• 제목/요약/키워드: hormone therapy

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국소 진행성 유방암 환자에서 선행 항암화학요법의 치료결과 (Result of Neoadjuvant Chemotherapy, Surgery and Radiation Therapy in Locally Advanced Breast Cancer)

  • 배선현;박원;허승재;최두호;남희림;양정현;남석진;이정언;임영혁;안진석;박연희
    • Radiation Oncology Journal
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    • 제28권2호
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    • pp.71-78
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    • 2010
  • 목 적: 국소 진행성 유방암으로 선행 항암화학요법 후 수술과 방사선치료를 시행한 환자를 대상으로 치료 결과와 예후에 영향을 미치는 인자를 알아보고자 하였다. 대상 및 방법: 1995년 4월부터 2006년 11월까지 삼성서울병원에서 유방암으로 선행 항암화학요법을 받은 환자는 총 159명이었다. 이중에서 진단 당시 종양의 크기가 5.0 cm를 초과하거나 액와림프절 전이가 의심된 유방암 환자로 항암화학요법 후 근치적 수술을 시행하고 방사선치료가 시행된 105명을 대상으로 하였다. 선행 항암화학요법은 2명을 제외한 모든 환자에서 anthracycline을 기반으로 하는 복합항암요법을 사용하였다. 치료 전 임상적 병기는 T1 3명(3%), T2 26명(25%), T3 39명(37%), T4 37명(35%)이었고 액와림프절 전이가 의심되는 사람이 98명(93%)이었다. 선행 항암화학요법을 시작한 날을 기준으로 추적 조사하였고 중앙추적조사기간은 41개월(7~142개월)이었다. 결 과: 전체 환자의 5년 국소제어율은 82.1%, 원격전이제어율은 69.9%, 무병생존율은 66.1%, 전체생존율은 77.1%이었다. 무병생존율과 전체생존율에 영향을 미치는 인자를 알아보기 위해 단변량분석을 시행하였을 때 임상적 원발병소 병기, 병리학적 원발병소 병기, 병리학적 림프절 병기 그리고 병리학적 TNM 병기가 공통적으로 통계적으로 유의한 인자들이었다. 다변량 분석을 시행하였을 때 호르몬치료 유무만 생존율과 연관된 의미 있는 인자였다. 결 론: 본 연구를 통하여 삼성서울병원에서 국소 진행성 유방암으로 선행 항암화학요법이 시행된 환자의 치료 성적이 지금까지 보고된 다른 선행 항암화학요법 치료 결과와 비교할 때 비슷하거나 나은 결과를 보여주었다. 또한, 호르몬치료를 시행한 경우에만 생존율이 의미 있게 좋았고 임상적 병기나 병리학적 병기가 낮은 경우 생존율이 좋은 경향을 보였다.

Vitamin D Proliferates Vaginal Epithelium through RhoA Expression in Postmenopausal Atrophic Vagina tissue

  • Lee, Arum;Lee, Man Ryul;Lee, Hae-Hyeog;Kim, Yeon-Suk;Kim, Jun-Mo;Enkhbold, Temuulee;Kim, Tae-Hee
    • Molecules and Cells
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    • 제40권9호
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    • pp.677-684
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    • 2017
  • Postmenopausal atrophic vagina (PAV) is the thinning of the walls of the vagina and decreased lugae of the vagina. PAV is caused by decreased estrogen levels in postmenopausal women. However, the harmful effects of hormone replacement therapy (HRT) have resulted in considerable caution in its use. Various estrogen agonist treatment options are available. Vitamin D is influences the regulation of differentiation and proliferation of various cells, especially tissues lining stratified squamous epithelium, such as the vaginal epithelium. In this study, we hypothesized that vitamin D could provide an alternative and a safe treatment option for PAV by promoting the proliferation and differentiation of the vaginal epithelium. Thirty six patients were enrolled in this case-control study. Vitamin D associated proteins in a vitamin D and sex hormone treated vaginal epithelial cell line as well as normal and PAV tissues were measured. To confirm of cell-to-cell junction protein expression, cell line and tissue studies included RT-PCR, immunohistochemistry staining, and immunoblot analyses. The expression of cell-to-cell junction proteins was higher in women with symptoms of atrophic vagina tissue compared to women without the symptoms. Vitamin D stimulated the proliferation of the vaginal epithelium by activating p-RhoA and Erzin through the vitamin D receptor (VDR). The results suggest that vitamin D positively regulates cell-to-cell junction by increasing the VDR/p-RhoA/p-Ezrin pathway. This is the first study to verify the relationship of the expression of RhoA and Ezrin proteins in vaginal tissue of PAV.

