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Young Ju Song,Sun Hyoung Shin,Jin Seong Cho,Min Ho Park,Jung Han Yoon,Young Jong Jegal 한국유방암학회 2011 Journal of breast cancer Vol.14 No.3
Purpose: Lymphovascular invasion (LVI) is an important prognostic factor in patients with lymph node-negative patients with invasive breast cancer. However, the prognostic value of LVI it is unclear and controversial about its prognostic value in patients with lymph node-positive breast cancer patients. So, we report the an analysis of the prognostic significance of LVI in a large cohort study of patients with lymph node-positive patients with invasive breast cancer. Methods: We retrospectively reviewed 967 patients with invasive breast cancer that had undergone surgical treatment at our hospital, from January 2004 to December 2007. Among these thempatients, 349 patients with lymph node-positive breast cancer patients are were included in this study. We evaluated clinical and pathological data in these patients, we compared with 5-year overall survival and disease-free survival between an LVI-present group and an LVI-absent group. Results: The median follow-up was 48 months (range, 12-78 months), and the mean age of the patients was 48 years (range, 23-78 years). LVI was present in 192 patients (55%) of with tumors and was associated with age ≤40 years (p=0.009), high histologichistological grade (p=0.007), estrogen receptor status (p=0.001), tumor size ≥2 cm (p<0.001), and number of involved lymph nodes (p<0.001), but not with progesterone receptor status, HER2 status, p53 status, or tumor multiplicity. LVI was a significant independent prognostic factor for disease-free survival (p<0.001) and overall survival (p=0.006). By multivariate analysis revealed that LVI (p=0.003), number of involved lymph nodes (≥4; p=0.005), and high histological grade (II and III; p=0.02) was were an independent significant predictors of disease-free survival and overall survival in the whole group of patients. Conclusion: In this case, we demonstrated that LVI is a significant predictor of poor prognosis in patients with lymph node-positive patients with primary invasive breast cancer, LVI is a significant predictive predictor value of poor prognosis. So, LVI should be considered in the therapeutic strategy as a decision making tool in the adjuvant chemotherapy setting.
Park, Young-Ki,Shin, Dong-Jun,Cho, Duck,Kim, Sang-Ki,Lee, Je-Jung,Shin, Myung-Geun,Ryang, Dong-Wook,Lee, Ji-Shin,Park, Min-Ho,Yoon, Jung Han,Jegal, Young Jong Potamitis Press 2012 Anticancer research Vol.32 No.3
<P>Interleukin-21(IL-21) stimulates cytotoxicity and interferon-γ (IFN-γ) production in natural killer (NK) cells. However, little has been reported on the stimulatory effect of IL-21 on ex vivo expanded NK cells. In this study, we examined the cytotoxicity and IFN-γ production of ex vivo expanded, IL-21-stimulated NK cells against trastuzumab-coated breast cancer cells.</P>
윤정한(Jung Han Yoon),제갈영종(Young Jong Jegal) 대한두경부종양학회 1989 대한두경부 종양학회지 Vol.5 No.1
It is frequently difficult to assess the presence of malignancy in patients with parotid tumor, because of unreliable diagnostic tools and riskful preoperative biopsy. In our case, a parotid adenocarcinoma and pleomorphic adenoma was revealed on permanent histologic section, which was made a impression as pleomorphic adenoma on preoperative Tru-Cut biopsy and intraoperative frozen section. So, the most accurate diagnosis of the parotid malignancy is a complete removal of tumor tissue, accompanied with permanent histologic section.
김정철(Jung Chul Kim),윤정한(Jung Han Yoon),제갈영종(Young Jong Jegal) 대한두경부종양학회 1994 대한두경부 종양학회지 Vol.10 No.2
Proliferating cell nuclear antgen(PCNA) plays an important role in DNA synthesis in nucleoli and is highly conserved non-histone nuclear protein composed of 261 amino acid. and is considered to correlated with the cells proliferative state, because it is synthesized particulary during the proliferative period of late Gland S-phase. Therefore, PCNA index meaningfully increases in the active or proliferative kinetic cells. By the use of recently developed monoclonal antibodies against PCNA, the immunohistochemical staining methods can make possible. These staining methods are the useful and productive one for ascertaining the cell's proliferating abillity. Moreover, immunohistochemical staining method with a antiPCNA antibody has particulrar advantages as follows. By means of these methods, we can stain the tissue that was already fixed in formalin or paraffin wax. We can see with naked eye that which cell is, where is differentiated through a microscope. Lastly, it maintains the whole tissue architecture and makes a search for the correlation. As we have seen above, the immunohistochemical staining methods for PCNA have been studied as an impotant factor that can find the cell proliferative kinetics in malignancy and biologic behavior of tumors. To investigate of the proliferative activity in thyroid nodule, Authors evaluated cell proliferative activity by immunostaing for PNCA in 45 pathologically confirmed solitary thyroid nodule. The results were as follows. 1) The benign nodules were 25 cases(Adenomatous Goiter: 20 cases, Follicular adenoma: 5 cases) and malignant nodules were 20 cases(Papillary Ca : 14 cases, Follicular Ca : 4 cases, Anaplastic Ca : 2 cases). 2) The Most prevalent age groups were 4th decade(11 cases), and the next group was 5th decade. 3) The average PCNA labelling indices were as follows. Adenomatous goiter(I6.9%), Follicular adenoma(37.6%), papillary Ca(26.3%), Follicular Ca(8.8%) and Anaplastic Ca(86.7%). There were no significant differences in benign(20.4) and malignant nodules (28.8%) except anaplastic Ca(p=0.3226). 4) When the average tumor size 2cm in papillary Ca, the PCNA indices were 26.0% (below 2cm) : 26.6% (above 2cm) (p=0.9642). The PCNA incidies were 23.9% (with lymphatic spread) : 28.7% (without lymphatic spread) (p=0.7056). There were no signlficant differences in the above cases. In conclusion, there were no significant differences in cell proliferative activity by staining for PCNA between benign and malignat nodules except anaplastic Ca.
