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대한부인종양학회> Journal of Gynecologic Oncology (JGO)> 인간 자궁경부암조직에서 세포주기 조절단백 G1 Cyclins의 발현이 임상적 예후인자에 미치는 영향

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인간 자궁경부암조직에서 세포주기 조절단백 G1 Cyclins의 발현이 임상적 예후인자에 미치는 영향

Effect of Gl Cyclins Expression on Clinical Prognostic Parameters in Cervical Carcinoma

김영태(Young Tae Kim) , 최병훈(Byung Hoon Choe) , 김재욱(Jae Wook Kim) , 고재흥(Jae Hoong Ko) , 최은경(Eun Kyoung Choi)
  • : 대한부인종양학회
  • : Journal of Gynecologic Oncology (JGO) 10권3호
  • : 연속간행물
  • : 1999년 09월
  • : 233-241(9pages)
Journal of Gynecologic Oncology (JGO)

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Alterations in the expression of genes that control the cell cycle may be of critical importance in tumorigenesis and malignant transformation. The major regulatory events leading to cell proliferation occur in Gl phase of cell cycle, and the deregulated expression of Gl cyclins is related to oncogenesis. Cyclins Dl and E play important roles in the progression of cell through Gl phase of the cell cycle. Amplification and/or overexpression of the cyclin Dl gene and aberrant expression of cyclin E has been described in various forms of human cancer. However, the role of cyclins Dl and E in cervical cancer has been poorly defined. In this study, we examined the expression of cyclins Dl and E by Northern blot technique and the status of human papil- lomavirus(HPV) type 16 and 18 by polymerase chain reaction in 25 cases of cervical carcinoma to explore the relationship between cyclins Dl and E and cervical cancer. We found cyclin Dl expression showed down-regulated expression in cervical cancer but cyclin E expression was increased in cancer group. Other clinicopathological prognostic factors were not correlated with cyclins D1 and E expression. Further study based on larger numbers of cases with correlation of cyclins D1 and E status and survival data will be needed to elucidate the use of cyclin expressions as prognostic factor. 


UCI(KEPA)

I410-ECN-0102-2009-510-005410243

간행물정보

  • : 의약학분야  > 산부인과학
  • : KCI등재
  • : SCOPUS
  • : 격월
  • : 2005-0380
  • : 2005-0399
  • : 학술지
  • : 연속간행물
  • : 1990-2022
  • : 1784


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1Incidence and risk factors for the development of cerebral metastasis in cervical cancer patients

저자 : Juliana De Brito Rangel , Alessandra Grasso Giglio , Cristiane Lemos Cardozo , Anke Bergmann , Luiz Claudio Santos Thuler

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-11 (11 pages)

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Objective: Cerebral metastasis (CM) in cervical cancer (CC) cases, although rare, results in high lethality rates. The present study aimed to assess CM incidence in a Brazilian reference CC center and evaluate the risk factors for CM development. Retrospective observational study of patients diagnosed with CC between 2010 and 2017.
Methods: Cumulative CM incidence and incidence density were evaluated. Characteristics associated to CM development risks were identified using crude (cOR) or adjusted (aOR) odds ratios.
Results: A total of 3,397 patients were included in this study. Patient age ranged from 18 to 101 years, with a mean age of 48.8±14.0. After a mean follow-up time of 3.2±2.1 years, 51 CM cases were identified, resulting in a cumulative incidence of 1.5% (95% confidence intervals [CI]=1.12-1.97) and an incidence density at the end of the 6th year of 27.4 per 1,000 women/year. Advanced clinical stage (aOR=3.15; 95% CI=1.16-8.58; p=0.025), the presence of previous lung metastasis (aOR=4.04; 95% CI=1.82-8.94; p=0.001) and the adenocarcinoma (aOR=2.90; 95% CI=1.46-5.76; p=0.002), adenosquamous carcinoma (aOR=7.33; 95% CI=2.87-18.73; p<0.001), undifferentiated carcinoma (aOR=14.37; 95% CI=3.77-54.76; p<0.001) and neuroendocrine carcinoma (aOR=21.31; 95% CI=6.65-68.37, p<0.001) histological types were associated with a higher risk for CM development. CM risk was higher in the first years of follow-up, with no cases observed after the 6th year.
Conclusion: CC patients in advanced clinical stages, displaying previous lung metastasis and non-squamous histological types are at high risk of developing CM.

