細胞癌に対するソラフェニブの有効性に関する検討上嶋 一臣; 早石 宗右; 永井 知行; 田北 雅弘; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 石川 恵美; 矢田 典久; 井上 達夫; 南 康範; 鄭 浩柄; 工藤 正俊 肝臓 50 (Suppl.1) A359 -A359 2009年04月
- Gd-EOB MRIによる肝細胞癌の診断能 造影超音波検査、Dynamic CTとの比較検討井上 達夫; 畑中 絹世; 早石 宗右; 永井 知行; 田北 雅弘; 上田 泰輔; 高橋 俊介; 北井 聡; 石川 恵美; 矢田 典久; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊 肝臓 50 (Suppl.1) A368 -A368 2009年04月
- 藤本研治; 辰巳千栄; 上嶋一臣; 外村明子; 三竹毅; 金栄浩; 山本佳司; 椎名毅; 工藤正俊; 加藤道夫 超音波医学 36 2009年
- 奥坂拓志; 古瀬純司; 金子周一; 工藤正俊; 池田公史; 仲地耕平; 山下竜也; 上嶋一臣 日本臨床腫瘍学会学術集会プログラム・抄録集 7th 2009年
- 大学病院における外来化学療法センターの運営今野 元博; 奥野 清隆; 上嶋 一臣; 岡本 勇; 辰己 陽一; 愼 玉姫; 藤原 季美子; 野村 守; 山添 譲; 渡部 洋; 中川 和彦; 塩崎 均 日本癌治療学会誌 43 (2) 513 -513 2008年10月
- Tatsuya Yamashita; Shuichi Kaneko; Junji Furuse; Takuji Okusaka; Masatoshi Kudo; Kohei Nakachi; Masafumi Ikeda; Kazuomi Ueshima HEPATOLOGY 48 (4) 949A -949A 2008年10月
- 肝癌の分子標的治療 進行肝細胞癌に対するソラフェニブの使用経験上嶋 一臣; 南 康範; 工藤 正俊 肝臓 49 (Suppl.2) A424 -A424 2008年09月
- 慢性肝炎staging評価のための低周波Real-time Tissue Elastographyの有用性藤本 研治; 辰巳 千栄; 上嶋 一臣; 葛下 典由; 三田 英治; 外村 明子; 三竹 毅; 金 栄浩; 岡本 幸春; 椎名 毅; 工藤 正俊; 加藤 道夫 肝臓 49 (Suppl.2) A522 -A522 2008年09月
- ソナゾイド造影超音波検査におけるpostvascular phase imagingとSPIO-MRIとの比較検討井上 達夫; 畑中 絹世; 上田 泰輔; 辰巳 千栄; 北井 聡; 高橋 俊介; 石川 恵美; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊; 横川 美加; 前野 知子; 市島 真由美; 前川 清 肝臓 49 (Suppl.2) A575 -A575 2008年09月
- 進行肝細胞癌に対するS-1・ペグインターフェロン併用療法上嶋 一臣; 早石 宗右; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 石川 恵美; 井上 達夫; 萩原 智; 南 康範; 鄭 浩柄; 工藤 正俊 日本消化器病学会雑誌 105 (臨増大会) A841 -A841 2008年09月
- 梅原 泰; 川崎 正憲; 朝隈 豊; 岡田 無文; 市川 勉; 松井 繁長; 今井 元; 野田 佳寿; 坂本 洋城; 石川 恵美; 井上 達夫; 萩原 智; 末冨 洋一郎; 南 康範; 鄭 浩柄; 上嶋 一臣; 北野 雅之; 汐見 幹夫; 工藤 正俊 Gastroenterological Endoscopy 50 (Suppl.2) 2337 -2337 2008年09月
- 今井 元; 南 康範; 梅原 泰; 石丸 英三郎; 上嶋 一臣; 松井 繁長; 末冨 洋一郎; 鄭 浩柄; 石川 恵美; 井上 達夫; 坂本 洋城; 萩原 智; 野田 佳寿; 北野 雅之; 汐見 幹夫; 工藤 正俊 日本消化器病学会雑誌 105 (臨増大会) A820 -A820 2008年09月
- 畑中 絹世; 南 康範; 北井 聡; 辰巳 千栄; 高橋 俊介; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊 Japanese journal of medical ultrasonics = 超音波医学 35 S626 2008年04月
- Defect Re-injection imagingの有用性について畑中 絹世; 南 康範; 北井 聡; 辰巳 千栄; 高橋 俊介; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊 超音波医学 35 (Suppl.) S626 -S626 2008年04月
- 肝画像診断の進歩 肝線維化評価における非侵襲的測定法(Real-time tissue elastography)の有用性に関する検討辰巳 千栄; 上嶋 一臣; 今井 元; 上田 泰輔; 川崎 正憲; 北井 聡; 萩原 智; 井上 達夫; 石川 恵美; 南 康範; 鄭 浩柄; 工藤 正俊 肝臓 49 (Suppl.1) A55 -A55 2008年04月
- 進行肝細胞癌に対するS-1、ペグインターフェロン併用療法上嶋 一臣; 早石 宗右; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 石川 恵美; 井上 達夫; 萩原 智; 南 康範; 鄭 浩柄; 工藤 正俊 肝臓 49 (Suppl.1) A278 -A278 2008年04月
- 上嶋 一臣; 工藤 正俊 綜合臨床 57 (増刊) 1050 -1052 2008年04月
- 藤本 研治; 辰巳 千栄; 上嶋 一臣; 前川 清; 加藤 道夫; 工藤 正俊; 外村 明子; 山川 誠; 椎名 毅 超音波医学 35 (Suppl.) S204 -S204 2008年04月
- 前川 清; 畑中 絹世; 横川 美加; 前野 知子; 市島 真由美; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊 超音波医学 35 (Suppl.) S438 -S438 2008年04月
- 進行肝細胞癌に対するS-1、ペグインターフェロン併用療法上嶋 一臣; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 井上 達夫; 石川 恵美; 南 康範; 鄭 浩柄; 工藤 正俊 日本消化器病学会雑誌 105 (臨増総会) A214 -A214 2008年03月
- Defect Re-injection Testの有用性について畑中 絹世; 北井 聡; 上田 泰輔; 辰巳 千恵; 井上 達夫; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣; 前川 清; 工藤 正俊 日本消化器病学会雑誌 105 (臨増総会) A218 -A218 2008年03月
- 難治性C型慢性肝炎(1型高ウイルス量)に対するPEG-IFNα2b/Ribavirin併用療法の長期投与成績と安全性について石川 恵美; 南 康範; 上嶋 一臣; 鄭 浩柄; 早石 宗介; 井上 達夫; 工藤 正俊 日本消化器病学会雑誌 105 (臨増総会) A308 -A308 2008年03月
- 上嶋 一臣; 工藤 正俊 綜合臨床 57 (3) 578 -582 2008年03月
- 上嶋一臣; 工藤正俊 モダンフィジシャン 28 (1) 56 -59 2008年
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- 乏血性肝腫瘍の診療アルゴリズム 転移性肝腫瘍・肝内胆管癌の画像診断 超音波診断を中心に上嶋 一臣; 前川 清; 工藤 正俊 日本消化器病学会雑誌 104 (臨増大会) A473 -A473 2007年09月
- 石川 恵美; 上嶋 一臣; 汐見 幹夫; 北野 雅之; 松井 繁長; 福永 豊和; 仲谷 達也; 鄭 浩柄; 南 康範; 末冨 洋一郎; 福田 信宏; 坂本 洋城; 井上 達夫; 梅原 泰; 永島 美樹; 宮部 欽生; 野田 佳寿; 工藤 正俊 肝臓 48 (Suppl.2) A431 -A431 2007年09月
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- 高度進行肝細胞癌に対するS-1、ペグインターフェロン併用療法の有用性上嶋 一臣; 南 康範; 工藤 正俊 肝臓 48 (Suppl.1) A106 -A106 2007年04月
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- 前川 清; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 工藤 正俊 超音波医学 34 (Suppl.) S646 -S646 2007年04月
- 上嶋 一臣; 工藤 正俊 薬局 58 (4) 1751 -1758 2007年03月
- 上嶋 一臣; 辰巳 千栄; 工藤 正俊 日本消化器病学会雑誌 104 (臨増総会) A16 -A16 2007年03月
- 南 康範; 上嶋 一臣; 坂口 康浩; 鄭 浩柄; 福永 豊和; 工藤 正俊 日本消化器病学会雑誌 104 (臨増総会) A155 -A155 2007年03月
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- 肝癌.上嶋 一臣; 工藤 正俊 病気と薬の説明ガイド2007 1231 -1238 2007年
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- 肝細胞癌への経皮的ラジオ波焼灼術におけるReal-time Virtual Sonographyの有用性南 康範; 高橋 俊介; 坂口 康浩; 井上 達夫; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 工藤 正俊 日本消化器病学会雑誌 103 (臨増大会) A968 -A968 2006年09月
- 原発性肝癌 手術か非手術的治療か適応を探る 肝細胞癌に対する経皮的ラジオ波焼灼療法の現況鄭 浩柄; 高橋 俊介; 井上 達夫; 南 康範; 上嶋 一臣; 福永 豊和; 工藤 正俊 日本癌治療学会誌 41 (2) 348 -348 2006年09月
- 南 康範; 鄭 浩柄; 高橋 俊介; 井上 達夫; 上嶋 一臣; 福永 豊和; 工藤 正俊 臨床外科 61 (9) 1193 -1199 2006年09月
- 【進行肝癌の治療最前線】リザーバー動注化学療法のあらたな展開上嶋 一臣; 辰巳 千栄; 坂口 康浩; 南 康範; 鄭 浩柄; 福永 豊和; 工藤 正俊 消化器科 43 (3) 253 -259 2006年09月
- Yasushi Umehara; Masatoshi Kudo; Yasunori Minami; Hiroshi Tei; Kazuomi Ueshima; Toyokazu Fukunaga; Tatsuya Nakatani; Shigenaga Matsui; Masayuki Kitano; Mikio Shiomi Digestive Endoscopy 18 (3) 221 -224 2006年07月
- 腹部臓器に発生した神経原性腫瘍のレボビスト造影超音波について市島 真由美; 前野 知子; 橋本 三紀恵; 前川 清; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 工藤 正俊 超音波医学 33 (Suppl.) S413 -S413 2006年04月
- レボビスト造影超音波の後血管相から見た肝機能評価について前川 清; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 工藤 正俊 超音波医学 33 (Suppl.) S440 -S440 2006年04月
- 西尾 健; 坂本 洋城; 北野 雅之; 坂口 康浩; 末冨 洋一郎; 上嶋 一臣; 汐見 幹夫; 工藤 正俊 Gastroenterological Endoscopy 48 (Suppl.1) 882 -882 2006年04月
- 肝癌の経皮的ラジオ波焼灼術におけるReal-time Virtual Sonographyの有用性について南 康範; 工藤 正俊; 鄭 浩柄; 福永 豊和; 上嶋 一臣; 萩原 智; 坂口 康浩; 高橋 俊介; 畑中 絹代; 井上 達夫 日本消化器病学会雑誌 103 (臨増総会) A144 -A144 2006年03月
- 純動脈相超音波造影法(PAP-US)と画像表示に用いる測定時相について前川 清; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 工藤 正俊 超音波医学 33 (1) 105 -105 2006年01月
- H. Chung; M. Kudo; S. Takahashi; T. Inoue; Y. Sakaguchi; S. Hagiwara; Y. Minami; K. Ueshima; T. Fukunaga; T. Matsunaga JOURNAL OF HEPATOLOGY 44 S99 -S99 2006年
- S. Hagiwara; T. Nakatani; Y. Minami; H. Chung; K. Ueshima; T. Fukunaga; M. Kudo; H. Munakata JOURNAL OF HEPATOLOGY 44 S172 -S172 2006年
- 上嶋 一臣; 工藤 正俊 臨床検査 49 (11) 1193 -1199 2005年11月
- 進行肝癌の治療最前線 進行肝癌に対するリザーバー動注化学療法の新たな展開上嶋 一臣; 工藤 正俊; 坂口 康浩 肝臓 46 (Suppl.2) A352 -A352 2005年09月
- 進行肝癌の治療最前線 進行肝癌に対するリザーバー動注化学療法の新たな展開上嶋 一臣; 工藤 正俊; 坂口 康浩 日本消化器病学会雑誌 102 (臨増大会) A538 -A538 2005年09月
- 上嶋 一臣; 工藤 正俊 肝・胆・膵 50 (6) 951 -956 2005年06月
- 井上 達夫; 坂口 康浩; 萩原 智; 南 康範; 鄭 浩柄; 上島 一臣; 福永 豊和; 前川 清 Journal of medical ultrasonics = 超音波医学 32 S386 2005年04月
- 井上 達夫; 坂口 康浩; 萩原 智; 南 康範; 鄭 浩柄; 上島 一臣; 福永 豊和; 前川 清; 綿井 良輔; 粟井 和夫 Journal of medical ultrasonics = 超音波医学 32 S387 2005年04月
- 前川 清; 井上 達夫; 南 康範; 鄭 浩柄; 植嶋 一臣; 福永 豊和; 工藤 正俊 Journal of medical ultrasonics = 超音波医学 32 S390 2005年04月
- 井上 達夫; 坂口 康浩; 萩原 智; 南 康範; 鄭 浩柄; 上島 一臣; 福永 豊和; 前川 清 Japanese journal of medical ultrasonics = 超音波医学 32 S386 2005年04月
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- バルーンを用いたEMR法の基礎的検討滝本 行延; 和田 将弥; 青木 信裕; 塩見 真理子; 高井 淳; 白倉 永理; 山本 修司; 上嶋 一臣; 木本 直哉; 岡田 明彦; 河南 智晴; 岡部 純弘; 織野 彬雄 Gastroenterological Endoscopy 47 (Suppl.1) 765 -765 2005年04月
- 胃原発follicular lymphomaの一例塩見 真理子; 山本 修司; 青木 信裕; 高井 淳; 白倉 永理; 和田 将弥; 上嶋 一臣; 木本 直哉; 岡田 明彦; 河南 智晴; 岡部 純弘; 滝本 行延; 織野 彬雄; 今井 幸弘 Gastroenterological Endoscopy 47 (Suppl.1) 837 -837 2005年04月
