記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Aim: To investigate the surgical outcome of FIGO stage IA1 cervical adenocarcinoma. Methods: Between 2005 and 2011, 12 patients from Kyushu University Hospital had cervical adenocarcinoma, with a tumor depth of less than 3 mm and a horizontal width of less than 7 mm (FIGO stage IA1), diagnosed by cervical conization. All patients underwent simple hysterectomy or simple trachelectomy with pelvic lymphadenectomy. Results: The mean patient age was 34 years (range, 26-70 years). The median follow-up period was 70.5 months (range, 26-99 months). No pelvic lymph-node metastasis was seen, and no patient experienced disease recurrence. Conclusion: Early invasive cervical adenocarcinoma with a depth of invasion of 3 mm or less and a horizontal spread of 7 mm or less has little potential for nodal metastasis or recurrence. Therefore, simple hysterectomy or trachelectomy without lymphadenectomy is an important treatment options for stage IA1 cervical adenocarcinoma.

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語  

記述言語：英語   出版者・発行元：Journal of Obstetrics and Gynaecology Research  

Aim: Clear cell carcinoma of the uterine cervix (CCCUC) is a rare disease, accounting for 4% to 9% of cervical adenocarcinomas. Because it is so rare, its pathogenesis is largely unknown, and the standard treatment is unclear due to a lack of prospective studies. Our aim is to investigate the clinical features, treatment, and prognosis of CCCUC. Methods: We retrospectively evaluated the clinical characteristics, treatment choices, and outcomes of 12 patients with CCCUC treated at our institution between January 2009 and July 2024. Results: The median patient age was 62.5 years (range, 14–90 years). The most common stage was IB (IA, n = 3; IB, n = 4; IIB, n = 1; IIIC, n = 2; IVB, n = 2). Ten patients underwent surgery as initial treatment: 6 underwent radical hysterectomy plus pelvic lymphadenectomy (PLD) or sentinel lymph node biopsy (SLNB), with or without para-aortic lymphadenectomy (PALD); 3 underwent modified radical hysterectomy plus PLD with or without PALD; and 1 underwent radical trachelectomy with SLNB as fertility-preserving surgery. All patients underwent bilateral salpingo-oophorectomy except for the patient who opted for radical trachelectomy. Five patients received adjuvant treatment: 3 received platinum-based systemic chemotherapy (2 of whom had combination therapy with bevacizumab), and 2 received concurrent chemoradiotherapy. The median follow-up was 43.5 months (range, 1–123 months). The 5-year progression-free survival rate was 64.5%. Conclusion: Systemic platinum-based chemotherapy with bevacizumab may be more effective than concurrent chemoradiotherapy as adjuvant therapy for CCCUC.

DOI： 10.1111/jog.16300

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記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

記述言語：英語   出版者・発行元：European Journal of Cancer  

Aim: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced cervical cancer (LACC), but recurrence rates remain high. This multicenter phase-3 randomized trial (GOTIC-002) evaluated the efficacy of low-dose oral tegafur-uracil (UFT) as maintenance chemotherapy following curative CCRT for LACC. Methods: Between 2010 and 2018, 351 patients with stage Ib2-IVa cervical cancer were enrolled. After achieving complete or partial remission post-CCRT, patients were randomized 1:1 into observation (arm O) or UFT maintenance therapy (arm UFT). UFT doses were 300–400 mg/day based on body surface area for 2 years, disease progression or adverse effects occurred. The primary endpoint was progression-free survival (PFS), with overall survival (OS) and safety as secondary endpoints. Results: Patient characteristics were similar between the groups (n = 178 in arm O, n = 173 in arm UFT). During a median follow-up of 3 years, median PFS was not reached in either group. 5-year PFS rates were similar between them (arm O: 61.3 %, arm UFT: 62.0 %, hazard ratio: 0.92, P = .634). 5-year OS rates were also comparable (77.6 % vs 76.1 %, hazard ratio: 1.04, P = .869). Compliance with UFT ranged from 87.8 % to 98.8 %. Although adverse events were more frequent in arm UFT (93.5 % vs 73.9 %, odds ratio: 5.05), most were mild or moderate. Despite its tolerability, UFT did not improve PFS or OS. Conclusions: These findings suggest the need to reconsider maintenance therapy strategies after CCRT for potentially shifting away from cytotoxic chemotherapy towards alternative methods to enhance survival outcomes in patients with LACC.

DOI： 10.1016/j.ejca.2025.115304

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記述言語：英語  

DOI： 10.3802/jgo.2025.36.e93

PubMed

記述言語：英語   出版者・発行元：Diagnostics  

Background: A molecular classification of endometrial cancer was developed based on an analysis of The Cancer Genome Atlas. In this classification, the group characterized by abnormal p53 immunohistochemical expression showed the poorest prognosis. However, there may be no need to apply a molecular classification in low-grade endometrial cancer. In this study, we investigated the clinical significance of abnormal p53 immunohistochemical expression in low-grade endometrial cancer. Methods: We obtained nine frozen samples of endometrial cancer [low-grade endometrial cancer with wild-type p53 expression (EC^lop53^wt group): n = 3, low-grade endometrial cancer with abnormal p53 expression (EC^lop53^ab group): n = 3, and high-grade endometrial cancer (EC^hi group): n = 3]. RNA sequencing was performed for each sample. All the samples passed RNA quality control. In addition, an immunohistochemical analysis was performed for 44 formalin-fixed paraffin-embedded samples. Results: Differentially expressed genes were identified in the RNA sequencing results (1811 genes between the EC^lop53^ab group and the EC^hi group, and 1088 genes between the EC^lop53^ab group and the EC^lop53^wt group). In a principal component analysis, the EC^lop53^ab group was more similar to the EC^lop53^wt group than to the EC^hi group. In the immunohistochemical analysis, L1CAM expression was significantly less frequently observed in the EC^lop53^ab group than in the EC^hi group. Moreover, p21 expression tended to be more frequently observed in the EC^lop53^ab group than in the EC^hi group. Conclusions: In this study, the RNA sequencing and immunohistochemical results revealed that the EC^lop53^ab group is a separate entity from the EC^hi group. While the abnormal p53 group is considered the most prognostically unfavorable in molecular classification, these findings suggest that routine molecular profiling is not necessary for patients with low-grade endometrial cancer. However, there is insufficient evidence to modify adjuvant treatment in low-grade endometrial cancer patients. Further investigation is needed on the clinical application of molecular classification to low-grade endometrial cancer.

DOI： 10.3390/diagnostics15060671

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記述言語：英語   出版者・発行元：Asian Journal of Endoscopic Surgery  

Introduction: This study examined factors that affected sentinel lymph node (SLN) identification of patients with endometrial cancer having a preoperative estimation of low recurrent risk. Methods: This study included 97 patients with endometrial cancer who attempted to identify SLN using a uterine cervical injection of technetium-99 m phytate under laparoscopic or robotic-assisted surgery at our institute. A preoperative single photon emission computed tomography (SPECT) and intraoperative gamma probe were used to detect hot nodes. Multiple clinical factors, including age, body mass index (BMI), and so on, were investigated for their association with SLN mapping failure. Results: Among 97 cases, SPECT failed to detect SLN unilaterally in 38 cases (39%) and on both sides in 9 cases (9%). Meanwhile, the gamma probe failed to detect SLN unilaterally in 23 cases (24%) and on both sides in 3 cases (3%). While only age was significantly associated with SLN detection failure using the SPECT detection system, both age and BMI were significantly associated with SLN detection failure using the gamma probe detection system. When limiting to the preoperative SLN detection failure cohort of 47 cases, there was a strong association between intraoperative SLN detection failure and BMI, but not age. Conclusion: The SLN biopsy system was effectively applied to patients with endometrial cancer who underwent minimally invasive surgery (MIS). Attempts to improve SLN identification in older patients and those with obesity are warranted to obtain maximum benefits of MIS for low- or medium-risk cases.

