• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.91.1-91.12
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• 2018

Objective: To examine the association between tumor grade and survival for women with squamous cervical cancer. Methods: This retrospective observational study utilized the Surveillance, Epidemiology, and End Result program data between 1983 and 2013 to examine women with squamous cervical cancer with known tumor differentiation grade. Multivariable analyses were performed to assess independent associations between tumor differentiation grade and survival. Results: A total of 31,536 women were identified including 15,175 (48.1%) with grade 3 tumors, 14,084 (44.7%) with grade 2 neoplasms and 2,277 (7.2%) with grade 1 tumors. Higher tumor grade was significantly associated with older age, higher stage disease, larger tumor size, and lymph node metastasis (all, p<0.001). In a multivariable analysis, grade 2 tumors (adjusted-hazard ratio [HR]=1.21; p<0.001) and grade 3 tumors (adjusted-HR=1.45; p<0.001) were independently associated with decreased cause-specific survival (CSS) compared to grade 1 tumors. Among the 7,429 women with stage II-III disease who received radiotherapy without surgical treatment, grade 3 tumors were independently associated with decreased CSS compared to grade 2 tumors (adjusted-HR=1.16; p<0.001). Among 4,045 women with node-negative stage I disease and tumor size ${\leq}4cm$ who underwent surgical treatment without radiotherapy, grade 2 tumors (adjusted-HR=2.54; p=0.028) and grade 3 tumors (adjusted-HR=4.48; p<0.001) were independently associated with decreased CSS compared to grade 1 tumors. Conclusion: Our study suggests that tumor differentiation grade may be a prognostic factor in women with squamous cervical cancer, particularly in early-stage disease. Higher tumor grade was associated with poorer survival.

• 대한방사선기술학회지:방사선기술과학
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• 제31권4호
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• pp.355-365
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• 2008

대뇌 종양의 질환에서 Tumor의 정도를 M.R.S(MR Spectroscopy)를 이용하여 질환의 등급별 비교 분석과 특성을 연구하고자 하였다. M.R.S의 STEAM과 PRESS의 Protocol를 이용하여 High grade Tumor와 Low grade Tumor의 성분을 절편화 하고 질환별 Voxel의 Spectrum의 신호를 얻어서 질환의 생화학적 정보를 정량 분석하고, 각각 실험 결과에 대하여 비교 분석하여 질환의 성분 분석과 질환의 유형을 이해하고자 하였다. High grade Tumor에서는 NAA/Cr이 29.4%와 53.9%의 신호 감소를 보였고, Cho/Cr은 570%와 711%의 급격한 신호 증가를 보임을 알 수 있었고, Low grade Tumor에서는 NAA/Cr이 42.6%와 58.1%의 신호 감소를 보였고, Cho/Cr은 188%와 195%의 신호 증가를 보임을 알 수 있었다. 그리하여, 각 신호의 비교분석을 통한 종양의 정도와 특성을 이해할 수 있었고, 여러 인체장기에 폭 넓은 연구와 자료 확립을 하여야 할 것이다.

• Radiation Oncology Journal
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• 제2권2호
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• pp.177-184
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• 1984

A retrospective analysis of survival data of i2 cases with brain astrocytomas was presented. All patients received post·operative radiotherapy in the period of $1973\~1983$ at YUMC, Yonsei Cancer Center. There were 24 patients with Grade II, 12 patients with Grade III and 16 patients with Grade IV astrocytomas. Survival rates o ere analyzed according to histologic grade of malignancy, age, tumor location, radiation dose and extent of surgical tumor resection. 5year actuarial survival for patients with Grade II astrocytomas was $32.9\%$ and Grade III was $42.9\%$. The 1 year and 2 year survival rate of Grade astrocytomas were $46.7\%$ and $0\%$. Histologic grade of tumor was important prognostic factor in brain astrocytomas. Age and extent of surgical resection were significant prognostic (actors in all grades of astrocytomas and tumor location and radiation dose were significant in Grade f astrocytomas.

