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Biomedical subjects

G Lapertosa

Publications and source records attributed to G Lapertosa.

At least 37 records · Page 2Linked to original sources

Mucin histochemical analysis in the interpretation of Barrett's esophagus. Results of a multicenter study. The Operative Group for the Study of Esophageal Precancer.

A multicentric study of Barrett's esophagus (BE) was started in November 1987 to evaluate (1) the prevalence of BE among subjects undergoing upper gastrointestinal endoscopic examination; (2) the pathologic features of BE; and (3) the correlation between BE and early malignant changes. In 157 of 330 patients who underwent multiple standardized biopsies, BE was confirmed with histologic evaluation. Specialized intestinal-type BE was observed in 84 patients. By applying Alcian blue (pH 2.5)-periodate oxidation-Schiff, high-iron diamine-Alcian blue (pH 2.5), and periodate borohydride-saponification-periodate oxidation-Schiff techniques, the intestinal type of BE was subclassified into colonic and ileal types, both complete and incomplete. Fifty cases had incomplete colonic metaplasia with sulphomucins in the columnar cells and 64 had complete colonic intestinal metaplasia, 49 of them containing O-acetylated sialomucins in the goblet cells. These patients are being included in a short-term follow-up. Dysplasia (six low grade, two high grade) was observed in eight patients in areas of intestinal colonic-type epithelium; in these patients, a complete loss of O-acetylated sialomucins in the dysplastic areas and a remarkable reduction of these mucins in the surrounding tissue were observed. The reduction of O-acetylated sialomucins might indicate relative tissue immaturity, which could represent an early sign of neoplastic dedifferentiation. Therefore, the relevance of O-acetylated sialomucin content in BE, first demonstrated in intestinal type, is now evident, although its biologic importance is being studied.

Adolescent↗

Alcian blue and epithelial membrane antigen are useful markers in differentiating benign from malignant papillae in thyroid lesions.

Immunohistochemistry for epithelial membrane antigen (EMA) and histochemistry for alcianophilic substances were performed in 17 cases of papillary thyroid carcinoma (PTC) and 11 cases of benign thyroid lesions showing papillary changes (7 diffuse hyperplastic goitres-Graves' disease; 4 colloid cystic goitres). In all PTCs the glycocalix of the cells lining the papillary structures was strongly positive with anti-EMA antiserum. Alcian blue pH 2.5 stain (AB 2.5) was also positive in 15 of these cases. In contrast, no cases of benign thyroid lesions showed AB 2.5 positivity in the cells lining the papillary structures and the positivity with anti-EMA antiserum, present in only 5 out the 11 cases, was focal and very weak. These results indicate that the presence and distribution of EMA and alcianophilic substances may be useful in distinguishing benign from malignant thyroid lesions containing papillae.

Alcian Blue↗

Patterns of intestinal metaplasia in gastric biopsies. A comparison of different histochemical classifications.

A total of 217 cases of gastric intestinal metaplasia (IM), out of 491 cases of consecutive multiple gastric biopsies, were examined using various histochemical methods. Three classifications were adopted (1) Jass and Filipe's (1979), (2) Segura and Montero's (1983), and (3) our own distinguishing two types of small intestine IM (incomplete and complete) and two types of colonic IM (incomplete and complete). Our classification revealed (1) a group of 'pure' IM cases (44%), (2) a group of 'combined' IM cases (15%), either small intestinal or colonic, expressing a maturating line, and (3) a conspicuous group of mixed 'mosaic' IM cases (41%) consisting of all possible combinations between the basic IM types. No significant correlations were found between each IM type and associated diseases (i.e. gastritis, stump gastritis, ulcer, adenoma and adenocarcinoma). However, a suggestive association between colonic IM and malignancy was observed. Our results confirmed the heterogeneity of IM and indicated two differentiation cell lines (ileal and colonic), thus providing additional evidence of impaired maturation and aberrant differentiation along various cell lines, supporting Leblond's (1976) unifying theory on the origin of intestinal epithelial cells.

Adult↗

Significance of the smooth muscle cell component in Peutz-Jeghers and juvenile polyps.