DOI： 10.1111/ases.70015

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記述言語：英語  

DOI： 10.7759/cureus.77060

PubMed

記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

記述言語：英語   出版者・発行元：Journal of Medical Virology  

Co-infections with human papillomavirus (HPV) of multiple genotypes mainly occur due to increased sexual activity. To address the prevalence and trend of HPV co-infections in Japan, HPV-type-specific data from Japanese women (n = 8128) aged < 40 years and newly diagnosed with cervical abnormalities at 24 hospitals between 2012 and 2023 were analyzed. These included cervical intraepithelial neoplasia grade 1/2 (CIN1/2, n = 2745), CIN3/adenocarcinoma in situ (AIS) (n = 3953), and invasive cervical cancer (ICC, n = 1430). For women enrolled in this study since 2019, information on sexual behaviors was collected via a self-administered questionnaire. Time-trend analyses by disease category showed significant declines in the prevalence of multiple HPV infections in CIN1/2 (49.1%−38.3%, p<inf>trend</inf> = 0.0004), CIN3/AIS (44.7%–31.5%, p<inf>trend</inf> = 0.0002), and ICC (26.7%–10.5%, p<inf>trend</inf> < 0.0001) during the last decade. When these data were analyzed separately for women aged 20–29 and 30–39 years, similar declining trends were observed in each disease category. Using data from 2111 women for whom information on sexual history was available, the number of sexual partners was strongly associated with increased multiple HPV infections (p < 0.0001). In conclusion, the declining prevalence of HPV co-infections in cervical cancer and its precursors may reflect a decrease in sexual activity among Japanese women of reproductive age.

DOI： 10.1002/jmv.70096

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出版者・発行元：International Journal of Gynecological Pathology  

The administration of immune checkpoint inhibitors (ICIs) is increasing in endometrial cancer, especially in the mismatch repair (MMR)-deficient group. To prevent unnecessary immune-related adverse events, ICIs need to be administered to more appropriate patients. The tumor immune microenvironment has been reported to be a predictive marker of the efficacy of ICI therapies. This study evaluated CD8, FoxP3, CD68, PD-L1, and β-catenin expression in endometrial endometrioid carcinoma, grade 1 (G1) with DNA mismatch repair protein loss (MMR loss), and their association with clinicopathological features. We retrospectively analyzed tumor samples from 107 patients with endometrial endometrioid carcinoma, G1 (MMR-deficient group: n=67; MMR-proficient group: n=40). Overall, 47 cases of MLH1/PMS2 loss and 20 cases of MSH2/MSH6 loss were observed. The patients with low intraepithelial CD8 expression significantly more frequently exhibited deep myometrial invasion, and the elderly group (≥60 y) significantly more frequently showed low stromal CD8 expression. In addition, FoxP3-positive cell count and FoxP3/CD8+ ratio were significantly correlated with the International Federation of Obstetrics and Gynecology 2023 stage and lymph node metastasis. In the Kaplan-Meier analysis, the patients with low intraepithelial or stromal CD8 expression had shorter progression-free survival (PFS) than those with high intraepithelial or stromal CD8 expression, albeit not significantly. We clarified that the tumor immune microenvironment had an impact on clinicopathological features within the group with MMR loss, which is the main target for ICIs, limited to endometrioid carcinoma, G1. Further studies are needed, including on patients administered ICIs.

DOI： 10.1097/PGP.0000000000001020

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記述言語：英語  

DOI： 10.7759/cureus.71503

PubMed

記述言語：英語  

DOI： 10.1093/jncics/pkae091

PubMed

記述言語：英語   出版者・発行元：Histopathology  

Aims: p16 is a sensitive surrogate marker for transcriptionally active high-risk human papillomavirus (HR-HPV) infection in endocervical adenocarcinoma (ECA); however, its specificity is not perfect. Methods and results: We examined p16 and Rb expressions by immunohistochemistry (IHC) and the transcriptionally active HR-HPV infection by mRNA in-situ hybridisation (ISH) with histological review in 108 ECA cases. Thirteen adenocarcinomas of endometrial or equivocal origin (six endometrioid and seven serous carcinomas) were compared as the control group. HR-HPV was detected in 83 of 108 ECA cases (77%), including five HPV-associated adenocarcinomas in situ and 78 invasive HPV-associated adenocarcinomas. All 83 HPV-positive cases showed consistent morphology, p16 positivity and partial loss pattern of Rb. Among the 25 cases of HPV-independent adenocarcinoma, four (16%) were positive for p16, and of these four cases, three of 14 (21%) were gastric type adenocarcinomas and one of 10 (10%) was a clear cell type adenocarcinoma. All 25 HPV-independent adenocarcinomas showed preserved expression of Rb irrespective of the p16 status. Similarly, all 13 cases of the control group were negative for HR-HPV with preserved expression of Rb, even though six of 13 (46%) cases were positive for p16. Compared with p16 alone, the combination of p16 overexpression and Rb partial loss pattern showed equally excellent sensitivity (each 100%) and improved specificity (100 versus 73.6%) and positive predictive values (100 versus 89.2%) in the ECA and control groups. Furthermore, HR-HPV infection correlated with better prognosis among invasive ECAs. Conclusions: The results suggest that the combined use of p16 and Rb IHC could be a reliable method to predict HR-HPV infection in primary ECAs and mimics. This finding may contribute to prognostic prediction and therapeutic strategy.

DOI： 10.1111/his.15169

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記述言語：英語  

DOI： 10.1007/s13691-024-00659-5

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記述言語：英語   出版者・発行元：シュプリンガー・ジャパン(株)  

症例は72歳女性、2妊2産であった。卵巣悪性腫瘍に対して52歳時に開腹子宮全摘術、両側卵管卵巣摘出術、大網切除術、骨盤リンパ節郭清術を施行され、最終診断はステージIaの成人型顆粒膜細胞腫(AGCT)であった。初回手術から19年後、他施設で受けたCTで後腹膜腫瘍が偶然発見された。腫瘍は直径11×10cmで、肝門部、下大静脈、右腎静脈が隆起していた。CTガイド下腫瘍生検によりAGCTの再発が確認された。腫瘍が巨大であり、完全切除を行うと出血多量による術中死亡のリスクがあると考えられた。そこで、パクリタキセル+カルボプラチン(PC)による術前化学療法を行い、再発腫瘍を縮小させた。その後、縮小手術を行った。再発腫瘍の完全切除に成功し、手術時間は12時間54分、出血量は700gであった。切除標本の病理所見からAGCTの再発と診断した。術後1年経過時点で再発は認められなかった。

記述言語：英語   出版者・発行元：Journal of Biological Chemistry  

BHLHE40 is a basic helix-loop-helix transcription factor that is involved in multiple cell activities including differentiation, cell cycle, and epithelial-to-mesenchymal transition. While there is growing evidence to support the functions of BHLHE40 in energy metabolism, little is known about the mechanism. In this study, we found that BHLHE40 expression was downregulated in cases of endometrial cancer of higher grade and advanced disease. Knockdown of BHLHE40 in endometrial cancer cells resulted in suppressed oxygen consumption and enhanced extracellular acidification. Suppressed pyruvate dehydrogenase (PDH) activity and enhanced lactated dehydrogenase (LDH) activity were observed in the knockdown cells. Knockdown of BHLHE40 also led to dephosphorylation of AMPKα Thr172 and enhanced phosphorylation of pyruvate dehydrogenase E1 subunit alpha 1 (PDHA1) Ser293 and lactate dehydrogenase A (LDHA) Tyr10. These results suggested that BHLHE40 modulates PDH and LDH activity by regulating the phosphorylation status of PDHA1 and LDHA. We found that BHLHE40 enhanced AMPKα phosphorylation by directly suppressing the transcription of an AMPKα-specific phosphatase, PPM1F. Our immunohistochemical study showed that the expression of BHLHE40, PPM1F, and phosphorylated AMPKα correlated with the prognosis of endometrial cancer patients. Because AMPK is a central regulator of energy metabolism in cancer cells, targeting the BHLHE40‒PPM1F‒AMPK axis may represent a strategy to control cancer development.

DOI： 10.1016/j.jbc.2024.105695

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Japanese Journal of Radiology  

Purpose: This study evaluated the efficacy and safety of transvaginal approach combined intracavitary and interstitial brachytherapy (IC/IS BT) assisted by transrectal ultrasound (TRUS) for treatment of locally advanced cervical cancer (LACC). Materials and Methods: A total of 30 patients of LACC treated with external beam radiotherapy and IC/IS BT via transvaginal approach assisted by transrectal ultrasound were observed retrospectively. The 2-year local control (LC), progression-free survival (PFS), and overall survival (OS) were analyzed using the Kaplan–Meier method. Late adverse events were also evaluated to assess the safety of IC/IS BT. Results: The median follow-up period was 22 months. The 2-year LC, PFS, and OS were 90%, 61%, and 82%, respectively. We observed no critical complications related to the IC/IS BT technique. Late adverse events of grade 3 or more included one case of grade 4 colon perforation. Conclusion: Our patient series demonstrated that radiotherapy combined with transvaginal approach, TRUS-assisted IC/IS BT achieves favorable local control and safety for LACC.

