987 MRI As A Guide for Prostatectomy Planning

Introduction NICE guidelines suggest that PSA, mp-MRI and targeted biopsies should be used for the diagnosis of prostate cancer. This audit looked at several aspects of prostate cancer assessment and diagnosis at our trust, however we will be focusing on the use of MRI. Method A retrospective cohort study was performed at Lancashire Teaching Hospitals and this included 49 patients. We compared the pre-operative MRI tumour location and tumour grading with post-operative histology tumour location and tumour grading of prostate cancer patients. The statistical analysis was performed using Chi-squared testing. Results Prostate tumour location mapping based on MRI was accurate in 70% of the cases, these results were statistically significant (p-value <0.01). However, the tumour grading according to the MRI was only accurate in 45% of the cases (p-value <0.05). Conclusions Tumour grading based on the MRI result should not be routinely used to stratify risk and plan treatment. However, a prostate planning meeting would be recommended prior to the surgery and this can use the MRI location of the tumour along with the patient’s baseline regarding urinary and erectile function to help plan nerve sparing and surgical margins, this would help improve outcomes for patient's post-operative quality of life.

Prognostic value of PD-L1 expression in bronchopulmonary neuroendocrine tumours

Programmed death protein 1 (PD-1) and its ligand, PD-L1, have emerged as promising therapeutic targets for many types of cancer that overexpress PD-L1. However, data on PD-L1 expression levels in bronchopulmonary neuroendocrine neoplasms (BP-NEN) are limited and contradictory. In the present study, a total of 298 archived, formalin-fixed, paraffin-embedded BP-NEN samples from 97 patients diagnosed with typical carcinoid (TC), atypical carcinoid (AC), small cell lung cancer (SCLC), or large cell neuroendocrine carcinoma of the lung (LCNEC) were evaluated for PD-L1 expression by immunohistochemistry using the highly sensitive monoclonal anti-PD-L1 antibody 73-10. PD-L1 expression levels were semiquantitatively estimated by tumour grading. Of the 298 BP-NEN samples, 85% were positive for PD-L1 expression. PD-L1 immunostaining predominantly localized to the plasma membrane of both tumour cells and tumour-infiltrating immune cells. SCLC and LCNEC exhibited significantly higher PD-L1 expression levels than TC or AC. PD-L1 expression levels were also higher in patients with lymph node or distant metastases, in patients who smoked, and in patients who died during the follow-up period. Moreover, PD-L1 expression levels correlated positively with tumour grading, Ki-67 index and the expression of the chemokine receptor CXCR4 and negatively with the levels of somatostatin receptor 1 and chromogranin A. High tumour PD-L1 levels were associated with poor patient outcomes. In conclusion, PD-L1 expression is common in BP-NEN, increases with malignancy, and is associated with poor prognosis. Therefore, targeting the PD-1/PD-L1 axis could be a promising strategy for treating BP-NEN. PD-L1 may also represent a useful prognostic biomarker for this tumour entity.

Different tumour grading in smokeless tobacco (Naswar) user and non-user in squamous cell carcinoma.

Objectives: To determine the relationship of Naswar with different tumour grading in squamous cell carcinoma. Study Design: Comparative cross-sectional study using non-probability, consecutive sampling. Setting: Department of Oral Pathology, Rehman College of Dentistry, Peshawar, Khyber Pakhtunkhwa, Pakistan. Period: January 2017 till June 2017. Material & Methods: 60 cases of oral squamous cell carcinoma were included. Half the cases (30) had a history of Naswar use while the other half (30) had no history of Naswar use. Data was analysed using SPSS v 22. Results: This study included 60% male and 40% female cases, ranging from 40 years to 80 years (mean = 57.6 + 11 years). Majority of patients 80% had well differentiated squamous cell carcinoma, while the rest (20%) had poorly differentiated. Distribution of male and female across both groups was equal (p 0.598). Both the groups were comparable in terms of grade of tumour (p 0.519). Conclusion: Naswar use was not associated with any particular histological grade of oral squamous cell carcinoma in our study. However, further research is needed to explore this association.

Renal nephroblastoma in a 10-month-old boxer

A 10-month-old male entire Boxer dog was presented for weight loss and abdominal distension with a large mass palpable within the abdomen. A unilateral nephrectomy was performed for a large renal nephroblastoma (30-cm diameter). The nephroblastoma was suspected stage I, with favourable histology (human Wilms tumour grading). No adjunctive chemotherapy was administered. The dog remains clinically well 27 months postnephrectomy. Renal nephroblastomas are rare canine neoplasms and reported survival time is variable. This case and other recent reports suggest that mean survival time may be longer than previously thought. Nephroblastomas should be considered as a differential in young dogs presenting with clinical signs of an abdominal space-occupying lesion. The absence of azotaemia on a biochemical profile does not preclude significant renal pathology.