• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6997-7005
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• 2013

Aim: To present an epidemiological and histological perspective of diseases of the gastrointestinal tract (including liver and biliary tract) at the Section of Histopathology, Department of Pathology, AKUH, Karachi, Pakistan. Materials and Methods: All consecutive endoscopic biopsies and resections between October 1 and December 31, 2012 were included. Results: A total of 2,323 cases were included. Carcinoma was overwhelmingly the commonest diagnosis on esophageal biopsies (69.1%); chronic helicobacter gastritis (45.6%) followed by adenocarcinoma (23.5%) were the commonest diagnoses on gastric biopsies; adenocarcinoma (27.3%) followed by ulcerative colitis (13.1%) were the commonest diagnoses on colonic biopsies; acute appendicitis (59.1%) was the commonest diagnosis on appendicectomy specimens; chronic viral hepatitis (44.8%) followed by hepatocellular carcinoma (23.4%) were the commonest diagnoses on liver biopsies; chronic cholecystitis was the commonest diagnosis (over 89%) on cholecystectomy specimens. Conclusions: Squamous cell carcinoma comprised 88.8% of esophageal cancers. About 67% were in the lower third and 56.5% were moderately differentiated; mean ages 49.8 years for females and 55.8 years for males; 66% cases were from South West Pakistan. Over 67% patients with gastric adenocarcinoma were males; mean ages 59 and 44 years in males and females respectively, about 74% gastric carcinomas were poorly differentiated; and 62.2% were located in the antropyloric region. About 63% patients with colorectal adenocarcinoma were males; mean ages 46.1 and 50.5 years for males and females respectively; tumor grade was moderately differentiated in 54%; over 80% were located in the left colon. In 21.2% appendicectomies, no acute inflammation was found. Acute appendicitis was most common in young people. Hepatitis C (66.3%) was more common than hepatitis B (33.7%); about 78% cases of hepatocellular carcinoma occurred in males; females comprised 76.7% patients with chronic cholecystitis; and 77.8% patients with gall bladder carcinoma. All resection specimens showed advanced cancers. Most cancers occurred after the age of 50 years.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권1호
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• pp.142-147
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• 1990

구강내에 발생하는 암종은 원발성으로 나타나는 것이 보통이지만 신체내 다른 부위의 원발성 암종에 의해 이차적으로 전이되기도 한다. Clausen 과 Poulsen에 의하면 원발성 암종중에서 breast, lung, kidney, thyroid의 순으로 구강내 전이암종을 많이 나타내는 것으로 알려져 있다. 문헌에 의하면 구강 및 악골에 발생한 전이암종 중에서 약 70%가 adenocarcinoma 이며 주로 혈행적(hematogenous) 전이를 하는 것으로 알려져 있다. 이때 전이는 일차적으로 악골내에, 이차적으로 연조직에 전이되며, 이로인해 발생한 악성 전이 암종은 구강내에 발생하는 악성종양의 약 1%에 해당한다. 그러나, 실제로 이의 발견이 어려운 것은 악골에 대한 일상의 검사가 이루어지지 않으며 환자 자신이 특별한 증상을 호소하지 않기 때문이다. 본 교실에서는 문헌상 빈도수가 적은 gall bladder cancer 와 pancreatic tumor 에서 전이된 암종이 특이하게 악골내에서는 나타나지 않고 연조직에만 발생하였기에 이에 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4057-4059
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• 2013

