• 제목/요약/키워드: Prognostic value

검색결과 506건 처리시간 0.029초

편평상피성 폐암에 있어서 S-Phase Fraction과 생존기간과의 관계 (Relationship between S-Phase Fraction and Survival Time in Patients with Primary Squamous Lung Cancer)

  • 정병학;강정성;장근;정은택;정현택;문형배
    • Tuberculosis and Respiratory Diseases
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    • 제40권6호
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    • pp.669-676
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    • 1993
  • 연구배경 : 종양세포는 세포의 분열성장이 매우 왕성하므로 정상 세포에 비하여 세포분열 주기 중 S-Phase fraction(SPF)의 증가를 예상할 수 있다. 같은 종양증에서도 SPF가 높으면 종양의 성장이 훨씬 빠를 것으로 생각되며, 이러한 종양세포의 생물학적 특성을 이용하여 원발성 편평상피성 폐암 환자에서 SPF와 생존기간과의 관계를 연구하였다. 방법 : 1985년 9월 부터 1990년 3월 까지 원광의대 부속병원에서 원발성 편평상피성 폐암으로 진단받고나서, 수술, 방사선, 화학요법 등을 실시받지 않고 사망한 21례를 대상으로 하였다. SPF 분석방법은 paraffin에 보관된 병리조직을 처리하여 유식세포 분석법에 의한 DNA histogram으로서 분석하였다. 결과 : 1) 전 대상군의 평균 생존기간은 225(${\pm}162$)일 이었고, TNM 병기, PS scale이 진행할 수록 단축되는 양상이다. 2) 전 대상군의 평균 SPF는 23.4(${\pm}11.3$)% 이었으며, TNM 병기, PS scale 별로 구분하여 비교한 결과, TNM 병기, PS scale의 진행정도와 SPF는 관계가 없었다. 3) SPF 20%를 기준으로 한, high SPF 군과 low SPF 군의 평균 생존기간은 각각 153(${\pm}99$)일, 342(${\pm}180$)일 로서 유의한 차이가 있었다(p<0.01). high SPF군과 low SPF군을 TNM 병기, PS scale 별로 구분하여 비교하여도 역시 유의하게 high SPF군이 low SPF 군 보다 평균 생존기간이 짧았다. 결론 : 편평상피성 폐암 환자에서 종양세포의 SPF가 증가되어 있으면, 예후가 유의하게 좋지 않으며, SPF는 TNM 병기, PS scale과는 무관한 독립된 예후추정 인자로서의 임상적 이용이 가능하다고 생각된다.

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Serum Carcinoembryonic Antigen Levels before Initial Treatment are Associated with EGFR Mutations and EML4-ALK Fusion Gene in Lung Adenocarcinoma Patients

  • Wang, Wen-Tao;Li, Yin;Ma, Jie;Chen, Xiao-Bing;Qin, Jian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권9호
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    • pp.3927-3932
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    • 2014
  • Background: Epidermal growth factor receptor (EGFR) mutations and echinoderm microtubule associated protein like 4-anaplastic lymphoma kinase (EML4-ALK) define specific molecular subsets of lung adenocarcinomas with distinct clinical features. Our purpose was to analyze clinical features and prognostic value of EGFR gene mutations and the EML4-ALK fusion gene in lung adenocarcinoma. Patients and Methods: EGFR gene mutations and the EML4-ALK fusion gene were detected in 92 lung adenocarcinoma patients in China. Tumor marker levels before first treatment were measured by electrochemiluminescence immunoassay. Results: EGFR mutations were found in 40.2% (37/92) of lung adenocarcinoma patients, being identified at high frequencies in never-smokers (48.3% vs. 26.5% in smokers; P=0.040) and in patients with abnormal serum carcinoembryonic antigen (CEA) levels before the initial treatment (58.3% vs. 28.6%, P=0.004). Multivariate analysis revealed that a higher serum CEA level before the initial treatment was independently associated with EGFR gene mutations (95%CI: 1.476~11.343, P=0.007). We also identified 8 patients who harbored the EML4-ALK fusion gene (8.7%, 8/92). In concordance with previous reports, younger age was a clinical feature for these (P=0.008). Seven of the positive cases were never smokers, and no coexistence with EGFR mutation was discovered. In addition, the frequency of the EML4-ALK fusion gene among patients with a serum CEA concentration below 5ng/ml seemed to be higher than patients with a concentration over 5ng/ml (P=0.021). No significant difference was observed for time to progression and overall survival between EML4-ALK-positive group and EML4-ALK-negative group or between patients with and without an EGFR mutation. Conclusions: The serum CEA level before the initial treatment may be helpful in screening population for EGFR mutations or EML4-ALK fusion gene presence in lung adenocarcinoma patients.

