• Title/Summary/Keyword: CEA, CA19-9

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Diagnosis and Cure Experience of Hepatolithiasis-Associated Intrahepatic Cholangiocarcinoma in 66 Patients

  • Li, Hong-Yang;Zhou, Shi-Ji;Li, Min;Xiong, Ding;Singh, Akanand;Guo, Qing-Xi;Liu, Chang-An;Gong, Jian-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.725-729
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    • 2012
  • Background: The management of hepatolithiasis combined with intrahepatic cholangicarcinoma (IHHCC) remains a challenge due to poor prognosis. The aim of this study was to summarize our diagnosis and cure experience of IHHCC over the recent 10 years. Methods: From January 1996 to January 2006, 66 patients with IHHCC were reviewed retrospectively. Results: Of the 66 patients, 52 underwent surgical resection (radical resection in 38 and palliative in 14) and 8 patients abdominal exploration, while the other 6 cases received endoscopic retrograde biliary internal drainage and stent implantation. In this series, correct diagnosis of advanced stage was made during operation in 8 cases (8/60, 13.3%) and all of them (underwent unnecessary abdominal exploration, among them the positive rate of CA19-9 was 100%, and the positive rate of CEA was 87.6% (7/8), incidence rate of ascites was 100% and short-term significant weight loss was 100%, with median overall survival of only 4 months. Conclusion: Radical resection is mandatory for IHHCC patient to achieve long-term survival, the CT and MR imaging features of IHHCC being concentric enhancement. Patients with IHHCC have significant higher CA199 and significant higher CEA and short-term significant weight loss and ascites should be considered with advanced stage of IHHCC and unnecessary non-therapeutic laparotomies should be avoided.

Current Status of Health Screening in Korea (한국의 건강검진 현황)

  • Jo, Han-Ik
    • Journal of Korea Association of Health Promotion
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    • v.2 no.3
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    • pp.73-96
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    • 2004
  • Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items and methods should be carefully selected. This study was to get hold of the test items of major health screening programs in Korea Most of the health screening programmes focused upon detection of risk factors and diagnosis of life - style related diseases (diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis) ,cancers (stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus) , infectious diseases (hepatitis, tuberculosis, sexually-transmitted diseases, parasites) , chronic obstructive respiratory diseases, chronic renal diseases (bacteriuria hematuria, proteinuria) , anemia, glaucoma, hearing loss, Alzheimer disease, stress, early psychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests (CBC, urinalysis, liver function tests, lipid tests, glucose, HbAlc, uric acid, electrolytes, serological tests (HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray (chest PA, CT) , endoscopy (gastroscopy, colonoscopy) , sonography(abdomen, thyroid, pelvis, breast) ,cytology (cervix) , bone density, tumor markets (NMP22, alpha-FP, CEA, CA-19-9, CA12S, PSA) and eye tests. Advanced technologies, like CT, PET, MRI, MRT/Angio, molecular testings) were widely used in hospital health screening programmes .In summary, a variety of tests were utilized in health screening in Korea. Those tests were utilized by stages or according to sex and age in most of health screening programmes, however a few program used tests to excess disregarding health screening subjects.

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Current Status of Health Screening in Korea (한국의 건강검진 현황)

  • Jo, Han-Ik
    • Journal of Korea Association of Health Promotion
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    • v.2 no.2
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    • pp.215-230
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    • 2004
  • Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items and methods should be carefully selected. This study was to get hold of the test items of major health screening programs in Korea. Most of the health screening programmes focused upon detection of risk factors and diagnosis of life-style related diseases(diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis) ,cancers(stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus), infectious diseases (hepatitis, tuberculosis, sexually-transmitted diseases, parasites),chronic obstructive respiratory diseases, chronic renal diseases(bacteriuria, hematuria, proteinuria), anemia, glaucoma, hearing loss, Alzheimer disease, stress, early Psychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests(CBC, urinalysis, liver function tests, lipid tests, glucose, HbAlc, uric acid, electrolytes, serological tests(HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray(chest PA, CT), endoscopy (gastroscopy, colonoscopy) , sonography(abdormen, thyroid, pelvis, breast) , cytology(cervix) ,bone density, tumor markers(NMP22, alpha-FP, CEA, CA-19-9, CA12S, PSA) and eye tests. Advanced technologies, like CT, PET, MIRI, MIRI/Angio, molecular testings) were widely usedin hospital health screening programmes. In summary, a variety of were utilized by stages or programmes, however a few subjects. tests were utilized in health screening in Korea. Those tests according to sex and age in most of health screening program used tests to excess disregarding health screening subject.

