• Title/Summary/Keyword: 동시 시행군

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Radiotherapy Results in Stage IIB Uterine Cervix Cancer (자궁경부암 병기 IIB의 방사선치료결과)

  • Kil Whoon Jong;Chun Mison;Kang Seunghee;Oh Young Taek;Ryu Hee Sug;Ju Hee Jae;Lee Eun Ju
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.345-352
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    • 2001
  • Purpose : To evaluate the treatment results and prognostic factors after radiotherapy in stage IIB uterine cervix cancer. Materials and methods : We retrospectively analyzed the records of 90 patients with stage IIB uterine cervix cancer who received radiotherapy between 9/94 and 12/99. Age was ranged from 28 to 79 years (median 57). Tumor size was $\geq4\;cm$ in 64 patients. Preteatment SCC level was measured in 75 patients. Twenty nine patients received conventional radiotherapy (QD) and the others received modified hyper-fractionated radiotherapy (BID). Only 7 patients in BID had tumor size <4 cm. All patients received high dose rate brachytherapy $(4\;Gy\times7\;or\;5\;Gy\times6)$. No Patient received concurrent chemotherapy during radiotherapy. Follow up period was ranging from 9 to 76 months (median 38). Results : The 5-year overall and disease free survival rates were $73.4\%\;and\;71.6\%$, respectively. Local recurrences occurred in $10\%$ of patients, and distant metastasis in $18.9\%$. There was a significant correlation between OS/DFS and tumor size $(<4cm;\;OS\;95.2\%,\;DFS\;91.4\%,\;\geq4cm;\;OS\;63.4\%,\;DFS\;63.4\%)$. Pretreatment SCC level was one of prognostic factors only in univariate analysis. Conclusion : With modified hyperfractionated radiotherapy, there was very low local recurrence rate $(6.6\%)$ and high 5-year overall and disease free survival rate $(75.4\%\;and\;70.5\%)$, which is comparable to results after concurrent chemoradiotherapy in bulky, locally advanced stage IIB uterine cervix cancer.

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A Comparison Study of MMP Inhibitors' and Doxorubicin's Effects on the Apoptosis of U2OS Osteosarcoma Cell Line (U2OS 골육종 세포주의 세포자멸사에서 MMP억제제와 Doxorubicin 작용의 비교연구)

  • Moon, Jeong-Seok;Yeom, Bum-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.88-95
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    • 2007
  • Purpose: The purpose of this study was to compare the proapoptotic effects of matrix metal-loproteinase inhibitor (MMPI) and doxorubicin on wild-type p53 osteosarcoma cell line, socalled U2OS cell line. Materials and Methods: U2OS cells were treated with MMP inhibitor III (MMPI III) and doxorubicin, either respectively or simultaneously. In cells treated with doxorubicin, Fas-neutralizing antibody so called ZB4 was additionally treated to examine whether the doxorubicin played a role through the Fas/FasL pathway. Cells were analysed regarding to apoptosis and cell death by flow cytometry. Results: U2OS cells incubated with doxorubicin showed significant amount of cell death in dose-dependent manner. However, those incubated with MMPI III mostly remained viable state. In addition, there is no relationship between two drugs. Cells treated with doxorubicin and ZB4 at the same time did not show down regulation of apoptosis through inhibition of Fas/FasL pathway. Conclusion: It is important to re-examine MMP inhibitor's effect on other osteosarcoma cell line with wild-type p14 as well as wild-type p53 to evaluate its proapoptotic effect.

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Early Results of VATS for Spontaneous Pneumothorax (자연기흉에 대한 비디오흉강경수술의 조기성적)

  • 김응중;박재형
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.747-752
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    • 1996
  • Video-assisted thoracic surgery(VATS) has been widely used in the treatment of spontaneous pneumothorax in spite of the absence of definitive data regarding the relative safety and long term results of this procedure. We reviewed 34 patients (group I) who underwent )8 video-assisted surgical procedures for spontaneous pneumothorax from June 1994 to December 1995 and compared the results of these patients with the results of another 14 patients (group ll) who underwent bullectomy through axillary Oho- racotomy during the same period. Average age, sex distribution, site and extent of pneumothorax, surgical indications, and complication rate showed no differences between the two groups. In group ll patients, th number and sites of bullae tend to be multiple compared to patients in group 1. The mean number of ends-GIA used for stapling of bullae was 2. 6 per patient with the range from 2 to 4 in group 1. The mean duration of chest tube drainage was not different between the two groups ().7 days and 3.9 days), but the mean time to discharge was significantly shorter in group I (5.6 days) than in group ll (8.9 days). Mean follow-up time was 12 and 11 months in each groups and ranged from 2 to 21 months. Pneumothorax recurred after three of 38 procedures in group I (7.9 %) with no recurrence in group ll. These data suggest that video-assisted thoracic surgery is a viable alternative to thoracotomy for the treatment of spontaneous pneumothorax with low morbidity and shorter hospital stay. However, it should be applied cautiously to patients with spontaneous pneumothorax because of the relatively high incidence of recurrence compared to axillary thoracotomy.

