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Recent updates of precision therapy for gastric cancer: Towards optimal tailored management

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World Journal of Gastroenterology 2016年第19期22卷 4638-4650页

Signaling pathways of gastric carcinogenesis and gastric cancer progression are being avidly studied to seek optimal treatment of gastric cancer. Among them, hepatocyte growth factor (HGF)/c-MET, phosphoinositide 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) and janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathways have been widely investigated. Their aberrant expression or mutation has been significantly associated with advanced stage or poor prognosis of gastric cancer. Recently, aberrations of immune checkpoints including programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) have been suggested as an important step in the formation of a microenvironment favorable for gastric cancer. Accomplishments in basic research have led to the development of novel agents targeting these signaling pathways. However, phase III studies of selective anti-HGF/c-MET antibodies and mTOR inhibitor failed to show significant benefits in terms of overall survival and progression-free survival. Few agents directly targeting STAT3 have been developed. However, this target is still critical issue in terms of chemoresistance, and SH2-containing protein tyrosine phosphatase 1 might be a significant link to effectively inhibit STAT3 activity. Inhibition of PD-1/PD-L1 showed durable efficacy in phase I studies, and phase III evaluation is warranted. Therapeutic strategy to concurrently inhibit multiple tyrosine kinases is a reasonable option, however, lapatinib needs to be further evaluated to identify good responders. Regorafenib has shown promising effectiveness in prolonging progression-free survival in a phase II study. In this topic highlight, we review the biologic roles and outcomes of clinical studies targeting these signaling pathways.

关键词： Gastric cancer Hepatocyte growth factor Mammalian target of rapamycin Signal transducer and activator of transcription 3 Programmed cell death ligand-1

Proton pump inhibitor: The dual role in gastric cancer

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World Journal of Gastroenterology 2019年第17期25卷 2058-2070页

作者： Moon Kyung Joo jong-jae park Hoon Jai Chun Division of Gastroenterology Department of Internal MedicineKorea University College of Medicine Guro Hospital Division of Gastroenterology and Hepatology Department of Internal MedicineInstitute of Digestive Disease and NutritionKorea University College of Medicine

Proton pump inhibitors(PPIs) are one of the most frequently used medications for upper gastrointestinal diseases. However, a number of physicians have raised concern about the serious side effects of long-term use of PPIs, including the development of gastric cancer. Recent epidemiological studies have reported a significant association between long-term PPI intake and the risk of gastric cancer, even after successful Helicobacter pylori eradication. However, the effects of PPIs on the development of pre-malignant conditions such as atrophic gastritis or intestinal metaplasia are not fully known, suggesting the need for comprehensive and confirmative studies are needed in the future. Meanwhile,several experimental studies have demonstrated the effects of PPIs in reducing chemoresistance in gastric cancer cells by modulating the acidic microenvironment, cancer stemness and signal transducer and activator of transcription 3(STAT3) signaling pathway. The inhibitory effects of PPIs on STAT3 activity may overcome drug resistance and enhance the efficacy of conventional or targeted chemotherapeutic agents. Taken together, PPIs may"play dual role" in gastric carcinogenesis and treatment of gastric cancer.

关键词： Proton pump inhibitor Gastric cancer Drug resistance Signal transducer and activator of transcription 3

Do you have what it takes for challenging endoscopic submucosal dissection cases?

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World Journal of Gastroenterology 2011年第31期17卷 3580-3584页

作者： Kyoung-Oh Kim Sung Jung Kim Tae Hyeon Kim jong-jae park Division of Gastroenterology and Hepatology Department of Internal MedicineHallym University Medical Center Division of Gastroenterology and Hepatology Department of Internal MedicineWonkwang University Hospital Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University Guro Hospital Korea University College of Medicine

Endoscopic submucosal dissection(ESD) is a widely accepted treatment for early gastric cancer(EGC),especially in Korea and *** criteria for the therapeutic use of ESD for EGC have been expanded ***,attention should be drawn to the technical feasibility of the ESD treatment which depends on a lesion's location,size or fibrosis level,or operator's *** the case of a lesion with a high level of difficulty,a more experienced operator is ***,the treatment for a lesion with a high level of difficulty should be performed according to the degree of the operator's *** this paper,the authors describe the ESD procedure for lesions with a high level of difficulty.

