• Journal of Gastric Cancer
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• 제13권3호
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• pp.185-187
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• 2013

Neurofibromas are benign tumors that originate from the peripheral nerves, including neurites and fibroblasts. Generally, a solitary neurofibroma is located in the skin and rarely in other places. A 72-year-old female suffered from epigastric discomfort for 2 months. Endoscopic findings showed an early gastric cancer type IIc at the antrum. Abdominal computed tomography revealed early gastric cancer with a 1.6 cm-sized metastatic node posterior to the duodenum. Laparoscopic assisted distal gastrectomy and retro-pancreatic dissection were performed uneventfully. Histological examination revealed gastric adenocarcinoma, invading the mucosa without nodal metastasis, and a neurofibroma. Herein, we present a case of a gastric cancer patient with a solitary retroperitoneal neurofibroma which mimicked a distant metastatic node.

• Journal of Gastric Cancer
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• 제19권4호
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• pp.484-492
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• 2019

Few surgeons have adopted pancreaticoduodenectomy (PD) for the treatment of advanced gastric cancer (AGC) invading the pancreas or duodenum because it remains controversial whether its prognostic benefits outweigh the high morbidity rates in such advanced cases. However, recent technical advances have revived diverse surgical procedures in minimally invasive approaches. Inspired by this trend, laparoscopic PD procedures have been performed for AGC in our institute since 2014. We recently performed a laparoscopic Whipple's operation in a case of cT4b gastric cancer with invasion of the pancreatic head and duodenum.

• Journal of Digestive Cancer Research
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• 제12권1호
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• pp.48-50
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• 2024

• 대한방사선기술학회지:방사선기술과학
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• 제39권1호
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• pp.81-88
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• 2016

인체의 지방조직이 증가하여 비만해지면 심혈관계 질환, 당뇨병, 대사성질환과 이상지질혈증 등의 위험인자로 나타난다. 이러한 대사성질환에는 심혈관 및 뇌혈관질환, 고혈압, 고지혈증 등이 있고, 췌장의 지방조직 증가는 이러한 질환의 위험요인으로 알려져 있다. 그리고 췌장암에 대한 진단과 치료에 대한 연구는 활발히 이루어졌으나, 췌장지방증에 관한 연구 사례는 많지 않다. 본 연구에서는 초음파 검사의 결과로 진단된 췌장지방군과 정상대조군으로 나누어 신체 특성과 혈청학적 검사와 혈압 및 동맥경화도검사를 평가하였다. 정상대조군과 췌장지방군 사이에서 연령이나 허리둘레, 체질량 지수, 총 콜레스테롤, HDL 콜레스테롤과 LDL 콜레스테롤, 수축기와 이완기혈압, 공복혈당, 대동맥 맥파전파속도는 췌장지방군에서 높게 나타났다. 그리고 족관절상완협착비와 HDL-콜레스테롤은 낮을수록 혈관에 유해하므로 췌장지방군이 정상대조군보다 낮게 나타났다(p < 0.05). 정상대조군과 췌장지방군의 차이가 통계적으로 유의함을 확인할 수 있었다. 결론적으로 복부초음파 검사에서 췌장지방증은 대사성 질환의 위험을 예측할 수 있으며 심혈관계 질환과 연관성이 있었다.

• 대한영상의학회지
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• 제81권5호
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• pp.1134-1150
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• 2020

췌장에는 다양한 종류의 종양 및 종양 유사 병변들이 생길 수 있다. 이 가운데, 췌장선암은 췌장의 가장 흔한 종양으로서 일반적으로 췌장암이라고 하면 이 종양을 가리킨다. 최근에는 영상 검사의 기술적 진보와 이용이 증가하면서 췌장의 희귀 종양 및 종양 유사 병변들의 발견 빈도가 증가하고 있다. 췌장의 드문 종양 및 종양과 유사한 병변들은 치료 방침과 예후가 췌장선암과 다르기 때문에 이들 질환의 감별은 임상적으로 중요한 의의가 있다. 영상 검사는 포상세포암이나 신경초종 등의 희귀 종양 및 자가면역 췌장염 또는 염증성 거짓종양과 같은 종양 유사 병변들과 췌장선암의 감별 진단에 중요한 역할을 하지만 영상 소견만으로 이들 질환을 정확히 구분하는 것은 한계가 있다. 이 논문에서는 췌장에서 생길 수 있는 희귀 종양 및 종양 유사 병변들의 다양한 영상 소견들과 췌장선암과의 감별에 있어 도움이 되는 특징들을 제시하고자 한다.

