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Intraperitoineal exosome as a novel target for peritoneal metastasis

Research Project

Project/Area Number 17H04286
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Research Field Digestive surgery
Research InstitutionJichi Medical University

Principal Investigator

KITAYAMA JOJI  自治医科大学, 医学部, 教授 (20251308)

Co-Investigator(Kenkyū-buntansha) 佐田 尚宏  自治医科大学, 医学部, 教授 (20261977)
山口 博紀  自治医科大学, 医学部, 教授 (20376445)
三木 厚  自治医科大学, 医学部, 講師 (20570378)
細谷 好則  自治医科大学, 医学部, 教授 (30275698)
大澤 英之  自治医科大学, 医学部, 講師 (60458271)
寺谷 工  自治医科大学, 医学部, 講師 (70373404)
Project Period (FY) 2017-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥17,030,000 (Direct Cost: ¥13,100,000、Indirect Cost: ¥3,930,000)
Fiscal Year 2019: ¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2018: ¥6,110,000 (Direct Cost: ¥4,700,000、Indirect Cost: ¥1,410,000)
Fiscal Year 2017: ¥7,280,000 (Direct Cost: ¥5,600,000、Indirect Cost: ¥1,680,000)
Keywordsエクソソーム / microRNA / 腹膜播種 / 腹腔内化学療法 / バイオマーカー / マイクロRNA / CART / 胃癌 / マイクロRNA / CART / 癌 / 消化器外科学 / 胃十二指腸外科学
Outline of Final Research Achievements

Exosomes were isolated from peritoneal fluids of patients of gastric cancer with or without peritoneal metastasis (PM) and comprehensive miRNA expression analysis was performed. In initial screening, we identified 11 dysregulated miRNAs in PM (+) samples. Validation analysis revealed that 4 miRNAs (miR-21-5p, miR-92a-3p, miR-223-3p, and miR-342-3p) were significantly upregulated in 12 PM (+) samples, and their expression levels showed positive correlation with peritoneal cancer index. In contrast, miR-29 family were all downregulated in patients with PM (+) samples. Moreover, miR-29b at gastrectomy was lower in patients with peritoneal recurrence. Ratios of miR-21-5p/miR-29b-3p and miR-223-3p/miR-29b-3p were inversely associated with tumor response and overall survival of the patients who received intraperitoneal chemotherapy. Expression pattern of miRNAs in peritoneal exosome well reflects the tumor burden in peritoneal cavity and could be useful biomarker in the treatment of PM.

Academic Significance and Societal Importance of the Research Achievements

血中エクソソーム成分ががんを含めた様々な病気のバイオマーカーとなることが報告されてきている反面、腹腔内液中のエクソソームの組成に関する情報は乏しかった。本研究で、胃癌患者から採取された腹腔内液中エクソソーム内のマイクロRNAの発現様式が、腹膜播種の病勢を反映し治療に応用できるバイオマーカーとなりうることが判明した。本研究は、その成果が難治性の腹膜播種の治療成績の向上に貢献するとともに、唾液、尿などの体液中に安定するエクソソームの解析が病態の理解や新規治療の開発に向けた糸口となりうることを示した点でも社会的意義があると思われる。

Report

(4 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Annual Research Report
  • 2017 Annual Research Report
  • Research Products

    (47 results)

All 2020 2019 2018 2017

All Journal Article (7 results) (of which Peer Reviewed: 4 results,  Open Access: 3 results) Presentation (40 results) (of which Int'l Joint Research: 11 results,  Invited: 3 results)

  • [Journal Article] Phase I Study of Intraperitoneal Administration of Paclitaxel Combined with S-1 Plus Cisplatin for Gastric Cancer with Peritoneal Metastasis2020

    • Author(s)
      Kobayashi Daisuke、Ishigami Hironori、Kanda Mitsuro、Tanaka Chie、Yamaguchi Hironori、Kitayama Joji、Kodera Yasuhiro
    • Journal Title

      Oncology

      Volume: 98 Issue: 1 Pages: 48-52

    • DOI

      10.1159/000502484

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Exosomal microRNA in peritoneal fluid as a biomarker of peritoneal metastases from gastric cancer2019

    • Author(s)
      Ohzawa Hideyuki、Kumagai Yuko、Yamaguchi Hironori、Miyato Hideyo、Sakuma Yasunaru、Horie Hisanaga、Hosoya Yoshinori、Kawarai Lefor Alan、Sata Naohiro、Kitayama Joji
    • Journal Title

