Evaluation of pre-operative clinical finding and per-operative assessment of carcinoma stomach in tertiary settings of Bangladesh

2020 ◽  
Vol 22 (1) ◽  
pp. 43-46
Author(s):  
Mst Jesmen Nahar ◽  
Md Mahiuddin Matubber ◽  
Md Mahbubur Rahman ◽  
Md Mahbubur Rahman ◽  
Syed Muhammad Baqul Billah ◽  
...  
Keyword(s):  
Lymph Node ◽  
Clinical Picture ◽  
Preoperative Evaluation ◽  
Lymph Node Involvement ◽  
Lesion Detection ◽  
Clinical Feature ◽  
P Value ◽  
Operative Finding ◽  
Node Involvement ◽  
Carcinoma Stomach

Background: Carcinoma stomach, a major killer cancer all over the world, is still presenting late in developing countries due to delay in early diagnosis, lack of awareness, infrastructure etc. Objectives: To establish the importance of preoperative evaluation on operability of carcinoma stomach. Methods: Sixty clinically and histopathologically diagnosed ca stomach cases who underwent surgery in department of Bangabandhu Sheikh Mujib Medical University, Dhaka, and Dhaka Medical College Hospital, Dhaka in 2011 were assessed with clinical picture, investigations, preoperative evaluation and peroperative findings were recorded. Z test for proportion was used to assess clinical decision predictability with a p value of :s;0.05 as significant. Results: Male (73.33%) predominant with 2.75:1 male:female ratio was observed. Mobility, fixity and abdominal lymphadenopathy were not well detected through clinical assessment (p=0.001) while ascites, metastasis and Shelf of Slummer were similar in both clinical and operative finding. The endoscopy of upper GIT finding gave a unique picture as the findings were almost same as were found during operation. USG detected a lesser proportion of the clinical condition compared to peroperative condition whereas CT performed better than the USG except for the lesion detection. Though Computed Tomography (CT) detected higher percentage of lesion, metastasis, ascites and lymph node involvement compared to ultrasonogram (USG), it was significantly higher only for lesion detection (p=0.002) and lymph node involvement (p=<0.001). In the similar manner USG assessment of lesion detection (p=<0.001) and lymph node involvement (p=0.003) was significantly low compared to operative finding. When we looked between CT and operative finding only lesion detection was significantly low (p=0.01) indicating CT to be most effective predictor of clinical picture for operative decision. Preoperative plan were mostly not in accordance with peroperative decision except for total gastrectomy. Conclusion: The study indicates weakness in clinical detection and pre-operative plan compared to per-operative finding. Hence combination of clinical feature and investigation tools especially endoscopy of upper GIT combined with CT is recommended to predict a better operative decision. Journal of Surgical Sciences (2018) Vol. 22 (1): 43-46

scholarly journals The Utility of CA125 and HE4 in Patients Suffering From Endometrial Cancer

2019 ◽  
Vol 8 (1) ◽  
pp. 95-100
Author(s):  
Narges Zamani ◽  
Mitra Modares Gilani ◽  
Majid Mirmohammadkhani ◽  
Sharzad Sheikhhasani ◽  
Azamsadat Mousavi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Preoperative Evaluation ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Surgical Staging ◽  
P Value ◽  
Preoperative Serum ◽  
Serum Ca125 ◽  
Node Involvement

