-
Journal of Cancer Research and... 2022We aimed to histopathologically evaluate the morphological spectrum, apoptotic index (AI), and mitotic index (MI) of endometrial lesions in patients presenting with...
OBJECTIVES
We aimed to histopathologically evaluate the morphological spectrum, apoptotic index (AI), and mitotic index (MI) of endometrial lesions in patients presenting with abnormal uterine bleeding (AUB).
METHODS
A cross-sectional study was done over a period of 18 months where a total of 60 newly diagnosed cases of perimenopausal women presenting with AUB were included. All H and E stained pathology slides from the specimens were reviewed for initial histopathological evaluation and diagnosis. Immunohistochemistry for Bcl-2 and Bax was done. The study subjects were divided into two groups: Group 1 included 30 cases of histologically proven proliferative endometrium (PE) and endometrial polyps and Group 2 included 30 cases of hyperplasia, endometrial epithelial neoplasia (EIN)/or carcinoma. For all cases, AI and MI were calculated and compared among the two groups.
STATISTICAL ANALYSIS
Quantitative variables were compared using the Independent t-test/Mann-Whitney test between the two groups and Kruskal-Wallis test for comparison between more than two groups. Qualitative variables were correlated using the Chi-square test. P < 0.05 was considered statistically significant.
RESULTS
In our study of 60 patients of AUB, the mean age was 45.87 years with a parity of 2 or more in most of the patients. Most of the patients in our study had heavy menstrual bleeding (66.67%) with associated complaints of weakness, pallor, and low backache. Out of 60 patients of AUB, Endometrial carcinoma was diagnosed in 13 (21.67%) patients, with the most common histopathological type being Endometrioid carcinoma. There was a significant difference in the AI, MI, and the ratio of AI/MI among various histopathological diagnoses. AI was highest for Endometrial carcinoma and lowest for hyperplasia and polyps. MI was also highest for Endometrial carcinoma and lowest for hyperplasia and polyps. However, the ratio was incongruent as it was highest for hyperplasia without atypia and lowest for PE with endometrial carcinoma being midway. The Bcl-2 expression of relatively benign conditions (Group 1) was significantly higher than Group 2 (Endometrial epithelial neoplasia/carcinoma). Bax intensity showed an almost inverse pattern, being highest in endometrial carcinoma and lower in hyperplasia and polyps with the lowest expression in PE. Even the Bcl-2:Bax ratio was also highest for PE and lowest for endometrial carcinoma with others falling in between them.
CONCLUSION
It can be concluded that the combination of the proliferative and apoptotic markers and the ratio will help as a tool in aiding the diagnosis of endometrial lesions for patients presenting with AUB.
Topics: Humans; Female; Middle Aged; Uterine Hemorrhage; Immunohistochemistry; Hyperplasia; Cross-Sectional Studies; bcl-2-Associated X Protein; Polyps; Endometrial Neoplasms; Carcinoma, Endometrioid
PubMed: 36412397
DOI: 10.4103/jcrt.JCRT_915_20 -
Anais Brasileiros de Dermatologia 2018Melanoma is a malignant neoplasia that shows high mortality when diagnosed in advanced stages. Early identification of high-risk patients for the development of melanoma...
BACKGROUND
Melanoma is a malignant neoplasia that shows high mortality when diagnosed in advanced stages. Early identification of high-risk patients for the development of melanoma metastases is the main strategy to reduce mortality.
OBJECTIVE
To assess the influence of eight epidemiological and histopathologic features on the development of metastases in patients diagnosed with primary cutaneous melanoma.
METHODS
Our historical cohort comprised patients with invasive primary cutaneous melanoma seen between 1995 and 2012 at a public university hospital and a private oncologic surgery institution in Southeastern Brazil. The following variables were analyzed: gender, age, family history of melanoma, site of the primary tumor, clinical and histologic subtype, Breslow thickness, histologic ulceration and the mitotic index. Kaplan-Meier univariate test and multivariate Cox proportional hazard analysis were used to assess factors associated with disease-free survival.
RESULTS
Five hundred and fourteen patients were enrolled. The univariate analysis identified the following significant risk factors: gender, age, site of the tumor, clinical and histologic subtype, Breslow thickness, histologic ulceration and mitotic index. Multivariate analysis included 244 patients and detected four significant prognostic factors: male gender, nodular clinical and histologic subtype, Breslow thickness > 4mm, and histologic ulceration. The mitotic index was not included in this analysis.
STUDY LIMITATIONS
Small number of patients in multivariate analysis.
