{"created":"2021-03-01T06:09:54.262069+00:00","id":6019,"links":{},"metadata":{"_buckets":{"deposit":"f2e6c39a-dace-4203-bc68-d16ecd7de4b6"},"_deposit":{"id":"6019","owners":[],"pid":{"revision_id":0,"type":"depid","value":"6019"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00006019","sets":["453:455","471:561:562"]},"item_6_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Clinical significance of desmoplastic reaction at advancing margin in patients with pT3/4 colorectal cancer"}]},"item_6_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018-03-23","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":"2018-03-23"}]},"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】間質線維化反応（Desmoplastic reaction：以下DR）とは，間質で線維芽細胞などが増生する状態を指し，癌が浸潤する際に発育先進部において認められる．早期大腸癌において，DRは粘膜下層浸潤の有無を判定する際の指標として用いられてきた．一方，進行大腸癌においては，発育先進部におけるDRが予後予測因子となるとの報告が散見される．本研究の目的は，進行大腸癌の発育先進部におけるDRの臨床的意義を明らかにすることである．【方法】2006年1月から2011年12月までの間に当科でR0切除されたpT3以深Stage II/III大腸癌のうち，家族性大腸腺腫症および炎症性腸疾患合併症例を除外した173例を対象とした．DRの診断は，病理組織診断時に切除検体から作製された全てのHE標本を観察して行われた．DRは原発巣の壁深達度が漿膜下層以深に及ぶ領域を観察して診断し，細い膠原線維が多層性に形成される成熟型（Mature：以下DR1），癌発育先進部の間質中に好塩基性の太い膠原線維の束からなるケロイド様線維が認められる中間型（Intermediate：以下DR2），やや好酸性の粘液様間質で囲まれたケロイド様線維が不規則に認められる未熟型（Immature：以下DR3）に分類した．そして，DRと臨床病理学的因子との関連について解析し，DRと無再発生存率との関連を検討した．さらに，観察者間の診断の一致度を評価するため，二人の診断医が独立してDRを評価した．診断の一致度は，k統計量を用いて評価した．【結果】対象173例中DR1が87例（50.3%），DR2が65例（37.6%），DR3が21例（12.1%）であった．DR3は，静脈侵襲（P＝0.026），リンパ節転移（P＝0.003），簇出（P＝0.012），および低分化胞巣（P＜0.001）との間に統計学的に有意な関連を認めた．無再発生存率の単変量および多変量解析では，DR3がハザード比1.539（95%信頼区間：1.146－2.066）であり，独立した予後不良因子であった（P＝0.004）．DR診断のk統計量は0.448であり，診断の再現性に関しては中等度の一致であった．【結論】進行大腸癌において，DRはR0切除後の独立した予後不良因子であり，再発高リスク群を抽出する指標になる可能性がある．","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: 甲第4421号. 学位記番号: 新大院博（医）甲第820号. 学位授与年月日: 平成30年3月23日","subitem_description_type":"Other"},{"subitem_description":"新潟医学会雑誌. 2017.  131(11), 635-643.","subitem_description_type":"Other"}]},"item_6_description_53":{"attribute_name":"学位記番号","attribute_value_mlt":[{"subitem_description":"新大院博（医）甲第820号","subitem_description_type":"Other"}]},"item_6_dissertation_number_52":{"attribute_name":"学位授与番号","attribute_value_mlt":[{"subitem_dissertationnumber":"13101甲第4421号"}]},"item_6_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"51263","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Hashimoto, Yoshifumi"}]}]},"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":"橋本, 喜文"}],"nameIdentifiers":[{"nameIdentifier":"51262","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":"h29nmk820.pdf","filesize":[{"value":"1.1 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"本文","url":"https://niigata-u.repo.nii.ac.jp/record/6019/files/h29nmk820.pdf"},"version_id":"9862ae9a-ae03-439d-8a79-98f90fc87507"},{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-05"}],"displaytype":"detail","filename":"h29nmk820_a.pdf","filesize":[{"value":"592.1 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"要旨","url":"https://niigata-u.repo.nii.ac.jp/record/6019/files/h29nmk820_a.pdf"},"version_id":"99dd611c-bec0-4229-987f-caaea7dc48f1"}]},"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":"間質線維反応","subitem_subject_scheme":"Other"},{"subitem_subject":"desmoplastic reaction","subitem_subject_scheme":"Other"},{"subitem_subject":"簇出","subitem_subject_scheme":"Other"},{"subitem_subject":"低分化胞巣","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":"進行大腸癌の発育先進部における間質線維化反応の臨床的意義","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"進行大腸癌の発育先進部における間質線維化反応の臨床的意義"},{"subitem_title":"進行大腸癌の発育先進部における間質線維化反応の臨床的意義","subitem_title_language":"en"}]},"item_type_id":"6","owner":"1","path":["455","562"],"pubdate":{"attribute_name":"公開日","attribute_value":"2018-07-26"},"publish_date":"2018-07-26","publish_status":"0","recid":"6019","relation_version_is_last":true,"title":["進行大腸癌の発育先進部における間質線維化反応の臨床的意義"],"weko_creator_id":"1","weko_shared_id":2},"updated":"2022-12-15T03:39:24.268200+00:00"}