Malignant transformation of ovarian mature cystic teratoma into squamous cell carcinoma: a Taiwanese Gynecologic Oncology Group (TGOG) study

An Jen Chiang,Min-Yu Chen,Chia-Sui Weng,Hao Lin,Chien-Hsing Lu,Peng-Hui Wang,Yu-Fang Huang,Ying-Cheng Chiang,Mu-Hsien Yu,Chih-Long Chang 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5

Objective: The malignant transformation (MT) of ovarian mature cystic teratoma (MCT)to squamous cell carcinoma (SCC) is very rare. This study analyzed cases from multiplemedical centers in Taiwan to investigate the clinicopathologic characteristics, treatment, andprognostic factors of this disease and reviewed related literature. Methods: Pathological reports of 16,001 patients with primary ovarian cancer who weretreated at Taiwan medical centers from 1990 to 2011 were reviewed. In total, 52 patients withMT of MCT to SCC were identified. Results: Among all ovarian MCTs, the incidence of MT to SCC is 0.2%. The median age ofpatients was 52 years (range, 29–89 years), and the mean tumor size was 10.5 cm (range, 1–40cm). We analyzed the patients in our study and those in the literature and determined thatearly identification and complete surgical resection of the tumor are essential for long-termsurvival. In addition, adjuvant chemotherapy or concurrent chemoradiotherapy can be usedto treat this malignancy. Old age, large tumor size (≥15.0 cm), and solid components in MCTsare suitable indicators predicting the risk of MT of MCT to SCC. Conclusion: Similar to general epithelial ovarian cancers, the early detection of MT of MCTto SCC is critical to long-term survival. Therefore, older patients with a large tumor or those with a tumor containing a solid component in a clinically diagnosed MCT should beevaluated to exclude potential MT to SCC.

Risk factors in progression from endometriosis to ovarian cancer: a cohort study based on medical insurance data

An Jen Chiang,Chung Chang,Chi-Hsiang Huang,Wei-Chun Huang,,Yuen-Yee Kan,Jiabin Chen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.3

Objective: The objective was to identify risk factors that were associated with the progression from endometriosis to ovarian cancer based on medical insurance data. Methods: The study was performed on a dataset obtained from the National Health Insurance Research Database, which covered all the inpatient claim data from 2000 to 2013 in Taiwan. The International Classification of Diseases (ICD) code 617 was used to screen the dataset for the patients who were admitted to hospital due to endometriosis. They were then tracked for subsequent diagnosis of ovarian cancer, and available biological, socioeconomic and clinical information was also collected. Univariate and multivariate analyses were then performed based on the Cox regression model to identify risk factors. C-index was calculated and cross validated. Results: A total of 229,617 patients who were admitted to hospital due to endometriosis from 2000 to 2013 were included in the study, out of whom 1,473 developed ovarian cancer by the end of 2013. A variety of factors, including age, residence, hospital stratification, premium range, and various comorbidities had significant impact on the progression (p<0.05). Among them, age, urbanization of residence, hospital stratification, premium range, post-endometriosis childbearing, pelvic inflammation, and depression all had independent, significant impact (p<0.05). The validated C-index was 0.69. Conclusion: For a woman diagnosed with endometriosis, increased age, residing in a highly urbanized area, low or high income, depression, pelvic inflammation, and absence of childbearing post-endometriosis all put her at high-risk to develop ovarian cancer. The findings may be of help to gynecologists to identify high-risk patients.

Sulforaphane Decrease of SERTAD1 Expression Triggers G1/S Arrest in Breast Cancer Cells

An-Chin Cheng,Ching-Ju Shen,Chao-Ming Hung,Yi-Chiang Hsu 한국식품영양과학회 2019 Journal of medicinal food Vol.22 No.5

Studies have identified the potential of chemopreventive effects of sulforaphane (SFN); however, the underlying mechanisms of its effect on breast cancer require further elucidation. This study investigated the anticancer effects of SFN that specifically induces G1/S arrest in breast ductal carcinoma (ZR-75-1) cells. The proliferation of the cancer cells after treatment with SFN was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. DNA content and cell cycle status were analyzed through flow cytometry. Our results demonstrated the inhibition of growth in ZR-75-1 cells upon SFN exposure. In addition, SERTAD1 (SEI-1) caused the accumulation of SFN-treated G1/S-phase cells. The downregulation of SEI-1, cyclin D2, and histone deacetylase 3 suggested that in addition to the identified effects of SFN against breast cancer prevention, it may also exert antitumor activities in established breast cancer cells. In conclusion, SFN can inhibit growth of and induce cell cycle arrest in cancer cells, suggesting its potential role as an anticancer agent.

