2023 Fiscal Year Final Research Report

Oncological significance of vagotomy in upper gastrointestinal surgery

Research Project

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Project/Area Number	21K08740
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	Jichi Medical University
Principal Investigator	Hosoya Yoshinori 自治医科大学, 医学部, 教授 (30275698)
Co-Investigator(Kenkyū-buntansha)	北山丈二自治医科大学, 医学部, 教授 (20251308) 堀江久永自治医科大学, 医学部, 教授 (20316532) 佐田友藍自治医科大学, 医学部, 助教 (40528585) 齋藤心自治医科大学, 医学部, 准教授 (60382909) 倉科憲太郎自治医科大学, 医学部, 准教授 (70382900) 宮戸秀世自治医科大学, 医学部, 准教授 (90813163)
Project Period (FY)	2021-04-01 – 2024-03-31
Keywords	迷走神経 / コリン作動性シグナル / 胃癌 / 腹膜播種 / 大腸乳斑 / 腹腔免疫 / マクロファージ / T細胞
Outline of Final Research Achievements	When gastric cancer cells YTN16 were administered intraperitoneally to mice three weeks after vagus nerve transection under the diaphragm, peritoneal dissemination was significantly increased compared to the control group. In the vagotomy group, immune cells in the peritoneal cavity and throughout the body tended to increase immediately after tumor cell administration. In addition, the milky spot in the omentum was significantly enlarged on the first day of YTN16P administration, and a large number of F4/80-positive macrophages were observed, as well as a significantly large number of cancer cells engrafting. These results suggest that vagotomy may contribute to the enhancement of peritoneal dissemination by inducing an inflammatory response in the milky spot early after administration and promoting the engraftment of cancer cells.
Free Research Field	消化器外科学
Academic Significance and Societal Importance of the Research Achievements	迷走神経シグナルは腹腔内の局所免疫を介して腹膜播種の成立に抑制的な作用を有しており、進行胃癌の根治手術に伴う横隔膜下での迷走神経切除は術後の播種再発を促進する可能性があることが示唆された。今回の研究結果から、進行胃癌に対する根治手術において、腹膜播種再発のハイリスク症例に対しては迷走神経を温存することで患者予後の改善につながる可能性があることが示唆され、進行胃癌の手術術式についての新たな示唆を与えることができた。