• Safety and Health at Work
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• 제8권2호
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• pp.169-174
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• 2017

Background: We assessed the cancer risks of four different Finnish asbestos-exposed cohorts. We also explored if the cohorts with varying profiles of asbestos exposure exhibited varying relative risks of cancer. Methods: The incident cancer cases for the asbestos-exposed worker cohorts were updated to the end of 2012 using the files of the Finnish Cancer Registry. The previously formed cohorts consisted of asbestos mine workers, asbestosis patients, asbestos sprayers, and workers who had taken part in a screening study based on asbestos exposure at work. Results: The standardized incidence ratio (SIR) for mesothelioma varied from about threefold to > 100-fold in the different cohorts. In the screening cohort the SIR for mesothelioma was highest in 2003-2007, In other cohorts it was more constant in 5-year period inspection. The SIR for lung cancer was about twofold to tenfold in all except the screening cohort. Asbestos sprayers were at the highest risk of mesothelioma and lung cancer. Conclusion: The SIR for mesothelioma is high in all of the cohorts that represent different kinds of asbestos exposure. The smaller SIR for mesothelioma in the screening cohort with lowest level of asbestos exposure might suggest dose-responsiveness between asbestos exposure and mesothelioma. It does seem that the highest risk of lung cancer in these cohorts except in the youngest of the cohorts, the screening cohort, is over. The highest SIR for lung cancer of the asbestosis patient and sprayers cohort is explained by their heavy asbestos exposure.

• 보험의학회지
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• 제31권1호
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• pp.34-36
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• 2012

Lung cancer such as small cell lung cancer(SCLC) and non small cell lung cancer(NSCLC) have high mortality rate, so, we insurance doctors have little interest in their risk. But nowadays there's a lot of development in targeted therapy of NSCLC. Screening by CT scanning and early resection strategy also shows better prognosis. It is helpful for underwriters and insurance doctors to review the current development of targeted therapy of NSCLC and estimation of extra-risk of early lung cancer. The preferred treatment option for patients whose tumors contain EGFR-activating mutations are one of the EGFR-directed tyrosine kinase inhibitors, such as gefitinib or erlotinib. In patients with NSCLC whose tumors harboured an ALK rearrangement, there was 61% objective response rate to crizotinib in the phase 1 study. The median survival progression-free survival was 10 months. Mortality analysis of early lung cancer who were detected by CT screening, MR of 105% and EDR of 1‰ were calculated.

• 대한영상의학회지
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• 제84권1호
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• pp.34-50
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• 2023

미국방사선의학회는 효과적인 국가 폐암 검진 시행을 위해 2019년도에 Lung CT Screening Reporting & Data System (이하 Lung-RADS) 1.0보다 폐암의 위양성을 줄이기 위해 개편된 Lung-RADS 1.1을 발표하였고, 2022년 12월에 새로운 Lung-RADS 1.1 개선안 Lung-RADS^Ⓡ 2022를 발표하였다. Lung-RADS^Ⓡ 2022은 Lung-RADS 1.0과 비교했을 때 결절의 크기는 소수점 첫째 자리까지 측정하고, 늑막근처 결절의 크기가 10 mm 미만인 경우까지 범주 2로 하며, 범주 2에서 간유리 결절의 크기 기준을 30 mm로 높이고, 범주 4B와 4X는 매우 의심으로 변경하며, 기도 결절의 위치와 비정형 폐 낭종의 형태와 벽 두께에 따라 범위를 나누었다. 이에 영상의학과 의사들의 개선된 Lung-RADS^Ⓡ 2022에 대한 이해를 돕고자, 이 종설에서는 Lung-RADS^Ⓡ 2022의 장점, 단점, 그리고 향후 개선점에 대해서 기술하고자 한다.

• Journal of Korean Medical Science
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• 제33권53호
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• pp.342.1-342.6
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• 2018

We validated the diagnostic performance of a previously developed blood-based 7-protein biomarker panel, $AptoDetect^{TM}$-Lung (Aptamer Sciences Inc., Pohang, Korea) using modified aptamer-based proteomic technology for lung cancer detection. Non-small cell lung cancer (NSCLC), 200 patients and benign nodule controls, 200 participants were enrolled. In a high-risk population corresponding to ${\geq}55years$ of age and ${\geq}30pack-years$, the diagnostic performance was improved, showing 73.3% sensitivity and 90.5% specificity with an area under the curve of 0.88. $AptoDetect^{TM}$-Lung (Aptamer Sciences Inc.) offers the best validated performance to discriminate NSCLC from benign nodule controls in a high-risk population and could play a complementary role in lung cancer screening.