Background: Fluorescence in situ hybridization (FISH) testing may be useful to screen for bladder carcinoma or dysplasia by detecting aneuploidy chromosomes 3, 7, 17 and deletion of the chromosome 9p21 locus in urine specimens. This study aimed to assess the sensitivity, specificity, positive and negative predictive value of FISH in a multi-ethnic population in Asia. Materials and Methods: Patients with haematuria and/or past history of urothelial cancer on follow-up had their voided urine tested with FISH. Patients then underwent cystoscopy/ureteroscopy and any lesions seen were biopsied. The histopathological reports of the bladder or ureteroscopic mucosal biopsies were then compared with the FISH test results. Results: Two hundred sixty patients were recruited. The sensitivity and specificity of the FISH test was 89.2% and 83.4% respectively. The positive (PPV) and negative predictive values (NPV) were 47.1% and 97.9%. By excluding patients who had positive deletion of chromosome 9, the overall results of the screening test improved: sensitivity 84.6%; specificity 96.4%; PPV 75.9% and NPV 97.9%. Conclusions: UroVysion FISH has a high specificity of detecting urothelial cancer or dysplasia when deletion of chromosome 9 is excluded. Negative UroVysion FISH-tests may allow us to conserve health resources and minimize trauma by deferring cystoscopic or ureteroscopic examination.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5647-5654
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• 2015

Gall bladder cancer (GBC) is a gastro-intestinal cancer with high prevalence among north Indian women. Platelet derived growth factor-B (PDGFB) and human epidermal growth factor receptor-2 (HER2) may play roles in the etiology of GBC through the inflammation-hyperplasia-dysplasia-carcinoma pathway. To study the association of PDGFB and HER2 polymorphisms with risk of GBC, 200 cases and 300 controls were considered. PDGFB +286A>G and +1135A>C polymorphisms were investigated with an amplification refractory mutation system and the HER2 $Ile^{655}Val$ polymorphism by restriction fragment length polymorphism. Significant risk associations for PDGFB +286 GG (OR=5.25) and PDGFB +1135 CC (OR=3.19) genotypes were observed for GBC. Gender wise stratification revealed susceptibility for recessive models of PDGFB +1135A>C (OR=3.00) and HER2 $Ile^{655}Val$ (OR=2.52) polymorphisms among female GBC cases. GBC cases with gall stones were predisposed to homozygous +286 GG and +1135 CC genotypes. Significant risk associations were found for ACIle (OR=1.48), GAVal (OR=1.70), GAIle (OR=2.00) haplotypes with GBC cases and GCIle haplotype with female GBC cases (OR=10.37, P=<0.0001). Pair-wise linkage disequilibrium revealed negative associations among variant alleles. On multi-dimensional reduction analysis, a three factor model revealed significant gene-gene interaction for PDGFB +286A>G, PDGFB +1135A>C and HER2 Ile165Val SNPs with GBC. Protein-protein interaction showed significant association of PDGFB and HER2 with the epidermal growth factor receptor signaling pathway.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.154-163
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• 2000

Growth factors and the receptors play an important role in the regulation of the growth and development of mammalian cells. In particular, epidermal growth factor is a polypeptide with potent mitogenic activity that stimulates proliferation of various normal and neoplastic cells through the interaction with its specific receptor(EGFR). EGFR has been described as a parameter of poor prognosis in many human neoplasms such as breast, bladder, and vulvar cancers. The objectives of this study are the evaluation of the expression of EGFR and cell cycle analysis in the head and neck squamous cell carcinomas(SCC), and the evaluation of the correlation between clinico-patholgic features and expression of EGFR and S-phase fraction. 37 head and neck squamous cell carcinoma specimens were evaluated for expression of EGFR by Western blot analysis and S-phase fraction by cell cycle analysis using the flow cytometry. The obtained results were as follows : 1. The expressions of EGFR were observed in 20 specimens(54%) among 37 head and neck SCC specimens. In case of oral SCC, 15 specimens(56%) out of 27 specimens were observed, and in case of nasopharyngeal SCC 5 specimens(50%) out of 10 specimens. 2. There was no correlation between clinical features(location, stage) of head and neck SCC and expression of EGFR (p>0.05). 3. There was a significant correlation between histo-pathological differentiation of head and neck SCC and expression of EGFR (p<0.02). 4. There was a significant correlation between expression of EGFR and S-phase fraction of cell cycle in the head and neck SCC (p<0.05). The above results suggest that expression of EGFR and S-phase fraction of cell cycle are adjunctive prognostic marker in the head and neck squamous cell carcinomas.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권5호
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• pp.364-371
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• 2002