Objectives: Uterine endometrial cancer (EC) is the most common female reproductive system malignancy. There are various comments on pelvic and para-aortic lymphadenectomy during the surgical staging of EC. Several oncologists believe that total lymphadenectomy, in some cases, may lead to operative morbidity without any considerable advantage over more surveillance, especially in patients with comorbidities. The purpose of the current study was to examine the correlation between serum tumor marker levels and stage, grade, histological type, myometrial invasion, and lymph node involvement in EC. Materials and Methods: A total of 131 patients with EC participated in the present cross-sectional study. Preoperative serum CA125 and HE4 levels were evaluated 1 week before surgery. Then, the stage, grade, and lymph node involvement were recorded according to the pathological findings. After Data analysis through SPSS software, P value<0.05 was considered to be significant. Results: One hundred thirty-one patients with EC (70, 31, 15, and 15 patients in sequence with stages IA, IB, II, and III) were analyzed. The serum CA125 and HE4 levels were significantly higher in more advanced stages (over IA), (P=0.016 and P=0.004, respectively). Levels of both tumor markers were significantly higher in patients with lymph node involvement, and cervical and myometrial invasions. In logistic regression analysis, a significant correlation was found between HE4 level (odds ratio [OR]=1.005, P=0.035) and grade of disease (OR=2.137, P=0.005). Conclusions: HE4 and CA125 are useful for predicting high-risk patients. Sensitivity of 64% and specificity of 60% were indicated at cut-off value of 70 pmol/L for HE4 in stage IA in comparison with stages over IA. Although the ideal cut-off which is defined as higher than 80% was not obtained, such a cut-off (60%) can also be considered for preoperative evaluation of surgical staging of EC.

scholarly journals The Role of BiP and the IRE1α–XBP1 Axis in Rhabdomyosarcoma Pathology

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4927
Author(s):  
Mahmoud Aghaei ◽  
Ahmad Nasimian ◽  
Marveh Rahmati ◽  
Philip Kawalec ◽  
Filip Machaj ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Lymph Node ◽  
Tumor Development ◽  
Tumor Stage ◽  
Lymph Node Involvement ◽  
P Value ◽  
Adult Disease ◽  
Specific Tumor ◽  
Node Involvement ◽  
The Unfolded Protein Response

Background: Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma in children, and is associated with a poor prognosis in patients presenting with recurrent or metastatic disease. The unfolded protein response (UPR) plays pivotal roles in tumor development and resistance to therapy, including RMS. Methods: In this study, we used immunohistochemistry and a tissue microarray (TMA) on human RMS and normal skeletal muscle to evaluate the expression of key UPR proteins (GRP78/BiP, IRE1α and cytosolic/nuclear XBP1 (spliced XBP1-sXBP1)) in the four main RMS subtypes: alveolar (ARMS), embryonal (ERMS), pleomorphic (PRMS) and sclerosing/spindle cell (SRMS) RMS. We also investigated the correlation of these proteins with the risk of RMS and several clinicopathological indices, such as lymph node involvement, distant metastasis, tumor stage and tumor scores. Results: Our results revealed that the expression of BiP, sXBP1, and IRE1α, but not cytosolic XBP1, are significantly associated with RMS (BiP and sXBP1 p-value = 0.0001, IRE1 p-value = 0.001) in all of the studied types of RMS tumors (n = 192) compared to normal skeletal muscle tissues (n = 16). In addition, significant correlations of BiP with the lymph node score (p = 0.05), and of IRE1α (p value = 0.004), cytosolic XBP1 (p = 0.001) and sXBP1 (p value = 0.001) with the stage score were observed. At the subtype level, BiP and sXBP1 expression were significantly associated with all subtypes of RMS, whereas IRE1α was associated with ARMS, PRMS and ERMS, and cytosolic XBP1 expression was associated with ARMS and SRMS. Importantly, the expression levels of IRE1α and sXBP1 were more pronounced in ARMS than in any of the other subtypes. The results also showed correlations of BiP with the lymph node score in ARMS (p value = 0.05), and of sXBP1 with the tumor score in PRMS (p value = 0.002). Conclusions: In summary, this study demonstrates that the overall UPR is upregulated and, more specifically, that the IRE1/sXBP1 axis is active in RMS. The subtype and stage-specific dependency on the UPR machinery in RMS may open new avenues for the development of novel targeted therapeutic strategies and the identification of specific tumor markers in this rare but deadly childhood and young-adult disease.

scholarly journals Correlation of lymph node size and their metastatic infiltration in gastric adenocarcinoma

