• 제목/요약/키워드: Tumor bulk

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Cancer Stem Cells in Head and Neck Squamous Cell Carcinoma: A Review

  • Satpute, Pranali Shirish;Hazarey, Vinay;Ahmed, Riyaz;Yadav, Lalita
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5579-5587
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    • 2013
  • Research indicates that a small population of cancer cells is highly tumorigenic, endowed with the capacity for self-renewal, and has the ability to differentiate into cells that constitute the bulk of tumors. These cells are considered the "drivers" of the tumorigenic process in some tumor types, and have been named cancer stem cells (CSC). Epithelial-mesenchymal transition (EMT) appears to be involved in the process leading to the acquisition of stemness by epithelial tumor cells. Through this process, cells acquire an invasive phenotype that may contribute to tumor recurrence and metastasis. CSC have been identified in human head and neck squamous cell carcinomas (HNSCC) using markers such as CD133 and CD44 expression, and aldehyde dehydrogenase (ALDH) activity. Head and neck cancer stem cells reside primarily in perivascular niches in the invasive fronts where endothelial-cell initiated events contribute to their survival and function. Clinically, CSC enrichment has been shown to be enhanced in recurrent disease, treatment failure and metastasis. CSC represent a novel target of study given their slow growth and innate mechanisms conferring treatment resistance. Further understanding of their unique phenotype may reveal potential molecular targets to improve therapeutic and survival outcomes in patients with HNSCC. Here, we discuss the state-of-the-knowledge on the pathobiology of cancer stem cells, with a focus on the impact of these cells on head and neck tumor progression, metastasis and recurrence due to treatment failure.

망막아세포종의 방사선치료 성적 (Retinoblastoma: Result of Radiotherapy)

  • 김일한;김종훈;박찬일
    • Radiation Oncology Journal
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    • 제8권2호
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    • pp.169-176
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    • 1990
  • 1980년 3월부터 1987년 8월까지 서울대학교병원 치료방사선과에서 망막아세포종으로 방사선 치료를 받았던 23예의 치료 성적을 보고한다. 20예의 편측성 종양에서, 13예는 안구적출술후 방사선치료를, 2예는 방사선치료만, 5예는 안구 적출후 동측 재발종양의 방사선치료를 받았다. 재발성 종양을 제외한 15예의 병기는 St. Jude Children's Research Hospital의 병기분류 기준에 의한 I 기(retinal)는 없고, II기(global) 5예, III기 (orbital) 8예, IV기 (cranial or metastatic) 2예였다. 양측성 종양 3예는 생후 1개월 이내에 증상이 나타났고, 진행된 종양측은 안구적출술을 시행했으며 조기 종양측은(3예 모두 I기)방사선 치료를 하였다. 시신경 절단부 또는 뇌척수액에서 종양 세포가 확인된 경우에는 항암화학치료를 병용하였다. 수술후 계획대로 방사선치료를 받은 12예의 5년 생존율은 $82.2\%$이며, 국소재발 또는 원격전이는 없었으나, 2환아(III기)의 진단시 무병상태였던 반대측 망막에서 종양이 속발하였다. 일차적 방사선 치료를 계획대로 받은 1예의 반대측 망막에서 종양이 속발하였다. 따라서 양측성 종양의 전반적 빈도는 $33\%$였다. 재발성종양 5예의 치료성적은 매우 불량하여 생존율은 $20\%$였다. 양측성 종양 3예중 2예가 무병상태로 생존하고 있다. 방사선 치료후의 변화로는 안와 연조직 위축이 관찰되었다. 방사선 치료성적은 조기 병기 또는 종양의 크기가 작은 경우에 양호하여 조기 치료가 중요하며 진단후 치료가 지연되지 않도록 함이 중요하다.

