• Journal of Gastric Cancer
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• v.15 no.4
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• pp.238-245
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• 2015

Purpose: This study aimed to identify time-dependent prognostic factors and demonstrate the time-dependent effects of important prognostic factors in patients with advanced gastric cancer (AGC). Materials and Methods: We retrospectively evaluated 3,653 patients with AGC who underwent curative standard gastrectomy between 1991 and 2005 at the Korea Cancer Center Hospital. Multivariate survival analysis with Cox proportional hazards regression was used in the analysis. A non-proportionality test based on the Schoenfeld residuals (also known as partial residuals) was performed, and scaled Schoenfeld residuals were plotted over time for each covariate. Results: The multivariate analysis revealed that sex, depth of invasion, metastatic lymph node (LN) ratio, tumor size, and chemotherapy were time-dependent covariates violating the proportional hazards assumption. The prognostic effects (i.e., log of hazard ratio [LHR]) of the time-dependent covariates changed over time during follow-up, and the effects generally diminished with low slope (e.g., depth of invasion and tumor size), with gentle slope (e.g., metastatic LN ratio), or with steep slope (e.g., chemotherapy). Meanwhile, the LHR functions of some covariates (e.g., sex) crossed the zero reference line from positive (i.e., bad prognosis) to negative (i.e., good prognosis). Conclusions: The time-dependent effects of the prognostic factors of AGC are clearly demonstrated in this study. We can suggest that time-dependent effects are not an uncommon phenomenon among prognostic factors of AGC.

• Journal of Gastric Cancer
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• v.5 no.1
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• pp.34-39
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• 2005

Purpose: KLF6, a member of the KLF family, is a ubiquitous zinc finger tumor suppressor protein that is mutated in several human cancers. Our aim was to determine whether the expression pattern of KLF6 might be associated with gastric cancer development and, if so, to determine to which pathologic parameter it is linked. Materials and Methods: For the construction of the gastric cancer tissue microarray, 85 paraffin-embedded tissues containing gastric cancer areas were cored 3 times and transferred to the recipient master block. The expression pattern of KLF6 was examined on tissue microarray slides by using immunohistochemistry and was compared with pathologic parameters, including histologic type, depth of invasion, lymph node metastasis, and peritoneal dissemination. Results: The KLF6 protein was expressed on superficial and foveolar epithelial cells in the gastric mucosa. We found loss of KLF6 expression in 28 ($32.9\%$) of the 85 gastric cancer tissues. There was a significant correlation between loss of KLF6 expression and lymph-node metastasis. However, other pathologic parameters, such as histologic type, depth of invasion, and peritoneal dissemination, were not statistically associated with loss of KLF6 expression. Conclusion: Our findings suggest that loss of KLF6 expression may contribute to abnormal regulation of gastrointestinal epithelial cell growth and differentiation and to the development and/or progression of Korean gastric cancer.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.25-30
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• 2006

Purpose: The EphB2 receptor, a member of the receptor tyrosine kinase family, is a target gene of the Wnt signaling pathway and may achieve a tumor suppressor function through regulation of cell growth and migration. Our aim was to determine whether an altered expression of EphB2 might be associated with gastric cancer development and, if so, to determine to which pathologic parameter it is linked. Materials and Methods: For the construction of the gastric cancer tissue microarray, 83 paraffin-embedded tissues containing gastric cancer areas were cored 3 times and transferred to the recipient master block. The expression patterns of EphB2 were examined on tissue microarray slides by using immunohistochemistry and were compared using pathologic parameters, including histological type, depth of invasion, lymph node metastatsis, and peritoneal dissemination. Results: The EphB2 protein was expressed in the normal gastric mucosal epithelium, especially in the bottom of the mucosa. We found loss of EphB2 expression in 30 (36.1%) of the 83 gastric cancer tissues. Statistically, loss of EphB2 expression was more common in gastric cancer with lymph-node metastasis. There was no significant correlation between EphB2 expression and depth of invasion, histologic type, or peritoneal dissemination. Conclusion: Our findings suggest that loss of EphB2 expression may represent a critical step in gastric carcinogenesis.

