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Ikuo Konishi,Kaoru Abiko,Takuma Hayashi,Koji Yamanoi,Ryusuke Murakami,Ken Yamaguchi,Junzo Hamanishi,Tsukasa Baba,Noriomi Matsumura,Masaki Mandai,Kyoto Study Group for Ovarian Cancer Research 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.5
Epithelial ovarian cancer remains the lethal gynecological malignancy in women. The representative histotype is high-grade serous carcinoma (HGSC), and most patients with HGSC present at advanced stages with peritoneal dissemination. Since the peritoneal dissemination is the most important factor for poor prognosis of the patients, complete exploration for its molecular mechanisms is mandatory. In this narrative review, being based on the clinical, pathologic, and genomic findings of HGSC, chromosomal instability and epigenetic dynamics have been discussed as the potential drivers for cancer development in the fallopian tube, acquisition of cancer stem cell (CSC)-like properties, and peritoneal metastasis of HGSC. The natural history of carcinogenesis with clonal evolution, and adaptation to microenvironment of peritoneal dissemination of HGSC should be targeted in the novel development of strategies for prevention, early detection, and precision treatment for patients with HGSC.
Ayami Inoue,Ken Yamaguchi,Yasuhisa Kurata,Ryusuke Murakami,Kaoru Abiko,Junzo Hamanishi,Eiji Kondoh,Tsukasa Baba,Aki Kido,Ikuo Konishi,Noriomi Matsumura 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5
Objective: Carcinosarcoma of the uterine corpus has a poor prognosis. Although pathologicalnecrosis is a prognostic factor of endometrial cancer, the clinicopathological influences of anunenhanced region observed on magnetic resonance imaging (MRI) are inconclusive. The aimof our study was to determine the clinicobiological impact of the presence of an unenhancedregion on MRI, which can represent necrosis, in uterine carcinosarcoma. Methods: The clinicopathological factors of 29 patients diagnosed with uterinecarcinosarcoma were assessed retrospectively. The percentage of the tumor that wasunenhanced on MRI was determined. The clinicopathological factors related to theunenhanced regions were evaluated. The prognostic significance was assessed using theKaplan-Meier method and Cox regression model. Results: Although the presence of pathological necrosis was not a poor prognosticfactor (p=0.704), unenhanced regions on MRI correlated with poor prognosis when theunenhanced regions in the tumor accounted for more than 10% of the total tumor (p=0.019). The percentage of unenhanced regions was positively correlated with stage (p=0.028;r=0.4691) and related to tumor size (p=0.086; r=0.3749). The Cox regression analysisindicated that the presence of lymph node (LN) metastasis and more than 10% of the tumorbeing unenhanced on MRI were prognostic factors of overall survival in the univariateanalyses (p=0.018 and p=0.047, respectively). Conclusion: The unenhanced region on MRI, which represents pathological necrosis, reflectstumor progression, and semi-quantification of the region is useful to predict the prognosis inpatients with uterine carcinosarcoma.
Serum lactate dehydrogenase is a possible predictor of platinum resistance in ovarian cancer
Asami Ikeda,Ken Yamaguchi,Hajime Yamakage,Kaoru Abiko,Noriko Satoh-Asahara,Kenji Takakura,Ikuo Konishi 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.6
ObjectiveThe need for tailoring ovarian cancer treatments to individual patients is increasing. This study aimed to evaluate theprognostic value of pretreatment laboratory test data for predicting the response and survival outcomes of platinumbasedchemotherapy in ovarian cancer. MethodsWe enrolled 270 patients with ovarian cancer diagnosed at the Kyoto Medical Center (n=120; group A) and KyotoUniversity (n=150; group B). Data on 9 blood parameters (neutrophil to lymphocyte ratio [NLR], platelet to lymphocyterate [PLR], C-reactive protein, lactate dehydrogenase [LDH], glucose, total cholesterol, high-density lipoprotein [HDL],low-density lipoprotein, and triglyceride levels), cancer pathology, cancer stage, cytoreduction outcomes, serumcancer antigen 125 levels, platinum-free interval (PFI), disease-free survival (DFS), and overall survival were assessedretrospectively. ResultsNLR, PLR, LDH, and HDL were significantly different in advanced stage patients (P<0.001, <0.001, 0.029, and <0.001,respectively). The Kaplan-Meier curves revealed that high LDH level (≥250 U/L) was associated with reduced PFI(P=0.037 and 0.012) and DFS (P=0.007 and 0.002) in groups A and B, respectively. High NLR (≥4) was associated withreduced DFS in both groups (P=0.036 and 0.005, respectively). LDH showed higher area under the curve (AUC) valuesin predicting platinum resistance with a PFI of less than 6 months and 12 months (AUC=0.606 and 0.646, respectively)than NLR. In the multivariate analysis, LDH remained significant (P=0.019) after adjusting for the 9 blood parameters. ConclusionSerum LDH level may possibly predict platinum resistance and prognosis in ovarian cancer and may be useful whendeveloping precision medicine for individual patients.
