Publications by authors named "Tatsuya Suzuki"

279 Publications

Usefulness of hematopoietic progenitor cell monitoring to predict autologous peripheral blood stem cell harvest timing: A single-center retrospective study.

Transfus Apher Sci 2021 Apr 24:103150. Epub 2021 Apr 24.

Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan.

Introduction: In autologous peripheral blood stem cell harvest (APBSCH), CD34-positive cells have been measured to assess the numbers of hematopoietic stem cells, but measurement requires specialized equipment. Recently, there was a report that peripheral blood hematopoietic progenitor cells (HPCs) are useful indicators of the presence of hematopoietic stem cells. We examined the usefulness of HPC monitoring to predict APBSCH timing.

Methods: We retrospectively analyzed the relationship between HPC and collected CD34-positive cells in 84 consecutive patients who underwent APBSCH.

Results: According to the receiver operating characteristics curve for the collection of ≥2 × 106 CD34-positive cells/kg, the HPC cut-off value on the day before collection was 21/μL, while that on the day of collection was 41/μL. No significant factors were found in the univariate analysis except for the HPC count on the day before collection (p < 0.001) and the day of collection (p < 0.001). According to the multivariate analysis, the HPC count on the day before collection (p < 0.001) and the day of collection (p < 0.001) were also factors that strongly influenced the quantity of CD34-positive cells collected.

Conclusion: Our results suggest that the HPC count on not only the day of collection but also the day before collection is a good indicator for appropriate APBSCH timing.
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http://dx.doi.org/10.1016/j.transci.2021.103150DOI Listing
April 2021

Clinicopathological factors and tumor microenvironment markers predicting watch-and-wait discontinuation in 82 patients with follicular lymphoma.

Eur J Haematol 2021 Apr 27. Epub 2021 Apr 27.

Department of Hematology, National Cancer Center Hospital, Tokyo, Japan.

Objectives: In this study, we aimed to determine the clinicopathological factors influencing the treatment-free period in patients with follicular lymphoma (FL) using a watch-and-wait (WW) strategy.

Methods: We retrospectively assessed histopathological parameters of 82 patients with FL.

Results: The median time from diagnosis to WW discontinuation was 62 months (range, 3-138), and median follow-up was 86 months (range, 3-183). Intermediate or high-risk Follicular Lymphoma International Prognostic Index score (P = .012), non-duodenal-type (P = .011), higher numbers of interfollicular CD4 (P = .038) and intrafollicular FOXP3 cells (P = .024) in the tumor microenvironment, and Ki-67 index ≥10% (P = .031) were significant adverse factors for WW discontinuation in univariate analyses.

Conclusion: Patients with adverse factors for WW discontinuation should be carefully observed during follow-up.
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http://dx.doi.org/10.1111/ejh.13637DOI Listing
April 2021

Long-term viability and extensibility of an in situ regenerated canine aortic wall using hybrid warp-knitted fabric.

Interact Cardiovasc Thorac Surg 2021 Apr 21. Epub 2021 Apr 21.

Healthcare Business Development-Medical Device, Teijin Limited, Tokyo, Japan.

Objectives: Many surgical materials promoting tissue regeneration have been explored for use in paediatric cardiac surgery. The aim of this study is to evaluate the long-term viability and extensibility of the canine aortic wall regenerated using a novel synthetic hybrid fabric.

Methods: The sheet is a warp-knitted fabric of biodegradable (poly-l-lactic acid) and non-biodegradable (polyethylene terephthalate) yarns coated with cross-linked gelatine. This material was implanted as a patch to fill an oval-shaped defect created in the canine descending aorta. The tissue samples were explanted after 12, 24 or 36 months (N = 3, 2, 2, respectively) for histological examination and biomechanical testing.

Results: There was no shrinkage, rupture or aneurysmal change after 24 months. The regenerated wall showed prototypical vascular healing without material degeneration, chronic inflammation, calcification or abnormal intimal overgrowth. Bridging tissue across the patch was well-formed and had expanded over time. The biodegradable yarns had completely degraded at 24 months after implantation, as scheduled, but the regenerated aortic wall demonstrated satisfactory levels of mechanical strength and extensibility in tensile strength tests.

Conclusions: The sheet achieved good long-term viability and extensibility in the regenerated aortic wall. These findings suggest that it is a promising surgical material for repairing congenital heart defects. Further developments of the sheet are required, including clinical studies.
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http://dx.doi.org/10.1093/icvts/ivab064DOI Listing
April 2021

[Cavernous Hemangioma Originating in the Left Atrial Appendage:Report of a Case].

Kyobu Geka 2021 Mar;74(3):237-240

Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Takatsuki, Japan.

A 66-year-old male with hypertension was referred for evaluation of abnormal find chest X-ray. A computed tomography (CT) scan revealed a solitary pericardial mass with a diameter of 5 cm, located in the left atrioventricular groove. It showed solid but unevenly enhanced contents suggesting a well vascularized tumor originating in either a part of the left heart or the pericardium. As magnetic resonance imaging showed a clear boundary between the tumor and the pericardium, cardiac origin was suspected. Surgical removal of the tumor was performed via median sternotomy. The tumor originated from the lateral aspect of the left atrial appendage, having a base of 10 mm in diameter. The tumor was fully excised with an associated left atrial cuff under cardiopulmonary bypass. The postoperative course was uneventful. The tumor was histopathologically diagnosed as cavernous hemangioma originating in the left atrial wall. There has been no sign of recurrence for four years following surgery.
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March 2021

Accuracy of carbohydrate-deficient transferrin as a biomarker of chronic alcohol abuse during treatment for alcoholism.

Hepatol Res 2021 Apr 2. Epub 2021 Apr 2.

Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan.

Aim: Clinical evaluations are generally used to verify the effectiveness of detoxification treatments for alcohol dependence, but new objective biomarkers are essential for accurate diagnosis. We aim to assess the accuracy of carbohydrate-deficient transferrin (%CDT) in a cohort of Japanese patients admitted to a psychiatric hospital specializing in alcohol dependence. In addition, we investigated the kinetics of %CDT during alcohol moderation or cessation.

