• Title/Summary/Keyword: pancreatic adenocarcinoma

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Comparison of survival prediction models for pancreatic cancer: Cox model versus machine learning models

  • Kim, Hyunsuk;Park, Taesung;Jang, Jinyoung;Lee, Seungyeoun
    • Genomics & Informatics
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    • 제20권2호
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    • pp.23.1-23.9
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    • 2022
  • A survival prediction model has recently been developed to evaluate the prognosis of resected nonmetastatic pancreatic ductal adenocarcinoma based on a Cox model using two nationwide databases: Surveillance, Epidemiology and End Results (SEER) and Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP). In this study, we applied two machine learning methods-random survival forests (RSF) and support vector machines (SVM)-for survival analysis and compared their prediction performance using the SEER and KOTUS-BP datasets. Three schemes were used for model development and evaluation. First, we utilized data from SEER for model development and used data from KOTUS-BP for external evaluation. Second, these two datasets were swapped by taking data from KOTUS-BP for model development and data from SEER for external evaluation. Finally, we mixed these two datasets half and half and utilized the mixed datasets for model development and validation. We used 9,624 patients from SEER and 3,281 patients from KOTUS-BP to construct a prediction model with seven covariates: age, sex, histologic differentiation, adjuvant treatment, resection margin status, and the American Joint Committee on Cancer 8th edition T-stage and N-stage. Comparing the three schemes, the performance of the Cox model, RSF, and SVM was better when using the mixed datasets than when using the unmixed datasets. When using the mixed datasets, the C-index, 1-year, 2-year, and 3-year time-dependent areas under the curve for the Cox model were 0.644, 0.698, 0.680, and 0.687, respectively. The Cox model performed slightly better than RSF and SVM.

One Case of BRCA2 Germline Mutation Ovarian Cancer Mother and Carrier Daughter found by Genetic Counseling

  • Lee, Eun Jung;Jeong, Hee Jeong;Kim, Min Kyu
    • Journal of Genetic Medicine
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    • 제10권2호
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    • pp.124-127
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    • 2013
  • Among cause of carcinogenesis, heredity is believed to take about 10 percent in ovarian cancer. BRCA1 or BRCA2 account for largest portion of Hereditary Breast and Ovary Cancer (HBOC). Frequency of BRCA1/2 germ line mutations varies according to region and ethnicity from 1.1-39.7 percent. The identification of ovarian cancers with a BRCA mutation is will be more and important due to the possibility to offer a genetic counseling and also due to potential beneficial treatment effects with a poly-ADP-ribose polymerase inhibitor in some individuals. We report the case of a 41 year old woman with a stage Ic mucinous ovarian adenocarcinoma and carrier daughter found on family genetic counseling. We indentified other family members with a history of breast cancer of 1st degree and pancreatic cancer of 2nd degree relative. After a screening with immunohistochemistry, the absence of nuclear expression for BRCA1 and BRCA2 was revealed. The gene sequencing confirmed heterozygous mutations of BRCA2 gene. The daughter of the case subject consented for a test. This test was shown the daughter is positive for BRCA2 mutation. Regular surveillance, chemoprophylaxis with oral contraceptive and prophylactic surgery after childbearing were offered to her.

췌장 두부 또는 십이지장을 침범한 위암에서의 수술적 치료 (Surgical Treatment of Gastric Cancer Invading the Pancreatic Head or Duodenum)

