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Park DJ, Kim YW, Yang HK, Ryu KW, Han SU, Kim HH, Hyung WJ, Park JH, Suh YS, Kwon OK, Yoon HM, Kim W, Park YK, Kong SH, Ahn SH, Lee HJ. Short-term outcomes of a multicentre randomized clinical trial comparing laparoscopic pylorus-preserving gastrectomy with laparoscopic distal gastrectomy for gastric cancer (the KLASS-04 trial). Br J Surg 2021; 108:1043-1049. [PMID: 34487147 DOI: 10.1093/bjs/znab295] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/20/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND There remain concerns about the safety and functional benefit of laparoscopic pylorus-preserving gastrectomy (LPPG) compared with laparoscopic distal gastrectomy (LDG). This study evaluated short-term outcomes of a randomized clinical trial (RCT) comparing LPPG with LDG for gastric cancer. METHODS The Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS)-04 trial was an investigator-initiated, open-label, parallel-assigned, superiority, multicentre RCT in Korea. Patients with cT1N0M0 cancer located in the middle third of the stomach at least 5 cm from the pylorus were randomized to undergo LPPG or LDG. Participants, care givers and those assessing the outcomes were not blinded to group assignment. Outcomes were 30-day postoperative morbidity rate and death at 90 days. RESULTS Some 256 patients from nine institutions were randomized (LPPG 129 patients, LDG 127 patients) between July 2015 and July 2017 and outcomes for 253 patients were analysed. Postoperative complications within 30 days were seen in 19.3 and 15.5 per cent in the LPPG and LDG groups respectively (P = 0·419). Postoperative pyloric stenosis was observed in nine (7.2 per cent) and two (1·5 per cent) patients in the LPPG and LDG groups (P = 0·026) respectively. In multivariable analysis higher BMI was a risk factor for postoperative complications (odds ratio 1·17, 95 per cent c.i. 1·04 to 1·32; P = 0·011). Death at 90 days was zero in both groups. CONCLUSION Postoperative complications and mortality was comparable in patients undergoing LPPG and LDG. Registration number: NCT02595086 (http://www.clinicaltrials.gov).
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Affiliation(s)
- D J Park
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Y-W Kim
- Department of Surgery, National Cancer Centre, Goyang, Korea
| | - H-K Yang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - K W Ryu
- Department of Surgery, National Cancer Centre, Goyang, Korea
| | - S-U Han
- Department of Surgery, Ajou University Hospital, Suwon, Korea
| | - H-H Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - W-J Hyung
- Department of Surgery, Yonsei University Severance Hospital, Seoul, Korea
| | - J H Park
- Department of Surgery, Gyeongsang National University Hospital, Daegu, Korea
| | - Y-S Suh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - O K Kwon
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - H M Yoon
- Department of Surgery, National Cancer Centre, Goyang, Korea
| | - W Kim
- Department of Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Y-K Park
- Department of Surgery, Chonnam National University Medical School, Hwasun, Korea
| | - S-H Kong
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - S H Ahn
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - H-J Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
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Park JM, Kim HI, Han SU, Yang HK, Kim YW, Lee HJ, An JY, Kim MC, Park S, Song KY, Oh SJ, Kong SH, Suh BJ, Yang DH, Ha TK, Hyung WJ, Ryu KW. Who may benefit from robotic gastrectomy?: A subgroup analysis of multicenter prospective comparative study data on robotic versus laparoscopic gastrectomy. Eur J Surg Oncol 2016; 42:1944-1949. [PMID: 27514719 DOI: 10.1016/j.ejso.2016.07.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/05/2016] [Accepted: 07/14/2016] [Indexed: 01/02/2023] Open
Abstract
AIMS Robotic gastrectomy for gastric cancer has been proven to be a feasible and safe minimally invasive procedure. However, our previous multicenter prospective study indicated that robotic gastrectomy is not superior to laparoscopic gastrectomy. This study aimed to identify which subgroups of patients would benefit from robotic gastrectomy rather than from conventional laparoscopic gastrectomy. METHODS A prospective multicenter comparative study comparing laparoscopic and robotic gastrectomy was previously conducted. We divided the patients into subgroups according to obesity, type of gastrectomy performed, and extent of lymph node dissection. Surgical outcomes were compared between the robotic and laparoscopic groups in each subgroup. RESULTS A total of 434 patients were enrolled into the robotic (n = 223) and laparoscopic (n = 211) surgery groups. According to obesity and gastrectomy type, there was no difference in the estimated blood loss (EBL), number of retrieved lymph nodes, complication rate, open conversion rate, and the length of hospital stay between the robotic and laparoscopic groups. According to the extent of lymph node dissection, the robotic group showed a significantly lower EBL than did the laparoscopic group after D2 dissection (P = 0.021), while there was no difference in EBL in patients that did not undergo D2 dissection (P = 0.365). CONCLUSION Patients with gastric cancer undergoing D2 lymph node dissection can benefit from less blood loss when a robotic surgery system is used.
