• Annals of Surgical Treatment and Research
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• 제95권6호
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• pp.303-311
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• 2018

Purpose: OncoHepa test is a multigene expression profile test developed for assessment of hepatocellular carcinoma (HCC) prognosis. Multiplication of ${\alpha}$-FP, des-${\gamma}$-carboxy prothrombin (DCP) and tumor volume (TV) gives the ${\alpha}$-FP-DCP-volume (ADV) score, which is also developed for assessment of HCC prognosis. Methods: The predictive powers of OncoHepa test and ADV score were validated in 35 patients who underwent curative hepatic resection for naïve solitary HCCs ${\leq}5cm$. Results: Median tumor diameter was 3.0 cm. Tumor recurrence and patient survival rates were 28.6% and 100% at 1 year, 48.6% and 82.9% at 3 years, and 54.3% and 71.4% at 5 years, respectively. The site of first tumor recurrence was the remnant liver in 18, lung in 1, and the peritoneum in 1. All patients with HCC recurrence received locoregional treatment. OncoHepa test showed marginal prognostic significance for tumor recurrence and patient survival. ADV score at 4log also showed marginal prognostic difference with respect to tumor recurrence and patient survival. Combination of these 2 tests resulted in greater prognostic significance for both tumor recurrence (P = 0.046) and patient survival (P = 0.048). Conclusion: Both OncoHepa test and ADV score have considerably strong prognostic power, thus individual and combined findings of OncoHepa test and ADV score will be helpful to guide postresection surveillance in patients with solitary HCCs ${\leq}5cm$.

• Tuberculosis and Respiratory Diseases
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• 제42권3호
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• pp.314-321
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• 1995

연구배경: 종양세포는 세포의 비정상적인 분열성장이 증가되므로, 세포내의 DNA가 양적인 변화를 일으킨다. DNA의 양적변화인 DNA ploidy 여부는 종양의 생물학적 특성을 반영하므로, 소세포 폐임에서 DNA ploidy의 변화와 생존기간을 비교하였다. 방법: 1990년 1월부터 1991년 12월까지 원광의대 부속병원에서 원발성 소세포 폐암으로 조직병리학적 진단을 받고나서, 2회 이상의 화학요법을 실시받은 후, 최소 2년이상의 후향적 추적에 의해 사망이 확인된 42례를 대상으로 하였다. DNA ploidy 분석방법은 paraffin에 보관된 병리조직을 이용하여 유식세포 분석법에 의한 DNA histogram으로 분석하였다. DNA ploidy 여부와 평균 생존기간을 비교하였으며, 다시 TNM 병기, PS scale, 화학요법 실시 횟수 등으로 세분하여 DNA ploidy 여부와 생존기간과의 관계를 재비교하였다. 결과: 1) 전 군의 평균 생존기간은 190(${\pm}156$)일이었으며, TNM 병기, PS scale이 진행할 수록 생존기간은 단축되었다. 2) 전 군에서 DNA aneuploidy의 발현 비율은 60%(26/42)였으며, 암의 진행정도와는 관계없었다. 3) 전 군에서의 평균 생존기간은 diploidy군이 272(${\pm}197$)일로서 aneuploidy 군의 138(${\pm}90$)일보다 유의하게 연장되었다(p<0.001). 4) DNA ploidy 여부에 의한 생존기간의 차이에 대한 TNM 병기, PS scale의 영향은 없었다. 결론: 소세포 폐암 환자에서 DNA aneuploidy 군은 diploidy 군보다 유의하게 생존기간이 짧았으며, DNA ploidy 여부는 TNM 병기, PS scale과는 무관한 예후추정 인자로서 임상적 이용아 가능하다고 생각된다.

• Radiation Oncology Journal
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• 제33권2호
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• pp.126-133
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• 2015

Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.193-199
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• 2009

