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Clinicopathologic factors and molecular markers related to lymph node metastasis in early gastric cancer

World Journal of Gastroenterology 2015年第2期21卷 571-577页

作者： Eun Hyo Jin Dong Ho Lee Sung-Ae Jung Ki-Nam Shim Ji Yeon seo Nayoung Kim Cheol Min Shin hyuk Yoon Hyun Chae Jung Department of Internal Medicine and Liver Research Institute Seoul National University College of MedicineSeoul 110-744South Korea Department of Internal Medicine Seoul National University Bundang HospitalGyeonggi-do 463-707South Korea Department of Internal Medicine Ewha Womans University College of MedicineSeoul 158-710South Korea

AIM: To analyze predictive factors for lymph node metastasis in early gastric ***: We analyzed 1104 patients with early gastric cancer(EGC) who underwent a gastrectomy with lymph-node dissection from May 2003 through July 2011. The clinicopathologic factors and molecular markers were assessed as predictors for lymph node metastasis. Molecular markers such as microsatellite instability, human mut L homolog 1, p53, epidermal growth factor receptor(EGFR) and human epidermal growth factor receptor 2(HER2) were included. The χ2 test and logistic regression analysis were used to determine clinicopathologic ***: Lymph node metastasis was observed in 104(9.4%) of 1104 patients. Among 104 cases of lymph node positive patients, 24 patients(3.8%) were mucosal cancers and 80 patients(16.7%) were submucosal. According to histologic evaluation, the number of lymph node metastasis found was 4(1.7%) for well differentiated tubular adenocarcinoma, 45(11.3%) for moderately differentiated tubular adenocarcinoma, 36(14.8%) for poorly differentiated tubular adenocarcinoma, and 19(8.4%) for signet ring cell carcinoma. Of 690 EGC cases, 77 cases(11.2%) showed EGFR overexpression. HER2 overexpression was present in 110 cases(27.1%) of 406 EGC patients. With multivariate analysis, female gender(OR = 2.281, P = 0.009), presence of lymphovascular invasion(OR = 10.950, P < 0.0001), diameter(≥ 20 mm, OR = 3.173, P = 0.01), and EGFR overexpression(OR = 2.185, P = 0.044) were independent risk factors for lymph node ***: Female gender, tumor size, lymphovascular invasion and EGFR overexpression were predictive risk factors for lymph node metastasis in EGC.

关键词： Receptor Epidermal growth factor Stomach neoplasms

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Clinicopathologic and molecular features associated with patient age in gastric cancer

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World Journal of Gastroenterology 2015年第22期21卷 6905-6913页

作者： Ji Yeon seo Eun Hyo Jin Hyun Jin Jo hyuk Yoon Cheol Min Shin Young Soo Park Nayoung Kim Hyun Chae Jung Dong Ho Lee Department of Internal Medicine and Healthcare Research Institute Healthcare System Gangnam Center Seoul National University Hospital Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Department of Internal Medicine Seoul National University Bundang Hospital Seongnam-si

AIM: To compare characteristics and prognosis of gastric cancer based on ***: A retrospective study was conducted on clinical and molecular data from patients(n =1658) with confirmed cases of gastric cancer in seoul National University Bundang Hospital(seoul, South Korea) from 2003 to 2010 after exclusion of patients diagnosed with lymphoma, gastrointestinal stromal tumor, and metastatic cancer in the stomach. DNA was isolated from tumor and adjacent normal tissue,and a set of five markers was amplified by polymerase chain reaction to assess microsatellite instability(MSI). MSI was categorized as high, low, or stable if ≥ 2, 1, or 0 markers, respectively, had *** was performed on tissue sections to detect levels of expression of p53, human epidermal growth factor receptor(HER)-2, and epidermal growth factor receptor. Statistical analysis of clinical and molecular data was performed to assess prognosis based on the stratification of patients by age(≤ 45 and> 45 years).RESULTS: Among the 1658 gastric cancer patients, the number of patients with an age ≤ 45 years was 202(12.2%; 38.9 ± 0.4 years) and the number of patients> 45 years was 1456(87.8%; 64.1 ± 0.3 years).Analyses revealed that females were predominant inthe younger group(P < 0.001). Gastric cancers in the younger patients exhibited more aggressive features and were at a more advanced stage than those in older patients. Precancerous lesions, such as atrophic gastritis and intestinal metaplasia, were observed less frequently in the older than in the younger group(P < 0.001). Molecular characteristics, including overexpression of p53(P < 0.001), overexpression of HER-2(P = 0.006), and MSI(P = 0.006), were less frequent in gastric cancer of younger patients. Cancer related mortality was higher in younger patients(P= 0.048), but this difference was not significant after adjusting for the stage of ***: Gastric cancer is distinguishable between younger and older patien

