• 핵의학기술
• /
• 제14권2호
• /
• pp.181-185
• /
• 2010

갑상선암 환자의 경부 림프절에서 미세침흡인생검술(fine needle aspiration biopsy, FNAB)을 시행하며 얻은 미세침세척액의 티로글로불린(thyroglobulin, Tg)측정법의 진단적 성적과 유용성을 알아보고자 FNAB 세포검사의 결과와 비교하였다. 갑상선암의 경부림프절 전이가 의심되어 초음파 시행한 총 37명의 환자 48개의 FNAB 검체를 대상으로 하였고, 수술 후 조직검사결과 또는 장기간 영상 추적검사를 기준으로 하여 세포검사와 미세침세척액 티로글로불린(FNAB-Tg)측정법을 비교하여, 각 검사의 특이도, 민감도 및 정확도를 평가하였다. 추가적으로 Tg-항체가 양성일때 FNAB-Tg 검사에는 어떠한 영향을 미치는지 Tg-항체 검사를 같이 시행한 34명을 대상으로 분석하여 보았다. FNAB 검체의 세포검사에서 전이 음성인 36개 검체 중 35개 검체에서 음성을 보였고, 전이 양성인 12개 검체 중 9개 검체에서 양성을 보였다. FNAB-Tg측정법의 경우 전이 음성인 36개의 검체 중 32개의 검체에서 음성을 보였고, 전이 양성인 12개의 검체 중 12개 검체 모두 양성을 보였다. 따라서 세포검사의 민감도와 특이도는 각각 75.0% (9/12)와 97.2% (35/36)였고, 위음성이 25% (3/12)였다. 반면에 FNAB-Tg 측정법의 민감도와 특이도는 각각 100% (12/12)와 88.9% (32/36)였고, 위양성이 11.1% (4/36)였다. 정확도는 두 검사 모두 91.7% (44/48)였다. Tg-항체에 대한 검사 결과를 얻을 수 있는 34명을 따로 분석한 결과, Tg-항체의 존재 유무가 FNAB-Tg 측정법의 진단 성능에 영향을 주지 않음을 확인할 수 있었다. FNAB 검체를 이용한 세포검사는 특이도가 높고 반면, FNAB-Tg 측정법은 민감도가 높은 검사임을 확인할 수 있었다. 따라서 림프절 전이가 의심되는 갑상선환자에서 FNAB를 시행할 때 세포검사와 FNAB-Tg 측정법은 동시에 시행되어야 할 상호보완적인 검사들이다.

• Radiation Oncology Journal
• /
• 제29권3호
• /
• pp.174-180
• /
• 2011

Purpose: To evaluate the radiotherapy treatment outcome of patients in stage IE and IIE nasal natural killer/T-cell lymphoma. Materials and Methods: From August 1999 to August 2009, 46 patients with stage IE and IIE nasal natural killer/T-cell lymphoma were treated by definitive radiotherapy and chemotherapy. 33 patients were treated with chemotherapy followed by radiotherapy (CT + RT) and they received 50.4 Gy in 28 fractions. 13 patients were treated with concurrent chemoradiotherapy (CCRT) and they received 40 Gy in 20 fractions. Results: The median follow-up period was 4.6-137.6 months (median, 50.2 months) for all patients. The 4-year overall survival was 68.6% and 4-year disease free survival (DFS) was 61.9%. The 4-year locoregional recurrence free survival was 65.0%, and 4-year distant metastasis free survival (DMFS) was 66.2%. For patients treated with CT + RT, 15 patients (45.5%) achieved complete response after chemotherapy, and 13 patients (39.4%) achieved partial response. 13 patients (81.8%) achieved complete response after radiotherapy, and 6 patients (18.2%) achieved partial response. For patients treated with CCRT, 11 patients (84.6%) achieved complete response, and one patient (7.7%) achieved partial response. In univariate analysis, presence of cervical lymph node metastasis was only significant prognostic factor for DFS and DMFS. Conclusion: This study did not show satisfactory overall survival rate and disease free survival rate of definitive radiotherapy and chemotherapy for stage IE and IIE nasal natural killer/T-cell lymphoma. For patients with cervical lymph node metastasis, further investigation of new chemotherapy regimens is necessary to reduce the distant metastasis.

