• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7101-7106
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• 2013

Background: The prognosis of patients with hepatocellular carcinoma (HCC) after curative resection varies greatly. Few studies had investigated the risk factors for early recurrence (recurrence-free time ${\leq}$ 1 year) of hepatitis B virus (HBV)-related HCCs meeting Milan criteria. Methods: A retrospective analysis was performed on the 224 patients with HCC meeting Milan criteria who underwent curative liver resection in our center between February 2007 and March 2012. The overall survival (OS) rate, recurrence-free survival (RFS) rate and risk factors for early recurrence were analyzed. Results: After a median follow-up of 33.3 months, HCC reoccurred in 105 of 224 patients and 32 died during the period. The 1-, 3- and 5-year OS rates were 97.3%, 81.6% and 75.6% respectively, and the 1-, 3- and 5-year RFS rates were 73.2%, 53.7% and 41.6%. Cox regression showed alpha-fetoprotein (AFP) > 800 ng/ml (HR 2.538, 95% CI 1.464-4.401, P=0.001), multiple tumors (HR 2.286, 95% CI 1.123-4.246, P=0.009) and microvascular invasion (HR 2.518, 95% CI 1.475-4.298, P=0.001) to be associated with early recurrence (recurrence-free time ${\leq}$ 1-year) of HCC meeting Milan criteria. Conclusions: AFP > 800 ng/ml, multiple tumors and microvascular invasion are independent risk factors affecting early postoperative recurrence of HCC. In addition resection appears capable of replacing liver transplantation in some situations with safety and a better outcome.

• Clinical and Experimental Reproductive Medicine
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• 제31권4호
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• pp.209-215
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• 2004

Objective: Embryonic stem (ES) cells could be differentiated into the specific cell types by alternation of culture condition and modification of gene expression. This study was performed to evaluate the differentiation protocol for mouse and human ES cells to insulin secreting cells. Methods: Undifferentiated mouse (JH-I) and human (Miz-hESI) ES cells were cultured on STO feeder layer, and embryoid bodies (EBs) were formed by suspension culture. For the differentiation, EBs were cultured by sequential system with three stage protocol. The differentiating ES cells were collected and marker gene expressions were analyzed by seIni-quantitative RT-PCR in each stage. Amount of secreted insulin levels in culture media of human ES cells were measured by human insulin specific RIA kit. Results: During the differentiation process of human ES cells, GATA-4, a-fetoprotein, glucose transporter-2 and Ngn-3 expression were increased whereas OctA was decreased progressively. Insulin and albuInin mRNAs were expressed from stage IT in mouse ES cells and from stage III in human ES cells. We detected 3.0~7.9 IlU/rnl secretion of insulin from differentiated human ES cells by in vitro culture for 36 days. Conclusion: The sequential culture system could induce the differentiation of mouse and human ES cells into insulin secreting cells. This is the fIrst report of differentiation of human ES cells into insulin secreting cells by in vitro culture with serum and insulin free medium.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3877-3880
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• 2013

Objective: To explore the expression and significance of tumor specific growth factor (TSGF), carcinoembryonic antigen (CEA) and alpha fetoprotein (AFP) in cancer tissue and serum of patients with colon cancer. Materials and Methods: Radical surgery for colon cancer was performed on 43 patients with laparoscopu under conditions of general anesthesia. The Elisa method was used to detect the levels of serum TSGF, CEA and AFP before and after radical operation, and cancer tissue underwent TSGF, CEA and AFP immunohistochemistry staining after laparoscopic surgery. The decreased conditions of serum TSGF, CEA and AFP in patients with colon cancer at different levels of differentiation and clinical stagings were analyzed, and the relationships of expression rates between histological types, colon cancer morphology, lymph node metastasis and TSGF, CEA as well as AFP in cancer tissue were assessed. Results: Compared with before radical surgery, the levels of serum TSGF, CEA and AFP decreased notably in patients after operations (p<0.01). The decreased degree of TSGF and CEA was the largest in patients with poorly differentiated cancer tissue (p<0.01), while that of AFP was noted in patients with moderately differentiated cancer tissue (p<0.01). The decreased degree of TSGF and AFP was the largest in patients at phase Dukes A (p<0.01), while that of CEA in patients at phase Dukes C (p<0.01). There were no significant differences among the positive expression rates of TSGF, CEA and AFP with different histological types and colon cancer morphologies (p>0.05). The positive expression rates of TSGF and CEA in patients with lymph node metastasis were significantly higher than those without lymph node metastasis (p<0.01). Conclusions: TSGF, CEA and AFP can be used to evaluate the effect of radical operation for colon cancer, and the changed levels of different markers are associated with tumor differentiation, clinical stating and presence or absence of lymph node metastasis.

