ABSTRACT
Purpose@#Intrahepatic cholangiocarcinoma (ICC) has various characteristics according to anatomical, histologic classifications, and its prognoses are different. This study aimed to compare oncologic outcomes according to tumor location (second bile duct confluence) and evaluate the effect of adjuvant chemotherapy. @*Methods@#Clinical data of 318 patients who underwent curative resection for ICC was reviewed. Central type ICC (C-ICC) and peripheral type ICC (P-ICC) were defined when the tumor invades the intrahepatic secondary biliary confluence and when located more peripherally, respectively. @*Results@#A larger tumor size, higher rate of elevated CA 19-9 level, vascular invasion, R1 resection, advanced T stage, and lymph node metastasis were found in C-ICC. C-ICC had poorer overall survival (median, 33 months vs. 58 months; P = 0.001), and the difference was more prominent in the early stage. C-ICC had a higher recurrence rate (68.7% vs. 55.1%, P = 0.014); otherwise, there was no difference in the recurrence patterns. There were no survival benefits of adjuvant chemotherapy in the entire cohort, but there were benefits in advanced stages (T3–4, N1 stage), especially in C-ICC. @*Conclusion@#C-ICC has more aggressive tumor characteristics and poor survival compared to P-ICC. Adjuvant chemotherapy seems to have survival benefits in the advanced stages, especially in the central type.
ABSTRACT
OBJECTIVE: This study was performed to evaluate the overall survival and the change in treatment modalities in patients with uterine endometrial cancer in Korea. METHODS: From January 1990 to March 2005, medical records of 740 patients with endometrial cancer in nine hospitals were reviewed. The overall survival was determined supported by the death statistics of Korea National Statistical Office. RESULTS: The mean age of patients was 51.5 years (range: 21-82 years). The mean gravidity and parity were 3.3 and 2.1 (range: 0-18, 0-9), respectively. The most common stage, grade and histological type at diagnosis were FIGO stage I, grade 1 and endometrioid adenocarcinoma (76.5%, 56.4% and 87.2%), respectively. The main treatment modalities was surgery on stage I (59.8%), surgery-adjuvant radiotherapy on stage II (55.1%), surgery-adjuvant radiotherapy or surgery-adjuvant chemoradiation on stage III (38.3%) and surgery-adjuvant chemotherapy on stage IV (55.6%). The preferred treatment modality was surgery only on grade 1 (69.0%) and surgery-adjuvant radiotherapy on grade 2-3 (43.4% and 53.2%). Surgery had been the most common method of therapy before 1998 but its prevalence gradually decreased. As a result, surgery-adjuvant radiotherapy and surgery-adjuvant chemotherapy were most widely performed in 2004-2005 and surgery-adjuvant chemoradiation also increased more than a twofold. The overall 5 years survival rate (5YSR) for all 740 patients was 81.3%. The overall 5YSR of stage I was 89.0%. The overall 5YSR of grade 1, grade 2, grade 3 were 96.0%, 92.0%, 80.0%. Before 1998, the survival rate was 77.0%. Since then it increased to 83-88% and in 2000-2001 it increased to 88.0%, and it was the highest survival rate. CONCLUSION: The survival rate of endometrial cancer has been improving for the past 15 years and the method of treatment is also being changed currently. In order to improve the survival rate of endometrial cancer, a close investigation including genetic and environmental factors of the pathophysiology of endometrial cancer along with the epidemiology of risk factors, should be carried out.
Subject(s)
Female , Humans , Carcinoma, Endometrioid , Diagnosis , Drug Therapy , Endometrial Neoplasms , Epidemiology , Gravidity , Korea , Medical Records , Parity , Prevalence , Radiotherapy , Risk Factors , Survival RateABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the role of HPV16 E6 protein on the expressions of MMP 2 and 9, major proteins associated with tumor invasion and metastasis, in human embryo skin fibroblast cell. METHODS: HPV16 E6 ORF was obtained by PCR from CaSki cell genomic DNA and was cloned into mammalian expression vector, pTARGET. Negative control vector was constructed with self ligated pTARGET. After confirmation of plasmid with color selection and restriction enzyme digestion, pTARGET-E6 and negative control vector were transfected into Detroit 551. On post-transfection third day, supernatant of both transfected cell were harvested and quantitative analysis was carried out with bradford method. Zymographic analyses were run in parallel. Areas of gelatinolytic activity were detected as clear bands on blue background and analyzed with computerized program. RESULTS: Zymogram followed by densitometric analysis was revealed the increased expression of MMP 2 zymogen (72 kDa) and active form (67 kDa) by 10.5% and 36.3%, respectively. On the contrary, MMP 9 expression was decreased by 0.21% on densitometric analysis. CONCLUSION: HPV16 E6 protein has influenced on MMP 2 over-expression.
