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위암 환자에서 수술 전 복막전이 예측을 위한 혈청 종양 표지자의 유용성: CA 19-9와 CEA
정오,주재균,박영규,유성엽,정미란,김호군,김동의,김영진,Cheong, Oh,Joo, Jae Kyun,Park, Young Kyu,Ryu, Seong Yeop,Jeong, Mi Ran,Kim, Ho Koon,Kim, Dong Yi,Kim, Young Jin 대한위암학회 2008 대한위암학회지 Vol.8 No.3
목적: 다른 소화기계 악성종양에 비하여 위암에서 종양표지자의 역할은 매우 제한적이다. 여러 연구들에서 종양표지자는 예후 및 재발과 밀접한 연관이 있음이 보고되었으나, 종양표지자를 이용한 수술 전 원격전이 예측의 유용성에 관한 보고는 매우 드물다. 대상 및 방법: 2004년부터 2006년까지 본원에서 위암으로 수술을 시행 받은 환자 중 종양 표지자의 비특이적 증가를 초래하는 요인을 가진 환자를 제외한 788명의 환자를 대상으로 수술 전 CEA, CA 19-9와 임상병리학적 특성간에 상관관계를 분석하였다. 결과: CEA 양성여부는 연령, 성별과 같은 종양과 무관한 비특이적 인자에 의해서도 영향을 받으며, 림프절 전이여부와 독립적인 상관관계가 있었으나 종양의 침윤도와는 상관관계가 없었다. 원격전이의 예측에서 CEA는 복막전이나 혈행성 전이와 유의한 상관관계가 없었다. 이에 비해 CA 19-9는 종양의 침윤도 림프절 전이와 각각 독립적인 상관관계를 보였으며, 원격전이 중 복막 전이여부와 유의한 상관관계를 보였다. 특히, 증가 정도에 따라 CA 19-9가 5배 이상 증가 시에 복막전이에 대한 위험도가 유의하게 증가함을 보였다. 결론: CA 19-9는 측정이 간편하고 용이할 뿐만 아니라, 수술 전 비치유인자인 복막전이를 예측하는데 도움을 줌으로써, 이에 따른 환자의 추가적인 검사를 통하여 적절한 치료 방침을 세우는데 임상적으로 유용한 도구라고 판단된다. Purpose: The usefulness of serum tumor markers for assessing gastric carcinoma is very limited compared to that for neoplasms in other digestive organs. Many reports have shown that serum tumor markers are closely associated with the prognosis and tumor recurrence in gastric cancer patients. However, little is known about the usefulness of serum tumor markers as a predictor of distant metastasis for gastric carcinoma. Materials and Methods: With excluding the non-specific causes of elevated tumor markers, a total of 788 patients with gastric carcinoma and who were seen at our hospitals between 2004 and 2006 were included in this study. The correlation between the preoperative level of tumor makers and the clinicopathological features was analyzed. Results: CEA was significantly correlated with age, gender and nodal metastasis, but not with the depth of tumor. The CEA level was not correlated with distant metastasis, such as peritoneal or hematogenous metastasis. In contrast, the CA 19-9 level was significantly correlated not only with the depth of tumor and nodal metastasis, but also with peritoneal metastasis. Especially, the patients with over 500% elevation of the CA 19-9 level had a significant risk of peritoneal metastasis. Conclusion: CA 19-9 is useful for predicting peritoneal metastasis in gastric cancer patients. It can be used efficiently in making the diagnostic and the treatment plan, in combination with other diagnostic tools, for gastric cancer patients.
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정오,구철모 한국정보시스템학회 2018 情報시스템硏究 Vol.27 No.4
Purpose The purpose of this study is to identify the effects of users’ perceived value of food delivery Apps and information quality on acceptance and intention to reuse of food delivery Apps. Design/methodology/approach This study made a design of the research model by integrating the factors of perceived value and information quality with the acceptance and continued usage of delivery Apps on the basis of the TAM (Technology Acceptance Model). Findings The results of this study suggests that perceived emotional value and monetary value, accuracy and timeliness of information have significant positive effects on usefulness and easiness of food delivery Apps. Meanwhile, both usefulness and easiness of food delivery Apps have significant positive influences on users’ continually use intention. Furthermore, implications in terms of the findings of this study are discussed.
정오,정미란,박영규,류성엽 대한위암학회 2017 Journal of gastric cancer Vol.17 No.2
The clinicopathological features and survival of the patients with gastric cancer with a FHX did not significantly differ from those of the patients without a FHX.
정오,정미란,류성엽 대한위암학회 2018 Journal of gastric cancer Vol.18 No.3
Purpose: With increasing life expectancy, the presence of comorbidities has become a major concern in elderly patients who require surgery. However, little is known about the impact of different comorbidities on the outcomes of laparoscopic total gastrectomy (LTG). In this study, we investigated the impact of comorbidities on postoperative complications in patients undergoing LTG for gastric carcinoma. Materials and Methods: We retrospectively reviewed the cases of 303 consecutive patients who underwent LTG for gastric carcinoma between 2005 and 2016. The associations between each comorbidity and postoperative complications were assessed using univariate and multivariate analyses. Results: A total of 189 patients (62.4%) had one or more comorbidities. Hypertension was the most common comorbidity (37.0%), followed by diabetes mellitus (17.8%), chronic viral hepatitis (2.6%), liver cirrhosis (2.6%), and pulmonary (27.1%), ischemic heart (3.3%), and cerebrovascular diseases (2.3%). The overall postoperative morbidity and mortality rates were 20.1% and 1.0%, respectively. Patients with pulmonary disease significantly showed higher complication rates than those without comorbidities (32.9% vs. 14.9%, respectively, P=0.003); patient with other comorbidities showed no significant difference in the incidence of LTG-related complications. During univariate and multivariate analyses, pulmonary disease was found to be an independent predictive factor for postoperative complications (odds ratio, 2.14; 95% confidence interval, 1.03–4.64), along with old age and intraoperative bleeding. Conclusions: Among the various comorbidities investigated, patients with pulmonary disease had a significantly higher risk of postoperative complications after LTG. Proper perioperative care for optimizing pulmonary function may be required for patients with pulmonary disease.
정오,김호군 대한위암학회 2019 Journal of gastric cancer Vol.19 No.1
Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.