• 한국산학기술학회논문지
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• 제15권5호
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• pp.2914-2922
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• 2014

진행성위암의 위험요인을 파악하고 조기검진의 효과를 평가하고자 2007년 6월부터 2011년 12월까지 대전 소재 1개 대학교병원에서 위암으로 최초 진단과 수술을 받은 조기위암 171명과 진행성위암 환자 342명, 총 580명을 대상으로 설문조사와 의무기록 조사를 실시하였다. 두 군간에 카이제곱 검정과 로지스틱 회귀분석으로 교차비를 계산한 결과 진행성위암은 조기위암에 비하여 70세 이상에서(OR 2.393; 95%CI 1.329-4.310), 과거 흡연자(OR 1.612; 95%CI 0.970-2.680), 혈액형 A형(OR 1.784; 95%CI 1.035-3.075) 및 H. pylori균 감염(OR 1.699; 95%CI 0.905-3.191)에서 상대적으로 높았다. 또한 체중감소(OR 2.752; 95%CI 1.333-5.684)와 소화불량(OR 1.574; 95%CI 1.069-2.319)이 중요한 증상과 징후였다. 조기진단의 효과는 파악할 수 없었지만 조기진단이 성공적인 치료의 기회를 높이고 생존율을 향상시킨다는 것을 감안할 때 집단을 대상으로 조기검진을 고취시키는 교육과 선별검사가 요구된다.

• Journal of Hospice and Palliative Care
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• 제19권4호
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• pp.331-334
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• 2016

목적: 진행성 암 환자에서 발열이 동반되지 않은, 암성 발한에서 NSAID (non-steroid anti-inflammatory drug) 치료 효과를 알아보고자 함이 목적이다. 방법: 다음과 같은 조건을 만족하는 환자를 대상으로 후향적으로 의무 기록을 조사하였다. 1) 수술적 절제나 항암방사선 치료로 완치가 불가능한 진행성 암 환자 2) 숫자평가등급 4점 이상의 식은 땀을 호소하며 발열이 동반되지 않은 환자 3) 식은 땀의 원인이 될 만한 감염이 없고, 마약성 진통 및 호르몬 차단제를 현재 최근 1개월 이내 새롭게 사용하지 않는 환자 4) 식은 땀 치료를 위해 NSAID를 사용하고, NRS 평가가 치료 전 후 시행한 환자. 결과: 총 13명의 환자가 등록되었다. 남자가 9명(69%)이었고, 평균 59세(범위: 50~71)였다. 암종별 빈도는 담도암, 췌장암, 위암, 전립선암 순이었다. 치료 전 환자들의 식은 땀은 평균 NRS 6.5 (최소값: 4, 최대값: 10) 이었고, 치료 후에는 NRS 1.9 (최소값: 0, 최대값: 5)이었다. 평균 추적 관찰 기간은 9.1일이었다. 결론: 진행성 암 환자에서 열이 동반되지 않은 중등도 이상의 식은 땀 환자에서 NSAID는 효과적인 치료방법이다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.261-267
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• 2012

Purpose: The relationship between thymidylate synthase (TS) expression and outcomes in gastric cancer (GC) patients remains controversial, although most studies reported poor survival and reduced response to fluoropyrimidine were related to high TS in tumors. We carried out a systematic review of the literature with meta-analysis to estimate the predictive value of TS expression from published studies. Methods: We indentified 24 studies analysing the outcome data in gastric cancer stratified by TS expression. Effect measures of outcome were hazard ratios (HRs) for overall survival (OS) and event-free survival (EFS), or the odds ratio (OR) for overall response rate (ORR). HRs and ORs from these eligible studies were pooled using random-effects meta-analysis. Results: Fifteen studies investigated outcomes in a total of 844 patients with advanced GC, and nine studies investigated outcomes in a total of 1,235 patients with localized GC undergoing adjuvant therapy. Meta-analysis of estimates showed high TS expression was significantly associated with poor OS in the advanced setting (HR: 1.43, 95%CI: 1.08 - 1.90), and poor EFS in the adjuvant setting (HR: 1.53, 95%CI: 1.01 - 2.32). Subgroup analysis demonstrated TS expression to haves even greater value in predicting OS, EFS and ORR in advanced GC patients treated with fluoropyrimidine monotherapy (HR for OS: 2.32, 95%CI: 1.53 - 3.50; HR for EFS: 1.76, 95%CI: 1.19 - 2.60; OR for ORR: 0.32, 95%CI: 0.11 - 0.95). Conclusion: High levels of TS expression were asssociated with a poorer OS for advanced GC patients compared with low levels. In the adjuvant setting, high TS expression was also associated with a worse EFS. Additional studies with consistent methodology are needed to define the precise predictive value of TS.

