• 동의생리병리학회지
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• 제19권4호
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• pp.965-972
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• 2005

To investigate the effects of Trichosanthes semen extract on the growth and apoptosis of human uterine cervical carcinoma cells. Effects of Trichosanthes semen extract on the growth of ME-180 cells were assayed by MTT assay. Apoptosis induced by Trichosanthes semen extract was detected by fluorescent microscopy, DNA fragmentation analysis and flow cytometry. Caspase-3 and caspase-8 activities were assayed. Trichosanthes semen extract induced ME-180 cells to die in a dose- and time-dependent manner. ME-180 cells treated with Trichosanthes semen extract exhibited typical characteristics of apoptosis. The population of Sub-G1 cells increased significantly, and the cells represented the reduced size, condensed chromatin and apoptotic bodies. They showed the decreased mitochondrial membrane potential and increased activities of caspase-3 and caspase-8. The results suggest that Trichosanthes semen extract induced ME-180 cell apoptosis and the activation of caspase and mitochondrial pathway were involved in the process of Trichosanthes semen extract-induced apoptosis.

• Journal of Yeungnam Medical Science
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• 제16권2호
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• pp.296-301
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• 1999

자궁의 MMMT와 자궁내막암을 감별진단할 수 있는 자기공명영상 소견을 알아보기 위하여 자궁적출술에 의해 병리적으로 확인된 5례의 MMMT와 14례의 자궁내막암을 대상으로 종괴의 크기, 자궁근층 및 자궁경부의 침범 유무, 종괴의 성장 양상, 신호강도와 조영증강의 정도 및 양상을 후향적으로 분석하였다. 종괴의 장경은 MMMT가 1.5-9cm(평균, 5.7cm)이었고, 자궁내막암은 0.5-6.0cm(평균, 2.5cm)이었다. MMMT 5례 중 3례에서 자궁경부의 침범이 확인되었는데, 이들은 자궁강과 자궁경부의 내강을 확장시키면서 외자궁구로 성장하는 양상을 보였으며, 자궁내막암은 14례 중 1례에서만 자궁경부 침범이 확인되었다. 자궁근층 침범의 유무, T1- 및 T2-강조영상에서의 신호강도와 균일성, 조영증강의 정도와 양상은 별다른 차이가 없었다. 이상의 결과에서, MMMT와 자궁내막암을 감별할 수 있는 특이한 소견은 확인할 수 없었으나, 종괴가 5cm 이상으로 크고, 자궁경부 내강을 확장시키면서, 자궁경부를 침범하는 경우에는 MMMT의 가능성을 고려해야 할 것으로 생각한다.

• 대한의생명과학회지
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• 제22권2호
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• pp.37-45
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• 2016

High risk human papillomavirus (HR-HPV) is major risk factor for uterine cervical cancer. There are approximately 15 types of HR-HPV. Liquid based cytology samples (116 samples) with high grade cervical lesions belonging to cervical intraepithelial neoplasia (CIN) 2, CIN 3, carcinoma in situ (CIS) and squamous cell carcinoma (SCC) were used after histologic confirmation. HR-HPV genotype assay was conducted using DNA chips. The HR-HPV infection rate was 81.9% with SCC samples showing the highest HR-HPV infection rate of 31%. CIN 3, CIS and CIN 2 showed infection rates of 25%, 16.4% and 9.5%, respectively. According to age with HR HPV infection rate, the 30~39 years-old group showed the highest infection rate by 92.3%. According to distribution with HR HPV genotyping, HPV 16 showed the highest infection rate by 42.3% whereas HPV 33 and HPV 58 showed infection rates of 11.7% and 10.8%, respectively. HPV 18 which is the second most common infected HPV genotype in the world showed 3.6%. Of the three most common oncogenic HR-HPV genotypes in CIN 2, we detected HPV 16, 35, 58; CIN 3 was HPV 16, 33, 58; CIS was HPV 16, 58, 33 (35/52); and SCC was HPV 16, 33, and 18 (31/52/58). Among the HPV 18, CIN 2, CIN 3, CIS and SCC showed 0.9%, 0.9%, 0% and 1.8%, respectively. The most often used preventive vaccines for cervical cancers use HPV 16 and HPV 18 as targets. However, results derived from this study suggest that a preventive vaccine against HPV 16 and HPV 18 would not be optimal for populations in this study.

