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Background: Various grading systems have been suggested in the literature by different authors to determine the severity of dysplastic features. Histopathological grading is subjective with low reproductivity and lacks sensitivity. Aim: To determine the inter observer and intra observer variability in diagnosing oral epithelial dysplasia using different grading systems. Materials and methods: Three oral pathologists from the Department the Oral pathology, GDC Srinagar observed the same 30 consecutive sections of oral epithelial dysplasia. Each reviewing pathologist asked to grade each case on the basis of WHO (2005) and binary grading system (2006) at different time intervals and was repeated twice. Results: The inter observer variability ranged from poor to slight in WHO system and slight to fair in binary system whereas the intra observer variability ranged from slight to fair in WHO system and fair in the binary system. Conclusion: Grading of oral epithelial dysplasia is subjective and has been shown not to be highly reproducible. The binary grading system verified to have better inter observer and intra observer agreement in the present study than the WHO grading system.
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Objective@#To explore the value of CT texture analysis (CTTA) in differentiating the pathological grade of urothelial carcinoma of the bladder (UCB).@*Methods@#A total of 53 lesions from 43 patients with bladder cancer confirmed by postoperative pathology were retrospectively analyzed, including 27 cases of high-grade urothelial carcinoma (HGUC) and 26 cases of low-grade urothelial carcinoma (LGUC). All the patients took pelvic CT and enhanced scanning in the same CT scanner with same scanning parameters. Lesions on both plain and enhanced CT images were delineated on software by two radiologists to extract the corresponding volumes of interest (VOI) and then 92 parameters based on feature classes were generated. The average values of two radiologists were obtained. The difference parameters between HGUC group and LGUC group were screened by nonparametric test, and the receiver operating characteristic (ROC) was drawn. The corresponding optimal thresholds were determined and diagnostic effect was assessed.@*Results@#Nine difference texture parameters between HGUC group and LGUC group were selected, including 5 parameters on unenhanced images, namely, skewness, root mean squared, cluster shade, zone percentage and large area high gray level emphasis. There were 4 parameters on enhanced images, namely, skewness, kurtosis, cluster shade and zone percentage. The largest area under curve of 0.840±0.058 (95% CI 0.726-0.955) was obtained from skewness generated by VOI of unenhanced images. The cut-off value of skewness was 0.186 5, which permitted the diagnosis of HGUC with sensitivity of 92.59%, specificity of 73.08%, positive predictive value of 78.13%, negative predictive value of 90.48% and accuracy of 83.02%.@*Conclusion@#CTTA can effectively distinguish between LGUC and HGUC. Skewness from unenhanced CT images had the optimal diagnostic performance.
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Context: Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy and its grading is greatly consequential in the management and prognosis of patients with the disease. Aims: To compare histologic grading systems in MEC of minor salivary glands. Settings and Design: Two qualitative (modified Healy and Memorial Sloan‑Kettering Cancer Center [MSKCC] methods) and two quantitative (Armed Forces Institute of Pathology [AFIP] and Brandwein methods) were evaluated. Subjects and Methods: Diagnostics slides of 19 patients including one recurrent case were evaluated using the four grading systems. Statistical Analysis Used: Percentages and proportions were used. Results: Agreement across all grading system was found to be very low (32%) while there was a better agreement between AFIP and MSKCC methods (84%) between modified Healy and Brandwein (58%). The method that gave the poorest agreement with all the others was the Brandwein grading. In general, the AFIP and MSKCC methods tended to grade the tumors lower while the Brandwein and modified Healy methods seemed to grade them higher. Conclusions: Most MEC of minor salivary glands appear to be low‑grade tumors. It is conceivable that some grading methods (Brandwein and modified Healy) may lead to an unnecessary escalation of management methods in these tumors. The MSKCC method may have emphasized some parameters which may not have much importance in minor salivary gland MEC. The AFIP method appears to be the most appropriate to use for the grading of minor salivary gland MEC. Further studies are required to confirm or disprove this finding.
