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PubMed1988

[Tumor markers in colorectal neoplasm pathology: our experience of the diagnostic and prognostic importance of CEA antigen].

It is well known that the presence of a tumour may be accompanied by production and release into the serum of a substantial number of protein and/or hormonal substances. Only relatively recently, however, have investigators begun to identify which of these supposed markers may actually be clinically useful. A picture is thus gradually emerging of a number of markers (in actual fact only very few) which are already clinically useful, as well as others which are clinically promising and numerous markers which require more thorough clinical evaluation. Prominent among those already in clinical use is undoubtedly CEA. Carcinoembryonic antigen (CEA) is a glycoprotein isolated for the first time by Gold and Friedman in 1965. Very recently, sensitive radioimmune and immuno-enzymatic assays have made it possible to determine serum levels lower than 3 ng/ml. Though high plasma levels of CEA do not indicate the presence of a tumour with certainty, very high levels are, however, to some extent indicative of its existence. In view of the fact that CEA possesses neither the sensitivity nor the specificity to be able to diagnose the presence or otherwise of a tumour, its use is generally recommended when formulating a prognosis or for monitoring surgical and/or medical therapy (chemotherapy and radiotherapy) in asymptomatic patients. We therefore carried out tests in 357 patients on file as having undergone surgery for neoplasms of the colon-rectum-anus, monitored in our colostomy outpatients' department, which was started up in 1980. 188 of these patients had already been submitted to CEA assay prior to surgery. The data are analyzed in relation to the site, stage and grade of differentiation of the neoplasm, the supposed radicality of the operation and the period of follow-up in these patients.

Carcinoembryonic Antigen↗

PubMed1994

Splenic lymphoma with circulating villous lymphocytes: report of seven cases and review of the literature.

Splenic lymphoma with villous lymphocytes (SLVL) is a relatively new entity with only a few reports published. We report seven cases of SLVL with detailed clinicopathologic and comprehensive immunophenotypic studies to further characterize this lymphoma, which is frequently confused with hairy cell leukemia and other low-grade B-cell lymphoid neoplasms. The diagnostic criteria we used include 1) prominent splenomegaly, 2) insignificant or no lymphadenopathy, 3) lymphocytosis without leukopenia, 4) presence of circulating villous lymphocytes, 5) characteristic cytologic and histologic features, and 6) specific phenotypic and cytochemical findings. Our studies show that SLVL does not represent a pure entity but rather a morphologically heterogeneous group of low-grade lymphomas with various cytologic and histologic features. Although immunophenotyping is helpful in differential diagnosis, multiparameter studies are necessary to confirm the diagnosis. In our series, only two patients died of SLVL, who probably developed transformation to a higher-grade lymphoma.

Aged↗

PubMed1992

Hepatotoxicity and carcinogenicity in female Sprague-Dawley rats treated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD): a pathology working group reevaluation.

Risk assessment for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has been based in part on the incidences of liver neoplasms in female Sprague-Dawley (SD) rats reported in a 2-year study conducted by Dow Chemical Corporation and published in 1978. In the years subsequent to the Dow report, the criteria for the diagnosis of proliferative hepatocellular lesions in the rat have been refined based upon ongoing study of these lesions. Because of this, PATHCO, Inc., was requested to conduct an independent review of the liver slides from the Dow TCDD study in order to assess how the current terminology might impact on interpretation of proliferative liver lesions in rats compared to the terminology used in the past. In March 1990, a pathology working group (PWG) was convened to review proliferative lesions in the livers of the female rats. The results of the PWG's evaluation of the microslides indicated a trend in tumor incidence similar to that published in 1978 but with a lower incidence of tumors in the middle and high dose females. Based on the morphologic findings, including the fact that the tumors were predominantly benign and usually associated with lesions of hepatic toxicity, the PWG considered this study to demonstrate a weak oncogenic effect of TCDD in the livers of female SD rats. As a result of its review, the PWG noted that in order to establish a relationship between the toxic hepatitis and the hepatocellular neoplasms, an independent review and grading of the toxic lesions in all female rats would be required.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1999

Chromosomal imbalances in noninvasive papillary bladder neoplasms (pTa).

