2020 Fiscal Year Final Research Report
Establishment and therapeutic application of a new clinical staging system based on the biological features of pancreatic adenocarcinoma
| Project/Area Number |
17K09459
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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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| Research Field |
Gastroenterology
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| Research Institution | Mie University |
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Principal Investigator |
Isaji Shuji 三重大学, 医学部附属病院, 病院長 (70176121)
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| Co-Investigator(Kenkyū-buntansha) |
村田 泰洋 三重大学, 医学部附属病院, 講師 (20572655)
水野 修吾 三重大学, 医学系研究科, 教授 (70335131)
岸和田 昌之 三重大学, 医学部附属病院, 准教授 (40501961)
加藤 宏之 三重大学, 医学部附属病院, 助教 (50737004)
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| Project Period (FY) |
2017-04-01 – 2021-03-31
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| Keywords | 浸潤性膵管癌 / 生物学的悪性度 / 化学放射線治療 / 免疫栄養指標 / 局所進行切除不能膵癌 / 境界切除可能膵癌 |
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| Outline of Final Research Achievements |
Preoperative chemoradiotherapy (CRT) offers benefits, including downstaging of the primary tumor with a consequent reduction in the risks of a microscopically positive resection for the patients with localized pancreatic adenocarcinoma (PDAC). However, the prognosis of the localized PDAC patients who could not undergo resection after CRT because of local progression and distant metastasis is usually dismal. This study aimed to clarify the clinicopathological features of localized PDAC that was resistant to CRT or have distant occult metastasis. We reported that the international consensus on the definition of borderline resectable PDAC based on anatomical, biological, and conditional factors, was associated with prognosis after CRT and the prognostic nutritional index after CRT was the strongest prognostic factor among the conditional factors. We reported that CEA value before preoperative CRT was a crucial prognostic indicator for the patients with locally advanced unresectable PDAC.
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| Free Research Field |
肝胆膵・移植外科学
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| Academic Significance and Societal Importance of the Research Achievements |
本研究の結果、術前化学放射線治療に耐性を示し、潜在性微小遠隔転移が顕在化したため、非切除となった予後不良な局所性膵癌の生物学的特性や宿主の因子を新たに同定した。膵癌のさらなる治療成績向上のためには、個々の腫瘍の生物学的悪性度ならびに宿主の免疫栄養指標に基づいた膵癌の臨床病期システムとそれに基づいた治療プロトコールの確立が急務であり、本研究の成果は今後さらなる臨床応用が期待され、膵癌の予後改善に貢献することが期待される。
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