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이형욱(Hyung Wook Lee),안태성(Tae Sung Ahn),조성우(Sung Woo Cho),신응진(Eung Jin Shin),박내경(Nae Kyung Park),이문수(Moon Soo Lee),김창호(Chang Ho Kim),백무준(Moo Jun Baek) 대한종양외과학회 2012 Korean Journal of Clinical Oncology Vol.8 No.1
목적 : 신경주위 침윤(Perineural invasion, PNI)은 많은 악성종양에서 생존율과 좋지 않은 상관관계를 보이는 것이 알려져 있으나, 대장암에서 암 세포의 신경주위 침윤과 대장암 환자의 예후와의 관련성에 대해서는 아직 명확하게 확인되지 않았다. 이에, 저자들은 대장암 환자에서 암세포의 침윤과 다른 임상병리학적 예후인자와의 관련성을 확인하여 대장암에서 침윤이 대장암 환자의 또 다른 예후인자로서 가능한지를 알아보고자 하였다. 방법 : OO에서 2007년 1월부터 2010년 12월까지 대장암으로 수술 받은 환자 148명을 대상으로 조사하였다. 신경주위 침윤 여부와 대상 대장암 환자의 기타 임상병리학적 인자와 비교하였고, 이들의 관계에 대하여 통계학적 유의성을 검정하였다. 결과 : 신경주위 침윤은 대상 환자 148명중 31명인 20.9%에서 확인할 수 있었다. 대장암 조직에서의 신경주위 침습은 환자의 T병기와 무관하였다. (p=0.114) 반면에, 신경주위 침습이 있는 경우 대장암의 림프절 전이와 강한 상관관계를 보였고(p<0.001), 림프관 및 혈관침습이 더 많이 발견되었다(p=0.001). 그리고, 신경주위 침습 여부는 대장암 환자의 전체 병기와의 관련성을 보였다(p<0.001). 하지만 그 외, 암 세포의 분화도와는 상관관계가 없었고, 대장암의 원격전이가 있는 군과 없는 군에서는 신경주위 침습이 21%, 20%로 각각 발현되어 서로 연관성이 없었다. 결론 : 대장암에서 암 세포의 신경주위 침습은 환자의 추적 관찰기간이 충분하지 않아 환자의 예후와의 관계가 확인되지 않았지만, 다른 여러 중요 예후 인자들, 즉 림프절 전이 여부, 림프관 및 혈관 침습, 환자의 병기 등과 상관관계가 확인되었다. 이는 신경주위 침습이 대장암 환자에서 또 다른 예후인자로 기능할 수 있음을 보여주는 결과로 생각되며 이 결과가 대장암 환자의 보조 치료를 계획하는데 고려되어야 할 것으로 생각된다. Purpose : Perineural invasion (PNI) is widely known to be correlated with poor survival in many type of malignancy but the connection between perineural invasion of colorectal cancer and the prognosis has not yet been clearly confirmed. Therefore, we examined perineural invasion in colorectal cancers and investigated its relationship to clinicopathological features such as tumor staging, lymph node metastasis, vascular invasion, lymphatic invasion and patient’s prognosis in this study Methods : The subjects were 148 colorectal cancer patients who underwent surgical resection in OOO. The pathologists who were not aware of the prognosis of the patients reexamined the existing biopsy results and reevaluated the perineural invasion. The presence of perineural invasion and the other clinicopathological factors were compared and the statistical significance of the correlation between these was examined. Results : Perineural invasion was confirmed in less than 10% of the patients in the initial biopsy results. However, it was confirmed in 20.9% of the patients reevaluating the biopsy. Perineural invasion in colorectal cancer was found to be unrelated to the T stage of the patients (p=0.114). On the other hand, perineural invasion appeared to be strongly related to lymph node metastasis of colorectal cancer (p<0.001) and lymphatic and vascular invasion was more common in the patients with perineural invasion (p=0.001). Moreover, perineural invasion seemed to be related to the stage of cancer (p<0.001) and patient’s survival (p<0.05). Nevertheless, it was neither correlated to the level of differentiation nor to the distant metastasis since perineural invasion was expressed in 21% of the patients with distant metastasis and in 20% of the patients without distant metastasis. Conclusion : The correlation of perineural invasion in colorectal cancer to the clinicopathologic factors such as lymph node metastasis, lymphatic invasion, vascular invasion and the stage of disease were confirmed. And perineural invasion was significantly correlated with patient’s survival. This is thought to be that perineural invasion can be a prognostic factor of colorectal cancer and it should be utilized planning adjuvant therapy for colorectal cancer patients.
유방암 환자에서 c-erbB-2, p53, bcl-2, 그리고 c-myc의 발현유무와 임상적 의의
최남규(Nam Kyu Choi),김성용(Sung Yong Kim),김태윤(Tae Yun Kim),채만규(Man Kyu Chae),백무준(Moo Jun Baek),임철완(Chul Wan Lim),박내경(Nae Kyung Park),이문수(Moon Soo Lee),김형철(Hyung Chul Kim),김창호(Chang Ho Kim),이민혁(Min Hyuk Lee 대한외과학회 2002 Annals of Surgical Treatment and Research(ASRT) Vol.62 No.5
김태윤,백무준,김성용,신응진,박내경,이문수,김창호,송옥평 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1
Locally recurrent rectal cancer is a difficult clinical problem. Local recurrence following treatment for rectal cancer is a major cause of morbidity and mortality. The reported range of local recurrence rates following surgical treatment for rectal cancer has varied from 4% to 50%. We retrospectively reviewed the charts of 142 rectal cancer patients from January 1991 to December 1999. Analysis of patients factors included age, gender, type of surgery, and adjuvant therapy. Tumors were assessed for level, stage, and grade. Local recurrence and distant metastases were also documented. Variables influencing local recurrence in this group were identified and disease-free survival is determined. Of the 142 patients(74 males, 68 females; mean age 62.6 years), 137 consecutive patients operated on for rectal cancer and followed up to December 2000 (range 23-118months) were analyzed. Local recurrence rate was 18.3%. Age and sex of patients, type of surgery, location of tumor in the rectum, size, morphology and grading of the tumor were all unrelated to the event under investigation. At Cox regression, the Dukes stage and the postoperative radiotherapy were the only independent prognostic factors for local recurrence, and Dukes stage (Hazard ratio=2.89, p<0.001) and local recurrence (Hazard ratio=3.31, p<0.01) were the only independent factors associated with improved survival.