• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2363-2367
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• 2014

The association between the NAD(P)H:quinone oxidoreductase 1 (NQO1) gene C609T polymorphism (rs1800566) and gastric cancer has been widely evaluated, but a definitive answer is so far lacking. We first conducted a case-control study to assess this association in a large Han Chinese population, and then performed a meta-analysis to further address this issue. Although our case-control association study indicated no significant difference in the genotype and allele distributions of C609T polymorphism between gastric cancer patients and controls, in the meta analysis involving 4,000 subjects, comparison of alleles 609T and 609C indicated a significantly increased risk (46%) for gastric cancer (95% confidence interval (95%CI) for odds ratio (OR)=1.20-1.79) in individuals with the T allele. The tendency was similar to the homozygote (OR=1.81, 95%CI: 1.16-2.84), dominant models (OR=1.41, 95%CI: 1.12-1.79), as well as recessive model (OR=1.58, 95%CI: 1.06-2.35). Stratified analysis by study design demonstrated stronger associations in population-based than in hospital-based studies. And ethnicity-based analysis demonstrated a significant association in Asians. We conclude that the NQO1 gene C609T polymorphism increases the risk for gastric cancer, especially in Asian populations.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.915-921
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• 2012

Background: Previous studies investigating the association between TP53 Arg72Pro polymorphism and gastric cancer (GC) risk in Asian population have reported controversial results. Thus, a meta-analysis was performed. Methods: A comprehensive literature search was conducted and 17 case-control studies were finally included, involving a total of 5,990 GC cases and 6,812 controls. Subgroup analyses were performed by the sample size. Results: Meta-analysis of all 17 studies showed variant genotypes of TP53 Arg72Pro to be associated with an elevated GC risk in three genetic comparison models ($OR_{Pro\;vs.\;Arg}$=1.13, 95%CI 1.03-1.25, $P_{OR}$=0.01; $OR_{Homozygote\;comparison\;model}$=1.33, 95%CI 1.07-1.64, $P_{OR}$=0.009; $OR_{Dominant\;genetic\;model}$=1.13, 95%CI 1.05-1.22, $P_{OR}$=0.002). Besides, a more obvious association was observed after the heterogeneity was decreased (all P values less than 0.001). This association was further identified by both subgroup and sensitivity analyses. Conclusions: This meta-analysis suggests the Pro variant of TP53 Arg72Pro contributes to gastric cancer risk in Asians.

• Journal of Gastric Cancer
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• v.19 no.4
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• pp.417-426
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• 2019

Purpose: Although an increased incidence of gallbladder (GB) stone formation after gastrectomy has been reported, its etiology remains uncertain. The goal of this study was to explore the incidence of gallstone formation after gastrectomy in gastric cancer patients and investigate the risk factors therein. Materials and Methods: Medical records of patients who underwent curative gastrectomy, performed by a single surgeon between August 2012 and December 2015 at the Asan Medical Center, were retrospectively reviewed. Baseline characteristics and surgical outcomes, including GB stone gallstone formation after gastrectomy, were analyzed. Results: Of 561 patients included in the study, 36 presented with GB stone formation after gastrectomy for gastric cancer. The incidence of gallstone formation was 6.4%. The mean interval between gallstone formation and gastrectomy was 21.9 months. In multivariate analyses, the incidence of gallstone formation increased in patients 63 years or older, with greater than 6.2 kg weight loss in the first 6 months after the procedure, a preoperative serum total bilirubin level greater than 0.5 mg/dL, and in patients who did not receive adjuvant chemotherapy. Conclusions: This study presented risk factors for GB stone formation after gastric cancer surgery, and special attention should be afforded to patients with such risk factors.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6095-6101
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• 2013

