일반연제 발표(2) : 자궁경부암 환자들에서의 P16 유전자 변이와 P53 유전자 변이, HPV 16, 18발현과의 상호관계와 P16 유전자가 생존율에 미치는 영향

안선의,김원규 대한산부인과학회 2001 대한산부인과학회 학술대회 Vol.86 No.-

침윤성 자궁 경부암에서 p16 단백의 변형

안선의,김원규 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.4

목적 : 한국여성에서 흔히 발생하는 침윤성 자궁경부암 환자들의 p16단백의 변형을 알아보고 이것이 인유두종 바이러스 16, 18아형 감염과 p53단백의 과발현 그리고 임상병리학적 특성과는 어떤 상관관계에 있는지 파악하고 나아가 p16단백의 변형과 p53단백의 과발현 그리고 인유두종 바이러스 16, 18아형 감염이 생존율에 영향을 미치는지 알아봄으로써 침윤성자궁경부암 환자들의 예후와의 연관성을 알아보고자 본 연구를 실시하였다. 연구 방법 : 1994년 1월부터 1995년 12월까지 고신대학교 복음병원 산부인과에 입원하여 근치적 자궁적출술을 시행한 자궁경부암환자 29예를 대상으로 하여 임상병리학적 특성과 p16단백의 변형, p53단백의 과발현, 인유두종 바이러스 16, 18아형의 감염여부를 조사하고 Kaplan-Meier법으로 이들의 생존율을 조사하였다. p16단백과 p53단백은 면역조직화학요법으로 인유두종 바이러스는 PCR법으로 검사를 시행하였다. 결과 : p16단백의 변형율은 31% (9/29)였으며, p53단백의 과발현율은 72.4% (21/29)이고, 인유두종 바이러스 감염율은 89.6% (26/29)로 나타났다. p16단백의 변형과 임상병리학적 특성들간에는 통계학적 유의성은 없었다 (P>0.05). p53단백의 과발현 양성인 21예중 p16단백의 변형 양성은 6예 (28.6%), 음성은 15예 (71.4%)였고 p53단백의 과발현 음성인 8예중 p16단백의 변형 양성은 3예 (37.5%), 음성은 5예 (62.5%)였고 이들간에 통계학적 유의성은 없었다. 인유두종 바이러스 감염 양성인 26예 중 p16단백의 변형 양성은 9예 (34.6%), 음성은 17예 (65.4%)였고 인유두종 바이러스 감염 음성인 3예는 모두 p16단백 변형 음성을 보였으나 이들간에도 통계학적 유의성은 없었다. 환자들의 전체 5년 생존율은 86.2%로 나타났고 p16단백 변형 음성군이 80%의 생존율을 보였고 p16단백변형 양성군은 100%의 생존율을 보였다. p53단백의 과발현과 인유두종 바이러스 감염 음성군은 모두 생존하였고 p53단백 과발현 양성인 군은 80.9%, 인유두종 바이러스 감염 양성인군은 84.6%의 생존율을 보였다. 이들 인자들과 5년 생존율과는 통계학적 유의성이 없었다. 결론 : 자궁경부암에서 p16단백의 변형과 임상병리학적 특성들간에는 통계학적 유의성이 없었다 p16단백 변형과 p53단백 과발현, 인유두종 바이러스 감염간에도 통계학적인 유의성이 없었으며 p16단백 변형, p53단백 과발현, 인유두종 바이러스 감염과 같은 자궁경부암 유발하는 인자들은 생존율과 연관성이 없는 것으로 나타났다. Objective : Recently p16 gene has been found as a new factor for cervical carcinogenesis. The purpose of this study is to investigate the p16 protein alteration in invasive cervical cancers, and to find the correlation with the p53 protein overexpression, HPV infection and the clinicopathologic prognostic parameters, as well as to predict the prognosis by examining the influences of the p16 gene, p53 gene, HPV to the survival rate. Material & Methods : We examined 29 invasive cervical cancer patients who visited and operated in Obstetrics & Gynecology department of Kosin University Gospel Hospital from Jan. 1994 to Dec. 1995. We investigated clinicopathologic parameters and p16 protein alteration, p53 protein overexpression, HPV 16, 18 infection in these patients. p16 protein and p53 protein were examined by immunohistochemistry method and HPV was done by PCR method. The survival rate was examined by Kaplan-Meier method. Results : The rate of p16 protein alteration, p53 protein overexpression, HPV infection were respectively 31% (9/29), 72.4% (21/29), 80.6% (26/29), and all of these factors had no statistical correlations with the clinicopathologic parameters (p>0.05). Among the 21 positive cases for p53 protein overexpression, p16 protein alteration was positive in 6 (28.6%), negative in 15 (71.4%) cases and among the 8 negative cases for p53 overexpression, p16 showed positive in 3 (37.5%), negative in 5 (62.5%). Finally among the 26 positive cases of HPV infection, p16 alteration was positive in 9 (34.6%) and negative in 17 (65.4%) and all of the 3 HPV infection negative cases showed no p16 alteration. The p16 alteration had no significant correlation with the p53 overexpression and HPV infection. The total 5 years survival rate in 29 cases of invasive cervical cancer patients was 86.2%. In the negative group of p16 protein alteration the survival rate was 80% and the positive group was all alive. In the positive groups of p53 protein overexpression and HPV infection the survival rate were 80.9% and 84.6% respectively and the negative groups were all alive. And these factors had no significant correlation with the survival rates. Conclusion : This results indicate that p16 protein alteration had no correlation with clinicopathologic prognostic parameters and survival rates in invasive cervical cancer. In addition p16 protein alteration had no correlation with p53 protein overexpression and HPV infection respectively.

