• Title/Summary/Keyword: 종양표지

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Clinical Significance of Tumor Markers in Gastric Cancer Patients after Curative Resection (근치적 절제술을 시행한 위암 환자에서 종양 표지자의 임상적 의미)

  • Kim, Sa-Young;Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.136-142
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    • 2009
  • Purpose: This clinical study was conducted to evaluate the predictive value of tumor markers for recurrence and the clinical significance of false positive findings after curative gastrectomy in patients with gastric cancer. Materials and Methods: Two hundred ninety patients with gastric cancer who underwent gastrectomy with curative intent were evaluated retrospectively. We analyzed the correlations between changes in tumor markers (CEA, CA 19-9, AFP, and CA-125) and clinicopathologic data, and basis for changes in tumor markers without recurrence during the follow-up period. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of tumor markers for recurrence were 75.0%, 64.6%, 23.1%, 94.8%, and 65.9% respectively. Among 36 patients with recurrences, 10 patients (27.8%) had elevated tumor markers prior to positive findings on imaging studies, while 13 patients (36.1%) had concomitant elevation in tumor markers. At least 1 of the 4 tumor markers increased in 90 of 290 patients during the follow-up period; however, there was no evidence of tumor recurrence. Twenty patients had persistently elevated tumor markers, while the tumor marker levels in 70 patients returned to normal level within $9.08\pm7.2$ months. The patients with pulmonary disease, hepatobiliary disease, diabetes, hypertension, or herbal medication users had elevated tumor markers more frequently than patients without disease (P<0.001). Conclusion: Although detecting recurrence of gastric cancer with tumor markers may be useful, false positive findings of tumor markers are common, so surgeons should consider other chronic benign diseases and medical conditions when tumor markers increase without evidence of recurrence.

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Association with Recurrence of Giant cell Tumor of Bone Between Immunohistochemical Marker (MCM3, Ki-67 and HH3) Expression Rate (골의 거대세포종양의 재발과 면역조직화학적 표지자(MCM3, Ki-67 그리고 HH3)의 발현율과의 연관성)

  • Ha, Jong-Kyoung;Jeong, Hoon;Kim, Yong-Ju;Lee, Kwan-Hee;Choi, Kyoung-Eob
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.67-74
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    • 2007
  • Purpose: To evaluate association of giant cell tumors recurrence between markers of proliferation cells (MCM3, Ki-67 and HH3) Materials and Methods: Ten case of giant cell tumor of bone were reviewed. The patients were six males and four females (mean age: 33 yrs). All patients were done operation after biopsy. The radiologic grading was determined according to Enneking grading system. The immunohistochemical stains of MCM3, HH3, and Ki-67 were done with Microarray block. Results: The three cases of 10 cases (30%) were recurred at same sites. Two case of recurrence was grade II according to radiologic features. The remaining case was grade I. The expression rate of immunohistochemical markers in radiologic grade 2 and 3 were more increased than grade 1. But there was not association between radiologic grading and proliferation of tumor cells because result data was not coherence. Mean MCM3 labeling index of non-recurred case was 11.2%, recurred case was 7.2%. Ki-67 was 12% vs. 8.9%, respectively and HH3 was 66.9 % vs. 75.4%, respectively. Thus there was no association between local recurrence and immunohistochemical Ki-67, MCM3 expression rate. But HH3 marker expression rate was increased in recurred cases compared to non-recurred cases. Conclusion: Our study suggests that HH3 immunohistochemical marker can be a useful prognostic factor.

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Expression of Tumor Markers and its Clinical Impacts in Resectable Gastric Cancer (절제 가능한 위암에서 종양표지자의 발현과 임상적 의의)

