記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：HUMANA PRESS INC  

The International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society (IASLC/ATS/ERS) proposed a new histologic classification of lung adenocarcinoma in 2011. While several studies have already validated the prognostic value of this new classification of lung adenocarcinoma, we conducted own investigation in the present study. This study included 197 patients with invasive lung adenocarcinoma who underwent complete resection. Pathologic diagnoses were made in accordance with the new IASLC/ATS/ERS classification for lung adenocarcinoma. The lepidic/acinar/papillary group had a significantly better prognosis than the micropapillary/solid/ invasive mucinous adenocarcinoma group (5-year recurrence- free survival [RFS] 73 vs. 21%: p < 0.01, 5-year overall survival 85 vs. 52%: p < 0.01). Age (hazard ratio [HR], 1.898; p = 0.03), CEA (HR, 1.873; p = 0.03), pStage (HR, 6.149; p < 0.01), and histologic subtype (HR, 2.342; p = 0.01) were independent prognostic factors for the RFS. Furthermore, age (HR, 3.242; p = 0.04), CEA (HR, 3.405; p = 0.03) and histologic subtype (HR, 11.108; p < 0.01) were independent prognostic factors for the progression-free survival in pStage I. The histologic subtype correlated with the prognosis of pStage I of lung adenocarcinoma. Patients in the high-grade group of lung adenocarcinoma, which included solid, micropapillary and invasive mucinous adenocarcinoma with pStage I, should be considered candidates for postoperative adjuvant therapy.

DOI： 10.1007/s12032-017-0962-x

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記述言語：英語   出版者・発行元：ELSEVIER SCIENCE INC  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Ltd  

Introduction An anomalous systemic arterial supply to the normal basal segment without sequestration is a rare congenital vascular malformation. The discovery age is relatively young, and the most common clinical symptom is hemoptysis due to pulmonary hypertension or heart failure. We herein describe a case of endovascular embolization of in an elderly and asymptomatic patient with an anomalous systemic arterial supply to the normal basal segment. Presentaition of case An 80-year-old male was referred to our hospital due to an abnormal chest shadow. The patient was diagnosed with an anomalous systemic arterial supply to normal basal segment. We performed coil embolization via the catheterization. Discussion The application of coil embolization via catheterization results in a low risk of infection and small burden on the body compared with surgery. There are few report of the coil embolization for an anomalous systemic arterial supply to the normal basal segment. Hence, it is necessary to accumulate additional cases. Conclusion The outcome of thie case indicates that coil embolization is a very useful treatment method for elderly patients with an anomalous systemic arterial supply to the normal basal segment.

DOI： 10.1016/j.ijscr.2017.03.030

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記述言語：英語  

BACKGROUND:The aim of the study was to examine the influence of the changes in the atmospheric temperature (ATemp) and the atmospheric pressure (APres) on the occurrence of a spontaneous pneumothorax (SP).;PATIENTS AND METHODS:From January 2000 to March 2014, 192 consecutive SP events were examined. The ATemp and APres data at the onset of SP, as well as those data at 12, 24, 36, 48, 60, and 72 h prior to the onset time, were analyzed.;RESULTS:The frequencies of SP occurrence were not statistically different according to the months or seasons, but were statistically different according to the time period (P < .01) and SP events occurred most frequently from 12:00 to 18:00. SP events frequently occurred at an ATemp of 25 degrees Celsius or higher. There was a significantly negative correlation between the APres and the ATemp at the SP onset time. The values of change in the APres from 36 to 24 h prior to SP onset were significantly lower than the preceding values.;CONCLUSIONS:In this study, we observed that a SP event was likely to occur in the time period from 12:00 to 18:00, at an ATemp of 25 degrees Celsius or higher, and at 24-36 h after a drop of APres.

DOI： 10.1111/crj.12562

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器内視鏡学会  

背景. 肺葉切除後の気管支断端瘻の治療には難渋することがしばしば経験される。症例. 患者は80歳、女性。左肺下葉切除10ヵ月後に気管支断端瘻疑いにて当科に入院、胸腔ドレナージを開始、胸水から細菌が検出された。胸腔ドレーンから色素を注入後に左下葉気管支断端から色素の漏出を認め、気管支断端瘻と診断した。気管支鏡下に1%ポリドカノールを気管支断端の粘膜下に注入し、2日後に気漏の停止を認めた。気漏の再燃を認めなかったため、胸腔内洗浄と抗菌薬投与を行い、膿胸腔は縮小し無菌化を確認した。4週間気漏がない状態が続いたため胸腔ドレーンを抜去し、その後の気管支鏡所見で気管支断端の瘢痕性癒着と瘻孔閉鎖を確認し、独歩退院した。退院後10ヵ月が経過しているが、気管支断端瘻の再燃を認めていない。結論. 気管支鏡下のポリドカノール粘膜下注入は簡便かつ低侵襲であり、気管支断端瘻の閉鎖に有効な場合がある。(著者抄録)

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

目的. 肺癌診療ガイドラインでは臨床病期IA期の非小細胞肺癌に対しては、肺葉以上の切除がグレードAの標準術式とされている。肺葉切除への耐術能を有さない場合は消極的縮小手術や定位放射線治療の対象となるが、その治療効果を比較した報告は少ない。方法. 2009年1月〜2015年3月に当科で治療した臨床病期IAの非小細胞肺癌症例のうち、消極的縮小手術および定位放射線治療を施行した症例を対象とした。結果. 消極的縮小手術(部分切除)20例、定位放射線治療20例であった。以下、消極的/定位の順で示す。平均年齢73.9歳/78.9歳(P=0.05)、ECOGPS(0:1:2)5:14:1/0:15:5(P=0.02)、5年局所制御率84.4%/77.8%(P=0.82)、5年無再発生存率73.2%/45.7%(P=0.14)であった。結論. 肺葉以上の切除が困難な臨床病期IA非小細胞肺癌において、消極的縮小手術および定位放射線治療は一定の治療効果が期待できると考えられる。しかし、どちらを標準治療とすべきかの決定にはランダム化比較試験が必要である。(著者抄録)

