Mapowanie węzłów wartowniczych w raku brodawkowatym tarczycy z zastosowaniem radioznacznika i niebieskiego barwnika

Introduction: In the current study, we evaluated the accuracy of sentinel node mapping in thyroid cancer patients using both radiotracer and blue dye.Material and methods: 30 patients with a diagnosis of papillary thyroid carcinoma (PTC) were included in the study; 2–3 hours before surgery, 0.5 mCi 99m-Tc-Antimony Sulfide Colloid was injected intra-tumourally. 15 minutes post-injection, lymphoscintigraphy images of the neck were obtained. Immediately after anaesthesia induction, 0.5 mL patent blue V was also injected in the same fashion. Sentinel lymph nodes were detected intraoperatively using gamma probe and blue dye. Total thyroidectomy was performed for all patients with dissection of central neck lymph nodes as well as sampling of the lateral neck lymph nodes.Results: At least one sentinel node could be identified during surgery in 19 patients (63.3%). The median number of sentinel nodes per patient was 1. Sentinel nodes in 12 patients were pathologically involved. No false negative case was noted. Upstaging occurred in six patients (20%).Conclusions: Sentinel node mapping in papillary thyroid carcinoma is a feasible technique with high accuracy for the detection of lymph node involvement. This technique can guide surgeons to perform central lymph node dissection only in patients with pathologically involved sentinel nodes. Although SLN detection in the lateral neck lymph nodes increases the extension of lymphadenectomy, SLN mapping can result in upstaging in older patients (> 45 years of age) or treatment plan change in younger patients (< 45 years of age) by the detection of lateral lymph node involvement. (Endokrynol Pol 2014; 65 (4): 281–286)Wstęp: W badaniu oceniono dokładność mapowania węzłów wartowniczych u chorych na raka tarczycy w przypadku jednoczesnego zastosowania radioznacznika i niebieskiego barwnika.Materiał i metody: Do badania włączono 30 chorych z rozpoznaniem raka brodawkowego tarczycy (PTC, papillary thyroid carcinoma). Dwie do trzech godzin przed zabiegiem do guza wstrzykiwano koloid siarczanu antymonu znakowany 99m-Tc (0,5 mCi). Po upływie 15 minut od wstrzyknięcia radioznacznika wykonywano badanie limfoscyntygraficzne szyi. Bezpośrednio po znieczuleniu w ten sam sposób wstrzykiwano 0,5 ml błękitu patentowego V. Węzły wartownicze wykrywano śródoperacyjnie, używając sondy promieniowania gamma i błękitnego barwnika. U wszystkich pacjentów wykonano totalną tyroidektomię z wycięciem węzłów chłonnych szyjnych środkowego przedziału oraz pobraniem wycinków węzłów szyjnych bocznych.Wyniki: U 19 chorych (63,3%) udało się zidentyfikować w trakcie zabiegu co najmniej jeden węzeł wartowniczy. Mediana liczby węzłów wartowniczych na pacjenta wynosiła 1. U 12 chorych w węzłach wartowniczych wykryto zmiany patologiczne. Nie stwierdzono ani jednego przypadku uzyskania fałszywie ujemnego wyniku. U 6 (20%) chorych zmieniono stopień zaawansowania nowotworu na wyższy.Wnioski: Mapowanie węzłów wartowniczych w raku brodawkowatym tarczycy jest dostępną metodą cechującą się dużą dokładnością w wykrywaniu zajętych węzłów chłonnych. Ta metoda może stanowić wskazówkę dla chirurgów, aby usuwać węzły chłonne szyjne środkowego przedziału tylko u pacjentów ze zmianami w węzłach wartowniczych. Mimo że wykrycie węzłów wartowniczych w obrębie węzłów szyjnych bocznych zwiększa zakres limfadenektomii, mapowanie węzłów wartowniczych może spowodować zmianę oceny stopnia zaawansowanie nowotworu u starszych pacjentów (> 45 lat) lub zmianę planu leczenia u młodszych pacjentów (< 45 lat) w związku z wykryciem zmian w węzłach bocznych szyi. (Endokrynol Pol 2014; 65 (4): 281–286

The expression of heat shock proteins 27 and 105 in squamous cell carcinoma of the tongue and relationship with clinicopathological index

