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| 1 | Helicobacter pylori infection in subjects negative for high titer serum antibody显示文摘AIM To investigate the clinicopathological features of the patients testing negative for high titer serum antiHelicobacter pylori(H. pylori) antibody.METHODS The antibody titers were measured using antigens derived from Japanese individuals. ^(13)C-urea breath test-positive individuals were defined as having H. pylori infection. We investigated the demographic characteristics, laboratory data, endoscopic findings including Kyoto classification of gastritis, and histology in negative-high titer patients without H. pylori eradication therapy. Kyoto classification consisted of scores for gastric atrophy, intestinal metaplasia, enlarged folds, nodularity, and redness.RESULTS Of the 136 subjects enrolled, 23(17%) had H. pylori infection. Kyoto classification had an excellent area under the receiver operating characteristics curve(0.886, 95% confidence interval: 0.803-0.968, P = 3.7 × 10^(-20)) for predicting H. pylori infection with a cutoff value of 2. Further, Kyoto classification, H. pylori density, and neutrophil activity had high accuracies(89.7%, 96.3%, and 94.1%, respectively). Kyoto classification was independent of the demographic and laboratory parameters in multivariate analysis.CONCLUSION Endoscopic Kyoto classification of gastritis is a useful predictor of H. pylori infection in negative-high titer antibody patients. | Osamu Toyoshima Toshihiro Nishizawa Masahide Arita Yosuke Kataoka Kosuke Sakitani Shuntaro Yoshida Hiroharu Yamashita Keisuke Hata Hidenobu Watanabe Hidekazu Suzuki | 2018 | World Journal of Gastroenterology2018，24，13： | 9 |
| 2 | Serum anti-Helicobacter pylori antibody titer and its association with gastric nodularity,atrophy,and age:A cross-sectional study显示文摘AIM To clarify the role of serum anti-Helicobacter pylori(H. pylori) antibody titers in gastric cancer.METHODS In this cross-sectional study, the effect of patients' baseline characteristics and endoscopic findings on their serum antibody titers were assessed. We evaluated consecutive patients who underwent esophagogastroduodenoscopy and their first evaluation for H. pylori infection using a serum antibody test. We excluded patients with a history of eradication therapy. The participants were divided into four groups according to their E-plate serum antibody titer. Patients with serum antibody titers < 3, 3-9.9, 10-49.9, and ≥ 50 U/m L were classified into groups A, B, C, and D, respectively. RESULTS In total, 874 participants were analyzed with 70%, 16%, 8.7%, and 5.1% of them in the groups A, B, C, and D, respectively. Patients in group C were older than patients in groups A and B. Gastric open-type atrophy, intestinal metaplasia, enlarged folds, diffuse redness, and duodenal ulcers were associated with a high titer. Regular arrangements of collecting venules, fundic gland polyps, superficial gastritis, and gastroesophageal reflux disease were related to a low titer. Multivariate analysis revealed that nodularity(P = 0.0094), atrophy(P = 0.0076), and age 40-59 years(vs age ≥ 60 years, P = 0.0090) were correlated with a high serum antibody titer in H. pylori-infected patients. Intestinal metaplasia and atrophy were related to age ≥ 60 years in group C and D.CONCLUSION Serum antibody titer changes with age, reflects gastric mucosal inflammation, and is useful in predicting the risk of gastric cancer. | Osamu Toyoshima Toshihiro Nishizawa Kosuke Sakitani Tadahiro Yamakawa Yoshiyuki Takahashi Nobutake Yamamichi Keisuke Hata Yasuyuki Seto Kazuhiko Koike Hidenobu Watanabe Hidekazu Suzuki | 2018 | World Journal of Gastroenterology2018，24，35： | 9 |
