Tubular gastric adenocarcinoma: machine learning-based CT texture analysis for predicting lymphovascular and perineural invasion

PURPOSELymphovascular invasion (LVI) and perineural invasion (PNI) are associated with poor prognosis in gastric cancers. In this work, we aimed to investigate the potential role of computed tomography (CT) texture analysis in predicting LVI and PNI in patients with tubular gastric adenocarcinoma (GAC) using a machine learning (ML) approach.METHODSSixty-eight patients who underwent total gastrectomy with curative (R0) resection and D2-lymphadenectomy were included in this retrospective study. Texture features were extracted from the portal venous phase CT images. Dimension reduction was first done with a reproducibility analysis by two radiologists. Then, a feature selection algorithm was used to further reduce the high-dimensionality of the radiomic data. Training and test splits were created with 100 random samplings. ML-based classifications were done using adaptive boosting, k-nearest neighbors, Naive Bayes, neural network, random forest, stochastic gradient descent, support vector machine, and decision tree. Predictive performance of the ML algorithms was mainly evaluated using the mean area under the curve (AUC) metric.RESULTSAmong 271 texture features, 150 features had excellent reproducibility, which were included in the further feature selection process. Dimension reduction steps yielded five texture features for LVI and five for PNI. Considering all eight ML algorithms, mean AUC and accuracy ranges for predicting LVI were 0.777–0.894 and 76%–81.5%, respectively. For predicting PNI, mean AUC and accuracy ranges were 0.482–0.754 and 54%–68.2%, respectively. The best performances for predicting LVI and PNI were achieved with the random forest and Naive Bayes algorithms, respectively.CONCLUSIONML-based CT texture analysis has a potential for predicting LVI and PNI of the tubular GACs. Overall, the method was more successful in predicting LVI than PNI

Epstein-Barr virus infection in patients with chronic gastritis without Helicobacter pylori infection

WOS: 000529401300002PubMed: 32343232Background/Aims: the association of Epstein-Barr virus (EBV) with gastric malignancies has been proven by many studies in the literature. However, information about EBV-associated inflammation/gastritis remains limited. the aim of this study is to establish the prevalence of latent EBV infection in patients with chronic gastritis without H. pylori infection. Materials and Methods: in this study, 119 patients with gastritis without H. pylori infection were included. Furthermore, 28 patients with H. pylori gastritis were included in the study as a control group. Chromogenic in situ hybridization (EBV-encoded RNA) and immunohistochemistry (LMP-1 antibody) were performed in all 147 cases. the prevalence of EBV and its relationship with age, sex, the affected part of the stomach, the density of inflammation, inflammatory activity, intestinal metaplasia, and atrophy were analyzed. Results: in this study, 14 cases showed positive immunostaining for EBV. EBV positivity was seen mostly in the lymphoid tissue (13 cases), but it was also detected at the gastric epithelium (7 cases). the mean age of the patients was 44 years, which was slightly younger than that of the EBV-negative cases (48 years). the inflammation density was higher in EBV-positive cases than the EBV-negative gastritis cases (p=0.002). Intestinal metaplasia was detected in 7% of the cases. EBV-positive cases had a higher incidence of atrophy without intestinal metaplasia (21% vs 3.8% without EBV). Conclusion: EBV was detected in 12% of the cases with gastritis without H. pylori infection. Endoscopic follow-up may be appropriate for patients with gastritis, who have atrophy without intestinal metaplasia and are H. pylori negative but EBV positive

Comparison of World Health Organization 2000/2004 and World Health Organization 2010 classifications for gastrointestinal and pancreatic neuroendocrine tumors

Gastroenteropancreatic neuroendocrine tumors (GEPNETs) were divided into 4 groups based on tumor diameter and stage in World Health Organization (WHO) 2000/2004 classification as well-differentiated endocrine tumor benign (WDETB), well-differentiated endocrine tumor with uncertain behavior (WDETUB), well-differentiated endocrine carcinoma (WDEC), and poorly differentiated endocrine carcinoma (PDEC). World Health Organization 2000/2004 was not widely accepted because of stage-related classification and the category of "uncertain behavior." The European NET Society proposed a grading classification and site-specific staging system in 2010. Gastroenteropancreatic NETs were divided into 3 groups as NET grade 1 (G1), NET grade 2 (G2), and neuroendocrine carcinoma (NEC) grade 3 (G3) based on mitoses and the Ki-67 index. We evaluated 63 GEPNET cases according to both classifications. We compared two classifications and the tumor groups in terms of prognostic parameters (diameter, mitosis, Ki-67 index, angioinvasion, perineural invasion, necrosis, and metastasis) and pathologic stage. All 14 cases diagnosed as PDEC were included in the NEC G3 according to WHO 2010. Seventeen cases were diagnosed as WDETB, 9 as WDETUB, and 23 as WDEC. There was statistically significant difference between these groups in terms of all prognostic parameters except for necrosis, mitosis, Ki-67 index, and grade. All WDETB cases, 89% of WDETUBs, and 87% of WDECs were included in the NET G1. There were 45 cases evaluated as NET G1 and 4 cases as NET G2 according to WHO 2010. Metastasis and perineural invasion were more common in NET G2, no significant differences in other parameters. In conclusion, WHO 2010 is easier to use, whereas WHO 2000/2004 shows higher correlation with prognosis. However, it includes benign and uncertain behavior categories, although small tumors with low proliferative activity can also cause metastases. All GEPNETs should be considered potentially malignant (C) 2015 Elsevier Inc. All rights reserved

Effects of Intracordal Estradiol and Dexamethasone Injection on Wound Healing in Vocal Fold Injuries

