Cancer Research and Treatment

Volume 30(6); December 1998

Original Articles

Correlation between VEGF Expression and Angiogenesis in Advanced Gastric Carcinoma: Young Bae Kim, Jee Young Han, Sang Hyun Lee, Hae Seung Han, Tae Sook Kim, Young Chae Chu, Tae Sook Hwang; J Korean Cancer Assoc. 1998;30(6):1061-1068.

Abstract PDF: PURPOSE
VEGF is thought to be an important angiogenic factor playing significant a role in the aggressiveness of malignant tumor by stimulating neovascularization. We morphologically investicated the tumor angiogenesis in terms of the presence of VEGF expression in advanced gastric carcinoma.
MATERIALS AND METHODS
We performed immunohistochemical stains for VEGF, CD 34, and MIB-1 (Ki-67) on the 51 paraffin-embedded tissue sections. The degree of angiogenesis was determined by counting microvessel densities and their Ki-67 labelling indices of endothelial cells within the tumors. We evaluated the correlation between the expression of VEGF, angiogenesis and clinicopathologic factors such as histologic differentiation, depth of invasion, and lymph node metastasis.
RESULTS
Immunoreactivity for VEGF revealed positivity in 34 out of 51 cases (66.7%). Microvessel densities and Ki-67 labelling indices of endothelial cells reflecting angiogenesis were higher in VEGF-positive tumors than VEGF-negative tumors. There were no conelations between VEGF expression, histologic differentiation and the depth of invasion. We failed to evaluate the conelation of VEGF expression and lymph node metastasis.
CONCLUSION
This study suggests that VEGF expressian is closely related to tumor asso- ciated angiogenesis in advanced gastric carcinoma. Considering that tumor growth depends on angiogenesis, therapies reducing VEGF may be a means of inhibiting angiogenesis and tumor aggressiveness.

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p53 Mutation in Gastric Carcinoma Detected by PCR - SSCP and Direct - Sequencing: Sang Suk Lee, Sang Pyo Kim, Eun Joo Sohn, Mi Seon Hwang, Soo Sang Sohn; J Korean Cancer Assoc. 1998;30(6):1069-1077.

Abstract PDF: PURPOSE
p53 gene mutations, one of the most common alterations found in human tumors, has also been detected in gastric carcinoma, and shown to have a crucial and early role in gastric carcinogenesis of intestinal type and mainly associated with tumor progression in the cancer of diffuse type. We tried to investigate the frequency of p53 mutations in 27 gastric carcinomas.
MATERIALS AND METHODS
Fresh tumor tissue from a series of gastric carcinoma was screened for p53 mutations by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with silver staining and confirmed by direct-sequencing in 27 cases of gastric carcinoma. Immunohistochemical method for p53 protein accumulation was also performed in the same cases.
RESULTS
Immunohistochemistry revealed 20 of 27 cases of gastric carcinoma, positive for p53. PCR-SSCP analysis of p53 exons 5-8 detected mobility shift in 4 out of 20 p53-positive tumors; three from exon 5 and the other from exon 7, respectively. DNA sequencing of exon 5 showed CGC to CAC point mutation in one of three cases; exon 7, ATC to AAC point mutation. It seemed that there was no correlation between genetic alterations of p53 gene detected by PCR-SSCP and expression of p53 protein by immunohistochemistry. CONCLUSIOAS: Our results suggest that mutations of the p53 gene are rare genetic events in carcinogenesis of gastric carcinomas. There was discrepancy between mutations screened by PCR-SSCP and overexpressions in immunohistochemical staining.

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Correlation between Proliferative Index by DNA Flow Cytometry and Histological Features in Stomach Cancer: Hyoung Kug Kim, Myeong Soo Lee, Hong Yong Kim, Se Hwan Han, Seok Yong Rhu, Hong Joo Kim, Young Doug Kim; J Korean Cancer Assoc. 1998;30(6):1078-1088.

Abstract PDF: PURPOSE
Stomach cancer is the most prevalent malignancy in Korea. The survival rate in advanced stage disease has stayed in less than 50%. One of the possible explanation for dismal outcome of stomach cancer is various biologic behavior of cancer cells of heterogeneous clones. Introduction of flow cytometric analysis has provided objective information of cancer cell kinetics, and it could help us in deciding the appropriate adjuvant therapy. The prospective study was undertaken to evaluate the clinical implication of DNA ploidy and each proliferative fraction by DNA flowcytometry. The other aim of the study was to evaluate which one is the most valuable index for proliferative activity of cancer cells.
MATERIALS AND METHODS
One hundred and fifty-four patients who underwent gastric resection for primary stomach cancer were included in this study. Male to female ratio was 2.1: 1, and mean age was 58.2 years (range: 26-81). Resected cancer tissues were immediately transported to the flow cytometry laboratory, and analyses for DNA content and cell cycle distribution were carried out by FACScan. The results of flow cytometric analysis were studied in correlation with clinical and histologic parameters; depth of invasion, lymph node metastasis, distant metastasis, stage, Laurens classification, histologic types and grade.
RESULTS
The frequency of aneuploid cancer was 40.3% (62 cases). The mean value of GO/Gl fraction was 75.9% and that of S-phase was 16.0%. Decrease of GO/Gl correlates with lymph node metastasis (p 0.015) and stage (p-0.046). Aneuploid cancer exhibited significant decrease of GO/Gl fraction. However, there was no significant conelation between decreased GO/Gl and depth of invasion, distant metastasis, Laurens classi- fication, differentiation of the cancer cells. Patients with metastasis to the lymph node or distant organs had increased S-phase fraction (p-0.032). High S-phase fraction also correlates with advanced stage (p-0.011) and ploidy of the oancer cells (p=0.001). When the ploidy of the tumor was analysed with clinical variables, aneuploid pattern was increased in cancer cells with intestinal type according to Laurens classificatian (p=0.042), Diploid cancer had significantly lower level of S-phase fraction than aneuploid cancer (p 0.001).
CONCLUSION
Ploidy and growth fraction of the stomach cancer reflected the extent of disease in different aspects. However, there was no single parameter which reflected the extent of disease and degree of malignant potential. Furthermore, there is a possibility that S-phase & action alone is not an accurate parameter for the proliferative activity of stomach cancer cells. In conclusion, flow cytometric analyses is a valuable study providing us more precise information about biologic properties of cancer cells. However, further evaluation with longer follow-up period is imperative because the ultimate value as an prognostic factors can be estimated in respective of clinical outcomes.

