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• 2012年

  　

  　

  札幌医科大学   医学部   助教

  助教

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• ライフサイエンス   消化器外科学   肝胆膵外科

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• 札幌医科大学   医学部   講師   講師  

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• 肝幹細胞

• 肝予備能評価

• 肝予備機能

• 新規分子

• 組織肝細胞

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• Concordance of claudin-18.2 expression in biopsy, resection, and recurrent specimens: implications for zolbetuximab therapy in pancreatic ductal adenocarcinoma.

  Daisuke Kyuno, Kazuhiko Yanazume, Akira C Saito, Yusuke Ono, Tatsuya Ito, Masafumi Imamura, Makoto Osanai

  Tissue barriers     2535047 - 2535047  2025年07月  [国際誌]

  　概要を見る

  Claudin-18.2 is a promising therapeutic target for gastrointestinal cancer. However, its expression pattern in pancreatic ductal adenocarcinoma, especially the concordance between biopsy and resection specimens, is unknown. This study aimed to evaluate the consistency of claudin-18.2 positivity across different specimen types using the clinically validated antibody clone 43-14A employed in ongoing zolbetuximab trials. Immunohistochemical analysis for claudin-18 was conducted on 211 resected pancreatic cancer tissues, 133 matched preoperative biopsy samples, and 60 samples from recurrent lesions. The concordance between the biopsy and resection specimens was 92.5% using a 75% staining threshold. However, this high concordance likely reflects the large proportion of claudin-18.2-negative cases, as the biopsy sensitivity for detecting claudin-18.2-positive tumors was only 54.6%. This raises concerns about underdiagnosis and suggests that biopsy alone may miss patients eligible for zolbetuximab therapy. Receiver operating characteristic analysis showed that lowering the threshold to 20% in biopsy samples improved the sensitivity to 100%. However, patients meeting this threshold would still not qualify for therapy under the current trial criteria, highlighting a potential clinical dilemma. Claudin-18.2 expression was generally preserved in recurrent lesions (83.3% concordance with primary tumors), although reductions were noted in local recurrence and liver metastasis. These findings suggest that although biopsy-based assessments may be a practical initial tool, they should be interpreted with caution. Confirmatory studies on resection specimens using the same clinical trial protocol may be necessary to ensure the accurate identification of patients eligible for claudin-18.2-targeted therapy.

  DOI PubMed

• Patients With Pancreatic Cancer With Synchronous Liver Oligometastasis Show a Significant Long-Term Survival Benefit From Resection Under Specific Conditions: A Multicenter National Cohort Study.

  Kohei Nakata, Yoshihiro Miyasaka, Takeaki Ishizawa, Masayuki Ohtsuka, Masamichi Mizuma, Sohei Satoi, Masaaki Hidaka, Shuji Suzuki, Hiroshi Kurahara, Chie Kitami, Satoshi Hirano, Dongha Lee, Saiho Ko, Munenori Tahara, Isaku Yoshioka, Kenjiro Date, Kazuyuki Nagai, Goro Honda, Shugo Mizuno, Kenichi Hakamada, Yasuro Futagawa, Shigeru Marubashi, Hiroshi Yoshida, Akihiko Horiguchi, Yasuo Hosouchi, Masafumi Imamura, Naoto Gotohda, Hiroaki Nagano, Masaji Tani, Takeshi Sudo, Teijiro Hirashita, Junichi Arita, Katsutoshi Murase, Ken Fukumitsu, Toshiki Rikiyama, Teruyuki Usuba, Toshiya Abe, Masafumi Nakamura, Itaru Endo

  Journal of hepato-biliary-pancreatic sciences    2025年07月  [国内誌]