Few studies have examined the relationship between social support and stages of adoption of cancer screening. Here we investigated associations between both structural and functional aspects of social support and stages of adoption of gastric cancer screening in the general population of Korea. The study population was derived from the 2011 Korean National Cancer Screening Survey (KNCSS), an annual cross-sectional survey that uses nationally representative random sampling to investigate cancer screening rates. Data were analyzed from 3,477 randomly selected respondents aged 40-74 years. Respondents were classified according to their stage of adoption of gastric cancer screening: precontemplation (13.2%), contemplation (18.0%), action/maintenance (56.1%), relapse risk (8.5%), and relapse stage (4.1%). Respondents with larger social networks were more likely to be in the contemplation/action/maintenance, or the relapse risk/relapse stages versus the precontemplation stage (OR=1.91, 95%CI: 1.52-2.91; p for tend=0.025). Emotional and instrumental supports were not associated with any stage of adoption of gastric cancer screening. However, respondents who reported receiving sufficient informational support were more likely to be in the relapse risk/relapse stages versus the precontemplation, or the contemplation/action/maintenance stage (p for trend=0.016). Interventions involving interactions between social network members could play an important role in increasing participation in gastric cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2745-2750
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• 2016

Gastric cancer is a multifactorial and complex malignant disease seen commonly worldwide. It is one of the few malignant conditions in which the etiology involves infectious agents (Helicobacter pylori), but there are many other risk factors incuding high salt intake. Its pathogenesis generally involves interactions between environmental factors and genetic disposition. It is currently onsidered that stem cells may play a central role in gastric cancer development.

• Journal of Gastric Cancer
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• v.16 no.1
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• pp.34-42
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• 2016

Purpose: Early gastric cancer cases that are estimated to meet indications for treatment before endoscopic submucosal resection are often revealed to be out-of-indication after the treatment. We investigated the short-term treatment outcomes in patients with early gastric cancer according to the pretreatment clinical endoscopic submucosal resection indications. Materials and Methods: We retrospectively reviewed the medical records of patients with early gastric cancer that met the pretreatment endoscopic submucosal resection indications, from 2004 to 2011. Curative resection rate and proportion of out-of-indication cases were compared according to the pre-endoscopic submucosal resection indications. Pre-endoscopic submucosal resection factors associated with out-of-indication in the final pathological examination were analyzed. Results: Of 756 cases, 660 had absolute and 96 had expanded pre-endoscopic submucosal resection indications. The curative resection rate was significantly lower in the patients with expanded indications (64.6%) than in those with absolute indications (81.7%; P<0.001). The cases with expanded indications (30.2%) were revealed to be out-of-indication more frequently than the cases with absolute indications (13.8%; P<0.001). Age of >65 years, tumor size of >2 cm, tumor location in the upper-third segment of the stomach, and undifferentiated histological type in pre-endoscopic submucosal resection evaluations were significant risk factors for out-of-indication after endoscopic submucosal resection. Conclusions: Non-curative resection due to out-of-indication occurred in approximately one-third of the early gastric cancer cases that clinically met the expanded indications before endoscopic submucosal resection. The possibility of additional surgery should be empha-sized for patients with early gastric cancers that clinically meet the expanded indications.

• Journal of Gastric Cancer
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• v.24 no.2
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• pp.172-184
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• 2024

Purpose: The original eCura system was designed to stratify the risk of lymph node metastasis (LNM) after endoscopic resection (ER) in patients with early gastric cancer (EGC). We assessed the effectiveness of a modified eCura system for reflecting the characteristics of undifferentiated-type (UD)-EGC. Materials and Methods: Six hundred thirty-four patients who underwent non-curative ER for UD-EGC and received either additional surgery (radical surgery group; n=270) or no further treatment (no additional treatment group; n=364) from 18 institutions between 2005 and 2015 were retrospectively included in this study. The eCuraU system assigned 1 point each for tumors >20 mm in size, ulceration, positive vertical margin, and submucosal invasion <500 ㎛; 2 points for submucosal invasion ≥500 ㎛; and 3 points for lymphovascular invasion. Results: LNM rates in the radical surgery group were 1.1%, 5.4%, and 13.3% for the low-(0-1 point), intermediate- (2-3 points), and high-risk (4-8 points), respectively (P-fortrend<0.001). The eCuraU system showed a significantly higher probability of identifying patients with LNM as high-risk than the eCura system (66.7% vs. 22.2%; McNemar P<0.001). In the no additional treatment group, overall survival (93.4%, 87.2%, and 67.6% at 5 years) and cancer-specific survival (99.6%, 98.9%, and 92.9% at 5 years) differed significantly among the low-, intermediate-, and high-risk categories, respectively (both P<0.001). In the high-risk category, surgery outperformed no treatment in terms of overall mortality (hazard ratio, 3.26; P=0.015). Conclusions: The eCuraU system stratified the risk of LNM in patients with UD-EGC after ER. It is strongly recommended that high-risk patients undergo additional surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2333-2340
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• 2015

