• Radiation Oncology Journal
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• 제12권3호
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• pp.337-347
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• 1994

병기 1기, 2기 유방암에서 유방보존적 수술 후 방사선치료는 기존의 유방전적출술을 대치할 수 있는 치료법으로 정립되었다. 연세암센터에서는 1991년 부터 유방보존술을 적극적으로 시행하였고 첫 3년동안 140예를 치료하였다. 목적 : 연세암센터에서 시행하고 있는 유방보존술의 적응증, 치료방침과 방사선치료 방법을 소개하고 결과 및 방사선치료의 부작용을 보고하고자 한다. 방법 : 1991년 1월부터 1992년 12월까지 연세암센터 치료방사선과에서 유방보존적수술 후 근치적 방사선치료를 받았던 64명의 조기 유방암 환자를 대상으로 하였다. 모든 환자들은 종괴 또는 병변을 포함한 부분유방절제술과 액와임파절 곽청술을 시행받은 후 방사선치료를 받았다. 방사선치료는 수술후 3-18주에 시행되었는데 선형가속기 4MV X-ray를 사용하여서 침범된 유방 전체에 4500-5040 cGy를 5-6주에 걸쳐서 조사하였고 원발 병소 주변에 전자선을 사용하여서 1-2주에 걸쳐서 1000-2000 cGy를 추가 조사하였다. 치료를 받았던 환자들의 임상적 특성과 치료방법, 방사선치료에 따르는 부작용, 재발 여부 등을 분석하였다. 결과 : 대상환자들의 연령은 23세에서 59세로 중앙값이 40세 였다. 총 64명중 T1은 27명, T2는34명 이었으며 3명은 비침윤성 암이었다. 또한 전체의 $42.2\%$인 27명은 액와임파절 침윤이 있었다. 추적 기간(6-30개월, 중앙값 14개월) 동안 1예의 유방내 재발과 2예의 원격 전이가 관찰되었는데 유방내 재발은 원발병소와 다른 사분원에 위치하여서 처음 진단에서 발견하지 못했던 유방조영술상의 미세석회화음영에서 종괴가 자랐던 예로 다시 유방전적출술을 받은 후 무병생존 중이다. 방사선치료 중 또는 추적 기간 동안 치료를 요하는 부작용으로는 1예에서만 방사선 폐렴이 있었으나 대증요법 으로 완쾌되었다. 결론 : 추적 기간이 짧기 때문에 국소재발율, 생존율, 미용효과 등의 치료 결과를 평가하기는 이르지만 조기 유방암에서 유방보존적 수술과 근치적 방사선치료는 심한 급성 또는 아급성 부작용이 없는 안전하고 편안한 치료법임을 확인할 수 있었다. 또한 국소재발율을 낮추기 위해서는 유방보존술에 적합한 환자들을 선택하기 위한 철저한 평가가 필수적임을 알 수 있었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2851-2856
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• 2014

The aim of this study is to evaluate clinicopathologic characteristics and the multi-disciplinary treatment results of metaplastic breast cancer (MBC) patients treated in a single institute. Seventeen female patients with MBC treated in our department between June 2000 and January 2012 were identified and retrospectively evaluated. The median age at diagnosis was 46 years (range, 26-66 years). The median tumor size at diagnosis was 3.5 cm (range 1.5-12 cm). Six (35%) patients underwent breast conservation surgery and 11 (65%) mastectomy. Axillary lymph node metastasis was found in 6 (35%) patients. Twelve (71%) had triple negative tumors. Postoperative RT and systemic adjuvant treatment was given to all patients accordingly to stage and biological characteristics. Median follow-up time was 27 months (range, 12-151 months). At the time of this analysis, 14 (82%) patients were alive with no evidence of disease, and 1 (6%) was alive with disease. The 3-year OS was 91% and 5-year 80%, and DFS rates were 76% and 76%, respectively. Despite the young age of our patients with mostly high grade tumors, larger tumor size and higher rates of lymph node metastasis, the survival outcomes in our study are favorable in comparison with previously reported series.

