辻　喜久

写真a

所属

医学部 総合診療医学講座

職名

教授
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  • 医学博士

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研究分野 【 表示 ／ 非表示 】

  • ライフサイエンス   消化器内科学  

  • ライフサイエンス   放射線科学  

  • ライフサイエンス   免疫学  

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researchmapの所属 【 表示 ／ 非表示 】

  • 滋賀医科大学   IR室   准教授   室長  

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研究キーワード 【 表示 ／ 非表示 】

  • 医学教育

  • 重症急性膵炎

  • 急性膵炎

  • Perfusion CT

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論文 【 表示 ／ 非表示 】

  • Impact of S‐1 adjuvant chemotherapy longer than 6 months on survival in patients with resected pancreatic cancer: a nationwide survey by the Japan Pancreas Society based on real‐world data

    Yoshito Tomimaru, Hidetoshi Eguchi, Yosuke Inoue, Yuichi Nagakawa, Akihiro Ohba, Hideki Takami, Michiaki Unno, Tomohisa Yamamoto, Shoji Kawakatsu, Tsuyoshi Hayashi, Ryota Higuchi, Hirohisa Kitagawa, Satoshi Hattori, Tsutomu Fujii, Yoshiki Hirooka, Hisato Igarashi, Masayuki Kitano, Tamotsu Kuroki, Atsushi Masamune, Yasuhiro Shimizu, Masaji Tani, Satoshi Tanno, Yoshihisa Tsuji, Hiroki Yamaue, Sohei Satoi, Yoshifumi Takeyama

    Cancer ( Wiley )  129 ( 5 ) 728 - 739  2022年12月  [査読有り]

    DOI

  • Estimated tumor blood flow as a predictive imaging indicator of therapeutic response in pancreatic ductal adenocarcinoma: use of three-phase contrast-enhanced computed tomography.

    Hiromitsu Maehira, Yoshihisa Tsuji, Hiroya Iida, Haruki Mori, Nobuhito Nitta, Takeru Maekawa, Sachiko Kaida, Toru Miyake, Masaji Tani

    International journal of clinical oncology   27 ( 2 ) 373 - 382  2022年02月  [国内誌]

    　概要を見る

    BACKGROUND: Preoperative chemotherapy or chemoradiotherapy is a common strategy for treating pancreatic ductal adenocarcinoma (PDAC). This study aimed to assess the association between the therapeutic response in PDAC and tumor blood circulation. METHODS: The medical records of patients who underwent chemotherapy or chemoradiotherapy prior to pancreatectomy for PDAC were reviewed. Of these, patient data that included three-phase contrast-enhanced computed tomography (CECT) findings before treatments were used in this study. We evaluated the estimated tumor blood flow (eTBF) using CECT. According to the therapeutic histopathological response defined by the Evans classification, patients were divided into poor (grade I/IIa) and good (grade IIb/III/IV) responder groups. The variables, including eTBF, were compared between the two groups. RESULTS: Thirty patients were enrolled in this study. Of these, 13 (43.3%) (grade IIB/III/IV: 8/4/1 patients) were categorized into the good responder group and 17 patients (56.7%) (grade I/IIA: 4/13 patients) were categorized into the poor responder group. eTBF was significantly higher in the good responder group (0.39 s-1 vs. 0.32 s-1, p = 0.007). An eTBF ≥ 0.36 s-1 was found to be an independent predictive factor for the destruction of over 50% of tumor cells (p = 0.036; odds ratio, 9.71; 95% confidence interval, 1.16-81.30). CONCLUSIONS: eTBF can be used to predict the therapeutic histopathological response in PDAC prior to treatment.

    DOI PubMed

  • The clinical efficacy of azathioprine as maintenance treatment for autoimmune pancreatitis: a systematic review and meta-analysis.

    Yoshiharu Masaki, Hiroshi Nakase, Yoshihisa Tsuji, Masanori Nojima, Kyoko Shimizu, Nobumasa Mizuno, Tsukasa Ikeura, Kazushige Uchida, Akio Ido, Yuzo Kodama, Hiroshi Seno, Kazuichi Okazaki, Seiji Nakamura, Atsushi Masamune

    Journal of gastroenterology   56 ( 10 ) 869 - 880  2021年10月  [国内誌]

