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Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

  • Tae-Han Kim;In-Ho Kim;Seung Joo Kang;Miyoung Choi;Baek-Hui Kim;Bang Wool Eom;Bum Jun Kim;Byung-Hoon Min;Chang In Choi;Cheol Min Shin;Chung Hyun Tae;Chung sik Gong;Dong Jin Kim;Arthur Eung-Hyuck Cho;Eun Jeong Gong;Geum Jong Song;Hyeon-Su Im;Hye Seong Ahn;Hyun Lim;Hyung-Don Kim;Jae-Joon Kim;Jeong Il Yu;Jeong Won Lee;Ji Yeon Park;Jwa Hoon Kim;Kyoung Doo Song;Minkyu Jung;Mi Ran Jung;Sang-Yong Son;Shin-Hoo Park;Soo Jin Kim;Sung Hak Lee;Tae-Yong Kim;Woo Kyun Bae;Woong Sub Koom;Yeseob Jee;Yoo Min Kim;Yoonjin Kwak;Young Suk Park;Hye Sook Han;Su Youn Nam;Seong-Ho Kong;The Development Working Group for the Korean Practice Guidelines for Gastric Cancer 2022 Task Force Team
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.3-106
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    • 2023
  • Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

Temporal variation in the community structure of green tide forming macroalgae(Chlorophyta; genus Ulva) on the coast of Jeju Island, Korea based on DNA barcoding (DNA 바코드를 이용한 제주도 연안 파래대발생(green tide)을 형성하는 갈파래(genus Ulva) 군집구조 및 주요 종 구성의 시간적 변이)

  • Hye Jin Park;Seo Yeon Byeon;Sang Rul Park;Hyuk Je Lee
    • Korean Journal of Environmental Biology
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    • v.40 no.4
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    • pp.464-476
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    • 2022
  • In recent years, macroalgal bloom occurs frequently in coastal oceans worldwide. It might be attributed to accelerating climate change. "Green tide" events caused by proliferation of green macroalgae (Ulva spp.) not only damage the local economy, but also harm coastal environments. These nuisance events have become common across several coastal regions of continents. In Korea, green tide incidences are readily seen throughout the year along the coastlines of Jeju Island, particularly the northeastern coast, since the 2000s. Ulva species are notorious to be difficult for morphology-based species identification due to their high degrees of phenotypic plasticity. In this study, to investigate temporal variation in Ulva community structure on Jeju Island between 2015 and 2020, chloroplast barcode tufA gene was sequenced and phylogenetically analyzed for 152 specimens from 24 sites. We found that Ulva ohnoi and Ulva pertusa known to be originated from subtropical regions were the most predominant all year round, suggesting that these two species contributed the most to local green tides in this region. While U. pertusa was relatively stable in frequency during 2015 to 2020, U. ohnoi increased 16% in frequency in 2020 (36.84%), which might be associated with rising sea surface temperature from which U. ohnoi could benefit. Two species (Ulva flexuosa, Ulva procera) of origins of Europe should be continuously monitored. The findings of this study provide valuable information and molecular genetic data of genus Ulva occurring in southern coasts of Korea, which will help mitigate negative influences of green tide events on Korea coast.

Etiology and Risk Factors of Community-Acquired Pneumonia in Hospitalized Children During the COVID-19 Pandemic in South Korea (국내 코로나19 판데믹 기간 발생한 입원을 요하는 소아청소년 지역사회폐렴의 원인과 위험 인자)

  • Hae Min Kang;Seung Ha Song;Bin Ahn;Ji Young Park;Hyunmi Kang;Byung Ok Kwak;Dong Hyun Kim;Joon Kee Lee;Soo-Han Choi ;Jae Hong Choi;Eun Hwa Choi;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.20-32
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    • 2023
  • Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children's Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%. A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions: Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.

