• 제목/요약/키워드: Liver metastasis

검색결과 378건 처리시간 0.022초

췌장선암 환자의 수술 전 CT 단독 평가와 추가적 MRI 평가에 따른 생존 결과 비교 분석 (A Comparative Study of Survivor Outcomes between Preoperative Evaluation Using CT Alone and Combined CT and MRI in Patients with Pancreatic Ductal Adenocarcinoma)

  • 이지은;김성현;이순진;최서연;이선영;이보라
    • 대한영상의학회지
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    • 제82권3호
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    • pp.638-653
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    • 2021
  • 목적 췌장선암으로 완치 수술을 시행 받은 환자들 중 수술 전 CT만 시행 받은 환자군과 추가적 MRI를 시행 받은 환자군의 재발 양상 및 생존율을 비교하고, 첫 재발 위치에 따른 예후 차이를 비교하고자 한다. 대상과 방법 췌장선암으로 R0 수술을 시행 받은 152명의 환자를 대상으로 하였다. 이중 103명은 수술 전 CT만 시행 받았고, 나머지 49명은 추가적 MRI를 시행 받았다. 두 명의 영상의학과 의사가 합의하에 각 환자의 첫 재발 위치와 재발 시기를 평가하였다. 두 환자군의 재발 양상, 무병 생존율, 전체 생존율을 비교하고, 첫 재발 위치에 따른 예후를 비교하였다. 결과 두 환자군 모두 간 전이가 가장 흔한 재발 양상이었고, 무병 생존율(p = 0.247)과 전체 생존율(p = 0.067)은 유의한 차이가 없었다. 첫 재발 위치에 따른 예후는 간 전이가 가장 나빴고, 그다음은 국소 재발이었다(p < 0.001). 결론 췌장선암으로 완치 수술을 시행 받은 환자에서 수술 전 CT만 시행 받은 환자군과 추가적 MRI를 시행 받은 환자군 사이에 재발 양상과 생존율은 유의한 차이가 없었다. 간 전이가 가장 흔한 재발 양상이었고, 다른 재발 양상과 비교하여 예후가 가장 나빴다.

Stereotactic body radiation therapy for liver oligo-recurrence and oligo-progression from various tumors

  • Cha, Yu Jin;Kim, Mi-Sook;Jang, Won-Il;Seo, Young Seok;Cho, Chul Koo;Yoo, Hyung Jun;Paik, Eun Kyung
    • Radiation Oncology Journal
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    • 제35권2호
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    • pp.172-179
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    • 2017
  • Purpose: To evaluate the outcomes of stereotactic body radiation therapy (SBRT) for patients with liver oligo-recurrence and oligo-progression from various primary tumors. Materials and Methods: Between 2002 and 2013, 72 patients with liver oligo-recurrence (oligo-metastasis with a controlled primary tumor) and oligo-progression (contradictory progression of a few sites of disease despite an overall tumor burden response to therapy) underwent SBRT. Of these, 9 and 8 patients with uncontrollable distant metastases and patients immediate loss to follow-up, respectively, were excluded. The total planning target volume was used to select the SBRT dose (median, 48 Gy; range, 30 to 60 Gy, 3-4 fractions). Toxicity was evaluated using the Common Toxicity Criteria for Adverse Events v4.0. Results: We evaluated 55 patients (77 lesions) treated with SBRT for liver metastases. All patients had controlled primary lesions, and 28 patients had stable lesions at another site (oligo-progression). The most common primary site was the colon (36 patients), followed by the stomach (6 patients) and other sites (13 patients). The 2-year local control and progression-free survival rates were 68% and 22%, respectively. The 2- and 5-year overall survival rates were 56% and 20%, respectively. The most common adverse events were grade 1-2 fatigue, nausea, and vomiting; no grade ${\geq}3$ toxicities were observed. Univariate analysis revealed that oligo-progression associated with poor survival. Conclusion: SBRT for liver oligo-recurrence and oligo-progression appears safe, with similar local control rates. For liver oligo-progression, criteria are needed to select patients in whom improved overall survival can be expected through SBRT.

