Details of a Researcher - SHIMA Hiroaki

Papers - SHIMA Hiroaki

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Randomized phase II trial of survivin 2B peptide vaccination for patients with HLA-A24-positive pancreatic adenocarcinoma

Hiroaki Shima, Giichiro Tsurita, Satoshi Wada, Yoshihiko Hirohashi, Hiroshi Yasui, Hiroshi Hayashi, Takashi Miyakoshi, Kazue Watanabe, Aiko Murai, Hiroko Asanuma, Serina Tokita, Terufumi Kubo, Munehide Nakatsugawa, Takayuki Kanaseki, Tomohide Tsukahara, Yutaka Nakae, Osamu Sugita, Yoichi M. Ito, Yasunori Ota, Yasutoshi Kimura, Goro Kutomi, Koichi Hirata, Toru Mizuguchi, Kohzoh Imai, Ichiro Takemasa, Noriyuki Sato, Toshihiko Torigoe

Cancer Science 110 ( 8 ) 2378 - 2385 2019 [Refereed] [International journal]

© 2019 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association. The prognosis of advanced pancreatic adenocarcinoma is still extremely poor. This study sought to determine the efficacy of, and immunological response to, peptide vaccination therapy in patients with this disease. In this multicenter randomized phase II study, patients with advanced pancreatic adenocarcinoma after gemcitabine and/or tegafur/gimeracil/oteracil were randomly assigned to 3 groups that each received a 2-step treatment course. In Step 1, the groups received treatments of: (i) survivin 2B peptide (SVN-2B) plus interferon-β (IFNβ); (ii) SVN-2B only; or (iii) placebo until the patients show progression. In Step 2, all patients who consented to participate received 4 treatments with SVN-2B plus IFNβ. The primary endpoint was progression-free survival (PFS) after initiation of Step 1 treatment. Secondary endpoints included immunological effects assessed by analysis of PBMCs after Step 1. Eighty-three patients were randomly assigned to receive SVN-2B plus IFNβ (n = 30), SVN-2B (n = 34), or placebo (n = 19). No significant improvement in PFS was observed. Survivin 2B-specific CTLs were found to be increased in the SVN-2B plus IFNβ group by tetramer assay. Among patients who participated in Step 2, those who had received SVN-2B plus IFNβ in Step 1 showed better overall survival compared with those who had received placebo in Step 1. Patients vaccinated with SVN-2B plus IFNβ did not have improved PFS, but showed significant immunological reaction after vaccination. Subgroup analysis suggested that a longer SVN-2B plus IFNβ vaccination protocol might confer survival benefit. (Clinical trial registration number: UMIN 000012146).

DOI PubMed

Immunohistological analysis of pancreatic carcinoma after vaccination with survivin 2B peptide: Analysis of an autopsy series

Terufumi Kubo, Giichiro Tsurita, Yoshihiko Hirohashi, Hiroshi Yasui, Yasunori Ota, Kazue Watanabe, Aiko Murai, Kazuhiko Matsuo, Hiroko Asanuma, Hiroaki Shima, Satoshi Wada, Munehide Nakatsugawa, Takayuki Kanaseki, Tomohide Tsukahara, Toru Mizuguchi, Koichi Hirata, Ichiro Takemasa, Kohzoh Imai, Noriyuki Sato, Toshihiko Torigoe

Cancer Science 110 ( 8 ) 2386 - 2395 2019 [Refereed] [International journal]

© 2019 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association. Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer by providing new options in addition to existing therapies. However, peptide vaccination therapies still represent an attractive approach, because of the antigen specificity. We identified survivin 2B peptide (SVN-2B), a 9-mer antigenic peptide encoded by survivin, and an SVN-2B peptide vaccine-based phase II randomized clinical trial targeting unresectable and refractory pancreatic carcinoma was undertaken. The SVN-2B peptide vaccine did not have any statistically significant clinical benefits in that study. Therefore, we undertook an autopsy study to analyze the immune status of the pancreatic cancer lesions at the histological level. Autopsies were carried out in 13 patients who had died of pancreatic cancer, including 7 who had received SVN-2B peptide vaccination and 6 who had not, as negative controls. The expression of immune-related molecules was analyzed by immunohistochemical staining. Cytotoxic T lymphocytes were analyzed by tetramer staining and enzyme-linked immunospot assay. Histological analysis revealed dense infiltration of CD8+ T cells in some lesions in patients who had received the SVN-2B peptide vaccine. A high rate of programmed cell death ligand 1 expression in cancer cells was observed in these cases, indicating that CTLs were induced by SVN-2B peptide vaccination and had infiltrated the lesions. The lack of a significant antitumor effect was most likely attributable to the expression of immune checkpoint molecules. These findings suggest that the combination of a tumor-specific peptide vaccine and an ICI might be a promising approach to the treatment of pancreatic carcinoma in the future.