Methods: The study cohort consisted of 126 alcohol-dependent patients. The levels of serum %CDT were assessed by the N Latex CDT direct immunonephelometric assay.

Results: Alcohol consumption was significantly correlated with %CDT. The only independent predictive factor of alcohol consumption was %CDT, with glutamyltranspeptidase (GGT) and albumin-bilirubin score proving insufficient. The cut-off value of %CDT was 1.9% with high sensitivity and specificity in detecting alcohol abstinence beyond 30 days (68.6% sensitivity, 91.8% specificity) and excessive alcohol drinking (77.9% sensitivity, 77.1% specificity). The %CDT levels were significantly decreased at 30 days of abstinence when compared with baseline. Notably, %CDT values were significantly changed even in the light alcohol drinking cohort (p = 0.0009), whereas GGT levels were not significantly changed.

Conclusions: Our results indicate that %CDT is an accurate and specific biomarker of alcohol consumption and is useful in detecting alcohol abstinence even in a low alcohol intake patient cohort. These results suggest that %CDT could be a useful objective biomarker of chronic alcohol abuse during clinical treatment for alcoholism.
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http://dx.doi.org/10.1111/hepr.13642DOI Listing
April 2021

Oxazosulfyl, a Novel Sulfyl Insecticide, Binds to and Stabilizes the Voltage-Gated Sodium Channels in the Slow-Inactivated State.

J Agric Food Chem 2021 Apr 1;69(14):4048-4055. Epub 2021 Apr 1.

Health & Crop Sciences Research Laboratory, Sumitomo Chemical Co., Ltd., 2-1 Takatsukasa 4-chome, Takarazuka, Hyogo 665-8555, Japan.

Oxazosulfyl is the first representative of a novel sulfyl class of insecticides with a potent and cross-spectrum insecticidal activity, albeit with an unclear mechanism of action. As a potential agent of pest control in rice fields, we investigated the action of oxazosulfyl on the nervous system and voltage-gated sodium channels in insects. After the injection of 10 μg of oxazosulfyl, American cockroaches () were quickly paralyzed, which persisted for more than 7 days. Extracellular recordings revealed a depressed spontaneous nerve activity in the cockroaches injected with oxazosulfyl, which specifically affected the voltage-gated sodium channels (in German cockroaches () expressed in oocytes) in the slow-inactivated state resulting in the inhibition of sodium currents. The potency of oxazosulfyl and other sodium channel blockers to block sodium channels was consistent with their insecticidal activity. Thus, we conclude that the action mode of oxazosulfyl involves the state-dependent blockage of voltage-gated sodium channels.
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http://dx.doi.org/10.1021/acs.jafc.0c04617DOI Listing
April 2021

The Impact of COVID-19 on Cancer Care in the Post Pandemic World: Five Major Lessons Learnt from Challenges and Countermeasures of Major Asian Cancer Centres.

Asian Pac J Cancer Prev 2021 Mar 1;22(3):681-690. Epub 2021 Mar 1.

Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Objective: The COVID-19 pandemic has dramatically affected healthcare services around Asia. The Asian National Cancer Centres Alliance and the Asia-Pacific Organisation for Cancer Prevention collaborated to assess the mid- and long- term impact of COVID-19 to cancer care in Asia.

Methods: The two entities organised a combined symposium and post-meeting interactions among representatives of major cancer centres from seventeen Asian countries to outlining major challenges and countermeasures.

Results: Participating stakeholders distilled five big questions. 1) "Will there be an explosion of late-stage cancers after the pandemic?" To address and recover from perceived delayed prevention, screening, treatment and care challenges, collaboration of key stakeholders in the region and alignment in cancer care management, policy intervention and cancer registry initiatives would be of essential value. 2) "Operations and Finance" The pandemic has resulted in significant material and financial casualties. Flagged acute challenges (shortages of supplies, imposition of lockdown) as well as longer-standing reduction of financial revenue, manpower, international collaboration, and training should also be addressed. 3) "Will telemedicine and technological innovations revolutionize cancer care?" Deploying and implementing telemedicine such as teleconsultation and virtual tumour boards were considered invaluable. These innovations could become a new regular practice, leading to expansion of tele-collaboration through collaboration of institutions in the region. 4) "Will virtual conferences continue after the pandemic?" Virtual conferences during the pandemic have opened new doors for knowledge sharing, especially for representatives of low- and middle-income countries in the region, while saving time and costs of travel. 5) "How do we prepare for the next pandemic or international emergency?" Roadmaps for action to improve access to appropriate patient care and research were identified and scrutinised.

Conclusion: Through addressing these five big questions, focused collaboration among members and with international organisations such as City Cancer Challenge will allow enhanced preparedness for future international emergencies.
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http://dx.doi.org/10.31557/APJCP.2021.22.3.681DOI Listing
March 2021

CD5-negative blastoid variant mantle cell lymphoma: a diagnostic dilemma.

Hum Pathol 2021 Mar 13;111:84-91. Epub 2021 Mar 13.

Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.

