PubMed Health⌕ Search

Biomedical subjects

Niki J Agnantis

Publications and source records attributed to Niki J Agnantis.

At least 37 records · Page 2Linked to original sources

A rare case of primary malignant melanoma of the scrotum diagnosed by fine-needle aspiration.

We report a case of a 55-yr-old man with malignant melanoma of scrotum. He was referred to our Hospital with a complaint of gradual focal enlargement of the scrotum in a period of 3 yr. On physical examination, a pigmented, poorly marginated mass, with central necrosis was observed. A fine-needle aspiration (FNA) of the lesion was performed. Cytological examination revealed highly cellular smears, containing malignant cells, dispersed or arranged in loose aggregates. Cellular morphology and characteristics were identical to those of malignant melanoma arising elsewhere in the skin. The immunocytochemical study revealed positivity of neoplastic cells for anti-melanoma monoclonal antibody (HMB-45) antigen. Histological confirmation finally was provided after wide excision of the lesion. We emphasize the difficulties in differential diagnosis considerations and diagnostic pitfalls of scrotal lesions.

Biopsy, Fine-Needle↗

Estrogen receptor beta (ERbeta) is expressed in brain astrocytic tumors and declines with dedifferentiation of the neoplasm.

PURPOSE: Estrogen receptor beta (ERbeta) is the second identified receptor mediating the effects of estrogen on target tissues. The role of ERbeta in cancer pathobiology is largely unknown, because specific antibodies have not been available until recently. Initial studies have shown that ERbeta expression declines in breast, ovarian, prostatic, and colon carcinomas. Tamoxifen, a synthetic anti-estrogen compound that is a mixed agonist/antagonist of estrogen receptor alpha (ERalpha) and a pure antagonist of ERbeta, has moderate beneficial effects in human astrocytic neoplasms. However, most published studies agree that glial tumors do not express ERalpha. The purpose of this study was to explore the expression of ERbeta in astrocytic neoplasms. METHODS: ERbeta expression was monitored immunohistochemically in 56 cases of astrocytomas of all grades (grade I-IV) and in adjacent non-neoplastic brain tissue. RESULTS: Moderate or strong nuclear immunopositivity was obtained in non-neoplastic astrocytes and in low-grade astrocytomas, whereas the majority of high-grade tumors were immunonegative or displayed weak immunoreactivity. The progressive decline in ERbeta expression paralleled the increase in tumor grade. CONCLUSIONS: In as much as ERbeta is possibly the only ER expressed in astrocytes, its decreased expression may play an important role in astrocytic tumor initiation and in the potential response of glial neoplasms to tamoxifen.

Adolescent↗

Immunohistochemical expression of vascular endothelial growth factor (VEGF) and C-KIT in cutaneous melanocytic lesions.

Vascular endothelial growth factor (VEGF) and C-KIT are involved in tumor progression in several human neoplasms. The aim of the present study has been to investigate their immunohistochemical expression in melanocytic lesions. We examined 11 compound nevi, 12 dysplastic nevi, and 18 melanomas. Immunostaining for VEGF was observed only in melanomas; c-kit expression was detected in melanomas (higher in radial than in vertical growth phase) and in nevi (predominantly in the junctional component). Our data indicate that assessment of VEGF expression might aid in the differential diagnosis between dysplastic nevi and melanomas. Moreover, VEGF might be a candidate for targeted therapy. The loss of c-kit expression might contribute to melanoma progression.

Biomarkers, Tumor↗

Immunohistochemical analysis of expression of bcl-2 protein in papillary carcinomas and papillary microcarcinomas of the thyroid gland.

