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Pancreatic Neoplasms: HELP
Articles by Hirotaka Ohara
Based on 15 articles published since 2010
(Why 15 articles?)
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Between 2010 and 2020, Hirotaka Ohara wrote the following 15 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 Role of endoscopy in the diagnosis of autoimmune pancreatitis and immunoglobulin G4-related sclerosing cholangitis. 2014

Kamisawa, Terumi / Ohara, Hirotaka / Kim, Myung Hwan / Kanno, Atsushi / Okazaki, Kazuichi / Fujita, Naotaka. ·Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. ·Dig Endosc · Pubmed #24712522.

ABSTRACT: Autoimmune pancreatitis (AIP) must be differentiated from pancreatic carcinoma, and immunoglobulin (Ig)G4-related sclerosing cholangitis (SC) from cholangiocarcinoma and primary sclerosing cholangitis (PSC). Pancreatographic findings such as a long narrowing of the main pancreatic duct, lack of upstream dilatation, skipped narrowed lesions, and side branches arising from the narrowed portion suggest AIP rather than pancreatic carcinoma. Cholangiographic findings for PSC, including band-like stricture, beaded or pruned-tree appearance, or diverticulum-like outpouching are rarely observed in IgG4-SC patients, whereas dilatation after a long stricture of the bile duct is common in IgG4-SC. Transpapillary biopsy for bile duct stricture is useful to rule out cholangiocarcinoma and to support the diagnosis of IgG4-SC with IgG4-immunostaining. IgG4-immunostaining of biopsy specimens from the major papilla advances a diagnosis of AIP. Contrast-enhanced endoscopic ultrasonography (EUS) and EUS elastography have the potential to predict the histological nature of the lesions. Intraductal ultrasonographic finding of wall thickening in the non-stenotic bile duct on cholangiography is useful for distinguishing IgG4-SC from cholangiocarcinoma. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is widely used to exclude pancreatic carcinoma. To obtain adequate tissue samples for the histological diagnosis of AIP, EUS-Tru-cut biopsy or EUS-FNA using a 19-gauge needle is recommended, but EUS-FNA with a 22-gauge needle can also provide sufficient histological samples with careful sample processing after collection and rapid motion of the FNA needles within the pancreas. Validation of endoscopic imaging criteria and new techniques or devices to increase the diagnostic yield of endoscopic tissue sampling should be developed.

3 Article Clinical features of acute obstructive suppurative pancreatic ductitis: A retrospective review of 20 cases. 2016

Kondo, Hiromu / Naitoh, Itaru / Okumura, Fumihiro / Nakazawa, Takahiro / Hayashi, Kazuki / Miyabe, Katsuyuki / Shimizu, Shuya / Nishi, Yuji / Yoshida, Michihiro / Umemura, Shuichiro / Hori, Yasuki / Kato, Akihisa / Ohara, Hirotaka / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. · Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan. · Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. ·J Gastroenterol Hepatol · Pubmed #26840231.

ABSTRACT: BACKGROUND AND AIMS: The clinical features of acute obstructive suppurative pancreatic ductitis (AOSPD) have not been elucidated. We aimed to clarify the clinical features of AOSPD. METHODS: We retrospectively reviewed the clinical features of 20 patients with AOSPD at two tertiary referral centers between 1993 and 2012. We compared 17 AOSPD patients with chronic pancreatitis (CP) and 42 patients with acute-on-CP in terms of clinical characteristics, presentation, and laboratory and imaging findings. RESULTS: The etiology of AOSPD involved CP in 17 (85%) patients, pancreatic ductal adenocarcinoma in 2 (10%), and intraductal papillary mucinous neoplasm in 1 (5%). Endoscopic pancreatic drainage was effective in 19 (95%) patients. Body temperature was significantly higher in AOSPD with CP than acute-on-CP patients (median: 38.2 vs 36.9 °C; P < 0.001). Serum amylase levels at onset were significantly lower (median: 133 vs 364.5 U/L; P = 0.009), and C-reactive protein was significantly higher (median: 9.42 vs 1.06 mg/dL; P < 0.001) in AOSPD with CP patients. Enlargement of the pancreatic parenchyma (18 vs 93%; P < 0.001) and stranding of the surrounding fat (12 vs 93%; P < 0.001) on computed tomography were observed less frequently in patients with AOSPD with CP patients. The diameter of the main pancreatic duct was significantly greater in AOSPD with CP than acute-on-CP patients (median: 7 vs 5 mm; P = 0.006). CONCLUSIONS: The major etiology of AOSPD involved CP, and endoscopic pancreatic drainage was effective. The clinical features differ between AOSPD with CP and acute-on-CP.

