• Clinical Endoscopy
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• 제55권1호
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• pp.113-121
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• 2022

Background/Aims: We have been developing artificial intelligence based polyp histology prediction (AIPHP) method to classify Narrow Band Imaging (NBI) magnifying colonoscopy images to predict the hyperplastic or neoplastic histology of polyps. Our aim was to analyze the accuracy of AIPHP and narrow-band imaging international colorectal endoscopic (NICE) classification based histology predictions and also to compare the results of the two methods. Methods: We studied 373 colorectal polyp samples taken by polypectomy from 279 patients. The documented NBI still images were analyzed by the AIPHP method and by the NICE classification parallel. The AIPHP software was created by machine learning method. The software measures five geometrical and color features on the endoscopic image. Results: The accuracy of AIPHP was 86.6% (323/373) in total of polyps. We compared the AIPHP accuracy results for diminutive and non-diminutive polyps (82.1% vs. 92.2%; p=0.0032). The accuracy of the hyperplastic histology prediction was significantly better by NICE compared to AIPHP method both in the diminutive polyps (n=207) (95.2% vs. 82.1%) (p<0.001) and also in all evaluated polyps (n=373) (97.1% vs. 86.6%) (p<0.001) Conclusions: Our artificial intelligence based polyp histology prediction software could predict histology with high accuracy only in the large size polyp subgroup.

• Clinical Endoscopy
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• 제55권1호
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• pp.45-46
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• 2022

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3869-3872
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• 2012

Background: The majority of patients with gastric cancer in developing countries present with advanced disease. Systemic chemotherapy therefore has limited impact on overall survival. Patients eligible for chemotherapy should be selected carefully. The aim of this study was to analyze prognostic factors for survival in advanced gastric cancer patients undergoing first-line palliative chemotherapy. Methods: We retrospectively reviewed 107 locally advanced or metastatic gastric cancer patients who were treated with docetaxel and cisplatin plus fluorouracil (DCF) as first-line treatment between June 2007 and August 2011. Twenty-eight potential prognostic variables were chosen for univariate and multivariate analyses. Results: Among the 28 variables of univariate analysis, nine variables were identified to have prognostic significance: performance status, histology, location of primary tumor, lung metastasis, peritoneum metastasis, ascites, hemoglobin, albumin, weight loss and bone metastasis. Multivariate analysis by Cox proportional hazard model, including nine prognostic significance factors evident in univariate analysis, revealed weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level to be independent variables. Conclusion: Performance status, weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level were identified as important prognostic factors in advanced gastric cancer patients. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.

• 대한이식학회지
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• 제28권3호
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• pp.135-143
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• 2014

Background: Kidney injury molecule-1 (KIM-1) is known as a good ancillary marker of acute kidney injury (AKI) and its expression has also been observed in acute rejection and chronic graft dysfunction. We tested usefulness of KIM-1 as an indicator of acute and chronic renal graft injury by correlating KIM-1 expression with renal graft function and histology. Methods: A total of 133 zero-time biopsies and 42 follow-up biopsies obtained within 1 year posttransplantation were selected. Renal tubular KIM-1 staining was graded semiquantitatively from 0 to 3 and the extent of staining was expressed as the ratio of KIM-1 positive/CD10 positive proximal tubules using Image J program. Results: KIM-1 was positive in 39.8% of zero-time biopsies. KIM-1 positive cases were predominantly male and had received grafts from donors with older age, deceased donors, and poor renal function at the time of donation, compared with KIM-1 negative cases. KIM-1 expression showed correlation with delayed graft function and acute tubular necrosis. In comparison of KIM-1 expression between stable grafts (n=23) and grafts with dysfunction (n=19) at the time of repeated biopsy, the intensity/extent of KIM-1 staining and renal histology at zero-time did not differ significantly between the two groups. Histologically, KIM-1 expression was significantly increased with both acute and chronic changes of glomeruli, tubules and interstitium, peritubular capillaritis, and arteriolar hyalinosis. Conclusions: KIM-1 can be used as an ancillary marker of AKI and a nonspecific indicator of acute inflammation and tubulointerstitial fibrosis. However, KIM-1 expression at zero-time is not suitable for prediction of long-term graft dysfunction.