전립선 암의 다발성 기관지내전이 1예 (A Case of Multiple Endobronchial Metastases from Prostatic Carcinoma)

  • 이정은;이유진;정미경;박희선;정성수;김주옥;강대영;설종구;김선영
    • Tuberculosis and Respiratory Diseases
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    • 제61권2호
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    • pp.162-166
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    • 2006
  • The lung is the most common site for the metastasis of extrapulmonary malignant tumors. However, endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are the breast, renal and colorectal carcinomas. Lung metastasis from prostate cancer is often encountered but EBM is rare. We report a 74-year old man with endobronchial metastases from prostatic carcinoma presented with cough. The diagnosis of prostatic cancer and the endobronchial metastasis were confirmed by immunohistological staining with the prostate specific antigen. Hormonal therapy (lutenizing hormone releasing hormone agonist) was applied to this patient.

Cyclooxygenase-2 Expression in Invasive Breast Carcinomas of No Special Type and Correlation with Pathological Profiles Suggest a Role in Tumorigenesis Rather than Cancer Progression

  • Misron, Nurul Akmar;Looi, Lai-Meng;Mustapha, Nik Raihan Nik
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1553-1558
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    • 2015
  • Background: COX-2 has been shown to play an important role in the development of breast cancer and increased expression has been mooted as a poor prognostic factor. The purpose of this study was to investigate the relationship between COX-2 immunohistochemical expression and known predictive and prognostic factors in breast cancer in a routine diagnostic histopathology setting. Materials and Methods: Formalin-fixed paraffin-embedded tumour tissue of 144 no special type (NST) invasive breast carcinomas histologically diagnosed between January 2009 and December 2012 in Hospital Sultanah Bahiyah, Alor Setar, Kedah were immunostained with COX-2 antibody. COX-2 overexpression was analysed against demographic data, hormone receptor status, HER2-neu overexpression, histological grade, tumour size and lymph node status. Results: COX-2 was overexpressed in 108/144 (75%) tumours and was significantly more prevalent (87%) in hormone receptor-positive tumours. There was no correlation between COX-2 overexpression and HER2/neu status. Triple negative cancers had the lowest prevalence (46%) (p<0.05). A rising trend of COX-2 overexpression with increasing age was observed. There was a significant inverse relationship with tumour grade (p<0.05), prevalences being 94%, 83% and 66% in grades 1, 2 and 3 tumours, respectively. A higher prevalence of COX-2 overexpression in smaller size tumours was observed but this did not reach statistical significance. There was no relationship between COX-2 expression and lymph node status. Conclusions: This study did not support the generally held notion that COX-2 overexpression is linked to poor prognosis, rather supporting a role in tumorigenesis. Larger scale studies with outcome data and basic studies on cancer pathogenetic pathways will be required to cast further light on whether COX-2 inhibitors would have clinical utility in cancer prevention or blockage of cancer progression. In either setting, the pathological assessment for COX-2 overexpression in breast cancers would have an important role in the selection of cancer patients for personalized therapy with COX-2 inhibitors.

Patterns of Metastasis and Survival in Breast Cancer Patients: A Preliminary Study in an iranian Population

  • Ziaei, Jamal Eivazi;Pourzand, Ali;Bayat, Amrollah;Vaez, Jalil
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.937-940
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    • 2012
  • Due to lack of sufficient data on characteristics of breast cancer patients and risk factors for developing metastasis in Iran this study was designed to understand clinical aspects impacting on survival. A cross-sectional study on breast cancer patients was conducted in an oncology clinic of the university hospital between 1995 and 2010. Data were retrieved from medical records and included age, menopausal status, tumor diameter, number of involved nodes, histopathological type, estrogen and progesterone receptor expression, c-erbB-2, primary and secondary metastasis sites, overall survival, disease free interval and type of chemotherapy protocol. The results were analyzed with SPSS 13 software. The mean age of the patients was 49.2 (27-89) years. The primary tumors were mainly ER positive (48%) and PR negative (49.3%). The status of lymph nodes dissected and examined in these patients was unknown in 19 patients (25.3%) while 18 patients (24%) had positive lymph nodes with no report on the number of involved nodes. All of the patients had received antracyclin based chemotherapy in an adjuvant or metastatic setting. Adjuvant hormonal therapy was administered to receptor positive patients. In average, overall survival after recurrence was 30 months (95%CI 24.605-35.325) for non-skeletal versus 42 months (95%CI 31.211-52.789) for skeletal metastasis (P= 0.002). The median survival was also greater for receptor positive patients; 39 months (95%CI 33.716-44.284) for PR+ versus 26 months (95%CI 19.210-32.790) for PR- (P=0.047) and 38 months (95%CI 32.908-43.092) for ER+ versus 27 months (95%CI 18.780-35.220) for ER- patients (P=0.016). No relation was found between site of first metastasis and hormone receptor, age, tumor diameter, DFI and menopausal status. Sites of metastasis were independent of age, size of the tumor, menopausal and hormone receptor status in this study. Overall survival provided significant relations with respect to receptor status and bone metastasis.