Background: Due to the strong inhibitory effects of $PPAR{\gamma}$ gene on the growth of cancer cells, the role of Pro12Ala polymorphism in $PPAR{\gamma}$ gene has been extensively investigated in cancer recently. However, the results were inconsistent according to cancer type. The aim of this study was to comprehensively evaluate the $PPAR{\gamma}$ Pro12Ala polymorphism and gastric cancer susceptibility. Materials and Methods: Search strategies were conducted in Pubmed, Medline (Ovid), Chinese biomedical database (CBM), China national knowledge infrastructure (CNKI), VIP, and Wanfang database, covering all publications, with the last search up to November 01, 2014. The strength of association between $PPAR{\gamma}$ Pro12Ala polymorphism and gastric cancer risk was assessed by OR with 95%CI. Results: A total of 546 cases and 827 controls in 5 case-control studies were included in this meta-analysis. The results indicated that the variant G allele carriers (CG+GG) had a 2.31 times higher risk for gastric cancer when compared with the homozygote CC (odds ratio (OR)=2.31, 95% confidence interval (CI)=1.67-3.21 for CG+GG vs. CC). In the subgroup analysis by ethnicity, significantly elevated risks were both found in Asians (OR=2.56, 95% CI=1.42-4.64) and Caucasians (OR=2.20, 95% CI=1.48-3.25). Similarly, in the subgroup analysis by H. pylori status, a significantly increased risk was identified in H. pylori (+) populations (OR=3.68, 95%CI=2.07-6.52), but not in H. pylori(-) populations (OR=1.17, 95%CI=0.58-2.39). Conclusions: This pooled analysis suggested that the $PPAR{\gamma}$ Pro12Ala polymorphism could be an independent predictive risk factor for gastric cancer especially in H. pylori infected populations in Asians and Caucasians. Nevertheless, prospectively designed cohort studies are needed to further investigate gene-gene and gene-environment interactions to confirm the combined effects of $PPAR{\gamma}$ Pro12Ala polymorphisms and H. pylori infection on gastric cancer risk.

• Journal of Gastric Cancer
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• v.10 no.2
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• pp.49-54
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• 2010

Endoscopic resection is now accepted as curative treatment modalities for early gastric cancer without lymph node metastasis. However, based on large-scaled data about the risk of lymph node metastasis in early gastric cancer and as a result of the technical development of endoscopic devices, it was suggested that the criteria for endoscopic resection should be extended. According to the treatment guidelines for gastric cancer in Japan, the extended indications include the following: differentiated-type mucosal cancer without ulceration and greater than 2 cm in diameter, differentiated-type mucosal cancer with ulceration and up to 3 cm in diameter, undifferentiated-type mucosal cancer without ulceration and up to 2 cm in diameter, and, in the absence of lymphovascular invasion, a tumor not deeper than submucosal level 1 (less than $500\;{\mu}m$). In this review, we discuss the evidence of the application of expanded endoscopic indication based on analysis of biologic behavior and data of endoscopic resection.

• Journal of Gastric Cancer
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• v.10 no.3
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• pp.137-140
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• 2010

Gastrointestinal stromal tumors (GISTs) constitute the most common primary mesenchymal tumors of the digestive tract and characteristically express c-kit (CD117). GISTs are the most common non-epithelial tumor of the GI tract and frequently originate from the stomach and small bowel. Specifically, the synchronous occurrence of a GIST with other epithelial tumors is rarely reported. Recently, we discovered one case of a concurrent gastric cancer and a small bowel GIST that was initially suspected to be peritoneal seeding from gastric cancer. The patient was initially admitted with epigastric pain. Gastric cancer with peritoneal seeding was suspected after an evaluation. Following a laparoscopic examination, a distal gastrectomy with D2 lymph node dissection and small-intestine segmental resection was performed. The final pathologic diagnosis was early gastric cancer and high-risk small bowel GIST. The patient refused adjuvant therapy for the GIST, and currently shows no other marked indisposition. He has been disease-free for 14 months.