Prediction of Perineural Invasion and Its Prognostic Value in Patients with Prostate Cancer

이준택,이승수,윤창진,전병주,김정만,하홍구,이완,정문기 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.11

Purpose: The prognostic significance of perineural invasion by prostate cancer is debated. We investigated the association between perineural invasion and clinicopathological factors and the effect of perineural invasion on survival in patients with prostate cancer. Materials and Methods: A total of 361 patients with prostate cancer without any neoadjuvant therapies prior to surgery from 1999 to 2010 were analyzed retrospectively. Whole-mount sections of surgical specimens from all patients who underwent radical prostatectomy were evaluated. Positive perineural invasion was defined as infiltration of cancer cells in the perineurium or neural fascicles. The relationship of perineural invasion with clinicopathological features and prognosis of prostate cancer was studied. We also researched preoperative factors that were associated with perineural invasion. Results: Perineural invasion in a prostatectomy specimen (PNIp) was positive in 188 of 361 patients (52.1%). In the multivariate analysis of the preoperative variables, PNIp was related to the primary Gleason grade (p=0.020), the number of positive cores (p= 0.008), and the percentage of tumor cells in positive cores (p=0.021), but not to perineural invasion of a prostate biopsy. In the evaluation between PNIp and pathologic findings of the prostatectomy specimen, PNIp was related to the Gleason score (p=0.010), T-stage (p=0.015), and lymphovascular invasion (p=0.019). However, by multivariate analysis, the PNIp was not an independent prognostic factor of biochemical serum recurrence (p=0.364) or cancer-specific survival (p=0.726). Conclusions: PNIp was significantly related to biologically aggressive tumor patterns but was not a prognostic factor for biochemical serum PSA recurrence or cancer-specific survival in patients with prostate cancer. Purpose: The prognostic significance of perineural invasion by prostate cancer is debated. We investigated the association between perineural invasion and clinicopathological factors and the effect of perineural invasion on survival in patients with prostate cancer. Materials and Methods: A total of 361 patients with prostate cancer without any neoadjuvant therapies prior to surgery from 1999 to 2010 were analyzed retrospectively. Whole-mount sections of surgical specimens from all patients who underwent radical prostatectomy were evaluated. Positive perineural invasion was defined as infiltration of cancer cells in the perineurium or neural fascicles. The relationship of perineural invasion with clinicopathological features and prognosis of prostate cancer was studied. We also researched preoperative factors that were associated with perineural invasion. Results: Perineural invasion in a prostatectomy specimen (PNIp) was positive in 188 of 361 patients (52.1%). In the multivariate analysis of the preoperative variables, PNIp was related to the primary Gleason grade (p=0.020), the number of positive cores (p= 0.008), and the percentage of tumor cells in positive cores (p=0.021), but not to perineural invasion of a prostate biopsy. In the evaluation between PNIp and pathologic findings of the prostatectomy specimen, PNIp was related to the Gleason score (p=0.010), T-stage (p=0.015), and lymphovascular invasion (p=0.019). However, by multivariate analysis, the PNIp was not an independent prognostic factor of biochemical serum recurrence (p=0.364) or cancer-specific survival (p=0.726). Conclusions: PNIp was significantly related to biologically aggressive tumor patterns but was not a prognostic factor for biochemical serum PSA recurrence or cancer-specific survival in patients with prostate cancer.

Prediction of Perineural Invasion and Its Prognostic Value in Patients with Prostate Cancer

Lee, Jun Taik,Lee, Seungsoo,Yun, Chang Jin,Jeon, Byung Joo,Kim, Jung Man,Ha, Hong Koo,Lee, Wan,Chung, Moon Kee The Korean Urological Association 2010 Korean Journal of Urology Vol.51 No.11

