Histopathological Type Of Tumor Research Articles

Predictors of Spermatogenesis in Orchiectomy Specimens

To evaluate the presence of spermatogenesis in orchiectomy specimens of patients with testicular cancer to determine possible predictors of success with oncologic testicular sperm extraction of the cancerous testis at orchiectomy. We retrospectively reviewed the pathology reports and slides from 83 men who underwent radical orchiectomy for testicular cancer at 2 institutions from 1999 to 2010. The presence or absence of spermatogenesis in each specimen was determined. Data on tumor histopathologic type, serum tumor markers, and tumor size were also obtained and analyzed to detect any associations with the presence of spermatogenesis. The 83 specimens included 41 pure seminomas, 36 nonseminomatous and mixed germ cell tumors, and 6 benign lesions. Overall, spermatogenesis was detected in 48 of 77 (62%) cancerous specimens. Spermatogenesis was present in 22 of 41 (54%) pure seminomas and 26 of 36 (72%) nonseminomatous and mixed germ cell tumors, with no significant difference found between the 2 subtypes (P = .11). No association was found between tumor marker levels and the presence of spermatogenesis. A logistic regression model revealed a statistically significant inverse relationship between tumor size and spermatogenesis presence (P = .004). At orchiectomy, most cancerous testes contained active spermatogenesis and, thus, represent a viable source for sperm cryopreservation with oncologic testicular sperm extraction. A small tumor size proved to be a positive prognostic indicator for the presence of spermatogenesis, although a larger tumor size did not preclude the presence of spermatogenesis.

Five-point scoring system based on clinicopathological data: A convenient criterion to determine prognosis of patients with colorectal carcinoma

The aim of this study was to elucidate the significance of a novel staging criterion, a five-point scoring system (FPSS), determined by five histopathological factors of colorectal carcinoma. These factors included depth of invasion, lymph node metastasis, lymphatic invasion, venous invasion and histopathological tumor type. In total, 357 patients with colorectal carcinoma who had had been treated by surgical resection were investigated. One point was assigned to each of the five aforementioned tumor-related pathological factors. The FPSS score was determined by an aggregate of the points. A significant difference was observed between the survival of patients with FPSS scores of 0 and 1, and 2 and 3 (P=0.0002); and FPSS scores of 2 and 3, and 4 and 5 (P<0.0001). We demonstrate that the FPSS is a convenient criterion for stratifying the prognosis of patients with colorectal carcinoma.

A Study on Cervical Lymph Node Metastasis from Cancer of Unknown Primary Origin

Between 2002 and 2011, we treated 18 cases of cervical lymph node metastasis from cancer of unknown primary origin. The subjects were 15 men and 3 women, ranging in age from 45 to 83 years (mean: 65.5 years). The histopathological tumor types were squamous cell carcinoma (15 cases), mucoepidermoid carcinoma (1 case), adenocarcinoma (1 case), and undifferentiated carcinoma (1 case). The largest metastatic lymph nodes were located in the upper deep cervical region in 16 cases. For histologic diagnosis of the metastatic lymph nodes, FNAB (fine needle aspiration biopsy) was conducted in 14 cases and open biopsy in 4 cases. Neck dissection was performed in 17 cases, of which 14 also received postoperative radiotherapy. The overall 5-year survival rate in this study was 63.6%. For the control of metastatic lymph nodes and minute tumors at the primary site, combination therapy consisting of neck dissection and chemoradiotherapy is desirable.

Synchronous gastric and rectal cancer in a 50 year-old man - case report.

The occurrence of synchronous tumors of the gastrointestinal tract is rarely observed in general surgery, diagnosis is frequently incidental, often intraoperatively. The aim of this study was to present a case of a 50 year-old male patient admitted to the Department of Gastroenterology, University Hospital in Białystok, due to abdominal pain, significant weakness and excretion of tarry stools. Imaging diagnostics revealed the presence of a large gastric tumor (histopathological type - adenocarcinoma), and single metastasis to the liver. The patient was qualified for total gastrectomy. Surgery was performed at the 1st Department of General and Endocrinological Surgery, University Hospital in Białystok. Rectal cancer, which was observed during the operation was removed simultaneously.

