Details of a Researcher - Iwata, Takashi

Papers - Iwata, Takashi

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P16^INK4a immunohistochemistry is a promising biomarker to predict the outcome of low grade cervical intraepithelial neoplasia

Nishio Sakiko, Fujii Takuma, Nishio Hiroshi, Kameyama Kaori, Saito Miyuki, Iwata Takashi, Kubushiro Kaneyuki, Aoki Daisuke

Journal of Gynecologic Oncology 24 ( 3 ) 215 - 221 2013

ISSN 2005-0380

Objective: In cervical intraepithelial neoplasia (CIN), p16^INK4a immunohistochemistry has been reported to be a useful diagnostic biomarker. However, limited information is available about the association between the p16^INK4a immunohistochemistry and the outcomes of CIN. Here, we report p16^INK4a immunohistochemistry as an effective biomarker to predict the outcomes of CIN. Methods: p16^INK4a immunohistochemistry was performed in patients with CIN from January 2000 to August 2009. Among these patients, we have performed a retrospective analysis of the medical records to evaluate the outcome of CIN 1-2 and performed statistical analysis to determine the correlation between p16^INK4a expression and the outcomes. We also performed HPV genotyping and analyzed the relation between the infecting human papillomavirus (HPV) genotype and the outcomes. Results: A total of 244 patients, including 82 with CIN 1, 60 with CIN 2, and 102 with CIN 3, were examined. The rate of p16^INK4a overexpression increased with increasing CIN grade, 20.7% for CIN 1, 80.0% for CIN 2, and 89.2% for CIN 3, with significant differences between CIN 1 and CIN 2-3 group. In the 131 CIN 1-2 patients, the progression rate was significantly higher for the patients showing p16^INK4a overexpression than for those not showing p16^INK4a overexpression (p=0.005); the regression rate was also found to be significantly lower for the patients showing p16^INK4a overexpression (p=0.003). High-risk HPV genotypes were detected in 73 patients (73.7%). Both progression and regression rates were not significantly different between the high-risk HPV-positive and HPV-negative groups (p=0.401 and p=0.381, respectively). Conclusion: p16^INK4a overexpression was correlated with the outcome of CIN 1-2, and p16^INK4a is considered to be a superior biomarker for predicting the outcome of CIN 1-2 compared with HPV genotyping. © 2013. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

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【らくらく理解!見方・読み方・読む視点　保存版:産科の検査値まるごと大図鑑】子宮頸部細胞診

岩田, 卓

ペリネイタルケア 32 ( 6 ) 532 - 534 2013

ISSN 0910-8718

【婦人科がん手術の基本手技を学ぶ】広汎性子宮頸部摘出術における妊孕能向上への工夫

藤井, 多久磨, 田中, 京子, 廣瀬, 茂道, 岩田, 卓, 杉山, 重里 and 青木, 大輔

産婦人科手術 ( 24 ) 37 - 42 2013

ISSN 0915-8375

Cancer-testis antigen BORIS is a novel prognostic marker for patients with esophageal cancer

Okabayashi, K., Fujita, T., Miyazaki, J., Okada, T., Iwata, T., Hirao, N., Noji, S., Tsukamoto, N., Goshima, N., Hasegawa, H., Takeuchi, H., Ueda, M., Kitagawa, Y. and Kawakami, Y.

