• Journal of Gastric Cancer
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• 제23권4호
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• pp.574-583
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• 2023

Purpose: Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide. National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. Materials and Methods: We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the "before COVID" period, and the years 2020 and 2021 as the "during COVID" period. Results: Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it. Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. Conclusions: During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.

• Asian Pacific Journal of Cancer Prevention
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• 제15권10호
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• pp.4307-4309
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• 2014

Purpose: To calculate the probability of one person's life-time death caused by a malignant tumor and provide theoretical basis for cancer prevention. Materials and Methods: The probability of one person's death caused by a tumor was calculated by a probability additive formula and based on an abridged life table. All data for age-specific mortality were from the third retrospective investigation of death cause in China. Results: The probability of one person's death caused by malignant tumor was 18.7% calculated by the probability additive formula. On the same way, the life-time death probability caused by lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal and anal cancer were 4.47%, 3.62%, 3.25%, 2.25%, 1.11%, respectively. Conclusions: Malignant tumor is still the main cause of death in one's life time and the most common causes of cancer death were lung, gastric, liver, esophageal, colorectal and anal cancers. Targeted forms of cancer prevention and treatment strategies should be worked out to improve people's health and prolong life in China. The probability additive formula is a more scientific and objective method to calculate the probability of one person's life-time death than cumulative death probability.

• Journal of Gastric Cancer
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• 제12권3호
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• pp.201-204
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• 2012

Gastroduodenal intussusception is an infrequent cause of gastrointestinal obstructive disease. Benign neoplasms, gastrointestinal stromal tumors and pedunculated adenocarcinomas of less than 5 cm have been reported to cause gastroduodenal intussusception. We report a case of 76-year-old woman who was presented with a 3-day history of nausea and vomiting due to upper gastrointestinal obstruction. Computed tomography revealed gastroduodenal intussusception with the transpyloric herniation of alarge gastric hyperplastic polyp. The patient underwent laparoscopic wedge resection with the eversion method.

• 전기학회논문지
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• 제67권7호
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• pp.928-933
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• 2018

Nowadays, gastropathy is a common disease. As endoscopic equipment are developed and used widely, it is possible to provide a large number of endoscopy images. Computer-aided Diagnosis (CADx) systems aim at helping physicians to identify possibly malignant abnormalities more accurately. In this paper, we present a CADx system to detect and classify the abnormalities of gastric lesions which include bleeding, ulcer, neuroendocrine tumor and cancer. We used an Inception module based deep learning model. And we used data augmentation for learning. Our preliminary results demonstrated promising potential for automatically labeled region of interest for endoscopy doctors to focus on abnormal lesions for subsequent targeted biopsy, with Az values of Receiver Operating Characteristic(ROC) curve was 0.83. The proposed CADx system showed reliable performance.

• Journal of Gastric Cancer
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• 제8권4호
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• pp.237-243
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• 2008

목적: 최근 감염성 합병증은 병원의 감염관리 및 질적 평가의 지표와도 관련이 있어 관심이 증가하고 있다. 본 연구의 목적은 정규 위암 수술 후 감염성 합병증에 노출되기 쉬운 고위험군의 환자에 대해 알아보고자 하였다. 대상 및 방법: 2000년 1월부터 2007년 12월까지 전북대학교 병원에서 위암으로 정규 위절제술을 받은 환자를 대상으로 의무기록 분석을 통한 후향적 조사를 하였으며, 진단적 개복술과 고식적 우회술만 시행한 환자를 제외한 788명을 대상으로 하였다. 환자의 특성을 환자의 요인과 수술적 요인으로 나누었으며, 환자의 요인으로는 성별, 연령, 체질량 지수, Eastern Cooperative Oncology Group (ECOG) score, 흡연과 음주 여부, 동반된 기저질환 유무와 종류, 조직학적 병기 등이 포함되었고, 수술적 요인으로는 위 절제범위와 림프절 곽청 정도, 수술 시간, 수술 전후 수혈 여부, 수술 중 복강 내 항암화학요법 시행여부 등이 포함되었다. 결과: 평균 나이는 58.9세(범위: 24~91세)였고, 남자는 545명 여자는 243명이었다. 평균재원 기간은 20.3일(범위: 5~135일), 평균 수술시간은 181.3분(범위: 65~440분)이었다. 전체 합병증 발생률은 17.1% (n=135)였으며, 이중 감염성 합병증은 38.5% (n=52)였다. 감염성 합병증에는 창상감염(59.7%), 폐렴(19.3%), 복강 내 농양(11.5%), 거짓막 대장염(5.7%), 균혈증(1.9%) 그리고 간농양(1.9%)이 있었다. 단변량 분석에서 유의한 위험인자는 남자, 수혈, 진단 당시의 흡연과 음주, 당뇨, 심혈관계 질환이었고, 다변량 분석에서는 수혈, 진단 당시의 흡연, 당뇨, 심혈관계 질환이 감염성 합병증의 위험인자였다. 결론: 감염예방을 위해 수술 전후의 수혈을 가급적 피하는 것이 좋다. 또한 수술 전 환자의 동반 기저 질환 유무에 대한 병력과 흡연 등의 개인력 수집에 있어서 세심한 주의가 필요하며 위험인자를 가진 환자들은 수술 후 감염 예방을 위해 집중적인 관리가 필요하다.

