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Selected AbstractsAn audit of ,equivocal' (C3) and ,suspicious' (C4) categories in fine needle aspiration cytology of the breastCYTOPATHOLOGY, Issue 4 2001R. A. Deb An audit of ,equivocal' (C3) and ,suspicious' (C4) categories in fine needle aspiration cytology of the breast We have audited the frequency of use and outcome of the ,equivocal/atypia probably benign' (C3) and ,suspicious of malignancy' (C4) category for breast cytology in our Unit. A total of 14 935 cytological specimens were reported by at least one of the three pathologists with a special interest in breast pathology, according to five categories of the NHSBSP guidelines for cytology reporting, 1992; 3.7% (555 cases) and 3.9% (587 cases) of cases were classified as equivocal (C3) and suspicious (C4), respectively, giving a total rate (C3 + C4) of 7.6%. Of the C3 cases, 68% were subsequently benign and 32% were malignant. Of the C4 cases, 19% were subsequently benign and 81% malignant. The commonest benign lesions in both categories were fibroadenomas (7.6% of C3 and 19.8% of C4), fibrocystic change (14.3% of C3 and 12.5% of C4), radial scars (6.2% of C3 and 10.4% of C4) and papillomas (6.2% of C3 and 6.3% of C4). Of the malignant lesions (particularly those classified as C3), a high proportion were low grade or special type cancers. The categories of atypia probably benign (C3) and suspicious of malignancy (C4) in breast cytology provide a strategy for classification of problematic or uncertain cases; this maintains the predictive value of the benign (C2) and malignant (C5) categories, and allows separation of these difficult cases into clinically useful groups with differing probabilities of malignancy. [source] Comparison of the sensitivity of conventional cytology and the ThinPrep Imaging System for 1,083 biopsy confirmed high-grade squamous lesions,DIAGNOSTIC CYTOPATHOLOGY, Issue 5 2010C.T. (A.S.C.), C.T. (I.A.C.), J. A. Halford B.App.Sc. Abstract Liquid-based cytology continues to be utilized as an adjunct to conventional cytology in most Australian laboratories, even though a direct-to-vial ThinPrep protocol has been introduced in many countries with established cervical screening programs. Manual screening of ThinPrep slides has been widely practiced for more than 10 years and the recent introduction of the ThinPrep Imaging System (TPI) has been reported as being more sensitive than the conventional smear (CS) in the identification of high-grade cervical disease. We report our experience with ThinPrep Imaging since its introduction into our routine gynecological cytology service. 87,284 split sample pairs reported using the Imaging System demonstrated a decrease in unsatisfactory reports (3.65% for CS and 0.87% for TPI) and an increase in possible high grade and definite high-grade squamous reports (1.57% for CS and 1.62% for TPI). For 1,083 biopsy confirmed high-grade lesions, the correct diagnosis of high grade or possible high-grade squamous disease was made on the ThinPrep imaged slide in 61.0% (661/1,083) of cases and on the CS in 59.4% (643/1,083). This was not statistically significant. When all abnormalities identified on cytology were considered, including possible low grade and definite low-grade abnormalities, the difference in sensitivity for Thinprep imaged slides of 96.0% (1,040/1,083) and CSs of 91.6% (992/1,083) was statistically significant. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source] The expression pattern of MUC1 (EMA) is related to tumour characteristics and clinical outcome in ,pure' ductal carcinoma in situ of the breastHISTOPATHOLOGY, Issue 2 2007M A J De Roos Aims:, To classify MUC1 according to five predefined expression patterns in ductal carcinoma in situ (DCIS) and related clinicopathological parameters, coexpression of other biological markers and prognosis. Methods and results:, With a manual tissue arrayer, 92% (n = 80) of the 87 DCIS samples were successfully targeted. Immunohistochemistry was carried out for MUC1, oestrogen receptor (ER), progesterone receptor (PR), Her2/Neu, p53 and cyclin D1. Entire membrane expression was related to Her2/neu negativity (P =0.042). Apical membrane expression was associated with low grade (P = 0.027), Her2/neu negativity (P = 0.014) and PR positivity (P = 0.005). Focal cytoplasmic expression was related to high grade (P = 0.006). Diffuse cytoplasmic expression was associated with high grade (P = 0.004), large tumour size (P = 0.046), Her2/neu positivity (P =0.042) and cyclin D1 positivity (P = 0.002). On the basis of these analyses the four patterns were reclassified as membranous or cytoplasmic expression. On multivariate analysis, cytoplasmic MUC1 expression (hazard ratio 8.5, 95% confidence interval 1.0, 73.0; P = 0.04) was the only independent predictor of local recurrence. Conclusions:, Four patterns of MUC1 expression are