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H E Stegner

Publications and source records attributed to H E Stegner.

At least 19 recordsLinked to original sources
PubMed1998

Scintimammography with technetium-99m methoxyisobutylisonitrile: results of a prospective European multicentre trial.

The aim of the trial was to determine the diagnostic accuracy of scintimmammography with technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) in the detection of primary breast cancer and to verify its clinical usefulness. A total of 246 patients with a suspicious breast mass or positive mammogram were included in this prospective European multicentre trial. At 5 min and 60 min (optional) p.i. two lateral prone images were acquired for 10 min each; 30 min p.i. one anterior image was acquired for 10 min. There were 253 lesions (195 palpable and 58 non-palpable), in respect of which histology revealed 165 cancers and 88 benign lesions. Institutional and blinded read results were correlated to core laboratory histopathology results obtained during excisional biopsy. Diagnostic accuracy for the detection of breast cancer was calculated per lesion. The overall sensitivity and specificity of blinded read scintimammography were 71% and 69%, respectively. For palpable lesions, the sensitivity of blinded read and institutional read scintimammography was 83% and 91%, respectively. Sensitivity was not dependent on the density of the breast tissue. Invasive ductal and invasive lobular cancers showed similar sensitivity. The sensitivity and specificity of mammography were 91% and 42%, respectively, and did not depend on the tumour size. In 60% of false-negative mammograms, 99mTc-MIBI was able to diagnose malignancy (true-positive). High-quality imaging with 99mTc-MIBI has a high diagnostic accuracy for the detection of primary breast cancer. Used as a complementary method, scintimammography with 99mTc-MIBI can help to diagnose breast cancer at an earlier stage in patients with dense breasts.

Breast Neoplasms↗
PubMed1995

[Uterine stromal tumor with ovarian sex cord differentiation].

Uterine tumors resembling sex-cord ovarian structures are exceptionally rare. Clement and Scully divided them into two groups. The first group includes cases with less than 50% and the second with more than 50% sex-cord elements. Group one tumors show a higher incidence of recurrences. We report a case of a 54-year-old women with a partly retroperitoneal, cystic tumor 7.6.6 cm. Histologically, sex-cord differentiation of more than 50% was seen with positive immunostaining against vimentin, desmin and focally against myoglobin and cytokeratines. The reaction against EMA, CEA and S 100 was negative. The patient was treated by abdominal hysterectomy with bilateral salpingo-oovorectomy. She shows no evidence of disease 2.3 years after the initial surgery. Based on the light microscopic features and immunohistochemical pattern, the tumor was interpreted as arising from the endometrial stromal cells or multipotential uterine mesenchyme that showed diverse differentiation toward ovarian sex-cord stroma and uterine smooth muscle with interspersed stromal cell clusters.

Biomarkers, Tumor↗
PubMed1995

Gliomatosis peritonei combined with mature ovarian teratoma: immunohistochemical observations.

Gliomatosis peritonei (GP) is the metastatic implantation of glial cells within the peritoneal cavity of patients with ovarian teratomas. The case of a young woman is presented, who initially developed a mature teratoma in the left ovary that was surgically removed. Nine years later a mature teratoma in the right ovary was excised, upon which GP was found in the greater omentum. To identify the cellular composition of the ovarian teratoma and of the omental implants, immunostainings were performed using antibodies against glial and neuronal antigens as well as against determinants of hematopoietic cells. In the teratoma the neuroectodermal part was strongly HNK-1-positive and contained GFAP- and vimentin-positive astrocytes and some NSE-positive neuron-like cells. In addition, neuroectodermal tissue was infiltrated by numerous CD68-positive macrophages/histiocytes and CD20-positive B lymphocytes. The omental nodules consisted of astrocytes, which expressed GFAP, vimentin and desmin. The implants also contained macrophages/histiocytes, which exhibited morphologic features reminiscent of microglial cells. In GP, macrophages might release glia-promoting trophic factors, which could allow the neural component of ovarian teratoma to implant in the peritoneal cavity and survive there for many years. Macrophage-derived factors might induce astroglial differentiation, which could explain why the peritoneal implants are mostly mature even when they originate from immature teratomas.

Adolescent↗
PubMed1995

[Primary lymphoma of the cervix uteri--2 case reports].

Two cases of primary non-Hodgkin's lymphoma of the uterine cervix are described. Diagnostic pitfalls and therapeutic applications of this rare disease are discussed. The main approach in local therapy is external beam radiation--with or without surgical staging. Prognosis is favourable--depending on the stage of disease.

Adult↗
PubMed1994

Intracellular sex hormone-binding globulin (SHBG) in normal and neoplastic breast tissue--an additional marker for hormone dependency?

