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Biomedical subjects

N Apostolikas

Publications and source records attributed to N Apostolikas.

At least 37 records · Page 2Linked to original sources

"Butterfly" operation vs triple incision technique in vulvar cancer. a comparison of morbidity and clinical outcome.

Two groups (group A = 25 cases and group B = 34 cases) of vulvar cancer patients, treated with a modified "butterfly" operation (MBO = group A) and a triple incision (TI = group B) technique, were evaluated retrospectively. The aim was to compare the two operative methods, regarding perioperative morbidity and clinical outcome. The histopathologic and clinical characteristics of the patients were comparable, in the two groups. The hospitalization period was significantly shorter in group B (TI), both when primary (22 vs 34 days, p < 0.01) or secondary (41 vs 55 days, p < 0.05) healing occurred. Local recurrences were quite similar in number (A = 5/25, B = 6/34) and were successfully treated. No relapses in the remaining skin bridges were observed in group B. The overall survival was similar in the two groups (A = 64%, B = 63%). However, LN positive cases had a better (p < 0.05) survival when treated by MBO (48% vs 23%).

Adult↗

Sources of discrepancies in the diagnosis of Hodgkin's disease by fine needle aspiration.

The aim of this study was to assess the value of Fine Needle Aspiration (FNA) Cytology in the diagnosis of Hodgkin's Disease (HD) and to identify the sources and nature of the inaccuracies related to this procedure. We retrospectively studied all cases cytologically diagnosed in our laboratory as HD during a five year period (1990-1994). We also traced cases in which FNA cytology failed to reveal HD and where a subsequent HD diagnosis was made by histology. Of the 99 cases studied, a histological report was available for 93. In 82 cases FNA was carried out as part of the initial evaluation. In the remaining 17 cases the diagnosis of HD was known and FNA was performed in order to confirm or exclude a relapse. The results included 4 false positive for HD, 5 false negative and 3 HD-suspicious cases (only one of which proved histologically to be HD while the remaining two were other neoplasms). The re-evaluation of the last 12 cases identified 3 different sources of error: a) Material adequacy criteria; b) Sampling techniques; c) Interpretation.

Adolescent↗

The prognostic significance of breast tumour microcalcifications.

The prognostic significance of breast tumour microcalcifications has shown, so far, contradictory results. We compared two groups of breast cancer patients: in the first group, the patients showed mammographic and histological microcalcifications, whereas the second group did not. The prognostic indices for both groups included the size of the primary tumour, the number of positive axillary nodes, the histological type, the grade, the hormone-receptor status and the menopausal status. An increased number of cases with both oestrogen and progesterone receptor-positive tumours was found in the group with microcalcifications, which is a favorable prognostic sign for these patients. For the remaining prognostic indices there was no difference between the two groups.

Breast Neoplasms↗

Renal cell carcinoma metastases to the skin: a not so rare case?

OBJECTIVE: To describe the clinical, histological, immunohistochemical and behavioural patterns of the metastases of renal cell carcinoma to the skin. PATIENTS AND METHODS: In a retrospective review of 132 cases of renal cell carcinoma submitted for examination to the Anticancer Institute 'St Savas' nine patients with metastatic disease to the skin were discovered. Clinical data and follow-up information were collected and correlated to tumour behaviour and patient survival. Immunohistochemical studies with epithelial membrane antigen (EMA), vimentin, keratin and carcino-embryonic antigen (CEA) were performed. RESULTS: In six of the nine patients the skin metastasis was the first evidence of a tumour. Histology of the skin nodule led to identification of the primary site. Histological proof of the renal origin of the tumour was obtained using the above immunohistochemical studies. All patients died from their disease within 3 years of presenting with the skin metastases. CONCLUSION: Metastases to the skin from a renal cell carcinoma as first evidence of the disease may not be as rare as the literature describes. Definite proof of the origin of the tumour requires specialized immunohistochemical techniques.

Adult↗

Immunohistochemical detection of ras p21 and c-myc p62 in colonic adenomas and carcinomas.

In the present paper we review the results of our study on the use of monoclonal antibodies Y13,259 to the ras p21 and MYC1 9E10 to the c-myc p62 oncoprotein products in human tumors and tumorlike conditions of the colorectum. A total of 78 tissue sections were analyzed immunohistochemically and revealed the following: 42 adenocarcinomas with 8 normal mucosae adjacent to the tumor, 25 adenomas (with or without dysplasia and with in situ carcinoma) and 3 hyperplastic polyps. Parallel tissue sections were used in order to compare ras and c-myc oncoproteins. Reviewing our results we made the following remarks: 1. All adenocarcinomas but one were expressed with both oncoproteins, most of them being strongly positive. 2. All adenomas were positive for ras p21, and all but two were also positive for c-myc p62. An interesting point is that the degree of staining intensity increased in accordance with the degree of dysplasia and/or in situ carcinoma association. 3. The hyperplastic polyps, as well as all normal mucosae were negative.

