전이성 융모암 10예에 대한 추적

김두상(DS Kim),문형(H Moon),황윤형(YH Hwang),김문신(MS Kim),오영돈(WD Oh) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.9

한양대학병원 산부인과에서 치료한 전이성 융모암 13예증 β-HCG 3.0mIU./ml 이하로 음전된 10예에 대하여 그 이후 12개월 이상 계속 추적 조사한 바 있어 이를 종합, 그 결과를 보고하는 바 이다. 1. Good prognosis metastatic choriocarcinoma중에 서도 전이가 2개 장기에 미쳤고 또 발병기간이 2~4개월의 보다 장기간이었던 2예에서 그렇지 못한 2예보다 β-HCG음전까지의 치료횟수가 더 많았다. 4예 모두 12 ~46개월간의 negative value에 있다. 2. 6예의 poor risk metastatic GTN에 대하여 조사한 poor risk factor중 발병기간 8~43개월이 5예로서 가장 많았다. 동일 환자에서 poor risk factor 둘이 3예에, 그리고 하나도 3예에 있었는데 전자에서 음전까지에 더 많은 치료횟수솨 보다 더 심한 독성을 보았으며 l예의 재발도 보았다. 음전된 poor risk group 6예중 5예는 12~54개월간 계속 negative value를 유지하고 있다. 3. poor risk factor가 둘 병합한 증례 5에서 불규칙 치료와 심한 독성이후 Drug resistance가 발생되어 VBP regimen으로 변경, 2회 치료후 음전하였다. 이어서 추가치료 2회로 치료중단한 바, 15주후 재발을 일으켜 사망함으로써 실패하였으나 VBP regimen의 유효성은 인정할 수 있었다 4. 음전된 10예의 전이성 융모암 중 추가화학치료가 없었던 5예에서는 재발이 없었으나 추가치료 2 kur할 poor risk metastatic GTN l예에서 재발을 보았다. 이로 미루어 추가치료의 지표는 혈청 β-subunit RIA에 의하여서도 아직 막연함을 고찰하였다. Among the 13 cases of metastatic GTN who were treated from 1978 to 1982 at the Department of Obstetrics and Gynecology of Hanyang University Hospital, 10 cases who achieved remission were analysed. Among 10 cases of metastatic choriocarcinoma, 4 cases of good prognosis metastatic GTN were treated with single agent (methotrexate or dactinomycin) and 6 of poor prognosis metastatic GTN with combination therapy (mainly MAC). The average numbers of the courses of chemotherapy needed for negative turn-out of b-hCG (less than 3mIU) were 3.0 in cases of good prognosis GTN and 4.2 in poor prognosis ones. Among the good prognosis metastatic GTN. 2 cases with more than 2 metastatic lesions and duration of 2-4 months from the onset of the disease to the initiation of the therapy needed more courses of chemotherapy for negative turn-out of b-hCG than the others with single lesion and shorter duration. Among the poor prognosis metastatic GTN those with 2 or more risk factors needed more courses of chomotherapy than those with single factor. The most common risk factor was more than 4 months from the onset of the disease to initiation of therapy and it was noted in 5 cases(8-43 months). A case of recurrence was encountered among the poor prognosis metastatic GTN with 2 risk factors. MAC had to be substituted with VBP because of severe dreug toxicity and resistance. Negative turn-out of b-hCG was achieved after 7 courses of chemotherapy including last 2 courses of VBP regimen. Twelve weeks later, however, the disease recurred and the patient died of brain metastasis. The medians of duration of remission have been noticed 36 months (12-46 months) in cases of good prognosis metastatic GTN and 33 months (12-54 months) in poor prognosis ones.