Salivary Gland Tumors in Turkey: Demographic Features and Histopathological Distribution of 510 Patients

The aim of this study was to evaluate the demographic and clinicopathologic data of salivary gland tumors managed at a tertiary referral medical center in Turkey. The data of 510 patients with salivary gland tumors managed during the period of January 1984 to May 2012, were reviewed. Only primary neoplasms derived from salivary glands were included. Out of 510 neoplasms, 352 (69.0%) were classified as benign and 158 (31.0%) were classified as malignant. There was a male predominance and male:female ratio was 1.23 (281/229). The most common location was parotid gland (372/510, 72.9%) followed by minor salivary glands (97/510, 19.0%) and submandibular gland (40/510, 7.9%). The malignancy rates were 21.5, 40.0, and 56.7% in parotid, submandibular, and minor salivary glands locations, respectively. The most common location for minor salivary gland neoplasms was oral cavity (61/97, 62.9%). Pleomorphic adenoma (PA) was the most common histopathological type (45.3%) in the whole study group and also among pediatric patients. The most common malignant neoplasms were adenoid cystic carcinoma (39/510, 7.6%) and mucoepidermoid carcinoma (5.7%). Salivary gland tumors are more common in men. The malignancy rate is almost three times higher in neoplasms derived from minor glands when compared to parotid gland. PA is the most common histopathological tumor type in all locations and in all age groups.

Testicular Tumor Ultrasound Characteristics and Association with Histopathology

Introduction: This study was undertaken to develop knowledge of ultrasound characteristics of germ cell testicular neoplasms, associate these characteristics with histopathologic tumor types, and lay a foundation for study of ultrasound findings in benign versus malignant testicular lesions. Materials and Methods: The medical records and ultrasound images of 107 patients with testicular tumor were reviewed. Demographic and clinical characteristics and ultrasound findings of patients with seminoma were compared to those of patients with non-seminoma. Results: 55 patients had seminoma (1 bilateral) and 52 non-seminoma. Ultrasound images of seminoma were more often hypoechoic, homogeneous, and lobulated than those of non-seminoma (p < 0.001). Images of non-seminoma were more often heterogeneous and cystic (p < 0.001). There was no difference in tumor size, multiplicity, presence of calcium or lesion margination. Testicular microlithiasis was more common in seminoma (p < 0.02). Conclusion: Careful analysis of ultrasound images can permit an educated assessment of testicular tumor histopathology.

The evaluation of tumor histopathology, location, characteristic, size and thickness of nonmelanoma skin cancers of the head and neck

This study aims to investigate the characteristic features of tumors and relationship between features in cases who underwent surgery for nonmelanoma skin cancer (NMSC) of the head and neck. Between December 2007 and March 2011, 106 lesions of 90 cases who underwent excision of NMSC of the head and neck in our clinic were included. The statistical analysis was performed by evaluating the demographic data, histopathologic type, size and thickness of tumor, location, Clark stage, T stage, risk of recurrence and the presence of recurrence, reconstruction technique and success rate of surgery. Basal cell carcinoma (BCC) was approximately two-fold more common than squamous cell carcinoma (SCC). The most common locations of tumors were the nose and lip. Most of lesions (71.7%) were at high-risk of recurrence. When the relationship of histopathologic type with the size and depth of tumor were analyzed, it was found that the size and thickness of tumor in SCC were relatively higher with a statistically significant difference. The relationship between histopathologic type and the location of tumors was also statistically significant. Basal cell carcinoma is the most common NMSC of the head and neck. Most of these cases have the potential of high rate of recurrence. The size and thickness of SCC are higher than BCC.

The value of Pap test in women with endometrial cancer

Introduction: Endometrial cancer is the second most common gynecological tumor. There is still no recommended screening method for endometrial cancer. The application of transvaginal sonography, hysteroscopy and Pap test may prove useful in screening for this disease. Atypical glandular cells represent an important finding in Pap tests and they are related to histopathological verification of the endometrium. The aim of the study was to determine the usefulness of the Pap test in assessing the cervical infiltration, as well as to determine the significance of hormonal status and histopathological type of tumor in a pathological Pap test in patients with endometrial cancer.Methods: The study was retrospective. The analysis included the data obtained from 62 operated patients diagnosed with enometrial cancer, medical history (menopausal status), histopathological findings after surgery (type and stage of the disease) and a preoperative Pap smear. The chi squared and Fisher’s test were used.Results: The difference in the prevalence of pathological Pap test in premenopausal and postmenopausal group of patients was not statistically significant. The difference in the prevalence of pathological Pap test in the group of endometrioid and non-endometrioid tumours of the uterine corpus had statistical significance. The difference in the prevalence of pathological Pap test compared to the present stage (I and II) was not statistically significant.Conclusion: Pap smear does not correlate with menopausal status in women with endometrial carcinoma. Abnormal Pap test is more commonly found in cases of non-endometroid tumours. Pap smears cannot beused to assess cervical involvement.

