• Journal of Gastric Cancer
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• 제12권1호
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• pp.18-25
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• 2012

Purpose: Recently, laparoscopy-assisted gastrectomy (LAG) has been widely accepted modality for early gastric cancer in Korea. The indication of LAG may be extended in an experienced institution. In our institution, the first case of laparoscopy-assisted gastrectomy (LAG) for gastric cancer was performed in May 1998. We retrospectively reviewed the long-term oncologic outcomes over 12 years to clarify the feasibility of LAG for gastric cancer. Materials and Methods: The authors retrospectively analyzed 753 patients who underwent LAG for gastric cancer, from May 1998 to August 2010. We reviewed clinicopathological features, postoperative outcomes, mortality and morbidity, recurrence, and survival of LAG for gastric cancer. Results: During the time period, 3,039 operations for gastric cancer were performed. Among them, 753 cases were done by LAG (24.8%). There were 69 cases of total gastrectomy, 682 subtotal gastrectomies, and 2 proximal gastrectomies. According to TNM stage, 8 patients were in stage 0, 619 in stage I, 88 in stage II, and 38 in stage III. The operation-related complications occurred in 77 cases (10.2%). Median follow-up period was 56.2 months (range 0.7~165.6 months). Twenty-five patients (3.3%) developed recurrence, during the follow-up period. The overall 5-year and disease free survival rates were 97.1% and 96.3%, respectively. Conclusions: The number of postoperative complications and survival rates of our series were comparable to the results from that of other reports. The authors consider LAG to be a feasible alternative for the treatment of early gastric cancer. However, rationale for laparoscopic surgery in advanced gastric cancer has yet to be determined.

• 약학회지
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• 제56권6호
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• pp.358-363
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• 2012

Nemo-like kinase (NLK), an evolutionarily conserved serine/threonine protein kinase, plays an important role in wide variety of developmental events. NLK phosphorylates T-cell factor/lymphoid enhancer factor (TCF/LEF) transcriptional complex and suppresses wnt signaling pathway through inhibition of ${\beta}$-catenin/TCF complex interaction. However, the function of NLK in gastric carcinogenesis has not been investigated. In the present study, we have examined whether the NLK gene is involved in the development and/or progression of gastric cancers. NLK expression was analyzed by immunohistochemical staining in 153 advanced gastric cancer specimens. Immunhistochemical analysis showed increased expression of NLK in 91 (59.5%) out of 153 gastric cancer specimens. Statistically, there was no significant relationship between altered expression of NLK protein and clinicopathological parameters, including tumor differentiation, location, lymph node metastasis. We identified that mRNA and protein expression of NLK was significantly up-regulated in human gastric cancer tissues compare to corresponding normal gastric tissues. In addition, we found that human gastric cancer cell lines exhibited relatively high expression of NLK, as compared with normal gastric cells. The results of this study suggest that aberrant regulation of NLK may contribute to the development or progression of gastric cancers and serve as a potential biomarker for advanced gastric cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5269-5273
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• 2013

Aim: We conducted a case-control matched study to investigate the role of IL-16 gene polymorphisms, rs4072111, rs1131445, rs4778889 and rs11556218, in the risk of gastric cancer in a Chinese population, also performing subgroup analysis by subsites. Methods: To test the hypothesis of involvement, we analyzed the four SNPs of IL16 in 347 cancer patients and 368 controls. Demographic data and other information were collected using a newly designed questionnaire. Genotyping of IL16 (rs4072111, rs1131445, rs4778889 and rs11556218) was performed in a 384-well plate format on the MassARRAY(R) platform. Results: In our study, we found the gastric cancer patients were more likely to be male and have a family history of cancer (P<0.05). We found the rs4778889 CC and rs11556218 GG genotype was significantly associated with 1.97 and 1.84-fold increased risk of non-cardia gastric cancer, while we did not find significant association between the four IL-16 SNPs and cardia gastric cancer. Conclusions: In conclusion, our study indicated that IL-16 rs4778889 CC and rs11556218 GG genotypes are associated with an increased risk of non-cardia gastric cancer in a Chinese population. Our results offer insights into the influence of IL-16 on development of gastric cancer.

• Journal of Gastric Cancer
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• 제19권1호
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• pp.92-101
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• 2019

Purpose: The aim of this study was to evaluate the trend of non-compliance with treatment (NCT) among gastric cancer patients in the Korean population. Materials and Methods: Using data from the Korea Central Cancer Registry from 1999 to 2015, patients who did not receive any treatment for gastric cancer within 4 months after diagnosis were defined as the NCT group. The annual incidence rate, distributions according to age group and stage, and 5-year relative survival of the patients exhibiting NCT were analyzed. Results: The number of NCT patients was 5,871 (30.6%) in 1999 and continuously decreased to 4,434 (15.3%) in 2015. Between 2006 and 2015, the proportions of NCT patients decreased from 72.9% to 55.0% among those 80 years old or older and from 9.2% to 5.4% among patients younger than 40 years. In patients with distant metastases, this proportion decreased from 35.5% to 32.7%, and this proportion also decreased from 17.6% to 8.2% among those with localized disease. The 5-year relative survival rates of NCT patients between 2011 and 2015 were significantly lower than those of the treated patients in each stage (60.2% vs. 99.7%, 13.8% vs. 67.1%, and 2.0% vs. 8.3% among those with localized, regional, and distant disease, respectively). Conclusions: The proportion of NCT gastric cancer patients has decreased during the last 16 years. However, considerable numbers of elderly patients are still NCT. There must be a strategy to decrease NCT and improve the nationwide survival rate of patients with gastric cancer.