목적: 고려대학교 구로병원에서 14년간 위암으로 수술받은 예를 대상으로 임상병리학적 특성, 치료 결과 및 예후 인자를 분석하여 보고자 하였다. 대상 및 방법: 1993년부터 2006년까지 본 교실에서 수술받은 2,327명의 위암 환자를 대상으로 후향적 연구를 하였다 결과: 절제율은 92.8%였고 근치적 절제율은 90.8%였다. 5년 생존율은 절제 예 70.0%, 근치적 절제 예 79.2%, 비근치적 절제 예 3.7% 그리고 비절제 1.5%였으며, 절제 예에서 병기별 5년 생존율은 IA기 98.9%, IB기 94.4%, II기 77.3%, IIIA기 69.3%, IIIB기 38.9% 그리고 IV기 13.6%였다. 예후 인자의 단변량 분석결과 나이, 종양의 크기 및 위치, 육안적 형태, 위벽 침윤, 림프절 전이, 원격 전이가 통계적으로 유의하였고 다변량 분석 결과 독립적 예후 인자는 림프절 전이, 위벽의 침윤도, 정맥 침윤, 연령의 순으로 나타났다. 결론: 위암에서의 예후는 병기에 의해서 가장 많이 영향을 받으므로 예후 향상을 위해서는 조기발견이 가장 중요하고, 적극적이며 체계적인 외과적 치료가 위암의 생존율향상에 기여할 것으로 생각한다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1839-1843
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• 2015

Background: MicroRNAs are a class of noncoding RNAs which regulate multiple cellular processes during tumor development. The purpose of this report is to investigate the clinicopathological and prognostic significance of miR-218 in human gliomas. Materials and Methods: Quantitative RT-PCR (qRT-PCR) was conducted to detect the expression of miR-218 in primary normal human astrocytes, three glioma cell lines and 98 paired glioma and adjacent normal brain tissues.Associations of miR-218 with clinicopathological variables of glioma patients were statistically analyzed. Finally, a survival analysis was performed using the Kaplan-Meier method and Cox's proportional hazards model. Results: The expression level of miR-218 in primary normal human astrocytes was significantly higher than that in glioma cell lines (p<0.01). Also, the expression level of miR-218 in glioma tissues was significantly downregulated in comparison with that in the adjacent normal brain tissues (p<0.001). Statistical analyses demonstrated that low miR-218 expression was closely associated with advanced WHO grade (p=0.002) and low Karnofsky performance score (p=0.010) of glioma patients. Kaplan-Meier analysis with the log-rank test showed that patients with low-miR-218 expression had poorer disease-free survival and overall survival (p=0.0045 and 0.0124, respectively). Multivariate analysis revealed that miR-218 expression was independently associated with the disease-free survival (p=0.009) and overall survival (p=0.004) of glioma patients. Conclusions: Our results indicate that miR-218 is downregulated in gliomas and that its status might be a potential valuable biomarker for glioma patients.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.132-139
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• 2012

Background: Periostin is preferentially expressed in periosteum, indicating a potential role in bone formation. Recently, there have been emerging controversies about its role in invasion and metastasis of human malignancies. We attempted to determine the clinicopathological significance of periostin expression in non-small cell lung carcinoma (NSCLC). Methods: Immunohistochemical staining of periostin protein from 91 cases of NSCLCs was performed using tissue microarray blocks. The results were correlated with clinicopathological parameters. Results: Positive reaction to periostin was predominantly noted in the tumor stroma. The strongest reaction presented as a band-like pattern just around the tumor nests. Non-neoplastic lung tissue and most in-situ carcinomas did not show a positive reaction in their stroma. With respect to tumor differentiation, moderate to poor differentiated tumors (47/77) revealed even higher periostin expression than the well-differentiated ones (4/14) (p=0.024). High periostin expression was positively correlated with E-cadherin and p53 expression, but was not related with patient age, sex, tumor type, PCNA index, b-catenin, cyclin D1, pTNM-T, pTNM-N, stage, and patient survival (p>0.05). Conclusion: These results suggest that periostin might play a role during the biological progression of NSCLC, but may not be related to the clinical prognostic parameters.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10171-10174
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• 2015

Background: The purpose of this study was to determine the prognostic significance of the maximum standardized uptake value (SUVmax) on F-18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in patients undergoing surgical treatment for non-small cell lung cancer. Materials and Methods: Seventy-eight consecutive patients (58 with adenocarcinomas, 20 with squamous cell carcinomas) treated with potentially curative surgery were retrospectively reviewed. Results: The SUVmax was significantly higher in the patients with recurrent than with non-recurrent adenocarcinoma (p<0.01). However, among the patients with squamous cell carcinoma, there were no differences with or without recurrence (p=0.69). Multivariate analysis indicated that the SUVmax of adenocarcinoma lesions was a significant predictor of disease-free survival (p=0.04). In addition, an SUVmax of 6.19, the cut-off point based on ROC curve analysis of the patients with pathological IB or more advanced stage adenocarcinomas, was found to be a significant predictor of disease-free survival (p<0.01). Conclusions: SUVmax is a useful predictor of disease-free survival in patients with resected adenocarcinoma, but not squamous cell carcinoma. Patients with adenocarcinoma exhibiting an SUVmax above 6.19 are candidates for more intensive adjuvant therapy.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.661-666
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• 2017