• Korean Journal of Radiology
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• 제24권7호
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• pp.626-639
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• 2023

Objective: To investigate the association of clinical, pathologic, and magnetic resonance imaging (MRI) variables with progressive disease (PD) during neoadjuvant chemotherapy (NAC) and distant metastasis-free survival (DMFS) in patients with triple-negative breast cancer (TNBC). Materials and Methods: This single-center retrospective study included 252 women with TNBC who underwent NAC between 2010 and 2019. Clinical, pathologic, and treatment data were collected. Two radiologists analyzed the pre-NAC MRI. After random allocation to the development and validation sets in a 2:1 ratio, we developed models to predict PD and DMFS using logistic regression and Cox proportional hazard regression, respectively, and validated them. Results: Among the 252 patients (age, 48.3 ± 10.7 years; 168 in the development set; 84 in the validation set), PD was occurred in 17 patients and 9 patients in the development and validation sets, respectively. In the clinical-pathologic-MRI model, the metaplastic histology (odds ratio [OR], 8.0; P = 0.032), Ki-67 index (OR, 1.02; P = 0.044), and subcutaneous edema (OR, 30.6; P = 0.004) were independently associated with PD in the development set. The clinical-pathologic-MRI model showed a higher area under the receiver-operating characteristic curve (AUC) than the clinical-pathologic model (AUC: 0.69 vs. 0.54; P = 0.017) for predicting PD in the validation set. Distant metastases occurred in 49 patients and 18 patients in the development and validation sets, respectively. Residual disease in both the breast and lymph nodes (hazard ratio [HR], 6.0; P = 0.005) and the presence of lymphovascular invasion (HR, 3.3; P < 0.001) were independently associated with DMFS. The model consisting of these pathologic variables showed a Harrell's C-index of 0.86 in the validation set. Conclusion: The clinical-pathologic-MRI model, which considered subcutaneous edema observed using MRI, performed better than the clinical-pathologic model for predicting PD. However, MRI did not independently contribute to the prediction of DMFS.

• Journal of Digestive Cancer Research
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• 제3권2호
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• pp.89-94
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• 2015

The role of adjuvant chemotherapy in patients with stage II colon cancer remains a controversial issue. Adjuvant chemotherapy aims to eliminate any micrometastatic disease that may have been missed, at the time of surgery. Although one prospective study showed a small but statistically significant benefit with respect to the overall survival for those who received adjuvant chemotherapy, multiple pooled data did not demonstrate any benefit of this therapy in patients with stage II colon cancer. Current national and international guidelines for the adjuvant treatment of stage II colon dose not advise routine implementation of adjuvant chemotherapy, but rather recommend selective use of this therapy for patients with high risk of recurrence. High risk features for recurrence include T4 disease, poorly differentiated histology, presence of lymphovascular invasion, presence of perineural invasion, inadequate retrieval of lymph nodes, bowel obstruction, localized perforation, or positive margins. More recently, prediction tools using gene expression cancer profiles are proposed to identify patients who are most likely to have recurrence and therefore may benefit from postoperative chemotherapy in stage II colon cancer. These novel methods together with conventional prognosticators, will allow us to implement more optimized personalizing adjuvant therapy in these patients.

