{"created":"2021-03-01T06:09:21.827446+00:00","id":5504,"links":{},"metadata":{"_buckets":{"deposit":"b44c5c21-a00b-4863-a24e-d56c1afb8a22"},"_deposit":{"id":"5504","owners":[],"pid":{"revision_id":0,"type":"depid","value":"5504"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00005504","sets":["453:455","471:561:562"]},"item_6_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014-03-24","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"25","bibliographicPageStart":"1","bibliographic_titles":[{}]}]},"item_6_date_granted_51":{"attribute_name":"学位授与年月日","attribute_value_mlt":[{"subitem_dategranted":"2014-03-24"}]},"item_6_degree_grantor_49":{"attribute_name":"学位授与機関","attribute_value_mlt":[{"subitem_degreegrantor":[{"subitem_degreegrantor_name":"新潟大学"}]}]},"item_6_degree_name_48":{"attribute_name":"学位名","attribute_value_mlt":[{"subitem_degreename":"博士（医学）"}]},"item_6_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"【緒言】近年,切除可能な大腸癌肝転移に対して腫瘍の生物学的評価や潜在的転移巣の治療,切除範囲の縮小を目指した術前化学療法を行う機会が増えてきているが,術前化学療法を施行した大腸癌肝転移における適切な肝切離マージンは解明されていない.本研究の目的は,術前化学療法施行例と未施行例から摘出された標本を用いて,大腸癌肝転移に対する術前化学療法が肝内微小転移巣に与える効果を検討し,術前化学療法施行例における適切な肝切離マージンを解明することである.【材料と方法】2005年1月から2011年12月までに,当科で肝切除が行われた大腸癌肝転移63例(術前化学療法施行21例,未施行42例)を対象とし,切除標本における肝内微小転移巣の頻度,分布を算出した.術前化学療法の治療効果判定は造影CT検査を用いてRECISTガイドラインに準じて行い,組織学的効果判定は大腸癌取扱い規約に準じて行った.肝内微小転移巣の定義は,肉眼的肝転移巣から非癌肝組織により隔てられた組織学的病巣とし,肉眼的肝転移巣から各肝内微小転移巣までの組織学的距離および肉眼的肝転移巣から1cm未満の近位領域における肝内微小転移巣の密度(微小転移個数/mm^2)を算出した.【結果】術前化学療法施行21例中13例が部分奏効を示し,奏効率は62%であった.術前化学療法のRECIST評価は組織学的効果判定と有意に関連していた(P=0.048).肝内微小転移巣を63例中39例(62%)に計260病巣認めた.肝内微小転移巣の頻度は,術前化学療法未施行42例中34例(81%)に認めたのに対し,術前化学療法施行例では21例中5例(24%)と有意に低かった(P＜0.001).肉眼的肝転移巣から各肝内微小転移巣までの距離は,術前化学療法未施行例で中央値2.25mm(範囲：0.1-17mm),施行例で中央値1.5mm(範囲：0.2-8mm)であった(P=0.313).肉眼的肝転移巣から1cm未満の近位領域における肝内微小転移巣の密度は,未施行例で75.9×10^<-4>個/mm^2,施行例で87.7×10^<-4>個/mm^2であった(P=0.526).【結語】術前化学療法施行により肝内微小転移巣の頻度は減少するが,分布(距離・密度)には影響を与えない.現在,大腸癌肝転移において推奨されている肝切離マージン1cm確保は,術前化学療法を施行した症例においても推奨される.","subitem_description_type":"Abstract"}]},"item_6_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"学位の種類: 博士（医学）. 報告番号: 乙第2178号. 学位記番号: 新大博（医）乙第1771号. 学位授与年月日: 平成26年3月24日","subitem_description_type":"Other"},{"subitem_description":"新潟医学会雑誌. 2013, 127(10), 538-547","subitem_description_type":"Other"}]},"item_6_description_53":{"attribute_name":"学位記番号","attribute_value_mlt":[{"subitem_description":"新大博（医）乙第1771号","subitem_description_type":"Other"}]},"item_6_dissertation_number_52":{"attribute_name":"学位授与番号","attribute_value_mlt":[{"subitem_dissertationnumber":"13101乙第2178号"}]},"item_6_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟大学"}]},"item_6_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"ETD"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"野上, 仁"}],"nameIdentifiers":[{"nameIdentifier":"50392","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-05"}],"displaytype":"detail","filename":"h25nmo1771.pdf","filesize":[{"value":"454.6 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"本文","url":"https://niigata-u.repo.nii.ac.jp/record/5504/files/h25nmo1771.pdf"},"version_id":"ec687577-d14c-4d9e-a8a9-76cf9ce175c3"},{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-05"}],"displaytype":"detail","filename":"h25nmo1771_a.pdf","filesize":[{"value":"164.7 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"要旨","url":"https://niigata-u.repo.nii.ac.jp/record/5504/files/h25nmo1771_a.pdf"},"version_id":"1f40f4b6-884f-400f-9921-fd6d2028b3e1"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"大腸癌肝転移","subitem_subject_scheme":"Other"},{"subitem_subject":"肝内微小転移","subitem_subject_scheme":"Other"},{"subitem_subject":"術前化学療法","subitem_subject_scheme":"Other"},{"subitem_subject":"肝切除","subitem_subject_scheme":"Other"},{"subitem_subject":"肝切離マージン","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":"thesis","resourceuri":"http://purl.org/coar/resource_type/c_46ec"}]},"item_title":"大腸癌肝転移の術前化学療法が肝内微小転移に与える効果","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"大腸癌肝転移の術前化学療法が肝内微小転移に与える効果"},{"subitem_title":"大腸癌肝転移の術前化学療法が肝内微小転移に与える効果","subitem_title_language":"en"}]},"item_type_id":"6","owner":"1","path":["455","562"],"pubdate":{"attribute_name":"公開日","attribute_value":"2014-05-20"},"publish_date":"2014-05-20","publish_status":"0","recid":"5504","relation_version_is_last":true,"title":["大腸癌肝転移の術前化学療法が肝内微小転移に与える効果"],"weko_creator_id":"1","weko_shared_id":2},"updated":"2022-12-15T03:38:33.500175+00:00"}