| Project/Area Number |
18K07925
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 53010:Gastroenterology-related
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| Research Institution | National Cancer Center Japan |
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Principal Investigator |
Yamada Masayoshi 国立研究開発法人国立がん研究センター, 中央病院, 医員 (80454239)
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| Project Period (FY) |
2018-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2019: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | 鋸歯状病変 / 大腸前がん病変 / 内視鏡診断 / 体細胞遺伝子変異 / WNT経路 / MAPK経路 / 有茎性病変 / ポリープ切除後出血 / 鋸歯状腺腫 / 大腸腫瘍 / 内視鏡治療 / 合併症 / 古典的鋸歯状腺腫 / 遺伝子解析 / WNT / 組織学的多様性 / 遺伝子変異 / 臨床病理学的特徴 / 大腸癌 / 分子病理学 |
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| Outline of Final Research Achievements |
This study demonstrated that the JNET classification using NBI, which is one of the image-enhanced endoscopes, proved useful in a clinical setting for most serrated lesions (United European Gastroenterol J. 2019).
Giving result of spectra analysis of alterations in MAPK and WNT pathway genes, TSAs mostly harbor various combinations of concurrent WNT and MAPK gene alterations. The associations between genetic and morphological features suggest that the histological diversity of TSA reflects the underlying molecular heterogeneity (J Gastroenterol. 2020).
Furthermore, pedunculated morphology was accounted for 16% of TSAs and the increased risk for delayed bleeding with injecting the stalk and prophylactic clipping before polypectomy suggests that simple resection with coagulation mode is a suitable strategy in endoscopic resection of pedunculated polyps. Moreover, prophylactic endoloop use was highly likely to inhibit immediate bleeding with polyp size >15 mm(Gastrointest Endosc. 2021).
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| Academic Significance and Societal Importance of the Research Achievements |
早期大腸癌および前がん病変の内視鏡診断は治療方針の決定において重要な役割を担っている。しかし、鋸歯状病変に関する内視鏡診断学はまだ十分に確立しているとは言いがたい。そこで、本研究では大腸鋸歯状病変の内視鏡的所見と、組織型、分子病理学的因子、臨床病理学的特徴との相関を明らかにすることを目指した。研究の結果、古典的鋸歯状腺腫の内視鏡診断、分子病理学的因子、臨床病理学的特徴、内視鏡治療成績を明らかにする事ができ、より正確な内視鏡診断や治療方針の決定に繋がる成果が得られたと考えられた。
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