RESUMEN
BACKGROUND/AIMS: Adenocarcinoma of the stomach is still among the leading malignancies in human morbidity and mortality statistics in spite of endoscopic screening of the high-risk patients. Investigation of prognostic factors of gastric cancer disease seems to be still very important. The authors present a clinicopathological study based on the analysis of 49 gastric carcinomas. METHODOLOGY: P53 overexpression and proliferation activity of the cells were examined by immunohistological method with peroxidase-antiperoxidase technique. The percentage of the positive cells was calculated after counting of 300 tumor cells in each case. The rate of the labeled cells was related to different pathological characteristics of the carcinomas i.e., TNM stage of the tumor, histological subtypes of Ming's as well as Laurén's and Goseki's classification respectively, grade of differentiation and lymph node status. RESULTS: According to the above-mentioned parameters, p53 overexpression was significantly higher in carcinomas of the cardiac region than in those of the distal parts of the stomach. These findings are consistent with results published in the literature: cell proliferation rate alone is not an independent prognostic factor, but the degree of cell proliferation activity and p53 expression are changing usually parallel with each other and with other prognostic markers as well. CONCLUSIONS: The assessment of p53 activity and cell proliferation rate in gastric carcinoma is of prognostic value especially if evaluated together with other clinical and histopathological characteristics. The examination of these markers is useful in detecting early gastric cancer, in selecting high-risk patients and in planning proper individual treatment.
Asunto(s)
Adenocarcinoma/metabolismo , Neoplasias Gástricas/metabolismo , Proteína p53 Supresora de Tumor/metabolismo , Adenocarcinoma/patología , Cardias/metabolismo , Diferenciación Celular , Femenino , Humanos , Técnicas para Inmunoenzimas , Inmunohistoquímica , Metástasis Linfática , Masculino , Neoplasias Gástricas/patologíaRESUMEN
OBJECTIVES/HYPOTHESIS: The main objective of this study was to investigate the effect of the administration of a novel immunoadjuvant, leukocyte interleukin injection, as part of an immuno-augmenting treatment regimen on the peritumoral and intratumoral subpopulations of the tumor infiltrating mononuclear cells and on the epithelial and stromal components, when administered to patients with advanced primary oral squamous cell carcinoma classified as T2-3N0-2M0, as compared with disease-matched control patients (not treated with leukocyte interleukin injection). STUDY DESIGN: Multicenter Phase I/II clinical trial. Fifty-four patients from four clinical centers were included in the dose-escalating study (27 in each group [leukocyte interleukin injection-treated and control groups]). Cumulative leukocyte inter-leukin injection doses were 2400, 4800, and 8000 IU (as interleukin-2 equivalent). METHODS: Paraffin-embedded tumor samples obtained at surgical resection of the residual tumor (between days 21 and 28 after treatment initiation) were used. Histological analysis, necrosis evaluation, and American Joint Committee on Cancer grading were performed from H&E-stained sections. Immunohistochemical analysis was performed on three different tumor regions (surface, zone 1; center, zone 2; and tumor-stroma interface, zone 3). Trichrome staining was used to evaluate connective tissue, and morphometric measurements were made using ImagePro analysis software. Cell cycling was determined by the use of Ki-67 marker. RESULTS: Leukocyte interleukin injection treatment induced a shift from stromal infiltrating T cells toward intraepithelial T cells and posted a significant (P <.05) increase in intraepithelial CD3-positive T cells independent of the leukocyte interleukin injection dose, whereas the increase in CD25 (interleukin-2 receptor alpha [IL-2Ralpha])-positive lymphoid cells was significant only at the lowest leukocyte interleukin injection dose (P <.05). Furthermore, both low- and medium-dose leukocyte interleukin injection treatment induced a significant (P <.05) increase in the number of cycling tumor cells, as compared with control values. CONCLUSION: The results could be highly beneficial for patients with oral squamous cell carcinoma. First, leukocyte interleukin injection treatment induces T-cell migration into cancer nests and, second, noncycling cancer cells may enter cell cycling on administration of leukocyte interleukin injection. This latter effect may modulate the susceptibility of cancer cells to radiation therapy and chemotherapy. The findings may indicate a need to re-evaluate the way in which follow-up treatment (with radiation therapy and chemotherapy) of patients with head and neck cancer is currently approached.
