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S Masood

Publications and source records attributed to S Masood.

At least 37 records · Page 2Linked to original sources
PubMed1998

Automation in cytology: a survey conducted by the New Technology Task Force, Papanicolaou Society of Cytopathology.

Despite the overwhelming interest in the development of several computer based technologies in the last several years, the role of automation in cytology has remained controversial. The potential of these technologies in the reduction of false negative results in pap smears is well recognized. However, there is still remarkable confusion as how to incorporate automation in the routine practice of cytology. This prompted the New Technology Task Force of the George Papanicolaou Society of Cytopathology to design a survey to seek the opinion of those engaged in cervicovaginal cytology screening regarding the value of automation in cytology. In 1996, a ten question survey was sent to 1800 cytopathology laboratories throughout the nation. The response rate was 23% (416/1800). The responders represented laboratories varying from those with less than 5,000 pap smears to those with over 100,000 cases per year. The majority of the responders did not believe that automation is essential for cervicovaginal cytology. This was evidenced by the fact that only 12% of the laboratories were engaged in automated cytology and predominantly used it for quality control measures. The inability of small laboratories to absorb the extra expense involved in the integration of automated cytology in their practice, particularly in the current era of managed care was a major concern. There was also concern about the potential for compromise of patient care by the drive for corporate profits and the dissemination of wrong information to the public and physicians. Suggestions most frequently proposed included appropriate patient and physician education about the merits and pitfalls of the pap smear, and also endorsing an affordable universal fee for pap smears. Rescreening for all pap smears, reassessing the benefits of automation in cytology and development of the standards were other proposals. Partnership with larger cytology laboratories, creation of "cytology consortiums" with shared resources to provide regionalized automated rescreening services were also strongly suggested. This survey clearly indicates the need for further evaluation of automation in cytopathology and a focused attention to various issues surrounding cervicovaginal cytology screening.

Automation↗
PubMed1998

Interobserver variability in the classification of proliferative breast lesions by fine-needle aspiration: results of the Papanicolaou Society of Cytopathology Study.

This study evaluates the applicability of the published cytologic criteria in the categorization of proliferative breast lesions by assessing the diagnostic accuracy and interobserver reproducibility of a panel of experts. Twelve breast fine-needle aspiration (FNA) specimens of biopsy-proven nonproliferative breast lesion (NPL) (1 case), proliferative lesions without atypia (PL) (7 cases), proliferative lesion with atypia (PLA) (1 case), and low-nuclear grade ductal carcinoma in situ (DCIS) (3 cases) were selected. Six FNAs were Papanicolaou (PAP) and 6 were Diff-Quik-stained (DQ). Six expert cytopathologists classified the smears using a summary of published criteria as a guideline. All 6 participants rendered the same cytologic diagnosis in 2/12 (16%) cases. The agreement among the 6 raters was low (Kappa = 0.35). Cytohistologic correlation was achieved in 26/72 (36%) FNA diagnoses. The correlation of the PAP-stained cases was better than the DQ: 17/36 (47%) PAP and 9/36 (25%) DQ correlated. Improving the correlation was achieved by amalgamation of NPL and PL into "low risk" and PLA and DCIS into "high risk" categories: 47/72 (65%) FNA diagnoses then correlated with histology [29/36 (81%) PAP and 18/36 (50%) DQ]. We conclude that the cytologic criteria of proliferative breast lesions need to be further defined and assessed. Consideration should be given to minimizing the number of diagnostic categories and adopting a terminology that has a direct effect on patient management.

Adult↗
PubMed1998

Nuclear grooves in fine-needle aspiration biopsies of breast lesions: do they have any significance?

