• Journal of Gastric Cancer
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• v.2 no.1
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• pp.5-11
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• 2002

Purpose: The purpose of this study is to identify immunohistochemical evidence of lymph-node micrometastasis in histologic node-negative gastric cancer patients and to evaluate the prognostic significance of lymph-node micrometastasis.Materials and Methods: A retrospective study of 50 gastric cancer patients who underwent curative resections from October 1990 to November 1994 was performed. Two consecutive sections were prepared: one for ordinary hematoxylin and eosin staining, and the other for immunohistochemical staining with Pan cytokeratin antibody (Novocastra, UK). In the univariate analysis, the survival rate was calculated using the Life Table Method, and the multivariate analysis was determined using a Cox Proportional HazardsModel. The statistical analyses of the relationships between the clinicopathologic factors and micrometastases were performed by using a Chi-square test. Results: Of 2522 harvested lymph nodes, 81 ($4.1\%$) nodes and 19 ($38\%$) of 50 patients were identified as having lymphnode micrometastases by using immunohistochemical staining for cytokeratin. The incidence of lymph-node micrometastases was significantly higher in diffuse type carcinomas ($54\%$, P=0.024) and in patients with serosal invasion ($52.2\%$, P=0.05). For patients with lymph-node micrometastases (n=19), the 5-year survival rate was significantly decreased ($73.7\%$, P=0.015). The Lauren's classirication (P=0.021) and the depth of invasion (P=0.035) were shown by multivariate analysis to have a significant relationship with the presence of micrometastases. Multivariate analysis revealed that lymph-node micrometastasis was independently correlated with survival in histologic node-negative gastic cancer patients. Conclusion: The presence of cytokeratin detected lymphnode micrometastases correlates with the worse prognosis for patients with histologic node-negative gastric cancer.

• Journal of Gastric Cancer
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• v.1 no.2
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• pp.92-99
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• 2001

Purpose: E-cadherin is an adhesion molecule essential for tight connection between cells, forming the cadherin/catenin complex. Truncated $\beta$-catenin disrupts the interaction between E-cadherin and $\alpha$-catenin, leading to the loss of intercellular adhesion. Met protein, the hepatocyte growth factor receptor, plays important roles in signal transduction. We investigated the relationships between the expressions of E-cadherin, $\beta$-catenin, and c-met protein and the clinicopathological and prognostic parameters in gastric adenocarcinomas. Materials and Methods: The patterns of E-cadherin, $\beta$-catenin, and c-met protein expression were studied using immunohistochemistry in formalin-fixed, paraffin-embedded archival tissues from 76 surgically resected gastric adenocarcinomas. Results: Increased expressions of E-cadherin, $\beta$-catenin, and c-met were more significantly correlated in early gastric cancers (EGC) than in advanced gastric cancers (AGC) (P=0.002, P=0.003 and P=0.026). The positive immunoreactivities of all three markers were markedly lower in signet ring-cell type and poorly differentiated type lesions than in intestinal-type lesions. Decreased expression of the $\beta$-catenin protein correlated well with increased tumor invasion depth (P=0.039), and increased lymph node metastasis correlated well with reduced expression of c-met (P=0.046). Conclusion: In gastric cancers, reduced expressions of the E-cadherin, $\beta$-catenin, and c-met proteins may play some role in poorer tumor differentiation, deeper tumor invasion, and increased lymph node metastasis. Also, the c-met gene is thought to play a specific role in the mechanism of the yet unknown catenin action.

• Journal of Gastric Cancer
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• v.1 no.2
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• pp.106-112
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• 2001

