• Title/Summary/Keyword: Cancer metastasis

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Optimal Imaging Time for Diagnostic I-123 Whole Body Scan in the Follow-up of Patients with Differentiated Thyroid Cancer: Comparison between 6- and 24-Hour Images of the Same Subjects (분화 갑상선 암의 추적 관찰에서 진단적 I-123 전신 스캔의 최적 영상 시점: 동일 환자에서 6시간과 24시간 영상의 비교)

  • Lee, Hong-Je;Lee, Sang-Woo;Song, Bong-Il;Kang, Sung-Min;Seo, Ji-Hyoung;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.129-136
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    • 2009
  • Purpose: To determine optimal imaging time for diagnostic I-123 whole body scan in the follow-up of patients with differentiated thyroid cancer(DTC), we compared the image quality of 6- and 24-hour images of the same subjects. Materials and Methods: Four hundred ninety-eight patients(M:F = 55:443, Age $47.6{\pm}12.9$ years) with DTC who had undergone total thyroidectomy and I-131 ablation therapy underwent diagnostic whole body scanning 6 hour and 24 hour after oral ingestion of 185 MBq(5 mCi) of I-123. Serum thyroglobulin measurement and ultrasonography of the neck were performed at the time of imaging. In 40 patients underwent additional I-131 therapy, post-therapy I-131 images were obtained and compared with diagnostic I-123 images. Results: In 440 patients(88.4%), 6- and 24-hour diagnostic I-123 images were concordant, and 58 patients(11.6%) showed discordant findings. Among 58 discordant patients, 31 patients showed abnormal tracer uptake on only 6-hour image, which turned out false-positive findings in all cases. In 12 patients with positive findings on only 24-hour image, remnant thyroid tissue(4 patients) and cervical lymph node metastasis(3 patients) were presented. Among 40 patients underwent additional I-131 therapy, 6-hour and 24-hour images were discordant in 13 patients. All 5 patients with abnormal uptake on only 6-hour image revealed false-positive results, whereas most of 24-hour images were concordant with post-therapy I-131 images. Conclusion: I-123 imaging at 24-hour could reduce false-positive findings and improve diagnostic accuracy, compared with 6-hour image in the follow-up of patient with DTC.

Results of Radiation Alone Versus Neoadjuvant Chemotherapy and Radiation in Locally Advanced Stage of Uterine Cervical Cancer (진행된 자궁경부암에서 방사선치료 단독과 항암 화학요법 및 방사선치료 병용요법의 결과)

  • Kim, Jin-Hee;Choi, Tae-Jin;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.255-262
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    • 1997
  • Purpose : This is retrospective study to compare the results of radiation therapy alone and neoadjuvant chemotherapy and radiation in advanced stage of uterine cervical cancer. Materials and Methods : Seventy-six Patients who were treated with definitive radiation therapy for locally advanced cervical cacinoma between June 1988 and December 1993 at the department of radiation oncology, Keimyung University Dong-san Hospital. Thirty six patients were treated with radiation therapy alone and forty patients were treated with cisplatin based neoadjuvant chemotherapy and radiation therapy. According to FIGO staging system. there were 48 patients in stage IIb, 3 patients in stage IIIa, 23 patients in stage lIIb and two patients in stage IVa with median age of 53 years old. Follow-up periods ranged from 7 to 95 months with median 58 months. Results : Complete response (CR) rate were $86.1\%$ in radiation alone group and $80\%$ in chemoradiation group. There was no statistical difference in CR rate between the two groups. Overall five-year survival rate was $67.3\%$. According to stage, overall five-rear survival rates were $74\%$ in stage IIb, $66.7\%$ in stage IIIa, $49.8\%$ in stage IIb, $50\%$ in stage IVa. According to treatment modality overall five year survival rates were $74.1\%$ in radiation alone and $61.4\%$ in chemoradiation group (P=0.4) Five rear local failure free survival rates were $71.5\%$ in radiation alone group and $60\%$ in chemoradiation group (P=0.17). Five year distant metastasis free survival rates were $80.7\%$ in radiation aione group and $89.9\%$ in chemoradiation group (P=0.42). Bone marrow suppression (more than noted in 3 cases of radiaion alone group and 1 case of chemoradiation group. Grade II retal complication was noted in 5 patients of radiation group and 4 patients In chemoradiation group. Bowel obstruction treated with conservative treatment (1 patient) and bowel perforation treated with surgery (1 patient) were noted in radiation alone group. There was no statistical difference in complication between two groups. Conclusion : There was no statistical difference in survival, failure and complication between neoadjuvant chemotherapy and radiation versus radiation alone in locally advanced uterine cervical carcinoma.

