• Journal of Gastric Cancer
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• 제17권2호
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• pp.180-185
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• 2017

Despite the decreasing incidence and mortality from gastric cancer, it remains a major health problem worldwide. Ninety percent of cases are adenocarcinomas. Here, we report a case of gastric adenocarcinoma developed after successful treatment of prior primary gastric diffuse large B-cell lymphoma (DLBCL). Our patient was an elderly man with primary gastric DLBCL in whom complete remission was achieved after R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone plus rituximab) chemotherapy. Helicobacter pylori infection persisted despite adequate treatment leading to sustained chronic gastritis. The mean time to diagnose metachronous gastric carcinoma was seven years. We believe that a combination of many risk factors, of which chronic H. pylori infection the most important, led to the development of gastric carcinoma following primary gastric lymphoma. In summary, patients who have been successfully treated for primary gastric lymphoma should be followed up at regular short intervals. H. pylori infection should be diagnosed promptly and treated aggressively.

• Journal of Gastric Cancer
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• 제14권3호
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• pp.204-206
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• 2014

Gastric complications following unintentional foreign body ingestion are extremely rare. Here, we report the case of a 59-year-old healthy woman who presented with nonspecific abdominal pain and an apparent gastric submucosal tumor that was incidentally detected by gastrofiberscopy. The patient underwent laparoscopic surgery, which revealed an intact gastric wall with no tumor invasion, deformity, or evidence of a gastric submucosal lesion. However, an impacted fish bone was found.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.256-261
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• 2009

목적: 진단 기술의 발전과 함께 위암 환자에서 동시성과 이시성암이 발견되는 빈도가 증가하고 있다. 본 연구에서는 위암에서 발견된 동시성과 이시성암의 임상병리학적 특성과 임상적 의의에 대하여 알아보고자 하였다. 대상 및 방법: 1998년 1월부터 2008년 3월까지 조선대학교병원에서 위암으로 진단된 환자들의 의무기록을 후향적으로 분석하였다. 결과: 1,048명 위암 환자 중 38명(3.6%)에서 동시성과 이시성암이 있었다. 38명 중 16명(42.1%)은 동시성암이었고 22명(57.9%)은 이시성암이었다. 위암과 이차성 원발암 간의 평균 시간간격은 $27.08{\pm}31.25$개월이었다. 가장 흔한 중복암은 폐암(8/38, 21.1%)과 대장암(8/38, 21.1%)이었다. 27명의 환자가 위암에 대하여 수술적 치료를 하였으며 이 중 5명(18.5%)은 동시성암, 22명(81.5%)은 이시성암이었다. 평균 생존 기간은 49.8개월이었으며 동시성암의 경우는 24.6개월 이시성암의 경우는 68.1개월이었고 이들의 3년 생존율은 동시성암, 이시성암 각각 33.3%, 81.1%였다. 결론: 위암에서의 이차성 원발암 진단에 대한 진단에 있어 충분한 수술 전 검사를 통한 동시성암의 발견과 지속적인 추적검사를 통한 이시성암의 발견을 위해 주의를 기울여야 한다.

• Journal of Gastric Cancer
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• 제12권4호
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• pp.254-257
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• 2012

Gastric tuberculosis is rare even in the endemic areas of tuberculosis, and can mimic neoplasm by causing elevation of the mucosa with or without ulceration. Here, we report a case in which a 54-year-old female patient admitted for resection of early gastric cancer was found to have coexisting histopathologically and bacteriologically confirmed gastric cancer and tuberculosis.

• Journal of Digestive Cancer Research
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• 제3권1호
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• pp.11-16
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• 2015

The discovery of HER2, a biomarker in advanced gastric cancer, and successful clinical trial using trastuzumab that targets this biomarker signaled a revolutionary turning point in treatment of metastatic gastric cancer. Many studies about targeted agents for gastric cancer have been attempted. Among them, ramicirumab, a monoclonal antibody that targets vascular endothelial growth factor receptor-2 (VEGFR-2), and apatinib, a tyrosine kinase inhibitor (TKI) that targets VEGFR2, have shown to improve the survival rates in advanced gastric cancer patients, for whom previous therapies had failed; hence, they are expected to be accepted as one of the standard therapies for advanced gastric cancer.

• 한국산학기술학회논문지
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• 제18권5호
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• pp.596-607
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• 2017