DOI： 10.1007/s11604-023-01481-4

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記述言語：英語   出版者・発行元：(公社)日本医学放射線学会  

局所進行子宮頸癌(LACC)に対し、経直腸超音波(TRUS)ガイド下経腟的アプローチによる組織内照射併用腔内照射(IC/IS BT)を行い、有効性と安全性を後向きに調査した。外照射療法とTRUSガイド下で経腟アプローチによりIC/IS BTの治療を受けたLACC患者30例(年齢31～82歳)を調査対象とし、2年局所制御率(LC)、無増悪生存率(PFS)および全生存率(OS)をKaplan-Meier法で分析した。また、遅発性有害事象に基づきIC/IS BTの安全性についても評価した。その結果、経過観察期間の中央値は22ヵ月で、2年LC、PFSおよびOSはそれぞれ90%、61%、82%であった。また、IC/IS BT法に関連した重篤な合併症例はみられず、グレード3以上の遅発性有害事象としては、グレード4の結腸穿孔が認められた。以上より、経腟的アプローチによるTRUSガイド下でのIC/IS BTは、LACCにおいて、安全且つ良好な局所腫瘍制御が得られることが確認された。

記述言語：英語   出版者・発行元：Wiley  

Indocyanine green (ICG) with near-infrared (NIR) fluorescence imaging is used for lymphatic mapping. However, binding of ICG to blood proteins like serum albumin can shorten its retention time in sentinel lymph nodes (SLNs). Here, we investigated the efficacy and safety of a new fluorescence tracer comprising phytate and liposome (LP)-encapsulated ICG. Coadministration of phytate with LP containing phosphatidic acid promotes chelation mediated by Ca²⁺ in bodily fluids to enhance SLN retention. Uniformly sized LPs (100 nm) encapsulating ICG under conditions that minimized fluorescence self-quenching during storage were produced. We analyzed the behavior of the new tracer (ICG-phytate-LP) and control tracers (ICG and ICG-LP) in the lymphatic flow of mice in terms of lymph node retention time. We also tested lymphatic flow and safety in pigs that have a more human-like lymphatic system. LPs encapsulating stabilized ICG were successfully prepared. Mixing LP with phytate in the presence of Ca²⁺ increased both the particle size and negative surface charge. In mice, ICG-phytate-LP had the best lymph node retention, with a fluorescence intensity ratio that increased over 6 h and then decreased slowly over the next 24 h. In pigs, administration of ICG and ICG-phytate-LP resulted in no death or weight loss. There were no obvious differences between blood test results for the ICG and ICG-phytate-LP groups, and the overall safety was good. ICG-phytate-LP may be a useful new tracer for gynecological cancers that require time for lymph node identification due to a retroperitoneal approach.

DOI： 10.1111/cas.15927

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CiNii Research

記述言語：英語   出版者・発行元：Cancer Science  

The first prophylactic vaccine against human papillomavirus (HPV) 16 and HPV18 was licensed in Japan in 2009. HPV vaccine effectiveness against high-grade cervical lesions has been demonstrated among young Japanese women, but evidence of its effects on invasive cervical cancer (ICC) is lacking. Using data from two different cancer registries, we compared recent trends of new ICC cases by age group using Poisson regression analysis. We also analyzed time trends in HPV16/18 prevalence among 1414 Japanese women aged <40 years newly diagnosed with ICC in the past decade. Based on the population-based cancer registry, the incidence of ICC among young women aged 20–29 years showed a significant decline from 3.6 to 2.8 per 100 000 women-years during 2016–2019, but no similar decline was observed for older age groups (p < 0.01). Similarly, using data from the gynecological cancer registry of the Japan Society of Obstetrics and Gynecology, the annual number of ICCs among women aged 20–29 years also decreased from 256 cases to 135 cases during 2011–2020 (p < 0.0001). Furthermore, a declining trend in HPV16/18 prevalence in ICC was observed only among women aged 20–29 years during 2017–2022 (90.5%–64.7%, p = 0.05; Cochran–Armitage trend test). This is the first report to suggest population-level effects of HPV vaccination on ICC in Japan. Although the declining trend in HPV16/18 prevalence among young women with ICC supports a causal linkage between vaccination and results from cancer registries, further studies are warranted to confirm that our findings are attributable to vaccination.

DOI： 10.1111/cas.15943

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記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

センチネルリンパ節(SLN)を同定するためのトレーサーとして、リポソーム封入インドシアニングリーン(ICG)とフィチン酸塩で構成される新規な蛍光トレーサーを開発し、その有効性と安全性を調査した。まず、安定化したICGが封入されているリポソームを調製した。次にキレート反応が発揮されることを期待し、Ca2+の存在下でリポソームとフィチン酸塩を混和した。その結果、生成される粒子のサイズとその表面の陰電荷が共に増加した。このようにICG、リポソーム、フィチン酸塩を構成要素とした新規トレーサーがマウスのリンパ節内に滞留する時間を評価した。その結果、対照のトレーサー(ICGおよびリポソーム封入ICG)と比較して最も良好な滞留性を発揮した。その蛍光強度比は6時間かけて上昇し、次いで24時間かけて緩やかに低下していった。ブタで安全性評価を行ったが、本新規トレーサーを投与しても死亡または体重減少は発生しなかった。ICGのみ投与した場合との明確な違いも示されず、全安全性は良好であった。本新規トレーサーは、後腹膜アプローチのためリンパ節を同定する時間が必要になる婦人科癌で有用なものになると考えられた。

記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

日本で近年発生した浸潤子宮頸癌(ICC)新規症例の傾向を年齢層別に比較解析した。解析には別個の癌レジストリを二つ利用した。国立がん研究センターのがん情報サービスが収集している住民ベースの癌レジストリを利用して解析を行った場合、10万人当たりのICC発症率は、20歳代女性では2016年の3.6件から2019年には2.8件へと有意に低下していた(p<0.01)。それよりも高齢な年齢層の集団では似たような低下傾向は認められなかった。次に日本産科婦人科学会による婦人科悪性腫瘍登録事業のデータを解析したが、先の解析と同じように、20歳代女性での年間ICC発症例数が2011年の256例から2020年には135例へと有意に減少していることが示された(p<0.0001)。加えて、ICC例におけるヒトパピローマウイルス(HPV)16/18の陽性率も、20歳代女性でのみ、2017～2022年にかけて減少傾向が観察された(p=0.05)。

記述言語：英語   出版者・発行元：JNCI Cancer Spectrum  

Background: Although many human papillomavirus (HPV)–targeted therapeutic vaccines have been examined for efficacy in clinical trials, none have been translated into clinical use. These previous agents were mostly administered by intramuscular or subcutaneous injection to induce systemic immunity. We investigated the safety and therapeutic efficacy of an HPV-16 E7-expressing lacticaseibacillus-based oral vaccine. Methods: In a double-blind, placebo-controlled, randomized trial, a total of 165 patients with HPV-16–positive high-grade cervical intraepithelial neoplasia 2 and 3 were assigned to orally administered placebo or low, intermediate, or high doses of IGMKK16E7 (lacticaseibacillus paracasei expressing cell surface, full-length HPV-16 E7). In the 4 groups, IGMKK16E7 or placebo was administered orally at weeks 1, 2, 4, and 8 postenrollment. The primary outcomes included histopathological regression and IGMKK16E7 safety. Results: In per-protocol analyses, histopathological regression to normal (complete response) occurred in 13 (31.7%) of 41 high-dose recipients and in 5 (12.5%) of 40 placebo recipients (rate difference = 19.2, 95% confidence interval [CI] = 0.5 to 37.8). In patients positive for HPV-16 only, the clinical response rate was 40.0% (12 of 30) in high-dose recipients and 11.5% (3 of 26) in recipients of placebo (rate difference = 28.5, 95% CI = 4.3 to 50.0). There was no difference in adverse events that occurred in the high-dose and placebo groups (P = .83). The number of HPV-16 E7–specific interferon-c producing cells within peripheral blood increased with level of response (stable disease, partial, and complete responses; P = .004). The regression to normal (complete response) rates among recipients with high levels of immune response were increased in a dose-dependent manner. Conclusion: This trial demonstrates safety of IGMKK16E7 and its efficacy against HPV-16–positive cervical intraepithelial neoplasia 2 and 3. IGMKK16E7 is the first oral immunotherapeutic vaccine to show antineoplastic effects.

