This study was conducted to explore the relationship between locus of control and health belief. the life style of gastric cancer patients. The subjects of this study were 40 of the early gastric cancer and 90 of the advanced gastric cancer who first visiting patient to general surgery out patient department of Chungnam University Hospital for operation. The data was collected with structured questionnaire from July. 1998 to Feb. 1999 The tool were Moon's Health Belief Scale and Multiple Locus of Control of Wallston. Wallston, DeVellis. The data was analysed by SAS program using frequency, $X^2$-test, Pearson's correlation coefficient, ANOVA. Scheffe-test, t-test. The results were as follows 1. 30.8% of subjects were early gastric cancer anf 69.2% were advanced gastric cancer. The subject knowing about diagnosis was 83.1%. 16.9% did'nt know about diagnosis. 2. The correlationship between Health belief and Locus of control of subjects was not supported. 3. There was statistically no difference of life style between early and advanced gastric cancer patients. 4. There were statistically significant differences in perceived sensitivity according to weight. educational level. and birth order, in perceived barrier according to educational level. and in perceived severity according to occupation among demographic characteristics of study subjects. From above results. health professional has to educate general population to detect gastric cancer early to improve survival rate because early gastric cancer is high in survival rate, and to prevent recurrence and to maintain continuing healthy status. In the future, gastroscopy also has to expand to detect early. For there was no difference in life style between early and advanced gastric cancer. carcinogen related to diet should be emphasized through education. The perceived benefit among health belief model was not supported in this study therefore further study and comparison between gastric cancer and normal population are needed.
Moon, Jong Wun;Lee, Chung Wun;Seo, Young Deok;Yun, Sang Hyeok;Kim, Yong Keun;Won, Woo Jae
The Korean Journal of Nuclear Medicine Technology
/
v.17
no.2
/
pp.31-36
/
2013
Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.
Purpose: The aims of this study were to evaluate the expression of the large tumor suppressor (LATS) genes LATS1 and LATS2 by immunohistochemical staining of gastric cancer, and to evaluate the clinicopathological significance of LATS expression and its correlation with overall survival (OS). Materials and Methods: LATS1 and LATS2 expression in a tissue microarray was detected by immunohistochemistry, using 264 gastric cancer specimens surgically resected between July 2006 and December 2009. Results: Low expression of LATS1 was significantly associated with more advanced American Joint Committee on Cancer (AJCC) stage (P=0.001) and T stage (P=0.032), lymph node (LN) metastasis (P=0.040), perineural invasion (P=0.042), poor histologic grade (P=0.007), and diffuse-type histology by the Lauren classification (P=0.033). Low expression of LATS2 was significantly correlated with older age (${\geq}65$, P=0.027), more advanced AJCC stage (P=0.001) and T stage (P=0.001), LN metastasis (P=0.004), perineural invasion (P=0.004), poor histologic grade (P<0.001), and diffuse-type histology by the Lauren classification (P<0.001). Kaplan-Meier survival analysis revealed significantly poor OS rates in the groups with low LATS1 (P=0.037) and LATS2 (P=0.037) expression. Conclusions: Expression of LATS1 or LATS2 is a significant marker for a good prognosis in patients with gastric cancer.
Background: Human leukocyte antigen (HLA)-G-positive gastric cancers are associated with poor survival, but links with tumor escape mechanisms remain to be determined. Materials and Methods: We used immunohistochemistry to investigate HLA-G expression, tumor infiltrating CD8+ T lymphocytes, and Treg cells in 52 gastric cancer patients. Results: There were 29 cancer-related deaths during the follow-up period. Kaplan-Meier analysis indicated that patients with HLA-G-positive (n=16) primary tumors had a significantly poorer prognosis than patients with HLA-G-negative tumors (n=36, p=0.008). The median survival time was 14 months and 47 months, respectively. Patients with high numbers of Tregs and low numbers of CD8+T lymphocytes in the primary tumor had a poorer prognosis than those with low numbers of Tregs and high numbers of CD8+T lymphocytes (p=0.034, p=0.043). Multivariate Cox proportional hazard regression analysis showed that HLA-G expression (hazard ratio: 2.662; 95% confidence interval: 1.242-5.723; p=0.012) and stage (hazard ratio: 2.012;95% confidence interval: 1.112-3.715; p=0.041) were independent unfavorable factors for patient survival. Conclusions: We found a significant positive correlation between HLA-G expression and the number of tumor infiltrating Tregs (p=0.01) and a negative correlation with the number of CD8+T lymphocytes (p=0.041). HLA-G may protect gastric cancer cells from cytolysis by inducing Foxp3+Treg lymphocytes and suppressing CD8+T lymphocytes.
