本邦における抗I型インターフェロン中和抗体とCOVID-19重症化の関連

内容の要約広島大学(Hiroshima University)博士(医学)Doctor of Philosophy in Medical Sciencedoctora

SDF-1 expression in rectal cancer

Stromal cell-derived factor-1 (SDF-1) expression is associated with cancer progression, as a biomarker of prognosis. We clarified the significance of SDF-1 expression on chemoradiotherapy (CRT) resistance and prognosis in advanced lower rectal cancer patients. We evaluated 98 patients with advanced lower rectal cancer who underwent preoperative CRT. All patients received 40 Gy of radiation therapy, with concurrent chemotherapy containing fluorinated pyrimidines, followed by surgical resection. SDF-1 expression in surgical specimens was examined by immunohistochemistry. We divided the patients into SDF-1-positive- (n = 52) and SDF-1-negative groups (n = 46) and compared the clinicopathological factors and survival rates. The SDF-1-positive group was more resistant to CRT than the SDF-1-negative group (non-responder rate, 63.5% vs. 47.8%, respectively ; p = 0.12). Overall survival (OS) in the SDF-1 positive group was significantly poorer vs. the SDF-1-negative group (5-year OS, 73.4% vs. 88.0%, respectively ; p = 0.02), and disease-free survival (DFS) was worse (5-year DFS, 61.0% vs. 74.1%, respectively ; p = 0.07). Multivariate analysis confirmed that SDF-1 expression was a significant independent prognostic predictor of OS (p = 0.04). SDF-1 expression after preoperative CRT is significantly associated with a poor prognosis in advanced lower rectal cancer patients and is a promising biomarker

3層グラフェン/LiNbO3界面における音波伝搬特性

第40回超音波エレクトロニクスの基礎と応用に関するシンポジウム/The 40th Symposium on UltraSonic Electronics (USE2019), 2019年11月25日～27日, 明治大学, 東

CMTM6 is a Prognostic Factor in GC

Background : CKLF-like MARVEL transmembrane domain containing 6 (CMTM6) is the master regulator of programmed cell death-ligand 1 (PD-L1). We aimed to clarify the significance of CMTM6 expression in gastric cancer (GC). Methods : A total of 105 patients who had undergone curative surgical resection for stage II / III GC at Tokushima University Hospital were included in this study. The expression of CMTM6 was examined by immunohistochemistry. Additionally, the relationship of each expression level to several prognostic factors was examined using univariate and multivariate analyses. Results : CMTM6 was not positively correlated with any of the factors examined. The overall survival (OS) rates were significantly poorer in the CMTM6 high-expression group than in the CMTM low-expression group (5-year OS : 57.2% vs. 79.2%, respectively ; p < 0.05). Disease-free survival (DFS) was significantly poorer in the CMTM high-expression group than in the CMTM6 low-expression group (5-year DFS : 52.8% vs. 72.4%, respectively ; p < 0.05). Multivariate analysis confirmed CMTM6 expression as an independent prognostic factor in DFS (p < 0.05). CMTM6 expression tended to be correlated with PD-L1 expression (p = 0.07). Conclusions : CMTM6 is associated with a poor prognosis and immunotolerance through PD-L1 in GC

Lymphocyte to C-reactive protein ratio predicts long-term outcomes for patients with lower rectal cancer

Backgrounds: The lymphocyte to C-reactive protein (CRP) ratio (LCR) is an indicator of systemic inflammation and host–tumor cell interactions. The aim of this study was to investigate the prognostic significance of LCR in lower rectal cancer patients who received preoperative chemo-radiotherapy (CRT). Methods: Forty-eight patients with lower rectal cancer who underwent CRT followed by curative surgery were enrolled in this study. Routine blood examinations were performed before and after CRT were used to calculate pre-CRT LCR and post-CRT LCR. The median LCR was used to stratify patients into low and high LCR groups for analysis. The correlation between pre- and post-CRT LCR and clinical outcomes was retrospectively investigated. Results: The pre-CRT LCR was significantly higher than the post-CRT LCR (11,765 and 6780, respectively, P < 0.05). The 5-year overall survival rate was significantly higher for patients with high post-CRT LCR compared with low post-CRT LCR (90.6% and 65.5%, respectively, P < 0.05). In univariate analysis, post-CRT LCR, post-CRT neutrophil to lymphocyte ratio, and fStage were significant prognostic factors for overall survival. In multivariate analysis, post-CRT LCR, but not other clinicopathological factors or prognostic indexes, was a significant prognostic factor for overall survival (P < 0.05). Conclusions: Post-CRT LCR could be a prognostic biomarker for patients with lower rectal cancer

