論文 - 齋藤　豪

Placenta Percreta Progression to Resistance Against Uterine Artery Embolization and Penetration Into the Bladder.

Yukiko Miyashita, Tasuku Mariya, Masayuki Someya, Shinichi Ishioka, Tsuyoshi Saito

Cureus   16 ( 3 ) e55651  2024年03月  [国際誌]

　概要を見る

A 31-year-old female sought termination of pregnancy due to a fetal body stalk anomaly diagnosed at 18 weeks of gestation. Despite an anterior placenta previa, successful vaginal delivery occurred. However, placental adhesion over a previous cesarean scar occurred, and part of the placenta could not be removed. Immediate postpartum bleeding prompted imaging studies, revealing extravasation from adherent placental remnants. Uterine artery embolization (UAE) provided initial hemostasis, but recurrent bleeding necessitated re-embolization. Although conservative treatment was initially pursued, significant hematuria prompted reevaluation, revealing extensive uterine wall and bladder penetration. Surgical intervention with total hysterectomy and partial bladder resection was performed, leading to the successful recovery of bladder function following surgical repair. While this case achieved a positive outcome, there is a potential for permanent urinary dysfunction if lesions are more extensive. While achieving a conservative cure is ideal, it is essential to assess the timing for opting for surgical intervention.

DOI PubMed

The frequency and pathogenicity of BRCA1 and BRCA2 variants in the general Japanese population.

Masashi Idogawa, Tasuku Mariya, Yumi Tanaka, Tsuyoshi Saito, Hiroshi Nakase, Takashi Tokino, Akihiro Sakurai

Journal of human genetics    2024年02月  [国際誌]

　概要を見る

Hereditary breast and ovarian cancer syndrome (HBOC) resulting from pathogenic variants of BRCA1 or BRCA2 is the most common and well-documented hereditary tumor. Although founder variants have been identified in population-based surveys in various countries, the types of variants are not uniform across races and regions. Recently, the Tohoku Medical Megabank Organization (ToMMo) released whole-genome sequence data including approximately 54,000 individuals from the general population of the Tohoku area in Japan. We analyzed these data and comprehensively identified the prevalence of BRCA1/2 pathogenic and truncating variants. We believe that an accurate understanding of the unique distribution and characteristics of pathogenic BRCA1/2 variants in Japan through this analysis will enable better surveillance and intervention for HBOC patients, not only in Japan but also worldwide.

DOI PubMed

当科における最近10年間のCesarean hysterectomy症例の検討

齋藤 晋平, 石岡 伸一, 新開 翔太, 真里谷 奨, 染谷 真行, 小川 万梨絵, 森下 美幸, 馬場 剛, 齋藤 豪

日本産科婦人科学会雑誌 ( (公社)日本産科婦人科学会 )  76 ( 臨増 ) S - 592  2024年02月

経過観察中に自然軽快した広汎性卵巣浮腫の2症例

馬場 剛, 遠藤 俊明, 新開 翔太, 真里谷 奨, 染谷 真行, 森下 美幸, 岩崎 雅宏, 石岡 伸一, 齋藤 豪

日本産科婦人科学会雑誌 ( (公社)日本産科婦人科学会 )  76 ( 臨増 ) S - 383  2024年02月

The interplay between the epithelial permeability barrier, cell migration and mitochondrial metabolism of growth factors and their inhibitors in a human endometrial carcinoma cell line.

Takumi Konno, Takayuki Kohno, Shin Kikuchi, Arisa Kura, Kimihito Saito, Tadahi Okada, Hiroshi Shimada, Yuya Yamazaki, Tomoki Sugiyama, Motoki Matsuura, Yuki Ohsaki, Tsuyoshi Saito, Takashi Kojima

Tissue barriers     2304443 - 2304443  2024年01月  [国際誌]