CONCLUSIONS
The following prognostic factors to the development of melanoma metastasis were identified in the study: male gender, nodular histologic subtype, Breslow thickness > 4mm and ulceration.
Topics: Adolescent; Adult; Age Factors; Analysis of Variance; Female; Humans; Male; Melanoma; Middle Aged; Neoplasm Staging; Prognosis; Proportional Hazards Models; Risk Factors; Sex Factors; Skin Neoplasms; Skin Ulcer; Young Adult
PubMed: 29641692
DOI: 10.1590/abd1806-4841.20184779 -
Veterinary Sciences Nov 2021Oral malignant melanoma (OMM) is the most common neoplasm of the canine oral cavity. It is characterized by its aggressive local disease as well as its high rate of... (Review)
Review
Oral malignant melanoma (OMM) is the most common neoplasm of the canine oral cavity. It is characterized by its aggressive local disease as well as its high rate of lymphatic invasion and distant metastasis. OMM carries a poor prognosis, with most patients succumbing to the disease due to progression of the neoplasm. Histopathologically, OMM is characterized by significant nuclear atypia, a mitotic index of greater than 4/10 hpf, and evidence of vascular invasion or metastasis. Clinically, these lesions can become locally invasive, causing lysis of bones and severe inflammation of the surrounding soft tissue. With time, these lesions can spread to the regional lymph node and to the lungs and other organs. Prognosis can vary depending on the size of the primary tumor, regional node involvement, and distant metastatic disease; however, multiple studies report a relatively short median survival time ranging from less than 4 months to 8 months. Histologically well- differentiated melanocytic neoplasms (HWDMN) are a variant of OMM and sometimes referred to as canine oral melanocytic neoplasms of low malignant potential. Unlike OMM, patients with HWDMN have longer survival times. Histopathologically, HWDMNs have well-differentiated melanocytes with a low mitotic index of 3 or less per 10 hpf and minimal nuclear atypia. HWDMNs have better prognosis with a mean survival time of up to 34 months. This article is a comparative review of OMM and its less aggressive counterpart.
PubMed: 34822634
DOI: 10.3390/vetsci8110261 -
Journal of Gastrointestinal Cancer Sep 2014Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the gastrointestinal tract, which are characterized in the majority of cases by activating mutations in... (Review)
Review
INTRODUCTION
Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the gastrointestinal tract, which are characterized in the majority of cases by activating mutations in KIT and platelet-derived growth factor receptor alpha (PDGFRA). The introduction of tyrosine kinase inhibitors has revolutionized the management of patients with metastatic GIST. However, complete surgical resection remains the mainstay of management for those with localized disease. Recently, three large trials have confirmed the benefit of adjuvant imatinib therapy in patients who were at high risk of recurrence following complete resection. In this setting, it is critical that oncologists understand the various GIST risk assessment criteria and be able to apply these methods to accurately assess the risk of recurrence and the need for adjuvant imatinib therapy.
PURPOSE
The aim of this review is to outline the risk stratification systems currently available to oncologists who are treating patients with GIST, so they can be optimally applied for clinical decision-making.
Topics: Antineoplastic Agents; Benzamides; Chemotherapy, Adjuvant; Consensus Development Conferences, NIH as Topic; Gastrointestinal Neoplasms; Gastrointestinal Stromal Tumors; Humans; Imatinib Mesylate; Mitotic Index; Molecular Targeted Therapy; Multicenter Studies as Topic; Mutation; Nomograms; Piperazines; Prognosis; Protein Kinase Inhibitors; Pyrimidines; Randomized Controlled Trials as Topic; Risk Assessment; Treatment Outcome; Tumor Burden; United States
PubMed: 24802226
DOI: 10.1007/s12029-014-9615-x -
Translational Gastroenterology and... 2017Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with the majority found in the stomach. Surgical resection... (Review)
Review
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with the majority found in the stomach. Surgical resection of the primary gastric GISTs with complete resection margin has been the forefront of curative treatment. The indications for surgical resection are usually related to symptomatic gastric GISTs at presentation. Primary gastric GISTs resection performed conventionally through an open surgery can now be frequently achieved by minimal invasive surgery with similar oncological outcome. Surgeon's selection of the type of surgical techniques such as open, laparoscopic and endoscopic resections depends on the site, size and local invasion of gastric GISTs to the adjacent organ. Similarly those factors dictate the extent of gastric resections in the form of wedge, partial or total gastrectomy. All these inherent tumor factors (size and mitotic index), patient factors (older age, male) and surgical factors (incomplete resection margin, tumor rupture or spillage) play an important role in stratifying the malignant potential risk of primary gastric GISTs and their chances of recurrence. The understanding of gene mutation driving the growth of GISTs and the discovery of tyrosine kinase inhibitors (TKIs) has altered the surgical management of advanced and metastatic GISTs. Multi-modal therapy incorporating the surgical resection of GISTs and utilizing the molecular targeted therapy in the adjuvant, neoadjuvant and palliative settings can offer optimal personalized outcome and prolong patient's overall survival (OS).
