• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.6
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• pp.594-601
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• 2008

Cervical lymph node metastasis is one of the most important predicting factors that influence the prognosis of oral squamous cell carcinoma. Correct diagnosis on cervical lymph node metastasis is essential in determining the extent of operation and treatment modality. So we investigated a clinico-statistical evaluation on cervical lymph node metastasis in 183 patients who were diagnosed with oral squamous cell carcinoma at the Department of Oral and Maxillofacial Surgery in Kyungpook National University Hospital, from January 1st, 1999 to December 31st, 2007. The following results were obtained : 1. Among 183 patients who were diagnosed with oral squamous cell carcinoma, 149 were male and 49 were female. The average age of the patients was 61.8 years old. 2. Patients with advanced T classification showed higher incidence of cervical lymph node metastasis than those with lower T classification. 3. Patients with less differentiated tumors had higher tendency of manifesting cervical lymph node metastasis than those with more differentiated tumors. 4. Sensitivity and specificity on PET/CT was 87.5% and 58.3% respectively. PET/CT showed higher sensitivity and lower false-negative values than those of CT or USG. 5. The 5 - year survival rate of all the oral squamous cell carcinoma patients appeared to be 63.2% By N classification, patients in N0 stage showed a higher survival rate than patients in N1 or N2. 5 - year survival rates according to the modality of neck dissection were as follows in increasing order: no neck dissection group, MRND group, SND group, and RND group.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.4013-4017
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• 2016

Background: To compare the pathological findings and oncologic outcomes of stage IA cervical carcinoma patients, between adenocarcinoma and squamous cell carcinoma cases. Materials and Methods: A total of 151 medical records of stage IA cervical carcinoma patients undergoing primary surgical treatment during 2006-2013 were reviewed. Information from pathological diagnosis and recurrence rates were compared with descriptive statistical analysis. The Kaplan-Meier method and Cox proportional hazards model were used for survival analysis. Results: The median age was 48.9 years. There was no significant difference in rates of lymph node, parametrium, uterine, vaginal, or ovarian metastasis, when comparing adenocarcinoma with squamous cell carcinoma. Overall recurrence rates of adenocarcinoma (5.7%) and squamous cell carcinoma (2.6%) were not statistically significant different, even when stratified by stage. When comparing progression free survival with squamous cell carcinoma, adenocarcinoma had an HR of 0.448 (0.073-2.746), p=0.386. Conclusions: Microinvasive adenocarcinoma of cervix has similar rate of extracervical involvement and oncologic outcomes to squamous cell carcinoma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.3
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• pp.133-138
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• 2016

Objectives: To assess the association between muscle invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis on the basis of preoperative magnetic resonance imaging (MRI). Materials and Methods: Twenty-six patients with oral squamous cell carcinoma of the posterior mandibular alveolar ridge were evaluated by MRI. The associations between cervical lymph node metastasis and independent factors evaluated by MRI were analyzed. Overall survival was also analyzed in this manner. Representative biopsy specimens were stained with anti-podoplanin and anti-CD34 antibodies. Results: Mylohyoid muscle invasion was associated with cervical lymph node metastasis. A combinational factor of mylohyoid and/or buccinator muscle invasion was also associated with cervical lymph node metastasis. Cervical lymph node metastasis and masticator space invasion had a negative effect on overall survival. No lymphatic vessels were identified near the tumor invasion front within the mandible. In contrast, lymphatic vessels were identified near the front of tumor invasion in the muscles. Conclusion: This study demonstrates an association between muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.147-151
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• 2000

Background and Objectives： Metastasis to the submental and submandibular lymph nodes rarely occurs in squamous cell carcinoma of the larynx and hypopharynx. The aim of this study is to evaluate the effectiveness of level I neck dissection in squamous cell carcinoma of larynx and hypopharynx. Materials and Methods : Forty-three patients with pathologically positive cervical nodal involvement in squamous cell carcinoma of larynx and hypopharynx treated between 1989 to 1998 were reviewed. Fifteen patients were treated with neck dissection including level 1,28 patients were treated with neck dissection excluding the level 1. Results : The regional recurrence at the level I in patients treated with neck dissection excluding the level I, was shown in only one case (recurrence rate 3.6%), but this patient was efficiently managed with salvage operation and adjuvant radiotherapy. No recurrence was shown in patients treated with neck dissection including the level I. So, total recurrence rate at the level I was 2.3%. Conclusion : This study suggests that dissection of the level I is not justified in squamous cell carcinoma of larynx and hypopharynx even if metastasis to cervical lymph node was confirmed preoperatively (cN+).

