위선암에서 인환 세포암의 임상적 특징에 관한 연구

김준희,김예희 인제대학교 1999 仁濟醫學 Vol.20 No.1

위선암 중 인환 세포암은 다른 종류의 위선암과는 달리 젊은 연령에 잘 생기고 조기 위암 환자에서 많이 발견되며 예후가 나쁜 것으로 알려져 있다. 저자들은 근치 위 절제술을 받아서 위선암으로 확인된 환자를 인환 세포암과 비인환 세포암의 두 집단으로 구분한 뒤 이들의 병리 조직학적 소견 및 임상상 그리고 전체 환자를 조기 위암과 진행된 위암으로 구분하여 두 집단 사이에 임상적 차이가 실제로 존재하는 지를 밝히고자 하였다. 이를 바탕으로 인환 세포암 환자를 치료 하는데 있어서 병리 조직의 주의 깊은 검색 및 병의 조기 발견의 중요성에 대하여 연구하였다. To compare the clinical characteristics of the signet ring cell carcinoma with those of other histologic subtypes in the setting of surgically resectable diseases to identify the difference in clinical courses between the signet ring cell gastric carcinoma and other gastric carcinomas. The study was conducted retrospectively by reviewing the clinicopathological data on 167 consecutive gastric cancer patients who underwent surgical resection from January 1989 through December 1990 at the Inje University Seoul Paik Hospital. The patients were stratified to 37 patients with signet ring cell carcinoma and 130 patients with other histologic subtypes. Clinical characteristics of two groups were compared with regards to age, tumor location in stomach, degree of tumor infiltration, nodal metastasis, and survival duration. Student t-test and chi-square test and log rank test of Kaplan-Meier survival plot by SPSS/PC computer program were used for statistical anaysis of the variables and survival durations respectively. Among 167 cases of gastric adenocarcinoma, 37(22%) cases were identified as signet ring cell carcinoma. The average age of the patients with signet ring cell carcinoma was 51.0+10.6 versus 55.4+10.6, the average age of the patients with other histologic types (p<0.05). Early gastric cancers comprised 18.56% of all gastric cancers studied, 24.2% of signet ring cell carcinomas versus 16.92% of other histological types of gastric cancer (p>0.05). The average age of early gastric cancer patients with signet ring cell subtype was 50.9+10.4 versus 56.1+10.3, that of early gastric cancer patients with other histologic subtypes (p<0.05). The most common location of early signet ring cell carcinoma was gastric corpus (88.9%) as was in other-histologic subtypes (50.0%) (p>0.05). Tumor infiltration was limited to muscularis propria in 51.4% of signet ring carcinomas compared to 43.1% of other histologic subtypes(p>0.05). Tumor infiltration was confined to serosa without nodal metastasis in 42.4% of signet ring cell carcinomas versus 36.2% of other histologic subtypes(p>0.05). The overall 3 year and 5 year survival rates of all gastric cancer patients studied were 71.6% and 65.5% respectively. The 3 year and 5 year survival rates of signet ring cell carcinoma patients were 64.9% and 62.2% versus those of patients with other histologic subtypes, 73.1% and 66.4% respectively(p>0.05). There was no death of early gastric cancer patients during the observation period. The signet ring cell carcinoma was more prevalent in women and younger age group than other histologic subtypes as other reports. The signet ring cell carcinoma tended to locate in gastric corpus. When surgically amenable, the pathologic staging of signet ring carcinoma and that of other subtypes were not different meaningfully. Either were the survival durations. However, it was worthy of note to notice several findings. Early gastric cancer was more prevalent in signet ring cell carcinoma than other histologic subtypes although the difference did not reach a statistically discriminable power. Signet ring cell carcinoma implied a slight worse survival duration than other histologic subtypes despite that signet ring carcinoma tended to be in a slight lower stage than that of other histologic subtypes on surgical pathologic evaluation. The differences did not reach a statistical significance either.

