• 대한두경부종양학회지
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• 제21권2호
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• pp.196-200
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• 2005

Objectives: The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in oral cavity squamous cell carcinomas to form a rational basis for elective contralateral neck management. Materials and Methods: We performed a retrospective analysis of 66 N0-2 oral cavity cancer patients undergoing elective neck dissection for contralateral clinically negative necks from 1991 to 2003. Results: Clinically negative but pathologically positive contralateral lymph nodes occurred in 11%(7 of 66) . Of the 11 cases with a clinically ipsilateral node positive neck, contralateral occult lymph node metastases developed in 36%(4 of 10, in contrast with 5%(3/55) in the cases with clinically ipsilateral node negative necks(p<0.05). Based on the clinical staging of the tumor, 8%(3 of 37) of the cases showed lymph node metastases in T2 tumors, 25%(2 of 8) in T3, and 18%(2 of 11) in T4. None of the T1 tumors(10 cases) had pathologically positive lymph nodes. The rate of contralateral occult neck metastasis was significantly higher in advanced stage cases and those crossing the midline, compared to early stage or unilateral lesions(p<0.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes(5-year disease-specific survival rate was 79% vs. 43%, p<0.05). Conclusion: The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 stage or those crossing the midline with unilateral metastases was high. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in oral cavity squamous cell carcinoma patients with ipsilateral node metastases or tumors that are greater than stage T3 or crossing the midline.

• 대한두경부종양학회지
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• 제13권2호
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• pp.228-234
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• 1997

Squamous cell carcinoma originating in the parotid gland has rare occurrence. The primary squamous cell carcinoma of the parotid gland comprise about 0.3% and 9.8% of all parotid malignant tumor. We investigated the clinical behavior and treatment outcome of patients with primary squamous cell carcinoma of the parotid gland. We reviewed all cases of possible primary squamous cell carcinoma of the parotid gland treated at Yonsei Cancer Center, Seoul, Korea, from 1981 through 1995. A total of 128 had primary parotid malignancy. Metastatic squamous cell carcinoma and mucoepidermoid carcinoma were excluded in this study. Ten cases of primary squamous cell carcinoma of the parotid gland were identified. 6 cases of them are men & 4 cases are women. The age of patients ranged from 31 to 68 years with median age of 55 years. On physical examination, 5 cases had palpated cervical neck node and 6 cases had facial nerve palsy. Staging was done according to the current guidelines established by the American Joint Committee on Cancer (1992). Two cases were stage I, 1 in stage III, and 7 in stage IV. Six cases were performed operation and postoperative radiation therapy. Four cases were treated by curative radiation therapy, dose of more than 65 Gy on parotid gland region. The 5 year actual survival rate and the 5 year disease free survival rate were 30.8%, and 40.0%. Initial complete response rate was 70% for all patients. Local failure were occurred 3 of 7 patients with local controlled cases, failure sites were primary site, ipsilateral cervical neck node, contralateral supraclavicular node. Most recurrences developed within 1 year of initial treatment. Distant metastasis was appeared 2 of 3 patients who did not achieved local control. Primary squamous cell carcinoma of the parotid gland occured infrequently. A retrospective study at the Yonsei Cancer Center indicates incidence of 7.8%. At diagnosis, advanced stage, neck node presentation, facial nerve paralysis were associated with a poor prognosis. These results may suggested that radical surgical excision may be treatment of choice and that planned postoperative radiotherapy may be bendicial for reducing locoregional recurrence rates.

• 대한두경부종양학회지
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• 제19권2호
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• pp.148-157
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• 2003

Background and Objectives: Individual genetic susceptibilities to chemical carcinogens have been recognized as a major important host factors in human cancers. The cytochrome P450 family (CYPs) and glutathione S-transferase(GST) have been reported to be associated with risks to the smoking-related human cancers. Inactivation of tumor suppressor genes like p53 playa key role in tumor progression. The purpose of this study is to demonstrate an association between p53 overexpression and the prevalence of the genetic polymorphisms of CYP1A1 and GSTs in Korean head and neck squamous cell carcinoma (HNSCC). Materials and Methods: The polymorphisms of CYPIA1 and GSTs were analyzed by PCR and PCR-RFLP in 98 Korean head and neck squamous cell carcinoma patients. The expression of p53 was analyzed by immunohistochemistry with anti-p53 Ab (DO7). Results: Overexpression of p53 detected in 45.9% of HNSCC. The odds ratio for p53 overexpression in GSTM1(-), GSTT1(-), GSTP1(val/val) and CYP1A1(val/val) were 1.53, 1.83, 1.17 and 1.47, respectively. Among the combined genotypes, the odds ratio of the CYP1A1 val/val, GSTM1 (-), CYP1A1 val/val, GSTT1(-), and CYP1A1 val/val, GSTT1(-) were 2.0, 2.34 and 4.68, respectively. Conclusion: Based on our results, it might be suggested that p53 overexpression is slightly increased in GSTM1(-), GSTT1(-), GSTP1 val/val, CYP1A1 val/val genotypes. The further study is needed to evaluate the relationship and mechanism between the p53 overexpression and the specific CYP1A1 and GSTs genotypes.