• The Korean Journal of Cytopathology
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• v.12 no.1
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• pp.31-37
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• 2001

Whlie cytologic characteristics of squamous dysplasia, carcinoma in situ, and invasive squamous cell carcinoma of the uterine cervix are well documented, relatively few studios have dealt with the cellular features of microinvasive carcinoma. In order to describe the cellular characteristics of microinvasive squamous cell carcinoma, we retrospectively reviewed 45 cervovaginal smears(15 carcinoma in situ, 15 microinvasive cancer, 15 invasive cancer) which were confirmed by histologic examination of specimens obtained by hysterectomy at the Seoul National University Hospital during S years from 1995 to 1999. The cytologic features about tumor diathesis, inflammatory background, ceil arrangement, anisonucleosis, nuclear membrane irregularity, nuclear chromatin pattern, and nucleoli were observed. The cytologlc characteristics of microinvasive squamous cell carcinoma of the uterine cervix are syncytial pattern, mild tumor diathesis, the irregularity of nuclear membrane, irregularly distributed nuclear chromatin, and occurrence of micronucleoli. But, correlation between the depth of Invasion and the cytologic feature had limited value.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8145-8147
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• 2016

Background: Atypical squamous cells of undetermined significance (ASCUS) feature a wide variety of cervical cells, including benign and malignant examples. The management of ASCUS is complicated. Guidelines for office gynecology in Japan recommend performing a high-risk human papillomavirus (HPV) test as a rule. The guidelines also recommend repeat cervical cytology after 6 and 12 months, or immediate colposcopy. The purpose of this study was to determine the clinical significance of ASCUS. Materials and Methods: Between January 2012 and December 2014, a total of 162 patients underwent cervical conization for cervical intraepithelial neoplasia grade 3 (CIN3), carcinoma in situ, squamous cell carcinoma, microinvasive squamous cell carcinoma, and adenocarcinoma in situ at our hospital. The results of cervical cytology prior to conization, the pathology after conization, and high-risk HPV testing were obtained from clinical records and analyzed retrospectively. Results: Based on cervical cytology, 31 (19.1%) of 162 patients were primarily diagnosed with ASCUS. Among these, 25 (80.6%) were positive for high-risk HPV, and the test results of the remaining 6 patients (19.4%) were uncertain. In the final pathological diagnosis after conization, 27 (87.1%) and 4 patients (12.9%) were diagnosed with CIN3 and carcinoma in situ, respectively. Conclusions: Although ASCUS is known as a low-risk abnormal cervical cytology, approximately 20% of patients who underwent cervical conization had ASCUS. The relationship between the cervical cytology of ASCUS and the final pathological results for CIN3 or invasive carcinoma should be investigated statistically. In cases of ASCUS, we recommend HPV tests or colposcopic examination rather than cytological follow-up, because of the risk of missing CIN3 or more advanced disease.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.13-18
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• 2004

Objectives: Cancer lethality is usually the result of local invasion and metastasis of neoplastic cell from the primary tumor. Because of their ability to degrade extracellular matrix components, matrix metalloproteinases (MMPs) and basic fibroblast growth factor (bFGF) have been implicated in the breakdown of basement membrane and underlying stroma, thereby facilitating tumor growth and invasion. It has been well established that MMPs and bFGF expression correlate with cervical lymph node metastasis, but studies on expression in the metastatic cervical lymph node itself are not enough. We have analyzed matrix metalloproteinases (MMPs) and basic fibroblast growth factor (bFGF) in squamous cell carcinoma of the head and neck and metastatic cervical lymph node, and evaluated their relationship and clinicophathologic significance. Material and Methods: 20 cases of squamous cell carcinoma of the head and neck were entered on the study of immunohistochemical stains for MMP-9 and bFGF in the obtained tissue from primary tumor and metastatic cervical lymph node. We analyzed the relationship between MMP-9, bFGF expression of the primary tumor and metastatic node with age, sex, T-stage, N-stage, histologic grade, pathologic stage and disease free survival. Results: Expression of MMP-9 and bFGF in cancer cell and metastatic lymph node was higher than that in normal cell and lymph node. According to histologic differentiation, expression of MMP-9 of the metastatic cervical lymph node was higher than primary tumor. Considering to other clinicopathologic factor, no statistical significance was seen in MMP-9 and bFGF. Conclusion: We found that expression of MMP-9 is higher in the metastatic lymph node than primary tumor in the poorly differentiated squamous cell carcinoma. But we don't find out the statistical significance in relation between bFGF and clinical factors. So we guess that some different mechanism of MMP-9 and bFGF in Head & Neck squamous cell carcinoma exist. Further studies will be necessary to establish their pathogenesis in the Head and Neck cancer.