We encountered two cases of CD5 blastoid variant mantle cell lymphoma (MCL), prompting us to investigate the proportion of CD5 negativity in MCL and assess the diagnosis of aggressive MCL variants. Among 117 patients diagnosed with MCL, CD5 negativity was observed in 13% (13/104) of cases with classical MCL and 15% (2/13) of cases with blastoid/pleomorphic variant MCL. Of the aggressive MCL variant cases, tumor cells exhibited intermediate nuclear size and required differential diagnosis between blastoid variant and classical MCL in six patients, and classical MCL cells were found in the background of aggressive variant tumors or in other sites in six patients. Of 1534 patients with diffuse large B-cell lymphoma (DLBCL), CD5 positivity was observed in 8% (121/1534) of cases. Immunohistochemical staining for cyclin D1 performed for these cases revealed one cyclin D1-positive and IGH/CCND1 fusion-positive case (0.9%, 1/114), namely pleomorphic variant MCL. Of the remaining 1413 patients initially diagnosed with CD5 DLBCL, the diagnoses of two patients (0.1%) were amended to CD5 blastoid variant MCL in the relapse phase based on morphology, cyclin D1 immunostaining, and fluorescence in situ hybridization. The incidence of CD5 negativity was similar between classical MCL and two aggressive variants. Accurate diagnosis of MCL variants was enabled by identifying a classical MCL component and/or CD5 positivity; however, we misdiagnosed two cases of CD5 blastoid variant MCL. A small number of MCL variants may be included in CD5 DLBCL cases. The diagnosis of CD5 aggressive variant MCL remains challenging but crucial because of its therapeutic significance.
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http://dx.doi.org/10.1016/j.humpath.2021.03.005DOI Listing
March 2021

Expectant management of retained products of conception following abortion: A retrospective cohort study.

Eur J Obstet Gynecol Reprod Biol 2021 May 2;260:1-5. Epub 2021 Mar 2.

Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, 329-0498, Japan.

Objective: To clarify the natural history of retained products of conception (RPOC) following abortion at less than 22 weeks of gestation, and those who show major bleeding during course observation.

Study Design: We retrospectively reviewed 640 patients who had spontaneous or artificial abortion at less than 22 weeks of gestation between January 2011 and August 2019 in our institute. Of those, patients with RPOC were included. The maternal background, RPOC characteristics, and subsequent complications including additional interventions were reviewed.

Results: Fifty-four patients with RPOC were included. The incidence of RPOC was 6.7 %. The median (interquartile range: IQR) RPOC length was 29 (20-38) mm. RPOC hypervascularity was observed in 26 (48 %) patients. The median (IQR) periods of RPOC flow disappearance and RPOC disappearance on ultrasound from abortive treatment were 50 (28-76) and 84 (50-111) days, respectively. Of the 54, 44 patients were selected for expectant management. Of the 44, 34 (77 %) patients were observed without intervention (recovery group); the other 10 (23 %) patients required additional interventions associated with subsequent bleeding (intervention group). Compared with the recovery group, heavy bleeding (> 500 mL) at abortion (6/10: 60 %) and RPOC hypervascularity (8/10: 80 %) were more frequently observed in the intervention group.

Conclusion: Expectant management was successful in almost 80 % of patients with RPOC following abortion. The additional interventions were required in patients with heavy bleeding at abortion and RPOC hypervascularity.
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http://dx.doi.org/10.1016/j.ejogrb.2021.02.028DOI Listing
May 2021

Performance of a deep learning-based identification system for esophageal cancer from CT images.

Esophagus 2021 Feb 26. Epub 2021 Feb 26.

Department of Biosciences and Informatics, Keio University, 3-13-1 Hiyoshi, Kohoku-ku, Yokohama, 223-8522, Japan.

Background: Because cancers of hollow organs such as the esophagus are hard to detect even by the expert physician, it is important to establish diagnostic systems to support physicians and increase the accuracy of diagnosis. In recent years, deep learning-based artificial intelligence (AI) technology has been employed for medical image recognition. However, no optimal CT diagnostic system employing deep learning technology has been attempted and established for esophageal cancer so far.

Purpose: To establish an AI-based diagnostic system for esophageal cancer from CT images.

Materials And Methods: In this single-center, retrospective cohort study, 457 patients with primary esophageal cancer referred to our division between 2005 and 2018 were enrolled. We fine-tuned VGG16, an image recognition model of deep learning convolutional neural network (CNN), for the detection of esophageal cancer. We evaluated the diagnostic accuracy of the CNN using a test data set including 46 cancerous CT images and 100 non-cancerous images and compared it to that of two radiologists.

Results: Pre-treatment esophageal cancer stages of the patients included in the test data set were clinical T1 (12 patients), clinical T2 (9 patients), clinical T3 (20 patients), and clinical T4 (5 patients). The CNN-based system showed a diagnostic accuracy of 84.2%, F value of 0.742, sensitivity of 71.7%, and specificity of 90.0%.

Conclusions: Our AI-based diagnostic system succeeded in detecting esophageal cancer with high accuracy. More training with vast datasets collected from multiples centers would lead to even higher diagnostic accuracy and aid better decision making.
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http://dx.doi.org/10.1007/s10388-021-00826-0DOI Listing
February 2021

Comparison of short-channel separation and spatial domain filtering for removal of non-neural components in functional near-infrared spectroscopy signals.

Neurophotonics 2021 Jan 13;8(1):015004. Epub 2021 Feb 13.

Yale School of Medicine, Department of Psychiatry, Brain Function Laboratory, New Haven, Connecticut, United States.

With the increasing popularity of functional near-infrared spectroscopy (fNIRS), the need to determine localization of the source and nature of the signals has grown. We compare strategies for removal of non-neural signals for a finger-thumb tapping task, which shows responses in contralateral motor cortex and a visual checkerboard viewing task that produces activity within the occipital lobe. We compare temporal regression strategies using short-channel separation to a spatial principal component (PC) filter that removes global signals present in all channels. For short-channel temporal regression, we compare non-neural signal removal using first and combined first and second PCs from a broad distribution of short channels to limited distribution on the forehead. Temporal regression of non-neural information from broadly distributed short channels did not differ from forehead-only distribution. Spatial PC filtering provides results similar to short-channel separation using the temporal domain. Utilizing both first and second PCs from short channels removes additional non-neural information. We conclude that short-channel information in the temporal domain and spatial domain regression filtering methods remove similar non-neural components represented in scalp hemodynamics from fNIRS signals and that either technique is sufficient to remove non-neural components.
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http://dx.doi.org/10.1117/1.NPh.8.1.015004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881368PMC
January 2021

Radiologic features of mixed epithelial and stromal tumors of the kidney: Hyperattenuating on unenhanced computed tomography and T2-hypointensity on magnetic resonance imaging.

