• 대한두경부종양학회지
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• 제20권2호
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• pp.147-155
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• 2004

Objectives: Head and neck squamous cell carcinoma (HNSCC) is the most common head and neck malignant tumor. The molecular genetic changes involving both oncogenes and tumor suppressor genes are known to be involved in head and neck squamous cell carcinogenesis, but the roles of the known tumor suppressor genes in carcinogenesis are not fully elucidated. The objectives of this study are to demonstrate the genetic alterations including the loss of heterozygosity (LOH) , amplification, and microsatellite instability of known tumor suppressor genes in HNSCC and to evaluate the relationship between genetic alterations of tumor suppressor genes and clinicopathologic features. Materials and Methods: Genetic alterations of 10 micro satellite markers of the 6 known tumor suppressor genes (APC, EXT1, DPC4, p16, FHIT, and PTEN) were analysed by DNA-PCR in paraffin-embedded histologically confirmed HNSCC specimens. Results: The genetic alterations of tumor suppressor genes were found frequently. Among the genetic alterations, LOH was most frequently found one. LOH was found frequently in APC (45.4%), EXT1 (36.4%), DPC4 (54.5%), and p16 (50%), but not found in FHIT. Also, the author found that abnormalities of APC gene was related to cervical lymph node metastasis and recurrence and that abnormalities of EXT1 gene were coexisted with those of APC gene or DPC4 gene. But these coexistences had no correlation with clinical features. Conclusion: These results suggested that APC, EXT1, p16, and DPC4 genes might play important roles and multiple tumor suppressor genes may participate dependently or independently in the carcinogenesis of HNSCC. These results also suggested that APC gene might relate to prognosis.

• Radiation Oncology Journal
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• 제11권1호
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• pp.83-90
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• 1993

During the period from January, 1975, to June, 1989, one hundred patients with histopathologically proven polymorphic reticulosis in the upper respiratory tract were treated with radiation therapy and the analysis of treatmemt results was undertaken. One hundred patients (69 males, 31 females) with a mean age of 46 years (range 12-79 years) were presented. Nasal cavity was the most frequent site of involvement ($56{\%}$), and 44 cases had multifocal sites of involvement. The incidence of cervical lymph node metastasis at initial diagnosis was $24{\%}$. Staging was determined by Ann-Arbor classification, retrospectively. The number of patients of stage IE, IIE, IIIE and IVE were 35, 60, 1, and 4, respectively. The overall 5 year actuarial survival rates were $38.4{\%}$. The difference in 5 year survival rates between patients with stage IE and IIE, with solitary and multiple, with CR and PR after irradiation were significant statistically. For the analysis of failure patterns, failure sites include the following: local failure alone (30/55=$54.6{\%}$), systemic failure alone (9/55=$16.4{\%}$), both local and systemic failure (16/55=$29.0{\%}$). Retrograde slide review was available in 29 cases of PMR with respect to histopathologic bases, and immunohistochemical studies were performed using MT1 and DACO-UCHL-1 as T-cell markers, MB2 as a B-cell marker and alpha-1-antichymotrypsin as a histiocytic markers. All that 29 cases showed characteristic histologic features similar to those of peripheral T-cell lymphoma and showed positive reactio to the T-cell marker. These findings suggest strongly that quite a significant portion of PMR may be in fact T-cell lymphoma.

• 대한두경부종양학회지
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• 제3권1호
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• pp.25-35
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• 1987

Irradiated 88 patients of Maxillary Sinus Carcinoma at Yonsei Cancer Center for 10years between 1971 and 1980 were retrospectively analysed. The majority of patients had very advanced disease(87.5% of $T_3\;and\;T_4$) and 17% of cervical lymph node involvement. 80.6% of all patients were epidermoid type. In 44 cases(50%), irradiation alone was performed. 28 cases(32%) of postoperative radiation after incomplete surgery and the remaining 16 cases(18%) of postoperative radiation after radical surgery were done. The majority of patients except 6 cases had irradiation a dose between 60Gy and 80Gy in 30-40 fractions over 6-8 weeks. The actuarial overall 3 and 5 year survival rate were 362% and 26%, respectively. The actuarial 5 year survival rate for 44 cases of radiation alone group was 14.1%, The actuarial 5 year survival rate for 28 cases of incomplete surgery and postoperative radiation group and 16 cases of radical surgery and postoperative radiation group were 312% and 67.4% respectively. In the actuarial 5 year survival rate according to the stage, stage II, III and IV were 79.5%, 20.9% and 0%. In recent, for the improvement of survival rate of advanced Maxillary Sinus Carcinoma at Yonsei Cancer Center, combined multidisplinary or trimodal treatment modality have been applied and in near time the more excellent results expect to be analyse.

