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ABSTRACT: This study was designed to compare survival outcomes of patients with uterine papillary serous carcinoma (UPSC) or clear cell carcinoma (CC) to those of patients with grade 3 endometrioid carcinoma (G3EC) according to 1988 and 2009 International Federation of Gynecology and Obstetrics (FIGO) staging systems.
We retrospectively reviewed all patients with endometrial cancer treated at a single institution between 1995 and 2009. Among the 647 patients with endometrial cancer, 51 with G3EC and 46 with UPSC and CC histology were confirmed.
1988 FIGO stage, 2009 FIGO stage, and extrauterine metastasis were significantly different between the UPSC and CC group and G3EC group (p=0.002, p=0.041, and p=0.020, respectively). Restaging from the 1988 FIGO to the 2009 FIGO criteria increased the number of stage I cases by 10 (11.0%). Overall, 8 in the UPSC and CC and 2 in the G3EC group were down-staged to stage I. In the UPSC and CC group, the 3-year overall survival for 1988 FIGO stage I was 92.9%. When UPSC and CC patients were restaged using the 2009 staging system, the 3-year overall survival of 2009 FIGO stage I dropped to 81.6%. UPSC and CC was associated with poor OS outcome compared with G3EC, after adjustment for 2009 FIGO stage and other clinicopathologic factors.
We observed that UPSC and CC patients had different prognosis according to the old and new FIGO staging system. Our results suggest that UPSC and CC compared with the G3EC may retain the 1988 FIGO to be a slightly better discriminator than 2009 FIGO.
Journal of Gynecologic Oncology 04/2013; 24(2):120-7. · 1.49 Impact Factor
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ABSTRACT: Galectin-7 (GAL-7) has been highlighted as an important marker in many types of cancers by either inhibiting or promoting tumor growth. In this novel study, we assessed the association of GAL-7 with clinicopathological variables and survival outcomes in epithelial ovarian cancer (EOC) and investigated the role of GAL-7 in proliferation of ovarian cancer cell lines.
The expression of GAL-7 was determined in 63 formalin-fixed, paraffin-embedded EOC tissues using an immunohistochemical method and we compared various associated clinicopathological factors. To evaluate the role of GAL-7 in cell proliferation, we performed proliferation assays with GAL-7 siRNA using ovarian cancer cell lines, including A2780-PAR cells.
Immunohistochemical analysis revealed that GAL-7 expression was primarily detected in nuclei and occasionally in the nucleus and cytoplasm. High GAL-7 expression was associated with greater age (p=0.016), high mortality (p=0.025), and poor overall survival outcome (p=0.029). In addition, the residual tumor volume was larger in the high-expression group compared to the low-expression group, although the difference was not statistically significant (p=0.059). Down-regulation of GAL-7 using siRNA resulted in the inhibition of cell proliferation of A2780-PAR cells.
We observed that high GAL-7 might be associated with poor survival outcome in patients with EOC, and may be functionally involved in cell proliferation.
Anticancer research 04/2013; 33(4):1555-61. · 1.73 Impact Factor
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Jae Kwan Lee,
Jin Hwa Hong,
Sokbom Kang,
Dae-Yeon Kim, Byoung-Gie Kim,
Sung-Hoon Kim,
Yong-Man Kim,
Jae-Weon Kim,
Jae-Hoon Kim,
Tae-Jin Kim, [......],
Jeong-Won Lee,
Taek Sang Lee,
Myong Cheol Lim,
Suk-Joon Chang,
Hyun Hoon Chung,
Woong Ju,
Hee Jae Joo,
Soo-Young Hur,
Sung-Ran Hong,
Joo-Hyun Nam
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ABSTRACT: The consensus guideline development committee of Korean Society of Gynecologic Oncology was reconvened in March 2012. The committee consisted of 36 experts representing 12 university hospitals and professional organizations. The objective of this committee was to develop standardized guidelines for cervical cancer screening tests for Korean women and to distribute these guidelines to every clinician, eventually improving the quality of medical care. Since the establishment of the consensus guideline development committee, evidence-based guidelines have either been developed de novo considering specific Korean situations or by adaptation of preexisting consensus guidelines from other countries. Recommendations for cervical cancer screening tests, management of atypical squamous and glandular cells, and management of low-grade and high-grade squamous intraepithelial lesions were developed. Additionally, recommendations for human papillomavirus DNA testing and recommendations for adolescent and pregnant women with abnormal cervical screening test results were also included.
