Učestalost pločaste metaplazije u karcinoma prijelaznog epitela mokraćnog mjehura

Squamous metaplasia in transitional cell carcinoma of urinary bladder is considered as an adverse prognostic factor. Those patients have weaker response on therapy and lower survival rate. The aim of our study was to determine the incidence of squamous metaplasia in bioptic material according to histologic grade and growth pattern. In our study we used pathohistological data of 1781 patients operated for urinary bladder cancer in Department of Urology of Sestre milosrdnice University Hospital during the period from 1989 to 2000 squamousmetaplasia was found in 5.7% of patients. According to growth pattern, this phenomenon is more frequent in patients with solid growth pattern. In papillary cancers, the higher incidence of squamousmetaplasia was determined in G1 and G2 histologic grade, while in solid growth pattern, the most cases with squamous metaplasia or over 90% were of G3 histologic grade. Muscle layer invasion were present in high percentage of both, papillary and solid urothelial cancers with squamous metaplasia, which imply the high malignant potential of cancers with foci of squamous metaplasia.Pločasta metaplazija u karcinomima urotela mokraćnog mjehura smatra se jednim od važnih, prognostički lošijih znakova ove bolesti. Bolesnici s karcinomima urotela koji sadrže žarišta pločaste metaplazije, slabije reagiraju na terapiju, i imaju značajno kraće preživljavanje. Cilj istraživanja bio je utvrditi učestalost pločaste metaplazije u karcinomima urotela mokraćnog mjehura s obzirom na histološki gradus i način rasta. U radu je pregledana 1771 biopsija karcinoma mokraćnog mjehura pacijenata operiranih na Klinici za urologiju Kliničke bolnice «Sestre milosrdnice». Pločasta metaplazija nađena je u 102 (5,7%) bolesnika. Ova promjena je češće bila zastupljena u karcinomima solidnog načina rasta, osim kod papilarnih karcinoma urotela G1 i G2 stupnja diferenciranosti. Invazija u mišićni sloj stjenke mokraćnog mjehura nađena je u visokom postotku istraživanih karcinoma i papilarnog i solidnog načina rasta, što nedvosmisleno govori o značajnim visokim malignim potencijalima karcinoma urotela s ovom promjenom

Expression of PCNA and Ki-67 Antigens in Oral Lichen Ruber

Prema kriterijima WHO oralni lihen ruber (OLR) ubraja se u prekancerozne lezije. Opažena je češća maligna transformacija i prelazak u planocelularni karcinom pojedinih kliničkih oblika, i to atrofičnih, erozivnih i ulceroznih lezija. Navedeni razlozi naveli su na ispitivanje izmijenjene tkivne ekspresije antigena PCNA i Ki-67 u lezijama OLR-a kao važnih pokazatelja prognoze i tijeka bolesti. Nastojalo se je utvrditi ekspresiju navedenih antigena u lezijama oralnoga lihena i to u odnosu prema pojedinim kliničkim oblicima OLR-a i u odnosu prema kliničkom nalazu. U ispitivanju je bilo uključeno 30 oboljelih (N = 30) s klinički i patohistološki utvrđenom dijagnozom OLR-a. Kontrolnu skupinu tvorile su osobe (N = 15) s klinički i patohistološki potvrđenom dijagnozom oralne leukoplakije (OL). Klinička ispitivanja provedena su na temelju standardnih kliničkih parametara, a biopsijski uzorci obrađeni su imunohistokemijskom metodom primjenom specifičnih monoklonskih protutijela. Dobiveni rezultati pokazali su statistički znatno jaču ekspresiju antigena PCNA i Ki-67 u lezijama OLR-a u usporedbi s lezijama OL. Također je i jača ekspresija na tkivni antigen Ki-67 opažena u lezijama erozivnoga lihena u odnosu na plani oblik. Na temelju dobivenih rezultata može se reći da ovako izmijenjena ekspresija tkivnih antigena PCNA i Ki-67 upućuje na izmijenjenu njihovu prirodu, a pokazatelj je postojanja određenog potencijala moguće maligne transformacije.Oral Lichen Ruber (OLR) is a precancerous lesion of mucous membrane, according to WHO criteria.Increasing frequency of malignant alteration was observed among atrophic, erosive and ulcerous lesions. The aim of this investigation was to define possible malignant potential of OLR lesions by determining the expression intensity of PCNA and Ki-67 antigens, as indicators of activity and proliferation of these lesions. The aim was to determine expression of these antigens in lesions of OLR and compare with some clinical forms of these lesions. The investigation included 30 patients with OLR (N = 30) with clinical and pathologically confirmed diagnosis and a control group of patients with lesion of oral leukoplakia (OL) (N = 15). Clinical tests based on standard clinical tests and methods and biopsy samples were observed by immunohistochemical methods by specific monoclonal antibody. Results showed more statistically significant expression of PCNA and Ki-67 in OLR lesions than in OL lesions and expression was stronger in erosive than in planes forms of OLR. It can be concluded that such altered expression of PCNA and Ki-67 antigens in OLR lesions points to the altered nature of those lesions with the potential to undergo malignant transformation

