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L Diamanti

Publications and source records attributed to L Diamanti.

28 records · Page 2Linked to original sources

Prostatic intra-epithelial neoplasia. Qualitative and quantitative analyses of the blood capillary architecture on thin tissue sections.

The aim of our study was to qualitatively and quantitatively investigate the capillary architecture on lectin Ulex Europaeus agglutinin I-stained histological section in prostatic intra-epithelial neoplasia. The capillaries appeared as small, short or elongated vessels with either a smooth or undulated external contour and either virtual or visible lumen, sometimes with a clearly identifiable endothelial nucleus/i. In the benign prostatic hyperplasia and prostatic intra-epithelial neoplasia categories, the capillaries appeared located in close contact with (i.e. touching) or in proximity to the basement membrane of ducts and acini. In the invasive adenocarcinoma category, on the contrary, the capillaries in general appeared interspersed within the tumour stroma and septa. Our quantitative studies of the capillary architecture showed that, going from benign prostatic hyperplasia through prostatic intra-epithelial neoplasia up to invasive adenocarcinoma, an increasing proportion of capillaries becomes shorter, with open lumen and undulated external contour and with a greater number of endothelial cells. The highest proportion of touching capillaries was seen in benign prostatic hyperplasia, while the lowest was in invasive adenocarcinoma, being intermediate in prostatic intra-epithelial neoplasia. When the prostatic intra-epithelial neoplasia samples were divided into low-grade and high-grade, the feature values in the low-grade approached those in benign prostatic hyperplasia, whereas in the high-grade they were close to invasive adenocarcinoma. Half of the benign prostatic hyperplasia samples were taken from total prostatectomies because of the preoperative diagnosis of prostatic adenocarcinoma. The feature values in this subcategory were close to those of prostatic intra-epithelial neoplasia of low grade.

Adenocarcinoma↗

Aneuploidy and nuclear features of prostatic intraepithelial neoplasia (PIN).

Quantitative analyses (QAs) of prostatic intraepithelial neoplasia (PIN) helped to objectively define some traditional features of the lesion because, first, changes in value are represented by numbers and not by subjective evaluation of morphologic clues. QAs have also helped to identify subtle abnormalities. For example, the degree of nucleolar margination is a new diagnostic feature which can be easily evaluated as the proportion of nucleoli touching the nuclear membrane. Thirdly, QAs have provided useful insights into understanding some morphologic changes. PIN, in fact, appears to be characterized by complex changes which involve the secretory cells as well as the basal layer and which affect the surrounding stroma. In the epithelial lining, two types of simultaneous changes take place, the first in the nucleus (expression of abnormal proliferative and/or renewal activity) and the second in the cytoplasm (expression of the disorder in cell differentiation), pointing out that only PIN samples of high grade can be considered as having acquired the characteristics of a neoplastic lesion.

Aneuploidy↗

Computer-aided S-phase fraction determination in DNA static cytometry in breast cancer. A preliminary methodologic study on cytologic material.

This methodologic study was performed on a single-cell-cycle breast carcinoma to evaluate the feasibility of computer-aided S-phase fraction determination in DNA static cytometry. The investigation was performed on Feulgen-stained cytologic material in which the total optical density values of 1,000 consecutive, randomly selected nuclei were analyzed (MultiCycle software). A good correlation in the S-phase fraction value with flow cytometry was obtained when the G2/G1 ratio was fixed at 1.95, when the histogram data points were smoothed at least once and the coefficient of variation of the G2 peak was the same as that of G0-G1 or when a first-order S-phase polynomial model was used. The percentages of nuclei in G0-G1 and G2 were somewhat similar to those obtained with flow cytometry. The greatest discrepancy with flow cytometry was observed in the value of the coefficient of variation of the G0-G1 peak of the static cytometric data: it was at least twice as great. It always remained high despite the software options used. As for the influence of the sample size in the S-phase calculation, the software was also run on samples of 600 and 200 nuclei. When the G2/G1 ratio was fixed at 1.95, the data obtained from 600 nuclei did not differ from those obtained with 1,000 nuclei, whereas an analysis on 200 nuclei showed a substantial variation. The software also allowed calculation of the ratio of the G0-G1 peak of the neoplastic population against that of the diploid reference (DNA index), the value of which in flow cytometry was 1.0.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗

Quantitative analysis of nucleolar margination in diagnostic cytopathology.