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Affiliation(s)
- J M Park
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - H I Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - S U Han
- Department of Surgery, Ajou University College of Medicine, Gyeonggido, South Korea
| | - H K Yang
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Y W Kim
- Center for Gastric Cancer, National Cancer Center, Gyeonggido, South Korea
| | - H J Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - J Y An
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - M C Kim
- Department of Surgery, Dong-A University College of Medicine, Busan, South Korea
| | - S Park
- Department of Surgery, Korea University College of Medicine, Seoul, South Korea
| | - K Y Song
- Department of Surgery, The Catholic University of Korea, Seoul, South Korea
| | - S J Oh
- Department of Surgery, Inje University College of Medicine, Busan, South Korea
| | - S H Kong
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - B J Suh
- Department of Surgery, Inje University College of Medicine, Busan, South Korea
| | - D H Yang
- Department of Surgery, Hallym University College of Medicine, Seoul, South Korea
| | - T K Ha
- Department of Surgery, Hanyang University College of Medicine, Seoul, South Korea
| | - W J Hyung
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - K W Ryu
- Center for Gastric Cancer, National Cancer Center, Gyeonggido, South Korea.
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3
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Han SU, Kwak TH, Her KH, Cho YH, Choi C, Lee HJ, Hong S, Park YS, Kim YS, Kim TA, Kim SJ. CEACAM5 and CEACAM6 are major target genes for Smad3-mediated TGF-β signaling. Oncogene 2007; 27:675-83. [PMID: 17653079 DOI: 10.1038/sj.onc.1210686] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The carcinoembryonic antigen (CEAs) family consists of a large group of evolutionarily and structurally divergent glycoproteins. The transforming growth factor-beta (TGF-beta) signaling pathway has been implicated in the stimulation of CEA secretion in TGF-beta-sensitive colon cells, thereby possibly modulating cell adhesion and differentiation. However, the specific CEAs targeted by TGF-beta signaling or underlying mechanism of the expression of CEAs has not yet been clarified. In this study, we investigated the specific CEAs targeted by the TGF-beta signaling pathway. In nine human gastric cancer cell lines examined, TGF-beta-responsive cell lines showed positive expression of CEAs. Expression patterns of CEA proteins correlated well with the level of CEA (CEACAM5) and CEACAM6 transcripts in these cell lines, but CEACAM1 expression was not observed in all of these cells. To investigate the role of TGF-beta signaling in CEA expression, we selected two TGF-beta unresponsive gastric cancer cell lines; SNU638 cells that contain a mutation in the TGF-beta type II receptor and SNU484 cells that express low to undetectable level of the TGF-beta pathway intermediate protein, Smad3. Restoration of TGF-beta signaling in these cells induced expression of the CEAs and increased activity of both CEA (CEACAM5) and CEACAM6 promoters. CEA expression was observed in the epithelium of the stomach of wild-type mice, but was markedly decreased in Smad3 null mice. These findings suggest that CEA (CEACAM5) and CEACAM6 are major target genes for Smad3-mediated TGF-beta signaling.