Radiol Case Rep 2021 Apr 30;16(4):858-862. Epub 2021 Jan 30.

Department of Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

In the 2016 World Health Organization renal tumor classification, the mixed epithelial and stromal tumor family was introduced as a new entity. This family encompasses a spectrum of tumors, ranging from predominantly cystic tumors (adult cystic nephromas) to tumors that are variably solid (mixed epithelial and stromal tumors). The majority of previous studies incorporating "mixed epithelial and stromal tumor" in the titles were actually reports of imaging findings of adult cystic nephroma. Thus, the solid component of mixed epithelial and stromal tumors has not been well evaluated. In this study, we present 2 cases of mixed epithelial and stromal tumors, as defined by the 2016 World Health Organization classification, showing a predominantly solid component. The characteristic findings of the solid component of these tumors were T2-hypointensity on magnetic resonance imaging and hyperattenuation on unenhanced computed tomography. Angiomyolipoma with epithelial cysts and epithelioid angiomyolipoma should be considered in the differential diagnosis of mixed epithelial and stromal tumors.
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http://dx.doi.org/10.1016/j.radcr.2021.01.048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850961PMC
April 2021

Updated trends in cancer in Japan: incidence in 1985-2015 and mortality in 1958-2018 - a sign of decrease in cancer incidence.

J Epidemiol 2021 Feb 6. Epub 2021 Feb 6.

Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center.

Background: Unlike many North American and European countries, Japan has observed a continuous increase in cancer incidence over the last few decades. We examined the most recent trends in population-based cancer incidence and mortality in Japan.

Methods: National cancer mortality data between 1958 and 2018 were obtained from published vital statistics. Cancer incidence data between 1985 and 2015 were obtained from high-quality population-based cancer registries maintained by three prefectures (Yamagata, Fukui, and Nagasaki). Trends in age-standardized rates (ASR) were examined using Joinpoint regression analysis.

Results: For males, all-cancer incidence increased between 1985 and 1996 (annual percent change (APC): +1.1% [95% confidence interval: 0.7, 1.5]), increased again in 2000-2010 (+1.3% [0.9, 1.8]), and then decreased until 2015 (-1.4% [-2.5, -0.3]). For females, all-cancer incidence increased until 2010 (+0.8% [0.6, 0.9] in 1985-2004, +2.4% [1.3, 3.4] in 2004-2010), and stabilized thereafter until 2015. The post-2000 increase was mainly attributable to prostate in males and breast in females, which slowed or levelled during the first decade of the 2000s. After a sustained increase, all-cancer mortality for males decreased in 1996-2013 (-1.6% [-1.6, -1.5]) and accelerated thereafter until 2018 (-2.5% [-2.9, -2.0]). All-cancer mortality for females decreased intermittently throughout the observation period, with the most recent APC of -1.0% [-1.1, -0.9] in 2003-2018. The recent decreases in mortality in both sexes, and in incidence in males, were mainly attributable to stomach, liver and male lung.

Conclusion: The ASR of all-cancer incidence began decreasing significantly in males and levelled off in females in 2010.
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http://dx.doi.org/10.2188/jea.JE20200416DOI Listing
February 2021

Deneddylation by SENP8 restricts hepatitis B virus propagation.

Microbiol Immunol 2021 Mar 24;65(3):125-135. Epub 2021 Feb 24.

Institute for Advanced Co-Creation Studies, Research, Institute for Microbial Diseases, Osaka University, Suita, Japan.

Proteins newly synthesized from messenger RNA undergo Posttranslational modifications (PTMs) such as phosphorylation, glycosylation, methylation, and ubiquitination. These PTMs have important roles in protein stability, localization, and conformation and have been reported to be involved in hepatitis B virus (HBV) propagation. Although ubiquitination plays an essential role in HBV life cycles, the involvement of ubiquitin-like proteins (UBLs) in HBV life cycles has been understudied. Through comprehensive gain- and loss-of-function screening of UBLs, we observed that neddylation, a PTM in which neural precursor cell, expressed developmentally downregulated 8 (NEDD8) is conjugated to substrate proteins, was required for efficient HBV propagation. We also found that overexpression of sentrin-specific protease 8 (SENP8), which cleaves conjugated NEDD8, suppressed HBV propagation. Further, the catalytic activity of SENP8 was required for the suppression of HBV propagation. These results indicated that the reduction of neddylation negatively regulated HBV propagation. In addition, we demonstrated that suppression of HBV propagation via SENP8 overexpression was independent of hepatitis B protein X (HBx) and HBV promoter activity. Therefore, our data suggested that neddylation plays an important role in the late stages of HBV life cycles.
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http://dx.doi.org/10.1111/1348-0421.12874DOI Listing
March 2021

Urgent intraoperative endovascular stent placement to resolve acute hepatic or portal venous obstruction during liver surgery: a case series.

Surg Case Rep 2021 Jan 6;7(1). Epub 2021 Jan 6.

Department of Surgery, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.

Background: Acute obstruction of the hepatic vein (HV) or the portal vein (PV), particularly when it occurs during liver surgery, is potentially fatal unless repaired swiftly. As surgical interventions for this problem are technically demanding and potentially unsuccessful, other treatment options are needed.