Identification and Functional Analysis of Differentially Expressed Genes Related to Metastatic Osteosarcoma

Niu, Feng,Zhao, Song,Xu, Chang-Yan,Chen, Lin,Ye, Long,Bi, Gui-Bin,Tian, Gang,Gong, Ping,Nie, Tian-Hong Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.24

Background: To explore the molecular mechanisms of metastatic osteosarcoma (OS) by using the microarray expression profiles of metastatic and non-metastatic OS samples. Materials and Methods: The gene expression profile GSE37552 was downloaded from Gene Expression Omnibus database, including 2 human metastatic OS cell line models and 2 two non-metastatic OS cell line models. The differentially expressed genes (DEGs) were identified by Multtest package in R language. In addition, functional enrichment analysis of the DEGs was performed by WebGestalt, and the protein-protein interaction (PPI) networks were constructed by Hitpredict, then the signal pathways of the genes involved in the networks were performed by Kyoto Encyclopaedia of Genes and Genomes (KEGG) automatic annotation server (KAAS). Results: A total of 237 genes were classified as DEGs in metastatic OS. The most significant up- and down-regulated genes were A2M (alpha-2-macroglobulin) and BCAN (brevican). The DEGs were significantly related to the response to hormone stimulus, and the PPI network of A2M contained IL1B (interleukin), LRP1 (low-density lipoprotein receptor-related protein 1) and PDGF (platelet-derived growth factor). Furthermore, the MAPK signaling pathway and focal adhesion were significantly enriched. Conclusions: A2M and its interactive proteins, such as IL1B, LRP1 and PDGF may be candidate target molecules to monitor, diagnose and treat metastatic OS. The response to hormone stimulus, MAPK signaling pathway and focal adhesion may play important roles in metastatic OS.

구강내 연조직 전이암종의 임상적 연구

박주용,김형섭,옥용주,송진아,이종호,김명진,최성원,Park, Joo-Yong,Kim, Hyung-Sup,Ok, Yong-Ju,Song, Jin-A,Lee, Jong-Ho,Kim, Myung-Jin,Choi, Sung-Weon 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4

Metastatic tumours to oral soft tissue are uncommon and accounts for approximately 1% of malignant oral neoplasms. Because of its rarity and clinical appearance of benign nature, the diagnosis of a metastatic lesion in the oral soft tissue may be challenging, both to clinicians and pathologists. We analyzed the clinical data of 9 patients who had metastatic carcinoma to oral soft tissues. The metastatic site to oral soft tissue was the gingiva in all cases. The most common primary site was lung (6 cases) followed by liver (2 cases) and breast (1 case). The clinical appearance resembled gingiva hyperplasia, pyogenic granuloma or gingival swelling. In one case, the metastatic gingiva lesion was found before detection of primary cancer. The mean survival time after diagnosis of metastatic lesion was 3 months. Although this metastatic lesion is rare, oral and maxillofacial surgeon should recognized that benign inflammatory lesion may be the metastatic malignant lesion or the first sign of undiagnosed underlying malignancy.

암전문 3차의료기관 피부과에 내원한 고형암에 의한 전이피부암 191예의 임상 및 조직병리학적 고찰

박형건 ( Hyung Keon Park ),윤숙정 ( Sook Jung Yun ) 대한피부과학회 2023 대한피부과학회지 Vol.61 No.1

Background: Metastatic skin cancers occur when cancer cells metastasize to the skin as the primary cancer progresses, but few studies in Korea have included a large number of patients. Objective: To analyze the clinicopathological characteristics of metastatic skin cancers originating from solid cancers. Methods: A total of 191 patients with metastatic skin cancer diagnosed by skin biopsy from April 2004 to December 2021 were retrospectively analyzed. Data on age, sex, duration, symptoms, clinical manifestations, metastatic sites, and histopathological findings were obtained from medical records and photographs. Results: The mean age of onset was 65.3 years, the male/female ratio was 80:111, and the mean duration was 3.3 months. Most patients were asymptomatic (65.4%), and the most frequent manifestation was nodular lesions (64.4%). Among the 191 metastatic skin cancers, the most common primary cancers were breast cancer (31.9%), lung cancer (25.7%), and melanoma (18.8%). The most common primary cancer in males was lung cancer (52.5%), and that in females was breast cancer (54.1%). The most common sites of metastatic skin cancer were the chest (26.6%), scalp (17.9%), abdomen (10.6%), and back (9.2%). The most common histopathological finding of metastatic skin cancer was adenocarcinoma (53.4%), followed by melanoma (18.8%) and squamous cell carcinoma (14.7%). Conclusion: We believe that this study will be helpful in diagnosing metastatic skin cancer in patients with a history of cancer or a newly diagnosed primary cancer. (Korean J Dermatol 2023;61(1):13∼21)

