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Clinical backgrounds and outcomes of patients with Barrett's esophageal adenocarcinoma treated via endoscopic submucosal dissection in Kyushu, Japan: A retrospective multicenter cohort study.

Fumisato Sasaki, Kazuhiro Mizukami, Taro Akashi, Naoyuki Yamaguchi, Ryosuke Gushima, Hideaki Miyamoto, Shohei Uehara, Yoichiro Ono, Takashi Hisabe, Yuzuru Kinjo, Yuichiro Nasu, Kensuke Fukuda, Taisuke Inada, Yorinobu Sumida, Takashi Akutagawa, Tadashi Miike, Sho Suzuki, Hiroki Fukuya, Michita Mukasa, Mitsuru Esaki, Shinsuke Kumei, Yosuke Minoda, Tetsu Kinjo, Daisuke Yamaguchi, Yoshio Fukuda, Kazutoshi Hashiguchi, Hiroki Yano, Hiroshi Fujita, Ryo Shimoda

DEN open 6 ( 1 ) e70102 2026.04 [ Peer Review Accepted ]

Type of publication: Research paper (scientific journal)

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OBJECTIVES: Most esophageal cancers in Japan are squamous cell carcinomas; however, there has been some concern regarding a recent increase in Barrett's esophageal adenocarcinoma (BEA). This study aimed to clarify the clinical characteristics and outcomes of patients treated via endoscopic submucosal dissection (ESD) in Kyushu, including changes over time. METHODS: This multicenter, retrospective, observational study was conducted among 21 institutes situated in Kyushu. Data from patients who underwent ESD for BEA or esophageal squamous cell carcinoma between January 2010 and December 2023 were extracted from the pathology database and reviewed. RESULTS: The total number of esophageal ESD cases increased from 2299 over the first 7 years to 4009 over the second seven. The incidence of BEA increased from 3.6% (86/2299) over the earlier period to 4.7% (197/4009; p = 0.034) over the latter. We analyzed data from 283 patients (287 lesions). Smaller tumor-sized lesions were detected over the latter period (14.2 ± 11.6 vs. 11.2 ± 9.5 cm2, p = 0.022), significantly reducing treatment times (122.1 ± 81.2 vs. 93.2 ± 53.3 min p < 0.001). The procedure was safe, with low incidence rates, over both the earlier and later periods (respectively), of perforation (0% vs. 1.0%), delayed bleeding (1.2% vs. 2.0%), and pneumonia (4.7% vs. 4.6%). CONCLUSION: The proportion of esophageal ESD procedures to treat BEA has increased in Japan's Kyushu region. This procedure has a comparable safety profile to similar ESD procedures used to treat other conditions.
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Prevalence and clinical impact of latent tuberculosis infection in patients with inflammatory bowel disease in Japan: a retrospective multicenter study by the IBD-Quality team.

Nanae Tsuruoka, Hironobu Takedomi, Yasuhisa Sakata, Shin Fujioka, Ryosuke Sakemi, Shinya Ashizuka, Nobuaki Nishimata, Kazumi Inaba, Shuji Kanmura, Tetsu Kinjo, Yoki Furuta, Shinichiro Yoshioka, Shojiro Yamamoto, Ayako Takamori, Fumihito Hirai, Motohiro Esaki

Journal of gastroenterology 2026.03 [ Peer Review Accepted ]

Type of publication: Research paper (scientific journal)

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BACKGROUND: Screening and preventive treatment are recommended for latent tuberculosis infection (LTBI) before immunosuppressive therapy in patients with inflammatory bowel disease (IBD). However, the prevalence of LTBI and active tuberculosis, combined with their influence on selection of immunosuppressive therapy, remains uncertain. This retrospective multicenter study aimed to determine the prevalence of LTBI and to evaluate therapeutic management in Japanese patients with IBD according to tuberculosis infection status. METHODS: The clinical profiles and therapeutic management of patients with IBD who were screened for LTBI at any of 10 Japanese institutions between July 2010 and June 2020 were identified by review of the electronic medical records. LTBI was defined as positive when an interferon-gamma release assay or tuberculin test was positive with a normal chest radiograph. RESULTS: A total of 4257 patients with IBD (Crohn's disease, n = 1646; ulcerative colitis, n = 2611) were included. Sixty-nine patients (1.62%) tested positive for LTBI. Ustekinumab and vedolizumab were used significantly more often in the LTBI group than in the non-LTBI group. Fifty-seven patients (82.6%) in the LTBI group received preventive treatment, while 12 (17.4%) were followed without treatment; only ustekinumab and vedolizumab were selected as advanced therapies. During follow-up, two patients developed active tuberculosis after preventive therapy while receiving immunosuppressive agents. CONCLUSIONS: The prevalence of LTBI among Japanese patients with IBD was 1.62%. Both LTBI status and use of preventive treatment may influence selection of advanced therapies for IBD. Although rare, active tuberculosis can occur despite preventive treatment, highlighting the need for appropriate monitoring strategies.
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Linked color imaging improves polyp miss rates in total colonoscopy in a multicenter randomized back to back trial.