We have previously reported the presence of smooth muscle cells (SMCs) in the lamina propria of both tubular and villous adenomatous polyps. In the current study, we investigated the presence and distribution of SMCs with immunohistochemical techniques using anti-alpha smooth muscle actin and anti-desmin antibodies on a series of hamartomatous polyps. In five Peutz-Jeghers polyps, large tree-like branches of SMCs were observed, while in 13 juvenile polyps, rare elongated SMCs were found in the lamina propria, partially surrounding cystically dilated glands. Apart from the quantitative differences, the SMC distribution was similar in the two types of hamartomatous polyps and not dissimilar from the pattern described in neoplastic polyps. These findings make the category "juvenile polyp" less clear and its differentiation from other histologic types of polyp less sharp. Thus, the presence or absence of SMCs cannot form the basis of the differential diagnosis between adenomatous and hamartomatous polyps.

Adolescent↗

[The ambulatory medical treatment of colonic diverticulitis. An open clinico-endoscopic-histological study with rifaximin, a nonaminoglycoside enteric antibiotic].

Twenty patients with mild acute diverticulitis of the colon were treated with rifaximine 400 mg b.i.d. per os per 10 days. From a clinical point of view, spontaneous and evoked abdominal pain, diarrhoea, nausea, leukocytosis and hyperthermia resulted in marked significant reduction at the end of treatment, as compared to the basal data (P less than 0.01). A significant reduction of the peridiverticular oedema, mucosal redness, submucosal haemorrhage and diffuse granular pattern was observed endoscopically at the end of treatment (P less than 0.05). Only a trend toward degrees of vasodilation and submucosa hemorrhage was observed from the histological point of view. No side-effect was observed during and after the treatment period.

Adult↗

[A case of leiomyosarcoma of the small intestine. Clinical and anatomopathologic considerations].

Leiomyosarcoma of the small intestine is a malignant mesenchymal tumour composed of smooth muscle cells from the muscular coat or, rarely, from muscularis mucosae, which in the majority of cases is characterised by a clinically silent development and by an unfavorable prognosis. The considerable difficulty of obtaining a histological definition of the degree of malignancy of the leiomyosarcoma is also typical. The paper reports a clinical case and summarises its main clinical and anatomopathological aspects. In particular, the difficulties of clinical and histological diagnosis of the degree of malignancy are underlined, together with the fact that these have a considerable influence on the possibilities and results of surgical therapy and survival rates.

Female↗

Histochemical study of mucinous ovarian cystomas of intestinal and mixed types: O-acetylated sialomucin content in relation to biologic behavior.

The subgroup of mucinous ovarian cystomas of intestinal type containing site 8 O-acetylated sialomucins and its relation to malignant behavior were studied. Of 75 mucinous cystomas of the ovary from the files of the Institute of Pathological Anatomy and Histology (University of Genoa), 54 were endocervical, 19 were mixed, and 2 were intestinal. As regards their histologic pattern, the 54 mucinous endocervical cystomas were benign, whereas the 19 mixed type group included 8 benign, 5 borderline and 6 malignant; the 2 intestinal type tumors were borderline. According to histochemical investigations, the frequency of tumors with goblet cells containing site 8 O-acetylated sialomucins (positive to PB/KOH/PAS) was 47% in the mixed type cystomas and 100% in the intestinal type cystomas. Twenty-five percent of benign mixed cystomas, 60% of borderline mixed cystomas, and 67% of mixed cystadenocarcinomas were positive to PB/KOH/PAS. One hundred percent of the borderline cystomas of intestinal type were positive. Our results confirm that among mucinous ovarian cystomas, those containing intestinal type epithelium are the most likely to fall within the borderline or malignant categories. Moreover, of all ovarian cystomas of intestinal type, those characterized by site 8 O-acetylated sialomucins seem to be more aggressive and, in general, to have a more malignant behavior than the mucinous cystic tumors of müllerian or endocervical type.

Acetylation↗

Prognostic value of the Jass histopathologic classification in left colon and rectal cancer: a multivariate analysis.

