• 제목/요약/키워드: Tumor response assessment

검색결과 66건 처리시간 0.033초

악성 고형암의 항암제 동반진단 기술에서 분자진단기술의 적용 (Application of Molecular Diagnostics Technology in the Development of a Companion Diagnostics for Malignant Solid Tumors)

  • 김진희
    • 한국콘텐츠학회논문지
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    • 제19권3호
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    • pp.365-374
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    • 2019
  • 악성종양은 양성종양과 달리 전이가 가능하고 재발이 쉬울 뿐 아니라 생존율 및 삶의 질이 떨어지는 질환이다. 국내의 경우 악성종양 치료 시 건강보험심사평가원이 제시한 항암화학요법 일반원칙에 따라 일괄적으로 치료하는 경향이 있다. 하지만 근래에는 일방적인 약물치료보다는 동반진단제를 사용을 권고하는데 이는 바이오마커를 이용한 분자진단기법으로 동반진단하여 치료 전에 환자의 약물 반응을 예측할 수 있기 때문이며, 국내외 식품의약품안전처에서는 의약품의 반응성 및 안전성을 확보하기 위하여 신약개발단계에서 동반진단제를 함께 개발하기를 권고한다. 본 종설에서는 악성 고형암을 중심으로 동반진단제의 개발방향 및 개발현황을 문헌고찰을 통해 분석하였고, 동반진단제로 사용되는 다양한 분자진단기법, 예컨대 면역조직화학염색법, 중합효소연쇄반응법, 제자리부합법, 차세대염기서열분석법 등에 따른 동반진단제 개발현황 및 미국 식품의약품안전청의 승인사례를 조사하여 최신 동반진단 개발동향을 함께 살폈다. 그리고 동반진단제 개발과정에서 기술적 사항으로 허가시점에 맞춘 분자진단기술을 선택과 진단제에 대한 명확한 기전이해와 더불어 치료와 동반진단제의 융합을 제언하였고, 사회적으로 동반진단제에 대한 공공보험의 급여책정이 필요함을 제언하였다.

Iris Nertschinskia Ethanol Extract Differentially Induces Cytotoxicity in Human Breast Cancer Cells Depending on AKT1/2 Activity

  • Shin, Jae-Sik;Maeng, Hyung-Gun;Hong, Seung-Woo;Moon, Jai-Hee;Kim, Jin-Sun;Suh, Young-Ah;Kim, Eun-Sung;Lee, Young-Min;Kim, Ye-Seul;Choi, Eun-Kyung;Kim, Inki;Lee, Sok-Young;Cho, Dong-Hyung;Hong, Nam-Joo;Kim, Tae-Won;Jin, Dong-Hoon;Lee, Wang Jae
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권12호
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    • pp.6511-6516
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    • 2012
  • Recently, we reported that an ethanol extract of Iris nertschinskia induces p53-dependent apoptosis in the MCF7 human breast cancer cell line. However, the detailed mechanisms were not fully explored. Here, we demonstrate another aspect of the activity of I. nertschinskia in breast cancer cells. We compared the response to an ethanol extract of I. nertschinskia in two different human breast cancer cell lines, Hs578Tand MDA-MB231, respectively with relatively low and high AKT1/2 activity by trypan blue exclusion assay and FACS analysis. Knockdown of endogenous AKT1 or AKT2 in breast cancer cells by RNA interference determined the sensitivity to I. nertschinskia ethanol extract compared to control cells. The I. nertschinskia ethanol extract induced cell death in a manner that depended on the level of phosphorylated AKT1/2 protein and was associated with a significant increase in the sub-G1 cell population, indicative of apoptosis. Our results indicate that an ethanol extract of I. nertschinskia differentially induces cell death in breast cancer cells depending on their level of phosphorylated AKT1/2.

