• 제목/요약/키워드: neoplasm grading

검색결과 11건 처리시간 0.023초

Prognostic Value of Tumor Regression Grade on MR in Rectal Cancer: A Large-Scale, Single-Center Experience

  • Heera Yoen;Hye Eun Park;Se Hyung Kim;Jeong Hee Yoon;Bo Yun Hur;Jae Seok Bae;Jung Ho Kim;Hyeon Jeong Oh;Joon Koo Han
    • Korean Journal of Radiology
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    • 제21권9호
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    • pp.1065-1076
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    • 2020
  • Objective: To determine the prognostic value of MRI-based tumor regression grading (mrTRG) in rectal cancer compared with pathological tumor regression grading (pTRG), and to assess the effect of diffusion-weighted imaging (DWI) on interobserver agreement for evaluating mrTRG. Materials and Methods: Between 2007 and 2016, we retrospectively enrolled 321 patients (male:female = 208:113; mean age, 60.2 years) with rectal cancer who underwent both pre-chemoradiotherapy (CRT) and post-CRT MRI. Two radiologists independently determined mrTRG using a 5-point grading system with and without DWI in a one-month interval. Two pathologists graded pTRG using a 5-point grading system in consensus. Kaplan-Meier estimation and Cox-proportional hazard models were used for survival analysis. Cohen's kappa analysis was used to determine interobserver agreement. Results: According to mrTRG on MRI with DWI, there were 6 mrTRG 1, 48 mrTRG 2, 109 mrTRG 3, 152 mrTRG 4, and 6 mrTRG 5. By pTRG, there were 7 pTRG 1, 59 pTRG 2, 180 pTRG 3, 73 pTRG 4, and 2 pTRG 5. A 5-year overall survival (OS) was significantly different according to the 5-point grading mrTRG (p = 0.024) and pTRG (p = 0.038). The 5-year disease-free survival (DFS) was significantly different among the five mrTRG groups (p = 0.039), but not among the five pTRG groups (p = 0.072). OS and DFS were significantly different according to post-CRT MR variables: extramural venous invasion after CRT (hazard ratio = 2.259 for OS, hazard ratio = 5.011 for DFS) and extramesorectal lymph node (hazard ratio = 2.610 for DFS). For mrTRG, k value between the two radiologists was 0.309 (fair agreement) without DWI and slightly improved to 0.376 with DWI. Conclusion: mrTRG may predict OS and DFS comparably or even better compared to pTRG. The addition of DWI on T2-weighted MRI may improve interobserver agreement on mrTRG.

뇌종양에서의 $^{18}F-FDG$ PET의 임상 이용 (Clinical Application of $^{18}F-FDG$ PET in Brain Tumors)

  • 홍일기;김재승
    • Nuclear Medicine and Molecular Imaging
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    • 제42권sup1호
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    • pp.1-5
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    • 2008
  • Primary brain tumor accounts for 1.4% of entire cancer. For males between the ages of 15 and 34 years, central nervous system tumors account for the leading cause of cancer death. $^{18}F-FDG$ PET has been reported that it can provide important diagnostic information relating to tumor grading and differentiation from non- tumorous condition. In addition, the degree of FDG metabolism carries prognostic significance. By mapping the metabolic pattern of heterogeneous tumors, $^{18}F-FDG$ PET can aid in targeting for stereotactic biopsy by selecting the subregions within the tumor that are most hypermetabolic and potentially have the highest grade. According to clinical research data, FOG PET is expected to be a helpful diagnostic tool in the management of brain tumors.

Clinicopathological Features and Prognosis of Gastroenteropancreatic Neuroendocrine Tumors: Analysis from a Single-institution