| 3 | Enlarged folds on endoscopic gastritis as a predictor for submucosal invasion of gastric cancers显示文摘BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;however,evaluating invasion depth based on endoscopic background gastritis remains unclear.AIM To investigate predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis.METHODS Patients with gastric cancer detected on esophagogastroduodenoscopy at Toyoshima Endoscopy Clinic were enrolled.We analyzed the effects of patient and tumor characteristics,including age,sex,body mass index,surveillance endoscopy within 2 years,current Helicobacter pylori infection,the Kyoto classification,and Lauren’s tumor type,on submucosal tumor invasion and curative endoscopic resection.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Atrophy was characterized by non-reddish and low mucosa.Intestinal metaplasia was detected as patchy whitish or grayish-white flat elevations,forming an irregular uneven surface.An enlarged fold referred to a fold width≥5 mm in the greater curvature of the corpus.Nodularity was characterized by goosebump-like multiple nodules in the antrum.Diffuse redness was characterized by uniform reddish nonatrophic mucosa in the greater curvature of the corpus.RESULTS A total of 266 gastric cancer patients(mean age,66.7 years;male sex,58.6%;mean body mass index,22.8 kg/m2)were enrolled.Ninety-three patients underwent esophagogastroduodenoscopy for surveillance within 2 years,and 140 had current Helicobacter pylori infection.The mean Kyoto score was 4.54.Fifty-eight cancers were diffuse-type,and 87 cancers had invaded the submucosa.Multivariate analysis revealed that low body mass index(odds ratio 0.88,P=0.02),no surveillance esophagogastroduodenoscopy within 2 years(odds ratio 0.15,P<0.001),endoscopic enlarged folds of gastritis(odds ratio 3.39,P=0.001),and Lauren’s diffuse-type(odds ratio 5.09,P<0.001)were independently associated with submucosal invasion.Similar results were obtained with curative endoscopic resection.Among cancer patients with enlarged folds,severely enlarged folds(width≥10 mm)were more related to submucosal invasion than mildly enlarged folds(width 5-9 mm,P<0.001).CONCLUSION Enlarged folds of gastritis were associated with submucosal invasion.Endoscopic observation of background gastritis as well as the lesion itself may help diagnose the depth of cancer invasion. | Osamu Toyoshima Shuntaro Yoshida Toshihiro Nishizawa Akira Toyoshima Kosuke Sakitani Tatsuya Matsuno Tomoharu Yamada Takashi Matsuo Hayato Nakagawa Kazuhiko Koike | 2021 | World Journal of Gastrointestinal Endoscopy2021，13，9： | 2 |
| 4 | Kyoto classification in patients who developed multiple gastric carcinomas after Helicobacter pylori eradication显示文摘BACKGROUND Endoscopic Kyoto classification predicts gastric cancer risk;however,the score in the patients with primary gastric cancer after Helicobacter pylori(H.pylori)eradication therapy is unknown.AIM To elucidate the Kyoto classification score in patients with both single gastric cancer and multiple gastric cancers developed after H.pylori eradication.METHODS The endoscopist recorded the Kyoto classification at the endoscope and the Kyoto classification score at the time of the first diagnosis of gastric cancer after H.pylori eradication.The score was compared between single gastric cancer group and multiple gastric cancers group.RESULTS The Kyoto score at the time of diagnosis of 45 cases of gastric cancer after H.pylori eradication was 4.0 points in average.The score was 3.8 points in the single gastric cancer group,and 5.1 points in the multiple gastric cancers group.The multiple group had a significantly higher score than the single group(P=0.016).In the multiple gastric cancers group,all the patients(7/7)had 5 or higher Kyoto score,while in single gastric cancer group,the proportion of patients with a score of 5 or higher was less than half,or 44.7%(17/38).CONCLUSION Patients diagnosed with gastric cancer after H.pylori eradication tended to have advanced gastritis.In particular,in cases of multiple gastric cancers developed after H.pylori eradication,the endoscopic Kyoto classification score tended to be 5 or higher in patients with an open type atrophic gastritis and the intestinal metaplasia extended to the corpus. | Kosuke Sakitani Toshihiro Nishizawa Akira Toyoshima Shuntaro Yoshida Tatsuya Matsuno Tomoharu Yamada Masatoshi Irokawa Yoshiyuki Takahashi Yousuke Nakai Osamu Toyoshima Kazuhiko Koike | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，9： | 2 |
| 5 | Apoptosis signal‐regulating kinase‐1 inhibitor as a potent therapeutic drug for the treatment of gastric cancer显示文摘 | Yoku Hayakawa Yoshihiro Hirata Kosuke Sakitani Hayato Nakagawa Wachiko Nakata Hiroto Kinoshita Ryota Takahashi Kohsuke Takeda Hidenori Ichijo Shin Maeda Kazuhiko Koike | 2012 | Cancer Sci2012，，： | 1 |