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記述言語：英語  

DOI： 10.1007/s00384-015-2198-6

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記述言語：英語  

BACKGROUND: Precise staging of lung cancer is usually evaluated by PET-CT and brain MRI. Recently, however, whole-body diffusion-weighted magnetic resonance imaging (WB-DWI) has be applied. The aim of this study is to determine whether the diagnostic performance of lung cancer staging by WB-DWI is superior to that of PET-CT+brain MRI. MATERIALS AND METHODS: PET-CT + brain MRI and WB-DWI were used for lung cancer staging before surgery with 59 adenocarcinomas, 16 squamous cell carcinomas and 6 other carcinomas. RESULTS: PET-CT + brain MRI correctly identified the pathologic N staging in 67 patients (82.7%), with overstaging in 5 (6.2%) and understaging in 9 (11.1%), giving a staging accuracy of 0.827. WB-DWI correctly identified the pathologic N staging in 72 patients (88.9%), with overstaging in 1 (1.2%) and understaging in 8 patients (9.9%), giving a staging accuracy of 0.889. There were no significant differences in accuracies. PET-CT + brain MRI correctly identified the pathologic stages in 56 patients (69.1%), with overstaging in 7 (8.6%) and understaging in 18 (22.2%), giving a staging accuracy of 0.691. WB-DWI correctly identified the pathologic stages in 61 patients (75.3%), with overstaging in 4 (4.9%) and understagings in16(19.7%), giving a staging accuracy of 0.753. There were no significant difference in accuracies. CONCLUSIONS: Diagnostic efficacy of WB-DWI for lung cancer staging is equivalent to that of PET-CT + brain MRI.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Asian Pacific Organization for Cancer Prevention  

Background: The Glasgow Prognostic Score (GPS) is calculated from measured CRP and albumin levels. We here evaluated the significance of the GPS in patients with resected pulmonary adenocarcinoma. Materials and Methods: The present study included 156 patients with lung adenocarcinoma who underwent lobectomy at Kanazawa Medical University between 2002 and 2012. Classification was into three groups: those with normal albumin ( &gt
=3.5 g/dl) and C-reactive protein (CRP) ( &lt
=1.0 mg/dl) levels were classified as GPS 0 (n =136), those with low albumin ( &lt
3.5 g/ dl) or elevated CRP ( &gt
1.0 mg/dl) levels as GPS 1 (n = 16), and those with low albumin ( &lt
3.5 g/dl) and elevated CRP ( &gt
1.0 mg/dl) levels as GPS 2 (n = 4). We retrospectively investigated relationships between the patient characteristics including the GPS, and disease-free survival and cancer-specific survival. Results: The pathological stages of the patients were as follows: IA (n=78, 50%), IB (n=31, 19.9%), IIA (n=20.0, 12.8%), IIB (n=9.0, 5.7%), and IIIA (n=18.0, 11.5%). Lobectomy was performed in all cases. The average GPS was 0.15 (0-2) and showed significant relationships with stage and tumor size. The 2-year survival rates in patients with GPS0, 1 and 2 were 81.4%, 38.4%, and 25.0%, respectively. Clear correlations were noted with both cancer-specific survival and disease-free survival. Furthermore, multivariate analysis revealed that GPS was a significant prognostic factor. Conclusions: The GPS could be a prognostic factor for patients with resected pulmonary adenocarcinoma.

DOI： 10.7314/APJCP.2016.17.10.4677

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記述言語：日本語   出版者・発行元：金沢医科大学医学会  

肺がん検診の喀痰細胞診の対象者の基準が2015年から改訂され、これまでの「血痰を有する例」などが削除されて、喫煙指数のみで定められることになった。本稿では、その背景を詳述する。(著者抄録)

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記述言語：英語  

DOI： 10.1164/rccm.201501-0122IM

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記述言語：英語  

OBJECTIVE: In cancer screening programs, performing appropriate further work-up is essential. In order to elucidate whether the further work-up for the subjects with positive screening results by sputum cytology was performed appropriately, the present study was conducted as the first large-scale thorough survey in Japan. METHODS: All of the lung cancer screening records from 2007 to 2012 in Ishikawa Prefecture were reviewed. Additional investigations about the further work-up were performed. RESULTS: In total, 2 234 984 people were invited to undergo lung cancer screening, and 494 424 people participated in the screening. Of these, 25 264 people underwent sputum cytology, and 68 positive cases were identified. Three of these 68 cases did not undergo further work-up, and another three cases had already been diagnosed to have lung cancer. Forty-five of the remaining 62 cases did not have suspicious chest shadows, and bronchoscopic examinations were performed in 36 cases. Seventeen of these 36 cases were diagnosed as having cancer, whereas none of the nine cases who did not receive the examination was diagnosed (P = 0.038). A bronchoscopic examination was not performed due to other medical conditions in three cases, due to the patient's refusal in another three cases and in the remaining three cases, the reasons were unknown. CONCLUSION: The participation rate for further work-up was very high. However, there are some issues to be resolved regarding the transmission of information. With our new registered hospital system, the quality assurance of our screening program will be improved.

