• Radiation Oncology Journal
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• 제26권1호
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• pp.17-23
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• 2008

목적: 최근 진행된 식도암의 치료는 병행항암방사선요법 후 수술을 시행하는 것이 가장 성적이 좋은 것으로 보고되고 있다. 그러나 병행치료의 발전에도 불구하고 여전히 많은 식도암 환자에서 병행치료가 어려워 방사선치료 단독으로 치료받게 된다. 이에 저자는 통상적인 외부방사선치료를 받은 식도암 환자의 치료성적과 예후인자를 알아 보고자 하였다. 대상 및 방법: 1998년 1월부터 2005년 12월까지 식도의 편평상피세포암으로 진단받고 40 Gy 이상 외부방사선조사를 받은 30명의 환자를 대상으로 분석하였다. 총방사선량은 $44{\sim}60Gy$(중간선량 57.2 Gy)이었으며 방사선치료 기간은 $36{\sim}115$일(중간방사선치료기간 45일)이었다. 13명(43.3%)의 환자는 당뇨, 고혈압, 결핵 등의 과거력이 있었으며 그중 4명의 환자에서 식도암 진단 전 3명이 위암, 1명이 하인두암으로 진단받고 치료받은 적이 있었다. 원발병소부위는 중흉부식도에 위치한 예가 19명(63.3%)으로 가장 많았고 상흉부식도 4명(13.3%), 하흉부식도 7명(23.3%)이었다. 원발병소의 길이는 $2{\sim}11cm$이었고, 중간 길이는 6 cm이었다. 진단당시 병기는 AJCC 병기로 병기 I이 2명(6.7%), 병기 II 4명(13.3%), 병기 III 19명(63.3%), 병기 IV 5명(16.7%)이었다. 결과: 전체 환자의 중간 생존기간은 8.3개월이었고 1년 생존율 33.3%, 2년 생존율 18.7%이었다. 치료종료 $1{\sim}3$개월째 치료결과를 판정하여 완전관해를 보인 환자가 6명(20%), 부분관해 21명(70%)이었다. 치료종료 $1{\sim}3$개월 후에 평가한 연하곤란증상은 29명(96.7%)의 환자에서 호전되었다. 치료성적에 영향을 미치는 예후인자에 대한 단변량 분석결과 연령, 종양의 길이, 병기, 치료 전 식사, 치료 목적, 치료에 따른 반응정도가 통계적인 유의성을 보였다. 다변량분석에서는 종양의 길이, 치료 목적, 치료에 따른 반응정도가 생존율에 영향을 미치는 인자로 확인되었다. 치료실패는 국소 실패가 28명, 전이가 4명이었다. 추적조사기간동안 2명의 환자에서 이차적인 암이 발생하여 과거력상 식도이외의 암이 있었던 환자를 포함하면 6명(20%)에서 다발성 암으로 진단받았다. 치료로 인한 부작용 중 식도협착이 발생한 예가 3명(10%), 방사선폐렴이 발생한 예가 2명(6.7%)이었다. 결론: 식도암에서 단독 방사선치료 결과는 병행치료에 비해 만족스럽지 못하지만 부작용이 많지 않아 연하곤란증상을 완화시키기 위한 목적으로 여전히 이용되고 있다. 진행된 식도암에서 항암제 혹은 항암제 이외의 적절한 병행치료를 시행하여 완전관해율을 높인다면 생존율의 향상을 얻을 수 있으리라 기대해 본다.

• 한국식품영양과학회지
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• 제25권2호
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• pp.352-366
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• 1996

The nutritional status of host has a profound effect on immune response and its ability to defend aganinst invading pathogen. Almost all nutrient dificiencies impaired host defence, and more than recommended levels of certain nutrient enhance immune response beyond that observed with 'adequate'. But high-fat diets have been associated with various types of immune dysfunction in experimental animal models and humans. Also, high linoleic acid suppressed immune function and growth and metastasis of tumor than saturated fatty acids. The present review focused on the effect of dietary lipid on immune fuction, cytokine production and clinical conditions like infection, autoimmune disease and cancer.

• Radiation Oncology Journal
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• 제35권3호
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• pp.217-226
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• 2017

Purpose: Hematotoxicity following anti-cancer treatment is known to be related to treatment efficacy in several malignancies. The purpose of this study was to examine the hematologic parameters related to the tumor response and survival in patients treated with curative surgery following preoperative chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: Four hundred eighteen patients with rectal cancer who underwent preoperative CRT and curative surgery were analyzed, retrospectively. The main clinical factors and blood cell counts before and after CRT were investigated with respect to their relationships with tumor downstaging and patient survival. Results: The post-CRT leukocyte count was significantly different between the tumor downstaging group and the non-downstaging group (median, 4740/uL vs. 5130/uL; p = 0.013). Multivariate analysis showed that histological grade, circumferential extent, and post-CRT leukocyte count were related to tumor downstaging. In addition, histological grade, post-CRT leukocyte count, and tumor downstaging were related to disease-free survival. The 5-year disease-free survival and overall survival in patients with post-CRT leukocyte count ${\leq}3730/uL$, which is the cut-off value derived from the receiver operation characteristic (ROC) curve analysis, were significantly higher than those with higher counts (88.0% vs. 71.6%, p = 0.001; 94.4% vs. 84.1%, p = 0.024). Conclusion: Post-CRT leukocyte count of ${\leq}3730/uL$ could be regarded as a good prognostic factor for tumor response and survival in rectal cancer patients treated with preoperative CRT.