AIM: To compare the expression of anti-apoptotic protein bcl-2 and tissue proliferation Ki-67 antigen in tissues of human papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC). METHODS: Bcl-2 protein expression in PTC and PTMC has been evaluated by immunohistochemical analysis. RESULTS: Bcl-2 protein was observed in normal thyroid gland in all the cases; in 25% of the cases of papillary carcinomas the immunoreaction was strong and in 75% of the cases--moderate. In 25% of the cases of papillary microcarcinomas the bcl-2 expression was totally negative and 35% was moderate. Bcl-2 expression was lower in non-sclerosing non-encapsulated (NSNE) (25%) cases of PMCs than in non-sclerosing encapsulated (NSE) (57.15%) cases of PTMCs (p < 0.05). MIB-1/Ki-67 expression was notably reduced or not expressed in normal and benign thyroid tissue. MIB-1 immunoreactivity was present in papillary carcinoma, and on a lower level--in PTMCs. The MIB-1 labelling index of NSE and sclerosing non-encapsulated (SNE) cases was lower than that in NSNE (p < 0.005). CONCLUSION: The present study indicated that NSNE cases of PTMCs may be an early stage in tumor progression, and the bcl-2 and MIB-1 immunohistochemistry may be a valuable tool in predicting the malignant behavior in PMTCs, and contributes to the understanding the growth characteristics of papillary carcinomas of the thyroid gland.

Adult↗

Prognostic significance of the deleted in colorectal cancer gene protein expression in high-risk resected gastric carcinoma.

The deleted in colorectal cancer (DCC) gene is a candidate tumor suppressor gene that may be associated with differentiation and proliferation of normal cells. Loss of heterozygosity (LOH) of 18q, where the gene is located, and absence of DCC protein expression have been associated with worse prognosis in certain subgroups of patients with colorectal adenocarcinoma. We studied the prognostic significance of loss-of-protein expression in 66 patients with resected gastric cancer with a high probability of relapse (T3, T4, N+). The DCC protein was detected with immunohistochemistry using an anti-DCC monoclonal antibody on paraffin-embedded sections. The DCC protein expression was present in 51 cases (77.3%) and absent in 15 cases (22.7%). Poorly differentiated and signet ring carcinomas had significantly lower expression than more differentiated tumors (p < 0.05) as did diffuse-type tumors compared to intestinal and mixed (p < 0.01). There was no correlation with proliferation rate, estimated immunohistochemically using an anti-proliferating cell nuclear antigen (PCNA) monoclonal antibody. Absence of DCC protein was an independent favorable prognostic factor (median survival 57 months vs. 18 months, p = 0.0176). The DCC protein expression was correlated with relapse site: all patients with distant metastases were positive for DCC staining, while one-third of patients with local/peritoneal relapse were negative (p < 0.01). In conclusion, DCC protein expression seems to be a significant prognostic factor in high-risk resected gastric cancer. Our results support previous data associating the DCC gene with differentiation and indicate that this gene may play a role in the metastatic potential of these tumors. These findings need to be confirmed by future larger studies.

Adenocarcinoma↗

Delivery outcomes following loop electrosurgical excision procedure for microinvasive (FIGO stage IA1) cervical cancer.

OBJECTIVE: The goal of this study was to report the delivery outcomes in women who had loop electrosurgical excision procedure (LEEP) for microinvasive cervical cancer (stage IA1 without lymphovascular invasion) and became pregnant and progressed beyond 24 weeks. METHODS: A case-control study was performed. Twenty-eight women who were managed exclusively with LEEP for microinvasive cervical carcinoma had at least one pregnancy beyond 24 weeks and were the cases. Each case was matched with one woman who delivered at the same department without prior treatment of her cervix (controls) and their delivery outcomes were compared with those of the cases. Known risk factors for preterm delivery were used as matching factors. RESULTS: There was no statistically significant difference (P > 0.05) between cases and controls in the duration of pregnancy (37.6-38.4 weeks respectively), birth weight (3212-3315 g), cesarean section rate (17.8-32.1%), neonatal unit admission rate (21.4-10.7%), and precipitate labor rate (13-10.5%). The duration of labor was significantly shorter in cases (5.5-7.1 h, P = 0.032). After LEEP the relative risk for preterm delivery is 3.67 (95% confidence interval, 0.97-20.27), for low birth weight infant 0.67 (0.06-5.8), for precipitate labor 1 (0.05-3.88), and for delivery by cesarean section 0.5 (0.17-4.46). CONCLUSIONS: Women treated for microinvasive cancer with LEEP did not have significantly more delivery complications compared with controls apart from shorter duration of labor. There was a possible non-statistically significant trend toward shorter duration of pregnancy in cases. While caution should be advised when selecting and treating women with microinvasive carcinoma by LEEP, the apparent safety of the management and the satisfactory delivery outcome seem to justify this approach in many cases.

