• Journal of Chest Surgery
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• 제27권11호
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• pp.922-929
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• 1994

This research represents an attempt to study the postoperative results among 32 patients who underwent complete resections of primary lung and involved mediastinal lymph nodes between January 1988 and June 1993. Ages ranged from 34 to 73 years with a mean age of 51.31 $\pm$ 8.17 years. There were 29 male patients[90.6%]. Left lung cancers were more frequent than right lung cancers. There were 19 cases of left lung cancers accounting for 59.4% of the total lung cancers. The difference, however, was insignificant. There was no T1 lesion. T2 and T3 lesions were 21[65.6%] and 11 cases[34.4%], respectively. As for cell type, squamous cell carcinomas were reported in 25 cases making up 78.1% of the cell types. Pneumonectomy was conducted on 20[62.5%] cases. Lobectomy and sleeve lobectomy were conducted on 12[37.5%] cases respectively. Mediastinal lymph node involvemednts were most frequent in subcarinal lymph node[9/13] among right lung cancers, while subaortic lymph noce[12/19] was most frequent among left lung cancers. Postoperative complications were reported in 18.9% of the total cases, including 2 cases each of paralysis of the recurrent laryngeal nerve and 1 case each of chylothorax and pyothorax. They were more frequent among patients who underwent pneumonectomy. The operative mortality stood at 3.1% with 1 patient who underwent pneumonectomy dying of pulmonary edema. The 1-year and 5-year survival rates were 50.8% and 30.1%, respectively. Patients treated with squamous cell carcinoma, involvement of single level mediastinal lymph node and lobectomy showed a higher level of survival. These fidings suggest that a long-term survival can be expected of a considerable number of N2 non-small cell lung cancer patients with a selective complete surgical resection of primary lung cancers involved mediastinal lymph nodes.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1577-1581
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• 2016

Tobacco use is a well-established risk factor for many types of cancers. Recent data on selected cancer incidence and mortality related to smoking in the Indonesian population are provided in this study. Morbidity and mortality data were derived from GLOBOCAN 2012 and the population attributable fraction (PAF) was estimated using the standard methodology developed by the World Health Organization. Using these data, we calculated disability adjusted life year (DALY) values for smoking-related cancer. The DALY was estimated by summation of the years lived with disability (YLD) and years life lost due to premature death (YLL). The cancer cases related to smoking in Indonesia numbered 45,132, accounting for 35,580 cancer deaths. The morbidity and mortality of lung cancer can be considered as the highest priority in both men and women. Furthermore the greatest YLD due to smoking in Indonesian men and women were from pancreas and lung cancers. For YLL among men, the highest years lost were from lung and liver cancers. On the other hand, among women lung oral cavity and lip were most important. Based on the DALY indicator, burden priorities for Indonesian men were lung cancer (298,980), liver cancer (60,367), and nasopharynx (46,185), while among Indonesian women they were lung cancer (34,119), cervix uteri (9,213) and pancreas cancer (5,433). In total, Indonesian burden of cancers attributed to smoking was 638,682 DALY. This study provides evidence about the burden of cancers caused by smoking as a rational basis for initiating national tobacco control policies in Indonesia.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2167-2172
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• 2013

Lung cancer remains a major cause of morbidity and mortality worldwide, accounting for more deaths than any other cause. All the clinical practice guidelines recommended against routine screening for lung cancer have cited lack of robust evidence, at least until a few years back. However, the potential to screen lung cancers has received renewed interest due to superior performance of low dose CT (LD-CT) in detecting early stage cancers. The incremental costs and risks involved due to the invasive procedures in the screened population due to a high false positivity rate questions the use of LD-CT scan as a reliable community based screening tool. There is therefore an urgent need to find a less invasive and a more reliable biomarker that is crucial to increase the probability of early lung cancer detection. This can truly make a difference in lung cancer survival and at the same time be more cost and resource utilization effective. Sampling blood serum being minimally invasive, low risk and providing an easy to obtain biofluid, needs to be explored for potential biomarkers. This review discusses the use of circulatory miRNAs that have been able to discriminate lung cancer patients from disease free controls. Several studies conducted recently suggest that circulating miRNAs may have promising future applications for screening and early detection of lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.657-662
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• 2014

