• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.381-385
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• 2015

Background:Hepatocellular carcinoma (HCC) is the second most common malignancy in Egypt. Data mining is a method of predictive analysis which can explore tremendous volumes of information to discover hidden patterns and relationships. Our aim here was to develop a non-invasive algorithm for prediction of HCC. Such an algorithm should be economical, reliable, easy to apply and acceptable by domain experts. Methods: This cross-sectional study enrolled 315 patients with hepatitis C virus (HCV) related chronic liver disease (CLD); 135 HCC, 116 cirrhotic patients without HCC and 64 patients with chronic hepatitis C. Using data mining analysis, we constructed a decision tree learning algorithm to predict HCC. Results: The decision tree algorithm was able to predict HCC with recall (sensitivity) of 83.5% and precession (specificity) of 83.3% using only routine data. The correctly classified instances were 259 (82.2%), and the incorrectly classified instances were 56 (17.8%). Out of 29 attributes, serum alpha fetoprotein (AFP), with an optimal cutoff value of ${\geq}50.3ng/ml$ was selected as the best predictor of HCC. To a lesser extent, male sex, presence of cirrhosis, AST>64U/L, and ascites were variables associated with HCC. Conclusion: Data mining analysis allows discovery of hidden patterns and enables the development of models to predict HCC, utilizing routine data as an alternative to CT and liver biopsy. This study has highlighted a new cutoff for AFP (${\geq}50.3ng/ml$). Presence of a score of >2 risk variables (out of 5) can successfully predict HCC with a sensitivity of 96% and specificity of 82%.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.177-184
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• 1991

From December 1984 to February 1990, 16 patients with tumors of pineal and suprasellar location were treated with radiation therapy. Tissue diagnoses were obtained before radiation therapy in 5 patients and 11 were irradiated without histologic confirmation. Initial treatments for these patients were craniospinal plus boost primary irradiation(six), whole brain plus boost primary irradiation(nine), primary tumor site irradiation(one). The 5 year actuarial survival rate is $71\%$. Three cases with elevated beta-human chorionic gonadotropin(HCG) responded favorably to radiation, but pineal tumors with elevated alpha-fetoprotein(AFP) did not respond well. Spinal metastasis developed in 2 cases(2/15) with elevated AFP : one received prophylactic spinal irradiation, another did not. Our studies suggest that more aggressive treatment would be necessary in patient with elevated AFP and in this patient, radiation therapy may be initiated without pathologic confirmation. From the result of our study, routine use of prophylactic spinal irrdiation for all patients with pineal region tumor is not indicated and use of prophylactic spinal irradiation is considered for the patients with positive craniospinal fluid cytology, meningeal seeding, disease extension along the ventricular wall and biopsy proven germinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1657-1663
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• 2015

Background: Early diagnosis of hepatocellular carcinoma (HCC) is the most important step in successful treatment. However, it is usually rare due to the lack of a highly sensitive specific biomarker so that the HCC is usually fatal within few months after diagnosis. The aim of this work was to study the role of plasma nuclear factor kappa B (NF-${\kappa}B$) and serum peroxiredoxin 3 (PRDX3) as diagnostic biomarkers for early detection of HCC in a high-risk population. Materials and Methods: Plasma nuclear factor kappa B level (NF-${\kappa}B$) and serum peroxiredoxin 3 (PRDX3) levels were measured using enzyme linked immunosorbent assay (ELISA), in addition to alpha-fetoprotein (AFP) in 72 cirrhotic patients, 64 patients with HCC and 29 healthy controls. Results: NF-${\kappa}B$ and PRDX3 were significantly elevated in the HCC group in relation to the others. Higher area under curve (AUC) of 0.854 (for PRDX3) and 0.825 (for NF-${\kappa}B$) with sensitivity of 86.3% and 84.4% and specificity of 75.8% and 75.4% respectively, were found compared to AUC of alpha-fetoprotein (AFP) (0.65) with sensitivity of 72.4% and specificity of 64.3%. Conclusions: NF-${\kappa}B$ and PRDX3 may serve as early and sensitive biomarkers for early detection of HCC facilitating improved management. The role of nuclear factor kappa B (NF-${\kappa}B$) as a target for treatment of liver fibrosis and HCC must be widely evaluated.