| 6 | Therapeutic effect of c‐Jun N‐terminal kinase inhibition on pancreatic cancer显示文摘 | Ryota Takahashi Yoshihiro Hirata Kosuke Sakitani Wachiko Nakata Hiroto Kinoshita Yoku Hayakawa Hayato Nakagawa Kei Sakamoto Yohko Hikiba Hideaki Ijichi Harold L. Moses Shin Maeda Kazuhiko Koike | 2013 | Cancer Sci2013，，3： | 1 |
| 7 | Comparison of endoscopic gastritis based on Kyoto classification between diffuse and intestinal gastric cancer显示文摘BACKGROUND Gastric cancers can be categorized into diffuse-and intestinal-type cancers based on the Lauren histopathological classification.These two subtypes show distinct differences in metastasis frequency,treatment application,and prognosis.Therefore,accurately assessing the Lauren classification before treatment is crucial.However,studies on the gastritis endoscopy-based Kyoto classification have recently shown that endoscopic diagnosis has improved.AIM To investigate patient characteristics including endoscopic gastritis associated with diffuse-and intestinal-type gastric cancers in Helicobacter pylori(H.pylori)-infected patients.METHODS Patients who underwent esophagogastroduodenoscopy at the Toyoshima Endoscopy Clinic were enrolled.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.The effects of age,sex,and Kyoto classification score on gastric cancer according to the Lauren classification were analyzed.We developed the Lauren predictive background score based on the coefficients of a logistic regression model using variables independently associated with the Lauren classification.Area under the receiver operative characteristic curve and diagnostic accuracy of this score were examined.RESULTS A total of 499 H.pylori-infected patients(49.6%males;average age:54.9 years)were enrolled;132 patients with gastric cancer(39 diffuse-and 93 intestinal-type cancers)and 367 cancer-free controls were eligible.Gastric cancer was independently associated with age≥65 years,high atrophy score,high intestinal metaplasia score,and low nodularity score when compared to the control.Factors independently associated with intestinal-type cancer were age≥65 years(coefficient:1.98),male sex(coefficient:1.02),high intestinal metaplasia score(coefficient:0.68),and low enlarged folds score(coefficient:-1.31)when compared to diffuse-type cancer.The Lauren predictive background score was defined as the sum of+2(age≥65 years),+1(male sex),+1(endoscopic intestinal metaplasia),and-1(endoscopic enlarged folds)points.Area under the receiver operative characteristic curve of the Lauren predictive background score was 0.828 for predicting intestinal-type cancer.With a cut-off value of+2,the sensitivity,specificity,and accuracy of the Lauren predictive background score were 81.7%,71.8%,and 78.8%,respectively.CONCLUSION Patient backgrounds,such as age,sex,endoscopic intestinal metaplasia,and endoscopic enlarged folds are useful for predicting the Lauren type of gastric cancer. | Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Tomonori Aoki Fumiko Nagura Kosuke Sakitani Yosuke Tsuji Hayato Nakagawa Hidekazu Suzuki Kazuhiko Koike | 2021 | World Journal of Gastrointestinal Endoscopy2021，13，5： | 1 |
| 8 | Sitafloxacin resistance in Helicobacter pylori isolates and sitafloxacin-based triple therapy as a third-line regimen in Japan显示文摘 | Yoshihiro Hirata Tomoya Ohmae Ayako Yanai Kosuke Sakitani Yoku Hayakawa Shuntaro Yoshida Takafumi Sugimoto Yuzo Mitsuno Masao Akanuma Yutaka Yamaji Keiji Ogura Shin Maeda Kazuhiko Koike | 2012 | International Journal of Antimicrobial Agents2012，，4： | 1 |
| 9 | Clinical features of cardiac nodularity-like appearance induced by Helicobacter pylori infection显示文摘We have previously reported that Helicobacter pylori(H.pylori)-associated nodular gastritis could occur in both the antrum and the cardia.Cardiac nodularity-like appearance(hereafter,called as cardiac nodularity)had a high predictive accuracy for the diagnosis of H.pylori infection.In the previous study,we included only the patients who were evaluated for H.pylori infection for therst time,and excluded patients with a history of eradication.Therefore,the prevalence and clinical features of cardiac nodularity remains unknown.AIM To perform this cross-sectional study to explore the characteristics of cardiac nodularity.METHODS Consecutive patients who underwent esophagogastroduodenoscopy betweenMay,2017 and August,2019 in the Toyoshima Endoscopy Clinic were enrolled in this study.We