• Archives of Plastic Surgery
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• v.32 no.5
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• pp.635-640
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• 2005

Sentinel lymphnode biopsy is widely performed in the management of malignant melanoma and breast cancer. The sentinel lymphnode is the prime site of draining from the malignant lesion and of metastasis. The aim of this study was to evaluate a usefulness of lymphoscintigraphy in conjunction with a removal of sentinel lymphnodes of skin and soft tissue malignancy. We studied 11 patients selected between January, 2003 and November, 2004. Clinically sentinel lymphnodes free of metastasis were examined with lymphoscintigraphy, gamma detection probe and vital dye staining, and we reviewed histopathologic findings and inert status of the nodes and the results fo treatment. Nine cases were malignant melanoma, one was squamous cell carcinoma on the left hand and another one leiomyosarcoma. Sentinel lymphnodes were identified in all cases. Three cases of malignant melanoma had positive sentinel lymphnodes on histological examination. All patients with positive sentinel lymphnodes were treated with therapeutic regional lymphadectomy, chemotherapy and adjuvant regimen. Four patients underwent PET scanning and followed sentinel lymphnode biopsy. Two had no metastasis signs on PET scanning. Therapeutic lymphnode dissection was carried out upon the patients whose sentinel lymphnode was positive on PET scanning. We contend that lymphoscintigraphy and sentinel lymphnode biopsy are reliable to confirm regional lymphnode metastasis of the skin and soft tissue malignancy, and blind extensive lymphnode dissection can be spared.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.997-1001
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• 2013

Background: Lymphangiogenesis, assessed as lymphovascular density (LVD), is the initial step of generalized tumor lymphovascular invasion (LVI). It also involves VEGF-C as the most important protein family. Lymphangiogenesis among breast cancer cases correlations with several clinicopathological factors are important to determine prognosis and treatment strategies, but results have been controversial and require clarification. Aim: To define correlations between VEGF-C expression, LVD and LVI with several clinicopathological parameters from Indonesian breast cancer patients. Materials and Methods: Using a cross-sectional study, a total of 48 paraffin-embedded tissues of breast cancer from Dr. Sardjito General Hospital Indonesia were assessed for VEGF-C expression, LVD and LVI by immunohistochemistry. Correlations of these markers with clinicopathological parameters like patient age, tumor size, lymph node status, grade, ER/PR and Her-2 status, cell proliferation and p-53 expression were investigated by linear analysis. Correlations of VEGF-C expression and LVI with several clinicopathological parameters were analyzed with Coefficient Contingency Chi-Square test. Results: The mean of patients age was 53.0 year, pre and post-menopausal patients accounting for 56.3% and 43.8%, respectively. Some 10.4% were well, 41.7% moderate and 47.9% poorly differentiated. ER positivity was evident in 50% while PR and Her-2 positivity was found in 31.3% and 33.3%, respectively. Breast cancer cells with over-expression of p-53 was 64.6% and with high cell proliferation was 56.3%. Lymph node metastasis was noted in 63.5%, and LVI in 72.9%. Significant correlations were found between LVD and tumor size (p:0.037), grade (p:0.000), lymphnode status (p:0.036), LVI (p:0.003), as well as with p-53 and cell proliferation. There were also significant correlation of VEGF-C (p:0.011) and LVI (p:0.001) with tumor grade. Only ER status was found to have a correlation with tumor size (p:0.027). Conclusions: This study suggested that in Indonesian breast cancer patients, lymphangiogenesis is correlated with tumor size, grade, lymph node status and tumor lymphovascular invasion, the latter also being related with p-53 over expression and high cell proliferation.

• Journal of Gastric Cancer
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• v.3 no.2
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• pp.104-111
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• 2003

Purpose: The prognostic significance of peri-operative serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA)19-9 determination in patients with gastric cancer has been controversial. This study was performed to evaluate the significance of CEA and CA19-9 as clinical predictors of prognosis. Materials and Methods: The correlations between peri-operative serum CEA/CA19-9 levels and clinicopathologic factors were evaluated retrospectively in gastric cancer patients who had undergone curative surgery during the period from January 1995 to December 1998 at the Department of Surgery, Yonsei University College of Medicine. Results: The positive rates for CEA and CA19-9 were $17.9\%$ and $18.4\%$, respectively. The CEA positivity was related to the depth of invasion (P=0.040), lymph-node metastasis (P=0.000), and stage (P=0.001). The CA19-9 positivity was significantly related to the depth of invasion (P=0.000), lymph-node status (P=0.000), and stage (P=0.000). The positive rate of combined assay of pre-operative CEA and CA19-9 was $30.0\%$ There were statistically significant correlations with stage, depth of invasion, or degree of lymphnode metastasis in the combined assay. The survival rates according to the positivity of CEA and to the positivity of CA19-9 were clearly different (P=0.000). Conclusion: It should be stressed that even a simple blood test prior to surgery could be useful in establishing the depth of invasion, the status of lymph-node involvement, and the prognosis. For improved survival, an aggressive lymphadenectomy and adjuvant chemotherapy should be considered for patients with positive levels of pre-operative CA19- 9.