Cancer In South Korea Research Articles

Diagnostic Value of Circulating miR-202 in Early-Stage Breast Cancer in South Korea.

Background and objectives: Breast cancer is the most common cancer among women worldwide. Early stage diagnosis is important for predicting increases in treatment success rates and decreases in patient mortality. Recently, circulating biomarkers such as circulating tumor cells, circulating tumor DNA, exosomes, and circulating microRNAs have been examined as blood-based markers for the diagnosis of breast cancer. Although miR-202 has been studied for its function or expression in breast cancer, its potential diagnostic value in a clinical setting remains elusive and miR-202 has not been investigated in South Korea. In this study, we aimed to evaluate the diagnostic utility of miR-202 in plasma samples of breast cancer patients in South Korea. Materials and Methods: We investigated miR-202 expression in the plasma of 30 breast cancer patients during diagnosis along with 30 healthy controls in South Korea by quantitative reverse transcription PCR. Results: The results showed that circulating miR-202 levels were significantly elevated in the breast cancer patients compared with those in healthy controls (p < 0.001). The sensitivity and specificity of circulating miR-202 were 90.0% and 93.0%, respectively. Additionally, circulating miR-202 showed high positivity at early stage. The positive rate of miR-202 was as follows: 100% (10/10) for stage I, 90% (9/10) for stage II, and 80% (8/10) for stage III. miR-202 was also a predictor of a 9.6-fold high risk for breast cancer (p < 0.001). Conclusions: Additional alternative molecular biomarkers for diagnosis and management of pre-cancer patients are needed. Circulating miR-202 might be potential diagnostic tool for detecting early stage breast cancer.

Incidence, cost and gender differences of oropharyngeal and noncervical anogenital cancers in South Korea

BackgroundHuman papillomavirus (HPV) is associated with a significant public health burden, yet few studies have been conducted in Asia, especially on noncervical cancers. We estimated the incidence and cost of oropharyngeal and noncervical anogenital (anal, vulvar, vaginal, penile) cancer in Korea.MethodsWe conducted a retrospective cohort study using Korea’s National Health Insurance (NHI) claim database from 2013 to 2016. The main outcome measures were the number of respective cancer incidences during the study period and the annual costs per patient in the first year after diagnosis, which was adjusted by relevant variables based on the regression analysis.ResultsDuring the study period, 8022 patients with these cancers were identified, and oropharyngeal cancer comprised 46% of them. The crude incidence rate for male oropharyngeal cancer was significantly higher than that of females (3.1 vs. 0.7 per 100,000 as of 2016, respectively). Additionally, the crude incidence of male oropharyngeal cancer increased from 2.7 in 2013 to 3.1 in 2016, whereas that of female and other cancers was stable during the study period. The mean annual incidence-based cost per patient in 2016 was highest for oropharyngeal cancers (21,870 USD), and it was significantly higher in males than in females based on then regression analysis (p < .001).ConclusionsOropharyngeal cancer comprises the highest number of HPV-associated noncervical cancer incidences in Korea, and the incidence and cost of oropharyngeal cancer was significantly higher among males than females. More aggressive public health policy toward males may decrease gender gap of oropharyngeal cancer.

Drug-specific and dosage effects of statins and the risk of cancer: a population-based cohort study in South Korea.

This study aimed to investigate whether the drug-specific and dosage effects of statin use were associated with a lower risk of cancer in adults in South Korea. We evaluated the adult population registered in the 2010 sample cohort database of South Korea. Subjects were divided into the statin group (those who had been prescribed continuous oral statin over 1 year) and the control group (those who had never been prescribed statin from 2010 to 2016). In total, 687 396 individuals were included in the analysis [statin group, 53 592 (7.8%); control group, 633 804 (92.2%)]. In a multivariable Cox model, the hazard of cancer in the statin group was 5% lower than that in the control group [hazard ratio, 0.95; 95% confidence interval (CI), 0.91-0.98; P = 0.004]. Additionally, the hazard of cancer in patients receiving moderate- and high-intensity daily dosages of statin were 5% (hazard ratio, 0.95; 95% CI, 0.91-0.98; P = 0.005) and 9% (hazard ratio, 0.91; 95% CI, 0.83-0.99; P = 0.042) lower than that of the control group, respectively. The hazard of cancer in patients receiving atorvastatin was 6% (hazard ratio, 0.94; 95% CI, 0.90-0.98; P = 0.005) lower than that in the control group, while other types of statins showed no significant associations (all P > 0.05). Statin use was associated with a lower risk of cancer in South Korea. This association was stronger in patients receiving moderate and high daily dosages of statin and in patients receiving atorvastatin.