Journal of Gynecologic Oncology 04/2013; 24(2):186-203. · 1.49 Impact Factor
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ABSTRACT: STUDY OBJECTIVE: To compare cosmetic satisfaction with laparoendoscopic single-site surgery (LESS) compared with multi-port surgery. DESIGN: Randomized controlled trial (Canadian Task Force classification I). SETTING: University hospital. PATIENTS: Twenty women who underwent laparoscopically-assisted vaginal hysterectomy (LAVH) via LESS or multi-port surgery. INTERVENTIONS: Laparoendoscopic single-site surgery or multi-port surgery. MEASUREMENT AND MAIN RESULTS: Cosmetic satisfaction was assessed using the Body Image Questionnaire at baseline and at 1, 4, and 24 weeks after surgery. Of the 20 LESS procedures, 1 was converted to multi-port surgery because of severe adhesions, and 1 woman assigned to undergo multi-port surgery was lost to follow-up. The 2 surgery groups did not differ in clinical demographic data and surgical results or postoperative pain scores at 12, 24, and 36 hours. Compared with the multi-port group, the LESS group reported significantly higher cosmetic satisfaction at 1, 4, and 24 weeks after surgery (p < .01). CONCLUSION: Compared with multi-port surgery, LESS is not only a feasible approach with comparable operative outcomes but also has an advantage insofar as cosmetic outcome.
Journal of Minimally Invasive Gynecology 03/2013; · 1.74 Impact Factor
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ABSTRACT: In some unusual cases, in patients with cervical cancer, an elevation of squamous cell carcinoma antigen (SCC-Ag) was not observed at diagnosis but was observed on recurrence, or vice versa. The objective of this study was to identify patient-, disease-, and treatment-related factors associated with this unusual level of SCC-Ag, and to determine whether SCC-Ag is a useful tumor marker in such patients.
Among 129 patients with recurrence, 14 who showed a normal SCC-Ag level at diagnosis but an elevated level at recurrence were classified as group I; 22 patients with an elevated SCC-Ag level at diagnosis but not at recurrence were classified as group II; and 76 patients with an elevated SCC-Ag level at both diagnosis and recurrence were classified as group III.
In univariate analysis, unusual SCC-Ag showed statistically significant relationships with pathology and biochemical response to treatment. However, in the multivariate analysis, none of the clinicopathologic factors showed a statistical relationship with unusual levels of SCC-Ag. The 5-year disease-free survival rates for groups I, II, and III were 7.1%, 9.1%, and 0% (p=0.418), and the 5-year overall survival rates were 34.3%, 58.4%, and 33.3% (p=0.142), respectively.
The value of SCC-Ag has been confirmed in all patients; thus, check of SCC-Ag level at follow-up should be considered. Although no statistically significant differences were observed among the groups, we conclude that patients with a high initial SCC-Ag and elevated SCC-Ag at relapse have poor prognosis due to high SCC-Ag level.
Cancer Research and Treatment 03/2013; 45(1):48-54.
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ABSTRACT: OBJECTIVE: To present 515 LESS surgeries and report the perioperative outcomes and late complications according to the Clavien-Dindo classification. STUDY DESIGN: We performed a prospective single-center study (Canadian Task Force classification II-2). One surgeon trained in minimally invasive surgery performed 515 cases of LESS surgery from May 2008 to September 2011. RESULTS: LESS gynecological surgery was performed on 515 patients (274 total hysterectomies; 26 subtotal hysterectomies; 87 adnexectomies including oophorectomy, salpingectomy, and salpingo-oophorectomy; 100 ovarian cystectomies; 17 myomectomies; 11 others). The median age and body mass index of the patients were 45 years and 22.6kg/m(2), respectively. LESS surgery was successfully completed in 493 patients (95.7%) without the need for one or more ancillary ports or conversion to laparotomy. Twenty patients needed one or more additional ports and two cases were converted to laparotomy. One or more additional ports were required most frequently in ovarian cystectomy procedures (12/100, 12%). Thirty-six patients (7.0%) required intraoperative and/or postoperative transfusions. Each of these patients underwent hysterectomy (33/274, 12.0%) or subtotal hysterectomy (3/26, 11.5%). Perioperative complications (<30 postoperative days), excluding transfusions, occurred in 8 patients (1.6%) and included one case each of vault bleeding, vault abscess, stump watery discharge, rectal injury, and vesicovaginal fistula, and three cases of urinary tract injury. Late complications occurred in three patients (0.6%) and included two umbilical hernias and one vault evisceration. The overall complication rate, excluding transfusions, was 2.1% (11/515). CONCLUSION: The rate of late postoperative complications, including umbilical port site hernia and vault evisceration, was not increased in this study, as compared to previous reports of single-port and conventional laparoscopic surgeries.