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Effects of Simulation-Based Training on the Clinical Competence and Confidence of Nursing Students in Intravenous Injection Performance and the Satisfaction of Clients (시뮬레이션 기반 정맥주사 교육이 간호학생의 임상수행능력과 수행자신감 및 대상자 만족도에 미치는 효과)

  • Jeong, Hyeon-Cheol;Choi, Na-Young;Kim, Mi-Seon;Jeon, Mi-Yang
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.6
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    • pp.2600-2606
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    • 2012
  • Purpose: This study was conducted to examine the effect of simulation-based training on the clinical competence and confidence of nursing students in intravenous injection performance and the satisfaction of clients. Methods: This study employed a randomized control posttest non-synchronized design. The participants were 90 second-year nursing students(31 multimedia group, 28 IV model group, 31 IV computerized systems group) of S-University in Seoul, Korea. Each group was given 30 minutes for five trial injections, then the students performed intravenous injections on the back of hands of the clients, and the results were measured. Results: There were significant differences in competence of clinical performance among the three groups showed no significant differences in confidence before and after intravenous injections. While there was no significant difference in the satisfaction of clients among the three groups, there were significant differences in the satisfaction of clients resulting from the success or failure of intravenous injections(p=<.001). Conclusion: This study shows that simulation-base training contributes to the enhancement of competence and confidence of nursing students in clinical performance. It would be helpful to use various simulation-based training media as another choice of education in different fields.

Surgical Treatment for Isolated Aortic Endocarditis: a Comparison with Isolated Mitral Endocarditis (대동맥 판막만을 침범한 감염성 심내막염의 수술적 치료: 승모판막만을 침범한 경우와 비교 연구)

  • Hong, Seong-Beom;Park, Jeong-Min;Lee, Kyo-Seon;Ryu, Sang-Woo;Yun, Ju-Sik;CheKar, Jay-Key;Yun, Chi-Hyeong;Kim, Sang-Hyung;Ahn, Byoung-Hee
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.600-606
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    • 2007
  • Background: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. Material and Method: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male female=18 : 7, mean age $43.2{\pm}18.6$ years) and 23 patients with isolated mitral endocarditis (Group II, male female=10 : 13, mean age $43.2{\pm}17.1$ years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patients developed mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II, The pre-operative left ventricular ejection fraction for each group was $60.8{\pm}8.7%$ and $62.1{\pm}8.1%$ (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was $37.2{\pm}23.5$ (range $9{\sim}123$) months. Result: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and foo%, 84.9%, and 84.9% for Group II patients, respectively. Conclusion: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.

Role of Invasive Procedures in the Diagnosis and Management of Pulmonary Infiltrates in Patients with Leukemia (백혈병 환자에서 발생한 폐침윤의 진단 및 치료에 있어 침습적 검사의 역할)

  • Kang, Soo-Jung;Park, Sang-Joon;An, Chang-Hyeok;Ahn, Jong-Woon;Kim, Ho-Cheol;Lim, Si-Young;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Lee, Hong-Ghi;Rhee, Chong-H.;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.448-463
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    • 2000
  • Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

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The Relationship between Expression of EGFR, MMP-9, and C-erbB-2 and Survival Time in Resected Non-Small Cell Lung Cancer (수술을 시행한 비소세포 폐암 환자에서 EGFR, MMP-9 및 C-erbB-2의 발현과 환자 생존율과의 관계)