Minor salivary gland tumors in the oral cavity: Diagnostic value of dynamic contrast-enhanced MRI

ObjectiveTo evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for minor salivary gland tumors in the oral cavity. Materials and methodsThirty-two patients with minor salivary gland tumors were examined preoperatively using DCE-MRI. Their maximum contrast index (CImax), time of CImax (Tmax), Tpeak; i.e., the time that corresponded to the CImax×0.90, and washout ratios (WR300 and WR600) were determined from contrast index (CI) curves. We compared these parameters between benign and malignant tumors and among the different histopathological types of minor salivary gland tumors. Then, we categorized the patients’ CI curves into four patterns (gradual increase, rapid increase with high washout ratio, rapid increase with low washout, and flat). ResultsStatistically significant differences in Tmax (P=0.004) and Tpeak (P=0.002) were observed between the benign and malignant tumors. Regarding each histopathological tumor type, significant differences in Tmax (P<0.001), Tpeak (P<0.001), and WR600 (P=0.026) were observed between the pleomorphic adenomas and mucoepidermoid carcinomas. It was difficult to distinguish between benign and malignant tumors using our CI curve classification because that two-thirds of the cases were classified into the same type (gradual increase). ConclusionThe DCE-MRI parameters of minor salivary gland tumors contributed little to their differential diagnosis compared with those for major salivary gland tumors. During the diagnosis of minor salivary gland tumors, Tmax is useful for distinguishing between benign and malignant tumors.

Association studies of OGG1, XRCC1, XRCC2 and XRCC3 polymorphisms with differentiated thyroid cancer

The role of the DNA repair genes OGG1, XRCC1, XRCC2 and XRCC3 on differentiated thyroid cancer (DTC) susceptibility was examined in 881 individuals (402 DTC and 479 controls). DNA repair genes were proposed as candidate genes, since the current data indicate that exposure to ionizing radiation is the only established factor in the development of thyroid cancer, especially when it occurs in early stages of life. We have genotyped DNA repair genes involved in base excision repair (BER) ( OGG1, Ser326Cys; XRCC1, Arg280His and Arg399Gln), and homologous recombination repair (HRR) ( XRCC2, Arg188His and XRCC3, ISV-14G). Genotyping was carried out using the iPLEX (Sequenom) technique. Multivariate logistic regression analyses were performed in a case-control study design. From all the studied polymorphism, only a positive association (OR = 1.58, 95% CI 1.05–2.46, P = 0.027) was obtained for XRCC1 (Arg280His). No associations were observed for the other polymorphisms. No effects of the histopathological type of tumor were found when the DTC patients were stratified according to the type of tumor. It must be emphasized that this study include the greater patients group, among the few studies carried out until now determining the role of DNA repair genes in thyroid cancer susceptibility.

