• 제목/요약/키워드: Head and neck cancer patients

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후두암종에서 Ebstein-Barr 바이러스 DNA와 Bcl-2 단백의 검색 (Detection of Ebstein-Barr Virus DNA and Bcl-2 Protein in Laryngeal Squamous Cell Carcinoma)

  • 이상숙;박남조;박준식
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.14-19
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    • 2000
  • Objectives: Epstein-Barr virus(EBV) is a B-lymphotrophic virus with a tumorigenic potential. EBV infection has been recognized as the main cause of nasopharyngeal carcinoma and Burkitt's lymphoma. Bcl-2 protein expression is known to be up-regulated by the EBV-latency associated antigen latent membrane protein(LMP). The aim of this study was to determine the incidence of EBV in squamous cell carcinomas of the larynx and the relationship between the presence of EBV and bcl-2 expression. Patients and Methods: From January 1994 to December 1977, 35 patients with primary squamous cell carcinoma of the larynx were studied. EBV genome DNA was surveyed by polymerase chain reaction(PCR) assay and then compared the results of in situ hybridization(ISH) for EBER1 using digoxigenin-tailed oligonucleotide probe. The expression of bcl-2 protein was studied by immunohistochemistry(IHC) using bcl-2 monoclonal antibody. Results: By PCR, EBV genome was detected in 22 of 35(62.9%) squamous cell carcinomas of the larynx. Nineteen of 35 cases(54.3%) showed a positive nuclear staining for EBER1 in tumor cells by ISH. Three cases showed positivity in inflammatory cells by ISH and one of them showed a positive staining of both tumor cells and inflammatory cells. Eighteen of 32 specimens(62.5%) were positive for bcl-2 protein. There was no significant correlations between the presence of EBV DNA and bcl-2 expression. Conclusions: It could be concluded that high incidence of EBV in the laryngeal cancer tissue may indicate a probable role of EBV in the development of laryngeal carcinoma.

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악성종양의 임상적 병기에 따른 $^{99m}Tc-MDP$ 골주사의 비교관찰 ($^{99m}Tc-MDP$ Bone Scan Findings in Various Clinical Stages of Malignancies)

  • 윤휘중;이명철;조보연;김노경;고창순
    • 대한핵의학회지
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    • 제15권2호
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    • pp.1-9
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    • 1981
  • Bone scans with $^{99m}Tc-MDP$ (methylene diphosphonate) were obtained and analysed in 574 patients with biopsy-proven malignancy, who visited Seoul National University Hospital from April, 1979 to June, 1931. Clinical staging was done in all patients without bone scan information and compared with bone scan to determine the predictive value of bone scanning. 1. Primary site of the maligancies were lung in 152, breast in 97, stomach in 43, colon in 15, esophagus in 9, liver and pancreas in 11, kidney in 14, bladder in 27, prostate in 22, thyroid in 20, skin in 11, bone in 9, head and neck in 36, ovary and uterus in 17, hematopoietic and lymphoretic ular system in 33, nervous system in 10, and others in 9 cases. Primary site was not defined in 39 cases. 2. Bone scans were positive in 186 cases (32.4%), which, included 48 cases (31.6%) of lung cancer, 27 cases (27.8%) of breast cancer, 12 cases(28%) of stomach cancer, 6 cases(40%) of colon cancer, 6 cases(43%) of kidney tumor, 4 cases(15%) of bladder cancer, 14 cases(64%) of prostate cancer, 3 cases(15%) of thyroid cancer and 66 other cases. 3. Bone scans were suspicious in 64 cases (11.2%) which included 29 cases (19.1%) of lung cancer, 10 cases (10.3%) of breast cancer, 4 cases (9.3%) of stomach cancer, one case (7%) of colon cancer, 3 cases(11%) of bladder cancer, 2 cases(10%) of thyroid cancer and 15 other cases. 4. Out of 121 cases with early stage of malignancy (which included 20 cases of lung cancer in stage I, II, 38 cases of breast cancer, 13 cases of stomach cancer, 8 cases of kidney tumor, 14 cases of thyroid cancer in stage $I{\sim}III$, and 6 cases of colon cancer, 14 cases of bladder cancer, 8 cases of prostate cancer in stage $A{\sim}C$, bone scans were positive in 5 cases (4.1%) which included 3 cases of lung cancer one case of breast cancer and one case of prostate cancer, and considered as further advanced stage. Out of 121 cases with early stage of malgnancy, bone scans were suspicious in 21 cases (17.4%) which inlcuded 9 cases of lung cancer, 4 cases of breast cancer, 2 cases of stomach cancer, one case of colon cancer, 3 cases of bladder cancer, and 2 cases of thyroid cancer. From these results, we concluded bone scan was useful in detecting bone metastasis in patients of early stage of malignancy, determining prognosis and establishing therapentic plan.

