• 보험의학회지
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• 제31권1호
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• pp.34-36
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• 2012

Lung cancer such as small cell lung cancer(SCLC) and non small cell lung cancer(NSCLC) have high mortality rate, so, we insurance doctors have little interest in their risk. But nowadays there's a lot of development in targeted therapy of NSCLC. Screening by CT scanning and early resection strategy also shows better prognosis. It is helpful for underwriters and insurance doctors to review the current development of targeted therapy of NSCLC and estimation of extra-risk of early lung cancer. The preferred treatment option for patients whose tumors contain EGFR-activating mutations are one of the EGFR-directed tyrosine kinase inhibitors, such as gefitinib or erlotinib. In patients with NSCLC whose tumors harboured an ALK rearrangement, there was 61% objective response rate to crizotinib in the phase 1 study. The median survival progression-free survival was 10 months. Mortality analysis of early lung cancer who were detected by CT screening, MR of 105% and EDR of 1‰ were calculated.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9367-9373
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• 2014

In diagnosis of lung cancer, rapid distinction between small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) tumors is very important. Serum markers, including lactate dehydrogenase (LDH), C-reactive protein (CRP), carcino-embryonic antigen (CEA), neurone specific enolase (NSE) and Cyfra21-1, are reported to reflect lung cancer characteristics. In this study classification of lung tumors was made based on biomarkers (measured in 120 NSCLC and 60 SCLC patients) by setting up optimal biomarker joint models with a powerful computerized tool - gene expression programming (GEP). GEP is a learning algorithm that combines the advantages of genetic programming (GP) and genetic algorithms (GA). It specifically focuses on relationships between variables in sets of data and then builds models to explain these relationships, and has been successfully used in formula finding and function mining. As a basis for defining a GEP environment for SCLC and NSCLC prediction, three explicit predictive models were constructed. CEA and NSE are requentlyused lung cancer markers in clinical trials, CRP, LDH and Cyfra21-1 have significant meaning in lung cancer, basis on CEA and NSE we set up three GEP models-GEP 1(CEA, NSE, Cyfra21-1), GEP2 (CEA, NSE, LDH), GEP3 (CEA, NSE, CRP). The best classification result of GEP gained when CEA, NSE and Cyfra21-1 were combined: 128 of 135 subjects in the training set and 40 of 45 subjects in the test set were classified correctly, the accuracy rate is 94.8% in training set; on collection of samples for testing, the accuracy rate is 88.9%. With GEP2, the accuracy was significantly decreased by 1.5% and 6.6% in training set and test set, in GEP3 was 0.82% and 4.45% respectively. Serum Cyfra21-1 is a useful and sensitive serum biomarker in discriminating between NSCLC and SCLC. GEP modeling is a promising and excellent tool in diagnosis of lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6415-6419
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• 2014

Purpose: To explore the relationship between SER (time between the start of any treatment and the end of radiation therapy) and the survival of patients with limited-stage small cell lung cancer. Materials and Methods: Between 2008 and 2013, 135 cases of limited-stage small cell lung cancer (LS-SCLC) treated with consecutively curative chemoradiotherapy were included in this retrospective analysis. In terms of SER, patients were divided into early radiotherapy group (SER<30 days, n=76) and late radiotherapy group ($SER{\geq}30$ days, n=59) with a cut-off of SER 30 days. Outcomes of the two groups were compared for overall survival. Results: For all analyzable patients, median follow-up time was 23.8 months and median overall survival time was 16.8 months. Although there was no significant differences in distant metastasis free survival between the two groups, patients in early radiotherapy group had a significantly better PFS (p=0.003) and OS (p=0.000). Conclusions: A short SER may be a good prognostic factor for LD-SCLC patients treated with concurrent chemoradiotherapy.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.436-439
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• 2015

