消化器内科診療Controversy

出版社: 中外医学社
著者:
発行日: 2023-01-25
分野: 臨床医学:内科  >  消化器一般
ISBN: 9784498140523
電子書籍版: 2023-01-25 (1版1刷)
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消化管も肝胆膵も網羅,消化器内科診療の難問に答える1冊! 「ガイドラインの隙間を埋める」好評シリーズ! 目の前の患者に最適な診療をするためにエキスパートはどう考え,どう対応しているのか1問1答形式で伝授.検査や診断から薬剤選択,治療の進め方まで診療のすべてを対象に臨床現場で実際に生じる疑問に答える具体的な知識が満載.

目次

  • 1 B型慢性肝疾患に対する核酸アナログ製剤の選択や変更はどのように判断すべきか?
    2 妊娠希望のあるB型慢性肝炎患者に対する治療方針はどうあるべきか?
    3 HBs抗原陽性患者における核酸アナログ製剤の中止にはどのようなリスクがあるのか?
    4 推定余命を踏まえ高齢者DAA治療の適応はどのように考えるべきか?
    5 SVR後の外来通院はどこまで継続するべきか?
    6 SVR後症例は献血が可能か?(HCV RNA陰性HCV抗体陽性患者)
    7 NAFLD患者における飲酒はどのようなリスクをもたらすのか?
    8 肝線維化の改善は期待できるか?
    9 不顕性脳症における治療適応はどのように判断すべきか?
    10 門脈圧亢進症における肝静脈圧較差測定は普及するのか?
    11 静脈瘤はどこまで治療すべきか?
    12 すべての門脈血栓症患者は治療適応となりうるのか?
    13 AIHにおけるステロイドの維持量はどうあるべきか?
    14 AIHに対する免疫抑制薬使用のタイミングはどのように判断すべきか?
    15 PBCに対してベザフィブラート投与は推奨されるのか?
    16 PBCの予後予測はどの程度正確か?
    17 肝細胞癌に対する肝動脈化学塞栓術と薬物療法はどのように組み合わされるべきか?
    18 肝細胞癌に対する薬物療法はどの順番で選択されるべきか?
    19 切除不能肝内胆管癌に対する一次治療には何を選択するべきか?
    20 薬物性肝障害とirAEとしての肝障害はどのように鑑別できるか?
    21 悪性肝門部胆管閉塞に対するステントとしてPSとUSEMSのどちらを選択するべきか?
       また,ドレナージ領域として両葉と片葉のどちらを選択するべきか?
    22 胆道癌術前診断におけるmapping biopsyの意義はあるのか?
    23 胆嚢腫瘍性病変の病理診断―病理診断の必要性と限界は?
    24 胆道癌における術前治療は有効か?
    25 良性狭窄に対する診療戦略―必要不可欠な精査モダリティおよび経過観察法は?
    26 膵癌高リスク群のスクリーニング法―必要不可欠な精査モダリティおよび経過観察法は?
    27 充実性膵腫瘍診療における病理診断の功罪? 播種リスクを考慮した病理診断の必要性は?
    28 局所進行膵癌に対する化学放射線療法の意義―放射線治療addonは必要か否か?
       どのような症例に必要か?〈小西浩司〉
    29 切除不能膵癌に伴う悪性十二指腸閉塞に対する治療選択肢は?
       ―内視鏡的十二指腸金属ステント留置術vs外科的胃空腸バイパス術
    30 膵神経内分泌腫瘍の治療戦略―薬物療法の現状は? 放射性核種標識ペプチド治療の位置づけは?
    31 膵神経内分泌腫瘍に対する局所治療の適応は?
    32 系統だった膵嚢胞診療の重要性―適切な画像診断法や病理診断の必要性,適切な経過観察法は?
    33 免疫関連の有害事象としての膵炎・胆管炎の実状と対策―特徴的な画像や治療介入のタイミング
    34 慢性膵炎診療の実際―日常診療で,どのように診断,介入し,経過観察すべきか?
    35 自己免疫性膵炎ステロイド不応例に対する治療戦略
       ―ステロイド不応例再燃例に対する治療をどうするか?
    36 IgG4関連疾患では悪性疾患合併頻度とそのスクリーニング法は? また,そのメカニズムは?
    37 膵多血性病変におけるEUS-FNA―多血性腫瘍に適した穿刺方法は?
    38 胆膵内視鏡検査・処置の教育―初学者,中級者ごとの指導法は?
    39 全周性表在型食道癌に対する治療戦略は?
    40 粘膜下層浸潤食道癌に対する治療戦略は?
    41 食道表在癌の深達度診断において,拡大内視鏡,endoscopic ultrasonography (EUS)は有用か?
    42 食道癌に対する化学放射線療法後の局所遺残・再発に対する適切な救済治療は?
    43 内視鏡治療後病理診断におけるT1a-MM/T1b-SM1食道癌に対する追加治療の必要性と方法は?
    44 逆流性食道炎に対する治療戦略をどう考えるか?
    45 食道癌治療後の全身スクリーニングも含めたサーベイランスの在り方は?
    46 食道アカラシアに対する治療戦略は?
    47 食道胃接合部癌に対する内視鏡治療後の適切なサーベイランスは?
    48 胃腺腫に対する治療の必要性は?
    49 食道・胃悪性消化管狭窄に対する治療戦略は?
    50 胃底腺型胃癌に対する内視鏡治療適応と追加治療の必要性は?
    51 進行胃癌に対する免疫チェックポイント阻害薬の位置づけは?
    52 機能性ディスペプシアに対する治療戦略をどう考えるか?
    53 早期胃癌の深達度診断と適切な治療戦略は?
    54 進行消化管神経内分泌腫瘍に対する薬物療法の選択とペプチド受容体放射性核種療法の位置づけは?
    55 胃粘膜下腫瘍の適切な診断法と経過観察法は?
    56 十二指腸腺腫に対する治療戦略は?
    57 進行小腸癌に対する薬物療法についてどう選択するか?
    58 短腸症候群に対する治療選択とその適応は?
    59 大腸腫瘍の内視鏡治療後の適切なサーベイランス法は?
    60 過形成性ポリープに対する適切な治療戦略は?
    61 切除不能進行再発大腸癌の後方治療においてレゴラフェニブと
       トリフルリジン/チピラシル塩酸塩のいずれを先行して投与するか?
    62 下部消化管出血に対する内視鏡検査の適切なタイミングは?
    63 大腸ポリープに対するコールドスネアポリペクトミーの位置づけは?
    64 進行大腸癌に対する治療におけるリキッドバイオプシーの用い方は?
    65 免疫関連有害事象(irAE)腸炎の診断・治療戦略―炎症性腸疾患(IBD)と何が違うのか?
    66 消化管神経内分泌腫瘍に対する内視鏡治療の適応と治療法は?
    67 循環器疾患に合併した難治性消化管出血の病態と治療法は?
    68 ステロイド抵抗・依存性潰瘍性大腸炎の寛解導入治療に最適な薬剤は?
       ―どの薬剤から始めるのがよいか?
    69 ステロイド抵抗・依存性クローン病の寛解導入治療に最適な薬剤は?
       ―どの薬剤から始めるのがよいか?
    70 炎症性腸疾患(IBD)の疾患活動性モニタリングに最適なモダリティやバイオマーカーは?
    71 IBD関連癌に対する適切なスクリーニング方法は?
    72 CD狭窄病変に対する内視鏡的バルーン拡張術の適応と問題点は?
    73 クローン病術後再発に対する適切な予防法や薬物治療法は?
    74 高齢発症炎症性腸疾患に対して非高齢発症例と同様の治療を行ってよいか?
    75 Mediterranean fever (MEFV) 遺伝子関連腸炎と炎症性腸疾患の
       臨床所見・内視鏡所見・発症機序に違いはあるか?
    76 好酸球性消化管疾患に対する免疫統御治療の選択と適応は?
    77 がんゲノムパネル検査の適切なタイミングは?

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

1 B型慢性肝疾患に対する核酸アナログ製剤の選択や変更はどのように判断すべきか ?

P.5 掲載の参考文献
1) 日本肝臓学会, 編. B型肝炎治療ガイドライン (第3.4版). 2021. https://www.jsh.or.jp/lib/files/medical/guidelines/jsh_guidlines/B_v3.4.pdf
2) Hosaka T, Suzuki F, Kobayashi M, et al. Long-term entecavir treatment reduces hepatocellular carcinoma incidence in patients with hepatitis B virus infection. Hepatology. 2013 ; 58 : 98-107.
3) Suzuki F, Hosaka T, Suzuki Y, et al. Long-term outcome of entecavir treatment of nucleos (t) ide analogue-naive chronic hepatitis B patients in Japan. J Gastroenterol. 2019 ; 54 : 182-93.
4) Kitrinos KM, Corsa A, Liu Y, et al. No detectable resistance to tenofovir disoproxil fumarate after 6 years of therapy in patients with chronic hepatitis B. Hepatology. 2014 ; 59 : 434-42.
5) Koike K, Suyama K, Ito H, et al. Randomized prospective study showing the non-inferiority of tenofovir to entecavir in treatment-naive chronic hepatitis B patients. Hepatol Research. 2018 ; 48 : 59-68.
6) Suzuki F,Suzuki Y,Hosaka T, et al. Efficacy of long-term tenofovir-based rescue therapy in patients with chronic hepatitis B refractory to nucleoside/nucleotide analogs. J Gastroenterol. 2017 ; 52 : 641-51.
7) Suzuki F, Sezaki H, Hosaka T,et al. Virologic analysis of tenofovir resistance in a patient with chronic hepatitis B experiencing viral breakthrough during combination treatment with tenofovir disoproxil fumarate and entecavir. Hepatol Res. 2021 ; 51 : 503-8.
8) Agarwal K, Brunetto M, Seto WK, et al. 96 weeks treatment of tenofovir alafenamide vs. tenofovir disoproxil fumarate for hepatitis B virus infection. J Hepatol. 2018 ; 68 : 672-81.
9) Hagiwara S, Nishida N, Ida H, et al. Switching from entecavir to tenofovir alafenamide versus maintaining entecavir for chronic hepatitis B. J Med Virol. 2019 ; 91 : 1804-10.
10) Itokawa N, Atsukawa M, Tsubota A, et al. Sequential therapy from entecavir to tenofovir alafenamide versus continuous entecavir monotherapy for patients with chronic hepatitis B. JGH Open. 2020 ; 5 : 34-40.
11) Uchida Y, Nakao M, Tsuji S, et al. Significance of switching of the nucleos (t) ide analog used to treat Japanese patients with chronic hepatitis B virus infection from entecavir to tenofovir alafenamide fumarate. J Med Virol. 2020 ; 92 : 329-38.
12) Ogawa E, Nomura H, Nakamuta M, et al. Tenofovir alafenamide after switching from entecavir or nucleos (t) ide combination therapy for patients with chronic hepatitis B. Liver Int. 2020 ; 40 : 1578-89.
13) Nguyen MH, Atsukawa M, Ishikawa T, et al. Outcomes of sequential therapy with tenofovir alafenamide after long-term entecavir. Am J Gastroenterol. 2021 ; 116 : 1264-73.
14) Byun KS, Choi J, Kim JH, et al. Tenofovir alafenamide for drug-resistant hepatitis B : A randomized trial for switching from tenofovir disoproxil fumarate. Clin Gastroenterol Hepatol. 2021 ; 20 : 427-37. e5.
15) Sano T, Amano K, Ide T, et al. Short-term efficacy after switching from adefovir dipivoxil and tenofovir disoproxil fumarate therapy to tenofovir alaferamide for chronic hepatitis B. Biomed Rep. 2021 ; 14 : 12.
16) Yamashige D, Hosaka T, Suzuki F, et al. Effectiveness of tenofovir alafenamide for chronic hepatitis B patients with a poor response to the previously used nucleos (t) ide analogs. J Gastroenterol. 2021 ; 56 : 1008-21.
17) Brouwer WP, Xie Q, Sonneveld MJ, et al. Adding pegylated interferon to entecavir for hepatitis B e antigenpositive chronic hepatitis B : A multicenter randomized trial (ARES study). Hepatology. 2015 ; 61 : 1512-22.
18) Matsumoto A, Nishiguchi S, Enomoto H, et al. Combinational use of hepatitis B viral antigens predicts responses to nucleos (t) ide analogue/peg-interferon sequential therapy. J Gastroenterol. 2018 ; 53 : 247-57.

2 妊娠希望のあるB型慢性肝炎患者に対する治療方針はどうあるべきか ?

P.11 掲載の参考文献
1) World Health Organization. Global health sector strategy on viral hepatitis 2016-2021. https://www.who.int/hepatitis/strat egy2016-2021/ghss-hep/en/. Published June 2016. Accessed September 2019.
2) Pan C, Perumalswami PV. Pregnancy-related liver diseases. Clin Liver Dis. 2011 ; 15 : 199-208.
3) World Health Organization. Hepatitis B. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b. Published July 18, 2019. Accessed August 2019.
4) Chang MS, Nguyen MH. Epidemiology of hepatitis B and the role of vaccination. Best Pract Res Clin Gastroenterol. 2017 ; 31 : 239-47.
5) Tran TT. Hepatitis B in pregnancy. Clin Infect Dis. 2016 ; 62 (Suppl. 4) : S314-7.
6) Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B : AASLD 2018 hepatitis B guidance. Hepatology. 2018 ; 67 : 1560-99.
7) European Association for the Study of the Liver. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017 ; 67 : 370-98.
8) Sarin SK, Kumar M, Lau GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B : a 2015 update. Hepatol Int. 2016 ; 10 : 1-98.
9) Joshi SS, Coffin CS. Hepatitis B and pregnancy : virologic and immunologic characteristics. Hepatol Commun. 2020 ; 4 : 157-71.
10) 日本肝臓学会, 編. B型肝炎治療ガイドライン (第3.4版). 2021.
11) Song J, Yang F, Wang S, et al. Efficacy and safety of antiviral treatment on blocking the mother-to-child transmission of hepatitis B virus : a meta-analysis. J Viral Hepat. 2019 ; 26 : 397-406.
12) Agarwal K, Fung SK, Nguyen TT, et al. Twenty-eight day safety, antiviral activity, and pharmacokinetics of tenofovir alafenamide for treatment of chronic hepatitis B infection. J Hepatol. 2015 ; 62 : 533-40.
13) Gupta SK, Post FA, Arribas JR, et al. Renal safety of tenofovir alafenamide vs. tenofovir disoproxil fumarate : a pooled analysis of 26 clinical trials. AIDS. 2019 ; 33 : 1455-65.
14) Tong MJ, Pan CQ, Han SB, et al. An expert consensus for the management of chronic hepatitis B in Asian Americans. Aliment Pharmacol Ther. 2018 ; 47 : 1181-200.
15) U.S. Food and Drug Administration. Pregnancy and lactation labeling (drugs) final rule. https://www.fda.gov/drugs/labeling/pregnancy-and-lactation-labeling-drugs-final-rule. Published September 11, 2019. Accessed October 2019.
16) Zeng QL, Yu ZJ, Ji F, et al. Tenofovir alafenamide to prevent perinatal hepatitis B transmission : a multicenter, prospective, observational study. Clin Infect Dis. 2021 ; 73 : e3324-32.
17) Ding Y, Cao L, Zhu L, et al. Efficacy and safety of tenofovir alafenamide fumarate for preventing mother-tochild transmission of hepatitis B virus : a national cohort study. Aliment Pharmacol Ther. 2020 ; 52 : 1377-86.
18) Chen R, Zou J, Long L, et al. Safety and efficacy of tenofovir alafenamide fumarate in early-middle pregnancy for mothers with chronic hepatitis B. Front Med (Lausanne). 2022 ; 8 : 796901.
19) 日本産婦人科感染症学会, 監修. HIV感染妊娠に関する診療ガイドライン 第2版. 2021.

3 HBs抗原陽性患者における核酸アナログ製剤の中止にはどのようなリスクがあるのか ?

P.16 掲載の参考文献
1) Honkoop P, de Man RA, Niesters HG, et al. Acute exacerbation of chronic hepatitis B virus infection after withdrawal of lamivudine therapy. Hepatology. 2000 ; 32 : 635-9.
2) 日本肝臓学会 肝炎診療ガイドライン作成委員会 編「B型肝炎治療ガイドライン (第4版) 」2022年6月, https://www.jsh.or.jp/medical/guidelines/jsh_guidlines/hepatitis_b.html (2022年8月参照)
3) Liaw YF, Leung N, Kao JH, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B : a 2008 update. Hepatol Int. 2008 ; 2 : 263-83.
4) Liaw YF, Kao JH, Piratvisuth T, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B : a 2012 update. Hepatol Int. 2012 ; 6 : 531-61.
5) Sarin SK, Kumar M, Lau GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B : a 2015 update. Hepatol Int. 2016 ; 10 : 1-98.
7) Wong DK, Tanaka Y, Lai CL, et al. Hepatitis B virus core-related antigens as markers for monitoring chronic hepatitis B infection. J Clin Microbiol. 2007 ; 45 : 3942-7.
8) Matsumoto A, Tanaka E, Suzuki Y, et al. Combination of hepatitis B viral antigens and DNA for prediction of relapse after discontinuation of nucleos (t) ide analogs in patients with chronic hepatitis B. Hepatol Res. 2012 ; 42 : 139-49.
9) Luo M, Zhou B, Hou J, et al. Biomarkers for predicting nucleos (t) ide analogs discontinuation and hepatitis B virus recurrence after drug withdrawal in chronic hepatitis B patients. Hepatol Res. 2022 ; 52 : 337-51.
10) Tanaka E, Matsumoto A. Guidelines for avoiding risks resulting from discontinuation of nucleoside/nucleotide analogs in patients with chronic hepatitis B. Hepatol Res. 2014 ; 44 : 1-8.
11) Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B : AASLD 2018 hepatitis B guidance. Hepatology. 2018 ; 67 : 1560-99.
12) EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017 ; 67 : 370-98.
13) Hadziyannis SJ, Sevastianos V, Rapti I, et al. Sustained responses and loss of HBsAg in HBeAg-negative patients with chronic hepatitis B who stop long-term treatment with adefovir. Gastroenterology. 2012 ; 143 : 629-36 e1.
14) Berg T, Simon KG, Mauss S, et al. Long-term response after stopping tenofovir disoproxil fumarate in noncirrhotic HBeAg-negative patients - FINITE study. J Hepatol. 2017 ; 67 : 918-24.
15) Jeng WJ, Chen YC, Chien RN, et al. Incidence and predictors of hepatitis B surface antigen seroclearance after cessation of nucleos (t) ide analogue therapy in hepatitis B e antigen-negative chronic hepatitis B. Hepatology. 2018 ; 68 : 425-34.
16) Carey I, Gersch J, Wang B, et al. Pregenomic HBV RNA and hepatitis B core-related antigen predict outcomes in hepatitis B e antigen-negative chronic hepatitis B patients suppressed on nucleos (T) ide analogue therapy. Hepatology. 2020 ; 72 : 42-57.

4 推定余命を踏まえ高齢者DAA治療の適応はどのように考えるべきか ?

