論文 - 橋口　明典

Detection of the Highest-Grade Lesion in Multifocal Discordant Prostate Cancer by Multiparametric Magnetic Resonance Imaging

Matsumoto K., Akita H., Hashiguchi A., Takeda T., Kosaka T., Fukumoto K., Yasumizu Y., Tanaka N., Morita S., Mizuno R., Asanuma H., Oya M., Jinzaki M.

Clinical Genitourinary Cancer （Clinical Genitourinary Cancer）  22 （ 3 ） 102084 - 102084 2024年06月

共著,  ISSN  15587673

　概要を見る

Purpose: Prostate cancer generally occurs multifocally. The lesions of the largest size and highest-grade are often concordant, and defined as an index tumor. However, these factors sometimes do not coincide within one lesion. In such discordant cases, not the largest size lesion but the highest-grade lesion is known to determine the prognosis. We focused on the multiparametric magnetic resonance imaging (mpMRI) detectability of the highest-grade tumors in discordant cases. Materials and Methods: We investigated the detectability of the highest-grade tumor using preoperative mpMRI in 50 discordant patients who underwent radical prostatectomy. The radiologist was informed of the tumor location on the pathological tumor map, and mpMRI interpretation for each tumor was performed. Results: Prostate Imaging-Reporting and Data System (PI-RADS) scores of 1, 2, 3, 4, and 5 on preoperative mpMRI were assigned to 13, 1, 9, 16, and 11 of the largest tumors, respectively. On the other hand, scores of 1, 2, 3, 4, and 5 were assigned to 23, 0, 7, 19, and 1 of the highest-grade tumors, respectively. The difference between them was statistically significant (p=0.007). We also found that the largest anterior tumor frequently hid the ipsilateral posterior highest-grade tumor; the detection rate of the highest-grade tumor in this pattern was 42.1% (8 of 19 cases) Conclusion: We found that mpMRI detectability of the highest-grade tumor in discordant cases was inferior to that of the largest tumor with low malignant potential. Our results suggest that the risk of high-grade tumors which determine patient prognosis being overlooked.

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慢性腎臓病患者における腎洞脂肪量と腎血行動態の関連の検証

金子 賢司, 満野 竜之介, 児島 大輝, 畔上 達彦, 小杉 将太郎, 中村 俊文, 橋口 明典, 山田 祥岳, 陣崎 雅弘, 山口 慎太郎, 伊藤 裕, 吉野 純, 林 香

日本腎臓学会誌 （(一社)日本腎臓学会）  66 （ 4 ） 586 - 586 2024年06月

共著,  ISSN  0385-2385

Establishment of artificial intelligence model for precise histological subtyping of lung adenocarcinoma and its application to quantitative and spatial analysis.

Miura E, Emoto K, Abe T, Hashiguchi A, Hishida T, Asakura K, Sakamoto M

Japanese journal of clinical oncology 54 （ 9 ） 1009 - 1023 2024年05月

共著,  ISSN  0368-2811

　概要を見る

Background: The histological subtype of lung adenocarcinoma is a major prognostic factor. We developed a new artificial intelligence model to classify lung adenocarcinoma images into seven histological subtypes and adopted the model for whole-slide images to investigate the relationship between the distribution of histological subtypes and clinicopathological factors. Methods: Using histological subtype images, which are typical for pathologists, we trained and validated an artificial intelligence model. Then, the model was applied to whole-slide images of resected lung adenocarcinoma specimens from 147 cases. Result: The model achieved an accuracy of 99.7% in training sets and 90.4% in validation sets consisting of typical tiles of histological subtyping for pathologists. When the model was applied to whole-slide images, the predominant subtype according to the artificial intelligence model classification matched that determined by pathologists in 75.5% of cases. The predominant subtype and tumor grade (using the WHO fourth and fifth classifications) determined by the artificial intelligence model resulted in similar recurrence-free survival curves to those determined by pathologists. Furthermore, we stratified the recurrence-free survival curves for patients with different proportions of high-grade components (solid, micropapillary and cribriform) according to the physical distribution of the high-grade component. The results suggested that tumors with centrally located high-grade components had a higher malignant potential (P < 0.001 for 5-20% high-grade component). Conclusion: The new artificial intelligence model for histological subtyping of lung adenocarcinoma achieved high accuracy, and subtype quantification and subtype distribution analyses could be achieved. Artificial intelligence model therefore has potential for clinical application for both quantification and spatial analysis.

