• Title/Summary/Keyword: Advanced breast cancer

검색결과 223건 처리시간 0.022초

약하게 조영증강된 병변의 유방 전용 CT 영상의 대조도 개선을 위한 적응적 영상 재조정 방법: 팬텀 연구 (Adaptive Image Rescaling for Weakly Contrast-Enhanced Lesions in Dedicated Breast CT: A Phantom Study)

  • 김빛별;김호경;김진성;기용간;주지현;전호상;박달;김원택;남지호;김동현
    • 대한영상의학회지
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    • 제82권6호
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    • pp.1477-1492
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    • 2021
  • 목적 Dedicated breast CT (이하 DBCT)는 유방 압박의 고통이 없는 영상 진단 기법으로 최근 주목받고 있다. 본 연구에서는 DBCT 영상에서 약하게 조영증강된 작은 병변의 검출률을 높이기 위해 피사체의 기하학적 정보를 이용하여 최적의 영상 문턱값을 제공하는 adaptive image rescaling (이하 AIR) 기법을 제안하였다. 대상과 방법 5개의 동일 크기의 구멍과 서로 다른 크기의 구멍을 가지는 두 개의 디스크를 각각 제작하고, 이를 60 kVp와 100 kVp로 스캔하여 single-energy CT (이하 SECT), dual-energy CT (이하 DECT), 그리고 AIR 영상을 생성하였다. 전임상 평가를 위해 돼지 조직 영상도 획득하였다. Image contrast (이하 IC)와 contrast-to-noise ratio (이하 CNR)로 화질을 평가하였으며, student's t test를 이용하여 영상 간 화질의 차이를 검증하였다. 결과 AIR의 평균 IC (0.70)는 DECT (0.94)의 74.5%로 나타났으며, SECT (0.22) 보다 318.2% 높았다. 또한 AIR의 평균 CNR (5.08)은 SECT (14.30)의 35.5%로 나타났고 DECT (2.28) 보다 222.8% 높게 측정되었다. 돼지 조직의 전임상 평가 결과도 비슷한 양상을 보였다. 결론 AIR은 SECT보다 높은 영상 대조도를 가지며, 50% 선량만으로도 DECT에 비견할 만한 화질 성능을 제공할 수 있음을 확인하였다. 따라서 AIR은 DBCT 영상에서 약하게 조영증강된 병변의 검출률을 개선할 수 있을 것으로 생각된다.

Apoptosis Induction in MV4-11 and K562 Human Leukemic Cells by Pereskia sacharosa (Cactaceae) Leaf Crude Extract

  • Asmaa, Mat Jusoh Siti;Al-Jamal, Hamid Ali Nagi;Ang, Cheng Yong;Asan, Jamaruddin Mat;Seeni, Azman;Johan, Muhammad Farid
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.475-481
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    • 2014
  • Background: Pereskia sacharosa is a genus of cacti widely used in folk medicine for cancer-related treatment. Anti-proliferative effects have been studied in recent years against colon, breast, cervical and lung cancer cell lines, with promising results. We here extended study of anti-proliferative effects to a blood malignancy, leukemia. Materials and Methods: Two leukemic cell lines, MV4-11 (acute myeloid leukemia) and K562 (chronic myeloid leukemia), were studied. $IC_{50}$ concentrations were determined and apoptosis and cell cycle regulation were studied by flow cytometric analysis. The expression of apoptosis and cell-cycle related regulatory proteins was assessed by Western blotting. Results: P sacharosa inhibited growth of MV4-11 and K562 cells in a dose-dependent manner. The mode of cell death was via induction of intrinsic apoptotic pathways and cell cycle arrest. There was profound up-regulation of cytochrome c, caspases, p21 and p53 expression and repression of Akt and Bcl-2 expression in treated cells. Conclusions: These results suggest that P sacharosa induces leukemic cell death via apoptosis induction and changes in cell cycle checkpoint, thus deserves further study for anti-leukemic potential.