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Affiliation(s)
- S-U Han
- Laboratory of Cancer Biology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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4
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Abstract
BACKGROUND Although activation of mitogen activated protein kinases (MAPKs) by Helicobacter pylori infection is associated with induction of host angiogenesis, which may contribute to H pylori associated gastric carcinogenesis, the strategy for its prevention has not been identified. As we previously reported a strong inhibitory action of gastric proton pump inhibitors (PPIs) on MAPK extracellular signal regulated kinase (ERK)1/2 phosphorylation, we investigated whether PPIs could suppress the H pylori induced angiogenesis via inhibition of MAPK ERK1/2. METHODS To address the relationship between H pylori infection and angiogenesis, comparative analysis of density of CD34(+) blood vessel was performed in tissues obtained from 20 H pylori positive gastritis and 18 H pylori negative gastritis patients. Expression of hypoxia inducible factor 1 (HIF-1alpha) and vascular endothelial growth factor (VEGF) was tested by reverse transcription-polymerase chain reaction and secretion of interleukin 8, and VEGF was measured by ELISA. To evaluate the direct effect of H pylori infection on the tubular formation of human umbilical vein endothelial cells (HUVEC), an in vitro angiogenesis assay was employed. Activation of MAPK and nuclear factor kappaB (NFkappaB) was detected by immunoblotting. RESULTS H pylori positive gastritis patients showed a higher density of CD34(+) blood vessels (mean 40.9 (SEM 4.4)) than H pylori negative gastritis patients (7.2+/-0.8), which was well correlated with expression of HIF-1alpha. Conditioned media from H pylori infected gastric epithelial cells directly induced tubular formation of HUVEC and the increase of in vitro angiogenesis was suppressed by PPI treatment. Infection of H pylori significantly upregulated expression of HIF-1alpha and VEGF in gastric epithelial cells and expression of proangiogenic factors was mediated by MAPK activation and partially responsible for NFkappaB activation. PPIs effectively inhibited the phosphorylation of MAPK ERK1/2 that is a principal signal for H pylori induced angiogenesis. CONCLUSIONS The fact that PPIs could downregulate H pylori induced angiogenesis indicates that antiangiogenic treatment using a PPI could be a promising protective therapeutic approach for H pylori associated carcinogenesis.
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Affiliation(s)
- M Yeo
- Genome Research Centre for Gastroenterology, Ajou University Medical Centre, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 442-749, Korea.
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5
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Kim HH, Kim KH, Kim DH, Kim MC, Kim BS, Kim YW, Kim YI, Kim YH, Kim W, Kim WW, Kim JJ, Kim TB, Ryu SY, Ryu SW, Min YD, Park YC, Park CH, Baik HK, Song KY, Yang HK, Lee KY, Lee BE, Lee BH, Lee YJ, Lee WK, Lee JH, Lee HJ, Jeon HM, Jung SJ, Cho GS, Chin HM, Choi SH, Choi YB, Han SU, Hur KY, Hur YS, Hyung WJ, Hong BH. Nationwide Survey of Laparoscopic Gastric Surgery in Korea, 2004. ACTA ACUST UNITED AC 2005. [DOI: 10.5230/jkgca.2005.5.4.295] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- H H Kim
- Department of Surgery, College of Medicine, Seoul National University
| | - K H Kim
- Department of Surgery, DongKang Medical Center
| | - D H Kim
- Department of Surgery, Pusan National University
| | - M C Kim
- Department of Surgery, Dong-A University
| | - B S Kim
- Department of Surgery, Ulsan University
| | | | - Y I Kim
- 7Department of Surgery, Ewha Woman's University
| | - Y H Kim
- Department of Surgery, Gangneung Asan Hospital
| | - W Kim
- Department of Surgery, The Catholic University of Korea
| | - W W Kim
- Department of Surgery, Pochon CHA University
| | - J J Kim
- Department of Surgery, The Catholic University of Korea
| | - T B Kim
- Department of Surgery, Kyungpook National University
| | - S Y Ryu
- Department of Surgery, Chonnam National University
| | - S W Ryu
- Department of Surgery, Keimyung University
| | - Y D Min
- Department of Surgery, Chosun University
| | - Y C Park
- Department of Surgery, Dankook University
| | - C H Park
- Department of Surgery, The Catholic University of Korea
| | - H K Baik
- Department of Surgery, Hanyang University
