• Journal of Chest Surgery
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• 제31권4호
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• pp.380-387
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• 1998

기관지 유암종의 두 아형(전형적 & 이형성)은 치료방침에 차이가 있으므로, 아형에 따른 CT 소견의 차이와, 수술전 병리학적 진단의 정확도를 알아보고자 하였다. 수술후 기관지 유암종으로 확진되고, 수술전 CT를 시행한 10예(전형적:5예, 이형성:5예)를 대상으로 하였다. 수술전 진단으로 객담세포 검사(n=10), 기관지내시경 생검(n=8), 그리고 경피적 세침검사(n=1)가 시행되었다. CT소견을 두 아형에 따라 비교하였다. 전형적 유암종 5예 모두 중심성 기관지강내 종괴로, 조영 증강되었고, 변연은 매끈하였다. 2예에서는 종괴로 폐쇄된 기관지 내강의 끝이 넓어지는 코끼리 다리(elephant foot) 모양을 보였다. 이형성 유암종은 5예 중 2예는 말초성 병변이었고, 중심성인 3예는 기관지내강 종괴로, 기관지내강의 끝이 넓어지지 않는 평평한 반월(flat meniscus)모양이거나(n=2), 미만성 기관지벽 비후로 보였다(n=1). 전 예에서 조영 증강되었으나, 1예에서는 괴사에 의한 종괴내 저밀도 부위가 동반되었다. 변연 확인이 가능한 2예에서는 각각 침상상과 분엽상을 보였다. 수술전 진단으로, 객담세포 검사, 경피적 세침검사 등은 전 예에서 정확한 진단을 하지 못했고, 기관지내시경 생검은 시행된 8예 중 전형적 유암종 3예만을 정확히 진단하였다. 다른 예는 비소세포성 폐암으로 해석되었다. CT상 전형적 유암종은 조영 증강되는 기관지강내 종괴로 보이는 반면, 이형적 유암종의 형태는 다양하였다. 수술전 진단에 있어서, 일부 전형적 유암종과 이형성 유암종 전부는 진단이 정확하지 못했다. 이형성 유암종은 전부 원발성 폐암으로 수술전 진단되었으나, 절제술 선택에 영향을 끼치지는 않는다. 그러나 전형적 유암종의 경우, 보존적 절제술이 가능하므로, CT소견을 숙지하는 것이, 수술전 병리진단 결과와 일치하지 않을 경우, 아형에 따른 적절한 절제술식을 선택하는데 도움이 될 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3797-3800
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• 2014

Background: BMI1, TWIST1 and SNAI2/SLUG have been implicated in aggressive behavior of squamous cell carcinoma (SCC) and melanoma and BMI1 expression could identify subtypes of Merkel cell carcinoma (MCC). However, BMI1, TWIST1 and SNAI2 expression levels in basal cell carcinomas (BCCs) have not been elucidated. We hypothesized BCC could be a good model system to decipher mechanisms which inhibit processes that drive tumor metastasis. The aim of this study was to examine the mRNA expression level of BMI1, TWIST1, and SNAI2 in BCCs. Materials and Methods: Thirty-five fresh non-metastatic BCC tissue samples and seven fresh normal skin tissue samples were evaluated by real-time RT-PCR. Results: BMI1 and TWIST1 demonstrated marked down-regulation (p<0.00l, p=0.00l respectively), but SNAI2 showed no significant change (p=0.12). Conclusions: Previous literature has clearly demonstrated a positive association between BMI1 and TWIST1 expression and metastatic BCC, aggressive SCC and melanoma. Here, we demonstrated a negative association between BMI1 and TWIST1 mRNA expression level and BCC.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.499-508
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• 2007

Background and Purpose: Some subtypes of malignant salivary gland tumors such as adenoid cystic carcinoma (ACC) frequently result in distant metastasis of vascular origin, which are main causes of treatment failure. The reasons for the affinity for vascular metastatic potential are unclear. Therefore, molecular characteristics that influence the dissemination of metastatic tumor cells are important for the design of more effective treatment of salivary ACC. Tumor angiogenesis has been known to be essential for the distant metastasis of malignant cells. So, we determined expressions of vascular metastasis related factors in orthotopic (parotid) murine models of parotid ACC and compared with those in ectopic (subcutis) tumors of athymic mice. Experimental Design: Using specimens from murine parotid (orthotopic, experimental group) and subcutaneous (ectopic, control group) tumors, which have developed via transplantation of tumor cells, originated from human parotid ACC, we performed immunohistochemical assays with anti-vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF, FGF2), matrix metalloproteinase (MMP)-9, and interleukin (IL)-8 antibodies. We also performed immunohistochemical assays with VEGF receptor (VEGFR)-1, VEGFR-2, VEGFR-3, and phosphorylated VEGFR-2. Results: Transplantation of human ACC tumor cell $(5{\times}10^5)$ into the parotid and subcutis successfully resulted in orthotopic (parotid) and ectopic (subcutaneous) tumors in athymic mice. Immunohistochemical staining demonstrated higher expression of major angiogenic factors (VEGF, bFGF, MMP-9) in the orthotopic tumors than in ectopic tumors (P<0.05). But the expression level of angiogenic receptors were same in orthotopic and ectopic tumors of parotid ACC. Conclusion: VEGF, bFGF, and MMP-9 could be a good candidates for antiangiogenic therapy for the contol of vascular metastatic lesions of salivary ACC.