DOI： 10.1093/jncics/pkad101

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Springer  

It can be difficult to distinguish an interstitial pregnancy from an angular pregnancy because of the close proximity of the implantation sites. The difference in pregnancy outcomes between interstitial and angular pregnancies makes this distinction very important. A 39-year-old gravida 7 para 4 who had undergone a laparoscopic right salpingo-oophorectomy (RSO) one year ago and a pregnancy termination via dilation and curettage (D&C) three weeks ago was suspected to have a ruptured right interstitial or angular pregnancy. The patient underwent a laparoscopic total hysterectomy. The postoperative histologic diagnosis was an abortion of a right angular pregnancy. Indeed, it is essential to rule out an interstitial or angular pregnancy during adnexal surgery, even soon after elective abortion. Proper management of an angular pregnancy could prevent a fatal outcome following a rupture or massive hemorrhage.

CiNii Research

記述言語：英語  

DOI： 10.7759/cureus.46171

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：American Journal of Clinical Oncology Cancer Clinical Trials  

Objective: The aim of this study was to evaluate the progression-free survival (PFS) and overall response rate (ORR) of patients with recurrent endometrial cancer (REC) or advanced endometrial cancer (AEC) retreated with platinum-containing chemotherapy (PCC) based on the platinum-free interval (PFI). We compared our results with those reported in the KEYNOTE-775 study (that used pembrolizumab plus lenvatinib). Methods: A retrospective analysis was conducted of 65 patients with REC or AEC retreated with PCC between 2005 and 2020 at our hospital. Various clinicopathologic variables were analyzed: (1) age, (2) performance status, (3) histology, (4) history of pelvic irradiation in the adjuvant setting, (5) PFI, (6) chemotherapy regimen, (7) PFS and overall survival after retreatment with PCC, and (8) best ORR. Survival analyses were performed using Kaplan-Meier curves and log-rank tests. Results: The best ORR and PFS were 43.3% and 9.5 months, respectively, in patients with REC/AEC with a PFI ≥6 months. These results were comparable with those of patients treated with pembrolizumab and lenvatinib. The best ORR and PFS of patients with a PFI of <6 months appeared to be inferior to those of patients treated with pembrolizumab plus lenvatinib. Conclusions: Pembrolizumab plus lenvatinib seems to be a better treatment choice for patients with REC or AEC with a PFI of <6 months. For a PFI of ≥6 months, pembrolizumab plus lenvatinib or PCC can be used depending on the degree of residual side -effects associated with cytotoxic agents.

DOI： 10.1097/COC.0000000000001021

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記述言語：英語   出版者・発行元：American Journal of Surgical Pathology  

Tubo-ovarian high-grade serous carcinoma (HG-SC) and ovarian endometrioid carcinoma (EC) can show overlapping morphologic features, such as glandular and solid patterns. The differential diagnosis of these subtypes is thus sometimes difficult. The existence of "squamous differentiation"tends to lead to a diagnosis of EC rather than HG-SC. We noticed that HG-SC can contain a "squamoid component,"but its nature has been poorly investigated. This study was thus established to clarify the nature of this "squamoid component"in HG-SC by investigating its frequency and immunohistochemical features. We reviewed hematoxylin and eosin-stained slides of 237 primary untreated cases of tubo-ovarian HG-SC and identified 16 cases (6.7%) of HG-SC with "squamoid component."An immunohistochemical staining panel (CK5/6, CK14, CK903, p40, p63, WT1, ER, and PgR) was used to analyze all of these 16 cases. We also selected 14 cases of ovarian EC with "squamous differentiation"as a control. The "squamoid component"in HG-SC was completely p40-negative and showed significantly lower expression of CK5/6, CK14, CK903, and p63 than the "squamous differentiation"in EC. The immunophenotype of the "squamoid component"in HG-SC was concordant with the conventional HG-SC component (WT1-positive/ER-positive). Furthermore, all 16 tumors were confirmed to be truly "HG-SC"by the findings of aberrant p53 staining pattern and/or WT1/p16 positivity, and the lack of mismatch repair deficiency and POLE mutation. In conclusion, HG-SC can on rare occasions show a "squamoid component"mimicking "squamous differentiation."However, the "squamoid component"in HG-SC does not represent true "squamous differentiation."The "squamoid component"is one part of the morphologic spectrum of HG-SC, which should be interpreted carefully for the differential diagnosis of HG-SC and EC. An immunohistochemical panel including p40, p53, p16, and WT1 is a useful adjunct to achieve a correct diagnosis.

DOI： 10.1097/PAS.0000000000002089

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   出版者・発行元：日本臨床細胞学会-九州連合会  

子宮頸部腺癌は近年増加傾向にあり,子宮頸部細胞診での早期発見が重要である.子宮頸部の細胞診判定としてはベセスダ分類では,頸管炎や頸管ポリープのような反応性病変から上皮内腺癌(Adenocarcinoma in situ,以下AIS)を含む浸潤腺癌の可能性がある病変までを異型腺細胞(Atypical glandular cells,以下AGC)と判定している.子宮頸部腺系病変におけるAGCの細胞判定について検証した結果,AGCの判定には,集塊の形状,核の重なりなどの細胞配列に加え,核形やクロマチンパターンなどの所見に着目し,可能な限りAGC-favor neoplastic(以下AGC-FN)とAGC-not otherwise specified(以下AGC-NOS)を積極的に活用していくことが重要である.(著者抄録)

記述言語：英語   出版者・発行元：Japanese Journal of Clinical Oncology  

DOI： 10.1093/jjco/hyad017

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3390/reports6020018

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

日本産科婦人科学会会員を対象とした質問票調査を実施し、COVID-19パンデミック下での学会への対面参加が参加者の健康に及ぼす影響について検討した。調査項目は第74回日本産科婦人科学会学術集会(2022年8月5日～7日に開催)後の一定期間(8月7日～8月12日)の健康状態、年齢、性別、居住地、COVID-19ワクチン接種状況などとした。3054名(対面参加1566名、オンライン参加1488名)を解析対象とした。その結果、対面参加102名(6.5%)、オンライン参加93名(6.2%)が健康上の問題を訴えたが、両群間で有意差はみられなかった。単変量解析の結果、60歳以上の参加者では20歳代の参加者と比較して、健康上の問題が有意に少なかった(オッズ比0.366、p=0.0120)。多変量解析の結果、COVID-19ワクチン4回接種者では、3回接種者と比較して健康上の問題が有意に少なかった(オッズ比0.397、p=0.0010)。以上のように、学会への対面参加により、健康上の問題が有意に多く発症するわけでないことが示された。

記述言語：英語   出版者・発行元：Journal of Obstetrics and Gynaecology Research  

Objective: To analyze the effects of in-person attendance at an academic conference held during the Covid-19 pandemic on the health of the attendees, as assessed based on symptoms such as fever and cough attributed to infection with the Covid-19 virus. Methods: A questionnaire was used to survey the members of the Japan Society of Obstetrics and Gynecology (JSOG) about their health during the period from August 7 to August 12, 2022, after the 74th Annual Congress of the JSOG, which was held August 5 to 7. Results: Our survey yielded responses from 3054 members (1566 of whom had attended the congress in person and 1488 of whom had not attended in person); 102 (6.5%) of the in-person attendees and 93 (6.2%) of the people who did not attend in person reported problems with their health. No statistically significant difference was found between these two groups (p = 0.766). In a univariate analysis of factors affecting the presence of health problems, attendees with age ≥60 years had significantly fewer health problems than attendees who were in their 20s (odds ratio: 0.366 [0.167–0.802; p = 0.0120]). In a multivariate analysis, attendees who had received four vaccine shots had significantly fewer health problems than attendees who had received three shots (odds ratio: 0.397 [0.229–0.690, p = 0.0010]). Conclusion: Congress attendees who took precautions at the congress to avoid being infected and who had a high vaccination rate did not develop significantly more health problems associated with in-person attendance at the congress.

