Cancer Research and Treatment

MET-Amplified Intramucosal Gastric Cancer Widely Metastatic after Complete Endoscopic Submucosal Dissection: Dakeun Lee, Young Chul Kim, Kee Myung Lee, Joon-Kee Yoon, Young-Bae Kim; Cancer Res Treat. 2015;47(1):120-125. Published online August 25, 2014; DOI: https://doi.org/10.4143/crt.2013.137

Intramucosal gastric cancer (IGC) is associated with a very low risk of lymph node metastasis; thus it is the main candidate for minimally invasive surgical procedures, such as endoscopic submucosal dissection (ESD). Herein, we document an extraordinary case of IGC, which showed a very aggressive clinical course. A 66-year-old female underwent ESD for early gastric cancer. Histologically, the tumor consisted mainly of moderately differentiated adenocarcinoma measuring 1.6 cm in diameter, and the tumor was confined to the mucosa. Despite annual esophagogastroduodenoscopic follow-up, the tumor recurred, with wide metastasis to multiple lymph nodes and bones throughout the body after three years. Fluorescence in situ hybridization study demonstrated MET gene amplification as well as low grade polysomy 7 in both original and recurrent tumors. The clinical characteristics of metastatic IGCs and the implication of MET amplification are discussed.

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MicroRNA signatures associated with lymph node metastasis in intramucosal gastric cancer
Seokhwi Kim, Won Jung Bae, Ji Mi Ahn, Jin-Hyung Heo, Kyoung-Mee Kim, Kyeong Woon Choi, Chang Ohk Sung, Dakeun Lee
Modern Pathology.2021; 34(3): 672. CrossRef

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A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians: Do Yeun Kim, Jin Seok Ahn, Kyung Hee Lee, Young Chul Kim, Juneyoung Lee, Si-Young Kim; Cancer Res Treat. 2014;46(2):131-140. Published online April 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.2.131

Abstract PDF PubReader ePub

Purpose

Although cancer pain is prevalent, under-treatment still remains a problem. Knowledge of and compliance with guidelines for management of cancer pain were analyzed for exploration of physician-related barriers to cancer pain management. In addition, physicians' knowledge and its correlation with cancer pain control were audited.

Materials and Methods

From July 8 to December 2, 2010, a nationwide survey of house staff enquired about their knowledge of cancer pain control guidelines, and the medical records of patients under their care were analyzed.

Results

In total, 180 physicians participated in the study. Their average score for knowledge was 14.6 (range, 7 to 19; maximum possible, 20). When the knowledge score was divided into low, medium, and high scores, patients receiving care from physicians with high levels of knowledge tended to have better cancer pain control (p<0.001). Of the total patients with severe pain, 19.5% were not prescribed strong opioids, and 40% were not prescribed any medication for breakthrough pain.

Conclusion

Physicians' knowledge of guidelines for control of cancer pain showed an association with improvement of pain management. Overall adherence to the guidelines was lacking. Continuous interventions such as education and audits regarding cancer pain control guidelines for physician are needed.