Roles of Cancer Registries in Enhancing Oncology Drug Access in the Asia-Pacific Region

  • Soon, Swee-Sung;Lim, Hwee-Yong;Lopes, Gilberto;Ahn, Jeonghoon;Hu, Min;Ibrahim, Hishamshah Mohd;Jha, Anand;Ko, Bor-Sheng;Lee, Pak Wai;MacDonell, Diana;Sirachainan, Ekaphop;Wee, Hwee-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2159-2165
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    • 2013
  • Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.

전남 동부지역에서 손목터널증후군의 수술 전 후 신경전도검사 결과의 평가 (Evaluation of Nerve Conduction Study Result in Carpal Tunnel Syndrome before and after operation in eastern area of Jeonnam)

  • 서충원;김철승
    • 한국산학기술학회논문지
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    • 제13권11호
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    • pp.5305-5310
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    • 2012
  • 본 연구에서 손목터널 증후군의 발생은 손목의 정중 신경 손상에 의한다. 일반적으로 임상 발현 및 신경전도검사를 통해 진단된다. 신경전도검사는 손목터널 증후군 환자 24명을 대상으로 하여 수술 전 후 정중 신경을 비교 평가 하였고, 이중 17명을 대상으로 평가 분석 하였다. 손목터널 증후군 증상의 분석 결과는 전체 환자 수 17명(여:17, 남0), 21손(오른쪽:9, 왼쪽:4, 양쪽:4), 연령(31~60세), 평균 유병 기간 ($46.6{\pm}36.1$), NCS의 첫 번째와 두 번째 검사 간격 개월 수($20.5{\pm}7.1$), 감각 신경(감각 이상:21, 감각 저하:19, 야간통증:17), 운동 신경(무지구 위축:20, 방아쇠 손가락:2, 조조 경직:3), 수술 후 증상은(증상 소실:38.1%, >50% 개선:52.4%, <50% 개선:9.5%) 이었다. 신경전도검사는 수술 후 감각 신경전도검사에서 4명, 운동 신경전도검사에서 5명이 정상 범위 이었다. 수술 전 후의 감각신경활동전위 반응은 이전 결과보다 호전된 결과를 보였다. 앞으로 환자의 직업에 의한 손목터널증후군의 양상과 직업별 수술외적인 치료방법과 수술치료방법을 비교하여 손목터널증후군의 호전정도를 파악하고 정확한 신경전도검사를 통해 환자의 수술여부를 판단해야 된다.

Chromosome Imbalances and Alterations of AURKA and MYCN Genes in Children with Neuroblastoma

  • Inandiklioglu, Nihal;Yilmaz, Sema;Demirhan, Osman;Erdogan, seyda;Tanyeli, Atila
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5391-5397
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    • 2012
  • Background: Neuroblastoma (NB), like most human cancers, is characterized by genomic instability, manifested at the chromosomal level as allelic gain, loss or rearrangement. Genetics methods, as well as conventional and molecular cytogenetics may provide valuable clues for the identification of target loci and successful search for major genes in neuroblastoma. We aimed to investigate AURKA and MYCN gene rearrangements and the chromosomal aberrations (CAs) to determine the prognosis of neuroblastoma. Methods: We performed cytogenetic analysis by G-banding in 25 cases [11 girls (44%) and 14 boys (66%)] and in 25 controls. Fluorescence in situ hybridization (FISH) with AURKA and MYCN gene probes was also used on interphase nuclei to screen for alterations. Results: Some 18.4% of patient cells exhibited CAs., with a significant difference between patient and control groups in the frequencies (P<0.0001). Some 72% of the cells had structural aberrations, and only 28% had numerical chnages in patients. Structural aberrations consisted of deletions, translocations, breaks and fragility in various chromosomes, 84% and 52% of the patients having deletions and translocations, respectively. Among these expressed CAs, there was a higher frequency at 1q21, 1q32, 2q21, 2q31, 2p24, 4q31, 9q11, 9q22, 13q14, 14q11.2, 14q24, and 15q22 in patients. 32% of the patients had chromosome breaks, most frequently in chromosomes 1, 2, 3, 4, 5, 8, 9, 11, 12, 19 and X. The number of cells with breaks and the genomic damage frequencies were higher in patients (p<0.001). Aneuploidies in chromosomes X, 22, 3, 17 and 18 were most frequently observed. Numerical chromosome abnormalities were distinctive in 10.7% of sex chromosomes. Fragile sites were observed in 16% of our patients. Conclusion: Our data confirmed that there is a close correlation between amplification of the two genes, amplification of MYCN possibly contributing significantly to the oncogenic properties of AURKA. The high frequencies of chromosomal aberrations and amplifications of AURKA and MYCN genes indicate prognostic value in children with neuroblastomas and may point to contributing factors in their development.

