| Project/Area Number |
18K07985
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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 | Hyogo Medical University |
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Principal Investigator |
Iijima Hiroko 兵庫医科大学, 医学部, 教授 (80289066)
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| Co-Investigator(Kenkyū-buntansha) |
藤元 治朗 兵庫医科大学, 医学部, 特別招聘教授 (90199373)
矢野 博久 久留米大学, 医学部, 教授 (40220206)
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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 |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | 線維化 / 肝脂肪化 / 超音波 / 脂肪減衰法 / Elastography / 肝発癌リスク |
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| Outline of Final Research Achievements |
Liver stiffness (LS) by shear wave elastography was obtained with 809 patients. The result was compared with histology of fibrosis. The AUROC of transient elastography to predict F2<, F3<, and F4 was 0.809, 0.860 and 0.947; that of virtual touch quantification was 0.793, 0.836 and 0.941, respectively. LS showed significant increase with the progression of fibrosis. Diagnosis of liver fibrosis based on LS measurement was established to avoid invasive diagnosis. Attenuation imaging (ATI) enables to quantitively assess liver steatosis as accurate as controlled attenuation parameter. In 119 steatosis cases, the correlation of ATI with MRI-derived proton density fat fraction (PDFF) was r=0.70. ATI showed a good diagnostic ability as MRI-PDFF.
Post-sustained virologic response HCC occurrence is observed more in patients with higher LS and glucose level. A electronic microscopic study showed a higher rate of mitochondrial disorder in HCC recurrence cases.
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| Academic Significance and Societal Importance of the Research Achievements |
超音波エラストグラフィは、機種間の差が無く肝線維化診断ができる方法として確立された。異なる方法でも換算式で比較出来る方法を考案した。ゴールドスタンダードである肝生検は入院が必須で出血等の合併症がある。肝臓全体の1/50,000の組織しか採取できずサンプリングエラーが30％前後と報告され、病理医間の読影差もある。エラストグラフィは肝生検に替わる方法として医療に貢献できる。さらに測定値は、線維化と脂肪減衰量を連続変数で定量評価できる。脂肪肝の有病率が上昇し肝線維化脂肪化診断は今後さらに社会的需要が高まる。発癌リスク危険群が同定できたことは極めて大きい。
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