  • Koo Bon Yong;Kim Chan Young;Yang Doo Hyun;Hwang Yong
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.235-241
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    • 2004
  • Purpose: This study was performed to evaluate the effectiveness of the serum tumor markers CEA, CA 19-9, and CA 72-4 in monitoring the recurrence of gastric cancer and in its preoperative assessment. Materials and Methods: Two hundred fifty-five patients who underwent potentially curative surgery during period from January 1995 to December 2000 at the Department of Surgery were assessed. Serum samples were obtained preoperatively, 2 weeks after the surgery, and at 6-month intervals. The cut-off levels were established as 5 ng/ml for CEA, 36 U/ml for CA 19-9, and 4 U/ml for CA 72-4. The tumor stage was described according to the 5th edition of the Union Internationale Contra la Cancer (UICC) TNM classification in 1997. Results: The preoperative positivities were $10.5\%$ for CEA, $9.7\%$ for CA 19-9, and $12.4\%$ for CA 72-4. The serum levels of the three tumor markers decreased after curative surgery. The preoperative serum levels of the three tumor markers were significantly related to the depth of invasion, the tumor size, lymph-node metastasis, the pathologic stage, and recurrence, except that CEA was not associated with tumor size. The marker sensitivities in recurrent cases were $43.3\%$ for CEA, $\%41.8$ for CA 19-9, and $50.0\%$ for CA 72-4, and the marker specificities were $85.1\%$ for CEA, $96.8\%$ for CA 19-9, and $87.8\%$ for CA 72-4. Conclusion: The preoperative serum levels of CEA, CA 19-9, and CA 72-4 are not useful for the initial diagnosis of gastric cancer because of their low positivity. However, we should consider their relationship with depth of invasion, lymph-node metastasis, tumor size, pathologic stage, and recurrence. Also, the follow-up levels of the three markers have a statistical relationship with recurrence of gastric cancer even though their sensitivities are low.

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Circulating Tumor Marker (순환 종양 표지자)

  • Sung Yong Han;Dong Uk Kim
    • Journal of Digestive Cancer Research
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    • v.6 no.2
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    • pp.59-63
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    • 2018
  • Over the past decade, circulating tumor cell have received tremendous attention as new biomarkers and basic research subjects.In recent years, research on circulating tumor DNA, exosomes and microRNAs has also been actively conducted.These circulating tumor markers have the potential to become the basis of precision medicine, such as determining the genome / immune profile, monitoring response and tolerance, and selecting therapeutic agents beyond the early diagnosis and prognosis prediction.In this article, we introduce the diagnostic methods, efficacy, meaning, and applicability of various circulating tumor markers.

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Positive Rate of Tumor Marker according to Sites of Recurrence in Gastric Cancer (위암 재발부위에 따른 종양표지자의 양성률)

  • Jang, Jin-Seok;Lee, Sung-Wook;Lee, Jong-Hun;Roh, Myung-Hwan;Han, Sang-Young;Kim, Min-Chan;Jeong, Gap-Jung;Choi, Seok-Reyol
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.222-227
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    • 2005
  • Purpose: There are several reports suggested the usefulness of serum tumor markers, AFP, CEA and CA19-9 as prognostic factors or indicators for recurrence in gastric cancer. This clinical study was peformed to evaluate positive rate of tumor markers according to site of recurrence in gastric cancer. Materials and Methods: From the database of patients who underwent radical gastrectomy for gastric cancer between January 1999 and January 2004, 52 patients who showed recurrence were included in this retrospective study. Serum levels of tumor markers were measured at the time of preoperative diagnosis of the gastric cancer and at the time of postoperative recurrence during follow up, respectively. Results: The overall positivity of tumor markers at the time of recurrence was found to be significantly higher than that of prior to surgery in the recurred group for the single test as well as the combination tests. For the peritoneum, the most common recurrent site, the positivity of CA19-9 was higher at the time of recurrence. And the significant positivity of CEA at the time of recurrence was detected in the liver cases. Conclusion: Having a preoperative positive tumor marker may identify the patient as having an increased chance of a recurrence. Although tumor markers continue to have limited diagnostic significance in gastric cancer, CA19-9 may be useful as a predictor for peritoneal recurrence of the gastric cancer, and CEA for recurrence to liver.