recognized in DCIS that suggest a relationship to functional differentiation and can be simplified into two types that are clinically relevant and could therefore be helpful in the distinction between different subgroups of DCIS. [source] Expression of multiple human endogenous retrovirus surface envelope proteins in ovarian cancerINTERNATIONAL JOURNAL OF CANCER, Issue 1 2007Feng Wang-Johanning Abstract Individual classes of human endogenous retrovirus (HERV) genes and proteins are expressed in cancer, but expression of more than one type of HERV is rare. We report here the expression of multiple HERV genes and proteins in ovarian cell lines and tissues. Expression of HERV-K env mRNA was greater in ovarian epithelial tumors than in normal ovarian tissues (N = 254). The expression of this protein on the surface and in the cytoplasm of ovarian cancer cells was confirmed using anti-HERV-K specific antibody by flow cytometric analysis. The frequency of expression of HERV-K env protein in multitissue microarrays (N = 641) was determined by immunohistochemistry and a significant correlation with tumor histotype was found. A significantly increased expression of HERV-K was observed in tumors with low malignant potential and low grade, relative to expression in normal ovarian tissues. The increase in expression of HERV-K env protein took place in a stepwise fashion in serous papillary adenocarcinoma. Interestingly, we found that other classes of HERV env mRNAs, including ERV3 and HERV-E, are expressed in the same ovarian cancer tissues that expressed HERV-K. Furthermore, anti-HERV antibodies including anti-ERV3 (30%), anti-HERV-E (40%) and anti-HERV-K (55%) were detected in patients with ovarian cancer, but not in normal female controls. HERV env proteins are frequently transcribed and translated in ovarian epithelial tumors, and multiple HERV families are detectable in ovarian cancer. HERV env proteins, and especially those expressed on the cell surface, may serve as novel tumor targets for detection, diagnosis and immunotherapy of ovarian cancer. © 2006 Wiley-Liss, Inc. [source] Inverse correlation of microvessel density with metastasis and prognosis in renal cell carcinomaINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2004TETSUYA IMAO Abstract Background: Although a correlation between microvessel density (MVD) and tumor aggressiveness has been established for several malignancies, the data for renal cell carcinoma (RCC) is conflicting. In order to clarify the significance of MVD, we investigated the relationships between MVD and tumor stage, grade, size, occurrence of metastasis and patient survival. Methods: Tumor specimens from 70 patients with primary renal cell carcinoma were examined by immunohistochemical staining for CD34. Results: There was a tendency for MVD to decrease from G1 to G3 tumors or from stage T1 to T3 tumors, although this was not statistically significant. However, the MVD for 56 non-metastatic and 14 metastatic tumors were significantly different (P = 0.005) at 109 ± 67 and 58 ± 35 per ×400 field (mean ± SD), respectively. Microvessel density for 36 large and 34 small tumors was also significantly different (P < 0.0001) at 48 ± 22 and 142 ± 54 per ×400 field, respectively. The survival rate of patients with small, low grade and hypervascular tumors was significantly higher than that of patients with large (P = 0.0015), high grade (P = 0.05) or low MVD (P = 0.039) tumors. Cox proportional hazards regression analysis showed that tumor grade and size emerged as independent prognostic factors. Conclusion: High MVD in RCC was inversely associated with tumor aggressiveness, but MVD was not the independent prognostic factor. [source] Clinical features of renal cell carcinoma less than 25 millimeters in diameterINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2002YOSHIAKI YAMADA Abstract Background: We retrospectively investigated the clinicopathological features and prognosis of patients who underwent surgical treatment at our department for renal cell carcinoma (RCC) less than 25 mm in diameter. Methods: Of the 158 patients who underwent surgical treatment between April 1975 and April 1998, 16 (17 kidney, 10.1%) were included in this study. The study included 11 men and 5 women (ratio: 2.2). The age range was 35,76 years (average: age 53). The right kidney was involved in 9, left kidney in 6 and bilateral kidneys in 1 patient. The follow-up period was 26,157 months (mean: 86 months). Results: Thirteen tumors (81.2%) were incidental carcinomas. No patients had a tumor of rapid growing type. Radical nephrectomy was performed for 12 kidneys (70.6%), simple nephrectomy for 2 (11.8%) and partial nephrectomy for 3 (17.8%). Seven patients (43.7%) received interferon-, as postoperative adjuvant therapy. All tumors were pathologically classified as expansive type; 11 (64.8%) as clear cell carcinoma; 3 (17.6%) cyst-associated, and 