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만성 C 형 간질환에서 혈청 히아루론산 및 PIIINP 농도와 간조직 소견의 비교
이준성 ( Jun Sung Lee ),김태헌 ( Tae Hun Kim ),임영석 ( Young Suk Lim ),이효석 ( Hyo Suk Lee ),김정룡 ( Chung Yong Kim ),윤정환 ( Jung Hwan Yoon ),우광훈 ( Gwang Hoon Woo ),김경아 ( Kyung Ah Kim ),장자준 ( Ja Jun Jang ) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.4
Background/Aims: In chronic liver disease type C, there have been no clinically useful serum markers to reflect histological findings such as hepatic necroinflammation and fibrosis except for an invasive liver biopsy. In an attempt to find out serum markers predicting these histological degree of progression in patients with chronic liver disease type C, we compared the histological findings with the levels of serum hyaluronate and N-terminal peptide of procollagen III (PIIINP) which are produced during the metabolism of extracellular matrices. Methods: Thirty-seven patients with antibody to HCV were enrolled in this study. Histological findings were scored for degree of piecemeal necrosis, lobular inflammation and fibrosis according to Ludwig's score. Then, serum concentrations of hyaluronate and PIIINP were measured by enzyme immunoassay and radioimmunoassay, respectively. Results: Hyaluronate at the concentration of 100 ng/mL had a positive predictive value of 80% and a negative predictive value of 100% for diagnosis of stage 3, 4 fibrosis. The positive and negative predictive values of PIIINP at the level above 1.5 U/mL were 100% and 89.3% for the diagnosis of grade 3, 4 piecemeal necrosis, and 100%, 85.7% for the diagnosis of grade 3, 4 lobular inflammation, respectively. Conclusions: Serum hyaluronate may be a useful serum marker of liver fibrosis compared with PIIINP. However, PIIINP may be a useful marker for detecting grade 3, 4 necroinflammation in patients with chronic liver disease type C. (Korean J Gastroenterol 2001;38:254-261)
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최석호,김대연,박귀원,정성은,이성철,김우기,장자준,Choi, Seok-Ho,Kim, Dae-Yeon,Park, Kwi-Won,Jung, Sung-Eun,Lee, Seong-Cheol,Kim, Woo-Ki,Jang, Ja-Jun 대한소아외과학회 1998 소아외과 Vol.4 No.1
Six children with solid and papillary epithelial neoplasm of the pancreas were studied retrospectively. There were 2 boys and 4 girls. The mean age at operation was 11 years(range; 8-13years). Three patients had incidental abdominal mass, in two patients the mass was non-tender, in one patient the mass was tender. The minimum size of tumor was $6.5{\times}6.0$ cm and the maximum was $10.5{\times}8.0$ cm. Five tumors were located in the head of the pancreas, and the other one in the tail. Local invasion or metastasis was not noticed. Tumors were removed completely by performing the following operations: 3 pylorous preserving pancreaticoduodenectomy, 2 Whipple's operation and 1 distal pancreatectomy. There was no mortality. The histologic findings were characteristic. There were no recurrences during a follow-up of 0.5 to 12 years (mean; 5.0 years).
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병합형 간세포암-담관암종의 수술 절제 후 예후 인자 분석
김원 ( Won Kim ),이정훈 ( Jeong Hoon Lee ),김윤준 ( Yoon Jun Kim ),윤정환 ( Jung Hwan Yoon ),서경석 ( Kyung Suk Suh ),이건욱 ( Kuhn Uk Lee ),장자준 ( Ja June Jang ),이효석 ( Hyo Suk Lee ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.3
Background/Aims: Combined hepatocellular and cholangiocarcinoma (HCC-CC) is a rare form of primary liver carcinoma which contains characteristics of both hepatocellular carcinoma and cholangiocarcinoma. The aim of this study was to evaluate the prognostic factors of combined HCC-CC after curative resection. Methods: Between January 1987 and December 2005, pathologically confirmed combined HCC-CC patients who underwent curative resection at Seoul National University Hospital were evaluated. We reviewed the medical records and evaluated the time-to-recurrence (TTR), overall survival (OS) and prognostic factors of combined HCC-CC. Results: A total of 31 patients were evaluated (M:F=27:4; median age, 61 years). According to the American Joint Committee on Cancer system, patients with stage Ⅰ, Ⅱ, ⅢA, ⅢB and ⅢC at the time of resection were 4, 16, 7, 2 and 2, respectively. Twenty six patients (83.9%) had tumor recurrence during the follow-up period and their median TTR was 5.7 months. Twenty one patients received additional treatment while 5 patients did not. As a result, median OS was 21.6 months and 3 year survival rate was 15.4%. In multivariate analysis, stage Ⅲ than stage Ⅰ or Ⅱ at resection was an independent prognostic factor associated with shortened TTR (p<0.01). Older age (p=0.03), stage ⅢC rather than stage Ⅰ, Ⅱ, ⅢA at time of resection (p=0.02), and Child-Pugh B rather than A (p<0.01) were independent prognostic factors associated with shortened OS. Conclusions: Even after curative resections, patients with combined HCC-CC show poor prognosis with early recurrence and poor survival. However, surgical treatment should be warranted for relatively young patients in early stage with well preserved liver function. (Korean J Gastroenterol 2007;49:158-165)
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