DOI： 10.1093/jjco/hyu214

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記述言語：日本語   出版者・発行元：(一社)呼吸研究  

低線量胸部CTを用いた肺がん検診の現状と展望について概括した。健常人に対する標準線量でのCTは、放射線被曝のための不利益が検診の利益を上回ることから、検診としては行ってはいけない。撮影・読影などに関する方法は「肺癌取扱い規約」に載っているが、管電流自動調整装置付き機器での条件は現在検討中である。胸部CT検診では数mm程度の陰影から発見可能で、肺がん発見率は胸部X線検査の10倍以上、発見肺がん患者の5年生存率も80%以上と高い。しかし、バイアスが存在するため、有効性の有無はいまだ確実ではない。2011年に報告されたNLSTの結果では、高喫煙者においてCT検診による20%の肺がん死亡率減少効果が示されたが、最終的な評価はNELSONの結果を待つ必要がある。今後の課題として、(1)喫煙者における有効性の確定、(2)非喫煙者に対するCT検診の有効性の評価、(3)適切な精度管理の実施、(4)必要なインフラの整備、などが重要である。(著者抄録)

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記述言語：英語  

BACKGROUND: Diffusion-weighted magnetic resonance imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. It is uncertain whether DWI is more useful than positron emission tomography-computed tomography (PET-CT) for distinguishing benign from malignant mediastinal tumors and mass lesions. MATERIALS AND METHODS: Sixteen malignant mediastinal tumors (thymomas 7, thymic cancers 3, malignant lymphomas 3, malignant germ cell tumors 2, and thymic carcinoid 1) and 12 benign mediastinal tumors or mass lesions were assessed in this study. DWI and PET-CT were performed before biopsy or surgery. RESULTS: The apparent diffusion coefficient (ADC) value (1.51±0.46x10(-3) mm2/sec) of malignant mediastinal tumors was significantly lower than that (2.96±0.86x10(-3) mm2/sec) of benign mediastinal tumors and mass lesions (P<0.0001). Maximum standardized uptake value (SUVmax) (11.30±11.22) of malignant mediastinal tumors was significantly higher than that (2.53±3.92) of benign mediastinal tumors and mass lesions (P=0.0159). Using the optimal cutoff value (OCV) 2.21x10(-3) mm2/sec for ADC and 2.93 for SUVmax, the sensitivity (100%) by DWI was not significantly higher than that (93.8%) by PET-CT for malignant mediastinal tumors. The specificity (83.3%) by DWI was not significantly higher than that (66.7%) for benign mediastinal tumors and mass lesions. The accuracy (92.9%) by DWI was not significantly higher than that (82.1%) by PET-CT for mediastinal tumors and mass lesions. CONCLUSIONS: There was no significant difference between diagnostic capability of DWI and that of PET-CT for distinguishing mediastinal tumors and mass lesions. DWI is useful in distinguishing benign from malignant mediastinal tumors and mass lesions.

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記述言語：英語  

A bronchial fistula is one of the most serious complications that can occur following pulmonary lobectomy. We herein report a case of bronchial fistula that was successfully treated by endobronchial embolization using an Endobronchial Watanabe Spigot (EWS). A 72-year-old male underwent right lower lobectomy of the lung with nodal dissection for a pulmonary squamous cell carcinoma. A bronchial fistula developed 53 days after surgery. Tube drainage was performed, and air leakage was apparent. Under endoscopic observation, intrathoracic injection of indigo carmine revealed that a fistula existed at the peripheral site of the B(2)ai bronchus. After one EWS (small) was inserted into the B(2)a bronchus tightly using a bronchoscope, the air leakage was stopped. Pleurodesis was further carried out, the thoracostomy tube was subsequently removed, and the patient was discharged. Endobronchial embolization using an EWS is an option for the treatment of a bronchial fistula after pulmonary resection.

DOI： 10.1155/2015/425694

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記述言語：英語  

BACKGROUND: It is sometimes difficult to assess patients who have multiple hilar and mediastinal lymph nodes (MHMLN) with FDG accumulation in PET-CT. Since it is uncertain whether diffusion-weighted magnetic resonance imaging (DWI) is useful in the assessment of such patients, its diagnostic performance was assessed. MATERIALS AND METHODS: Twenty-three patients who had three or more stations of hilar and mediastinal lymph nodes with SUVmax of 3 or more in PET-CT were included in this study. RESULTS: For diagnosis of disease, there were 20 malignancies (lung cancers 17, malignant lymphomas 2 and metastatic lung tumor 1), and 3 benign cases (sarcoidosis 2 and benign disease 1). For diagnosis of lymph nodes, there were 7 malignancies (metastasis of lung cancer 7 and malignant lymphoma 1) and 16 benign lymphadenopathies (pneumoconiosis/silicosis 7, sarcoidosis 4, benign disease 4, and atypical lymphocyte infiltration 1). The ADC value (1.57±0.29x10(-3) mm2/sec) of malignant MHMLN was significantly lower than that (1.99±0.24x10(-3) mm2/sec) of benign MHMLN (P=0.0437). However, the SUVmax was not significantly higher (10.0±7.34 as compared to 6.38±4.31) (P=0.15). The sensitivity (86%) by PET-CT was not significantly higher than that (71%) by DWI for malignant MHMLN (P=1.0). The specificity (100%) by DWI was significantly higher than that (31%) for benign MHMLN (P=0.0098). Furthermore, the accuracy (91%) with DWI was significantly higher than that (48%) with PET-CT for MHMLN (P=0.0129). CONCLUSIONS: Evaluation by DWI for patients with MHMLN with FDG accumulation is useful for distinguishing benign from malignant conditions.

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記述言語：日本語   出版者・発行元：北陸外科学会  

68歳男。50歳の頃から糖尿病であった。右肺扁平上皮癌に対し胸腔鏡下右肺全摘+リンパ節郭清術を施行されたが、術後40日目に発熱を認め、検査結果にて膿胸が疑われ当院入院となった。入院後、胸腔ドレナージを施行し、胸水培養よりMRSAが検出されたため、MRSA膿胸の診断にて、VCMによる抗生剤の全身投与を開始した。入院4日目に発熱は改善したが、胸腔洗浄の効果が不十分であったため、入院14日目に胸腔鏡下右胸腔内掻爬術を行った。術後もVCM投与、胸腔洗浄を続けたが、胸水培養からMRSAが検出された。ウロキナーゼと抗生剤をABKに変更したが、その後もMRSAは検出され、最終的にウロキナーゼとVCMの投与、胸腔内洗浄にてMRSAは陰性化し、膿胸の改善を得た。退院後2年経過した現在、膿胸の再発は認めず、良好に経過している。