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Objective: To investigate the expression of arginase-2 (Arg-2) in hepatocellular carcinoma (HCC) tissues and to discuss its clinicopathological significance. Methods: Totally 113 HCC samples and corresponding adjacent liver tissues were collected. Among them 29 cases were characterized by the presence of dysplastic nodules (DN). Another 12 samples of normal liver tissues were collected as controls. Western blotting analysis was used to detect the Arg-2 protein expression in 15 HCC samples, corresponding adjacent liver tissues and 12 control samples. Immunohistochemical staining was performed to detect the Arg-2 expression in 113 HCC samples, corresponding adjacent liver tissues and DN samples. The correlation of Arg-2 expression with clinicopathological features of HCC was analyzed. Results: Western blotting analysis revealed no Arg-2 expression in adjacent liver tissues and normal liver tissues, while the expression was significantly increased in HCC tissues (P<0. 01). Immunohistochemical staining showed that Arg-2 was expressed in the cytoplasm of HCC cells, with a positive rate of 77. 0% (87/113). Arg-2 expression was found to be correlated with the histological grades of HCC tissue (P<0. 05). Arg-2 was not expressed in low-grade DN; its positive rate was 14. 3% (2/14) in the high-grade DN and 66. 7% (8/12) in well-differentiated HCC (P<0. 05). Conclusion: Arg-2 is highly expressed in the HCC tissues and its expression is associated with histological grades of HCC, and it may be involved in the development and progression of HCC. Detecting Arg-2 expression may help to differentiate HCC from DN.
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Chondrosarcomas represent the third primary malignant bone tumor. Costal location occurs in 12 percent, being the most common tumor of the ribs. It affects most frequently in the second and fifth decades of life. This tumor is histologically classified into grades 1, 2 and 3 in descending order of differentiation. For grade 2, with oncologic resection, there is a 10-year survival of 64 percent, and a 10 percent risk for metastasis. Radiotherapy has a limited therapeutic role and chemotherapy has not shown benefits. We report a case of a 45 years old woman, who presented with a symptomatic growing mass in the right rib cage, of three months of evolution, whose evaluation by magnetic resonance imaging and computed tomography shows a sarcomatous tumor with involvement of ribs, muscles, diaphragm, pleura, peritoneum and liver. A small amount of intraperitoneal free fluid was observed. A block resection was made, resulting a 16.8 cm long at the widest point chondrosarcoma, grade 2, with involvement of all layers of the wall, tumor microfoci in the liver capsule and malignant tumor cells in peritoneal fluid.
Los condrosarcomas representan la tercera neoplasia ósea maligna primaria. La ubicación costal representa el 12 por ciento, siendo el tumor más frecuente de las costillas. Se presenta con mayor frecuencia en la segunda y quinta décadas de la vida. Este tumor se clasifica histológicamente en grados 1, 2 y 3 en orden decreciente de diferenciación. Para el grado 2, resecado oncológicamente, se observa una sobrevida a 10 años del 64 por ciento; existiendo un 10 por ciento de riesgo de metástasis. La radioterapia tiene un escaso rol terapéutico y la quimioterapia no ha demostrado beneficios. Presentamos el caso de una mujer de 45 años que consultó por un aumento de volumen sintomático de la parrilla costal derecha, de tres meses de evolución, cuya evaluación a través de tomografía axial y resonancia magnética permitió delinear un tumor sarcomatoso de la pared con afectación de costillas, músculos, diafragma, pleura, peritoneo e hígado. Además se observaba escasa cantidad de líquido libre intraperitoneal. Fue resecado en block un condrosarcoma de 16,8 cm de eje mayor, grado 2, con compromiso de todos los planos de la pared, microfocos tumorales en cápsula hepática y células neoplásicas malignas en líquido peritoneal.
