• Title/Summary/Keyword: Uterine cervical carcinoma

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Human Papillomavirus Prevalence and Distribution according to Age among Korean and Chinese Women (중국과 한국여성에서 나이에 따른 인유두종바이러스의 유병률과 분포)

  • Kim, Geehyuk;Kim, Sunghyun;Park, Sunyoung;Park, Sangjung;Lin, Han;Ren, Yubo;Li, Yingxue;Lee, In Soo;Lee, Jae Dal;Lee, Dongsup
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.259-266
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    • 2015
  • Cervical cancer is the third most common cancer among women worldwide. Cervical cancer is significantly associated with human papillomavirus (HPV) infection. The prevalence of HPV infection is influenced by geography, immune status, sexual history and genetic factors. For example, geographically, HPV prevalence varies from 1.5% to 39%. However, little is known about the relationship between HPV prevalence and age. An analysis of HPV prevalence by age will help determine when high-risk groups are exposed to HPV. Such an analysis could also demonstrate a correlation between specific HPV genotypes and age. In addition, the analysis might clarify the optimum age for using vaccines. In this study, HPV prevalence and genotype distribution among Korean and Chinese women are analyzed by age. The REBA HPV-ID$^{(R)}$ assay (YD diagnostics, Yong-in, Republic of Korea) was used for detecting HPV genotypes in uterine cervical liquid-based cytology samples from 533 women from Korea and 324 from East China (Western Shandong province. Women with severe dysplasia such as SCC (Squamous cell carcinoma) and HSIL (High-grade squamous intraepithelial lesion) groups were primarily in their 40s and 50s, whereas women with mild and moderate dysplasia (ASCUS and LSIL groups) were primarily in their 30s and 40s. Women with HPV genotype 16 and 18 infections were primarily in their 40s. The results suggest that HPV infection is associated with certain age groups in the Korean population.

The Expression of Vascular Endothelial Growth Factor (VEGF) is a Highly Significant Prognostic Factor in Stage IB Carcinoma of the Cervix (병기 IB 자궁경부암에서 혈관내피세포성장인자(VEGF)의 발현이 예후에 미치는 영향)

  • Lee Ik Jae;Park Kyung Ran;Lee Jong Young;Lee Kang Kyoo;Song Ji Sun;Lee Kwang Gil;Cha Dong Soo;Choi Hyun Il
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.335-344
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    • 2001
  • Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

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Results of Radiotherapy for the Uterine Cervical Cancer (자궁경부암의 방사선치료성적)

  • Kim, Chul-Yong;Choi, Myung-Sun;Suh, Won-Hyuck
    • Radiation Oncology Journal
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    • v.6 no.1
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    • pp.63-73
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    • 1988
  • One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIGO including physical examination, pelvic examination, cystoscopy, rectosigmoidoscopy, chest X-ray, IVP. Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; in case of radiation therapy only, whole pelvic irradiation was given with Co-60 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cGy per day, 5 days per week and intracavitary insertion was performed. In satges Ia, Ib, and IIa with small primary lesion, external irradiation was initially given to pelvis up to $2,000\~3,000\;cGy/2frac{1}{2}\;-3frac{1}{2}$ weeks and then intracavitary insertion was performed using Fletcher-Mini-Declos Applicator with cesium-137 cources and followed by external irradiation of $1,000\~2,000\;cGy/1frac{1}{2}\;-2frac{1}{2}$weeks via AP and PA parallel opposing fields with midline shield to spare of bladder and rectum. However, if the primary lesion is large, external irradiation was given without midline shield. More than stages IIb, the patients were treated by external beam irradiation up to 5,400cGy/30f for 6 weeks via 4-oblique portals and at the dose of 5,040cGy/28f the field was cut 5cm from the top margin for spare of small bowel, and followed by intracavitary irradiation, If there was residual tumor an additional dose of $900\~l,200cGy/5\~7f$ was given to parametrium and/or residual tumor area. Total dose of radiation to A and B-point were as follows; A-point; In early stages, Ia, Ib, IIa; $8,000\~9,000$ B-point $5,000\~6,000 cGy$ A-point; In advanced stages IIb, IIIa, IIIb; $9,000\~10,000$ B-point $60,000\~7,000cGy$ The results were obtained and as fellows; 1 The patients distribution according to FIGO staging system were stage Ia 6, Ib 27, IIa 28, IIb 54, IIIa 12, IIIb 18, and stage IVa 9. 2. Value of CT scan were demonstration of cervix tumor mass, parametrial and pelvic side wall tumor spread, pelvic and inguinal lymph nodes metastases, and hydronephrosis. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. 3. Local control rate of tumor according to the size was $91.3\%$ for less than 5cm in size and $44.6\%$ in tumor over 5cm (p<0.0068). 4. Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the para-aortic lymph nodes were the most common site for distant metastases. 5. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. 6. The 5-year survival rates showed; stage la and Ib $95\%,\;stage\;IIa\;81\%\;stage\;lIb\;67\%,\;stage\;IIIa\;37.7\%,\;stage\;IIIb\;23\%$ and 3-year survival rate of stage IVa showed $11.6%$, retrospectively.

