Biomedical subjects

P Pesko

Publications and source records attributed to P Pesko.

56 records · Page 4Linked to original sources

PubMedDate not supplied

Correlation of macroscopic and histological characteristics in the regional lymph nodes of patients with rectal and sigmoidal adenocarcinoma.

BACKGROUND/AIMS: The number of involved lymph nodes is a relevant prognostic parameter which determines the duration of survival in patients with colonic and rectal adenocarcinoma. The purpose of this study was to establish a correlation between the macroscopic (size and consistency) and microscopic characteristics of the regional lymph nodes (type of involvement in tumor tissue, state of the capsule, adherence of the lymph nodes, etc.) in patients with colorectal carcinoma. METHODOLOGY: In this prospective study, 46 patients with rectal and sigmoid adenocarcinoma were studied through randomized selection. From the resected specimens, a total of 736 lymph nodes were identified (average 15.66 per patient), with the precise location determined according to Enker and Philiphsken. The macroscopic and microscopic characteristics of each lymph node were identified. These lymph node findings were then distributed by means of the x2 test, while the interrelationship of lymph node characteristics was determined by factor analysis. RESULTS: Within the group of "small" lymph nodes, 17.18% were malignant. Additionally, of all the malignant lymph nodes, 46.23% were less than 5 mm in diameter. Although the malignant lymph nodes were predominantly diffusely involved within the tumor tissue, 19.50% were focally involved within the tumor tissue, of which 48.38% were "small" lymph nodes, which are commonly non-palpable. Perforation of the capsule and adherence were more characteristic for focally mutated than for diffusely mutated lymph nodes in the cases of malignantly mutated lymph nodes. CONCLUSION: Size and consistency of the lymph nodes are not dependable parameters for appraisal of lymph node involvement in tumor tissue, the state of the lymph node capsule, nor the interrelation among the lymph nodes. As in the case of the primary tumor, local tumor aggression in the lymph nodes is conditioned by the grade of differentiation, i.e. histologic immaturity, rather than by tumor size.

Adenocarcinoma↗

PubMedDate not supplied

Discriminant analysis of pre- and intraoperatively detected prognostic factors influencing lymph node involvement in patients with colorectal carcinoma.

BACKGROUND/AIMS: The aim of this study was to establish whether, and to what extent, pre- and intraoperatively detected characteristics (demographic, anamnestic and laboratory data) and tumor characteristics can be used in the assessment of regional lymph node involvement in patients with colorectal carcinoma. The assessment also included the number of lymph nodes involved in patients with positive lymph nodes. Considering that the number of obtained lymph nodes widely varies in resected specimens, assessment parameters also included the percentage of the involved lymph nodes within the total population of lymph nodes. METHODOLOGY: From 1992-1993, 46 patients with carcinoma of the rectum and sigmoid colon were studied, with a total number of 736 lymph nodes evaluated. Out of the total number of lymph nodes, 577 (78.4%) were benign and 159 (21.6%), malignant. Data were analyzed by multi-variant statistical methods, namely: discriminant analysis and multiple regression with the aid of SPSS/PC+ software. RESULTS: For this patient group, we evaluated the following potentially predictive factors for lymph node involvement: age; serum hemoglobin, albumin and alkaline phosphatase levels; weight loss; and the primary tumor localization characteristics: histologic type, macroscopic growth pattern and depth of tumor invasion of the bowel wall. We found that there was no difference in the prediction of regional lymph node involvement between analysis of the aforementioned parameters and analysis of the isolated discriminators only. CONCLUSION: A predictability likelihood of 83.78% greatly surpasses the acceptable error tolerance level of 5%. Correlation of demographic, anamnestic and laboratory data about the patient and the characteristics of the primary tumor cannot be used in distinguishing malignant lymph nodes from benign ones. These data cannot be the basis for exact intraoperative staging and thus cannot be significant criteria for decision-making about operative treatment modalities.

Adenocarcinoma↗