Background: Gastroenteropancreatic neuroendocrine tumors (GNs) are slow growing and although their incidence has increased in recent years, they are relatively rarely seen. Somatostatin analogues are used in the treatment of GNs that express somatostatin receptor (SR). We aimed to investigate the expression of SR2 and SR5 in GNs. Materials and Methods: In this study the expression of SR2 and SR5 was investigated immunohistochemically in 49 cases (26 males, 23 females) diagnosed and graded with GN according to the World Health Organization classification 2010. Results: The percentage of SR2 staining was 91.0% in grade 1, 82.8% in grade 2 and 100% in grade 3. On the other hand, the percentage of SR5 staining was 81.8% % in grade 1, 60.0% in grade 2 and 0% in grade 3. According to the tumor localization, the percentages of SR2 expression were as follows: pancreas 85.7%, stomach 100%, small bowel 70%, appendix 85.7% and rectum 100%. The percentages of SR5 expression were: pancreas 61,9%, stomach 37.5%, small bowel 70%, appendix 71.5% and rectum 66.6%. There was a significant negative correlation between ki67 percentage and SR5 expression (r=-0.341, p=0.016). Conclusions: In this study, GNs were found to highly express SR2 and SR5. Although the expression of SR2 and SR5 changed according to tumor localization, the expression of SR2 was higher than the expression of SR5 in GN. There was a significant negative correlation between ki67 and SR5. Accordingly, SR5 may be a prognostic indicator of GN.
Objectives: This study aimed to learn what should be considered in [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer)] by analyzing the existing guidelines and clinical trials. Methods: The development committee searched guidelines for herbal medicinal product or gastric cancer developed already. Then, clinical trials for gastric cancer using herbal medicine were searched. The searched trials were analyzed in terms of inclusion and exclusion of participants, intervention, comparator, outcomes and trial design. Then, we compared the results of analysis with the regulations and guidelines of Ministry of Food and Drug Safety to suggest the issue that we will have to consider when making the [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer]. Results: As a result, few guidelines for anti-tumor agent and clinical trial with herbal medicinal product were searched in the national institution homepage. In addition, 10 articles were searched by using the combination following search term; 'stomach neoplasm', 'herbal medicine', 'Medicine, Korean traditional', 'Medicine, Chinese Traditional', 'TCM', 'TKM', 'trial'. Most trials included gastric cancer participants with medical history of operation. The type of intervention was various such as decoction, granules, and fluid of intravenous injection. Comparators were diverse such as placebo, conventional treatment including chemotherapy and nutritional supplement. The most frequently used outcome for efficacy was quality of life. Besides, the symptom score, tumor response, and survival rate were used. Safety was investigated by recording adverse events. Conclusion: We found out some issue by reviewing the existing guidelines and comparing it with clinical trials for gastric cancer and herbal medicinal products. These results will be utilized for developing [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer].
The cytotoxic effects of partially purified substances from Bacillus polylfermenticus SCD toward a variety tumor cell lines were studied. Cytotoxic activity was determined with regard to the A549 (human lung carcinoma), AGS (human stomach adenocarcinoma), DLD-1 (human colon adenocarcinoma), HEC-1-B (human uterus adenocarcinoma), SW-156 (human kidney carcinoma), and NIH/3T3 (murine normal fibroblast) cell lines using the MTT assay. Cytotoxic substances were partially purified through Diaion HP-20 columns and extracted with methanol or other organic solvents (n-hexane, chloroform, ethylacetate, and butanol). B. polyfermenticus SCD supernatant showed up to 60% inhibition of cell viability fer all five human cancer cell lines tested. When treated with 10 mg/mL of n-hexane, chloroform, ethylacetate, and butanol extract, HEC-1-B cells showed a 25,62,35, and 63% rate of inhibition respectively, and AGS cells showed a 72, 61, 44, and 67% rate of inhibition, respectively. At a concentration of 10 mg/mL, 100% methanol Diaion HP-20 extracts showed inhibition rates of 97.0% toward A-549 cells, 98.1% toward AGS cells, 81.6% toward DLD-1 cells, 83.5% toward HEC-1-B cells, and 92.7% toward SW-156 cells. These results indicate that partially purified fractions from B. polyfermenticus SCD have the potential to inhibit not only colon cancer cells, but also lung, stomach uterus, and kidney cancer cells. Further studies are needed to characterize the cytotoxic substances released in B. polyfermenticus SCD cultures.
