scholarly journals Computer Based Correlation of the Texture of P63 Expressed Nuclei with Histological Tumour Grade, in Laryngeal Carcinomas

2014 ◽  
Vol 2014 ◽  
pp. 1-13
Author(s):  
Konstantinos Ninos ◽  
Spiros Kostopoulos ◽  
Ioannis Kalatzis ◽  
Panagiota Ravazoula ◽  
George Sakelaropoulos ◽  
...  
Keyword(s):  
Histologic Grade ◽  
Low Grade ◽  
Local Contrast ◽  
Biopsy Specimens ◽  
Architectural Features ◽  
Laryngeal Tumour ◽  
Laryngeal Carcinomas ◽  
Potential Prognostic Factor ◽  
Computer Based ◽  
Grade Ii

Background. P63 immunostaining has been considered as potential prognostic factor in laryngeal cancer. Considering that P63 is mainly nuclear stain, a possible correlation between the texture of P63-stained nuclei and the tumor’s grade could be of value to diagnosis, since this may be related to biologic information imprinted as texture on P63 expressed nuclei.Objective. To investigate the association between P63 stained nuclei and histologic grade in laryngeal tumor lesions.Methods. Biopsy specimens from laryngeal tumour lesions of 55 patients diagnosed with laryngeal squamous cell carcinomas were immunohistochemically (IHC) stained for P63 expression. Four images were digitized from each patient’s IHC specimens. P63 positively expressed nuclei were identified, the percentage of P63 expressed nuclei was computed, and 118 textural, morphological, shape, and architectural features were calculated from each one of the 55 laryngeal lesions. Data were split into the low grade (21 grade I lesions) and high grade (34 grade II and grade III lesions) classes for statistical analysis.Results. With advancing grade, P63 expression decreased, P63 stained nuclei appeared of lower image intensity, more inhomogeneous, of higher local contrast, contained smaller randomly distributed dissimilar structures and had irregular shape.Conclusion. P63 expressed nuclei contain important information related to histologic grade.

scholarly journals RTID-05. INDIGO: A GLOBAL, RANDOMIZED, DOUBLE-BLIND, PHASE 3 STUDY OF VORASIDENIB (AG-881) VS PLACEBO IN PATIENTS WITH RESIDUAL/RECURRENT GRADE II GLIOMA WITH AN ISOCITRATE DEHYDROGENASE 1/2 (IDH1/2) MUTATION

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii194-ii194
Author(s):  
Ingo Mellinghoff ◽  
Martin van den Bent ◽  
Jennifer Clarke ◽  
Elizabeth Maher ◽  
Katherine Peters ◽  
...  
Keyword(s):  
High Risk ◽  
Dose Escalation ◽  
Objective Response ◽  
Data Monitoring Committee ◽  
Progression Free Survival ◽  
High Risk Population ◽  
Low Grade ◽  
Who Grade ◽  
Free Survival ◽  
Grade Ii

Abstract BACKGROUND Low-grade gliomas (LGGs; WHO grade II) are incurable and ultimately progress to high-grade gliomas. The current treatment options are surgery followed by observation (“watch and wait”) for patients with lower risk for disease progression or postoperative chemoradiotherapy (high-risk population). There are no approved targeted therapies. IDH1 and IDH2 mutations (mIDH1/2) occur in approximately 80% and 4% of LGGs, respectively, and promote tumorigenesis via neomorphic production of D-2-hydroxyglutarate. Vorasidenib, an oral, potent, reversible, brain-penetrant pan-inhibitor of mIDH1/2, was evaluated in 76 patients with glioma in two phase 1 studies (dose escalation and perioperative) and was associated with a favorable safety profile at daily doses below 100 mg. Preliminary clinical activity was observed in non-enhancing glioma patients in both studies, with an objective response rate (ORR) of 18.2% and median progression-free survival of 31.4 months in the dose escalation study. METHODS Approximately 366 patients will be randomized 1:1 to vorasidenib (50 mg QD) or matched placebo and stratified by 1p19q status (intact vs co-deleted). Key eligibility criteria: age ≥ 12 years; grade II oligodendroglioma or astrocytoma (per WHO 2016 criteria) not in need of immediate treatment and without high-risk features; centrally confirmed mIDH1/2 status; ≥ 1 surgery for glioma with most recent ≥ 1 year but ≤ 5 years before randomization, and no other anticancer therapy; Karnofsky performance status ≥ 80%; and centrally confirmed measurable, non-enhancing disease evaluable by magnetic resonance imaging. Crossover from placebo to the vorasidenib arm is permitted upon centrally confirmed radiographic progression per RANO-LGG criteria. Primary endpoint: progression-free survival assessed by independent review. Secondary endpoints: safety and tolerability, tumor growth rate assessed by volume, ORR, overall survival, and quality of life. Clinical data will be reviewed regularly by an independent data monitoring committee. The study is currently enrolling patients in the US, with additional countries planned (NCT04164901).