<P><B>Purpose</B></P><P>The prognostic significance of perineural invasion by prostate cancer is debated. We investigated the association between perineural invasion and clinicopathological factors and the effect of perineural invasion on survival in patients with prostate cancer.</P><P><B>Materials and Methods</B></P><P>A total of 361 patients with prostate cancer without any neoadjuvant therapies prior to surgery from 1999 to 2010 were analyzed retrospectively. Whole-mount sections of surgical specimens from all patients who underwent radical prostatectomy were evaluated. Positive perineural invasion was defined as infiltration of cancer cells in the perineurium or neural fascicles. The relationship of perineural invasion with clinicopathological features and prognosis of prostate cancer was studied. We also researched preoperative factors that were associated with perineural invasion.</P><P><B>Results</B></P><P>Perineural invasion in a prostatectomy specimen (PNIp) was positive in 188 of 361 patients (52.1%). In the multivariate analysis of the preoperative variables, PNIp was related to the primary Gleason grade (p=0.020), the number of positive cores (p=0.008), and the percentage of tumor cells in positive cores (p=0.021), but not to perineural invasion of a prostate biopsy. In the evaluation between PNIp and pathologic findings of the prostatectomy specimen, PNIp was related to the Gleason score (p=0.010), T-stage (p=0.015), and lymphovascular invasion (p=0.019). However, by multivariate analysis, the PNIp was not an independent prognostic factor of biochemical serum recurrence (p=0.364) or cancer-specific survival (p=0.726).</P><P><B>Conclusions</B></P><P>PNIp was significantly related to biologically aggressive tumor patterns but was not a prognostic factor for biochemical serum PSA recurrence or cancer-specific survival in patients with prostate cancer.</P>

β-Catenin expression is associated with cell invasiveness in pancreatic cancer

Jin Niang Nan,김옥란,이명아 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.3

Background/Aims: This study was tried to determine the role of β-catenin in invasion in pancreatic cancer. Methods: We analyzed cancer invasiveness according to β-catenin expression in pancreatic cancer cell line. We also investigated the change in cancer invasiveness when β-catenin expression was changed. To enhance β-catenin activity, we treated low β-catenin cancer cell line, PANC1, with Wnt-3a conditioned media and transected β-catenin. We also treated high β-catenin expressing cell line, BxPC3, with XAV939, β-catenin inhibitor and siRNA for β -catenin to inhibit β -catenin expression. Results: The high β-catenin expressing cancer cell line, BxPC3 showed higher invasiveness, and low β-catenin expressing cell lines, PANC1and MIA-PaCa-2, were less invasive. By adding the Wnt-3a conditioned media or performing transfection with β-catenin in PANC1, cell invasiveness was increased (p < 0.05 and p < 0.01, respectively). On inhibition of β-catenin by XAV939 and siRNA in BxPC3 cell line, invasiveness was significantly decreased (p < 0.01). It was not correlated with the expression of cluster of differentiation 44 (CD44) or CD44 variant 6 (CD44v6), the invasion related protein. On analysis of association with metastasis in human tissue, Wnt-3a expression was statistically correlated with the development of metastasis (p = 0.029). Conclusions: Based on our data, β-catenin may be involved in cancer invasion in pancreatic cancer, and it is not associated with CD44, the invasion related protein.

Relationship Between Preepiglottic Space Invasion and Lymphatic Metastasis in Supracricoid Partial Laryngectomy With Cricohyoidopexy

주영훈,박준욱,조광재,김민식 대한이비인후과학회 2014 Clinical and Experimental Otorhinolaryngology Vol.7 No.3