- 甲田 洋一; 伊藤 亨; 和田 将弥; 上嶋 一臣; 織野 彬雄 消化器画像 7 (2) 234 -237 2005年03月
- 南 康範; 鄭 浩柄; 畑中 絹代; 井上 達夫; 坂口 康浩; 萩原 智; 上嶋 一臣; 福永 豊和; 工藤 正俊; 土師 誠二; 中居 卓也; 大柳 治正 胆と膵 26 (3) 279 -283 2005年03月
- 進行肝細胞癌に対するリザーバー動注化学療法の検討上嶋 一臣; 青木 信裕; 塩見 真理子; 高井 淳; 白倉 永理; 山本 修司; 木本 直哉; 岡田 明彦; 河南 智晴; 岡部 純弘; 滝本 行延; 織野 彬雄; 和田 将弥 日本消化器病学会雑誌 102 (臨増総会) A293 -A293 2005年03月
- 再発性多発性軟骨炎を合併した潰瘍性大腸炎の一例山本 修司; 青木 信裕; 塩見 真理子; 高井 淳; 白倉 永理; 和田 将弥; 上嶋 一臣; 木本 直哉; 岡田 明彦; 河南 智春; 岡部 純弘; 滝本 行延; 織野 彬雄 日本消化器病学会雑誌 102 (臨増総会) A341 -A341 2005年03月
- 内科的保存療法にて軽快した門脈ガス血栓症の一例青木 信裕; 木本 直哉; 塩見 真理子; 高井 淳; 白倉 永理; 和田 将弥; 山本 修司; 上嶋 一臣; 岡田 明彦; 河南 智晴; 岡部 純弘; 滝本 行延; 織野 彬雄; 本郷 俊樹 日本消化器病学会雑誌 102 (臨増総会) A366 -A366 2005年03月
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- 下剤による腸管壁の変化について岩崎 信広; 岡部 純弘; 杤尾 人司; 門永 しのぶ; 大下 幸江; 中村 仁美; 小畑 美佐子; 和田 将弥; 山本 修司; 木本 直哉; 上嶋 一臣; 岡田 明彦; 河南 智晴; 滝本 行延; 織野 彬雄 超音波医学 32 (1) 42 -42 2005年01月
- 特徴的な超音波像を呈した食道アカラシアの1例門永 しのぶ; 岩崎 信広; 杤尾 人司; 大下 幸江; 中村 仁美; 小畑 美佐子; 和田 将弥; 山本 修司; 上嶋 一臣; 木本 直哉; 岡田 明彦; 河南 智晴; 岡部 純弘; 滝本 行延; 織野 彬雄 超音波医学 32 (1) 43 -43 2005年01月
- 白倉 永理; 岡部 純弘; 上嶋 一臣; 木本 直哉; 織野 彬雄; 中島 亮太郎; 梶原 建熈; 杉野 善雄; 川喜多 睦司; 今井 幸弘; 甲田 洋一; 伊藤 享 消化器画像 6 (5) 651 -658 2004年09月
- 【Interventional EUS】EUS下穿刺による膵仮性嚢胞穿刺ドレナージ術のマネージメントと問題点岡部 純弘; 上嶋 一臣; 木本 直哉; 織野 彬雄 消化器内視鏡 16 (8) 1299 -1305 2004年08月
- 最近経験した後腹膜腫瘍の2例曽我 登志子; 岡部 純弘; 大下 幸江; 浜田 一美; 佐々木 一朗; 岩崎 信広; 杤尾 人司; 中村 仁美; 小形 恵子; 藤本 敏明; 和田 将也; 上嶋 一臣; 木本 直哉; 滝本 行延; 織野 彬雄 超音波医学 31 (4) J269 -J269 2004年07月
- アルコール摂取による肝血流の変化:超音波ドプラ法による観察杤尾 人司; 岡部 純弘; 岩崎 信広; 大下 幸江; 浜田 一美; 佐々木 一朗; 中村 仁美; 小形 恵子; 曽我 登志子; 藤本 敏明; 和田 将也; 木本 直哉; 上嶋 一臣; 滝本 行延; 織野 彬雄 超音波医学 31 (4) J271 -J271 2004年07月
- 各種腸疾患における病変部の経時的変化についての検討岩崎 信広; 岡部 純弘; 栃尾 人司; 大下 幸江; 中村 仁美; 曽我 登志子; 藤本 敏明; 和田 将弥; 山本 修司; 上嶋 一臣; 木本 直哉; 岡田 明彦; 河南 智晴; 滝本 行延; 織野 彬雄 超音波医学 31 (4) J273 -J273 2004年07月
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- 内視鏡的に治療した膜様十二指腸狭窄成人例西馬 信一; 樫田 博史; 鄭 浩柄; 上嶋 一臣; 木本 直哉; 福永 豊和; 岡田 明彦; 岡部 純弘; 平佐 昌弘; 伊吹 康良 Gastroenterological Endoscopy 42 (Suppl.1) 699 -699 2000年04月
- 重症型腸管出血性大腸菌O-157腸炎の経時的変化 US像西馬 信一; 冨田 周介; 岩崎 信広; 鄭 浩柄; 西本 正興; 上嶋 一臣; 木本 直哉; 福永 豊和; 岡部 純弘; 樫田 博史 超音波医学 27 (2) 157 -157 2000年02月
- 超音波検査にてクローン病における結腸-胃瘻を観察し得た1例西本 正興; 岡部 純弘; 富田 周介; 鄭 浩柄; 上嶋 一臣; 木本 直哉; 福永 豊和; 樫田 博史; 平佐 昌弘; 伊吹 康良 超音波医学 27 (2) 157 -157 2000年02月
- 早期肝細胞癌及びその境界病変の流出血管 カラードプラ法による観察鄭 浩柄; 西本 正興; 上嶋 一臣; 木本 直哉; 福永 豊和; 岡部 純弘; 樫田 博史; 平佐 昌弘; 伊吹 康良; 冨田 周介 超音波医学 27 (2) 159 -159 2000年02月
- 腹壁瘢痕部に出現した腹壁静脈瘤の1例上嶋 一臣; 鄭 浩柄; 西本 正興; 木本 直哉; 福永 豊和; 岡部 純弘; 樫田 博史; 平佐 昌弘; 伊吹 智良; 冨田 周介 超音波医学 27 (2) 166 -166 2000年02月
- 膵頭十二指腸切除後の吸収不良症候群にみられた皮疹大郷 典子; 菅野 優子; 藤井 公男; 上嶋 一臣 皮膚 42 (1) 119 -119 2000年02月
- 上嶋一臣; 西本正興; 木本直哉; 岡部純弘; 樫田博史; 平佐昌弘; 伊吹智良; 冨田周介; 織野彬雄 超音波医学 27 (2) 2000年
- 西馬信一; 木本直哉; 平佐昌弘; 上嶋一臣; 福永豊和; 岡田明彦; 樫田博史; 伊吹康良; 織野彬雄 映像情報 32 (2) 2000年
- 西馬 信一; 木本 直哉; 平佐 昌弘; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 岡田 明彦; 岡部 純弘; 樫田 博史; 伊吹 康良; 織野 彬雄 映像情報Medical 32 (2) 109 -112 2000年01月
- 超音波ドプラ法でみた肝内血流動態異常.工藤 正俊; 上嶋 一臣; 鄭 浩柄; 福永 豊和; 杤尾人司; 岡部純弘; 冨田周介; 岩崎信広; 中村仁美; 太田圭子; 曽我登志子; 西馬信一; 木本直哉; 岡田明彦; 樫田博史; 平佐昌弘; 伊吹康良; 藤本敏明; 森本義人; 織野彬雄 消化器画像 2 (2) 159 -172 2000年
- 50歳以下の大腸癌例の特徴鄭 浩柄; 樫田 博史; 織野 彬雄; 伊吹 康良; 平佐 昌弘; 福永 豊和; 木本 直哉; 西馬 信一; 上嶋 一臣; 西本 正興 Gastroenterological Endoscopy 41 (Suppl.2) 1876 -1876 1999年09月
- 早期及び早期癌類似進行大腸癌の形態と分布樫田 博史; 西本 正興; 鄭 浩柄; 上嶋 一臣; 木本 直哉; 福永 豊和; 平佐 昌弘; 伊吹 康良; 冨田 周介; 織野 彬雄 Gastroenterological Endoscopy 41 (Suppl.1) 896 -896 1999年04月
- 経皮内視鏡的胃瘻造設術(PEG) 本院の経験を踏まえて木本 直哉; 西本 正興; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 岡部 純弘; 樫田 博史; 平佐 昌弘; 伊吹 康良; 冨田 周介 兵庫県医師会医学雑誌 41 (3) 121 -122 1999年03月
- 成人急性喉頭蓋炎の症例を経験しての考察北村 薫子; 大野 城太郎; 立道 清; 有吉 孝一; 上嶋 一臣; 宮本 義久; 田村 寛; 倉井 大輔; 古山 賢一郎; 小林 恭 兵庫県医師会医学雑誌 41 (3) 119 -119 1999年03月
- MRCPが診断に有用であった膵胆管合流異常の4例木本 直哉; 岡部 純弘; 織野 彬雄; 西本 正興; 鄭 浩柄; 上嶋 一臣; 渡邊 智裕; 福永 豊和; 樫田 博史; 平佐 昌弘 Gastroenterological Endoscopy 40 (Suppl.2) 1660 -1660 1998年10月
- いわゆる側方発育型大腸腫瘍の特徴樫田 博史; 西本 正興; 鄭 浩柄; 木本 直哉; 福永 豊和; 平佐 昌弘; 伊吹 康良; 冨田 周介; 織野 彬雄; 上嶋 一臣 Gastroenterological Endoscopy 40 (Suppl.2) 1694 -1694 1998年10月
- 当院における肝癌患者10年生存率の臨床的検討上嶋 一臣; 西本 正興; 鄭 浩柄; 木本 直哉; 福永 豊和; 岡部 純弘; 樫田 博史; 平佐 昌弘; 伊吹 康良; 冨田 周介 新薬と臨牀 47 (9) 1492 -1492 1998年09月
- 急性炎症性腸炎の血流〜カラードプラ法を用いて 虚血性腸炎,薬剤性腸炎と細菌性腸炎との比較木本 直哉; 岩崎 信広; 富田 周介; 上嶋 一臣; 渡邊 智裕; 福永 豊和; 岡部 純弘; 樫田 博史; 平佐 昌弘; 伊吹 康良 超音波医学 25 (8) 913 -913 1998年08月
- 陥凹型腫瘍 陥凹型を中心とした大腸早期癌の診断樫田 博史; 柴田 俊一; 上嶋 一臣; 木本 直哉; 渡邊 智裕; 福永 豊和; 平佐 昌弘; 伊吹 康良; 冨田 周介; 織野 彬雄 早期大腸癌 2 (3) 365 -365 1998年05月
- Power Doppler法にて興味ある血流動態が観察された粘液産生膵癌の1例上嶋 一臣 超音波医学 24 (10) 1681 -1681 1997年10月
- 著明な低カルシウム血症をきたし1α25(OH)2D3パルス療法により改善を認めたRODを伴う保存期慢性腎不全の1例上嶋 一臣 腎と骨代謝 10 (3) 332 -332 1997年07月
- 上嶋 一臣 肺癌 37 (2) 272 -272 1997年04月
- 渡辺智裕; 冨田周介; 木本直哉; 上嶋一臣; 福永豊和; 岡部純弘; 樫田博史; 平佐昌弘; 黒川学 神戸市立病院紀要 (36) 1997年
書籍等出版物
- 工藤, 正俊 医学書院 2018年11月 ISBN: 9784260035972 xvii, 461p
- 上嶋 一臣(担当共著) 中外医学社 2013年10月 ISBN: 9784498142121 v, 313p
- 血管新生阻害薬のベストマネジメント 癌治療と副作用対策, 肝細胞癌(hepatocellular carcinoma).上嶋 一臣; 工藤 正俊 (担当:共著範囲:)金原出版, 東京 2011年
- 肝疾患Review 2010~2011 日本メディカルセンター, 東京, ソラフェニブによる進行肝癌の治療. 第2部 トピックス 肝癌の診断・治療上嶋 一臣; 工藤 正俊 (担当:共著範囲:)2010年
- 肝細胞癌の分子標的治療, ソラフェニブによりCRとなった進行肝細胞癌の2症例.上嶋 一臣; 工藤 正俊 (担当:共著範囲:)アークメディア, 東京 2010年
- 肝疾患Review, 非侵襲的肝線維化測定法-Real-time Tissue ElastographyとFibroscanはどちらが優るか.辰巳 千栄; 工藤 正俊; 上嶋 一臣 (担当:共著範囲:)日本メディカルセンター, 東京 2010年
- 今日の消化器疾患治療指針 第3版, 肝細胞癌の治療方針.上嶋 一臣; 工藤 正俊 (担当:共著範囲:)医学書院, 東京 2010年
- 消化器研修ノート, 腹部超音波(エコー)検査.上嶋 一臣; 工藤 正俊 (担当:共著範囲:)診断と治療社, 東京 2009年
講演・口頭発表等
- 肝細胞癌診療の現状と今後の展望 [招待講演]上嶋一臣日本消化器病学会近畿支部第118回例会 2023年01月 公開講演,セミナー,チュートリアル,講習,講義等
- 肝細胞癌治療における局所療法と全身薬物療法の位置づけ [招待講演]上嶋一臣日本消化器病学会近畿支部第71回教育講演会 2023年01月 公開講演,セミナー,チュートリアル,講習,講義等
- 肝細胞癌薬物療法の進歩 [招待講演]上嶋一臣日本消化器病学会近畿支部第69回教育講演会 2022年06月 公開講演,セミナー,チュートリアル,講習,講義等
- 肝細胞癌薬物療法のUp-to-date [招待講演]上嶋一臣日本消化器病学会中国支部第35回教育講演会 2022年06月 公開講演,セミナー,チュートリアル,講習,講義等
- 非代償性肝硬変による直腸静脈瘤出血に対して内視鏡的組織接着剤注入術を施行した1例加藤 弘樹; 松井 繁長; 田北 雅弘; 上中 大地; 今村 瑞貴; 原 茜; 野村 健司; 瀬海 郁衣; 高田 隆太郎; 河野 匡志; 正木 翔; 永井 知行; 本庶 元; 米田 頼晃; 上嶋 一臣; 渡邉 智裕; 西田 直生志; 辻 直子; 樫田 博史; 工藤 正俊日本消化器内視鏡学会近畿支部例会プログラム・抄録集 2022年06月 日本消化器内視鏡学会-近畿支部
- 非代償性肝硬変による直腸静脈瘤出血に対して内視鏡的組織接着剤注入術を施行した1例加藤 弘樹; 松井 繁長; 田北 雅弘; 上中 大地; 今村 瑞貴; 原 茜; 野村 健司; 瀬海 郁衣; 高田 隆太郎; 河野 匡志; 正木 翔; 永井 知行; 本庶 元; 米田 頼晃; 上嶋 一臣; 渡邉 智裕; 西田 直生志; 辻 直子; 樫田 博史; 工藤 正俊日本消化器内視鏡学会近畿支部例会プログラム・抄録集 2022年06月 日本消化器内視鏡学会-近畿支部
- 上嶋 一臣; 田北 雅弘; 工藤 正俊日本消化器病学会雑誌 2022年03月 (一財)日本消化器病学会
- 上・下腸間膜動静脈奇形に伴う門脈圧亢進からの難治性腹水及び循環血液量低下に伴う血圧低下に対し血管内治療(IVR)にて改善しえた1例上原 広樹; 田北 雅弘; 杉森 啓伸; 岡井 夏輝; 野村 健司; 盛田 真弘; 千品 寛和; 青木 智子; 萩原 智; 依田 広; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊日本消化器病学会近畿支部例会プログラム・抄録集 2022年02月 日本消化器病学会-近畿支部
- 免疫チェックポイント阻害剤をめぐる諸問題 免疫チェックポイント阻害剤投与後に発現した肝障害の臨床的、病理学的検討萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊日本消化器病学会近畿支部例会プログラム・抄録集 2022年02月 日本消化器病学会-近畿支部
- Segmental arterial mediolysis(SAM)に伴う肝動脈瘤破裂に対して肝動脈塞栓術を施行した1例加藤 弘樹; 千品 寛和; 瀬海 郁衣; 盛田 真弘; 青木 智子; 田北 雅弘; 萩原 智; 南 康範; 依田 広; 上嶋 一臣; 西田 直生志; 工藤 正俊肝臓 2021年11月 (一社)日本肝臓学会
- 進行肝細胞癌治療の現状と課題 [招待講演]上嶋 一臣日本消化器病学会近畿支部第64回教育講演会 2020年10月 公開講演,セミナー,チュートリアル,講習,講義等
- 肝細胞癌に対する分子標的治療の今後の展望 [招待講演]上嶋一臣第17回日本肝がん分子標的治療研究会 2018年01月 シンポジウム・ワークショップパネル(指名) 横浜 日本肝がん分子標的治療研究会
- 2013年版 肝癌診療ガイドラインについて [招待講演]上嶋一臣日本消化器病学会近畿支部第45回教育講演会 2014年06月 公開講演,セミナー,チュートリアル,講習,講義等
- TACE不応の進行肝細胞癌に対するソラフェニブ開始時期の検討. [通常講演]有住 忠晃; 上嶋 一臣; 千品 寛和; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 櫻井 俊治; 西田 直生志; 工藤 正俊第9回日本肝がん分子標的治療研究会 2014年01月 海運クラブ, 東京 第9回日本肝がん分子標的治療研究会
