• Title/Summary/Keyword: Cancer metastasis

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Worse Survival of Patients With T1 Stage II Gastric Cancer Following Radical Gastrectomy

  • Hayemin Lee;Kyo Young Song;Han Hong Lee;Junhyun Lee
    • Journal of Gastric Cancer
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    • v.23 no.4
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    • pp.598-608
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    • 2023
  • Purpose: Lymph node (LN) metastasis is a crucial factor in the prognosis of patients with gastric cancer (GC) and is known to occur more frequently in cases with an advanced T stage. This study aimed to analyze the survival data of patients with advanced LN metastasis in T1 GC. Materials and Methods: From January 2008 to June 2018, 677 patients with pathological stage II GC who underwent radical gastrectomy were divided into an early GC group (EG: T1N2 and T1N3a, n=103) and an advanced GC (AGC) group (AG: T2N1, T2N2, T3N0, T3N1, and T4aN0, n=574). Short- and long-term survival rates were compared between the 2 groups. Results: A total of 80.6% (n=83) of the patients in the EG group and 52.8% (n=303) in the AG group had stage IIA AGC. The extent of LN dissection, number of retrieved LNs, and short-term morbidity and mortality rates did not differ between the 2 groups. The 5-year relapse-free survival (RFS) of all patients was 87.8% and the overall survival was 84.0%. RFS was lower in the EG group than in the AG group (82.2% vs. 88.7%, P=0.047). This difference was more pronounced among patients with stage IIA (82.4% vs. 92.9%, P=0.003). Conclusions: T1 GC with multiple LN metastases seems to have a worse prognosis compared to tumors with higher T-stages at the same level. Adjuvant chemotherapy is highly recommended for these patients, and future staging systems may require upstaging T1N2-stage tumors.

A Case of Duodenal Metastasis from Adenocarcinoma of the Lung (십이지장으로 전이된 폐선암 1예)

  • Yoo, Seung Hyun;Sim, Yun Su;Lee, Jin Hwa;Shim, Ki Nam;Chang, Jung Hyun;Kim, Yoon Kyung;Sung, Sun Hee
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.3
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    • pp.283-288
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    • 2007
  • A gastrointestinal metastasis from lung cancer is rare and is quite often found during an autopsy. A 58-year-old man was admitted with left upper back pain and a mass in the left upper lobe on the chest radiograph. The transbronchial lung biopsy revealed an adenocarcinoma of the lung. A gastroduodenoscopy was carried out to evaluate the indigestion and epigastric discomfort. The duodenofibroscopy revealed bulging mucosa on the minor papilla of the duodenum. A metastasis to the duodenum from an adenocarcinoma of the lung was diagnosed by a duodenofibroscopic biopsy of the bulging lesion. We report this rare case of an adenocarcinoma of lung with a metastasis to the duodenum.

Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer

  • Kim, Wan Wook;Lee, Jeeyeon;Jung, Jin Hyang;Park, Ho Yong;Kim, Won Hwa;Kim, Hye Jung;Park, Ji-Young;Tufano, Ralph P.
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.302-307
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    • 2020
  • Background: This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon's palpation in papillary thyroid cancer. Methods: This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness. Results: Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively. Conclusion: Determination of central LN metastasis by a surgeon's palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.

Expression of VEGF-C/VEGFR-3 in Human Laryngeal Squamous Cell Carcinomas and its Significance for Lymphatic Metastasis

  • Wang, Zhongliang;Chen, Yao;Li, Xiaofeng;Xu, Li;Ma, Wei;Chang, Lingmei;Ju, Funian
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.27-31
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    • 2012
  • Objectives: Expression of vascular endothelial growth factor C (VEGF-C)and vascular endothelial growth factor feceptor-3 (VEGFR-3) in laryngeal squamous carcinoma and its relationship to lymph node metastasis were investigated. Methods: VEGF-C and VEGFR-3 gene expression in 30 cases of normal laryngeal mucosa tissue (NLM), primary laryngeal carcinoma cell carcinomas (PLC) and cervical lymph nodes (CLN) was examined by reverse transcription polymerase chain reaction (RT-PCR). Protein levels of VEGF-C expression were determined by immunohistochemical staining in 60 cases of PLC. Results: Expression of VEGF-C and VEGFR-3 different among NLM, PLC and CLN in the same patient. In PLC, expression was significantly higher in lymph node positive group than in the lymph node negative group and associated with histological grade of differentiation; Expression of VEGF-C and VEGFR-3 was not linked with age, sex, site or T stage. Conclusions: A close correlation was found between VEGF-C/VEGFR-3 expression and lymph node metastasis in PLC, suggesting a role in metastasis of laryngeal carcinomas.

