Expanding biospecimens from Korean gynecologic cancer bank: Construction of tissue micro arrays and establishment of immortalize cell line

( Geum Seon Sohn ),( Doo Byung Chay ),( Hyun Ja Kwon ),( Wook Yeom Yang ),( Jae Hoon Kim ) 대한산부인과학회 2015 대한산부인과학회 학술대회 Vol.101 No.-

Risk of neonatal morbidity in term infants delivered by emergency cesarean delivery in single institution

( Geum Seon Sohn ),( Eui Hyeok Kim ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Objective: Neonatal outcomes in deliveries with labor can be different from ones without labor. The purpose of this study is to investigate the association between emergency delivery with labor and the neonatal morbidity and outcomes. Methods: This was a retrospective observational study of singleton liveborn deliveries by cesarean with gestational ages between 38 and 41 weeks at National Health Insurance Service Ilsan Hospital with electronic medical record data from 2013 to 2017. Neonatal outcomes and morbidities in elective cesarean delivery without labor were compared with ones in emergency cesarean delivery with labor. Results: A total of 225 women who underwent a cesarean deliveries was recruited. Of these, 61 infants was delivered by emergency cesarean, while 164 infants by elective cesarean without labor. Maternal age and gestational age was higher in elective cesarean delivery group. The 1 minute and 5-min APGAR score were higher in the elective cesarean delivery group than emergency cesarean (6.59 vs. 6.18, p = 0.014, 7.70 vs. 8.01, p = 0.019). Compared with elective cesarean, the rate of NICU admission and intubation were higher in emergency cesarean group (39.3% vs. 4.3%, p < 0.001, 0.0% vs. 9.8%, p < 0.001). The rate of 5 minutes APGAR score less than 7 and neonatal length of stay, however, were not different and severe neonatal morbidities such as respiratory distress syndrome and tachypnea of newborn also were very low in both groups and were not different between two groups. Conclusion: Compared with newborns delivered by emergency cesarean deliveries, those delivered by elective cesarean delivery around term without labor have a lower risk of morbidities and better transient outcomes, however, serious respiratory morbidity or overall outcomes was not different between two groups.

GO-23 : Chemosensitivity testing based on gene expression profiling in patients with ovarian cancer

( Geum Seon Sohn ),( Hyeong Ju Kim ),( Ji Yun Lee ),( Jinkyoung Kong ),( Ji Hee Choi ),( Hanbyoul Cho ),( Eun Ji Nam ),( Sang Wun Kim ),( Sunghoon Kim ),( Jae Hoon Kim ),( Young Tae Kim ),( Doo Byung 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: To evaluate the association between clinical response of treatment agents and results of chemosensitivity testing in ovarian cancer. 방법: Tissue was obtained from 21 ovarian cancer patients and gene expression was evaluated by quantitative real-time polymerase chain reaction (PCR). Selected gene panel with expression of specific genes in the pathways that are related to drug responses in ovarian cancer were analyzed( AKT, Aurora A, BCRP, CD31, ERCC1, GSTpi, HER2, MDR1, Mitosin, PI3 Kinase, RRM1, Survivin, TOP1, TOP2A, TS, VEGF, VEGFR2, XIAP, P73). Gene expression were matched with therapeutic agent including Platinum, Taxanes, Bevacizumab, Gemcitabine, Topoisomerase I Inhibitors, Topoisomerase II Inhibitors, Cyclophosphamide, Herceptin, and 5-fluorouracil for chemosensitivity. 결과: Chemosensitivity testing revealed sensitivity rate of 66%, 81%, 96%, 56% and 61% for Platinum, Taxanes, Topoisomerase I Inhibitors, Topoisomerase II Inhibitors, and Bevacizumab, respectively. Treatment response rate was 70% (Complete Response: 40%, Partial Response: 30%). Treatment response was not significantly increased in the platinum sensitive patients (p=0.613), and overall response rate did not significantly differ according to the chemosensitivity test. 결론: This study may provide useful information in optimizing individual chemotherapy in the treatment of ovarian cancer.