- B-mode ultrasonography versus contrast-enhanced ultrasonography for surveillance of hepatocellular carcinoma: a prospective multicenter randomized controlled trial [通常講演]Masatoshi Kudo; Kazuomi Ueshima; Yukio Osaki; Masashi Hirooka; Yasuharu Imai; Kazunobu Aso; Kazushi Numata; Masao Ichinose; Takashi Kumada; Namiki Izumi; Yasukiyo Sumino; Kouhei AkazawaThe 64th Annual Meeting of the American Association for the Study of Liver Disease (AASLD) 2013年11月 Washington D.C., USA The 64th Annual Meeting of the American Association for the Study of Liver Disease (AASLD)
- Role of oxidative stress and epigenetic alteration on chronic hepatitis C-related human hepatocarcinogenesis [通常講演]西田 直生志; 工藤 正俊; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 櫻井 俊治; 上嶋 一臣; Takeshi Nagasaka; Ajay GoelThe 64th Annual Meeting of the American Association for the Study of Liver Disease (AASLD) 2013年11月 Washington D.C. The 64th Annual Meeting of the American Association for the Study of Liver Disease (AASLD)
- 肝のう胞に対するオレイン酸モノエタノールアミン注入療法の検討 [通常講演]田北 雅弘; 有住 忠晃; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊第17回日本肝臓学会大会(第21回日本消化器関連学会週間JDDW2013) 2013年10月 グランドプリンスホテル新高輪, 東京 第17回日本肝臓学会大会(第21回日本消化器関連学会週間JDDW2013)
- Sorafenib treatment for non-hypervascular hepatocellular carcinoma [通常講演]有住 忠晃; 上嶋 一臣; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 櫻井 俊治; 西田 直生志; 工藤 正俊Seventh Annual Conference International Liver Cancer Association (ILCA) 2013年09月 Washington D.C. Seventh Annual Conference International Liver Cancer Association (ILCA)
- The factors related to the vascularization of border line lesions detected as low intensity on hepatobiliary phase image of GD-EOB-DTPA MRI [通常講演]井上 達夫; 有住 忠晃; 上嶋 一臣; 西田 直生志; 工藤 正俊Seventh Annual Conference International Liver Cancer Association (ILCA) 2013年09月 Washington D.C. Seventh Annual Conference International Liver Cancer Association (ILCA)
- 慢性C型肝炎に対するテラプレビル3剤併用療法中に結核性リンパ節炎を発症した1例 [通常講演]千品 寛和; 井上 達夫; 南 知宏; 岡元 寿樹; 山田 光成; 田中 梨絵; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊日本消化器病学会近畿支部第99回例会 2013年09月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第99回例会
- 急激な肝機能低下をきたしたBudd-Chiari症候群の1例 [通常講演]鍵岡 賛典; 萩原 智; 岩西 美奈; 南 知宏; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 南 康範; 上嶋 一臣; 櫻井 俊治; 工藤 正俊日本消化器病学会近畿支部第99回例会 2013年09月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第99回例会
- 急性発症型自己免疫性肝炎の一例 [通常講演]岩西 美奈; 萩原 智; 鍵岡 賛典; 南 知宏; 有住 忠晃; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 南 康範; 上嶋 一臣; 櫻井 俊治; 西田 直生志; 工藤 正俊日本消化器病学会近畿支部第99回例会 2013年09月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第99回例会
- TACE不応の進行肝細胞癌患者に対するソラフェニブ開始時期の検討. パネルディスカッション2「根治治療不能進行消化器癌に対する治療選択」 [通常講演]有住忠晃; 上嶋 一臣; 工藤 正俊日本消化器病学会近畿支部第99回例会 2013年09月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第99回例会
- Unique association between global dna hypomethylation and chromosomal alterations in human hepatocellular carcinoma. [通常講演]西田 直生志; 工藤 正俊; 千品 寛和; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 井上 達夫; 南 康範; 上嶋 一臣; 櫻井 俊治; Yokomichi N; Nagasaka T; Goel ASeventh Annual Conference International Liver Cancer Asso-ciation(ILCA) 2013年09月 Washington D.C., USA Seventh Annual Conference International Liver Cancer Asso-ciation(ILCA)
- 経皮的ラジオ波焼灼術後の穿刺経路焼灼は必要か?: 後出血予防の検討 [通常講演]南 康範; 早石 宗右; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊; 鄭 浩柄第49回日本肝癌研究会 2013年07月 京王プラザホテル, 東京 第49回日本肝癌研究会
- TACEまたは肝動注化学療法とソラフェニブの併用療法の重要性. シンポジウム1「肝癌における分子標的治療の最前線」 [通常講演]上嶋 一臣; 有住 忠晃; 工藤 正俊第49回日本肝癌研究会 2013年07月 京王プラザホテル, 東京 第49回日本肝癌研究会
- 肝がん化学療法からみた肝動注リザーバーの生き残る道~SILIUS Phase Ⅲ trialの重要性~. シンポジウム1「肝細胞癌に対する肝動注療法の生き残る道」 [通常講演]上嶋 一臣; 有住 忠晃; 工藤 正俊第38回リザーバー研究会 2013年06月 かがわ国際会議場, 香川 第38回リザーバー研究会
- 進行肝細胞癌のソラフェニブ治療における腫瘍血流と治療効果との関連. ワークショップ1「分子標的薬の効果予後予測因子から治療法対象を考える」 [通常講演]有住 忠晃; 上嶋 一臣; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 櫻井 俊治; 西田 直生志; 工藤 正俊第8回日本肝がん分子標的治療研究会 2013年06月 和倉温泉「加賀屋」, 石川 第8回日本肝がん分子標的治療研究会
- 肝血管筋脂肪腫の3例 [通常講演]田中 梨絵; 南 康範; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊日本超音波医学会第86回学術集会 2013年05月 大阪国際会議場, 大阪 日本超音波医学会第86回学術集会
- Noninvasive assessment of liver fibrosis by measurement of LF index in patients with chronic viral hepatitis. [通常講演]矢田 典久; 萩原 智; 有住 忠晃; 田北 雅弘; 北井 聡; 井上 達夫; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊Digestive Disease Week(DDW) 2013 2013年05月 Orlando, USA Digestive Disease Week(DDW) 2013
- 肝血管筋脂肪腫の3例 [通常講演]田中 梨絵; 上嶋 一臣; 千品 寛和; 有住 忠晃; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 西田 直生志; 工藤 正俊第99回日本消化器病学会総会 2013年03月 かごしま県民交流センター, 鹿児島 第99回日本消化器病学会総会
- 腫瘍内出血を呈した肉腫様肝癌の1例 [通常講演]千品 寛和; 井上 達夫; 田中 梨絵; 山田 光成; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊日本消化器病学会近畿支部第98回例会 2013年02月 神戸ポートピアホテル, 兵庫 日本消化器病学会近畿支部第98回例会
- ソラフェニブ治療後の後治療についての検討. シンポジウム「進行肝細胞癌に対してネクサバールを含んだ治療を、どう生命予後改善につなげるか?」 [通常講演]上嶋 一臣; 有住 忠晃; 工藤 正俊第7回日本肝がん分子標的治療研究会 2013年01月 じゅうろくプラザ, 岐阜 第7回日本肝がん分子標的治療研究会
- The retrospective study of novel anticancer agent, miriplatin in TACE and TAI for unresectable hepatocellular carcinoma in Japan. [通常講演]永井 知行; 上嶋 一臣; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 西田 直生志; 工藤 正俊Asian Pacific Digestive Week (APDW) 2012 2012年12月 Bangkok, Thailand Asian Pacific Digestive Week (APDW) 2012
- 肝細胞癌に対するラジオ波焼灼療法の治療効果判定における造影超音波検査の有用性の検討~造影CTとの比較~ [通常講演]井上 達夫; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊第20回日本消化器関連学会週間JDDW2012 2012年10月 神戸国際展示場, 兵庫 第20回日本消化器関連学会週間JDDW2012
- 肝嚢胞に対するオレイン酸モノエタノールアミン注入療法の検討 [通常講演]田北 雅弘; 井上 達夫; 有住 忠晃; 早石 宗右; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊第20回日本消化器関連学会週間JDDW2012 2012年10月 神戸国際展示場, 兵庫 第20回日本消化器関連学会週間JDDW2012
- The decrease of blood flow after administration of sorafenib may improve overall survival in patients with advanced hepatocellular carcinoma. [通常講演]有住 忠晃; 上嶋 一臣; 工藤 正俊Sixth Annual Conference International Liver Cancer Association(ILCA) 2012年09月 Berlin, Germany Sixth Annual Conference International Liver Cancer Association(ILCA)
- 転移性肝癌に対する肝動脈塞栓術とラジオ波焼灼術の併用療法の有用性 [通常講演]南 康範; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊第48回日本肝癌研究会 2012年07月 石川県立音楽堂, ANAクラウンプラザホテル金沢, 石川 第48回日本肝癌研究会
- 進行肝細胞癌に対するソラフェニブ投与における投与後の腫瘍濃染の低下の有無と生存期間の検討 [通常講演]有住 忠晃; 上嶋 一臣; 早石 宗右; 田北 雅弘; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 南 康範; 櫻井 俊治; 西田 直生志; 工藤 正俊第48回日本肝癌研究会 2012年07月 石川県立音楽堂, ANAクラウンプラザホテル金沢, 石川 第48回日本肝癌研究会
- 肝細胞癌に対するラジオ波焼灼療法の治療効果判定における造影超音波検査の有用性~造影CTとの比較~ [通常講演]井上 達夫; 有住 忠晃; 早石 宗右; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊第48回日本肝癌研究会 2012年07月 石川県立音楽堂, ANAクラウンプラザホテル金沢, 石川 第48回日本肝癌研究会
- 肝血行動態解析によるソラフェニブ治療効果の早期予測-CT perfusionを用いて [通常講演]兵頭 朋子; 村上 卓道; 岡田 真広; 香川 祐毅; 日高 正二朗; 任 誠雲; 栁生 行伸; 上嶋 一臣; 矢田 典久; 石井 一成; 工藤 正俊; 工藤 正幸第48回日本肝癌研究会 2012年07月 石川 第48回日本肝癌研究会
- CT perfusionによる肝血行動態解析:sorafenib投与による背景肝血流の変化と肝細胞癌治療効果 [通常講演]兵頭 朋子; 村上 卓道; 岡田 真広; 香川 祐毅; 日高 正二朗; 栁生 行伸; 上嶋 一臣; 矢田 典久; 松木 充; 石井 一成; 工藤 正俊第12回関西肝血流動態イメージ研究会 2012年06月 大阪 第12回関西肝血流動態イメージ研究会
- IL28BとPEG-IFN/RBV併用療法をうけたHCVジェノタイプ1型高ウイルス量患者の効果との関連について [通常講演]田北 雅弘; 萩原 智; 有住 忠晃; 早石 宗右; 上田 泰輔; 北井 聡; 矢田 典久; 井上 達夫; 南 康範; 上嶋 一臣; 櫻井 俊治; 西田 直生志; 工藤 正俊; 鄭 浩柄第48回日本肝臓学会総会 2012年06月 JR金沢駅前もてなしドーム, 金沢 第48回日本肝臓学会総会
- 進行肝細胞癌に対するソラフェニブ投与における投与後の腫瘍濃染の低下の有無と生存期間の検討. [通常講演]有住 忠晃; 上嶋 一臣; 工藤 正俊第48回日本肝臓学会総会 2012年06月 石川県立音楽堂, 金沢 第48回日本肝臓学会総会