• Journal of Gastric Cancer
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• 제4권3호
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• pp.149-155
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• 2004

Purpose: According to the recent studies, it is shown that the polymorphism of Interleukin $1\beta$ gene is associated with the incidence of gastric cancer caused by the Helicobacter pylori infection. Interleukin $1\beta$ is a cytokine markedly inhibiting gastric acid secretion. Interleukin $1\beta$ production associated with Helicobacter pylori gastric infection may exacerbate mucosal damage including chronic gastritis and atrophic gastritis, may induce eventual neoplasia. Among these Interleukin $1\beta$ gene polymorphisms, polymorphisms at -31 portion and -511 portion may associated with these processes, eventually increase the risk of gastric cancer. We investigated the risk of gastric cancer according to the Helicobacter pylori infection and genetic polymorphism of Interleukin $1\beta$ in gastric cancer patients. Materials and Methods: 176 individuals with gastric cancer and 40 healthy controls were analyzed. Each group was divided into two groups whether they infected with Helicobacter pylori or not. DNA was extracted from the peripheral blood in all groups. The PCR-RFLP method was used for investigating the distribution of genotype of C/C, C/T, T/T at -31 portion and -511 portion. Results: T/T genotype at -511 portion was $19.3\%$ in gastric cancer cases and $10\%$ in controls, which was statistically significant. (P=0.0432) The risk of gastric cancer was increased 4.86 ($1.26\∼18.77$) in group which had T/T genotype. In gastric cancer cases, C/C genotype at 31 portion was $27.6\%$ in group with Helicobacter pylori infection and $12.8\%$ in group without infection, which was statistically significant. (P=0.0047) The risk of gastric cancer was increased 4.82 ($1.81\~12.81$) in group which had C/C genotype. Conclusion: T genotype at -511 portion among the Interleukin $1\beta$ genetic polymorphisms may be the risk factor of gastric cancer. And, with Helicobacter pylori infection, C genotype at -31 portion may be the risk factor of gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5563-5568
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• 2012

Based on our previous report on gastric cancer which documented ATP4A and ATP4B mRNA down-regulation in gastric tumors relative to normal gastric tissues, we hypothesized that epigenetic mechanisms could be responsible. ATP4A and ATP4B mRNA expression in gastric cancer cell lines AGS, SNU638 and NUGC-3 was examined using reverse transcriptase PCR (RT-PCR). AGS cells were treated with TSA or 5'-AzaDC and methylation specific PCR (MSP) and bisulfite sequencing PCR (BSP) analysis were performed. MSP analysis was on DNA from paraffin embedded tissues sections and plasma. Expression analysis revealed downregulation of ATP4A and ATP4B genes in gastric cancer cell lines relative to normal gastric tissue, while treatment with 5'-AzaDC re-activated expression of both. Search for CpG islands in their putative promoter regions did not indicate CpG islands (CGI) but only further downstream in the bodies of the genes. Methylation specific PCR (MSP) in the exon1 of the ATP4B gene and exon7 in ATP4A indicated methylation in all the gastric cancer cell lines tested. MSP analysis in tumor tissue samples revealed methylation in the majority of tumor samples, 15/19, for ATP4B and 8/8 for ATP4A. There was concordance between ATP4B and ATP4A down-regulation and methylation status in the tumour samples tested. ATP4B methylation was detectable in cell free DNA from gastric cancer patient's plasma samples. Thus ATP4A and ATP4B down-regulation involves DNA methylation and methylated ATP4B DNA in plasma is a potential biomarker for gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4239-4242
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• 2013