• Korean Journal of Radiology
• /
• 제23권11호
• /
• pp.1102-1111
• /
• 2022

Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권9호
• /
• pp.5165-5169
• /
• 2013

Background: To evaluate the pathological characteristics of invasive margins in early-stage cervical squamous cell carcinomas and their association with other clinicopathological features including clinical outcomes. Materials and Methods: Patients with FIGO stage IB-IIA cervical squamous cell carcinomas who received surgical treatment and had available follow-up information were identified. Their histological slides were reviewed for prognostic variables including tumor size, grade, extent of invasion, lymphovascular invasion, involvement of vaginal margin or parametrium, and lymph node metastasis. The characteristics of invasive margins including invasive pattern (closed, finger-like, or spray-like type), degree of stromal desmoplasia, and degree of peritumoral inflammatory reaction were evaluated along the entire invasive fronts of tumours. Associations between the characteristics of invasive margins and other clinicopathological variables and disease-free survival were assessed. Results: A total of 190 patients were included in the study with a median follow-up duration of 73 months. Tumour recurrence was observed in 18 patients (9%). Spray-like invasive pattern was significantly more associated as compared with closed or finger-like invasive pattern (p=0.005), whereas the degree of stromal desmoplasia or peritumoral inflammatory reaction was not. Low degree of peritumoral inflammatory reaction appeared linked with lymph node metastasis (p=0.021). In multivariate analysis, a spray-like invasive pattern was independently associated with marked stromal desmoplasia (p=0.013), whilst marked desmoplasia was also independently associated with low inflammatory reactions (p=0.009). Furthermore, low inflammatory reactions were independently associated with positive margins (p=0.022) and lymphovascular invasion (p=0.034). The patients with spray-like invasive pattern had a significantly lower disease-free survival compared with those with closed or finger-like pattern (p=0.004). Conclusions: There is a complex interaction between cancer tissue at the invasive margin and changes in surrounding stroma. A spray-like invasive pattern has a prognostic value in patients with early-stage cervical squamous cell carcinoma.

• 대한두경부종양학회지
• /
• 제36권2호
• /
• pp.9-15
• /
• 2020

Background/Objectives: To analyze the clinical characteristics of differentiated thyroid cancer (DTC) in children and adolescents. Materials & Methods: Medical records of 31 DTC cases that were diagnosed and treated at Korea Cancer Center Hospital between 2002 and 2018 were retrospectively reviewed. Results: Most cases were papillary carcinoma (n=26), with female predominance (n=25). Median age was 16.4 years (range, 11.9-18.6 years). Extrathyroidal extension was present in 24 cases. Twenty cases had tumor involvement at cervical lymph nodes and three had lung metastasis. Twenty-two patients received radioactive iodide treatment with a median cumulative dose of 300 mCi (range, 100-920 mCi). During a median follow-up of 68.2 months (range, 2.3-191.4 months), serum thyroglobulin level was elevated in 15 patients. Among them, two cases had remnant thyroid tissue, 4 had recurrence at cervical lymph nodes, and the remaining 9 did not have any detectable lesion. All were alive, and 5-year event-free survival (EFS) was 45.2±10.1%. Age £15 years, tumor size, lymph node status (N1b), and distant metastasis had negative effects on EFS. On multivariate analysis, age and tumor size had prognostic significance. Conclusion: For DTC of children and adolescents (£18 years old), age ≤15 years and tumor size were prognostic factor. Therefore, patients in this age group need meticulous follow-up. Further studies are necessary to answer the potential influence of age on the incidence and behavior of DTC.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권6호
• /
• pp.537-543
• /
• 2010

Purpose: The objective of this study is to evaluate the survival rate and influencing factors. Patients and Methods: We studied 104 patients who were diagnosed for squamous cell carcinoma of tongue and received curative treatment in oral oncology clinic of National Cancer Center from June 2001 to December 2009. Results: We found the following results. 1. The overall 5-year survival rate of tongue cancer was 67.0% and there was no significant statistical difference between male and female. 2. A lower survival rate was shown in patients under 40 years (42.2%) than over 40 years (75.5%)(P < 0.05). 3. 5-year survival rates of patients with tongue cancer classified by pTNM classification were 87.4% in early stage and 43.3% (P < 0.05). 4. A higher survival rate was seen in patients without cervical lymph node metastasis (82.0% > 44.1%)(P < 0.05). 5. A higher survival rate was seen in patients of tongue cancer with higher differenciation grade (P < 0.05). 6. It is well known that drinking and smoking have great influence on the survival rate of patients of squamous cell carcinoma of tongue. But these was no statistical significance. Conclusion: The overall 5-year survival rate of tongue cancer was 67.0% and it was mostly influenced by factors like age, pTNM stage, cervical lymph node metastasis, differentiation of cancer cell etc.

• Journal of Chest Surgery
• /
• 제31권11호
• /
• pp.1081-1084
• /
• 1998

연구배경 : 식도암은 근치율이 낮고, 광범위 림프절 절제후에도 그 성적이 나쁜 편이다. 따라서 경부 림프절 절제가 식도수술결과에 미치는 효과를 알아보고자 식도수술 환자에서 경부림프절 전이가 된 환자를 조사하였다 대상 및 방법 : 1994년부터 1996년 6월까지 본원에서 흉부식도암 수술을 받은 32명의 환자 중 고식적 수술을 시행받은 25명의 환자를 대상으로 하여 경부림프절 절제의 유무를 기준으로 두 그룹으로 나뉘어 연구하였다. 두 그룹 모두 흉부식도 전절제술과 동반하여 종격림프절과 복부림프절 절제를 시행하였으나 B그룹은 양측 경부림프절 절제를 추가하여 시행하였다. 결과 : 수술합병증은 두 그룹 사이에서 의미있게 차이가 나지않았다. t수술사망과 병원사망은 두 그룹 모두에서 보이지 않았다. 그러나 평균 마취시간은 B그룹에서 의밌게 더 길었다.(평균 마취시간 90분). B그룹에서 27%가 경부림프절 전이를 보였다 결론 : 그러므로 경부림프절 절제는 흉부식도암 수술에서 의미있는 수술방법이라고 할 수 있다. 장기생존율의 비교가 더 필요하리라고 생각한다.