4 Article Predictive factors for positive diagnosis of malignant biliary strictures by transpapillary brush cytology and forceps biopsy. 2016

Naitoh, Itaru / Nakazawa, Takahiro / Kato, Akihisa / Hayashi, Kazuki / Miyabe, Katsuyuki / Shimizu, Shuya / Kondo, Hiromu / Nishi, Yuji / Yoshida, Michihiro / Umemura, Shuichiro / Hori, Yasuki / Kuno, Toshiya / Takahashi, Satoru / Ohara, Hirotaka / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences. · Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences. · Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. ·J Dig Dis · Pubmed #26717051.

ABSTRACT: OBJECTIVE: The diagnostic yields of endoscopic transpapillary brush cytology and forceps biopsies for malignant biliary strictures (MBS) remain unclear and predictive factors for diagnosis have not been established. We aimed to clarify the diagnostic yields of both methods and the predictive factors METHODS: We reviewed 241 patients with biliary strictures who underwent transpapillary brush cytology (n = 202) or forceps biopsy (n= 208) between 2004 and 2014 at a single academic center. RESULTS: The sensitivity of forceps biopsy for MBS was significantly higher than that of brush cytology [60.6% (97/160) vs 36.1% (57/158), P < 0.01). The sensitivity of forceps biopsy was significantly higher in diagnosing bile duct cancer than pancreatic cancer [78.8% (52/66) vs 42.4% (28/66), P < 0.01). Multivariate analysis revealed that serum total bilirubin (TB) level (T-Bil) ≥ 4 mg/dL [odds ratio (OR) 2.506, 95% confidence interval (CI): 1.139-5.495, P = 0.022) was an independent predictor for positive diagnosis by brush cytology, while bile duct cancer (OR 4.926, 95% CI 2.183-11.111, P < 0.001), stricture length ≥ 30 mm (OR 2.941, 95% CI 1.119-7.752, P = 0.029) and TB ≥ 4 mg/dL (OR 2.252, 95% CI 1.052-4.831, P = 0.037) were significant indicators of a positive diagnosis by forceps biopsy. CONCLUSIONS: Endoscopic transpapillary forceps biopsy shows higher sensitivity than that of brush cytology for MBS. Bile duct cancer, stricture length ≥ 30 mm and TB ≥ 4 mg/dL are good indicators of forceps biopsy.

5 Article Chemopreventive effect of resveratrol and apocynin on pancreatic carcinogenesis via modulation of nuclear phosphorylated GSK3β and ERK1/2. 2015

Kato, Akihisa / Naiki-Ito, Aya / Nakazawa, Takahiro / Hayashi, Kazuki / Naitoh, Itaru / Miyabe, Katsuyuki / Shimizu, Shuya / Kondo, Hiromu / Nishi, Yuji / Yoshida, Michihiro / Umemura, Shuichiro / Hori, Yasuki / Mori, Toshio / Tsutsumi, Masahiro / Kuno, Toshiya / Suzuki, Shugo / Kato, Hiroyuki / Ohara, Hirotaka / Joh, Takashi / Takahashi, Satoru. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. · Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. · Radioisotope Research Center, Nara Medical University School of Medicine, Kashihara, Nara, Japan. · Department of Pathology, Saiseikai Chuwa Hospital, Sakurai, Nara, Japan. · Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. ·Oncotarget · Pubmed #26556864.

