Mutation of c-kit and platelet-derived growth factor receptor alpha (PDGFRA) is the most important molecular feature of gastrointestinal stromal tumor (GIST). Mutation detection of these two genes is of great significance when establishing the diagnosis of a kit-negative GIST, or when predicting response to tyrosine kinase inhibitor. Furthermore, more and more researches focus on the feasibility of the mutation status using as a prognostic factor in recent years.
Gastrointestinal Neoplasms ; diagnosis ; drug therapy ; genetics ; Gastrointestinal Stromal Tumors ; diagnosis ; drug therapy ; genetics ; Humans ; Mutation ; Proto-Oncogene Proteins c-kit ; genetics ; Receptor, Platelet-Derived Growth Factor alpha ; genetics

PURPOSE: Fatigue is one of the most common complaints of cancer patients. In this study, we analyzed the change of fatigue level and general symptoms as time go by, so that, we could explain more on the mechanism and change of fatigue in relation with treatment, and explore the influencing factors. METHOD: The subjects of this study were 50 GI cancer patients who have visited the cancer center of A hospital in Suwon. We measured fatigue by using the Revised Piper Fatigue Scale(RPFS) at the time of starting and finishing induction chemotherapy, and starting the 2nd cycle of chemotherapy. RESULTS: 1) The fatigue score was 2.81, 3.73, and 3.82 in a 10 point scale at the time of starting and finishing induction chemotherapy, and starting the 2nd chemotherapy, respectively. This means fatigue persisted until after the treatment. 2) Fifty two percent of participants complained of some kinds of symptoms when starting the treatment, and the proportion increased up to 92% when finishing the treatment. 3) Fatigue scores were significantly high in patients with fatigue-related symptoms than for patients without those symptoms. 4) Fatigue scores showed significant differences according to patients' general characteristics such as age, educational level, economic status, occupation, diagnosis, hematocrit, weight, and amount of sleepy. CONCLUSION: We have to develop intervention strategies to reduce fatigue in cancer patients in the consideration of influencing factors.
Diagnosis ; Drug Therapy* ; Fatigue* ; Gastrointestinal Neoplasms* ; Gyeonggi-do ; Hematocrit ; Humans ; Induction Chemotherapy ; Occupations ; Piper ; Recurrence*

PURPOSE: The purpose of the present study was to assess factors associated with quality of life (QOL) and to determine whether anxiety and depression are predictive of QOL in patients with advanced gastrointestinal cancer at initial diagnosis and during the treatment process. METHODS: One hundred and twenty patients with gastrointestinal cancer requiring palliative chemotherapy were enrolled. RESULTS: At baseline, depression, performance status, and anxiety accounted for 55.0% (p<.001) of the variance in global health status score, depression accounted for 22.0% (p<.001) of the variance in functional scales score, and anxiety accounted for 19.0% (p<.001) of the variance in symptom scales score. At 3 months, depression, pain, and performance status accounted for 72.0% (p<.001) of the variance in global health status score, 76.0% (p<.001) of the variance in functional scales score, and 74.0% (p<.001) of the variance in symptom scales score. CONCLUSION: Anxiety and depression were significant predictive factors of QOL in patients with advanced gastrointestinal cancer. Depression and performance status were significant predictive factors of QOL at both baseline and 3 months, and anxiety and pain were significant predictive factors of QOL at baseline and 3 months, respectively.
Anxiety* ; Depression* ; Diagnosis ; Drug Therapy ; Gastrointestinal Neoplasms* ; Global Health ; Humans ; Quality of Life* ; Weights and Measures

