• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9801-9804
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• 2014

Background: Colorectal cancer is currently the third most common cancer in Indonesia, yet colonoscopy - the most accepted mode of screening to date - is not done routinely and national data are still lacking. Objective: To determine the detection rate of colorectal cancers and adenomas in unselected patients undergoing colonoscopy for various large bowel symptoms at the Digestive Disease and GI Oncology Centre, Medistra Hospital in Jakarta, Indonesia. Materials and Methods: Colonoscopy data from January 2009 to December 2012 were reviewed. New patients referred for colonoscopy were included. Data collected were patient demographic and significant colonoscopy findings such as the presence of hemorrhoids, colonic polyps, colonic diverticula, inflammation, and tumor mass. Histopathological data were obtained for specimens taken by biopsy. Associations between categorical variables were analyzed using chi-square test, while mean differences were tested using the t-test. Results: A total of, 1659 cases were included in this study, 889 (53.6%) of them being men. Polyps or masses were found in 495 (29.8%) patients while malignancy was confirmed in 74 (4.5%). Patients with a polyp or mass were significantly older (60.2 vs 50.8 years; p<0.001; t-test) and their presence was significantly associated with male gender (35.0% vs 23.9%; prevalent ratio [PR] 1.71; 95% confidence interval [CI] 1.38-2.12; p<0.001) and age >50 years (39.6% vs 16.6%; PR 3.29; 95% CI 2.59-4.12; p<0.001). Neoplastic lesions was found in 257 (16.1%), comprising 180 (11.3%) adenomas, 10 (0.6%) in situ carcinomas, and 67 (4.2%) carcinomas. Conclusions: Polyps or masses were found in 30% of colonoscopy patients and malignancies in 16.1%. These figures do not represent the nation-wide demographic status of colorectal cancer, but may reflect a potentially increasing major health problem with colorectal cancer in Indonesia.

• Journal of Korean Neurosurgical Society
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• v.57 no.1
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• pp.23-31
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• 2015

Objective : The aims of this study were to investigate the quantitative relationship between pituitary macroadenoma size and degree of visual impairment, and assess visual improvement after surgical resection of the tumor. Methods : The medical records of patients with pituitary adenoma, who had undergone trans-sphenoidal adenectomy between January 2009 and January 2011, were reviewed. Patients underwent an ocular examination and brain MRI before and after surgery. The visual impairment score (VIS) was derived by combining the scores of best-corrected visual acuity and visual field. The relationship between VIS and tumor size/tumor type/position of the optic chiasm was assessed. Results : Seventy-eight patients were included (41 male, 37 female). Thirty-two (41%) patients experienced blurred vision or visual field defect as an initial symptom. Receiver operating characteristic curve analysis showed that tumors <2.2 cm tended to cause minimal or no visual impairment. Statistical analysis showed that 1) poor preoperative vision is related to tumor size, displacement of the optic chiasm in the sagittal view on MRI and optic atrophy, and 2) poorer visual prognosis is associated with greater preoperative VIS. In multivariate analysis the only factor significantly related to VIS improvement was increasing pituitary adenoma size, which predicted decreased improvement. Conclusion : Results from this study show that pituitary adenomas larger than 2 cm cause defects in vision while adenomas 2 cm or smaller do not cause significant visual impairment. Patients with a large macroadenoma or giant adenoma should undergo surgical resection as soon as possible to prevent permanent visual loss.

• YAKHAK HOEJI
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• v.50 no.2
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• pp.84-92
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• 2006

The present study investigated an effect of arsenic trioxide on the urethane-induced lung carcinogenesis in mice. To understand its carcinogenesis, we examined proliferating cell nuclear antigen (PCNA), apoptotic index as well as cell cycle-related proteins (cyclin D1, p21, and p27). Urethane was injected intraperitoneally in ICR mice, and then they were sacrificed at 5, 15, or 25 weeks following treatment of arsenic trioxide. Arsenic trioxide was given with tap water at a concentration of 1 mg/l (low-dose) and 5mg/1 (high-dose) for 25 weeks. During the carcinogenesis, sequential histological changes from hyperplasia to adenomas, and ultimately to overt carcinomas were noted. The development of hyperplasias, adenomas, and carcinomas in the lung were slightly increased by the treatment of low-dose arsenic trioxide. However, there is no correlation between dose and tumor multiplicity. The administration of low-dose arsenic trioxide, significantly increased the tumor size. The proliferative index observed on 5 weeks after significantly increased. Cyclin D1 and p21 protein, cell cycle related proteins, were more significantly increased in hyperplasia and adenoma in low dose arsenic treated group than urethane alone group. The p27 protein expression did not show any significantly changes with arsenic treated or untreated group. Low dose exposure to arsenic trioxide resulted in increased expression of cyclin D1 and p21 protein. The present results indicate that low-dose treatment of arsenic trioxide, but not high dose of it, partly modulate the cellular proliferation, cyclin D1, and p21 protein expression, and that this effect may contribute to accelerated development of lung adenocarcinomas in urethane-induced mice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.2
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• pp.116-122
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• 2003

