Objective: To study the relationship between clinical pathologic characteristics, treatment modalities and prognostic factors in HER-2 (Human Epidermal growth factor Receptor-2) overexpressed breast carcinoma. Materials and Methods: Major clinico-pathological factors including therapeutic modalities and survival status of 371 breast cancer patients with HER2 over-expression, teated at Yantai Yuhuangding Hospital from March of 2002 to December of 2010 were retrospectively studied, with special attention focused on survival-related factors. Results: The median age of the total 371 patients in this study was 48 years at time of diagnosis, among which, the leading pathological type was infiltrating ductal carcinoma (92.5%); 62.8% presented with a primary tomor larger than 2 cm in diameter at diagnosis, 51.0% had axillary lymph node (ALN) metastases; ER (Estrogen receptor)/PR (Progesterone receptor) double negative occured in 52.8% of cases, and PCNA (proliferation cell nuclear antigen) (+++) was found in 55.1%. HER-2 overexpressed patients were usually in advanced stage when the diagnosis was made (72.8% at stages IIA~IIIC). The prognosis and survival were assessed in 259 patients with complete follow-up data. 5-year DFS (disease-free survival) and OS (overall survival) rate was 68.0% and 78.0% respectively. Univariate analysis revealed that age, tumor size, ALN metastases, LVSI (lymph-vascular space involvement), PCNA status, hormonal therapy, chemotherapy cycles, and HER-2 overexpression, correlated closely with the prognosis. ALN metastases, LVSI, PCNA status and chemotherapy cycles were independent predictors of survival. Conclusions: HER-2 overexpressed breast cancer has special clinical and pathological characteristics, with advanced clinical stages and high rate of ER/PR double negative. Lymph node metastases, LVSI, PCNA and chemotherapy cycles are independent predictors of prognosis.
Zheng, Chun-Hua;Quan, Yuan;Li, Yi-Yang;Deng, Wei-Guo;Shao, Wen-Jing;Fu, Yan
Asian Pacific Journal of Cancer Prevention
/
v.15
no.4
/
pp.1589-1595
/
2014
Objective: Forkhead box C2 (FOXC2) is a member of the winged helix/forkhead box (Fox) family of transcription factors. It has been suggested to regulate tumor vasculature, growth, invasion and metastasis, although it has not been studied in cervical cancer. Here, we analyzed FOXC2 expression in cervical tissues corresponding to different stages of cervical cancer development and examined its correlation with clinicopathological characteristics. In addition, we examined the effects of targeting FOXC2 on the biological behavior of human cervical cancer cells. Methods: The expression of FOXC2 in normal human cervix, CIN I-III and cervical cancer was examined by immunohistochemistry and compared among the three groups and between cervical cancers with different pathological subtypes. Endogenous expression of FOXC2 was transiently knocked down in human Hela and SiHa cervical cells by siRNA, and cell viability and migration were examined by scratch and CCK8 assays, respectively. Results: In normal cervical tissue the frequency of positive staining was 25% (10/40 cases), with a staining intensity (PI) of $0.297{\pm}0.520$, in CIN was 65% (26/40cases), with a PI of $3.00{\pm}3.29$, and in cancer was 91.8% (68/74 cases), with a PI of $5.568 {\pm}3.449$. The frequency was 100% in adenocarcinoma (5/5 cases) and 91.3% in SCCs (63/69 cases). The FOXC2 positive expression rate was 88.5% in patients with cervical SCC stage I and 100% in stage II, showing significant differences compared with normal cervix and CIN. With age, pathologic differentiation degree and tumor size, FOXC2 expression showed no significant variation. On transient transfection of Hela and SiHa cells, FOXC2-siRNA inhibition rates were 76.2% and 75.7%; CCK8 results showed reduced proliferation and relative migration (in Hela cells from $64.5{\pm}3.16$ to $49.5{\pm}9.24$ and in SiHa cells from $60.1{\pm}3.05$ to $44.3{\pm}3.98$) (P < 0.05). Conclusion: FOXC2 gene expression increases with malignancy, especially with blood vessel hyperplasia and invasion degree. Targeted silencing was associated with reduced cell proliferation as well as invasion potential.
