• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2519-2522
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• 2012

Objective: Data from a recent genome-wide association studiesy of gastric cancer (GC) and oesophageal squamous cell carcinoma in Chinese living in the Taihang Mountains of north-central China suggest that 1q22 and 10q23 are susceptibility-associated regions for GC. However, this has not been confirmed in southern Chinese populations. The aim of this study was to investigate whether these polymorphisms at 1q22 and 10q23 are associated with the risk of GC in a southern Chinese population. Methods: We selected seven top significant associated single nucleotide polymorphisms (SNPs) at 1q22 and 10q23 and conducted a population-based case-control study in a southern Chinese population. Genotypes were determined using MassARRAYTM system (Sequenome, San Diego, CA). Results: Two SNPs at 1q22, rs4072037 and rs4460629, were significantly associated with a reduced risk of GC, best fitting the dominant genetic model. Logistic regression models adjusted for age and sex showed that rs4072037 AG and GG (OR=0.64, P=0.017, compared with AA) and rs4460629 CT and TT (OR=0.54, P=0.0016, compared with TT) significantly reduced the risk of GC. However, no significant results for the five SNPs at 10q23 were obtained in this study. Conclusion: These outcomes indicate that 1q22 is associated with GC susceptibility in this southern Chinese population, while an association for the locus at 10q23 was not confirmed.

• Clinical Endoscopy
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• 제56권1호
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• pp.75-82
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• 2023

Background/Aims: The etiology of superficial non-ampullary duodenal epithelial tumors (SNADETs) remains unclear. Recent studies have reported conflicting associations between duodenal tumor development and Helicobacter pylori infection or endoscopic gastric mucosal atrophy. As such, the present study aimed to clarify the relationship between SNADETs and H. pylori infection and/or endoscopic gastric mucosal atrophy. Methods: This retrospective case-control study reviewed data from 177 consecutive patients with SNADETs who underwent endoscopic or surgical resection at seven institutions in Japan over a three-year period. The prevalence of endoscopic gastric mucosal atrophy and the status of H. pylori infection were compared in 531 sex- and age-matched controls selected from screening endoscopies at two of the seven participating institutions. Results: For H. pylori infection, 85 of 177 (48.0%) patients exhibited SNADETs and 112 of 531 (21.1%) control patients were non-infected (p<0.001). Non-atrophic mucosa (C0 to C1) was observed in 96 of 177 (54.2%) patients with SNADETs and 112 of 531 (21.1%) control patients (p<0.001). Conditional logistic regression analysis revealed that non-atrophic gastric mucosa was an independent risk factor for SNADETs (odds ratio, 5.10; 95% confidence interval, 2.44-8.40; p<0.001). Conclusions: Non-atrophic gastric mucosa, regardless of H. pylori infection status, was a factor independently associated with SNADETs.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.6103-6108
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• 2013

Objective: Excision repair cross-complementing group 6 (ERCC6) is a major component of the nucleotide excision repair pathway that plays an important role in maintaining genomic stability and integrity. Several recent studies suggested a link of ERCC6 polymorphisms with susceptibility to various cancers. However, the relation of ERCC6 polymorphism with gastric cancer (GC) risk remains elusive. In this sex- and age-matched case-control study including 402 GC cases and 804 cancer-free controls, we aimed to investigate the association between a potentially functional polymorphism (rs1917799 T>G) in the ERCC6 regulatory region and GC risk. Methods: The genotypes of rs1917799 were determined by Sequenom MassARRAY platform and the status of Helicobacter pylori infection was detected by enzyme-linked immunosorbent assay. Odd ratios (ORs) and 95% confidential interval (CI) were calculated by logistic regression analysis. Results: Compared with the common TT genotype, the ERCC6 rs1917799 GG genotype was associated with increased GC risk (adjusted OR=1.46, 95%CI: 1.03-2.08, P=0.035). When compared with (GT+TT) genotypes, the GG genotype also demonstrated a statistical association with increased GC risk (adjusted OR=1.38, 95%CI: 1.01-1.89, P=0.044). This was also observed for the male subpopulation (GG vs. TT: adjusted OR=1.71, 95%CI: 1.12-2.62, P=0.013; G allele vs. T allele: adjusted OR=1.32, 95%CI: 1.07-1.62, P=0.009). Genetic effects on increased GC risk tended to be enhanced by H. pylori infection, smoking and drinking, but their interaction effects on GC risk did not reach statistical significance. Conclusions: ERCC6 rs1917799 GG genotype might be associated with increased GC risk in Chinese, especially in males.