Almost 70% of urinary bladder neoplasms present as low-grade papillary noninvasive tumors (stage pTa). To determine which genomic alterations can occur in pTa tumors of different grades and to evaluate the prognostic significance of chromosomal imbalances, we analyzed 113 pTa tumors (40 grade 1, 55 grade 2, 18 grade 3) by comparative genomic hybridization. pTaG1 (1.9 +/- 2.0) and pTaG2 (3.1 +/- 2.9) tumors had only few genomic alterations with 9q- (44%), 9p- (36%), and -Y (21%) being most prevalent. Neither the total number of aberrations nor any individual alteration was linked to the risk of recurrence in 95 pTaG1/G2 tumors with clinical follow-up information. pTaG3 tumors were characterized by a high number of alterations (7.7 +/- 4.5; P < 0.0001 for G3 versus G2). Several chromosomal imbalances that have previously been reported to be typical for invasive bladder neoplasms were significantly more frequent in pTaG3 than in pTaG2 tumors, including 2q-, 5p+, 5q-, 6q-, 8p-, 10q-, 18q-, and 20q+. A malfunction of genes at these loci may contribute to the development of high-grade urothelial neoplasias. However, there is no evidence for a direct role of these alterations for development of invasive tumor growth.

Carcinoma in Situ↗

PubMed1989

[Clinical study of surgically treated parotid tumors during 1981-1985].

There is a great histologic diversity in parotid tumors. Four categories can be distinguished: pleomorphic adenoma, monomorphic adenomas, low-grade malignant tumors and high-grade malignant tumors. The most current neoplasm is the pleomorphic adenoma. The first three groups have a nearly similar clinical evolution and surgical treatment. The high-grade malignant tumors often cause a facial nerve paralysis and require a radical approach.

Adenoma↗

PubMed2000

Evaluation of angiogenesis in canine mammary tumors by quantitative platelet endothelial cell adhesion molecule immunohistochemistry.

Angiogenesis was evaluated by immunohistochemistry for platelet endothelial cell adhesion molecule (CD31) in a series of benign and malignant canine mammary neoplasms. Computer image analysis was used to measure the intratumoral microvessel density (number of microvessels per square millimeter) and the area and perimeter of immunolabeled vascular structures. A higher intratumoral microvessel density and lower values for area and perimeter were found in malignant neoplasms compared with benign tumors and among the malignant tumors, in less differentiated phenotypes and in more anaplastic histological types (solid and squamous carcinomas), most of which had metastasized. These findings are consistent with an increase in angiogenesis in multistage neoplasia. Therefore, in more anaplastic malignant neoplasms, numerous but small and often malformed new vessels can be identified. The correlation of angiogenesis data with differentiation grade and histological type of mammary neoplasms is consistent with the findings in human medicine and demonstrates that angiogenesis can also have a prognostic value in veterinary medicine.

Animals↗

PubMedDate not supplied

MTH-68/H oncolytic viral treatment in human high-grade gliomas.

Application of virus therapy to treat human neoplasms has over a three decade history. MTH-68/H, a live attenuated oncolytic viral strain of the Newcastle disease virus, is one of the viruses used in the treatment of different malignancies. Here we report on the administration of MTH-68/H to patients with glioblastoma multiforme, the most common and most aggressive neuroectodermal neoplasm with a poor prognosis, averaging six months to a year. Four cases of advanced high-grade glioma were treated with MTH-68/H after the conventional modalities of anti-neoplastic therapies had failed. This treatment resulted in survival rates of 5-9 years, with each patient still living today. Against all odds, each patient resumed a lifestyle that resembles their previous daily routines and enjoys a good quality of life, Each of these patients has regularly received MTH-68/H as their sole form of onco-therapy for a number of years now without interruption.

Brain Neoplasms↗

PubMed1986

Ectopic beta-human chorionic gonadotropin production by bladder urothelial neoplasia.

Endocrine manifestations are rarely observed in bladder urothelial neoplasia. To our knowledge, only 11 cases of choriocarcinoma have been reported in this site, and recently the production of beta-human chorionic gonadotropin has been demonstrated in these tumors by applying the immunoperoxidase technique. Of 104 transitional cell neoplasms of the bladder, we demonstrated by the indirect immunoperoxidase technique beta-human chorionic gonadotropin production in 12 neoplasms, 11 of which were grade 3 and 4 transitional cell carcinomas.