DOI： 10.1111/jog.15626

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記述言語：英語   出版者・発行元：Gynecologic Oncology  

Objective: This multicenter study aimed to evaluate the accuracy of the one-step nucleic acid amplification (OSNA) assay in diagnosing lymph node metastasis (LNM) in patients with cervical and endometrial cancers. Methods: Surgically removed LNs from patients with cervical and endometrial cancer were sectioned at 2-mm intervals along the short axis direction and alternately examined using the OSNA assay and conventional histopathological examination. Ultrastaging (200-μm LN sections) was performed for metastatic LNs using hematoxylin and eosin staining and immunostaining with an anti-CK19 antibody in cases where the OSNA assay and histopathological examination (performed using 2-mm LN sections) results showed discordance. Results: A total of 437 LNs from 133 patients were included; 61 patients (14%) showed metastasis by histopathological examination, with a concordance rate of 0.979 (95% confidence interval [CI]: 0.961–0.991) with the OSNA assay. The sensitivity and specificity of the OSNA assay were 0.918 (95% CI: 0.819–0.973) and 0.989 (95% CI: 0.973–0.997), respectively. Discordance between the two methods was observed in nine LNs (2.1%), and allocation bias of metastatic foci was identified as the major cause of discordance. Conclusions: The OSNA assay showed equally accurate detection of LN metastasis as the histopathological examination. We suggest that the OSNA assay may be a useful tool for the rapid intraoperative diagnosis of LN metastasis in patients with cervical and endometrial cancers.

DOI： 10.1016/j.ygyno.2022.12.016

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記述言語：英語   出版者・発行元：Asian Society of Gynecologic Oncology  

Objective: To apply the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system to all patients who underwent trachelectomy in our previous study and to update the oncologic and obstetric results. Methods: We retrospectively reviewed the medical records of patients in whom abdominal trachelectomy was attempted between June 2005 and September 2021. The FIGO 2018 staging system for cervical cancer was applied to all patients. Results: Abdominal trachelectomy was attempted for 265 patients. Trachelectomy was converted to hysterectomy in 35 patients, and trachelectomy was completed successfully in 230 (conversion rate: 13%). Applying the FIGO 2018 staging system, 40% of the patients who underwent radical trachelectomy had stage IA tumors. Among 71 patients who had tumors measuring ≥2 cm, 8 patients were classified as stage IA1 and 14 as stage IA2. Overall recurrence and mortality rates were 2.2% and 1.3%, respectively. One hundred twelve patients attempted to conceive after trachelectomy; 69 pregnancies were achieved in 46 patients (pregnancy rate: 41%). Twenty-three pregnancies ended in first-trimester miscarriage, and 41 infants were delivered between gestational weeks 23 and 37; 16 were deliveries at term (39%) and 25 were premature deliveries (61%). Conclusion: This study suggested that patients judged to be ineligible for trachelectomy and patients receiving overtreatment will continue to appear using the current standard eligibility criteria. With the revisions to the FIGO 2018 staging system, the preoperative eligibility criteria for trachelectomy, which were based on the FIGO 2009 staging system and tumor size, should be changed.

DOI： 10.3802/jgo.2023.34.e41

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CiNii Research

記述言語：日本語   出版者・発行元：福岡産科婦人科学会  

症例は76歳、3妊3産。不正性器出血を主訴に前医を受診し、子宮内膜肥厚を認め、精査加療目的に当科を紹介受診した。当科の子宮内膜全面掻爬にて子宮内膜異型増殖症の診断で、全腹腔鏡下単純子宮全摘出術+両側付属器摘出術を施行した。最終診断は子宮体癌IA期、類内膜癌G1の診断で、再発低リスク群であり、追加治療は施行せず経過観察とした。2年後の造影CT検査で大網左側に結節状の軟部陰影と周囲脂肪織混濁を認め再発が疑われた。CTガイド下生検を施行し、病理組織検査で非特異的な炎症所見を認めるのみで、悪性所見は認めなかった。更に1年後のCTで軟部陰影は増大傾向であり、子宮体癌再発の可能性も否定できず、診断確定目的に大網部分切除術を施行した。最終病理組織診断の結果は放線菌症の診断であった。放線菌症は悪性腫瘍との鑑別が難しいため、非典型的な臨床経過の場合は放線菌感染も鑑別の一つとして念頭においておくべきと思われた。(著者抄録)

記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

ロボット支援手術が施行された子宮内膜癌患者63例を対象とした後向きコホート研究を実施し、肥満がロボット支援手術の安全性および質に及ぼす影響について検討した。患者を非肥満群40例(BMI:30未満、中央値54歳)、肥満群13例(BMI:30以上35未満、中央値54歳)、病的肥満10例(BMI;35以上、中央値50歳)に分類した。評価項目は手術時間、出血量、周術期合併症、再発率とした。その結果、開腹術への移行は非肥満群1例、病的肥満群1例であった。総手術時間、セッティング時間(トロッカー留置、ダヴィンチロボットドッキングを含む)、コンソール時間、創部閉鎖時間に群間差は認められなかったが、セッティングおよび創部閉鎖の合計時間に群間差が認められた。出血量や合併症には群間差が認められた。非肥満群3例、肥満群2例に対して、術後補助療法が実施されたが、平均観察期間21ヵ月において再発は認められなかった。非肥満群2例、肥満群1例が平均観察期間38ヵ月に再発していた。以上から、肥満を呈する子宮内膜癌患者に対するロボット支援手術の安全性が示された。

記述言語：英語   出版者・発行元：Journal of Obstetrics and Gynaecology Research  

Aim: Westernization of lifestyle has increased the numbers of patients with endometrial cancer and obesity. This study aimed to compare the clinical outcomes of robotic-assisted surgery according to whether patients are obese, morbidly obese, or nonobese. Methods: Sixty-three patients with endometrial cancer who underwent robotic-assisted surgery between March 2014 and June 2022 were categorized according to whether they had a body mass index (BMI) <30 (group A, nonobese, n = 40), ≥30 and <35 (group B, obese, n = 13), or ≥35 (group C, morbidly obese, n = 10). Operation time, blood loss, perioperative complications, and recurrence rate were investigated. Results: Conversion to laparotomy was required in one case in group A and one in group C. There was no difference in total operation time, time for setting (including trocar installation and docking of the da Vinci robot), console time, or time for wound closure between the groups; however, there was a significant between-group difference in the total time for setting and wound closure. There was no significant difference in blood loss or complications between the groups. Three patients in group A and two in group B received adjuvant treatment; none have shown evidence of recurrent disease during a mean observation time of 21 months (range, 2–29). Two cases in group A and one in group B had recurrence during a mean observation time of 38 months (range, 19–46). Conclusion: Patients with endometrial cancer who are obese can be treated safely by robotic-assisted surgery with a low risk of complications and few relapses.

DOI： 10.1111/jog.15434

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記述言語：英語   出版者・発行元：Japanese journal of clinical oncology  

Although geographical differences in the distribution of human papillomavirus genotypes have been observed worldwide, no studies have reported on national differences in the prevalence of human papillomavirus types in Japan. Here, we report a cross-sectional study to explore regional differences in the prevalence of human papillomavirus types among Japanese women with cervical intraepithelial neoplasia or invasive cervical cancer. Using human papillomavirus genotyping data from the nationwide prospective study on human papillomavirus vaccine effectiveness, we compared the frequency of detection of 15 high-risk and two low-risk human papillomavirus types in each disease category between the women who visited hospitals located in eastern Japan and those who visited hospitals located in western Japan. The risk of cervical intraepithelial neoplasia progression was assessed by calculating a prevalence ratio of each human papillomavirus type for cervical intraepithelial neoplasia grade 2/3 versus grade 1. Among the human papillomavirus types studied, human papillomavirus 52 was detected significantly more frequently in western hospitals than in eastern hospitals in cervical intraepithelial neoplasia grade 1 patients, but was less frequent in cervical intraepithelial neoplasia grade 2/3. The prevalence of particular human papillomavirus types was not significantly different between patients in hospitals in eastern Japan and those in hospitals in western Japan for invasive cervical cancer. In both eastern and western hospitals, a higher risk of cervical intraepithelial neoplasia progression was observed in patients infected with human papillomavirus 16, 31 or 58. In contrast, there was a significantly higher prevalence of human papillomavirus 52 infection in women with cervical intraepithelial neoplasia grade 2/3 than in those with cervical intraepithelial neoplasia grade 1 in eastern hospitals (prevalence ratio, 1.93; 95% confidence interval, 1.48-2.58), but not in western hospitals (prevalence ratio, 1.03; 95% confidence interval, 0.83-1.30). Regional differences of human papillomavirus 52 prevalence in cervical intraepithelial neoplasia lesions may exist and emphasize the importance of continuous monitoring of human papillomavirus type prevalence throughout the country in order to accurately assess the efficacy of human papillomavirus vaccines.