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)癌と化学療法社  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本呼吸器外科学会  

非常にまれな胸骨体部後方脱臼を外科的に治療した一例を経験した。症例は23歳男性。スノーボードで滑走中に、胸部を強く強打し、胸骨体部後方脱臼を発症した。保存的に経過観察したが、整復されないため、プレート固定なしの整復手術を行った。術後経過は順調で再発の兆候はない。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：特定非営利活動法人 日本呼吸器内視鏡学会  

Objective. For safe flexible bronchoscopy, it is essential that the sedation level be evaluated accurately. A prospective study was undertaken to determine usefulness of the bispectral index (BIS) monitor system during flexible bronchoscopy and evaluate how much amnesia patients experienced. Methods. We performed flexible bronchoscopy in 42 patients. Injections of midazolam (2.5 mg) were administered until amnesia was achieved. BIS values were recorded continuously. Injection of midazolam (2.5 mg) was administered when BIS value remained over 85 for 30 seconds, but not for coughs or body movement when BIS value stayed below 80. Results. There were 31 patients (74%) who remembered nothing at all, 11 (26%) who remembered no details, and none (0%) who remembered some details, many details, or every detail. Regarding patient satisfaction, 25 patients (60%) felt "excellent" or "good" during premedication, 33 (79%) during the bronchoscopic procedure, 28 (67%) during the post-bronchoscopic procedure, and 34 (81%) during the total procedure. The mean BIS value of patients was 76.4±5.2 during the bronchoscopic procedure; the minimum mean BIS value was 65, and the maximum mean BIS value was 85. BIS values rose 7 to 40 (17.9±7.6) with coughs or body movement. BIS value (76.4±4.9) of patients who remembered nothing at all was similar to that (74.3±4.8) of patients who remembered no details. BIS values did not suggest the degree of patient memory or satisfaction. Conclusions. BIS value is useful in the administration of midazolam and keeps patients at an appropriate level of sedation. The BIS value taken during flexible bronchoscopy is not an indicator of patient memory or satisfaction.

DOI： 10.18907/jjsre.36.1_12

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ASIAN PACIFIC ORGANIZATION CANCER PREVENTION  

Background: The epidermal growth factor receptor (EGFR) mutation status of lung cancer is important because it means that EGFR-tyrosine kinase inhibitor treatment is indicated. The purpose of this prospective study is to determine whether EGFR mutation status could be identified with reference to preoperative factors. Materials and Methods: One hundred-forty eight patients with lung cancer (111 adenocarcinomas, 25 squamous cell carcinomas and 12 other cell types) were enrolled in this study. The EGFR mutation status of each lung cancer was analyzed postoperatively. Results: There were 58 patients with mutant EGFR lung cancers (mutant LC) and 90 patients with wild-type EGFR lung cancers (wild-type LC). There were significant differences in gender, smoking status, maximum tumor diameter in chest CT, type of tumor shadow, clinical stage between mutant LC and wild-type LC. EGFR mutations were detected only in adenocarcinomas. Maximum standardized uptake value (SUVmax:3.66 +/- 4.53) in positron emission tomography-computed tomography of mutant LC was significantly lower than that (8.26 +/- 6.11) of wild-type LC (p&lt;0.0001). Concerning type of tumor shadow, the percentage of mutant LC was 85.7% (6/7) in lung cancers with pure ground glass opacity (GGO), 65.3%(32/49) in lung cancers with mixed GGO and 21.7%(20/92) in lung cancers with solid shadow (p&lt;0.0001). For the results of discriminant analysis, type of tumor shadow (p=0.00036) was most significantly associated with mutant EGFR. Tumor histology (p=0.0028), smoking status (p=0.0051) and maximum diameter of tumor shadow in chest CT (p=0.047) were also significantly associated with mutant EGFR. The accuracy for evaluating EGFR mutation status by discriminant analysis was 77.0% (114/148). Conclusions: Mutant EGFR is significantly associated with lung cancer with pure or mixed GGO, adenocarcinoma, never-smoker, smaller tumor diameter in chest CT. Preoperatively, EGFR mutation status can be identified correctly in about 77 % of lung cancers.

DOI： 10.7314/APJCP.2014.15.2.657

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

To expand postoperative residual lungs after pulmonary lobectomy, thoracic drainage with two chest tubes has been recommended. Several studies recently demonstrated that postoperative drainage with one chest tube (PD1) was as safe as that with two chest tubes (PD2). However, most of the patients in those studies underwent lobectomy by standard thoracotomy. Although the number of pulmonary lobectomies by video-assisted thoracic surgery (VATS) has been increasing in recent years, there have been no reports that compared PD1 with PD2 after pulmonary lobectomy, including that by VATS. To elucidate whether postoperative management with PD1 is as safe as that with PD2, we conducted a randomized controlled trial. Lung cancer patients who underwent lobectomies with mediastinal nodal dissection in our hospital were assigned to one of two groups: one chest tube placed in PD1 group and two chest tubes placed in PD2 group. A total of 108 patients were registered in the study. There were no signifcant differences in the age, gender, pathological stage or histological type between two groups. Since the residual lung expansion was good in both groups, there were no patients who needed thoracentesis. There were no signifcant differences in the number of cases with pleurodesis, the amount/duration of drainage or the pain of the patients between two groups. In conclusion, since PD1 has advantages in saving cost and time and in low risk of transcutaneous infection, PD1 is appropriate after pulmonary lobectomy by VATS and by open thoracotomy. © 2014 Tohoku University Medical Press.