Research to Establish a Common Standard for Assent by Assessing the Current State of the Assent Process and Conducting Interviews with Pediatrician/Pediatric Neurologist (소아승낙 현황조사와 소아청소년과/소아신경과 전문의를 대상으로 면담조사를 통한 소아승낙서 공통기준 수립 연구)

  • Yoon Jin Lee;Sun Ju Lee;Su Jin Kang;Dae Ho Lee;Kyun-Seop Bae;Jong Woo Chung;Byung Soo Kim;Jin Seok Kim;Myung Ah Lee
    • The Journal of KAIRB
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    • v.6 no.1
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    • pp.5-16
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    • 2024
  • Purpose: The purpose of this study is to investigate the current status of pediatric assent in nationwide hospitals and to assess the children's comprehension for pediatric assent by interviewing pediatricians/pediatric neurologists to determine whether children of the age (elementary and middle school students) can understand the purpose, risks, benefits, and concepts of voluntary participation in clinical research described in the assent form, and to help improve the administrative efficiency of multicenter clinical trials. Methods: The status of pediatric assent was surveyed online using Google Forms at 141 university hospitals with administrative staff who are members of the Institutional Review Board (IRB) administrative staff subcommittee with in Korean Association of Institutional Review Boards (KAIRB). Additionally, face-to-face interviews were conducted with 7 pediatricians/pediatric neurologists. Survey and interview responses were summarized using descriptive statistics. Results: Out of the 141 institutions surveyed, 35 institutions (24.8%) responded. Among them, 30 institutions (85.7%) reported having age criteria for acquiring pediatric assent forms in the case of children. The age range for pediatric assent acquisition have been from 7 years old to 12 years old (15 institutions, 50%), and from 7 years old to 15 years old (7 institutions, 23.3%). Nine institutions (25.7%) have had criteria for obtaining both parents' consent in cases involving the participation of children. Nineteen institutions (54.3%) have had checklists or guidelines available for use by IRB members in study protocols involving vulnerable research subjects. Three pediatricians/pediatric neurologists have believed that upper-grade elementary school students (5th-6th grade) could comprehensively understand informed consent forms. Two have believed that middle school students would be able to understand them if they included personal information. Two pediatricians/pediatric neurologists have believed that even lower-grade elementary school students (1st-4th grade) could understand the explanations if they were made simpler. Conclusion: It is suggested that not only elementary school students (7-12 years old) but also middle school students (13-15 years old) should receive pediatric assent forms, as it would facilitate a comprehensive understanding of the forms. To enhance the comprehension of assent form content, it is necessary to use age-appropriate words, language, and expressions in the forms hospital. It is also recommended to create comics or videos to make the content of the assent forms more accessible for children.

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Multi-classification of Osteoporosis Grading Stages Using Abdominal Computed Tomography with Clinical Variables : Application of Deep Learning with a Convolutional Neural Network (멀티 모달리티 데이터 활용을 통한 골다공증 단계 다중 분류 시스템 개발: 합성곱 신경망 기반의 딥러닝 적용)

  • Tae Jun Ha;Hee Sang Kim;Seong Uk Kang;DooHee Lee;Woo Jin Kim;Ki Won Moon;Hyun-Soo Choi;Jeong Hyun Kim;Yoon Kim;So Hyeon Bak;Sang Won Park
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.187-201
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    • 2024
  • Osteoporosis is a major health issue globally, often remaining undetected until a fracture occurs. To facilitate early detection, deep learning (DL) models were developed to classify osteoporosis using abdominal computed tomography (CT) scans. This study was conducted using retrospectively collected data from 3,012 contrast-enhanced abdominal CT scans. The DL models developed in this study were constructed for using image data, demographic/clinical information, and multi-modality data, respectively. Patients were categorized into the normal, osteopenia, and osteoporosis groups based on their T-scores, obtained from dual-energy X-ray absorptiometry, into normal, osteopenia, and osteoporosis groups. The models showed high accuracy and effectiveness, with the combined data model performing the best, achieving an area under the receiver operating characteristic curve of 0.94 and an accuracy of 0.80. The image-based model also performed well, while the demographic data model had lower accuracy and effectiveness. In addition, the DL model was interpreted by gradient-weighted class activation mapping (Grad-CAM) to highlight clinically relevant features in the images, revealing the femoral neck as a common site for fractures. The study shows that DL can accurately identify osteoporosis stages from clinical data, indicating the potential of abdominal CT scans in early osteoporosis detection and reducing fracture risks with prompt treatment.

