• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.50-54
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• 2017

Pancreatic neuroendocrine tumors are rare pancreatic neoplasms comprising 1-2% of all pancreatic tumors and typically present high attenuating mass on arterial and venous phase images, due to their rich capillary network. A 70-year-old South Korean female visited our hospital presenting with jaundice and dark urine color. She had received an operation for treatment of small bowel perforation seven years ago. On physical examination, icteric sclera was observed but otherwise unremarkable. Laboratory tests were abnormal liver function test and suspected obstructive jaundice. Computed tomography revealed 4 cm sized cystic mass lesion with homogeneous low attenuation in the head of pancreas and distal common bile duct was compressed by the mass. During review of past medical records, we found that the mass was observed and measured about 1.7 cm seven years ago. To resolve obstructive jaundice, pylorus preserving pancreaticoduodenectomy was performed and diagnosed with well differentiated pancreatic neuroendocrine carcinoma with intermediate grade.

• Journal of Digestive Cancer Research
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• 제11권1호
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• pp.21-29
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• 2023

Despite recent advancements in the diagnosis and treatment of pancreatic cancer, clinical results remain dismal. Furthermore, there are no reliable biomarkers or alternatives beyond carbohydrate antigen 19-9. Circulating tumor cells (CTCs) may be a potential biomarker, but their therapeutic application is constrained by their rarity in peripheral venous blood. Theoretically, the portal vein can be a more appropriate location for the detection of CTCs, because the first venous drainage of pancreatic cancer is portal circulation. According to several studies, the number and detection rate of CTCs may be higher in the portal blood than in the peripheral blood. CTC counts in the portal blood are strongly correlated with several prognostic parameters such as hepatic metastasis, recurrence after surgery, and survival. The phenotypic and genotypic properties analyzed in the captured portal CTCs can assist us to comprehend tumor heterogeneity and predicting the prognosis of pancreatic cancer. The investigations to date are limited by small sample sizes and varied CTC detection techniques. Therefore, a large number of prospective studies are required to confirm portal CTCs as a valid biomarker in pancreatic cancer.

• Journal of Digestive Cancer Reports
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• 제9권1호
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• pp.8-18
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• 2021

Although many guidelines for pancreatic cystic neoplasms focus on the management of intraductal papillary mucinous neoplasm of the pancreas (IPMN) at the highest oncological risk, there are many issues that surgeons need to consider at the time to plan the surgical procedures based on characteristics of IPMN subtypes, such as multiplicity of branch duct-IPMN (BD-IPMN) and intraductal spreading of main duct-IPMN (MD-IPMN). For multifocal BD-IPMN, partial pancreatectomy would be selected to remove BD-IPMN with predictors of malignancy, while the other lesions without risk factors can be left, although total pancreatectomy might be considered if the patients have a strong family history of pancreatic cancer. Partial pancreatectomy would be also adequate procedure for MD-IPMN if negative surgical margin for high-grade dysplasia or invasive carcinoma were achieved. It has become to be well-known that patients with BD-IPMN are at increased risk for developing not only IPMN-associated pancreatic ductal adenocarcinoma (PDAC) but also PDAC independent from the IPMN. Hence, the detection of a concomitant PDAC is also an important focus for strategies after resection of BD-IPMNs. Our recent analysis of patients after partial pancreatectomy for MD-IPMN with negative surgical margin identified an unexpected recurrence pattern, which we called "monoclonal skip" recurrence. MD-IPMN seems to be disseminated in the pancreatic ductal systems and MD-IPMN with identical genetic background was detected in the remnant pancreas even in a long time after index surgery. We proposed strategies of postoperative surveillance based on characteristics and natural history of each morphological subtype.

• 종양간호연구
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• 제12권2호
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• pp.117-124
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• 2012

Purpose: The purpose of this study was to assess pain, sleep disturbance, fatigue, and the quality of life and to identify the impact of pain, sleep disturbance and fatigue on the quality of life in patients with pancreatic cancer undergoing chemotherapy. Methods: Data were collected from June to July, 2010. Participants were recruited from Y university hospital in Seoul. Research instruments included numeric rating scale for pain, Functional Assessment Chronic Illness Therapy-Functional Well-Being (FACIT-FWB): General Factor 5 (GF5) for sleep disturbance, Functional Assessment of Cancer Therapy-General (FACT-G) for quality of life, and FACT-Fatigue for fatigue. Results: The quality of life for cancer patients had a significant relationship with pain, sleep disturbance, and fatigue. The significant factors influencing quality of life were pain, sleep disturbance, and fatigue that explained 52.6% of the variance. Conclusion: Patients with pancreatic cancer undergoing chemotherapy experienced pain, fatigue, and sleep disturbance which led to a negative effect on quality of life. The results suggest that intervention program to improve quality of life could reduce pain, fatigue, and sleep disturbance of pancreatic cancer patients undergoing chemotherapy.

