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      • KCI등재

        Expression of Programmed Death Receptor Ligand 1 with High Tumor-Infiltrating Lymphocytes Is Associated with Better Prognosis in Breast Cancer

        배상병,조현득,오미혜,이지혜,장시형,홍순억,조준훈,김성용,한선욱,이종은,김한조,이현주 한국유방암학회 2016 Journal of breast cancer Vol.19 No.3

        Purpose: The interaction of programmed death receptor 1 (PD-1) and its ligand, programmed death receptor ligand 1 (PD-L1), negatively regulates immune responses. This study aimed to clarify PD-L1 expression levels in breast cancer through immunohistochemistry (IHC) and to evaluate associations between these findings and clinicopathologic variables, including prognosis. Methods: PD-L1 expression was analyzed using IHC on tissue microarrays of 465 invasive breast carcinomas. Results: High PD-L1 expression was demonstrated in 63 of 465 tumors (13.5%). High PD-L1 expression was significantly associated with high histologic grade (p<0.001), negative lymph nodes (p=0.011), early pathologic stage (p=0.025), high tumor-infiltrating lymphocyte (TIL) (p<0.001) counts, negative estrogen receptor (p<0.001) and progesterone receptor (p=0.002) expression, positive human epidermal growth factor receptor 2 (HER2) (p=0.003), cytokeratin 5/6 (p=0.011), epidermal growth factor receptor (p<0.001), and p53 (p<0.001) expression, and high Ki-67 proliferating index (p<0.001). Based on intrinsic subtypes, high PD-L1 expression and high TIL counts were significantly associated with the HER2 and triple-negative basal type (p<0.001). PD-L1 expression was significantly associated with better disease-free survival (DFS) (p=0.041) and overall survival (OS) (p=0.026) in the univariate analysis, but not in the multivariate analysis. Higher TIL levels was an independent prognostic factor for decreased disease progression (hazard ratio [HR], 2.389; 95% confidence interval [CI], 1.284–4.445; p=0.006) and overall death (HR, 3.666; 95% CI, 1.561–8.607; p=0.003). Conclusion: PD-L1 protein expression in breast cancer is associated with better DFS and OS, but is not an independent prognostic factor. High PD-L1 expression was significantly associated with high TIL levels. This finding has important implications for antibody therapies targeting the PD-1/PD-L1 signaling mechanism in breast cancer.

      • 다발성 골수종 환자에서 자가 말초혈액 조혈모세포이식

        배상병,김현정,이상철,김찬규,이남수,이규택,박성규,원종호,홍대식,박희숙 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.2

        Autologous peripheral blood stem cell transplantation (APBSCT) with high dose chemotherapy could be converted into prolongation of remission and of survival in multiple myeloma patients. From May 2003 to November 2006, We are retrospectively analysis of 13 patients with newly diagnosed multiple myeloma who received APBSCT with high dose therapy at Soon Chun Hyang Bucheon hospital. VAD(vincristine, adrimycin, dexamethasone) or VAMP(vincristine, adriamycin, methylprednisolone) was used to induction chemotherapy regimen. Cyclophosphamide and melphalan was respectively used as mobilization and conditioning regimen. The median age at the time of diagnosis was 55 years(range;40-67) with male sexual predominance(M:F=8:5). Most of patients(12/13,92%) were diagnosed with stage III(Durie-Salmon staging system). Tandem transplantation was eight patients. Overall response rate to induction chemotherapy and ASCT were 85% (CR; 31%, PR; 54%) and 100% (CR; 69%, PR; 31%), respectively. Median event free survival and overall survival after ASCT was 28.2 months and 35.6 months. In univariable analysis, there was no significant difference in the Ig isotype(Ig G vs Ig A), hemoglobin(below 8.5 vs above 8.5 g/dL), creatinine(below 2 vs above 2 mg/dL), LDH(below 400 vs above 400 IU/L), chromosomal abnormality(normal vs abnormal), frequency of transplantation(single vs tandem), but 2-microglobulin(below 4 vs above 4 mg/dL) was significant difference (log-rank ; p=0.014) for the median duration of overall survival. Although the number of patients was small and follow up duration was short in this study, APBSCT with high dose chemotherapy was effective and feasible in patients with newly diagnosed multiple myeloma. 2-microglobulin also can be a potent prognostic factor of APBSCT in multiple myeloma for overall survival.

