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Biomedical subjects

L Palombini

Publications and source records attributed to L Palombini.

At least 37 records · Page 2Linked to original sources

Cyclin dependent kinase inhibitor p27Kip1 expression in normal and neoplastic cervical epithelium.

AIM: To investigate whether there is loss of the p27Kip1 protein in developing cervical cancer and whether p27Kip1 immunoreactivity has any relation to the proliferative indicator Ki-67. METHODS: The expression of p27Kip1 and Ki-67 was assessed by immunohistochemistry in serial sections from normal epithelium (13), low grade (27) and high grade (19) squamous intraepithelial lesions (LSIL, HSIL), and invasive cervical cancer (23). In the SIL cases the presence of human papillomavirus (HPV) genomic sequences was assessed by in situ hybridisation. The results were evaluated by image analysis, and reported as mean score of the percentage of p27Kip1 and of Ki-67 positive cells in each histological group. RESULTS: In general, p27Kip1 immunostaining was related to squamous differentation, and was intense in normal epithelium (47%), while it was reduced in SIL lesions as an effect of the decreased number of differentiating cells. However, decrease in the p27Kip1 expression was more evident in LSIL (36%) than in HSIL (39%); in the latter, p27Kip1 had a different intraepithelial distribution in that the staining extended to the basal cells. The average levels of p27Kip1 were similar in SIL lesions associated to low, intermediate, and high risk HPV types. Compared with normal epithelium and dysplasia, invasive cancer showed significantly lower p27Kip1 levels (23%). There was no relation between p27Kip1 and Ki-67 labelling indices in any of the histological groups examined. CONCLUSIONS: A reduction in p27Kip1 protein occurs in cervical cancer independently of the proliferative status. The changes in p27Kip1 expression may be related to the unregulated kinetics of developing cervical cancer.

Biomarkers, Tumor↗

Beta- and gamma-catenin expression in thyroid carcinomas.

Cadherins are calcium-dependent cell-cell adhesion molecules whose intracellular domain forms a complex with proteins required for their function, called catenins. Down-regulation of cadherins has frequently been detected in many types of human carcinomas, being associated with tumour progression. The present study investigates the immunohistochemical expression of E-cadherin and beta- and gamma-catenin in 27 human thyroid carcinomas. E-cadherin immunoreactivity was found to be decreased at cell-cell contacts in 8/15 (53 per cent) papillary, 5/7 (71 per cent) follicular, and 5/5 (100 per cent) anaplastic carcinomas. Beta-catenin membrane localization was found to be decreased in 6/15 (40 per cent) papillary, 2/7 (28 per cent) follicular, and 5/5 (100 per cent) anaplastic carcinomas. Gamma-catenin expression was partially or totally lost in 13/15 (86 per cent) papillary, 6/7 (85 per cent) follicular, and 5/5 (100 per cent) anaplastic carcinomas. A normal pattern of expression for these three molecules was observed in areas of normal tissue in each sample. These data indicate that in addition to E-cadherin, catenins are also down-regulated at cell-cell junctions in thyroid tumours and could represent potentially useful differentiation and/or transformation markers. The high frequency of alterations of gamma-catenin expression found in thyroid carcinomas suggests an important role for this gene product in thyroid carcinogenesis.

Adenocarcinoma, Follicular↗

Retrospective evaluation of DNA ploidy of hepatocarcinoma on cytologic samples.

DNA ploidy was evaluated by image cytometry in a series of 84 hepatocellular carcinomas diagnosed by fine-needle aspiration biopsy. In the series were included eight cases originally diagnosed as suspect and reclassified as well-differentiated hepatocarcinoma. The study was retrospectively performed on Papanicolaou-destained, Feulgen-restained smears. The 5c exceeding rate and the visual interpretation of the corresponding histograms were evaluated and compared with size of the tumors, serum alpha-fetoprotein values, hepatic functional staging, and patient survival. Sixty-eight cases were aneuploid and 16 euploid (9 diploid and 7 polyploid). Four of the eight cytologically suspect cases were aneuploid. Statistical analysis showed an association between size and cytologic grading, 5c exceeding rate and cytologic grading, and between aneuploidy and multiple tumors; in a Cox multivariate DNA content analysis, aneuploidy and multiple tumors were the two prognostically significant variables. DNA ploidy evaluation by static cytometry of hepatic tumors may be useful in the diagnosis on cytologic samples and could represent an independent prognostic parameter in predicting the survival outcome of patients with hepatocellular carcinoma.

Adult↗

Immunohistochemical expression of mdm2 and p21WAF1 in invasive cervical cancer: correlation with p53 protein and high risk HPV infection.