• 대한한방내과학회지
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• 제41권5호
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• pp.911-925
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• 2020

Objectives: The purpose of this study was to report a case of a patient with advanced gastric cancer with peritoneal metastasis treated with chemotherapy and Korean medicine Methods: A patient with advanced gastric cancer with peritoneal metastasis was treated with Xeloda/cisplatin since April 2019. The cycle was repeated every three weeks for a total of 11 times. At the same time, the patient was treated with Korean medicine. The tumor size was measured by computed tomography (CT) and esophagogastroduodenoscopy (EGD). Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After treatment with Xeloda/cisplatin and Korean medicine for nine months, the extent of the proximal portion of the primary tumor and the size and number of multiple nodules around the stomach decreased and the cancer cells with peritoneal metastasis disappeared. The symptoms of discomfort and physical activity were gradually improved. As a result, the patient underwent conversion surgery. Conclusions: This case study suggests that the combination of chemotherapy and Korean medicine may contribute to the reduction in tumor size as well as the improvement in the quality of life.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.175-178
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• 2014

Background: Resection rates of lung cancer are low in general and especially in countries like Nepal. Advanced stage at presentation and poor general condition of the patient are the usual causes. Materials and Methods: In this prospective observational study, one hundred cases of lung cancer who presented at the Thoracic Surgery Unit between October 2011 and October 2012 were included. Results: Those aged in the $6^{th}$ and $7^{th}$ decades together accounted for 72/100 patients. The male to female ratio was 2:1. There was a mean-$29.2{\pm}14.2$ pack yrs smoking history with only five non-smokers. Seventy-six patients presented with locally advanced disease while 21 had metastases. Only three had local disease. The average time between onset of symptoms to first contact with a doctor was $2.3{\pm}5.3$ months (range: 0-35.6 months). Average time between first contact to referral was $50.4{\pm}65.7$ days (range-0-365). Only three patients were resected, one after neo-adjuvant chemotherapy. Advanced disease was the cause of unresectability in 95 cases. One of three patients with local disease had pulmonary functions allowing the warranted resection. $N_2$ disease with $T_{1-3}$ on CT scan was found in 47. Three of these patients underwent mediastinoscopy and all confirmed uninvolved $N_2$. Conclusions: Lung resection rates in our center remain low. Late presentation leading to advanced disease and poor pulmonary reserves preclude resection in most cases. More liberal use of mediastinal staging and better assessment of pulmonary functions may allow us to improve resection rates.

• 대한기관식도과학회지
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• 제15권2호
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• pp.42-48
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• 2009

Background and Objectives : Obstructive laryngeal cancers have to be managed with tracheostomy, which has been reported with increased local or stomal recurrence. Stomal recurrence after treatment of laryngeal cancer is one of the most serious issues in the management of laryngeal cancer. Prognosis of locally advanced laryngeal cancer in patients with previous tracheostomy is evaluated. Materials and Methods : Between 1996 and 2007, 174 patients with previously untreated advanced laryngeal cancer(stage III, IV) were enrolled. Overall survival(OS) and disease specific survival(DSS) according to the presence of previous tracheostomy were compared. OS and DSS of the groups with different duration from tracheostomy to treatment were compared. Results : Among 174 patients with advanced laryngeal cancer, previous tracheostomy was performed in 24 patients. Of 24 patients, there were stomal recurrences in 5 patients. DSS of previous tracheostomy group and that of the other group were statistically different(p=0.001). There was statistical significant difference between OS of groups which start treatment more than 14 days after tracheostomy and within 14 days(p=0.03). Conclusions : If possible, Previous tracheostomy should be avoided and if it is inevitable, the elective treatment should be recommended at least within 2 weeks.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2013-2020
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• 2014

Background: The aldehyde dehydrogenase 1 family member A1 (ALDH1A1) is one of the promising markers for identifying cancer stem cells in many cancer types, along with other markers including CD44. The aim of the present study was to evaluate the expression and clinical significance of putative cancer stem cell markers, CD44 and ALDH1A1, in a series of urothelial carcinomas of urinary bladder (UCUB) by tissue microarray (TMA). Materials and Methods: A total of 159 Urothelial Carcinomas (UC) including 96 (60%) low grade and 63 (40%) high grade carcinomas were immunohistochemically examined for the expression of CD44 and ALDH1A1. Correlations of the relative expression of these markers with clinicopathological parameters were also assessed. Results: High level expression of ALDH1A1 was found in 16% (25/159) of bladder UC which was significantly correlated with increased tumor size (p value=0.002), high grade (p value<0.001), pathologic stage (T1, p value=0.007 and T2, p value<0.001) and increased rate of recurrence (p value=0.013). A high level of CD44 expression was found in 43% (68/159) of cases, being positively correlated with histologic grade (p value=0.032) and recurrence (p value=0.039). Conclusions: Taken together, our results showed that ALDH1 was concurrently expressed in a fraction of CD44+ tumors and its expression correlated with poor prognosis in UCs. ALDH1A1 could be an ideal marker for targeted therapy of UCs in combination with conventional therapies, particularly in patients with high grade carcinomas. These findings indicate that cells expressing ALDH1A1 along with CD44 can be a potential therapeutic target in bladder carcinomas.