Objective : Atypical meningioma is rare tumor and there is no accurate guide line for optimal treatment. This retrospective study analyzed the prognostic factors, the effect of different methods of treatments and the behavior of atypical meningioma. Methods : Thirty six patients were diagnosed as atypical meningioma, among 273 patients who were given a diagnosis of meningioma in the period of 2002 to 2015. Age, gender, tumor location, Ki 67, Simpson grade and treatment received were analyzed. We studied the correlation between these factors with recurrence, overall survival rate and progression free survival. Results : Median overall survival time and progression free survival time are 60 and 53 (months). Better survival rate was observed for patients less than 50 years old but with no statistical significance (p=0.322). And patients with total resection compared with subtotal resection also showed better survival rate but no statistical significance (p=0.744). Patients with a tumor located in skull base compared with patients with a tumor located in brain convexity and parasagittal showed better progression free survival (p=0.048). Total resection is associated with longer progression-free survival than incomplete resection (p=0.018). Conclusion : We confirmed that Simpson grade was significant factor for statistically affect to progression free survival in univariate analysis. In case of skull base atypical tumor, it is analyzed that it has more recurrence than tumor located elsewhere. Overall survival was not affected statistically by patient age, gender, tumor location, Ki 67, Simpson grade and treatment received in this study.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8155-8161
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• 2016

The prognostic significance of AgNOR proteins in stage II-III rectal cancers treated with chemoradiotherapy was evaluated. Silver staining was applied to the $3{\mu}m$ sections of parafin blocked tissues from 30 rectal cancer patients who received 5-FU based chemoradiotherapy from May 2003 to June 2006. The microscopic displays of the cells were transferred into the computer via a video camera. AgNOR area (nucleolus organizer region area) and nucleus area values were determined as a nucleolus organizer regions area/total nucleus area (NORa/TNa). The mean NORa/TNa value was found to be $9.02{\pm}3.68$. The overall survival and disease free survival in the high NORa/TNa (>9.02) patients were 52.2 months and 39.4 months respectively, as compared to 100.7 months and 98.4 months in the low NORa/TNa (<9.02) cases. (p<0.001 and p<0.001 respectively). In addition, the prognosis in the high NORa/TNa patients was worse than low NORa/TNa patients (p<0.05). In terms of overall survival and disease-free survival, a statistically significant negative correlation was found with the value of NORa/TNa in the correlations tests. Cox regression analyses demostrated that overall survival and disease-free survival were associated with lymph node status (negative or positive) and the NORa/TNa value. We suggest that two-dimensional AgNOR evaluation may be a safe and usable parameter for prognosis and an indicator of cell proliferation instead of AgNOR dots.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.325-327
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• 2013

Objective: To differentiate between benign and malignant hyperparathyroidism on the basis of excretion of HCG and its malignant isoforms in urine. Materials and Methods: This hospital based study was carried out using data retrieved from the register maintained in Manipal Teaching Hospital from $1^{st}$ January, 2008 and $31^{st}$ August, 2012. The variables collected were urinary HCG and HCG malignant isoform, calcium and parathyroid hormone. Preceding the study, approval was obtained from the institutional research ethical committee. Analysis was by descriptive statistics and testing of hypothesis. A p-value of <0.05 (two-tailed) was used to establish statistical significance. Results: Out of the 20 cases, 10 were primary hyperparathyroidism and the remainder were parathyroid carcinomas. The urinary HCG $6.1{\pm}0.6$ fmol/mgCr was with in normal range in benign hyperthyroidism but was markedly elevated in three cases of malignant hyperparathyroidism (maximum value of excretion in urine for HCG was 2323 fmol/mgCr). The excretion of malignant isoform of HCG in urine was 0 in benign hyperparathyroidsm and in four cases of malignant hyperparathyroidism which fell into the category of persistantly low HCG. The maximum excretion of the malignant isoform of HCG in urine was 1.8, in the category of very high HCG. Calcium and parathyroid hormone were mildly raised in benign parathyroidism, while parathyroid hormone was markedly elevated in cases of malignant hyperparathyroidism falling into the category of very high HCG. Conclusions: The excretion of urinary HCG in urine has the ability to distinguish between parathyroid adenomas and carcinomas and thus has potential to become a marker of disease progression in malignant parathyroid disease.