Psychiatric comorbidities among patients with esophageal cancer in South Korea: a nationwide population-based, longitudinal study.

BackgroundThis longitudinal study aimed to analyze the prevalence of psychological distress in esophageal cancer survivors, using claims data in South Korea.MethodsFrom January 2010 to December 2014, we identified the four most frequent psychological distress in a nationwide cohort of 8,879 patients diagnosed with esophageal cancer. We analyzed the prevalence and the pattern of psychological distress before and after the initial treatment.ResultsAmong esophageal cancer patients, 669 patients (7.5%) were diagnosed with a psychological distress between 1 year prior to initial treatment and the time of last follow-up. Among them, depression and anxiety had a similar frequency of 237 (35.4%). The overall frequency of psychological distress peaked within 2 months after the initial treatment. Stress reaction/adjustment disorders showed the highest increase rate after treatment. The rate of patients who had psychological distress was higher among those who underwent surgery as their initial treatment than in those who received radiotherapy [odds ratio (OR): 1.39, P<0.001]. Further, female patients were more likely to be diagnosed with psychological distress compared with male patients (OR: 1.30, P<0.001).ConclusionsPsychological distress in esophageal cancer survivors showed different patterns of prevalence depending on the nature of disease, sex, and initial treatment. Considering individual factors, timely diagnosis and intervention for psychological distress could improve the quality of life for esophageal cancer survivors.

Hermeneutic Phenomenological Study on the Lived Experience of Illness among Older Females with Cancer in South Korea

Purpose: The purpose of the study was to understand the lived experience of illness among older females with cancer in South Korea. Methods: Data were collected from May to December of 2019 through individual in-depth interviews with eight older females with cancer who have undergone thorough cancer diagnosis and treatments. Transcribed data were analyzed using the hermeneutic phenomenological method developed by van Manen. Results: Six essential themes emerged: old body physically devastated through the fight against cancer; tug of war for symbiosis between cancer and the old body; home that does not provide comfort anymore; twilight years with no regrets even with cancer; womanhood to keep for a lifetime even in old age; and putting pieces together of the relationships around oneself. Conclusion: Based on the participants’ illness experience, efforts need to be made to develop and implement effective strategies to improve nurses’ understanding of the life experiences of illness among older females with cancer in the Korean socio-cultural context, and to provide patient and family-centered nursing interventions that reflect patients’ age and gender characteristics.

The Effect of Video Education on Cancer Patient Advance Directive Writing

Purpose: This study was conducted to examine the role of video education on cancer patient advance directive writing. Methods: To evaluate the effects of video education on cancer patient advance directive knowledge, attitude, writing intention and writing, this study employed a non-equivalent control group and non-synchronized design as a quasi-experimental study. The target population of this study were adults aged ≥50 years old, diagnosed with cancer in South Korea. The proximity population were also cancer patients who visited a university hospital. The control group (n=31) were educated verbally using a leaflet and the experimental group (n=30) were educated by a video program developed by the National Bioethics Policy Institute for 10 minutes, supplemented with a leaflet. The advance directives video program form provided by the Korean Ministry of Health and Welfare was used. Results: The experimental group showed a positive change in knowledge level (F=52.82, p＜.001, effect size=0.96), attitude (F=12.21, p＜.001, effect size=0.46), the intention to write (F=18.22, p＜.001, effect size=0.56) advance directives and a higher proportion of writing (χ²=13.87, p＜.001) than the control group. Conclusion: The results of this research show that providing information through video is a more effective educational medium for retention of knowledge, attitude, writing intention, and writing of cancer patient’s advance directives.

