• Clinical and Experimental Pediatrics
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• 제58권2호
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• pp.69-72
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• 2015

Insulinoma, which arises from insulin-producing pancreatic beta cells, is a rare tumor in children. Only 5%-10% of insulinomas are malignant and undergo metastasis. We report a case of an 11-year-old girl who experienced hypoglycemia-related seizures induced by an insulinoma; after resection of the primary tumor, she developed hepatic focal nodular hyperplasia (FNH). Laboratory test results indicated marked hypoglycemia with hyperinsulinemia. Abdominal ultrasonography (US) and computed tomography results were normal; however, magnetic resonance imaging (MRI) showed a solid mass in the pancreatic tail. Therefore, laparoscopic distal pancreatectomy was performed. Two months after the surgery, an abdominal MRI revealed multiple nodular lesions in the liver. An US-guided liver biopsy was then performed, and histological examination revealed FNH without necrosis or mitotic activity. The patient has been free of hypoglycemia for 2 years, and recent MRI studies showed a decrease in the size of FNH lesions, without any evidence of metastasis. Even though no metastatic lesions are noted on imaging, close observation and follow-up imaging studies are required in a child with insulinoma that has malignant potential on histopathologic findings.

• Journal of Gastric Cancer
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• 제14권1호
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• pp.58-62
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• 2014

We report an extremely rare case of primary squamous cell carcinoma of the stomach. A 69-year-old man was admitted to our hospital with a 2-month history of dysphagia and tarry stools. Endoscopic examination revealed a cauliflower-shaped protruding mass along the lesser curvature of the gastric cardia. Biopsy of the lesion revealed squamous cell carcinoma of the stomach. Computed tomography revealed a thickened stomach wall and a mass protruding into the gastric lumen. Total gastrectomy with splenectomy, distal pancreatectomy, and Roux-en-Y reconstruction was performed, together with a lower thoracic esophagectomy via a left thoracotomy. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma of the stomach. Postoperative follow-up was uneventful for the first 18 months. However, multiple liver metastases and para-aortic lymph node metastasis developed subsequently. Despite systemic combination chemotherapy, the patient died because of progression of the recurrent tumors. Here, we review the characteristics of 56 cases of gastric squamous cell carcinoma reported in Japan.

• Journal of Digestive Cancer Reports
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• 제7권1호
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• pp.18-21
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• 2019

Serine protease inhibitor Kazal-type 1 (SPINK1) is a gene expressed from pancreatic acinar cell which its mutation is known to be associated with chronic pancreatitis (CP) and pancreatic cancer. We report a case of a 47-years-old female with nausea and weight loss with yellow discoloration of skin. Initial imaging and endoscopic study led us to an impression of chronic pancreatitis with pancreatic cancer with common bile-duct dilation. Biopsy result was confirmed with pancreatic adenocarcinoma and additional imaging revealed lymph node and bone metastasis. Our genetic analysis revealed 194+2T>C mutation of SPINK1. Biliary obstruction was successfully decompressed by stent insertion and underwent chemotherapy and radiotherapy. Although there is accumulating evidence of association between SPINK1 mutation and CP, the relationship between SPINK1 mutation and pancreatic cancer in CP patient is an emerging concept. Genetic analysis should be considered in patients with young age especially when diagnosed with both CP and pancreatic cancer.

• 대한한방내과학회지
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• 제45권3호
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• pp.508-518
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• 2024

Objectives: To report a correlation of IL-6 of pancreatic cancer and cancer progression in three pancreatic cancer patients. Method: Three pancreatic cancer patients were monitored for changes in IL-6 levels, tumor markers (CEA, CA19-9), and clinical outcomes over their treatment period. Results: Patient 1's IL-6 levels rose with liver metastasis and tumor progression, coinciding with increases in tumor markers. Patient 2's IL-6 levels remained elevated during chemotherapy, correlating with tumor growth. Patient 3's IL-6 levels spiked prior to cancer progression. Conclusion: Elevated IL-6 levels were observed in advancing pancreatic cancer patients, suggesting IL-6 as a potential biomarker for monitoring cancer progression in pancreatic cancer. Regular IL-6 monitoring could improve prognostic evaluations and treatment strategies.

• 대한영상의학회지
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• 제81권2호
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• pp.418-422
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• 2020

췌장의 장액성 낭성 종양은 일반적으로 양성 질환으로 알려져 있으나 드물게 악성화를 보이는 사례들이 보고되고 있다. 영운에서 췌장 미부에 발생한 장액성 낭성 종양을 수술로 제거한 후 추적 관찰 중 국소 재발과 함께 간으로의 원격전이가 발생한 증례를 경험하여 보고하고자 한다.