- 肝癌診療ガイドラインにおける治療アルゴリズムの妥当性~実臨床への展開とその問題点~. ワークショップ12「肝癌診療ガイドラインの活用と改訂への提案」 [通常講演]上嶋 一臣; 南 康範; 工藤 正俊第48回日本肝臓学会総会 2012年06月 ANAクラウンプラザホテル金沢, 金沢 第48回日本肝臓学会総会
- 当院における肝細胞癌分子標的治療の現状. パネルディスカッション「ソラフェニブ治療の実践-多数症例の使用経験を踏まえた治療の実践と問題点の解決を示す―」 [通常講演]上嶋 一臣; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 櫻井 俊治; 西田 直生志; 工藤 正俊第6回日本肝がん分子標的治療研究会 2012年06月 ザ・プリンス箱根, 神奈川 第6回日本肝がん分子標的治療研究会
- Usefulness of contrast-enhanced ultrasonography to evaluate a post treatment effect of radiofrequentry ablation about hepatocellular carcinoma: comparison with contrast-enhanced CT [通常講演]井上 達夫; 有住 忠晃; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 櫻井 俊治; 上嶋 一臣; 西田 直生志; 工藤 正俊Digestive Disease Week(DDW) 2012 2012年05月 San Diego, USA Digestive Disease Week(DDW) 2012
- The gross classification of hepatocellular carcinoma: usefulness of contrast-enhanced sonography using perfluorocarbon microbubbles (sonazoid) [通常講演]南 康範; 畑中 絹世; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊Digestive Disease Week(DDW) 2012 2012年05月 San Diego, USA Digestive Disease Week(DDW) 2012
- The decrease of blood flow after administration of sorafenib may improve overall survival in patients with advanced hepatocellular carcinoma [通常講演]有住 忠晃; 上嶋 一臣; 工藤 正俊Digestive Disease Week(DDW) 2012 2012年05月 San Diego, USA Digestive Disease Week(DDW) 2012
- Activation of JNK in the Non-cancerous liver tissue predicts a high risk of recurrence after hepatic resection for hepatocellular carcinoma [通常講演]櫻井 俊治; 萩原 智; 井上 達夫; 上嶋 一臣; 松井 繁長; 西田 直生志; 樫田 博史; 工藤 正俊Digestive Disease Week(DDW) 2012 2012年05月 San Diego, USA Digestive Disease Week(DDW) 2012
- Novel association between global DNA hypomethylation and chromosomal instability phenotype in human hepatocellular carcinoma [通常講演]西田 直生志; 工藤 正俊; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 上嶋 一臣; 櫻井 俊治Digestive Disease Week(DDW) 2012 2012年05月 San Diego, USA Digestive Disease Week(DDW) 2012
- 経皮的ラジオ波焼灼術後の後出血予防における穿刺経路焼灼の有効性の検討. [通常講演]早石 宗右; 南 康範; 足立 哲平; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 工藤 正俊; 鄭 浩柄第98回日本消化器病学会総会 2012年04月 京王プラザ 第98回日本消化器病学会総会
- 非上皮性肝悪性腫瘍の3例. [通常講演]足立 哲平; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 櫻井 俊治; 上嶋 一臣; 西田 直生志; 工藤 正俊第98回日本消化器病学会総会 2012年04月 京王プラザ 第98回日本消化器病学会総会
- Prognostic impact of EMT-related genes on post-operative prognosis in hepatocellular carcinoma. [通常講演]永井 知行; 荒尾 徳三; 松本 和子; 藤田 至彦; 林 秀敏; 木村 英晴; 萩原 智; 櫻井 俊治; 上嶋 一臣; 土師 誠二; 工藤 正俊; 西尾 和人AACR 103rd Annual Meeting 2011 2012年03月 Chicago, USA AACR 103rd Annual Meeting 2011
- 進行肝細胞癌患者に対する分子標的薬(ソラフェニブ)投与における治療効果判定基準の比較. [通常講演]有住 忠晃; 上嶋 一臣; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 櫻井 俊治; 西田 直生志; 工藤 正俊; 竹田 治彦; 大﨑第18回肝血流動態イメージ研究会 2012年01月 神戸ポートピアホテル, 兵庫 第18回肝血流動態イメージ研究会
- 造影エコーによる肝癌肉眼分類の有用性について. [通常講演]早石 宗右; 南 康範; 畑中 絹世; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 西田 直生志; 工藤 正俊第18回肝血流動態イメージ研究会 2012年01月 神戸ポートピアホテル, 兵庫 第18回肝血流動態イメージ研究会
- Interventional radiologyにおける新しい支援画像「FlightPlan」の初期臨床経験. [通常講演]南 康範; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 工藤 正俊; 柳生 行伸; 村上 卓道第18回肝血流動態イメージ研究会 2012年01月 神戸ポートピアホテル, 兵庫 第18回肝血流動態イメージ研究会
- 超音波エラストグラフィーは、肝生検の代替になりうるか. [通常講演]矢田 典久; 萩原 智; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 井上 達夫; 南 康範; 上嶋 一臣; 西田 直生志; 工藤 正俊第53回大阪肝穿刺生検治療研究会 2011年11月 ホテルグランヴィア大阪, 大阪 第53回大阪肝穿刺生検治療研究会
- Assessment of hepatobiliary phase Gd-EOB-DTPA-enhanced MRI for HCC and dysplastic nodules and comparison of detection ability versus MDCT. [通常講演]井上 達夫; 工藤 正俊; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 岡田 真広; 兵頭 朋子; 村上 卓道The 62nd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD) 2011年11月 San Francisco, USA The 62nd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD)
- 体外式超音波穿刺用コンベックスプローブEUP-B715の使用経験. [通常講演]矢田 典久; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 井上 達夫; 萩原 智; 南 康範; 上嶋 一臣; 工藤 正俊日本超音波医学会第38回関西地方会学術集会 2011年11月 大阪国際会議場, 大阪 日本超音波医学会第38回関西地方会学術集会
- 非上皮性肝腫瘤2例の造影超音波像について. [通常講演]横川 美加; 辻 裕美子; 桑口 愛; 前野 知子; 前川 清; 井上 達夫; 南 康範; 上嶋 一臣; 樫田 博史; 工藤 正俊日本超音波医学会第38回関西地方会学術集会 2011年11月 大阪国際会議場, 大阪 日本超音波医学会第38回関西地方会学術集会
- 肝エラストグラフィ ?各モダリティ―における測定原理と結果の解釈-. ワークショップ「組織弾性イメージング」 [通常講演]矢田 典久; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 井上 達夫; 萩原 智; 南 康範; 上嶋 一臣; 工藤 正俊日本超音波医学会第38回関西地方会学術集会 2011年11月 大阪国際会議場, 大阪 日本超音波医学会第38回関西地方会学術集会
- 肝癌に対するラジオ波焼灼療法の治療効果判定 造影USと造影CTの比較検討. パネルディスカッション「造影超音波」 [通常講演]井上 達夫; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 工藤 正俊日本超音波医学会第38回関西地方会学術集会 2011年11月 大阪国際会議場, 大阪 日本超音波医学会第38回関西地方会学術集会
- Phase I study of Sorafenib in combination with low-dose cisplatin and fluorouracil intra-arterial infusion chemotherapy. [通常講演]上嶋 一臣; 工藤 正俊; 鄭 浩柄; 萩原 智; 井上 達夫; 矢田 典久; 南 康範; 櫻井 俊治; 田中 正俊; 熊田 卓The 62nd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD) 2011年11月 San Francisco, USA The 62nd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD)
- Usefullness of contrast-enhanced ultrasonography to evaluate a post treatment effect of radiofrequentry ablation about hepatocellular carcinoma: Comparion with multidetector row CT. [通常講演]井上 達夫; 工藤 正俊; 畑中 絹世; 南 康範; 上嶋 一臣; 有住 忠晃; 田北 雅弘; 北井 聡The 62nd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD) 2011年11月 San Francisco, USA The 62nd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD)
- Evaluation of Angiogenesis after Antiangiogenic Therapy Using Liver CT Perfusion: Additional Detailed Capillary-level Hemodynamics in Patients with Advanced Hepatocellular Carcinoma. [通常講演]岡田 真広; 工藤 正俊; 矢田 典久; 上嶋 一臣; 村上 卓道; 工藤 正幸RSNA - Scientific Poster Session 2011年11月 Chicago RSNA - Scientific Poster Session
- Long duration of stable disease may improve the overall survival in the patients with advanced hepa-tocellular carcinoma treated with Soraenib. [通常講演]有住 忠晃; 上嶋 一臣; 工藤 正俊United European Gastroenterology Week (UEGW) 2011年10月 Stockholm, Sweden United European Gastroenterology Week (UEGW)
- Usefullness of contrast-enhanced ultrasonography to evaluate a post treatment effect of radiofrequentry ablation about hepatocellular carcinoma; comparion eith MDCT. [通常講演]井上 達夫; 工藤 正俊; 畑中 絹世; 南 康範; 上嶋 一臣; 北井 聡19th United European Gastroenterology Week (UEGW) 2011年10月 Stockholm, Sweden 19th United European Gastroenterology Week (UEGW)
- 肝血管肉腫の2例. [通常講演]有住 忠晃; 萩原 智; 大本 俊介; 早石 宗右; 上田 泰輔; 田北 雅弘; 北井 聡; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第19回日本消化器関連学会週間JDDW 2011(第15回日本肝臓学会大会) 2011年10月 福岡国際会議場, 福岡 第19回日本消化器関連学会週間JDDW 2011(第15回日本肝臓学会大会)
- Impact of TJP-1 and TWIST expression on post-operative prognosis in hepatocellular carcinoma. [通常講演]永井 知行; 荒尾 徳三; 松本 和子; 工藤 可苗; 木村 英晴; 藤田 至彦; 萩原 智; 櫻井 俊治; 上嶋 一臣; 土師 誠二; 工藤 正俊; 西尾 和人70th Annual Meeting of the Japanese Cancer Association 2011年10月 Nagoya, Japan 70th Annual Meeting of the Japanese Cancer Association
- Long duration of stable disease may improve the overall survival in the patients with advanced hepatocellular carcinoma treated with Sorafenib. [通常講演]有住 忠晃; 上嶋 一臣; 工藤 正俊International Liver Cancer Association Fifth Annual Conference (ILCA) 2011 2011年09月 Hong Kong, China International Liver Cancer Association Fifth Annual Conference (ILCA) 2011