Cancer is one of the leading causes of death in human, and among various cancers, gastrointestinal cancers occupy more than 55%. Gastric cancer is the first leading cause of cancer-related mortality in the world and the number of pancreas and colon cancers are increasing remarkably during last two decades which will continue to increase in the future. Even though the clinical importance of gastrointestinal cancers is very high and endless efforts has been made to develop novel diagnostic and therapeutic methods to improve the patient's quality of life and survival, the realistic advance in the actual survival benefit of the cancer patients are still strongly required. Nanotechnology has the power to radically change the way of cancer diagnosis and treatment. Currently, there is a lot of researches on novel nanodevices capable of detecting cancer at its earliest stage, pinpointing its location within the body, and delivering anticancer drugs specifically to the malignant cells. Nanoscale devices can readily interact with biomolecules both on the cell surface and within the cell. In addition, nanoscale devices are already proven that they can deliver therapeutic agents to target cells even within specific organelles. Major areas in which nanomedicine is being developed in cancer include early detection and proteomics, imaging diagnostics and multifunctional therapeutics. Because nanotechnology would provide a technical power and tool that enable new diagnostics, therapeutics, and preventives to keep pace with today's explosion in knowledge in the future, it would be very useful to know the perspectives in the direction of nanotechnology as a major clinician responsible for the patients with gastrointestinal malignancies.
Drug Delivery Systems ; Gastrointestinal Neoplasms/*diagnosis/*drug therapy ; Humans ; Nanocapsules/therapeutic use ; *Nanomedicine ; Nanoparticles/diagnostic use/therapeutic use ; Nanotechnology

The aim of the present study was to accurately evaluate the association of Sox2 expression with the survival of patients with digestive tract cancers. Relevant literatures were identified by comprehensively searching databases including the Pubmed, Embase, CBMdisc, and Wanfang (up to October 2014). A meta-analysis was performed to clarify the association between Sox2 expression and overall survival or clinicopathological parameters of patients with digestive tract cancers (esophageal, gastric, and colorectal cancers). The results showed a significant association between high Sox2 expression and poor overall survival in patients with digestive tract carcinomas (HR=1.55, 95% CI=1.04-2.31), especially for patients with esophageal cancer (HR=2.04, 95%CI=1.30-3.22), colorectal cancer (HR=1.40, 95% CI=1.04-1.89), and digestive tract adenocarcinoma (HR=1.80, 95% CI=1.12-2.89), for Europeans (HR=1.98, 95% CI=1.44-2.71) or patients who did not receive neoadjuvant treatment (HR=1.73, 95% CI=1.10-2.72). Furthermore, Sox2 over-expression was highly correlated with vascular invasion (OR=1.86, 95% CI=1.25-2.77) and poor differentiation (OR=1.88, 95% CI=1.14-3.08), especially in esophageal and colorectal cancers. In conclusion, Sox2 expression may serve as a novel prognostic factor for patients with digestive tract cancers. Over-expression of Sox2 that is correlated with vascular invasion and poor differentiation suggests poor outcomes of patients with digestive tract cancers.
Antineoplastic Agents ; therapeutic use ; Biomarkers, Tumor ; genetics ; metabolism ; Colorectal Neoplasms ; diagnosis ; drug therapy ; mortality ; pathology ; Esophageal Neoplasms ; diagnosis ; drug therapy ; mortality ; pathology ; Gastrointestinal Tract ; metabolism ; pathology ; Gene Expression ; Humans ; Neoadjuvant Therapy ; methods ; Neoplasm Grading ; Neoplasms, Vascular Tissue ; diagnosis ; drug therapy ; mortality ; secondary ; Prognosis ; SOXB1 Transcription Factors ; genetics ; metabolism ; Stomach Neoplasms ; diagnosis ; drug therapy ; mortality ; pathology ; Survival Analysis

