Correlation Between Tumor Microvessel Density and Prognosis in Breast Cancer

It has been recognized that angiogenesis has a profound effect on growth of tumors in various animal models. Recently, it was suggested that tumor microvessel density may be an independent prognostic factor in breast cancer and other human tumors. This study was designed to define the correlation between tumor microvessel density and survival in breast cancer. Pathological parameters of 60 patients with breast cancer were analyzed: stage, nodal status, histologic grade, vascular invasion, and p53 expression. Tumor microvessels were stained by the immunohistochemical method in formalin-fixed, paraffin-embedded tissues by using the anti-CD31 monoclonal antibody (JC/70A, DAKO) and were counted with in a 10 objective field (about 0.74 mm2) in the area of the most intense neovascularization. The microvessel density (MVD) of the tumor was compared with other prognostic factors and 5-year survival rate. The mean MVD of the 60 breast cancers was 36.5 15.3 (range: 17~112). The MVD did not correlate with the stage, the node metastasis, the histologic grade, the vascular invasion, or the p53 expression. The MVD was graded by the number of microvessels as grade 1 (MVD 17~32), grade 2 (MVD 33~48), and grade 3 (MVD>49). The 5-year survival rate of patients with MVD grade 1 was 69.0%, and those of grades 2 and 3 were 58.2% and 29.6%, respectively, which was statistically significant (p=0.004). By univariate analysis, the stage (p<0.001), the axillary nodal status (p<0.001), the MVD (p=0.004), and the p53 expression (p=0.041) had a significant correlation with survival. In 25 patients with node-negative breast cancer, the MVD was the single significant prognostic factor (p=0.047). These results suggest that tumor microvessel density is a significant prognostic factor in invasive breast cancer and that it may be a prognostic factor in node-negative breast cancer.

Perioperative Studies of Folcal & Diffuse Type Nesidioblastosis in Adult: 2 case report

Nesidioblastosis is a term that describes the prolonged differentiation of the Langerhan's islet cells from the epithelium of the pancreatic duct. Islet cell lesions accompanied with hyperinsulinemic, 80% are found to be benign islet cell tumors. In additional 10% are malignant and the remaining are nesidioblastosis. Children are usually affected and develop hyperinsulinemic hypoglycemia, but it is rare in adults. Only 20 cases has been reported worldwide and 6 cases in Korea. A 41-year old man & 42-year old woman was admitted due to intermittent hypoglycemic symptoms, that had been relieved by carbohydrate ingestion. Hyperinsulinemic hypoglycemia was documented during prolonged fasting. Under the presumptive diagnosis of insulinoma, Abdominal CT, Celiac angiogram and percutaneous transhepatic portal venous sampling were done, but we could not find any definitive mass. 85% of the pancreas & 88% of the pancreas was removed respectively. Pathologic examination of the resected pancreas revealed irregularly sized islets and scattering of small endocrine cell clusters throughout the acinar tissue and ductuloinsular complex.

Diffuse Nesidioblastosis of the Pancreasin Adult with Persistent Hyperinsulinemic Hypoglycemia / 대한내분비학회지

Nesidioblastosis is a term that describes multifocal hyperplasia of all panereatic cell components and is characterized primarily by their disorganization and proliferation throughout the entire panaeas. Adult onset nesidioblastosis is an extremely rare entity associated with hypersecretion of insulin. The authors have recently experieneed a case of nesidioblastosis in an adult. A 41-year old man was admitted due to interrnittenr hypoglycemic symptoms, that had been relieved by carbohydrate ingestion. Hyperinsulinemic hypoglycemia was documented during prolonged fast. Under the presumptive diagnosis of insulinoma, abdominal CT, celiac angiogram and percutaneous transhepatic portal venous sampling were done but we could not find any definitive mass. Eight-five percent of the panacas was removed. Pathologic examination of the resected pancreas revealed irregularly sized islets and scattering of small endocrine cell clusters throughout the acinar tissue and ductuloinsular complex.