• 대한한의학회지
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• 제30권6호
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• pp.112-117
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• 2009

Objective: Rhus verniciflua Stokes (RVS) has anticancer effect confirmed by preclinical studies and historical records. We thus tried to evaluate retrospectively the effect of RVS as a complementary medicine for patients with advanced non-small-cell lung cancer (NSCLC) showing refractory to conventional chemotherapy. Patients and Methods: From June 1, 2006 to June 30, 2007, patients with advanced NSCLC who received both the standardized RVS extract and a standard course of second or more line therapy such as pemetrexed ($Alimta^{(R)}$), erlotinib ($Tarceva^{(R)}$), and gefitinib ($Iressa^{(R)}$) were checked. A total of 13 patients were eligible for the final analysis after fulfilling inclusion/exclusion criteria. Time to progression (TTP) of these patients treated with the standardized RVS extract was checked in the aftercare period. Results: Patients received RVS treatment for a median period of 296 (range 84-698) days. The median TTP was 220.5 (range 36-489) days, and three patients (23.1%) had TTP values of 15 more months. No significant side effects from RVS treatment have been observed. Conclusion: The standardized RVS extract might have synergetic effects by assisting apoptosis in advanced NSCLC with concurrent standard therapy agents, since it prolonged TTP without significant adverse effects. This study suggests that the standardized RVS extract is beneficial to patients with chemotherapy-refractory NSCLC. Further clinical trials and preclinical studies are necessary to determine the efficacy and safety of the standardized RVS extract in NSCLC.

• Journal of Gastric Cancer
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• 제19권4호
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• pp.460-472
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• 2019

Purpose: Long noncoding RNA 00703 (LINC00703) was found originating from a region downstream of Kruppel-like factor 6 (KLF6) gene, having 2 binding sites for miR-181a. Since KLF6 has been reported as a target of miR-181a in gastric cancer (GC), this study aims to investigate whether LINC00703 regulates the miR-181a/KLF6 axis and plays a functional role in GC pathogenesis. Materials and Methods: GC tissues, cell lines, and nude mice were included in this study. RNA binding protein immunoprecipitation (RIP) and pull-down assays were used to evaluate interaction between LINC00703 and miR-181a. Quantitative real-time polymerase chain reaction and western blot were applied for analysis of gene expression at the transcriptional and protein levels. A nude xenograft mouse model was used to determine LINC00703 function in vivo. Results: We revealed that LINC00703 competitively interacts with miR-181a to regulate KLF6. Overexpression of LINC00703 inhibited cell proliferation, migration/invasion, but promoted apoptosis in vitro, and arrested tumor growth in vivo. LINC00703 expression was found to be decreased in GC tissues, which was positively correlated with KLF6, but negatively with the miR-181a levels. Conclusions: LINC00703 may have an anti-cancer function via modulation of the miR-181a/KLF6 axis. This study also provides a new potential diagnostic marker and therapeutic target for GC treatment.

• Genomics & Informatics
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• 제21권3호
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• pp.30.1-30.13
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• 2023

Ephs belong to the largest family of receptor tyrosine kinase and are highly conserved both sequentially and structurally. The structural organization of Eph is similar to other receptor tyrosine kinases; constituting the extracellular ligand binding domain, a fibronectin domain followed by intracellular juxtamembrane kinase, and SAM domain. Eph binds to respective ephrin ligand, through the ligand binding domain and forms a tetrameric complex to activate the kinase domain. Eph-ephrin regulates many downstream pathways that lead to physiological events such as cell migration, proliferation, and growth. Therefore, considering the importance of Eph-ephrin class of protein in tumorigenesis, 7,620 clinically reported missense mutations belonging to the class of variables of unknown significance were retrieved from cBioPortal and evaluated for pathogenicity. Thirty-two mutations predicted to be pathogenic using SIFT, Polyphen-2, PROVEAN, SNPs&GO, PMut, iSTABLE, and PremPS in-silico tools were found located either in critical functional regions or encompassing interactions at the binding interface of Eph-ephrin. However, seven were reported in nonsmall cell lung cancer (NSCLC). Considering the relevance of receptor tyrosine kinases and Eph in NSCLC, these seven mutations were assessed for change in the folding pattern using molecular dynamic simulation. Structural alterations, stability, flexibility, compactness, and solvent-exposed area was observed in EphA3 Trp790Cys, EphA7 Leu749Phe, EphB1 Gly685Cys, EphB4 Val748Ala, and Ephrin A2 Trp112Cys. Hence, it can be concluded that the evaluated mutations have potential to alter the folding pattern and thus can be further validated by in-vitro, structural and in-vivo studies for clinical management.