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곽희숙 부산대학교 병원 암연구소 2006 부산대병원학술지 Vol.- No.20
유방의 침윤관암종으로 신보강화학요법을 시행한 환자들을 대상으로 조기 및 지연 Tc-MIBI 유방스캔을 실시하여 WR을 구하고, 화학요법 후 종양의 반응을 조사하여 이와 관련한 근거를 탐구하고자 하였다. 신보강화학요법 후 반응군에 따른 Tc-MIBI의 WR은 반응군에 비해 비반응군에서 낮게 나왔으나 통계적인 유의성은 없었다(p=0.674). 본 연구는 P-당단백질 발현 여부를 같이 조사하지 않아 섣불리 결론을 내리기 힘들지만, Tc-MIBI 의 WR 만으로서 신보강화학요법의 반응률을 예측하는 데에는 아직 제한적일 것으로 생각되며, 이미 다른 연구에서 입증된 바 있는 P-당단백질 발현 및 다약제내성 유전자 발현과의 연관성을 입증한다면 비침습적인 방법으로 신보강화학요법에 대한 반응을 예측하는 데에 도움이 될 것으로 본다. Numerous non-invasive imaging methods in the evaluation of chemotherapy response of breast cancer are currently being explored. The aim of present study was to investigate whether the washout rates(WR) of Tc-MIBI could predict the response to chemotherapy in patients with infiltrating ductal carcinoma. Between January 2005 and October 2005, the patients were selected for neoadjuvant chemotherapy. A total 45 patients with infiltrating ductal carcinoma were referred to the double phase Tc-MIBI mammoscintigraphy after injection of 925 MBq of Tc-MIBI to calculate WR. Mter completion of neoadjuvant chemotherapy, the tumor response was evaluated. Tumor response was classified as complete or partial response(Responder group) and stable or progression(Non-responder group). All patients underwent surgery. The WR of non-responder group was lower than that of responder group although the difference was not statistically significant(p=0.674). In conclusion, the WR of Tc-MIBI only is not helpful for prediction of response after neoadjuvant chemotherapy in infiltrating ductal carcinoma of breast.
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김동원,김원택,남지호 부산대학교 병원 암연구소 2006 부산대병원학술지 Vol.- No.20
Purpose : To evaluate the significance of squamous cell carcinoma antigen (SCC) as tumor markers in uterine cervix carcinoma. Subjects and Methods : This is a retrospective study of 90 cervical carcinomas who have received primary(radical) radiotherapy and checked serial serum SCC antigen levels before and after radiotherapy and during follow-up period from February 1994 to January 1998 at Busan National University Hospital. The relationship between radiotherapy results including some variable prognostic factors and serial serum SCC antigen levels were analyzed according to various statistical methods. Results : SCC antigen level was raised in 75 patients (83.3%) before primary radiotherapy. In these patients, clinical remission was achieved in 93.3% and SCC antigen level was decreased to normal range in 90.7% after radiotherapy. Rising SCC antigen levels preceded the clinical detection of relapse by a mean of 3.6 months (range 1~14 months). Negative linear correlation was observed between initial SCC antigen levels and relapse free survival, and by multivariate analysis, initial SCC antigen level was a significantly independent prognostic factor on the relapse free survival. Conclusions : Serum SCC antigen was good tumor marker for monitoring treatment effect in patients with raised pre-treatment levels. Serial SCC antigen level check after treatment will be a useful aid to detect early recurrence.
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색도플러 초음파상 혈관형태에 의한 갑상선 여포성 암의 진단
이석홍 부산대학교 병원 암연구소 2006 부산대병원학술지 Vol.- No.20
Purpose: The aim of this study was to define the preoperative diagnosis of thyroid follicular carcinoma by the vascular pattern and veIocimetric parameters using color resolution pulsed and power Doppler ultrasonography (US). Methods: We compared the vascular pattern and the veIocimetric parameters, such as peak systolic velocity (Vmax), end-diastolic velocity (Vmin), puIsatility index (PI), or resistance index (RI) between follicular adenoma (FA, n=25) and follicular carcinoma (FC, n=10) and analysed them by means of receiver characteristrics curves (ROC). Results: Of 10 patients with FC. 8 (80%) patients presented a moderate increase of intranodular vascularization using power Doppler US. In contrast, the majority (84%, 21 out of 25 cases) of FA cases showed only a peripheral rim of color flow even by power Doppler US. These color flow imagings by power Doppler US were suggested to be a reliable tool for the differential diagnosis of thyroid follicular tumor with a sensitivity of 87.5% and a specificity of 92%. In velocimetric analyses, the Vmax/Vmin ratios, PI, and RI were significantly higher in the patients with FC than those with FA (p<0.001, p<0.005, and p<0.001, respectively). By menas of ROC, FC could be diagnosed with a cutoff value of ratio of PI (>1.35), RI (>0.78), and Vmax/Vmin (>3.79). The diagnostic efficiency evaluated by ROC curves were 0.898 for PI, 0.876 for RI, and 0.888 for V max/V min, repectively. Conclusion: The evaluation of the vascular pattern and the velocimetric parameters using color Doppler ultrasound may provide important information that is useful in making correct differential diagnosis of malignant or benign thyroid follicular tumor preoperatively.
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