자궁경부 소세포암종의 방사선치료 (Radiotherapy in Small Cell Carcinoma of the Uterine Cervix)

  • 정은지;이용희;김귀언;서창옥
    • Radiation Oncology Journal
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    • 제15권4호
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    • pp.369-377
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    • 1997
  • 목적 : 자궁경부 소세포암종으로 진단되어 방사선치료를 받은 환자에서 조직병리학적인 재검사를 시행하여 조직병리학적 특성을 알아보고, 환자 및 종양의 특징, 방사선치료 후의 치료 성적등을 조직병리학적 유형에 따라 후향적으로 비교 분석해 보았다. 대상 및 방법 : 1981년 10월부터 1995년 4월까지 연세의대 연세암센터 치료방사선과에서 자궁경부암으로 방사선치료를 받은 환자 총 2890명 중 조직학적 유형이 소세포암종이었던 환자는 60명으로 $2.08\%$였다. 타병원예서 조직검사 및 병기 결정 후 방사선치료 만을 위해 전과되었던 36예에서는 자궁경부 생검 조직을 확보할 수 없었고, 이들을 제외한 24명에서 조직에 대한 병리학적 재검사가 가능하여 H&E 염색 및 신경내분비 표지인 neuron-specific enolase(NSE), chromogranin, synaptophysin, Grimelius 면역조직화학 염색을 시행하였다. 이들 24예의 환자 및 종양좌 특성, 방사선치료에 대한 반응, 치료 실패 양상, 5년 생존율 및 5년 무병 생존율 등을 후향적으로 분석하였다. 결과 : H&E 염색 및 4가지 neuroendocrine marker 검사 후 13예는 신경내분비암종으로 진단되었고 11예는 소세포 유형의 편평상피암종으로 진단되어 병리학적으로 크게 2가지 군으로 분류하였다. 신경내분비암종으로 분류된 13예 중 5예는 중등도 이상으로 분화가 좋은 편아었으나 8예는 분화가 나쁘거나 미분화되었다. 전체 24예 대상 환자들의 연령은 23-79세로 중앙 연령치 54세였으며 FIGO 병기 분포는 Ib 8예$(33.3\%)$, IIa 1예$(4.2\%)$, IIb 11예$(45.8\%)$, IIIa 2예$(8.3\%)$, IIIb 1예$(4.2\%)$, IV 1예$(4.2\%)$로 병기 I-II가 20예로 대다수를 차지하였다. 골반 림프절에 전이가 있었던 환자가 5예(20.8%) 있었는데 이 중 3예는 수술후 조직학적으로 확인되었고(2예는 근치적 수술, 1예는 골반 림프절 생검) 다른 2예는 전산화 단층 촬영상 골반 림프절이 커져 있어 전이로 판단되었다. 이들 2가지 병리학적 분류군에 따라 환자 및 종양의 특성을 비교해 보았는데 특별한 차이는 발견할 수 없었으며, 방사선치료에 대한 반응, 치료 실패 양상, 5년 생존율 및 5년 무병 생존율 등의 치료 결과를 비교해 보았을 때 치료 실패 양상에 있어서 소세포형의 편평상피암종에서는 원격 전이가 2예$(18.2\%)$인데 반해 신경내분비암종에서는 6예$(46.2\%)$로 신경내분비암종(neuroendocrine carcinoma)에서 원격 전이율이 높았으나 환자 수가 적어 통계학적인 유의성은 없었다(P>0.05). 결론: 병리조직학적 재검사가 가능하였던 24예의 자궁경부 소세포암종 환자 중 13예가 신경 내분비암종으로 진단되었으며 나머지 11예는 소세포형의 편평상피암종으로 분류되었는데 환자 및 종양의 특징, 방사선치료 성적을 비교해 볼 때 신경내분비암종에서 원격 전이가 호발하였으나 $(46.2\%\;vs.\;18,2\%)$, 5년 생존율과 5년 무병 생존율의 차이는 없었다. 이런 결과로 자궁경부에서 발생한 소세포암종 중 신경내분비암종의 경우는 원격 전이가 맡으므로 방사선치료, 수술 등의 국소 치료와 더불어 적절한 항암화학요법을 추가하여 치료 결과를 증진시킬 수 있으리라 생각한다.

