Development of innovative techniques of endoscopic ultrasound for early diagnosis of pancreatic cancer and its prognostic improvement

2018 Fiscal Year Annual Research Report

• Project/Area Number: 16K09410
• Research Institution: Wakayama Medical University
• Principal Investigator: 北野 雅之 和歌山県立医科大学, 医学部, 教授 (50314571)
• Co-Investigator(Kenkyū-buntansha): 西尾 和人 近畿大学, 医学部, 教授 (10208134) ; 工藤 正俊 近畿大学, 医学部, 教授 (10298953)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 超音波内視鏡 / 膵癌 / 胆管ドレナージ / 造影ハーモニック法

Outline of Annual Research Achievements

本研究では、超音波内視鏡の新規技術を開発し、膵癌に対する早期診断・治療に応用することを目的としている。平成30年度は以下の研究を実施した。
1.新規超音波内視鏡画像診断技術の開発：膵癌診断における造影超音波内視鏡検査の有用性についてメタ解析を実施し、その診断精度を算出した（Dig Endosc 2019）。膵癌化学療法効果判定における造影ハーモニック超音波内視鏡の有用性を評価した（Dig Liver Dis 2019）。消化管粘膜下腫瘍および胆嚢隆起性病変の診断における造影ハーモニック超音波内視鏡の有用性を評価した（J Gastroenterol Hepatol. 2017, Dig Endosc 2018）。
2.新規超音波内視鏡下治療法の臨床研究：超音波内視鏡下胆管ドレナージ術のCholedocho-duodenostomyにおいて、新規開発した細径デリバリーシステムを用いることで、超音波内視鏡下胆管ドレナージ術は安全かつ容易に実施できることが判明した（Dig Endosc 2018）。超音波内視鏡下胆管ドレナージ術のhepaticogastrostomyにantegrade stentingを加えることの有効性と安全性を評価する多施設共同前向き臨床試験を行った（Dig Endosc. 2018）。超音波内視鏡下胆管ドレナージ術の経胃的および経十二指腸的経路のどちらが最適な経路であるかを検討する多施設共同無作為化試験を実施した。両治療法に優劣はないことが示唆され、一方の治療が不成功であれば、別の治療を選択することで、高い手技成功率が得られることが判明した（Dig Endosc 2019）。多施設共同後ろ向き研究にて、超音波内視鏡下胆嚢ドレナージ術を用いて経皮経肝的胆嚢ドレナージ術から内瘻化した患者の手技成功率、偶発症発生率、ステント開存率を検討した（Dig Endosc 2019）。