Nuclear grooving is a recognized morphologic feature frequently seen in papillary carcinoma of the thyroid. This feature is also occasionally seen in other nonneoplastic and neoplastic conditions. Nuclear grooves have been described in tubular carcinoma of the breast. However, the significance of nuclear grooves in benign and malignant conditions of the breast has been rarely studied. In a retrospective study, we searched for the presence of nuclear grooves in Papanicolaou-stained and Diff-Quik-stained fine-needle aspiration biopsies (FNAB) of 50 cases of primary breast carcinomas, 25 cases of proliferative breast disease, and 25 cases of fibroadenoma. In addition, 10 cases of metastatic breast carcinoma diagnosed by FNAB were reviewed. Nuclear grooves were identified in 39 of 50 (78%) of the histologically confirmed primary breast carcinomas and in 9 of 10 (90%) of the cases of metastatic breast carcinomas in the Papanicolaou-stained smears. Nineteen of 50 (38%) of the cases of proliferative breast disease/fibroadenoma showed nuclear grooves in the Papanicolaou-stained smears. The difference between the percentage of cases showing nuclear grooves seen in the Papanicolaou-stained primary breast carcinomas and metastatic breast carcinomas compared with the benign breast lesions was statistically significant (P < 0.001 in the primary breast carcinoma cases and P < 0.01 in the metastatic breast cancer cases). Nuclear grooves were identified less often in the Diff-Quik-stained smears, and their presence in malignant lesions versus cases diagnosed as benign breast disease was not statistically significant. This study suggests that although the presence of nuclear grooves is more frequently seen in malignant breast lesions, their presence cannot totally exclude the possibility of benign breast disease. The presence of nuclear grooves, however, may serve as a diagnostic clue in metastatic tumors of unknown primary.

Adult↗
PubMed1998

DNA content and cell proliferation in giant congenital melanocytic naevi (GCMN). An analysis by image cytometry.

GCMN may be precursors of melanoma, and it has been suggested that the presence of atypical foci could increase the risk of malignant transformation. In order to better define atypical GCMN, we analyzed DNA content and proliferative activity in 21 samples of GCMN, with (n=13) or without (n=8) cytologic atypia. Six benign acquired naevi (AN) and 6 malignant melanoma (MM) were used as controls. DNA content was determined with the CAS 200 image analyzer, and DNA histograms were classified according to the Auer classification. The proliferative indices (PI) were measured after Ki 67 immunostaining using the CAS 200 system. All AN and GCMN without atypia showed class I histograms (normal DNA content) and low PI (mean 1.9 and 2.1). Atypical GCMN showed in 10 cases an abnormal DNA content (class III or IV histograms) with low PI (mean 2.7), and in 3 cases a normal DNA content (class I histograms) with higher PI (mean 16.2). All MM displayed abnormal DNA content and high PI (mean 32.6). In conclusion, abnormal DNA content seems to correlate with cytologic atypia in GCMN. Atypical GCMN exhibit an overall pattern of DNA content and cell proliferation intermediate between non-atypical naevi and MM.

Cell Division↗
PubMed1997

Fat embolism with the use of intraosseous infusion during cardiopulmonary resuscitation.

The objective of this prospective study was to assess the incidence and magnitude of fat emboli after cardiopulmonary resuscitation and intraosseous infusions. An animal laboratory at a university center was used to study 33 mixed-breed piglets. The piglets underwent hypoxic cardiac arrest followed by chest compressions and mechanical ventilation for a minimum of 30 minutes. The animals were divided in groups: group 1 (n = 5), which had no intraosseous cannulas, group 2 (n = 6), which had intraosseous cannulas with infusion, groups 3 (n = 6), 4 (n = 6), and 5 (n = 8), which had intraosseous cannulas with infusion of epinephrine, normal saline, and sodium bicarbonate respectively, and group 6 (n = 2), which was a sham group with no intraosseous cannulas and no cardiopulmonary resuscitation. At cessation of cardiopulmonary resuscitation, representative lung samples were collected from upper and lower lobes of each lung and observed for fat globules and bone marrow elements. Fat globules were seen in the peribronchial blood vessels and intravascular areas throughout all lung fields of groups 1 through 5. There was no difference in appearance or distribution of fat globules among the 5 treatment groups. Analysis of variance showed no statistical significance (P < 0.05) within or among groups 1 through 5. The use of the intraosseous cannula for infusion of emergency drugs and fluids did not increase the magnitude of fat embolization over cardiopulmonary resuscitation alone in this animal model. The benefits of using this procedure in critically ill children as a means of rapid vascular access for resuscitation is well established. However, the risk of fat embolism in this population needs further study.