Significance of nm23, Bcl2 and Bax Expression in Papillary Thyroid Carcinoma (유두상 갑상선암에서 nm23, Bcl2, Bax 발현도의 임상적 의의)

  • Chung Woung-Youn;Lee Hae-Kyung;Baik So-Ya;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.2
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    • pp.161-166
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    • 2000
  • Objective: The nm23 gene has been identified as a potential metastasis suppressor gene in various human neoplasms. Both Bcl-2, which promotes cell survival, and Bax, which promotes cell death, have been considered as major factors in controlling the apoptotic pathway. This study was carried out to determine whether these markers are useful in distinguishing potential intrinsic differences in tumor virulence of papillary thyroid cancers. Material and Method: The expressions of nm23, Bcl-2 and Bax have been evaluated using immunohistochemical techniques in 100 pure papillary thyroid cancers and 20 metastatic lymphnodes. The intensity of immnunoreactivity was graded on arbitrary four point scale(grade 0 or 1 : negative reactivity, grade 2 or 3 positive reactivity). The immunoreactivities were analyzed in relation to TNM atage, AMES score, local recurrence and distant metastasis, and that of metastatic LNs was compared with the tumors. Results: The expression of Bcl-2 and bax did not show any statistical differences by TNM stage, AMES score, recurrence, distant metastasis and also between the tumor and metastatic LN. However, the nm23 showed higher expression of Ki67 in distant metastasis than in control group and in metastatic LNs than in the tumors(p<0.05). Conclusion: Although the expression of Bcl-2 and Bax protein showed no correlation with clinical parameters representing tumor virulence, the nm23 expression could be an useful prognostic factor, especially in predicting nodal or distant metastasis in papillary thyroid cancer.

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Expression of RECK and MMPs in Hepatoblastoma and Neuroblastoma and Comparative Analysis on the Tumor Metastasis

  • Xu, Meng;Wang, Hai-Feng;Zhang, Huan-Zhi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4007-4011
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    • 2015
  • Objective: To explore the expression of RECK and relevant matrix metalloproteinases (MMPs) in hepatoblastoma (HB) and neuroblastoma (NB) and their clinical significance in the tumor metastasis. Materials and Methods: Forty-five wax-stone samples of HB and 43 wax-stone samples of NB removed by surgical resection and confirmed by pathology in Linyi Yishui Central Hospital were selected. According to presence and absence of metastasis, both NB and HB samples were divided into metastatic group and non-metastatic group, namely NB metastatic group (n=28), NB non-metastatic group (n=15), HB metastatic group (n=15) and HB non-metastatic group (n=30). The expression of RECK, membrane type-1 matrix metalloproteinase (MT1-MMP) in HB tissue and RECK, MMP-14 in NB tissue was detected using immunohistochemical method, and the correlation between RECK and MT1-MMP, MMP-14 was analyzed. Results: The metastatic rate of NB was dramatically higher than that of HB, with statistical significance (P=0.003). The positive rate of RECK expression in NB group (30.2%) was slightly lower than in HB group (40.0%), but no significant difference was presented (P=0.338). The positive rate of MMPs expression in NB metastatic group was evidently higher than in HB metastatic group (P=0.024). The results of Spearman correlation analysis revealed that the expression of RECK in HB and NB tissues had a significantly-negative correlation with MT1-MMP and MMP-14, respectively (r=-0.499, P=0.012; r=-0.636, P=0.000). Conclusions: In HB and NB tissues, RECK is expressed lowly, while relevant MMPs highly, and RECK inhibits the tumor invasion and metastasis through negative regulation of relevant MMPs.