DOI： 10.1093/jjco/hyac127

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1038/s41417-022-00547-1

記述言語：英語   出版者・発行元：Oxford University Press  

日本における全国規模の前向きヒトパピローマウイルス(HPV)サーベイランス調査によるHPV遺伝子型データを用いて、HPV保有率の遺伝子型による地域差について検討するための横断研究を実施した。東日本の病院を受診した女性と西日本の病院を受診した女性の間で、高リスク型15種と低リスク型2種のHPV検出頻度を比較した。HPV52型は、子宮頸部上皮内腫瘍(CIN)グレード1において、西日本の病院で東日本の病院より有意に多く検出されたが、CINグレード2/3では検出頻度が少なかった。浸潤性子宮頸癌では、HPV遺伝子型の保有率は、東日本の病院の患者と西日本の病院の患者で有意差はなかった。東日本の病院でも西日本の病院でも、HPV16型、31型、58型に感染した患者ではCINへの進行リスクが高かった。CINグレード2/3の女性におけるHPV52型の保有率は、東日本の病院ではCINグレード1の女性よりも有意に高かったが(保有率比1.93、95%CI 1.48～2.58)、西部病院では差は認められなかった(保有率比1.03、95%CI 0.83～1.30)。以上より、CINにおけるHPV52型の保有率には地域差がある可能性があり、HPVワクチンの有効性を正確に評価するために、全国でHPV遺伝子型の保有率を継続的に監視することの重要性が強調された。

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.annonc.2022.08.027

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記述言語：英語   出版者・発行元：(公社)宮崎県医師会  

動脈-腸管瘻は消化管出血の原因としてはまれであるが,初発症状が致死性の大量出血の場合もある緊急性の高い疾患である。症例は44歳,9妊7産,子宮頸癌IB3期(扁平上皮癌)に対して広汎子宮全摘出術,両側付属器摘出術,術後補助療法として同時化学放射線療法を施行した。治療終了6ヵ月後に骨盤内再発を認め,全身化学療法を施行したが奏効しなかった。MSI検査の結果,MSI-highであったためペムブロリズマブ療法を開始した。腫瘍の著明な縮小を認め,4コース後の治療効果判定はPRであった。ペムブロリズマブ療法4コース目day7,当科入院中に突然,多量の下血,意識レベルの低下を認めた。緊急造影CTの結果,左内腸骨動脈からS状結腸への造影剤の漏出を認め,左内腸骨動脈-S状結腸瘻と診断した。直ちに左内腸骨動脈塞栓術を施行し止血した。発症から止血まで3時間の間に赤血球32単位,新鮮凍結血漿28単位,血小板10単位の輸血を要した。(著者抄録)

記述言語：英語   出版者・発行元：Taiwanese Journal of Obstetrics and Gynecology  

Objective: Recent randomized phase III trial has shown significant benefit in overall survival (OS) for patients with advanced cervical cancer by adding bevacizumab to conventional chemotherapy. The aim of this study was to evaluate the prognostic impact for Japanese recurrent, persistent, or metastatic cervical cancer patients where bevacizumab was added to paclitaxel plus carboplatin. Materials and methods: A retrospective analysis was performed on 90 patients with recurrent, persistent, or metastatic cervical cancer mainly treated by paclitaxel plus carboplatin between 2005 and 2019 at our hospital. Data for the following clinicopathological variables were analyzed: (1) bevacizumab use; (2) histology; (3) disease presentation; (4) performance status; (5) prior chemotherapy containing platinum agent; (6) pelvic disease; (7) prior pelvic radiotherapy; (8) location of target lesions. Survival analysis was performed using Kaplan–Meier curves, log-rank tests, Wilcoxon tests, and Cox proportional hazards models combined with propensity score matching. Results: Adding bevacizumab to paclitaxel plus carboplatin showed significantly increased complete response to compared with that of non-users. In a Cox regression hazard model, bevacizumab use tended to show better OS though without statistically significance. After propensity score matching, adding bevacizumab to paclitaxel plus carboplatin showed a significant better OS by univariate analysis using Wilcoxon test, not by log-rank test. Conclusion: Adding bevacizumab to paclitaxel plus carboplatin showed a limited prognostic impact for recurrent, persistent or advanced cervical cancer patients in the real world. Further effective second-line treatments are needed to prolong OS of patients with recurrent, persistent or advanced cervical cancer.

DOI： 10.1016/j.tjog.2022.06.005

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記述言語：英語   出版者・発行元：European Journal of Surgical Oncology  

Objective: Gastric-type mucinous carcinoma (GAS) is a novel variant of uterine cervix mucinous carcinoma. GAS is a distinct entity that can be distinguished from typical endocervical adenocarcinoma (UEA). In Japan, postoperative adjuvant therapy for cervical cancer includes not only radiation therapy (RT) or concurrent chemoradiotherapy (CCRT) but also chemotherapy in many cases. However, no previous studies have analyzed adjuvant therapy for GAS. In the present study, we investigated the efficacy of adjuvant therapy for GAS. Methods: This was a preplanned secondary analysis of a dataset from previous nationwide, retrospective, observational study. The study population comprised women with stage I–II GAS who underwent surgery. Progression-free survival (PFS) and overall survival (OS) were compared among patients who did and did not receive adjuvant therapy using the Kaplan–Meier method. Results: Data were analyzed for a total of 102 enrolled patients, who were classified as low- (17 patients), intermediate- (37 patients), or high risk (48 patients) based on the risk of postoperative cervical cancer recurrence. In the intermediate-risk group, median survival could not be assessed due to a lack of sufficient events, but the no-adjuvant and RT groups tended to exhibit better prognoses. In contrast, within the high-risk group, patients in the RT subgroup exhibited a trend towards better PFS and OS than those in the CCRT and chemotherapy groups. Conclusions: The prognosis of GAS was confirmed to be poor, even in cases of early-stage cancer and following surgical resection. Chemotherapy strategies, including CCRT as postoperative adjuvant therapy, tend to have a poor prognosis.

DOI： 10.1016/j.ejso.2022.03.007

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出版者・発行元：金原出版  

DOI： 10.18888/sp.0000002227

CiNii Research

記述言語：英語   出版者・発行元：Pathology Research and Practice  

Cyclin-dependent kinase 8 (CDK8) is associated with the transcriptional mediator complex and regulates several transcription factors implicated in cancer. CDK8 expression is a poor prognostic marker in colon and breast cancer by immunohistochemistry. However, somatic mutations in exon 2 of the RNA polymerase II transcriptional mediator subunit MED12 occur in 7–30% of cases of uterine leiomyosarcoma (ULMS), suggesting that these alterations contribute to tumorigenesis. Public genomic mutation data of 80 patients with ULMS were used for MED12 and CDK8 mutation analysis. The expression of MED12, CDK8 and β-catenin was evaluated by immunohistochemistry in our cohort of 60 patients with ULMS, in addition with MED12 mutation status and survival stage. Univariate analysis was performed using the log-rank test, and Cox regression was used to identify independent prognostic factors. Multivariate Cox regression analysis revealed that advanced stage (p < 0.0001) and high CDK8 expression (p = 0.0014) were independent predictors of poor prognosis. MED12 mutation status was not significantly associated with CDK8 expression (p = 0.6873) and DSS (p = 0.8075). In conclusion, our data suggest that CDK8 expression may identify a subset of ULMS patients with a poor prognosis.

DOI： 10.1016/j.prp.2022.153920

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PubMed

出版者・発行元：金原出版  

DOI： 10.18888/sp.0000002169

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.prp.2022.153920.

出版者・発行元：International Journal of Surgical Pathology  

Phyllodes tumors of the breast are uncommon, and 6.2% of phyllodes tumors behave in a malignant fashion. The metastatic spread of malignant phyllodes tumor is mainly hematogenous to lung and bone, and malignant phyllodes tumor metastasizing to the ovary is rare, with only 2 cases reported. We report the third case of metastatic malignant phyllodes tumor to the ovary with a focus on the differential diagnosis of ovarian cancer.