Analysis of Variance↗
PubMed1996

Estrogen receptor immunocytochemistry in endometrial carcinoma: a prognostic marker for survival.

UNLABELLED: Only a few parameters such as tumor grade and stage are of value in prognosticating disease course in endometrial carcinoma. Biochemical steroid hormone receptor assays could also be useful but are difficult to perform and interpret. Immunocytochemical assay (ICA) might be the method of choice for detecting endometrial receptors. METHODS: Frozen tissue from 78 cases of endometrial adenocarcinoma was examined for the presence of estrogen (ER) and progesterone receptors (PgR) with specific monoclonal anti-receptor antibodies and the peroxidase-antiperoxidase method. In over 60 cases, frozen tissue was also assayed for ER and PgR by biochemical means. RESULTS: Fifty-five (71%) of the endometrial carcinomas were ERICA-positive and 55 (71%) PgRICA-positive. Although both ERICA and PgRICA correlated significantly with biochemical ER and PgR only ERICA was predictive of survival. A woman with a negative ERICA was 4 times more likely to die of her disease than if she were ERICA-positive (P = 0.009; mean follow-up, 37.5 months). Three cases ERICA-positive and PgRICA-negative survived while 3 others ERICA-negative and PgRICA-positive died. CONCLUSION: ERICA, a technique easy to perform and interpret at the community hospital level, appears to provide prognostic information independent of tumor stage and grade. Such information might be of value in planning postoperative therapies for women with endometrial cancer.

Adult↗
PubMed1996

Cytopathology and the pathology resident. A survey of residency program directors.

OBJECTIVE: To collect information on the status of cytopathology training in the United States. DESIGN: Questionnaire survey mailed in June 1994. SETTING: Pathology residency training programs in the United States. PARTICIPANTS: Pathology residency directors. MAIN OUTCOME MEASURES: Training length, numbers of cytology specimens, teaching methods and topics, and graduated responsibility. RESULTS: Of the 196 surveys mailed, 101 (52%) programs responded. The average length of required training was 3 months. The perceived optimal training time averaged 4.5 months, however, with 80% of programs requiring less than their stated optimum. The median numbers of gynecologic, nongynecologic, and fine-needle aspiration biopsy specimens examined per resident were 1100, 500, and 200, respectively. Cytopreparatory techniques, laboratory management, computer systems, and immunocytochemistry were included in over 75% of cytopathology training programs. Teaching at the microscope was rated as the most important teaching method by 90% of respondents. The majority of senior residents performed fine-needle aspiration biopsy procedures and screened and signed out cases with direct faculty supervision, but fewer than 20% of programs allowed senior residents to independently sign out specimens. CONCLUSIONS: Recommendations based on this review include a minimum training time of 3 months, improved training in both fine-needle aspiration biopsy techniques and gynecologic cytology, continuous exposure to cytopathologic techniques, and increased graded responsibility for senior residents.

Education, Medical, Graduate↗
PubMed1996

Altered expression of alpha-smooth muscle isoactin in Hirschsprung's disease.