Therapeutic Regimens and Prognostic Factors of Brain Metastatic Cancers

Song, Wen-Guang,Wang, Yi-Feng,Wang, Rui-Lin,Qu, Yin-E,Zhang, Zhi,Li, Guo-Zhong,Xiao, Ying,Fang, Fang,Chen, Hong Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.2

Objective: This work aims to investigate the therapeutic regimen of brain metastatic cancers and the relationship between clinical features and prognosis. Methods: Clinical data of 184 patients with brain metastatic cancers were collected and analysed for the relationship between survival time and age, gender, primary diseases, quantity of brain metastatic foci, their position, extra cranial lesions, and therapeutic regimens. Results: The average age of onset was 59.1 years old. The median survival time (MST) was 15.0 months, and the patients with breast cancer as the primary disease had the longest survival time. Females had a longer survival time than males. Patients with meningeal metastasis had extremely short survival time. Those with less than 3 brain metastatic foci survived longer than patients with more than 3. The MST of patients receiving radiotherapy only and the patients receiving chemotherapy only were all 10.0 months while the MST of patients receiving combination therapy was 16.0 months. Multiple COX regression analysis demonstrated that gender, primary diseases, and quantity of brain metastatic foci were independent prognostic factors for brain metastatic cancers. Conclusions: Chemotherapy is as important as radiotherapy in the treatment of brain metastatic cancer. Combination therapy is the best treatment mode. Male gender, brain metastatic cancers originating in the gastrointestinal tract, more than 3 metastatic foci, and involvement of meninges indicate a worse prognosis.

위암에서 근치적 절제술 후 전이 림프절 수가 예후에 미치는 영향

임호영,최진혁,김현수,남동기,김효철 아주대학교 의과학연구소 1998 아주의학 Vol.3 No.1

Gastric cancer is the most common cause of cancer death in Korea, and the most important prognostic factor for patients with gastric cancer is the extent of TNM stage. Among TNM staging system, lymph node involvement (N) has been recognized as one of the significant prognostic indicators after curative resection. Recently, nodal stage of new AJCC TNM staging system has changed its emphasis on the location of metastatic lymph nodes to the number of metastatic lymph nodes. Thus, we attempted to analyze the survival difference based on the number of metastatic lymph nodes after curative resection of gastric cancer. Two hundred and forty two patients of curatively resected gastric cancer were retrospectively studied to identify the number of metastatic lymph nodes to influence prognosis. The following results were obtained. The results showed that there was a significant difference in the survival rate between the patients with 0-2 metastatic lymph nodes and those with ≥3 metastatic lymph nodes in adjuvant chemotherapy (FA) group (DFS; 36.7% vs. 23.4%, OS; 38.3% vs. 26.0%). In adjuvant chemoimmunotherapy (FA+poly-AU) group, there was a significant difference in the overall survival between the patients with 0∼2 metastatic lymph nodes and those with ≥ 3 metastatic lymph nodes(70.1% vs. 47.4%). The present report demonstrates the prognostic importance of the number of metastatic lymph nodes in gastric cancer after curative resection and a necessity of further evaluation of current nodal stage.