  　概要を見る

  BACKGROUND: In this study, we investigated the criteria that predict the long-term survival benefits after surgical resection in patients with pancreatic cancer accompanied by liver oligometastasis. METHODS: In total, 60 patients from 34 high-volume Japanese centers who underwent surgical resection for liver oligometastasis between 2005 and 2020 were included. Univariate and multivariate methods of survival analyses were performed. All patients were followed up for at least 36 months. RESULTS: Overall survival (OS) was significantly longer in the preoperative chemotherapy group than in the up-front surgery group (37.4 vs. 20.4 months, p = 0.001). In the operation with preoperative chemotherapy group, a complete response was observed in eight patients (28.6%). The 1-, 3-, and 5-year OS rates were 92.9%, 50.0%, and 35.7%, respectively. The multivariate analysis showed that low CA19-9 (< 100 U/mL; HR: 0.25; 95% CI: 0.06-0.96; p = 0.043), low CEA (< 5 U/mL; HR: 0.14; 95% CI: 0.04-0.48; p = 0.002), and resectable (R) or borderline resectable pancreatic cancer invading the portal vein (BR-PV) status (HR: 0.19; 95% CI: 0.07-0.51; p < 0.001) were positive prognostic factors. The median OS of the patients who met all three criteria was 106.6 months. CONCLUSION: Preoperative chemotherapy is essential for the treatment of liver oligometastases. Despite the high recurrence rates, patients who met the specific criteria have a favorable prognosis with liver resection.

  DOI PubMed

• Preventive effect of jejunal limb decompression on early-onset postoperative cholangitis after pancreaticoduodenectomy: a propensity score-matched study.

  Kazuharu Kukita, Masafumi Imamura, Eiji Yoshida, Toru Kato, Takeshi Murakami, Daisuke Kyuno, Masayuki Koyama, Yasutoshi Kimura

  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract   29 ( 9 ) 102143 - 102143  2025年07月  [国際誌]

  　概要を見る

  BACKGROUND: Jejunal limb (JL) peristalsis may affect recovery at reconstructed sites after pancreatobiliary reconstruction in pancreaticoduodenectomy. This study aimed to investigate the effect of JL peristalsis on early-onset postoperative cholangitis and evaluate the prevention effectiveness of JL decompression (JLD). METHODS: A modified Child reconstruction was performed in 281 patients during pancreaticoduodenectomy. Patients were divided into JLD (n = 210) and non-JLD (n = 71) groups based on the placement of a JLD tube. In the decompression group, the relationship between drainage volume of decompression, a potential surrogate for JL peristalsis, and early-onset postoperative cholangitis was analyzed. Postoperative outcomes were compared between the 2 groups using propensity score matching. RESULTS: In the JLD group, the drainage volume was significantly higher in patients with early-onset postoperative cholangitis than in those without early-onset postoperative cholangitis (3330 mL [IQR, 1355-7135] vs 770 mL [IQR, 280-1710], respectively; P <.001). Multivariate analysis identified a drainage volume of ≥1555 mL within 14 days after pancreaticoduodenectomy as an independent risk factor for early-onset postoperative cholangitis (odds ratio, 4.91 [95% CI, 2.18-11.10]; P <.001). After propensity score matching, the incidence of early-onset postoperative cholangitis was significantly lower in the decompression group than in the nondecompression group (1.7% vs 20.7%, respectively; P <.003). CONCLUSION: Impaired JL peristalsis after pancreaticoduodenectomy may be associated with the development of early-onset postoperative cholangitis. The incidence of early-onset postoperative cholangitis is reduced by the placement of a JLD tube.

  DOI PubMed

• The Role of Claudin-1 in Enhancing Pancreatic Cancer Aggressiveness and Drug Resistance via Metabolic Pathway Modulation.

  Daisuke Kyuno, Hinae Asano, Reona Okumura, Kumi Takasawa, Akira Takasawa, Takumi Konno, Yuna Nakamori, Kazufumi Magara, Yusuke Ono, Masafumi Imamura, Yasutoshi Kimura, Takashi Kojima, Makoto Osanai

  Cancers   17 ( 9 )  2025年04月  [国際誌]