OBJECTIVE: To analyze the expression of smooth muscle actin (SMA) contractile proteins in the intestinal muscle of patients with Hirschsprung's disease. DESIGN: A total of 56 colonic whole-wall specimens were tested with immunohistochemistry and monoclonal antibodies directed against, respectively, alpha and pan (alpha and gamma) SMA. PATIENTS: The study included both aganglionic and dilated normoganglionic colonic samples from 29 children who had undergone definitive surgery for Hirschsprung's disease. Morphologically normal (n = 6) and dilated colons (n = 5) from 11 patients suffering from conditions unrelated to Hirschsprung's disease served as controls. RESULTS: The alphaSMA immunostaining showed a pattern identical to normal controls in all the aganglionic areas and in 70% of the normoganglionic segments. In contrast, a lack of alphaSMA expression confined to the circular muscle cells was observed in 30% of the normoganglionic specimens and in the five dilated control specimens. The same areas showed a faintly reduced immunoreactivity with the antibody to pan SMA, consistent with the absence of alpha-isoactin, but implying the presence of gamma-isoactin. In the Hirschsprung's disease cases, the absence of alphaSMA expression at the time of surgery was associated with the occurrence of long-term postoperative motility problems (p<.01). CONCLUSION: These data suggest that alphaSMA expression defect in Hirschsprung's disease may be acquired and related to chronic colonic obstruction and subsequent dilatation. The observed changes correlate with disturbances of peristalsis and could be used to assess the risk of intestinal dysmotility frequently reported after surgical removal of the aganglionic bowel.

Actins↗
PubMed1995

Application of immunostaining for muscle specific actin in detection of myoepithelial cells in breast fine-needle aspirates.

Myoepithelial cells play an important role in the interpretation of breast fine-needle aspiration biopsy, since these cells are believed to be a component of a benign process in breast lesions. Myoepithelial cells are usually easy to recognize, however, other cells can morphologically simulate myoepithelial cells and make the distinction difficult. To assess the feasibility of immunostaining as an adjunct to identify myoepithelial cells, we have used immunocytochemistry using monoclonal antibody against muscle specific actin (MSA) in our breast fine-needle aspirates. Herein, we report our experience in immunocytochemical detection of myoepithelial cells using labeled Streptavidin Biotin Detection System on destained Papanicolaou stained smears and cell block preparations obtained from breast aspirates.

Actins↗
PubMed1995

Value of ancillary studies in fine-needle aspiration biopsy.

With growing interest in the application of fine-needle aspiration biopsy (FNAB) in primary diagnosis of benign and malignant lesions, there has been a significant increase in the use of ancillary studies in the aspirated material. To assess the value of such studies, we reviewed 254 morphologically difficult aspiration biopsy cases obtained from different sites that underwent ancillary studies which included microbiology (MC), special stains (SS), immunocytochemistry (ICC), electron microscopy (EM) and flow cytometry (FC). Correlation with available histologic material and/or pertinent clinical information was used as a "gold" standard. In some cases, more than one ancillary study was performed on a single aspirate. According to the impact of the ancillary studies on the final diagnosis, these studies were divided into three categories: confirmatory/diagnostic (22%), helpful (41%), and non-helpful (37%). Overall, more studies had positive contributory effect to the diagnosis (63%) than those with non-helpful results (37%). Among these adjunct testings, ICC were the most commonly used tests (135/296, 46%), while the EM studies had more positive impact in establishing the diagnosis. These findings emphasize the usefulness of ancillary testings in FNAB and justify the more selective use of these studies in the aspirated material.

Adolescent↗
PubMed1995

Prognostic factors in breast cancer: use of cytologic preparations.

There is increasing evidence that certain morphological features and biological markers found in breast tumors may provide prognostic information by predicting the risk of recurrence and metastasis in early breast cancer. This information may also be important in choosing therapeutic options in patients with advanced disease. Prognostic testing is commonly performed on surgically excised lesions. However, there are clinical conditions in which a surgical specimen may not be suitable or available for such analysis. In these circumstances, fine-needle aspiration biopsy and imprint preparation provide an attractive sample for prognostic testings. This review summarizes the current approach to the use of cytologic preparation for assessment of established and newly recognized prognostic factors.

Biomarkers, Tumor↗
PubMed1995

Preoperative factors of prognostic significance in gastric cancer.

