• Title/Summary/Keyword: High-Grade Dysplasia

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Efficacy and Safety of Endoscopic Submucosal Dissection for Superficial Gastric Neoplasms: A Latin American Cohort Study

  • Fernando Palacios-Salas;Harold Benites-Goni;Luis Marin-Calderon;Paulo Bardalez-Cruz;Jorge Vasquez-Quiroga;Edgar Alva-Alva;Bryan Medina-Morales;Jairo Asencios-Cusihuallpa
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.248-255
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    • 2022
  • Background/Aims: Endoscopic submucosal dissection (ESD) is the preferred technique for treating early gastric cancer (EGC). However, very few studies have been conducted in South America. This study aimed to assess the efficacy and safety of ESD for EGC. Methods: We analyzed data from a prospective cohort from 2013 to 2020. A total of 152 superficial gastric neoplasms that fulfilled the absolute or expanded criteria for ESD were included. Outcomes were en bloc, R0, and curative resection rates, incidence of adverse events, and length of procedure. Results: The age of the enrolled patients was 68.4±11.3 years. The number of included patients based on the absolute and expanded indications was 150 and 2, respectively. En bloc, R0, and curative resections were achieved in 98.0%, 96.1%, and 89.5% of the cases, respectively. Bleeding and perforation were reported in 5.9% and 6.6% of the cases, respectively. Histopathological examination revealed low-grade dysplasia, high-grade dysplasia, well-differentiated adenocarcinoma, and poorly differentiated adenocarcinoma in 13, 20, 117, and 2 cases, respectively. Conclusions: Our study shows that ESD performed by properly trained endoscopists in reference centers is safe and effective, with comparable therapeutic outcomes to those reported in the Eastern series.

Evaluation of Endoscopic Characteristics of Upper Gastrointestinal Polyps in Patients with Familial Adenomatous Polyposis

  • Fatemi, Seyed Reza;Safaee, Azadeh;Pasha, Sara;Pourhoseingholi, Mohamad Amin;Bahrainei, Rasool;Molaei, Mahsa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6945-6948
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    • 2014
  • Background: Familial adenomatous polyposis (FAP) is a disease inherited in an autosomal dominant fashion. Most FAP patients develop upper gastrointestinal polyps; especially those in the antrum and duodenum are usually neoplastic. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in Iranian FAP patients. Materials and Methods: 28 patients affected by FAP underwent front-view and side-view endoscopy. Papillary biopsies were performed in all patients. Location of polyps, their number and size, pathology study, patient general information (gender, age, family history of FAP or colorectal cancer and gastroduodenal polyps) were analyzed. Results: Gastric polyps were seen in 39.3 % of patients. Some 72.7% of the affected individuals had fundic gland polyps and 36.36% had hyperplastic polyps. Duodenal adenoma was observed in 25% of patients. While 57% of patients had tubular adenoma with low grade dysplasia, 42.8% showed tubulovillous adenoma with low grade dysplasia. Conclusions: Findings of this study indicated that the prevalence of gastroduodenal polyps in FAP patients is high and dysplasia may be evident in duodenal polyps. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.

UCHL1 Overexpression Is Related to the Aggressive Phenotype of Non-small Cell Lung Cancer

