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Pancreatic Neoplasms: HELP
Articles by Shigeyuki Kawa
Based on 9 articles published since 2010
(Why 9 articles?)

Between 2010 and 2020, Shigeyuki Kawa wrote the following 9 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Guideline Clinical diagnostic criteria of IgG4-related sclerosing cholangitis 2012. 2012

Ohara, Hirotaka / Okazaki, Kazuichi / Tsubouchi, Hirohito / Inui, Kazuo / Kawa, Shigeyuki / Kamisawa, Terumi / Tazuma, Susumu / Uchida, Kazushige / Hirano, Kenji / Yoshida, Hitoshi / Nishino, Takayoshi / Ko, Shigeru B H / Mizuno, Nobumasa / Hamano, Hideaki / Kanno, Atsushi / Notohara, Kenji / Hasebe, Osamu / Nakazawa, Takahiro / Nakanuma, Yasuni / Takikawa, Hajime / Anonymous3940729 / Anonymous3950729 / Anonymous3960729 / Anonymous3970729. ·Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. hohara@med.nagoya-cu.ac.jp ·J Hepatobiliary Pancreat Sci · Pubmed #22717980.

ABSTRACT: BACKGROUND: IgG4-sclerosing cholangitis (IgG4-SC) patients have an increased level of serum IgG4, dense infiltration of IgG4-positive plasma cells with extensive fibrosis in the bile duct wall, and a good response to steroid therapy. However, it is not easy to distinguish IgG4-SC from primary sclerosing cholangitis, pancreatic cancer, and cholangiocarcinoma on the basis of cholangiographic findings alone because various cholangiographic features of IgG4-SC are similar to those of the above progressive or malignant diseases. METHODS: The Research Committee of IgG4-related Diseases and the Research Committee of Intractable Diseases of Liver and Biliary Tract in association with the Ministry of Health, Labor and Welfare, Japan and the Japan Biliary Association have set up a working group consisting of researchers specializing in IgG4-SC, and established the new clinical diagnostic criteria of IgG4-SC 2012. RESULTS: The diagnosis of IgG4-SC is based on the combination of the following 4 criteria: (1) characteristic biliary imaging findings, (2) elevation of serum IgG4 concentrations, (3) the coexistence of IgG4-related diseases except those of the biliary tract, and (4) characteristic histopathological features. Furthermore, the effectiveness of steroid therapy is an optional extra diagnostic criterion to confirm accurate diagnosis of IgG4-SC. CONCLUSION: These diagnostic criteria for IgG4-SC are useful in practice for general physicians and other nonspecialists.

2 Review Type 1 autoimmune pancreatitis. 2011

Zen, Yoh / Bogdanos, Dimitrios P / Kawa, Shigeyuki. ·Institute of Liver Studies, King's College Hospital and King's College London School of Medicine, Denmark Hill, London SE5 9RS, UK. yoh.zen@kcl.ac.uk ·Orphanet J Rare Dis · Pubmed #22151922.

ABSTRACT: Before the concept of autoimmune pancreatitis (AIP) was established, this form of pancreatitis had been recognized as lymphoplasmacytic sclerosing pancreatitis or non-alcoholic duct destructive chronic pancreatitis based on unique histological features. With the discovery in 2001 that serum IgG4 concentrations are specifically elevated in AIP patients, this emerging entity has been more widely accepted. Classical cases of AIP are now called type 1 as another distinct subtype (type 2 AIP) has been identified. Type 1 AIP, which accounts for 2% of chronic pancreatitis cases, predominantly affects adult males. Patients usually present with obstructive jaundice due to enlargement of the pancreatic head or thickening of the lower bile duct wall. Pancreatic cancer is the leading differential diagnosis for which serological, imaging, and histological examinations need to be considered. Serologically, an elevated level of IgG4 is the most sensitive and specific finding. Imaging features include irregular narrowing of the pancreatic duct, diffuse or focal enlargement of the pancreas, a peri-pancreatic capsule-like rim, and enhancement at the late phase of contrast-enhanced images. Biopsy or surgical specimens show diffuse lymphoplasmacytic infiltration containing many IgG4+ plasma cells, storiform fibrosis, and obliterative phlebitis. A dramatic response to steroid therapy is another characteristic, and serological or radiological effects are normally identified within the first 2 or 3 weeks. Type 1 AIP is estimated as a pancreatic manifestation of systemic IgG4-related disease based on the fact that synchronous or metachronous lesions can develop in multiple organs (e.g. bile duct, salivary/lacrimal glands, retroperitoneum, artery, lung, and kidney) and those lesions are histologically identical irrespective of the organ of origin. Several potential autoantigens have been identified so far. A Th2-dominant immune reaction and the activation of regulatory T-cells are assumed to be involved in the underlying immune reaction. IgG4 antibodies have two unique biological functions, Fab-arm exchange and a rheumatoid factor-like activity, both of which may play immune-defensive roles. However, the exact role of IgG4 in this disease still remains to be clarified. It seems important to recognize this unique entity given that the disease is treatable with steroids.

