Vol.11 No.2, August 20, 2023
김유진Journal of Digestive Cancer Research 2023; 11(2): 61-65 https://doi.org/10.52927/jdcr.2023.11.2.61
Abstract : Globally, esophageal cancer is the seventh most common cancer, and the male-to-female ratio in esophageal adenocarcinoma (EAC) is significantly imbalanced at 4:1 to 8:1. Obesity, reflux, and smoking are known risk factors for this sex difference; however, fully explaining this remains challenging. Studies have investigated the link between exogenous sex hormones and esophageal cancer occurrence. A meta-analysis revealed a lower risk of EAC in female who had undergone hormone replacement therapy. Androgen-deprivation therapy in patients with prostate cancer was associated with a decreased risk of EAC. Tissue-based studies have reported varied results regarding the relationship between estrogen receptor expression and survival in female patients with esophageal squamous cell carcinoma (ESCC). Circulating hormone studies have suggested that higher testosterone and luteinizing hormone levels decreased EAC risk in men, and free testosterone was inversely correlated in female with ESCC. However, a high androgen–estrogen ratio in male patients with EAC was linked to increased odds of EAC. Sex hormones influence carcinogenesis, affecting cell proliferation, differentiation, metabolism, inflammation, and cell death. The studies were limited by the small sample size and varying hormone measurement methods; thus, future studies with definitive conclusions on the association between esophageal cancer and sex hormones are warranted.
주일석1, 조현진1, 최수인2Journal of Digestive Cancer Research 2023; 11(2): 66-76 https://doi.org/10.52927/jdcr.2023.11.2.66
Abstract : Endoscopy is an important noninvasive procedure for patients with gastrointestinal problems. However, surgical techniques are shifting to laparoscopic surgery, and changes in endoscopic findings after laparoscopic surgery differ from those after previous surgical methods. Postoperative endoscopic findings differ from normal anatomical structures, and findings reportedly vary depending on the type of surgical technique. Therefore, we aimed to summarize the surgical and endoscopic findings for each surgical method from the surgeon’s point of view. The causes of gastric emptying delay, bleeding, afferent loop syndrome, or anastomosis leakage occurring after gastric cancer surgery can be identified via upper gastrointestinal endoscopy that is relatively less invasive than the surgical method. Regarding postoperative anastomosis leakage, endoscopy can directly evaluate the degree of leakage at the anastomosis site more accurately than computed tomography and enable immediate intervention. As endoscopy is less invasive than the surgical method, patients can be evaluated and treated more safely. However, coordination between the surgeon and the endoscopist is necessary to perform the procedures effectively. Therefore, reviewing the changes in surgical and endoscopic findings is important.
정소연1,2, 김정호1,2,3Journal of Digestive Cancer Research 2023; 11(2): 77-84 https://doi.org/10.52927/jdcr.2023.11.2.77
Abstract : Dietary habits play a significant role in the development of colorectal cancer. Over the past decades, various epidemiological and meta-studies have indicated a close relationship among nutrient intake, dietary habits, and incidence of colorectal cancer. Less consumption of red or processed meat and alcohol, if possible, and high consumption of vitamins B and D, garlic, magnesium, fiber, calcium, and omega-3 fatty acids reduce the risk of colorectal cancer. Additionally, balanced diet intake and proper weight maintenance are crucial for colon cancer prevention. All these factors are modifiable and associated with the recurrence and overall survival after cancer development, thereby greatly contributing to the nutritional treatment of patients diagnosed with colorectal cancer.
Abstract : Colorectal cancer (CRC) is one of the most prevalent cancers and is the leading cause of cancer-related mortality worldwide. Based on the current screening guidelines by the American Cancer Society and Korean multi-society expert committee, CRC screening is recommended in asymptomatic adults starting at the age of 45 years. Fecal immunochemical test-based screening programs reduce the development of CRC and related mortality in the general population. However, this most popular CRC screening strategy demonstrates a crucial limitation due to modest diagnostic accuracy. Colonoscopy may be considered as an alternative primary method for CRC screening; however, its implementation can still be challenging due to concerns regarding invasiveness, low adherence, cost-effectiveness, and quality assurance. To overcome the limitations of current screening tests, innovative noninvasive tests for CRC screening have been developed with advances in molecular biology, genetics, epigenetics, and microbiomics for detecting CRC, which may enhance the approach to CRC screening and diagnosis in clinical practice in the near future. This review explores the emerging screening methods and discusses their potential for integration into current practice.