Experiences of Inpatients Living with Lung Cancer in South Korea

Experiences of Inpatients Living with Lung Cancer in South Korea

Abdominal obesity increases risk for esophageal cancer: a nationwide population-based cohort study of South Korea.

The relationship between overall obesity, as measured by body mass index (BMI) and risk of esophageal squamous cell carcinoma (ESCC) has been reported to show a negative correlation. However, the relationship of ESCC, which accounts for around 90% of esophageal cancers in South Korea, with abdominal obesity, as measured by waist circumference (WC), may be different. Thus, we investigated the association between abdominal obesity and esophageal cancer in a nationwide population-based cohort. A retrospective cohort study of 22,809,722 individuals who had undergone regular health check-ups provided by the National Health Insurance Corporation between 2009 and 2012 (median follow-up period, 6.4years) in South Korea was conducted. Abdominal obesity was defined as a WC > 90cm for men and > 85cm for women. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using χ2 test and Cox proportional hazards model adjusted for confounding factors. The primary outcome was newly developed esophageal cancer. After adjusting for BMI, abdominal obesity increased the risk of esophageal cancer (HR 1.29, 95% CI 1.23-1.36). WC increased the risk for esophageal cancer in a dose-dependent manner (p values for trend < 0.0001). Among overweight (BMI 23-24.9kg/m2) and obese I (BMI 25-29.9kg/m2) individuals, abdominal obesity was a risk factor for esophageal cancer (HR 1.22, 95% CI 1.11-1.34; HR 1.28, 95% CI 1.18-1.39, respectively). Increasing abdominal obesity may be associated with an increased risk for esophageal cancer. Further studies are warranted to confirm the relationship.

Collaborative Care to Relieve Psychological Distress in Patients with Medically Inoperable Lung Cancer: Design and Rationale for a Clinical Trial.

Psychological distress is common in lung cancer patients with a poor prognosis. The present study aims to investigate the efficacy of collaborative care for patients with newly diagnosed inoperable lung cancer in South Korea. The study is a three-arm parallel-groups nonrandomized clinical trial with an active arm that includes distressed patients who receive collaborative care, one comparison arm that includes distressed patients who receive enhanced usual care, and another comparison arm that includes non-distressed patients. In total, 267 consecutive patients newly diagnosed with medically inoperative lung cancer will be recruited. The primary outcomes are the changes in Hospital Anxiety and Depression Scale-depression and the Distress Thermometer at 12 and 32 weeks after enrollment. Sub-analyses of patients in the active arm of the study will include a comparison of the efficacy of a combination of oral antidepressant (escitalopram) treatment and collaborative care versus that of collaborative care alone.

Cost-Effectiveness Analysis of Hospice-Palliative Care for Adults with Terminal Cancer in South Korea