Small cell lung cancer (SCLC), which originated from neuroendocrine tissue, can develop into paraneoplastic endocrine syndromes, such as Cushing syndrome, because of an inappropriate secretion of ectopic adrenocorticotropic hormone (ACTH). This paraneoplastic syndrome is known to be a poor prognostic factor in SCLC. The reason for poor survival may be because of a higher risk of infection associated with hypercortisolemia. Therefore, early detection and appropriate treatment for this syndrome is necessary. But the diagnosis is challenging and the source of ACTH production can be difficult to identify. We report a 69-year-old male patient who had severe hypokalemia, metabolic alkalosis, and hypertension as manifestations of an ACTH-secreting small cell carcinoma of the lung. He was treated with ketoconazole and spironolactone to control the ACTH dependent Cushing syndrome. He survived for 15 months after chemotherapy, which is unusual considering the poor outcome of the ectopic ATH syndrome associated with SCLC.

• Radiation Oncology Journal
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• 제37권3호
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• pp.185-192
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• 2019

Purpose: The effectiveness of thoracic radiation therapy (TRT) in extensive-stage small cell lung cancer (ES-SCLC) patients is increasingly reported, but there is no definite consensus on its application. The aim of this study was to identify factors associated with better outcomes of TRT among patients with ES-SCLC, focusing on whether a higher TRT dose could improve treatment outcome. Materials and Methods: The medical records of 85 patients with ES-SCLC who received TRT between January 2008 and June 2017 were retrospectively reviewed. Eligibility criteria were a biological effective dose with α/β = 10 (BED) higher than 30 Gy₁₀ and completion of planned radiotherapy. Results: During a median follow-up of 5.3 months, 68 patients (80.0%) experienced disease progression. In univariate analysis, a BED >50 Gy₁₀ was a significant prognostic factor for overall survival (OS; 40.8% vs. 12.5%, p = 0.006), progression-free survival (PFS; 15.9% vs. 9.6%, p = 0.004), and intrathoracic PFS (IT-PFS; 39.3% vs. 20.5%, p = 0.004) at 1 year. In multivariate analysis, a BED >50 Gy₁₀ remained a significant prognostic factor for OS (hazard ratio [HR] = 0.502; 95% confidence interval [CI], 0.287-0.876; p = 0.015), PFS (HR = 0.453; 95% CI, 0.265-0.773; p = 0.004), and IT-PFS (HR = 0.331; 95% CI, 0.171-0.641; p = 0.001). Response to the last chemotherapy was also associated with better OS in both univariate and multivariate analysis. Conclusion: A TRT dose of BED >50 Gy₁₀ may be beneficial for patients with ES-SCLC. Further studies are needed to select patients who will most benefit from high-dose TRT.

• 생명과학회지
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• 제33권9호
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• pp.713-723
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• 2023

폐암은 전 세계적으로 사망률이 높은 암으로서 소세포성 폐암(small cell lung cancer, SCLC)과 비소세포성 폐암(non-small cell lung cancer, NSCLC)으로 분류된다. 오늘날까지 폐암 치료를 위해 많은 화학요법이 사용되어 왔으나 장기간 화학요법에 의한 부작용 및 항암제 내성 유발로 인해 항암 치료에 한계가 있으므로, 이와 같은 문제점을 해결하기 위해 현재는 천연물로부터 유래한 항암물질을 탐색하는 추세이다. Curcumin은 강황의 뿌리에서 추출된 polyphenol 화합물로서 항균, 항암, 항산화 및 항염증 작용이 보고되어 현재까지 꾸준히 항암 연구가 진행되어 왔으나 인간 폐암 세포주의 종류에 따른 항암 효과는 거의 연구되지 않았다. 따라서 본 연구에서는 여러 종류의 인간 폐암 세포주에 대한 curcumin의 항암 효과를 조사하고자 하였다. 그 결과, 10, 30, 50 μM 농도의 curcumin은 폐암 세포주에 따라 경미한 차이가 나타내면서 농도 의존적으로 세포 생존을 저해하였다. 또한 A549 (NSCLC) 및 DMS53 (SCLC) 세포주를 대상으로 apoptosis, autophagy, reactive oxygen species (ROS)를 flow cytometry로 측정한 결과, 농도 의존적으로 이러한 현상들이 증가되었으며 각각의 저해제를 처리했을 때 이러한 현상들이 회복되는 것이 관찰되었다. Apoptosis와 관련된 단백질인 Bax, PARP, pro-caspase-3 및 Bcl-2의 발현이 curcumin 농도 의존적으로 조절되었으며, 특히 DMS53에서 Bax/Bcl-2 비율이 더 높았다. 또한, autophagy 단백질인 p-AKT, p62 및 LC3B도 curcumin 농도 의존적으로 조절되었다. 한편, ROS 저해제인 diphenyleneiodonium 처리 시, curcumin에 의해 유도된 apoptosis와 autophagy 수준이 저해되었으며 관련 단백질의 발현도 조절되었다. 이를 통해 curcumin의 항암 작용은 curcumin에 의해 생산된 ROS를 매개로 하여 폐암 세포주의 apoptosis 및 autophagy의 유도를 통해 나타나는 것으로 확인되었다.