AIM: To investigate the immunocytochemical staining pattern of mdm2 and p21WAF1 proteins in invasive cervical cancer and to determine its relation with the expression of p53 and with the high risk HPV infection. METHODS: Immunocytochemistry for p53, mdm2, and p21WAF1 was performed in 31 paraffin embedded sections of invasive cervical cancer. The results were assessed by image analysis, evaluating for each protein the optical density of the immunostained area, scored as percentage of the total nuclear area. The presence of high risk human papillomavirus (HPV) infection was detected by using the polymerase chain reaction. RESULTS: Immunostaining for both mdm2 and p21WAF1 was correlated with p53 expression; however, the correlation between p53 and mdm2 (R = 0.49; p < 0.01) was more significant than between p53 and p21WAF1 (R = 0.31; p < 0.05); the less stringent correlation between p53 and p21WAF1 might reflect the p53 independent mechanisms of p21WAF1 induction. Similar average levels of p53, mdm2, and p21WAF1 immunostaining were found in the presence or absence of high risk HPV-DNA, without significant differences between the two groups. CONCLUSIONS: These data suggest that mdm2 and p21WAF1 proteins are expressed in invasive cervical cancer and that their immunocytochemical staining pattern is not abrogated by the presence of high risk HPV genomic sequences.

Carcinoma, Squamous Cell↗

Fine needle aspiration (FNA) biopsy of orbital masses: a critical review of 51 cases.

FNA biopsy of 51 orbital masses is critically reviewed. Aspiration was performed with a 23 G needle inserted by an ophthalmologist; the smears were prepared by a cytologist. Forty-two cases (83%) were correctly diagnosed as benign or malignant either with (68%) or without (15%) correct specification of the histology. There were two false-negative and seven inadequate cases. Immunocytochemical stains were performed in five cases using the following antibodies: L26 (Pan B), UCHL1 (Pan T), kappa and lambda immunoglobulin light chains (three cases) in order to distinguish inflammatory pseudotumours from low-grade non-Hodgkin's lymphomas. In two cases we used CAM 5.2 (a monoclonal cytokeratin cocktail) and vimentin to ascertain the epithelial origin of two metastatic tumours. In five other cases cytospins were not adequately cellular for immunocytochemistry. Insufficient material and one false-negative sample were obtained from very fibrotic lesions or from posteriorly located lesions. The results are discussed and compared with other series reported in the literature. Orbital FNA biopsy may be considered a useful tool in the diagnostic approach to orbital masses in which the relatively high number of inadequate aspirations is offset by a low cost-benefit ratio.

Adenocarcinoma↗

c-erbB-2 expression in FNAB smears and matched surgical specimens of breast cancer.

Most of the data regarding the significance of c-erbB-2 oncogene expression as a prognostic marker in breast cancer have been generated in many large retrospective studies by retrieving the corresponding oncoprotein in archival paraffin embedded sections. Recently, employing fresh breast cancer cells obtained by means of fine-needle aspiration biopsy, we found a rate of c-erbB-2 positive breast tumors (58%) higher than that reported in paraffin-embedded tissue sections by others studies. The present analysis was undertaken to investigate the impact of routine tissue processing on the preservation of the c-erbB-2 immunoreactivity. This issue was addressed by assessing the relative rate of c-erbB-2 oncoprotein immunodetection on FNAB smears and matched surgical specimens of breast cancer. The expression of c-erbB-2 oncoprotein was evaluated using the alkaline phosphate-anti-alkaline phosphatase (APAAP) technique in 54 breast aspirates and corresponding surgical specimens of primary breast cancer. Twenty-six (48%) smears and 23 (43%) matched paraffin sections gave specific signal for c-erbB-2 oncoprotein. The slightly higher incidence of c-erbB-2 expression found on smears seems to be mainly due to the better antigen preservation in the fresh cytological preparations. We conclude that routine histological processing may affect c-erbB-2 immunoreactivity; therefore, in mounting prospective studies, it is advisable to assess c-erbB-2 status in fresh tissue. Moreover, the assessment of c-erbB-2 expression on aspirate samples may yield additional information to the pre-surgical prognostic evaluation of breast cancer diagnosed by FNAB.

Biopsy, Needle↗

Osteomyelitis by Paracoccidioides brasiliensis (South American blastomycosis): cytologic diagnosis on fine-needle aspiration biopsy smears: a case report.

A case of osteomyelitis caused by Paracoccidioides brasiliensis primarily diagnosed by means of fine-needle aspiration biopsy is reported here in a 60-yr-old Italian patient who had lived in Venezuela for 40 yr. The cytologic and electron microscopic features of the exudate aspirated from a left femoral osteolytic area are described, and the differential diagnosis of this mycotic infection is discussed briefly.

Biopsy, Needle↗

The prognostic significance of tumor angiogenesis in nonaggressive and aggressive basal cell carcinoma of the human skin.

