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( Hyo Sook Bae ),( Jin Hwa Hong ),( Jae Kwan Lee ),( Nak Woo Lee ),( Jae Yun Song ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
Vitamin D deficiency has shown various conflicting effects on cancer biology although vitamin D is a common nutrient. Sometimes, it has different prognosis along with the type of the cancer. Few studies have evaluated the effect of vitamin D deficiency on the development and growth of breast cancer in xenograft model. Antitumor effect of vitamin D deficiency was evaluated in breast cancer (MTV/TM-011) xenografts in Balb/c mice. Serum vitamin D and calcium levels were measured. To determine the effect of vitamin D deficiency on breast cancer proliferation, Balb/c mice were rendered vitamin D deficient by feeding them a vitamin D-deficient diet for 5 weeks. A group of vitamin D-sufficient mice was given the same diet with supplemental vitamin D. The mice were injected with MTV/TM-011 breast cancer cells and the tumors were measured for 2 weeks. The tumors were evaluated for mRNA expression of the vitamin D receptor (VDR), CYP27B1, p21, p27, cyclinD1, Cox2 and mPGES by PCR and quantitative RT-PCR. Vitamin D-sufficient mice had 50% smaller tumors than vitamin D-deficient mice. The expression of the mRNA for the VDR, p21 and p27 was similar between the two groups within two-fold gap. And the expression of CYP27B1, cyclinD1, Cox2, mPGES and IL-4 was over two-fold higher in the vitamin D-sufficient mice compared with the vitamin D- deficient mice. We conclude that vitamin D deficiency enhances the growth of breast cancer in mice. The tumor expression of VDR and CYP27B1 indicates possible homeostasis by vitamin D. By the tumor expression of Cox2, mPGES and IL-4, we suggest that there might be an immunologic pathway stimulating tumor growth except VDR.
Bae, Hyo Sook,Kim, Yeon-Joo,Lim, Myong Cheol,Seo, Sang-Soo,Park, Sang-yoon,Kang, Sokbom,Kim, Sun Ho,Kim, Joo-Young Blackwell Scientific Publications 2016 International journal of gynecological cancer Vol.26 No.4
<B>Purpose</B><P>We identified the predictive factors for locoregional failure after definitive chemoradiation in patients with locally advanced cervical cancer.</P><B>Methods</B><P>Altogether, 397 patients with locally advanced cervical cancer (stage IB2-IVA) were treated with definitive chemoradiation between June 2001 and February 2010. Platinum-based concurrent chemotherapy was given to all patients with median radiation dose of external beam radiotherapy 50.4 Gy in 28 fractions and intracavitary radiotherapy 30 Gy in 6 fractions. Competing risk regression analysis was used to reveal the predictive factors for locoregional failure.</P><B>Results</B><P>During the median follow-up of 7.2 years, locoregional failure occurred in 51 (12.9%) patients. The estimated 3-year rate of locoregional control was 89%, whereas the overall survival rate was 82%. After univariate and multivariate analyses, large tumor size (>5 cm), young age (≤40 years), nonsquamous histology, positive lymph node on magnetic resonance imaging, and advanced stage (III-IV) were identified as risk factors for locoregional failure (<I>P</I> = 0.003, <I>P</I> = 0.075, <I>P</I> = 0.005, <I>P</I> = 0.055, and <I>P</I> < 0.001, respectively). After risk grouping according to the coefficients from the multivariate model, we identified a high-risk group for locoregional failure after treatment with definitive chemoradiation as follows: (1) tumor size larger than 5 cm, and at least 1 other risk factor or (2) tumor size 5 cm or less, and at least 3 other risk factors. The cumulated estimated 3-year rate of locoregional failure of the high-risk group was 26%, which was significantly higher than that of the low-risk group (7%, <I>P</I> < 0.001). The 3-year overall survival rates of the 2 groups were also significantly different (57% vs 86%, <I>P</I> < 0.001).</P><B>Conclusions</B><P>Large tumor size (>5 cm), young age (≤40 years), nonsquamous histology, positive lymph node on magnetic resonance imaging, and advanced stage are all risk factors for locoregional failure after definitive platinum-based chemoradiation in patients with locally advanced cervical cancer. In the high-risk group, further clinical trials are warranted to improve the locoregional control rate.</P>
( Hyo Sook Bae ),( Ye Won Jung ),( Jae Seung Jung ),( Jae Yun Song ),( Tak Kim ),( Kyu Wan Lee ) 대한산부인과학회 2010 Journal of Womens Medicine Vol.3 No.2
It is difficult to diagnose a pulmonary embolism based on the manifestations in the postpartum period alone. However, pre-syncope and syncope reflect the severity of the disease. Based on the 2 cases reported herein, we propose that spiral computed tomography and embolectomy is an appropriate combination for the management of massive postpartum pulmonary embolism, even in less severe cases.
