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Histopathological Grading (histopathological + grading)
Selected AbstractsMulticenter prospective analysis of newly diagnosed hepatocellular carcinoma with respect to the percentage of Lens culinaris agglutinin-reactive ,-fetoprotein,JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 12 2001Hiroko Oka Abstract Background and Aim: The Lens culinaris agglutinin-reactive fraction of ,-fetoprotein (AFP-L3) has been reported to be a highly useful marker for hepatocellular carcinoma (HCC) compared with a conventional serum AFP concentration, which allows earlier detection of HCC compared with using other imaging modalities and predicting prognosis after therapy. A collaborative prospective study involving nine Japanese hospitals was conducted to analyze the relationships between the tumor characteristics of a HCC patient and the percentage of AFP-L3/AFP total at the initial detection. Methods: Between 1 October 1996 and 30 September 1997, a total of 388 patients with newly diagnosed HCC were registered. Results: The cut-off level of the percentage of AFP-L3 was altered from 15 to 10%. The AFP-L3-positive HCC patients demonstrated the characteristics of having an advanced tumor, such as the number of tumors, maximum diameter, tumor spread, portal vein invasion, tumor stage, and tumor classification. With the conventional cut-off level of 15% of the percentage of AFP-L3, the malignant characteristics were more definite than that of 10%. However, no significant differences of serum AFP concentration were observed for malignant characteristics such as maximum diameter and histopathological grading. Conclusion: Serum AFP concentration does not reveal a malignancy of HCC, however, the AFP-L3-positive HCC has biologically malignant characteristics, especially portal vein invasion and lower tumor classification, and is an advanced tumor regardless of small tumor size and lower serum AFP concentration. As AFP-L3 shows the tumor characteristics, its presence should be an important factor in the determination of therapy and prognosis of patients. [source] Predicting the Histopathological Grade of Cerebral Gliomas Using High b value MR DW Imaging at 3-TeslaJOURNAL OF NEUROIMAGING, Issue 3 2008Juan Alvarez-Linera MD ABSTRACT BACKGROUND Our aim was to prospectively assess whether magnetic resonance (MR) diffusion-weighted (DW) imaging using high b values can predict better than b value of 1,000 s/mm2 the histopathological grade of cerebral gliomas. METHODS Fifty-four patients with histologically verified brain gliomas (35 high-grade and 19 low-grade gliomas) underwent MR DW imaging. Isotropic DW images and apparent diffusion coefficient (ADC) were obtained with b values of 1,000 and 3,000 s/mm2. Each tumor was evaluated as being hyperintense, iso-intense or hypointense to normal, contralateral-hemisphere white matter. RESULTS Most of the patients with high- and low-grade gliomas showed areas of increased signal intensity on their isotropic images, obtained with a b value of 1,000 s/mm2. However, with a b value of 3,000 s/mm2 the areas of increased signal intensity were seen in 97.1% of the high-grade gliomas, while 94.7% of the low-grade gliomas showed no area of increased signal intensity. The mean area under the ROC curve for ADC ratio, obtained with a b value of 3,000 s/mm2, was significantly higher than that obtained with 1,000 s/mm2 (.932 vs. .856, P= .04). CONCLUSION High b value DW MR might be useful as a complementary tool in preoperative assessment of the histopathological grading of cerebral gliomas. [source] Factors affecting carbon dioxide laser treatment for oral precancer: A patient cohort studyLASERS IN SURGERY AND MEDICINE, Issue 1 2009O. Hamadah DDS Abstract Background Although the benefits of CO2 laser surgery in oral precancer management have been evaluated, little consideration has been given to the factors which may influence treatment outcome, especially amongst patients developing recurrence or malignant transformation. Study Design Seventy eight patients (51 males, 27 females; mean age 57.8 years) undergoing CO2 laser excision of single, new dysplastic oral precancer lesions (OPLs) were followed up for a minimum of 2 years and the influence of clinico-pathological parameters, socio-demographic factors and the presence or absence of residual