• Tuberculosis and Respiratory Diseases
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• 제77권2호
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• pp.60-64
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• 2014

MicroRNAs (miRNAs) are a class of small noncoding RNAs that modulate target gene activity, and are aberrantly expressed in most types of cancer as well in lung cancer. A miRNA can potentially target a diverse set of mRNAs; further, it plays a critical role in lung tumorigenesis as well as affects patient outcome. Previous studies focused mainly on abnormal miRNAs expressions in lung cancer tissues. Interestingly, circulating miRNAs were identified in human plasma and serum in 2008. Since then, considerable effort has been directed to the study of circulating miRNAs as one of the biomarkers of lung cancer. miRNAs expression of tissues and blood in lung cancer patients is being analyzed by more researchers. Recently, to overcome the high false-positivity of low-dose chest computed tomography scan, miRNAs in lung cancer screening are being investigated. This article summarizes the recent researches regarding clinical applications of miRNAs in the diagnosis and management of lung cancer.

• Journal of Radiation Protection and Research
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• 제38권4호
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• pp.214-227
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• 2013

MDCT의 등장과 함께 병적 증상이 없는 개인이 조기검진을 위해 CT검사를 하는 예가 꾸준히 증가하고 있다. 이러한 검사의 임상적 효용성과 방사선에 의한 암 발생위험에 대한 여러 가지 논란을 살펴보았다. 1. 저선량흉부CT(LDCT)를 이용한 폐암의 조기 검진 효용성을 보기 위해 설계된 무작위배정대조검사(randomized controlled trial)인 NLST(National Lung Screening Trial)의 분석 결과, CT선별검사가 선별검사를 하지 않은 그룹의 사망률 1.67%를 1.33%로, 20% (p=0.004) 감소시키는 것으로 나타났다. CT선별검사군에서 양성결과를 보인 사람의 96.4%는 위양성(false-positive)이었다. 그리고 방사선에 의한 폐암의 ERR (excess radiation risk)은 다른 고형암과는 달리 나이와 함께 감소하지 않으며, 더욱이 흡연 위험과 방사선 위험이 상승작용을 하여 폐암 검진 대상인 고위험군에게 더욱 위험할 수 있는 것으로 평가되었다. 따라서 방사선에 의한 위험이 NLST에서 관측한 이득을 상쇄할 수도 있다. 아직은 최적의 전략이 확립되지 않은 상태이므로 임상에서 광범위하게 적용하기에는 한계가 있다. 2. 대장CT검사(CT colonography)는 10 mm보다 큰 용종의 검출에는 정확도가 뛰어나지만 이보다 작은 경우에는 민감도와 특이도가 급격히 감소하고, 용종이 발견되어 제거하고자 하는 경우 다시 기존의 대장내시경을 이용해야 하는 불편함이 있다. 현재 대장CT검사 1회 시행의 평균유효선량은 약 8-10 $mS{\nu}$로 보고되어, 만약 이 검사가 많은 사람들을 대상으로 일상적으로 행해지면 공중보건에 영향을 미칠 수 있다. 따라서 집단검진 방법으로 정착하기 위해서 는 용종 크기 6-10 mm 범위에서 높은 민감도와 특이도를 확립하고, 하제를 사용하지 않는 방법을 개발하여야 하며, 선량을 더 감소시킬 수 있는 최적화된 전략을 세워 표준화하여야만 한다. 3. 전신CT검사는 그 효용성이 검증된 선행연구가 없는 상태이다. 이 검사는 약 90%의 검사자들에게서 최소한 하나 이상의 이상소견을 확인하였지만 그 중 약 2%만이 임상적으로 중요한 질환으로 판명되었다. 전신CT검사 1회 시행으로 인한 평균유효선량은 약 12 $mS{\nu}$이며 45세부터 75세까지 매년 검사를 받는 경우 LAR (lifetime attributable risk)이 1.9%로 보고되었다. 현재 의학계의 어떤 단체도 이 검사를 권고하고 있지 않다. 현재까지 CT선별검사는 정당화에 대한 충분한 논의를 위해 심도 있는 다양한 연구가 필요하며 최적화된 프로토콜이 확립된 후 이용하는 것이 바람직하다.

