• Title/Summary/Keyword: positive recurrence

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A case of granular cell tumor of the cervical esophagus misdiagnosed as parathyroid tumor (부갑상선 종양으로 오인된 경부 식도 과립세포종 1례)

  • Kim, Dong Hwan;Bang, Seong Sik;Shin, Su-Jin;Tae, Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.81-84
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    • 2018
  • Granular cell tumor is an uncommon neoplasm that can occur everywhere in the human body. Granular cell tumor of the cervical esophagus is rare. Histopathologically, granular cell tumor consists of large polygonal cells with small dark nuclei and abundant, fine, granular eosinophilic cytoplasm that show positive immunohistochemical staining using S-100 protein. Surgical excision is the treatment of choice for granular cell tumor. Recurrence is rare, but inadequate resection of granular cell tumor may cause local recurrence. We have experienced one case of granular cell tumor of the cervical esophagus that was misdiagnosed with parathyroid tumor. Therefore, we report it with the literature review.

The Significance of Serum Carcinoembryonic Antigen in Lung Adenocarcinoma

  • Kim, Jae Jun;Hyun, Kwanyong;Park, Jae Kil;Moon, Seok Whan
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.335-344
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    • 2015
  • Background: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma. Methods: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013. Results: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis. Conclusion: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.

Prognostic Value of Serum AFP, AFP-L3, and GP73 in Monitoring Short-term Treatment Response and Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

  • Wang, Nan-Ya;Wang, Cong;Li, Wei;Wang, Guan-Jun;Cui, Guo-Zhen;He, Hua;Zhao, Heng-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1539-1544
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    • 2014
  • Purpose: Alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and Golgi protein 73 (GP73) levels have been widely used as tumor markers for the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to investigate whether these tumor markers could be used to monitor short-term treatment response and recurrence of HCC in patients undergoing radiofrequency ablation (RFA). Methods: Between July 2012 and July 2013, 53 consecutive patients with newly diagnosed HCC were prospectively enrolled in this study. Among these, 32 patients underwent RFA, after which they were followed up prospectively at the First Hospital of Jilin University in China. Results: AFP, AFP-L3, and GP-73 values pre-RFA were not associated with tumor size, whereas AFP and GP-73 levels tended to be associated with tumor number, the presence of vascular invasion, deterioration of liver function, advanced-stage disease, and a poor performance status. GP-73 levels were dramatically elevated in the patients with hepatitis C-associated HCC. Neither pre-RFA nor 1-month post-RFA tumor marker values were associated with short-term outcome. The short-term recurrence rate of AFP-positive patients measured 1 month post-RFA was obviously higher than that of AFP-negative patients. Conclusions: AFP and GP-73 values were associated with clinical variables representing tumor growth and invasiveness, and the AFP value measured 1 month post-RFA was a strong predictor of short-term recurrence in patients with HCC.

The Prognosis According to Patterns of Mediastinal Lymph Node Metastasis in Pathologic Stage IIIA/N2 Non-Small Cell Lung Cancer

  • Kim, Do Wan;Yun, Ju Sik;Song, Sang Yun;Na, Kook Joo
    • Journal of Chest Surgery
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    • v.47 no.1
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    • pp.13-19
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    • 2014
  • Background: The aim of this study is to evaluate prognostic factors for survival in pathologic stage IIIA/N2 non-small-cell lung cancer (NSCLC), to identify the prognostic significance of the metastatic patterns of mediastinal lymph nodes (MLNs) relating to survival and to recurrence and metastasis. Methods: A total of 129 patients who underwent radical resection for pathologic stage IIIA-N2 NSCLC from July 1998 to April 2011 were retrospectively reviewed. The end points of this study were rates of loco-regional recurrence and distant metastasis, and survival. Results: The overall 5-year survival rate was 47.4%. A univariate analysis showed that age, pathologic T stage, and adjuvant chemotherapy were significant prognostic factors, while in multivariate analysis, pathologic T stage and adjuvant chemotherapy were significant prognostic factors. The metastasis rate was higher in patients with multi-station N2 involvement and with more than 3 positive MLNs. Further, non-regional MLN metastasis was associated with a higher loco-regional recurrence rate. Conclusion: Pathologic T stage and adjuvant chemotherapy were independent prognostic factors for long-term survival in pathologic stage IIIA/N2 NSCLC. The recurrence and the metastasis rate were affected by the metastatic patterns of MLNs. These results may be helpful for planning postoperative therapeutic strategies and predicting outcomes.