• 한국방사선학회논문지
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• 제12권5호
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• pp.677-682
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• 2018

본 연구는 유방 전단파 탄성 초음파에서 탄성도 점수와 변형비를 이용한 방법이 양성과 악성병변의 감별진단에 유용한지를 평가하였다. 탄성 초음파를 시행한 224명을 대상으로 하였으며, 유방조직검사 결과를 바탕으로 후향적인 분석을 하였다. 유방 종괴의 양성과 악성에 따른 5단계의 탄성도 점수와의 동질성 비교는 Fisher's Exact test, 변형비와의 차이검증은 Mann-Whitney U test를 실시하였다. ROC 곡선분석을 통해 악성병변의 예측을 위한 탄성도 점수와 변형비의 최적 cut off 값을 결정하였다. 양성과 악성 결절 군의 분류에 따른 탄성도 점수의 동질성 비교와 변형비의 차이검증 결과에서 각각 통계적으로 유의한 차이를 보였으며(p=.000), ROC 곡선분석에서 양성과 악성 결절의 예측을 위한 탄성도 점수와 변형비의 AUC 0.824, 0.806, cut off 값 3, 4.4로 결정되었다(p=.001). 따라서 탄성도 점수와 변형비는 유방 종괴의 감별진단에 도움을 줄 수 있을 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7463-7466
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• 2015

Aims: To analyse the predictors of recurrence, disease free survival and overall survival in cases with endometrial cancer. Materials and Methods: A total of 152 women diagnosed with endometrial cancer were screened using a prospectively collected database including age, smoking history, menopausal status, body mass index, CA125, systemic disorders, tumor histology, tumor grade, lymphovascular space invasion, tumor diameter, cervical involvement, myometrial invasion, adnexal metastases, positive cytology, serosal involvement, other pelvic metastases, type of surgery, fertility sparing approach to assess their ability to predict recurrence, disease free survival and overall survival. Results: In ROC analyses tumor diameter was a significant predictor of recurrence (AUC:0.771, P<0.001). The optimal cut off value was 3.75 with 82% sensitivity and 63% specificity. In correlation analyses tumor grade (r=0.267, p=0.001), tumor diameter (r=0.297, p<0.001) and the serosal involvement (r=0.464, p<0.001) were found to significantly correlate with the recurrence. In Cox regression analyses when some different combinations of variables included in the model which are found to be significantly associated with the presence of recurrence, tumor diameter was found to be a significant confounder for disease free survival (OR=1.2(95 CI,1.016-1.394, P=0.031). On Cox regression for overall survival only serosal involvement was found to be a significant predictor (OR=20.8 (95 % CI 2.4-179.2, P=0.006). In univariate analysis of tumor diameter > 3.75 cm and the recurrence, there was 14 (21.9 %) cases with recurrence in group with high tumor diameter where as only 3 (3.4 %) cases group with smaller tumor size (Odds ratio:7.9 (95 %CI 2.2-28.9, p<0.001). Conclusions: Although most of the significantly correlated variables are part of the FIGO staging, tumor diameter was also found to be predictor for recurrence with higher values than generally accepted.

• International Journal of Oral Biology
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• 제40권4호
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• pp.197-204
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• 2015

MicroRNA (miRNA, miR) is essential in regulating cell differentiation either by inhibiting mRNA translation or by inducing its degradation. However, the role of miRNA in odontoblastic cell differentiation is still unclear. In this study, we examined the molecular mechanism of miR-27-mediated regulation of odontoblast differentiation in MDPC-23 mouse odontoblastic cells derived from mouse dental papilla cells. The results of the present study demonstrated that the miR-27 expression increases significantly during MDPC-23 odontoblastic cell differentiation. Furthermore, miR-27 up-regulation promotes the differentiation of MDPC-23 cells and accelerates mineralization without cell proliferation. The over-expression of miR-27 significantly increased the expression levels of Wnt1 mRNA and protein. In addition, the results of target gene prediction revealed that Wnt1 mRNA has an miR-27 binding site in its 3'UTR, and is increased by miR-27. These results suggested that miR-27 promotes MDPC-23 odontoblastic cell differentiation by targeting Wnt1 signaling. Therefore, miR-27 is a critical odontoblastic differentiation molecular target for the development of miRNA based therapeutic agents in dental medicine.