  　概要を見る

  BACKGROUND/OBJECTIVES: Pancreatic ductal adenocarcinoma is a lethal malignancy, necessitating an understanding of its molecular mechanisms for the development of new therapeutic strategies. The tight junction protein claudin-1, known to influence cellular functions in various cancers and is considered a therapeutic target, remains unclear in pancreatic cancer. METHODS: This study assessed claudin-1 expression in resected pancreatic cancer samples, public databases, and pancreatic cancer cell lines. Claudin-1 knockout with CRISPR/Cas9 on poorly differentiated pancreatic cancer cell lines and a proteome analysis were performed to investigate the intracellular mechanisms of claudin-1. RESULTS: Claudin-1 was markedly overexpressed in pancreatic ductal adenocarcinoma and intraepithelial neoplasia compared to normal ducts, and high claudin-1 levels were an independent predictor of poor prognosis. Claudin-1 knockout diminished cell proliferation, migration, invasion, and chemoresistance in pancreatic ductal adenocarcinoma. Proteome analysis revealed the significant downregulation of aldo-keto reductase family proteins (AKR1C2, AKR1C3, and AKR1B1) in claudin-1 knockout cells, which are linked to metabolic pathways. Aldo-keto reductase knockdown reduced chemoresistance, proliferation, and invasion in these cell lines. CONCLUSIONS: These findings indicate that the abnormal expression of claudin-1 promotes tumor progression and drug resistance through its interaction with aldo-keto reductase proteins, highlighting claudin-1 and aldo-keto reductase family proteins as potential biomarkers and therapeutic targets for pancreatic cancer.

  DOI PubMed

• Impact of Infrared Indocyanine Green Fluorescence Imaging-guided Laparoscopic Hepatectomy on Securing the Resection Margin for Colorectal Liver Metastasis.

  Toru Kato, Masafumi Imamura, Daisuke Kyuno, Yasutoshi Kimura, Kazuharu Kukita, Takeshi Murakami, Eiji Yoshida, Toru Mizuguchi, Ichiro Takemasa

  Surgical laparoscopy, endoscopy & percutaneous techniques   34 ( 6 ) 551 - 558  2024年12月  [国際誌]

  　概要を見る

  BACKGROUND: Laparoscopic hepatectomy for colorectal liver metastases (CRLM) is performed worldwide. However, owing to a lack of palpatory information and difficulties associated with accurate intraoperative ultrasonographic diagnosis, the tumor may be exposed at the hepatic transection margin. This study aimed to investigate the pathological significance of near-infrared (NIR) fluorescence imaging with indocyanine green (ICG)-guided laparoscopic hepatectomy and determine its usefulness in securing the resection margin for CRLMs. METHODS: Fifty-nine patients who underwent laparoscopic hepatectomy for CRLM using NIR fluorescence imaging between February 2017 and June 2021 at Sapporo Medical University Hospital were included. Generally, all patients received intravenous ICG (2.5 mg/body) as a fluorescence agent 1 to 2 days before surgery. During the surgical procedure, real-time NIR fluorescence imaging was repeatedly performed to assess the surgical margins. RESULTS: Of the 94 tumors in 59 patients, laparoscopic NIR fluorescence imaging identified 56 tumors (59.6%) on the liver surface. Pathological analysis indicated clear margins in 96.6% (57/59) of patients. Examination of paraffin-embedded sections, which were successful in only 20 of 94 cases (21.3%), revealed that there were no tumor cells positive for NIR fluorescence, and the median distance of the continuous fluorescent signal from the tumor margin was 1.074 mm. CONCLUSIONS: We demonstrated a high R0 rate using NIR fluorescence-guided hepatectomy. This technique has the potential to improve intraoperative tumor identification and tumor margin assurance and reduce the rate of positive resection margins in patients with CRLMs.