PubMed: 29354761
DOI: 10.21037/tgh.2017.12.01 -
South Asian Journal of Cancer Jan 2022Shilpa Garg Nuclear size, shape, chromatin pattern, and nucleolar size and number have all been reported to change in breast cancer. The aim of the study was to...
Shilpa Garg Nuclear size, shape, chromatin pattern, and nucleolar size and number have all been reported to change in breast cancer. The aim of the study was to quantify nuclear changes on malignant breast aspirates using morphometry and to correlate the morphometric parameters with clinicopathologic features such as cytologic grade, tumor size, lymph node status, mitotic index, and histopathologic grade. Forty-five cases of carcinoma breast diagnosed on cytology were included in this study. Cytologic grading was performed as per the Robinson's cytologic grading system. Nuclear morphometry was done on Papanicolaou stained smears. One hundred nonoverlapping cells per case were evaluated. Both geometrical and textural parameters were evaluated. Comparison of cytologic grades with most morphometric features (nuclear area, perimeter, shape, long axis, short axis, intensity, total run length, and TI homogeneity) was highly significant on statistical analysis. Correlation with tumor size yielded significant results for nuclear area, perimeter, long and short axes, and intensity with < 0.05. The study of lymph node status and morphometry showed a highly significant statistical association with all the parameters. Mitotic count was significantly associated with all the geometric parameters and one textural parameter (total run length). On correlation of ductal carcinoma in situ and histopathological Grades 1 to 3 with morphometry, it was found that all the parameters except long-run emphasis were highly significant with < 0.001. Morphometry as a technique holds immense promise in prognostication in breast carcinoma.
PubMed: 35833049
DOI: 10.1055/s-0040-1721215 -
Scientific Reports Jan 2020In this study, the toxic effects of phenoxyethanol (Phy-Et), which is widely used in cosmetic industry, has been investigated with Allium test by means of physiological,...
In this study, the toxic effects of phenoxyethanol (Phy-Et), which is widely used in cosmetic industry, has been investigated with Allium test by means of physiological, cytogenetic, anatomical and biochemical parameters. To determine the changes in physiological reactions weight gain, relative injury rate, germination percentage and root length were investigated. Malondialdehyde, superoxide dismutase, glutathion and catalase levels were analyzed as biochemical parameters for determining the presence of oxidative stress. Mitotic index, micronucleus and chromosomal abnormality frequencies were studied as cytogenetic evaluation and the anatomical changes in root tip cells were investigated by cross sections. Changes in surface polarity and wettability were investigated by taking contact angle measurements of pressed root preparations. The mechanism of toxicity has been tried to be explained by these contact angles and this is the first study using contact angle measurements in toxicity tests. Consequently, exposure to Phy-Et resulted in a decrease in all measured physiological parameters and in mitotic index. In contrast, significant increases in the micronucleus and chromosomal abnormality frequencies were observed and the most significant toxic effect was found in 10 mM Phy-Et treated group. Phy-Et application induced oxidative damage and caused a significant increase in malondialdehyde level and a decrease in glutathione level compared to control group. Also a response occured against oxidative damage in superoxide dismutase and catalase activity and the activities increased in 2.5 mM and 5 mM Phy-Et treated groups and decreased in 10 mM Phy-Et treated groups. Furthermore, Phy-Et treatment resulted in some anatomical damages and changes such as necrosis, cell deformation and thickening of the cortex cell wall in root tip meristem cells of A. cepa. In the contact angle measurements taken against water, it was found that the wettability and hydrophilicity of the root preparations treated with Phy-Et were reduced, and this was the explanation of the growth abnormalities associated with water uptake. As a result, it was found that Phy-Et application caused toxic effects on many viability parameters and A. cepa test material was a reliable biomarker in determining these effects.