• IMMUNE NETWORK
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• 제5권2호
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• pp.55-67
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• 2005

Cancer vaccine is an active immunotherapy to stimulate the immune system to mount a response against the tumor specific antigen. Working as a stimulant to the body's own immune system, cancer vaccines help the body recognize and destroy targeted cancers and may help to shrink advanced tumors. Research is currently underway to develop therapeutic cancer vaccines. It is also possible to develop prophylactic vaccines in the future. The whole cell approach to eradicate cancer has used whole cancer cells to make vaccine. In an early stage of this approach, whole cell lysate or a mixture of immunoadjuvant and inactivated cancer cells has been used. Improved vaccines are being developed that utilize cytokines or costimulatory molecules to mount an attack against cancer cells. In case of melanoma, these vaccines are expected to have a therapeutic effect of vaccine. Furthermore, it is attempting to treat stomach cancer, colorectal cancer, pancreatic cancer, and prostate cancer. Other vaccines are being developing that are peptide vaccine, recombinant vaccine and dendritic cell vaccine. Out of them, reintroduction of antigen-specific dendritic cells into patient and DNA vaccine are mostly being conducted. Currently, research and development efforts are underway to develop therapeutic cancer vaccine such as DNA vaccine for the treatment of multiple forms of cancers.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5029-5034
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• 2014

This study aimed to summarize published epidemiological evidence for the relationship between pancreatitis and subsequent risk of pancreatic cancer (PC). We searched Medline and Embase for epidemiological studies published by February $5^{th}$, 2014 examining the risk of PC in pancreatitis patients using highly inclusive algorithms. Information about first author, year of publication, country of study, recruitment period, type of pancreatitis, study design, sample size, source of controls and attained age of subjects were extracted by two researchers and Stata 11.0 was used to perform the statistical analyses and examine publication bias. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with the random effects model. A total of 17 articles documenting 3 cohort and 14 case-control studies containing 14,667 PC cases and 17,587 pancreatitis cases were included in this study. The pooled OR between pancreatitis and PC risk was 7.05 (95%CI: 6.42-7.75). Howeever, the pooled ORs of case-control and cohort studies were 4.62 (95%CI: 4.08-5.22) and 16.3 (95%CI: 14.3-18.6) respectively. The risk of PC was the highest in patients with chronic pancreatitis (pooled OR=10.35; 95%CI: 9.13-11.75), followed by unspecified type of pancreatitis (pooled OR=6.41; 95%CI: 4.93-8.34), both acute and chronic pancreatitis (pooled OR=6.13; 95%CI: 5.00-7.52), and acute pancreatitis (pooled OR=2.12; 95%CI: 1.59-2.83). The pooled OR of PC in pancreatitis cases diagnosed within 1 year was the highest (pooled OR=23.3; 95%CI: 14.0-38.9); and the risk in subjects diagnosed with pancreatitis for no less than 2, 5 and 10 years were 3.03 (95%CI: 2.41-3.81), 2.82 (95%CI: 2.12-3.76) and 2.25 (95%CI: 1.59-3.19) respectively. Pancreatitis, especially chronic pancreatitis, was associated with a significantly increased risk of PC; and the risk decreased with increasing duration since diagnosis of pancreatitis.

• 한국간담췌외과학회지
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• 제27권2호
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• pp.195-200
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• 2023