Asunto(s)
Adyuvantes Inmunológicos/administración & dosificación , Carcinoma de Células Escamosas/tratamiento farmacológico , Interleucinas/administración & dosificación , Neoplasias de la Boca/tratamiento farmacológico , Adulto , Anciano , Antineoplásicos Alquilantes/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica , Complejo CD3/análisis , Carcinoma de Células Escamosas/patología , Ciclofosfamida/administración & dosificación , Células Dendríticas/patología , Femenino , Humanos , Indometacina/administración & dosificación , Inyecciones , Inyecciones Intradérmicas , Antígeno Ki-67/análisis , Células Asesinas Naturales/patología , Leucocitos , Leucocitos Mononucleares/patología , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Necrosis , Receptores de Interleucina-2/análisis , Linfocitos T/inmunología , Sulfato de Zinc/administración & dosificaciónRESUMEN
It is widely acknowledged that most stomach carcinomas developed from dysplastic lesions of gastric mucosa. They can be found in known precancerous conditions as chronic gastritis, gastric adenoma, giant rugal hypertrophy, chronic peptic ulcer, gastric stump after partial resection and pernicious anemia. Several grading systems of gastric dysplasia have been suggested. Nagayo's or the ISGGC classification was applied to 367 biopsy specimens of 258 patients between 1979-1995. The frequency of moderate and severe dysplasia was 0,84% regarding all gastric endoscopies in the same period of time. Follow-up studies were performed in 56 cases in a period of 1 7 ys. In this group cancer developed during 14 patients. The authors' recommendation is to follow up the patients gastric dysplasia for least 10 ys after with diagnosis.
Asunto(s)
Carcinoma/etiología , Mucosa Gástrica/patología , Lesiones Precancerosas/patología , Gastropatías/patología , Neoplasias Gástricas/etiología , Biopsia , Carcinoma/epidemiología , Carcinoma/patología , Progresión de la Enfermedad , Estudios de Seguimiento , Gastritis/epidemiología , Gastritis/patología , Gastroscopía , Humanos , Hungría/epidemiología , Hiperplasia , Incidencia , Lesiones Precancerosas/clasificación , Lesiones Precancerosas/epidemiología , Prevalencia , Índice de Severidad de la Enfermedad , Gastropatías/clasificación , Gastropatías/epidemiología , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/patología , Úlcera Gástrica/epidemiología , Úlcera Gástrica/patologíaRESUMEN
The effectiveness of seromyotomy of the lesser curvature of the stomach--the simplified version of proximal selective vagotomy--was investigated in eleven dogs. Decreased acid secretion was proved with congo red test and pH measuring by glass electrode. No significant damage to the motor function of the stomach was found with scintigraphy. Histological examinations revealed neurofibre degeneration peripherally to the seromyotomy line after peripheral vagotomy and vacuolar degeneration in the ganglion cells and amputation neuromas in the seromyotomy line.
Asunto(s)
Estómago/inervación , Vagotomía Gástrica Proximal/métodos , Animales , Perros , Electrodos , Femenino , Ácido Gástrico/metabolismo , Vaciamiento Gástrico , Concentración de Iones de Hidrógeno , Masculino , Neurofibrillas/ultraestructura , Estómago/fisiología , Estómago/ultraestructuraRESUMEN
In our Department, between 1991 and 1996, 132 patients, there of 87 male-45 female, average age of 48.2 years underwent surgery because of stage 1 (T2) to stage 3 melanoma that was located on the skin. None of patients suffered from early or in situ melanoma. Our retrospective study was based on those 94 patients who had been followed up by Department or dermatology-oncology in our medical centre. Surgery is still the primary treatment for cutaneous malignant melanoma. Thin melanomas (up to 2 mm in thickness) can be excised with 2 cm margins. Whether this is also true for thicker melanomas is not known and the only way to obtain more knowledge is to participate in prospective randomised studies. Elective lymph node dissection is associated with significant morbidity which includes lymphedema, wound complications and paresthesias of the extremity. For this reason we use an alternative operative approach uses selective lymphadenectomy with identification of the sentinel node.