• 동의생리병리학회지
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• 제21권6호
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• pp.1513-1519
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• 2007

Yukwool-tang (YWT) is a traditional Chinese medicine, which has been used for patients suffering from a uterine disease in Oriental medicine. In the present study, it was examined the biochemical mechanisms of apoptosis by YWT in human cervical carcinoma HeLa cells. It was found that YWT could inhibit the cell growth of HeLa cells in a dose-dependent manner, which was associated with apoptotic cell death such as formation of apoptotic bodies and DNA fragmentation. Flow cytometry analysis confirmed that YWT treatment increased populations of apoptotic-sub-G1 phase of the cell cycle. We observed the p53-independent induction of p21 proteins, down-regulation of anti apoptotic Bcl-2 expression and proteolytic activation of caspase-3 in YWT-treated HeLa cells. YWT treatment also concomitant degradation and/or inhibition of poly (ADP-ribose) polymerase (PARP), phospholipase C-1 ($PLC{\gamma}1$), ${\beta}-catenin$ and DNA fragmentation factor 45/inhibitor of caspase-activated DNase (DFF45/ICAD). Taken together, these findings partially provide novel insights into the possible molecular mechanism of the anti-cancer activity of YWT.

• Radiation Oncology Journal
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• 제16권4호
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• pp.357-366
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• 1998

Brachytherapy is an essential part of radiotherapy for uterine cervical cancer. The low dose rate (LDR) regimen has been the major technique of intracavitary therapy for cervical cancer. However, there has been an expansion in the last 20 years of high dose rate (HDR) machines using Ir-192 sources. Since 1979, HDR brachytherapy has been used for the treatment of uterine cervical cancer in Korea. The number of institutions employing HDR has been increasing, while the number of low dose rate system has been constant. In 1995, there was a total 27 HDR brachytherapy units installed and 1258 cases of patients with cervical cancer were treated with HDR Most common regimens of HDR brachytherapy are total dose of 30-39 Gy at point A with 10-13 fractions in three fractions per week. 24-32 Gy with 6-8 fractions in two fractions per week, and 30-35 Gy with 6-7 fractions in two fractions per week. The average fractionation regimen of HDR brachytherapy is about 8 fractions of 4.1 Gy each to Point A. In Korea, treatment results for HDR brachytherapy are comparable with the LDR series and appears to be a safe and effective alternative to LDR therapy for the treatment of cervical carcinoma. Studies from the major centers report the five-year survival rate of cervical cancer as. 78-86$\%$ for Stage 1, 68-85$\%$ for stage 11, and 38-56$\%$ for Stage III. World-wide questionnaire study and Japanese questionnaire survey of multiple institutions showed no survival difference in any stages and dose-rate effect ratio (HDR/LDR) was calculated to be 0.54 to 0.58. However the optimum treatment doses and fractionation schemes appropriate to generate clinical results comparable to conventional LDR schemes have yet to be standardized. In conclusion, HDR intracavitary radiotherapy is increasingly practiced in Korea and an effective treatment modality for cervical cancer. To determine the optimum radiotherapy dose and fractionation schedule, a nation-wide prospective study is necessary in Korea. In addition, standardization of HDR application (clinical, computer algorithms, and dosimetric aspects) is necessary.

• Radiation Oncology Journal
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• 제29권3호
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• pp.191-198
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• 2011

Purpose: Although the role of squamous cell carcinoma antigen (SCC-Ag) as a predictive and prognostic factor for uterine cervical cancer has been identified in previous studies, 1) the effective patient group of screening for recurrence with SCC-Ag, 2) the relationship between SCC-Ag and recurrence site, and 3) the relationship between the change of SCC-Ag and treatment outcome or recurrence have not been described. Materials and Methods: The study included 506 patients with histologically proven uterine cervical cancer between January 1994 and December 2010. We determining the serum SCC-Ag level before treatment and after treatment, and conducted a retrospective review of the patients' records. We evaluated the sensitivity and specificity of SCC-Ag for the detection of tumor recurrence by comparing biochemical recurrence with clinical recurrence. Results: The pretreatment SCC-Ag level and the proportion of patients over 1.5 ng/mL were higher in poor prognostic patient group. In the univariate and multivariate analysis, pretreatment SCC-Ag showed a statistically significant correlation with tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology. In patients with biochemical recurrence vs. those without, 5-year DFS and OS were 27.6 vs. 92.7% (p ${\leq}$ 0.001) and 53.7 vs. 92.5% (p ${\leq}$ 0.001), respectively. Conclusion: Our study reconfirmed the known function of pretreatment SCC-Ag, but could not confirm the function of biochemical response as a predictive factor for treatment and as a prognostic factor. There was no statistically significant relationship between SCC-Ag level and recurrence site. We confirmed the role of SCC-Ag as a follow-up tool for recurrence of disease and which patient groups SCC-Ag was more useful for.

