JaLCDOI 10.18926/AMO/43825
フルテキストURL 65_1_11.pdf
著者 Kuwaki, Kenji| Nouso, Kazuhiro| Kobayashi, Yoshiyuki| Nakamura, Shinichiro| Ito, Yoichi M.| Iwadou, Shouta| Hagihara, Hiroaki| Yasunaka, Tetsuya| Toshimori, Junichi| Miyatake, Hirokazu| Miyoshi, Kenji| Onishi, Hideki| Miyake, Yasuhiro| Shoji, Bon| Takaki, Akinobu| Shiraha, Hidenori| Iwasaki, Yoshiaki| Kobashi, Haruhiko| Yamamoto, Kazuhide|
抄録 The purpose of this study was to build a prognostic model of hepatocellular carcinoma (HCC) using time-dependent covariates to re-evaluate the prognosis at any stage of the disease. The subjects were consecutive HCC patients who were treated at our institute between 1995 and 2007. We constructed time-fixed and time-dependent prognostic models with a training group (n=336) and compared the prognostic abilities between conventional Cancer of the Liver Italian Program (CLIP) scores, Japan Integrated Staging (JIS) scores, an Okuda classification, and our prognostic models in the testing group (n=227) with the c-index. The time-dependent prognostic model consisted of main tumor size, tumor number, portal vein invasion, distant metastasis, alpha-fetoprotein, des-gamma-carboxy prothrombin (DCP), bilirubin, and albumin and the weighted scores were set for each factor depending on the hazard ratio for the prognosis. The prognostic index was determined by summing the scores. The c-index values for the CLIP scores, JIS scores, Okuda classification, and our time-dependent model were 0.741, 0.727, 0.609, and 0.870, respectively. These results indicate that our time-dependent model can estimate the prognosis of HCC more precisely than traditional time-fixed models and can be used to re-predict the prognosis of HCC.
キーワード hepatocellular carcinoma humans prognosis proportional hazards models time factors
Amo Type Original Article
発行日 2011-02
出版物タイトル Acta Medica Okayama
65巻
1号
出版者 Okayama University Medical School
開始ページ 11
終了ページ 19
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2011 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 21339791
Web of Sience KeyUT 000287620500002
著者 Nakanishi, Yutaka| Shiraha, Hidenori| Nishina, Shin-ichi| Tanaka, Shigetomi| Matsubara, Minoru| Horiguchi, Shigeru| Iwamuro, Masaya| Takaoka, Nobuyuki| Uemura, Masayuki| Kuwaki, Kenji| Hagihara, Hiroaki| Toshimori, Junichi| Ohnishi, Hideki| Takaki, Akinobu| Nakamura, Shinichiro| Kobayashi, Yoshiyuki| Nouso, Kazuhiro| Yagi, Takahito| Yamamoto, Kazuhide|
発行日 2011-01-04
出版物タイトル BMC Cancer
11巻
資料タイプ 学術雑誌論文
著者 Tanaka, Shigetomi| Shiraha, Hidenori| Nakanishi, Yutaka| Nishina, Shin-Ichi| Matsubara, Minoru| Horiguchi, Shigeru| Takaoka, Nobuyuki| Iwamuro, Masaya| Kataoka, Junro| Kuwaki, Kenji| Hagihara, Hiroaki| Toshimori, Junichi| Ohnishi, Hideki| Takaki, Akinobu| Nakamura, Shinichiro| Nouso, Kazuhiro| Yagi, Takahito| Yamamoto, Kazuhide|
発行日 2012-12-01
出版物タイトル International Journal of Cancer
131巻
11号
資料タイプ 学術雑誌論文
著者 Kobayashi, Sayo| Nouso, Kazuhiro| Kinugasa, Hideaki| Takeuchi, Yasuto| Tomoda, Takeshi| Miyahara, Koji| Hagihara, Hiroaki| Kuwaki, Kenji| Onishi, Hideki| Nakamura, Shinichiro| Ikeda, Fusao| Miyake, Yasuhiro| Shiraha, Hidenori| Takaki, Akinobu| Yamamoto, Kazuhide|
発行日 2012-12
出版物タイトル Hepatology Research
42巻
12号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/51068
フルテキストURL 67_4_239.pdf