Pleomorphic adenoma is the most common salivary neoplasm mainly occurring in the major salivary glands - especially in parotid gland, which is characterized by variable histopathologic appearances and high recurrence rate with malignant transformation according to surgical situations. And this benign mixed tumor occurring in minor salivary glands is believed to shows same clinicopathologic appearances and relatively low recurrent rate compared with the case in major salivary glands. But there are few comparative studies of large series of pleomorphic adenoma occurring in minor salivary glands which includes different histopathologic appearance, clinical characteristics, treatment methods, recurrence rate, and malignant transformation. We retrospectively studied the 54 patients who were pathologically confirmed with pleomorphic adenoma occurring in minor salivary glands, and analyzed the clinico-histopathological appearance, surgical methods, recurrent cases. The results obtained are as follows. 1. The incidence of the tumor was most frequent in 4th & 5th decade, and in female. 2. Palate(90%) including hard & soft palate was the most frequent site for pleomorphic adenoma in minor salivary glands. 3. The exact duration could not be known due to asymptomatic slow growth patterns of the tumor. 4. The mean tumor size was 2.3cm. 5. 28 (52%) pleomorphic adenomas were classified as Cellular type (cell-rich), 17 (31%) specimen as Intermediate type(equal cell to stroma ratio), and 9 (17%) as Myxoid type(stroma-rich). 6. Surgically 51 cases (94%) were showed well-encapsulated tumors, but histopathologically only 34 specimen (63%) were wellencapsulated. Therefore pleomorphic adenomas in minor salivary glands also have to be excised more widely, not enucleated. And in case of suspicious malignancy or large tumor, preoperative incisional biopsy can be applied in the center of the tumor for prevention of rupture of tumor cell, and total excision with use of frozen biopsy for detection of malignancy and confirming the excision margin, and closed follow-up according to final histopathologic results is recommended.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.167-176
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• 1991

This is three case-reports of pleomorphic adenomas arising from one parotid gland and two minor salivary glands treated by total parotidectomy and complete enucleation. We conclude as follows : 1. During the parotidectomy, we tried to preserve the facial nerve by retrograde approach to the trunk from the mandibular branch where it passes over the posterior facial vein. Although the paresis of the lower lip following the operation was seen, it disappeared in about 3 months. 2. Microscopically, the tumor of the first patient (case 1) contained equally myxoid and cellular components and showed well encapsulation. 3. In the second patient (case 2), the tumor revealed large areas of hemorrhage, cystic change, dystrophic calcification and stromal hyalinization, but no definite evidence of carcinoma, therefore we labeled this tumer as "atypical mixed tumor". 4. In the third patient (case 3), the tumor showed principally myxoid component and incomplete capsule, but the tumor was well demarcated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.4
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• pp.206-211
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• 2003

The pleomorphic adenoma is the most common neoplasm involving both the major and minor salivary glands. It is a benign, slowgrowing tumor, but local recurrences can occur. The pleomorphic adenoma gene 1 (PLAG1), which is a novel zinc finger gene, is frequently activated by reciprocal chromosomal translocations involving 8q12 in a subset of salivary gland pleomorphic adenomas. This experimental study was preformed to observe the translocation patterns between PLAG1 gene and the three translocation partner genes. We also have analyzed the presence of PLAG1 transcripts by RT-PCR. CTNNB1/PLAG1 gene fusion was observed in three of nine pleomorphic adnomas. However, LIFR/PLAG1 and SII/PLAG1 gene fusions were not detectable. All of three gene fusions was not detectable in one Warthin's tumor and three inflammatory salivary gland tissues. PLAG1 transcripts were expressed in all inflammatory salivary gland tissues and tumors except for three pleomorphic adenomas. Of particular one pleomorphic adenoma showing CTNNB1/PLAG1 gene fusion did not express PLAG1 transcipt. Our data indicate that gene fusion involving PLAG1 is a frequent event in pleomorphic adenoma, but correlation between gene fusion involving PLAG1 and PLAG1 transcription is not definite.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.341-345
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• 2016

Background: Colorectal polyps are common in Thailand, particularly in the northeastern region. The present study aimed to determine any correlation between Helicobacter pylori-associated gastritis and colorectal polyps in the Thai population. Materials and Methods: A total of 303 patients undergoing esophagogastroduodenoscopy with colonoscopy for investigation of chronic abdominal pain participated in this study from November 2014 to October 2015. A diagnosis of Helicobacter pylori associated gastritis was made if the bacteria were seen on histopathological examination and a rapid urease test was positive. Colorectal polyps were confirmed by histological examination of colorectal biopsies. Patient demographic data were analyzed for correlations. Results: The prevalence of colorectal polyps was 77 (25.4%), lesions being found more frequently in Helicobacter pylori infected patients than non-infected subjects [38.4% vs. 12.5%; Odds Ratio (OR) (95% CI): 2.26 (1.32 - 3.86), p < 0.01]. Patients with Helicobacter pylori - associated gastritis were at high risk of having adenomas featuring dysplasia [OR (95% CI): 1.15 (1.16 - 7.99); P = 0.02]. There was no varaition in location of polyps, age group, sex and gastric lesions with respect to Helicobacter pylori status. Conclusions: This study showed that Helicobacter pylori associated gastritis is associated with an increased risk of colorectal polyps, especially adenomas with dysplasia in the Thai population. Patients with Helicobacter pylori-associated gastritis may benefit from concurrent colonoscopy for diagnosis of colorectal polyps as a preventive and early treatment for colorectal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5565-5570
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• 2014

