Diagnostic and predictive value of horizontal sections of scalp biopsy specimens in male pattern androgenetic alopecia

Introduction: Scalp biopsy is a standard method for the definitive diagnosis of alopecia. The hair count parameters of each scalp area remain unclear. This study aimed to determine hair count values at different scalp locations from histopathology and to establish reference values for each part of the scalp. Methods: We obtained biopsy specimens from the frontal, vertex, temporoparietal, and occipital areas of the scalps of normal deceased subjects. All specimens were evaluated for the number of follicular units, hair counts, hair types, and stages of the hair cycle. Results: In total, 240 specimens were collected from 60 cadavers. Across all scalp sites, the temporoparietal area showed the lowest mean hair count, number of follicular units, terminal and vellus hairs, and terminal-to-vellus hair ratio. The average anagen-to-telogen hair ratio was comparable across all scalp sites. This study did not observe a significant association of hair parameters with gender differences or increasing age in all scalp areas. Conclusions: The present study revealed the diversity of the hair index among different scalp areas and suggested that normal hair count values should be separately standardized on each scalp region. Our findings may provide useful reference values for the histopathological evaluation of hair disorders in Asians.

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Rapid in vitro assay for predicting response to fluorouracil in patients with metastatic breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1995.13.2.419 ◽

1995 ◽

Vol 13 (2) ◽

pp. 419-423 ◽

Cited By ~ 5

Author(s):

R M Elledge ◽

G M Clark ◽

J Hon ◽

M Thant ◽

R Belt ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Clinical Response ◽

Tumor Cells ◽

Predictive Value ◽

Metastatic Breast ◽

In Vitro Assay ◽

Vitro Assay ◽

Biopsy Specimens

PURPOSE To determine if a rapid 3H-uridine uptake assay using breast tumor cells from biopsy specimens could predict clinical response to fluorouracil (5FU) in patients with metastatic breast cancer. PATIENTS AND METHODS A double-blind prospective study was conducted of 60 patients with measurable, metastatic breast cancer who had failed to respond to at least one prior chemotherapy regimen. Patients received 5FU 300 mg/m2/d by continuous infusion and were monitored for response. Tumor cells from biopsy specimens were grown in microwells and exposed for 3 days to 0.1, 1.0, 10.0, and 100.00 micrograms/mL of 5FU on strips coated with drug and extracellular matrix. Cells were pulsed with 3H-uridine overnight. Incorporated radioactivity was compared for wells with and without drug. Results were available 4 days from specimen submission. RESULTS Of 45 eligible patients, 11 (24%) were not assessable in vitro. Nine patients were assessable in vitro, but not clinically. Of the remaining 25 patients, who were assessable both clinically and in vitro, there was one complete response (CR), five partial responses (PRs), five cases of stable disease, and 14 cases of progressive disease, for an objective response rate of 24%. Response in vitro was significantly correlated with clinical response (P = .002). Of six clinical responders, five also responded in vitro, for an assay sensitivity of 83%. Of 19 nonresponders, 17 were nonresponders in vitro, for a specificity of 89%. The positive predictive value of the test was 71% (five of seven), and the negative predictive value was 94% (17 of 18). CONCLUSION Results of an in vitro assay were significantly correlated with clinical response in patients with metastatic breast cancer treated with continuous infusion 5FU.

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RA08.04: IMPORTANT ENDOSCOPIC AND HISTOPATHOLOGICAL CHARACTERISTICS FOR PREDICTING SUBMUCOSAL TUMOR INVASION IN SUPERFICIAL BARRETT ADENOCARCINOMA

Diseases of the Esophagus ◽

10.1093/dote/doy089.ra08.04 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 38-38

Author(s):

Ken Namikawa ◽

Kaoru Nakano ◽

Naoki Akazawa ◽

Akiyoshi Ishiyama ◽

Jyunko Fujisaki

Keyword(s):