3 (17.6%) papillary. Nine (52.9%) tumors were grade 1, and 8 (47.1%) were grade 2. Fourteen patients were pNo and V(,). The 5- and 10-year survival rates were excellent (100%). Conclusion: The features of small RCCs less than 25 mm were as follows: many tumors were incidental to clear cell carcinomas; all tumors were low grade, low stage and expansive type; no tumors showed acute phase reactants; and few tumors were of the solid type. Thus, the prognosis seemed to be excellent. [source] Clinical, urodynamic and endoscopic characteristics of the Stanford pouch ileal neobladder constructed with absorbable staplesINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2000M Cemil Uygur Abstract Purpose The clinical, urodynamic and endoscopic aspects of the Stanford pouch ileal neobladder formed with absorbable staples were investigated. Methods A Stanford pouch ileal neobladder was formed using absorbable staples after radical cystoprostatectomy in 30 male patients with the diagnosis of muscle invasive carcinoma of the bladder between 1995 and 1998. The mean age of the patients was 62 (range 41,70) years. Patients were followed with arterial blood gas, serum biochemistry, pouch cystography, urodynamic tests and endoscopy. Results Five (16.7%) patients had early postoperative complications and three were related to the neobladder. One year postoperatively, low grade (I, II) vesicoureteral reflux was present in five (16.7%) cases. The mean preoperative and 6 months postoperative serum creatinine levels were 1.07 ± 0.3 mg/dL and 1.2 ± 0.4 mg/dL, respectively, but the difference was not statistically significant (P = 0.1). Six months postoperatively the mean serum chloride level was 109 ± 4.5 (range 100,113) mmol/L and the mean arterial blood pH was 7.37 ± 0.2 (range 7.3,7.4). Two (6.7%) patients required oral alkaline supplementation because of high chloride levels. All the patients except one were continent throughout the day after 1 year. However, nocturnal enuresis was present in 25 (83.3%) cases. The pouch capacity was increased gradually up to 12 months postoperatively and the mean pouch capacity 12 months postoperatively was 460 ± 95.8 mL. Micturition occurred spontaneously in most patients while some needed abdominal straining. None of the patients had a residual urine of more than 60 mL. The mean maximum flow rate 6 months postoperatively was 9.8 (range 5.4,15.0) mL/s. After 6 months the stapled edge was noticed as a nodular line. One year postoperatively only a white scar could be observed at the suture line. Conclusion The Stanford pouch ileal neobladder constructed using absorbable staples was able to provide a good capacity,low pressure reservoir with a low rate of complications. [source] Prospect theory analysis of guessing in multiple choice testsJOURNAL OF BEHAVIORAL DECISION MAKING, Issue 4 2002Yoella Bereby-Meyer Abstract The guessing of answers in multiple choice tests adds random error to the variance of the test scores, lowering their reliability. Formula scoring rules that penalize for wrong guesses are frequently used to solve this problem. This paper uses prospect theory to analyze scoring rules from a decision-making perspective and focuses on the effects of framing on the tendency to guess. In three experiments participants were presented with hypothetical test situations and were asked to indicate the degree of certainty that they thought was required for them to answer a question. In accordance with the framing hypothesis, participants tended to guess more when they anticipated a low grade and therefore considered themselves to be in the loss domain, or when the scoring rule caused the situation to be framed as entailing potential losses. The last experiment replicated these results with a task that resembles an actual test. Copyright © 2002 John Wiley & Sons, Ltd. [source] Superficial leiomyosarcoma: a clinicopathologic review and updateJOURNAL OF CUTANEOUS PATHOLOGY, Issue 2 2010Clarissa T. Fauth Fauth CT, Bruecks AK, Temple W, Arlette JP, DiFrancesco LM. Superficial leiomyosarcoma: a clinicopathologic review and update. Background: Superficial leiomyosarcomas (SLMSs) are rare soft tissue malignancies. A clinicopathologic review of 25 cases was undertaken. Methods: Twenty-five cases diagnosed between 1990 and 2007 were reviewed. Clinical information was obtained from patient charts. Histologic slides were reviewed, and immunohistochemical stains were performed. Results: All patients presented with a nodule. Fourteen tumors were confined to the dermis and 11 involved subcutaneous tissue. Smooth muscle markers were positive in all cases. CD117 was consistently negative. Novel histological features included epidermal hyperplasia, sclerotic collagen bands and increasing tumor grade with the depth of the lesion. Poor outcome was associated with size > 2 cm, high grade and depth of the lesion. Conclusions: SLMSs