http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
췌장암 항암치료 및 표적치료 그리고 관련된 합병증 치료
이광혁 ( Kwang Hyuck Lee ) 대한췌장담도학회 2015 대한췌담도학회지 Vol.20 No.1
Prognosis of pancreatic ductal adenocarcinoma is exceptionally poor because timely diagnosis in resectable stages is rare and there is no curative treatment for unresectable cases. Numerous researches to overcome these obstacles resulted in statistically significant but small progress. Recently two randomized controlled trial reported combination chemotherapy with 5-FU, irinotecan, leucovorin and oxaliplatin or Nab-paclitaxel plus gemcitabine was better survival than gemcitabine monotherapy. Many novel biological agents targeting the pancreatic cancer itself and surrounding micro-environment has been reported to be promising in preclinical investigations and phase 1/2 clinical studies. However, only erlotinib ? a small molecular inhibitor of the epidermal growth factor receptor pathway ? was approved for the targeted therapy for metastatic pancreatic cancer. In this review, we discuss briefly about recent advances in the combination chemotherapy and the targeted therapy including several complications related with these drugs.
췌장 질환에 대한 초음파 내시경 유도하 세침흡입술 및 조직 검사
이광혁 ( Kwang Hyuck Lee ) 대한췌장담도학회 2021 대한췌담도학회지 Vol.26 No.4
초음파 내시경 검사는 내시경 선단에 달린 초음파 탐지자를 이용하여 위장관 내에서 초음파를 이용하여 주변 장기를 관찰하는 검사다. 초음파 내시경을 이용하면 췌장을 고해상도로 실시간 관찰하면서 병소에 대한 조직 검사가 가능하다. 초음파 내시경 유도하 조직 검사는 지난 20여 년간 초음파 내시경 및 세침의 발전과 해부학적 구조의 이해 및 내시경을 통한 조직 검사 술기 등의 발전으로 췌장 질환에 대한 기본적인 비수술적 조직 검사가 되었다. 본고에서는 최근에 발표된 유럽 및 국내 가이드라인에서 언급하고 있는 내시경 초음파 유도하 조직 검사의 췌장 병변에서의 활용 기준과 다양한 종류의 조직 세침의 특성에 따른 선택, rapid on site evaluation, stylet 및 음압의 사용, fanning technique 등 검사에서 고려할 사항 및 조직 검체 처리 방법, 합병증 및 교육에 대해서 간략히 기술하였다. The endoscopic ultrasound (EUS) is a device with an ultrasound probe on the tip of endoscope. We can observe the surrounding structures outside the alimentary tract by using EUS. It is also possible to get a tissue from the pancreatic lesion for histopathologic diagnosis by using EUS. The development of devices and techniques of EUS guided tissue acquisitions made it the choice of non-operative pathologic test for pancreatic diseases. This paper describes the clinical applications of this procedure in pancreatic lesions from the recent European and Korean guidelines, including how to choose the needle, role of rapid on site evaluation, usage of stylet, suction and fanning technique, how to process acquired specimen, procedure-related complications and educations of this method. Korean J Pancreas Biliary Tract 2021;26(4):241-247
이광혁 ( Kwang Hyuck Lee ),윤원재 ( Won Jae Yoon ),이준규 ( Jun Kyu Lee ),류지곤 ( Ji Kon Ryu ),김용태 ( Yong Tae Kim ),윤용범 ( Yong Bum Yoon ) 대한소화기학회 2005 대한소화기학회지 Vol.46 No.3
