九州大学-研究者情報 [藤森尚 (講師) 九州大学病院肝臓・膵臓・胆道内科]

1.	Masatoshi Murakami, Nao Fujimori, Kohei Nakata, Masafumi Nakamura, Shinichi Hashimoto, Hiroshi Kurahara, Kazuyoshi Nishihara, Toshiya Abe, Shunpei Hashigo, Naotaka Kugiyama, Eisuke Ozawa, Kazuhisa Okamoto, Yusuke Ishida, Keiichi Okano, Ryo Takaki, Yutaka Shimamatsu, Tetsuhide Ito, Masami Miki, Noriko Oza, Daisuke Yamaguchi, Hirofumi Yamamoto, Hironobu Takedomi, Ken Kawabe, Tetsuro Akashi, Koichi Miyahara, Jiro Ohuchida, Yasuhiro Ogura, Yohei Nakashima, Toshiharu Ueki, Kousei Ishigami, Hironobu Umakoshi, Keijiro Ueda, Takamasa Oono, Yoshihiro Ogawa, Machine learning-based model for prediction and feature analysis of recurrence in pancreatic neuroendocrine tumors G1/G2., Journal of gastroenterology, 10.1007/s00535-023-01987-8, 58, 6, 586-597, 2023.06, BACKGROUND: Pancreatic neuroendocrine neoplasms (PanNENs) are a heterogeneous group of tumors. Although the prognosis of resected PanNENs is generally considered to be good, a relatively high recurrence rate has been reported. Given the scarcity of large-scale reports about PanNEN recurrence due to their rarity, we aimed to identify the predictors for recurrence in patients with resected PanNENs to improve prognosis. METHODS: We established a multicenter database of 573 patients with PanNENs, who underwent resection between January 1987 and July 2020 at 22 Japanese centers, mainly in the Kyushu region. We evaluated the clinical characteristics of 371 patients with localized non-functioning pancreatic neuroendocrine tumors (G1/G2). We also constructed a machine learning-based prediction model to analyze the important features to determine recurrence. RESULTS: Fifty-two patients experienced recurrence (14.0%) during the follow-up period, with the median time of recurrence being 33.7 months. The random survival forest (RSF) model showed better predictive performance than the Cox proportional hazards regression model in terms of the Harrell's C-index (0.841 vs. 0.820). The Ki-67 index, residual tumor, WHO grade, tumor size, and lymph node metastasis were the top five predictors in the RSF model; tumor size above 20 mm was the watershed with increased recurrence probability, whereas the 5-year disease-free survival rate decreased linearly as the Ki-67 index increased. CONCLUSIONS: Our study revealed the characteristics of resected PanNENs in real-world clinical practice. Machine learning techniques can be powerful analytical tools that provide new insights into the relationship between the Ki-67 index or tumor size and recurrence..
2.	Tsukasa Miyagahara, Nao Fujimori, Keijiro Ueda, Yu Takamatsu, Kazuhide Matsumoto, Katsuhito Teramatsu, Takehiro Takaoka, Yuta Suehiro, Yuzo Shimokawa, Kaoru Omori, Yusuke Niina, Yuichi Tachibana, Tetsuro Akashi, Takamasa Oono, Yoshihiro Ogawa, Incidence and appropriate management of drug-induced interstitial lung disease in Japanese patients with unresectable pancreatic cancer: A multicenter retrospective study., Asia-Pacific journal of clinical oncology, 10.1111/ajco.13903, 19, 4, 533-541, 2022.12, AIM: Drug-induced interstitial lung disease (DI-ILD) is a serious adverse event during chemotherapy. This study aimed to obtain real-world data of the incidence, clinical characteristics, predictive factors, and prognosis of patients with pancreatic cancer who developed DI-ILD. METHODS: In patients with locally advanced or metastatic pancreatic cancer who underwent standard chemotherapy at our hospital and its participating facilities between April 2014 and March 2019, the clinical features, occurrence rate and clinical course of DI-ILD, and prognosis were retrospectively evaluated. RESULTS: Altogether, 390 patients were finally enrolled. DI-ILD occurred in 24 cases (6.2%). The median period from diagnosis of pancreatic cancer to the onset of DI-ILD was 2.2 months (.6-13.3 months). The rate of DI-ILD onset according to each regimen was 5.8% of gemcitabine (GEM) plus albumin-bound paclitaxel therapy (18/308), 3.8% of GEM (4/106), and 2.3% of FOLFIRINOX (2/88). The incidence of DI-ILD in GEM-based regimens was significantly higher than that in non-GEM-based regimens (p