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원발성위장관임파종의 방사선치료 (Localized Primary Gastrointestinal Lymphomas)

  • 서창옥;김귀언;박창윤;김병수
    • Radiation Oncology Journal
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    • 제2권1호
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    • pp.93-100
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    • 1984
  • Among 238 patients with Non-Hodgkin's lymphoma received radiotherapy at Yonsei Cancer center, Yonsei University Medical College, from 1970 to 1981, 30 patients presented with localized(Stage I&II ) gastrointestinal lymphomas. Retrospective analysis of these 30 cases in an attempt to evaluate the influence of various prognostic factors and the effectiveness of therapy is presented. Overall 5 year survival rate of 30 cases of primary gastrointestinal lymphoma was $48\%$. Bulk of residual disease after initial surgery and stage were significant prognostic factors. Stage I with small residual disease treated with post-op irradiation achieved $100\%$ 5 year survival rate. So above group is considered curable with surgery and post-op irradiation. $80\%$ of Stage II with large residual disease were died with intra-abdominal local tumor control failure. Stage II with small residual disease showed $31.5\%$ 5 year survival rate. Non of them died with local failure. So, we suggest that complete surgical resection of tumor mass should be attempted initially in the management of localized gastrointestinal lypmhomas and systemic chemotherapy is needed in addition to post-op irradiation in the cases of Stage II and large residual disease after initial surgery.

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Stem Cell Biology, 최근의 진보 (Recent Advancement in the Stem Cell Biology)

  • 한창열
    • Journal of Plant Biotechnology
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    • 제33권3호
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    • pp.195-207
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    • 2006
  • Stem cells are the primordial, initial cells which usually divide asymmetrically giving rise to on the one hand self-renewals and on the other hand progenitor cells with potential for differentiation. Zygote (fertilized egg), with totipotency, deserves the top-ranking stem cell - he totipotent stem cell (TSC). Both the ICM (inner cell mass) taken from the 6 days-old human blastocyst and ESC (embryonic stem cell) derived from the in vitro cultured ICM have slightly less potency for differentiation than the zygote, and are termed pluripotent stem cells. Stem cells in the tissues and organs of fetus, infant, and adult have highly reduced potency and committed to produce only progenitor cells for particular tissues. These tissue-specific stem cells are called multipotent stem cells. These tissue-specific/committed multipotent stem cells, when placed in altered environment other than their original niche, can yield cells characteristic of the altered environment. These findings are certainly of potential interest from the clinical, therapeutic perspective. The controversial terminology 'somatic stem cell plasticity' coined by the stem cell community seems to have been proved true. Followings are some of the recent knowledges related to the stem cell. Just as the tissues of our body have their own multipotent stem cells, cancerous tumor has undifferentiated cells known as cancer stem cell (CSC). Each time CSC cleaves, it makes two daughter cells with different fate. One is endowed with immortality, the remarkable ability to divide indefinitely, while the other progeny cell divides occasionally but lives forever. In the cancer tumor, CSC is minority being as few as 3-5% of the tumor mass but it is the culprit behind the tumor-malignancy, metastasis, and recurrence of cancer. CSC is like a master print. As long as the original exists, copies can be made and the disease can persist. If the CSC is destroyed, cancer tumor can't grow. In the decades-long cancer therapy, efforts were focused on the reducing of the bulk of cancerous growth. How cancer therapy is changing to destroy the origin of tumor, the CSC. The next generation of treatments should be to recognize and target the root cause of cancerous growth, the CSC, rather than the reducing of the bulk of tumor, Now the strategy is to find a way to identify and isolate the stem cells. The surfaces of normal as well as the cancer stem cells are studded with proteins. In leukaemia stem cell, for example, protein CD 34 is identified. In the new treatment of cancer disease it is needed to look for protein unique to the CSC. Blocking the stem cell's source of nutrients might be another effective strategy. The mystery of sternness of stem cells has begun to be deciphered. ESC can replicate indefinitely and yet retains the potential to turn into any kind of differentiated cells. Polycomb group protein such as Suz 12 repress most of the regulatory genes which, activated, are turned to be developmental genes. These protein molecules keep the ESC in an undifferentiated state. Many of the regulator genes silenced by polycomb proteins are also occupied by such ESC transcription factors as Oct 4, Sox 2, and Nanog. Both polycomb and transcription factor proteins seem to cooperate to keep the ESC in an undifferentiated state, pluripotent, and self-renewable. A normal prion protein (PrP) is found throughout the body from blood to the brain. Prion diseases such as mad cow disease (bovine spongiform encephalopathy) are caused when a normal prion protein misfolds to give rise to PrP$^{SC}$ and assault brain tissue. Why has human body kept such a deadly and enigmatic protein? Although our body has preserved the prion protein, prion diseases are of rare occurrence. Deadly prion diseases have been intensively studied, but normal prion problems are not. Very few facts on the benefit of prion proteins have been known so far. It was found that PrP was hugely expressed on the stem cell surface of bone marrow and on the cells of neural progenitor, PrP seems to have some function in cell maturation and facilitate the division of stem cells and their self-renewal. PrP also might help guide the decision of neural progenitor cell to become a neuron.