• Journal of Gastric Cancer
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• 제13권3호
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• pp.164-171
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• 2013

Purpose: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. Materials and Methods: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopyassisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. Discussion: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).

• Journal of Gastric Cancer
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• 제7권4호
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• pp.237-241
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• 2007

목적: 만성 골수성 백혈병이나 말성 림프구성 백혈병에서 이차성 암의 위험은 증가하는 것으로 알려져 있다. 백혈병을 비롯한 혈액질환을 가진 환자에서 우리나라에서 가장 흔한 암 가운데 하나인 위암의 위험이 증가하는지 조사하여 혈액질환 환자를 대상으로 위암에 대한 보다 적극적인 검진이 필요한지 알아보고자 하였다. 또한 응고장애나 면역저하와 같은 수술에 관련된 위험인자가 있을 수 있는 혈액질환 환자에서 위암 수술이 안전하게 이루어질 수 있는지에 대해 조사하고자 하였다. 대상 및 방법: 지난 15년가 성모병원에서 백혈병 및 다발성 골수종, 재생불량성 빈혈로 진단받은 8,376명의 환자를 대상으로 의무기록을 후향적으로 조사하였다. 결과: 총 9예의 이차성 위암이 확인되었다. 감염이나 출혈등 수술관련 합병증은 발생하지 않았으며, 조기에 발견된 경우 재발도 관찰되지 않았다. 결론: 위암의 빈도가 일반인에 비해 크게 증가하지 않아 혈액질환 환자에서 이차성 위암의 감시를 위한 집중적인 프로그램이 따로 도입되어야 할 필요성은 없는 것으로 생각되며, 혈액질환 환자의 위암 수술에 있어 합병증도 크게 증가하지는 않는 것으로 생각된다.

• Journal of Gastric Cancer
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• 제2권1호
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• pp.12-19
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• 2002

Purpose: The H. pylori cagA gene, vacA gene and iceA gene are considered to be important virurence factors that have been implicated in the development of gastric adenocarcinoma. It was reported that the presence of IS605 elements may be responsible for rearrangements and lead to partial or total deletions of the cag pathogenicity island (PAI) and the virulence of cag PAI may be changed. However, different results regarding the association between these virulence factors and clinical disease have been reported from different geographic regions. This study evaluated the relationship between H. pylori virulence factors such as cagA, vacA, iceA, IS605 and gastric adenocarcinoma. Materials and Methods: H. pylori isolates were obtained from 54 infected patients (24 cases of gastric adenocarcinoma, 30 cases of control). H. pylori isolates were identified by PCR with ureC gene and 16S rRNA. PCR was performed to examine cagA, vacA, iceA and IS605 genotypes. Results: Significant difference was found in the negative rates of cagA between gastric adenocarcinoma group and control ($62.5\%\;vs.\;33.3\%$ P=0.033). No significant difference was found in the prevalence of iceA, vacA between gastric adenocar cinoma and control. The genotype of cagA+ vacA s1-m1 iceA1 was predominant in H. pylori isolates irrespective of the clinical outcome. IS605 in PAI was not found in gastric adenocarcinoma gruop and control. The positive rates of IS605 in genome were $33.3\%$ in gastric adenocarcinoma group and $36.7\%$ in control (P>0.05). In gastric carcinoma, the positive rate of $cagA^{+}/IS605$ was lower than in control ($12.5\%\;vs\;40.0\%$, P=0.025) and the positive rate of cagA-/IS605 was higher than in control ($54.2\%\;vs\;23.3\%$, P=0.02). Conclusion: H. pylori virulence factors had not related significantly with gastric adenocarcinoma. Further study is needed to examine the specificity of H. pylori strains.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.9005-9008
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• 2014