| | - K Y Song
- Department of Surgery, The Catholic University of Korea
| | - H K Yang
- Department of Surgery, College of Medicine, Seoul National University
| | - K Y Lee
- Department of Surgery, Kyung Hee University
| | - B E Lee
- Department of Surgery, Changwon Fatima Hospital
| | - B H Lee
- Department of Surgery, Hallym University
| | - Y J Lee
- Department of Surgery, Gyeongsang National University
| | - W K Lee
- Department of Surgery, Gachon Medical School
| | - J H Lee
- 7Department of Surgery, Ewha Woman's University
| | - H J Lee
- Department of Surgery, College of Medicine, Seoul National University
| | - H M Jeon
- Department of Surgery, The Catholic University of Korea
| | - S J Jung
- Department of Surgery, Daegu Catholic University
| | - G S Cho
- Department of Surgery, Soonchunhyang University
| | - H M Chin
- Department of Surgery, The Catholic University of Korea
| | - S H Choi
- Department of Surgery, Yonsei University
| | - Y B Choi
- Department of Surgery, Ulsan University
| | - S U Han
- Department of Surgery, Ajou University
| | - K Y Hur
- Department of Surgery, Hansol Hospital
| | - Y S Hur
- Department of Surgery, Inha University
| | - W J Hyung
- Department of Surgery, Yonsei University
| | - B H Hong
- Department of Surgery, Eulji University
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Yang HK, Kim MC, Kim YW, Kim YI, Kim EK, Kim HH, Park KK, Bae JM, Baik HG, Sul JY, Shin SH, Lee YB, Lee JM, Lee JH, Lee HJ, Jeon HM, Cho GS, Choi SH, Choi YB, Han SU, Han HS, Hur KY, Hyung WJ, Hong BH. Nationwide Survey of Laparoscopic Gastric Surgery in Korea. ACTA ACUST UNITED AC 2004. [DOI: 10.5230/jkgca.2004.4.3.196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- H K Yang
- Seoul National University, Korea
| | | | - Y W Kim
- National Cancer Center, Korea
| | - Y I Kim
- Ewha Woman's University, Korea
| | - E K Kim
- Catholic University of Korea, Korea
| | - H H Kim
- Seoul National University, Korea
| | | | - J M Bae
- National Cancer Center, Korea
| | | | - J Y Sul
- Chungnam National University, Korea
| | | | - Y B Lee
- Changwon Fatima Hospital, Korea
| | - J M Lee
- Jeonju Presbyterian Medical Center, Korea
| | - J H Lee
- Ewha Woman's University, Korea
| | - H J Lee
- Seoul National University, Korea
| | - H M Jeon
- Catholic University of Korea, Korea
| | - G S Cho
- Soonchunhyang University, Korea
| | | | | | | | - H S Han
- Seoul National University, Korea
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7
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Kim DH, Kim SW, Song YJ, Oh TY, Han SU, Kim YB, Joo HJ, Cho YK, Kim DY, Cho SW, Kim MW, Kim JH, Hahm KB. Long-term evaluation of mice model infected with Helicobacter pylori: focus on gastric pathology including gastric cancer. Aliment Pharmacol Ther 2003; 18 Suppl 1:14-23. [PMID: 12925137 DOI: 10.1046/j.1365-2036.18.s1.4.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Long-term evaluation of gastric pathology after H. pylori infection is very important in order to reveal its clinical implications, since debate still exists on the gastric carcinogenesis provoked by H. pylori infection in animal models. AIM Either to evaluate the long-term outcome of H. pylori infection or to determine how H. pylori could provoke gastric cancer in the mice model. METHODS Four-week-old specific pathogen free C57BL/6 mice (n = 115) were infected with SS1, the mouse-adapted H. pylori strain. After 4, 8, 16, 24, 36, 50 and 80 weeks of bacterial infection, the H. pylori-infected mice were sacrificed. RESULTS After 80 weeks of infection, almost all the H. pylori-infected mice developed hyperplastic gastritis, but did not show any evidence of gastric adenoma, dysplasia or carcinoma. PCNA positive cells were most abundant after 50 weeks and tended to decrease thereafter up to 80 weeks, whereas apoptosis began to be noted 8 weeks after H. pylori infection, showing 7-8 apoptotic cells/high power field, and tending to increase as time passed. Normally observed neutral mucin decreased during the experiment, showing the most marked decrease 50 weeks after H. pylori infection. In contrast, acidic mucin was noted from 50 weeks after infection. CONCLUSION The SS1-infected mouse seems to be a suitable animal model for H. pylori-related research, and H. pylori itself does not induce gastric cancer in normal wild-type mouse model following long-term exposure, which could be explained by the balance that exists between cell proliferation and apoptosis.