Case-Control Studies↗

Incidence of apoptosis and cell proliferation in multiple myeloma: correlation with bcl-2 protein expression and serum levels of interleukin-6 (IL-6) and soluble IL-6 receptor.

UNLABELLED: We evaluated the in vivo incidence of apoptosis and cell proliferation in multiple myeloma (MM) and investigated the correlation of both cellular events with histological tumour stage and grade, bcl-2 protein expression, serum IL-6 and sIL-6R. MATERIAL AND METHODS: The TUNEL method was used to assess apoptosis and immunohistochemistry to assess the expression of proliferating cell nuclear antigen (PCNA) and bcl-2 protein in 30 bone marrow biopsy specimens. The apoptotic index (AI) and proliferative index (PI) were defined as the percentage of TUNEL and PCNA positive plasma cells, respectively. RESULTS: The mean AI was 0.162% and the mean PI 27.44%. A positive correlation between AI and PI was found (r = 0.44, P = 0.017). PI was also correlated with tumour grade (P = 0.015). The mean bcl-2 protein expression was 70% and did not correlate with AI or PI, but was higher in specimens taken at first diagnosis than in specimens taken after response to treatment (P = 0.035). The mean serum IL-6 and sIL-6R values were 9.43 pg mL-1 and 47.27 ng mL-1, respectively. These parameters did not correlate with AI or PI. CONCLUSIONS: The results indicate that MM might be among the malignancies with very low incidence of apoptosis. Proliferative activity increased in parallel with tumour histological grade. A positive correlation between apoptosis and proliferation was observed, but the incidence of these two cellular events seems not to be related to the bcl-2 protein expression and the serum levels of IL-6 and sIL-6R.

Aged↗

Sudden death due to an unrecognized cardiac hydatid cyst.

Echinococcosis is an endemic disease, most common in sheep-raising communities, usually caused by the larval or cyst stage of the tapeworm Echinococcus granulosus. Isolated cardiac hydatid cyst is uncommon at any age, occurs through the coronary circulation, and accounts for less than 3% of all hydatid disease. We describe a case of an 1%-year-old female, who died suddenly. The post-mortem examination revealed an isolated cyst in the left ventricle of the heart with intact wall. The cytologic examination of the cyst fluid demonstrated the presence of the characteristic scolices and hooklets and established the diagnosis of cardiac hydatid cyst. The present case is of special interest because of the rare primary localization and the onset of sudden death in a young person as the initial manifestation of the disease.

Adolescent↗

Telomerase activity and genetic alterations in primary breast carcinomas.

It has been proposed that the structural and numerical chromosome abnormalities recorded in breast cancer could be the result of telomere dysfunction and that telomerase is activated de novo to provide a survival mechanism curtailing further chromosomal aberrations. However, recent in vivo and in vitro data show that the ectopic expression of telomerase promotes tumorigenesis via a telomere length-independent mechanism. In this study, the relation between telomerase expression and the extent of chromosomal aberrations was investigated in 62 primary breast carcinomas. Telomerase activity was measured using a polymerase chain reaction-based telomeric repeat amplification protocol assay and 92% of the tumors were found to express telomerase with a relative activity ranging from 0 to 3839.6. Genetic alterations were determined by G-banding and comparative genomic hybridization analysis and 97% of the tumors exhibited chromosomal aberrations ranging from 0 to 44 (average: 10.98). In the overall series, the relationship between telomerase activity levels and genetic changes could be best described by a quadratic model, whereas in tumors with below-average genetic alteration numbers, a significant positive association was recorded between the two variables (coefficient=0.374, P=.017). The relationship between telomerase activity levels and the extent of genetic alteration may reflect the complex effect of telomerase activation upon tumor progression in breast carcinomas.