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A Comparison between the 4 th and 5 th Editions of the UICC Stage Classification of the Gastric Cancer with Special Emphasis: Joon Ho Yang, Seong Heum Park, Sei Hyeog Park, Chong Heung Kim, Kyung Woo Choi; J Korean Cancer Assoc. 1998;30(6):1089-1095.

Abstract PDF: PURPOSE
In the new 5th edition of the UICC-TNM stage classification for gastric cancer, there were substantial changes for the N classification by accepting the convenience of the quantitative system. This study is intended to evaluate the efficacy of the new edition.
MATERIALS AND METHODS
The stages and nodal status were retrospectively reclassified according to the 5th edition in 399 patients with gastric cancer who were operated at the NMC and they were compared with the result classified by the 4th edition.
RESULTS
Each stage system showed a significant difference in respect to the survival among subgroups of patients. Lymph nodes metastasis by both classification systems also showed a significant difference in respect to the survival among the subgroups. Five-year survival rate decreased significantly in relation to numbers of metastatic lymph nodes. Multivariate analysis revealed that new staging system was one of the highly significant prognostic factor. Patients with metastatic deposits in the regional lymph nodes in the hepatoduodenal ligament, classified as distant nodes in the 4th edition, had worse survival than those without. There was no significant survival difference between the patients with N3 and those with distant node metastasis in the 5th edition.
CONCLUSION
Although the new UICC-TNM classification seemed to need further classification by comparative studies, it might be a more convenient staging system with an ability to identify subgroups with different survival. But, it still has some controversies.

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Prognostic Factor in Early Gastric Cancer: Seung Hwan Lee, Hyung Rok Kim, Dong Yi Kim, Young Jin Kim, Shin Kon Kim; J Korean Cancer Assoc. 1998;30(6):1096-1102.

Abstract PDF: PURPOSE
In advanced gastric cancer, the important prognostic factors are depth of invasion and status of lymph node metastasis, etc. In early gastric cancer, it remains controversial that depth of invasion or lymph node metastasis is corelated to the prognosis. A retrospective analysis of early gastric cancer was performed to evaluate the clinicopathologic features and to know the factors affecting the prognosis.
MATERIALS AND METHODS
From January 1981 to May 1997, we experienced 1850 cases of gastric cancer who performed gastric resections. Among them, 371 cases were early gastric cancer (20.1% of all resected gastric cancer cases). We defined 12 variable factors such as sex, age, tumor location, gross type, histologic type, depth of invasion, status of lymph node metastasis, tumor size, DNA ploidy pattem, stage, operation type, and resection type for prognostic factor and analyzed them.
RESULTS
Overall five year survival rate was 89.6% and ten year survival rate was 82.0%. The trend of annual incidence in recent nine years showed steady increase from 13.1% in 1988 to 25.7% in 1996. Survival showed no significant correlation with sex, age, tumor location, gross type, histologic type, tumor size, DNA ploidy, resection type. According to univariate analysis, depth of invasion, lymph node metastasis, stage had statistically significant association with prognosis. Among them, lymph node metastasis had an inde- pendent and predominant impact on survival according to multivariate analysis.
CONCLUSION
Early gastric cancer appears to show steady increase of annual incidence, and lymph node metastasis appears to be closely related to the prognosis.

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Clinical Review for the Some Patients of Lung Cancer in Pusan - Kyungnam Area: Sung Hyun Kim, Young Ki Son, Chng Hoon Moon, Jae Seok Kim, Hyo Jin Kim, Hyung Sik Lee, Won Joo Hur, Pill Joe Choi, Jong Su Woo; J Korean Cancer Assoc. 1998;30(6):1103-1109.

Abstract PDF: PURPOSE
This study was performed to find out the natural history of lung cancer in Pusan-Kyungnam area and changing of that in previous report.
MATERIALS AND METHOD
We studied retrospectively 508 patients with pathologically proven lung cancer from January 1991 to December 1995. We analysed age and sex distribution, initial symptoms before diagnosis, first method yielding histologic diagnosis, cell types of lung cancer, initial stage of lung cancer, schema of overall patients, survivial of lung cancer patients, and prognostic factors affecting survival of lung cancer patients..
RESULTS
The overall male to female ratio was 4.5: 1 and the age distribution ranged from 20 to 86 years, and the median age of overall patients was 60 years. Histologic classification revealed that the most prevalent type was squamous cell carcinoma (251 cases, 49.4%), followed by adenocarcinoma (141 cases, 27.8%), small cell carcinoma (91 cases, 17.9%), and large cell carcinoma (3 cases, 0.6%). In non-smali cell lung cancer 56.8% were stage IIIb and IV, therefore curative operation was done in 18.7% of all cases, but in small cell lung cancer 65.6% were extended disease. Meidan survival of overall patients was 11.8 months. There was a quite difference in survival among the stages. In non-small cell lung cancer, median survival was 59.7 months, 27.3 months, 18.5 months, 12.7 months, 5.9 months in stage I, II, IIIa, IIIb, IV in each. In small cell lung cancer, median survival of limited disese was 12.2 months and median survival of extended disease was 6.7 months. The stage and the performance status were independent prognostic factors in both small cell and non-small cell lung cancer.
CONCLUSION
The prognosis of patients with lung cancer was still grave, but the survival was better than that of a previous report. This may be accorded to increase in early diagnosis and operation and advance in supportive care.

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Concomitant Boost Radiotherapy for Stage 3 Non - Small Cell Lung Cancer: Kyung Hwan Shin, Charn Il Park, Young Soo Shim, Yung Jue Bang, Sung Koo Han; J Korean Cancer Assoc. 1998;30(6):1110-1118.