P.20 掲載の参考文献
1) Suda G, Nagasaka A, Yamamoto Y, et al. Safety and efficacy of daclatasvir and asunaprevir in hepatitis C virusinfected patients with renal impairment. Hepatol Res. 2017 ; 47 : 1127-36.
2) Kumada H, Suzuki Y, Karino Y, et al. The combination of elbasvir and grazoprevir for the treatment of chronic HCV infection in Japanese patients : a randomized phase II/III study. J Gastroenterol. 2017 ; 52 : 520-33.
3) Lee J, Ahn SB, Yim SY, et al. Efficacy and safety of direct-acting antiviral therapy for hepatitis C virus in elderly patients (>/=65 years old) : A systematic review and meta-analysis. J Viral Hepat. 2022 ; 29 : 496-517.
4) Janjua NZ, Wong S, Abdia Y, et al. Impact of direct-acting antivirals for HCV on mortality in a large population-based cohort study. J Hepatol. 2021 ; 75 : 1049-57.
5) Tokuchi Y, Suda G, Kimura M, et al. Changes in the estimated renal function after hepatitis C virus eradication with direct-acting antiviral agents : Impact of changes in skeletal muscle mass. J Viral Hepat. 2021 ; 28 : 755-63.

5 SVR後の外来通院はどこまで継続するべきか ?

P.24 掲載の参考文献
1) 日本肝臓学会肝炎診療ガイドライン作成委員会, 編. C型肝炎治療ガイドライン. 2012.
2) 日本肝臓学会, 編. 肝癌診療ガイドライン 2021年版. 2021.
3) 日本肝臓学会肝炎診療ガイドライン作成委員会, 編. C型肝炎治療ガイドライン. 第8.1版. 2022年5月.
4) Kobayashi M, Suzuki F, Fujiyama S, et al. Sustained virologic response by direct antiviral agents reduces the incidence of hepatocellular carcinoma in patients with HCV infection. J Med Virol. 2017 ; 89 : 476-83.
5) Nagata H, Nakagawa M, Asahina Y, et al. Effect of interferon-based and -free therapy on early occurrence and recurrence of hepatocellular carcinoma in chronic hepatitis C. J Hepatol. 2017 ; 67 : 933-9.
6) Yamada R, Hiramatsu N, Oze T, et al. Incidence and risk factors of hepatocellular carcinoma change over time in patients with hepatitis C virus infection who achieved sustained virologic response. Hepatol Res. 2019 ; 49 : 570-8.
7) Toyoda H, Kumada T, Tada T, et al. Impact of previously cured hepatocellular carcinoma (HCC) on new development of HCC after eradication of hepatitis C infection with non-interferon-based treatments. Aliment Pharmacol Ther. 2018 48 : 664-70.
8) Toyoda H, Kumada T, Tada T, et al. The impact of HCV eradication by direct-acting antivirals on the transition of precancerous hepatic nodules to HCC : A prospective observational study. Liver Int. 2019 39 : 448-54.

6 SVR後症例は献血が可能か ? ( HCV RNA 陰性 HCV 抗体陽性患者 )

P.26 掲載の参考文献
1) Simmons B, Saleem J, Hill A, et al. Risk of late relapse or reinfection with hepatitis C Virus after achieving a sustained virological response : a systematic review and meta-analysis. Clin Infect Dis. 2016 ; 62 : 683-94.
2) Morgan T, Ghany M, Kim H, et al. Outcome of sustained virological responders with histologically advanced chronic hepatitis C. Hepatology. 2010 ; 52 : 833-44.
3) Huang P, Wang Y, Yue M, et al. The risk of hepatitis C virus recurrence in hepatitis C virus-infected patients treated with direct-acting antivirals after achieving a sustained virological response : A comprehensive analysis. Liver Int. 2021 ; 41 : 2341-57.

7 NAFLD患者における飲酒はどのようなリスクをもたらすのか ?

P.31 掲載の参考文献
1) Eslam M, Newsome PN, Sarin SK, et al. A new definition for metabolic dysfunction-associated fatty liver disease : An international expert consensus statement. J Hepatol. 2020 ; 73 : 202-9.
2) Monroy-Ramirez HC, Galicia-Moreno M, Sandoval-Rodriguez A, et al. PPARs as metabolic sensors and therapeutic targets in liver diseases. Int J Mol Sci. 2021 ; 22 : 8298.
3) Fujita K, Imajo K, Shinohara Y, et al. Novel findings for the development of drug therapy for various liver diseases : Liver microsomal triglyceride transfer protein activator may be a possible therapeutic agent in non-alcoholic steatohepatitis. J Pharmacol Sci. 2011 ; 115 : 270-3.
4) Park JW, Kim SE, Lee NY, et al. Role of microbiota-derived metabolites in alcoholic and non-alcoholic fatty liver diseases. Int J Mol Sci. 2021 ; 23 : 426.
5) Bianco C, Casirati E, Malvestiti F, et al. Genetic predisposition similarities between NASH and ASH : Identification of new therapeutic targets. JHEP Rep. 2021 ; 3 : 100284.
6) Hotta K, Yoneda M, Hyogo H, et al. Association of the rs738409 polymorphism in PNPLA3 with liver damage and the development of nonalcoholic fatty liver disease. BMC Med Genet. 2010 ; 11 : 172.

8 肝線維化の改善は期待できるか ?

P.37 掲載の参考文献
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3) Suzuki Y, Kumada H, Ikeda K, et al. Histological changes in liver biopsies after one year of lamivudine treatment in patients with chronic hepatitis B infection. J Hepatol. 1999 ; 30 : 743-8.
4) Hadziyannis SJ, Tassopoulos NC, Heathcote EJ, et al. Long-term therapy with adefovir dipivoxil for HBeAg-negative chronic hepatitis B. N Engl J Med. 2005 ; 352 : 2673-81.
5) Hadziyannis SJ, Tassopoulos NC, Heathcote EJ, et al. Long-term therapy with adefovir dipivoxil for HBeAg-negative chronic hepatitis B for up to 5 years. Gastroenterology. 2006 ; 131 : 1743-51.
6) Yokosuka O, Takaguchi K, Fujioka S, et al. Long-term use of entecavir in nucleoside-naive Japanese patients with chronic hepatitis B infection. J Hepatol. 2010 ; 52 : 791-9.
7) Chang TT, Liaw YF, Wu SS, et al. Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B. Hepatology. 2010 ; 52 : 886-93.
8) Marcellin P, Gane E, Buti M, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B : a 5-year open-label follow-up study. Lancet. 2013 ; 381 : 468-75.
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21) Dhaliwal HK, Hoeroldt BS, Dube AK, et al. Long-term prognostic significance of persisting histological activity despite biochemical remission in autoimmune hepatitis. Am J Gastroenterol. 2015 ; 110 : 993-9.

9 不顕性脳症における治療適応はどのように判断すべきか ?

P.43 掲載の参考文献
1) Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease : 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014 ; 60 : 715-35.
2) Kato A, Tanaka H, Kawaguchi T, et al. Nutritional management contributes to improvement in minimal hepatic encephalopathy and quality of life in patients with liver cirrhosis : A preliminary, prospective, open-label study. Hepatol Res. 2013 ; 43 : 452-8.
3) Groeneweg M, Quero JC, De Bruijn I, et al. Subclinical hepatic encephalopathy impairs daily functioning. Hepatology. 1998 ; 28 : 45-9.
4) Bao ZJ, Qiu DK, Ma X, et al. Assessment of health-related quality of life in Chinese patients with minimal hepatic encephalopathy. World J Gastroenterol. 2007 ; 13 : 3003-8.
5) Bajaj JS, Saeian K, Schubert CM, et al. Minimal hepatic encephalopathy is associated with motor vehicle crashes : the reality beyond the driving test. Hepatology. 2009 ; 50 : 1175-83.
6) Roman E, Cordoba J, Torrens M, et al. Minimal hepatic encephalopathy is associated with falls. Am J Gastroenterol. 2011 ; 106 : 476-82.
7) Sugimoto R, Iwasa M, Maeda M, et al. Value of the apparent diffusion coefficient for quantification of low-grade hepatic encephalopathy. Am J Gastroenterol. 2008 ; 103 : 1413-20.
8) Sharma P, Agrawal A, Sharma BC, et al. Prophylaxis of hepatic encephalopathy in acute variceal bleed : a randomized controlled trial of lactulose versus no lactulose. J Gastroenterol Hepatol. 2011 ; 26 : 996-1003.
9) Bajaj JS, Heuman DM, Wade JB, et al. Rifaximin improves driving simulator performance in a randomized trial of patients with minimal hepatic encephalopathy. Gastroenterology. 2011 ; 140 : 478-87.e1.
10) Bajaj JS, Saeian K, Christensen KM, et al. Probiotic yogurt for the treatment of minimal hepatic encephalopathy. Am J Gastroenterol. 2008 ; 103 : 1707-15.
11) Nakanishi H, Hayakawa Y, Kubota Y, et al. Impaired brain function improved by L-carnitine in patients with cirrhosis : evaluation using near-infrared spectroscopy. Sci Rep. 2020 ; 10 : 13566.
12) Brandi G, de Rosa F, Calza L, et al. Can the tyrosine kinase inhibitors trigger metabolic encephalopathy in cirrhotic patients? Liver Int. 2013 ; 33 : 488-93.
13) Patel V, Lee S, McPhail M, et al. Rifaximin reduces gut-derived inflammation and mucin degradation in cirrhosis and encephalopathy : RIFSYS randomised controlled trial. J Hepatol. 2022 ; 76 : 332-42.

10 門脈圧亢進症における肝静脈圧較差測定は普及するのか ?

P.47 掲載の参考文献
1) 日本門脈圧亢進症学会, 編. 門脈圧亢進症取り扱い規約第3版. 東京 : 金原出版 ; 2013. p.20.
2) 2016 practice guidance by the American Association for the study of liver diseases. Hepatology. 2016 ; 65 ; 310-35.
3) EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018 ; 69 ; 406-60.
4) de Franchis R. Expanding consensus in portal hypertension : Report of the Baveno VI Consensus Workshop : Stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015 ; 63 : 743-52.
5) Colecchia A, Ravaioli F, Marasco G, et al. A combined model based on spleen stiffness measurment and Baveno IV criteria to rule out high-risk varices in advanced chronic liver disease. J Hepatol. 2018 ; 69 : 308-17.
6) 日本消化器病学会・日本肝臓学会, 編. 肝硬変診療ガイドライン 2020 (改訂第3版). 東京 : 南江堂 ; p.10-3.
7) Uojima H, Hidaka H, Tanaka Y, et al. Wisteria floribunda agglutinin-positive human Mac-2 binding protein in decompensated cirrhosis. J Gastroenterol Hepatol. 2018 ; 33 : 1889-96.
8) Shao X, Uojima H, Setsu T,et al. Usefulness of autotaxin for the complications of liver cirrhosis. World J Gastroenterol. 2020 ; 26 : 97-108.

11 静脈瘤はどこまで治療すべきか ?

P.51 掲載の参考文献
1) Saad WE, Darcy MD. Transjugular intrahepatic portosystemic shunt (TIPS) versus balloon-occluded retrograde transvenous obliteration (BRTO) for the management of gastric varices. Semin Intervent Radiol. 2011 ; 28 : 339-49.
2) 小原勝敏, 豊永純, 國分茂博. 食道・胃静脈瘤内視鏡治療ガイドライン. 日本消化器内視鏡学会, 監. 消化器内視鏡ガイドライン (第3版). 東京 : 医学書院 ; 2006.
3) Sarin SK, Lahoti D, Saxena SP, et al. Prevalence, classification and natural history of gastric varices : a long-term follow-up study in 568 portal hypertension patients. Hepatology. 2012 ; 16 : 1343-9.
4) Yoshida H, Mamada Y,Taniai N, et al. Risk factors for bleeding esophagogastric varices. J Nippon Med Sch. 2013 ; 80 : 252-9.
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6) Kerbert AJ, Chiang FW, van der Werf, et al. Hemodynamic response to primary prophylactic therapy with nonselective β-blockers is related to a reduction of first variceal bleeding risk in liver cirrhosis : a meta-analysis. Eur J Gastroenterol Hepatol. 2017 ; 29 : 380-7.
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13) Kanagawa H, Mima S, Kouyama H, et al. Treatment of gastric fundal varices by balloon-occluded retrograde transvenous obliteration. J Gastroenterol Hepatol. 1996 ; 11 : 51-8.
14) Park JK, Saab S, Kee ST, et al. Balloon-occluded retrograde transvenous obliteration (BRTO) for treatment of gastric varices : Review and meta-analysis. Dig Dis Sci. 2015 ; 60 : 1543-53.
15) Saad WE, Simon PO Jr, Rose SC. Balloon-occluded retrograde transvenous obliteration of gastric varices. Cardiovasc Intervent Radiol. 2014 ; 37 : 299-315.
16) Akahoshi T, Hashizume M, Tomikawa M, et al. Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices : a 10-year experience. J Gastroenterol Hepatol. 2008 ; 23 : 1702-9.
17) Kumamoto M, Toyonaga A, Inoue H, et al. Long-term results of balloon-occluded retrograde transvenous obliteration for gastric fundal varices : hepatic deterioration links to portosystemic shunt syndrome. J Gastroenterol Hepatol. 2010 ; 25 : 1129-35.
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19) Luo X, Xiang T, Wu J, et al. Endoscopic cyanoacrylate injection versus balloon-occluded retrograde transvenous obliteration for prevention of gastric variceal bleeding : A randomized controlled trial. Hepatology. 2021 ; 74 : 2074-84.
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12 すべての門脈血栓症患者は治療適応となりうるのか ?

P.57 掲載の参考文献
1) 渡辺勲史, 小嶋清一郎, 高清水眞二. 門脈血栓症をめぐって. 日門亢会誌. 2014 ; 20 : 104-7.
2) Okuda K, Ohnishi K, Kimura K, et al. Incidence of portal vein thrombosis in liver cirrhosis. An angiographic study in 708 patients. Gastroenterology. 1985 ; 89 : 279-86.
3) Northup PG, Garcia-Pagan JC, Garcia-Tsao G, et al. Vascular liver disorders, portal vein thrombosis, and procedural bleeding in patients with liver disease : 2020 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021 ; 73 : 366-413.
4) Maruyama H, Okugawa H, Takahashi M, et al. De novo portal vein thrombosis in virus-related cirrhosis : predictive factors and long-term outcomes. Am J Gastroenterol. 2013 ; 108 : 568-74.
5) Hidaka H, Kokubu S, Sato T, et al. Antithrombin III for portal vein thrombosis in patients with liver disease : A randomized, double-blind, controlled trial. Hepatology Res. 2017 : 48 : 107-16
6) Plessier A, Darwish-Murad S, Hernandez-Guerra M, et al. Acute portal vein thrombosis unrelated to cirrhosis : a prospective multicenter follow-up study. Hepatology. 2010 ; 51 : 210-8.
7) Turnes J, Garcia-Pagan JC, Gonzalez M, et al. Portal hypertension-related complications after acute portal vein thrombosis : impact of early anticoagulation. Clin Gastroenterol Hepatol. 2008 ; 6 : 1412-7.
8) de Franchis R, Bosch J, Garcia-Tsao G, et al. BAVENO VII-renewing consensus in portal hypertension. J Hepatol. 2022 ; 76 : 959-74.

13 AIHにおけるステロイドの維持量はどうあるべきか ?

P.61 掲載の参考文献
1) Takahashi A, Arinaga-Hino T, Ohira H, et al. Autoimmune hepatitis in Japan : trends in a nationwide survey. J Gastroenterol. 2017 ; 52 : 631-40.
2) Tanaka A, Mori M, Matsumoto K, et al. Increase trend in the prevalence and male-to-female ratio of primary biliary cholangitis, autoimmune hepatitis, and primary sclerosing cholangitis in Japan. Hepatol Res. 2019 ; 49 : 881-9.
3) Seki T, Kiyosawa K, Inoko H, et al. Association of autoimmune hepatitis with HLA-Bw54 and DR4 in Japanese patients. Hepatology. 1990 ; 12 : 1300-4.
4) 厚生労働科学研究費補助金 難治性疾患政策研究事業「難治性の肝・胆道疾患に関する調査研究」班 自己免疫性肝炎分科会・原発性胆汁性胆管炎分科会, 田中篤, 大平弘, 他. 改訂自己免疫性肝炎・原発性胆汁性胆管炎診療ガイドライン. 肝臓. 2018 ; 59 : 211-6.
5) Yoshizawa K, Matsumoto A, Ichijo T, et al. Long-term outcome of Japanese patients with type 1 autoimmune hepatitis. Hepatology. 2012 ; 56 : 668-76.
6) Joshita S, Yoshizawa K, Umemura T, et al. Clinical features of autoimmune hepatitis with acute presentation : a Japanese nationwide survey. J Gastroenterol. 2018 ; 53 : 1079-88.
7) Mack CL, Adams D, Assis DN, et al. Diagnosis and management of autoimmune hepatitis in adults and children : 2019 Practice guidance and guidelines from the American Association for the Study of Liver Diseases. Hepatology. 2020 ; 72 : 671-722.
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10) Dixon WG, Abrahamowicz M, Beauchamp ME, et al. Immediate and delayed impact of oral glucocorticoid therapy on risk of serious infection in older patients with rheumatoid arthritis : a nested case-control analysis. Ann Rheum Dis. 2012 ; 71 : 1128-33.
12) De Vries F, Bracke M, Leufkens HG, et al. Fracture risk with intermittent high-dose oral glucocorticoid therapy. Arthritis Rheum. 2007 ; 56 : 208-14.
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15) Hartl J, Ehlken H, Weiler-Normann C, et al. Patient selection based on treatment duration and liver biochemistry increases success rates after treatment withdrawal in autoimmune hepatitis. J Hepatol. 2015 ; 62 : 642-6.
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19) Sato T, Takagawa T, Kakuta Y, et al. NUDT15, FTO, and RUNX1 genetic variants and thiopurine intolerance among Japanese patients with inflammatory bowel diseases. Intest Res. 2017 ; 15 : 328-37.

14 AIHに対する免疫抑制薬使用のタイミングはどのように判断すべきか ?

P.66 掲載の参考文献
1) 厚生労働省難治性疾患政策研究事業「難治性の肝・胆道疾患に関する調査研究」班. 自己免疫性肝炎 (AIH) 診療ガイドライン (2021年), http://www.hepatobiliary.jp/modules/medical/index.php?content_id=9.
2) Yoshizawa K, Matsumoto A, Ichijo T, et al. Long-term outcome of Japanese patients with type 1 autoimmune hepatitis. Hepatology. 2012 ; 56 : 668-76.
3) 三浦亮, 八木みなみ, 松本康佑, 他. 既存治療に不耐・不応の自己免疫性肝炎に対するミコフェノール酸モフェチルの使用経験. 日消誌. 2021 ; 118 : 318-26.
4) Wang G, Tanaka A, Zhao H, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidance : the diagnosis and management of patients with autoimmune hepatitis. Hepatol Int. 2021 ; 15 : 223-57.

