{"created":"2023-07-26T01:10:54.786127+00:00","id":2001048,"links":{},"metadata":{"_buckets":{"deposit":"388a8dda-cad5-4de2-b5e7-ffd274433578"},"_deposit":{"created_by":4,"id":"2001048","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"2001048"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:02001048","sets":["453:455","471:561:562"]},"author_link":[],"item_6_date_granted_51":{"attribute_name":"学位授与年月日","attribute_value_mlt":[{"subitem_dategranted":"2023-03-23"}]},"item_6_degree_grantor_49":{"attribute_name":"学位授与機関","attribute_value_mlt":[{"subitem_degreegrantor":[{"subitem_degreegrantor_language":"ja","subitem_degreegrantor_name":"新潟大学"},{"subitem_degreegrantor_language":"en","subitem_degreegrantor_name":"Niigata University"}],"subitem_degreegrantor_identifier":[{"subitem_degreegrantor_identifier_name":"13101","subitem_degreegrantor_identifier_scheme":"kakenhi"}]}]},"item_6_degree_name_48":{"attribute_name":"学位名","attribute_value_mlt":[{"subitem_degreename":"博士（医学）","subitem_degreename_language":"ja"}]},"item_6_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"低分化胞巣は“間質浸潤を呈する癌胞巣の中で，5個以上の細胞から構成され，腺腔形成が乏しい癌胞巣”と定義され，大腸癌の予後不良因子の一つとされている．本研究では，低分化胞巣のpT1(SM)大腸癌のリンパ節転移との関係を検討し，そのリンパ節転移リスク因子としての有用性について考察した．リンパ節郭清がなされたホルマリン固定外科切除大腸pT1(SM)癌221例を対象に，大腸癌取扱い規約に従い，癌の主組織型，SM浸潤距離，脈管侵襲(リンパ管侵襲:Lyと静脈侵襲:V)の有無，簇出のGrade，低分化胞巣の出現の有無，を検索した．対象例のリンパ節転移率は8.6%であった．低分化胞巣は221例中の102例(46.2%)に認められた．各病理組織因子とリンパ節転移との相関では，単変量解析でLy, 簇出, 低分化胞巣がリンパ節転移と有意に相関していた(P<0.0001, P=0.027, P<0.0001)．多変量解析では，Lyと低分化胞巣のみが独立したリンパ節転移リスク因子であった(P=0.021, P=0.013)．各病理組織因子と低分化胞巣との相関では，SM浸潤距離1,000μm以上，Ly陽性，簇出Grade 2/3の病変で，有意に低分化胞巣出現頻度が高かった(全てP<0.001). 低分化胞巣が出現していた102例では，67.6%で簇出と出現部位が重複していた．重複例は，簇出Grade1で56.5%，Grade 2/3で90.0%であり，簇出Grade 2/3で有意に低分化胞巣との重複頻度が高かった(P=0.0005)．低分化胞巣はHE染色標本でも評価が容易であり，免疫染色等の併用も不要であることから，pT1(SM)大腸癌のリンパ節転移を予測する簡便かつ正確性，再現性の高い病理組織因子として有用と考えられた．また，簇出と密接な関連があることから，低分化胞巣は簇出の代用になりうる可能性があると同時に，癌組織型の最低分化度も代表しうる組織因子である可能性も示唆された．これらのことから，癌の組織型と簇出の2因子を包括し，pT1(SM)大腸癌のリンパ節転移予測病理組織因子の軽減にも寄与することが期待される．","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_6_description_53":{"attribute_name":"学位記番号","attribute_value_mlt":[{"subitem_description":"新大院博(医)第1101号","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_6_dissertation_number_52":{"attribute_name":"学位授与番号","attribute_value_mlt":[{"subitem_dissertationnumber":"甲第5110号"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"大内, 彬弘","creatorNameLang":"ja"},{"creatorName":"Ohuchi, Akihiro","creatorNameLang":"en"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2023-07-26"}],"displaytype":"detail","filename":"r4nmk1101.pdf","filesize":[{"value":"1.95MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"本文","objectType":"fulltext","url":"https://niigata-u.repo.nii.ac.jp/record/2001048/files/r4nmk1101.pdf"},"version_id":"b8291d59-f812-4499-89cb-3df6623de7a6"},{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2023-07-26"}],"displaytype":"detail","filename":"r4nmk1101_a.pdf","filesize":[{"value":"524KB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"要旨","objectType":"abstract","url":"https://niigata-u.repo.nii.ac.jp/record/2001048/files/r4nmk1101_a.pdf"},"version_id":"37f85bf0-d076-4fcb-8095-485d650d68b2"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"pT1(SM)大腸癌","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"低分化胞巣","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"簇出","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"リンパ節転移","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"doctoral thesis","resourceuri":"http://purl.org/coar/resource_type/c_db06"}]},"item_title":"pT1(SM)大腸癌における低分化胞巣とリンパ節転移との関係","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"pT1(SM)大腸癌における低分化胞巣とリンパ節転移との関係","subitem_title_language":"ja"},{"subitem_title":"Relation between Poorly Differentiated Clusters and Lymph Node Metastasis of pT1 (SM) colorectal carcinoma.","subitem_title_language":"en"}]},"item_type_id":"6","owner":"4","path":["455","562"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2023-07-26"},"publish_date":"2023-07-26","publish_status":"0","recid":"2001048","relation_version_is_last":true,"title":["pT1(SM)大腸癌における低分化胞巣とリンパ節転移との関係"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-07-26T01:11:03.227346+00:00"}