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2Where is ERAS in the management of advanced ovarian cancer?: between myths and truths

저자 : Joseph J. Noh , Yoo-young Lee

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-3 (3 pages)

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3Frequency and clinical features of deficient mismatch repair in ovarian clear cell andendometrioid carcinoma

저자 : Tamaki Tanaka , Kazuhiro Takehara , Natsumi Yamashita , Mika Okazawa-sakai , Kazuya Kuraoka , Kenichi Taguchi , Katsushige Yamashiro , Hidenori Kato , Tomoya Mizunoe , Rie Suzuki , Dan Yamamoto , Arisa Ueki ,

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-13 (13 pages)

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Objective: To clarify the frequency of deficient mismatch repair (dMMR) in Japanese ovarian cancer patients, we examined microsatellite instability (MSI) status and immunohistochemistry (IHC) subtypes, including endometrioid carcinoma (EMC), clear cell carcinoma (CCC), or a mixture of both (Mix).
Methods: We registered 390 patients who were diagnosed with EMC/CCC/Mix between 2006 and 2015 and treated at seven participating facilities. For 339 patients confirmed eligible by the Central Pathological Review Board, MSI, IHC, and MutL homolog 1 methylation analyses were conducted. The tissues of patients with Lynch syndrome (LS)-related cancer histories, such as colorectal and endometrial cancer, were also investigated.
Results: MSI-high (MSI-H) status was observed in 2/217 CCC (0.9%), 10/115 EMC (8.7%), and 1/4 Mix (25%). Additionally, loss of MMR protein expression (LoE-MMR) was observed in 5/219 (2.3%), 16/115 (14.0%), and 1/4 (25%) patients with CCC, EMC, and Mix, respectively. Both MSI-H and LoE-MMR were found significantly more often in EMC (p<0.001). The median (range) ages of patients with MMR expression and LoE-MMR were 54 (30-90) and 46 (22-76) (p=0.002), respectively. In the multivariate analysis, advanced stage and histological type were identified as prognostic factors.
Conclusion: The dMMR rate for EMC/CCC was similar to that reported in Western countries. In Japan, it is assumed that the dMMR frequency is higher because of the increased proportion of CCC.

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4The added value of SLN mapping with indocyanine green in low- and intermediate-risk endometrial cancer management: a systematic review and meta-analysis

저자 : Lara C. Burg , Shenna Verheijen , Ruud L. M. Bekkers , Joanna Inthout , Robert W. Holloway , Salih Taskin , Sarah E. Ferguson , Yu Xue , Antonino Ditto , Glauco Baiocchi , Andrea Papadia , Giorgio Bogani ,

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-14 (14 pages)

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Objective: The aim of this study was to assess the SLN detection rate in presumed early stage, low- and intermediate-risk endometrial cancers, the incidence of SLN metastases, and the negative predictive value of SLN mapping performed with indocyanine green (ICG).
Methods: A systematic review with meta-analyses was conducted. Study inclusion criteria were A) low- and intermediate-risk endometrial cancer, B) the use of ICG per cervical injection; C) a minimum of twenty included patients per study. To assess the negative predictive value of SLN mapping, D) a subsequent lymphadenectomy was an additional inclusion criterion.
Results: Fourteen studies were selected, involving 2,117 patients. The overall and bilateral SLN detection rates were 95.6% (95% confidence interval [CI]=92.4%-97.9%) and 76.5% (95% CI=68.1%-84.0%), respectively. The incidence of SLN metastases was 9.6% (95% CI=5.1%-15.2%) in patients with grade 1-2 endometrial cancer and 11.8% (95% CI=8.1%-16.1%) in patients with grade 1-3 endometrial cancer. The negative predictive value of SLN mapping was 100% (95% CI=98.8%-100%) in studies that included grade 1-2 endometrial cancer and 99.2% (95% CI=97.9%-99.9%) in studies that also included grade 3.
Conclusion: SLN mapping with ICG is feasible with a high detection rate and negative predictive value in low- and intermediate-risk endometrial cancers. Given the incidence of SLN metastases is approximately 10% in those patients, SLN mapping may lead to stage shifting with potential therapeutic consequences. Given the high negative predictive value with SLN mapping, routine lymphadenectomy should be omitted in low- and intermediaterisk endometrial cancer.

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5Evaluation of perioperative management of advanced ovarian (tubal/peritoneal) cancer patients: a survey from MITO-MaNGO Groups

저자 : Stefano Greggi , Francesca Falcone , Giovanni D. Aletti , Marco Cascella , Francesca Bifulco , Nicoletta Colombo , Sandro Pignata

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-15 (15 pages)

