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P Vassilakos

Publications and source records attributed to P Vassilakos.

At least 19 recordsLinked to original sources
PubMed1992

Delayed recognition of a vascular complication, carotid artery aneurysm, 60 years after operation for muscular torticollis. A case report.

An extremely rare vascular complication, carotid artery aneurysm, developed 60 years after a torticollis operation. The patient's internal jugular vein was completely obstructed proximal to the subclavian vein. There was an associated incomplete obstruction of the ipsilateral common carotid artery on the right aspect of the neck--the site where resection of the whole sternocleidomastoid muscle had been performed when she was one year old. The patient had audible bruits over the right common carotid at the base of her neck but no signs of occlusive cerebrovascular disease. The diagnosis was made mainly with use of technetium radionuclide angiography. To the authors' knowledge, this is the first such report in the English or German literature.

Aneurysm↗
PubMed1992

[Intraepithelial squamous lesions of the cervix and vulva. Necessity of a common language].

It is almost universally agreed that there is a variety of terminology currently used for the classification of intraepithelial squamous lesions of the cervix and vulva, which in some instances is ambiguous. The optimal management and welfare of patients with such lesions requires a language accepted and readily understood among gynaecologists, cytopathologists and dermatologists. Moreover, a common system of terminology will encourage standardization and comparability of reports on an international and interdisciplinary basis. This communication studies: (a) the existing systems of terminology and the problems associated with them; (b) the new concepts of precancerous lesions and their relation to the natural history, pathogenesis and treatment; (c) the need to establish a common language between specialists. It is concluded that despite the fact that for the moment there is no perfect system of nomenclature, the recent effort made by experts to adopt an international system for reporting should be supported.

Carcinoma, Squamous Cell↗
PubMed1991

DNA ploidy status in the diagnosis and prognosis of cancer.

DNA ploidy status of tumour cells is becoming a part of patient's record, because it brings an objective assessment of diagnostic and prognostic significance. DNA ploidy status in diagnosis--DNA ploidy status of some tumour types can be used as an adjunct to cytologic or histologic examination and provide an additional diagnostic information. For example, small cell lung carcinoma cells may be difficult to differentiate from cells of other benign neuroendocrine tumours. By computing the DNA malignancy grade, as defined by Bocking A. et al., it was possible to distinguish levels of malignancy among neuroendocrine tumours. Thus we were able to demonstrate that typical carcinoids may be differentiated from small cell carcinomas and atypical carcinoids. DNA ploidy status in prognosis--A large number of studies strongly support a correlation between DNA ploidy patterns and clinical course of malignant tumours. However, the prognostic value of DNA ploidy status has to be evaluated in relation to conventional clinico-pathologic characteristics, by multivariate analysis in order to demonstrate its independent contribution. For example, we demonstrated, in a prospective study of 211 colorectal adenocarcinomas, that ploidy status was an independent predictor of prognosis only in the early stages of the disease (Dukes' A, B, C), but not when advanced stages-(Dukes' D) were considered. In conclusion, DNA ploidy status may be used as an important objective parameter either in diagnosis or in prognosis, complementary to the traditional clinico-pathological characteristics.

DNA, Neoplasm↗
PubMed1990

Independent prognostic value of ploidy in colorectal cancer. A prospective study using image cytometry.

In a prospective study, the DNA content of Feulgen-stained nuclei obtained from fresh samples of 211 colorectal adenocarcinomas was evaluated by means of image analysis. The DNA histogram classification took into account aneuploidy and S-phase fraction for diploid cases. No significant relationship was found between ploidy and sex, age, preoperative carcinoembryonic antigen (CEA), size of the tumor, histologic differentiation, or Dukes' stage. Aneuploidy was more frequently encountered in distal tumors. Preoperative CEA, histologic differentiation, Dukes' stage, and ploidy were individually associated with overall survival. In Dukes' A, B, and C tumors, patients with normal and elevated CEA had no significant difference in overall survival. A relationship was apparent between disease-free survival and site, histologic differentiation, Dukes' stage, and ploidy. Multivariate overall survival analysis did not reveal independent prognostic significance of ploidy when all Dukes' stages were considered. In contrast, Dukes' stage, differentiation, and ploidy were good indicators of higher risk of colorectal cancer-related death in patients undergoing curative surgery. Dukes' stage and ploidy were also indicators for recurrence. Thus, routine histopathologic characteristics should be used in combination with quantitative cytologic features for the definition of a relevant prognostic index in colorectal cancer.

