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Lv L, Liang X, Wu D, Wang F, Zhang Y, Cang H, Deng X, Li M. Is cardia cancer a special type of gastric cancer? A differential analysis of early cardia cancer and non-cardia cancer. J Cancer 2021; 12:2385-2394. [PMID: 33758614 PMCID: PMC7974896 DOI: 10.7150/jca.51433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022] Open
Abstract
Background: The prognosis of early cardia cancer and non-cardia cancer is still controversial. It is difficult to collect a large number of cases with complete information in clinical practice. Our study was aimed to identify the differences in clinicopathological characteristics and outcomes of early cardia gastric cancer and non-cardia gastric cancer. Methods: All cases analyzed were from Surveillance, Epidemiology, and End Results database. The data of the patients with early gastric cancer from 2004 to 2010 was retrospectively analyzed. Patients were distributed to cardia cancer group and non-cardia cancer group. Univariate and multivariate analyses were performed to examine differences between groups. The competitive risk model was made to compare the association with cardia cancer and non-cardia cancer about the causes of death. Propensity score matching (PSM) was performed to reduce the bias. Results: We found that cardia cancer was more common in male patients and the White than that in non-cardia cancer at early stage, signet ring cell carcinoma was more common in non-cardia cancer, and the differentiation of non-cardia cancer was worse. Univariate analysis showed that age, marital status, race, tumor location, histology, grade, stage, and operation or not can determine the prognosis. And the prognosis of patients with cardia cancer was worse than that of non-cardia cancer, according to lymph node metastasis and the depth of tumor invasion. Multivariate analysis showed cardia cancer was an independent prognostic factor for poor prognosis. After PSM, cardia cancer still exhibited poor prognosis. Conclusions: At early stage, cardia cancer had a poor prognosis compared with non-cardia cancer. The prevention and treatment of early cardia cancer need to be seriously treated.
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Affiliation(s)
- Liting Lv
- Department of oncology, Affiliated hospital of Nantong University, Nantong, 226001, Jiangsu Province, China
| | - Xiao Liang
- Department of oncology, Jiangyin People's Hospital, Wuxi, 214400, Jiangsu Province, China
| | - Dan Wu
- Department of oncology, Jiangyin People's Hospital, Wuxi, 214400, Jiangsu Province, China
| | - Feng Wang
- Department of oncology, Affiliated hospital of Nantong University, Nantong, 226001, Jiangsu Province, China
| | - Yan Zhang
- Department of oncology, Affiliated hospital of Nantong University, Nantong, 226001, Jiangsu Province, China
| | - Hui Cang
- Department of gastroenterology, Jiangyin People's Hospital, Wuxi, 214400, Jiangsu Province, China
| | - Xiongwei Deng
- Department of orthopedics, Jiangyin People's Hospital, Wuxi, 214400, Jiangsu Province, China
| | - Mei Li
- Department of oncology, Affiliated hospital of Nantong University, Nantong, 226001, Jiangsu Province, China
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Lou GC, Dong J, Du J, Chen WY, He XL. Clinical significance of lymph node micrometastasis in T1N0 early gastric cancer. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2020; 17:3252-3259. [PMID: 32987528 DOI: 10.3934/mbe.2020185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To investigate the significance of lymph node micrometastasis in T1N0 early gastric cancer. Lymph node micrometastasis may be a key mechanism in the recurrent T1N0 EGC patients after surgical treatment. It's unknow whether it is safe to leave the lymph nodes with micrometastasis untreated after ESD. A total of 106 T1N0 EGC patients were enrolled in this study. Immunohistochemical technique with CAM5.2 was employed to detect lymph node micrometastasis, and Immunohistochemical with D2-40 was used to detect the lymphatic vessels. Prognostic significance of lymph node micrometastasis and the relationship of lymph nodes micrometastasis with Clinicopathological features were analyzed. Twenty-two of the 106 T1N0 EGC cases were detected with lymph nodes micrometastasis, with the detection rate of 20.8%. The median survival time of the group with positive lymph nodes micrometastasis was lower than that of the group with negative micrometastasis, 48 vs 60 months. The incidence of lymph nodes micrometastasis in submucosal T1N0 EGC was 23.9%, while no micrometastasis was found in the mucosal T1N0 EGC. Of all the 30 cases according with the expanded ESD indications, six patients were found with lymph nodes micrometastasis. The occurrence of lymph node micrometastasis was common in T1N0 EGC. The cases with positive lymph nodes micrometastasis showed a lower median survival time than those with negative micrometastasis. lymph nodes micrometastasis incidence was higher in the submucosal ECG than in the mucosal ECG. lymph nodes micrometastasis was also found in the cases according to the expanded ESD indications.