Case Presentation: We report two cases of acute, surgically uncorrectable HV or PV obstruction during liver resection or living donor liver transplantation (LDLT), which was successfully treated with urgent intraoperative placement of endovascular stents using interventional radiology (IVR). In Case 1, a patient with colonic liver metastases underwent a non-anatomic partial hepatectomy of the segments 4 and 8 with middle hepatic vein (MHV) resection. Additionally, the patient underwent an extended right posterior sectionectomy with right hepatic vein (RHV) resection for tumors involving RHV. Reconstruction of the MHV was needed to avoid HV congestion of the anterior section of the liver. The MHV was firstly reconstructed by an end-to-end anastomosis between the MHV and RHV resected stumps. However, the reconstruction failed to retain the HV outflow and the anterior section became congested. Serial trials of surgical revisions including re-anastomosis, vein graft interposition and vein graft patch-plasty on the anastomotic wall failed to recover the HV outflow. In Case 2, a pediatric patient with biliary atresia underwent an LDLT and developed an intractable PV obstruction during surgery. Re-anastomosis with vein graft interposition failed to restore the PV flow and elongated warm ischemic time became critical. In both cases, the misalignment in HV or PV reconstruction was likely to have caused flow obstruction, and various types of surgical interventions failed to recover the venous flow. In both cases, an urgent IVR-directed placement of self-expandable metallic stents (SEMS) restored the HV or PV perfusion quickly and effectively, and saved the patients from developing critical conditions. Furthermore, in Cases 1 and 2, the SEMS placed were patent for a sufficient period of time (32 and 44 months, respectively).

Conclusions: The IVR-directed, urgent, intraoperative endovascular stenting is a safe and efficient treatment tool that serves to resolve the potentially fatal acute HV or PV obstruction that occurs in the middle of liver surgery.
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http://dx.doi.org/10.1186/s40792-020-01093-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788127PMC
January 2021

[Promotion of Equal Access to Medical Services for Children, Adolescent and Young Adult(CAYA)Cancer Patients with Reproductive Problems-A Nationwide Expansion of the Regional Oncofertility Network in Japan].

Gan To Kagaku Ryoho 2020 Dec;47(12):1691-1696

Dept. of Obstetrics and Gynecology, Gifu University Graduate School of Medicine.

Objectives: Fertility preservation is important for Children, Adolescent and Young Adult(CAYA)cancer patients. Although a regional oncofertility network was established in Japan in 2012, regional inequality persists. This study was aimed at expanding the oncofertility network throughout Japan.

Methods: Oncologists, reproductive medicine specialists, and administrative officials from 24 regions, currently without a regional oncofertility network, conferred to discuss problems and strategies for network expansion.

Results: Regional oncofertility networks had already been established in 4 of 24 regions. Consultation and support and a collaboration system between facilities and individual doctors were found in 13 and 14 regions, respectively. Regarding which organization should lead the network operation, the regions(number)chose the prefecture (10), prefectural cancer centers(10), and OB/GYN department of hospitals specializing in cancer treatment(9). Obstacles to establishing a regional oncofertility network were the lack of manpower(21), budget(19), know-how(16), and specialists( 12).

Discussion: CAYA cancer patients need equal access to oncofertility networks, and a public support system is essential for preserving the fertility of cancer patients. We should organize a oncofertility network in association with prefectural administration. Medical staff training and supply of materials using the Oncofertility Consortium Japan system are required to promote the oncofertility network throughout Japan.
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December 2020

Evaluation of preoperative prediction of intestinal invasion in patients with ovarian cancer.

Int J Gynaecol Obstet 2021 Jun 22;153(3):398-404. Epub 2020 Dec 22.

Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.

Objective: To optimize prediction for intestinal invasion of epithelial ovarian cancer. It is important to achieve debulking surgery to improve prognosis in ovarian cancer; intestinal resection is adopted if the cancer is invaded and resectable, but the preoperative evaluation method of intestinal invasion is still controversial.

Methods: Patients (n = 174) who underwent primary debulking surgery for epithelial ovarian cancer were recruited for retrospective study; 28 and 146 patients were classified into the invasion and non-invasion groups, whether they needed intestinal resection or not. We collected clinical data including evaluation of computed tomography (CT), magnetic resonance imaging (MRI), and barium contrast radiography, and analyzed their accuracy.

Results: The sensitivity and specificity for intestinal invasion were 33.3% and 98.6%, 42.9% and 98.6%, and 66.7% and 93.9% in CT, MRI, and barium contrast radiography, respectively. CT and MRI combined showed a sensitivity of 58.3% and specificity of 96.9%; all three methods combined was the most sensitive combination, showing a sensitivity of 79.2% and specificity of 90.8%.

Conclusion: Combination of CT, MRI, and barium contrast radiography predicts intestinal invasion with the highest sensitivity. These three modalities, however, could not predict all intestinal invasion. Patients should be informed of the possibility of unexpected extensive resection.
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http://dx.doi.org/10.1002/ijgo.13492DOI Listing
June 2021

Evaluation of tacrolimus and mycophenolic acid removal by simultaneous continuous hemodiafiltration and plasma exchange in a lung transplant patient.

J Clin Pharm Ther 2021 Apr 10;46(2):515-518. Epub 2020 Oct 10.

Division of Pharmacy, Chiba University Hospital, Chiba, Japan.

What Is Known And Objective: The removal rates of tacrolimus (TAC) and mycophenolic acid (MPA) by simultaneous plasma exchange (PE) and continuous hemodiafiltration (CHDF) are not clear.

Case Summary: We evaluated the removal rates of TAC and MPA by PE and CHDF started simultaneously 5 hours after administration in a lung transplant patient. TAC was not removed. MPA was transferred into the PE effluent, but the total amount in the effluent was only 1% of the dosage.

What Is New And Conclusion: TAC and MPA were less likely to be removed by PE and CHDF initiated 5 hours after administration.
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http://dx.doi.org/10.1111/jcpt.13286DOI Listing
April 2021

Transformation Scoring System (TSS): A new assessment index for clinical transformation of follicular lymphoma.

Cancer Med 2020 12 6;9(23):8864-8874. Epub 2020 Oct 6.

Department of Hematology, National Cancer Center Hospital, Tokyo, Japan.