• 생명과학회지
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• 제23권8호
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• pp.970-977
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• 2013

Epithelial-to-mesenchymal transition (EMT)는 embryogenesis에서 중요한 역할을 하며 tumor metastasis, invasion에도 관여함으로써 tumor progression 및 aggressiveness에 기여한다. EMT는 EMT hallmark인 epithelial E-cadherin의 발현 감소와 mesenchymal-like cell morphology를 획득함으로써 epithelial cell polarity를 잃어버리는 특징을 가지고 있다. $O_2{^-}$, $H_2O_2$, $OH^-$와 같은 활성산소가 EMT를 유도하는 것으로 알려져 있다. Snail이 E-cadherin의 발현을 억제함으로써 ROS에 의한 EMT에 관여하는 것으로 알려져 있으나, 그 기작은 완전히 밝혀져 있지 않다. 본 연구에서는, noninvasive breast tumor cell line인 MCF-7 세포에 Egr-1을 과발현시킨 후 그 영향을 조사하였다. Egr-1이 과발현되면, MCF-7 세포는 epithelial cell polarity를 잃고 spindle-shaped로 변화되므로, Egr-1이 EMT를 유도할 가능성이 대두되었다. 또한 Snail이 Egr-1에 의한 EMT에 관여함을 확인하였다. 나아가, 본 연구진은 Egr-1-Snail axis가 ROS에 의해 활성화 되고, ROS에 의한 EMT에서 중요한 역할을 함을 발견하였다.

• Journal of Animal Science and Technology
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• 제50권6호
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• pp.849-856
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• 2008

본 연구에서는 복분자(라즈베리)의 돼지 비장 임파구에 대한 면역 반응을 조사하였다. 복분자의 70% 에틸 알코올 추출물을 돼지 비장 임파구에 처리하였다. 복분자의 추출물은 비장 면역세포의 증식을 촉진하였으며, 복분자(라즈베리)의 추출물은 돼지 비장 임파구에 대해 CD3-T 세포, CD4-T 세포와 B 세포의 구성분을 증가시켰다. 복분자 추출물은 비장 임파구 세포의 활력을 증가시킴으로써 면역반응을 향상시켰다. 본 연구에서 우리는 돼지 비장세포에 복분자 추출물을 처리한 결과 8개의 유전자 발현이 증가되었음을 확인했는데, 이들 중에는 세포구조와 면역반응에 관여하는 유전자가 포함되었다. 특히 microtubule-associated protein 4, cytoplasmic dynein heavy chain, tumor necrosis factor alpha, 및 lymphotoxin-beta receptor precursor 유전자 발현이 증가되었다. 한편 10개의 유전자는 복분자 추출물에 의해 그 발현이 감소되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2647-2650
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• 2014

Background: Colorectal cancers(CRC) are the third most common cancer in the western world, with surgery preferred for management of non-metastatic disease and post surgical treatment usually arranged according to the TNM staging system. However, there is still prognostic variation between patients who have the same stage. It is increasingly recognized that variations within disease course and clinical outcome in colorectal cancer patients are influenced by not only oncological characteristics of the tumor itself but also host response factors. Recent studies have shown correlation between the inflammatory response and clinical outcomes in various cancers. The neutrophil/lymphocyte ratio (NLR) has been described as a marker for immune response to various stimuli including cancer. Material-Methods: Two hundred eighty-one CRC patients were included in our retrospective analysis, separated into two groups according to a cut-off value for the NLR. Patient data including age, gender, vertical penetration, anatomic location, and differentiation of the tumor, TNM stage, survival rate, and disease-free survival were analyzed for correlations with the NLR. Results: Using ROC curve analysis, we determined a cut-off value of 2.2 for NLR to be best to discriminate between patient survival in the whole group. In univariate analysis, high pretreatment NLR (p=0.001, 95%CI 1.483-4.846), pathologic nodal stage (p<0.001, 95%CI 1.082-3.289) and advanced pathologic TNM stage (p<0.001, 95%CI 1.462-4.213) were predictive of shorter survival. In multivariate analysis, advanced pathologic TNM stage (p=0.001, 95%CI 1.303-26.542) and high pretreatment NLR (p=0.005, 95%CI 1.713-6.378) remained independently associated with poor survival. Conclusions: High pre-treatment NLR is a significant independent predictor of shorter survival in patients with colorectal cancer. This parameter is a simple, easily accessible laboratory value for identifying patients with poorer prognosis.

