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医学部 医学科 臨床神経科学講座脳神経外科学分野 |
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論文 【 表示 ／ 非表示 】
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Tamura M, Yamashita S, Kawano T, Komaki S, Tsukino T, Kojima K, Maeda K, Kimoto Y, Kadota Y, Azuma M, Okita Y
NMC Case Report Journal 13 ( 0 ) 69 - 75 2026年12月
担当区分：最終著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本脳神経外科学会
Abusive head trauma in infants and young children can have a significant impact on neurological outcomes and, in severe cases, may be life-threatening. We report 3 cases of abusive head trauma that presented with acute subdural hematomas on computed tomography scans, accompanied by extensive low-density areas and parenchymal brain swelling. All patients exhibited impaired consciousness due to brain injury and underwent craniotomy for hematoma evacuation as well as extensive decompressive craniectomy. Despite the severity of the initial presentation, hemiparesis was mild and gradually improved over several months. Postoperative magnetic resonance imaging revealed widespread parenchymal injury but preservation of the corticospinal tract, including the precentral gyrus. In the acute phase, diffusion-weighted imaging showed no irreversible infarction in the motor cortex, and arterial spin labeling demonstrated increased perfusion in peri-motor regions of the affected hemisphere. These findings suggest that preserved corticospinal pathways and compensatory hyperperfusion may correlate with favorable motor recovery even in the presence of extensive parenchymal damage. These cases highlight the radiological features and short-term neurological outcomes of abusive head trauma, demonstrating preserved motor function despite extensive parenchymal damage.
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Molecular characteristics of isocitrate dehydrogenase 1 R132C-mutant diffuse gliomas: association with TP53 alterations and Li-Fraumeni syndrome. 査読あり 国際誌
Yamashita S, Matsumoto F, Saito K, Hidaka M, Arikawa S, Kawano T, Kawano T, Tamura M, Okuyama H, Higa N, Hanaya R, Akahane T, Tanimoto A, Sato Y, Okita Y
Acta neuropathologica communications 2026年7月
担当区分：最終著者 記述言語：英語 掲載種別：研究論文（学術雑誌）
BACKGROUND: The non-canonical isocitrate dehydrogenase 1 (IDH1) R132C mutation is rare in diffuse gliomas but appears to be enriched in tumors associated with Li-Fraumeni syndrome (LFS), which is caused by germline tumor protein p53 (TP53) mutations. However, the molecular relationship between TP53 alterations and IDH1 R132C, as well as the prevalence of LFS among patients with R132C-mutant gliomas, remains unclear. METHODS: We analyzed 93 consecutive patients retrospectively with IDH1-mutant diffuse gliomas (Central Nervous System World Health Organization (CNS WHO) Grades 2 and 3) treated at our institution between 2005 and 2025. IDH, TP53, and ATRX status were assessed by immunohistochemistry, Sanger sequencing, multiplex ligation-dependent probe amplification, and targeted next-generation sequencing. Germline TP53 mutations were assessed using peripheral blood samples. DNA methylation profiling was performed using the Methylscape platform and the DKFZ methylation classifier. RESULTS: Three of 90 IDH1-mutant gliomas (3%) harbored the R132C variant. All three tumors were astrocytomas with concurrent TP53 mutation, ATRX alteration, and 1p/19q non-codeletion. Exploratory cancer cell fraction analysis suggested that both IDH1 R132C and TP53 mutations were present in the major tumor cell population, supporting a biological association between TP53 alterations and the occurrence of the IDH1 R132C variant. One patient harbored a pathogenic germline TP53 mutation despite lacking a family history or fulfilling the established clinical diagnostic criteria for LFS. DNA methylation analysis demonstrated partial overlap with conventional IDH-mutant astrocytoma and also revealed atypical clustering patterns. CONCLUSIONS: IDH1 R132C-mutant gliomas are characterized by concurrent TP53 mutation, ATRX alteration, and 1p/19q non-codeletion. Although based on a small cohort, our findings support a biological association between TP53 alterations and the rare IDH1 R132C variant and suggest that germline TP53 testing may be considered in selected patients, particularly younger individuals, to identify previously unrecognized Li-Fraumeni syndrome.
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Rural medical disparities in multimodal glioblastoma treatment. 査読あり 国際誌
Momii Y, Hata N, Fudaba H, Yonezawa H, Shinojima N, Negoto T, Ujifuku K, Nagamine H, Kuga D, Nakahara Y, Yamashita S, Nakano Y, Enomoto T, Hanaya R, Mukasa A, Morioka M, Matsuo T, Hamasaki T, Yoshimoto K, Abe T, Okita Y, Yamamoto J, Abe H, Fujiki M, Kyushu Neuro-Oncology Study Group
Scientific reports 2026年6月
記述言語：英語 掲載種別：研究論文（学術雑誌）
Glioblastoma continues to have a poor prognosis, although recent advancements in multimodal treatments have gradually improved outcomes. However, treatment options have become increasingly complex and highly specialized. In rural areas, patients often travel long distances for treatments such as bevacizumab (BEV) administration, which may hinder treatment adherence and potentially lead to poorer outcomes. This study analyzed the impact of commuting distance on survival using clinical data from the Kyushu Neuro-Oncology Study Group. We measured the commuting distances of 564 patients with glioblastoma who were initially treated at 11 participating institutions between 2010 and 2023. Patients were categorized into nearby and remote groups using a threshold of 20 km, and their overall survival (OS) was analyzed using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazards model, incorporating additional potential prognostic factors. In the overall cohort, there was no significant difference in OS between the nearby and remote groups (median OS: 19.2 vs. 18.3 months). However, among the 452 patients who underwent second-line treatment for recurrence, OS was significantly longer in the nearby group (median OS: 18.7 vs. 16.8 months). Univariate analysis revealed that commuting distance (P = 0.037), age, extent of resection, and performance status (PS) were all significant prognostic factors. Multivariate analysis demonstrated that commuting distance was an independent prognostic factor (P = 0.009). These results were validated through propensity score matching, which analyzed 148 patients in each group (median OS: 19.3 vs. 16.4 months). Our findings suggest that commuting distance is associated with prognosis in glioblastoma patients who require second-line treatment. To address this issue, it is necessary to establish an environment that enables the smooth and continuous delivery of multimodal treatment, particularly in rural areas.