Background: Gastric cancer is the second leading course of cancer death worldwide and H. pylori infection is an important risk factor for gastric cancer development. This study was design to evaluate the clinical, pathological features, survival rate and prevalence of H. pylori infection in gastric cancer in Thailand. Materials and Methods: Clinical information, histological features, endoscopic findings and H. pylori status were collected from gastric cancer patients from Thammasat university hospital during June 1996-December 2011. H. pylori infection was assessed by histological evaluation, rapid urease test and serological test. Clinical information, endoscopic findings and histopathology of all patients were recorded and compared between patients with active or non-active H. pylori infection. Results: A total of 100 gastric cancer patients (55 men and 45 women with mean age of $55{\pm}16.8years$) were enrolled in this study. Common presenting symptoms were dyspepsia (74%), weight loss (66%), anemia (63%) and anorexia (38%). Mean duration of symptoms prior to diagnosis was 98 days. Overall prevalence of H. pylori infection was 83% and active H. pylori infection was 40%. 1-year and 5-year survival rates were 43% and 0%. There was no significant difference between active H. pylori infection in different locations (proximal vs non-proximal: 47.1% vs 48.5%; P-value = 0.9, OR=0.9; 95%CI=0.3-3.1) and histology of gastric cancer (diffuse type vs intestinal type: 47.4% vs 50%; P-value = 0.8, OR=0.9, 95%CI=0.3-2.7). However, linitis plastica was significantly more common in non-active than active H. pylori infection (27.9% vs 0%; P-value<0.0001, OR=13.3, 95%CI=3.2-64.5). Moreover, gastric cancer stage 4 was higher in non-active than active H. pylori infection (93% vs 50%, P-value<0.001). Conclusions: Prevalence of H. pylori infection in Thai gastric cancer patients was high but active infection was low. Most gastric cancer patients presented in advance stage and had a grave prognosis. Screening for gastric cancer in high risk individuals might be an appropriate tool for early detection and improve the treatment outcome for this particular disease in Thailand.

• 대한한방내과학회지
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• 제29권1호
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• pp.117-129
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• 2008

Background & Objective : Naeso-san(NSS) has been used for the treatment of functional dyspepsia, regarded as a gastric dysmotility disease. A main cause of gastric dysmotility is antral dilatation or antroduodenal uncoordination. Therefore, we investigated the effect of NSS on gastric motility and its mechanism of action, as well as the morphologic changes in antral dilatated rats. Methods : Antral dilatated rats were induced by wrapping a nonabsorbable rubber ring(D:6mm, W:4mm, T:1mm) around the 1st portion of the duodenum for 8 weeks. Then morphologic changes were investigated and compared with normal intact rats before and after 8 weeks. Gastric emptying was measured by administration of normal saline(NS) or NSS in normal intact and antral dilatated rats. In another series of experiments to evaluate the mechanism of NSS under delayed conditions, normal intact rats were treated with atropine sulfate(1mg/kg, s.c.), quinpirole HCl(0.3mg/kg, i.p.), $NAME(N^{G}-nitro-L-arginine$ methyl ester, 75mg/kg, s.c.) and cisplatin(10mg/kg, i.p.), respectively. The myoelectrical activity of the gastric smooth muscle was recorded in normal intact and antral dilatated rats. The contractile waves were measured for 30 minutes before and after administration of each solution(NS, NSS). Results : Body weight gain of antral dilatated rats was significantly lower than that of the controls. Futhermore, we found the thickness of the mucosal and muscular layers and surface area of the stomach increased significantly compared with controls. NSS 278㎎/㎏ improved gastric emptying more than normal saline or NSS 93mg/kg in normal intact(p=0.026) and antral dilatated rats(p=0.03). NSS enhanced gastric emptying significantly in the NAME treated group(p=0.002). NSS 278mg/kg increased the significant postprandial dominant power than that of NS in normal intact rats, whereas there was no statistical significance in antral dilatated rats. Conclusions : NSS stimulates gastric motility through the cholinergic pathway. We expect that pathologic model with antral dilatation can be used as an exprimental tool which is similar to dyspepsia and NSS would be effective especially in dysmotility-like functional dyspepsia with antral dilatation or impaired reservoir functions such as gastric adaptive relaxation.