• 치과방사선
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• 제29권1호
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• pp.105-117
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• 1999

Purpose: Ionizing radiations have been reported as an apoptosis initiating stimulus in various cells and it has established that sustained elevations in [Ca/sup 2+/] can lead to DNA fragmentation by Ca/sup 2+/-dependent endonucleases, ultimately resulting in apoptotic cell death. The previous experiments have been reported by using primarily thymocytes and lymphocytes and the change of [Ca/sup 2+/] was measured only by minutes or hours respectively. We need to evaluate [Ca/sup 2+/] in both several minutes and hours after irradiation of radiation of radiation therapy and verify the apoptotic cells. Materials and Methods: We have measured [Ca/sup 2+/] in human gingival epitheloid cancer cell with 10Gy irradiation, at minutely intervals and hourly intervals using digitized video-intensified fluorescence microscopy and the fluorescent Ca/sup 2+/ indicator dye, fura-2. In order to find out that the transient rise in [Ca/sup 2+/] could induced apoptosis, cells were incubated for 1 hour at 37℃ with TdT enzyme, rinsed and resuspended containing fluorescence and observed under a confocal fluorescence microscope. MTT assay was done to determine cell activity and LDH assay was done to determine the amount of necrotic cells. Results: After irradiation, the transient and temporal increasing of [Ca/sup 2+/] in the KB cells was founded. Though, there was no change in the intracellular [Ca/sup 2+/] at 30 minutes and 2 hours after irradiation. We could detect of DNA fragmented cells at 4 hours after 10Gy irradiated cells. There were no significant differences between 4 hour, 1 day, 3 day cells. There were no significant differences in MTT and LDH assay between the irradiated group and the control group after 4 hours and 1 day. Though after 3 days there were differences in MTT and LDH assay between the irradiated group was significantly decreased than the control group, in LDH assay the number of necrotic cell death of the irradiated was higher than the control group. Conclusion: In KB cells there were incipient and temporal increasing of the [Ca/sup 2+/] with 10Gy irradiation and the apoptosis was founded from 4 hours later which was earlier than seeing of the change of the amount of the cellular ability and necrosis.

• 치과방사선
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• 제29권1호
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• pp.149-159
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• 1999

Purpose: The purpose of this study was to evaluate cervical lymph node metastasis of oral squamous cell carcinoma patients by MRI film and neural network system. Materials and Methods: The oral squamous cell carcinoma patients(21 patients. 59 lymph nodes) who have visited SNU hospital and been taken by MRI. were included in this study. Neck dissection operations were done and all of the cervical lymph nodes were confirmed with biopsy. In MR images. each lymph node were evaluated by using 6 MR imaging criteria(size. roundness. heterogeneity. rim enhancement. central necrosis, grouping) respectively. Positive predictive value. negative predictive value. and accuracy of each MR imaging criteria were calculated. At neural network system. the layers of neural network system consisted of 10 input layer units. 10 hidden layer units and 1 output layer unit. 6 MR imaging criteria previously described and 4 MR imaging criteria (site I-node level II and submandibular area. site II-other node level. shape I-oval. shape II-bean) were included for input layer units. The training files were made of 39 lymph nodes(24 metastatic lymph nodes. 10 non-metastatic lymph nodes) and the testing files were made of other 20 lymph nodes(10 metastatic lymph nodes. 10 non-metastatic lymph nodes). The neural network system was trained with training files and the output level (metastatic index) of testing files were acquired. Diagnosis was decided according to 4 different standard metastatic index-68. 78. 88. 98 respectively and positive predictive values. negative predictive values and accuracy of each standard metastatic index were calculated. Results: In the diagnosis of using single MR imaging criteria. the rim enhancement criteria had highest positive predictive value (0.95) and the size criteria had highest negative predictive value (0.77). In the diagnosis of using single MR imaging criteria. the highest accurate criteria was heterogeneity (accuracy: 0.81) and the lowest one was central necrosis (accuracy: 0.59). In the diagnosis of using neural network systems. the highest accurate standard metastatic index was 78. and that time. the accuracy was 0.90. Neural network system was more accurate than any other single MR imaging criteria in evaluating cervical lymph node metastasis. Conclusion: Neural network system has been shown to be more useful than any other single MR imaging criteria. In future. Neural network system will be powerful aiding tool in evaluating cervical node metastasis.