Ryo Shimoda, Daisuke Yamaguchi, Kazutoshi Hashiguchi, Kazuhiro Mizukami, Akira Aso, Takashi Akutagawa, Koichi Miyahara, Tetsuro Honda, Keiichi Hashiguchi, Tetsuya Ohira, Kensuke Fukuda, Masayuki Kabayama, Hideaki Miyamoto, Ryosuke Gushima, Yorinobu Sumida, Sho Suzuki, Fumisato Sasaki, Naoyuki Yamaguchi, Tetsu Kinjo, Tadashi Miike, Ken Ohnita, Tomohiko Moriyama, Shin Fujioka, Takashi Shono, Shimpei Shirai, Kensei Ohtsu, Fumiaki Kiyomi

Scientific reports 15 ( 1 ) 36788 - 36788 2025.10 [ Peer Review Accepted ]

Type of publication: Research paper (scientific journal)

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Linked color imaging (LCI) was developed to detect gastrointestinal neoplasms. The current study aimed to determine whether the use of LCI, compared with white-light imaging (WLI), can improve the miss rates of colorectal polyp. A multicenter, randomized back-to-back study was conducted in 16 Japanese endoscopy units. Patients were randomized according to examination: tandem colonoscopy with WLI followed by LCI (WLI-LCI group) and with LCI followed by WLI (LCI-WLI group). The detected polyps were evaluated according to location, size, morphology, and histopathological diagnosis. The primary outcome was polyp miss rate per patient (PMR-PP) in total colonoscopy. The secondary outcome was adenoma detection rate (ADR) during the first assessment in each group. The full analysis set comprised 327 participants, and 320 were included in either two groups. The PMR-PPs were 9.3% and 20.6% in the LCI-WLI and WLI-LCI groups, respectively. Regarding location, the PMR-PP of LCI was significantly lower than that of WLI in the transverse and descending colons and rectum. In terms of diminutive adenomas (< 5 mm), the ADR of LCI (38.2%) was significantly higher than that of WLI (29.1%). LCI was superior to WLI in terms of polyp miss rate particularly in the transverse and descending colons and rectum.
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Fine-scale population structure of Japanese Helicobacter pylori provides new anthropological and epidemiological insights.

Kohei Tomonari, Batsaikhan Saruuljavkhlan, Ricky Indra Alfaray, Kartika Afrida Fauzia, Osamu Matsunari, Daisuke Chinda, Tadashi Shimoyama, Phawinee Subsomwong, Nagisa Kinjo, Tetsu Kinjo, Yasuo Hanamure, Masato Shinzato, Rumiko Suzuki, Fukunori Kinjo, Shigeru Takigami, Toshio Fujioka, Takeshi Matsuhisa, Junko Akada, Takashi Matsumoto, Yoshio Yamaoka

Microbial genomics 11 ( 6 ) 2025.06 [ Peer Review Accepted ]

Type of publication: Research paper (scientific journal)

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Helicobacter pylori is considered to contribute to gastric cancer and is also used as a marker to trace human migration due to its co-evolution with humans. To understand the recently proposed tripartite model suggesting three ancestral origins for the Japanese population and address the enigma of the high incidence of gastric cancer in Northeast Hondo (Hondo is mainland Japan), we conducted a fine-scale population structure analysis using a large Japanese H. pylori dataset, including 438 strains from 9 regions based on whole-genome sequences. As a result of fineSTRUCTURE analysis, it was found that H. pylori in Northeast Hondo is genetically distinct from hspEAsia subgroup 7 (sg7), which is widely distributed elsewhere in Hondo. We named this new subgroup hspEAsia-sg8 (Northeast Hondo). Ancestry analysis using ChromoPainter revealed that, while a large proportion of the genomes of hspEAsia-sg8 strains were painted by donors from their own population, the ancestry components of hspEAsia-sg7 showed a high proportion of Chinese and Korean components, suggesting that they were formed through admixture with continental hspEAsia subgroups. These results align with human genome studies, which indicate an original ancestry component in Northeast Hondo and a higher proportion of East Asian components in West Hondo, supporting the tripartite model. This also suggests novel potential for biogeographic ancestry inference in forensic science, as the H. pylori genome can distinguish Hondo populations. Furthermore, fixation index analysis comparing the genome of hspEAsia-sg8 with other Japanese hspEAsia subgroups revealed a high number of nonsynonymous mutations in hp0378 (ccsBA) and hp0377 (dsbC/ccmG). Because these genes are involved in cytochrome c maturation and disulphide bond formation, the detected mutations may affect bacterial survival, growth or pathogenicity. This study supports the tripartite model for the formation of modern Japanese people and suggests that the strain of H. pylori prevalent in the Northeast Hondo region may contribute to the high incidence of gastric cancer there.
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Validation of British Society of Gastroenterology guidelines for acute lower GI bleeding from 8956 cases in Japan.