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Affiliation(s)
- Guo Chun Lou
- Department of Gastroenterology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, Zhejiang Province, China
| | - Jie Dong
- Department of Gastroenterology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, Zhejiang Province, China
| | - Jing Du
- Department of Gastroenterology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, Zhejiang Province, China
| | - Wan Yuan Chen
- Departments of Pathology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, Zhejiang Province, China
| | - Xiang Lei He
- Departments of Pathology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, Zhejiang Province, China
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Candido MV, Syrjä P, Kilpinen S, Spillmann T. Canine breeds associated with gastric carcinoma, metaplasia and dysplasia diagnosed by histopathology of endoscopic biopsy samples. Acta Vet Scand 2018; 60:37. [PMID: 29914568 PMCID: PMC6004666 DOI: 10.1186/s13028-018-0392-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 06/08/2018] [Indexed: 01/14/2023] Open
Abstract
Background Gastric carcinoma (GC) is a rather rare pathological finding in dogs, with the exception of some breeds which seem predisposed. The etiopathogenesis is largely unknown in dogs, whereas in humans GC often develops from gastric mucosal metaplasia and dysplasia. This study investigates whether dogs of certain breeds are more often subject to gastroduodenoscopy (GDS), and diagnosed with GC, mucosal metaplasia or dysplasia. A retrospective clinical database search was performed at the Veterinary Teaching Hospital at the University of Helsinki, Finland. The following inclusion criteria were applied to estimate relative risk for metaplasia/dysplasia and GC: dogs from pure breeds with at least five individuals subject to GDS with histopathology of gastric biopsies. Results Between 2006 and 2016, from a total of 54945 canine patients presented, 423 dogs underwent GDS. Inclusion criteria were met in 180 dogs of 20 different pure breeds. Eight dogs had GCs (mean age = 9.8 ± 1.7 years): Belgian Tervuren (n = 4), Collie (n = 2), Golden Retriever (n = 1) and Jack Russel Terrier (n = 1). Fourteen dogs of eight breeds had gastric mucosal metaplasia or dysplasia. A log-binomial statistical model revealed that dogs in the following breeds had a significantly higher probability to undergo GDS than the others in the study population: Australian Terrier, Belgian Tervuren, Cairn Terrier, Collie and Siberian Husky. Belgian Tervuren was found at higher risk to be diagnosed with GC [RR = 19 (5.7–63.9; P < 0.0001)], as well as mucosal metaplasia/dysplasia [RR (7.6; 2.95–19.58; P < 0.0001)], as compared to the other breeds included. Shetland Sheepdog had an increased RR (5.83; 1.75–19.45; P = 0.0041) for metaplasia. Conclusions The results indicate a very low incidence of GC in dogs. The Belgian Tervuren, however, appears as predisposed. The histopathologic descriptions of mucosal changes such as metaplasia and dysplasia were also rare, but were more frequent in the Belgian Tervuren. Previous reports of these changes in dogs are very scarce, but they might be presumably related to GC in dogs, as they are in humans. Future research should investigate the possible role of metaplasia and dysplasia in the development of GC in dogs, especially those of predisposed breeds.