의학학술문헌에는 해부학적 조직이나 기관명이 종양, 질환 또는 감염 용어들과 서로 조합하여 사용되는 언어적 특성을 가지고 있다. 의학학술문헌을 검색할 때 데이터베이스가 제공하는 통제어휘도구인 Medical Subject Headings (MeSH)를 활용하면 합성어, 동의어, 그리고 관련어를 추가로 검색할 수 있어 검색효율이 높다. 본 연구에서는 위암(Stomach Neoplasms) 어휘군을 검색용 필터로 추가하는 방법과 동시출현용어의 거리를 측정하여 단어인접탐색 기법으로 검색효율성을 향상시키는 연구를 수행하였다. 검색용 MeSH에 추가할 어휘군을 결정하기 위해 실험데이터로 PubMed에서 중심주제어가 "Stomach Neoplasms"인 2007년~2016년 논문 8,625편을 내려 받아 논문제목으로부터 Stomach와 Neoplasms 관련 용어의 동시출현여부를 분석하였다. 검색효율성은 KoreaMed에서 검색되는 MEDLINE 학술지를 대상으로 "Stomach Neoplasms"가 MeSH로 색인되어 있는 277편으로 검증하였는데 MEDLINE MeSH, MeSH on Demand, 그리고 KoreaMed MeSH Indexer의 "Stomach Neoplasms" 색인어 추출여부와 검색용 필터로 어휘군을 적용했을 때, 그리고 동시출현 용어의 단어인접검색 기법을 적용했을 때 "Stomach Neoplasms"의 매칭여부를 비교하였다. 가장 출현빈도가 높은 용어는 "Gastric Cancer"로 2,780회 출현하였다. "Gastric Adenocarcinoma", "Gastric MALT Lymphoma" 등과 같이 "Stomach" 용어와 "Neoplasms" 관련 조직학적 용어가 조합된 경우는 7,376개(88.51%)였다. 동시출현 거리가 2단어인 용어는 "Stomach"와 "Neoplasms"의 합성어로 5,234개(70.95%)였다. 연구 결과 MeSH용어를 제외하고 973개의 용어를 후보어휘군으로 선정하였다. MEDLINE MeSH와 KoreaMed MeSH Indexer의 MeSH 매칭률은 209편(75.5%)이었는데 검색필터를 적용한 결과 263편(94.9%)으로, 동시출현 용어의 13단어 단어인접탐색 기법을 적용한 경우 268편(96.7%)으로 매칭률이 향상되었다. 본 연구를 통해 자연어 검색에 있어서 검색효율을 향상시키는 수단으로 검색용 시소러스를 사용하면 색인비용에 대한 부담이 적고, 통제어의 망라적 장점과 자연어가 가지는 용어의 특정성을 유지할 수 있음을 증명하였다. 또한 불리안 검색보다는 단어인접탐색 기법을 활용하면 정확률을 높일 수 있어 검색 효율성이 향상됨을 알 수 있었다.

• Journal of Gastric Cancer
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• 제17권2호
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• pp.154-161
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• 2017

Purpose: This study aimed to investigate the correlation between multiple early gastric cancer (MEGC) and multiple primary malignancies during the follow-up of patients with gastrectomy. Materials and Methods: The number of primary tumors detected in other organs after gastrectomy for early gastric cancer (EGC) has been increasing because of improved survival and surveillance programs. A total of 3,129 patients underwent radical gastrectomy for treatment of EGC at Samsung Medical Center from January 2000 to December 2005. Of these, 3,057 patients were selected and their medical records were retrospectively analyzed. Results: Among the 3,057 patients, 148 (4.8%) had MEGC, 84.5% were male, 57.4% were over 60 years old, 42.6% had a macroscopic type EGC IIb main lesion, and 68.9% had well-differentiated tumors with a significantly high incidence of MEGC. There were no differences between patients with solitary early gastric cancer (SEGC) and those with MEGC with regard to overall survival or recurrence-free survival, but MEGC was an independent risk factor for metachronous primary malignancies in other organs (P=0.004, hazard ratio [HR]=2.444). Conclusions: MEGC is not a risk factor for poor prognosis after curative gastrectomy, but it is a risk factor for metachronous primary malignancies in other organs during postoperative follow-up; therefore, careful surveillance is needed.

• Journal of Gastric Cancer
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• 제14권3호
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• pp.215-219
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• 2014

Distant metastasis from papillary thyroid carcinoma (PTC), particularly from papillary thyroid microcarcinoma, is rare. We present a case of perigastric lymph node metastasis from PTC in a patient with early gastric cancer and breast cancer. During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer. Therefore, laparoscopic distal gastrectomy with lymph node dissection and left thyroidectomy were performed. On the basis of the pathologic findings of the surgical specimens, the patient was diagnosed to have papillary thyroid microcarcinoma with perigastric lymph node metastasis and early gastric cancer with mucosal invasion. Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made. When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

• Journal of Gastric Cancer
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• 제11권3호
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• pp.185-188
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• 2011

Gastric necrosis due to gastric outlet obstruction is a very rare condition, but it might be fatal if missed or if diagnosis is delayed. Our patient was a 73-year-old male complaining of abdominal pain, distension and dyspnea for 1 day. In plain radiography and computed tomography, a markedly distended stomach and decreased enhancement at the gastric wall were noted. He underwent explo-laparotomy, and near-total gastric mucosal necrosis accompanied by sludge from the soaked laver was noted. A total gastrectomy with esophagojejunostomy was performed, and he recovered without sequelae. Final pathologic examination revealed advanced gastric cancer at the antrum with near-total gastric mucosal necrosis.

• Journal of Gastric Cancer
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• 제23권3호
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• pp.451-461
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• 2023

Purpose: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastrointestinal neoplasms. However, this is a time-consuming procedure requiring various devices. This study aimed to evaluate the efficacy and safety of the ClearCut^TM Knife H-type, which is an integrated needle-tipped and insulated-tipped (IT) knife. Materials and Methods: Between July 2020 and September 2021, 99 patients with gastric epithelial neoplasms scheduled for ESD at three tertiary care hospitals were randomly assigned to H-knife (ClearCut^TM Knife H-type) or IT-knife (conventional IT knife) groups. Procedure times, therapeutic outcomes, and adverse events were analyzed. Results: A total of 98 patients (50 in the H-knife group and 48 in the IT-knife group) were analyzed. The median total procedure time was 11.9 minutes (range, 4.4-47.2 minutes) in the H-knife group and 12.7 minutes (range, 5.2-137.7 minutes) in the IT-knife group (P=0.209). Unlike the IT-knife group, which required additional devices in all cases, no additional devices were used in the H-knife group (P<0.001). En-bloc resection was performed for all lesions in both groups. The incidence of adverse events was not significantly different between groups (4.0% in the H-knife group vs. 8.3% in the IT-knife group; P=0.431). Conclusions: The newly developed hybrid device, the ClearCut^TM Knife H-type, had comparable efficacy to the conventional IT knife for gastric ESD.