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2.
Indian J Otolaryngol Head Neck Surg ; 74(Suppl 2): 2256-2264, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36452646

RESUMO

The surgical management of the clinical negative neck node in early oral tongue squamous cell carcinoma (OTSCC) has been the topic of debate since few decades. As the occult cervical lymph node metastasis is considered to be the prime prognostic factor in early OTSCC, this meta-analysis has been carried out to find the risk of regional nodal recurrence, disease specific survival and overall survival rates in outcome of Elective neck dissection (END) versus patients under observation. The articles were electronically retrieved from Ovid Medline, PubMed, Cochrane and Scholar for comparison of END versus Observation in early OTSCC. The search strategy identified 37 relevant review articles from April 1979 to April 2020 from different search engines. A total of 11,973 patients from 32 retrospective analysis, 4 prospective and 1 randomised control trial were included in this meta-analysis. Statistical analysis revealed Overall test (OR: 5.31 95% CI: - 2.132-14.698) with t-test 1.919 and p value 0.113 which is not statistically significant but the readings says that there is always better Disease specific survival with END patients rather than patients kept on observation. Overall test revealed (OR: 13.02 95% CI: 1.360-17.154) with t test 2.382 and p value 0.023 which is statistically significant and showed that End significantly reduced the risk of regional nodal recurrence. Overall test revealed (OR: 7.93 95% CI: - 15.461-4.238) with t test - 1.347 and p value 0.220 which is statistically insignificant and but showed that to some extent Overall survival improves in patient with END than the patients kept on observation. This meta-analysis find that there is statistically significant relationship when Elective neck dissection was performed which reduced the risk of regional nodal recurrence. This analysis didn't statistically find any significance in Disease specific survival and Overall survival with Elective neck dissection patients rather than patients kept on observation but however showed good prognosis when elective neck dissection was performed.

3.
Indian J Otolaryngol Head Neck Surg ; 74(Suppl 3): 6001-6006, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36742945

RESUMO

Oral squamous cell carcinoma (SCC) is one among the most frequent cancers across the globe. The postoperative overall survival (OS) has not improved over years much despite of advanced surgical techniques and various anticancer drugs. A better and good understanding of molecular mechanisms and identification of potential oncogenes in OSCC may provide new therapeutic decisions such as target therapy in management of these cancer patients. To find whether there is any association between surgical margins and pathological staging with epidermal growth factor receptor expression affecting the prognosis in oral squamous cell carcinomas. A prospective cohort study was performed in 25 patients with biopsy proven oral squamous cell carcinoma who presented to our hospital from July 2017 to June 2019. The data collected from their report were pTNM staging, surgical margins (anterior, posterior, superior and inferior) and scoring of EGFR expression. Surgical margins with EGFR expression was found to have p-value of 0.023 and pTNM staging with EGFR expression was found to have p-value of 0.051 which were statistically significant. This study concludes that there is strong association of EGFR expression with pTNM and surgical margins which may influence the prognosis of the patient. This study helps us to understand the need of adding EGFR targets like cetuximab along with radiation instead of conventional cisplatin therapy.

4.
J Maxillofac Oral Surg ; 21(4): 1065-1073, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36896074

RESUMO

Background: Oral squamous cell carcinomas (OSCC) are the most common type of variant causing oral cancers, contributing for around 90%. The overall survival of these patients is below 50%. The postoperative overall survival (OS) has not improved over years much despite of advanced surgical techniques and invention of various anticancer drugs. There was always a requirement for a non-invasive molecular marker to predict the prognosis of these patients. The epidermal growth factor and their receptors are not only thought to play a critical but also an influential role in growth of the cell and differentiation in normal/ healthy tissues. They also play an important role in malignant progression of disease and tumorigenesis. A better and sound understanding of mechanisms at molecular level and identification of potential oncogenes in OSCC may provide innovative therapeutic decisions such as targeted therapy in management of these cancer patients. Aim & objectives: The aim of this study is to check whether epidermal growth factor expression is a prognosticator in oral squamous cell carcinoma and also to propose a mathematical model to find the prognosis of the patients which have not been done so far in the literature. Materials & methods: The study was a prospective cohort study with 25 patients who had biopsy proven OSCC who reported to our hospital from July 2017 to June 2019. The data collected from their histopathological report for this prospective study and model were: surgical margins (superior, inferior, anterior and posterior), depth of tumor, lymph nodal metastasis, lymphovascular invasion and scoring of epidermal growth factor receptor (EGFR) expression done by immunohistochemistry (IHC) on wax blocks. Results: EGFR expression on surgical margins was found to have a p-value of 0.023 which was significant statistically. EGFR expression showed a statistically significant p value 0.002 as independent marker in prognosis with sensitivity of 97.7% and specificity of 61.2%. The tumor depth of infiltration showed an insignificant correlation with pathological Tumor, Node, Metastasis (TNM) staging with a p value of 0.860. A mathematical model linear regression equation was proposed which predicted a cutoff value above 16, the prognosis of the patient being bad (Stages III and IV), and below 16, the prognosis of the patient being good (Stages I and II). Conclusion: This study put forward a proposed mathematical model by incorporating all important parameters to predict the prognosis of the patients. EGFR expression is one such important parameter to be considered to develop anti-EGFR agents to improve the OS of the patients. Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-022-01797-0.