dysplasia in excision margins upon clinical outcome were examined. Results Seventy three percent of patients were smokers and 78% consumed alcohol regularly. The majority of lesions were leukoplakias arising in the floor of mouth and ventro-lateral tongue and moderate or severe dysplasia accounted for 86% of histopathological diagnoses. Patient follow up ranged from 24 to 119 months (mean 58 months). Sixty four percent of patients were disease free at most recent clinical follow up, whilst 32% developed local recurrent dysplasia or new site dysplasia with 4% developing oral squamous cell carcinoma (but at sites distinct from their initial OPL). Excision margins were clear in 55% of cases, but 19% showed mild, 21% moderate and 5% severe dysplasia on histopathological examination. No statistically significant associations were seen between patients' age, gender, lesion appearance, site of origin, histopathological grading, presence of dysplasia in resection margins, or alcohol consumption and clinical outcome. Smokers, however, were at significantly higher risk of dysplasia recurrence compared to ex-smokers or non-smokers (P,=,0.04). Conclusions In the absence of agreed treatment protocols for OPLs, we recommend CO2 laser surgery as an effective treatment modality offering precise lesion excision, full histopathological assessment, minimal post-operative morbidity and a 64% disease free clinical outcome. Regular patient follow up is encouraged due to the persistence of field cancerisation effects. Lasers Surg. Med. 41:17,25, 2009. © 2008 Wiley-Liss, Inc. [source] Metabolic differences between primary and recurrent human brain tumors: a 1H NMR spectroscopic investigationNMR IN BIOMEDICINE, Issue 6 2005Fritz-Georg Lehnhardt Abstract High-resolution proton magnetic resonance spectroscopy was performed on tissue specimens from 33 patients with astrocytic tumors (22 astrocytomas, 11 glioblastomas) and 13 patients with meningiomas. For all patients, samples of primary tumors and their first recurrences were examined. Increased anaplasia, with respect to malignant transformation, resulting in a higher malignancy grade, was present in 11 recurrences of 22 astrocytoma patients. Spectroscopic features of tumor types, as determined on samples of the primary occurrences, were in good agreement with previous studies. Compared with the respective primary astrocytomas, characteristic features of glioblastomas were significantly increased concentrations of alanine (Ala) (p,=,0.005), increased metabolite ratios of glycine (Gly)/total creatine (tCr) (p,=,0.0001) and glutamate (Glu)/glutamine (Gln) (p,=,0.004). Meningiomas showed increased Ala (p,=,0.02) and metabolite ratios [Gly, total choline (tCho), Ala] over tCr (p,=,0.001) relative to astrocytomas, and N -acetylaspartate and myo-inositol were absent. Metabolic changes of an evolving tumor were observed in recurrent astrocytomas: owing to their consecutive assessments, more indicators of malignant degeneration were detected in astrocytoma recurrences (e.g. Gly, p,=,0.029; tCho, p,=,0.034; Glu, p,=,0.015; tCho/tCr, p,=,0.001) in contrast to the comparison of primary astrocytomas with primary glioblastomas. The present investigation demonstrated a correlation of the tCho-signal with tumor progression. Significantly elevated concentrations of Ala (p,=,0.037) and Glu (p,=,0.003) and metabolite ratio tCho/tCr (p,=,0.005) were even found in recurrent low-grade astrocytomas with unchanged histopathological grading (n,=,11). This may be related to an early stage of malignant transformation, not yet detectable morphologically, and emphasizes the high sensitivity of 1H NMR spectroscopy in elucidating characteristics of brain tumor metabolism. Copyright © 2005 John Wiley & Sons, Ltd. [source] Prognostic Indicators of Occult Metastases in Oral CancerTHE LARYNGOSCOPE, Issue 7 2002Mario Russolo MD Abstract Objective We evaluated the importance of several tumor factors related to predicting the presence of occult metastases in the oral cavity. Study Design Retrospective case study. Methods The study comprises 29 patients treated at the Department of Otorhinolaryngology (University of Trieste, Cattinara Hospital, Trieste, Italy) between January 1990 and December 2000, who had T1-T2 carcinoma of the oral cavity that had or had not extended to the oropharynx and were clinically