Adenocarcinoma↗
PubMed1990

The application of immunocytochemical techniques to routinely-fixed and stained cytologic specimens. An aid in the differential diagnosis of undifferentiated malignant neoplasms.

Routinely-fixed and Papanicolaou stained smears with the cytologic diagnosis of undifferentiated malignant neoplasm that had been prepared with cells obtained by fine needle aspiration biopsy (n = 7), pulmonary lavage (n = 5), or thoracentesis (n = 3) from 15 unselected patients were stained by an immunocytochemical technique to evaluate the presence of keratin proteins and the leukocyte common antigen (LCA). Commercially available, well-characterized monoclonal antibodies with specificities for keratin proteins and the leukocyte common antigen, and a streptavidin-biotin-horseradish peroxidase labelling method were used. Evaluation of the stained smears revealed the presence of one of the two antigens in material obtained from each patient, thus indicating the probable cell-lineage of the neoplastic cells. The specificity of the monoclonal antibody reagents used was further evaluated in routinely-fixed and stained cytologic material from 24 histologically confirmed carcinomas and 12 lymphomas. In conclusion, immunocytochemical techniques may be successfully applied to routinely processed archival cytologic smears to determine the antigenic profile of morphologically undifferentiated cells and therefore aid in the differential diagnosis of undifferentiated malignant neoplasms.

Adult↗
PubMed1990

CA 125 is an excretory product of human endometrial glands.

The present investigation was undertaken to study the cellular localization and kinetics of synthesis of CA 125 in the endometrium. CA 125 was localized by immunohistochemistry to the infranuclear region of epithelial cells during the proliferative phase and to the apical luminal border during the secretory phase. In gestational endometrium, both the cytoplasm and the apical luminal border of epithelial cells were intensely positive. No staining was seen in endometrial stromal cells during the normal cycle or in decidualized endometria. Results obtained from in vitro cultures of separated glandular and stromal cells were similar to those obtained by immunohistochemistry. That is, epithelial cells released between 5 and 25 times more CA 125 into the culture medium than did stromal cells. The release of CA 125 was highest in epithelial and stromal cells obtained during the early secretory phase. CA 125 concentrations were markedly elevated in endometrial aspirations obtained during the secretory phase or in endometria with crumbling stroma compared to plasma levels. Plasma levels of CA 125 were slightly elevated during menses. These results suggest that CA 125 is an exocrine product of endometrial epithelial cells. Plasma levels of CA 125 may be of endometrial origin only when the membrane barriers, which normally prevent its entry into the circulation, are damaged.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1990

[Melanoma of the vagina. Apropos of a case and review of the literature].

We describe the unusual case of a 60-year-old woman with malignant melanoma of the vagina and positive right inguinal lymph nodes. Etiopathogenesis of this lesion, prognostic factors, and therapeutic attitude, are discussed in the light of data from the literature and the case reported herein.

Female↗
PubMed1989

A simple method for estrogen receptor antigen preservation in cytologic specimens containing breast carcinoma cells.

We report a modified method to prepare cytologic specimens for the evaluation of estrogen receptors by immunocytochemistry. Cytologic samples were obtained by needle aspiration of tumor masses (nine patients) and body cavity fluids (nine patients). The cytologic material was divided, and slides for immunostaining were prepared according to two different techniques: (1) fixation of cells in suspension (modified method); and (2) fixation of cells adherent to slides (standard method). The results after immunostaining demonstrated that the number of cells adhering to slides prepared according to the modified method was greatly increased as compared with the number of cells remaining attached to slides prepared according to the standard method. There was no loss of cell groups or aggregates using the modified method. The antigenicity of estrophilin and the cell morphology were well-preserved for up to 30 days. With this modified method, cytologic samples may be stored and conveniently processed in batches, thereby improving the utilization of laboratory resources.

