• Title/Summary/Keyword: Pancreatic cancer surgery

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EZH2-Mediated microRNA-139-5p Regulates Epithelial-Mesenchymal Transition and Lymph Node Metastasis of Pancreatic Cancer

  • Ma, Jin;Zhang, Jun;Weng, Yuan-Chi;Wang, Jian-Cheng
    • Molecules and Cells
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    • v.41 no.9
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    • pp.868-880
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    • 2018
  • Pancreatic cancer (PC) is one of the most aggressive cancers presenting with high rates of invasion and metastasis, and unfavorable prognoses. The current study aims to investigate whether EZH2/miR-139-5p axis affects epithelial-mesenchymal transition (EMT) and lymph node metastasis (LNM) in PC, and the mechanism how EZH2 regulates miR-139-5p. Human PC and adjacent normal tissues were collected to determine expression of EZH2 and miR-139-5p, and their relationship with clinicopathological features of PC. Human PC cell line was selected, and treated with miR-139-5p mimics/inhibitors, EZH2 vector or shEZH2 in order to validate the regulation of EZH2-mediated miR-139-5p in PC cells. Dual-luciferase report gene assay and chromatin immunoprecipitation assay were employed to identify the relationship between miR-139-5p and EZH2. RT-qPCR and Western blot analysis were conducted to determine the expression of miR-139-5p, EZH2 and EMT-related markers and ZEB1/2. Tumor formation ability and in vitro cell activity were also analyzed. Highly-expressed EZH2 and poorly-expressed miR-139-5p were detected in PC tissues, and miR-139-5p and EZH2 expressions were associated with patients at Stage III/IV, with LNM and highly-differentiated tumors. EZH2 suppressed the expression of miR-139-5p through up-regulating Histone 3 Lysine 27 Trimethylation (H3K27me3). EMT, cell proliferation, migration and invasion were impeded, and tumor formation and LNM were reduced in PC cells transfected with miR-139-5p mimics and shEZH2. MiR-139-5p transcription is inhibited by EZH2 through up-regulating H3K27me3, thereby down-regulation of EZH2 and up-regulation of miR-139-5p impede EMT and LNM in PC. In addition, the EZH2/miR-139-5p axis presents as a promising therapeutic strategy for the treatment of PC.

Role of PET Scan in Gastric Cancer as a Diagnostic Tool (위암에서 PET의 임상적 역할)

  • Cheon, Gi-Jeong;Kim, Byung-Il;Lim, Sang-Moo
    • Journal of Gastric Cancer
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    • v.2 no.4
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    • pp.184-190
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    • 2002
  • Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studies performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in gastrointestinal and abdominal organs, it is particularly useful for identification and characterization of whole body at the same time. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterization of indeterminate soft-tissue masses. Most gastrointestinal cancer need to surgical management. FDG PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The gastrointestinal cancers, such as gastroesophageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea. PET is one of the most promising and useful methodology for the management of gastric cancer as well as other gastrointestinal cancers.

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Identification of Biomarkers for Diagnosis of Gastric Cancer by Bioinformatics

  • Wang, Da-Guang;Chen, Guang;Wen, Xiao-Yu;Wang, Dan;Cheng, Zhi-Hua;Sun, Si-Qiao
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1361-1365
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    • 2015
  • Background: We aimed to discover potential gene biomarkers for gastric cancer (GC) diagnosis. Materials and Methods: Genechips of 10 GC tissues and 10 gastric mucosa (GM, para-carcinoma tissue, normal control) tissues were generated using an exon array of Affymetrix containing 30,000 genes. The differentially expressed genes (DEGs) between GC tissues and normal control were identified by the Limma package and analyzed by hierarchical clustering analysis. Gene ontology (GO) and pathway enrichment analyses were performed for investigating the functions of DEGs. Receiver operating characteristics (ROC) analysis was performed to measure the effects of biomarker candidates for diagnosis of GC. Results: Totals of 896 up-regulated and 60 down-regulated DEGs were identified to be differentially expressed between GC samples and normal control. Hierarchical clustering analysis showed that DEGs were highly differentially expressed and most DEGs were up-regulated. The most significantly enriched GO-BP term was revealed to be mitotic cell cycle and the most significantly enriched pathway was cell cycle. The intersection analysis showed that most significant DEGs were cyclin B1 (CCNB1) and cyclin B2 (CCNB2). The sensitivities and specificities of CCNB1 and CCNB2 were both high (p<0.0001). Areas under the ROC curve for CCNB1 and CCNB2 were both greater than 0.9 (p<0.0001). Conclusions: CCNB1 and CCNB2, which were involved in cell cycle, played significant roles in the progression and development of GC and these genes may be potential biomarkers for diagnosis and prognosis of GC.

