Papers - YOSHII Shinji

MicroRNA-31 expression in relation to BRAF mutation, CpG island methylation and colorectal continuum in serrated lesions

Miki Ito, Kei Mitsuhashi, Hisayoshi Igarashi, Katsuhiko Nosho, Takafumi Naito, Shinji Yoshii, Hiroaki Takahashi, Masahiro Fujita, Yasutaka Sukawa, Eiichiro Yamamoto, Taiga Takahashi, Yasushi Adachi, Masanori Nojima, Yasushi Sasaki, Takashi Tokino, Yoshifumi Baba, Reo Maruyama, Hiromu Suzuki, Kohzoh Imai, Hiroyuki Yamamoto, Yasuhisa Shinomura

INTERNATIONAL JOURNAL OF CANCER ( WILEY-BLACKWELL )  135 ( 11 ) 2507 - 2515  2014.12  [Refereed]  [International journal]

　View Summary

The CpG island methylator phenotype (CIMP) is a distinct form of epigenomic instability. Many CIMP-high colorectal cancers (CRCs) with BRAF mutation are considered to arise from serrated pathway. We recently reported that microRNA-31 (miR-31) is associated with BRAF mutation in colorectal tumors. Emerging new approaches have revealed gradual changes in BRAF mutation and CIMP-high throughout the colorectum in CRCs. Here, we attempted to identify a possible association between miR-31 and epigenetic features in serrated pathway, and hypothesized that miR-31 supports the "colorectal continuum" concept. We evaluated miR-31 expression, BRAF mutation and epigenetic features including CIMP status in 381 serrated lesions and 222 non-serrated adenomas and examined associations between them and tumor location (rectum; sigmoid, descending, transverse and ascending colon and cecum). A significant association was observed between high miR-31 expression and CIMP-high status in serrated lesions with BRAF mutation (p=0.0001). In contrast, miR-31 was slightly but insignificantly associated with CIMP status in the cases with wild-type BRAF. miR-31 expression in sessile serrated adenomas (SSAs) with cytological dysplasia was higher than that in SSAs, whereas, no significant difference was observed between traditional serrated adenomas (TSAs) and TSAs with high-grade dysplasia. The frequency of miR-31, BRAF mutation CIMP-high and MLH1 methylation increased gradually from the rectum to cecum in serrated lesions. In conclusion, miR-31 expression was associated with CIMP-high status in serrated lesions with BRAF mutation. Our data also suggested that miR-31 plays an important role in SSA evolution and may be a molecule supporting the colorectal continuum.

DOI PubMed

Novel risk factors for lymph node metastasis in early invasive colorectal cancer: a multi-institution pathology review

Hideki Ueno, Kazuo Hase, Yojiro Hashiguchi, Hideyuki Shimazaki, Shinji Yoshii, Shin-ei Kudo, Masafumi Tanaka, Yoshito Akagi, Takeshi Suto, Shinji Nagata, Keiji Matsuda, Koji Komori, Kazuhiko Yoshimatsu, Yasuhiko Tomita, Shozo Yokoyama, Eiji Shinto, Takahiro Nakamura, Kenichi Sugihara

JOURNAL OF GASTROENTEROLOGY ( SPRINGER JAPAN KK )  49 ( 9 ) 1314 - 1323  2014.09  [Refereed]  [Domestic journal]

　View Summary

Background Novel risk factors for lymph node metastasis (LNM) in T1 colorectal cancer (CRC) have been recently proposed, but most have not been implemented because of the lack of validation. Here we determined the value of poorly differentiated clusters (PDCs) in a multi-institutional cohort of T1 CRC cases. Methods A pathology review involving 30 institutions was conducted for 3556 T1 CRCs. PDC was defined as malignant clusters comprising >= 5 cells and lacking a glandular formation. The ability to identify LNM risk was compared using Akaike's information criterion (AIC). Results PDC was observed in 1401 tumors (39.4 %), including 94 (17.8 %) with <1000 mu m submucosal invasion and 1307 (43.2 %) with >= 1000 mu m submucosal invasion (P<0.0001). The incidence of LNM was higher in PDC-positive tumors (17.4 %) than in PDC-negative tumors (6.9 %; P<0.0001), and PDCs had an adverse impact on LNM irrespective of the degree of submucosal invasion. Grade 3, vascular invasion, budding, and submucosal invasion depth were also significant factors (all, P<0.0001). AIC of risk factor to identify LNM risk was most favorable for vascular invasion (2273.4), followed by PDC (2357.4); submucosal invasion depth (2429.1) was the most unfavorable. Interinstitutional judgment disparities were smaller in PDC (kappa, 0.51) than vascular invasion (0.33) or tumor grade (0.48). Conclusions PDC is a promising new parameter with good ability to identify LNM risk. Use of its appropriate judgment criteria will enable us determine whether an observational policy can be safely applied following local tumor excision in T1 CRC cases.