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Objective: The European Society of Gynaecological Oncology (ESGO)-quality indicators (QIs) for advanced ovarian cancer (AOC) have been assessed only by few Italian centers, and data are not available on the proportion of centers reaching the score considered for a satisfactory surgical management. There is great consensus that the Enhanced Recovery After Surgery (ERAS) approach is beneficial, but there is paucity of data concerning its application in AOC. This survey was aimed at gathering detailed information on perioperative management of AOC patients within MITO-MaNGO Groups.
Methods: A 66-item questionnaire, covering ESGO-QIs for AOC and ERAS items, was sent to MITO/MaNGO centers reporting to operate >20 AOC/year.
Results: Thirty/34 questionnaires were analyzed. The median ESGO-QIs score was 31.5, with 50% of centers resulting with a score ≥32 which provides satisfactory surgical management. The rates of concordance with ERAS guidelines were 46.6%, 74.1%, and 60.7%, respectively, for pre-operative, intra-operative, and post-operative items. The proportion of overall agreement was 61.3%, and with strong recommendations was 63.1%. Pre-operative diet, fasting/bowel preparation, correction of anaemia, post-operative feeding and early mobilization were the most controversial. A significant positive correlation was found between ESGO-QIs score and adherence to ERAS recommendations.
Conclusion: This survey reveals a satisfactory surgical management in only half of the centers, and an at least sufficient adherence to ERAS recommendations. Higher the ESGO-QIs score stronger the adherence to ERAS recommendations, underlining the correlations between case volume, appropriate peri-operative management and quality of surgery. The present study is a first step to build a structured platform for harmonization within MITO-MaNGO networks.

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6Cervical cancer patient reported gastrointestinal outcomes: intensity/volumetric modulated vs. 3D conformal radiation therapy

저자 : Ryan Urban , Justin Wong , Peter Lim , Susan Zhang , Ingrid Spadinger , Robert Olson , Francois Bachand , Clement Ho , Anna V. Tinker , Lovedeep Gondara , Sarah Nicole Hamilton

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-15 (15 pages)

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Objective: To evaluate gastrointestinal (GI) patient reported outcomes (PROs) in cervical cancer patients treated with definitive radiotherapy (RT), comparing 3D conformal RT (3DCRT) vs. intensity modulated/volumetric modulated arc therapy (IMRT/VMAT).
Methods: An analysis of patients treated with definitive RT between 2015-2018 was performed. GI PROs were prospectively collected at baseline, during RT (acute), ≤12 weeks after RT (subacute), and >12 weeks after RT (late). GI PROs evaluated three symptom domains: bowel problems (BPs), bowel bother (BB), and abdominal problems (APs). Multiple linear regression analysis was performed to investigate associations between mean changes of symptom scores with clinical and dosimetric variables.
Results: The cohort included 167 patients. A total of 100 (60%) patients were treated with IMRT/VMAT and 67 (40%) with 3DCRT. In the subacute phase, the mean change of symptom scores from baseline in 3DCRT vs. IMRT/VMAT were +0.9 vs. -1.15 (p=0.004) for BP, +2.18 vs. -0.10 (p=0.019) for BB, and +1.41 vs. -0.38 (p=0.021) for AP. Likewise, in the late phase, mean changes were +0.72 vs. -0.82 (p=0.014) for BP, +1.98 vs. -0.03 (p=0.008) for BB, and +1.29 vs. -0.31 (p<0.001) for AP. On multiple linear regression, use of 3DCRT vs. IMRT/VMAT was associated with greater mean changes in subacute BP (p=0.023) and late phase AP (p=0.019). A higher small bowel V50Gy was associated increased symptom scores in late AP (p=0.012).
Conclusion: 3DCRT was associated with significantly greater worsening of GI PRO symptom scores in the subacute and late phase. These data support the ongoing use of IMRT/VMAT in routine practice.

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7Prognostic factors of dose-response relationship for nodal control in metastatic lymph nodes of cervical cancer patients undergoing definitive radiotherapy with concurrent chemotherapy

저자 : Won Hee Lee , Gwi Eon Kim , Yong Bae Kim

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-13 (13 pages)

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Objective: Regional control is occasionally unsatisfactory in cervical cancer, with the optimal radiation dose for nodal metastases in definitive radiotherapy (RT) with concurrent chemotherapy (CRT) remaining controversial. We investigated dose-response relationship for nodal local control in cervical cancer.
Methods: We identified 115 patients with 417 metastatic nodes who received definitive CRT for cervical cancer with nodal metastases. External beam radiation therapy and brachytherapy plans were summated to determine total dose received by each node. Prognostic factors of nodal control and dose-response relationship were investigated using Cox-regression and restricted cubic spline function.
Results: The 2-year progression-free survival rate was 69.4%. Among 43 patients with failures, 17 patients (37.5%) had regional failure included in first failure sites of which all except one were in-field only regional failures. Total 30 nodes showed recurrence at initial metastatic site after treatment. Neutrophil-to-lymphocyte ratio (NLR) ≥3.1, total radiation dose (minimum dose received by 98% of the target volume in equivalent dose in 2 Gy per fractions), and initial nodal volume ≥5.29 mL were poor prognostic factors (all p<0.050) of nodal local control. Restricted cubic spline functions revealed strongest dose-response relationship in high NLR (NLR ≥3.1) and initial nodal volume ≥5.29 mL subgroup.
Conclusion: Initial nodal volume, radiation dose, and NLR were significant factors of nodal local control in cervical cancer; a stronger dose-response relationship was seen in bulky nodes with high NLR. Clinicians may consider these factors when determining the RT dose and the need for boost to nodal metastases in cervical cancer.