  • Lee, Seung Heon;Jung, Jin Yong;Lee, Kyoung Ju;Lee, Seung Hyeun;Kim, Se Joong;Ha, Eun Sil;Kim, Jeong-Ha;Lee, Eun Joo;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hye Cheol;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa;Kim, Chul Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.286-297
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    • 2005
  • Background : Non-small cell lung cancer (NSCLC) is a common cause of cancer-related death in North America and Korea, with an overall 5-year survival rate of between 4 and 14%. The TNM staging system is the best prognostic index for operable NSCLC . However, epidermal growth factor receptor (EGFR), matrix metalloproteinase-9(MMP-9), and C-erbB-2 have all been implicated in the pathogenesis of NSCLC and might provide prognostic information. Methods : Immunohistochemical staining of 81 specimens from a resected primary non-small cell lung cancer was evaluated in order to determine the role of the biological markers on NSCLC . Immunohistochemical staining for EGFR, MMP-9, and C-erbB-2 was performed on paraffin-embedded tissue sections to observe the expression pattern according to the pathologic type and surgical staging. The correlations between the expression of each biological marker and the survival time was determined. Results : When positive immunohistochemical staining was defined as the extent area>20%(more than Grade 2), the positive rates for EGFR, MMP-9, and C-erbB-2 staining were 71.6%, 44.3%, and 24.1% of the 81 patients, respectively. The positive rates of EGFR and MMP-9 stain for NSCLC according to the surgical stages I, II, and IIIa were 75.0% and 41.7%, 66.7% and 47.6%, and 76.9% and 46.2%, respectively. The median survival time of the EGFR(-) group, 71.8 months, was significantly longer than that of the EGFR(+) group, 33.5 months.(p=0.018, Kaplan-Meier Method, log-rank test).. The MMP-9(+) group had a shorter median survival time than the MMP-9(-) group, 35.0 and 65.3 months, respectively (p=0.2). The co-expression of EGFR and MMP-9 was associated with a worse prognosis with a median survival time of 26.9 months, when compared with the 77 months for both negative-expression groups (p=0.0023). There were no significant differences between the C-erbB-2(+) and C-erbB-2 (-) groups. Conclusion : In NSCLC, the expression of EGFR might be a prognostic factor, and the co-expression of EGFR and MMP-9 was found to be associated with a poor prognosis. However, C-erbB-2 expression had no prognostic significance.

The Results of Definitive Radiation Therapy and The Analysis of Prognostic Factors for Non-Small Cell Lung Cancer (비소세포성 폐암에서 근치적 방사선치료 성적과 예후인자 분석)

  • Chang, Seung-Hee;Lee, Kyung-Ja;Lee, Soon-Nam
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.409-423
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    • 1998
  • Purpose : This retrospective study was tried to evaluate the clinical characteristics of patients, patterns of failure, survival rates, prognostic factors affecting survival, and treatment related toxicities when non-small cell lung cancer patients was treated by definitive radiotherapy alone or combined with chemotherapy. Materials and Methods : We evaluated the treatment results of 70 patients who were treated by definitive radiation therapy for non-small cell lung cancer at the Department of Radiation Oncology, Ewha Womans University Hospital, between March 1982 and April 1996. The number of patients of each stage was 2 in stage I, 6 in stage II, 30 in stage III-A, 29 in stage III-B, 3 in stage IV. Radiation therapy was administered by 6 MV linear accelerator and daily dose was 1.8-2.0 Gy and total radiation dose was ranged from 50.4 Gy to 72.0 Gy with median dose 59.4 Gy. Thirty four patients was treated with combined therapy with neoadjuvant or concurrent chemotherapy and radiotherapy, and most of them were administered with the multi-drug combined chemotherapy including etoposide and cisplatin. The survival rate was calculated with the Kaplan-Meier methods. Results : The overall 1-year, 2-year, and 3-year survival rates were 63$\%$, 29$\%$, and 26$\%$, respectively. The median survival time of all patients was 17 months. The disease-free survival rate for 1-year and 2-year were 23$\%$ and 16$\%$, respectively. The overall 1-year survival rates according to the stage was 100$\%$ for stage I, 80$\%$ for stage II, 61$\%$ for stage III, and 50$\%$ for stage IV. The overall 1-year 2-year, and 3-year survival rates for stage III patients only were 61$\%$, 23$\%$, and 20$\%$, respectively. The median survival time of stage III patients only was 15 months. The complete response rates by radiation therapy was 10$\%$ and partial response rate was 50$\%$. Thirty patients (43$\%$) among 70 patients assessed local control at initial 3 months follow-up duration. Twenty four (80$\%$) of these 30 Patients was possible to evaluate the pattern of failure after achievement of local control. And then, treatment failure occured in 14 patients (58$\%$): local relapse in 6 patients (43$\%$), distant metastasis in 6 patients (43$\%$) and local relapse with distant metastasis in 2 patients (14$\%$). Therefore, 10 patients (23$\%$) were controlled of disease of primary site with or without distant metastases. Twenty three patients (46$\%$) among 50 patients who were possible to follow-up had distant metastasis. The overall 1-year survival rate according to the treatment modalities was 59$\%$ in radiotherapy alone and 66$\%$ in chemoirradiation group. The overall 1-year survival rates for stage III patients only was 51$\%$ in radiotherapy alone and 68$\%$ in chemoirradiation group which was significant different. The significant prognostic factors affecting survival rate were the stage and the achievement of local control for all patients at univariate- analysis. Use of neoadjuvant or concurrent chemotherapy, use of chemotherapy and the achievement of local control for stage III patients only were also prognostic factors. The stage, pretreatment performance status, use of neoadjuvant or concurrent chemotherapy, total radiation dose and the achievement of local control were significant at multivariate analysis. The treatment-related toxicities were esophagitis, radiation pneunonitis, hematologic toxicity and dermatitis, which were spontaneously improved, but 2 patients were died with radiation pneumonitis. Conclusion : The conventional radiation therapy was not sufficient therapy for achievement of long-term survival in locally advanced non-small cell lung cancer. Therefore, aggressive treatment including the addition of appropriate chemotherapeutic drug to decrease distant metastasis and preoperative radiotherapy combined with surgery, hyperfractionation radiotherapy or 3-D conformal radiation therapy for increase local control are needed.

