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C M Fenoglio-Preiser

Publications and source records attributed to C M Fenoglio-Preiser.

At least 19 recordsLinked to original sources
PubMed1992

The future of prognostic factors in outcome prediction for patients with cancer.

The anatomic description of the extent of tumor spread (tumor staging) assists clinical management, facilitates communication among physicians, is an essential part of randomized controlled trials, and may help in the counseling patients and their families. However, in recent years, additional "prognostic factors" have been defined, many of which assess or reflect the biologic behavior of malignant neoplasms. Other measures of tumor biochemistry address the natural history of neoplastic development and often are included in a discussion of new prognostic factors. This review article summarizes current knowledge and thinking related to tumor prognostic factors in four areas by providing: (1) a definition and principles of anatomic spread of tumor (staging) and some suggestions for improvement, (2) a description of some examples of additional factors of prognostic significance, (3) some statistical methods to evaluate prognostic factors, and (4) an examination of the possible future of summary statements of outcome (i.e., prognostic indexes).

Biomarkers↗
PubMed1992

The relationship of human papillomaviruses to anorectal neoplasia.

This review begins with an overview of the anatomy of the anal canal, which is followed by a discussion of human papillomavirus (HPV) infections in the anogenital tract. The organization of the HPV genome and the function of the encoded proteins is discussed in relation to the oncogenic potential of these viruses. Particularly stressed are interactions with known tumor suppressor genes. Then the interaction of HPV with the host cells and some growth factors is reviewed. An important consideration is the synergy between this virus and other known carcinogenic factors. These include smoking, immunologic status, and other factors. Finally, the pathologic features of anal warts and malignant lesions are summarized with respect to their histologic findings and expression of viral subtypes.

Anus Neoplasms↗
PubMed1992

Selection of appropriate cellular and molecular biologic diagnostic tests in the evaluation of cancer.

In this article, the use of cellular and molecular markers to diagnose and stage tumors is discussed. Their role in the evaluation of tumor prognosis and tumor susceptibility also is covered. The immunologic, cytogenetic, and molecular phenotype is discussed. Traditional markers are compared with newer methodologic approaches including evaluation of oncogenes, tumor suppressor genes, and genes that predict tumor susceptibility. These discussions are presented in relation to specific tumors. Finally, statements one might use to decide which tests to perform are presented.

Biomarkers, Tumor↗
PubMed1992

Interinstitutional database for comparison of performance in lung fine-needle aspiration cytology. A College of American Pathologists Q-Probe Study of 5264 cases with histologic correlation.

In 1990, the College of American Pathologists Q-Probes Quality Assurance Program studied performance in fine-needle aspiration (FNA) of pulmonary lesions derived by retrospective analyses of cases accessioned throughout 1989 by 436 institutions in North America. The aggregate database consisted of 13,094 lung FNA cases with 11,922 (91%) judged as satisfactory for cytologic evaluation. Of these satisfactory aspirates, 5264 (40%) had corresponding histologic tissue biopsy preparations and FNA diagnoses available for further evaluation and formed the basis for determining diagnostic accuracy. There was no significant difference in overall performance results derived from the data provided by all participants compared with the median of those reporting a greater number of correlated FNA cases. In the diagnosis of lung cancer by FNA, the following performance results were derived using the aggregate database: 89% sensitivity of FNA procedure, 99% sensitivity of FNA diagnosis, 96% specificity, 99% positive predictive value, 70% negative predictive value, 91% efficiency, 0.8% false-positive FNA interpretation, and 8% false-negative rate. The aggregate value and median performance values of sensitivity and specificity derived from this Q-Probe study, which reflects the general practices of mostly non-university hospitals in North America, compare very favorably with study results of similar design in the literature reflecting practices from academic centers. This appears to validate published rates from academic centers as reproducible in the general practice of pathology and validates the use of these values derived from an aggregate database as a benchmark to measure performance improvement in lung FNA.

Biopsy, Needle↗
PubMed1990

Mixed hyperplastic adenomatous polyps/serrated adenomas. A distinct form of colorectal neoplasia.

We present the clinicopathologic characteristics of 110 colorectal mixed hyperplastic adenomatous polyps (MHAP) that exhibited the architectural but not the cytologic features of a hyperplastic polyp. They are compared with 60 traditional adenomas, 40 hyperplastic polyps, and five colonic polyps that contained admixed but well-defined hyperplastic and adenomatous glands (HP/AD). The patients with MHAP ranged in age from 15 to 88 years (mean, 63 years). Five patients had two or more (up to seven) lesions. MHAP measured 0.2-7.5 cm in diameter. They were distributed throughout the colorectum, but a slight preponderance of large lesions (more than 1.0 cm) occurred in the cecum and appendix. All MHAP were characterized by a serrated glandular pattern simulating that seen in hyperplasia (27% of MHAP were initially diagnosed as hyperplastic polyps). However, MHAP were distinguished by the presence of goblet cell immaturity, upper zone mitoses, prominence of nucleoli, and the absence of a thickened collagen table. Although surface mitotic activity, nuclear pseudostratification, and nuclear cytoplasmic ratio were greater in MHAP than in hyperplastic polyps, they were slightly less than in traditional adenomas. Thirty-seven percent of MHAP contained foci of significant dysplasia; 11% contained areas of intramucosal carcinoma. We conclude that these lesions reflect a morphologically unique variant of adenoma and suggest that they be termed "serrated adenoma" in order to emphasize their neoplastic nature. We further offer the hypothesis that MHAP may arise from the neoplastic transformation of a more differentiated cell in the crypt than the traditional adenoma.