Aged↗

PubMed1990

Post-traumatic squamous-cell carcinoma.

Between January 1, 1976, and January 1, 1986, we treated sixty-three patients who had histologically proved squamous-cell carcinoma that originated in a pre-existing scar or sinus of an extremity. In 49 per cent of the patients, metastases to regional lymph nodes either were present when the patient was first seen or subsequently developed. The age and sex of the patient, the etiology of the original scar, and the duration of illness bore no relationship to the result. The most significant factor in predicting the outcome was the grade of the tumor: for grade-I (low-grade) lesions, the incidence of metastasis was 10 per cent; for grade-II (moderately well differentiated) lesions, 59 per cent; and for grade-III (poorly differentiated) lesions, 86 per cent. Eleven patients had wide local excision of the lesion, which resulted in local recurrence in four patients and metastasis in three. Thirty patients had therapeutic amputation: one patient had recurrent disease and five patients had metastasis. Radical resection of lymph nodes after metastasis was uniformly unsuccessful in preventing additional metastasis. Ten patients who had a grade-II or grade-III tumor had prophylactic irradiation of the regional lymph nodes after the definitive operative treatment. At an average of thirty-seven months of follow-up, only one of them had metastasis. We recommend that well differentiated squamous-cell carcinoma be considered a low-grade tumor, according to the staging system for musculoskeletal neoplasms, and that more poorly differentiated squamous-cell carcinoma (grades II and III) be considered a high-grade lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1993

Serum manganese superoxide dismutase (MnSOD) and histological virulence of ovarian cancer.

The serum level of a scavenging enzyme, manganese superoxide dismutase (MnSOD), was examined in 78 patients with ovarian cancer. Tumors included 27 stage I, 6 stage II, 37 stage III and 8 stage IV diseases. They were classified as 43 serous, 18 mucinous, 10 clear cell and 7 endometrioid neoplasms, and grouped into 25 grade I, 27 grade II and 26 grade III cancers. Factors affecting the MnSOD level were estimated by analysis of variance and Bonferroni t-test. From these, both the stage and histology were less-effectively affected by the level, while the histological grade was estimated as effective with p < 0.05. The MnSOD value increased significantly in accordance with the escalation of the tumor grade with p = 0.02 for grade I vs II, 0.005 for II vs III, and 0.0001 for I vs III respectively. MnSOD determination may be unique as a predictor of the histological virulence of ovarian carcinoma.

Adenocarcinoma↗

PubMed1994

A simplified grading method of transitional cell carcinoma of the urinary bladder: reproducibility, clinical significance and comparison with other prognostic parameters.

OBJECTIVE: To determine the extent to which the biological potential of transitional cell neoplasms can be predicted by histological grading of the primary tumour in a two grade system using simple histological criteria and to evaluate the additional value of grading when combined with other prognostic factors. The inter-observer variability of the World Health Organization grading and the two grade system was tested. PATIENTS AND METHODS: The study included 311 patients with newly diagnosed transitional cell carcinoma of the urinary bladder. Two-hundred and fifty-six patients (82.3%) were men and 55 (17.7%) were women. Age ranged from 17 to 92 years with a mean of 66 years. The median follow-up was 38 months, with a maximum of 150 months (mean 46.2 months). RESULTS: A simplified grading system was developed in which only low-grade and high-grade tumours were distinguished. Reproducibility of this grading system was good to excellent with a group kappa value of 0.78. The survival of patients with low-grade tumours was significantly better than that of patients with high-grade tumours (P < 0.0001). The progression-free interval was also significantly longer in patients with low-grade tumours than in patients with high-grade tumours (P = 0.0032). Combining low-high grading, histological stage, mitotic index and age, histological stage appeared to be the most important parameter in predicting survival and progression. CONCLUSION: A reproducible and discriminating system such as this low-high grade system is an important prognostic factor when stage cannot be established with certainty.

Adolescent↗

PubMed1986

Tumor-host interactions as prognostic factors in the histologic assessment of carcinomas.

