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| 1 | Current clinical management of gastrointestinal stromal tumor显示文摘Gastrointestinal stromal tumors(GISTs) are the most common malignant subepithelial lesions(SELs) of the gastrointestinal tract. They originate from the interstitial cells of Cajal located within the muscle layer and are characterized by over-expression of the tyrosine kinase receptor KIT. Pathologically, diagnosis of a GIST relies on morphology and immunohistochemistry [KIT and/or discovered on gastrointestinal stromal tumor 1(DOG1) is generally positive]. The prognosis of this disease is associated with the tumor size and mitotic index. The standard treatment of a GIST without metastasis is surgical resection. A GIST with metastasis is usually only treated by tyrosine kinase inhibitors without radical cure; thus, early diagnosis is the only way to improve its prognosis. However, a GIST is usually detected as a SEL during endoscopy, and many benign and malignant conditions may manifest as SELs. Conventional endoscopic biopsy is difficult for tumors without ulceration. Most SELs have therefore been managed without a histological diagnosis. However, a favorable prognosis of a GIST is associated with early histological diagnosis and R0 resection. Endoscopic ultrasonography(EUS) and EUS-guided fine needle aspiration(EUSFNA) are critical for an accurate diagnosis of SELs. EUSFNA is safe and effective in enabling an early histological diagnosis and adequate treatment. This review outlines the current evidence for the diagnosis and management of GISTs, with an emphasis on early management of small SELs. | Kazuya Akahoshi Masafumi Oya Tadashi Koga Yuki Shiratsuchi | 2018 | World Journal of Gastroenterology2018，24，26： | 70 |
| 2 | Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration显示文摘瞄准:在胃肠的基质肿瘤(大意) 的外科手术前的诊断评估内视镜的指导 ultrasonography 的好针渴望(EUS-FNA ) 的角色。方法:从 2002 年 9 月到 2006 年 6 月,有到合适的肌肉层的连续性的上皮的低亚硫酸钠拟声肿瘤由标准 EUS 作为大意怀疑了的官方补给的道潜水艇的 53 连续 EUS-FNAs 有希望地被评估。为最后的诊断的参考标准是外科(n = 31 ) ,或临床的后续(n = 22 ) 。另外,标本的免疫 phenotyping 由 EUS-FNA 获得了,外科的切除术标本被比较。结果:因为解剖问题,没在 2 情况刺被执行。从官方补给的道的足够的标本的收集率与连续性代替上皮的低亚硫酸钠拟声肿瘤到合适的肌肉层是 82%(42/51 ) 。为肿瘤的诊断的率不到 2 厘米, 2 ~ 4 厘米,和 4 厘米或更多是 71%(15/21 ) , 86%(18/21 ) ,并且 100%(9/9 ) 分别地。在 29 通过手术用免疫的 EUS-FNA 的 resected 盒子,敏感,特性,积极预兆的价值,否定预兆的价值,和诊断精确性大意的组织化学的分析是100%( 24/24 ),80%( 4/5 ),96%( 24/25 ),100%( 4/4 ),并且97%( 28/29 )分别地。没有主要复杂并发症被遇到。结论:有免疫的 EUS-FNA 组织化学的分析是在大意的 prethera-peutic 诊断的一个安全、精确的方法。它应该在决策被考虑,特别在跟随为大意的最小的侵略外科的早诊断。 | Kazuya Akahoshi Yorinobu Sumida Noriaki Matsui Masafumi Oya Rie Akinaga Masaru Kubokawa Yasuaki Motomura Kuniomi Honda Masayuki Watanabe Takashi Nagaie | 2007 | World Journal of Gastroenterology2007，13，14： | 34 |
| 3 | Extremely well-differentiated adenocarcinoma of the stomach: Clinicopathological and immunohistochemical features显示文摘瞄准:否则作为极其区分得好的腺癌(EWDA ) 知道,子宫的宫颈的最小的偏差癌被它的良性的显微镜的外观与它的好攻击的行为相对照描绘。以便阐明 clinicopathological 特征和 EWDA 的胃的对应物的生物行为,用免疫组织化学,我们为联系 oncogene 的产品的表型的表示,增生的活动,和表示分析了九损害。方法:包括外科手术前的活体检视诊断, Clinicopathological 特征被考察。用免疫组织化学,在胃的损害把 p53 和 c-erbB-2 蛋白质的索引和表示标记的 Ki-67 被检测。结果:在中间的地点或上面第三个胃和水虫息似的宏观的特征胃的 EWDA 是特征的。尽管 9 损害中的 4 个显示出仅仅焦点的淋巴或静脉的侵略,淋巴节点转移不是现在,任何一个都没损害死于病人(吝啬的后续时期, 56 瞬间) 。EWDA 的所有 9 个盒子能被分类进胃的显型(5 损害) 和肠的显型(4 损害) 。以前的类似于的胃的小凹的上皮,颈部粘液细胞或幽门的腺,而是他们的乳突的结构经常被伸长,肿瘤房间和他们的原子核稍微更大并且更亢奋与正常上皮相比色彩。后者与最小的原子非典型和不规则的腺类似于肠的组织变形;二这些损害表明了完全的肠的显型,当二表明了不完全的肠的显型时。把索引标记的 Ki-67 是低的,任何一个都没盒子揭示 p53 和 c-erbB-2 蛋白质的在表示上。结论:不同于宫颈的最小的偏差癌,这些调查结果建议胃的 EWDA 是低档恶意的损害。这有利生物行为被把索引和 p53 或 c-erbB-2 蛋白质在表示上的缺乏标记的低 Ki-67 的数据支持。因为它到有肠的组织变形的正常胃粘膜或粘膜的相似, EWDA 经常被误诊。阻止如此的损害的错误诊断,临床、病理学的特征应该被考虑。 | Takashi Yao Takashi Utsunomiya Masafumi Oya Kenichi Nishiyama Masazumi Tsuneyoshi | 2006 | World Journal of Gastroenterology2006，12，16： | 16 |