A Comparative Study on the Distinction of Patients with Stroke in the Case of the First Attack and Recurrence (중풍(中風) 초발(初發) 및 재발환자(再發患者)의 특성(特性)에 관한 비교연구(比較硏究))

  • Kwon, Jun-Cheol
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.25-34
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    • 2007
  • Objectives : The present study was carried out to provide basic information necessary for the prevention and efficient treatment of stroke through a comparison between thr patients of the first attack and those of recurrence. Methods : The observation f3r the current study was made on 210 cases of stroke that were confirmed through brain CT-scan. The patients were hospitalized at one of two oriental medical hospitals in Seoul during 2006. Result : The main results were as follows. First, the male-to-female ratio of stroke patients were 1:1.26, with more primary stroke far females and more recurrent stroke for males. Second, in the age distribution, seventies was the top, and sixties, fifties, and forties were next in the order of frequency. A large city was the most frequent residential site and unemployment was the most frequent occupation to have stroke. The incidence of stroke became higher as patients had a taste for spicy and salty food. Third, the most common preceding disease was hypertension. In the relationship of diastolic blood pressure with recurrence, there was significance in the test of independence. Fourth, the most important precipitating conditions at the onset of stroke were rest and steeping. The most common precedent symptoms were verbal disturbance, numbness, and dizziness. In the stroke patients with hemiparesis, male and female patients usually showed It. hemiparesis. Fifth, as a result of brain CT-scan, cerebral hemorrhage was inclined to reduce but cerebral infarction was inclined to increase due to senility and change of lifestyle. Finally, total cholesterol findings disclosed that 22.4% were hypercholesteremia, 18.6 % were hyperlipemia in triglyceride findings, and 19.0% were glycosemia in glucose findings. Conclusions : The above results suggested avoidance of meat and salty fDod and positive control of hypertension and diabetes mellitus in order to prevent stroke.

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High Cytoplasmic CXCR4 Expression Predicts Prolonged Survival in Triple-Negative Breast Cancer Patients Treated with Adjuvant Chemotherapy

  • Shim, Bobae;Jin, Min-Sun;Moon, Ji Hye;Park, In Ae;Ryu, Han Suk
    • Journal of Pathology and Translational Medicine
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    • v.52 no.6
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    • pp.369-377
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    • 2018
  • Background: Chemokine receptor CXC chemokine receptor type 4 (CXCR4) and its ligand CXC motif chemokine 12 (CXCL12; stromal cell-derived factor-1) are implicated in tumor growth, metastasis, and tumor cell-microenvironment interaction. A number of studies have reported that increased CXCR4 expression is associated with worse prognosis in triple-negative breast cancer (TNBC), but its prognostic significance has not been studied in TNBC patients treated with adjuvant chemotherapy. Methods: Two hundred eighty-three TNBC patients who received adjuvant chemotherapy were retrospectively analyzed. Tissue microarray was constructed from formalin-fixed, paraffin-embedded tumor tissue and immunohistochemistry for CXCR4 and CXCL12 was performed. Expression of each marker was compared with clinicopathologic characteristics and outcome. Results: High cytoplasmic CXCR4 expression was associated with younger age (p=.008), higher histologic grade (p=.007) and lower pathologic stage (p=.045), while high CXCL12 expression was related to larger tumor size (p=.045), positive lymph node metastasis (p=.005), and higher pathologic stage (p=.017). The patients with high cytoplasmic CXCR4 experienced lower distant recurrence (p=.006) and better recurrence-free survival (RFS) (log-rank p=.020) after adjuvant chemotherapy. Cytoplasmic CXCR4 expression remained an independent factor of distant recurrence (p=.019) and RFS (p=.038) after multivariate analysis. Conclusions: High cytoplasmic CXCR4 expression was associated with lower distant recurrence and better RFS in TNBC patients treated with adjuvant chemotherapy. This is the first study to correlate high CXCR4 expression to better TNBC prognosis, and the underlying mechanism needs to be elucidated in further studies.