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편평세포 폐암환자에서 Squamous Cell Cancer Antigen(SCC 항원)의 변화 (The Change of Squamous Cell Cancer Antigen (SCC Ag) Level as A Tumor Marker in Squamous Cell Lung Cancer)

  • 김영준;박인원;최병휘;허성호
    • Tuberculosis and Respiratory Diseases
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    • 제39권5호
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    • pp.400-406
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    • 1992
  • 연구배경 : 최근 연구가 활발한 SCC 항원을 이용하여 폐암환자의 진단적 의미, 치료효과 판정, 예후를 예측할 수 있는 지표로써의 가능성을 알아보고자 본 연구를 시행하였다. 방법 : 정상대조군, 양성 폐질환 환자군과 폐암환자에서 SCC 항원을 측정하였으며 폐암 환자를 대상으로 치료전과 치료후 SCC Riabeap radioimmunoassay kit를 이용하여 SCC 항원을 측정하였다. 결과 : 1) SCC 항원치는 편평세포 폐암환자인 경우 $2.26{\pm}1.53\;ng/ml$, 기타 폐암은 $0.62{\pm}0.53\;ng/ml$, 양성 폐질환 환자는 $0.67{\pm}0.38\;ng/ml$, 정상 대조군은 $0.53{\pm}0.36\;ng/ml$ 이었다. 2) SCC 항원이 양성을 보인 편평세포 폐암환자는 42%(5/12)이었고 기타 폐암환자 양성 폐질환환자, 정상 대조군은 1명도 없었다. 3) 편평 세포폐암 환자의 SCC 항원 평균치는 병기에 따라 I기에 $2.07{\pm}1.56\;ng/ml$, $III_a$기는 $5.04{\pm}0.53\;ng/ml$, $III_b$기는 $1.94{\pm}0.7\;ng/ml$, IV기는 $1.07{\pm}0.64\;ng/ml$ 이었다. 4) 치료에 따른 항원역가는, 치료에 반응을 보인 환자에게서 치료 전보다 치료후 유의하게 감소하는 것을 볼 수가 있었다. 결론 : 이상의 결과로 SCC 항원은 편평세포 폐암을 진단하는 보조적인 수단으로서 이용 가능성과 치료에 따른 효과를 판정할 수있는 추적검사 방법으로서의 가능성을 제시하였다.

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인천시 고잔동에서 제기된 유리섬유에 의한 건강피해 역학 조사 (Health Assessment for Glass Fibre Landfill at Gozan-dong, Inchon)

  • 조수헌;주영수;김경렬;이강근;홍국선;은희철;송동빈;홍재웅;권호장;하미나;한상환;성주헌;강종원
    • Journal of Preventive Medicine and Public Health
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    • 제30권1호
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    • pp.77-101
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    • 1997
  • In September 1994, residents of Gozan-dong, Incheon City, made a petition to the government about their health problems which might be caused by previous glass fibre landfill nearby 'H' company. In february 1995, at regular academic meeting of occupational and environmental medicine, a research team of 'D' University presented that they had found glass fibres in groundwater of the area through their survey. They were suspicious of probable association between ingestion of groundwater contaminated with glass fibres and skin tumors among residents. A joint research team was formed and carried out the survey of environment concerning groundwater and its glass fibre existence, and health assessment of residents in the area and industrial workers of 'H' company during May to November, 1995. Analysis of groundwater flow system indicates that the flow lines from the glass fibre landfill pass through or terminate at the 6 houses around the landfill. This means that the groundwater of the 6 houses around the glass fibre landfill could be affected by some possible contaminants from the landfill, but the groundwater quality of the other houses was irrelevant to the landfill. The qualitative and qualitative analyses for glass fibres in 54 groundwater samples including those from the nearby 6 houses, were carried out using SEM equipped with EDS, resulting in no evidence for the presence of glass fibres in the waters. Major precipitates, formed in waters while boiling, were identified as calcium carbonates, in particulary, aragonites in needle form. The results of health assessments of 889 residents in Gozan-dong, participated in this study, showed statistically significant differences in past medical histories of skin tumor and respiratory disease between the exposed group (31 persons who inhabited in 6 houses around the landfill) and the control group, but no significant differences in past medical histories of other diseases, such as cancer mortality, current gastroscopic findings, current skin diseases and respiratory diseases, etc. Also, we could not prove any glass fibres in excised specimens of 9 skin tumors in both groups and there were no health problems possibly associated with glass fibres in employees of the 'H' company. After all, we could not authenticate the association, raised by prior investigators, between groundwater streams, assumedly contaminated with glass fibres or not, and specific disease morbidities or common disease/symptom prevalences. That is, we could not find any glass fibres in groundwater as the only exposure factor of this study hypothesis, and there were not enough certain evidences such as increasing disease prevalences, for examples, skin, respiratory and gastrointestinal diseases etc, possibly related to glass fibre exposure, in exposed group. As a matter of course, the conditions for confirming causal association, for example, strength of the association, consistency of the association, specificity of the association, temporality of the association and dose-response relationship etc, have not been satisfied. In conclusion, we were not able to certify the hypothesis that contamination of groundwater with glass fibres might cause any hazardous health effects in residents who used it for drinking.