• 대한영상의학회지
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• 제81권2호
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• pp.418-422
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• 2020

췌장의 장액성 낭성 종양은 일반적으로 양성 질환으로 알려져 있으나 드물게 악성화를 보이는 사례들이 보고되고 있다. 영운에서 췌장 미부에 발생한 장액성 낭성 종양을 수술로 제거한 후 추적 관찰 중 국소 재발과 함께 간으로의 원격전이가 발생한 증례를 경험하여 보고하고자 한다.

• Tuberculosis and Respiratory Diseases
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• 제67권1호
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• pp.42-46
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• 2009

저자들은 복통으로 내원한 환자에서 발견된 췌장 결절이 수술을 통하여 비소세포폐암의 단일성 췌장전이로 확진 되었던 드문 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.753-759
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• 2012

Radixin, encoded by a gene on chromosome 11, plays important roles in cell motility, invasion and tumor progression. However, its function in pancreatic cancer remains elusive. In this study, radixin gene expression was suppressed with a lentivirus-mediated short-hairpin RNA (shRNA) method. We found that radixin shRNA caused down-regulation of radixin in PANC-1 cells, associated with inhibition of pancreatic cancer cell proliferation, survival, adhesion and invasive potential in vitro. When radixin-silenced cells were implanted in nude mice, tumor growth and microvessel density were significantly inhibited as compared to blank control cells or nonsense shRNA control cells. Thrombospondin-1 (TSP-1) and E-cadherin were up-regulated in radixin-silenced PANC-1 cells. Our results suggest that radixin might play a critical role in pancreatic cancer progression, possibly through invvolvement of down-regulation of TSP-1 and E-cadherin expression.

• Journal of Digestive Cancer Research
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• 제10권2호
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• pp.92-98
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• 2022

Self-expandable metal stent (SEMS) is effective for biliary drainage, especially in pancreaticobiliary cancer. The mechanical properties, material, and design of SEMS are important in preventing recurrent biliary obstruction and complication. Radial and chronic expansion forces play roles in preventing stent migration and collapse. Complications, such as stent impaction, cholecystitis, and pancreatitis, were related to the axial force. The nickel-titanium alloy shows more flexibility, conformability, and optimal axial force compared to previously used stainless steel. Additionally, the stent structure affected the mechanical properties of SEMS. Therefore, understanding the mechanical properties, material, and design of SEMS will provide the best outcome for biliary drainage, as well as better SEMS development.

• 대한영상의학회지
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• 제81권5호
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• pp.1134-1150
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• 2020

췌장에는 다양한 종류의 종양 및 종양 유사 병변들이 생길 수 있다. 이 가운데, 췌장선암은 췌장의 가장 흔한 종양으로서 일반적으로 췌장암이라고 하면 이 종양을 가리킨다. 최근에는 영상 검사의 기술적 진보와 이용이 증가하면서 췌장의 희귀 종양 및 종양 유사 병변들의 발견 빈도가 증가하고 있다. 췌장의 드문 종양 및 종양과 유사한 병변들은 치료 방침과 예후가 췌장선암과 다르기 때문에 이들 질환의 감별은 임상적으로 중요한 의의가 있다. 영상 검사는 포상세포암이나 신경초종 등의 희귀 종양 및 자가면역 췌장염 또는 염증성 거짓종양과 같은 종양 유사 병변들과 췌장선암의 감별 진단에 중요한 역할을 하지만 영상 소견만으로 이들 질환을 정확히 구분하는 것은 한계가 있다. 이 논문에서는 췌장에서 생길 수 있는 희귀 종양 및 종양 유사 병변들의 다양한 영상 소견들과 췌장선암과의 감별에 있어 도움이 되는 특징들을 제시하고자 한다.

• Radiation Oncology Journal
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• 제32권2호
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• pp.49-56
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• 2014

Purpose: Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. Materials and Methods: Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. Results: With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). Conclusion: Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.