Abstract PDF: PURPOSE
This study was undertaken to evaluate the treatment outcome and side effects of accelerated radiotherapy (RT) using concomitant boost for stage III non-small cell lung cancer (NSCLC).
METHODS
Between April 1991 and December 1994, 102 patients with stage III NSCLC who had the favorable prognostic factors by CALGB criteria, were treated with concomitant boost radiotherapy. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment was administered concomitantly during the last 2 weeks with a dose of 13 Gy in 10 fractions. The interfraction interval was at least 6 hours. The total tumor dose was 66-70 Gy, given over 6 weeks.
RESULTS
With 30 months median follow-up period for survivors, median survival was 15 months with 2 and 3-year overall survival rates of 34% and 19%, respectively. Thirty patients (29%) who had achieved complete remission after RT showed significantly better 2-year survival rates than those without complete remission (58% vs 22%, p 0.001). Local failure and distant metastases as the first or only failure occurred in 40 (44%) and 13 (14%), respectively, and ultimate local and distant failure rates were 45% and 29%, respectively. Although Grade IV esophageal complication of T-E fistula was observed in one patient, most patients with pulmonary complication showed mild, transient radiation pneumonitis.
CONCLUSION
This result suggests that the treatrnent of stage III NSCLC with concomitant boost RT may improve survival rates without enhanced radiation induced toxicity compared with conventional RT. Further investigation of dose escalation by conformal radiotherapy of combining chemotherapy and accelerated RT is warranted.

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The Expression of c-erbB-2 and CD44 Gene in Breast Cancer: Jun Heyoung Heo, Yong Gui Kim, Sung Hyuk Kim, Jai Hak Lee; J Korean Cancer Assoc. 1998;30(6):1119-1130.

Abstract PDF: PURPOSE
There are some controversial opinions on the prognostic value of metastasis- associated tumor markers in breast cancer. Out of them, the overexpression of c-erbB-2 proto-oncogene or CD44 gene has been debated on their activities in promoting metastatic potential.
MATERIALS AND METHODS
To detennine the relationship between expression of these genes, and, clinicopathological parameters and disease outcomes including relapse and survival, 48 archival paraffin-embeded breast-cancer tissues were stained using monoclonal antibody against each gene product by immunohistochemical staining method, and the result was analyzed.
RESULTS
The positive expression rates of c-erbB-2 and CD44 genes were 45.8% and 18.8%, respectively. The expression rates of both genes were 14.6% and 50% of cases showed no expression of either gene. Except the statistically significant positive correlation between CD44 and tumor size (P=0.003), the expression of c-erbB-2 or CD44 expression had no significant relationship with tumor size, stage, lymph node status, and disease recurrence (P>0.05). In the positive expression cases for CD44, disesase-free survival (DFS) and overall survival (OS) in months were shorter than the negative ones (53+/- 8 vs. 64+/-5 and 67+/-8 vs. 77+/-5 S.E.). And, the c-erbB-2 positive cases had longer OS than the negative ones (78+/- 6 vs. 71+/- 6). The OS of positive co-expression cases with the c-erbB-2 and CD44 was shorter than that of one-gene expression ones (66+/- 6 vs. 75+/-7). Thus the OS result observed in the expression of c-erbB-2 alone was reversed in the co-expression study. Though these results had no statistically significant level (P> 0.05).
CONCLUSION
We suggest a question if there is any interaction or dependency between c-erbB-2 and CD44 expression in view of disease process including OS. Finally, further randomised controlled studies are advisable for the reproducible and significant results.

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Status of Bcl-2 expression and Its Relationship to the Other Prognostic Factors in Breast Cancer: Gun Young Roh, Dong Ha Shin, Yong Lae Park, Jun Ho Shin, Heung Dae Kim, Yong Sin Kim, Won Kon Han, Joo Seob Keum, Myung Sook Kim, Gu Kong, Myung Suk Kim; J Korean Cancer Assoc. 1998;30(6):1131-1139.

Abstract PDF: PURPOSE
There are several well-established prognostic factors to predict the course of breast cancer. Recently, a new category of genes that control the process of programmed cell death, also called apoptosis, has been identified. It includes the bcl-2 proto-oncogene which actively blocks apoptosis. The purpose of this retrospective study is to investigate the relationship between Bcl-2 protein expression in primary breast cancers and other markers of prognostic value.
MATERIALS AND METHODS
We analyzed 43 cases of invasive ductal carcinoma of breast cancer, which were consecutively operated in the period from January 1990 to December 1994. Analysis of Bcl-2 protein, ER and PgR expression was carried out using immunohistochemistry on the paraffin-embedded tissue section. The following indices were measured.; size of the tumor, number of axillary metastasis, histological grade, menopausal status, ER, PgR, and Bcl-2 status.
RESULTS
Expression of the bcl-2 proto-oncogene was found in 28 cases of 43 patients (65.1%). No relationship could be observed between Bcl-2 status and tumor grade, TNM staging and menopausal status. A strong positive relationship was demonstrated between Bcl-2 immunoreactivity and ER status (P 0.001) and PgR status (P=0.014). A favorable prognostic value was demonstrated for Bcl-2 expression on overall survival (P=0.0427), but no prognostic value was demonstrated on disease-free survival (P=0.1587).
CONCLUSION
Our results suggest that the Bcl-2 expression may be a favorable prognostic marker and its important role may be a modulator of response to adjuvant therapy in breast cancer.

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The Predicition of Axillary Lymph Node Metastasis in T1 Breast Cancer: Jae Woo Kim, Ja Yun Koo, Hy Do Lee, Woo Hee Jung; J Korean Cancer Assoc. 1998;30(6):1140-1146.

Abstract PDF: PURPOSE
The axillary lymph node status is the most important prognostic factor in breast cancer. The axillary node dissection is usually performed in infiltrating brcast cancer for the information of therapeutic decision and prediction of prognosis. But this procedure may result in lymphedema of affected upper extremity nearly about 25%, increased axillary drainage, sensory abnormality and pain. Many researches are focussed to find the patients group who do not need axillary dissection according to the status of tumor size, patient age, hormonal receptor and histologic grade. MATERIAL AND METHODS: We evaluated the axillary lymph node status in patients with tumor size less than 2 cm in diameter and thein correlation of other prognostic factor. We reviewed 127 women with histologically diagnosed infiltrating ductal carcinoma of breast who were treated by one surgeon at Yongdong Severance Hospital, Yonsei University College of medlcine between 1991 and 1996.
RESULTS
Five patients (3.9%) had Tla lesion (<5 mm), 24 patients (18.9%) had Tlb tumors (6-10 mm), and 98 cases (77.2%) had Tlc lesion (11-20 mm). The average numbers of axillary lymph nodes dissected were 14.2. We found that smallcr tumor size, good histologic grade, estrogen receptor positivity, old age (over 50 years) showed a tendency of decreased axillary node metastasis but without statistical significance.
CONCLUSION
There are possibility of finding subset with low risk of axillary lymph node metastasis in small sized tumor with addition of good prognostic indicators such as good histologic grade, hormonal receptors and old age.