Asunto(s)
Melanoma/cirugía , Neoplasias Cutáneas/cirugía , Procedimientos Quirúrgicos Dermatologicos , Procedimientos Quirúrgicos Electivos/efectos adversos , Femenino , Estudios de Seguimiento , Humanos , Escisión del Ganglio Linfático/efectos adversos , Linfedema/etiología , Masculino , Melanoma/patología , Melanoma/secundario , Persona de Mediana Edad , Estadificación de Neoplasias , Parestesia/etiología , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Retrospectivos , Neoplasias Cutáneas/patología , Infección de la Herida Quirúrgica/etiología , Resultado del TratamientoRESUMEN
In a randomised study 25 patients with gastrointestinal surgery combined with extended lymphadenectomy (three field lymphadenectomy in case of esophageal cancer, D2 lymphadenectomy in case of gastric cancer) has been compared to the same number of patients with limited lymphadenectomy (D1). The operation time and the need for blood transfusion has increased in the extended lymphadenectomy group. The complication rate was more than doubled in the extended lymphadenectomy group, due to fluid or lymph collection, lymphatic edema, and infection. The mapping and staging was superior in extended lymphadenectomy group, but increased morbidity and mortality has been found in this group. However the favourable effect of extended lymphadenectomy on survival needs further long-term studies and proofs.
Asunto(s)
Neoplasias Esofágicas/cirugía , Escisión del Ganglio Linfático/métodos , Neoplasias Gástricas/cirugía , Transfusión Sanguínea , Exudados y Transudados , Humanos , Estudios Longitudinales , Linfa , Escisión del Ganglio Linfático/efectos adversos , Metástasis Linfática/patología , Linfedema/etiología , Estadificación de Neoplasias , Infección de la Herida Quirúrgica/etiología , Tasa de Supervivencia , Factores de Tiempo , Resultado del TratamientoRESUMEN
The PGE2, PGF2 alpha, PGI2, and TXB2 content in biopsies of healthy esophageal mucosa and inflamed mucosa and from subjects with chronic esophagitis was measured and statistically analyzed. No significant differences were found between the tissue concentrations of prostaglandins in the inflamed and the healthy mucosa, except for elevated PGI2 content in the inflamed esophageal mucosa in comparison to healthy mucosa. The prostaglandin content of jejunal mucosa was unchanged in jejunitis and in atrophy compared to findings in healthy subjects. Regression analysis revealed a significant negative correlation between the PGF2 alpha and PGI2 content in both inflamed esophageal and inflamed jejunal mucosa. In healthy mucosa, no correlation was found between the tissue concentrations of these two prostaglandins, either in the esophagus or in the jejunum. These results suggest the redistribution of cyclic endoperoxide metabolism under certain pathological conditions.
Asunto(s)
Esofagitis/metabolismo , Enfermedades del Yeyuno/metabolismo , Prostaglandinas/metabolismo , Análisis de Varianza , Biopsia , Enfermedad Crónica , Dinoprost/metabolismo , Dinoprostona/metabolismo , Epoprostenol/análisis , Esofagitis/patología , Humanos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Enfermedades del Yeyuno/patología , Modelos Lineales , Membrana Mucosa/metabolismo , Membrana Mucosa/patología , Tromboxano B2/metabolismoRESUMEN
The pathogenesis of larynx papillomas has been a challenge of medical science for a long time. Both clinical observations and electronmicroscopical examinations have made it possible to establish the viral origin. Final evidence, however, has been achieved only by complicated immunohistochemical investigations. The Papova viruses--types 6 and/or 11--can be detected with in situ hybridization polymerase chain reaction amplification. HPV can be positivity demonstrated not only from visible papillomas but--in significant percentage--in neighboring healthy-looking mucous membranes. It may reveal the inadequacies of removal of lesions and the need for adjuvant therapy. To make treatment more effective we have developed a therapeutic regimen that combines CO2 laser microsurgery with immunostimulants.