• Biomolecules & Therapeutics
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• 제25권6호
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• pp.625-633
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• 2017

Sphingosylphosphorylcholine (SPC) is one of the bioactive phospholipids that has many cellular functions such as cell migration, adhesion, proliferation, angiogenesis, and $Ca^{2+}$ signaling. Recent studies have reported that SPC induces invasion of breast cancer cells via matrix metalloproteinase-3 (MMP-3) secretion leading to WNT activation. Thrombospondin-1 (TSP-1) is a matricellular and calcium-binding protein that binds to a wide variety of integrin and non-integrin cell surface receptors. It regulates cell proliferation, migration, and apoptosis in inflammation, angiogenesis and neoplasia. TSP-1 promotes aggressive phenotype via epithelial mesenchymal transition (EMT). The relationship between SPC and TSP-1 is unclear. We found SPC induced EMT leading to mesenchymal morphology, decrease of E-cadherin expression and increases of N-cadherin and vimentin. SPC induced secretion of thrombospondin-1 (TSP-1) during SPC-induced EMT of various breast cancer cells. Gene silencing of TSP-1 suppressed SPC-induced EMT as well as migration and invasion of MCF10A cells. An extracellular signal-regulated kinase inhibitor, PD98059, significantly suppressed the secretion of TSP-1, expressions of N-cadherin and vimentin, and decrease of E-cadherin in MCF10A cells. ERK2 siRNA suppressed TSP-1 secretion and EMT. From online PROGgene V2, relapse free survival is low in patients having high TSP-1 expressed breast cancer. Taken together, we found that SPC induced EMT and TSP-1 secretion via ERK2 signaling pathway. These results suggests that SPC-induced TSP-1 might be a new target for suppression of metastasis of breast cancer cells.

• 대한한방내과학회지
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• 제42권3호
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• pp.420-430
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• 2021

The survival time of breast cancer patients with lung metastasis has been prolonged as treatment methods have improved. However, there is yet no definitive therapy for the additional symptoms of lung metastasis to improve the quality of life of these patients. We report a patient who was suffering from pleural effusion due to metastasized breast cancer. She was treated with Korean medicine, including herbal medicine (Bojungikgi-tang-gami), combined with hormone therapy, for two months. We assessed her other symptoms, such as shortness of breath, generalized weakness, and lower extremity swelling, using a numeric rating scale (NRS). We also evaluated pleural effusion with chest X-rays. Shortness of breath was maintained at NRS 5, generalized weakness was slightly improved from NRS 6~7 to NRS 7~8 (10=healthy condition), and lower extremity edema was improved from NRS 3 to NRS 2 (10=highest score of discomfort). Malignant pleural effusion was maintained during the admission period. This report suggests that Korean medicine can help to maintain malignant pleural effusion and improve additional symptoms of lung metastasis.

• Journal of Gastric Cancer
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• 제16권2호
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• pp.85-92
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• 2016

Purpose: PIK3CA is often mutated in a variety of malignancies, including colon, gastric, ovary, breast, and brain tumors. We investigated PIK3CA expression in gastric cancer and explored the relationships between the PIK3CA expression level and clinicopathological features as well as survival of the patients. Materials and Methods: We examined PIK3CA expression in a tissue microarray of 178 gastric adenocarcinomas by immunohistochemistry and reviewed patients' medical records. Results: In our study, 112 of the 178 gastric cancer patients displayed positive PIK3CA expression. Overexpression of PIK3CA was correlated with low grade differentiation (P=0.001), frequent lymphatic invasion (P=0.032), and high T stage (P=0.040). Patients with positive PIK3CA staining were more likely to display worse overall survival rate than those with negative PIK3CA staining, as determined by Kaplan-Meier survival analysis with log-rank test (P=0.047) and a univariate analysis using the Cox proportional hazard model (hazard ratio=1.832, P=0.051). Conclusions: Elevated PIK3CA expression was significantly correlated with tumor invasiveness, tumor phenotypes, and poor patient survival.