DOI： 10.1177/10668969211056912

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PubMed

記述言語：英語   出版者・発行元：Human Pathology  

Endometrial stromal sarcoma (ESS) is a rare uterine malignancy that requires accurate pathological diagnosis for proper treatment. This study aimed to clarify the discrepancies in the pathological diagnosis of ESS and obtain practical clues to improve diagnostic accuracy. Between 2002 and 2015, 148 patients with low-grade ESS (LGESS), high-grade ESS (HGESS), undifferentiated endometrial sarcoma (UES), or undifferentiated uterine sarcoma (UUS) diagnosed at 31 institutions were included. We performed immunohistochemistry, real-time polymerase chain reaction for JAZF1-SUZ12 and YWHAE-NUTM2A/B, and break-apart fluorescent in situ hybridization for JAZF1, PHF1, and YWHAE. Central pathology review (CPR) was performed by six pathologists. After CPR, LGESS, HGESS, UES/UUS, and other diagnoses were confirmed in 72, 25, 16, and 31 cases, respectively. Diagnostic discrepancies were observed in 19.6% (18/92) of LGESS and 34% (18/53) of HGESS or UUS/UES. Adenosarcomas, endometrial carcinomas, carcinosarcomas, and leiomyosarcomas were common diagnostic pitfalls. JAZF1-SUZ12 transcript, PHF1 split signal, and YWHAE-NUTM2A/B transcript were mutually exclusively detected in 23 LGESS, 3 LGESS, and 1 LGESS plus 3 HGESS, respectively. JAZF1-SUZ12 and YWHAE-NUTM2A/B transcripts were detected only in cases with CPR diagnosis of LGESS or HGESS. The CPR diagnosis of LGESS, HGESS, and UUS was a significant prognosticator, and patients with LGESS depicted a favorable prognosis, while those with UUS showed the worst prognosis. Pathological diagnosis of ESS is often challenging and certain tumors should be carefully considered. The accurate pathological diagnosis with the aid of molecular testing is essential for prognostic prediction and treatment selection.

DOI： 10.1016/j.humpath.2022.03.007

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Oncology Switzerland  

Introduction: The prognostic significance of lymphovascular space invasion (LVSI) in stage IA endometrial cancer remains unclear. The aim of this study was to evaluate the clinical significance of LVSI in stage IA endometrial cancer. Methods: Clinical data of patients with stage IA endometrial cancer who underwent initial surgery at our institution between January 2008 and December 2018 were reviewed retrospectively. Information of patients, surgery, and characteristics of cancer were obtained from medical records and pathological reports. Results: Two hundred ninety-seven patients were enrolled in this study. With a median follow-up of 60 months, 15 patients experienced recurrence (5.1%) and 4 patients died of endometrial cancer (1.3%). The recurrence and mortality rates did not differ significantly between the LVSI-positive and-negative groups (p = 0.07 and p = 0.41, respectively). Recurrence-free survival and endometrial cancer-specific survival also did not differ significantly between these groups (p = 0.11 and p = 0.49, respectively). The 5-year endometrial cancer-specific survival rates for tumors with and without LVSI were 97.0% and 98.9%, respectively. Among patients with low-grade tumors, recurrence-free survival and endometrial cancer-specific survival did not differ significantly between patients with tumors with and without LVSI (p = 0.92 and p = 0.72, respectively). The 5-year endometrial cancer-specific survival rates for low-grade tumors with and without LVSI were 100% and 99.3%, respectively. Conclusion: LVSI was not a prognostic factor of not only stage IA endometrial cancer but also stage IA low-grade cancer.

DOI： 10.1159/000521382

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PubMed

記述言語：英語   出版者・発行元：Gynecologic Oncology  

Objective: Sentinel node biopsy alone (SNB) reduces the postoperative complications of pelvic lymphadenectomy, such as lymphedema and lymphangitis; however, the long-term prognosis after SNB is unclear. The objective of this study was to evaluate the long-term outcome and complications of patients with early-stage cervical cancer who underwent SNB for hysterectomy or trachelectomy. Methods: We performed SNB for cervical cancer using a radioisotope method in 181 patients between 2009 and 2017. If the intraoperative sentinel lymph node evaluation was negative for metastasis, no further lymph nodes were removed. Results: The median age of the patients was 34 years (range, 21–73 years). The International Federation of Gynecology and Obstetrics 2008 stage was IA1 in 6 patients, IA2 in 18, IB1 in 154, and IIA1 in 3. Of the 181 patients (44 with hysterectomy, 137 with trachelectomy), 8 did not undergo pelvic lymphadenectomy because of a false-negative intraoperative diagnosis, 20 received adjuvant therapy after surgery, and 4 (2.2%) experienced recurrence over a median follow-up period of 83.5 months (range, 25–145 months). In the four recurrent cases, recurrence occurred in the pelvis, lung, and bone in one patient each, while the remaining patient developed pelvic and para-aortic lymph node metastases. Of these four patients, one died, and the remaining three are alive without disease after multidisciplinary therapy. The 5-year progression-free and overall survival rates were 98.8% and 99.4%, respectively. Postoperative complications, such as lymphedema, were very low rate. Conclusions: SNB for early-stage cervical cancer might be safe and effective, with no increase in the recurrence and postoperative complications rate.

DOI： 10.1016/j.ygyno.2022.01.031

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PubMed

記述言語：英語   出版者・発行元：Cancer Science  

In Japan, the National Immunization Program against human papillomavirus (HPV) targets girls aged 12-16 years, and catch-up vaccination is recommended for young women up to age 26 years. Because HPV infection rates increase soon after sexual debut, we evaluated HPV vaccine effectiveness by age at first vaccination. Along with vaccination history, HPV genotyping results from 5795 women younger than 40 years diagnosed with cervical intraepithelial neoplasia grade 2-3 (CIN2-3), adenocarcinoma in situ (AIS), or invasive cervical cancer were analyzed. The attribution of vaccine-targeted types HPV16 or HPV18 to CIN2-3/AIS was 47.0% for unvaccinated women (n = 4297), but 0.0%, 13.0%, 35.7%, and 39.6% for women vaccinated at ages 12-15 years (n = 36), 16-18 years (n = 23), 19–22 years (n = 14), and older than 22 years (n = 91), respectively, indicating the greater effectiveness of HPV vaccination among those initiating vaccination at age 18 years or younger (P <.001). This finding was supported by age at first sexual intercourse; among women with CIN2-3/AIS, only 9.2% were sexually active by age 14 years, but the percentage quickly increased to 47.2% by age 16 and 77.1% by age 18. Additionally, the HPV16/18 prevalence in CIN2-3/AIS was 0.0%, 12.5%, and 40.0% for women vaccinated before (n = 16), within 3 years (n = 8), and more than 3 years after (n = 15) first intercourse, respectively (P =.004). In conclusion, our data appear to support routine HPV vaccination for girls aged 12-14 years and catch-up vaccination for adolescents aged 18 years and younger in Japan.

DOI： 10.1111/cas.15270

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記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

ヒトパピローマウイルスワクチン(HPV)ワクチン接種を受けた日本人女性の年齢別にワクチンの有効性を検討した。子宮頸部上皮内腫瘍グレード2～3(CIN2～3)、上皮内腺癌(AIS)、浸潤子宮頸癌と診断された40歳未満の女性5795例のHPV遺伝子型検査結果を解析した。HPVワクチンの標的であるHPV16やHPV18のCIN2-3/AISへの帰属は、ワクチン未接種女性(4297例)では47.0%であったが、ワクチン接種年齢が12～15歳(36例)、16～18歳(23例)、19～22歳(14例)、22歳以上(91例)ではそれぞれ0.0、13.0、35.7、39.6%であり、18歳以下の初回接種でHPVワクチンのより高い効果が示された(p<0.001)。本知見は、初回性交年齢によって裏付けられ、CIN2-3/AISの女性では、14歳までに性交を行った割合は9.2%に過ぎなかったが、16歳までは47.2%、18歳までは77.1%と急速に増加した。さらに、CIN2-3/AISにおけるHPV16/18保有率は、初回ワクチン接種が初回性交前(16例)、初回性交後3年以内(8例)、3年以上(15例)でそれぞれ0.0、12.5、40.0%であった(p=0.004)。本研究は、日本における12～14歳の女性へのHPVワクチンの定期接種と18歳以下の思春期でのキャッチアップ接種を支持した。

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.ejso.2022.03.007.