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慢性腎臓病患者における腎洞脂肪量と腎血行動態の関連の検証

金子 賢司, 満野 竜ノ介, 児島 大輝, 畔上 達彦, 中村 俊文, 橋口 明典, 山田 祥岳, 陣崎 雅弘, 山口 慎太郎, 伊藤 裕, 吉野 純, 林 香

日本内分泌学会雑誌 （(一社)日本内分泌学会）  100 （ 1 ） 348 - 348 2024年05月

共著,  ISSN  0029-0661

慢性腎臓病患者における腎洞脂肪量と腎血行動態の関連の検証

金子 賢司, 満野 竜ノ介, 児島 大輝, 畔上 達彦, 中村 俊文, 橋口 明典, 山田 祥岳, 陣崎 雅弘, 山口 慎太郎, 伊藤 裕, 吉野 純, 林 香

日本内分泌学会雑誌 （(一社)日本内分泌学会）  100 （ 1 ） 348 - 348 2024年05月

共著,  ISSN  0029-0661

透析導入期に進行する心機能低下からミトコンドリア病の診断に至った一例

松本 大, 萩原 あいか, 満野 竜ノ介, 吉本 憲史, 菱川 彰人, 畔上 達彦, 橋口 明典, 森本 耕吉, 吉田 理, 山口 慎太郎, 林 香

日本透析医学会雑誌 （(一社)日本透析医学会）  57 （ Suppl.1 ） 547 - 547 2024年05月

共著,  ISSN  1340-3451

反復する肉眼的血尿に伴う急性腎障害で発症したIgA腎症の9歳男児

小林 寛太朗, 吉田 真, 湯浅 絵理佳, 高橋 努, 橋口 明典, 本田 雅敬

日本小児腎臓病学会雑誌 （(一社)日本小児腎臓病学会）  37 （ Suppl. ） 104 - 104 2024年05月

共著,  ISSN  0915-2245

アシクロビルによる急性腎障害に対して血液透析を行った一例

三守 賢, 畔上 達彦, 萩原 あいか, 菱川 彰人, 吉本 憲史, 橋口 明典, 吉田 理, 森本 耕吉, 山口 慎太郎, 林 香

日本透析医学会雑誌 （(一社)日本透析医学会）  57 （ Suppl.1 ） 529 - 529 2024年05月

共著,  ISSN  1340-3451

Renal sinus fat is associated with intrarenal hemodynamic abnormalities independent of visceral fat in patients with chronic kidney disease

Kaneko K., Mitsuno R., Kojima D., Azegami T., Kosugi S., Nakamura T., Hashiguchi A., Yamada Y., Jinzaki M., Yamaguchi S., Itoh H., Yoshino J., Hayashi K.

Obesity Research and Clinical Practice （Obesity Research and Clinical Practice）  18 （ 2 ） 118 - 123 2024年03月

共著,  ISSN  1871403X

　概要を見る

Objective: Obesity is a risk factor of chronic kidney disease (CKD), contributing to the rising incidence of cardiometabolic diseases. Renal sinus fat (RSF) is an ectopic fat depot located at the renal cavity that could impair renal function and hemodynamic through compression of renal structures. The major purpose of this study was to explore the relationship between RSF accumulation and renal dysfunction in CKD patients. Methods: We evaluated the associations between computed tomography measured RSF volume and key clinical and histologic parameters involved in renal function and hemodynamics in 132 well-characterized CKD patients who underwent renal biopsy (median age: 62 years; 63.6% men). Results: RSF volume normalized by renal volume (RSF%) positively correlated with obesity-related traits such body mass index and visceral fat volume (VFV) (all P < 0.001) whereas it negatively correlated with estimated glomerular filtration rate (eGFR) (ρ = −0.42, P < 0.001) and 24-h urinary creatinine clearance (CCr) (ρ = −0.34, P < 0.001). Notably, we found robust positive correlations between RSF% and renal resistive index (RRI) measured by the Doppler ultrasound (ρ = 0.40, P < 0.001), and the histological severity of global glomerular sclerosis (ρ = 0.48, P < 0.001) and interstitial fibrosis and tubular atrophy (IFTA) (ρ = 0.35, P < 0.001). In the multivariate linear regression models, after accounting for potential confounders including VFV, RSF% remained significantly associated with CCr (β = −0.26, P < 0.001), RRI (β = 0.17, P = 0.022), global glomerular sclerosis (β = 0.21, P = 0.002), and IFTA (β = 0.17, P = 0.012). Conclusion: RSF accumulation is associated with renal dysfunction and hemodynamic abnormalities independent of visceral adiposity. Our results suggest that RSF may have a potential unique role in the pathogenesis of CKD.

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Morphological and etiological analyses of C3 and non-C3 glomerulonephritis in primary membranoproliferative glomerulonephritis using periodic acid-methenamine silver stain electron microscopy: a retrospective multicentered study

Honma S., Sato N., Sakaguchi R., Hashiguchi A., Uesugi N., Nakamura Y., Sasano H., Joh K.