European journal of obstetrics, gynecology, and reproductive biology 01/2013; · 1.97 Impact Factor
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ABSTRACT: STUDY OBJECTIVE: The aim of this study was to compare operative outcomes from 300 patients who underwent laparoendoscopic single-site surgery (LESS) with hysterectomy (H) according to previous cesarean section and to describe the bladder dissection technique in detail. DESIGN: Retrospective cohort study (Canadian task classification II-2). SETTING: A university hospital, research hospital, and a tertiary care center. PATIENTS: In total, 300 LESS-H procedures were performed for benign gynecologic disease, cervical disease, and endometrial disease at Samsung Medical Center in Seoul, Korea, between May 2008 and February 2012. Patients were categorized into 2 groups according to previous cesarean history: the previous cesarean section group (n = 98) and the no history of previous cesarean section group (n = 202). INTERVENTION: LESS-H with vaginal or lateral approach for bladder dissection. MEASUREMENTS AND MAIN RESULTS: Baseline demographics and clinical characteristics, except for age, were generally the same between the 2 groups. The operative outcomes including operative time, uterine weight, estimated blood loss, hemoglobin change, hospital stay, and transfusion rate were not different between the 2 groups. Adhesiolysis was required more in the previous cesarean section group (p = .002). LESS failure requiring additional trocars occurred more often in the previous cesarean section group (p = .041), but the rates of conversion to laparotomy were not different (p = .327). The overall surgical complication rate except transfusion was 2.67% in this study. Two cases of urologic problems with ureter injury or bladder injury were reported in the previous cesarean section group. In the no previous cesarean section group, there were 2 urologic problems. CONCLUSION: LESS-H is a feasible procedure with a lateral approach or vaginal approach for bladder dissection, even in patients with previous cesarean section.
Journal of Minimally Invasive Gynecology 01/2013; · 1.74 Impact Factor
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ABSTRACT: OBJECTIVE: To assess the incidence and management of accidental rectal injury during gynecologic laparoscopic surgery. DESIGN: A retrospective study with review of outcomes (Canadian Task Force classification II-3). SETTING: A tertiary care/research/university hospital. PATIENTS: Patients with colon injury during laparoscopy for gynecologic diseases at Samsung Medical Center, Seoul, Korea, from January 2000 to April 2012. INTERVENTION: Use of absorbable suture or staples in primary repair of injured colon. MEASUREMENTS AND MAIN RESULTS: From January 2000 to April 2012, 12 354 patients underwent laparoscopic surgery. Rectal injury occurred in 15 women (0.12%). Their median age was 42.5 years (30-49), and the median length of injury was 3 cm (0.7-7). Among 13 patients with rectal injuries recognized during surgery, 10 patient injuries were repaired primarily with interrupted absorbable sutures without converting laparotomy, 1 patient underwent laparoscopic low anterior resection with Endo-GIA, 1 underwent open primary repair, and 1 underwent open low anterior resection. Two rectal injuries were detected after surgery. One of these patients underwent primary repair under laparotomy at day 4 after surgery. The other patient had development of a rectovaginal fistula requiring open segmental resection 30 days after primary laparoscopy despite conservative management, including percutaneous drainage and prophylactic antibiotics. CONCLUSION: Rectal injury during laparoscopy in the gynecologic field can be repaired successfully without the need for a colostomy regardless of mechanism of injury and the size of injury if adequate rectal tissue is available and recognized during surgery.