DOI： 10.1620/tjem.232.55

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ASIAN PACIFIC ORGANIZATION CANCER PREVENTION  

Background: Diffusion-weighted magnetic resonance imaging (DWI) is reported to be useful for detecting malignant lesions. The purpose of this study is to clarify characteristics of imaging, detection rate and sensitivity of DWI for recurrence or metastasis of lung cancer. Methods: A total of 36 lung cancer patients with recurrence or metastasis were enrolled in this study. While 16 patients underwent magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography-computed tomography (PET-CT), 17 underwent MRI and CT, and 3 underwent MRI and PET-CT. Results: Each recurrence or metastasis showed decreased diffusion, which was easily recognized in DWI. The detection rate for recurrence or metastasis was 100% (36/36) in DWI, 89% (17/19) in PET-CT and 82% (27/33) in CT. Detection rate of DWI was significantly higher than that of CT (p=0.0244) but not significantly higher than that of PET-CT (p=0.22). When the optimal cutoff value of the apparent diffusion coefficient value was set as 1.70x10(-3) mm(2)/sec, the sensitivity of DWI for diagnosing recurrence or metastasis of lung cancer was 95.6%. Conclusions: DWI is useful for detection of recurrence and metastasis of lung cancer.

DOI： 10.7314/APJCP.2014.15.16.6843

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ASIAN PACIFIC ORGANIZATION CANCER PREVENTION  

Background: The purpose of this study was to determine the prognostic significance of the maximum standardized uptake value (SUVmax) on F-18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in patients undergoing surgical treatment for non-small cell lung cancer. Materials and Methods: Seventy-eight consecutive patients (58 with adenocarcinomas, 20 with squamous cell carcinomas) treated with potentially curative surgery were retrospectively reviewed. Results: The SUVmax was significantly higher in the patients with recurrent than with non-recurrent adenocarcinoma (p&lt;0.01). However, among the patients with squamous cell carcinoma, there were no differences with or without recurrence (p=0.69). Multivariate analysis indicated that the SUVmax of adenocarcinoma lesions was a significant predictor of disease-free survival (p=0.04). In addition, an SUVmax of 6.19, the cut-off point based on ROC curve analysis of the patients with pathological IB or more advanced stage adenocarcinomas, was found to be a significant predictor of disease-free survival (p&lt;0.01). Conclusions: SUVmax is a useful predictor of disease-free survival in patients with resected adenocarcinoma, but not squamous cell carcinoma. Patients with adenocarcinoma exhibiting an SUVmax above 6.19 are candidates for more intensive adjuvant therapy.

DOI： 10.7314/APJCP.2014.15.23.10171

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ASIAN PACIFIC ORGANIZATION CANCER PREVENTION  

Background: Diffusion-weighted imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. However, it is uncertain whether DWI has advantages over FDG-PET for distinguishing malignant from benign pulmonary nodules and masses. Materials and Methods: One hundred-forty-three lung cancers, 17 metastatic lung tumors, and 29 benign pulmonary nodules and masses were assessed in this study. DWI and FDG-PET were performed. Results: The apparent diffusion coefficient (ADC) value (1.27 +/- 0.35x10(-3) mm(2)/sec) of malignant pulmonary nodules and masses was significantly lower than that (1.66 +/- 0.58x10(-3) mm(2)/sec) of benign pulmonary nodules and masses. The maximum standardized uptake value (SUVmax: 7.47 +/- 6.10) of malignant pulmonary nodules and masses were also significantly higher than that (3.89 +/- 4.04) of benign nodules and masses. By using optimal cutoff values for ADC (1.44x10(-3) mm(2)/sec) and for SUVmax (3.43), which were determined with receiver operating characteristics curves (ROC curves), the sensitivity (80.0%) of DWI was significantly higher than that (70.0%) of FDG-PET. The specificity (65.5%) of DWI was equal to that ( 65.5%) of FDG-PET. The accuracy (77.8%) of DWI was not significantly higher than that (69.3%) of FDG-PET for pulmonary nodules and masses. As the percentage of bronchioloalveolar carcinoma (BAC) component in adenocarcinoma increased, the sensitivity of FDG-PET decreased. DWI could not help in the diagnosis of mucinous adenocarcinomas as malignant, and FDG-PET could help in the correct diagnosis of 5 out of 6 mucinous adenocarcinomas as malignant. Conclusions: DWI has higher potential than PET in assessing pulmonary nodules and masses. Both diagnostic approaches have their specific strengths and weaknesses which are determined by the underlying pathology of pulmonary nodules and masses.

DOI： 10.7314/APJCP.2014.15.11.4629

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：北陸外科学会  

2002年1月〜2013年12月間に根治術を施行した非小細胞肺癌症例136例を対象に術前CEA陽性群48例とCEA陰性群88例に分け、carcino embryonic antigen(CEA)の予後予測因子としての有用性を検討した。その結果、1)CEA陽性群は進行期の症例が多く、術後CEAも有意に高く、全症例中81例(68.7%)が再発していた。2)CEA陰性群の再発は22例(38.6%)で認められた。一方、再発時に術後CEAの陽転は13例(14.7%)でCEA陽転とはならない傾向も認められた。3)再発予測因子ではpStage、術前CEA、術後CEAに再発との相関がみられたが、無再発生存期間における有意因子はpStageおよび術後CEAであった。4)全生存期間と術前CEAおよび術後CEAとの関係はいずれも有意因子ではなかった。また、生存曲線においてCEAの術前後の推移と予後との関係では無再発生存率は術前CEAが陽性でも術後CEAが陰性なら再発率は低かった。反対に術前CEAが陰性でも術後CEAが陽性なら再発率は高く、全生存率はCEAの推移での有意差は認められなかった。5)pStage別のCEAと予後との関係ではpStage 1では術前CEA陽性群で有意に術後CEA陽性例が多く、再発率も高く、無再発生存率は低かった。6)再発予測因子として術後CEAが有用と考えられるが、術前CEAが陰性の場合は再発時にCEAは陽転しない場合もあり、一方、pStage 1では術前CEA陽性例の再発率は高く厳重な経過観察が必要と考えられた。

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Association for Chest Surgery  

