Histological Classification Of Tumours Research Articles

SOLUBLE FORMS OF THE NKG2D RECEPTOR AND LIGAND NKG2DL1 IN PATIENTS WITH COLORECTAL CANCER

Relevance. Natural killer (NK) cells are considered to be effective cytotoxic cells of the tumor microenvironment, whose function is to effectively eliminate tumor cells. Their activation can occur when the NKG2D receptor interacts with the NKG2DL ligand expressed, for example, on tumor cells, which leads to the death of the latter. The aim of the study was a comparative study of the content of soluble forms of the sNKG2D receptor and its ligand sNKG2DL1 in the blood serum of healthy donors and patients with colorectal cancer (CRC), taking into account the clinical and morphological characteristics of the disease and prog-nosis. Material and methods. We examined 65 patients with CRC (32 women and 33 men), who were treated at the “National Medical Research Center of Oncology named after N.N. Blokhin” of the Ministry of Health of Russia aged (median 60 years) and 30 healthy donors (20 women and 10 men) aged (median 47 years). The clinical diagnosis in all patients was confirmed by the data of the morphological study of the tumor according to the Interna-tional Histological Classification of Tumors of the Digestive System (WHO, 2019), all had adenocarcinoma. The concentration of NKG2D and NKG2DL proteins was determined by ELISA in blood serum before treatment with Human B7-H3 Quantikine ELISA Kit reagents firm R&D (USA) in accordance with the manufacturer's instructions. The measurements were carried out on an automatic enzyme immunoassay analyzer BEP 2000 Advance (Siemens Healthcare Diagnostics, Germany). Statistical analysis of the obtained results was carried out using GraphPad Prizm v. 9. Overall survival analysis was performed by constructing survival curves using the Kaplan-Meier method. Results. In patients with colorectal cancer, a significant increase in the content of sNKG2DL in blood serum was found compared to the control group. sNKG2D concentrations did not differ between controls and CRC patients. No significant associations were found between the content of sNKG2D and sNKG2DL1 proteins in the blood serum of CRC patients and the main clinical and morphological characteristics of the disease. A decrease in the con-centration of sNKG2D was noted with the progression of the disease, and the highest content of sNKG2D was found in the localization of the tumor in the caecum. For the ligand sNKG2DL1, the opposite pattern was observed, namely, its lowest concentration in blood serum in tumors located in the caecum. For the ligand sNKG2DL1, the opposite pattern was observed, namely, its lowest concentration in blood serum in tumors located in the cae-cum. At the same time, the levels of sNKG2D and sNKG2DL1 in the control group directly and significantly correlated with each other (r=0.453; p=0.014), while no such pattern was found in the group of CRC patients (r=0.014; p=0.935). sNKG2DL1 concentrations are not a prognostic factor in CRC, while high levels of sNKG2D tended to lead to a favorable prognosis of the disease, which indirectly confirms the positive significance of tumor in-filtration by NK cells. Conclusions. The mechanisms of the relationship between CRC avoidance of immune surveillance and the expression of the sNKG2D receptor and the sNKG2DL ligand are discussed as one of the directions in the study of immune checkpoints. We believe that the effect of CRC immunotherapy can be achieved by increasing the expression of NKG2D on immune cells and inducing the expression of NKG2DL in tumor cells, which is the basis of the con-cept of this line of research.

Lightweight Histological Tumor Classification Using a Joint Sparsity-Quantization Aware Training Framework

Lightweight Histological Tumor Classification Using a Joint Sparsity-Quantization Aware Training Framework

Retrospective study of tumors from cattle slaughtered in Lombardy (Italy): preliminary evaluation on the establishment of a bovine cancer registry.

Forty‑one tumors were detected in a population of 1,649,003 cattle slaughtered in 4 abattoirs in Lombardy over a 5‑year period, for an overall prevalence of 2.5 tumors per 100,000 cattle. Tumors were classified according to the WHO histological classification of tumors of domestic animals. Alimentary and hemopoietic systems were commonly affected with 9 cases each. Other affected sites were the respiratory (n = 3), urinary (n = 2), endocrine (n = 2), musculoskeletal (n = 2), nervous (n = 1), and cardiovascular (n = 1) systems. The peritoneum was affected by 6 cases, while the primary location of 3 tumors of the connective tissues and 3 metastatic carcinomas was unidentified. Liver tumors and mesotheliomas, for which environmental risk factors are well‑known in humans, were common, as well as tumors typically encountered in pediatric human patients (tumors of mesenchymal tissues, pulmonary blastomas and nephroblastomas). These findings suggest the useful role of bovines as sentinel and model for human carcinogenesis. Our study indicates that the establishment of a bovine cancer registry in Lombardy is feasible considering its potential contribution to understanding the role of environmental risk factors in the genesis of tumors in animals and humans.