Effect of Artificial Menopause on Diagnosis of Common Cancers in Women: Focusing on Thyroid Cancer, Breast Cancer, and Cervical Cancer (인공폐경이 여성의 다빈도암 진단에 미치는 영향: 갑상선암, 유방암, 자궁경부암을 중심으로)

  • Hyun-Jung Jung;Ji-Kyeong Park
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.2
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    • pp.45-57
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    • 2024
  • Objectives: The purpose of this study is to determine the impact of artificial menopause on the diagnosis of thyroid cancer, breast cancer, and cervical cancer, and to provide basic data for cancer prevention and early diagnosis in women. Methods: Analysis was conducted using raw data from the 2011-2020 National Health and Nutrition Examination Survey. Among the 79,262 people surveyed in the 2011-2020 National Health and Nutrition Examination Survey, 10,207 people were selected as the final research subjects, excluding men, those under 18 years old, those over 80 years old, those who did not participate in the health survey, those with missing data, and those who were not in menopause. Among them, 248 people were diagnosed with thyroid cancer (2.7%), 225 people were diagnosed with breast cancer (2.5%), and 143 people were diagnosed with cervical cancer (21.5%). Results: First, there appeared to be differences between the thyroid cancer diagnosed group and the non-diagnosed group depending on educational level, childbirth experience, and menopause type. Second, there appeared to be differences between the breast cancer diagnosis group and the non-diagnosis group depending on educational level, menopause age, pregnancy experience, childbirth experience, subjective health status, and menopause type. Third, there appeared to be differences between the cervical cancer diagnosis group and the non-diagnosis group depending on menopause age, subjective health status, and menopause type. Fourth, compared to natural menopause, in the case of artificial menopause, the diagnosis probability of women increased by 2.010 times for thyroid cancer, 3.872 times for breast cancer, and 14.902 times for cervical cancer. Conclusion: For thyroid cancer, breast cancer, and cervical cancer, the probability of cancer diagnosis increases in the case of artificial menopause compared to natural menopause, so it is considered important to avoid experiencing artificial menopause to prevent cancer.

Emoticon by Emotions: The Development of an Emoticon Recommendation System Based on Consumer Emotions (Emoticon by Emotions: 소비자 감성 기반 이모티콘 추천 시스템 개발)