are rare but important smooth muscle tumors of the skin. The clinical presentation may be non-specific. The histologic appearance is that of a smooth muscle lesion, but epidermal hyperplasia and thickened collagen bands are previously underrecognized features. Immunohistochemical stains are useful in confirming smooth muscle differentiation, but CD117 is of limited utility. SLMS can appear low grade or even benign on superficial biopsies, leading to undergrading or a delay in the correct diagnosis. Clinicians and pathologists alike should therefore be aware of these pitfalls and must approach these cases with caution. [source] Epithelial salivary gland tumors of children and adolescents in west China population: a clinicopathologic study of 79 casesJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 4 2008Liu Laikui Objective:, Determine the clinical and histopathologic features of epithelial salivary gland tumors of children and adolescents. Methods:, A total of 79 cases of epithelial salivary gland tumors of children and adolescents were retrieved from the files. Information about demographic, clinical, histopathologic characteristics, and follow-up status were analyzed. Results:, Sixty tumors (75.9%) were benign and 19 (24.1%) malignant. The most common tumor overall was pleomorphic adenoma (PA). The parotid was the most frequently involved site (43.0%). PA was the most common type of benign tumor. The most common malignant tumor was mucoepidermoid carcinoma. Five patients with parotid PA and two cases with palate myoepithelioma showed local recurrences. One patient with mucoepidermoid carcinoma showed local recurrences and died from the tumor 3 years after the initial treatment. One patient with adenocarcinoma presented local and neck recurrences, and died 4 years after initial treatment. Conclusions:, Our data showed that the salivary gland tumors in children and adolescents may be the higher incidence of benign tumors, especially of PA; the slightly higher tendency for female predominance; the higher incidence of parotid glands. Mucoepidermoid carcinoma was the most common malignant tumor, with majority of low grade. Initial treatment should be planned to excise the tumor completely with satisfactory margins. The neck dissections or postoperative radiotherapy were performed in patients with low differentiation malignancies, or patients who present nodal metastasis or with clinically suspicious regional metastasis. [source] Comparison of dentine hypersensitivity in selected occidental and oriental populationsJOURNAL OF ORAL REHABILITATION, Issue 1 2001D. G. Gillam Epidemiological data on dentine hypersensitivity (DH) prevalence are limited. Few studies have compared prevalence between populations. The aim of this investigation, therefore, was to compare the perception and prevalence of DH in two distinct non-periodontal practice populations, one U.K. and one Korean. Completed questionnaires from 557 patients (230 males and 327 females, comprising 115 males and 162 females, mean age 41·7 years (s.d.=14·36), U.K. and 115 males and 165 females, mean age 29·7 years (s.d.=11·86), Korean) were collected. Analysis was by frequency distribution and cross-tabulation (Statistical Package for the Social Sciences (SPSS)). DH prevalence was similar and at levels comparable with those reported previously. Prevalence was higher in the third and fourth decades in both populations. Although there were no differences between U.K. or Korean males and U.K. or Korean females, there was a significant difference between gender reporting of DH, with more females complaining of DH than males (standard normal deviation (SND)=4·3, 95% confidence interval (CI)=0·1134,0·2736). DH appeared to be regarded by patients as not severe in most cases, so treatment was not generally sought. Of those who claimed to have sought treatment, a significant number had received restorative treatment. Of those patients, only 23·3% of U.K. and ,2% of Korean patients claimed to have used a desensitizing dentifrice. Pain from DH was reported as low grade (slight, occasional) occurring over 5 years in both populations. Cold appeared to be the most reported stimulus in the two populations. Less periodontal surgery had been undertaken in these two populations (12·6% U.K. and 7·1% Korean) compared with those referred to a teaching hospital periodontal department (34·5%). This compared favourably with previous findings in the general dental population (15·5%). Discomfort following hygiene therapy did not appear to last ,7 days in either population. The results indicated that there were no significant differences between U.K.