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| 1.
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論文
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Kobayashi, Mio ; Kakuda, Yuko ; Harada, Kenichi ; Sato, Yasunori ; Sasaki, Motoko ; Ikeda, Hiroko ; Terada, Mitsuhiro ; Mukai, Munenori ; Kaneko, Shuichi ; Nakanuma, Yasuni ; 小林, 水緒 ; 原田, 憲一 ; 佐藤, 保則 ; 佐々木, 素子 ; 池田, 博子 ; 金子, 周一 ; 中沼, 安二
概要:
金沢大学医薬保健研究域医学系<br />AIM: To investigate histological and immunohistochemical differences in hepatitis between autoimmune
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hepatitis (AIH) and primary biliary cirrhosis (PBC) with AIH features. METHODS: Liver needle biopsies of 41 PBC with AIH features and 43 AIH patients were examined. The activity of periportal and lobular inflammation was scored 0 (none or minimal activity) to 4 (severe), and the degree of hepatitic rosette formation and emperipolesis was semiquantatively scored 0-3. The infiltration of mononuclear cells positive for CD20, CD38, CD3, CD4, and CD8 and positive for immunoglobulins (IgG, IgM, and IgA) at the periportal areas (interface hepatitis) and in the hepatic lobules (lobular hepatitis) were semiquantitatively scored in immunostained liver sections (score 0-6). Serum aspartate aminotransferase (AST), immunoglobulins, and autoantibodies at the time of liver biopsy were correlated with the histological and immunohistochemical scores of individual lesions. RESULTS: Lobular hepatitis, hepatitic rosette formation, and emperipolesis were more extensive and frequent in AIH than in PBC. CD3+, CD4+, and CD8+ cell infiltration scores were higher in the hepatic lobules and at the interface in AIH but were also found in PBC. The degree of mononuclear cell infiltration correlated well with the degree of interface and lobular hepatitis in PBC, but to a lesser degree in AIH. CD20+ cells were mainly found in the portal tracts and, occasionally, at the interface in both diseases. Elevated AST correlated well with the hepatocyte necroinflammation and mononuclear cell infiltration, specifically CD38+ cells in PBC. No correlation existed between autoantibodies and inflammatory cell infiltration in PBC or AIH. While most AIH cases were IgG-predominant at the interface, PBC cases were divided into IgM-predominant, IgM/IgGequal, and IgG-predominant types, with the latter sharing several features with AIH. CONCLUSION: These results suggest that the hepatocellular injuries associated with interface and lobular hepatitis in AIH and PBC with interface hepatitis may not be identical. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
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| 2.
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Onishi, Ichiro ; Kitagawa, Hirohisa ; Harada, Kenichi ; Maruzen, Syogo ; Sakai, Seisyo ; Makino, Isamu ; Hayashi, Hironori ; Nakagawara, Hisatoshi ; Tajima, Hidehiro ; Takamura, Hiroyuki ; Fujimura, Takashi ; Kayahara, Masato ; Ikeda, Hiroko ; Ohta, Tetsuo ; Nakanuma, Yasuni ; 北川, 裕久 ; 原田, 憲一 ; 牧野, 勇 ; 林, 泰寛 ; 中川原, 寿俊 ; 田島, 秀浩 ; 高村, 博之 ; 藤村, 隆 ; 萱原, 正都 ; 池田, 博子 ; 太田, 哲生 ; 中沼, 安二
概要:
金沢大学医薬保健研究域医学系<br />We present the first case of an intraductal papillary neoplasm of the bile duct (IPNB) accompanying
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a mixed adenoneuroendocrine carcinoma (MANEC). A 74-yearold woman presented with fever of unknown cause. Laboratory data revealed jaundice and liver injury. Contrast-enhanced computed tomography revealed a 20 mm polypoid tumor in the dilated distal bile duct, which exhibited early enhancement and papillary growth. Upper gastrointestinal endoscopy revealed mucus production from the papilla of Vater, characterized by its protruding and dilated orifice. Endoscopic ultrasonography visualized the polypoid tumor in the distal bile duct, but no invasive region was suggested by diagnostic imaging. Therefore, the initial diagnosis was IPNB. After endoscopic nasobiliary drainage, a pylorus-preserving pancreaticoduodenectomy was performed. Pathological examination of the resected bile duct revealed papillary proliferation of biliary-type cells with nuclear atypia, indicating pancreaticobiliary-type IPNB. In addition, solid portions comprised of tumor cells with characteristic salt-and-pepper nuclei were evident. Immunohistochemistry revealed expression of the neuroendocrine marker synaptophysin in this solid component, diagnosing it as a neuroendocrine tumor (NET). Furthermore, the MIB-1 proliferation index of NET was higher than that of IPNB, and microinvasion of the NET component was found, indicating neuroendocrine carcinoma (NET G3). This unique case of MANEC, comprising IPNB and NET, provides insight into the pathogenesis of biliary NET. © 2013 Baishideng. All rights reserved.