ABSTRACT: Despite progress in clinical cancer medicine in multiple fields, the prognosis of pancreatic cancer has remained dismal. Recently, chemopreventive strategies using phytochemicals have gained considerable attention as an alternative in the management of cancer. The present study aimed to evaluate the chemopreventive effects of resveratrol (RV) and apocynin (AC) in N-Nitrosobis(2-oxopropyl)amine-induced pancreatic carcinogenesis in hamster. RV- and AC-treated hamsters showed significant reduction in the incidence of pancreatic cancer with a decrease in Ki-67 labeling index in dysplastic lesions. RV and AC suppressed cell proliferation of human and hamster pancreatic cancer cells by inhibiting the G1 phase of the cell cycle with cyclin D1 downregulation and inactivation of AKT-GSK3β and ERK1/2 signaling. Further, decreased levels of GSK3β(Ser9) and ERK1/2 phosphorylation and cyclin D1 expression in the nuclear fraction were observed in cells treated with RV or AC. Nuclear expression of phosphorylated GSK3β(Ser9) was also decreased in dysplastic lesions and adenocarcinomas of hamsters treated with RV or AC in vivo. These results suggest that RV and AC reduce phosphorylated GSK3β(Ser9) and ERK1/2 in the nucleus, resulting in inhibition of the AKT-GSK3β and ERK1/2 signaling pathways and cell cycle arrest in vitro and in vivo. Taken together, the present study indicates that RV and AC have potential as chemopreventive agents for pancreatic cancer.

6 Article Impact of TP53 codon 72 and MDM2 SNP 309 polymorphisms in pancreatic ductal adenocarcinoma. 2015

Hori, Yasuki / Miyabe, Katsuyuki / Yoshida, Michihiro / Nakazawa, Takahiro / Hayashi, Kazuki / Naitoh, Itaru / Shimizu, Shuya / Kondo, Hiromu / Nishi, Yuji / Umemura, Shuichiro / Kato, Akihisa / Ohara, Hirotaka / Inagaki, Hiroshi / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. · Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. · Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. ·PLoS One · Pubmed #25734904.

ABSTRACT: Single-nucleotide polymorphisms (SNPs) of TP53 (codon 72, rs1042522) and MDM2 promoter (SNP 309, rs2279744) have been associated with risk for various human cancers. However, studies analyzing these polymorphisms in pancreatic ductal adenocarcinoma (PDAC) are lacking. We investigated TP53 codon 72 and MDM2 SNP 309 polymorphisms in 32 patients with PDAC, 16 patients with chronic pancreatitis (CP), and 32 normal controls, using formalin-fixed paraffin-embedded tissue. We also examined TP53 and MDM2 protein immunohistochemistry (IHC) to assess the involvement of these differences in malignant transformation and disease progression. TP53 Pro/Pro genotype was significantly more frequent in PDAC patients than in controls (65.6 vs. 15.6%, p < 0.001) and no significant difference was found between CP patients (37.5%) and controls. In MDM2 SNP 309, there were no significant differences among the three groups. Based on the Kaplan-Meier analysis, overall survival was significantly shorter in MDM2 G/G genotypes compared with other genotypes (G/T and T/T) (359 vs. 911 days, p = 0.016) whereas no significant differences in TP53 genotypes were observed (638 vs. 752 days, p = 0.471). Although TP53 IHC was frequent in PDAC patients (53.1%), TP53 and MDM2 protein expression was not correlated with polymorphisms. Our study demonstrated TP53 codon 72 polymorphism is potentially a genetic predisposing factor while MDM2 SNP 309 polymorphism might be useful in predicting survival outcome.

7 Article Locus/chromosome aberrations in intraductal papillary mucinous neoplasms analyzed by fluorescence in situ hybridization. 2015

Miyabe, Katsuyuki / Hori, Yasuki / Nakazawa, Takahiro / Hayashi, Kazuki / Naitoh, Itaru / Shimizu, Shuya / Kondo, Hiromu / Nishi, Yuji / Yoshida, Michihiro / Umemura, Shuichiro / Kato, Akihisa / Ohara, Hirotaka / Joh, Takashi / Inagaki, Hiroshi. ·Departments of *Gastroenterology and Metabolism †Anatomic Pathology and Molecular Diagnostics ‡Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. ·Am J Surg Pathol · Pubmed #25517961.