- and Korean-based populations in their perception of DH, with the exception that more females complained of sensitivity than males in both groups. Overall, DH was not considered a major dental problem by most patients in either of the populations. [source] Low utilisation of unactivated protein C in a patient with meningococcal septic shock and disseminated intravascular coagulationACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2003A. Lignell Background:, Activated protein C has recently been shown in a multicentre trial to significantly reduce mortality in patients with septic shock. There are also some case reports and minor studies demonstrating promising results with the unactivated form of protein C. However, in children with severe meningococcal infection, skin biopsies have demonstrated low expression of endothelial thrombomodulin and protein C receptors, suggesting low protein C activation capacity in severe meningococcal sepsis. Methods:, A patient with meningococcal septic shock was treated with two doses of the unactivated form of protein C, the first during intense activation of the coagulation system and the second during a phase of low grade or no activation. Repeated plasma samples were analysed for protein C concentration, which made it possible to compare pharmacokinetics and half-lives of the two administrations. A shorter half-life during intense coagulation was expected if there was an activation and consumption of the protein C administered. Results:, The calculated half-lives of protein C during intense and low grade activation were 32 h and 19 h, respectively, a magnitude similar to that reported in protein C-deficient patients without infection. Conclusion:, The result indicates that whole body utilisation of the unactivated protein C was low. Endothelial impairment of protein C activation does not seem to be restricted to the skin vessels only. [source] Salivary gland neoplasms in children: The experience of the Istituto Nazionale Tumori of MilanPEDIATRIC BLOOD & CANCER, Issue 6 2006Marco Guzzo MD Abstract Background Epithelial salivary gland tumors are very uncommon in pediatric age. We report a series of 52 cases treated at the Istituto Nazionale Tumori of Milan, Italy, over a 30-year period. These results are presented in conjunction with a literature review of salivary tumors with a view to providing an up-to-date overview of the clinical course, prognosis, and treatment options for this rare tumor. Procedure Fifty-two cases of epithelial salivary tumors were reviewed and the clinical-pathological information concerning tumor characteristics, therapy, and follow-up were collected. Patients' age ranged between 4 and 18 years. Results The major salivary glands were the main site of tumor occurrence (79% of cases arose in parotid glands); 37 patients had benign tumors (pleomorphic adenoma), 15 had malignant tumors (12 mucoepidermoid carcinoma, 9 low grade). All the patients were treated by surgery; local relapses after parotidectomy were 4% and 25%, in benign and malignant tumors, respectively. When tumor enucleation was performed, recurrences occurred in 50% of benign neoplasms. At the time of the report, all patients with benign tumors were alive, 35(95%) without evidence of disease; only one patient with malignant tumor died of disease. Conclusions Epithelial salivary glands tumor in children had different characteristics compared with their adult counterpart with respect to the frequency of histotypes and site of occurrence, but their prognosis seems to be similar. Parotidectomy (total or superficial) is the best choice for achieving good cure rates in both benign and malignant tumors. Pediatric Blood Cancer 2006;47:806,810. © 2006 Wiley-Liss, Inc. [source] The value of postoperative radiotherapy in childhood nonrhabdomyosarcoma soft tissue sarcoma,PEDIATRIC BLOOD & CANCER, Issue 5 2004Arnold C. Paulino MD Abstract Objective To determine the value of postoperative radiotherapy (RT) in the management of nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) of childhood. Procedure From 1964 to 2000, 62 children with a median age of 14 years were seen at the University of Iowa and underwent a wide local excision for non-metastatic NRSTS. Tumors were high grade in 36 (58%) and >5 cm in 24 (39%). Margins of resection were negative (Group I) in 37 (60%) and positive (Group II) in 25 (40%). Postoperative RT was delivered to 20 patients (32%); eight of 37 (22%) Group I and 12 of 25 (48%) Group II children received postoperative RT. Chemotherapy was employed in 19 patients (31%). Median follow-up was 9.6 years. Results The 5- and 10-year overall survival rates for Group I were 69 and 63% and for Group II were 66 and 60%. The 5- and 10-year local control rate was 66%. On multivariate analysis, size of tumor (P,<,0.001) and postoperative RT (P,=,0.017) were prognostic factors for local control. All 13 Group I children with low grade, ,5 cm tumors were locally controlled without RT. For Group II patients, 2- and 5-year local control rates were 92 and 82% with postoperative RT and 51 and 43% for no RT (P,=,0.0426). Conclusions Local control was improved by the addition