Objective: This study aimed to survey the current status of laryngopharyngeal cancer detected by endoscopic screening of the upper gastrointestinal tract.

Methods: We retrospectively collected data from those who had health checkups at our center from August 2012 to January 2022. Detection rates for laryngopharyngeal and esophageal cancer were calculated and clinical characteristics were compared between them.

Results: Of 43,526 cases (mean age 60.0 years), 52 cases (0.12%) required further investigation in the laryngopharyngeal region. The detection rates for pharyngeal and esophageal cancer were 0.018% and 0.090%, respectively, a 5-fold difference. Both diseases predominated in men (≥89%) in their late 60s, and there was no difference in smoking or drinking histories and degree of obesity. Among pharyngeal cancers, the most popular type was the protruding type with a size of 20 mm or less, but the proportion of lesions adequate for endoscopic treatment was significantly low (29% vs 74%, p=0.032). There was a trend towards a positive correlation between the detection rate of epithelial tumors in the laryngopharyngeal region including dysplasia and esophageal cancer by each endoscopist (r=0.601, p=0.066).

Conclusion: These results suggest that the identification and observation techniques used for early detection of esophageal cancer in high-risk individuals can also be applied to the detection of laryngopharyngeal cancer. In addition to considering the anatomical characteristics and risk of laryngopharyngeal cancer, establishing standards for the observation of this region in screening endoscopy is an urgent issue.

Objective: Mean platelet volume, a measure of platelet size, could be a potentially simple approach for estimating platelet activity. The current study aimed to elucidate the relationship between mean platelet volume and metabolic syndrome, including an investigation of which component of metabolic syndrome was significantly associated with increased mean platelet volume.

Methods: We enrolled 910 individuals who underwent a complete medical check-up at Tokyo Women's Medical University between June 2018 and September 2022. The relationship between metabolic syndrome and mean platelet volume was analysed through contingency tables using multivariate logistic regression. Statistical significance was set at p<0.05.

Results: Metabolic syndrome, particularly the dyslipidemia and hypertension components, was significantly associated with increased mean platelet volume.

Conclusions: This study indicated that higher mean platelet volume is an independent risk factor for metabolic syndrome, which warrants extensive study, particularly given its potential for becoming a diagnostic tool during annual and general regular medical checkups, with low cost and wide availability.

Objective: To analyze the frequency of thrombocytosis diagnosed in general health examination institutions and the background of examinees to consider the direction of secondary screening.

Methods: We analyzed the complete blood count data collected at health examination foundation-related facilities from fiscal year 2016 to fiscal year 2020. Furthermore, we conducted detailed analysis including past medical history and current medical history for examinees in fiscal year 2020.

Results: The total number of platelet tests conducted and the number of cases meeting the criteria of the Japan Society of Ningen Dock and Preventive Medical Care Grade D (platelet count of 400,000/μL or higher) and the diagnostic criteria for essential thrombocythemia (ET) of the World Health Organization (platelet count of 450,000/μL or higher) at four health examination foundation-affiliated facilities from 2016 to 2020 were as follows:

· Fiscal year 2016: 43,964/805 (1.8%)/264 (0.60%)

· Fiscal year 2017: 50,171/1,095 (2.18%)/346 (0.69%)

· Fiscal year 2018: 54,854/1,222 (2.23%)/426 (0.78%)

· Fiscal year 2019: 59,160/1,464 (2.47%)/493 (0.83%)

· Fiscal year 2020: 62,420/1,678 (2.69%)/548 (0.88%)

Among the cohort of examinees undergoing total platelet tests, the number of individuals subjected to ET examination was 0.6–0.9% annually (approximately 500 individuals). The incidence of thrombocytosis was 1.5 to 2 times higher in females than in males, with a tendency towards microcytic anemia observed.

Conclusion: It was found that approximately 1% of all health examination attendees may be candidates for secondary examination for thrombocytosis. Currently, we are developing a comprehensive data analysis program that can comprehensively understand factors such as sustained hematopoietic increases and referral and attendance status for the same examinee.

Objective: To determine whether underlying heart disease can be predicted using electrocardiograms obtained before the development of complete left bundle branch block (CLBBB) which was incidentally detected during routine medical examination.

Methods: The primary endpoint was the association between abnormal electrocardiographic findings before the development of CLBBB and the prevalence of comorbid heart disease. The secondary endpoints were type of heart disease, age at development of CLBBB, and disease duration.

CLBBB was confirmed in 68 of 71,675 individuals (40,084 men and 31,591 women) who underwent electrocardiography from April 2021 to March 2023. Among them, 37 individuals who had available electrocardiograms before the development of CLBBB were included in this study.

