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박길효,Soon Ha Kwon,Yong Sub Lee,정승원,장재영,이세환,김상균,차상우,김영석,조영덕,김홍수,김부성,김용재 대한간학회 2015 Clinical and Molecular Hepatology(대한간학회지) Vol.21 No.2
Background/Aims: The predictive role of contrast-enhanced ultrasonography (CEUS) before performing transarterial chemoembolization (TACE) has not been determined. We assessed the possible predictive factors of CEUS for the response to TACE. Methods: Seventeen patients with 18 hepatocellular carcinoma (HCC) underwent TACE. All of the tumors were studied with CEUS before TACE using a second-generation ultrasound contrast agent (SonoVue®, Bracco, Milan, Italy). The tumor response to TACE was classified with a score between 1 and 4 according to the remaining enhancing-tumor percentage based on modified response evaluation criteria in solid tumors (mRECIST): 1, enhancing tumor <25%; 2, 25%≤enhancing tumor<50%; 3, 50%≤enhancing tumor<75%; and 4, enhancing tumor≥75%). A score of 1 was defined as a “good response” to TACE. The predictive factors for the response to TACE were evaluated during CEUS based on the maximum tumor diameter, initial arterial enhancing time, arterial enhancing duration, intensity of arterial enhancement, presence of a hypoenhanced pattern, and the feeding artery to the tumor. Results: The median tumor size was 3.1 cm. The distribution of tumor response scores after TACE in all tumors was as follows: 1, n=11; 2, n=4; 3, n=2; and 4, n=1. Fifteen tumors showed feeding arteries. The presence of a feeding artery and the tumor size (≤5 cm) were the predictive factors for a good response (P=0.043 and P=0.047, respectively). Conclusions: The presence of a feeding artery and a tumor size of less than 5 cm were the predictive factors for a good response of HCC to TACE on CEUS. (Clin Mol Hepatol 2015;21:158-164)
차병효,문도호,전승민,이나리,박길효,현진남,유우주 대한소화기내시경학회 2005 Clinical Endoscopy Vol.31 No.4
Esophageal small cell carcinoma is a very rare disease. Primary extra-pulmonary small cell carcinoma was reported to account for 4% of primary small cell carcinoma and only 2% of all esophageal malignancy. Because the rate of early distant metastasis is very high, the prognosis is very poor. In Korea, 20 cases were reported. Seventeen cases were located at the mid or lower esophagus and 3 cases were located at the upper esophagus. We have experienced a case of primary upper esophageal small cell cancer, a 65-year-old female with cervical lymph node metastasis, which were diagnosed by endoscopy, open surgical lymph node biopsy and immunohistochemical analysis. 식도의 원발성 소세포암은 매우 드문 질환이다. 원발성 폐외 소세포암은 전체 소세포암의 4% 정도이며 전체 식도암 중에서는 2% 정도로 알려져 있다. 국내에서는 지금까지 20예가 보고되었는데 그 중 17예가 하부나 중부 식도에서 발생하였고 나머지 3예가 상부식도에 발생한 것으로 보고되었다. 또한 원격전이가 조기에 많이 일어나 예후가 아주 나쁜 것으로 알려져 있다. 저자들은 경부 림프절 종대를 주소로 내원한 65세 여자 환자에서 내시경 검사, 조직검사, 면역조직학적 표지자 검사를 통하여 상부식도에 발생한 원발성 식도 소세포암을 진단하였기에 보고한다.