Objectives. The aim of this study was to determine the role of preepiglottic space (PES) invasion in lymph node metastasis and prognosis in patients undergoing supracricoid partial laryngectomy (SCPL) with cricohyoidopexy (CHP). Methods. A retrospective review of 42 previously untreated patients with squamous cell carcinoma of the larynx that un- derwent surgery was performed. The mean age of the subjects was 61.3 years, and the male-to-female ratio was 38:4. Regarding their pathological stages, there were 3, 8, 22, and 9 cases of stage T1 to T4, respectively. Concerning the disease stage of the cervical lymph nodes, there were 30, 5, 6, and 1 cases with N0 to N3, respectively. Results. The PES invasion rate was 23.8% (10/42). Significant correlations were found between PES invasion and cervical lymph node metastasis (P=0.002). Seven of the 10 patients (70.0%) with PES invasion had cervical lymph node me- tastasis, whereas only 5 of the 32 patients (15.6%) without any evidence of PES invasion had lymph node metasta- sis. There was also a significant correlation of PES invasion with age (P=0.002) and T stage (P=0.030). However, there was no significant relationship between gender, primary tumor site, anterior commissure invasion, subglottic extension, paraglottic space invasion and PES invasion. There was a 5-year disease-specific survival of 70%. PES in- vasion served as a statistically significant prognostic factor for disease-specific survival (P=0.004). Cervical nodal me- tastasis (P=0.003) and subglottic extension (P=0.01) were also statistically significant prognostic factors associated with disease-specific survival. Conclusion. The PES invasion was significantly related to the cervical lymph node metastasis and prognosis in patients un- dergoing SCPL with CHP.

갑상선암의 갑상선 주위 침범에 대한 실시간 초음파 진단

허영진,김동욱 대한영상의학회 2011 대한영상의학회지 Vol.65 No.1

Purpose: To assess the diagnostic accuracy of real-time ultrasound (US) for perithyroidal invasion of thyroid malignancy. Materials and Methods: From January 2009 to December 2009, real-time US was performed on malignant thyroid nodules (largest diameter ≥ 10 mm) located in the isthmus or attached to the adjacent tracheal wall, by a single radiologist who prospectively determined the presence or absence of perithyroidal invasion. Results: Of the 60 malignant thyroid nodules examined, intraglandular location (n = 0), capsular attachment with clear perithyroidal fat (n = 15), perithyroidal fat infiltration without tracheal invasion (n = 43), and tracheal invasion (n = 2) were prospectively determined. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of real-time US diagnosis for perithyroidal invasion were 80%, 90%, 94.1%, 69.2% and 83.3%, respectively when the pathological result was used as reference standard. Real-time US accuracies for intraglandular location, capsular attachment with clear perithyroidal fat, perithyroidal fat infiltration without tracheal invasion, and tracheal invasion were 76.6%, 53.3%, 51.7%, and 85.0%, respectively. Conclusion: The results of the real-time US diagnoses indicate that this method may be useful for diagnosing perithyroidal invasion of thyroid malignancies. Hence, further research is needed to prove the use of diagnosing perithyroidal invasion of thyroid malignancies. 목적: 갑상선암의 갑상선 주위 침범에 대한 실시간 초음파 진단의 정확도를 알아보고자 하였다. 대상과 방법: 2009년 1월부터 2009년 12월까지 본원에서 수술 전 갑상선 초음파 검사에서 갑상선암의 장경이 10 mm 이상인 증례에 대하여 한 명의 영상의학과 전문의가 실시간 초음파 검사를 시행하였으며, 갑상선암의 갑상선 주위와 기관 침범 여부를 전향적으로 진단하였다. 초음파 진단과 수술로 확진된 병리결과를 비교 분석하여, 실시간 초음파 검사의 진단 정확도를 평가하였다. 결과: 총 60명의 환자에서 장경 10 mm 이상인 악성 갑상선 결절 60개에서 갑상선 내 위치(n = 0), 갑상선막 침범(n = 15), 갑상선 주위 침범(n = 43) 및 기관 침범(n = 2)을 보였다. 실시간 초음파 진단을 병리 소견과 비교하였을 때 실시간 초음파 진단은 진양성 32, 위양성 2, 진음성 18, 위음성 8이었으며, 민감도 80%, 특이도 90%, 양성예측도 94.1%, 음성예측도 69.2% 및 정확도 83.3%였다. 갑상선 내 위치, 갑상선막 침범, 갑상선 주위 침범, 기관 침범에 대한 실시간 초음파 진단의 정확도는 각각 76.6%, 53.3%, 51.7% 및 85.0%였다. 결론: 갑상선암의 갑상선 주위 침범에 대한 실시간 초음파 진단의 정확도는 비교적 높았으나 기관 침범에 대한 초음파 진단의 민감도와 양성예측도는 낮았다.