Current medical treatment of uterine fibroids

( Geum Seon Sohn ),( Sihyun Cho ),( Yong Man Kim ),( Chi-heum Cho ),( Mee-ran Kim ),( Sa Ra Lee ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.2

Uterine fibroids (leiomyomas or myomas), benign monoclonal tumors, are the most common benign tumors in women. Heavy or prolonged menstrual bleeding, abnormal uterine bleeding, resultant anemia, pelvic pain, infertility, and/or recurrent pregnancy loss are generally associated with uterine fibroids. Although curative treatment of this tumor relies on surgical therapies, medical treatments are considered the first-line treatment to preserve fertility and avoid or delay surgery. The aim of this review is to provide available and emerging medical treatment options for symptomatic uterine fibroids. Literature review and consensus of expert opinion. Many uterine fibroids are asymptomatic and require no intervention, although it is advisable to follow-up patients to document stability in size and growth. Fibroid-associated symptoms include heavy menstrual bleeding and pain or pelvic discomfort. The association between infertility and fibroids increases with age. Treatment options for symptomatic uterine fibroids ― include medical, surgical, and radiologically guided interventions. Various medical therapies are now available for women with uterine fibroids, although each therapy has its own advantages and disadvantages. Currently, gonadotrophin-releasing hormone (GnRH) agonists and selective progesterone receptor modulators (SPRMs) are the most effective medical therapies, with the most evidence to support their reduction of fibroid volume and symptomatic improvement in menstrual bleeding. The choice of treatment depends on the patient's personal treatment goals, as well as efficacy and need for repeated interventions.

Preoperative serum levels of cancer antigen 125 and carcinoembryonic antigen ratio can improve differentiation between mucinous ovarian carcinoma and other epithelial ovarian carcinomas

( Ji Hui Choi ),( Geum Seon Sohn ),( Doo Byung Chay ),( Han Byoul Cho ),( Jae-hoon Kim ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.3

Objective The main aim of this study was to evaluate cancer antigen 125 (CA125)/carcinoembryonic antigen (CEA) ratio (CCR), as a reliable marker to differentiate ovarian mucinous carcinoma from other epithelial ovarian carcinomas (EOCs), namely serous, clear cell, and endometrioid carcinomas. Methods Female patients suffering from different kinds of EOCs whom were subjected to elective surgery at the Gangnam Severance Hospital between January 2008 and December 2016, were included in this study. The serum levels of CA125 and CEA were assayed using commercially available kits per the manufacturer's instructions. Results The CCR in mucinous carcinoma (mean 32.1) was significantly lower than that of clear cell (mean 235.0) and endometrioid carcinoma (mean 427.0) in stage I (all P<0.05). In stage II-IV, CCR in mucinous carcinoma (mean 37.6) was significantly lower than that of serous carcinoma (mean 148.0) (P<0.01). The sensitivity and specificity of CCR in detecting mucinous carcinoma from other types of EOC was 75.0% and 77.5%, respectively in stage I and 100.0% and 84.4%, respectively in stage II-IV (both cut-off value <90.7). Conclusion The present results suggest that pretreatment CCR might provide higher specificity and clinically relevant information as a criterion for the differentiation between ovarian mucinous carcinoma and other types of EOC.

HBV : Quantitative Hepatitis B Surface Antigen Kinetics in Entecavir Treated Patients

( Ju Yeon Cho ),( Yong Han Paik ),( Seon Woo Kim ),( Sook Young Woo ),( Won Sohn ),( Geum Youn Gwak ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ),( Byung Chul Yoo ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1

Background: Hepatitis B surface antigen (HBsAg) loss is associated with immunological control of the hepatitis B virus and durable suppression of viral replication. HBsAg levels reflect transcription of closed covalent circular DNA in patients with chronic hepatitis B (CHB). The aim of this study was to investigate the on-treatment kinetics of quantitative HBsAg during entecavir therapy to predict the treatment period needed to achieve HBsAg seroconversion. Methods: From a cohort of 1006 CHB treatment-naive patients who were started on entecavir, 426 patients with a quantitative HBsAg value after initiation of entecavir were selected. Among the patients, 321 patients (75.1%) had more than 2 serial samples. The kinetics of quantitative HBsAg decline was assessed using 1469 samples by mixed linear model to predict the time to clear HBsAg while on entecavir treatment. Results: Among the 426 patients, 221 patients (51.9%) were HBeAg positive and 205 patients (48.1%) were HBeAg negative. At baseline, the age of the HBeAg(-) group was significantly older (P<0.001) and the level of HBV-DNA was significantly lower (P<0.001) compared to the HBeAg (+) group. During a median follow up of 49.5 months, the quantitative HBsAg level showed a slow but consistent decrease in value regardless of the HBeAg status. The HBeAg-positive group had a mean slope of -0.0077 ± 0.0011 Log10 IU/month (P<0.001) and the HBeAg-negative group had a mean slope of -0.0052 ± 0.0010 Log10 IU/month (P<0.001). The calculated time to clear quantitative HBsAg in HBeAg-positive and HBeAg-negative groups were 37 years and 50 years, respectively. Conclusions: The analysis of kinetics for HBsAg level during entecavir therapy suggests the treatment period required to achieve quantitative HBsAg clearance during entecavir therapy is life-long, regardless of the HBeAg status of chronic hepatitis B patients.