An 84 yr-old male with a history of nausea and vomiting for 3 weeks was admitted to our hospital. Esopahgogastroduodenoscopy showed the diffuse infiltrative type of gastric cancer encircling from the cardia to the lower body. On abdominal computerized tomography, the gastric wall was diffusely thickened with overlying mucosal enhancement without lymph node involvement. Histologic examination revealed poorly differentiated adenocarcinoma. So surgical resection was planned. However, patient refused all medical care, and then he was discharged. He lived without any medical support and then he revisited our hospital and showed relieved symptoms on the follow-up exam. On esophagogastroduodenoscopy, the gastric mucosa of the body looked normal without any dysplastic change. Abdominal CT revealed a decreased thickening of the gastric wall of the body. The histology from the endoscopic forceps biopsy showed no evidence of malignancy. The patient is alive without any sign of tumor recurrence after 14 months.
Adenocarcinoma/*diagnosis/pathology ; Aged, 80 and over ; Diabetes Mellitus/drug therapy ; Endoscopy, Gastrointestinal ; Humans ; Hypoglycemic Agents/therapeutic use ; Male ; Stomach Neoplasms/*diagnosis/pathology ; Tomography, X-Ray Computed

Primary gallbladder carcinoma is relatively uncommon, but not a very rare disease. It accounts for 3- 4% of all gastrointestinal tract tumors, and is the most common malignant disease of the biliary tract. It occurs more frequently in women than in men at a ratio of 3:1. The etiology of gallbladder carcinoma is unknown, but the association of gallstones with it is well known. The diagnosis often is not made before laparotomy because its symptoms and signs are very nonspecific and are similar to those of cholecystitis. Commonly, it is encountered in the later stages and has very unfavorable courses. Recently, the operative treatments of gallbladder carcinoma have advanced significantly, and many studies revealed that more aggressive surgery gives rise to better prognosis in comparison with previous surgical treatment modalities. We reviewed 60 cases of this disease experienced in our hospital from October, 1988 to February, 1998. We evaluated whether the aggressive surgical treatment and the adjuvant therpy of gallbladder cancer had influence on prognosis. And additionally, we examined the clinical situations of primary gallbladder carcinoma. Only 33 patients of 60 were followed up until a recent date, and so all survival data were calculated within 33 cases. The results are as follows : 1) The incidence of gallbladder carcinoma in females outnumbered in males at a ratio of 1.2:1, and sixty per cent of all patients were 7th and 8th decades of age. 2) Almost all patients had varying degrees of upper abdominal pain, and the duration of symptoms was less than 4 weeks in half of the patients. 3) Forty-five per cent of all patients had gallstones. 4) Preoperative diagnoses were made in 28 cases(46.7%). 5) At the time of diagnosis, many patients(about 70%) were on the TNM stage III and IV. 6) The curative resectability rate of the cancer was merely 53.3%(32/60), and in the remainder of patients(n=28), palliative surgery and only laparotomy were carried out. The operative methods performed on purpose of a curative resection of the cancer were simple cholecystectomy in 14 patients(23.3%), cholecystectomy plus liver wedge resection plus LN dissection(radical cholecystectomy) in 15 patients(25%), radical cholecystectomy plus Roux-en-Y hepaticojejunostomy in 1(1.7%), and radical cholecystectomy plus right hepatic lobectomy in 2(3.3%). 7) The cumulative 5-year-survival rates of gallbladder carcinoma were 80% in stage I, 75% in stage II, 33% in stage III, and 0% in stage IV(p=0.002). In advanced cases(that is, in stage III and IV), the survival data was analized according to the operation methods. The mean survival times were 25.9 months in curative operation group and 3.3 months in palliative operation or explo-laparotomy group(p=0.003). 8) In a small number of patients of stage III and IV, chemotherapy and radiation therapy were carried out. But we could not find the statistical significances on the differences of survival rates.
Abdominal Pain ; Biliary Tract ; Cholecystectomy ; Cholecystitis ; Diagnosis ; Drug Therapy ; Female ; Gallbladder Neoplasms* ; Gallbladder* ; Gallstones ; Gastrointestinal Tract ; Humans ; Incidence ; Laparotomy ; Liver ; Male ; Palliative Care ; Prognosis ; Rare Diseases ; Survival Rate