• Tuberculosis and Respiratory Diseases
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• 제42권6호
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• pp.934-940
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• 1995

기침, 호흡곤란 및 성한 전신 쇄약감을 주소로 내원하여 기관지 내시경 및 경부 림프절 생검을 통한 조직검사로 소세포 폐암을 확진하고, 병력상 심한 전신무력감 및 체중감소를 호소해며, 검사상 성한 저칼륨혈증 및 대사성 알칼리증의 소견이 있으며, 최근 발생된 고혈당, 고혈압 등의 증상이 있어 시행한 내분비학적 생화학 검사상 혈중 cortisol이 상승하고, cortisol의 일간 변동(diurnal variation)이 소실되었으며, 24시간 뇨 free cortisol의 현저한 상승으로 Cushing 증후군이 paraneoplastic syndrome으로 소세포 폐암에서 동반되었음을 확인한 1예를 경험하였기에 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.82-88
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• 2014

Background: Lung cancer is the most common cause of cancer-related death worldwide and in Korea, and small cell lung cancer (SCLC) is the most deadly tumor type in the different lung cancer histology. Chemotherapy is the main strategy of the treatment for SCLC, and etoposide and platinum regimen has been the only standard chemotherapy for about 30 years. To test feasibility of weekly divided dose irinotecan and carboplatin for Korean patients is the aim of this study. Methods: Patients with histologically or cytologically confirmed extensive stage SCLC were included. Patients with limited stage (LD), who could not tolerate concurrent chemoradiotherapy were also included. All the patients received irinotecan $60mg/m^2$, carboplatin 2 area under the curve at day 1, 8, and 15 every 4 weeks. Study regimen was discontinued when the disease progressed or intolerable side effects occurred. No more than 6 cycles of chemotherapy were given. Results: Total 47 patients were enrolled, among them 9 patients were LD. Overall response rate was 74.5% (complete response, 14.9%; partial response, 59.6%). Side effects greater than grade 3 were neutropenia (25.5%), fatigue (12.8%), thrombocytopenia (8.5%), sepsis (4.3%), and pancytopenia (2.1%). There was no treatment related death. Conclusion: Weekly divided irinotecan and carboplatin regimen is effective, and safe as a first line therapy for both stage of SCLC. Large scaled, controlled study is feasible.