Genetic Variations in the HIF1A Gene Modulate Response to Adjuvant Chemotherapy after Surgery in Patients with Colorectal Cancer

  • Zhang, Yi;Wang, Peng;Zhou, Xing-Chun;Bao, Guo-Qiang;Lyu, Zhuo-Ming;Liu, Xiao-Nan;Wan, Shao-Gui;He, Xian-Li;Huang, Qi-Chao
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권11호
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    • pp.4637-4642
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    • 2014
  • Background: Hypoxia-inducible factor $1{\alpha}$ (HIF-$1{\alpha}$) plays an important role in regulating cell survival and angiogenesis, which are critical for tumor growth and metastasis. Genetic variations of HIF1A have been shown to influence the susceptibility to many kinds of human tumors. Increased expression of HIF-$1{\alpha}$ has also been demonstrated to be involved in tumor progression. However, the prognostic value of single nucleotide polymorphisms (SNPs) inthe HIF1A gene remains to be determined in most cancer types, including colorectal cancer (CRC). In this study, we sought to investigate the predictive role of HIF1A SNPs in prognosis of CRC patients and efficacy of chemotherapy. Materials and Methods: We genotyped two functional SNPs in HIF1A gene using the Sequenom iPLEX genotyping system and then assessed their associations with clinicopathological parameters and clinical outcomes of 697 CRC patients receiving radical surgery using Cox logistic regression model and Kaplan Meier curves. Results: Generally, no significant association was found between these 2 SNPs and clinical outcomes of CRC. In stratified analysis of subgroup without adjuvant chemotherapy, patients carrying CT/TT genotypes of rs2057482 exhibited a borderline significant association with better overall survival when compared with those carrying CC genotype [Hazard ratio (HR), 0.47; 95% confidence interval (95% CI): 0.29-0.76; P < 0.01]. Moreover, significant protective effects on CRC outcomes conferred by adjuvant chemotherapy were exclusively observed in patients carrying CC genotype of rs2057482 and in those carrying AC/CC genotype of rs2301113. Conclusions: Genetic variations in HIF1A gene may modulate the efficacy of adjuvant chemotherapy after surgery in CRC patients.

Serum Gastrin and the Pepsinogen I/II Ratio as Markers for Diagnosis of Premalignant Gastric Lesions

  • Shafaghi, Afshin;Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Sharafkhah, Maryam;Mesbah, Alireza;Askari, Kurosh;Geranmayeh, Siamak;Mehrvarz, Alireza;Souti, Fatemeh;Sokhanvar, Homayoon;Fakhrieh, Saba;Aminian, Keyvan;Yousefi-Mashhour, Mahmud;Khosh-Sorur, Mahmud;Rasoulian, Javid
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3931-3936
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    • 2013
  • Background: Iran is a country with very high incidences of stomach cancer, especially in Northern parts. Here we assessed prognostic value of serum screening biomarkers among people >50 years old for early detection of precancerous lesions in a hot spot for gastric carcinoma in Guilan Province, North Iran. Methods: A cross-sectional population-based survey was conducted on 1,390 residents of Lashtenasha city with the mean age (SD) of 61.8 (9.02) years old (50.8% females) to assess the association of gastrin and the pepsinogen (PG) I/II ratio with premalignant gastric lesions. Blood samples were taken for CBC, blood group, and serologic exams (PGI, PGII, and gastrin 17) from each subject. Expert gastroenterologists performed upper GI endoscopy and ROC curves were generated to determine appropriate cutoff points. Results: Mean values of PGI, PGII, PGI/PGII and gastrin were significantly different between patients with and without atrophy or metaplasia (P<0.05). To diagnose atrophy and intestinal metaplasia, a significantly higher AUC was observed for the PGI/PGII ratio (70 and 72%, respectively) compared to the PGI (56, 55%), PGII (63, 64%) and gastrin (59, 61%) (all p<0.001). Conclusions: Biomarker tests such as the PGI/II ratio can be used in the screening and diagnosis of subjects at high gastric cancer risk in our region.

이차성 원발암에서의 $^{18}F$-FDG PET/CT의 이용 (Use of $^{18}F$-FDG PET/CT in Second Primary Cancer)

  • 최준영;김병태
    • Nuclear Medicine and Molecular Imaging
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    • 제41권3호
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    • pp.185-193
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    • 2007
  • 이 종설은 이차성 원발암에서의 $^{18}F-FDG$ PET/CT의 이용을 다루었다. 암환자에서 이차성 원발암의 발병 유무는 주요한 예후인자 중의 하나이다. 이차성 원발암을 조기에 진단하고 치료하는 것은 이와 관련된 암 사망률을 낮추는 데 중요하다. $^{18}F-FDG$ PET/CT는 해부학적 및 대사적 정보를 동시에 제공함으로써 종양 영역에서 CT나 기존의 PET보다 진단성능이 더 우수하다. 이러한 우수한 진단성능과 전신영상이 가능하다는 장점 때문에 PET/CT는 이차성 원발암을 발견하는 데에 CT나 기존의 PET보다 더 적합하다. $^{18}F-FDG$ PET/CT는 이차성 원발암에 대한 선별검사로서 높은 예민도와 비교적 좋은 양성예측도를 보이므로 유용하다. PET/CT 영상에서 이차성 원발암이 의심되는 병변이 보일 경우 추가적인 진단적 검사는 필수적이다. PET/CT는 이차성 원발암을 발견하는데 PET보다 우수하다.

