• Korean Journal of Radiology
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• v.2 no.1
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• pp.1-7
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• 2001

Objective: To determine the usefulness of perfusion MR imaging in assessing the histologic grade of cerebral gliomas. Materials and Methods: In order to determine relative cerebral blood volume (rCBV), 22 patients with pathologically proven gliomas (9 glioblastomas, 9 anaplastic gliomas and 4 low-grade gliomas) underwent dynamic contrast-enhanced T2^*-weighted and conventional T1- and T2-weighted imaging. rCBV maps were obtained by fitting a gamma-variate function to the contrast material concentration versus time curve. rCBV ratios between tumor and normal white matter (maximum rCBV of tumor / rCBV of contralateral white matter) were calculated and compared between glioblastomas, anaplastic gliomas and low-grade gliomas. Results: Mean rCBV ratios were 4.90°±1.01 for glioblastomas, 3.97°±0.56 for anaplastic gliomas and 1.75°±1.51 for low-grade gliomas, and were thus significantly different; p < .05 between glioblastomas and anaplastic gliomas, p < .05 between anaplastic gliomas and low-grade gliomas, p < .01 between glioblastomas and low-grade gliomas. The rCBV ratio cutoff value which permitted discrimination between high-grade (glioblastomas and anaplastic gliomas) and low-grade gliomas was 2.60, and the sensitivity and specificity of this value were 100% and 75%, respectively. Conclusion: Perfusion MR imaging is a useful and reliable technique for estimating the histologic grade of gliomas.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.76-76
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• 2003

Purpose: To assess clinical proton MR spectroscopy (MRS) as a noninvasive method for evaluating tumor malignancy at 3T high field system. Methods: Using 3T MRI/MRS system, localized water-suppressed single-voxel technique in patients with brain tumors was employed to evaluate spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cr) and lactate. On the basis of Cr, these peak areas were quantificated as a relative ratio. Results: The variation of metabolites measurements of the designated region in 10 normal volunteers was less than 10%. Normal ranges of NAA/Cr and Cho/Cr ratios were 1.67$\pm$018 and 1.16:1:0.15, respectively. NAA/Cr ratio of all tumor tissues was significantly lower than that of the normal tissues (P=0.005). Cho/Cr ratio of high-grade gliomas was significantly higher than that of low-grade gliomas (P= 0.001), Except 4 menigiomas, lactate signal was observed in all tumor cases. Conclusions: The present study demonstrated that the neuronal degradation or loss was observed in all tumor tissues. Higher grade of brain tumors was correlated with higher Cho/Cr ratio, indicating a significant dependence of Cho levels on malignancy of gliomas. This results suggest that clinical proton MR spectroscopy could be useful to predict tumor malignancy. Acknowledgement: This study was supported by a grant of the Mid and Long Term Nuclear R/D Plan Program, Ministry of Science and Technology, Republic of Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2871-2877
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• 2015

Background: Urothelial carcinoma (UC) is a malignant neoplasm that most commonly occurs in the urinary bladder. The primary aim of this study was to evaluate the clinicopathologic features, recurrence and progression in patients with bladder urothelial cancer. Materials and Methods: The medical records of patients diagnosed with UC in the state pathology laboratory between January 2006 and July 2014 were retrospectively included. Carcinomas were categorized according to age, gender, histologic grade, tumor configuration, pathologic staging, recurrence status, and progression. Results: A total of 125 (113 men, 12 women) patients were examined. The mean age was 65.9 years and the male-to-female urothelial cancer incidence ratio was 9.4:1. Low-grade UCs were observed in 85 (68%) and high-grade in 40 (32%). A papillary tumor pattern was observed in 67.2% of the UCs. Cases were classified with the following pathological grades: 34 (27.2%) cases of pTa, 70 (56%) of pT1, and 21 (16.8%) of pT2. Recurrence occurred in 27 (21.6%) patients. Ten progressed to a higher stage (pT1 to pT2), and three cases to higher grade (low to high). We also analyzed the results separately for 70 (56%) patients 65 years of age and older. Conclusions: With early detection and diagnosis of precursor lesions in older patients, by methods such as standard urologic evaluation, urinary cytology, ultrasound scanning and contrast urography, and cystoscopy, in addition to coordinated efforts between pathologists and urologists, early diagnosis may reduce the morbidity and mortality of patients with urothelial carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.997-1001
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• 2013

