폐암 진단방법으로서 객담검사의 유용성

조은윤,박희대,김선희,박운선,채승완,김어진,손진희,Cho, Eun-Yoon,Park, Hee-Dae,Kim, Sun-Hee,Park, Woon-Sun,Chae, Seoung-Wan,Kim, Eo-Jin,Sohn, Jin-Hee 대한세포병리학회 2004 대한세포병리학회지 Vol.15 No.2

To analyze the accuracy and usefulness of sputum cytology as a screening method, 103 cases of histologically proven lung cancer registered from 1998 to 2000 at Kangbuk Samsung Hospital were retrospectively examined. We reviewed the original cytologic and surgical diagnoses for the cases, and the cytology slides of all cytologically negative cases. The overall sensitivity of sputum cytology was 0.83 ; the sensitivity of prebronchoscopy sputum cytology for bronchogenic carcinoma was 0.87. Central tumor location (P=0.002), tumor size (>2.4 cm), (P=0.027) and the number of sputum samples $(\geq3)$ (P=0.001) were associated with a positive cytologic diagnosis. Of the 18 cytologically negative cases, 9 cases(38% of smears) were determined to be insufficient for diagnosis, due strictly to low cellularity and saliva. After a review of the cytology slides of cytologically negative cases, we identified several atypical clusters in one case of bronchioloalveolar carcinoma. This negativity was thus attributed to an interpretation error (1/18, 5.6%). Our results suggest that its sensitivity is more strongly related to the specimen adequacy and the times of sampling than to interpretation error. In terms of sensitivity, specificity, accessibility, cost, and morbidity associated with the screening tests, sputum cytology was found to be an accurate effective screening method for lung cancer.

Comparative Study of Metaplastic Breast Carcinoma and Triple-Negative Breast Carcinoma Using Histologic and Immunohistochemical Analyses

조은윤,김지연,김태은 대한병리학회 2010 Journal of Pathology and Translational Medicine Vol.44 No.6

Background : Metaplastic carcinoma of the breast is a rare subtype of breast cancer, which is characterized by estrogen receptor/progesterone receptor and HER2 negativity. Methods : Tissue specimens from 60 metaplastic breast cancer and 60 triple-negative breast cancer patients diagnosed at a single institution between 1995 and 2009 were analyzed. Immunohistochemistry for caveolin-1 (CAV-1), vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), c-kit, p53, Ki-67, breast cancer type 1 susceptibility protein (BRCA1), cytokeratin (CK)14, and CK17 were performed on both retained tissue sets. Results : Of the 60 metaplastic carcinomas, 15 tumors (25%) exhibited spindle cell component, 27 (45%) exhibited chondroid differentiation, and 18 (30%) exhibited squamous areas. Compared to triple-negative carcinomas, metaplastic carcinomas significantly more frequently expressed CK14 (p < 0.0001), CK17 (p = 0.002), EGFR (p < 0.0001), CAV-1 (p < 0.0001), and VEGF (p = 0.029). However, expressions of BRCA1, p53, c-kit, and Ki-67 were not significantly different between both groups. Conclusions : The expression profile of metaplastic carcinoma of the breast is more homogeneous than that of other triple-negative tumors and frequently over-expresses basal markers, CAV-1, and VEGF. A typical “asal-like”phenotype and frequent expressions of CAV-1 and VEGF may justify specific therapeutic approaches.

The Spectrum of Epstein-Barr Virus-Associated Lymphoproliferative Disease in Korea: Incidence of Disease Entities by Age Groups

조은윤,Ki Hyun Kim,김원석,유건희,구홍회,Young Hyeh Ko 대한의학회 2008 Journal of Korean medical science Vol.23 No.2

