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설미영,최경운,김지연,강현정,신동훈,김익두,최효선,서순정 대한병리학회 2007 Journal of Pathology and Translational Medicine Vol.41 No.6
Background : The aim of this study was to clarify the incidence and role of microsatellite instability (MSI) in sporadic ovarian epithelial cancers (OEC). We investigated the MSI status and mismatch repair (MMR) protein expression in OEC. Methods : MSI was examined by fluorescence- based polymerase chain reaction using five NCI panel markers (BAT25, BAT26, D2S123, D5S346 and D17S250) in 46 cases of OEC. Immunohistochemistry (IHC) for hMLH1 and hMSH2 was performed. Results : Seven cases (15.2%) exhibited high-frequency MSI (MSIH), one exhibited low-frequency MSI (MSI-L), and the remaining 38 demonstrated microsatellite stability (MSS). MSI-H in OEC was not associated with histologic grade, FIGO stage, tumor size, mitoses or histologic type. Loss of expression of either hMLH1 or hMSH2 was observed in 4 of the 7 (59.3%) MSI-H cases, whereas 4 of the 39 (10.3%) MSI-L or MSS tumors revealed loss of expression of MMR proteins. The sensitivity and specificity of immunohistochemistry for hMLH1 and hMSH2 were 57.1% and 89.7%. Conclusions : Our data suggest that a genetic defect in the MMR system might play a role in the carcinogenesis of a minor subset of sporadic OEC however, immunohistochemical testing for hMLH1 and hMSH2 cannot accurately determine microsatellite instability status in OEC.
IgA 신증 (WHO 3급 이상)과 국소성 분엽성 사구체 경화증의 비교
설미영,신동훈,김익두 부산대학교 병원 암연구소 2007 부산대병원학술지 Vol.- No.21
Purpose: IgA nephropathy WHO class 3-5 and focal segmental glomerulosclerosis have similar histologic features. This study was to compare the histologic features and laboratory results of both diseases to clarify the similarities and dissimilarities of both diseases and to provide guides for the treatment and prediction of the disease progression. Methods: Eighty seven cases of IgA nephropathies(WHO class 3-5) and 63 cases of focal segmental glomerulosclerosis without evidence of IgA nephropathy or other systemic diseases, diagnosed at Pusan National University hospital were included in this study. Histologic features were reevaluated by the archives of slides stained by H-E, Masson’s trichrome, PAS and Methenamin silver technique, immunofluorescent results and the electron microscopic feaures of each cases were reevaluated by the photographs stored in the computer files. Laboratory results at the biopsy were reviewed. Results: Mean age at the diagnosis were 30 years old in IgA nephropathy group and 40 years old in focal segmental sclerosis group with male predominance in both disease group. This results were similar to the most reported Cases. Serum BUN, creatinine and total cholesterol, and 24 hour urine protein excretion results were higher in focal segmental sclerosis group than IgA nephropathy group. Serum albumin levels were lower in focal segmental sclerosis group. This results means degrees of renal parenchymal damage and loss of renal function were severe in focal segmental glomerulosclerosis group compared to the IgA nephropathy group. Incidences of global sclerosis and arteriosclerosis were higher in focal segmental sclerosis group and the incidence of focal segmental sclerosis were higher in IgA nephropathy group. Histiologic features of podocyte proliferation, expansion and sclerosis of mesangial matrix,and tubular atrophy with interstitial fibrosis and inflammatory cell infiltration were similar in two groups. Comparative analysis between high class IgA nephropathy(class 4-5) and focal segmental glomerulosclerosis revealed highεr level of serum total cholesterol, higher numbers of glomeruli with synechia, and higher degrees of interstitial fibrosis with inflammatory cell infiltration in focal segmental glomerulosclerosis group with statistical significance. In comparison between IgA nephropathy(class 3-5) and focal segmental glomerulosclerosis, higher incidence of urinary protein excretion above 3gm/24hour and more percentages of glomeruli with severe glomerulosclerosis were noted in the focal segmental glomerulosclerosis with statistical significance. Conclusion: Focal segmental glomerulosclerosis has more risk factors for the progression of renal damage and renal function loss than the IgA nephropathy(WHO 3-5) inspite of many histologic and laboratory features of similarities.