Antigen-Antibody Reactions↗
PubMed1989

[Synchronous hepatic metastases of colorectal adenocarcinoma: what is the course? Apropos of 36 cases].

The discovery of synchronous hepatic metastases from colorectal cancer poses a tactical problem ticklish to resolve. What are favourable circumstances for curative excision of hepatic metastases? When and how to operate them? To try to respond, we analysed a collective of 36 patients between 10. 1. 1985 and 30. 12. 1986. Of the patients staged Dukes B presenting synchronous hepatic metastases (less than 4, less than 50% of hepatic involvement by the tumour) without systemic involvement, excision at the first attempt is realizable and will be a benefit for the patient. For the others, excision is to be considered in the near future after having analysed (tumour grading and staging, CEA, ploidy of primary tumour). Patients presenting extrahepatic metastases will not benefit from hepatic resection. Surgery, associated or not to regional infusion chemotherapy is discussed.

Adenocarcinoma↗
PubMed1989

[Prognostic value of DNA ploidy of colorectal tumor cells].

The analysis of ploidy provides valuable information allowing a more precise diagnosis, a more dependable prognostic and the choice of appropriate therapy. With ploidy analysis one can assess the aggressiveness of a given tumor. Aneuploidy of tumors clearly indicates a significantly lower patient survival index. Ploidy analysis of tissue sections yields a clear overall indication of the proportion of cells exhibiting hyperploidy within the tumor mass. The application of this approach is amenable to diverse types of tumors including colo-rectal neoplasias. Additionally, it provides a correlation with the histological presentation of each tumor. The study includes DNA ploidy analysis of 212 patients with primary adenocarcinoma. Sixty-four of the cases examined had follow-ups of a least 2 years. Eighteen of this group had diploid non-proliferating tumors, of which 2 (11%) subsequently died. Nineteen of the 64 had proliferating diploid tumors, 11 (58%) of whom died within the follow-up periods. Twenty-seven patients had tumors which were clearly aneuploid, 12 (45%) of whom later died. Our study demonstrates the prognostic value of ploidy analysis. The preliminary results indicate that mortality of patients with proliferating tumors is approximately 50% after 2 years. This prognostic is independent of other more classical criteria of tumor staging, namely Dukes' classification, histological differentiation and size of tumor. In the near future, ploidy analysis should be introduced as a standard part of tumor assessment. It clearly provides a valuable prognostic allowing the selection of patients requiring a careful follow-up.

Adenocarcinoma↗
PubMed1987

Evaluation of estrogen receptors by immunocytochemistry on fine-needle aspiration biopsy specimens from breast tumors.

The estrogen receptor (ER) content of 31 surgically removed breast tumors (26 duct carcinomas, one lobular carcinoma, one papillary carcinoma, one colloid carcinoma, one duct carcinoma in situ, and one atypical fibroadenoma) was determined by a commercially available immunocytochemical method (Abbott Laboratories, ER-ICA) on cytologic material obtained by fine needle aspiration biopsy (FNAB) of surgical specimens. Immunocytochemical staining of cells by a peroxidase-antiperoxidase technique was evaluated on the basis of the percentage of positive cells and the intensity of staining. An immuno-staining score for cytologic (IS-CYTO) and histologic (IS-HISTO) material was defined and a threshold of positivity determined to facilitate the semi-quantitation of results and the comparison of cases. The results of immunostaining of cytologic material were compared with the evaluation of ER in corresponding tissue samples as determined by the radioligand binding assay using the dextran-coated charcoal procedure (ER-DCC) and by ER-ICA using cryostat sections of frozen tissue. The sensitivity, specificity, predictive value of a positive test, and test efficiency of ER-ICA in cytologic material as compared to ER-DCC was 96%, 83%, 96% and 93%, respectively. The IS-CYTO was significantly correlated with the IS-HISTO in corresponding histologic material (r = 0.72, P less than 0.001). In conclusion, the combination of ER-ICA with FNAB represents a useful new technique for the evaluation of ER which may be applied to small primary tumors, tumor recurrences, and metastases.