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De Re V, Orzes E, Canzonieri V, Maiero S, Fornasarig M, Alessandrini L, Cervo S, Steffan A, Zanette G, Mazzon C, De Paoli P, Cannizzaro R. Pepsinogens to Distinguish Patients With Gastric Intestinal Metaplasia and Helicobacter pylori Infection Among Populations at Risk for Gastric Cancer. Clin Transl Gastroenterol 2016; 7:e183. [PMID: 27441820 PMCID: PMC5543486 DOI: 10.1038/ctg.2016.42] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 06/08/2016] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The objectives of this study were to investigate the serum pepsinogen test for the prediction of OLGIM (Operative Link on Gastric Intestinal Metaplasia Assessment) stages in first-degree relatives (FDR-GC) of patients with gastric cancer (GC) and autoimmune chronic atrophic gastritis (ACAG). METHODS In 67 consecutive patients with ACAG, 82 FDR-GC, and 53 controls (CTRL) without gastric disease (confirmed by biopsy), serum levels of pepsinogen 1 (PG1), pepsinogen 2 (PG2), G17, and the PG1/2 ratio were assessed by enzyme-linked immunosorbent assay kit. All ACAG patients had positive antiparietal cell antibody levels, estimated by indirect immunofluorescence. Biopsies taken in duplicate from the antrum, corpus, and fundus were stained with Giemsa for Helicobacter pylori detection. Endoscopic detection of metaplasia was confirmed by histological diagnosis. Histological classification of OLGIM stages was applied by using the criteria of severity and topography of intestinal metaplasia (IM). RESULTS The highest discrimination capacity for distinguishing ACAG from other groups of patients was the gastrin G17 test. The lowest mean for PG1 and PG2 serum levels was found in ACAG. In multivariate analysis by age, PG1 and PG1/PG2 were independent prognostic factors for metaplasia, and PG2 also for the presence of a histological H. pylori infection. The serum PG1 level was significantly lower in individuals with IM at OLGIM stage >2 than in those with IM at OLGIM stage <2, resulting in a useful method for the prediction of OLGIM stage. With the inclusion of patient age at diagnosis in the prediction of ≥2 vs. 0-1 OLGIM stages, the receiver operating characteristic (ROC) curve at 47.9 ng/ml PG1 level reached a significant area under the curve (AUC) value (0.978, P<0.001). We also observed a slight difference in PG2 serum levels between histological H. pylori-positive and H. pylori-negative subjects (ROC AUC: 0.599). CONCLUSIONS This study demonstrated an important increase in gastrin G17 serum level in autoimmune gastritis. PG1 serum level corrected by patient age can be used in the management of patients at risk for GC with a high predicted probability of having an OLGIM stage ≥2. Using a cutoff of 47.9 ng/ml, PG1 testing in FDR-GC and ACAG patients had a sensitivity of 95.83% and a specificity of 93.37. Although these results could be validated in a prospective study, the known importance of higher OLGIM stages in increasing the risk of GC development supports the rationale of proposing PG1 algorithm as a diagnostic tool for the selection of high-risk FDR-GC and ACAG patients at high-risk stages for subsequent detailed endoscopic examination to detect dysplasia and asymptomatic GC. In addition, serum PG1 and PG2 levels could stratify patients based on both H. pylori infection and OLGIM risk in consideration of the increased acknowledge regarding the role of H. pylori in the progression of gastritis to GC.
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Affiliation(s)
- Valli De Re
- Bio-Immunotherapy/Bio-Proteomics, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Enrico Orzes
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Vincenzo Canzonieri
- Division of Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Stefania Maiero
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Mara Fornasarig
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Lara Alessandrini
- Division of Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Silvia Cervo
- Clinical Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Agostino Steffan
- Clinical Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Giorgio Zanette
- Division of Diabetology, Pordenone Hospital, Pordenone, Italy
| | - Cinzia Mazzon
- Division of Endocrinology, Pordenone Hospital, Pordenone, Italy
| | - Paolo De Paoli
- Scientific Direction, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Renato Cannizzaro
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
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Chang HR, Nam S, Kook MC, Kim KT, Liu X, Yao H, Jung HR, Lemos R, Seo HH, Park HS, Gim Y, Hong D, Huh I, Kim YW, Tan D, Liu CG, Powis G, Park T, Liang H, Kim YH. HNF4α is a therapeutic target that links AMPK to WNT signalling in early-stage gastric cancer. Gut 2016; 65:19-32. [PMID: 25410163 PMCID: PMC4717359 DOI: 10.1136/gutjnl-2014-307918] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 10/25/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Worldwide, gastric cancer (GC) is the fourth most common malignancy and the most common cancer in East Asia. Development of targeted therapies for this disease has focused on a few known oncogenes but has had limited effects. OBJECTIVE To determine oncogenic mechanisms and novel therapeutic targets specific for GC by identifying commonly dysregulated genes from the tumours of both Asian-Pacific and Caucasian patients. METHODS We generated transcriptomic profiles of 22 Caucasian GC tumours and their matched non-cancerous samples and performed an integrative analysis across different GC gene expression datasets. We examined the inhibition of commonly overexpressed oncogenes and their constituent signalling pathways by RNAi and/or pharmacological inhibition. RESULTS Hepatocyte nuclear factor-4α (HNF4α) upregulation was a key signalling event in gastric tumours from both Caucasian and Asian patients, and HNF4α antagonism was antineoplastic. Perturbation experiments in GC tumour cell lines and xenograft models further demonstrated that HNF4α is downregulated by AMPKα signalling and the AMPK agonist metformin; blockade of HNF4α activity resulted in cyclin downregulation, cell cycle arrest and tumour growth inhibition. HNF4α also regulated WNT signalling through its target gene WNT5A, a potential prognostic marker of diffuse type gastric tumours. CONCLUSIONS Our results indicate that HNF4α is a targetable oncoprotein in GC, is regulated by AMPK signalling through AMPKα and resides upstream of WNT signalling. HNF4α may regulate 'metabolic switch' characteristic of a general malignant phenotype and its target WNT5A has potential prognostic values. The AMPKα-HNF4α-WNT5A signalling cascade represents a potentially targetable pathway for drug development.