• Radiation Oncology Journal
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• 제31권4호
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• pp.216-221
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• 2013

Purpose: The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Materials and Methods: Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. Results: The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Conclusion: Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

• 대한세포병리학회지
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• 제19권2호
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• pp.111-118
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• 2008

Background : Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. Materials and Methods : We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed. Results: The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%. Conclusions : Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.

• Radiation Oncology Journal
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• 제18권4호
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• pp.300-308
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• 2000

목적 :자궁경부암은 우리나라 여성에서 가장 많은 발생을 보이는 악성종양으로 비교적 완치율이 높은 것으로 알려져 있다. 자궁경부암의 치료는 병원 마다 매우 다양해졌으나 방사선에 의한 치료가 주이며 높은 완치율을 얻고있다. 치료의 실패는 대부분 3년이내에 일어나며, 국소재발시에는 자궁방 결합조직에서 더 많이 재발하는 것으로 보고되고 있다. 이에 저자들은 방사선치료를 받은 자궁경부암 환자를 대상으로 이들의 치료성적과 재발여부를 후향적으로 분석하여 생존률과 재발에 영향을 미치는 인자들을 분석하여 보았다. 대상 및 방법 : 1981년 1월 1일부터 1998년 12월 31일까지 고려대학교 방사선 종양학과에서 자궁경부암으로 방사선 치료를 받은 970명중 추적관찰이 가능했던 827명을 대상으로 하였다. 대상환자는 방사선 단독치료군과 수술후 방사선치료군으로 나누었으며 각 환자에 대하여 나이, 임상적 병기, 세포병리학적 소견, 재발유무 등이 치료결과에 미치는 영향을 알아보았고 특히 치료 후 자궁경부질세포진검사(Papanicolaou smear; Pap smear), 배아성항원(carcinoembryogenic antigen; CEA)와 편평상피 암종항원(squamous cell carcinoma antigen; SCC antigen) 수치가 생존률과 국소재발에 유의한 인자인가를 알아보았다. 결과: 전체환자의 평균나이는 51.3세(방사선 단독치료존 53.1세, 수술 후 치료곰 48.3세)였고, 평균 추적관찰기간은 38.6개월(방사선 단독치료군: 38.8개월, 수술후 치료군: 38.4개월)이었다. 방사선 단독치료군의 경우 대상환자는 521명이었고, 임상병기는 CIS; 5명, IA; 3명, IB; 36명, IIA; 77명, IIB; 284명, IIIA; 31명, IIIB; 47명, IVA; 21명, IVB; 3명, 재발암 14명이었다. 세포병리학적 소견상 편평상피암 495명, 선세포암 23명이었고 완치상태로 추적관찰된 환자는 314명(60.3$\%$), 국소재발: 47명(9$\%$), 대동맥 림프절전이; 28명(5$\%$), 폐전이: 19명(4$\%$), 골전이: 12명(2$\%$)이었다. 수술 후 치료군은 326명이었고 임상병기는 CIS; 6명, IA: 50명, IB: 181명, IIA; 46명, IIB; 43명이었다. 세포병리학적 소견상 편평상피암: 291명, 선세포앓 32명이었고, 완치상태로 추적관찰된 환자는 276명(85$\%$), 국소재발 8명(2$\%$), 대동맥 림프절전이: 7명(2$\%$), 폐전이: 10명(3$\%$), 골전이; 10(3$\%$)이었다. 전체환자를 대상으로 분석한 결과 5년 생존율은 71.2$\%$(방사선 단독치료군: 55.8$\%$, 수술 후 치료군: 88.1$\%$)였고 생존율에 있어서는 단변량분석상 임상병기(p=0.0001), 재발유무(p=0.0001), 방사선치료 후 자궁경부질세포진검(p=0.0329), CEA수치($\geq$5 ng/ml, p=0.00001), SCC수치$\geq$2 ng/ml, p=0.0001)가 의미있는 인자로 나타났고, 재발율에 있어서는 CEA가 $\geq$5 ng/ml인 경우, SCC는 $\geq$2 ng/ml인 경우가 2$\~$3배 높은 것으로 나타났다. 결론: 방사선치료 후 Pap smear, CEA, SCC는 생존율과 재발율에 모두 비교적 의미있게 작용하는 예후인자로 나타나 앞으로 방사선치료 후 환자의 추적관찰시 자궁경부암의 국소재발과 전이 그리고 생존률을 미리 예견할 수 있는 지표로 삼을 수 있을 것이다.