목적: 암 환자에서는 혈중 DNA 농도가 정상인보다 증가된다. 따라서 증가된 혈장 DNA 농도나 혈액 내 암 특이 유전자 검출이 종양 표지자로 이용될 수 있다. 이번 연구에서는 정량 real-time PCR 방법으로 췌장암 환자 혈장 내 DNA 농도를 측정하여 이것이 췌장암 진단에 이용될 수 있는지 알아보고자 하였다. 대상 및 방법: 조직으로 진단된 췌장암 환자 24명(남 16명, 나이 60.5±11.4세)을 환자군으로 하였고 만성 췌장염 환자 15명과 정상인 15명을 대조군(남 26명, 나이 53.5±11.2세)으로 하였다. 혈장에서 DNA를 추출하여 human telomerase reverse transcriptase에 대한 RT-PCR를 시행하여 DNA 농도를 측정하였다. 결과: 환자군에서 혈장 DNA 농도는 46.4±63.2ng/mL로서 만성 췌장염과 정상인을 합한 대조군에서의 농도 15.8±30.6ng/mL보다 의미 있게 높았다. 혈장 DNA 농도 46.9ng/mL을 기준으로 하였을 때, 췌장암 진단의 예민도 및 특이도는 각각 75% 및 70%였다. 췌장암의 병기, 림프절 전이와 원격전이 여부 등에 따른 혈장 DNA 농도는 차이가 없었고, 원발 종양의 크기와 혈장 DNA 농도 간의 상관 관계도 없었다. 결론: 췌장암 환자에서 혈장 DNA 농도는 대조군에 비해 증가되어 있으나, 진단 예민도와 특이도가 충분히 높지 않아서 종양인자로서 임상으로 적용하기는 어렵다. Background/Aims: The plasma DNA concentration of patients with cancer is known to be higher than normal controls. Increased DNA concentration and tumor-specific genes in plasma can be used as tumor markers in some cancers. This study was designed to evaluate whether quantification of plasma DNA concentration by using real-time PCR is useful as a tumor marker in the diagnosis of pancreatic cancer. Methods: Twenty-four patients (M:F=16:8, mean age; 60.5±11.5 years) with pancreatic cancer were recruited for this study. Fifteen patients with chronic pancreatitis and fifteen healthy persons were selected as controls (M:F=26:4, 53.5±11.2 years). The concentration of plasma DNA was determined by real-time PCR for telomerase reverse transcriptase gene. Results: Plasma DNA concentration in patients with pancreatic cancer (46.4±63.2ng/mL) was higher than that of chronic pancreatitis (p=0.041) and normal controls (p=0.030). The sensitivity and specificity in detecting pancreatic cancer were 75% and 70% respectively when the cut-off value of plasma DNA concentration was set at 46.9ng/mL. Conclusions: Plasma DNA concentration in patients with pancreatic cancer was higher than that of controls. However, its sensitivity and specificity is not high enough to be used as a tumor marker for pancreatic cancer. (Korean J Gastroenterol 2005;46:226-232)
한국인 만성 췌장염 환자에서 SPINK1 및 PRSS1 유전자 변이
이광혁 ( Kwang Hyuck Lee ),윤원재 ( Won Jae Yoon ),류지곤 ( Ji Kon Ryu ),김용태 ( Yong Tae Kim ),윤용범 ( Yong Bum Yoon ),김정룡 ( Chung Yong Kim ) 대한소화기학회 2004 대한소화기학회지 Vol.44 No.2
Background/Aims: It has been found that mutations of cationic trypsinogen gene (PRSS1) and serine protease inhibitor, Kazal type 1 gene (SPINK1) increase the susceptibility of chronic pancreatitis (CP). Specifically, mutations in the PRSS1 gene are relate
담낭 결석이 동반되지 않은 담낭 용종의 악성화 관련 인자
이재승 ( Jae Seung Lee ),이규택 ( Kyu Taek Lee ),정재홍 ( Jae Hong Jung ),오성욱 ( Sung Wook Ok ),최성철 ( Sung Chul Choi ),이광혁 ( Kwang Hyuck Lee ),이종균 ( Jong Kyun Lee ),허진석 ( Jin Seok Heo ),최성호 ( Seong Ho Choi ),이종 대한소화기학회 2008 대한소화기학회지 Vol.52 No.2
Background/Aims: The purpose of this study was to find the factors predicting the neoplastic polyp of gallbladder and analyze the size criteria associated with malignancy. Methods: A total of 354 subjects with gallbladder polyps confirmed by tissue pathology were included for the analysis. The clinical and radiological features of the polyps were compared between the two groups (neoplastic vs. non-neoplastic) and in the three groups (non-neoplastic vs. adenoma vs. adenocarcinoma). The independent factors associated with malignancy were studied. Results: Of 354 patients, non-neoplastic polyps were observed in 229 (64.7%) patents, adenoma in 85 (24.0%) and adenocarcinoma in 40 (11.3%). The mean diameter of non-neoplastic polyp, adenoma, and adenocarcinoma were 