Background: Non-epithelial malignant ovarian tumors and clear cell carcinomas, Brenner tumors, transitional cell tumors, and carcinoid tumors of the ovary are rare ovarian tumors (ROTs). In this study, our aim was to determine the clinicopathological features of ROT patients and prognostic factors associated with survival. Materials and Methods: A total of 167 patients with ROT who underwent initial surgery were retrospectively analyzed. Prognostic factors that may influence the survival of patients were evaluated by univariate and multivariate analyses. Results: Of 167 patients, 75 (44.9%) were diagnosed with germ-cell tumors (GCT) and 68 (40.7%) with sex cord-stromal tumors (SCST); the remaining 24 had other rare ovarian histologies. Significant differences were found between ROT groups with respect to age at diagnosis, tumor localization, initial surgery type, tumor size, tumor grade, and FIGO stage. Three-year progression-free survival (PFS) rates and median PFS intervals for patients with other ROT were worse than those of patients with GCT and SCST (41.8% vs 79.6% vs 77.1% and 30.2 vs 72 vs 150 months, respectively; p=0.01). Moreover, the 3-year overall survival (OS) rates and median OS times for patients with both GCT and SCST were better as compared to patients with other ROT, but these differences were not statistically significant (87.7% vs 88.8% vs 73.9% and 170 vs 122 vs 91 months, respectively; p=0.20). In the univariate analysis, tumor localization (p<0.001), FIGO stage (p<0.001), and tumor grade (p=0.04) were significant prognostic factors for PFS. For OS, the univariate analysis indicated that tumor localization (p=0.01), FIGO stage (p=0.001), and recurrence (p<0.001) were important prognostic indicators. Multivariate analysis showed that FIGO stage for PFS (p=0.001, HR: 0.11) and the presence of recurrence (p=0.02, HR: 0.54) for OS were independent prognostic factors. Conclusions: ROTs should be evaluated separately from epithelial ovarian cancers because of their different biological features and natural history. Due to the rarity of these tumors, determination of relevant prognostic factors as a group may help as a guide for more appropriate adjuvant or recurrent therapies for ROTs.
Background: A number of clinicopathologic factors have been found to be associated with pathological lymph node metastasis (pLNM) in rectal cancer; however, most of them can only be identified by expensive high resolution imaging or obtained after surgical treatment. Just like the Child-Turcotte-Pugh (CTP) and the model for end-stage liver disease (MELD) scores which have been widely used in clinical practice, our study was designed to assess the pre-operative factors which could be obtained easily to predict intra-operative pLNM in rectal cancer. Methods: A cohort of 469 patients who were treated at our hospital in the period from January 2003 to June 2011, and with a pathologically hospital discharge diagnosis of rectal cancer, were included. Clinical, laboratory and pathologic parameters were analyzed. A multivariate unconditional logistic regression model, areas under the curve (AUC), the Kaplan-Meier method (log-rank test) and the Cox regression model were used. Results: Of the 469 patients, 231 were diagnosed with pLNM (49.3%). Four variables were associated with pLNM by multivariate logistic analysis, age<60 yr (OR=1.819; 95% CI, 1.231-2.687; P=0.003), presence of abdominal pain or discomfort (OR=1.637; 95% CI, 1.052-2.547; P=0.029), absence of allergic history (OR=1.879; 95% CI, 1.041-3.392; P=0.036), and direct $bilirubin{\geq}2.60{\mu}mol/L$ (OR=1.540; 95% CI, 1.054-2.250; P=0.026). The combination of all 4 variables had the highest sensitivity (98.7%) for diagnostic performance. In addition, age<60 yr and direct $bilirubin{\geq}2.60{\mu}mol/L$ were found to be associated with prognosis. Conclusion: Age, abdominal pain or discomfort, allergic history and direct bilirubin were associated with pLNM, which may be helpful for preoperative selection.