Recent studies indicate that in addition to free diffusion, uptake of sex hormones into target cells is mediated by sex hormone-binding globulin (SHBG). The purpose of this study was to investigate localization and distribution of SHBG in normal and neoplastic breast tissue. We examined 31 normal, 21 non-invasive, 52 invasive breast cancer tissues and 33 cases of recurrences and metastases of breast cancer immunohistochemically for SHBG by the ABC-peroxidase method, using a polyclonal, monospecific antiserum derived from rabbit. The proportion of stained cells was evaluated semiquantitatively. In 81 malignant cases the oestrogen receptor (ER) content was evaluated by the ER-ICA method. Positive staining for SHBG was found exclusively in epithelial cell cytoplasm. Benign tissue was focally SHBG-positive and showed more stained cells in proliferating epithelium. Staining of neoplastic tissue was more heterogeneous. Half of the non-invasive carcinomas were SHBG-positive; particularly the highly differentiated. Independent of subtype and differentiation, invasive tumours were SHBG-negative in 32.5% of cases, while 19.3% were SHBG-positive in most cells. In 13 cases of invasive carcinomas, associated intraductal parts showed more staining for SHBG than the invasive tissue. Recurrences and metastases of breast cancer were SHBG-negative in 45.5% of cases, while only 3% were positive in most cells. SHBG-staining was unrelated to ER content. These results suggest that the demonstration of cytoplasmic SHBG represents a physiological feature of breast epithelium and its presence is compatible with a mechanism for cellular uptake of SHBG-bound sex hormones preceding their interaction with nuclear receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomarkers, Tumor↗
PubMed1993

Human papillomavirus detection in cervical adenocarcinoma by polymerase chain reaction.

Twenty-five primary cervical adenocarcinomas and five cervical infiltrates from endometrial or rectal adenocarcinomas were analyzed for human papillomavirus (HPV) DNA by polymerase chain reaction with consensus and type-specific primers. Sixty-four percent (16 of 25) of the primary carcinomas and 20% (one of five) of the secondary infiltrates were positive for HPV types 16 and/or 18 DNA. Among the primary tumors HPV DNA was found in 80% of the endocervical cell-type tumors and in 60% of the endometrioid tumors, whereas two undifferentiated scirrhous carcinomas, one clear cell carcinoma, and one serous-papillary tumor were HPV negative. Human papillomavirus-positive patients were younger than HPV-negative patients (mean ages, 49.2 v 64.2 years). Our results indicate that papillomavirus play a major role in the etiology of cervical adenocarcinomas, at least in premenopausal women. However, in contrast to other studies, HPV type 18 was not the predominant type of HPV, HPV types 16 and 18 occurring with similar frequency in our patients.

Adenocarcinoma↗
PubMed1992

DNA cytophotometry and prognosis in ovarian tumors of borderline malignancy. A clinicomorphologic study of 80 cases.

Surgical specimens of 80 ovarian tumors of borderline malignancy (OTBM) were investigated by scanning DNA cytophotometry. Diploid or euploid DNA histograms were found for 21 tumors, whereas 59 OTBM showed noneuploid or aneuploid DNA patterns. All patients were followed-up after surgery for at least 3 years (mean observation period, 6.7 years). Follow-up showed 11 cases of recurrent disease and 6 deaths. DNA findings and several other morphologic and clinical details (including patient age, histologic type and stage of disease, and extent of therapy) were correlated to the postoperative course. Statistical analyses disclosed that, of these parameters, only DNA content significantly affected prognosis. Recurrences and deaths resulting from tumor exclusively were observed among patients with noneuploid or aneuploid OTBM, whereas none of the diploid or euploid tumors recurred (P less than 0.05). DNA cytophotometry thus might be regarded as an effective complementary means to assess the prognosis of individual OTBM cases.

Adult↗
PubMed1992

DNA-cytophotometry and immunocytochemistry in ovarian tumours of borderline malignancy and related peritoneal lesions.

A total of 34 surgical specimens, obtained from 13 patients with ovarian tumours of borderline malignancy (OTBM), were investigated by conventional histology, immunocytochemistry and DNA cytophotometry. The lesions were obtained by primary ovarian surgery or second-look procedures and altogether comprised 19 (single and bilateral) OTBM, 8 cases of endosalpingiosis, 4 in situ and 2 invasive peritoneal implants and 1 overt adenocarcinoma. The morphological findings were related to follow-up data, which showed neoplasms with clinically malignant behaviour in 2 patients. The histology of the extra-ovarian manifestations was not associated with their immunocytochemical properties or with their DNA content. There were no correlations between the evolution of disease and microscopical features but the clinical course appeared to be linked to the DNA content of the extra-ovarian lesions, which was of greater prognostic importance than DNA ploidy of the ovarian tumours. Recurrence-free survival was noted in all 5 patients with diploid or euploid extra-ovarian proliferations, while the 2 clinically malignant cases fell into the group of 3 patients with noneuploid or aneuploid specimens. DNA estimations may be a methodology which increases the prognostic value of second-look procedures in OTBM patients.

Adult↗
PubMed1990

[Results of treatment following breast-saving therapy: analysis of intramammary recurrence].