• 대한두경부종양학회지
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• 제28권1호
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• pp.42-45
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• 2012

Small cell carcinoma mainly occurs in the lung. Approximately 2.5-5% of small cell carcinomas are primary extrapulmonary which are commonly found in the esophagus, GI tract, skin, uterus, and urinary tract. Small cell carcinoma of the head and neck is extremely rare and its prognosis is poor. We report a case of supraglottic small cell carcinoma with cervical lymph node and rib metastasis in a 75-year-old man. The patient was treated with sequential combination of chemotherapy and radiotherapy, but the cancer has progressed. We concluded that we have to find an effective therapy for laryngeal small cell carcinoma.

• 대한두경부종양학회지
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• 제15권2호
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• pp.222-225
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• 1999

Background and Objectives: Medullary thyroid carcinoma(MTC) is a rare tumor derived from the parafollicular C cells of the thyroid gland accounting for 5-10% of all thyroid malignancies. In Korea, there has been a few case report of medullary thyroid carcinoma(MTC) but their clinical analysis were not exactly studied. So, we made clinical study of 10 patients diagnosed as medullary thyroid carcinoma. Materials and Methods: We reviewed clinical data of 10 patients who were diagnosed as medullary thyroid carcinoma(MTC) from April 1973 to August 1998 at National Medical Center. Results: The incidence of MTC was 2.3% of all thyroid cancer and their mean age were 44.2 years old. Preoperative thyroid scan showed cold nodule in all patients and thyroid function test(TFT) was within normal range. Of the 10 patents, only 4 patients had diagnosis of MTC in preoperative fine needle aspiration biopsy. All the patients underwent total thyroidectomy with central neck dissection. Two patients with cervical lymph node metastasis underwent total thyroidectomy, central neck dissection and modified neck dissection. Two patients (20%) showed recurrence at the site of neck, lung, mediastinum, bone and liver. Conclusion: Most MTC is sporadic form and have peak incidence in the fifth decade and female preponderance. Preoperative fine needle aspiration biopsy is considered to be a clinically useful diagnostic method, but its accuracy is not considered as much high as others. Total thyroidectomy with central neck dissection may be an useful surgical modality in treating medullary thyroid carcinoma.

• 한국임상수의학회지
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• 제26권3호
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• pp.263-267
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• 2009

A 9-year-old, female, Maltese Dog(2.15 kg of body weight) was referred to the Veterinary Medical Teaching Hospital, Chungnam National University with cervical masses, abdominal masses and petechia. Physical examination showed masses in mandibular, prescapular, inguinal, popliteal lymph node and abdominal subcutaneous hemorrhage. This case was diagnosed as the multicentric lymphoma by physical examination, laboratory examination, radiography, ultrasonography, CT, fine needle aspiration and histopathologic examination. This dog was treated by low-budget protocol with lomustine and prednisolone. The dog show that response duration and survival time is 143days and 263 days, respectively.

• Journal of Endocrine Surgery
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• 제18권4호
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• pp.228-235
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• 2018

Purpose: The epidermal growth factor receptor (EGFR) family plays a crucial role in the growth of malignant tumors. EGFR and human EGFR 2 (HER2) protein overexpression are associated with an unfavorable prognosis and are important therapeutic targets in breast cancer. The aim of this study was to evaluate the relationship between EGFR and HER2 expression and clinicopathological factors in papillary thyroid carcinoma (PTC) at a single institution. Methods: A total of 129 consecutive patients with PTC were enrolled in this study and underwent thyroid surgery between October 2013 and February 2015. EGFR and HER2 protein expression was evaluated in the 129 primary tumors by immunohistochemistry, and the results were compared with the clinicopathological features. Results: Of the 129 PTC tumors, 20 (15.5%) were HER2 positive, and 109 (84.5%) were HER2 negative. Moreover, EGFR positivity were observed in 111 (86%) tumors. The mean age of the patients was $46.3{\pm}11.9years$ (range, 20-74 years), and the mean tumor size was $1.08{\pm}0.75cm$ (range, 0.2-3.5 cm). Tumor size, extrathyroidal extension, histological subtype, and TNM stage were not significantly associated with EGFR or HER2 expression. Meanwhile, high Ki-67 labeling index was significantly associated with EGFR expression (P=0.002), HER2 expression was significantly associated with younger age (${\leq}45years$) and cervical lymph node metastasis. Conclusion: Based on our data, it is not clear whether EGFR and HER2 expression is associated with tumor aggressiveness in PTC.

