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Modification of the TNM Staging System for Stage II/III Gastric Cancer Based on a Prognostic Single Patient Classifier Algorithm

  • Choi, Yoon Young;Jang, Eunji;Seo, Won Jun;Son, Taeil;Kim, Hyoung-Il;Kim, Hyeseon;Hyung, Woo Jin;Huh, Yong-Min;Noh, Sung Hoon;Cheong, Jae-Ho
    • Journal of Gastric Cancer
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    • v.18 no.2
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    • pp.142-151
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    • 2018
  • Purpose: The modification of the cancer classification system aimed to improve the classical anatomy-based tumor, node, metastasis (TNM) staging by considering tumor biology, which is associated with patient prognosis, because such information provides additional precision and flexibility. Materials and Methods: We previously developed an mRNA expression-based single patient classifier (SPC) algorithm that could predict the prognosis of patients with stage II/III gastric cancer. We also validated its utilization in clinical settings. The prognostic single patient classifier (pSPC) differentiates based on 3 prognostic groups (low-, intermediate-, and high-risk), and these groups were considered as independent prognostic factors along with TNM stages. We evaluated whether the modified TNM staging system based on the pSPC has a better prognostic performance than the TNM 8th edition staging system. The data of 652 patients who underwent gastrectomy with curative intent for gastric cancer between 2000 and 2004 were evaluated. Furthermore, 2 other cohorts (n=307 and 625) from a previous study were assessed. Thus, 1,584 patients were included in the analysis. To modify the TNM staging system, one-grade down-staging was applied to low-risk patients according to the pSPC in the TNM 8th edition staging system; for intermediate- and high-risk groups, the modified TNM and TNM 8th edition staging systems were identical. Results: Among the 1,584 patients, 187 (11.8%), 664 (41.9%), and 733 (46.3%) were classified into the low-, intermediate-, and high-risk groups, respectively, according to the pSPC. pSPC prognoses and survival curves of the overall population were well stratified, and the TNM stage-adjusted hazard ratios of the intermediate- and high-risk groups were 1.96 (95% confidence interval [CI], 1.41-2.72; P<0.001) and 2.54 (95% CI, 1.84-3.50; P<0.001), respectively. Using Harrell's C-index, the prognostic performance of the modified TNM system was evaluated, and the results showed that its prognostic performance was better than that of the TNM 8th edition staging system in terms of overall survival (0.635 vs. 0.620, P<0.001). Conclusions: The pSPC-modified TNM staging is an alternative staging system for stage II/III gastric cancer.

Disturbed Functional Asymmetry of Sensorimotor Cortex in Schizophrenia: A Study with Functional Magnetic Resonance Imaging (정신분열증에서 감각운동피질의 기능적 비대칭성의 장애: 기능적 자기공명영상을 이용한 연구)

  • Ahn, Kook-Jin;Chae, Jeong-Ho;Kim, Tae;Kim, Euy-Neyng;Lee, Jee-Mun;Choi, Kyu-Ho;Hahn, Seong-Tai
    • Investigative Magnetic Resonance Imaging
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    • v.4 no.1
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    • pp.52-57
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    • 2000
  • Purpose : The purpose of this study was to investigate the pattern of cerebral response to motor tasks in patients with schizophrenia compared with normal subjects using functional MRI. Materials and methods ; Nine right handed-schizophrenic patients and six right-handed normal subjects were included. We used right hand movement as task. Series of 120 consecutive echo-planar images per section were acquired during three cycles of task and rest activations. Lateralization index of cortical response was measured and compared between patients and normal subjects. Results ; Right hand motor task was associated with greater activation in left sensorimotor cortex than the right in normal subjects. Schizophrenia patients showed relatively decreased activation in left cortex and increased activation in right cortex compared with normal subjects. In one patient, reversed lateralization was noted. Conclusion : Normal hemispheric asymmetry of cortical response to motor task was found in different pattern in schizophrenia. Our result is consistent with functional disturbance of motor circuitry in this disorder. Functional MRI will play an important role in diagnosis and research of this disorder.