Although histologic analysis is the gold standard for diagnosing follicular lymphoma (FL) transformation, many patients are diagnosed with transformation by clinical factors as biopsy specimens often cannot be obtained. Despite the frequency of clinical diagnosis, no clinical assessment tool has yet been established for FL transformation in the rituximab era. We derived and validated a transformation scoring system (TSS) based on retrospective analyses of 126 patients with biopsy-proven FL and histologic transformation (HT) at two hospitals of the National Cancer Center of Japan. In the derivation set (76 patients), the detailed analyses of the clinical characteristics at disease progression showed that lactate dehydrogenase (LDH) elevation, focal lymph nodal (LN) enlargement, hemoglobin <12 g/dl, and poor performance status (PS) (2-4) were associated with HT. The weights of these variables were decided based on the regression coefficients. Next, we constructed a TSS encompassing the above four factors: LDH, (> upper limit of normal [ULN], ≤ULN ×2) (1 point), (≥ULN ×2) (2 points); focal LN enlargement, (≥3 cm, <7 cm) (1 point), (≥7 cm) (2 points); hemoglobin <12 g/dl (1 point); poor PS (2 points). We identified a high positive predictive value (PPV) (96.4%) and negative predictive value (NPV) (85.4%) for diagnosing HT when a cutoff score of 2 was selected for our TSS. In an external validation set (50 patients), the probability of HT was high with scores ≥2 (PPV, 93.3%; NPV, 82.9%). We developed a TSS that offers a simple, yet, valuable tool, for diagnosing HT, especially in patients who cannot undergo biopsy.
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http://dx.doi.org/10.1002/cam4.3501DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7724492PMC
December 2020

Primary Appendiceal Adenocarcinoma Presenting with Hematochezia due to the Invading Tumor in the Sigmoid Colon.

Case Rep Surg 2020 7;2020:8833573. Epub 2020 Sep 7.

Department of Surgery, Kobayashi Hospital, 4-2, Kita-3-Jonishi, Kitami, Hokkaido 090-8567, Japan.

Primary appendiceal tumors are rare malignancies; some cases have been described to invade other organs, and this represents a very rare clinical condition. We report a case of appendiceal adenocarcinoma invading the sigmoid colon and a review of similar cases. A 69-year-old woman with complaints of hematochezia was admitted to the hospital. Colonoscopy revealed a tumor in the sigmoid colon, which was a well-differentiated tubular adenocarcinoma. A computed tomography scan showed an appendiceal mass that involved the sigmoid colon, suggesting an appendiceal cancer invading the sigmoid colon. Ileocecal resection with extended lymphadenectomy and en bloc resection of the sigmoid colon was performed. The appendiceal tumor involved the sigmoid colon and the terminal ileum. The ileocecal part which included the tumor and the involved sigmoid colon was resected in total. Macroscopic findings showed that the appendiceal tumor made a fistula with the sigmoid colon. Pathological examination revealed that the tumor was a well-differentiated tubular adenocarcinoma that invaded the sigmoid colon. The final pathological stage was T4bN0M0, stage IIC. The patient was discharged from the hospital uneventfully. She was alive without relapse after a 20-month follow-up. Although an appendiceal tumor invading the rectosigmoid region is rare, a preoperative diagnosis can be obtained that facilitates the planning of a suitable surgical procedure: en bloc resection of the ileocecal part and the rectosigmoid part.
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http://dx.doi.org/10.1155/2020/8833573DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492942PMC
September 2020

COVID-19 pneumonia in a patient with adult T-cell leukemia-lymphoma.

J Clin Exp Hematop 2020 Dec 3;60(4):174-178. Epub 2020 Sep 3.

Department of Hematology, National Cancer Center Hospital, Tokyo, Japan.

Although some patients with COVID-19 develop only mild symptoms, fatal complications have been observed among those with comorbidities. As patients with cancer are immunocompromised, they are thought to have a high risk of severe illness associated with COVID-19. We report a COVID-19 patient with adult T-cell leukemia-lymphoma (ATL) who was treated using favipiravir. A 69-year-old woman with lymphoma-type ATL was treated using cyclophosphamide, doxorubicin, vincristine, prednisolone and mogamulizumab (M-CHOP) with substantial efficacy. However, in cycle 4 of M-CHOP therapy, she developed fever with mild cough. The patient was admitted to the hospital and CT revealed bilateral ground-glass opacities. SARS-CoV-2 was detected by RT-PCR and the patient was diagnosed with COVID-19. Considering severe immunosuppression caused by ATL, we initiated favipiravir therapy. Subsequently, the fever improved without antipyretics and her C-reactive protein level decreased rapidly. SARS-CoV-2 PCR tests were negative on days 17 and 18 of favipiravir therapy, and the patient was discharged without residual disease on the final CT. This is the first documented case of COVID-19 in a patient with ATL. Although severe immunosuppression caused by ATL was present, severe COVID-19 pneumonia did not develop. The immunosuppressed condition caused by hematological malignancy may not always be a risk factor for severe illness associated with COVID-19. Further accumulation of data regarding COVID-19 in patients with hematological malignancies is warranted to clarify the risk factors for severe illness, the best-in-class antiviral agent, and the optimal treatment strategy in this population.
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http://dx.doi.org/10.3960/jslrt.20030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810254PMC
December 2020

Clinical utility of the Vesical Imaging-Reporting and Data System for muscle-invasive bladder cancer between radiologists and urologists based on multiparametric MRI including 3D FSE T2-weighted acquisitions.

Eur Radiol 2021 Feb 23;31(2):875-883. Epub 2020 Aug 23.

Department of Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Objectives: To investigate the clinical utility of the Vesical Imaging-Reporting and Data System (VI-RADS) by comparing its diagnostic performance for muscle-invasive bladder cancer (MIBC) between radiologists and urologists based on multiparametric MRI, including three-dimensional (3D) fast spin-echo (FSE) T2-weighted acquisitions.

Methods: This study included 66 treatment-naïve patients (60 men, 6 women; mean age 74.0 years) with pathologically proven bladder cancer who underwent multiparametric MRI, including 3D FSE T2-weighted imaging, before transurethral bladder tumour resection between January 2010 and November 2018. The MRI scans were categorised according to the five-point VI-RADS score by four independent readers (two board-certified radiologists and board-certified urologists each), blinded to the histopathological findings. The VI-RADS scores were compared with the postoperative histopathological diagnosis. Interobserver agreement was assessed using weighted kappa coefficients. ROC analysis and generalised estimating equations were used to evaluate the diagnostic performance.