• Journal of Korea Entertainment Industry Association
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• v.15 no.8
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• pp.389-401
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• 2021

This study was performed to generate basic data to establish a health promotion plan for residents of Chungcheongbuk-do by identifying characteristics of discharged patients residing in the Chungcheongbuk-do area from an In-Depth Post-Discharge Injury Survey reported by the Korea Centers for Disease Control and Prevention(KCDCP). The Report provided data on demographic characteristics, medical institution use characteristics, medical use characteristics, and disease characteristics of patients discharged from medical institutions with 100 or more beds from 2013 to 2017. The total number of Chungcheongbuk-do residents who were admitted and discharged from 2013 to 2017 was estimated to be 1,656,590, and the discharge rate was 21,089, which was higher than the national average of 13,882 in 2016. The regions where the discharge rate increased during this period include Goesan, Yeongdong, Boeun, Okcheon, Jeungpyeong, and Eumseong-gun, which are mainly rural areas. Among the patients hospitalized and discharged from hospitals outside the Chungcheongbuk-do area, the discharge rate of patients who used hospitals in Incheon/Gyeonggi areas and Daejeon/Chungnam areas increased slightly. Among the malignant tumor patients, the number of lung cancer(included trachea & bronchial cancer) patients was the highest. In addition, the discharge rate was highest for patients with respiratory diseases. This study suggests that efforts need to be made to lower the discharge rate for infection, circulatory disease, genitourinary disease, and musculoskeletal disorder patients

• Journal of Gastric Cancer
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• v.18 no.2
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• pp.109-117
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• 2018

Purpose: This study aimed to investigate the outcomes of laparoscopic gastrectomy in very elderly patients with gastric cancer, who have outlived the average lifespan of the Korean population (men: ${\geq}77years$, women: ${\geq}84years$). Materials and Methods: Between 2004 and 2015, 836 patients with gastric cancer underwent a laparoscopic gastrectomy. They were divided into the elderly group (EldG) and non-elderly group (nEldG). Propensity score matching for covariates of sex, tumor depth, node status, and extent of resection was performed. Clinicopathologic characteristics, and surgical and survival outcomes were compared between the 2 groups. Results: The EldG had a higher American Society of Anesthesiologists (ASA) score and a higher number of comorbidities. There was no significant difference in the post-operative complications, except for pulmonary complications, which were more frequent in the EldG (5/56, 8.9%) than in the nEldG (0/56, 0%). The EldG had a shorter overall survival (OS), but cancer-specific survival was similar for both groups. Among deceased patients, 2 (25%) and 8 patients (50%) died within a year of surgery in the nEldG and EldG, respectively. Univariate and multivariate risk factor analyses for OS showed that age, ASA score, tumor, node, metastasis (TNM) stage, and occurrence of complications were significantly related to deterioration in OS. Conclusions: Laparoscopic gastrectomy can be safely performed in very elderly patients with gastric cancer who have outlived the average lifespan of the Korean population. However, impact of laparoscopic gastrectomy on improving survival is not clear, and careful patient selection is recommended.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.11-20
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• 1984

The renewed interest in the use of hyperthermia in cancer therapy is bases on radiobiological and clinical evidence indicated that there may be a significant therapeutic advantage with the use of heat alone or combined with radiation or chemotherapy, There are many methods for generating heat for localized tumor as like radiofrequency, microwave, electromagnetic induction and ultrasound. But it is very difficult to be even thermal dose distribution and stable output of power and then the detection of temperature in tumor is difficult to be precise with thermocouples and semiconductor sensors. We designed the microwave heating generator, dipole antenna applicators and autometic temperature controlled thermocouples for localized hyperthermia on skin and in cavities. 1. The microwave generator with 120 W, 2,450MHz magnetron could be heating up to $40^{\circ}C\~50^{\circ}C\;for\;1\~2$ hours in living tissues. 2. The thermal dose distribution in tissue with microwave was described $42^{\circ}C\~44^{\circ}C$ with in 3 cm depth and $2\~6cm$ diameter area. 3. Skin surface heating applicator with spiral 3 times wave length antenna radiated high Power of microwave. 4, Intracavitary heating applicator with dipole antenna with autometic control temperature sensor kept up continuously constant temperature in tissue. 5. For constant thermal distribution, applied two steps power with 10W microwave after $17\~20W$ during first 10 minutes. 6. The cooling rate by blood flew in living tissue was rised as $10\%$ then meats.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4549-4552
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• 2013

