Borderline conditions in dermato-oncology

This review article provides an overview of the etiology, pathogenesis, clinical presentation, diagnosis, and treatment methods for actinic keratosis, keratoacanthoma, and Bowen’s disease. The provoking factors are described, where the main importance is attached to insolation, previous immunosuppression and immunodeficiency and trauma. The pathogenesis of these diseases is described in the form of cascade models. Various clinical forms and their main dermatoscopic features, suitable for digital processing in automated diagnostic systems, are presented. A stepwise approach to the treatment of these nosologies is described, and a preliminary prognosis is assessed based on the duration of progression and the likelihood of transformation into squamous cell carcinoma. Given the fact that dermato-oncologists have not yet come to a consensus on the classification of the described diseases, in this article they are considered as a borderline, thereby demonstrating a fine line of transition from a precancerous state to cancer in situ.

The process of carcinogenesis described by mathematical formulas

The paper presents neoplasms as dissipative structures formed de novo in the host organism under conditions far from thermodynamic equilibrium. The neoplastic process has also been described as a form of random ”blastoid regeneration” (Fig. 2), and the use of information theory elements in this process has been shown to be expedient. The dissipative (precancerous) state may regress, or a thermodynamic branch may develop, and from it – as a result of neoplastic transformation – neoplasm, as illustrated in Figure 4, in the form of an ontogenetic ”tree”. Structures dissipative with fluctuating changes can probably create more and more organized formations, and thus the molecular level would explain Darwin’s theory of evolution and selection. Neoplasms are emergent structures created in the creative process and as disordered and unstable systems, they tend to the state of thermodynamic equilibrium, i.e. death. Their death can be accelerated by anti-cancer therapy or they die with the death of the macro-organism.

Comprehensive analysis of liver and blood miRNA in precancerous conditions

Streptozotocin administration to mice (STZ-mice) induces type I diabetes and hepatocellular carcinoma (HCC). We attempted to elucidate the carcinogenic mechanism and the miRNA expression status in the liver and blood during the precancerous state. Serum and liver tissues were collected from STZ-mice and non-treated mice (CTL-mice) at 6, 10, and 12 W. The exosome enriched fraction extracted from serum was used. Hepatic histological examination and hepatic and exosomal miRNA expression analysis were serially performed using next-generation sequencing (NGS). Human miRNA expression analysis of chronic hepatitis liver tissue and exosomes, which were collected before starting the antiviral treatment, were also performed. No inflammation or fibrosis was found in the liver of CTL-mice during the observation period. In STZ-mice, regeneration and inflammation of hepatocytes was found at 6 W and nodules of atypical hepatocytes were found at 10 and 12 W. In the liver tissue, during 6–12 W, the expression levels of let-7f-5p, miR-143-3p, 148a-3p, 191-5p, 192-5p, 21a-5p, 22-3p, 26a-5p, and 92a-3p was significantly increased in STZ-mice, and anti-oncogenes of their target gene candidates were down-regulated. miR-122-5p was also significantly down-regulated in STZ-mice. Fifteen exosomal miRNAs were upregulated in STZ-mice. Six miRNAs (let-7f-5p, miR-10b-5p, 143-3p, 191-5p, 21a-5p, and 26a-5p) were upregulated, similarly to human HCC cases. From the precancerous state, aberrant expression of hepatic miRNAs has already occurred, and then, it can promote carcinogenesis. In exosomes, the expression pattern of common miRNAs between mice and humans before carcinogenesis was observed and can be expected to be developed as a cancer predictive marker.