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Radioimmunoassay Reagent Survey and Evaluation (검사별 radioimmunoassay시약 조사 및 비교실험)

  • Kim, Ji-Na;An, Jae-seok;Jeon, Young-woo;Yoon, Sang-hyuk;Kim, Yoon-cheol
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.1
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    • pp.34-40
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    • 2021
  • Purpose If a new test is introduced or reagents are changed in the laboratory of a medical institution, the characteristics of the test should be analyzed according to the procedure and the assessment of reagents should be made. However, several necessary conditions must be met to perform all required comparative evaluations, first enough samples should be prepared for each test, and secondly, various reagents applicable to the comparative evaluations must be supplied. Even if enough comparative evaluations have been done, there is a limit to the fact that the data variation for the new reagent represents the overall patient data variation, The fact puts a burden on the laboratory to the change the reagent. Due to these various difficulties, reagent changes in the laboratory are limited. In order to introduce a competitive bid, the institute conducted a full investigation of Radioimmunoassay(RIA) reagents for each test and established the range of reagents available in the laboratory through comparative evaluations. We wanted to share this process. Materials and Methods There are 20 items of tests conducted in our laboratory except for consignment tests. For each test, RIA reagents that can be used were fully investigated with the reference to external quality control report. and the manuals for each reagent were obtained. Each reagent was checked for the manual to check the test method, Incubation time, sample volume needed for the test. After that, the primary selection was made according to whether it was available in this laboratory. The primary selected reagents were supplied with 2kits based on 100tests, and the data correlation test, sensitivity measurement, recovery rate measurement, and dilution test were conducted. The secondary selection was performed according to the results of the comparative evaluation. The reagents that passed the primary and secondary selections were submitted to the competitive bidding list. In the case of reagent is designated as a singular, we submitted a explanatory statement with the data obtained during the primary and secondary selection processes. Results Excluded from the primary selection was the case where TAT was expected to be delayed at the moment, and it was impossible to apply to our equipment due to the large volume of reagents used during the test. In the primary selection, there were five items which only one reagent was available.(squamous cell carcinoma Ag(SCC Ag), β-human chorionic gonadotropin(β-HCG), vitamin B12, folate, free testosterone), two reagents were available(CA19-9, CA125, CA72-4, ferritin, thyroglobulin antibody(TG Ab), microsomal antibody(Mic Ab), thyroid stimulating hormone-receptor-antibody(TSH-R-Ab), calcitonin), three reagents were available (triiodothyronine(T3), Tree T3, Free T4, TSH, intact parathyroid hormone(intact PTH)) and four reagents were available are carcinoembryonic antigen(CEA), TG. In the secondary selection, there were eight items which only one reagent was available.(ferritin, TG, CA19-9, SCC, β-HCG, vitaminB12, folate, free testosterone), two reagents were available(TG Ab, Mic Ab, TSH-R-Ab, CA125, CA72-4, intact PTH, calcitonin), three reagents were available(T3, Tree T3, Free T4, TSH, CEA). Reasons excluded from the secondary selection were the lack of reagent supply for comparative evaluations, the problems with data reproducibility, and the inability to accept data variations. The most problematic part of comparative evaluations was sample collection. It didn't matter if the number of samples requested was large and the capacity needed for the test was small. It was difficult to collect various concentration samples in the case of a small number of tests(100 cases per month or less), and it was difficult to conduct a recovery rate test in the case of a relatively large volume of samples required for a single test(more than 100 uL). In addition, the lack of dilution solution or standard zero material for sensitivity measurement or dilution tests was one of the problems. Conclusion Comparative evaluation for changing test reagents require appropriate preparation time to collect diverse and sufficient samples. In addition, setting the total sample volume and reagent volume range required for comparative evaluations, depending on the sample volume and reagent volume required for one test, will reduce the burden of sample collection and planning for each comparative evaluation.

