How pathological criteria can impact prognosis of tongue and floor of the mouth squamous cell carcinoma

Abstract Pathological parameters have been indicated as tumor prognostic factors in oral carcinoma. Objective: The objective of this study was to investigate the impact of pathological parameters on prognosis of patients affected only by tongue and/or floor of the mouth squamous cell carcinoma (SCC). Methodology: In total, 380 patients treated in the Brazilian National Cancer Institute (INCA) from 1999 to 2006 were included. These patients underwent radical resection followed by neck dissection. The clinical and pathological characteristics were recorded. The Kaplan-Meier method and Cox proportional hazards model were used in survival analysis. Overall survival (OS), cancer-specific survival (CSS) and disease-free interval (DFI) were estimated. Cox residuals were evaluated using the R software version 3.5.2. Worst OS, CSS and DFI were observed in patients with tumors in advanced pathological stages (p<0.001), with the presence of perineural invasion (p<0.001) and vascular invasion (p=0.005). Results: Advanced pathological stage and the presence of a poorly differentiated tumor were independent prognostic factors for OS and CSS. However, advanced pathological stage and perineural invasion were independent predictors of a shorter OS, DFI and CSS. Conclusion: Pathological stage and perineural invasion were the most significant pathological variables in survival analysis in tongue and/or floor of the mouth SCC.

Escala patológica de Gleason para el cáncer de próstata y sus modificaciones / Pathological scale of Gleason for prostate cancer and its modifications

Resumen:El sistema de puntuación o escala de Gleason es una herramienta ampliamente utilizada en la actualidad debido a su adecuada orientación pronóstica y de tratamiento en la evaluación del adenocarcinoma prostático. Dicha escala ha sufrido diversas modificaciones desde sus inicios en los años sesenta así como en los últimos años, las cuales buscan facilitar y homogenizar los criterios patológicos de cada una de sus categorías.

Summary:The Gleason scoring system is a tool widely used today due to its adequate prognostic and treatment orientation in the evaluation of prostatic adenocarcinoma. This scale has suffered several modifications since its beginnings in the sixties as well as in recent years, which seek to facilitate and homogenize the pathological criteria of each of its categories.

Clinicopathologic Impacts of Poorly Differentiated Cluster-Based Grading System in Colorectal Carcinoma

Differentiation-based histologic grading of colorectal carcinoma (CRC) is widely used, but its clinical impact is limited by insufficient prognostic value, interobserver disagreement, and the difficulty of its application to CRC with specific histologic types such as mucinous and medullary carcinoma. A recently proposed novel grading system based on quantifying poorly differentiated clusters (PDCs) claims to have the advantages of reproducibility and improved prognostic value, and might apply to heterogeneous CRC. We aimed to validate the clinicopathologic significance of the PDCs-based grading system and to determine the relationship between this grading system and microsatellite instability (MSI). Two hundred and one patients who had undergone radical surgery were reviewed. Based on the number of PDCs, 85, 58, and 58 tumors were classified as grade (G) 1 (42.3%), G2 (28.9%), and G3 (28.9%), respectively. PDCs-based grade was significantly associated with T, N, and M stages; lymphovascular invasion; conventional histologic grade; and frequent tumor budding (all P <0.001). In multivariate analysis, PDCs-based grade was found to be an independent prognostic factor for disease-free survival (P = 0.022; hazard ratio, 3.709 [G2], 7.461 [G3]). G3 CRC significantly correlated with high MSI (MSI-H) compared to G1 and G2 (P = 0.002; odds ratio, 5.750). In conclusion, this novel grading would provide valuable prognostic information to a greater number of patients and would require continued verification. PDCs-based grading is feasible for CRCs with heterogeneous morphology, and we propose that the association between G3 and MSI-H be further evaluated in different histological subtypes of CRC.