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Physiological activities of water extract and solvent fractions of Grifola frondosa (잎새버섯 물추출물 및 유기용매 분획물의 생리활성)

  • Kim, Eun-Jung;Kim, Jun-Ho
    • Journal of Mushroom
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    • v.13 no.3
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    • pp.192-198
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    • 2015
  • This study was performed in order to analyze the fibrinolytic, thrombin inhibitory, anti-oxidative, acetylcholinesterase inhibitory, and immuno-enhancing activities of the water extract and solvent fractions isolated from Grifola frondosa. Fibrinolytic activity was analyzed using the fibrin plate method, and thrombin inhibitory activity was assayed using the substrate H-D-Phe-piparg- pna. Anti-oxidative activity was estimated using the DPPH assay, and AChE inhibitory activity was measured using the spectrophotometric method. Immuno-enhancing activity was examined using the nitric oxide (NO) production in RAW 264.7 macrophage cells. Cell viability was determined using the MTS assay. Fibrinolytic activities were the highest in water extract (1.55 plasmin units/mL) followed by water fraction (0.85 plasmin units/mL). The thrombin inhibitory activities of the water and ethyl acetate fractions were determined to be 76.43% and 72.59%, respectively. The acetylcholinesterase inhibitory activities of chloroform and hexane fractions exhibited values of 95.14% and 94.74%, respectively. The butanol fraction showed the highest anti-oxidative activity at 94.47%. Anti-proliferating activity against Raw 264.7 cells showed no cytotoxicity. The production of NO in Raw 264.7 cells increased up to 2-fold by adding the water fraction compared to the untreated control. These results suggest that Grifola frondosa may serve as a useful functional food for the enhancement of immune function and the prevention and therapy of cardiovascular diseases.

IL28B rs12979860 Gene Polymorphism in Egyptian Patients with Chronic Liver Disease Infected with HCV

  • Zekri, Abdel-Rahman N.;Salama, Hosny;Medhat, Eman;Bahnassy, Abeer A.;Morsy, Heba M.;Lotfy, Mai M.;Ahmed, Rasha;Darwish, Tarneem;Marei, Mohamad S.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7213-7218
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    • 2014
  • Background: Egypt has one of the highest prevalences of hepatitis C virus (HCV) infection worldwide. Although the IL28B gene polymorphism has been shown to modify the course of chronic HCV infection, this has not been properly assessed in the Egyptian population. Materials and Methods: The IL28B rs12979860 single nucleotide polymorphism (SNP) was therefore examined in 256 HCV-infected Egyptian patients (group II) at different stages of disease progression and in 48 healthy volunteers (group I). Group II was subdivided into GII-A (chronic hepatitis patients, n=119), GII-B (post hepatitis cirrhosis, n=66) and GII-C (HCC on top of cirrhosis, n=71). Results: The C/T genotype was the commonest in all groups. It was more frequent in GI (52%) than in GII (48%). There was no significant difference in the frequency of C/T and C/C or T/T genotypes between groups and subgroups (p=0.82). Within the subgroups; the C/C genotype was more common in GII-B while C/T and T/T genotypes were more common in GII-C, though with no significant difference (p=0.59 and p=0.80). There was no significant association between IL28B rs12979860 SNP and viral load, ALT, AFP level, METAVIR scores for necro-inflammation and fibrosis, and Child-Pugh classification. Conclusions: 1) IL28Brs12979860 C/T genotype is the commonest genotype in HCV-associated CH and HCC in Egypt. 2) IL28Brs12979860 polymorphisms are not associated with disease progression or aggression (histological staging, severity of fibrosis in CH or the incidence of post-HCV HCC). 3) Differences in IL28Brs12979860 genotypes could be a consequence of environmental or ethnic variation.

