• Clinical Endoscopy
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• v.56 no.1
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• pp.14-22
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• 2023

Barrett's esophagus is associated with an increased risk of adenocarcinoma. Thorough screening during endoscopic surveillance is crucial to improve patient prognosis. Detecting and characterizing dysplastic or neoplastic Barrett's esophagus during routine endoscopy are challenging, even for expert endoscopists. Artificial intelligence-based clinical decision support systems have been developed to provide additional assistance to physicians performing diagnostic and therapeutic gastrointestinal endoscopy. In this article, we review the current role of artificial intelligence in the management of Barrett's esophagus and elaborate on potential artificial intelligence in the future.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.787-790
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• 2008

Barrett's esophagus is precancerous lesion of esophageal adenocarcinoma, but this has been rarely reported in Korea. A 81-year-old man with esophageal adenocarcinoma was admitted to our hospital, and we performed a distal esophagectomy and end-to-end esophagogastrostomy. The microscopic examination of the resected tissue revealed the intestinal metaplasia with goblet cells around the esophageal adenocarcinoma, which indicates this was a Barrett's esophagus. We report here on this case along with a review of the relevant literature.

• Journal of Digestive Cancer Research
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• v.11 no.1
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• pp.9-14
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• 2023

The prevalence of Barrett's esophagus is increasing in South Korea. Several strategies have been tried to prevent its progression to esophageal adenocarcinoma. It is questionable whether the strategies being tried in the West can be applied adequately in South Korea. However, despite the incidence of esophageal adenocarcinoma in the West, which is considerably higher than that in South Korea, the incidence of high-grade dysplasia/esophageal adenocarcinoma in population-based studies is as low as 0.23%/person-year. Therefore, in Korea, where the prevalence is lower than that, it is necessary to select high-risk groups more carefully for chemoprevention. The age of onset of gastroesophageal reflux disease-like symptoms at least once a week is related to the high-risk group rather than the presence or absence of chronic gastroesophageal reflux symptoms. The risk factors for esophageal adenocarcinoma include the patient's sex, age, smoking habit, and obesity. Proton pump inhibitors have a better preventive effect against esophageal adenocarcinoma compared to H2-receptor blockers, but their application to patients in Korea is limited due to the high number of individuals in need of treatment. Therefore, while considering the risk factors for the progression of esophageal adenocarcinoma, the administration of proton pump inhibitors should be considered for gastroesophageal reflux disease.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.679-683
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• 2013

Background: Dysplasia and adenocarcinoma developing in Barrett's esophagus (BE) are not always endoscopically identifiable. Molecular markers are needed for early recognition of these focal lesions and to identify patients at increased risk of developing adenocarcinoma. The aim of the current study was to correlate increased telomerase activity (TA) with dysplasia and adenocarcinoma occurring in the setting of BE. Materials and Methods: Esophageal mucosal biopsies were obtained from patients (N=62) who had pathologically verified BE at esophagogastroduodenoscopy (EGD). Mucosal biopsies were also obtained from the gastric fundus as controls. Based on histopathology, patients were divided into three groups: 1) BE without dysplasia (n=24); 2) BE with dysplasia (both high grade and low grade, n=13); and 3) BE with adenocarcinoma (n=25). TA was measured by a PCR-based assay (TRAPeze$^{(R)}$ ELISA Telomerase Detection Kit). Statistical analyses were performed using one-way ANOVA and post-hoc Bonferroni testing. Results: TA was significantly higher in biopsies of BE with dyplasia and BE with adenocarcinoma than in BE without dysplasia. Subgroup analyses did not reveal any significant correlations between TA and patient age, length of BE, or presence of gastritis. Conclusions: Telomerase activity in esophageal mucosal biopsies of BE may constitute a useful biomarker for the early detection of esophageal dysplasia and adenocarcinoma.

• Journal of Veterinary Clinics
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• v.34 no.4
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• pp.295-298
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• 2017

A 6-year-old female Pekingese dog, weighing 3.85 kg was presented with regurgitation, ptyalism, weight loss and anorexia. The dog was cachexic and severely dehydrated. Physical examination of the dog confirmed upper respiratory noise, which was classified as a stridor most apparent on inspiration, respiratory effort with stenotic nares. Upper respiratory signs were thought to be caused by brachycephalic syndrome. On the lateral thoracic radiograph, the caudal one third of the esophagus was visible as a soft tissue band. CT revealed oval-shaped, soft tissue attenuating mass in size of $2.3{\times}1.0{\times}1.1cm$ arising from caudal one third of the esophagus. The mass was protruding from esophageal wall to lumen and irregular margined with heterogenous contrast enhancement. The wall of cardia and fundus was focally thickened. Gastric lymph node was enlarged with contrast enhancing. On histopathologic examination, esophageal mass was confirmed as papillary adenocarcinoma, and the gastric sample showed the same result. In human, adenocarcinoma commonly occur in esophagus and cardia, but it has not been commonly reported in veterinary medicine. This report described computed tomographic features of adenocarcinoma of the esophagocardia region in a Pekingese dog with brachycephalic syndrome.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1087-1092
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• 1992