Many chemical compopunds are converted into reactive electrophilic metabolites by the oxidative(Phase I) enzymes, which are mainly cytochrome P-450 enzyme(CYPs). Phase II conjugating enzymes, such as glutathione S-transferase(GST), usually act as inactivation of enzymes. Genetic polymorphisms have been found to be associated with increased susceptibility to cancer of the lung, bladder, breast and colorectal. Many of the polymorphic genes of carcinogen metabolism show considerably different type of cancer among different ethnic groups as well as individuals within the same group. The aim of this study is (1) to establish the frequencies of genetic polymorphisms of GSTM1 and CYP1A1 in Korean oral squamous cell carcinoma(SCC), (2) to associate oral SCC with the risk of these genetic polymorphisms. The genetic polymorphisms of the GSTM1 and the CYP1A1 genes among 50 Korean oral SCC were analyzed using polymerase chain reaction(PCR). The results suggest that the homozygote and the mutant type of CYP1A1 MspI polymorphisms may be associated with genetic susceptibility to oral SCC in Korean. A combination of the GSTM1 null type with the homozygote(m1/m1), and the mutant(m2/m2) type of CYP1A1 MspI polymorphisms showed a relatively high risk of oral SCC in Korean. In the smoking group, the GSTM1 wild genotype may be the high risk factor of oral SCC in Korean. These data coincide with the hypothesis which states that different susceptibility to cancer of genetic polymorphisms exist among different ethnic group and different types of human cancer.

• Radiation Oncology Journal
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• 제34권2호
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• pp.145-155
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• 2016

Purpose: Radiation therapy targeting axilla and groin lymph nodes improves regional disease control in locally advanced and high-risk skin cancers. However, trials generally used conventional two-dimensional radiotherapy (2D-RT), contributing towards relatively high rates of side effects from treatment. The goal of this study is to determine if three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), or volumetric-modulated arc therapy (VMAT) may improve radiation delivery to the target while avoiding organs at risk in the clinical context of skin cancer regional nodal irradiation. Materials and Methods: Twenty patients with locally advanced/high-risk skin cancers underwent computed tomography simulation. The relevant axilla or groin planning target volumes and organs at risk were delineated using standard definitions. Paired t-tests were used to compare the mean values of several dose-volumetric parameters for each of the 4 techniques. Results: In the axilla, the largest improvement for 3D-CRT compared to 2D-RT was for homogeneity index (13.9 vs. 54.3), at the expense of higher lung $V_{20}$ (28.0% vs. 12.6%). In the groin, the largest improvements for 3D-CRT compared to 2D-RT were for anorectum $D_{max}$ (13.6 vs. 38.9 Gy), bowel $D_{200cc}$ (7.3 vs. 23.1 Gy), femur $D_{50}$ (34.6 vs. 57.2 Gy), and genitalia $D_{max}$ (37.6 vs. 51.1 Gy). IMRT had further improvements compared to 3D-CRT for humerus $D_{mean}$ (16.9 vs. 22.4 Gy), brachial plexus $D_5$ (57.4 vs. 61.3 Gy), bladder $D_5$ (26.8 vs. 36.5 Gy), and femur $D_{50}$ (18.7 vs. 34.6 Gy). Fewer differences were observed between IMRT and VMAT. Conclusion: Compared to 2D-RT and 3D-CRT, IMRT and VMAT had dosimetric advantages in the treatment of nodal regions of skin cancer patients.

• Radiation Oncology Journal
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• 제14권2호
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• pp.129-136
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• 1996