11.3±2.8 mm, 16.0±7.2 mm, and 27.0±8.9 mm, respectively. The mean age of patients with non-neoplastic polyp, adenoma, and adenocarcinoma were 44.8±11.3, 49.9±12.5, and 60.8±9.6, respectively. Age, size of polyp, number of polyp, presence of diabetes, and presence of symptom showed statistically significant difference between the neoplastic polyp and non-neoplastic polyp groups. But only age, size of polyp, number of polyp were statistically independent factors associated with neoplastic polyp (p<0.05). To predict the neoplastic polyp, sensitivity was 94.4%, but specificity was 18.3% on the basis of 10 mm criteria. whereas sensitivity and specificity was 76.0% and 55.5% on the 12 mm-criteria. Conclusions: On the basis of our analysis, the size of polyp is the most important factor to predict the malignancy. In the 10 mm criteria, sensitivity is satisfactory but specificity is very low. Therefore 10 mm size should not be considered to be the absolute size-criterion for surgery. (Korean J Gastroenterol 2008;52:97-105)
박윤경 ( Yun Gyoung Park ),이광혁 ( Kwang Hyuck Lee ),이종균 ( Jong Kyun Lee ),이규택 ( Kyu Taek Lee ),최동욱 ( Dong Wook Choi ),최성호 ( Seong Ho Choi ),허진석 ( Jin Seok Heo ),장기택 ( Kee Taek Jang ),이은미 ( Eun Mi Lee ),김정 대한소화기학회 2011 대한소화기학회지 Vol.58 No.4
Background/Aims: Intraductal papillary mucinous neoplasms (IPMN) are precursor lesions of fatal pancreatic cancer. Physiological function of microRNA is to regulate the stability and translation of mRNA. The aberrant microRNA expression is commonly observed in many cancers. The aim of this study was to analyze the expression pattern of microRNA in IPMN and evaluate the role of the microRNA. Methods: Using two paraffin-embedded IPMN tissues, microRNA expression of normal tissue, IPMN adenoma and carcinoma were compared by cDNA-mediated annealing, selection, extension and ligation microarray assay. Using real time PCR, expression levels of aberrantly up-regulated microRNAs were assessed in another 20 IPMNs, four pancreatic cancer cell lines (Panc1, MiaPaCa-2, XPA-3, BxPC-3) and immortalized pancreatic ductal cell line (HPNE). Effect of suppressing highly over-expressed two microRNAs in pancreatic cancer cell lines with anti-microRNA inhibitors were evaluated using CCK-8 assay. Results: Among aberrantly expressed 122 microRNAs in IPMN, miR-552, miR-25*, miR-183, miR-1300, miR-196a, miR-182*, and miR-30c-1* were consistently increased more than 3-fold. On average, miR-196a and miR-183 increased 10,824 folds and 26,519 folds in four pancreatic cancer cell lines compared with HPNE. These two microRNAs were also over-expressed in 20 IPMNs compared with HPNE. After applying anti-miRNA inhibitors, cell survival of four pancreatic cancer cell lines decreased by 24.5% with anti-miR-196a and by 14.2% with anti-miR-183 on average. Conclusions: Aberrant expression of 122 microRNAs was observed in IPMN. Two microRNAs, miR-196a and miR-183-increased in IPMN and pancreatic cancer cell lines compared with immortalized dancreatic ductal cell line. The inhibitions of these microRNAs repressed cell proliferation of pancreatic cancer cell lines. (Korean J Gastroenterol 2011;58:190-200)