ëª©ì  호스피스 완화의료는 중요한 ê³µì¤‘ë³´ê±´í•™ì  ê³¼ì œë¡œì¨ 관심이 ë†’ì•„ì§€ê³ ìžˆì§€ë§Œ, 호스피스 완화의료의 효과에 대한 연구는 국내에서는 부족한 ì‹¤ì •ì´ê¸° 때문에 이에 대한 연구는 중요한 ì •ë³´ì™€ 함의를 ì œê³µí•´ì¤„ 수 있을 것이다. 이 연구는 말기 암환자들을 대상으로 호스피스 완화의료의 비용효과 분석을 시행하였다. 방법 ê²°ì •ìˆ˜í˜•(decision tree)ê³¼ 함께 마콥모형(Markov model)을 이용하여 비용효과 분석을 시행하였으며, 병원내 일반 병동 대비 호스피스 완화의료 병동에서 치료받았을 때의 비용, 삶의 질 ê·¸ë¦¬ê³ ë¹„ìš©íš¨ê³¼ì„±ì„ 비교하였다. 비용과 삶의 질은 국내에서 출판된 국내 연구에서 활용된 값을 이용하여 ì¶”ì •í•˜ì˜€ìœ¼ë©° 비용효과성은 ICER을 통하여 산출하였다. ì¶”ê°€ì ìœ¼ë¡œ 비용 상승을 ê°€ì •í•˜ì—¬ 일요인(one-way) 민감도 분석을 시행하였다. ê²°ê³¼ 일반 병동 대비 호스피스 완화의료 병동에서 치료 받는 대안이 가장 ë¹„ìš©íš¨ê³¼ì ì´ì—ˆë‹¤. ì ì¦ë¹„ìš©(incremental cost)은 290,401원이었으며, ì ì¦íš¨ê³¼(incremental effect)는 -0.25였다. ì ì¦ì  비용효과비는 -1,174,045원이었다. 민감도 분석 ê²°ê³¼ 비슷한 경향성이 관찰되었다. ê²°ë¡ ì¼ë°˜ 병동 대비 호스피스 완화의료 병동에서 치료받는 대안이 비용은 더 ë‚®ê³ íš¨ê³¼ëŠ” 더 좋은 것으로 관찰되었다. 따라서 이 연구 결과를 통하여 일반 병동 대비 호스피스 완화의료 병동에서 치료받는 대안이 ë¹„ìš©íš¨ê³¼ì ì¸ ê´€ì ì—ì„œ ì„ íƒí• ìˆ˜ 있는 대안임을 ì œì•ˆí•œë‹¤. 중심 단어: 비용효과 분석; 호스피스 완화의료; 한국

Clinical characteristics of clear cell ovarian cancer: A retrospective multicenter experience of 308 patients in South Korea.

e17062 Background: Clear cell ovarian cancer is rare, accounts for about 3-10% of epithelial ovarian carcinoma, and is known to be associated with endometriosis. This tumor type has poor prognosis due to inherent chemoresistance. We investigated clinical characteristics and prognostic factors of clear cell ovarian cancer in South Korea. Methods: We reviewed the medical records of 308 patients with clear cell histology ovarian cancer who underwent debulking surgery from 21 institutions in South Korea between 1995 and 2015. Results: Mean age was 51 years (range, 25-81) and 194 patients (63.7%) had stage I disease, 34 (11.1%) had stage II, 66 (21.6%) had stage III, and 11 (3.6%) had stage IV. 107 patients (34.9%) had endometriosis. 9 patients (2.9%) received neoadjuvant chemotherapy, 248 (80.5%) received postoperative chemotherapy, and among them, 238 (96%) received taxane-platinum chemotherapy. 275 patients (89.3%) achieved optimal debulking. 112 patients (37%) had recurrence, 182 (59.1%) was disease-free, and 12 (3.9%) lost follow up. Median value of CA-125 was 72.34 U/ml (range, 1.9-8930), 45.7 in stage I, 98.9 in stage II, 192.1 in stage III, and 634.8 in stage IV. 1-year, and 3-year rate of disease-free survival (DFS) was 70%, and 63%, respectively. 1-yr DFS rate was 90% in stage Ia and Ib, 88% in stage Ic and II, and 60% in stage III and IV. According to the same stage grouping, 3-year DFS rate was 82%, 70%, and 40%, respectively. Overall survival (OS) rate at 1 year was 97%, 99%, and 90%, and 97%, 96%, and 88% at 3 year. Multivariate analysis revealed optimal debulking (HR 6.62, p &lt; 0.001) as a significant prognostic factor for DFS. Among the 94 patients with early stage (Ia and Ib), 17 patients (18.1%) received adjuvant chemotherapy, and there was no significant difference in DFS according to adjuvant chemotherapy (log rank p = 0.57). Conclusions: In patients with clear cell ovarian cancer, optimal debulking surgery was associated with improved DFS. And the role of adjuvant chemotherapy in early stage clear cell ovarian cancer is elusive and needs further study.