Background: Lymphangiogenesis, assessed as lymphovascular density (LVD), is the initial step of generalized tumor lymphovascular invasion (LVI). It also involves VEGF-C as the most important protein family. Lymphangiogenesis among breast cancer cases correlations with several clinicopathological factors are important to determine prognosis and treatment strategies, but results have been controversial and require clarification. Aim: To define correlations between VEGF-C expression, LVD and LVI with several clinicopathological parameters from Indonesian breast cancer patients. Materials and Methods: Using a cross-sectional study, a total of 48 paraffin-embedded tissues of breast cancer from Dr. Sardjito General Hospital Indonesia were assessed for VEGF-C expression, LVD and LVI by immunohistochemistry. Correlations of these markers with clinicopathological parameters like patient age, tumor size, lymph node status, grade, ER/PR and Her-2 status, cell proliferation and p-53 expression were investigated by linear analysis. Correlations of VEGF-C expression and LVI with several clinicopathological parameters were analyzed with Coefficient Contingency Chi-Square test. Results: The mean of patients age was 53.0 year, pre and post-menopausal patients accounting for 56.3% and 43.8%, respectively. Some 10.4% were well, 41.7% moderate and 47.9% poorly differentiated. ER positivity was evident in 50% while PR and Her-2 positivity was found in 31.3% and 33.3%, respectively. Breast cancer cells with over-expression of p-53 was 64.6% and with high cell proliferation was 56.3%. Lymph node metastasis was noted in 63.5%, and LVI in 72.9%. Significant correlations were found between LVD and tumor size (p:0.037), grade (p:0.000), lymphnode status (p:0.036), LVI (p:0.003), as well as with p-53 and cell proliferation. There were also significant correlation of VEGF-C (p:0.011) and LVI (p:0.001) with tumor grade. Only ER status was found to have a correlation with tumor size (p:0.027). Conclusions: This study suggested that in Indonesian breast cancer patients, lymphangiogenesis is correlated with tumor size, grade, lymph node status and tumor lymphovascular invasion, the latter also being related with p-53 over expression and high cell proliferation.

• Korean Journal of Veterinary Pathology
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• v.2 no.2
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• pp.85-94
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• 1998

This study was performed to evaluate whether the loss or overexpression of Rb, and overexpression of p53 were prognostic indicators for bladder neoplasia, 52 tumor specimens from transitional cell carcinoma of the urinary bladder were from 42 male and 10 female patients whose age ranged from 30 to 83 years old(mean age; 63,5 years old), This group included 36 superficial and 16 invasive stage bladder tumors, and grades 16-25, p53 was significantly associated with tumor stage and grade(p＜0,05 in each), but not with tumor recurrence. Loss of Rb gene expression or Rb overexpression was correlated with stage, but not grade. These results suggested that changes of Rb and p53 expression might play an important role in assessing the aggressiveness of human neoplasms.

• Journal of Digestive Cancer Reports
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• v.9 no.2
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• pp.57-59
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• 2021

Carcinoid tumor is called as neuroendocrine tumor and is classified into neuroendocrine tumor Grade 1, neuroendocrine tumor Grade 2, and neuroendocrine carcinoma based on the differentiation of tumors. Recently, the incidence of rectal carcinoid tumor has been increasing probably due to the increased interest on screening colonoscopy and the advancement of endoscopic imaging technology. As the rectal carcinoid shows a wide range of clinical characteristics such as metastasis and long-term prognosis depending on the size and histologic features, it is a challenge to give a consistent diagnostic code in patients with the rectal carcinoid. If the rectal carcinoid tumor is less than 1 cm in size, it can be given as the code of definite malignancy or the code of uncertain malignant potential according to International Classification of Diseases for Oncology (ICD-O) by World Health Organization (WHO). Because patients get different amount of benefit from the insurance company based on different diagnostic codes, this inconsistent coding system has caused a significant confusion in the clinical practice. In 2019, WHO updated ICD-O and Statistics Korea subsequently changed Korean Standard Classification of Diseases (KCD) including the code of rectal carcinoid tumors. This review will summarize what has been changed in recent ICD-O and KCD system regarding the rectal carcinoid tumor and surmise its clinical implication.

• Korean Journal of Radiology
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• v.20 no.4
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• pp.569-579
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• 2019

Objective: To investigate the usefulness of computed tomography (CT) texture analysis (CTTA) in estimating histologic tumor grade and in predicting disease-free survival (DFS) after surgical resection in patients with hepatocellular carcinoma (HCC). Materials and Methods: Eighty-one patients with a single HCC who had undergone quadriphasic liver CT followed by surgical resection were enrolled. Texture analysis of tumors on preoperative CT images was performed using commercially available software. The mean, mean of positive pixels (MPP), entropy, kurtosis, skewness, and standard deviation (SD) of the pixel distribution histogram were derived with and without filtration. The texture features were then compared between groups classified according to histologic grade. Kaplan-Meier and Cox proportional hazards analyses were performed to determine the relationship between texture features and DFS. Results: SD and MPP quantified from fine to coarse textures on arterial-phase CT images showed significant positive associations with the histologic grade of HCC (p < 0.05). Kaplan-Meier analysis identified most CT texture features across the different filters from fine to coarse texture scales as significant univariate markers of DFS. Cox proportional hazards analysis identified skewness on arterial-phase images (fine texture scale, spatial scaling factor [SSF] 2.0, p < 0.001; medium texture scale, SSF 3.0, p < 0.001), tumor size (p = 0.001), microscopic vascular invasion (p = 0.034), rim arterial enhancement (p = 0.024), and peritumoral parenchymal enhancement (p = 0.010) as independent predictors of DFS. Conclusion: CTTA was demonstrated to provide texture features significantly correlated with higher tumor grade as well as predictive markers of DFS after surgical resection of HCCs in addition to other valuable imaging and clinico-pathologic parameters.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.32-39
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• 2005