골에서 발생한 전이성편평세포암조직의 Acid Deoxyribonuclease의 활성과 작용기전에 관한 연구

현재요,김성준,고재경 한양대학교 의과대학 1992 한양의대 학술지 Vol.12 No.2

Acid DNase in metastatic squamous cell carcinoma tissue of bone was partially purified, and substrate specificity of the enzyme and hydrolytic products of DNA by the enzyme were analyzed to investigate the mechanism of action of the acid DNase and tis role in carcinogemesis and maintenance of the bone cancer. Also studied were changes in patterns of proteins associated with the acid DNase analyzing proteins eluted with the enzyme by a DEAE-cellulose column chromatography, HPLC and PAGE. Concentrations of protein and nucleic acids were incresed significantly in metastatic squamous cell carcinoma tissue of the bone and acid DNase activity was markdely increased. The positive rate of the enzyme activity as a marker for the bone cancer was shown to be high, suggesting that the acid DNase could be used as a biochemical marker for metastatic squamous cell carcinoma. DEAE-cellulose column chromatographical analysis revealed that proteins in the metastatic squamous cell carcinoma tissue were separated into 7 peaks, of which peak Ⅶ appeared to be specific to the bone cancer. Acid DNase in the bone cancer tissue was eluted in a single peak along with protein peak Ⅱ as in the case with that of control bone tissue of the bone. Acid DNase in metastatic squamous cell carcinoma tissue was partially purified up to 44-fold by centrifugation, ultrafiltration, and DEAE-cellulose column chromatography. The partially purified enzyme was much more active against ds DNA than ss DNA, and species specificity of the hydrolytic products of ds DNA by the purified enzyme are found to be oligodeoxyribonucleotides, suggesting that the acid DNase is endonuclease in nature. HPLC and PAGE patterns for proteins associated with acid DNase (DEAE-peak Ⅱ proteins) from metastatic squamous cell carcinoma tissue appeared to be different from those from control bone tissue. This means that nature of proteins complexed with the acid DNase from the bone cancer would be different in nature from that from the control bone tissue, but does not mean that nature of the acid DNase from the bone cancer is different from that from control bone tissue. Although the acid DNase in metastatic squamous cell carcinoma tissue exhibited no absolute specificity toward ds DNA and the enzyme did not appear to be specific to the bone cancer, observations that the acid DNase activity in the bone cancer tissue was markedly increased and the enzyme was endonuclease in nature suggested a psssible role of the acid DNase in carcinogenesis and maintenance of the metastatic squamous cell carcinoma of the bone.

The Clinical Value of Hybrid Sentinel Lymphoscintigraphy to Predict Metastatic Sentinel Lymph Nodes in Breast Cancer

나창주,김정훈,최세훈,한연희,정환정,손명희,윤현조,임석태 대한핵의학회 2015 핵의학 분자영상 Vol.49 No.1

Purpose Hybrid imaging techniques can provide functionaland anatomical information about sentinel lymph nodes inbreast cancer. Our aim in this study was to evaluate whichimaging parameters on hybrid sentinel lymphoscintigraphypredicted metastatic involvement of sentinel lymph nodes(SLNs) in patients with breast cancer. Methods Among 56 patients who underwent conventionalsentinel lymphoscintigraphy, 45 patients (age, 53.1±9.5 years)underwent hybrid sentinel lymphoscintigraphy using a singlephotonemission computed tomography (SPECT)/computedtomography (CT) gamma camera. On hybrid SPECT/CTimages, we compared the shape and size (long-to-short axis[L/S] ratio) of the SLN, and SLN/periareolar injection site(S/P) count ratio between metastatic and non-metastaticSLNs. Metastatic involvement of sentinel lymph nodes wasconfirmed by pathological biopsy. Results Pathological biopsy revealed that 21 patients (46.7%)had metastatic SLNs, while 24 (53.3 %) had non-metastaticSLNs. In the 21 patients with metastatic SLNs, the SLN wasmostly round (57.1 %) or had an eccentric cortical rim(38.1 %). Of 24 patients with non-metastatic SLNs, 13patients (54.1 %) had an SLN with a C-shape rim or eccentriccortex. L/S ratio was 2.04 for metastatic SLNs and 2.38 fornon-metastatic SLNs. Seven (33 %) patients had T1 primarytumors and 14 (66 %) had T2 primary tumors in the metastaticSLN group. In contrast, 18 (75 %) patients had T1 primarytumors and six (25 %) had T2 tumors in the non-metastaticSLN group. S/P count ratio was significantly lower in themetastatic SLN group than the non-metastatic SLN groupfor those patients with a T1 primary tumor (p=0.007). Conclusions Hybrid SPECT/CToffers the physiologic data ofSPECT together with the anatomic data of CT in a singleimage. This hybrid imaging improved the anatomic localizationof SLNs in breast cancer patients and predicted themetastatic involvement of SLNs in the subgroup of breastcancer patients with T1 primary tumors.

