Clinical Endoscopy

Immunohistochemical Expression of Epithelial-Mesenchymal Transition Markers in Early Gastric Cancer: Cancer Tissue versus Noncancer Tissue: Hee Jae Jung, Su Jin Hong, Shin Hee Kim; Clin Endosc 2019;52(5):464-471. Published online May 22, 2019; DOI: https://doi.org/10.5946/ce.2018.181

Background
/Aims: Epithelial-mesenchymal transition (EMT) is a developmental process, wherein the epithelial cells show reduced intercellular adhesions and acquire migratory fibroblastic properties. EMT is associated with downregulation in epithelial marker expression, abnormal translocation of E-cadherin, and upregulation in mesenchymal marker expression. Here, we investigated the immunohistochemical (IHC) expression of EMT markers in early gastric cancer (EGC) between cancer and noncancer tissues.
Methods
Tissue samples were prospectively obtained from 19 patients with EGC that underwent endoscopic submucosal dissection (ESD). We compared the expression level of transforming growth factor (TGF)-β, vascular endothelial growth factor (VEGF), E-cadherin, α-smooth muscle actin (α-SMA), and vimentin between cancer and noncancer tissues using IHC. Among the 19 patients, 15 patients had follow-up biopsy at 3 months after ESD for EGC.
Results
Cancer tissues presented higher values of EMT mesenchymal markers (α-SMA/vimentin/TGF-β/VEGF) than the noncancerous tissues (p<0.05) that were significantly low after ESD (p<0.05). No significant correlation was reported for tumor location and initial Helicobacter pylori infection.
Conclusions
The mesenchymal expression of EMT markers was higher in the cancerous tissues than in the noncancer tissues.

Citations

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The Efficacy of Diagnostic and Therapeutic Laparoscopic Lymph Node Dissection after Endoscopic Submucosal Dissection in Early Gastric Cancer: Yong Hun Kim, M.D., Joo Young Cho, M.D., Won Young Cho, M.D., Young Kwan Cho, M.D., Tae Hee Lee, M.D., Hyun Gun Kim, M.D., Jin Oh Kim, M.D., Joon Seong Lee, M.D., Yong Jin Kim, M.D.* and So Young Jin, M.D.^†; Korean J Gastrointest Endosc 2010;40(2):90-96. Published online February 27, 2010

Abstract PDF: Background
/Aims: Lymph node metastasis is infrequently found in patients with early gastric cancer (EGC) following surgery. Accurate evaluation of lymph node status is very important in determining the appropriate treatment for patients with EGC. The efficacy of diagnostic and therapeutic laparoscopic lymph node dissection after endoscopic submucosal dissection in patients with EGC at high risk for lymph node metastasis was evaluated.
Methods
Among patients with EGC who underwent endoscopic submucosal dissection between November 2006 and February 2009, 9 patients with undifferentiated adenocarcinoma, submucosal cancer, immunohistochemically-positive cytoplasmic staining for vascular endothelial growth factor, lymphovascular invasion, a high lymphatic microvessel density, or high microvessel density were selected. All patients underwent laparoscopic lymph node dissection for determination of lymph node status. The local IRB approved the study.
Results
All of the dissected lymph nodes were free of cancer cells in all of the patients. During 16 months of follow-up, no patients had evidence of tumor recurrence.
Conclusions
Laparoscopic lymph node dissection after endoscopic submucosal dissection is useful to assess lymph node status and may help guide further treatment for patients with EGC at high risk for lymph node metastasis. (Korean J Gastrointest Endosc 2010;40:90-96)

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췌장의 비기능성 소도세포종 1예 ( Nonfunctioning Pancreatic Islet Cell Tumor - A case report - ): Korean J Gastrointest Endosc 1993;13(3):581-585. Published online November 30, 1992

Abstract PDF: A case of nonfunctioning pancreatic islet cell tumor is described. A 34 years old female patient had intermittent epigastric pain and nausea for 6 months and she had nothing suggestive of neuroendocrine symtoms. Physcial examination showed an epigastric mass which wae deepseated, nontender, and well-demarcated. The routine upper endoscopic evatuation was negative. Abdominal ultrasonography and computed tomography showed a well-defined round solid mass with multifocal necrosis but did not revealed the origin of the lesion. Endoscopic retrograde pancreatography showed upward and rightward displacement of the proximal body portion of main pancreatic duct with nonvisualization of the secondary branches of pancreatic duct, suggesting that the mass originated from the pancreas. Resection of the mass with partial pancreatectomy and Roux-en-Y pancreaticojejunostomy was perfomed and the pathology was coafirmed as nonfunctioning pancreatic islet cell tumor containing somatostatin by immunohistochemical technique.

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