　概要を見る

It is known that there are abnormalities of tight junction functions, cell migration and mitochondrial metabolism in human endometriosis and endometrial carcinoma. In this study, we investigated the effects of growth factors and their inhibitors on the epithelial permeability barrier, cell migration and mitochondrial metabolism in 2D and 2.5D cultures of human endometrioid endometrial carcinoma Sawano cells. We also investigated the changes of bicellular and tricellular tight junction molecules and ciliogenesis induced by these inhibitors. The growth factors TGF-β and EGF affected the epithelial permeability barrier, cell migration and expression of bicellular and tricellular tight junction molecules in 2D and 2.5D cultures of Sawano cells. EW-7197 (a TGF-β receptor inhibitor), AG1478 (an EGFR inhibitor) and SP600125 (a JNK inhibitor) affected the epithelial permeability barrier, cell migration and mitochondrial metabolism and prevented the changes induced by TGF-β and EGF in 2D and 2.5D cultures. EW-7197 and AG1478 induced ciliogenesis in 2.5D cultures. In conclusion, TGF-β and EGF promoted the malignancy of endometrial cancer via interplay among the epithelial permeability barrier, cell migration and mitochondrial metabolism. EW-7197 and AG1478 may be useful as novel therapeutic treatments options for endometrial cancer.

DOI PubMed

妊孕性温存療法後、胚移植に至った症例に関する検討

久野 芳佳, 馬場 剛, 齋藤 晋平, 古来 愛香, 長尾 沙智子, 玉手 雅人, 小川 万梨絵, 森下 美幸, 遠藤 俊明, 齋藤 豪

日本がん・生殖医療学会誌 ( (一社)日本がん・生殖医療学会 )  7 ( 1 ) 112 - 112  2024年01月

Restoration of ARID1A Protein in ARID1A-deficient Clear Cell Carcinoma of the Ovary Attenuates Reactivity to Cytotoxic T Lymphocytes.

Risa Tsunematsu, Aiko Murai, Yuka Mizue, Terufumi Kubo, Tasuku Mariya, Rena Morita, Kenji Murata, Takayuki Kanaseki, Tomohide Tsukahara, Yoshihiko Hirohashi, Tsuyoshi Saito, Toshihiko Torigoe

Cancer genomics & proteomics   21 ( 4 ) 414 - 420  2024年  [国際誌]

　概要を見る

BACKGROUND/AIM: Clear cell carcinoma is a prevalent histological type of ovarian cancer in East Asia, particularly in Japan, known for its resistance to chemotherapeutic agents and poor prognosis. ARID1A gene mutations, commonly found in ovarian clear cell carcinoma (OCCC), contribute to its pathogenesis. Recent data revealed that the ARID1A mutation is related to better outcomes of cancer immunotherapy. Thus, this study aimed to investigate the immunotherapy treatment susceptibility of OCCC bearing ARID1A mutations. MATERIALS AND METHODS: Expression of ARID1A was analyzed using western blotting in ovarian cancer cell lines. OCCC cell lines JHOC-9 and RMG-V were engineered to overexpress NY-ESO-1, HLA-A*02:01, and ARID1A. Sensitivity to chemotherapy and T cell receptor-transduced T (TCR-T) cells specific for NY-ESO-1 was assessed in ARID1A-restored cells compared to ARID1A-deficient wild-type cells. RESULTS: JHOC-9 cells and RMG-V cells showed no expression of ARID1A protein. Overexpression of ARID1A in JHOC-9 and RMG-V cells did not impact sensitivity to gemcitabine. While ARID1A overexpression decreased sensitivity to cisplatin in RMG-V cells, it had no such effect in JHOC-9 cells. ARID1A overexpression reduced the reactivity of NY-ESO-1-specific TCR-T cells, as observed by the IFNγ ESLIPOT assay. CONCLUSION: Cancer immunotherapy is an effective approach to target ARID1A-deficient clear cell carcinoma of the ovary.

DOI PubMed

A Rare Case of Small Intestinal Cancer With Uterine Metastasis After Surgery for Ovarian Metastasis, Diagnosed Using Immunostaining.

Sachiko Nagao, Motoki Matsuura, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Tsuyoshi Saito

Case reports in oncological medicine   2024   8551816 - 8551816  2024年  [国際誌]

　概要を見る

Uterine metastases from extragenital sites are rare. We present a case of a woman who had undergone surgery for small intestinal cancer and subsequently developed metastases in her left ovary and uterus. A nulliparous woman in her 50s underwent laparoscopic partial small bowel resection with lymph node dissection for small intestinal cancer. Five months later, computed tomography (CT) revealed a left ovarian tumor and ascites. She underwent bilateral adnexectomy and adjuvant chemotherapy, and the ovarian tumor was diagnosed as a small intestinal cancer metastasis. Two years after the small intestinal cancer surgery, a positron emission tomography (PET)-CT scan revealed a uterine accumulation. Cervical cytology was negative for intraepithelial lesion or malignancy. Endometrial histology showed an adenocarcinoma of the uterus. The patient underwent total abdominal hysterectomy followed by adjuvant chemotherapy. Histopathology and immunohistochemistry of the uterine tumor revealed that it was a metastasis of small intestinal cancer (Cytokeratin 7 [CK7] [-], Cytokeratin 20 [CK20] [+], Special AT-Rich Sequence-Binding Protein 2 [SATB2] [+], Paired Box Gene 2 [PAX2] [-], and estrogen receptor [ER] [-]). In patients with cancer, histopathology and immunohistochemistry are important for distinguishing between primary and metastatic tumors and for guiding the choice of treatment.