The diagnostic value of nucleolar margination, defined as the percentage of nucleoli touching the nuclear membrane, was investigated in 359 cytological preparations of benign and malignant lesions of the thyroid, breast, prostate and central nervous system. Premalignant lesions of the uterine cervix and non-invasive papillary carcinomas of the bladder were also examined. It was observed that the percentages in benign lesions were, in general, lower than in the malignant and that the values increased progressively with increasing grade in the cervix and bladder. When the overlap index was calculated, this gave exact information on the usefulness of nucleolar margination in distinguishing benign from malignant lesions, particularly in the prostate and thyroid and, to a lesser extent, in the breast and central nervous system. As for lesions of different grades, the calculation of the index allowed the identification of two subgroups, one corresponding to low grades (mild cervical dysplasia or urothelial papillary carcinoma of grade 1), the other subgroup to high grades (severe cervical dysplasia and carcinoma in situ, or papillary carcinoma of grade 3). Moderate dysplasia cases and grade 2 papillary carcinomas do not appear as separate intermediate categories but rather show values falling into the range of either the higher or lower grades. The margination values obtained from the cytological preparations corresponded well to those in the histological slides obtained from the resected specimens. In conclusion, nucleolar margination appears to be a feature which is easy to evaluate in a reproducible way and useful in cytological diagnosis.

Biopsy, Needle↗

TGF beta 1 immunostaining patterns and locations in adenoma which later recurred.

To investigate whether the immunohistochemical pattern of TGF beta 1 may be a marker of relapse for adenomatous pathology, 18 follicular adenomas, surgically removed by hemithyroidectomy between 1977 and 1982, were studied. The adenomas were divided into two groups according to the presence (group 1, N = 9) or absence (group 2, N = 9) of nodules recurring in the residual thyroid tissue. The presence and location of TGF beta 1 were evaluated a posteriori by immunohistochemistry in the removed adenoma. Fifty randomly selected subcapsular follicles were studied in each adenoma in order to evaluate the percentage of positive follicles and TGF beta 1 intra-thyrocyte location. In adenoma of group 1, the percentage of positive follicles for TGF beta 1 was lower (80%) than in adenoma of group 2 (84%); this was, however, not statistically significant. The location of TGF beta 1 was mainly at the cell base of the epithelial cells in the microfollicles of group 1, but was dominant at the cell apex in group 2 (p < 0.01). In conclusion, adenoma recurrence is independent of TGF beta 1 production; it may be due to an abnormal TGF beta 1 regulation in response to hyperplasiogenic stimuli.

Adenoma↗

Surgical pathology examination of radical prostatectomy specimens. Updated protocol based on the Italian TAP study.

Between January 1996 and June 2000, 192 men with prostate cancer underwent radical retropubic prostatectomy (RP) and bilateral pelvic node dissection in 26 centers participating in the Italian randomized prospective TAP study. The reviewing pathologist evaluated 145 RP specimens. Seventy-five cases had not been treated with total androgen ablation before RP was performed, whereas 70 had been treated for three months. Whole-mount sectioning of the complete radical prostatectomy specimens was adopted in each center for accurately evaluating the pathological stage of prostate cancer and resection limit status. The results of this study suggest that total androgen ablation before RP is beneficial in men with clinical stage T2 because of the significant pathological down-staging and decrease in the number of positive margins in the RP specimens. On the basis of the experience acquired through the Italian TAP study and recent publications on prognostic factors in prostate cancer, the original practice protocol for examination of RP specimens removed from patients with carcinoma of the prostate glands was updated.

Androgen Antagonists↗

Frequency and location of mitoses in prostatic intraepithelial neoplasia (PIN).

The aim of our study was to assess the frequency and location of mitoses in routine haematoxylin- and eosin-stained sections of prostatic intraepithelial neoplasia (PIN) and then to compare the patterns with those in benign prostatic hyperplasia (BPH) and prostatic invasive adenocarcinoma (PAC). The frequency of mitoses in the epithelial cell layers increased from BPH through PIN up to PAC. The proportions of mitoses in PIN lesions of low grade (PINlow) and high grade (PINhigh) were greater than in BPH (mean 0.001%; standard error, SE, 0.001%), the values decreasing from the basal layer towards the lumenal. In PINlow, the mean category values were 0.087% (SE 0.04%) in the basal, 0.046% (SE 0.033%) in the intermediate and 0.024% (SE 0.024%) in the lumenal position. In PINhigh, the mean category values were 0.194% (SE 0.178%) in the basal position, 0.075% (SE 0.06%) in the intermediate and 0.049% (SE 0.033%) in the lumenal position. The proportions of mitoses in adenocarcinoma with cribriform pattern decreased from the basal towards the lumenal layer, as for PIN: 0.154% (SE 0.096%) in the basal position, 0.072% (SE 0.044%) in the intermediate and 0.064% (SE 0.04%) in the lumenal position. In the solid/trabecular adenocarcinomas, the mean category value in the cell layer adjacent to the stroma was 0.22% (SE 0.111%), whereas in the other cell layers it was 0.074% (SE 0.045). In small and large acinar adenocarcinomas, the proportions of mitoses were 0.058% (SE 0.024%) and 0.068% (SE 0.019%), respectively. In conclusion, the evaluation of mitotic frequency and location in haematoxylin- and eosin-stained sections gives accurate information on how the mitotic activity in PIN compares with BPH and PAC.

