Papers - SAITOU Tsuyoshi

卵巣癌に対するPARP阻害薬の中期成績と有害事象・内服アドヒアランスの関係性に関する検討

萬 和馬, 松浦 基樹, 有元 千紘, 黒川 晶子, 玉手 雅人, 秋元 太志, 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 )  75 ( 臨増 ) S - 292  2023.02

当科における卵巣組織凍結の現状報告と北海道における小児科医の卵巣組織凍結に対する意識調査

古来 愛香, 玉手 雅人, 春日 芙貴子, 長尾 沙智子, 西村 庸子, 松浦 基樹, 久野 芳佳, 馬場 剛, 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 )  6 ( 1 ) 49 - 53  2023.02

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【緒言】小児・思春期・若年成人(children,adolescents and young adults:C-AYA)世代のがんサバイバーが増加することにともない、QOL向上の意識が高まり妊孕性温存法も発展しつつある。当科では、小児がん患者の卵巣組織凍結保存を実施してきた。今回、当院での卵巣組織凍結保存の現状報告(研究1)、および北海道内の小児科医における卵巣組織凍結に対する意識調査(研究2)について報告する。【対象と方法】研究1:2012年12月～2021年6月までに当科で卵巣組織凍結保存を目的とした卵巣摘出術手術20例を対象に、年齢、原疾患、コンサルトから手術までの期間、周術期経過、合併症などの背景を集積した。研究2:北海道内の悪性疾患を診療する小児科医に卵巣組織凍結の認識を匿名でアンケート調査した。【結果】研究1:初診時平均年齢は18.8±8.49歳。原疾患は、血液腫瘍13例、脳腫瘍3例、乳癌2例、軟部腫瘍2例であった。手術までの期間は3-99日(平均31.5±21.5日)、全例腹腔鏡手術であった。研究2:アンケートは5施設18名から回収した。卵巣組織凍結について認識している人が18名(100%)、情報提供をしたことがある人が13名(72.2%)であった。卵巣組織凍結の情報提供をしたが治療の同意が得られない理由としては、経済的理由(保険適応外)、手術のリスク、原疾患治療の遅れ、エビデンスが乏しい、などがあげられた。【結語】卵巣組織凍結保存は微小残存がん病巣(MRD:minimal residual disease)のリスクがあるが、月経発来前の女児に対して唯一の妊孕性温存療法である。しかし、社会的要因によって普及には至っていない。今後、凍結卵巣融解移植成績の発信や卵巣組織凍結の説明方法の均てん化などにより一層卵巣組織凍結という選択肢を提示していきたい。症例治療が滞りなく円滑に進むよう、主治医、生殖医、婦人科腫瘍医の連携が重要であり、今後尽力したい。(著者抄録)

化学療法抵抗性再発子宮体癌に対する当院におけるPembrolizumab/Lenvatinibの使用経験

南 怜毅, 幅田 周太朗, 有元 千紘, 堀 清貴, 萬 和馬, 野藤 五沙, 黒川 晶子, 玉手 雅人, 秋元 太志, 松浦 基樹, 岩崎 雅宏, 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 )  75 ( 臨増 ) S - 347  2023.02

帝王切開後高度癒着症例に対する腹腔鏡下子宮全摘術における,Retrovesical Lower Uterine Segment Bypassと検討

有元 千紘, 玉手 雅人, 足立 岳貴, 黒川 晶子, 西村 庸子, 秋元 太志, 松浦 基樹, 岩崎 雅宏, 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 )  75 ( 臨増 ) S - 278  2023.02

中心核ミオパチーの児出産を契機に発見された1型リアノジン受容体(RYR1)遺伝子のバリアントを有する妊婦の一例

古来 愛香, 石岡 伸一, 新開 翔太, 真里谷 奨, 常松 梨紗, 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 )  75 ( 臨増 ) S - 459  2023.02

Letrozole increases preantral follicle growth and decreases estradiol production without impairing follicle survival.