C-erbB-2 as a Biomarker for Premalignant Potential of Oral Lichen Ruber

Ovim istraživanjem nastojao se procijeniti mogući premaligni potencijal lezija oralnoga lihen rubera (OLR-a) određivanjem intenziteta ekspresije tkivnog antigena c-erbB-2 u odnosu prema kliničkom obliku i kliničkom statusu lezija. Napravljena je usporedba tkivne ekspresije antigena c-erbB-2 između erozivnog (LRE) i planog oblika (LRP) oralnog lihena, te usporedba s intenzitetom upale i hiperkeratozom lezija. U istraživanje je bilo uključeno 30 bolesnika s kliničkom i patohistološkom dijagnozom OLR-a. Dobiveni rezultati uspoređeni su s kontrolnom skupinom koju je tvorilo 15 bolesnika s dijagnozom oralne leukoplakije (OL) koja je verificirana kao leukoplakija simpleks. Tkivni antigen c-erbB-2 dokazan je APAAP i LSAB imunohistokemijskim metodama nakon predhodne obradbe biopsijskih uzoraka u mikrovalnoj peći. Reakcija je pokazala određeni mozaicizam i u intenzitetu i u topografiji pojavljivanja. Opažena je pozitivna reakcija na taj tkivni antigen prvenstveno u spinoznom sloju stanica oralnoga epitela, a negativna je bila u bazalnome sloju stanica. Reakcija je bila intenzivno pozitivna u tonofibrilima stanica spinoznoga sloja. Nije opažena razlika u intenzitetu reakcije na taj tkivni antigen između erozivnog i planog oblika oralnoga lihena. Intenzitet reakcije na tkivni antigen c-erbB-2 nije korelirao s intenzitetom upale, ali je zato pozitivno korelirao s intenzitetom hiperkeratoze lezija. Može se reći da je ekspresija tkivnog antigena c-erbB-2 u lezijama OLR-a izmijenjena, što upućuje na njihovu izmijenjenu prirodu i na njihov određeni premaligni potencijal.The object of this investigation was to estimate the possible premalignant potential of lesions of oral lichen ruber (OLR) by determining the intensity of expression of tissue antigen c-erbB-2 in relation to the clinical form and clinical status of the lesion. Comparison of the tissue expression of antigen cerbB- 2 was carried out between erosive (LRE) and planus form (LRP) oral lichen, and comparison according to the intensity of inflammation and hyperceratous lesions. The investigation included 30 patients with clinical and histopathological diagnosis of OLR. The results obtained were compared with a control group comprising 15 patients with a diagnosis of oral leukoplakia (OL), verified as leukoplakia simplex. Tissue antigen c-erbB-2 was demonstrated by APAAP and LSAB immunohistochemical methods, following prior analysis of biopsy samples in a microwave oven. The reaction showed specific mosaicism, in both intensity and topography occurrence. Positive reaction to this tissue antigen was observed, primarily in the spinous layer of cells of the oral epithelia, while negative reaction occurred in the basal layer of cells. The reaction was intensively positive in the tonofibrile cells of the spinous layer. No difference was observed in the intensity of the reaction to this tissue antigen between erosive and planus form of oral lichen. The intensity of the reaction to tissue antigen c-erbB-2 did not correlate with the intensity of the inflammation, although it positively correlated with the intensity of the hyperkeratose lesion. It can be said that expression of tissue antigen c-erbB-2 in ORL lesions was changed, which indicates their changed nature and specific premalignant potential