A longitudinal analysis with CA-125 to predict overall survival in patients with ovarian cancer

An Jen Chiang,Jiabin Chen,Yu-Che Chung,Huan-Jung Huang,Wen Shiung Liou,Chung Chang 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.1

Objective: The objective of this study was to explore the association of longitudinal CA-125 measurements with overall survival (OS) time by developing a flexible model for patient-specific CA-125 profiles, and to provide a simple and reliable prediction of OS. Methods: A retrospective study was performed on 275 patients with ovarian cancer who underwent at least one cycle of primary chemotherapy in our institute. Serial measurements of patients’ CA-125 levels were performed at different frequencies according to their clinical plans. A statistical model coupling the Cox proportional hazards and the mixed-effects models was applied to determine the association of OS with patient-specific longitudinal CA-125 values. Stage and residual tumor size were additional variables included in the analysis. Results: A total of 1,601 values of CA-125 were included. Longitudinal CA-125 levels, stage, and the residual tumor size were all significantly associated with OS. A patient-specific survival probability could be calculated. Validation showed that, in average, 85.4% patients were correctly predicted to have a high or low risk of death at a given time point. Comparison with a traditional model using CA-125 half-life and time to reach CA-125 nadir showed that the longitudinal CA-125 model had an improved predicative value. Conclusion: Longitudinal CA-125 values, measured from the diagnosis of ovarian cancer to the completion of primary chemotherapy, could be used to reliably predict OS after adjusting for the stage and residual tumor disease. This model could be potentially useful in clinical counseling of patients with ovarian cancer.

APPLICATION OF DEPTH-AVERAGED TWO-DIMENSIONAL NUMERICAL MODELS TO DAM BREAK FLOWS

HSU CHIANG-AN 한국수자원학회 2005 한국수자원학회 학술대회 Vol.2005 No.1

Trends in incidence and survival outcome of epithelial ovarian cancer: 30-year national population-based registry in Taiwan

Ying-Cheng Chiang,Chi-An Chen,Chun-Ju Chiang,Tsui-Hsia Hsu,Ming-Chieh Lin,San-Lin You,Wen-Fang Cheng,Mei-Shu Lai 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.4

Objective: To investigate the changes of incidence and prognosis of epithelial ovarian cancer in thirty years in Taiwan. Methods: The databases of women with epithelial ovarian cancer during the period from 1979 to 2008 were retrieved from the National Cancer Registration System of Taiwan. The incidence and prognosis of these patients were analyzed. Results: Totally 9,491 patients were included in the study. The age-adjusted incidences of epithelial ovarian cancer were 1.01, 1.37, 2.37, 3.24, 4.18, and 6.33 per 100,000 person-years, respectively, in every 5-year period from 1979 to 2008. The age-specific incidence rates increased especially in serous, endometrioid and clear cell carcinoma, and the age of diagnosis decreased from sixty to fifty years old in the three decades. Patients with mucinous, endometrioid, or clear cell carcinoma had better long-term survival than patients with serous carcinoma (log rank test, p<0.001). Patients with undifferentiated carcinoma or carcinosarcoma had poorer survival than those with serous carcinoma (log rank test, p<0.001). The mortality risk of age at diagnosis of 30-39 was significantly higher than that of age of 70 years or more (test for trend, p<0.001). The mortality risk decreased from the period of 1996-1999 (hazard ratio [HR], 0.90; p=0.054) to the period after 2000 (HR, 0.74; p<0.001) as compared with that from the period of 1991-1995. Conclusion: An increasing incidence and decreasing age of diagnosis in epithelial ovarian cancer patients were noted. Histological type, age of diagnosis, and treatment period were important prognostic factors for epithelial ovarian carcinoma.

MnO2/carbon nanotube-embedded carbon nanofibers as core–shell cables for high performing asymmetric flexible supercapacitors

Cheng-Liang Huang,Li-Ming Chiang,Chien-An Su,YUAN-YAO LI 한국공업화학회 2021 Journal of Industrial and Engineering Chemistry Vol.103 No.-

Supercapacitors (SCs) are important devices for energy storage because they provide a higher power densityas compared to that of batteries. However, SCs with high energy density and good flexibility are stillunder development. In this study, we fabricated MnO2-coated Carbon nanotube (CNT)-embedded carbonnanofiber (CNF) (referred to as MnO2/CNF-CNT) core–shell cables to investigate pseudo-capacitators,while activated CNF-CNTs obtained by CO2 activation was used for Electrical double-layer capacitors(EDLCs). Owing to the unique structure of the materials and high electrical conductivity of the CNTson the CNFs, a specific capacitance of 483.5 F/g was achieved using MnO2/CNF-CNT mat with 1 MNa2SO4 aqueous electrolyte at 0.5 A/g. A flexible MnO2/CNF-CNT supercapacitor was assembled, whichwas binder-free, electrically conductive media-free, and current collector-free. Further an asymmetricsupercapacitor was assembled with the MnO2/CNF-CNT mat and activated CNF-CNT mat in an ionic liquid(1-ethyl-3-methylimidazolium bis (trifluoromethylsulfonyl) imide) electrolyte. The maximum specificcapacitance of, energy density of and power density of 94.25 F/g, 209.4 Wh/kg and 1000 W/kg can beachieved with the asymmetric supercapacitor at 0.5 A/g and 4.0 V. We believe that these materials havesignificant potential for use in light-weight and flexible SCs.