• Brain Tumor Research and Treatment
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• 제6권2호
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• pp.97-100
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• 2018

Meningioma is relatively common, benign, and extra-axial tumor accounting for about 20% of primary brain and spinal cord tumors. The World Health Organization (WHO) classified these tumors into Grade I (benign), Grade II (atypical), and Grade III (anaplastic) meningioma. Grade I meningioma which is slowly growing tumor and have some rare subtypes. Among them, metaplastic subtype is defined as a tumor containing focal or widespread mesenchymal components including osseous, cartilaginous, lipomatous, myxoid or xanthomatous tissue, singly or in combinations. We report a rare metaplastic meningioma overspreading nearly whole cerebral convexity from main extra-axial tumor bulk in the parietal lobe.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7821-7824
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• 2014

Background: We investigated the correlation between standardized uptake value (SUVmax), tumor size and Fuhrman grade in patients with renal cell carcinoma (RC). Materials and Methods: We retrospectively analyzed the data of 54 patients with clear cell renal cell carcinoma histopathologically diagnosed who underwent fluorine-18 fluoro-2 deoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) between January 2005 and March 2014. Results: Avarage tumor sizes were $5.64{\pm}1.85$, $6.85{\pm}2.24$ and $7.98{\pm}2.45$ in low, medium and high SUVmax groups, respectively. The Spearman's correlation coefficient between the tumor size and SUVmax was 0.385 (p=0.004) and between the Fuhrman grade and SUVmax was 0.578 (p<0.001). Conclusions: SUVmax appears highly correlated with tumor size and Fuhrman grade in patients with histopathologically confirmed clear cell RC. Multicenter studies are needed to provide larger series for more accurate results.

• 대한골관절종양학회지
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• 제9권1호
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• pp.45-51
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• 2003

목적: 골종양이 의심되는 환자들에게 탈륨 스캔을 시행하여 섭취 정도를 정량적으로 측정하고 비교 분석하여 탈륨 스캔의 악성 골종양 조직에 대한 판별 능력을 규명하고자 한다. 대상 및 방법: 골종양이 의심되는 82명의 환자에 대하여 조직 생검 전에 다른 영상검사와 함께 전향적으로 탈륨 스캔을 시행하였다. 스캔의 결과는 정성적 판독과 정량적 탈륨 섭취율을 측정하였으며, retention index(delayed/early phase의 탈륨 섭취량)를 구하였다. 결과의 분석을 위하여 고등급 악성 골종양 군, 양성 골종양 군, 거대세포종 군 및 저등급 악성 골종양 군으로 나누고 각 그룹간의 통계적 유의성을 조사하였다. 결과: 탈륨 섭취율의 정량적 측정에서는 고등급 악성 골종양 군에서는 early phase에 평균 4.14, delayed phase에서는 평균 2.26였으며, 양성 골종양 군에서는 각각 1.16과 1.09, 거대세포종 군에서는 3.15와 1.94, 저등급 악성 골종양 군에서는 1.41과 1.31이었다. Retention index는 고등급 악성 골종양 군에서는 평균 0.62, 양성 골종양 군에서는 0.97, 거대세포종 군에서는 0.66, 저등급 악성 골종양 군에서는 0.93이었다. 고등급 악성 골종양 군은 early phase와 delayed phase의 탈륨 섭취율이 거대세포종을 제외한 양성 골종양 군 보다 유의하게 높았으며(p<0.001), retention index는 유의하게 낮았다(p<0.001). 결론: 탈륨 스캔은 악성 골종양과 대부분의 양성 골종양을 구분 할 수 있는 유용한 검사라고 사료되지만, 거대세포종의 경우 악성 골종양 같이, 저등급 악성 골종양의 경우 양성 골종양 같이 나타나는 특성에 유의하여 사용하여야 할 것이다.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.67-72
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• 2002

Purpose : Treatment of giant cell tumor of distal radius can be treated in several ways according to the agressiveness of the tumor. We treated 3 cases of widely involved giant cell tumor of distal radius with wide resection and proximal fibular graft and report the results with review of literatures. Material and Method : We have treated 3 cases of giant cell tumor of the distal radius since last 1990. Among 3 cases, two cases were grade III radiologically and treated by wide resection of distal radius and vascularized proximal fibular graft, and one case, grade II radiologically, treated by distal radial resection and non-vascularized proximal fibular graft. We followed up clinical results of above three cases 9 years, 12 years and 2 years. Result : In all three cases, tranplanted fibula graft showed solid union but grade III tumors recurred at 4 year and 6 year postoperatively. One of the case which recurred 4 year later was treated with secondary wide resection and wrist fusion with autogenous iliac bone graft, and didn't show any recurrent finding for these 5 years after re-operation. And another grade III, which recurred at 6th post-operative year, is under follow-up for 6 years after recur without 2nd operation. Grade II case didn't show any recurrent findings on 2 year follow-up. Conclusion : Grade III cases recurred at 4 year and 6 year follow-up. The cause of recurrence was thought to be invasion of remaining tumor cell in the soft tissue. To prevent recurrence, complete resection of primary tumor was necessary.