ABSTRACT: Locus and chromosome abnormalities have not been well clarified in intraductal papillary mucinous neoplasms (IPMNs). The aim of this study was to retrospectively examine these abnormalities using fluorescence in situ hybridization. IPMNs (n=28) were histopathologically classified into noninvasive IPMN (n=17) and IPMN with an associated invasive carcinoma (invasive IPMN, n=11) groups. Noninvasive IPMNs possessed non-neoplastic and noninvasive spots in their tissues, and invasive IPMN cases possessed non-neoplastic, noninvasive, and invasive spots. Non-neoplastic (n=28), noninvasive (n=28), and invasive (n=11) spots were then analyzed for aneuploidy of chromosomes 3, 6, 7, 8, 17, and 18 and deletions of p16 and p53 loci. Polysomy 6 and p16 deletion were significantly more frequent in noninvasive than in non-neoplastic spots. Polysomy 7, polysomy 18, p16 deletion, and p53 deletion were significantly more frequent in invasive than in noninvasive spots. Detection of polysomy 7 and p53 deletion gave a high diagnostic accuracy for invasive IPMN (sensitivity, 90.9%; specificity, 94.1%; and accuracy, 92.5%). Our study suggests that: (1) polysomy 6 and p16 deletion may contribute to adenomatous change of IPMN; (2) polysomy 7, polysomy 18, p16 deletion, and p53 deletion play roles in malignant transformation of noninvasive IPMN; and (3) polysomy 7 and p53 deletion may be excellent diagnostic markers for invasive IPMN.

8 Article Comparison study of immunohistochemical staining for the diagnosis of type 1 autoimmune pancreatitis. 2015

Miyabe, Katsuyuki / Notohara, Kenji / Nakazawa, Takahiro / Hayashi, Kazuki / Naitoh, Itaru / Shimizu, Shuya / Kondo, Hiromu / Yoshida, Michihiro / Yamashita, Hiroaki / Umemura, Shuichiro / Hori, Yasuki / Kato, Akihisa / Takahashi, Satoru / Ohara, Hirotaka / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan, kmiyabe@med.nagoya-cu.ac.jp. ·J Gastroenterol · Pubmed #25108524.

ABSTRACT: BACKGROUND: Various methods to evaluate immunohistochemical staining (IHC) for the diagnosis of type 1 autoimmune pancreatitis (AIP) have been proposed. Our goal was to determine the most useful IHC method for the diagnosis of AIP. METHODS: Specimens of AIP (18 patients), chronic pancreatitis (CP, 24 patients), and pancreatic ductal adenocarcinoma (PDA, 45 patients) were evaluated with IHC for immunoglobulin G (IgG), IgG1, IgG4, and CD138 (syndecan-1). The number of IHC-positive cells was counted in 3, 5, and 10 different high-power fields (HPFs) by selecting fields with the most numerous positive cells (hotspot) or by randomly selecting fields in the affected areas (random). We evaluated the mean number of IgG4-positive plasma cells (IgG4+)/HPF (mean IgG4+), the number of fields with >10 and >50 IgG4+ (NOF >10 and NOF >50 IgG4+), the ratio of IgG4+/IgG+, IgG4+/IgG1+, and IgG4+/CD138+. RESULTS: Analysis with receiver operator characteristic curves revealed that accurate and practical parameters in 3 HPFs were mean IgG4+ with the hotspot method (sensitivity, 88.9; specificity, 92.8 %), mean IgG4+ with the random method (100, 95.7 %), and NOF >10 IgG4+ with the random method (94.4, 97.1 %). These results were as accurate as results from 5 HPFs to 10 HPFs. The combination of mean IgG4+ and IgG4+/IgG+ did not provide more accurate diagnosis for AIP than a single criterion itself. CONCLUSIONS: Mean IgG4+ or NOF >10 IgG4+ with the random method in 3 HPFs was a useful and simple diagnostic method for AIP. The combined criteria of mean IgG4+ and IgG4+/IgG+ might not be required for accurate diagnosis of AIP.