Serum Oncofetal Fibronectin (onfFN) mRNA in Differentiated Thyroid Carcinoma (DTC): Large Overlap between Disease-Free and Metastatic Patients

  • Sritara, Chanika;Charoenphun, Putthiporn;Ponglikitmongkol, Mathurose;Musikarat, Suchawadee;Utamakul, Chirawat;Chokesuwattanasakul, Payap;Thakkinstian, Ammarin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4203-4208
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    • 2012
  • Aim: This study assessed if onfFN mRNA in the peripheral blood of patients with DTC can identify individuals with metastatic disease. Methods: Comparison of onfFN mRNA was made among 3 groups: disease-free, lymph node metastasis, and distant metastasis using real-time RT-PCR on 5 ml blood samples from each DTC patient. Results: Fifty-one patients were included: 30 (59%) were disease-free; 7 (13.7%) had lymph node metastasis; and 14 (27.5%) had distant metastasis. OnfFN mRNA levels in the 3 groups were significantly different (P=0.001) but with a large overlap and the expression being highest in the disease-free group. Subgroup analysis of the metastatic groups did not show any effect of age, cell type, and serum TSH, Tg, and antiTg on onfFN mRNA. The within-run and between-run root mean square coefficients of variations were <2%. Conclusion: OnfFN mRNA in patients with DTC cannot identify those with metastatic disease.

Effects of PTTG Down-regulation on Proliferation and Metastasis of the SCL-1 Cutaneous Squamous Cell Carcinoma Cell Line

  • Xia, Yong-Hua;Li, Min;Fu, Dan-Dan;Xu, Su-Ling;Li, Zhan-Guo;Liu, Dong;Tian, Zhong-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6245-6248
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    • 2013
  • Aims: To study effects of down-regulation of pituitary tumor-transforming gene (PTTG) on proliferation and metastasis ability of the SCL-1 cutaneous squamous cell carcinoma (CSCC) cell line and explore related mechanisms. Methods: SCL-1 cells were divided into 3 groups (untreated, siRNA control and PTTG siRNA). Cell proliferation assays were performed using a CCK-8 kit and proliferation and metastasis ability were analyzed using Boyden chambers. In addition, expression of MMP-2 and MMP-9 was detected by r-time qPCR and Western blotting. Results: Down-regulation of PTTG could markedly inhibit cell proliferation in SCL-1 cells, compared to untreated and control siRNA groups (P < 0.05). Real-time qPCR demonstrated that expression levels of PTTG, MMP-2 and MMP-9 in the PTTG siRNA group were 0.8%, 23.2% and 21.3% of untreated levels. Western blotting revealed that expression of PTTG, MMP-2 and MMP-9 proteins in the PTTG siRNA group was obviously down-regulated. The numbers of migrating cells ($51.38{\pm}4.71$) in the PTTG siRNA group was obviously lower than that in untreated group ($131.33{\pm}6.12$) and the control siRNA group ($127.72{\pm}5.20$) (P < 0.05), suggesting that decrease of proliferation and metastasis ability mediated by PTTG knock-down may be closely correlated with down-regulation of MMP-2 and MMP-9 expression. Conclusion: Inhibition of PTTG expression may be a new target for therapy of CSCC.

Classification of Whole Body Bone Scan Image with Bone Metastasis using CNN-based Transfer Learning (CNN 기반 전이학습을 이용한 뼈 전이가 존재하는 뼈 스캔 영상 분류)

  • Yim, Ji Yeong;Do, Thanh Cong;Kim, Soo Hyung;Lee, Guee Sang;Lee, Min Hee;Min, Jung Joon;Bom, Hee Seung;Kim, Hyeon Sik;Kang, Sae Ryung;Yang, Hyung Jeong
    • Journal of Korea Multimedia Society
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    • v.25 no.8
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    • pp.1224-1232
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    • 2022
  • Whole body bone scan is the most frequently performed nuclear medicine imaging to evaluate bone metastasis in cancer patients. We evaluated the performance of a VGG16-based transfer learning classifier for bone scan images in which metastatic bone lesion was present. A total of 1,000 bone scans in 1,000 cancer patients (500 patients with bone metastasis, 500 patients without bone metastasis) were evaluated. Bone scans were labeled with abnormal/normal for bone metastasis using medical reports and image review. Subsequently, gradient-weighted class activation maps (Grad-CAMs) were generated for explainable AI. The proposed model showed AUROC 0.96 and F1-Score 0.90, indicating that it outperforms to VGG16, ResNet50, Xception, DenseNet121 and InceptionV3. Grad-CAM visualized that the proposed model focuses on hot uptakes, which are indicating active bone lesions, for classification of whole body bone scan images with bone metastases.

Surgical Treatment of Thyroid Carcinoma - A Relation between Prognostic Factors and Survival Rate - (갑상선암의 외과적 치료 - 예후인자와 생존율의 관계)

  • Kim Jae-Hong;Oh Sang-Hoon;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.187-199
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    • 1997
  • Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

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