Subject(s)
Animals , Humans , Carcinogenesis , Clone Cells , Digestion , DNA , Ecthyma, Contagious , Embryonic Structures , Fibroblasts , Matrix Metalloproteinase 2 , Neoplasm Metastasis , Plasmids , Polymerase Chain Reaction , SkinABSTRACT
OBJECTIVE: The aim of this study was to determine clinical significance of weight difference in twin pregnancies. METHODS: The medical records of 157 sets of twin pregnancies delivered between 1992 and 2001 were reviewed retrospectively. Birth weight differences were stratified 3 categries; 15% or less, 16-30%, 31%, or more. x2 stastics and ANOVA was used. RESULTS: The degree of difference correlated strongly with risk for SGA, RDS, Sepsis, Length of hospital stay, congenital anomaly, perinatal mortality but there were no increment in PDA and preterm delivery. There were no differences in outcomes for the smaller compared with larger twin of the twin pair. Maternal complications such as preeclampsia was increased in weight discordant twin. CONCLUSION: Twin birth weight difference was closely related to adverse perinatal outcome. In severe intrapair weight difference (31% or more), all cases showed fetal death, which means physicians need to consider pregnancy termination. Birth weight discordance was a very complex problem. In the management of discordant twin, more frequent antenatal care and closer observation was recommended.
Subject(s)
Humans , Pregnancy , Birth Weight , Fetal Death , Length of Stay , Medical Records , Parturition , Perinatal Mortality , Pre-Eclampsia , Pregnancy, Twin , Retrospective Studies , SepsisABSTRACT
The prevalence of Epstein-Barr virus(EBV) in the uterine cervix was investigated to define the possible etiologic role in cervical carcinogenesis. The viral genotyping and LMP-1 30bp deletion were also studied. The materials included 169 uterine cervical swabs(152 within normal limits, 12 atypical squamous cells of uncertain significance, 3 low grade intraepithelial lesions, and 2 high grade squamous intraepithelial lesion) and 104 uterine cervical tissues obtained from hysterectomy specimens(32 carcinoma in situ, 9 microinvasive squamous cell carcinomas, 37 invasive squamous cell carcinomas, 7 adenocarcinomas, 7 adenosquamous carcinomas, and 12 cervicitis). EBV detected by PCR for EBNA-1 was positive in 52(56.5%) of 92 invasive and noninvasive cervical carcinomas, and 80(48.8%) of 164 inflammatory or normal cervices. The viruses detected in carcinomas were all type A, and LMP-1 30bp deletion form was more frequent in premalignant and malignant cervical lesions than in nonneoplastic cervices. From the above results, it may be concluded that EBV is one of common viruses detected in uterine cervix of Korean women, and type A virus and LMP-1 30bp deletion form may have a role in cervical carcinogenesis.
Subject(s)
Female , Humans , Adenocarcinoma , Carcinogenesis , Carcinoma in Situ , Carcinoma, Adenosquamous , Carcinoma, Squamous Cell , Cervix Uteri , Genotype , Herpesvirus 4, Human , Hysterectomy , Polymerase Chain Reaction , PrevalenceABSTRACT
Cancer results from mutations that disrupt the harmonious checks and balances that regulate normal cellular growth and development. These mutations arise in two classes of interacting genes:those that facilitate cell growth and tumor formation(oncogenes), in which mutation or overexpression is oncogenic, and those that inhibit these processes(tumor supp-ressor genes) whose loss is oncogenic. The human retinoblastoma(Rb) protein, a tumor suppressor, acts as transcription factor or/and cell cycle regulator. Heterogenous expression of the Rb gene product contributes to the genesis of a diverse group of human neoplasma such as breast, prostate, small cell lu- ng, bladder carcinoma and leukemia. Its structural aberrations were observed in 25% of br- east tumor cell lines studied and 7% of the primary tumors, such as homozygous internal deletions and total deletion. These observations suggest that Rb protein is involved in bre- ast cancer development. Here we report that Rb protein represses steroid receptor function and its involvement of cell cycle process in human breast cancer cell line, MCF7 cells. 1. The overexpression of Rb protein repressed the steroid receptor function in breast cancer cell line, MCF 7. 2. When we introduced the mutant type Rb expression vector(deletion of exon 22), such repression was not observed. 3. By introducing E2F expression vector, the action of Rb protein was repressed. 4. Rb protein modulated the binding patterns of proteins to Kil-GRE site. 5. Flow cytometry analysis showed that Rb protein acts on G0/G1 stage of cell cycle process. These findings provide the molecular basis of breast cancer therapy using Rb protein.