This study was undertaken to investigate the ability of local anatomical and primary histological features of gastric cancers, as well as DNA analysis, to predict prognosis. Using multivariate analysis, results indicate that location of a tumor in the gastric cardia, poor differentiation, involvement of adjacent organs, and aneuploidy are all independent predictors of survival. All of the factors studied can be determined by endoscopic procedures preoperatively on patients with gastric cancers and could be helpful in selecting some patients for perioperative adjunctive therapies.

Adenocarcinoma↗
PubMed1995

Prediction of recurrence for advanced breast cancer. Traditional and contemporary pathologic and molecular markers.

Approximately 50% of patient with breast cancer ultimately develop metastases, among which only 10% to 15% of patients live 5 years or more. Patients with locally advanced (stage III) breast cancer have a 5-year survival rate of approximately 20% to 30%. Thus, despite high remission rates obtained with current therapies, the poor long-term results associated with the apparent plateau of response achievable with systemic therapies emphasize the necessity of identifying accurate prognostic factors for this group of patients. This will allow an informed discussion with the individual patient. In addition, prognostic information could be used to guide the therapy and also to identify those subgroups of patients who may benefit with less-aggressive therapies. Furthermore, in the context of randomized studies, prognostic factors can be used to stratify patients. Prognostic factors have been extensively studied in early-stage breast cancer. In comparison, only a few studies exist on biologic prognostic factors in advanced breast cancer. Based on the limited information available, it appears that the biologic factors prognostic for locally advanced breast cancer are similar to those reported for early-stage breast cancer. Apparently, certain factors have a prognostic value irrespective of the stage of the disease at the time of presentation. This would then suggest that certain factors maintain their significance as the breast cancer progresses from an overtly local to a systemic disease. It is already well recognized that histologic grade is a significant prognostic factor for early-stage as well as metastatic breast disease. Hormone receptors have been reported to be of prognostic value at all stages of disease. Proliferation rate assessed by a variety of techniques as well as determination of the Nottingham Primary Prognostic Index provides important information about the rate of the growth of the tumor. Thymidine labeling index and S-phase fraction also provide information in regard to response to chemotherapy. DNA ploidy has been reported to be of significance in prediction of response to adjuvant chemotherapy and to a lesser extent to hormone therapy. The value of DNA ploidy in relation to survival in advanced breast cancer, however, remains controversial. Other prognostic factors such as oncogenes, tumor suppressor genes, and growth factors have also shown some predictive value in advanced breast cancer. Similar to what has also been suggested in early breast cancer, much research still needs to be done to clarify the role of currently available prognostic factors and to identify new, more powerful discriminants.(ABSTRACT TRUNCATED AT 400 WORDS)

Breast↗
PubMed1994

Prognostic and diagnostic implications of estrogen and progesterone receptor assays in cytology.

Scientific evidence suggests that cancer is a consequence of genetic changes that result in uncontrolled cellular growth, tissue invasion, and metastasis. This concept has led to a great deal of excitement in the medical community in the hope that precise identification of genes involved in human cancer could potentially facilitate our understanding of human malignancies. It may also be possible to apply this information directly to different clinical settings. Many technologies are now available which offer opportunities for pathologists to not only expand their diagnostic abilities, but also to assess the prognosis of a given tumor in a specific patient. These include immunocytochemistry, flow cytometry, cell image analysis, and molecular genetic studies. In this review, the role of immunocytochemical hormone receptor assay as an aid in tumor prognosis and in prediction of tumor response to endocrine therapy will be discussed. Emphasis will be placed on the use of hormone receptor assay as an adjunct in diagnostic pathology and in assessment of metastatic tumors of unknown origin. The potential value of assessment of hormone receptors in different cytologic preparations will also be discussed.

Cytodiagnosis↗
PubMed1994

Standardization of immunobioassays as surrogate endpoints.

