• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6071-6074
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• 2014

Background: Evidence suggests that the rs11615 (C>T) polymorphism in the ERCC1 gene may be a risk factor for gynecological tumors. However, results have not been consistent. Therefore we performed this meta-analysis. Methods: Eligible studies were identified by search of PubMed, MEDLINE and Chinese National Knowledge Infrastructure (CNKI). Odds ratios (ORs) and 95% confidence intervals (CIs) were applied to assess associations between rs11615 (C>T) and gynecological tumor risk. Heterogeneity among studies was tested and sensitivity analysis was applied. Results: A total of 6 studies were identified, with 1,766 cases and 2,073 controls. No significant association was found overall between rs11615 (C>T) polymorphism and gynecological tumors susceptibility in any genetic model. In further analysis stratified by cancer type, significantly elevated ovarian cancer risk was observed in the homozygote and recessive model comparison (TT vs. CC: OR=1.69, 95% CI=1.03-2.77, heterogeneity=0.876; TT vs. CT/CC: OR=1.72, 95% CI=1.07-2.77, heterogeneity=0.995). Conclusion: The results of the present meta-analysis suggest that there is no significant association between the rs11615 (C>T) polymorphism and gynecological tumor risk, but it had a increased risk in ovarian cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4297-4302
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• 2015

Background: To evaluate HPV testing by Hybrid Capture II (HCII) in conjunction with cytology in detecting the residual/recurrence disease after treatment of high-grade cervical intraepithelial neoplasia (CIN II-III) with loop electrosurgical excision procedure (LEEP). Materials and Methods: A retrospective review of 158 patients with histologically confirmed CIN II-III who underwent LEEP between January 2011 and October 2012 was conducted. Post-treatment control was scheduled at the 3rd, 6th, 12th and 18th month. All patients were followed up by Pap smear and HR-HPV genotype and viral load testing. Results: Pre-treatment, HR-HPV DNA, was detected in all specimens of the patients. At follow-up, 25 patients were diagnosed as the residual/recurrent disease during the FU visit, among whom, 16 patients with positive margin: 13 patients (52%) with HR-HPV DNA+/cytology+, 2 patients (8%) with HR-HPV DNA+/cytology-, 1 patient (4%) with cytology+/HR-HPV DNA-; 9 patients with clean margin - 5 patients (55.6%) with HR-HPV DNA+/cytology+; 2 patients (22.2%) with HRHPV DNA+/cytology-, 2 patients (22.2%) with cytology+/HR-HPV DNA-. None of them persisting HR-HPV DNA-/cytology-with positive or negative margin was identified as the residual/recurrent disease. The majority of residual/recurrent disease was detected at the 12th and 18th month FU, and there was almost no difference in the sensitivity and negative predictive value (NPV) between at the 3rd month and the 6th month FU visits. 14 residual/recurrence disease (14/46:30.4%) had pre-treatment high viral load (>5 000 RUL/PC) and 11 (11/112, 9.8%) with pre-treatment low viral load, P<0.05. Conclusions: (1) The persistence HR-HPV DNA is the root cause of the residual/recurrent disease for the women treated for high-grade CIN; the pre-treatment viral load and margin can be seen as the predictor. (2) The FU visit beginning at the 6th month post-treatment and lasting at least 24 months with the combination of cytology and HPV testing. (3) Patients with high pre-treatment HPV load, which is considered as one risk of developing the residual/recurrent disease, should be paid more attention (especially above 500RUL/PC) to by clinicians.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.4983-4988
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• 2013