  • Chi Young Kim;Eun Hye Lee;Se Hyun Kwak;Sang Hoon Lee;Eun Young Kim;Min Kyoung Park;Yoon Jin Cha;Yoon Soo Chang
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.4
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    • pp.494-504
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    • 2024
  • Background: Ubiquitin C-terminal hydrolase L1 (UCHL1), which encodes thiol protease that hydrolyzes a peptide bond at the C-terminal glycine residue of ubiquitin, regulates cell differentiation, proliferation, transcriptional regulation, and numerous other biological processes and may be involved in lung cancer progression. UCHL1 is mainly expressed in the brain and plays a tumor-promoting role in a few cancer types; however, there are limited reports regarding its role in lung cancer. Methods: Single-cell RNA (scRNA) sequencing using 10X chromium v3 was performed on a paired normal-appearing and tumor tissue from surgical specimens of a patient who showed unusually rapid progression. To validate clinical implication of the identified biomarkers, immunohistochemical (IHC) analysis was performed on 48 non-small cell lung cancer (NSCLC) tissue specimens, and the correlation with clinical parameters was evaluated. Results: We identified 500 genes overexpressed in tumor tissue compared to those in normal tissue. Among them, UCHL1, brain expressed X-linked 3 (BEX3), and midkine (MDK), which are associated with tumor growth and progression, exhibited a 1.5-fold increase in expression compared to that in normal tissue. IHC analysis of NSCLC tissues showed that only UCHL1 was specifically overexpressed. Additionally, in 48 NSCLC specimens, UCHL1 was specifically upregulated in the cytoplasm and nuclear membrane of tumor cells. Multivariable logistic analysis identified several factors, including smoking, tumor size, and high-grade dysplasia, to be typically associated with UCHL1 overexpression. Survival analyses using The Cancer Genome Atlas (TCGA) datasets revealed that UCHL1 overexpression is substantially associated with poor survival outcomes. Furthermore, a strong association was observed between UCHL1 expression and the clinicopathological features of patients with NSCLC. Conclusion: UCHL1 overexpression was associated with smoking, tumor size, and high-grade dysplasia, which are typically associated with a poor prognosis and survival outcome. These findings suggest that UCHL1 may serve as an effective biomarker of NSCLC.

p53 Expression Helps Identify High Risk Oral Tongue Premalignant Lesions and Correlates with Patterns of Invasive Tumour Front and Tumour Depth in Oral Tongue Squamous Cell Carcinoma Cases

  • Viveka, Thangaraj Soundara;Shyamsundar, Vidyarani;Krishnamurthy, Arvind;Ramani, Pratibha;Ramshankar, Vijayalakshmi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.189-195
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    • 2016
  • Oral tongue squamous cell carcinoma (OTSCC) is the most common oral cancer subtype with a maximum propensity for regional spread. Our objective was to study if p53 expression might have any correlation with aggressive patterns of invasion within oral tongue cancers as well as with the histologically identified degree of oral tongue dysplasia. p53 immunoexpression was studied using immunohistochemistry in early staged OTSCCs (n=155), oral tongue dysplasias, (n=29) and oral tongue normal specimens (n=10) and evaluated for correlations with histological and clinicopathological parameters. Our study (n=194) showed a pattern of p53 expression increasing with different grades of tongue dysplasia to different grades of invasive OTSCC (p=0.000). Among the OTSCC tumours, positive p53 expression was seen in 43.2% (67/155) and a higher p53 labelling index was significantly associated with increased Bryne's grade of the tumour invasive front (p=0.039) and increased tumour depth (p=0.018). Among the OTSCC patients with tobacco habits, (n=91), a higher p53 labelling index was significantly associated with increased risk of local recurrence (p=0.025) and with lymphovascular space involvement (p=0.014). Evaluation of p53 through varying degrees of dysplasia to oral tongue cancer indicates that p53 expression is linked to aggressive features of oral tongue cancers and tongue precancers entailing a closer monitoring in positive cases. Among the OTSCCs, p53 expression is associated with tumour aggressiveness correlating with increased grading of invasive tumour front and tumour depth.

Radiographic Evaluation of Hip Dysplasia of the Sapsaree (삽사리 고관절 이형성의 방사선 평가)