Role of exon 7 PTEN Gene in Endometrial Carcinoma

  • Kafshdooz, Leila;Kafshdooz, Taiebeh;Tabrizi, Ali Dastranj;Ardabili, Seyyed Mojtaba Mohaddes;Akbarzadeh, Abolfazl;Gharesouran, Jalal;Ghojazadeh, Morteza;Farajnia, Safar
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권11호
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    • pp.4521-4524
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    • 2015
  • Background: Endometrial carcinoma is the most common malignant tumor of the female genital tract and the fourth most common cancer in Iranian women after breast, colorectal and lung cancers. Various genetic alterations appear to be early events in the pathogenesis of endometrial carcinoma and it seems that PTEN is the most commonly mutated gene in the endometrioid subtype. The aim of the present study was to investigate the correlation between mutations in exon 7 of PTEN gene and endometrial carcinoma. Materials and Methods: Seventy-five patients with endometrial carcinoma and 75 females whose underwent hysterectomy for non tumoral indication were selected for evaluation of PTEN mutations in exon 7 by PCR-SSCP and sequencing. Correlations between the frequency and type of mutation and the pathologic findings of the cancer (tumor subtype, stage and grade) were assessed. Results: All of the samples were obtained from Iranian patients. 60 % (45 cases) of the tumors were endometriod and 40% (30 cases) were of serous type. The grade distributions of the 75 cases according to the FIGO staging system were as follows: low grade, 20 cases; high grade 55 cases, low stage, 41 cases; high stage 34 cases. For exon 7 of the PTEN gene, the analysis showed that there were no mutations in our cases. Conclusions: Our findings in the present study suggest that exon 7 of PTEN does not play any significant role in the development of endometrial carcinoma in Iranian cases.

A Retrospective Analysis of the Clinical Outcomes of Leptomeningeal Metastasis in Patients with Solid Tumors

  • Kim, Hyojeong;Lee, Eun Mi
    • Brain Tumor Research and Treatment
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    • 제6권2호
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    • pp.54-59
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    • 2018
  • Background Leptomeningeal metastasis (LM) is an uncommon, but devastating complication of advanced cancer and has no standard treatment. Herein, we analyzed the clinical characteristics and outcomes of patients with solid tumors who were diagnosed with LM. Methods Between January 2007 and December 2017, we retrospectively analyzed the medical records of patients with solid tumors who were diagnosed with LM. Results A total of 58 patients were enrolled in this study. The median age of patients was 51 years (range, 27-72 years), and 62.1% had a poor Eastern Cooperative Oncology Group (ECOG) performance status (PS) (>2). The common types of primary tumor were breast cancer (39.7%), gastric cancer (25.9%), and non-small cell lung cancer (20.7%). Forty-two patients (72.4%) were diagnosed with LM by MRI of the brain and/or spine and cerebrospinal fluid (CSF) analysis, 14 were diagnosed by CSF analysis alone, and 2 were diagnosed by MRI alone. Treatments for LM were performed in 53 patients (91.4%), and best supportive care was provided for 5 patients (8.6%). Intrathecal chemotherapy, radiotherapy, and systemic chemotherapy were administered in 43 (74.1%), 17 (29.3%), and 24 (41.4%) patients, respectively. The median overall survival of the entire cohort was 2.4 months (95% confidence interval, 1.0-3.7). In the analysis of prognostic factors for survival, a good ECOG PS (${\leq}2$), administration of systemic chemotherapy after LM diagnosis, and a prior history of brain radiation were associated with prolonged survival. Conclusion Although the prognosis of LM in patients with solid tumors is poor, systemic chemotherapy might improve survival in selected patients with a good PS.

국소진행성 유방암에서 F-18 FLT-PET 적용 가능성에 대한 예비 연구: F-18 FDG-PET와 비교 (A Pilot Study for the Feasibility of F-18 FLT-PET in Locally Advanced Breast Cancer: Comparison with F-18 FDG-PET)

