Accuracy of spiral CT in preoperative staging of gastric carcinoma: correlation with surgical and pathological findings.

OBJECTIVE: To assess the accuracy of spiral CT scan in the preoperative staging of gastric carcinoma by comparing it with surgical/pathological staging. MATERIAL AND METHOD: Twenty-eight patients with gastric carcinoma who underwent both preoperative CT scan and surgery were retrospectively studied for TNM classification. All CT scans were reviewed for tumor location, gastric wall thickness, tumor extension, N1 and N2 nodal involvement, and metastases to the liver, peritoneum and lung. RESULTS: Spiral CT staging was correct in 20 of 28 patients (71.4%). The preoperative CT scan had 96.1% sensitivity, 100% specificity and 96.4% accuracy for evaluating serosal invasion. The sensitivity, specificity and accuracy for assessing pathologic lymph node involvement were 73.1, 50.0 and 84.2 percent, respectively. In the present study, peritoneal metastasis could not be identified by CT but CT had 100% sensitivity for evaluating hepatic metastases. CONCLUSION: Spiral CT is a useful modality for preoperative staging of gastric carcinoma with high accuracy for evaluating serosal invasion and hepatic metastases.

Mutations of KRAS and TP53 in a minor proportion of Opisthorchis viverrini-associated cholangiocarcinomas in a hamster model.

BACKGROUND/AIMS: KRAS oncogene and TP53 tumor suppressor gene have been known as common genes involving in many cancers including cholangiocarcinoma (CCC). Activation of these genes could lead to uncontrolled proliferation and cancer ultimately. The aim of this study was to investigate mutation of KRAS exon 1 and TP53 exon 5-8 in Opisthorchis viverrini (OV)-induced cholangiocarcinoma (CCA) in a hamster model. METHODS: Twenty-seven CCAs were obtained from Syrian golden hamsters induced by OV infection and N-nitrosodimethylnitrosamine (N-NDDM) administration. The tumor tissues were processed for histopathology. Genomic DNA extracted from paraffin sections by microdissection was amplified for KRAS exon 1 and TP53 exon 5-8 mutations by PCR-direct sequencing. RESULTS: Histopathologically, the tumors were classified into tubular (81.5%, 22/27), papillary (3.7%, 1/27), mucinous (3.7%, 1/27) and mixed types (11.1%, 3/27). Of the 27 CCAs, PCR-direct sequencing of KRAS showed G[see text]A transition at codon 37 exon 1 in one CCA sample (3.70%). Point mutations of p53 exon 6 (G[see text]C transversion at codon 119 and 218 and A[see text]C transversion at codon 217) were found in 3 CCA samples (11.1%). CONCLUSIONS: The results suggest that mutation of TP53 particularly at exon 6 may be involved in cholangiocarcinogenesis and a novel mutation of KRAS exon 1 was firstly reported in OV-induced hamster CCA.

Risk factors and histological outcome of abnormal cervix with human papilloma infection in northeastern Thai-women.

This study aimed to investigate the histological outcome of cervix with human papillomavirus (HPV) infection and the association of risk factors with cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma (ICC) development in Northeast Thai women. The study population (n=210) comprised 71 cases of normal cervix, 71 cases of CIN and 68 cases of ICC. The histological outcome of HPV infection was determined for 9.5% of the study population. Increased risk factors for CIN were observed for more than one partner (odds ratio (OR)=3.75, p<0.05), history of sexually transmitted disease (STD) (OR=2.28, p<0.05), menarche under 14 years of age (OR=0.31, p<0.05) and partners' smoking history (OR=3.98, p<0.01). Increased risk for ICC was observed for those with a history of STDs (OR=0.14, p<0.01) and multiparity (OR=2.53, p<0.01). Age at first sexual intercourse was not a risk factor in this study population. Further studies with HPV-DNA tests should more precisely quantify the risks.

The role of CT scan in preoperative staging of colorectal carcinoma.

OBJECTIVES: To evaluate the role of CT scan in preoperative staging of colorectal carcinoma by comparing it with the surgical-pathologic staging and pathologic findings. MATERIAL AND METHOD: The CT scans of twenty four patients with pathological proven primary colorectal carcinoma from January 1998 to December 2002 at Srinagarind hospital Khon Kaen University were review. The CT findings were analyzed according to serosal and or pericolic fat invasion, involvement of lymphnodes, liver or other metastases, and correlated the CT staging with TNM staging. RESULTS: The CT imaging had 100% sensitivity, 57% specificity, 87.5% accuracy for evaluating serosal and/or pericolic fat invasion, 93.2% sensitivity, 54% specificity, 75% accuracy for evaluating involvement of the lymph nodes. In the present study, the distant metastases was not detected CONCLUSION: The role of CT in preoperative staging of colorectal carcinoma in this report can be summarized as: (1) The sensitivity in detecting serosal and/or pericolic fat invasion is relatively higher than in previous reports. (2) The criteria for evaluation of nodal disease increased accuracy of CT and its high sensitivity is considered clinically useful.

Chromosome 3p alterations in northeastern Thai women with cervical carcinoma.

The purpose of this study was to determine the incidence of the loss of heterozygosity (LOH) among normal cervixes, cervical intraepithelial neoplasias (CINs) and invasive cervical cancers (ICCs). DNA samples (136) were obtained from 31 normal cervixes, 49 CINs and 56 ICCs. Four polymorphic microsatellite markers (D3S1300, D3S1351, D3S1478 and D3S4103) covering the chromosome 3p arm, were employed. LOH at one or more loci were identified in: 9/31 (8.1%) normal cervixes, 17/49 (14.6%) CINs and 26/56 (22.1%) invasive cancers. The incidence of the LOH at 3p varied for each locus and ranged from 5.6% for D3S1351 to the highest rate of 16.6% for D3S1300. We thus found that LOH of chromosome 3p can occur in normal cervixes and that incidences increase in CINs and ICCs. Deletion in the 3p14.2 (D3S1300) and 3p21.2 (D3S1478) regions might be an early event and, in fact, necessary for cervical cancer progression. The loss of function of tumor suppressor genes (TSGs) located in these regions may have a sequential effect in cervical cancer carcinogenesis.