Структура захворюваності на пухлини вилочкової залози у харківському регіоні та аналіз діагностично значущих показників імунної відповіді у пацієнтів з тимомами

The purpose of the study was to determine the structure of the incidence of thymus tumors in the Kharkiv region, taking into account the histological classification of thymus tumors and to analyze diagnostically significant indicators of the immune response of patients with thymomas. Materials and methods. The medical histories of 158 patients aged 16 to 80 years with diseases of the thymus gland were studied during 2006-2019. The indices of phagocytic activity of granulocytic neutrophils in blood heparinization, phagocytic index, phagocytic number, phagocytosis completion index and activity of proteins of the complement system were analyzed. We also analyzed the indices of the number of T- and B-lymphocytes obtained using monoclonal antibodies (CD2+, CD3+, CD4+, CD8+, CD16+, CD19+) (immunofluorescence method). Results and discussion. The structure of the incidence of tumors of the thymus in the Kharkiv region was determined, taking into account the histological classification of tumors of the thymus and indicators of the immune status of patients with thymomas. The relationship was determined between the indicators of the phagocytic activity of granulocytic neutrophils and the activity of proteins of the complement system, as well as changes in the ratio of the subpopulation composition of T-lymphocytes in patients with different types of thymomas. Lymphoepithelial thymoma is most widespread in male population in the age groups 40-59 and 20-39 years, and the lymphoid thymoma – in male population in the age group 20-39 years and female population in the age group 40-59 years. The significant decrease (p <0.05) in the mean value of the phagocytic index was revealed in group of patients with lymphoid thymomas. The subpopulations of T-lymphocytes CD3+ and CD4+ were significantly reduced (p <0.05) in group of patients with lymphoepithelial thymomas. The subpopulations of T-lymphocytes CD4+ and CD8+ were significantly reduced (p <0.05) in group of patients with lymphoid thymomas. The increasing of the mean values of markers CD16+ and CD19+ (p <0.05) in all study groups indicates that the processes of antibody production in patients with thymomas are activated regardless of the type of thymoma. Conclusion. The structure of thymus pathology in the population of the Kharkiv region is characterized by the predominance of tumor pathology in the general structure of thymus pathology, which is 51.3%. The lymphoepithelial and lymphoid thymomas are the most common tumors of the thymus and were recorded in 64.2% and 30.8% of patients with thymomas, respectively

Rapid Proteomic Profiling by MALDI-TOF Mass Spectrometry for Better Brain Tumor Classification.

Glioblastoma is one of the most aggressive primary brain cancers. The precise grading of tumors is important to adopt the best follow-up treatment but complementary methods to histopathological diagnosis still lack in achieving an unbiased and reliable classification. To progress in the field, a rapid Matrix Assisted Laser Desorption Ionization - Time of Flight Mass spectrometry (MALDI-TOF MS) protocole, devised for the identification and taxonomic classification of microorganisms and based on the analysis of whole cell extracts, was applied to glioma cell lines. The analysis of different human glioblastoma cell lines permitted to identify distinct proteomic profiles thus demonstrating the ability of MALDI-TOF to distinguish different malignant cell types. In the study, the authors showed the ability of MALDI-TOF profiling to discriminate glioblastoma cell lines, demonstrating that this technique could be used in complement to histological tumor classification. The proposed procedure is rapid and inexpensive and could be used to improve brain tumors classification and help propose a personalized and more efficient treatment.