Adenoma↗

The reliability of histologically negative axillary lymph nodes in breast cancer. Preliminary report.

In an effort to evaluate the reliability of negative axillary lymph nodes in breast cancer patients, we did recuts in three levels in order to detect occult metastases. Our material consisted of 50 breast cancer cases with negative axilla. From each lymph node two routine sections were reviewed. Consequently, we examined six additional sections from the recuts. Out of the 50 cases, 7 (14%) had occult metastases in one or more section. Our results suggest that a negative axilla in the routine study can show in a considerable percentage occult metastases corresponding to the number of recuts. This means that a sufficient number of patients have only theoretically negative axillary lymph nodes and for that reason may show a low survival rate and a worse prognosis than the one expected. On the other hand, the need for axillary dissection or the appropriate postoperative treatment for carcinoma of the breast is supported.

Adult↗

Therapeutic effect of bovine albumin in the experimental fat embolism syndrome.

The toxic effects of the free fatty acids (FFA) are responsible for the initiation and the clinical manifestations of the fat embolism syndrome (FES). Serum albumin binds to the FFA and by producing atoxic compounds it has a therapeutic effect on the syndrome. In this study we applied bovine albumin to 48 Sprague-Dawley rats which were previously submitted to intravenous infusions of FFA solutions (oleic, palmitic, stearic). The histopathologic lesions observed in their lungs were compared to those of 50 control animals suffering from the FES. The administration of 0.5% bovine albumin solution intravenously and 0.2% intraperitoneally, especially when it was synchronous to the FFA infusion and not metachronous, resulted in substantial and statistically significant therapeutic effects.

Animals↗

The reliability of frozen-section diagnosis in various breast lesions: a study based on 3451 biopsies.

In this study, we analyze breast biopsy material over a 5-year period and we compare the results of frozen-section diagnosis with the corresponding diagnosis of the permanent histologic sections. In this study, which represents the largest series in the available international literature, it is proven that frozen-section diagnosis of various breast lesions is a highly accurate procedure in spite of the difficulties facing the pathologist with the frequent borderline or premalignant lesions. The great responsibility of the pathologist is emphasized.

Biopsy↗

delta IK17 antigen: a possible early marker of cancer development.

delta IK17 is a 44 kD molecule located on the surface of T, B and NK cells in normal peripheral blood mononuclear cells (PBMC) (1). The portion of PBMC expressing delta IK17 was determined in 52 patients with benign breast diseases, 182 patients with breast malignancies and 132 healthy individuals. The percentage of delta IK17-positive cells was significantly lower in the early stages (I-IIA) of malignancy compared to that of healthy donors. However, the percentage of PBMC expressing delta IK17 tended to increase as the stage of the disease advanced. delta IK17 seems to be the only antigen among the other cellular markers tested (CD2, CD4, CD8, HLA-DR) with a statistically significant correlation between a low percentage of positive cells and the early stages of malignancy and between a high expression and advanced disease. Its potential use as a tumor marker in breast cancer is discussed here.

Adult↗

Long-term tamoxifen treatment: a possible aetiological factor in the development of uterine carcinosarcoma: two case-reports and review of the literature.

Two cases of uterine carcinosarcoma developing after long-term tamoxifen (TAM) treatment are presented. The patients, 67 and 72 years old, were treated with TAM for 6 and 7 years, continuously. They both developed an heterologous malignant mixed Mullerian tumor (mmMt). At laparotomy, an advanced stage of disease was found with peritoneal spread. In spite of the surgical and the postoperative treatment, they both died of disease, 3 and 10 months later. There are only 10, well documented, similar cases reported. Another 7 were identified in series of uterine malignancies developing after TAM treatment. Considerable evidence suggests that mmMt represents an epithelial cancer with sarcomatous dedifferentiation. Prolonged (> 5 years) TAM treatment may represent a causative factor in the development of this highly lethal disease (80% of the reported patients had a dismal prognosis). Large uterine polyps with special histological features, may represent an intermediate step in the tumor formation. Close follow-up of the patients is warranted.

Adenocarcinoma↗

Treatment of malignant colonic obstructions with metal stents and laser.

