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16 세 여학생에서 발생한 난소의 원발성 비임신성 융모상피암 1 예
김정희,오병찬,김관식,정명자 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8
Primary ovarian choriocarcinoma is an extremely rare germ cell neoplasm, and the prognosis is poor. Especially, the diagnosis of primary ovarian nongestational chori-ocarcinoma can be reliably established in a girl or innocent virgin. We report a case of primary ovarian, nongestational, pure choriocarcinoma in a 16-year-old woman. She died within 1 year after diagnosis in spite of the treatment with surgery and combin-ation chemotherapy.
제IB기 자궁경부암에 있어서 5 년 무병생존율과 예후인자와의 관계
김정희,오병찬,김종덕,김주영,김관식,박종을 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.8
1985년 1월부터 1991년 12월까지 전북대학병원 산부인과에 입원하여 근치적 자궁적출술 및 골반림프절제술 또는 이와 병행하여 보조적 방사선 치료를 받았던 자궁경부암 IB기 70예를 대상으로 5년 무병생존율과 예후인자와의 관계를 분석하여 다음과 같은 결론을 얻었다. 1. 림프절 전이는 종양 크기와 상호 연관관계가 있었 으나(P<0.05), 환자의 연령, 조직학적 분화도 및 암세포 형태와는 유의한 관계가 없었다. 2. 5년 무병생존율과 관계있는 예후인자는 종양 크기 였으며(P<0.05), 환자의 연령, 암세포 형태, 조직학적 분화도, 임파절 전이에 따른 5년 무병생존율은 유의한 차이가 없었다. 3. 치료 방법에 따른 재발률은 수술만 시행한 군은 4.8%, 수술 후 보조 방사선 치료를 병행한 군은 32.1%로 유의한 차이가 있었다(P<0.05). 4. 종양 크기에 따른 재발률은 4 cm 이하인 경우가 13.3%, 4 cm 이상인 경우는 30.0%로서 유의한 차이가 있 었다(P<0.05). 5. 임파절 전이에 따른 재발률은 임파절에 전이가 없었던 군은 13.8%, 전이가 있었던 군은 25%로서 유의한 차이가 없었다. 이상의 결과를 종합하면 보고자에 따라 초기 자궁경 부암 환자의 생존율에 영향을 주는 예후인자는 차이가 있지만, 이러한 예후인자들은 표준 치료 방법의 원칙을 바꿀 수는 없고 보조 치료를 결정할 때 고려되어야 한다고 사료된다. Radical hysterectomy and pelvic lymph node dissection is well accepted as primary treatment for early stage carcinoma of the cervix. While surgery and radiotherapy achieve similar survival results, surgery may offer additional benefits, including preserved ovarian and sexual function. Patient selection is the key to good results for treatment method of the early stage cervical cancer. This study was undertaken to identify clinicopathological prognostic factors in 70 patients with stage IB carcinoma of the cervix treated by radical surgery with or without adjuvant radiotherapy from January 1985 to December 1991. Prognostic factors included patient age, tumor size, cell type and differentiation, and lymph node metastasis. Tumor size was found to be the only important prognostic factor for 5-year disease free survival rate (P<0.05), and tumor size also correlated significantly with metastasis to lymph nodes (P<0.05). Patient age, tumor cell type, histologic grade, and positive lymph nodes did not significantly affect 5-year disease free survival rate (P>0.05). The recurrence rate was higher in patients with large primary tumor (P<0.05). There was significant difference in recurrence rate between surgery alone and surgery plus postoperative radiotherapy in all patients (P<0.05). In conclusion, these factors are important from a prognostic standpoint but often do not alter the standard therapy of either radiation or radical surgery. As effective adjuvant therapy become available, these prognostic factors will be critical to determine which patients would benefit from adjuvant therapy.
산전 진단된 Congenital Cystic Adenomatoid Malformation of the Fetal Lung 2 예
김정희,진소자,양기환,정명자,방해미 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.8
Congenital cystic adenomatoid malformation (CCAM) is a rare pulmonary lesion that can be diagnosed prenatally by ultrasonography. CCAM is a benign hamartomatous or dysplastic tumor that is characterized by overgrowth of the terminal bronchioles. It is typically unilateral and usually involves one lobe or segment with a broad spectrum of clinical presentation. In 1977, Stocker et al. examined 38 cases of CCAM and divided these lesions into three types based on the gross size of the cysts and histologic findings. The overall prognosis of an affected fetus depends on the size of the lung mass and the secondary pathophysiologic derangement. Recently we experienced two cases of congenital cystic adenomatoid malformation of the lung, which was diagnosed by prenatal ultrasonography.