38th National Congress of Turkish Otorhinolaryngology and Head and Neck Surgery -- OCT 26-30, 2016 -- Antalya, TURKEYSunter, Ahmet Volkan/0000-0001-8601-0450; Yildiz, Muhammet/0000-0002-1771-7345WOS: 000486445200025PubMed: 29496298Objective. the aim of this study was to investigate the effects of intracordal estradiol and dexamethasone injection on wound healing in vocal fold injuries. Study Design. A prospective controlled animal study was carried out. Setting. This study was conducted at a tertiary center. Subjects-Methods. Ten rabbits were randomly divided into two groups. As surgical procedure, cordotomy technique was performed in the middle third of the vocal folds bilaterally. in the first group, 0.1 mL of dexamethasone was injected into the right side, and 0.1 mL of saline was injected into the left side. in the second group, 0.1 mL of estradiol was injected into the right side, and 0.1 mL of saline was injected into the left side. Animals were sacrificed after 1 month and laryngeal specimens were evaluated histopathologically. Results. No statistically significant difference was observed in terms of inflammatory response, epithelial thickness, type I and III collagen, and hyaluronic acid parameters in dexamethasone and estradiol injections compared to the saline injection. in terms of elastin level, estradiol injection demonstrated statistically higher values compared to the saline injection. Elastin level of dexamethasone injected vocal folds was not statistically different compared to the saline injection. No significant differences were observed in terms of inflammatory response, epithelial thickness, type I and III collagen, and hyaluronic acid parameters between the estradiol and dexamethasone injected vocal folds. Conclusion. It is thought that the effects of estradiol or dexamethasone injections may have similar effects on wound healing in vocal fold injuries. Intracordal estradiol injection has positive effects on tissue elastin levels

The relationship between diverticula and low-grade mucinous neoplasm of the appendix. Does the diverticulum play a role in the development of periappendicular mucin deposition or pseudomyxoma peritonei?

Prevalences of diverticulum and low-grade mucinous neoplasm (LGMN) were reported as 0.04-2% and less than 1% in the appendix. In this study, the frequency of diverticulum in LGMN cases, the relationship between diverticula and periappendicular mucin, and the possible role of diverticula in pseudomyxoma peritonei pathogenesis were researched. Through systematic review and targeted search, 38 LGMN and 96 diverticula were identified, frequencies and relationship between diverticulum and LGMN were analysed. Diverticulum and LGMN were determined in 4.8% and 1.04%, respectively, of 1922 appendectomy materials specifically grossed by the same pathologist. The prevalence of diverticulum was higher in our study than literature. The difference may be due to detailed macroscopic examination. Diverticulum was detected in 60% of LGMN cases. The rate of diverticulum was found to be significantly higher in LGMNs than non-neoplastic diverticulum (p < 0.001). Periappendicular mucin deposition was significantly more frequent in LGMN cases with diverticulum than in other groups (p < 0.05). Follow-ups were available in 18 patients; none of them had mucin deposition in the peritoneal cavity. We detected that periappendicular mucin was highly associated with diverticula in LGMN cases. Periappendicular acellular mucin deposition may not give rise to pseudomyxoma peritonei. We may think that mucin could move out of the appendix through the diverticulum rather than neoplastic spread in some of these cases

Servikal sitolojide skuamöz hücre anormallikleri saptanan olgularda Histopatolojik Korelasyon]

Objective: To investigate the correlation between cytology and cervical biopsy in patients with squamous cell abnormality on cervical cytology. Material and Method: The cervical smears diagnosed in our clinic between 2005-2008 were reviewed retrospectively. Cases which exhibited squamous cell abnormality (n: 374) were evaluated. Results: The mean age was 45.15 +/- 10.78. In the cytopathological results, 256 (68.4%) ASC-US, 21 (5.6%) ASC-H, 31 (8.2%) LSIL, 48 (12.8%) HSIL, and 8 (4.8%) invasive carcinomas were diagnosed. Histopathological results were 213 (57%) nonneoplastic, 85 (22.7%) CIN I, 14 (3.7%) CIN II, 34(9.0%) CIN III and 28 (7.5%) invasive squamous cell carcinomas. Including all squamous cell abnormalities, the sensitivity of the smear test in CIN I and higher grade lesions was 56.95% and the false positivity was 43.04%. Excluding ASC-US and ASC-H lesions, the sensitivity of the smear test was 77.31% and the false positivity was 22.68%. After evaluating cervical cyto-histopathological correlation, the positive predictive value was found to be 100% in invasive carcinoma, 62% in HSIL and 38% in LSIL. Conclusion: As the grade of cytopathological result increases, the correlation between biopsy and the smear test also increases. The high sensitivity of the cervical smear test for high-grade lesions shows that it is an effective screening test

Galectin-3 Expression in Human Endometrium and Decidua During The Menstrual Cycle and in Gestation

OBJECTIVE: G3 is one of the members of the lectin family that may be involved in the establishment of endometrial receptivity by regulating the proliferation and adhesion of endometrial cells. STUDY DESIGN: Immunohistochemical expression of G3 was tested in late secretory phase of the endometrium (SPE)(n=30), proliferative phase of the endometrium (PPE)(n=34), and decidua (n=41) and induced abortions in the first trimester. RESULTS: Expression of G3 during the PPE was low; 12 cases were score 1 and 19 cases were score 2 (p<0.001). However, among the late SPE, there were 11 cases at score 2, and 15 cases at score 3. In the decidua expression of G3, 37 cases were score 3 (p<0.001). CONCLUSION: There is a significant progression of G3 expression in SPE and gestation. Although during the PPE expression is considerably lower. This shows that G3 plays an important role in implantation