• Tuberculosis and Respiratory Diseases
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• 제86권3호
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• pp.176-182
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• 2023

Since the introduction of low-dose computed tomography (CT) screening for patients at high risk of lung cancer, the detection rate of suspicious lung cancer has increased. In addition, there have been many advances in therapeutics targeting oncogenic drivers in non-small cell lung cancer. Therefore, accurate pathological diagnosis of lung cancer, including molecular diagnosis, is increasingly important. This review examines the problems in the pathological diagnosis of suspected lung cancer. For successful pathological diagnosis of lung cancer, clinicians should determine the appropriate modality of the diagnostic procedure, considering individual patient characteristics, CT findings, and the possibility of complications. Furthermore, clinicians should make efforts to obtain a sufficient amount of tissue sample using non- or less-invasive procedures for pathological diagnosis and biomarker analysis.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9557-9565
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• 2014

MiRNAs are endogenous, single stranded ~22-nucleotide non-coding RNAs (ncRNAs) which are transcribed by RNA polymerase II and mediate negative post-transcriptional gene regulation through binding to 3'untranslated regions (UTR), possibly open reading frames (ORFs) or 5'UTRs of target mRNAs. MiRNAs are involved in the normal physiology of eukaryotic cells, so dysregulation may be associated with diseases like cancer, and neurodegenerative, heart and other disorders. Among all cancers, lung cancer, with high incidence and mortality worldwide, is classified into two main groups: non-small cell lung cancer and small cell lung cancer. Recent promising studies suggest that gene expression profiles and miRNA signatures could be a useful step in a noninvasive, low-cost and repeatable screening process of lung cancer. Similarly, every stage of lung development during fetal life is associated with specific miRNAs. Since lung development and lung cancer phenomena share the same physiological, biological and molecular processes like cell proliferation, development and shared mRNA or expression regulation pathways, and according to data adopted from various studies, they may have partially shared miRNA signature. Thus, focusing on lung cancer in relation to lung development in miRNA studies might provide clues for lung cancer diagnosis and prognosis.

• Genomics & Informatics
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• 제12권2호
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• pp.50-57
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• 2014

We present a new next-generation sequencing-based method to identify somatic mutations of lung cancer. It is a comprehensive mutation profiling protocol to detect somatic mutations in 30 genes found frequently in lung adenocarcinoma. The total length of the target regions is 107 kb, and a capture assay was designed to cover 99% of it. This method exhibited about 97% mean coverage at $30{\times}$ sequencing depth and 42% average specificity when sequencing of more than 3.25 Gb was carried out for the normal sample. We discovered 513 variations from targeted exome sequencing of lung cancer cells, which is 3.9-fold higher than in the normal sample. The variations in cancer cells included previously reported somatic mutations in the COSMIC database, such as variations in TP53, KRAS, and STK11 of sample H-23 and in EGFR of sample H-1650, especially with more than $1,000{\times}$ coverage. Among the somatic mutations, up to 91% of single nucleotide polymorphisms from the two cancer samples were validated by DNA microarray-based genotyping. Our results demonstrated the feasibility of high-throughput mutation profiling with lung adenocarcinoma samples, and the profiling method can be used as a robust and effective protocol for somatic variant screening.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2307-2312
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• 2015

Curcumol is a sesquiterpene originally isolated from curcuma rhizomes, a component of herbal remedies commonly used in oriental medicine. Its beneficial pharmacological activities have attract significant interest recently. In this study, anti-cancer activity of curcumol was examined with both in vitro and in vivo models. It was found that curcumol exhibited time- and concentration-dependent anti-proliferative effects in SPC-A-1 human lung adenocarcinoma cells with cell cycle arrest in the G0/G1 phase while apoptosis-induction was also confirmed with flow cytometry and morphological analyses. Interestingly, curcumol did not display growth inhibition in MRC-5 human embryonic lung fibroblasts, suggesting the anti-proliferative effects of curcumol were specific to cancer cells. Anti-neoplastic effects of curcumol were also confirmed in tumor bearing mice. Curcumol (60 mg/ kg daily) significantly reduced tumor size without causing notable toxicity. In conclusion, curcumol appears a favorable anti-cancer candidate for further development.