    　概要を見る

    The effectiveness of azathioprine (AZA) in preventing relapse and maintaining autoimmune pancreatitis (AIP) remission has been reported; however, most of these studies are case series with no randomized control trials available in the literature. Therefore, this study performed a systematic review and meta-analysis of the existing literature on this subject to determine the clinical efficacy of AZA as maintenance therapy for AIP patients. A systematic search was performed to identify studies on the clinical efficacy of AZA as maintenance therapy in AIP patients. The crude multiple relapse rate was estimated to assess the ability of AZA to control relapses in AIP. Pooled estimates were obtained using a random-effects model with the DerSimonian-Laird method. We identified AIP patients who did not respond to initial steroid treatment, experienced steroid weaning failure, or those who relapsed during remission as refractory cases. After reviewing the studies, ten articles fulfilled the inclusion criteria and were selected for meta-analysis. Of all 4504 patients, 3534 patients were treated with steroids, and 346 patients were treated with AZA for relapsed AIP. In this meta-analysis, 14/73 (19.2%) patients receiving AZA for refractory AIP relapsed. Meanwhile, 14/47 (29.8%) patients without AZA experienced relapse. The integrated odds ratio for relapse risk in patients receiving AZA was estimated to be 0.52 (p = 0.15). This systematic review and meta-analysis demonstrated the efficacy of AZA in preventing relapse of AIP, which supports the use of AZA as a maintenance treatment in patients with AIP who relapse upon withdrawal of steroid therapy.

    DOI PubMed

  • Reducing the risk of developing walled-off necrosis in patients with acute necrotic collection using recombinant human soluble thrombomodulin.

    Takaaki Eguchi, Yoshihisa Tsuji, Akihiko Okada, Dai Inoue, Hironobu Tokumasu, Kosuke Iwane, Yoshitaka Nakai, Toshihiro Kusaka, Yoshito Uenoyama, Koichi Fujita, Masataka Yokode, Yukimasa Yamashita, Yugo Sawai, Masanori Asada, Takao Mikami, Chiharu Kawanami, Yasushi Kudo, Shujiro Yazumi, Tsuyoshi Sanuki, Arata Sakai, Toshihiro Morita, Yojiro Sakuma, Norimitsu Uza, Yutaka Takada, Toshinao Itani, Katsutoshi Kuriyama, Kazuyoshi Matsumura, Kazuki Ikeda, Hitoshi Someda, Eiji Funatsu, Shinji Katsushima, Yuzo Kodama, Hiroshi Seno

    Journal of hepato-biliary-pancreatic sciences   28 ( 9 ) 788 - 797  2021年06月  [国内誌]

    　概要を見る

    BACKGROUND/PURPOSE: The purpose of the present study was to investigate the possibility of reducing clinical impacts of acute necrotic collection (ANC) on patients with acute pancreatitis (AP) using recombinant human soluble thrombomodulin (rTM). METHODS: In this retrospective multicenter study, 233 consecutive AP patients with ANC and acute peripancreatic fluid collection (APFC) from 2012 to 2016 were enrolled. To assess clinical impacts of ANC, severity on admission (JPN score, JPN CT grade, and Modified CT severity index), development of walled-off necrosis (WON), imaging costs for follow-up, and mortality were recorded. Finally, we investigated whether rTM could reduce the clinical impacts, adjusting the severity using propensity analysis with Inverse probability of treatment weighting. RESULTS: Patients with ANC developed WON with higher ratio than APFC (58/98 [59.2%] vs 20/135 [14.8%], OR = 8.3, P < .01]. Severity on admission and imaging costs for follow-up in ANC patients were significantly higher than those in APFC (P < .01). However, regarding mortality, there was no significant difference between patients with ANC and APFC (P = .41). Adjusting severity, it was revealed that rTM administration significantly reduced the risk of ANC developed WON (OR = 0.23, P = .01). CONCLUSIONS: While ANC had a higher clinical impact than that of APFC, we found that early administration of rTM may reduce the impact.

    DOI PubMed

  • Optimal Treatment for Octogenarians With Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: A Multicenter Retrospective Study.

    Sohei Satoi, Tomohisa Yamamoto, Kazushige Uchida, Tsutomu Fujii, Toshifumi Kin, Satoshi Hirano, Keiji Hanada, Takao Itoi, Yoshiaki Murakami, Hisato Igarashi, Hidetoshi Eguchi, Tamotsu Kuroki, Yasuhiro Shimizu, Masaji Tani, Satoshi Tanno, Yoshihisa Tsuji, Yoshiki Hirooka, Atsushi Masamune, Toshio Shimokawa, Hiroki Yamaue, Kazuichi Okazaki

    Pancreas   49 ( 6 ) 837 - 844  2020年07月  [国際誌]

    　概要を見る

    OBJECTIVES: The objective of this study was to clarify the role of pancreatectomy for patients with resectable and borderline resectable pancreatic ductal adenocarcinoma aged 80 years or older using a nationwide audit by the Japan Pancreas Society. METHODS: Data were collected from 39 institutions from 2007 to 2014. The primary endpoint was overall survival, and secondary endpoints were surgical outcomes and predictive factors for prognosis. RESULTS: Data were obtained from 556 octogenarians who underwent pancreatectomy (n = 369, 66%), chemo(radio)therapy (n = 99, 18%), and palliative therapy (n = 88, 16%). Median survival times were 20.6, 18.6, and 8.8 months in each group, respectively. Even after propensity score matching, median survival time in the surgery group (22.8 months) was significantly higher than that in the chemotherapy group (18.5 months; hazard ratio, 0.64 [95% confidence interval, 0.44-0.93]; P = 0.020). Significant independent prognostic factors were body mass index, lymph node metastasis, and tumor diameter in the surgery group, and serum albumin level, American Society of Anesthesiologists classification, body mass index, modified Glasgow prognostic score, second-line chemotherapy, and tumor diameter in the chemotherapy group. CONCLUSIONS: Octogenarians with resectable/borderline resectable pancreatic ductal adenocarcinoma can be recommended for pancreatectomy according to mental and physical fitness for surgical procedures.

