Biomedical subjects

Y Collan

Publications and source records attributed to Y Collan.

At least 73 records · Page 4Linked to original sources

PubMed1990

Prognostic value of ovarian carcinoma grading methods--a method comparison study.

The prognostic value of subjective histological and morphometric grading was studied in 75 primary ovarian carcinomas. Histological grading methods recommended by Czernobilsky and by Russell and the morphometric method of Baak and co-workers were compared in a two-observer system. The 5-year survival could be correctly predicted in about two-thirds of the patients with all three methods. When mitotic counting (volume corrected mitotic index, M/V-index) was compared with the above grading methods by using a receiver operating characteristic curve) the M/V-index was generally superior in its prognostic power regardless of the sensitivity/specificity level chosen. The morphometric grading method and the grading method based on the M/V index were also shown to be readily reproducible.

Carcinoma↗

PubMed1990

Comparison of morphometry and DNA flow cytometry with standard prognostic factors in bladder cancer.

In 83 bladder cancer patients with adequate follow-up (mean 13 years, range 9-22) the prognostic value of morphometric, DNA flow cytometric and clinical parameters was assessed. Paraffin embedded material was used in flow cytometry. Univariate life-table analysis showed the statistically significant relation of clinical stage, histological grade, mean nuclear area, the Standard Deviation (SD) of nuclear area, mean maximal nuclear diameter, mean nuclear perimeter and the volume corrected mitotic index (M/V index) to survival when bladder cancer deaths alone were used in the analysis. The recurrence of bladder cancer could be predicted with the M/V index. Survival analysis with Cox's regression model pointed to primary tumour clinical stage as the most important prognostic factor of crude survival. Histologically, grade and the SD of nuclear area were the best prognostic factors. Primary tumour stage and histological grade were the best predictors of death from bladder cancer. In Cox's model, histoquantitative methods are almost as good as clinical staging in predicting prognosis. DNA flow cytometry of paraffin embedded material offered no advantage over clinical stage, histological grade or morphology in assessing prognosis.

Adult↗

PubMed1990

Taurine in normal and diseased human skeletal muscle.

Taurine content of 199 clinical muscle biopsies was determined and correlated to histometric data of 121 cases. Taurine concentration in muscles was markedly dependent on fiber type distribution, taurine being more abundant in the slow, oxidative type 1 fibers than in the type 2 fibers. Taurine concentration rose slightly with age and tended to be higher in denervations, muscular dystrophies and myotonias, but the differences from the control values were non-significant.

Adolescent↗

PubMed1990

DNA ploidy and S phase fraction in human bladder cancer. Relation to survival and histological grade (WHO).

The nuclear DNA content of archival paraffin-embedded bladder cancer samples (70 patients) of WHO grades I-III has been measured by flow cytometry. The female/male ratio was 15/55. The mean follow-up time was 13 years (range 9.6-22.0 years). 37 of 70 (53%) patients had DNA index 1.0 (diploid DNA content), and the remaining 33 (47%) patients had an aneuploid tumor. There was no significant difference in the age (mean +/- SD) of the patients having a diploid (66 +/- 9 years) or an aneuploid tumor (68 +/- 11 years) at the time of diagnosis. 47 deaths occurred during the follow-up period; 24 (51%) of these were due to bladder cancer (12 diploid, 12 aneuploid tumors). No significant difference was found after radical treatment during the disease-free interval (mean +/- SD) between diploid (48 +/- 45 months) and aneuploid (35.5 +/- 35 months) groups of patients. Recurrences during the follow-up period were equally common among aneuploid and diploid tumors. A statistically significant relation between histological grade and survival could be demonstrated, but DNA ploidy and S phase fraction had little prognostic value in this respect. There was no statistically significant difference in survival between aneuploid (30%) and diploid (35%) groups of tumors during the follow-up period. The study suggests that flow cytometric determination of nuclear DNA ploidy from paraffin-embedded samples in bladder tumors does not add to the prognostic power of subjective histological grading.

Aged↗

PubMed1990

Prognostication of bladder carcinoma by immunohistochemistry: refined and combined analysis of staining for MCA and CA50.