Journal of Minimally Invasive Gynecology 01/2013; · 1.74 Impact Factor
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Chel Hun Choi,
Chang Ohk Sung,
Ha-Jeong Kim,
Yoo-Young Lee,
Sang Yong Song,
Taejong Song,
Junhwan Kim,
Tae-Joong Kim,
Jeong-Won Lee,
Duk-Soo Bae, Byoung-Gie Kim
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ABSTRACT: Annexin A4 study in ovarian cancer has been primarily focused on clear cell carcinoma, which exhibits strong resistance to chemotherapy. The aim of this study was to examine the expression and cellular localization of annexin A4 in serous ovarian carcinomas. We evaluated the expression of annexin A4 with real-time polymerase chain reaction in 40 ovarian serous carcinoma tissues. Furthermore, the distribution of the protein within the tumor was studied by immunohistochemistry in 70 epithelial ovarian carcinoma tissues. The levels of annexin A4 transcripts were higher in 14 chemoresistant tumors than those in 26 chemosensitive tumors (P = .013). Immunohistochemical expressions showed that nuclear expression was detected in 14 (20.0%) of 70 samples, and cytoplasmic expression was detected in 17 (24.3%) of 70 samples. The results showed that 35.7% of women with nuclear expression were resistant to platinum-based chemotherapy, whereas only 14.3% of women without expression were chemoresistant (P = .065). In addition, patients with nuclear staining had significantly shorter disease-free survival than did patients who showed negative staining. Multivariate proportional hazards model revealed that the stage and nuclear annexin A4 expression were independent prognostic factors (hazard ratios, 6.34 [P = .001] and 2.85 [P = .011], respectively). This study showed that overexpression and nuclear localization of annexin A4 are related to chemoresistance and poor survival in patients with serous papillary ovarian carcinomas. Future studies are required to develop new therapies targeting annexin A4 in patients with ovarian epithelial adenocarcinoma.
Human pathology 01/2013; · 3.03 Impact Factor
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ABSTRACT: The histologic types of borderline ovarian tumors (BOTs) exhibit striking differences in clinical behavior and prognosis. Yet, there is no information available on the histologic distribution of BOTs according to geographic region. The purpose of this study was to systematically review this issue worldwide.
A comprehensive search of the literature was conducted using electronic databases. Studies were eligible if BOTs were investigated and the histologic distribution of the data was shown. The studies were grouped by geographic region and totaled by country.
Of 487 potentially relevant studies, 51 met our inclusion criteria, as follows: 8 studies from North America (2 countries); 26 studies from Europe (14 countries); 7 studies from the Middle East (3 countries); and 10 studies from East Asia (5 countries). The histologic distribution of BOTs was considerably different in different parts of the world, but follows specific patterns. In general, serous-type BOTs were the predominantly identified histology in North America, the Middle East, and Europe, while mucinous-type BOTs predominated in East Asia.
Significant geographic variation is evident among BOT histology in different parts of the world. More research is needed to understand this phenomenon.
Journal of Gynecologic Oncology 01/2013; 24(1):44-51. · 1.49 Impact Factor
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ABSTRACT: Aim: To determine whether the use of high-intensity focused ultrasound (HIFU) ablation combined with cisplatin, compared with HIFU ablation, and cisplatin alone, facilitates tumor necrosis and reduces tumor volume in an animal model.
The cervical cancer cell line SiHa was cultured and injected subcutaneously into female BALB/c nude mice. Animals that developed tumors were randomized to four groups: treatment with HIFU ablation and cisplatin (i.p. injection, 100 mg/mouse twice per week); cisplatin treatment alone; HIFU ablation alone; and control. The dimensions of the tumor were measured transcutaneously using a vernier caliper. After mice were sacrificed, tumor excised, and triphenyl tetrazolium chloride (TTC) staining was carried out to investigate the area of coagulation necrosis in the tumors.
Out of the 32 animals that developed tumors, 25 had tumors able to be measured through subcutaneous palpation in the pretreatment period (control, n=7; HIFU ablation, n=7; cisplatin, n=6; combination of HIFU ablation and cisplatin, n=5). In the group receiving HIFU ablation with cisplatin, tumor volume decreased significantly when compared with the other groups. TTC staining showed that necrosis was induced in the central zone of the tumors that were ablated by HIFU, and chemotherapy enhanced the effect of HIFU ablation in the combination therapy group.
HIFU ablation combined with cisplatin facilitates reductions in tumor volume and increases in tumor necrosis and could be useful as another option in treating patients with cervical cancer.
Anticancer research 12/2012; 32(12):5285-9. · 1.73 Impact Factor
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ABSTRACT: The relationship between treatment outcomes, alteration of the expression of biological markers, and tumor volume response during radiotherapy (RT) in patients with uterine cervical cancer was analyzed.