  • Song, Gyoung-Ho;Seong, Yun-Sang;Eom, Ki-Dong;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.50-54
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    • 2010
  • This study was carried out to estimate the range of the hip score with 3 radiographic evaluation techniques and to identify the relationship among these methods in 71 Sapsarees (35 males and 36 females). Mean age of dogs was ranged from 4 to 73 months (averaged $24{\pm}18$ months). Hip joints were evaluated with OFA method, BVA/KC scoring scheme, and $PennHIP^{(R)}$ method. Hip joints were graded by the OFA grading system(only used for dogs over 24 month old age). The 64 joints evaluated were graded as good (17.2%), fair (46.9%), mild dysplastic (12.5%), moderate dysplastic (7.8%), and severe dysplastic (15.6%), respectively. In BVA/KC scoring scheme, the mean score of the 86 joints was recorded as $14.5{\pm}12.8$ (range from 2 to 52). The mean of Norberg angle in the 78 joints was $92.5{\pm}8.5$ degree (ranged from 63 to 110.5 degree). In $PennHIP^{(R)}$ method on the 126 joints, the mean DI was resulted as $0.60{\pm}0.16$ (ranged from 0.08 to 1.0). BVA/KC scores were gradually increased with age, positively correlated with OFA grade (r = 0.92, P < 0.001), but inversely proportional to Norberg angle (r = -0.79, P < 0.001). However, there was no correlation between BVA/KC and DI (r = 0.11). It was suggested that Sapsarees have high prevalence of cannine hip dysplasia, so selective breeding among sapsarees having normal hip joints might be necessary for preventing or controlling hip dysplasia.

Advanced endoscopic imaging for detection of Barrett's esophagus

  • Netanel Zilberstein;Michelle Godbee;Neal A. Mehta;Irving Waxman
    • Clinical Endoscopy
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    • v.57 no.1
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    • pp.1-10
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    • 2024
  • Barrett's esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC), and is caused by chronic gastroesophageal reflux. BE can progress over time from metaplasia to dysplasia, and eventually to EAC. EAC is associated with a poor prognosis, often due to advanced disease at the time of diagnosis. However, if BE is diagnosed early, pharmacologic and endoscopic treatments can prevent progression to EAC. The current standard of care for BE surveillance utilizes the Seattle protocol. Unfortunately, a sizable proportion of early EAC and BE-related high-grade dysplasia (HGD) are missed due to poor adherence to the Seattle protocol and sampling errors. New modalities using artificial intelligence (AI) have been proposed to improve the detection of early EAC and BE-related HGD. This review will focus on AI technology and its application to various endoscopic modalities such as high-definition white light endoscopy, narrow-band imaging, and volumetric laser endomicroscopy.

Echocardiographic Diagnosis of Subaortic Stenosis with Severe Deformation of Mitral Valve Apparatus in a Dog

  • Chung, Doo-ri;Yoon, Young-min;Hwang, Tae-sung;Choi, Moon-yeong;Jung, Dong-in;Yeon, Seong-chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.34 no.1
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    • pp.54-57
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    • 2017
  • A 1-year-old castrated male Schnauzer dog was presented with heart murmur. Auscultation revealed systolic murmur located at the left heart base (grade 5/6). There were no remarkable findings on thoracic radiographs. Two-dimensional echocardiography revealed subaortic tunnel-like obstruction at the entrance to the left ventricular outflow tract. Anterior mitral valve leaflet appeared to be tethered to septum with minimal motion. Chordae tendineae was abnormally thickened. Color Doppler analysis revealed turbulent flow starting below the aortic valve. Mitral regurgitation was presented during systole. Spectral Doppler recordings revealed high velocity flow through the aorta and mitral regurgitation. Based on echocardiographic examination, the dog was diagnosed with subaortic stenosis concurrent with mitral dysplasia. The patient was medicated with ${\beta}-blocker$ and diuretics. It has been doing well without apparent clinical signs at 2 year after the diagnosis.