The immunohistochemical reactivity of tumour markers MCA and CA50 was determined in transitional cell carcinoma of the bladder of WHO grades I-III. The material consisted of paraffin-embedded biopsies from bladder tumors in 83 patients. Mean follow-up time was 13 years (range 9.6-22 years). Staining indexes for the whole section and for the area with maximal staining intensity were calculated (for MCA; IMCAtot, IMCAmax, for CA 50: ICA50tot, ICA50max). Also two combination indexes were created (Itot, Imax). The relations between histological grade on one hand, and IMCAtot (p less than 0.001), IMCAmax (p = 0.007), ICA50tot (p less than 0.001), and ICA50max (p less than 0.001) on the other were statistically significant. IMCAtot (p = 0.008) and ICA50max (p 0.040) had a statistically significant relation to clinical stage. IMCAtot (p = 0.004) and IMCAmax (p = 0.001) also predicted node involvement with statistical significance. Metastasizing behavior could be predicted with all four indexes with statistical significance (IMCAtot p = 0.021; IMCAmax, p = 0.001; ICA50tot, p = 0.021; ICA50max, p = 0.050), but best with IMCAmax. Bladder cancer survival was related to IMCAtot (p = 0.044) and to ICA50tot (p = 0.0009) with statistical significance. The higher the MCA positivity and the lower the CA50 positivity, the worse was the prognosis. The combination index (Itot) predicted survival (p = 0.0004) better than IMCAtot or ICA50tot separately. Itot and Imax did not offer any advantages over other indexes in predicting node involvement or metastasis. Grade II tumors were divided into two prognostic groups using Itot, but the difference between survival was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1990

Potential of nuclear morphometry and volume-corrected mitotic index in grading transitional cell carcinoma of the urinary bladder.

The potential of nuclear morphometry and volume-corrected mitotic index (M/V index) in grading cases of transitional cell carcinoma of the urinary bladder was studied. 30 cases of bladder cancer including all three WHO grades were evaluated. Four investigators selected independently the most atypical field from paraffin sections, and one investigator measured the nuclear areas from these fields using the IBAS 1&2 image analyzer system. Following the same sampling rule, four investigators counted the mitotic figures per area of neoplastic tissue in the microscopic image at an objective magnification of X40. The mean nuclear areas covered values from 28.1 to 139.0 microns 2 (mean +/- SD 57.2 +/- 18.9). The total variance of measurements was 359.1 and the mean variance between corresponding fields 110.2 (about 30% of the total variation). The efficiency was evaluated by estimating the fraction of falsely classified cases. Instrumental morphometry of nuclear area in a three-grade system gave an efficiency of 79% and of 90%, in a two-grade system. The M/V index varied from 0 to 54 (mean +/- SD 12.3 +/- 10.9). The total variance was 119.8 and the methodological variance 15.5 (about 13% of total variance). In a three-grade system this would correspond to an efficiency of about 75%; in a two-grade system the efficiency would be 88%. The results suggest that nuclear area and M/V index estimates constitute efficient grading systems in bladder carcinoma.

Carcinoma, Transitional Cell↗

PubMed1990

Volume-corrected mitotic index in human pancreatic cancer. Relation to histologic grade, clinical stage, and prognosis.

A retrospective study was performed on 59 pancreatic cancer patients diagnosed during 1970-1988. The mean follow-up time of all individual patients was 6.9 months (range, 0-37 months). Histologic grade, clinical stage (UICC), and volume-corrected mitotic index (M/V index) were correlated to the survival of patients. Histologic grade (p = 0.167) and clinical stage (p = 0.066) were not related to overall survival with statistical significance. The M/V index was significantly associated with overall survival (p = 0.004). M/V index (p = 0.004), clinical stage (p = 0.029), and histologic grade (p = 0.126) predicted survival at 1 year after diagnosis. M/V index divided grade-II tumors into two prognostically different groups (p = 0.050). Seven of 59 patients who survived more than 12 months had an M/V index less than 2, and patients who survived less than 6 months had significantly higher M/V index values (chi-square = 528.3, p less than 0.001). The metastasizing potential of pancreatic cancer and lymph node involvement was also associated with the M/V index. Histologic grade and M/V index were positively correlated (chi-square = 38.6, p less than 0.001, r = 0.702). On the basis of our results, it seems that the M/V index is better than histologic grade or clinical stage in predicting survival of pancreatic cancer patients. This result suggests the potential use of the M/V index in selecting patients for different modes of therapy.

Adenocarcinoma↗

PubMed1990

Volume corrected mitotic index (M/V index) in human bladder cancer; relation to histological grade (WHO), clinical stage (UICC) and prognosis.

A retrospective study was performed on 83 bladder cancer patients diagnosed at the Department of Surgery, Kuopio University Central Hospital, during the years 1965-1987. The follow-up time was 22 years, and the mean follow-up time of individual patients was 13 years (range 9.4-22 years). Histological grade (WHO), volume corrected mitotic index (M/V index) and clinical stage (UICC) were correlated to the survival of patients. Histological grade, M/V index and clinical stage were associated with crude survival (all causes of death included) with little predictive power. The recurrence of the disease could be predicted by the M/V index, but not by histological grade or clinical stage. When bladder cancer deaths only were included, histological grade (chi 2 = 26.6, p less than 0.001), M/V index (chi 2 = 6.6, p = 0.042) and clinical stage (chi 2 = 31.7, p less than 0.001) were clearly associated with prognosis. Also the metastasizing potential of bladder carcinomas could be predicted by the M/V index and by the histological grade at the time of primary diagnosis. Histological grade and M/V index were positively correlated (chi 2 = 16.7, p = 0.002, r = 0.47). In multivariate analysis clinical stage, histological grade and M/V index predicted prognosis in the order of importance.