DOI PubMed

Case report: Long-term survival of a pancreatic cancer patient immunized with an SVN-2B peptide vaccine.

Hiroaki Shima, Goro Kutomi, Fukino Satomi, Masafumi Imamura, Yasutoshi Kimura, Toru Mizuguchi, Kazue Watanabe, Akari Takahashi, Aiko Murai, Tomohide Tsukahara, Takayuki Kanaseki, Yoshihiko Hirohashi, Yuji Iwayama, Tetsuhiro Tsuruma, Hidekazu Kameshima, Noriyuki Sato, Toshihiko Torigoe, Ichiro Takemasa

Cancer immunology, immunotherapy : CII 67 ( 10 ) 1603 - 1609 2018.10 [International journal]

A 62-year-old woman who underwent surgery to treat pancreatic cancer provided written, informed consent to undergo adjuvant therapy with gemcitabine, tegafur, and uracil. However, this was stopped after only 14 days due to Grade 4 neutropenia. She was then started on vaccine therapy with Survivin 2B peptide (SVN-2B) including IFA and INF-α. Although metastatic lung tumors were identified and resected at 82 months after surgery, the patient has remained free of new or relapsed disease for 12 years thereafter. Tetramer and ELISPOT assays revealed the continuous circulation of SVN-2B-restricted cytotoxic T-lymphocytes (CTLs) in her peripheral blood, and CTL clones had specific activity for SVN-2B at 12 years after surgery. The adverse effects of the peptide vaccination were tolerable and comprised low-grade headache, nausea, and fatigue. A prognosis beyond 10 years in the face of pancreatic cancer with distant metastasis is extremely rare. This experience might indicate the value of cancer vaccination therapy.

DOI PubMed

切除不能膵がんに対するサバイビン2Bペプチドワクチン療法後腫瘍組織の免疫病理学的検討(Immunohistological analysis of the unresectable pancreatic carcinoma after survivin 2B peptide vaccination)

久保輝文, 釣田義一郎, 廣橋良彦, 大田泰徳, 安井寛, 渡邉一絵, 村井愛子, 浅沼広子, 島宏彰, 竹政伊知朗, 水口徹, 佐藤昇志, 鳥越俊彦

日本癌学会総会記事 ( (一社)日本癌学会 ) 77回 2371 - 2371 2018.09

サバイビン2Bペプチドワクチン第II相臨床試験における膵がん組織の免疫病理学的解析

久保輝文, 釣田義一郎, 廣橋良彦, 大田泰徳, 安井寛, 渡邉一絵, 村井愛子, 浅沼広子, 島宏彰, 塚原智英, 金関貴幸, 中津川宗秀, 水口徹, 竹政伊知朗, 平田公一, 佐藤昇志, 鳥越俊彦

日本がん免疫学会総会プログラム・抄録集 ( 日本がん免疫学会 ) 22回 93 - 93 2018.07

Comparison of surgical outcomes and complications between the Harmonic FOCUS and conventional surgery for open thyroidectomy.

Maeda H, Kutomi G, Satomi F, Shima H, Mori M, Takemasa I

Molecular and clinical oncology 8 ( 4 ) 557 - 560 2018.04 [Refereed] [International journal]

The aim of the present study was to evaluate the potential advantages of the ultrasonic scalpel compared with the conventional technique in thyroid surgery. Patients with resectable thyroid cancer and Basedow's disease were assigned to ultrasonic scalpel or conventional technique (knot-tying and electrocoagulation). The present study used the Harmonic FOCUS® (HF) as an ultrasonic scalpel. Between February 2013 and May 2016, 45 patients were enrolled into the study. Duration of the surgery was significantly decreased in the HF group compared with the conventional surgery (CS) group (median 142 vs. 151 min; P=0.0406). Intraoperative blood loss and total volume of drainage fluid were significantly decreased in the HF group compared with the CS group (median 40 vs. 125 ml; P=0.0054, and median 120 vs. 175.5 ml; P=0.0490). Duration of drain placement and length of hospitalization stay were similar in the two groups. Furthermore, the overall incidence of postoperative complications did not differ between the two groups. Overall, the present study suggests that open thyroidectomy using the HF is safe and effective and not associated with any increase in complications.

