• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1181-1186
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• 2014

Sialyltransferase gene expression is altered in several cancers, including examples in the cervix. Transcriptional regulation of the responsible genes depends on different promoters. We aimed to determine the association of single-nucleotide polymorphisms in the B3 promoter of the ST3GAL4 gene and the P1 promoter of the ST6GAL1 gene with cervical premalignant lesions or cervical cancer. A blood sample and/or cervical scrapes were obtained from 104 women with normal cytology, 154 with premalignant lesions and 100 with cervical cancer. We also included 119 blood samples of random donors. The polymorphisms were identified by sequencing from PCR products. For the B3 promoter, a fragment of 506 bp (from nucleotide -408 to +98) was analyzed, and for the P1 promoter a 490 bp (-326 to +164) fragment. The polymorphism analysis showed that at SNP rs10893506, genotypes CC and CT of the ST3GAL4 B3 promoter were associated with the presence of premalignant lesions (OR=2.89; 95%CI 1.72-4.85) and cervical cancer (OR=2.23; 95%CI 1.27-3.91). We detected only one allele of each polymorphism in the ST6GAL1 P1 promoter. We did not detect any genetic variability in the P1 promoter region in our study population. Our results suggest that the rs10893506 polymorphism -22C/T may increase susceptibility to premalignant and malignant lesions of the cervix.

• 대한의생명과학회지
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• 제4권2호
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• pp.143-151
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• 1998

1998년 8월 5일부터 1998년 8월 12일까지 8일간 경상북도 울릉도에서 지역 여성 330명을 대상으로 자궁경부암 발생과 관련된다고 알려진 역학적 요인의 설문과 자궁경부암 집단검진으로 많이 이용되는 자궁경부 Pap. smear를 실시하여 다음과 같은 결과를 얻었다. 검사자의 평균연령은 52.1세였고 50대와 60대의 연령분포가 전체 검사자의 49.0%를 차지하였으며, 교육정도는 중학교 이하가 56.9%로 낮은 교육수준을 나타내었고, 첫 성교연령은 21세 이하가 43.9%를 차지하였고, 첫 임신연령은 21세 이하에서 33.3%로 나타났다. 총 임신횟수는 5회 이상인 대상자는 전체의 52.1%를 차지하였고, 5회 이상의 출산을 한 응답자는 전체의 24.5%였다. 전체의 68.8%에서 유산경험이 있었으며, 대상자의 80.0%에서 남편이 포경수술을 하지 않은 것으로 나타났다. 증상은 전체의 52.1%에서 증상이 있다고 응답하였으며, 증상이 있는 응답자의 증상으로는 대하 48.3%, 소양증 21.5%로 나타났다. 자궁암세포검사 경험과 빈도에서 자궁암세포검사를 받아본적이 있는 응답자는 전체의 63.9%였으며, Pap. smear결과와 검사유무의 관찰에서 정상군보다 비전형세포와 이형성증이 있는 군에서 검사를 받아 본 경험이 유의하게 낮게 관찰되었다(p＜0.05).검사를 받아 본 응답자 중 검사경험자의 44.1%에서 단 1회의 검사를 받아보았고, 30.3%는 비정기적으로 검사하였다. 한 번도 검사를 받은 경험이 없는 응답자의 이유로는 특별한 이상이 없었기 때문 51.3%, 부끄러움 때문에 16.8%나타났다. 자궁경부도말의 세포학적 검사결과는 정상 45.8%, 염증 47.3%, 트리코모나스증과 캔디다증이 1.8%, 비정형세포 4.5%, 이형성증이 0.6%였다.인되어, 국내에서도 진드기 교상시 이들 두 가지 열성질환이 동시에 감염될 가능성이 있는 것으로 사료됨으로 진드기 매개성 열성질환에 대한 적절한 진단법 등을 보다 체계적으로 연구하여야 할 것으로 판단된다.A typing 방법은 비교적 빠른 시간 내에 많은 종류의 HLA 대립 유전자형을 정확하게 구분할 수 있으므로 앞으로 tissue typing 실험실에서 유용하게 활용될 수 있을 것으로 생각된다. 또한 DNA typing방법을 이용하여 분석한 한국인의 HLA-class I, II 유전자군의 유전자형 빈도는 골수이식을 비롯한 각종 이식검사, 특수 질환 관련검사나 인류유전학연구 등 HLA 유전자의 임상적 활용을 위한 자료로 사용될 수 있을 것으로 기대된다.있음을 볼 수 있으며 하루 세끼의 식사형태에서 밥을 중심으로 하는 비율은 국내 보다 크게 낮았지만 여전히 다른 식사형태 보다 높은 것을 알 수 있다. 한국 고유의 식문화 특성을 가지면서 거주지역의 식품생산 및 사회 문화적 특성에 영향을 받음으로써 거주국의 식품, 식사 형태, 조리방법을 도입하는 등 부분적으로 변화가 진행되고 있음을 확인 할 수 있었다.가장 시급한 개선점이라고 생각된다. 따라서 효과적인 급식운영을 하기 위해서는 학교식당은 맛, 다양한 메뉴의 식단, 위생, 가격의 저렴 등을 통해서 급식대상자들이 만족한 급식을 할 수 있도록 체계적인 관리 및 운영을 통해 적극적으로 개선해 나가야 할 것으로 사료된다.er (p<0.05), $T_{max}$ might be an insignificant parameter because cyclosporin A generally requires long-term administration. From these results, the two products