세침흡인 검사물을 이용한 유방암세포 에스트로젠수용체 분석 : 동결절편조직과의 비교 (Estrogen Receptor Analysis in Fine Needle Aspirates and Frozen Sections from Human Breast Carcinomas)

  • 공경엽;안세현;박건춘;최기영;유은실;이인철
    • 대한세포병리학회지
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    • 제5권1호
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    • pp.10-14
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    • 1994
  • The expression of sex steroid hormone receptors by neoplastic cells is an important predictor of response to hormone therapy. Thus, the selection of treatment modality is often based on the identification of receptors in tumor tissue. Various monoclonal antibodies of high specificity are now available for analyzing the estrogen receptor (ER). With these antibodies, biochemical enzyme immunoassay and immunohistochemistry using histologic sections have been used for ER analysis. We used fine needle aspirates from 15 human primary breast carinomas for the analysis of ERs. The semiquantitative receptor values obtained in cytologic specimens were correlated well with those from histologic specimens. The results of ER in fine needle aspirates were concordant with ER in histologic specimens(r=0.94). Only three cases showed a little difference in staining intensity and proportion of positive cells. Our results showed a good correlation between the receptor values determined in cytologic smears and those determined in tissue sections. It is suggested that measurement of the ER in cytologic smears may be a reliable technique which can be performed on aspiration cytologic samples.

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체외수정시술을 위한 성선자극호르몬 과배란유도에 Poor Response를 나타낸 환자에서 GnRH Analogue의 사용 (GnRH Analogue in Controlled Ovarian Hyperstimulation for Gonadotropin Poor Responder)

  • 김선행;이희경;구병삼
    • Clinical and Experimental Reproductive Medicine
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    • 제20권1호
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    • pp.37-43
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    • 1993
  • In 27 patients with the past history of poor response to the gonadotropin superovulation induction due to poor follicular growth or permature surge of endogenous luteinizing hormone, the effectiveness of pituitary supperssion with the gonadotropin releasing hormone agonist(GnRH-a) in in vitro fertilization(IVF) program was evaluated in 43 cycles using a combination regimen of D-Trp-6 LHRH(Decapeptyl, Ferring)and FSH/hMG from June, 1989 to August, 1990 at Korea University Hospital IVF Clinic. At midluteal phase of menstrual cycle, Decapeptyl-CR was administered by long-term protocol to minimize initial agonistic effect of endogenous gonadotropins. After the confirmation of pituitary suppression, about 2-3 weeks after GNRH-a administration, ovarian follicle growth was stimulated with FSH/hMG and followed by transvaginal ultrasonic measurement of follicle size and by monitoring of serm E2 and LH if necessary. When compared with the control group stimulated with gonadotropin regimen only, the cancellation rate and occurrence rate of premature LH surge during gonadotropin treatment were significantly lower in study group(11.6% and 2.4%, respectively). There is no significant differences in the mean number of aspirated oocytes, fertilization/cleavage rate, embryo transfer(ET) rate, and mean number of embryos transferred between the two groups. The pregnancy rate per treatment cycle, 16.3%, and per ET cycle, 23.3%, were significantly higher in the study group compared with those of control group. These data suggest that GnRH-a therapy is effective for previous poor responder In gonadotropin superovulation induction for IVF.

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월경전증후군의 한약 치료 효과에 관한 무작위대조비교임상시험연구에 대한 고찰 (Review of Randomized Controlled Trials on the Therapeutic Effects of Herb Medicine for Premenstrual Syndrome)