- Phase I study of Sorafenib in combination with low-dose cisplatin and flurouracil intra-arterilal infusion chemotherapy. [通常講演]上嶋 一臣; 工藤 正俊; 櫻井 俊治; 鄭 浩柄; 南 康範; 萩原 智; 井上 達夫; 矢田 典久; 北井 聡; 有住 忠晃; 早石 宗右; 田中 正俊; 熊田 卓International Liver Cancer Association Fifth Annual Conference (ILCA) 2011 2011年09月 Hong Kong, China International Liver Cancer Association Fifth Annual Conference (ILCA) 2011
- Assessment of hepatobiliary phase Gd-EOB-DTPA-Enhanced MRI for HCC and dysplastic nodules and comparison of detection ability versus MDCT. [通常講演]井上 達夫; 工藤 正俊; 北井 聡; 有住 忠晃; 南 康範; 上嶋 一臣; 岡田 真広; 村上 卓道International Liver Cancer Association Fifth Annual Conference (ILCA) 2011 2011年09月 Hong Kong, China International Liver Cancer Association Fifth Annual Conference (ILCA) 2011
- CT Perfusionによる肝細胞癌の分子標的薬治療効果予測 [通常講演]兵頭 朋子; 香川 祐毅; 岡田 真広; 日高 正二朗; 柳生 行伸; 熊野 正士; 柏木 伸夫; 小塚 健倫; 今岡 いずみ; 足利 竜一朗; 石井 一成; 工藤 正俊; 北野 雅之; 上嶋 一臣; 井上 達夫; 矢田 典久; 村上 卓道; 工藤 正幸第2回大阪消化器画像・IVR研究会 2011年09月 大阪 第2回大阪消化器画像・IVR研究会
- Interventional radiologyにおける新しい支援画像「FlightPlan」の初期臨床経験. [通常講演]南 康範; 足立 哲平; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 工藤 正俊; 村上 卓道; 柳生 行伸日本消化器病学会近畿支部第95回例会 2011年08月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第95回例会
- 経皮的ラジオ波焼灼術後の後出血予防における穿刺経路焼灼の有効性の検討. [通常講演]早石 宗右; 南 康範; 足立 哲平; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 工藤 正俊; 鄭 浩柄日本消化器病学会近畿支部第95回例会 2011年08月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第95回例会
- 肝細胞癌に対するラジオ波焼灼療法の治療効果判定~造影超音波検査と造影CTの比較検討~. [通常講演]井上 達夫; 畑中 絹世; 有住 忠晃; 早石 宗右; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 南 康範; 上嶋 一臣; 工藤 正俊日本消化器病学会近畿支部第95回例会 2011年08月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第95回例会
- 術前診断が困難であった肝血管肉腫の一例. [通常講演]足立 哲平; 早石 宗右; 有住 忠晃; 田北 雅弘; 北井 聡; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 上嶋 一臣; 工藤 正俊; 土師 誠二; 武本 昌子; 鄭 浩柄日本消化器病学会近畿支部第95回例会 2011年08月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第95回例会
- 進行肝細胞癌に対する分子標的治療を先行した肝切除の妥当性. シンポジウム「進行肝細胞癌に対する治療戦略」 [通常講演]土師 誠二; 竹山 宜典; 上嶋 一臣; 工藤 正俊日本消化器病学会近畿支部第95回例会 2011年08月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第95回例会
- 進行肝細胞癌に対するソラフェニブ投与例におけるSDの持続期間と生存期間の検討. シンポジウム「進行肝細胞癌に対する治療戦略」 [通常講演]有住 忠晃; 上嶋 一臣; 工藤 正俊日本消化器病学会近畿支部第95回例会 2011年08月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第95回例会
- CT perfusionを用いた肝細胞癌に対するソラフェニブの効果判定の検討 [通常講演]村上 卓道; 香川 祐毅; 岡田 真広; 兵頭 朋子; 日高 正二朗; 柳生 行伸; 熊野 正士; 柏木 伸夫; 小塚 健倫; 今岡 いずみ; 足利 竜一朗; 石井 一成; 工藤 正俊; 北野 雅之; 上嶋 一臣; 井上 達夫; 矢田 典久; 工藤 正幸第11回関西肝血流動態イメージ研究会 2011年07月 第11回関西肝血流動態イメージ研究会
- 進行肝細胞癌に対するソラフェニブ投与例におけるSDの持続期間と生存期間の検討. [通常講演]有住 忠晃; 上嶋 一臣; 工藤 正俊第47回日本肝癌研究会 2011年07月 静岡県コンベンションアーツセンター, 静岡 第47回日本肝癌研究会
- ソラフェニブによりCRとなった進行肝細胞癌2症例の臨床的特徴について. ワークショップ「ソラフェニブによりRECISTにてCR例の集積から特徴を掴む」 [通常講演]上嶋 一臣; 有住 忠晃; 早石 宗右; 北井 聡; 矢田 典久; 萩原 智; 井上 達夫; 南 康範; 櫻井 俊治; 工藤 正俊第47回日本肝癌研究会 2011年07月 静岡県コンベンションアーツセンター, 静岡 第47回日本肝癌研究会
- Phase I/II study of Sorafenib in combination with low-dose cisplatin and fluorouracil intra-arterial infusion chemotherapy. International Session “Hepato-biliary-pancreatic Cancer” [通常講演]上嶋 一臣; 工藤 正俊; 南 康範; 田中 正俊; 熊田 卓The 9th Annual Meeting of Japanese Society of Medical Ocology 2011年07月 Yokohama, Japan The 9th Annual Meeting of Japanese Society of Medical Ocology
- C型肝炎治療におけるReal-time Tissue Elastographyを用いた肝線維化の非侵襲的評価法. [通常講演]藤本 研治; 矢田 典久; 上嶋 一臣; 工藤 正俊; 石田 哲士; 椎名 毅; 加藤 道夫日本超音波医学会第84回学術集会 特別企画「びまん性肝疾患2011(組織性状・コントラスト・硬さ評価)」 2011年05月 グランドプリンスホテル新高輪, 東京 日本超音波医学会第84回学術集会 特別企画「びまん性肝疾患2011(組織性状・コントラスト・硬さ評価)」
- B型慢性肝炎に対するPRG-IFNa2bとエンテカビル48週併用療法の有効性について. [通常講演]萩原 智; 峯 宏昌; 有住 忠晃; 早石 宗右; 上田 泰輔; 田北 雅弘; 畑中 絹世; 北井 聡; 矢田 典久; 井上 達夫; 鄭 浩柄; 櫻井 俊治; 上嶋 一臣; 工藤 正俊; 犬塚 義; 大﨑第97回日本消化器病学会総会 2011年05月 京王プラザホテル, 東京 第97回日本消化器病学会総会
- P38alpha inhibits liver fibrogenesis and consequent hepatocarcinogenesis by curtailing accumulation of reactive oxygen species. [通常講演]櫻井 俊治; 工藤 正俊; 上嶋 一臣; 松井 繁長; 樫田 博史Digestive Disease Week (DDW) 2011 2011年05月 Chicago, USA Digestive Disease Week (DDW) 2011
- Expression levels of EMT-related genes in hepatocellular carcinoma. [通常講演]永井 知行; 荒尾 徳三; 松本 和子; 工藤 可苗; 萩原 智; 櫻井 俊治; 上嶋 一臣; 土師 誠二; 工藤 正俊; 西尾 和人AACR 102th Annual Meeting 2011 2011年04月 Florida, USA AACR 102th Annual Meeting 2011
- 線維化進行C型肝炎患者における脾摘後のインターフェロン導入における問題点-好中球数の変化について-. [通常講演]鄭 浩柄; 上田 泰輔; 早石 宗右; 田北 雅弘; 北井 聡; 畑中 絹世; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 工藤 正俊第18回日本消化器関連学会週間(第14回日本肝臓学会大会) 2010年10月 パシフィコ横浜, 神奈川 第18回日本消化器関連学会週間(第14回日本肝臓学会大会)
- 造影エコーによる肝細胞癌の診断能、Gd-EOB-MRI、Dynamic CTとの比較検討. [通常講演]井上 達夫; 畑中 絹世; 早石 宗右; 上田 泰輔; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第18回日本消化器関連学会週間(第14回日本肝臓学会大会) 2010年10月 パシフィコ横浜, 神奈川 第18回日本消化器関連学会週間(第14回日本肝臓学会大会)
- 非閉塞性腸管虚血を発症した悪性リンパ腫の一例. [通常講演]宮田 剛; 井上 達夫; 有住 忠晃; 早石 宗右; 上田 泰輔; 辰巳 千栄; 田北 雅弘; 北井 聡; 石川 恵美; 矢田 典久; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第18回日本消化器関連学会週間(第52回日本消化器病学会), 2010年10月 パシフィコ横浜, 神奈川 第18回日本消化器関連学会週間(第52回日本消化器病学会),
- Can Gd-EOB-DTPA-enhanced MRI discriminate between dysplastic nodules and early-to- well-differentiated HCC? [通常講演]井上 達夫; 工藤 正俊; 早石 宗右; 上田 泰輔; 田北 雅弘; 北井 聡; 畑中 絹世; 矢田 典久; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣; 岡田 真広; 熊野 正士; 村上 卓道; 坂元 亨宇18th United European Gastroenterology Week (UEGW) 2010 2010年10月 Barcelona, Spain 18th United European Gastroenterology Week (UEGW) 2010
- Usefulness of hepatocyte phase imaging of Gd-EOB-DTPA-MRI in detecting borderline lesions which are difficult to detect other imaging modalities. [通常講演]井上 達夫; 工藤 正俊; 早石 宗右; 上田 泰輔; 田北 雅弘; 北井 聡; 矢田 典久; 萩原 智; 鄭 浩柄; 上嶋 一臣18th United European Gastroenterology Week (UEGW) 2010 2010年10月 Barcelona, Spain 18th United European Gastroenterology Week (UEGW) 2010
- The usefulness of the post-vascular phase of contrast-enhanced ultrasonography with Sonazoid in the evaluation of gross type of hepatocellular carcinoma. [通常講演]畑中 絹世; 鄭 浩柄; 工藤 正俊; 北井 聡; 井上 達夫; 矢田 典久; 萩原 智; 上嶋 一臣American Association for the Study of Liver Diseases (AASLD) The Liver Meeting 2010 2010年10月 Massachusetts, USA American Association for the Study of Liver Diseases (AASLD) The Liver Meeting 2010
- 発熱、及び軽度の肝機能障害に発症した肝サルコイドーシスの1例. [通常講演]有住 忠晃; 萩原 智; 早石 宗右; 田北 雅弘; 上田 泰輔; 北井 聡; 畑中 絹世; 矢田 典久; 井上 達夫; 鄭 浩柄; 上嶋 一臣; 樫田 博史; 工藤 正俊日本消化器病学会近畿支部第93回例会 2010年09月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第93回例会
- 進行型肝細胞癌に対するSorafenib治療効果判定における肝CT Perfusion検査 [通常講演]岡田 真広; 熊野 正士; 香川祐毅; 上嶋 一臣; 矢田 典久; 井上 達夫; 工藤 正俊; 村上 卓道第10回関西肝血流動態イメージ研究会 2010年07月 オーバルホール,大阪 第10回関西肝血流動態イメージ研究会
- HCCに対するソラフェニブを用いた血管新生抑制治療の効果予測因子としてのPIVKA-IIの有用性に関する検討. [通常講演]上嶋 一臣; 工藤 正俊第10回関西肝血流動態イメージ研究会 2010年07月 オーバルホール, 大阪 第10回関西肝血流動態イメージ研究会
- 進行型肝細胞癌症例に対するSorafenib治療前後の肝CT prefusion検査 [通常講演]岡田 真広; 熊野 正士; 香川祐毅; 塚部明大; 上嶋 一臣; 矢田 典久; 井上 達夫; 工藤 正俊; 村上 卓道第2回日本肝がん分子標的治療研究会 2010年06月 大手町サンケイプラザ,東京 第2回日本肝がん分子標的治療研究会
- 発癌分子機序に基づく新しい肝がん治療薬の可能性. [通常講演]櫻井 俊治; 萩原 智; 矢田 典久; 井上 達夫; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第2回日本肝がん分子標的治療研究会 2010年06月 大手町サンケイプラザ, 東京 第2回日本肝がん分子標的治療研究会
- Real-time Tissue Elastographyによる非侵襲的肝線維化評価法は炎症の影響を受けない. [通常講演]藤本 研治; 辰巳 千栄; 上嶋 一臣; 工藤 正俊; 石田 哲士; 山本 佳司; 椎名 毅; 加藤 道夫第46回日本肝臓学会総会 2010年05月 ホテルメトロポリタン山形, 山形 第46回日本肝臓学会総会
- HCCに対するソラフェニブの治療効果予測について. [通常講演]上嶋 一臣; 工藤 正俊第46回日本肝臓学会総会, シンポジウム「肝細胞癌の分子標的探索と臨床応用」 2010年05月 ホテルメトロポリタン山形, 山形 第46回日本肝臓学会総会, シンポジウム「肝細胞癌の分子標的探索と臨床応用」
- C型慢性肝疾患患者に対する非侵襲的肝線維化評価の有用性に関する検討. [通常講演]矢田 典久; 辰巳 千栄; 上嶋 一臣; 工藤 正俊; 藤本 研治; 加藤 道夫; 椎名 毅日本超音波医学会 第83回学術集会, ワークショップ「びまん性肝疾患のUltrasound Functional Imaging」 2010年05月 京都国際会議場, 京都 日本超音波医学会 第83回学術集会, ワークショップ「びまん性肝疾患のUltrasound Functional Imaging」