Adult↗

Occult thyroid carcinoma. A study of 160 autopsy cases. The first report for the region of Epirus-Greece.

Thyroid glands from 160 patients, aged 11 to 95 years, without known thyroid disease, collected from medicolegal autopsies, were sectioned at 3-5 mm slices and microscopically examined for occult disease. The glands were normal in 57.9%, while nodules were observed in 16.8% and adenomas in 10.6% of the cases. Carcinomas were found in 12 cases (7.7%) and occult papillary carcinomas in 5.6%. No carcinomas were found in the thyroids of patients less than 40 years of age. There were no significant differences in frequency of occult carcinomas between female and male patients. The diameter of these tumors was less than or equal to 5 mm, with one exception, which had a diameter more than 6 mm. The aim of this article is to provide data about the frequency of occult thyroid tumors in the population of Epirus, which is a district in the north west part of Greece.

Adolescent↗

Immunohistochemical study of the expression of S-100 protein, epithelial membrane antigen, cytokeratin and carcinoembryonic antigen in thyroid lesions.

The diagnosis of papillary carcinoma of the thyroid is based on the two morphological features that best characterize this tumor, the papillae and the nuclear changes. However, both the architectural and cytological hallmarks may be encountered in other conditions such as multinodular goiter, Grave's disease, thyroiditis and hyperplastic areas of follicular neoplasms and thus produce problems in the histopathological interpretation. The distinction of these lesions from papillary carcinoma has important implications for clinical management. Thus the availability of supportive diagnostic evidence would be helpful. In the present study we compared the immunoreactivity for S-100 protein, epithelial membrane antigen (EMA), cytokeratin (Ck) and carcynoembryonic antigen (CEA) in different thyroid pathologies. We conclude that the strong expression of S-100 protein, in combination with EMA expression, is of value in identifying papillary neoplasia and distinguishing it from papillary hyperplasia.

Biomarkers, Tumor↗

The natural history of HPV infection of the uterine cervix. Long-term observational and histological data.

BACKGROUND: To investigate the natural history of HPV infection of the uterine cervix following a 10-year prospective observational study. PATIENTS AND METHODS: Three hundred and thirty women with cytological and colposcopic features of HPV infection +/- CIN 1 were recruited into the study. These women were followed up for a period of 10 years, during which time they had repeated colposcopic assessments and cytological monitoring Those women with evidence of high-grade disease at any stage of follow-up were treated by Large Loop excision of the transformation zone (LLETZ) and excluded from the study. At the end of the surveillance period, 179 women with evidence of persistent HPV infection alone or in conjunction with low-grade disease underwent a shallow diagnostic LLETZ. In total, 51 women defaulted from follow-up. RESULTS: Thirty-three per cent of the women with cytological and colposcopic features suggestive of persistent HPV infection alone during the 10-year follow-up period had histological evidence of CIN at the end of the study. Two thirds of this disease was graded as CIN 2 or 3. Nineteen per cent of the women with cytological and colposcopic features suggestive of persistent HPV infection and CIN 1 actually had high-grade CIN at histology (CIN 2 and 3). Only 6.1% of the study population had normal histological findings. CONCLUSION: The finding that a relatively large percentage of high-grade lesions might have been masked for anything up to a decade by a low-grade phenotype, coupled with the worrying percentage of defaulters from follow-up, indicate that an early decision for intervention (diagnostic and/or therapeutic) may be appropriate if a low-grade abnormality persists after a short surveillance period.

Adolescent↗

Expression of cathepsin D in urothelial carcinoma of the urinary bladder: an immunohistochemical study including correlations with extracellular matrix components, CD44, p53, Rb, c-erbB-2 and the proliferation indices.