This study is to identify the spectrum of Epstein-Barr virus (EBV)-positive lymphoproliferative diseases (LPD) and relationships between these diseases in Korea. The EBV status and clinicopathology of 764 patients, including acute EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH), chronic active EBV (CAEBV) infections, B-LPD arising in chronic latent EBV infection, T & natural killer (NK) cell non-Hodgkin’s lymphomas (NHL), B-NHLs, and Hodgkin’s lymphomas (HD), were analyzed. T or NK cell NHLs were the most common forms of EBV-positive NHLs (107/167, 64%); among these, nasal-type NK/T cell lymphomas were the most common (89/107, 83%). According to the age, Burkitt’s lymphoma was the most common in early childhood; in teenagers, chronic (active) EBV infection-associated LPD was the most common type. The incidence of NK/T cell lymphoma began to increase from the twenties and formed the major type of EBV-associated tumor throughout life. Diffuse large B cell lymphoma formed the major type in the sixties and seventies. In conclusion, primary infections in early childhood are complicated by the development of CAEBV infections that are main predisposing factors for EBV-associated T or NK cell malignancies in young adults. In old patients, decreased immunity associated with old age and environmental cofactors may provoke the development of peripheral T cell lymphoma, unspecified, and diffuse large B cell lymphoma.

Expression of Actin-bundling Protein Fascin and its Relationship withAltered E-cadherin and -catenin Expressions in Ovarian SerousNeoplasms

조은윤,최윤라,채승완,김어진,김계현,안긍환,손진희 대한병리학회 2005 Journal of Pathology and Translational Medicine Vol.39 No.4

Background : Fascin, an actin-bundling protein, has been found in specialized normal cells, including the neuronal, endothelial and dendritic cells, and its expression is known to be greatly increased in various human neoplasms. Methods : Immunohistochemical stainings for fascin, -catenin, and E-cadherin were performed in normal ovary tissue (n=13), and in benign (n=14), borderline (n=32), and malignant (n=74) ovarian serous neoplasms. We evaluated the fascin expression, and its relationship with the -catenin and E-cadherin expressions, as well as the clinicopathologic factors. Results : Fascin expression was detected in the majority of the borderline (100%, 32/32) and malignant tumors (90.5%, 67/74), but it was not seen in the normal ovarian surface epithelial cells and the benign tumors (p<0.001). Fascin expression was significantly correlated with the occurrence of peritoneal metastases in the carcinomas (p=0.043). A significant relationship between the expressions of fascin and -catenin (p=0.046), as well as E-cadherin (p=0.035) was noted. There was no significant correlation with the tumor grade of carcinoma, the FIGO stage, tumor recurrence, tumor-related death and the survival rate. Conclusions : In ovarian serous neoplasms, the fascin expression may be closely linked with tumor progression and metastasis, and it was associated with the up-regulation of -catenin and E-cadherin.

림프구성 종양의 클론성 분석을 위하여 중합효소연쇄반응을 이용한 면역글로불린 중쇄와 T-세포 수용체 감마쇄 유전자 재배열 검사의 진단적 유용성

조은윤,고영혜,김대식,한재준,이회정 대한병리학회 2001 Journal of Pathology and Translational Medicine Vol.35 No.6

활액막 육종에서 새로운 종양 표지자로서 TLE1의 가치

조은윤,김동욱,서성욱,Cho, Eun-Yun,Kim, Dong-Wook,Seo, Sung-Wook 대한근골격종양학회 2009 대한골관절종양학회지 Vol.15 No.1

목적: 활액막 육종에서 TLE1의 발현과 정상 조직에서의 발현을 비교하고 환자의 예후와의 관련성을 알아 보고자 한다. 대상 및 방법: 2001년 1월부터 2008년 9월까지 삼성서울병원에서 수술 및 치료를 시행한 36예의 활액막 육종 환자들의 조직과 정상 대조군 조직들에서 TLE1의 발현을 비교 분석하였다. TLE1의 발현 정도를 음성, 약 양성, 중등도 양성, 강 양성으로 분류하였고, 환자들의 전체 생존율을 분석하여 관련성을 알아보았다. 결과: 정상 간엽조직에서는 TLE1의 발현이 관찰되지 않았고, 분화가 빠른 정상 혈관의 내피세포와 상피세포에서 TLE1의 발현이 약하게 관찰되었다. 활액막 육종 36예 중 35예에서 TLE1의 발현을 확인할 수 있었다. 이 중 28예에서는 중등도 이상의 발현, 5예에서는 약한 발현, 2예는 매우 강한 강도의 발현을 보였으며, 활액막 육종에서 TLE1의 발현 정도와 예후와는 통계적 연관성이 없었다. 결론: TLE1은 향후 활액막 육종의 진단에 효과적으로 사용될 수 있을 것으로 생각되며, 정상 조직에서의 발현도가 낮으므로 종양의 표적 치료시의 좋은 target으로 사용될 수 있는 새로운 인자로 생각된다. Purpose: This study was aimed to assess TLE1 as a target molecule of synovial sarcoma. Method: We obtained tissue samples and clinical data from 36 patients who were diagnosed and treated for synovial sarcoma in our hospital. Immunohistochemical staining was performed to detect the expression of TLE1 in synovial sarcoma and normal tissues such as fat, skeletal muscle, peripheral nerve, vascular endothelium, and epithelium. Univariate survival analysis was performed to find whether overexpression of TLE1 is correlated to poor prognosis. Results: TLE1 was expressed in 35 (97%) cases (grade 1 was 5 cases, grade 2 was 28 cases, grade 3 was 2 cases.). Normal tissues from mesenchymal origin did not express TLE1. However, epithelial and endothelial cells showed weak expression (grade 1) of TLE1. The level of TLE1 expression did not have any prognostic significance according to univariate survival analysis. Conclusion: TLE1 may be a new molecular target of synovial sarcoma that differentiates synovial sarcoma from normal mesenchymal cells.