Pneumatosis cystoides intestinalis (PCI) is a rare condition defined as the presence of multiple gas-filled cysts in the wall of gastrointestinal tract. The etiology and pathogenesis of PCI remain uncertain. It is associated with various medicosurgical conditions, including various pulmonary and gastointestinal diseases, connective tissue diseases and endoscopic procedures. The diagnosis is confirmed by endoscopic puncture and biopsy. PCI in adults, for the most part, show a benign clinical course and better prognosis if the associated disease is well controlled. Infantile PCI is more serious condition and especially associated with necrotizing enteritis. The treatment is usually conservative, However surgical intervention is needed when complications such as intussusception, obstruction, bleeding and perforation develope. We experienced a case of PCI found during the follow-up colonoscopy in a patient taken right hemicolectomy and systemic adjuvant chemotherapy due to colon cancer.
Adult ; Biopsy ; Chemotherapy, Adjuvant ; Colonic Neoplasms ; Colonoscopy ; Connective Tissue Diseases ; Diagnosis ; Drug Therapy ; Enteritis ; Follow-Up Studies ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intussusception ; Pneumatosis Cystoides Intestinalis* ; Prognosis ; Punctures

PURPOSE: Dexamethasone is a mainstay antiemetic regimen for the prevention of chemotherapy-induced nausea and vomiting. The aim of this pilot study was to assess the incidence of and factors associated with steroid-induced diabetes in cancer patients receiving chemotherapy with dexamethasone as an antiemetic. MATERIALS AND METHODS: Non-diabetic patients with newly diagnosed gastrointestinal cancer who received at least three cycles of highly or moderately emetogenic chemotherapy with dexamethasone as an antiemetic were enrolled. Fasting plasma glucose levels, 2-hour postprandial glucose levels, and hemoglobin A1C tests for the diagnosis of diabetes were performed before chemotherapy and at 3 and 6 months after the start of chemotherapy. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an index for measurement of insulin resistance, defined as a HOMA-IR ≥ 2.5. RESULTS: Between January 2012 and November 2013, 101 patients with no history of diabetes underwent laboratory tests for assessment of eligibility; 77 of these patients were included in the analysis. Forty-five patients (58.4%) were insulin resistant and 17 (22.1%) developed steroid-induced diabetes at 3 or 6 months after the first chemotherapy, which included dexamethasone as an antiemetic. Multivariate analysis showed significant association of the incidence of steroid-induced diabetes with the cumulative dose of dexamethasone (p=0.049). CONCLUSION: We suggest that development of steroid-induced diabetes after antiemetic dexamethasone therapy occurs in approximately 20% of non-diabetic cancer patients; this is particularly significant for patients receiving high doses of dexamethasone.
Antiemetics ; Blood Glucose ; Dexamethasone* ; Diabetes Mellitus ; Diagnosis ; Drug Therapy ; Fasting ; Gastrointestinal Neoplasms ; Glucose ; Homeostasis ; Humans ; Incidence ; Insulin ; Insulin Resistance ; Multivariate Analysis ; Nausea ; Pilot Projects* ; Vomiting

Childhood Burkitt lymphoma is most often diagnosed in the abdomen, with the majority of intra-abdominal cases arising from the small or large intestines. Involvement of the gastric mucosa is rare. Here, we present a six-year-old boy who was found to have gastric Burkitt lymphoma through biopsy obtained by esophagogastroduodenoscopy. The child was treated with six cycles of chemotherapy without surgery, and he remains free of disease fourteen months since initial diagnosis. Early definitive diagnosis through endoscopic biopsy and appropriate treatment are necessary for rare instances where children present with upper gastrointestinal tract tumors.
Abdomen ; Biopsy ; Burkitt Lymphoma ; Child ; Diagnosis ; Drug Therapy ; Endoscopy ; Endoscopy, Digestive System ; Gastric Mucosa ; Hematemesis ; Hemorrhage ; Humans ; Intestines ; Lymphoma, Non-Hodgkin ; Male ; Stomach Neoplasms ; Upper Gastrointestinal Tract