• Tuberculosis and Respiratory Diseases
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• 제39권6호
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• pp.502-510
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• 1992

연구배경 : Neuron specific enolase (NSE)는 뇌조직의 신경원에서 처음 발견된 당분해 효소이며, APUD 세포 및 신경내분비계에도 존재하는 것으로 알려졌다. 소폐포폐암은 신경내분비세포 및 APUD 세포와 많은 공통점을 가지고 있다. 따라서 NSE 항체를 사용하는 면역조직화학 염색과 혈청내 NSE 농도측정은 신경내분비 분화를 하는 폐종양의 표지자로서 사용될 수 있으며 소세포폐암의 진단에 유용할 수 있다. 방법 : 소세포폐암으로 진단받은 22명과 대조군으로는 비소세포폐암환자 21명을 대상으로 하였으며 생검조직에서 NSE 항체를 이용한 면역조직화학염색을 시행하고 환자의 혈청에서 방사면역측정법으로 NSE 농도를 측정하였다. 결과: 1) NSE 항체를 이용한 면역조직화학염색 NSE 항체를 이용한 면역조직화학영색에서 소세포폐암군 환자는 18명중 9명에서 양성 반응을 보였으며, 비소세포폐암 환자중 면역조직화학염색을 시행한 16명중 5명에서 양성 반응을 보였다. 2) 방사면역 측정법에 의한 혈청 NSE농도 측정 비소세포폐암군의 혈청 NSE평균치는 $11.79{\pm}4.47\;ng/ml$이었으며 소세포폐암군의 혈청 NSE치는 개인차가 심하기는 하였으나(6.01~361.4 ng/ml) 그 평균치는 $59.30{\pm}77.88\;ng/ml$으로 두 군 사이에는 유의한 차이가 있었다. 소세포폐암환자중 limited disease군의 혈청 NSE 평균치는 $20.19{\pm}12.91\;ng/ml$이었으며, extended disease군의 혈청 NSE치는 역시 개인차가 심하기는 하였으나(17.15~361.44 ng/ml) 그 평균치는 $91.9{\pm}94.2\;ng/ml$로 두 군 사이에 유의한 차이를 보였다. 정상인에서의 혈청 NES 농도는 측정하지 않았으나 대조군인 비소세포폐암군환자 평균+2x표준편차인 20 ng/ml을 기준으로 할 때 소세포폐암환자 22명중 16명(73%)에서 증가된 소견을 보였고 이중 limited disease는 50%(5/10), extended disease는 92% (11/12)에서 증가되었으며, 비소세포암 환자중에서는 1명(1/21)만이 증가된 소견을 보였다. NSE 혈청농도와 면역조직화학염색 정도를 비교시 소세포폐암군과 비소세포폐암군 모두에서 유의한 상관관계를 보이지 않았다. 결론 : 혈청 NSE농도측정은 소세포폐암환자에서 암표지자로서 유용한 방법이 될 수 있을 것으로 사료되며 항 NSE 항체를 이용한 생검조직의 면역조직화학염색은 분화가 나빠 고식적인 현미경적 소견만으로는 소세포암과 비소세포암과의 강벌이 어려운 경우 정확한 조직유형 결정과 신경내분비 기원을 뵈이는 폐암의 진단에 도움을 줄 수 있을 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7295-7300
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• 2013

Lung cancer is the most common cause of cancer-related death in the world. The main types are small-cell lung carcinoma (SCLC) and non-small-cell lung carcinoma (NSCLC), the latter including squamous cell carcinoma (SCC), adenocarcinoma and large cell carcinoma. NSCLCs account for about 80% of all lung cancer cases. Microcephalin (MCPH1), also called BRIT1 (BRCT-repeat inhibitor of hTERT expression), plays an important role in the maintenance of genomic stability. Recently, several studies have provided evidence that the expression of MCPH1 gene is decreased in several different types of human cancers. We evaluated the expression of protein MCPH1 in 188 lung cancer and 20 normal lung tissues by immunohistochemistry. Positive MCPH1 staining was found in all normal lung samples and only some cancerous tissues. MCPH1-positive cells were significantly lower in lung carcinoma compared with normal tissues. Furthermore, we firstly found that MCPH1 expression in lung adenocarcinoma is higher than its expression in squamous cell carcinoma. Change in MCPH1 protein expression may be associated with lung tumorigenesis and may be a useful biomarker for identification of pathological types of lung cancer.