of postoperative RT in tumors with positive margins of resection. © 2004 Wiley-Liss, Inc. [source] Physical activity reduces prostate carcinogenesis in a transgenic modelTHE PROSTATE, Issue 13 2009Karyn A. Esser Abstract BACKGROUND Several epidemiological studies have reported an inverse association between physical activity and the risk of prostate cancer. To date, there are few animal studies looking at physical activity and cancer incidence, although the results are consistent with the epidemiological evidence. In general, as exercise intensity increased in the rats/mice, the likelihood that physical activity inhibited carcinogenesis increased. METHODS The present study used voluntary wheel running with C3(1)Tag mice that are predisposed to prostate cancer due to the directed expression of SV40 oncogenes. After 10 weeks, the prostates were collected from run and non-run mice and histopathology performed for the presence or absence of low grade or high grade PINS. RESULTS We found that for those mice that ran >5Km/group, 83% of the dorsolateral prostates were classified as within normal levels vs. 43% for the <5 km/day group (p,=,0.16). In addition, there was a relationship between average distance run and pathologic progression to high-grade PIN and local invasion, considered to be an early event in the formation of prostate adenocarcinoma. Forty three percent of dorsalateral prostates from mice that ran less than 5 km/day were classified with advanced pathology as compared to none (0) in mice that ran more than 5.0 km/day (p,=,0.05). CONCLUSIONS The results presented herein indicate that prostatic cancer progression is likely delayed or diminished by wheel running activity in a dose dependent manner in transgenic mice. These findings provide further evidence that exercise acts to decrease the progression of prostate cancer and they establish a transgenic animal model for future studies to define mechanism(s). Prostate 69: 1372,1377, 2009. © 2009 Wiley-Liss, Inc. [source] Pathologic stage T2a and T2b prostate cancer in the recent prostate-specific antigen era: Implications for unilateral ablative therapyTHE PROSTATE, Issue 13 2008Thomas J. Polascik Abstract BACKGROUND Early detection of small volume prostate cancer (PCa) has led to the concept of focal therapy to treat in an organ-sparing manner. We evaluated trends in pathologic staging among patients with localized PCa undergoing radical prostatectomy (RP), defining the frequency of unilateral cancers during 1988,1995, 1996,2000 and 2001,2006. METHODS Data were abstracted from the Duke Prostate Cancer Outcome database selecting 3,676 men with available pathology treated with RP. Based on surgical pathology, trends in as pathological T (pT) stage, pathological Gleason Score (pGS), and percent tumor involvement (PTI) were evaluated. RESULTS pT2a increased from 2.8% of men undergoing RP in 1988,1995 to 13.0% during 2001,2006 (P,,<,,0.0005). PTI analysis shifted towards low volume disease, e.g. PTI,,,5% increased from 10% during 1988,1995, to 37% in 2001,2006 (P,<,0.005). Of all pT2a disease throughout 1988,2006, an increase in proportion of pT2a tumors from 10% during 1988,1995 to 69.4% during 2001,2006 was identified. Over three eras, pT2a had minimal (65% had PTI,,,5%) or small volume (14% had PTI 5.01,10.00) disease, and 59% were low grade (pGS,,,6). Using a Cox Hazard model, pT2a versus pT2b disease, surgical margins, PTI, and PSA statistically contributed to PSA disease-free survival in the contemporary era 2001,2006. CONCLUSIONS The increasing prevalence of unilateral pT2a/T2b PCa characterizes a growing proportion of men recently electing RP. These tumors are associated with lower PTI, pGS,,,7, and demonstrated better PSA-free survival in the 2001,2006 era. These low risk pathologic characteristics may allow for unilateral focal therapy in carefully selected patients. Prostate 68: 1380,1386, 2008. © 2008 Wiley-Liss, Inc. [source] HuR expression in the nucleus correlates with high histological grade and poor disease-free survival in ovarian cancerAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Xiaofang YI Background: HuR, a nucleo-cytoplasmic shuttling protein, plays an important role in mRNA stability as well as cellular differentiation. Recently, HuR expression, particularly in the cytoplasm, was thought to be associated with the prognosis of several cancers including ovarian cancer. Aims: To study the clinical significance of nuclear HuR expression in ovarian cancer. Methods: Primary epithelial ovarian carcinomas (102) and ovarian low malignant potential tumours (11) were assessed for HuR protein expression by immunohistochemistry. HuR scoring accounted for both intensity and percentage of cells stained, and ranged from 0 to 300. Results: HuR was found to be present predominantly in the nucleus, where it was expressed in 85.8% of cases. Nuclear HuR was associated with