Background: The epidermal growth factor receptor (EGFR) mutation status of lung cancer is important because it means that EGFR-tyrosine kinase inhibitor treatment is indicated. The purpose of this prospective study is to determine whether EGFR mutation status could be identified with reference to preoperative factors. Materials and Methods: One hundred-forty eight patients with lung cancer (111 adenocarcinomas, 25 squamous cell carcinomas and 12 other cell types) were enrolled in this study. The EGFR mutation status of each lung cancer was analyzed postoperatively. Results: There were 58 patients with mutant EGFR lung cancers (mutant LC) and 90 patients with wild-type EGFR lung cancers (wild-type LC). There were significant differences in gender, smoking status, maximum tumor diameter in chest CT, type of tumor shadow, clinical stage between mutant LC and wild-type LC. EGFR mutations were detected only in adenocarcinomas. Maximum standardized uptake value (SUVmax:$3.66{\pm}4.53$) in positron emission tomography-computed tomography of mutant LC was significantly lower than that ($8.26{\pm}6.11$) of wild-type LC (p<0.0001). Concerning type of tumor shadow, the percentage of mutant LC was 85.7% (6/7) in lung cancers with pure ground glass opacity (GGO), 65.3%(32/49) in lung cancers with mixed GGO and 21.7%(20/92) in lung cancers with solid shadow (p<0.0001). For the results of discriminant analysis, type of tumor shadow (p=0.00036) was most significantly associated with mutant EGFR. Tumor histology (p=0.0028), smoking status (p=0.0051) and maximum diameter of tumor shadow in chest CT (p=0.047) were also significantly associated with mutant EGFR. The accuracy for evaluating EGFR mutation status by discriminant analysis was 77.0% (114/148). Conclusions: Mutant EGFR is significantly associated with lung cancer with pure or mixed GGO, adenocarcinoma, never-smoker, smaller tumor diameter in chest CT. Preoperatively, EGFR mutation status can be identified correctly in about 77 % of lung cancers.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7029-7035
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• 2014

Certain types of human papillomaviruses (HPVs) are undoubtedly involved in genesis of human malignancies. HPV plays an etiological role in cervical cancer, but also in many vaginal, vulvar, anal and penile cancers, as well as head and neck cancers. In addition, a number of non-malignant diseases such as genital warts and recurrent respiratory papillomatosis are attributable to HPV. Moreover, HPV forms have detected in several other cancers including esophageal squamous cell carcinoma, lung, prostate, ovarian, breast, skin, colorectal and urinary tract cancers, but associations with etiology in these cases is controversial. The aim of this systematic assessment was to estimate the prevalence of HPV infection and HPV types in HPV-associated cancers, HPV-related non-malignant diseases and in cancers that may be associated with HPV in Iran. The present investiagtion covered 61 studies on a variety of cancers in Iranian populations. HPV prevalence was 77.5 % and 32.4% in cervical cancer and head and neck cancers, respectively. HPV was detected in 23.1%, 22.2%, 10.4%, 30.9%, 14% and 25.2% of esophageal squamous cell, lung, prostate, urinary tract cancers, breast and skin cancers, respectively. HPV16 and 18 were the most frequent HPV types in all cancers. The findings of present study imply that current HPV vaccines for cervical cancer may decrease the burden of other cancers if they are really related to HPV.