      Annals of Gastroenterological Surgery

      Volume: 4 Issue: 1 Pages: 84-93

    • DOI

      10.1002/ags3.12296

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] 特集 最新版 "腸閉塞"を極める! 疾患別 診断と治療 胃癌腹膜播種による腸閉塞2018

    • Author(s)
      山口 博紀、北山 丈二
    • Journal Title

      臨床外科

      Volume: 73 Issue: 7 Pages: 826-829

    • DOI

      10.11477/mf.1407212091

    • ISSN
      0386-9857, 1882-1278
    • Year and Date
      2018-07-20
    • Related Report
      2018 Annual Research Report
  • [Journal Article] 特集 腹膜と腹水を究める-新しい考え方と治療法 8.腹膜播種に対する腹腔内化学療法の基礎と臨床2018

    • Author(s)
      山口 博紀、石神 浩徳、北山 丈二
    • Journal Title

      外科

      Volume: 80 Issue: 6 Pages: 630-634

    • DOI

      10.15106/j_geka80_630

    • ISSN
      0016-593X, 2432-9428
    • Year and Date
      2018-05-01
    • Related Report
      2018 Annual Research Report
  • [Journal Article] 【胃癌のすべて】 薬物療法 胃癌腹膜播種に対するタキサン腹腔内反復化学療法2018

    • Author(s)
      北山丈二
    • Journal Title

      医学のあゆみ

      Volume: 266(9) Pages: 717-723

    • Related Report
      2018 Annual Research Report
  • [Journal Article] Phase III Trial Comparing Intraperitoneal and Intravenous Paclitaxel Plus S-1 Versus Cisplatin Plus S-1 in Patients With Gastric Cancer With Peritoneal Metastasis: PHOENIX-GC Trial.2018

    • Author(s)
      Ishigami H, Fujiwara Y, Fukushima R, Nashimoto A, Yabusaki H, Imano M, Imamoto H, Kodera Y, Uenosono Y, Amagai K, et al
    • Journal Title

      J Clin Oncol

      Volume: 36 Issue: 19 Pages: 1922-1929

    • DOI

      10.1200/jco.2018.77.8613

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Treatment of patients with peritoneal metastases from gastric cancer2018

    • Author(s)
      Kitayama Joji、Ishigami Hironori、Yamaguchi Hironori、Sakuma Yasunaru、Horie Hisanaga、Hosoya Yoshinori、Lefor Alan Kawarai、Sata Naohiro
    • Journal Title

      Annals of Gastroenterological Surgery

      Volume: 2 Issue: 2 Pages: 116-123

    • DOI

      10.1002/ags3.12060

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Presentation] 腹腔内液中エクソソームを用いた胃癌腹膜播種症例のリキッドバイオプシー.2020

    • Author(s)
      大澤 英之,木村 有希,齋藤 晶,山口 博紀,細谷 好則,佐田 尚宏,北山 丈二.
    • Organizer
      第4回Liquid Biopsy研究会
    • Related Report
      2019 Annual Research Report
    • Invited
  • [Presentation] Exosomal microRNA in Peritoneal Fluid as a Biomaler of Peritoneal Metastases from Gastric Cancer.2020

    • Author(s)
      Joji Kitayama.
    • Organizer
      2020 Advanced Cancer Therapies
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Conversion surgery for gastric cancer patients with peritoneal metastasis after intraperitoneal(IP) chemotherapy with taxanes.2019

    • Author(s)
      福島 亮治,石神 浩徳,藪崎 裕,大森 健,小寺 泰弘,今野 元博,有上 貴明, 富田 寿彦,岸 健太郎,北山 丈二.
    • Organizer
      第119回日本外科学会定期学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 胃癌腹膜播種に対するタキサンを用いた腹腔内化学療法ー基礎研究から臨床試験までー.2019

    • Author(s)
      山口 博紀, 石神 浩徳, 薮崎 裕, 大森 健, 小寺 泰弘, 福島 亮二, 今野 元博, 有上 貴明, 富田 寿彦, 北山 丈二.
    • Organizer
      第91回日本胃癌学会総会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 腹腔内液中エクソソームを用いた胃癌腹膜播種症例のリキッドバイオプシー.2019

    • Author(s)
      大澤 英之,齋藤 晶,熊谷 祐子,山口 博紀,細谷 好則,佐田 尚宏,北山 丈二.
    • Organizer
      第74回日本消化器外科学会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 腹腔内液中エクソソームを用いた胃癌症例のリキッドバイオプシー.2019

