Ocena wartości prognostycznej wybranych cech klinicznych i objawów mammograficznych w raku piersi

Background: The aim of the work is to assess the probability of the breast cancer occurrence on the basis of analysis of the clinical and mammographical factors in women with unpalpable breast tumor. Material/Methods: In the period from the 1st February 1995 to the 31st August 2000, 163 surgical procedures for the removal of any lesions in the breasts were conducted, after being previously marked by localized needle, in women who earlier underwent mammography exam.Following data was taken into consideration: patients age, type of the breast structure; side of the breast, where the lesion was localized in the mammography exam; localized lesions depending on the quadrant; shape of the lesion; size of the lesion in millimeters; presence and the type of microcalcifications. Results/Conclusions: 1. The only one population factor, which can be distinguished as characteristic for the women suffering from the breast cancer impalpable in clinical testing, is the age of the patient, because the breast cancer in these women more frequently occurs after 53 years of age. 2. On the basis of our own material the following radiological symptoms characteristic for the breast cancer in mammography exam were stated: the breast cancer is more frequently found in the upper external quadrant; all lesions, which in mammography exam were identified as multifocal and radiologicaly suspected in histopathology exam turned out to be the cancer; pleomorphic microcalcifications are characteristic for the malignant lesions; external outline and the shape of the lesion are the features, which allow to differentiate malignant and benign lesions. 3. The analysis of the material indicates that the greatest probability of the breast cancer occurrence is in case of the four risk factors occurrence simultanosly, and the smallest in case of only one risk factor occurrence

Rak wewnątrzprzewodowy, a rak naciekający u chorych z rakiem piersi usuniętym po oznakowaniu igłą lokalizacyjną

Background: Early diagnosis of a breast cancer is very important and challenging aspect in imaging the lesion in the breast. The small lesions visible in imaging exams, in majority of cases are not palpable in clinical testing. The aim of the work is to make a comparison between the clinical features and radiological image in patients with impalpable breast cancer in clinical testing. Material/Methods: 338 operating procedures of the breast tumors removal were conducted after preliminary marking them by the localized needle. The lesion in the breast was shown in the mammography or ultrasonography exam. Results: In histopathology exam the breast cancer was confirmed in 131 women. The ductal carcinoma in situ (DCIS) occurred in 41 (31 %) women and the invasive ductal carcinoma (IDC) in 91 (69 %) women. Microcalcifications find out to be characteristic for the DCIS. The shape of the spicular lesion is characteristic for the invasive carcinoma. DCIS in mammography exam is bigger than invasive carcinoma. Conclusions: 1. The mammography exam is the basic method for the detection of the breast cancer and the best method for the detection of DCIS, which is often visible in the form of microcalcifications. 2. The average size of the DCIS in mammography exam is twice as large than in ultrasonography and three times larger than in histopathology exam. 3. Size of the lesion in microscopic and macroscopic exam is equal with size of the lesion in ultrasound exam and the diameter of the solid center in the mammography and because of that reason, presence of the processes around the malignant tumor, which is visible in mammography exam should not have influenced the qualification for the surgical treatment