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| 3.
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Wakisaka, Naohiro ; Endo, Kazuhira ; Kitazawa, Tomohiro ; Shimode, Yuzo ; Kato, Koroku ; Moriyama-Kita, Makiko ; Koda, Wataru ; Ikeda, Hiroko ; Ishikawa, Kazuya ; Ueno, Takayoshi ; Nakanishi, Yosuke ; Kondo, Satoru ; Sugimoto, Hisashi ; Yoshimura, Kenichi ; Tsujii, Hiroyuki ; Kawashiri, Shuichi ; Omoto, Kiyoshi ; Yoshizaki, Tomokazu ; 脇坂, 尚宏 ; 遠藤, 一平 ; 加藤, 広禄 ; 喜多, 万紀子 ; 香田, 渉 ; 池田, 博子 ; 石川, 和也 ; 上野, 貴雄 ; 中西, 庸介 ; 近藤, 悟 ; 杉本, 寿史 ; 吉村, 健一 ; 川尻, 秀一 ; 吉崎, 智一
概要:
金沢大学医薬保健研究域医学系<br />Background: In sentinel lymph node (SLN) biopsy for head and neck cancers, the radioisotope method h
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as been the gold standard. However, this method has several problems, such as unavoidable radiation exposure and requirements of expensive equipment. Aims/Objectives: To overcome these problems, we evaluated the contrast-enhanced ultrasonography (CEUS)-guided SLN-detection method, and predicted the SLN metastatic status using novel ultrasound technology, superb microvascular imaging (SMI). Methods: Ten patients (6 with oral and 4 with oropharyngeal cancers) without neck lymph node metastasis were enrolled in this study. Ultrasound contrast agent, Sonazoid ™ , was infiltrated into the mucosa at the primary site to observe the lymphatic ducts and SLNs in the neck field. The detected SLNs were examined for blood flow using SMI to categorize the SLNs metastases-positive or negative. Results: SLNs were successfully detected in 8 out of 10 cases. In 7 out of the 8 cases, in whom SLNs were successfully detected, the metastatic status of SLNs was correctly diagnosed with SMI. Conclusions and significance: Although more clinical data are needed based on a larger cohort, establishing the CEUS-guided SLN-detection and criteria for the accurate diagnosis of SLN-metastases using SMI would be valuable as an alternative to radioisotope method, in oral and oropharyngeal cancers. © 2019, © 2019 Acta Oto-Laryngologica AB (Ltd).<br />Embargo Period 12 months<br /># This study was approved by the Bioethics Committee of Kanazawa University (Nos.2016-037 and 2017-015). The clinical study protocol was explained in detail to patients eligible for the study. Written consent was obtained from all patients who agreed to participate.# This work was supported by a grant-in-aid from The Public Trust Fund For Clinical Cancer Research.
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| 4.