• 대한임상검사과학회지
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• 제47권3호
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• pp.132-139
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• 2015

최근 $p16^{INK4a}$/Ki-67 이중면역염색은 액상세포검사에서 자궁경부 이형성증과 암을 조기에 발견하기 위한 새로운 생체 표지자로 대두되고 있다. 저자들은 자궁경부질도말의 액상세포검체 총 109례에서 CINtec$^{(R)}$ PLUS kit를 사용하여 $p16^{INK4a}$/Ki-67 이중면역염색을 시행하였고, 그 결과를 액상세포검사, HPV hybrid capture II (HC II) 검사 그리고 조직학적 진단과 서로 비교하였다. $p16^{INK4a}$/Ki-67 양성 발현은 세포학적 진단에서 저등급 편평상피내병변 이상의 증례 그리고 조직학적 진단에서 자궁경부 상피내종양 1등급 이상의 증례에서 유의미하게 높았다. 액상세포검사상 비정형 편평 상피세포 소견을 보이는 46례 중, 31례 (67.4%)가 $p16^{INK4a}$과 Ki-67 양성 소견을 보였고, 이러한 양성 증례들은 조직검사에서도 대부분 자궁경부 상피내종양 1등급 이상의 병변에 해당하였다. 자궁경부 상피내종양 1등급 이상의 병변을 발견하기 위한 $p16^{INK4a}$/Ki-67 이중면역염색의 민감도는 액상세포검사보다 높은 89.0%였고, 특이도는 73.5%로 HC II 검사보다 높게 분석되었다. 따라서, $p16^{INK4a}$/Ki-67 이중면역염색 방법은 액상세포검사법의 민감도와 HC II 검사법의 특이도를 보완하기 위한 진단적 검사로 유용하다고 할 수 있다.

• 대한미생물학회지
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• 제17권1호
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• pp.7-14
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• 1982

A model of induction of neoplasia by viruses has develpoed from experimental studies in animals and in cultured cells and oncogenic transformation of cells is the result of integration of viral genetic information into the cellular DNA. The evidence for these associations was derived primarily from seroepidemiologic investigation. However, data indicating that the relation between HSV-2 and cervical cancer fits the model derived from experimental animal studies are not yet sufficient to draw conclusion with regard to the etiologic role the virus in the development of the neoplasms. In other hand, the K562 tumor cell is highly susceptible target for natural killer cell lysis by the lymphocytes of human and murine periperal blood. The characteristics of this effector cell type has been investigated. A study on natural killer cell mediated cytotoxicity(NKMC) against $^{51}Cr$-K562 as target cell was studed in HSV-2 infected ICR mouse. We have studied for susceptibility of HSV-2 against mouse embryo fibroblast(MEF) cells and NKMC from HSV-2 infected mouse. The results obtained that the mouse embryo fibroblast cells culture, the number and size of the cells were markedly increased and formed a monolayers relatively rapid, and become complete monolayer sheet around 72 hrs. Duration of cytopathic effect on MEF cells was rapid by serial passing of HSV-2. The morphology of the HSV-2 infected cells appear to be mainly round, ovium, spindle form and some of them was forming large giant cells. The NKMC was decrease in mouse with HSV-2 and comparison between effector/target cells ratio as 25:1 and 50:1 respectively, the NKMC was found to be more significantly decreased than normal control we have concluded that the natural killer cell activity of the viral infected mouse was shown as a suppressed during the HSV-2 infection, day 7th and 14th.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4815-4818
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• 2013