Park Hee-Boong;Lee Myo-Kyung;Hong Jeong;Jung Woo-Hee;Hwang Eui-Ho;Sul Joon-Hee
Korean Journal of Head & Neck Oncology
/
v.9
no.2
/
pp.210-220
/
1993
Histologically proven 465 cases of neck mass in children were analized for the determination of the nature of lesions. Pathologic specimens were obtained during 10 years from January 1981 to December 1989 at Severance Hospital, Yonsei University, College of Medicine. 1) Congenital lesion was most common in neonate(80%) and congenital lesion and inflamatory disease were common in infancy and inflammatory disease was most common in more than one year old children. Thyroglossal duct cyst was most common(35.4%) disease of the congenital lesion. followed by cytic hygroma(34%) and branchial cleft remnants(29.2%). 2) Benign tumors were discovered most frequently in adolescence (55.2%) and thyroid adenoma(23.7%) and epithelial tumor(21.1%) and hemangiomas(19.7%) were most common. Most common malignant tumors were malignant lymphoma (50%) and Hodgkin's disease and were present in the older children. Metastatic cancers were very rare and their primary sites were deductable in all cases. 3) Reactive hyperplasia of lymph node was most common in inflammatory disease(23.7%). Tuberculosis lymphadenitis was more common than nonspecific lymphadenitis. 4) Bilaterality of lesion was commonly seen in malignant disease(41.7%), reactive hyperplasia of lymph node (38.85%) and metastatic disease(33.3%). Size and duration of the masses were not helpful in the differential diagnosis of the cause of the masses. Pediatric neck mass must be evaluated with its characteristics. sites, bilaterality, size and its cange, duration and patient's age but any of these alone cant not be predicted its causes without biopsy or excision. Biopsy or excision can be done with few complication but biopsy of lymph node for diagnosis is carefully made because a large number of lymph node biopsy showed no definite diagnosis in these selected cases of patients.
Fifty patients with residual, unresectable or recurrent rectal cancer were treated with external irradiation using a 6-MV linear accelerator at the Division of Therapeutic Radiology, Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College during the period of April 1983 to December 1987. This paper describes the results of a retrospective analysis of the results of external irradiation for the residual, unresectable and recurrent rectal cancer in 46 patients. Four patients were lost to follow-up. Of the 46 patients, $18 (39\%)$ presented with unresectable primary lesions and $28 (61\%)$ with residual or recurrent rectal cancer. In $93\%$, the pathologic diagnosis was adenocarcinoma. Resonse to irradiation was observed in $22 (73\%)$ out of 30 patients who were treated for pain, $12 (86\%)$ out of 14 patients who were treated for mass, and $17 (77\%)$ out of 22 patients who were treated for bloody discharge. The actuarial postoperative 2-year and 3-year survival rates in recurrent and unresectable patients were $43\%$ and $22\%$, respectively. However, the post-RT 2-year survival rate was $13\% (6/46)$.
Shin, Young Seob;Yoon, Yong sik;Lim, Seok-Byung;Yu, Chang Sik;Kim, Tae Won;Chang, Heung Moon;Park, Jin-hong;Ahn, Seung Do;Lee, Sang-Wook;Choi, Eun Kyung;Kim, Jin Cheon;Kim, Jong Hoon
Radiation Oncology Journal
/
v.34
no.3
/
pp.177-185
/
2016
Purpose: To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. Materials and Methods: Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months. Results: All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting. Conclusion: PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer.