DOI PubMed

A genome-wide association study identifies three novel genetic markers for response to tamoxifen: A prospective multicenter study.

Hiroshi Onishi, Chihiro Udagawa, Michiaki Kubo, Seigo Nakamura, Sadako Akashi-Tanaka, Takashi Kuwayama, Chie Watanabe, Tomoko Takamaru, Hiroyuki Takei, Takashi Ishikawa, Kana Miyahara, Hiroshi Matsumoto, Yoshie Hasegawa, Yukihide Momozawa, Siew-Kee Low, Goro Kutomi, Hiroaki Shima, Fukino Satomi, Minoru Okazaki, Hisamitsu Zaha, Mai Onomura, Ayami Matsukata, Yasuaki Sagara, Shinichi Baba, Akimitsu Yamada, Kazuhiro Shimada, Daisuke Shimizu, Koichiro Tsugawa, Arata Shimo, Mikael Hartman, Ching-Wan Chan, Soo Chin Lee, Itaru Endo, Hitoshi Zembutsu

PloS one 13 ( 8 ) e0201606 2018 [Refereed] [International journal]

PURPOSE: Although association studies of genetic variations with the clinical outcomes of breast cancer patients treated with tamoxifen have been reported, genetic factors which could determine individual response to tamoxifen are not fully clarified. We performed a genome-wide association study (GWAS) to identify novel genetic markers for response to tamoxifen. EXPERIMENTAL DESIGN: We prospectively collected 347 blood samples from patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative, invasive breast cancer receiving preoperative tamoxifen monotherapy for 14 to 28 days. We used Ki-67 response in breast cancer tissues after preoperative short-term tamoxifen therapy as a surrogate marker for response to tamoxifen. We performed GWAS and genotype imputation using 275 patients, and an independent set of 72 patients was used for replication study. RESULTS: The combined result of GWAS and the replication study, and subsequent imputation analysis indicated possible association of three loci with Ki-67 response after tamoxifen therapy (rs17198973 on chromosome 4q34.3, rs4577773 on 6q12, and rs7087428 on 10p13, Pcombined = 5.69 x 10-6, 1.64 x 10-5, and 9.77 x 10-6, respectively). When patients were classified into three groups by the scoring system based on the genotypes of the three SNPs, patients with higher scores showed significantly higher after/before ratio of Ki-67 compared to those with lower scores (P = 1.8 x 10-12), suggesting the cumulative effect of the three SNPs. CONCLUSION: We identified three novel loci, which could be associated with clinical response to tamoxifen. These findings provide new insights into personalized hormonal therapy for the patients with breast cancer.

DOI PubMed

デジタルマンモグラフィ導入に伴う地方対策型検診への影響

九冨五郎, 島宏彰, 里見蕗乃, 空閑陽子, 竹政伊知朗, 黒蕨邦夫, 今野信代, 周東百合子, 前田豪樹

北海道外科雑誌 ( 北海道外科学会 ) 62 ( 2 ) 205 - 205 2017.12

Significant Effect of Polymorphisms in CYP2D6 on Response to Tamoxifen Therapy for Breast Cancer: A Prospective Multicenter Study

Hitoshi Zembutsu, Seigo Nakamura, Sadako Akashi-Tanaka, Takashi Kuwayama, Chie Watanabe, Tomoko Takamaru, Hiroyuki Takei, Takashi Ishikawa, Kana Miyahara, Hiroshi Matsumoto, Yoshie Hasegawa, Goro Kutomi, Hiroaki Shima, Fukino Satomi, Minoru Okazaki, Hisamitsu Zaha, Mai Onomura, Ayami Matsukata, Yasuaki Sagara, Shinichi Baba, Akimitsu Yamada, Kazuhiro Shimada, Daisuke Shimizu, Koichiro Tsugawa, Arata Shimo, Ern Yu Tan, Mikael Hartman, Ching-Wan Chan, Soo Chin Lee, Yusuke Nakamura

CLINICAL CANCER RESEARCH ( AMER ASSOC CANCER RESEARCH ) 23 ( 8 ) 2019 - 2026 2017.04 [Refereed]