1,135 patients were subjected to conservation treatment of the breast between 1972 and April 1990. The probability of survival without relapses and metastases is 82.2% (5 years) or 72.1% (10 years), respectively. Local recurrence from relapses is 94.8% (5 years) or 88.9% (10 years), respectively. 31 patients developed an intramammary relapse, whereas 3 presented a renewed ductal in-situ manifestation, that was not considered to be a relapse. An unfavourable prognosis in respect of the rate of local relapses is considered to be dependent upon the size of the tumour. Other unfavourable factors are youthful age, concomitant DCIS formations, lymphangiosis carcinomatosa and "incomplete" resection (i.e. not including healthy tissue surrounding the tumour). These various "risk factors" are discussed on the basis of the literature and the authors' patient material.

Adult↗
PubMed1987

[Clinical and histopathologic studies of primary glandular cancer of the uterine cervix. An analysis of 78 cases from 1972 to 1984].

In the period between 1972 and 1984 716 cervical carcinomas, of which 78 were glandular cancers, were diagnosed at the University Hospital in Hamburg-Eppendorf. The incidence of invasive adenocarcinomas of the cervix is 10.9%. When compared with a study published in 1949 (19) the incidence of adenocarcinoma has risen from 3% to 10.9%. In the period of observation, i.e., from 1972 to 1984, no trend to an increase in incidence was observed. The average age of the patients, 62.6 years, is relatively high in comparison with other studies. An earlier onset of disease has not been observed. The available data do not provide any evidence of connection between the use of oral contraceptives and later development of an adenocarcinoma. The five-year survival rate for all stages taken together was 40.4%. The five-year survival rate, and thus the prognosis for glandular carcinomas of the cervical glands, depends primarily on the clinical stage of the disease, though also on the histological type and the degree of differentiation of the tumor.

Adenocarcinoma↗
PubMed1986

Relation between receptor status and ultrastructure in breast cancer: E+P+ versus E-P-.

Invasive breast cancer specimens were selected, which were either estrogen and progesterone receptor positive (E+P+), (30 cases) or both negative (E-P-). Light microscopical typing and grading were performed. From electron microscopic sections 27 nuclear and cytoplasmic features were recorded. Both estrogen and progesterone receptor content were evaluated using agar gel electrophoresis. As regards grading, highly differentiated tumors were significantly associated with E+P+ receptor status. Among the nuclear ultrastructural features, marked polymorphia, irregular chromatin distribution and multiple nucleoli were associated with lack of receptors. E+P+ tumors more often had surface structures which establish cell interconnection, such as desmosomes, halfdesmosomes and membrane interdigitations, and structures indicating special membrane differentiation, such as microvilli and intracytoplasmic ductuli. Most correlations with receptor content were observed in the assortment of cytoplasmic organelles studied. E-P- tumors were rich in organelles which indicate high metabolic activity, such as mitochondria and ribosomes. A polar organization and smooth ER were more frequent in E+P+ tumors. The biochemical-ultrastructural correlations presented in this study support the hypothesis that the formation of steroid receptors runs parallel to the individual degree of cytoplasmic and nuclear organization and is independent of the histological tumor type. The functional integrity of the complete estrogen response mechanism in E+P+ tumors is indicated by high grades of ultrastructural organization.

Breast Neoplasms↗
PubMed1986

Tissue polypeptide antigen and keratins in cervical neoplasia.

Antibodies against tissue polypeptide antigen (TPA) and keratins of high molecular weight (62-67 kD) were used to indicate different stages of cell differentiation. The immunohistochemical study was carried out by indirect immunofluorescence. In dysplasia, particularly in CIN grades II to III, TPA labeling comprised not only basal layer cells (as seen in normal mucosa) but more superficial layers as well. Expression of keratins of high molecular weight was reduced to small foci of keratinization and scattered dyskeratotic cells. In typical small cell anaplastic carcinoma in situ, TPA antibodies were observed to label all epithelial cell layers. There was no reactivity with antibodies against keratins of high molecular weight. In invasive cancer, TPA staining was closely related to the degree of maturation. Nonkeratinized tumor zones were entirely labeled by TPA antibodies, whereas keratinized tumor foci were negative for TPA except for peripheral tumor cell layers. In invasive cancer, keratins of high molecular weight were restricted to differentiated portions of the tumor. Our immunohistochemical findings support the present concepts of TPA (as a member of the heterogeneous keratin family) as an indicator of cell differentiation. Immunohistochemical demonstration of keratins of different molecular weight offers a method of assessing squamous differentiation at the cervical transformation zone and in cervical cancer and precancer.

Antigens, Neoplasm↗
PubMed1986

Immunohistochemical measurement of estrogen receptors in breast cancer tissue samples.

A new estrogen receptor immunocytochemical assay (ER-ICA) which uses monoclonal antibodies to the estrogen receptor protein was applied to 97 breast cancer tissues. The results were correlated to those obtained by conventional dextran coated charcoal assays. The presence or absence of nuclear staining was significantly associated with positive or negative estrogen receptor status by dextran-coated charcoal (P less than 0.001). Furthermore ER-ICA results showed a high degree of correlation with a light microscopic grading. The relationship between ER-ICA results and response to endocrine therapies in patients with advanced disease was assessed in 20 patients. Six of 11 (55%) ER-ICA positive patients responded, whereas 8 of 9 (89%) ER-ICA negative patients failed.

Antibodies, Monoclonal↗