6.
Acta Cytol ; 53(4): 437-9, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19697732

RESUMO

BACKGROUND: Oncocytic lipoadenoma is an uncommon benign salivary gland tumor. There are only rare case reports of this distinct entity in which only the histopathologic aspects are discussed. Fine needle aspiration cytologic (FNAC) findings of oncocytic lipoadenoma have not yet been documented. CASE: A 50-year-old woman presented with a slow-growing swelling in the left parotid region that was clinically interpreted as a soft tissue tumor, with a differential of neurofibroma/lipoma. FNAC showed moderate cellularity, with oncocytic cells arranged predominantly as microacini in a prominent lipoid background. The adipose tissue background of the cytologic smears was ignored as material derived from the normal fat tissue; based on the oncocytic population of cells, a diagnosis of oncocytoma was considered. A remote possibility of acinic cell carcinoma with oncocytic features was also suggested. However, histopathologic examination showed it to be an oncocytic lipoadenoma, a tumor we were unaware of at the time of cytodiagnosis. CONCLUSION: Both cytopathologists and histopathologists need to be aware of oncocytic lipoadenoma of the salivary gland in order to diagnose it precisely. The clinicocytopathologic correlation highlighted in our case will be useful for cytopathologists in preoperative interpretation and diagnosis.


Assuntos
Adenoma Oxífilo/patologia , Neoplasias Parotídeas/patologia , Adenoma/patologia , Biópsia por Agulha Fina , Feminino , Humanos , Lipoma/patologia , Pessoa de Meia-Idade
7.
Diagn Cytopathol ; 37(4): 277-80, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19217036

RESUMO

We report the cytology of a rare case of dermatofibrosarcoma protuberans (DFSP) involving the parotid region. Our patient was a 55-year-old female who presented with a swelling in the right parotid region, which was clinically interpreted as a "recurrent parotid tumor." Fine needle aspiration revealed a moderate cellular yield with spindle cell component, seen discretely as well as, embedded loosely within a fibrillary magenta matrix. A few cellular spindle cell fascicles and several discrete, naked, spindly nuclei were also noted. Neoplastic cells exhibited a minimal pleomorphism with a relatively bland chromatin and inconspicuous nucleoli. A differential diagnosis of the benign spindle cell tumor/low, or intermediate grade myxoid, spindle cell sarcomas was considered. Owing to its clinical presentation simulating a parotid tumor, possibility of "spindle cell myoepithelioma" was suggested. However, histopathologic examination with immunohistochemistry showed it to be a DFSP. A precise diagnosis of DFSP is not always possible on cytology alone. Owing to its location, as well as the spindle cell morphology, DFSP occurring in the parotid region is likely to be mistaken for a spindle cell myoepithelioma, in which case, an appropriate panel of immunomarkers is required for resolving the diagnostic dilemma.


Assuntos
Dermatofibrossarcoma/diagnóstico , Dermatofibrossarcoma/patologia , Neoplasias Parotídeas/diagnóstico , Neoplasias Parotídeas/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade
8.
Diagn Cytopathol ; 37(5): 355-8, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19217052

RESUMO

Pure neuritic leprosy (PNL) with nerve abscess manifesting as a huge, cystic, soft tissue mass is highly uncommon. Fine needle aspiration cytology can serve as an important initial diagnostic modality in such an instance. We report a case of 28-year-old male, who presented with a huge swelling in the lower, medial aspect of the right upper arm. The clinical diagnosis was schwannoma. Fine needle aspiration (FNA) yielded 80 ml of sticky, turbid, pale brown fluid. Cytologic examination revealed abundant, caseous, necrotic material and many degenerated neutrophils in a thin proteinaceous background. Stain for acid fast bacilli (AFB) was negative. Based on an AFB negative, caseous, necrotic material obtained from the soft tissue mass located in the ulnar nerve region, a cytodiagnosis of tuberculoid PNL with nerve abscess was given, and this was confirmed by the subsequent histopathologic examination. Our case emphasizes the major role of minimally traumatic, FNA technique in the diagnosis of rare cases of clinically unsuspected neuritic leprosies.


Assuntos
Abscesso/patologia , Cistos/patologia , Hanseníase/complicações , Hanseníase/diagnóstico , Neurite (Inflamação)/diagnóstico , Neoplasias de Tecidos Moles/patologia , Nervo Ulnar/patologia , Abscesso/complicações , Adulto , Biópsia por Agulha Fina , Diagnóstico Diferencial , Humanos , Hanseníase/patologia , Masculino , Neurite (Inflamação)/complicações , Neurite (Inflamação)/patologia
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