15 PBCに対してベザフィブラート投与は推奨されるのか ?

P.70 掲載の参考文献
1) 厚生労働省難治性疾患政策研究事業「難治性の肝・胆道疾患に関する調査研究」班 原発性胆汁性胆管炎 (PBC) 診療ガイドライン (2017年) 原発性胆汁性肝硬変の診療ガイドライン (案) (hepatobiliary.jp)
2) 本多彰, 池上正, 松崎靖司. 原発性胆汁性胆管炎 (PBC) のup-to-date. 胆道. 2018 ; 32 : 233-40.
3) Iwasaki S, Tsuda K, Ueta H, et al. Beneficial effects of bezafibrate in ursodeoxycholic acid resistant pre-cirrhotic primary biliary cirrhosis. Hepatol Res. 1999 ; 16 : 12-8.
4) Nakai S, Masaki T, Kurokohchi K, et al. Combination therapy of bezafibrate and ursodeoxycholic acid in primary biliary cirrhosis : a preliminary study. Am J Gastroenterol. 2000 ; 95 : 326-7.
5) Itakura J, Izumi N, Nishimura Y, et al. Prospective randomized cross-over trial of combination therapy with bezafibrate and UDCA for primary biliary cirrhosis. Hepatol Res. 2004 ; 29 : 216-22.
6) Iwasaki S, Ohira H, Nishiguchi S, et al. The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis : A prospective, multicenter study. Hepatol Res. 2008 ; 38 : 557-64.
7) Tanaka A, Hirohara J, Nakanuma Y, et al. Biochemical responses to bezafibrate improve long-term outcome in asymptomatic patients with primary biliary cirrhosis refractory to UDCA. J Gastroenterol. 2015 ; 50 : 675-82.
8) Rudic JS, Poropat G, Krstic MN, et al. Bezafibrate for primary biliary cirrhosis. Cochrane Database Syst Rev. 2012 ; 1 : CD009145.
9) Hosonuma K, Sato K, Yamazaki Y, et al. A prospective randomized controlled study of long-term combination therapy using ursodeoxycholic acid and bezafibrate in patients with primary biliary cirrhosis and dyslipidemia. Am J Gastroenterol. 2015 ; 110 : 423-31.
10) Yin Q, Li J, Xia Y, et al. Systematic review and meta-analysis : bezafibrate in patients with primary biliary cirrhosis. Drug Des Devel Ther. 2015 ; 9 : 5407-19.
11) Shen N, Pan J, Miao H, et al. Fibrates for the treatment of pruritus in primary biliary cholangitis : a systematic review and meta-analysis. Ann Palliat Med. 2021 ; 10 : 7697-705.
12) Corpechot C, Chazouilleres O, Rousseau A, et al. A placebo-controlled trial of bezafibrate in primary biliary cholangitis. N Engl J Med. 2018 ; 378 : 2171-81.
13) Honda A, Tanaka A, Kaneko T, et al. Bezafibrate improves GLOBE and UK-PBC scores and long-term outcomes in patients with primary biliary cholangitis. Hepatology. 2019 ; 70 : 2035-46.
14) Tanaka A, Hirohara J, Nakano T, et al. Association of bezafibrate with transplant-free survival in patients with primary biliary cholangitis. J Hepatol. 2021 ; 75 : 565-71.

16 PBCの予後予測はどの程度正確か ?

P.76 掲載の参考文献
1) Nakamura M, Kondo H, Tanaka A, et al. Autoantibody status and histological variables influence biochemical response to treatment and long-term outcomes in Japanese patients with primary biliary cirrhosis. Hepatol Res. 2015 ; 45 : 846-55.
2) Lammers WJ, Hirschfield GM, Corpechot C, et al. Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy. Gastroenterology. 2015 ; 149 : 1804-12.
3) Carbone M, Sharp SJ, Flack S, et al. The UK-PBC risk scores : derivation and validation of a scoring system for long-term prediction of end-stage liver disease in primary biliary cholangitis. Hepatology. 2016 ; 63 : 930-50.
4) Cumali E, KorayT, Ida H, et al. Validation of risk scoring systems in ursodeoxycholic acid-treated patients with primary biliary cholangitis. Am J Gastroenterol. 2019 ; 114 : 1101-8.
5) Jorn C, Carla F, Maren H, et al. A comparison of prognostic scores (Mayo, UK-PBC, and GLOBE) in primary biliary cholangitis. Am J Gastroenterol. 2021 ; 116 : 1514-22.
6) Carbone M, Nardi A, Flack S, et al. Pretreatment prediction of response to ursodeoxycholic acid in primary biliary cholangitis : development and validation of the UDCA Response Score. Lancet Gastroenterol Hepatol. 2018 ; 3 : 626-34.
7) Jakub G, Martin J, Sylvia D, et al. External validation of UDCA Response Score in Slovak and Croatian patients with primary biliary cholangitis. Can J Gastroenterol Hepatol. 2021 ; 2021 : 9928065.
8) Yagi M, Matsumoto K, Tanaka A, et al. Avalidation study of the Ursodeoxycholic Acid Response Score in Japanese patients with primary biliary cholangitis. Liver Int. 2020 ; 40 : 1926-33.

17 肝細胞癌に対する肝動脈化学塞栓術と薬物療法はどのように組み合わされるべきか ?

P.81 掲載の参考文献
1) Kudo M, Matsui O, Izumi N, et al. Transarterial chemoembolizationfailure/refractoriness : JSH-LCSGJ criteria 2014 update. Oncology. 2014 ; 87 suppl 1 : 22-31.
2) Llovet JM, Ricci S, Blanc JF, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008 ; 359 : 378-90.
3) Reig M, Former A, Bruix J, et al. BCLC strategy for prognosis prediction and treatment recommendation : The 2022 update. J Hepatol. 2022 ; 76 : 681-93.
4) Llovet JM, Finn RS, Roberts L, et al. Trial design and endpoints in hepatocellular carcinoma : AASLD consensus conference. Hepatology. 2021 ; 73 : 158-91.
5) Llovet JM, Meyer T, Lencioni R, et al. Locoregional therapies in the era of molecular and immune treatments for hepatocellular carcinoma. Nat Rev Gastroenterol Hepatol. 2021 ; 18 : 293-313.
6) Kudo M, Ikeda M, Torimura T, et al. Randomised, multicentre prospective trial of transarterial chemoembolization (TACE) plus sorafenib as compared with TACE alone in patients with hepatocellular carcinoma : TACTICS trial. Gut. 2020 ; 69 : 1492-501.
7) Kudo M. Proposal of primary endpoints for TACE combination trials with systemic therapy : lessons learned from 5 negative trials and the positive TACTICS trial. Liver Cancer. 2018 ; 7 : 225-34.
8) Park J-W, Kim YJ, Hwang J, et al. Sorafenib with or without concurrent transarterial chemoembolization in patients with advanced hepatocellular carcinoma : the phase III STAH trial. J Hepatol. 2018 ; 70 : 684-91.
9) Choi GH, Shim JH, Kang YK, et al. Sorafenib alone versus sorafenib combined with transarterial chemoembolization for advanced-stage hepatocellular carcinoma : results of propensity score analyses. Radiology. 2013 ; 269 : 603-11.
10) Kok VC, Chen YC, Kuo JT, et al. Sorafenib with transarterial chemoembolization achieves improved survival vs. sorafenib alone in advanced hepatocellular carcinoma : a nationwide population-based cohort study. Cancers (Basel). 2019 ; 11 : 985.
11) Ando Y, Kawaoka T, Aikata H, et al. Efficacy and safety of Lenvatinib-transcatheter arterial chemoembolization sequential therapy for patients with intermediate-stage hepatocellular carcinoma. Oncology. 2021 ; 99 : 507-17.
12) Yang B, Jie L, Liao Z, et al. TACE plus Lenvatinib versus TACE plus sorafenib for unresectable hepatocellular carcinoma with portal vein tumor thrombus : a prospective cohort study. Front Oncol. 2021 ; 11 : 821599.

18 肝細胞癌に対する薬物療法はどの順番で選択されるべきか ?

P.85 掲載の参考文献
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3) Finn RS, Qin S, Ikeda M, et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. N Engl J Med. 2020 ; 382 : 1894-905.
4) Cheng AL, Qin S, Ikeda M, et al. Updated efficacy and safety data from IMbrave150 : Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma. J Hepatol. 2021 ; 76 : 862-73.
6) Zhu AX, Kang YK, Yen CJ, et al. Ramucirumab after sorafenib in patients with advanced hepatocellular carcinoma and increased alpha-fetoprotein concentrations (REACH-2) : a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019 ; 20 : 282-96.
8) Onishi H, Nouso K, Takaki A, et al. Prior treatment with transcatheter arterial chemoembolization determines the efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma patients. Acta Med Okayama. 2022 (in press).

19 切除不能肝内胆管癌に対する一次治療には何を選択するべきか ?

P.90 掲載の参考文献
1) Kudo M, Izumi N, Kubo S, et al. Report of the 20th Nationwide follow-up survey of primary liver cancer in Japan. Hepatol Res. 2020 ; 50 : 15-46.
2) Cancer Survival in Hospital-based Cancer Registries. Cancer Information Service, National Cancer Center, Japan (accessed on 31 December 2021).
4) Morizane C, Okusaka T, Mizusawa J, et al. Combination gemcitabine plus S-1 versus gemcitabine plus cisplatin for advanced/recurrent biliary tract cancer : the FUGA-BT (JCOG1113) randomized phase III clinical trial. Ann Oncol. 2019 ; 30 : 1950-8.
5) Sakai D, Kanai M, Kobayashi S, et al. Randomized phase III study of gemcitabine, cisplatin plus S-1 (GCS) versus gemcitabine, cisplatin (GC) for advanced biliary tract cancer (KHBO1401-MITSUBA). Ann Oncol. 2018 ; 29 (Supplement 8) : viii205-70.
7) Perkhofer L, Striefler JK, Sinn M, et al. Nal-IRI with 5-fluorouracil (5-FU) and leucovorin or gemcitabine plus cisplatin in advanced biliary tract cancer : Final results of the NIFE-trial (AIO-YMO HEP-0315), a randomized phase II study of the AIO biliary tract cancer group. Ann Oncol. 2021 ; 32 (Supplement 5) : S1282.
8) Phelip JM, Desrame J, Edeline J, et al. Modified FOLFIRINOX versus CISGEM chemotherapy for patients with advanced biliary tract cancer (PRODIGE 38 AMEBICA) : A randomized phase II study. J Clin Oncol. 2022 ; 40 : 262-71.
9) Maruki Y, Morizane C, Arai Y, et al. Molecular detection and clinicopathological characteristics of advanced/recurrent biliary tract carcinomas harboring the FGFR2 rearrangements : a prospective observational study (PRELUDE Study). J Gastroenterol. 2021 ; 56 : 250-60.
10) Abou-Alfa GK, Sahai V, Hollebecque A, et al. Pemigatinib for previously treated, locally advanced or metastatic cholangiocarcinoma : a multicentre, open-label, phase 2 study. Lancet Oncol. 2020 ; 21 : 671-84.

20 薬物性肝障害とirAEとしての肝障害はどのように鑑別できるか ?

P.98 掲載の参考文献
1) Remash D, Prince DS, McKenzie C, et al. Immune checkpoint inhibitor-related hepatotoxicity : A review. World J Gastroenterol. 2021 ; 27 : 5376-91.
2) Konig D, Laubli H. Mechanisms of immune-related complications in cancer patients treated with immune checkpoint inhibitors. Pharmacology. 2021 ; 106 : 123-36
3) De Martin E, Michot JM, Papouin B, et al. Characterization of liver injury induced by cancer immunotherapy using immune checkpoint inhibitors. J Hepatol. 2018 ; 68 : 1181-90.
4) Suzuki A, Brunt EM, Kleiner DE, et al. The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury. Hepatology. 2011 ; 54 : 931-9.
5) Tang SQ, Tang LL, Mao YP, et al. The pattern of time to onset and resolution of immune-related adverse events caused by immune checkpoint inhibitors in cancer : A Pooled Analysis of 23 Clinical Trials and 8,436 Patients. Cancer Res Treat. 2021 ; 53 : 339-54.

21 悪性肝門部胆管閉塞に対するステントとしてPSとUSEMSのどちらを選択するべきか ? また, ドレナージ領域として両葉と片葉のどちらを選択するべきか ?

P.107 掲載の参考文献
1) Mukai T, Yasuda I, Nakashima M, et al. Metallic stents are more efficacious than plastic stents in unresectable malignant hilar biliary strictures : a randomized controlled trial. J Hepatobiliary Pancreat Sci. 2013 ; 20 : 214-22.
2) Kubota K, Hasegawa S, Iwasaki A, et al. Stent placement above the sphincter of Oddi permits implementation of neoadjuvant chemotherapy in patients with initially unresectable Klatskin tumor. Endosc Int Open. 2016 ; 4 : E427-33.
3) 肝胆膵外科学会, 胆道癌診療ガイドライン改定委員会, 編. 第V章. 胆道ドレナージ. In : エビデンスに基づいた胆道癌診療ガイドライン改定 第2版. 東京 : 医学図書出版 ; 2014. p.56-69.
4) 肝胆膵外科学会, 胆道癌診療ガイドライン改定委員会, 編. 第V章. 胆道ドレナージ. In : エビデンスに基づいた胆道癌診療ガイドライン改定 第3版. 東京 : 医学図書出版 ; 2019. p.52-70.
5) Miura S, Kanno A, Masamune A, et al. Bismuth classification is associated with the requirement for multiple biliary drainage in preoperative patients with malignant perihilar biliary stricture. Surg Endosc. 2015 ; 29 : 1862-70.
6) Dumonceau JM, Tringali A, Papanikolaou IS, et al. Endoscopic biliary stenting : indications, choice of stents and results : European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2018 ; 50 : 910-30.
7) Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T, et al. Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J Gastroenterol Hepatol. 2013 ; 28 : 593-607.
8) Vienne A, Hobeika E, Gouya H, et al. Prediction of drainage effectiveness during endoscopic stenting of malignant hilar strictures : the role of liver volume assessment. Gastrointest Endosc. 2010 ; 72 : 728-35.
9) Takahashi E, Fukasawa M, Sato T, et al. Biliary drainage strategy of unresectable malignant hilar strictures by computed tomography volumetry. World J Gastroenterol. 2015 ; 21 : 4946-53.
10) Qumseya BJ, Jamil LH, Elmunzer BJ, et al. ASGE guideline on the role of endoscopy in the management of malignant hilar obstruction. Gastrointest Endosc. 2021 ; 94 : 222-34.
11) Miura S, Kanno A, Masamune A, et al. Risk factors for recurrent biliary obstruction following placement of self-expandable metallic stents in patients with malignant perihilar biliary stricture. Endoscopy. 2016 ; 48 : 536-45.
12) Sawas T, Al Halabi S, Parsi MA, et al. Self-expandable metal stents versus plastic stents for malignant biliary obstruction : a meta-analysis. Gastrointest Endosc. 2015 ; 82 : 256-67.
13) Uchida N, Tsutsui K, Ezaki T, et al. Estimation of the stent placement above the intact sphincter of Oddi against malignant bile duct obstruction. J Gastroenterol. 2015 ; 40 : 291-6.
14) Kanno Y, Koshita S, Ogawa T, et al. Inside plastic stents versus metal stents for treating unresectable malignant perihilar biliary obstructions : A retrospective comparative study. Clin Endosc. 2020 ; 53 : 735-42.
15) Ogura T, Yamada M, Ueno S, et al. Hybrid placement technique for hepatic hilar obstruction using a new uncovered self-expandable metal stent. Endosc Int Open. 2019 ; 7 : E1288-92.
16) Aghaie Meybodi M, Shakoor D, Nanavati J, et al. Unilateral versus bilateral endoscopic stenting in patients with unresectable malignant hilar obstruction : a systematic review and meta-analysis. Endosc Int Open. 2020 ; 8 : E281-90.
17) Kanno Y, Ito K, Koshita S, et al. Soft surface irregularity of malignant perihilar biliary strictures in cholangiography as a risk factor for early dysfunction of multiple metal stents. Dig Liver Dis. 2017 ; 49 : 1014-21.
18) 河本博文, 谷川朋広, 浦田矩代, 他. 肝門部悪性胆道狭窄に対する内視鏡的マルチステンティング. 日本消化器内視鏡学会雑誌. 2016 ; 58 : 1354-66.
19) 向井強, 奥野充, 手塚隆一, 他. ERCP による肝門部領域胆管閉塞に対する胆管ドレナージ. 消化器内科. 2021 ; 15 : 83-94.
20) Naitoh I, Hayashi K, Nakazawa T, et al. Side-by-side versus stent-in-stent deployment in bilateral endoscopic metal stenting for malignant hilar biliary obstruction. Dig Dis Sci. 2012 ; 57 : 3279-85.
21) Chennat J, Waxman I. Initial performance profile of a new 6F self-expanding metal stent for palliation of malignant hilar biliary obstruction. Gastrointest Endosc. 2010 ; 72 : 632-6.
22) Inoue T, Ishii N, Kobayashi Y, et al. Simultaneous versus sequential side-by-side bilateral metal stent placement for malignant hilar biliary obstruction. Dig Dis Sci. 2017 ; 62 : 2542-9.
23) Inoue T, Naitoh I, Okumura F, et al. Reintervention for stent occlusion after bilateral self-expandable metallic stent placement for malignant hilar biliary obstruction. Dig Endosc. 2016 ; 28 : 731-7.
24) Fujii M, Kawamoto H, Tsutsumi K, et al. Management of occluded metallic stents in malignant hilar biliary stricture. Hepatogastroenterology. 2013 ; 60 : 447-51.
25) Isayama H, Nakai Y, Itoi T, et al. Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography-guided biliary drainage : 2018. J Hepatobiliary Pancreat Sci. 2019 ; 26 : 249-69.
26) Nakai Y, Kogure H, Isayama H, et al. Endoscopic ultrasound-guided biliary drainage for unresectable hilar malignant biliary obstruction. Clin Endosc. 2019 ; ; 52 : 2205.

22 胆道癌術前診断におけるmapping biopsyの意義はあるのか ?

P.112 掲載の参考文献
1) Sakamoto E, Nimura Y, Hayakawa N, et al. The pattern of infiltration at the proximal border of hilar bile duct carcinoma : a histologic analysis of 62 resected cases. Ann Surg. 1998 ; 227 : 405-11.
2) Takahashi Y, Nagino M, Nishio H, et al. Percutaneous transhepatic biliary drainage catheter tract recurrence in cholangiocarcinoma. Br J Surg. 2010 ; 97 : 1860-6.
3) Komaya K, Ebata T, Yokoyama Y, et al. Verification of the oncologic inferiority of percutaneous biliary drainage to endoscopic drainage : A propensity score matching analysis of resectable perihilar cholangiocarcinoma. Surgery. 2017 ; 161 : 394-404.
4) Nagino M, Hirano S, Yoshitomi H, et al. Clinical practice guidelines for the management of biliary tract cancers 2019 : The 3rd English edition. J Hepatobiliary Pancreat Sci. 2021 ; 28 : 26-54.
5) Wakai T, Shirai Y, Moroda T, et al. Impact of ductal resection margin status on long-term survival in patients undergoing resection for extrahepatic cholangiocarcinoma. Cancer. 2005 ; 103 : 1210-6.
6) Tsukahara T, Ebata T, Shimoyama Y, et al. Residual carcinoma in situ at the ductal stump has a negative survival effect : an analysis of early-stage cholangiocarcinomas. Ann Surg. 2017 ; 266 : 126-32.
7) Kawashima H, Itoh A, Ohno E, et al. Transpapillary biliary forceps biopsy to distinguish benign biliary stricture from malignancy : how many tissue samples should be obtained? Dig Endosc. 2012 ; 24 Suppl 1 : 22-7.

23 胆嚢腫瘍性病変の病理診断 - 病理診断の必要性と限界は ?