• Archives of Plastic Surgery
• /
• 제35권5호
• /
• pp.607-610
• /
• 2008

Purpose: Salivary duct carcinoma(SDC) is uncommon but high grade adenocarcinoma arising in the ductal epithelium of salivary glands. SDC is characterized by distinctive clinical and pathologic features. The most important histologic aspect of this neoplasm is its resemblance to ductal carcinoma of the breast. Clinically SDC is defined by cervical lymph node involvement and distant metastasis with a high rate of recurrence and mortality. We described some of the clinical and pathological features of SDC and the management using case report for our patient. Methods: We present a case of a 40-year-old male with 2-year history of a swelling arising in his left preauricular region. There was a single painless, firm and solid $2{\times}1.5cm$ mass in the left parotid area. Facial nerve function was intact and no cervical lymph node were palpable. In August 2005, we found out $1.7{\times}1.8cm$ sized cystic, nodular lesions that were located in the superficial lobe of left parotid gland through Computed tomography. And then superficial parotidectomy and postoperative radiation therapy were performed in Jan 2007. Results: Pathologically, the specimen were consisted of homogeneous, chondoid to myxoid type of tissues. It was yellow mass that has multiloculated cystic lesions. In postoperative PET(Positiron emission tomography) CT, there was no evidence of uptaking FDG(Fluorodeoxyglucose) into the deep layers of parotid gland and distant metastasis were not seen. Conclusion: Salivary duct carcinoma(SDC) is a rare but high grade adenocarcinoma related to pleomorphic adenocarcinoma. The prognosis of SDC can be different according to the type of tumor such as mucoepidermoid adenocarcinoma, adenoid duct carcinoma and acinar cell carcinoma. So we need to study more carefully for accurate diagnosis in early stage of diagnosis. Although radiotherapy has not yet proven to be a significant factor in overall survival, the combination of parotidectomy and postoperative radiation therapy can lead to more favorable results in treating of SDC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제35권5호
• /
• pp.299-303
• /
• 2009

Introduction: Maxillary malignant tumors are primary tumors of the maxillary gingiva, sinus, and palate. The purpose of this study was to research the prognosis and treatment modalities of maxillary malignant tumors. Materials & Methods: For this study, 52 patients, who were treated after being diagnosed for maxillary malignant tumors at the department of OMFS at Yonsei University college of Dentistry from January 1997 till April 2008, were classified, then the prognoses of these patients were evaluated depending on their primary site, histopathology and treatment modalities. The results of this study showed that the most common primary site for maxillary malignant tumors was the gingiva and for histopathology, squamous cell carcinoma. Result & Conclusion: The average follow up period was 32.7 months. In determining prognosis, the most important factors were the control of local site and metastasis of cervical lymph nodes. Therefore, for a better prognosis, a tumor free margin during surgery and a periodic follow up to examine for metastasis to cervical lymph nodes and other organs are necessary.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제37권6호
• /
• pp.490-495
• /
• 2011

Introduction: Development of carcinoma on oral tongue may cause bilateral cervical lymph node metastasis, rapid invasion and growth of the cancer cells due to rich blood supply in muscle tissues. It is not only difficult to develop an animal experimental model, but also to proceed follow-up research after the development of such model as the induction of cancer lead to difficulty in taking nutrition for the experimental animals that often causes early death. Materials and Methods: IIn this study, author have transplanted YD-$10B_{mod}$ cells into nude mouse oral tongues with different cells number ($5{\times}10^4$, $5{\times}10^5$, $5{\times}10^6$ cells/mouse) and observed the development aspect of oral tongue cancers. Results: The cancer developed from orthotopic transplantation of YD-$10B_{mod}$ cells into nude mouse oral tongue show invasion and central necrosis of the tumor, similar to the cancers developed human oral tongue cancer. The difference in tumor size and the time of central necrosis development depending on the number of transplanted tumor cells shows the feasibility of extending the survival period of the nude mouse by limiting the transplanted tumor cells to < $5{\times}10^4$ cells/mouse or under per nude mouse. Conclusion: This nude mouse model could be used effectively in developing effective chemotheray agent and establishing an animal experimental model that can be used to study the mechanism of cervical lymph node metastasis of the oral tongue cancer.