Purpose: Even with excellent surgical outcome, recurrence of early gastric cancer (EGC) after a curative resection is not declining because the incidence of EGC is increasing. The aim of this study was to propose an appropriate treatment strategy by assessing the risk factors for recurrence of curatively resected early gastric cancer. Materials and Methods: Of 3662 patients who had undergone gastric resections for gastric cancer from 1987 to 1996, the cases of 1050 curatively resected EGC patients were reviewed retrospectively. Among those 1050 patients, 50 patients ($4.8\%$) were diagnosed as having recurrent cancer, which was confirmed by clinico-radiological examination or re-operation. The risk factors that determined the recurrence patterns were investigated by using univariate and multivariate analyses. Results: The mean time to recurrence was 30.9 months, and hematogenous recurrence was the most frequent type ($32.0\%$). Among the 50 recurred patients, peritoneal recurrence showed the shortest mean time to recurrence ($18.5\pm17.7$months). Between the recurred and the non-recurred patients, there was no statistically significant difference with respect to age, sex, operation type, tumor size, tumor location, gross appearance, or histological differentiation. However, depth of invasion (submucosal invasion) and nodal involvement were significantly different (P<0.001) between the two groups. Using logistic regression analyses, nodal involvement was the only significant risk factor for recurrence in early gastric cancer (P<0.001). The median survival after the recurrence had been diagnosed was 4 months. Conclusion: Although the prognosis for EGC patients is excellent and recurrence of EGC after a curative resection is rare, the time to recurrence and the patterns of recurrence in EGC patients were diverse and unpredictable, and the result after recurrence is dismal. Considering the impact of lymph node metastasis on recurrence of EGC, a systematic lymphadenectomy, rather than limited surgery, should be performed if lymph node involvement is confirmed pre- or intraoperatively. Also if the postoperative pathologic findings reveal lymph node involvement, adjuvant chemotherapy is recommended.

• Journal of Gastric Cancer
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• v.3 no.4
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• pp.221-225
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• 2003

Purpose: The prognosis for Borrmann type 4 gastric cancer is dismal although therapies for gastric cancer have been developed. We investigated the outcomes for Borrmann type 4 gastric cancers compared to those for other types of cancer. Materials and Methods: Between 1993 and 2000, 777 patients with advanced gastric cancer underwent surgical resection at the Department of Surgery, Korea University Hospital. The clinicopathologic features of 138 patients with Borrmann type 4 carcinomas of the stomach were retrospectively reviewed from the database of gastric cancer. The results were compared with those of 639 patients with other types of gastric carcinomas. Results: Patients with Borrmann type 4 carcinomas tended to be younger and to have larger tumors. The location, the depth of invasion, lymph node metastasis, and distant metastasis were significantly different between the two groups. Patients with Borrmann type 4 carcinomas had a more advanced stage than patients with other types of carcinomas. The analysis of the treatment factors revealed that total gastrectomies were more frequent in the group with Borrmann type 4 carcinomas and that the curative resection rate of patients with Borrmann type 4 gastric carcinomas was lower than that of patients with other types of gastric carcinomas (P<0.001). The 5-year survival rate for Borrmann type 4 gastric cancer was $19.4\%$ and that for other types was $52.9\%$ (P=0.001). In curative cases, the 5-year survival rates were $32.8 \%$ for patients with Borrmann type 4 gastric carcinomas and $63.4\%$ for other types of carcinomas (P=0.001). Conclusion: Borrmann type IV gastric cancer has more advanced features and a poorer prognosis than other types of gastric cancer. Improving the prognosis for patients with Borrmann type 4 gastric cancer requires early detection and a curative resection.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.3-8
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• 1997

Malignant melanoma has a very poor prognosis compared to other cancers. There are no specific tumor markers other than clinical staging and depth of invasion to predict the prognosis of the malignant melanoma. The nm23 has been known to inhibit the metastasis of the malignant melanoma, some studies showed that it is highly expressed in the malignant melanoma cell line which has a relatively weak metastatic potential. In this study, we compared the expression of nm23 in mucosal type with that in cutaneous type of the malignant melanoma in the head and neck according to the stage and survival rate to identify the role of nm23 expression as a prognostic factor in mucosal melanoma of the head and neck. Six out of eight cases in mucosal type and seven out of 11 cases in cutaneous type expressed nm23, which showed no significant differences. Between the two groups there were no significant differences in expression of nm23 according to clinicopathologic staging or two year survival rate. However, in cases with low cliniopathological staging and those surviving more than two years the expression was significantly increased which suggests that expression of nm23 can be used as an aid in determining the prognosis of mucosal melanoma.

• Journal of Oral Medicine and Pain
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• v.39 no.4
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• pp.133-139
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• 2014