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F-18-FDG Whole Body Scan using Gamma Camera equipped with Ultra High Energy Collimator in Cancer Patients: Comparison with FDG Coincidence PET (종양 환자에서 초고에너지(511 keV) 조준기를 이용한 전신 F-18-FDG 평면 영상: Coincidence 감마카메라 단층 촬영 영상과의 비교)

  • Pai, Moon-Sun;Park, Chan-H.;Joh, Chul-Woo;Yoon, Seok-Nam;Yang, Seung-Dae;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.1
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    • pp.65-75
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    • 1999
  • Purpose: The aim of this study is to demonstrate the feasibility of 2-[fluorine-18] fluoro-2-deoxy-D-glucose (F-18-FDG) whole body scan (FDG W/B Scan) using dual-head gamma camera equipped with ultra high energy collimator in patients with various cancers, and compare the results with those of coincidence imaging. Materials and Methods: Phantom studies of planar imaging with ultra high energy and coincidence tomography (FDG CoDe PET) were performed. Fourteen patients with known or suspected malignancy were examined. F-18-FDG whole body scan was performed using dual-head gamma camera with high energy (511 keV) collimators and regional FDG CoDe PET immediately followed it Radiological, clinical follow up and histologic results were correlated with F-18-FDG findings. Results: Planar phantom study showed 13.1 mm spatial resolution at 10 cm with a sensitivity of 2638 cpm/MBq/ml. In coincidence PET, spatial resolution was 7.49 mm and sensitivity was 5351 cpm/MBq/ml. Eight out of 14 patients showed hypermetabolic sites in primary or metastatic tumors in FDG CoDe PET. The lesions showing no hypermetabolic uptake of FDG in both methods were all less than 1 cm except one lesion of 2 cm sized metastatic lymph node. The metastatic lymph nodes of positive FDG uptake were more than 1.5 cm in size or conglomerated lesions of lymph nodes less than 1cm in size. FDG W/B scan showed similar results but had additional false positive and false negative cases. FDG W/B scan could not visualize liver metastasis in one case that showed multiple metastatic sites in FDG CoDe PET. Conclusion: FDG W/B scan with specially designed collimators depicted some cancers and their metastatic sites, although it had a limitation in image quality compared to that of FDG CoDe PET. This study suggests that F-18-FDG positron imaging using dual-head gamma camera is feasible in oncology and helpful if it should be more available by regional distribution of FDG.

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Identification of Tumor Suppressor Loci on the Short Arm of Chromosome 16 in Primary Small Cell Lung Cancers (원발성 소세포폐암에서 염색체 16번의 단완에 위치한 종양억제유전자좌의 확인)

  • Kee, Hyun Jung;Shin, Ju Hye;Chang, Joon;Chung, Kyung Young;Shin, Dong Hwan;Kim, Young Sam;Chang, Yoon Soo;Kim, Sung Kyu;Kwak, Seung Min;Kim, Se kyu
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.597-611
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    • 2003
  • Background : Loss of the short arm of chromosome 16 is a frequent event in various cancers, which suggests the presence of tumor suppressor gene(s) there. To map precise tumor suppressor loci on the chromosome arm for further positional cloning efforts, we tested 23 primary small cell lung cancers. Method : The DNAs extracted from paraffin embedded tissue blocks with primary tumor and corresponding control tissue were investigated. Twenty polymorphic microsatellite markers located in the short arm of chromosome 16 were used in the microsatellite analysis. Results : We found that six (26.1%) of 23 tumors exhibited LOH in at least one of tested microsatellite markers. Two (8.7%) of 6 tumors exhibiting LOH lost a larger area in chromosome 16p. LOH was observed in five common deleted regions at 16p. Among those areas, LOH between D16S668 and D16S749 was most frequent (21.1%). LOH was also observed at four other regions, between D16S3024 and D16S748, D16S405, D16S420, and D16S753. Six of 23 tumors exhibited shifted bands in at least one of the tested microsatellite markers. Shifted bands occurred in 3.3% (15 of 460) of the loci tested. Conclusion : Our data demonstrated that at least five tumor suppressor loci might exist in the short arm of chromosome 16 and that they may play an important role in small cell lung cancer tumorigenesis.

