研究等業績 - その他 - 羽渕　友則

腎移植患者におけるタクロリムス変動係数と服薬アドヒアランス、拒絶反応との関連性

山本 竜平, 齋藤 満, 藤山 信弘, 奈良 健平, 神田 壮平, 沼倉 一幸, 鶴田 大, 成田 伸太郎, 井上 高光, 佐藤 滋, 羽渕 友則

移植 ( (一社)日本移植学会 )  52 ( 総会臨時 ) 370 - 370   2017年08月

Inhibition of the RANK/RANKL signaling with osteoprotegerin prevents castration-induced acceleration of bone metastasis in castration-insensitive prostate cancer

Takayama K.

Cancer Letters ( Cancer Letters )  397   103 - 110   2017年07月

Androgen deprivation therapy (ADT) for patients with metastatic or locally advanced prostate cancer reduces bone mineral density by stimulating receptor activator of nuclear factor kappa-B (RANK) signaling in osteoclasts. The involvement of the RANK/RANKL signaling in ADT-induced acceleration of bone metastasis in castration-insensitive prostate cancer was examined in a murine model using osteoprotegerin (OPG). Male Balb/c nude mice were divided into three groups: the non-castration, castration, and castration + OPG groups. PC-3M-luc-C6 was injected into the left ventricle of the mice. Recombinant OPG was injected intravenously twice weekly in the castration + OPG group. In-vivo imaging system (IVIS®) determined that the prevalence and photon counts of bone metastasis in the castration group were significantly higher than that in the non-castration and castration + OPG groups. The mean number of RANKL-positive osteoblasts and the mean serum RANKL level in the castration group were significantly higher than those in the non-castration group. RANKL-enhanced activation of osteoclasts was attenuated in the castration + OPG group. These results suggest that the mechanisms of RANK/RANKL signaling are involved in the ADT-induced acceleration of bone metastasis in castration-insensitive prostate cancer.

DOI PubMed

SunitinibおよびN-desethyl-sunitinibの血中濃度の測定による治療薬物モニタリングと治療効果に関する検討

沼倉 一幸, 藤山 信広, 鶴田 大, 前野 淳, 成田 伸太郎, 井上 高光, 佐藤 滋, 新岡 丈典, 三浦 昌朋, 羽渕 友則

腎癌研究会会報 ( (一社)腎癌研究会 )  ( 47 ) 32 - 32   2017年07月

【泌尿器腹腔鏡技術認定取得に向けて:各術式のポイントと手術手技】泌尿器腹腔鏡技術認定医に求められるポイント

羽渕 友則

泌尿器外科 ( 医学図書出版(株) )  30 ( 7 ) 1099 - 1105   2017年07月

2004年に日本内視鏡外科学会技術認定制度に歩調を合わせて始まった泌尿器腹腔鏡技術認定制度では、現在、腎摘除術、副腎摘除術および腎盂形成術の無編集ビデオにおいて審査を行うこととし、その審査項目を定義している。本項では、泌尿器腹腔鏡技術認定医として求められるポイントをできるかぎり簡潔に記すこととする。技術認定制度の審査が非常に細かく厳しすぎる、とのご批判もあるが、長年、泌尿器腹腔鏡を数多く経験された先生方が、「いかに安全に手術を遂行するか」という観点から築いてきた基準を基にしており、十分理解して安全な腹腔鏡手術に役立てていただきたい。(著者抄録)

分子標的薬時代の転移性腎癌における一次転移臓器別の予後解析

井上 高光, 高山 孝一朗, 喜早 祐介, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 成田 伸太郎, 佐藤 滋, 羽渕 友則

腎癌研究会会報 ( (一社)腎癌研究会 )  ( 47 ) 42 - 42   2017年07月

腎移植後のメタボリックシンドローム予防 効果的な栄養指導方法の検討

高橋 真子, 安藤 雪, 石黒 なつ美, 齋藤 満, 佐藤 滋, 羽渕 友則

日本臨床腎移植学会雑誌 ( (一社)日本臨床腎移植学会 )  5 ( 1 ) 62 - 65   2017年07月

【研究目的】当院では2010年にメタボリックシンドローム(メタボ)対策として移植後1ヵ月の時点で管理栄養士による栄養指導と、病棟看護師によるメタボ予防指導を開始したが、移植後定期入院時に体重増加している患者がいまだに多い。腎移植患者の栄養指導導入前後のメタボの現状と病棟看護師によるメタボ予防指導の実態を明らかにし、効果的な栄養指導方法について検討する。【方法】2004〜2014年に腎移植を受けた患者201名の栄養指導導入前後の体重増加率とBMIを比較した。病棟看護師21名への栄養指導方法に関する質問紙調査を行った。【結果】体重増加率、BMIともに栄養指導導入前後で有意差はみられず、栄養指導導入後の改善はみられなかった。病棟看護師への質問紙調査では、指導方法や内容にばらつきがあることが判明した。【結論】効果的な栄養指導ができていないため、改訂した退院指導パンフレットを使用し、継続的なメタボ予防指導を行っていく必要がある。(著者抄録)

転移性腎癌患者における1st-line Sunitinib療法とAxitinib療法とのアウトカムの比較検討

喜早 祐介, 井上 高光, 高山 孝一朗, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 羽渕 友則

腎癌研究会会報 ( (一社)腎癌研究会 )  ( 47 ) 36 - 36   2017年07月

Overall survival of first-line axitinib in metastatic renal cell carcinoma: Japanese subgroup analysis from phase II study

Oya M.