Histopathological characteristics of carcinoma of the uterine cervix in a tertiary hospital in southern Nigeria

Background: Carcinoma of the uterine cervix is the fourth-most common cancer among women worldwide, and the leading cause of cancer-related death for women in developing countries. Objective: Cervical carcinoma is a major cause of mortality in a developing nation such as Nigeria. This study provides an update on the prevalence of pathological variants of cervical carcinomas seen at the University College Hospital, Ibadan, Southwestern Nigeria. Materials and Methods: This is a retrospective study involving the review of all the histologically diagnosed cervical carcinoma in the Department of Pathology, University College Hospital, Ibadan between January 2012 and December 2016. The histologically diagnosed cancers and the relevant clinical and histopathological information relating to these tumors were extracted from the records of the department. All cases were treated as anonymous with strict confidentiality. The cases were classified using the World Health Organization histological classification of tumors of the cervix (2014). The obtained data were analyzed using the Statistical Package for the Social Sciences version 23. Results: A total of 294 cases were included in this study. The peak age of diagnosis was in the 6th decade. Two hundred and fifty-two cases (86.0%) were squamous cell carcinoma, 18 cases (6.1%) were adenocarcinomas, 16 cases (5.5%) were adenosquamous carcinomas, and 6 cases (2.2%) were adenoid cystic carcinomas, and one representing 0.3% was a neuroendocrine carcinoma. The most common histological grade was moderately differentiated (Grade 2). The large cell nonkeratinizing squamous cell carcinoma was the most common histological variant.Conclusion: A majority of cervical carcinomas are squamous cell carcinomas and are majorly the large cell nonkeratinizing variant.

Some Considerations on the WHO Histological Classification of Laryngeal Neoplasms.

A new edition of the World Health Organization (WHO) Histological classification of tumours of the hypopharynx, larynx, trachea and parapharyngeal space was published in 2017. We have considered this classification regarding laryngeal neoplasms and discuss the grounds for said revision. Many of the laryngeal neoplasms described in the literature and in the previous WHO edition from 2005 have been omitted from this current revision. Many are described elsewhere in the book but it may give the new generation of pathologists/surgeons/oncologists the false impression that these tumour entities do not exist in the larynx.

Primary Solid and Cystic Tumours of the Exocrine Pancreas in Cats

Tumours of the exocrine pancreas are rare in cats and few cases are described in the literature. Cystic tumours of the pancreas are not included in the World Health Organization (WHO) international histological classification of tumours of domestic animals. The aim of this study was to characterize the pathology of primary epithelial tumours of the feline exocrine pancreas, with emphasis on cystic tumours. We reviewed tumours of the exocrine pancreas in 70 cats, including complete tumours or the entire pancreas (n=18) and excisional biopsy samples of pancreatic tumours (n=52). Macroscopically, the tumours were grouped as solid (n=45) or cystic (n=25). Solid tumours were subdivided into adenomas (n=5) and carcinomas (n=40) and cystic neoplasms into adenomas (n=15), carcinomas (n=7) and cases with diverse growth patterns (n=3). All five grossly solid adenomas had acinar morphology, while the macroscopically solid carcinomas showed acinar (n=17), tubular (n=14) or mixed (n=9) growth microscopically. Cystic adenomas had acinar (n=2), tubular (n=12) or mixed (n=1) growth, while cystic carcinomas had exclusively tubular growth (n=7). Three cases with cystic lesions showed diverse histopathological growth patterns. The clinical outcome was available in 57 cases. The majority of cats with carcinomas died or were humanely destroyed during or shortly after surgery (n=32). However, 2/7 animals with cystic carcinomas showed longer survival times. Cats with cystic adenomas had survival times of up to 5 years. The results of this study show that cystic pancreatic tumours should be considered a differential diagnosis in cats with cystic intra-abdominal masses, even though these are not yet described in the WHO classification. Based on the relatively long survival times of cats with cystic adenomas, complete resection with subsequent histopathological examination is recommended.

Clinical presentation and epidemiology of brain tumors firstly diagnosed in adults in the Emergency Department: a 10-year, single center retrospective study.