Basal cell carcinoma (BCC) is currently the most common cutaneous cancer found in humans. Although it generally shows a relatively benign course (BCC1), some cases of BCCs show "aggressive" behavior, rapidly infiltrating deeper structures, or metastasizing (BCC2). Until now, the traditional histological diagnostic criteria have failed to discriminate unequivocally between BCC1 and BCC2. Therefore, there is still a need to find reliable prognostic indicators that correlate with outcome and may detect patients at high risk for BCC recurrence, or metastasis and death. Recent studies have suggested that there is a significant correlation between tumor angiogenesis, expressed as the microvessel density within and toward a tumor, tumor aggressiveness, and the overall survival of patients with solid tumors. In this study, the authors examined the angiogenic rate in human cutaneous BCCs, to establish if it correlates with their biological behavior. Vessels were highlighted by immunocytochemical staining for FVIII-related antigen in formalin-fixed, paraffin-embedded tissues. All BCC2 samples of this series showed a significantly higher microvessel count than did BCC1. The existence of a significant discrepancy between the neovascularization in BCC1 and BCC2 suggests that the angiogenetic process may be an important step in the acquisition of the aggressive (malignant) phenotype in human. BCCs. The findings of the present study seem to establish a correlation between tumor vascularization and clinicobiological parameters of aggressiveness in BCC. Considering the emerging studies on the possible clinical use of substances interfering with the angiogenetic process, it is possible that the local therapy for BCCs could become less destructive, with consequent improvement in the quality of life of these patients, apart from the prolongation of the overall survival. From this view-point, the assay of microvessel density might be helpful in selecting patients with cutaneous BCCs at high risk for recurrence or metastasis, who could benefit ab initio from additional therapies and closer follow-up.

Adult↗

Calcifying epithelial odontogenic tumor (Pindborg's tumor) on fine-needle aspiration biopsy smears: a case report.

A 44-yr-old woman with a long-standing history of painful mandibular swelling was hospitalized for the diagnostic evaluation of an osteolytic mandibular lesion in the premolar-canine area. Fine-needle aspiration biopsy (FNAB) was performed and cytologic smears were characterized by clusters, sheets, and rare isolated pleomorphic cells of the squamoid type, blocks of amorphous material encircled by fibroblasts, and occasional calcifications. A cytological diagnosis of Pindborg's tumor was made, which was confirmed by histopathological examination. Evaluation of DNA ploidy by semiautomated image cytometry produced an aneuploid histogram. The patient is free of residual neoplasm at a 12-mo post-operative interval. The cytological differential diagnosis of this rare odontogenic neoplasm is discussed briefly.

Biopsy, Needle↗

bcl-2 protein in breast cancer cells obtained by fine needle aspiration (FNA): a preliminary report.

The bcl-2 protein plays a role in the regulation of programmed cell death (PCD), overriding apoptosis. Its expression has been reported in breast ductal cells, where it is believed to be involved in the hormonal regulation of hyperplasia and involution. To date, bcl-2 gene product has not been investigated on breast cancer FNA. The expression of bcl-2 protein was evaluated using an immunoalkaline phosphatase technique in 54 pre-operative breast cancer aspirates and in paraffin-embedded sections from 20 matched surgical specimens. A high rate of bcl-2 protein expression was found on FNA samples (65%) and on the corresponding tissue sections (60%); there was a nearly absolute concordance in the two specimens, with 19/20 (95%) cases showing a concordant staining. These findings concur with the view that bcl-2 gene is frequently expressed in breast cancer, possibly through a hormonal-dependent pathway.

Apoptosis↗

Hodgkin's disease: diagnostic accuracy of fine needle aspiration; a report based on 62 consecutive cases.

We report on our series of 62 cases occurring between January 1977 and December 1990, which were diagnosed as Hodgkin's disease by fine needle aspiration (FNA) samples. The overall accuracy of the cytological diagnosis was high, with only four incorrect diagnoses and a positive predictive value of 93.5%. The value of FNA as a first level diagnostic technique in the screening of lymphadenopathies is discussed, as well as the limitations and pitfalls of the cytological diagnosis.

Adolescent↗

L-thyroxine effects on thyreocytes and Hürthle cells in nodular hyperplastic goiter on fine needle aspiration samples. Morphometric evaluation.