Medical Molecular Morphology （Medical Molecular Morphology）  57 （ 1 ） 23 - 34 2024年03月

共著,  ISSN  18601480

　概要を見る

This study elucidated the etiology of C3 glomerulonephritis (C3GN) and non-C3GN with primary membranoproliferative glomerulonephritis (MPGN) using transmission electron microscopy (TEM) and periodic acid-methenamine silver stain (PAM-EM). Thirty-one primary MPGN cases were analyzed by TEM and PAM-EM to distinguish among MPGN I, MPGN II, MPGN III Burkholder subtype (MPGN IIIB), and Anders and Strife subtype (MPGN IIIA/S). Each case was also classified into C3GN or non-C3GN according to the standard C3GN definition using immunostaining. Four cases of MPGN II met C3 glomerulopathy; whereas, four cases of MPGN IIIB did not meet C3 glomerulopathy. Seven of 11 cases (64%) of MPGN I without GBM disruption and 7 of 12 cases (58%) of MPGN IIIA/S with GBM disruption met the non-C3GN criteria with significant immunoglobulins’ deposition. Regardless of the C3GN or non-C3GN diagnosis, the deposits in primary MPGN I and MPGN IIIA/S exhibited ill-defined, amorphous, and foggy characteristics similar to those found in postinfectious GN but were different from immune complex (IC) deposits seen in MPGN IIIB. Not only C3GN but also non-C3GN was due to mechanisms other than IC deposition as found in postinfectious GN. Consequently, GBM disruption of MPGN IIIA/S was not due to IC deposition.

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Clinicopathological prognostic stratification for proteinuria and kidney survival in IgA nephropathy: a Japanese prospective cohort study

Koike K., Kawamura T., Hirano K., Nishikawa M., Shimizu A., Joh K., Katafuchi R., Hashiguchi A., Yano Y., Matsuzaki K., Matsushima M., Tsuboi N., Maruyama S., Narita I., Yokoo T., Suzuki Y.

Clinical Kidney Journal （Clinical Kidney Journal）  17 （ 1 ） sfad294 2024年01月

共著,  ISSN  20488505

　概要を見る

Background. We require a clinicopathological risk stratification method for immunoglobulin A nephropathy (IgAN) to predict kidney outcomes. We examined a renal failure risk group (RF-RG) classification system created following a prior multicentre, retrospective study to determine if RF-RG could predict kidney outcomes. Methods. We collected data from Japanese patients with IgAN registered between 1 April 2005 and 31 August 2015. The primary outcome was a composite 50% increase in serum creatinine from baseline or dialysis induction. The secondary outcomes were times to proteinuria remission (ProR) and haematuria remission (HemR). Results. The enrolled 991 patients from 44 facilities were followed for a median of 5.5 years (interquartile range 2.5-7.5), during which 87 composite events (8.8%) occurred. RF-RG was significantly associated with the primary outcome {hazard ratio [HR] II 2.78 [95% confidence interval (CI) 1.12-6.93], III 7.15 (2.90-17.6), IV 33.4 (14.1-79.0), I as a reference, P < .001}. The discrimination performance was good [C-statistic 0.81 (95% CI 0.76-0.86)] and the time-dependent C-statistics exceeded 0.8 over 10 years. Among the 764 patients with proteinuria and 879 patients with haematuria at baseline, 515 and 645 patients showed ProR and HemR, respectively. ProR was significantly less frequent in patients with advanced disease [subdistribution HR: II 0.79 (95% CI 0.67-0.94), III 0.53 (0.41-0.66), IV 0.15 (0.09-0.23), I as a reference, P < .001]. We also observed an association between HemR and RF-RG. Conclusions. RF-RG demonstrated good predictive ability for kidney outcomes.

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Associations of corticosteroid therapy and tonsillectomy with kidney survival in a multicenter prospective study for IgA nephropathy

Kawamura T., Hirano K., Koike K., Nishikawa M., Shimizu A., Joh K., Katafuchi R., Hashiguchi A., Matsuzaki K., Maruyama S., Tsuboi N., Narita I., Yano Y., Yokoo T., Suzuki Y.

Scientific Reports （Scientific Reports）  13 （ 1 ） 18455 - 18455 2023年12月

共著

　概要を見る

Efficacy of systemic corticosteroid therapy (CS) for long-term kidney survival in patients with IgA nephropathy (IgAN) is controversial. Therefore, prospective studies evaluating targeted therapies to lymphatic tissues in mucosal immune system responsible for production of nephritogenic IgA have been desired worldwide. Here, we aimed to evaluate the associations of CS and combination therapy of CS and tonsillectomy (CS + Tx) with kidney survival, using database from a nationwide multicenter prospective cohort study on IgAN. Primary outcome was a 50% increase in serum creatinine from baseline or dialysis induction. The analysis included 941 patients (CS/CS + Tx/non-CS 239/364/338), 85 (9.0%) of whom reached outcomes during median follow-up of 5.5 (interquartile range 2.0–8.0) years. On overlap weighting analysis with balanced baseline characteristics, CS and CS + Tx were associated with lower risk of kidney events when compared with non-CS (hazard ratio [HR] 0.51, 95% confidence interval [CI] 0.29–0.88 and HR 0.20, 95%CI 0.09–0.44, respectively). Notably, when compared with the CS, CS + Tx was associated with a lower risk of kidney events (HR 0.40, 95%CI 0.18–0.91). Present study demonstrated, keeping with favorable association of systemic CS with kidney survival, concurrent tonsillectomy as one of targeted interventions to lymphatic tissues may provide additional improvement to kidney survival in patients with IgAN.

