論文 - 齋藤　豪

帝王切開瘢痕部妊娠に対する一期的修復術の工夫

齋藤 晋平, 玉手 雅人, 西村 庸子, 磯山 響子, 幅田 周太郎, 松浦 基樹, 岩崎 雅宏, 齋藤 豪

産婦人科手術 ( (株)メジカルビュー社 )  ( 33 ) 129 - 129  2022年06月

失敗から学ぶ 手術におけるわれわれの取組みやコツ 開腹、腟式 帝王切開瘢痕部妊娠に対する 一期的修復術の工夫

齋藤 晋平, 玉手 雅人, 松浦 基樹, 齋藤 豪

産婦人科手術 ( (株)メジカルビュー社 )  ( 33 ) 13 - 17  2022年06月

Radiotherapy for HPV-related cancers: prediction of therapeutic effects based on the mechanism of tumor immunity and the application of immunoradiotherapy.

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

Japanese journal of radiology   40 ( 5 ) 458 - 465  2022年05月  [国内誌]

　概要を見る

Human papillomavirus (HPV)-related cancer is one of the diseases entities for which the applications of radiotherapy have been increasing. Recently, the process of carcinogenesis from HPV infection and the mechanism of tumor immunity that develops during disease progression have been elucidated. In this review, we will describe the mechanism of tumor immunity and how chemoradiotherapy may overcome and improve the efficacy of tumor immunity. We will also discuss the usefulness of proteins involved with tumor immunity as a predictive marker of radiotherapy response, and present an overview of ongoing clinical trials of combinations of immune checkpoint inhibitors and radiotherapy to demonstrate the promising combination therapy that has been currently emerging.

DOI PubMed

がん・生殖手術の未来図 当院における子宮頸がんに対するがん生殖技術の足取りと未来図

玉手 雅人, 松浦 基樹, 足立 岳貴, 有元 千紘, 西村 庸子, 黒川 晶子, 秋元 太志, 齋藤 豪

日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 404 - 404  2022年05月

液体クロマトグラフィー・タンデム質量分析(LC-MS/MS)法にて診断した偽性高テストステロン血症の一例

小川 万梨絵, 馬場 剛, 春日 芙貴子, 玉手 雅人, 池田 桂子, 森下 美幸, 久野 芳佳, 遠藤 俊明, 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 )  66 ( 1 ) 55 - 58  2022年03月

　概要を見る

日常診療におけるホルモン検査は,主に免疫学的測定法を用いて行われるが,時に臨床所見と検査所見の乖離をみることがある。今回,無月経を主訴に来院された女性で,男性化徴候がないにもかかわらず高テストステロン血症を呈した偽性高テストステロン血症の症例を経験したので報告する。症例は17歳女性,続発性無月経のため前医を受診したところ,高テストステロン血症を認めた。経腹超音波検査で明らかな卵巣腫瘍もなく,また単純MRIでも明らかな副腎腫瘍もないため,精査加療目的に当科に紹介受診となった。当科初診時の免疫学的測定法で遊離テストステロンは基準値内であったが,総テストステロンは前医同様に高値であった。男性化徴候がないことと,総テストステロン値と遊離テストステロン値とに大きな乖離を認めたため,異好抗体による偽性高値を疑い液体クロマトグラフィー-タンデム質量分析(liquid chromatography-tandem mass spectrometry:LC-MS/MS)法にてテストステロン測定を行った。結果は総テストステロンも遊離テストステロンも基準値内であった。今回使用した免疫学的測定法において,総テストステロン検査にはヒツジ由来の抗体が,遊離テストステロン検査にはウサギ由来の抗体が用いられていたため,当患者の血漿中にヒツジの抗体に非特異的に反応する異好抗体の存在が疑われた。無月経の原因として,2年前に減量を行い,BMI:22から16に低下して以来無月経となった経緯があり,体重減少性無月経が第一に考えられた。今回LC-MS/MSにて測定を行うことで,侵襲の高い選択的副腎・卵巣静脈血サンプリングを回避し診断することができた。臨床所見と検査所見に乖離がある場合には,異好抗体の存在を念頭に検査法を検討する必要がある。(著者抄録)

胎児超音波にて屈曲肢骨異形成症を疑い,胎盤絨毛の遺伝子検査で診断確定した一例

小川 万梨絵, 寺本 瑞絵, 染谷 真行, 石堂 茉泉, 新開 翔太, 真里谷 奨, 池田 桂子, 森下 美幸, 久野 芳佳, 馬場 剛, 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 )  74 ( 臨増 ) S - 374  2022年02月