  • Zeng, Yu-Jie;Liu, Lu;Wu, Heng;Lai, Wei;Cao, Jie-Zhi;Xu, He-Yang;Wang, Jie;Chu, Zhong-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5775-5781
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    • 2013
  • Background: The gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is the most common type of neuroendocrine neoplasm. We summarized data in our centre to investigate the clinicopathological features, diagnostic methods, therapeutic approaches and prognosis for this neoplasm to increase knowledge of this disease in Asian populations. Method: A total of 122 patients treated at Sun Yet-san Memorial Hospital of Sun Yat-sen University between January 2000 and December 2011 were analyzed retrospectively. Results: Pancreas was the most common site of involvement (65/122, 53.3%); this disease has no special symptoms; positive rates of chromogranin A (CgA) and synaptophysin (Syn) were 81.1% and 87.7%, respectively. The positive rate of Syn had statistical difference among the three grades, but not CgA. Some 68 patients had G1 tumors, 32 G2 tumors and 22 G3 tumors, and Chi-square test showed that higher grading was correlated with worse prognosis (${\chi}^2=32.825$, P=0.0001). A total of 32 patients presented with distant metastasis, and 8 cases emerged during following up. Cox proportional hazards regression modeling showed that the tumor grade (P=0.01), lymphatic metastasis (P=0.025) and distant metastasis (P=0.031) were predictors of unfavorable prognosis. The overall 5-year survival rate was 39.6%, the 5-year survival rate of G1 was 55.7%, and the G2 and G3 were 34.2% and 0%, respectively. Conclusions: The incidence of gastroenteropancreatic neuroendocrine tumors has risen over the last 12 years. All grades of these diseases metastasize readily, and further research regarding the treatment of patients after radical surgery is needed to prolong disease-free survival.

High-grade mucoepidermoid carcinoma in the thyroid gland with poor prognosis

  • Shin, Hyeong Chan
    • Journal of Yeungnam Medical Science
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    • 제38권2호
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    • pp.169-174
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    • 2021
  • Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid-Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and paired box gene 8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

DMH에 의한 비정상적인 혈관 내피세포의 증식에서 Protein Kinase C 동종효소 Alpha 단백발현의 특성 (Characterization of the Expression of PKCα(Isoform) in DMH-induced Vascular Endothelial Proliferation)

  • 남수봉;배용찬;박숙영;최수종
    • Archives of Plastic Surgery
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    • 제34권6호
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    • pp.679-684
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    • 2007
  • Purpose: DMH(1,2-dimethylhydrazine) has been known to induce vascular neoplasm such as malignant endothelioma in animal experiment, through induction of abnormal proliferation of HUVECs. In our previous studies, 11 types of PKC isoenzymes were determined by RT-PCR and the expression of $PKC{\alpha}$, and ${\mu}$ was more prominent than other PKC isoenzymes in the DMH-treated group. However, this result was not based on objective assessment. In this study, we further evaluated the role of $PKC{\alpha}$ on the DMH-induced abnormal proliferation of HUVECs by two different methods to identify its presence with high relevance in objective view. $PKC{\mu}$ will be investigated in further study. Methods: The study was conducted with the cultured HUVECs group(control) and the $0.75{\times}10^{-9}M$ DMH-treated group. After processing protein extraction in 0 and 24 hour, extracted protein was treated of quantitative test through BCA protein assay. In the western blot analysis, electrophoresis was performed in the order of gel preparation, sample preparation, and gel running. Electrotransfer to nitrocellulose membrane and reaction with antibody were done. Detection of $PKC{\alpha}$ was achieved through "Gel Image Analysis System". In the fluorescence immunocytochemical analysis, the grading of radiance of the intracellular $PKC{\alpha}$ particles was detected with confocal microscope after treating with primary and fluorescent secondary antibody in 0 and 24 hours. Results: The Western blot analysis showed increased $PKC{\alpha}$ expression from the specimen obtained in 24 hour of the DMH treatment group when compared to those in control group. Under confocal fluorescence microscope, the emitting radiance in the DMH treated group was brighter at 24 hours as well. Conclusion: We believe that $PKC{\alpha}$ plays a role in DMH-induced abnormal proliferation of the vascular endothelium, which may provide insights in understanding the vascular neoplasm.

Korean Prostate Cancer Patients Have Worse Disease Characteristics than their American Counterparts

