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- 저자 : Keng Shen (검색결과 11 건)
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Jie Yang,Keng Shen,Jinhui Wang,Jiaxin Yang,Dongyan Cao 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.4
Objective: To evaluate whether adjuvant simple hysterectomy after concurrent chemoradiotherapy (CCRT) improves progression-free survival (PFS) compared with current standard care in locally advanced cervical adenocarcinoma (LACAC). Methods: We reviewed a cohort of 55 patients with LACAC (International Federation of Gynecology and Obstetrics [FIGO] stage IB2, IIA2, IIB, III without distant metastasis) diagnosed and treated with radical CCRT at Peking Union Medical College Hospital between January 2004 and October 2014. We compared 34 patients who underwent adjuvant extrafascial hysterectomy with 21 patients with standard care after CCRT. The primary outcome was PFS. Overall survivals (OS) between the two groups were also compared. Surgery feasibility, operative complications, and pathologic features after radiation therapy were also analyzed. Results: PFS was significantly improved in surgery group (log-rank p=0.0097; hazard ratio [HR], 0.3431; 95% CI, 0.152 to 0.772), as were OS (log-rank p=0.0419; HR, 0.3667; 95% CI, 0.139 to 0.964). Analysis of stage IIB demonstrates a similar result. There were no severe complications related to postradiation surgery in this series. The mean blood loss was less in laparoscopic group than those in the open group (87 mL vs. 208 mL, p=0.036, Mann-Whitney U-test). Approximately 47% patients (16/34) had pathologic residue tumor on hysterectomy specimens. About 94% patients (32/34) got complete remission after adjuvant surgery. Conclusion: Adjuvant hysterectomy after CCRT improves survival outcome for patients with LACAC compared with current standard care. Extrafascial hysterectomy is sufficient in tumor reduction and laparoscopic procedure may be more promising with lower blood loss and expedite recovery.
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Jwu-Sheng Hu,Keng-Yuan Chen,Chi-Him Tang,Te-Yang Shen 전력전자학회 2011 ICPE(ISPE)논문집 Vol.2011 No.5
This work proposes a new switching strategy for field oriented control of a motor driver to minimize the power of filtered error induced by finite bit resolution of the gating signal. It is shown that the conventional space vector pulse width modulation (SVPWM) is a special case of the proposed general switching strategy which has infinite bit resolution within one input period. Another special case, multi-dimensional feedback quantization modulator: MDFQM, is proposed and compared with SVPWM. The experiments in this study compared mean-square-error of motor speed, switching number of the three-phase voltage source inverter, and current waveforms. The experimental results show that MDFQM can reduce the switching number as well as the heat dissipation of the power transistors.
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Dan Wang,Jiaxin Yang,Keng Shen,Yang Xiang 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.3
Fertility-sparing surgery was optimal to patients with tumor diameter smaller than 2 cm. For patients with larger tumors, neoadjuvant chemotherapy can debulk the tumor and offer the chance of surgery. We report 2 cases of stage IB1 cervical cancer treated by neoadjuvant chemotherapy and fertility-sparing surgery. Relevant literature was reviewed. Its safety, efficacy, and reproductive outcome need to be validated in the future.
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Cervical Cancer Screening and Analysis of Potential Risk Factors in 43,567 Women in Zhongshan, China
Wang, Ying,Yu, Yan-Hong,Shen, Keng,Xiao, Lin,Luan, Feng,Mi, Xian-Jun,Zhang, Xiao-Min,Fu, Li-Hua,Chen, Ang,Huang, Xiang Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.2
Objective: The objective of this study was to establish a program model for use in wide-spread cervical cancer screening. :Methods: Cervical cancer screening was conducted in Zhongshan city in Guangdong province, China through a coordinated network of multiple institutes and hospitals. A total of 43,567 women, 35 to 59 years of age, were screened during regular gynecological examinations using the liquid-based ThinPrep cytology test (TCT). Patients who tested positive were recalled for further treatment. Results: The TCT-positive rate was 3.17%, and 63.4% of these patients returned for follow-up. Pathology results were positive for 30.5% of the recalled women. Women who were younger than 50 years of age, urban dwelling, low-income, had a history of cervical disease, began having sex before 20 years of age, or had sex during menstruation, were at elevated risk for a positive TCT test. The recall rate was lower in women older than 50 years of age, urban dwelling, poorly educated, and who began having sex early. Ahigher recall rate was found in women 35 years of age and younger, urban dwelling, women who first had sex after 24 years of age, and women who had sex during menstruation. The positive pathology rate was higher in urban women 50 years of age and younger and women who tested positive for human papillomavirus. Conclusion: An effective model for large-scale cervical cancer screening was successfully established. These results suggest that improvements are needed in basic education regarding cervical cancer screening for young and poorly educated women. Improved outreach for follow-up is also necessary to effectively control cervical cancer.