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Affiliation(s)
- D H Kim
- Genomic Research Center for Gastroenterology and Ajou Helicobacter pylori Research Group, Ajou University School of Medicine, Suwon, Korea
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Hahm KB, Lee KM, Kim YB, Hong WS, Lee WH, Han SU, Kim MW, Ahn BO, Oh TY, Lee MH, Green J, Kim SJ. Conditional loss of TGF-beta signalling leads to increased susceptibility to gastrointestinal carcinogenesis in mice. Aliment Pharmacol Ther 2002; 16 Suppl 2:115-27. [PMID: 11966532 DOI: 10.1046/j.1365-2036.16.s2.3.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Downregulation of TGF-beta receptors is implicated in colon cancer development. Inactivation of either of the two transmembrane serine/threonine kinases, TGF-beta1 types I/II receptors, is now implicated in carcinogenesis, especially gastrointestinal carcinogenesis. METHODS We generated transgenic mice, called pS2-dnRII or ITF-dnRII, of which the dominant negative mutant of the TGF-beta type II receptor was expressed under the control of tissue-specific promoters, the pS2 promoter for stomach and ITF for intestine. They were either infected with H.pylori (ATCC 43504 strain, CagA+ and VacA+) or administered with azoxymethane to determine the significance of loss of TGF-beta signalling in gastrointestinal carcinogenesis. RESULTS Gastric adenocarcinoma developed in pS2-dnRII mice, whereas only chronic active gastritis was noted in wild-type littermates after 36 weeks of H.pylori infection. Mice lacking in TGF-beta signalling specifically in the stomach showed a significantly higher proliferation cell nuclear antigen-labelling index when infected with H.pylori than wild-type littermates (P < 0.01). Development of colonic aberrant crypt foci was provoked in mice by intraperitoneal injections of azoxymethane, and ITF-dnRII mice showed significantly higher incidences of ACF and colon cancers than wild-type littermates. CONCLUSIONS Maintaining normal TGF-beta signalling in the gastrointestinal tract seems to be important either for preventing abnormal mucosal proliferation, or for suppressing or retarding carcinogenesis.
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Affiliation(s)
- K-B Hahm
- Ajou Helicobacter Research Group, Ajou University School of Medicine, Wonchon-dong, Padal-ku, Suwon, Korea.
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9
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Park TJ, Han SU, Cho YK, Paik WK, Kim YB, Lim IK. Methylation of O(6)-methylguanine-DNA methyltransferase gene is associated significantly with K-ras mutation, lymph node invasion, tumor staging, and disease free survival in patients with gastric carcinoma. Cancer 2001; 92:2760-8. [PMID: 11753949 DOI: 10.1002/1097-0142(20011201)92:11<2760::aid-cncr10123>3.0.co;2-8] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND O(6)-methylguanine-DNA methyltransferase (MGMT) can remove O(6)alkylG DNA adducts. If they are not removed, then the adducts mispair with T during DNA replication, resulting in G-to-A mutation. Interrelations between MGMT gene inactivation by promoter methylation, K-ras mutation, and clinicopathologic features in patients with gastric carcinoma were studied. METHODS Surgically removed tumor tissues from 79 patients were analyzed with MGMT methylation by genomic DNA modification and methylation specific polymerase chain reaction analysis, K-ras mutation by mutant allele specific amplification, TNM classification according to the International Union Against Cancer system, and MGMT protein expression by immunohistochemistry. RESULTS MGMT-promoter methylation was found in 18 of 79 tumors. Among those 18 tumors, K-ras mutations were found in 33% and 11% of tumors at codons 12 and 13, respectively, corresponding to 20 times and 7 times greater rates of mutation compared with unmethylated tumors. MGMT methylation was associated significantly with lymph node invasion (P < 0.01), tumor stage (P < 0.03) and 5-year disease free survival (P < 0.02). MGMT protein expression was detected in intestinal metaplasia and adenocarcinoma samples, whereas no expression was detected in normal foveolar cells. CONCLUSIONS MGMT-promoter methylation in patients with gastric carcinoma was associated significantly with point mutations of K-ras at codons 12 and 13, lymph node invasion, tumor stage, and disease free survival. These associations indicate a significant role of MGMT methylation during gastric carcinogenesis.
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Affiliation(s)
- T J Park
- Department of Biochemistry and Molecular Biology, Ajou University School of Medicine, Suwon, Korea
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10
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Abstract
Although histone deacetylases (HDACs) appear to play a crucial role in carcinogenesis, the expression status of HDACs in primary human cancer tissues has not yet been reported. In this study, we investigated the expression level of HDAC1 in 25 paired primary human gastric cancer (GC) tissues and corresponding normal tissues through semi-quantitative RT-PCR and immunoblot analysis. The HDAC1 expression pattern was also topologically examined through immunohistochemistry. Overexpression of HDAC1 mRNA was detected in 68% of GC tissues (17 of 25), and the relative density of HDAC1 mRNA in GC tissue was increased 1.8-fold versus the normal counterpart (P < 0.01). Elevated expression of HDAC1 protein was also detected in 61% of GC samples (11 of 18), which also showed an increased mRNA level of HDAC. Immunohistochemically, overexpression of HDAC1 was predominantly localized in the nuclei of most neoplastic cells, including embolic tumor cells, whereas normal glandular epithelial cells revealed only weak HDAC1 expression that was focal in distribution. Thus, the present study clearly demonstrates that HDAC1 is overexpressed in GC and probably plays a significant role in gastric carcinogenesis.
