위암 환자에 있어서 p53 유전자 돌연변이, 종양 p53 단백질 과발현 및 혈청 p53 항체

봉진구 대한위암학회 2003 Journal of gastric cancer Vol.3 No.4

방사광 X-선으로 찰영한 갑상선 조직 영상

봉진구,황정연<SUP>1<.SUP>,박성환,Jin Gu Bong,M.D.,Jung Yun Huang,Ph.D.<SUP>1<.SUP> and Sung Hwan Park,M.D. 대한갑상선-내분비외과학회 2010 The Koreran journal of Endocrine Surgery Vol.10 No.1

Purpose: X-ray microscopy with synchrotron radiation will soon be a useful tool for innovative x-ray imaging in clinical and laboratory settings. It enables us to observe the detailed internal structure of human tissue samples with great magnification power and excellent resolution. So, it has the possibility to be used for the clinical and research purposes to investigate thyroid diseases if it can effectively evaluate the various conditions of thyroid tissue. To determine the relation with their optical microscopic features, we compared the synchrotron X-ray images of unstained normal and thyroid cancer tissue samples with the histopathologic findings of their adjacent, stained thyroid tissue sections. Methods: An x-ray microscope was installed on a 1B2 beamline with a Pohang Light Source, which is a 3rd generation synchrotron radiation facility with an operating energy of 2.5 GeV at Pohang, Korea. The x-ray energy was set at 11.1 keV and the x-ray beam was monochromatized using a W/B4C monochromator. Formalin-fixed 10Ռm-thick female thyroid tissues from normal cases and carcinoma cases were attached on Kapton film for the imaging. The sample was positioned 25 m away from the beam source. The x-ray image of the sample was converted into a visual image on the CsI (TI) scintillation crystal, and it was magnified 20 times by the microscopic objective lens. After an additional 10 times digital magnification, this visual image was captured by a full frame CCD camera. Results: The monochromated x-ray microscopic images of the female thyroid tissues of the normal cases and carcinoma cases were obtained with good resolution. These synchrotron images showed the normal follicular structures in the normal thyroid tissue sections and the characteristic severe stromal fibrosis with collagen fiber accumulation in the cancer tissue sections. Conclusion: Owing to the great magnification and excellent resolution, the synchrotron x-ray microscopic images of the normal and cancerous thyroid tissues showed good correspondence with the histopathologic findings of their adjacent, stained tissue sections. So, the x-ray microscopic imaging of thyoid tissue using synchrotron radiation has good potential for use in various clinical and research settings in the future. (Korean J Endocrine Surg 2010;10: 19-23)

위암 환자에 있어서 p53 유전자 돌연변이, 종양 p53 단백질 과발현 및 혈청 p53 항체

봉진구,이명훈,송경은,김태봉,유완식,Bong Jin-gu,Lee Myung-Hoon,Song Kyung-Eun,Kim Taebong,Yu Wansik 대한위암학회 2003 대한위암학회지 Vol.3 No.4

Purpose: The clinical implication of p53 mutation in gastric cancer is still unclear, as shown by the discordant results that continue to be reported in the literature. Materials and Methods: To assess p53 gene mutation, tumor p53 overexpression, and serum anti-p53 antibody, we employed a polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis, an immunohistochemistry using monoclonal antibody DO-7, and an enzymelinked immunosorbent assay (ELISA), respectively. Results: Of 169 surgical specimens of gastric cancer, mutation at exon $5\∼8$ of the p53 was identified in 33 ($19.5\%$) and was significantly correlated with lymph node metastasis. Overexpression of p53 was found in 62 specimens ($36.7\%$) and had a significant correlation with tumor differentiation. Serum anti-p53 antibody was positive in 18 patients ($10.7\%$). Twenty-three of the mutated tumors ($69.7\%$) and 39 of the non-mutated tumors ($28.7\%$) displayed immunoreactivity. Twelve of the immunopositive tumors ($19.4\%$) and 6 of the immunonegative tumors produced anti-p53 antibody. These differences were statistically significant (P<0.001 and P=0.005, respectively). There was no significant difference in survival according to the mutation of p53. Conclusion: Mutation and overexpression of p53 can be easily detected by immunohistochemistry. However, standardization of the immunohistochemical staining method, as well as guidelines for interpreting the stained result, will produce concordant results and thereby improve clinical application.