The incidence of gastric cancer worldwide, and in particular in developing countries, has shown a marked increase. Poor prognosis of gastric cancer patients occurs due to the rapid metastasis of the disease via the lymphatic and blood vessels. The aim of this study was to investigate the expression and the clinical significance of D2-40 and CD34 in human gastric cancer. D2-40 and CD34 expression wasdetected in 1,072 cases of Chinese patients with gastric carcinoma using immunohistochemistry. The lymphatic vessel density (LVD) and microvessel density (MVD) were calculated and analyzed and the correlation with the clinicopathological factors and prognosis was determined. The LVD and MVD of the gastric cancer cases were significantly higher compared to those of normal tissues (P < 0.05). The expression of D2-40-LVD and CD34-MVD in the malignancies were positively related to the age, tumor size, invasion depth, lymphatic metastasis and pathological tumor-node-metastasis (pTNM) (P < 0.05); However, no statistically significant difference was identified between them with the patient gender (P > 0.05). Up-regulation of D2-40 and CD34 expression was significantly correlated with the poor survival rate in univariate and multivariate analyses. The LVD marked by D2-40 and the MVD marked by CD34 were positively correlated to the clinicopathological factors of the malignancies and may play important role in the development and progression of gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2741-2744
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• 2016

The CKLF-like MARVEL transmembrane domain-containing family (CMTM) is a novel family of genes first reported at international level by Peking University Human Disease Gene Research Center. The gene products act between chemokines and the transmembrane-4 superfamily. Located in several human chromosomes, the CMTMs CKLF and CMTM1 to CMTM8 may be unregulated in tumors and act as potential tumor suppressor genes with important roles in the immune, male reproductive and hematopoietic systems. In-depth studies in recent years established a close relation between CMTMs and tumorigenesis and metastasis. The CMTM family has a significant clinical value in diagnosis and treatment of diseases linked to tumors and the immune system.

• Journal of Gastric Cancer
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• v.4 no.2
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• pp.89-94
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• 2004

Purpose: There is no established treatment-related prognostic factor for gastric cancer except a curative tumor resection. This study was done to clarify the prognostic value of early postoperative intraperitoneal chemotherapy (EPIC) in patients with serosa-positive gastric cancer. Materials and Methods: We analyzed retrospectively the postoperative survival data of 209 patients with serosapositive gastric cancer treated by surgery and chemotherapy. The survival period for patients was calculated from the date of resection until cancer-related death or the last date of follow-up; Kaplan-Meier survival curves were plotted and compared by using the log-rank test. A multivariate analysis was done by using the Cox proportional hazards model. Results: Statistically significant differences in survival rates were noted based on gender, depth of invasion, lymph node metastasis, distant metastasis, stage, location of tumor, macroscopic type, extent of gastric resection, curability of surgery, and adjuvant chemotherapy. Five-year survival rates of patients who received EPIC and systemic chemotherapy were 49 per cent and 25 per cent, respectively (P=0.009). A multivariate analysis revealed that invasion of an adjacent organ, lymph node metastasis, total gastrectomy, and palliative surgery were poor independent prognostic factors. Also, EPIC had a marginal prognostic value (P=0.056). Conclusion: Perioperative intraperitoneal chemotherapy can possibly be one of the independent prognostic indicators in case of serosa-positive gastric cancer. (J Korean Gastric Cancer Assoc 2004;4:89-94)

• Journal of Gastric Cancer
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• v.18 no.4
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• pp.409-416
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• 2018

A 55-year-old man visited our hospital for a detailed examination of a gastric submucosal tumor that was first detected 10 years prior. The tumor continued to grow and had developed a depressed area in its center. A histopathological examination of biopsy specimens revealed gastric adenocarcinoma of the fundic gland type (GA-FG). It was diagnosed as T2 based on the invasion depth as determined by white-light endoscopy and endoscopic ultrasonography. A total gastrectomy with lymphadenectomy was performed and a GA-FG in the mucosa and submucosa was confirmed histopathologically. However, there was a gradual transition to an infiltrative tubular adenocarcinoma with poorly differentiated components in the muscular and subserosal layers. Metastasis was identified in a dissected lymph node (LN). This is the first report of a GA-FG progressing to an aggressive cancer with LN metastasis. These findings modify our understanding of the pathophysiology of GA-FG.