• Genomics & Informatics
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• 제20권3호
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• pp.27.1-27.13
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• 2022

Oral squamous cell carcinoma (OSCC) is the most prevalent head and neck malignancy, with frequent cervical lymph-node metastasis, leading to a poor prognosis in OSCC patients. The present study aimed to identify potential markers, including microRNAs (miRNAs) and genes, significantly involved in the etiology of early-stage OSCC. Additionally, the main OSCC's dysregulated Gene Ontology annotations and significant signaling pathways were identified. The dataset GSE45238 underwent multivariate statistical analysis in order to distinguish primary OSCC tissues from healthy oral epithelium. Differentially expressed miRNAs (DEMs) with the criteria of p-value < 0.001 and |Log2 fold change| > 1.585 were identified in the two groups, and subsequently, validated targets of DEMs were identified. A protein interaction map was constructed, hub genes were identified, significant modules within the network were illustrated, and significant pathways and biological processes associated with the clusters were demonstrated. Using the GEPI2 database, the hub genes' predictive function was assessed. Compared to the healthy controls, main OSCC had a total of 23 DEMs. In patients with head and neck squamous cell carcinoma (HNSCC), upregulation of CALM1, CYCS, THBS1, MYC, GATA6, and SPRED3 was strongly associated with a poor prognosis. In HNSCC patients, overexpression of PIK3R3, GIGYF1, and BCL2L11 was substantially correlated with a good prognosis. Besides, "proteoglycans in cancer" was the most significant pathway enriched in the primary OSCC. The present study results revealed more possible mechanisms mediating primary OSCC and may be useful in the prognosis of the patients with early-stage OSCC.

• Radiation Oncology Journal
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• 제28권3호
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• pp.125-132
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• 2010

목 적: 자궁경부암에서 근치적 절제술 후 림프절 침범은 중요한 예후인자 중 하나이다. 본 연구에서는 총장골동맥림프절 침범 시 대동맥주위림프절에 대한 예방적 방사선조사의 효과를 알아보고자 하였다. 대상 및 방법: 1985년 5월부터 2004년 10월까지 총 909명의 환자가 서울대병원에서 자궁경부암으로 근치적 절제술 후 방사선치료를 시행받았다. 골반 내 림프절 침범이 있는 환자는 375명이었고 총장골동맥림프절 침범이 있는 환자는 69명이었다. 이 중 총장골동맥림프절 침범이 있으면서 대동맥주위림프절 침범은 없었던 54명의 환자를 대상으로 후향적 분석을 시행하였다. 대상환자의 FIGO 병기는 IB, IIA, IIB가 각각 22명, 21명, 11명이었다. 이 중 10명은 전골반과 대동맥주위림프절을 포함하는 확장조사야로 방사선치료를 받았고 모두 항암화학치료를 병용하였으며, 나머지 44명은 전골반 만을 포함하는 표준조사야로 방사선치료를 받았고 이 중 16명이 항암화학치료를 병용하였다. 확장조사군과 표준조사군의 추적관찰기간은 각각 21~58개월(중간값, 47개월)과 6~201개월(중간값, 58개월)이었다. 결 과: 전체 환자의 4년 생존율, 4년 무병생존율, 4년 무전이생존율은 각각 70.0%, 61.1%, 71.7%였다. 단변량 분석 시 절제연 침범(p<0.001), 림프관내 종양 침범(p=0.041)이 있는 경우 유의하게 생존율이 낮았고, 양측 림프절침범(p=0.001), 5개 이상의 림프절 전이(p=0.006)가 있는 경우 유의하게 낮은 무병생존율을 보여주었다. 낮은 무전이생존율과 관련 있는 인자는 양측 림프절 침범(p=0.009), 5개 이상의 림프절 전이(p=0.003), 자궁경부 전층 침범(p=0.013), 절제연 침범(p=0.014), 림프관내 종양 침범(p=0.041)이었다. 확장조사군과 표준조사군의 4년 생존율은 90.0%와 67.2% (p=0291), 4년 무병생존율은 70.0%와 59.0% (p=0.568), 4년 무전이생존율은 90.0%와 67.5% (p=0.196), 4년 대동맥주위림프절 전이율은 0%와 14.3% (p=0.249)로 통계적으로 유의한 차이가 없었다. 3등급 이상의 중등도 급성합병증은 확장조사군 10명 중 4명(40%; 조혈계 2명, 위장관계 2명)에서 발생하였고, 표준조사군 44명 중에서는 11명(25%; 조혈계 2명, 위장관계 6명, 비뇨생식계 3명)에서 발생하였다. 결론: 자궁경부암의 근치적 절제술 후 총장골동맥림프절 침범이 있는 경우 예방적 대동맥주위림프절 방사선조사의 생존율에 대한 통계적 유용성은 확인할 수 없었다. 그러나 확장조사야로 치료받은 환자수가 적고 추적관찰기관이 짧았던 점을 고려하면 추가적인 추적관찰이 필요할 것으로 생각한다.