2020 ◽  
Vol 7 (7) ◽  
pp. 2151
Author(s):  
Pratap Kumar Deb ◽  
Syed Abul Fazal
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Significant Proportion ◽  
Metastatic Potential ◽  
Lymph Node Involvement ◽  
Reliable Criterion ◽  
Lymph Node Size ◽  
Node Involvement ◽  
Carcinoma Stomach ◽  
High Chance

Background: In adenocarcinoma stomach, lymph node involvement is a significant predictor of survival, and a decisive factor in planning management. Size has always been an important criterion while considering the metastatic status of the node, in its radiological evaluation or otherwise. However, to what extent the size of a node can be considered as a reliable criterion for its metastatic potential remains a question.Methods: The present study is based on retrieving lymph nodes per operatively from patients of carcinoma stomach, measuring each node, evaluating its metastatic status and comparing the results to find a correlation between these two parameters.Results: The present study, examined a total of 187 nodes from 30 gastrectomy specimens. Among them, metastasis was found in 59 nodes (31.55%). Among these metastatic nodes, 34 (57.62%) were actually less than 5mm in size. Among the total sizes of all the lymph nodes examined, the mean±SD (standard deviation) of the metastasis positive nodes were found to be 6.42±3.86 mm, while that of the non-metastatic nodes were found to be 5.51±1.99 mm. However, it was also observed that larger nodes (>1 cm), tend to have a high chance of being malignant (62.5%).Conclusions: The above study shows though large nodes tend to be malignant, ignoring small nodes can lead to gross under staging or incomplete clearance while treating patients of adenocarcinoma stomach. Smaller nodes constitute a significant proportion of malignant nodes and must be evaluated. Size is not a reliable criterion of metastasis in lymph nodes of carcinoma stomach.

scholarly journals Comparison of MRI findings with actual HPE findings in case of carcinoma endometrium

2016 ◽  
Author(s):  
Shaveta Gupta
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Common Finding ◽  
Mri Findings ◽  
Pelvic Mri ◽  
Histopathological Findings ◽  
Node Involvement ◽  
Cervical Involvement

Objectives: The objectives of this study is to investigate the correlation of magnetic resonance imaging (MRI) in predicting the depth of myometrial invasion, cervical involvement and lymph node involvement and actual histopathological findings in the women with endometrial cancer. Methods: This is a reterospective study of the patients of endometrial cancer from Nov 2011 to Jan 2016 who underwent Surgery (Total abdominal Hystrectomy with B/l salpingoophorectomy with peritoneal washings with b/l pelvic lymphadenectomy with or without para aortic lymphadenectomy) at our centre Max Superspeciality Hospital. CE MRI Pelvis has been done pre operatively in every patient. After the surgery Histopathological reports of the specimen checked and compared with MRI findings of that case. The purpose of the study is to evaluate the validity of MRI findings of endometrial cancer in comparison to final histopathological findings. Results: For the detection of myometrial invasion, overall sensitivity of MRI is 93.9%, specificity is 66.6%, for cervical involvement Senstivity is 60% and specificity 1s 93.75% and for detection of lymph node involvement sensitivity is 66.6% and specificity is 93.5%. Most common Finding on MRI is thickened endometrium with disruption of Junction jone. Conclusions: Preoperative pelvic MRI is a sensitive method of identifying invasion to the myometrium in endometrial cancer. MRI Is a sensitive noninvasive modality in predicting locoregional spread in ca endometrium. Senstivity in detecting Myometrial invasion is high but sensitivity is less in detecting cervical involvement and lymph node involvement is less.

Effects of Tumor Volume on Lymph Node Involvement and Prognosis at Stage pt3 Colon Cancers

2021 ◽  
Author(s):  
Mustafa Şentürk ◽  
Halil Özer ◽  
Abdülkadir Çelik ◽  
Mehmet Aykut Yıldırım ◽  
Murat Çakır ◽  
...  
Keyword(s):  
Lymph Node ◽  
Tumor Volume ◽  
Lymph Node Involvement ◽  
Colon Cancers ◽  
Node Involvement
Sign in / Sign up

Export Citation Format

Share Document