P.120 掲載の参考文献
1) 日本肝胆膵外科学会, 胆道癌診療ガイドライン作成委員会, 編. エビデンスに基づいた胆道癌診療ガイドライン 改訂第3版. 東京 : 医学図書出版 ; 2019.
2) Choi JH, Seo DW, Choi JH, et al. Utility of contrast-enhanced harmonic EUS in the diagnosis of malignant gallbladder polyps (with videos). Gastrointest Endosc. 2013 ; 78 : 484-93.
3) Sugimoto M, Takagi T, Konno N, et al. The efficacy of contrast-enhanced harmonic endoscopic ultrasonography in diagnosing gallbladder cancer. Sci Rep. 2016 ; 6 : 25848.
4) Shibata T, Arai Y, Totoki Y. Molecular genomic landscapes of hepatobiliary cancer. Cancer Sci. 2018 ; 109 : 1282-91.
5) Itoi T, Sofuni A, Itokawa F, et al. Preoperative diagnosis and management of thick-walled gallbladder based on bile cytology obtained by endoscopic transpapillary gallbladder drainage tube. Gastrointest Endosc. 2006 ; 64 : 512-9.
6) 芹川正浩, 石井康隆, 壷井智史, 他. 胆嚢癌早期診断における細胞診の適応と有用性. 肝胆膵. 2017 ; 75 : 691-6.
7) Varadarajulu S, Eloubeidi MA. Endoscopic ultrasound-guided fineneedle aspiration in the evaluation of gallbladder masses. Endoscopy. 2005 ; 37 : 751-4.
8) Meara R, Jhala D, Eloubeidi M. Endoscopic ultrasound-guided FNA biopsy of bile duct and gallbladder : analysis of 53 cases. Cytopathology. 2006 ; 17 : 42-9.
9) Hijioka S, Hara K, Mizuno N, et al. Diagnostic yield of endoscopic retrograde cholangiography and of EUS-guided fine needle aspiration sampling in gallbladder carcinomas. J Hepatobiliary Pancreat Sci. 2011 ; 19 : 650-5.
10) Kim HJ, Lee SK, Jang JW, et al. Diagnostic role of endoscopic ultrasonography-guided fine needle aspiration of gallbladder lesions. Hepatogastroenterology. 2012 ; 59 : 1691-5.
11) Ogura T, Kurisu Y, Masuda D, et al. Can endoscopic ultrasound guided fine needle aspiration offer clinical benefit for thick-walled gallbladders? Dig Dis Sci. 2014 ; 59 : 1917-24.
12) Singla V, Agarwal R, Anikhindi SA, et al. Role of EUS-FNA for gallbladder mass lesions with biliary obstruction : A large single-center experience. Endsc Int Open. 2019 ; 7 : E1403-9.
13) 松本慎平, 原和生, 水野伸匡, 他. 胆道癌におけるEUS-FNAの適応, 治療. 肝胆膵. 2019 ; 78 : 809-16.
14) Kai Y, Ikezawa K, Takada R, et al. Success rate of microsatellite instability examination and complete response with pembrolizumab in biliary tract cancer. JGH Open. 2021 ; 5 : 712-6.
15) Hirata K, Kuwatani M, Suda G, et al. A novel approach for the genetic analysis of biliary tract cancer specimens obtained through endoscopic ultrasound-guided fine needle aspiration using targeted amplicon sequencing. Clin Trans Gastroentel. 2019 ; 10 : e-00022.

24 胆道癌における術前治療は有効か ?

P.126 掲載の参考文献
1) Ishihara S, Horiguchi A, Miyakawa S, et al. Biliary tract cancer registry in Japan from 2008 to 2013. J Hepatobiliary Pancreat Sci. 2016 ; 23 : 149-57.
2) 日本肝胆膵外科学会 胆道癌診療ガイドライン作成委員会, 編. エビデンスに基づいた胆道癌診療ガイドライン 改訂第3版. 東京 : 医学図書出版 ; 2019.
3) 日本肝癌研究会, 編. 肝内胆管癌診療ガイドライン 2021年版. 東京 : 金原出版 ; 2020.
4) 日本肝胆膵外科学会, 編. 臨床・病理 胆道癌取扱い規約 第7版. 東京 : 金原出版 ; 2021.
5) Kobayashi S, Nagano H, Marubashi S, et al. Multi-detector computed tomography for preoperative prediction of postsurgical prognosis of patients with extrahepatic biliary cancer. J Surg Oncol. 2010 ; 101 : 376-83.
6) Okumoto T, Sato A, Yamada T, et al. Correct diagnosis of vascular encasement and longitudinal extension of hilar cholangiocarcinoma by four-channel multidetector-row computed tomography. Tohoku J Exp Med. 2009 ; 217 : 1-8.
7) 梶山英樹. 3DCT を用いた肝門部胆管癌及び胆嚢癌における術前血管浸潤診断の有用性の研究-MIP画像の読影を中心に-. 胆道. 2013 ; 27 : 63-9.
8) Kobayashi S, Nagano H, Marubashi S, et al. Treatment of borderline cases for curative resection of biliary tract cancer. J Surg Oncol. 2011 ; 104 : 499-503.
9) Kobayashi S, Tomokuni A, Gotoh K, et al. A retrospective analysis of the clinical effects of neoadjuvant combination therapy with full-dose gemcitabine and radiation therapy in patients with biliary tract cancer. EJSO. 2017 ; 43 : 763-71.
10) Ueno M, Ikeda M, Morizane C, et al. Nivolumab alone or in combination with cisplatin plus gemcitabine in Japanese patients with unresectable or recurrent biliary tract cancer : a non-randomised, multicentre, open-label, phase 1 study. Lancet Gastroenterol Hepatol. 2019 ; 4 : 611-21.
11) Abou-Alfa GK, Sahai V, Hollebecque A, et al. Pemigatinib for previously treated, locally advanced or metastatic cholangiocarcinoma : a multicentre, open-label, phase 2 study. Lancet Oncol. 2020 ; 21 : 671-84.
12) Goetze TO, Bechstein WO, Bankstahl US, et al. Neoadjuvant chemotherapy with gemcitabine plus cisplatin followed by radical liver resection versus immediate radicalliver resection alone with or without adjuvant chemotherapy in incidentally detected gallbladder carcinoma after simplecholecystectomy or in front of radical resection of BTC (ICC/ECC) -a phase III study of the German registry of incidentalgallbladder carcinoma platform (GR) -the AIO/CALGP/ACO-GAIN-trial. BMC Cancer. 2020 ; 20 : 122.
13) Kobayashi S, Eguchi H, Kanai M, et al. Impact of tumor shrinkage pattern by biweekly triplet gemcitabine/cisplatin/s-1 for biliary tract cancers : Implication for neoadjuvant therapy (KHBO1401-1A study). J Clin Oncol. 2019 ; 37 (suppl 15), abstr 4093.

25 良性狭窄に対する診療戦略 - 必要不可欠な精査モダリティおよび経過観察法は ?

P.132 掲載の参考文献
1) Fidelman N. Benign biliary strictures : diagnostic evaluation and approaches to percutaneous treatment. Tech Vasc Interv Radiol. 2015 ; 18 : 210-217.
2) 日本肝胆膵外科学会 胆道癌診療ガイドライン作成委員会, 編. エビデンス に基づいた胆道癌診療ガイドライン 改訂第3版. 東京 : 医学図書出版 ; 2019.
3) Hosokawa I, Shimizu H, Yoshitomi H, et al. Impact of biliary drainage on multidetector-row computed tomography on R0 resection of perihilar cholangiocarcinoma. World J Surg. 2018 ; 42 : 3676-84.
4) Navaneethan U, Njei B, Lourdusamy V, et al. Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures : a systematic review and meta-analysis. Gastrointest Endosc. 2015 ; 81 : 168-76.
5) Osanai M, Itoi T, Igarashi Y, et al. Peroral video cholangioscopy to evaluate indeterminate bile duct lesions and preoperative mucosal cancerous extension : a prospective multicenter study. Endoscopy. 2013 ; 45 : 635-42.
6) Nishikawa T, Tsuyuguchi T, Sakai Y, et al. Comparison of the diagnostic accuracy of peroral video-cholangioscopic visual findings and cholangioscopy-guided forceps biopsy findings for indeterminate biliary lesions : a prospective study. Gastrointest Endosc. 2013 ; 77 ; 219-26.
7) 伊佐山浩通, 田中篤, 田妻進. 原発性硬化性胆管炎ガイドラインについて. 日消誌. 2019 : 116 : 631-38.
8) Kobayashi S, Asano T, Yamasaki M, et al. Risk of bile duct carcinogenesis after excision of extrahepatic bile ducts in pancreaticobiliary maljunction. Surgery. 1999 ; 126 ; 939-44.
9) 日本消化器病学会, 編. 慢性膵炎診療ガイドライン 2021. 改訂第3版. 東京 : 南江堂 ; 2021.
10) Slivka A, Tarnasky P, Mullady DK, et al. Effect of covered metallic stents compared with plastic stents on benign biliary stricture resolution : a randomized clinical trial. JAMA. 2016 ; 315 : 1250-7.
11) Tomishima K, Ishii S, Fujisawa T, et al. Evaluation of the feasibility and effectiveness of placement of fully covered self-expandable metallic stents via various insertion routes for benign biliary strictures. J Clin Med. 2021 ; 10 : 2397.

26 膵癌高リスク群のスクリーニング法 - 必要不可欠な精査モダリティおよび経過観察法は ?

P.138 掲載の参考文献
1) Yoon JG, Smith D, Ojili V, et al. Pancreatic cystic neoplasms : a review of current recommendations for surveillance and management. Abdom Radiol (NY). 2021 ; 46 : 3946-62.
2) Kasuga A, Okamoto T, Udagawa S, et al. Molecular features and clinical management of hereditary pancreatic cancer syndromes and familial pancreatic cancer. Int J Mol Sci. 2022 ; 23 : 1205.
3) Mizukami K, Iwasaki Y, Kawakami E, et al. Genetic characterization of pancreatic cancer patients and prediction of carrier status of germline pathogenic variants in cancer-predisposing genes. EBioMedicine. 2020 ; 60 : 103033.
4) Golan T, O'Kane GM, Denroche RE, et al. Genomic features and classification of homologous recombination deficient pancreatic ductal adenocarcinoma. Gastroenterology. 2021 ; 160 : 2119-32 e9.
5) Daly MB, Pilarski R, Yurgelun MB, et al. NCCN guidelines insights : genetic/familial high-risk assessment : breast, ovarian, and pancreatic, version 1.2020. J Natl Compr Canc Netw. 2020 ; 18 : 380-91.

27 充実性膵腫瘍診療における病理診断の功罪 ? 播種リスクを考慮した病理診断の必要性は ?

P.143 掲載の参考文献
1) Abraham SC, Wilentz RE, Yeo CJ, et al. Pancreaticoduodenectomy (Whipple resections) in patients without malignancy : are they all 'chronic pancreatitis'? Am J Surg Pathol. 2003 ; 27 : 110-20.
2) Ishii Y, Serikawa M, Tsuboi T, et al. Role of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic cancer. Diagnostics (Basel). 2021 ; 11 : 238.
3) Kovacevic B, Vilmann P. EUS tissue acquisition : From A to B. Endosc Ultrasound. 2020 ; 9 : 225-31.
4) Yane K, Kuwatani M, Yoshida M, et al. Non-negligible rate of needle tract seeding after endoscopic ultrasound-guided fine-needle aspiration for patients undergoing distal pancreatectomy for pancreatic cancer. Digestive Endoscopy. 2020 ; 32 : 801-11.
5) Kojima H, Kitago M, Iwasaki E, et al. Peritoneal dissemination of pancreatic cancer caused by endoscopic ultrasound-guided fine needle aspiration : A case report and literature review. World J Gastroenterol. 2021 ; 27 : 294-304.
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8) Hanada K, Minami T, Shimizu A, et al. Roles of ERCP in the early diagnosis of pancreatic cancer. Diagnostics (Basel). 2019 ; 9 : 30.
9) Egawa S, Toma H, Ohigashi H, et al. Japan Pancreatic Cancer Registry ; 30th year anniversary ; Japan Pancreas Society. Pancreas. 2012 ; 41 : 985-92.

28 局所進行膵癌に対する化学放射線療法の意義 - 放射線治療addonは必要か否か ? どのような症例に必要か ?

P.148 掲載の参考文献
1) Klaassen DJ, MacIntyre JM, Catton GE, et al. Treatment of locally unresectable cancer of the stomach and pancreas : a randomized comparison of 5-fluorouracil alone with radiation plus concurrent and maintenance 5-fluorouracil-- an Eastern Cooperative Oncology Group study. J Clin Oncol. 1985 ; 3 : 373-8.
2) Gastrointestinal Tumor Study Group. Treatment of locally unresectable carcinoma of the pancreas : comparison of combined-modality therapy (chemotherapy plus radiotherapy) to chemotherapy alone. J Natl Cancer Inst. 1988 ; 80 : 751-5.
3) Chauffert B, Mornex F, Bonnetain F, et al. Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine with gemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of the 2000-1 FFCD/SFRO study. Ann Oncol. 2008 ; 19 : 1592-9.
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9) Hammel P, Huguest F, van Laethem JL, et al. Effect of chemoradiotherapy vs chemotherapy on survival in patients with locally advanced pancreatic cancer controlled after 4 months of gemcitabine with or without erlotinib : the LAP07 randomized clinical trial. JAMA. 2016 ; 315 : 1844-53.
10) Takada R, Ikezawa K, Daiku K, et al. The survival benefit of chemoradiotherapy following induction chemotherapy with gemcitabine plus nab-paclitaxel for unresectable locally advanced pancreatic cancer. Cancers. 2021 ; 13 : 4733.

29 切除不能膵癌に伴う悪性十二指腸閉塞に対する治療選択肢は ? - 内視鏡的十二指腸金属ステント留置術vs外科的胃空腸バイパス術

P.153 掲載の参考文献
1) Topazian M, Ring E, Grendell J. Palliation of obstructing gastric cancer with steel mesh, self-expanding endoprostheses. Gastrointest Endosc. 1992 ; 38 : 58-60.
2) Jeurnink SM, Steyerberg EW, van Hooft JE, et al. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study) : a multicenter randomized trial. Gastrointest Endosc. 2010 ; 71 : 490-9.
3) 日本膵臓学会, 膵癌診療ガイドライン改訂委員会. 膵癌診療ガイドライン 2019年度版.
4) Hong J, Chen Y, Li J, et al. Comparison of gastrojejunostomy to endoscopic stenting for gastric outlet obstruction : An updated Systematic Review and Meta-analysis. Am J Surg. 2022 ; 223 : 1067-78.
5) Uemura S, Iwashita T, Iwata K, et al. Endoscopic duodenal stent versus surgical gastrojejunostomy for gastric outlet obstruction in patients with advanced pancreatic cancer. Pancreatology. 2018 ; 18 : 601-7.
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7) Yamao K, Kitano M, Chiba Y, et al. Endoscopic placement of covered versus uncovered self-expandable metal stents for palliation of malignant gastric outlet obstruction. Gut. 2021 ; 70 : 1244-52.
8) Itoi T, Ishii K, Ikeuchi N, et al. Prospective evaluation of endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS) for malignant gastric outlet obstruction. Gut. 2016 ; 65 : 193-5.

30 膵神経内分泌腫瘍の治療戦略 - 薬物療法の現状は ? 放射性核種標識ペプチド治療の位置づけは ?

P.159 掲載の参考文献
1) Yao JC, Shah MH, Ito T, et al. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med. 2011 ; 364 : 514-23.
2) Raymond E, Dahan L, Raoul JL, et al. Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med. 2011 ; 364 : 501-13.
3) Caplin ME, Pavel M, Cwikla JB, et al. Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N Engl J Med. 2014 ; 371 : 224-33.
4) Moertel CG, Hanley JA, Johnson LA, et al. treptozocin alone compared with streptozocin plus fluorouracil in the treatment of advanced islet-cell carcinoma. N Engl J Med. 1980 ; 303 : 1189-94.
5) Strosberg J, El-Haddad G, Wolin E, et al. Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med. 2017 ; 376 : 125-35.
6) 小林規俊. 膵神経内分泌腫瘍におけるソマトスタチン受容体を標的とした放射線リガンド療法 (PRRT). 胆と膵. 2022 ; 43 : 159-66.
7) 日本神経内分泌腫瘍研究会 (JNETS) 膵・消化管神経内分泌腫瘍診療ガイドライン第2版作成委員会, 編. 膵・消化管神経内分泌腫瘍 (NEN) 診療ガイドライン 2019年. 2版. 東京 ; 金原出版 : 2019.
8) Pavel M, Oberg K, Falconi M, et al. ESMO guidelines committee gastroenteropancreatic neuroendocrine neoplasms : ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 ; 31 : 844-60.
9) Ikeda M, Morizane C, Hijioka S, et al. Pancreatology. Optimal strategy of systemic treatment for unresectable pancreatic neuroendocrine tumors based upon opinion of Japanese experts. Pancreatology. 2020 ; 20 : 944-50.
10) Krug S, Damm M, Garbe J, et al. Finding the appropriate therapeutic strategy in patients with neuroendocrine tumors of the pancreas : guideline recommendations meet the clinical reality. J Clin Med. 2021 ; 10 : 3023.

31 膵神経内分泌腫瘍に対する局所治療の適応は ?

P.163 掲載の参考文献
2) 日本神経内分泌腫瘍研究会, 編. 膵・消化管神経内分泌腫瘍 (NEN) 診療ガイドライン 2019年 (第2版). 東京 : 金原出版 ; 2019.
3) Aoki S, Miyata H, Konno H, et al. Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications : a nationwide study of 17,564 patients in Japan. J Hepatobiliary Pancreat Sci. 2017 ; 24 : 243-51.
4) Falconi M, Mantovani W, Crippa S, et al. Pancreatic insufficiency after different resections for benign tumours. Br J Surg. 2008 ; 95 : 85-91.
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6) Sallinen VJ, Le Large TYS, Tieftrunk E, et al. Prognosis of sporadic resected small (</=2 cm) nonfunctional pancreatic neuroendocrine tumors - a multi-institutional study. HPB (Oxford). 2018 ; 20 : 251-9.
7) Sadot E, Reidy-Lagunes DL, Tang LH, et al. Observation versus resection for small asymptomatic pancreatic neuroendocrine tumors : a matched case-control study. Ann Surg Oncol. 2016 ; 23 : 1361-70.
8) Kurita Y, Hara K, Kuwahara T, et al. Comparison of prognosis between observation and surgical resection groups with small sporadic non-functional pancreatic neuroendocrine neoplasms without distant metastasis. J Gastroenterol. 2020 ; 55 : 543-52.
9) Postlewait LM, Ethun CG, Baptiste GG, et al. Pancreatic neuroendocrine tumors : Preoperative factors that predict lymph node metastases to guide operative strategy. J Surg Oncol. 2016 ; 114 : 440-5.
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12) Matsumoto K, Kato H, Kawano S, et al. Efficacy and safety of scheduled early endoscopic ultrasonography-guided ethanol reinjection for patients with pancreatic neuroendocrine tumors : Prospective pilot study. Dig Endosc. 2020 ; 32 : 425-30.

32 系統だった膵嚢胞診療の重要性 - 適切な画像診断法や病理診断の必要性, 適切な経過観察法は ?

P.169 掲載の参考文献
1) Suzuki R, Thosani N, Annangi S, et al. Diagnostic yield of endoscopic retrograde cholangiopancreatography-based cytology for distinguishing malignant and benign intraductal papillary mucinous neoplasms : systematic review and meta-analysis. Dig Endosc. 2014 ; 26 : 586-93.
2) Tanaka M, Fernandez-Del Castillo C, Kamisawa T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017 ; 17 : 738-53.
3) Yoon WJ, Daglilar ES, Fernandez-Del Castillo C, et al. Peritoneal seeding in intraductal papillary mucinous neoplasm of the pancreas patients who underwent endoscopic ultrasound-guided fine-needle aspiration : the PIPE study. Endoscopy. 2014 ; 46 : 382-7.
4) Vege SS, Ziring B, Jain R, et al. Clinical Guidelines Committee ; American Gastroenterology Association. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 2015 ; 148 : 819-22.