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

  • Kim, Young-Jun;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.400-406
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    • 1992
  • Background: It has been known that see antigen was used in diagnosis of uterine cervical cancer and also known to be higher in squamous cell lung cancer. There has been no report about see antigen in squamous cell lung cancer in Korea. This study was designed to evaluate the usefulness of see antigen as a diagnostic tool and index for follow up after treatment. Method: The serum level of see antigen was measured in 12 cases with squamous cell lung carcinoma, 9 patients with other types of lung cancer, 7 patients with benign lung disease and 7 normal subjects by radioimmunoassay with Abott see Riabeap radioimmunoassay kit. We also measured see antigen after treatment in 6 patients who had received chemotherapy or sugery. Result: 1) The level of see antigen ($mean{\pm}1$ SD) was $2.27{\pm}1.53$, $0.67{\pm}0.38$, $0.62{\pm}0.53$, $0.53{\pm}0.36\;ng/ml$ respectively. 2) The see antigen activity in squamous cell lung carcinoma according to stage were as gollows. I; $2.07{\pm}1.56$, $III_a$; $5.04{\pm}0.53$ $III_b$; $1.94{\pm}0.7$ IV; $1.07{\pm}0.64$ (ng/ml). 3) In squamous cell lung cancer, 5 of 12 (42%) cases was shown more than 2.0 ng/ml see antigen. (sensitivity; 42%), but there was no case in any other type of lung cancer, benign lung disease, and in control groups (specificity; 100%). 4) The serum sec antigen level after treatment was significantly decreased in patients with partial or complete remission (p<0.01). Conclusion; It was suggested that see antigen might be used as a useful tumor marker for the response of treatment and assessment of prognosis in squamous cell lung cancer, but further study should be performed for the clinical use of see antigen.

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Change of Frequency of Chromosome Aberration by Time Interval after Radiation Therapy (방사선 치료후 시간경과에 따른 염색체이상 빈도의 변화)

  • Kim, Mi-Sook;Yi, Chun-Ja;Ha, Sung-Whan;Song, Myung-Jae;Kim, Hee-Jeun
    • Journal of Radiation Protection and Research
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    • v.19 no.1
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    • pp.51-68
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    • 1994
  • It is good method to use frequency of chromosome aberration in Lymphocytes for a biological dosimetry in cases of accidental exposure to radiation. But in cases of past exposure, biological dosimetry is limited because the frequency of aberration decreases by time after exposure. To provide a basic data for estimation of past radiation exposure, the changing pattern of frequency of unstable chromosome aberration by time interval after exposure was studied. Observation was made on peripheral lymphocytes of 41 blood samples from 20 patients treated for uterine cervical carcinoma and endometrial carcinoma. The patients received 50.4Gy radiation to whole pelvis. Elapsed times after the completion of radiation therapy were 1 day, 3, 6, 9, 12, 24, 52, 104, 156, 208, 260 and 520 weeks. All the blood sample were microcultured. The Ydr, Qdr and Qdra were calculated from frequency of unstable aberration. Ydr did not decrease for 3 weeks after radiation therapy, and thereafter, decreased very rapidly and reached 0.05 at two years after radiation therapy and decreased very slowly until 5 years after radiation therapy. Relationship between unstable chromosome aberration and time interval after radiation therapy was described as $Ydr=0.259{\times}exp(-0.0429T)+0.0560{\times}exp(-0.00106T)$ (time in weeks) Qdr remained constant at 1.51 until 24 weeks after radiation therapy and then decreased to 1.17 at 52 weeks. Therafter, it did not change. Qdra remained constant at 1.10 for 12 weeks after radiation therapy and decreased to 0.81 at 52 weeks. Thereafter, it remained constant. Two superimposed exponential Ydr disappearance rate suggests that it is possible to calculate the past exposure dose. When the elapsed time after exposure is short, Qdr and Qdra are useful papameters for biological dosimetry for past radiation exposure.

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The Relationship between F-18-FDG Uptake, Hexokinase Activity and Glut-1 Expression in Various Human Cancer Cell Lines (다양한 사람 종양세포주에서 F-18-FDG의 섭취와 Hexokinase 활성 및 Glut-1 발현과의 상관관계)

  • Kim, Bo-Kwang;Chung, June-Key;Lee, Yong-Jin;Choi, Yong-Woon;Jeong, Jae-Min;Lee, Dong-Soo;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.294-302
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    • 2000
  • Purpose: To investigate the mechanisms related to F-18-FDG uptake by tumors, F-18-FDG accumulation was compared with glucose transporter-1 (Glut-1) expression and hexokinase activity in various human cancer cell lines. Materials and Methods: Human colon cancer (SNU-C2A, SNU-C4, SNU-C5), hepatocellular carcinoma (SNU-387, SNU-423, SNU-449), lung cancer (NCI-H522, NCI-H358, NCI-H1299), uterine cervical cancer (HeLa, HeLa 229, HeLa S3) and brain tumor (A172, Hs 683) cell lines were used. After 24 hr incubation of $5{\times}10^5$ cells, 37 kBq F-18-FDG was added and the uptake by cells at 10 min was measured using a gamma counter. Hexokinase activity was measured by continuous spectrophotometric rate determination. To measure mitochondrial hexokinase activity, mitochondrial fraction was separated by a high speed centrifuge. Immunohistochemical staining of Glut-1 was performed, and graded as 0, 1, 2, or 3 according to expression. Results: There was difference among F-18-FDG uptake, total and mitochondrial hexokinase activity, and Glut-1 expression with different cancer cell lines. The correlations of F-18-FDG with total hexokinase and mitochondrial hexokinase activity were low (r=0.27 and 0.26, respectively). Glut-1 expression showed a good correlation with F-18-FDG uptake (p=0.81, p=0.0015). Previously, we reported no correlation of F-18-FDG uptake with hexokinase activity in colon cancer cell lines. Thus, when colon cancer cells were excluded, F-18-FDG uptake showed higher correlation with total hexokinase and mitochondrial hexokinase activity (r=0.81, p=0.0027 and r=0.81, p=0.0049, respectively). Conclusion: Both Glut-1 expression and hexokinase activity were contributing factors related to F-18-FDG accumulation in human cancer cell lines. The relative contribution of Glut-1 expression and hexokinase activity, however, was different among different cancer cell types.

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