Background: Atrophic epithelium of cervix sampled from postmenopausal women may mimic high-grade cervical intraepithelial neoplasia in Papanicolaou-stained (Pap) smears. Ki-67 (MIB-1) protein presents on proliferating cells, and percentage of cells with positive nuclei provides a reliable tool for rapid evaluation of the growth fraction. The aim of this study was to determine the diagnostic value of protein Ki67 staining in atypical pap smears of postmenopausal women. Methods: In a case-control setting, pap smears of 75 women with an atypical pap smear (case group) and 75 with normal pap smears (controls) were obtained before and after estrogen treatment. Afterward, samples were exposed to the monoclonal antibody Ki-67 (MIB-1) and the immunohistochemically demonstrated Ki-67+ cells were compared. Results: Mean ages of cases and controls were $60.4{\pm}4.5$ and $59.9{\pm}4.3$ years respectively (P=0.50). There was one (2.7%) positive Ki-67 specimen in the case group, without any positive Ki-67 specimen in the control group (P=0.50). Conclusions: Measurement of proliferative activity index in Pap smears restrained with MIB1 is a simple, reliable, and cost-effective method for excluding negatives. This would imply that it might allow a substantial reduction of diagnostic estrogen courses and subsequent Pap smears in postmenopausal women with atypical findings.

• 한국동물번식학회:학술대회논문집
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• 한국동물번식학회 2003년도 학술발표대회 발표논문초록집
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• pp.54-54
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• 2003

The activation of protooncogenes or the inactivation of their gene products may be a specific and effective functional study for human neoplasia. To examine this possibility, we have used the tetracycline regulatory system to generate transgenic mice that conditionally express the HccR-2 protooncogene in vivo. The new human cervical cancer protooncogene (HccR-2) was detected from cervical cancer cell line. To elucidate its biological functions, we generated transgenic mice that expressed the HccR-2 gene. The sustained expression of the HccR-2 transgene culminated chronic neutrophilic leukemia (CNL). CNL is a rare chronic myeloproliferative disorder that presents as a sustained, mature neutrophilic leukocytosis with few or no circulating immature granulocytes, the absence of peripheral blood monocytosis, basophilia, or eosinophilia, and infiltration of neutrophils at the liver, spleen and kidney. Mice expressing the HccR-2 and tetracycline-transactivating protein (tTa) transgene were found to have altered myeloid development that was characterized by increased percentages of mature neutrophil and band form neutrophil in the peripheral blood, liver and spleen. Activation of the transgene causes CNL. In our model, expression of HccR-2 transgene mice was similar in many respects to the human CNL. This model will be valuable not only for investigating the biological properties of the HccR-2 and other protooncogenes in vivo but also for analyzing the mechanism involved in the progression of CNL.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.511-514
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• 2013

Background: A small but significant proportion of cases with atypical squamous cells of undetermined significance (ASCUS) may harbour CIN 2-3, or even invasive carcinoma. Although immediate colposcopy, HPV-DNA testing or expectant management are three recommended options in ASCUS triage, a consensus does not currently exist on which one of these approaches is the most efficient. In this study, we aimed to compare the performance and cost of immediate colposcopy and colposcopy based on the human papillomavirus (HPV) testing for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN) in women with ASCUS. Materials and Methods: Records of 594 women with an index Papanicolaou smear showing ASCUS were retrospectively analyzed. Women in the immediate colposcopy arm were referred directly to colposcopy (immediate colposcopy group, n=255) and those in the HPV triage arm were proceeded to colposcopy if the high-risk HPV (hrHPV) test was positive (HPV triage group, n=339). High grade CIN (CIN2+) detection rate and treatment costs were compared between the groups. Results: The detected rate of CIN2+ was higher in the HPV triage group compared to immediate colposcopy group (8% vs. 1.6%, p=0.011). In the HPV triage group, the total cost, cost per patient, and the cost for detecting one case of high grade CIN were higher than the immediate colposcopy group (p<0.001). Conclusions: In women with ASCUS cytology, HPV DNA testing followed by colposcopy is more costly than immediate colposcopy, but this approach is associated with a higher rate of CIN2+ detection. This findings suggest that HPV DNA testing combined with cervical cytology could reduce the referral rate to colposcopy.