• 대한약침학회지
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• 제12권4호
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• pp.63-76
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• 2009

This study was performed to observe the effect of Keughachukeo-tang(KH) extract on the hepatocellular carcinogenesis and acute liver damage induced by Diethylnitrosamine(DENA) and $CCl_4$ in Rats. Experimental groups were divided into four; normal group(Nor), acute liver damage and hepatocellular cancer inducing control group(Con), KH extract 350㎎/㎏/day(KHA), and 700㎎/㎏/day(KHB) administered groups to Con. The results obtained are as follows: The body weight increased in KHA and KHB than Con from 7th week to the 8th week. The activities of Alanine aminotransferase(ALT) were the most increased in the Con among experimental group. The activities of aspartate aminotransferase(AST), alkaline phosphatase(ALP), and lactacte dehydrogenase(LDH) were significantly decreased(p$<$0.05) in the KHA and KHB compared with Con. Alpha fetoprotein(AFP) were the most increased in the Con among experimental groups. The activities of superoxide dismutase(SOD) were the most increased in the Con among experimental groups. The activities of catalase were significantly increased(p$<$0.05) in the KHA and KHB compared with Con. The results of light microscopical observation, a number of hepatocytes were damaged in the Con compared with Nor and KH extract administerd groups. The number of hepatic p53 positive cells was reduced in the KH extract administered groups compared with Con. These results suggest that administration of KH extract suppress or retard on the Hepatocellular Carcinogenesis and acute liver damage induced by DENA and $CCl_4$ in Rats.

• Clinical and Experimental Pediatrics
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• 제58권10호
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• pp.386-391
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• 2015

Purpose: To evaluate the outcomes and prognostic factors in children with extracranial germ cell tumors (GCTs) treated at a single institution. Methods: Sixty-six children diagnosed with extracranial GCTs between 1996 and 2012 were included in the study. Primary treatment was surgical excision, followed by six cycles of cisplatin-based chemotherapy. The survival rates were compared according to the International Germ Cell Cancer Cooperative Group classification used for GCTs in adults to validate the classification guidelines for GCTs in children. Results: The median patient age was 4.4 years. In 34 patients (51.5%), the primary tumor site was the gonad. Extragonadal GCTs were detected in 32 patients. The 5-year overall survival and event-free survival (EFS) were $92.0%{\pm}3.5%$ and $90.4%{\pm}3.7%$, respectively. In univariate analysis, tumor histology, metastasis, and elevated alpha-fetoprotein were not prognostic factors in children with extracranial GCTs. However, EFS was poorer in patients with mediastinal disease (n=12, $66.7%{\pm}13.6%$) than in those with nonmediastinal disease (n=54, $96.0%{\pm}2.8%$) (P=0.001). The 5-year EFS was lower in patients older than 10 years, (n=21, $80.0%{\pm}8.9%$) compared with those younger than 10 years (n=45, $95.2%{\pm}3.3%$) (P=0.04). Multivariate analysis identified the mediastinal tumor site as the only independent prognostic factor. Conclusion: The prognosis of children with extracranial GCTs was favorable. However, nongerminomatous mediastinal tumors were associated with poor survival in children. Further research is needed to improve the prognosis of children with malignant mediastinal GCTs.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.637-642
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• 2014