Variables correlated to survival were studied in 121 patients who had undergone potentially curative surgery for left colon and rectal cancer. To investigate the prognostic value of the parameters both univariate and multivariate analysis were carried out. Minimum follow-up was 5 years. Multivariate analysis showed that while disease stage (p less than 0.0001) and site of primary tumor (p less than 0.0006) independently influenced survival, type of surgical procedure and histopathologic grade had no impact on survival. Jass histopathologic classification predicted survival for patient group I and IV whereas no significant relationship was observed for group II and III, which, in our series, were the most frequently encountered groups. Of the three parameters considered for Jass classification, tubule configuration, pattern of tumor growth and lymphocytic infiltration, only the latter was significantly correlated to survival (p less than 0.005). Different results were obtained when the prognostic values of Jass group was investigated separately for the 49 patients with adenocarcinoma of the left colon and the 72 patients with rectal cancer. Further investigation is required before routine clinical application of the Jass classification can be recommended.

Adenocarcinoma↗

[The prognostic value of Jass' histopathological classification of cancer of the left colon and rectum].

Histological material from 121 patients who underwent surgery for cancer of the left colon and rectum was reexamined by two pathologists according to criteria put forward in Jass' histopathological classification. A prevalence of Jass' grades II (36.4%) and III (47.9%) were observed in this series. There was no correlation between the site of neoplasia but there was a clearly increased incidence of advanced stages C and D according to Dukes-Kirklin's classification within Jass' grades II, III and IV (p less than 0.005) and growth pattern, but not for the configuration of tubules. The new histopathological model proved to be more reliable in prognostic terms in the case of cancer of the rectum compared to that of the left colon, but at present its clinical significance is limited to specifying the site and stage of the neoplasia. The latter was found to be the most reliable prognostic parameter.

Adenocarcinoma↗

Grading as a prognostic factor: review of 209 primary gastric cancer patients.

Two hundred and nine cases of primary gastric cancer were treated surgically from January 1968 to December 1983 and analyzed retrospectively. All patients were followed up for a minimum of 5 years. There were 25 SI cases (12%), 22 SII (10.5%), 55 SIII (26.3%) and 107 SIV (51.2%). Tumor grade according to Broders classification showed 50 cases of G1 lesions (23.9%), 44 G2 (21.1%) and 115 G3 (55%). Patients with well differentiated G1 lesion, compared to G2-G3 patients, presented a greater incidence of T1-T2 tumors and decreased incidence of T4 tumors (p less than 0.05). The lymph node involvement rate significantly increased with variation of T (p less than 0.001) but not with tumor grade. Survival results correlated with tumor stage (p less than 0.01) but not with tumor grade or histological type.

Adult↗

Prognostic value of the immunocytochemical detection of extramural venous invasion in Dukes' C colorectal adenocarcinomas. A preliminary study.

In postsurgical staging of colorectal adenocarcinomas, it is sometimes difficult to determine the range of possible venous spread. Distinguishing between the extramural veins (especially when the neoplastic embolus takes up the whole lumen and the endothelium cannot be identified) and the smallest extramural lymph nodes (when they are completely replaced by metastatic carcinoma, leaving the capsule alone) is also difficult. This work proposes a more precise definition of true venous invasion to improve histopathologic staging. Immunohistochemical techniques employing commercial antibodies against Factor VIII RAG, with and without enzymatic digestion, and UEA I lectin for residual endothelium detection, were applied, as well as antibodies against vimentin, desmin, and alpha sm-1 actin to detect wall components. The immunohistochemical evaluation of colorectal adenocarcinomas, in particular by anti-alpha sm-1 actin antibodies, permitted a reliable morphologic distinction of the true venous invasion. This factor proved to be relevant for survival rate prediction.

Actins↗

Distribution and significance of the smooth muscle component in polyps of the large intestine.

Immunocytochemical staining for alpha smooth muscle actin specifically reveals the distribution of the muscularis mucosae and pericryptal intramucosal smooth muscle fibers in the normal mucosa and polyps of the large intestine. In the latter, the muscular component is hyperplastic, especially in pedunculated polyps, which display a thick "muscular zone" at the top of the stalk. The diagnostic (and prognostic) significance of the distribution pattern of the muscular component in polyps, and in "early invasion" cases, is discussed.