DOI PubMed

IGF2 differentially methylated region hypomethylation in relation to pathological and molecular features of serrated lesions

Takafumi Naito, Katsuhiko Nosho, Miki Ito, Hisayoshi Igarashi, Kei Mitsuhashi, Shinji Yoshii, Hironori Aoki, Masafumi Nomura, Yasutaka Sukawa, Eiichiro Yamamoto, Yasushi Adachi, Hiroaki Takahashi, Masao Hosokawa, Masahiro Fujita, Toshinao Takenouchi, Reo Maruyama, Hiromu Suzuki, Yoshifumi Baba, Kohzoh Imai, Hiroyuki Yamamoto, Shuji Ogino, Yasuhisa Shinomura

WORLD JOURNAL OF GASTROENTEROLOGY ( BAISHIDENG PUBLISHING GROUP INC )  20 ( 29 ) 10050 - 10061  2014.08  [Refereed]  [International journal]

　View Summary

AIM: To investigate insulin-like growth factor 2 (IGF2) differentially methylated region (DMR)0 hypomethylation in relation to clinicopathological and molecular features in colorectal serrated lesions. METHODS: To accurately analyze the association between the histological types and molecular features of each type of serrated lesion, we consecutively collected 1386 formalin-fixed paraffin-embedded tissue specimens that comprised all histological types [hyperplastic polyps (HPs, n = 121), sessile serrated adenomas (SSAs, n = 132), traditional serrated adenomas (TSAs, n = 111), non-serrated adenomas (n = 195), and colorectal cancers (CRCs, n = 827)]. We evaluated the methylation levels of IGF2 DMR0 and long interspersed nucleotide element-1 (LINE-1) in HPs (n = 115), SSAs (n = 120), SSAs with cytological dysplasia (n = 10), TSAs (n = 91), TSAs with high-grade dysplasia (HGD) (n = 15), non-serrated adenomas (n = 80), non-serrated adenomas with HGD (n = 105), and CRCs (n = 794). For the accurate quantification of the relative methylation levels (scale 0%-100%) of IGF2 DMR0 and LINE-1, we used bisulfite pyrosequencing method. Tumor specimens were analyzed for microsatellite instability, KRAS (codons 12 and 13), BRAF (V600E), and PIK3CA (exons 9 and 20) mutations; MLH1 and MGMT methylation; and IGF2 expression by immunohistochemistry. RESULTS: The distribution of the IGF2 DMR0 methylation level in 351 serrated lesions and 185 non-serrated adenomas (with or without HGD) was as follows: mean 61.7, median 62.5, SD 18.0, range 5.0-99.0, interquartile range 49.5-74.4. The IGF2 DMR0 methylation level was divided into quartiles (Q1 >= 74.5, Q2 62.6-74.4, Q3 49.6-62.5, Q4 <= 49.5) for further analysis. With regard to the histological type, the IGF2 DMR0 methylation levels of SSAs (mean +/- SD, 73.1 +/- 12.3) were significantly higher than those of HPs (61.9 +/- 20.5), TSAs (61.6 +/- 19.6), and non-serrated adenomas (59.0 +/- 15.8) (P < 0.0001). The IGF2 DMR0 methylation level was inversely correlated with the IGF2 expression level (r = -0.21, P = 0.0051). IGF2 DMR0 hypomethylation was less frequently detected in SSAs compared with HPs, TSAs, and non-serrated adenomas (P < 0.0001). Multivariate logistic regression analysis also showed that IGF2 DMR0 hypomethylation was inversely associated with SSAs (P < 0.0001). The methylation levels of IGF2 DMR0 and LINE-1 in TSAs with HGD (50.2 +/- 18.7 and 55.7 +/- 5.4, respectively) were significantly lower than those in TSAs (61.6 +/- 19.6 and 58.8 +/- 4.7, respectively) (IGF2 DMR0, P = 0.038; LINE-1, P = 0.024). CONCLUSION: IGF2 DMR0 hypomethylation may be an infrequent epigenetic alteration in the SSA pathway. Hypomethylation of IGF2 DMR0 and LINE-1 may play a role in TSA pathway progression. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