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Study of Bone Marrow Micrometastases in Breast Cancer Patient: So Hwan Chung, Jeong Han Yoon, Young Jong Jegal; J Korean Cancer Assoc. 1998;30(6):1147-1155.

Abstract PDF: PURPOSE
To determine accurately the extent of the disease and risk of recurrence is important in enhancing the therapeutic success rate of breast cancer. Primary tumor state and axillary node invasion were some well known factors to predict the prognosis of breast cancer. However, some patients with early stage cancer developed systemic metastasis later despite of little possibility of recurrence based on some previously establised prognostic system. These results demand another approach to predict systemic metastases in patient without gross evidence of further recurrence. Micrometastases is a promising key to explain the recurrence in these patients and micrometastases in bone marrow could raised the ongoing recurrence in skeletal system which is the most frequent metastatic site in breast cancer. Therefore we tricd to determine the rate of micrometastasis in surgically resectable Korean breast cancer patients and the relationship with clinicopathological characteristics of the cancer.
MATERIALS AND METHODS
We studied bone marrow aspirate specimens from 38 patients with breast cancer who underwent curative resection at Chonnam University Hospital from January 1996 to February 1997. And reverse transcription polymerase chain reaction (RT-PCR) to detect messenger RNA for cytokeratin 19 was performed.
RESULTS
Metastases in bone marrow were detected in 8/38 patients (21.1%). No sta- tistically significant relationship existed between bone marrow metastasis and clinicopa- thological parameters for predicting prognosis that consisted of tumor state, lymph node invasion, histologic grade, steroid receptor, and c-erbB2 overexpression. In particular, bone marrow metastasis developed even from ductal carcinoma in situ.
CONCLUSION
Bone marrow metastasis may be developed from the extremely early stage of breast cancer and we can not make the corelationship between the bone marrow metastasis and establised some prognostic factors. Based on these results, we recommand the evaluation of bone marrow metastasis in all breast cancer patients and require the close follow-up to allow more sensitive prediction of ongoing recurrence and higher curability.

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Transarterial Chemoembolization ( TACE ) for Hepatocellular carcinoma: Comparison of Adriamycin alone vs . Cisplatin alone vs . Adriamycin + Cisplatin: Jung Ae Lee, Keun Chil Park, Bong Seog Kim, Young Soo Do, Duk Lim, Tae Sung Park, Chang Min Kim, Jhin Oh Lee, Taik Koo Yun; J Korean Cancer Assoc. 1998;30(6):1156-1167.

Abstract PDF: PURPOSE
Although transarterial chemoembolization (TACE) has been widely used for the treatment of unresectable hepatocellular carcinoma, it has not been determined yet which chemotherapeutic agents were best for TACE. To determine the best chemotherapeutic regimen for TACE, we performed a prospective randomized study comparing 3 chemo- therapeutic regimen (adriamycin alone vs. cisplatin alone vs. adriamycin + cisplatin).
MATERIALS AND METHODS
The patients with unresectable hepatocellular carcinoma were eligible for this study and were randomly assigned to three treatment groups (A: adriamycin 30 mg/m(2), B: cisplatin 60 mg/m(2), C: adriamycin 30 mg/m(2) + cisplatin 60 mg/m(2)). The TACE were performed by administering the mixture of lipiodol and the assigned chemotherapeutic drugs through the hepatic artery, followed by embolization with gelfoam powder. The treatment was planned to be repeated every 4 weeks.
RESULTS
After 40 patients (14 in group A, 16 in group B, 10 in group C) entered, the study was stopped prematurely because of serious treatment-related complications including 15% of local complications, 18% of hepatic encephalopathy, and 8% of deaths. Because TACE could result in necrosis without reduction of mass size, the response could not be evaluated by the change of mass size, but by the change of serum alpha-fetoprotein level. Of 25 patients who had elevated serum alpha-fetoprotein and were assessable for response, there were one complete response (CR) and 5 partial responses (PR) out of 10 in group A, 5 PRs out of 10 in group B, and 2 PRs out of 5 in group C. There was no difference in response rates among the 3 treatment groups (p > 0.05). The response rate in patients treated with gelform embolization was higher than patients without embolization (63% (12/19) vs 19% (1/6): p<0.05). The median survival (OS) was 23 weeks for all 40 patients, 15 weeks for group A, 42 weeks for group B and 24 weeks for group C. The difference of OS between group A and B was statistically significant (p=0.02). However, the OS was not associated with any prognostic factors including treatment group in multivariate analysis.
CONCLUSION
Although cisplatin seemed to be more effective in TACE than adriamycin, no firm conclusion could be drawn from this prematurely ended study. However, we could conclude that the TACE with gelform powder is so toxic that it could not be given safely to the patients with unresectable hepatocellular carcinoma

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The Effect of the Degree of Tumor Necrosis on Survival in Patients with Hepatocellular carcinoma Treated with Curative Resection Following Preoperative Transcatheter Arterial Therapy: Chang Mok Lee, Dong Sup Yoon, Sung Won Kwon, Hoon Sang Chi, Byong Ro Kim; J Korean Cancer Assoc. 1998;30(6):1168-1174.

Abstract PDF: PURPOSE
To investigate the effect of patient and tumor factors on the degree of tumor necrosis and the effect of the degree of the tumor necrosis on the survival in patients treated with curative resection following transcatheter arterial therapy.
MATERIALS AND METHODS
90 patients diagnosed as having hepatocellular carcinoma and treated with curative resection following transcatheter arterial therapy at Yonsei Medical Center between January 1986 and December 1995. The subjects were classified into four groups: 100% necrosis group (Group I, n=29), over 95% necrosis group (Group II, n=28), 50-95% necrosis group (Group III, n=13) and below 50% necrosis group (Group IV, n=20). The factors which affect on the necrosis of the tumor were compared. The overall and disease-free survival rates according to the degree of tumor necrosis were illustrated.
RESULTS
There was no statistical difference in the degree of the tumor necrosis according to age, sex, HBsAg, g-FP, liver cirrhosis, tumor size and morphological classification. In the comparison between the preoperative transcatheter arterial therapies, however, transcatheter arterial chemo-oily embolization (TACOE), which used the injection of the mixture of 3 10 cc Lipiodol and 30-50 mg Adriamycin followed by Gelfoam em- bolization, showed the higher number of 100% necrosis and over 95% necrosis cases. The 1, 3 year overall survival rates were greater for Group I, although not statistically significant. The 1, 5 year disease-free survival rates were greater for Group I, although not statistically significant.
CONCLUSION
In the preoperative transcatheter arterial embolization, TACOE was most effective to get total necrosis of tumor. However overall survival and disease free survival were not affected by the amount of tumor necrosis.