피부 전이암의 임상 및 병리조직학적 소견

김승희 ( Kim Seung Hui ),전영승 ( Jeon Yeong Seung ),심형준 ( Sim Hyeong Jun ),서기석 ( Seo Gi Seog ),김상태 ( Kim Sang Tae ) 대한피부과학회 2004 大韓皮膚科學會誌 Vol.42 No.3

N/A Background: The incidence of metastatic skin cancer has been reported to be relatively low. Because the diagnosis is not so difficult, cutaneous metastasis could be an important clue to discover the hidden internal malignancy, if found before recognizing primary cancer, or play a significant role to determine therapeutical plans and prognosis if found after diagnosis of primary cancer. Material and methods: This study was made upon the 68 cases of metastatic skin cancer, which had been confirmed histopathologically in the department of dermatology, Kosin University Gospel hospital from January, 1986 to August, 2003. Age and sex distributions, sites of primary cancer, time of detection, localization of the lesions, morphologic and histopathologic findings were examined by the review of medical records, clinical photographs, and pathologic slides. Results: 1. The mean age at the time of diagnosis was 56.6 years and most patients were distributed over 5 decades. The male to female ratio was 1:1.3. 2. Metastasis from breast carcinoma consisted of 19 cases, this was the most common primary cancer, followed by lung cancer, melanoma, and stomach cancer. In men, lung cancer and stomach cancer were the most common primary neoplasm, while breast cancer was the most frequent in women. 3. 50 of the cases were detected after diagnosis of primary cancer and during therapy. The other 18 cases were detected before the internal malignancy was recognized. 4. The localization of metastatic skin cancer was widespread over the whole body. The majority of cutaneous metastasis was predisposed to the surface near primary cancer, but distant metastases 5. The most common morphologic features were single or multiple nodules, while inflammatory and indurated plaques were also found. 6. Histopathologic examination revealed that adenocarcinoma was the most common pathologic type, followed by squamous cell carcinoma and melanoma. The histopathologic features of cutaneous metastasis generally mimicked that of primary tumors. Conclusion: Generally, metastatic skin cancer is detected after the diagnosis of primary cancer showing subsequent treatment failure and poor prognosis. In some cases, however, cutaneous metastasis can be the earliest sign to recognize internal malignancy. Especially in the cases of metastatic skin cancer originating from the kidney, liver and thyroid gland, cutaneous features are the most significant evidences to presume the site of origin without any other findings. Therefore, it is important to recognize the clinical and histopathologic findings of metastatic skin cancer for the most successful diagnostic, therapeutic and prognostic determination. (Korean J Dermatol 2004;42(3):300~308)

전이성 갈색세포종치험1례

김중규,김성열,최경현,최영식,염하용 고신대학교(의대) 고신대학교 의과대학 학술지 1997 고신대학교 의과대학 학술지 Vol.12 No.1

-Abstract- Pheochromocytomas are tumors arising in chromaffin tissue derived from the neural crest, commonly secrete catecholamine and fulfill the criteria for neoplasms arising in APUD cells. In the presence of recurrent unresectable and/or metastatic disease, other modes of treatment are employed. Treatment initially involves pharmacologic attempts to prevent the physiologic and metabolic consequences of excess catecholamine production such as a alpha-methylty-rosine. In view of the well-recognized indolent course of metastatic disease, other therapeutic attempts are usually directed towards control of metastatic disease Iodine-131-labeled metaiodobenyl-guanidine as a localizing technique for pheochromocytoma has also recently been used therapeutically. Use of chemotherapy has received little attention in metastatic disease, with data on its effects and use being anecdotal. Authors experienced a metastatic disease, with data on its effects and use being anecdotal. Authors experienced a metastatic pheochromocytoma, treated with surgery, I-131-MIBG scan and I-131-MIBG therapy, chemotherapy, and report with literature review.