the invasive cancers (P = 0.004), high grade (P < 0.0001), large residual disease (P = 0.045) and poor disease-free survival (P = 0.0009). Among those 91 specimens with high grade, 76.9% had a high nuclear HuR score, while in those 22 cases with low grade, only 31.8% had a high HuR score (P < 0.0001). Multivariate analysis showed that nuclear HuR intensity was an independent prognostic factor for poor disease-free survival (P = 0.0484). When the invasive cancers were analysed separately, only the association between nuclear HuR and high grade remained (P = 0.0089). Conclusions: Our results support the clinical significance of nuclear HuR in ovarian carcinoma and suggest that nuclear HuR may also play a role in the biology of ovarian cancer. These data suggest a more complex model for HuR in ovarian cancer than one limited to cytoplasmic localisation. [source] The comparative diagnostic accuracy of conventional and liquid-based cytology in a colposcopic settingBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2005T. Hussein Objective This study was conducted to compare the performance of liquid-based cytology (LBC) and conventional cytology (CS) in the high prevalence setting of colposcopy clinic. Design A split sample of matched ThinPrep (TP) and conventional smear from 563 patients were evaluated blindly. The performance of both techniques was compared with the gold standard of biopsy results or normal colposcopy examination in 441 cases. Setting Colposcopy clinic of an inner city hospital for women and children. Sample Five hundred and sixty-three women referred to colposcopy clinic over 14-month period. Methods Cervical smears were taken from 563 women referred for colposcopy. Using the split-sample technique, the material was spread on a conventional (CS) slide and the remaining material rinsed in a PreservCyt solution. A T2000 processor was used to prepare LBC preparations. All women underwent colposcopy/biopsy according to local protocol. Four hundred and forty-one women met the diagnostic standard criteria of the study, which was either a normal colposcopy or histopathology result. Sensitivity, specificity and positive and negative predictive values were calculated for both methods of cytology preparations. Main outcome measures Matched TP and conventional smears, detection of abnormality, matched biopsies, sensitivity, specificity, and positive and negative predictive values. Results Inadequate rates for CS and LBC (TP) were 4.3% and 0.68%, respectively. In 73% of cases, the CS and the LBC preparations showed exact agreement, whereas 77% agreement was seen when comparison was made for amalgamated low grade and high grade abnormalities. Low grade cytological abnormalities accounted for 44% of LBC slides versus 37% in CS slides. High grade cytological abnormalities accounted for 22% of LBC versus 17% seen in CS cases (P < 0.001). LBC showed increased sensitivity in the detection of CIN2 or worse than CS (92% and 83%, respectively) and CS showed greater specificity than LBC (82% and 76%, respectively). Conclusions In high prevalence setting, LBC performed at least as well as CS. The inadequate rate was significantly lower with LBC. The numbers are too small, however, to make confident comments about increased sensitivity and negative predictive value with LBC. Larger studies are required to verify these findings. [source] Glucose-regulated protein 78 expression in urothelial carcinoma of the upper urinary tractBJU INTERNATIONAL, Issue 6 2010Kenji Uematsu OBJECTIVE To examine glucose-regulated protein 78 (GRP78; a major molecular chaperone at the endoplasmic reticulum, strongly expressed in several tumours) expression in urothelial carcinoma (UC) of the upper urinary tract (UUT) and to evaluate the diagnostic and progressive importance of GRP78 expression in UC-UUT. PATIENTS AND METHODS We investigated GRP78 expression (using immunohistochemistry) in 126 UC-UUTs to assess its relevance to progression. GRP78 overexpression was recognised in 23 (18.3%) of tumour samples. RESULTS There was no association between GRP78 overexpression and clinicopathological findings, except for an association with low grade in invasive tumours. GRP78 overexpression significantly improved the disease-free survival rate in all patients (according to univariate and multivariate analyses), but did not alter the overall survival rate. CONCLUSION The detection of GRP78 overexpression would appear to provide valuable information for the prognosis of UC-UUT. [source] Elective endoscopic management of transitional cell carcinoma first diagnosed in the upper urinary tractBJU INTERNATIONAL, Issue 9 2008R. Houston Thompson OBJECTIVE To report our experience using ureteroscopic or percutaneous management of upper urinary tract (UUT) transitional cell carcinoma (TCC) in patients with no history of bladder TCC. PATIENTS AND METHODS Between 1983 and 2004 we identified 