Asunto(s)
Laringe , Papiloma/etiología , Papillomaviridae/patogenicidad , Polyomaviridae , Terapia Combinada , ADN Viral , Humanos , Hibridación in Situ , Interferón-alfa/uso terapéutico , Laringe/patología , Terapia por Láser , Papiloma/tratamiento farmacológico , Papiloma/patología , Papillomaviridae/aislamiento & purificación , Reacción en Cadena de la Polimerasa , RecurrenciaRESUMEN
In the course of memorial lecture the author commemorates Professor Géza Hetényi. His synthetizering role is stressed, analysing the professor's views on the clinical and theoretical medicine, on the medical practice and teaching in the medicine. Author performs it from the points of view of practising pathologist who considered the clinical pathology as the most important. After these introductory thoughts the role of pathologist is outlined in the gastroenterological diagnostics. Before the introduction of modern fiberoptic endoscopy, the pathologist met with some forms of the gastroenterological diseases at most during the processing work of surgically removed specimens or even more in the autopsy room, but in the latter cases only their end stage could be demonstrated. The introduction of so-called blind exfoliative cytology by the gastric lavage was a great leap forward. Advanced gastric carcinoma were detected mostly by this method but some early gastric cancer could be also discovered occasionally. The more and more wide-spread use of modern fiberpotic endoscopy was of decisive importance because by this way the aimed forceps biopsy could be performed completed with a new form of gastric cytology, with abrasive smears. The specificity and sensitivity of the latter method achieves or surpasses the 90%. Nowadays, not only the stomach carcinomas but their possible precancerous conditions and changes as chronic gastritis can be diagnosed on morphological basis. The history of different gastritis classifications is also surveyed emphasised author's own pathogenetic conceptions which can be included well in our now accepted modern Sydney-classification.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Enfermedades Gastrointestinales/patología , Gastroenterología/historia , Historia del Siglo XX , Humanos , HungríaAsunto(s)
Ampolla Hepatopancreática , Cuerpos Extraños/etiología , Cuerpos Extraños/cirugía , Cálculos Biliares/etiología , Cálculos Biliares/cirugía , Solanum lycopersicum/efectos adversos , Esfinterotomía Endoscópica , Anciano , Anciano de 80 o más Años , Ampolla Hepatopancreática/cirugía , Femenino , HumanosRESUMEN
The authors investigated the efficiency of the seromyotomy of the lesser curvature of the stomach in 11 dogs. Reduction of the acid production was verified by glass electrode pH measuring of the gastric mucosa. Scintigraphic examination showed that the operation did not damage the motor function (motility) of the stomach. The fact of peripheral vagotomy was established by histological examination: degeneration of nerve fibres was detected on the peripheral side of the line of the seromyotomy, vacuolar degeneration was found in the cells of parasympathetic ganglions, and amputation neurinomas were shown in the line of the seromyotomy.
Asunto(s)
Estómago/cirugía , Vagotomía/métodos , Animales , Perros , Ganglios Parasimpáticos/patología , Gastrectomía/métodos , Jugo Gástrico/fisiología , Mucosa Gástrica/anatomía & histología , Mucosa Gástrica/metabolismo , Motilidad Gastrointestinal/fisiología , Concentración de Iones de Hidrógeno , Fibras Nerviosas/patologíaRESUMEN
The histological evaluation of precancerous alterations of larynx epithelium is, in transitional cases, very difficult. The differentiation of harmless metaplasia, hyperplasia and keratosis from abnormal proliferation depends on the pathologist's training and experience. Fine diagnostic lines separate the different grades of dysplastic epithelial alterations. The tritiated thymidine, 3H-TdR, labelling and histoautoradiographic procedure of biopsy specimens taken from the larynx provide the possibility to recognise the DNA synthetiser cells. The number, location and distribution of 3H-TdR labelled cells in the epithelial layers help us to distinguish with clarity the growth activity, the degree of dysplasia. After 3 weeks' exposition time of sections prepared by photoemulsion and stained with haematoxilin-eosin, the result can be assessed. In addition to histoautoradiography HPV-assay was applied, as HPV may play a role in the pathogenesis of laryngeal preneoplastic alterations.