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8Systematic lymph node dissection during interval debulking surgery for advanced epithelial ovarian cancer: a systematic review and meta-analysis

저자 : Giuseppe Caruso , Innocenza Palaia , Giorgio Bogani , Federica Tomao , Giorgia Perniola , Pierluigi Benedetti Panici , Ludovico Muzii , Violante Di Donato

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-19 (19 pages)

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Objective: To evaluate the efficacy and safety of systematic lymph node dissection (SyLND) at the time of interval debulking surgery (IDS) for advanced epithelial ovarian cancer (AEOC).
Methods: Systematic literature review of studies including AEOC patients undergoing SyLND versus selective lymph node dissection (SeLND) or no lymph node dissection (NoLND) after neoadjuvant chemotherapy (NACT). Primary endpoints included progression-free survival (PFS) and overall survival (OS). Secondary endpoints included severe postoperative complications, lymphocele, lymphedema, blood loss, blood transfusions, operative time, and hospital stay.
Results: Nine retrospective studies met the eligibility criteria, involving a total of 1,660 patients: 827 (49.8%) SyLND, 490 (29.5%) SeLND, and 343 (20.7%) NoLND. The pooled estimated hazard ratios (HR) for PFS and OS were, respectively, 0.88 (95% confidence interval [CI]=0.65-1.20; p=0.43) and 0.80 (95% CI=0.50-1.30; p=0.37). The pooled estimated odds ratios (ORs) for severe postoperative complications, lymphocele, lymphedema, and blood transfusions were, respectively, 1.83 (95% CI=1.19-2.82; p=0.006), 3.38 (95% CI=1.71-6.70; p<0.001), 7.23 (95% CI=3.40-15.36; p<0.0001), and 1.22 (95% CI=0.50-2.96; p=0.67).
Conclusion: Despite the heterogeneity in the study designs, SyLND after NACT failed to demonstrate a significant improvement in PFS and OS and resulted in a higher risk of severe postoperative complications.

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9Rotational intraperitoneal pressurized aerosol chemotherapy with paclitaxel and cisplatin: pharmacokinetics, tissue concentrations, and toxicities in a pig model

저자 : Soo Jin Park , Eun Ji Lee , Aeran Seol , Sunwoo Park , Jiyeon Ham , Ga Won Yim , Seung-hyuk Shim , Whasun Lim , Suk-joon Chang , Gwonhwa Song , Ji Won Park , Hee Seung Kim

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-12 (12 pages)

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Objective: We used paclitaxel and cisplatin, known to be effective in intraperitoneal chemotherapy, in a novel prototype of rotational intraperitoneal pressurized aerosol chemotherapy (RIPAC) and evaluated the pharmacokinetics, tissue concentrations, and toxicities in a pig model.
Methods: We developed RIPAC, including the nozzle with the conical pendulum motion, and used 10% of intravenous doses of paclitaxel and cisplatin. We used high-performance liquid chromatography followed by tandem mass spectrometry to analyze serum and tissue concentrations. We applied a non-compartment model to study pharmacokinetics to analyze the time-dependent serum concentrations measured before RIPAC to 48 hours. We evaluated the difference in tissue concentrations between twelve peritoneal regions by the modified peritoneal cancer index. For evaluating toxicities, we observed hepatic and renal function until 4 days after RIPAC.
Results: Six pigs underwent RIPAC using paclitaxel (n=3) and cisplatin (n=3). The peak serum concentration (Cmax) and the area under the curve were higher for cisplatin, while the time to the peak serum concentration (Tmax) was longer for paclitaxel. Moreover, the parietal peritoneum showed higher tissue concentrations than the visceral peritoneum, and the ratio of tissue to serum concentrations using Cmax was higher for paclitaxel (172.2-6,237.9) than for cisplatin (0.1-9.3). However, there were no renal and hepatic toxicities after RIPAC with paclitaxel or cisplatin.
Conclusion: Delayed absorption of paclitaxel sprayed by RIPAC into the peritoneum to the bloodstream may lead to higher tissue concentrations at different regions and lower serum concentrations than cisplatin.