Brennerov tumor jajnika

Brenner tumor of the ovary is very rare, mostly benign, small, and unilateral. It mostly occurs in elderly women and produces no symptoms. In the last ten years (1994-2004), seven women were operatively treated at Sestre milosrdnice University Hospital in Zagreb for Brenner tumor. Six patients were treated for this type of tumor, whereas in one patient Brenner tumor was an accidental finding. The former six patients underwent preoperative ultrasonography and Ca 125 determination. The patient age ranged from 41 to 72 years. In six cases, the tumor was unilateral. One patient had a mucionus proliferating cystadenoma in the same ovary affected with benign Brenner tumor. The size of tumors varied from 0.5 to 20 cm in diameter.Brennerov tumor jajnika je vrlo rijedak, uglavnom benigan, većinom malen, najčešće jednostran. Obično se javlja u starijih osoba i ne izaziva nikakve smetnje. U posljednjih 10 godina (1994.-2004.) u Kliničkoj bolnici "Sestre milosrdnice" operirano je sedam bolesnica s Brennerovim tumorom. Šest ih je operirano zbog tumora jajnika, dok je kod jedne bolesnice Brennerov tumor otkriven kao slučajan histopatološki nalaz. Kod šest bolesnica koje su operirane zbog tumora jajnika prijeoperacijski je učinjena ultrasonografija i pretraga na biljeg Ca 125. žene su bile u dobi od 41 do 72 godine. U šest bolesnica je tumor bio jednostran. Kod jedne žene nađen je mucinozni proliferirajući cistadenom u istom ovariju s benignim Brennerovim tumorom. Tumori su bili promjera od 0,5 do 20 cm

Brennerov tumor jajnika

Brenner tumor of the ovary is very rare, mostly benign, small, and unilateral. It mostly occurs in elderly women and produces no symptoms. In the last ten years (1994-2004), seven women were operatively treated at Sestre milosrdnice University Hospital in Zagreb for Brenner tumor. Six patients were treated for this type of tumor, whereas in one patient Brenner tumor was an accidental finding. The former six patients underwent preoperative ultrasonography and Ca 125 determination. The patient age ranged from 41 to 72 years. In six cases, the tumor was unilateral. One patient had a mucionus proliferating cystadenoma in the same ovary affected with benign Brenner tumor. The size of tumors varied from 0.5 to 20 cm in diameter.Brennerov tumor jajnika je vrlo rijedak, uglavnom benigan, većinom malen, najčešće jednostran. Obično se javlja u starijih osoba i ne izaziva nikakve smetnje. U posljednjih 10 godina (1994.-2004.) u Kliničkoj bolnici "Sestre milosrdnice" operirano je sedam bolesnica s Brennerovim tumorom. Šest ih je operirano zbog tumora jajnika, dok je kod jedne bolesnice Brennerov tumor otkriven kao slučajan histopatološki nalaz. Kod šest bolesnica koje su operirane zbog tumora jajnika prijeoperacijski je učinjena ultrasonografija i pretraga na biljeg Ca 125. žene su bile u dobi od 41 do 72 godine. U šest bolesnica je tumor bio jednostran. Kod jedne žene nađen je mucinozni proliferirajući cistadenom u istom ovariju s benignim Brennerovim tumorom. Tumori su bili promjera od 0,5 do 20 cm

