• Korean Journal of Radiology
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• 제22권5호
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• pp.751-758
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• 2021

Objective: Preoperative differentiation between inverted papilloma (IP) and its malignant transformation to squamous cell carcinoma (IP-SCC) is critical for patient management. We aimed to determine the diagnostic accuracy of conventional imaging features and histogram parameters obtained from whole tumor apparent diffusion coefficient (ADC) values to predict IP-SCC in patients with IP, using decision tree analysis. Materials and Methods: In this retrospective study, we analyzed data generated from the records of 180 consecutive patients with histopathologically diagnosed IP or IP-SCC who underwent head and neck magnetic resonance imaging, including diffusion-weighted imaging and 62 patients were included in the study. To obtain whole tumor ADC values, the region of interest was placed to cover the entire volume of the tumor. Classification and regression tree analyses were performed to determine the most significant predictors of IP-SCC among multiple covariates. The final tree was selected by cross-validation pruning based on minimal error. Results: Of 62 patients with IP, 21 (34%) had IP-SCC. The decision tree analysis revealed that the loss of convoluted cerebriform pattern and the 20th percentile cutoff of ADC were the most significant predictors of IP-SCC. With these decision trees, the sensitivity, specificity, accuracy, and C-statistics were 86% (18 out of 21; 95% confidence interval [CI], 65-95%), 100% (41 out of 41; 95% CI, 91-100%), 95% (59 out of 61; 95% CI, 87-98%), and 0.966 (95% CI, 0.912-1.000), respectively. Conclusion: Decision tree analysis using conventional imaging features and histogram analysis of whole volume ADC could predict IP-SCC in patients with IP with high diagnostic accuracy.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2629-2633
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• 2012

Background: Raw betel nut (RBN) chewing is an important contributing factor for esophageal squamous cell carcinoma (ESCC), although associated genomic changes remain unclear. One difficulty in assessing the effects of exclusively RBN induced genetic alterations has been that earlier studies were performed with samples of patients commonly using tobacco and alcohol, in addition to betel-quid. Both CDKN2A (at 9p21) and Rb1 gene (at 13q14.2) are regarded as tumor suppressors involved in the development of ESCC. Therefore, the present study aimed to verify the RBN's ability to induce ESCC and assess the involvement of CDKN2A and Rb1 genes. Methods: A panel of dinucelotide polymorphic markers were chosen for loss of heterozygosity studies in 93 samples of which 34 were collected from patients with only RBN-chewing habit. Promoter hypermethylation was also investigated. Results: Loss in microsatellite markers D9S1748 and D9S1749, located close to exon $1{\beta}$ of CDKN2A/ARF gene at 9p21, was noted in 40% ESCC samples with the habit of RBN-chewing alone. Involvement of a novel site in the 9p23 region was also observed. Promoter hypermethylation of CDKN2A gene in the samples with the habit of only RBN-chewing alone was significantly higher (p=0.01) than Rb1 gene, also from the samples having the habit of use both RBN and tobacco (p=0.047). Conclusions: The data indicate that the disruption of 9p21 where CDKN2A gene resides, is the most frequent critical genetic event in RBN-associated carcinogenesis. The involvement of 9p23 as well as 13q14.2 could be required in later stages in RBN-mediated carcinogenesis.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4335-4338
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• 2015

Background: Oral cancer is the third most common malignancy in Saudi Arabia, the highest incidence of which is reported from Jazan province. The objective of this study was to evaluate the association of various locally used substances, especially shamma, with oral cancer in the Jazan region of Saudi Arabia. Materials and Methods: A hospital-based case-control study was designed and patient records were scanned for histologically confirmed oral cancer cases. Forty eight patients who were recently diagnosed with oral cancer were selected as cases. Two healthy controls were selected for each observed case and they were matched with age (+/- 5 years) gender and location. Use of different forms of tobacco such as cigarettes, pipe-smoking and shamma (smokeless-tobacco) was assessed. Khat, a commonly used chewing substance in the community was also included. Descriptive analysis was first performed followed by multiple logistic regression (with and without interaction) to derive odds ratios (ORs) and 95% confidence interval (CIs). Results: Mean age of the study sample (56% males and 44% females) was 65.3 years. Multinomial regression analysis revealed that shamma use increased the odds of developing oral cancer by 29 times (OR=29.3; 10.3-83.1). Cigarette (OR=6.74; 2.18-20.8) was also seen to have an effect. With the interaction model the odds ratio increased significantly for shamma users (OR=37.2; 12.3-113.2) and cigarette smokers (OR=10.5; 2.88-3.11). Khat was observed to have negative effect on the disease occurrence when used along with shamma (OR=0.01; 0.00 - 0.65). Conclusions: We conclude that shamma, a moist form of smokeless tobacco is a major threat for oral cancer occurrence in the Jazan region of Saudi Arabia. This study gives a direction to conduct further longitudinal studies in the region with increased sample size representing the population in order to provide more substantial evidence.

• Radiation Oncology Journal
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• 제13권1호
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• pp.9-18
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• 1995

목적 :상악동암의 적절한 치료 방법을 알기 위하여 후향적 분석을 시행하였다. 대상 및 방법 : 1986년 1월 부터 1992년 12월 까지 전남대학교 병원에서 치료받은 상악동에서 발생한 편평상피세포암 33명을 대상으로 하였다. 남자가 24명 여자가 9명이었고 연령의 중앙간은 55세였다. 1988년에 제시된 AJCC 병기 분류법에 따른 종양의 병기는 T2 1명, T3 10명, T4 22명이었으며 경부임파절 전이는 5명에서 관찰되었다(Nl:4명, N2b;1명). 치료방법에 따라 3군으로 분류하여 분석하였으며 첫 군(FAR 군으로 명명, 16명)은 수술전 경동맥 항암화학요법(5-FU, 평균 3078mg)과 방사선치료(평균 3433cGy) 및 비타민 A(50,000 IU. daily)를 병용하고 이어서 상악전적출술 과 술 후 방사선치료(평균 2351cGy)를 시행하였다. 방사선총량은 5255cGy였다. 둘째군(SR 군으로 명명, 7명)은 상악전적출술과 술후 방사선 치료(평균 5920cGy)를 시행하였다. 셋째군(R 군으로 명명, 6명)은 근치적 목적의 방사선 치료(평균 7164cGy)만 시행하였다. 생존율 분석에는 Kaplan-Meier법을 이용하였고 두 군간의 차이에 대한 검정은 Mantel-Cox법으로 하였다. 결과 : 국소종양 제어율은 2년에 FAR, SR, R군에서 각각 $100\%$, $50\%$, $27.7\%$로 나타났다. 무병생존율은 2년에 FAR, SR, R군에서 각각 $88.9\%$, $33.3\%$, $0\%$였다. 전체적인 생존율은 2년에 FAR, SR, R군에서 각각 $88.9\%$, $40\%$, $50\%$였다. FAR군과 SR군간에, 그리고 FAR군과 R군간에 국소종양 제어율, 2년 무병생존율, 2년 생존율에 있어서의 차이는 통계학적으로 유의하였다. 그러나 SR군과 R군간의 차이는 통계학적 유의성이 없었다. 결론 :수술전 경동맥 5-FU와 비타민 A 그리고 방사선 치료를 병용 치료하여 종양의 부분적 관해를 유도한 후 상악전적출술과 추가적인 방사선 치료를 시행한 FAR군이 상악전적출술후 방사선치료를 시행한 군이나 방사선 단독치료군보다 더 좋은 성적을 보였다. 앞으로 이에 대한 전향적 연구가 필요할 것으로 사료된다.