Fukiko Kasuga-Yamashita, Tsuyoshi Baba, Sachiko Nagao, Yuya Fujibe, Miyuki Morishita, Yoshika Kuno, Tasuku Mariya, Hiroyuki Honnma, Toshiaki Endo, Tamotsu Kiya, Tsuyoshi Saito

Journal of ovarian research   15 ( 1 ) 136 - 136  2022.12  [International journal]

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BACKGROUND: Letrozole has been reported to be effective in treating anovulation, preventing ovarian hyperstimulation syndrome (OHSS), and retrieving oocytes in breast cancer patients. However, the role and mechanism of letrozole in follicular development remain unclear. RESULTS: We treated mouse preantral follicles with various treatments; we found no significant difference in follicle survival rates in the letrozole (LET) group compared with the control group, but the average diameter of follicles in the LET group tended to be larger (CTRL vs. LET 30, p = 0.064; CTRL vs. LET 100, p = 0.025). The estradiol concentrations in culture media of the LET group were significantly lower than those observed in the control group (CTRL vs. LET 30, p = 0.038; CTRL vs. LET 100, p = 0.025). We further found a marked increase in follicle-stimulating hormone receptor (FSHR) gene expression in response to letrozole treatment (CTRL vs. LET 30, p = 0.075; CTRL vs. LET 100, p = 0.034). This result suggested that increased FSHR expression promotes follicle development. Letrozole inhibited aromatase activity, but the effect was limited. Letrozole did not significantly reduce vascular endothelial growth factor (VEGF) gene expression. CONCLUSIONS: Letrozole may promote follicle development by increasing the expression of FSHR. Letrozole may be useful for fertility preservation of patients with estrogen-dependent cancers such as breast cancer and various other cancers. Whether letrozole has a direct effect in reducing OHSS requires further investigation.

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A mixed-method evaluation of cadaver surgery training for gynecologic oncology.

Masato Tamate, Motoki Matsuura, Hiroyuki Kanao, Tsuyoshi Saito

The journal of obstetrics and gynaecology research   48 ( 12 ) 3252 - 3261  2022.12  [International journal]

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AIM: Traditional surgical training techniques with using patients, and new advances with live animals, artificial models, and simulation methods have several shortcomings. There are a few reports on the usefulness of cadaver surgery training (CST) in gynecology. Herein, we used a mixed-method evaluation to qualitatively and quantitatively explore the educational efficacy of CST by conducting CST programs at the Sapporo Medical University, Japan. METHODS: In 2020, we conducted two CST programs with 45 participants-13 residents, 8 specialists recognized by Japan Society of Obstetrics and Gynecology, 23 certified endoscopists recognized by Japan Society of Gynecology and Obstetrics Endoscopy and Minimally Invasive Therapy, 15 specialists recognized by Japan Society of Gynecologic Oncology, and 14 certified endoscopists cum oncology. Three participants observed the procedure virtually and 42 were physically present. Laparoscopic radical hysterectomy and pelvic exenteration were performed on five Thiel-embalmed cadavers. Participants were asked to complete pre- and post-training surveys that included qualitative questions, concerning the purpose and cost of CST, and quantitative questions, testing anatomical knowledge. RESULTS: We observed that the rate of score improvement to the quantitative questions increased from 58.6% pre-CST to 75.6% post-CST. Furthermore, oncology specialists and those who performed more surgeries and faced more complications during surgeries recorded high percentage of correct answers. Multiple regression analysis statistically confirmed these results. CONCLUSIONS: This study confirmed the educational efficacy of CST.

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vNOTESによる膜解剖理論に基づいた直腸周囲展開

足立 岳貴, 松浦 基樹, 黒川 晶子, 西村 庸子, 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 )  27 ( 7 ) 599 - 599  2022.12

Predictive value of an exosomal microRNA-based signature for tumor immunity in cervical cancer patients treated with chemoradiotherapy.