구연 발표 : 부인종양학 ; 상피성 난소 종양에서의 HIF-α와 cathepsin D의 발현과 이 인자들이 예후와 생존율에 미치는 영향

최종열,석원일,안선의,이천준,김원규 대한산부인과학회 2004 대한산부인과학회 학술대회 Vol.90 No.-

침윤성 자궁경부암조직에서 Ureaplasma urealyticum의 검출

김도형,김동휘,김준홍,강태경,박은동,여태홍,서남원,안은모,안선의 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4

Objective : Mycoplasmas have been implicated in many diseases including cervicitis, urethritis, salpingitis, endometritis... and functioning as cofactors catalyzing the HIV disease state. The oncogenic potentiality of mycoplasma was only recently realized when they were shown causing chromosomal changes and in vitro cell transformations through gradual progressive chromsomal loss and translocation. Few study has been reported the prevalence of mycoplasma infection in human cancers and suggested that there was a connection between these organisms and human cancers. The objective of this study was to determine the relationship between Ureaplasma urealyticum infection and cervical cancer. Methods : The detection frequency of Ureaplasma urealyticum in 52 invasive cervical cancer tissues and 17 normal cervical tissues was studied using PCR. Results : U. urealyticum DNA was detected in 8 out of 52(15.4%) invasive cervical cancer tissues and 1 out of 17(5.9%) normal cervical tissues. No statistic significance was observed between the detection frequency of Ureaplasma urealyticum and clinicopathologic parameters. The prevalence of Ureaplasma urealyticum in invasive cervical tissues was 15.4% and this rate was higher than 5.9% in normal cervical tissues but there was no statistic significance. Conclusions : With respect to clinicopathologic parameters of cervical cancer, there was no significant relation between U. urealyticum infection and cervical cancer. There is, however, few study and case on cervical cancer internally and externally. It is considered that more studies on the subject with much cases should be made.

지속성 또는 재발성 난소암에서 Docetaxel-Carboplatin 병합 요법

김영환 ( Young Hwan Kim ),신홍천 ( Hong Cheun Shin ),안선의 ( Sun Nie Ahn ),이천준 ( Chun June Lee ),김원규 ( Won Gyu Kim ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.11

양측 난소를 침범한 복막의 결합조직형성 소원형세포종양

김준경 ( Jun Kyung Kim ),이윤식 ( Yun Sik Lee ),안선의 ( Sun Nie Ahn ),신홍천 ( Hong Cheun Shin ),이천준 ( Chun June Lee ),김원규 ( Won Gyu Kim ),김원 ( Weon Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.1

난소의 악성 생식세포종양 31예의 임상 병리학적 고찰

서남원(Nam Won Seo),이천준(Cheon Jun Lee),김도형(Do Hyung Kim),안은모(Un Mo Ahn),여태홍(Tae Hong Yeo),김준홍(Jun Houg Kim),안선의(Sunn Ie Ahn),김동휘(Dong Hwi Kim),박은동(Un Dong Park) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1