• Journal of Pharmacopuncture
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• v.13 no.2
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• pp.13-31
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• 2010

Objective : Bujeonghangam-tang(BH) has been used for cure of tumor as a traditional medicine. This study was carried out to clarify the effect of BH extract on hepatocellular carcinogenesis and hepatic cirrhosis induced by Diethylnitrosamine(DENA) and $CCl_4$ in Rats. Method : Experimental groups were divided into two, 8th and 12th week groups, and subdivided into four; normal group(Nor), cirrhosis and hepatic cancer inducing control group(Con), and BH extract 320 mg/kg/day(BHA) or 640 mg/kg/day(BHB) administered groups to Con. Results: In the 8th week group: The body weight decreased significantly in Con compared with the Nor. The activities of transaminase, alkaline phosphatase(ALP), and lactacte dehydrogenase(LDH) were significantly increased(p<0.05) in the Con compared with Nor, but decreased in the BHA and BHB compared with Con. Alpha fetoprotein(AFP) were the most increased in the Con compared to BHA and BHB. The results of light microscopical observation, a number of hepatocytes were damaged in the Con compared with Nor and BH extract administerd groups. The number of hepatic p53 positive cells was reduced in the BH extract administered groups. According to the electron microscopical observation, hepatocarcinoma cells were observed distinctly in the Con compared with BH extract administered groups. In the 12 weeks group: The results of body were similar to 8th week groups. The activities of transaminase and ALT were significantly increased(p<0.05) in the Con compared with Nor. LDH was significantly(p<0.05) increased in the Con compared with Nor but significantly (p<0.05) decreased in the BHB. Alpha fetoprotein(AFP) were the most increased in the Con among ex perimental groups. The activities of superoxide dismutase(SOD) were significantly (p<0.05) increased in the Con, but the activities of catalase were not increased(p<0.05) compared with Nor. The number of hepatic p53 positive cells was increased in the Con. The results of electron microscopical observation were similar to 8th week groups. Conclusion : These results suggest that ad ministration of BH extract suppress or retard DENA and $CCl_4$-induced hepatocellular carcinogenesis and hepatic cirrhosis in rats.

• The Korea Journal of Herbology
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• v.22 no.4
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• pp.213-218
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• 2007

Objectives : Effects of Fructus Foeniculi extract on liver function were investigated in carbon tetrachloride(CCl4) intoxicated rats. Methods : Thirty two male Sprague-Dawley rats with mean weight of $227.28{\pm}7.92g$ were used in these experiments and housed with food and water ad libitum. Fructus Foeniculi extract was administerd at dose 100mg/kg/day and 200mg/kg/day p.o. for 2 weeks after that CCl4 was treated 3 times at dose of 2.5ml/kg, p.o. in alternate day basis. Then serum AFP(${\alpha}$-Fetoprotein), Total protein, Albumin, Triglyceride, Total cholesterol concentrations and ALP (Alkaline phosphatase), AST(Aspartate Aminotransferase), ALT(Alanine Aminotransferase), ${\gamma}$-GT( ${\gamma}$-Glutamyl transferase), LDH(Lactate Dehydrogenase) activities were determined with commercial kit by autoanalyzer. Results : Plasma ${\alpha}$-fetoprotein and total protein concentration showed a tendency to decrease in Fructus Foeniculi extract-treated groups. However, plasma albumin concentration showed no significant differences in all treatment groups. Activity of plasma aspartate aminotransferase and alanine aminotransferase in Fructus Foeniculi extract-treated groups showed a lower value than that of control group. Alkaline phosphatase and lactate dehydrogenase activities showed a tendency to decrease in Fructus Foeniculi treated groups. However, ${\gamma}$-glutamyl transferase activity showed no significant difference in all treated groups. Concentration of plasma triglyceride and total cholesterol showed a high level in CCl4 intoxicated rats but not in Fructus Foeniculi treated groups. Conclusion : Reviewing these experimental results, it appears that Fructus Foeniculi extract have recovering effect against liver injury.

• Radiation Oncology Journal
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• v.33 no.1
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• pp.36-41
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• 2015

Purpose: To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC). Materials and Methods: Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed. Results: Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause. Conclusion: WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

• Advances in pediatric surgery
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• v.9 no.2
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• pp.94-97
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• 2003