    • Author(s)
      大澤 英之,齋藤 晶,熊谷 祐子,山口 博紀,細谷 好則,佐田 尚宏,北山 丈二.
    • Organizer
      第28回日本がん転移学会学術集会・総会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 腹腔内液中エクソソームマイクロRNAを用いた胃癌腹膜播種症例のリキッドバイオプシー.2019

    • Author(s)
      大澤 英之,木村 有希,齊籐 晶,山口 博紀,細谷 好則,佐田 尚宏,北山 丈二.
    • Organizer
      第57回日本癌治療学会学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 腹腔内液中エクソソームマイクロRNAを用いた胃癌腹膜播種症例のリキッドバイオプシー. Liquid biopsy for peritoneal metastasis of gastric cancer using exosome microRNA inperitoneal fluid.2019

    • Author(s)
      大澤 英之,齋藤 晶,熊谷 祐子,山口 博紀,北山 丈二.
    • Organizer
      第78回日本癌学会学術総会
    • Related Report
      2019 Annual Research Report
  • [Presentation] MIR-29S in peritoneal exosome predicts peritoneal recurrence in T4 gastric cancer.2019

    • Author(s)
      Hideyuki Ohzawa., Joji Kitayama., Yuki Kimura., Akira Saito., Hironori Yamaguchi., Yoshinori Hosoya., Naohiro Sata.
    • Organizer
      1st Congress of ISSPP 2019
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Development of new drugs to prevent peritoneal metastasis in gastric cancer.2019

    • Author(s)
      Joji Kitayama., Hideyuki Ohzawa., Rihito Kanamaru., Yuki Kimura., Hironori Yamaguchi., Nahiro Sata.
    • Organizer
      1st Congress of ISSPP 2019
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Repeated Intraperitoneal Chemotherapy(RIPEC) Combined with Cell-free and Concentrated Ascites Reinfusion Therapy(CART) for Carcinomatous Peritonitis with Massive Malignant Ascites.2019

    • Author(s)
      Joji Kitayama, Hironori Yamaguchi, Hironori Ishigami, Norio Hanafusa, Rihito Kanamaru, Shin Saito, Yoshinori Hosoya, Sata. Naohiro.
    • Organizer
      14th International Symposium on Regional Cancer Therapies
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Novel Strategies for Biomarker Identification and Use in Cancer 2.2019

    • Author(s)
      Hideyuki Ohzawa., Akira Saito., Yuko Kumagai., Hironori Yamaguchi., Yoshinori Hosoya., Naohiro Sata., Joji Kitayama.
    • Organizer
      AACR ANNUAL MEETING 2019
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Exosomal microRNA profiles in peritoneal fluids as a therapeutic biomarker for peritoneal metastasis of gastric cancer.2018

    • Author(s)
      H. Ohzawa, Y. Kumagai, H. Yamaguchi, Y. Hosoya, N. Sata and J. Kitayama .
    • Organizer
      AACR Annual Meeting 2018
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Presentation] A phase II study of perioperative intraperitoneal paclitaxel plus S-1/paclitaxel for curatively resectable gastric cancer with serosal invasion: The GAPS study.2018

    • Author(s)
      Seiji Ito, Motohiro Imano, Yoshikazu Uenosono, Takaaki Arigami, Hiroshi Yabusaki, Yasuo Hirono, Shugo Ueda, Tatsuki Matsumura, Ryoji Fukushima, Atsushi Takeno, Kentaro Kishi, Yasutaka Chiba, Sachi Chiba, Haruhiko Imamoto, Yuichi Ito, Atsushi Matsuki, Hironori Ishigami, Hironori Yamaguchi, Joji Kitayama,et al.
    • Organizer
      USA(Chicago)
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Quantification of CEAmRNA in peritoneal fluids is useful to predict the benefit of conversion gastrectomy after intraperitoneal chemotherapy in patients with peritoneal metastasis.2018

    • Author(s)
      Kitayama J, Yamaguchi H, Ishigami H and Sata N.
    • Organizer
      USA(FL Jacksonville)
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Repeated intraperitoneal chemotherapy using Taxane for Gastric Cancer with Peritoneal Metastases.2018

    • Author(s)
      J, Kitayama
    • Organizer
      England(Southampton)
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] 胃癌腹膜播種治療における腹腔内液中エクソソームマイクロRNA解析(Exosomal microRNA profiles in peritoneal fluids as a therapeutic biomarker for peritoneal metastasis of gastric cancer.)2018