3.	Katsuhito Teramatsu, Takamasa Oono, Koki Oyama, Nao Fujimori, Masatoshi Murakami, Sho Yasumori, Akihisa Ohno, Kazuhide Matsumoto, Ayumu Takeno, Kohei Nakata, Masafumi Nakamura, Yoshihiro Ogawa, Circulating CD8+CD122+ T cells as a prognostic indicator of pancreatic cancer., BMC cancer, 10.1186/s12885-022-10207-0, 22, 1, 1134-1134, 2022.11, PURPOSE: The distribution of tissue infiltrating lymphocytes has been shown to affect the prognosis of patients with pancreatic cancer in some previous studies. However, the role of peripheral lymphocytes in pancreatic cancer remains debated. The purpose of this study was to analyze the peripheral subtypes of T lymphocytes, and establish their association with the prognosis of patients with pancreatic cancer. METHODS: Blood and tissue samples were collected from patients with metastatic pancreatic cancer (n = 54), resectable pancreatic cancer (n = 12), and benign pancreatic cysts (n = 52) between April 2019 and January 2022 and analyzed. RESULTS: Patients with metastatic pancreatic cancer had a larger proportion of both tumor-suppressive and tumor-promoting cells than those with benign pancreatic cysts. In addition, the proportion of peripheral CD4+ T cells positively correlated with the survival of patients with metastatic pancreatic cancer, and the proportion of peripheral CD8+CD122+ T cells was associated with early mortality (
4.	Kyoko Shimizu, Tetsuhide Ito, Atsushi Irisawa, Takao Ohtsuka, Hirotaka Ohara, Atsushi Kanno, Mitsuhiro Kida, Junichi Sakagami, Naohiro Sata, Yoshifumi Takeyama, Junko Tahara, Morihisa Hirota, Nao Fujimori, Atsushi Masamune, Satoshi Mochida, Nobuyuki Enomoto, Tooru Shimosegawa, Kazuhiko Koike, Evidence-based clinical practice guidelines for chronic pancreatitis 2021., Journal of gastroenterology, 10.1007/s00535-022-01911-6, 57, 10, 709-724, 2022.10, BACKGROUND: Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. METHODS: The clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions. RESULTS: Based on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition. CONCLUSIONS: These updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP..
5.	Masami Miki, Nao Fujimori, Keijiro Ueda, Lingaku Lee, Masatoshi Murakami, Yu Takamatsu, Yuzo Shimokawa, Yusuke Niina, Takamasa Oono, Terumasa Hisano, Masayuki Furukawa, Yoshihiro Ogawa, Treatment Effect and Safety of Nanoliposomal Irinotecan with Fluorouracil and Folinic Acid after Gemcitabine-Based Therapy in Patients with Advanced Pancreatic Cancer: A Multicenter, Prospective Observational Study., Journal of clinical medicine, 10.3390/jcm11175084, 11, 17, 2022.08, Although the combination of nanoliposomal irinotecan plus fluorouracil/folinic acid (nal-IRI/FF) exhibited survival benefits in gemcitabine-refractory patients with advanced pancreatic cancer (APC) in the phase III NAPOLI-1 trial, there is limited data on the efficacy and safety of this regimen in real-world settings in Japan. This multicenter, prospective observational study enrolled patients with APC who received nal-IRI/FF after a gemcitabine-based regimen from July 2020 to June 2021. We collected and analyzed clinical data and conducted survival and multivariate analyses. Thirty-one (78%) of the 40 patients had metastases. Nal-IRI/FF was the second-line therapy in 36 patients (90%). The median duration was 3.2 months. The disease control rate was 57%. The median progression-free survival and overall survival (OS) were 4.5 months (95% confidence interval [CI]: 2.8-5.5) and 7.4 months (95% CI: 5.1-10.6), respectively. Common ≥grade 3 toxicities included neutropenia (28%) and fatigue (23%). Fatigue led to treatment discontinuation in 6 out of 10 patients. Multivariate analysis showed that a neutrophil-to-lymphocyte ratio > 4 was a significant risk factor for a short OS (hazard ratio (HR) = 3.08, 95% CI: 1.21-7.85, p = 0.02). In conclusion, nal-IRI/FF is an appropriate treatment option for APC following gemcitabine-containing regimens..
6.	Akihisa Ohno, Nao Fujimori, Toyoma Kaku, Yu Takamatsu, Kazuhide Matsumoto, Masatoshi Murakami, Katsuhito Teramatsu, Ayumu Takeno, Masayuki Hijioka, Ken Kawabe, Naohiko Harada, Makoto Nakamuta, Akira Aso, Takamasa Oono, Yoshihiro Ogawa, Feasibility and Efficacy of Endoscopic Ultrasound-Guided Hepaticogastrostomy Without Dilation: A Propensity Score Matching Analysis., Digestive diseases and sciences, 10.1007/s10620-022-07555-z, 67, 12, 5676-5684, 2022.06, BACKGROUND: Recently, endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) procedures have been gradually established; nonetheless, some adverse events (AEs) have been reported. Dilation procedures using a non-cautery or cautery device increase the incidence of AEs in EUS-HGS. AIMS: We evaluated EUS-HGS procedures without dilation and the factors associated with dilation. METHODS: We enrolled 79 patients who underwent EUS-HGS between July 2015 and March 2021 at two centers, 72 of whom had technical success (72/79, 91%). During the EUS-HGS procedures, we defined patients without dilation procedures as the dilation (-) group. We divided the patients into two groups: the dilation (+) (35 patients) and dilation (-) (37 patients) groups. We performed a propensity score matching analysis to adjust for confounding bias between the two groups. Multivariable logistic regression analysis was conducted to identify factors associated with dilation. RESULTS: There was no difference in clinical success rate between the dilation (+) and dilation (-) groups (91% vs. 95%, P = 0.545). The AE rate (P = 0.013) and long procedure time (P = 0.017) were significantly higher in the dilation (+) group than in the dilation (-) group before and after propensity score matching. Factors associated with dilation were plastic stent placement (odds ratio [OR], 6.96; 95% confidence interval [CI], 1.68-28.7; P = 0.007) and puncture angle of ≤ 90° (OR, 44.6; 95% CI, 5.1-390; P
7.	Yu Takamatsu, Nao Fujimori, Tsukasa Miyagahara, Yuta Suehiro, Toyoma Kaku, Ken Kawabe, Akihisa Ohno, Kazuhide Matsumoto, Masatoshi Murakami, Katsuhito Teramatsu, Ayumu Takeno, Takamasa Oono, Yoshihiro Ogawa, The Glasgow Prognostic Score and stricture site can predict prognosis after endoscopic duodenal stent placement for malignant gastric outlet obstruction., Scientific reports, 10.1038/s41598-022-13209-x, 12, 1, 9746-9746, 2022.06, Endoscopic duodenal stent (DS) placement for malignant gastric outlet obstruction (GOO) is rapidly increasing in clinical practice; however, the most suitable patient candidates for DS placement have not been determined. One hundred and thirty-five patients with GOO who underwent DS placement in three Japanese referral centers between January 2010 and October 2019 were retrospectively evaluated. Overall survival (OS) after DS placement, technical/clinical success rates, adverse events, and predictive factors affecting OS after DS placement were also analyzed. The median OS after DS placement of all patients was 81 (7-901) days. Technical and clinical success rates were 99.3% and 83.7%, respectively. The GOO Scoring System score significantly increased before and after DS placement (0.9 vs. 2.7, P
8.	Fujimori N, Miki M, Lee L, Matsumoto K, Takamatsu Y, Takaoka T, Teramatsu K, Suehiro Y, Murakami M, Igarashi H, Oono T, Ohtsuka T, Nakamura M, Koga Y, Oda Y, Ito T, Ogawa Y, Natural history and clinical outcomes of pancreatic neuroendocrine neoplasms based on the WHO 2017 classification; a single-center experience of 30 years., Pancreatology, 10.1016/j.pan.2020.04.003, 20, 4, 709-715, 2020.06.
9.	Fujimori Nao, Osoegawa Takashi, Lee Lingaku, Tachibana Yuichi, Aso Akira, Kubo Hiroaki, Kawabe Ken, Igarashi Hisato, Nakamura Kazuhiko, Oda Yoshinao, Ito Tetsuhide, Efficacy of endoscopic ultrasonography and endoscopic ultrasonography-guided fine-needle aspiration for the diagnosis and grading of pancreatic neuroendocrine tumors, SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 10.3109/00365521.2015.1083050, 51, 2, 245-252, 2016.02.

主要総説, 論評, 解説, 書評, 報告書等

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主要学会発表等

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学会活動

所属学会名

日本内科学会・日本膵臓学会・日本消化器病学会・日本消化器内視鏡学会・日本胆道学会・日本臨床腫瘍学会・日本糖尿病学会・日本神経内分泌腫瘍研究会

学会大会・会議・シンポジウム等における役割

2023.07.22～2023.07.22, 第54回日本膵臓学会　Interventional EUS for pancreatic diseases ～Asian Symposium～, Chair.

2017.05.19～2018.05.20, 第109回日本消化器病学会／第103回日本消化器内視鏡学会九州支部例会, その他.

2017.11.17～2017.11.18, 第110回日本消化器病学会／第104回日本消化器内視鏡学会九州支部例会, その他.

2018.11.09～2018.11.10, 第112回日本消化器病学会／第106回日本消化器内視鏡学会九州支部例会, その他.

2019.05.24～2019.05.25, 第113回日本消化器病学会／第107回日本消化器内視鏡学会九州支部例会, その他.

2020.05.14～2020.05.14, The 5th EUS-Asia Teleconference, Chair.

2020.06.19～2020.06.20, 第115回日本消化器病学会／第109回日本消化器内視鏡学会九州支部例会, その他.

2020.09～2020.09, 第99回日本消化器内視鏡学会総会, 座長.

2020.09.17～2020.09.17, The 6th EUS-Asia Teleconference, Chair.

2020.12.03～2020.12.03, 神経内分泌腫瘍 Web Seminar in 福岡, 座長.

2020.12.17～2020.12.17, The 7th EUS-Asia Teleconference, Chair.

2021.04.20～2021.04.20, The 8th EUS-Asia Teleconference, Chair.

2021.08.24～2021.08.24, The 9th EUS-Asia Teleconference, Chair.

2021.12.07～2021.12.07, The 10th EUS-Asia Teleconference, Chair.

2022.04.12～2022.04.12, The 11th EUS-Asia Teleconference, Chair.

2022.06.24～2022.06.25, 第119回⽇本消化器病学会九州⽀部例会・第113回⽇本消化器内視鏡学会九州⽀部例会, 座長.

2022.06.29～2022.06.29, 九州胆石症 Web セミナー, 座長.

2022.08.30～2022.08.29, The 12th EUS-Asia Teleconference, Chair.

2022.09.09～2022.09.09, PancreaticCancer Seminarin FUKUOKA, 座長.

2022.10.01～2022.10.01, 第10 回日本神経内分泌腫瘍研究会学術集会, 座長.

2022.10.13～2022.10.14, 第58回日本胆道学会学術集会, 座長.

2022.10.28～2022.10.28, JDDW2022, 座長.

2022.12.14～2022.12.14, 1st FligHT-K Workshop ～ Advanced Interventional EUS ～, 座長.