Objectives: To establish a taxol-resistant cell line of human ovarian carcinoma (A2780/Taxol) and investigate its biological features. Methods: The drug-resistant cell line (A2780/Taxol) was established by continuous stepwise selection with increasing concentrations of Taxol. Cell morphology was assessed by microscopy and growth curves were generated with in vitro and in vivo tumor xenograft models. With rhodamine123 (Rh123) assays, cell cycle distribution and the apoptotic rate were analyzed by flow cytometry (FCM). Drug resistance-related and signal associated proteins, including P-gp, MRPs, caveolin-1, PKC-${\alpha}$, Akt, ERK1/2, were detected by Western blotting. Results: A2780/Taxol cells were established with stable resistance to taxol. The drug resistance index (RI) was 430.7. Cross-resistance to other drugs was also shown, but there was no significant change to radioresistance. Compared with parental cells, A2780/Taxol cells were significantly heteromorphous, with a significant delay in population doubling time and reduced uptake of Rh123 (p<0.01). In vivo, tumor take by A2780 cells was 80%, and tumor volume increased gradually. In contrast, with A2780/Taxol cells in xenograft models there was no tumor development. FCM analysis revealed that A2780/Taxol cells had a higher percentage of G0/G1 and lower S phase, but no changes of G2 phase and the apoptosis rate. Expression of P-gp, MRP1, MRP2, BCRP, LRP, caveolin-1, PKC-${\alpha}$, Phospho-ERK1/2 and Phospho-JNK protein was significantly up-regulated, while Akt and p38 MARK protein expression was not changed in A2780/Taxol cells. Conclusion: The A2780/Taxol cell line is an ideal model to investigate the mechanism of muti-drug resistance related to overexpression of drug-resistance associated proteins and activation of the PKC-${\alpha}/ERK$ (JNK) signaling pathway.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2039-2044
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• 2014

This study was conducted in order to obtain a screening and early detection reference for children whose mothers had been diagnosed with cancer. Data for 276 mother-child pairs with malignant tumors were analyzed. The distribution of cancers in affected families was generally similar to that of the general Chinese population, and correspondingly breast cancer was the most common malignancy amongst daughters whose mother had cancer (32.7%). The most prevalent cancer amongst sons with affected mothers was gastric cancer, rather than lung cancer. Daughters were more likely to have the same kind of malignant tumor as their mother (P<0.05), and were more likely to develop breast cancer than any other malignant disease if their mother had a breast tumor (P<0.0001). Likewise, if the mother was diagnosed with breast or gynecological cancer, the daughter was more likely to be diagnosed with breast or gynecological cancer than any other cancer (P<0.01). Daughters and sons developed malignant diseases 11 and 6.5 years earlier than their mothers, respectively (P<0.0001).Women with a mother who suffered cancer should be screened for malignancy from 40 years of age especially for breast, lung, and gynecological cancers. For men with affected mothers, screening should start when they are 45 years old focusing particularly on lung and digestive system cancers.

• Asian Pacific Journal of Cancer Prevention
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• 제16권12호
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• pp.4839-4841
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• 2015

We conducted a retrospectively reviewed of the literature published of patients underwent fertility-preserving treatments for cervical, endometrial and ovarian cancers using the WANFANG database in Chinese. A majority were retrospective studies and case reports. With cervical cancer, radical trachelectomy(RT) in combination with pelvic lymphadenectomy could preserve the fertility of patients with early stage IA1-IB1 cancers, Tumor size ${\leq}2cm$ should be emphasized as the indication of RT in considering of the higher recurrent rate in patients with tumor size >2cm. For endometrial cancers, there is much experience on it. Given accurate pretreatment assessment, hormonal therapy is feasible management option to preserve fertility in young patients with early stage lesions that limited to the endometrium and well differentiated. High dose progestin have been applied, oral medroxyprogesterone acetate (MPA), 250-500mg/day, megestrol acetate 160-480mg/day. Other therapies that have been used in a limited number of cases include GnRH analog, intrauterine devices (IUDS) containing progestogen, usually combination of these therapies. All patients should be followed up by ultrasound and/or MRI evaluation, and endometrial curettage at intervals of 3 months. With ovarian cancer, in China, fertilitypreserving surgery in patients with stage IA (grade G1) of epithelial ovarian tumor and patients with germ cell tumor and borderline ovarian tumor have been successfully performed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.133-137
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• 2013

Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and Methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%), OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS). These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. $P{\leq}0.05$ was considered to be statistically significant. Results: The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1310-1322
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• 2021

Immunotherapy is an effective treatment option for gynecological malignancies. Radiologists dealing with gynecological patients undergoing treatment with immune checkpoint inhibitors should be aware of unconventional immune-related imaging features for the evaluation of tumor response and immune-related adverse events. In this paper, immune checkpoint inhibitors used for gynecological malignancies and their mechanisms of action are briefly presented. In the second part, patterns of pseudoprogression are illustrated, and different forms of immune-related adverse events are discussed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5589-5597
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• 2013

The aim of this review article was to evaluate the relationship and the possible etiological mechanisms between endometriosis, leiomyoma (LM) and adenomyosis and gynecological cancers, such as ovarian and endometrial cancer and leiomyosarcoma (LMS). MEDLINE was searched for all articles written in the English literature from July 1966 to May 2013. Reports were collected systematically and all the references were also reviewed. Malignant transformation of gynecologic benign diseases such as endometriosis, adenomyosis and LM to ovarian and endometrial cancer remains unclear. Hormonal factors, inflammation, familial predisposition, genetic alterations, growth factors, diet, altered immune system, environmental factors and oxidative stress may be causative factors in carcinogenesis. Early menarche, low parity, late menopause and infertility have also been implicated in the pathogenesis of these cancers. Ovarian cancers and endometriosis have been shown to have common genetic alterations such as loss of heterozygosity (LOH), PTEN, p53, ARID1A mutations. MicroRNAs have also been implicated in malignant transformation. Inflammation releases proinflammatory cytokines, and activates tumor associated macrophages (TAMS) and nuclear factor kappa b (NF-KB) signaling pathways that promote genetic mutations and carcinogenesis. MED12 mutations in LM and smooth muscle tumors of undetermined malignant potential (STUMP) may contribute to malignant transformation to LMS. A hyperestrogenic state may be shared in common with pathogenesis of adenomyosis, LM and endometrial cancer. However, the effect of these benign gynecologic diseases on endometrial cancer should be studied in detail. This review study indicates that endometriosis, LM, adenomyosis may be associated with increased risk of gynecological cancers such as endometrial and ovarian cancers. The patients who have these gynecological benign diseases should be counseled about the future risks of developing cancer. Further studies are needed to investigate the relationship between STUMPs, LMS and LM and characteristics and outcome endometrial carcinoma in adenomyotic patients.

• 동의생리병리학회지
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• 제28권5호
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• pp.571-575
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• 2014

This study was aimed to obtain epidemiological information of cancer patients treated with Oriental medicine. 58 breast and gynecological cancer patients treated in Cancer Center of Daeguhanny Oriental Hospital from August 2012 to August 2013 were reviewed. Careful investigations were done by categorizing these patients by their origin, stage, treatment, conventional treatment type, chief complaint, etc. In tumor origin, breast cancer showed the largest proportion in total patients(74.1%) and inpatients(81.8%). 63.8% of the patients' tumors were stage III and IV. 48.3% of patients visited Oriental hospital for combination treatment with conventional medicine. 91.4% of the patients have under 5 years of cancer duration. Their cheif complaints are general weakness, postoperative pain and abdominal discomfort in general. This study presented the characteristics of breast and gynecological cancer patients treated by Oriental medical therapies, and thus would be valuable for futher studies of Oriental medical cancer treatments.