목적: 본 연구는 난소의 악성 생식세포종의 임상 병리학적 특징과 이에 따른 재발율 및 생존율을 알아보아 치료에 있어서 논란이 되는 여러 문제점들을 고찰하고자 함에 있다. 대상 및 방법: 1991년 8월부터 1998년 11월까지 고신대학교 부속 복음병원 산부인과에서 난소의 악성 생식세포종양으로 진단 및 치료 받은 환자 31명을 대상으로 조직학적 분포, 연령, 병기, 임상증상, 종양표지물질, 치료 방법, 추적 관찰의 결과등에 대해 후향적 조사를 하였다. 결과: 이 기간내에 전체 난소 악성종양에서 악성 생식세포종양이 차지하는 비율은 6.37%였다. 조직학적 분포로는 미성숙기형종이 10예(32.3%)로 가장 많았고 미분화배세포종 8예(25.8%) 내배엽동종양 7예(22.6%), 혼합배세포종 및 융모상피암이 각각 3예(9.7%)였다. 평균 발생 연령은 24.26세(10∼40세)였고 가장 흔한 증상은 복부동통(38.7%)이었다. FIGO 병기로는 Ⅰ기가 18예(58.0%)로 가장 많았고, Ⅲ기 5예(16.2%), Ⅱ기 3예(9.6%) 순이었다. 모든 대상 환자에서 초기 치료로 수술이 시행되었으며 9명의 환자에서 이차추시개복술 및 시험적 개복술이 시행되었고, 술후 보조적 항암화학요법으로는 VAC, VBP, EP, BEP, EMA와 EMA CO 복합항암화학요법이 투여되었다. 평균 추적 관찰기간은 26.0(±S.D.;±20.3)개월이었고, 2년 및 5년 생존율은 각각 91.97%(±S.E.;±0.05) 및 86.86%(±S.E.;±0.07)이었다. Objective: The purpose of this study was to review the clinicopathologic features, recurrent rate, survival rate and controversable issues in the treatment of the ovarian malignant germ cell tumors. Patients and Methods: From August, 1991 to November, 1998 thirty-one patients with malignant germ cell tumors of the ovary treated in the department of obstetrics and gynecology, Kosin University Medical college, were eligible and assessable. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow up were reviewed retrospectively. Results: The patients with malignant germ cell tumor constituted 6.37% of all ovarian malignancies during this period. Histologic subtypes were 8 dysgerminoma(25.8%), 7 endodermal sinus tumor(22.6%), 10 immature teratoma(32.3%), 3 mixed germ cell tumor(9.7%), 3 choriocarcinoma(9.7%). The age of the patients ranged from 10 to 40 years (mean ±S.D.; 24.26 ± 7.51). The most common symptom was abdominal pain(38.7%). Most had stageⅠ(18 cases, 58.0%) or stageⅢ(5 cases, 16.2%) diseases. All patients underwent surgery as the initial treatment, and nine patients received more than one operation. Postoperative adjuvant chemotherapeutic regimens were VAC, VBP, EP, BEP, EMA, and EMA CO. The mean follow up duration was 26.0(± S.D.; ± 20.3) months. The 2-year and 5-year survival rate were 91.97%(± S.E.; ± 0.05) and 86.86%(± S.E.; ± 0.07).

자궁경부암에서 MAGE 3 유전자 산물의 발현

강태경(Tae Kyoung Kang),서남원(Nam Won Seo),김도형(Do Hyung Kim),안은모(Un Mo Ahn),여태홍(Tae Hong Yeo),김준홍(Jun Hong Kim),안선의(Sune Ie Ahn),김동휘(Dong Hwi Kim),박은동(Un Dong Park) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3

N/A Objective: The human MAGE 3 gene encodes tumor specific antigens that are recognized by autologue cytotoxic T lymphocytes (CTL). The MAGE 3 gene is expressed not only in melanoma but in the other malignant tumors as well. There is, however, little information on the expression of the gene in uterine cervical carcinomas. The author thus studied the expression of the MAGE 3 gene products in uterine cervical carcinoma and discuss the possibility of specific immunologic diagnosis using MAGE 3 gene products. Methods: The expression of MAGE 3 gene product in 17 normal tissues of the cervix, 32 cervical intraepithelial neoplasia (8 CINⅠ, 10 CINⅡ, 14 CIS), and 43 invasive cervical carcinomas was studied by immunohistochemistry using anti-MAGE 3 mAb 57B in paraffin sections. Results: No expression of MAGE 3 gene product was detected in normal cervical tissues and in cervical intraepithelial neoplasias. The expression of MAGE 3 gene product was detected in 30.2% (13/43) of invasive cervical carcinomas. The MAGE 3 gene product was stained as a cytoplasmic protein in cancer cells. No statistically significant differences were observed between MAGE 3 gene product expression status and clinicopathologic parameters. Conclusions: The MAGE 3 gene products was expressed in invasive cervical carcinoma tissues.