著者 Nakamura, Shinichiro| Nouso, Kazuhiro| Kobayashi, Yoshiyuki| Shiraha, Hidenori| Ohnishi, Hideki| Toshimori, Junichi| Kuwaki, Kenji| Hagihara, Hiroaki| Takayama, Hiroki| Yamamoto, Kazuhide|
抄録 The aim of this study was to evaluate the histologic diagnosis of hypovascular hepatic lesions showing hypointensity on hepatobiliary phase images of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI (EOB-MRI). In 38 patients with hepatocellular carcinoma (HCC) after curative treatments and 18 patients with liver cirrhosis, 105 hypovascular nodules that were hypointense at the hepatobiliary phase of EOB-MRI were biopsied and the clinical usefulness of these EOB-MRI findings for the diagnosis of HCC was examined. Of the 105 nodules (median diameter=12mm), 78 (74.3%), 11 (10.5%), and 16 (15.2%) were diagnosed as HCC, dysplastic, and non-neoplastic, respectively. The positive predictive value (PPV) of hypointensity at the hepatobiliary phase of EOB-MRI for the diagnosis of HCC increased to 77-90% when combined with the following factors: washout appearance on the delayed phase of triple-phase CT, hyperintensity in diffusion-weighted image of MRI, or the appearance of a hypoechoic part in ultrasonography. PPV increased to 100% when all 3 factors were positive. A relatively large proportion of hypovascular lesions that showed hypo-intensity in the hepatobiliary phase were confirmed to be HCC, and the accuracy of HCC increased when combined with other imaging findings.
キーワード hepatocellular carcinoma hypovascular diagnosis gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging
Amo Type Original Article
発行日 2013-08
出版物タイトル Acta Medica Okayama
67巻
4号
出版者 Okayama University Medical School
開始ページ 239
終了ページ 244
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23970322
Web of Sience KeyUT 000323470100005
著者 Nishimura, Mamoru| Takaki, Akinobu| Tamaki, Naofumi| Maruyama, Takayuki| Onishi, Hideki| Kobayashi, Sayo| Nouso, Kazuhiro| Yasunaka, Tetsuya| Koike, Kazuko| Hagihara, Hiroaki| Kuwaki, Kenji| Nakamura, Shinichiro| Ikeda, Fusao| Iwasaki, Yoshiaki| Tomofuji, Takaaki| Morita, Manabu| Yamamoto, Kazuhide|
発行日 2013-01-30
出版物タイトル Hepatology Research
43巻
10号
資料タイプ 学術雑誌論文
著者 Kinugasa, Hideaki| Nouso, Kazuhiro| Takeuchi, Yasuto| Yasunaka, Tetsuya| Onishi, Hideki| Nakamura, Shin-ichiro| Shiraha, Hidenori| Kuwaki, Kenji| Hagihara, Hiroaki| Ikeda, Fusao| Miyake, Yasuhiro| Takaki, Akinobu| Yamamoto, Kazuhide|
発行日 2012-04
出版物タイトル Journal of Gastroenterology
47巻
4号
資料タイプ 学術雑誌論文
著者 Takeuchi, Yasuto| Ikeda, Fusao| Moritou, Yuki| Hagihara, Hiroaki| Yasunaka, Tetsuya| Kuwaki, Kenji| Miyake, Yasuhiro| Ohnishi, Hideki| Nakamura, Shinichiro| Shiraha, Hidenori| Takaki, Akinobu| Iwasaki, Yoshiaki| Nouso, Kazuhiro| Yamamoto, Kazuhide|
発行日 2013-03
出版物タイトル Journal of Gastroenterology
48巻
3号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/56178
フルテキストURL 72_4_401.pdf
著者 Wada, Nozomu| Ikeda, Fusao| Mori, Chizuru| Takaguchi, Koichi| Fujioka, Shin-ichi| Kobashi, Haruhiko| Morimoto, Yoichi| Kariyama, Kazuya| Sakaguchi, Kosaku| Hashimoto, Noriaki| Moriya, Akio| Kawaguchi, Mitsuhiko| Miyatake, Hirokazu| Hagihara, Hiroaki| Kubota, Junichi| Takayama, Hiroki| Takeuchi, Yasuto| Yasunaka, Tetsuya| Takaki, Akinobu| Iwasaki, Yoshiaki| Okada, Hiroyuki|