• Journal of Preventive Medicine and Public Health
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• 제42권2호
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• pp.117-122
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• 2009

Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4215-4218
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• 2015

Gastric cancer (GC) is one of the most common malignancies in the world. It is the first cause of cancer deaths in both sexes In Iranian population. Circulating insulin-like growth factor-one (IGF-1) levels have been associated for gastric cancer. IGF-1 protein has central roles involved in the regulation of epithelial cell growth, proliferation, transformation, apoptosis and metastasis. Single nucleotide polymorphism in IGF-1 regulatory elements may lead to alter in IGF-1expression level and GC susceptibility. The aim of this study was to investigate the influence of IGF-1 gene polymorphism (rs5742612) on risk of GC and clinicopathological features for the first time in Iranian population. In total, 241 subjects including 100 patients with GC and 141 healthy controls were recruited in our study. Genotypes were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay with DNA from peripheral blood. The polymorphism was statistically analyzed to investigate the relationship with the risk of GC and clinicopathological properties. Logistic regression analysis revealed that there was no significant association between rs5742612 and the risk of GC. In addition, no significant association between genotypes and clinicopathological features was observed (p value>0.05). The frequencies of the CC, CT, and TT genotypes were 97%, 3%, and 0%, respectively, among the cases, and 97.9%, 2.1%, and 0%, respectively, among the controls. CC genotype was more frequent in cases and controls. The frequencies of C and T alleles were 98.9% and 1.1% in controls and 98.5% and 1.5% in patient respectively. Our results provide the first evidence that this variant is rare in Iranian population and it may not be a powerful genetic predisposing biomarker for prediction GC clinicopathological features in an Iranian population.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3301-3307
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• 2016

Background: Cancer is a leading cause of death in Korea. To prevent cancer, it is essential to facilitate and promote appropriate cancer screening behavior in the adult population. The aim of this study was to examine health beliefs related to cancer screening intentions using the Health Belief Model (HBM). Materials and Methods: The research participants comprised 275 male health and safety managers at commercial companies in Korea. The self-administered survey explored demographic characteristics, cancer-related factors, beliefs about cancer/cancer screening (BCCS) (vulnerability to cancer, severity of cancer, benefits of screening, and barriers to screening), and cancer screening intention. Multivariate logistic regression analyses were used to identify factors associated with an intention to be screened for cancer. Results: Perceived health status and need for cancer prevention education were major factors associated with BCCS. Poorer health status was associated with greater perceived vulnerability, a perception of fewer benefits, and more barriers (p<0.05). A perceived greater need for cancer prevention education was associated with a higher perceived severity of cancer and more perceived barriers to screening (p<0.05). Marital status, cancer screening experience, and perceived vulnerability to cancer were significant influences on the cancer screening intention (p<0.05). Participants who had undergone cancer screening in the past 2 years were more likely to intend to be screened for cancer than were those who had not been screened; this was true across all degrees of intention and all types of cancer (p<0.01). Hesitant people considered themselves less vulnerable to gastric, lung, and liver cancer than did the poeple who intended to undergo cancer screening (p<0.05). Conclusions: Based on our findings, we recommend that workplace cancer prevention programs attempt to increase awareness about vulnerability to cancer among workers who hesitate to undergo cancer screening.

