scholarly journals Results of Two Years Expenience with Fluorescence Bronchoscopy in Detection of Preinvasive Bronchial Neoplasia

1999 ◽  
Vol 5 (2) ◽  
pp. 77-84 ◽  
Author(s):  
Ben J. W. Venmans ◽  
Ton J. M. Van Boxem ◽  
Egbert F. Smit ◽  
Pieter E. Postmus ◽  
Tom G. Sutedja
Keyword(s):  
At Risk ◽  
Patient Group ◽  
Carcinoma In Situ ◽  
Separate Analysis ◽  
Predictive Values ◽  
Neoplastic Lesions ◽  
Preinvasive Lesions ◽  
Bronchial Biopsies

The aim of the study was to determine whether use of fluorescence bronchoscopy improves the detection of preinvasive neoplastic bronchial lesions. The data of all patients who underwent fluorescence bronchoscopy and in whom bronchial biopsies were taken, were analyzed. Most patients were at risk for preinvasive lesions. A total of 174 bronchoscopies were performed in 95 patients. Of the 681 representative biopsies, 31 were found to be moderate dysplastic, 39 were found to be severe dysplastic and 9 exhibited carcinoma in situ. These 79 preinvasive lesions were found in 34 patients. The respective results of fluorescence bronchoscopy in addition to conventional bronchoscopy and of conventional bronchoscopy alone for detection of preinvasive lesions were: sensitivity 85% (67/79) and 59% (47/79); specificity 60% (351/581) and 85% (493/581); positive predictive values of 23% (67/297) and 35% (47/135); negative predictive values of 97% (351/363) and 94% (493/525). A separate analysis of only the first bronchoscopy of each patient showed similar results. Results of fluoresence bronchoscopy were better in the second part of the patient group. We conclude that after a learning period fluorescence bronchoscopy can increase the yield of finding preinvasive neoplastic lesions when used in addition to conventional bronchoscopy.

Carcinoma in situ of the urinary bladder. Effect of associated neoplastic lesions on clinical course and treatment

Cancer ◽  
1987 ◽  
Vol 59 (1) ◽  
pp. 164-173 ◽  
Author(s):  
Iwao Fukui ◽  
Masayuki Yokokawa ◽  
Hideaki Sekine ◽  
Takumi Yamada ◽  
Kazushige Hosoda ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Carcinoma In Situ ◽  
Clinical Course ◽  
Neoplastic Lesions

scholarly journals Galactography Combined with Sonogalactography for Improving the Evaluation of Pathological Nipple Discharge

2020 ◽  
Vol 11 (1) ◽  
pp. 327
Author(s):  
Juan de Dios Berná-Serna ◽  
Florentina Guzmán-Aroca ◽  
César Leal-Costa ◽  
Miguel Alcaraz ◽  
Juan de Dios Berná-Mestre
Keyword(s):  
Gold Standard ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Diagnostic Efficiency ◽  
Predictive Values ◽  
Malignant Lesions ◽  
Diagnosis Algorithm ◽  
Sensitivity Specificity

Diagnosing patients with pathological nipple discharge (PND) is controversial, and therefore a standardized diagnosis algorithm is needed. The objective of this study was to investigate the usefulness of galactography (GL) combined with sonogalactography (SGL) for the evaluation of PND patients. A retrospective study was conducted of 51 patients with PND who were evaluated with GL and SGL. The findings from the galactograms of the patients in this study were assigned to different categories of the Galactogram Image Classification System. Additionally, the sensitivity, specificity, and the positive predictive values and negative predictive values of the GL and SGL tests were calculated, considering the gold standard of pathology diagnosis. The results obtained show that GL combined with SGL improved the diagnostic efficiency of ductal lesions, especially for borderline and malignant lesions. Papilloma was diagnosed in 19 cases, and ductal carcinoma in situ in 8 patients. Conclusions: To the best of our knowledge, this is the first study in which the combination of GL and SGL improves the diagnostic efficiency of ductal lesions of patients with PND. A diagnosis algorithm is recommended for women with PND.