• 약학회지
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• 제41권5호
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• pp.629-637
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• 1997

Tumor necrosis factor-${alpha}$ (TNF) induced a cytotoxic response in ME-180 cervical carcinoma cells in vitro. This cytotoxic response was accompanied by a temporal series of mitogenic stimuli : increased c-fos, c-jun and jun-B expression. Depletion of protein kinase C (PKC) by exposure of ME-180 cells to 100ng/ml phorbol myristate acetate (PMA) for 24hours almost completely abolished TNF-mediated increase in these signals, indicating that a PKC-dependent pathway is involved in TNF-mediated increases in the expression of c-fos, c-jun and jun-B. Characteristics of TNF receptors after exposure to 100ng/ml PMA or 24hours were not altered, suggesting that diminished induction of these oncogenes by TNF after PMA treatment is not due to any changes at the receptor level. To examine whether a PKC-dependent pathway is involved in TNF-mediated cytotoxicity in ME-180 cells, cytotoxicity was measured after depletion of PKC. No apparent changes in cytototoxicity after PKC depletion suggest that a PKC-dependent pathway is not involved in TNF-mediated cytotoxicity. Furthermore, results from cytotoxicity tests after exposure to staurosporine (PKC inhibitor) did not show any changes in the TNF-mediated cytotoxicity, confirming that a PKC-dependent pathway is not involved in this process. These data indicate that 1) TNF induces expression of c-fos, c-jun and jun-B oncogenes via a PKC-dependent pathway and 2) PKC-dependent expression of these three oncogenes by TNF may not be involved in TNF-mediated cytotoxicity in ME-180 cells.

• 대한기관식도과학회지
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• 제8권1호
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• pp.35-41
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• 2002

Background and Objectives : Angiogenesis within malignant tumors has been considered to be essential for the growth and expansion of cancer cells, especially for solid tumors, and has been implicated in the overall growth and metastases of tumors. Such angiogenesis within tumors depends upon the secretion of vascular growth factor to allow the growth of newly formed vessels from peripheral tissue into the malignant tumor. %n, an exploration of the relations between cancer cells and vascular growth factors is absolutely critical to understanding the growth of malignant tumors. According to recent reports, vascular endothelial growth factor(VEGF) has been found to play a role in lymphatic metastases, tumor recurrence and survival in various human tumors. To evaluate the role of VEGF in head and neck squamous cell carcinoma(HNSCC) we performed this study. Materials and Methods : We examined the expression of VEGF and microvessel density in 39 HNSCC by immunohistochemistry and correlated them with various clinical data such as stage, cervical lymphatic metastasis, recurrence, and overall survival. Results : The expression of VEGF was not correlated with overall stage, T stage and N stage. There was no statistical correlation between the expression of VEGF and recurrence in the Primary site, cervical lymph node, and the distant metastases. There was no statistical correlation between the expression of VEGF and microvessel density. Conclusion : Based on these results, it is suggested that the expression of vascular endothelial growth factor is not a major prognostic factor for head and neck squamous cell carcinoma. Further studies are needed to evaluate significance of VEGF expression in head and neck squamous cell carcinoma.

• 대한방사선치료학회지
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• 제26권1호
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• pp.1-9
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• 2014

목 적 : 간암 치료 시 호흡으로 인한 움직임을 최소화하기 위해 환자 체위 변화에서 종양의 움직임과 용적 변화를 분석하고자 하였다. 대상 및 방법 : 간 세포암종(Hepatocellular Carcinoma) 환자 14명의 환자를 대상으로 시행하였다. 바로 누운 자세(Supine position)와 엎드린 자세(Prone position)에서 2가지 방법으로 환자 고정기구를 제작하고 영상을 획득하여 간 종양의 움직임과 용적 그리고 선량을 분석하였다. 결 과 : 바로 누운 자세(Supine position)와 엎드린 자세(Prone position) 에서 표적의 왼쪽-오른쪽(LR, Left-right) 움직임은 평균 $2.76{\pm}1.25mm$, $2.21{\pm}0.93mm$이고, 앞-뒤(AP, Anterior-posterior)와 상하(SI. Superior-inferior) 방향의 움직임은 각각 $4.02{\pm}1.63mm$, $11.56{\pm}3.08mm$, $3.36{\pm}1.17mm$, $7.45{\pm}1.96mm$이었다. 이를 이용한 엎드린 자세(Prone position)에서 치료 용적(Treatment volume)은 감소하였고, 이에 따라 정상간 용적은 증가 하였다. 결 론 : 호흡에 의한 간의 움직임을 최소화함으로써 치료 용적(Treatment volume)의 경계여유를 감소시킬 수 있었다. 즉 환자 자세 변화 특히 엎드린(Prone) 자세는 간의 움직임을 감소 시켜주고 정상 간의 용적을 증가 시킬 수 있을 것으로 사료된다.