Cancer Sci 103 ( 9 ) 1617 - 24 2012.09

ISSN 1349-7006

Esophageal squamous cell cancer (ESCC) is one of the most common lethal tumors in the world, and development of new diagnostic and therapeutic methods is needed. In this study, cancer-testis antigen, BORIS, was isolated by functional cDNA expression cloning using screening technique with serum IgG Abs from ESCC patients. BORIS was previously reported to show cancer-testis antigen like expression, but its immunogenicity has remained unclear in cancer patients. BORIS was considered to be an immunogenic antigen capable of inducing IgG Abs in patients with various cancers, including four of 11 ESCC patients. Immunohistochemical study showed that the BORIS protein was expressed in 28 of 50 (56%) ESCC tissues. The BORIS expression was significantly associated with lymph node metastasis in ESCC patients with pT1 disease (P = 0.036). Furthermore, the patients with BORIS-positive tumors had a poor overall survival (5-year survival rate: BORIS-negative 70.0% vs BORIS-positive 29.9%, log-rank P = 0.028) in Kaplan-Meier survival analysis and log-rank test. Multivariate Cox proportional hazard model demonstrated that BORIS expression was an independent poor prognostic factor (hazard ratio = 4.158 [95% confidence interval 1.494-11.57], P = 0.006). Downregulation of BORIS with specific siRNAs resulted in decreased cell proliferation and invasion ability of ESCC cell lines. BORIS may be a useful biomarker for prognostic diagnosis of ESCC patients and a potential target for treatment including by BORIS-specific immunotherapy and molecular target therapy.

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Cancer-testis antigen BORIS is a novel prognostic marker for patients with esophageal cancer

Okabayashi Koji, Fujita Tomonobu, Miyazaki Junichiro, Okada Tsutomu, Iwata Takashi, Hirao Nobumaru, Noji Shinobu, Tsukamoto Nobuo, Goshima Naoki, Hasegawa Hirotoshi, Takeuchi Hiroya, Ueda Masakazu, Kitagawa Yuko, Kawakami Yutaka

Cancer Science 103 ( 9 ) 1617 - 1624 2012.09

ISSN 1347-9032

Esophageal squamous cell cancer (ESCC) is one of the most common lethal tumors in the world, and development of new diagnostic and therapeutic methods is needed. In this study, cancer-testis antigen, BORIS, was isolated by functional cDNA expression cloning using screening technique with serum IgG Abs from ESCC patients. BORIS was previously reported to show cancer-testis antigen like expression, but its immunogenicity has remained unclear in cancer patients. BORIS was considered to be an immunogenic antigen capable of inducing IgG Abs in patients with various cancers, including four of 11 ESCC patients. Immunohistochemical study showed that the BORIS protein was expressed in 28 of 50 (56%) ESCC tissues. The BORIS expression was significantly associated with lymph node metastasis in ESCC patients with pT1 disease (P = 0.036). Furthermore, the patients with BORIS-positive tumors had a poor overall survival (5-year survival rate: BORIS-negative 70.0% vs BORIS-positive 29.9%, log-rank P = 0.028) in Kaplan-Meier survival analysis and log-rank test. Multivariate Cox proportional hazard model demonstrated that BORIS expression was an independent poor prognostic factor (hazard ratio = 4.158 [95% confidence interval 1.494-11.57], P = 0.006). Downregulation of BORIS with specific siRNAs resulted in decreased cell proliferation and invasion ability of ESCC cell lines. BORIS may be a useful biomarker for prognostic diagnosis of ESCC patients and a potential target for treatment including by BORIS-specific immunotherapy and molecular target therapy. © 2012 Japanese Cancer Association.

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Tumor volume and lymphovascular space invasion as a prognostic factor in early invasive adenocarcinoma of the cervix

Murakami, I., Fujii, T., Kameyama, K., Iwata, T., Saito, M., Kubushiro, K. and Aoki, D.

J Gynecol Oncol 23 ( 3 ) 153 - 8 2012.07

ISSN 2005-0399

The aim of this study was to investigate the risk and recurrence of early invasive adenocarcinoma of the cervix, and to determine whether non-radical methods of management could be performed.|The medical and histopathological records of 50 patients with early invasive adenocarcinoma of the cervix treated at Keio University Hospital between 1993 and 2005 were reviewed, and compared with the literature.|The median follow-up period was 64.3 months. The depth of stromal invasion was ≤3 mm in 33 cases and >3 mm, but ≤5 mm in 17 cases. The horizontal spread was ≤7 mm in 25 cases and >7 mm in 25 cases. One of the 33 cases that had tumor volumes of ≤500 mm(3), and three of the 17 cases with tumor volumes of >500 mm(3) were positive for lymph node metastasis. When our data were combined with previously reported results, statistically significant differences were observed between the tumor volume and the frequency of pelvic lymph node metastasis/the rate of recurrence (p<0.0001). The frequency of pelvic lymph node metastases was significantly higher in the lymphovascular space invasion (LVSI)-positive group than in the LVSI-negative group (p=0.02). No adnexal metastasis or parametrial involvement was noted.|Assessment of the depth of stromal invasion, tumor volume, and LVSI is critical for selecting an appropriate therapeutic modality. Non-radical methods of management are considered suitable for patients with LVSI-negative adenocarcinoma of the cervix exhibiting a stromal invasion depth of ≤5 mm and a tumor volume of ≤500 mm(3).