  DOI PubMed

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• 高齢者,併存疾患を有する症例などハイリスク症例の胃癌に対するconversion手術の現況と成績 るいそう・肥満が高度進行胃癌conversion surgeryに与える影響

  伊東 竜哉, 小川 宰司, 木村 明菜, 三浦 亮, 石井 雅之, 秋月 恵美, 三代 雅明, 奥谷 浩一, 今村 将史, 竹政 伊知朗

  日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  124回   WS - 4  2024年04月

  J-GLOBAL

• ロボット手術で挑む高難度直腸癌手術 他臓器合併切除を要する直腸癌に対するロボット支援手術

  石井 雅之, 奥谷 浩一, 秋月 恵美, 野田 愛, 三代 雅明, 三浦 亮, 市原 もも子, 豊田 真帆, 伊東 竜哉, 今村 将史, 竹政 伊知朗

  日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  124回   WS - 1  2024年04月

  J-GLOBAL

• 直腸癌手術における縫合不全低減への試み 直腸癌術後の縫合不全を予防するための手術マネージメント

  奥谷 浩一, 秋月 恵美, 野田 愛, 三代 雅明, 石井 雅之, 三浦 亮, 市原 もも子, 豊田 真帆, 伊東 竜哉, 小川 宰司, 木村 明菜, 今村 将史, 沖田 憲司, 竹政 伊知朗

  日本内視鏡外科学会雑誌 ( (一社)日本内視鏡外科学会 )  28 ( 7 ) 2301 - 2301  2023年12月

  J-GLOBAL

• 脾彎曲癌に対する腹腔鏡下手術手技およびICGを用いたリンパ流の検討

  沖田 憲司, 奥谷 浩一, 秋月 恵美, 植木 知身, 三代 雅明, 石井 雅之, 伊東 竜哉, 今村 将史, 向谷 充宏, 竹政 伊知朗

  日本消化器外科学会雑誌 ( (一社)日本消化器外科学会 )  56 ( Suppl.2 ) 301 - 301  2023年11月

• Transanal Minimally Invasive Surgery(TAMIS)による筋層合併切除術

  石井 雅之, 沖田 憲司, 奥谷 浩一, 秋月 恵美, 三代 雅明, 三浦 亮, 市原 もも子, 古来 貴寛, 近藤 裕太, 伊東 竜哉, 今村 将史, 竹政 伊知朗

  日本消化器外科学会雑誌 ( (一社)日本消化器外科学会 )  56 ( Suppl.2 ) 300 - 300  2023年11月

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共同研究・競争的資金等の研究課題 【 表示 ／ 非表示 】

共同研究・競争的資金等の研究課題 【 表示 ／ 非表示 】

• 膵癌の予後不良群に過剰発現するタイト結合分子が促進する癌進展機構の解明

  基盤研究(C)

  研究期間:

  2024年04月

  -

  2027年03月

   

  及能 大輔, 今村 将史, 高澤 啓, 木村 康利

• 遺伝子プロファイルとctDNAに基づくサブタイプ別膵癌精密医療実装のための探索的研究

  基盤研究(C)

  研究期間:

  2023年04月

  -

  2026年03月

   

  木村 康利, 今村 将史, 竹政 伊知朗, 村上 武志, 久木田 和晴, 及能 大輔

• 経時的exosomal miRNA解析による膵癌術後早期再発新規バイオマーカーの開発

  基盤研究(C)

  研究期間:

  2023年04月

  -

  2026年03月

   

  今村 将史, 木村 康利, 永山 稔, 及能 大輔, 久木田 和晴, 村上 武志, 竹政 伊知朗

• IPMN発生機序に基づいた転写共役因子YAPの役割の解明と臨床応用を目指した研究

  基盤研究(C)

  研究期間:

  2022年04月

  -

  2025年03月

   

  山口 洋志, 今村 将史, 永山 稔, 竹政 伊知朗, 及能 大輔, 木村 康利

• 経時的エクソソーム解析による膵癌術後早期再発ハイリスク症例診断法の開発

  基盤研究(C)

  研究期間:

  2020年04月

  -

  2023年03月

   

  今村 将史, 永山 稔, 竹政 伊知朗, 及能 大輔, 木村 康利, 山口 洋志

  　研究概要を見る

  ①前向き研究として、2021年度は31例の血漿サンプルを収集し、同時に臨床データを整備している。 ②臨床研究論文の作成。当該研究に関連して、当施設の過去の膵癌切除症例を解析し、「Perioperative Predictors of Early Recurrence for Resectable and Borderline-Resectable Pancreatic Cancer」のタイトルで論文を作成した。2021年5月6日「Cancers」に受理された。

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