背景．空洞を形成する肺病変には感染性肺疾患，原発性肺癌，転移性肺腫瘍などがあるが，時に診断確定に難渋することがある．今回，MRI拡散強調画像が診断に有用であった肺癌の症例を経験したので報告する．症例．59歳，男性．検診目的の胸部X線検査で右肺異常影を指摘された．2年前の胸部CTで右肺S9に肺炎を疑わせる浸潤影をみとめたが，今回の胸部CTは同部位に4.5 cm大の空洞を伴う腫瘤を認めた．気管支鏡では確定診断に至らず，経過からは遺残した肺膿瘍腔の可能性も考えられ，抗生剤を投与したが画像上改善を認めなかった．しかし，MRI拡散強調画像で空洞壁に一致して高信号を認めた点から細胞密度の高い腫瘍性病変の存在が疑われたため手術を施行した．病理組織検査では粘液産生性混合型腺癌（腺房型および細気管支肺胞上皮癌），pT2aN2M0 pStage IIIAであった．結論．MRI拡散強調画像が肺悪性腫瘍の診断補助になる可能性が示唆された．

DOI： 10.2995/jacsurg.27.632

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その他リンク： http://search.jamas.or.jp/link/ui/2014014310

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Association for Chest Surgery  

肺切除周術期の重要な合併症として不整脈があるが，心不全の指標であるヒト脳性利尿ペプチド（BNP）の関与に関する知見は乏しい．呼吸器外科周術期におけるBNPの推移，術後不整脈発症との関連を検討した．<br>2008年1月から2010年5月に当科の呼吸器外科手術例のうち術前後にBNPを測定した63例を対象とした．術前から術後第8病日までに血清BNPを複数回測定し，術前併存症・術後の不整脈出現との関連を検討した．<br>術前併存症では，心不全，虚血性心疾患，不整脈，腎不全，高尿酸血症，間質性肺炎例で術前BNPが高かった．周術期のBNP値は，術前BNP正常例は術後1週までに著明に低下したが，術前BNP上昇例は低下が鈍かった．術前BNP 100 pg/ml以下の54例の検討では，後の不整脈出現例は術翌日のBNP値と術前値との差が非出現例に比べ有意に大きく，この差が不整脈発症の指標となることが示唆された．

DOI： 10.2995/jacsurg.27.3

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その他リンク： http://search.jamas.or.jp/link/ui/2013133823

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本呼吸器内視鏡学会  

DOI： 10.18907/jjsre.35.Special_S220_2

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A certified method for lung cancer screening in Japan is the combination of chest X-ray and sputum cytology. The chest X-ray examination is intended primarily for the detection of peripheral-type lung cancer. Interpretation of the films should be performed by two different physicians, and the films of screenees suspected to have abnormal shadow should be compared to the same screenee's films from previous screening visits. Sputum cytology is conducted for heavy smokers, and is useful for early detection of central lung cancer. The efficacy of this lung cancer screening method has been shown in several case-control studies. There are some problems to solve i. e., a low rate of attendance and inadequate quality control. Low-dose thoracic CT screening is performed with an exposure within a single breath hold, and its interpretation can be conducted with films, CRT, or a LCD monitor. Even when taken at low doses, the radiation exposure dose is large compared to a chest X-ray, being about 3-10 times greater than the absorbed dose and 20-40 times greater than the effective dose. Since the radiation dose in a usual clinical condition is much higher, the clinical condition is not recommended for screening. Concerning the efficacy of low-dose CT screening for heavy-smokers, a positive result was reported in June 2011, and further detailed analyses are required. There are still some problems to solve i. e., the management of undiagnosed shadows, harm caused by the screening, quality control, and efficacy in non-smokers.

Scopus

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japan Lung Cancer Society  

目的．細胞膜水輸送チャネルとして発見されたアクアポリンaquaporin（AQP）にがんの発生や進展に関わる新規機能の存在が近年提唱された．本稿では多様な肺腺癌亜型におけるAQPの発現と進展への関与に関する知見を紹介する．結果．肺癌ではAQP1，3，4，5が腺癌細胞に発現する．その発現は，1）細胞分化に相当する極性を有するAQP1，3の発現，2）極性は保たれるが正常肺では認められないAQP5の異所性発現，3）極性を喪失したAQP1，5の過剰発現に区分される．1）は細気管支肺胞上皮癌に高頻度で，進展に伴い減少する．2）は肺胞上皮癌のみならず異型腺腫様過形成でも見られ，腫瘍発生に関係していると考えられる．3）は微小浸潤部から観察され始め，進展とともに頻度を増し，生命予後と有意な関連を示す．AQP1は浸潤先進部での発現亢進と浸潤部lamellipodia細胞膜での発現を介した，AQP5は細胞増殖や上皮間質移行関連分子の活性化を介した肺腺癌の浸潤・転移能亢進への関与が示唆されている．AQP5の発現と粘液産生性肺癌の進展，AQP1の過剰発現と微小乳頭状成分の侵襲性との関連性も認められる．また，AQP4は肺腺癌で発現レベルが高く，生命予後良好因子となる．結論．AQP1，5は肺腺癌の進展に関わる重要分子の一つと考えられ，新たな進展阻止法の確立のための標的分子となる可能性が示唆される．<br>

DOI： 10.2482/haigan.52.17

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その他リンク： http://search.jamas.or.jp/link/ui/2012192671

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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:The aim of this study was to interpret diffusion-weighted imaging (DWI) signals in lung cancers. They were converted into several three-dimensional DWI signals patterns, which represent the degree of DWI signal intensity by height and the degree of distribution by area: flat, low elevation, irregular elevation, single-peak elevation, multiple-peak elevation, and nodular elevation. There were 39 adenocarcinomas and 21 squamous cell carcinomas. Three-dimensional DWI signals decreased significantly in order of cell differentiation. Tumor cellular densities were increased according to the increase in three-dimensional DWI signals. DWI signal intensity and distribution can represent the amount of cancer cells and their distribution in the carcinoma.