PO-140 Psychiatric comorbidities among tongue cancer in South Korea: A nationwide population-based study

PO-140 Psychiatric comorbidities among tongue cancer in South Korea: A nationwide population-based study

P117 - The current status of interval breast cancers in South Korea by National Cancer Screening Programs: an analysis of the national health insurance claim’s data

P117 - The current status of interval breast cancers in South Korea by National Cancer Screening Programs: an analysis of the national health insurance claim’s data

Reliability and validity of the short‐version instrument to measure health promotion for Korean cancer survivors

AbstractPurposeThe current study tests the validity and reliability of the short version of the Health Promoting Lifestyle Profile II (HPLP‐II) when used to measure health promotion for Korean cancer survivors.MethodsThe survey data were collected from 175 Korean cancer survivors who were diagnosed with breast or colorectal cancer in South Korea. The confirmatory factor analysis (CFA) and structural equation modeling were conducted to examine the construct and criterion validity of the Korean version of the HPLP‐II.ResultsFindings demonstrated that excluding nutrition and stress management, four subscales showed good internal consistency. The three competing models of the HPLP‐II were tested to determine the factor structure of the HPLP‐II for Korean cancer survivors: (a) the original 6‐factor, (b) the modified 4‐factor, and (c) the modified 5‐factor. The five‐factor solution with 23 items was selected for the final model. The criterion‐related validity based on the relationships between health promotion and HRQOL was demonstrated.DiscussionThis study makes an important contribution to understanding the health promotion measure used by Korean cancer survivors. Specifically, this study provides a rationale to investigate the validity of a measure before such measures are used in the different language and cultural groups.

Risk factors for developing liver cancer in people with and without liver disease.

BackgroundThe National Liver Cancer Surveillance Program (NLCSP) targets patients with liver diseases that lead to liver cancer in South Korea. This study aimed to investigate the risk of liver disease leading to liver cancer using nationally representative data to establish an efficient NLCSP.MethodsThis study used data from the National Health Insurance Service National Sample Cohort (NHIS-NSC) from 2002 to 2013. A retrospective matched cohort design was applied to compare the development of liver cancer in patients with and without liver disease. Cox- proportional hazard regression for liver cancer with competing risk of death was performed for all subjects or each group stratified according to age or income level.ResultsA total of 66,192 patients with liver disease and matched subjects without liver disease were included in the study. The incidences of liver cancer among patients with and without liver disease within a median 8-year follow-up period were 2.68% (n = 1,772) and 0.34% (n = 210), respectively. Cox- regression analysis for liver cancer incidence indicated that cirrhosis had the highest risk (hazard ratio [HR]: 18.13, 95% confidence interval [CI]: 15.24–21.58), followed by hepatitis B (HR: 9.32, 95% CI: 8.00–10.85). Subgroup analysis showed that the presence of liver disease was an important risk factor in younger as well as elderly people, and a higher risk of liver disease was also observed in the patients with Medicaid.ConclusionsAttention should be paid to the development of liver cancer in young people under 50 years old and preventive efforts to decrease the incidence of liver cancer among Medicaid recipients is needed.

Incidence and Overall Survival of Biliary Tract Cancers in South Korea from 2006 to 2015: Using the National Health Information Database.

