• Tuberculosis and Respiratory Diseases
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• 제45권4호
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• pp.776-784
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• 1998

연구목적: 폐암은 생불학적 및 병리학적인 특성에 따라 비소세포폐암과 소세포폐암으로 구분되는데 전체폐암의 약 80%가 비소세포폐암으로 국소적인 폐암인 경우 수술적 치료가 절대적 완치 방법인데 조기에 발견하여 광범위한 절제로 치료된 경우에도 환자의 약 50% 정도만이 5년간 생존한다. 확실히 비소세포폐암에서 비슷한 병기의 환자들도 생존 가망성은 상당한 차이를 보인다. 이러한 상황이 보다 정확히 생존 가망성을 예측하고 각각의 환자에게 보다 효율적인 치료를 제공할 수 있게 도울 수 있는 새로운 예측 인자를 밝혀야 하는 필요성이 제기되었다. 정상적인 세포주기 뿐만 아니라 암종의 세포주기에 중요한 역할을 하는 cyclin D계중 하나인 cyclin D1이 세포주기에서 G1기에서 S기로의 전환을 유도하므로써 세포주기를 진행시키는데 유방암, 식도암 및 방광암에서 이의 과발현이 암발생에 중요한 요인이 되다는 보고가 있다. 이에 본 연구에서는 광범위 절제된 비소세포폐암에서 cyclin D1의 과발현이 예후에 미치는 영향을 알아보기 위해 연구를 시행하였다. 방 법: 1983년 1월부터 1995년 7월까지 한양대학교 부속병원에서 비소세포폐암으로 진단된 술전 병기 IIIa 이하인 환자 총 81예를 대상으로 치료적 목적으로 광범위 폐절제술을 통해 얻어진 술후 조직에서 cyclin D1에 대한 단클론성 향체를 사용하여 면역조직화화적 염색을 시행하고 더불어 병리조직학적 특정과 임상적 특정, 특히 생존률과의 연관성을 알아보았다. 또한 술후 환자의 예후적 인자를 최소한으로 줄이기 위해 술전에 방사선 치료나 항암제 치료를 받은 환자는 제외하였고 혼합형의 조직학적 진단이 이루어진 경우와 술후 l달 이내에 사망한 경우는 본 연구의 대상에서 제외하였다. 조직병리학적 병기 판정은 TNM 병기 판정 기준에 맞추었고 조직학적 특징은 WHO 표준 기준에 맞추었다. 결 과: Cyclin D1의 발현은 총 81예에서 시행하여 26에에서 발현되어 30.9%의 발현율을 보였고 각각의 조직형이나 병기, 암의 크기에는 통계적 차이를 보이지 않았으나 TNM 병기 판정에 따라 NO와 나머지 N1-3의 두군으로 나누어 비교할 때 cyclin D1에 따른 통계적 의의를 보였고(p=0.035) cyclin D1 양성 발현군의 평균생존기간은 $22.76{\pm}3.507$개월, 음성 발현군의 평균생존기간이 $45.3{\pm}5.64$개월 (p=0.0515)로 생존율과외 상당한 통계적인 연관성의 가능성을 나타내었다. 결 론: 본 연구에서는 여러 가지 세포주기를 직, 간접으로 조절하는 인자중 cyclin D1의 과발현은 비소세포폐암에서 상당히 불량한 예후 인자로 작용할 수 있다고 생각되며 앞으로 보다 초기와 진행된 병기에 따른 cyclin D1의 발현이 예후에 미치는 영향 등 보다 세밀하고 대단위적인 연구가 진행되어 비소세포폐암에서 보다 정확한 치료와 예후를 예측활 수 있는 인자로서의 역할을 밝혀야 한다고 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제48권3호
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• pp.339-346
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• 2000

연구배경 : 혈액형 A 항원의 발현은 적혈구외에 비뇨기, 위장, 폐, 구강점막 동의 상피세포에도 존재한다. 조직 손상 치유 과정 중 인접 상피세포는 혈액형 A 항원이 소실되고, 상처가 치유되면 혈액형 A 항원은 다시 발현된다. 방광암등의 조직에서도 혈액형 A 항원이 소실될 경우가 발현유지 되는 경우보다 종양의 증식이 활발하다고 보고하였다. 또한 수술한 비소세포폐암의 조직에서 혈액형 A 항원이 소실될 경우 생존율은 불량하다고 보고하였다. 그러나, 이에 반하는 보고도 다수 있어 저자들은 근치적 절제술을 시행 받은 말초 혈액형이 A, AB형인 비소세포폐암에서 혈액형 A항원의 소실여부와 생존율과의 관계를 검색하였다. 대상 및 방법 : 원발성 비소세포폐암으로 진단 받은 후 근치 목적의 절제술을 받았던 환자 76명중 혈액형이 A형, 또는 AB형인 26명을 대상으로 paraffin에 보관된 조직을 면역조직화학염색법을 이용하여 혈액형 A항원의 소실유무을 확인한 후, 발현 및 소실에 따른 생존율은 Kaplan-Meier법, Log-rank로서 검색하였다. 결 과 : 대상군은 26례(A형 : 22례, AB형 : 4례)로 남 : 녀는 20 : 6이었고, 평균연령은 63세였으며, 조직학적으로 편평상피암 16례, 선암 6례, 대세포암 4례였고, TNM병기는 I 16례, II 5례, IIIA 5례였다. 종양조직에서 A항원 발현유지는 15례(58%), A 항원 소실은 11례(42%)였으며, A 항원 발현율과 병리조직형, 조직의 분화도와는 상관관계가 없었다. A항원 발현유지군과 소실군간의 중간 생존기간은 11개월, 18개월이며, 2년 생존률은 36%, 64%로서 A 항원 소실군의 예후가 양호하였으나, 통계적으로 유의한 차이는 없었다. 결 론 : 원발성 비소세포폐암으로 절제수술을 받았던 혈액형이 A형, 또는 AB형인 환자중 조직에서의 A 항원소실은 42%이었고, A항원 소실군이 발현유지군보다 생존율이 길었으나 예후인자로서의 유의성은 찾지 못했다.