33 免疫関連の有害事象としての膵炎・胆管炎の実状と対策 - 特徴的な画像や治療介入のタイミング

P.174 掲載の参考文献
1) George J, Bajaj D, Sankaramangalam K, et al. Incidence of pancreatitis with the use of immune checkpoint inhibitors (ICI) in advanced cancers : A systematic review and metaanalysis. Pancreatology. 2019 ; 19 : 587-94.
2) Nakabori T, Abe Y, Higashi S, et al. Feasibility of immunotherapy in cancer patients with persistent or past hepatitis B or C virus infection. JGH Open. 2022 ; 6 : 309-16.
3) Tanaka T, Sakai A, Shiomi H, et al. An autopsy case of severe acute pancreatitis induced by administration of pazopanib following nivolumab. Pancreatology. 2021 ; 21 : 21-4.
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6) 滝川 一, 恩地森一, 高森頼雪, 他. DDW-J 2004 ワークショップ薬物性肝障害診断基準の提案. 肝臓. 2005 ; 46 : 85-90.

34 慢性膵炎診療の実際 - 日常診療で, どのように診断, 介入し, 経過観察すべきか ?

P.178 掲載の参考文献
1) 日本消化器病学会. 慢性膵炎診療ガイドライン 2021 (改訂第3版). 東京 : 南江堂 ; 2021.
2) 厚生労働省難治性膵疾患に関する調査研究班, 日本膵臓学会, 日本消化器病学会. 慢性膵炎臨床診断基準 2009. 膵臓. 2009 ; 24 : 645-6.
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6) Masamune A, Kikuta K, Kume K, et al. Nationwide epidemiological survey of chronic pancreatitis in Japan : introduction and validation of the new Japanese diagnostic criteria 2019. J Gastroenterol. 2020 ; 55 : 1062-71.
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8) 肱岡真之, 立花雄一, 植田圭二郎, 他. 早期慢性膵炎の前向き予後調査. 胆と膵. 2016 ; 37 : 339-43.
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12) Higuchi K, Futagami S, Yamawaki H, et al. Endosonographic features in patients with non-alcoholic early chronic pancreatitis improved with treatment at one year follow up. J Clin Biochem Nutr. 2021 ; 68 : 86-94.
13) Raimondi S, Lowenfels AB, Morselli-Labate AM, et al. Pancreatic cancer in chronic pancreatitis ; aetiology, incidence, and early detection. Best Pract Res Clin Gastrroenterol. 2010 ; 24 : 349-58.
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17) Wang YT, Gou YW, Jin WW, et al. Association between alcohol intake and the risk of pancreatic cancer : a dose-response meta-analysis of cohort studies. BMC Cancer. 2016 ; 16 : 212.
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21) 正宗淳, 入澤篤志, 菊田和宏, 他. 「慢性膵炎臨床診断基準 2019」の背景と概要. 膵臓. 2019 ; 34 : 282-92.
22) 日本膵臓学会. 日本膵臓学会慢性膵炎臨床診断基準 2001. 膵臓. 2001 ; 16 : 560-1.

35 自己免疫性膵炎ステロイド不応例に対する治療戦略 - ステロイド不応例再燃例に対する治療をどうするか ?

P.184 掲載の参考文献
1) Yoshida K, Toki F, Takeuchi T, et al. Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis. Dig Dis Sci. 1995 ; 40 : 1561-8.
2) Shimosegawa T, Chari ST, Frulloni L, et al. International consensus diagnostic criteria for autoimmune pancreatitis : Guidelines of the International Association of Pancreatology. Pancreas. 2011 ; 40 : 352-8.
3) 日本膵臓学会・厚生労働科学研究費補助金 (難治性疾患等政策研究事業) 「IgG4 関連疾患の診断基準並びに治療指針の確立を目指す研究」班. 自己免疫性膵炎臨床診断基準 2018 (自己免疫性膵炎臨床診断基準 2011 改訂版). 膵臓. 2018 ; 33 : 902-13.
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5) 日本膵臓学会・厚生労働省IgG4 関連疾患の診断基準並びに治療指針を目指す研究班. 自己免疫性膵炎診療ガイドライン 2020. 膵臓. 2020 ; 35 : 465-550.
6) Masaki Y, Nakase H, Tsuji Y, et al. The clinical efficacy of azathioprine as maintenance treatment for autoimmune pancreatitis : a systematic review and meta-analysis. J Gastroenterol. 2021 ; 56 : 869-80.
7) Uchida K, Okazaki K. Current Status of type l (IsG4-related) autoimmune pancreatit's. J Gastroenterol. 2022. (in press).

36 IgG4関連疾患では悪性疾患合併頻度とそのスクリーニング法は ? また, そのメカニズムは ?

P.188 掲載の参考文献
1) Yamamoto M, Takahashi H, Tabeya T, et al. Risk of malignancies in IgG4-related disease. Mod Rheumatol. 2012 ; 22 : 414-8.
2) Shiokawa M, Kodama Y, Yoshimura K, et al. Risk of cancer in patients with autoimmune pancreatitis. Am J Gastroenterol. 2013 ; 108 : 610-7.
3) Hirano K, Tada M, Sasahira N, et al. Incidence of malignancies in patients with IgG4-related disease. Intern Med. 2014 ; 53 : 171-6.
4) Hart PA, Law RJ, Dierkhising RA, et al. Risk of cancer in autoimmune pancreatitis : a case-control study and review of the literature. Pancreas. 2014 ; 43 : 417-21.
5) Huggett MT, Culver EL, Kumar M, et al. Type 1 autoimmune pancreatitis and IgG4-related sclerosing cholangitis is associated with extrapancreatic organ failure, malignancy, and mortality in a prospective UK cohort. Am J Gastroenterol. 2014 ; 109 : 1675-83.
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7) Bernatsky S, Ramsey-Goldman R, Clarke A. Malignancy and autoimmunity. Curr Opin Rheumatol. 2006 ; 18 : 129-34.
8) Szekanecz Z, Szekanecz E, Bako G, et al. Malignancies in autoimmune rheumatic diseases? a mini-review. Gerontology. 2011 ; 57 : 3-10,
9) Sigurgeirsson B, Lindelof B, Edhag O, et al. Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study. N Engl J Med. 1992 ; 326 : 363-7.
10) Hamano H, Kawa S, Horiuchi A, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med. 2001 ; 344 : 732-8.
11) Hirano K, Kawabe T, Yamamoto N, et al. Serum IgG4 concentrations in pancreatic and biliary diseases. Clin Chim Acta. 2006 ; 367 : 181-4.
12) Tabata T, Kamisawa T, Hara S, et al. Intraductal papillary mucinous neoplasm of the pancreas and IgG4-related disease : a coincidental association. Pancreatology. 2013 ; 13 : 379-83.
13) Oseini AM, Chaiteerakij R, Shire AM, et al. Utility of serum Immunoglobulin G4 in distinguishing immunoglobulin G4-associated cholangitis from cholangiocarcinoma. Hepatology. 2011 ; 54 : 940-8.
14) Mendes FD, Jorgensen R, Keack J, et al. Elevated serum IgG4 concentration in patients with primary sclerosing cholangitis. Am J Gastroenterol. 2006 ; 101 : 2070-5.

37 膵多血性病変におけるEUS - FNA - 多血性腫瘍に適した穿刺方法は ?

P.194 掲載の参考文献
1) Fitzgerald TL, Hickner ZJ, Schmitz M, et al. Changing incidence of pancreatic neoplasms. A 16-year review of statewide tumor registry. Pancreas. 2008 ; 37 ; 134-8.
2) Kanno A, Yasuda I, Irisawa A, et al. Adverse events of endoscopic ultrasound-guided fine needle aspiration for histologic diagnosis in Japanese tertiary centers : Multicenter retrospective study. Dig Endosc. 2021 ; 33 ; 1146-57.
3) de Moura DTH, McCarty TR, Jirapinyo P, et al. Endoscopic ultrasound fine needle aspiration vs fine needle biopsy in solid lesions : A multi-center analysis. World J Clin Cases. 2021 ; 9 ; 10507-17.
4) Antonio F, Valentina P, Vincenzo B, et al. Diagnostic yield of Franseen and Fork-Tip biopsy needles for endoscopic ultrasound-guided tissue acquisition : a meta-analysis. Endosc Int Open. 2019 ; 7 ; 1221-30.
5) Nakai Y, Isayama H, Chang KJ, et al. Slow pull versus suction in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid masses. Dig Dis Sci. 2014 ; 59 ; 1578-85.
6) Katanuma A, Itoi T, Todd B, et al. Bench-top testing of suction forces generated through endoscopic ultrasound-guided aspiration needles. J Hepatobiliary Pancreat Sci. 2015 ; 22 ; 379-85.

38 胆膵内視鏡検査・処置の教育 - 初学者, 中級者ごとの指導法は ?

P.200 掲載の参考文献
1) Omoto S, Takenaka M, Maluf-Filho F, et al. A novel and effective EUS training program that enables visualization of the learning curve : Educational Program of Kindai system (EPOK). VideoGIE. 2022 ; 7 : 165-8.
2) Takenaka M, Yoshikawa T, Minaga K, et al. A novel teaching tool for visualizing the invisible bile duct axis in 3 dimensions during biliary cannulation (Compact Disc method). VideoGIE. 2020 ; 5 : 389-94.

39 全周性表在型食道癌に対する治療戦略は ?

P.205 掲載の参考文献
1) 日本食道学会, 編. 食道癌診療ガイドライン 2017年版 (第4版). 東京 : 金原出版 ; 2017.
2) Ishihara R, Arima M, Iizuka T, et al. Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer. Dig Endosc. 2020 ; 32 : 452-93.
3) Minashi K, Nihei K, Mizusawa J, et al. Efficacy of endoscopic resection and selective chemoradiotherapy for stage I esophageal squamous cell carcinoma. Gastroenterology. 2019 ; 157 : 382-90 e383.
4) Yamamoto Y, Kikuchi D, Nagami Y, et al. Management of adverse events related to endoscopic resection of upper gastrointestinal neoplasms : Review of the literature and recommendations from experts. Dig Endosc. 2019 ; 31 Suppl 1 : 4-20.
5) 石原立. 食道内視鏡切除後の狭窄予防. Gastroenterological Endoscopy. 2019 ; 61 : 2518-30.
6) Kadota T, Yoda Y, Hori K, et al. Prophylactic steroid administration against strictures is not enough for mucosal defects involving the entire circumference of the esophageal lumen after esophageal endoscopic submucosal dissection (ESD). Esophagus. 2020 ; 17 : 440-7.
7) Kato K, Ito Y, Nozaki I, et al. Parallel-group controlled trial of surgery versus chemoradiotherapy in patients with stage I esophageal squamous cell carcinoma. Gastroenterology. 2021 ; 161 : 1878-86 e1872.

40 粘膜下層浸潤食道癌に対する治療戦略は ?

P.209 掲載の参考文献
1) Shimada H, Nabeya Y, Matsubara H, et al. Prediction of lymph node status in patients with superficial esophageal carcinoma : analysis of 160 surgically resected cancers. Am J Surg. 2006 ; 191 : 250-4.
2) Eguchi T, Nakanishi Y, Shimoda T, et al. Histopathological criteria for additional treatment after endoscopic mucosal resection for esophageal cancer : analysis of 464 surgically resected cases. Mod Pathol. 2006 ; 19 : 475-80.
3) Kim DU, Lee JH, Min BH, et al. Risk factors of lymph node metastasis in T1 esophageal squamous cell carcinoma. J Gastroenterol Hepatol. 2008 ; 23 : 619-25.
4) Tomita N, Matsumoto T, Hayashi T, et al. Lymphatic invasion according to D2-40 immunostaining is a strong predictor of nodal metastasis in superficial squamous cell carcinoma of the esophagus : algorithm for risk of nodal metastasis based on lymphatic invasion. Pathol Int. 2008 ; 58 : 282-7.
5) Oyama T, Monma K. A new classification of magnified endoscopy for superficial esophageal squamous cell carcinoma. Esophagus. 2011 ; 8 : 247-51.
7) Kato K, Ito Y, Nozaki I, Daiko H, et al. Parallel-group controlled trial of surgery versus chemoradiotherapy in patients with stage I esophageal squamous cell carcinoma. Gastroenterology. 2021 ; 161 : 1878-86.
8) Hayashi Y, Iijima H, Isohashi F, et al. The heart's exposure to radiation increases the risk of cardiac toxicity after chemoradiotherapy for superficial esophageal cancer : a retrospective cohort study. BMC Cancer. 2019 ; 19 : 195.
9) Minashi K, Nihei K, Mizusawa J, et al. Efficacy of endoscopic resection and selective chemoradiotherapy for stage I esophageal squamous cell carcinoma. Gastroenterology. 2019 ; 157 : 382-90.
10) Yano T, Kasai H, Horimatsu T, et al. A multicenter phase II study of salvage photodynamic therapy using talaporfin sodium (ME2906) and a diode laser (PNL6405EPG) for local failure after chemoradiotherapy or radiotherapy for esophageal cancer. Oncotarget. 2017 ; 8 : 22135-44.

41 食道表在癌の深達度診断において, 拡大内視鏡, endoscopic ultrasonography ( EUS ) は有用か ?

P.214 掲載の参考文献
1) Ishihara R, Mizusawa J, Kushima R, et al. Assessment of the diagnostic performance of endoscopic ultrasonography after conventional endoscopy for the evaluation of esophageal squamous cell carcinoma invasion depth. JAMA Netw Open. 2021 ; 4 : e2125317.
2) 日本消化器内視鏡学会食道癌に対するESD/EMRガイドライン委員会, 編. 食道癌に対するESD/EMRガイドライン. 日本消化器内視鏡雑誌. 2020 ; 62 : 221-71.
3) Goda K, Tajiri H, Ikegami M, et al. Magnifying endoscopy with narrow band imaging for predicting the invasion depth of superficial esophageal squamous cell carcinoma. Dis Esophagus. 2009 ; 22 : 453-60.
4) Katada C, Tanabe S, Wada T, et al. Retrospective assessment of the diagnostic accuracy of the depth of invasion by narrow band imaging magnifying endoscopy in patients with superficial esophageal squamous cell carcinoma. J Gastrointest Cancer. 2019 ; 50 : 292-7.
5) Mizumoto T, Hiyama T, Oka S, et al. Diagnosis of superficial esophageal squamous cell carcinoma invasion depth before endoscopic submucosal dissection. Dis Esophagus. 2018 ; 31.
6) Uema R, Hayashi Y, Tashiro T,et al. Use of a convolutional neural network for classifying microvessels of superficial esophageal squamous cell carcinomas. J Gastroenterol Hepatol. 2021 ; 36 : 2239-46.
7) Shimamoto Y, Ishihara R, Kato Y,et al. Real-time assessment of video images for esophageal squamous cell carcinoma invasion depth using artificial intelligence. J Gastroenterol. 2020 ; 55 : 1037-45.

42 食道癌に対する化学放射線療法後の局所遺残・再発に対する適切な救済治療は ?

P.221 掲載の参考文献
1) 日本食道学会, 編. 食道癌診療ガイドライン 2017年版 (第4版). 東京 : 金原出版 ; 2017.
2) Minashi K, Nihei K, Mizusawa J, et al. Efficacy of endoscopic resection and selective chemoradiotherapy for stage I esophageal squamous cell carcinoma. Gastroenterology 2019 ; 157 : 382-90.
3) 日本消化器内視鏡学会食道癌に対するESD/EMRガイドライン委員会, 編. 食道癌に対するESD/EMRガイドライン. 日本消化器内視鏡学会雑誌. 2020 ; 62 : 223-71.
4) Ishihara R, Mizusawa J, Kushima R, et al. Assessment of the diagnostic performance of endoscopic ultrasonography after conventional endoscopy for the evaluation of esophageal squamous cell carcinoma invasion depth. JAMA Netw Open. 2021 ; 4 : e2125317.
5) Tu CH, Muto M, Horimatsu T, et al. Submucosal tumor appearance is a useful endoscopic predictor of early primary-site recurrence after definitive chemoradiotherapy for esophageal squamous cell carcinoma. Dis Esophagus. 2011 ; 24 : 274-8.
6) Yano T, Muto M, Hattori S, et al. Long-term results of salvage endoscopic mucosal resection in patients with local failure after definitive chemoradiotherapy for esophageal squamous cell carcinoma. Endoscopy. 2008 ; 40 : 717-21.
7) Hombu T, YanoT, Hatogai K, et al. Salvage endoscopic resection (ER) after chemoradiotherapy for esophageal squamous cell carcinoma : What are the risk factors for recurrence after salvage ER? Dig Endosc. 2018 ; 30 : 338-46.
8) Ali AK, Erik JS, Pierre HD, et al. Salvage endoscopic resection after definitive chemoradiotherapy for esophageal cancer : a Western experience. Gastrointest Endosc. 2021 ; 93 : 888-98.
9) Yano T, Muto M, Minashi K, et al. Long-term results of salvage photodynamic therapy for patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Endoscopy. 2011 ; 43 : 1-7.
10) Yano T, Muto M, Minashi K, et al. Photodynamic therapy as salvage treatment for local failure after chemoradiotherapy in patients with esophageal squamous cell carcinoma : A phase II study. Int J Cancer. 2012 ; 131 : 1228-34.
11) Yano T, Kasai H, Horimatsu T, et al. A multicenter phase II study of salvage photodynamic therapy using talaporfin sodium (ME2906) and a diode laser (PNL6405EPG) for local failure after chemoradiotherapy or radiotherapy for esophageal cancer. Oncotarget. 2017 ; 8 : 22135-44.
12) Amanuma Y, Horimatsu T, Ohashi S, et al. Association of local complete response with prognosis aftersalvage photodynamic therapy for esophageal squamous cell carcinoma. Dig Endosc. 2021 ; 233 : 355-63.
13) Tamaoki M,Yokoyama A, Horimatsu T, et al. Repeated talaporfin sodium photodynamic therapy for esophageal cancer : safety and efficacy. Esophagus. 2021 ; 18 : 817-24.
14) Swisher SG, Wynn P, Putnam JB, et al. Salvage esophagectomy for recurrent tumors after definitive chemotherapy and radiotherapy. J Thorac Cardiovasc Surg. 2002 ; 123 : 175-83.
15) Faiz Z, Dijksterhuis WPM, Burgerhof JGM, et al. A meta-analysis on salvage surgery as a potentially curative procedure in patients with isolated local recurrent or persistent esophageal cancer after chemoradiotherapy. Eur J Sur Oncol. 2019 ; 45 : 931-40.

43 内視鏡治療後病理診断におけるT1a - MM / T1b - SM1食道癌に対する追加治療の必要性と方法は ?