The pathogenesis of hepatocellular carcinoma (HCC) related to habitual betel quid (BQ) chewing is unclear. Risk of HCCis increased with adverse hepatic fibrosis. This study aimed to assess the impact of chronic viral hepatitis on adverse hepatic fibrosis in HCC related to BQ chewing. This hospital-based case-control study enrolled 200 pairs of age- and gender-matched patients with HCC and unrelated healthy controls. Serologic hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV), ${\alpha}$-fetoprotein (AFP), and surrogate markers for significant hepatic fibrosis were measured. Information on substance-use habits was obtained with a questionnaire. By analysis of surrogate markers for hepatic fibrosis, the prevalence of significant hepatic fibrosis in patients chewing BQ was between 45.8% and 91.7%, whereas that for patients without BQ chewing was between 18.4% and 57.9%. The difference was significant (P <0.05 for each surrogate marker). Multivariate analysis indicated that cirrhosis with Child-Pugh C (odds ratio (OR) = 3.28; 95% confidence interval (CI), 1.29-8.37), thrombocytopenia (OR = 3.92, 95% CI, 1.77-8.68), AFP >400 mg/L (OR = 2.21, 95% CI, 1.05-4.66) and male gender (OR = 4.06, 95% CI, 1.29-12.77) were independent factors associated with habitual BQ chewing. In conclusion, adverse hepatic fibrosis and severe liver damage play important roles in the pathogenesis of BQ-related HCC, which could be aggravated by chronic hepatitis B and hepatitis C. BQ-cessation programs and prevention of chronic HBV/HCV infection are needed to prevent HCC related to BQ chewing.

• Journal of Genetic Medicine
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• 제6권1호
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• pp.74-80
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• 2009

목 적: 임신 제1삼분기와 2삼분기에 시행하고 있는 다운증후군 선별검사 지표들이 다른 임신합병증 예측에 있어서 갖는 의의를 알아보고자 한다. 대상 및 방법: 2005년 1월부터 2006년 12월까지 만2년간 강남차병원 산부인과에서 산전진찰을 받으며 임신 제1삼분기에 PAPP-A와 NT, 2삼분기에AFP, hCG, Inhibin-A, 그리고 uE3로 다운증후군 선별검사를 시행 받고 분만한 3,121명의 산모와 이들의 신생아를 대상으로 하였다. 의무기록지 검토를 통해 산모의 나이, 임신합병증과 제태연령, 분만시와 분만후의 합병증 유무, 그리고 integrated test 시기와 각 지표의 수치를 조사하여 SPSS 프로그램을 이용하여 정규성 검정과 t-test, 그리고 로지스틱 회귀분석을 시행하였다. 결 과: 다운증후군 선별검사의 표지물질들이 다른 임신 합병증에서도 이상소견을 보였는데, 특히 조산과 자간전증 시에 AFP 수치의 증가, hCG증가, Inhibin-A증가, PAPP-A감소, NT 감소가 있었다. Inhibin-A는 자간전증, 저체중아 출산, 조산시에 임신 제2삼분기에 증가되어 있었는데 odds ratio는 각각 2.843, 1.446, 1.287이었다. AFP는 임신 24주 이전의 태아손실(odds ratio 2.868)과 조산(odds ratio 1.653)시 에 임신 제2삼분기에 증가하였고, 임신 제1삼분기의 PAPP-A는 자간전증(odds ratio 0.51)과 조산(odds ratio 0.75)시에 감소함을 알 수 있었다. 결 론: 모든 산전 클리닉에서 시행하고 있는 다운증후군 선별검사의 지표 중 특히 임신 제2삼분기의 Inhibin-A와 AFP, 제1삼분기의 PAPP-A의 이상 수치는 태반기능 관련 임신합병증인 조산, 자간전증과 저체중아 출산의 동반 가능성이 높아 이를 이용하면 이들 질환의 고위험군을 분류할 수 있으며, 이런 산모를 대상으로 보다 주의깊은 산전관리와 상담이 가능할 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1281-1287
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• 2015