Incidence Analysis of Recurrent Milk Fever in Korean Domestic Dairy Cattle (국내 사육중인 젖소에서 발생하는 재발성 유열의 특징 분석)

  • Jeon, Ryoung-Hoon;Rho, Gyu-Jin
    • Journal of Animal Reproduction and Biotechnology
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    • v.34 no.1
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    • pp.30-34
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    • 2019
  • Milk fever is a metabolic disease with manifestation of clinical signs due to hypocalcemia, which usually occurs within 48-72 h after delivery. However, even after a successful treatment of milk fever, recurrence of milk fever may occur, and studies on recurrent milk fever are still lacking. Accordingly, the present study was conducted for the purpose of identifying the characteristics of recurrent milk fever according to farm, season, parity, and dystocia that can cause physiological changes in the mother during peri- and postpartum periods. The analysis results showed that the incidence rate of initial and recurrent milk fever according to breeding farm was 5.7%-14.1% and 3.1%-7.2%, respectively, demonstrating a positive correlation between the initial and recurrent milk fever (r = 0.613, p < 0.01). With respect to season, the incidence rate of initial and recurrent milk fever during summer was 12.3% and 7.5%, respectively, which were significantly higher than that of other seasons (p < 0.05). In addition, the recurrence rate, the ratio of recurrence relative to initial milk fever, was highest during summer with 62.7%. Regarding parity, the incidence rate of initial and recurrent milk fever in 3rd parity was 11.1% and 5.8%, respectively, which was significantly higher than in 1st and 2nd parity (p < 0.05). Furthermore, the recurrence rate in 4th parity was 64.1%, showing a pattern of increase in incidence rate with increase in parity. Finally, there were no differences in the incidence rate of initial and recurrent milk fever according to eutocia and dystocia. The findings indicated that the incidence rate of initial milk fever should be reduced to effectively prevent the recurrent milk fever, while animals with 3rd parity or higher should be expected to occur high rate of recurrent milk fever, especially during summer, and the necessary preparations should be made for intensive treatment of such individuals.

Prognostic Role of Circulating Tumor Cells in the Pulmonary Vein, Peripheral Blood, and Bone Marrow in Resectable Non-Small Cell Lung Cancer

  • Lee, Jeong Moon;Jung, Woohyun;Yum, Sungwon;Lee, Jeong Hoon;Cho, Sukki
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.214-224
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    • 2022
  • Background: Studies of the prognostic role of circulating tumor cells (CTCs) in early-stage non-small cell lung cancer (NSCLC) are still limited. This study investigated the prognostic power of CTCs from the pulmonary vein (PV), peripheral blood (PB), and bone marrow (BM) for postoperative recurrence in patients who underwent curative resection for NSCLC. Methods: Forty patients who underwent curative resection for NSCLC were enrolled. Before resection, 10-mL samples were obtained of PB from the radial artery, blood from the PV of the lobe containing the tumor, and BM aspirates from the rib. A microfabricated filter was used for CTC enrichment, and immunofluorescence staining was used to identify CTCs. Results: The pathologic stage was stage I in 8 patients (20%), II in 15 (38%), III in 14 (35%), and IV in 3 (8%). The median number of PB-, PV-, and BM-CTCs was 4, 4, and 5, respectively. A time-dependent receiver operating characteristic curve analysis showed that PB-CTCs had excellent predictive value for recurrence-free survival (RFS), with the highest area under the curve at each time point (first, second, and third quartiles of RFS). In a multivariate Cox proportional hazard regression model, PB-CTCs were an independent risk factor for recurrence (hazard ratio, 10.580; 95% confidence interval, 1.637-68.388; p<0.013). Conclusion: The presence of ≥4 PB-CTCs was an independent poor prognostic factor for RFS, and PV-CTCs and PB-CTCs had a positive linear correlation in patients with recurrence.