( Hyo Sook Bae ),( Myong Cheol Lim ),( Sang Soo Seo ),( Joo Young Kim ),( Sang Yoon Park ),( Sok Bom Kang ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-
목적: To investigate the predictive factor and risk grouping for the local recurrence/persistent disease in cervical cancer patients who underwent primary CCRT 방법: Between June 2001 and February 2010, cervical cancer patients who underwent primary CCRT in National Cancer Center were included in this study. General characteristics and survival data were reviewed from the medical record. Competing risk analysis model was used to reveal risk factors for the local recurrence. Estimated risk was calculated using coefficient followed by subgrouping analysis. Kaplan-meier method was used to analysis progression free survival among risk subgroups. 결과: 314 patients were enrolled. The mean age was 55 years old (range, 22-87). Most of patients was stage II (223, 71%) and squamous cell carcinoma (276, 87.9%). The mean mass size was 4.2 cm (range, 1.3-11.0) and the mean value of SCC was 4.6 ng/ml (0.1-395.0). 297 patients (94.6%) had intracavitary radiotherapy (ICR) and 98 patients (31.2%) boost radiotherapy. In univariate analysis, age, FIGO stage, histology, ICR, boost and mass size showed significantly related to local recurrence. In multivariate analysis, age (≤40 years), non-squamous histology, ICR and mass size (> 5cm) showed statistically significant risk factors for the local recurrence (SHR 3.32, 95% CI 1.67-6.60; SHR 3.87, 95% CI 1.94-7.73; SHR 0.31, 95% CI 0.11-0.89 and SHR 2.72, 95% CI 1.43-5.19, respectively). Estimated risk was calculated using the coefficient derived from competing risk analysis (ER = young * 1.19976 + nonscc * 1.353775 + size5 * 1.00077) and three subgroups were developed along the scores. Progression free survival were statistically significant among the subgroups (p<0.001). 결론: Younger age (≤40yrs), non-squamous histologic type and large mass size (>5 cm) are risk factors for the local recurrence after CCRT while ICR is protective factor. ICR should be actively used in the high risk group and the development of additional new treatments are needed.
( Hyo Sook Bae ),( Jin Hwa Hong ),( Jae Kwan Lee ),( Nak Woo Lee ),( Jae Yun Song ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
Studies that have examined the association between obesity and ovarian cancer survival have provided conflicting results. We reviewed and quantitatively summarized existing evidence, exploring potentially important sources of variability, such as the timing of body mass index (BMI) assessment, different cut points used to categorize BMI, the reference used in multivariate analysis and stages of ovarian cancer. Eligible studies were searched using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials, and manual review of relevant bibliography to look for additional studies was done. Adjusted hazard ratios (HRs) from individual studies were pooled using a random effects model. 17 cohort studies of 929 screened articles were included in the final analysis. The meta-analysis showed that obesity at early adulthood and obesity 5-year before diagnosis are associated with poor survival of patients with ovarian cancer (pooled HR, 1.67; 95% CI 1.29-2.16 and pooled HR, 1.35; 95% CI 1.03-1.76, respectively). However, obesity at diagnosis showed two different tendency along with the characteristics of BMI as a variable. Obesity with categorical BMI variable does not affect the prognosis of ovarian cancer (pooled HR, 1.07; 95% CI 0.95-1.21) and obesity with continuous BMI variable showed slightly poor survival per 1 unit (pooled HR, 1.02; 95% CI 1.01-1.04). We found that obesity 5-year before diagnosis and obesity at young age are associated with poor prognosis of ovarian cancer. However, there is no reliable correlation between obesity at diagnosis and survival of patients with ovarian cancer. Further studies are needed to elucidate the effect of obesity on the survival of patients with ovarian cancer.
GO-18 : Atypical endometriosis: Morphologic, immunohistochemical and molecular changes
( Hyo Sook Bae ),( Jin Hwa Hong ),( Jae Kwan Lee ),( Nak Woo Lee ),( Insun Kim ),( Jae Yun Song ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-
목적: Endometriosis is a benign disorder, but may be progressive and complicated by malignant transformation, frequently endometrioid and clear cell carcinomas. Morphologic, immunohistochemical and molecular changes in atypical endometriosis are evaluated and compared with the neoplastic component of respective histologic type. 방법: The endometriosis-associated lesions of the ovary were collected; 16 clear cell type (4 atypical, 2 borderline and 10 malignant), 7 endometrioid carcinoma, 2 serous (1 proliferative and 1 malignant), and 2 seromucinous (1 benign and 1 borderline). Immunohistochemical stains for ER, PTEN, ARID1A, HNF-1β, MLH1, and WT-1 were performed. Mutational analysis for K-RAS, BRAF, and PIK3CA was performed in some cases. 결과: Morphologically, atypical endometriosis in clear cell tumor was characterized by flat or papillary tufting of the polygonal or hobnail cells with nuclear enlargement, hyperchromatism and clear cytoplasm, whereas in endometrioid tumor, the endometrial glands were crowded and irregular, with rounded and vesicular nuclei. Clear cell lesions were characterized by ER-/HNF-1β+/WT-1- with loss of PTEN in some, and ARID1A in one, but without loss of MLH1. PI3KCA mutation was only found in malignant component of 2 tumors, without K- RAS and BRAF mutation. Endometrioid carcinomas were characterized by ER+/ HNF-1β±/WT-1- with frequent loss of PTEN, but without loss of ARID1A. One tumor had K-RAS mutation in only malignant component without mutation of BRAF and PIK3CA. Serous tumors were characterized by ER+/ HNF-1β-/WT-1+ without loss of PTEN, ARID1A and MLH1. Seromucinous tumors were characterized by ER±/HNF- 1β±/PTEN±. 결론: Morphologic criteria for atypical endometriosis should be differently defined according to the histologic types, and immunophenotype will be helpful in evaluation. Loss of ARID1A and molecular changes seem to occur during malignant transformation than in benign and atypical endometriosis status.
Bae, Hyo Sook,Lee, Jong-Min,Lee, Jae-Kwan,Kim, Jae-Weon,Cho, Chi-Heum,Kim, Seok-Mo,Park, Sang-Yoon,Park, Chan-Yong,Kim, Ki-Tae,Kang, Sokbom Blackwell Scientific Publications 2014 International journal of gynecological cancer Vol.24 No.8
<P>The aim of this study was to determine whether knowledge of lymph node status improves survival prediction in clinically early-stage endometrial cancer.</P>