Stupnjevanje invazivnih stanica - pregled

Pathohistologic diagnosis plays a pivotal role in therapeutic modalities for cancer, and acts as a prognostic factor. The histologic grade is a numeric expression of tumor differentiation and is linked to patient outcome. Broders\u27 scoring system is still widely used in scoring squamous cell carcinomas. New data suggest that in the most invasive parts of a malignant tumor, the morphology and biologic behavior differ from the central and superficial areas of the same tumor. A new invasive cell grading system has been proposed as a better prognostic factor in the multifactorial diagnostic and therapeutic approach to the patient with malignant tumor. Numerous studies performed to date have provided sufficient evidence to propose the invasive cell grading system to be introduced instead of the "old" Broders\u27 scoring system.Patohistološka dijagnoza igra ključnu ulogu u terapijskom pristupu raku te djeluje i kao prognostički čimbenik. Histološki stupanj je brojčani izražaj diferencijacije tumora i vezan je uz prognozu tumorske bolesti u pojedinog bolesnika. Danas je u širokoj uporabi Brodersov sustav histološkog stupnjevanja u karcinomima pločastog epitela. Noviji podatci ukazuju na to da se morfologija i biološko ponašanje stanica u invazivnim dubokim dijelovima malignog tumora razlikuju od središnjih i površinskih dijelova istoga tumora. Novi sustav ICG (invasive cell grading . stupnjevanje invazivnih stanica) predložen je kao bolji prognostički čimbenik u složenom dijagnostičkom i terapijskom pristupu bolesniku s malignim tumorom. Brojna su istraživanja potvrdila da se novi sustav ICG može s dovoljnom sigurnošću rabiti u patohistološkom stupnjevanju malignih tumora umjesto "starog" Brodersovog načina

Simplified description and interpretation of pathological thermography signs in malignant breast lesions

Background and Purpose: Breast cancer is the leading cause of death among women aged 20–59 years in developed countries, with similar mortality trends, observed among women in Croatia. Breast cancer detection usually relies on mammography, ultrasound (US) and magnetic resonance imaging (MRI), however, thermography is a noninvasive, reliable and applicable diagnostic procedure for early detection of breast disease that has attracted interest in this field. The aim of this study was to establish the frequency and characteristics of pathological thermographic signs in female patients, who were operated on malignant breast lesions. In addition, the authors offered a simplified description and interpretation of pathological thermographic signs, based on published literature. Matherial and Methods: The seventy four female patients with histopathologically confirmed breast cancer were included in the study. In all patients breast cancer was diagnosed using standard protocol which have included clinical examination, mammography, ultrasound and for selected patients MRI and/or fine needle aspiration (FNA). Thermographic imaging has been conducted 1 to 14 days before scheduled surgical procedures. Results: Mean tumor size positively correlated with number of pathological thermographic signs (IR 3 vs. IR 5, p < 0.05). Mean number of pathological thermographic signs per patient was 3.5±1, 72 (range 1 to 8). The most frequently noted singular signs were heat in area of finding and vascular signs, as well. Conclusion: The simplified description could offer a suitable clinical tool for standardization of pathological thermography signs in malignant breast lesions, taking into account the learning curve of medical teams involved and ethical aspects, as well