GO-24 : Forkhead box P1 (Foxp1) in cervical cancer

( Hyeong Ju Kim ),( Ji Yun Lee ),( Jinkyoung Kong ),( Ji Hee Choi ),( Geum Seon Sohn ),( Eun Ji Nam ),( Sang Wun Kim ),( Doo Byung Chay ),( Sunghoon Kim ),( Jae Hoon Kim ),( Young Tae Kim ),( Han Byou 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: The forkhead box protein 1 (FOXP1) is considered as both a tumor suppressor candidate and a potential oncogene. Here, we investigated FOXP1 expression in cervical cancer, and the clinical significance of FOXP1 and it`s mechanism of action in cervical cancer. 방법: FOXP1`s functional role was investigated by employing lentiviral-mediated overexpression and knockdown in cervical cancer cell lines. Immunohistochemical staining for FOXP1 was performed on a cervical cancer tissue microarray consisting of 158 primary cervical cancers, 280 cervical intraepithelial neoplasias (CINs), and 378 matched normal tissues. 결과: FOXP1 overexpression promoted cell proliferation and tumorigenesis, whereas FOXP1 knockdown inhibited these properties in HeLa and CaSki cell lines. By immunohistochemical staining, FOXP1 expression increased during the normal to tumor transition of cervical carcinoma (p< 0.001), and this increased expression was significantly associated with tumor stage (p=0.009) and tumor grade (p< 0.001). In multivariate analysis, FOXP1+ (p=0.031) and tumor stage (p=0.032) were independent prognostic factors for overall survival. 결론: Taken together, our data indicate that FOXP1 has a crucial role in cervical cancer progression, and its overexpression is associated with poor prognosis, supporting that FOXP1 may be used as a promising novel target for therapeutic interventions.

GO-17 : Makorin Ring Finger Protein 1 (MKRN1) as an adjunct marker in liquid-based cervical cytology

( Ji Yun Lee ),( Hyeong Ju Kim ),( Jinkyoung Kong ),( Ji Hee Choi ),( Geum Seon Sohn ),( Hanbyoul Cho ),( Eun Ji Nam ),( Sang Wun Kim ),( Doo Byung Chay ),( Sunghoon Kim ),( Young Tae Kim ),( Jae Hoon 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: The aim of the study was to test the ability of MKRN1 to detect cervical lesion in a screening setting and its use as a surrogate marker of HPV infection. 방법: We conducted PROspective specimen collection and retrospective Blinded Evaluation (PROBE) study. Liquid-based cytology samples were collected from 187 women. A cell block was prepared from residual cervical cytology specimen for immunocytochemistry of MKRN1 and P16 INK4a.Liquid-based cervical cytology, MKRN1, P16 INK4a, P21, P57, KI-67 immunostaining on cell block sections, HPV hybrid capture and real time Polymerase chain reaction (PCR) were performed and analyzed with pathologic results.Clinical performances [sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV)] were calculated for all women and subgroup analysis was performed for patients with ASCUS or LSIL. 결과: MKRN1 positivity increased with histologic severity, from 32.4% in CIN1, 60.0% in CIN2, 80.0% in CIN3 to 92.3% in invasive cancer. The sensitivity, specificity, PPV and NPV of MKRN1 to detect CIN2+ was 73.8%, 76.8% 75.6%, and 75.0%, respectively. However, liquid-based cytology showed poorer clinical performance than MKRN1 immunostaining (61.3%, 69.5%, 66.2% and 64.8%, respectively) and HPV testing had lower specificity than MKRN1 (67.7%). When combining two screening tests, MKRN1 + HPV showed the highest sensitivity, specificity, PPV and NPV (71.8%, 85.5%, 82.3%, 76.5%, respectively), while there were no significant differences between cytology + HPV (60.6%, 81.8%, 75.4%, 69.2%) and cytology + MKRN1 (58.8%, 84.1%, 78.3%, 67.7%) in all aspects. In cases of ASCUS/LSIL, MKRN1 + HPV (100%, 72.7%, 73.9%, 100%, respectively) showed the best clinical performances followed by MKRN1 + cervical cytology (100%, 50.0%, 60.7%, 100%, respectively). 결론: MKRN1 was more sensitive and specific than liquid-based cytology, and it was more specific than HPV test. Our study showed that MKRN1 + HPV has the highest sensitivity and specificity when combining two diagnostic tests. As part of screening procedure, MKRN1 could be used as a satisfactory biomarker for the primary screening of cervical cytology.