Introduction: In oral cavity, the tongue is the most common site prone to development of squamous cell carcinoma (SCC). Considering malignant transformation as a cellular stress, the expression of heat shock proteins (HSPs) may be affected in this process. In this study we assessed the expression of HSP105 and HSP27 as two of the most interested stress proteins and investigated their relationship with grade and stage of the tongue SCC. Material and Methods: Fifty-six specimens including 31 early and 25 advanced tongue SCC were gathered. All specimens were graded histologically from I to III. Sixteen sections of normal oral mucosa were used as control group. The cellularity and intensity of HSP105 and HSP27 expression were studied immunohistochemically in both case and control groups. Results were expressed by histochemical score (HSCORE). Results: Significant differences were observed between expression of HSPs and stage of the disease. From early to advanced stage, the expression of HSP105 and HSP27 increased and decreased, respectively. There was no relationship between histological grade of lesion and HSCORE of HSP105 expression (P=0.5), although, HSP27 expression had reverse relationship with the SCC histological grade. Conclusion: HSP27 and HSP105 may be indicated for prognostic purposes in evaluation of tongue SCC. HSP 27 may be used for more accurate microscopic grading of tongue SCC. Increased expression of HSP105 in advanced stage may lead to using this protein for immunotherapy of tongue SCC. © Medicina Oral S. L

Evaluation of the diagnostic value of Sentinel Lymph Node in patients with gastric adenocarcinoma

Objective(s):  Sentinel lymph node biopsy (SLNB) has been proven as a safe and efficient procedure in some cancers like breast cancer and melanoma with a reduction of complications and side effects of unnecessary lymphadenectomy in many patients. However, the diagnostic value of SLNB in gastric cancer is a point of debate. This study evaluated the diagnostic value of SLNB using radiotracer and isosulphan blue dye injection in patients with Gastric Adenocarcinomas (GA).Methods: This descriptive study was performed at Imam-Reza HOSPITAL on 39 patients diagnosed with GA with no lymphatic metastasis using two methods: the combination of radionuclide with isosulphan together (R&I) method compared with the isosulphan alone method. Lymphatic dissection was performed in all patients. The pathological results were compared between the sentinel lymph nodes (SLN) and other lymph nodes and their accordance rate was calculated.Results: In the T1 group, the sentinel lymph node biopsy detection rate was 100% for the combination of the R&I method and 60% for the isosulphan method and the false negative rate was zero. These values respectively were 88.8% and 88.8% in the T2 group with a false negative rate of 75%. In the T3 group, the values were 100% for the combination of the R&I method and 93.7% for the isosulphan method with a false negative rate of 40%. In the combination of the R&I method, the sensitivity, specificity, and positive and negative predictive values were 57.9, 100, 100, and 69.2 percent respectively.Conclusion: Based on the false negative rate (47.4%), SLNB by injection of isosulphan blue dye alone is not a diagnostic enough value for predicting lymph node metastasis in GA. Although, SLNB by combination of the R&I had better accuracy compared to the isosulphan alone, more studies with larger samples are needed to prove this result

p16INK4a hypermethylation and p53, p16 and MDM2 protein expression in Esophageal Squamous Cell Carcinoma

<p>Abstract</p> <p>Background</p> <p>Tumor suppressor genes <it>p53 </it>and <it>p16</it>^INK4aand the proto-oncogene <it>MDM2 </it>are considered to be essential G1 cell cycle regulatory genes whose loss of function is associated with ESCC carcinogenesis. We assessed the aberrant methylation of the <it>p16 </it>gene and its impact on <it>p16</it>^{<it>INK4a </it>}protein expression and correlations with <it>p53 </it>and <it>MDM2 </it>protein expressions in patients with ESCC in the Golestan province of northeastern Iran in which ESCC has the highest incidence of cancer, well above the world average.</p> <p>Methods</p> <p>Cancerous tissues and the adjacent normal tissue obtained from 50 ESCC patients were assessed with Methylation-Specific-PCR to examine the methylation status of <it>p16</it>. The expression of <it>p16</it>, <it>p53 </it>and <it>MDM2 </it>proteins was detected by immunohistochemical staining.</p> <p>Results</p> <p>Abnormal expression of <it>p16 </it>and <it>p53</it>, but not <it>MDM2</it>, was significantly higher in the tumoral tissue. <it>p53 </it>was concomitantly accumulated in ESCC tumor along with <it>MDM2 </it>overexpression and <it>p16 </it>negative expression. Aberrant methylation of the <it>p16</it>^{<it>INK4a </it>}gene was detected in 31/50 (62%) of esophageal tumor samples, while two of the adjacent normal mucosa were methylated (P < 0.001). <it>p16</it>^{<it>INK4a </it>}aberrant methylation was significantly associated with decreased <it>p16 </it>protein expression (P = 0.033), as well as the overexpression of <it>p53 </it>(P = 0.020).</p> <p>Conclusions</p> <p><it>p16 </it>hypermethylation is the principal mechanism of <it>p16 </it>protein underexpression and plays an important role in ESCC development. It is associated with p53 protein overexpression and may influence the accumulation of abnormally expressed proteins in <it>p53-MDM2 </it>and <it>p16-Rb </it>pathways, suggesting a possible cross-talk of the involved pathways in ESCC development.</p