3 Article Promoter hypomethylation of SKI in autoimmune pancreatitis. 2018

Kinugawa, Yasuhiro / Uehara, Takeshi / Matsuda, Kazuyuki / Kobayashi, Yukihiro / Nakajima, Tomoyuki / Hamano, Hideaki / Kawa, Shigeyuki / Higuchi, Kayoko / Hosaka, Noriko / Shiozawa, Satoshi / Ishigame, Hiroki / Nakamura, Toshitsugu / Maruyama, Yasuhiro / Nakazawa, Koh / Nakaguro, Masato / Sano, Kenji / Ota, Hiroyoshi. ·Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan. · Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: tuehara@shinshu-u.ac.jp. · Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan. · Internal Medicine, Matsumoto Dental University, Shiojiri, Japan. · Department of Pathology, Aizawa Hospital, Matsumoto, Japan. · Department of Pathology, Nagano Municipal Hospital, Nagano, Japan. · Department of Pathology, Saku Central Hospital, Saku, Japan. · Department of Pathology, Suwa Red Cross Hospital, Suwa, Japan. · Department of Clinical Laboratory, National Hospital Organization, Matsumoto Medical Center, Matsumoto Hospital, Matsumoto, Japan. · Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan. · Department of Pathology, Iida Municipal Hospital, Iida, Japan. · Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Department of Biomedical Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan. ·Pathol Res Pract · Pubmed #29534839.

ABSTRACT: The relationship between methylation abnormality and autoimmune pancreatitis (AIP)-a representative IgG4-related disease-has not yet been elucidated. We identified SKI might have a significant methylation abnormality in AIP through methylation array analysis using the Illumina Infinium Human Methylation 450K BeadChip array, and investigated the relationship of SKI with AIP clinicopathological features. The methylation rate of SKI was assessed by quantitative SYBR green methylation-specific PCR, and the degree of SKI expression in tissue specimens was assessed by immunohistochemistry in 10 AIP cases, 14 cases of obstructive pancreatitis area in pancreatic ductal adenocarcinoma (PDA) without a history of AIP, and 9 normal pancreas (NP) cases. The SKI methylation ratio was significantly lower in AIP than in PDA and NP. Additionally, the immunohistochemical staining-index (SI) score for SKI was significantly higher in AIP than NP, although there was no significant difference between AIP and PDA. There was a strong negative correlation between SI score and SKI methylation ratio, and between the serum concentrations of IgG4 and the SKI methylation ratio. There was a moderate positive correlation between the serum concentrations of IgG4 and SI. SKI is thought to be an oncogene indicating that SKI hypomethylation and carcinogenesis might be linked to AIP. Furthermore, the correlation between serum concentrations of IgG4 and SKI methylation levels suggest SKI might be involved in the pathogenesis of AIP. However, the role of SKI has not been clearly elucidated. Further studies are needed to understand further the function of SKI.

4 Article Methylation of Tumor Suppressor Genes in Autoimmune Pancreatitis. 2017

Kinugawa, Yasuhiro / Uehara, Takeshi / Sano, Kenji / Matsuda, Kazuyuki / Maruyama, Yasuhiro / Kobayashi, Yukihiro / Nakajima, Tomoyuki / Hamano, Hideaki / Kawa, Shigeyuki / Higuchi, Kayoko / Hosaka, Noriko / Shiozawa, Satoshi / Ishigame, Hiroki / Ota, Hiroyoshi. ·From the *Department of Laboratory Medicine, and †Department of Gastroenterology, Shinshu University School of Medicine; ‡Center for Health, Safety, and Environmental Management, Shinshu University; §Department of Pathology, Aizawa Hospital, Matsumoto; ∥Department of Pathology, Nagano Municipal Hospital, Nagano; ¶Department of Pathology, Saku Central Hospital, Saku; and #Department of Biomedical Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan. ·Pancreas · Pubmed #28196014.