Purpose: Extranodal marginal zone B cell lymphoma of MALT type represents approximately 8% of non-Hodgkin's lymphomas and this lymphoma is present in extranodal sites. Although the presentation of this lymphomain in stomach is usually associated with H. pylori infection in 95% of cases, MALT lymphoma found in soft tissue has been reported very rarely in the field of plastic surgery. We report a case of MALT lymphoma in the submandibular gland without any involvement of other organs such as the stomach. Methods: A 49-year-old man complained of a huge neck mass sized about $10{\times}12cm$. It started about 2 years ago and grew rapidly for the late 6 months. It was of hard nature with erythematous skin overlying it. Under the diagnosis of possible malignant lymphoma or sarcoma, radical resection was performed and the defect was reconstructed using transverse rectus abdominis musculocutaneous free flap. Results: The mass was well demarcated from the normal tissue, $11{\times}10.5{\times}10cm$ in size and whitish-gray color. Immunohistochemical analysis demonstrated that the tumor cells were LCA(+), CD20(+), CD3(-) and CD5(-). The tumor was diagnosed as extranodal marginal zone B cell lymphoma. The patient was treated with prophylactic radiation therapy after surgery, there was no complication for 1 year. Conclusion: We reported that very rare form of MALT lymphoma in 49-year-old male patient was experienced with clinical characteristics, histologic features and references.
Neck mass as a primary presenting sign is a common problem that physicians and surgeons alike have to face but conclusive diagnosis cna be made only by histopathological examination. During the period of four years from January 1988 to December 1991, three hundred sixteen diagnostic incisional or excisional biopsies of the neck masses were performed at the outpatient department of Surgery, Seoul National University Hospital and tissue diagnoses were confirmed by histopatholotical examination. On which a clinical analysis was performed and its results were compared with the results of one hundred fifteen Fine Needle Aspiration Cytologic examinations on neck masses during the same period. The results were as follows: In the histologic types of neck masses. inflammatory disease was the most common (58.2%), metastatic malignant tumor(22.5%), benign tumor(15.2%). primary malignant tumor(0.4%) in decreasing order. Among the individual lesions. tuberculous lymphadenitis was the most common(29.4%) and nonspecific lymphadenitis was the next. Of overall sexual distribution, female preponderated by a ratio of 1.15:1, but in the primary and metastatic malignancies, male did by a ratio of 1.60:1 and 1.53:1, respectively. The most common age group was third decade(26.8%), and fourth decade was the next(20.9%) but in malignant tumors. sixth decade was the most commom. The duration of symptom between one and three months(33.8%), was the most common and between three and six month was the next but the difference between the individual diseases was not significant. Of the metastatic tumor of seventy one cases, primary site was found in fifty cases(84.2%) and stomach cancer was the most comon primary site. In the result of the Fine Needle Aspiration Cytologic(FNAC) examinations, positive for mlignant cells was the most common(33.1%), following the frequencies with tuberculosis(22.6%), and nonspecific lymphadenitis(16.5%) in decreasing order. Eleven cases of FNAC underwent diagnostic biopsies and the diagnostic accuracy of FNAC was 83.3%. Conclusively, in our study, tuberculous lymphadenitis was the most common histologic type, female was predominant third decade was the most common age group. the duration of symptom between one and three month was the most common and in the metastatic tumors, stomach cancer was the most common primary site.