Many of these observations appear to define a reasonable hypothesis. High-grade or poorly differentiated malignant neoplasms have a shorter tumor-doubling time, are less cohesive, often with irregular borders, and tend to invade by small aggregates and individual tumor cells. The observation of the pattern of invasion provides considerable information on the aggressiveness of the neoplasm. The pattern of invasion appears to correlate with tumor cell cohesiveness, motility, loss of contact inhibition, excretion of enzymes, and other factors associated with aggressiveness in experimental models. It is clear that the pattern of tumor-host interaction indirectly reflects many of these parameters and provides major clues to the biologic potential of human carcinomas. These observations should be used to supplement the histologic and cytologic features commonly used to derive a tumor grade. Aggressive tumors are usually larger and are associated with a greater blood supply. Vascular invasion is more common in this situation and large veins may be invaded by tumor by intravascular growth. Penetration of small lymphatic and blood vessels is associated with a poor prognosis and involvement of large veins with intravascular extensions of tumor have the potential of releasing tumor cell aggregates or emboli into the venous circulation. These large tumor cell aggregates have been demonstrated to be associated with a higher efficiency of metastasis formation and infer a poorer prognosis. Why have I bothered with all this detail about the occurrence of circulating tumor cells and their relation to the development of metastases? It must be stressed that many malignant cells are being released into the circulation of cancer patients and few, if any, ever successfully complete the complex sequence leading to a metastatic focus. This has been termed "metastatic inefficiency." Other investigators have referred to the unique cells that have mastered the intricate sequence of steps required to establish metastases as winners of the metastases decathlon. The observations of vascular (lymphatic or blood) invasion in random tissue sections and their relation to patient prognosis can be best explained by our basic knowledge of cancer biology. The finding of occasional small aggregates of single tumor cells in vascular spaces statistically implies that a considerable number of cells must be entering the vascular compartment.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗

PubMed1983

Adenocarcinoma of the parotid gland in nude rats.

Seven of approximately 200 rnu/rnu nude rats developed adenocarcinomas of the parotid gland. The malignant neoplasms ranged from well differentiated (grade 1) to poorly differentiated (grade 3) adenocarcinomas. The age of affected rats varied from 6 months to 1 year. The appearance of salivary gland adenocarcinomas in rnu/rnu rats is unusual and may have important implications for human tumor xenotransplantation in these animals.

Adenocarcinoma↗

PubMed1998

Immunohistochemical detection of c-fos and c-jun expression in osseous and cartilaginous tumours of the skeleton.

The products of c-fos and c-jun proto-oncogenes form the heterodimeric complex AP-1 (activator protein 1), which play an important part in the control of bone cell proliferation and differentiation and in the development of bone tumours. We examined the expression of c-fos and c-jun in a series of 52 primary skeletal neoplasms, using an immunohistochemical method on formalin-fixed, paraffin-embedded sections. The expression of c-fos and c-jun was restricted to bone-forming lesions, while cartilaginous tumours were devoid of immunoreactivity. In benign osteoblastic lesions moderate c-fos and c-jun expression was found in 2 cases (18.1%). The highest levels of c-fos and c-jun expression were detected in high-grade central osteosarcomas (7 of 15 cases with moderate/diffuse expression) while 1 telangiectatic osteosarcoma, 2 low-grade central osteosarcomas, 1 low-grade periosteal osteosarcoma and 7 low-grade parosteal osteosarcomas were either negative or had low expression. The high-grade component of a dedifferentiated parosteal osteosarcoma showed diffuse immunoreactivity for both oncoproteins. Comparison of c-fos and c-jun expression by histological grade showed that high-grade osteosarcomas had a significantly higher expression of both oncoproteins than did low-grade osteosarcomas (P = 0.01, Fisher's exact test). Thus, c-fos and c-jun overexpression may be implicated in the development of high-grade osteosarcomas, but they appear to have little or no relevance for the development of low-grade osteosarcomas and cartilaginous skeletal neoplasms.

Bone Neoplasms↗

PubMed1999

[Value and limits of cytology in the diagnosis of cervico-vaginal lesions at the Mahajanga University Hospital Center: 465 cases].