A Rare Case of Metastatic Pancreatic Hepatoid Carcinoma Treated with Sorafenib

Hepatoid carcinoma (HC) is a rare histopathological tumor type with prominent features of hepatoid differentiation, and while most of the reported cases are of gastric origin, ten cases of pancreatic HC have been reported to date. The majority of HC cases are metastatic at presentation, mainly to the liver, lymph nodes, and lungs. They are aggressive, invading, and proliferating in the venous and lymphatic systems, with a behavior similar to that of hepatocellular carcinoma. Diagnosis is challenging: alpha-Fetoprotein, the most useful marker, is not always positive. We present the first case of metastatic pancreatic HC treated with sorafenib, an oral multikinase inhibitor approved for advanced hepatocellular carcinoma that has antiangiogenic, pro-apoptotic, and raf-kinase inhibitory properties. The patient, a 37-year-old male, was diagnosed with hepatoid carcinoma of the pancreas that had metastasized to liver, lungs, and lymph nodes. The cytokeratin (CK) profile was useful for the diagnosis: Both the hepatoid and adenocarcinoma components of the tumors were CK18+, CK19+, and CK20+/-, whereas normal and neoplastic hepatocytes are CK18+, CK19-, and CK20-. Amylase, lipase, and liver enzyme levels were elevated, but bilirubin was normal. Treatment with sorafenib resulted in more than 7 months of progression-free survival. Therapy was discontinued after 8 months when his bilirubin level increased dramatically. Signs of liver failure resolved temporarily with insertion of a biliary stent, but his condition deteriorated and he died 3 months later, 1 year after diagnosis. In the absence of evidence-based experience with this rare and aggressive tumor and given its similarities with hepatocellular carcinoma, sorafenib should be considered as a possible treatment.

Bypass Surgery Versus Intentionally Incomplete Resection in Palliation of Pancreatic Cancer: Is Resection the Lesser Evil?

ObjectiveAs technical expertise increases, the indication for pancreatic resection for advanced pancreatic cancer has been expanded over the last years. Recently, several groups reported their series of unintentionally incomplete tumor resections and reported a potential survival benefit for patients after incomplete resection when compared with palliative bypass surgery. We investigated in a retrospective analysis whether even tumor resection that was intended to be incomplete might provide a better outcome than conventional palliative procedures. MethodsTwenty-two patients with a locally non-resectable or disseminated adenocarcinoma of the pancreas underwent a palliative intentionally incomplete resection. Outcome after resection was compared with that of 46 patients matched for age, sex, and histopathological tumor type who underwent a palliative bypass operation. ResultsOverall surgical morbidity was significantly higher in the resection group (59%) compared with the bypass group (33%, p < 0.05), resulting in a higher relaparotomy rate and a significantly longer postoperative hospital stay (p < 0.001). Surgery-related mortality was significantly higher in the resection group (p < 0.05). Overall survival showed no statistically significant difference between the two groups. ConclusionsBecause of the higher surgery-related morbidity and mortality and lack of survival benefit in cases of advanced adenocarcinoma of the pancreas, intentionally incomplete palliative resection is not advisable.

Immunohistochemical detection of p16INK4a proteins expression in paraffin embedded sections of colorectal cancer tissues.

Background: Uncontrolled tumor cell proliferation is a reality in tumor cells, and the progression from a normal cell into a transformed cell probably includes genetic events affecting checkpoints in the cell cycle machinery.Materials and methods: This study investigated the immunoexpression of p16INK4a in the paraffin sections from 43-cancers of colorectal tissue (CRC),26-hyperplastic polyps and adenomas(CRHPA) and 35-normal tissues (CRN),using immunohistochemical assay. We correlated the expression patterns with tumor histopathological type, site of the tumor, distance metastasis according to the TNM system.Results: In colorectal cancer (CRC) patients’ p16INK4a,immunoexpression was detected in 32/43, there was significant association for p16INK4a, which showed high reaction with monoclonal antibodies in the distal colon and rectal area with P value &lt; 0.001. There was no significant correlation between tissue invasion stage and p16INK4a. There was no significant difference in the immunoexpression of p16INK4a in relation to the two groups of patients with the stage of the disease.Conclusion: p16INK4a, expression have high level in CRHPA than in CRN tissue. Also, their expression in CRC is more than in CRN tissue. In addition, p16INK4a immunoexpression in CRC was significantly more than in CRHPA.

Association between polymorphisms of XRCC1, p53 and MDR1 genes, the expression of their protein products and prognostic significance in human breast cancer.