Adenoma↗
PubMed1989

Colorectal adenomas containing invasive carcinoma. Pathologic assessment of lymph node metastatic potential.

Adenomas that contain early invasive carcinoma (ACIC) represent the earliest form of clinically relevant cancer of the colorectum in most patients. In order to assess the incidence of nodal metastases of ACIC, we studied 31 patients in whom the colon was resected after endoscopic polypectomy (EP) done from 1975 to 1987. We also reviewed the pathologic features reported in individual cases and in literature series of ACIC with lymph node metastases published from 1958 to 1986. The lymph node metastatic potential of ACIC is relatively high, ranging from an average value of 8.5% in the literature of to 16.1% in our own study, and is equivalent to the range of 10%-17% that occurs in colorectal carcinomas that invade the submucosa. When an ACIC is seen in an EP specimen in which the polypectomy margin is normal, the decision as to whether the patient should enter a follow-up protocol or have radical surgical resection is determined by the assessment of the probability of the occurrence of nodal metastases. According to several authors, certain histopathologic features make it possible to distinguish between an ACIC with a high-risk of nodal metastases versus those with a low-risk. The most relevant pathologic parameters include the state of the resection margins, the grade of the invasive carcinoma, and the presence or absence of vascular invasion. Of 351 cases of ACIC that were operated on, derived from 16 literature series, 45.6% were high-risk cases and 8.5% had lymph node metastases. In our group of high-risk ACIC that had surgical resection subsequently, the lymph node metastatic rate was 35.7%. Our results help to estimate the nodal metastatic potential of early colorectal carcinomas and stress the importance of adequate pathologic evaluation in order to assess metastatic risk in these patients accurately.

Adenoma↗
PubMed1989

Immunoreactivity of tumor-associated glycoprotein (TAG-72) in normal, hyperplastic, and neoplastic colon.

Monoclonal antibody B72.3 recognizes tumor-associated glycoprotein (TAG-72) and has been widely used to identify malignant epithelial cells in cytologic and histologic preparations. We investigated TAG-72 expression in normal, hyperplastic, and neoplastic adult colon tissues. Formalin-fixed, paraffin-embedded samples of normal (43), hyperplastic (20), and neoplastic (70) colonic tissue were studied with B72.3 using the avidin-biotin complex immunoperoxidase method. TAG-72 expression was detected in 100% of the invasive carcinomas, in 84% of the normal colon samples, in 100% of the hyperplastic polyps, and in 93% of the adenomatous or mixed hyperplastic-adenomatous lesions. Among cases expressing TAG-72 immunoreactivity, the extent of staining varied from 100% of cells in normal and hyperplastic lesions to 10% to 100% in neoplastic lesions. A consistent supranuclear (presumably Golgi) staining pattern was observed in all tissues with the exception of carcinoma and some adenomas; in these cases, staining localized to the luminal surface and intraluminal mucin and/or was diffusely cytoplasmic. From these data, it is clear that TAG-72 is expressed in both benign and neoplastic cells of the human adult colon, although different patterns of expression may distinguish malignant transformation. Furthermore, carcinoma cells less consistently express TAG-72, so that small biopsies or cytologic specimens may be falsely negative due to sampling errors.

Adenoma↗
PubMed1989

Large colorectal polyps: colonoscopy, pathology, and management.

Between 1984 and 1987, we reviewed all large (greater than or equal to 3.0 cm) colorectal polyps to determine the efficacy of colonoscopic polypectomy from both an oncologic and technical viewpoint. Forty-eight polyps greater than or equal to 3.0 cm were identified in 46 patients. Twenty polyps were entirely benign, 20 polyps contained noninvasive carcinoma, and invasive carcinoma was present in eight polyps. Four of the invasive cancers were associated with residual adenoma; the remaining four were polypoid carcinomas. Among the eight cases of invasive carcinoma, four had tumors that did not extend through the submucosa. Invasive cancer was more prevalent in left-side sessile lesions but was absent in all 10 right-sided polyps. Thirty-two polyps were removed by colonoscopic polypectomy. Four patients required colectomy after polypectomy for the following reasons: incomplete excision (N = 1), presence of invasive carcinoma at the resection margin (N = 1), and inability to define the level of carcinoma on pathologic examination (N = 2). Two polyps with cancer confined to the submucosa were successfully excised colonoscopically. Complications of polypectomy included three cases of minor hemorrhage. Sixteen polyps (the majority located in the right colon) were removed by primary surgical colectomy. We conclude that colonoscopic polypectomy is oncologically and technically successful for most large colorectal polyps. A minority of large polyps require colectomy because of incomplete removal or the presence of invasive cancer that is not curable with colonoscopic excision.