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池田, 博子 ; Ikeda, Hiroko
概要:
近年，日本国民の約2人に1人は生涯のうちにがんに罹患すると推計されている．日本ではがん対策基本法に基づき，癌に対する取り組みが進められている．1990年に始まったヒトゲノム計画ではヒト1人分の全ゲノム解析に，13年の歳月と30億ドルの費用を
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要していたが，目覚ましい技術進歩により，2016年には解析期間は1週間以下にまで短縮し，費用は約1000ドルにまで低廉化してきた．こうした技術革新により，次世代シークエンシング法 (next-generation sequencing; NGS) を用いたゲノム解析が，研究のみならず，患者の診断･治療といった診療にも拡がってきている．政府はがんゲノム医療の計画的な推進を提唱し，2017年には厚生労働省主導のがんゲノム医療推進コンソーシアム懇談会が立ち上げられ，当該医療の推進に必要な薬事承認や保険適用の制度設計などが議論されている1)． 悪性腫瘍の病理組織・細胞検体を用いた体細胞遺伝子検査は急増しており，今後は次世代シークエンシング法 (NGS) などの新規技術を用いたゲノム診断 (遺伝子パネル検査) の臨床導入が見込まれている．日常の病理組織診断では，生検もしくは手術などにより採取･切除された組織のホルマリン固定パラフィン包埋 (formalin-fixed, paraffin-embedded; FFPE) 検体が主として用いられ，形態診断に加え，核酸やタンパクなどの検索を目的とした分子診断に供される．ゲノム解析では生体内環境に近い新鮮検体の利用が望ましいが，現況では治療法選択などにおいて腫瘍の病理診断は必須である．今後は形態診断，免疫組織化学法を用いた分子診断，ゲノム診断，いずれの利用にも耐えうる一定水準以上の病理検体の品質が求められるようになり，病理検査室ではその対応が急務となっている． 本稿では，がんゲノム医療の国内動向と遺伝子パネル検査の現状を概説し，ゲノム診療，研究のための病理組織検体取扱い規定を紹介する．
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| 5.
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池田, 博子 ; Ikeda, Hiroko
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| 6.
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池田, 博子 ; Ikeda, Hiroko ; イケダ, ヒロコ
概要:
取得学位 : 博士（医学）, 学位授与番号 : 医博甲第1878号 , 学位授与年月日 : 平成19年6月30日, 学位授与大学 : 金沢大学, 主査教授 : 大井 章史, 副査教授 : 金子 周一 , 清水 徹
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| 7.
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Tajima, Hidehiro ; Takamura, Hiroyuki ; Kitagawa, Hirohisa ; Nakayama, Akira ; Shoji, Masatoshi ; Watanabe, Toshifumi ; Tsukada, Tomoya ; Nakanuma, Shinichi ; Okamoto, Koichi ; Sakai, Seisho ; Kinoshita, Jun ; Makino, Isamu ; Nakamura, Keishi ; Hayashi, Hironori ; Oyama, Katsunobu ; Inokuchi, Masafumi ; Nakagawara, Hisatoshi ; Miyashita, Tomoharu ; Ninomiya, Itasu ; Fushida, Sachio ; Fujimura, Takashi ; Wakayama, Tomohiko ; Iseki, Shoichi ; Ikeda, Hiroko ; Ohta, Tetsuo ; 田島, 秀浩 ; 高村, 博之 ; 北川, 裕久 ; 中村, 信一 ; 岡本, 浩一 ; 木下, 淳 ; 牧野, 勇 ; 中村, 慶史 ; 林, 泰寛 ; 尾山, 勝信 ; 井口, 雅史 ; 中川原, 寿俊 ; 宮下, 知治 ; 二宮, 致 ; 若山, 友彦 ; 藤村, 隆 ; 井関, 尚一 ; 池田, 博子 ; 太田, 哲生
概要:
金沢大学医薬保健研究域医学系<br />A 33-year-old female was diagnosed with a solid pseudopapillary tumor (SPT) of the pancreas and mult
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iple liver metastases at the Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital (Kanazawa, Japan). Distal pancreatectomy and postoperative systemic chemotherapy with gemcitabine (GEM) and S-1, an oral fluoropyrimidine derivative, was administered, however, liver metastases became enlarged and local recurrence occurred. Therefore, the patient was referred to the Department of Gastroenterologic Surgery at the Graduate School of Medicine (Kanazawa, Japan) for hepatic arterial infusion (HAI) chemotherapy. Oral S-1 (80 mg/m2) was administered as well as HAI chemotherapy with GEM (1,000 mg/standard liver volume). Following 18 cycles, tumor sizes were reduced and 18-fluorodeoxyglucose positron emission tomography (18FDG-PET) examination revealed obvious reduction of tumor FDG uptake. Transarterial tumor embolization (TAE) was performed for the previously unresectable right subphrenic liver tumor, and the other tumors were surgically resected. The resected tumors were diagnosed as liver metastases and a local recurrence of SPT in the postoperative pathological examination, which revealed that the resected tumors were composed of sheets of bland cells, which were positive for CD10, CD56, vimentin, neuron-specific enolase and α-antitrypsin. The postoperative course was uneventful, and the patient is currently under observation at an outpatient clinic; postoperative adjuvant chemotherapy with oral S-1 has continued, and additional TAE is planned. In the future, if the middle segment of the liver becomes enlarged, surgery for the residual right lobe tumor may be possible. This case demonstrates one method of SPT treatment: Preoperative HAI chemotherapy with GEM, plus oral S-1 and TAE. If complete resection can be achieved, the majority of patients with SPT have a favorable prognosis. In patients with unresectable metastases from SPT, it is crucial to conduct systematic multimodal treatment to maximize treatment success. © 2015, Spandidos Publications. All Rights Reserved.<br />Embargo Period 6 months
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| 8.
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池田, 博子 ; Ikeda, Hiroko
概要:
ラットやマウスなどの動物研究ではDelta-like protein(DLK)-1が肝プロジェニター/ステム細胞に発現していると報告されており,一方で肝線維化に関連することが知られている肝星細胞でのDLK1発現が文献的に報告されている.ヒト
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肝組織におけるDLK1発現を分子病理学的に解析した.その結果, DLK1はステム細胞関連と推察される腫瘍で発現しており, DLK1が肝癌ステム細胞のマーカーとなりうる分子であることを解明した.<br />The expression of Delta-like protein(DLK)-1 in hepatic progenitor/stem cell has been known in animal experiments, whereas the upregulation of DLK1 in hepatic stellate cells has been reported and implied relation to fibrosis. I examined the expression of DLK1 in human tissue. As results, The expression of DLK1 was demonstrated in liver cancer associated with stem-cell origin. It was suggested that DLK1 could be cancer stem-cell marker of the liver.<br />研究課題/領域番号:22790341, 研究期間(年度):2010-2011
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| 9.
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池田, 博子 ; Ikeda, Hiroko
概要:
細胞老化は不可逆的な細胞周期の停止として定義されており、前癌病変におけるセネッセンス細胞の出現およびセネッセンスからの回避機序は腫瘍発生初期段階での重要なステップであると考えられている。分子病理学的に検討の結果、ヒト肝組織では肝硬変でセネッ
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センス関連マーカー発現細胞が出現し、肝ディスプラジア結節では消失していた。肝硬変は肝細胞癌の前癌病変である可能性が示唆された。<br />Cellular senescence is defined as the irreversible arrest of cell cycle. Senescence in premalignant lesion and escape from senescence are thought to be important the early stage of tumoriogenesis. Senescence-associated markers are observed in cirrhotic liver and the markers disappear in dysplastic nodules. The results imply that the cirrhotic state already might to be premalignancy.
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