Background/AimsThere have been no nationwide studies to investigate the trends in incidence and 5-year survival rates of intra- and extrahepatic bile duct cancers and gall-bladder cancer. Therefore, our study aimed to describe the incidence and 5-year survival rates of biliary tract cancers by subsites in South Korea.MethodsA total of 86,134 patients with biliary tract cancers were selected from the National Health Information Database. Age-standardized incidence rates and annual percentage changes were calculated. Life-table methods and log-rank tests were used to determine the differences in survival rates. Cox-proportional hazard models were used to estimate the hazard ratio of the patients with biliary tract cancers.ResultsThe incidence rate of intra-hepatic bile duct cancer decreased by 1.3% annually from 8.8 per 100,000 in 2006 to 7.8 per 100,000 in 2015. Extrahepatic bile duct cancer also showed a decreasing trend by 2.2% per year from 8.7 per 100,000 in 2006 to 6.7 per 100,000 in 2015. Gallbladder cancer showed the greatest decline, with an annual percentage change of 2.8% from 6.3 per 100,000 to 5.2 per 100,000 during the same period. The 5-year survival rates were 30.0% in gallbladder cancer, 27.8% in extrahepatic bile duct cancer, and 15.9% in intra-hepatic bile duct cancer.ConclusionsThe overall incidence rates of intrahepatic and extrahepatic bile duct cancer and gallbladder cancer decreased from 2006 to 2015. Among biliary tract cancers, intrahepatic bile duct cancers exhibited the highest incidence rate and the worst survival rate.

Cigarette smoking, alcohol consumption, and risk of colorectal cancer in South Korea: A case-control study.

The current case-control study comprehensively evaluated the status, quantity, and duration of smoking and alcohol drinking for both men and women, considering the subsites of colorectal cancer. A total of 925 colorectal cancer cases and 2775 controls were included in the analysis. Odds ratios (OR) and 95% confidence intervals (CI) were computed by logistic regression models adjusting for potential confounders. In men, the risk of colorectal cancer significantly increased for heavy smokers who smoked ≥40 pack-years (OR 1.74, 95% CI 1.22-2.50), ≥40 years (OR 1.50, 95% CI 1.05-2.16), or ≥40 cigarettes/day (OR 1.92, 95% CI 1.04-3.54). Men showed a significant increase in risk, especially for rectal cancer with an increasing amount or duration of smoking. In women, distal colon cancer risk increased in smokers who smoked ≥20 years (OR 3.21, 95% CI 1.27-8.14) or ≥20 cigarettes/day (OR 4.75, 95% CI 1.09-20.57). Additionally, female smokers who smoked ≥20 cigarettes/day had an increased risk of rectal cancer (OR 6.46, 95% CI 1.64-25.46). Regarding the association of cigarettes smoked per day and the risk of rectal cancer, there was no significant difference between men and women (gender interaction p value=0.14). Compared with never-drinkers, those who consumed alcohol at ≥40g/day in men and ≥20g/day in women had an OR of 2.39 (95% CI 1.68-3.41) and 3.52 (95% CI 1.56-7.96), respectively. The effect of daily alcohol consumption (g of ethanol/day) on cancer risk was not significantly different among subsites. Association of alcohol consumption quantity (g of ethanol/day) and the risk of proximal and distal colon cancer were stronger in women than in men (gender interaction p value<0.01). There was no significant interaction in the multiplicative level when alcohol consumption and cigarette smoking were combined. The duration and amount of smoking as well as the amount of alcohol consumption were associated with an elevated risk of colorectal cancer in both men and women.

Palliative Performance Scale Score at 1 Week After Palliative Care Unit Admission is More Useful for Survival Prediction in Patients With Advanced Cancer in South Korea.

The Palliative Performance Scale (PPS) is a useful prognostic index in palliative care. Changes in PPS score over time may add useful prognostic information beyond a single measurement. To investigate the usefulness of repeated PPS measurement to predict survival time of inpatients with advanced cancer admitted to a palliative care unit (PCU) in South Korea. Prospective observational cohort study. 138 patients with advanced cancer admitted to a PCU in a university hospital in South Korea from June 2015 to May 2016. The PPS score was measured on enrollment and after 1 week. We used Cox regression analyses to calculate hazard ratios (HRs) to demonstrate the relationship between survival time and the groups categorized by PPS and changes in PPS score, after adjusting for clinical variables. There were significant differences in survival time among 3 groups stratified by PPS (10-20, 30-50, and ≥60) after 1 week. A group with a PPS of 10 to 20 at 1 week had the highest risk (HR: 5.18 [95% confidence interval, 1.57-17.04]) for shortened survival. On the contrary, there were no significant differences among these groups by initial PPS alone. Similarly, change in PPS was prognostic; median survival was 13 (10.96-15.04) days for those whose PPS decreased after 1 week and 27 (10.18-43.82) days for those with stable or increased PPS ( P < .001). Measuring PPS over time can be very helpful for predicting survival in terminally ill patients with cancer, beyond a single PPS measure at PCU admission.

