Cases Of Mild Dysplasia Research Articles

Risk of gastric carcinoma in patients with mucosal dysplasia associated with atrophic gastritis: a follow up study.

To assess the risk of gastric carcinoma in patients with histologically verified dysplasia and atrophic gastritis of the stomach. One hundred and one patients with mild (n = 84), moderate (n = 14), or severe (n = 3) dysplasia among 359 elderly men who smoked underwent gastroscopy because of low serum pepsinogen. Patients with dysplasia were prospectively followed up for an average of four years with repeated gastroscopies and multiple biopsies. Four of the 84 (4.8%) cases of mild dysplasia had progressed to moderate dysplasia during the follow up. Most of the cases of mild dysplasia had resolved spontaneously. No surgical intervention was required. Three of the 14 (21%) cases of moderate dysplasia had progressed to severe dysplasia, but no carcinomas were observed during follow up. Five moderately dysplastic lesions were removed surgically or endoscopically. In two of these five cases, moderate or severe dysplasia recurred. Two of the three severe dysplasias progressed to carcinoma. In atrophic gastritis progression of mild and moderate dysplastic lesions seems to be a slow process and is rare in mild dysplasia. However, severe dysplasia is highly predictive of subsequent cancer. It is suggested that a five year follow up interval is sufficient in cases with mild dysplasia and two years in those with moderate dysplasia. Local removal of moderate dysplasia is indicated but does not guarantee that the lesion will not progress. Severe dysplasia requires immediate surgical intervention.

P53 Overexpression in laryngeal squamous cell carcinoma and dysplasia

Aim-To investigate the expression of p53 protein in invasive squamous cell carcinoma (SCC) of the larynx and dysplasia in relation to histological grade and tobacco smoking.Method-Paraffin wax embedded tissue sections from 41 cases of invasive SCC of the larynx, 28 cases of dysplasia and 14 control laryngeal biopsy specimens were studied immunohistochemically using two anti-p53 monoclonal antibodies (DO7 and 1801). The Streptavidin/horseradish peroxidase method was used after microwave antigen retrieval and a semiquantitative method was applied to assess the extent of p53 expression.Results-Of the cases of invasive SCC of the larynx, 78% (32/41), regardless of histological grade, overexpressed p53 compared with only 30% (eight of 28) of cases of mild dysplasia. A gradual increase in p53 expression from mild to severe dysplasia (60%) was observed, and only three of 14 control biopsy specimens of laryngeal nodules showed occasional weakly positive basal cells.Conclusion-The gradual increase in p53 expression from mild to severe dysplasia to invasive SCC indicates that p53 overexpression is an early event in laryngeal carcinogenesis which may lead to invasive malignancy. p53 overexpression may be related to environmental factors as most of the patients smoked tobacco. Microwave postfixation may be essential for the reliable detection of p53.

子宮頸部前癌および初期癌に対するlaserthermiaの効果

To investigate the effect of laserthermia in CIN, we performed fundamental study and clinical trial, using Nd-YAG laser. As the result of fundamental study using OMC-i which was established from a uterine cervical squamous cell carcinoma, the antitumor effect of laserthermia was confirmed. We devised aluminium reflector, in which Intralipid dilution injected, as a novel method of laserthermia in the uterine cervix.Laserthermia was performed in 15 patients included 8 cases of mild dysplasia, 6 cases of severe dysplasia and 1 case of intraepithelial cancer. Seven cases (46.7%) showed disease free after three months of laserthermia. Therefore, although irradiation method needs to be improved further, laserthermia is considered that it should become a useful therapeutic method in the future for the CIN.

Morphometric analysis of gallbladder adenocarcinoma: Discrimination between carcinoma and dysplasia

To characterize the cytological features of well differentiated adenocarcinoma of the gallbladder, a comparative morphometric analysis was made using 35 histologically classified cases of invasive well differentiated adenocarcinoma, 13 cases of mild dysplasia, 19 cases of severe dysplasia, and 22 control gallbladders. The variables analyzed were nucleocytoplasmic (N/C) ratio and nuclear area (N.A.). Both the mean values of N/C ratio and N.A. demonstrated a progressive increase from control to mild dysplasia, to severe dysplasia and to carcinoma. The differences were statistically significantly different. Discriminant analysis was made with a set for learning and a set for testing, selected from the 89 lesions with random numbers. Using this discriminant function, all the cases except one carcinoma were discriminated as carcinoma, and all the cases of control, adenoma, and mild dysplasia were discriminated as benign lesions. However, cases of severe dysplasia were subdivided into benign or malignant. These results indicate that morphometric analysis clearly differentiates carcinomas from benign lesions, and that the dysplastic mucosal lesions can be divided into benign and malignant, although some difficult borderline lesions exist.

The demonstration of papilloma virus in cervical dysplasia and/or neoplasia.

Thirty-three random biopsy specimens of uterine cervix were studied by immunoperoxidase technique to evaluate the presence of HPV antigen in dysplastic and neoplastic cells. Four cases of mild dysplasia, nine cases of moderate to severe dysplasia, two cases of carcinoma in situ and one case of invasive carcinoma were associated with condylomatous lesions. Intranuclear dark-brown precipitates were observed in superficial and intermediate zones of the dysplastic epithelium. Positive reaction was seen in condylomatous epithelium associated with neoplasia. No nuclear precipitates were observed in carcinoma cells, but one noncondylomatous lesion with moderate dysplasia showed positive intranuclear staining. These preliminary findings suggest that papilloma viruses may play a role in the development of human cervical neoplasias.