• Radiation Oncology Journal
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• 제16권2호
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• pp.167-175
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• 1998

목적 : 원발성 혹은 재발한 부인과암(자궁경부암, 질암, 및 외음부암)에서 질부위의 병소에 추가선량를 조사하기 위한 기존의 방법들 즉, 실린더(cylinder)를 이용한 강내치료와 바늘(needle)을 사용한 조직내 평면삽입(Single plane Implant)만으로는 이상적인 선량분포를 얻기 힘든 경우가 많다. 저자들은 방광 및 직장에 대한 조사선량을 최소화하면서 질내의 병소에 국한하여 고선량의 방사선을 효과적으로 조사하기 위해 체적삽입(Volume Implant)이 가능한 기구(applicator 혹은 template)를 고안, 자체 제작하여 사용하고 있으며 이를 소개하고자 한다. 대상 및 방법 : 1994년 8월부터 1998년 2월까지 9명의 환자를 대상으로 아주대학교병원에서 조직내 방사선치료를 시행하였다 이들은 질벽에 재발한 자궁경부암(5명), 원발성 자궁경부암(3명), 원발성 질암(1명)으로 치료받았다. 첫 3명의 환자는 기구없이 바늘을 평면삽입하였고 이후에는 병변의 위치 및 크기 등을 고려할 때 주위정상조직에 대한 선량을 줄이면서 종양에는 균등한 선량 분포로 고선량의 방사선을 조사하기 위해서는 체적삽입이 유리할 것으로 판단되어 기구를 고안, 자체 제작하였다. 바늘은 일반적인 조직내 삽입용(Microselectron, Nucletron)을 사용하였고 이는 저선량율(LDR) 및 고선량율(HDR) 근접치료 모두에서 사용 가능하였다. 6명중 3명은 50cc 주사기를 이용하여 만든 초기 단계의 기구를 사용하였다(1차 형태). 이러한 초기 단계의 기구는 표면이 매끈하지 못하여 질점막을 손상시킬 수 있고 바늘 삽입후 기구가 움직이지 않도록 회음부에 고정시키는 날개부위가 없는 단점이 있었다. 나머지 3명의 환자는 이러한 단점을 보완하고 종양의 크기 및 위치에 따라 좀 더 많은 바늘을 삽입할 수 있도록 새롭게 고안한 기구를 사용하였다 (2차 형태). 재료는 투명 아크릴 혹은 치과용 몰드(mold) 소재($Provil^{(R)}$)를 사용하였으며 회음부에 기구를 고정시키기 위한 날개를 만들었다. 2차 형태의 기구를 사용한 환자중 마지막 1명은 종양의 위치를 고려하여 삽입할 수 있는 바늘의 갯수를 증가시켜서 새로이 제작하였다 실제로 환자에게 시술하기 전에 예비치료계획을 시행하여 필요한 동위원소의 수량 및 배열을 결정하였다. 결과 : 자체 제작한 기구를 사용함으로써 바늘을 일정간격으로 삽입하는 것이 용이해졌으며 시술시간을 단축시킬 수 있고 삽입방향이 잘못되어 여러번 바늘을 찌르는 경우가 적어져 조직에 대한 손상을 줄일 수 있었다. 손쉽게 구할 수 있는 재료를 사용하여 병소에 따라 개별화간 가능한 값싸고 유용한 기구의 제작이 가능함을 확인하였으며 이를 통해 좀 더 이상적인 선량분포곡선을 얻을 수 있었다. 3명의 환자에서 바늘 삽입후 컴퓨터 단층촬영을 시행하여 배열의 정확성과 방광 및 직장에 조사되는 선량을 감소시킬 수 있음을 확인하였다. 마지막 추적관찰시 원발성 종양으로 치료받았던 3명의 환자 모두가 국소제어되었으나 재발하여 치료하였던 경우에는 모두 국소재발하였다. 결론 : 저자들은 부인과암에서 근접치료시 환자의 종양 특성에 따라 기구를 적절하게 고안하여 적은 비용으로 비교적 손쉽게 자체 제작하여 사용함으로써 효과적인 조직내 삽입 방사선치료를 시행할 수 있었다.