Adenoma↗

O-acylated sialic acid variants in mucinous tumours of the ovary.

O-acylated sialic acid variants (site 8) can be demonstrated histochemically by the PB/KOH/PAS method. They are secreted by goblet cells of the lower gastrointestinal tract, by colorectal adenocarcinomas, and by their metastases. Since the metastases are positive only when the primary tumour is positive, O-acylated sialomucins can be considered to be specific markers of colorectal adenocarcinomas if identified in metastases of a tumour of unknown origin. In our histochemical study we evaluated 29 mucinous cystomas of the ovary (23 benign and 6 malignant). We found that six cases were positive to PB/KOH/PAS. The positivity was observed in a limited number of cells and only in areas which presented an intestinal type epithelium. It was also more evident in malignant cystomas than in benign ones. We therefore think that the PB/KOH/PAS positivity can not only be considered a marker of colorectal adenocarcinomas, but also of all neoplasms which originate from an intestinal epithelium or appear to an "intestinal type epithelium".

Adenocarcinoma, Mucinous↗

O-acetylated sialic acid variants in intestinal glandular metaplasia of the urinary tract.

Two cases of chronic cystitis, two of chronic ureteritis, one of chronic pyelitis and two transitional cell carcinomas of the urinary tract showed glandular metaplasia or focal mucin production. Positive staining for O-acetylated sialic acid variants (sites 7 and 8) detected by the PB-KOH-PAS method was found in the two cases of cystitis, in one of chronic ureteritis and in one of chronic pyelitis. Positive staining was observed only in areas showing an intestinal type of metaplasia and in which goblet cells and argyrophil cells were also identified. These findings taken together with earlier studies on ovarian cystadenomas lead the authors to believe that O-acetylated variants are markers of an intestinal type of epithelium. Evaluation of O-acetylated sialomucins may be useful in further studies on the histogenesis of primary adenocarcinomas of the bladder.

Adult↗

Immunohistochemical study of carcinoembryonic antigen, epithelial membrane antigen, and secretory immunoglobulin system in the large bowel adenoma-carcinoma sequence.

To identify parameters for the malignant potential of large bowel adenomas, we used the avidin-biotin-peroxidase complex (ABC) technique. Patterns of carcinoembryonic antigen, epithelial membrane antigen, IgAs, and secretory component in 31 tubular, tubulovillous, and villous adenomas with different grading of dysplasia (mild, moderate, severe) and with early cancer were studied. All markers showed different degrees of staining intensity and various cellular localizations. We found that these variations might be related to dysplasia grading. Adenoma size did not influence the marker patterns. IgAs seemed to be the more selective among the markers studied. Our results suggested a dysplasia-carcinoma sequence instead of an adenoma-carcinoma sequence concept.

Adenocarcinoma↗

Patterns of mucous secretion in normal and pathological conditions of the endocervix.

20 specimens of normal endocervix, 30 of chronic cervicitis, 20 of endocervical polyps and 10 of adenocarcinomas were histochemically investigated in order to assess their mucin pattern. Diastase periodic acid-Schiff (D-PAS), Alcian blue pH 2.5 (AB), High iron-diamine (HID) and HID followed by Alcian blue pH 2.5 (HID-AB) were used. Both the superficial and glandular epithelium of the normal endocervix contained abundant amounts of neutral mucins. Generally sialomucins were scarce and predominant over sulphomucins: the latter were in some cases absent in the proliferative phase of the menstrual cycle and increased in the secretory phase. In chronic cervicitis a slight amount of sulphomucins in the residual glandular epithelium, especially in areas presenting severe inflammation, pseudoerosion, or both was observed. Nabothian cysts mainly contained sulphomucins. In the endocervical polyps, the mucin pattern was various. In adenocarcinomas mucin secretion was usually scanty and mixed with a predominance of sialomucins. Therefore resulted: the mucin pattern of the normal endocervical epithelium is related to the menstrual cycle; the histochemical evaluation of mucous secretion, presently doesn't seem to be helpful in differentiating endocervical from endometrial adenocarcinomas.

Adenocarcinoma↗