关键词： Endoscopic submucosal dissection Anatomical location Technical feasibility

Antiviral efficacy of adefovir dipivoxil versus lamivudine in patients with chronic hepatitis B sequentially treated with lamivudine and adefovir due to lamivudine resistance

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World Journal of Gastroenterology 2007年第30期13卷 4072-4079页

作者： Yeon Seok Seo Ji Hoon Kim jong Eun Yeon jong-jae park jae Seon Kim Kwan Soo Byun Young-Tae Bak Chang Hong Lee Division of Gastroenterology and Hepatology Department of Internal Medicine Korea University College of Medicine Seoul Korea Division of Gastroenterology and Hepatology Department of Internal Medicine Konkuk University College of Medicine Seoul Korea

AIM： To compare the antiviral efficacy of adefovir （ADV） in lamivudine （LMV）-resistant patients with LMV treatment in nucleoside-naive patients, using serum samples collected sequentially during the course of treatment progressing from LMV to ADV.METHODS： Forty-four patients with chronic hepatitis B （CHB） were included. The patients were initially treated with LMV and then switched to ADV when LMV resistance developed. Antiviral efficacy was assessed by measuring the following： reduction in serum HBV DNA from baseline, HBV DNA negative conversion （defined as HBV DNA being undectable by the hybridization assay）, and HBV DNA response （either HBV DNA level ≤ 10^s copies/mL or a ≥ 2 log10 reduction from baseline HBV DNA level）.RESULTS： After two and six months of treatment, HBV DNA reduction was greater with LMV compared to ADV treatment （P = 0.021）. HBV DNA negative conversion rates were 64% and 27% after one month of LMV and ADV treatment respectively （P = 0.001）. Similarly, HBV DNA response rates were 74% and 51% after two months of LMV and ADV treatment respectively （P = 0.026）. The time taken to HBV DNA negative conversion and to HBV DNA response were both delayed in ADV treatment compared with LMV.CONCLUSION： The antiviral efficacy of ADV in LMV-resistant patients is slower and less potent than that with LMV in nucleoside-naive patients during the early course of treatment.

关键词： Chronic hepatitis B Lamivudine Adefovir Treatment efficacy

Upper gastrointestinal bleeding from duodenal vascular ectasia in a patient with cirrhosis

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World Journal of Gastroenterology 2007年第38期13卷 5154-5157页

作者： Beom jae Lee jong-jae park Yeon Seok Seo Ji Hoon Kim Aeree Kim jong Eun Yeon jae Seon Kim Kwan Soo Byun Young-Tae Bak Division of Gastroenterology Department of Internal Medicine Korea University College of Medicine Seoul Korea

We report a cirrhotic patient with duodenal vascular ectasia and spontaneous bleeding. The bleeding was successfully controlled with argon plasma coagulation. Duodenal vascular ectasia may be a cause of upper gastrointestinal bleeding in patients with cirrhosis, and argon plasma coagulation may be effective and safe to achieve hemostasis of this lesion.

关键词： Vascular ectasia Duodenum Cirrhosis Gastrointestinal hemorrhage Hemostasis

Usefulness of CA 19–9 for pancreatic cancer screening in patients with new-onset diabetes

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Hepatobiliary & Pancreatic Diseases International 2018年第3期17卷 263-268页

作者： Jung Wan Choe Hyo Jung Kim jae Seon Kim jaehyung Cha Moon Kyung Joo Beom jae Lee jong-jae park Young-Tae Bak Department of Internal Medicine Korea University College of MedicineSeoul 08308Korea Department of Biostatistics Korea University Medical CenterSeoul 08308Korea

Background： Generally, carbohydrate antigen 19–9 （CA 19–9） is not useful for screening pancreatic cancerin the asymptomatic general population. This study aimed to evaluate the utility of CA 19–9 level as a scre... 详细信息

关键词： Diabetes mellitus Pancreatic neoplasms Early detection of cancer Carbohydrate antigen 19-9 Bilirubin

Removal of press-through-packs impacted in the upper esophagus using an overtube

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World Journal of Gastroenterology 2006年第36期12卷 5909-5912页

作者： Yeon Seok Seo jong-jae park Ji Hoon Kim Jin Yong Kim jong Eun Yeon jae Seon Kim Kwan Soo Byun Young-Tae Bak Department of Internal Medicine Korea University Medical Center Guro Hospital Seoul Korea Department of Internal Medicine Sungkyunkwan University School of Medicine Seoul Korea

Foreign bodies in the upper esophagus should be re-moved as soon as possible to avoid serious complica-tions. However, removals of foreign bodies in the upper esophagus are very difficult, especially if they have sharp edges, such as press-through-packs (PTPs). We expe-rienced four cases of the impacted PTPs in the upper esophagus which was successfully extracted endoscopi-cally with the overtube. Because two edges of PTPs were so firmly impacted in the esophageal wall in all cases, the PTPs were not movable in the upper esophagus. However, after insertion of the overtube, PTPs became movable and were successfully extracted and no serious complications occurred after extraction of PTPs. In one case, insertion of the overtube rapidly expanded the up-per esophagus and PTP progressed to the gastric cavity and it could be extracted with the endoscopic protector hood. The endoscopic removal with the overtube was a simple, safe and effective technique for the removal of the impacted PTPs in upper esophagus.