SummaryBackgroundThis study aimed to examine the relationship between XRCC1, p53 and MDR1 protein, along with polymorphisms of their genes and their prognostic values in breast cancer. The following clinical and pathological parameters were evaluated: histopathological type of tumor, grade, stage, Her2/neu expression, ER, PR positivity and involvement of regional lymph nodes.Material/MethodsExpression of proteins was determined in 39 samples of breast cancer by immunohistochemistry. Nucleotide polymorphisms were analyzed by PCR-RFLP. For statistical analysis, chi-square test (Yates), Fisher’s exact test, and correlation test were used to analyze the data.ResultsThe highest protein expression was immunohistochemically found in MDR1 protein, with 54% of samples testing positive. In addition, the evaluation of MDR1 expression revealed higher positive immunoreactivity in lobular (LIC) and other types of tumor in comparison to ductal (DIC) type. The expression of p53 and XRCC1 protein was equal, but lower compared to MDR1, both testing positive in 36% of all tissue samples. Comparison of XRCC1 protein and histopathological type of tumor revealed that DIC and LIC types were mostly XRCC1-negative, while other types, papillary and mucinous were more likely to be XRCC1-positive. Interestingly, when evaluating LIC samples separately, a negative correlation between the Her2/neu and expression of XRCC1 was detected. Apparently, all Her2/neu-positive samples were XRCC1-negative (6/86%). The correlation test indicated a negative correlation between Her2/neu-positive samples and XRCC1-negative specimens (r=1, p<0.05). Statistical analysis did not reveal a correlation of p53 expression with clinical and pathological parameters. Similarly, no statistically significant difference was found between the tested polymorphisms and protein expression.ConclusionsWe did not find statistically significant correlation between tested polymorphisms and their protein expression.

Prognostic Significance of p53 Protein and X-ray Repair Cross-Complementing Protein 1 in Non-Small Cell Lung Cancer

p53 and XRCC1 protein expression were evaluated in 54 samples of nonsmall cell lung cancer. The immunohistochemical method was used for detection of the monitored proteins. Tissue samples were divided according to histopathological tumor type. The results were then compared with basic clinical and histopathological parameters (histopathological type, nuclear grade and TNM tumor stage IA, IB). Statistically significant correlations were found between histopathological type and p53 expression, since P < 0.05 (P = 0.015). Comparing p53 expression with grade resulted in a strong positive correlation (P < 0.0396, R2 = 0.9223). The percentage of p53-positive tumors progressively increased from 0% in grade 1 to 75% in grade 4. No correlation was found between p53 expression and tumor stage. In case of XRCC1, the highest level was found in squamous cell lung carcinoma, where 71% of samples was positive. In case of large cell carcinoma samples, it was 67%, and in adenocarcinoma 52% of samples showed XRCC1 immunoreactivity. No statistically significant correlation was found between histopathological type, grade or early stage (IA, IB) of non-small cell lung cancer and expression of XRCC1 protein profile without neoadjuvant therapy. We found a statistically significant correlation between p53 expression and histopathological tumor type. It is possible that stabilized p53 protein plays an important role in the development of squamous and large cell carcinoma. Our findings also suggest that p53 expression cumulates with the dedifferentiation of cancer cells. It is possible that the expression of XRCC1 is not fixed and could be changed by the status of cancer cells and in relation to therapy. Relevant data about pre- versus post-chemotherapy and XRCC1 expression are needed to evaluate the influence of XRCC1 on drug resistance.

Small-ventricle neuroendoscopy for pediatric brain tumor management

The use of intraventricular endoscopy to achieve diagnosis or to resect accessible intraventricular or paraventricular tumors has been described in the literature in both adults and children. Traditionally, these techniques have not been used in patients with small ventricles due to the perceived risk of greater morbidity. The authors review their experience with the effectiveness and safety of endoscopic brain tumor management in children with small ventricles. Between July 2002 and December 2009, 24 children with endoscopically managed brain tumors were identified. Radiological images were reviewed by a radiologist blinded to study goals and clinical setting. Patients were categorized into small-ventricle and ventriculomegaly groups based on frontal and occipital horn ratio. Surgical success was defined a priori and analyzed between groups. Trends were identified in selected subgroups, including complications related to pathological diagnosis and surgeon experience. Six children had small ventricles and 18 had ventriculomegaly. The ability to accomplish surgical goals was statistically equivalent in children with small ventricles and those with ventriculomegaly (83% vs 89%, respectively, p = 1.00). There were no complications in the small-ventricle cohort, but in the ventriculomegaly cohort there were 2 cases of postoperative hemorrhages and 1 case of infection. All hemorrhagic complications occurred in patients with high-grade tumor histopathological type and were early in the surgeon's endoscopic career. Based on our experience, endoscopy should not be withheld in children with intraventricular tumors and small ventricles. Complications appear to be more dependent on tumor histopathological type and surgeon experience than ventricular size.