• Investigative Magnetic Resonance Imaging
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• 제2권1호
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• pp.113-119
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• 1998

목적 : 자궁경부 선암종은 자궁경부 편평 세포 암종보다 림프절 전이와 국소적인 파급이 빨리 일어나고 5년 생존율이 낮으므로 임상적으로 선암종이 진단되었거나 의심될 경우에는 방바선학적 검사로 종양의 림프절 전이와 국소적인 파급을 세심하게 평가할 필요가 있다. 본 연구의 목적은 자궁경부 선암조의 자기공명영상(MRI) 소견을 분석하려 편평 세포암종과 다른 특징이 있는지 알아보는 데에 있다. 대상 및 방법 : 병리학적으로 확진된 자궁경부 선암종 환자 21명 중 MRI에서 종양이 관찰되는 18명(조직학적 병기 : Ib 10예, IIa 4예, IIb 2예, IIIa 1예, IIIb 1예)을 대상으로 그 MRI 소견을 후향적으로 분석한 후, 최근에 연속적으로 입원하여 편평 세포 암종으로 확진된 40명의 환자로 구성된 대조군과 비교하였다. 1.5T의 MRI기기로 조영 전후의 T1강조 및 급속 스핀 에코 T2 강조 영상을 축상 및 시상면에서 얻었다. MRI에 나타난 종양의 최대직경, 위치, 신호강도 및 조영증강정도, 윤곽, 형태, 상하 침범 범위, 동반 질환 유무 등을 분석하였다. 결과 : 자궁경부 선암종의 최대 직경은 0.8-4.1cm(평균 2.2cm)이었고, 이 종양이 경관내막을 따라 위치한 경우가 9예이었다. 모든 선암종의 신호 강도는 T1 강조 영상에서 주위 자궁경부 간질과 비슷하였고 급속 스핀 에코 T2 강조 영상에서는 높았다(균질성 10, 비균질성 8). 모든 선암종은 gadolinium 정맥 주입시 모두 조영 증강되었다(균질성 6, 비균질성 12 : 높은 신호강도의 고리 2). 선암종의 윤곽이 매끈한 경우가 8예이었고, 불규칙한 경우가 10예이었다. 선암종의 모든 예에서 자궁경부의 하부가 침범되었는데, 이중에서도 상부까지 침범된 경우는 6예이었다. 선암종 2예에서는 MRI상 직경 1.5cm 이상의 골반강 림프절들이 관찰되었고, 1예의 MRI에서는 림프절이 관찰되지 않았는데, 병리 검사상 모두 악성으로 판명되었다. 2예의 선암종에서 자궁 유수증이, 1예에서 자궁 유혈증이 동반되었다. 이상의 소견을 편평 세포 암종의 대조군과 비교하였을 대 선암종에서 경관내막형과 술통형이 더 많은 것이 통계학적으로 유의하였다. 결론 : 자궁경부 선암종은 편평 세포 암종에 비해 경과내막형, 술통형이 많은 MRI 소견을 보였다. MRI에서 자궁경부암의 모양이 경관내막을 따라 술통형이거나 병기가 낮은데도 주위 림프절로 파급되는 경향을 보이면, 자궁경부 선암종을 의심할 수 있을 것이다.