Asunto(s)
ADN Viral/análisis , Neoplasias Laríngeas/microbiología , Neoplasias Laríngeas/patología , Laringe/patología , Papillomaviridae/aislamiento & purificación , Lesiones Precancerosas/microbiología , Lesiones Precancerosas/patología , Infecciones Tumorales por Virus/diagnóstico , Autorradiografía , Biopsia , Sondas de ADN de HPV , Humanos , Laringe/microbiologíaRESUMEN
Synovial sarcoma in an extra-articular location is a very rare tumor, particularly in relation to childhood tumors. We report our experiences with an 11-year-old boy who suffered from swallowing difficulties caused by a polypoid tumor of the hypopharynx. Biopsy demonstrated a fusocellular carcinoma, while the epithelial components showed cytokeratin and neuron-specific enolase positivity. A correct final diagnosis could only be established by the histology of the surgical preparation following partial laryngopharyngectomy. The presence of spindle cells associated with glandular-like ones proved the synovial character of the tumor. The spindle cells were negative for epithelial marker but were positive for vimentin. S-100 protein positivity could only be demonstrated in the nerve elements encapsulated in the tumor. Ultrastructural examinations confirmed the presence of the different cell types. The spindle cells were rich in intermediate fibers, as demonstrated by electron microscopy.
Asunto(s)
Neoplasias Hipofaríngeas/cirugía , Laringectomía , Faringectomía , Sarcoma Sinovial/cirugía , Niño , Humanos , Neoplasias Hipofaríngeas/patología , Laringectomía/métodos , Masculino , Faringectomía/métodos , Sarcoma Sinovial/patologíaRESUMEN
After conventional gastroscopy and biopsy the endoscopic ultrasonography (EUS) was performed in 115 patients with gastric ulcer and carcinoma. The markers of benignity and malignity were analyzed by EUS, and the criteria of benign and malign excavated lesions were described. On the base of endoscopic pictures 3 groups of gastric excavations were distinguished, and the recorded images of this excavations were reevaluated. Benign ultrasonic markers were detected in one case of excavated tumors, in 54% in group of ulcers with suspicion of malignity and in 82% in cases of benign ulcers. Authors evaluate the cause of overestimate. Ten cases of early gastric cancers are reported. Authors believe that the endosonographic examinations of the stomach are valuable in detecting and stating of gastric carcinoma.
Asunto(s)
Neoplasias Gástricas/diagnóstico por imagen , Úlcera Gástrica/diagnóstico por imagen , Diagnóstico Diferencial , Gastroscopía , Humanos , UltrasonografíaRESUMEN
The stomach cancer develops on dysplastic lesions of gastric mucosa. It can be found in every precancerous condition, as chronic gastritis, gastric adenoma, giant rugal hypertrophy, chronic peptic ulcer, gastric stump after partial resection, pernicious anaemia. So, this dysplastic change is not a specific lesion. Different classifications are known for grading of gastric dysplasia. Authors evaluated them compared with each other. The signs of dysplasia were studied in 306 gastric aimed biopsy specimens from 233 patients between 1979-1990. In this material severe dysplasia occurred in 20.6%. It means a frequency of 0.84% regarding all gastric endoscopies in the same period of time. The endoscopic investigation revealed a protruded lesion in 18.5% and excavated one in 45.9%. What is very important, local change could not be detected in 35.6%. Follow-up study could be performed in 49 patients in a period of 1-7 years. In this group cancer developed in five patients. By the other hand, 22 gastric carcinomas were proved amongst 233 patients. The authors' recommendation is to follow-up the patients bearing gastric dysplasia at least during 10 years after the diagnosis.
Asunto(s)
Mucosa Gástrica/anomalías , Lesiones Precancerosas/diagnóstico , Gastropatías/diagnóstico , Diagnóstico Diferencial , Mucosa Gástrica/patología , Humanos , Lesiones Precancerosas/patología , Gastropatías/patología , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/etiología , Neoplasias Gástricas/patologíaRESUMEN
Lithotomy and endoscopic sphincterotomy were carried out in a 83-year-old woman because of choledocholithiasis. One year later calculi and tomato skins were found in the common bile duct. Significance is attributed to the tomato skins in the development of calculi. The attention is drawn to the observation that operative interventions performed through the Vater's papilla, spontaneous or iatrogenic choledochoduodenal fistulas create favourable conditions for foreign material to get into the choledochus and this may cause lithogenesis.