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        간경변증 환자에서 간세포암 발생 위험 요인의 분석

        이헌주(Heon Ju Lee),이재련(Jae Lyun Lee),이재춘(Jae Chun Lee),이은정(Eun Jung Lee),김기범(Ki Beom Kim),임상우(Sang Woo Lim),이동준(Dong Jun Lee),전경진(Kyeoung Jin Jeon),조영복(Young Bog Cho),도갑석(Gab Suk Doh),서정일(Jeong Ill Suh) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

        N/A Objectives: 80-90% of the cases of hepatocellular carcinoma(HCC) are associated with cirrhosis. Hepatitis B virus(HBV) is known as a major etiologic factor of HCC and about 10% of Koreans are HBV carriers. And the prevalence of HCC is high in Korea. Early detection of HCC is important for the better treatment especially in the patients with cirrhosis who usually have the decreased functional hepatic reserve. Risk factors for the hepatocellular carcinoma in the korean patients with cirrhosis were evaluated. Methods: Risk factors for hepatocellular carcinogenisis such as age, sex, ascites, alcohol, HBsAg, anti-HCV, AFP, ICG R(15) and risk score were investigated among the 176 patients with cirrhosis and HCC(group I) and 72 patients with cirrhosis(group II) and compared between the two groups. Results: 1) No age difference was noted between group I and group II. 2) Male to female sex ratio were 5.7: 1 and 2.4: 1 for group I and II in each(p<0.01) and the frequency of HCC among cirrhosis was higher in male than female sex(p<0.01). 3) Both HBsAg and anti-HCV positivity were significantly higher in group I than in group II (p<0.01 and p<0.05 respectively). 4) The frequencies of Child-Pugh A, elevated AFP, elevated ICG R(15) and the frequency of super-high risk patient were higher in group I than in group II(p<0.01). 5) The frequency of alcoholic patients was significantly higher in group II than in group I (p<0.05) but no difference was noted between HBsAg positive group I and group II patients. 6) The frequency of abnormal AST with the level of below 100IU was not significantly different between group I and group II. 7) The frequency of the patients with ascites was higher in group II than in group I (p<0.01). Conclusion: Risk factors for hepatocellular carcinogenesis in korean patients with cirrhosis are male, Child-Pugh A, HBsAg positivity, anti-HCV positivity, absence of ascites, higher AFP, lower ICG R15 and higher platelet count.

      • 좌측 주기관지 및 기관에 발생한 선양낭포성암 2례

        이관호,정진홍,조영복,이학준,이현우,김미진,김기범 영남대학교 의과대학 1996 Yeungnam University Journal of Medicine Vol.13 No.2

        기관이나 주기관지에서 발생한 선양 낭포암은 서서히 진행하며 조기진단이 어렵고 특징적인 임상적증상이나 소견이 없어 만성적인 호흡기 질환과의 감별 진단이 힘들어서 질환이 상당히 진행된 후에야 발견되는 수가 많고 원격전이가 많으며, 또한 대부분 재발하는 특성이 있으므로 치료후 10년이상의 세심한 추적관찰이 필요하다. 저자들은 선양낭포암이 좌측 주 기관지에 발생한 58세 여자 환자와 기관후벽에 발생한 25세 여자 환자를 각각 경험하였기에 보고하는 바이다 Adenoid cystic carcinoma is an uncommon histologic variant of adenocarcinoma which usually arises from the salivary, lacrimal, or other exocrine glands. Characteristics of adenoid cystic carcinoma are its potential for extending long distance submucosally and for perineural invasion. It grows slowly and may have a prolonged course before diagnosis and after treatment. Recently, we have experienced 2 cases of adenoid cystic carcinoma arising from main bronchus and trachea. One case was 58 years old female patient. Her symptoms were productive cough with dyspnea. She has been history of shortness of breath, wheezing and cough during 4 years, which was initially diagnosed as bronchial asthma. The tumor was located on the left main stem bronchus which was obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenoid cystic carcinoma by bronchoscopic biopsy. The patient underwent radiation to relieve a bronchial stenosis caused by her tumor. The patient has remained well and is asymptomatic without evidence of clinical recurrence. The other case was 25 year old female. She complained shortness of breath and inspiratory difficulty during sleep. The tumor was located in upper trachea, which protruded from the posterior well of the trachea and obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenocystic carcinoma by rigid bronchoscopic biopsy. The patient was underwent operation for removal of the mass and received radiotherapy. The patient has remained well are follwing up now.

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