• 대한한방내과학회지
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• 제23권2호
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• pp.165-173
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• 2002

Purpose : Among numerous biological symptoms of cancer, matrix metalloproteinases (MMPs) are essential for tumor invasion and metastasis. HAD is used as an inhibitor of MMP gene. This study was designed to evaluate the effects of HAD on anti metastasis and preventing recurrence in cancer patients. Materials and Methods : We retrospectively analyzed the medical records of 69 cancer patients who had been administered with HAD for over 12 months continuously in East-West Cancer Center of Oriental Hospital of Daejeon University, from January 1993 to May 2002. Results : We analyzed gender, portion, stage and anti-metastasis & recurrence rates of cancer patients. Analysis of sex cases showed that the percentage of male is 62.3%, female is 37.7%. Analysis of cancer portion showed that the percentage of stomach is 31.9%, colorectum is 26.1%, lung is 21.7%, liver is 8.7%, breast is 8.7% Analysis of stage showed that the rate of III is 78.3%, IV is 13.0% and II is 8.7%. Analysis of anti-metastasis and recurrence rates showed that colorectal cancer is 77.8%, stomach cancer is 63.6%, lung cancer is 33.4% and breast cancer is 33.3% (mean : 53.6%). Conclusions : HAD has significant effects on anti-metastasis and preventing recurrence of tumor on cancer patients. So it helps to prolong the survival rates of cancer patients.

• Radiation Oncology Journal
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• 제8권1호
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• pp.65-71
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• 1990

유방암의 일차 치료후 흉벽이나 국소임파절에 국한된 재발은 비교적 흔하게 관찰된다. 방사선치료는 이러한 국소재발유암 환자에게 효과적인 치료법으로 사용되어 왔으나 국소병변의 관해에도 불구하고 많은 경우에서 이차개발 또는 원격전이로 인해 불량한 예후를 보이므로 최근에는 다방면 병용요법을 시도하여 환자의 수명을 연장시키고 관해율을 증가시켰다는 고들이 있다. 이에 저자들은 국소 재발유암 환자의 특성과 치료결과, 치료후 실패양상, 생존율에 영향을 미치는 예후인자를 분석하여 향후치료의 지침으로 삼고자, 1974년 부터 1986년까지 연세대학교 의과대학 치료방사선과에서 방사선치료를 받은 53명을 대상으로 후향적분석을 통해 다음과 같은 결과를 얻었다. 32예 ($60.4\%$)가 단일 병소에, 21예 ($39.4\%$)가 다발병소에 재발하였다. 방사선치료후 31예 ($58.4\%$)에서 완전관해를 보였으나 그 중 7예는 치료부위에 다시 재발하였다. 전체환자의 5년 생존율과 무병생존율은 각각 $27\%,\;15\%$였다. 각각의 예후인자에 대한 단일변량분석에서는 최초 수술당시의 액와임파절전이 숫자, 보조적 화학요법의 시행 유무, 경도의 유무 등이 통계적 유의성을 보였고, 다변량분석법을 통한 분석에서는 최초수술당시의 액와임파절전이의 수, 경도의 유무, 재발시 병변의 크기, 치료후 관해기간 등이 생존율에 통계적으로 유의한 영향을 끼치는 예후인자였다.

• Journal of Gastric Cancer
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• 제3권3호
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• pp.139-144
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• 2003