Several patients with new onset brain tumors present to the Emergency Department (ED) complaining for new symptoms. Although information exists on symptom prevalence in the entire population of patients with brain tumors, little is known about the clinical presentation in ED. This retrospective study was planned to investigate clinical presentation and epidemiology of brain tumors firstly diagnosed in a large urban ED throughout a 10-year period. All medical records of patients aged ≥18 years, discharged from our ED with a diagnosis of brain tumor were retrieved from the electronic hospital database during a 10-year period (2006 to 2015). The records were reassessed for selecting only brain tumors firstly diagnosed in the ED. The symptoms at presentation were divided in six categories: (I) headache; (II) seizures; (III) focal signs; (IV) altered mental status; (V) nausea/vomiting/dizziness; (VI) trauma. For all cases, the hospital record was retrieved, to obtain histologic classification of tumors. Patients with inflammatory neoformations were excluded from the study. Overall, 205 patients with firstly diagnosed brain tumor were identified among 870,135 ED visits (i.e., <1%). Glial tumors were the most frequent (50% of the entire sample). No significant differences were found between mean age of patients in the different histologically based groups (meningiomas 66±14; glioblastomas 65±16 years; metastases 66±13 years; other miscellaneous 66±19 years). Focal signs accounted for more than 50% of all presentation signs/symptoms. First presentation of brain tumor in the ED is not a rare occurrence, so that the emergency physicians should be aware of this possibility.

Spontaneous Skin Tumor in a Companion Dwarf Rabbit

Background: Scarce reports have been published worldwide on primary skin tumours in pet rabbits. Trichoblastoma is a rare benign neoplasm of animals and humans derived from or reduplicating the primitive germ of embryonic follicular development; it was previously classified as a basal cell tumor, meanwhile its malignant counterpart is referred to as malignant trichoblastoma or trichoblastic carcinoma. Neoplasms of domestic animals that once were lumped into the broad histologic diagnosis of basal cell tumors have since been split into distinct entities, dependent on evidence of differentiation, although a cytologic diagnosis of basal cell tumor continues to be used indistinctly to represent the large, heterogeneous group of epidermal, trichofollicular, and adnexal skin tumors with basal cell characteristics. Hereby, it is described the morphological and immunohistochemical findings of a case of spontaneous malignant trichoblastoma on a domestic companion rabbit from South America.Case: A 4-year-old, male black dwarf rabbit (Oryctolagus cuniculus) was brought to the Veterinary College when appeared with a sudden appearance of a grayish nodular subcutaneous mass measuring 3.0 x 2.0 cm and located on left tarsal zone, during march 2014. A case of malignant trichoblastoma with a predominance of trabecular architecture was diagnosed based on morphologic and microscopic results. Fine-needle aspiration, histopathology and immunohistochemistry were performed on the ulcerated mass. The mass was sectioned and stained with hematoxylin and eosin (HE), periodic acid-Schiff (PAS) and Masson trichrome stain. Replicate serial sections from the paraffin-embedded tissue blocks were immunostained for cytokeratin (AE1/AE3), smooth muscle actin, polyclonal nestin, desmin and myoglobin, using commercial kits. Mayer’s hematoxylin solution was used as a counterstain. Negative controls were produced by substituting the primary antibody with 5% bovine serum albumin in phosphate buffered saline. To assess mitotic activity, mitoses count in 10 randomly selected high-power fields was done. Diagnoses was made in accordance with the recommendations for the histological classification of tumors of domestic animals. After surgical excision, the animal remains healthy.Discussion: Epithelial nonviral skin neoplasms are uncommon in rabbits and have been cited in sporadic case reports or few case series including basal cell tumors and squamous cell carcinomas. All these cases emphasized the need for cytologic criteria and nomenclature on rabbit tumors that better reflect potential variation in tissue differentiation. As a consequence, based on limited current knowledge, the practitioner is left to make decisions for diagnostics and therapeutics in these cases based upon current recommendations for other companion animals with adjustments for lagomorph physiology. This tumor, though variable in size (0.2 to 10 cm in diameter) in domestic animals (i.e., older dogs and cats), it most often appears as a solitary, well-circumscribed hairless mass in the skin, and occasionally ulcerated. The pathological data, that included tumor location, gross appearance, tumor size, growth pattern, cellular atypia, mitosis and immunohistochemistry studies, led to the malignant trichoblastoma diagnosis and these features concurred to those described in the literature. Increasing number of sporadic or induced tumors may be expected in pet rabbits in the veterinary clinic, as these animals have a high consideration among the people, and also they live longer (natural life span range: 5-10 years) than wild or farmed rabbits.

