• Title/Summary/Keyword: primary liver cancer

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Creatine Kinase (CK)-MB-to-Total-CK Ratio: a Laboratory Indicator for Primary Cancer Screening

  • Chang, Chih-Chun;Liou, Ching-Biau;Su, Ming-Jang;Lee, Yi-Chen;Liang, Chai-Ting;Ho, Jung-Li;Tsai, Huang-Wen;Yen, Tzung-Hai;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6599-6603
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    • 2015
  • Background: For the determination of creatine kinase (CK)-MB, the immunoinhibition method is utilized most commonly. However, the estimated CK-MB activity may be influenced by the presence of CK isoenzymes in some conditions like cancer. Thus, a CK-MB-to-total-CK ratio more than 1.0 could be found in such a situation. The study aimed to explore the relationship of cancer to high CK-MB-to-total-CK ratio. Materials and Methods: From January 2011 to December 2014, laboratory data on all CK-MB and total CK test requests were extracted at Far Eastern Memorial Hospital (88,415 requests). Patients with a CK-MB-to-total-CK ratio more than 1.0 were registered in this study. Clinical data including tumor location, tumor TNM stage and metastatic status were also collected. Results: A total of 846 patients were identified with a CK-MB-to-total-CK ratio more than 1.0. Of these, 339 (40.1%) were diagnosed with malignancies. The mean CK-MB-to-total-CK ratio was significantly higher in malignancy than in non-malignancy ($1.35{\pm}0.28$ vs $1.25{\pm}0.23$, p<0.001) groups. The most frequent malignancy with a CK-MB-to-total-CK ratio more than 1.0 was colorectal cancer ($1.42{\pm}0.28$, 16.5%, n=56), followed by lung cancer ($1.38{\pm}0.24$, 15.9%, n=54) and hepatocellular carcinoma (14.5%, n=49). Higher CK-MB-to-total-CK ratios in hematological malignancies ($1.44{\pm}0.41$)were also noted. Additionally, the CK-MB-to-total-CK ratio was markedly higher in advanced stage malignancy than in early stage ($1.37{\pm}0.26$ vs. $1.29{\pm}0.31$, p=0.014) and significantly higher in liver metastasis than in non-liver metastasis ($1.48{\pm}0.30$ vs. $1.30{\pm}0.21$, p<0.001). Conclusions: The CK-MB-to-total-CK ratio is an easily available indicator and could be clinically utilized as a primary screening tool for cancer. Higher ratio of CK-MB-to-total-CK was specifically associated with certain malignancies, like colorectal cancer, lung cancer and hepatocellular carcinoma, as well as some cancer-associated status factors such as advanced stage and liver metastasis.

A Case of Extramedullary Hematopoiesis Presenting as a Lung Mass in a Patient with Primary Myelofibrosis (폐 종괴로 나타난 원발성 골수섬유증 환자의 골수 외 조혈 1예)

  • Kim, Yeo Myeong;Kim, Hyeon Tae;Noh, Geum Youb;Kang, Min Soo;Chang, Yoon Hwan;Kim, Hye-Ryoun;Lee, Jae Cheol;Kim, Cheol Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.244-248
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    • 2009
  • Primary myelofibrosis is characterized by replacement of bone marrow with fibrotic tissue and the development of extramedullary hematopoiesis. Extramedullary hematopoiesis primarily involves the spleen and liver, but can also occur in the lungs. We report the case of an 80-year-old male who was admitted for evaluation of a lung mass and persistent thrombocytopenia. A percutaneous needle aspiration from the mass in the right lower lung showed myelopoietic cells with fatty tissue. A bone marrow biopsy revealed a hypercellular marrow with an increased number of atypical megakaryocytes. The final diagnosis was a prefibrotic stage of primary myelofibrosis leading to extramedullary hematopoiesis in the lung.

Caregiver burden and family functioning of cancer patient (암환자 가족원의 부담감과 가족기능)

  • Park, Yeon Hwan;Hyun, Hye Jin
    • Korean Journal of Adult Nursing
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    • v.12 no.3
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    • pp.384-395
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    • 2000
  • This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.

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Clinical Observation of Liver Scintigram (간(肝) Scintigram의 임상적(臨床的) 고찰(考察))

  • Moon, Sung-Soo;Oh, Kyoung-Sik;Kim, Yul-Za;Kim, Yong-Cheol;Lee, Chong-Suk;Lee, Hak-Choong
    • The Korean Journal of Nuclear Medicine
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    • v.14 no.2
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    • pp.19-27
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    • 1980
  • Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.