  • 김수열;이종명;김우영
    • Journal of Gastric Cancer
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    • 제7권4호
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    • pp.193-199
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    • 2007
  • 목적: 주위 장기를 침범한 진행성 위암에서 병소의 완전한 절제를 위해서는 침범된 장기의 합병 절제가 필수적이다. 그러나 종양이 췌장 두부나 십이지장물 침범하는 경우에는 낮은 절제 성공과 높은 이환율로 인하여 병소의 완전한 절제는 제한된다. 이에 저자들은 췌장 두부 또는 십이지장을 침범한 위암에서 시행된 수술 방법을 후향적으로 분석하여 수술 방법 선정의 적절성을 알아보고가 하였다. 대상 및 방법: 1998년 1월부터 2003년 12월까지 5년가 예수병원 외과에서 위선암으로 진단되어 수술을 시행한 환자 중 수술 소견상 원발 종양이나 구역 림프절에 의해 췌장 두부나 십이지장의 침범이 의심되는 45명의 환자 중 비치유 인자를 동반하지 않은 22예를 대상으로 후향적 연구를 시행하였다. 합병 절제를 시행한 4예를 PD군, 위아전절제술만을 시행한 12예를 STG군, 고식적 우회술만을 시행한 6예를 GJ군으로 분류하였다. 각 군에서 임상병리학적 특성 및 수술적 자료를 비교 분석하였다. 결과: PD군은 모두 D3 림프절 절제술을 포함하는 췌십이지장절제술을 시행하여 병소의 완전한 절제를 하였으며, 1예에서 췌장루를 보였고(이환율 25%) 수술로 인할 사망 예는 없었다(사망률 0%), PD군은 모두 제 IV 병기였으나 75%의 2년 생존율과 50%의 5년 생존율을 보였다. STG군은 종양을 변연 절제(marginal resection)하거나 (6예) 고식적 절제술을 시행하였으며(6예) 림프절 절제의 범위도 D2 이하로 적었고 41.7%의 2년 생존율과 16,7%의 5년 생존율 보였다. GJ군은 평균 연령이 $72.7{\pm}8.6$세로 고랑이었으며 2년 생존율이 0%였다. 결론: 췌장 두부를 침범한 진행성 위선암에서 합병 절제로서의 췌십이지장절제는 중등도 이환율과 낮은 사망률로 비교적 안전하게 시행될 수 있고 비치유 인자가 없는 경우 장기 생존을 기대할 수 있는 술식으로 생각된다.

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하지의 통증 및 부종을 주소로 내원한 환자에서 발견된 폐암1예 (Lung Cancer Presented as Painful Swelling of Lower Legs)

  • 안진영;이장은;박형욱;이정화;양승아;박용근;이상록
    • Tuberculosis and Respiratory Diseases
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    • 제61권4호
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    • pp.398-402
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    • 2006
  • 저자들은 하지 부종과 통증을 주소로 내원한 환자에서 심부 정맥혈전증과 폐암이 있는 환자를 경험하였기에 혈전의 유발 원인이 없는 환자에서 발생하는 특발성 혈전증 환자에서 잠재적 종양에 대한 주의 관찰이 필요할 것으로 보여 문헌 고찰과 함께 더불어 보고하는 바이다.

Xanthogranulomatous Pancreatitis Mimicking a Pancreatic Cancer on CT and MRI: a Case Report and Literature Review

  • Park, Jong Min;Cho, Seung Hyun;Bae, Han-Ik;Seo, An Na;Kim, Hye Jung;Lee, So Mi;Yi, Jae Hyuck;Lim, Jae-Kwang;Cho, Chang Min
    • Investigative Magnetic Resonance Imaging
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    • 제20권3호
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    • pp.185-190
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    • 2016
  • Xanthogranulomatous inflammation is a rare benign condition involving various organs. However, its pancreas involvement is very rare. To the best of our knowledge, only 17 cases have been described in the literature. Interestingly, all reported 17 cases due to various causes underwent surgical resection. Here, we present a case of xanthogranulomatous pancreatitis in a 63-year-old man. He presented with epigastric pain and solid mass mimicking ductal adenocarcinoma in the body and tail of pancreas on magnetic resonance imaging. The patient was diagnosed as xanthogranulomatous pancreatitis via endoscopic ultrasound-guided fine needle aspiration. After that, he was followed up and monitored without any surgical treatment. Here, we show imaging findings and serial image changes of xanthogranulomatous pancreatitis for this case.