Apoptoza u bubrežnom tkivu štakora uzrokovana okratoksinom A

The aim of our study was to find whether ochratoxin A (OTA) induces the apoptosis and/or necrosis of kidney tissue in rats. In the first experiment, the highest number of apoptotic cells was found in rats sacrificed one day after OTA administration (1.00 mg/kg b.w., i.p.). The number of apoptotic cells reduced gradually and they were not seen nine days after OTA administration. A possible dose-dependence of histological changes was checked in kidney tissue of rats given 0.25, 0.50 or 1.00 mg of OTA/kg b.w., i.p. three times a week for four weeks. The number of apoptotic cells showed a clear dose-dependence, but necrosis was absent even at the highest doses. The time-dependent appearance of lesions related to OTA administration was checked by administering 0.50 mg OTA/kg body weight to rats, and sacrificing them one day after 1, 3, 6, and 9 doses/administrations, or 6 and 21 day after 12 doses/administrations. Long-term administration is associated with continued and increased apoptosis without necrosis, suggestive of OTA’s role in the pathogenesis of progressive renal atrophy.Okratoksin A (OTA) nefrotoksični je mikotoksin za koji se pretpostavlja da je uzročnik endemske nefropatije i tumora urotela koji se s većom učestalošću javljaju u području endemske nefropatije. Endemska nefropatija je smrtonosna bolest koja zahvaća oba bubrega, a primarno dolazi do oštećenja proksimalnih tubula bubrega. Za sada uzrok bolesti nije poznat. Međutim, niske koncentracije OTA čest su nalaz u krvi ljudi i iz drugih područja. Cilj našeg istraživanja bio je utvrditi da li OTA u bubregu pokusnih životinja uzrokuje apoptozu ili nekrozu. U prvom pokusu štakori su bili tretirani jednokratnom dozom OTA (1,00 mg/kg tj. t., ip.) te su žrtvovani u razdoblju od jedan do 9 dana. Najveći broj apoptotskih stanica nađen je u životinja koje su žrtvovane jedan dan nakon tretmana, njihov se broj postepeno smanjivao te u životinja koje su žrtvovane 9 dana nakon tretmana nisu nađene apoptotske stanice. Ovisnost nastanka histoloških promjena u bubregu štakora o dozi ispitana je u supkroničnom pokusu primjenom triju doza OTA (0,25, 0,50 i 1,00 mg/kg tj. t., ip.) tijekom 4 tjedna (3 puta na tjedan). Koncentracija OTA i nastanak apoptotskih stanica bili su ovisni o primijenjenoj dozi, a u histološkim preparatima nije nađena nekroza. Ovisnost nastanka apoptotskih stanica u bubregu o duljini tretmana s OTA ispitana je na štakorima koji su tretirani višekratno s OTA (0,50 mg/kg tj. t., ip.) i žrtvovani jedan dan nakon prvog, trećeg, šestog, devetog i dvanaestog tretmana, odnosno 6. i 21. dan nakon dvanaestog tretmana. Ovim je pokusom dokazano da je nastanak apoptotskih stanica u bubregu štakora povezan s duljinom tretmana s OTA

Thermography in patients with inflammatory bowel disease and colorectal cancer: evidence and review of the method

Background and Purpose: There is a need for a simple, noninvasive and reproducible test that could accurately reflect the inflammatory activity and neoplastic lesions, and that could be used safely and repeatedly during the biological course of inflammatory and neoplastic bowel disease. During past few decades, the joint efforts of professionals have resulted in evolution of technological advances in infrared sensor technology, thus developing the new methods that enabled the use of thermal imaging in biomedical research and clinical medicine. The aim of this viewpoint was to present, and comment on,the possibility of thermal imaging in assessing inflammatory disease activity and the existence of neoplastic bowel lesions. Materials and Methods: The authors presented thermal images of several patients (n=6: five patients with inflammatory bowel disease and one female patient with colorectal cancer), and one female healthy individual, describing the tem erature patterns and commenting on the possible thermographic signs of underlying disease. Results: Inflammatory bowel disease and colorectal cancer show a clear change in the thermal pattern of the abdominal surface and a different pattern of histogram temperature distribution. Conclusion: This review has indicated the potential of infrared thermography as a feasible and noninvasivemethod in additional evaluation of patients with various manifestations of inflammatory bowel disease and also of colon cancer

Simplified description and interpretation of pathological thermography signs in malignant breast lesions