We conducted a case-control study to determine the association between several potential SNPs of excision repair cross complementing group 5 (XPG) and gastric cancer susceptibility, and roles of XPG polymorphisms in combination with H.pylori infection in determining risk of gastric cancer. In our study, we collected 337 newly diagnosed gastric cancer cases and 347 health controls. Three SNPs of XPG, rs2296147T>C, rs2094258C>T and rs873601G>A, were genotyped using the Taqman real-time PCR method with a 7900 HT sequence detector system. H. pylori infection was diagnosed by ELISA. By multivariate logistic regression analysis, the rs2296147 CC genotype was associated with a decreased risk of gastric cancer (OR=0.52, 95% CI=0.27-0.97), and rs2094258 TT was associated with elevated risk (OR=2.13, 95% CI=1.22-3.35). Positive H.pylori individuals with rs2094258 TT genotypes demonstrated increased risk of gastric cancer (OR=2.13, 95% CI=1.22-3.35), while rs2296147 CC was associated with lower risk among patients with negative H.pylori (OR=0.45, 95%CI=0.22-0.89). Our findings suggested that XPG polymorphisms might contribute to risk of gastric cancer among Chinese populations, but the effect needs to be further validated by larger sample size studies.
Kim, Hyoung-Il;Kim, Sang Yong;Yu, Jae Eun;Shin, Su-Jin;Roh, Yun Ho;Cheong, Jae-Ho;Hyung, Woo Jin;Noh, Sung Hoon;Park, Chung-Gyu;Lee, Hyuk-Joon
Journal of Gastric Cancer
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v.20
no.2
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pp.190-201
/
2020
Purpose: This study sought to investigate the prognostic significance of tumor-infiltrating lymphocytes (TILs) in relation to tumor location within the stomach. Materials and Methods: The densities and prognostic significance of TIL subsets were evaluated in 542 gastric cancer patients who underwent gastrectomy. Immunohistochemical staining for CD3, CD4, CD8, forkhead/winged helix transcription factor (Foxp3), and granzyme B was performed. Results: Cardia cancer was associated with significantly lower densities of CD8 T-cells and higher densities of Foxp3 and granzyme B T-cells than non-cardia tumors. Multivariate analysis showed that advanced age (hazard ratio [HR], 1.023; 95% confidence interval [CI], 1.006-1.040), advanced T classification (HR, 2.029; 95% CI, 1.106-3.721), lymph node metastasis (HR, 3.319; 95% CI, 1.947-5.658), low CD3 expression (HR, 0.997; 95% CI, 0.994-0.999), and a high Foxp3/CD4 ratio (HR, 1.007; 95% CI, 1.001-1.012) were independent predictors of poor overall survival in cardia cancer patients. In non-cardia cancer patients, total gastrectomy (HR, 2.147; 95% CI, 1.507-3.059), advanced T classification (HR, 2.158; 95% CI, 1.425-3.266), lymph node metastasis (HR, 1.854; 95% CI, 1.250-2.750), and a low Foxp3/CD4 ratio (HR, 0.978; 95% CI, 0.959-0.997) were poor prognostic factors for survival. Conclusions: The densities and prognostic effects of TILs differed in relation to the location of tumors within the stomach. The contrasting prognostic effects of Foxp3/CD4 ratio in cardia and non-cardia gastric cancer patients suggests that clinicians ought to consider tumor location when determining treatment strategies.