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Physicians’ views of the use of morphine in palliative care: a cross-sectional survey from a tertiary care centre in Northern Sri Lanka
Balasingam Nisahan, Shobika Raviraj, Sancica Navaratnam, Rajeshkannan Nadarajah
BMC Research Notes.2025;[Epub] CrossRef
Compliance with the breakthrough cancer pain European guidelines and impact on patients' quality of life: an observational prospective study
Paolo Bossi, Tatiana Pietrzyńska, César Margarit Ferri, Irene Mansilla, Valeria Tellone, Sara Fioravanti, Giorgio Di Loreto, Alessandro Comandini
Frontiers in Pain Research.2024;[Epub] CrossRef
A Survey of Knowledge and Barriers of Healthcare Professionals toward Opioid Analgesics in Cancer Pain Management
Nehad M. Ayoub, Malak Jibreel, Khawla Nuseir, Ghaith M. Al-Taani, Manish Gupta
International Journal of Clinical Practice.2022; 2022: 1. CrossRef
Rapid-Onset Opioids for Management of Breakthrough Cancer Pain: Considerations for Daily Practice
Paolo Bossi, Yolanda Escobar, Federico Pea
Frontiers in Pain Research.2022;[Epub] CrossRef
Ozono y COVID-19: bases fisiológicas y sus posibilidades terapéuticas según el estadio evolutivo de la infección por SARS-Cov-2.
Marcos Edgar Fernández Cuadros, María Jesús Albaladejo Florin, Sandra Alava Rabasa, Daiana Peña Lora, Olga Susana Pérez Moro
Revista de la Sociedad Española del Dolor.2021;[Epub] CrossRef
Comparing Methadone Rotation to Consensus Opinion
Michael A. Smith, Kyle C. Quirk, D'Anna C. Saul, Phillip E. Rodgers, Maria J. Silveira
Journal of Pain and Symptom Management.2020; 59(1): 116. CrossRef
Physician’s Attitude toward Treating Breakthrough Cancer Pain in Korea
Min Seok Seo, Jae Yong Shim, Youn Seon Choi, Do Yeun Kim, In Gyu Hwang, Sun Kyung Baek, Jin Young Shin, Juneyoung Lee, Chang Geol Lee
The Korean Journal of Hospice and Palliative Care.2017; 20(1): 18. CrossRef
Commentary on “A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians”
Kieran Walsh
Cancer Research and Treatment.2014; 46(4): 425. CrossRef

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Genetic Polymorphism of Epoxide Hydrolase and GSTM1 in Lung Cancer Susceptibility of Korean Population: Jun Hwa Hwang, Kyu Sik Kim, Yu Il Kim, Eun Joung Kim, Kyung Hwa Park, Gye Jung Cho, Jin Young Ju, Sung Chul Lim, Young Chul Kim, Kyung Ok Park, Jong Tae Park, Sung Ja Ahn; Cancer Res Treat. 2003;35(6):483-488. Published online December 31, 2003; DOI: https://doi.org/10.4143/crt.2003.35.6.483

Abstract PDF: PURPOSE
Although 80~90% of patients with lung cancer are smokers, only 11% of smokers develop lung cancer. Genetic susceptibility according to the polymorphism of the epoxide hydrolase (mEPHX) gene and homozygous deletion of GSTM1 (M1 subunit of Glutathione S transferase) was studied in this case control study. MATERIALS AND METHODS: Genomic DNA from 76 subjects with lung cancer (40 squamous cell carcinoma, 13 adenocarcinoma, 10 subtype undetermined non-small cell lung cancer, and 13 small cell lung carcinoma) and 62 age- matched controls were extracted from peripheral white blood cells. PCR and RFLP (restriction fragments length polymorphism) with restriction enzyme (RsaI) and automatic sequencing were used for mEPHX genotyping (T-->C, Tyr113His) in exon 3 and (A-->G, His139Arg) in exon 4. Looking for homozygous deletions of GSTM1, multiplex PCR with primers for the GSTM1 gene and coagulation factor V gene (as positive control) were performed. RESULTS: The age distribution between the cancer and control groups were similar (63.6 7.2 vs. 61.1 7.9 years). The lung cancer group, however, had more smokers (73.3%, 44/60) than the control group (21/54, 38.9%, p<0.001). The rate of homozygous deletion of the GSTM1 gene was significantly higher in the lung cancer group (65.8%, 50/76) than in the control group (46.8%, 29/62, p<0.05), causing the relative risk of GSTM1 deletion for lung cancer as 2.19 (95% CI: 1.10~4.35, p=0.02). Among 118 subjects whose mEPHX gene polymorphisms were studied, 62 (52.5%) subjects showed genotypes with slow enzyme activity while 45 (38.1%) showed normal enzyme activity and 11 (9.3%) showed fast enzyme activity. There was no significant difference in the distribution of mEPHX gene polymorphisms between the two groups. CONCLUSION: The homozygous deletion of the GSTM1 gene was associated with high lung cancer susceptibility, whereas the mEPHX genotype showed no significant connection with risk of lung cancer in a sample Korean population.