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Treatment of Hepatic Metastasis of Colorectal Cancer: A Retrospective Analysis of the Outcome in 99 Patients: Jin Cheon Kim, Chang Nam Kim, Chang Sik Yu, Han Il Lee, Sang We Kim, Je Hwan Lee, Woo Kun Kim, Gyeong Hoon Kang, Moon Kyu Lee; J Korean Cancer Assoc. 1998;30(6):1175-1183.

Abstract PDF: PURPOSE
Among various modalities of treatment in hepatic metastasis of colorectal cancer, hepatic resection has been proven to be the most effective treatment. This analysis was intended to determine important prognostic parameters and to understand clinically significant factors during hepatic resection and follow-up period in patients with hepatic metastasis from colorectal cancer.
MATERIALS AND METHODS
Among 1,022 colorectal cancer patients treated at Asan Medical Center from July 1989 to December 1995, 99 patients were found to have liver metastasis at the time of first diagnosis or during follow-up period. These 99 patients were the subject of analysis in this retrospective clinical study. Surgical resection with curative intent was done in 35 patients and chemotherapy in 46 patients. Eighteen patients were with no treatment or misssed during follow-up. Survival rate was analysed according to clinicopathological parameters: sex, age, location of primary tumor, preoperative serum CEA level, TNM staging of primary tumor, number of hepatic metastasis, distribution, synchronous or metachronous lesions, diesase free interval, mode of treatment, type of resection, tumor free resection margin.
RESULTS
Overall survival of the patients with hepatic metastasis was significantly related with numbers of metastasis (<4 vs. >4), distribution (unilobar vs. bilobar), synchronous or metachronous lesions, disease free interval ( < 12 vs. > 12 months), mode of treatment (hepatic resection vs. chemotherapy vs, no treatment, p<0.01. A multivariate analysis showed a significant association of survival with mode of treatment (p<0.01). Survival of patients with hepatic resection was significantly related with resection margin (positive vs. < 1 cm vs. > 1 cm), TNM staging of primary tumor (II vs. III), number of hepatic metastasis (p<0.01), disease free interval (p<0.05). A multivariate analysis showed a significant correlation with survival for tumor free resection margin (p<0.01).
CONCLUSION
An aggressive approach of hepatic resection in the colorectal liver metastasis will improve survival, if the lesion pennits. In patients with hepatic resection, tumor free resection margin was the most important prognostic parameter by the uniand multivariate analysis. Therefore, every effort should be made to ensure that the clear margin be kept at least more than 1 cm during hepatic resection.

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Integration of HPV and the Antibody Respones to HPV Proteins in Patients with Cervical Cancer: Joon Mo Lee, Seung Jo Kim, Jong Sup Park, Sung Eun Namkoong, Chan Joo Kim, Tae Chul Park, Soo Jong Um; J Korean Cancer Assoc. 1998;30(6):1184-1197.

Abstract PDF: PURPOSE
HPV (human papillomavirus) are known as the major causative agent for development of cervical cancer. High-risk HPVs, especially HPV-16 /18 DNA, are often found to be integrated into the human genome in high grade CINs as well as cervial cancer. Investigation of the relationship between the genomic states of HPV genes and their antibody response against the HPV-16 Ll/L2 virus-like particles (VLPs) and the in vitro translated E6 and E7 proteins may help to explain the mechanism of HPV-related cervical carcinogenesis and host immune responses.
MATERIALS AND METHODS
Cervical cancer tissues obtained from 41 patients with cervical cancer were studied by PCR, Southern blot hybridization and the antibody response against HPV-16 Ll/L2 VLPs and HPV-16 E6, E7 proteins of serum were tested by ELISA and radioimmunoprecipitation assay (RIPA), respectively.
RESULTS
Integrated forms of the HPV-16 DNA were found in 23 of the 38 patients (60.5%). The HPV-16 positive cervial cancer patients had a significantly higher prevalence (39.5%; 15/38) of antibodies to HPV-16 Ll/L2 VLPs than 8.7% (2/28) of the the control group (p<0.05). Antibodies to HPV-16 Ll/L2 VLPs were more detectable in 60% (9/15) of the cervical cancer patients with episomal forms of HPV-16 DNA than those who having only integrated HPV-16 (26.1%; 6/23) (p<0.05). Antibodies to E6 and E7 proteins were positive in 36.8% (14/38) and 50% (19/38) of the patients with HPV-16 positive cervical cancer. And those were siginificantly higher than the positivities for the control group (8.3% and 2.8%), (p<0.05). The difference between seroreactivities to E6 and E7 proteins in the patients with episomal forms of HPV-16 DNA (pure episomal and mixed forms) and those with integrated froms of HPV-16 DNA was not significant (P>0.05). CONCLUSION: Integrated forms of HPV-16 DNA were prevalent in most patients with cervical cancer. Antibodies to HPV-16 Ll/L2 VLPs, in vitro translated HPV-16 E6 and E7 proteins appeared in the significantly larger proportions of the HPV-associated cervical cancer patients than in the controls. Antibodies to HPV-16 Ll/L2 VLPs were more detectable in the cervical cancer patients with episomal form of HPV-16 DNA than those who having only integrated forms of HPV-16. Antibody responses to HPV-16 E6 and E7 proteins were not influenced by the different viral states. More numbers of studies would be necessary to determine the relationship between the genomic states of HPV and the immune responses to their proteins by the such genomic and serologic parameters.

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Cytologic Screening History of 249 Patients with Cervical Cancer: Jae Weon Kim, Sok Bom Kang, Dong Ki Seo, Soo Hee Choi, Chul Min Lee, Yong Beom Kim, No Hyun Park, Yong Sang Song, Soon Beom Kang, Hyo Pyo Lee; J Korean Cancer Assoc. 1998;30(6):1198-1206.