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Affiliation(s)
- J H Choi
- Department of Veterinary Pathology, College of Veterinary Medicine and Agricultural Biotechnology, Seoul National University, Suwon, 441-744, Japan
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11
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Lee JH, Han SU, Cho H, Jennings B, Gerrard B, Dean M, Schmidt L, Zbar B, Vande Woude GF. A novel germ line juxtamembrane Met mutation in human gastric cancer. Oncogene 2000; 19:4947-53. [PMID: 11042681 DOI: 10.1038/sj.onc.1203874] [Citation(s) in RCA: 261] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Activating mutations in the Met receptor tyrosine kinase, both germline and somatic, have been identified in human papillary renal cancer. Here we report a novel germline missense Met mutation, P1009S, in a patient with primary gastric cancer. The dosage of the mutant Met DNA was elevated in the tumor when compared to its matched normal DNA. Therefore, as with hereditary renal papillary cancer, the mutant Met allele may also be selectively duplicated in the tumor. Different from previously reported Met mutations, which occur in the tyrosine kinase domain, this missense mutation is located at the juxtamembrane domain, and is not constitutively activated. However, following treatment with HGF/SF, the P1009S mutant Met protein, expressed in NIH3T3 cells, displays increased and persistent tyrosine phosphorylation compared to the wild-type Met. Importantly, these cells also form colonies in soft agar, and are highly tumorigenic in athymic nude mice. A second nucleotide change in this region of Met, T1010I, was found in a breast cancer biopsy and a large cell lung cancer cell line. Although this previously reported 'polymorphism' did not stimulate NIH3T3 cell growth in soft agar, it was more active than the wild-type Met in the athymic nude mice tumorigenesis assay, suggesting that it may have effects on tumorigenesis. Met has been shown to be highly expressed in human gastric carcinoma cell lines, and our results raise the possibility that activating missense Met mutations could contribute to tumorigenesis of gastric cancer.
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Affiliation(s)
- J H Lee
- NCI-Frederick Research and Development Center, P.O. Box B, Frederick, Maryland, MD 21702, USA
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12
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Kim TH, Han SU, Cho YK, Kim MW. Perigastric lymph node status can be a simple prognostic parameter in patients with gastric cancer. Hepatogastroenterology 2000; 47:1475-8. [PMID: 11100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND/AIMS The number of metastatic lymph nodes has been a significant prognostic factor after curative resection of gastric cancer and adopted as a new UICC classification of nodal stages in gastric cancer. The extent of lymphadenectomy is another significant factor but has been fiercely debated. Regardless of the type of lymphadenectomy, perigastric lymph node dissection is always carried out. In this study, we examined whether the number of metastatic perigastric nodes can be a prognostic indicator of gastric cancer. METHODOLOGY For the purpose of evaluating perigastric lymph node status, a retrospective study was carried out with 760 patients who underwent curative gastric resection from June 1994 to November 1998. RESULTS The 4-year cumulative survival rate was 64% and the survival rate decreased significantly when the number of positive perigastric nodes exceeded 3. Comparing with the patients having 0-2 positive perigastric nodes, patients whose metastatic perigastric lymph nodes exceeded 3 or more exhibited deeper tumor invasion, larger tumor size and older age. Multivariate analysis identified the number of positive perigastric nodes, together with depth of tumor invasion, as the strongest independent prognostic factors for survival. CONCLUSIONS We suggest that the number of metastatic perigastric nodes can be used as a simple prognostic parameter in patients with gastric cancer and that intensive follow-up and adjuvant chemotherapy should be recommended for the patients with more than 3 metastatic perigastric nodes.