BACKGROUND/AIMS: The aim of this study was to evaluate the efficacy and safety of combined endoscopic therapy with self-expanding metallic endoprostheses and laser application in the management of malignant colonic obstruction. METHODOLOGY: Between March 1998 and September 2000, obstruction of the distal colon was diagnosed in a total of 11 patients (6 M, 5 F, age range: 67-87 years, mean: 73). The site of obstruction was located in the rectosigmoid colon (n = 6), in the sigmoid colon (n = 4) and in the descending colon (n = 1). The etiology of stenosis was colorectal adenocarcinoma (n = 8), ovarian cancer (n = 2) and infiltrating bladder carcinoma (n = 1). In all patients the tumor was considered non-resectable. Six patients had confirmed metastases, one refused colostomy and 4 were unable to undergo surgery. After radiological visualization of the proximal extent of the stricture, the stenosis was dilated with Savary-like (10 patients) and pneumatic balloon dilators (1 patient-descending colon). RESULTS: Stents were placed successfully in 10 patients. Prostheses migration distal to lesion, into the sigmoid colon, was observed in one patient (bladder cancer). A mild autoresolved bleeding was observed in 8 patients. Five patients remained free of clinical colonic obstruction until their death, which occurred 6-16 weeks (mean: 10) after stent placement. A moderate non-occlusive ingrowth of tumor into the stent lumen was documented in the other 5 cases. These patients were treated with introspective application of Diomed laser in a total of 16 sessions (4120-12,476 Joules each session, mean: 6258, power 10-14 W, interval between 2 sessions 6 weeks) and died of progressive disease without clinical signs and endoscopic findings of reobstruction 22-56 weeks (mean: 32) after stent placement. CONCLUSIONS: Metallic stent placement is an adequate palliative and cost-effective option, effective and save, in advanced colonic obstruction due to non-resectable tumors. It circumvents the need for colostomy and allows the patient a better quality of life. Delayed stent occlusion with tumor ingrowth requires a regular follow-up and can be treated with introspective laser ablation.

Adenocarcinoma↗

Comparative immunohistochemical study of ras-p21 oncoprotein in adenomatous hyperplasia and adenocarcinoma of the prostate gland.

The present study assessed the immunohistochemical expression of ras p21 oncoprotein in 41 cases of benign and cancerous lesions of the prostate gland and correlated p21 expression with survival of patients operated for prostate cancer. Our results show that p21 is detected in both categories of patients, the expression being weak in adenomatous hyperplasia and more intense in cancer. We were also able to show an inverse relation between ras p21 positivity and the degree of differentiatin. Follow-up study revealed a statistically significant (p < 0.05) correlation between 5 year survival and p21 expression.

Adenocarcinoma↗

Assessment of proliferating cell nuclear antigen (PCNA) immunoreactivity in exocrine pancreatic carcinomas.

Twenty patients with exocrine pancreatic carcinomas were studied immunohistochemically, using a monoclonal antibody against PCNA. The percentage of tumor cells with positive staining was defined as PCNA Labelling Index (L.I.), and ranged from 13.8% to 92.8%. PCNA LI was found to correlate significantly with grading and more specifically with mitotic activity and degree of nuclear anaplasia. No correlation was found with glandular differentiation or with vessel invasion, lymphatic vessel invasion, lymph node metastasis, perineural invasion or size of tumor. Our results indicate that mitotic activity and degree of nuclear anaplasia might be the most important parameters to take into consideration, when studying the role of PCNA in exocrine pancreatic carcinomas.

Adult↗

Cathepsin D concentration in tumor cytosols improves the accuracy of prognostic evaluation of primary breast cancer.

One hundred and seventy three women were followed-up for a median of 62 months after surgery for Stage I-III breast cancer. The concentration of cathepsin D (CD) in tumor cytosols was compared to the standard prognostic factors for the disease and related to relapse free and overall survival and type of relapse. Three groups were identified with different prognostic profile. High CD levels significantly shorten DFS in both node-negative and node-positive patients; a correlation between high cathepsin D levels and locoregional relapse should also be noted. This marker should be included in the initial evaluation of breast cancer as an indicator of invasiveness.

Adult↗

Isolation of a cDNA clone from colon carcinoma.

cDNA clones of differentially expressed mRNAs in a colon carcinoma have been isolated by subtractive cDNA cloning. The substracted material was at least 90x enriched for differentially expressed sequences and can be used for the construction of substractive cDNA libraries and polymerase chain reaction (PCR) amplification to generate differential probes. In this way rare mRNA (less than 0.1% abundance) which are differentially expressed, can be isolated utilising this procedure. A cDNA clone which we call IH12 has been isolated. Its mRNA is expressed exclusively in actively proliferating cells.

Adenocarcinoma↗

Relationships between cathepsin-D, pS2 protein and hormonal receptors in breast cancer cytosols: inconsistency with their established prognostic significance.

In this study the unexpected findings from the analysis of 278 breast cancer tissue specimens are reported. A surprising strongly positive correlation between an unfavourable and a favourable prognosis with markers cathepsin D and pS2 respectively, was revealed by linear regression analysis (Pearson, Student-T-Test). In the relevant literature reviewed only one similar, although indirect, observation was found. On the other hand, a weak relationship between pS2 and ER has emerged using the same method, while the pS2/PgR association remained strong. The latter supports the hypothesis that pS2 positivity is associated with positive PgR and may be a marker of functioning ER, irrespective of ER status. These and other similar findings underline the need for a better understanding of the underlying molecular events as well as the necessity of an effective prognostic evaluation model for breast cancer.

Adult↗