Correlation between the Her-2/neu Status as Determined by Immunohistochemical Analysis and the Serum Her-2/neu Concentration as Determined by the Use of ADVIA Cencaur(R) Automated Immunoassay in Breast Cancer Patients / 한국유방암학회지

PURPOSE: Serum Her-2/neu is extracted from the extracelluar domain of the Her-2/neu tyrosine kinase to serum. We evaluated the correlation between the Her-2/neu status as determined by immunohistochemical analysis (IHC) and the serum Her-2/neu concentration in a population of Korean women with breast cancer. METHODS: Serum Her-2/neu levels were examined from 254 female patients with primary breast cancer and 38 patients with metastatic breast cancer. Serum Her-2/neu levels were measured by the use of a chemiluminescence immunoassay (ADVIA centaur(R) system) during the preoperative period. The level of Her-2/neu in all of the breast cancer tissue samples was determined by IHC, and samples with an IHC grade +2 were subject to fluorescence in situ (FISH). When tissue samples exhibited IHC grade +3 or showed amplification of Her-2/neu as determined by FISH analysis, Her-2/neu was considered overexpressed. The cut-off value for serum Her-2/neu level was 10.2 ng/mL. RESULTS: The mean serum Her-2/neu level was 10.1 ng/mL in primary breast cancer samples. The serum Her-2/neu concentration significantly correlated with expression of Her-2/neu as determined by tissue IHC analysis (grade 1/3, 9.33+/-1.7 ng/mL; grade 2/3, 8.89+/-1.6 ng/mL; grade 3/3, 12.37+/-4.0 ng/mL, p<0.001). Increased serum HER-2/neu levels were associated with the lymph node status (p=0.003) and hormone unresponsiveness (p<0.001), tumor size (p<0.01) and age group (p<0.001). In metastatic breast cancer samples, the mean serum Her-2/neu level was 13.6 ng/mL. Elevated serum Her-2/neu levels were seen in 71.7% of metastatic breast cancer samples. The serum Her-2/neu level correlated with expression of Her-2/neu in metastatic tissue as determined by IHC analysis (p<0.001) rather than with the Her-2/neu status of the primary breast cancer (p=0.16) CONCLUSION: Serum Her-2/neu appears to be correlate with tissue Her-2/neu expression in primary and metastatic breast cancer where Her-2/neu is overexpressed. Further studies to determine levels of serum Her-2/neu are required to determine cuttoff values and the clinical application of the finding for breast cancer patients in Korea.

Effects on Er,Cr:YSGG Laser on Peri-Implantitis

Rupture of Metastatic Omental Hepatocellular Carcinoma Following the Treatment of Ruptured HCC / 한국간담췌외과학회지

Hepatocellular carcinoma (HCC) has a tendency of rupturing, which can lead to massive hemorrhage. Although the majority of HCC ruptures occur in the liver, some reports have shown that HCC ruptures developed at various metastatic sites including the lung, pleura, rib, sternum, spleen, kidney, adrenal gland, mediastinal lymph node, peritoneum, ileum, and peripancreatic lymph node. Here, we reported a case of HBV-related HCC rupture that was treated by operation and recurred in the form of ruptured omental metastasis. A 55- year-old man, who complained of diffuse abdominal pain, was admitted to our hospital in a state of shock. Abdominal CT showed massive hemoperitoneum with a HCC of 6 cm size in diameter in the left lobe of the liver. The alphafetoprotein level was above 300 ng/ml. After transarterial chemoembolization for hemostasis, left lateral segmentectomy was performed. Resected tumor showed complete tumor necrosis. Four months later, the follow-up CT revealed an extrahepatic abdominal tumor near the transverse colon. With surgery, a ruptured tumor implanted on the great omentum near the transverse colon was found and removed along with the segmental transverse colon. The pathologic result reported that the omental tumor was a poorly differentiated hepatocellular carcinoma.

Retrospective study on prognosis of the medically compromised patients in department of oral and maxillofacial surgery

Stage Migration of Gastric Cancer According to the Extent of Lymph Node Dissection

PURPOSE: In this study, the authors attempted to evaluate the stage migration phenomenon according to D1 lymphadectomy and D2 lymphadectomy in the same patients. METHODS: A retrospective study was performed in 300 consecutive patients with gastric cancer who had undergone curative resection with nodal yields of D2 or more from 1994 to 1997. The lymph node status was evaluated in two different extents. Group B included patients with whole harvested regional lymph nodes (D2<) while group A include patients with perigastric lymph nodes (D1). Each group was staged by the number of involved lymph nodes according to the UICC-TNM stage (5th), and by the ratio of involved to resected lymph nodes. Stage migration and the difference of 5YSR were observed between the two groups. RESULTS: In staging by the number of involved lymph nodes, 25 cases (8.3%) of group B were staged up. According to the status by the ratio of involved lymph nodes, 14 cases (4.6%) of group B were staged up and 28 (9.3%) were staged down. CONCLUSION: In the staging of gastric cancer, adequate lymph node dissection was essential for accurate lymph node staging. In the cases of limited lymph node dissection, some extent of stage migration was considered assessing in the prognosis.

Operative Indications for Hashimoto's Thyroiditis in Consideration of the Risk of Concurrent Thyroid Carcinoma / 대한내분비외과학회지

PURPOSE: This study was performed to further refine the indications for operative treatment of patients with Hashimoto's thyroiditis, and also to present the better histopathologic diagnosis method for Hashimoto's thyroiditis. METHODS: The authors evaluated retrospectively 130 patients with surgically proven Hashimoto's thyroiditis at presbyterian medical center in Chonju and Yonsei hospital in Masan from Jan. 1995 to Feb. 2002. RESULTS: The sensitivity of gun biopsy for the diagnosis of Hashimoto's thyroiditis was significantly higher than the one of fine needle aspiration (83.3% vs 46..2%, P<0.001). There were 26 cases (13.8%) of coexistent carcinoma of 130 patients. The incidence of carcinoma in men (6 in 9, 66.6%) was significantly higher than in women (20 in 121, 16.5%, P<0.05). The incidence of carcinoma in antithyroglobulin antibody negative group (8 in 10, 80%) was significantly higher than in antibody positive guoup (16 in 111, 14.4%, P<0.001). There was no significant difference in the incidence of carcinoma between positive and negative lymphadenopathy groups (22.6% vs 20.0%, P=0.681). As for ultrasonographic findings, patients with irregular-marginated dominant nodule or calcification had significantly higher incidence of carcinoma than those without so findings had (P<0.001). As for the distribution patterns of lymphocytes infiltration, the incidence of carcinoma in nodular or localized pattern groups is significantly higher than in diffuse group (24.5% vs 8.3%, P<0.05). CONCLUSION: For histopathologic diagnosis of Hashimoto's thyroiditis, gun biopsy is more sensitive than fine needle aspiration. And the incidence of concurrent carcinoma in patients with Hashimoto's thyroiditis is increased under the circumstances as follows: men, negative antithyroglobulin antibody results on serologic test, ultrasonographic findings such as irregular-marginated dominant nodule, increased vascularity or calcification, and nodular or localized patterns of lymphocytes infiltration on histopathologic examination.