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RISS 인기검색어
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- 저자 : 양성천(Seung Chun Yang) (검색결과 2 건)
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Smooth Muscle Tumor of Uncertain Malignant Potential ( STUMP ) 의 임상적·병리학적 고찰
이희종(Hee Jong Lee),유희석(Hee Sug Ryu),박영한(Young Han Park),주희재(Hee Jae Joo),양성천(Seung Chun Yang),오기석(Kie Suk Oh) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10
목적 : 본 연구는 Smooth muscle tumor of uncertain malignant potential(이후 STUMP로 표기함)을 평활근 육종과 비교하여 임상적. 병리학적으로 고찰하고, 1994년 개정된 자궁평활근종 분류법으로 재분류후 그 결과를 임상경과와 비교하여, 새로운 분류법의 실용성을 검토하였다.연구방법 : 1995년부터 1999년까지 아주대학교병원 산부인과를 내원한 환자들 중 STUMP로 진단된 11례와 평활근 육종으로 진단된 7례의 의무기록과 조직표본을 통해 임상적 병리학적 소견을 검토하였고, 1994년 Kempson과 Hendrickson에 의해 정립된 자궁평활근종의 분류법에 의해 재분류하였다.결과 : 환자의 연령분포/ 분만력/ 폐경유무/ 호르몬제재 복용 기왕력은 양군에서 유의한 차이가 없었다. 가장 흔한 임상증상은 불규칙한 자궁출혈이었고 (STUMP 54%, 평활근 육종 62%), 수술전 초음파상 악성종양이 의심된 경우는 STUMP 군에서 1례(9%), 평활근 육종군에서 2례(29%)였다. STUMP 군 2례에서는 근종 절제술만으로 치료를 종결하였고 총 18례중 나머지 환자들은 전자궁 적출술 및 선택적 자궁부속기 절제술을 시행하였으며, 모든 예에서 재발이나 전이소견은 없었다. 총 18례 중 STUMP 10례와 평활근 육종 4례는 유사분열지수가 증가된 평활근종으로, STUMP 1례는 비정형 평활근종으로, 평활근 육종 3례는 같은 진단명으로 재분류되었다.결론 : STUMP에서 유사분열지수가 증가된 평활근종(leiomyoma with increased mitotic index)으로 재분류된 종양의 환자들은 모두 양호한 임상경과를 보여 본 연구에서 자궁평활근종의 새로운 분류법은 임상경과와 일치하였다. 이 경우 임신을 원하는 여성이면 근종 절제술만으로 치료를 종결할 수 있다. 그러나 재발가능성이 적은 비정형 평활근종(atypical leiomyoma with low risk recurrence)이나 저급악성도를 갖는 평활근종(smooth muscle tumor of low malignant potential)으로 분류된 예는 악성 임상경과의 가능성이 있어, 예후에 대한 장기적인 추적조사가 필요할 것으로 본다. Objective : To evaluate clinical-pathological aspects of smooth muscle tumor of uncertain malignant potential (STUMP), comparing those of leiomyosarcomas and to reclassify them according to the revised classification of smooth muscle tumor, and to investigate the clinical value of new classification.Methods : A retrospective review of clinical and pathological characteristics of 11 cases of STUMP and 7 cases of leiomyosarcoma was done at department of obstetrics and gynecology of Ajou university hospital from 1995 to 1999. They were reclassified according to the revised classification by Kempson and Hendrickson in 1994.Results : Patients' age, parity, status of menopause, history of hormonal use were not significantly different. Vaginal bleeding was most common clinical symptom in both groups(STUMP 55%, leiomyosarcoma 63%) and sarcomatous change was suspected in 1 case of STUMPs and 2 cases of leiomyosarcomas with preoperative transvaginal sonographic examination. Two cases of STUMP were treated with myomectomy only and hysterectomy with or without salpingo-oophorectomy was performed in all cases of leiomyosarcomas and 9 cases of 11 STUMPs. No adjuvant therapy was done and none recurred. Ten cases of STUMP and four cases of leiomyosarcoma were reclassified into leiomyoma with increased mitotic index, one STUMP into atypical leiomyoma, and three leiomyosarcomas remained in the same category by revised classification.Conclusion : Such tumors reclassified into leiomyoma with increased mitotic index showed benign clinical course and the results of this study support new classification. However, atypical leiomyoma with low risk recurrence and smooth muscle tumor with low malignant potential still have possibility of malignant clinical course.
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임산부 자궁경부 조직에서 cyclooxygenase-1 , -2의 발현 양상
한기수,김명신,양성천,김행수,양정인,오준환,금승섭,오기석 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.11
Objective : To determine whether cyclooxygenase (COX)-1 and COX-2 are expressed differentially during the whole gestational period in the pregnant human uterine cervix and if they are involved in the process of labor. Methods : Nine patients were matched for obstetrical history and maternal age were divided into an abortion group who aborted between 13 and 16 weeks(n=3), a preterm group who delivered between 20 and 37 weeks(n=3), and a term group who delivered between 37 and 42 weeks of gestation(n=3). Immediately after vaginal delivery cervical biopsy samples were obtained and immunohistochemically stained for COX-1 and COX-2 and the degree of staining was evaluated by H-scoring system. Results : Expression of COX-1 and COX-2 was found in epithelial and stromal cells of uterine cervical tissues of preterm and term group. The immunohistochemical expression of COX-1 and COX-2 was strongest in the term group compared to the preterm group in stromal cells(HSCORE : 2.0 vs. 4.0 ; 2.0 vs. 3.0), and in epithelial cells(HSCORE : 1.0 vs. 3.0 ; 1.0 vs. 3.0). Conclusion : Although small amount of the groups were investigated, in the pregnant human uterine cervix, COX-1 and COX-2 are found to be expressed, and both shows the strongest expression in term cervical tissue. It is suggested that the uterine cervix, under the control of prostaglandins, is actively involved in the process of labor, and it is thought that the role of COX-1 and COX-2 is more important in parturition process with advancing gestational age.
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