Combined Hepatocellular-Cholangiocarcinoma in Extrahepatic Bile Duct with Co-existing of Scirrhous Type of Hepatocellular Carcinoma

  • Sang Hoon Lee;Moon Jae Chung
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.32-36
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    • 2014
  • We report a patient with combined hepatocellular-cholangiocarcinoma confined in the common hepatic duct and scirrhous type of hepatocellular carcinoma in the caudate lobe of liver simultaneously. The patient was a 55-yearsold Korean man with hepatitis B virus (HBV) carrier who was referred from a local hospital due to detected liver mass on abdominal computed tomography (CT). He has presented jaundice and weight loss for the previous 3 weeks. Laboratory examination showed AST/ALT elevation and hyperbilirubinemia. HBsAg was positive. The tumor marker study showed elevated AFP and DCP, not CEA and CA 19-9. Abdominal CT disclosed an about 2.1×0.9 cm sized soft tissue density in hilum with both intrahepatic duct (IHD) dilatations and an about 3×2.1 cm sized arterial enhancing lesion at segment 8 of the liver. Patient received 15 cycles of Gemcitabine/Cisplantin chemotherapy from February 27, 2013 to December 31, 2013. Caudate lobectomy of liver, segmental resection of bile duct and Roux-en-Y hepaticojejunostomy was performed on February 10, 2014. The final pathologic report showed double primary liver cancer, combined hepatocellular-cholangiocarcinoma in common hepatic bile duct and scirrhous type of hepatocellular carcinoma in segment 1 of the liver. This is a very unusual case in which combined hepatocellular-cholangiocarcinoma confined in the large bile duct and two rare hepatic cancers coexisted.

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A Case of Primary Mucinous Cystadenocarcinoma (원발성 후복막 점액낭샘암종 1예)

  • Ji, Jun-Ho;Lee, Hwa-Jung;Park, Seung-Chan;Park, Jung-Chul;Choi, Eun-Jung;Seo, Hye-Jin;Lee, Won-Sik;Lee, Jung-Lim;Bae, Byung-Jo;Shon, Kyung-Rak;Lee, Kyung-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.134-138
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    • 2008
  • Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its pathogenesis, optimal treatment, and prognosis. A 29-year-old pregnant woman (21 weeks) presented with abdominal discomfort. CA 19-9, CA 125, and CEA were normal. Abdominal CT scanning revealed a $19{\times}15{\times}13cm$ retroperitoneal tumor. Exploratory laparotomy and tumor excision were performed. Mucinous retroperitoneal implants were removed as completely as possible. Histologically, the tumor showed focal areas of capsular invasion, but free resection margins. The uterus and both ovaries were normal in appearance. No adjuvant therapy was pursued. Six months later, peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous cystadenocarcinoma and present a review of the literature.

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A Case of Advanced Metastatic Gallbladder Cancer Patients Treated with Oriental Medicine for Four Months (4개월간 한방치료를 받은 전이성 담낭암 환자 증례)

  • Jeon, Hyung-Joon;Cho, Chong-Kwan;Lee, Yeon-Weol;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.33 no.3
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    • pp.338-346
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    • 2012
  • Objectives : To observe the therapeutic effects of Oriental herbal prescriptions on an advanced metastatic gallbladder cancer patient. Methods : Hang-Am-Plus (HAP), Gun-Chil-Gye-Bok-Jung (GGJ) and Se-Gan-San (SGS) were prescribed three times a day. To observe the therapeutic effects of oriental medical prescriptions, computed tomography (CT) and magnetic resonance imaging (MRI) images, tumor markers and laboratory tests were carried out regularly. Results : The levels of AST, ALT, ALP, ${\gamma}$-GTP, TB, DB, CA19-9, and CEA decreased significantly from November 29th 2011 to March 14th 2012. There was no interval change on CT images taken between November 15th 2011 and January 3rd 2012. Conclusions : In this case, it could be concluded that Oriental medicinal treatment might be considered as a palliative alternative therapy for the advanced metastatic gallbladder patient.