ABSTRACT: OBJECTIVES: Autoimmune pancreatitis (AIP) is a representative IgG4-related and inflammatory disease of unknown etiology. To clarify mechanisms of carcinogenesis resulting from AIP, we focused on methylation abnormalities and KRAS mutations in AIP. METHODS: Six tumor suppressor genes (NPTX2, Cyclin D2, FOXE1, TFPI2, ppENK, and p16) that exhibited hypermethylation in pancreatic carcinoma were selected for quantitative SYBR green methylation-specific polymerase chain reaction in 10 AIP specimens, 10 pancreatic adenocarcinoma cases without history of AIP containing carcinoma areas (CAs) and noncarcinoma areas (NCAs), and 11 normal pancreas (NP) samples. KRAS mutation in codons 12, 13, and 61 were also investigated using direct sequencing. RESULTS: Hypermethylation events (≥10%) were identified in NPTX2, Cyclin D2, FOXE1, TFPI2, ppENK, and p16 in 1, 2, 2, 0, 2, and 0 CA cases, respectively, but not in these 6 candidate genes in AIP, NCA, and NP. However, the TFPI2 methylation ratio was significantly higher in AIP than NCA and NP. Direct sequencing results for KRAS showed no single-point mutations in AIP. CONCLUSIONS: These are the first studies characterizing methylation abnormalities in AIP. AIP's inflammatory condition may be related to carcinogenesis. Further study will elucidate methylation abnormalities associated with carcinogenesis in AIP.

5 Article Association Between Immunoglobulin G4-related Disease and Malignancy within 12 Years after Diagnosis: An Analysis after Longterm Followup. 2015

Asano, Junpei / Watanabe, Takayuki / Oguchi, Takaya / Kanai, Keita / Maruyama, Masahiro / Ito, Tetsuya / Muraki, Takashi / Hamano, Hideaki / Arakura, Norikazu / Matsumoto, Akihiro / Kawa, Shigeyuki. ·From the Department of Gastroenterology, the Endoscopic Examination Center, and the Center for Health, Safety, and Environmental Management, Shinshu University School of Medicine, Matsumoto, Japan.J. Asano, MD, Department of Gastroenterology, Shinshu University School of Medicine; T. Watanabe, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Oguchi, MD, Department of Gastroenterology, Shinshu University School of Medicine; K. Kanai, MD, Department of Gastroenterology, Shinshu University School of Medicine; M. Maruyama, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Ito, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Muraki, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; H. Hamano, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; N. Arakura, MD, PhD, Endoscopic Examination Center, Shinshu University School of Medicine; A. Matsumoto, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; S. Kawa, MD, PhD, Center for Health, Safety, and Environmental Management, Shinshu University. ·J Rheumatol · Pubmed #26472416.

ABSTRACT: OBJECTIVE: Because it is uncertain whether immunoglobulin G4-related disease (IgG4-RD) is associated with malignancy, we evaluated the incidence of cancer development in a large cohort of patients with IgG4-RD. METHODS: The study enrolled 158 patients diagnosed as having IgG4-RD between 1992 and 2012. We calculated the standardized incidence ratio (SIR) and cumulative rate of malignancies in this group and searched for risk factors associated with the occurrence of tumors. RESULTS: A total of 34 malignancies were observed in the patients with IgG4-RD over a mean followup period of 5.95 ± 4.48 years. The overall SIR of malignancies was 2.01 (95% CI 1.34-2.69). The SIR of patients who exhibited a tumor within 1 year after IgG4-RD diagnosis was 3.53 (95% CI 1.23-5.83), while that of subjects forming a malignancy in subsequent years was 1.48 (95% CI 0.99-1.98). The cumulative rate of malignancy development was significantly higher in patients with IgG4-RD within 12 years after diagnosis than in the Japanese general population. Comparable results were obtained for an autoimmune pancreatitis subgroup. The serum concentrations of several disease activity markers at diagnosis were significantly higher in patients with malignancies than in those without. CONCLUSION: We identified a close association between IgG4-RD and malignancy formation within 12 years after diagnosis, particularly during the first year. An active IgG4-RD state is presumed to be a strong risk factor for malignancy development.

