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Abstract : Gleason Score Discrepancies Between Needle Biopsies and Radical Prostatectomy Specimens in an African Men: Clinical Implication
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Abstract: Objective:Gleason scores, as determined by 18-gauge core needle biopsies (NB), were compared with both Gleason scores and the pathological staging of corresponding radical prostatectomy( RP) specimens. The goal was to evaluate the clinical implication and the prognostic impact of these discrepancies. Methods: Records of 234 consecutive patients undergoing a radical retro pubic prostatectomy between 2001 and 2012 were reviewed. In total, all our patients were enrolled, al1 of whom had been diagnosed with adenocarcinoma by transrectal needle biopsies using an 18-gauge automated spring-loaded biopsy gun. Results: Grading errors were greatest with wel1-differentiated tumors. The accuracy was 18 (23%) for Gleason scores of 2-4 on needle biopsy. Of the 108 evaluable patients with Gleason scores of 5-7 on needle biopsy, 84 (78%) were graded correctly. All of the Gleason scores of 8-10 on needle biopsy were graded correctly. 54 of 162 patients (33%), with a biopsy Gleason score of < 7 had their cancer upgraded to above 7. Tumors in 18 patients (60%) with both a Gleason score < 7 on the needle biopsy and a Gleason score of 7 for the prostatectomy specimen were confined to the prostate. Conclusion: The potential for grading errors is greatest with well-differentiated tumors and in patients with a Gleason score of < 7 on the needle biopsy. Predictions using Gleason scores are sufficiently accurate to warrant its use with all needle biopsies, recognizing that the potential for grading errors is greatest with well-differentiated tumors. Keywords: Prostate adenocarcinoma, needle biopsy, radical prostatectomy, Gleason score correlation, prognostic significance.Download Full Article |
Abstract : Salivary Diagnosis: Detection of Several Intracellular Enzymes in Patients with Oral Lichen Planus
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Abstract: Introduction: Oral lichen planus is a chronic inflammatory disease, presenting malignant potential. An association between chronic inflammation and initiation and progression of cancer has long been established. Aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase and gammaglutamil transferase are intracellular enzymes associated with cell injury and cell death. The main aim of the present study is to evaluate changes of enzymatic activity of mentioned enzymes in saliva and serum of patients with oral lichen planus. Materials and Methods: 20 patients with oral lichen planus and 20 healthy controls were included in the present study. Aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alkaline phosphatase (ALP) and gammaglutamil transferase (GGT) were detected in both serum and saliva. Results and Discussions: Salivary levels of ALP were decreased while LDH levels were increased in patients with oral lichen planus vs controls (p<0.05). At the same time GGT and AST levels were decreased (not significantly significant) in oral lichen planus patients and control groups. Serum levels of ALP were markedly increased while GGT was found decreased in patients vs. controls (p<0.05). AST and LDH were decreased but not significantly in oral lichen planus patient’s as compared to controls. Conclusions: Our results reflect increased levels for salivary LDH and serum ALP in patients with oral lichen panus. Saliva can be used as a new diagnostic fluid to detect certain biomarkers such as enzymes in patients with oral lichen planus. Keywords: Oral lichen planus, saliva, inflammation, enzymes, cell injury.Download Full Article |
Abstract : Efficacy of Chemiluminescence (ViziLite™) as a Screening Method in the Detection of Clinically Suspicious Oral Cancerous and Precancerous Lesions
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Abstract: Several screening techniques based on light interaction with tissue have been described to aid clinicians in the detection of early oral cancerous lesions. One of the most studied techniques is chemiluminescence. This method has been used in different studies but always by Oral Medicine specialists. Objective: To evaluate the chemiluminescence system as a screening method in the detection of clinically suspicious cancerous and precancerous oral lesions when used by clinicians without an Oral Medicine Speciality. Study Design: A total of 100 patients attending the Oral Medicine Unit at the Dental School of the University of Seville were enrolled. All patients were current smokers and were above the age of 40. The clinical examination was performed by dental students who were instructed in the location and recognition of potentially malignant oral disorders, using visual examination and the chemiluminescence test ViziLite Plus ™ (Zila Pharmaceuticals, Phoenix, AZ, USA). To assess the validity of the chemiluminescence test as a screening method, a visual exam was performed by a specialist in Oral Medicine which was used as a gold-standard. Results: Conventional oral visual examination by the Oral Medicine Specialist found 13 lesions suspicious for malignancy, out of which 7 were also detected using the chemiluminescence test. Furthermore, 87 patients were diagnosed as lesion-free, of which 49 obtained negative results during the chemiluminescence test and 38 patients had some sort of lesion. With these results, the test yielded a sensitivity of 0.56 and a specificity of 0.56. These results indicate values similar to other studies, in fact lower sensitivity values, possibly due to the lack of experience of the clinician. Conclusions: The chemiluminescence test (ViziLite Plus™) did not present any advantages in terms of cost-benefit compared to conventional examination as a screening method for cancerous and precancerous oral lesions. Keywords: Chemiluminescence, screening method, oral cancer.Download Full Article |
Abstract : Diagnostic Testing of Primary Vitreo-Retinal Lymphoma
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Abstract: Primary Vitreo-Retinal Lymphoma (PVRL) or Primary Intra-Ocular Lymphoma (PIOL) is a rare malignancy often seen as a context of primary central nervous system lymphoma (PCNSL). This article reviews the diagnostic approach of PVRL. The techniques for diagnosing PVRL from ocular biopsy specimens includes cytologic analysis, immuno-cytochemistry, flow-cytometry, polymerase chain reaction (PCR) to detect V-J Ig gene re-arrangements, and analysis of IL6, IL10 in aqueous or vitreous fluid. Currently, cytology in combination with immunohistochemistry is considered the gold standard for the diagnosis of PVRL. But ancillary tests including IgH, TCR gene rearrangements and cytokine analysis are reliable biomarkers for B and T cell PVRL. Genetic testing with t(14:18) detection may show promising results in future. Keywords: Primary vitreoretinal lymphoma, intraocular lymphoma, diagnosis, CNS lymphoma.Download Full Article |