Twenty patients with cervical squamous cell carcinoma received definitive RT with (n = 17) or without (n = 3) concurrent chemotherapy. Tumor volumes were measured by three serial magnetic resonance imaging scans at pre-, mid-, and post-RT. Two serial punch biopsies were performed at pre- and mid-RT, and immunohistochemical staining for cyclooxygenase (COX)-2 and epidermal growth factor receptor was performed. The median follow-up duration was 60 months.
The median tumor volume response at mid-RT (V2R) was 0.396 (range, 0.136 to 0.983). At mid-RT, an interval increase in the distribution of immunoreactivity for COX-2 was observed in 8 patients, and 6 of them showed poor mid-RT tumor volume response (V2R ≥ 0.4). Four (20%) patients experienced disease progression after 10 to 12 months (median, 11 months). All 4 patients had poor mid-RT tumor volume response (p = 0.0867) and 3 of them had an interval increase in COX-2 expression. Overall survival (OS) and progression-free survival (PFS) decreased in patients with V2R ≥ 0.4 (p = 0.0291 for both). An interval increase in COX-2 expression at mid-RT was also associated with a decreased survival (p = 0.1878 and 0.1845 for OS and PFS, respectively).
Poor tumor volume response and an interval increase in COX-2 expression at mid-RT decreased survival outcomes in patients with uterine cervical cancer.
Radiation oncology journal. 12/2012; 30(4):218-25.
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ABSTRACT: Aim: To evaluate prognostic factors in Korean patients with endometrial cancer. Methods: A retrospective analysis was conducted on 248 patients who were staged surgically at the Samsung Medical Center between 1995 and 2004. Survival data were analyzed using Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression method. Results: The median age was 51 years (range 21-75), which was younger than in previous studies in Western patients, and the age of 50 years was the cutoff to predict survival. More than half (55.6%) were normal weight or underweight (BMI <25). Multivariate analysis revealed that age, Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stage, and histopathology were independent predictors of disease-free survival, and FIGO stage and p53 mutation were independent prognostic factors for disease-specific survival (DSS). The 5-year DSS for patients with stage I, II, III and IV disease was 95.6, 93.8, 69.8 and 50%, respectively. The 5-year DSS rate for patients with a p53 mutation was 84.4%, compared with 97.1% for patients without. Conclusions: Korean patients with endometrial cancer were younger and had a lower BMI than previously reported. Furthermore, age greater than 50 years was predictive of a poor outcome. Age, FIGO stage, histopathology and a p53 mutation were independent prognostic factors for survival.
Gynecologic and Obstetric Investigation 10/2012; · 1.28 Impact Factor
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Jeong-Yeol Park,
Dae-Yeon Kim,
Jong-Hyeok Kim,
Yong-Man Kim,
Young-Tak Kim,
Young-Seok Kim,
Ha Jeong Kim,
Jeong-Won Lee, Byoung-Gie Kim,
Duk-Soo Bae,
Seung Jae Huh,
Joo-Hyun Nam
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ABSTRACT: To compare survival outcomes and treatment-related morbidities between radical hysterectomy (RH) and primary chemoradiation therapy (CRT) in patients with bulky early-stage cervical cancer.
We selected 215 patients with stage IB2 and IIA2 cervical cancer (tumor diameter > 4 cm on magnetic resonance imaging) who underwent RH followed by tailored adjuvant therapy (n=147) or primary CRT (n=68) at two tertiary referral centers between 2001 and 2010.
About twenty nine percent of patients were cured by RH alone and these patients experienced the best survival outcomes with the lowest morbidity rates. After the median follow-up times of 40 months, 27 RH (18.4%) and 20 CRT (29.4%) patients had recurrence (p=0.068) and 23 (15.6%) and 17 (25%) patients died of disease (p=0.101). The 5-year progression-free survival were 77% and 66% (p=0.047), and the 5-year overall survival were 78% and 67% (p=0.048) after RH and primary CRT, respectively. In multivariate analysis, patients who received primary CRT was at higher risk for tumor recurrence (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.24 to 4.14; p=0.008) and death (OR, 3.02; 95% CI, 1.53 to 5.98; p=0.001) than those who received RH. Grade 3-4, early (17% vs. 30.9%, p=0.021) and late (1.4% vs. 8.8%, p=0.007) complications were significantly less frequent after RH than primary CRT.
Thirty percent of patients were cured by RH alone. A treatment outcome was better in this retrospective study in terms of morbidity and survival. Randomized trials are needed to confirm this result.