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악성종양 환자의 통증 및 통증관리에 관한 연구 (The Study of Pain and Pain Management of Cancer Patients)

  • 윤귀옥;박형숙
    • 기본간호학회지
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    • 제3권2호
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    • pp.299-316
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    • 1996
  • This study is the descriptive survey to provide basic data for nursing intervention to pain management of cancer patients by finding more effective way to manage pain with recognize pain level and pain characteristics. To achieve the purpose of this study, the subjects of this study are 110 male or female gastro intestinal tract patients who are older than twenty, are hospitalized in Pusan University Hospital from 1995. 5. 28 to 1995. 9. 25 and have had medical treatment. The modified pain assessment of cancer patients of Cornne, H. Rosermary, M. was used as the tool of study with 16 questionaries. The pain score consists of sensory intensity score and distress score. The data was analyzed by the SPSS statistical program number, percentage, mean, standard deviation, t-test, One Way Anova and Duncan's Multiple Range Test were utilized for analysis. The results were summarized as follows : 1. In population-sociological characteristics : in the age-range of subject, the sixties are most as 32.7% and the subjects after the forties are 89.5%, in sex of subjects, male patients are 66.4% and female 33.6%, in the number of family, the subjects who has 4 or above families are 70% and the subjects who live with their spouse, sons and daughters are 54.5% 2. In the disease characteristics : stomach cancer patients were most as 39.1%. And the most of patient who had never been operated before. In time of pain, the most of subjects were intermittent. In the type of pain, the most of subjects were 'dully pain' as 31.8%. Metastatic subjects were 30.0%. In the origin of pain, nervous pressure was 50.8%. The number of complication was 46 and most of complication are obstruction as 6%. 3. In the pain level, 91subjects complained pain. And mean pain score was $287.1{\pm}116.1$ The mean pain score of female subjects was higher than that of male subjects. 4. In the pain characteristics, the pain began usually at meal time as 40.7%. The duration of pain was mostly from 1 month to 3 months as 57.1%. The appetite was mainly concerned with the pain as 31.8%. The etiology of pain was usually tumor as 69.3%. The meaning of pain was incurable disease as 14.5%, anxiety, death and suffering. 5. The 56(61%) of 91subjects were treated with Analgesic pain management. The kinds of Analgesic is usually valentac as 46.4%. The medication was usually intramuscle as 66.1% at whenever necessary, Response of Analgesic after Medication was usually 'moderate release'. The side effects of medication were nausea as 26.8%. The average amount of morphine dosage hospitalized to cancer patients with pain was 80mg in a day and metastatic cancer patients with pain was 101.9mg in a day. 6. In the relation between the disease characteristics and pain level, there is a significant statistical difference : whether subjects had been operated or not : (t=2.88, p=0.005), time of pain is(t=3.34, p=0.005), stage of metastatic(F=9.323, P=0.0002), and type of pain(F=4.013, p=0.0008). In the pain level of diagnosis, Colon cancer was $353.3{\pm}81.7$(F=2.34, p=0.049), the origin of pain, nerve pressure $316.3{\pm}98.5$(F=2.44, P=0.045), In the complication, ascites and obstruction $324.9{\pm}96.8$(T=2.60, P=0.04).

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