P.227 掲載の参考文献
1) 日本食道学会, 編. 食道癌診療ガイドライン 2017年版 (第4版). 東京 : 金原出版 ; 2017.
2) 日本消化器内視鏡学会食道癌に対するESD/EMRガイドライン委員会, 編. 食道癌に対するESD/EMRガイドライン. 日本消化器内視鏡学会雑誌. 2020 ; 62 : 221-71.
3) Yamashina T, Ishihara R, Nagai K, et al. Long-term outcome and metastatic risk after endoscopic resection of superficial esophageal squamous cell carcinoma. Am J Gastroenterol. 2013 ; 108 : 544-51.
4) Berger A, Rahmi G, Perrod G, et al. Long-term follow-up after endoscopic resection for superficial esophageal squamous cell carcinoma : a multicenter Western study. Endoscopy. 2019 ; 51 : 298-306.
5) Kato K, Ito Y, Nozaki I, et al. Parallel-group controlled trial of surgery versus chemoradiotherapy in patients with stage I esophageal squamous cell carcinoma. Gastroenterology. 2021 ; 161 : 1878-86.e2.
6) Minashi K, Nihei K, Mizusawa J et al. Efficacy of endoscopic resection and selective chemoradiotherapy for stage I esophageal squamous cell carcinoma. Gastroenterology. 2019 ; 157 : 382-90.
7) Minashi K, Nihei K, Ogawa G, et al. Final analysis of single-arm confirmatory study of diagnostic endoscopic resection (ER) plus selective chemoradiotherapy (CRT) for stage I esophageal squamous cell carcinoma (ESCC) : JCOG0508. J Clin Oncol. Volume 36, Issue 15_suppl Meeting Abstract | 2018 ASCO Annual Meeting.
8) Nakajo K, Abe S, Oda I, et al. Impact of the Charlson Comorbidity Index on the treatment strategy and survival in elderly patients after non-curative endoscopic submucosal dissection for esophageal squamous cell carcinoma : a multicenter retrospective study. J Gastroenterol. 2019 ; 54 : 871-80.
9) Tajiri A, Ishihara R, Sakurai H, et al. Positive predictive value of the clinical diagnosis of T1a-epithelial/lamina propria esophageal cancer depends on lesion size. Dig Endosc. 2022 ; 34 : 782-90.

44 逆流性食道炎に対する治療戦略をどう考えるか ?

P.232 掲載の参考文献
1) Iwakiri K, Fujiwara Y, Manabe N, et al. Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2021. J Gastroenterol. 2022 ; 57 : 267-85.
2) Malfertheiner P, Nocon M, Vieth M, et al. Evolution of gastro-oesophageal reflux disease over 5 years under routine medical care--the ProGERD study. Aliment Pharmacol Ther. 2012 ; 35 : 154-64.
3) Manabe N, Yoshihara M, Sasaki A, et al. Clinical characteristics and natural history of patients with low-grade reflux esophagitis. J Gastroenterol Hepatol. 2002 ; 17 : 949-54.
4) Manabe N, Haruma K. Optimal acid suppressive treatment for adequate symptom relief and prevention of the complications of gastroesophageal reflux disease : differences in long-term clinical course and pathophysiology among disease subtypes. Esophagus. 2017 ; 14 : 113-21.
5) Sakaguchi M, Manabe N, Ueki N, et al. Factors associated with complicated erosive esophagitis : A Japanese multicenter, prospective, cross-sectional study. World J Gastroenterol. 2017 ; 23 : 318-27.
6) Richter JE, Kahrilas PJ, Johanson J, et al. Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis : a randomized controlled trial. Am J Gastroenterol. 2001 ; 96 : 656-65.
7) Fass R, Shapiro M, Dekel R, et al. Systematic review : proton-pump inhibitor failure in gastro-oesophageal reflux disease--where next? Aliment Pharmacol Ther. 2005 ; 22 : 79-94.
8) 眞部紀明. 【機能性胃腸障害のすべて】NERDと機能性胸やけ. 機能性胸やけの治療. 医学のあゆみ. 2015 ; 252 : 686-90.

45 食道癌治療後の全身スクリーニングも含めたサーベイランスの在り方は ?

P.237 掲載の参考文献
1) Katada C, Yokoyama T, Yano T, et al. Alcohol consumption and multiple dysplastic lesions increase risk of squamous cell carcinoma in the esophagus, head, and neck. Gastroenterology. 2016 ; 151 : 860-9.
2) Yokoyama A, Katada C, Yokoyama T, et al. Alcohol abstinence and risk assessment for second esophageal cancer in Japanese men after mucosectomy for early esophageal cancer. PLoS One. 2017 ; 12 : e0175182.
3) Muto M, Katada C, Yokoyama T, et al. Field effect of alcohol, cigarette smoking and their cessation on the development of multiple dysplastic lesions and squamous cell carcinoma : Long term multicenter cohort study. Gastro Hep Advances. 2022 ; 1 : 265-76.
4) Tabuchi T, Ito Y, Ioka A, et al. Tobacco smoking and the risk of subsequent primary cancer among cancer survivors : a retrospective cohort study. Ann Oncol. 2013 ; 24 : 2699-704.
5) Katada C, Yokoyama T, Yano T, et al. Association between the findings of metachronous secondary primary malignancies and the number of Lugol-voiding lesions. Dis Esophagus. 2020 ; 33 : doz110.
6) Shinozaki T, Katada C, Shiga K, et al. Effectiveness of planned surveillance for detecting second primary head and neck cancers after endoscopic resection of esophageal squamous cell carcinoma. Jpn J Clin Oncol. 2020 ; 50 : 1162-7.
7) Onochi K, Shiga H, Takahashi S, et al. Risk factors linking esophageal squamous cell carcinoma with head and neck cancer or gastric cancer. J Clin Gastroenterol. 2019 ; 53 : e164-70.
8) Katada C, Muto M, Momma K, et al. Clinical outcome after endoscopic mucosal resection for esophageal squamous cell carcinoma invading the muscularis mucosae--a multicenter retrospective cohort study. Endoscopy. 2007 ; 39 : 779-83.
9) Toh Y, Kitagawa Y, Kuwano H, et al. A nation-wide survey of follow-up strategies for esophageal cancer patients after a curative esophagectomy or a complete response by definitive chemoradiotherapy in Japan. Esophagus. 2016 ; 13 : 173-81.
10) Katada C, Yokoyama T, Yano T, et al. Association between macrocytosis and metachronous squamous cell carcinoma of the esophagus after endoscopic resection in men with early esophageal squamous cell carcinoma. Esophagus. 2020 ; 17 : 149-58.

46 食道アカラシアに対する治療戦略は ?

P.241 掲載の参考文献
1) Boeckxstaens GE, Zaninotto G, Richter JE. Achalasia. Lancet. 2014 ; 383 : 83-93.
2) Vaezi MF, Pandolfino JE, Yadlapati RH, et al. ACG Clinical Guidelines : Diagnosis and management of achalasia. Am J Gastroenterol. 2020 ; 115 : 1393-411.
3) Vela MF, Richter JE, Khandwala F, et al. The long-term efficacy of pneumatic dilatation and Heller myotomy for the treatment of achalasia. Clin Gastroenterol Hepatol. 2006 ; 4 : 580-7.
4) Lynch KL, Pandolfino JE, Howden CW, et al. Major complications of pneumatic dilation and Heller myotomy for achalasia : single-center experience and systematic review of the literature. Am J Gastroenterol. 2012 ; 107 : 1817-25.
5) Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy for esophageal achalasia. Endoscopy. 2010 ; 42 : 265-71.
6) Rohof WO, Salvador R, Annese V, et al. Outcomes of treatment for achalasia depend on manometric subtype. Gastroenterology. 2013 ; 144 : 718-25.
7) Boeckxstaens GE, Annese V, des Varannes SB, et al. Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia. N Engl J Med. 2011 ; 364 : 1807-16.
8) Ponds F, Fockens P, Lei A, et al. Effect of Peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia : a randomized clinical trial. JAMA. 2019 ; 322 : 134-44.
9) Werner YB, Hakanson B, Martinek J, et al. Endoscopic or surgical myotomy in patients with idiopathic achalasia. N Engl J Med. 2019 ; 381 : 2219-29.
10) Mundre P, Black JC, Mohammed N, et al. Efficacy of surgical or endoscopic treatment of idiopathic achalasia : a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2021 ; 6 : 30-8.
11) Urakami S, Abe H, Tanaka S, et al. Development of a preoperative risk-scoring system for predicting poor responders to peroral endoscopic myotomy. Gastrointest Endosc. 2021 ; 93 : 398-405.
12) Kumbhari V, Tieu AH, Onimaru M, et al. Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of type III achalasia in 75 patients : a multicenter comparative study. Endosc Int Open. 2015 ; 3 : 195-201.
13) Abe H, Tanaka S, Kawara F, et al. Comparison of the safety and efficacy of peroral endoscopic myotomy between octogenarians and non-octogenarians. Dig Endosc. 2021 ; 33 : 110-7.
14) Lee Y, Brar K, Doumouras AG, et al. Peroral endoscopic myotomy (POEM) for the treatment of pediatric achalasia : a systematic review and meta-analysis. Surgical Endosc. 2019 ; 33 : 1710-20.
15) Vosko S, Cohen DL, Neeman O. Achalasia during pregnancy : proposed management algorithm based on a thorough literature review. J Neurogastroenterol Motil. 2021 ; 27 : 8-18.
16) Ueda C, Abe H, Tanaka S. Peroral endoscopic myotomy for advanced achalasia with megaesophagus. Esophagus. 2021 ; 18 : 922-31.
17) Tanaka S, Toyonaga T, Kawara F, et al. Novel per-oral endoscopic myotomy method preserving oblique muscle using two penetrating vessels as anatomic landmarks reduces postoperative gastroesophageal reflux. J Gastroenterol Hepatol. 2019 ; 34 : 2158-63.
18) Inoue H, Ueno A, Shimamura Y, et al. Peroral endoscopic myotomy and fundoplication : a novel NOTES procedure. Endoscopy. 2019 ; 51 : 161-4.

47 食道胃接合部癌に対する内視鏡治療後の適切なサーベイランスは ?

P.247 掲載の参考文献
1) 日本胃癌学会, 編. 胃癌取扱い規約 第15版. 東京 : 金原出版 ; 2017.
2) 日本食道学会, 編. 食道癌取扱い規約 第11版. 東京 : 金原出版 ; 2015.
3) Vizcaino AP, Moreno V, Lambert R, et al. Time trends incidence of both major histologic types of esophageal carcinomas in selected countries, 1973-1995. Int J Cancer. 2002 ; 99 : 860-8.
4) Buas MF, Vaughan TL. Epidemiology and risk factors for gastroesophageal junction tumors : understanding the rising incidence of this disease. Semin Radiat Oncol. 2013 ; 23 : 3-9.
5) Kusano C, Gotoda T, Khor CJ, et al. Changing trends in the proportion of adenocarcinoma of the esophagogastric junction in a large tertiary referral center in Japan. J Gastroenterol Hepatol. 2008 ; 23 : 1662-5.
6) Park CH, Kim EH, Kim HY, et al. Clinical outcomes of endoscopic submucosal dissection for early stage esophagogastric junction cancer : asystematic review and meta-analysis. Dig Liver Dis. 2015 ; 47 : 37-44.
7) Nagami Y, Ominami M, Otani K, et al. Endoscopic submucosal dissection for adenocarcinomas of the esophagogastric junction. Digestion. 2018 ; 97 : 38-44.
8) Katada C, Yokoyama T, Yano T, et al. Alcohol consumption and multiple dysplastic lesions increase risk of squamous cell carcinoma in the esophagus, head, and neck. Gastroenterology. 2016 ; 151 : 860-9.
9) Matsubara T, Yamada K, Nakagawa A. Risk of second primary malignancy after esophagectomy for squamous cell carcinoma of the thoracic esophagus. J Clin Oncol. 2003 ; 21 : 4336-41.
10) Katada C, Tanabe S, Koizumi W, et al. Narrow band imaging for detecting superficial squamous cell carcinoma of the head and neck in patients with esophageal squamous cell carcinoma. Endoscopy. 2010 ; 42 : 185-90.
11) Yoshimura N, Goda K, Tajiri H, et al. Diagnostic utility of narrow-band imaging endoscopy for pharyngeal superficial carcinoma. World J Gastroenterol. 2011. 7 ; 17 : 4999-5006.
12) Abe S, Ishihara R, Takahashi H, et al. Long-term outcomes of endoscopic resection and metachronous cancer after endoscopic resection for adenocarcinoma of the esophagogastric junction in Japan. Gastrointest Endosc. 2019 ; 89 : 1120-8.
13) 日本消化器内視鏡学会食道癌に対するESD/EMRガイドライン委員会, 編. 食道癌に対するESD/EMRガイドライン. 日本消化器内視鏡学会雑誌. 2020 : 62 ; 221-71.
14) Abe S, Oda I, Suzuki H, et al. Long-term surveillance and treatment outcomes of metachronous gastric cancer occurring after curative endoscopic submucosal dissection. Endoscopy. 2015 ; 47 : 1113-8.
15) Nakajima T, Oda I, Gotoda T, et al. Metachronous gastric cancers after endoscopic resection : how effective is annual endoscopic surveillance? Gastric Cancer. 2006 ; 9 : 93-8.
16) Ezoe Y, Muto M, Uedo N, et al. Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer. Gastroenterology. 2011 ; 141 : 2017-25.
17) Goda K, Takeuchi M, Ishihara R, et al. Diagnostic utility of a novel magnifying endoscopic classification system for superficial Barrett's esophagus-related neoplasms : a nationwide multicenter study. Esophagus. 2021 ; 18 : 713-23.

48 胃腺腫に対する治療の必要性は ?

P.251 掲載の参考文献
1) Maekawa A, Kato M, Nakamura T, et al. Incidence of gastric adenocarcinoma among lesions diagnosed as low-grade adenoma/dysplasia on endoscopic biopsy : A multicenter, prospective, observational study. Dig Endosc. 2018 ; 30 : 228-35.
2) Kato M, Nishida T, Tsutsui S, et al. Endoscopic submucosal dissection as a treatment for gastric noninvasive neoplasia : A multicenter study by Osaka University ESD Study Group. J Gastroenterol. 2011 ; 46 : 325-31.
3) Nakamura S, Matsumoto T, Ishikawa T, et al. Long term clinical course of gastric adenoma : a retrospective analysis of tumors with enlargement and those with malignant transformation (in Japanese). Stomach Intest. (Tokyo). 2003 ; 38 : 1389-400.
4) Jung SH, Chung WC, Lee KM, et al. Risk factors in malignant transformation of gastric epithelial neoplasia categorized by the reviced Vienna Classification : endoscopic, pathological, and immunophenotypic features. Gastric Cancer. 2010 ; 13 : 123-30.
5) 日本胃癌学会, 編. 胃癌取扱い規約. 第15版. 東京 : 金原出版 ; 2017.
6) 九嶋亮治, 松原亜希子, 吉永繁高, 他 胃型腺腫の臨床病理学的特徴-内視鏡像, 組織発生, 遺伝子変化と癌化. 胃と腸. 2014 ; 49 : 1838-49.
7) Schlemper RJ, Riddell RH, Kato Y, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000 ; 47 : 251-5.
8) 大江原誠一, 菅智明, 岡村琢磨, 他. 胃腺腫に対する治療方針 私はこう思う ; 積極的に治療する立場から. 胃と腸. 2014 ; 49 : 1850-7.
9) Sakurai U, Lauwers GY, Vieth M, et al. Gastric high-grade dysplasia can be associated with submucosal invasion evaluation of its prevalence in a series of 121 endoscopically resected specimens. Am J Surg Pathol. 2014 ; 38 : 1545-50.
10) Takenawa H, Kurosaki M, Enomoto N, et al. Differential gene-expression profiles associated with gastric adenoma. Br J Cancer. 2004 ; 90 : 216-23.
11) Park SY, Jeon SW, Jung MK, et al. Long-term follow-up study of gastric intraepithelial neoplasias : progression from low-grade dysplasia to invasive carcinoma. Eur J Gastroenterol Hepatol. 2008 ; 20 : 966-70.
12) Yamada M, Ikegami M, Shimoda T. Long term follow up study of gastric adenoma/dysplasia Endoscopy. 2004 ; 36 : 390-6.
13) 森源喜, 小田一郎, 谷口浩和, 他 胃腺腫に対する治療方針 私はこう思う ; 経過観察する立場から 胃と腸. 2014 ; 49 : 1859-69.
14) Park SH, Choi KD, Jung K, et al. Gastric cancer caused by adenoma : predictive factors associated with lesions other than the expanded indication. Gut and Liver. 2018 ; 12 : 246-54.
15) Sumiyoshi T, Kondo H, Fujii R, et al. Short- and long-term outcomes of endoscopic submucosal dissection for early gastric cancer in elderly patients aged 75 years and older. Gastric Cancer. 2017 ; 20 : 489-95.
16) Maki S, Yao K, Nagahama T, et al. Magnifying endoscopy with narrow-band imaging is useful in the differential diagnosis between low-grade adenoma and early cancer of superficial elevated gastric lesions. Gastric Cancer. 2013 ; 16 : 140-6.
17) Yao K, Iwashita A, Tanabe H, etal. White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow band imaging : a new optical sign for differentiating between adenoma and carcinoma. Gastrointest Endsc. 2008 ; 68 : 574-80.
18) 長浜孝, 小島俊樹, 八尾建史, 他. 胃扁平隆起型腺腫と0-IIa型病変の鑑別診断における非熟練者に対する狭帯域光観察 併用拡大内視鏡の有用性と問題点. 胃と腸. 2014 ; 49 : 1815-26.
19) 金光高雄, 八尾建史, 今村健太郎, 他. 腺腫と分化型癌の組織分類の新展開 腺腫と分化型癌の内視鏡診断. 胃と腸. 2021 ; 56 : 1261-73.
20) 菅井有, 幅野渉, 小西康弘, 他. 核異型度に基づいた腸型分化型胃粘膜内癌の分子病理学的解析-特に腸型低異型度胃癌における分子解析. 胃と腸. 2010 ; 45 : 1212-25.
21) 具嶋亮介, 八尾隆史. 胃腺腫と分化型癌との病理学的鑑別-腸型腺腫. 胃と腸. 2014 ; 49 : 1827-36.
22) Rokutan H, Abe H, Nakamura H, et al. Initial and crucial genetic events in intestinal-type gastric intramucosal neoplasia. J Pathol. 2019 ; 247 : 494-504.
23) Lee JH, Abraham SC, Kim HS, et al. Inverse relationship between APC gene mutation in gastric adenomas and development of adenocarcinoma. Am J Pathol. 2002 ; 161 : 611-8.

49 食道・胃悪性消化管狭窄に対する治療戦略は ?