DOI： 10.1016/j.clinimag.2012.04.026

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：特定非営利活動法人 日本呼吸器内視鏡学会  

Background. Patients expect flexible bronchoscopy to be painless and completely safe. The purpose of this study was to show how patient satisfaction improved and how the lidocaine dose was reduced in a new bronchoscopy method. Methods. Group A was composed of 28 patients who underwent bronchoscopy as follows (conventional method): (1) lidocaine administration in the throat using jelly, by nebulizer and spray, (2) injection of midazolam until achieving amnesia, and (3) the bolus administration of lidocaine into the airway. Group B was composed of 29 patients who underwent bronchoscopy as follows (new method): (1) lidocaine administration by nebulizer, (2) injection of midazolam until achieving amnesia, and (3) lidocaine spray through a catheter to the throat, trachea and bronchi. Patient satisfaction was classified into 5 categories; very poor, poor, fair, good, excellent. Results. The mean dose of lidocaine (334±81mg) in group B was significantly lower than 450±67mg in group A. In group A, the percentage of patients who felt "excellent" or "good" was 21% during premedication, 89% during the bronchoscopic procedure, 75% after the bronchoscopic procedure, and 75% during the total procedure. In group B, the percentage of patients who felt "excellent" or "good" was 48% in premedication, 90% during the bronchoscopic procedure, 66% after the bronchoscopic procedure, and 86% during the total procedure. The degree of patient satisfaction during premedication in group B was significantly higher than in group A. Conclusion. Lidocaine administration to the throat during amnesia can improve patient satisfaction. Lidocaine dosage can be reduced by using lidocaine spray through a catheter in a bronchoscopy.

DOI： 10.18907/jjsre.32.5_409

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

PURPOSE: The aim of this study was to determine if glucose transporter-1 (Glut1) expression correlates with (18)F-FDG ((18)F-fluoro-2-deoxyglucose) uptake on positron emission tomography (PET) in lung cancer and to examine the similarities and differences between them. METHODS: A total of 34 patients with resected primary lung cancers were investigated in this study. There were 17 adenocarcinomas, 12 squamous cell carcinomas, and 5 cancers of other cell types. Immunohistochemical Glut1 intensity was categorized into three groups: negative, positive, and strongly positive. Glut1 frequency was defined by the proportion of positive cells among all cancer cells, and it was graded on a semiquantitative scale as 0-100% in 10% increments. The data are expressed as the mean +/- SD. RESULTS: Maximum standardized uptake values (SUVmax) were 4.8 +/- 6.3 in "negative" Glut1 intensity cases, 4.7 +/- 3.1 in "positive" Glut1 intensity cases, and 11.2 +/- 5.2 in "strongly positive" Glut1 intensity cases. Although SUVmax correlated significantly with tumor size (correlation coefficient 0.58, P = 0.00033), Glut1 frequency did not correlate significantly with tumor size (correlation coefficient 0.18, P = 0.301). Cell type and cell differentiation correlated significantly with Glut1 expression and (18)F-FDG uptake. CONCLUSION: Glut1 expression correlates significantly with (18)F-FDG uptake. There are similarities in cell differentiation and cell type between Glut1 expression and (18)F-FDG uptake. (18)F-FDG uptake correlates significantly with tumor size, but Glut1 expression does not.

DOI： 10.1007/s11748-010-0603-1

PubMed

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：特定非営利活動法人 日本呼吸器内視鏡学会  

背景. 気管支鏡検査に際して,患者の苦痛を軽減し安全に施行することが時代のニーズである. 目的. ミダゾラムを用いた気管支鏡検査の患者満足度および問題点を明らかにする. 方法. 28症例(観察15例,肺門精査2例,肺野精査11例)を対象とした. 手順 : (1)2%リドカインビスカス4ml. (2)2%リドカイン3ml吸入後,舌牽引下に1%リドカイン10mlをスプレー散布. (3)ペンタゾシン15mgの筋注. (4)ミダゾラムを2.5mg(1/4A)ずつ静注し,意識が消失後気管支鏡を気道内へ挿入. (5)1%リドカインを2mlずつ散布. (6)終了後,フルマゼニル0.5mgを静注し覚醒.アンケート調査で,患者満足度を,とても楽・楽・普通・苦しい・とても苦しい,の5段階に分類した. 結果. ミダゾラム使用量は,年齢との間に相関係数-0.589で有意の負の相関を認めた. 「楽」・「とても楽」と感じた患者は,前処置で6例(21%),検査中で25例(89%),検査後で21例(75%),全体で21例(75%)であり,前処置で低く,リドカインビスカス・スプレー散布・舌の牽引が辛いと判明した.検査中の記憶は,24例(86%)で全くなく,4例(14%)で少し認めた. 呼吸抑制および合併症を認めなかった. 気管支鏡の再検は,23例(82%)が「受けてもいい」,5例(18%)が「受けたくない」と回答した. 結論. ミダゾラムによる鎮静下に行った気管支鏡検査は,患者の苦痛を軽減し,患者満足度が高く推奨される. 患者の満足度をさらに向上させるために前処置を改善すべきである.

DOI： 10.18907/jjsre.32.2_133

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

The efficacy of lung cancer screening should not be evaluated by the survival rate of lung cancer patients but by lung cancer mortality in a certain population because the survival rate can be greatly affected by several types of bias. Randomized controlled trials that were conducted during the 1970s and 1980s in Europe and the United States failed to prove the efficacy of lung cancer screening in decreasing the mortality rate; but recently the results of case-control studies in Japan have revealed that undergoing currently available screening decreases the risk of lung cancer deaths by 30%-60%. A system is now being created in Japan whereby the guidelines regarding cancer screening will continue to be updated. The preliminary reports concerning lung cancer screening using thoracic computed tomography revealed that not only the detection rate of lung cancer but also the survival rate of detected lung cancer patients were surprisingly high. However, the presence of some potential bias in these studies cannot be ignored; therefore, it is still unknown whether there is actual efficacy. Several randomized controlled trials are presently in progress overseas, but the interim results were not favorable. A randomized controlled trial should therefore immediately be started in Japan as well.