Ductal carcinoma in situ of the breast and gene expression markers for prediction of invasive recurrence

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 550-550
Author(s):  
H. A. McKean ◽  
C. Reynolds ◽  
T. L. Hoskin ◽  
V. J. Suman ◽  
C. S. Grant ◽  
...  
Keyword(s):  
At Risk ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Nuclear Grade ◽  
Adjuvant Radiation ◽  
Continuous Variables

550 Background: Ductal carcinoma in situ (DCIS) is a heterogeneous group of non-invasive cancers with varying propensity for recurrence. There are no validated markers that identify patients at risk for invasive recurrence following lumpectomy. HOXB13/IL17BR (H/I) is expressed in both DCIS and invasive cancer (Ma Cancer Cell. 2004) and associated with recurrence in stage I cancer. A 5-gene molecular grade index (MGI) distinguishes outcome in grade II disease (Ma Clin Cancer Res. 2008). We sought to determine whether H/I or MGI was associated with invasive recurrence in resected DCIS. Methods: We identified patients at Mayo Rochester who underwent lumpectomy ± radiation for DCIS between 1988 and 2001 and performed a nested case/control study. Cases were patients with ipsilateral invasive recurrence, matched to controls based on age, surgery date, length of follow-up, and adjuvant radiation. DCIS was macrodissected from paraffin sections and RNA extracted to obtain H/I and MGI RT-PCR profiles. The association of H/I and MGI with case-control status was assessed with conditional logistic regression; results reported are odds ratios (OR) with 95% confidence intervals (CI). The association of H/I and MGI as continuous variables with nuclear grade (low, intermediate, high) was estimated with Spearman's rank correlation. Results: 427 patients underwent lumpectomy for DCIS, and 33 were identified as possible cases. Histologic review excluded 8 (non-sufficient tissue or DCIS recurrence without invasion). 25 cases were matched to 48 controls (2 controls for 23 cases, 1 control for 2 cases). Both H/I (r = 0.43, p = 0.0001) and MGI (r = 0.41, p = 0.0004) were significantly correlated with nuclear grade. Positive H/I was associated with trend towards higher recurrence (OR 1.9; p = 0.22) that was most pronounced in cases/controls (15/28) treated with lumpectomy alone (OR 3.3; CI: 0.8–13.2, p = 0.09). Similarly, positive MGI was associated with a trend towards higher recurrence risk in patients treated with surgery alone (OR 2.0; CI: 0.6–6.4, p = 0.27). Conclusions: These data suggest that both HOXB13/IL17BR and MGI can identify a subset of patients with surgically resected DCIS who are at risk for invasive recurrence. Further studies in larger cohorts are needed to confirm these findings. [Table: see text]

scholarly journals Multiphoton Microscopy: A Potential Intraoperative Tool for the Detection of Carcinoma In Situ in Human Bladder

2015 ◽  
Vol 139 (6) ◽  
pp. 796-804 ◽  
Author(s):  
Manu Jain ◽  
Brian D. Robinson ◽  
Maria M. Shevchuk ◽  
Amit Aggarwal ◽  
Bekheit Salamoon ◽  
...  
Keyword(s):  
Carcinoma In Situ ◽  
Interobserver Agreement ◽  
Imaging Technique ◽  
Multiphoton Microscopy ◽  
Three Dimensional ◽  
Predictive Values ◽  
Diagnostic Potential ◽  
Subcellular Resolution ◽  
Hematoxylin Eosin

Context Urothelial carcinoma in situ (CIS) is a precursor of invasive bladder cancer, which if left untreated, will likely progress to more aggressive disease. Approximately 50% of CIS lesions are missed on routine cystoscopy owing to their flat architecture. Furthermore, many benign but abnormal-appearing areas may be biopsied owing to lack of cellular resolution of cystoscopes. Multiphoton microscopy (MPM) is an optical imaging technique that generates subcellular-resolution three-dimensional images from unfixed tissue without using exogenous dyes. Objective To assess the diagnostic potential of MPM in identifying and differentiating benign from malignant flat bladder lesions, especially CIS. Design Seventy-eight specimens (benign = 46, CIS = 23, invasive = 9, as diagnosed on histopathology) were obtained from flat bladder mucosa via transurethral resection of bladder, cold cup biopsy, or cystectomy, imaged fresh with a commercial benchtop MPM, and submitted for routine histopathology. Multiphoton microscopy and hematoxylin-eosin diagnoses were compared. Results In 77 of 78 specimens (99%), accurate MPM diagnoses (benign/malignant) were given on the basis of their architectural and cytologic features (nuclear to cytoplasmic ratio, pleomorphism, polarity/organization of urothelial layers, etc). The sensitivity and specificity were 97% and 100%, respectively, with positive (malignant) and negative (benign) predictive values of 100% and 98%, respectively. The interobserver agreement, κ, was 0.93. Conclusions Our study demonstrates the capability of MPM to identify and differentiate benign from malignant flat bladder lesions, especially CIS. With the advent of MPM endoscopes, we foresee their potential as a biopsy guidance tool for early detection and treatment of CIS, thus reducing the rate of biopsies with benign diagnoses and their associated complications.

Sign in / Sign up

Export Citation Format

Share Document