Characteristics of Phonatory and Respiratory Control on Pitch, Loudness, Register Change in Untrained and Trained Singers (성악가와 훈련 받지 않은 일반인의 음도, 강도, 성구 변화 시 발성 및 호흡조절 특성)

  • Choi, Seong-Hee;Nam, Do-Hyun;Kim, Deak-Won;Kim, Young-Ho;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.2
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    • pp.115-126
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    • 2006
  • Background and Objectives : Training of breath support and laryngeal muscles control are important components in the development of the singing voice. The purpose of this study is to compare characteristics of respiratory and phonatory control on pitch, loudness, register change with untrained males and trained male singers. Materials and Methods : The 11 untrained males and 11 trained male singers participated. Closed Quotient(CQ), fundamental frequency (fo) and relative volume contribution of the rib cage (in percentage rib cage, % RC) and relative volume contribution of abdomen (in percentage abdomen, % AB) were measured during various pitch, loudness, register tasks using /a/ vowel phonation : Legato, staccato with C3-D3-E3-F3-G3 notes and crescendo and decrescendo with C3 note as well as modal register with C3 and falsetto register with C4 note using an integrated analysis system of Respiration, EGG and Voice. Results : (1) When pitch increased with legato task, loudness also increased in untrained male group but maintained in trained male singers. CQ was also increased both untrained and trained male singers but it was not significantly different ($p>.05$). The abdomen contribution to lung volume were significantly predominant both in inhalation and exhalation in trained males singers ($p<.05$). (2) When pitch increased with staccato task, CQ was not significantly different in untrained but significantly different in trained male singers. The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$) (3) When loudness increased with crescendo, fo was significantly increased with increasing CQ in untrained males but fo was relatively consistent with increasing CQ in trained male singers. The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$). (4) Most male singers were able to change register from modal to falsetto register, but untrained males were not. Thus, CQ was significantly different between modal and falsetto register in trained male singers ($p<.05$). The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$). Conclusion : Male singers were superior to untrained males in coordination of respiratory and phonatory control on pitch, loudness, register change. Implication are offered regarding how the results might be applied to the voice therapy as well as singing training.

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Immunomodulating Activity of Crude Polysaccharide from Inonotus obliquus Sclerotia by Fractionation including MeOH Reflux

  • Lee, Kyung-Haeng;Kim, Hoon;Oh, Sung-Hoon;Hwang, Jong-Hyun;Yu, Kwang-Won
    • The Korean Journal of Food And Nutrition
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    • v.30 no.1
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    • pp.96-104
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    • 2017
  • To obtain the immunomodulating polysaccharide from chaga mushroom (Inonotus obliquus sclerotia, IO), crude polysac- charide fractions (IO-M-CP and IO-CP, respectively) prepared from hot-water extract (IO-W) of I. obliquus by EtOH precipitation after MeOH reflux or not. After IO-W was re-dissolved in water followed by EtOH addition in the case without MeOH reflux, EtOH mixture was fractionated into EtOH-soluble (IO-E) and crude polysaccharide (IO-CP). In the meanwhile, MeOH-soluble fraction (IO-M) was separated from IO-W after MeOH reflux. The residue was dissolved in water and was added by EtOH, and then EtOH mixture was also fractionation into EtOH-soluble (IO-M-E) and crude polysaccharide (IO-M-CP). As a result of the macrophage stimulating activity of these fractions, IO-CP and IO-M-CP showed significantly increased cell proliferation and cytokines production than IO-W. Particularly, IO-M-CP promotes the production of IL-12 more than IO-CP. In the splenocytes proliferating activity and intestinal immune system modulating activity through Peyer's patch, both of 2 crude polysaccharide fractions were significantly promoted in cell proliferation and cytokines production than IO-W, and IO-M-CP was more potent than IO-CP in IL-2 production from splenocytes and GM-CSF production ($10{\mu}g/mL$) in Peyer's patch cells. In addition, immunomodulating polysaccharide fractions (IO-M-CP and IO-CP) prepared from IO-W by EtOH precipitation with or without EtOH reflux showed no significant difference in the chemical composition and component sugar. These results suggested that MeOH reflux might exclude low-molecular weight materials from IO-W and consequently increase the immunomodulating activity of IO-M-CP. Therefore, it was confirmed that immunomodulation of polysaccharide prepared from hot-water extract of chaga mushroom was enhanced by fractionation including MeOH reflux and EtOH precipitation.