Analysis of the Interdecadal and Interannual Variability of Autumn Extreme Rainfall in Taiwan Using a Deep-Learning-Based Weather Typing Approach

Li‑Huan Hsu,Yi‑chao Wu,Chou‑Chun Chiang,Jung‑Lien Chu,Yi‑Chiang Yu,An‑Hsiang Wang,Ben Jong‑Dao Jou 한국기상학회 2023 Asia-Pacific Journal of Atmospheric Sciences Vol.59 No.2

This study sought to assess the interdecadal and interannual variability of autumn extreme rainfall (ER) in Taiwan from 1979to 2019. Three types of ER events were identified based on a clustering analysis augmented by a deep autoencoder-basedneural network model. This method outperforms other methods in obtaining the optimal number of clusters by extractingthe synoptic features in advance. The patterns associated with these three types include a tropical cyclone covering Taiwan(TC), a TC-like circulation in the South China Sea (SCS) accompanied by northeasterly near northern Taiwan (TC-NE), andnortheasterly near northern Taiwan (NE). The differences in the rainfall pattern caused by the three types were discernableover Taiwan. How the PDO or ENSO modulates the regional large-scale environment to favor the occurrence of these ERevents was investigated. The occurrence of TC-NE events was simultaneously correlated with the negative phases of PDO/ENSO in the interdecadal/interannual scale. In the negative phases of PDO/ENSO, a low-level anomalous cyclone overSCS accompanied by background northeasterly favored the regional TC activities and may cause more TC-NE events. Theoccurrence of NE events is simultaneously correlated with the cold phase of ENSO. An anomalous low-level anticyclone inNortheast Asia strengthened the northeasterly toward northern Taiwan, and with the seasonal background moisture, providedfavorable conditions for the occurrence of the NE events. Overall, the occurrence of the TC events did not correlate with thePDO or ENSO signals; the reasons for the lack of correlation were discussed herein.

Risks of cervical intraepithelial neoplasia grade 3 or invasive cancers in ASCUS women with different management: a population-based cohort study

Yi-Jou Tai,Yun-Yuan Chen,Huang-Cheng Hsu,Chun-Ju Chiang,San-Lin You,Chi-An Chen,Wen-Fang Cheng,Taiwan Cervical Cancer Control Task Force 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.4

OBJECTIVE: To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. METHODS: Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). RESULTS: There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07–0.68; p=0.010). Women in their 40s–50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03–1.49; p=0.020). CONCLUSION: In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years.

Survival benefit of patients with early-stage ovarian carcinoma treated with paclitaxel chemotherapeutic regimens

Chien-An Chen,Chun-Ju Chiang,Yun-Yuan Chen,San-Lin You,Shu-Feng Hsieh,Chao-Hsiun Tang,Wen-Fang Cheng 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.1

Objective: Adjuvant chemotherapy was introduced in patients with early-stage ovarian cancer (OC). The benefit of standard chemotherapeutic regimens including taxane has not been established. Methods: Patients with early-stage OC from the National Health Insurance Research database of Taiwan who received platinum plus cyclophosphamide (CP) or platinum plus paclitaxel (PT) for 3–6 cycles were recruited, and the disease-free survival (DFS) and overall survival (OS) were determined. Results: A total of 1,510 early-stage OC patients, including 841 who received CP regimen and 699 who received PT regimen, were included. The 2 groups had a similar estimated probability of 5-year DFS (PT vs. CP, 79.0% vs. 77.6%; p=0.410) and OS (84.6% vs. 84.3%; p=0.691). Patients >50 years of age who received the CP regimen had a lower 5-year DFS than the patients ≤50 years of age who received the CP (p<0.001) or PT regimens (p=0.001). Additionally, patients >50 years of age who received the CP regimen had a worse 5-year OS compared with the other 3 groups (p=0.019) (p=0.179 for patients >50 years of age in the PT group; p=0.002 for patients ≤50 years of age in the CP group; and p=0.061 for patients ≤50 years of age in the PT group). Patients with the CP or PT regimen for 3–5 cycles had a similar 5-year DFS and OS compared to 6 cycles (p>0.050). Conclusion: Chemotherapeutic regimens with taxane could be recommended for early-stage OC patients >50 years of age.