Cancer Research and Treatment

Tumors of Central Nervous System - Histological Analysis of 327 Cases among Koreans -: Je G. Chi, Hyun Soon Lee, Myung Sook Kim, Chul Woo Kim; J Korean Cancer Assoc. 1980;12(1):3-24.

Abstract PDF: A total of 3?7 cases of primary intracranial and intraspinal tumors was obtained from the Pathoiogy file of Department of Pathology, Seoul National University Hospital during a period of 17 vears beginnig from 1963 to December 1979. These tumors werc divided sccording to modified WHO classification, and the results were tabulated in Table 2. There were 250 intracranial tumors and 77 instraspinal tu nors. Among intracranial tumors giioma, meningioma and pituitary adeno:na were more commonly seen to be 29%, 19% and 17%, respectively. In pocliatric age group (under 17 years of age) supratentorial tumor was more frequent than infratentoriai or spinal.tumors. Among intracranial tumors of childhood, astrocytoma and merlui1oblastama were commonly encountered. Microcystic astrocytoma of tbe cerebellum appeared to be histologically unique tumor. There were 26 metastatic brain during tbe same period.

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Histopathological Study on Tumors of Urinary System: Sang Kook Lee, Hyun Soon Lee, Tae Dong Park; J Korean Cancer Assoc. 1980;12(1):25-32.

Abstract PDF: A histopathological study was made with the 233 cases of urinary tract tumors. All these tumors wer.e submitted for histologic examination to the Department of Pathology, College of Medicine, Seoul National University Hospital during a period of 10 years from 1970 to 1979. These tumors consisted af 41 cases of renal tumor, 184 cases of bladder tumor, and 8 cases of ureter and urethral tumor. Forty one renal tumors consisted of 21 cases of renal cell carcinama and 6 cases of Wilms tumor, 12 cases of renal pelvis tumor, 1 case of cortical adenoma and 1 case of angiomyolipoma. Renal cell carcinoma reveals male female ratio as 2. 6 to 1. one hundred eighty four cases of urinany bladder tumor consisted of 5 cases of papilloma,171 cases of transitional cell carcinoma, 4 cases of squamous cell carcinoma, 2 cases of adenocarcinoma, and 2 cases of sarcoma. Male female ratio was 3. 7 to 1. Seventy per cent of all patients was distributed between 40 and 70 years. Average age of transitional cell carcinoma was 54. 6 years. Distr- ibution of grade of transitional cell carcinoma comprise4 of grade I (90 cases), grade ll (66 cases), grade III (15 cases). Ureter tumors, though 5 cases, are all transitional cell tumora and urethral tumors consisted of I case of verrucous carcinoma and 2 cases of benign neoplasm.

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Primary Malignant Epitelial Neoplasms of the Liver in Korea - Part 1 . Reclassification and Mode of Histological Growth Pattern in 302 Cases -: Yong Il Kim, Chul Keun Park, Jung Ran Kim, Ja June Jang; J Korean Cancer Assoc. 1980;12(1):33-54.

Abstract PDF: The etiological impacts in primary carcinama of the liver among .Koreans differ from those is western countries as with its high incidence anri unusual association of preneoplastic conditiens, requiring an unique criterion-setting on histopathologic description and the aaeurate prevalence rate in each types and groups. Three hundred and two cases of primary malignant epithelial neoplasm of the liver were reclasaified in accordance with two-way specifications of histological growth patterns and cytological features, and the mode of growth in each of hepatocellular carcinoma wae discussed along with degree of differentiation, atromal reaction and functional expressions. Of 302 cases, hepatocellular carcinoma(HCC) comprised 87. 4%, cholangiocarcinoma (CC) 8.3%, combined carcinoma L3% and hepatoblastoma 3.0%, respectively. The male to female ratio waa 4. 8: 1 in overall ceses. Trabecular structure was essumed as a baaic histological growth pattern of HCC. from which all other variants developed by imbalance of growth rate between neop1astic hepatocytes and stramal reactian. purther subolassification of HCC was rationalized by cytologlc features of neoplaetic celle, raaging from cirrhotomimetic (84.1%) to pleomorphic (9.5%), clear cell (5. 7%) and spindle cell groups (0. 7%) in order af fnquency. The combination of these two criteria seems to provide more accurate and sufficient informations not only for morpholagical differential diagnoeis but also in evaluation of clinical prognosis in HCC. Eight percent of clear cell group wae found to be a variant by excessive accumulation of glycogen within the reoplastic cells, and the rest by neutral fatty suhstance. which required careful seatch for differential diagnoais -from aon-neoplaatic steatosis. Degree af cellular differentiation was indirectly reflected by cytological features, and its grading eeemed an unreliable indicator for clinical correlatioa because of ita subjectivity of criterion-setting and limited reproducibility. Functional expressian of HCC such as bile production, glycogen storage and teatosis was the secondary morphological manifestation of differentiated neoplastic hepatocytes with limited significance as a separate heading for biological behavior. Three types of intracellular inclusiona were presented. and their morphogeneais and etiolagical implication were emphasized. Hyaline globule was found in 10.3% of HCC, and was discussed along the line of relationship to alpha-1-antitrypsin and HBsAg. A case of so-called easinophilic hepatocelJ,ular carcinoma with lamellar fibrosis, the first proven case in Korea, was included in this study. and histological characteristics and frequency of cholangiocarcinomas and hepatoblastamas were analized. It seems appropriate that the above two-way specification is essential and valid for the determination of carcinogenesis snd prognosis in HCC especially in Korea, and should be applied for a baseline criterion in interpretation of statistical data.