이하선종양 적출술후 흉쇄유돌근을 이용한 함몰기형교정의 임상적 고찰 (Reconstruction of Soft Tissue Deficit After Parotidectomy by Sternocleidomastoid Muscle Flap)

  • 최희윤;정효경;이영만;류재만
    • 대한두경부종양학회지
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    • 제3권1호
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    • pp.37-54
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    • 1987
  • The aim of surgery for all parotid masses is directed toward total removal of the tumor with adequate safe margins of adjacent normal tissue and preservation of the facial nerve whenever possible. Reconstructive procedures following parotidectomy for benign or low grade malignant lesions are most commonly necessary if soft tissue deficits appear at the angle of the mandible below the earlobe as a major cosmetic deformity. This is a report of Z4 cases with a diagnosis of parotid tumor who were treated using various surgical procedures at Department of Plastic and Reconstructive Surgery, Hanyang University Hospital over the period of 4 years from January, 1983 to December, 1986. Among 24 cases, 11 cases were reconstructed by Sternocleidomastoid muscle flap at the same time that extirpative surgery is outlined. The advantage of Sternocleidomastoid muscle flap is the coverage of the facial nerve, so adhesion between the facial nerve and skin was prevented. Absorption and loss of bulk was not found such as dermofat graft. It was a simple method. Neither donor site defect nor sternocleidomastoid muscle deformity was developed. Sternocleidomastoid muscle flap have been found satisfactory in maintaining filled-out soft tissue hollows with good result cosmetically and functionally.

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Green Fluorescent Protein-reporter Mammalian One-hybrid System for Identifying Novel Transcriptional Modulators for Human $p14^{ARF}$ Tumor Suppressor Gene

  • Lee, Hye Jin;Yang, Dong Hwa;Yim, Tae Hee;Rhee, Byung Kirl;Kim, Jung-Wook;Lee, Jungwoon;Gim, Jin Bae;Kim, JungHo
    • Animal cells and systems
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    • 제6권4호
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    • pp.317-322
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    • 2002
  • To improve conventional yeast one-hybrid screening, we have developed an efficient mammalian one-hybrid system that allows rapid isolation of com-plementary DNAs which are able to induce human p14$^{ARF}$. tumor suppressor gene. A 1.5 kb promoter region of p14$^{ARF}$ was fused to EGFP to generate ARF promoter-EGFP reporter vector. This reporter plasmid was stably trans-fected into NIH3T3 cells for generation of reporter cell line. When the reporter cell line was infected with E2F-1 together with excess amounts of empty vector, the cells that received the positive modulator were readily identifiable by green fluorescence using FACS. The GFP-positive cells were cloned directly from the cultured cells and expanded in bulk culture. The genomic DNAs from GFP-positive cells were prepared and the CDNA insert in integrated retroviral genome was recovered by PCR using primers annealing to the retroviral vector sequences flanking the insert-cloning site. This system should be useful for efficient screening of expression CDNA libraries in mammalian cells to identify novel upstream regulators for spe-cific genes by one-hybrid interaction.ion.

비소세포성 폐암에 의한 뇌전이 환자의 예후인자 (Prognostic Factors in Patients with Brain Metastases from Non-Small Cell Lung Carcinoma)

  • 홍성언
    • Radiation Oncology Journal
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    • 제9권2호
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    • pp.197-204
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    • 1991
  • 비소세포성 폐암의 뇌전이 환자에서 방사선 치료후 예후인자를 분석하기 위하여 경희대학부속병원 치료방사선과에서 치료받은 53예의 방사선치료 결과를 분석하였다. 전체 53예중 남자가 37명 여자가 16예이고, 연령분포는 39세부터 85세까지로 평균 59세 였다. 조직학적 소견은 선암이 27예($50.9\%$)로 가장 많았으며 편평세포암(21예), 대세포암(5예) 순이었다. 모든 환자에서 스테로이드투여와 함께 전뇌조사를 시행하였다. 전체 환자의 중간생존 기간은 5개월이었고, 나이, 성별, 조직형태, 초기 수행상태는 예후에 영향을 미치지 않았다. 가장 중요한 예후인자는 방사선치료후 반응여부와 뇌이외 부위의 다발성 전이 유무 였다. 따라서 뇌전이 단독소견을 가진 비소세포성 폐암 환자에서 적정한 방사선 치료선량으로 적극적인 치료로써 생존기간을 연장시키고 quality of life를 향상시킬 수 있을 것으로 기대한다.