Results: The median age was 64 (57–75) years, age at the development of CLBBB was 59 (53–71) years, and disease duration was 3 (0–6) years. Common electrocardiographic findings before the development of CLBBB were left ventricular hypertrophy (43.2%) and normal electrocardiograms (37.8%), followed by T-wave changes (10.8%). Structural heart disease was observed in 12 (32.4%) of the 37 patients. For patients with normal electrocardiograms, the prevalence of comorbid heart disease was 7.1%, which was lower than that for patients with abnormal findings (47.8%). Electrocardiograms before the development of CLBBB had a sensitivity of 91.6% and specificity of 52% for detecting comorbid heart disease. The probability of not having heart disease when the pre-CLBBB electrocardiogram was normal was 92.9%.

Conclusion: Underlying heart diseases are unlikely when electrocardiograms before the development of CLBBB are normal.

Objective: Metabolic syndrome (MetS) is a condition consisting of three components (hypertension, dyslipidemia, and impaired fasting glucose tolerance). Our previous study demonstrated that MetS is a significant risk factor for colorectal adenoma (CRA). The current study aimed to identify a more convenient surrogate marker of CRA. In particular, mean platelet volume (MPV), in addition to MetS, in the development of CRA was investigated.

Methods: This study enrolled 451 participants who visited Tokyo Women's Medical University for a complete medical checkup between June 2018 and October 2022. The risk factors of CRA were analyzed using contingency tables via a multivariate logistic regression analysis. A p-value of <0.05 was considered statistically significant.

Results: Increased MPV, excessive alcohol use, and aging were significant risk factors of CRA. Further, smoking was a statistically significant risk factor of ≥5-mm CRA. This study also showed that CRA ≥5 mm which was potentially eligible for endoscopic resection was slightly more frequent in participants in their 60s.

Conclusions: With consideration to its low cost and availability, increased MPV should be extensively evaluated as a convenient tool for determining the need to undergo CRA screening. In addition, individuals who have excessive alcohol use and who smoke should undergo assessments to rule out CRA as they age, especially those in their 60s.

Objective: Breast fine-needle aspiration cytology is minimally invasive and simple, and continues to be an essential diagnostic tool. This study serves as a preliminary investigation into the potential of using cytology specimens for RNA extraction with sufficient quality for subsequent gene expression analysis, with a focus on breast cancer samples obtained via puncture from surgical resection specimens.

Methods: The samples were obtained via puncture from surgical resection specimens of breast cancers from October 2016 to September 2018. We gathered 140 samples, including 86 from tumor areas and 54 from non-tumor areas. Specimens were punctured with an 18-G needle, transferred into tubes containing 1 mL of RNA extract solution kept on ice, and frozen for storage.

The samples were thawed on ice, and RNA extraction was conducted on ice to prevent RNA degradation due to temperature increase. RNA concentrations were identified using a UV spectrophotometer and a fluorescent RNA-binding dye. Additionally, RNA integrity number (RIN) and DV200 were calculated to assess RNA quality.

Results: A strong correlation was found between RNA concentrations identified by the two distinct methods. Additionally, a moderate correlation was observed between RIN and DV200. Multivariate linear analysis of RIN identified DV200 as an independent factor although it showed no association with RNA concentration or histopathological diagnosis.

Conclusions: Our findings demonstrated that maintaining strict temperature control during the RNA extraction process enables the extraction of high-quality RNA from specimens.

Objective: Although colon capsule endoscopy (CCE) is a non-invasive method, the procedure requires a substantial dose of bowel cleansing agent, which can be burdensome. This preliminary study aimed to verify the feasibility and effectiveness of using a small, more palatable dose of cleansing agent for CCE.

Methods: The study involved 11 participants (six men and five women; mean age, 54.6±7.4 years) who underwent CCE at our facility between November 2022 and August 2023 and received oral sulfate solution as the bowel cleanser. The participants also completed a questionnaire survey. Four participants underwent CCE without the standard 1 h water drinking restriction before capsule ingestion.

Results: The survey results indicated that seven participants perceived the examination as either easy or relatively easy. However, two participants with non-restriction on water drinking reported prolonged procedure times (>10 h) and significant difficulty. Despite this, >50% of the participants considered the bowel cleanser dosage (687 mL on average) as manageable, with a palatable taste. Bowel cleansing was categorized as excellent or good in all cases. The mean procedure time was 7 h 44 min. Lesions were detected in 90.1% of the cases, with colonic polyps identified in 63.6%.

Conclusions: A reduced dose of bowel cleansing agents was effective in alleviating the pretreatment burden of CCE and in ensuring adequate cleansing for lesion detection. CCE utilizing reduced doses of bowel cleansing solution offers a safe and effective alternative for colorectal cancer screening, promising accurate diagnostic performance.

Objective: This study aimed to identify risk factors associated with mean platelet volume (MPV), focusing on arteriosclerotic factors and lifestyle-related diseases, in the general Japanese population using artificial intelligence (AI).