  • Kang, Dong Il;Chung, Jae Il;Ha, Hong Koo;Min, Kweonsik;Yoon, Jangho;Kim, Wansuk;Seo, Won Ik;Kang, Pil Moon;Jung, Soo Jin;Kim, Isaac Yi
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6913-6917
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    • 2013
  • Background: Although the PSA test has been used in Korea for over 20 years, the incidence of prostate cancer has risen, and the associated mortality has increased about 13-fold over the 20-year period. Also, several investigators have suggested that Asians in America are more likely to present with more advanced prostate cancer than Caucasians. We compared the characteristics of native Koreans and Americans (Caucasians and African-Americans) undergoing radical prostatectomies in Korea and the US. Materials and Methods: Study subjects comprised patients at Korean and US hospitals from 2004 to 2012 who had undergone radical prostatectomies. We compared the characteristics of the subjects, including age, preoperative prostate-specific antigen (PSA) levels, body mass index (BMI), Gleason score, and pathological T stage. Results: In total, 1,159 males (502 Koreans, 657 Americans) were included. The Korean and American patients had mean ages of $67.1{\pm}6.6$ and $59.2{\pm}6.7$ years, respectively. The mean preoperative PSAs were $15.4{\pm}17.9$ and $6.2{\pm}4.6ng/mL$ (p=0.0001) and the mean BMIs were $23.6{\pm}2.6$ and $28.7{\pm}4.4kg/m^2$ (p=0.0001), respectively. Pathological localized prostate cancer represented 71.7% of cases for Koreans and 77.6% for Americans (p=0.07). According to age, Koreans had higher T stages than Americans in their 50s (p=0.021) and higher Gleason scores than Americans in all age groups. According to PSA, Koreans had higher Gleason scores than Americans for PSA >10 ng/mL (p<0.05). According to prostate size and Gleason scores, Koreans had higher PSA values than Americans (p<0.01). Conclusions: These results show that Korean patients have elevated risk of malignant prostate cancers, as indicated by the significantly higher Gleason scores and PSAs, suggesting a need for novel prostate cancer treatment strategies in Korea.

Clinicopathological characteristics of extrahepatic biliary neuroendocrine neoplasms in the gallbladder, extrahepatic biliary tract, and ampulla of Vater: A single-center cross-sectional study

  • Young Mok Park;Hyung Il Seo;Byeong Gwan Noh;Suk Kim;Seung Baek Hong;Nam Kyung Lee;Dong Uk Kim;Sung Yong Han
    • 한국간담췌외과학회지
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    • 제27권4호
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    • pp.380-387
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    • 2023
  • Backgrounds/Aims: In 2019, the grading and staging system for neuroendocrine neoplasms (NENs) was significantly changed. In this study, we report the clinicopathological characteristics and surgical outcomes of patients with extrahepatic biliary NENs who underwent curative resection with or without adjuvant treatment. Methods: We retrospectively reviewed a database of 16 patients who developed NENs, neuroendocrine carcinoma (NEC), and mixed endocrine non-endocrine neoplasms (MiNENs) after curative resection. Among them, eight patients had ampulla of Vater (AoV) tumors, and eight patients had non-AoV tumors. Results: G1 and G2 were more frequently observed in the AoV group than in the non-AoV group (12.5% and 62.5%, respectively). In contrast, NEC and MiNEN were more common in the non-AoV group (50.0%). High Ki-67 index (> 20%) and perineural invasion (PNI) were more frequently observed in the non-AoV group. Advanced age (> 65 years), mitotic count > 20 per 2 mm2, and Ki-67 index > 20% were strongly correlated with patient survival (p = 0.018, 0.009, and 0.044, respectively). Advanced age (> 65 years) and mitotic count > 20 per 2 mm2 were significantly correlated with disease recurrence (p = 0.033 and 0.010, respectively). Conclusions: AoV and non-AoV tumors had significant differences in the histologic grade, Ki67, and PNI. Patients with non-AoV tumors had an increased risk for survival and recurrence than those in the AoV group. For extrahepatic biliary NENs, early detection of tumors, adequate surgery, and aggressive adjuvant treatment for high-risk patients are important to achieve long-term survival and prevent disease recurrence.

점액표피양 암종의 세침흡인 세포학적 소견 (Fine Needle Aspiration Cytology of Mucoepidermoid Carcinoma of the Salivary Gland)

  • 문정석;오화은;이주한;김애리;김철환;김한겸;박미자;원남희
    • 대한세포병리학회지
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    • 제8권2호
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    • pp.135-142
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    • 1997
  • Mucoepidermoid carcinoma is the most common malignant neoplasm of the salivary gland, compring between 30 and 40%. Fine needle apsiration cytology was performed in five patients with mucoepidermoid carcinoma. The patients consisted of three males aged of 42, 48, and 60 years, and two females aged 36, and 56 years. The primary tumor sites were the parotid gland in four patients and the submandibular gland in the rest one. The histologic grades were low in one patient, intermediate in two patients and high in other two. In our experience, the common cytologic findings of low grade subtype were predominent mucous cells with some intermediate cells in an abundant mucinous background. The cytologic findings of intermediate grade subtype were predominant clusters of intermediate cells with or without mucous cells in an abundant mucinous background. And the cytologic findings of high grade subtype were predominant clusters of epidermoid cells with intermediate cells in a bloody background. Cytologic pleomorphism and atypia were more severe in high grade than low and intermediate grade, and nucleoli were more frequently noted in epidermoid cells. In low grade, it is very difficult to decide the benignancy or malignancy of the tumor. In fact, the presence of mucous cells in a mucinous background should rule out any other type of well differentiated carcinoma.