Up-regulation of Thy-1 Promotes Invasion and Metastasis of Hepatocarcinomas

  • Cheng, Bian-Qiao;Jiang, Yi;Li, Dong-Liang;Fan, Jing-Jing;Ma, Ming
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권4호
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    • pp.1349-1353
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    • 2012
  • Increasing evidence has revealed that thy-1 was a potential stem cell marker of liver cancer, but no data have been shown on how thy-1 regulates the pathophysiology of liver cancer, such as proliferation, apoptosis, invasion and migration. We previously demonstrated that thy-1 was expressed in about 1% of hepg2 cells, thy-1+hepg2 cells, but not thy-1-, demonstrating high tumorigenesis on inoculation $0.5{\times}10^5$ cells per BACA/LA mouse after 2 months. In the present study, our results showed that higher expression of thy-1 occurs in 72% (36/50 cases) of neoplastic hepatic tissues as compared to 40% (20/50 cases) of control tissues, and the expression of thy-1 is higher in poorly differentiated liver tumors than in the well-differentiated ones. In addition, thy-1 expression was detected in 85% of blood samples from liver cancer patients, but none in normal subjects or patients with cirrhosis or hepatitis. There was a significant negative correlation between thy-1expression and E-cadherin expression (a marker of invasion and migraton), but not between thy-1 expression and AFP expression in all the liver cancer and blood samples. We further investigated the relationship between thy-1 and E-cadherin in liver cancer hepg2 cell line which was transfected with pReceiver-M29/thy-1 eukaryotic expression vector followed by aspirin treatment. Lower expression of E-cadherin but higher expressions of thy-1 were detected in hepg2 cells transfected with pReceiver-M29/thy-1. Taken together, our study suggested that thy-1 probably regulates liver cancer invasion and migration.

판정행렬분석을 통한 PET-MRI의 간암 진단성능 평가 (Evaluation of the Liver Cancer Diagnosis Function of PET-MRI Based on Decision Matrix Analysis)

  • 김진의;김정수;최남길;한재복
    • 한국콘텐츠학회논문지
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    • 제17권11호
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    • pp.50-59
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    • 2017
  • 최근 임상에서 활용하고 있는 일체형 PET-MRI의 간암 진단능력을 평가하기 위해 $2{\times}2$ 판정행렬을 이용하여 유용성을 평가하였다. 실험대상의 PET-MRI 검사 결과를 통해 간암 판정 여부 즉 비정상과 정상 판정을 받은 경우는 각각 98건, 51건 이었으며, 세포병리학적 결과가 양성과 음성 판정을 받은 경우는 각각 103건, 62건으로 나타났다. 이 중 두가지 검사에서 진양성의 경우는 95건, 위양성은 3건으로 나타났으며, 진음성은 62건, 위음성의 경우는 5건으로 분석되었다. 실험결과 PET-MRI 검사의 예민도는 95.00%, 특이도는 95.38%, 위음성률은 0.05%, 위양성률은 0.05%, 정확도는 95.15%로 분석되었다. 따라서 간암의 진단에 있어 수술 전 병기 결정이나 치료 후 재발 및 원격전이의 발견, 불분명한 원발 림프절 전이 등의 평가 등에 활용 가능성이 높을 것으로 판단되며, 특히 병리학적 검사와의 복합적 진단 및 추적검사를 통해 간암 진단을 위한 PET-MRI 임상적 유용성은 충분할 것으로 사료된다.