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자장의 세기에 따른 유방 확장기 주위의 인공물 평가 (Evaluation of artifacts around the breast expander according to magnetic field strength)

  • 정동일;김재석
    • 한국정보통신학회논문지
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    • 제24권9호
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    • pp.1144-1149
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    • 2020
  • 유방조직확장기의 Magnetic Valve는 MRI 검사 시 영상 인공물이 발생하여 MRI 검사가 제한적이다. MRI 검사가 필요한 유방조직확장기 삽입 환자에 대해 영상 인공물이 진단영역에 미치는 영향을 평가한다. 자체 제작한 팬텀과 실제 임상 조건을 이용하여 영상 인공물 측정을 실시하였다. 영상 인공물은 1.5 Tesla와 3.0 Tesla 환경에 따라 상이하게 측정되었으며, C-spine, L-spine 검사 시 영상 인공물의 영향이 T-spine에 비해 상대적으로 적었다. 유방암 전이로 인한 MRI 검사가 꼭 필요한 경우 주로 1.5 Tesla에서 Head & Neck 검사와 L-spine 아래 부위를 검사 할 수 있으나 일부 시퀀스에서는 영상 인공물로 인한 왜곡이 발생할 수 있다. 유방조직확장기 삽입 환자의 MRI 검사는 안전성 측면에서는 3.0T는 피하고 1.5T에서 조건부로 가능하다.

유두상 갑상선암의 피부전이 1예 (A Case of Skin Metastasis from Papillary Thyroid Carcinoma)

  • 임치영;이잔디;남기현;권지은;장항석;정웅윤;박정수
    • 대한두경부종양학회지
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    • 제21권2호
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    • pp.174-177
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    • 2005
  • Skin metastasis from papillary thyroid carcinoma is extremely rare. Due to similar histopathologic features, it is difficult to differentiate skin metastatic papillary thyroid carcinoma and some primary skin neoplasms without a clinical history. However, most of metastatic skin lesions showed a strong reactivity to the antithyroglobulin antibodies unlike primary skin neoplasms. Metastatic skin lesions must be completely removed and radiotherapy can be added. Investigators reported that prognosis of skin metastases from thyroid carcinoma is dismal and the average survival after it's diagnosis was only 19 months because distant metastases were often discovered at diagnosis of skin metastasis or during follow-up period. We report a case of skin metastasis from tall cell variant of papillary thyroid carcinoma. In our case, the anti thyroglobulin antibodies measured from cystic fluid from a skin lesion was more than 2000 IU/ml. Skin metastasis was diagnosed at 20 months after primary surgery for thyroid cancer and brain metastasis at 12 months after diagnosis of skin metastasis. Although skin metastasis is an ominous prognostic indicator in patients with thyroid carcinoma, a radical treatment for skin lesions and early diagnosis of distant metastasis could provide a chance to the patients to improve their survival.

양전자방출단층촬영술(PET/CT)을 이용한 메르켈 세포암(Merkel cell carcinoma)의 전이 평가 (Evaluation of Merkel Cell Carcinoma Metastasis Using Positron Emission Topography/CT)

  • 권순홍;송진경;유결;변준희
    • Archives of Plastic Surgery
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    • 제33권2호
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    • pp.233-236
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    • 2006
  • Merkel cell carcinoma is rare skin malignancy originated from epidermal mechanoreceptor of neural origin. The tumor usually affects older individuals at sun exposed area such as head, neck and extremity. Subclinical involvement of regional lymph node is reported frequently at the time of initial treatment. Thus even asymptomatic patients who present with clinically localized tumor should undergo evaluation with computed tomography and lymphangiography. Positron emission tomography(PET) scans can imaging the metabolic difference of malignant tumors. Increased glucose uptake of malignant tumor cells are detected by PET scanner. PET scans can provide qualitative and quantitative informations about systemic metastasis of tumors. Although there are no data that define the efficacy of PET scans in the initial diagnostic evaluation of head and neck cancer, they could be considered. Current standards of treatment of Merkel cell carcinoma is wide surgical excision and regional lymphadenectomy if there are suspicious lymph nodes. The author reported a patient with Merkel cell carcinoma of cheek. Wide surgical excision and postoperative PET/CT was done for evaluation of regional lymph node and distant metastasis. There were two hot-uptakes in patient's neck, so they were considered as metastatic node, but finally they were proved to be tuberculosis lymphadenitis after excision.

