Specificity For Malignant Tumors Research Articles

Significance of Insulin-Like Growth Factor II Mrna-Binding Protein 3 (IMP3) Expression in Selected Thyroid Lesions

Background: Differentiation of benign from malignant follicular thyroid lesions remains difficult and the ability of molecular markers to differentiate between them still unclear. The aim of this study was to evaluate the usefulness of IMP3 expression to distinguish benign from malignant thyroid lesions. Methods: This is a retrospective study upon selected 57 thyroid lesions designated as; 7 cases of Hashimoto thyroiditis (HT), 10 cases of hyperplastic nodules (HN), 15 cases of follicular thyroid adenoma (FTA), 13 cases of conventional papillary thyroid carcinoma (PTC), 6 cases of follicular variant of papillary thyroid carcinoma (FV-PTC), and 6 cases of follicular thyroid carcinoma (FTC). Immunohistochemistry was applied on formalin-fixed, paraffin-embeded tissue blocks using IMP3. clinicopathological data were reviewed from patients' pathological reports and correlated with IMP3 expression. Results: IMP3 positivity was seen in1/7 cases (14.3%) of HT, 2/10 cases (20%) of HN, 4/15 cases (26.7%) of FTA, 12/13 cases of PTC, and in all (100%) FV-PTC & FTC cases. IMP3 staining was significantly increased from normal thyroid tissue up to malignant tumors (P<0.01). IMP3 showed 96% sensitivity and 78.1% specificity for malignant tumors. IMP3 expression was positively correlated with grade and tumor size in malignant cases (P<0.05). No significant correlation was found in IMP3 expression with patient age, sex, capsular invasion, lymphatic/vascular invasion, lymph node metastasis, distant metastasis and TNM stage. Conclusions: IMP3 is a potential diagnostic marker for thyroid cancer and can be a promising marker for distinguishing benign from malignant follicular patterned thyroid lesions.

Treatment Strategy of a Huge Ameloblastic Carcinoma

Ameloblastic carcinoma is a very rare malignant odontogenic tumor. We report a case of secondary-type ameloblastic carcinoma that extended transversally over almost half of the side of the face. Malignant transformation and identification of the malignant region in the large tumor were achieved using L-3-[F]fluoro-α-methyltyrosine (FAMT)-positron emission tomography (PET); FAMT is transported into cancer cells by L-type amino acid transporter 1 and shows high specificity for malignant tumors. The malignant region determined by microscopic evaluation of resected samples was similar to the region showing high FAMT uptake in PET. Using preoperative FAMT-PET and magnetic resonance imaging, we were able to achieve total resection of the very large tumor, while avoiding excessive resection that could cause severe functional loss or a poor aesthetic facial appearance. We used a modified Weber-Fergusson incision along the nasolabial fold to the labiajugal fold and reconstruction with a pectoralis major muscle flap, and this gave a good aesthetic outcome. Safe surgical resection was possible because preoperative three-dimensional computed tomography angiography was used to identify the position of the main trunk of the external carotid artery, which was closely aligned with the tumor in a posterior direction in the infratemporal fossa region.

Diagnostic performance of transvaginal gray-scale ultrasound for specific diagnosis of benign ovarian cysts in relation to menopausal status

In this study we aimed to assess the diagnostic accuracy of transvaginal ultrasound for assigning a specific diagnosis to benign adnexal masses in pre- and postmenopausal women. The study comprised 2146 adnexal masses in 1980 women. 1420 women were premenopausal and 560 were postmenopausal. Specific diagnosis of presumed histology of the lesion using gray-scale ultrasound findings was provided based on examiner's impression. Definitive diagnosis was obtained in all cases. Sensitivity and specificity for each diagnosis were calculated in both pre and postmenopausal women. Specificity for malignant tumors was significantly higher in premenopausal women ( p < 0.001). Sensitivity for endometrioma ( p < 0.05) and hemorrhagic cyst ( p < 0.01) was significantly higher in premenopausal women. There was a trend for a higher sensitivity for serous cyst in postmenopausal women ( p = 0.09). We conclude that the diagnostic performance of transvaginal gray-scale ultrasound for specific diagnosis of adnexal masses based on examiner's impression is different in premenopausal and postmenopausal women.