The Clinicopathological Factors That Determine a Local Recurrence of Rectal Cancers That Have Been Treated with Surgery and Chemoradiotherapy (직장암의 수술 후 방사선 치료 시 국소 재발의 임상 병리적 예후 인자)

  • Choi, Chul-Won;Kim, Min-Suk;Lee, Seung-Sook;Yoo, Seong-Yul;Cho, Chul-Koo;Yang, Kwang-Mo;Yoo, Hyung-Jun;Seo, Young-Seok;Hwang, Dae-Yong;Moon, Sun-Mi;Kim, Mi-Sook
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.255-262
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    • 2006
  • $\underline{Purpose}$: To evaluate the pathological prognostic factors related to local recurrence after radical surgery and adjuvant radiation therapy in advanced rectal cancer. $\underline{Materials\;and\;Methods}$: Fifty-four patients with advanced rectal cancer who were treated with radical surgery followed by adjuvant radiotherapy and chemotherapy between February 1993 and December 2001 were enrolled in this study. Among these patients, 14 patients experienced local recurrence. Tissue specimens of the patients were obtained to determine pathologic parameters such as histological grade, depth of invasion, venous invasion, lymphatic invasion, neural invasion and immunohistopathological analysis for expression of p53, Ki-67, c-erb, ezrin, c-met, phosphorylated S6 kinase, S100A4, and HIF-1 alpha. The correlation of these parameters with the tumor response to radiotherapy was statistically analyzed using the chi-square test, multivariate analysis, and the hierarchical clustering method. $\underline{Results}$: In univariate analysis, the histological tumor grade, venous invasion, invasion depth of the tumor and the over expression of c-met and HIF-1 alpha were accompanied with radioresistance that was found to be statistically significant. In multivariate analysis, venous invasion, invasion depth of tumor and over expression of c-met were also accompanied with radioresistance that was found to be statistically significant. By analysis with hierarchical clustering, the invasion depth of the tumor, and the over expression of c-met and HIF-1 alpha were factors found to be related to local recurrence. Whereas 71.4% of patients with local recurrence had 2 or more these factors, only 27.5% of patients without local recurrence had 2 or more of these factors. $\underline{Conclusion}$: In advanced rectal cancer patients treated by radical surgery and adjuvant chemo-radiation therapy, the poor prognostic factors found to be related to local recurrence were HIF-1 alpha positive, c-met positive, and an invasion depth more than 5.5 mm. A prospective study is necessary to confirm whether these factors would be useful clinical parameters to measure and predict a radio-resistance group of patients.

Is Surgical Staging Necessary for Patients with Low-risk Endometrial Cancer? A Retrospective Clinical Analysis

  • Kokcu, Arif;Kurtoglu, Emel;Celik, Handan;Kefeli, Mehmet;Tosun, Migraci;Onal, Mesut
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5331-5335
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    • 2015
  • Purpose: The aim of this study was to compare the tumor-free and overall survival rates between patients with low-risk endometrial cancer who underwent surgical staging and those who did not undergo surgical staging. Materials and Methods: Data, including demographic characteristics, grade of the tumor, myometrial invasion, cervical involvement, peritoneal washing, lymph node involvement, lymphovascular space invasion, postoperative complication, adjuvant treatment, cancer recurrence, and tumor-free and overall survival rates, for patients with low-risk endometrioid endometrial cancer who were treated surgically with and without pelvic and paraaortic lymph node dissection (LND) were analyzed retrospectively. The patients diagnosed with endometrioid endometrial cancer including the following criteria were considered low-risk: 1) a grade 1 (G1) or grade 2 (G2) endometrioid histology; 2) myometrial invasion of <50% upon magnetic resonance imaging (MRI); 3) no stromal glandular or stromal invasion upon MRI; and 4) no evidence of intra-abdominal metastasis. Then the patients at low-risk were divided into two groups; group 1 (n=117): patients treated surgically with pelvic and paraaortic LND and group 2 (n=170): patients treated surgically without pelvic and paraaortic LND. Results: There was no statistical significance when the groups were compared in terms of lymphovascular space invasion, cervical involvement, positive cytology, and recurrence, whereas the administration of an adjuvant therapy was higher in group 2 (p<0.005). The number of patients with positive pelvic nodes and the number of metastatic pelvic nodes were significantly higher in the group with positive LVI than in the group without LVI (p<0.005). No statistically significant differences were detected between the groups in terms of tumor-free survival (p=0.981) and overall survival (p=0.166). Conclusions: Total hysterectomy with bilateral salpingo-oophorectomy and stage-adapted postoperative adjuvant therapy without pelvic and/or paraaortic lymphadenectomy may be safe and efficient treatments for low-risk endometrial cancer.