9 Article Autoimmune pancreatitis presenting a short narrowing of main pancreatic duct with subsequent progression to diffuse pancreatic enlargement over 24 months; natural history of autoimmune pancreatitis. 2014

Umemura, Shuichiro / Naitoh, Itaru / Nakazawa, Takahiro / Hayashi, Kazuki / Miyabe, Katsuyuki / Shimizu, Shuya / Kondo, Hiromu / Nishi, Yuji / Yoshida, Michihiro / Hori, Yasuki / Kato, Akihisa / Ohara, Hirotaka / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. inaito@med.nagoya-cu.ac.jp. ·JOP · Pubmed #24865539.

ABSTRACT: CONTEXT: Initial pancreatogram and natural history of autoimmune pancreatitis (AIP) have not been clarified, and there were few recent studies concerning the association between AIP and intraductal papillary mucinous neoplasm (IPMN). CASE REPORT: We report an 81-year- old man with AIP associated with IPMN. Although the initial pancreatogram was normal, a short narrowing of the main pancreatic duct (MPD) appeared during a follow-up for IPMN after 6 months, which was highly suggestive of pancreatic cancer. A narrowing of the MPD extended after 15 months, and this progressed to diffuse narrowing of the MPD with an elevation in the serum IgG4 levels after 24 months. Finally, the patient was diagnosed with diffuse-type AIP, according to the Japanese diagnostic criteria 2011 and the International Consensus Diagnostic Criteria. Considering the natural history of AIP, this marked change of the MPD is indicative of this condition. CONCLUSION: We report a case of AIP presenting with a short narrowing of the MPD with subsequent progression to diffuse pancreatic enlargement during a follow-up for IPMN.

10 Article Histological evaluation of obliterative phlebitis for the diagnosis of autoimmune pancreatitis. 2014

Miyabe, Katsuyuki / Notohara, Kenji / Nakazawa, Takahiro / Hayashi, Kazuki / Naitoh, Itaru / Okumura, Fumihiro / Shimizu, Shuya / Yoshida, Michihiro / Yamashita, Hiroaki / Takahashi, Satoru / Ohara, Hirotaka / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan. ·J Gastroenterol · Pubmed #23645070.

ABSTRACT: BACKGROUND: Obliterative phlebitis is a useful pathological finding for the diagnosis of lymphoplasmacytic sclerosing pancreatitis (LPSP), or type 1 autoimmune pancreatitis. The present study evaluated histological findings of obliterative phlebitis, including the significance of adding Elastica van Gieson stain (EVG) in comparison with other pancreatic conditions. METHODS: Specimens of LPSP (n = 18), chronic pancreatitis (CP; n = 24), and pancreatic ductal adenocarcinoma (PDA; n = 45) were enrolled. Obliterative venous lesions (OVLs), defined as the presence of inflammatory cells and/or fibrosis inside the tunica adventitia, were counted and compared between hematoxylin and eosin stain (H&E) and EVG. OVLs were classified into three types: OVL-1, lymphoplasmacytic infiltration and fibrosis against a loose textured background; OVL-2, dense fibrosis with minimal or no lymphoplasmacytic infiltration; and OVL-3, densely packed lymphoplasmacytic infiltration without fibrosis. OVL type and OVL size were compared between disease groups. RESULTS: OVL counts in LPSP, CP, and PDA were significantly higher with EVG than with H&E (p < 0.001). OVL-1 was most common in LPSP (H&E 92.4 %, EVG 79.8 %), and was identified in almost all cases of LPSP, but was less common in CP and PDA. Maximum diameter and OVL count in 1 cm(2) of OVL-1 were high for LPSP. Maximum diameter of OVL-1 ≥150 μm was observed in 17 LPSP, 0 CP, and 1 PDA cases (sensitivity 94.4 %, specificity 98.6 %). CONCLUSIONS: Additional EVG is useful for excluding conditions mimicking OVL-1 or detecting OVL in small specimens. The presence of OVL-1 with diameter ≥150 μm is highly diagnostic for LPSP.