• 대한한의학회지
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• 제39권4호
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• pp.171-176
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• 2018

Background: Small cell lung cancer (SCLC) tends to grow more rapidly and spread much faster than non-small cell lung cancer (NSCLC). A concurrent combination of chemotherapy and thoracic radiotherapy is suggested as the standard conventional treatment, but it is more challenging for elderly patients having pulmonary and cardiovascular comorbidities. Case presentation: Here we present a case of an 80-year-old male, current smoker diagnosed with SCLC in limited stage T3N0M0 (36mm right upper lobe, satellite nodule) in Dec, 2015. The standard concurrent chemoradiotherapy was not available for his comorbidities, which included chronic obstructive pulmonary disease (COPD) and angina pectoris. Furthermore, he and his family refused the recommended chemotherapy or radiotherapy exclusively. Alternatively, he received various non-conventional treatments including local radiofrequency hyperthermia, mistletoe, and Traditional Korean medicine including acupuncture, moxibustion and herbs since Jan. 2016. Despite the progression in primary tumor size, there have been no other distant relapse so far, and the patient has been in stable condition ever since. Conclusion: We suggest that a combination of various alternative treatments could be a candidate for elderly patients intolerable to conventional cytotoxic treatments.

• Tuberculosis and Respiratory Diseases
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• 제75권5호
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• pp.181-187
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• 2013

The emergence of new therapeutic agents for non-small cell lung cancer (NSCLC) implies that histologic subtyping and molecular predictive testing are now essential for therapeutic decisions. Histologic subtype predicts the efficacy and toxicity of some treatment agents, as do genetic alterations, which can be important predictive factors in treatment selection. Molecular markers, such as epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement, are the best predictors of response to specific tyrosine kinase inhibitor treatment agents. As the majority of patients with NSCLC present with unresectable disease, it is therefore crucial to optimize the use of tissue samples for diagnostic and predictive examinations, particularly for small biopsy and cytology specimens. Therefore, each institution needs to develop a diagnostic approach requiring close communication between the pulmonologist, radiologist, pathologist, and oncologist in order to preserve sufficient biopsy materials for molecular analysis as well as to ensure rapid diagnosis. Currently, personalized medicine in NSCLC is based on the histologic subtype and molecular status. This review summarizes strategies for tissue acquisition, histologic subtyping and molecular analysis for predictive testing in NSCLC.

• Tuberculosis and Respiratory Diseases
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• 제66권1호
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• pp.42-46
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• 2009

폐암의 자연적 퇴화는 매우 드문 질환이다. 아직 그 기전은 불분명하다. 그러나 신체의 면역반응이 중요한 역할을 하는 것으로 알려져 있다. 이에 본 저자들은 폐의 편평 세포암 환자에서 항암치료 및 방사선 치료 등을 하지 않은 상태에서 자연적 퇴화가 발생한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 동의생리병리학회지
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• 제22권3호
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• pp.630-641
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• 2008

Gamisamgibopae-tang (GMSGBPT) is a traditional Korean medicine, which has been used for patients suffering from a lung disease in Oriental medicine. In the present study, we examined the biochemical mechanisms of apoptosis by GMSGBPT in NCI-H460 and A549 human non-small-cell lung cancer cell lines. It was found that GMSGBPT could inhibit the cell proliferation of A549 cells in a concentration-dependent manner, however GMSGBPT did not affect the cell proliferation of NCI-H460 cells. Apoptotic cell death in A549 cells were detected using DAPI staining and annexin V fluorescein methods. The induction of apoptotic cell death by GMSGBPT was connected with a down-regulation of anti-apoptotic Bcl-2 and Bcl-xL expression, and proteolytic activation of caspase-3 and caspase-9 in A549 cells. However, GMSGBPT did not affect the levels of pro-apoptotic Bax and Bad expression, and activity of caspase-8. GMSGBPT treatment also concomitant degradation and/or inhibition of poly (ADP-ribose) polymerase (PARP), ${\beta}$-catenin, phospholipase C-1 (PLC${\gamma}$1) and DNA fragmentation factor 45/inhibitor of caspase-activated DNase (DFF45/ICAD). Taken together, these findings suggest that GMSGBPT may be a potential chemotherapeutic agent for the control of human non-small-cell lung cancer cells and further studies will be needed to identify the active compounds that confer the anti-cancer activity of GMSGBPT.