It is reported that the expression level of MLL3 in gastric cancer tissue highly correlates with tumor progression. However, whether MLL3 genetic variants are associated with the risk of gastric cancer remains unclear. In this study, we conducted a genotyping analysis for MLL3 in 314 cases of gastric cancer and 322 controls from the Chinese Han population. 4 SNPs (rs6943984, rs4725443, rs3800836, rs6464211) were selected for the present analysis. We found 2 SNPs (rs6943984, rs4725443) of MLL3 gene were significantly associated with the risk of gastric cancer : the rs6943984 with the minor allele A and rs4725443 with the minor allele C revealed strong associations with increased gastric cancer risk [P < 0.001, OR=1.97, 95% CI=1.48~2.64 and P <0.001, OR=2.23, 95% CI=1.54~3.24]. Haplotype analysis of the four SNPs showed that haplotype A-T-A-C, G-T-G-C, and G-C-A-C increased the risk of gastric cancer (P <0.001, P=0.18, and P<0.001, respectively), while haplotype G-T-A-C significantly reduced the risk of gastric cancer (P <0.001). We concluded that MLL3 variants are significantly associated with gastric cancer risk. Our results for the first time provided new insight into susceptibility factors of MLL3 gene variants in carcinogenesis of gastric cancer of the Chinese Han population.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.219-225
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• 2010

Purpose: The long-term survival rate of gastric cancer patients after surgery has recently increased as a result of making an early diagnosis of gastric cancer. Therefore, the incidence of remnant gastric cancer is increasing. This study was performed to evaluate the clinicopathological characteristics and prognosis of patients with remnant gastric cancer. Materials and Methods: From January 2005 to December 2009, twenty-nine patients with remnant gastric cancer and who underwent surgery at Pusan National University Hospital were enrolled in this study. We retrospectively reviewed and analyzed their medical records. We also divided them into two groups: the remnant gastric cancer (RGC)-B group (first operation for benign disease) and the RGC-M group (first operation for malignant disease). Results: The RGC-B group included ten patients and the RGC-M group included nineteen patients. The mean interval between the first and second operations was 17 years. The curative resection rate was 93.1% (27/29). The postoperative complication rate was 20.7% (6/29) and there was no perioperative mortality. Ten (37%) of twenty-seven patients experienced recurrence after curative resection and eight patients (27.6%) expired due to aggravation of remnant stomach cancer. An advanced TNM stage and non-curative resection were the negative prognostic factors for survival for patients with remnant stomach cancer (P=0.0453 and P<0.001). The RGC-M group showed a shorter interval (P<0.001) and the RGC-B group had more advanced TNM stage (P=0.003). Conclusions: Long-term follow-up should be considered not only for patients who undergo an operation for malignant disease, but also for the patients who underwent an operation for benign disease. When remnant gastric cancer is diagnosed, curative resection is essential to improve the survival.

• Journal of Gastric Cancer
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• 제18권4호
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• pp.339-347
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• 2018

Purpose: To evaluate the status of number 3b lymph node (LN) station in patients with adenocarcinoma of the esophagogastric junction (AEG) and to investigate the optimal indications for radical proximal gastrectomy (PG) for AEG. Materials and Methods: Data of 51 patients with clinically advanced Siewert types II and III AEG who underwent total gastrectomy (TG) between April 2010 and July 2017 were reviewed. The proportion of metastatic LNs at each LN station was examined. Number 3 LN station was separately classified into number 3a and number 3b. The risk factors for number 3b LN metastasis and the clinicopathological features of number 3b-positive AEG patients were investigated. Results: The incidences of LN metastasis were the highest in number 1 (47.1%), followed by number 2 (23.5%), number 3a (39.2%), and number 7 (23.5%) LN stations. LN metastasis in number 3b LN station was detected in 4 patients (7.8%). A gastric invasion length of more than 40 mm was a significant risk factor for number 3b LN metastasis. All 4 patients with number 3b-positive AEG had advanced cancer with a gastric invasion length of more than 40 mm. The 5-year survival rate of patients with a gastric invasion length of more than 40 mm was 50.0%. Conclusions: Radical PG may be indicated for patients with AEG with gastric invasion length of less than 40 mm.

• Journal of Gastric Cancer
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• 제1권2호
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• pp.119-123
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• 2001

Purpose: The prognosis of operated early gastric cancer is quite excellent and the 5-year survival rate shows to be over $90\%$. The less extensive treatment has been considered to be attractive. However, lymph node metastasis remains a main risk factor for recurrence of early gastric cancer. The author performed this study in order to determine which clinicopathologic factors of early gastric cancer influence lymph node metastasis and recurrence. Materials and Methods: A retrospective study was conducted on 222 patients with early gastric cancer who had been treated by gastrectomy combined with D2 or more extended lymph node dissection between January 1991 and December 1997 at the Department of Surgery, Kyunghee University Hospital. Results: Lymph node metastasis was observed in 26 patients ($11.7\%$), and the depth of tumor invasion and tumor size among clinicopathologic factors affected lymph node metastasis. The 5-year recurrence rate was $4.4\%$, and it was revealed that lymph node metastasis and depth of tumor invasion had a greater effect on recurrence than other clinicopathologic factors. Conclusion: The high risk factors of early gastric cancer in recurrence were submucosal tumor invasion, tumor size more than 2 cm, and lymph node metastasis. Patients of early gastric cancer with such high risk factors should undergo radical gastric resection than limited surgery. (J Korean Gastric Cancer Assoc 2001;1:119-123)