• Journal of Digestive Cancer Reports
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• 제9권1호
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• pp.25-32
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• 2021

내시경초음파가 1980년대에 개발된 이후, 내시경초음파는 췌장 종양 관리에 있어서 진단적인 역할뿐만 아니라 치료적인 역할로 그 기능이 확대되고 있다. 췌장 양성 종양에 대한 전통적인 치료방법은 수술적 절제를 시행하거나 주기적인 경과관찰을 하는 것이었다. 그러나 내시경초음파는 그 대안으로 췌장 양성 종양을 가진 환자에게 최소 침습적인 치료법을 제공한다. 본고에서는 췌장 양성 종양치료에 있어서 내시경초음파의 역할에 대해 알아보고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.373-376
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• 2015

Background: EVA1A (eva-1 homolog A) is a novel gene that regulates programmed cell death through autophagy and apoptosis. Our objective was to investigate the expression profiles and potential role of EVA1A in normal and neoplastic human pancreatic tissues. Materials and Methods: The expression pattern of EVA1A in normal pancreatic tissue was examined by indirect immunofluorescence and confocal microscopy. Protein levels in paraffin-embedded specimens from normal and diseased pancreatic and matched non-tumor tissues were evaluated by immunohistochemistry. Results: EVA1A colocalized with glucagon but not with insulin, demonstrating production in islet alpha cells. Itwas strongly expressed in chronic pancreatitis, moderately or weakly expressed in the plasma membrane and cytoplasm in pancreatic acinar cell carcinoma, and absent in normal pancreatic acinar cells. Although the tissue architecture was deformed, EVA1A was absent in the alpha cells of pancreatic ductal adenocarcinomas, intraductal papillary mucinous neoplasms, mucinous cystadenomas, solid papillary tumors and pancreatic neuroendocrine tumors. Conclusions: EVA1A protein is specifically expressed in islet alpha cells, suggesting it may play an important role in regulating alpha-cell function. The ectopic expression of EVA1A in pancreatic neoplasms may contribute to their pathogenesis and warrants further investigation.

• 한국간담췌외과학회지
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• 제27권2호
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• pp.141-150
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• 2023

Pancreatic carcinosarcoma is a very rare malignancy with a poor prognosis. Because of these characteristics, a treatment strategy for it has not been established yet. The aim of this study was to establish a therapeutic strategy for pancreatic carcinosarcoma. We reviewed data of a 65-year-old female patient who was diagnosed with pancreatic carcinosarcoma through endoscopic ultrasound-guided fine needle aspiration biopsy before surgery. For literature review, we searched PubMed using terms of "Pancreatic" or "Pancreas" and "carcinosarcoma" or "carcinosarcomatous". The patient received 11 cycles of neoadjuvant treatment with leucovorin, fluorouracil, irinotecan, oxaliplatin and pembrolizumab because the tumor was borderline resectable. She underwent stereotactic ablative body radiotherapy (SABR) with 35 Gy in 5 fractions, followed by robotic pylorus-preserving pancreaticoduodenectomy. After surgery, the patient received adjuvant chemotherapy in the same regimen as before surgery. She is alive without any recurrence. Among 48 patients within 33 available papers, the median survival time was 15 months. The survival rate of patients who received adjuvant chemotherapy tended to be higher than that of those who did not receive adjuvant chemotherapy, although the difference was not statistically significant (median survival, 47 vs. 15 months; p = 0.485). Three patients who received neoadjuvant chemotherapy had a survival period of 13-23.5 months. Surgery with lymphadenectomy, adjuvant therapy, and neoadjuvant therapy are thought to help improve survival outcomes. Modern treatment approaches for conventional pancreatic ductal adenocarcinoma could be applied to pancreatic carcinosarcoma.