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Immunohistochemical Expression of Galectin-3, Cytokeratin 19 and HBME-1 in Papillary Microcarcinoma of the Thyroid Gland (갑상선 미세 유두암종에서 Galectin-3, Cytokeratin 19와 HBME-1의 발현)

  • Kim, Jin-Hwan;Lee, Sang-Sook
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.133-137
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    • 2007
  • With the wide use of ultrasonography and fine needle aspiration of the thyroid gland, the incidence of papillary microcarcinoma of the thyroid gland is rapidly increasing nowadays. To improve the diagnostic accuracy of histopathologic findings of papillary thyroid carcinoma, various molecular markers have been used recently. We analysed the expression of galectin-3, cytokeratin 19 and HBME-1, using immunohistochemical technique in 37 cases of papillary microcarcinoma of the thyroid gland to evaluate the diagnostic value of these molecular markers. Immunohistochemically, galectin-3 expression was found in 37 cases of papillary microcarcinoma. Its localization was mostly cytoplasmic. Cytokeratin 19 expression was found in 36 cases. It was mostly localized to the cytoplasm and membrane. HBME-1 expression was found in all cases. Its localization was plasma membrane. The expression of these three molecular markers was negative in the adjacent normal thyroid tissue and accompanying benign lesions, although there are scattered foci of incomplete positive staining in cases of Hashimoto's thyroiditis. Our findings suggest that the immunohistochemical staining using antibodies for galectin-3, cytokeratin 19 and HBME-1 is an useful adjunctive method for the histopathological diagnosis of a papillary microcarcinoma of the thyroid gland.

원자로 생산 방사성 핵종의 임상이용

  • 임상무
    • Nuclear Engineering and Technology
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    • v.27 no.4
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    • pp.635-643
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    • 1995
  • 핵의학(nuclear medicine )이 란 방사성 및 안정 핵종의 동위원소표지 화합물을 인체에 투여하여, 관심장기의 형태 및 기능을 평가하여 해부학적 또는 생리학적 상태를 진단, 치료하는 의학의 전문 분야이다. 핵의학에 이용되던 방사성 핵종은 1960년대 까지만 해도 $^{131}$ I이 주였으나 1970년대 부터는 $^{99}$Mo -$^{99m}$ Tc 발생기와 $^{99m}$ TC으로 표지된 방사성의 약품이 활발히 이용되면서 $^{131}$ I을 대신하게 되었다. 원자로-생산핵종들의 특성은 중성자가 과잉이어 붕괴시 배타입자를 방출하는 점으로, 이것이 각종 질병의 치료에 이용되고 있다. 특히 각종 표시 화합물의 성질을 이용하여 원하는 부위에 방사선을 집중시킬 수 있음이 외부조사보다 유리한 점이다. 방사성핵종을 이용한 악성종양의 치료에 가장 성공적인 것은 분화된 갑상선 암환자에서 $^{131}$ I을 사용한 것이며, 갈색세포종 등에 $^{131}$ I-MIBG도 효과적이다. 악성종양의 골전이 치료에 베타선을 방출하는$^{32}$P, $^{186}$ Re, $^{153}$ Sm 등이 이용되었다. 종양의 동맥에 주입하여 세동맥이나 모세혈관에 걸리는 기름, 교진 또는 입자에 의한 치료에 $^{131}$ I-lipiodol, ethiodol, $^{32}$P 또는$^{90}$ Y흡사 ceramic resin 미소구 $^{166}$ Ho 유산중합체 미소구 등이 이용된다. $^{166}$ Ho, $^{198}$ Au, $^{32}$P, $^{90}$ Y, $^{169}$ Er, $^{186}$ Rc, $^{131}$ I, $^{211}$ At 등 의 방사성 핵종의 교질, 미소구 또는 단세포군 항체표지 형태로 직접 종양내 또는 공동이나 체강에 투여하는 치료법이 있다. 류마치스 관절염의 슬관절에 $^{165}$ Dy colloid를 주사하는 $^{166}$ Ho-MAA도 활발히 이용되고 있다.