Helicobactor pylori Infection and Gastric Carcinoma in Korea

Kang, Seok Jin,Jee, Mi Kyung,Park, Yeon Joon,Choi, Yeong Jin,Kim, Byung Kee,Kim, Sun Moo CATHOLIC MEDICAL CENTER 1994 Bulletin of the Clinical Research Institute Vol.22 No.2

Gastric carcinoma is the most frequent malignant disease and the leading cause of cancer death in Korean. And the incidence of gastric carcinoma can change dramatically from place to place and from one generation to the next, if has been hypothesized that its incidence is determined largely by environmental rather than genetic factors. One specific histologic type of gastric carcinoma, the so-called intestinal type, is particularly prone to the regional and temporal variations of an environmentally related malignant condition. The recent identification of Helicobacter pylori (H. pylori) in chronic inflammatory conditions of the stomach, however, has stimulated interest in its potential role in carcinogenesis. H. pylori has been linked to chronic atrophic gastritis, and established precursor of intestinal type of gastric carcinoma. We designed a study to estimate the prevalence of H. pylori in 41 patients of intestinal type of gastric carcinoma and 42 patients of diffuse type gastric carcinoma and in 88 age and sex matched control persons by histologic examination of stomach in Warthin-Starry staining. The results were as follow; 1. In gastric carcinoma, 85.37% of 41 patients of intestinal type carcinoma, and 59.2% of 42 patients of diffuse type carcinoma were positive for H. pylori. In control group, 27.7% of 88 persons were positive for H. pylori. 2. To compare to control group, intestinal type of gastric carcimona was higher incidence of H. pylori infection to than that of diffuse type of gastric carcinoma. These findings suggest that H. pylori infection of stomach may be related to the gastric carcinoma in Korean. And H. pylori is more frequently found in the intestinal type of gastric carcinoma than diffuse type of gastric carcinoma.

위암에서의 Transforming Growth Factor-B의 발현에 대한 연구

구자영(Ja Young Koo),공덕경(Deuk Kyung Kong),박종남(Jeong Nam Park),박선자(Seon Ja Park),정숙금(Seuk Kum Chung),허만하(Man Ha Huh) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3

N/A Background/Aims: Transforming growth factor-g(TGF-g), mutifanctional cytokine, has been suggested to have many actions related to tumor progression and tumor cell behavior, because of its increased expression in cancer cells. Only small number of studies were done for its role in gastric carcinoma, and we have conducted this study to elucidate in depth the role of TGF-/3 in gastric carcinoma progression. Methods: Expression of TGF-/3, epidermal growth factor(EGF), p53 and proliferating cell nuc1ear antigen(PCNA) in gastric carcinoma was studied by immunohi- stochemical method applied to paraffin-embedded tissue sections of endoscopic biopsy materials of 71 cases of gastric carcinoma(24 early and 47 advanced) and imrnunoreactivity of antigens was correlated with histological differentintion of carcinoma, degree of tumor infiltration of mononu- clear cells, serum levels of alphafetoprotein(AFP) and carcinoembryonic antigen(CEA), and pre- sence of distant metastases. Results: TGF-0 in carcinoma tissue was expressed in 31 cases(43.7%) of total 71 cases, and immunopositivity of TGF-0 in advanced gastric carcinoma(AGCj was 55.3%, which was much higher than that(20.8%) of early gastric carcinoma(EGC)(pC0.05). 1here was no significant difference in imrnunopositivity of TGF-0 between different differentiation group. There was negative correlation between expression of TGF-g and degree of tumor infiltration of mono- nuclear cells(p0.05). Immunopositivity of TGF-0 in AGC group was significantly higher in the cases with elevated serum AFP level(82.6%) than that with normal serum AFP leve1(29.1%)(p. 0.05), and also was significantly higher in the cases with elevated serum CEA level(87.6%) than that with normal serum CEA level(40.6%)(pw0.05). There was no correlation between expression of TGF-g and presence of distant metastases or metastatic sites. There was significant positive correlation between expression of TGF-g and EGF(p=0.004), TGF-g and p53(p=0.02) but no correlation between expression of TGF-g and PCNA. Conclusions: Above data indicate that TGF-f3 rnay contributes to gastric carcinoma progression by immunosuppressive action and fibrosis, by growth-stimulatory action via EGF modulation, and that loss of growth-inhibitory effects of TGF-0 on gastric carcinoma, which is related to p53 mutation, may be a critical factor in gastric carcinoma progression. (Korean J Gastroenterol 1996;28:336 - 348)