Results: Forty-nine (74.2%) and 17 (25.8%) tumours were confirmed to be non-MIBC and MIBC, respectively, based on pathological examination. The interobserver agreement was good-to-excellent between all pairs of readers (range, 0.73-0.91). The urologists' sensitivity/specificity values for DCE-MRI VI-RADS scores were significantly lower than those of radiologists. No significant differences were observed for the overall VI-RADS score. The AUC for the overall VI-RADS score was 0.94, 0.92, 0.89, and 0.87 for radiologists 1 and 2 and urologists 1 and 2, respectively.

Conclusions: The VI-RADS score, based on multiparametric MRI including 3D FSE T2-weighted acquisitions, can be useful for radiologists and urologists to determine the bladder cancer muscle invasion status preoperatively.

Key Points: • VI-RADS (using multiparametric MRI including 3D FSE T2-weighted acquisitions) achieves good to excellent interobserver agreement and has similar diagnostic performance for detecting muscle invasion by both radiologists and urologists. • The diagnostic performance of the overall VI-RADS score is high for both radiologists and urologists, particularly due to the dominant effect of diffusion-weighted imaging on the overall VI-RADS score. • The sensitivity and specificity values of the T2WI VI-RADS scores for four readers in our study (using 3D FSE T2-weighted acquisitions) were similar (with slightly higher specificity values) to previously published results (using 2D FSE T2-weighted acquisitions).
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http://dx.doi.org/10.1007/s00330-020-07153-5DOI Listing
February 2021

The RNA transport factor PHAX is required for proper histone H2AX expression and DNA damage response.

RNA 2020 11 5;26(11):1716-1725. Epub 2020 Aug 5.

Institute for Frontier Life and Medical Sciences, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan.

PHAX (phosphorylated adaptor for RNA export) promotes nuclear export of short transcripts of RNA polymerase II such as spliceosomal U snRNA precursors, as well as intranuclear transport of small nucleolar RNAs (snoRNAs). However, it remains unknown whether PHAX has other critical functions. Here we show that PHAX is required for efficient DNA damage response (DDR) via regulation of phosphorylated histone variant H2AX (γH2AX), a key factor for DDR. Knockdown of PHAX led to a significant reduction of H2AX mRNA levels, through inhibition of both transcription of the H2AX gene and nuclear export of H2AX mRNA, one of the shortest mRNAs in the cell. As a result, PHAX-knockdown cells become more sensitive to DNA damage due to a shortage of γH2AX. These results reveal a novel function of PHAX, which secures efficient DDR and hence genome stability.
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http://dx.doi.org/10.1261/rna.074625.120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566570PMC
November 2020

A hierarchical hybrid system of integrated longitudinal and lateral control for intelligent vehicles.

ISA Trans 2020 Nov 8;106:200-212. Epub 2020 Jul 8.

Department of Mechanical Science and Engineering, Graduate School of Engineering, Nagoya University, Furo-cho, Nagoya, Aichi, 4648601, Japan.

A hierarchical hybrid control system is proposed to cope with highly automated driving in highway environments with multiple lanes and surrounding vehicles. In the high-level layer, the discrete driving decisions are coordinated by the finite-state machine (FSM) based on the relative position identification and predictive longitudinal distance of the surrounding vehicles. The low-level layer is responsible for the vehicle motion control, where the model predictive control (MPC) approach is utilized to integrate the longitudinal and lateral control mainly including car-following control and lane changing control. The proposed control system focuses on two issues regarding safe driving on highways. On one hand, the subject vehicle must always keep a safe distance with its leading vehicle to avoid the rear-end collision. On the other hand, the subject vehicle should also overtake the preceding vehicle by safe lane changes if the desired speed is not achieved. The effectiveness of the hybrid control is tested in the simulation, whose results verify that the driving decisions are made reasonably and the vehicle motion control obeys stability and comfort requirements. Moreover, it is also indicated by the simulations in random scenarios that the control strategy is able to deal with most of ordinary situations on highways although some emergency situations or critical driving maneuvers of other vehicles are not considered.
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http://dx.doi.org/10.1016/j.isatra.2020.07.009DOI Listing
November 2020

Non-diffuse large B-cell lymphoma transformation from follicular lymphoma: a single-institution study of 19 cases.

Hum Pathol 2020 08 12;102:33-43. Epub 2020 Jun 12.

Departments of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan.

Diffuse large B-cell lymphoma (DLBCL) is the most common histological transformation (HT) of follicular lymphoma (FL). Other types of HT are very rare, and their incidence, histopathology, and patient outcomes have not been sufficiently described. Here, we assessed the clinicopathological characteristics of 19 cases of non-DLBCL HT of FL in a single institution in Japan to advance the understanding of the disease. Among 889 consecutive patients diagnosed with FL between 2000 and 2018, 191 suffered HT (21%). The median follow-up period was 94 months (range = 3-225). A total of 172 patients (90%) had DLBCL transformation, whereas the remaining 19 patients (10%) exhibited non-DLBCL transformation. In the latter cases, the following diagnoses were made based on morphology, immunohistochemistry, flow cytometry, and fluorescence in situ hybridization analyses: classic Hodgkin lymphoma (7 patients; 4%); high-grade B-cell lymphoma (HGBL) with MYC and BCL2 rearrangements (4 patients; 2%); HGBL, not otherwise specified (4 patients; 2%); B-cell lymphoblastic leukemia/lymphoma (2 patients; 1%); anaplastic large-cell lymphoma-like lymphoma (1 patient; 0.5%); and plasmablastic lymphoma (1 patient; 0.5%). Epstein-Barr virus-encoded RNA-1 did not associate with HT in any of the cases tested (n = 8). Patients with non-DLBCL transformation showed poor outcomes, with a median overall survival of 13 months (range = 2 days-107 months); 10 of the patients (53%) died of HT. In conclusions, non-DLBCL transformation was observed in 10% of patients with HT from FL. Our data show that timely, accurate, and comprehensive histopathological diagnosis is needed to ensure optimal treatment and improve the outcome of these patients.
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http://dx.doi.org/10.1016/j.humpath.2020.06.001DOI Listing
August 2020

Imaging features of hepatic inflammatory pseudotumor: distinction from colorectal liver metastasis using gadoxetate disodium-enhanced magnetic resonance imaging.