  • 이재현;김의녕;홍일기;안진희;김성배;안세현;공경엽;김재승;오승준;문대혁;류진숙
    • Nuclear Medicine and Molecular Imaging
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    • 제42권1호
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    • pp.29-38
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    • 2008
  • 목적: 최근에 세포증식성 PET 방사성의약품으로 소개되고 있는 FLT를 이용하여 국소진행성 유방암 환자에서 FLT-PET 영상을 시행하여 종양 영상으로서의 향후 적용 가능성을 살펴보고, FDG와 FLT의 섭취양상에 대한 비교 및 정상 장기에 대한 섭취분포 양상을 알아보고자 하였다. 대상 및 방법: 본 연구는 2005년 8월부터 2006년 11월까지 총 22명(모두 여성, 평균나이; 42세)의 국소진행성 유방암 진단 받은 환자들을 대상으로 하였으며, 모든 종양의 조직형은 침윤성관상피암이었다. 모든 환자를 대상으로 하여 conventional imaging workup, FLT PET/CT, FDG-PET를 시행하였다. MRI로 측정 한 종양 장경의 평균은 $7.2{\pm}3.4$ cm 이었다. 원발 병소와 림프절 섭취에 대한 육안적인 분석과 반정량적인 분석(SUVmax, $SUV_{75}$, TB ratio)을 하였고, 림프절 섭취에 대한 FDG-PET와 FLT-PET의 일치도를 살펴보았다. 정상장기에서의 FLT와 FDG 분포양상을 비교하기 위해 간과 골수의 SUVmax와 $SUV_{75}$을 측정하였다. 결과: 모든 원발 종양근 FLT-PET와 FDG-PET에서 섭취 증가를 나타냈다. MR로 측정한 종양 장경과 FLT-PET 또는 FDG-PET의 SUVmax간에 유의한 상관관계는 없었다(p>0.05). 종양의 SUVmax (FLT $6.5{\pm}5.2$ vs FDG $8.3{\pm}4.9$, p=0.02)와 $SUV_{75}$ (FLT $5.3{\pm}4.3$ vs FDG $6.9{\pm}4.2$, p=0.02)에서는 FDG가 FLT보다 유의하게 높았으며, 중등도의 유의한 상관관계를 보였다(SUVmax; rho=0.450, p=0.04 / $SUV_{75}$; rho=0.472, p=0.03). 반면, TB 섭취비는 FLT가 FDG보다 현저히 높았다(FLT $11.7{\pm}7.7$ vs FDG $6.3{\pm}3.8$, p=0.001). 림프절 섭취 분포에 대한 비교에서는 FDG와 FLT-PET는 34개 구역에서 33개가 일치하였다. FLT와 FDG의 정상 장기의 섭취분포를 보았을 때 FLT는 간(FLT $4.2{\pm}1.2$ vs FDG $1.8{\pm}0.4$)과 골수(FLT $7.4{\pm}1.2$ vs FDG $1.6{\pm}0.4$)의 섭취가 FDG보다 높고 환자마다 다양하였다. 결론: 국소진행성 유방암에서 FTLT는 FDG보다 종양 섭취도는 낮지만 종양과 전이 림프절 섭취가 PET에서 잘 관찰되었다. FLT-PET는 종양 대 주변섭취의 비가 FDG-PET보다 높았으며, 전이 림프절의 진단에서도 FDG-PET와 높은 일치율을 보여 종양 진단 영상으로 유용할 것으로 생각된다. FLT는 정상 간과 골수 조직의 섭취가 높고 개인차가 커서 이들 장기의 전이를 진단하는 데는 제한적일 것으로 생각된다.

인간 유방암 줄기세포에서 레몬잎 메탄올 추출물의 항암 효능 (Anticancer Activities of the Methanolic Extract from Lemon Leaves in Human Breast Cancer Stem Cells)