Background: Gastric cancer (GC) is one the common lethal cancers in Iran. Detection of GC in the early stages would assesses to improve the survival of patients. In this study, we attempt to evaluate the accuracy of EUS in detection depth of invasion of GC among Iranian Patients. Materials and Methods: This study is a retrospective study of patients with pathologically confirmed GC. They underwent EUS before initiating the treatment. The accuracy of EUS and agreement between the two methods was evaluated by comparing pre treatment EUS finding with post operative histopathological results. Results: The overall accuracy of EUS for T and N staging was 67.9% and 75.47, respectively. Underestimation and overestimation was seen in 22 (14.2%) and 40 (25.6%) respectively. The EUS was more accurate in large tumors and the tumors located in the middle and lower parts of the stomach. The EUS was more sensitive in T3 staging. The values of weighted Kappa from the T and N staging were 0.53 and 0.66, respectively. Conclusions: EUS is a useful modality for evaluating the depth of invasion of GC. The accuracy of EUS was higher if the tumor was located in the lower parts of the stomach and the size of the tumor was more than 3 cm. Therefore, judgments made upon other criteria evaluated in this study need to be reconsidered.
Yoo, Hyung-Sik;Suh, Jung-Ho;Lee, Jong-Tae;Kim, Dong-Ik;Park, Chang-Yun;Kim, Byung-Soo;Park, Chan-H.;Thakur, M.
The Korean Journal of Nuclear Medicine
/
v.20
no.2
/
pp.61-71
/
1986
An iodized oil such as Ethiodol or Lipiodol was selectively retained in the tumor vessels of the large hepatomas as well as in the small daughter hepatomas for long periods following the intra-arterial hepatic injection of such contrast material. The specific aim of the study is to deliver a high internal radiation dose to hepatocellular carcinoma (HCC) in an attempt to control the disease. We were able to replace a small fraction of the stable iodine (I-127) of the 37% iodine in Lipiodol by the $I^{-131}$ with 100% exchange efficiency. $I^{-131}$ labeled Lipiodol was injected through the super-selected tumor feeding artery under superselection or into the proper hepatic arterial level of patients who have malignant hepatomas confirmed by aspiration cytology serum AFP and various imaging modalities. Clinical traial was performed on 43 cases during recent 6 months and follow-up observation was carried out. No severe complications or other adverse reactions were encountered until nowdays. $I^{-131}-Lipiodol$ was stable in vivo and no significant activity was noted in the thyroid, stomach, blood and urine after the injection. Only small fraction of radioisotope activity was noticed in the both side of lungs. Tumor to normal liver radio was very high. Therefore, $I^{-131}-Lipiodol$ (or P-32-Lipiodol) will be effective delivering high internal radiation dose to the tumor while delivering small radiation doses to normal tissues. Labeling, tumor dose calculation and preliminary findings will be presented.
Purpose: Despite knowledge of the adverse effects of resection-line disease, surgeons continue to perform inadequate resections. This demonstrates the need for a more aggressive approach to assessment of resection margins at operation. Materials and Methods: Seven hundred fifteen gastric cancer patients who were operated on at our hospital from 1992 to 1998 were included in this analysis. Various clinicopathological factors, including resection-line involvement, were ascertained from the surgical and histopathological records. Results: Of the 715 evaluable patients, 27 patients ($3.8\%$) had involvement of one or both resection lines; in 10 patients the proximal resection line only, in 16 the distal resection line only, and 1 both resection lines were involved. Presence of resection-line involvement was significantly associated with T3 and T4 stage, N (+) stage, M (+) stage, type of operation (total gastrectomy), tumor location (entire stomach), size$\geq$11 cm), and gross type of tumor (Borrmann 4 type). When performing a distal subtotal gastrectomy, no involvement was found when the cranial and caudal distances between the lesion and the line of transection was equal to or greater than 2 cm and 3 cm, respectively, for early cancer and 7 cm and 3 cm, respectively, for advanced cancer. When performing a total gastrectomy for upper 1/3 or middle 1/3 gastric cancer, no involvement was found when the cranial distances between the lesion and the line of transection were equal to or greater than 3 cm and 4 cm, respectively, without distinction of the presence of serosal invasion. Conclusions: The difference in survival between positive and negative margin patients is limited to the group of patients with curative surgery. An important principle of treatment is that the entire tumor must be removed with a 3 cm distal margin and a 2- to 7 cm margin depending on the location and the depth of wall invasion of the tumor, to provide histologically negative margins.