Masanori Someya, Tomokazu Hasegawa, Takaaki Tsuchiya, Mio Kitagawa, Yuki Fukushima, Toshio Gocho, Shoh Mafune, Yutaro Ikeuchi, Yoh Kozuka, Masashi Idogawa, Yoshihiko Hirohashi, Toshihiko Torigoe, Masahiro Iwasaki, Motoki Matsuura, Tsuyoshi Saito, Koh-Ichi Sakata

Medical molecular morphology   56 ( 1 ) 38 - 45  2022.11  [Domestic journal]

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Resistance of cervical cancer to radiotherapy with concurrent chemotherapy (CCRT) results in a poor prognosis. To identify new biomarkers for predicting the treatment response and prognosis, we explored exosomal microRNA (miRNA) expression signatures associated with the outcome of cervical cancer patients treated with CCRT. Exosomes were isolated from the plasma of 45 patients prior to CCRT during 2014-2020, and miRNA analysis was performed by next-generation sequencing. At a median follow-up of 38 months, 26 patients were recurrence free, 15 patients had died of the disease, and 4 patients received salvage chemotherapy due to distant metastasis. Of the 2522 miRNAs detected, 9 (miR-148a-5p, 1915-3p, 3960, 183-5p, 196b-5p, 200c-3p, 182-5p, 374a-5p, and 431-5p) showed differential expression between the recurrence-free and recurrence groups. Patients were divided into high- and low-risk groups according to the cutoff of the miRNAs-based risk score calculated from respective expression levels. The high-risk group had significantly worse disease-specific survival than the low-risk group (p < 0.001). In addition, miR-374a-5p and miR-431-5p expression showed a weak inverse correlation with tumor-infiltrating CD8+ and FOXP3+ T cells, suggesting a potential inhibitory effect on CCRT by suppressing tumor immunity. This miRNA signature could improve non-invasive monitoring and personalized treatment for cervical cancer.

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Human papillomavirus testing and cytology using physician-collected uterine cervical samples vs. self-collected vaginal samples and urine samples.

Noriko Terada, Motoki Matsuura, Shoko Kurokawa, Yoko Nishimura, Masato Tamate, Kyoko Isoyama, Satoko Yamazaki, Hiroshi Shimada, Masahiro Suzuki, Yuta Tabuchi, Mizue Teramoto, Tsuyoshi Saito

International journal of clinical oncology   27 ( 11 ) 1742 - 1749  2022.11  [Domestic journal]

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BACKGROUND: Human papillomavirus (HPV) testing using self-collected vaginal samples and urine samples is convenient and effective for improving the screening rate. But, to serve as an alternative cervical cancer screening technique, such tests must offer sensitivity equivalent to the HPV testing of physician-collected cervical samples. To examine the effectiveness of HPV testing using self-collected samples and urine samples, we compared the results of HPV testing using these samples with those of HPV testing using physician-collected samples and cytological examinations. METHODS: The study population included 300 women (age: 20-50 years) with abnormal cervical cytology. The results of HPV testing using self-collected samples and urine samples and physician-collected samples and cervical cytology were compared. RESULTS: For all HPV types, the κ-value was 0.773 for physician- and self-collected samples and 0.575 for physician-collected and urine samples. The κ-value for HPV type 16-positive samples was 0.988 for physician- and self-collected samples and 0.896 for physician-collected and urine samples. The κ-value for HPV type 18-positive samples was 0.856 for physician- and self-collected samples and 0.831 for physician-collected and urine samples. For other HPV types, the value was 0.809 for physician- and self-collected samples and 0.617 for physician-collected and urine samples. CONCLUSIONS: The obtained results were consistent between physician- and self-collected samples as well as between physician-collected and urine samples. Considering that the agreement rate was particularly high for the high-risk HPV types 16 and 18, HPV testing using physician-collected samples, self-collected samples, and urine samples was equally effective for the types with high carcinogenicity.

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子宮移植/妊娠中免疫抑制療法/胎児免疫 Thiel法固定献体における子宮移植トレーニング

玉手 雅人, 松浦 基樹, 木須 伊織, 齋藤 豪

Organ Biology ( (一社)日本臓器保存生物医学会 )  29 ( 3 ) 86 - 86  2022.11

細胞診におけるAIの活用 子宮頸部細胞診におけるAIの活用

新開 翔太, 真里谷 奨, 梅本 美菜, 南部 優太, 永田 舞, 淺沼 広子, 上野 太郎, 廣橋 良彦, 鳥越 俊彦, 佐藤 生馬, 藤野 雄一, 齋藤 豪

日本臨床細胞学会雑誌 ( (公社)日本臨床細胞学会 )  61 ( Suppl.2 ) 447 - 447  2022.10

子宮動脈塞栓術併用の子宮鏡下切除術において子宮内バルーニングが有用であったRPOCの一例

南 怜毅, 長尾 沙智子, 木嶋 紗弓, 小川 栞, 山崎 智子, 玉手 雅人, 松浦 基樹, 齋藤 豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 )  69回   64 - 64  2022.10