The immunohistochemical Cathepsin D (CD) expression of tumor and stromal cells was investigated in a series of 77 urothelial carcinomas of the urinary bladder with the intention to evaluate its prognostic significance and its contribution to the metastatic potential of bladder cancer. CD expression (clone D13A) was correlated with the expression of extracellular matrix components (collagen type IV, laminin, fibronectin), CD44, p53, pRb, proliferation indices (PCNA and MIB1) as well as with other conventional clininopathological features. CD expression (> 10% of positive tumor cells) was observed in 77.9% of the carcinomas. Stromal CD expression was detected in all cases. Linear collagen type IV and laminin deposit at the tumor-stroma border (in > 25% of the BM) was found in 26% and 57.6% of the cases, respectively. The CD of cancer cells (CCCD) was inversely-correlated with the CD of the stromal cells (p = 0.039), tumor grade (p = 0.0028), tumor stage (p = 0.0046), p53 protein (p = 0.05) and positively-correlated with CD44 (p = 0.002) and pRb (p = 0.05). The stromal cells CD (SCCD) showed a statistically significant positive correlation with tumor grade (p < 0.0001) and stage (p = 0.0001), and the proliferation indices PCNA and MIB1 (p = 0.0001 and p = 0.0002, respectively). These data suggest that both CD of tumor and stromal cells could play important roles in the expansion of urothelial carcinoma of the urinary bladder.

Adult↗

Update of the role of surgery in the multimodal treatment of MALT gastric lymphomas.

BACKGROUND: Primary gastric non-Hodgkin's lymphoma is a well-defined clinicopathological entity with a distinct histological spectrum and indolent course. Its optimal management still remains controversial. In this study we present our experience with surgery being part of the multimodal treatment and we compare our results with those referred to in the world literature. MATERIALS AND METHODS: Sixty-five patients (37 males, 28 females) with gastric MALT lymphoma were retrospectively analyzed. Forty-seven patients underwent curative resection, eleven received chemotherapy as primary treatment, two patients received radiotherapy before any other treatment and five patients received combined chemo-radiation therapy. RESULTS: For the early stages of the disease (I-III), radical resection offered a two-year survival rate of 100% and 93%, respectively, and a five-year survival of 85% and 67%, respectively. For those stage I patients, who were managed surgically followed by adjuvant therapy, the two- and five-year survival was 90% and 78%, respectively. For stage II patients for whom chemo-radiation therapy followed surgery, the two- and five-year survival was 88% and 65%, respectively. CONCLUSION: In view of the results of our study, surgery is an adequate treatment modality for the early stages of the disease. The addition of radiotherapy or chemotherapy does not improve the overall survival. Conversely, for the advanced stages (II2-IV), primary chemotherapy is the best treatment option with surgery being reserved for cytoreduction or chemo-radiotherapy-induced complications.

Adult↗

Evaluation of dHPLC in mutation screening of the APC gene in a Greek FAP cohort.

BACKGROUND: Germline mutations in the APC gene predispose to colorectal adenomas leading to cancer in over 80% of patients. A multitude of mutations, dispersed throughout the gene, have been described. We wanted to evaluate the usefulness of denaturing high performance liquid chromatography (dHPLC) for mutation screening. MATERIALS AND METHODS: Ten amplicons containing 14 mutations in the APC, previously identified by sequencing in 22 FAP patients, were analysed by dHPLC. dHPLC was also used to screen members of a family for a mutation identified in the proband. RESULTS: We analysed 10 amplicons under a total of 59 temperatures. Successful results were obtained from 51 out of 59 tested temperatures (86.4%). In all cases a different heteroduplex-homoduplex pattern was obtained from mutant DNA in at least two of the temperatures. All 14 mutations identified by sequencing were also detected using dHPLC. Sequence analysis of a large family confirmed the dHPLC results. CONCLUSION: Using dHPLC we detected all mutations previously identified by sequencing.

Adenomatous Polyposis Coli↗