The Effect of Nonaromatic Naphthalane on Mice Oral Planocellular Carcinoma - a Pilot Study

Nearomatski visokosteranski naftalan (NAVS) posebna je frakcija hrvatske nafte, iznimno bogata steranima, iz koje je odstranjen aromatski sastav. Steranima se pripisuje bioaktivnost slična steroidnim hormonima, modulatorima tumorskoga rasta. Potaknuti rezultatima prijašnjih in vitro i in vivo studija o inhibitornom efektu NAVS-a na rast planocelularnog karcinoma, proveli smo studiju o njegovu učinku na oralni planocelularni karcinom (OPCC) u miševa. Ciljevi: 1) ispitati valjanost jednostavnog eksperimentalnog modela OPCC-a; 2) ispitati mogući antiproliferativni učinak NAVS-a na postavljenome modelu praćenjem tumorskoga rasta; 3) ispitati antineoangiogeni učinak NAVS-a kao objašnjenje mogućeg antiproliferativnog učinka, te za tu prigodu procijeniti mogućnost križne reaktivnosti anti-humanih imunohistokemijskih markera s mišjim tkivom. Suspenzija od 100 μl s 105 SCC VII stanica inokulirana je intraoralnim putem pod bukalnu sluznicu u 48 singeničnih C3H miševa. Sedam dana nakon inokulacije životinje su podijeljene u 6 jednakih skupina, te se miševima, ovisno o skupini, intratumorski injiciralo po 100 μl sljedećih tvari: parafinsko ulje (PO) kao negativna kontrola, NAVS (u jednoj skupini 7 dana, a u drugoj skupini 14 dana nakon inokulacije tumora), 1, 25 dihidroksiergotamin (1,25-D3) kao pozitivna kontrola, te kombinacije NAVS s 1,25-D3 i PO s 1,25-D3. Rast tumora praćen je tjednim mjerenjem s pomoću kalipera. Životinje su žrtvovane 1., 2., 3. i 4. tjedna nakon aplikacije ispitivanoga sredstva. Histološki pripravci eksplantiranih tumora bojeni su hematoksilin-eozinom te imunohistokemijski s anti-CD34 protutijelima radi procjene tumorske neoangiogeneze. U usporedbi s PO skupinom, tumorski rast i angiogeneza bili su sniženi u 1,25-D3 i NAVS skupinama. NAVS vjerojatno smanjuje rast OPCC-a inhibicijom vaskularne proliferacije potrebne za tumorski rast.Nonaromatic naphthalane (NAVS) is a specific fraction of Croatian oil, extremely rich in steranes from which the aromatic system is removed. Steranes are attributed with bioactivity similar to steroid hormones, modulators of tumour growth. Encouraged by the results of earlier in vitro and in vivo studies on the inhibitory effect of NAVS on the growth of planocellular carcinoma, we carried out a study on its effect on oral planocellular carcinoma (OPCC) in mice. Aims: 1) To test the validity of the simple experimental model OPCC, 2) to test possible antiproliferative effect of NAVS on the above model by monitoring tumour growth, 3) to test the antineoangiogenic effect of NAVS to explain the possible antiproliferative effect, and to estimate the possibility of crisis reactivity of anti-human immunohistochemical markers with mice tissue. A suspension of 100 μl s 105 SCC VII cell was inoculated intraorally under the buccal mucous membrane in 48 syngeneic C3H mice. Seven days after inoculation the animals were divided in six equal groups and the mice, depending on the group, were intratumorously injected with 100 μl of the following substances: paraffin oil (PO) as a negative control, NAVS (in one group 7 days, and in the second group 14 days, after inoculation of the tumour), 1.25 dihydroxyergotamine (1.25-D3) as a positive control, and a combination of NAVS with 1.25 D3 and PO with 1.25- D3. Tumour growth was monitored weekly by measuring with callipers. The animals were sacrificed 1, 2, 3 and 4 week after application of the tested substance. Histological specimens of explanted tumours were stained with hematoxylin-eozine, and immunohistochemically with anti-CD34 antibodies for estimation of tumour neoangiogenesis. Compared with the PO group, tumour growth and angiogenesis were decreased in the 1.25-D3 and NAVS groups. NAVS probably reduced growth by OPCC inhibition of vascular proliferation, needed for tumour growth