Park In-Kyu;Cho Sang-Ho;Kim Dae-Joon;Chung Kyung-Young
Journal of Chest Surgery
/
v.39
no.6
s.263
/
pp.470-474
/
2006
Background: Mediastinal lymph node metastasis is an important factor for staging and prognosis of non-small cell lung cancer (NSCLC), so accurate diagnosis is essential for treatment. Mediastinoscopy provides histopathological diagnosis of mediastinal lymphnode metastasis in NSCLC. The efficacy of mediastinoscopy was investigated. Material and Method: From Jun, 1999 to Aug, 2005, mediastinoscopic lymph node biopsy was performed to 348 patients with NSCLC. Patients characteristics, radiologic findings, mediastinoscopic results and pathologic stages were evaluated for investigation of safety and efficacy of modiastinoscopy in NSCLC. Result: There was 263 male and 85 female patients and the mean age was $62.1{\pm}8.5$ years. By radiologic study for mediastinal lymph node metastasis, 203 patients were negative and 145 patients were positive. Mean procedure time was $55.5{\pm}16.5$ minutes and biopsy was peformed at $2.2{\pm}1.0$ lymph node stations. There were only transient complications (1.7%) during the procedure, without other complication and mortality. There was 7.8% of false negative result in mediastinoscopy. Sensitivity (77.5% vs 71.9%, p=0.012), specificity (100% vs 74.4%, p=0.00), and accuracy (92.2% vs 73.6%, p=0.00) of mediastinoscopy were more superior than that of radiologic study for the diagnosis of mediastinal lymph node metastasis in NSCLC. Conclusion: Mediastinoscopy is a safe and effective modality for diagnosis of mediastinal lymph node metastasis in NSCLC.
Choi, Hyun Ho;Hong, Yu Ah;Choi, Jae Ki;Kim, Ju Sang;Kim, Seung Joon;Kim, Seok Chan;Lee, Sook Young;Kim, Young Kyoon;Park, Sung Hak;Kim, Tae Jung;Lee, Kyo Young;Park, Hyun Jin;Kim, Hyo Lim;Ahn, Myeong Im
Tuberculosis and Respiratory Diseases
/
v.66
no.4
/
pp.309-313
/
2009
There are several respiratory diseases that show chronic granulomatous inflammation for the histologic finding. Among them, sarcoidosis and tuberculosis are not easy to differentiate when the clinical and radiological features present similar patterns. The increasing incidence of nontuberculous mycobacteria pulmonary disease is making it more difficult for clinicians to arrive at a proper diagnosis. A 69 year old male patient visited our hospital with chronic cough as his chief compliant. His radiologic findings were multiple enlarged mediastinal lymphadenpathies with innumerable micronodules and multiple patch infiltrations. The spleen biopsy finding showed chronic granulomatous inflammation, and Mycobacterium avium was identified on the bronchoscopic culture. Because of these findings, we treated him with drugs for nontuberculous mycobacteria disease other than sarcoidosis. However, during the treatment, his symptoms and radiological features became aggravated. Thus, we reviewed the radiologic and pathologic findings and decided to treat him with steroid, which relieved his symptoms and improved the radiologic findings. We report here on a case of sarcoidosis that was initially misdiagnosed as nontuberculous mycobacteria pulmonary disease.
The Journal of the Korean bone and joint tumor society
/
v.11
no.1
/
pp.40-45
/
2005
Purpose: To suggest an accurate diagnosis and treatment of infiltrating intramuscular lipoma by analysis of the clinical, biological, radiological and pathological features. Materials & Methods: 20 patients who treated at our hospital for infiltrating intramuscular lipoma from 1998. to 2001 were selected for this study. Mean age was 45.8 years old. Four were male and eight female. All cases were checked preoperative radiographs, MRI and diagnosed by biopsy. The methods of surgical treatment included excision of tumor and peripheral tissue. We assessed the recurrence by follow up. Results: Tumors located in upper limbs 5 cases, lower limbs 3 cases, abdomen 3 cases, gluteal region 1 case. In preoperative radiographs, infiltrating intramuscular type were 7 cases. In 11 cases, tumors were completely excied with peripheral tissue. 1 cases was incompletely excised because it was very huge mass and infiltrated lung. Encapsulated tumors were 3cases and uncapsulated tumors 9 cases. There were no recurrence excepts 1 case that was infiltrated lung. Conclusion: Infiltrating intramuscular lipoma was wrongly diagnosed as well differentiated liposarcoma. To increase the rate of correct diagnosis, preoperative radiographs, MRI and pathologic diagnosis were performed. Careful wide excision is necessary to prevent the recurrence.
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