Clinical Significance of the Aortic Node in Non-small Cell Lung Cancer of the Left Upper Lobe (좌상엽에 발생한 비소세포형 폐암에서 Aortic Node의 의의)

  • 김대준;김길동;이기종;정경영
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.846-851
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    • 2003
  • Background: To clarify the clinical significance of the aortic nodes in resected non-small cell lung cancer of the left upper lobe. Material and Method: One hundred fifty six patients with resected non-small cell lung cancer of the left upper lobe were studied. Patients who received preoperative induction therapy, non-curative operation or defined as operative mortality were excluded from this study. Result: In N2 left upper lobe tumors, aortic nodes comprised 52.7% of the metastatic mediastinal lymph nodes. In single station N2 disease, a frequently metastasized station was aortic node (64.3%). 5-year actuarial survival according to the N status was 65.0% in N0, 30.4% in N1, and 17.9% in N2. There was no statistically significant difference in survival between N1 and N2 diseases (p=0.06). The patients with metastasis to aortic node alone had a comparatively good prognosis (5-year survival: 35.6%) than other N2 diseases (5-year survival: 4.6%) (p=0.01) and had a similar survival outcome as N1 diseases (p=0.97). Considering the aortic node as N1 node, 5-year survival according to the N status was 65.0% in N0, 31.2% in N1, 4.6% in N2 and significant survival difference was observed between N1 and N2 disease (p=0.00). In multivariate analysis, the male sex (hazard ratio 6.892, p=0.011) and the involvement to the aortic node alone (hazards ratio 2.799, p=0.009) were the significant factors affecting postoperative survival. Conclusion: According to the our data, involvement to the aortic node alone in left upper lobe tumors should be grouped with N1 disease because this combined category reflects the surgical outcome more accurately.

An Analysis of Prognostic Factors in the Uterine Cervical Cancer Patients (자궁경부암 환자의 예후인자에 관한 분석)

  • Yang, Dae-Sik;Yoon, Won-Sub;Kim, Tae-Hyun;Kim, Chul-Yong;Choi, Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.300-308
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    • 2000
  • Purpose :The aim of this study is to analysis of suwival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. Methods and Materials : From January 1981 to December 1998, eight-hundred twenty-seven uterine carvical cancer patients were treat with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (S2l patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were peformed with the Kaplan-Meier method and the Cox hazard model, respectively. Median rollow-up was 38.6 months. Results :On the radiation therapy only group, 314 patients (60$\%$) achieved complete response (CR), 47 patients (9$\%$) showed local recurrence (LR), 78 patients (15$\%$) developed distant metastasis (DM). On the Postoperative radiation therapy group, showed 276 Patients (85$\%$) CR, 8 Patients (2$\%$) LR, 37 Patients (11$\%$) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality (p=0.0010), recurrence (p=0.0001), Pap smear (p=0.0329), CEA (p=0.0001) and SCC antigen (p=0.0001). Conclusion: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.

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Field-in-Field Technique to Improve Dose Distribution in the Junction of the Field with Head & Neck Cancer (Field-in-Field Technique을 이용한 두경부암의 접합부위 선량개선에 관한 고찰)

  • Kim, Seon-Myeong;Lee, Yeong-Cheol;Jeong, Deok-Yang;Kim, Young-Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.1
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    • pp.17-23
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    • 2009
  • Purpose: In treating head and neck cancer, it is very important to irradiate uniform dose on the junction of the bilateral irradiation field of the upper head and neck and the anterior irradiation field of the lower neck. In order to improve dose distribution on the junction, this study attempted to correct non uniform dose resulting from under dose and over dose using the field-in-field technique in treating the anterior irradiation field of the lower neck and to apply the technique to the treatment of head and neck cancer through comparison with conventional treatment. Materials and Methods: In order to examine dose difference between the entry point and the exit point where beam diffusion happens in bilateral irradiation on the upper head and neck, we used an anthropomorphic phantom. Computer Tomography was applied to the anthropomorphic phantom, the dose of interest points was compared in radiation treatment planning, and it was corrected by calculating the dose ratio at the junction of the lower neck. Dose distribution on the junction of the irradiated field was determined by placing low-sensitivity film on the junction of the lower neck and measuring dose distribution on the conventional bilateral irradiation of the upper head and neck and on the anterior irradiation of the lower neck. In addition, using the field-in-field technique, which takes into account beam diffusion resulting from the bilateral irradiation of the upper head and neck, we measured difference in dose distribution on the junction in the anterior irradiation of the lower neck. In order to examine the dose at interest points on the junction, we compared and analyzed the change of dose at the interest points on the anthropomorphic phantom using a thermoluminescence dosimeter. Results: In case of dose sum with the bilateral irradiation of the upper head and neck when the field-in-field technique is applied to the junction of the lower neck in radiation treatment planning, The dose of under dose areas increased by 4.7~8.65%. The dose of over dose areas also decreased by 2.75~10.45%. Moreover, in the measurement using low-sensitivity film, the dose of under dose areas increased by 11.3%, and that of over dose areas decreased by 5.3%. In the measurement of interest point dose using a thermoluminescence dosimeter, the application of the field-in-field technique corrected under dose by minimum 7.5% and maximum 17.6%. Thus, with the technique, we could improve non.uniform dose distribution. Conclusion: By applying the field-in-field technique, which takes into account beam divergence in radiation treatment planning, we could reduce cold spots and hot spots through the correction of dose on the junction and, in particular, we could correct under dose at the entry point resulting from beam divergence. This study suggests that the clinical application of the field-in-field technique may reduce the risk of lymph node metastasis caused by under dose on the cervical lymph node.