Usefulness of infection team in CRS

Background : Surgical site infection (SSI) is an adverse event that places a major burden on patients and staff. In this study, we examined the occurrence of SSI and the characteristics of patients referred to the SSI team after colorectal surgery. Methods : In total, 955 patients underwent colorectal surgery at our hospital from 2014 to 2019. Of these 955 patients, 516 received therapeutic support by the SSI team from 2017 to 2019. All patients were evaluated using an SSI surveillance sheet, and we checked for reports of SSI once a month. Each attending physician performed SSI prophylaxis (use of new instruments before wound irrigation and closure). Results : SSI occurred in 80 (8.4%) patients. The incidence of SSI and the incidence of surface SSI were higher in the patients who did not receive intervention by the SSI team than in the patients who did. Organ / space SSI occurred in 18 patients. Among patients with surface SSI, Enterococcus was the most commonly detected bacteria. Among the 18 patients with organ / space SSI, 5 developed anastomotic leakage and 4 developed intra-abdominal abscesses. Conclusions : An SSI team for prevention and treatment of infection may contribute to reduction of SSI

Results of Hepatic Resection for Liver Metastasis of Gastric Cancer : A Single Center Experience

Background : Surgical indication for hepatic resection is controversial in gastric cancer liver metastasis (GLM). The aim of this study is to clarify the effect of hepatic resection for GLM. Methodology : Ten patients who underwent hepatic resection for GLM between 2001 and 2013 were enrolled in this study. Six patients underwent synchronous hepatic resection and gastrectomy, and the remaining four patients underwent metachronous hepatic resection. Six patients had solitary liver metastasis, and 4 patients had multiple liver metastasis. The median follow-up period was 12.4 months (the range being 0.5months to 50 months). Result : The actual 1- year and 3-year overall survival rates for the patients who underwent hepatic resection are 88.9% and 17.8%, respectively. The median survival time was 21.5 months. And the 1-year recurrence free survival time was 20.0%. The median recurrence free survival rate was 4.7 months. Regarding post-operative recurrence, synchronous hepatic resection tended to be a recurrence factor (p=0.08). Conclusion : Hepatic resection for GLM has an acceptable outcome. Metachronous hepatic resection tends to have a better outcome than synchronous hepatic resection for the treatment of GLM

イガン ジュツゴ ニ チョクチョウ テンイ オ キタシタ 1レイ

We report a case of rectal metastasis from gastric cancer. The patient was a 69-year-old man with diarrhea as his major symptoms, who underwent a distal gastrostomy for gastric cancer 2 years previously. We suspected primary or metastatic rectal cancer from colonoscopic examination and barium enema. A lower anterior resection was performed. Postoperative historical examination identified poorly differentiated adenocarcinoma and signet cell carcinoma identical to the gastric cancer. Finally the lesion was diagnosed as metastatic rectal cancer from gastric cancer that showed same pattern in PAS stain. There were only 40 cases in reports in the literature from 2002 to 2012, to our knowledge. We report a rare case

ジュツゼン シンダン ガ コンナン ダッタ フクジン シュッケツ ノ １レイ

A 73-year-old man was admitted to the hospital because of a growing tumor in his left upper abdomen. The tumor was peripherally enhanced and filled with necrotic tissue by contrast CT. By PET-CT, SUV max was high in the peripheral area of the tumor. Endocrinogical data for adrenal function were within the normal range. Accordingly, we diagnosed a nonfunctional adrenal tumor. Left adrenalectomy was performed, because a possibility of malignant tumor could not be ruled out and abdominal tumor was growing fast for a few months. At laparotomy, we saw the dorsal displacement of the transverse colon by a giant cystic tumor, which has several septums and was filled with old bloody fluid components. The resected tumor was 15cm in maximum diameter and 860g in weight. Histopathological diagnosis was adrenal hemorrhage without malignant findings