P.256 掲載の参考文献
1) Homs MYV, Steyerberg EW, Eijkenboom WMH, et al. Single-dose brachytherapy versus metal stent placement for the palliation of dysphagia from oesophageal cancer : Multicentre randomised trial. Lancet. 2004 ; 364 : 1497-504.
2) Muto M, Ohtsu A, Miyata Y, et al. Self-expandable metallic stents for patients with recurrent esophageal carcinoma after failure of primary chemoradiotherapy. Jpn J Clin Oncol. 2001 ; 31 : 270-4.
3) Reijm AN, Didden P, Schelling SJC, et al. Self-expandable metal stent placement for malignant esophageal strictures - Changes in clinical outcomes over time. Endoscopy. 2018 ; 51 : 18-29.
4) Bergquist H, Wenger U, Johnsson E, et al. Stent insertion or endoluminal brachytherapy as palliation of patients with advanced cancer of the esophagus and gastroesophageal junction. Results of a randomized, controlled clinical trial. Dis Esophagus. 2005 ; 18 : 131-9.
5) Song JH, Ko J, Min YW, et al. Comparison between percutaneous gastrostomy and self-expandable metal stent insertion for the treatment of malignant esophageal obstruction, after propensity score matching. Nutrients. 2020 ; 12 : 1-10.
6) Nishimura Y, Nagata K, Katano S, et al. Severe complications in advanced esophageal cancer treated with radiotherapy after intubation of esophageal stents : A questionnaire survey of the Japanese Society for Esophageal Diseases. Int J Radiat Oncol Biol Phys. 2003 ; 56 : 1327-32.
7) Qiu G, Tao Y, Du X, et al. The impact of prior radiotherapy on fatal complications after self-expandable metallic stents (SEMS) for malignant dysphagia due to esophageal carcinoma. Dis Esophagus. 2013 ; 26 : 175-81.
8) Sugimura K, Miyata H, Tanaka K, et al. Multicenter randomized phase 2 trial comparing chemoradiotherapy and docetaxel plus 5-fluorouracil and cisplatin chemotherapy as initial induction therapy for subsequent conversion surgery in patients with clinical T4b esophageal cancer : Short-term result. Ann Surg. 2021 ; 274 : E465-72.
9) Dormann AJ, Meisner S, Verin N, et al. Self-expanding metal stents for gastroduodenal malignancies : Systematic review of their clinical effectiveness. Endoscopy. 2004 ; 36 : 543-50.
10) Van Den Berg MW, Haijtink S, Fockens P, et al. First data on the Evolution duodenal stent for palliation of malignant gastric outlet obstruction (DUOLUTION study) : A prospective multicenter study. Endoscopy. 2013 ; 45 : 174-81.
11) Hori Y, Naitoh I, Hayashi K, et al. The utility and efficacy of self-expandable metal stents for treating malignant gastric outlet obstructions in patients under best supportive care. Support Care Cancer. 2018 ; 26 : 3587-92.
12) Takeno A, Takiguchi S, Fujita J, et al. Clinical outcome and indications for palliative gastrojejunostomy in unresectable advanced gastric cancer : Multi-institutional retrospective analysis. Ann Surg Oncol. 2013 ; 20 : 3527-33.
13) Bian SB, Shen WS, Xi HQ, et al. Palliative therapy for gastric outlet obstruction caused by unresectable gastric cancer : A meta-analysis comparison of gastrojejunostomy with endoscopic stenting. Chin Med J (Engl). 2016 ; 129 : 1113-21.
14) Ly J, O'Grady G, Mittal A, et al. A systematic review of methods to palliate malignant gastric outlet obstruction. Surg Endosc. 2010 ; 24 : 290-7.
15) Jue TL, Storm AC, Naveed M, et al. ASGE guideline on the role of endoscopy in the management of benign and malignant gastroduodenal obstruction. Gastrointest Endosc. 2021 ; 93 : 309-22.
16) Fujitani K, Yang HK, Mizusawa J, et al. Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA) : A phase 3, randomised controlled trial. Lancet Oncol. 2016 ; 17 : 309-18.

50 胃底腺型胃癌に対する内視鏡治療適応と追加治療の必要性は ?

P.260 掲載の参考文献
1) Ueyama H, Yao T, Nakashima Y et al. Gastric adenocarcinoma of fundic gland type (chief cell predominant type) proposal for a new entity of gastric adenocarcinoma. Am J Surg Pathol. 2010 ; 34 ; 609-19.
2) Ueyama H, Yao T, Akazawa Y, et al. Gastric epithelial neoplasm of fundic-gland mucosa lineage : proposal for a new classification in association with gastric adenocarcinoma of fundic-gland type. J Gastroenterol. 2021 ; 56 : 814-28.
3) 田邉寛, 岩下明徳, 池田圭祐, 他. 胃底腺型胃癌の病理組織学的特徴. 胃と腸. 2015 ; 50 : 1469-79.
4) Singhi AD, Lazenby AJ, Montgomery EA. Gastric adenocarcinoma with chief cell differentiation : a proposal for reclassification as oxyntic gland polyp/adenoma. Am J Surg Pathol. 2012 ; 36 ; 1030-5.
5) Lee TI, Jang JY, Kim S, et al.Oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor : A case report. World J Gastroenterol. 2015 ; 21 : 5099-104.
6) Chan K, Brown IS, Kyle T, et al. Chief cell-predominant gastric polyps : a series of 12 cases with literature review. Histopathology. 2016 ; 68 : 825-33.
7) 上山浩也, 八尾隆史, 松本健史, 他. 『早期胃癌 2018』9. 特殊な組織型を呈する早期胃癌 4) 胃底腺型胃癌. 胃と腸. 2018 ; 53 : 753-67.

51 進行胃癌に対する免疫チェックポイント阻害薬の位置づけは ?

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52 機能性ディスペプシアに対する治療戦略をどう考えるか ?

P.272 掲載の参考文献
1) 日本消化器病学会. 機能性消化管診療ガイドライン 2021-機能性ディスペプシア (FD) 改訂第2版. 東京 : 南江堂 ; 2021.
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53 早期胃癌の深達度診断と適切な治療戦略は ?

P.278 掲載の参考文献
1) 日本胃癌学会, 編. 胃癌治療ガイドライン 第6版. 東京 : 金原出版 ; 2021.
2) Sano T, Okuyama Y, Kobori O, et al. Early gastric cancer. Endoscopic diagnosis of depth of invasion. Dig Dis Sci. 1990 ; 35 : 1340-4.
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5) Tsujii Y, Kato M, Inoue T, et al. Integrated diagnostic strategy for the invasion depth of early gastric cancer by conventional endoscopy and EUS. Gastrointest Endosc. 2015 ; 82 : 452-9.
6) Nagahama T, Yao K, Imamura K, et al. Diagnostic performance of conventional endoscopy in the identification of submucosal invasion by early gastric cancer : the "non-extension sign" as a simple diagnostic marker. Gastric Cancer. 2017 ; 20 : 304-13.
7) Mouri R, Yoshida S, Tanaka S, et al. Usefulness of endoscopic ultrasonography in determining the depth of invasion and indication for endoscopic treatment of early gastric cancer. J Clin Gastroenterol. 2009 ; 43 : 318-22.
8) Kuroki K, Oka S, Tanaka S, et al. Clinical significance of endoscopic ultrasonography in diagnosing invasion depth of early gastric cancer prior to endoscopic submucosal dissection. Gastric Cancer. 2021 ; 24 : 145-55.
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10) Hirasawa T, Gotoda T, Miyata S, et al. Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer. Gastric Cancer. 2009 ; 12 : 148-52.
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12) Hasuike N, Ono H, Boku N, et al. A non-randomized confirmatory trial of an expanded indication for endoscopic submucosal dissection for intestinal-type gastric cancer (cT1a) : the Japan Clinical Oncology Group study (JCOG0607). Gastric Cancer. 2018 ; 21 : 114-23.
13) Takizawa K, Ono H, Hasuike N, et al. A nonrandomized, single-arm confirmatory trial of expanded endoscopic submucosal dissection indication for undifferentiated early gastric cancer : Japan Clinical Oncology Group study (JCOG1009/1010). Gastric Cancer. 2021 ; 24 : 479-91.
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54 進行消化管神経内分泌腫瘍に対する薬物療法の選択とペプチド受容体放射性核種療法の位置づけは ?

P.282 掲載の参考文献
1) WHO Classification of Tumours Editorial Board. International Agency for Research Cancer. Digestive System Tumours (World Health Organization Classification of Tumours). International Agency for Research Cancer. 5th ed. 2019.
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3) Pavel M, Oberg K, Falconi M, et al. Gastroenteropancreatic neuroendocrine neoplasms : ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 ; 31 : 844-60.
5) 松本繁巳. 消化管神経内分泌腫瘍に対する薬物療法 (特集 神経内分泌腫瘍の薬物療法). 腫瘍内科. 2019 ; 23 : 215-20.
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8) 内科・集学的治療 CQ9 膵・消化管NEN に対して放射線治療は推奨されるか? 改訂版 膵・消化管NEN診療ガイドライン 第2版. http://jnets.umin.jp/guideline.html
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14) Hope TA, Calais J, Zhang L, et al. 111In-pentetreotide scintigraphy versus 68Ga-DOTATATE PET : Impact on krenning scores and effect of tumor burden. J Nucl Med. 2019 ; 60 : 1266-9.

55 胃粘膜下腫瘍の適切な診断法と経過観察法は ?

P.288 掲載の参考文献
1) 加藤洋. 【粘膜下腫瘍のすべて】粘膜下腫瘍の頻度と病理. 消化器内視鏡. 2009 ; 2 : 177-94.
2) 日本癌治療学会, 日本胃癌学会, GIST研究会, 編. GIST診療ガイドライン. 第3版. 東京 : 金原出版 ; 2014年4月改訂.
3) Dumonceau JM, Polkowski M, Larghi A, et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS) -guided sampling in gastroenterology : European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2011 ; 43 : 897-912.
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5) Zhang X-C, Li Q-L, Yu Y-F, et al. Diagnostic efficacy of endoscopic ultrasound-guided needle sampling for upper gastrointestinal subepithelial lesions : a meta-analysis. Surg Endosc. 2016 ; 30 : 2431-41.
6) Mekky MA, Yamao K, Sawaki A, et al. Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors. Gastrointest Endosc. 2010 ; 71 : 913-9.
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11) Fang YJ, Cheng TY, Sun MS, et al. Suggested cutoff tumor size for management of small EUS-suspected gastric gastrointestinal stromal tumors. J Formos Med Assoc. 2012 ; 111 : 88-93.
12) Koizumi S, Kida M, Yamauchi H, et al. Clinical implications of doubling time of gastrointestinal submucosal tumors. World J Gastroenterol. 2016 ; 22 : 10015-23.
13) Ji JS, Lee BI, Choi KY, et al. Diagnostic yield of tissue sampling using a bite-on-bite technique for incidental subepithelial lesions. Korean J Intern Med. 2009 ; 24 : 101-5.
14) Kobara H, Mori H, Nishimoto N, et al. Comparison of submucosal tunneling biopsy versus EUS-guided FNA for gastric subepithelial lesions : a prospective study with crossover design. Endosc Int Open. 2017 ; 5 : E695-705.

56 十二指腸腺腫に対する治療戦略は ?

P.293 掲載の参考文献
1) Goda K, Kikuchi D, Yamamoto Y, et al. Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors in Japan : Multicenter case series. Dig Endosc. 2014 ; 2 : 23-9.
2) Okada K, Fujisaki J, Kasga A, et al. Sporadic nonampullary duodenal adenoma in the natural history of duodenal cancer : a study of follow-up surveillance. Am J Gastroenterol. 2011 ; 106 : 357-64.
3) Kanzaki H, Matsueda K, Nakagawa M, et al. Clinical characteristics and course of sporadic non-ampullary duodenal adenomas : A multicenter retrospective study. Medicine (Baltimore). 2021 ; 100 : e27382.
4) 十二指腸癌診療ガイドライン作成委員会, 編. 十二指腸癌診療ガイドライン 2021. 東京 : 金原出版 ; 2021.
5) Kato M, Takeuchi Y, Hoteya S, et al. Outcomes of endoscopic resection for superficial duodenal tumors : 10 years' experience in 18 Japanese high volume centers. Endoscopy. 2022 ; 54 : 663-70.
6) Shichijo S, Takeuchi Y, Kitamura M, et al. Does cold snare polypectomy completely resect the mucosal layer? A prospective single-center observational trial. J Gastroenterol Hepatol. 2020 ; 35 : 241-8.
7) Nakayama A, Kato M, Takatori Y, et al. How I do it : Endoscopic diagnosis for superficial non-ampullary duodenal epithelial tumors. Dig Endosc. 2020 ; 32 : 417-24.
8) Kiguchi Y, Kato M, Nakayama A, et al. Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non-ampullary duodenal epithelial tumor < 20 mm. Dig Endosc. 2020 ; 32 : 753-60.
9) Takatori Y, Kato M, Masunaga T, et al. Efficacy of partial injection underwater endoscopic mucosal resection for superficial duodenal epithelial tumor : Propensity score-matched study (with video). Dig Endosc. 2022 ; 34 : 535-42.
10) Tsutsumi K, Kato M, Kakushima N, et al. Efficacy of endoscopic preventive procedures to reduce delayed adverse events after endoscopic resection of superficial nonampullary duodenal epithelial tumors : a meta-analysis of observational comparative trials. Gastrointest Endosc. 2021 ; 93 : 367-74 e3.
11) Fukuhara S, Kato M, Iwasaki E, et al. External drainage of bile and pancreatic juice after endoscopic submucosal dissection for duodenal neoplasm : Feasibility study (with video). Dig Endosc. 2021 ; 33 : 977-84.
12) Masunaga T, Kato M, Takatori Y. Spurting delayed bleeding on postoperative day six after cold snare polypectomy for small superficial duodenal epithelial tumor. Dig Endosc. 2021 ; 33 : 1198.
13) Toba T, Inoshita N, Kaise M, et al. Clinicopathological features of superficial non-ampurally duodenal epithelial tumor ; gastric phenotype of histology correlates to higher malignant potency. J Gastroenterol. 2018 ; 53 : 64-70.

57 進行小腸癌に対する薬物療法についてどう選択するか ?

P.298 掲載の参考文献
1) Overman MJ, Hu CY, Kopetz S, et al. A population-based comparison of adenocarcinoma of the large and small intestine : insights into a rare disease. Ann Surg Oncol. 2011 ; 19 : 1439-45.
2) Horimatsu T, Nakayama N, Moriwaki T, et al. A phase II study of 5-fluorouracil/L-leucovorin/oxaliplatin (mFOLFOX6) in Japanese patients with metastatic or unresectable small bowel adenocarcinoma. Int J Clin Oncol. 2017 ; 22 : 905-12.
3) Gulhati P, Raghav K, Shroff RT, et al. Bevacizumab combined with capecitabine and oxaliplatin in patients with advanced adenocarcinoma of the small bowel or ampulla of vater : A single-center, open-label, phase 2 study. Cancer. 2017 ; 123 : 1011-7.
4) Legue LM, van Erning FN, Bernards N, et al. Addition of bevacizumab to first-line palliative chemotherapy in patients with metastatic small bowel adenocarcinoma : A population-based study. Target Oncol. 2019 ; 14 : 699-705.
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6) Dell'Aquila E, Zeppola T, Stellato M, et al. Anti-EGFR therapy in metastatic small bowel adenocarcinoma : Myth or reality? Clin Med Insights Oncol. 2020 ; 14 : 1179554920946693.
7) Gulhati P, Raghav K, Shroff R, et al. Phase II study of panitumumab in RAS wild-type metastatic adenocarcinoma of small bowel or ampulla of vater. Oncologist. 2018 ; 23 : 277-e26.
8) Nakazawa T, Narita Y, Kumanishi R, et al. Second-line chemotherapy for previously treated metastatic small bowel adenocarcinoma : A retrospective analysis. Anticancer Res. 2021 ; 41 : 5147-55.
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58 短腸症候群に対する治療選択とその適応は ?

P.303 掲載の参考文献
1) Cristina C, Loris P, Jann A, et al. ESPEN practical guideline : Clinical nutrition in chronic intestinal failure. Clin Nutr. 2021 ; 40 : 5196-220.
2) 田附裕子, 窪田昭男. 短腸症候群の栄養療法. 臨床栄養. 2012 ; 120 : 820-5.
3) Mizushima T, Udagawa E, Hasegawa M, et al. Etiologies and treatment of chronic intestinal failure-short bowel syndrome (SBS) in Japanese adults : a real-world observational study. Surgery Today. 2022 ; Online ahead of print.
4) 畠山勝義, 小山真, 山寺陽一, 他. 広範囲小腸切除後の病態生理とその管理. 外科治療. 1983 ; 49 : 610-6.
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59 大腸腫瘍の内視鏡治療後の適切なサーベイランス法は ?

P.308 掲載の参考文献
1) 日本消化器病学会. 大腸ポリープ診療ガイドライン 2020 (改訂第2版). http://www.jsge.or.jp/guideline/guideline/cpgf.html
2) 日本消化器内視鏡学会. 大腸内視鏡スクリーニングとサーベイランスガイドライン. 日本消化器内視鏡学会雑誌. 2020 ; 62 : 1521-60.
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4) Hassan C, Giulio A, Dumoncreau JM. Post-polepectomy colonoscopy surveillance : Europena Society of Gastrointestinal Endoscopy (ESGE) guideline-update 2020. Endoscopy. 2020 ; 52 : 687-700.
5) Rutter M, East J, Rees C, et al. British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England postpolypectomy and post-colorectal cancer resection surveillance guidelines. Gut. 2020 ; 69 : 201-23.
6) Matsuda T, Fujii T, Sano Y, et al. Randomized comparison of post-polypectomy surveillance intervals following a two-round baseline colonoscopy : The Japan Polyp Study Workgroup. Gut. 2021 ; 70 : 1469-78.
7) Ishikawa H, Mutoh M, Suzuki S, et al. The preventive effects of low-dose enteric-coated aspirin tablets on the development of colorectal tumours in Asian patients : a randomised trial. Gut. 2014 ; 63 : 1755-9.

60 過形成性ポリープに対する適切な治療戦略は ?

P.313 掲載の参考文献
1) Longacre TA, Fenoglio-Preiser CM : Mixed hyperplastic adenomatous polyps/serrated adenomas. A distinct form of colorectal neoplasia. Am J Surg Pathol. 1990 ; 14 : 524-37.
2) Jass JR. Serrated adenoma of the colorectum and the DNA-methylator phenotype. Nat Clin Pract Oncol. 2005 ; 2 : 398-405.
3) Nagtegaal ID, Oze RD, Klimstra D, et al. The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020 ; 76 : 182-8.
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5) Erichsen R, Baron JA, Hamilton-Dutoit SJ, et al. Increased risk of colorectal cancer development among patients with serrated polyps. Gastroenterology. 2016 ; 150 : 895-902.e5.
6) 小西一男, 久保田祐太郎, 矢野雄一郎, 他. 遺伝子研究の立場から (1) SSA/Pと過形成性ポリープにおける分子生物学的特徴. INTESTINE. 2012 ; 16 : 541-8.
7) 日本消化器病学会, 編. 大腸ポリープ診療ガイドライン 2020. 改訂第2版. 東京 : 南江堂 ; 2021.
8) Shida Y, Ichikawa K, Fujimori T, et al. Differentiation between sessile serrated adenoma/polyp and non-sessile serrated adenoma/polyp in large hyper plastic polyp : A Japanese collaborative study. Mol Clin Oncol. 2013 ; 1 : 53-8.
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13) 樫田博史, 工藤進英. 大腸ポリープの新知見-大腸鋸歯状腺腫の概念, 特徴, 診断. 医学のあゆみ別冊 (消化器疾患 Ver. 3). 2006 : 628-33.
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61 切除不能進行再発大腸癌の後方治療においてレゴラフェニブとトリフルリジン / チピラシル塩酸塩のいずれを先行して投与するか ?

P.318 掲載の参考文献
1) 大腸癌研究会. 大腸癌治療ガイドライン医師用 2022年版. 東京 : 金原出版 ; 2022.
2) Grothey A, Van Cutsem E, Sobrero A, et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT) : an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013 ; 381 : 303-12.
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5) Masuishi T, Taniguchi H, Hamauchi S, et al. Regorafenib versus trifluridine/tipiracil for refractory metastatic colorectal cancer ; A retrospective comparison. Clin Colorectal Cancer. 2017 ; 16 : e15-22.
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62 下部消化管出血に対する内視鏡検査の適切なタイミングは ?