DOI PubMed

Diagnosis and Methods of Repair for a Uteroperitoneal Fistula (UPF) Formed After Gynecological Surgeries.

Nagisa Wada, Masato Tamate, Motoki Matsuura, Tsuyoshi Saito

Cureus   15 ( 12 ) e51064  2023年12月  [国際誌]

　概要を見る

A uteroperitoneal fistula (UPF) is a rare disorder that can lead to infertility and has never been reported. UPFs can cause infertility and perinatal complications. A 34-year-old woman (gravida 0) with a history of three gynecological surgeries using a uterine manipulator was diagnosed with a UPF using hysteroscopy and hysterosalpingography. She underwent laparoscopic uterine repair as an infertility treatment. The uterine perforation may have been caused by uterine manipulator insertion or suture failure in the myometrium during her previous laparoscopic myomectomy and cystectomy procedures. The UPF disappeared after the current surgical treatment. The complications of UPFs include infection, infertility, ectopic pregnancy, and uterine rupture. We expected that the presence of a fistula would increase the risk of impaired fertilization, implantation failure, and ectopic pregnancy. This case report contributes valuable insights into the diagnosis of UPFs and their laparoscopic repair.

DOI PubMed

腟に発症したPEComaの1例

小谷松 紗弓, 松浦 基樹, 西村 庸子, 秋元 太志, 磯山 響子, 玉手 雅人, 齋藤 豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 )  67 ( 1 ) 89 - 89  2023年12月

待機療法にて管理したHypervascular RPOCの3例

堀 清貴, 山崎 智子, 有元 千紘, 長尾 沙智子, 玉手 雅人, 高田 さくら, 松浦 基樹, 斎藤 豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 )  67 ( 1 ) 86 - 87  2023年12月

当科における卵巣組織凍結の報告と北海道内の同技術の認識について

古来 愛香, 玉手 雅人, 春日 芙貴子, 長尾 沙智子, 小川 万梨絵, 池田 桂子, 久野 芳佳, 森下 美幸, 馬場 剛, 齋藤 豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 )  67 ( 1 ) 85 - 85  2023年12月

内視鏡手術支援ロボット最新事情-開発者と使用者から見た理想と現実、問題点- da Vinci SPが切り拓く婦人科ロボット手術の近未来

松浦 基樹, 長尾 沙智子, 黒川 晶子, 玉手 雅人, 秋元 太志, 齋藤 豪

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  28 ( 7 ) 981 - 981  2023年12月

分娩後の子宮全摘術時に発見され腹膜癌との鑑別が困難であった異所性脱落膜の1例

有元 千紘, 長尾 沙智子, 堀 清貴, 山崎 智子, 玉手 雅人, 高田 さくら, 松浦 基樹, 齋藤 豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 )  67 ( 1 ) 11 - 15  2023年12月

　概要を見る

異所性脱落膜は,妊娠中の間葉系未分化細胞の化生もしくは子宮内膜症組織などにプロゲステロンが作用することにより生じる。悪性所見と類似した肉眼的所見を呈することがあるため,鑑別や治療方針の決定に難渋することがある。今回我々は,分娩後の子宮全摘術時に偶然発見され,腹膜癌との鑑別が困難であった異所性脱落膜の一例を経験したため,文献的考察とともに報告する。症例は,39歳,2妊1産,妊娠初期に子宮体部後壁に内膜を圧排する粘膜下筋腫を認めていた。妊娠40週0日に陣痛誘発目的に入院し翌日経腟分娩となったが,胎盤娩出後より出血の増加を認めた。経腹超音波検査にて子宮頸部に6cm大の筋腫を認め,筋腫分娩が疑われた。子宮収縮薬投与や子宮用止血バルーン挿入を行ったが止血は得られず,分娩6時間後に子宮全摘術を決定した。術中にダグラス窩,子宮,直腸からS状結腸漿膜面に散在する集簇性小結節を認め,肉眼的には腹膜播種に類似しており腹膜癌などの悪性腫瘍を否定できなかった。子宮全摘術と小結節の一部生検を行い,手術終了とした。病理組織学的検査では異所性脱落膜の診断であり,悪性所見を認めなかった。術後経過問題なく,1週間後に退院となった。異所性脱落膜は悪性腫瘍と類似した所見を呈する場合があるが,確立された鑑別方法はなく,現時点では病理組織学的診断が不可欠である。本邦での報告は稀ではあるが,妊娠中ないし産褥期の女性において悪性腫瘍との鑑別が必要な病態の1つとして異所性脱落膜があることを認識しておくことが重要であると考える。(著者抄録)