Age and prognosis of papillary thyroid carcinoma
Jin Seong Cho,Jung Han Yoon,Min Ho Park,Sun Hyoung Shin,Young Jong Jegal,Ji Shin Lee,Hee Kyung Kim 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.83 No.5
We investigated the prognosis according to age in papillary thyroid carcinoma (PTC) patients. Methods: We retrospectively evaluated 2,890 patients who underwent thyroidectomy due to PTC between May 2004 and Aug 2008. We divided patients into 3 groups: young (≤35 years old), middle (between 35 and 54 years old), and old (≥55 years old). Results: Median age was 47.0 years old (range, 15 to 82 years). Within a follow-up period median of 50 months, there were 148 (5.1%) locoregional recurrences, 6 (0.2%) PTC-related deaths, and 18 (0.6%) PTC-unrelated deaths. Outcomes were more favorable in the young group, with no PTC-related death despite the frequent locoregional recurrence. In the old group compared to the middle, there was a higher proportion of male, and more aggressive types as T3 or N1b, higher mean tumor number, more multiplicity, and bilaterality. The old group of ≥55 years did not show a significant difference in PTC-related deaths than other age groups in Cox analysis (OR, 0.9; P = 0.677), but a significant cutoff age in PTC-related deaths at 62.5 years was determined in ROC analysis (area under curve = 0.912). Conclusion: We showed that the ≤35 years group shows favorable prognosis despite the frequent locoregional recurrence and ≥62.5 years group shows a poor prognosis regardless of other factors such as male sex or tumor aggressiveness. Further multiinstitutional studies are needed to elucidate the prognosis according to patient’s age.
피부보존 유방절제술 및 즉각적 유방복원수술 환자들의 임상병리학적 특성 및 재발
윤인상(In Sang Yoon),박민호(Min Ho Park),윤정한(Jung Han Yoon),제갈영종(Young Jong Jegal) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.3
Purpose: For those women with breast cancer who require mastectomy for surgical treatment, consideration should be given to optimize the cosmetic outcome. Skin-sparing mastectomy (SSM) is being used more frequently to treat many of these patients. Skin-sparing mastectomy can maximize breast skin preservation and facilitate immediate reconstruction, and so result in an excellent cosmetic appearance. The aim of this study was to access the local recurrence rate of breast cancer after SSM. Methods: A retrospective review was conducted of 53 patients who underwent skin-sparing mastectomy with immediate reconstruction between January 1996 and February 2006. Immediate reconstruction was achieved via the TRAM flap or latissimus dorsi flap or artificial bag. The mean follow-up time was 34.6 months (range: 7∼142 months). Results: Local recurrence occurred in 1 (2.1%) of 53 patients. The time to local recurrence was 44 months. The patient with local recurrence was well controlled by wide excision and postoperative chemotherapy and radiotherapy. The patient with local recurrence is still free of disease. Distant metastasis occurred in 7 (14.9%) of 53 patients. Of the 7 patients with distant metastasis, 1 patient was died from brain involvement. Conclusion: The risk of local recurrence after skin-sparing mastrectomy was not different from that of conventional mastectomy. Local recurrence was effectively managed with surgical excision of the involved tissues and then administering chemotherapy or radiotherapy.
Jin Seong Cho,Jung Han Yoon,Min Ho Park,Sun Hyoung Shin,Young Jong Jegal,Ji Shin Lee,Hee Kyung Kim 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.83 No.4
Purpose: There are no guidelines for the optimal timing of the decision of when to perform completion thyroidectomy, and controversy exists regarding how the timing of completion thyroidectomy impacts survival patterns. We investigated the legitimacy of an observational strategy in central node metastasis after thyroid lobectomy for papillary thyroid cancer (PTC). Methods: We retrospectively evaluated 522 consecutive patients who underwent thyroid lobectomy. Of the 69 patients with central metastasis, 61 patients (88.4%) were included in an observational study under cautious evaluation with informed consent by the patients, and compared with an observation arm of 180 postlobectomy N0 (node negative proven) patients. Results: Of the 522 patients, six (1.1%) thyroid, five (0.9%) central, and two (0.4%) lateral recurrences were observed. Lateral recurrences occurred in the immediate completion N0 and Nx groups but not in the N1a observation arms. There were two (3.3%) central recurrences without thyroid or lateral recurrence on the observation arm of N1a observation patients. But two (1.1%) thyroid and three (1.7%) central recurrences were on the observation arm of N0 patients. In Kaplan-Meier survival curves for central or lateral recurrences between observation arms for the N1a and N0 groups, no significant difference was found between the N1a and N0 observation arms (P = 0.365). Conclusion: The timing of when to perform completion thyroidectomy in central metastases-proven patients after lobectomy for PTC should be based on the patient’s risk category.