Updated Meta-analysis of the Association Between CYP2E1 RsaI/PstI Polymorphisms and Lung Cancer Risk in Chinese Population

  • Wang, Ya-Dong;Yang, Hai-Yan;Liu, Jing;Wang, Hai-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5411-5416
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    • 2014
  • Background: A number of studies have reported relationships of CYP2E1 RsaI/PstI polymorphisms with susceptibility to lung cancer in Chinese population. However, the epidemiologic results have been conflictive rather than conclusive. The purpose of this study was to address the associations of CYP2E1 RsaI/PstI polymorphisms with lung cancer risk in Chinese population comprehensively. Materials and Methods: Systematic searches were conducted in the PubMed, Science Direct, Elsevier, CNKI and Chinese Biomedical Literature Databases. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to estimate the strength of association. Results: Overall, we observed a decreased lung cancer risk among subjects carrying CYP2E1 RsaI/PstI c1/c2 and c1/c2+c2/c2 genotypes (OR=0.76, 95%CI: 0.64-0.90 and OR=0.78, 95%CI: 0.66-0.93, respectively), as compared with subjects carrying the c1/c1 genotype. In subgroup analysis, we observed a decreased lung cancer risk among c1/c2 carriers in hospital-based studies (OR=0.81, 95%CI: 0.68-0.98) and among carriers with c1/c2 and c1/c2+c2/c2 genotypes in population-based studies(OR=0.57, 95%CI: 0.42-0.79 and OR=0.58, 95%CI: 0.43-0.79, respectively), as compared with subjects carrying the c1/c1 genotype. Limiting the analysis to studies with controls in Hardy-Weinberg equilibrium (HWE), we similarly observed a decreased lung cancer risk among c1/c2 and c1/c2+c2/c2 carriers (OR=0.73, 95%CI: 0.60-0.88 and OR=0.73, 95%CI: 0.60-0.88, respectively), as compared with c1/c1. Conclusions: Our results suggested that CYP2E1 RsaI/PstI c1/c2 and c1/c2+c2/c2 variants might be a protective factor for developing lung cancer in Chinese population. Further well-designed studies with larger sample size are required to verify our findings.

Allele and Genotype Frequencies of the Polymorphic Methylenetetrahydrofolate Reductase and Colorectal Cancer among Jordanian Population

  • Yousef, Al-Motassem;Shomaf, Maha;Berger, Sondra;Ababneh, Nidaa;Bobali, Yahya;Ali, Dema;Al-Hasan, Sara;Diab, Ola;Ismail, Said
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4559-4565
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    • 2013
  • Background: Methylenetetrahydrofolate reductase (MTHFR) is involved in DNA synthesis and repair. We here aimed to investigate two common polymorphisms, C677T and A1298C, with genotype and haplotype frequencies in colorectal cancer (CRC) cases among Jordanian. Materials and Methods: 131 CRC cases were studied for MTHFR C677T and A1298C polymorphisms, compared to 117 controls taken from the general population, employing the PCR-RFLP technique. Results: We found the frequency of the three different genotypes of MTHFR C677T among Jordanians to be CC: 61.7%, CT: 35.2%, and TT 3.1% among CRC cases and 50.9%, 38.8% and 10.3% among controls. Carriers of the TT genotype were less likely to have CRC (OR=0.25; 95%CI: 0.076-0.811; p=0.021) as compared to those with the CC genotype. Genotype analysis of MTHFR A12987C revealed AA: 38.9%, AC: 45%, and CC 16% among CRC cases and 37.4%, 50.4% and 12.2% among controls. There was no significant association between genetic polymorphism at this site and CRC. Haplotype analysis of MTHFR polymorphism at the two loci showed differential distribution of the TA haplotype (677T-1298A) between cases and controls. The TA haplotype was associated with a decreased risk for colorectal cancer (OR=0.6; 95% CI: 0.4-0.9, p=0.03). Conclusions: The genetic polymorphism of MTHFR at 677 and the TA haplotype may modulate the risk for CRC development among the Jordanian population. Our findings may reflect an importance of genes involved in folate metabolism in cancer risk.