Cervix neoplasms are the most frequent of female neoplasms in Madagascar. The authors reported a prospective study carried out at the Hospital Center of the University of Mahajanga for ten months (January-October 1993). 500 patients were investigated. 465 results of cervix and vaginal smears were considered. The Bethesda group classification was used to interpret lesions. 333 specific pathological lesions were listed. Bacterial infections and trichomoniasis were their principal causes. 4 cases were presumed as human papillomavirus condylomata. 39 SIL low-grade and 24 SIL high-grade were detected. 5 cervix neoplasms were diagnosed. Only few patients had consultation to perform cervix and vaginal smears because these exams are expensive. It may be an explication to the chronicity of lesions, a favourising factor of cancer. The role of viruses, especially human papillomavirus, in the development of cervix neoplasms is mentioned. The authors conclude that the low number of cervix neoplasms they founded is misleading. Cervix neoplasms are the first female cancers in Madagascar. A systematic surveillance of all female genitalia diseases must be programed. While its settling, cervix neoplasms control must be centred on Information--Education--Communication.

Academic Medical Centers↗

PubMed1996

The staging and surgery of musculoskeletal neoplasms.

This review has outlined the surgical staging of benign and malignant musculoskeletal neoplasms. Based on their unique natural history, these neoplasms behave in a predictable fashion. The surgical staging system assigns progressively higher degrees of risks to the neoplasms based on their surgical grade, their anatomic location, and the presence or absence of metastases. The staging system articulates well with preoperative planning, defining the margins needed for local tumor control. Because surgery distorts most of the imaging modalities available, all clinical staging studies must be completed before surgical intervention. As more data accrue as to the importance of DNA ploidy, genetic markers, and other characteristics, it is likely they will play an important role in the diagnosis and treatment of musculoskeletal neoplasms in the future.

Bone Neoplasms↗

PubMed1992

Primitive neuroectodermal tumors of the uterus: a report of four cases.

Four cases of primitive neuroectodermal tumor (PNET) of the uterine corpus are reported, bringing the total number of reported PNETs in this site to seven. The four women were in their seventh decade of life and presented with abnormal vaginal bleeding and, in two cases, an enlarged uterus. The patients underwent total or subtotal abdominal hysterectomy and bilateral salpingo-oophorectomy and, in one patient, pelvic lymphadenectomy. Three patients received postoperative radiation therapy, chemotherapy, or both. Gross examination revealed fleshy polypoid masses filling the endometrial cavity and, in two cases, deeply invading the myometrium. Histologic, immunohistochemical, and, in two cases, ultrastructural examination revealed typical PNETs that exhibited variable degrees of neural, glial, ependymal, and medulloepithelial differentiation. Two PNETs were admixed with other neoplasms: in one case a grade I endometrial adenocarcinoma and in the other a low-grade endometrial stromal sarcoma. The prognosis of the tumors was related to their stage: two patients with stage I tumor were alive with no evidence of disease at 5 and 6 years, whereas two patients with stage III or IV tumor died of tumor at 6 and 12 months. Although it has been suggested that uterine PNETs may be derived from displaced germ cells or implanted fetal tissues, evidence provided by this study, including the advanced ages of the patients and an admixture with neoplasms of unquestioned müllerian origin, suggests a müllerian origin for these tumors in at least some cases.

Aged↗

PubMed1982

Carcinoma cuniculatum (verrucous carcinoma of the skin): a clinicopathologic study of 46 cases with ultrastructural observations.

Forty-six examples of carcinoma cuniculatum, a rare variant of squamous cell carcinoma of the skin, were studied by means of light and electron microscopy and immunoperoxidase techniques. The tumors usually presented as ulcerated, fungating, and polypoid masses with openings of sinus tracts onto the skin surface that exuded foul-smelling greasy material when pressure was applied. On microscopic examination the tumors were seen to be composed mainly of mature squamous keratinocytes with foci of cellular atypia. Electron microscopic studies revealed features of well-differentiated squamous cell carcinoma. The tumor may affect any cutaneous area of the body, and there is a predilection for the feet, particularly the soles. The cause must still be determined, but trauma, chronic irritation, and/or viral infection may play a role. The neoplasm is a low-grade carcinoma capable of local invasion, extension into bone, and rare metastasis to the regional lymph node. Although immunoperoxidase studies revealed no inclusions, infection by human papilloma virus (HPV) remains a possibility.

Adult↗