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RISS 인기검색어
- 검색키워드
- 저자 : Bruce Kessel (검색결과 3 건)
- 무료
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- 유료
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Ovarian cancer screening in menopausal females with a family history of breast or ovarian cancer
Tiffany Lai,Bruce Kessel,Hyeong Jun Ahn,Keith Y. Terada 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.4
Objective: To determine whether annual screening reduces ovarian cancer mortality in women with a family history of breast or ovarian cancer. Methods: Data was obtained from the Prostate, Lung, Colorectal, and Ovarian cancer trial, a randomized multi-center trial conducted to determine if screening could reduce mortality in these cancers. The trial enrolled 78,216 women, randomized into either a screening arm with annual serum cancer antigen 125 and pelvic ultrasounds, or usual care arm. This study identified a subgroup that reported a first degree relative with breast or ovarian cancer. Analysis was performed to compare overall mortality and disease specific mortality in the screening versus usual care arm. In patients diagnosed with ovarian cancer, stage distribution, and survival were analyzed as a secondary endpoint. Results: There was no significant difference in overall mortality or disease specific mortality between the two arms. Ovarian cancer was diagnosed in 48 patients in the screening arm and 44 patients in the usual care arm. Screened patients were more likely to be diagnosed at an earlier stage than usual care patients. Patients in the screening arm diagnosed with ovarian cancer experienced a significantly improved survival compared to patients in the usual care arm; relative risk 0.66 (95% CI, 0.47 to 0.93). Conclusion: Screening did not appear to decrease ovarian cancer mortality in participants with a family history of breast or ovarian cancer. Secondary endpoints, however, showed notable differences. Significantly fewer patients were diagnosed with advanced stage disease in the screening arm; and survival was significantly improved. Further investigation is warranted to assess screening efficacy in women at increased risk.
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Differences in risk for type 1 and type 2 ovarian cancer in a large cancer screening trial
Keith Y. Terada,안형준,Bruce Kessel 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.3
Objective: To investigate the role of previous gynecologic surgery, hormone use, and use ofnon-steroidal anti-inflammatory drugs on the risk of type 1 and type 2 ovarian cancer. Methods: We utilized data collected for the Prostate, Lung, Colorectal, and Ovarian cancerscreening trial. All diagnosed ovarian cancers were divided into three groups: type 1,endometrioid, clear cell, mucinous, low grade serous, and low grade adenocarcinoma/nototherwise specified (NOS); type 2, high grade serous, undifferentiated, carcinosarcoma, andhigh grade adenocarcinoma/NOS; and other: adenocarcinoma with grade or histology notspecified, borderline tumors, granulosa cell tumors. The odds ratios for type 1, type 2, andother ovarian cancers were assessed with regard to historical information for specificrisk factors. Results: Ibuprofen use was associated with a decrease in risk for type 1 ovarian cancer. Tuballigation and oral contraceptive use were associated with a decrease in risk for type 2 ovariancancer. A history of ectopic pregnancy was associated with a decreased risk for all ovariancancers by almost 70%. Conclusion: These findings support the hypothesis that carcinogenic pathways for type 1 andtype 2 ovarian cancer are different and distinct. The marked reduction in all ovarian cancerrisk noted with a history of ectopic pregnancy and salpingectomy implies that the fallopiantube plays a key role in carcinogenesis for both type 1 and type 2 ovarian cancer.
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Byung-Koo Yoon,Young-Hee Kang,오원종,이동윤,Duk-Kyung Kim,Bruce Kessel,강치덕 대한폐경학회 2020 대한폐경학회지 Vol.26 No.1
Objectives: When administered soon after menopause, hormone therapy can prevent coronary heart diseases in women. To explore the mechanism underlying the cardioprotective actions of estrogen, we investigated the effects of 17β-estradiol (17β-E2) on the plasminogen activator system using cultured vascular smooth muscle cells (VSMCs). Methods: VSMCs were isolated from rat aortas. Protein expression of plasminogen activator inhibitor type 1 (PAI-1) and tissue-type plasminogen activator (t-PA) were evaluated using Western blotting and enzyme-linked immunosorbent assay, respectively. The enzyme activity of PAI-1 in a conditioned medium was assessed via reverse fibrin overlay zymography and that of t-PA was assessed via fibrin overlay zymography. Gene expression was quantified using real-time reverse transcription-polymerase chain reaction. Results: Following pre-treatment for 24 hours, 17β-E2 suppressed both protein expression and enzyme activity of PAI-1 stimulated by lysophosphatidylcholine (lysoPC) in a significant and dose-dependent manner at a near physiological concentration. Moreover, 17β-E2 (10−7 M) inhibited PAI-1 gene expression, and ICI 182,780—a specific estrogen receptor antagonist—blocked the effects of 17β-E2 on the PAI-1 protein. 17β-E2 did not affect t-PA secretion but significantly enhanced free t-PA activity through reduced binding to PAI-1. Furthermore, 17β-E2 suppressed intracellular reactive oxygen species production and nuclear factor-κB-mediated transcription. Conclusions: In VSMCs stimulated with lysoPC, 17β-E2 reduced PAI-1 expression through a non-receptor-mediated mechanism via antioxidant activity as well as a receptor-mediated mechanism; however, it did not alter t-PA secretion. Of note, 17β-E2 suppressed PAI- 1 activity and concurrently enhanced t-PA activity, suggesting a beneficial influence on fibrinolysis.
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