• 대한임상검사과학회지
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• 제38권2호
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• pp.99-104
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• 2006

파필로마바이러스(Human papilloma virus; HPV)는 자궁경부암의 주요한 원인균으로 30종 이상의 여성성기감염과 관련된 유전자형이 보고되었으며 자궁경부암과 관련성이 높은 고위험군과 관련성이 낮은 저위험군으로 나뉘어 진다. 최근 HPV 유전자형의 임상적 활용이 높아짐에 따라 신속하고 정확하게 HPV 유전자형을 선별할 수 있는 방법이 요구되고 있다. 본 연구의 목적은 여러 가지 분자생물학적 방법 중에서 정확도가 높은 DNA 염기서열분석을 이용하여 한국인 여성에서 HPV의 유전자형분포와 빈도를 구하고자 하였다. 전국 각 지역의 3,978명으로부터 채취한 자궁경부 검체에서 DNA를 추출하고, HPV L1 유전자 영역에서 PCR을 실시하였다. PCR 양성이 나온 경우 DNA 염기서열분석을 실시하였으며 GenBank BLAST program을 이용하여 HPV 유전자형을 분석하였다. 검사대상의 평균 년령은 37.6세였으며 년령 범위는 20-73세였고, 30대 여성이 검사를 가장 많이 실시하였다(42.2%). 총 3.978명 중에서 1,174명(1,174/3,978, 29.5%)이 HPV 양성을 보였으며 136명(11.6%)이 중복감염을 보여, 총 1,310개의 HPV 유전자를 분석하였다. 본 연구에서는 21종의 고위험군, 16종의 저위험군을 포함하여 총 37종의 HPV 유전자형이 검출되었으며, HPV 고위험군의 빈도는 69.8%(914/1,310), 저위험군은 26.0% (340/1,310)로 나타났다. 년령은 20대에서 HPV 양성률이 가장 낮았으며(69.5%), 60대 이상의 검체에서 발견된 HPV는 대부분이 고위험군이었다. 고위험군에서는 HPV 16형이 13.21%로 가장 높게 나타났으며, HPV 53형이 9.62%, 58형이 9.24%로 높게 나타났다. 다음으로 HPV 70(5.50%), 33(4.73%), 66(4.20%), 18(4.05%), 52 (4.05%), 31(3.97%), 56(3.51%)의 순으로 나타났다. 저위험군에서는 HPV 62(4.20%), 61(3.89%), 6(3.59%), 81(3.59%), 84(3.51%), 11(2.6%)의 순으로 검출되었다. DNA 염기서열분석을 이용한 한국인 여성의 HPV 유전자형빈도 분석 결과는 HPV의 역학적 연구와 백신개발을 위한 자료로 유용할 것이며, 자궁경부암의 치료와 관련한 특이적 HPV 유전자형 관련 연구에 도움을 줄 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6857-6862
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• 2015

Background: To identify the optimal cost effective strategy for the management of women having ASC-US who attended at King Chulalongkorn Memorial Hospital (KMCH). Design: An Economical Analysis based on a retrospective study. Subject: The women who were referred to the gynecological department due to screening result of ASC-US at King Chulalongkorn Memorial Hospital, a general and tertiary referral center in Bangkok Thailand, from Jan 2008 - Dec 2012. Materials and Methods: A decision tree-based was constructed to evaluate the cost effectiveness of three follow up strategies in the management of ASC-US results: repeat cytology, triage with HPV testing and immediate colposcopy. Each ASC-US woman made the decision of each strategy after receiving all details about this algorithm, advantages and disadvantages of each strategy from a doctor. The model compared the incremental costs per case of high-grade cervical intraepithelial neoplasia (CIN2+) detected as measured by incremental cost-effectiveness ratio (ICER). Results: From the provider's perspective, immediate colposcopy is the least costly strategy and also the most effective option among the three follow up strategies. Compared with HPV triage, repeat cytology triage is less costly than HPV triage, whereas the latter provides a more effective option at an incremental cost-effectiveness ratio (ICER) of 56,048 Baht per additional case of CIN 2+ detected. From the patient's perspective, the least costly and least effective is repeat cytology triage. Repeat colposcopy has an incremental cost-effectiveness (ICER) of 2,500 Baht per additional case of CIN2+ detected when compared to colposcopy. From the sensitivity analysis, immediate colposcopy triage is no longer cost effective when the cost exceeds 2,250 Baht or the cost of cytology is less than 50 Baht (1USD = 31.58 THB). Conclusions: In women with ASC-US cytology, colposcopy is more cost-effective than repeat cytology or triage with HPV testing for both provider and patient perspectives.