체외순환을 이용한 T4 폐암의 수술적 치험 -장기 생존 1예 보고-

조규도,조민섭,윤정섭,김치경,곽문섭 대한흉부외과학회 2004 Journal of Chest Surgery (J Chest Surg) Vol.37 No.2

We report a case of a patient with lung cancer, which invaded the left atrium and pericardium. Right middle and lower lobectomy was performed with the use of the extracorporeal circulation. Postoperative pathologic examination revealed the stage of IIIB (T4N1M0). Although the postoperative clinical course was complicated by acute localized right sided pulmonary edema and the bronchopleural fistula, the patient recovered smoothly after the procedure of omentopexy with pedicled graft of greater omentum in closing the BPF. As of August 2003, he has been followed up for 6 years and he is healthy without any evidence of recurrence. We could not find any report concerning lung cancer resection using cardiopulmonary bypass in Korean literature and believe this is the first report, especially with long-term survival. 우폐하엽의 폐암이 심낭과 좌심방의 하폐정맥 유입구를 침범한 62세 남자 환자에서 심폐체외순환을 이용하여 우폐 중하엽절제술을 시행하였다. 환자는 수술 후 제2일째에 우폐상엽의 국한성 폐부종이 발생하였으며 폐부종이 치료된 후 우폐의 기관지늑막루가 발생하였다. 유경대망을 이용하여 기관지늑막루를 봉합하였다. 그 후의 임상 경과는 양호하였으며 환자는 현재 6년째 재발 없이 건강히 지내고 있다.

Risk Stratification for Serosal Invasion Using Preoperative Predictors in Patients with Advanced Gastric Cancer

Park, Sung-Sil,Min, Jae-Seok,Lee, Kyu-Jae,Jin, Sung-Ho,Park, Sunhoo,Bang, Ho-Yoon,Yu, Hwang-Jong,Lee, Jong-Inn The Korean Gastric Cancer Association 2012 Journal of gastric cancer Vol.12 No.3

Purpose: Although serosal invasion is a critical predisposing factor for peritoneal dissemination in advanced gastric cancer, the accuracy of preoperative assessment using routine imaging studies is unsatisfactory. This study was conducted to identify high-risk group for serosal invasion using preoperative factors in patients with advanced gastric cancer. Materials and Methods: We retrospectively analyzed clinicopathological features of 3,529 advanced gastric cancer patients with Borrmann type I/II/III who underwent gastrectomy at Korea Cancer Center Hospital between 1991 and 2005. We stratified patients into low-(${\leq}40%$), intermediate-(40~70%), and high-risk (>70%) groups, according to the probability of serosal invasion. Results: Borrmann type, size, longitudinal and circumferential location, and histology of tumors were independent risk factors for serosal invasion. Most tumors of whole stomach location or encircling type had serosal invasion, so they belonged to high-risk group. Patients were subdivided into 12 subgroups in combination of Borrmann type, size, and histology. A subgroup with Borrmann type II, large size (${\geq}7$ cm), and undifferentiated histology and 2 subgroups with Borrmann type III, large size, and regardless of histology belonged to high-risk group and corresponded to 25% of eligible patients. Conclusions: This study have documented high-risk group for serosal invasion using preoperative predictors. And risk stratification for serosal invasion through the combination with imaging studies may collaboratively improve the accuracy of preoperative assessment, reduce the number of eligible patients for further staging laparoscopy, and optimize therapeutic strategy for each individual patient prior to surgery.

Can CD44+/CD24- Tumor Cells Be Used to Determine the Extent of Breast Cancer Invasion Following Neoadjuvant Chemotherapy?