Methods: We enrolled 2,970 participants between June 6, 2018, and October 31, 2022. First, the risk factors associated with increased MPV were analyzed through machine learning using the AI software Prediction One. Subsequently, these factors were investigated and confirmed through contingency tables using multivariate logistic regression analysis.

Results: Machine learning indicated that the important predictors of increased MPV comprised nonalcoholic fatty liver disease (NAFLD) only (fatty liver with NAFLD but not metabolic dysfunction-associated fatty liver disease [MAFLD]), increased fibrosis-4 (FIB-4) index, alcohol consumption, and levels of fasting plasma glucose, triglycerides, estimated glomerular filtration rate, high-sensitivity C-reactive protein, high-density lipoprotein cholesterol, systolic blood pressure, and cholinesterase. Contingency tables using multivariate logistic regression analysis also revealed NAFLD only, increased FIB-4 index, and metabolic syndrome (particularly its dyslipidemia and impaired fasting glucose components) as risk factors for increased MPV.

Conclusions: Using AI, this study indicated that increased MPV was associated with atherosclerotic risk factors and lifestyle-related diseases. Machine learning may be an effective tool for analyzing multiple factors simultaneously, exploring their relationships, and identifying new biomarkers.

Objective: Hyperinsulinemia increases serum uric acid levels by decreasing urinary uric acid excretion. Moreover, elevated plasma glucose levels decrease serum uric acid levels by increasing urinary uric acid excretion. However, it is unknown whether serum uric acid and glucose levels in nonobese participants (with normal glucose tolerance [NGT]) are related. In this retrospective clinical study, we investigated the association of longitudinal changes in serum uric acid and glucose levels in nonobese healthy participants for 10 years.

Methods: In this single-center retrospective study, we used annual Ningen Dock (health checkup) medical records of 84 participants obtained at Kiryu Kosei General Hospital, Japan over the 10 years from 2008–2018. We analyzed the correlation between differences in annual serum uric acid (Δserum uric acid) and glycated hemoglobin (ΔHbA1c) levels over the 10-year observational period, using levels measured in 2008 as baseline.

Results: On multiple regression analysis, uric acid level was associated with gender but not with age or HbA1c level. The Δuric acid level was not associated with gender or age but was independently associated with ΔHbA1c level. Concomitant with these results, Δserum uric acid level (2008–2017) was positively and significantly associated with the ΔHbA1c (2008–2017) (r=0.272, p=0.018). Moreover, Δserum uric acid level (2008–2018) was positively and significantly associated with the ΔHbA1c (2008–2018) (r=0.371, p=0.001).

Conclusions: In nonobese participants with NGT, long-term longitudinal changes in serum uric acid and blood glucose levels are positively correlated.

Objective: To examine the prevalence of asymptomatic uterine fibroids (UFs) in Japanese women visiting a medical checkup center and assess the associations between the prevalence of asymptomatic UF and parity.

Methods: Transvaginal ultrasound was performed on 3,682 healthy Japanese women 19–81 years old at our center between April 2021 and March 2022. We examined the overall and age group prevalence of asymptomatic UFs. Furthermore, we determined the relationship between the prevalence of asymptomatic UFs and parity.

Results: The overall prevalence of asymptomatic UFs was 39.2%. By age group, women in their 50s had the highest rate at 50.5%, followed by those in their 60s (39.6%) and those in their 40s (39.1%). The prevalence of asymptomatic UFs was significantly higher in postmenopausal women than in premenopausal women (44.7% vs. 36.0%, respectively, p<0.001), and in nulliparous women than in parous women (51.1% vs. 36.5%, respectively, p<0.001). The highest rate of asymptomatic UFs was seen in nulliparous women in their 50s (70.9%). The prevalence of asymptomatic UFs decreased significantly as parity increased (p<0.001).

Conclusions: The prevalence of asymptomatic UFs in Japanese women was 39.2%. Asymptomatic UFs are more common in women in their 50s. Prevalence was higher in postmenopausal than premenopausal women. Women with asymptomatic UFs were more likely to be nulliparous than parous.

To understand the actual status of cancer screening during the course of physical examinations and to evaluate the effectiveness and accuracy of cancer screening methods, we conducted a survey among the Assessment Certified Facilities membership of the Japan Society of Ningen Dock and Preventive Medical Care. The survey covered cancer cases detected in subjects who underwent physical checkups in 2021 (April 2021 to March 2022).

Cancer risk factors include lifestyle habits such as smoking (including passive smoking), alcohol consumption, lack of exercise, obesity, lack of fruit, excess salt, and infections. In this study, smoking status (current, past, and nonsmoking) and facial flushing after alcohol consumption were investigated as lifestyle habits, and Helicobacter pylori (H. pylori) infection and human papillomavirus (HPV) infection status as infectious diseases. In addition, we also examined the categorization of main cancers detected by abdominal ultrasonography.