• Journal of Gastric Cancer
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• 제21권4호
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• pp.368-378
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• 2021

Purpose: When patients with early gastric cancer (EGC) undergo non-curative endoscopic submucosal dissection requiring gastrectomy (NC-ESD-RG), additional medical resources and expenses are required for surgery. To reduce this burden, predictive model for NC-ESD-RG is required. Materials and Methods: Data from 2,997 patients undergoing ESD for 3,127 forceps biopsy-proven differentiated-type EGCs (2,345 and 782 in training and validation sets, respectively) were reviewed. Using the training set, the logistic stepwise regression analysis determined the independent predictors of NC-ESD-RG (NC-ESD other than cases with lateral resection margin involvement or piecemeal resection as the only non-curative factor). Using these predictors, a risk-scoring system for predicting NC-ESD-RG was developed. Performance of the predictive model was examined internally with the validation set. Results: Rate of NC-ESD-RG was 17.3%. Independent pre-ESD predictors for NC-ESD-RG included moderately differentiated or papillary EGC, large tumor size, proximal tumor location, lesion at greater curvature, elevated or depressed morphology, and presence of ulcers. A risk-score was assigned to each predictor of NC-ESD-RG. The area under the receiver operating characteristic curve for predicting NC-ESD-RG was 0.672 in both training and validation sets. A risk-score of 5 points was the optimal cut-off value for predicting NC-ESD-RG, and the overall accuracy was 72.7%. As the total risk score increased, the predicted risk for NC-ESD-RG increased from 3.8% to 72.6%. Conclusions: We developed and validated a risk-scoring system for predicting NC-ESD-RG based on pre-ESD variables. Our risk-scoring system can facilitate informed consent and decision-making for preoperative treatment selection between ESD and surgery in patients with EGC.

• Clinical Endoscopy
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• 제55권1호
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• pp.77-85
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• 2022

Background/Aims: Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitored anesthesia care (MAC). Methods: Between 2012 and 2018, 674 patients underwent ESD for gastric tumors in the midbody, high body, fundus, or cardia (100 patients received GA; 574 received MAC). The outcomes of the propensity score (PS)-matched (1:1) patients receiving either GA or MAC were analyzed. Results: The PS matching identified 94 patients who received GA and 94 patients who received MAC. Both groups showed high rates of en bloc resection (GA, 95.7%; MAC, 97.9%; p=0.68) and complete resection (GA, 81.9%; MAC, 84.0%; p=0.14). There were no significant differences between the rates of adverse events (GA, 16.0%; MAC, 8.5%; p=0.18) in the anesthetic groups. Logistic regression analysis indicated that the method of anesthesia did not affect the rates of complete resection or adverse events. Conclusions: ESD of tumors in the mid-to-upper stomach at our high-volume center had good outcomes, regardless of the method of anesthesia. Our results demonstrate no differences between the efficacies and safety of ESD performed under MAC and GA.

• Journal of Gastric Cancer
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• 제8권4호
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• pp.237-243
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• 2008

목적: 최근 감염성 합병증은 병원의 감염관리 및 질적 평가의 지표와도 관련이 있어 관심이 증가하고 있다. 본 연구의 목적은 정규 위암 수술 후 감염성 합병증에 노출되기 쉬운 고위험군의 환자에 대해 알아보고자 하였다. 대상 및 방법: 2000년 1월부터 2007년 12월까지 전북대학교 병원에서 위암으로 정규 위절제술을 받은 환자를 대상으로 의무기록 분석을 통한 후향적 조사를 하였으며, 진단적 개복술과 고식적 우회술만 시행한 환자를 제외한 788명을 대상으로 하였다. 환자의 특성을 환자의 요인과 수술적 요인으로 나누었으며, 환자의 요인으로는 성별, 연령, 체질량 지수, Eastern Cooperative Oncology Group (ECOG) score, 흡연과 음주 여부, 동반된 기저질환 유무와 종류, 조직학적 병기 등이 포함되었고, 수술적 요인으로는 위 절제범위와 림프절 곽청 정도, 수술 시간, 수술 전후 수혈 여부, 수술 중 복강 내 항암화학요법 시행여부 등이 포함되었다. 결과: 평균 나이는 58.9세(범위: 24~91세)였고, 남자는 545명 여자는 243명이었다. 평균재원 기간은 20.3일(범위: 5~135일), 평균 수술시간은 181.3분(범위: 65~440분)이었다. 전체 합병증 발생률은 17.1% (n=135)였으며, 이중 감염성 합병증은 38.5% (n=52)였다. 감염성 합병증에는 창상감염(59.7%), 폐렴(19.3%), 복강 내 농양(11.5%), 거짓막 대장염(5.7%), 균혈증(1.9%) 그리고 간농양(1.9%)이 있었다. 단변량 분석에서 유의한 위험인자는 남자, 수혈, 진단 당시의 흡연과 음주, 당뇨, 심혈관계 질환이었고, 다변량 분석에서는 수혈, 진단 당시의 흡연, 당뇨, 심혈관계 질환이 감염성 합병증의 위험인자였다. 결론: 감염예방을 위해 수술 전후의 수혈을 가급적 피하는 것이 좋다. 또한 수술 전 환자의 동반 기저 질환 유무에 대한 병력과 흡연 등의 개인력 수집에 있어서 세심한 주의가 필요하며 위험인자를 가진 환자들은 수술 후 감염 예방을 위해 집중적인 관리가 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제35권3호
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• pp.245-254
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• 2002