当院における妊孕性温存手術後の癒着因子の抽出とアウトカム

和田 渚, 玉手 雅人, 木島 紗弓, 篠原 由梨, 西村 庸子, 磯山 響子, 秋元 太志, 幅田 周太朗, 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 )  74 ( 臨増 ) S - 344  2022年02月

CD138免疫染色と子宮内microbiotaのcombined testに子宮内pH測定を加えた慢性子宮内膜炎の病態整理

遠藤 俊明, 池田 詩子, 逸見 博文, 本間 寛之, 木谷 保, 真里谷 奨, 久野 芳佳, 馬場 剛, 山田 秀人, 東口 篤司, 藤井 美穂, 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 )  74 ( 臨増 ) S - 359  2022年02月

子宮頸部原発胎児型横紋筋肉腫の一例

小谷松 紗弓, 玉手 雅人, 篠原 由梨, 西村 庸子, 磯山 響子, 秋元 太志, 幅田 周太朗, 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 )  74 ( 臨増 ) S - 297  2022年02月

当院における妊孕性温存手術後の癒着因子の抽出とアウトカム

和田 渚, 玉手 雅人, 木島 紗弓, 篠原 由梨, 西村 庸子, 磯山 響子, 秋元 太志, 幅田 周太朗, 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 )  74 ( 臨増 ) S - 344  2022年02月

子宮頸部原発胎児型横紋筋肉腫の一例

小谷松 紗弓, 玉手 雅人, 篠原 由梨, 西村 庸子, 磯山 響子, 秋元 太志, 幅田 周太朗, 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 )  74 ( 臨増 ) S - 297  2022年02月

Aberrant expression of claudin-6 contributes to malignant potentials and drug resistance of cervical adenocarcinoma.

Yui Ito, Akira Takasawa, Kumi Takasawa, Taro Murakami, Taishi Akimoto, Daisuke Kyuno, Yuka Kawata, Kodai Shano, Kurara Kirisawa, Misaki Ota, Tomoyuki Aoyama, Masaki Murata, Kotaro Sugimoto, Hideki Chiba, Tsuyoshi Saito, Makoto Osanai

Cancer science    2022年01月  [査読有り]  [国際誌]

　概要を見る

Recent studies have revealed that aberrant expression of tight junction (TJ) proteins is a hallmark of various solid tumors and it is recognized as a useful therapeutic target. Claudin-6 (CLDN6), a member of the family of TJ transmembrane proteins, is an ideal therapeutic target because it is not expressed in human adult normal tissues. In this study, we found that CLDN6 is highly expressed in uterine cervical adenocarcinoma and that high CLDN6 expression was correlated with lymph node metastasis and lymphovascular infiltration and was an independent prognostic factor. Shotgun proteome analysis revealed that cell-cell adhesion-related proteins and drug metabolism-associated proteins (aldo-keto reductase (AKR) family proteins) were significantly increased in CLDN6-overexpressing cells. Furthermore, overexpression of CLDN6 enhanced cell-cell adhesion properties and attenuated sensitivity to anticancer drugs including doxorubicin, daunorubicin and cisplatin. Taken together, the results indicate that aberrant expression of CLDN6 enhances malignant potentials and drug resistance of cervical adenocarcinoma, possibly due to increased cell-cell adhesion properties and drug metabolism. Our findings provide an insight into a new therapeutic strategy, a CLDN6-targeting therapy, against cervical adenocarcinoma.

DOI PubMed

A screening assistance system for cervical cytology of squamous cell atypia based on a two-step combined CNN algorithm with label smoothing.

Yuta Nambu, Tasuku Mariya, Shota Shinkai, Mina Umemoto, Hiroko Asanuma, Ikuma Sato, Yoshihiko Hirohashi, Toshihiko Torigoe, Yuichi Fujino, Tsuyoshi Saito

Cancer medicine   11 ( 2 ) 520 - 529  2022年01月  [国際誌]