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Affiliation(s)
- T H Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
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Lee HJ, Lee SB, Chung JS, Han SU, Han O, Guh JO, Jeon JS, An G, Back K. Transgenic rice plants expressing a Bacillus subtilis protoporphyrinogen oxidase gene are resistant to diphenyl ether herbicide oxyfluorfen. Plant Cell Physiol 2000; 41:743-749. [PMID: 10945344 DOI: 10.1093/pcp/41.6.743] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Protoporphyrinogen oxidase (Protox), the penultimate step enzyme of the branch point for the biosynthetic pathway of Chl and hemes, is the target site of action of diphenyl ether (DPE) herbicides. However, Bacillus subtilis Protox is known to be resistant to the herbicides. In order to develop the herbicide-resistant plants, the transgenic rice plants were generated via expression of B. subtilis Protox gene under ubiquitin promoter targeted to the cytoplasm or to the plastid using Agrobacterium-mediated gene transformation. The integration and expression of the transgene were investigated at T0 generation by DNA and RNA blots. Most transgenic rice plants revealed one copy transgene insertion into the rice genome, but some with 3 copies. The expression levels of B. subtilis Protox mRNA appeared to correlate with the copy number. Furthermore, the plastidal transgenic lines exhibited much higher expression of the Protox mRNA than the cytoplasmic transgenic lines. The transgenic plants expressing the B. subtilis Protox gene at T0 generation were found to be resistant to oxyfluorfen when judged by cellular damage with respect to cellular leakage, Chl loss, and lipid peroxidation. The transgenic rice plants targeted to the plastid exhibited higher resistance to the herbicide than the transgenic plants targeted to the cytoplasm. In addition, possible resistance mechanisms in the transgenic plants to DPE herbicides are discussed.
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Affiliation(s)
- H J Lee
- Biotechnology Research Institute, Chonnam National University, Kwangju, Korea
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Kim WH, Lee JH, Han SU, Jin YM, Kwak YS, Wang HJ, Kim MW. Systematic analysis of the effects of hepatocyte transplantation on rats with acute liver failure. Hepatogastroenterology 2000; 47:371-4. [PMID: 10791192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND/AIMS Acute liver failure either after liver resection or as part of underlying liver disease is still associated with high mortality. Hepatocyte transplantation in various forms has attracted attention recently. However, none of those reports have investigated the thorough and systematic analysis of effect of hepatocyte transplantation on acute liver failure induced by 90% hepatectomy. Therefore, we investigated systematic analysis of effect of hepatocyte transplantation on rats with acute liver failure. METHODOLOGY Male Sprague-Dawley rats were used. Group I rats (n = 26) received intrasplenic injection of 2 x 10(7) hepatocytes in 0.3 mL Dulbecco's modified Eagle's medium (DMEM) 24 hours prior to 90% hepatectomy. Group II rats (n = 24) received intrasplenic injection of DMEM only. Twenty-two rats from group I and 20 from group II were observed for the determination of survival time. The remaining 8 (4/each group) rats were used to assess the liver function and regeneration. RESULTS The hepatocyte bearing spleen revealed active glucose-6-phosphatase activity. In group I rats, the survival was longer and that group had more long-term survivors than those of group II controls. In group I, there was significant increase in the ratio of weight of remnant liver lobes to body weight. At 24 hours after hepatectomy, group I rats had improved biochemical parameters compared to those of group II rats. CONCLUSIONS In rats with acute liver failure, intrasplenic hepatocyte transplantation acts as a bridge to support experimental rats from acute liver failure to liver regeneration, prolong survival in rats with acute liver failure and improve biochemical parameters.
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Affiliation(s)
- W H Kim
- Department of Surgery, Biochemistry, Ajou University School of Medicine, Suwon, Korea
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Han SU, Lee JH, Kim WH, Cho YK, Kim MW. Significant correlation between serum level of hepatocyte growth factor and progression of gastric carcinoma. World J Surg 1999; 23:1176-80. [PMID: 10501881 DOI: 10.1007/s002689900642] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hepatocyte growth factor (HGF) can promote proliferation of many types of tumor cells including gastric cancer cells. To study the role of HGF in the progression of gastric carcinoma, HGF levels were measured by an enzyme immunoassay (EIA) system in sera of gastric cancer patients and followed up the levels after the operation. The mean serum HGF level in 212 healthy control subjects, 140 patients with primary gastric cancer, and 13 patients with recurrent gastric cancer were 0.199 +/- 0.073, 0.325 +/- 0.209, and 0.578 +/- 0.258 ng/ml, respectively. The increase of the levels was significantly correlated with the progression of tumor stage. The levels decreased to normal levels 1 month after curative resection of the tumors. However, the levels did not decrease significantly in nonresected cases. During the follow-up of the patients for several months, the level was significantly increased in recurrent gastric cancer patients, whereas there was no increase in nonrecurrent patients. In conclusion, the serum HGF levels significantly correlated with the aggressiveness of the tumors, suggesting an important role of HGF in the progression of gastric carcinoma.