Purpose: CYP2D6 is the key enzyme responsible for the generation of the potent active metabolite of tamoxifen, "endoxifen." There are still controversial reports questioning the association between CYP2D6 genotype and tamoxifen efficacy. Hence, we performed a prospective multicenter study to evaluate the clinical effect of CYP2D6 genotype on tamoxifen therapy. Experimental Design: We enrolled 279 patients with hormone receptor-positive and human epidermal growth factor receptor 2-egative, invasive breast cancer receiving preoperative tamoxifen monotherapy for 14 to 28 days. Ki-67 response in breast cancer tissues after tamoxifen therapy was used as a surrogate marker for response to tamoxifen. We prospectively investigated the effects of allelic variants of CYP2D6 on Ki-67 response, pathological response, and hot flushes. Results: Ki-67 labeling index in breast cancer tissues significantly decreased after preoperative tamoxifen monotherapy (P = 0.0000000000000013). Moreover, proportion and Allred scores of estrogen receptor-positive cells in breast cancer tissues were significantly associated with Ki-67 response (P = 0.0076 and 0.0023, respectively). Although CYP2D6 variants were not associated with pathologic response nor hot flushes, they showed significant association wyith Ki-67 response after preoperative tamoxifen therapy (P = 0.018; between two groups, one with at least one wild-type allele and the other without a wild-type allele). Conclusions: This is the first prospective study evaluating the relationship between CYP2D6 variants and Ki-67 response after tamoxifen therapy. Our results suggest that genetic variation in CYP2D6 is a key predictor for the response to tamoxifen in patients with breast cancer. (C) 2016 AACR.

DOI PubMed

Flap revascularization in patients following immediate reconstruction using an autologous free dermal fat graft for breast cancer: a report of two cases.

Hiroaki Shima, Goro Kutomi, Takuro Kyuno, Fukino Satomi, Satoko Uno, Hideki Maeda, Hidekazu Kameshima, Tosei Omura, Yasutoshi Kimura, Toru Mizuguchi, Koichi Hirata, Ichiro Takemasa

Surgical case reports 2 ( 1 ) 54 - 54 2016.12 [International journal]

It has been reported that use of the free dermal fat graft (FDFG) technique produces a good cosmetic outcome for breast cancer. An FDFG is harvested from the lower abdomen as a columnar-shaped specimen and implanted into the defect of the breast after a partial mastectomy as a volume replacement technique. In this report, two patients who underwent breast-conserving surgery with immediate reconstruction using an autologous FDFG are described in order to show the difference in status between one case with and one without blood flow in the graft. To assess the benefit of this technique using FDFGs, their cosmetic satisfaction was evaluated using a questionnaire, graft shrinkage was measured by CT, and blood flow was assessed using contrast-enhanced ultrasound (CEUS). Both patients scored 10 of 12 points on the questionnaire. After 2 years, shrinkage of the grafts was 21.6 and 25.2 %, respectively. Although one patient had no blood flow in the center of the graft, the other had blood flow from the pectoralis major muscle to the center of the graft. While satisfaction and graft shrinkage were similar in the two patients, one case showed blood flow and had a somewhat softer graft than the other. The graft status was maintained with a good cosmetic outcome for 3 years after breast-conserving surgery with immediate reconstruction using an autologous FDFG, despite mild shrinkage and hardness of the graft. It is notable that blood flow was observed into the graft on CEUS, and more distinct perfusion was seen in the softer graft case after more than 3 years.

DOI PubMed

Clinicopathological characteristics of thyroid cancer misdiagnosed by fine needle aspiration

Hideki Maeda, Goro Kutomi, Fukino Satomi, Hiroaki Shima, Mitsuru Mori, Koichi Hirata, Ichiro Takemasa

EXPERIMENTAL AND THERAPEUTIC MEDICINE ( SPANDIDOS PUBL LTD ) 12 ( 4 ) 2766 - 2772 2016.10 [Refereed]