Grau de malignidade do mastocitoma cutâneo canino quanto a localização segundo as classificações de Patnaik et al. (1984) e Kiupel et al. (2011) / Degree of malignancy of the canine cutaneous mast cell tumor as forlocation according to the classifications of Patnaik et al. (1984) and Kiupel et al. (2011)

Objetivou-se com o presente trabalho coletar dados epidemiológicos relacionados com o mastocitoma canino, além de verificar se há relação entre sua malignidade e localização e, por fim, comparar os métodos de classificação histopatológica segundo Patnaik et al. (1984) e segundo Kiupel et al. (2011). Informações foram coletadas da ficha clínica de 55 cães e 60 fragmentos de pele com mastocitomas foram avaliados histologicamente. Verificou-se que a ocorrência de mastocitoma cutâneo não é influenciada pelo sexo e raça, porém cães sem raça definida e boxers são mais acometidos. Não há uma faixa etária susceptível bem definida, sendo o mastocitoma mais frequente em cães de 8 a 9 anos de idade. A região mais acometida foi a inguinal (50%) e a cabeça a região que apresentou mastocitomas com maior malignidade. Utilizando a classificação de Patnaik et al. (1984) houve diferença significativa entre as classificações histopatológicas de mastocitoma avaliadas por diferentes patologistas, o que não ocorreu utilizando a classificação de Kiupel et al. (2011). Pode-se dizer então que a classificação de Kiupel et al. (2011) gera menor divergência nos diagnósticos, demonstrando-se um método simples e eficaz para a avaliação histopatológica de mastocitoma.

The aim of the present study is to collect epidemiological data related to the canine mastocytoma, to check if there is relationbetween malignancy and its location and, finally, to compare the methods of histopathological classification according to Patnaiket al. (1984) and Kiupel et al. (2011). Informations were collected from the clinical record of 55 dogs and 60 fragments of skinwith a diagnosis of mast cell tumor were evaluated histologically. It was found that the occurrence of cutaneous mast cell tumorsis not influenced by gender and race, but dogs without defined breed and boxers are most affected. There is not a well-definedsusceptible age, but the most mast cell tumors in dogs often 8 to 9 years old. The highest affected region was inguinal (50%) andhead proved a region with higher malignancy. Using the classification Patnaik et al. (1984) there was a significant difference betweenthe histopathological ratings mastocytoma evaluated by different pathologists, which did not occur using the classification Kiupel etal. (2011). It can be said then that the classification Kiupel et al. (2011) generates less divergence in the diagnosis, demonstratinga simple and effective method for histopathological evaluation of mastocytoma.

Comparative study of various grading systems in oral squamous cell carcinoma and their value in predicting lymph node metastasis.

Background: Regional lymph node (LN) metastasis is the single most prognostic factor for oral squamous cell carcinoma (OSCC). An analysis of the prognostic factors is important for predicting prognosis and reducing the mortality in these patients. Objectives: (1) To compare the value of various grading systems in predicting LN metastasis. (2) To evaluate histopathological parameters, which could help in predicting LN metastasis. Materials and Methods: A total of 20 excisional biopsies of OSCCs, were graded according to the four grading systems that is, Broder’s, Jakobsson's, Anneroth and Hansen’s, and Brynes. We also evaluated various histopathological parameters, which could help in predicting LN metastasis. Results: Grading at the invasive front was most prognostic of LN metastasis. Tumors with total malignancy score ≥8 showed higher incidence of metastases. Conclusion: The histopathological parameters that could help in predicting lymph node metastases (LNM) are keratinization, nuclear pleomorphism (NP), and the pattern of invasion (POI) when assessed at the invasive front. When the whole tumor was considered, histopathological parameters like NP and POI were significant in predicting LNM.

Study of DNA flowcytometry, serum CEA, CA 19-9 in correlation with histopathological staging and grading of colorectal carcinoma

Colorectal carcinoma CRC is estimated to have a high incidence among all cancer diagnosis in both sexes. The present work aimed at studying the growth parameters of CRC by measurement of DNA content by flowcytometry and to correlate these parameters with those of adjacent mucosa and those of normal control. Also to correlate these parameters with staging, grading of the tumour and also with serum level of CEA and CA 19-9. Flowcytometric analysis yielded aneuploidy in 65% of cases. Aneuploid tumours were associated with advanced stage and poor differentiation, but the relation between ploidy and both staging and grading of the tumours was insignificant. DI correlated significantly with staging and grading of tumours. S.PF and PI correlated significantly with staging and grading of the tumour and with preoperative value of tumour markers