Cancer Science ( Cancer Science )  108 ( 6 ) 1231 - 1239   2017年06月

Subgroup analyses of a randomized global phase II study of axitinib showed objective response rate of 66% and median progression-free survival of 27.6 months in treatment-naïve Japanese patients with metastatic renal cell carcinoma (RCC). This analysis evaluated overall survival (OS) and safety in 44 Japanese patients and compared the results with 169 non-Japanese patients. In addition, baseline characteristics for predictive factors that may influence OS in first-line metastatic RCC were explored in all patients using a Cox proportional hazard model. With median follow-up of 33 months, fewer than half (16 of 44) of the Japanese patients had died and median OS was not reached (95% confidence interval [CI], 38.8 months-not estimable), whereas 107 of 169 (63%) non-Japanese patients had died and median OS was 33.9 months (95% CI, 28.9-42.7). Estimated 1-year, 2-year and 3-year survival probability (95% CI) was 86.4% (76.2-96.5), 75.0% (62.2-87.8) and 68.2% (54.4-81.9), respectively, in Japanese patients, and was higher than that in non-Japanese patients (75.1% [68.4-81.8], 62.1% [54.5-69.7] and 47.2% [39.3-55.1], respectively). The updated safety analysis did not reveal any new adverse events of concern among Japanese or non-Japanese patients. The multivariate analysis identified that lower baseline Eastern Cooperative Oncology Group performance status, lower baseline tumor burden, and longer time from histopathological diagnosis to treatment were significant positive predictors of OS. The current analysis confirmed the clinical activity of axitinib in treatment-naïve Japanese patients with metastatic RCC, with an acceptable toxicity profile.

DOI PubMed

嫌色素性腎細胞癌を合併した結節性硬化症の1例

奈良 健平, 成田 伸太郎, 関根 悠哉, 石田 雅宣, 五十嵐 龍馬, 沼倉 一幸, 鶴田 大, 前野 淳, 斎藤 満, 井上 高光, 羽渕 友則, 沢石 由記夫, 小原 崇

日本小児血液・がん学会雑誌 ( (一社)日本小児血液・がん学会 )  54 ( 2 ) 184 - 185   2017年06月

Inverse relationship between insulin receptor expression and progression in renal cell carcinoma

Takahashi M.

Oncology Reports ( Oncology Reports )  37 ( 5 ) 2929 - 2941   2017年05月

We investigated the relationship among serum insulin level, insulin receptor (IR) expression in renal cell carcinoma (RCC), and outcomes in patients with RCC who underwent nephrectomy. We also explored the role of insulin signaling in RCC progression in a murine RCC allograft RENCA model using metformin to treat hyperinsulinemia induced by a high-carbohydrate diet. Clinically, the IR expression level in RCC tissue was significantly lower in patients with tumor stage pT2-4 and/or distant metastases. The IR expression level in RCC tissue was significantly lower in patients with preoperative serum C-peptide levels greater than or equal to the median than in patients with levels less than the median. High IR expression level was significantly associated with better disease-free and overall survival after nephrectomy. The IR expression level was significantly higher in murine subcutaneous flank tumors of the low-carbohydrate diet group and high-carbohydrate diet plus metformin group than of the high‑carbohydrate diet group. In vivo progression of murine tumors was not significantly enhanced by hyperinsulinemia induced by a high-carbohydrate diet and was significantly inhibited by metformin in both the low- and high‑carbohydrate diet groups. IR expression in RCC tissue was inversely associated with cancer progression in the clinical and murine experimental model studies. The clinical and murine allograft model study results suggested that hyperinsulinemia does not promote RCC progression. Decreased IR expression in high‑stage RCC tumors with poor prognosis may be the result of downregulation induced by the host's hyperinsulinemia.