침윤성 유방암에서 Methylene Blue Dye를 이용한 감시림프절 생검술의 경험

봉진구 한국유방암학회 2007 Journal of breast cancer Vol.10 No.3

Purpose: Isosulfan blue has been traditionally used as a tracer to map the lymphatic system during identification of the sentinel lymph node (SLN). However, this vital dye is difficult to obtain in Korea. Radioisotopes such as technetiumlabeled sulfur colloid or albumin colloid are also expensive and complex to use. The purpose of this study is to evaluate usefulness of a sentinel lymph node biopsy (SLNB) using methylene blue dye in breast cancer patients. Methods: We evaluated the sentinel node mapping experience using methylene blue dye from July 2003 to January 2007. Fifty-eight patients with clinical T1-T2 breast cancer without palpable axillary lymph nodes were enrolled. All SLNs were submitted for intraoperative frozen section and hematoxyline and eosin (H & E) stain analysis. For the negative SLNs, serial sections of each SLN specimen were examined by permanent H & E staining and by immunohistochemical techniques (IHC) using cytokeratin. Regardless of the results of a frozen section for the SLNs, a backup level II or III axillary lymph node dissections (ALND) was performed. Results: Of the 58 patients that underwent a SLNB using methylene blue dye, an SLN was identified in 56 patients (96.6%), and metastatic SLNs were detected in 14 cases. Axillary lymph node metastasis found in 18 out of 58 patients. Thus, the false negative rate for a SLNB was 22.2% (4/18). Two patients had a micrometastasis (pN1mi) and two patients had clusters of isolated tumor cells (pN0[i+]) that were identified in the SLNs by IHC with the additional use of cytoketatin. The sensitivity, specificity, and accuracy of the SLNBs were 77.8%, 100%, and 92.9%, respectively. The false negative rate improved with the accumulation of experience for performing a SLNB (12.5% vs 30.0%). The sensitivity, specificity, positive predictive value, and accuracy of preoperative ultrasonography (USG) for an axillary lymph node metastsis were 50.0%, 95.5%, 81.8% and 81.0% respectively. Conclusion: Based on our initial experience, methylene blue dye is safe, inexpensive, and a readily available tracer for the SLN mapping, and it could be an effective alternative to the use of isosulfan blue dye for accurately identifying SLNs in early breast caner patients. We expected that the findings of preoperative USG could serve as useful adjuncts to a SLNB.

각종 종양표지자를 이용한 위암의 병기진단

봉진구,유완식,황일우 大韓消化器病學會 1994 大韓消化器病學會誌 Vol.26 No.6

유방암에서 동측 상쇄골 림프절 재발의 병합치료

봉진구,이윤식,박진현,정민희,신미정,이병철 대한외과학회 2004 대한외과학회 학술대회 초록집 Vol.2004 No.5

대장 항문병 크리닉에 필요한 장비 및 운용의 실제 : 대장 항문 기능 검사

봉진구,이윤식 釜山外科學會 1999 釜山外科學會誌 Vol.15 No.12

Intraductal appraoch for breast cancer

봉진구 대한외과학회 2010 대한외과학회 학술대회 초록집 Vol.2010 No.11

각종 종양표지자를 이용한 위암의 병기진단

봉진구(Jin Gu Bong),유완식(Wan Sik Yu),황일우(Il Woo Whang) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.6

N/A The serum concentrations of AFP, CEA, CA19 9 and CA125 were measured in sera of 401 patients with histologically proven gastric cancer, who were managed at the Department of Surgery, Kyungpook National University Hospital from January 1991 to July 1993 to evaluate the clinical significance of these tumor markers in diagnosis and staging of gastric cancer. The percentages of patients whose serum samples were positive for AFP, CEA, CA19 9, and CA125 were 13.7%, 31.8%, 21.6%, and 13.6%, respectively. Positive rates of tumor markers were significantly increased with the depth of tumor invasion(CEA and CA19 9), the tumor size or ulcer size(CA19 9), the lymph node metastasis(CEA and CA19 9), and the TNM stage (AFP, CEA, CA19 9, CA125). The specificity of AFP, CEA, CA19 9, and CA125 in detecting nodal metastasis was 90.5%, 76.9%, 89.5%, and 84.6%, in detecting hepatic me- tastasis was 86.6%, 69.3%, 78.6%, and 86.9%, in detecting peritoneal seeding was 87.3%, 69.6%, 81.1%, and 89.2%, and in detecting distant metastasis was 87.6%, 71.7%, 82.1%, and 88.3%, respectively. The combined analysis of these tumor markers was more sensitive than single analysis. The combined analysis of CEA and CA19 9 revealed higher positive rate than other combinations, and the positive rate of this combination and combined analysis of four markers were signifi- cantly increased with the depth of tumor invasion, the tumor size, the nodal involvement, the distant metastasis, and the TNM stage. Because of the low sensitivity, measurement of these tumor markers in patients serum cannot provide information for diagnosis of gastric cancer. But because of significant correlation of high serum concentration of these tumor markers and distant metastasis of gastric cancer, this can provide information about the operability and the prognosis of the patients with gastric cancer.(Korean J Gastroenterol 1994; 26: 899-906)

폐선암 및 직장암의 이시성 중복암을 가진 환자에서 갑상선으로의 전이암

봉진구(Jingu Bong),조창호(Changho Cho),박성환(Sunghwan Park) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.6

Metastasis to the thyroid gland is rare in clinical settings despite its rich vascular supply. A 60-year-old woman who had rectal cancer was diagnosed with thyroid malignancy with bilateral cervical lymph node metastases and primary adenocarcinoma of the left upper lung. We compared findings of H&E and various immunohistochemical stains including Thyroglobulin, CK7, CK20, CEA, TTF-1 of specimens of thyroid tumor, lung cancer and rectal cancer after total thyroidectomy. Thus, we achieved the final diagnosis of thyroid tumor as metastasis to the thyroid glands from primary adenocarcinoma of the lungs. In patients with a history of extra-thyroidal adenocarcinomas, we should consider metastasis to the thyroid gland. Immunohistochemical staining including thyroglobulin, CK7, CK20, CEA, TTF1 might be helpful to differentiate between primary thyroid carcinoma and metastasis from extra-thyroidal carcinoma to identify their origin.