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10Peritoneal dissemination of high-grade serous ovarian cancer: pivotal roles of chromosomal instability and epigenetic dynamics

저자 : Ikuo Konishi , Kaoru Abiko , Takuma Hayashi , Koji Yamanoi , Ryusuke Murakami , Ken Yamaguchi , Junzo Hamanishi , Tsukasa Baba , Noriomi Matsumura , Masaki Mandai

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 33권 5호 발행 연도 : 2022 페이지 : pp. 1-17 (17 pages)

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Epithelial ovarian cancer remains the lethal gynecological malignancy in women. The representative histotype is high-grade serous carcinoma (HGSC), and most patients with HGSC present at advanced stages with peritoneal dissemination. Since the peritoneal dissemination is the most important factor for poor prognosis of the patients, complete exploration for its molecular mechanisms is mandatory. In this narrative review, being based on the clinical, pathologic, and genomic findings of HGSC, chromosomal instability and epigenetic dynamics have been discussed as the potential drivers for cancer development in the fallopian tube, acquisition of cancer stem cell (CSC)-like properties, and peritoneal metastasis of HGSC. The natural history of carcinogenesis with clonal evolution, and adaptation to microenvironment of peritoneal dissemination of HGSC should be targeted in the novel development of strategies for prevention, early detection, and precision treatment for patients with HGSC.

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KCI등재SCOUPUS

1자궁경부 상피암종에서 Fragile Histidine Triad(FHIT) 유전자 산물의 발현에 대한 면역조직화학적 연구

저자 : 이상준(Sang Joon Lee) , 김창진(Chang Jin Kim)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 217-223 (7 pages)

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To investigate the involvement of expression of the Fragile Histidine Triad(FH1T) gene product in the process of carcinogenesis and progression in cervical carcinoma, we examined its expression by immunohistochemical method in 15 cervical invasive carcinomas, 10 low grade cervical intraepithelial neoplasias(CINs) and 30 high grade CINs(CMI and III). We detected expression of FHIT gene product in 4 of 15(27%) of invasive carcinomas, 3 of 10(30%) low grade CIN and 7 of 30(23%) of high grade CIN, while we detected expression of FHIT gene product in 28 of 45(62%) normal and metaplastic epithelium near the tumor. Thesc data indicate that loss of expression of FH1T gene product has some role in the early tumorigenesis of uterine cervical carcinoma, but not the consequence of the pregression of the tumor

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2LEEP으로 치료한 자궁 경부 상피내 종양에서 고위험 인유두종 바이러스 감염 및 절제면 병변여부의 의의

저자 : 김종열(Jong Youl Kim) , 박은주(Eun Ju Park) , 이동헌(Dong Heon Lee) , 나준희(Jun Hee Na) , 이상수(Sang Soo Lee) , 이주학(Joo Hak Lee) , 김종혁(Jong Hyeok Kim) , 김용만(Yong Man Kim) , 김영탁(Young Tak Kim) , 목정은(Jung Eun Mok) , 남주현(Joo Hyun Nam)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 224-232 (9 pages)

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This study evaluated the degree and the frequency of cervical lesions after treatment with LEEP(loop electrosurgical excision procedure) in patients with abnormal Pap smears according to the presence or absence of high-risk HPV infection. From June 1994 to May 1997, eighty patients who showed CIN or chronic cervicitis on LEEP specimens were followed up with Pap smears. The histologic results and follow-up Pap smear data were analyzed. In all cases HPV test by Hybrid Capture assay was performed. Those with neoplastic lesion underwent follow-up Pap smears at least for 1 year with 3 month interval after LEEP. In HPV-positive group(N 38), 63.2% of the cases revealed neoplastic lesion(CIN) on final histologic evaluation, and in HPV-negative group(N 42) 54.8% of the cases did(p 0.26). HPV-positive group represented 25.0%(6/24) of abnormal Pap smear result on follow-up, which is higher than that of HPV-negative group(4.3%; 1/23), showing significant difference (p<0.05). There was a significant difference in the rate of neoplastic lesion developed during follow-up between resection margin-positive group and resection margin-negative group on LEEP(p 0,04). Also, HPV-positive group had significantly higher chance to show abnormal Pap smear results during follow-up(p 0.02). In conclusion, HPV test and margin status were shown to be useful parameters to predict the recurrence or persistence of CIN lesion treated by LEEP.