Journal of Gynecologic Oncology 10/2012; 23(4):226-34. · 1.49 Impact Factor
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ABSTRACT: Little is known about patient satisfaction with single-port access (SPA) surgery for gynaecologic disease related to body image and cosmesis.
This study aimed to determine cosmetic satisfaction with SPA surgery.
Postal questionnaires, including the Body Image Questionnaire, were sent to 159 women who had undergone SPA surgery between May 2008 and April 2010.
Hundred and forty-six women participated in this study. Most of the women reported a relatively high body image and cosmetic score. The mean scores were 19.6 ± 1.1 and 21.9 ± 2.5, respectively. More than 67% of the women (N = 98) reported that the scar was invisible, and 97.3% of the women said that they would recommend SPA surgery to others.
Single-port access surgery is a good option for the management of gynaecologic disease with respect to patient satisfaction.
Australian and New Zealand Journal of Obstetrics and Gynaecology 10/2012; 52(5):465-9. · 1.24 Impact Factor
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ABSTRACT: Dynamin 2, which plays a role in endocytosis, is known to be required for HPV infection on host cells. We investigated dynamin 2 as a biomarker in grading of cervical intraepithelial neoplasia (CIN) by comparing with Ki-67 expression and the type of HPV infection (low-risk vs. high-risk).
We performed immunohistochemical stains of dynamin 2 and Ki-67 on tumor samples of patients with CIN and the type of HPV infection was investigated.
All the patients with reactive changes (n=7) or normal (n=4) did not show dynamin 2 expression. There were 33, 14, and 12 cases with CIN I, II, and III, respectively, and there was a negative correlation between the degree of dynamin 2 expression and the severity of CIN lesions with statistical significance (P<0.001). Negative expression of dynamin 2 was more sensitive for the detection of CIN II/III than high expression (2+) of Ki-67 (96.2% vs. 73.1%, P=0.041). Among patients in whom HPV infection was detected, the degrees of dynamin 2 expression were not associated with the type of HPV infection (low-risk vs. high-risk). Overall, there was a negative correlation between the expression patterns of Ki-67 and dynamin 2.
We found that dynamin 2 may be a helpful biomarker in grading of CIN lesions and a candidate biomarker for detecting low grade CIN with high sensitivity.
European journal of obstetrics, gynecology, and reproductive biology 09/2012; 164(2):180-4. · 1.97 Impact Factor
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Ha-Jeong Kim,
In-Gu Do,
Hye-Kyung Jeon,
Young Jae Cho,
Young Ae Park,
Jung-Joo Choi,
Chang Ohk Sung,
Yoo-Young Lee,
Chel Hun Choi,
Tae-Joong Kim, Byoung-Gie Kim,
Jeong-Won Lee,
Duk-Soo Bae
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ABSTRACT: Galectin 1 is a 14-kd laminin-binding lectin involved in important biologic mechanisms of tumors, including neoplastic transformation, cell survival, angiogenesis, cell proliferation, and metastasis. In this study, we investigated the role of galectin 1 in cell survival and metastasis in cervical cancer. The expression of galectin 1 was determined in 73 formalin-fixed, paraffin-embedded cervical cancer tissues using an immunohistochemical method and compared with clinicopathologic risk factors for recurrence after surgery. To evaluate the role of galectin 1 in cell proliferation and invasion, we performed proliferation and invasion assays with galectin 1 small interfering RNA (siRNA) using cervical cancer cell lines, including HeLa and SiHa cells. Immunohistochemical analysis revealed that galectin 1 expression was found in most peritumoral stroma samples (72/73; 98.6%). Galectin 1 expression was significantly correlated with the depth of invasion in the cervix (P=.015) and lymph node metastasis (P=.045) on univariate analysis. When progression-free survival of all of the patients studied was analyzed based upon galectin 1 expression, galectin 1 expression was not correlated with progression-free survival (P=.32). Down-regulation of galectin 1 using small interfering RNA resulted in the inhibition of cell growth and proliferation of HeLa and SiHa cells. Moreover, the ability of cells to invade was significantly reduced by galectin 1 small interfering RNA. Our results revealed that high galectin 1 expression in peritumoral stroma was significantly correlated with depth of invasion in cervical lesions and lymph node metastasis of cervical cancer and that galectin 1 may be functionally involved in cell proliferation and invasion.