Ultrasound-guided fine needle aspiration cytology diagnosis of gall bladder lesions with application of WHO histological classification of tumors on cytoaspirate material

Introduction: Due to the increasing trend in gall bladder (GB) carcinoma in India, early diagnosis of GB lesion has become essential. Aim: It is to determine the accuracy of Ultrasonography (USG)-guided fine needle aspiration cytology (FNAC) and an attempt to classify the cytological material according to World Health Organization classification. Materials and Methods: This retrospective study for a span of 3 years was done in the Departments of Radiology and Pathology in Tertiary Teaching Hospital. US-guided FNAC of GB lesion and their histopathological finding were compared. Results: Sensitivity of US-guided FNAC was 98.6% and specificity 97.3%.

Mise au point sur les classifications moléculaires et la nouvelle classification histologique du cancer de la vessie

Comment the new WHO histological classification of tumors of the urinary system and male genital organs 2016 and expose the state of art about urothelial carcinogenesis and molecular modifications of bladder cancer, with the consequences on the treatments. A systematic review of the literature search was performed from the data base PubMed, focused on the following keywords: "bladder cancer", "molecular", "subtypes". The new WHO histological classification of tumors of the urinary system 2016 confirm the importance of pathology in determining the care of patients, especially the grade, the histological type and the infiltration, while taking into account the difficulties. In 2014, the Cancer Genome Atlas reported genetic modifications of bladder cancer. Recently, several studies explored molecular anomalies of bladder cancer and elaborated molecular classifications, analyzing their predictive value. According to the groups, different molecular subtype had been defined: Urobasal A, Urobasal B, genomically unstable, infiltrated, squamous cell carcinoma-like and p53-like luminal bladder cancers. This latter subgroup seems to be chemoresistant. The molecular biology and classifications allow a better understanding of bladder cancer and could complete in near future histological data to improve patient management.

Molecular biology of papillary thyroid microcarcinomas: What is new?

ObjectivesPapillary thyroid microcarcinoma (PTMC), a tumor that measures 1cm or less, according to World Health Organization (WHO) histological classification of tumors, is the most common form of papillary thyroid carcinoma (PTC) comprising much more than half of all PTCs if one includes the so-called incidentalomas. Although PTMC has an excellent prognosis, a minority of cases were found to be clinically aggressive. We decided to perform a review of the literature on records on PTMC in attempt to find which molecular markers might be used as predictors of the clinical behavior of PTMC. This review article aims to summarize the molecular mechanisms that were associated to PTMCs described in the last 10 years, with a particular focus on the clinical importance of genetic alterations (BRAF mutation, RET/PTC rearrangement, NAD(P)H and NRH polymorphisms and TERT mutation) and anomalous expression of several molecules (P53, P27, COX-2, EGFR, ki-67, S100A4, cyclin D1, galectin-3, HMWK, CK-19, HBME-1, HGF, c-MET, membrane mucins and cell adhesion molecules). MethodsWe made a systematic search in the PubMed database using the keywords papillary thyroid microcarcinoma and reviewed all the articles published in the last 10 years, in English, addressing issues related to PTMC. ResultsUnfortunately, all genetic alterations and biomarkers reported to date have little potential per se to differentiate between indolent and aggressive PTMCs. Further studies using the aforementioned markers and, most likely, others are needed in order to try to find a combination of several markers that may be used for increasing the probability of identifying PTMC cases with more aggressive behavior, thus allowing the establishment of a more appropriately targeted treatment.

Relevant risk factors for positive lateral margin after en bloc endoscopic submucosal dissection for early gastric adenocarcinoma.

This study aimed to systematically assess the relevant risk factors of positive lateral margin (LM) after en bloc resection of early gastric adenocarcinoma. A total of 242 patients who had undergone endoscopic submucosal dissection (ESD) due to early gastric lesions from January 2009 to March 2015 were included in the study. Clinicopathological features of the lesions and the risk factors related to positive LM were analyzed. The curative rate was 82.2% and positive LM was found in 12.4% of the lesions. Univariate analysis showed that positive LM was significantly associated with the tumor location (at the upper third of the stomach), size (>3 cm), histological findings, the presence of lymphovascular invasion and deeper invasion depth. Moreover, positive LM had a higher incidence of recurrent or residual tumors. A multivariate analysis showed that the location, tumor size and histological classification of tumors were independent risk factors for positive LM. Positive LM is closely related to the upper third of stomach, a tumor larger than 3 cm and a mixed-type carcinoma. Additionally, positive LM has a predilection for recurrent or residual tumors.