Tumor Size ◽

Predictive Value ◽

Tumor Invasion ◽

Submucosal Invasion ◽

Depth Of Invasion ◽

Tumor Diameter ◽

Poorly Differentiated Adenocarcinoma ◽

Macroscopic Type ◽

Biopsy Specimens ◽

Poorly Differentiated

Abstract Background Predicting the depth of invasion of superficial Barrett adenocarcinoma (s-BA) is important for choosing an appropriate treatment. This study aimed to evaluate the endoscopic and histopathological characteristics related to s-BA submucosal invasion. Methods We retrospectively reviewed 67 lesions in 63 cases with pathologically defined s-BA (SSBE, n = 56; LSBE, n = 7) that underwent endoscopic resection at our hospital from January 2004 to December 2017. Initial treatment included endoscopic mucosal resection (EMR) (n = 4), endoscopic submucosal dissection (ESD) (n = 99), and surgery (n = 33). We grouped 133 lesions into two groups based on depth of tumor invasion: group M comprised 87 intramucosal tumors and group SM comprised 49 submucosal tumors. We defined characteristic criteria for submucosal invasion as follows: tumor size ≥ 21 mm, complex macroscopic type; composed of > 2 macroscopic types, biopsy-por; biopsy specimens including poorly differentiated adenocarcinoma. Endoscopic ultrasound (EUS) was performed only in cases in which predicting the depth of tumor invasion was difficult. Results In group M, the median tumor diameter was 13 (range, 1–82) mm and included 68 SSBEs and 19 LSBEs. In group SM, the median tumor diameter was 23 (range, 4–55) mm and included 41 SSBEs and 8 LSBEs. Tumors larger than 21 mm were seen in 12 (13.8%) patients in group M and 25 (51.0%) in group SM. Complex macroscopic type tumors were present in 20 patients (23.0%) in group M and 30 (61.2%) in group SM. Biopsy-por was present in 2 (2.3%) in group M and 12 (24.5%) in group SM. Multivariate analysis indicated the above three characteristics as independent predictors of submucosal invasion; in particular, biopsy-por was highly significant (P < 0.001, odds ratio, 10.81). EUS was performed in 55 lesions including 28 tumors invading the submucosa. Sensitivity, specificity, positive predictive value, and negative predictive value of EUS for predicting submucosal invasion were 46.4%, 70.4%, 61.9%, and 57.5%, respectively. Conclusion Tumor size ≥ 21 mm, complex macroscopic type, and biopsy specimens including poorly differentiated adenocarcinoma were independent predictors of submucosal invasion. Specificity of EUS was relatively high for cases that were difficult to predict depth of tumor invasion. Disclosure All authors have declared no conflicts of interest.

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Clinical and Histopathologic Predictors of Disaccharidase Deficiency in Duodenal Biopsy Specimens

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz091 ◽

2019 ◽

Vol 152 (6) ◽

pp. 742-746 ◽

Cited By ~ 1

Author(s):

Robyn C Reed ◽

M Cristina Pacheco

Keyword(s):

Predictive Value ◽

Gold Standard ◽

Chart Review ◽

Retrospective Chart Review ◽

Mucosal Injury ◽

Clinical Suspicion ◽

Duodenal Biopsy ◽

Biopsy Specimens ◽

Active Inflammation ◽

Intraepithelial Lymphocytosis

Abstract Objectives Disaccharidase (DS) activity in duodenal biopsy specimens is the gold standard for diagnosing DS deficiency. We investigated strategies to reduce the need for DS testing and whether clinical or histopathologic factors predict DS deficiency. Methods A retrospective chart review analyzed 1,678 DS results in children, biopsy indication(s), and duodenal histopathology. Results One or more DSs were abnormal in 42.8%. Sufficient lactase predicted sucrase, palatinase, and maltase sufficiency (negative predictive value 97.7%). Three patients had sucrase-isomaltase deficiency (0.2%). DS deficiency was more common in biopsy specimens for positive celiac serology (78.0%). Villous blunting, intraepithelial lymphocytosis, and active inflammation predicted DS deficiency; a combination of any two had an 81.4% positive predictive value. Conclusions Utilization could be reduced by only testing cases with normal duodenal histopathology and ongoing clinical suspicion for DS deficiency after reviewing pathology. In cases with suspected celiac disease and/or mucosal injury, DS deficiency is common and likely secondary, limiting test utility.

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