  • Kim, Keon-Woo;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.24 no.1
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    • pp.227-252
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    • 2018
  • The evolution of instant communication has mirrored the development of the Internet and messenger applications are among the most representative manifestations of instant communication technologies. In messenger applications, senders use emoticons to supplement the emotions conveyed in the text of their messages. The fact that communication via messenger applications is not face-to-face makes it difficult for senders to communicate their emotions to message recipients. Emoticons have long been used as symbols that indicate the moods of speakers. However, at present, emoticon-use is evolving into a means of conveying the psychological states of consumers who want to express individual characteristics and personality quirks while communicating their emotions to others. The fact that companies like KakaoTalk, Line, Apple, etc. have begun conducting emoticon business and sales of related content are expected to gradually increase testifies to the significance of this phenomenon. Nevertheless, despite the development of emoticons themselves and the growth of the emoticon market, no suitable emoticon recommendation system has yet been developed. Even KakaoTalk, a messenger application that commands more than 90% of domestic market share in South Korea, just grouped in to popularity, most recent, or brief category. This means consumers face the inconvenience of constantly scrolling around to locate the emoticons they want. The creation of an emoticon recommendation system would improve consumer convenience and satisfaction and increase the sales revenue of companies the sell emoticons. To recommend appropriate emoticons, it is necessary to quantify the emotions that the consumer sees and emotions. Such quantification will enable us to analyze the characteristics and emotions felt by consumers who used similar emoticons, which, in turn, will facilitate our emoticon recommendations for consumers. One way to quantify emoticons use is metadata-ization. Metadata-ization is a means of structuring or organizing unstructured and semi-structured data to extract meaning. By structuring unstructured emoticon data through metadata-ization, we can easily classify emoticons based on the emotions consumers want to express. To determine emoticons' precise emotions, we had to consider sub-detail expressions-not only the seven common emotional adjectives but also the metaphorical expressions that appear only in South Korean proved by previous studies related to emotion focusing on the emoticon's characteristics. We therefore collected the sub-detail expressions of emotion based on the "Shape", "Color" and "Adumbration". Moreover, to design a highly accurate recommendation system, we considered both emotion-technical indexes and emoticon-emotional indexes. We then identified 14 features of emoticon-technical indexes and selected 36 emotional adjectives. The 36 emotional adjectives consisted of contrasting adjectives, which we reduced to 18, and we measured the 18 emotional adjectives using 40 emoticon sets randomly selected from the top-ranked emoticons in the KakaoTalk shop. We surveyed 277 consumers in their mid-twenties who had experience purchasing emoticons; we recruited them online and asked them to evaluate five different emoticon sets. After data acquisition, we conducted a factor analysis of emoticon-emotional factors. We extracted four factors that we named "Comic", Softness", "Modernity" and "Transparency". We analyzed both the relationship between indexes and consumer attitude and the relationship between emoticon-technical indexes and emoticon-emotional factors. Through this process, we confirmed that the emoticon-technical indexes did not directly affect consumer attitudes but had a mediating effect on consumer attitudes through emoticon-emotional factors. The results of the analysis revealed the mechanism consumers use to evaluate emoticons; the results also showed that consumers' emoticon-technical indexes affected emoticon-emotional factors and that the emoticon-emotional factors affected consumer satisfaction. We therefore designed the emoticon recommendation system using only four emoticon-emotional factors; we created a recommendation method to calculate the Euclidean distance from each factors' emotion. In an attempt to increase the accuracy of the emoticon recommendation system, we compared the emotional patterns of selected emoticons with the recommended emoticons. The emotional patterns corresponded in principle. We verified the emoticon recommendation system by testing prediction accuracy; the predictions were 81.02% accurate in the first result, 76.64% accurate in the second, and 81.63% accurate in the third. This study developed a methodology that can be used in various fields academically and practically. We expect that the novel emoticon recommendation system we designed will increase emoticon sales for companies who conduct business in this domain and make consumer experiences more convenient. In addition, this study served as an important first step in the development of an intelligent emoticon recommendation system. The emotional factors proposed in this study could be collected in an emotional library that could serve as an emotion index for evaluation when new emoticons are released. Moreover, by combining the accumulated emotional library with company sales data, sales information, and consumer data, companies could develop hybrid recommendation systems that would bolster convenience for consumers and serve as intellectual assets that companies could strategically deploy.

Chest CT Finding and Its Comparison with Bronchoscopic Finding in Endobronchial Tuberculosis (기관지결핵의 흉부전산화단층촬영소견 및 기관지경소견과의 비교)

