• 대한핵의학회지
• /
• 제38권5호
• /
• pp.344-346
• /
• 2004

A 69-year-old woman was presented with progressed dysphagia, gastric soreness and weight loss during 2 months. She was performed abdomen x-ray, EGDS and abdomen CT. Abdomen x-ray demonstrated punctuate calcification on LUQ. EGDS showed an ulceroinfiltrative mass with bleeding on cardia to antrum of stomach. And CT showed diffuse gastric wall thickness with multiple calcifications. Biopsy of the stomach and esophagus during EGDS examination revealed an adenocarcinoma, with signet ring cell type, infiltrating the wall of the stomach and the distal esophagus. Then acne scan was performed a few days later. It revealed intense uptake in LUQ, corresponding to the calcium containing neoplasm seen on the abdomen x-ray, EGDS and abdomen CT. And there was no evidence of any metastatic lesion and thyroid uptake on the bone scan. There are many reports about accumulation of the tracer in extraosseous lesion, but only a few literatures were reported about gastric calcification in stomach cancer. More over, no reports showed CT images. We are performed many diagnostic examinations and found well correlation between them. The reason of gastric calcification is considered with calcium deposition within extracellular space due to hemorrhage or necrosis. Other possibility offered to explain gastric calcification have been increased blood flow and/or increased neovascularity with capillary leaks of tracer, and specific enzymatic (phosphatases) receptor binding of tracer. So, it was happened ion exchange between intracellular calcium and phosphate groups of tracer.

• Journal of Gastric Cancer
• /
• 제10권4호
• /
• pp.212-218
• /
• 2010

Purpose: The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease. Materials and Methods: The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated. Results: The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006). Conclusions: The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권22호
• /
• pp.9661-9666
• /
• 2014

Background: A number of studies have identified a shared susceptibility locus in phospholipase C epsilon 1 (PLCE1) for esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinomas (GCA). However, the results of PLCE1 expression in esophageal and gastric cancer remain inconsistent and controversial. Moreover, the effects on clinicopathological features remain undetermined. This study aimed to provide a precise quantification of the association between PLCE1 expression and the risk of ESCC and GCA through meta-analysis. Materials and Methods: Eligible studies were identified from PubMed, Wanfang Data, ISI Web of Science, and the Chinese National Knowledge Infrastructure databases. Using RevMan5.2 software, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were employed to assess the association of PLCE1 expression with clinicopathological features relative to ESCC or GCA. Results: Seven articles were identified, including 761 esophageal and gastric cancer cases and 457 controls. Overall, we determined that PLCE1 expression was associated with tumor progression in both esophageal cancers (pooled OR=5.93; 95%CI=3.86 to 9.11) and gastric cancers (pooled OR=9.73; 95%CI=6.46 to 14.7). Moreover, invasion depth (pooled OR=3.62; 95%CI=2.30 to 5.70) and lymph node metastasis (pooled OR=4.21; 95%CI=2.69 to 6.59) were linked with PLCE1 expression in gastric cancer. However, no significant associations were determined between PLCE1 overexpression and the histologic grade, invasion depth, and lymph node metastasis in esophageal cancer. Conclusions: Our metaanalysis results indicated that upregulated PLCE1 is significantly associated with an increased risk of tumor progression in ESCC and GCA. Therefore, PLCE1 expression can be appropriately regarded as a promising biomarker for ESCC and GCA patients.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권4호
• /
• pp.1407-1412
• /
• 2012

Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권7호
• /
• pp.2951-2957
• /
• 2014