• 대한기관식도과학회지
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• 제17권1호
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• pp.9-13
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• 2011

Endobronchial ultrasound (EBUS), which enables visualization of lesions beyond the bronchus, broadens the fields of bronchoscopy. Two types of ultrasound, radial and linear, are used for bronchoscopy. Radial EBUS is performed by inserting an ultrasound mini-probe through the working channel of a flexible bronchoscope. Evaluation of the depth of invasion of early endobronchial lung cancers using radial EBUS is useful in deciding endobronchial treatment. A central tumor limited to within the cartilaginous layer is a good indication for endobronchial photodynamic therapy. EBUS-guide sheath (GS) technique is a sampling method assisted by localization of peripheral lesions using EBUS. The diagnostic yield of EBUS-GS method is higher than that of conventional transbronchial biopsy. High diagnostic values of EBSU-GS method are reported even in small (${\leq}2cm$) peripheral tumors. Linear EBUS is used for endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). EBUS-TBNA has high diagnostic yields in mediastinal staging of lung cancer even in patients having radiologically early stage lung cancers with normal CT or PET findings in the mediastinum. EBUS is a valuable method in evaluating early endobronchial tumors and peripheral small lung cancers and as well as in mediastinal staging.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4661-4664
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• 2016

Background: Artificial light at night (ALAN) has been linked to increased risk of cancers in body sites like the breast and colorectum. However exposure of ALAN as an environmental risk factor and its relation to cancers in humans has never been studied in detail. Objective: To explore the association of ALAN with all forms of cancers in 158 countries. Materials and Methods: An ecological study encompassing global data was conducted from January to June 2015, with age-standardized rates (ASR) of cancers as the outcome measure. ALAN, in the protected areas, as the exposure variable, was measured with reference to the Protected Area Light Pollution Indicator (PALI) and the Protected Area Human Influence Indicator (PAHI). Pearson's correlations were calculated for PALI and PAHI with ASR of cancers for 158 countries, adjusted for country populations, electricity consumption, air pollution, and total area covered by forest. Stratified analysis was conducted according to the country income levels. Linear regression was applied to measure the variation in cancers explained by PALI and PAHI. Results: PALI and PAHI were positively associated with ASR of all forms of cancer, and also the four most common cancers (p < 0.05). These positive correlations remained statistically significant for PAHI with all forms of cancer, lung, breast, and colorectal cancer after adjusting for confounders. Positive associations of PALI and PAHI with cancers varied with income level of the individual countries. Variation in all forms of cancers, and the four most common cancers explained by PALI and PAHI, ranged from 3.3 - 35.5%. Conclusion: Artificial light at night is significantly correlated for all forms of cancer as well as lung, breast, colorectal, and prostate cancers individually. Immediate measures should be taken to limit artificial light at night in the main cities around the world and also inside houses.

• Tuberculosis and Respiratory Diseases
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• 제45권3호
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• pp.565-573
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• 1998

연구배경: 악성 흉막 삼출증은 폐암에 합병되는 경우가 가장 흔하지만 그 외에 유방암, 난소암, 위암등에서도 호발하며 조직학적 아형에 따라 나누면 선암이 가장 흔하며 편평상피세포암이 악성 흉막 삼출을 일으키는 경우는 매우 드물다고 보고되어왔다. 연자들은 악성 흉막 삼출증의 조직학적 아형에 따른 빈도와 흉수의 특징을 분석하였다. 방 법: 1992년 1월부터 1997년 5월까지 서울대학교 병원에서 흉수의 세포진 검사나 경피적 혹은 흉강경을 이용한 흉막 조직 검사 결과 악성 흉막삼출증로 확인된 84예의 환자를 대상으로 하여 조직 표본과 의무기록을 통해 조직학적 아형을 구분하고 임상적 양상과 생화학적 지표 등을 조사하고 생존기간을 분석하였다. 결 과: 총 84명의 대상 환자 중 남자 52명, 여자 32명으로 남녀 성비는 1.6:1이었고 연령의 중앙값은 56세였다. 환자의 주 증상은 호흡곤란이 42명으로 가장 흔했고 기침과 객담, 흉막성 흉통 등의 순서였으며 평균 생존 기간은 6.4개월이었다. 그 중 혈성 흉수의 빈도는 66%. 림프구 우위성은 39%, 삼출성 흉수는 93%였고 조직학적 아형은 선암 54예(33예가 폐암), 편평상피세포암 10예 (8예가 폐암), 악성림프종 10예, 소세포암 8예 그리고 악성 중피종과 백혈병이 각각 1예였고 각각의 혈성 흉수, 림프구 우위성, 삼출성 흉수의 빈도는 별다른 차이가 없었으며 생화학적 수치의 차이도 관찰되지 않았다. 악성 흉막 삼출을 일으킨 원인 질환은 폐암이 49예로 가장 많았고 그외 원발 부위 불명확 악성 종양 7예, 위암, 유방암이 각각 5예, 담관암이 3예 그리고 난소암, 급성 백혈병, 악성 중피종이 각각 1예 씩 이었고 각각의 혈성 흉수, 림프구 우위성, 삼출성 흉수의 빈도, 생화학적 지표의 차이도 역시 관찰되지 않았다. 결 론: 같은 시기의 서울대학교병원의 폐암의 조직학적 아형의 빈도가 편평상피세포암 47%, 선암 33%, 소세포암 12%, 대세포암 2%인 것과 비교해보면 선암에서 악성 흉악 삼출증이 호발하며 편평 상피 세포암에서는 상대적으로 드물다는 것을 확인할 수 있었고 악성 흉막 삼출증 환자를 조직학적 아형이나 원발 악성 질환에 따라 분류하였을 때 혈성 흉수, 림프구 우위성, 삼출성 흉수의 빈도의 차이는 없었다.