We underwent two surgical resection of synchronous primary esophageal squamous cell carcinoma and gastric adenocarcinoma after obtaining histologic comfirmation 74-years old male pateint was recieved esophagectomy & total gastrectomy with esophagojejunostomy and 59-years old man was recieved near total esophagectomy and total gastrectomy with esophagocolo-gejunostomy. Their was no postoperative complications. The hospital day was 15 and 21 days postoperatively. All of them started oral intake at 7 days postoperatively and possible soft diet soon. We conclude that total resection of esophagus and stomach is the recommendable methods for prolong the life of double primary cancer patients of esophagus and stomach. Also, the reconstruction of the esophagus with colon or jejunal transposition is one of the recommenable procedure for curative surgical resection of double primary cancer in esophagus and stomach. And we also wish to emphasize the importance of detailed preopertive gastric examination for detect of gastric lesion and of careful intraoperative inspection of the gastric mucosa in patients with esophageal cancer whose preoperative gastric examination provide inconclusive evidence due to the severe esophageal stenosis.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1144-1149
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• 1995

Adenocarcinoma involving esophago-gastric junction[EGJ is usually originated from the gastric cardia and it presents unique clinical manifestations, requires special surgical care, and bears a much poor prognosis. We analyse the clinical data of 109 adenocarcinoma involving EGJ operated between August, 1987 and March, 1994. Curative resection of primary tumor including esophagus and lymph node dissection was possible on 102 cases[93.5% . Among these cases, 89 cases were advanced state over the stage III. The operative mortality was 1.8% and postoperative morbidity was 16.5%. The overall 3 year and 5 year survival rate was 48.5%, 34.1% each, and median survival was 27.5 month in the curative resected cases. The treatment failure was mainly distant metastsis including lymph node, except one local recurrence.Among many factors influencing long term results of resected adenocarcinoma involving EGJ, the only effort a surgeon can make is to attain completeness of tumor removal by dissecting all involved lymph node and ensuring adequate tumor free margins of both esophageal and cardiac side.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3491-3497
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• 2013

Background: Gastric and esophageal cancers are among the most lethal human malignancies worldwide. Of all malignancies estimated in Iran (47,100), gastric and esophageal cancers were responsible for 7,800 and 3,500 deaths in 2008 respectively. The present study aimed to provide an image of patho-epidemiological characteristics with their trends during two past decades with emphasis on topographic, morphologic, and some demographic features. Materials and Methods: In a hospital-based retrospective study in 2009, all pathological reports from esophageal endoscopies and gastric biopsies through a 20 years period (1989-2008) were collected and analyzed in four interval periods(five years each). Also, all eligible samples in hospital archives were enrolled for further testing. Besides, demography, topography and morphology of all samples were determined and analyzed by statistical software. Results: No significant statistical difference was seen in frequency of espohageal and gastric tumors throughout the study. Esophageal cancer cases were older than gastric. Sex ratio was 2.33/1 and men had a higher rate of both esophageal and gastric tumors. Stomach cancer included 64.3% of all cases. Inferior third and end of esophagus were common locations for esophageal tumors whereas proximal stomach was common for gastric tumors. Squamous cell carcinoma and adenocarcinoma were common morphological types of tumors in esophagus and stomach respectively. Conclusions: Morphological trends showed an increase of esophageal adenocarcinoma and diffuse/intestinal ratio in stomach cancers. Trends in incidence from gastric cancer decreased based on topographic studies but we could not find a topographical trend toward cadia.

• Proceedings of the Korean Society of Toxicology Conference
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• 2001.05a
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• pp.146-146
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• 2001

Gastroesophageal reflux disease (GERD) is multifactorial in etiology and is characterized by movement of acid and other noxious substances from the stomach into the esophagus. The most severe histologic consequence of chronic gastroesophgeal reflux is Barrett's esophagus, which has been considered as a premalignant condition often leading to the formation of adenocarcinoma of esophagus.(omitted)

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.105-111
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• 1998

Double primary cancer is a rare disease in which two cancers occur in an individual independently. As prolonged survival of patients with malignant tumors is expected in the future due to advances in methods of treatment, the chance of double primary cancer will be increased. We experienced one case of double primary cancer which was developed in esophagus and chest wall. A 72 year-old male visited our hospital complaining of epigastric discomfort and right chest wall mass. We studied esophagus, chest wall, and other organs including gastrointestinal tract by various methods to exclude the cancer of other sites and could diagnose squamous cell carcinoma of mid-esophagus and adenocarcinoma of chest wall. The patient underwent esophagogastrostomy following esophagectomy and wide-resection of chest wall tumor. The postoperative course was uneventful.