　概要を見る

BACKGROUND: Although many cervical cytology diagnostic support systems have been developed, it is challenging to classify overlapping cell clusters with a variety of patterns in the same way that humans do. In this study, we developed a fast and accurate system for the detection and classification of atypical cell clusters by using a two-step algorithm based on two different deep learning algorithms. METHODS: We created 919 cell images from liquid-based cervical cytological samples collected at Sapporo Medical University and annotated them based on the Bethesda system as a dataset for machine learning. Most of the images captured overlapping and crowded cells, and images were oversampled by digital processing. The detection system consists of two steps: (1) detection of atypical cells using You Only Look Once v4 (YOLOv4) and (2) classification of the detected cells using ResNeSt. A label smoothing algorithm was used for the dataset in the second classification step. This method annotates multiple correct classes from a single cell image with a smooth probability distribution. RESULTS: The first step, cell detection by YOLOv4, was able to detect all atypical cells above ASC-US without any observed false negatives. The detected cell images were then analyzed in the second step, cell classification by the ResNeSt algorithm, which exhibited average accuracy and F-measure values of 90.5% and 70.5%, respectively. The oversampling of the training image and label smoothing algorithm contributed to the improvement of the system's accuracy. CONCLUSION: This system combines two deep learning algorithms to enable accurate detection and classification of cell clusters based on the Bethesda system, which has been difficult to achieve in the past. We will conduct further research and development of this system as a platform for augmented reality microscopes for cytological diagnosis.

DOI PubMed

Twin pregnancy with untyped Ehlers-Danlos syndrome requiring prompt genetic testing: A case report.

Shiori Ogawa, Tasuku Mariya, Yuya Fujibe, Marie Ogawa, Keiko Ikeda, Miyako Mizukami, Yoshika Kuno, Aki Ishikawa, Shinichi Ishioka, Akihiro Sakurai, Tsuyoshi Saito

Case reports in women's health   33   e00384  2022年01月  [国際誌]

　概要を見る

Ehlers-Danlos syndrome is a rare genetic disorder that presents with a variety of pathologies depending on the disease type. Among them, vascular Ehlers-Danlos syndrome requires extremely careful management as there have been many reports of fatal perinatal complications such as uterine rupture. Although hypermobile Ehlers-Danlos syndrome is less likely to cause fatal complications, symptoms such as arthralgia, hip dislocation, and depression may be seen throughout pregnancy. We report here a case of twin pregnancy in which Ehlers-Danlos syndrome was first suspected at 19 weeks of gestation. Vascular Ehlers-Danlos syndrome could not be ruled out based on family medical history, making it difficult to determine the perinatal management strategy. Prompt genetic testing did however rule out the vascular type and the patient was diagnosed with hypermobile Ehlers-Danlos syndrome from the clinical symptoms, enabling us to manage the pregnancy safely until 34 weeks of gestation.

DOI PubMed

Case of superficial myofibroblastoma protruding from the posterior fornix treated using laparoscopic surgery

Satoshi Shikanai, Motoki Matsuura, Hiroaki Soyama, Nagisa Wada, Mina Umemoto, Ichiro Miura, Tsuyoshi Saito

JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY ( Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy )  38 ( 2 ) 230 - 234  2022年

DOI

Comparative Evaluation of Preoperative Imaging and Postoperative Histopathology in 108 Patients Who Underwent Laparoscopic- or Robot-Assisted Surgery for Endometrial Cancer.

Noriko Terada, Motoki Matsuura, Shoko Kurokawa, Mizue Teramoto, Masamitsu Hanakenaka, Tsuyoshi Saito

Gynecology and minimally invasive therapy   11 ( 4 ) 203 - 208  2022年  [国際誌]

　概要を見る

OBJECTIVES: The aim of this study was to compare preoperative imaging evaluation results and postoperative histopathology examinations of patients who underwent laparoscopic- or robot-assisted surgery for suspected Stage IA endometrial carcinoma. MATERIALS AND METHODS: There were 298 patients diagnosed with endometrial cancer at our institution between April 2014 and March 2019. Preoperative imaging evaluation based on magnetic resonance imaging (MRI) and computed tomography (CT) revealed 180 patients suspected of having Stage IA disease. Of these, 72 underwent open surgery, 12 underwent robot-assisted surgery, and 96 underwent laparoscopic surgery. In this study, preoperative imaging evaluation results and postoperative histopathology examinations of 108 patients who underwent laparoscopic- or robot-assisted surgery were retrospectively compared. RESULTS: Of the 108 patients, who underwent laparoscopic- or robot-assisted surgery for suspected Stage IA disease, 98 had Stage IA, two had Stage IB, and four had Stages II and III disease. The sensitivity of imaging evaluations based on preoperative MRI and CT was 90.7%. CONCLUSION: Utilizing preoperative MRI and CT imaging resulted in a high rate of successful diagnosis of Stage IA endometrial carcinoma.