• Journal of Gastric Cancer
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• 제22권3호
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• pp.184-196
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• 2022

Purpose: Total or proximal gastrectomy of the upper-third early gastric cancer (u-EGC) often causes severe post-gastrectomy syndrome, suggesting that these procedures are extremely invasive for patients without pathologically positive lymph node (LN) metastasis. This study aimed to evaluate the clinical applicability of a stomach function-preserving surgery, local resection (LR), with prophylactic left gastric artery (LGA)-basin dissection (LGA-BD). Materials and Methods: The data of patients with u-EGC (pathologically diagnosed as T1) were retrospectively analyzed. Total gastrectomy was performed in 30 patients, proximal gastrectomy in 45, and subtotal gastrectomy in 6; the LN status was evaluated assuming that the patients had already underwent LR + LGA-BD. This procedure was considered feasible in patients without LN metastases or in patients with cancer in the LGA basin. The reproducibility of the results was also evaluated using an external validation dataset. Results: Of the 82 eligible patients, 79 (96.3%) were cured after undergoing LR + LGA-BD, 74 (90.2%) were pathologically negative for LN metastases, and 5 (6.1%) had LN metastases, but these findings were only observed in the LGA basin. Similarly, of the 406 eligible tumors in the validation dataset, 396 (97.5%) were potentially curative. Tumors in the lesser curvature, post-endoscopic resection status, and small tumors (<20 mm) were considered to be stronger indicators of LR + LGA-BD as all subpopulation cases met our feasibility criteria. Conclusions: More than 95% of the patients with u-EGC might be eligible for LR + LGA-BD. This function-preserving procedure may contribute to the development of u-EGC without pathological LN metastases, especially for tumors located at the lesser curvature.

• 대한수의학회지
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• 제53권1호
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• pp.61-64
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• 2013

A ten-year-old dog was presented with pancreatitis and increased hepatic enzymes. On necropsy a large firm mass was observed in the liver extending to the gall bladder. Smaller masses with similar texture were found in multiple organs including lung, stomach, pancreas, lymph nodes, omentum, and mesentery. Neoplastic cells were spindle shaped with prominent osteoid production and occasional trabeculae of woven bone. Tumor cell emboli were observed in the blood vessels and lymphatics of the omentum and stomach. Hepatic osteosarcoma with systemic metastasis is very rare and may serve to broaden the diagnostic spectrum of hepatic and pancreatic diseases in dogs.

• Molecules and Cells
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• 제41권9호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5403-5408
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• 2013

Objective: CXCL12 exerts a wide variety of chemotactic effects on cells. Evidence indicates that CXCL12, in conjunction with its receptor, CXCR4, promotes invasion and metastasis of tumor cells. Our objective was to explore whether the CXCL12-CXCR4 biological axis might influence biological behavior of pancreatic cancer cells. Methods: Miapaca-2 human pancreatic cancer cells were cultured under three different conditions: normal medium (control), medium + recombinant CXCL12 (CXCL12 group), or medium + CXCR4-inhibitor AMD3100 (AMD3100 group). RT-PCR was applied to detect mRNA expression levels of CXCL12, CXCR4, matrix metalloproteinase 2 (MMP-2), MMP-9, and human urokinase plasminogen activator (uPA). Additionally, cell proliferation and invasion were performed using CCK-8 colorimetry and transwell invasion assays, respectively. Results: CXCL12 was not expressed in Miapaca-2 cells, but CXCR4 was detected, indicating that these cells are capable of receiving signals from CXCL12. Expression of extracellular matrix-degrading enzymes MMP-2, MMP-9, and uPA was upregulated in cells exposed to exogenous CXCL12 (P<0.05). Additionally, both proliferation and invasion of pancreatic cancer cells were enhanced in the presence of exogenous CXCL12, but AMD3100 intervention effectively inhibited these processes (P<0.05). Conclusions: The CXCL12-CXCR4 biological axis plays an important role in promoting proliferation and invasion of pancreatic cancer cells.

• Journal of Digestive Cancer Research
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• 제5권2호
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• pp.91-96
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• 2017

Background: To evaluate whether DM affects the SUVmax of metastatic lesions on ¹⁸F-FDG PET/CT and whether the SUVmax can influence the prognosis of metastatic PDAC patients. Methods: We conducted a retrospective study of 86 patients with metastatic PDAC who underwent PET/CT before treatment. The SUVmax of primary and metastatic lesions and the ratios of the SUVmax were measured. Long-term survival was evaluated using clinical parameters. Results: The mean SUVmax of primary lesion was lower in the DM group than in the non-DM group (4.74 vs. 5.96, p=0.009). The SUVmax for all metastatic lesions, except those in the lung, were lower in the DM group than in the non-DM group, and these differences were statistically significant in the lymph nodes and peritoneum. In the 35 patients with hepatic metastasis, higher ratios of the liver SUVmax significantly correlated with shorter OS (HR, 2.625; p=0.013). Conclusion: DM can influence the lower SUVmax of metastatic lesions as well as primary lesions. The SUVmax ratio of hepatic metastasis could influence on prognosis in metastatic PDAC patients.