抄録 Daclatasvir (DCV) + asunaprevir (ASV) combination therapy has become available for patients with hepatitis C virus (HCV) serogroup 1 infection. We studied the efficacy of this therapy by focusing on the factors associated with sustained virological responses (SVR) including resistance-associated variants (RAVs) and mixed infection of different HCV genotypes. We enrolled 951 HCV serogroup 1-positive patients who received this combination therapy at our hospital or affiliated hospitals. The presence of RAVs in non-structural (NS) regions 3 and 5A was analyzed by direct sequencing. HCV genotypes were determined by PCR with genotype-specific primers targeting HCV core and NS5B regions. SVR was achieved in 91.1% of patients. Female sex, age > 70 years, and RAVs were significantly associated with non-SVR (p<0.01 for all). Propensity score-matching results among the patients without RAVs regarding sex, age, and fibrosis revealed that mixed HCV infection determined by HCV NS5B genotyping showed significantly lower SVR rates than 1B-mono infection (p=0.02). Female sex and RAVs were significant factors associated with treatment failure of this combination therapy for patients with HCV serogroup 1 infection. Mixed HCV infection other than 1B-mono infection would be useful for predicting treatment failure.
キーワード mixed genotype daclatasvir asunaprevir HCV serogrouping 1 infection
Amo Type Original Article
発行日 2018-08
出版物タイトル Acta Medica Okayama
72巻
4号
出版者 Okayama University Medical School
開始ページ 401
終了ページ 406
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30140089
JaLCDOI 10.18926/AMO/56935
フルテキストURL 73_4_333.pdf
著者 Kuwaki, Kenji| Nouso, Kazuhiro| Miyashita, Manabi| Makino, Yasuhiro| Hagihara, Hiroaki| Moriya, Akio| Adachi, Takuya| Wada, Nozomu| Yasunaka, Yuki| Yasunaka, Tetsuya| Takeuchi, Yasuto| Onishi, Hideki| Nakamura, Shinichiro| Ikeda, Fusao| Shiraha, Hidenori| Takaki, Akinobu| Okada, Hiroyuki|
抄録 Steroids are often administered at the time of transcatheter arterial chemoembolization (TACE), a standard treatment of hepatocellular carcinoma (HCC), with the expectation of preventing postembolization syndrome. Here we investigated the precise effects of steroids on TACE. We prospectively enrolled 144 HCC patients from 10 hospitals who underwent TACE. Three hospitals used steroids (steroid group, n=77) and the rest did not routinely use steroids (control group, n=67). The occurrence of adverse events and the algetic degree at 1-5 days post-treatment were compared between the groups. Fever (grades 0-2) after TACE was significantly less in the steroid group (56/21/0) compared to the control group (35/29/3, p=0.005, Cochran-Armitage test for trend). The suppressive effect of steroids against fever was prominent in females (p=0.001). Vomiting (G0/G1/ G2-) was also less frequent in the steroid group (70/5/2) versus the control group (53/10/3), but not significantly (p=0.106). The algetic degree and the grade of hematological adverse events, including hyperglycemia, did not differ between the groups. We conclude that the administration of steroids was useful for the prevention of adverse events after TACE in patients with HCC.
キーワード antipyretic hepatocellular carcinoma therapeutic chemoembolization steroid
Amo Type Original Article
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
4号
出版者 Okayama University Medical School
開始ページ 333
終了ページ 339
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439956