Changes in the Tissue Expression of the C-erbB-2 Oncogen in the Oral Lichen Ruber

The aim of this study was to determine the expression intensity of c-erbB-2 antigen in oral lichen planus and erosive form of oral lichen in 30 patients, and to compare the obtained results with the inflammation intensity i.e. hyperkeratosis. The examination of expression intensity of c-erbB-2 antigen was conducted through immunohistochemical analysis by APAAP method. Obtained reaction of examined tissue antigen was positive in individual or in group cells of spinous epithelium layer and mosaically expressed. The reaction was negative in basal cell epithelium layer. Strong intensity reaction was observed in intercellular bridges of spinous cells layer. In control group, the reaction was of uniform strong intensity in all epithelium layers. The reaction was not dependent on the inflammation intensity in lesions but it was positively correlated with their degree of hyperkeratosis. Changed expression of c-erbB-2 antigen in OLR lesions reveals the possibility of potential malignant transformation of these lesions

Histopathologic and Morphometrie Parameters in the Assessment of Oral Lichen Ruber

Kod 30 ispitanika s OLR uzeti su biopsijski uzorci s oralne sluznice u svrhu određivanja histopatoloških obilježja. Uzorci su obrađeni klasičnom histološkom preparatornom tehnikom. Studija je pokazala karakteristične promjene za OLR: hiperparakeratozu kod 53,3% ispitanika uz pojačan nalaz keratohijalinih granula kod 23,3%, akantozu epitela kod 50% uz nalaz papilomatoze kod 66,6%, vakuolarnu degeneraciju citoplazme bazalnih stanica kod 50%, te infiltraciju limfocitima u lamini propriji kod 60% i povećan nalaz makrofaga subbazalno u 40% uzoraka. Na temelju prisutnih histopatoloških obilježja predloženi su detaljniji histopatološki kriteriji za oralni lichen ruber koji mogu biti od dijagnostičke vrijednosti u histološkoj evaluaciji oralnih lezija klinički sličnih oralnom lichen ruberu.Biopsies were taken from thirty examinees with oral lichen ruber in order to establish histopathologic criteria. Specimens were prepared by means o f routine histopathologic procedures. In this study results have shown characteristic changes for OLR: hyperparakeratosis in 53,3% specimens with increased finding o f keratohyaline granules in stratum granulosum in 23,3%, acanthosis in 50% with papillomatosis in 66,6%, vacuolar degeneration o f basal cells cytoplasm in 50%, and subepithelial lymphocytes infiltrate in 60% with increased macrophage finding in 40% o f specimens. On the basis o f present histopathologic characteristics histopathologic criteria for O LR are suggested which can be o f diagnostic value in the histological evaluation o f oral lesions that are clinical similar to OLR

Cytologic Follow-up in Patients with CIN Treated by LLETZ, Cold Knife Conization and Semm’s Cold Coagulation

Management of cervical premalignant lesions starts with abnormal Pap smear. Regular screening of asymptomatic women (the Pap smear) allows us to diagnose and treat preinvasive lesions before they progress to cervical cancer. There is a wide variety of ablative and destructive methods used in treatment of cervical premalignant lesions. In this study we have compared follow-up cytology results in patient groups treated by LLETZ (Large Loop Excision of the Transformation Zone), Cold Knife Conization (CKC) and Semm’s cold coagulation (Electrocoagulation, ECG) according to CIN on target biopsy specimen, and definite therapeutic approach according to patient age, parity and lesion grading. The aim was to evaluate therapeutic success in all three patient groups on the basis of control cytology findings. Normal cytology findings after treatment were recorded in 43 women in LLETZ group (88%), 22 women in CKC group (73%) and in 22 women from the Semm’s cold coagulation group (73%). The importance of the use of diagnostic and therapeutic guidelines and regular follow up is emphasized, bearing in mind primarily the young female population with severe preinvasive lesions of uterine cervix. Treating cervical preinvasive lesions offers an excellent opportunity to prevent the occurrence of cervical cancer in the large majority of women with abnormal cervical smears