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3인간 자궁경부암조직에서 세포주기 조절단백 G1 Cyclins의 발현이 임상적 예후인자에 미치는 영향

저자 : 김영태(Young Tae Kim) , 최병훈(Byung Hoon Choe) , 김재욱(Jae Wook Kim) , 고재흥(Jae Hoong Ko) , 최은경(Eun Kyoung Choi)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 233-241 (9 pages)

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Alterations in the expression of genes that control the cell cycle may be of critical importance in tumorigenesis and malignant transformation. The major regulatory events leading to cell proliferation occur in Gl phase of cell cycle, and the deregulated expression of Gl cyclins is related to oncogenesis. Cyclins Dl and E play important roles in the progression of cell through Gl phase of the cell cycle. Amplification and/or overexpression of the cyclin Dl gene and aberrant expression of cyclin E has been described in various forms of human cancer. However, the role of cyclins Dl and E in cervical cancer has been poorly defined. In this study, we examined the expression of cyclins Dl and E by Northern blot technique and the status of human papil- lomavirus(HPV) type 16 and 18 by polymerase chain reaction in 25 cases of cervical carcinoma to explore the relationship between cyclins Dl and E and cervical cancer. We found cyclin Dl expression showed down-regulated expression in cervical cancer but cyclin E expression was increased in cancer group. Other clinicopathological prognostic factors were not correlated with cyclins D1 and E expression. Further study based on larger numbers of cases with correlation of cyclins D1 and E status and survival data will be needed to elucidate the use of cyclin expressions as prognostic factor.

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4미세침윤성 자궁경부암의 임상병리학적 고찰

저자 : 박철민(Chul Min Park) , 이동영(Dong Young Lee) , 주응식(Eung Sik Ju) , 이윤순(Yoon Soon Lee) , 조영래(Young Lae Cho) , 박일수(II Soo Park)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 242-250 (9 pages)

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Microinvasive carcinoma of the uterine cervix(Stage Ia) is the earliest stage of squamous carcinoma. The transition from preinvasive to invasive disease is a crucial juncture in the development of cervical cancer. The clinical experience that microinvasive lesions carry a better prognosis justifies a separate diagnostic category. To investigate the clinical and pathological aspects of microinvasive cervical carcinoma, a retrospective study was made on 84 cases, histologically reconfirmed surgical specimens, which had been treated during the period from January, 1985 to December, 1996 at Department of Obstetrics and Gynecology, Kyung-pook National University Hospital. We defined microinvasive carcinoma as stromal invasion not exceeding a depth of Smm from the base of the epithelium presented by FIGO in 1985. The results obtained were as follows; 1. Mean age of 84 patients was 46.9 year old, all were parous women but not 1 patients. 60 cases(71.4%) belonged to stage Ial and 24 cases(28,6%) to stage Ia2. 2. Chief complaints were postcoital spotting and leukorrhea. 3, The corresponding rate of Pap. smear to histologic diagnosis was approximately 29.8%. However correponding rate within one histologic grade was about 33,3%. 4. According to the colposcopic examination, 26.4% of cases revealed suspected abnormal findings suggesting invasive lesion. 5. As to the reports of punch biopsy, 55.1% of cases showed microinvasive and/or invasive lesion. With additional diagnostic conization of cervix, the preoperative diagnosis were correct in 72%. 6. Operation performed were simple hysterectomy, extrafascial hysterectomy or modified radical hysterectomy with both pelvic LN dissection, Simple hysterectomy was most commonly performed. 7. Post-treatment complications were developed in 73.9% of patients who were done with modified radical hysterectomy with both pelvic LN dissection and bladder dysfunction was developed in 50% of the patients.

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5자궁경부암 환자에서 근치적 자궁적출술 및 골반림프절 절제술후 배액술 유무에 따른임상적 고찰

저자 : 정진(Jin Jeong) , 김경훈(Kung Hun Kim) , 최호선(Ho Sun Choi)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 251-257 (7 pages)

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Objectives: This study was to determine whether drainage after radical hysterectomy and bilateral pelvic lymphadenectomy can reduce the risk of postoperative morbidity as compared with no drainage. Methods: 165 patients with stage Ia2 to Ilb underwent radical hysterectomy and bilateral pelvic lymphadenectomy between January 1995 and May 1997, and those medical records were analyzed, Closed suction drains were placed in group I (n 102), not in group II (n 67). All surgeries were perforrned by the same surgeon in a uniform method. Results: The characteristics of two groups were similar for mean age, preoperative weight, total protein, serum albumin, tumor cell histology, invasion depth, and tumor stage. There was no difference in mean operation time in two groups. But mean estimated blood loss was more in group I than group lI(p<0.05), Postoperative ileus and postoperative stay was similar in both groups. The incidence of pelvic lymphocyst and febrile morbidity in two groups were comparable with 17% in group I and 27% in poup II, but not statistically significant(p>0.05). Rehospitalization rate was higher in group I than in group II. Condusion: Pelvic drainage didn't reduce the postoperative febrile morbidity and lymphocyst formation. Therefore the author could not find any necessity to perform the drainage following radical hysterectomy and pelvic lymphadenectomy,

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6자궁경부암 환자의 혈중 ICAM-1(Intercelluar Adhesion Molecule-1) 농도에 관한 연구