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Affiliation(s)
- Hae Ryung Chang
- New Experimental Therapeutics Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Seungyoon Nam
- New Experimental Therapeutics Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Myeong-Cherl Kook
- Department of Pathology, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Kyung-Tae Kim
- Molecular Epidemiology Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Xiuping Liu
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hui Yao
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hae Rim Jung
- New Experimental Therapeutics Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Robert Lemos
- Cancer Center, Sanford-Burnham Medical Research Institute, La Jolla, California, USA
| | - Hye Hyun Seo
- Animal Sciences Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Hee Seo Park
- New Experimental Therapeutics Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Youme Gim
- New Experimental Therapeutics Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Dongwan Hong
- Cancer Genomics Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Iksoo Huh
- Department of Statistics, Seoul National University, Seoul, Republic of Korea
| | - Young-Woo Kim
- Gastric Cancer Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
| | - Dongfeng Tan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Chang-Gong Liu
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Garth Powis
- Cancer Center, Sanford-Burnham Medical Research Institute, La Jolla, California, USA
| | - Taesung Park
- Department of Statistics, Seoul National University, Seoul, Republic of Korea
| | - Han Liang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yon Hui Kim
- New Experimental Therapeutics Branch, National Cancer Center of Korea, Goyang-si, Kyeonggi-do, Republic of Korea
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Differences in Clinicopathology of Early Gastric Carcinoma between Proximal and Distal Location in 438 Chinese Patients. Sci Rep 2015; 5:13439. [PMID: 26310451 PMCID: PMC4550893 DOI: 10.1038/srep13439] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/27/2015] [Indexed: 12/23/2022] Open
Abstract
Early gastric carcinoma (EGC) in Chinese patients remains poorly understood and endoscopic therapy has not been well established. Here, we compared endoscopic and clinicopathologic features between early proximal gastric carcinoma (PGC, n = 131) and distal gastric carcinoma (DGC, n = 307) in consecutive 438 EGCs diagnosed with the WHO criteria. By endoscopy, PGCs showed protruding and elevated patterns in 61.9%, while depressed and excavated patterns in 33.6%, which were significantly different from those (32.6% and 64.5%) in DGCs. PGCs were significantly smaller (1.9 cm in average, versus 2.2 cm in DGCs), invaded deeper (22.9% into SM2, versus 13% in DGCs), but had fewer (2.9%, versus 16.7% in DGCs) lymph node metastases. Papillary adenocarcinoma was significantly more frequent (32.1%, versus 12.1% in DGCs), as were mucinous and neuroendocrine carcinomas, carcinoma with lymphoid stroma (6.9%, versus 1.6% in DGCs); but poorly cohesive carcinoma was significantly less frequent (5.3%, versus 35.8% in DGCs). The overall 5-year survival rate was 92.9% in EGCs, and PGC patients showed shorter (42.4 months, versus 48.3 in DGCs) survival. Papillary and micropapillary adenocarcinomas and nodal metastasis were independent risk factors for worse survival in EGCs. EGCs in Chinese were heterogeneous with significant differences in endoscopy and clinicopathology between PGC and DGC.
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Gallardo Cabrera VE, Hernández Mondragón O, Rascón Martínez DM, Blanco Velasco G, Ramos González R, Tun Abraham AE, Blancas Valencia JM. Disección endoscópica submucosa: curva de aprendizaje en modelos porcinos. ENDOSCOPIA 2015. [DOI: 10.1016/j.endomx.2015.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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GAO ZHITAO, ZHU MOLI, WU YAPING, GAO PAN, QIN ZHIHAI, WANG HUI. Interferon-λ1 induces G1 phase cell cycle arrest and apoptosis in gastric carcinoma cells in vitro. Oncol Rep 2014; 32:199-204. [DOI: 10.3892/or.2014.3185] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 04/30/2014] [Indexed: 12/16/2022] Open
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Lee SY. Gastric adenoma with low-grade dysplasia: two countries, two outcomes. Dig Dis Sci 2014; 59:235-7. [PMID: 24052193 DOI: 10.1007/s10620-013-2860-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 08/23/2013] [Indexed: 12/16/2022]
Affiliation(s)
- Sun-Young Lee
- Department of Internal Medicine, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 143-729, South Korea,
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