• Journal of Digestive Cancer Research
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• 제10권2호
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• pp.112-116
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• 2022

Idiopathic inflammatory myopathy (IIM) is known for its association with malignant diseases. Moreover, various solid organ malignancies, such as ovarian, breast, lung, esophageal, stomach, and colorectal cancers, have been reported to occur with IIM. Furthermore, its relationship with hematologic malignancies, including non-Hodgkin lymphoma, myeloma, and leukemia, has been reported. However, to date, IIM related to pancreatic cancer has scarcely been reported, particularly in patients with polymyositis (PM). Therefore, here we report a case of PM developed immediately after the diagnosis of pancreatic ductal adenocarcinoma.

• 한국간담췌외과학회지
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• 제27권4호
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• pp.415-422
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• 2023

Backgrounds/Aims: Although cancer survivors are at higher risk of developing second primary malignancies, cancer surveillance strategies for them have not yet been established. This study aimed to identify first primary cancers that had high risks of developing second primary exocrine pancreatic cancer (EPC). Methods: Data on individuals diagnosed with primary cancers between 1993 and 2017 were obtained from the Korea Central Cancer Registry. The standardized incidence ratios (SIRs) of second primary EPCs were analyzed according to the primary tumor sites and follow-up periods. Results: Among the 3,205,840 eligible individuals, 4,836 (0.15%) had second primary EPCs, which accounted for 5.8% of the total EPC patients in Korea. Between 1 and 5 years after the diagnosis of first primary cancers, SIRs of second primary EPCs were increased in patients whose first primary cancers were in the bile duct (males 2.99; females 5.03) in both sexes, and in the small intestine (3.43), gallbladder (3.21), and breast (1.26) in females. Among those who survived 5 or more years after the diagnosis of first primary cancers, SIRs of second primary EPCs were elevated in patients whose first primary cancers were in the bile duct (males 2.61; females 2.33), gallbladder (males 2.29; females 2.22), and kidney (males 1.39; females 1.73) in both sexes, and ovary (1.66) and breast (1.38) in females. Conclusions: Survivors of first primary bile duct, gallbladder, kidney, ovary, and female breast cancer should be closely monitored for the occurrence of second primary EPCs, even after 5 years of follow-up.

• Journal of Digestive Cancer Research
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• 제12권1호
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• pp.31-37
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• 2024

Pancreatic cancer is a highly fatal malignancy with a 5-year survival rate of < 10%. Endoscopic ultrasound (EUS) is a useful noninvasive tool for differential diagnosis of pancreatic malignancy and treatment decision-making. However, the performance of EUS is suboptimal, and its accuracy for differentiating pancreatic malignancy has increased interest in the application of artificial intelligence (AI). Recent studies have reported that EUS-based AI models can facilitate early and more accurate diagnosis than other preexisting methods. This article provides a review of the literature on EUS-based AI studies of pancreatic malignancies.

• Journal of Digestive Cancer Research
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• 제11권1호
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• pp.1-8
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• 2023

Pancreatic cancer treatment has advanced. In particular, effective chemotherapy regimen development has fundamentally altered the therapeutic concept and strategy for pancreatic cancer treatment. Consequently, the prognosis of patients with pancreatic cancer has gradually improved. Conversion surgery for locally advanced pancreatic cancer may offer long-term survival or even a full recovery in some individuals. In contrast, metastatic pancreatic cancer has long been considered a surgical contraindication because aggressive surgical resection of the metastatic lesions does not prolong patient survival. Unexpectedly positive benefits of anticancer therapy in recent clinical experience were observed even with metastatic pancreatic cancer. To date, little evidence presented the success of surgical resection for metastatic pancreatic cancer treatment in such rare cases. However, hope and concern are growing that surgical intervention, even in patients with metastatic cancer, may result in favorable outcomes. Several studies suggested different surgical intervention effects depending on metastasis sites and patterns. Thus, this review summarizes the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer and discusses future perspectives.