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Tumors of Peripheral Nervous System - Histological Analysis of 434 Cases among Koreans -: Je G. Chi, Geung Hwan Ahn, Young Ki Shong; J Korean Cancer Assoc. 1980;12(1):55-71.

Abstract PDF: A total of 434 tumors of the peripheral nerve and neuroectodermal tissue is hiatologically analyzed. These tumors were collected from Department of Pathology, Seoul National University, during a period of 17 years from January 1963 to December 1979, After critical review of the diagnosis of tumars and their clinical data we have obtained following informations. l. Among 434 tumors in this series there were 174 cases of neurilemmoma, 72 cases of solitary benign neurofibroma, 128 cases of neurofibromatosis, 25 cases of neurogenic sarcama (malignant schwannorna), 29 cases of neuroblastoma, 4 cases ot ganglio- neuroblaatoms and 2 cases of ganglioneuroma. 2. Neurilemmoma was found more frequently in sofc tissue(61%) and spinal canal(25%), and the remainder occured in cranial cavity. The average age was 39.7 years and sex ratio was I: 1.1. 3. Seventy two cases of. solitary benign neurofibroma occurred mostly in soft tissue(93%). The remaining fivc cases occurred in spinal canal. Among soft tisaue tumors, head and neck were the sites in 23 cases, trunk in 23 cases and extremities in 21 cases. In 9 cases we could identify the nerve trunk from whicb the tumar arose. Among these cases sciatic nerve was the most common. 4. Neurafibromatosis was usually characterized by plexiform pattern of the tumors. However, cutaneous involvement did not show charactersitic plexifrom structure. In this series there was not a aingle case of malignant transformatian among 12S neurofi- bromatosis. 5. There were 25 cases of malignant schwannoma. Among those 23 cases occurred in soft tissue and the remaining two cases accurred in the spinal canal. The site distributioa of soft tissue neurogenic sarcomas was 13 in trunk, 6 in extremities, and 4 in head and neck. 6. Twenty-nine neuroblastomas occurred most frequently in adrenals and retroperitoneum(86%). The remainder occurred in mediastinem(2 cases), nasal cavity(1 case) and spinal(1 case). average age of neuroblastomas was 8.6 years and sex ratio was 1.9:1.

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Histochemical NBT test in Various Diseases: Byung Soo Kim, Baek Keun Lim, Chang Joon Coe, Ki Young Lee, Kir Young Kim; J Korean Cancer Assoc. 1980;12(1):71-78.

Abstract PDF: NBT(Nitroblue tetrazolium) reduction by phagocytic leukocytes was investigated histochemically in 188 cases with and without infections. The mean proportion of NBT positive neutrophis was 10.67 +- 6.24% in healthy children, 30.52 +- 10.48% in healthy newborn infants. Patients with bacterial infection had a mean count of 23.75 +- 10.85, patients with non-infectious illness had a mean count of 10.5 +- 6.14%, Patients with bacterial infection, differ significantly from patients with non-bacterial infection, non-infectious illness. The histochemical NBT test would appear to be a useful adjuntive to microbiologic technique in establishing the diagnosis in patients with suspected bacterial infections.

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A Clinical study of Periampullary Carcinoma: Woo Song Ha, Jin Pok Kim; J Korean Cancer Assoc. 1980;12(1):79-90.