위암에서의 nm23 단백 발현 양상에 대한 면역 조직 화학적 검색 -위암의 발생 및 전이와 nm23 발현과의 관계-

손진희,박혜림,박영의 대한병리학회 1996 Journal of Pathology and Translational Medicine Vol.30 No.6

Survival of Node-Positive Mucosal Gastric Carcinoma Patients

Yong Chul Cho,Ho Goon Kim,Mi Ran Jung,Seong Yeob Ryu,Young Kyu Park,Dong Yi Kim,Young Jin Kim 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.1

Purpose: The presence or absence of lymph node metastasis is significantly associated with the survival of patients with gastric carcinoma. We compared node-positive and node-negative mucosal gastric carcinoma patients to identif y the clinicopathological characteristics of node-positive mucosal gastric carcinoma. We also evaluated the variables associated with lymph node metastasis and survival in this group of patients. Methods: Of the 580 mucosal gastric carcinoma patients, 32 (5.5%) were node-positive. A statistical analysis using the Cox model was performed to determine the factors that can predict the patients’ outcomes. Results: The mean tumor size was significantly larger in the patients with node-positive mucosal gastric carcinoma than that in the node-negative patients (3.3 vs. 1.8 cm; P<0.001). The overall survival rate was lower for the patients who were node-positive than for the patients who were node-negative (83.3% vs. 91.4%, respectively), but the difference was not significant (P>0.05). Using the Cox proportional hazard regression model, tumor size was an independent statistically significant parameter associated with lymph node metastasis (risk ratio: 4.70, 95% confidence interval: 1.20 to 18.35; P<0.05). Conclusion: Tumor size is the most reliable predictor of lymph node metastasis for patients with node-positive mucosal gastric carcinoma. Nevertheless, a large tumor size is not associated with a poor outcome for patients with node-positive mucosal gastric carcinoma. The patients with node-positive mucosal gastric carcinoma showed good survival rates after undergoing gastrectomy and extensive node dissection.

위선암에서 장형화생의 변이형에 관한 연구

제갈승주,최영자,곽효일,노정섭,최찬 대한임상병리사협회 2001 대한임상병리사회지 Vol.21 No.1

노인 위암의 임상 병리학적 특징 및 Helicobacter pylori 감염

김혜랑,문영수,박영숙 凡石學術奬學財團 1999 凡石學術論文集 Vol.3 No.-

부산지역 한국인 위암종의 병리학적 및 역학적 분석

이숙녀,석동수,정연재,이선경 대한병리학회 1990 Journal of Pathology and Translational Medicine Vol.24 No.4

위암종에서 Vascular Endothelial Growth Factor에 관한 면역조직화학적 연구

장태정,김정란 대한병리학회 1997 Journal of Pathology and Translational Medicine Vol.31 No.5

Decreased Expression of 15-hydroxyprostaglandin Dehydrogenase in Gastric Carcinomas

장태정,지예섭,정기훈 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.6

Purpose: Gastric carcinoma tissues release high level of prostaglandin E2 (PGE2) when compared to non-neoplastic mucosa, and cyclooxygenase-2 (COX-2), which is the rate-limiting enzyme in prostaglandin (PG) biosynthesis, is often overexpressed in gastric carcinomas and during gastric carcinogenesis. However, little is known about the expression of 15-hydroxyprostaglandin dehydrogenase (15-PGDH), the key enzyme responsible for the biological inactivation of PG, in gastric carcinomas. Materials and Methods: We investigated the expression of 15-PGDH in 28 cases of advanced gastric carcinomas by Western blot analysis and also the relation between its expression and the gene promoter methylation. Results: 15-PGDH expression was significantly decreased in gastric carcinomas compared to corresponding non-neoplastic tissues and inversely correlated with the expression of proliferating cell nuclear antigen in gastric carcinomas. However, there was no correlation between 15-PGDH expression and pathological findings such as nodal metastasis and vascular invasion. Promoter hypermethylation of 15-PGDH gene was not detected in carcinomas, with only a negligible expression of the enzyme. Conclusion: Our results suggested that 15- PGDH has tumor suppressor activity in gastric carcinomas.