DOI PubMed

Association of microRNA-31 with BRAF mutation, colorectal cancer survival and serrated pathway

Katsuhiko Nosho, Hisayoshi Igarashi, Masanori Nojima, Miki Ito, Reo Maruyama, Shinji Yoshii, Takafumi Naito, Yasutaka Sukawa, Masashi Mikami, Wakana Sumioka, Eiichiro Yamamoto, Sei Kurokawa, Yasushi Adachi, Hiroaki Takahashi, Hiroyuki Okuda, Takaya Kusumi, Masao Hosokawa, Masahiro Fujita, Tadashi Hasegawa, Kenji Okita, Koichi Hirata, Hiromu Suzuki, Hiroyuki Yamamoto, Yasuhisa Shinomura

CARCINOGENESIS ( OXFORD UNIV PRESS )  35 ( 4 ) 776 - 783  2014.04  [Refereed]  [International journal]

　View Summary

High miR-31 expression was associated with BRAF mutation and unfavourable survival in CRCs. Moreover, miR-31 inhibitor exhibited antitumour effect in colon cancer cell line, suggesting that miR-31 may be a useful biomarker and therapeutic target in CRC.BRAF is an important gene in colorectal cancers (CRCs) that is associated with molecular characterization and resistance to targeted therapy. Although microRNAs (miRNAs) are useful biomarkers of various cancers, the association between miRNA and BRAF in CRCs is undefined. Therefore, this study was conducted to identify a relationship between specific miRNA molecules and BRAF mutation in CRCs and serrated lesions. miRNA array was used for the measurement of 760 miRNAs in 29 CRCs. To assess the identified miRNAs, quantitative reverse transcriptionPCR was performed on 721 CRCs, 381 serrated lesions and 251 non-serrated adenomas. Moreover, proliferation and invasion assays were conducted using cell lines. miRNA array analysis revealed that microRNA-31 (miR-31)-5p was the most up-regulated miRNA in CRCs with mutated BRAF (V600E) compared with CRCs possessing wild-type BRAF (including cases with KRAS mutation). High miR-31 expression was associated with BRAF and KRAS mutations and proximal location (P < 0.0001). High miR-31 expression was related to cancer-specific mortality [multivariate hazard ratio 2.06, 95% confidence interval: 1.363.09, P 0.0008]. Functional analysis demonstrated that miR-31 inhibitor decreased cell invasion and proliferation. With regard to serrated lesions, high miR-31 expression was less frequently detected in hyperplastic polyps compared with other serrated lesions. In conclusion, associations were identified between miR-31, BRAF and prognosis in CRC. Transfection of miR-31 inhibitor had an antitumour effect. Thus, miR-31 may be a promising diagnostic biomarker and therapeutic target in colon cancers. Moreover, high miR-31 expression in serrated lesions suggested that miR-31 may be a key molecule in serrated pathway.

DOI PubMed

Submucosal hematoma is a highly suggestive finding for amyloid light-chain amyloidosis: Two case reports.

Yoshii S, Mabe K, Nosho K, Yamamoto H, Yasui H, Okuda H, Suzuki A, Fujita M, Sato T

World journal of gastrointestinal endoscopy ( BAISHIDENG PUBLISHING GROUP INC )  4 ( 9 ) 434 - 437  2012.09  [Refereed]  [International journal]

　View Summary

The clinical and endoscopic features of amyloid lightchain (AL) amyloidosis are diverse and mimic various other diseases. Endoscopically, few reports on submucosal hematomas of the gastrointestinal (GI) tract are available in the literature. Here, we report two cases of AL amyloidosis presenting as submucosal hematomas in the absence of clinical disease elsewhere in the body. The 2 cases were referred to our hospital because of hematochezia. The endoscopic findings in both cases were similar in submucosal hematoma formation. However, the clinical courses differed. In the first case, there was no evidence of systemic amyloidosis and the disease was conservatively managed. In the second case, the disease progressed to systemic amyloidosis and the patient died within a short time. We conclude that the endoscopic detection of a submucosal hematoma in the setting of GI bleeding should raise suspicion of AL amyloidosis. Referral to a hematologist should be done immediately for treatment while the involvement is limited to the GI tract. (C) 2012 Baishideng. All rights reserved.

DOI PubMed