Groin lymph node detection and sentinel lymph node biopsy in vulvar cancer
Chieko Sakae,Ken Yamaguchi,Noriomi Matsumura,Hidekatsu Nakai,Yumiko Yoshioka,Eiji Kondoh,Junzo Hamanishi,Kaoru Abiko,Masafumi Koshiyama,Tsukasa Baba,Aki Kido,Masaki Mandai,Ikuo Konishi 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.6
Objective: To identify suitable diagnostic tools and evaluate the efficacy of sentinel lymphnode (SLN) biopsy for inguinal lymph node metastasis in vulvar cancer. Methods: Data from 41 patients with vulvar cancer were evaluated retrospectively, includingmagnetic resonance imaging (MRI) measurements, SLN biopsy status, groin lymph nodemetastasis, and prognosis. Results: SLN biopsy was conducted in 12 patients who had stage I to III disease. Groinlymphadenectomy was omitted in five of the nine patients with negative SLNs. All SLNnegativepatients who did not undergo groin lymphadenectomy showed no evidence ofdisease after treatment. On MRI, the long and short diameters of the inguinal node weresignificantly longer in metastasis-positive cases, compared with negative cases, in 25 patientswhose nodes were evaluated pathologically (long diameter, 12.8 mm vs. 8.8 mm, p=0.025;short diameter, 9.2 mm vs. 6.7 mm, p=0.041). The threshold of >10.0 mm for the longaxis gave a sensitivity, specificity, positive predictive value, and negative predictive value of87.5%, 70.6%, 58.3%, and 92.3%, respectively, using a binary classification test. Decisiontree analysis revealed a sensitivity, specificity, and accuracy of 87.5%, 70.6%, and 76.0%,respectively, with the threshold of >10.0 mm for the long axis on MRI. The criteria of >10.0mm for the long axis on MRI predicted an advanced stage and poorer prognosis using avalidation set of 15 cases (p=0.028). Conclusion: Minimally invasive surgery after preoperative evaluation on MRI and SLN biopsyis a feasible strategy for patients with vulvar cancer.
( Hitoshi Kuramae ),( Norio Tatsumi ),( Keiko Sugaki ),( Atsushi Naito ),( Hiroki Kawai ),( Ikuo Yamaguchi ),( Mitsuhiro Hori ),( Kazuhisa Inuzuka ) 대한임상병리사협회 2015 임상미생물검사학회 발표자료집 Vol.2015 No.-
Introduction Recently, several bacteria isolated in a clinical setting have drug-resistance, which has become a serious problem. Particularly, extended-spectrum β- lactamase (ESBL) producing Enterobacteriaceae(ESBLPE) have spread not only in-hospital infection but also community-acquired infection. In 2006, we established a meeting which is called "Mikawan-kai" for the purpose of establishment and the standardization of the method for detection criteria of ESBLPE with 17 institutions in east area of Aichi prefecture. We report about the situation and trend of ESBLPE detection in this area. Materials and Methods This study was carried out by 7 institutions (190-836 bed) in east area of Aichi prefecture from January to December in 2013. The judgment of ESBLPE was conducted by the routine method in each institution. Results The range of detection rates identified or suspected ESBLPE were E. coli : 8-13%, K. pneumoniae : 3-6%, K. oxytoca : 0-17%, and P. mirabilis : 6-22%, respectively. And the results of antimicrobial susceptibility tests of E. coli showed that the rates of resistance to CPDX, CTX, and CAZ, which were recommended as a screening of identification for ESBLPE, were 12-18%, 8-13%, and 2-6%. Discussion and conclusion The highest frequency of detection of ESBLPE was E. coli, which was about 10% in each institution and has been increasing as compared with that of previous research in 2009 (4-9%). The results of ESBLPE detection in K. oxytoca and P. mirabilis showed some differences among institutions. Resistance rate for antimicrobial drug seems to be higher in CPDX, which is lower in CAZ. The detection rate of ESBLPE has not steeply increased for recent 5 years, whereas it still accounts for a high rate. For the prevention to further expansion of ESBLPE in this area, we intend to develop our activity through standardization of detection methods and criterion of identification for ESBLPE and share information.