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Effect of Vinorelbine, Ifosfamide and Cisplatin Combination Chemotherapy in Stage III-IV Non-Small-Cell Lung Cancer: Young Chul Kim, So Young Lee, Hong Joo Cho, Jung A Kim, So Hyang Song, Chi Hong Kim, Hoon Kyo Kim, Meyung Im Ahn, Jin Young You, Sung Whan Kim, Deng Gon Cho, Kyu Do Cho, Jin Hyung Kang; Cancer Res Treat. 2002;34(5):352-356. Published online October 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.5.352

Abstract PDF: PURPOSE
To evaluate the response rates, toxicitiesy, and survival rates, to vinorelbine (Navelbine(R)), cisplatin and ifosfamide combination chemotherapy, of the patients with inoperable NSCLC (stage III and IV), who received vinorelbine (Navelbine(R)), cisplatin, ifosfamide combinationthe mentioned chemotherapy every 4 weeks.
MATERIALS AND METHODS
This study included 26 patients with inoperable NSCLC (stage III and IV), who attended St. Vincent's Hospital Bbetween April 1999 and December 2001, 26 patients were included at St.Vincent's Hospital. The chemotherapy regimen consisted of vinorelbine (25 mg/m2 on days 1 and 8), ifosfamide (1,500 mg/m2 on days 1- and 2 with mesna), and cisplatin (30 mg/m2 on days 1- to 3). The cycles were administered every 4 weeks. A 25% reduction in the doses reduction was applied into subsequent courses if there werewas grade 3~4 neutropenia.
RESULTS
The median age was 63 (range, 44~73) years and the male : to female ratio was 19 : 7. One patient had stage IIIa, 6 had stage IIIb and 19 had stage IV. Twenty two patients had an ECOG performance status of 0 or 1, andwith 4 hadhave one of 2. Eighteen of the patients had adenocarcinoma, 7 had squamous cell carcinomas, and 1 had an undifferentiated NSCLC. Two patients were innot able to be evaluatedble due to follow-up loss. Among Of the 24 patients able to be evaluatedble patients, 1 patient had a complete response and 9 patients hada partial responses, and thewith an overall response rate wasof 41.7%. During a total of 104 cycles, grade 3 neutropenia occurred in 29%, grade 4 neutropenia in 12%, grade 3~4 thrombocytopenia in 4%, grade 3 anemia in 11%, and grade 3~4 mucositis in 2%. The mean time to progression was 6.4 months (range 1~13) and the median overall survival was 10 months (range 1.5~32).
CONCLUSION
The combination of vinorelbine, ifosfamide and cisplatin, in the dose and schedule employed in this study, shows an response rate of 41.7%, but, because grade 3- or 4 neutropenia occurred in 41%, a careful investigation is needed.

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Relationship of HPV Detection and p53 Expression in Urinary Bladder Cancer: Keun Hong Kee, Hyang Mee Shin, Young Chul Kim; J Korean Cancer Assoc. 2000;32(1):129-135.