Background and Purpose: Breast cancer is the leading cause of death among women aged 20–59 years in developed countries, with similar mortality trends, observed among women in Croatia. Breast cancer detection usually relies on mammography, ultrasound (US) and magnetic resonance imaging (MRI), however, thermography is a noninvasive, reliable and applicable diagnostic procedure for early detection of breast disease that has attracted interest in this field. The aim of this study was to establish the frequency and characteristics of pathological thermographic signs in female patients, who were operated on malignant breast lesions. In addition, the authors offered a simplified description and interpretation of pathological thermographic signs, based on published literature. Matherial and Methods: The seventy four female patients with histopathologically confirmed breast cancer were included in the study. In all patients breast cancer was diagnosed using standard protocol which have included clinical examination, mammography, ultrasound and for selected patients MRI and/or fine needle aspiration (FNA). Thermographic imaging has been conducted 1 to 14 days before scheduled surgical procedures. Results: Mean tumor size positively correlated with number of pathological thermographic signs (IR 3 vs. IR 5, p < 0.05). Mean number of pathological thermographic signs per patient was 3.5±1, 72 (range 1 to 8). The most frequently noted singular signs were heat in area of finding and vascular signs, as well. Conclusion: The simplified description could offer a suitable clinical tool for standardization of pathological thermography signs in malignant breast lesions, taking into account the learning curve of medical teams involved and ethical aspects, as well

Utjecaj tvrdokorne infekcije bakterijom helicobacter pylori na izraženost bcl-2 u upalnim stanicama želučane sluznice

Chronic Helicobacter (H.) pylori infection is an etiological factor related to gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. The expression of bcl-2 protein significantly decreases as the grade of MALT lymphoma advances. The aim of this study was to evaluate bcl-2 expression in inflammatory cells in lamina propria in gastric biopsy samples collected from two groups of patients with chronic gastritis divided on the basis of the success or failure of H. pylori eradication. Sixty-five patients with chronic gastritis were divided into two groups of 45 and 20 patients according to their therapeutic response. The gastric mucosa samples were analyzed histologically in both groups of patients before and after standard therapy (for eradicated, after one therapeutic cycle; and for non-eradicated, after three therapeutic cycles) for H. pylori density, urease activity and bcl-2 expression. In the eradicated group of patients, H. pylori eradication was accompanied by significantly lower grades of bacterial colonization and lower urease activity in the corpus and antrum. Bcl-2 expression in inflammatory cells showed no statistically significant changes in either patient group at either location. There was no between-group difference in bcl-2 expression either. In conclusion, persistent long-lasting H. pylori infection is associated with higher grades of bacterial colonization and higher urease activity but not with bcl-2 expression in inflammatory cells.Kronična infekcija bakterijom Helicobacter (H.) pylori je etiološki čimbenik želučanog adenokarcinoma i limfoma limfoidnog tkiva povezanog sa sluznicom (MALT limfoma). Izraženost proteina bcl-2 značajno se smanjuje s napredovanjem stupnja MALT limfoma. Cilj ove studije bio je procijeniti izraženost bcl-2 u upalnim stanicama lamine proprije u uzorcima dobivenim želučanom biopsijom u dvjema skupinama bolesnika s kroničnim gastritisom podijeljenim prema uspješnoj ili neuspješnoj eradikaciji H. pylori. Ukupno je 65 bolesnika s kroničnim gastritisom podijeljeno u dvije skupine od po 45 i 20 bolesnika prema terapijskom odgovoru. U objema skupinama su uzorci želučane sluznice analizirani histološki prije i nakon standardne terapije (kod onih s uspješnom eradikacijom nakon jednog terapijskog ciklusa, a u onih s neuspješnom eradikacijom nakon tri terapijska ciklusa) na gustoću H. pylori, aktivnost ureaze i izraženost bcl-2. Eradikacija H. pylori u skupini bolesnika s uspješnom eradikacijom bila je praćena značajno nižim stupnjem bakterijske kolonizacije i nižom aktivnošću ureaze u korpusu i antrumu. Izraženost bcl-2 nije se statistički značajno promijenila ni na jednoj lokaciji ni u jednoj skupini bolesnika. Isto tako, nije bilo nikakve razlike među dvjema skupinama bolesnika u izraženosti bcl-2. Zaključuje se kako je dugotrajna ustrajna infekcija bakterijom H. pylori povezana s višim stupnjem bakterijske kolonizacije i višom aktivnošću ureaze, ali nije povezana s izraženošću bcl-2 u upalnim stanicama