2021 Fiscal Year Final Research Report

Development of new diagnostic method for duodenal ampullary carcinoma amenable to local excision

Research Project

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Project/Area Number	18K08614
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 55020:Digestive surgery-related
Research Institution	Nagoya University
Principal Investigator	Kawashima Hiroki 名古屋大学, 医学部附属病院, 准教授 (20378045)
Co-Investigator(Kenkyū-buntansha)	廣岡芳樹藤田医科大学, 医学部, 教授 (50324413) 大野栄三郎名古屋大学, 医学部附属病院, 病院講師 (00447822) 宮原良二名古屋大学, 医学系研究科, 講師 (50378056) 中村正直名古屋大学, 医学部附属病院, 講師 (60467321) 舩坂好平名古屋大学, 医学系研究科, 助教 (70599034) 古川和宏名古屋大学, 医学部附属病院, 病院講師 (70624310)
Project Period (FY)	2018-04-01 – 2022-03-31
Keywords	十二指腸乳頭部腫瘍 / 内視鏡的乳頭切除術 / 十二指腸乳頭部癌 / 十二指腸乳頭部腺腫 / 免疫染色 / IMP3
Outline of Final Research Achievements	Diagnosis by immunostaining: 14 surgically removed specimens of papillary tumor cases and 11 specimens removed by endoscopic resection were included. A relationship between pathologic progression and IMP3 staining morphology was observed in these cases. A significant difference in the ratio of positive cells was observed between tumors that were epidemiologically considered locally resectable (n=10) and those that required surgery (n=15). The ROC curve showed that setting the cut-off value at 10% enabled a positive diagnosis with accuracy of 80% for resection specimens, and accuracy of 75% for biopsy specimens. These results were reported. Diagnosis by computer aided diagnostic imaging (CAD): Various methods were explored in 150 cases with unsatisfactory results.
Free Research Field	消化器内科
Academic Significance and Societal Importance of the Research Achievements	画像診断では客観的な診断方法がない局所切除可能な乳頭部腫瘍（腺腫とOddi筋に浸潤のない癌）を、IMP3の生検組織による免疫染色で75％の正診率で診断可能であることを示した。この結果は内視鏡的切除あるいは手術の方針決定に客観性を担保する上で意義深いと考えられる。