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갑상선유두암에서 Galectin-3, p53, Ki-67 단백질의 발현과 임상학적 의미
김병섭(Byung Seup Kim),강경호(Kyung Ho Kang),임영아(Young Ah Lim),김이수(Lee Su Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.1
Purpose: There are few molecular markers useful in practice for predicting prognosis of papillary thyroid carcinoma (PTC) despite numerous basic researches. The objective of this study was to evaluate the prognostic values of several candidate markers of PTC (p53, Ki-67 and galectin-3) using immunohistochemistry (IHC), one of the most practical methods. Methods: IHC for p53, Ki-67 and galectin-3 were performed on formalin-fixed paraffin-embedded tissues of 160 PTC specimens using monoclonal antibodies. The associations of the expressions of these markers with multiple clinicopathologic prognostic factors were assessed. Results: The overexpresion rates of p53, Ki-67 and galectin-3 were 48.8%, 64.3% and 97.8%, respectively. Overexpression of p53 protein was positively associated with extrathyroidal extension (P<0.001). In addition, p53 immunoreactivity was more prevalent among Ki-67 overexpressed specimens (P<0.001). Ki-67 immunoreactivity was positively correlated with tumor size (P<0.05), which became more distinct when accompanied with p53 overexpression (P<0.01). In contrast, no relationship between galectin-3 immunoreactivity and clinical prognostic factors was found. Conclusion: Our results suggest that overexpression of p53 protein and Ki-67 in papillary thyroid carcinoma is associated with tumor progression and that IHC for these proteins could be useful for predicting prognosis of patients with PTC.
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김병섭(Byung Seup Kim),임영아(Yong-Ah Lim),장경미(Kyung Mi Jang),김인규(In-Gyu Kim),전장용(Jang Yeong Jeon) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.5
Internal abdominal hernia is an unusual cause of intestinal obstruction. Paraduodenal hernia is relatively rare congenital malformations resulting from incomplete rotation of the midgut with entrapment of the small intestine beneath the developing colon. We report a case of paraduodenal hernia treated by laparoscopic approach. The patient was a 45-year-old man presenting with severe abdominal pain for 5 hours. Left paraduodenal hernia with jejunum hernia containing jejunal loops showed in abdominal CT. At operation, herniation of the small intestine into a retroperitoneal space through a defect on the left mesocolon was noted. After the herniated bowel was fully reduced, the hernia orifice was closed intra-corporeally in the manner of interrupted sutures with absorbable suture materials. The patient was discharged home without any serious complications on postoperative day 9. Conclusively, we think laparoscopic surgery in left paraduodenal hernia is feasible.
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갑상선 유두암의 술 전 경부 림프절 전이 예측을 위한 초음파검사와 CT 스캔의 효용성
임영아,강경호,김병섭,김이수,Young Ah Lim,M,D,Kyung Ho Kang,M,D,M,S,Byung Seup Kim,M,D,B,S,and Lee Su Kim,M,D,Ph,D 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.3
Purpose: Lymph node (LN) metastasis of papillary thyroid carcinoma (PTC) is related to a high local recurrence rate and a low disease-specific survival rate. So, the diagnosis of LN metastasis according to the compartment is important for surgical planning. We evaluated the value of preoperative USG and CT for predicting LN metastasis Methods: USG, CT or both were performed preoperatively for 325 consecutive patients who were newly diagnosed with PTC and who were operated on between Dec 1, 2004 and Dec 31, 2008. The reports of the preoperative USG and CT were compared with the histopathologic results. The accuracy of these studies for assessing LN metastasis were calculated, and we investigated whether combined USG and CT (US/CT) showed any additional benefit over USG or CT only. Results: For the central compartment, USG, CT and US/CT showed high specificities (98.2%, 98.6%, 98.2%, respectively) and low sensitivities (7.1%, 4.6%, 12.0%, respectively),and US/CT showed higher sensitivity than CT only. For the lateral compartment, USG demonstrated higher sensitivity and lower specificity compared with CT (76.2% vs 43.5%, 50.0% vs 70.0%, respectively), and US/CT had a higher sensitivity than CT only (81.0% vs 43.5%, respectively). By the per patient analysis, the sensitivity of US/CT (38.6%) was higher than those of USG (30.6%) or CT (19.3%),and the specificity was highest for CT (96.4%). Conclusion: Prophylactic central LN dissection for PTC can be justifiedby the low sensitivity and high specificity of USG and CT for predicting central LN metastasis. For the lateral LN compartment, a combination of USG and CT can increase the sensitivity for predicting LN metastasis. (Korean J Endocrine Surg 2009;9:149-154)
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