Ectopic Expression of Human DPPA2 Gene in ESCC Cell Line Using Retroviral System

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Evaluating the Effects and Safety of Intravenous Lipid Emulsion on Haloperidol-Induced Neurotoxicity in Rabbit

There are many reports on the effect of intravenous lipid emulsion (ILE) as an antidote in drugs related toxicities. We determined the effects of ILE on neurotoxicity of haloperidol (HA), a highly lipophilic antipsychotic, as a model of antipsychotics poisoning. We used six groups of five male rabbits. Two groups received distilled water intravenously followed by infusions of either 18 mL/kg of normal saline or ILE 20%, after 30 minutes. The third group received 18 mL/kg of normal saline after HA (2.6 mg/kg) administration. The three other groups received ILE 20% solution (6, 12, and 18 mL/kg) following HA injection. Catalepsy scores, temperature, pupil size, and mortality rate were measured at 0, 0.5, 1, 2, 3, 4, 8, and 24 hours after HA administration began. Blood and tissue samples were taken from all animals at 24 hours or at death time for biochemical, cell count, and pathological studies. ILE reversed cataleptic scores, miotic pupils, and hypothermia of HA intoxication much faster than normal saline ( &lt; 0.001). Biochemical complications and mortality rate of the animals were significantly higher in the HA + 18 mL/Kg ILE group. ILE reversed sings of HA neurotoxicity; however, synergistic effect of high dose of ILE and HA increased complications and mortality

Protective Effect of Silymarin against Acrolein-Induced Cardiotoxicity in Mice

Reactive α,β-unsaturated aldehydes such as acrolein (ACR) are major components of environmental pollutants and have been implicated in the neurodegenerative and cardiac diseases. In this study, the protective effect of silymarin (SN) against cardiotoxicity induced by ACR in mice was evaluated. Studies were performed on seven groups of six animals each, including vehicle-control (normal saline + 0.5% w/v methylcellulose), ACR (7.5 mg/kg/day, gavage) for 3 weeks, SN (25, 50 and 100 mg/kg/day, i.p.) plus ACR, vitamin E (Vit E, 100 IU/kg, i.p.) plus ACR, and SN (100 mg/kg, i.p.) groups. Mice received SN 7 days before ACR and daily thereafter throughout the study. Pretreatment with SN attenuated ACR-induced increased levels of malondialdehyde (MDA), serum cardiac troponin I (cTnI), and creatine kinase-MB (CK-MB), as well as histopathological changes in cardiac tissues. Moreover, SN improved glutathione (GSH) content, superoxide dismutase (SOD), and catalase (CAT) activities in heart of ACR-treated mice. Western blot analysis showed that SN pretreatment inhibited apoptosis provoked by ACR through decreasing Bax/Bcl-2 ratio, cytosolic cytochrome c content, and cleaved caspase-3 level in heart. In conclusion, SN may have protective effects against cardiotoxicity of ACR by reducing lipid peroxidation, renewing the activities of antioxidant enzymes, and preventing apoptosis

Safranal as a safe compound to mice immune system

Objectives: The aim of the present study was to investigate immunotoxic effect of safranal (SAF), a main component of Crocus sativus essential oil, using Balb/c mice. Materials and Methods: SAF was administered intraperitoneally at doses of 0.1, 0.5 and 1 ml/kg for 3 weeks. Hystopathological examination of spleen and bone marrow, cellularity of spleen, delayed type of hypersensitivity (DTH) response, hemagglutination titer (HA), cytokine production and lymphocyte proliferation assay were studied in various groups of animals. Results: Spleen cellularity for SAF groups (0.1 ml/kg SAF: 6.68 [± 0.88] × 107, 0.5 ml/kg SAF: 8.16 [± 1.33] × 107, 1 ml/kg SAF: 6.12 [± 0.59] × 107) did not significantly differ as compared to vehicle control (8.52 [± 1.36] × 107; p > 0.05). In addition, SAF at all doses could not produce any significant changes in hematological parameters, HA titer, DTH and lymphoproliferation responses, as well as in release of cytokines by isolated splenocytes (p > 0.05). Despite a few studies demonstrating some immunomodulatory effects for saffron extract, SAF as a major constituent of saffron did not induce any marked effects in immune system parameters of mice. Conclusion: Contrary to the toxicological studies which have indicated that SAF is more toxic than other active constituents in saffron stigma, at least it was found to be safe to mice immune system and has no toxicity on humoral and cellular immune responses