- 慢性肝疾患におけるReal-time Tissue Elastographyの精度の検討. [通常講演]藤本 研治; 辰巳 千栄; 上嶋 一臣; 工藤 正俊; 石田 哲士; 椎名 毅; 加藤 道夫日本超音波医学会 第83回学術集会, シンポジウム「組織エラストグラフィーの現況と展望」 2010年05月 京都国際会議場, 京都 日本超音波医学会 第83回学術集会, シンポジウム「組織エラストグラフィーの現況と展望」
- 遊走脾の捻転により脾梗塞をきたした一例. [通常講演]宮田 剛; 鄭 浩柄; 有住 忠晃; 早石 宗右; 田北 雅弘; 上田 泰輔; 辰巳 千栄; 北井 聡; 畑中 絹世; 石川 恵美; 矢田 典久; 井上 達夫; 萩原 智; 上嶋 一臣; 工藤 正俊; 土師 誠二; 山崎 満夫日本消化器病学会近畿支部第92回例会 2010年02月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第92回例会
- 肝機能障害を認めたエルシニア腸炎の一例. [通常講演]足立 哲平; 萩原 智; 有住 忠晃; 峯 宏昌; 宮田 剛; 早石 宗右; 辰巳 千栄; 上田 泰輔; 田北 雅弘; 畑中 絹世; 北井 聡; 石川 恵美; 矢田 典久; 井上 達夫; 鄭 浩柄; 上嶋 一臣; 工藤 正俊; 梅原 泰日本消化器病学会近畿支部第92回例会 2010年02月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第92回例会
- C型慢性肝炎SVR後に悪性リンパ腫を発症した一例. [通常講演]高場 雄久; 宮田 剛; 峯 宏昌; 鎌田 研; 有住 忠晃; 田北 雅弘; 早石 宗右; 永井 知行; 上田 泰輔; 辰巳 千栄; 北井 聡; 畑中 絹世; 矢田 典久; 井上 達夫; 石川 恵美; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊日本消化器病学会近畿支部第92回例会 2010年02月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第92回例会
- 慢性C型肝炎に対してPEG-IFN+Ribavirin併用療法中にITPを発症した1例. [通常講演]有住 忠晃; 石川 恵美; 宮田 剛; 峯 宏昌; 早石 宗右; 田北 雅弘; 上田 泰輔; 辰巳 千栄; 北井 聡; 畑中 絹世; 矢田 典久; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊; 金井 良高日本消化器病学会近畿支部第92回例会 2010年02月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第92回例会
- 癌幹細胞のマーカーであるCD133は進行肝細胞癌に対するS1+PEG-IFNalpha2b治療における効果予測因子である. シンポジウム「消化器癌化学療法の適応と限界-肝胆膵領域-」 [通常講演]萩原 智; 上嶋 一臣; 鄭 浩柄; 工藤 正俊日本消化器病学会近畿支部第92回例会 2010年02月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第92回例会
- The cancer stem cell marker CD133 is a predictor of the effectiveness of S1+PEG-IFN α-2b therapy against advanced hepatocellular carcinoma [通常講演]萩原 智; 工藤 正俊; 上嶋 一臣; 鄭 浩柄; 井上 達夫; 矢田 典久; 北井 聡; 田北 雅弘; 永井 知行; 土師 誠二; 木村 雅友; Ah-Mee Park; 宗像 浩The 60th Annual Meeting of the American Association for the study of liver diseases (AASLD) 2009年11月 Boston, USA The 60th Annual Meeting of the American Association for the study of liver diseases (AASLD)
- Gd-EOB MRIによる肝細胞癌の診断能~造影超音波検査, Dynamic CTとの比較検討. [通常講演]井上 達夫; 畑中 絹世; 早石 宗右; 永井 知行; 田北 雅弘; 上田 泰輔; 高橋 俊介; 北井 聡; 石川 恵美; 矢田 典久; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第45回日本肝臓学会総会 2009年06月 神戸ポートピアホテル, 兵庫 第45回日本肝臓学会総会
- 進行肝細胞癌に対するソラフェニブの有効性に関する検討. [通常講演]上嶋 一臣; 早石 宗右; 永井 知行; 田北 雅弘; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 石川 恵美; 矢田 典久; 井上 達夫; 南 康範; 鄭 浩柄; 工藤 正俊第45回日本肝臓学会総会 2009年06月 神戸ポートピアホテル, 兵庫 第45回日本肝臓学会総会
- 特異な経緯をたどったアルコール性肝硬変に合併した肝細胞癌の一例. [通常講演]早石 宗右; 鄭 浩柄; 辰巳 千栄; 永井 知行; 上田 泰輔; 高橋 俊介; 北井 聡; 石川 恵美; 矢田 典久; 井上 達夫; 萩原 智; 南 康範; 上嶋 一臣; 工藤 正俊第45回日本肝臓学会総会 2009年06月 神戸ポートピアホテル, 兵庫 第45回日本肝臓学会総会
- 進行肝細胞癌に対するS-1, ペグインターフェロン併用療法の有用性. [通常講演]矢田 典久; 鄭 浩柄; 早石 宗右; 永井 知行; 田北 雅弘; 辰巳 千栄; 上田 泰輔; 高橋 俊介; 北井 聡; 石川 恵美; 井上 達夫; 南 康範; 上嶋 一臣; 工藤 正俊第45回日本肝臓学会総会 2009年06月 神戸ポートピアホテル, 兵庫 第45回日本肝臓学会総会
- 分子鎖アミノ酸顆粒製剤による肝硬変患者の予後に与える影響に関する検討. [通常講演]早石 宗右; 石川 恵美; 辰巳 千栄; 上田 泰輔; 高橋 俊介; 北井 聡; 矢田 典久; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第45回日本肝臓学会総会 2009年06月 神戸ポートピアホテル, 兵庫 第45回日本肝臓学会総会
- 肝疾患におけるReal-time Tissue Elastography-第4報. [通常講演]藤本 研治; 辰巳 千栄; 上嶋 一臣; 工藤 正俊; 金 栄浩; 山本 佳司; 椎名 毅; 加藤 道夫パネルディスカッション「びまん性肝疾患の超音波による評価」, 日本超音波医学会第82回学術集会 2009年05月 東京国際フォーラム, 東京 パネルディスカッション「びまん性肝疾患の超音波による評価」, 日本超音波医学会第82回学術集会
- ステロイド未使用の潰瘍性大腸炎に対するサイクロスポリン持続静注と経口タクロリムスの比較検討. [通常講演]梅原 泰; 高山 政樹; 川崎 正憲; 朝隈 豊; 岡田 無文; 松井 繁長; 早石 宗右; 野田 佳寿; 坂本 洋城; 井上 達夫; 石川 恵美; 矢田 典久; 萩原 智; 末冨 洋一郎; 南 康範; 鄭 浩柄; 上嶋 一臣; 北野 雅之; 汐見 幹夫; 工藤 正俊第82回日本消化器内視鏡学会近畿地方会 2009年03月 大阪国際交流センター, 大阪 第82回日本消化器内視鏡学会近畿地方会
- Usefullness of single balloon enteroscopy for diagnosis in small intestinal disease. [通常講演]川崎 正憲; 松井 繁長; 上嶋 一臣; 朝隈 豊; 岡田 無文; 工藤 正俊16th United Europian Gastroenterology Week(UEGW) 2008年10月 Vienna Asutria 16th United Europian Gastroenterology Week(UEGW)
- 当院でのステロイド未使用の潰瘍性大腸炎に対する白血球除去療法の治療成績. [通常講演]梅原 泰; 川崎 正憲; 朝隈 豊; 岡田 無文; 市川 勉; 松井 繁長; 今井 元; 野田 佳寿; 坂本 洋城; 石川 恵美; 井上 達夫; 萩原 智; 末冨 洋一郎; 南 康範; 鄭 浩柄; 上嶋 一臣; 北野 雅之; 汐見 幹夫; 工藤 正俊第76回日本消化器内視鏡学会総会 2008年10月 グランドプリンスホテル新高輪, 東京 第76回日本消化器内視鏡学会総会
- ソナゾイド造影超音波検査におけるpost vascular phase imagingとSPIO-MRIとの比較. [通常講演]井上 達夫; 畑中 絹世; 上田 泰輔; 辰巳 千栄; 北井 聡; 高橋 俊介; 石川 恵美; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊; 横川 美加; 前野 智子; 市島 真由美; 前川 清第12回日本肝臓学会大会 2008年10月 グランドプリンスホテル新高輪, 東京 第12回日本肝臓学会大会
- 進行肝細胞癌に対するソラフェニブの使用経験. [通常講演]上嶋 一臣; 南 康範; 工藤 正俊第12回日本肝臓学会大会 2008年10月 グランドプリンスホテル新高輪, 東京 第12回日本肝臓学会大会
- Experimental and early clinical studies of S-1, a novel oral DPD inhibitor, chemotherapy for advanced hepatocellular carcinoma. [通常講演]山下 竜也; 工藤 正俊; 上嶋 一臣; 金子 周一; 古瀬 純司; 奥坂 拓志; 仲地 耕平; 池田 公史The 59th Annual Meeting of the American Association for the Study of Liver Diseases(AASLD) 2008年10月 San Francisco, USA The 59th Annual Meeting of the American Association for the Study of Liver Diseases(AASLD)
- Qualitative and quantitative analysis of liver-parenchymal phase contrast-enhanced US with Sonazoid in detecting HCC; Comparison with SPIO-MRI. [通常講演]井上 達夫; 工藤 正俊; 畑中絹世; 前川 清; 高橋 俊介; 北井 聡; 上田 泰輔; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣16th United Europian Gastroenterology Week(UEGW) 2008年10月 Vienna, Austria 16th United Europian Gastroenterology Week(UEGW)
- C型慢性肝炎に対するインターフェロン療法著効後に発症した肝細胞癌破裂の1例 [通常講演]峯 宏昌; 萩原 智; 早石 宗右; 辰巳 千栄; 上田 泰輔; 高橋 俊介; 北井 聡; 畑中 絹世; 石川 恵美; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊日本消化器病学会近畿支部第89回例会 2008年09月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第89回例会
- 肝動注用リザーバーのGDAコイルによる難治性十二指腸潰瘍出血を止血し得た1例. [通常講演]早石 宗右; 辰巳 千栄; 上嶋 一臣; 北井 聡; 高橋 俊介; 石川 恵美; 南 康範; 鄭 浩柄; 工藤 正俊日本消化器病学会近畿支部第89回例会 2008年09月 大阪国際交流センター, 大阪 日本消化器病学会近畿支部第89回例会
- Phase I/II study of the efficacy and safety of S-1 in patients(PTS) with advanced hepatocellular carcinoma(HCC). [通常講演]工藤 正俊; 上嶋 一臣; 古瀬 純司; 奥坂 拓志; 金子 周一; 仲地 耕平; 池田 公史; 山下 竜也2nd International Liver Cancer Association(ILCA) 2008 Annual Conference 2008年09月 Chicago, USA 2nd International Liver Cancer Association(ILCA) 2008 Annual Conference
- 進行肝細胞癌に対するS-1, ペグインターフェロン併用療法. [通常講演]上嶋 一臣; 早石 宗右; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 石川 恵美; 井上 達夫; 萩原 智; 南 康範; 鄭 浩柄; 工藤 正俊第44回日本肝臓学会総会 2008年06月 愛媛県県民文化会館, 愛媛 第44回日本肝臓学会総会
- ソナゾイド造影超音波による肝腫瘤の質的診断評価. [通常講演]前川 清; 畑中 絹世; 井上 達夫; 横川 美加; 前野 知子; 市島 真由美; 内藤 昭智; 上硲 俊法; 高橋 俊介; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第8回関西肝血流動態イメージ研究会 2008年06月 オーバルホール, 兵庫 第8回関西肝血流動態イメージ研究会
- Defect Re-inection imagingの有用性について. [通常講演]畑中 絹世; 南 康範; 北井 聡; 辰巳 千栄; 高橋 俊介; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊日本超音波医学会第81回学術集会 2008年05月 神戸国際会議場, 兵庫 日本超音波医学会第81回学術集会
- ソナゾイド造影超音波による肝癌局所療法の効果判定『特にDefect-reinjection-testと支援画像表示』 [通常講演]前川 清; 畑中 絹世; 横川 美加; 前野 知子; 市島 真由美; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊日本超音波医学会第81回学術集会 2008年05月 神戸国際会議場, 兵庫 日本超音波医学会第81回学術集会
- 肝臓エラストグラフィの定量化の試みと深部領域の感度の改善. パネルディスカッション「弾性の考え方と診断法: 各領域における見方」 [通常講演]藤本研吾; 辰巳 千栄; 上嶋 一臣; 前川 清; 工藤 正俊; 加藤 道夫; 外村 明子; 山川 誠; 椎名 毅日本超音波医学会第81回学術集会 2008年05月 神戸国際会議場, 兵庫 日本超音波医学会第81回学術集会
- 非B非C肝癌の臨床的特徴: B型関連肝癌・C型関連肝癌との比較. [通常講演]畑中 絹世; 南 康範; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 石川 恵美; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第44回日本肝癌研究会 2008年05月 大阪国際会議場, 大阪. 第44回日本肝癌研究会