Treatment and Outcomes of Ewing Sarcoma in Turkish Adults: A Single Centre Experience

  • Seker, Mehmet Metin;Kos, Tugba;Ozdemir, Nuriye;Seker, Ayse;Aksoy, Sercan;Uncu, Dogan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.327-330
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    • 2014
  • Background: Ewing sarcoma is a small round cell tumor arising from soft tissue and bone that predominantly affects children and adolescents. The most unfavorable prognostic factor is the presence of distant metastasis at the time of diagnosis. Materials and Methods: The records of 26 Ewing sarcoma patients (14 male, 12 female) were re-evaluated retrospectively. Results: The median age was 26.5 (19-42) years. Eight patients (31%) showed a primary tumor in their extremities, 8 (31%) in the thorax, 4 (15%) at the vertebra, 4 (15%) in the head and neck, and 2 (8%) in the abdomen. Five patients (19%) had distant metastasis at diagnosis. The median progression-free survival was 72 months and 10 months in localized and metastatic disease, respectively (p=0.005). The overall survival rate was 19 months in metastatic disease, and the 5-year overall survival rate was 64% in localized disease (p=0.006). Patients who had localized disease in the extremities and were under age 30 had a favorable prognosis. Conclusions: Although Ewing sarcoma is a tumor affecting children and adolescents, it may be seen in adults, where the prognosis is generally worse. Although it is a highly malignant tumor, it is possible to achieve improved survival with combined modality treatments.

근치적 방사선치료에 완전반응을 보인 경부 림프절에서의 재발 양상 및 그 의의 (Significance of the Failure Patterns in Cervical Lymph Nodes Achieving a Complete Response to Radical Radiotherapy)

  • 남지호;김원택;기용간;김동현;최영진;조규섭;이진춘;이병주;김동원
    • Radiation Oncology Journal
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    • 제28권1호
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    • pp.9-15
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    • 2010
  • 목 적: 진행된 두경부암 환자들에서 근치적 방사선치료 후 완전반응을 보인 경부 림프절 병변에서의 재발 빈도와 양상을 확인하고, 이의 임상적 의미를 알아보고자 이 연구를 진행하였다. 대상 및 방법: 1987년부터 2008년까지 원발성 두경부 상피세포암종 및 경부 림프절 종대 병변에 대해 근치적 방사선치료를 받았던 환자들의 임상자료를 분석하였다. 이들 중 경부 림프절 병변에 충분한 방사선조사를 받은 후 완전 반응으로 평가된 환자들을 최종 연구대상으로 선정하였다. 대상 환자들의 주기적 영상자료를 바탕으로 경부 림프절에서의 재발 빈도와 양상을 확인하였다. 아울러 재발률과 관련된 예후인자들도 분석하였다. 결 과: 방사선치료 후 경부 림프절에서 완전반응으로 평가된 환자들은 73명이었다. 이들의 추적관찰 기간 동안의 재발률은 19.2%였다. 원발 병변에서도 완전반응을 보인 55명에서의 경부 재발률은 5.5%였다. 경부 재발의 80% 이상이 3년 이내에 확인되었으며, 47%에서 원발 병변의 재발이나 진행과 관련이 있었다. 치료 후 원발 병변의 반응 정도와 방사선 모의치료 방법이 경부 림프절 재발률과 관련 있었다. 결 론: 방사선치료 후 원발 병변 및 경부 림프절 병변에서 완전반응으로 평가된 환자들에서의 경부 림프절 재발률은 약 5%로, 이들에서는 계획된 림프절 절제술 없이 정기적인 추적관찰이 가능할 것으로 판단된다.

두경부암 경부 림프절 전이의 진단에서 $^{18}F-FDG-PET/CT$의 유용성 (Usefulness of $^{18}F-FDG$ PET/CT in the Diagnosis of Cervical Lymph Node Metastases of Head and Neck Cancer)