Early-Stage Diagnosis of Cervix using the Polarization Sensitive Optical Coherence Tomography(A Preliminary Study) (편광 민감 광결맞음 단층 촬영 장치를 이용한 자궁경부의 조기 진단(A Preliminary Study))

  • Kang, Jin-Ho;Lee, Sang-Won;Yoo, Ji-Yeong;Kang, Moon-Sik;Kim, Beop-Min;Yoon, Bo-Sung;Kim, Young-Tae;Cho, Nam-Hoon
    • Korean Journal of Optics and Photonics
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    • v.18 no.5
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    • pp.367-372
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    • 2007
  • Cervical dysplasia induces morphologic changes in the cervical epithelium which involve changes in the nuclear/cytoplasmic (N/C) ratio. Since the nucleus is one of the significant scattering sources, the N/C ratio change reflects the degree of circular polarization (DOCP) with the depth of signals. Therefore, we used the polarization-sensitive OCT (PS-OCT) technique to measure the polarization changes caused by scattering. Cervical tissues were obtained from a high-grade squamous intraepithelial lesion (H-SIL) of one woman and from low normal women. We obtained the mean of the DOCP as a function of depth in the cervix and quantified the change ratio of the DOCP using slopes that were determined by linear fits in the epithelium layer. We found that DOCP of H-SIL decayed faster than that of normal tissue because of the higher scattering in H-SIL as expected. This result indicates that the PS-OCT system might be useful in measurements of change ratio of DOCP with depth for screening of cervical dysplasia.

Anal Cancer Screening by Modified Liquid-Based Cytology in an HIV Clinic

  • Patarapadungkit, Natcha;Koonmee, Supinda;Pasatung, Emorn;Pisuttimarn, Pornrith;Mootsikapun, Piroon
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4487-4490
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    • 2012
  • This study aimed to screen for anal cancer and to determine its cytomorphology using liquid-based cytology (LBC) with specimens preserved in 95% ethyl alcohol. Anal swabs were collected for cytological examination from 177 adult, HIV-infected patients. After collection, sample slides were reviewed and classified according to their cytomorphology using the modified Bethesda 2001 system. An abnormal anal Pap smear was found in 26.0% of the patients. The diagnoses were: 66.7% negative for intraepithelial lesions (NIL), 14.1% with atypical squamous cells of undetermined significance (ASC-US), 10.7% (19) with low-grade squamous intraepithelial lesions (LSIL), and 1.13% with high-grade squamous intraepithelial lesions (HSIL). The cytological evaluation was an unsatisfactory result only with 6.67%. The present modified LBC using 95% ethyl alcohol as the preservative could thus be used for anal cancer screening. The number of SILs in Thai HIV-infected patients is lower than that in Western countries. We found anal cytology a satisfactory tool for early screening and detection of anal dysplasia commonly found in high-risk, HIV-infected patients.

Development of Urinary Bladder Pre-Neoplasia by Schistosoma haematobium Eggs and Chemical Carcinogen in Mice

  • Chala, Bayissa;Choi, Min-Ho;Moon, Kyung Chul;Kim, Hyung Suk;Kwak, Cheol;Hong, Sung-Tae
    • Parasites, Hosts and Diseases
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    • v.55 no.1
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    • pp.21-29
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    • 2017
  • Schistosoma haematobium is a biocarcinogen of human urinary bladder (UB). The present study investigated developing UB cancer mouse model by injecting S. haematobium eggs into the bladder wall and introduction of chemical carcinogens. Histopathological findings showed mild hyperplasia to epithelial vacuolar change, and high grade dysplasia. Squamous metaplasia was observed in the S. haematobium eggs+NDMA group at week 12 but not in other groups. Immunohistochemistry revealed significantly high expression of Ki-67 in urothelial epithelial cells of the S. haematobium eggs+BBN group at week 20. The qRT-PCR showed high expression of p53 gene in S. haematobium eggs group at week 4 and S. haematobium eggs+BBN group at week 20. E-cadherin and vimentin showed contrasting expression in S. haematobium eggs+BBN group. Such inverse expression of E-cadherin and vimentin may indicate epithelial mesenchymal transition in the UB tissue. In conclusion, S. haematobium eggs and nitrosamines may transform UB cells into squamous metaplasia and dysplasia in correlation with increased expression of Ki-67. Marked decrease in E-cadherin and increase in p53 and vimentin expressions may support the transformation. The present study introduces a promising modified animal model for UB cancer study using S. haematobium eggs.