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Ethanol Extract from Cnidium monnieri (L.) Cusson Induces G1 Cell Cycle Arrest by Regulating Akt/GSK-3β/p53 Signaling Pathways in AGS Gastric Cancer Cells (AGS 위암세포에서 Akt/GSK-3β/p53 신호경로 조절을 통한 벌사상자 에탄올 추출물의 G1 Cell Cycle Arrest 유도 효과)

  • Lim, Eun Gyeong;Kim, Eun Ji;Kim, Bo Min;Kim, Sang-Yong;Ha, Sung Ho;Kim, Young Min
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.4
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    • pp.417-425
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    • 2017
  • Cnidium monnieri (L.) Cusson is distributed in China and Korea, and the fruit of C. monnieri is used as traditional Chinese medicine to treat carbuncle and pain in female genitalia. In this study, we examined the anti-proliferation and cell cycle arrest effects of ethanol extracts from C. monnieri (CME) in AGS gastric cancer cells. Our results show that CME suppressed cell proliferation and induced release of lactate dehydrogenase (LDH) in AGS cells by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay and LDH assay. Cell morphology was altered by CME in a dose-dependent manner. In order to identify the cell cycle arrest effects of CME, we investigated cell cycle analysis after CME treatment. In our results, CME induced cell cycle arrest at G1 phase. Protein kinase B (Akt) plays a major role in cell survival mechanisms such as growth, division, and metastasis. Akt protein regulates various downstream proteins such as glycogen synthase kinase-$3{\beta}$ (GSK-$3{\beta}$) and tumor protein p53 (p53). Expression levels of p-Akt, p-GSK-$3{\beta}$, p53, p21, cyclin E, and cyclin-dependent kinase 2 (CDK2) were determined by Western blot analysis. Protein levels of p-Akt, p-GSK-$3{\beta}$, and cyclin E were reduced while those of p53, p21, and p-CDK2 (T14/Y15) were elevated by CME. Moreover, treatment with CME, LY294002 (phosphoinositide 3-kinase/Akt inhibitor), BIO (GSK-$3{\beta}$ inhibitor), and Pifithrin-${\alpha}$ (p53 inhibitor) showed that cell cycle arrest effects were mediated through regulation of the Akt/GSK-$3{\beta}$/p53 signaling pathway. These results suggest that CME induces cell cycle arrest at G1 phase via the Akt/GSK-$3{\beta}$/p53 signaling pathway in AGS gastric cancer cells.

APOPTOTIC EFFECT IN COMBINATION OF CYCLOSPORIN A AND TAXOL ON ORAL SQUAMOUS CELL CARCINOMA CELL LINE THROUGH THE PI-3 KINASE/AKT1 PATHWAY (구강 편평세포암종 세포주에서 Cyclosporin A와 Taxol 투여시 PI-3 kinase/Akt1 Pathway에 의한 세포사멸 병용효과)