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폐암의 조기진단

  • Lee, Hyeon-U;Lee, Gwan-Ho
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.195-207
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    • 1998
  • 폐암을 집단 검진으로 조기 진단하려는 노력은 현재까지 뚜렷한 성과를 얻지 못하고 있는 실정이다. 미국의 국립암연구소에서 실시한 흉부엑스선 촬영과 객담세포진 검사를 이용한 폐암의 집단 검진 결과는 검진군에서 대조군보다 유의하게 진단율이 높았으며 절제율도 더 높았고 5년 생존율도 향상시킬 수 있었다. 그러나 폐암을 조기 진단하기 위한 집단 검진의 궁극적인 목표인 사망률을 감소시키지는 못하였다. 최근에는 미국 국립암 연구기관에서 실시했던 결과에 대한 해석이 다양하여 아직까지도 폐암 조기 진단에 있어서 흉부액스선촬영과 객담세포진검사의 의의에 관한 결론에 대해서는 논란이 되고 있다. 1993년부터 새로운 집단 검진에 관한 연구가 진행중에 있어서 그 결과가 나올 때까지는 흉부엑스선촬영과 객담세포진검사를 이용한 집단 검진의 의의에 대한 결과는 기다려 보아야 할 것이다. 분자생물학적으로 폐암을 조기 검진하기 위한 검체로는 혈액보다는 객담이 훨씬 적절하고 합리적인 검체이다. 폐암의 발생은 가장 먼저 기관지 상피 세포에서 일어나서 암화 과정의 여러 단계에서 다양한 종양 표지자가 객담에 섞여 나오기 때문에 이 표지자를 객담에서 측정하는 것이 훨씬 합리적인 조기 진단법이 될 수 있다. 동시에 폐암을 집단 검진으로 조기 진단하기 위해서는 종양 표지자를 대량으로 측정하기 위한 자동측정법도 개발되어야 할 것이다. 암을 예방하기 위하여는 여러면에서 방안이 연구되어야 한다. 즉 암발생의 가능성이 높은 대상을 선태하여야 하며 초기에 집단 검진으로 진단을 할 수 있어야 하고, 이러한 검진으로 추적 검사가 가능하여야 하며 마지막으로 결과를 판정할 수 있어야 한다. 이 가운데 현재까지 유일하게 실시할 수 없는 것은 조기 진단으로 사용할 수 있는 뚜렷한 종양 표지자가 없는 것이다. 이와 같이 현재까지는 폐암을 조기 진단하기 위한 특이한 표지자는 없으나 앞으로 폐암 발생 기전의 여러 단계가 체계적으로 밝혀진다면 그 과정에서 중요한 표지자들이 밝혀질 것이다. 그리고 이들을 간단하게 검사할 수 있는 검사법도 밝혀져 폐암 조기 진단의 궁극적 목적인 폐암으로 인한 사망률을 감소시킬 수 있을 것으로 기대된다.

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Evaluation of usefulness for Stereotactic Partial Breast Irradiation(S-PBI) by using Surface Fiducial Marker (표면위치표지자를 적용한 정위적 부분유방방사선치료의 유용성 평가)

  • Kim, JongYeol;Jung, DongMin;Kim, SeYoung;Yoo, HyunJong;Choi, JungHoan;Park, HyoKuk;Baek, JongGeol;Lee, SangKyu;Cho, JeongHee
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.99-108
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    • 2021
  • Purpose: The goal of this study is to evaluate usefulness of noninvasive method instead of previous inserting Fiducial Marker Method when performing Stereotactic Partial Breast Irradiation in CyberKnife. Material and methods: For consistency of Imaging Center, we evaluated both oblique images at angle 45 and 315 acquired from 2D Simulator and CyberKnife quantitatively through dice similarity coefficient. Also, location reproducibility of Surface Fiducial Marker was analyzed from 2D Simulator, treatment plans and CyberKinfe images by using 8 Fiducial Markers made of gold attached to ATOM Phantom based on our institution's protocols. Results: The results of the estimated consistency were 0.87 and 0.9 at the oblique angle 45 and 315, respectively. For location consistency of Surface Fiducial Markers, values of horizontal vertical direction of left breast were Superior/Inferior 0.3 mm, Left/Right -0.3 mm, Anterior/Posterior 0.4 mm, and the values of rotational direction were Roll 0.3 °, Pitch 0.2 °, Yaw 0.4 °. The values of horizontal vertical direction of right breast were Superior/Inferior -0.1 mm, Left/Right -0.1 mm, Anterior/Posterior -0.1 mm, and the values of rotational direction were Roll 0.2°, Pitch 0.1°, Yaw 0.1°. Conclusions: We expect that the protocols used by Surface Fiducial Markers when performing Stereotactic Partial Breast Irradiation in CyberKnife will provide protection from pain and cut expenses for treatment and reduce treatment errors and make treatment more accurate by suggesting treatment protocols based on high consistency of Imaging Center and reproducibility of Fiducial Markers.