• Journal of Korean Neurosurgical Society
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• 제40권6호
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• pp.428-433
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• 2006

Objective : We investigated the pattern of glucose uptake in meningiomas using $^{18}F$-fluoro-2-deoxy-D-glucose[FDG] PET/CT. It was hypothesized that the degree of glucose uptake in each tumor could predict the histologic grade. Methods : In 19 patients with meningiomas, the Ki-67 proliferative index, standardized uptake values[SUV] of FDG uptake, tumor to contralateral gray matter ratio[TGR] of SUV, tumor size, edema grade, vascular endothelial growth factor[VEGF] expression, histopathologic grade and the blood supply pattern were assessed. Results : Of the 19 meningiomas, 8 were meningothelial, 1 fibrous, 2 transitional, 1 psammomatous, 2 angiomatous, and 5 atypical. The tumor proliferative index of Ki-67, tumor size, and peritumoral edema were larger in the histopathologic grade-2 meninigiomas than in the grade-1 meningioma group. There were no significant differences in SUV and TGR between two groups. Tumor size and peritumoral edema were significantly larger in VEGF-positive tumors than in negative tumors. Conventional angiography was performed in 12 patients. Dural supply was noted predominantly in 2 patients. Four patients had mainly pial cortical supply patterns. In tumors with more pial supply, VEGF was more frequently positive. There was a significant relation between SUV and Ki-67 and between SUV and peritumoral edema. Conclusion : We found FOG uptake in meningiomas is associated with proliferative potential, however, no clear limits of SUV and TGR can be set to distinguish between grade-1 and grade-2 meningiomas, which makes the assessment of malignancy grade using PET scan metabolic imaging difficult in individual cases.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7541-7546
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• 2015

Aim: To report the histologic findings on Whipple resection specimens and thus determine the extent and spread of carcinomas of ampullary region and head of pancreas in our population. Setting: Section of Histopathology, Department of Pathology, Aga Khan University Hospital (AKUH), Karachi, Pakistan. Materials and Methods: A case series of 311 consecutive Whipple resection specimens received between January 1,2003 and December 31, 2014. Specimens processed for histologic sections and representative sections submitted and histologically examined as per established and standard protocols. All relevant tumor parameters including histologic type, histologic grade, pathologic T and N stage and tumor size were assessed. Epidemiologic data were also recorded. All findings were analysed using SPSS 19.0 software. Results: Ampullary (periampullary) carcinomas were much more common than carcinomas of the head of the pancreas, especially in males, with an average age of 53 years. Mean tumor size was 2.5 cms, over 54% were well differentiated. A large majority were pT2 or pT3 and N0. Carcinomas of pancreatic head were also more common in males, mean age was 55 years, mean tumor size was 3.5cms, and over 65% were moderately differentiated. The majority were T2 or T3 and pN1. Prognostically, significant statistical correlation was seen with tumor grade and pathologic T and N stage (p values statistically significant). However, tumor size was not statistically significant. Conclusions: Ampullary carcinomas are more common compared to pancreatic carcinomas. Majority of ampullary carcinomas were well differentiated while majority of pancreatic carcinomas were moderately differentiated. Large majority of both types of cases were pT2 or T3. Histologic tumor grade and pathologic T and N stage are significantly related to prognosis in Pakistani patients with ampullary and pancreatic cancers.

• Journal of Chest Surgery
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• 제55권2호
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• pp.101-107
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• 2022

Background: Spread through air spaces (STAS) has recently emerged as a prognostic factor in lung adenocarcinoma, but little is known about the association of STAS and its grade with recurrence in neuroendocrine tumors (NETs). This study investigated the prognostic effect of STAS grade in NETs after curative resection. Methods: Seventy-seven patients were retrospectively reviewed, including 9 with typical carcinoid (TC), 6 with atypical carcinoid (AC), 26 with large cell neuroendocrine carcinoma (LCNEC), and 36 with small cell carcinoma (SCC). STAS was defined as the presence of floating tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. STAS was classified as grade 1 or 2 depending on whether it was found within or beyond one ×10 objective lens field away from the main tumor margin, respectively. Results: Fifty-four patients (70%) had STAS, including 22% with TC, 50% with AC, 69% with LCNEC, and 86% with SCC. Patients with STAS had more nodal metastasis, lymphatic and vascular invasion, tumor necrosis, and tumor subtypes other than TC. Among STAS cases, grade 2 STAS was present in 33% of AC, 78% of LCNEC, and 87% of SCC. The 5-year recurrence-free survival (RFS) rate was 81%, 63%, and 35% in patients with no STAS, grade 1, and grade 2 STAS, respectively. Multivariate analysis found that grade 2 STAS was an independent negative prognostic factor for RFS. Conclusion: Although STAS itself was not associated with a poor prognosis, grade 2 STAS was an independent negative prognostic factor for RFS.