  • Lee, Jae-Ho;Yoon, Hye-Kyung;Song, Jae-Woo;Yoo, Chul-Gyu;Chung, Hee-Soon;Kim, Young-Hwan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.742-755
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    • 1997
  • Background : Endobronchial tuberculosis(ET) is still relatively common disease in Korea. We intended to evaluate the length of endobronchial lesion, peribronchial thickness, luminal irregularity and associated mediastinal lymph node enlargement with Chest CT to get information for such aggressive treatment as electrocautery, laser therapy and so on of bronchial stricture in ET, and also to compare the change of Chest CT finding with that of bronchoscopic finding after one month of anti-tuberculosis treatment. Method : We performed CT in 26 patients who were diagnosed as ET by bronchoscopy at Boramae Hospital from November 1991 to March 1996. After classifying ET into seven subtypes according to bronchoscopic finding, we analyzed the CT finding of each subtype. And we followed up the bronchoscopy, CT, and PIT after one month of anti-tuberculosis treatment, and compared the change of CT findings with those of bronchoscopic findings in nine patients. Results : Age of the patients was from 17 to 73 years old, and the ratio of male to female was 1 : 25 with absolute female predominance. The site(s) of bronchial involvement by tuberculosis is one in 14 cases, two in nine cases and three in one case, respectively, and the left main bronchus was the most frequently involved site (13 cases for multiple involvements and 7 cases for single involvement among 26 cases). The length of bronchial involvement by tuberculosis which was measured by CT was from 10 to 55 mm, and there was a tendency that the length of involved lesion in fibrostenotic type was shorter than that of actively caseating type. Bronchial stricture on CT was noticed in 25 (96%) cases and the range of severity was from total occlusion to near-normal and also showed wide variation even though the subtype of ET was same. The increase of peribronchial thickness which was measured by CT, was noticed in 21 cases (91%) among 23 cases (in which the measurement was possible), and there was no improvement of peribronchial thickness in those cases which showed little improvement in bronchial stricture despite anti-tuberculosis treatment. There was no difference in the luminal irregularity of involved bronchi on CT in relation to bronchoscopic subtypes. The mediastinal lymph node enlargement, defined as the diameter of lymph node was larger than 1cm on CT, was detected in 20 cases (77%), and right side was more frequently involved (L : R = 1 : 5.2). The CT finding usually showed extrinsic bronchial compression but showed direct invasion in two cases which were bronchoscopically classified as tumorous type. When follow-up bronchoscopy and CT was performed after one month of anti-tuberculosis treatment in nine patients, CT showed significant improvement in peribronchial thickness and mediastinal lymph node enlargement. Bronchial stricture was also improved in 6 cases but aggravated in 3 cases despite anti-tuberculosis therapy. In two cases which were classified as fibrostenotic type by bronchoscopy, CT showed significant improvement in bronchial stricture, interestingly. Conclusion : We concluded that the role of Chest CT was complimentary to bronchoscopy in ET, since CT was useful in evaluating the length of bronchial involvement, peribronchial thickness, and mediastinal lymph node enlargement.

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The Mediating Effect of Experiential Value on Customers' Perceived Value of Digital Content: China's Anti-virus Program Market (경험개치대소비자대전자내용적인지개치적중개영향(经验价值对消费者对电子内容的认知价值的中介影响): 중국살독연건시장(中国杀毒软件市场))

  • Jia, Weiwei;Kim, Sae-Bum
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.219-230
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    • 2010
  • Digital content makes big changes to our daily lives while bringing opportunities and challenges for companies. Creative firms integrate pictures, texts, videos, audios, and data by digitalization to develop new products or services and create digital experiences to promote their brands. Most articles on digital content contribute to the basic concept or development of marketing it in literature. Actually, compared with traditional value chains for common products or services, the digital content industry seems to have more potential value. Because quite a bit of digital content is free to the consumer, price is not necessarily perceived as an indicator of the quality or value of information (Rowley 2008). It becomes evident that a current theme in digital content is the issue of "value," and research on customers' perceived value of digital content is a necessity. This article argues that experiential value has an advantage in customers' evaluations of digital content. Two different but related contributions to the understanding of "value" of digital content are made here. First, based on the comparison of digital content with products and services, the article proposes two key characteristics that make experiential strategy available for digital content: intangibility and near-zero reproduction cost. On top of that, based on the discussion of the gap between company's idealized value and customer's perceived value, this article emphasizes that digital content prices and pricing of digital content is different from products and services. As a result of intangibility, prices may not reflect customer value. Moreover, the cost of digital content in the development stage may be very high while reproduction costs shrink dramatically. Moreover, because of the value gap mentioned before, the pricing polices vary for different digital contents. For example, flat price policy is generally used for movies and music (Magiera 2001; Netherby 2002), while for continuous demand, digital content such as online games and anti-virus programs involves a more complicated matter of utility and competitive price levels. Digital content companies have to explore various kinds of strategies to overcome this gap. Rethinking marketing solutions such as advertisements, images, and word-of-mouth and their effect on customers' perceived value becomes essential. China's digital content industry is becoming more and more globalized and drawing special attention from different countries and regions that have respective competitive advantages. The 2008-2009 Annual Report on the Development of China's Digital Content Industry (CCIDConsulting 2009) indicates that, with the driven power of domestic demand and governmental policy support, the country's digital content industry maintained a fast growth of some 30 percent in 2008, obviously indicating the initial stage of industry expansion. In China, anti-virus programs and other software programs which need to be updated use a quarter-based pricing policy. Customers can download a trial version for free and use it for six months or a year. If they want to use it longer, continuous payment is needed. They examine the excellence of the digital content during this trial period and decide whether to pay for continued usage. For China’s music and movie industries, as a result of initial development, experiential strategy has not been much applied, even though firms in other countries find the trial experience and explore important strategies(such as customers listening to music for several seconds for free before downloading it). For the above reasons, anti-virus program may be a representative for digital content industry in China and an exploratory study of the advantage of experiential value in customer's perceived value of digital content is done in the anti-virus market of China. In order to enhance the reliability of the survey data, this study focused on people who were experienced users of anti-virus programs. The empirical results revealed that experiential value has a positive effect on customers' perceived value of digital content. In other words, because digital content is intangible and the reproduction costs are nearly zero, customers' evaluations are based heavily on their experience. Moreover, image and word-of-mouth do not have a positive effect on perceived value, only on experiential value. That is to say, a digital content value chain is different from that of a general product or service. Experiential value has a notable advantage and mediates the effect of image and word-of-mouth on perceived value. The results of this study help provide an understanding of why free digital content downloads exist in developing countries. Customers can perceive the value of digital content only by using and experiencing it. This is also why such governments support the development of digital content. Other developing countries whose digital content business is also in the beginning stage can make use of the suggestions here. Moreover, based on the advantage of experiential strategy, companies should make more of an effort to invest in customers' experience. As a result of the characteristics and value gap of digital content, customers perceive more value in the intangible digital content only by experiencing what they really want. Moreover, because of the near-zero reproduction costs, companies can perhaps use experiential strategy to enhance customer understanding of digital content.