Purpose: Because of an improving gastric cancer detection program and treatment methods, we can expect improved survival of patients with gastric cancer. Given the longer survival times, the chance of an occurrence of multiple primary malignant tumors other than stomach is increased in the same patients. The purpose of this study is to analyze the clinical characteristrics and the survival of patients with gastric cancer and other malignancies. Materials and Methods: A retrospective study of 3669 patients with gastric cancer observed at our department between January 1994 to December 2002 was conducted. Associated tumors were diagnosed using the Warren and Gates criteria, and included tumors that were not considered to be a metastasis, invasion, or recurrence of the gastric cancer. Results: Of all 3669 patients, $2.07\%$ (n=76) had primary tumors other than gastric cancer, $63\%$ of which were synchronous (n=48) and $37\%$ metachronous (n=28). The mean age of the study group was 64.9 (65.5 in males, 61.8 in females), and the male-to-female ratio was 4.8 : 1. The most common cancer associated with gastric cancer was a hepatocellular carcinoma ($23.7\%$), followed by colorectal cancer ($17.1\%$), esophageal cancer ($10.5\%$), breast cancer ($6.6\%$). Of the 45 patients who had undergone a resection, 14 were in stage I, 12 in stage II, 13 in stage III, and 6 in stage IV. No statistically significant differences were found between the synchronous and the metachronous groups with regard to age, sex ratio, differentiation, and stage. The 5-year survival rates of the metachronous and the resected patients were significantly higher than those of the synchronous and the non resected patients, respectively. Conclusion: Due to increasing length of the follow-up period for patients with gastric cancer, another malignancy may develop in other organs. Therefore, physicians should pay attention to detect other cancers early in these patients, and a surgical resection is recommended as the treatment of choice in the management of multiple primary cancer associated with gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2231-2235
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• 2013

Background: Categorizing breast tumors based on the ER, PR and HER/Neu 2 receptor status is necessary in order to predict outcome and assist in management of breast cancer. Herfe we assessed this question in South Indian patients. Materials and Methods: A total of 619 formalin fixed paraffin embedded breast tumor tissues were collected from pathology archives after receipt of ethical clearance. With the help of primary and secondary conjugated antibodies, expression status of ER, PR and HER2/neu was determined. All the experimental data were assessed for correlations with histopathological features of tumors and clinical presentation of the subjects. Results: In the present study, the ages ranged from 20-87 years with a mean of $50.0{\pm}12.q$ years, and majority of the tumors (84%) were of infiltrating duct cell carcinoma type. Assessment of ER, PR and Her-2/neu expression showed that 46% were triple negative. Interestingly, an inverse relation between ER, PR and HER-2/neu was apparent in 41.2% (p<0.0001) of the tumors, of which 24.5% (p<0.0001) were ER and PR co-negative but HER-2 positive. Conclusions: ER and PR positive tumors are less common (i.e<30%) compared to HER-2/neu positive tumors (i.e>50%) in Indian breast cancer patients, underlining the need for effective diagnostic screening and specific therapeutic managements in order to improve the survival rate of patients in low resource countries such as India.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.581-590
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• 2016

Resistance to anoikis, a cell-detachment induced apoptosis, is one of the malignant phenotypes which support tumor metastasis. Molecular mechanisms underlying the establishment of this phenotype require further investigation. This study aimed at exploring protein expression profiles associated with anoikis resistance of a metastatic breast cancer cell. Cell survival of suspension cultures of non-metastatic MCF-7 and metastatic MDA-MB-231 cells were compared with their adherent cultures. Trypan blue exclusion assays demonstrated a significantly higher percentage of viable cells in MDA-MB-231 than MCF-7 cell cultures, consistent with analysis of annexin V-7-AAD stained cells indicating that MDA-MB-231 possess anti-apoptotic ability 1.7 fold higher than MCF-7 cells. GeLC-MS/MS analysis of protein lysates of MDA-MB-231 and MCF-7 cells grown under both culture conditions identified 925 proteins which are differentially expressed, 54 of which were expressed only in suspended and adherent MDA-MB-231 but not in MCF-7 cells. These proteins have been implicated in various cellular processes, including DNA replication and repair, transcription, translation, protein modification, cytoskeleton, transport and cell signaling. Analysis based on the STITCH database predicted the interaction of phospholipases, PLC and PLD, and 14-3-3 beta/alpha, YWHAB, with the intrinsic and extrinsic apoptotic signaling network, suggesting putative roles in controlling anti-anoikis ability. MDA-MB-231 cells grown in the presence of inhibitors of phospholipase C, U73122, and phospholipase D, FIPI, demonstrated reduced ability to survive in suspension culture, indicating functional roles of PLC and PLD in the process of anti-anoikis. Our study identified intracellular mediators potentially associated with establishment of anoikis resistance of metastatic cells. These proteins require further clarification as prognostic and therapeutic targets for advanced breast cancer.