Hong Wu,Ruhui Li,XiaoDong Hang,Ming Yan,Feng Niu,Lidi Liu,Wei Liu,Song Zhao,Shaokun Zhang 한국유방암학회 2011 Journal of breast cancer Vol.14 No.3

Purpose: To investigate the distribution of CD44+/CD24- cells in breast cancers in relation to tumor size before and after the administration of neoadjuvant chemotherapy. Methods: CD44+/CD24- tumor cells obtained from breast cancer specimens were characterized in vivo and in vitro using tumor formation assays and mammosphere generation assays, respectively. The distribution of CD44+/CD24- tumor cells in 78 breast cancer specimens following administration of neoadjuvant chemotherapy was also evaluated using immunofluorescence assays, and this distribution was compared with the extent of tumor invasion predicted by Response Evaluation Criteria in Solid Tumours (RECIST). Results: In 27/78 cases, complete remission (CR) was identified using RECIST. However, 18 of these CR cases were associated with a scattered distribution of tumor stem cells in the outline of the original tumor prior to neoadjuvant chemotherapy. After neoadjuvant chemotherapy, 24 cases involved cancer cells that were confined to the tumor outline, and 21 cases had tumor cells or tumor stem cells overlapping the tumor outline. In addition, there were 6 patients who were insensitive to chemotherapy, and in these cases, both cancer cells and stem cells were detected outside the contours of the tumor volume imaged prior to chemotherapy. Conclusion:CD44+/CD24- tumor cells may be an additional parameter to evaluate when determining the extent of breast cancer invasion.

Oncological impact of vascular invasion in colon cancer might differ depending on tumor sidedness

Moamen Shalkamy Abdelgawaad Shalkamy,Jung Hoon Bae,이철승,Seung Rim Han,김지훈,계봉현,이인규,이윤석 대한내시경로봇외과학회 2022 Journal of Minimally Invasive Surgery Vol.25 No.2

Purpose: Vascular invasion is a well-known independent prognostic factor in colon cancer and tumor sidedness is also being considered a prognostic factor. The aim of this study was to compare the oncological impact of vascular invasion depending on the tumor location in stages I to III colon cancer. Methods: A retrospective analysis was performed using data from patients who underwent curative resection between 2004 and 2015. Patients were divided into right-sided colon cancer (RCC) and left-sided colon cancer (LCC) groups according to the tumor location. Disease-free survival (DFS) and overall survival (OS) were compared between the RCC and LCC groups, depending on the presence of vascular invasion. Results: A total of 793 patients were included, of which 304 (38.3%) had RCC and 489 (61.7%) had LCC. DFS and OS did not differ significantly between the RCC and LCC groups. Vascular invasion was a poor prognostic factor for DFS in both RCC (hazard ratio [HR], 2.291; 95% confidence interval [CI], 1.186–4.425; p = 0.010) and LCC (HR, 1.848; 95% CI, 1.139–2.998; p = 0.011). Additionally, it was associated with significantly worse OS in the RCC (HR, 3.503; 95% CI, 1.681–7.300; p < 0.001), but not in the LCC group (HR, 1.676; 95% CI, 0.885–3.175; p = 0.109). Multivariate analysis revealed that vascular invasion was independently poor prognostic factor for OS in the RCC (HR, 3.186; 95% CI, 1.391–7.300; p = 0.006). Conclusion: This study demonstrated that RCC with vascular invasion had worse OS than LCC with vascular invasion.

Is the oncological impact of vascular invasion more important in right colon cancer?

손경모 대한내시경로봇외과학회 2022 Journal of Minimally Invasive Surgery Vol.25 No.2

Vascular invasion is an unfavorable prognostic factor for the recurrence and systemic metastasis of colon cancer. An interesting study in this issue evaluate the difference in the oncological impact of vascular invasion according to tumor side in colon cancer. The authors suggest that the oncological impact of vascular invasion could be worse in nonmetastatic right colon cancer than in nonmetastatic left colon cancer. Herein, hematoxylin-eosin staining was used to detect vascular invasion. In a recent study, elastin staining could detect more venous invasion. It is expected that the molecular pathologic characteristics of colon cancer can be identified precisely and the oncological outcomes of colon cancer can be improved in the future.