DOI PubMed

後腟円蓋より発生する腟腫瘍に対し腹腔鏡下手術を行い、表在性筋線維芽細胞腫と判明した1例

鹿内 智史, 松浦 基樹, 曽山 浩明, 和田 渚, 梅本 美菜, 三浦 一郎, 齋藤 豪

日本産科婦人科内視鏡学会雑誌 ( (一社)日本産科婦人科内視鏡学会 )  38 ( 2 ) 230 - 234  2022年

　概要を見る

症例は43歳(0妊0産)で、過多月経と外陰部腫瘤を主訴とした。腫瘍は腟鏡診では後腟円蓋より外向性に発育し表面平滑で、各種画像、子宮頸部擦過診所見より、良性の腟壁由来の間葉系腫瘍、多発子宮筋腫を疑った。腹腔鏡下子宮全摘出術および腟腫瘍摘出術を行い、病理組織学的所見より表在性筋線維芽細胞腫と診断した。

The Roles of Tricellular Tight Junction Protein Angulin-1/Lipolysis-Stimulated Lipoprotein Receptor (LSR) in Endometriosis and Endometrioid-Endometrial Carcinoma.

Hiroshi Shimada, Takayuki Kohno, Takumi Konno, Tadahi Okada, Kimihito Saito, Yuma Shindo, Shin Kikuchi, Mitsuhiro Tsujiwaki, Marie Ogawa, Motoki Matsuura, Tsuyoshi Saito, Takashi Kojima

Cancers   13 ( 24 )  2021年12月  [国際誌]

　概要を見る

Tight junction proteins play roles beyond permeability barriers functions and control cell proliferation and differentiation. The relation between tight junctions and the signal transduction pathways affects cell growth, invasion and migration. Abnormality of tight junction proteins closely contributes to epithelial mesenchymal transition (EMT) and malignancy of various cancers. Angulin-1/lipolysis-stimulated lipoprotein receptor (LSR) forms tricellular contacts that has a barrier function. Downregulation of angulin-1/LSR correlates with the malignancy in various cancers, including endometrioid-endometrial carcinoma (EEC). These alterations have been shown to link to not only multiple signaling pathways such as Hippo/YAP, HDAC, AMPK, but also cell metabolism in ECC cell line Sawano. Moreover, loss of angulin-1/LSR upregulates claudin-1, and loss of apoptosis stimulating p53 protein 2 (ASPP2) downregulates angulin-1/LSR. Angulin-1/LSR and ASPP2 concentrate at both midbody and centrosome in cytokinesis. In EEC tissues, angulin-1/LSR and ASPP2 are reduced and claudin-2 is overexpressed during malignancy, while in the tissues of endometriosis changes in localization of angulin-1/LSR and claudin-2 are seen. This review highlights how downregulation of angulin-1/LSR promotes development of endometriosis and EEC and discusses about the roles of angulin-1/LSR and its related proteins, including claudins and ASPP2.

DOI PubMed

マイクロバイオーム最前線-ヒト常在菌叢と各種疾患との関連- 腟内および子宮内細菌叢Dysbiosisへの真なるアプローチとは?

真里谷 奨, 島野 敏司, 遠藤 俊明, 和田 真一郎, 山田 秀人, 藤井 美穂, 水無瀬 昂, 桜庭 喜行, 鳥越 俊彦, 齋藤 豪

日本臨床微生物学会雑誌 ( (一社)日本臨床微生物学会 )  32 ( Suppl.1 ) 164 - 164  2021年12月

Radical Vaginal Trachelectomy.

Tsuyoshi Saito, Motoki Matsuura, Masato Tamate, Masahiro Iwasaki, Tasuku Mariya

Surgery journal (New York, N.Y.)   7 ( Suppl 2 ) S103-S107  2021年12月  [国際誌]

　概要を見る

Recently, radical vaginal hysterectomy (RVH) has developed into laparoscopically assisted radical vaginal hysterectomy (LARVH), which is associated with the laparoscopical procedure, and it is applied as radical vaginal trachelectomy and semi-radical vaginal hysterectomy. LARVH is indicated for patients with stage IB1 and IIA1 cervical carcinoma, especially those with a tumor size of less than 2 cm, because the cardinal ligaments cannot be resected widely. Although RVH that is associated with laparoscopic pelvic lymphadenectomy is the most used surgical procedure, radical trachelectomy may be performed either abdominally or vaginally (laparoscopic or robotic). One report found that the pregnancy rate was higher in patients who underwent minimally invasive or radical vaginal trachelectomy than in those who underwent radical abdominal trachelectomy.

DOI PubMed