Staging of esophageal cancer: TNM and beyond

Previous staging of esophageal cancer was based on a simple, orderly arrangement of increasing anatomic T, then N, then M classifications. This system is consistent with neither data nor cancer biology. Recent worldwide collaboration has provided data for unique, modern machinelearning analysis that has resulted in a new, data-driven staging system for cancer of the esophagus and esophagogastric junction. This new system is presented in the seventh editions of the AJCC and UICC Cancer Staging Manuals. It is more representative of and consistent with the clinical reality of survival of patients with esophageal cancer. Changes address problems of empiric stage grouping and lack of harmonization with stomach cancer. In addition, for the first time, nonanatomic cancer characteristics such as tumor location, histologic grade, and histopathologic cell type are incorporated. The new era of data-driven staging of esophageal cancer promises a bright future for staging of all cancers. However, more extensive worldwide collaboration is required to refine and broaden TNM classifications and identify cancer and patient characteristics that influence esophageal cancer stage and impact survival.

Sensitivity of integral computer-aided detection with full-field digital mammography for detection of breast cancer according to different histopathological tumor types and appearances

Sensitivity of integral computer-aided detection with full-field digital mammography for detection of breast cancer according to different histopathological tumor types and appearances

Conspicuity of breast cancer according to histopathological type and breast density when imaged by full-field digital mammography compared with screen-film mammography

To compare the conspicuity of different histopathological types of breast cancer according to breast density and mammographic imaging in patients with screen-detected breast cancers undergoing both full-field digital mammography (FFDM) and screen-film mammography (SFM) in the United Kingdom National Health Service Breast Screening Programme (NHSBSP). 185 patients underwent routine screening with SFM followed by further imaging using FFDM with consequent diagnosis of breast cancer. All SFM and soft-copy FFDM images were evaluated by two readers in an independent, retrospective review. The visualisation and conspicuity of the mammographic abnormality were recorded and graded using a four-level scale. Conspicuity of breast cancer was qualitatively evaluated. Breast density and conspicuity were correlated with histopathological diagnosis and inter-observer correlation was calculated. Mixed Model ANOVA demonstrated significant differences between FFDM and SFM (p<0.001) and breast densities (p=0.009): conspicuity of the mammographic abnormality (p<0.001) and visualisation of the dominant mammographic feature (p<0.001) were significantly greater with FFDM than SFM. This held true for both readers and for all histopathological tumour types with no significant differences between each tumour type. FFDM is significantly superior to SFM for conspicuity of screen-detected breast cancers for all histopathological types and breast densities.

Survival and prognostic factors in surgically resected synchronous multiple primary lung cancers

The presence of synchronous multiple primary non-small-cell lung cancers (SMPLC) is a rare condition and the optimal treatment remains unclear. In this study, the survival of surgically treated SMPLC patients and the factors affecting survival were analyzed. Between 2001 and 2008, 26 consecutive patients diagnosed with SMPLC, who had all of their tumors resected, were retrospectively evaluated. Patients, who had bronchoalveolar carcinoma or carcinoid tumors and satellite nodules, were excluded. Prognostic factors were analyzed using univariate and multivariate analyses. The tumors were unilateral in 14 and bilateral in 12 patients. In total, 38 procedures were performed. A complete resection was achieved in 35 (92.1%) procedures. The in-hospital mortality rate was 7.6% (two patients). The overall 5-year survival rate was 49.7%, and the median survival time was 40 months. The 5-year survival rate was 40.6% for unilateral and 62.8% for bilateral SMPLC patients (p = 0.47). Histopathologic tumor type, N1 nodal disease, tumor (T) status, and older age did not influence survival. There was no survival disadvantage for patients, upon whom a sublobar resection had been performed. There was a trend toward poorer survival in patients upon whom a pneumonectomy had been performed (p = 0.12). The 3-year survival rate for patients, who received adjuvant chemotherapy and/or radiotherapy (66.7%), was better than other patients (56.3%). In the multivariate analysis, we found a trend toward poor survival in patients, who received a pneumonectomy, and a trend toward better survival in patients, who received adjuvant therapy (p = 0.05 and p = 0.06). The survival of SMPLC patients, who were treated surgically, was satisfactory. Pneumonectomy was a poor prognostic factor, whereas adjuvant therapy was a good prognostic factor.