多変量データ解析法を用いた口くう領域悪性しゅようの細胞解析

The aim of this study was to characterize the nuclear atypia of cells for oral cancer in order to establish its new diagnostic criterion from a data analysis point of views, 171 exfoliative normal oral epithelium cells (BEN) from nine cases and 290 exfoliative squamous cell carcinoma cells (MAL) from 15 cases were sampled and examined. After Feulgen staining the nuclear DNA were measured by an autoscanning microphotometer connected to a computer. Multivariate statistical analysis was applied to these measurements. The analysis consisted of 1) analyzing the nuclear atypia of MAL from its varied aspects, 2) detecting MAL by using the linear discriminant analysis, and 3) establishing diagnostic criterion of the cases rather than the cells. The atypia scores of the cells were treated in each case and the malignancy score (MGD: the degree of deviation from the barycenter of the normal cases) was calculated and predicted based upon the mean score of one case and the score of the cell with the severest atypia of this case.This method was applied to 24 new cases and the diagnostic results were evaluated 2/3 of the normal cases and 1/2 of the cases of mild dysplasia were evaluated benign, whereas 1/2 of the cases of severe dysplasia and carcinoma in situ and 17/17 of invasive carcinoma were evaluated malignant. Satistical study was attempted on the relationship between the diagnostic results obtained by the present method and the following; 1) level of histological differentiation and 2) clinical course. When MGD values of squamous cell carcinoma cases were compared with the calssification of Broders, Broders I group showed a tendency of having a lower value than those of groups II, I, and IV. As for the clinical course of invasive carcinoma cases, a comparison was made of the MGD values of the surviving satisfactory group showing neither recurrence nor metastasis during the follow-up period of more than two years and of those of the unsatisfactory group which died of tumor. The results of this comparison showed that the MGD values of the unsatisfactory group had a tendti to have a higher value than that of the satisfactory group. This approach of cytoanalysis was useful for the diagnosis and the prognostic estimation of oral cancer.

Cancer risk in diethylstilbestrol-exposed offspring

The occurrence of columnar epithelium in the vagina (vaginal adenosis) in young women with intrauterine exposure to diethylstilbestrol (DES) during the first trimester of pregnancy was observed in 231 patients (82 per cent of 280 cases who underwent colposcopic study.) Extension of columnar epithelium onto the portio of the cervix was present in the remaining 18 per cent of the cases. Abnormal colposcopic findings were present in the transformation zone in 96 per cent of the patients with vaginal adenosis. Directed biopsy revealed four cases of vaginal and/or cervical squamous carcinoma in situ (CIS), two cases of severe dysplasia, five cases of moderate, and 29 cases of mild dysplasia. The prevalence of CIS in DES-exposed girls (1.4 per cent) was nearly five times the prevalence rate of CIS in a control group of 5,808 DES-unexposed women (0.44 per cent). This finding correlates well with the hypothesis that the genesis of squamous intraepithelial neoplasia is specifically related to the extent and surface area of the vaginal transformation zone. An unusual case of invasive squamous carcinoma in a DES-exposed young girl is presented, which represents the initial observation of this association to date.

Cytological follow-up of 200 women using copper device for contraception

Two hundred women who used copper devices for contraception were followed by cytological smear examination to study the effect of copper on the cervical epithelium. A pre-insertion smear was taken in all cases and follow-up smears were obtained every six months. The study covered the period from August 1971 to September 1975 amounting to a total of 3754 woman months of use. Twenty-one women have satisfactorily completed 36 months of use. Ten cases of mild dysplasia, 6 cases of moderate dysplasia and one case of severe dysplasia were detected and followed.

Microspectrophotometric studies of DNA contents in various lesions of the uterine cervix

The following conclusions were drawn from the microspectrophotometric studies of DNA contents of various lesions of the uterine cervix.Measurements were made of the DNA contents of the specimens as follows: normal squamous epithelium (two cases);low high and equivocal dysplasias (eight cases);carcinoma in situ (three cases);invasive cancer that had carcinoma in situ lesions just above the cancer nestles (three cases).1.In the cases of normal squamous epithelium, the predominance of diploid DNA value was characteristic of its mode, and its distribution was confined between diploid and tetraploid levels.2.The cases of low dysplasia gave different histog rams of the layers.At the basal layer, 8 n or greater DNA values were recognized, while such irregularities were diminished as the layers went up, and finally in the fourth layer the whole histogram was confined mostly between diploid and tetraploid range.3.In the cases of high dysplasia, the distribution of DNA was ranged further wider, spreading beyond 8n. The gradual narrowing of histograms as observed in the upper layers of the cases of mild dysplasia was absent here.However, in the case where modes were recognizable, they tended towards the lower value as the layer went up.4.In the cases of equivocal dysplasia, histograms showed a broader range of DNA distribution, some including as much as 10n or even larger values.There was no discrepancy between the respective layers.The mode, if any, stayed on a single definite value, regar dless of layers.5.The cases of carcinoma in situ tended to show a wider range of DNA distribution than the cases of equivocal dysplasia did.The second or the third layer gave a broader histogram than the basal layer and sometimes the fourth layer had the widest DNA distribution.And such a trend was also recognized that the values of DNA became higher as the layers went up.6.Comparison made between the histograms of carcinoma in situ lesions that had cancer nestles developed underneath and those of carcinoma in situ lesions without invasive cancer nestles demonstrated that there was no significant difference between them.7.From these data the following conclusions were drawn: high dysplasia and equivocal dysplasia were precancerous lesions, and carcinoma in situ, malignant lesions.8.Comparison between the histograms of carcinoma in situ lesions and cancer nestles taken from one tissue demonstrated a clear difference in their patterns: in other words, the histograms of the invasive cancer tend to have the mode in hyperdiploid or hypertetra ploid.It appears that this may be attributed to the possible presence of stem cells in cancer of the uterine cervix as suggested by Makino.