Abstract PDF: PURPOSE
The purpose of this study was to investigate the relationship between aberrant p53 expression and the presence of human papillomavirus DNA in transitional cell carcinomas of the urinary bladder.
MATERIALS AND METHODS
This study analyzed 30 paraffin-embedded transitional cell carcinoma of the urinary bladder, including 10 cases of grade I, 10 cases of grade II, and 10 cases of grade III, for the presence of DNA-HPV and abnormal accumulation of p53. We used immunohistochemical staining for p53 protein and in situ hybridization for HPV DNA, respectively.
RESULTS
Overall positive rate of HPV DNA type 16 and type 18 was 60.0% and 53.3%, respectively. Nuclear accumulation of p53 was found in 13 cases (43.3%) of all transitional cell carcinomas. In HPV DNA type 16 positive cases, the p53 was positive in 8 cases and negative in 10 cases. In HPV DNA type 16 negative cases, the p53 was positive in 5 cases and negative in 7 cases. In HPV DNA type 18 positive cases, the p53 was positive in 7 cases and negative in 9 cases. In HPV DNA type 16 negative cases, the p53 was positive in 6 cases and negative in 8 cases.
CONCLUSION
This results suggest that HPV infection and p53 gene accumulation may contribute to the significant role in the carcinogenesis of the utinary bladder. In additon, HPV infection and p53 accumulation may be related to tumor progression and higher grade.

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A Case-Control Study of the Association between Glutathione S-transferase (GST) M1 and T1 Genetic Polymorphism and Breast Cancer in Korean Women: Preliminary report: Sue Kyung Park, Dae Hee Kang, Byung Joo Park, Seung Joon Lee, Young Chul Kim, Han Sung Kang, Jun Suk Suh, Se Hyun Ahn, Dong Young Noh, Kuk Jin Choe; J Korean Cancer Assoc. 1999;31(4):653-662.

Abstract PDF: PURPOSE
A hospital-based case-control study was conducted to evaluate the role of glutathione-S-transferase (GST) Ml and Tl genetic polymorphism for developing breast cancer in Korea.
MATERIALS AND METHODS
Histologically confirmed incident cases of breast cancer (n=176) were selected from inpatients at the Department of General Surgery, Seoul National University Hospital (SNUH), Borame hospital, and Asan Medical Center from 1994 to 1998. Women with no self-reporting past history of any malignancies who were selected from the inpatients at the same department at three hospitals during the same period served as controls (n 118). Information on the life-styles including reproductive factors were obtained by interview using questionnaire. Age and education adjusted odds ratio and 95% confidence interval were estimated by unconditional linear logistic regression.
RESULTS
These subjects had similar risk factors for developing breast cancer to general Korean population based on other epidetniologic studies previously performed in Korea. GSTI1 null type showed a borderline significance relation in the breast cancer risk (adjusted OR=1.6, 95% CI=0.96-2.62), however, GSTM1 null type was not significant (adjusted OR=1.1, 95% CI=0.67-1.80). Particularly noteworthy was an borderline increasing tendency (p<0.1) of the breast cancer risk with the risk null genotypes assessed by multivariate logistic regression model after adjusting age and education: the putative low-risk genotype with both GSTM1 & GSTT1 wild type, OR=1.0; one putative high risk genotype with GSTM1 null or GSTMl null type, OR=1.9 (95% CI=0.92-3.74); all two putative high risk genotype with both GSTM1 & GSTT1 null type, OR=2.0 (95% CI=0.89-4.68).
CONCLUSIONS
These findings suggest that both GSTMl and GSTT1 null type might be the risk factor of developing breast cancer in Korean women. Further investigation with larger sample size should be needed to provide more concrete information on the role of GST genetic polymorphism in breast cancer.

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A Clinical Study of Infiltrating Lobular Breast Cancer: Jung Mo Kim, Young Chul Kim, Dong Young Noh, Yeo Kyu Yong, Seung Keun Oh, Kuk Jin Choe; J Korean Cancer Assoc. 1999;31(1):90-97.

Abstract PDF: PURPOSE
Infiltrating lobular carcinoma of the breast was known to have a high incidence of multicentricity and bilaterality in patients. We analyzed the clinical features of infiltrating lobular breast cancer.
MATERIALS AND METHODS
We studied 29 patients with infiltrating lobular carcinoma of the breast, from Jan. 1980 to Mar. 1997 in the Department of Surgery, Seoul National University Hospital.
RESULTS
The age of the patients ranged from 32 to 71 years with an average of 45.2 years. The main complaining symptom was a painless mass. The diameter of the tumor ranged from 0.7 to 7 cm with a mean size of 2.8 cm. The axillary lymph node was positive for malignancy in 12 cases. The number of multicentric breast cancers were 7 cases (24.1%), and the number of bilateral breast cancers were 3 cases (10.3%). The estrogen receptor was positive in 66.7%, and the progesterone receptor was positive in 75% of the cases. There were one local recurrence and three distant metastases during a mean follow-up period of 4.5 years. The 5-year survival rate and 5-year disease free survival rate were 89.6% and 88.6%, respectively.
CONCLUSION
Infiltrating lobular breast cancers are at greater risk of developing multicentricity and bilaterality than nonlobular breast cancers. Careful program of frequent follow-up examinations and thorough histopathological studies are needed for patients with infiltrating lobular breast cancers.

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Clinicopathological Analysis of Female Gastric Cancer - Comparative study according to the sex fo the patients: Jin Pok Kim, Hang Jong Yu, Young Chul Kim, Soo Jin Kim, Joo Ho Lee, Han Kwang Yang; J Korean Cancer Assoc. 1998;30(5):879-885.

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the differences of the clinicopathological features and survival rates in gastric cancer according to the sex of the patients.
MATERIALS AND METHODS
We reviewed 5,784 cases of gastric cancer patients who underwent laparotomy at the Department of Surgery, Seoul National University Hospital fmm Jan. 1986 to Dec. 1995. We have analyzed clinicopathologic features including tumor location, Bonmann type, depth of invasicm, lymph node metastasis, distant metastasis, TNM stage, histologic differentiation and survival rates according to the sex of the patients.
RESULTS
The mean age of female patients was 52.4 years, which is lower than that of male, 54.8 years. There were no differences in tumor location, Borrmann type, depth of invasion, lymph node metastasis, distant metastasis, TNM stage of tumor between male and female. But there were some differences in histologic differentiation; well- and moderately differentiated cancers were more common in male and signet-ring cell cancers were more common in female. Female shows slightly better prognosis than male. But the prognosis of young female was poorer than that of young male.
CONCLUSION
In gastric cancer patients, differences in histologic differentiation and more aggressive nature of the signet-ring cell cancer in female may affect the survival differences according to the sex.

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The Expression of Phospholipase C-gamma1 and Its Cellular Characteristics: Dong Young Noh, Han Sung Kang, Young Chul Kim, In Ae Park, Yeo Kyu Yong, Seung Keun Oh, Kuk Jin Choe; J Korean Cancer Assoc. 1998;30(3):457-463.

Abstract PDF: BACKGROUND
The activation of phospholipase C(PLC) is one of the early cellular events in various growth process, including malignant transformation. PLC-gamma1 is activated through direct interaction with growth factor receptor tyrosine kinase. MATERIAL AND METHODS: Using immunoblot assay, we evaluated overexpression of PLC-gamma1 expression in twenty human breast cancer tissues. It was also determined whether there was any connection between other prognostic factors(numbers of metastatic axillary nodes, nuclear and histological grade, c-erbB2, p53 and E-cadherin) and the overexpression of PLC-gamma1 protein.
RESULTS
Seventeen of 20 breast cancer tissues showed overexpression of PLC-gamma1, which was corresponded to that seen on the immunohistochemistry( kappa= 0.8275, p = 0.003). Of 3 tumor markers, immunohistochemically determined, positive expression of E-cadherin only was associated with PLC-gamma1 protein overexpression in a range of statistical significance (p=0.045, kappa=0.607).
CONCLUSION
PLC-gamma1 overexpression might be pathogenic trigger involved in breast cancer and the relationship between expression of E-cadherin and PLC-gamma1 would require further elucidation.

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The Comparative Study between Peripharal Venous Blood and Draining Venous Blood CEA Levels in Colorectal Cancer: Kyung Bum Lee, Eun Sook Lee, Young Chul Kim; J Korean Cancer Assoc. 1998;30(2):306-312.

Abstract PDF: PURPOSE
In colon cancer, CEA(carcinoembryonic antigen) has become one of the useful tools for the management of patients because the antigen has been found to be useful as a monitor for detection, staging, recurrence, determining the response to therapy, and estimating the prognosis or survival. Many investigators have been analyzing the peripheral CEA levels for these purpose. Correlation between CEA levels of peripheral and portal blood, and histopathologic variables, was examined in 92 patients. This study evaluates importance of draining vein CEA levels in sensitivity and specificity of the prognosis.
MATERIALS AND METHODS
In 92 patients, comparison between peripheral and draining venous blood CEA levels was performed in order to get better sensitivity and specificity and precise prognosis of CEA in colorectal cancer. Stage, tumor site, tumor emboli, lymph nodes, ascitic fluid cytology and differentiations were considered.
RESULTS
There was no significant difference in peripheral and draining venous blood CEA levels in these variables. CEA positive rate of peripheral and draining vein were 57% and 60%. It has statistically no significance. More elevated CEA levels of draining vein than peripheral levels was detected in Duke C comparison (p=0.013). And more elevated CEA levels was observed in more advanced stages(33%, 59%, 63%, 83%) in draining vein(p < or = 0.01).
CONCLUSION
The prognosis of elevated CEA level in draining venous blood CEA levels in advanced stage is significant in prediction of patients prognosis and degree of advanced cancers.

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Effects of Combined Splenectomy with Total Gastrectomy on the Prognosis in Gastric Cancer: Young Jae Mok, Seung Joo Kim, Gil Soo Son, Min Young Cho, Young Chul Kim, Sae Min Kim; J Korean Cancer Assoc. 1997;29(4):632-639.

Abstract PDF: PURPOSE
This study was carried out to evaluate the impact of combined splenectomy with total gastrectomy on survival and postoperative morbidity in advanced gastric cancer. PATIENTS AND METHODS: We performed a retrospective analysis of 193 patients who underwent curative resection among 289 patients with total gastrectomy during the period of Sep. 1983 through Dec. 1995 at the Department of Surgery, Korea University Hospital.
RESULTS
Out of 11 clinicopathologic factors, 5 were associated with splenectomy through univariate analysis. The incidence of splenectomy increased when the patients with advanced gastric cancer had Borrmann type III, Gross T3 & T4 stage, greater than 4 cm of tumor size, Serosal invasion, or UICC stage IIIb, IV (p<0.05). Postoperative complication occurred more commonly in splenectomy group than in non-splenectomy group (20.2% vs 16.9%). The 5-year survival rate of Stage II was lower in splenectomy group than in non-splenectomy group (63.5% vs 83.5%) but that of Stage III was higher in splenectomy group than in non-splenectomy group (22.8% vs 17.3%), there was no significant difference between the survival rates across different stages.
CONCLUSION
We could not find any beneficial effect of splenectomy in gastric cancer patients who underwent curative total gastrectomy in this retrospective analysis. There was no clinical evidence to support splenectomy as a general policy in patients with total gastrectomy. We conclude that the randomized prospective clinical trials using more precise criteria for the indication of splenectomy are needed in order to assess the beneficial effect of splenectomy.

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Histocompatibility antigens in primary gastric carcinoma of young adults: Suk Joo Lee, Wan Sik Yoo, Soo Il Chang, Yong Hwan Choi, Young Chul Kim, Tae Ho Jung; J Korean Cancer Assoc. 1993;25(6):826-836.

Abstract PDF: No abstract available.

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Distribution of Major Histocompatibility Antigen Class 1 in Patientw with Thyroid Carcinoma: Nung Soo Chung, Young Chul Kim, Young Chul Kim, Shung Chull Chae, Won Hee Jang, In Sun Lee, Tai Ho Chung; J Korean Cancer Assoc. 1994;26(1):89-100.

Abstract PDF: This study was carried out to see if there are any peculiar pattern of HLA distribution in patients with thyroid carcinoma. Analysis of tissue antigens were done with Park and Terasaki method on the 25 cases of papillary cancer, 24 cases of follicular cancer, and 1S cases of medullary cancer. In order to comparison with benign tumor and healthy person, 21 cases of thyroid adenoma and 30 students were tested. Compared to the control group, papillary cancer showed high frequencies in HLA-B7, B46, and C6. In follicular cancer, high frequencies occgrred in HLA-A33 and HLA-B7. In medullary cancer, distribution was high on HLA-A3 and low an HLA-A24, In HLA-B locus, high was shown in B38, B4l, and B75 antigens while for HLA-C, C2, and CB were showed high frequencies. In follicuiar adenoma, a benign tumor, HLA-A1, A33 turned out with high frequencies. In HLA-B locus, HLA-B7 and B60 were high in distribution. In HLA-C locus, C6 showed high frequenices. In papillary caneer and follicular adenoma, HLA-B7 and HLA-C6 were commonly high.

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The Usefuness of laparoscope for the Staging of Gastric Cancer: Jae Bok Lee, Young Jae Mok, Ho Sang Ryu, Young Chul Kim, Jin Hai Hyun, Sae Min Kim; J Korean Cancer Assoc. 1995;27(5):836-846.

Abstract PDF: The purpose of this study is to evaluate the usefulness of preoperative laparoscopic examination in gastric cancer. A more accurate preoperative cancer staging may allow a better prepared setting in which to avdoid unnecessary laparotomy, decide preoperative neoadjuvant chemotherapy and prepare the operation far combined resections or intraoperative radiotherapy. The subjects of this study were the 105 patients who were diagnosed preoperatively by gastrofiberscopic examination with biopsy and had received gastric resections in our department from 1986 to 1993. We performed laparoscopy preoperatively in all patients to characterize the location of the tumor and its and regional infiltration. Abdomi- nal CT staging, preoperative laparoscopic staging, and staging with CT and laparoscopy were compared for serosal infiltration, lymph node metastasis, peritoneal seeding and hepatic me- tastasis. The diagnostic indices such as sensitivity, specificity, accuracy, prevalence and predictive value of each staging were calculated and compared. For the statistical interpretation of the results, diagnostic indexes were calculated in two-way contingency tables of the frequencies of positive and negative results construed as either true or false upon surgical and histo- logic evaluation. The sensitivities for laparoscopic examination of serosal invasion, lymph node metastasis, peritoneal seeding and liver metastasis were 87.3%, 26.8%, 37.5% and 10.5% respectivelym and the specificity of the above findings were 61.8%, 76.5%, 100% and 94.2% respectively. The sensitivities of CT staging for above findings were 50.7%, 39.4%, 0%, 15.8% respectively, and the specificity was 73.5% 97.1%, 99.0%, 93.0% respectively. The sensitivity of combined modalities for above findings were 94.4%, 59.2%, 50.0%, 15.8% respectively, and the specificity was 70.6%, 70.6%, 99%, 94.2% respectively, and which indicates that seosal invasion, lymph node metastasis and peritoneal seeding could be detected accurately, while liver metas- tasis could not be. 1) Serosal infiltration was more accurately diagnosed by preoperative laparoscopy (sensitivity 87.3%, specificity 61.8%, p=0.024). 2) Diagnostic indices of lymph node metastasis, peritoneal seeding and liver metastasis were not different between preoperative laparoscopy and CT (p > 0.05).

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Comparison of PCNA Index between Cancer , Normal Mucosa and Intestinal Metaplasia Around the Gastric Cacner: Jae Bok Lee, Han Kyeum Kim, Seon Hahn Kim, Young Jae Mok, Young Chul Kim, Bum Hwan Koo, Sae Min Kim; J Korean Cancer Assoc. 1996;28(4):639-646.