Research Products

• [Journal Article] A multicenter randomized trial comparing a 25-gauge EUS fine-needle aspiration device with a 20-gauge EUS fine-needle biopsy device (2019)
  • Author(s): Van Riet PA, Larghi A, Attili F, Rindi G, Nguyen NQ, Ruszkiewicz A, Kitano M, Chikugo T, Aslanian H, Farrell J, Robert M, Adeniran A, Van Der Merwe S, Roskams T, Chang K, Lin F, Lee JG, Arcidiacono PG, Petrone M, Doglioni C, Iglesias-Garcia J, Abdulkader I, et al.
  • Journal Title: Gastrointestinal Endoscopy Volume: 89 Pages: 329～339
  • DOI: 10.1016/j.gie.2018.10.026
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Prospective multicenter study of primary EUS-guided choledochoduodenostomy using a covered metal stent (2019)
  • Author(s): Nakai Y, Isayama H, Kawakami H, Ishiwatari H, Kitano M, Ito Y, Yasuda I, Kato H, Matsubara S, Irisawa A, Itoi T
  • Journal Title: Endoscopic Ultrasound Volume: 8 Pages: 111～111
  • DOI: 10.4103/eus.eus_17_18
  • Peer Reviewed
• [Journal Article] Radical treatment for walled‐off necrosis: Transmural nasocyst continuous irrigation (2019)
  • Author(s): Tamura T, Itonaga M, Tanioka K, Kawaji Y, Nuta J, Hatamaru K, Yamashita Y, Yoshida T, Ida Y, Maekita T, Iguchi M, Kitano M
  • Journal Title: Digestive Endoscopy Volume: 31 Pages: 307～315
  • DOI: 10.1111/den.13319
  • Peer Reviewed
• [Journal Article] Value of contrast‐enhanced harmonic endoscopic ultrasonography with enhancement pattern for diagnosis of pancreatic cancer: A meta‐analysis (2019)
  • Author(s): Yamashita Y, Shimokawa T, Napoléon B, Fusaroli P, Gincul R, Kudo M, Kitano M
  • Journal Title: Digestive Endoscopy Volume: 31 Pages: 125～133
  • DOI: 10.1111/den.13290
  • Peer Reviewed / Open Access
• [Journal Article] International study of endoscopic management of distal malignant biliary obstruction combined with duodenal obstruction (2018)
  • Author(s): Hamada T, Nakai Y, Lau JY, Moon JH, Hayashi T, Yasuda I, Hu B, Seo DW, Kawakami H, Kuwatani M, Katanuma A, Kitano M, Ryozawa S, Hanada K, Iwashita T, Ito Y, Yagioka H, Togawa O, Maetani I, Isayama H
  • Journal Title: Scandinavian Journal of Gastroenterology Volume: 53 Pages: 46～55
  • DOI: 10.1080/00365521.2017.1382567
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of localized gallbladder lesions (2018)
  • Author(s): Kamata K, Takenaka M, Kitano M, Omoto S, Miyata T, Minaga K, Yamao K, Imai H, Sakurai T, Nishida N, Kashida H, Chikugo T, Chiba Y, Nakai T, Takeyama Y, Lisotti A, Fusaroli P, Kudo M
  • Journal Title: Digestive Endoscopy Volume: 30 Pages: 98～106
  • DOI: 10.1111/den.12900
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Multicenter prospective evaluation study of endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting (with video) (2018)
  • Author(s): Ogura T, Kitano M, Takenaka M, Okuda A, Minaga K, Yamao K, Yamashita Y, Hatamaru K, Noguchi C, Gotoh Y, Kuroda T, Yokota T, Nishikiori H, Sagami R, Higuchi K, Chiba Y
  • Journal Title: Digestive Endoscopy Volume: 30 Pages: 252～259
  • DOI: 10.1111/den.12976
  • Peer Reviewed
• [Journal Article] Long-term outcomes of EUS-guided choledochoduodenostomy using a lumen-apposing metal stent for malignant distal biliary obstruction: a prospective multicenter study (2018)
  • Author(s): Tsuchiya T, Teoh AYB, Itoi T, Yamao K, Hara K, Nakai Y, Isayama H, Kitano M
  • Journal Title: Gastrointestinal Endoscopy Volume: 87 Pages: 1138～1146
  • DOI: 10.1016/j.gie.2017.08.017
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Outcomes of endoscopic biliary drainage in pancreatic cancer patients with an indwelling gastroduodenal stent: a multicenter cohort study in West Japan (2018)
  • Author(s): Yamao K, Kitano M, Takenaka M, Minaga K, Sakurai T, Watanabe T, Kayahara T, Yoshikawa T, Yamashita Y, Asada M, Okabe Y, Hanada K, Chiba Y, Kudo M
  • Journal Title: Gastrointestinal Endoscopy Volume: 88 Pages: 66～75.e2
  • DOI: 10.1016/j.gie.2018.01.021
  • Peer Reviewed
• [Journal Article] Clinical efficacy and safety of endoscopic ultrasound‐guided gallbladder drainage replacement of percutaneous drainage: A multicenter retrospective study (2018)
  • Author(s): Minaga K, Yamashita Y, Ogura T, Takenaka M, Shimokawa Y, Hisa T, Itonaga M, Kato H, Nishikiori H, Okuda A, Matsumoto H, Uenoyama Y, Watanabe T, Chiba Y, Higuchi K, Kudo M, Kitano M
  • Journal Title: Digestive Endoscopy Volume: 31 Pages: 180～187
  • DOI: 10.1111/den.13242
  • Peer Reviewed
• [Journal Article] Value of additional endoscopic ultrasonography for surveillance after surgical removal of intraductal papillary mucinous neoplasms (2018)
  • Author(s): Kamata K, Takenaka M, Minaga K, Omoto S, Miyata T, Yamao K, Imai H, Nakai A, Tanaka H, Chiba Y, Watanabe T, Sakurai T, Nishida N, Chikugo T, Matsumoto I, Takeyama Y, Kitano M, Kudo M
  • Journal Title: Digestive Endoscopy Volume: 30 Pages: 659～666
  • DOI: 10.1111/den.13176
  • Peer Reviewed
• [Journal Article] Endoscopic ultrasound‐guided choledochoduodenostomy using a thin stent delivery system in patients with unresectable malignant distal biliary obstruction: A prospective multicenter study (2018)
  • Author(s): Itonaga M, Kitano M, Hatamaru K, Tamura T, Nuta J, Kawaji Y, Takenaka M, Minaga K, Kudo M, Ogura T, Higuchi K, Chiba Y
  • Journal Title: Digestive Endoscopy Volume: 31 Pages: 291～298
  • DOI: 10.1111/den.13300
  • Peer Reviewed
• [Journal Article] Recent advances in endoscopic ultrasound-guided biliary drainage (2018)
  • Author(s): Minaga K, Kitano M
  • Journal Title: Digestive Endoscopy Volume: 30 Pages: 38～47
  • DOI: 10.1111/den.12910
  • Peer Reviewed
• [Journal Article] Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis (2018)
  • Author(s): Minaga K, Takenaka M, Kamata K, Yoshikawa T, Nakai A, Omoto S, Miyata T, Yamao K, Imai H, Sakamoto H, Kitano M, Kudo M
  • Journal Title: Cancers Volume: 10 Pages: 50～50
  • DOI: 10.3390/cancers10020050
  • Peer Reviewed / Open Access
• [Presentation] Guide of Tissue Acquisition (2018)
  • Author(s): Kitano M
  • Organizer: AFSUMB 2018
  • Int'l Joint Research / Invited
• [Presentation] Interventional EUS for pancreatic cancer (2018)
  • Author(s): Kitano M
  • Organizer: IASGO 2018
  • Int'l Joint Research / Invited
• [Presentation] EUS-FNAによる確定診断法の位置づけ，膵臓 現行膵癌超音波診断基準の見直し (2018)
  • Author(s): 北野雅之，糸永昌弘，幡丸景一，山下泰伸，田村崇，奴田絢也，川路祐輝
  • Organizer: 日本超音波医学会第91回学術集会