Abstract PDF: This paper present 78 patients with periampullary carcinoma, whose medical records were available and who received laparotomy at the Department of Surgery of S.N.U..H. from May 1974, to may 1980. The results were as follows: 1) 51. 3% of ail periampuliary carcinoma were of pancreas head, 35. 9,. were of distal cammon bile duct, 7. 7,. were of ampulla of Vater, and 5. 1were of duodenum. 2) Male to female ratio was 1. 9: 1 and average age was 57. 3 years. 3) Chief complaints were jaundice (46%), abdominal pain (30.8%), fever and chill(3.8), indigestion,(3. 8%), back pain (l.3%), and hematemesis (l.3%). Average duration of chief complaints was 2. 9 Months. 4) Freguent subjective symptoms were jaundice (80.8%), RUQ pain (43.6%), epigastric pain (42.3%), Pururitus (30.8%), fever % chill (28.2%), anorexia (28. 2%), weakness (25.6%), inriigestion (23.1%), nausea and vomiting (9. 0%), GI bleeding (5.1%) and back pain (3.8%). 5) Frequent physical findings were hepatomegaly (66.7%), wt loss (48.7%), palpation of gailbadder (19. 5%), RUQ mass (28. 2%) and ascites (10.3%). 6) Importan#t laboratory findings were reversed A/G ratio (66. 2%), increased alkaline phosphatase (85. 7%), increased bilirubin (74. 4%), increased SGOT(74.4%), increased SGPT (57.7%) and prolonged pnthrombin time (20.8%). On stool examination occult blood was positive in 48.1%. 7) Most effective method of investigation was P.T.C. The rate of abnormal find- ings of P.T.C. was 94.6%, oral GB & IVC were 90% ultrasonography was 87. 5%, ERCP was 85.7%, Liver scan was 78.4%, HTD was 70.0%, and UGI was 58.1%, 8) Diagnostic accuracy of periampullary carcinoma was 70. 5%. 9) Whipple procedures were performed on 21 patients, palliative procedures on 44 patients, and biopsy only on 13 patients. Resectability of perjampullary carcinoma was26.9%. 10) In 21 patients who received whipple procedures, absence of metastasis to regional lymphnodes was 38.1%. 11) Postoperative bilirubin level was decreased in 83.3% of whipple procedures, and 47.5% of palliative procedures. 12) Postoperative compoications occured of 26.9% of perlampllary carcinoma, and operative mortalicy was 19.2%. 13) Average survival rate of periampullary carcinoma was 10.7 months. the 1 year survival rate was 37.5% overall, the 2 year survival rate was 12.5%, the 3 year survival rate was 6.5%, and the 4 year survival rate was 3.2%.

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A Study on the Relationship beween Cellular Replicative Activity and Malignant Tumor: Seung Ho Um, Min Chul Lee, Dale Lee; J Korean Cancer Assoc. 1980;12(1):101-106.

Abstract PDF: Every cell type has the capability of giving rise to cancer and, in general, the greater tbe replicative activity, the greater the cancer risk. However, there is neitber report on the extent of each cellular type of human body classified by cellular replicative activity, nor attempt to classify human malignant tumor by replicative activity of tissue of origin. The author tried to divide human body by 3 types of cell, so called, labile, stable and permanent cell, and calculated their percentage based on Forbes data on the gross composition of tbe adult body. And 1074 cases of malignant tumors diagnosed during 1976 1979 at Korea University Hospital were classified into labile, stable and permanent cell origin cancer based on replicative actvity of their tissue of origin. The data obtained are as following. l. Among tbe total cellular weight of adult human body, labile cells accounted for about 26%, and malignant tumors originated from this part occupied 83. 80% (900cases) of total 1074 cases. 2. Extent of stable cells in adult human body was about 14%, and percentage of malignant tumor from this part was 14.80%(159cases). 3. About 60% of adult human body was composed of permanant cells, but only 0. 37% (4cases) of malignant tumors were originated from this part. Above findings support the general knowledge.that the greater the replicative activity, the greater the cancer risk.

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A Histopathological Study of Primary Lung Tumors: Eui Keun Ham, Shin Kwang Khang, Yoon Seong Lee; J Korean Cancer Assoc. 1980;12(1):107-116.

Abstract PDF: Four hundred and eighty cases of primary 1ung tumors were presented during the period of 1Z years from 1968 to 1979 in the Department of Pathology, CoIiege of Medicine, Seoul National University. Authors. classified them histopathologically according to the W.H.O. international classification of diseases for oncology, and studied on their occurence, prevalence and frequency with clinical information, and the results obtained were as follows. 1. Sixth and seventh decades of life were predominant in their morbidity. 2. Incidences by histopathologic classification were made as epidermoid carcinoraa: 47. 7%, small cell anaplas'tic carcinoma: 16. 9%, undifferentiated large cell carcinoma: 16.3%, and adenocarcinoma: 10.4%. 3. Male was dominant to female in sex difference incidence(5:1), especially on epidermoid carcinoma and small cell anaplastic carcinoma. 4. Among the group of smokers, epidermoid carcinoma and small cell anaplastic carcinoma showed high incidence, while no recognigible difference was noted in histopathol.ogic type among the non-smokers. 5. Cough was the most common (32.1%) chief complaint, and others were dyspnea, chest pain, hoarseness, and general weakness in order. Durations of the chief complaints were less than 6 months in most cases. 6. Frequent metastatic lesions were mostly cervical and supraclavicular lymph nodes (32.3%) and pleura (15.0%).

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