The teratoma is a unique complex neoplasm and is one of the most frequent pediatric tumors originated from the extragonadal germ cells. Mature teratoma is composed of mature differentiated tissues, while immature teratoma always contains embryonic tissues of variable degrees of immaturity, especially in the neuroepithelial elements. Diagnosis of teratoma is relatively easy by conventional radiologic study, but the immaturity can be identified only by histopathological examination. Between January 1993 to December 2002, 63 cases of teratoma were operated and analysed retrospectively at the Chonnam University Hospital Female to male ratio was about 3:1 and age distribution was relatively even. Among 63 cases, gonadal teratoma was the most common (52.4%), followed by sacrococcygeal (25.4%), retroperitoneal (9.5%) and mediastinal teratoma (9.5%). Fifty-six cases were mature teratomas and seven were immature teratomas. Alpha-fetoprotein (AFP) was elevated in 4 of 6 immature cases, but in 2 of 51 mature ones Elevated AFP progressively returned to normal range by 1 month after operation in all. Complete excision of the mass was performed, and major complication was not noticed. In five immature cases, PEB chemotherapy (Cisplatin, Etoposide, Bleomycin) was performed. Two of 2 cases in histological grade II were well tolerated to the aggressive chemotherapy. One of three cases in grade III expired due to severe bone marrow depression, and two of them expired by tumor recurrences. In conclusion, immature teratoma in histological grade III showed high potentiality of recurrence. Therefore, postoperative chemotherapy has to be applied to the high graded immature tumors.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2399-2403
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• 2012

Objective: To compare expression level of serum tumor associated materials (TAM) with several conventional serum tumor biomarkers, eg., carcinoembryonic antigen (CEA), carbohydrate antigen19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3), alpha-fetoprotein(AFP), in selected solid tumors. Methods: Patients diagnosed histologically or cytologically with liver, breast, esophageal, gastric, colorectal or pancreatic cancers were enrolled into this study. After diagnosis, the level of TAM was determined by chemical colorimetry, and levels of conventional tumor markers was measured by chemiluminescence methods. Results: A total of 560 patients were enrolled into this study. No statistically significant difference was detected in TAM and the above mentioned tumor biomarkers in terms of their positivity and negativity ( P>0. 05). Conclusions: Detection of TAM in liver, breast, esophageal, gastric, colorectal, and pancreatic cancer patients demonstrates a good accordance with CEA, CA199, CA153, and AFP, thus suggesting that further study is warranted to verify whether TAM could be a surrogate for these conventional biomarkers.

• Journal of Korean Traditional Oncology
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• v.21 no.2
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• pp.63-74
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• 2016

Objective : The purpose of this study is to report the effects of radio-frequency hyperthermia cancer treatment in conjunction with Sorafenib on hepatocellular carcinoma patient. Method : The patient was diagnosed with hepatocellular carcinoma at S6/7 and treated with right posterior sectionectomy. After 4 months, tumor recurrence was found at S4, 5 and 8. After transarterial chemoembolization, the patient was prescribed Sorafenib (proprietary name $Nexavar^{(R)}$ ) as well as proceeding with radio-frequency hyperthermia. The clinical outcomes were measured by computed tomography, laboratory findings including tumor markers (AFP, PIVKA-II), natural killer (NK) cell activity, and numeric rating scales (NRS). Results : After the treatment, tumor size was decreased accompanying by reducing the level of tumor markers (AFP, PIVKA-II). Major clinical symptoms were improved with increasing NK cell activity. There were no adverse events based on National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Conclusion : This case suggests that radio-frequency hyperthermia has synergistic effect for the treatment of hepatocellular carcinoma patient in conjunction with Sorafenib.

• Journal of Ginseng Research
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• v.35 no.1
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• pp.69-79
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• 2011

Hepatocellular carcinoma (HCC) is the fi fth most common malignancy in the world and complicates liver cirrhosis related to hepatitis C virus (HCV) in many cases. We evaluated the therapeutic effect of Korean red ginseng extract (KGE) in patients with chronic liver diseases. Thirty male and female patients with HCC and another thirty with liver cirrhosis were included. Each category was divided into two groups; the first was used as control group, and received medical therapy only and the second group received the medical therapy supplemented with KGE capsules. The treated group with HCC received three KGE capsules/day (900 mg) while the treated group with HCV received two KGE capsules/day (600 mg) for 11 weeks along with their medical therapy. All patients were subjected to clinical examination and laboratory investigations, including liver function tests (at baseline, after 6 weeks of treatment and at the end of the study) and abdominal ultrasonography. Patients showing focal hepatic lesions were subjected to triphasic spiral abdominal computerized tomography and alpha-fetoprotein (AFP). HCV RNA was determined quantitatively by Roche for patients in the HCV group. Results showed that the medical therapy alone failed to normalize the liver enzymes or decrease the virus concentration. KGE administration induced a significant improvement in liver function tests, decreased the tumor marker (AFP) levels, and decreased the viral titers in HCV patients. Thus, KGE demonstrated powerful therapeutic effects against HCV and liver cancer.