정회훈, 박재근Journal of Digestive Cancer Research 2023; 11(2): 93-98 https://doi.org/10.52927/jdcr.2023.11.2.93
Abstract : Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47–93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5–31%. Hence, regular follow-up via endoscopy is required.
김기현Journal of Digestive Cancer Research 2023; 11(2): 99-103 https://doi.org/10.52927/jdcr.2023.11.2.99
Abstract : Malignant tumors located near the papilla of the duodenum can cause concomitant biliary and duodenal obstruction, which reduces the quality of life and increases the morbidity and mortality. Apart from traditional surgical treatment methods, various treatment methods such as endoscopic treatment and radiological interventions are used for the treatment. This study aimed to explore treatment methods according to the situation of patients with malignant biliary obstruction combined with duodenal obstruction.
배윤경, 유미영Journal of Digestive Cancer Research 2023; 11(2): 104-107 https://doi.org/10.52927/jdcr.2023.11.2.104
Abstract : The Ministry of Health and Welfare of Korea has implemented various social security programs to ensure a basic standard of living and raise overall quality of life for all citizens. The Korean social security system provides social insurance, public assistance, and social welfare services. To achieve adequate drug benefits, the Drug Management Department of Health Insurance Review and Assessment Service (HIRA) implement drug management duties including drug listing, upper price limit setting, scope of benefits, and post-factum management. When a manufacturer or an importer wants to apply for National Health Insurance (NHI) coverage of the drug that has obtained safety and efficacy approval, the pharmaceutical benefit assessment committee of HIRA evaluates the drug’s clinical efficacy and cost-effectiveness to determine whether or not to include the drug into the benefit package. The benefit standards for a listed drug (ingredient) are set either for the whole permitted range or a part of range with conditions. To increase the coverage rate for new drugs, the listed drugs are regularly reviewed for their value. The status of listed drugs can be adjusted or eliminated from the benefit package if the clinical efficacy turns out to be insignificant. Therefore, through these pharmaceutical management procedures, high-quality drugs are provided at reasonable prices, which save healthcare expenditure by price determination and selective coverage in consideration of economic evaluation.
이종윤Journal of Digestive Cancer Research 2023; 11(2): 108-113 https://doi.org/10.52927/jdcr.2023.11.2.108
Abstract : Dyspnea is a common symptom among patients with gastrointestinal cancer, and a comprehensive evaluation of their respiratory function is essential. Self-reporting aids in the assessment of the degree of dyspnea, while objective examination methods are performed to identify the potential underlying causes when subjective symptoms are present. Standard treatment protocols should be followed for potentially reversible and common causes of dyspnea, such as pleural effusion, pneumonia, airway obstruction, anemia, asthma, exacerbation of chronic obstructive pulmonary disease, pulmonary thromboembolism, or drug-induced interstitial lung disease. Careful and close monitoring is required due to the high frequency of pulmonary thromboembolism and the risk of cardiovascular accidents, drug-induced interstitial lung disease, or other complications from some anticancer drugs. In case of hypoxemia with an oxygen saturation of 90% or less, palliative treatment should comprise standard oxygen therapy such as nasal cannula, mask, or high-flow nasal cannula. If non-pharmacological oxygen therapy is not effective, pain control through systemic narcotic analgesics and anti-anxiety therapy with benzodiazepines may be helpful.
Abstract : Intestinal T-cell lymphoma is a rare and aggressive form of non-Hodgkin lymphoma. Owing to its rarity and variable manifestations, intestinal T-cell lymphoma is usually diagnosed at an advanced stage. Therefore, it may be accompanied with serious complications at the time of diagnosis. Herein, I reports a case of intestinal T-cell lymphoma with multiple severe complications.
장희령1,2, 임규형1,2Journal of Digestive Cancer Research 2023; 11(2): 119-121 https://doi.org/10.52927/jdcr.2023.11.2.119