Plasmodium fulcipurum 감염 실험에 있어서의 혈소판과 혈액치의 변각 -Saimiri과 Aotus 원숭이의 비교 시험- (Platelet Kinetics and Other Hematological Profiles in Experimental Plasmodium falciparum Infection: A Comparative Study between Saimiri and Aotus Monkeys)

  • Kakoma I.;Jam
    • Parasites, Hosts and Diseases
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    • 제30권3호
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    • pp.177-182
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    • 1992
  • Saimiri 원숭이 21마리와 Aotus 원숭이 12마리에게 Plasmedium falciparum Indochina CDC-1충주(원숭이 순응 충주)를 접종시킨 후 3주간 혈소판과 혈액치를 경시적으로 관찰하였던 바, 이들 원숭이 (Saimiri sciureus boliviensis와 Aotus nancymai karyotype-1)는 접종 14일 후에 최고의 기생률, 호중구감소증, 임파구증가증 그리고 심한 혈색소혈증과 섬유소원의 퇴행성 산물(FDP's)치의 증가를 수반한 섬한 혈소판 감소성 빈혈증이 관찰되었다. Aotus에 있어서는 평균혈색소량(MCH)과 평균혈구용적(MCV)치의 감소와 기생률의 증가를 가져왔으나, Saimiri에 있어서는 기생률이 상승함에 따라서 이들 혈액치는 유의적 차이로 상승하는 결과를 가져왔다. 일반적으로 이들 두 원숭이에 있어서 혈소판의 감소 증세와 최고 기생률을 14잎 째 나타낸 후 곧 정상 혈액치로 회복되는 소견이 관찰된다. 특히 혈소판의 변화에 있어서 Aotus 원숭이는 다른 혈액치의 변화 그리고 기생률과 깊 은 상관관계를 갖고 있었으나, Saimiri에 있어서는 상관관계를 유지하지 못하였다. 결론적으로 말라리아 연구시 Aotus 원숭이가 Saimiri 원숭이 보다 우수한 품종임과 말라리아 진단과정에 있어서 혈소판의 회복률과 재생은 말라리아의 감염시기 판정에 유용한 자료로서 활용될 수 있음을 관찰하였으며, 말라리아 병원성 판정에 대한 실험에 있어서 이들 두 종류 원숭이의 혈액치 변화 특이성을 보고하는 바이다.

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Effect of leukocyte alteration on treatment outcomes following preoperative chemoradiotherapy in patients with rectal cancer

  • Kim, Tae Gyu;Park, Won;Choi, Doo Ho;Park, Hee Chul;Kim, Seok-Hyung;Cho, Yong Beom;Yun, Seong Hyen;Kim, Hee Cheol;Lee, Woo Yong;Lee, Jeeyun;Park, Joon Oh;Park, Young Suk
    • Radiation Oncology Journal
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    • 제35권3호
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    • pp.217-226
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    • 2017
  • Purpose: Hematotoxicity following anti-cancer treatment is known to be related to treatment efficacy in several malignancies. The purpose of this study was to examine the hematologic parameters related to the tumor response and survival in patients treated with curative surgery following preoperative chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: Four hundred eighteen patients with rectal cancer who underwent preoperative CRT and curative surgery were analyzed, retrospectively. The main clinical factors and blood cell counts before and after CRT were investigated with respect to their relationships with tumor downstaging and patient survival. Results: The post-CRT leukocyte count was significantly different between the tumor downstaging group and the non-downstaging group (median, 4740/uL vs. 5130/uL; p = 0.013). Multivariate analysis showed that histological grade, circumferential extent, and post-CRT leukocyte count were related to tumor downstaging. In addition, histological grade, post-CRT leukocyte count, and tumor downstaging were related to disease-free survival. The 5-year disease-free survival and overall survival in patients with post-CRT leukocyte count ${\leq}3730/uL$, which is the cut-off value derived from the receiver operation characteristic (ROC) curve analysis, were significantly higher than those with higher counts (88.0% vs. 71.6%, p = 0.001; 94.4% vs. 84.1%, p = 0.024). Conclusion: Post-CRT leukocyte count of ${\leq}3730/uL$ could be regarded as a good prognostic factor for tumor response and survival in rectal cancer patients treated with preoperative CRT.