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Jie Yang,Jiaxin Yang,Dongyan Cao,Keng Shen,Jiabin Ma,Fuquan Zhang 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.2
Objective: To compare patient survival outcomes between completion hysterectomy and conventional surveillance in locally advanced adenocarcinoma of the cervix after concurrent chemoradiotherapy (CCRT). Methods: Patients with adenocarcinoma of the cervix after CCRT were identified in a tertiary academic center database from 2004 to 2018. Patients received completion hysterectomy or surveillance after CCRT. We compared the progression-free survival (PFS) and overall survival (OS) between the patients with or without adjuvant hysterectomy. Surgery features, operative complications, and pathologic characteristics were documented. Patient outcomes were also analyzed according to clinicopathologic factors. Results: A total of 78 patients were assigned to completion surgery and 97 to surveillance after CCRT. The PFS was better in the surgery group compared to the CCRT only group, at 3 years the PFS rates were 68.1% and 45.2%, respectively (hazard ratio [HR]=0.46; 95% confidence interval [CI]=0.282–0.749; p=0.002). Adjuvant surgery was also associated with a higher rate of OS (HR=0.361; 95% CI=0.189–0.689; p=0.002), at 3 years, 87.9% and 67%, respectively. Tumor stage, size, lymph-vascular space invasion (LVSI), lymphadenopathy were associated with PFS but not with OS. Hysterectomy specimens revealed 64.1% (50/78) of the patients had pathologic residual tumor. Patients age less than 60, tumor size over 4 cm, stage IIB and persistent residual disease after CCRT were most likely to benefit from hysterectomy. Hysterectomy was associated with a lower rate of locoregional recurrence but did not reach statistical significance (5.13% vs. 13.5%, p=0.067). Conclusion: Completion hysterectomy after CCRT was associated with better survival outcome compared with the current standard of care.
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Qianying Zhao,Jiaxin Yang,Lei Li,Dongyan Cao,Meiyun Ke,Keng Shen,BGI Group 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4
Objective: To define genetic profiling of homologous recombination (HR) deficiency inChinese ovarian cancer patients. Methods: We have applied next-generation sequencing to detect deleterious mutationsthrough all exons in 31 core HR genes. Paired whole blood and frozen tumor samples from50 Chinese women diagnosed with epithelial ovarian carcinomas were tested to identify bothgermline and somatic variants. Results: Deleterious germline HR-mutations were identified in 36% of the ovarian cancerpatients. Another 5 patients had only somatic mutations. BRCA2 was most frequentlymutated. Three out of the 5 somatic mutations were in RAD genes and a wider distributionof other HR genes was involved in non-serous carcinomas. BRCA1/2-mutation carriers hadfavorable platinum sensitivity (relative risk, 1.57, p<0.05), resulting in a 100% remissionprobability and survival rate. In contrast, mutations in other HR genes predicted poorprognosis. However, multivariate analysis demonstrated that platinum sensitivity andoptimal cytoreduction were the independent impact factors influencing survival (hazardsratio, 0.053) and relapse (hazards ratio, 0.247), respectively. Conclusion: Our results suggest that a more comprehensive profiling of HR defect thanmerely BRCA1/2 could help elucidate tumor heterogeneity and lead to better stratification ofovarian cancer patients for individualized clinical management.
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Qiuhong Qian,Jiaxin Yang,Dongyan Cao,Yan You,Jie Chen,Keng Shen 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.4
Objective: To explore appropriate treatment modality of microinvasive cervical cancer (MIC) and to analyze prognosis and risk factors of recurrence. Methods: A cohort of 324 Chinese patients with MIC diagnosed and treated at Peking Union Medical College Hospital was retrospectively reviewed. Demographic features, treatment modalities, pathologic parameters, risk factors of residual disease, survival and risk factors of recurrence were analyzed. Results: Of all patients, 280 cases were staged IA1 and 44 cases staged IA2 MIC. Twenty-five cases (7.7%) were found to have lympho-vascular space involvement (LVSI), but no parametrial involvement or ovarian metastasis was detected. Only one staged IA2 patient with LVSI was found to have lymph node metastasis. 32.4% patients (82/253) had residual diseases after conization. No significant difference of LVSI, lymph node metastasis and residual disease after coniztion was found between stage IA1 and IA2 MIC patients. Multivariate logistic analysis showed positive margin was the only independent risk factor of residual disease after conization (odds ratio [OR], 4.18; p<0.001). Recurrence occurred in five cases, but no mortality was found. Progression-free survival for stage IA1 patients treated by conization or hysterectomy was similar (92.3% and 98.8%, p=0.07). Cox regression analysis revealed LVSI as an independent risk factor for recurrence in stage IA1 patients (OR, 12.14; p=0.01). Conclusion: For stage IA1 patients with negative resection margin and no LVSI, conization can be an ideal treatment modality. For stage IA2 patients, more conservative surgery such as simple hysterectomy may be considered. LVSI is an independent risk factor for recurrence in patients with stage IA1 cervical cancer.