Despite centuries of scientific inquiry and medical effort, breast cancer remains one of the most dreaded human illnesses, emphasizing the need for prevention, early detection, and better management of these patients. Currently, newly recognized biomarkers are being examined as prognostic indicators to identify potentially aggressive cancers and to aid in planning treatment. Although the new prognostic factors are not yet firmly established, recent insights coupled with the availability of new biological markers have provided an opportunity to understand the initial genetic events leading to the development of breast cancer. Knowledge about those genetic events may provide opportunities for prophylactic intervention, improve our ability to predict breast cancer risk, and lead to strategies for early detection. Attention has focused on histomorphological changes and, to a lesser extent, cytomorphological changes in breast lesions associated with increased risk for subsequent breast cancer. However, the goal underlying the detection of early breast cancer is to distinguish patients who will develop breast cancer from those who will not. This task involves complex issues surrounding the selection, validation, quantitation, standardization, and population application of breast cancer biomarkers, and perhaps designing a protocol to control four major sources of cancer marker variability which may confound biomarker clinical application. These include biological and sampling diversity, variability of detection procedures, and validation against acknowledged disease endpoints. Immunocytochemistry has been applied extensively to assess the pattern of expression of different biomarkers in breast cancer. Immunocytochemical assays have permitted the localization of estrogen and progesterone receptors, oncogenes and tumor suppressor genes, growth factors, and other constituents at the cellular level, and also facilitated correlative analysis of morphology with specific expression of gene products.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomarkers, Tumor↗
PubMed1993

Expression and prognostic significance of estrogen and progesterone receptors in adenocarcinoma of the uterine cervix. An immunocytochemical study.

BACKGROUND: Adenocarcinoma of the uterine cervix typically is an aggressive neoplasm with a propensity for early invasion and dissemination. Little data are available correlating histologic, histochemical, or immunocytochemical parameters with the biologic behavior of this neoplasm. Specifically, the implication of expression of estrogen and progesterone receptors in cervical adenocarcinoma is essentially undefined. METHODS: An immunocytochemical hormone receptor assay using specific monoclonal antibodies against estrogen receptors (ER) and progesterone receptors (PgR) was used to study paraffin-embedded specimens from 54 patients with primary cervical adenocarcinomas. The specimens were evaluated for heterogeneity and intensity of staining. An attempt also was made to study the relationship between the pattern of hormone receptor expression and other established prognostic indicators. RESULTS: In all patients, diffuse positive staining of benign endocervical epithelial or stromal cells was observed. Positive immunostaining was seen in the adenocarcinoma specimens of 16 of 54 (30%) patients for ER and 19 of 54 (35%) patients for PgR. Expression of ER and PgR statistically correlated with each other (P = 0.0001). Endocervical-type adenocarcinoma had the highest degree of staining for both ER and PgR. Clear cell carcinomas and intestinal-type carcinomas were negative for both receptors. Positivity for ER and PgR inversely correlated with histologic grade as defined by the International Federation of Gynecology and Obstetrics (FIGO). The relationship between hormone receptor expression and FIGO stage was not statistically significant. Survival was associated with clinical stage (P = 0.004) and with immunocytochemical status of ER expression (P = 0.032) and PgR expression (P = 0.009). CONCLUSIONS: This study of 54 specimens from patients with cervical adenocarcinoma suggests that positive expression of ER and PgR is associated with prolonged survival.

Adenocarcinoma↗
PubMed1993

The value of flow cytometric analysis in patients with gastric cancer.

Tumors in the gastric cardia and the body/antrum were studied to determine the effect of ploidy and S-phase fractions on patient survival. Forty-two percent of tumors were located in the cardia and 58% in the body/antrum. Nodal metastases occurred more often with cardia tumors than with body/antrum tumors (86% vs 65%). Aneuploidy occurred more frequently in patients with cardia tumors than in patients with body/antrum tumors (39% vs 20%). Metastasis to lymph nodes was more common in patients with aneuploidy than in patients with diploidy (31% vs 7%). S-phase fractions were not different between aneuploid and diploid tumors. More patients with diploid cancer were alive at 5 years than were patients with aneuploid tumors (90% vs 10%). We conclude that primary cellular differences in gastric tumors of the cardia or body/antrum determine patient survival.

Adenocarcinoma↗