• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4393-4398
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• 2013

Background: Chromosomal translocations are genetic aberrations associated with specific non-Hodgkin lymphoma (NHL) subtypes. This study investigated the differential gene expression profile of Egyptian NHL cases based on a microarray approach. Materials and Methods: The study included tissue samples from 40 NHL patients and 20 normal lymph nodes used as controls. Total RNA was extracted and used for cDNA microarray assays. The quantitative real time polymerase chain reaction was used to identify the aberrantly expressed genes in cancer. Results: Significant associations of 8 up-regulated and 4 down-regulated genes with NHL were observed. Aberrant expression of a new group of genes not reported previously was apparent, including down-regulated NAG14 protein, 3 beta hydroxy-delta 5-c27 steroid oxi-reductase, oxi-glutarate dehydrogenase (lipo-amide), immunoglobulin lambda like polypeptide 3, protein kinase x linked, Hmt1, and caveolin 2 Tetra protein. The up-regulated genes were Rb binding protein 5, DKFZP586J1624 protein, protein kinase inhibitor gamma, zinc finger protein 3, choline ethanolamine phospho-transferase CEPT1, protein phosphatase, and histone deacetylase-3. Conclusions: This study revealed that new differentially expressed genes that may be markers for NHL patients and individuals who are at high risk for cancer development.

• Tuberculosis and Respiratory Diseases
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• 제56권5호
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• pp.505-513
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• 2004

목 적 : 폐암이 인접장기를 침범하거나 림프절이나 원격장기에 전이가 되었는지를 아는 것은 폐암의 병기결정에서 가장 중요한 요소가 된다. 본 연구에서는 폐암 환자에서 촉진 되지 않는 경부 림프절에 대하여 초음파 유도하의 세침흡인 세포검사의 임상적 유용성을 알아보고자 하였다. 방 법 : 조직학적으로 폐암으로 확진 된 환자 중 경부 진찰 상 경부 림프절이 촉지 되지 않고 흉부 전산단층 촬영소견 상 편측에 종격동 임파절이 1 cm이상 커지지 않은 46명을 대상으로 하였다. 대상 환자의 나이의 중앙값은 62세 (37-73)였으며 남자가 34명, 여자가 12명이였다. 조직학적 분류는 편평상피암이 16명(34.7%), 선암이 20명(43.4%), 소세포폐암이 10명(21.7%)이였다. 초음파를 이용하여 단축이 0.5 cm이상의 림프절 종대가 관찰되면 초음파 유도하 세침흡인을 시행한 뒤 Papanicolau염색을 시행하였다 결 과 : 대상 환자 중 비소세포폐암 36명중 14명(38.8%)에서 초음파 상 경부 임파절의 증대가 관찰되었고 14명중 8명(57.1%)에서 비소세포폐암(선암 6례, 편평상피세포암 2례), 6명(42.8%)에서 양성 병변으로 진단되었고 전체 림프절 크기의 평균은 $0.98cm{\pm}0.17$ 이고 흉부 전산 단층 촬영 소견 상 동측의 종격동에 1 cm이상의 림프절 증대가 관찰되어 임상적 림프절 병기가 2이상 경우와 경부 악성 림프절 전이와 유의한 차이가 있었다(p=0.01). 임상적 병기가 IIIa이하로 수술적 치료의 대상이 되는 18의 환자 중 3명(11.1%), 이중 종격동 림프절이 양성인 IIIa 환자 명중 2명(33.3%)에서 경부 림프절 전이가 있었다. 소세포폐암의 경우 10명중 5명(50%)에서 발견되어 검사 상 모두 소세포 폐암으로 진단 되었다. 결 론 : 경부 림프절에서 초음파 유도하의 세침흡인세포검사는 안전하며 폐암환자의 경부 림프절 전이의 진단과 함께 정확한 병기 설정에 유용하고 소세포 폐암 환자의 비침습적인 진단에 보완적인 역할을 할 것으로 사료된다.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.100.1-100.13
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• 2018

Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.