저자 : 김용민(Yong Min Kim) , 조윤정(Yoon Jung Cho) , 이규완(Kyu Wan Lee)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 258-263 (6 pages)

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ICAM-l(Intercellular adhesion molecule-1) is an important early marker of immune activation and response. ICAM-1 is expressed on varous cell types and observed in a variety of diseases, including patients with asthma, melanoma, prostatic cancer, ovarian and colon cancer. Some authors demonstrated the expression of ICAM-1 protein in high-grade intraepithelial squamous neoplasia of cervix by immunohistochemistry and suggested that the expression was related to human papillomavirus infection. The aim of this study was to determine the serum levels of soluble intercellular adhesion molecule-1(sICAM-1) in patients with squamous cell carcinoma of the cervix, Serum levels of sICAM-1 were measured by enzyme-linked immunosorbent assay(ELISA), We evaluate invasive squamous cell carcinoma of the cervix (40), carcinoma in situ (16) and control (15) patients. Serum levels of sICAM-1 in healthy volunteers, in parients with carcinoma in situ and invasive cervical cancer were 150.1±41.3, 182.7±105.9, 189.8±60.0 ng/ml, respectively. Although the serum levels of sICAM-1 in patients with carcinoma in situ did not increase, serum levels of ICAM-1 in patients with invasive cervical cancer were significantly increased (control vs invasive cervical cancer, p < 0,05). From the above results, sICAM-1 is shed from the cancerous tissue in patients with squamous cell carcinoma of the cervix.

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7초음파를 이용한 형태학적 점수화 체제와 혈류학적 특징에 따른 부속기 종양의 진단 예측

저자 : 이정한(Jung Han Lee) , 조삼현(Sam Hyun Cho) , 문형(Moon Hyang) , 황윤영(Youn Yeoung Hwang) , 김경태(Kyung Tal Kim) , 박지수(Ji Soo Park) , 유중배(Jung Bae Yoo)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 264-271 (8 pages)

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Objectr. The purpose of this study was to evaluate the relative usefulness of the morphologic scoring system and spectral doppler ultrasonographic analysis in differentiating between benign and malignant adnexal masses. Methods: All patients scanned between July 1995 and June 1998 with sonographically identified and pathologically confirmed adnexal masses formed the study group. The adnexal masses were scored as benign or malignant on the basis of their sonographic appearance. Specific categories included inner wall structure, wall thickness, septal structure, and echogenicity. Women whose morphologic findings were suspicious for malignancy underwent doppler sonography. A threshold pulsatility index of 1.0 and resistance index of 0.4 were used to differentiate benign from malignant lesions. The findings were correlated with the presence of malignancy. Results: Two hundred fifty one patients formed the study group; 215 patients were benign and 36 patients were malignant pathologically. Using the morphologic scoring system, 31 of the 36 malignant masses were classified as suggestive of malignant tumor, and 147 of the 215 benign masses were classified as not suggestive of malignant tumor (sensitivity, 86%; specificity, 68%; positive predictive value, 31%; negative predictive value, 97%). Doppler velocimetry was performed on a total of 62 patients, 19 patients with malignant tumors and 43 patients with benign tumors. A mean PI value of 0.85 and RI value of 0.52 for malignant tumors and mean PI value of 2.00 and RI value of 0.75 for benign tumors was shown. The PI value was significantly lower (p 0.001) in malignant than that of in benign masses, but RI value was not significant (p 0.184). The sensitivity and specificity in the detection of malignancy combined with doppler velocimetry was 86% and 67%, respectively. Conclusion: Doppler velocimetry studies did not add substantially to the prediction of malignancy using the morphologic scoring system.

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8자궁경부암에서의 bc1-2, p53 단백의 발현

저자 : 이천준(Cheon Jun Lee) , 안은모(Eun Mo Ahn) , 여태홍(Tae Hong Yeo) , 김동휘(Dong Hwi Kim) , 박은동(Un Dong Park)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 272-550 (279 pages)

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Recently, the bcl-2 and p53 protein have been recognized as important factors that is contributed to programmed cell death. The objective of this study was to evaluate the prognostic significance of bcl-2 and p53 protein expression in uterine cervical carcinoma. The expression of bcl-2 and p53 in 59 cases of uterine cervical carcinoma (stage IB to IIB) were surgically treated from January 1993 to June 1994. The expression of bcl-2 and p53 was examined by immunohistochemical method using formalin fixed paraffin embedded tissue specimens. The 48 cases were squamous cell carcinoma and 11 cases were adenocarcinoma. The results were as follows: 1. The expression rate of bcl-2 protein was 28.8%(17/59) and there was no significant correlaltion between the expression of bcl-2 protein and the clinicopathologic parameters (histologic type, grade, FIGO stage, cervical invasion depth, lymph node metastasis, parametrial invasion, tumor size, neoadjuvant chemotherapy response, recurrence, survival). 2. The expression rate of p53 protein was 32.2%(19/59) and there was no significant correlation between expression of p53 protein and the clinicopathologic parameters. 3. There was significant correlation between and expression of bcl-2 and p53 protein (P 0.05). In conclusion, bcl-2 and p53 protein are thought to be possible factors in the carcinogenesis of uterine cervical carcinoma and correlate with progression of it. But further study will be required to clarify the role of bcl-2 and p53 in carcinogenesis of the uterine cervix.