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Tumor volume and lymphovascular space invasion as a prognostic factor in early invasive adenocarcinoma of the cervix

Murakami Isao, Fujii Takuma, Kameyama Kaori, Iwata Takashi, Saito Miyuki, Kubushiro Kaneyuki, Aoki Daisuke

Journal of Gynecologic Oncology 23 ( 3 ) 153 - 158 2012.06

ISSN 2005-0380

Objective: The aim of this study was to investigate the risk and recurrence of early invasive adenocarcinoma of the cervix, and to determine whether non-radical methods of management could be performed. Methods: The medical and histopathological records of 50 patients with early invasive adenocarcinoma of the cervix treated at Keio University Hospital between 1993 and 2005 were reviewed, and compared with the literature. Results: The median follow-up period was 64.3 months. The depth of stromal invasion was ≤3 mm in 33 cases and >3 mm, but ≤5 mm in 17 cases. The horizontal spread was ≤7 mm in 25 cases and >7 mm in 25 cases. One of the 33 cases that had tumor volumes of ≤500 mm ³, and three of the 17 cases with tumor volumes of >500 mm ³ were positive for lymph node metastasis. When our data were combined with previously reported results, statistically significant differences were observed between the tumor volume and the frequency of pelvic lymph node metastasis/the rate of recurrence (p<0.0001). The frequency of pelvic lymph node metastases was significantly higher in the lymphovascular space invasion (LVSI)-positive group than in the LVSI-negative group (p=0.02). No adnexal metastasis or parametrial involvement was noted. Conclusion: Assessment of the depth of stromal invasion, tumor volume, and LVSI is critical for selecting an appropriate therapeutic modality. Non-radical methods of management are considered suitable for patients with LVSI-negative adenocarcinoma of the cervix exhibiting a stromal invasion depth of ≤5 mm and a tumor volume of ≤500 mm ³. © 2012. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

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”大建中湯”の長期内服が深部静脈血栓症発症後の下肢痛に有効であった1例

堀場, 裕子, 牧田, 和也, 横田, めぐみ, 岩田, 卓, 青木, 大輔 and 吉村, 泰典

産婦人科漢方研究のあゆみ ( 29 ) 50 - 53 2012

ISSN 0913-865X

53歳女性。27歳時に胞状奇胎にて子宮内容掻爬術を2回施行され、34歳時には単純子宮全摘術+肺部分切除術が予定されていたが、術前に深部静脈血栓症が判明し、IVCフィルター挿入後に手術施行となった。今回、腹部膨満の自覚ほか、冷えの増悪と便秘が出現して紹介来院となった。漢方医学的所見では顔面蒼白で、体格は中程度、舌は白色・湿潤・歯痕ありで、脈は沈・遅であった。以上、これらを踏まえ、全身の冷えと腹部膨満を目標に大建中湯エキス顆粒(15g/日)の処方を行ったところ、内服開始4週間で冷えと腹部膨満の軽減を自覚、更に1ヵ月経過で腹部膨満はほとんど消失した。しかし、内服開始3ヵ月経過で冷えは軽減し熟眠できるようになったが、内服を中止すると腹部膨満と便秘が出現するため、本人の希望で現在も同処方を内服継続中である。以上、大建中湯の長期内服は腸閉塞の発症予防とともに患者のQOLの改善に有用であり、身近で簡便に使用できる漢方製剤の一つと考えられた。