scholarly journals A 25-year retrospective, single center analysis of 343 WHO grade II/III glioma patients: implications for grading and temozolomide therapy

2021 ◽  
Author(s):  
Eike Steidl ◽  
Katharina Filipski ◽  
Pia S. Zeiner ◽  
Marlies Wagner ◽  
Emmanouil Fokas ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Molecular Markers ◽  
Treatment Time ◽  
Real Life ◽  
Patient Characteristics ◽  
Low Grade ◽  
Who Grade ◽  
Idh1 R132h ◽  
Treatment Data ◽  
Grade Ii

Abstract Purpose Classification and treatment of WHO grade II/III gliomas have dramatically changed. Implementing molecular markers into the WHO classification raised discussions about the significance of grading and clinical trials showed overall survival (OS) benefits for combined radiochemotherapy. As molecularly stratified treatment data outside clinical trials are scarce, we conducted this retrospective study. Methods We identified 343 patients (1995–2015) with newly diagnosed WHO grade II/III gliomas and analyzed molecular markers, patient characteristics, symptoms, histology, treatment, time to treatment failure (TTF) and OS. Results IDH-status was available for all patients (259 mutant, 84 IDH1-R132H-non-mutant). Molecular subclassification was possible in 173 tumors, resulting in diagnosis of 80 astrocytomas and 93 oligodendrogliomas. WHO grading remained significant for OS in astrocytomas/IDH1-R132H-non-mutant gliomas (p < 0.01) but not for oligodendroglioma (p = 0.27). Chemotherapy (and temozolomide in particular) showed inferior OS compared to radiotherapy in astrocytomas (median 6.1/12.1 years; p = 0.03) and oligodendrogliomas (median 13.2/not reached (n.r.) years; p = 0.03). While radiochemotherapy improved TTF in oligodendroglioma (median radiochemotherapy n.r./chemotherapy 3.8/radiotherapy 7.3 years; p < 0.001/ = 0.06; OS data immature) the effect, mainly in combination with temozolomide, was weaker in astrocytomas (median radiochemotherapy 6.7/chemotherapy 2.3/radiotherapy 2.0 years; p < 0.001/ = 0.11) and did not translate to improved OS (median 8.4 years). Conclusion This is one of the largest retrospective, real-life datasets reporting treatment and outcome in low-grade gliomas incorporating molecular markers. Current histologic grading features remain prognostic in astrocytomas while being insignificant in oligodendroglioma with interfering treatment effects. Chemotherapy (temozolomide) was less effective than radiotherapy in both astrocytomas and oligodendrogliomas while radiochemotherapy showed the highest TTF in oligodendrogliomas.