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Affiliation(s)
- S U Han
- Department of Surgery, School of Medicine, Ajou University, San-5, Wonchon-Dong, Paldal-Gu, Suwon 442-749, Korea
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Park YJ, Youk EG, Choi HS, Han SU, Park KJ, Lee KU, Choe KJ, Park JG. Experience of 1446 rectal cancer patients in Korea and analysis of prognostic factors. Int J Colorectal Dis 1999; 14:101-6. [PMID: 10367255 DOI: 10.1007/s003840050193] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In order to investigate the changing pattern of rectal cancers in Korea and to identify prognostic factors, we investigated the case histories of 1446 rectal cancer patients who had received surgical treatment. During the study period there were trends toward a decrease in the ratio of rectal cancer to colon cancer, earlier detection (more Dukes' stages A and B and fewer C), a decrease in the number of abdominoperineal resections, and an increase in the number of sphincter-preserving operations. Univariate analysis of prognostic factors showed that gender, obstruction symptoms, preoperative serum carcinoembryonic antigen (CEA) level, tumor size, depth of bowel wall invasion, lymph node metastases (presence and number), tumor differentiation, operative method, and date of operation were significant, but age, symptom duration, and tumor location were not. The use of sphincter-saving operations did not adversely affect the clinical outcome. Multivariate analysis showed lymph node metastasis factor to be the most significant factor (P < 0.001); the depth of bowel wall invasion, differentiation, CEA level, and date of operation were also significant (0.001 < P < 0.05). This study shows that although anatomical extent of disease (depth of invasion and lymph node metastasis) is the most reliable prognostic predictor in rectal cancer, other factors such as preoperative CEA level and tumor differentiation also provide important information on the outcome and use of an anal-preserving operation does not adversely affect the patient survival.
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Affiliation(s)
- Y J Park
- Department of Surgery, Seoul National University College of Medicine, Korea
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Kim WH, Lee JH, Han SU, Wang HJ, Kim MW. Can clamping of splenic vessels prevent abrupt increase of portal vein pressure and migration of transplanted hepatocytes to the liver after intrasplenic hepatocyte transplantation? Hepatogastroenterology 1998; 45:2425-9. [PMID: 9951937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND/AIMS It is well known that hepatocyte transplantation can retain some proper functions, significantly improve the survival rate of rats with different models of acute fulminant hepatic failure, correct some congenital genetic disorders, and improve liver function in cirrhosis. Portal hypertension and hepatic embolization have been described following intrasplenic hepatocyte transplantation. We evaluated the effect of temporary occlusion of splenic vessels on changes in portal vein pressure and on distribution of transplanted hepatocytes after hepatocyte transplantation into the spleen in normal rats. METHODOLOGY Liver cirrhosis has been induced in rats by 1% dimethylnitrosamine (Sigma, St. Louis, Mo) dissolved in normal saline at the dose of 10 ml of DMN/Kg, i.p., 3 consecutive days a week for 4 weeks. Donor hepatocytes were harvested by in situ ethylenediaminetetraacetic acid (EDTA) perfusion. Changes in portal vein pressures were monitored by a pressure monitor and distribution of transplanted hepatocytes was assayed by measurement of radioactivity of 51Cr-labeled transplanted hepatocytes according to clamping or non-clamping during intrasplenic hepatocyte transplantation. RESULTS The changes in portal pressure remained significantly high 10 min after hepatocyte transplantation in the nonocclusion groups compared to the occlusion groups. However, the changes in portal vein pressures in cirrhotic rats returned to normal faster than in normal rats after cell transplantation in the nonocclusion groups. The distribution of 51Cr-labeled transplanted hepatocytes into the spleen significantly diminished radioactivity of the liver at 10 min, 2 hours, and 24 hours in the occlusion groups compared to the nonocclusion groups. Also, duration of clamping time of splenic vessels did not influence the initial distribution of transplanted hepatocytes at the time of intrasplenic hepatocyte injection. CONCLUSIONS These results suggested that temporary occlusion of splenic vessels should be routinely used during intrasplenic hepatocyte transplantation.
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Affiliation(s)
- W H Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
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