Abstract PDF: PURPOSE
Cervical neoplasias are known to be preventable. But the outcome of our efforts for early detection in Korea is disappointing. This study was undertaken to determine the level of screening participation in Korean women with cervical cancer and how the early detection of cervical cancer might be improved.
MATERIALS AND METHODS
Two hundred and forty-nine women with cervical cancer diag- nosed and treated at Seoul National University Hospital from September 1996 to February 1998 were subjected to this study. Self-reported cervical cancer screening histories, med- ical records obtainable were reviewed and analysed.
RESULTS
One hundred forty-seven women (147/249; 59.0%) hadn't got through the screen- ing at proper intervals. Ninety-nine women (39.9%) had never been screened and remain- ing 48 (19.3%) hadn't had their last Pap test 3 years before their diagnosis of nvasive cancer. Of the 150 women (60.1%) who had ever had a Pap test, only 47 (18.9%) had had annual Pap test during recent 5 years and 55 (22.1%) had had routine Pap test with interval between 1-3 years. Among 102 women who had at least one Pap test during recent 3 year, 73 (71.6%) had had a normal Pap report within three years of diagnosis, including 36 (35.3%) whose last normal Pap report was within a year of diagnosis. This results suggest the possibilities of smear-taking and/or reading errors. Women who had had routine Pap with interval less than 3 years had significantfy less chance of advanced tumor (FIGO stage Ib < ) than unscreened population. There was a statistically significant trend for the more younger and educated groups to be participated at the screening program with more shortened interval. All the other factors had failed to show significant correlation with adequacy or regularity of screening interval.
CONCLUSIONS
Despite widespread chance of opportunistic cervical cancer screening, non-participants form the main reason for the failure of cervical cancer screening in Korea. So, far much efforts should be aimed at participating more women in cervical cytologic screening program, especially in the old-aged and less-educated groups.

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Bcl-2 Expression in Endometrial Hyperplasia and Carcinoma: Jong Hyeok Kim, Chang Won Koh, Joor Yung Huh, Bong Hee Kim, Hun Sik Kong, Jun Hee Na, Yong Nam Kim, Young Tak Kim, Joo Hyun Nam; J Korean Cancer Assoc. 1998;30(6):1207-1218.

Abstract PDF: PURPOSE
To speculate the role of bcl-2 protooncogene in endometrial carcinogenesis by determination of the expression of bcl-2 in endometrial hyperplasia and carcinoma.
MATERIALS AND METHODS
We studied bcl-2 expression by an immunohistochemical method in the paraffin-embedded blocks of 78 patients with endometrial hyperplasia, 64 with simple hyperpasia, 9 with complex hyperplasia and 5 with atypical hyperplasia respectively, and 33 endometrial carcinoma treated at Asan Medical Center from June, 1989 to May, 1997. Intensity of bcl-2 staining was scored on a scale of 0 to 4, calibrated by comparison with stromal lymphocytes, which always received a score of 4.
RESULTS
The results of this study showed that bcl-2 was relatively highly expressed in simple (n= 64), complex (n=9) and atypical hyperplasias (n=5) with mean staining scores of 2.95+/-1.09 (Mean+Standard Deviation), 2.78+/-1.20 and 3.60+/-0.89 respectively, which showed no difference among histologic types. In endometrial carcinoma, the expression of bcl-2 was significantly down regulated (mean score=1.76+/-1.35) compared with that of hyperplasia, and did not conelate with FIGO surgical stage. However, grade III tumor showed significantly lower expression that grade I or II tumor.
CONCLUSION
Bcl-2 expression is down regulated in endometrial carcinoma than endo- metrial hyperplasia, and correlates with tumor grade, which suggest that bcl-2 expression might be the result of carcinogenesis or bcl-2 plays only an adjunctive role in the endometrial carcinogenesis.

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The Clinical Usefulness of Membranous E-cadherin in Transitional Cell Carcinoma of the Bladder: Bong Ryoul Oh, Gil Joo Nah, Seong Jin Kim, Jae Hong Sim, Dong Deuk Kwon, Kwang Sung Park, Soo Bang Ryu, Yang Il Park; J Korean Cancer Assoc. 1998;30(6):1219-1226.

Abstract PDF: PURPOSE
E-cadherin, a cell adhesive molecule that plays a diverse role in cell-cell and cell-matrix interaction, is essential for maintaining epithelial intercellular adhesion and acts particularly as a suppressor of invasive ability of cancer. To detennine the potential pro- gnostic values of membranous E-cadherin, we evaluated the correlation between the clin- ical outcome and its expression in patients with transitional cell carcinoma of the bladder.
MATERIALS AND METHODS
Membranous E-cadherin immunoreactivity was evaluated in 75 cases of transitional bladder cancer and 15 controls (5 cases of cystitis and 10 normal controls). The expression of membranous E-cadherin were compared with histological grade, T category of TNM stage, and survival.
RESULTS
Abnonnal immunohistochemical expression of membranous E-cadherin was observed in 53 (70.7%) patients with bladder cancer and undetected in controis. Abnormal immunohistochemical expression of membranous E-cadherin was significantly correlated with grade (p<0.01) and T category of TNM stage (p<0.01) of transitional cell carcinoma of the bladder. Progression to invasive cancer occurred in 6 patients with 45 superficial bladder cancer and 5 of them showed abnormal expression of E-cadherin, which had statistical significance (p<0.05) but not with recurrence. There was statistically significant correlation between the abnormal expression of E-cadherin and poor prognosis (p < 0.01).
CONCLUSIONS
We conclude that abnormal expression of membranous E-cadherin is a useful prognostic marker in patients with transitional bladder cancer.

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The Significance of Urinary Nuclear Matrix Protein ( NMP22 ) Measurement in Patients with transitional Cell Carcinoma of the Bladder: Seok Heun Jang, Hak Ryong Choi, Bong Suk Shim, Sung Won Kwon; J Korean Cancer Assoc. 1998;30(6):1227-1230.

Abstract PDF: PURPOSE
The objective of this study was to evaluate an immunoassay for urinary nuclear matrix protein (NMP22) as an indicator for transitional cell carcinoma of the bladder.
MATERIALS AND METHODS
Three groups of subjects attended the trial of NMP22. First group was 27 patients with transitional cell carcinoma of the bladder, second group was 24 patients with other urinary cancer consisted of prostate cancer and renal cell carcinoma, and third group was 24 healthy volunteers. NMP22 was determined using a commercial test kit, which is based on an enzyme-linked immunosorbent assay.
RESULTS
In normal healthy volunteers and other urinary cancer group median NMP22 levels were 2.24 and 3.27 U/ml, respectively. Median urinary NMP22 levels in patients with transitional cell carcinoma of the bladder were 54.30 U/ml. It was significantly greater than other two groups. Median NMP22 levels according to the tumor stage and the tumor grade did not show the significant difference statistically. CONCLUSIONS: Urinary NMP22 is a useful marker that is more specific for bladder cancer thsn for other urinary cancer. Further tests are required to clarify the influence of other spe- cific conditions, such as urinary tract infection, and intravesical drug instillation or procedure.