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Comparing artificial intelligence and physician performance in predicting IDH mutation status in glioma. 査読あり
Takahashi S, Takahashi M, Kinoshita M, Miyake M, Kawaguchi R, Shinojima N, Mukasa A, Saito K, Nagane M, Otani R, Higuchi F, Tanaka S, Hata N, Tamura K, Tateishi K, Nishikawa R, Arita H, Nonaka M, Uda T, Fukai J, Okita Y, Tsuyuguchi N, Kanemura Y, Tsushima F, Kakeda S, Akashi T, Taoka T, Watanabe Y, Yamada K, Hirai T, Azuma M, Yoshiura T, Sese J, Ichimura K, Narita Y, Hamamoto R
NPJ digital medicine 2026年5月
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Okuyama H., Yokogami K., Yamashita S., Okita Y.
Human Pathology Reports 43 2026年3月
掲載種別：研究論文（学術雑誌） 出版者・発行元：Human Pathology Reports
Currarino syndrome is a rare congenital disorder characterized by a triad of presacral mass, sacral agenesis, and anorectal malformation. We report a case of Currarino syndrome with heterozygous in-frame deletion in homeobox of MNX1 gene. Currarino syndrome is an autosomal-dominant inheritance, and many cases of MNX1 mutations have been reported, but there are no reports of symptomatic with heterozygous in-frame deletions in sporadic cases. We downloaded the MNX1 data from open database ClinVar-NCBI. After adding seven literature reports not included in the database with present case, we re-analyzed the mutation type, location and symptoms. Among 81 cases with gene mutations upstream of homeobox, structural changes in homeobox were observed in 39 of 41 symptomatic cases (95.1%), while in only 1 of 40 asymptomatic cases (2.5%). This finding indicates that structural changes in the homeobox of the MNX1 gene are significantly involved in whether Currarino syndrome becomes symptomatic.
講演・口頭発表等 【 表示 ／ 非表示 】
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悪性脳腫瘍の診断と集学的治療
沖田 典子
神戸オンコロジーセミナー 2025年12月11日
開催年月日： 2025年12月11日
記述言語：日本語 会議種別：公開講演，セミナー，チュートリアル，講習，講義等
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悪性脳腫瘍診療と私なりのリーダーシップ ― 女性が管理職になるということ
沖田 典子
愛知脳神経外科カンファレンス2025 2025年8月7日
開催年月日： 2025年12月6日
記述言語：日本語 会議種別：公開講演，セミナー，チュートリアル，講習，講義等
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悪性脳腫瘍の診断と集学的治療
沖田 典子
第14回Mt.Tsukuba 2025年11月7日
開催年月日： 2025年11月7日
記述言語：日本語 会議種別：公開講演，セミナー，チュートリアル，講習，講義等
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KINEVO 900Sが可能にする術者の体格に左右されない脳腫瘍手術
沖田 典子
日本脳神経外科第84回学術集会 2025年10月29日
開催年月日： 2025年10月29日 - 2025年11月1日
記述言語：日本語 会議種別：公開講演，セミナー，チュートリアル，講習，講義等
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少人数医局における脳腫瘍手術の安全管理ー合併症対策の実際と工夫
沖田 典子
日本脳神経外科第84回学術集会 2025年10月30日
開催年月日： 2025年10月29日 - 2025年11月1日
記述言語：日本語 会議種別：公開講演，セミナー，チュートリアル，講習，講義等
科研費（文科省・学振・厚労省）獲得実績 【 表示 ／ 非表示 】
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膠芽腫に対する新規治療法の探索を可能とするデジタルツインの基盤技術開発
研究課題/領域番号：25K22913 2025年04月 - 2027年03月
独立行政法人日本学術振興会 科学研究費基金 挑戦的研究（萌芽）
担当区分：研究分担者
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膠芽腫におけるシングルセルラマン分光法の確立による腫瘍細胞特性の解明
研究課題/領域番号：24K12261 2024年04月 - 2027年03月
独立行政法人日本学術振興会 科学研究費基金 基盤研究(C)
担当区分：研究代表者
寄附金・講座・研究部門 【 表示 ／ 非表示 】
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臨床神経科学講座脳神経外科学分野研究奨学金
2025年01月
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臨床神経科学講座脳神経外科学分野研究奨学金
2024年11月
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臨床神経科学講座脳神経外科学分野研究奨学金（潤和ﾘﾊﾋﾞﾘﾃｰｼｮﾝ振興財団）
2024年09月
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臨床神経科学講座脳神経外科学分野研究奨学金
2024年06月
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臨床神経科学講座脳神経外科学分野研究奨学金（潤和ﾘﾊﾋﾞﾘﾃｰｼｮﾝ振興財団）
2024年05月