노인에서 $H_2$-RA의 복용과 위암간의 관련성을 밝히기 위한 코호트 내 환자-대조군 연구를 수행하였다. 연구 모집단은 공무원 및 사립학교 교직원을 대상으로 하는 의료보험 관리공단의 피보험자 및 피부양자로서 부산지역에 거주하는 65세 이상의 노인들을 대상으로 구축된 한국노인약물역학코호트의 구성원 중에서 교란변수에 대한 정보 획득을 위해 실시한 설문조사에서 응답한 사람들로 구성된 코호트이었다. $H_2$-RA폭로군은 1993년 1월 1일부터 1994년 12월 31일 사이에 코호트 대상자들이 병원에서 약물을 처방 받아 청구한 자료를 바탕으로 구축한 약물처방 데이터베이스에서 1회 이상 $H_2$-RA를 처방 받은 사람들도 정의하였다. 환자군 76명은 코호트의 위암 환자 확진을 위한 병원방문 조사 자료, 중앙 암등록 자료, 부산 지역 암등록 자료를 이용하여 확인되었다. 대조군은 환자군 확인방법과 동일한 방법을 이용하여 확인하였을 때 암으로 진단받은 병력이 없는 코호트 대상자들 중에서 환자군의 출생 년도와 성별에 따라 1:4의 비율로 개별 짝짓기를 실시하여 뽑은 304명이었다. 잠재적 인 교란변수에 대한 정보는 설문조사를 통해 수집하였다. 조건부 로지스틱 회귀모델을 이용하여 교란변수의 영향을 통제한 상태에서 구한 $H_2$-RA 복용과 위암 발생간의 관련성을 대응비와 95% 신뢰구간으로 제시하였다. 그 결과, 위궤양 증상 여부, 약물 복용력, 체질량 지수의 영향을 통제한 상태에서 $H_2$-RA의 복용은 위암 발생의 위험을 4.6배 증가시키는 것으로 관찰되었다. $H_2$-RA를 7일 이내로 사용한 군은 $H_2$-RA를 사용하지 않은 군에 비해 위암 발생의 위험이 4.6배 증가하는 것으로 관찰되었고 7일 이상 사용한 군은 2.3배 증가하는 것으로 관찰되었다. 투여 경로별로 나누어 보았을 때에는 경구로 투여한 경우에서 유의한 위험 수준의 상승을 관찰하지 못한 반면에 주사로 투여한 경우에서 위험이 4.4배 증가하는 것으로 관찰되었고, 주사와 경구의 두 가지 경로 모두로 $H_2$-RA를 투여 받은 경우 그 위험은 더욱 상승하는 것으로 관찰되었다.시메티딘, 라니티딘, 파모티딘 등의 개별 성분명 별로 위암 발생의 위험에 대한 차이는 관찰되지 않았다. 결론적으로 $H_2$-RA를 사용한 노인에서 사용하지 않은 노인에서 비해 위암 발생의 위험이 더 높아진다는 결론을 얻었으며, 이는 $H_2$-RA투여로 인해 위내에 발생한 무위산증(achlorhydria)이 위암 발생의 위험을 높일 것이라는 기존의 가설을 뒷받침하는 결론이라고 할 수 있었다.