6 Article Comparison of histopathological features of pancreatic carcinoma and type 1 autoimmune pancreatitis. 2014

Uehara, Takeshi / Hamano, Hideaki / Kawa, Shigeyuki / Kobayashi, Yukihiro / Yoshizawa, Akihiko / Oki, Keiko / Nakata, Rie / Kobayashi, Akira / Sano, Kenji / Ota, Hiroyoshi. ·Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan. ·Pathol Int · Pubmed #24629172.

ABSTRACT: Type 1 autoimmune pancreatitis (AIP-1) is an immunoglobulin G (IgG)-4-related disease (IgG4-RD), characterized by elevated serum immunoglobulin G4 (IgG4) and infiltration by IgG4(+) plasma cells. Pancreatic carcinoma (PC) sometimes shows infiltration by IgG4(+) plasma cells, but details have been unclear. We compared pathological findings and expression of IgG4 and IgG in fibroses in 18 PC patients to those from 9 AIP-1 patients. Fibroses were divided into areas of ductal adenocarcinoma (DA) and obstructive pancreatitis (OP). Serum IgG4 levels were lower than the cut-off value in all PC patients with no IgG4-RD. Diffuse lymphoplasmacytic infiltration and eosinophil infiltration were characteristic of fibroses in PC. Though AIP-1 samples often had storiform fibrosis even in biopsies, PC did not show storiform fibrosis. Ratios of IgG4(+) plasma cells/IgG(+) plasma cells (IgG4/IgG ratios) in DA and OP were significantly lower than in AIP-1. However, high-density IgG4(+) plasma cell foci were detected in PC fibroses, particularly around peripheral nerves, vessels, and lymphoid follicles; between lobules and invasion fronts; and within neutrophilic abscesses. In conclusion, the IgG4/IgG ratio is useful in distinguishing PC from AIP-1, and should be evaluated in three or more areas, as PC can show localized high-density IgG4(+) plasma cell areas.

7 Article Long-term outcomes of autoimmune pancreatitis: a multicentre, international analysis. 2013

Hart, Phil A / Kamisawa, Terumi / Brugge, William R / Chung, Jae Bock / Culver, Emma L / Czakó, László / Frulloni, Luca / Go, Vay Liang W / Gress, Thomas M / Kim, Myung-Hwan / Kawa, Shigeyuki / Lee, Kyu Taek / Lerch, Markus M / Liao, Wei-Chih / Löhr, Matthias / Okazaki, Kazuichi / Ryu, Ji Kon / Schleinitz, Nicolas / Shimizu, Kyoko / Shimosegawa, Tooru / Soetikno, Roy / Webster, George / Yadav, Dhiraj / Zen, Yoh / Chari, Suresh T. ·Division of Gastroenterology and Hepatology, Mayo Clinic, , Rochester, Minnesota, USA. ·Gut · Pubmed #23232048.

ABSTRACT: OBJECTIVE: Autoimmune pancreatitis (AIP) is a treatable form of chronic pancreatitis that has been increasingly recognised over the last decade. We set out to better understand the current burden of AIP at several academic institutions diagnosed using the International Consensus Diagnostic Criteria, and to describe long-term outcomes, including organs involved, treatments, relapse frequency and long-term sequelae. DESIGN: 23 institutions from 10 different countries participated in this multinational analysis. A total of 1064 patients meeting the International Consensus Diagnostic Criteria for type 1 (n=978) or type 2 (n=86) AIP were included. Data regarding treatments, relapses and sequelae were obtained. RESULTS: The majority of patients with type 1 (99%) and type 2 (92%) AIP who were treated with steroids went into clinical remission. Most patients with jaundice required biliary stent placement (71% of type 1 and 77% of type 2 AIP). Relapses were more common in patients with type 1 (31%) versus type 2 AIP (9%, p<0.001), especially those with IgG4-related sclerosing cholangitis (56% vs 26%, p<0.001). Relapses typically occurred in the pancreas or biliary tree. Retreatment with steroids remained effective at inducing remission with or without alternative treatment, such as azathioprine. Pancreatic duct stones and cancer were uncommon sequelae in type 1 AIP and did not occur in type 2 AIP during the study period. CONCLUSIONS: AIP is a global disease which uniformly displays a high response to steroid treatment and tendency to relapse in the pancreas and biliary tree. Potential long-term sequelae include pancreatic duct stones and malignancy, however they were uncommon during the study period and require additional follow-up. Additional studies investigating prevention and treatment of disease relapses are needed.