Introduction: Currently, F-18 fluorodeoxyglucose positron emission tomography scans (FDG-PET) has been investigated in soft tissue tumor especially for tumor detection and noninvasive grading. However, the validity and the efficacy of FDG-PET are still unclear in clinical evaluation. The purpose of this study is to determine the efficacy of FDG-PET in compared to conventional diagnostic imaging studies currently used in the soft tissue tumor. Methods: Between March 2001 and March 2002, 29 patients (sixteen males, thirteen females, mean age, 47 years; a range from 4 to 73) diagnosed with soft tissue tumor were evaluated by both conventional diagnostic imaging and FDG-PET. Valid reference test of the local lesion was the histopathologic diagnosis, which was measured in all patients. The suspecting metastasis in the imaging studies was validated by pathology or follow up imaging for at least 6 months. Each imaging diagnosis was made independently. The accuracy of each diagnostic method was evaluated. The incremental cost accuracy ratio was determined in each diagnostic method. Results: For detection of local lesion, sensitivity, specificity, and accuracy for MRI and FDGPET scans were 91%, 57%, 83% and 95%, 43%, 83% respectively. For detection of distant lesion, sensitivity, specificity, accuracy for conventional diagnostic methods and FDG-PET scans were 77%, 89%, 87% and 92%, 94%, 93% respectively. The incremental cost accuracy ratio (ICAR) of FDG-PET for detection of distant lesion was 145,000won/%. According to ICAR for each tumor grade, PET strategy is most cost-effective at high grade tumors. Conclusions: For detection of local lesion such as recurrence or remnant tumor, FDG-PET scan was not more accurate than MRI. However, It was more accurate for detection of metastatic lesion than conventional methods. For detection of high grade tumor, PET was most costeffective than for detection of lower grade tumor.

• The Korean Journal of Cytopathology
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• v.17 no.2
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• pp.153-158
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• 2006

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor. There have been only a few prior fine-needle aspiration (FNA) cytological reports. Recognition of this tumor is important because of its potential for metastasis despite its indolent nature and its deceptively bland cytologic appearance. A 60-year-old male presented with a slowly growing mass in the left calf detected 10 years ago. The patient underwent surgical excision. FNA cytology was performed directly on the mass. The smears showed low cellularity composed of hypercellular tissue fragments, hypocellular loose aggregates, and stripped nuclei. The cytoplasm was seen as either collagenous material or very thin fibrillary collagen strands. Tumor cells had spindle, ovoid, or irregular nuclei, fine chromatin, and small nucleoli. Focally slight degree of nuclear pleomorphism is noted. There were no mitotic figures. Blood vessels were frequently seen. Immunocytochemically, tumor cells were negative for S-100 protein, desmin, smooth muscle actin, and CD34. The diagnosis of LGFMS is rarely possible by cytology alone; however, LGFMS should be included in the differential diagnosis of spindle-cell tumors consisting of hypercellular and hypocellular components with some capillary-sized vessels arising in the deep soft tissue of the lower extremities, particularly the thigh. The immunocytochemical findings are of help in the differential diagnosis.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.47-53
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• 1996

Synovial sarcoma is an uncommon malignant soft tissue tumor which usually occurs in young-aged person, and frequently involves the lower extremities. Many authors recommended wide excision, adjuvant chemotherapy and radiation therapy. The proposed factors that affect the prognosis are age, size of tumor, site of tumor in the body, depth of tumor, histologic grade and method of treatment. The purpose of the study is to analyze the factors that affect the 5-year survival rate. We retrospectively evaluated 19 cases of synovial sarcoma treated in the Kosin University Medical Center from Jan. 1982 to Dec. 1994. The overall 5-year survival rate was 47.6% and the 5-year survival rates were significantly higher(P<0.05) in the group with smaller size of mass. The significantly lower 5-year survival rates were observed in the patient with deeply located lesion and with higher histologic grade. The 5-year survival rates were higher in the patients treated with wide excision than in the patients treated with amputation. But there was no significant difference between these groups. The adjuvant chemotherapy and radiotherapy were performed. In conclusion, we suggest that the better prognosis will be observed in the patients with smaller size of tumor mass, superficially located and lower histologic grade.