| 4 | Gastrointestinal stromal tumor of the stomach:How to manage?显示文摘Gastrointestinal stromal tumor (GIST) is one of the most common malignant mesenchymal tumors of the stomach. Prognosis of this disease is related to tumor size and mitotic activity and early diagnosis is the only way to improve it.Diagnosis of GIST always requires histological and immunohistochemical confirmation as no imaging modalities can diagnose it conclusively.Endoscopic forceps biopsy results are frequently negative. Endoscopic ultrasound-guided fine needle asp- iration (EUS-FNA) is a technique which allows tissue samples to be obtained with minimal risks and is accurate in the diagnosis of GIST. From the point of view of the endoscopist, aggressive use of EUS-FNA is the only promising way to allow early diagnosis and early treatment of this disease. | Kazuya Akahoshi Masafumi Oya | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，8： | 16 |
| 5 | 为用离合器切割器的食道的小粒的房间肿瘤的内视镜的 submucosal 解剖显示文摘 Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate.The shortcomings of this method are the deficiencies of fixing the knife to the target lesion,and of compressing it.These shortcomings can lead to major complications such as perforation and bleeding.To reduce the risk of complications related to ESD,we developed a new grasping type scissors forceps (Clutch Cutter,Fujifilm,Japan) which can grasp and incise the targeted tissue using an electrosurgical current.Esophagogastroduodenoscopy on a 59-year-old Japanese man revealed a 16mm esophageal submucosal nodule with central depression.Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement.The histologic diagnosis of the specimen obtained by biopsy was granular cell tumor.It was safely and accurately resected without unexpected incision by ESD using the CC.No delayed hemorrhage or perforation occurred.Histological examination confirmed that the granular cell tumor was completely excised with negative resection margin.We report herein a case of esophageal granular cell tumor successfully treated by an ESD technique using the CC. | Keishi Komori Kazuya Akahoshi Yoshimasa Tanaka Yasuaki Motomura Masaru Kubokawa Soichi Itaba Terumasa Hisano Takashi Osoegawa Naotaka Nakama Risa Iwao Masafumi Oya Kazuhiko Nakamura | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，1： | 8 |
| 6 | Clinical outcomes of Clutch Cutter endoscopic submucosal dissection for older patients with early gastric cancer显示文摘AIM To evaluate the clinical outcome of endoscopic submucosal dissection using the Clutch Cutter(ESDCC) in older patients. METHODS We reviewed 232 consecutive patients with early gastric cancer who underwent ESDCC between June 2010 and February 2014 at Aso Iizuka Hospital. We divided patients into two groups according to age: Older patients(> 80 years, n = 64) and non-older patients(≤ 80 years, n = 168). We retrospectively compared the prevalence rates of pre-existing comorbidities, anticoagulant therapy, en bloc resection, mean duration of hospitalization, incidence of ESDCC-related complications, change in performance status(PS) before and after ESDCC, and financial cost of admission. RESULTS The older group comprised 64 patients with a mean age of 84.1 years, and the non-older group comprised 168 patients with a mean age of 69.5 years. Older patients had significantly more pre-existing comorbidities than did non-older patients, specifically heart disease(P < 0.05). The en bloc resection rate in non-older patients was significantly higher than that in older patients(100% vs 95.3%, P = 0.02). There were no significant differences between the older and non-older groups in the incidence of ESDCC-related complications(i.e., postoperative bleeding and perforation) and the post-ESDCC change in PS. There were also no significant differences between the older and non-older groups in the mean duration of hospitalization(11.4 and 10.7 d, respectively) and financial cost of admission(657040 JPY and 574890 JPY, respectively).CONCLUSION ESDCC has a good clinical outcome in older patients. | Yoshihiro Otsuka Kazuya Akahoshi Kayoko Yasunaga Masaru Kubokawa Junya Gibo Shigeki Osada Kayo Tokumaru Kazuaki Miyamoto Takao Sato Yuki Shiratsuchi Masafumi Oya Hidenobu Koga Eikichi Ihara Kazuhiko Nakamura | 2017 | World Journal of Gastrointestinal Oncology2017，9，10： | 4 |
| 7 | Endoscopic submucosal dissection of a rectal carcinoid tumor using grasping type scissors forceps显示文摘Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate. The shortcomings of this method are the inability to fix the knife to the target lesion, and compression of the lesion. These can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (GSF), which can grasp and incise the targeted tissue using electrosurgical current. Colonoscopy on a 55-year-old woman revealed a 10-mm rectal submucosal nodule. The histological diagnosis of the specimen obtained by biopsy was carcinoid tumor. Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement. It was safely and accurately resected without unexpected incision by ESD using a GSF. No delayed hemorrhage or perforation occurred. Histological examination confirmed the carcinoid tumor was completely excised with negative resection margin. | Kazuya Akahoshi Yasuaki Motomura Masaru Kubokawa Noriaki Matsui Manami Oda Risa Okamoto Shingo Endo Naomi Higuchi Yumi Kashiwabara Masafumi Oya Hidefumi Akahane Haruo Akiba | 2009 | World Journal of Gastroenterology2009，15，17： | 4 |
| 8 | Endoscopic submucosal dissection by using a grasping-type scissors forceps: a preliminary clinical study (with video)显示文摘 | Kazuya Akahoshi Kuniomi Honda Hidefumi Akahane Haruo Akiba Noriaki Matsui Yasuaki Motomura Masaru Kubokawa Shingo Endo Naomi Higuchi Masafumi Oya | 2008 | Gastrointestinal Endoscopy2008，，7： | 1 |
| 9 | Suitability of the expanded indication criteria for the treatment of early gastric cancer by endoscopic submucosal dissection: Japanese multicenter large-scale retrospective analysis of short- and long-term outcomes显示文摘 | Kazuhiko Nakamura Kuniomi Honda Kazuya Akahoshi Eikichi Ihara Hiroshi Matsuzaka Yorinobu Sumida Daisuke Yoshimura Hirotada Akiho Yasuaki Motomura Tsutomu Iwasa Keishi Komori Yoshiharu Chijiiwa Naohiko Harada Toshiaki Ochiai Masafumi Oya Yoshinao Oda Ryoic | 2014 | Scandinavian Journal of Gastroenterology2014，，4： | 1 |
| 10 | Endoscopic submucosal dissection of gastric adenomas using the clutch cutter显示文摘AIM To evaluate the efficacy and safety of endoscopic submucosal dissection(ESD) using the clutch cutter(CC)(ESD-CC) for gastric adenoma(GA).METHODS From June 2007 to August 2015,122 consecutive patients with histological diagnoses of GA from specimens resected by ESD-CC were enrolled in this prospective study.The CC was used for all ESD steps(marking,mucosal incision,submucosal dissection,and hemostatic treatment),and itstherapeutic efficacy and safety were assessed.RESULTS Both the en-bloc resection rate and the R0 resection rate were 100%(122/122).The mean surgical time was 77.4 min,but the time varied significantly according to tumor size and location.No patients suffered perforation.Post-ESD-CC bleeding occurred in six cases(4.9%) that were successfully resolved by endoscopic hemostatic treatment.CONCLUSION ESD-CC is a technically efficient,safe,and easy method for resecting GA. | Kazuya Akahoshi Masaru Kubokawa Junya Gibo Shigeki Osada Kayo Tokumaru Eriko Yamaguchi Hiroko Ikeda Takao Sato Kazuaki Miyamoto Yusuke Kimura Yuki Shiratsuchi Kazuaki Akahoshi Masafumi Oya Hidenobu Koga Eikichi Ihara Kazuhiko Nakamura | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，7： | 0 |
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