P.324 掲載の参考文献
1) Nagata N, Kobayashi K, Yamauchi A, et al. Identifying bleeding etiologies by endoscopy affected outcomes in 10,342 cases with hematochezia : CODE BLUE-J study. Am J Gastroenterol. 2021 ; 116 : 2222-34.
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17) Lau JYW, Yu Y, Tang RSY, et al. Timing of endoscopy for acute upper gastrointestinal bleeding. N Engl J Med. 2020 ; 382 : 1299-308.
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19) Lin HJ, Wang K, Perng CL, et al. Early or delayed endoscopy for patients with peptic ulcer bleeding. A prospective randomized study. J Clin Gastroenterol. 1996 ; 22 : 267-71.
20) Lee JG, Turnipseed S, Romano PS, et al. Endoscopy-based triage significantly reduces hospitalization rates and costs of treating upper GI bleeding : a randomized controlled trial. Gastrointest Endosc. 1999 ; 50 : 755-61.
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63 大腸ポリープに対するコールドスネアポリペクトミーの位置づけは ?

P.331 掲載の参考文献
1) Tanaka S, Saitoh Y, Matsuda T, et al. Evidence-based clinical practice guidelines for management of colorectal polyps. J Gastroenterol. 2021 ; 56 : 323-35.
2) Shinozaki S, Kobayashi Y, Hayashi Y, et al. Efficacy and safety of cold versus hot snare polypectomy for resecting small colorectal polyps : Systematic review and meta-analysis. Dig Endosc. 2018 ; 30 : 592-9.
3) Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993 ; 329 : 1977-81.
4) Tappero G, Gaia E, De Giuli P, et al. Cold snare excision of small colorectal polyps. Gastrointest Endosc. 1992 ; 38 : 310-3.
5) Shimodate Y, Mizuno M, Takezawa R, et al. Safety of cold polypectomy for small colorectal neoplastic lesions : a prospective cohort study in Japan. Int J Colorectal Dis. 2017 ; 32 : 1261-6.
6) Kawamura T, Takeuchi Y, Asai S, et al. A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps : a multicentre randomised controlled trial (CRESCENT study). Gut. 2018 ; 67 : 1950-7.
7) Tutticci N, Burgess NG, Pellise M, et al. Characterization and significance of protrusions in the mucosal defect after cold snare polypectomy. Gastrointest Endosc. 2015 ; 82 : 523-8.
8) Matsueda K, Takeuchi Y, Kitamura M, et al. Depth of the cutting plane with underwater and conventional endoscopic mucosal resection : Post-hoc analysis of a randomized study. J Gastroenterol Hepatol. 2022 ; 37 : 741-8.
9) Abe Y, Nabeta H, Koyanagi R, et al. Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate. Endosc Int Open. 2018 ; 6 : E254-e8.
10) Horiuchi A, Hosoi K, Kajiyama M, et al. Prospective, randomized comparison of 2 methods of cold snare polypectomy for small colorectal polyps. Gastrointest Endosc. 2015 ; 82 : 686-92.
11) Arimoto J, Chiba H, Ashikari K, et al. Safety of cold snare polypectomy in patients receiving treatment with antithrombotic agents. Dig Dis Sci. 2019 ; 64 : 3247-55.
12) Yabuuchi Y, Imai K, Hotta K, et al. Efficacy and safety of cold-snare endoscopic mucosal resection for colorectal adenomas 10 to 14 mm in size : a prospective observational study. Gastrointest Endosc. 2020 ; 92 : 1239-46.

64 進行大腸癌に対する治療におけるリキッドバイオプシーの用い方は ?

P.337 掲載の参考文献
1) Santini D, Vincenzi B, Addeo R, et al. Cetuximab rechallenge in metastatic colorectal cancer patients : how to come away from acquired resistance? Ann Oncol. 2012 ; 23 : 2313-8.
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3) Sartore-Bianchi A, Pietrantonio F, Lonardi S, et al. Phase II study of anti-EGFR rechallenge therapy with panitumumab driven by circulating tumor DNA molecular selection in metastatic colorectal cancer : The CHRONOS trial. JCO. 2021 ASCO #3506.
4) Nakajima H, Kotani D, Bando H, et al. REMARRY and PURSUIT trials : liquid biopsy-guided rechallenge with anti-epidermal growth factor receptor (EGFR) therapy with panitumumab plus irinotecan for patients with plasma RAS wild-type metastatic colorectal cancer. BMC Cancer. 2021 ; 21 : 674.
5) Nakamura Y, Taniguchi H, Ikeda M, et al. Clinical utility of circulating tumor DNA sequencing in advanced gastrointestinal cancer : SCRUM-Japan GI-SCREEN and GOZILA studies. Nat Med. 2020 ; 26 : 1859-64.
6) Nakamura Y, Okamoto W, Kato T, et al. Circulating tumor DNA-guided treatment with pertuzumab plus trastuzumab for HER2-amplified metastatic colorectal cancer : a phase 2 trial. Nat Med. 2021 ; 27 : 1899-903.
7) Kotaka M, Shirasu H, Watanabe J, et al. Association of circulating tumor DNA dynamics with clinical outcomes in the adjuvant setting for patients with colorectal cancer from an observational GALAXY study in CIRCULATE-Japan. JCO. 2022 ASCO-GI#9.

65 免疫関連有害事象 ( irAE ) 腸炎の診断・治療戦略 - 炎症性腸疾患 ( IBD ) と何が違うのか ?

P.342 掲載の参考文献
1) Soularue E, Lepage P, Colombel JF, et al. Enterocolitis due to immune checkpoint inhibitors : a systematic review. Gut. 2018 ; 67 : 2056-67.
2) Shimozaki K, Hirata K, Horie S, et al. The entire intestinal tract surveillance using capsule endoscopy after immune checkpoint inhibitor administration : A prospective observational study. Diagnostics (Basel). 2021 ; 11 : 543.
3) Geukes Foppen MH, Rozeman EA, van Wilpe S, et al. Immune checkpoint inhibition-related colitis : symptoms, endoscopic features, histology and response to management. ESMO Open. 2018 ; 3 : e000278.
5) Chen JH, Pezhouh MK, Lauwers GY, et al. Histopathologic features of colitis due to immunotherapy with anti-PD-1 antibodies. Am J Surg Pathol. 2017 ; 41 : 643-54.
6) Bergqvist V, Hertervig E, Gedeon P, et al. Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis. Cancer Immunol Immunother. 2017 ; 66 : 581-92.
7) Shimozaki K, Sukawa Y, Beppu N, et al. Multiple immune-related adverse events and anti-tumor efficacy : Real-world data on various solid tumors. Cancer Manag Res. 2020 ; 12 : 4585-93.

66 消化管神経内分泌腫瘍に対する内視鏡治療の適応と治療法は ?

P.346 掲載の参考文献
2) 日本神経内分泌腫瘍研究会 (JNETS), 膵・消化管神経内分泌腫瘍診療ガイドライン第2版作成委員会, 編. 膵・消化管神経内分泌腫瘍 (NEN) 診療ガイドライン 2019 第2版. 東京 : 金原出版 ; 2019.
3) Ono A, Fujii T, Saito Y, et al. Endoscopic submucosal resection of rectal carcinoid tumors with a ligation device. Gastrointest Endosc. 2003 ; 57 : 583-7.
4) Zhou X, Xie H, Xie L, et al. Endoscopic resection therapies for rectal neuroendocrine tumors : a systematic review and meta-analysis. J Gastroenterol Hepatol. 2014 ; 29 : 259-68.
5) Sekiguchi M, Sekine S, Sakamoto T, et al. Excellent prognosis following endoscopic resection of patients with rectal neuroendocrine tumors despite the frequent presence of lymphovascular invasion. J Gastroenterol. 2015 ; 50 : 1184-9.
6) Kitagawa Y, Ikebe D, Hara T, et al. Enhanced detection of lymphovascular invasion in small rectal neuroendocrine tumors using D2-40 and Elastica van Gieson immunohistochemical analysis. Cancer Med. 2016 ; 5 : 3121-7.
7) Nakamura K,Osada M,Goto A, et al. Short-and long-term outcomes of endoscopic resection of rectal neuroendocrine tumors : analyses according to the WHO 2010 classification. Scand J Gastroenterol.2016 ; 51 : 448-55.
8) Zhou X, Xie H, Xie L, et al. Factors associated with lymph node metastasis in radically resected rectal carcinoids : a systematic review and meta-analysis. J Gastrointest Surg. 2013 ; 17 : 1689-97.
9) Nishikawa Y, Chino A, Ide D, et al. Clinicopathological characteristics and frequency of multiple rectal neuroendocrine tumors : a single-center retrospective study. Int J Colorectal Dis. 2019 ; 34 : 1887-94.

67 循環器疾患に合併した難治性消化管出血の病態と治療法は ?

P.351 掲載の参考文献
1) von-Willebrand 病の診療ガイドライン 2021年版. 血栓止血誌. 2021 ; 32 : 413-81.
2) Tamura T, Horiuchi H, Imai M, et al. Unexpectedly high prevalence of acquired von Willebrand syndrome in patients with severe aortic stenosis as evaluated with a novel large multimer index. J Atheroscler Thromb. 2015 ; 22 : 1115-23.
3) Loscalzo J. From clinical observation to mechanism--Heyde's syndrome. N Engl J Med. 2012 ; 367 : 1954-6.
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5) Sakatsume K, Saito K, Akiyama M, et al. Association between the severity of acquired von Willebrand syndrome and gastrointestinal bleeding after continuous-flow left ventricular assist device implantation. Eur J Cardiothorac Surg. 2018 ; 54 : 841-6.
6) Nagao K, Taniguchi T, Morimoto T, et al. Anemia in patients with severe aortic stenosis. Sci Rep. 2019 ; 9 : 1924.
7) Tsuchiya S, Matsumoto Y, Doman T, et al. Disappearance of angiodysplasia following transcatheter aortic valve implantation in a patient with Heyde's syndrome : A case report and review of the literature. J atheroscler Thromb. 2020 ; 27 : 271-7.

68 ステロイド抵抗・依存性潰瘍性大腸炎の寛解導入治療に最適な薬剤は ? - どの薬剤から始めるのがよいか ?

P.357 掲載の参考文献
1) 厚生労働科学研究費補助金難治性疾患等政策研究事業「難治性炎症性腸管障害に関する調査研究」 (久松班) : 炎症性腸疾患の腸管外合併症治療指針 (2022年3月改訂). 令和3年度分担研究報告書「潰瘍性大腸炎・クローン病診断基準・治療指針 令和3年度改訂版」. 2022. p.9-18.
2) Laharie D, Bourreille A, Branche J, et al. Ciclosporin versus infliximab in patients with severe ulcerative colitis refractory to intravenous steroids : a parallel, open-label randomised controlled trial. Lancet. 2012 ; 380 : 1909-15.
3) Laharie D, Bourreille A, Branche J, et al. Long-term outcome of patients with steroid-refractory acute severe UC treated with ciclosporin or infliximab. Gut. 2018 ; 67 : 237-43.
5) Panaccione R, Ghosh S, Middleton S, et al. Combination therapy with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis. Gastroenterology. 2014 ; 146 : 392-400.
6) Yzet C, Diouf M, Singh S, et al. No benefit of concomitant immunomodulator therapy on efficacy of biologics that are not tumor necrosis factor antagonists in patients with inflammatory bowel diseases : A meta-analysis. Clin Gastroenterol Hepatol. 2021 ; 19 : 668-79.
7) Sands BE, Peyrin-Biroulet L, Loftus EV Jr, et al. Vedolizumab versus adalimumab for moderate-to-severe ulcerative colitis. N Engl J Med. 2019 ; 381 : 1215-26.
8) Bonovas S, Lytras T, Nikolopoulos G, et al. Systematic review with network meta-analysis : comparative assessment of tofacitinib and biological therapies for moderate-to-severe ulcerative colitis. Aliment Pharmacol Ther. 2018 ; 47 : 454-65.

69 ステロイド抵抗・依存性クローン病の寛解導入治療に最適な薬剤は ? - どの薬剤から始めるのがよいか ?

P.363 掲載の参考文献
1) 「難治性炎症性腸管障害に関する調査研究」 (久松班) 令和3年度分担研究報告書. 令和元年度 改訂版 (令和3年3月31日) 潰瘍性大腸炎・クローン病診断基準・治療指針. 厚生労働科学研究費補助金 難治性疾患等政策研究事業「難治性炎症性腸管障害に関する調査研究」 (久松班) 令和3年度分担研究報告書. (http://www.ibdjapan.org/pdf/doc01.pdf)
2) 日本消化器病学会, 編. 炎症性腸疾患 (IBD) 診療ガイドライン 2020 改訂第2版. 東京 : 南江堂 ; 2020.
3) Feagan BG, Sandborn WJ, Gasink C, et al. Ustekinumab as induction and maintenance therapy for Crohn's disease. N Engl J Med. 2016 ; 375 : 1946-60.
4) Sandborn WJ, Feagan BG, Rutgeerts P, et al. Vedolizumab as induction and maintenance therapy for Crohn's disease. N Engl J Med. 2013 ; 369 : 711-21.
5) Ng WK, Wong SH, Ng SC. Changing epidemiological trends of inflammatory bowel disease in Asia. Intest Res. 2016 ; 14 : 111-9.
6) Kotze PG, Shen B, Lightner A, et al. Modern management of perianal fistulas in Crohn's disease : future directions. Gut. 2018 ; 67 : 1181-94.
7) Attauabi M, Burisch J, Seidelin JB. Efficacy of ustekinumab for active perianal fistulizing Crohn's disease : a systematic review and meta-analysis of the current literature. Scand J Gastroenterol. 2021 ; 56 : 53-8.
8) Schwartz DA, Peyrin-Bioulet L, Lasch K, et al. Efficacy and safety of 2 vedolizumab intravenous regimens for perianal fistulizing crohn's disease : ENTERPRISE study. Clin Gastroenterol Hepatol. 2022 ; 20 : 1059-67. e9.
9) Kobayashi T, Hishida A, Tanaka H, et al. Real-world experience of anti-tumor necrosis factor therapy for internal fistulas in Crohn's disease : A retrospective multicenter cohort study. Inflamm Bowel Dis. 2017 ; 23 : 2245-51.

70 炎症性腸疾患 ( IBD ) の疾患活動性モニタリングに最適なモダリティやバイオマーカーは ?

P.367 掲載の参考文献
1) Peyrin-Biroulet L, Sandborn W, Sands BE, et al. Selecting therapeutic targets in inflammatory bowel disease (STRIDE) : Determining therapeutic goals for treat-to-target. Am J Gastroenterol. 2015 ; 110 : 1324-38.
2) Turner D, Ricciuto A, Lewis A, et al. STRIDE-II : An update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the international organization for the study of IBD (IOIBD) : Determining therapeutic goals for treat-to-target strategies in IBD. Gastroenterology. 2021 ; 160 : 1570-83.
3) Shinzaki S, Matsuoka K, Iijima H, et al. Leucine-rich alpha-2 glycoprotein is a serum biomarker of mucosal healing in ulcerative colitis. J Crohn Colitis. 2017 ; 11 : 84-91.
4) Kawamoto A, Takenaka K, Hibiya S, et al. Serum leucine-rich α2 glycoprotein : A novel biomarker for small bowel mucosal activity in Crohn's disease. Clin Gastroenterol Hepatol. 2022 ; 20 : 1196-200.

71 IBD関連癌に対する適切なスクリーニング方法は ?

P.373 掲載の参考文献
1) Turner D, Ricciuto A, Lewis A, et al. STRIDE-II : An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD) : Determining therapeutic goals for treat-to-target strategies in IBD. Gastroenterology. 2021 ; 160 : 1570-83.
2) 渡辺憲治, 佐藤寿行, 上小鶴孝二. 全大腸NBI観察による潰瘍性大腸炎サーベイランス内視鏡. Gastroenterol Endosc. 2020 ; 62 : 2972-9.
3) 渡辺憲治, 樋田信幸, 中村志郎. 炎症性腸疾患関連腫瘍サーベイランスの精度向上に向けて. 日本消化器病学会雑誌. 2019 ; 116 : 878-90.
4) Laine L, Kaltenbach T, Barkun A, et al. SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease. Gastroenterology. 2015 ; 148 : 639-51.
5) Kiesslich R. SCENIC update 2021 : Is chromoendoscopy still standard of care for inflammatory bowel disease surveillance? Gastrointest Endosc. 2022 ; 95 : 38-41.
6) Oka S, Uraoka T, Watanabe K, et al. Endoscopic diagnosis and treatment of ulcerative colitis-associated neoplasia. Dig Endosc. 2019 ; 31 Suppl 1 : 26-30.
7) Watanabe T, Ajioka Y, Mitsuyama K, et al. Comparison of targeted vs random biopsies for surveillance of ulcerative colitis-associated colorectal cancer. Gastroenterology. 2016 ; 151 : 1122-30.
8) Watanabe K, Hida N, Ajioka Y, et al. Photodynamic diagnosis of endoscopically invisible flat dysplasia in patients with ulcerative colitis by visualization using local 5-aminolevulinic acid-induced photosensitization. Gastrointest Endosc. 2010 ; 71 : 1094-6.
9) 日本消化器病学会, 編. 炎症性腸疾患 (IBD) 診療ガイドライン 2020. 東京 : 南江堂 ; 2020.
10) Sogawa M, Watanabe K, Egashira Y, et al. Precise endoscopic and pathologic features in a Crohn's disease case with two fistula-associated small bowel adenocarcinomas complicated by an anal canal adenocarcinoma. Intern Med 2013 ; 52 : 445-9.
11) 味岡洋一, 谷優佑, 高村佳緒里, 他. 炎症性発癌の病理診断と発癌機序. 病理と臨床. 2018 ; 36 : 1076-81.
12) Tanaka S, Kashida H, Saito Y, et al. Japan Gastroenterological Endoscopy Society guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc. 2020 ; 32 : 219-39.

72 CD狭窄病変に対する内視鏡的バルーン拡張術の適応と問題点は ?

P.378 掲載の参考文献
1) Yamamoto H, Sekine Y, Sato Y, et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc. 2001 ; 53 : 216-20.
2) Tsujikawa T, Saitoh Y, Andoh A, et al. Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine : preliminary experiences. Endoscopy. 2008 ; 40 : 11-5.
3) Hirai F, Andoh A, Ueno F, et al. Efficacy of endoscopic balloon dilation for small bowel strictures in patients with Crohn's disease : A nationwide, multi-centre, open-label, prospective cohort study. J Crohns Colitis. 2018 ; 12 : 394-401.
4) 潰瘍性大腸炎・クローン病診断基準・治療指針 令和2年度改訂版 「難治性炎症性腸管障害に関する調査研究」 (久松班) 令和2年度分担研究報告書. 2021年. 34頁.
5) Pelletier AL, Kalisazan B, Wienckiewicz J, et al. Infliximab treatment for symptomatic Crohn's disease strictures. Aliment Pharmacol Ther. 2009 ; 29 : 279-85.
6) Moroi R, Shiga H, Kuroha M, et al. Endoscopic radial incision and cutting for Crohn's Disease-associated intestinal stricture : a pilot study. Endosc Int Open. 2020 ; 8 : E81-6.

73 クローン病術後再発に対する適切な予防法や薬物治療法は ?

P.382 掲載の参考文献
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74 高齢発症炎症性腸疾患に対して非高齢発症例と同様の治療を行ってよいか ?

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75 Mediterranean fever ( MEFV ) 遺伝子関連腸炎と炎症性腸疾患の臨床所見・内視鏡所見・発症機序に違いはあるか ?

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76 好酸球性消化管疾患に対する免疫統御治療の選択と適応は ?

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77 がんゲノムパネル検査の適切なタイミングは ?

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