  • 문정용;;현호봉;;조민환;한수영;이동선;안광석
    • Journal of Applied Biological Chemistry
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    • 제58권3호
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    • pp.219-226
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    • 2015
  • 본 연구에서는 레몬 잎 메탄올 추출물(MLL)의 인간 유방암 줄기 세포인 MCF-7-SC에 대한 항암 활성을 조사하였다. MLL이 MCF-7-SC에서 apoptosis를 유도하였으며, 이를 apoptotic body의 형성, sub-G1 phase 및 annexin V-positive 세포와 Bax/Bcl-2 ratio의 증가, caspase-9과 caspase-3의 활성화 및 PARP의 절 단을 통하여 확인하였다. 동시에 MCF-7-SC에서 MLL은 acidic vesicular organelles의 형성, LC3-II의 축적 증가, Akt/mTOR/p70S6K의 활성 억제 등을 통하여 autophagy를 유도하였다. Epithelial-mesenchymal transition (EMT)는 세포가 전이 상태를 획득하기 위한 중요한 과정이며, 이 기작은 암세포가 전이되는 것을 억제함에 있어서 중요한 표적이 된다. 낮은 농도에서의 MLL은 epithelial 마커 단백질인 E-cadherin이 증가와 mesenchymal 마커 단백질인 Snail과 Slug의 발현 감소를 통해 EMT 과정을 저해함으로써 MCF-7-SC에서 항전이 활성을 나타내었다. 본 연구에서는 레몬 잎 메탄올 추출물이 농도 의존적으로 유방암 줄기세포에 대해 세포 독성과 항전이 활성을 나타내고 있으며, 따라서 레몬잎은 항암 소재로서의 개발 가능성이 높은 식물이라고 사료된다.

Prostate Cancer Screening in a Healthy Population Cohort in Eastern Nepal: an Explanatory Trial Study

  • Belbase, Narayan Prasad;Agrawal, Chandra Shekhar;Pokharel, Paras Kumar;Agrawal, Sudha;Lamsal, Madhab;Shakya, Vikal Chandra
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2835-2838
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    • 2013
  • Background: Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. Objective: To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. Materials and Methods: This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in four Teaching District Hospitals of BPKIHS, all in Eastern Nepal. Digital rectal examination (DRE) was conducted by trained professionals after collecting blood for assessment of serum prostatic specific antigen (PSA). Trucut biopsies were performed for all individuals with abnormal PSA/DRE findings. Results: A total of 1,521 males more than 50 years of age were assessed and screened after meeting the inclusion criteria. The vast majority of individuals, 1,452 (96.2%), had PSA ${\leq}4.0$ ng/ml. Abnormal PSA (>4 ng/ml) was found in 58 (3.8%). Abnormal DRE was found in 26 (1.72%). DRE and PSA were both abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed benign prostatic hyperplasia in 47 (3.11%) and adenocarcinoma prostate in 11 (0.73%). The specificity of DRE was 66.0%with a sensitivity of 90.9% and a positive predictive value of 38.5%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 19.0% Conclusions: The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.

Clinical Course of Suspected Diagnosis of Pulmonary Tumor Thrombotic Microangiopathy: A 10-Year Experience of Rapid Progressive Right Ventricular Failure Syndrome in Advanced Cancer Patients

  • Minjung Bak;Minyeong Kim;Boram Lee;Eun Kyoung Kim;Taek Kyu Park;Jeong Hoon Yang;Duk-Kyung Kim;Sung-A Chang
    • Korean Circulation Journal
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    • 제53권3호
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    • pp.170-184
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    • 2023
  • Background and Objectives: Several cases involving severe right ventricular (RV) failure in advanced cancer patients have been found to be pulmonary tumor thrombotic microangiopathies (PTTMs). This study aimed to discover the nature of rapid RV failure syndrome with a suspected diagnosis of PTTM for better diagnosis, treatment, and prognosis prediction in clinical practice. Methods: From 2011 to 2021, all patients with clinically suspected PTTM were derived from the one tertiary cancer hospital with more than 2000 in-hospital bed. Results: A total of 28 cases of clinically suspected PTTM with one biopsy confirmed case were included. The most common cancer types were breast (9/28, 32%) and the most common tissue type was adenocarcinoma (22/26, 85%). The time interval from dyspnea New York Heart Association (NYHA) Grade 2, 3, 4 to death, thrombocytopenia to death, desaturation to death, admission to death, RV failure to death, cardiogenic shock to death were 33.5 days, 14.5 days, 7.4 days, 6.4 days, 6.1 days, 6.0 days, 3.8 days and 1.2 days, respectively. The NYHA Grade 4 to death time was 7 days longer in those who received chemotherapy (7.1 days vs. 13.8 days, p value=0.030). However, anticoagulation, vasopressors or intensive care could not change clinical course. Conclusions: Rapid RV failure syndrome with a suspected diagnosis of PTTM showed a rapid progressive course from symptom onset to death. Although chemotherapy was effective, increased life survival was negligible, and treatments other than chemotherapy did not help to improve the patient's prognosis.