The Effect of miR-361-3p Targeting TRAF6 on Apoptosis of Multiple Myeloma Cells

  • Fan, Zhen;Wu, Zhiwei;Yang, Bo
    • Journal of Microbiology and Biotechnology
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    • 제31권2호
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    • pp.197-206
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    • 2021
  • microRNA-361-3p (miR-361-3p) is involved in the carcinogenesis of oral cancer and pancreatic catheter adenocarcinoma, and has anti-carcinogenic effects on non-small cell lung cancer (NSCLC). However, its effect on multiple myeloma (MM) is less reported. Here, we found that upregulating the expression of miR-361-3p inhibited MM cell viability and promoted MM apoptosis. We measured expressions of tumor necrosis factor receptor-associated factor 6 (TRAF6) and miR-361-3p in MM cells and detected the viability, colony formation rate, and apoptosis of MM cells. In addition, we measured expressions of apoptosis-related genes Bcl-2, Bax, and Cleaved caspase-3 (C caspase-3). The binding site between miR-361-3p and TRAF6 was predicted by TargetScan. Our results showed that miR-361-3p was low expressed in the plasma of MM patients and cell lines, while its overexpression inhibited viability and colony formation of MM cells and increased the cell apoptosis. Furthermore, TRAF6, which was predicted to be a target gene of miR-361-3p, was high-expressed in the plasma of patients and cell lines with MM. Rescue experiments demonstrated that the effect of TRAF6 on MM cells was opposite to that of miR-361-3p. Upregulation of miR-361-3p induced apoptosis and inhibited the proliferation of MM cells through targeting TRAF6, suggesting that miR-361-3p might be a potential target for MM therapy.

Reconstruction and Exploratory Analysis of mTORC1 Signaling Pathway and Its Applications to Various Diseases Using Network-Based Approach

  • Buddham, Richa;Chauhan, Sweety;Narad, Priyanka;Mathur, Puniti
    • Journal of Microbiology and Biotechnology
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    • 제32권3호
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    • pp.365-377
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    • 2022
  • Mammalian target of rapamycin (mTOR) is a serine-threonine kinase member of the cellular phosphatidylinositol 3-kinase (PI3K) pathway, which is involved in multiple biological functions by transcriptional and translational control. mTOR is a downstream mediator in the PI3K/Akt signaling pathway and plays a critical role in cell survival. In cancer, this pathway can be activated by membrane receptors, including the HER (or ErbB) family of growth factor receptors, the insulin-like growth factor receptor, and the estrogen receptor. In the present work, we congregated an electronic network of mTORC1 built on an assembly of data using natural language processing, consisting of 470 edges (activations/interactions and/or inhibitions) and 206 nodes representing genes/proteins, using the Cytoscape 3.6.0 editor and its plugins for analysis. The experimental design included the extraction of gene expression data related to five distinct types of cancers, namely, pancreatic ductal adenocarcinoma, hepatic cirrhosis, cervical cancer, glioblastoma, and anaplastic thyroid cancer from Gene Expression Omnibus (NCBI GEO) followed by pre-processing and normalization of the data using R & Bioconductor. ExprEssence plugin was used for network condensation to identify differentially expressed genes across the gene expression samples. Gene Ontology (GO) analysis was performed to find out the over-represented GO terms in the network. In addition, pathway enrichment and functional module analysis of the protein-protein interaction (PPI) network were also conducted. Our results indicated NOTCH1, NOTCH3, FLCN, SOD1, SOD2, NF1, and TLR4 as upregulated proteins in different cancer types highlighting their role in cancer progression. The MCODE analysis identified gene clusters for each cancer type with MYC, PCNA, PARP1, IDH1, FGF10, PTEN, and CCND1 as hub genes with high connectivity. MYC for cervical cancer, IDH1 for hepatic cirrhosis, MGMT for glioblastoma and CCND1 for anaplastic thyroid cancer were identified as genes with prognostic importance using survival analysis.

내시경초음파 세침흡인술을 통한 전이성 미분화육종의 진단 (Diagnosis of Metastatic Undifferentiated Sarcoma by Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS-FNA))

  • 김시영;이희승;정문재;박정엽;방승민;박승우;송시영
    • Journal of Digestive Cancer Research
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    • 제5권2호
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    • pp.120-124
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    • 2017
  • A-49-year-old male patient with no specific medical history was admitted to the clinic because of persistent epigastric pain radiating to back for 4 months. He had multiple parenchymal tumors in body and tail of pancreas, para-spinal muscle, and mediastinum on abdomen CT image. Cytologic examination of the pancreas which was done by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) showed adenocarcinoma, whereas histological examination of the para-spinal mass showed undifferentiated sarcoma. Histologic examination of the pancreatic mass was made through endoscopic ultrasound guided fine needle biopsy (EUS-FNB) for accurate diagnosis, and the histologic examination of both the pancreas and posterior mediastinal mass showed the same undifferentiated sarcoma. Therefore, we reviewed the cytopathic tissue obtained from the pancreas for the first time, and it was confirmed to be similar to histologic findings in the mediastinal mass.