Abdom Radiol (NY) 2020 08;45(8):2400-2408

Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: To identify gadoxetate disodium-enhanced MRI features distinguishing hepatic IPT from CLM.

Methods: From February 2008 to December 2019, 162 lesions (IPT, n = 31 and CLM, n = 131) from 94 patients (mean age 65.1 ± 12.2 years; 65 men and 29 women) were retrospectively assessed for the presence or absence of obscure boundary, rim enhancement on arterial phase (AP), persistent rim enhancement during AP to transitional phase (TP), blood vessel penetration, peritumoral parenchymal enhancement on AP, peritumoral parenchymal hypointensity on hepatobiliary phase (HBP), peritumoral parenchymal hyperintensity on T2-weighted imaging (T2WI), biliary dilatation, central hypointensity with a relatively hyperintense periphery on HBP, peripheral hyperintensity on diffusion-weighted imaging (DWI) and T2WI, and lesion to liver signal intensity ratio (SIR) on HBP and DWI. Relevant features for differentiating between ITP and CLM were identified by univariate and multivariate analyses.

Results: Univariate analysis revealed significantly higher frequencies of the following features in IPT than CLM: younger age, obscure boundary, blood vessel penetration, central hypointensity with a relatively hyperintense periphery on HBP, higher SIR on HBP, and lower SIR on DWI (P < 0.001‒0.035). Rim enhancement on AP and persistent rim enhancement during AP to TP were significantly more common in CLM than in IPT (P ≤ 0.001). Multivariate analysis revealed that a central hypointensity with a relatively peripheral hyperintensity on HBP, higher SIR on HBP, and lower SIR on DWI were predictive of IPT (P = 0.003‒0.039).

Conclusion: Central hypointensity with a relatively peripheral hyperintensity on HBP and SIR on HBP and DWI may be reliable gadoxetate disodium-enhanced MRI features for distinguishing IPT from CLM.
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http://dx.doi.org/10.1007/s00261-020-02575-7DOI Listing
August 2020

An Asian Body to Tackle Cancers in Asia - The Asian National Cancer Centers Alliance.

Asian Pac J Cancer Prev 2020 May 1;21(5):1207-1212. Epub 2020 May 1.

National Cancer Center, Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.

The socioeconomic burden of cancer is growing rapidly in the Asian region, with a concentrated burden on low- and middle- income countries. The residents of this region, representing almost 60% of the global population, demonstrate an eclectic and complex nature, with huge disparities in ethnicity, sociocultural practices among others. The Asian National Cancer Centers Alliance (ANCCA) was established in 2005 by heads of several national cancer centers (NCCs) in the region to address common issues and concerns among Asian countries. During the first 13 years of ANCCA's existence, the participating NCCs' senior managers paved the way toward collaboration through transparent sharing of key facts and activities. Concrete achievements of the Alliance include the Asia Tobacco-Free Declaration, the establishment of the ANCCA Constitution in 2014 as well as the creation of an official website more recently. In November 2019, the most active ANCCA members (China, India, Indonesia, Japan, Korea, Mongolia, Singapore, Thailand, and Vietnam) strengthened the bonds of the entity with the clear aim to halt the increase in cancer and mortality rates in Asian countries by 2030. New opportunities including accelerated cooperation between members as well as collaboration with external and multidisciplinary stakeholders at local, regional and international levels are an essential step to most effectively tackle cancers in Asia.
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http://dx.doi.org/10.31557/APJCP.2020.21.5.1207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541889PMC
May 2020

Immunohistochemical CD20-negative change in B-cell non-Hodgkin lymphomas after rituximab-containing therapy.

Ann Hematol 2020 Sep 26;99(9):2141-2148. Epub 2020 May 26.

Department of Hematology, National Cancer Center Hospital, Tokyo, Japan.

CD20 change after rituximab-containing therapy is considered one of the main reasons of rituximab resistance of B-cell non-Hodgkin lymphomas (B-NHLs). However, the clinicopathological characteristics of B-NHL with CD20 change are not entirely understood. In this study, 252 B-NHL patients who were CD20 at initial diagnosis, whose diseases relapsed or were refractory after rituximab-containing therapy, and who were re-biopsied between 2000 and 2018, were included. The median number of rituximab administration was 11 (range, 1-48). Completely negative (cCD20) and partially negative (pCD20) change of CD20 was observed in 49 (20%) and 16 (6%) cases, respectively. Among cCD20 and pCD20 cases, 74% and 62% of the cases changed to CD20 at the second relapse or later, respectively. Overall survival was significantly shorter in cCD20 follicular lymphoma (FL) cases than in CD20 FL cases. Seven histopathological patterns, such as CD20 change without histological change, histological transformation (HT) to CD20 diffuse large B-cell lymphoma, and proliferation of plasmablastic/plasmacytoid tumor cells, were associated with CD20 change. HT occurred more frequently in FLs with CD20 change than in FLs continuously expressing CD20 (P < 0.0001), regardless of the timing of HT. Nine out of 25 cases (36%) showed regain or heterogeneous regain of CD20 expression. In conclusion, 20% and 6% of the 252 B-NHL cases show cCD20 and pCD20 changes with 7 histological patterns after rituximab-containing therapy. Because changes in morphology and CD20 expression after rituximab-containing therapy vary, and recovery of CD20 expression is not rare, careful follow-up and re-biopsy in B-NHL patients are recommended.
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http://dx.doi.org/10.1007/s00277-019-03853-1DOI Listing
September 2020