간전이를 동반한 폐기관지 비정형 카르시노이드 종양 1예 (A Case of Bronchopulmonary Atypical Carcinoid Tumor with Liver Metastasis)

  • 이동수;이태원;김지연;김휘정;송소향;김석찬;김영균;송정섭;박성학
    • Tuberculosis and Respiratory Diseases
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    • 제43권4호
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    • pp.623-629
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    • 1996
  • 기관지 비정형 카르시노이드 종양은 임파절 및 다른 장기로의 전이율이 높은 질환으로 특별한 증상 없이 우연히 방사선학적 검사상 발견되어 지는 드문 질환으로 알려져 있으며, 수술적 절제술이 우선적 치료로 되어 있다. 저자들은 흥부 방사선적 검사 및 조직 검사로 진단되어 수술적 절제술을 시행한 간전이를 동반한 폐기관지 비정형 카르시노이드 종양 1예를 경험하였기에 보고한다.

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알러젠 제거 옻나무 추출물 투여로 소퇴된 신세포암 유래 부신전이암 1례 (Adrenal Metastasis from Renal Cell Carcinoma Regressed with Allergen-removed Rhus verniciflua Stokes;A Case Report)

  • 정의민;정종수;정현식;박재우;윤성우
    • 대한한방내과학회지
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    • 제29권2호
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    • pp.529-534
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    • 2008
  • Renal cell carcinoma(RCC) is one of the major malignant renal cell tumors. Although RCC can metastasize to almost every organ, the most common metastatic sites are the lung parenchyma, the bones, the liver, and the brain. Adrenal metastasis from RCC is extremely rare. Adrenal metastasis from RCC shows poor prognosis, with little benefit from chemotherapy, radiation therapy, hormone therapy or immunotherapy. In this report, we describe a case of an RCC patient who showed lung and adrenal metastasis. The patient underwent left nephrectomy and chemotherapy(sunitinib), which were not effective. He refused further conventional medical treatment, and instead started treatment with Traditional Korean Medicine using allergen-removed Rhus verniciflua Stokes. After about 3 months of this treatment, the size of the adrenal tumor had decreased significantly with good performance status. Further study will be needed to demonstrate the tumor regression effect of allergen-removed Rhus verniciflua Stokes on patients with metastatic renal cell carcinoma.

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와송(瓦松) 약침(藥鍼)이 mouse의 간전이 암모델에 미치는 영향 (Effects of Orostachys Japhonicus Herbal-Acupuncture on Transferred Hepatic Cancer of Mouse Induced by Colon26-L5 Human Colon Cancer Cells)

  • 손승현;박희수
    • Journal of Acupuncture Research
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    • 제23권6호
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    • pp.61-76
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    • 2006
  • To study the effects of anti-cancer, anti-metastasis and immune response improvement effects of herbal-accupunture with Orostachys japhonicus A.Berger, infusion solution put into Kansu(BL18) of mouse induced by Colon26-L5 human colon cancer cells, which are corresponding to humanbody. We observed the change of body weight, surviving number, median surviving time, increase of life span, changes in amount of leukocyte, erythrocyte, platelet, total protein, creatinine, glucose and LDH, weight of spleen and kidney, histological analysis on tissue metastasis of liver, splenic cell proliferation, the expression of cytokine gene, the number of CD4+, CD8+, CD9+ and NK cell, and concluded like this. The results were obtained as follows ; 1. In acute and sub-acute cytotoxicity experiment, significantly signs were not appeared in all groups. 2. Antimetastatic experiment in vitro and in vivo showed that Orostachys Japhonicus A.Berger Herbal-acupuncture at Kansu(BL18) has antimetastatic effects. 3. The spleen cells proliferation of the experimental groups treated with Orostachys Japhonicus A.Berger infusion solution extract has increased significantly compared with that of the control group. 4. As compared with control, the population of total T cell, helper T cell, cytotoxic T cell and macrophage were increased. 5. The production of Th 1 type cytokines from splenocyte and cytokines which is associated with anti-tumor activity form macrophage were increased significantly. Above the results revealed that herbal-accupunture with Orostachys Japhonicus A.Berger infusion solution has effects of anti-cancer, anti-metastasis and immune response improvement.