关键词： Age Gastric cancer Microsatellite instability Molecular pathology Prognosis Stage

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Signet-ring cell carcinoma arising from a fundic gland polyp in the stomach

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World Journal of Gastroenterology 2014年第47期20卷 18044-18047页

作者： Yong seol Jeong Sung Eun Kim Mi-Jung Kwon Jae Yong seo Hyun Lim Ji Won Park Ho Suk Kang Sung Hoon Moon Jong hyuk Kim Choong Kee Park Department of Internal Medicine University of Hallym College of MedicineHallym University Sacred Heart Hospital Department of Pathology University of Hallym College of MedicineHallym University Sacred Heart Hospital

Fundic gland polyps(FGPs)are currently the most common type of gastric polyps and are usually ***,although rare,gastric adenocarcinoma of FGP has been recently proposed as a new variant of gastric *** we report the first case of a49-year-old woman with focal signet ring cell carcinoma that arose from an FGP of the *** tumor was completely excised by endoscopic snare *** should therefore be evaluated for malignant changes although they occur rarely,if the FGP has an erosive or irregular surface.

关键词： Fundic gland polyp Signet ring cell

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Prognostic value of inflammation-based markers in patients with pancreatic cancer administered gemcitabine and erlotinib

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World Journal of Gastrointestinal Oncology 2016年第7期8卷 555-562页

作者： Jae Min Lee Hong Sik Lee Jong Jin Hyun hyuk Soon Choi Eun Sun Kim Bora Keum Yeon seok seo Yoon Tae Jeen Hoon Jai Chun Soon Ho Um Chang Duck Kim Division of Gastroenterology and Hepatology Department of Internal Medicine Korea University College of Medicine

AIM: To evaluate the value of systemic inflammationbased markers as prognostic factors for advanced pancreatic cancer(PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio(NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein(CRP)-to-albumin(CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival(PFS) and overall survival(OS). RESULTS: The univariate analysis demonstrated the prognostic value of the NLR(P = 0.049) and the CRP/Alb ratio(P = 0.047) in relation to PFS, and a positiverelationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR(hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients' prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > ***: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.

关键词： Pancreatic cancer Neutrophil-to-lymphocyte ratio C-reactive protein Albumin Prognostic factor

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Predictors of the patency of self-expandable metallic stents in malignant gastroduodenal obstruction

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World Journal of Gastroenterology 2015年第30期21卷 9134-9141页

作者： Seung Han Kim Hoon Jai Chun In Kyung Yoo Jae Min Lee Seung Joo Nam hyuk Soon Choi Eun Sun Kim Bora Keum Yeon seok seo Yoon Tae Jeen Hong Sik Lee Soon Ho Um Chang Duck Kim Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University College of Medicine

AIM:To investigate the predictive factors of selfexpandable metallic stent patency after stent placement in patients with inoperable malignant gastroduodenal obstruction. METHODS:A total of 116 patients underwent stent placements for inoperable malignant gastroduodenal obstruction at a tertiary academic center. Clinical success was defined as acceptable decompression of the obstructive lesion within the malignant gastroduodenal neoplasm. We evaluated patient comorbidities and clinical statuses using the World Health Organization's scoring system and categorized patient responses to chemotherapy using the Response Evaluation Criteria in Solid Tumors criteria. We analyzed the relationships between possible predictive factors and stent patency. RESULTS:Self-expandable metallic stent placement was technically successful in all patients(100%),and the clinical success rate was 84.2%. In a multivariate Cox proportional hazards model,carcinoembryonic antigen(CEA) levels were correlated with a reduction in stent patency [P = 0.006; adjusted hazard ratio(a HR)= 2.92,95%CI:1.36-6.25]. Palliative chemotherapy was statistically associated with an increase in stent patency(P = 0.009; a HR = 0.27,95%CI:0.10-0.72).CONCLUSION:CEA levels can easily be measured at the time of stent placement and may help clinicians to predict stent patency and determine the appropriate stent procedure.

关键词： Malignant gastroduodenal obstruction Stent Patency Predictive factor Carcinoembryonicantigen

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