• Radiation Oncology Journal
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• 제1권1호
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• pp.55-60
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• 1983

To evaluate the usefulness of computed tomography (CT) in radiotherapy treatment planning in malignant tumors of thoracic cage, the computer generated dose distributions were compared between plans based on conventional studies and those based on CT scan. 22 cases of thoracic malignancies, 15 lung cancers and 7 esophageal cancers, diagnosed and treated in Department of Therapeutic Radiology of Seoul National University Hospital from September, 1982 to April, 1983, were analyzed. In lung cancers, dose distribution in plans using AP, PA parallel opposing ports with posterior spinal cord block and in plans using box technique both based on conventional studies were compared with dose distribution using AP, PA and two oblique ports based on CT scan. In esophageal cancers, dose distribution in plans based on conventional studies and those based on CT scans, both using 3 port technique were compared. The results are as follows: 1. Parallel opposing field technique were inadequate in all cases of lung cancers, as portion of primary tumor in 13 of 15 cases and portion of mediastinum in all were out of high dose volume. 2. Box technique was inadequate in 5 of 15 lung cancers as portion of primary tumor was not covered and in every case the irradiated normal lung volume was quite large. 3. Plans based on CT scan were superior to those based on conventional studies as tumor was demarcated better with CT and so complete coverage of tumor and preservation of more normal lung volume could be made. 4. In 1 case of lung cancer, tumor localization was nearly impossible with conventional studies, but after CT scan tumor was more clearly defined and localized. 5. In 1 of 7 esophageal cancers, the radiation volume should be increased for marginal coverage after CT scan. 6. Depth dose correction for tissue inhomogeneity is possible with CT, and exact tumor dose can be calculated. As a result radiotherapy treatment planning based on CT scan has a pteat advantage over that based on conventional studies.

• BMB Reports
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• 제41권9호
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• pp.615-625
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• 2008

Over a last decade, intense interest has been focused on biomarker discovery and their clinical uses. This interest is accelerated by the completion of human genome project and the progress of techniques in proteomics. Especially, cancer biomarker discovery is eminent in this field due to its anticipated critical role in early diagnosis, therapy guidance, and prognosis monitoring of cancers. Among cancers, lung cancer, one of the top three major cancers, is the one showing the highest mortality because of failure in early diagnosis. Numerous potential DNA biomarkers such as hypermethylations of the promoters and mutations in K-ras, p53, and protein biomarkers; carcinoembryonic antigen (CEA), CYFRA21-1, plasma kallikrein B1 (KLKB1), Neuron-specific enolase, etc. have been discovered as lung cancer biomarkers. Despite extensive studies thus far, few are turned out to be useful in clinic. Even those used in clinic do not show enough sensitivity, specificity and reproducibility for general use. This review describes what the cancer biomarkers are for, various types of lung cancer biomarkers discovered at present and predicted future advance in lung cancer biomarker discovery with proteomics technology.