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Qianying Zhao,Jiaxin Yang,Dongyan Cao,Jiangna Han,Kaifeng Xu,Yongjian Liu,Keng Shen 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.3
Objective: To explore the appropriate treatment of malignant germ cell tumor (MGCT) in thefemale genital system, and to analyze the factors influencing both therapeutic response andsurvival outcome. Methods: A cohort of 230-Chinese women diagnosed with MGCT of the genital systemwas retrospectively reviewed and prospectively followed. The demographic and pathologicalfeatures, extent of disease and surgery, treatment efficiency, recurrence and survival wereanalyzed. Results: MGCTs from different genital origins shared a similar therapeutic strategy andresponse, except that all eight vaginal cases were infantile yolk sac tumors. The patients’ curerate following the initial treatment, 5-year overall survival and disease-free survival (DFS)were 85.02%, 95.00%, and 86.00%, respectively. Although more extensive excision couldenhance the remission rate; it did not improve the patients’ survival. Instead, the level of themedical institution, extent of surgery and disease were independent prognostic factors forrelapse (p<0.05). Approximately 20% of patients had recurrent or refractory disease, morethan half of whom were in remission following secondary cytoreductive surgery with salvagechemotherapy. Conclusion: Fertility-sparing surgery with or without standardized PEB/PVB (cisplatin,etoposide/vincristine, and bleomycin) chemotherapy is applicable for female MGCTsof different origins. Comprehensive staging is not required; nor is excessive debulkingsuggested. Appropriate cytoreduction by surgery and antineoplastic medicine at anexperienced medical institution can bring about an excellent prognosis for these patients.
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Deng, Niantao,Goh, Liang Kee,Wang, Hannah,Das, Kakoli,Tao, Jiong,Tan, Iain Beehuat,Zhang, Shenli,Lee, Minghui,Wu, Jeanie,Lim, Kiat Hon,Lei, Zhengdeng,Goh, Glenn,Lim, Qing-Yan,Tan, Angie Lay-Keng,Sin P BMJ Group 2012 Gut Vol.61 No.5
<P><B>Objective</B></P><P>Gastric cancer is a major gastrointestinal malignancy for which targeted therapies are emerging as treatment options. This study sought to identify the most prevalent molecular targets in gastric cancer and to elucidate systematic patterns of exclusivity and co-occurrence among these targets, through comprehensive genomic analysis of a large panel of gastric cancers.</P><P><B>Design</B></P><P>Using high-resolution single nucleotide polymorphism arrays, copy number alterations were profiled in a panel of 233 gastric cancers (193 primary tumours, 40 cell lines) and 98 primary matched gastric non-malignant samples. For selected alterations, their impact on gene expression and clinical outcome were evaluated.</P><P><B>Results</B></P><P>22 recurrent focal alterations (13 amplifications and nine deletions) were identified. These included both known targets (<I>FGFR2</I>, <I>ERBB2</I>) and also novel genes in gastric cancer (<I>KLF5</I>, <I>GATA6</I>). Receptor tyrosine kinase (RTK)/RAS alterations were found to be frequent in gastric cancer. This study also demonstrates, for the first time, that these alterations occur in a mutually exclusive fashion, with <I>KRAS</I> gene amplifications highlighting a clinically relevant but previously underappreciated gastric cancer subgroup. <I>FGFR2</I>-amplified gastric cancers were also shown to be sensitive to dovitinib, an orally bioavailable FGFR/VEGFR targeting agent, potentially representing a subtype-specific therapy for <I>FGFR2</I>-amplified gastric cancers.</P><P><B>Conclusion</B></P><P>The study demonstrates the existence of five distinct gastric cancer patient subgroups, defined by the signature genomic alterations <I>FGFR2</I> (9% of tumours), <I>KRAS</I> (9%), <I>EGFR</I> (8%), <I>ERBB2</I> (7%) and <I>MET</I> (4%). Collectively, these subgroups suggest that at least 37% of gastric cancer patients may be potentially treatable by RTK/RAS directed therapies.</P>
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