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Comparison of the Results between Anterior Cruciate Ligament Reconstruction alone and Combined with High Tibial Osteotomy for anterior Cruciate Ligament Ruptured Knees with Varus Alignment (전방 십자 인대 파열과 슬관절 내반 변형 동반시 근위 경골 절골술과 전방 십자 인대 재건술의 동반 치료와 전방 십자 인대 재건술의 단독 치료의 비교)

  • Kwak, Ji Hoon;Sim, Jae Ang;Lee, Yong Seuk;Hwang, Chul Ho;Lee, Beom Koo
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.44-49
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    • 2013
  • Purpose: To compare of the results between anterior cruciate ligament (ACL) reconstruction alone and combined with high tibial osteotomy for ACL ruptured knees with varus alignment. Materials and Methods: We retrospectively reviewed 8 cases of ACL reconstruction combined with high tibial osteotomy (Group I) and 13 cases of ACL reconstruction alone (Group II) for varus angulated ACL ruptured knees (from March 2005 to February 2007). Mean age were 34.1 years (range: 20-53) in Group I, 34.9 years (range: 21-50) in Group II. Average follow up period were 22.6 months (range: 12-35) in Group I, 20 months (range: 13-33) in Group II. We analyzed clinical and radiological results. Results: There were no significant differences in clinical and radiologic results between two groups for IKDC scores, Lysholm knee scores, Lachman test, pivot shift test, KT-2000 arthrometer, $30^{\circ}$ and $90^{\circ}$ anterior drawer stress radiographs. Tegner activity scales and Cincinnati knee ligament rating scales were 4.9, 57.9 in Group I, and 5.6, 72.9 in Group II. Group I was statistically lower than Group II for Tegner activity scales and Cincinnati knee ligament rating scales (p<0.05). Conclusion: There were no significant differences in daily living between ACL reconstruction alone and combined with high tibial ostetomy for varus angulated ACL ruptured knees. However, ACL reconstruction combined with high tibial osteotomy could limit sport activity ability.

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Expression of CD40, CD86, and HLA-DR in CD1c+ Myeloid Dendritic Cells Isolated from Peripheral Blood in Primary Adenocarcinoma of Lung (원발성 폐선암환자의 말초혈액에서 분리한 CD1c+ 골수성 수지상 세포에서의 CD40, CD86 및 HLA-DR의 발현)

  • Kang, Moon-Chul;Kang, Chang-Hyun;Kim, Young-Tae;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.499-505
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    • 2010
  • Background: There have been several reports using animal experiments that CD1-restricted T-cells have a key role in tumor immunity. To address this issue, we studied the expression of markers for CD1c+ myeloid dendritic cells (DCs) isolated from peripheral blood in the clinical setting. Material and Method: A total of 24 patients with radiologically suspected or histologically confirmed lung cancer who underwent pulmonary resection were enrolled in this study. The patients were divided according to histology findings into three groups: primary adenocarcinoma of lung (PACL), primary squamous cell carcinoma of lung (PSqCL) and benign lung disease (BLD). We obtained 20 mL of peripheral venous blood from patients using heparin-coated syringes. Using flow-cytometry after labeling with monoclonal antibodies, data acquisition and analysis were done. Result: The ratio of CD1c+CD19- dendritic cells to CD1c+ dendritic cells were not significantly different between the three groups. CD40 (p=0.171), CD86 (p=0.037) and HLA-DR (p=0.036) were less expressed in the PACL than the BLD group. Expression of CD40 (p=0.319), CD86 (p=0.036) and HLA-DR (p=0.085) were less expressed in the PACL than the PSqCL group, but the differences were only significant for CD86. Expression of co-stimulatory markers was not different between the PSqCL and BLD groups. Expression of markers for activated DCs were dramatically lower in the PACL group than in groups with other histology (CD40 (p=0.005), CD86 (p=0.013) HLA-DR (p=0.004). Conclusion: These results suggest the possibility that CD1c+ myeloid DCs participate in control of the tumor immunity system and that low expression of markers results in lack of an immune response triggered by dendritic cells in adenocarcinoma of the lung.