Background: Gastric carcinogenesis is a complicated process that involves environmental and genetic factors like interleukin-4 (IL-4) and IL-8. Single nucleotide polymorphisms in their genes are associated with changed levels of gene expression. Here, we investigated the association between IL4-590 C>T and IL8-251T>A and gastric cancer (GC) risk in Sichuan of Southwestern China. Materials and Methods: We surveyed the research subjects using a self-designed questionnaire with questions on demographic factors and putative risk factors. Approximately 2-5ml of whole blood was collected after field survey to analyze IL4-590 C>T and IL8-251T>A genotypes using MALDI-TOF MS. Results: Our study recruited 308 pairs of GC patients and controls, including 224 (72.7%) men and 84 (27.3%) women in each group. There were 99 cardia and 176 noncardia GC patients in the case group. The case and control groups had an average age of $57.7{\pm}10.6$ ($mean{\pm}SD$) and $57.6{\pm}11.1$ years. GC patients reported a significantly greater proportion of family history of cancer (29.9% vs 10.7%, p<0.01) and drinking (54.6% vs 43.2%, p<0.01) than did controls. Variant genotypes of IL-4-590 C>T and IL-8-251 T>A were not associated with overall GC risk (adjusted OR, 0.89; 95%CI, 0.61-1.28 for CT or CC vs TT; adjusted OR, 1.14; 95%CI, 0.86-1.79 for TA or AA vs TT). Stratification analysis of two SNPs for risk by subsites only found that variant IL-8-251 TA or AA genotype was associated with increased noncardia GC risk (adjusted OR, 2.58; 95%CI, 1.19-5.57). We did not observe interactions between the IL-8-251 T>A genotype and smoking (adjusted OR, 0.38; 95%CI, 0.08-1.79) or drinking (adjusted OR, 0.36; 95%CI, 0.08-1.65) for risk of noncardia GC. Conclusions: Our data indicate no association between the two SNPs of IL-4-590 and IL-8-251 with overall GC risk, while the IL-8-251 TA or AA genotype conferred risk of cardia GC. Our findings contribute to the evidence body for risk of SNPs associated with the development of gastric cancer in this region.

• Journal of Preventive Medicine and Public Health
• /
• 제52권3호
• /
• pp.179-187
• /
• 2019

Objectives: In the USA, certain races and ethnicities have a disproportionately higher gastric cancer burden. Selective screening might allow for earlier detection and curative resection. Among a USA-based multiracial and ethnic cohort diagnosed with non-cardia gastric cancer (NCGC), we aimed to identify factors associated with curable stage disease at diagnosis. Methods: We retrospectively identified endoscopically diagnosed and histologically confirmed cases of NCGC at Mount Sinai Hospital in New York City. Demographic, clinical, endoscopic and histologic factors, as well as grade/stage of NCGC at diagnosis were documented. The primary outcome was the frequency of curable-stage NCGC (stage 0-1a) at diagnosis in patients with versus without an endoscopy negative for malignancy prior to their index exam diagnosing NCGC. Additional factors associated with curable-stage disease at diagnosis were determined. Results: A total of 103 racially and ethnically diverse patients were included. Nearly 38% of NCGC were stage 0-Ia, 34% stage Ib-III, and 20.3% stage IV at diagnosis. A significantly higher frequency of NCGC was diagnosed in curable stages among patients who had undergone an endoscopy that was negative for malignancy prior to their index endoscopy that diagnosed NCGC, compared to patients without a negative endoscopy prior to their index exam (69.6% vs. 28.6%, p=0.003). A prior negative endoscopy was associated with 94.0% higher likelihood of diagnosing curable-stage NCGC (p=0.003). No other factors analyzed were associated with curablestage NCGC at diagnosis. Conclusions: Endoscopic screening and surveillance in select high-risk populations might increase diagnoses of curable-stage NCGC. These findings warrant confirmation in larger, prospective studies.

• Journal of Gastric Cancer
• /
• 제9권4호
• /
• pp.200-206
• /
• 2009

목적: 서구에서의 위암은 상부암과 미만형이 증가하고 있는 것으로 알려져 있다. 우리나라도 서구화되어 감에 따라 위암의 임상병리학적 특성과 생존율의 변화가 있는지를 알아보고자 하였다. 대상 및 방법: 위암의 위절제수술 환자 1,638명을 1990년대(1991~1999년)의 987명과 2000년대 초기(2000~2003년)의 651명으로 구분하였다. 두 시기별 임상병리학적 특성의 변화와 생존율의 영향을 미치는 인자에 대해 단변량과 다변량 분석을 하였다. 결과: 60대 이상의 고령환자가 1990년대 42.7%에서 2000년대 초기에는 50.7%로 증가하였다. 과체중(체질량지수$\geq$23)은 31.5%에서 43.2%로 증가하였다. Ia기 29.8%에서 44.5%로 증가하고 IV기는 23.5%에서 11.8%로 감소하였다. WHO 조직학적 분류, Lauren 분류와 병변의 위치는 변화 없었다. 전체 환자의 5년 생존율은 74.4%이고 5년 생존율은 67.7%에서 83.7%로 증가하였다. Cox proportional hazard 모델에서는 TNM, 근치도 여부와 시기의 구분이 생존율의 독립적인 예후 인자이었다. 2000년대 초기에 수술 받은 환자는 1990년대의 수술 환자에 비해 비교위험도 0.715 (95% 신뢰구간; 0.555~0.921)로 생존율이 좋았다. 결론: 본 연구의 결과 서구에서 나타나는 임상병리학적변화는 관찰되지 않았다. 그렇지만 조기위암과 고연령 환자가 증가하였으며 과체중 환자 증가의 특징이 관찰되었다. 또한 위암 수술 환자의 생존율도 1990년대에 비해 증가하였다.