Controversies in the Diagnosis of Barrett Esophagus and Barrett-Related Dysplasia: One Pathologist's Perspective

2010 ◽  
Vol 134 (10) ◽  
pp. 1479-1484 ◽  
Author(s):  
John R. Goldblum
Keyword(s):  
English Literature ◽  
Goblet Cells ◽  
High Grade Dysplasia ◽  
Barrett Esophagus ◽  
Low Grade ◽  
High Grade ◽  
Biopsy Specimens ◽  
Columnar Lined Esophagus ◽  
Intramucosal Adenocarcinoma ◽  
Rule Out

Abstract Context.—Pathologists frequently assess esophageal biopsy specimens to “rule out Barrett esophagus,” as well as to assess for the presence or absence of dysplasia. Objective.—To review some of the recent controversies in the diagnosis of Barrett esophagus and Barrett-related dysplasia. Data Sources.—Sources were the author's experience and review of the English literature from 1978 to 2009. Conclusions.—Although goblet cells are required by the American College of Gastroenterology to confirm a diagnosis of Barrett esophagus, this definition might expand to include columnar-lined esophagus without goblet cells. The recognition of dysplasia in Barrett esophagus remains a difficult task for the surgical pathologist, with difficulties in distinguishing reactive epithelium from dysplasia, low-grade dysplasia from high-grade dysplasia, and even high-grade dysplasia from intramucosal adenocarcinoma.

Rare sacral extradural grade II ependymoma: a comprehensive review of literature

2021 ◽  
Vol 14 (11) ◽  
pp. e246540
Author(s):  
Ricardo J Fernández-de Thomas ◽  
Natalie Amaral-Nieves ◽  
Orlando De Jesus ◽  
Emil A Pastrana
Keyword(s):  
Treatment Guidelines ◽  
Myxopapillary Ependymoma ◽  
Low Grade ◽  
Review Of Literature ◽  
Total Resection ◽  
Comprehensive Review ◽  
Sacral Region ◽  
Rare Tumours ◽  
Grade Ii ◽  
Sacral Spinal Cord

Sacral spinal cord ependymoma is an uncommon pathology. Most of the reported cases are consistent with a myxopapillary ependymoma histopathologic subtype. Non-myxopapillary ependymomas rarely occur in the sacral region. Most lesions are intradural; however, rare extradural cases can occur. We present the case of a 46-year-old female patient diagnosed with a grade II sacral extradural ependymoma, emphasising the importance of an interdepartmental case approach for diagnosis and management. Even though grade II ependymomas are considered low grade, the potential for recurrence and metastatic disease has been reported. There are no treatment guidelines for these rare tumours besides gross total resection.

scholarly journals Navigation-guided transsylvian approach and microsurgical resection of a deep left temporal low-grade arteriovenous malformation

2017 ◽  
Vol 43 (videosuppl1) ◽  
pp. V6
Author(s):  
William T. Couldwell
Keyword(s):  
Arteriovenous Malformation ◽  
Superior Temporal Gyrus ◽  
Adolescent Male ◽  
Low Grade ◽  
Link Type ◽  
Transsylvian Approach ◽  
Grade Ii ◽  
Microsurgical Resection ◽  
Martin Grade

This video demonstrates stereotactic-guided resection of a ruptured diffuse left temporal arteriovenous malformation (AVM) in an adolescent male who presented with headache and speech difficulties. The diffuse nidus of the AVM, 25 mm in size, was located in the posterior superior temporal gyrus, with drainage into the sylvian veins (Spetzler-Martin Grade II). The AVM was located stereotactically, and resection was performed through a small corticectomy. The clot cavity was evacuated. Feeding branches to the AVM were identified during careful dissection, and parent M1 and M2 branches were preserved. The patient recovered well, with no residual speech deficit. Postoperative angiogram demonstrated complete AVM removal.The video can be found here: https://youtu.be/Sttc86H8jCw.