8 Article Characteristic magnetic resonance features of focal autoimmune pancreatitis useful for differentiation from pancreatic cancer. 2012

Sugiyama, Yukiko / Fujinaga, Yasunari / Kadoya, Masumi / Ueda, Kazuhiko / Kurozumi, Masahiro / Hamano, Hideaki / Kawa, Shigeyuki. ·Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan. ysgym@shinshu-u.ac.jp ·Jpn J Radiol · Pubmed #22237599.

ABSTRACT: PURPOSE: To identify characteristic magnetic resonance (MR) features of focal autoimmune pancreatitis (f-AIP) useful for differentiation from pancreatic cancer (PC). METHODS: We retrospectively analyzed MR imaging findings of 20 f-AIP lesions and 40 PC lesions smaller than 40 mm in diameter. On fat-suppressed T2-weighted images and dynamic contrast-enhanced fat-suppressed T1-weighted images (DCE-T1WI), we classified MR features of internal signal intensity for each lesion into homogeneous, speckled, or target type. We assessed the sensitivity, specificity, and accuracy of these findings in the diagnosis of f-AIP. We also investigated the incidence of previously reported findings for differentiation between f-AIP and PC. RESULTS: Speckled enhancement within a hypointense or isointense lesion on pancreatic phase DCE-T1WI (speckled type) was observed more frequently in f-AIP than in PC, with high sensitivity, high specificity, and high accuracy. Hypointensity to hyperintensity surrounding a less enhanced focal area on DCE-T1WIs (target type) and upper stream main pancreatic duct dilatation were observed more frequently in PC than in f-AIP. CONCLUSION: Speckled enhancement inside an f-AIP lesion on pancreatic phase DCE-T1WI was useful for differentiation from PC.

9 Article [Basic and clinical studies for IgG4 measurement by nephelometric immunoassay]. 2010

Kameko, Mitsuaki / Kitamura, Hirofumi / Kawa, Shigeyuki / Hamano, Hideaki / Arai, Jirou. ·Clinical Laboratory, Nagano Municipal Hospital, Nagano 381-8551, Japan. kameko@hospital.nagano.nagano.jp ·Rinsho Byori · Pubmed #20496768.

ABSTRACT: After 2001, many reports have shown that serum IgG4 levels specifically elevate in patients with autoimmune pancreatitis (AIP), suggesting its clinical usefulness in discrimination between AIP and pancreatic cancer. To confirm this, we tried to examine a utility of IgG4 by measuring serum IgG4 levels of patients with healthy human, AIP, chronic pancreatitis, pancreatic cancer and autoimmune disease with nephelometric immunoassay (NIA). The between-assay variation (with coefficient of variation (CV)) in the IgG4 measurement and the within-assay variation were 0.3-3.2% and 1.9-4.5%, respectively. The analytical error was small as shown in 2.9%. Reference range of men and women was 5.6-117.2 mg/dl and 4.3-94.0 mg/dl, respectively, and men showed higher level than women significantly (p<0.05). The median IgG4 level (247.0 mg/dl) of patients with AIP showed significantly high level (p<0.01) compared with each patient group of a chronic pancreatitis (45.0 mg/dl), that of pancreatic cancer (59.6 mg/dl) and that of the autoimmune diseases (54.5 mg/dl). In discrimination between AIP and pancreatic cancer, we found excellent clinical utility showing sufficient sensibility (87.0%) and specificity (93.3%). As a result, we think the measurement of IgG4 is useful for the diagnosis of AIP. However, more popular assay system, such as immunoturbidimetry, will be needed for IgG4 measurement to be prevalent more widely.