Objectives: This study aimed to characterize the histopathological pattern of thyroid lesions among Saudi patients and to highlight the age and gender variations of these lesions as base line data. Materials and Methods: We retrospectively analyzed the data from thyroid specimens received at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Results: The 292 thyroidectomy specimens received during the study period came from 230 (78.8%) females and 62 (21.2%) males giving a female: male ratio of 3.7:1. Age of the patients ranged from 14 to 95 years with a mean age 39.7 years. Two hundred and eleven (72.3%) cases were found to be non-neoplastic and 81 (27.7%) cases were neoplastic. The non-neoplastic group included: colloid goiter, including both diffuse and nodular goiter (170 cases; 58.2%), nodular hyperplasia (28 cases; 9.6%), Hashimoto/chronic lymphocytic thyroiditis (12 cases; 4.1%), and Grave's disease (1 case; 0.3%). In neoplastic lesions, there were 7 benign tumors and 74 malignant tumors. Among the benign tumors, 5 were follicular adenomas and 2 were Hurthle cell adenomas. Papillary carcinoma was the commonest malignant tumor accounting for 87.8% of all thyroid malignancies, followed by lymphoma, follicular carcinoma and medullary carcinoma. The size of papillary carcinoma was more than 2 cm in 40 cases (76.9%). Conclusions: Non-neoplastic thyroid lesions were more common than neoplastic ones. Colloid goiter was the most common lesion. Follicular adenoma was the commonest benign tumor and papillary carcinoma was the commonest malignant lesion. There appears to be a slightly increased trend of papillary carcinoma diagnosis, most being diagnosed at an advanced stage.

• Biomedical Science Letters
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• v.19 no.4
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• pp.295-302
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• 2013

Some of the pituitary adenomas are invasive and spread into neighboring tissues. In previous studies, the invasion of pituitary adenomas is thought to be associated with epithelial-mesenchymal transition (EMT). In addition to that, we thought that mesenchymal stem cells (MSCs) exist in relevant microenvironment in pituitary adenoma. However, it has been little known about the existence of MSCs from pituitary adenoma. So we investigated whether mesenchymal stem-like cells (MSLCs) can be isolated from the pituitary adenoma specimen. We isolated and cultured candidate MSLCs from the fresh pituitary adenoma specimen with the same protocols used in culturing bone marrow derived MSCs (BM-MSCs). The cultured candidate MSLCs were analyzed by fluorescence-activated cell sorting (FACS) for surface markers associated with MSCs. Candidate MSLCs were exposed to mesenchymal differentiation conditions to determine the mesenchymal differentiation potential of these cells. To evaluate the tumorigenesis of candidate MSLCs from pituitary adenoma, we implanted these cells into the brain of athymic nude mice. We isolated cells resembling BM-MSCs named pituitary adenoma stroma mesenchymal stem-like cells (PAS-MSLCs). PAS-MSLCs were spindle shaped and had adherent characteristics. FACS analysis identified that the PAS-MSLCs had a bit similar surface markers to BM-MSCs. Isolated cells expressed surface antigen, positive for CD105, CD75, and negative for CD45, NG2, and CD90. We found that these cells were capable of differentiation into adipocytes, osteocytes and chondrocytes. Tumor was not developed in the nude mice brains that were implanted with the PAS-MSLCs. In this study, we showed that MSLCs can be isolated from a pituitary adenoma specimen which is not tumorigenic.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.3-8
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• 1999

Objective: The expression of Ki67, a proliferation marker, and p27, a cyclin dependent kinases(CDKs) inhibitor, has been studied in various human neoplasms. This study was carried out to determine whether these markers are useful in distinguishing benign from malignant lesions of the thyroid or predicting biologic behavior of malignant lesions. Material and Methods: Using immunohistochemical techniques with monoclonal antibodies to Ki67 and p27, we analyzed the expression of Ki67 and p27 in various thyroid disorders(25 follicular adenomas, 47 follicular carcinomas, 16 papillary carcinomas, 20 adenomatous goiters and 40 normal thyroid tissues). The labeling indices(LIs) were determined by counting cells expressing these markers in 1000 cells per immunostained slide. Results: Neoplastic thyroid diseases showed higher expression of Ki67 and lower expression of p27 than non-neoplastic diseases(p<0.05). The expression of p27 was significantly different between follicular adenomas($LI=55.4{\pm}5.7$) and follicular carcinomas($LI=23.2{\pm}10.2$). There was, however, no significant correlation between the degree of Ki67 and p27labeling indices and types of carcinoma or clinical aggressiveness of diseases. Conclusion: The degree of Ki67 and p27 expression was useful in distinguishing between benign from malignant thyroid lesions, particulary between follicular adenoma and follicular carcinoma, but was not directly proportional to the tumor aggressiveness.