Background: Early detection of hepatocellular carcinoma using serological markers with better sensitivity and specificity than alpha fetoprotein (AFP) is needed. Aims: The aim of this study was to evaluate the diagnostic value of serum sICAM-1, ${\beta}$-catenin, IL-8, proteasome and sTNFR-II in early detection of HCC. Materials and Methods: Serum levels of IL-8, sICAM-1, sTNFR-II, proteasome and ${\beta}$-catenin were measured by ELISA assay in 479 serum samples from 192 patients with HCC, 96 patients with liver cirrhosis (LC), 96 patients with chronic hepatitis C (CHC) and 95 healthy controls. Results: Serum levels of proteasome, sICAM-1, ${\beta}$-catenin and ${\alpha}FP$ were significantly elevated in HCC group compared to other groups (P-value<0.001), where serum level of IL-8 was significantly elevated in the LC and HCC groups compared to CHC and control groups (P-value <0.001), while no significant difference was noticed in patients with HCC and LC (P-value=0.09). Serum level of sTNFR-II was significantly elevated in patients with LC compared to HCC, CHC and control groups (P-value <0.001); also it was significantly higher in HCC compared to CHC and control groups (P-value <0.001). ROC curve analysis of the studied markers between HCC and other groups revealed that the serum level of proteasome had sensitivity of 75.9% and specificity of 73.4% at a cut-off value of $0.32{\mu}g/ml$ with AUC 0.803 sICAM-1 at cut off value of 778ng/ml, the sensitivity was 75.8% and the specificity was 71.8% with AUC 0.776. ${\beta}$-catenin had sensitivity and specificity of 70% and 68.6% respectively at a cut off value of 8.75ng/ml with an AUC of 0.729. sTNFR-II showed sensitivity of 86.3% and specificity of 51.8% at a cut off value of 6239.5pg/ml with an AUC of 0.722. IL-8 had sensitivity of 70.4% and specificity of 52.3% at a cut off value of 51.5pg/ml with AUC 0.631. Conclusions: Our data supported the role of proteasome, sICAM-1, sTNFR-II and ${\beta}$-catenin in early detection of HCC. Also, using this panel of serological markers in combination with ${\alpha}FP$ may offer improved diagnostic performance over ${\alpha}FP$ alone in the early detection of HCC.

• Radiation Oncology Journal
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• 제19권1호
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• pp.34-39
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• 2001

목적 : 간암을 대상으로 한 고식적인 방사선치료가 아닌 정위방사선치료에 대한 보고는 매우 드물다. 이에 저자들은 원발성 간암환자들을 대상으로 정위방사선치료에 대한 예비결과를 알아보고자 하였다. 대상 및 방법 : 1999년 7월부터 2000년 3월까지 성모병원 치료방사선과에서 두개외 종양으로 정위방사선치료를 33명의 환자들에서 시행하였으며 그중 13명의 원발성 간암환자들을 대상으로 하였다. 대상환자들의 성별은 남자가 12명, 여자가 1명이었으며 연령분포은 $44\~66$세(중앙값:59세)였고 종양의 크기는 $10\~825\;cc$ (평균 : 185 cc)였다. 정위방사선치료는 1회 $3\~5\;Gy$를 $90\%$의 등선량 곡선에 기준하여 주 3-5회씩, $2\~3$주 동안 조사선량의 범위는 $30\~50\;Gy$이고 중앙선량은 50 Gy였다. 결과 : 추적관찰기간은 $3\~13$개월이었다(중간추적관찰기간: 8개월). 정위방사선치료 후 전체 환자에서 완전관해 $7.7\%$, 부분관해 $v$, 미세관해 $30.8\%$, 무반응 $7.7\%$였으며 국소제어율(완전관해+부분관해)은 $61.5\%$였다. 혈청 AFP의 치료 전과 치료 후 수치의 변화를 비교한 결과, 전체환자 중 $92.3\%$에서 AFP이 감소하였다. 치료에 따른 부작용은 소화장애가 $84.6\%$, 경한 오심이 $69.2\%$, 일시적인 간 기능의 저하가 $15.4\%$, 미열이 $7.7\%$에서 나타났으나 치명적인 부작용은 없었다. 결론 : 원발성 간암에 대한 정위방사선치료를 시행한 결과 비교적 안전하고 효과적인 치료방법이었다. 그러나 새로운 치료방법으로서 검증하기 위해서는 보다 많은 환자와 장기적인 추적관찰이 필요하리라고 사료된다.