Subject(s)
Humans , Female , Middle Aged , Chondrosarcoma/surgery , Chondrosarcoma/diagnosis , Ribs/pathology , Bone Neoplasms/surgery , Bone Neoplasms/diagnosis , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
El carcinoma de células escamosas de la cavidad oral presenta una alta prevalencia en nuestro país, siendo el labio inferior el sitio más comúnmente afectado. El objetivo de este estudio fue determinar el grado de angiogénesis en el carcinoma de células escamosas de labio inferior, y su asociación con el grado de diferenciación según la Clasificación Internacional de Tumores y el Frente de Invasión Tumoral según el sistema de medición de Bryne, en pacientes con carcinoma de células escamosas de labio inferior, diagnosticados en los hospitales de Talca y Curicó, entre los años 1995 y 2005.
Squamous cell carcinoma of the oral cavity present a high prevalence in our country, become the lower lip the most common site affected. The aim of this study was determinated the angiogenesis grade in the lower lip squamous cell carcinoma and their relationship whit the histological grading according to the International Tumours Classification and the Invasion Tumoral Front according to the Bryne's system measuring in patients with lower lip squamous cell carcinoma diagnosed in the Talca´s and Curico´s Hospital between 1995 and 2005 years.
Subject(s)
Humans , Carcinoma, Squamous Cell/blood supply , Carcinoma, Squamous Cell/pathology , Neovascularization, Pathologic , Lip Neoplasms/blood supply , Lip Neoplasms/pathology , Neoplasm Invasiveness , Neoplasms, Squamous Cell/epidemiology , Lip Neoplasms/epidemiology , Retrospective StudiesABSTRACT
Sections from 31 liver needle biopsies of hepatocellular carcinomas(HCCs) were exa-mined for the histological grading of tumors with the expression of a labelling index, using monoclonal antibodies to proliferating cell nuclear antigen PC-10. The correlation between histological grading and the labelling index showed a statistically significant increase in the labelling index in grades III to IV of HCCs. A cut-off point of the labelling index at 49 per cent was proposed to indicate the prognosis of the patient. HCCs with a labelling index below 49 per cent has a better prognosis than HCCs with a labelling index above 49 per cent. A combination of histological grading and the labelling index indicated the prognosis of the patients with HCCs.
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Fifteen pediatric (age under 16) cases of oligodendroglioma (ODG) were surgically proven from January 1985 to April 1992 at the Division of Pediatric Neurosurgery, Seoul National University Children's Hospital. To observe the proportion of ODG's in primary intracranial tumors, the location of ODG's and the prognostic significance of the histological grading of ODG's in childhood, the 15 cases of pediatric ODG's were retrospectively analyzed. ODG's accounted for 5.6% of pediatric primary intracranial tumors operated on during the same period. Nine tumors were located in the cerebral hemisphere (3 cases each in the frontal, temporal and parietooccipital lobes), 1 in the thalamus, 2 in the pons-medulla, 2 in the cerebellum and 1 in the thoracolumbar spinal cord. Four tumors were anaplastic and an additional case showed positive cerebrospinal fluid (CSF) cytology for tumor cells. All the cases of anaplasia or positive CSF cytology had a poor outcome. All the seven cases of benign ODG's in cerebral hemispheres presented with seizures which were controlled with or without medication after tumor removal.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Brain Neoplasms/complications , Oligodendroglioma/complications , Prognosis , Seizures/etiologyABSTRACT
Objective To investigate the manifestation of HCC on superparamagnetic iron oxide(SPIO)-enhanced MRI in rats and clarify its pathologic basis in hope of the application of SPIO-enhanced MRI in estimation of histological grading in HCC.Methods HCC was induced chronically with 1 ml of 2% DEN solution once a day in 80 rats for 14 weeks,and another 10 rats served as normal controls.All rats received dynamic MR examinations on week 16,18,20,21,22,23,24,25.MR imaging was performed before and after SPIO injection using SE-T1WI,FMPSPGR-T1WI,GRE-T2WI,FSE-PDWI,FSE-T2WI, and the relative parameters were obtained.Rats were killed as soon as MRI finished.The tumors were observed grossly and the parts matched with the lesions on MRI were cut into pieces,stained with HE and PerIs,for pathologic examination.Results Kupffer cell number in HCCs was significantly smaller than that in normal liver tissues(P