Purpose: Lymph node (LN) metastasis is the best prognostic indicator in non-distant metastatic advanced gastric cancer. This study aimed to assess the prognostic value of various clinicopathologic factors in node-negative advanced gastric cancer. Materials and Methods: We retrospectively analyzed the clinical records of 254 patients with primary node-negative stage T2~4 gastric cancer. These patients were selected from a pool of 1,890 patients who underwent radical resection at Memorial Jin-Pok Kim Korea Gastric Cancer Center, Inje University Seoul Paik Hospital between 1998 and 2008. Results: Of the 254 patients, 128 patients (50.4%), 88 patients (34.6%), 37 patients (14.6%), and 1 patient (0.4%) had T2, T3, T4a, and T4b tumors, respectively. In a univariate analysis, operation type, T-stage, venous invasion, tumor size, and less than 15 LNs significantly correlated with tumor recurrence and cumulative overall survival. In a multivariate logistic regression analysis, tumor size, venous invasion, and less than 15 LNs significantly and independently correlated with recurrence. In a multivariate Cox proportional hazards analysis, tumor size (hazard ratio [HR]: 2.926; 95% confidence interval [CI]: 1.173~7.300; P=0.021), venous invasion (HR: 3.985; 95% CI: 1.401~11.338; P=0.010), and less than 15 LNs (HR: 0.092; 95% CI: 0.029~0.290; P<0.001) significantly correlated with overall survival. Conclusions: Node-negative gastric cancers recurred in 8.3% of the patients in our study. Tumor size, venous invasion, and less than 15 LNs reliably predicted recurrence as well as survival. Aggressive postoperative treatments and timely follow-ups should be considered in cases with these characteristics.
Purpose: Eupatilin is an antioxidative flavone and a phytopharmaceutical derived from Artemisia asiatica. It has been reported to possess anti-tumor activity in some types of cancer including gastric cancer. Eupatilin may modulate the angiogenesis pathway which is part of anti-inflammatory effect demonstrated in gastric mucosal injury models. Here we investigated the anti-tumor effects of eupatilin on gastric cancer cells and elucidated the potential underlying mechanism whereby eupatilin suppresses angiogenesis and tumor growth. Materials and Methods: The impact of eupatilin on the expression of angiogenesis pathway proteins was assessed using western blots in MKN45 cells. Using a chromatin immunoprecipitation assay, we tested whether eupatilin affects the recruitment of signal transducer and activator of transcription 3 (STAT3), aryl hydrocarbon receptor nuclear translocator (ARNT) and hypoxia-inducible factor-$1{\alpha}$ (HIF-$1{\alpha}$) to the human VEGF promoter. To investigate the effect of eupatilin on vasculogenesis, tube formation assays were conducted using human umbilical vein endothelial cells (HUVECs). The effect of eupatilin on tumor suppression in mouse xenografts was assessed. Results: Eupatilin significantly reduced VEGF, ARNT and STAT3 expression prominently under hypoxic conditions. The recruitment of STAT3, ARNT and HIF-$1{\alpha}$ to the VEGF promoter was inhibited by eupatilin treatment. HUVECs produced much foreshortened and severely broken tubes with eupatilin treatment. In addition, eupatilin effectively reduced tumor growth in a mouse xenograft model. Conclusions: Our results indicate that eupatilin inhibits angiogenesis in gastric cancer cells by blocking STAT3 and VEGF expression, suggesting its therapeutic potential in the treatment of gastric cancer.
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