• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6945-6948
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• 2014

Background: Familial adenomatous polyposis (FAP) is a disease inherited in an autosomal dominant fashion. Most FAP patients develop upper gastrointestinal polyps; especially those in the antrum and duodenum are usually neoplastic. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in Iranian FAP patients. Materials and Methods: 28 patients affected by FAP underwent front-view and side-view endoscopy. Papillary biopsies were performed in all patients. Location of polyps, their number and size, pathology study, patient general information (gender, age, family history of FAP or colorectal cancer and gastroduodenal polyps) were analyzed. Results: Gastric polyps were seen in 39.3 % of patients. Some 72.7% of the affected individuals had fundic gland polyps and 36.36% had hyperplastic polyps. Duodenal adenoma was observed in 25% of patients. While 57% of patients had tubular adenoma with low grade dysplasia, 42.8% showed tubulovillous adenoma with low grade dysplasia. Conclusions: Findings of this study indicated that the prevalence of gastroduodenal polyps in FAP patients is high and dysplasia may be evident in duodenal polyps. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.

• Journal of Gastric Cancer
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• 제6권2호
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• pp.91-96
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• 2006

목적: 일반적으로 DNA가 손상된 세포들은 사멸되거나 적절히 손상된 부위를 복구하여 항상성을 유지하거나, 손상된 DNA를 가지고 계속 증식하여 결국 암으로 진행한다. 그러므로 세포자멸사와 세포증식의 균형의 변화는 조직 항상성 및 암 발생의 중요한 조절기전이다. 이에 본 연구자들은 위샘종 또는 위샘암종 조직을 대상으로 세포 사멸 및 세포증식의 정도를 보고자 하였다. 대상 및 방법: 내시경적으로 절제된 위샘종 41예, 외과 수술로 절제된 위샘암종 100예를 대상으로 면역조직화학적 검사를 시행하여 Ki-67 labelling 지수를 구하고, TUNEL 방법을 이용하여 세포자멸사 지수를 구하여 위샘종에서의 이형성 정도에 따른 발현도의 차이 및 위샘암종에서의 조직분류 및 병기에 따른 발현도의 차이를 관찰하였다. 결과: Ki-67 labelling 지수는 위샘종 $51.90{\pm}1.45$, 위샘암종 $55.33{\pm}0.94$로서 위샘암종에서 의의 있게 높았다(P<0.05). 세포자멸사 지수는 위샘종 $53.27{\pm}2.67$, 위샘암종 $42.41{\pm}1.32$로서 위샘종에서 의의 있게 높았다(P<0.05). 위샘종에서 이형성에 따른 Ki-67 labelling 지수 및 세포자멸사 지수는 차이가 없었다. 위샘암종에서 Ki-67 labelling 지수 및 세포자멸사 지수는 Lauren 분류법에 의한 장형과 미만형, 조기 위암과 진행성 위암, 림프절 전이 유무, TNM 분류에 따른 각 군 간의 통계학적 차이는 보이지 않았다. 결론: 샘암종에서의 세포자멸사 지수와 Ki-67 labelling 지수에 대한 연구에서 위샘종은 위샘암종보다 좀 더 정적인 결과를 보이고, 위암발생에서는 세포증식이 중요한 역할을 하나 이 두 지수가 위암의 조직학적 분류 및 병기에 따른 예후와는 관련이 없었다.

• Clinical Endoscopy
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• 제56권1호
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• pp.114-118
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• 2023

Gastric wall abscess, a localized form of phlegmonous gastritis, is a rare complication of endoscopic resection. We report the first case of gastric wall abscess developing after endoscopic submucosal dissection in Korea. A 72-year-old woman visited our clinic to receive treatment for gastric adenoma. The patient successfully underwent endoscopic submucosal dissection with no complications. The final diagnosis was well-differentiated tubular adenocarcinoma. We performed follow-up endoscopy 10 weeks later and found a large subepithelial lesion on the posterior wall of the gastric antrum. Abdominal computed tomography revealed hypodense wall thickening and a 5 cm heterogenous multilobular mass in the submucosal layer of the gastric antrum. Submucosal invasion with mucin-producing adenocarcinomas could therefore not be excluded. The patient agreed to undergo additional gastrectomy due to the possibility of a highly malignant lesion. The final diagnosis was acute suppurative inflammation with the formation of multiple abscesses in the mural layers and omentum. The patient was discharged with no complications.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권2호
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• pp.195-198
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• 2000

Gastroduodenal intussusception is an invagination of part of the stomach through the pylorus and into the duodenum for a varying distance. The lead point of the intussusception is usually a benign gastric tumor such as gastric adenoma. We report a case of gastroduodenal intussusception in a 33-month-old boy presented with nonbilious vomiting and abdominal pain. Laparotomy revealed a gastroduodenal intussusception. After reduction and gastrostomy, a mass measuring $15{\times}5\;cm$ in size, was found at the leading point of the intussusceptum. The mass was resected, and pathological diagnosis showed a gastric hemangiomatosis.