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維持透析後のリツキシマブ寛解維持療法継続により血液透析を離脱した重症難治型ANCA関連血管炎の1例

星 健太, 村上 英人, 小野田 怜依, 熊谷 光祐, 佐藤 由佳, 渡部 統, 中村 彰良, 橋口 明典, 浦井 秀徳

日本透析医学会雑誌 （(一社)日本透析医学会）  56 （ 10 ） 377 - 384 2023年10月

共著,  ISSN  1340-3451

　概要を見る

当院において,コントロール不良の2型糖尿病および間質性肺炎を併存する高齢男性に生じた急速進行性糸球体腎炎(rapidly progressive glomerulonephritis:RPGN)で腎生検組織所見から感染後糸球体腎炎合併ANCA関連糸球体腎炎と診断した症例を経験した.プレドニゾロン(prednisolone:PSL)およびリツキシマブ(rituximab:RTX)で寛解導入療法を行うも腎機能が改善せず,維持血液透析療法導入となった.その後の寛解維持療法の継続により重篤な感染症を呈することなくステロイドを投与終了し残存腎機能の回復を認め,RTXの寛解維持治療中に透析導入後11ヵ月で透析離脱となった.高齢かつ合併症の多いANCA関連血管炎におけるRPGNにおいても,腎予後良好な徴候がみられた場合には適切な感染症予防を行ったうえでRTX療法を継続することで透析離脱が可能となる場合がある.(著者抄録)

当院における腎移植後5年の移植腎生検病理組織の検討

坂巻 裕介, 香野 日高, 橋口 明典, 環 聡, 桝田 司, 高橋 遼平, 萩生田 純, 徳山 博文, 中川 健

移植 （(一社)日本移植学会）  58 （ 総会臨時 ） 336 - 336 2023年09月

共著,  ISSN  0578-7947

慢性糸球体腎炎の臨床経過で腎生検によりmasked IgG kappa depositsを伴う膜性腎症と診断し保存的加療を行った一例

満野 竜ノ介, 吉本 憲史, 橋口 明典, 内山 清貴, 山口 慎太郎, 林 香

日本腎臓学会誌 （(一社)日本腎臓学会）  65 （ 6-E ） 638 - 638 2023年09月

共著,  ISSN  0385-2385

維持透析後のリツキシマブ寛解維持療法継続により血液透析を離脱した重症難治型ANCA関連血管炎の一例

星 健太, 村上 円人, 佐藤 芳紀, 戸田 匡太郎, 高橋 知里, 浦井 秀徳, 橋口 明典

日本腎臓学会誌 （(一社)日本腎臓学会）  65 （ 6-E ） 602 - 602 2023年09月

共著,  ISSN  0385-2385

病因不明の免疫複合体性糸球体腎炎の一例

岩渕 晟英, 吉本 憲史, 中山 尭振, 中道 蘭, 橋口 明典, 山口 慎太郎, 林 香

日本腎臓学会誌 （(一社)日本腎臓学会）  65 （ 6-E ） 622 - 622 2023年09月

共著,  ISSN  0385-2385

本態性血小板血症にネフローゼ症候群を合併し腎生検を行った一例

深澤 佑介, 菊地 隆之, 山中 真理子, 大久保 泰宏, 橋口 明典

日本腎臓学会誌 （(一社)日本腎臓学会）  65 （ 6-E ） 631 - 631 2023年09月

共著,  ISSN  0385-2385

抗凝固薬関連腎症かIgA腎症か,鑑別に難渋した一例

中村 健吾, 吉本 憲史, 中道 蘭, 鳥光 拓人, 安達 京華, 橋口 明典, 山口 慎太郎, 林 香

日本腎臓学会誌 （(一社)日本腎臓学会）  65 （ 6-E ） 659 - 659 2023年09月

共著,  ISSN  0385-2385

多発性嚢胞腎に合併した分節性硬化病変を伴う膜性腎症の1例

三崎 美佳, 川口 隆久, 伊藤 敬, 小林 絵美, 倉田 忠宜, 橋口 明典, 安藤 孝

日本腎臓学会誌 （(一社)日本腎臓学会）  65 （ 6-E ） 576 - 576 2023年09月

共著,  ISSN  0385-2385