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CLINICAL CHARACTERISTICS OF SECOND PRIMARY CANCER IN ORAL CANCER PATIENTS (구강암 환자에서 발생하는 이차암의 임상적 특징 분석)

  • Jo, Sae-Hyung;Shin, Jeong-Hyun;Lee, Ui-Ryoung;Park, Joo-Young;Choi, Sung-Weon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.1
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    • pp.57-61
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    • 2010
  • Objective: Second primary malignancy (SPM) that occur in various period and region are important factors that deteriorate long-term survival rate in patients who recovered from oral cancer. Researches such as chemoprevention are being tried to reduce occurrence of SPMs. Only if analysis of clinical features of patients who develop SPM such as period, region and factors precedes, adequate prevention and treatment of SPM is possible. But, there are few researches about clinical features of SPMs that have primary lesion in oral cavity. In this study, we analysis that occurrence rates, regions that happen, risk factors and effect to survival rates of 2nd primary malignancies in oral cancer patients. From this survey, we willing to collect basic data for prevention and early diagnosis of SPMs. Methods: The medical records of 139 patients of oral oncology clinic of National Cancer Center who had up to 2-years follow up records after surgical or radiological treatment due to squamus cell carcinoma of oral cavity were reviewed. In these patients, survey of occurrence rate of SPMs, duration, survival rate and risk factors about occurrence of SPMs such as history of smoking, body mass index, age, sex, stage of primary lesion and history of radiologic treatment were achieved. Results: There are 15 patients who developed SPM in 139 cases. The actual occurrence rate of SPM was 10.79% and SPM were more likely to occur in male patients with 11 male Vs 4 female patients. Median age of these patient is 61.47 within 32 to 74 range. The regions that develop SPM are oral cavities (2 cases), stomach (4 cases), esophagus (2 cases), lung (2 cases) and others (1 case each breast, larynx, cervix, liver and kidney). In addition, metachronous cancers were 11 cases which happened more common than 4cases of synchronous cancers. Surveys of risk factors that relate to development of SPMs, such as sex, age, history of radiologic treatment, body mass index, history of smoking and stage of primary disease were done. Among them, factor of sex is only appear statistically significant (P=0.001), but rest are not significant in statistically. Conclusion: Occurrence rates of SPMs were reported from 10% to 20% by precede study. In this study, occurrence rate of SPMs is 10.79% that is similar to results of precede research. In comparison of 5-yr survival rates of groups that develop SPMs or not, there is statistically significance between two groups. Present treatment modalities of SPMs are surgical operation, radiotherapy, chemotherapy and combination of these modalities. In choosing the treatment modality, we must consider the first treatment modality, region of primary disease, region of SPMs and general conditions of patient. Because development of SPMs have big effect on prognosis, prevention of SPMs must regard to important objective of treatments in patients of SCCa in oral cavity.

Rising Incidence of Primary Liver Cancer in Brunei Darussalam

  • Chong, Raymond Jih Yeong;Abdullah, Mohd Syafiq;Hossain, Mohammad Moshaddeque;Telisinghe, Pemasari Upali;Chong, Vui Heng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3473-3477
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    • 2013
  • Background: Primary liver cancer (PLC) is the fifth most common malignancy worldwide and is still associated with high mortality. Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the two most common PLCs, and their incidence varies across regions. Currently there are no published data available on the incidence of PLC in Brunei Darussalam. Materials and Methods: All proven PLCs between 2000 and 2009 were identified from the National Cancer Registry and reviewed. Metastatic diseases were excluded. A total of 123 cases (male 65.8%, female 34.2%) were identified and their data collected for calculation of the age standardised rate (ASR). Results: The most common type of PLC was HCC (87.8%) followed by cholangiocarcinoma (10.6%). There were two cases of hepatoblastoma. The mean age at diagnosis was 63.2 years. The overall ASR of PLC was 8.2/100,000, increasing from 4.5/100,000 population in 2000 to 11.4/100,000 population in 2009. The rates were higher among males (12.0/100,000) than females (4.7/100,000). Among the ethnic groups, Chinese had the highest rates (overall 13.1/100,000 with none recorded in 2000 to 30.3/100,000 in 2009) compared to the Malays (overall 8.5/100,000 increasing from 4.5/100,000 in 2000 to 12.3/100,000 in 2009) and the indigenous groups. The incidence increased after the age of 50 and was highest among the 75-79 age groups. Increase was seen for HCC but not for cholangiocarcinoma. Conclusions: The most common type of PLC is HCC and the annual incidence of PLC is increasing in Brunei Darussalam,rates being higher in males and Chinese.

A Case of Improvement of Metastatic Ovarian and Endometrial Cancer Treated by Integrative Medicine Therapy Combined with Chemotherapy (항암치료와 통합암치료 병용으로 호전된 전이성 난소 및 자궁내막암 환자 1례)