• Radiation Oncology Journal
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• 제24권1호
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• pp.37-43
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• 2006

목적 : 종양 내 VEGF의 발현이 방사선저항성과 관련이 있고, 자궁경부암에서 VEGF 발현이 예후와 관련된다는 보고들이 있다. 본 연구에서는 자궁경부암 환자에서 근치적 방사선치료를 시행받은 환자를 대상으로 후향적으로 VEGF 발현에 따른 임상적 특성 및 환자 예후와 연관 관계를 알아보고자 하였다. 대상 및 방법 : 1995 년 9 월부터 2003 년 4 월까지 삼성서울병원에서 자궁경부의 편평상피세포암 FIGO 병기 II로 진단받고 근치적 방사선치료가 시행된 환자 중 면역조직학 검사를 위한 파라핀 블록이 유용한 31 명 환자를 대상으로 하였다. 대상환자들의 연령 분포는 $38{\sim}83$세 (중간값 65세)였다 종양의 크기는 $1.2{\sim}8.2cm$( 평균 4.1cm)였고, 골반 내 림프절 전이는 7예 (22.6%) 에서 있었다 방사선치료는 15 MV 광자선으로 매일 1.8 Gy씩 주 5회, 전골반 내 조사가 시행되었는데 외부방사선치료 선량은 $45{\sim}56.4 Gy$ ( 중간값 50.4 Gy) 였고, 강내치료는 point A 에 1회 4Gy씩 주 2회, 총 24 Gy 조사되었다. 방사선치료 기간은 $48{\sim}67$일 (중간값 53 일) 이었다. VEGF 면역조직학 검사상 양성은 종양세포 중 VEGF 분포가 10% 이상인 경우로 정하였다. 대상환자들의 추적관찰기간은 $12{\sim}119$개월 (중간값 58 개월) 이었다. 결과 : VEGF 양성인 경우는 21 예 (67.7%)였다 VEGF 발현에 따른 골반 내 림프절 전이 유무, 종양 크기와 방사선 치료에 따른 관해 정도의 유의한 차이는 없었다. 전체 환자 중 7 예에서 재발이 있었는데 국소재발, 원격전이, 국소 재발과 원격전이가 동반된 경우가 각각 3예, 3예, 1예였다. VEGF 음성과 양성인 경우에 방사선치료 후 완전관해율 이 각각 90%와 81%로 의의있는 차이는 없었지만, 재발은 모두 VEGF 양성인 환자에서 발생하여 통계적으로 의의 있는 차이를 보였다 (p=0.040). 3년 무병생존율은 77.4%였는데, VEGF 음성과 양성인 경우 각각 100% 와 66.7%로 차이가 있었다 (p=0.047). 결과: 자궁경부암 lGO 병기 2기 환자의 근치적 방사선치료 시 종양 내 VEGF 발현 유무는 재발률과 무병생존율에 영향을 주는 인자였다. 그러나 VEGF 과발현에 대한 각 문헌마다 정의가 다르고, 문헌에 보고되는 환자수가 많지 않아 향후 VEGF 발현이 자궁경부암 환자의 예후인자로 결정되기 위해서는 대규모 연구가 필요하겠다.