Comparison of Her-2, EGFR and Cyclin D1 in Primary Breast Cancer and Paired Metastatic Lymph Nodes: An Immunohistochemical and Chromogenic In Situ Hybridization Study

조은윤,한재준,최윤라,김경미,오영륜 대한의학회 2008 Journal of Korean medical science Vol.23 No.6

The significant advance in the development of molecular-targeting drugs has made an evaluation of Her-2, EGFR, and cyclin D1 an important clinical issue in breast cancer patients. This study compared the Her-2, EGFR, and cyclin D1 status of primary tumors as well as their matching lymph node metastases using immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH) in 73 breast cancer patients. Her-2, EGFR, and cyclin D1 protein showed a concordance between the primary lesion and the metastatic regional lymph nodes in 82%, 90%, and 63%, respectively. CISH also revealed 92%, 93%, and 85% concordance in the gene amplification status of Her-2, EGFR, and cyclin D1, showing a reasonable agreement between primary tumors and metastatic regional lymph nodes. Although a statistically significant agreement was found in Her-2 expression, a relatively high discordance rate (18%) raises a little concern. Our findings suggest that the Her-2 status can be reliably assessed on primary tumor but a possible difference can be found in Her-2, EGFR, and cyclin D1 status between the primary and the metastatic sites and this possibility should be concerned in patients considering molecular targeted therapy or patients with progress of disease.

Analysis of Fine Needle Aspiration Cytology and Ultrasonography of Metastatic Tumors to the Thyroid

조은윤,오영륜,Cho, Eun-Yoon,Oh, Young-Lyun The Korean Society for Cytopathology 2007 대한세포병리학회지 Vol.18 No.2

Cytologic diagnosis of the metastatic tumors to the thyroid is important in the management of the patients. There have been rare reports analyzing fine-needle aspiration (FNA) cytology of metastatic tumors to the thyroid. This study examines comprehensive cytologic findings of metastatic tumors to the thyroid with radiologic findings. The FNA cytology slides obtained from 12 cases with metastatic tumors of the thyroid; lung cancer (n=5), tongue and tonsil cancer (n=3), esophageal cancer (n=2), and breast cancer (n=2) were reviewed. Radiological study showed single mass with heterogeneous texture or multiple masses without calcification. Metastatic tumor was easily considered in a differential diagnosis of FNA cytology because they had peculiar cytological features which were not seen in primary thyroid tumor. The smear background varied from predominantly necrotic, bloody, and inflammatory to colloid. The aspirates exhibited a mixture of benign follicular cells and malignant cells in 6 cases. The characteristic cytoplasmic features of the tumor cells, such as keratin, mucin and melanin, were found in 9 cases. Although some cases mimic primary thyroid neoplasm, a careful examination of the cytological characteristics may help cytopathologists to recognize a metastatic tumor in the thyroid by FNA, and may help the clinicians to establish a proper treatment plan.

16번 삼염색체증 마우스에서 관찰된 이상 뇌발달과 세포자멸사

조은윤,서연림,지제근 대한병리학회 1999 Journal of Pathology and Translational Medicine Vol.33 No.8

신장의 원시성 신경외배엽 종양

송상용,조은윤,이정원,고재향,김미경,김대식,고영혜 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.3