  • 김수경;윤영진
    • 대한한방부인과학회지
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    • 제33권4호
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    • pp.36-55
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    • 2020
  • Objectives: The present study is carried out to review the efficacy of Korean, Oriental medicine on premenstrual syndrome. Methods: We searched for 7 internet worldwide databases in order to find the studies with the keywords of 'premenstrual syndrome', 'premenstrual syndrome & Oriental medicine', 'premenstrual syndrome & traditional Chinese medicine' and 'premenstrual syndrome & herbal medicine' from 2009 to 2019. after selecting studies based on own criteria, total 8 studies are finally included. the studies were assessed with the Cochrane risk of bias criteria and reviewed systematically. Results: After intervention, cured patient rate in test groups in all of studies were significantly higher than rate in control group. there were significant decrease in headache, anorexia, dry mouth, breast mass, mastodynia, agitation, irascibility, edema, dizziness, fever, anhedonia, depression, inability to sleep, profuse dreaming with herbal medicinal intervention. 3 of those studies checked hormonal level. Estradiol (E2) and Progesteron (P) changed significantly in 2 of studies. Prolactin (PRL) in 1 study decreased significantly. FSH (Follicle stimulating hormone) and LH (Luteinizing hormone) had no significant decrease in 1 study. Conclusions: This review suggests that herbal medicine on premenstrual syndrome is effective without serious adverse effects. however, since unclear risk of bias, the result of this study should be considered carefully. further clinical trials should be carried out in order to academical clinical progress regarding treatment of premenstrual syndrome.

The Inhibitory Effects of Ahnjeonbaekho-tang on FRTL-5 Cell Proliferation and Thyroxine Synthesis

  • ;;;;안세영
    • 대한한방내과학회지
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    • 제27권3호
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    • pp.653-663
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    • 2006
  • Objective : Graves' disease, the most common cause of hyperthyroidism, is an autoimmune disorder associated with autoantibodies to the TSH receptor. The clinical features of Graves' disease are goiter and hypermetabolic symptoms induced by excessive hormones. Antithyroid drug therapy is the first-line treatment for Graves' disease in Korea, Japan and European countries. Yet in spite of a long period and high-dose of treatment, it is hard to achieve remission because of adverse effects, frequent recurrence and resistance to antithyroid drugs. Recently, it has been reported that the abnormal thyroid hormone and clinical symptoms of Graves' disease were reduced by Ahnjeonbaekho-tang (AJBHT). Methods : To investigate the effectiveness and action mechanism of AJBHT, we studied the influence of AJBHT on FRTL-5 thyroid cell proliferation, DNA synthesis and expression of T4, TSH, cAMP, Tg and TPO mRNA. Results : AJBHT significantly inhibited the FRTL-5 cell proliferation, DNA synthesis, T4 synthesis, cAMP production and the expression of Tg mRNA in comparison with control and MMI. Conclusions : These results suggest that AJBHT may inhibit the cell proliferation and DNA synthesis by regulating the cAMP, and suppress the T4 synthesis by modulating Tg mRNA expression and cAMP synthesis, and that it may be useful agent for treating the goiter and hormone abnormality of Graves' disease.

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Regulation of appetite-related neuropeptides by Panax ginseng: A novel approach for obesity treatment

  • Phung, Hung Manh;Jang, Dongyeop;Trinh, Tuy An;Lee, Donghun;Nguyen, Quynh Nhu;Kim, Chang-Eop;Kang, Ki Sung
    • Journal of Ginseng Research
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    • 제46권4호
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    • pp.609-619
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    • 2022
  • Obesity is a primary factor provoking various chronic disorders, including cardiovascular disease, diabetes, and cancer, and causes the death of 2.8 million individuals each year. Diet, physical activity, medications, and surgery are the main therapies for overweightness and obesity. During weight loss therapy, a decrease in energy stores activates appetite signaling pathways under the regulation of neuropeptides, including anorexigenic [corticotropin-releasing hormone, proopiomelanocortin (POMC), cholecystokinin (CCK), and cocaine- and amphetamine-regulated transcript] and orexigenic [agoutirelated protein (AgRP), neuropeptide Y (NPY), and melanin-concentrating hormone] neuropeptides, which increase food intake and lead to failure in attaining weight loss goals. Ginseng and ginsenosides reverse these signaling pathways by suppressing orexigenic neuropeptides (NPY and AgRP) and provoking anorexigenic neuropeptides (CCK and POMC), which prevent the increase in food intake. Moreover, the results of network pharmacology analysis have revealed that constituents of ginseng radix, including campesterol, beta-elemene, ginsenoside Rb1, biotin, and pantothenic acid, are highly correlated with neuropeptide genes that regulate energy balance and food intake, including ADIPOQ, NAMPT, UBL5, NUCB2, LEP, CCK, GAST, IGF1, RLN1, PENK, PDYN, and POMC. Based on previous studies and network pharmacology analysis data, ginseng and its compounds may be a potent source for obesity treatment by regulating neuropeptides associated with appetite.