22 patients who underwent endoscopic management of TCC first diagnosed in the UUT and in the setting of a normal contralateral kidney. We performed a retrospective chart review and conducted outcome analyses. RESULTS The median (range) age at diagnosis was 64 (37,86) years and the median tumour size was 0.8 (0.3,2.6) cm. The tumour grade was 1, 2, or diagnosed as visual low grade in two (9%), seven (32%), and 13 (59%) patients, respectively; no patient had grade 3 TCC at diagnosis. Tumour stage was Ta or visual Ta in all patients. The median follow-up was 4.9 (0.4,17) years during which 11 (50%) patients developed 21 UUT recurrences and 10 (45%) patients developed bladder TCC. At last follow-up, seven (32%) patients required a nephroureterectomy for recurrent TCC and two (9%) patients died from TCC. Among 13 patients with a diagnosis based on visual inspection only, three recurred with grade 3 invasive TCC during follow-up. No patient with pathological confirmation of low-grade/stage TCC recurred with high-grade or invasive TCC. CONCLUSIONS Recurrence is common after endoscopic management of UUT-TCC, underscoring the need for strict surveillance. Patients diagnosed visually, without adequate tissue for pathological examination, can recur with high-grade invasive TCC. No patient with pathological confirmation of low-grade TCC developed progressive disease during follow-up. [source] Microsatellite Instability and k- ras, p53 Mutations in Thyroid LymphomaCANCER SCIENCE, Issue 3 2000Tetsuya Takakuwa Patho-epidemiological studies showed that thyroid lymphoma (TL) arises in inflammatory lesions of chronic lymphocytic thyroiditis (CLTH). Replication error (RER) is found in inflammatory lesions and associated cancer, suggesting that chronic inflammation could be a risk factor for neoplastic development through causing RER. To clarify whether RER is involved in the pathogenesis of TL, we examined the microsatellite instability (MSI) in 9 cases with CLTH and 19 with TL, including 10 diffuse large B-cell lymphoma (DLBL), 4 follicle center cell lymphoma, 3 marginal zone B-cell lymphoma of extranodal (MALT) type, and 2 lymphoplasmacytic type. Sixteen distinct microsatellite repeats were analyzed. Mutations of p53 and k- ras genes were also examined. When alterations at 2 or more microsatellite loci were judged as positive, only 5 DLBL cases exhibited MSI. The frequency of MSI in DLBL was significantly higher than that in other types of TL and CLTH (P < 0.05). Four of 19 cases (21.1%) showed point mutation of the k- ras gene. The k- ras mutations occurred in the cases with DLBL with RER, and four of five cases with RER had a k- ras mutation, indicating a close association between RER and k- ras mutation. p53 mutations were not found in the CLTH. Two of 19 TL cases showed mutations of p53 gene. There was no significant association between RER and p53 mutation. These findings indicate that genomic instability contributes to the progression of TL from low grade to high grade, but not to the development of low grade lymphoma in CLTH lesions. [source] Subgrouping and grading of soft-tissue sarcomas by fine-needle aspiration cytology: A histopathologic correlation studyDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2001Hal E. Palmer M.D. Abstract To evaluate the accuracy and reproducibility of subgrouping and grading soft-tissue sarcomas by fine-needle aspiration biopsy (FNAB), a blind review was conducted of 84 FNAB specimens from 77 malignant and 7 benign soft-tissue lesions. Cytomorphologic subgroups included 31 spindle-cell, 24 pleomorphic, 11 myxoid, 7 epithelioid/polygonal, 3 small round cell, and 8 nondiagnostic cases. Malignancies included one lymphoma and 41 primary, 15 recurrent, and 20 metastatic soft-tissue sarcomas. Adequacy was defined as a majority of slides with at least 5 clusters of 10 unobscured cells. Five originally false-negative cases were considered nondiagnostic on review. Sarcoma was recognized in 59 of 64 adequate cases (92%) with available histology; however, the specific histopathologic subtype was identified in only 9 cases (14%). Benign myxoid and spindle-cell lesions were difficult to separate from low-grade sarcomas in 4 cases, and a B-cell lymphoma with sclerosis mimicked a low-grade myxoid sarcoma. The assigned cytologic grade accurately reflected the histologic grade in 90% of sarcomas when segregated into high and low grades. Pleomorphic, small round cell, and epithelioid/polygonal subgroups corresponded to high-grade sarcomas in all cases with only minor noncorrelations. Major grading noncorrelations occurred in 50% of myxoid and 9% of spindle-cell sarcomas. Therefore, attention should be given to specimen adequacy, and caution should be exercised when attempting to grade myxoid and spindle-cell sarcomas by FNAB. Diagn. Cytopathol. 24:307,316, 2001. © 2001 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||