Human pathology 08/2012; · 3.03 Impact Factor
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ABSTRACT: Gliomatosis peritonei (GP) is commonly associated with ovarian teratoma and is not thought to have an adverse prognostic effect. However, the prognostic impact and characteristics of GP remain to be clarified. In this study, we investigated the clinicopathologic features of ovarian teratoma associated with GP, and we further compared ovarian immature teratoma (IT) with GP to ovarian IT without GP. During the study period, there were a total of 16 ovarian teratomas associated with GP. Among them, 15 cases were ovarian ITs of various grades. When ovarian IT with GP (n = 15) was compared to ovarian IT without GP (n = 27), it was found that ovarian IT patients with GP had larger tumor size (median, 19 vs. 13 cm; P < 0.001), more frequent recurrence (40 %, 6/15 vs. 3.7 %, 1/27; P = 0.005), and frequently elevated preoperative CA-125 level (100 %, 12/12 vs. 50 %, 10/20; P = 0.004). All recurrences occurred within 2 years of the initial surgery. Survival curves indicated that ovarian IT patients with GP had significantly shorter recurrence-free survival compared to those without GP (P = 0.002). The 2-year recurrence-free survival rates were 59.3 and 96.3 % in IT with GP and IT without GP, respectively. However, all but one case of IT with GP are currently alive. In conclusion, GP is an adverse prognostic factor characterized by frequent recurrence in patients with ovarian IT.
Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 07/2012; 461(3):299-304. · 2.49 Impact Factor
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ABSTRACT: Epidemiological studies suggest that selenium protects against the development of several cancers. Selenium (sodium selenite) has been reported to interfere with cell growth and proliferation, and to induce cell death. In this study, we tested whether selenium could have growth-inhibiting effect in ovarian cancer cells and an orthotopic animal model.
Cell growth in selenium-treated cells was determined in human ovarian cancer cells, A2780, HeyA8, and SKOV3ip1 using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay. Animal experiment of selenium with paclitaxel was performed using SKOV3ip1 cells in nude mice to evaluate their inhibiting effect for tumor growth. In addition, another animal experiment of paclitaxel with or without selenium was performed to assess the effect of survival and food intake in mice.
The in vitro growth of selenium-treated cells was significantly decreased dose-dependently in A2780, HeyA8, and SKOV3ip1 cells. Therapy experiment in mice was started 1 week after injection of the SKOV3ip1 cells. Treatment with selenium (1.5 mg/kg, 3 times/week) and paclitaxel injection showed no addictive effect of the inhibition of tumor growth. However, combination of selenium and paclitaxel showed the slightly increased food intake compared with paclitaxel alone.
Although selenium has growth-inhibiting effect in ovarian carcinoma cells in vitro, there is no additive effect on tumor growth in mice treated with combination of paclitaxel and selenium. However, food intake is slightly higher in selenium-treated mice during chemotherapy.
Journal of Gynecologic Oncology 07/2012; 23(3):190-6. · 1.49 Impact Factor
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ABSTRACT: Immune competence is an important prognostic factor in cancer patients. Surgical management of cancer can cause a variety of immunological disturbances, the clinical consequences of which are still unclear.
Patients with clinically staged cervical carcinoma (IB to IIA) who were treated at Samsung Medical Center, Seoul, Korea from 1994 to 2007 were retrospectively enrolled. We compared peri-operative peripheral lymphocyte counts, tumor-infiltrating lymphocyte scores, and survival in patients with early cervical cancer treated by abdominal type III radical hysterectomy.
The sample included 756 patients. The median follow-up was 58 months with a range of 3-181 months. There was a positive correlation between pre-operative peripheral lymphocyte counts and tumor infiltrating lymphocyte score. Pre-operative peripheral lymphocyte counts decreased significantly after surgery. In multivariate analyses for recurrence, higher pre-operative peripheral lymphocyte counts and recovery of lymphocyte counts (more than 100/μL from the pre-operative level) on post-operative day 3 were independent positive prognostic factors and LN metastasis was negatively associated with post-operative recovery of peripheral lymphocyte counts.
Peripheral lymphocyte counts after cervical cancer surgery are important prognostic factors, and management aimed at minimizing immune disturbances after surgery should be assessed, especially in patients with LN metastasis.
Gynecologic Oncology 06/2012; 127(1):107-13. · 3.89 Impact Factor
