京都大学 · 医学
Takahiro Utsumi教授の研究室は、大腸がんの発症メカニズムの解明と、特にサージカル・ネオプラズム経路に注目した内視鏡的診断技術の高度化を主な研究テーマとしています。特に、sessile serrated lesions with dysplasia(SSLD)のような早期がん前駆病変の検出・評価に、Narrow-band imaging(NBI)やエンドオシトスコピーを応用したリアルタイム組織像診断の可能性を追求しています。また、内視鏡医の診断スキル、特にポリープサイズの推定に関する教育的支援の有効性についても実践的・教育的視点から研究を展開しています。
Figures are computed from collected data and may differ slightly.
The serrated neoplasia pathway constitutes an "alternative route" to colorectal cancer (CRC), and sessile serrated lesions with dysplasia (SSLDs) are an intermediate step between sessile serrated lesions (SSLs) and invasive CRC in this pathway. While SSLs show indolent growth before becoming dysplastic (> 10-15 years), SSLDs are considered to rapidly progress to either immunogenic microsatellite instable-high (MSI-H) CRC (presumably 75% of cases) or mesenchymal microsatellite stable (MSS) CRC. T
Narrow-band imaging (NBI) is a new imaging technology that was developed in 2006 and has since spread worldwide. Because of its convenience, NBI has been replacing the role of chromoendoscopy. Here we review the efficacy of NBI with/without magnification for detection, characterization, and management of colorectal polyps, and future perspectives for the technology, including education. Recent studies have shown that the next-generation NBI system can detect significantly more colonic polyps tha
Spontaneous regression (SR) has been reported in various malignant tumors. However, SR in colorectal cancer (CRC) is particularly rare and the mechanism remains unclear. We here report three cases of CRCs displaying SR, which were experienced at two institutions. Intriguingly, all of these cases displayed the common endoscopic characteristics; superficial elevated lesion accompanied by a central depression (0-IIa + IIc, in the Paris classification), with a nonpolypoid growth, located in the asce
Endocytoscopy showed a high diagnostic performance for differentiating between neoplastic and non-neoplastic colorectal diminutive polyps, and therefore has the potential to be used for "real-time histopathology".
Our educational video led to an improvement in polyp size estimation in beginners. Furthermore, this video may be useful for non-beginners with insufficient polyp size estimation accuracy.
Endoscopists with limited experience of colonoscopy in the past year were more likely to make frequent errors in size estimation. Furthermore, endoscopists making inaccurate size estimations had a propensity to overestimate polyp size.
Goal: This study investigated whether gastric hyperplastic polyps (GHPs) shrink after discontinuation of proton pump inhibitor (PPI) alone. Background: Long-term use of PPIs has been reported to increase the incidence of GHPs, which sometimes bleed and cause anemia. We experienced a patient whose recurrent hemorrhagic GHPs associated with long-term use of PPIs had disappeared after discontinuation of PPIs. Study: This study was conducted retrospectively at Kyoto University Hospital. Patients wit
Regardless of the findings of additional chromoendoscopy, all polyps should be resected and submitted for histopathological examination when the confidence level in differentiating adenomatous from hyperplastic polyps by magnifying NBI is low.
Polyp size, as well as the histology of colorectal polyps, is an essential factor in appropriate management. Western guidelines have recommended surveillance intervals according to the size, number, and histology of polyps.1, 2 In particular, adenomas with a diameter ≥10 mm are defined as advanced adenomas, and a shorter surveillance interval is recommended for patients with those adenomas. In Japan, the Colonoscopy Screening and Surveillance Guidelines of the Japan Gastroenterological Endoscopy
Utsumi, Takahiro; Horimatsu, Takahiro; Nishikawa, Yoshitaka; Seno, Hiroshi Author Information
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