included H.pylori-negative,H.pylori-positive,and H.pylorieradicated patients,and excluded patients with unclear H.pylori status and eradication failure.H.pylori infection was diagnosed according to serum anti-H.pylori antibody and the urea breath test or histology.Cardiac nodularity was defined as a miliary nodular appearance or the presence of scattered whitish circular small colorations within 2 cm of the esophagogastric junction.Nodularity was visualized as whitish in the narrow-band imaging mode.We collected data on the patients’baseline characteristics.RESULTS A total of 1078 patients were finally included.Among H.pylori-negative patients,cardiac nodularity and antral nodularity were recognized in 0.14%each.Among H.pylori-positive patients,cardiac nodularity and antral nodularity were recognized in 54.5%and 29.5%,respectively.Among H.pylori-eradicated patients,cardiac nodularity and antral nodularity were recognized in 4.5%and 0.6%,respectively.The frequency of cardiac nodularity was significantly higher than that of antral nodularity in H.pylori-positive and-eradicated patients.The frequencies of cardiac nodularity and antral nodularity in H.pylori-eradicated patients were significantly lower than those in H.pylori-positive patients(P<0.001).The patients with cardiac nodularity were significantly younger than those without cardiac nodularity(P=0.0013).Intestinal metaplasia score of the patients with cardiac nodularity were significantly lower than those without cardiac nodularity(P=0.0216).Among H.pylori-eradicated patients,the patients with cardiac nodularity underwent eradication significantly more recently compared with those without cardiac nodularity(P<0.0001).CONCLUSION This report outlines the prevalence and clinical features of cardiac nodularity,and confirm its close association with active H.pylori infection. | Toshihiro Nishizawa Kosuke Sakitani Hidekazu Suzuki Shuntaro Yoshida Yosuke Kataoka Yousuke Nakai Hirotoshi Ebinuma Takanori Kanai Osamu Toyoshima Kazuhiko Koike | 2020 | World Journal of Gastroenterology2020，26，35： | 1 |
| 10 | Brown slits for colorectal adenoma crypts on conventional magnifying endoscopy with narrow band imaging using the X1 system显示文摘BACKGROUND Accurate diagnosis of colorectal premalignant polyps,including adenomas,is vital in clinical practice.AIM To investigate the diagnostic yields of novel findings of brown slits for adenomas.METHODS Patients who underwent colonoscopy at the Toyoshima Endoscopy Clinic were enrolled.Polyps sized≥5 mm suspected of adenomas or clinically significant serrated polyps were included in the study.We defined the surface structures of colorectal polyps,which were brown curves inside and along the tubular glands identified using a combination of a new X1 system(Olympus Corporation)and a conventional magnifying colonoscope with non-staining narrow band imaging(NBI),as brown slits.The brown slits corresponded to slit-like lumens on endocytoscopy and histological crypt openings of an adenoma.We evaluated the diagnostic performance of brown slits for adenoma.RESULTS A total of 108 Lesions from 62 patients were eligible.The average age was 60.4 years and 41.9%were male.The mean polyp size was 7.45±2.83 mm.Fifty-seven lesions were positive for brown slits.Histopathological diagnosis comprised 59 low-grade tubular adenomas,16 sessile serrated lesions,and 33 hyperplastic polyps.Among 59 adenomas,56(94.9%)were positive for brown slits.Among 16 sessile serrated lesions,0(0%)was positive for brown slits.Among 33 hyperplastic polyps,1(3.0%)was positive for brown slits.The sensitivity,specificity,and accuracy of brown slits for adenoma were 94.9%,98.0%,and 96.3%,respectively.The positive predictive value and negative predictive value of brown slits for adenoma were also excellent for 98.2%,and 94.1%,respectively.CONCLUSION Brown slits on conventional magnifying endoscopy with non-staining NBI using the X1 system were useful for diagnosing colorectal adenoma.The new endoscopy system could be examined using new standards. | Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Hidenobu Watanabe Nariaki Odawara Kosuke Sakitani Toru Arano Hirotoshi Takiyama Hideyuki Kobayashi Hirofumi Kogure Mitsuhiro Fujishiro | 2022 | World Journal of Gastroenterology2022，28，24： | 1 |
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