Histopathological and Immunohistochemistry Observations Based Bukhari Grading for Squamous cell carcinoma.

Background: Increasing incidence of Squamous Cell Carcinoma (SCC) has emphasized the challenges of managing this condition. Traditional microscopic information often fails, especially when based on H & E methods. Immunohistochemistry (IHC) and molecular studies in combination with traditional histopathology may fill this gulf. Aims: The study was conducted to introduce new a grading system based on both histopathological and biological correlation of SCC. Settings and Design: A descriptive study included 180 cases of SCC of the skin (all regions of skin and oral mucosa). Cellular proliferation index (Ki‑67 and p53 expression) was studied in SCC by immunohistochemistry (IHC). This study was carried out in the Department of Pathology from January 2006 to December 2008. Methods and Material: The clinicopathological information regarding age, sex, primary tumor site, tumor size, local recurrence, distance metastasis and follow‑up status was collected for each case. Patient outcome was verified and updated through the medical records. Five micron thick (5μm) sections were cut from archival formalin fixed, paraffin embedded specimens. The first section was stained with haematoxylin and eosin (H&E) for histopathological analysis. Other sections were stained immunohistochemically with p53 and Ki‑67 and then independently scored for the expression of p53 proteins and Ki‑67 index. Results: SCC was designated low, intermediate, and high tirade grades based on the sum of point values assigned to each 4 scores of histological differentiation, staging, expression of p53 protein and Ki‑67 index. Expression of P53 was found to be related to the Ki‑67 and the scores of histology and stages of SCC. A significant correlation was found among the newly assigned grades, stages (Spearman correlation = 0.721, P value = 0.000). The grades were also significantly correlated with other prognostic factors like local invasion, lymph node and distance metastasis (Kendall’s Tau‑b = 0.394;p‑value = 0.00). Tumor recurrence was also significantly based on grades of SCC (Kendall’s Tau–b = 0.966, P value = 0.025). Conclusion: It was concluded that a new grading system is an important prognostic indicator of squamous cell carcinoma. This practical approach has potential to improve clinical evaluation of SCC in understanding the pathological as well as clinical behavior of SCC.

A Case of Locally Invasive Thyroid Papillary Cancer Diagnosed by Esophagoscopy / 대한소화기내시경학회지

Papillary carcinoma is the most common malignant tumor of the thyroid gland, and it only infrequently invades the upper aerodigestive tract. When such invasion does occur, it is a source of significant morbidity as well as mortality. Although most thyroid tumors first clinically manifest as a neck mass, there have been few reports of patients whose initial compliant was a disturbance of the aerodigestive tract. The patient in our present study had no significant past medical history, and esophagoscopy and biopsy revealed papillary adenocarcinoma. We report here on a case of thyroid papillary carcinoma that was diagnosed by esophagoscopic biopsy.

The Surgical Treatment of Locally Invasive Thyroid Papillary Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Thyroid papillary carcinoma usually progresses slowly and invades the surrounding tissues infrequently. About 10% of thyroid papillary carcinoma takes to local invasion that include larynx, pharynx, esophagus, and trachea. However, when invasion occurs, it becomes the source of significant morbidity and mortality to the patient. The main cause of death in thyroid papillary carcinoma is inappropriate treatment of local invasion. This study was designed to investigate the frequency and structure of local invasion, type of surgical treatment, complication and recurrence of locally invasive thyroid papillary carcinoma. SUBJECTS AND METHOD: Between August 1996 and July 2004, 114 patients were diagnosed with thyroid papillary carcinoma and were treated surgically at the Department of Otorhinolaryngology-head & neck surgery, Inha Univ. Hospital. Preoperative evaluation included needle aspiration biopsy, thyroid function test, computerized tomography and/or magnetic resonance imaging. Study was done retrospectively. RESULTS: Local invasion in thyroid papillary carcinoma was observed in 24% (27/114) of the thyroid papillary carcinoma. The most common invasion site was the recurrent laryngeal nerve. Total thyroidectomy was performed in all patients and was combined with radical procedures that included laryngectomy, pharyngectomy or with conservative procedures that included tracheal shaving and so on. Locoregional recurrence was observed in 19% of the cases and the most common site of local invasion was cervical lymph node. One case (4%) of patients died of locoregional recurrence. CONCLUSION: Thyroid papillary carcinoma frequently invades the surrounding structure. We believe that precise preoperative evaluation and treatment including primary resection specific to preoperative evaluation, the management of cervical lymph node metastasis and postoperative radioactive iodine therapy may all contribute to decreasing the mortality and morbidity of locally invasive thyroid papillary carcinoma.

Tumor Growth, Local Invasion, Micrometastasis, and Lymph Node Metastasis of Oral Squamous Cell Carcinoma Visualized in Live Tissue by Green Fluorescent Protein Expression / Oral Science International

We report the <i>in vitro</i> establishment of a highly stable green fluorescent protein (GFP) -expressing transfectant of a highly-invasive human tongue squamous cell carcinoma (HTSCC) cell line, SAS-H1. The fluorescent cells permitted the visualization of tumor growth, local invasion, micrometastasis and cervical lymph node metastasis after submucosal injection into the tongues of nude mice. SAS-H1 cells were transfected with the pEGFP-N1 expression vector containing the GFP and neomycin resistance genes. Stable SAS-H1 clones expressing high levels of GFP were selected stepwise <i>in vitro</i> in levels of geneticin (G418) of up to 3,500 μg/ml. Subsequent early stages of local invasion and micrometastasis were visualized by GFP fluorescence in a primary tumor of the tongue. Furthermore, lymph node metastasis was confirmed for all of the orthotopic transplants in mice. However, no distant metastases, including those of lung and liver, were observed. Thus, this model should be useful for studying the metastatic process and for evaluating anti-metastasis agents in pre-clinical trials.

Immunohistochemical study on expression of apoptosis related proteins in dentigerous cyst and ameloblastoma