Axilla↗
PubMed1987

Cytometry of breast carcinoma: significance of ploïdy balance and proliferation index.

Image cytometry of DNA distribution in fine needle biopsies of breast carcinomas at first diagnosis was performed to see if there were significant differences in DNA histograms between patients having very different outcome but same tumor histological typing and similar therapy. Two groups of patients were considered retrospectively: the first (20 patients) with survival time shorter than 5 years and the second (20 patients) with survival time longer than 10 years. Seven benign tumors were used as controls. Ten ploïdy classes were defined. The frequencies of cells in those classes were used as independent features in a supervised multivariate analysis. The advantages of this approach was pointed out with respect to the four-type classification of Auer. The scattering of DNA histograms within the feature space showed that a subgroup of patients with poor prognosis was clearly separated from a subgroup of patients with good prognosis but both long survival patients and short survival patients were scattered in between. In order to replace the multivariate classification of histograms by a simpler approach, two parameters were computed which explained most of the scattering in the feature space: the ploïdy balance (difference between the percentages of euploid and aneuploïd cells) and the proliferation index (percentage of cells between peaks). The scattergram of patients according to these parameters showed again that some DNA distributions were specific for either good or bad prognosis. But the separation was uncertain for seven short-survival patients and six long-survival patients. For six patients, the DNA distributions were very similar between long and short survival times. Those patients thus could not be separated even by means of discriminant analysis. The main conclusion of this study was that, for a significant number of patients, the objective multivariate classification of tumors DNA profiles is of little assistance to the pathologist who has to give a prognosis for the one patient under consideration.

Aneuploidy↗
PubMed1987

[Use of immunohistochemistry in clinical cytology].

The purpose of this study was to evaluate the usefulness of immunocytochemical methods of diagnosis in cytology. Pleural effusions and ascites fluids were analyzed from 16 patients in whom the possibility of a malignant effusion was suspected. Cells obtained from the effusions were examined following routine staining by the Papanicolaou method and immunocytochemical staining to determine the presence of tissue specific antigens, i.e. common leucocyte antigen (CLA), cytokeratins (CAM 5.2, AE1), a determinant of the Human Milk Fat Globule (HMFG2) and carcinoembryonic antigen (CEA). The results of the immunocytochemistry studies were compared with the cytologic diagnosis obtained from Papanicolaou stained smears. Good agreement was observed between the diagnosis based on the interpretation of the immunocytochemical studies and the morphological diagnosis. In particular the malignant as well as the benign cells were stained with the epithelial and leucocyte markers according to their tissue origin. Anti-cytokeratin antibody stained epithelial and mesothelial cells, antibody against HFMG2 and anti-CEA stained epithelial (adenocarcinoma) but not mesothelial cells. However macrophages were also positive with anti-CEA antibody. Anti-CLA antibody stained lymphocytes, granulocytes and macrophages but did not distinguish between benign and malignant cells. Based on the results of the present study, immunocytochemical methods using a panel of tissue specific antibodies represent a useful tool in the differential diagnosis of cellular effusions.

Antigens, Neoplasm↗
PubMed1987

Endometrial cytohistology by the pistol-aspiration technique: clinical applicability.

The purpose of this study was to assess the value of the endometrial pistol-aspiration technique as an office procedure for diagnosing corpus uteri cancer in symptomatic and asymptomatic women. Review of 3000 pistol aspirations in symptomatic outpatient women from 1974-1981 confirms that this method, with its high specificity and sensitivity, can be used for such women as a preliminary diagnostic procedure, eliminating risks from anesthesia and curettage as well as the cost of hospitalization. Analysis of resident incident cases shows that 82% were localized to the uterus, and more than 85% of these women were already symptomatic. Older women represent particularly difficult problems, both technical (cervical stenosis) and in recruitment. Because the natural history of the precursor lesions of corpus uteri cancer are not yet well established, use of this method for systematic population screening of asymptomatic women is questionable.

Adult↗