      • KCI등재

        A Phase II Study of Irinotecan, 5-Fluorouracil and Leucovorin for Treatment in Patients with Previously Untreated Advanced Colorectal Cancer

        배상병,이남수,김한조,김경하,김현정,김찬규,이규택,박성규,원종호,홍대식,박희숙 대한암학회 2006 Cancer Research and Treatment Vol.38 No.2

        Purpose: We prospectively conducted a non-randomized phase II trial to evaluate the efficacy and safety of combination irinotecan, leucovorin (LV) and 5-fluorouracil (FU) as a first-line regimen for treating patients with previously untreated advanced colorectal cancer (CRC).Materials and Methods: Twenty-six previously untreated patients with advanced, recurrent or metastatic CRC were enrolled in this study. The patients received either irinotecan 180 mg/m2 on day 1 with LV bolus of 200 mg/m2 and FU bolus of 400 mg/m2, and this was followed by FU continuous infusion of 600 mg/m2 on day 1 and day 2 (the FOLFIRI regimen), or they were treated with LV bolus of 400 mg/m2 and FU bolus of 400 mg/m2 followed by FU continuous infusion of 2,400 mg/m2 for 46 hours (the simplified FOLFIRI regimen), and these treatments were repeated every 2 weeks until disease progression.Results: The objective response rate was 23.1% (6/26) respectively, for both treatments. The median time to progression was 5.3 months (range: 0.4~19.9), and the overall survival was 11.2 months (range: 0.5~52.3). The prognostic factor for longer survival was the Eastern Cooperative Oncology Group (ECOG) performance status (PS). The non-hematological toxicities were similar for both treatment groups, with more frequent grade ≥3 neutropenia being noted for the simplified FOLFIRI regimen.Conclusion: The biweekly irinotecan based regimen was demonstrated to have a moderate antitumor activity with acceptable toxicity profiles, and the ECOG PS was the independent prognostic factor. (Cancer Res Treat.2006;38:72-77)

      • KCI등재후보

        암성 통증의 약물치료

        배상병 ( Sang-byung Bae ),이상철 ( Sang-cheol Lee ) 대한내과학회 2018 대한내과학회지 Vol.93 No.3

        Cancer pain is the most common and troublesome symptom for cancer patients. The more the cancer patient gets to the end of the life, the worse the pain. There are many clinical practice guidelines for cancer pain, and most pain can be controlled with appropriate medication by guideline. We would like to summarize various domestic and foreign clinical practice guidelines relatively simply. According to the clinical practice guidelines, medical treatment including opioids will greatly improve the quality of life of cancer patients. (Korean J Med 2018;93:260-265)

      • 비혈연간 동종 골수이식술 후 발생한 혈전성 미세혈관병증 1례

        이국경,배상병,김주성,이준혁,이유경,이규택,박성규,원종호,백승호,진소영,홍대식,박희숙 대한조혈모세포이식학회 2000 대한조혈모세포이식학회지 Vol.5 No.2