• IMMUNE NETWORK
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• 제4권2호
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• pp.88-93
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• 2004

Background: Bone marrow mesenchymal stem cells (MSC) inhibit the immune response of lymphocytes to specific antigens and dendritic cells (DC) are professional antigenpresenting cells whose function is to present antigen to naive T-lymphocytes with high efficiency and play a central role in the regulation of immune response. We studied the effects of MSC on DC to evaluate the relationship between MSC and DC in transplantation immunology. Methods: MSC were expanded from the bone marrow and DC were cultured from peripheral blood mononuclear cells (PBMNC) of 6 myelogenous leukemia after achieving complete response. Responder cells isolated from PBMNC and lysates of autologous leukemic cells are used as tumor antigen. The effect of MSC on the DC was analyzed by immunophenotype properties of DC and by proliferative capacity and the amount of cytokine production with activated PBMNC against the allogeneic lymphocytes. Also, cytotoxicity tests against leukemic cells studied to evaluate the immunologic effect of MSC on the DC. Results: MSC inhibit the CD83 and HLA-class II molecules of antigen-loaded DC. The proliferative capacity and the amount of INF-$\gamma$ production of lymphocytes to allogeneic lymphocytes were decreased in DC co-cultured with MSC. Also the cytotoxic activity of lymphocytes against leukemic cells was decreased in DC co-cultured with MSC. Conclusion: MSC inhibit the activation and immune response of DC induced by allogeneic or tumor antigen.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4679-4683
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• 2013

Background: ERCC1 is considered as a promising molecular marker that may predict platinum based chemotherapy response in non small cell lung cancer patients. We therefore investigated whether its expression is indeed associated with clinical outcomes in advanced stage NSCLC patients. Materials and Methods: Pretreatment tumor biopsy samples of 83 stage 3B and 4 non-small cell lung cancer patients treated with platinum based chemotherapy were retrospectively analyzed for immunohistochemical ERCC1 expression. None of the patients received curative surgery or radiotherapy. Results: By calculating H- scores regarding the extent and intensity of immunohistochemical staining of tumor biopsy samples, ERCC1 expression was found to be positive in 50 patients (60.2%). ERCC1 positive and negative groups had no statistically significant differences regarding treatment response, progression free survival and overall survival (respectively p=0.161; p=0.412; p=0.823). Conclusions: In our study we found no association between ERCC1 expression and survival or treatment response. The study has some limitations, such as small sample size and retrospective analysis method. There is need of more knowledge for use of ERCC1 guided chemotherapy regimens in advanced stage NSCLC.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.287-291
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• 2016

Cervical cancer is one of the most common gynecological cancers in Iranian women. This study was initiated to assess whether the combination of paclitaxel and cisplatin with radiation might feasible for these patients. The aim was to assess tumor response and toxicity of weekly cisplatin and paclitaxel along with radiotherapy in the treatment of cervical cancer. Women with primary untreated squamous cell carcinoma of the cervix with FIGO stages IB2 to IIIB were treated with weekly injections of cisplatin 30 mg/m2 and paclitaxel 35 mg/m2 for 5-6 weeks along with radiotherapy. A total of 25 patients were enrolled in this study who completed the intended treatment. Disease was assessed prior to treatment by pelvic examination and contrast enhanced MRI of the abdomen and pelvis. Response was assessed 1 month after completion of treatment by physical examination and 3 months after also by MRI.Toxicity was assessed and was graded using RTOG grading. There was a complete response rate of 84% after 3 months. The major toxicity was grade 1 and 2 anemia (92%). The mean duration of treatment was 58 days. In conclusion, combination chemotherapy with cisplatin and paclitaxel along with radiotherapy in patients with locally advanced squamous cell carcinoma of cervixwas well tolerated, in contrast to other studies, but it seems that there was no increase in tumor response and progression free survival with this treatment regimen.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.701-705
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• 2013

Polymorphisms in XPG are considered to contribute to the clinical outcome of patients receiving platinum drug chemotherapy. We aimed to investigate the role of five potential SNPs of XPG gene on the response to platinum-based chemotherapy in advanced Chinese NSCLC patients. A total of 451 patients with newly diagnosed and histopathologically confirmed primary NSCLC were consecutively collected. XPG rs2296147, rs4150261, rs17655, rs1047768 and rs2094258 were genotyped by the Taqman real-time polymerase chain reaction (PCR). In our study, we found patients carrying rs1057768 TT genotype had a significantly lower treatment response when compared with the CC genotype (OR=0.38, 95% CI=0.18-0.78). Patients carrying rs1047768 TT genotype showed a significantly short median PFS (11.2 months) and OS (13.6 months) than CC genotype, and the hazard ratios (HR) for PFS and OS were 2.06 (1.01-4.50) and 2.29 (1.21-2.49), respectively. Moreover, we found a significant decreased risk of death from NSCLC among patients carrying the rs2296147 TT genotype when compared with the CC genotype, the HR (95% CI) for OS being 0.50 (0.27-0.95). In conclusion, our study found that polymorphisms in rs1047768 C/T and rs2296147 C/T are associated with response to platinum-based chemotherapy in advanced NSCLC, and XPG polymorphisms could be predictive of prognosis.