• Korean Journal of Clinical Laboratory Science
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• v.37 no.3
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• pp.197-206
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• 2005

To determine the correlation between mast cells(MCs) and neoangiogenesis in the growth and progression of cervical cancer, we investigated mast cell density(MCD), microvessel density(MVD) and the expression of vascular epithelial growth factor(VEGF) in cervical intraepithelial neoplasia and invasive suqamous cell carcinoma of the uterine cervix. Forty-five cervical intraepithelial neoplasia(CIN I, II and III), 15 microinvasive carcinomas, 15 invasive squamous cell carcinomas and 20 normal cervical epithelia were included in this study. MCs were stained with anti-c-Kit antibody and alcian blue, microvessels with anti-factor VIII antibody and VEGF with anti-VEGF antibody. The adjacent fields of both normal and neoplastic epithelium were used for counting MCs and microvessels. Computerized image analysis was used to evaluate MCD and MVD. MCD and MVD were the mean numbers per $1mm^2$ counted in 5-10 high and low power fields respectively. In both c-Kit and alcian blue stained sections, MCD progressively increased along the continuum from CIN I to invasive squamous cell carcinoma(p<0.001). MVD increased significantly with cervical neoplasia progression, from CIN to invasive squamous cell carcinoma (p<0.001). In double c-Kit and Factor VIII-stained sections, MCs were mainly present in the areas adjacent to newly formed blood vessels. However, there were no significant differences in MCD and MVD between normal epithelum and CIN I. A strong correlation was also observed between MCD and MVD. In double VEGF and alcian blue-stained sections, VEGF was expressed in only MCs. Strong VEGF-positive MCs were particularly abundant around the tumorous region. Our results suggest that MCs may upregulate neoangiogenesis by VGEF secretion in the development and progression of cervical neoplasia.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.645-648
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• 2005

Cutaneous horn is a morphologic designation for a projectile, conical, dense hyperkeratotic nodule that resembles the horn of an animal. The lesion varies in size from only a few millimeters to several centimeters, in color(white or yellowish) and in form (straight, curved, or twisted). It arises from a wide range of epidermal lesions, which include benign lesions, premalignant lesions and malignant lesions. An 83-year-old women came to our clinic with a giant cutaneous horn on the right chin and a small horn on the left upper eyelid. The patient had no palpable cervical lymph node. A wide elliptical skin incision was made and the horn was totally excised. In pathology, the giant cutaneous horn on the right chin revealed a moderately differentiated squamous cell carcinoma with subcutis invasion at its base. "Giant cutaneous horns" have often been associated with invasive squamous cell carcinoma. Cutaneous horns are common lesions usually found on the face, rarely larger than 2 cm. As large cutaneous horns are often associated with underlying malignancy, histopathologic examination of the base of the lesion is necessary to rule out carcinoma and full excision is recommended.

• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.96-101
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• 1999

For many years it has been reported that seemingly benign neck cysts may contain carcinoma. Cystic metastases have often mistaken for either branchial cleft cysts or benign mass. Authors experienced two cases which presents cystic cervical metastatic cancer One was a tonsillar carcinoma and the other was a tongue carcinoma. Patients with a cystic squamous carcinoma in the neck likely have a primary in upper aero-digestive system and It is known that the tonsil is most common site. Radiologic examination and fine needle aspiration biopsy of the cyst proved to be non-diagnostic. The development of cervical lymph node metastases before clinical signs of carcinoma of the tonsil is also well recognized. So, in old patients, thorough head If neck examination, panendoscopy and ipsilateral tonsillectomy is mandatory to identify a primary carcinoma prior to cyst excision.