2023.01.10～2023.01.10, The 13th EUS-Asia Teleconference, Chair.

2023.03.18～2023.03.18, 第20 回日本臨床腫瘍学会学術集会（JSMO2023）, 座長.

2023.05.12～2023.05.12, 第121回⽇本消化器病学会九州⽀部例会・第115回⽇本消化器内視鏡学会九州⽀部例会　イブニングセミナー, 座長.

2023.05.13～2023.05.13, 第121回⽇本消化器病学会九州⽀部例会・第115回⽇本消化器内視鏡学会九州⽀部例会, ディスカッサント.

2023.05.27～2023.05.27, 第105 回　日本消化器内視鏡学会総会, 座長.

2023.10.26～2023.10.26, 第30 回若手膵臓研究会, 座長.

学術論文等の審査

年度	外国語雑誌査読論文数	日本語雑誌査読論文数	国際会議録査読論文数	国内会議録査読論文数	合計
2023年度	29			10	39
2022年度	23	0	0	5	28
2021年度	29	0		5	34
2020年度	15	0			15
2019年度	3			8	11
2017年度	1				1

その他の研究活動

海外渡航状況, 海外での教育研究歴

Peking Union Medical College Hospital, China, 2019.08～2019.08.

フィリピン内視鏡学会2019（ENDOSCOPICON PHILIPPINES）, Philippines, 2019.10～2019.10.

Hue Central Hospital, Hue University of Medicine and Pharmacy, Vietnam, 2020.02～2020.02.

Yangon General Hospital(YGH), Thingangyun General Hospital(TGH), Myanmar, 2020.01～2020.01.

チュラロンコン王立記念病院, Cho Ray Hospital, Thailand, Vietnam, 2018.12～2018.12.

Cipto Mungunkusumo病院, Indonesia, 2018.10～2018.10.

研究資金

科学研究費補助金の採択状況(文部科学省、日本学術振興会)

2016年度～2018年度, 基盤研究(C), ゲノム編集技術による膵管上皮細胞から膵β細胞新生の確立と新たな糖尿病治療戦略.

2020年度～2022年度, 基盤研究(C), 膵癌転移に関する指向性と予後の検討.

2022年度～2024年度, 基盤研究(C), 代表, AI及びシングルセル解析を用いた膵神経内分泌腫瘍の不均一性の解明.

2019年度～2021年度, 若手研究, 代表, 膵癌診療におけるliquid biopsyの確立と超早期診断への応用.

2018年度～2021年度, 基盤研究(C), 分担, アジアにおける膵癌早期発見率の向上を目指した国際間遠隔教育プログラムの実現.

競争的資金(受託研究を含む)の採択状況

2023年度～2024年度, 公益財団法人持田記念医学薬学振興財団, 代表, 膵癌患者由来オルガノイドを用いた肝転移メカニズムの解明と個別化治療の開発.

2023年度～2024年度, 公益財団法人大和証券財団, 代表, 患者由来オルガノイドを用いた高齢者膵癌に対する至適治療戦略の構築.

2022年度～2023年度, 公益財団法人日本膵臓病研究財団　膵臓病研究奨励賞, 代表, 膵癌患者由来オルガノイドを用いた新たなサブタイプ分類と臨床応用.

2022年度～2023年度, 公益財団法人臨床研究奨励基金, 代表, 超音波内視鏡を用いた膵神経内分泌腫瘍術後再発因子の同定と新規治療戦略の確立.

2021年度～2023年度, , 代表, AIを用いた膵神経内分泌腫瘍術後再発因子の同定と喫煙習慣の関連.

2019年度～2020年度, 膵臓病研究奨励賞, 代表, 原発巣と血中遊離DNAの遺伝学的情報を応用した膵癌予後改善への挑戦.

九大関連コンテンツ

pure2017年10月2日から、「九州大学研究者情報」を補完するデータベースとして、Elsevier社の「Pure」による研究業績の公開を開始しました。

QIR　九州大学学術情報リポジトリシステム情報科学研究院

九州大学病院


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