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EphB1 and Ephrin-B, New Potential Biomarkers for Squamous Cell/adenosquamous Carcinomas and Adenocarcinomas of the Gallbladder

  • Yuan, Yuan;Yang, Zhu-Lin;Miao, Xiong-Ying;Liu, Zi-Ru;Li, Dai-Qiang;Zou, Qiong;Li, Jing-He;Liang, Lu-Feng;Zeng, Gui-Xiang;Chen, Sen-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권3호
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    • pp.1441-1446
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    • 2014
  • Squamous cell/adenosquamous carcinoma (SC/ASC) of the gallbladder are rare tumors and there are few clinical reports in the literature. Herein we report our clinical experience with 46 patients with SC/ASC and 80 with adenocarcinoma (AC). Expression of EphB1 and Ephrin-B in each tumor was determined using immunohistochemical methods for determination of correlations with prognosis. There was no difference in EphB1 and Ephrin-B expression between SC/ASC and AC tumors (P>0.05), but greater expression in those less than 3 cm in diameter, stage I or II (TNM stage), with no lymph node metastases, with no local invasion and treated with radical resection was apparent. Expression of EphB1 (P<0.05) and Ephrin-B (P<0.01) was higher in well differentiated than in poorly differentiated AC tumors. Kaplan-Meier survival analysis indicated that degree of differentiation, tumor diameter, lymph node metastases, local invasion, surgical approach and expression rate of EphB1 and Ephrin-B were closely related to the survival of SC/ASC (P<0.05) and AC patients (P<0.01). Patients with tumors that positive expressed EphB1 and Ephrin-B, whether it is SC/ASC ($P_{SC/ASC}$ =0.000) or AC ($P_{AC}$ =0.000 or $P_{AC}$ =0.002) had longer survival than those negative expression. Cox multivariate analysis indicated a negative correlation between expression of EphB1 or Ephrin-B and overall survival. Hence, EphB1 and Ephrin-B could be regarded as independent good prognostic factorsand important biological markers for SC/ASC and AC of gallbladder.

위에 발생한 소세포암의 임상 경험 (Clinical Experience of Small-cell Carcinomas of the Stomach)

  • 김형주;박문향;권성준
    • Journal of Gastric Cancer
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    • 제5권4호
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    • pp.252-259
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    • 2005
  • 위에 발생하는 원발성 소세포암은 매우 드물며 예후는 좋지 않아 초기에 발견되어도 60% 이상이 1년 이내에 사망한다. 본원 외과에서 수술치료를 받은 위소세포암 첫 번째 증례는 수술소견상 복막전이 소견 등으로 근치적 수술이 불가능하여 위공장문합술을 시행하였다. 수술 후 etoposide, cisplatin화학요법을 시행하고 6개월 뒤에 찍은 CT촬영상 복막전이, 림프절전이가 악화되어 paclitaxel, cisplatin으로 약제변경 하였으나 수술 후 14개월째 사망하였다. 두 번째 증례는 내시경 조직검사상 위선암과 소세포암의 복합 소견을 보였으며 CT 촬영상 복강동맥주위 림프절종대 및 간전이 소견이 발견되었다. TS-1과 cisplatin 선행화학요법 2차 시행 후 림프절 종대는 완전관해, 원발소 및 간전이소는 부분관해 소견을 보여 위전절제술 및 확대림프절 절제술을 시행하였다. 수술로 절제된 위 및 주변 림프절 35개의 조직검사상 암세포가 모두 사멸되었으며 위내 원 발병소는 심한 심유화변성 소견을 보여 수술 전 사용한 항암요법이 유의했다고 판단되었다. 이에 수술 후에도 동일 제제로 4차례 추가 투약을 하였다. 수술 후 6개월에 시행한 CT촬영상 간전이가 진행된 소견을 보여 간우엽 후부절제술을 시행하고 이후 ininotecan과 cisplatin을 이용한 항암화학요법을 5차례 시행하고 있으며 술 후 14개월째 생존 중이다. 세 번째 증례는 순수 소세포암으로 근치적 위아전절제술을 시행하였으며 수술 후 5차례에 걸쳐 TS-1, cisplatin 보조항암화학요법 시행하였고 수술 후 13개월째 재발 없이 생존 중이다.

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