The Relationship between Expression of EGFR, MMP-9, and C-erbB-2 and Survival Time in Resected Non-Small Cell Lung Cancer (수술을 시행한 비소세포 폐암 환자에서 EGFR, MMP-9 및 C-erbB-2의 발현과 환자 생존율과의 관계)

  • Lee, Seung Heon;Jung, Jin Yong;Lee, Kyoung Ju;Lee, Seung Hyeun;Kim, Se Joong;Ha, Eun Sil;Kim, Jeong-Ha;Lee, Eun Joo;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hye Cheol;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa;Kim, Chul Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.286-297
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    • 2005
  • Background : Non-small cell lung cancer (NSCLC) is a common cause of cancer-related death in North America and Korea, with an overall 5-year survival rate of between 4 and 14%. The TNM staging system is the best prognostic index for operable NSCLC . However, epidermal growth factor receptor (EGFR), matrix metalloproteinase-9(MMP-9), and C-erbB-2 have all been implicated in the pathogenesis of NSCLC and might provide prognostic information. Methods : Immunohistochemical staining of 81 specimens from a resected primary non-small cell lung cancer was evaluated in order to determine the role of the biological markers on NSCLC . Immunohistochemical staining for EGFR, MMP-9, and C-erbB-2 was performed on paraffin-embedded tissue sections to observe the expression pattern according to the pathologic type and surgical staging. The correlations between the expression of each biological marker and the survival time was determined. Results : When positive immunohistochemical staining was defined as the extent area>20%(more than Grade 2), the positive rates for EGFR, MMP-9, and C-erbB-2 staining were 71.6%, 44.3%, and 24.1% of the 81 patients, respectively. The positive rates of EGFR and MMP-9 stain for NSCLC according to the surgical stages I, II, and IIIa were 75.0% and 41.7%, 66.7% and 47.6%, and 76.9% and 46.2%, respectively. The median survival time of the EGFR(-) group, 71.8 months, was significantly longer than that of the EGFR(+) group, 33.5 months.(p=0.018, Kaplan-Meier Method, log-rank test).. The MMP-9(+) group had a shorter median survival time than the MMP-9(-) group, 35.0 and 65.3 months, respectively (p=0.2). The co-expression of EGFR and MMP-9 was associated with a worse prognosis with a median survival time of 26.9 months, when compared with the 77 months for both negative-expression groups (p=0.0023). There were no significant differences between the C-erbB-2(+) and C-erbB-2 (-) groups. Conclusion : In NSCLC, the expression of EGFR might be a prognostic factor, and the co-expression of EGFR and MMP-9 was found to be associated with a poor prognosis. However, C-erbB-2 expression had no prognostic significance.