    • Author(s)
      大澤英之, 熊谷祐子, 山口博紀, 北山丈二
    • Organizer
      第77回日本癌学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Flowcytometric detection of intraperitoneal floating tumor stem cell2018

    • Author(s)
      Joji Kitayama, Rihito Kanamaru, Hideyo Miyato, Hironori Yamaguchi, Yoshinori Hosoya, Keisuke Matsuzaki and Naohiro Sata
    • Organizer
      第90回日本胃癌学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Gastrectomy after response to intraperitoneal and systemic chemotherapy for P1 or CY1 gastric cancer2018

    • Author(s)
      Hironori Ishigami, Hironori Yamaguchi, Hiroharu Yamashita, Masahiro Asakage and Joji Kitayama
    • Organizer
      第90回日本胃癌学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] miRNA profiles and the response of neoadjuvant chemotherapy in epidermal growth factor receptor 2-positive breast cancer2018

    • Author(s)
      Joji Kitayama, Hideyuki Ohzawa, Atsushi Miki, Takumi Teratani, Satomi Shiba and Naohiro Sata
    • Organizer
      Anti-Cancer Treatment Japan
    • Related Report
      2018 Annual Research Report
  • [Presentation] Phase II study of ip PTX + S-1/PTX for gastric cancer with positive peritoneal cytology2018

    • Author(s)
      Motohiro Imano, Hironori Ishigami, Hiroshi Yabusaki, Haruhiko Imamoto, Hiroharu Yamashita, Kentaro Kishi, Yasuhiro Kodera, Yoshikazu Uenosono, Yoshiyuki Fujiwara, Akio Hidemura, Shigeyuki Tamura, Ryoji Fukushima, Hironori Yamaguchi, Joji Kitayama and Japan intraperitoneal chemotherapy study group (JIPG)
    • Organizer
      第90回日本胃癌学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Treatment of peritoneal dissemination based on the unique microenvironment in peritoneal cavity.2018

    • Author(s)
      北山丈二, 金丸理人, 大澤英之, 熊谷祐子, 山口博紀, 細谷好則, 松崎圭祐, 佐田尚宏
    • Organizer
      第77回日本癌学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 胃癌腹膜播種に対するSOX+PTX腹腔内投与併 用化学療法の新規導入施設における治療成績2018

    • Author(s)
      山口博紀, 金丸理人, 大澤英之, 松本志郎, 倉科憲太郎, 春田英律, 細谷好則, 藤井博文, 北山丈二, 佐田尚宏
    • Organizer
      第56回日本癌治療学会学術集会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 胃癌腹膜播種に対する腹腔内化学療法における腹腔洗浄液中CEA mRNA定量 手術適応決定のバイオマーカーとしての意義2018

    • Author(s)
      山口博紀, 石神浩徳, 金丸理人, 大澤英之, 松本志郎, 倉科憲太郎, 春田英律, 細谷好則, 北山丈二, 佐田尚宏
    • Organizer
      第118回日本外科学会定期学術集会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 胃癌腹膜播種治療におけるバイオマーカーとしての腹水中エクソソームマイクロRNA2018

    • Author(s)
      大澤英之, 熊谷祐子, 山口博紀, 佐久間康成, 堀江久永, 細谷好則, 佐田尚宏, 北山丈二
    • Organizer
      第118回日本外科学会定期学術集会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 胃癌腹膜播種治療における腹腔内液中エクソソームマイクロRNA解析2018

    • Author(s)
      大澤英之, 熊谷裕子, 山口博紀, 佐久間康成, 堀江久永, 細谷好則, 佐田尚宏, 北山丈二
    • Organizer
      第104回日本消化器病学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 胃癌腹膜播種手術症例における予後因子としての腹腔洗浄液中CEA mRNA定量値2018

    • Author(s)
      山口博紀, 石神浩徳, 松本志郎, 宇井崇, 春田英律, 倉科憲太郎, 齋藤心, 細谷好則, 佐田尚宏, 北山丈二
    • Organizer
      第73回日本消化器外科学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 胃癌腹膜微小転移に対するパクリタキセル腹腔内反復化学療法の有用性2018

    • Author(s)
      北山丈二, 石神浩徳, 山口博紀, 腹腔内化学療法研究会
    • Organizer
      第73回日本消化器外科学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 高度進行胃癌に対する集学的治療  腹膜播種陽性または腹腔細胞診陽性胃癌に対する集学的治療2018