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장장근건을 포함한 요골 전완 유리피판술을 이용한 하안검 전층 재건 치험례 (Lower Eyelid Full-Thickness Reconstruction Using a Radial Forearm Free Flap with Palmaris Longus Tendon Sling: A Case Report)

  • 김태훈;은석찬;백롱민
    • 대한두개안면성형외과학회지
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    • 제12권1호
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    • pp.48-52
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    • 2011
  • Purpose: Many advances have been made in lower eyelid reconstruction surgical procedures after tumor ablative therapy. These include skin grafts, local flaps, free flaps, and skin expansion. When a full-thickness defect of the lower eyelid is reconstructed with many free flaps, ectropion and deformity of the medial and lateral canthal areas are common late complications caused by gravitational descent. The radial forearm free flap is widely used because of its lack of bulk, ease of dissection, malleability, and hairlessness. This report introduces a novel method for preventing ectropion using a composite radial forearm free flap reconstruction and palmaris longus suspension technique. Methods: A 70-year-old man had a malignant melanoma on his left lower eyelid. The patient was referred to our department after a biopsy confirmed the initial diagnosis. A full-thickness wide resection with a 25 mm free margin was performed, and a $5{\times}8cm$ radial forearm flap was elevated with a vascularised palmaris longus tendon. The palmaris longus tendon was fixed to the medial and lateral orbital rim perisoteum and the deep temporal fascia. The buccal mucosa was grafted to reconstruct the inner conjunctival layer. The pedicle vessels were anastomosed to the left superficial temporal artery and vein. Results: The postoperative clinical course was uneventful. The flap showed good texture and color match. No ectropion was noted 14 months after surgery and the tumor did not recur. The patient was quite satisfied with the final outcomes. Conclusion: Use of a radial forearm free flap and the palmaris longus tendon is an effective method for a full-thickness lower eyelid reconstruction.

MEG 영상진단 검사에 관한 연구 (A Study on the MEG Imaging)

  • 김종규
    • 대한임상검사과학회지
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    • 제37권2호
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    • pp.123-128
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    • 2005
  • Magnetoencephalography (MEG) is the measurement of the magnetic fields produced by electrical activity in the brain, usually conducted externally, using extremely sensitive devices such as Superconducting Quantum Interference Device (SQUID). MEG needs complex and expensive measurement settings. Because the magnetic signals emitted by the brain are on the order of a few femtoteslas (1 fT = 10-15T), shielding from external magnetic signals, including the Earth's magnetic field, is necessary. An appropriate magnetically shielded room is very expensive, and constitutes the bulk of the expense of an MEG system. MEG is a relatively new technique that promises good spatial resolution and extremely high temporal resolution, thus complementing other brain activity measurement techniques such as electroencephalography (EEG), positron emission tomography (PET), single-photon emission computed tomography (SPECT) and functional magnetic resonance imaging (fMRI). MEG combines functional information from magnetic field recordings with structural information from MRI. The clinical uses of MEG are in detecting and localizing epileptic form spiking activity in patients with epilepsy, and in localizing eloquent cortex for surgical planning in patients with brain tumors. Magnetoencephalography may be used alone or together with electroencephalography, for the measurement of spontaneous or evoked activity, and for research or clinical purposes.

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Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer

  • Kim, Yong-Hyub;Song, Sang-Yun;Shim, Hyun-Jeong;Chung, Woong-Ki;Ahn, Sung-Ja;Yoon, Mee Sun;Jeong, Jae-Uk;Song, Ju-Young;Nam, Taek-Keun
    • Radiation Oncology Journal
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    • 제33권1호
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    • pp.12-20
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    • 2015
  • Purpose: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT) Materials and Methods: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). Results: The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. Conclusion: Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT.