Dong Yi Kim

Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer

Elevated neutrophil to lymphocyte ratio (N/L ratio) has been shown to be a prognostic indicator in various cancers. We aimed to investigate the prognostic significance of the preoperative N/L ratio in late stage gastric cancer.

Clinicopathological characteristics of signet ring cell carcinoma of the stomach.

Background:  Signet ring cell (SRC) carcinoma of the stomach is characterized by its poor prognosis and potential to infiltrate the wall of stomach, although survival studies comparing carcinomas with and without SRC features have yielded inconsistent results. This study compared the clinicopathological features and prognosis of patients with SRC carcinoma with those with non‐signet ring cell carcinoma of the stomach (NSRC).

Significance of serum and tissue carcinoembryonic antigen for the prognosis of gastric carcinoma patients.

Carcinoembryonic antigen (CEA) has been widely accepted as a tumor marker useful in the diagnosis and management of colorectal carcinoma. When CEA levels are positive in patients with gastric carcinoma, they could be useful prognostic indicators. The value of CEA as a tumor marker for gastric carcinoma, however, remains a matter of controversy. The purpose of this study was to determine whether preoperative serum CEA value and tissue CEA staining are useful prognostic indicators for gastric carcinoma.

Clinicopathological features of patients with Borrmann type IV gastric carcinoma

Background:  To determine whether there is a specific pattern of clinicopathological features that could be used to distinguish Borrmanntype IV gastric carcinoma from other types of gastric carcinoma.

Aberrant methylation of DNA mismatch repair genes in elderly patients with sporadic gastric carcinoma: A comparison with younger patients.

Hypermethylation of promoters that regulate the expression of DNA repair genes is associated with gastric carcinoma (GC). Little is known regarding the association between age of disease onset and differences in molecular profiles.

E-cadherin expression in early gastric carcinoma and correlation with lymph node metastasis.

Abnormal expression of E‐cadherin plays an important role in the differentiation and progression of gastric carcinoma. However, the relationship between molecular changes in E‐cadherin and metastasis in early gastric carcinoma (EGC) is poorly understood.

Clinicopathological characteristics and prognosis of carcinoma of the gastric cardia.

Objective: The prognosis of patients with carcinoma of the gastric cardia (CGC) is poorer than that of patients with distal third gastric carcinoma (DTGC). The main aim of this study is to investigate whether the tumor location is an important prognostic factor. Methods: 312 patients (8.1%) were diagnosed with CGC and reviewed retrospectively. Results: T1 stage tumors were less common in patients with CGC than in those with DTGC (p< 0.001). Lymph node invasion was more common in CGC patients than in DTGC patients (p< 0.01). Multivariate analysis showed that patient age, lymph node status, and resection with curative intent were significant prognostic factors for the survival of CGC patients. Of the patients who underwent tumor resection with curative intent, the 5-year survival rate of CGC patients was lower than that of DTGC patients (57.4 vs. 63.1%), but no significant difference was observed between the two groups (p> 0.05). When the CGC group was divided into patients who underwent resection with or without curative intent, the 5-year survival rates were 52.8 and 6.0%, respectively (p< 0.001). Conclusion: According to our results, curative resection itself, rather than tumor location, was the determining factor in improving 5-year survival.

Lack of death receptor 4 (DR4) expression through gene promoter methylation in gastric carcinoma.

Background and aimsTo determine the underlying mechanism for the differential expression, the extent of promoter methylation in tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-related genes acting downstream of TRAIL was examined in early and advanced gastric carcinomas.MethodsThe extent of promoter methylation in the DR4, DR5, DcR1, DcR2, and CASP8 genes was quantified using bisulfite modification and methylation-specific polymerase chain reaction.ResultsThe promoters for DcR1, DcR2, and CASP8 were largely unmethylated in early gastric carcinoma, advanced gastric carcinoma, and controls, with no significant difference among them. Protein levels of DR4, DcR1, and DcR2 as revealed by immunohistochemistry correlated with the extent of the respective promoter methylation (P < 0.05 in all cases). Hypomethylation, rather than hypermethylation, of the DR4 promoter was noted in invasive gastric malignancies, with statistical significance (P = 0.003).ConclusionThe promoter methylation status of TRAIL receptors in gastric carcinoma may have clinical implications for improving therapeutic strategies in patients with gastric carcinoma.

Mesenteric extraskeletal osteosarcoma with telangiectatic features: a case report

BackgroundExtraskeletal osteosarcoma is a rare malignant mesenchymal tumor, with a predominant occurrence in the extremities. Only two cases of mesenteric extraskeletal osteosarcoma have been documented. We describe an unusual case of extraskeletal osteosarcoma with telangiectatic features occurring in the mesentery.Case presentationA 67-year-old male presented with blood-tinged stool of 1-months duration. On colonoscopy, a solid mass was detected protruding from the colon wall. Computed tomography showed a 15 × 9.7 cm heterogeneously enhancing mass, with mottled calcification and a cystic portion, occupying the left upper quadrant of the abdominal cavity. Curative resection of the tumor was performed, and the excised tumor was composed of large multilocular cysts containing old hematomas and necrotic debris. The histology revealed an osteosarcoma showing osteoid formation and blood-filled spaces lined with atypical cells. Despite postoperative chemotherapy, he developed a recurrent peritoneal mass and multiple lung metastases 3 months postoperatively.ConclusionGiven the rarity of cases of mesenteric extraskeletal osteosarcoma, its biologic behavior at this location remains to be determined. However, extraskeletal osteosarcoma with telangiectatic features is an uncommon entity to be recognized because of the possible fatal outcome related to the tumors.

Is palliative resection necessary for gastric carcinoma patients

Background and aimsThe benefit of palliative resection for gastric carcinoma patients remains controversial. We thus evaluated the survival benefit of palliative resection in advanced gastric carcinoma patients.Materials and methodsWe reviewed the hospital records of 466 gastric carcinoma patients who had palliative resection and compared the clinicopathologic findings to those of patients who underwent a bypass or exploration from 1986 to 2000.ResultsCox’s proportional hazard regression model revealed only one independent statistically significant prognostic parameter, the presence of peritoneal dissemination (risk ratio, 0.739; 95% confidence interval, 0.564–0.967; P < 0.05). The 5-year survival rate of patients who had palliative resection was higher than that of patients who did not (7.03 vs 0%, P < 0.001). When the 5-year survival rates of patients with peritoneal dissemination were examined, the rate was higher for those who underwent resection (4.43 vs 0%, P < 0.001).ConclusionThe results highlight the improved survivorship of gastric carcinoma patients with palliative resection compared to those who did not undergo the procedure. Although curative resection is not possible in this group of patients, we recommend performing resection aimed at palliation.