Anti-carcinogenic effects of non-polar components containing licochalcone A in roasted licorice root

  • Park, So Young;Kim, Eun Ji;Choi, Hyun Ju;Seon, Mi Ra;Lim, Soon Sung;Kang, Young-Hee;Choi, Myung-Sook;Lee, Ki Won;Yoon Park, Jung Han
    • Nutrition Research and Practice
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    • 제8권3호
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    • pp.257-266
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    • 2014
  • BACKGROUND/OBJECTIVE: Licorice has been shown to possess cancer chemopreventive effects. However, glycyrrhizin, a major component in licorice, was found to interfere with steroid metabolism and cause edema and hypertension. The roasting process of licorice modifies the chemical composition and converts glycyrrhizin to glycyrrhetinic acid. The purpose of this study was to examine the anti-carcinogenic effects of the ethanol extract of roasted licorice (EERL) and to identify the active compound in EERL. MATERIALS/METHODS: Ethanol and aqueous extracts of roasted and un-roasted licorice were prepared. The active fraction was separated from the methylene chloride (MC)-soluble fraction of EERL and the structure of the purified compound was determined by nuclear magnetic resonance spectroscopy. The anti-carcinogenic effects of licorice extracts and licochalcone A was evaluated using a MTT assay, Western blot, flow cytometry, and two-stage skin carcinogenesis model. RESULTS: EERL was determined to be more potent and efficacious than the ethanol extract of un-roasted licorice in inhibiting the growth of DU145 and MLL prostate cancer cells, as well as HT-29 colon cancer cells. The aqueous extracts of un-roasted and roasted licorice showed minimal effects on cell growth. EERL potently inhibited growth of MCF-7 and MDA-MB-231 breast, B16-F10 melanoma, and A375 and A2058 skin cancer cells, whereas EERL slightly stimulated the growth of normal IEC-6 intestinal epithelial cells and CCD118SK fibroblasts. The MC-soluble fraction was more efficacious than EERL in inhibiting DU145 cell growth. Licochalcone A was isolated from the MC fraction and identified as the active compound of EERL. Both EERL and licochalcone A induced apoptosis of DU145 cells. EERL potently inhibited chemically-induced skin papilloma formation in mice. CONCLUSIONS: Non-polar compounds in EERL exert potent anti-carcinogenic effects, and that roasted rather than un-roasted licorice should be favored as a cancer preventive agent, whether being used as an additive to food or medicine preparations.

유리 복직근 피판을 이용한 중안모 결손부 재건의 2 치험례 (RECONSTRUCTION OF MIDFACIAL DEFECTS UTILIZING RECTUS ABDOMINIS FREE FLAP : REPORT OF 2 CASES)

  • 이성근;성일용;김종렬
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권1호
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    • pp.98-104
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    • 2000
  • Expansion in the scope and technique of head and neck tumor resection during the past two decades has paralleled precise tumor localization with advanced radiographic imaging and the availability of microvascular free tissue transfer. Especially, the defect reconstruction utilizing free flap results in improvement of patient survival due to decrease of local recurrence by wide resection of cancer. The rectus abdominis free flap has been used widely in reconstruction of the breast and extremities. However, the report of cases on its applications in the head and neck, based on the deep inferior epigastric artery and vein, is rare. This flap is one of the most versatile soft-tissue flaps. The deep inferior epigastric artery and vein are long and large-diameter vessels that are ideal for microvascular anastomosis. The skin area that can be transferred is probably the largest of all flaps presently in use. The versatility of the donor site is due to the ability to transfer large areas of skin with various thickness and amounts of underlying muscle. This article is to report reconstruction of midface defects utilizing the rectus abdominis free flap in 2 patients with maxillary squamous cell carcinoma and discuss briefly considerations in flap design and orbital exenteration, and healing of irradiated recipient site by hyperbaric oxygen therapy with literature review.

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