    • Author(s)
      石神浩徳, 山口博紀, 山下裕玄, 浅蔭正宏, 北山丈二
    • Organizer
      第118回日本外科学会定期学術集会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 実臨床に即した切除不能・進行再発消化管がんに対する最適な治療戦略 消化器癌腹膜播種に対するタキサン腹腔内反復化学療法の可能性2018

    • Author(s)
      北山丈二, 石神浩徳, 山口博紀
    • Organizer
      第104回日本消化器病学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 腹腔内液中エクソソームマイクロRNAを用いた胃癌腹膜播種症例のリキッドバイオプシー2018

    • Author(s)
      大澤英之, 熊谷祐子, 山口博紀, 佐久間康成, 堀江久永, 細谷好則, 佐田尚宏, 北山丈二
    • Organizer
      第73回日本消化器外科学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 腹膜播種の診断と治療の工夫 腹膜播種に対するパクリタキセル腹腔内化学療法におけるドラッグデリバリー向上の工夫2018

    • Author(s)
      江本成伸, 北山丈二, 山口博紀, 石神浩徳, 室野浩司, 田中敏明, 畑啓介, 川合一茂, 野澤宏彰
    • Organizer
      第73回日本消化器外科学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 腹膜播種の診断と治療の工夫 腹膜播種陽性胃癌に対するSOX+PTX腹腔内投与併用化学療法の新規導入施設における治療成績2018

    • Author(s)
      齋藤心, 山口博紀, 松本志郎, 倉科憲太郎, 佐久間康成, 春田英律, 堀江久永, 細谷好則, 北山丈二, 佐田尚宏
    • Organizer
      第73回日本消化器外科学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 腹膜播種を伴う胃癌に対するS-1/CDDP+パクリタキセル腹腔内投与併用の第II相臨床試験2018

    • Author(s)
      小林大介, 太田光彦, 福島亮治, 伏田幸夫, 上田修吾, 楠本哲也, 秀村晃生, 山下直行, 藪崎裕, 大森健, 有上貴明, 石神浩徳, 北山丈二, 小寺泰弘, 腹腔内化学療法研究会
    • Organizer
      第56回日本癌治療学会学術集会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Quantification of CEAmRNA in peritoneal fluids is useful to predict the benefit of conversion gastrectomy after intraperitoneal chemotherapy in patients with peritoneal metastasis.2018

    • Author(s)
      Kitayama J, Yamaguchi H, Ishigami H, Sata N
    • Organizer
      SSO 2018 13th Regional Cancer Therapies
    • Related Report
      2017 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Peritoneal lavage CEA mRNA levels predict conversion gastrectomy outcomes after induction chemotherapy in gastric cancer patients with peritoneal metastasis.2017

    • Author(s)
      H. Yamaguchi,Y. Sato,H. Ishigami,H. Oozawa,M. Kurihara,Y. Yatomi, J. Kitayama
    • Organizer
      ESMO 2017 Congress
    • Related Report
      2017 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 胃癌腹膜播種治療における腹腔内液中バイオマーカーの意義2017

    • Author(s)
      北山丈二,山口博紀,石神浩徳,大澤英之,細谷好則,山下裕玄,瀬戸泰之,佐田尚宏
    • Organizer
      第72回日本消化器外科学会総会
    • Related Report
      2017 Annual Research Report
  • [Presentation] Flowcytometryを用いた腹腔内遊離癌細胞の質的・量的解析の試み2017

    • Author(s)
      北山丈二,山下裕玄,瀬戸泰之,山口博紀,金丸理人,津久井秀則,佐田尚宏
    • Organizer
      第26回日本がん転移学会学術集会・総会
    • Related Report
      2017 Annual Research Report
  • [Presentation] Exosomal microRNA profiles in peritoneal fluids as a therapeutic biomarker for peritoneal metastasis of gastric cancer.2017

    • Author(s)
      大澤英之,三木厚,山口博紀,佐久間康成,堀江久永,細谷好則,北山丈二,佐田尚宏
    • Organizer
      第76回日本癌学会学術集会
    • Related Report
      2017 Annual Research Report
  • [Presentation] Exsomal microRNA profiles in peritoneal fliods as a therapeutic biomarker for peritoneal metastasisi of gastric cancer.2017

    • Author(s)
      大澤英之,山口博紀,佐久間康成,堀江久永,細谷好則,北山丈二,佐田尚宏
    • Organizer
      第28回日本消化器癌発生学会総会
    • Related Report
      2017 Annual Research Report

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Published: 2017-04-28   Modified: 2021-02-19  

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