  • Jin, Yong Jae;Shin, Kwang Soon;Ha, Jee Yong
    • Journal of Korean Traditional Oncology
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    • v.19 no.1
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    • pp.33-41
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    • 2014
  • This report is aimed to investigate the effect of Integrative Medicine Therapy (IMT) in treating metastasized ovary and endometrial cancer. A 51-year-old woman who was diagnosed double primary ovarian and endometrial cancer in 2009. The patient was treated with Laparoscopic Assisted Vaginal Hysterectomy (LAVH), Bilateral Salpingo Oophorectomy (BSO) Pelvic Lymph Node Dissection (PLND), adjuvant chemotherapy till Sep. in 2013. But metastases to Rt. External Iliac artery, Aortocaval area Lymph Nodes, Liver(caudate lobe), Rt. Buttock subcutaneous area, Lt. Gastric Area Lymph Nodes were found. Finally, the patient decided to be treated by IMT including Abnoba Viscum, Vitamin C, herbal medication and pharmacopuncture combined with chemotherapy. The efficacy was evaluated with Positron Emission Tomography and Computed Tomography (PET-CT) and Abdomen Computed Tomography (CT). The metastatic tumor in liver was disappeared and Rt. external iliac artery, aortocaval area Lymph Nodes, Rt. buttock subcutaneous area were also decreased after 6 months treatment. These results suggest that IMT may have a potential role for metastatic cancer.

Microwave Ablation Treatment of Liver Cancer with a 2,450-MHz Cooled-shaft Antenna: Pilot Study on Safety and Efficacy

  • Jiao, De-Chao;Zhou, Qi;Han, Xin-Wei;Wang, Ya-Feng;Wu, Gang;Ren, Jian-Zhuang;Wang, Yan-Li;Ding, Peng-Xu;Ma, Ji;Fu, Ming-Ti
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.737-742
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    • 2012
  • To evaluate efficacy of microwave ablation in a primary clinical study, sixty patients (44 men, 16 women; mean age 53 years) with 96, 1-8 cm (mean $3.20{\pm}0.17$ cm) liver cancers were treated with 2,450-MHz internally cooled-shaft antenna. Complete ablation (CA) and local tumor progression (LTP) rates as well as complications were determined. CA rates in small (< 3.0 cm), intermediate (3.1-5.0 cm) and large (5.1-8.0 cm) liver cancers were 96.4% (54/56), 92.3% (24/26) and 78.6% (11/14), respectively. During a mean follow-up period of $17.17{\pm}6.52$ months, LTP occurred in five (5.21%) treated cases. There was no significant difference in the CA and LTP rates between the HCC and liver metastasis patient subgroups (P<0.05). Microwave ablation provides a reliable, efficient, and safe technique to perform hepatic tumor ablation.

Pyogenic Liver Abscess as a Warning Sign for Primary Liver Cancer: A Nationwide Population-based Study

  • Huang, Wen-Kuan;Lin, Yung-Chang;Chiou, Meng-Jiun;Yang, Tsai-Sheng;Chang, John Wen-Cheng;Yu, Kuang-Hui;Kuo, Chang-Fu;See, Lai-Chu
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4727-4731
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    • 2013
  • Background: There have been no large-scale population-based studies to estimate the subsequent risk of primary liver cancer (PLC) among patients with pyogenic liver abscess (PLA). This study aimed to provide relevant data. Materials and Methods: The Taiwan Longitudinal Health Insurance Database for the years 2000 and 2005 was used. The PLA group were adult inpatients who were newly diagnosed with PLA from 2000 to 2008. The control group was randomly selected and matched with the PLA group in terms of age, sex, and date in which medical treatment was sought other than for PLA. Results: There were 1,987 patients each in the PLA and control groups. In total, 56 had PLC, 48 (2.4%, 601.5 per 100,000 person-years) from the PLA group, and 8 from the control group. After adjusting for potential covariates, the hazard ratio of PLC for the PLA group was 3.4 times that of the control group (95% confidence interval = 1.6-7.3, p <0.001). The PLC risk for the PLA group was significantly higher within the first year after PLA diagnosis (hazard ratio: 35.4) as compared with the control group and became insignificant (hazard ratio: 2.0, 95% confidence interval = 0.8-4.9) more than one year after PLA diagnosis. Conclusions: Patients with PLA have a higher rate of PLC than matched controls, especially within the first year after the diagnosis of PLA, suggesting PLA is a warning sign for PLC.

Hepatic Solitary Metastasis of Gastric Cancer: Radiofrequency (위암의 단일결절 간전이에 대한 고주파 열치료(Radiofrequency))

  • Ryu, Keun-Won;Kim, Min-Ju;Park, Sook-Ryun;Lee, Jong-Seok;Lee, Jun-Ho;Kim, Young-Woo
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.10-13
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    • 2009
  • The prognosis of gastric cancer with hepatic metastasis is very poor, even though several treatment modalities exist, such as surgical resection. Indeed, a standard therapy has not been established in such patients. Recently, attempts were made to treat hepatic metastasis of gastric cancer with radiofrequency (RF), which was originally used in primary or metastatic liver cancer. RF has been reported to show similar survival compared to surgical resection and is emerging as a new treatment modality even though it is still not conclusive with respect to efficacy and safety due to the paucity of reports. A prospective study is warranted to evaluate the efficacy of RF in the treatment of gastric cancer with hepatic metastasis compared with conventional modalities.

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