11 Article Clinical evaluation of international consensus diagnostic criteria for type 1 autoimmune pancreatitis in comparison with Japanese diagnostic criteria 2011. 2013

Naitoh, Itaru / Nakazawa, Takahiro / Hayashi, Kazuki / Miyabe, Katsuyuki / Shimizu, Shuya / Kondo, Hiromu / Yoshida, Michihiro / Yamashita, Hiroaki / Umemura, Shuichiro / Hori, Yasuki / Ohara, Hirotaka / Joh, Takashi. ·From the Departments of *Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; and †Department of Community-Based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. ·Pancreas · Pubmed #24152949.

ABSTRACT: OBJECTIVES: The objective of this study was to evaluate the International Consensus Diagnostic Criteria (ICDC) for type 1 autoimmune pancreatitis (AIP) in comparison with the Japanese criteria 2011 (JPS2011). METHODS: We retrospectively investigated the usefulness of ICDC in comparison with JPS2011 in 64 patients with AIP and 90 patients with pancreatic cancer. RESULTS: The sensitivity and specificity of ICDC for AIP were 98.4% (63/64) and 100% (90/90), respectively. The sensitivities and specificities of ductal imaging, serology, other organ involvement, and pancreatic histology were 74.1%, 89.1%, 53.1%, and 26.1% and 94.7%, 94.5%, 100%, and 100%, respectively. On the other hand, the sensitivities and specificities of JPS2011 for AIP were 84.4% (54/64) and 100% (90/90), respectively. The condition of all the 10 patients who were deniable or possible under the JPS2011 could be diagnosed as definitive AIP under the ICDC. The sensitivities and specificities of Japanese criteria 2006, Asian Diagnostic Criteria, and HISORt criteria were 80.6%, 84.4%, and 92.2% and 95.8%, 87.8%, and 100%, respectively. CONCLUSIONS: The sensitivity and specificity of ICDC are higher than those of previous criteria. The JPS2011 is easy to handle for general practice, and specificity is very high. However, the sensitivity of JPS2011 is lower than that of ICDC, and improvement of sensitivity is to be hoped in the future.

12 Article Clinical differences between mass-forming autoimmune pancreatitis and pancreatic cancer. 2012

Naitoh, Itaru / Nakazawa, Takahiro / Hayashi, Kazuki / Okumura, Fumihiro / Miyabe, Katsuyuki / Shimizu, Shuya / Kondo, Hiromu / Yoshida, Michihiro / Yamashita, Hiroaki / Ohara, Hirotaka / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. ·Scand J Gastroenterol · Pubmed #22416894.

ABSTRACT: OBJECTIVE: Autoimmune pancreatitis (AIP) needs to be differentiated from pancreatic cancer (PC). We aimed to clarify the findings specific for AIP by comparing the clinical differences between mass-forming AIP and PC. MATERIAL AND METHODS: We retrospectively compared 36 patients with mass-forming AIP and 60 with PC without metastasis regarding clinical, imaging, serological, histological differences and other organ involvement (OOI). We evaluated the sensitivity, specificity and accuracy of these findings for the differential diagnosis between AIP and PC. RESULTS: The findings 100% specific for AIP were a capsule-like rim on computed tomography (CT), skipped lesion of main pancreatic duct (MPD) on endoscopic retrograde pancreatography (ERP) or magnetic resonance cholangiopancreatography (MRCP), γ-globulin > 2 g/dl, OOI (extrapancreatic biliary stricture, salivary gland swelling and retroperitoneal fibrosis) and ruling out PC by histopathological findings of endoscopic ultrasonography-guided fine-needle aspiration. The findings over 90% specific were IgG4 > 280 mg/dl (98%), IgG > 1800 mg/dl (97%), maximal diameter of upstream MPD < 5 mm on MRCP (95%) and IgG4 > 135 mg/dl (94%), respectively. CONCLUSIONS: Clinical, imaging, serological, histological findings and OOI differed between mass-forming AIP and PC. Capsule-like rim on CT, skipped lesion of MPD on ERP or MRCP, IgG4 > 280 mg/dl, and OOI were highly specific findings for AIP. These findings are useful in the differential diagnosis of mass-forming AIP from PC.