• Tuberculosis and Respiratory Diseases
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• 제46권4호
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• pp.542-547
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• 1999

연구배경: 전산화 단층 촬영(CT)에 의한 폐암의 종격동 림프절전이 판정은 폐암의 치료계획과 예후 결정에 중요하다. 일반적으로 종격동 림프절의 장경이 15mm 이상이면 폐암 전이로 인정하는 방법이 정확도가 양호하다고 한다. 림프절의 크기가 증가하기 이전의 미소전이 시에는 CT로서의 전이가 인정되지 못한다. 특히 폐암의 조직병리학적 구분에 의한 폐 선암은 다른 폐암보다 미소전이와 원격전이가 잘 되므로, 비선암에 비해 종격동 림프절 전이가 있더라도 CT상에 림프절 크기의 증가가 뚜렷하지 않으리라 생각된다. 이에 저자들은 폐암의 종격동 림프절 전이의 판정 기준으로 CT상의 일정 크기 이상의 기준을 일률적으로 적용하는 것보다는 미소전이가 잘 되는 선암은 비선암보다 림프절 크기의 증가 기준이 낮아야 한다는 생각아래 그 실태를 파악하였다. 방 법: 대상은 원광대학병원에서 원발성 비소세포 폐암으로 진단받고, 근치적 폐암 절제술을 실시받는 60례이다. 남녀비는 남자 46명, 여자 14명이었고, 중간 연령은 61.5세였다. 조직병리학적 구분은 편평상피암이 41례, 대세포암 2례, 선암 17례이다. TNM 병기상 I기가 23례 II기가 24례 IIIA기가 13례였다(Table 1). 수술전 CT상의 림프절 크기와 수술 후 병리학적으로 전이가 확인된 림프절의 크기를 상호 비교하여 비선암 및 선암의 경우에 있어서 각각의 전이 림프절 크기의 차이를 확인한다. 그리고 각 폐암별로 림프절 장경 기준 15mm, 10mm를 각각 폐암 전이기준으로 하였을 때의 예민도, 특이도, 정확도를 계산하여 서로 비교하였다. 결 과: CT상 림프절 장경 10mm 이상인 림프절군에서 수술후 조직병리학상 폐암의 전이가 인정된 림프절의 평균 장경은 비선암군이 16.0($\pm8.0$)mm, 선암군이 12.0($\pm3.2$)mm로서 통계화적으로 유의하게 선암군의 림프절 장경이 비선암군의 림프절 장경보다 작았다(p<0.05). 종격동 림프절의 장경 15mm이상을 폐암 전이로 인정할 경우에 예민도, 특이도, 양성예측율, 음성예측율, 정확도가 비선암군이 54%, 100%, 100%, 83%, 86%였으며 선암군은 43%, 90%, 75%, 69%, 71%였다(Table 2). 종격동 림프절의 장경 10mm 이상을 폐암 전이로 인정할 경우에 예민도, 특이도, 양성예측율, 음성예측율 정확도가 비산암군이 65%, 77%, 61%, 92%, 79%였으며 선암군은 100%, 80%, 78%, 100%, 88%였다(Table 3). 결 론: 선암군에 있어서 종격동 림프절 장경 10mm를 기준으로 하였을때의 폐암 전이 인정의 정확도가 88%로서, 15mm를 기준으로 하였을때의 79%보다 양호함을 확인할 수 있었다.

• Journal of Gastric Cancer
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• 제13권1호
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• pp.51-57
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• 2013

Purpose: Additional gastrectomy is needed after endoscopic resection for early gastric cancer when pathology confirms any possibility of lymph node metastasis or margin involvement. No studies depicted the optimal type of surgery to apply in these patients. We compared the short-term and long-term outcomes of laparoscopic gastrectomy with those of open gastrectomy after endoscopic resection to identify the optimal type of surgery. Materials and Methods: From 2003 to 2010, 110 consecutive patients who underwent gastrectomy with lymphadenectomy either by laparoscopic (n=74) or by open (n=36) for gastric cancer after endoscopic resection were retrospectively analyzed. Postoperative and oncological outcomes were compared according to types of surgical approach. Results: Clinicopathological characteristics were comparable between the two groups. Laparoscopic group showed significantly shorter time to gas passing and soft diet and hospital day than open group while operation time and rate of postoperative complications were comparable between the two groups. All specimens had negative margins regardless of types of approach. Mean number of retrieved lymph nodes did not differ significantly between the two groups. During the median follow-up of 47 months, there were no statistical differences in recurrence rate (1.4% for laparoscopic and 5.6% for open, P=0.25) and in overall (P=0.22) and disease-free survival (P=0.19) between the two groups. Type of approach was not an independent risk factor for recurrence and survival. Conclusions: Laparoscopic gastrectomy after endoscopic resection showed comparable oncologic outcomes to open approach while maintaining benefits of minimally invasive surgery. Thus, laparoscopic gastrectomy can be a treatment of choice for patients previously treated by endoscopic resection.