关键词： Esophagus Foreign body Endoscopy

Inverted cystic tubulovillous adenoma involving Brunner’s glands of duodenum

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World Journal of Gastroenterology 2007年第23期13卷 3262-3264页

作者： Ji Hoon Kim Jung Woo Choi Yeon Seok Seo Beom jae Lee jong Eun Yeon jae Seon Kim Kwan Soo Byun Young-Tae Bak Insun Kim jong- jae park Division of Gastroenterology Department of Internal Medicine Korea University College of Medicine Seoul South Korea Department of Pathology Korea University College of Medicine Seoul South Korea

Benign neoplasia of the duodenum are very rare. Moreover, duodenal tubulovillous adenomas are more uncommon lesions. The microscopic structure of tubulovillous adenoma has frond-like projection of mucosa with branching papillary structure and generally upward growth into the lumen. We describe a 72-year-old man who showed aduodenal tubulovillous adenoma with unusual inverted cystic growth pattern. Interestingly, this tubulovillous adenomatous lesion was interrupted by gastric metaplasia in the deep portion of the cyst and was closely surrounded by Brunner’s glands. Although histogenesis of gastric metaplasia of duodenum is not fully understood, Brunner’s glands has been suggested as a precursor for gastric metaplasia. Therefore, these findings argued that this adenoma arises from Brunner’s glands through gastric metaplasia. This is the first case of inverted cystic tubulovillous adenoma involving Brunner’s glands of duodenum with gastric metaplasia.

关键词： Brunner's glands Duodenum Gastric metaplasia Tubulovillous adenoma

Efficacy and safety of ecabet sodium on functional dyspepsia:A prospective,double-blinded,randomized,multi-center controlled trial

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World Journal of Gastroenterology 2006年第17期12卷 2756-2761页

作者： Jun Haeng Lee jae J Kim Ki-Baik Hahm Dong Ho Lee Nayoung Kim Sung Kook Kim jong jae park Seok Reyol Choi jong Hun Lee Soo Teik Lee Eun Hyun Lee jong Chul Rhee Department of Medicine Sungkyunkwan University School of Medicine SeoulKorea Department of Gastroenterology Ajou University School of Medicine SuwonKorea Department of Internal Medicine Seoul National University Bundang Hospital SeoungnamGyeonggi-doKorea Department of Internal Medicine Kyungpook National University College of Medicine DaeguKorea Department of Internal Medicine Korea University Guro Hospital SeoulKorea Department of Internal Medicine Dong-A University BusanKorea Department of Internal Medicine Chonbuk National University College of Medicine ChonjuKorea Department of Preventive Medicine Graduate School of Public Health Ajou UniversitySuwonKorea

AIM： To compare ecabet sodium and cimetidine in relieving symptoms of functional dyspepsia. METHODS： We performed a multi-center, prospective, randomized, double-blinded controlled trial to compare the clinical efficacy of ecabet sodium and cimetidine in patients with functional dyspepsia. Two-hundred and seventy-two patients with dyspeptic symptoms fulfilling the Rome-II criteria were enrolled from 7 centers. In the study group （115 patients）, 1.5 g ecabet sodium was given twice a day. In the control group （121 patients）, 400 mg cimetidine was given twice a day. Symptoms and parameters of quality of life were analyzed at baseline, 3, 14, and 28 d after initiating the treatment. RESULTS： Two-hundred and thirty-six patients completed the clinical trial. After 4 wk of treatment, the rates of improvement in patients with dyspeptic symptoms were not different between two groups （77.4% in the ecabet group and 79.3% in the cimetidine group, respectively, P 〉 0.05）. Likewise, the rates of symptomatic improvement were not different at 3 d and 14 d. The parameters of quality of life did not change significantly during the study period in both groups. There was no clinically significant adverse event in both groups.

关键词： Functional dyspepsia Ecabet sodium Cimetidine