Ken Kinjo, Tomonori Aoki, Katsumasa Kobayashi, Atsushi Yamauchi, Atsuo Yamada, Jun Omori, Takashi Ikeya, Taiki Aoyama, Naoyuki Tominaga, Yoshinori Sato, Takaaki Kishino, Naoki Ishii, Tsunaki Sawada, Masaki Murata, Akinari Takao, Kazuhiro Mizukami, Shunji Fujimori, Takahiro Uotani, Minoru Fujita, Hiroki Sato, Sho Suzuki, Toshiaki Narasaka, Junnosuke Hayasaka, Tomohiro Funabiki, Yuzuru Kinjo, Akira Mizuki, Shu Kiyotoki, Tatsuya Mikami, Ryosuke Gushima, Hiroyuki Fujii, Yuta Fuyuno, Takuto Hikichi, Yosuke Toya, Kazuyuki Narimatsu, Noriaki Manabe, Koji Nagaike, Tetsu Kinjo, Yorinobu Sumida, Sadahiro Funakoshi, Kiyonori Kobayashi, Tamotsu Matsuhashi, Yuga Komaki, Kazuhiro Watanabe, Takashi Hisabe, Kenshi Yao, Mitsuru Kaise, Naoyoshi Nagata

Gastrointestinal endoscopy 101 ( 6 ) 1131 - 1144 2025.06 [ Peer Review Accepted ]

Type of publication: Research paper (scientific journal)

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BACKGROUND AND AIMS: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower GI bleeding (ALGIB). METHODS: We analyzed 8956 patients with ALGIB in the Colonic Diverticular Bleeding Leaders Update Evidence From Multicenter Japanese Study (CODE BLUE-J) study and categorized them into 4 groups based on the BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding. RESULTS: The severe bleeding rates significantly decreased from group I to group IV: 92.1%, 70.1%, 58.7%, and 38.4%. The rate of the need for blood transfusion and 30-day mortality also decreased from group I to group IV. Although outpatient follow-up was recommended in group IV, it had high rates of severe bleeding (38%) and 30-day rebleeding (11%). Notably, for colonic diverticular bleeding, the rate of 30-day rebleeding was 25.5%, even with an Oakland score of ≤8. We identified abdominal pain, diarrhea, and a high white blood cell count as independent factors that differentiate between nonsevere and severe bleeding cases in group IV. Using these factors, we found that the 30-day rebleeding rate in the nonsevere group was 3.6%, suggesting the feasibility of outpatient follow-up in this group. Furthermore, a novel group, Group X, which deviated from the existing 4 groups, had a high severe bleeding rate (70.9%) comparable to that of group II. CONCLUSIONS: The BSG guidelines suggest a management approach that can clearly differentiate severity. However, caution is advised when using the Oakland score to triage patients for outpatient follow-up. Additionally, prompt intervention may be necessary for groups not covered by the guidelines.
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A Case of Multicentric Dedifferentiated Liposarcoma in the Stomach and Mesentery

Yumoto Kazuyoshi, Tsuchiya Nanae, Karimata Hiroyuki, Nakamura Youji, Miyahira Aya, Takatsuki Mitsuhisa, Ohira Tetsuya, Kinjo Tetsu, Shinjo Saaya, Tamaki Tomoko, Nishie Akihiro

Journal of the Japanese College of Radiology ( Japanese College of Radiology ) 4 6 - 12 2024 [Refereed]

DOI
Gastric Metastasis from Primary Lung Squamous Cell Carcinoma Presenting a "Bull's-Eye" Appearance.

Hokama A, Hashioka H, Miyagi K, Koga E, Oishi Y, Ohira T, Iraha A, Kinjo T, Fujita J.

Chonnam Medical Journal 2022.09 [Refereed]
Jejunal Arteriovenous Malformation Detected by Video Capsule Endoscopy.

Iraha A, Irei Y, Kinjo T, Oishi Y, Ohira T, Kinjo T, Hokama A, Kosuge N, Wada N, Takatsuki M, Fujita J.

Chonnam Medical Journal 2022.05 [Refereed]
Ischemic Enterocolitis Associated with Coronavirus Disease 2019: Two Case Reports and a Review of the Literature.

Kinjo T, Hokama A, Nakamura H, Miyagi K, Higure Y, Otsuki M, Nishiyama N, Nakamatsu M, Kinjo T, Tateyama M, Fujita J.

American Journal of Tropical Medicine and Hygiene 2021.03 [Refereed]
Elective staged proctocolectomy and living donor liver transplantation for colon cancer with sclerosing cholangitis-related ulcerative colitis: a case report.

Miyagi Y, Kinjo T, Yoshizumi T, Harada N, Arakaki S, Kinjo T, Hokama A, Takatsuki M.

Surgical Case Report 2020.11 [Refereed]