Adenoma↗
PubMed1987

Lymphatic distribution of the stomach in normal, inflammatory, hyperplastic, and neoplastic tissue.

Prompted by the lack of knowledge of the distribution of gastric lymphatics and the discrepancy between the incidence of lymph node metastases from intramucosal gastric carcinoma versus intramucosal colonic carcinoma, we undertook a study of the distribution of lymphatics in normal, abnormal non-neoplastic, and neoplastic gastric mucosas. The study involved the histologic, immunocytochemical, and electron microscopic evaluation of a total of 47 gastric biopsy, polypectomy, and resection specimens and showed that the gastric lymphatics normally begin as a plexus of vessels immediately superficial to, within, and below the muscularis mucosae. The upper two-thirds of the gastric lamina propria is normally devoid of lymphatics. This distribution is maintained throughout the cardia, fundus, and antrum and is also maintained in hyperplastic and neoplastic tissues. However, in patients with severe atrophic gastritis in which the overall height of the gastric mucosa is markedly decreased, lymphatic capillaries may be found near the surface epithelium. The relevance of these findings to the behavior of early gastric cancer is discussed.

Gastric Mucosa↗
PubMed1987

Molecular biology and the pathologist. General principles and applications.

This review article contains two parts. In the first part, molecular biological principles and techniques are discussed. These include nucleic acid isolation, restriction endonucleases, various types of hybridization methods, and restriction fragment-length polymorphisms. The second section focuses on the application of these techniques to genetic analyses, microbiological diagnosis, cell differentiation, and tumor biology. It is our hope to provide the reader with a broad understanding of the tools and an appreciation of their applications.

Cell Differentiation↗
PubMed1986

Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies.

The sequence of events in haematogenous metastasis from colonic carcinoma was analysed, using 1541 necropsy reports from 16 centres. The findings are consistent with the cascade hypothesis that metastases develop in discrete steps, first in the liver, next in the lungs and finally, in other sites. Deviations of necropsy findings from the cascade model are largely explained on the basis of false negative reports. In only 216 of 1194 cases was there suggestive evidence that metastatic patterns (excluding lymph nodes) were causally related to lymphatic or non-haematogenous pathways. The incidence of metastatic involvement in 'other' (quaternary) sites correlated with target organ blood-flow (ml min-) per g, only when bone marrow and thyroid were excluded. In the thyroid the incidence was lower than expected on the basis of blood flow per g tissue; this may indicate that the thyroid is an unfavourable site for metastatic growth of colonic carcinoma. In the bone marrow it is higher; the latter may be due to delivery of cancer cells via both arterial blood and the vertebral venous plexus. Recognition of this pattern of metastases in the bone marrow could be important with respect of diagnosis and therapy, in patients with colonic carcinoma.

Aged↗
PubMed1986

COTA (colon-ovarian tumor antigen). An immunohistochemical study.

A goat anti-serum was prepared against mucinous ovarian cyst fluid and absorbed with normal colon and a variety of normal tissues until the only residual immunoreactivity was directed against colon cancer and ovarian tumor mucin. The set of antigenic determinants defined by this anti-serum has been called COTA, standing for colon-ovarian-tumor-antigen. This highly absorbed anti-serum (anti-COTA) was used for immunohistochemical staining of 42 different tissues in parallel with staining with a goat anti-CEA, which was also highly absorbed. The results suggest that COTA is a highly sensitive and specific antigen for colon carcinoma and may have potential for the early detection of malignant changes predictive of cancer of the colon.

Adenocarcinoma↗
PubMed1986

Gastric carcinoma in the young: a clinicopathological and immunohistochemical study.

Seventeen patients 40 yr of age and less with gastric carcinoma were studied retrospectively. Clinicopathological findings and survival data were collected on all patients. Immunohistochemistry for serotonin, gastrin, somatostatin, carcinoembryonic antigen, beta-human chorionic gonadotropin, and alpha-fetoprotein was performed and the results correlated with pathological and survival data. Patients were divided into two groups according to the presence or absence of endocrine markers in their tumors. The group with endocrine immunoreactivity tended to present with less advanced disease and had longer survival than the group without endocrine immunoreactivity (p less than 0.05). Although the number of patients in the study is too small to reach definite conclusions, our results are interesting in light of current knowledge of the pathobiology of gastric carcinoma and have important implications for future investigations.

Adult↗