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Detection of lymph node micrometastasis in rectal cancer

Research Project

Project/Area Number 19K07735
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 50020:Tumor diagnostics and therapeutics-related
Research InstitutionJapanese Foundation for Cancer Research (2020-2021)
Kumamoto University (2019)

Principal Investigator

HIYOSHI Yukiharu  公益財団法人がん研究会, 有明病院 大腸外科, 副医長 (30573612)

Co-Investigator(Kenkyū-buntansha) 徳永 竜馬  熊本大学, 病院, 非常勤診療医師 (20594881)
清住 雄希  熊本大学, 病院, 非常勤診療医師 (30827324)
今村 裕  公益財団法人がん研究会, 有明病院 消化器外科, 医長 (70583045)
宮本 裕士  熊本大学, 病院, 講師 (80551259)
Project Period (FY) 2019-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2021: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords直腸癌 / リンパ節転移 / 微小転移 / OSNA / 放射線化学療法 / 手術 / CK19 / miRNA / real-time PCR / microarray / microRNA / 側方リンパ節
Outline of Research at the Start

本研究は、分子生物学的手法、特にmicroRNA解析を用いた新たな直腸癌微小リンパ節転移診断法を確立することで、まず、直腸所属リンパ節微小転移の臨床的意義を明らかにすることである。具体的には通常の病理診断ではリンパ節転移陰性で微小転移のみ陽性のいわゆるhigh risk stage II症例を同定し、予後を解析することで微小転移が再発リスクとなり得るかを検討する。次に、側方リンパ節微小転移を解析することで、側方微小転移が予後に与える影響を解析するとともに、微小転移を含めた側方転移リスク因子を同定し、側方郭清を省略可能な症例の選別を目指す。

Outline of Final Research Achievements

Lymph node micrometastasis in patients with rectal cancer treated with preoperative chemoratiotherapy was examined by OSNA (one-step nucleic acid amplification) method using resected lymph node samples. Lymph node positive rate with pathological examination and OSNA method was 24% (6/25) and 12% (3/25), respectively. The sensitivity, specificity, positive predictive value and negative predictive value of OSNA method were 33% (2/6), 95% (18/19), 67% (2/3) and 82% (18/22), respectively. One patient with pathological node negative turned out to be node positive in OSNA method. The low sensitivity of OSNA method due to several problems (e.g. small sample scale) was major issue. We could not make any conclusion with regard to the utility of the OSNA method to detect lymph node micrometastasis in rectal cancer.

Academic Significance and Societal Importance of the Research Achievements

直腸癌術前放射線化学療法後のリンパ節微小転移の臨床的意義はいまだ不明である。その微小転移の検出法確立と臨床的意義を明らかにすることを目的とした本研究は、進行直腸癌の治療成績向上のために学術的に重要であると考えられる。研究結果では、微小転移検出におけるOSNA法の有用性を証明するに至らなかったが、他の手法も含め、対象症例数を増やして引き続き解析を行い、研究結果を公表し、社会的に貢献することを目指していく。

Report

(4 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (6 results)

All 2022 2021 2020

All Journal Article (3 results) (of which Peer Reviewed: 3 results,  Open Access: 1 results) Presentation (3 results)

  • [Journal Article] Non-operative management after chemoradiotherapy plus consolidation or sandwich (induction with bevacizumab and consolidation) chemotherapy in patients with locally advanced rectal cancer: a multicentre, randomised phase II trial (NOMINATE trial)2022

    • Author(s)
      Akiyoshi Takashi、Shinozaki Eiji、Taguchi Senzo、Chino Akiko、Hiratsuka Makiko、Tominaga Tetsuro、Nonaka Takashi、Toda Shigeo、Matoba Shuichiro、Matsui Shimpei、Okabayashi Koji、Mukai Toshiki、Hiyoshi Yukiharu et al.
    • Journal Title

      BMJ Open

      Volume: 12 Issue: 3 Pages: e055140-e055140

    • DOI

      10.1136/bmjopen-2021-055140

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Treatment outcome of laparoscopic surgery after self-expandable metallic stent insertion for obstructive colorectal cancer2021

    • Author(s)
      Hiyoshi Yukiharu、Mukai Toshiki、Nagasaki Toshiya、Yamaguchi Tomohiro、Nagayama Satoshi、Akiyoshi Takashi、Sasaki Takashi、Saito Shoichi、Fukunaga Yosuke
    • Journal Title

      International Journal of Clinical Oncology

      Volume: 26 Issue: 11 Pages: 2029-2036

    • DOI

      10.1007/s10147-021-01990-0

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] The advantage of one‐step nucleic acid amplification for the diagnosis of lymph node metastasis in colorectal cancer patients2020

    • Author(s)
      Hiyoshi Yukiharu、Akiyoshi Takashi、Fukunaga Yosuke
    • Journal Title

      Annals of Gastroenterological Surgery

      Volume: 5 Issue: 1 Pages: 60-66

    • DOI

      10.1002/ags3.12392

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Presentation] 右側結腸癌に対する腹腔鏡下手術の治療成績: Inferior vs Medial approach2022

    • Author(s)
      日吉幸晴、向井俊貴、長嵜寿矢、山口智弘、秋吉高志、福長洋介
    • Organizer
      第122回日本外科学会定期学術集会
    • Related Report
      2021 Annual Research Report
  • [Presentation] 閉塞性大腸癌に対するステント留置後腹腔鏡手術の治療成績2021

    • Author(s)
      日吉幸晴、向井俊貴、長嵜寿矢、山口智弘、秋吉高志、福長洋介
    • Organizer
      第34回日本内視鏡外科学会総会
    • Related Report
      2021 Annual Research Report
  • [Presentation] 脾彎曲部癌に対する腹腔鏡下結腸切除術2021

    • Author(s)
      日吉幸晴、向井俊貴、長嵜寿矢、山口智弘、長山 聡、秋吉高志、福長洋介
    • Organizer
      第76回日本消化器外科学会総会
    • Related Report
      2021 Annual Research Report

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Published: 2019-04-18   Modified: 2023-01-30  

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