evaluated as N0 neck. The patients all underwent surgery with removal of tumor and neck dissection. Four tumor-related parameters were examined with the aim of evaluating their predictivity of metastasis: tumor class, degree of keratinization, degree of differentiation according to Brooler's histopathological grading, and invasive cell grading (ICG). With the exception of tumor class, these parameters were evaluated both in the biopsy and in the surgical specimen and the findings were then compared. We evaluated existing correlations between each individual parameter and the histopathological presence of micrometastases (pN+) and extracapsular spread revealed when specimens from the neck were examined. Results There was a highly significant correlation between ICG equal to or greater than 13 (range, 5,20) and the presence of occult metastases (P = .0017). On the basis of our findings, the ICG parameter correctly identified 9 of 10 (pN+) patients and could have reduced overtreatment from 65.5% to 17.2% in histopathologically negative necks (pN0). Conclusion It would appear that with a delay in programming a neck dissection so as to consider ICG in combination with thickness, as in seven recent patients, identification of locoregional occult metastases (pN+) might be more precise. [source] Does the current World Health Organization classification predict the outcome better in patients with noninvasive bladder cancer of early or regular onset?BJU INTERNATIONAL, Issue 2 2008Maximilian Burger OBJECTIVE To compare the clinical outcome and prognostic power of the former and current World Health Organization (WHO) grading system in patients with early vs regular onset of noninvasive urothelial bladder cancer (UBC), as little is known of the natural history of early onset UBC and in how far it is reflected by histopathological grading and staging in guiding clinical decisions. PATIENTS AND METHODS The medical records of 69 consecutive patients presenting with initial UBC of early onset (,45 years old, EO) and of 100 randomly chosen patients with regular onset (RO) were reviewed. There were no significant differences in gender distribution, risk factors or tumour stage. All histopathological specimens were re-staged and re-graded according to the former and current WHO grading. RESULTS In all, 51 EO and 63 RO patients with tumours staged pTa and complete follow-up information were analysed. Recurrence-free survival (RFS) was prolonged in patients with EO. In EO neither the former nor the current WHO grading system was significantly related to RFS or to progression to muscle-invasive disease. In RO, while both WHO grading systems were significantly related to RFS, only the current WHO grading system was related to progression. CONCLUSION While larger studies are needed, UBC in patients with EO and RO do not seem to differ in risk factors and oncological outcome. The current WHO classification reflects the outcome more accurately than the former classification in patients with RO. However, for EO no grading system has sufficient prognostic power and novel methods, i.e. molecular markers, need to be evaluated for clinical use. [source] Anaplasia and Grading in MedulloblastomasBRAIN PATHOLOGY, Issue 3 2003Charles G. Eberhart; The variable clinical outcomes of medulloblastoma patients have prompted a search for markers with which to tailor therapies to individuals. In this review, we discuss clinical, histological and molecular features that can be used in such treatment customization, focusing on how histopathological grading can impact both patient care and research on the molecular basis of CNS embryonal tumors. Medulloblastomas span a histological spectrum ending in overtly malignant large cell/anaplastic lesions characterized by increased nuclear size, marked cytological anaplasia, and increased mitotic and apoptotic rates. These "high-grade" lesions make up approximately one quarter of medulloblastomas, and recur and metastasize more frequently than tumors lacking anaplasia. We believe anaplastic change represents a type of malignant progression common to many medulloblastoma subtypes and to other CNS embryonal lesions as well. Correlation of these histological changes with the accumulation of genetic events suggests a model for the histological and molecular progression of medulloblastoma. [source] | ||||||||||