DOI PubMed

ロボット支援腎部分切除術 初期経験における留意点 秋田大学におけるロボット支援腎部分切除術の初期経験と留意点

井上 高光, 成田 伸太郎, 齋藤 満, 沼倉 一幸, 鶴田 大, 前野 淳, 佐藤 滋, 羽渕 友則

泌尿器外科 ( 医学図書出版(株) )  30 ( 臨増 ) 813 - 816   2017年05月

前立腺癌バイオマーカーのパラダイムシフト 遺伝子多型を用いた進行前立腺癌の予後・治療反応予測

成田 伸太郎, 土谷 順彦, 羽渕 友則

泌尿器外科 ( 医学図書出版(株) )  30 ( 臨増 ) 675 - 677   2017年05月

当院における腎癌肝転移に対する肝動脈塞栓療法の治療成績

五十嵐 龍馬, 前野 淳, 成田 伸太郎, 井上 高光, 齋藤 満, 鶴田 大, 沼倉 一幸, 佐藤 滋, 羽渕 友則

泌尿器外科 ( 医学図書出版(株) )  30 ( 臨増 ) 903 - 903   2017年05月

根治術不能な上部尿路癌に対する原発巣への放射線外照射療法の検討

高山 孝一朗, 成田 伸太郎, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 羽渕 友則

泌尿器外科 ( 医学図書出版(株) )  30 ( 臨増 ) 926 - 926   2017年05月

泌尿器科医の腎移植ことはじめ 生体腎移植における腹腔鏡下移植用腎採取術およびレシピエント手術の要点

井上 高光, 齋藤 満, 山本 竜平, 沼倉 一幸, 鶴田 大, 前野 淳, 成田 伸太郎, 佐藤 滋, 羽渕 友則

泌尿器外科 ( 医学図書出版(株) )  30 ( 臨増 ) 799 - 801   2017年05月

秋田大学における転移性腎細胞癌に対するPazopanibの使用経験

喜早 祐介, 井上 高光, 五十嵐 龍馬, 沼倉 一幸, 鶴田 大, 齋藤 満, 前野 淳, 成田 伸太郎, 佐藤 滋, 羽渕 友則

泌尿器外科 ( 医学図書出版(株) )  30 ( 臨増 ) 908 - 908   2017年05月

腎移植の現状と展望 高齢者腎移植の現状と展望

齋藤 満, 佐藤 滋, 羽渕 友則

日本透析医学会雑誌 ( (一社)日本透析医学会 )  50 ( Suppl.1 ) 348 - 348   2017年05月

血液透析患者の転移性腎細胞癌に対する分子標的薬治療の経験

奈良 健平, 成田 伸太郎, 関根 悠哉, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則

日本透析医学会雑誌 ( (一社)日本透析医学会 )  50 ( Suppl.1 ) 710 - 710   2017年05月

Clinical implications of serum N-glycan profiling as a diagnostic and prognostic biomarker in germ-cell tumors

Narita T.

Cancer Medicine ( Cancer Medicine )  6 ( 4 ) 739 - 748   2017年04月

Serum biomarker monitoring is essential for management of germ-cell tumors (GCT). However, not all GCT are positive for conventional tumor markers. We examined whether serum N-glycan-based biomarkers can be applied for detection and prognosis in patients with GCT. We performed a comprehensive N-glycan structural analysis of sera from 54 untreated GCT patients and 103 age-adjusted healthy volunteers using glycoblotting methods and mass spectrometry. Candidate N-glycans were selected from those with the highest association; cutoff concentration values were established, and an N-glycan score was created based on the number of positive N-glycans present. The validity of this score for diagnosis and prognosis was analyzed using a receiver operating characteristic (ROC) curve. We identified five candidate N-glycans significantly associated with GCT patients. The accuracy of the N-glycan score for GCT was significant with an area-under-the-curve (AUC) value of 0.87. Diagnostically, the N-glycan score detected 10 of 12 (83%) patients with negative conventional tumor markers. Prognostically, the N-glycan score comprised four candidate N-glycans. The predictive value of the prognostic N-glycan score was significant, with an AUC value of 0.89. A high value prognostic N-glycan score was significantly associated with poor prognosis. Finally, to identify a potential carrier protein, immunoglobulin (Ig) fractions of sera were subjected to N-glycan analysis and compared to whole sera. Candidate N-glycans in Ig-fractions were significantly decreased; therefore, the carrier protein for candidate N-glycans is likely not an immunoglobulin. In summary, our newly developed N-glycan score seems to be a practical diagnostic and prognostic method for GCT.

DOI PubMed

Scientific skill assessment of basic surgical dissection and overall laparoscopic performance

Matsuda T.

Journal of Endourology ( Journal of Endourology )  31 ( S1 ) S25 - S29   2017年04月

To improve surgical education, objective and scientific skill assessments are required. There are two types of skill evaluations: assessments of basic surgical skills and assessments of overall surgical performance. To establish a reliable assessment method for surgical dissection, we measured the force applied on the tip of a surgical instrument during dissection of the renal vessels of pigs. The experiments revealed that, during surgical dissection, expert laparoscopic surgeons applied vertical force at the beginning of the stroke and then horizontal force, with minimum vertical force, at the end of the stroke. As an assessment of overall surgical performance, the Endoscopic Surgical Qualification system was developed and has been used for 12 years in Japan. More than 3700 surgeons, including urologists, were determined to have appropriate laparoscopic surgical skills after assessments of unedited videos by referees.

DOI PubMed