Transoral CO2 Laser Surgery of Supraglottic Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Endoscopic supraglottic laryngectomy by CO2 laser for selected T1-T3 supraglottic cancer results in improved postoperative function and decreased morbidity, with comparable survival to open surgery. The aim of this study was to retrospectively evaluate oncologic and functional outcomes after transoral CO2 laser surgery for supraglottic cancers. SUBJECTS AND METHOD: Nineteen patients (Fresh group:13 patients, Radiotherapy failure group:6 patients) who were diagnosed as supraglottic cancer and treated with CO2 laser surgery between December, 1999 and September, 2006 were evaluated. All the patients were followed-up more than 12 months. Eleven patients in the Fresh group underwent neck dissection. RESULTS: Ultimate local control rate was 100% for both Fresh group and RT failure group. Survival rates of 3-year and 5-year for the Fresh group and the RT failure group were 100% and 68.6%, and 75% and 50%, respectively. There were no significant postoperative complications. CONCLUSION: Although our experience with supraglottic cancers treated by transoral CO2 laser surgery is still too limited to confirm the definite oncologic and functional results, transoral CO2 laser surgery seems to be a safe and reasonable tool, and a time and cost-effective alternative to the traditional surgery for selected supraglottic cancers.

Construction of MAGE - 3 Expressing Plasmid for Development of DNA Vaccine Encoding MAGE - 3 Cancer Antigen / 대한암학회지

PURPOSE: The spectrum of melanoma antigen gene (MAGE)-expressing tumor is very wide and the gene of MAGE express antigens that are targets for specific recognition by cytotoxic T lymphocytes derived from tumor-bearing patients. All of these characteristics represent MAGE as tumor vaccine can be useful for cancer prevention or treatment. Here, we detected MAGE-3 gene expression in cancer cell lines and evaluated recombinant MAGE-3 protein producibility of MAGE plasmid to develope MAGE DNA vaccine. MATERIALS AND METHODS: MAGE-3 gene expression of cancer cell lines was evaluated by reverse transcription-polymerase chanin reaction (RT-PCR). Two kinds of MAGE-3 expressing plasmids were constructed and their MAGE-3 protein producibility was evaluated by immunohistochemistry and immunoblotting using monoclonal anti-MAGE-3 antibody. RESULTS: Among 13 cell lines, SNU484, AMC-HN-3, AMC-HN-4, AMC-HN-7, HeLa, NCI H1703 and HT29 expressed MAGE-3 mRNA. In order to make MAGE plasmid, cDNA that showed 100% DNA homology with MAGE-3 gene was cloned into pcDNA 3 plasmid and pSecTag plasmid. Intracytoplasmic and secretory recombinant MAGE-3 was produced by MAGE-3 containing pcDNA 3 plasmid and pSecTag plasmid, respectively. CONCLUSION: In this study, we showed high expression frequency of MAGE-3 in cancer cell line, and established two kinds of plasmid that produce recombinant MAGE-3 in cell lines. We expect these plasmids will be used in cancer treatment or MAGE-3 function study in future.

Applicability of Genes of Cancer-associated Testis Antigens in Diagnosis of Cancer / 대한면역학회지

Genes of cancer-associated testis antigens (CTAs) are expressed in various cancer tissues. In order to use CTAs as cancer diagnosis marker, we developed molecular method for detection of CTAs transcripts in tissue. In order to know the applicability of DNA of cancer-associated testis antigens (CTAs) on cancer diagnosis, molecular diagnostic methods for detection of gene expression of melanoma antigen gene (MAGE), GAGE, and B melanoma antigen (BAGE) was studied. After comparing DNA sequences of CTAs, S1/AS1 and S2/AS2, GAGE-S/ GAGE-AS, and BAGE-S/BAGE-AS primers were designed for the detection of MAGEs, GAGEs and BAGEs, respectively. The gene expression of CTAs in cancer cell lines, head and neck cancer tissues, ovary cancer tissue, and peritoneal cells of gastric cancer patients were investigated by reverse transcription-polymerase chain reaction (RT-PCR) using these primers. The MAGEs, GAGEs and BAGE genes were expressed in 8/8 (100%), 5/8 (62.5%) and 1/8 (12.5%) of head and neck cancer tissues, respectively. The gene expression of MAGEs were also detected in 8/10 (80%) of ovary cancer tissues and in 9/10 (90%) of peritoneal cells of gastric cancer patients in RT-PCR test using S1/AS1 primers. The results of this study suggest that molecular diagnosis method using CTAs genes, especially RT-PCR using S1/AS1 primer combination, is useful for diagnosis of cancer and it will be used for the prediction of cancer progression or regression and metastasis in future.

A Case of Lambert-Eaton Myasthenic Syndrome Improved after Surgical Resection for Diagnosis of Small Cell carcinoma of the Lung / 결핵

Lambert Eaton myasthenic syndrome(LEMS) is a paraneoplastic syndrome caused by defects in the secretion of acetylcholine from the presynaptic membrane of nerve terminals and is strongly associated with small cell lung carcinoma. The pathogenesis of LEMS is the destruction of voltage gated calcium channels by an autoimmune process resulting in clinical manifestations consisting of lower extremity weakness, decreased deep tendon reflexes and autonomic dysfunctions. The diagnosis can be confirmed by the characteristic clinical features and repetitive nerve stimulation. The neurological symptoms and signs of LEMS may manifest themselves months before the clinical manifestation of the underlying malignancy. Therefore early diagnosis and treatment of the primary malignancy may become possible through the diagnosis of this rare paraneoplastic syndrome. We report a case of a patient diagnosed with LEMS who upon further evaluation for an underlying malignancy was found to have a 0.2cm sized nodular and infiltrative mass lesion at the bifurcation of the left apicoposterior segmental and anterior segmental bronchi by bronchoscopy. Although repeated bronchoscopic biopsies of the lesion was not able to disclose malignancy, under strong clinical suspicion left upper lobectomy was performed and subsequently the diagnosis of small cell carcinoma of the lung was confirmed. Muscle weakness began to improve starting from a week after the surgery, then reached a plateau 2 weeks later. Muscle weakness improved further after the trial of anticancer chemotherapy.