Topics: Catalase; Chromosome Aberrations; Ethylene Glycols; Germination; Glutathione; Malondialdehyde; Mitotic Index; Onions; Oxidative Stress; Plant Extracts; Plant Roots; Risk Assessment; Superoxide Dismutase; Tea; Wettability
PubMed: 31988350
DOI: 10.1038/s41598-020-58170-9 -
Granulosa Cell Tumor of the Ovary: A Retrospective Study of 31 Cases and a Review of the Literature.International Journal of Surgical... 2018Adult granulosa cell tumors (AGCTs) are the most common sex cord-stromal tumors. Unlike epithelial ovarian tumors, they occur in young women and are usually detected at... (Review)
Review
BACKGROUND
Adult granulosa cell tumors (AGCTs) are the most common sex cord-stromal tumors. Unlike epithelial ovarian tumors, they occur in young women and are usually detected at an early stage. The aim of this study was to report the clinical and pathological characteristics of AGCT patients and to identify the prognostic factors.
METHODS
All cases of AGCTs, treated at Salah Azaïz Institute between 1995 and 2010, were retrospectively included. Kaplan-Meier's statistical method was used to assess the relapse-free survival and the overall survival.
RESULTS
The final cohort included 31 patients with AGCT. The mean age was 53 years (35-73 years). Patients mainly presented with abdominal mass and/or pain (61%, = 19). Mean tumor size was 20 cm. The majority of patients had a stage I disease (61%, = 19). Two among 3 patients with stage IV disease had liver metastasis. Mitotic index was low in 45% of cases ( = 14). Surgical treatment was optimal in almost all cases (90%, = 28). The median follow-up time was 14 years (1-184 months). Ten patients relapsed (32%) with a median RFS of 8.4 years (6.8-9.9 years). Mean overall survival was 13 years (11-15 years). Stage I disease and low-to-intermediate mitotic index were associated with a better prognosis in univariate analysis (resp., = 0.05 and = 0.02) but were not independent prognostic factors.
CONCLUSION
GCTs have a long natural history with common late relapses. Hence, long active follow-up is recommended. In Tunisian patients, hepatic metastases were more frequent than occidental series. The prognosis remains good and initial staging at diagnosis is an important prognostic factor.
Topics: Adult; Aged; Antineoplastic Agents; Chemotherapy, Adjuvant; Female; Granulosa Cell Tumor; Humans; Hysterectomy; Middle Aged; Neoplasm Staging; Ovarian Neoplasms; Ovariectomy; Retrospective Studies; Salpingectomy
PubMed: 29796312
DOI: 10.1155/2018/4547892 -
World Journal of Gastroenterology Dec 2016Neuroendocrine carcinomas (NEC) of the pancreas are defined by a mitotic count > 20 mitoses/10 high power fields and/or Ki67 index > 20%, and included all the tumors... (Review)
Review
Neuroendocrine carcinomas (NEC) of the pancreas are defined by a mitotic count > 20 mitoses/10 high power fields and/or Ki67 index > 20%, and included all the tumors previously classified as poorly differentiated endocrine carcinomas. These latter are aggressive malignancies with a high propensity for distant metastases and poor prognosis, and they can be further divided into small- and large-cell subtypes. However in the NEC category are included also neuroendocrine tumors with a well differentiated morphology but ki67 index > 20%. This category is associated with better prognosis and does not significantly respond to cisplatin-based chemotherapy, which represents the gold standard therapeutic approach for poorly differentiated NEC. In this review, the differences between well differentiated and poorly differentiated NEC are discussed considering both pathology, imaging features, treatment and prognostic implications. Diagnostic and therapeutic flowcharts are proposed. The need for a revision of current classification system is stressed being well differentiated NEC a more indolent disease compared to poorly differentiated tumors.
Topics: Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinoma, Neuroendocrine; Cell Proliferation; Chemotherapy, Adjuvant; Cisplatin; Etoposide; Humans; Ki-67 Antigen; Mitotic Index; Neoadjuvant Therapy; Neoplasm Staging; Neuroendocrine Tumors; Pancreatectomy; Pancreatic Neoplasms; Prognosis
PubMed: 28018101
DOI: 10.3748/wjg.v22.i45.9944 -
Acta Dermato-venereologica Apr 2018
Topics: Adolescent; Adult; Aged; Australia; Disease-Free Survival; England; Female; Humans; Male; Melanoma; Middle Aged; Mitotic Index; Neoplasm Staging; Risk Factors; Skin Neoplasms; Terminology as Topic; Time Factors; Treatment Outcome; Young Adult
PubMed: 29182796
DOI: 10.2340/00015555-2855