- Defect Re-injection Testの有用性とRFA治療支援. [通常講演]畑中 絹世; 南 康範; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 石川 恵美; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊シンポジウム「RFA-STATE of ARTS」, 第44回日本肝癌研究会 2008年05月 大阪. シンポジウム「RFA-STATE of ARTS」, 第44回日本肝癌研究会
- 難治性C型慢性肝炎(Ⅰ型高ウイルス量)に対するPEG-IFN α2b/Ribavirin併用療法の長期投与成績と安全性について. [通常講演]石川 恵美; 南 康範; 上嶋 一臣; 鄭 浩柄; 早石 宗右; 井上 達夫; 工藤 正俊第94回日本消化器病学会総会, 2008年05月 福岡. 第94回日本消化器病学会総会,
- Defect Re-injection Testの有用性について. [通常講演]畑中 絹世; 北井 聡; 上田 泰輔; 辰巳 千栄; 井上 達夫; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣; 前川 清; 工藤 正俊第94回日本消化器病学会総会, 2008年05月 福岡. 第94回日本消化器病学会総会,
- 進行肝細胞癌に対するS-1、ペグインターフェロン併用療法. [通常講演]上嶋 一臣; 辰巳 千栄; 上田 泰輔; 北井 聡; 高橋 俊介; 井上 達夫; 石川 恵美; 南 康範; 鄭 浩柄; 工藤 正俊第94回日本消化器病学会総会 2008年05月 福岡. 第94回日本消化器病学会総会
- Phase I/II study of S-1 in patients (pts) with advanced hepatocellular carcinoma (HCC): Results of the pgase II part. [通常講演]奥坂 拓志; 工藤 正俊; 上嶋 一臣; 古瀬 純司; 金子 周一; 池田 公史; 仲地 耕平; 山下 竜也2008 Annual Meeting, AMERICAN SOCIETY OF CLINICAL ONCOLOGY 2008年05月 Chicago, America 2008 Annual Meeting, AMERICAN SOCIETY OF CLINICAL ONCOLOGY
- Sonazoid造影超音波によるRFA治療の効果判定: 特にDefect-reinjection-test (D-RIT)と支援画像表示. [通常講演]前川 清; 横川 美加; 前野 知子; 市島 真由美; 内藤 昭智; 上硲 俊法; 畑中 絹世; 高橋 俊介; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊ワークショップII 「肝腫瘤性病変のSonazoidr造影超音波「私の工夫」」, 第21回日本腹部造影エコー・ドプラ診断研究会 2008年04月 秋葉原コンベンションホール, 東京. ワークショップII 「肝腫瘤性病変のSonazoidr造影超音波「私の工夫」」, 第21回日本腹部造影エコー・ドプラ診断研究会
- Sonazoidを用いた造影超音波ガイド下ラジオ波焼灼術の有用性. [通常講演]南 康範; 今井 元; 上田 泰輔; 辰巳 千栄; 北井 聡; 高橋 俊介; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第21回日本腹部造影エコー・ドプラ診断研究会 2008年04月 秋葉原コンベンションホール, 東京. 第21回日本腹部造影エコー・ドプラ診断研究会
- 進行肝細胞癌に対するS-1・ペグインターフェロン併用療法の有用性. [通常講演]上嶋 一臣; 工藤 正俊第3回 Bay Area Gut Club (BAG) 2008年03月 淡路夢舞台国際会議場, 兵庫. 第3回 Bay Area Gut Club (BAG)
- ステロイド、免疫調節剤使用歴のないサイトメガロウイルス感染を合併した潰瘍性大腸炎の2例. [通常講演]梅原 泰; 川崎 正憲; 朝隈 豊; 岡田 無文; 市川 勉; 松井 繁長; 今井 元; 野田 佳寿; 坂本 洋城; 井上 達夫; 石川 恵美; 萩原 智; 末冨 洋一郎; 南 康範; 鄭 浩柄; 上嶋 一臣; 北野 雅之; 汐見 幹夫; 工藤 正俊第80回日本消化器内視鏡学会近畿地方会 2008年03月 大阪国際交流センター, 大阪 第80回日本消化器内視鏡学会近畿地方会
- 高齢発症クローン病に対するTOP-DOWN療法で経時的に粘膜治癒が追えた一例 [通常講演]有住 忠晃; 梅原 泰; 川崎 正憲; 朝隈 豊; 岡田 無文; 市川 勉; 松井 繁長; 今井 元; 野田 佳寿; 坂本 洋城; 石川 恵美; 井上 達夫; 萩原 智; 末冨洋一郎; 南 康範; 鄭 浩柄; 上嶋 一臣; 北野 雅之; 汐見 幹夫; 工藤 正俊第88回日本消化器病学会近畿支部例会 2008年02月 大阪国際交流センター, 大阪 第88回日本消化器病学会近畿支部例会
- Defect Re-injection imagingの有用性について. [通常講演]畑中 絹世; 南 康範; 上田 泰輔; 辰巳 千栄; 北井 聡; 高橋 俊介; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第88回日本消化器病学会近畿支部例会 2008年02月 大阪国際交流センター, 大阪. 第88回日本消化器病学会近畿支部例会
- Sonazoidを用いた造影超音波ガイド下ラジオ波焼灼術の有用性. [通常講演]南 康範; 今井 元; 上田 泰輔; 辰巳 千栄; 北井 聡; 高橋 俊介; 井上 達夫; 萩原 智; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第88回日本消化器病学会近畿支部例会 2008年02月 大阪国際交流センター, 大阪 第88回日本消化器病学会近畿支部例会
- 大学病院における外来化学療法センターの運営 [通常講演]今野 元博; 奥野 清隆; 上嶋 一臣; 岡本 勇; 辰巳 陽一; 慎 玉姫; 藤原 季美子; 野村 守; 山添 譲; 渡部 洋; 中川 和彦; 塩﨑 均第46回日本癌治療学会総会 2008年 第46回日本癌治療学会総会
- ソナゾイド造影超音波による肝癌局所療法の効果判定―特にdefect-reinjection-testによる判定. [通常講演]前川 清; 横川 美加; 前野 知子; 市島 真由美; 畑中 絹世; 辰巳 千栄; 北井 聡; 高橋 俊介; 石川 恵美; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第14回肝血流動態イメージ研究会 2008年01月 パシフィコ横浜, 横浜 第14回肝血流動態イメージ研究会
- Sonazoidを用いた造影超音波ガイド下ラジオ波焼灼術の有用性. [通常講演]南 康範; 今井 元; 上田 泰輔; 北井 聡; 高橋 俊介; 井上 達夫; 鄭 浩柄; 上嶋 一臣; 工藤 正俊第14回肝血流動態イメージ研究会 2008年01月 パシフィコ横浜, 横浜 第14回肝血流動態イメージ研究会
- Defect re-injection testの有用性について. [通常講演]畑中 絹世; 南 康範; 鄭 浩柄; 上嶋 一臣; 前川 清; 工藤 正俊第14回肝血流動態イメージ研究会 2008年01月 パシフィコ横浜, 横浜 第14回肝血流動態イメージ研究会
- ペグインターフェロンがS-1の抗腫瘍効果を増強したと考えられたHCC肺転移の1例. [通常講演]上嶋 一臣; 今井 元; 辰巳 千栄; 上田 泰輔; 川崎 正憲; 北井 聡; 高橋 俊介; 石川 恵美; 井上 達夫; 萩原 智; 南 康範; 鄭 浩柄; 工藤 正俊第45回 大阪肝穿刺生検治療研究会 2007年12月 大阪 第45回 大阪肝穿刺生検治療研究会
- Radiofrequency ablation of hepatocellular carcinoma: usefulness of real-time virtual CT sonography. [通常講演]南 康範; 鄭 浩柄; 工藤 正俊; 北井 聡; 高橋 俊介; 井上 達夫; 上嶋 一臣; 福永 豊和; 塩﨑 均15th United European Gastroenterology Week (UEGW) 2007年10月 Paris, France 15th United European Gastroenterology Week (UEGW)
- 進行性肝細胞癌に対するS-1、ペグインターフェロン併用療法. [通常講演]南 康範; 上嶋 一臣; 辰巳 千栄; 北井 聡; 高橋 俊介; 井上 達夫; 鄭 浩柄; 工藤 正俊第11回日本肝臓学会大会, 2007年10月 神戸 第11回日本肝臓学会大会,
- 難治性C型慢性肝炎(Ⅰ型高ウイルス量)に対するPEG-IFNα-2b/Ribavirin併用療法の使用成績と安全について. [通常講演]石川 恵美; 上嶋 一臣; 汐見 幹夫; 北野 雅之; 松井 繁長; 福永 豊和; 仲谷 達也; 鄭 浩柄; 南 康範; 末冨 洋一郎; 福田 信宏; 坂本 洋城; 井上 達夫; 梅原 泰; 永島 美樹; 宮部 欽生; 野田 佳寿; 工藤 正俊第11回日本肝臓学会大会, 2007年10月 神戸 第11回日本肝臓学会大会,
- クローン病に対するインフリキシマブ投与の有効性の検討. [通常講演]梅原 泰; 工藤 正俊; 仲谷 達也; 福田 信宏; 永島 美樹; 石川 恵美; 坂本 洋城; 井上 達夫; 坂口 康浩; 萩原 智; 南 康範; 末冨 洋一郎; 小牧 孝充; 鄭 浩柄; 上嶋 一臣; 松井 繁長; 福永 豊和; 北野 雅之; 汐見 幹夫第49回日本消化器病学会大会 2007年10月 神戸 第49回日本消化器病学会大会
- 転移性肝腫瘍・肝内胆管癌の画像診断~超音波診断を中心に~. ワークショップ「乏血性肝腫瘍の診療アルゴリズム」 [通常講演]上嶋 一臣; 前川 清; 工藤 正俊第49回日本消化器病学会大会 2007年10月 神戸 第49回日本消化器病学会大会
- LOGIQ7を用いたソナゾイド造影超音波検査における新しい支援画像表示の試み. [通常講演]前川 清; 上硲俊法; 上嶋 一臣; 工藤 正俊; 橋本 浩日本調音波医学会第34回関西地方学術集会 2007年10月 大阪 日本調音波医学会第34回関西地方学術集会
- 腸重積を発症したCrinkhite-Canada症候群も1例. [通常講演]早石 宗右; 石川 恵美; 北井 聡; 高橋 俊介; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊; 上田 和毅第79回日本消化器内視鏡学会近畿地方会 2007年09月 大阪 第79回日本消化器内視鏡学会近畿地方会
- Non-invasive methods for the assessment of liver fibrosis: comparision of transient elastography(Fibroscan), real-time tissue elastography and serum fibrotic markers. [通常講演]辰巳 千栄; 上嶋 一臣; 鄭 浩柄; 南 康範; 工藤 正俊The 4th Korea-Japan Liver Synposium 2007年09月 Seoul, Korea The 4th Korea-Japan Liver Synposium
- ソナゾイドを用いた造影超音波によるRFAの治療効果判定の検討. [通常講演]北井 聡; 畑中 絹世; 上田 泰輔; 辰巳 千栄; 高橋 俊介; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 工藤 正俊; 前川 清第7回関西肝血流動態イメージ研究会 2007年07月 大阪 第7回関西肝血流動態イメージ研究会
- ソナゾイド造影超音波検査による肝腫瘍の鑑別診断の試み. [通常講演]上嶋 一臣; 上田 泰輔; 辰巳 千栄; 北井 聡; 高橋 俊介; 畑中 絹世; 井上 達夫; 南 康範; 鄭 浩柄; 工藤 正俊; 前川 清第7回関西肝血流動態イメージ研究会 2007年07月 大阪 第7回関西肝血流動態イメージ研究会
- ソナゾイド造影超音波検査における新しい支援画像表示の試み 特にPAP時相及びDefect re-injection testの支援画像について. [通常講演]前川 清; 上硲 俊法; 上嶋 一臣; 工藤 正俊; 橋本 浩第7回関西肝血流動態イメージ研究会 2007年07月 大阪 第7回関西肝血流動態イメージ研究会
- B型慢性肝炎ウィルス感染における発癌リスク因子の検討. [通常講演]萩原 智; 高橋 俊介; 北井 聡; 石川 恵美; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 仲谷 達也; 工藤 正俊第18回南大阪肝疾患研究会 2007年07月 大阪 第18回南大阪肝疾患研究会
- 診断に苦慮し急速な経過をたどった肉腫様肝癌の一例. [通常講演]井上 達夫; 辰巳 千栄; 北井 聡; 高橋 俊介; 畑中 絹世; 萩原 智; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 工藤 正俊第43回日本肝癌研究会 2007年06月 東京ドームホテル, 東京 第43回日本肝癌研究会
- TAE併用RFA後に炎症性肉芽腫形成を来たし、播種性腫瘍再発との鑑別が困難であった一例. [通常講演]高橋 俊介; 鄭 浩柄; 辰巳 千栄; 北井 聡; 井上 達夫; 南 康範; 上嶋 一臣; 福永 豊和; 工藤 正俊; 土師 誠二第43回日本肝癌研究会 2007年06月 東京ドームホテル, 東京 第43回日本肝癌研究会
- 進行肝細胞癌に対するS-1, ペグインターフェロン併用療法の有用性. [通常講演]上嶋 一臣; 辰巳 千栄; 北井 聡; 高橋 俊介; 井上 達夫; 南 康範; 鄭 浩柄; 福永 豊和; 工藤 正俊第43回日本肝癌研究会 2007年06月 東京ドームホテル, 東京 第43回日本肝癌研究会
- Child-Pugh Aの早期肝細胞癌患者に対するラジオ波焼灼療法治療成績. パネルディスカッション「ガイドライン改訂に向けて; 肝移植, ラジオ波導入時代における肝切除の意義」 [通常講演]鄭 浩柄; 辰巳 千栄; 北井 聡; 高橋 俊介; 井上 達夫; 南 康範; 上嶋 一臣; 福永 豊和; 工藤 正俊; 土師 誠二第43回日本肝癌研究会 2007年06月 東京ドームホテル, 東京 第43回日本肝癌研究会
- 新しい超音波造影剤ソナゾイドによる肝腫瘍の造影評価. [通常講演]前川 清; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 工藤 正俊日本超音波医学会第80回学術集会 2007年05月 鹿児島 日本超音波医学会第80回学術集会
- 肝疾患におけるTissue Elastography -第2報 [通常講演]藤本 研治; 辰巳 千栄; 上嶋 一臣; 前川 清; 工藤 正俊; 外村 明子; 三竹 毅; 山川 誠; 加藤 道夫; 椎名 毅日本超音波医学会第80回学術集会 2007年05月 鹿児島 日本超音波医学会第80回学術集会
- 高度進行肝細胞癌に対するS-1, ペグインターフェロン併用療法の有用性. [通常講演]上嶋 一臣; 南 康範; 工藤 正俊第43回日本肝臓学会総会 2007年05月 ホテルグランパシフィックメリディアン, 東京 第43回日本肝臓学会総会
- ステージ4B肝内胆管癌に対するGemcitabine (GEM)をfirst lineとした化学療法と無治療群との比較検討. [通常講演]南 康範; 上嶋 一臣; 坂口 康浩; 鄭 浩柄; 福永 豊和; 工藤 正俊第93回日本消化器病学会総会 2007年04月 青森市文化会館, 青森 第93回日本消化器病学会総会
- 進行肝細胞癌に対するCDDP+5FU動注化学療法における5FU投与濃度の意義. シンポジウム「進行肝癌に対する集学的治療」 [通常講演]上嶋 一臣; 辰巳 千栄; 工藤 正俊第93回日本消化器病学会総会 2007年04月 青森市文化会館, 青森 第93回日本消化器病学会総会
- 新しい超音波造影剤ソナゾイドによる肝腫瘍の造影評価. [通常講演]前川 清; 井上 達夫; 鄭 浩柄; 南 康範; 上嶋 一臣; 工藤 正俊第20回日本腹部造影エコー・ドプラ診断研究会 2007年04月 今池ガスビル, 名古屋 第20回日本腹部造影エコー・ドプラ診断研究会