Apoptosis of alveolar lymphocytes. Part 1: pathways of lymphocyte apoptosis

Apoptoza jest postacią zaprogramowanej śmierci, zasadniczą w utrzymaniu homeostazy ustrojowej, w tym zapoczątkowania, rozwoju i zejścia reakcji odpornościowych. Wyróżniono dwa główne szlaki apoptozy, zewnątrzpochodny (z pośrednictwem receptorów śmierci) i wewnątrzpochodny (mitochondrialny). Dodatkowo limfocyty o czynności cytotoksycznej inicjują apoptozę komórek docelowych na szlaku granzymów/perforyny (pseudoreceptorowym). Swoiste procesy apoptotyczne, tj. śmierć komórkowa wzbudzona aktywacją (AICD) i śmierć z zaniechania (NID) są odmianami odpowiednio: szlaku zewnątrz- i wewnątrzpochodnego. Obydwa wydają się pełnić kluczową rolę w apoptozie uczulonych antygenowo komórek T w fazie kontrakcji odczynu zapalnego. Limfocyty pęcherzykowe (AL) są prawie wyłącznie efektorowymi komórkami T, uczestniczącymi w patofizjologii śródmiąższowych chorób płuc (ILD). Liczba AL w dolnych drogach oddechowych zależy od rekrutacji do płuc, proliferacji i miejscowej apoptozy. Zgodnie z piśmiennictwem należy zaznaczyć, że AL zwykle nie proliferują w pęcherzykach płucnych, częstość ich apoptozy wynosi około 1% komórek u osób zdrowych i jest ono znamiennie obniżone w chorobach z limfocytowym zapaleniem pęcherzyków, jak sarkoidoza i zewnątrzpochodne alergiczne zapalenie pęcherzyków (EAA). Mechanizmy apoptozy AL nie zostały całkowicie wyjaśnione. Prawdopodobnie zasadnicze znaczenie w wygaszaniu odpowiedzi ze strony komórek T, jak w remisji w EAA lub sarkoidozie, pełni jednak proces NID, podczas gdy mechanizm AICD ma znaczenie pomocnicze i/lub modulujące. Wypada podkreślić, że wiele chorób grupy ILD ma charakter przewlekły bez remisji lub poprawy klinicznej i opisanie ich w kategoriach ekspansji/kontrakcji odpowiedzi immunologicznej napotyka na trudności.Apoptosis is a form of programmed cell death essential for maintaining homeostasis, including onset, progress and resolution of immune reactions. Two major apoptosis pathways: extrinsic (mediated by death receptors) and intrinsic (mitochondrial), were distinguished. Lymphocytes with cytotoxic activity may also initiate apoptosis of target cells by granzyme/perforin (pseudoreceptor) pathway. The specific apoptotic processes, i.e. activation induced cell death (AICD) and neglect induced death (NID), are types of extrinsic and intrinsic pathways, respectively. They both seem to be crucial in apoptosis of antigen-primed T cells during the contraction phase of inflammation. Alveolar lymphocytes (AL) are almost exclusively T effector cells, engaged in interstitial lung disease (ILD) pathophysiologies. The AL numbers in lower airways depends on recruitment to the lung, proliferation and local apoptosis. According to the references, it should be noted that AL usually do not proliferate in alveoli; their apoptosis rate accounts, on average, for 1% of cells in healthy subjects, and this is significantly decreased in disorders with lymphocytic alveolitis such as sarcoidosis and extrinsic allergic alveolitis (EAA). The mechanisms of AL apoptosis have not been completely explained. However, it is the NID process that is probably critical for the culling of T-cell response, as in EAA or sarcoidosis remission, with AICD as an auxiliary and/or modulating mechanism only. It should be emphasised that many ILDs are chronic disorders with no remission or improvement, and it is difficult to describe the AL response in terms of immune expansion/contraction

Enhanced expression of Fas Ligand (FasL) in the lower airways of patients with fibrotic interstitial lung diseases (ILDs)

The exact role of FasL, and particularly its soluble and membrane-bound forms, in the development of chronic ILDs and lung fibrosis has not been extensively explored. We aimed at analyzing membrane-bound FasL expression on alveolar macrophages (AM) and lymphocytes (AL) as well as soluble FasL (sFasL) levels in bronchoalveolar lavage (BAL) from ILDs patients, incl. pulmonary sarcoidosis (PS), hypersensitivity pneumonitis (HP), silicosis, asbestosis, idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonia (NSIP), and healthy subjects (n = 89, 12, 7, 8, 23, 6, 17, respectively). In IPF, significantly increased percentage of AM FasL+ and CD8+FasL+ cells as well as sFasL levels in BAL were found. Increased sFasL levels were also observed in HP. NSIP and asbestosis were characterized by higher AM FasL+ relative number; CD8+FasL+ population was expanded in asbestosis only. There was a significant decline in AL FasL+ percentage in PS and HP. Vital capacity was negatively correlated with sFasL levels, AM FasL+ and CD8+FasL+ cell relative count. CD4+FasL+ and CD8+FasL+ percentage strongly correlated with BAL neutrophilia, an unfavorable prognostic factor in lung fibrosis. The concurrent comparative BAL analysis of FasL expression indicates that FasL+ AM and AL (mainly Tc cells) comprise an important element of the fibrotic process, mostly in IPF. FasL might play a crucial role in other fibrosis-complicated ILDs, like NSIP and asbestosis. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 4, pp. 636–645