• Journal of Yeungnam Medical Science
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• 제28권1호
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• pp.70-76
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• 2011

Rhabdomyosarcomas are soft tissue sarcomas; while extremely rare in adults, they are one of the most common neoplasms in children and adolescents. Histologically, they can be classified into embryonal (ERMS), alveolar (ARMS), pleomorphic, and undifferentiated types. The ARMS type is very rare, and is associated with a poor prognosis. Common primary sites of ARMS are the trunk and extremities. We report on a case of paraaortic, supraclavicular, and axillary lymph node metastasis from paratesticular ARMS treated with VAC (vincristine, dactinomycin, cyclophosphamide)/ IE(ifosfamide, etoposide) chemotherapy in a young adult. Administration of six cycles of chemotherapy with VAC/IE resulted in complete remission. The patient has maintained complete remission over the past 27 months.

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.247-253
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• 2017

Approximately 10-15% of pheochromocytomas are malignant. There are insufficient histologic criteria for the diagnosis of malignant pheochromocytoma. Thus, the term malignant pheochromocytoma is restricted to tumors with local invasion or distant metastases. We experienced a case of malignant pheochromocytoma recurred with spinal metastasis 4 years after the surgery for huge benign pheochromocytoma. A 68-year-old female was admitted for trunk and back pain. The patient had a history of surgery 4 years ago for a $10.0{\times}9.5{\times}7.5cm$ sized benign pheochromocytoma at the left adrenal gland. A thoracolumbar magnetic resonance imaging showed a tumor in the 7th thoracic vertebral body and a 24-hour urinary norepinephrine increased, suggesting metastatic recurrence of malignant pheochromocytoma. After metastasectomy in the 7th thoracic vertebral body, urine catecholamine was normalized and pain also disappeared. However, a metastatic lesion was found in the paraaortic area on a follow-up abdominal computed tomography scan and an additional metastasectomy was performed. The pathology confirmed the diagnosis of metastatic pheochromocytoma in the paraaortic lymph nodes. She is supposed to be treated with adjuvant iodine 131-meta-iodobenzylguanidine therapy. In our experience, a close follow-up should be considered in patients who had a huge benign pheochromocytoma due to the possibility of malignant metastases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권1호
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• pp.1-6
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• 2005

It becomes more concerned that the cell adhesion molecule plays an important role in the process of malignant transformation and tumor behaviors including invasive growth and metastasis. It is postulated if the expression of adhesion molecule is reduced in tumor tissue, the tumor cell will be undifferentiated and lose their cell adhesion ability and polarity. So the tumor cells lost the adhesion of cell to cell and to basement membrane that they became more aggressive. Reduced cadherin expression enhances invasiveness through infiltrative growth and metastasis of tumor cells is well known and mostly accepted in many epithelia tumors. We explored the expression of E-cadherin by immunohistochemical staining in 50 oral squamous cell carcinomas and investigated the correlation between the expression of E-cadherin and clinicopathologic parameters and prognosis. The expression of E-cadherin was reduced in 40/50(80%) of primary tumors, and 21/22(95.5%) of lymph nodes. The reduced expression of the E-cadherin was associated with lymph node metastasis(P=0.029), invasive mode(P=0.030) and marginal status(P=0.038). Survival analysis showed that predictive period of E-cadherin reduced group(37 months) was lower than that of E-cadherin preserved group(60 months), but there was no statistical significant difference.

• 대한수의학회지
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• 제60권1호
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• pp.9-14
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• 2020

This study describes pathological, immunohistochemical, and bacteriological findings in adult dogs and fetuses naturally infected with Brucella (B.) canis. A total of 42 dogs including 40 dogs and 2 aborted fetuses were examined. The most common gross lesions in infected dogs were swelling of lymph nodes and spleen. The testes showed marked swelling with multifocal to diffuse reddish discoloration. The most significant histopathological lesions were observed in the placenta. Placental trophoblasts were markedly hypertrophied due to the accumulation of intra-cellular gram-negative bacteria. Lymphocytic inflammation of varying severity was observed in the reproductive organs such as male testis, epididymis, and prostate gland and female uterus. Strong immunolabelling was observed in the cytoplasm of most trophoblasts in the placental tissues using immunohistochemistry. However, immunohistochemical staining did not demonstrate any organisms in other organs of dogs and fetuses. B. canis isolates were most frequently obtained from the whole blood (82.5%) and superficial inguinal lymph node (77.5%) in both sexes. In addition, the isolation rate was higher in male genital organs than in those of females. Hence, management of male dogs is most important because infected dogs can play a role as carriers.

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