C-erbB-2 as a Biomarker for Premalignant Potential of Oral Lichen Ruber

Ovim istraživanjem nastojao se procijeniti mogući premaligni potencijal lezija oralnoga lihen rubera (OLR-a) određivanjem intenziteta ekspresije tkivnog antigena c-erbB-2 u odnosu prema kliničkom obliku i kliničkom statusu lezija. Napravljena je usporedba tkivne ekspresije antigena c-erbB-2 između erozivnog (LRE) i planog oblika (LRP) oralnog lihena, te usporedba s intenzitetom upale i hiperkeratozom lezija. U istraživanje je bilo uključeno 30 bolesnika s kliničkom i patohistološkom dijagnozom OLR-a. Dobiveni rezultati uspoređeni su s kontrolnom skupinom koju je tvorilo 15 bolesnika s dijagnozom oralne leukoplakije (OL) koja je verificirana kao leukoplakija simpleks. Tkivni antigen c-erbB-2 dokazan je APAAP i LSAB imunohistokemijskim metodama nakon predhodne obradbe biopsijskih uzoraka u mikrovalnoj peći. Reakcija je pokazala određeni mozaicizam i u intenzitetu i u topografiji pojavljivanja. Opažena je pozitivna reakcija na taj tkivni antigen prvenstveno u spinoznom sloju stanica oralnoga epitela, a negativna je bila u bazalnome sloju stanica. Reakcija je bila intenzivno pozitivna u tonofibrilima stanica spinoznoga sloja. Nije opažena razlika u intenzitetu reakcije na taj tkivni antigen između erozivnog i planog oblika oralnoga lihena. Intenzitet reakcije na tkivni antigen c-erbB-2 nije korelirao s intenzitetom upale, ali je zato pozitivno korelirao s intenzitetom hiperkeratoze lezija. Može se reći da je ekspresija tkivnog antigena c-erbB-2 u lezijama OLR-a izmijenjena, što upućuje na njihovu izmijenjenu prirodu i na njihov određeni premaligni potencijal.The object of this investigation was to estimate the possible premalignant potential of lesions of oral lichen ruber (OLR) by determining the intensity of expression of tissue antigen c-erbB-2 in relation to the clinical form and clinical status of the lesion. Comparison of the tissue expression of antigen cerbB- 2 was carried out between erosive (LRE) and planus form (LRP) oral lichen, and comparison according to the intensity of inflammation and hyperceratous lesions. The investigation included 30 patients with clinical and histopathological diagnosis of OLR. The results obtained were compared with a control group comprising 15 patients with a diagnosis of oral leukoplakia (OL), verified as leukoplakia simplex. Tissue antigen c-erbB-2 was demonstrated by APAAP and LSAB immunohistochemical methods, following prior analysis of biopsy samples in a microwave oven. The reaction showed specific mosaicism, in both intensity and topography occurrence. Positive reaction to this tissue antigen was observed, primarily in the spinous layer of cells of the oral epithelia, while negative reaction occurred in the basal layer of cells. The reaction was intensively positive in the tonofibrile cells of the spinous layer. No difference was observed in the intensity of the reaction to this tissue antigen between erosive and planus form of oral lichen. The intensity of the reaction to tissue antigen c-erbB-2 did not correlate with the intensity of the inflammation, although it positively correlated with the intensity of the hyperkeratose lesion. It can be said that expression of tissue antigen c-erbB-2 in ORL lesions was changed, which indicates their changed nature and specific premalignant potential