Differentiation between Glioblastoma and Primary Central Nervous System Lymphoma Using Dynamic Susceptibility Contrast-Enhanced Perfusion MR Imaging: Comparison Study of the Manual versus Semiautomatic Segmentation Method

  • Kim, Ye Eun;Choi, Seung Hong;Lee, Soon Tae;Kim, Tae Min;Park, Chul-Kee;Park, Sung-Hye;Kim, Il Han
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.1
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    • pp.9-19
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    • 2017
  • Background: Normalized cerebral blood volume (nCBV) can be measured using manual or semiautomatic segmentation method. However, the difference in diagnostic performance on brain tumor differentiation between differently measured nCBV has not been evaluated. Purpose: To compare the diagnostic performance of manually obtained nCBV to that of semiautomatically obtained nCBV on glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL) differentiation. Materials and Methods: Histopathologically confirmed forty GBM and eleven PCNSL patients underwent 3T MR imaging with dynamic susceptibility contrast-enhanced perfusion MR imaging before any treatment or biopsy. Based on the contrast-enhanced T1-weighted imaging, the mean nCBV (mCBV) was measured using the manual method (manual mCBV), random regions of interest (ROIs) placement by the observer, or the semiautomatic segmentation method (semiautomatic mCBV). The volume of enhancing portion of the tumor was also measured during semiautomatic segmentation process. T-test, ROC curve analysis, Fisher's exact test and multivariate regression analysis were performed to compare the value and evaluate the diagnostic performance of each parameter. Results: GBM showed a higher enhancing volume (P = 0.0307), a higher manual mCBV (P = 0.018) and a higher semiautomatic mCBV (P = 0.0111) than that of the PCNSL. Semiautomatic mCBV had the highest value (0.815) for the area under the curve (AUC), however, the AUCs of the three parameters were not significantly different from each other. The semiautomatic mCBV was the best independent predictor for the GBM and PCNSL differential diagnosis according to the stepwise multiple regression analysis. Conclusion: We found that the semiautomatic mCBV could be a better predictor than the manual mCBV for the GBM and PCNSL differentiation. We believe that the semiautomatic segmentation method can contribute to the advancement of perfusion based brain tumor evaluation.

Allele and Genotype Frequencies of the Polymorphic Methylenetetrahydrofolate Reductase and Lung Cancer in ther Jordanian Population: a Case Control Study

  • Al-Motassem, Yousef;Shomaf, Maha;Said, Ismail;Berger, Sondra;Ababneh, Nidaa;Diab, Ola;Obeidat, Nathir;Awidi, Abdallah
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3101-3109
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    • 2015
  • Background: Methylenetetrahydrofolate reductase (MTHFR) is involved in amino acid synthesis and DNA function. Two common polymorphisms are reported, C677T and A1298C, that are implicated in a number of human diseases, including cancer. Objective: The association between MTHFR C677T and A1298C genotype and haplotype frequencies in risk for lung cancer (LC) was investigated in the Jordanian population. Materials and Methods: A total of 98 LC cases were studied for MTHFR C677T and A1298C polymorphisms, compared to 89 controls taken from the general population, employing the PCR-RFLP technique. Results: The frequency of the genotypes of MTHFR C677T among Jordanians was: CC, 59.6%, CT, 33%; and TT, 7.4% among LC cases and 49.4%, 40.2% and 10.3% among controls. No significant association was detected between genetic polymorphism at this site and LC. At MTHFR A12987C, the genotype distribution was AA, 29.5%; AC, 45.3%, and CC 25.3% among LC cases and 36.8%, 50.6% and 12.6% among controls. Carriers of the CC genotype were more likely to have LC (OR=2.5; 95%CI: 1.04-6; p=0.039) as compared to AA carriers. Smokers and males with the CC genotype were 9.9 and 6.7 times more likely to have LC, respectively ($OR_{smokers}=9.9$; 95%CI: 1.2-84.5, p=0.018; $OR_{men}=6.6$; 95%CI: 1.7-26.2, p=0.005). Haplotype analysis of MTHFR polymorphism at the two loci showed differential distribution of the CC haplotype (677C-1298C) between cases and controls. The CC haplotype was associated with an increased risk for lung cancer (OR=1.6; 95% CI: 1.03-2.4, p=0.037). Conclusions: The genetic polymorphism of MTHFR at 1298 and the CC haplotype (risk is apparently lower with the C allele at position 677) may modulate the risk for LC development among the Jordanian population. Risk associated with the 1298C allele is increased in smokers and in males. The results indicate that a critical gene involved in folate metabolism plays a modifying role in lung cancer risk, at least in the Jordanian population.