Fine-needle aspiration (FNA) is commonly used as a preoperative assessment to diagnose thyroid cancer. However, misdiagnosis of malignancy by FNA is not rare, even if image examination suggests the possibility of thyroid cancer. In the present study, the clinicopathological factors of patients whose preoperative FNA examination had not led to a diagnosis of thyroid cancer were examined. In total, 125 patients with thyroid cancer who underwent FNA and surgery (total thyroidectomy, subtotal thyroidectomy or hemithyroidectomy) at the Department of Surgery, Surgical Oncology and Science of the Sapporo Medical University Hospital between 2006 and 2013 were retrospectively analyzed. The patients were divided into two groups: Group A, malignancy determined by FNA, and group B, no malignancy. The groups were then compared by gender, age, tumor size, stage, tumor stage, lymph node metastasis, histology, surgical procedure methods, presence or absence of calcification and thyroglobulin levels. The mean age of the patients in group A (5 males and 59 females) was 53.0 years. The mean age in group B (11 males and 49 females) was 54.2 years. The mean tumor size in both groups was 1.6 cm. The mean thyroglobulin levels were 82.7 ng/ml in Group A and 525.5 ng/ml in group B. There were also significant differences between the groups for tumor stage (P=0.046), histological type (P=0.024) and thyroglobulin levels (P=0.035). The results of the present study suggested that it may be difficult to diagnose thyroid cancer by FNA in cases with non-papillary carcinoma and higher thyroglobulin levels.

DOI

対策型検診のマンモグラフィ読影の問題点デジタルマンモグラフィ導入に伴う地方対策型検診への影響

九冨五郎, 島宏彰, 前田豪樹, 里見蕗乃, 黒蕨邦夫, 今野信代, 周東百合子, 竹政伊知朗

日本乳癌検診学会誌 ( (NPO)日本乳癌検診学会 ) 25 ( 3 ) 372 - 372 2016.10

SOX2 and ALDH1 as Predictors of Operable Breast Cancer

Hiroaki Shima, Fukino Satomi, Hideki Maeda, Yoshihiko Hirohashi, Tadashi Hasegawa, Mitsuru Mori, Toshihiko Torigoe, Ichiro Takemasa

ANTICANCER RESEARCH ( INT INST ANTICANCER RESEARCH ) 36 ( 6 ) 2945 - 2953 2016.06 [Refereed]

Aim: Sex-determining region Y-box binding protein-2 (SOX2) and aldehyde dehydrogenase-1 (ALDH1) are known cancer stem-cell markers, and represent candidate predictors for breast cancer prognosis. In this study we investigated the relationships between SOX2/ALDH1 expression and prognosis. Materials and Methods: One hunred and two breast cancer surgical specimens were immunohistochemically analyzed for SOX2 and ALDH1 expression. Results: Disease-free survival (DFS) and overall survival (OS) were significantly poorer for SOX2-positive patients than SOX2-negative (p=0.0024 and p=0.0021, respectively), and for ALDH1-positive patients than ALDH1-negative (p=0.0049 and p=0.0083). DFS and OS were worse for SOX2- or ALDH1-positive patients than double-negative (p=0.0053 and p=0.0166). While an obvious tendency toward worse DFS was seen for estrogen receptor (ER)negative patients, and attenuated for ER-positive, only SOX2/ALDH1 any-positive patients showed significantly poorer DFS (p=0.0258). Conclusion: SOX2 and ALDH1 can be considered markers of poor prognosis, particularly in ER-negative patients. SOX2/ALDH1 any-positivity might also offer a reliable predictor of poor prognosis.

バイオマーカーをめぐるQ&A(Question 16) hERO1-Lα発現による乳癌予後予測は可能か?

九冨五郎, 久木田和晴, 里見蕗乃, 前田豪樹, 島宏彰, 水口徹, 平田公一

Surgery Frontier ( (株)メディカルレビュー社 ) 22 ( 3 ) 283 - 285 2015.09

A phase I study of combination therapy with nanoparticle albumin-bound paclitaxel and cyclophosphamide in patients with metastatic or recurrent breast cancer

Goro Kutomi, Tousei Ohmura, Fukino Satomi, Hideki Maeda, Hiroaki Shima, Hidekazu Kameshima, Minoru Okazaki, Hideji Masuoka, Kenichi Sasaki, Koichi Hirata

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY ( SPRINGER JAPAN KK ) 20 ( 3 ) 474 - 479 2015.06 [Refereed]