Backgrounds/Aims: We aimed to build a machine learning tool to help predict low-grade intraductal papillary mucinous neoplasms (IPMNs) in order to avoid unnecessary surgical resection. IPMNs are precursors to pancreatic cancer. Surgical resection remains the only recognized treatment for IPMNs yet carries some risks of morbidity and potential mortality. Existing clinical guidelines are imperfect in distinguishing low-risk cysts from high-risk cysts that warrant resection. Methods: We built a linear support vector machine (SVM) learning model using a prospectively maintained surgical database of patients with resected IPMNs. Input variables included 18 demographic, clinical, and imaging characteristics. The outcome variable was the presence of low-grade or high-grade IPMN based on post-operative pathology results. Data were divided into a training/validation set and a testing set at a ratio of 4:1. Receiver operating characteristics analysis was used to assess classification performance. Results: A total of 575 patients with resected IPMNs were identified. Of them, 53.4% had low-grade disease on final pathology. After classifier training and testing, a linear SVM-based model (IPMN-LEARN) was applied on the validation set. It achieved an accuracy of 77.4%, with a positive predictive value of 83%, a specificity of 72%, and a sensitivity of 83% in predicting low-grade disease in patients with IPMN. The model predicted low-grade lesions with an area under the curve of 0.82. Conclusions: A linear SVM learning model can identify low-grade IPMNs with good sensitivity and specificity. It may be used as a complement to existing guidelines to identify patients who could avoid unnecessary surgical resection.

• 한국간담췌외과학회지
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• 제27권1호
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• pp.76-86
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• 2023

Backgrounds/Aims: The aim of this study was to describe short- and long-term outcomes of patients who underwent pancreatoduodenectomy (PD) at a typical United Kingdom hepatopancreatobiliary unit. Methods: A retrospective analysis of all PD patients with histologically-confirmed pancreatic ductal adenocarcinoma (PDAC), ampullary adenocarcinoma (AA), or distal cholangiocarcinoma (CC) from September 1st, 2006 to May 31st, 2015 was carried out. The following information was obtained: demographics, comorbidities, preoperative investigations, neoadjuvant treatment, operative details, postoperative management, complications, adjuvant treatment, five-year recurrence, and five-year survival. Effects of selected preoperative variables on short- and long-term outcomes were investigated. Results: Of 271 included patients, 57.9% had PDAC, 25.8% had AA, and 16.2% had CC. In total, 67.9% experienced morbidity and 17.3% developed a Clavien-Dindo grade ≥ III complication. The 90-day mortality was 3.3%. Clinically-relevant postoperative pancreatic fistula, bile leak, gastrojejunal leak, postpancreatectomy haemorrhage and delayed gastric emptying affected 8.1%, 4.1%, 0.0%, 9.2%, and 19.9% of patients, respectively. American Society of Anesthesiologists grade III-VI correlated with overall morbidity (p = 0.002) and major morbidity (p = 0.009), but not 90-day mortality or five-year survival. The same pattern was observed in patients with a preoperative serum bilirubin > 29 µmol/L and/or a neutrophil/lymphocyte ratio > 3.1. Five-year cancer recurrence and five-year survival were 68.3% and 22.5%, respectively. PDAC patients had higher five-year recurrence but lower five-year survival rates (both p = 0.001). Conclusions: In our series, the majority of patients experienced a complication. However, few patients experienced major morbidity. Surgical risk factors did not affect five-year survival.

• Journal of Digestive Cancer Reports
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• 제9권1호
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• pp.1-7
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• 2021

췌관 내 유두상 점액종양은 매우 다양한 자연경과와 예후를 가지고 있어 추적 검사방법, 간격, 기간 등이 아직도 논란이 되고 있다. 이 종양에 대한 진료지침들에서는 추적 검사를 받을 환자군과 수술적 치료가 필요한 군으로 분류하기 위하여 악성화 고위험 특징 또는 절대적 수술 적응증과 걱정스러운 특징 또는 상대적 수술 적응증으로 분류하였다. 걱정스러운 특징이나 고위험 특징이 없는 분지형 유두상 점액종양은 혼합형이나 주췌관 종양에 비하여 악성화 위험성이 매우 낮다고 보고되고 있다. 그러나 저위험 특징을 가진 환자들을 장기간 추적한 연구에서 시간이 지남에 따라서 췌장암 발생이 점점 높아지고 있다고 보고하고 있어 지속적인 장기간 추적 검사가 필요하다. 혼합형과 주췌관형 유두상 점액종양은 악성화 가능성이 매우 높아 수술적 치료가 필요하다고 알려져 있다. 무결절이고 주췌관 직경이 10 mm 미만으로 분절형 주췌관 확장을 가진 환자들은 악성화 가능성이 낮아서 즉각적인 수술보다는 주의 깊은 추적관찰을 고려해볼 수 있다. 고령이나 기저질환을 동반한 환자의 치료 방향을 결정할 때는 췌장암 발생의 위험도와 수술의 위험성을 균형있게 평가해야 한다.