Abstract PDF: Due to the poor prognosis of advanced gastric cancer, it is well acknowledged that early diagnosis is the most important goal in the approach to gastric cancer. In 1970 Corres et al. reported that a close correlation existed between the occurrence rate of gastric cancer and the prevalence rate of chronic atrophic gastritis or intestinal metaplasia of the gastric mucosa. The purpose of this study is to define the significance of intestinal metaplasia as a precancerous lesion by comparing the proliferative potentials of intestinal metaplasia with that of cancer tissue and normal gastric mucosal tissue. This was accomplished immunohistochemically by measuring and comparing the amount of PCNA protein found in the cancerous tissue, intestinal metaplastic lesions and normal mucosa from the resected samples of gastric cancer patients. We examined resected samples of 86 gastric cancer patients who had been operated on between July 25 and September 23 of 1992, and selected samples of 89 cancerous tissue, 60 intestinal metaplasia tissue and 60 normal mucosa. Each tumor sample was investigated on the histological classification(WHO, Lauren, and Ming classification), degree of mucosal invasion, existence of tumor thrombus and degree of differentiation. PCNA staining was made according to Streptavidin-biotin method. The number of stained cells converted to the percentage of the total number of cells was defined as the PCNA labeling index(LI). Statistical analysis was performed with the Student t-test and ANOVA test by SAS program. Overall, there was no significant difference between the PCNA index of cancer(l6.0%) and intestinal metaplasia(12.6%) with p=0.055, but a significant difference existed between intestinal metaplasia and normal mucosa with an index of 12.6% and 7.42%, respectively(p =0.013). There were na significant differences found between early and advanced cancer(p =0.620). PCNA index was higher with lymph node metastasis than without metastasis in advanced gastric cancer(p=0.009). There were no differences in the LI value in degree of differentiation, tumor thrombi or the Lauren and Ming classifications(p>0.05). PCNA index was higher in the middle and lower zone of the glands of the intestinal metaplasia than normal mucosa. (p=0.001)From the current results, the proliferation potential of peritumoral intestinal metaplasia was found to be higher than normal tissue, and we believe that this lesion should be investigated further as a precancerous lesion. Also, we find the PCNA labeling index to be a useful method as an objective guide for these further investigations.

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Significance of Hormaone Receptors and nm23 Protein Expression in Human Breast Cancer: Ki Hoon Jung, Eun Sook Lee, Won Jun Choi, Jeoung Won Bae, Young Chul Kim, Bum Hwan Koo, Chul Hwan Kim, In Sun Kim; J Korean Cancer Assoc. 1996;28(6):1010-1021.

Abstract PDF: The nm23 gene was originally identified by differential hybridization between two murine melanoma cell sublines which have low and high metastatic potential, and located in the chromosome 17q22. This gene has known to be involved in metastasis of several cancers and its down-regulation usually associated with metastasis or disease progression in breast cancer. This study was designed to determine the significance of overexpression of the entimetastatic gene nm23 protein in human breast cancer and to compare it with established clinicopatholoaical prognostic factors such as the tumor size, number of involved lymph nodes, grade of differentiation, and hormone receptor status. 118 surgical specimens, which were obtained from breast cancer between July of 1989 and June of 1993 were used to evaluate nm23 protein expression using immunohistochemical staining. All patients were female. The nm23 protein expression was positive in 74 cases(63%) and was negative in 44 cases(37%). There was a significant inverse relationship between nm23 pratein overexpression and Bloom and Richardson histologic grade(p=0.023). Also overexpression of nm23 was significantly correlated with estrogen and progesterone receptor(p=0.031, 0.001) and with longer disease free survival and overall survival(p=0.0048, 0.0026). In conclusion, nm23 protein overexpression is one of good prognostic indicators independently in human breast cancer.

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