Management of Bladder Cancer

Bladder cancer is the fourth most common cancer in men and the tenth most common in women. Patients commonly present with painless hematuria. Urinary frequency, urinary tract infection, upper tract obstruction, and pain are also possible; however, the physical examination of the patients is often unremarkable. Clinical diagnosis depends on urine cytology, bladder ultrasonography, and office cystoscopy. This review describes the epidemiology, pathology and natural history, clinical presentation and workup, staging and grading, non–muscle-invasive bladder cancer, bladder preservation strategies, nontraditional approaches, chemotherapy for metastatic disease, immunotherapy, and predictive factors of response to chemotherapy for bladder cancer. Figures show representative images of urothelial cell carcinoma, diagrams showing a cystoscopy for a man and bladder cancer staging, urinary diversion, and computed tomographic scans of a patient with hepatic metastases from bladder cancer before and after treatment with gemcitabine-cisplatin. Tables list the tumor-node-metastasis staging system for bladder cancer, the histologic classification of tumors of the urinary tract (WHO 1973 versus WHO 2004), risk group stratification based on the European Organization for Research and Treatment of Cancer Scoring System, types of bacillus Calmette-Guérin failure/recurrence and treatment recommendations, unfavorable factors for bladder preservation chemoradiation, consensus criteria for patients unfit for cisplatin-based regimens, and first-line combination chemotherapy regimens. This review contains 5 highly rendered figures, 7 tables, and 80 references.

Management of Bladder Cancer

Bladder cancer is the fourth most common cancer in men and the tenth most common in women. Patients commonly present with painless hematuria. Urinary frequency, urinary tract infection, upper tract obstruction, and pain are also possible; however, the physical examination of the patients is often unremarkable. Clinical diagnosis depends on urine cytology, bladder ultrasonography, and office cystoscopy. This review describes the epidemiology, pathology and natural history, clinical presentation and workup, staging and grading, non–muscle-invasive bladder cancer, bladder preservation strategies, nontraditional approaches, chemotherapy for metastatic disease, immunotherapy, and predictive factors of response to chemotherapy for bladder cancer. Figures show representative images of urothelial cell carcinoma, diagrams showing a cystoscopy for a man and bladder cancer staging, urinary diversion, and computed tomographic scans of a patient with hepatic metastases from bladder cancer before and after treatment with gemcitabine-cisplatin. Tables list the tumor-node-metastasis staging system for bladder cancer, the histologic classification of tumors of the urinary tract (WHO 1973 versus WHO 2004), risk group stratification based on the European Organization for Research and Treatment of Cancer Scoring System, types of bacillus Calmette-Guérin failure/recurrence and treatment recommendations, unfavorable factors for bladder preservation chemoradiation, consensus criteria for patients unfit for cisplatin-based regimens, and first-line combination chemotherapy regimens. This review contains 5 highly rendered figures, 7 tables, and 80 references.

Efficacy of quercetin against chemically induced murine oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is the most common form of head and neck cancer, and oxidative damage is associated with the development of OSCCs. Antioxidants have therefore been proposed for use as chemoprotective agents against different types of cancer. In the present study, the effect of the antioxidant quercetin, administered at doses of 10 and 100 mg/kg/day, was investigated in an experimental murine model of 4-nitroquinoline 1-oxide (4-NQO)-induced carcinogenesis. The survival of the treated animals, the plasmatic levels of reduced glutathione and the type and severity of lesions (according the International Histological Classification of Tumors and Bryne's Multifactorial Grading System for the Invasive Tumor Front) were assessed. Additionally, the organization of the extracellular matrix was analyzed by carbohydrate and collagen histochemistry, and immunohistochemistry was used to assess the expression of the tumor markers proliferating cell nuclear antigen and mutated p53. The results indicate that, despite the promising effect of quercetin in other studies, this drug is ineffective as a chemoprotective agent against 4-NQO-induced OSCC in mice at the assayed doses.