Body Diffusion-Weighted MR Imaging Using High b-Value for Malignant Tumor Screening: Usefulness and Necessity of Referring to T2-Weighted Images and Creating Fusion Images

To evaluate the potential usefulness of high b-value body diffusion-weighted images (DWIs) as a screening tool in the depiction of abdominal malignant tumors. We selected 110 abdominal magnetic resonance examinations (1.5 T; 60 men; age range, 25-90 years) with and without malignant tumors (n = 37 and n = 73, respectively). Axial DWIs were obtained by single-shot spin-echo (SE) type echo planar imaging (EPI) sequence with inversion pulse (repetition time, 6,800 msec; echo time, 100 msec; T1, 150 msec; b value, 1,000 sec/mm(2)) without breath-holding. Two radiologists independently interpreted the DWIs, T2-weighted images (T2-WI), all three types of images including DWIs, T2-WIs, and fusion images at the same time (DWIs + T2-WIs + fusion) with 7-14 days' interval, and the diagnostic confidence for each patient was scored. The area under the curve (AUC) of the composite receiver operating characteristic (ROC) curve of DWIs + T2-WIs + fusion (0.904) was significantly higher than those of DWIs (0.720; P < .001) and T2-WIs (0.822; P < .05). Both sensitivity and specificity were higher in DWIs + T2-WIs + fusion (89.5% and 81.9%, respectively) compared with those of DWIs (72.4% and 59.0%; P < .01 and P < .001, respectively). Abdominal high b-value DWIs have a high sensitivity and specificity for malignant tumors when T2-WIs are referred and image fusion technique is employed, suggesting that it may potentially be a new screening tool.

Abberations in Phospholipase D Activity‐A Pharmacological Target for Cancer Detection

Understanding molecular targets and developing novel molecular imaging agents can improve early cancer detection. Radioiodinated NM404, a phospholipid ether analog in clinical trials, displays selective and prolonged retention in 28/28 xenograft and spontaneous tumor models. This specificity for malignant tumors is apparently due to prolonged and selective retention of NM404 in cancer cells having reduced ability to metabolize NM404. Prior in vitro studies implicate phospholipase D (PLD) in NM404 metabolism. PLD is a critical regulator of cell proliferation, survival signaling, cell transformation and tumor progression. Decreased expression of PLD in numerous tumors has been reported, and thus, reduced PLD levels in malignant cells may result in prolonged retention of NM404. PLD activity and expression were evaluated to assess the mechanism of action of NM404 and possibly identify novel drug development targets. Fluorescent enzyme assay and RT-PCR were used to quantify PLD in mouse and human malignant cell lines and solid tumors compared to normal host tissue. PLD activity and mRNA levels were significantly lower (p<0.05, T-test) in malignant cells compared to the respective normal host tissues. The data strongly suggest decreased PLD activity in malignant cells may result in selective retention of NM404 and that malignancy maybe associated with aberrations in PLD activity. Supported by NCI grant CA95240

Parotidectomy: review of treatment and outcomes.

Parotidectomy is a common surgical procedure performed for a wide array of benign and malignant tumours. The aim of the present study was to review a single-institution experience with parotidectomy over a 10 year period. We retrospectively reviewed 170 patients who had parotidectomy performed. The preoperative investigations, clinicopathological parameters, perioperative morbidity and mortality were assessed. One hundred and six (62%) of the patients were men. The mean age was 54 years (range 21-80). Indications for parotidectomy included benign tumour (44%), malignant tumour (42%), inflammatory parotid disease (7%) and miscellaneous (5%). The most common benign tumour was pleomorphic adenoma (25%). The most common malignant tumour was metastatic cutaneous squamous cell carcinoma (SCC) (19%). Fine needle aspiration cytology was performed in 83% patients with a sensitivity and specificity for benign tumours of 76% and 97%, respectively. The sensitivity and specificity for malignant tumours was 90% and 99%, respectively. One (0.6%) patient died in the postoperative period. Postoperative complications included wound infection (2.3%), wound haematoma (3.5%) and seroma (6.6%). Six patients (3.5%) developed temporary complete facial paresis, while 33 patients (20%) developed temporary partial facial palsy in the immediate postoperative period. The 2-year disease-free and disease-specific survival for those patients with metastatic cutaneous SCC were 75% and 76%, respectively. The most common indications for parotidectomy were pleomorphic adenoma and metastatic cutaneous SCC. Our perioperative morbidity and survival for patients with malignant parotid disease compare favourably with other institutional series.