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Extraperitoneal Laparoscopic Pelvic Lymph Node Dissection in the Staging of Prostate Carcinoma: Kyu Seung Lee, Wook Oh, Sang Jin Kim, Seong Soo Chun, Dae Kyung Kim, Sung Won Lee, Han Yong Choi, Soo Eung Chai; J Korean Cancer Assoc. 1998;30(6):1231-1239.

Abstract PDF: PURPOSE
Diagnostic sampling of pelvic lymph nodes is generally accepted as the optimal procedure for evaluating the metastatic status of locally curable prostate carcinoma. It is usually done by open surgery, but recent developments in laparoscopic surgery have provided another option and are theoretically associated with less trauma and fewer complications than those reported from conventional surgery. We now report our experience, progression and complication of extraperitoneal laparoscopic pelvic lymph node dissection (LPLND).
MATERIALS AND METHODS
Between Dec. 1996 and Feb. 1998, 14 patients with high serum PSA (> or = 10 ng/ml) or high Gleason score (> or =5) underwent LPLND before radical perineal prostatectomy. The mean age of 14 patients was 64.46.5 years. The mean of serum PSA level was 51.4+/-39.3 ng/ml, and the mean Gleason score was 7.3+/-1.6. We used balloon dissector for the creation of extraperitoneal space, and perfonned LPLND with a CO2 insufflation through extraperitonium.
RESULTS
The average operation time was 138.2+/-29.8 minutes and estimated intraoperative bload loss was 80ml. The Jackson-Pratt drain was removed 3 days postoperatively and the mean drainage volume was 220.5+/-105.2 ml. The average number of dissected nodes was 7.6+/-4.4 (Rt.: 4.1+/-2.9, Lt.: 3.5+/-2.3), and LN metastasis was noted in 4 patients (28.6%). Complications included subcutaneous emphysema (7 patients), peritoneal laceration (3) and obturator nerve injury (1). The mean dissected LN number of the latter 9 cases was 8.6+/-4.8 compared with 6.0+/-3.3 of initial 5 cases, the mean operation time (minute) of the latter 9 cases was 132.8+/-26.6 compared with 148.0+/- 35.8 of initial 5 cases.
CONCLUSIONS
The laparoscopic approach can be performed within a resonable time limit and allows adequate assessment of the pelvic lymph node with minimal operative morbidity. Extraperitoneal LPLND is the minimally invasive procedure of choice for the evaluation of patients who are at increased risk of having metastatic pelvic lymph node involvement by prostate cancer.

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A Comparison of the Acute Antiemetic Effect of Tropisetron with Ondansetron in Patients Receiving Cisplatin: Sung Tae Cho, Bo Kwon Hwang, Chan Kyu Kim, Bong Min Ko, Sung Han Bae, Jong Dae Bong, Cheol Woo Lee, Sung Kyu Park, Jong Ho Won, Seung Ho Baick, Dae Sik Hong, Hee Sook Park; J Korean Cancer Assoc. 1998;30(6):1240-1248.

Abstract PDF: PURPOSE
Tropisetron, a new specific 5-hydroxytryptamine3 (5-HT3) receptor antagonist, is an effective antiemetic agent in the control of chemotherapy induced emesis with a long half life and bioavailablity. We compared the efficacy and safefy of Tropisetron and ondansetron to control emesis induced by highly emetogenic chemotherapeutics (cisplatin > or = 50 mg/m(2)).
MATERIALS AND METHODS
Twenty-one patients were administered in a randomized, open, crossover study and received either tropisetron plus dexamethasone or ondansetron plus dexamethasone during two successive cycles of chemotherapy.
RESULTS
Control of acute emesis with either tropisetron or ondansetron was 100% vs 95.2%, and 80.9% vs 76.2% in control of delayed emesis. Both severity and duration of nausea showed no statistically significant difference between tropisetron and ondansetron. Poor appetite and headache were most common side effects in both groups.
CONCLUSION
There was no significant difference in efficacy for control of emesis and nausea between tropisetron and ondansetron in cisplatin-based chemotherapy.

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Granisetron in the Prevention of Nausea and Vomiting in Patients Receiving Platinum - Containing Chemotherapy: Woo Shik Kim, Si Young Kim, Kyung Sam Cho, Jeong Hee Kim, Hwi Joong Yoon; J Korean Cancer Assoc. 1998;30(6):1249-1258.

Abstract PDF: PURPOSE
In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data.
MATERIALS AND METHODS
The authors analyzed retrospectively pathological features of 95 patients who underwent paraacntic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation Bom May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unlmown causes of death in survival analysis.
RESULTS
The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSRs) in relation to the paraaortic lymph node (No16) status was 0.096 in No16+, and 57.8Po in Nol6 with D4 of advanced gastric cancer. The 5 YSRs were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, nl, n2 and n.3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively.
CONCLUSION
The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Bonmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p < 0.05).

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Strain - Specific Differences in Radiation - Induced Apoptosis in Murine Tissues: Jinsil Seong, Sung Hee Kim, Won Jae Lee, Chang Ok Suh, Jin Sik Min; J Korean Cancer Assoc. 1998;30(6):1259-1268.