• 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.

• Genomics & Informatics
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• 제21권4호
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• pp.44.1-44.10
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• 2023

Tumor hypoxia, oxygen deprivation state, occurs in most cancers and promotes angiogenesis, enhancing the potential for metastasis. The vascular endothelial growth factor (VEGF) family genes play crucial roles in tumorigenesis by promoting angiogenesis. To investigate the malignant processes triggered by hypoxia-induced angiogenesis across pan-cancers, we comprehensively analyzed the relationships between the expression of VEGF family genes and hypoxic microenvironment based on integrated bioinformatics methods. Our results suggest that the expression of VEGF family genes differs significantly among various cancers, highlighting their heterogeneity effect on human cancers. Across the 33 cancers, VEGFB and VEGFD showed the highest and lowest expression levels, respectively. The survival analysis showed that VEGFA and placental growth factor (PGF) were correlated with poor prognosis in many cancers, including kidney renal cell and liver hepatocellular carcinoma. VEGFC expression was positively correlated with glioma and stomach cancer. VEGFA and PGF showed distinct positive correlations with hypoxia scores in most cancers, indicating a potential correlation with tumor aggressiveness. The expression of miRNAs targeting VEGF family genes, including hsa-miR-130b-5p and hsa-miR-940, was positively correlated with hypoxia. In immune subtypes analysis, VEGFC was highly expressed in C3 (inflammatory) and C6 (transforming growth factor β dominant) across various cancers, indicating its potential role as a tumor promotor. VEGFC expression exhibited positive correlations with immune infiltration scores, suggesting low tumor purity. High expression of VEGFA and VEGFC showed favorable responses to various drugs, including BLU-667, which abrogates RET signaling, an oncogenic driver in liver and thyroid cancers. Our findings suggest potential roles of VEGF family genes in malignant processes related with hypoxia-induced angiogenesis.

• Tuberculosis and Respiratory Diseases
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• 제80권2호
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• pp.179-186
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• 2017

Background: Although the World Health Organization (WHO) classification of lung squamous cell carcinoma (SCC) was revised in 2015, its clinical implications for lung SCC subsets remain unclear. We investigated whether the morphologic characteristics of lung SCC, including keratinization, were associated with clinical parameters and clinical outcome of patients. Methods: A total of 81 patients who underwent curative surgical resection of diagnosed lung SCC, were enrolled in this study. Attributes such as keratinization, tumor budding, single cell invasion, and nuclear size within the tumor, as well as immunohistochemistry of Bcl-xL and pS6 expressions, were evaluated. Results: The keratinizing and nonkeratinizing subtypes did not differ with respect to age, sex, TNM stage, and morphologic parameters such as nuclear diameter, tumor budding, and single cell invasion at the tumor edge. Most patients with the keratinizing subtype (98.0%) had a history of smoking, whereas the nonkeratinizing group had a relatively higher proportion of never-smokers relative to the keratinizing group (24.0% vs. 2.0%; p=0.008, chi-square test). Expression of pS6 (a surrogate marker of mammalian target of rapamycin complex 1 [mTORC1] signaling that regulates keratinocyte differentiation), and Bcl-xL (a key anti-apoptotic molecule that may inhibit keratinization), did not correlate significantly with the presence of keratinization. Patients with the keratinizing subtype had a significantly shorter overall survival (85.2 months vs. 135.7 months, p=0.010, log-rank test), and a multivariate analysis showed that keratinization was an independent, poor prognostic factor (hazard ratio, 2.389; 95% confidence interval, 1.090-5.233; p=0.030). Conclusion: In lung SCC, keratinization is associated with a poor prognosis, and might be associated with smoking.

• Radiation Oncology Journal
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• 제34권3호
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• pp.216-222
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• 2016

Purpose: To evaluate the benefit of adjuvant radiation therapy (RT) for retroperitoneal liposarcoma (RPLS) following gross tumor removal. Materials and Methods: We reviewed 77 patients with primary RPLS surgically treated between January 2000 and December 2013. Cases with gross residual disease were excluded. Tumor grade was evaluated according to the French Federation of Cancer Centers Sarcoma Group (FNCLCC) system. Adjuvant RT was delivered to 32 patients (42%) using external beam RT alone. Median follow-up time was 36 months (range, 5 to 169). Results: Among 77 patients, 33 (43%) presented with well-differentiated, 31 (40%) with de-differentiated, 8 (10%) with myxoid/round and 4 (5%) with pleomorphic morphology. The RT group included less well-differentiated subtype than surgery group (28% vs. 53%). During follow up, 34 patients (44%) showed local recurrence. Local recurrence rate was lower in the RT group (38%) compared to the surgery group (49%). The 3-year local control rate (LC) was 55.6%, and the 3-year overall survival (OS) was 82.1%. Tumor histology and FNCLCC grade were significantly associated with local recurrence. There was no statistical significance of adding adjuvant RT in LC (p = 0.312). However, patients with tumor histology other than well-differentiated subtype showed marginally decreased local recurrence rate after adjuvant RT (3-year LC, RT 43.9% vs. no RT 35.3%; p = 0.087). Conclusion: RPLS patients receiving RT experienced less local recurrence. We suggest that the addition of adjuvant RT may be related to improvement of LCs, especially in patients with non-favorable histologic subtypes.

• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.499-506
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• 2022

Objective : We conducted this study with the aim of predicting the biological behavior of meningiomas, and determining the benefits of associating histological subtype and grade with the expression of proliferative markers and tumor suppressor proteins. Methods : The study included 29 patients with primary intracranial and intraspinal meningioma diagnosed in the pathology laboratory of Konya City Hospital between January 2014 and December 2020. Clinicopathological characteristics of the patients including parameters such as age and gender were obtained from the hospital records. Histopathological findings were obtained by re-evaluating the preparations stained with Hematoxylin-Eosin, which were extracted from the archive, and by evaluating new sections obtained from paraffin blocks of patients stained with Ki67, p53, and p57 immunohistochemical stains. Results : A moderate correlation was found between tumor size and Ki67 proliferation index (PI) (p=0.003, r=0.530). There was no significant difference between grade I and grade II tumors in terms of p53 (p=0.184) and p57 (p=0.487) expressions. There were higher levels of Ki67 PI in grade II tumors. The histological subtypes of the tumor had no significant difference with Ki67 PI (p=0.018), p53 (p=0.662), and p57 (p=0.368) expressions. Conclusion : In order to obtain more definitive results, there is a need for studies, which are conducted with a greater number of patients and in multiple centers, and in which a long prospective follow-up is planned. The combination of histological, surgical, and imaging markers could make a more sensitive tool for predicting recurrence, and this could also be tested in future studies.

• Korean Journal of Radiology
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• 제22권5호
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• pp.735-741
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• 2021

Objective: To evaluate circularity as a quantitative shape factor of small renal tumor on computed tomography (CT) in differentiating fat-poor angiomyolipoma (AML) from renal cell carcinoma (RCC). Materials and Methods: In 257 consecutive patients, 257 pathologically confirmed renal tumors (either AML or RCC less than 4 cm), which did not include visible fat on unenhanced CT, were retrospectively evaluated. A radiologist drew the tumor margin to measure the perimeter and area in all the contrast-enhanced axial CT images. In each image, a quantitative shape factor, circularity, was calculated using the following equation: 4 x π x (area ÷ perimeter²). The median circularity (circularity index) was adopted as a representative value in each tumor. The circularity index was compared between fat-poor AML and RCC, and the receiver operating characteristic (ROC) curve analysis was performed. Univariable and multivariable binary logistic regression analysis was performed to determine the independent predictor of fat-poor AML. Results: Of the 257 tumors, 26 were AMLs and 231 were RCCs (184 clear cell RCCs, 25 papillary RCCs, and 22 chromophobe RCCs). The mean circularity index of AML was significantly lower than that of RCC (0.86 ± 0.04 vs. 0.93 ± 0.02, p < 0.001). The mean circularity index was not different between the subtypes of RCCs (0.93 ± 0.02, 0.92 ± 0.02, and 0.92 ± 0.02 for clear cell, papillary, and chromophobe RCCs, respectively, p = 0.210). The area under the ROC curve of circularity index was 0.924 for differentiating fat-poor AML from RCC. The sensitivity and specificity were 88.5% and 90.9%, respectively (cut-off, 0.90). Lower circularity index (≤ 0.9) was an independent predictor (odds ratio, 41.0; p < 0.001) for predicting fat-poor AML on multivariable logistic regression analysis. Conclusion: Circularity is a useful quantitative shape factor of small renal tumor for differentiating fat-poor AML from RCC.

• 대한세포병리학회지
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• 제14권2호
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• pp.96-101
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• 2003

Synovial sarcoma is a rare soft tissue tumor accounting for 5-10% of soft tissue sarcomas. Most arise in the extremities and trunk, and a small proportion occur in the abdominal wall, head and neck legion, and mediastinum. It manifests different phenotypic subtypes that render their cytologic evaluation challenging. Moreover, cytomorphologic description of the epithelial component of synovial sarcoma is rare in Korea. We report a case of biphasic synovial sarcoma on the right lower extremity in a 49-year-old woman diagnosed by fine needle aspiration cytology. The aspirate was moderately cellular and composed of a mixture of tissue fragments and dissociated cells with bland chromatin, inconspicuous nucleoli, and oval to spindle-shaped cytoplasm. Mitosis was rare. A monolayer sheet of epithelial component was seen. The cells in this monolayer sheet had more abundant distinct cytoplasm, round nuclei, and prominent micronucleoli. Histologic examination showed a biphasic pattern consisting of mostly sarcomatous stroma and a few small glandular areas at the periphery of the tumor.