Role of PET Scan in Gastric Cancer as a Diagnostic Tool (위암에시 PET의 임상적 역할)

  • Cheon, Gi-Jeong;Kim, Byung-Il;Lim, Sang-Moo
    • 대한위암학회:학술대회논문집
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    • 2002.10a
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    • pp.24-33
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    • 2002
  • Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studies performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in gastrointestinal and abdominal organs, it is particularly useful for identification and characterization of whole body at the same time. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterization of indeterminate soft-tissue masses. Most gastrointestinal cancer need to surgical management. FDG PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The gastrointestinal cancers, such as gastroeso-phageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea. PET is one of the most promising and useful methodology for the management of gastric cancer as well as other gastrointestinal cancers.

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Incidental Adenomyoma of Stomach Associated with Early Gastric Cancer (조기위암과 우연히 동반된 위의 샘근종(Adenomyoma) 1예)

  • Yeo, Min-Seok;Yang, Hyun-Jun;Suh, Dong-Youb;Kim, Ki-Hong;Byun, Chang-Gyoo;Koh, Young-Taeg;Lee, Hyo-Jin;Choi, Seok-Ho
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.43-46
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    • 2006
  • An adenomyoma of the gastrointestinal tract is a rare, benign, tumor-like condition histologically characterized by glandular structures embedded within a smooth muscle stroma. An adenomyoma has been considered to be as an abortive variant of an ectopic pancreas. An ectopic pancreas is defined as the presence of pancreatic tissue that lacks anatomic and vascular continuity with the main body of the pancreas. Common sites of an ectopic pancreas are the stomach, duodenum, and upper jejunum. An adenomyoma may rarely undergo a malignant transformation or cystic dystrophy. Recently, the authors an experienced a case of an incidental adenomyoma of the stomach associated with early gastric carcinoma. We report that case here.

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METASTATIC CARCINOMA OF ORAL CAVITY (구강 및 악골에 생긴 전이 암종)

  • Kim, Chang-Soo;Lee, Jeong-Hoon;Ann, Heui-Yong;Chung, Sang-Chul;Choi, Hong-Sik
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.1
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    • pp.142-147
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    • 1990
  • Malignant oral tumors occurred in the oral cavity. They were thought to result from the other primary tumors through hematogenous metastasis. Primary tumors were unusually gall bladder tumor and pancreatic tumor. Biopsy was performed and these specimens were similar to those of the primary sites histologically and clinically. Diagnoses were adenocarcinomas metastatic from the primary tumors. They did not reveal the bony changes, only soft tissue masses.

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Histopathological changes in gall bladder mucosa in relation to the number, and size of gallstones, and analysis of the findings in the context of age distribution of the patients: A perspective

  • Sanjeev Sharma;Bhupinder Singh Walia;Mandeep Randhawa;Arjun Sharma;Pankaj Dugg;Jiteshwar Singh Pannu
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.277-286
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    • 2023
  • Backgrounds/Aims: To study histopathological changes in gall bladder mucosa in cholelithiasis patients, and analyse their relation to the number and size of gallstones. These findings were evaluated in the context of age distribution of the study population. Methods: One hundred cases of cholecystectomy were part of the study, which was conducted in collaboration with the pathology department. The time period of the study was January 2020 to June 2021. Results: Maximum cases had multiple stones (69.0%), while one third cases (31.0%) had solitary stones. While initial univariate analysis showed age (odds ratio [OR], 6.882; p = 0.043), gallstone number (OR, 9.1; p = 0.050), gallstone size (OR, 17.111; p = 0.013), and duration of symptom (OR, 34.125; p = 0.001) to be significant risk factors associated with gallbladder carcinoma, multivariate analysis found none of these variables to be significant. However, conditional multivariate analysis for the duration of symptom (p = 0.008; OR, 21.118) yielded significant p-value. With histopathological diagnoses, 5% of cases had gallbladder cancer. Conclusions: This study shed light on the rising incidence of cholelithiasis in the young population and the high rate of gallbladder carcinoma in Punjab, India. Although gall stone characteristics (size, number) and patient age appeared to be significant risk factors when their individual relation with gallbladder carcinoma was studied, multivariate analysis, could not prove that. Conditional multivariate analysis showed the duration of symptom to be the only significant risk factor associated with gallbladder carcinoma. Further research with larger sample size is needed to study the rising incidence of gallbladder carcinoma, and the risk factors associated with it.