DOI： 10.1007/s11748-009-0448-7

PubMed

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記述言語：日本語   掲載種別：学位論文（その他）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：南江堂  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2009296145

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：永井書店  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2009130296

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TOHOKU UNIV MEDICAL PRESS  

Pure bronchioloalveolar carcinomas have no stromal, vascular or pleural invasion, and they are candidates for curative wedge resection, although standard operative procedure for lung cancer is a pulmonary lobectomy. Most lung cancers with ground glass opacity (GGO), namely faint homogeneous shadows with sharp margin, are pure bronchioloalveolar carcinomas. This report presents the results of a pilot study on wedge resection with candidate selection by high-resolution computed tomography and positron emission tomography with 18F-fluorodeoxyglucose (FDG). The criteria for wedge resection were; 1) clinically no nodal or distant metastasis, 2) the location of the tumor was peripheral enough to undergo wedge resection, 3) the diameter of the shadow was 8-20 mm, 4) GGO% (diameter of GGO area/diameter of whole tumor) was 80% or over, 5) FDG uptake of the tumor was less than that of the mediastinum, 6) the intraoperative pathological diagnosis was non-invasive bronchioloalveolar carcinoma, and 7) informed consent was obtained. Nine tumors from 8 patients were selected in the study. The maximum diameter of the tumors was 9-18 mm and GGO% was 82-100%. All of nine tumors were treated with a wedge resection under video-assisted thoracic surgery. The postoperative courses were uneventful and no recurrence has been detected after 19-50-month follow-up. The changes in pulmonary function before and after the surgery were minimal. In conclusion, wedge resections were safely performed without any recurrence, and the postoperative pulmonary function was well preserved, suggesting the advantage of wedge resections for non-invasive bronchioloalveolar carcinomas.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TOHOKU UNIV MEDICAL PRESS  

Pure bronchioloalveolar carcinomas have no stromal, vascular or pleural invasion, and they are candidates for curative wedge resection, although standard operative procedure for lung cancer is a pulmonary lobectomy. Most lung cancers with ground glass opacity (GGO), namely faint homogeneous shadows with sharp margin, are pure bronchioloalveolar carcinomas. This report presents the results of a pilot study on wedge resection with candidate selection by high-resolution computed tomography and positron emission tomography with 18F-fluorodeoxyglucose (FDG). The criteria for wedge resection were; 1) clinically no nodal or distant metastasis, 2) the location of the tumor was peripheral enough to undergo wedge resection, 3) the diameter of the shadow was 8-20 mm, 4) GGO% (diameter of GGO area/diameter of whole tumor) was 80% or over, 5) FDG uptake of the tumor was less than that of the mediastinum, 6) the intraoperative pathological diagnosis was non-invasive bronchioloalveolar carcinoma, and 7) informed consent was obtained. Nine tumors from 8 patients were selected in the study. The maximum diameter of the tumors was 9-18 mm and GGO% was 82-100%. All of nine tumors were treated with a wedge resection under video-assisted thoracic surgery. The postoperative courses were uneventful and no recurrence has been detected after 19-50-month follow-up. The changes in pulmonary function before and after the surgery were minimal. In conclusion, wedge resections were safely performed without any recurrence, and the postoperative pulmonary function was well preserved, suggesting the advantage of wedge resections for non-invasive bronchioloalveolar carcinomas.

Web of Science

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

Diabetic patients have a decreased incidence of acute respiratory distress syndrome, but the mechanism responsible for the decreased incidence is uncertain. Reabsorption of alveolar edema fluid (alveolar fluid clearance) has been considered to play an important role in resolution of acute respiratory distress syndrome. However, little is known regarding alveolar fluid clearance in diabetes mellitus. Since the obese Zucker rat has been used as an experimental model for diabetes mellitus, we determined if alveolar fluid clearance increased in the obese Zucker rat. First, we compared alveolar fluid clearance in obese Zucker rats with that in lean Zucker rats and Sprague-Dawley (SD) rats. Then, we determined the role of sodium channel, Na,K-ATPase, and beta(2)-adrenoceptor, which drives alveolar fluid clearance, in obese Zucker rats. Alveolar fluid clearance was estimated by the progressive increase in alveolar albumin concentrations in the isolated lungs. We found that basal alveolar fluid clearance in obese Zucker rats was two-fold greater than that in lean Zucker rats and SD rats. The mRNA expression of alpha(1)-, beta(1)-Na, K-ATPase and beta(2)-adrenoceptor, but not mRNA expression of sodium channel, increased in obese Zucker rats. A selective beta(2)-agrenergic antagonist, but not a Na, K-ATPase inhibitor, specifically inhibited the increase in alveolar fluid clearance in obese Zucker rats. These results indicate that overexpression of beta(2)-adrenoceptor primarily increases basal alveolar fluid clearance in the obese Zucker rat. We speculate that the stimulation of alveolar fluid clearance ameliorates acute respiratory distress syndrome in patients with diabetes mellitus.

PubMed

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：学位論文（その他）  

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記述言語：英語   掲載種別：学位論文（その他）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   出版者・発行元：特定非営利活動法人 日本呼吸器外科学会  

DOI： 10.2995/jacsurg.21.452_2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：EUROPEAN RESPIRATORY SOC JOURNALS LTD  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：AMER THORACIC SOC  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：AMER THORACIC SOC  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：EUROPEAN RESPIRATORY SOC JOURNALS LTD  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：SPANDIDOS PUBL LTD  

Web of Science

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記述言語：日本語   出版者・発行元：(NPO)日本がん検診・診断学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：AMER THORACIC SOC  

Web of Science

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