From epithelial dysplasia to squamous carcinoma of the head and neck region: evolutive and prognostic histopathological markers.

Ki67 immunoreactivity, p53 expression and apoptotic index were examined in 26 non-malignant lesions of the head and neck region, 22 dysplastic lesions of patients without evidence of head and neck carcinoma during follow-up time, 24 dysplastic lesions of patients who subsequently developed a squamous carcinoma in the same area, and 42 squamous cancer cases. A directly proportional relation between Ki67 immunoreactive pattern, apoptotic index and histological evolution from normal to dysplastic or neoplastic mucosa was evident. As far as p53 protein is concerned, its expression became higher and frequently transmural in neoplastic mucosa. A strict correlation between frequency and density of Ki67/p53 immunoreactivity according to invasive cell grading (ICG) scores and poor prognosis of patients were found. On the contrary, malignant cells highly expressing p53 seemed not to undergo apoptosis. Ki67 antigen and p53 protein detection in premalignant lesions and in carcinomas of the head and neck tract could be a useful marker for the management of patients at risk.

Metastases of the heart and pericardium.

Tumours metastasizing to the heart are one of the least investigated subjects in clinical oncology. Nevertheless, this problem holds great practical significance in relation to the operability and type of treatment of neoplastic patients. Of 4769 patients autopsied at the Institute of Pathological Anatomy of Trieste from 1994 through 1995, 1148 males (42%) and 780 females (38%) had a primary tumour. Among them, 162 subjects had cardiac metastases (8.4%) of all cancers), with a significant decrease in frequency in elderly patients. Mesothelioma, melanoma and lung cancer showed the highest frequency of heart involvement in males (100, 50 and 31%, respectively). Melanoma, lung tumours and renal neoplasms had the highest percentages of secondary heart lesions in females (45, 26 and 20%, respectively). In lung cancer, anaplastic small-cell carcinoma (37%) and adenocarcinoma (33%) showed the most frequent heart involvement in males, while squamous carcinoma (43%) and anaplastic small-cell carcinoma (29%) had the highest frequency of heart metastases in females. Adenocarcinoma (82%) and anaplastic small-cell carcinoma (74%) of the lung, mesothelioma (100%) and breast tumours (73%) had the highest frequency of metastases to the pericardium. A particularly high frequency of myocardial involvement was observed in squamous cell carcinoma of the lung (62%), urinary tract tumours (60%) and melanoma (45%).