Total Gastrectomy with Distal Pancreatico-splenectomy for Treating Locally Advanced Gastric Cancer (진행 위암에서의 위 전절제술에 동반된 원위부 췌-비장 절제)

  • Lee, Sung-Ho;Kim, Wook;Song, Kyo-Young;Kim, Jin-Jo;Chin, Hyung-Min;Park, Jo-Hyun;Jeon, Hae-Myung;Park, Seung-Man;Ahn, Chang-Jun;Lee, Jun-Hyun
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.74-81
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    • 2007
  • Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.

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Associations between income and survival in cholangiocarcinoma: A comprehensive subtype-based analysis

  • Calvin X. Geng;Anuragh R. Gudur;Jagannath Kadiyala;Daniel S. Strand;Vanessa M. Shami;Andrew Y. Wang;Alexander Podboy;Tri M. Le;Matthew Reilley;Victor Zaydfudim;Ross C. D. Buerlein
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.144-154
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    • 2024
  • Backgrounds/Aims: Socioeconomic determinants of health are incompletely characterized in cholangiocarcinoma (CCA). We assessed how socioeconomic status influences initial treatment decisions and survival outcomes in patients with CCA, additionally performing multiple sub-analyses based on anatomic location of the primary tumor. Methods: Observational study using the 2018 submission of the Surveillance, Epidemiology, and End Results (SEER)-18 Database. In total, 5,476 patients from 2004-2015 with a CCA were separated based on median household income (MHI) into low income (< 25th percentile of MHI) and high income (> 25th percentile of MHI) groups. Seventy-three percent of patients had complete follow up data, and were included in survival analyses. Survival and treatment outcomes were calculated using R-studio. Results: When all cases of CCA were included, the high-income group was more likely than the low-income to receive surgery, chemotherapy, and local tumor destruction modalities. Initial treatment modality based on income differed significantly between tumor locations. Patients of lower income had higher overall and cancer-specific mortality at 2 and 5 years. Non-cancer mortality was similar between the groups. Survival differences identified in the overall cohort were maintained in the intrahepatic CCA subgroup. No differences between income groups were noted in cancer-specific or overall mortality for perihilar tumors, with variable differences in the distal cohort. Conclusions: Lower income was associated with higher rates of cancer-specific mortality and lower rates of surgical resection in CCA. There were significant differences in treatment selection and outcomes between intrahepatic, perihilar, and distal tumors. Population-based strategies aimed at identifying possible etiologies for these disparities are paramount to improving patient outcomes.

Optimal Timing to Assess Drain Amylase Concentration after Elective Gastrectomy

  • Wakahara, Tomoyuki;Kanemitsu, Kiyonori;Miura, Susumu;Tsuchida, Shinobu;Iwasaki, Takeshi;Sasako, Mitsuru
    • Journal of Gastric Cancer
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    • v.21 no.1
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    • pp.30-37
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    • 2021
  • Purpose: While the amylase concentration of the drainage fluid (dAmy) has been reported to be a predictor of postoperative pancreas-related complications (PPRC), the optimal timing for its measurement has not been fully investigated. Materials and Methods: The clinicopathological data of 387 patients who underwent elective gastrectomy for gastric cancer were reviewed. Laboratory data, including dAmy on postoperative days 1 (dAmy1) and 3 (dAmy3), and serum C-reactive protein (sCRP) concentrations on postoperative days 1 (sCRP1) and 3 (sCRP3) were compared between patients with PPRC and without PPRC. Results: Nineteen of the 387 patients (4.9%) developed PPRC. The optimal cutoff values of dAmy1, dAmy3, sCRP1, and sCRP3 were 1514 IU/L, 761 IU/L, 8.32 mg/dL, and 15.15 mg/dL, respectively. The area under the curve of dAmy1 was greater than that of dAmy3 (0.915 vs. 0.826), and that of sCRP3 was greater than that of sCRP1 (0.820 vs. 0.659). In the multivariate analysis, dAmy1 (P<0.001) and sCRP3 (P=0.004) were significant predictors of PPRC, while dAmy3 (P=0.069) and sCRP1 (P=0.831) were not. Thirteen (41.9%) of 31 patients with both dAmy1 ≥1,545 IU/L and sCRP3 ≥15.15 mg/dL had PPRC ≥Clavien-Dindo II. In contrast, among 260 patients with both dAmy1 <1,545 IU/L and sCRP3 <15.15 mg/dL, none developed PPRC. Conclusions: dAmy1 was more useful than dAmy3 in predicting PPRC. The combination of dAmy1 and sCRP3 may be a useful criterion for the removal of drains on postoperative day 3.