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9Comparative Genomic Hybridization을 이용한 자궁경부암의 유전적 변이 조사

저자 : 김태진(Tae Jin Kim) , 임경택(Kyung Taek Lim) , 정환욱(Hwan Wook Jung) , 이기헌(Ki Heon Lee) , 박인서(In Sou Park) , 심재욱(Jae Uk Shim) , 박종택(Chong Tak Park) , 최수경(Soo Kyung Choi) , 김영미(Young Mi Kim) , 김진미(Jin Mi Kim) , 홍성란(Sung Ran Hong)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 280-565 (286 pages)

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Comparative Genomic Hybridization (CGH) is a recently developed molecular cytogenetic technique, which makes it possible to detect chromosomal alteration in solid tumors. To determine whether chromosome alterations are related to cervical carcinoma, we have analyzed 33 cases (24 squamous cell carcinomas and 9 adenocarcinomas, stage Ib-IIIb) from tumor tissues and paraffin embedded tissues by CGH. The cut off value of CGH profiles was 1.15 and 0.85 (green/red ratio). Chromosomal aberrations were detected in 30 out of 33 cases (90.9%). In 32 cases, chromosome 3q was most frequently affected and had greater copy numbers in 20 of tbe 33 cases (60.6%). Interestingly, out of those 20 cases, 10 cases were shown to have a high-level of amplification of chr 3q. In addition to chr 3q, chromosomal gains were observed in chr 1q, 1p, 5p, Sq, 12p, 15q, 19q, 20q, Xp, and Xq. Furthermore chromosomal loss was detected, most commonly in chromosome 11q (11/33). Although less frequent, common losses were also detected in chr 2q, 4p, 4q, Sq, 1 1p, 17p, and 18p. In addition, there were cases of gross chromosome loss for chr 4, 6, 10, 11, 13, 14, 16, 17, 18, 19, 20, 21, 22 and X. In cases involving whole arm deletion, we utilized fluorescence in situ hybridization (FISH) using specific probes a-satellite. We performed HPV typing for 16 and 18 usiag polymerase chain reaction (PCR) and Southem blot analyses. Out of 33 tumor samples, 24 cases (72,7%) were HPV 16 positive, while only 6 cases were positive for HPV 18. two cases were positive for both HPV 16 and 18. We believe that a gain of chromosome 3q as a reeurrent chromosomal aberration may contribute to the tumorigenesis of cervical cancer. However, we could not correlate a pattern of chromosomal aberration with tumor stage or histologic type in cervical cancer.

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10난소와 부난소에서 발생한 원발성 이행상피암종 4예에 대한 임상 및 병리학적 분석

저자 : 김태진(Tae Jin Kim) , 전이경(Yi Kyeong Chun) , 임경택(Kyung Taek Lim) , 정환욱(Hwan Wook Jung) , 이기헌(Ki Heon Lee) , 박인서(In Sou Park) , 박종택(Chong Tak Park) , 홍성란(Sung Ran Hong) , 고명인(Myung In Koh) , 한인수(In Su Han) , 최용관(Yong Kwan Choi) , 심재욱(Jae Uk Shim) , 김의정(Yee Jeong Kim) , 김희숙(Hy Sook Kim)

발행기관 : 대한부인종양학회 간행물 : Journal of Gynecologic Oncology (JGO) 10권 3호 발행 연도 : 1999 페이지 : pp. 287-580 (294 pages)

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Four cases of primary transitional cell carcinoma (TCC) arising in the ovary (3 cases) and the parovarium (1 case) were collected for clinicopathologic analysis. The mean age was 46.2 years (range, 39-57 years). Two patients complained abdominal discomfort and vaginal discharge, respectively. Other 2 cases were incidentally found from routine check. Grossly, the tumors were solid and cystic (2 cases), solid (1 case) and surface papillary growth on capsule (1 case). Microscopically, the tumor showed almostly same to the histologic features of TCC of urinary bladder. Three cases were pure TCC, and one was mixed TCC and serous carcinoma. FIGO stage were 1 IIa, 2 IIc, and 1 IIIc. Treatment was surgery with adjuvant chemotherapy. Two patients are alive with no evidence of disease, and two have lung or brain metastasis.

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