A morphometric study was performed on the thyreocytes and Hürthle cells in 20 cases of nodular hyperplastic goiter (NHG) and in 8 cases of Hürthle cell-rich NHG. The study was carried out on cytologic samples obtained by fine needle aspiration twice from the same nodules in a selected series of patients before and after L-thyroxine therapy with the aim of evaluating the morphometric nuclear variations induced by that therapy. Thyreocytes and Hürthle cells were evaluated for nuclear Area, Perimeter, Maximum Diameter, Form Elliptic and Form Perimeter using a planimetric instrument. A statistically significant reduction in nuclear size was observed in 18 of 20 cases of NHG after L-thyroxine therapy, but the nuclear shape factors were modified only slightly or not at all. A slight reduction in the nuclear size of Hürthle cells was observed in five and an increase in the remaining three cases, but these differences were not statistically significant. Virtually no changes in shape factors were observed in this group of lesions before or after the therapy. These data are discussed and compared to the results of other series. Our results suggest that morphometry may be useful in the follow-up of NHG to evaluate the effects of L-thyroxine and that this therapy reduces the size of thyreocytes; the therapy, however, seems to have little or no effect on Hürthle cells.

Biopsy, Needle↗

Intraoperative cytology in breast cancer diagnosis: comparison between cytologic and frozen section techniques.

The diagnostic accuracy of frozen section (FS) examination and intraoperative cytology (IOC) has been compared in two different series of breast biopsies in which only one of the two methods has been used. The intraoperative results have been compared with the final histological diagnoses. Five-hundred-ten cases have been investigated by using FS only, and 407 by means of IOC. The two series were comparable because they included the same pathologies; moreover we have subdivided each series into four groups of pathologies to better evaluate the diagnostic accuracy of two methods. The total diagnostic accuracy of FS has been 93.13% vs. 95.33% of IOC. The value of diagnostic accuracy of FS and IOC in the four sub-groups substantially overlapped; there was only a little difference in the group of "various lesions" in which the diagnostic accuracy of IOC was higher. No false positive has been observed in IOC. FS have produced one false positive (0.19%), whereas false negatives have amounted to 1.77% for IOC and to 1.72% for FS. Deferred diagnoses have been 2.95% in IOC and 4.90% in FS examination. For both methods according to Galen and Gambino the following values have been calculated: sensitivity, specificity, efficiency, and predictive value. By comparing the data, the value of the cytological examination in the intraoperative diagnoses results is evident mainly when the latter is coupled with the gross observation.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗

C-erbB-2 expression and DNA ploidy status in breast cancer cells obtained by fine needle aspiration (FNA).

The aim of this study was to determine the relative rate of c-erbB-2 oncoprotein immunodetection on matched fine needle aspiration (FNA) smears and surgical specimens of breast cancer, and to correlate the c-erbB-2 expression with the assessment of the DNA ploidy status. The expression of c-erbB-2 oncoprotein was evaluated using an immunoalkaline phosphatase technique in 49 breast aspirates (four benign and 45 malignant lesions) and 21 matched surgical specimens. The DNA ploidy status was assessed by densitometric techniques on Feulgen-stained smears. Fifty-eight per cent of the smears obtained from 45 malignant lesions and 43% of the 21 corresponding paraffin sections contained cells that were stained by the antibody. The higher incidence of c-erbB-2 expression on smears seems to be due mainly to the better antigen preservation in the fresh cytological preparations. The correlation between c-erbB-2 oncogene expression and DNA ploidy assessment showed an increased incidence of oncogene expression in aneuploid tumours (71% vs 29%; P < 0.05).

Adult↗

Evolution of DNA content in small and well-differentiated hepatocarcinoma.

DNA ploidy of 10 well-differentiated hepatocarcinomas was evaluated by densitometry on smears obtained by fine needle aspiration biopsy (FNAB) with ultrasound guidance. Because of diagnostic difficulties or an increase in tumor size, FNAB was repeated once in six cases and twice in four. All the material collected was then analyzed to study the variation of DNA content over time in these neoplasms. The study was performed on Feulgen-stained slides using an IBAS image analyzer system. DNA ploidy was evaluated by visual interpretation of the corresponding histograms and by calculating the 5c exceeding rate (5cER), 2c deviation index (2cDI) and DNA malignancy grade (DNA-MG). In the first samples seven cases were euploid (four diploid and three polyploid), with 5cER < 5; three cases were aneuploid, with 5cER > 5. In the second samples, taken after four or six weeks, eight cases became aneuploid, with 5cER > 5, and two cases were polyploid, with 5cER > 5. Four cases in which a third FNAB was performed resulted in aneuploidy, with 5cER > 5. A progressive increase in aneuploidy, 5cER and DNA-MG values was observed in six cases in the second FNAB and in one case in the third FNAB along with the increasing size of the nodules. In only one case we observed a paradoxical reduction in the 5cER in the third FNAB; the corresponding histogram remained aneuploid. Limitations could have occurred because of sampling small nodules under ultrasound guidance and because of the relatively small number of cells measured. DNA evaluation seems to be useful in the diagnosis of hepatocarcinoma and in the study of its biologic features.

Aged↗