Relationship Between Expression of Gastrokine 1 and Clinicopathological Characteristics in Gastric Cancer Patients

  • Xiao, Jiang-Wei;Chen, Jia-Hui;Ren, Ming-Yang;Tian, Xiao-Bing;Wang, Chong-Shu
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5897-5901
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    • 2012
  • The aim of the study was to clarify the role of gastrokine 1 in the process of formation and development of gastric cancer. The expression of gastrokine 1 in gastric cancer and corresponding non-cancerous gastric tissues of 52 gastric cancer patients was assessed with the real-time fluorescence quantitative polymerase chain reaction (RT-PCR) and immunohistochemistry. We also analyzed the relationship between the expression level and clinicopathological characteristics. Gastrokine 1 gene and protein expression in gastric cancer tissues was in both cases significantly lower than in corresponding non-cancerous gastric tissues (both P<0.01), but no significant relationship was found with clinicopathological parameters including tumor location, depth of invasion, differentiation, lymph node metastasis, stage, gender, age and carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) level in peripheral blood preoperation of patients (P>0.05, respectively). Furthermore, gastrokine 1 gene expression was markedly lower in gastric cancer tissues of Helicobacter pylori (HP)-positive patients than negative ones (P<0.05). The result of the study showed that gastrokine 1 might play a significant role in the process of formation and development of gastric cancer as an anti-oncogene. Its effect might be weakened by HP infection.

The Effect of Hemolysis sample on the Result of Nuclear Medicine Blood test (용혈검체가 핵의학 검체검사 결과에 미치는 영향)

  • Kim, Jin-Tae;Lee, Jong-Pil;Lee, Soo-Bin;Kim, Dong-Min
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.1
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    • pp.41-43
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    • 2021
  • Purpose In nuclear medicine blood tests, hemolysis samples are considered as inappropriate sample and are recommended not to be used for blood test. So, the lab are required to collect the blood again in the blood collection room However, The effect of hemolyzed samples on radioimmunoassay has not studied yet. This study was designed to evaluate effects of hemolysis on radioimmunoassay. Materials and Methods The kit manuals of 23 test items were reviewed to confirm whether hemolyzed samples were used. The subjects were 19 general applicants(male : 9, female : 13) and the samples were collected by each two SST tubes, one tube was obtained by centrifugation normally, and the other was obtained hemolyzed sample by centrifugation after external shock. It has been known that highly hemolyzed samples can affect the test results, so the test was performed using the severe hemolyzed sample. The test was performed for each test item using 23 normal serum and hemolysis serum, and SPSS19 program was used for statistical comparison of the test result. Results There was no significant difference between normal serum and hemolysis serum in 21 of 23 test items, but the results of insulin and C-peptide were significantly different(P<0.05). Conclusion It has been known that hemolysis in blood samples can affect the results of biochemical and hematological test, However, hemolysis effect is relatively low. Similarly, this study showed that hemolysis had not much effect on most of immunological radioimmunoassay except for some tests. Therefore, it is thought that the demand for re-collection due to hemolysis will be reduced in the laboratory, which will improve the work process of the laboratory.

A Case Report of Patient with Left Neck Mass and a History of Thyroid and Ovarian Cancer in Head and Neck (갑상선암 및 난소암 병력을 가진 좌측 경부 종물을 주소로 내원한 환자 1례에 대한 증례 보고)

  • Jeong, Yong Jun;Oh, Kyoung Ho;Kwon, Soon Young
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.73-77
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    • 2020
  • Ovarian cancer is common malignant disease with high mortality in the female. However, lymph node metastasis in the head and neck of ovarian cancer is very rare than in para-aortic, pelvic lymph node. A 49-year-old female patient came to our clinic with a left neck mass. After total thyroidectomy and left selective neck dissection for the cervical neck level II, III, IV, V, VI for ovarian cancer and thyroid cancer, she had already undergone chemotherapy (Paclitaxel+Carboplatin) 18 month ago. CT scan showed only lymph node enlargement in left neck level II. Positron emission tomography-computed tomography (PET-CT) revealed a hypermetabolic lesion in same area but no other hypermetabolic lesion, especially in the pelvic and abdominal cavity. Fine needle aspiration cytology revealed metastatic carcinoma. The serum level of CA-125 was elevated to 43.8U/mL, whereas other tumor markers (CA 19-9, CEA) were in the normal range. She underwent a revision of selective neck lymph node dissection for the cervical neck levels I, II, and III, and on the review of surgical pathology, metastatic carcinoma was suspected. Thus, we performed immunohistochemical staining for the tissue; as a result, it was finally diagnosed as metastatic ovarian cancer (positive for CK7, ER and PR, and negative for CK20). Adjuvant chemotherapy (Paclitaxel+Carboplatin) was planned on the tumor board, and the patient successfully received chemotherapy.