Choi, Hee Jun;Kim, Su Mi;An, Ji Yeong;Choi, Min-Gew;Lee, Jun Ho;Sohn, Tae Sung;Bae, Jae Moon;Kim, Sung
Journal of Gastric Cancer
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v.16
no.4
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pp.215-220
/
2016
Purpose: This study aimed to evaluate the rate, patterns, and risk factors associated with tumor recurrence in patients with T1N0 gastric cancer. Materials and Methods: The medical records of 8,753 patients with pathological T1N0M0 gastric cancer who underwent gastrectomy between 1994 and 2014 at Sungkyunkwan University School of Medicine were examined. Results: Among the 8,753 patients, 95 patients (1.1%) experienced tumor recurrence; this included 31 remnant, 27 hematogenous, 9 lymph nodal, 5 peritoneal, and 23 multiple-site recurrences. When patients were divided into two groups according to the presence of tumor recurrence, the following characteristics were higher in the recurrence group than in the non-recurrence group: older age (${\geq}65years$), male gender, undifferentiated histology, submucosal invasion, and venous invasion. In multivariate analysis, older age, male gender, tumor depth (sm2 and sm3 invasion), and venous invasion were independent risk factors for tumor recurrence. The recurrence rates were 0.7% in patients with less than two risk factors, 1.7% in those with two risk factors, 3.0% in those with three risk factors, and 6.3% in those with four risk factors (P<0.001). Conclusions: Although tumor recurrence is rare in pT1N0M0 gastric cancer, some patients with certain risk factors demonstrate an increased rate of tumor recurrence. Careful follow-up is required for patients with three or four risk factors.
Kim Yong Jin;Kim Byung Sik;Choi Won Yong;Yook Jung Hwan;Oh Sung Tae;Park Kun Choon
Journal of Gastric Cancer
/
v.4
no.1
/
pp.32-35
/
2004
Purpose: The most important prognostic factors in gastric cancer is the depth of invasion of the primary tumor and lymph node metastasis. The nodal staging of the 5th edition of the Union Internationale Contrala Cancrums (UICC) TNM classification in 1997 was changed based on the number of metastatic lymph node. We attempted to evaluate the prognostic significance of N2 group metastasis in pT3pN1 gastric cancer patients by comparing two different nodal staging systems. Materials and Methods: A retrospective analysis was made for 352 gastric cancer patients who underwent curative resection, including D2 dissection, from 1991 to 1997 at Asan Medical Center. A clinicopathologic comparison between two groups by using a nodal staging systems was summarized into a table. Cumulative survival rates were calculated by using the Kaplan-Meier method. The difference between the two groups was evaluated by using the log rank test with SPSS 11.5 for Windows Results: There were no statistical differences in clinicopathologic factors. However, there was a significant difference in survival rate between the two groups (P=0.0009). This suggests that N2 group metastasis in pT3pN1 gastric cancer patients has a clinical significance for predicting prognosis. Conclusion: Our results suggest a possibility of prognostic significance of N2 group metastasis. Therefore, anatomical location of the lymph node should be described.
Purpose: We evaluated the efficacy and prognostic predictability of the $7^{th}$ UICC TNM classification compared to $6^{th}$ UICC TNM classification in patients with gastric cancer. Materials and Methods: Between June 1992 and December 2006, 1,633 patients with gastric cancer who had undergone gastric surgery and who had been analyzed by the $6^{th}$ UICC method were analyzed using the new $7^{th}$ UICC system. Results: Significant differences in 5-year survival rates were observed for $7^{th}$ UICC N0, N1, N2, N3a, and N3b compared to $6^{th}$ UICC. There were no significant differences in 5-year survival rates between T2 and T3. Distinct survival differences were present between stage III (IIIa, IIIb, and IIIc) and stage IV in $7^{th}$ UICC. Significant differences in 5-year survival rates were not expected for Ia versus Ib, Ib versus IIa, and IIb versus IIIa. The survival rates for the same stages were not homogeneously differentiated by $7^{th}$ UICC except for stage IV. Conclusion: The $7^{th}$ UICC classification system is not better able to predict patient survival compared to 6th UICC in patients with gastric cancer, but is better for accurate prognosis of patients with stage IV gastric cancer.
Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly $90\%$ of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, $33\%$ of the recurrences involved locoregional sites, $44\%$ the peritoneum, and $38\%$ distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during sep. 2004, cancer recurrence was found at the Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.
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