【婦人科悪性腫瘍の診断治療アップデート】子宮頸がん　子宮頸癌の進行期分類と治療方針

岩田, 卓 and 青木, 大輔

産婦人科の実際 61 ( 3 ) 301 - 308 2012

ISSN 0558-4728

【生殖医療と周辺領域との関わり】腫瘍　子宮頸癌の治療と生殖医療の役割

藤井, 多久磨, 西尾, 浩, 杉山, 樹里, 岩田, 卓 and 青木, 大輔

産科と婦人科 78 ( 3 ) 332 - 336 2011

ISSN 0386-9792

【症例の比較で学ぶ画像診断　婦人科・泌尿生殖器領域50選】子宮頸部　子宮頸癌術後の病変

秋田, あやの, 秋田, 大宇, 奥田, 茂男 and 岩田, 卓

画像診断 31 ( 4 ) s48 - s51 2011

ISSN 0285-0524

【症例の比較で学ぶ画像診断　婦人科・泌尿生殖器領域50選】子宮頸部　頸部の嚢胞性病変

秋田, あやの, 秋田, 大宇, 奥田, 茂男 and 岩田, 卓

画像診断 31 ( 4 ) s44 - s47 2011

ISSN 0285-0524

【症例の比較で学ぶ画像診断　婦人科・泌尿生殖器領域50選】子宮頸部　頸管内に下垂した体部病変

秋田, あやの, 秋田, 大宇, 奥田, 茂男 and 岩田, 卓

画像診断 31 ( 4 ) s40 - s43 2011

ISSN 0285-0524

【症例の比較で学ぶ画像診断　婦人科・泌尿生殖器領域50選】子宮頸部　頸部の腫瘤性病変

秋田, あやの, 秋田, 大宇, 奥田, 茂男 and 岩田, 卓

画像診断 31 ( 4 ) s36 - s39 2011

ISSN 0285-0524

【婦人科がん妊孕性・卵巣機能温存治療と妊娠・分娩】子宮頸癌に対する広汎性子宮頸部摘出術

西尾, 浩, 藤井, 多久磨, 杉山, 重里, 仲村, 勝, 岩田, 卓 and 青木, 大輔

産婦人科の実際 60 ( 2 ) 155 - 160 2011

ISSN 0558-4728

機能温存手術　広汎性子宮頸部摘出術におけるneo-cervix形成の工夫

田中, 京子, 藤井, 多久磨, 杉山, 重里, 西尾, 浩, 岩田, 卓 and 青木, 大輔

産婦人科手術 ( 22 ) 101 - 105 2011

ISSN 0915-8375

Digital colposcopy for the diagnosis of cervical adenocarcinoma using a narrow band imaging system

Fujii, T., Nakamura, M., Kameyama, K., Saito, M., Nishio, H., Ohno, A., Hirao, N., Iwata, T., Tsukazaki, K. and Aoki, D.

Int J Gynecol Cancer 20 ( 4 ) 605 - 10 2010.05

ISSN 1525-1438

Although the colposcopic features of cervical glandular disease and cervical adenocarcinoma are not widely well known, unique microvascular patterns are reportedly useful for identifying such diseases. The narrow band imaging (NBI) system used in endoscopy can be used to obtain high-contrast vascular images. Therefore, we examined the utility of NBI colposcopy and compared the results with those of conventional colposcopy.|Twenty-one patients with adenocarcinoma in situ or early invasive adenocarcinomas were examined using digital NBI colposcopy, and the photo records were compared with those of conventional colposcopy. The histological examination and immunohistochemistry with anti-CD31 antibody confirmed the microvascular pattern.|Digital NBI colposcopy depicted the fine vascular texture on the surface of the cervix more clearly than conventional colposcopy. The vascular pattern was depicted in 86% (18/21) of glandular disease cases. The characteristic fine vascular patterns were critical for identifying cervical glandular diseases.|Digital NBI colposcopy was useful for identifying early cervical adenocarcinoma as well as adenocarcinoma in situ. This system yields cervical glandular disease-related colposcopic findings that may be useful for both clinical and educational purposes.