    DOI PubMed

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Misc 【 表示 ／ 非表示 】

  • 造影ダイナミックCTとフッ素18フルオロミソニダゾール陽電子放出断層撮像法を用いた、腫瘍間質の評価および腫瘍低酸素との関連性の評価

    子安 翔, 辻 喜久, 原田 浩, 中本 裕士, 野橋 智美, 木村 寛之, 佐野 紘平, 小泉 幸司, 濱路 政嗣, 富樫 かおり

    JSMI Report ( 日本分子イメージング学会 )  10 ( 1 ) 63 - 66  2016年12月

  • 造影ダイナミックCTとフッ素18フルオロミソニダゾール陽電子放出断層撮像法を用いた、腫瘍間質の評価および腫瘍低酸素との関連性の評価

    子安 翔, 辻 喜久, 原田 浩, 中本 裕士, 野橋 智美, 木村 寛之, 佐野 紘平, 小泉 幸司, 濱路 政嗣, 富樫 かおり

    核医学 ( (一社)日本核医学会 )  53 ( Suppl. ) np2 - np3  2016年10月

  • Chemokine CXCL16 Plays a Critical Role in the Development of Severe Acute Pancreatitis

    Yojiro Sakuma, Yuzo Kodama, Tomoaki Matsumori, Teruko Tomono, Nobuyuki Kakiuchi, Atsushi Mima, Yuki Yamauchi, Yoshihiro Nishikawa, Motoyuki Tsuda, Tatsuki Ueda, Katsutoshi Kuriyama, Takahisa Maruno, Yuji Ota, Masahiro Shiokawa, Yoshihisa Tsuji, Norimitsu Uza, Tomohiro Watanabe, Hiroshi Nakase, Hiroshi Seno, Tsutomu Chiba

    GASTROENTEROLOGY ( W B SAUNDERS CO-ELSEVIER INC )  150 ( 4 ) S327 - S327  2016年04月

    研究発表ペーパー・要旨（国際会議）  

  • 造影ダイナミックCTとフッ素<sup>18</sup>フルオロミソニダゾール陽電子放出断層撮像法を用いた,腫瘍間質の評価および腫瘍低酸素との関連性の評価

    子安翔, 辻喜久, 原田浩, 中本裕士, 野橋智美, 木村寛之, 佐野紘平, 小泉幸司, 濱路政嗣, 富樫かおり

    核医学(Web)   53 ( Supplement )  2016年

    J-GLOBAL

  • 発症早期の集学的治療は、Walled-off necrosisに対する侵襲的治療の必要性を減ずる

    森田 敏広, 辻 喜久, 児玉 裕三

    日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  112 ( 臨増大会 ) A555 - A555  2015年09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 】

  • ナトリウム利尿ペプチドを用いた非アルコール性脂肪性肝疾患の新規診断治療の開発

    基盤研究(C)

    研究期間:

    2022年04月
    -
    2025年03月
     

    市来 智子, 辻 喜久, 沼田 泰尚, 佐々木 茂

  • マウスPerfusion CTによる膵腫瘍線維化の定量的測定系の確立

    研究活動スタート支援

    研究期間:

    2013年08月
    -
    2015年03月
     

    辻 喜久

    　研究概要を見る

    本年度の結果の意義として、小動物に関する腫瘍の線維化の非侵襲的な測定系は未だ未確立であるが、マウスでPerfusion CTによる線維化の測定ができるようになると分子学的検討や遺伝子学的検討が大変しやすくなることがあげられる。例えば、Perfusion CTを膵癌患者さんに応用し、膵癌の質的変化を正確に観察できれば、正確な分子標的薬剤の効果判定が可能となり、適切な抗がん剤投与の継続・中止の判断を可能とし予後改善に結びつくと考えられる。

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委員歴 【 表示 ／ 非表示 】

  • 2017年04月
    -
    継続中

      急性膵炎分科会委員

  • 2014年04月
    -
    2016年04月

      研究協力者

  • 2013年11月
    -
    継続中

      Member of DDW abstract review comitee

  • 　
    -
    継続中

      膵疾患臨床研究促進委員会委員

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