分娩後の子宮全摘出術時に発見され,腹膜癌との鑑別が困難であった異所性脱落膜の1例

有元 千紘, 長尾 沙智子, 山崎 智子, 玉手 雅人, 高田 さくら, 松浦 基樹, 齋藤 豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 )  67 ( 1 ) 85 - 86  2023年12月

子宮内異物・腟閉鎖症例に対して腹腔鏡下子宮全摘術を施行した一例

黒川 晶子, 玉手 雅人, 西村 庸子, 秋元 太志, 松浦 基樹, 齋藤 豪

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  28 ( 7 ) 3044 - 3044  2023年12月

婦人科良性疾患に対するロボット支援手術の在り方 良性婦人科ロボット手術の進むべき道筋

松浦 基樹, 長尾 沙智子, 黒川 晶子, 玉手 雅人, 秋元 太志, 齋藤 豪

日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  28 ( 7 ) 811 - 811  2023年12月

婦人科内視鏡技術認定医が不在である当院でのTLHの取り組み

西森 貢隆, 嶋田 浩志, 藤部 佑哉, 鈴木 美紀, 玉手 雅人, 松浦 基樹, 岩崎 雅宏, 齋藤 豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 )  67 ( 1 ) 91 - 91  2023年12月

Identification of cancer driver mutations in liquid-based cytology samples for the screening of endometrial diseases

Motoki Matsuura, Kiyoko Takane, Kiyoshi Yamaguchi, Tsuneo Ikenoue, Seira Hatakeyama, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Masahiro Iwasaki, Shintaro Sugita, Tadashi Hasegawa, Yasunori Ota, Tsuyoshi Saito, Yoichi Furukawa

BJC Reports ( Springer Science and Business Media LLC )  1 ( 1 )  2023年11月

　概要を見る

Abstract Background Endometrial cancer (EC) is one of the leading causes of cancer death among women and early detection is crucial for its successful treatment. We previously showed that cytological examination combined with genetic analysis using liquid-based cytology (LBC) samples improved the diagnostic sensitivity of EC. Methods Among 218 individuals who underwent endometrial screening by LBC, 208 samples were analysed by cancer-panel sequencing. Excluding 13 samples with low sequence coverage, we further analysed 195 samples. Results Among the 195 women analysed, 39 and 15 were eventually shown to suffer from malignant endometrial and non-endometrial neoplasms, respectively. Driver mutation(s) were found in nine of the 15 cytology-negative patients with endometrial malignancy, corroborating that combination of cytological and genetic analyses should increase the sensitivity of the diagnosis of malignant endometrial neoplasms. Importantly, driver alterations were found in 32 of 125 women without malignant or premalignant diseases, which raises caution for the interpretation of genetic alterations detected in the endometrial samples. Comparison between the driver mutations in the 32 subjects and those in the 29 endometrial malignancies unveiled that the number of mutations and mutations in PTEN, CTNNB1, and TP53 may be applied for the assessment and prediction of development of EC. Conclusions The genetic analysis combined with liquid-based cytology is useful to improve the diagnostic sensitivity of endometrial neoplasms. However, caution must be taken when cancer-associated mutation(s) are detected in the genetic analysis. Further investigation may clarify the risk of malignant endometrial neoplasms in women with driver mutation(s).

DOI

【婦人科悪性腫瘍手術-トラブルシューティングとその予防法-】単純外陰切除術

齋藤 豪, 松浦 基樹, 玉手 雅人, 真里谷 奨

産婦人科の実際 ( 金原出版(株) )  72 ( 12 ) 1397 - 1401  2023年11月