Histologic Grade Remains a Prognostic Factor for Breast Cancer Regardless of the Number of Positive Lymph Nodes and Tumor Size: A Study of 161 708 Cases of Breast Cancer From the SEER Program

2014 ◽  
Vol 138 (8) ◽  
pp. 1048-1052 ◽  
Author(s):  
Arnold M. Schwartz ◽  
Donald Earl Henson ◽  
Dechang Chen ◽  
Sivasankari Rajamarthandan
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Nodal Status ◽  
Histologic Grade ◽  
Axillary Lymph Nodes ◽  
Low Grade ◽  
Axillary Lymph ◽  
Data Set

Context.—The appropriate staging of breast cancers includes an evaluation of tumor size and nodal status. Histologic grade in breast cancer, though important and assessed for all tumors, is not integrated within tumor staging. Objective.—To determine whether the histologic grade remains a prognostic factor for breast cancer regardless of tumor size and the number of involved axillary lymph nodes. Design.—By using a new clustering algorithm, the 10-year survival for every combination of T, N, and the histologic grade was determined for cases of breast cancer obtained from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. There were 36 combinations of TN, defined according to the American Joint Committee on Cancer, and grade. Results.—For each combination of T and N, a categorical increase in the histologic grade was associated with a progressive decrease in 10-year survival regardless of the number of involved axillary lymph nodes or size of the primary tumor. Absolute survival differences between high and low grade persisted despite larger tumor sizes and greater nodal involvement, though trends were apparent with increasing breast cancer stage. Statistical significance depended on the number of cases for each combination. Conclusions.—Histologic grade continues to be of prognostic importance for overall survival despite tumor size and nodal status. Furthermore, these results seem to indicate that the assignment of the histologic grade has been consistent among pathologists when evaluated in a large data set of patients with breast cancer. The incorporation of histologic grade in TNM staging for breast cancer provides important prognostic information.

scholarly journals The Role of Extent of Resection in IDH1 Wild-Type or Mutant Low-Grade Gliomas

Neurosurgery ◽  
2017 ◽  
Vol 82 (6) ◽  
pp. 808-814 ◽  
Author(s):  
Toral Patel ◽  
Evan D Bander ◽  
Rachael A Venn ◽  
Tiffany Powell ◽  
Gustav Young-Min Cederquist ◽  
...  
Keyword(s):  
Cox Regression ◽  
Extent Of Resection ◽  
World Health ◽  
Low Grade ◽  
Wild Type ◽  
Who Grade ◽  
Cox Regression Analysis ◽  
Low Grade Gliomas ◽  
Grade Ii ◽  
The Impact

Abstract BACKGROUND Maximizing extent of resection (EOR) improves outcomes in adults with World Health Organization (WHO) grade II low-grade gliomas (LGG). However, recent studies demonstrate that LGGs bearing a mutation in the isocitrate dehydrogenase 1 (IDH1) gene are a distinct molecular and clinical entity. It remains unclear whether maximizing EOR confers an equivalent clinical benefit in IDH mutated (mtIDH) and IDH wild-type (wtIDH) LGGs. OBJECTIVE To assess the impact of EOR on malignant progression-free survival (MPFS) and overall survival (OS) in mtIDH and wtIDH LGGs. METHODS We performed a retrospective review of 74 patients with WHO grade II gliomas and known IDH mutational status undergoing resection at a single institution. EOR was assessed with quantitative 3-dimensional volumetric analysis. The effect of predictor variables on MPFS and OS was analyzed with Cox regression models and the Kaplan–Meier method. RESULTS Fifty-two (70%) mtIDH patients and 22 (30%) wtIDH patients were included. Median preoperative tumor volume was 37.4 cm3; median EOR of 57.6% was achieved. Univariate Cox regression analysis confirmed EOR as a prognostic factor for the entire cohort. However, stratifying by IDH status demonstrates that greater EOR independently prolonged MPFS and OS for wtIDH patients (hazard ratio [HR] = 0.002 [95% confidence interval {CI} 0.000-0.074] and HR = 0.001 [95% CI 0.00-0.108], respectively), but not for mtIDH patients (HR = 0.84 [95% CI 0.17-4.13] and HR = 2.99 [95% CI 0.15-61.66], respectively). CONCLUSION Increasing EOR confers oncologic and survival benefits in IDH1 wtLGGs, but the impact on IDH1 mtLGGs requires further study.