• Journal of Gastric Cancer
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• 제11권3호
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• pp.155-161
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• 2011

Purpose: To determine the diagnostic utility of a frozen section biopsy in patients undergoing endoscopic submucosal dissection (ESD) for early gastric neoplasms with obscure margins even with chromoendoscopy using acetic acid and indigo carmine (AI chromoendoscopy). Materials and Methods: The lateral spread of early gastric neoplasms was unclear even following AI chromoendoscopy in 38 patients who underwent ESD between June 2007 and May 2011. Frozen section biopsies were obtained by agreement of the degree of lateral spread between two endoscopists. Thus, frozen section biopsies were obtained from 23 patients (FBx group) and not in the other 15 patients (AI group). Results: No significant differences were observed for size, histology, invasive depth, and location of lesions between the AI and FBx groups. No false positive or false negative results were observed in the frozen section diagnoses. Adenocarcinoma was revealed in three patients and tubular adenoma in one, thereby changing the delineation of lesion extent and achieving free lateral margins. The rates of free lateral resection margins and curative resection were significantly higher in the FBx group than those in the AI group. Conclusions: Frozen section biopsy can help endoscopists perform more safe and accurate ESD in patients with early gastric neoplasm.

• Parasites, Hosts and Diseases
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• 제53권1호
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• pp.95-99
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• 2015

Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient's fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.

• Laboraroty Animal Research
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• 제34권4호
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• pp.257-263
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• 2018

Trefoil factor 1 (TFF1, also known as pS2) is strongly expressed in the gastrointestinal mucosa and plays a critical role in the differentiation of gastric glands. Since approximately 50% of all human gastric cancers are associated with decreased TFF1 expression, it is considered a tumor suppressor gene. Tff1 deficiency in mice results in histological changes in the antral and pyloric gastric mucosa, with severe hyperplasia and dysplasia of epithelial cells, resulting in the development of antropyloric adenoma. Here, we generated Tff1-knockout (KO) mice, without a neomycin resistant ($Neo^R$) cassette, using the clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease 9 (CRSIPR/Cas9) system. Though our Tff1-KO mice showed phenotypes very similar to the previous embryonic stem (ES)-cell-based KO mice, they differed from the previous reports in that a reduction in body weight was observed in males. These results demonstrate that these newly established Tff1-KO mice are useful tools for investigating genetic and environmental factors influencing gastric cancer, without the effects of artificial gene insertion. Furthermore, these findings suggest a novel hypothesis that Tff1 expression influences gender differences.

• The Korean journal of internal medicine
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• 제33권6호
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• pp.1084-1092
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• 2018

Background/Aims: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. Methods: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. Results: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). Conclusions: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.

• Journal of Gastric Cancer
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• 제1권1호
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• pp.4-9
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• 2001

Purpose: The trefoil factor family 1 (TFF1) has a protective effect against gastric mucosal damage induced by nonsteroidal anti-inflammatory drugs or ethanol. In addition, a TFF1 knockout mouse model has exhibited circumferential adenomas with high-grade dysplasia, of which $30\%$ progressed into frankly invasive carcinomas. We tried to determine whether the expression pattern of the TFF1 could be involved in the development of sporadic gastric carcinomas. Materials and Methods: We examined TFF1 expression in a series of 43 sporadic gastric carcinomas and 18 gastric adenomas by immunohistochemistry. Results: Strong positive TFF1 staining was identified primarily in the normal gastric mucosa, mainly in the cytoplasm of the superficial and foveolar epithelium. We found TFF1 expression in $55.8\%$ (24 out of 43) of the gastric carcinomas and in $16.7\%$ (3 out of 18) of the gastric adenomas. Statistically, TFF1 immunoreactivity was significantly higher in diffuse-type ($82.4\%$) than in intestinal-type ($38.5\%$) carcinomas(p=0.0058, Fisher's exact test). Conclusion: Our findings provide sufficient evidence that the expression of TFF1 in gastric cancer may simply disclose gastric-type differentiation of neoplastic cells and provide further support for the existence of at least two pathways of malignant transformation of the gastric mucosa: one via intestinal metaplasia and adenomatous dysplasia, leading to glandular carcinomas with intestinal-type differentiation, and the other via hyperplastic changes or de novo changes, leading to diffuse carcinomas and to a subset of glandular carcinomas displaying gastric-type differentiation.

• Journal of Gastric Cancer
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• 제6권2호
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• pp.76-83
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• 2006

목적: 최근 위선종 및 조기위암에 대해 새로운 내시경적 치료법인 내시경 절개 점막하 박리법은 기존의 내시경적 점막절제술 보다 더 넓은 적응증을 가지고 있지만 시술의 난이도가 높고 합병증의 위험이 있어 보편적으로 시술되고 있지 않다. 이에 내시경 절개 점막하 박리법으로 치료한 위의 종양성 병변의 치료 성적을 바탕으로 그 임상적 유용성을 알아보고자 하였다. 대상 및 방법: 내시경 절개 점막하 박리법을 시행한 164명의 환자들의 179개의 위종양성 병변에 대하여 완전절제 및 일괄절제 여부, 합병증, 재발 여부 등을 분석하였다. 결과: 179개의 병변은 조기위암 126예(70.3%), 선종 42예 (23.4%)였다. 병변의 침윤 깊이를 확인할 수 있었던 조기위암 420예는 각각 점막1층(sm1) 0.8% (1/120), 점막2층(m2) 38.3% (46/120), 점막3층(m3) 25% (57/120), 점막하1층(sm1) 11.7% (14/120), 점막하2층(sm2) 1.6% (2/120)이었다. 종양의 일괄절제율과 완전절제율은 각각 96.0%, 85.2%였다. 합병증은 천공 8예(4.4%), 출혈 38예(21.2%)가 발생하였으나, 천공 1예를 제외한 나머지는 비수술적으로 치료가 가능하였다. 결론: 본 연구에서 내시경 절개 점막하 박리법은 위종양성 병변의 근치적 치료에 비교적 안전하고 효과적인 술기이고, 향후 보다 장기간의 추적관찰을 통해 그 유용성이 검증되어야 할 것으로 생각한다.