• Journal of Gastric Cancer
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• 제5권1호
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• pp.52-56
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• 2005

위암은 국내에서 발생 빈도가 가장 높은 암으로서 근치적 절제술 및 확대 영역 림프절 절제술의 도입과 더불어 술후 보조 항암화학요법 및 면역요법 등의 이용으로 최근 치료성적의 향상을 보이고 있다. 그러나 수술적 치료를 포함한 치료법의 발전에도 불구하고 다양한 형태의 재발을 경험하게 되고, 대부분의 재발은 3년 이내에 일어난다. 재발양상으로는 크게 국소재발, 원격재발, 복막재발 등이 있으며, 여러 가지 재발양상이 한꺼번에 보이는 경우도 있다. 이 중 국소재발의 호발 부위로는 림프절($48\%$), 문합부($32\%$, 잔존 위($20\%$)의 순으로 보고되고 있다. 증례: 51세의 여자 환자로 1999년 10월 진행성 위암으로 근치적 위전절제술을 시행 받았고, 당시 병기는 T3N1M0(IIIa,AJCC 1997)이었다. 수술 후 10회의 보조적 정맥 주사용 항암화학요법 및 경구용 항암화학요법을 2년간 실시하였고, 외래를 통한 추적검사상 약 5년간 재발을 보이지 않았으나 2004년 9월 시행한 내시경상 Kim's tie 부근공장에서 궤양성 병변을 발견하고 조직검사를 시행, 병리학적으로 낮은 분화도를 보이는 인환 세포암종 형태의 위선암 재발로 진단하고 수술을 시행하였다. 수술 방법은 Kim's tie 위치를 포함해 근위부 6.5 cm, 원위부 4 cm의 절제연을 두고 공장부분 절제술을 시행하였다. 수술 당시 다른 복부장기로 전이는 없었으며 전이성 복수도 없었다. 수술 후 별다른 합병증 없이 회복하였으며 보조 항암화학요법 제제로써 TS-1을 사용하며 외래 통한 추적검사 중이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권2호
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• pp.139-148
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• 1999

Oral cancer is a common neoplasm in humans and etiologic mechanism is not well known, so treatment and evaluation of oral cancer is difficult problem. Traditional TNM classification between prognosis of tumors and classification of histopathologic differentiation has problem like lack of objectivity through operators. In molecular biology, cancer is developed by alteration of activation of oncogene and/or inactivation of tumor suppressor gene. The p53 gene, one of the tumor suppresor genes, is believed to play an important role through mutation and overexpression in the progression of human cancers. The p53 mutation is most frequent genetic disorder in humans. The Cyclin D1 has tumor suppresion activity by regulation of cell cycle. The Cyclin D1 regulate activity of Rb tumor suppresor gene by stimulation of CDK4 The purpose of this study was to observe the expression of p53 protein and Cyclin D1 in oral squamous cell carcinoma, and to get expectation of the malignancy and prognosis of oral squamous cell carcinoma. Using the 15 cases of squamous cell carcinoma and the microscopic H&E and immunohistochemical stain. We divided it into 3 groups according to the stain extent, clinical stage and histologic differentiation. The results were as follows1.In the features of immunohistochemical stain of 15 cases of squamous cell carcinoma, positive reaction of p53 was identified in 8 cases (53.3%) and positive reaction of cyclin D1 was identified in 3 cases (20%). Both positive reaction of p53 protein and Cyclin D1 was show in only one case. 2.8 of p53 positive cases were linked in 87.5% of the end stage tumor, 62.5% of neck node involvement, 87.5% of poorly and moderately histopathplogic differentiation. 3. All 3 of Cyclin D1 positive cases were linked in the end stage tumor, neck node involvement, poorly and moderately histopathologic differentiation. From above results, expression of p53 protein was identified in 53.3% of 15 cases and these results mean oral squamous cell carcinoma was drived by mutation of p53 protein. Especially, highly positive reaction of p53 protein and Cyclin D1 was identified in cases that involvement of neck lymph node and the end stage tumors and it means that the evaluation of p53 protein and Cyclin D1 was useful for evaluation of malignant tumor as specific tumor marker.