MR Imaging of Hepatocellular Carcinoma

1995 ◽  
Vol 36 (2) ◽  
pp. 163-167 ◽  
Author(s):  
H. Honda ◽  
H. Onitsuka ◽  
Y. Kanazawa ◽  
T. Matsumata ◽  
T. Hayashi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Mr Imaging ◽  
Low Grade ◽  
Hepatic Parenchyma ◽  
Grade Ii ◽  
Paramagnetic Ions ◽  
Grade Malignancy ◽  
Histopathologic Findings ◽  
Signal Intensities ◽  
Grade Iii

In order to clarify the factors contributing to the signal intensities (SIs) of HCC on T1-weighted images, the amount of water, lipid, copper (Cu), iron (Fe), and manganese (Mn) was determined in HCC and surrounding hepatic parenchyma of 13 patients. The relationships among these findings, the histopathologic findings, and the SIs of T1-weighted images were evaluated. Among the 13 HCC, 3 had a high SI, 5 were isointense, and 5 had a low SI on T1-weighted images compared to the surrounding hepatic parenchyma. The paramagnetic ions which contributed to the SI patterns were assumed to be Cu in HCC (38.0±62.4 μg/g ww), and Fe in the liver (61.1±42.4 μg/g ww) and HCC (40.0±34.3 μg/g ww). In 8 HCC with high- or isointensity, 2 were grades I, 5 were grade II, and one was grade III according to the Edmondson-Steiner's histopathologic classification. It is concluded that the SI patterns alone can not be a sign of low grade malignancy because of the existence of Fe in livers and HCC.

scholarly journals ASSESSMENT OF THE EFFECT OF DIFFERENT PARAMETERS OF RADIOTHERAPY ON TREATMENT OUTCOMES OF INFILTRATIVE LOW-GRADE GLIOMA (GRADE II)

2017 ◽  
Vol 16 (4) ◽  
pp. 11-18
Author(s):  
V. A. Solodkiy ◽  
G. A. Panshin ◽  
N. V. Kharchenko ◽  
Z. S. Tsallagova ◽  
S. M. Milyukov ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Grade Ii

scholarly journals Visualization of lenticulostriate arteries during insular low-grade glioma surgeries by navigated 3D ultrasound power Doppler: technical note

2016 ◽  
Vol 125 (4) ◽  
pp. 1016-1023 ◽  
Author(s):  
Andrej Šteňo ◽  
Michaela Jezberová ◽  
Vladimír Hollý ◽  
Gabriela Timárová ◽  
Juraj Šteňo
Keyword(s):  
Power Doppler ◽  
Residual Tumor ◽  
3D Ultrasound ◽  
Technical Note ◽  
Minimal Amount ◽  
Low Grade ◽  
Brain Shift ◽  
Lenticulostriate Arteries ◽  
Grade Ii ◽  
Intraoperative Localization

OBJECTIVE Resection of insular gliomas is challenging. In cases of intraoperative injury to the lenticulostriate arteries (LSAs), the usual result is a dense hemiplegia. LSAs are usually localized just behind the medial tumor border but they can also be encased by the tumor. Thus, exact localization of these perforators is important. However, intraoperative localization of LSAs using conventional neuronavigation can be difficult due to brain shift. In this paper, the authors present a novel method of intraoperative LSA visualization by navigated 3D ultrasound (3DUS) power Doppler. This technique enables almost real-time imaging of LSAs and evaluation of their shift during insular tumor resections. METHODS Six patients harboring insular Grade II gliomas were consecutively operated on at the Department of Neurosurgery in Bratislava using visualization of LSAs by navigated 3DUS power Doppler. In all cases, the 3DUS data were repeatedly updated to compensate for the brain shift and display the actual position of LSAs and residual tumor. RESULTS Successful visualization of LSAs was achieved in all cases. During all surgeries, the distance between the bottom of the resection cavity and LSAs could be accurately evaluated; in all tumors the resection approached the LSAs and only a minimal amount of tissue covering these perforators was intentionally left in place to avoid injury to them. CONCLUSIONS Visualization of LSAs by navigated 3DUS power Doppler is a useful tool that may help to prevent injury of LSAs during removal of insular low-grade gliomas. However, reliability of this method has to be carefully evaluated in further studies.

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