- ステージ4B肝内胆管癌に対するGemcitabine(GEM)をfirst lineとした化学療法と無治療群との比較検討. [通常講演]南 康範; 上嶋 一臣; 坂口 康浩; 鄭 浩柄; 福永 豊和; 工藤 正俊第5回日本臨床腫瘍学会学術集会 2007年03月 札幌コンベンションセンター, 北海道 第5回日本臨床腫瘍学会学術集会
- PEGインターフェロン併用療法の経験. [通常講演]上嶋 一臣; 南 康範; 工藤 正俊第5回日本臨床腫瘍学会学術集会 2007年03月 札幌コンベンションセンター, 北海道 第5回日本臨床腫瘍学会学術集会
- Real-time virtual CT sonographic-guided radiofrequency ablation for hepatocellular carcinoma. [通常講演]南 康範; 鄭 浩柄; 井上 達夫; 上嶋 一臣; 福永 豊和; 工藤 正俊17th APASL Conference 2007年03月 Kyoto 17th APASL Conference
- 進行肝細胞癌に対するS-1、ペグインターフェロン併用療法の経験. [通常講演]上嶋 一臣; 辰巳 千栄; 北井 聡; 高橋 俊介; 井上 達夫; 南 康範; 鄭 浩柄; 福永 豊和; 工藤 正俊第86回日本消化器病学会近畿支部例会 2007年02月 京都テルサ, 京都 第86回日本消化器病学会近畿支部例会
- C型肝硬変に伴う肝内びまん性動門脈シャントに対して肝動脈塞栓術およびバルン閉塞下逆行性シャント閉塞術が奏功した一例. [通常講演]前川 昌平; 鄭 浩柄; 辰巳 千栄; 北井 聡; 高橋 俊介; 萩原 智; 井上 達夫; 南 康範; 上嶋 一臣; 福永 豊和; 工藤 正俊; 堀 信一第86回日本消化器病学会近畿支部例会 2007年02月 京都テルサ, 京都 第86回日本消化器病学会近畿支部例会
- リザーバー肝動注化学療法が有効であった乳癌肝転移の一症例. [通常講演]辰巳 千栄; 上嶋 一臣; 上田 泰輔; 北井 聡; 高橋 俊介; 井上 達夫; 鄭 浩柄; 南 康範; 工藤 正俊第87回日本消化器病学会近畿支部例会 2007年 大阪 第87回日本消化器病学会近畿支部例会
- レボビスト造影超音波の後血管相における肝と脾臓の輝度評価「特に肝の過形所成結節について」. [通常講演]前川 清; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 工藤 正俊第13回肝血流動態イメージ研究会 2007年01月 パシフィコ横浜 第13回肝血流動態イメージ研究会
- レボビスト造影超音波の後血管相における肝と脾臓の輝度評価. [通常講演]前川 清; 工藤 正俊; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和第12回関西超音波造影剤研究会 2006年09月 日本シェーリング株式会社本社, 大阪 第12回関西超音波造影剤研究会
- 肝動脈塞栓術併用経皮的ラジオ波焼灼術後に炎症性肉芽腫形成を来たし、播種性腫瘍再発との鑑別が困難であった一例. [通常講演]高橋 俊介; 工藤 正俊; 鄭 浩柄; 北井 聡; 井上 達夫; 坂口 康浩; 南 康範; 上嶋 一臣; 福永 豊和; 土師 誠二第85回日本消化器病学会近畿支部例会 2006年09月 大阪国際交流センター, 大阪 第85回日本消化器病学会近畿支部例会
- S1とペグインターフェロンが奏功したHCC肺転移の1例. [通常講演]高瀬 徹; 工藤 正俊; 上嶋 一臣; 井上 達夫; 坂口 康浩; 南 康範; 鄭 浩柄; 福永 豊和; 北野 雅之第85回日本消化器病学会近畿支部例会 2006年09月 大阪国際交流センター, 大阪 第85回日本消化器病学会近畿支部例会
- B型肝炎ウイルス感染における発癌リスク因子の検討. [通常講演]萩原 智; 工藤 正俊; 仲谷 達也; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和第85回日本消化器病学会近畿支部例会 2006年09月 大阪国際交流センター, 大阪 第85回日本消化器病学会近畿支部例会
- 自然経過が観察し得たアルコール性過形成病変の一例. [通常講演]前川 清; 工藤 正俊; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和日本超音波医学会第32回関西地方会学術集会 2006年08月 大阪国際会議場, 大阪 日本超音波医学会第32回関西地方会学術集会
- 肝細胞癌への経皮的ラジオ波焼灼術におけるReal-time virtual sonographyの有用性. [通常講演]南 康範; 工藤 正俊; 高橋 俊介; 坂口 康浩; 井上 達夫; 鄭 浩柄; 上嶋 一臣; 福永 豊和第6回関西肝血流動態イメージ研究会 2006年07月 オーバルホール, 大阪 第6回関西肝血流動態イメージ研究会
- 自然経過が観察し得たアルコール性過形成病変の一例. [通常講演]前川 清; 工藤 正俊; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和第6回関西肝血流動態イメージ研究会 2006年07月 オーバルホール, 大阪 第6回関西肝血流動態イメージ研究会
- von Gierke disease(糖尿病I型)に肝細胞癌を合併した一症例. [通常講演]鄭 浩柄; 工藤 正俊; 高橋 俊介; 萩原 智; 井上 達夫; 坂口 康浩; 南 康範; 上嶋 一臣; 福永 豊和; 中居 卓也第42回日本肝癌研究会 2006年07月 東京ドームホテル, 東京 第42回日本肝癌研究会
- ステージIVB肝内胆管癌に対するGemcitabine (GEM)をfirst lineとした化学療法と無治療群との比較検討. ワークショップ2「肝内胆管癌の診断と治療ーエビデンスに基づいた次の一手を求めてー」 [通常講演]南 康範; 工藤 正俊; 上嶋 一臣; 坂口 康浩; 鄭 浩柄; 福永 豊和第42回日本肝癌研究会 2006年07月 東京ドームホテル, 東京 第42回日本肝癌研究会
- ペグインターフェロン(PEG-IFN)と5-FUの併用によるp53を介する肝細胞癌抑制効果. [通常講演]仲谷 達也; 工藤 正俊; 福永 豊和; 上嶋 一臣; 鄭 浩柄; 南 康範; 井上 達夫; 坂口 康浩; 萩原 智第47回京都肝疾患懇話会 2006年07月 京都ホテルオークラ, 京都 第47回京都肝疾患懇話会
- 腹部臓器に発生した神経原性腫瘍のレボビスト造影超音波について. [通常講演]市島 真由美; 工藤 正俊; 前野 知子; 橋本 美紀恵; 前川 清; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和日本超音波医学会第79回学術集会 2006年05月 大阪国際会議場 日本超音波医学会第79回学術集会
- レボビスト造影超音波の後血管相から見た肝機能評価について. [通常講演]前川 清; 工藤 正俊; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和日本超音波医学会第79回学術集会 2006年05月 大阪国際会議場 日本超音波医学会第79回学術集会
- Evaluation of liver function by contrast enhanced coded phase inversion harmonic ultrasonography with levovist using parenchymal imaging of liver and spleen in the post vascular phase. [通常講演]上嶋 一臣; 工藤 正俊; 前川 清; Chinamnan W; 南 康範; 鄭 浩柄; 福永 豊和11th Congress of the World Federation for Ultrasound in Medicine and Biology 2006年05月 COEX, Seoul, Korea 11th Congress of the World Federation for Ultrasound in Medicine and Biology
- EUS-CPN時のエタノール注入部位と疼痛改善度の関連性. [通常講演]西尾 健; 工藤 正俊; 坂本 洋城; 北野 雅之; 坂口 康浩; 末冨洋一郎; 上嶋 一臣; 汐見 幹夫第2回超音波内視鏡下生検法の診断精度向上のための研究会 2006年05月 京王プラザホテル 第2回超音波内視鏡下生検法の診断精度向上のための研究会
- Carcinogenic risk factors in hepatitis B rivus infection. [通常講演]萩原 智; 工藤 正俊; 仲谷 達也; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和; 宗像 浩41th Annual Meeting of the European Association for the Study of the Liver (EASL) 2006年04月 Vienna, Austria 41th Annual Meeting of the European Association for the Study of the Liver (EASL)
- Comparison of staging systems for hepatocellular carcinoma in Japanese cohort. [通常講演]鄭 浩柄; 工藤 正俊; 高橋俊介; 南 康範; 井上達夫; 坂口康浩; 萩原 智; 福永 豊和; 上嶋 一臣41th Annual Meeting of the European Association for the Study of the Liver (EASL) 2006年04月 Vienn, Austria 41th Annual Meeting of the European Association for the Study of the Liver (EASL)
- 肝癌の経皮的ラジオ波焼灼術におけるReal-time Virtual Sonographyの有用性について. [通常講演]南 康範; 工藤 正俊; 鄭 浩柄; 福永 豊和; 上嶋 一臣; 萩原 智; 坂口康浩; 高橋俊介; 畑中絹代; 井上達夫第92回日本消化器病学会総会 2006年04月 リーガロイヤルホテル小倉, 福岡 第92回日本消化器病学会総会
- レボビスト造影超音波で得られた後血管相画像の定量化について [通常講演]前川 清; 工藤 正俊; 井上達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和第19回日本造影エコー・ドプラ診断研究会 2006年04月 神戸商工会議所, 神戸 第19回日本造影エコー・ドプラ診断研究会
- レボビストによる純動脈相造影超音波法(PAP-US)の画像評価と腫瘍内の造影剤動態について [通常講演]前川 清; 工藤 正俊; 井上達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和第111回大阪超音波研究会 2006年03月 ホテルグランヴィア大阪, 大阪 第111回大阪超音波研究会
- 純動脈相超音波造影法(PAP-US)と画像表示に用いる測定時相について [通常講演]前川 清; 工藤 正俊; 井上 達夫; 南 康範; 鄭 浩柄; 上嶋 一臣; 福永 豊和日本超音波医学会第30回関西地方会学術集会 2005年09月 千里ライフサイエンスセンター 日本超音波医学会第30回関西地方会学術集会
- Real-time virtual sonography, an integrated system of computer tomography with ultrasound images: value in radiofrequency ablation guidance. [通常講演]南 康範; 工藤 正俊; 鄭 浩柄; 井上 達夫; 萩原 智; 畑中 絹代; 坂口 康浩; 上嶋 一臣; 福永 豊和15th Asian Pacific Association for the Study of the Liver (APASL) 2005年08月 Bali 15th Asian Pacific Association for the Study of the Liver (APASL)
- 日本肝癌研究会 肝障害度のスコア化による新分類法の提唱. ポスター「肝細胞癌の予後解析1」 [通常講演]鄭 浩柄; 工藤 正俊; 井上達夫; 坂口康浩; 萩原 智; 南 康範; 上嶋 一臣; 福永 豊和; 大崎往夫; 春日井博志; 関 寿人; 岡 博子第41回日本肝癌研究会 2005年06月 幕張メッセ国際会議場, 千葉 第41回日本肝癌研究会
- 肝癌の経皮的ラジオ波焼灼術におけるReal-time Virtual Sonographyの有用性について. ビデオセッション「経皮的局所療法(II)」 [通常講演]南 康範; 工藤 正俊; 鄭 浩柄; 井上達夫; 坂口康浩; 萩原 智; 畑中絹世; 上嶋 一臣第41回日本肝癌研究会 2005年06月 幕張メッセ国際会議場, 千葉 第41回日本肝癌研究会
- 当院における肝細胞癌に対する経皮的ラジオ波治療成績と工夫. パネルディスカッション「より安全で効果的なラジオ波焼灼療法」 [通常講演]鄭 浩柄; 工藤 正俊; 井上達夫; 坂口康浩; 萩原 智; 南 康範; 上嶋 一臣; 福永 豊和第41回日本肝癌研究会 2005年06月 幕張メッセ国際会議場, 千葉 第41回日本肝癌研究会
- 当院におけるラジオ波焼灼術の成績と工夫(シンポジウム「安全で確実なラジオ波熱凝固療法施行のために」) [通常講演]鄭 浩柄; 工藤 正俊; 井上達夫; 萩原 智; 南 康範; 上嶋 一臣; 福永 豊和第7回関西肝癌局所療法研究会 2005年03月 ホテルグランヴィア大阪, 大阪 第7回関西肝癌局所療法研究会
共同研究・競争的資金等の研究課題
- 日本学術振興会:科学研究費助成事業 新学術領域研究(研究領域提案型)研究期間 : 2017年06月 -2022年03月代表者 : 西尾 和人; 坂井 和子; 上嶋 一臣; 櫻井 俊治; 角田 郁生; 岡田 斉炎症性腸疾患(クローン病や過敏性大腸炎)および肝細胞癌患者の便中細菌叢のメタゲノム解析により、1)腸内細菌と腸上皮細胞のインタラクションが難治性炎症性腸疾患の発がんリスクに及ぼす影響の解明、2)免疫チェックポイント阻害薬による有害事象に及ぼす腸内細菌叢の影響、3)中枢神経系(CNS)炎症性疾患である多発性硬化症(MS)の発症に対する腸内細菌の影響を明らかにすることを目的とした。本年度は炎症性腸疾患4例、大腸がん110例の細菌叢のゲノム解析を行い、炎症性腸疾患症例におけるProteobacteriaの増加を検出した。潰瘍性大腸炎の病態の解明として、潰瘍性大腸炎関連大腸癌の発生に関連すると考えられる癌遺伝子ガンキリンについて大腸炎発生との関連を検討した結果、小腸粘膜でのガンキリン欠損により、大腸炎を増悪させることが明らかとなった。MSの発症と腸内細菌叢との関連について、マウス脳内にタイラーウイルスを接種するMS様病態を用いてCNSトランスクリプトーム解析と糞便を用いた腸内細菌叢解析を行った。CNS浸潤による炎症性脱髄病変の誘導に伴い、有意に腸内細菌叢の多様性増加が認められた。以上より、炎症性腸疾患ならびに中枢神経系炎症性疾患における宿主と細菌叢との化学コミュニケーションによる病態の解明は順調に進んでいる。
- 進行・再発肝細胞癌に対する動注化学療法と分子標的薬併用による新規治療法の確立を目指した臨床試験(Phase III)ならびに効果を予測するbiomarkerの探索研究厚生労働省科研費研究期間 : 2010年 -2012年代表者 : 工藤正俊; 西尾和人; 赤澤宏平; 奥坂拓志; 熊田卓; 池田公史; 荒井保明; 永野浩昭; 波多野悦朗; 佐々木裕; 相方浩; 山崎隆弘; 金井文彦; 泉並木; 小尾俊太郎; 山本和秀; 今井康陽; 日野啓輔; 高山哲治; 上嶋一臣; 石川達; 小川力; 小林功幸; 辻邦彦