        혈전성 미세혈관병증은 골수이식 후 발생하는 중한 합병증 중의 하나이다. 저자들은 22세의 급성 림프구성 백혈병(ALL, L3)을 진단 후 비혈연간 동종 골수이식을 받은 환자에서 발생한 혈전성 미세혈관병증을 경험하였다. 그는 비혈연간 동종골수이식술을 받았으며 이식의 전처치로 busulfan, cyclophosphamide, 전신방사선조사를 받았고 이식편대숙주반응을 막기 위하여 CsA와 methotrexate을 투여받았다. 이식 후 28일째 말초혈액도말검사상 Burr cell, schistocyte, tear drop cell이 관찰되었으며, 이식 후 31일째 혈변소견이 보여 S결장 내시경상 장관 이식편대 숙주질환 소견이 보였고 혈청검사상 거대세포바이러스가 양성소견을 보여 steroid와 gancyclovir를 투여받았고 2주 후에 장관 이식편대 숙주반응이 호전되었다. 이식 후 68일째 임상적으로 혈전성 미세혈관병증이 발생되었고 Cr 수치가 증가되어 TPE와 혈액투석을 격일로 시행하였으나 악화되었다. 이식 후 82일째 다발성 출혈로 사망하였다. Thrombotic microangiopathy (TMA) is one of the serious complications of bone marrow transplantation (BMT). We experienced a 22-year-old male with acute lymphoblastic leukemia (ALL, L3) who developed post BMT-TMA. He received pretransplant conditioning chemotherapy with busulfan, cyclophosphamide, and total body irradiation (TBI). He received cyclosporine (CsA) and methotrexate (MTX) for graft versus host disease (GVHD) prophylaxis. Peripheral blood smear revealed burr cells, schistocytes and tear drop cells on post BMT day 28. Hematochezia was developed on post BMT day 31. Biopsy specimen of sigmoid colon revealed grade III to IV acute GVHD and cytomegalovirus (CMV) culture was positive in blood on post BMT day 43. He received steroid pulse therapy and gancyclovir so that improved after 2 weeks. TMA was developed clinically on post BMT day 68 and creatine (Cr) was increased. In spite of undergoing plasma exchange with fresh frozen plasma and hemodialysis every other day, TMA progressed. He died due to multiple hemorrhage on post BMT day 86.

      • KCI등재

        Clinicopathologic and Prognostic Significance of Transducin-Like Enhancer of Split 1 Protein Expression in Invasive Breast Cancer

        이지혜,배상병,오미혜,조현득,장시형,홍순억,조준훈,김성용,한선욱,이종은,김한조,이현주 한국유방암학회 2017 Journal of breast cancer Vol.20 No.1

        Transducin-like enhancer of split 1 (TLE1) is a member of the TLE family of transcriptional co-repressors that control the transcription of a wide range of genes. We investigated the prognostic significance of TLE1 protein expression in breast cancers by using immunohistochemistry and explored the relationship of TLE1 with clinicopathological parameters. Methods: Immunohistochemistry was performed on 456 cases of breast cancer tiled on tissue microarrays. The relationship between TLE1 expression in normal breast specimens and ductal carcinoma in situ (DCIS) was also analyzed. Results: TLE1 was highly expressed in 57 of 456 (12.5%) carcinoma samples. TLE1 was more frequently expressed in DCIS and invasive breast cancers than in normal breast tissue (p=0.002). High expression of TLE1 significantly correlated with negative lymph node (LN) metastasis (p=0.007), high histologic grade (p<0.001), estrogen receptor negativity (p<0.001), progesterone receptor negativity (p<0.001), human epidermal growth factor receptor 2 (HER2) positivity (p<0.001), and high Ki-67 proliferation index (p<0.001). Based on intrinsic subtypes, high TLE1 expression was strongly associated with HER2+ and triple-negative breast cancers (TNBC) (p<0.001). Survival analysis demonstrated no significant association between TLE1 expression and disease-free survival (DFS) (p=0.167) or overall survival (OS) (p=0.286). In subgroup analyses, no correlation was found between TLE1 expression and DFS or OS according to LN status or intrinsic subtype. Conclusion: High TLE1 expression is significantly associated with the HER2+ and TNBC subtypes. This is the first study documenting immunohistochemical expression of TLE1 in invasive breast cancer and its association with clinicopathological parameters, prognosis, and intrinsic subtype.

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