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New Tumor Metastasis Suppressor Gene from Korean Tiger Shark (Scyliorhinus torazame)

  • CHO Jung Jong;LEE Jae Hyung;LEE Sang-Jun;LIM Woon Ki;KIM Yung-Jin;KIM Kyu-Won;KIM Young Tae
    • 한국수산과학회지
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    • 제30권6호
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    • pp.984-991
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    • 1997
  • New tumor suppressor gene, snm23, homologous to human nm23/NDP kinase (human nucleoside diphosphate kinase) gene whose product has a tumor metastasis inhibitory activity, was first cloned from Korean tiger shark (Scyliorhinus forazame) skin cDNA library constructed by using a $\lambda$ ZAP-II cDNA synthesis kit. About $1\times10^5$ plaques were screened and several positive plaques were isolated and confirmed by second screening. The phagemid containing a positive clone from the Uni-Zap XR vector was excised in vivo and the gene containing the tumor metastasis suppressor protein was named as snm23. Cloned gene, snm23, was sequenced with ABI-PRISM 310 Genetic Analyzer. The nucleotide and deduced amino acid sequences of snm23 have shown an open reading frame consisting of 450 base pairs that correspond to a protein of 150 amino acid residues, with a calculated molecular mass of 16.8 kDa. Sequence comparison of snm23 with human nm23/NDP kinase was performed by using Blast protein data base of National Center for Biotechnology Information. In order to determine tissue specificity, reverse transcription-polymerase chain reaction (RT-PCR) was used. Good expression level of snm23/NDP kinase was detected at the tissues from skin, cartilage, and liver of Korean tiger shark.

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혈관육종 환자에서 두피의 아전절제술 (Near Total Excision in Patients with Angiosarcoma on Scalp)

  • 최수영;백인수;박철규;홍인표
    • Archives of Plastic Surgery
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    • 제38권5호
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    • pp.711-714
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    • 2011
  • Purpose: Angiosarcoma is a rare malignant neoplasm of endothelial type cells that line vessel walls. It tends to occur in aged male and the prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. The treatment regimen is yet to be established from its rare occurrence but the wide excision in early stage is known to be the most effective. The authors report two cases of near totally excised angiosarcoma with more than a safety margin of 5 cm. Methods: The two subjects were aged male patients, one of the two was diagnosed with angiosarcoma from our institution confirmed by the biopsy. The other one went through the wide excision with a safety margin of 2 cm and split-thickness skin graft but local recurrence was observed. The two patients underwent near total excision with more than a safety margin of 5 cm, leaving only the periosteum. After confirming that the angiosarcoma had not infiltrated the excision margin, reconstruction with split-thickness skin graft was performed. Results: Based on 6 months and 24 months post-surgery assessment, no local recurrence or remote metastasis in the lungs, liver, bones, and lymph nodes at the neck, where remote metastasis is common, was reported by the two subjects who underwent near total excision with a safety margin of 5 cm. Conclusion: Angiosarcoma has very poor prognosis from its frequent recurrence and metastasis. To enhance the survival rate of angiosarcoma patients, early diagnosis, timely surgical treatment, and radiotherapy after surgery are critical. In addition, authors suggest that it is necessary to further study the efficacy of wide excision using a wider safety margin as much as possible, and to apply this to more cases.

진행성 위암의 추적 관찰 도중 다발성 수막내 전이가 발견된 환자 1례 (A Case of Advanced Gastric Cancer with Multiple Leptomeningeal Metastasis)

  • 신해진;정현용;문희석;성재규;강선형
    • Journal of Digestive Cancer Research
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    • 제4권2호
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    • pp.122-126
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    • 2016
  • Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 75-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IA (cT1N0M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as recurrence was suspected. After receiving chemotherapy in the order of DP (Cisplatin + Docetaxel), FOLFIRI (5-FU + Leucovorin + Irinotecan), an abdominal CT response assessment showed complete response. Since decreased mentality maintained throughout the follow up period based on outpatient clinic, brain MRI was performed and revealed multiple leptomeningeal metastasis. The Patient died 2 days after the diagnosis.

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