The objective of the present clinical study is to determine the maximum tolerated dose (MTD)/recommended dose (RD) of combination therapy with nanoparticle albumin-bound paclitaxel (nab-PTX) and cyclophosphamide (CPA) in patients with metastatic or recurrent breast cancer. nab-PTX and CPA were administered on the first day of each 21-day treatment cycle. The dose of CPA was fixed at 600 mg/m(2), while the dose of nab-PTX was increased from 180 mg/m(2) (Level 1) to 220 mg/m(2) (Level 2) and then to 260 mg/m(2) (Level 3). A total of 11 patients from two institutions were enrolled in the present study. At Level 3, a dose-limiting toxicity (DLT) was observed in 1 patient. Considering treatment continuity and the risk of adverse events in Cycle 2 and thereafter at this level, further subject enrollment at Level 3 was discontinued after two patients had been enrolled. Since the doses used at Level 3 were considered the MTD of nab-PTX and CPA and the doses used at Level 2 were considered the RD of nab-PTX and CPA, three additional subjects were enrolled at Level 2. No DLTs were observed at Level 2. The RD of combination therapy with nab-PTX and CPA was 220 mg/m(2) and 600 mg/m(2), respectively, in patients with metastatic or recurrent breast cancer.

DOI PubMed

Risk of node metastasis of sentinel lymph nodes detected in level II/III of the axilla by single-photon emission computed tomography/computed tomography

Hiroaki Shima, Goro Kutomi, Fukino Satomi, Hideki Maeda, Tomoko Takamaru, Hidekazu Kameshima, Tosei Omura, Mitsuru Mori, Masamitsu Hatakenaka, Tadashi Hasegawa, Koichi Hirata

EXPERIMENTAL AND THERAPEUTIC MEDICINE ( SPANDIDOS PUBL LTD ) 8 ( 5 ) 1447 - 1452 2014.11 [Refereed]

In breast cancer, single-photon emission computed tomography/computed tomography (SPECT/CT) shows the exact anatomical location of sentinel nodes (SN). SPECT/CT mainly exposes axilla and partly exposes atypical sites of extra-axillary lymphatic drainage. The mechanism of how the atypical hot nodes are involved in lymphatic metastasis was retrospectively investigated in the present study, particularly at the level II/III region. SPECT/CT was performed in 92 clinical stage 0-IIA breast cancer patients. Sentinel lymph nodes are depicted as hot nodes in SPECT/CT: Patients were divided into two groups: With or without hot node in level II/III on SPEC/CT. The existence of metastasis in level II/III was investigated and the risk factors were identified. A total of 12 patients were sentinel lymph node biopsy metastasis positive and axillary lymph node dissection (ALND) was performed. These patients were divided into two groups: With and without SN in level and nodes in level II/III were pathologically proven. In 11 of the 92 patients, hot nodes were detected in level There was a significant difference in node metastasis depending on whether there were hot nodes in level II/III (P=0.0319). Multivariate analysis indicated that the hot nodes in level II/III and lymphatic invasion were independent factors associated with node metastasis. There were 12 SN-positive patients followed by ALND. In four of the 12 patients, hot nodes were observed in level Two of the four patients with hot nodes depicted by SPECT/CT and metastatic nodes were pathologically evident in the same lesion. Therefore, the present study indicated that the hot node in level II/III as depicted by SPECT/CT may be a risk of SN metastasis, including deeper nodes.

DOI PubMed

Lymph node shape in computed tomography imaging as a predictor for axillary lymph node metastasis in patients with breast cancer

Goro Kutomi, Tousei Ohmura, Fukino Satomi, Tomoko Takamaru, Hiroaki Shima, Yasuyo Suzuki, Seiko Otokozawa, Hitoshi Zembutsu, Mitsuru Mori, Koichi Hirata

EXPERIMENTAL AND THERAPEUTIC MEDICINE ( SPANDIDOS PUBL LTD ) 8 ( 2 ) 681 - 685 2014.08 [Refereed]

The aim of the present study was to evaluate whether preoperative computed tomography (CT) is a useful modality for the diagnosis of axillary lymph node metastasis. The axillary lymph node status was examined in patients with primary breast cancer who had undergone surgery. In total, 75 patients were analyzed with preoperative contrast CT images, following which the patients underwent an intraoperative sentinel lymph node biopsy to determine possible predictors of axillary lymph node metastasis. The lymph node shape was classified into three groups, which included fat-, clear-and obscure-types. Multivariate analysis revealed that clear-type lymph nodes in preoperative contrast CT imaging may be an independent predictor of lymph node metastasis (odds ratio, 15; P=0.003). Therefore, the results indicated that preoperative CT examination is useful to predict axillary lymph node metastasis.