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Digital colposcopy for the diagnosis of cervical adenocarcinoma using a narrow band imaging system

Fujii Takuma, Nakamura Masaru, Kameyama Kaori, Saito Miyuki, Nishio Hiroshi, Ohno Akiko, Hirao Nobumaru, Iwata Takashi, Tsukazaki Katsumi, Aoki Daisuke

International Journal of Gynecological Cancer 20 ( 4 ) 605 - 610 2010.05

ISSN 1048-891X

Introduction: Although the colposcopic features of cervical glandular disease and cervical adenocarcinoma are not widely well known, unique microvascular patterns are reportedly useful for identifying such diseases. The narrow band imaging (NBI) system used in endoscopy can be used to obtain high-contrast vascular images. Therefore, we examined the utility of NBI colposcopy and compared the results with those of conventional colposcopy. Methods: Twenty-one patients with adenocarinoma in situ or early invasive adenocarci-nomas were examined using digital NBI colposcopy, and the photo records were compared with those of conventional colposcopy. The histological examination and immunohisto-chemistry with anti-CD31 antibody confirmed the microvascular pattern. Results: Digital NBI colposcopy depicted the fine vascular texture on the surface of the cervix more clearly than conventional colposcopy. The vascular pattern was depicted in 86% (18/21) of glandular disease cases. The characteristic fine vascular patterns were critical for identifying cervical glandular diseases. Conclusions: Digital NBI colposcopy was useful for identifying early cervical adeno-carcinoma as well as adenocarcinoma in situ. This system yields cervical glandular disease-related colposcopic findings that may be useful for both clinical and educational purposes.

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Abdominal Radical Trachelectomy as a Fertility-Sparing Procedure in Women With Early Stage Cervical Cancer in a Series of 61 Women COMMENT

Nishio, H., Fujii, T., Kameyama, K., Susumu, N., Nakamura, M., Iwata, T. and Aoki, D.

Obstetrical & Gynecological Survey 65 ( 1 ) 19 - 20 2010.01

ISSN 0029-7828

Although vaginal radical trachelectomy is an effective treatment for early stage cervical cancer and has an acceptable live birth rate, there are concerns over its oncological safety and possible-surgical injury with this radical procedure. Moreover, most gynecologists have difficulty performing this unfamiliar procedure and require special training. Many of these problems can be overcome with the use of abdominal radical trachelectomy. The abdominal approach provides adequate resection of the parametrial and vaginal tissue and does not require special training. Only a few case studies have investigated abdominal radical trachelectomy. This retrospective study presents follow-up data and reviews a series of cases conducted in Japanese women with early stage cervical cancer who had undergone elective abdominal radical trachelectomy and pelvic lymphadenectomy between 2002 and 2008. The aim of the study was to assess the effectiveness and safety of the abdominal approach in this population. A total of 61 patients at a median age of 33 years (range, 26-44 years) were followed up for a median 27 months (range, 1-67 months). There were 6 recurrences (9.8%, 6/61); 1 occurred in a patient with adenocarcinoma. None of the other 5 recurrences were found in cases with a primary tumor diameter of <20 mm. Twenty-nine (47.5%) of the 61 patients attempted to conceive and 4 (13.8%) were successful. Of the 4 live births, 2 were preterm, the remaining 2 were full term. The rates of serious intraoperative and postoperative complications were similar to those reported in the literature for standard radical hysterectomy and lymphadenectomy. The investigators conclude from these findings that an abdominal radical trachelectomy is an effective and relatively safe procedure in selected patients and may be an acceptable treatment option for young women with early stage cervical cancer.

Abdominal radical trachelectomy as a fertility-sparing procedure in women with early stage cervical cancer in a series of 61 women

Nishio Hiroshi, Fujii Takuma, Kameyama Kaori, Susumu Nobuyuki, Nakamura Masaru, Iwata Takashi, Aoki Daisuke

Obstetrical and Gynecological Survey 65 ( 1 ) 19 - 20 2010.01

ISSN 0029-7828

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