Abstract PDF: PURPOSE
To characterize strain-specific differences in radiation response in murine tissues with different radiosensitivity.
MATERIALS AND METHODS
Six-week old male mice of 2 strains, C57Bl/6J and C3H/HeJ, were given whole body gamma-radiation with a single dose of 10 or 25 Gy. At different times after irradiation, mice were killed and tissues with different radiosensitivity, thymus and liver, were collected. Each tissue sample was stained with hematoxylin and eosin and apoptotic cells were scored. Expression of p53, Bcl-2, Bcl-x, and Bax was analysed by western blotting and densitometry.
RESULTS
Radiation induced massive apoptosis in thymus with a peak level at 8 h after radiation. With 10 Gy irradiation, apoptotic indices in C57Bl/6J and C3H/HeJ were 81.0 2.5% and 59.4 4.0%, respectively (p<0.05). Radiation upregulated the expression of p53, Bcl-x, and Bax, but not Bcl-2; p53 with a peak level of 2.5 fold (C57Bl/6J) and 1.4 fold (C3H/HeJ) at 4 h, Bax with a peak level of 2.6 fold (C57Bl/6J) and 1.3 fold (C3H/HeJ) at 8 h, and Bcl-x with a peak level of 11.1 fold (C57Bl/6J) and 8.2 fold (C3H/HeJ) at 8 h after radiation. In liver, however, radiation-induced apoptosis was minimal (peak apoptotic index of 2.1% in C57Bl/6J and 1.7% in C3H/HeJ). None of p53, Bcl-2, Bcl-x, and Bax was significantly increased.
CONCLUSIONS
Induction of apoptosis and regulation of related genes by radiation were tissue specific. Strain difference of radiation-induced apoptosis was well coupled with theinduction of related genes in thymus, a radiosensitive tissue. This study shows that quantitative difference of radiation induced apoptosis by strain is regulated at the gene level with the involvement of multiple genes.

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Prognostic Factor Analysis of Aggressive Non - Hodgkin's Lymphoma Based on International Prognostic Index Model: Min Hee Ryu, Young Iee Park, Hark Kyun Kim, Dae Ho Lee, Joo Young Jeong, Dong Wan Kim, Im Il Na, Ji Hyun Kim, Se Hoon Lee, Dae Seog Heo, Yung Jue Bang, Seon Yang Park, Byoung Kook Kim, Noe Kyeong Kim; J Korean Cancer Assoc. 1998;30(6):1269-1278.

Abstract PDF: PURPOSE
International Prognostic Index Model (IPIM) in aggressive non-Hodgkin's lymphoma was published and accepted generally as a better predictive model for prognosis. This study was undertaken to identify prognostic factors of aggressive non- Hodgkin's lymphoma and usefulness of IPIM in Korea.
MATERIALS AND METHODS
Previously untreated, pathologically proven 226 aggressive non-Hodgkin's lymphoma patients who were treated with CHOP or COP-BLAM V between 1986 and 1995 in Seoul National University Hospital were evaluated for clinical features predictive of overall survival.
RESULTS
Complete response (CR) was reached in 76% of all patients. With a median follow-up of 62 months, 5-year disease free survival of complete reponders was 67% and 5-year overall survival of all patients was 54%. In a univriate analysis, age, ECOG performance status, Ann Arbor stage, histologic subtype, bone marrow involvement, bulkiness, serum LDH level and number of extranodal involvement were significant prognostic factors for CR and survival (p<0.05). Of these, by multivariate analysis, age(RR 0.4, 95% CI 0.2~0.9) alone was a independent prognostic factor for CR. For disease free survival, no independent prognostic factor was found. For overall survival, Ann Arbor stage (RR 1.7, 95% CI 1.1~2.8), age (RR 1.7, 95% CI 1.1~2.6), Histologic subtype (RR 1.7, 95% CI 1.1~2.8), serum LDH level (RR 1.7, 95% CI 1.1~2.6) and bone marrow involvement (RR 1.8, 95% CI 1.0~3.1) were independent prognostic factors. According to risk group of IPIM, 5-year overall survival rate was 72% in low risk group, 46% in low intermediate risk group, 32% in high intermediate risk group, respectively, and median survival of high risk group was 12 months (RR 1, 2.3, 4.3, 6.4 respectively).
CONCLUSION
IPIM is a useful model for identifying poor prognostic groups in aggressive non-Hodgkin's lymphoma.

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DNA Ploidy Study in 1,673 Fresh Solid Tumors: Min Joo Kim, Han Kyeum Kim, Yang Seok Chae, Bum Woo Yeom, In Sun Kim; J Korean Cancer Assoc. 1998;30(6):1279-1293.

Abstract PDF: PURPOSE
To evaluate the possible role of DNA content abnomrality in solid tumors as a diagnostic indicator in Korean patients, the incidence of aneuploidy in the major organs were analyzed and compared with the incidences which have been reported in the literatures.
MATERIALS AND METHODS
Flow cytometric analysis of DNA content were performed on the 1673 fresh tissues of neoplastic lesions which were obtained for the last five years in Hospital.
RESULTS
The frequency of aneuploidy was more than 50% in the primary malignant tumors of the stomach, colon, esophagus, liver, biliary tract, pancreas, head and neck organs, salivary gland, lung, breast, ovary, CNS and urinary tract. However, the frequency of aneuploidy was as low as 7% in papillary carcinoma of thyroid and about 30% in renal cell carcinoma and malignant lymphomas. High frequency of aneuploidy (more than 70%) was seen in the metastatic tumors in liver, brain, ovary and lymph nodes. Aneuploidy was also found in benign tumors of salivary gland, adenomas of endocrine organs, meningiomas, smooth muscle tumors and schwannomas.
CONCLUSION
The results of present study were in concordant with those of the other domestic and foreign studies. Although aneuploidy can be observed in some benign tumors, DNA ploidy pattern is considered to be an important diagnostic and prognostic factors in malignant lesions of the various organs.

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Case Report

A Case of Spontaneous Regression of Small Cell Lung Cancer: Gun Young Hong, Jong Seo Park, Sung Sik Ruy, Sung Jin Kang, Yong An Woo, Myung Won Kang, Yeun Keun Lim, Hyang Soon Yeo, Hun Nam Kim; J Korean Cancer Assoc. 1998;30(6):1294-1298.

Abstract PDF: Small cell lung cancer is the most aggressive tumor among lung cancers and has a greater tendency to be widely disseminated by the time of diagnosis. Without treatment, the median survial time of small cell lung cancer patients is only 2~4 months. However, though spontaneous regression of the malignant tumor has been frequently reported, spontaneous regression of the small cell lung cancer is rare. In this study a spontaneous regression of the small cell lung cancer is reported, along with a brief review of the literature. A 69 year-old woman was admitted for an evaluation for dyspnea. A chest roentgenogram obtained on admission revealed an abnormal mass shadow at the right hilus. She was diagnosed as having small cell lung cancer through a bronchoscopic biopsy. However this tumor regressed spontaneously without specific treatment after 12 months.

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