DOI PubMed

Use of the dye-guided sentinel lymph node biopsy method alone for breast cancer metastasis to avoid unnecessary axillary lymph node dissection

Tomoko Takamaru, Goro Kutomi, Fukino Satomi, Hiroaki Shima, Keisuke Ohno, Hidekazu Kameshima, Yasuyo Suzuki, Tousei Ohmura, Hiroyuki Takamaru, Masanori Nojima, Mitsuru Mori, Koichi Hirata

EXPERIMENTAL AND THERAPEUTIC MEDICINE ( SPANDIDOS PUBL LTD ) 7 ( 2 ) 456 - 460 2014.02 [Refereed]

For sentinel lymph node biopsy (SLNB), a combination of dye-guided and gamma-probe-guided methods is the most commonly used technique. However, the number of institutes in which the gamma-probe-guided method is able to be performed is limited, since special equipment is required for the method. In this study, SLNB with the dye-guided method alone was evaluated, and the clinicopathological characteristics were analyzed to identify any factors that were predictive of whether the follow-up axillary lymph node dissection (ALND) was able to be omitted. A total of 374 patients who underwent SLNB between 1999 and 2009 were studied. The SLN identification rate was analyzed, in addition to the false-positive and false-negative rates and the correlation between the clinicopathological characteristics and axillary lymph node metastases. The SLN was identified in 96.8% of cases, and, out of the patients who had SLN metastasis, 63.0% did not exhibit metastasis elsewhere. The sensitivity was 96.4% and the specificity was 100%. The false-negative rate was 3.6%. Univariate analyses revealed significant differences in the lymph vessel invasion (ly) status, nuclear grade (NG), maximum tumor size and the percentage of the area occupied by the tumor cells in the SLN (SLN occupation ratio) between the patients with and without non-SLN metastasis, indicating that these factors may be predictive of axillary lymph node metastasis. Multivariate analysis revealed that ly status was an independent risk factor for non-SLN metastasis. In conclusion, SLN with the dye-guided method alone provided a high detection rate. The study identified a predictive factor for axillary lymph node metastasis that may improve the patients' quality of life.

DOI PubMed

右乳房および左腋窩に病変を認めたSynchronous Paget病の1例

小林景樹, 澄川靖之, 菊池裕美子, 菅裕司, 加藤潤史, 山下利春, 里見蕗乃, 島宏彰, 九冨五郎

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 ) 124 ( 2 ) 197 - 197 2014.02

Relation of Serum Adiponectin Levels and Obesity with Breast Cancer: A Japanese Case-Control Study

Machiko Minatoya, Goro Kutomi, Hiroaki Shima, Sumiyo Asakura, Seiko Otokozawa, Hirofumi Ohnishi, Hiroshi Akasaka, Tetsuji Miura, Mitsuru Mori, Koichi Hirata

ASIAN PACIFIC JOURNAL OF CANCER PREVENTION ( ASIAN PACIFIC ORGANIZATION CANCER PREVENTION ) 15 ( 19 ) 8325 - 8330 2014 [Refereed]

Background: It is known that obesity is one of the risk factors for breast cancer although the association may differ between ethnic groups and with the menopausal status. Recently obesity-related risk factors including serum adiponectin and insulin levels have been analyzed together with BMI in association with breast cancer risk. Materials and Methods: We measured serum high molecular weight (HMW) adiponectin and insulin levels in a hospital based case-control study, including 66 sets of Japanese female breast cancer cases and age and menopausal status matched controls. Serum levels of HMW adiponectin, insulin levels and body mass index (BMI) were examined in association with breast cancer risk with adjustment for the various known risk factors by menopausal status. Results: Women in the highest HMW adiponectin levels showed significant reduced risk of breast cancer in both pre and postmenopausal women (odds ratio (OR), 0.01; 95% confidence interval (CI), 0.00-0.26 and 0.13; 0.03-0.57, respectively). Lower BMI showed decreased breast cancer risk in both pre and postmenopausal women (OR, 0.04; 95% CI, 0.00-0.69, OR, 0.28; 95% CI, 0.07-1.11, respectively). Conclusions: These results indicated that higher serum HMW adiponectin levels and lower BMI are associated with a decreased breast cancer risk in both pre and postmenopausal women in Japan, adding evidence for the obesity link.

DOI PubMed

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Papers - SHIMA Hiroaki