목적 : 담낭과 간외 담도를 포함한 간외 담도계암에 대한 방사선치료의 효과를 평가하고 방사선치료의 역할에 관하여 알아보고자 함이 본 연구의 목적이다. 대상 및 방법 : 1986년 4월에서 1994년 7월까지 본원 치료방사선과에서 외부 방사선치료를 받은 43명의 담낭 및 간외 담도계암 환자를 후향적으로 분석하였다. 23명은 담낭암이었고 20명은 간외 담도암이었다. 23명의 담낭암 환자중에서 제 2병기는 2명, 제 3 병기는 12명, 제 4병기는 9명이었다. 남녀비는 11명대 12명이었다. 15명은 근치적 절제술을 시행하였고, 8명은 조직생검과 우회수술만을 시행하였다. 3명을 제외한 모든 환자에서 수술후 4500 cGy 이상의 방사선을 조사하였으며, 추적기간은 11-82개월 이었다. 20명의 간외 담도암 환자중에서 제 1병기는 1명, 제 2병기는 2명, 제 3병기는 10명, 제 4병기는 7명이었다. 남녀비는 16명대 4명이었다. 16명이 근치적 목적으로 위플씨 수술 또는 절제와 배액술을 시행하였고, 나머지 4명은 우회수술만을 시행하였다. 16명은 수술후 방사선 치료로 4500 cGy 이상 조사하였고, 4명은 3180-4140cGy를 조사하였다. 추적기간은 8-34개월 이었다. 결과 : 담낭암 환자의 전체 중앙 생존기간은 11개월이었다. 제 3병기와 제 4병기의 중앙생존기간은 14개월과 5개월이었으며, 2년 생존율은 각각 $36\%$(4/11)와 $13\%$(1/8) 이었다. 근치적 목적으로 수술을 받은 환자들이 우회수술 만으로 치료받은 환자들보다 통계적으로 유의하게 생존율이 높았다. ($67\%$ : $13\%$ 12개월) 치료와 연관된 합병증으로 사망한 환자는 없었다. 20명의 간외 담도암 환자의 전체 중앙 생존기간은 10개월이었다. 제 3병기 10명과 제 4병기 7명의 중앙 생존기간은 각각 10개월과 8개월이었다. 위플씨 수술을 시행한 2명은 각각 11개월과 14개월간 생존하였으며, 절제와 배액술로 치료한 환자들의 중앙 생존기간은 10개월이었다. 결론 : 간외 담도계암 환자에서 수술후 외부 방사선치료에 의한 합병증은 미미하였으며, 특히 수술후 현미경적 또는 육안적 잔여병변이 있는 환자에서 방사선 치료에 의해 생존율이 증가하는 양상을 나타내었다.

• 대한핵의학회지
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• 제3권2호
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• pp.49-54
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• 1969

The present study has been undertaken to analyze scan manifestations in obstructive jaundice. Scan changes were cprrelated with the duration of jaundice. In addition, clearance rates of trace dose of colloidal radiogold were assessed in each case. The materials were consisted of 19 cases with surgically and/or histopathlogically verified obstructive jaundice from various causes including common duct stone, empyema of the gall bladder and carcinoma of the pancreas head etc. Blood clearance rates of colloidal $^{198}Au$ were determined after the injection of 8 uCi by simple geometrical drawing of recorded strip charts. Scan was performed following additional injection of the same radiogold. In 16 out of 19 cases, the scan revealed rather typical "arborifrom" mottlings around the porta hepatis. The intensity and appearance of such mottlings on the scan was related with the duration of jaundice and level of serum bilirubin and alkaline phosphatase. The blood clearance rates remained to be within normal range in 74 percent of the patients. In the remaining 26 percent, clearance rates ranged between 4.1 and 6 minutes. It is concluded that the association of "arboriform" mottlings and normal or mildly delayed clearance rates in the patients with jaundice is characteristic of obstructive changes in the biliary system.

• Pediatric Infection and Vaccine
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• 제5권1호
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• pp.139-142
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• 1998

BCG osteomyelitis is rare comlication and the incidence rate has been estimated to be 1/milion vaccinated neonate and infants. BCG osteomyelitis is also reported as a complication of intravesical BCG treatment for bladder carcinoma. We had experienced a 14 months old infant who presented swelling, tenderness and redness on left upper arm suspicious due to BCG vaccination. The MRI finding showed $2{\times}4{\times}4cm$ subcutaneous abscess with cortical defect on proximal humerus and axillary lymph adenopathy. The histologic finding showed diffuse caseous necrosis and Langhans type giant cell. We report A case of BCG osteomyelitis.