• Radiation Oncology Journal
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• 제35권1호
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• pp.16-24
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• 2017

Locally advanced non-small cell lung cancer (LA-NSCLC) is composed of heterogeneous subgroups that require a multidisciplinary team approach in order to ensure optimal therapy for each patient. Since 2010, the National Comprehensive Cancer Network has recommended chemoradiation therapy (CRT) for bulky mediastinal disease and surgical combination for those patients with single-station N2 involvement who respond to neoadjuvant therapy. According to lung cancer tumor boards, thoracic surgeons make a decision on the resectability of the tumor, if it is determined to be unresectable, concurrent CRT (CCRT) is considered the next choice. However, the survival benefit of CCRT over sequential CRT or radiotherapy alone carries the risk of additional toxicity. Considering severe adverse events that may lead to death, fit patients who are able to tolerate CCRT must be identified by multidisciplinary tumor board. Decelerated approaches, such as sequential CRT or high-dose radiation alone may be a valuable alternative for patients who are not eligible for CCRT. As a new treatment strategy, investigators are interested in the application of the innovative radiation techniques, trimodality therapy combining surgery after high-dose definitive CCRT, and the combination of radiation with targeted or immunotherapy agents. The updated results and on-going studies are thoroughly reviewed in this article.

• 셀메드
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• 제3권1호
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• pp.9.1-9.10
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• 2013

In traditional systems of medicine including homeopathy, the Condurango extract (Con) is often used to cure stomach cancer mainly, without having any scientific validation of its anti-cancer ability. Con has therefore been tested against non-small-cell lung cancer cells (NSCLC) A549 and NCI-H522 (H522) known to contain the KRAS mutation, making them resistant to most chemotherapeutic agents. As cancer cells generally defy cytotoxicity developed by chemopreventive agents and escape cell death, any drug showing the capability of preferentially killing cancer cells through apoptosis is worth consideration for judicious application. A549 and H522 cells were exposed to $0.35{\mu}g/{\mu}l$ and $0.25{\mu}g/{\mu}l$ of Con, respectively, for 48 h and analysed based on various protocols associated with apoptosis and DNA damage, such as MTT assay to determine cell viability, LDH assay, DNA fragmentation assay, comet assay, and microscopical examinations of DNA binding fluorescence stains like DAPI, Hoechst 33258 and acridine orange/ethidium bromide to determine the extent of DNA damage made in drug-treated and untreated cells and the results compared. Changes in mitochondrial membrane potential and the generation of reactive oxygen species were also documented through standard techniques. Con killed almost 50% of the cancer cells but spared normal cells significantly. Fluorescence studies revealed increased DNA nick formation and depolarized membrane potentials after drug treatment in both cell types. Caspase-3 expression levels confirmed the apoptosis-inducing potential of Con in both the NSCLC lines. Thus, overall results suggest considerable anticancer potential of Con against NSCLC in vitro, validating its use against lung cancer by practitioners of traditional medicine including homeopathy.

• 대한암한의학회지
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• 제22권1호
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• pp.13-22
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• 2017

Objective: The purpose of this study is to report the effect of Nobongsangki-Jeong on skin rash caused by Olmutinib. Methods: A female Non-Small cell lung carcinoma patient (Adenocarcinoma, Stage IV, Epidermal Growth Factor Receptor positive) suffered from skin rash due to the side effect of Olmutinib administration. She was treated with Nobongsangki-Jeong for the symptom management for 14 days. The clinical outcomes were measured by numeric rating scale (NRS) and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03. Results: After treatment, skin rash was improved from NRS 5 to 1. Pruritus and pain of skin were improved from NCI-CTCAE grade 2 to 1. Conclusion: This case study suggests that Nobongsangki-Jeong may have the efficacy for the treatment of skin rash caused by Olmutinib.

• Molecules and Cells
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• 제44권5호
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• pp.363-373
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• 2021

Immune checkpoint inhibitors have changed the paradigm of treatment options for non-small cell lung cancer (NSCLC). Monoclonal antibodies targeting programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) have gained wide attention for their application, which has been shown to result in prolonged survival. Nevertheless, only a limited subset of patients show partial or complete response to PD-1 therapy, and patients who show a response eventually develop resistance to immunotherapy. This article aims to provide an overview of the mechanisms of acquired resistance to anti-PD-1/PD-L1 therapy from the perspective of tumor cells and the surrounding microenvironment. In addition, we address the potential therapeutic targets and ongoing clinical trials, focusing mainly on NSCLC.