Reconocimiento histológico de grados de malignidad en el adenocarcinoma de ovario

El autor revisa brevemente los principios en que se basa la técnica histológica de clasificación de tumores según su grado de malignidad, que es útil a la clínica para establecer un pronóstico basado en la correlación que se ha establecido entre la gradación histológica de grado de malignidad y el curso clínico ulterior de los tumores malignos de ovario. Desde el punto de vista bioquímico, la determinación microespectrofotométrica del contenido tisular de DNA (ácido desoxiribonucleico) y la mediación del diámetro nucleolar como expresión del contenido tisular de RNA (ácido ribonucleico), correlacionan bien con el grado de malignidad establecida con las técnicas histológicas y citológicas tradicionales.

Locally advanced pancreatic adenocarcinoma: reassessment of response with CT after neoadjuvant chemotherapy and radiation therapy.

To prospectively evaluate the utility of computed tomography (CT) for determination of tumor response and prediction of resectability after neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with nonmetastatic locally advanced pancreatic cancer. This study received institutional review board approval, and all participants provided written informed consent. Consecutive patients with cephalic locally advanced pancreatic cancer who underwent surgical exploration and/or resection following neoadjuvant CRT were prospectively enrolled from June 2009 to May 2013. Two radiologists independently analyzed the baseline and post-CRT CT scans for the size, attenuation, and circumferential vascular contacts of the tumor. Associations between the postoperative histologic grade of the tumor response (pTNM) and the clinical, biologic, and CT criteria were assessed by using Spearman correlation coefficients. CT criteria related to the presence of complete (ie, R0) resection were assessed by using logistic regression. Forty-seven patients were included, 33 with an R0 resection and 14 with positive margins (ie, R1) or no resection. Variables demonstrating a significant correlation with the histologic tumor classification of tumor response were post-CRT carbohydrate antigen 19-9 level (r = 0.46), post-CRT largest tumor axis (r = 0.44), post-CRT sum of the largest and smallest tumor axes (r = 0.46), change in the largest axis (r = -0.31), change in the sum of the largest and smallest axes (r = -0.39), change in superior mesenteric vein (SMV) and/or portal vein (hereafter, SMV/portal vein) contact (r = -0.38), and post-CRT superior mesenteric artery contact (r = 0.34). Partial regression of tumor contact with the SMV/portal vein was associated in all cases with R0 resection (10 of 10 patients, positive predictive value = 100%), and partial regression of tumor contact with any peripancreatic vascular axis was associated with R0 resection in 91% of cases (20 of 22 patients, positive predictive value = 91%). Persistence of SMV/portal vein stenosis after CRT was not predictive of R1 resection. Partial regression of tumor-vessel contact indicates suitability for surgical exploration, irrespective of the degree of decrease in tumor size or the degree of residual vascular involvement.

Carcinoma of Exocrine Pancreas – A mortal enigma

Background and Objective: Exocrine pancreatic cancer is a highly malignant neoplasm with ductal adenocarcinoma being the most frequent type. The objective of this study is to understand the morphological spectrum of exocrine pancreatic tumors with their clinical aspect. Methods: This is a retrospective histopathological evaluation of 15 cases from 2006-2011 of exocrine pancreatic tumoursstudied light microscopically on Hematoxylin and Eosin stained paraffin sections and categorized according to the WHO Histological Classification of Tumors of Exocrine Pancreas (2000). Results: Periampullary adenocarcinoma formed the majority of malignant tumors accounting for 7 cases with age ranging from 45 to 88 years with male predominance followed by 5 cases of ductal adenocarcinomas,all found in females, age ranging from 45 to 67 years.There was one case each of Pancreatoblastoma (1year old boy), solid pseudopapillaryneoplasm of uncertain malignant potential (16 year old girl)and mucinous cystadenoma in the body and tail (32 year old lady). Conclusion: Malignant tumors were more common than benign tumors (93 %). Periampullary adenocarcinomas constituted the majority (47 %) with male predominance. Ductal adenocarcinomas were all found in females and the common site was head of the pancreas (80 %).Pancreatoblastoma, mucinous cystadenoma and solid pseudopapillary neoplasms are not uncommon. Body and tail of pancreas was the least common site of tumors (13 %). All periampullary and ductal adenocarcinomas were found in patients above 45 years of age.