基本情報
- 所属
- 自治医科大学 医学部外科学講座 消化器一般移植外科学部門 講師
- 学位
- 博士(医学)(2012年 弘前大学)
- 連絡先
- wakiya.taiichijichi.ac.jp
- 研究者番号
- 50571246
- ORCID ID
- https://orcid.org/0000-0003-3681-7736
- J-GLOBAL ID
- 202001018332988010
- Researcher ID
- F-4792-2015
- researchmap会員ID
- B000382357
研究分野
4経歴
1-
2022年10月
受賞
4論文
458-
PEDIATRIC TRANSPLANTATION 21(2) 2017年3月 査読有りThere is ongoing discussion regarding the indications and timing of LT for patients with a preexisting extrahepatic malignancy. We herein report a pediatric case that underwent LDLT after therapy for YST. The patient, a 13-year-old female with biliary atresia, had undergone portoenterostomy at 2 months of age. She developed a left ovarian tumor with a high serum alpha-fetoprotein concentration at 10 years of age. She underwent left oophorectomy and was diagnosed with ovarian YST (Stage I). After surgery, hepatopulmonary syndrome progressed gradually. She was examined carefully and exhibited no findings to suggest the recurrence of YST. We decided to perform LDLT at 3 years and 6 months of age after the surgery for YST. The patient is currently alive and doing well without recurrence of YST at approximately 2 years after transplantation. There is no significant difference between the recurrence rate of preexisting extrahepatic malignancy and the incidence of de novo malignancy if specific cases are selected. The indications and period from surgery for preexisting extrahepatic malignancy to LT should thus be determined according to the type and stage of cancer.
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Japanese Journal of Gastroenterological Surgery 50(8) 664-672 2017年 査読有りA 68-year-old man was admitted to our hospital with a diagnosis of resectable perihilar cholangiocarcinoma. In a preoperative indocyanine green (ICG) test, the ICG retention rate at 15 minutes (ICG R15) was more than 100%. Despite this finding, Child-Pugh classification and 99m-Tc-galactosyl-human serum albumin (GSA) liver scintigraphy did not show any abnormal findings and there was no background disease. Thus, we diagnosed constitutional ICG excretory defect and decided to perform radical surgery. We performed right hemihepatectomy extending to segment 1, extrahepatic bile duct resection and portal vein resection, and there were no postoperative complications. For patients requiring hepatectomy with this disease, it was concluded that the indications for surgery and the surgical procedure should be considered comprehensively, based on findings of liver function tests other than the ICG test, such as a general liver function test and GSA liver scintigraphy.
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Gan to kagaku ryoho. Cancer & chemotherapy 44(12) 1098-1100 2017年 査読有り
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ANTICANCER RESEARCH 37(1) 183-190 2017年1月 査読有りAim: The aim of this study was to examine the clinicopathological influence of tumor-infiltrating cluster of differentiation (CD) 163(+) macrophages and CD8(+) T-cells, and to clarify the prognostic effects of these cells in patients with invasive extrahepatic bile duct cancer (EHBC). Materials and Methods: The numbers of CD8(+) T-cells in cancer cell nests and CD163(+) macrophages in tumor stroma were evaluated using immunohistochemistry in 101 resected EHBC specimens. Correlations with clinicopathological variables and overall survival were analyzed. Results: Perihilar EHBC and perineural invasion were significantly associated with a low number of tumor-infiltrating CD8(+) T-cells. Poorly-differentiated histology and nodal metastasis were significantly associated with a high number of tumor-infiltrating CD163(+) macrophages. A combination of high number of CD8(+) T-cells and low number of CD163(+) macrophages was independently related to better overall survival in the whole patient cohort (hazard ratio=0.127, p<0.001) and in patients treated with adjuvant chemotherapy (hazard ratio=0.139, p=0.021). Conclusion: Infiltrating CD163(+) macrophages in tumor stroma and CD8(+) T-cells in cancer cell nests have a prognostic impact in patients with EHBC following resection and also after adjuvant chemotherapy.
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日本消化器外科学会雑誌 49(12) 1214-1221 2016年12月症例は65歳の女性で,2014年6月に前医で肝外胆管,総肝動脈,および膵頭部への浸潤を有する切除不能局所進行胆嚢癌の診断となり,gemcitabine+S-1併用療法が開始された.8コース施行後の腹部CTで上記浸潤所見が消失したため,2015年1月手術目的に当科紹介となった.拡大肝右葉切除術,肝外胆管切除術,総肝動脈合併切除術を施行し,病理組織学的診断は胆嚢体部を主座とする中〜高分化型管状線癌で,pT3N1M0,Stage IIIB,R0切除を達成した.S-1による術後補助化学療法を施行し,術後8ヵ月間の無再発生存が得られている.化学療法が奏効し非切除因子が消失した局所進行胆嚢癌の治療法について一定の見解は存在しない.しかし,conversion surgeryにより良好な予後を得られる可能性があり,化学療法中も外科的切除の可能性を定期的に追求することが重要であると思われた.(著者抄録)
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TRANSPLANTATION 100(7) S843-S843 2016年7月 査読有り
MISC
91共同研究・競争的資金等の研究課題
5-
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2021年4月 - 2024年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2018年4月 - 2021年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2016年4月 - 2020年3月
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日本学術振興会 科学研究費助成事業 若手研究(B) 2016年4月 - 2019年3月