  • Kim, Kyu-Young;Lee, Jae-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.426-436
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    • 2007
  • Oral cancer take up 2-6% of all carcinomas and squamous cell carcinoma, which is the most common type in oral cancer, has a poor prognosis due to its high metastasis and recurrence rates. In treating oral cancer, chemotherapy to the primary, metastasized and recurrent lesion is a very important and useful treatment, even though its widespread usage is limited due to high general toxicity and local toxicity to other organs. Taxol, a microtubule stabilizing agent, is an anticancer drug that induces cell apoptosis by inhibiting depolymerization of microtubules in between the metaphase and anaphase of the cell mitosis. Recently, its effectiveness and mechanism on various tumor has been reported. However, not much research has been done on the application of Taxol to oral squamous cell carcinoma. Cyclosporin A, which is an immunosuppressant, is being used on cancers and when co-administered with Taxol, effectiveness of Taxol is enhanced by inhibition of Taxol induced multidrug resistance. In this study, Cyclosporin A with different concentration of Taxol was co-administered to HN22, the oral squamous cell carcinomacell line. To observe the cell apoptosis and the mechanisms that take part in this process, mortality evaluation of tumor cell using wortmannin, c-DNA microarray, RT-PCR analysis, cytometry analysis and western blotting were used, and based upon the observation on the effect and mechanism of the agent, the following results were obtained: 1. The HN22 cell line viability was lowest when $100{\mu}M$ of Wortmannin and $5{\mu}g/ml$ of Taxol were co-administered, showing that Taxol participates in P13K-AKT1 pathway. 2. In c-DNA microarray, where $1{\mu}g/ml$ of cyclosporine A and 3mg/ml of Taxol were co-administered, no up regulation of AKT1, PTEN and BAD c-DNA that participate in cell apoptosis was observed. 3. When $1{\mu}g/ml$ of Cyclosporin A was applied alone to HN22 cell line, no difference was found in AKT1, PTEN and BAD mRNA expression. 4. Increased AKT1, mRNA expression was observed when $3{\mu}g/ml$ of Taxol was applied alone to HN22 cell line. 5. When $1{\mu}g/ml$ of Cyclosporin A and Taxol($3{\mu}g/ml\;and\;5{\mu}g/ml$) were co-administered to HN22 cell line, PTEN mRNA expression increased, whereas AKT1 and BAD mRNA decreased. 6. As a result of cytometry analysis, in the group of Cyclosporin A($1{\mu}g/ml$) and Taxol($3{\mu}g/ml$) co-administration, increased Annxin V was observed, which shows that apoptosis occurred by deformation of plasma membrane. However, no significant difference was observed with vary ing concentration. 7. In western blot analysis, no caspase 3 was observed in the group of Cyclosporin A($1{\mu}g/ml$) and Taxol($3{\mu}g/ml$) co-administration. From the results of this study, it can be concluded that synergistic effect can be observed in combination therapy of Taxol and Cyclosporin A on oral squamous cell carcinoma cell line, where decreased activity of the cell line was observed. This resulted in decreased AKT1 and BAD mRNA and increased PTEN mRNA expression and when wortmannin and Taxol were co-administered, the viability decreased which confirms that Taxol decreases the viability of tumor cell line. Hence, when Taxol and cyclosporine A are co-administered, it can be assumed that cell apoptosis occurs through AKt1 pathway.

The Expression of MUC1 and CD44s in Non-small Cell Lung Cancer (비소세포폐암에서 MUC1과 CD44s의 발현)

  • Park, Hye-Kyung;Lee, Ji-Seok;Lee, Jun-Hee;Lee, Jung-Wook;Kim, Yun-Seong;Lee, Min-Ki;Kim, Young-Dae;Lee, Hyung-Ryu;Kim, Kun-Il;Lee, Chang-Hun;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.117-127
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    • 2002
  • Backgroud : MUC1 mucin is a heavily glycosylated large glycoprotein and is expressed aberrantly in carcinoma. CD44 is polymorphic family of cell surface glycoproteins participating in cell-cell adhesion and modulation of the cell-matrix interaction. MUC1 mucin and CD44 expression have been implicated in a tumor invasion and metastasis in certain malignancies. In this study, the expression of MUC1 and the standard form of CD44 (CD44s) was examined in non-small cell lung cancer (NSCLC). Methods : Immunohistochemical staining using monoclonal antibodies including MUC1 glycoprotein and CD44s was performed on 80 NSCLC surgical specimens. The association between MUC1 and CD44s expression and the histological type and tumor stage was investigated. Results : Depolarized MUC1 expression in more than 10% of cancer cells was found in 12 (27.9%) out of 43 squamous cell carcinomas (SCCs) and 12 (32.4%) out of 37 adenocarcinomas (ACs). It was not associated with the tumor histological type and the TNM-stage in SCCs. Depolarized MUC1 expression correlated with the N-stage in ACs (p=0.036). CD44s was expressed in 36 (83.7%) out of 43 SCCs and 14 (37.8%) out of 37 ACs. Reduced CD44s expression correlated with the N-stage (p=0.031) and the TNM-stage (p=0.006) in SCCs. Conclusions : Depolarized MUC1 expression was related to the nodal stage in NSCLC adenocarcinoma. Reduced CD44s expression was related to nodal involvement and the TNM-stage in squamous cell carcinoma. This suggests that MUC1 and CD44s expression in NSCLC might play important roles in tumor progression and cap be used as prognostic variables.