Cervical Whole Slide Histology Image Analysis Toolbox

Cervical intraepithelial neoplasia (CIN) is regarded as a potential precancerous state of the uterine cervix. Timely and appropriate early treatment of CIN can help reduce cervical cancer mortality. Accurate estimation of CIN grade correlated with human papillomavirus (HPV) type, which is the primary cause of the disease, helps determine the patient's risk for developing the disease. Colposcopy is used to select women for biopsy. Expert pathologists examine the biopsied cervical epithelial tissue under a microscope. The examination can take a long time and is prone to error and often results in high inter- and intra-observer variability in outcomes. We propose a novel image analysis toolbox that can automate CIN diagnosis using whole slide image (digitized biopsies) of cervical tissue samples. The toolbox is built as a four-step deep learning model that detects the epithelium regions, segments the detected epithelial portions, analyzes local vertical segment regions, and finally classifies each epithelium block with localized attention. We propose an epithelium detection network in this study and make use of our earlier research on epithelium segmentation and CIN classification to complete the design of the end-to-end CIN diagnosis toolbox. The results show that automated epithelium detection and segmentation for CIN classification yields comparable results to manually segmented epithelium CIN classification. This highlights the potential as a tool for automated digitized histology slide image analysis to assist expert pathologists.

Fifty Years Research Output in Oral Submucous Fibrosis, A Bibliometric Analysis of Publications from 1967 to 2016

Oral submucous fibrosis (OSMF) is a precancerous state which affects the oral cavity. The etiology of OSMF is due to various factors like chilies consumption, deficiency of nutrition, areca nut chewing habits, genetic susceptibility, altered salivary constituents, and autoimmunity and collagen disorders. The present study is undertaken to find out the publication trends on OSMF during 1967-2016. The study mainly focus on year and decade wise research output, national and international collaborations, top journals for publications, most prolific authors, authorship pattern, citations pattern and highly cited papers on OSMF. The results indicate that highest growth rate of publications occurred between the years 1997-2006. India’s research share, citation score and h index was highest among all countries. Central South University, China topped the scene among all institutes. The maximum publications were two authored publications. CP Chiang of National Taiwan University was found to be the most prolific author.

The process of carcinogenesis described by mathematical formulas

The paper presents neoplasms as dissipative structures formed de novo in the host organism under conditions far from thermodynamic equilibrium. The neoplastic process has also been described as a form of random ”blastoid regeneration” (Fig. 2), and the use of information theory elements in this process has been shown to be expedient. The dissipative (precancerous) state may regress, or a thermodynamic branch may develop, and from it – as a result of neoplastic transformation – neoplasm, as illustrated in Figure 4, in the form of an ontogenetic ”tree”. Structures dissipative with fluctuating changes can probably create more and more organized formations, and thus the molecular level would explain Darwin’s theory of evolution and selection. Neoplasms are emergent structures created in the creative process and as disordered and unstable systems, they tend to the state of thermodynamic equilibrium, i.e. death. Their death can be accelerated by anti-cancer therapy or they die with the death of the macro-organism.

Contribution of Imaging in the Diagnosis of Cholangiocarcinoma in Choledochal Cyst

The choledochal cyst is a rare congenital malformation of the bile ducts. It is considered as a precancerous state. The incidence of cancer in choledochal cyst increases with age and occurs around 32 years old. Therefore, young adults are often involved. In adults, clinical signs are rare and unspecific. We are reporting here the case of a cholangiocarcinoma in choledochal cyst in young adult diagnosed by ultrasonography, CT scan, and MRI and confirmed by histopathological examination.

Cervical cancer screening in Hungary – epidemiological, historical and methodological aspects

The issue of cervical cancer has been raised again recently, as opposed to other states of the European Union our country shows a high incidence and mortality rate of cervical carcinoma. Although in the 21st century not a single woman should die of cervical cancer, cervical cancer claims the lives of approximately 500 women in Hungary annually until this day. The most typical point of development is where the columnar epithelium of the cervical canal and the squamous epithelium of the uterine cervix meet, the so called transformation zone (squamocolumnar junction). The disease is a several year long process of squamous epithelium metaplasia. This is what provides the opportunity for screening, as by recognizing the lesion in a precancerous state, treatment is possible prior to the development of a tumor. Authors review some epidemiological, historical and methodological issues related to cervical cancer screening. Orv. Hetil., 2011, 152, 2063–2066.