13 Article Diagnostic criteria for IgG4-related sclerosing cholangitis based on cholangiographic classification. 2012

Nakazawa, Takahiro / Naitoh, Itaru / Hayashi, Kazuki / Okumura, Fumihiro / Miyabe, Katsuyuki / Yoshida, Michihiro / Yamashita, Hiroaki / Ohara, Hirotaka / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. tnakazaw@med.nagoya-cu.ac.jp ·J Gastroenterol · Pubmed #21947649.

ABSTRACT: BACKGROUND: IgG4-related sclerosing cholangitis (IgG4-SC) needs to be differentiated from pancreatic cancer (PCa), primary sclerosing cholangitis (PSC), and cholangiocarcinoma (CC). We attempted to establish diagnostic criteria for IgG4-SC based on cholangiographic classification by comparison with several diagnostic modalities. METHODS: We classified 62 IgG4-SC patients into three groups on the basis of cholangiographic findings to allow differentiation from PCa, PSC, and CC: Group A IgG4-SC showed features similar to PCa (Type 1, n = 32), Group B showed similarity to PSC (Type 2, n = 15), and Group C showed similarity to CC (Type 3, 4, n = 15). Thirty-five patients with PCa, 40 with PSC, and 32 CC were enrolled as controls. We retrospectively compared the clinical, imaging, serological, and histopathological features and involvement of other organs between Group A and PCa, Group B and PSC, and Group C and CC. RESULTS: Association with autoimmune pancreatitis (AIP) (P < 0.001) and involvements with other organs (specificity 100%) were common useful diagnostic parameters in all three IgG4-SC groups. A high serum IgG4 level was a useful parameter in Groups A and B (P < 0.001). Discriminant analysis of cholangiograms (P < 0.001), liver biopsy (specificity 100%), and exclusion of inflammatory bowel disease (specificity 100%) were useful parameters in Group B. Intraductal ultrasonography findings (P < 0.001) and exclusion of malignancy by bile duct biopsy (specificity 100%) were useful parameters in Group C. We established diagnostic criteria for IgG4-SC (sensitivity 100%, specificity 96.3%) by incorporating parameters that showed P < 0.001 or 100% specificity. CONCLUSIONS: Diagnostic criteria for IgG4-SC based on cholangiographic classification are useful for distinguishing it from PCa, PSC, and CC.

14 Article A case of pancreatic glucagonoma with erythema. 2010

Yoshida, Michihiro / Hayashi, Kazuki / Ohara, Hirotaka / Miyabe, Katsuyuki / Okumura, Fumihiro / Naitoh, Itaru / Tanaka, Hajime / Ando, Tomoaki / Nakazawa, Takahiro / Takahashi, Satoru / Joh, Takashi. ·Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medicine, Japan. ·Nihon Shokakibyo Gakkai Zasshi · Pubmed #20530930.

ABSTRACT: A 38-year-old man was admitted because of exacerbation of erythema. Full-body computed tomography (CT) scanning revealed a tumor mass in the tail of the pancreas; CT and magnetic resonance imaging (MRI) scans confirmed the presence of a spherical mass. In contrast CT scans, although the contrast was gradually increased, no strong contrast differences were observed between the tumor and the surrounding tissue. Endoscopic ultrasonography (EUS) revealed a spherical low-density mass. Blood test results revealed that the patient had a high glucagon level. We diagnosed glucagonoma syndrome on the basis of the above results and resected the tail of the pancreas. Pathological analysis revealed that the tumor cells had proliferated in ribbon-like, cord-like structures. Immunostaining results were positive for glucagon, which confirmed our diagnosis.

15 Minor Intraductal papillary mucinous neoplasm associated with autoimmune pancreatitis. 2013

Naitoh, Itaru / Nakazawa, Takahiro / Notohara, Kenji / Miyabe, Katsuyuki / Hayashi, Kazuki / Shimizu, Shuya / Kondo, Hiromu / Yoshida, Michihiro / Yamashita, Hiroaki / Umemura, Shuichiro / Ohara, Hirotaka / Joh, Takashi. · ·Pancreas · Pubmed #23486370.

ABSTRACT: -- No abstract --