Epidemiology of liver cancer in South Korea.

Liver cancer is the sixth most common cancer (fourth in men and sixth in women) and the second largest cause of cancer mortality in South Korea. The crude incidence rate of liver cancer was 31.9/100,000 (47.5/100,000 in men and 16.2/100,000 in women) and the age-standardized incidence rate was 19.9/100,000 (32.4/100,000 in men and 8.8/100,000 in women) in 2014. The crude incidence rate increased from 1999 to 2011 and thereafter showed a subtle decreasing tendency. The crude prevalence rate was 113.6/100,000 (170.2/100,000 in men and 57.1/100,000 in women) and the age-standardized prevalence rate was 72.6/100,000 (115.7/100,000 in men and 33.7/100,000 in women) in 2014, which increased from 2010 to 2014. Survival from liver cancer has improved over the last two decades. The 5-year relative survival rate was markedly increased from 10.7% in those diagnosed with liver cancer between 1993 and 1995 to 32.8% in those diagnosed between 2010 and 2014. The epidemiology of liver cancer is influenced by that of underlying liver diseases such as viral hepatitis. Substantial progress has been made in the prevention and treatment of viral hepatitis; however, uncontrolled alcoholic liver disease, obesity and diabetes appears to have the potential to emerge as major causes for liver cancer. Depending on the success of the control of risk factors, the epidemiology of liver cancer in Korea may change.

Curcuzedoalide contributes to the cytotoxicity of Curcuma zedoaria rhizomes against human gastric cancer AGS cells through induction of apoptosis

Ethnopharmacological relevanceCurcuma zedoaria Roscoe (Zingiberaceae), also known as white turmeric or zedoaria, has been used in Ayurveda and traditional Chinese medicine to treat various cancers, and it possesses several sesquiterpenoid compounds. ObjectiveThis study aimed to evaluate the therapeutic effects of a methanolic (MeOH) extract of C. zedoaria rhizomes, as well as its active constituents, against gastric cancer, which is a frequently diagnosed cancer in South Korea. Materials and methodsRepeated column chromatography, together with semi-preparative HPLC purification, was used to separate the bioactive constituents from the C. zedoaria MeOH extract. The cytotoxic effects of the C. zedoaria MeOH extract and its active compounds were measured in human gastric cancer AGS cells. Expression of proteins related to apoptosis was evaluated using Western blotting analysis. ResultsThe MeOH extract of C. zedoaria rhizomes exerted a cytotoxic effect on AGS cells (IC50: 96.60 ± 4.87μg/mL). Based on the bioactivity-guided fractionation for antiproliferative activity, a chemical investigation of the MeOH extract led to the isolation of five sesquiterpenes including isoprocurcumenol (1), germacrone (2), curzerenone (3), curcumenol (4), and curcuzedoalide (5). Among these, curcuzedoalide demonstrated the strongest effect in suppressing gastric cancer cell proliferation in a dose-dependent manner with an IC50 value of 125.11±2.77μM. Western blotting analysis showed that curcuzedoalide inhibited AGS human gastric cancer cell viability by activating caspase-8, caspase-9, caspase-3, and PARP, which contributed to apoptotic cell death in AGS human gastric cancer cells. ConclusionThese data indicate that curcuzedoalide contributed to the cytotoxicity of C. zedoaria by activating the cleavage of caspases and PARP, which are representative markers for apoptosis. Therefore, curcuzedoalide is a positive candidate for the development of novel chemotherapeutics.