Adenocarcinoma↗

Quantitative evaluation of nucleolar features on cytologic material in brain tumor diagnosis.

Nucleolar-related features were quantified in toluidin blue-stained smears from 36 brain tumors in order to improve our knowledge of the nucleolar frequency, size and margination. It was observed that low-grade astrocytic tumors had high percentages of nucleolated cells but the nucleoli were mostly single with maximum nucleolar diameter smaller than 2.00 microns. The percentages of marginated nucleoli were also low, ranging between 3.00% and 30.00% (only one case had a higher percentage). The high-grade tumors, i.e. anaplastic astrocytomas and glioblastomas, did not significantly differ from low-grade astrocytomas in their percentages of nucleolated nuclei, but they showed a higher number of nuclei having three or more nucleoli and the mean nucleolar diameter was in general bigger than 2.00 microns. Glioblastomas had marginated nucleoli much more frequently than anaplastic astrocytomas, the percentage in all but one case being higher than 30.00%. The percentage of marginated nucleoli was much higher in glioblastomas than in metastases, while the nucleoli were bigger in the latter group. A wide range of values for most of the nucleolar-associated parameters was observed in the remaining non-astrocytic brain tumors. Our results, showing differences in nuclear number, size and margination in different brain tumors, lead us to consider it worthwhile to investigate nucleolar-related features and their relationships using a quantitative approach.

Astrocytoma↗

Up-date on quantitative grading systems and prognosis.

Several subjective grading systems have been proposed for different premalignant and malignant lesions with varying emphasis on the nuclear component. However, all subjective grading systems are prone to a significant degree of observer error because the subjective evaluation of nuclear features like size and staining density may be inaccurate and not reproducible. Therefore, quantitation-based methods are to be preferred to evaluate accurately the cell and its architectural features and to eliminate the subjective element of microscopy. The problems which have so far been considered and solved in some quantitation-based grading systems are as follows: 1. feature evaluation, selection and combination into indices and grading systems; 2. number of grades to be identified; 3. degree of certainty in the grading systems; 4. quality control and standardisation of the grading systems; 5. routine application of the grading systems and their efficacy in predicting tumour progression and/or regression (also in response to treatment); 6. current and future aims in researching new grading systems and improving the current ones. The solution of these problems has allowed the grading to be accurately evaluated; thus avoiding the poor reproducibility observed when features have been subjectively investigated.

Humans↗

Proliferating cell nuclear antigen (PCNA) in prostatic invasive adenocarcinoma. Is the proliferation state in the marginal zone of the tumour higher than in the central part?

Expression and location of Proliferating Cell Nuclear Antigen in epithelial nuclei were assessed in invasive adenocarcinoma of the prostate gland. The PCNA-positive nuclei showed homogeneous or granular types of immunostaining or a mixture of both, and a gradation in the intensity of staining. Nuclei with homogeneous pattern appeared darker brown than the lighter granular and mixed patterns. Darker nuclei were quite frequently noted, mainly among the epithelial cells adjacent to the stroma. For the marginal zone of invasive adenocarcinoma, the mean proportion of PCNA-stained nuclei in the small acinar pattern was somewhat similar to that in the large acinar pattern, i.e., 8.66% and 9.06%, respectively. In contrast, the mean values in the cribriform pattern were greater than in the small and large acinar patterns, and decreased from the nuclei in the basal position, or adjacent to the stroma, toward the lumen: 14.40% in the basal position, 11.84% in the intermediate and 9.26% in the lumenal. In the solid/trabecular pattern, the proportions of PCNA-positive nuclei were higher than in all the other patterns: 17.60% in the cell layer adjacent to the stroma and 13.88% in the other layers. The trend of value changes in the central zone of the tumour was similar to that obtained in the marginal zone. However, the proportions were lower and the differences statistically significant. This might indicate that the proliferation state is higher in the marginal zone and that the tumour grows eccentrically rather than centrally.

Adenocarcinoma↗