巨大嚢胞化し、子宮留膿腫を繰り返した帝王切開瘢痕部症候群の1例

仁木 舜一, 嶋田 浩志, 玉手 雅人, 杉山 芽, 今 沙織, 鈴木 美紀, 松浦 基樹, 齋藤 豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 )  69回   112 - 112  2022.10

巨大嚢胞化し、子宮留膿腫を繰り返した帝王切開瘢痕部症候群の1例

仁木 舜一, 嶋田 浩志, 玉手 雅人, 杉山 芽, 今 沙織, 鈴木 美紀, 松浦 基樹, 齋藤 豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 )  69回   112 - 112  2022.10

帝王切開創のケロイド予防とその修復の取り組み

杉山 芽, 嶋田 浩志, 玉手 雅人, 仁木 舜一, 今 沙織, 鈴木 美紀, 石岡 伸一, 斎藤 豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 )  69回   66 - 66  2022.10

子宮頸がん検診未受診者対策としての自己採取HPV検査の有効性評価

松浦 基樹, 寺田 倫子, 西村 庸子, 玉手 雅人, 長尾 沙智子, 秋元 太志, 幅田 周太朗, 岩崎 雅宏, 齋藤 豪

日本臨床細胞学会雑誌 ( (公社)日本臨床細胞学会 )  61 ( Suppl.2 ) 477 - 477  2022.10

子宮動脈塞栓術併用の子宮鏡下切除術において子宮内バルーニングが有用であったRPOCの一例

南 怜毅, 長尾 沙智子, 木嶋 紗弓, 小川 栞, 山崎 智子, 玉手 雅人, 松浦 基樹, 齋藤 豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 )  69回   64 - 64  2022.10

子宮悪性軟部腫瘍に対する新規薬剤が効果を認めた症例の検討

萬 和馬, 松浦 基樹, 足立 岳貴, 有元 千紘, 黒川 晶子, 西村 庸子, 玉手 雅人, 秋元 太志, 幅田 周太朗, 岩崎 雅宏, 齋藤 豪

日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 )  60回   O46 - 2  2022.10

Self-administration of gender-affirming hormones and supratherapeutic dosing are relatively common in Japanese transgender women.

Tsuyoshi Baba, Toshiaki Endo, Utako Ikeda, Hiroshi Ikeda, Koji Ichihara, Naoya Masumori, Tsuyoshi Saito

The journal of obstetrics and gynaecology research   48 ( 8 ) 2208 - 2213  2022.08  [International journal]

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AIM: This study was performed to determine the proportion of transgender women with self-adjusted hormone administration and excess dosing. METHODS: The medical records of 87 transgender women who visited our gender clinic from 2010 through 2019 were reviewed. The complete blood count and serum concentrations of D-dimer, gonadotropins, and sex steroids were compared between transgender women who were self-administering gender-affirming hormones and women not using such hormones. RESULTS: Fifty-eight of 87 (66.7%) transgender women had contravened the guideline and self-adjusted their hormone administration. The hormonal data of one woman with hypopituitarism were eliminated from the analyses. The serum gonadotropin and testosterone levels were significantly lower in the self-administration group than in the hormone-naïve group. Gonadotropin levels below the lower limit of normal were found in 32/86 (37.2%) transgender women. The testosterone levels in six transgender women were not analyzed because these women had undergone sex reassignment surgery before visiting our hospital. Testosterone levels below the lower limit of normal men were found in 36/80 (45.0%) transgender women. Unexpectedly, 29/36 (80.6%) transgender women who were classified as having suppressed serum testosterone levels had testosterone levels of <0.6 ng/mL, which corresponds to the levels in cisgender women. The white blood cell count and hemoglobin concentration were significantly different between the groups. CONCLUSION: Self-initiated hormonal treatments seem to affect the serum concentrations of gonadotropin and sex steroids and the complete blood count. The prevalence of transgender women with self-adjusted use of gender-affirming hormones is high, and an excess dose of hormones occasionally occurs.

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