  • 김정호;김성훈;오주현;유이령;정용안;박영하;손형선;이성용;정수교
    • 대한핵의학회지
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    • 제39권5호
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    • pp.269-277
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    • 2005
  • 목적: 두경부암 환자에서 경부림프절 전이의 진단에서의 $^{18}F-FDG$ PET/CT의 유용성을 알아보고자 하였다. 대상 및 방법: 환자들을 수술 전 병기 결정을 위해 PET/CT을 촬영한 환자 46명(수술 전 환자군, 남: 38명, 여: 8명, 평균나이: 54.54세)과 1차 치료 후 재발 병소의 병기 결정을 위해 PET/CT를 시행한 환자 20명(재발 환자군, 남: 15명, 여: 5명, 평균나이: 49.5세)의 두군으로 분류하였다. PET/CT에서 FDG 섭취를 보인 경부림프절을 병소 대 병소로 조직검사 소견과 후향적으로 비교하였다. 결과: 수술 전 환자 15명의 PET/CT에서 21개의 FDG 섭취 증가를 보이는 림프절이 관찰되었다. 이 중 20개가 조직학적으로 림프절 전이로 확진되었고 평균 최대 SUV는 5.84 (2.05-20.39)였다. 나머지 하나의 림프절은 조직 검사에서 염증성 병소로 진단되었고 최대 SUV는 2.75였다. 7개의 림프절전이가 조직검사에서만 발견되었다 민감도는 74.0%, 특이도는 99.6%, 양성 예측도는 95.2% 그리고 음성 예측도는 97.3%였다. 수술 후 환자 9명에서 11개의 림프절전이가 PET-CT에서 관찰되었고, 이 중 8개가 전이로 확진되었고 평균 최대 SUV는 5.65 (3.02-9.84)였다. 나머지 3개의 림프절들은 염증성 병소였고 평균 최대 SUV는 2.87였다. 1개의 위음성의 림프절이 발견되었다. 민감도는 88.8%, 특이도는 97.7%, 양성 예측도는 72.7% 그리고 음성 예측도는 92.9%였다. 결론: FDG-PET/CT은 두경부암 환자의 경부 림프절 전이를 평가하는데 수술 전 환자군에서는 보다 높은 양성 예측도를, 재발 환자군에서는 보다 높은 민감도를 보였다. 그러므로 PET/CT는 두경부암 환자에서 수술 전 환자와 재발 환자의 경부 림프절 전이의 진단에 유용하였다.

Cancer Detection Rates in a Population-Based, Opportunistic Screening Model, New Delhi, India

  • Shridhar, Krithiga;Dey, Subhojit;Bhan, Chandra Mohan;Bumb, Dipika;Govil, Jyostna;Dhillon, Preet K
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권5호
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    • pp.1953-1958
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    • 2015
  • Background: In India, cancer accounts for 7.3% of DALY's, 14.3% of mortality with an age-standardized incident rate of 92.4/100,000 in men and 97.4/100,000 in women and yet there are no nationwide screening programs. Materials and Methods: We calculated age-standardized and age-truncated (30-69 years) detection rates for men and women who attended the Indian Cancer Society detection centre, New Delhi from 2011-12. All participants were registered with socio-demographic, medical, family and risk factors history questionnaires, administered clinical examinations to screen for breast, oral, gynecological and other cancers through a comprehensive physical examination and complete blood count. Patients with an abnormal clinical exam or blood result were referred to collaborating institutes for further investigations and follow-up. Results: A total of n=3503 were screened during 2011-12 (47.8% men, 51.6% women and 0.6% children <15 years) with a mean age of 47.8 yrs (${\pm}15.1yrs$); 80.5% were aged 30-69 years and 77.1% had at least a secondary education. Tobacco use was reported by 15.8%, alcohol consumption by 11.9% and family history of cancer by 9.9% of participants. Follow-up of suspicious cases yielded 45 incident cancers (51.1% in men, 48.9% in women), consisting of 55.5% head and neck (72.0% oral), 28.9% breast, 6.7% gynecological and 8.9% other cancer sites. The age-standardized detection rate for all cancer sites was 340.8/100,000 men and 329.8/100,000 women. Conclusions: Cancer screening centres are an effective means of attracting high-risk persons in low-resource settings. Opportunistic screening is one feasible pathway to address the rising cancer burden in urban India through early detection.

구강악안면영역의 선양낭성암종환자의 생존율 등에 관한 임상적 연구 (A CLINICAL STUDY ABOUT ADENOID CYSTIC CARCINOMA IN ORAL AND MAXILLOFACIAL AREA)

  • 김용각;박형국
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제19권1호
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    • pp.79-86
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    • 1997
  • Adenoid cystic carcinoma is characterized by sloe growth, multiple recurrence, a long clinical course and late metastasis. It is less than 1% of all head and neck malignancy, but most prevalent malignancy in salivary gland origin. During 14 years(from 1982 to 1995), 24 patients were diagnosed as adenoid cystic carcinoma in oral and maxillfacial area, in department of Oral and Maxillofacial Surgery, Korea Cancer Center Hospital. We studied clinically about their age and sex distribution, primary site distribution, TNM staging, treatment modalities, overall survival rates, survival rates according to stages. The age range were from 15 years to 79 years, average age weas 51 years. 15 were men and 9 Were women. Maxilla and palate were the most prevalent primary site. The most cases were in stage III(37%) and stage IV(46%). The 3 year and 5 year overall survival rate were 65.0% and 58.5%. The 5 year survival rate of the stage III cases was 66.7%, and that of the stage IV cases was 38.4%.

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