Purpose: There have been reports regarding the various factors associated with the level of discomfort and recovery from neurosensory symptoms in patients with trigeminal nerve injury. However, the contributing factors remain uncertain and poorly understood. The purpose of this paper was to investigate the possible association between various factors expected to affect neurosensory discomfort and recovery in patients with mandibular nerve injury after dental implant surgery. Methods: Eighty-nine post-dental implant surgery patients with mandibular nerve injury were enrolled in this retrospective analysis. A medical records review of the patients was done to determine if the patients' improvement was related to pain intensity, the length of time between the injury and removal of the implant or the depth of penetration of the implant into the mandibular canal as determined by cone-beam computed tomography. Results: There was no significant linear relationship between pain intensity and symptomatic improvement (p=0.319). There was no significant linear relationship between the level of mandibular canal penetration and either pain intensity (p=0.588) or symptomatic improvement (p=0.760). There was a statistically significant linear relationship between length of time before the injury was treated, both with pain intensity (p=0.004), and symptomatic improvement (p=0.024). Conclusions: Our findings indicate that the length of time between nerve injury and initiation of conservative treatment is more closely related to the pain intensity and symptomatic improvement than other factors, including the level of mandibular canal invasion. Additionally, increased pain intensity and decreased symptomatic improvement can be expected over time, because of this linear trend. Therefore, although direct injury to the nerve is the most important factor contributing to a neurosensory disturbances, early neurosensory assessment and initiation of conservative treatment should be done to optimize recovery.

• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.81-87
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• 2010

In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5897-5901
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• 2012

The aim of the study was to clarify the role of gastrokine 1 in the process of formation and development of gastric cancer. The expression of gastrokine 1 in gastric cancer and corresponding non-cancerous gastric tissues of 52 gastric cancer patients was assessed with the real-time fluorescence quantitative polymerase chain reaction (RT-PCR) and immunohistochemistry. We also analyzed the relationship between the expression level and clinicopathological characteristics. Gastrokine 1 gene and protein expression in gastric cancer tissues was in both cases significantly lower than in corresponding non-cancerous gastric tissues (both P<0.01), but no significant relationship was found with clinicopathological parameters including tumor location, depth of invasion, differentiation, lymph node metastasis, stage, gender, age and carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) level in peripheral blood preoperation of patients (P>0.05, respectively). Furthermore, gastrokine 1 gene expression was markedly lower in gastric cancer tissues of Helicobacter pylori (HP)-positive patients than negative ones (P<0.05). The result of the study showed that gastrokine 1 might play a significant role in the process of formation and development of gastric cancer as an anti-oncogene. Its effect might be weakened by HP infection.

• The Korean Journal of Cytopathology
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• v.7 no.2
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• pp.144-150
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• 1996

Although bladder cancers are very common, little is known about their molecular pathogenesis. It is known that p53 alteration is found in about 60% of muscle-invasive bladder cancer, necessiating aggressive therapy and poor outcome. We examined the nuclear expression of p53 protein, using D07 monoclonal antibody in the urine samples from 31 patients with transitional cell carcinoma of the bladder to investigate the correlation of p53 overexpression with histologic grades and depth of invasion. The positive rate of p53 protein was 27% in superficial bladder tumor, but increased up to 71% in the invasive bladder carcinomas. The overexpression of p53 protein increased according to Mostofi grading system from 18% in grade I, 45% in grade II, and up to 100% in grade III. The p53 expression tended to be higher in the invasive and high grade bladder cancers than in the superficial and low grade ones(p<0.05). These results suggest that immunohistochemical analysis of the urine specimen in the bladder cancer patients could be a useful method of screening for the presence of p53 mutant protein. The mutant p53 protein expression may be an indicator of bladder cancer with more proliferative potential and/or aggressive biologic behavior.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4549-4552
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• 2013

The incidence of gastric cancer worldwide, and in particular in developing countries, has shown a marked increase. Poor prognosis of gastric cancer patients occurs due to the rapid metastasis of the disease via the lymphatic and blood vessels. The aim of this study was to investigate the expression and the clinical significance of D2-40 and CD34 in human gastric cancer. D2-40 and CD34 expression wasdetected in 1,072 cases of Chinese patients with gastric carcinoma using immunohistochemistry. The lymphatic vessel density (LVD) and microvessel density (MVD) were calculated and analyzed and the correlation with the clinicopathological factors and prognosis was determined. The LVD and MVD of the gastric cancer cases were significantly higher compared to those of normal tissues (P < 0.05). The expression of D2-40-LVD and CD34-MVD in the malignancies were positively related to the age, tumor size, invasion depth, lymphatic metastasis and pathological tumor-node-metastasis (pTNM) (P < 0.05); However, no statistically significant difference was identified between them with the patient gender (P > 0.05). Up-regulation of D2-40 and CD34 expression was significantly correlated with the poor survival rate in univariate and multivariate analyses. The LVD marked by D2-40 and the MVD marked by CD34 were positively correlated to the clinicopathological factors of the malignancies and may play important role in the development and progression of gastric cancer.