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Prostate cancer in workers exposed to night-shift work: two cases recognized by the Korean Epidemiologic Investigation Evaluation Committee

  • Sungkyun Park;Seongwon Ma;Hoekyeong Seo;Sang Gil Lee;Jihye Lee;Shinhee Ye
    • Annals of Occupational and Environmental Medicine
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    • 제35권
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    • pp.52.1-52.13
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    • 2023
  • Background: In 2019, the International Agency for Research on Cancer re-evaluated the carcinogenicity of night-shift work and reported that there is limited evidence that night-shift work is carcinogenic for the development of prostate cancer. Therefore, in 2020 and 2021, the Korean Epidemiologic Investigation Evaluation Committee concluded that 2 cases of prostate cancer were occupational diseases related to the night-shift work. Here, we report the 2 cases of prostate cancer in night-shift workers which were first concluded as occupational diseases by the Korean Epidemiologic Investigation Evaluation Committee. Case presentation: Patient A: A 61-year-old man worked as a city bus driver for approximately 17 years, from 2002 to 2019, and was exposed to night-shift work during this period. In March 2017, the patient was diagnosed with high-grade prostate cancer through core-needle biopsy after experiencing stinging pain lasting for 2 months. Patient B: A 56-year-old man worked as an electrician and an automated equipment operator in a cement manufacturing plant for 35 years from 1976 to 2013 and was exposed to night-shift work during this period. In 2013, the patient was diagnosed with high-grade prostate cancer through core needle biopsy at a university hospital because of dysuria that lasted for 6 months. Conclusions: The 2 workers were diagnosed with high-grade prostate cancer after working night shifts for 17 and 35 years respectively. Additionally, previous studies have reported that high-grade prostate cancer has a stronger relationship with night-shift work than low or medium-grade prostate cancer. Therefore, the Korean Epidemiologic Investigation Evaluation Committee concluded that night-shift work in these 2 patients contributed to the development of their prostate cancer.

소아 신경모세포종의 치료 후 조직소견의 변화와 예후와의 관계 (Pathologic Change and Prognosis after Combination Therapy in Advanced Neuroblastoma)

  • 서연경;정유진;김준식;김흥식;박우현;최순옥;이병육;권건영
    • Clinical and Experimental Pediatrics
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    • 제46권11호
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    • pp.1107-1111
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    • 2003
  • 목 적 : 진행된 신경모세포종 환아의 약물치료 후 수술한 예에서 조직변화를 관찰하여 예후와의 상관관계를 알아보고자 이 연구를 시행하였다. 방 법 : 1991년 1월부터 2000년 6월까지 계명대학교 동산병원 소아과에서 진단된 신경모세포종 환아 중 항암치료 후 종양절제를 시행한 6례를 대상으로 하였다. 진단 당시 침생검소견과 항암치료 후 조직소견에서 신경모세포의 분화정도와 핵 모양 및 간질조직의 기질화 양상과 석회와 유무 등을 비교하여 변형된 Shimada 분류에 따라 분류하였다 결 과 : 항암치료 전과 후에 조직소견의 변화를 관찰하였으며 변형된 Shimada 분류에 따라 2가지 예후군으로 분류하였으며, 좋은 예후군 3례 중 2명은 생존해 있으며, 1명은 추적되지 않고 사망한 것으로 추정하였으며, 나쁜 예후군의 3례는 각각 패혈증과 retinoic acid 복용 중 발생한 출혈성 췌장염으로 사망하였다. 결 론 : 항암치료 전과 후에 조직소견의 변화를 관찰하였으며 Shimada 분류에 따라 비교하고, 치료 후 종양세포의 성숙을 관찰하였으며, 좋은 예후군에서 생존수가 많은 것을 확인할 수 있었다.