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：Vaccines  

Since the human papillomavirus (HPV) vaccination program for Japanese girls aged 12–16 years began in 2010, vaccination uptake has been low in women born before 1993 but high (approximately 70%) in those born during 1994–1999. We previously compared the prevalence of vaccine types HPV16 and HPV18 in cervical intraepithelial neoplasia grade 1–3 (CIN1–3) or adenocarcinoma in situ (AIS) between vaccinated and unvaccinated cohorts and found direct protection effects among vaccinated women in Japan. In this study, we focused on changes in HPV16/18 prevalence among “unvaccinated” cohorts with CIN/AIS. We analyzed HPV16/18 prevalence among 5051 unvaccinated women aged <40 years, newly diagnosed with CIN/AIS during 2012–2021 for time trends. Declining trends in HPV16/18 prevalence over 9 years were observed in CIN1 (36.0–10.0%, Ptrend = 0.03) and CIN2–3/AIS (62.5–36.4%, Ptrend = 0.07) among women aged <25 years. HPV16/18 prevalence in CIN1 and CIN2–3/AIS diagnosed at age 20–24 years was lower in 1994–1999 birth cohorts compared with 1988–1993 birth cohorts (4.5% vs. 25.7% for CIN1 and 40.0% vs. 58.1% for CIN2–3/AIS, both p = 0.04). Significant reduction in HPV16/18 prevalence among young unvaccinated women with CIN1 and CIN2–3/AIS suggests herd effects of HPV vaccination in Japan.

DOI： 10.3390/vaccines10020188

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

開催年月日： 2024年4月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2024年4月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2022年8月

記述言語：英語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：福岡市   国名：日本国  

開催年月日： 2022年1月

記述言語：日本語   会議種別：口頭発表（招待・特別）  

国名：日本国  

開催年月日： 2021年12月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：神戸市   国名：日本国  

開催年月日： 2021年10月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：横浜市   国名：日本国  

開催年月日： 2021年9月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2021年6月

記述言語：日本語  

開催地：幕張メッセ   国名：日本国  

開催年月日： 2021年4月

記述言語：日本語  

国名：日本国  

開催年月日： 2021年1月

記述言語：日本語  

国名：日本国  

開催年月日： 2020年11月

記述言語：日本語  

国名：日本国  

開催年月日： 2020年9月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2019年12月

記述言語：日本語   会議種別：口頭発表（一般）  

国名：フィリピン共和国  

開催年月日： 2019年7月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2019年7月

記述言語：日本語  

国名：日本国  

開催年月日： 2019年7月

記述言語：英語  

国名：日本国  

開催年月日： 2018年7月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

国名：日本国  

開催年月日： 2018年6月

記述言語：日本語   会議種別：公開講演，セミナー，チュートリアル，講習，講義等  

開催地：仙台   国名：日本国  

開催年月日： 2018年6月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：東京   国名：日本国  

開催年月日： 2018年6月

記述言語：日本語  

国名：日本国  

開催年月日： 2018年6月

記述言語：英語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：Hong Kong  

開催年月日： 2015年10月

記述言語：日本語  

開催地：京都市   国名：日本国  

開催年月日： 2015年8月

記述言語：日本語   会議種別：公開講演，セミナー，チュートリアル，講習，講義等  

開催地：盛岡市   国名：日本国  

開催年月日： 2015年4月

記述言語：日本語  

開催地：横浜市   国名：日本国  

開催年月日： 2015年4月

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：横浜市   国名：日本国  

開催年月日： 2014年11月

記述言語：日本語  

開催地：下関市   国名：日本国  

開催年月日： 2014年9月

記述言語：英語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：Madrid   国名：スペイン  

開催年月日： 2011年11月

開催地：Seoul   国名：大韓民国  

開催年月日： 2011年8月

開催地：大阪市   国名：日本国  

開催年月日： 2011年7月

開催地：札幌市   国名：日本国  

開催年月日： 2011年7月

会議種別：口頭発表（一般）  

開催地：つくば市   国名：日本国  

開催年月日： 2009年7月

会議種別：口頭発表（一般）  

開催地：新潟市   国名：日本国  

開催年月日： 2009年4月

会議種別：口頭発表（一般）  

開催地：京都   国名：日本国  

開催年月日： 2008年10月 - 2008年11月

会議種別：口頭発表（一般）  

開催地：名古屋   国名：日本国  

会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：東京   国名：日本国  

記述言語：日本語  

開催地：神戸市   国名：日本国  

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：福岡市   国名：日本国  

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：東京都   国名：日本国  

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：熊本市   国名：日本国  

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：東京都   国名：日本国  

記述言語：日本語  

開催地：釧路市   国名：日本国  

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：京都市   国名：日本国  

記述言語：英語  

開催地：Kyoto   国名：日本国  

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

開催地：別府市   国名：日本国  

記述言語：日本語  

開催地：宇都宮市   国名：日本国  

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：福岡市   国名：日本国  

開催地：名古屋   国名：日本国  

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：日本語  

記述言語：英語  

記述言語：日本語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：日本語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）  

記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）  

記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）  

記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）  

記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）  

記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）  

記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）  

記述言語：日本語   出版者・発行元：(株)日本臨床社  

記述言語：英語   出版者・発行元：Oxford University Press  

ヒトパピローマウイルス(HPV)定期ワクチン接種対象集団の最適な年齢を特定するため、初性交年齢を調べた。国内医療施設24施設で子宮頸部上皮内腫瘍グレード1～3(CIN1～3)、上皮内腺癌(AIS)もしくは浸潤性子宮頸癌(ICC)と新規に診断された40歳未満の女性を対象としたMINT研究参加者から、CIN2-3/AIS患者1353例とICC患者209例の患者データを調査した。その結果、初性交年齢中央値はCIN2-3/AIS群で17歳(範囲9～35歳)、ICC群では16歳(範囲12～22歳)であった。また、ICC群のうち性的に活動的な女性の累積率は12歳以下が0.5%、13歳以下が3.8%、14歳以下が12.4%、15歳以下が30.1%、16歳以下が53.1%、18歳以下が80.4%で、既報の一般集団に比べ約2倍も高かった。以上より、CIN2-3/AIS患者に比べICC患者の初性交年齢は有意に低年齢で、ICC患者では14歳以降に性的に活発な女性の割合が高率に認められたことから、HPVワクチン接種は14歳以前に開始することが推奨された。

記述言語：日本語   出版者・発行元：金原出版(株)  

＜文献概要＞婦人科がんで最も使用されるTC療法時の前投薬においては特に注意すべき点はないもののパクリタキセルは体表面積を2.0m2を上限とし,360mg/bodyまでとする臨床試験もある。また,カルボプラチンに関しては日本人のGFRの正常値は70～130ml/minとされており,少なくとも1,000mg/bodyを超えるような場合は投与量の上限を考慮したほうがよい。ベバシズマブには体重に関する上限はなく,PARP阻害薬にも体重に関する上限はないが,BMIが30を超えると有害事象が多くなるとの報告もある。

記述言語：日本語   出版者・発行元：金原出版(株)  

＜文献概要＞早期子宮頸癌に対する妊孕性温存手術として子宮頸部摘出術は広く臨床の場に浸透してきており,婦人科腫瘍を扱う産婦人科医にとっては必要な手技になりつつある。一般的には適応は2cm未満であるとガイドラインにも記載されているが,腫瘍径よりも内子宮口との腫瘍までの距離が適応を考えるうえで重要と思われる。また,子宮動脈の温存を行わなければ通常の広汎子宮全摘術の手技を進め,子宮と腟管の吻合および子宮頸管縫縮術のみが通常の手技と異なる点も重要である。また,子宮頸部摘出術に特有の合併症も術前に十分に説明したうえで,早期の不妊治療の介入の必要性なども説明しておくべきである。

記述言語：日本語   出版者・発行元：大道学館出版部  

記述言語：日本語   出版者・発行元：大道学館出版部  

種別：審査・学術的助言 

種別：大会・シンポジウム等 

種別：大会・シンポジウム等 

種別：大会・シンポジウム等 

参加者数：500

種別：大会・シンポジウム等 

参加者数：50

種別：大会・シンポジウム等 

参加者数：100