• Journal of Gastric Cancer
• /
• 제6권1호
• /
• pp.47-51
• /
• 2006

위에서 생기는 점막하 종양은 내시경적 조직검사로는 그 기원을 알기 어려운 경우가 많다. 이러한 점막하 종양 중, 슈반 세포(Schwann cell)로부터 분화하여 생기는 종양을 신경초종(Schwannoma)이라고 하며, 위에서 생기는 전체 종양의 0.2%를 차지한다고 알려져 있다. 이 증례는 2개월 전부터 시작된 다량의 흑색변과 빈혈을 주소로 내원한 57세 여자 환자에 대한 보고이다. 복부 컴퓨터 단층 촬영 및 상부 위장관 내시경에서 위 분문에서 3 cm정도 아래부터 위각 직상부까지 위체부 소만을 대부분 차지하는 약 8 cm 이상의 돌출된 종양이 관찰되었고, 수 차례에 걸친 내시경적 조직검사를 시행하였으나 괴사조직과 육아종성 조직, 만성 위염 소견만 반복해서 나왔다. 출혈을 동반한 진행성 위암, 림프종 등을 생각하여 정확한 진단 및 출혈에 대한 치료를 위해 수술을 시행하였다. 술 후 조직검사에서 전반적으로 소엽상 형태(lobulating pattern)로 주변에 림프구 침윤(lymphocyte cuffing)이 있었고 책상핵(palisading nuclei), 방추세포(spindle-cell) 등이 보였다. C-kit, CD34, SMA 모두 음성이었으며 S-100 양성으로 신경초종으로 진단되었다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권6호
• /
• pp.2867-2871
• /
• 2012

Background: Multiple studies have reported associations between the PSCA rs2294008 C > T polymorphism and GC, but susceptibility has proven inconsistent. Therefore, we estimates the relationship between the rs2294008 C > T polymorphism and GC by meta-analysis. Methods: PubMed, Embase and Web of Science databases were searched and nine independent case-control studies were included in this meta-analysis. Crude ORs with 95% CIs were extracted according to the Mantal-Haenszel method and pooled to assess the strength of the association. Results: We observed that the PSCA rs2294008 C > T polymorphism was significantly correlated with GC risk when all studies were pooled into the meta-analysis. Further subgroup analysis showed the polymorphism to be linked with diffuse and noncardia GC in the allele contrast model, homozygote codominant model, dominant model, and recessive model. However, no connection was apparent for intestinal and cardia GC. In the stratified analysis by ethnicity, significant associations were observed in Asians for the recessive model. Interestingly, the relationship was particularly significant in the Chinese population. Conclusions: Our findings suggest that the PSCA rs2294008 C > T polymorphism is a risk factor for GC, especially in diffuse and noncardia GC and in Chinese.

• Journal of Gastric Cancer
• /
• 제6권3호
• /
• pp.193-197
• /
• 2006

흑색종은 피부나 점막에 존재하는 멜라닌 세포에서 기원하는 악성 종양으로 피부에 가장 흔하게 발생한다. 위장관계 점막에서도 흑색종이 발생할 수 있는데 원발성은 매우 드물고 대부분은 피부의 원발성 흑색종으로부터 전이되어 나타난다. 위에 발생한 원발성 흑색종은 매우 드물고 치료 성적이 나쁘고 전이 속도가 빨라서 예후가 매우 나쁘다. 저자들은 혈변, 복통과 체중 감소를 주소로 내원한 75세 남자로 수술 전 진행성 위암으로 진단되어 위전절제술을 시행하였으나 수술 후 위 분문부의 원발성 흑색종으로 식도-위 접합부까지 침범한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 흑색종 치료에서 수술은 가장 표준적인 치료법이다. 수술 후 보조 요법으로 항암화학요법, 방사선 치료, 면역 치료 등을 시도해 보았지만 생존율 증가가 입증된 치료 방법은 아직 없는 실정이다. 장기간 생존율을 향상시키기 위해서는 조기 진단과 수술적 치료가 가장 중요하다.