• Journal of Cancer Prevention
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• 제22권1호
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• pp.1-5
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• 2017

Pancreatic cancer is a highly aggressive malignant tumor of the digestive system and radical resection, which is available to very few patients, might be the only possibility for cure. Since therapeutic choices are limited at the advanced stage, prevention is more important for reducing incidence in high-risk individuals with family history of pancreatic cancer. Epidemiological studies have shown that a high consumption of fish oil or ${\omega}3-polyunsaturated$ fatty acids reduces the risk of pancreatic cancers. Dietary fish oil supplementation has shown to suppress pancreatic cancer development in animal models. Previous experimental studies revealed that several hallmarks of cancer involved in the pathogenesis of pancreatic cancer, such as the resistance to apoptosis, hyper-proliferation with abnormal $Wnt/{\beta}-catenin$ signaling, expression of pro-angiogenic growth factors, and invasion. Docosahexaenoic acid (DHA) is a ${\omega}3-polyunsaturated$ fatty acid and rich in cold oceanic fish oil. DHA shows anti-cancer activity by inducing oxidative stress and apoptosis, inhibiting $Wnt/{\beta}-catenin$ signaling, and decreasing extracellular matrix degradation and expression of pro-angiogenic factors in pancreatic cancer cells. This review will summarize anti-cancer mechanism of DHA in pancreatic carcinogenesis based on the recent studies.

• Journal of Digestive Cancer Reports
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• 제9권1호
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• pp.19-24
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• 2021

고해상도 영상기법과 내시경술기의 발전으로 인해 작고 무증상인 췌장 신경내분비종양의 발생률은 증가하고 있다. 대부분의 췌장 신경내분비종양은 느리게 성장하나 때때로 예후가 좋지 않은 국소 침윤 또는 전이를 보인다. 작고 비기능성인 췌장 신경내분비종양의 관리 방법에 대해서는 아직 정립되지 않았다. 미국종합암네트워크 지침은 2 cm 미만의 작은 췌장 신경내분비종양에서는 관찰을 권장한다. 외과 의사의 의견은 두 부류로 나뉘어진다. 작은 췌장 신경내분비종양에서도 악성의 위험이 높으므로 공격적인 수술 치료가 필요하다는 "매"파와 악성의 위험이 있지만 과도하게 치료할 위험이 훨씬 더 높다고 주장하는 "비둘기"파가 있다. 췌장수술은 28-30%의 이환율과 1%의 사망률로 고위험 수술이기 때문에 작은 췌장 신경내분비종양에 대한 치료 결정은 어렵다.

• Journal of Digestive Cancer Research
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• 제4권2호
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• pp.51-57
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• 2016

The epidemiology of pancreatic neuroendocrine neoplasms (PNENs) in Asia has been clarified through epidemiological studies, including one conducted in Japan, and subsequently another in South Korea. As endoscopic ultrasonography (EUS) has become more widely accessible, endoscopic ultrasound-fine needle aspiration (EUS-FNA) has been performed in pancreatic tumors for which the clinical course was only monitored previously. This has enabled accurate diagnosis of pancreatic tumors based on the 2010 WHO classification; as a result, the number of patients with an accurate diagnosis has increased. Although surgery has been the standard therapy for PNENs, new treatment options have become available in Japan for the treatment of advanced or inoperable PNENs; of particular note is the recent introduction of molecular target drugs (such as everolimus and sunitinib) and streptozocin. Treatment for progressive PNENs needs to be selected for each patient with consideration of the performance status, degree of tumor differentiation, tumor mass, and proliferation rate. Somatostatin receptor (SSTR)-2 is expressed in many patients with neuroendocrine tumor. Somatostatin receptor scintigraphy (SRS), which can visualize SSTR-2 expression, has been approved in Japan. The SRS will be a useful diagnostic tool for locating neuroendocrine neoplasms, detecting distant metastasis, and evaluating therapy outcomes. In this manuscript, we review the latest diagnostic methods and treatments for PNENs.