Aged↗

PubMed1990

Extranodal head and neck non-Hodgkin's lymphomas in children in Finland.

During the 20-year period from 1961 to 1980, 17 cases of extranodal head and neck non-Hodgkin's lymphoma in children under 15 years of age were diagnosed in Finland. Eight cases had tumours in tonsils or nasopharyngeal adenoids and 9 cases lymphomas of other sites of the head and neck. The age-adjusted annual incidence rate for all cases was 0.69 and for tumours of the pharyngeal lymphatic tissue 0.35 per 10(6) children. Seven of the 17 tumours were undifferentiated lymphomas (Burkitt's and non-Burkitt's types) and 5 lymphoblastic lymphomas. The overall 5-year disease-free survival rate was 37%. Five of the 9 patients with tonsillar or adenoid lymphomas were disease-free more than 5 years.

Adenoids↗

PubMed1990

Nuclear morphometry in human pancreatic adenocarcinoma; relation to histological grade, clinical stage, and survival.

A retrospective study was performed on 63 pancreatic cancer patients diagnosed during the years 1970-1988. The mean follow-up time of all individual patients was 6.9 months (range 0-37 months). Histological grade, clinical stage, and 12 morphometric nuclear variables were correlated to the survival of patients. Clinical stage (p = 0.066), histological grade (p = 0.095), and morphometric variables (p = 0.155) predicted survival in survival analysis. Clinical stage (p = 0.029), morphometric variables (p = 0.157), and histological grade (p = 0.306) predicted survival at one year after diagnosis. Morphometric variables divided grade II tumours into two prognostically different groups (p = 0.008) when the mean survival time was used as a classifier. Also the metastasizing potential of pancreatic cancer and lymph node involvement were associated with morphometric variables. Histological grade and morphometric variables were positively correlated (p less than 0.001). On the basis of our results, it seems that nuclear morphometric variables are more efficient or equal to subjective histological grade in predicting survival of pancreatic cancer patients. This result suggests the potential use of nuclear morphometric variables in grading pancreatic adenocarcinomas, and selecting patients for different modes of therapy.

Adult↗

PubMed1990

An improved prognostic index of axillary node involvement in breast cancer incorporating DNA ploidy and tumour size.

A multivariate prognostic index based on clinical data and the results of flow cytometry for the grading of breast cancer was evaluated in 117 patients whose disease had been detected and treated by mastectomy with axillary clearance between 1974 and 1976. Survival analysis with Cox's regression model pointed to three important prognostic factors: lymph node involvement (p less than 0.001), DNA ploidy (p less than 0.01) and tumour size (p less than 0.01). These factors were incorporated into a prognostic index, in which the lymph node involvement, DNA ploidy, and tumour size contributed to the index in that order. Logistic discriminant analysis with five year follow-up as the fixed end point (70 alive, 47 dead) gave the same result; lymph node involvement, tumour size, and DNA ploidy were the best prognostic indicators of survival. The result showed that our multivariate prognostic index was more powerful than lymph node involvement alone. The use of this prognostic index is recommended for selecting patients for different treatments.

Adult↗

PubMed1990

Morphometry in human transitional cell bladder cancer. Nuclear area and standard deviation of nuclear area--relation to tumor grade (WHO) and prognosis.

A retrospective follow-up (range 9.4-22 years, mean 13 years) study of 83 patients with grade I-III (WHO) bladder carcinomas was performed. Nuclear area (mean +/- SD 59.7 +/- 18.7 microns2) and the SD of nuclear area (mean +/- SD 19.7 +/- 13.4 microns2) were determined by using morphometric methods. The SD of nuclear area and histopathological grade exhibited a clearly significant relation, the relation between grade and nuclear area was weaker. The number of recurrences in the bladder and the recurrence-free period were not significantly related to histopathological grade, mean nuclear area or SD of nuclear area. The progress in nodal or metastatic stage could be predicted by histopathological grade, mean nuclear area and SD of the nuclear area. Prediction of crude survival, however, was not efficient. When only bladder cancer deaths were included in the analysis, histopathological grade (p less than 0.001), mean nuclear area (p = 0.011) and SD of the nuclear area (p = 0.001) showed a significant relation to survival. Grade II tumors could be divided into two prognostically different groups using nuclear area and SD of the nuclear area as classifiers. The results suggest that morphometric parameters are as good as histopathological grade in predicting long-term prognosis of bladder carcinomas, and better than the histopathological grade in predicting progress in nodal (N) or metastatic (M) stage.

Aged↗

PubMed1989

Relationship between DNA ploidy and survival in patients with primary breast cancer.

The DNA ploidy of breast cancer tissue from paraffin blocks was measured by flow cytometry in 117 patients whose disease had been detected and treated with surgery between 1974 and 1976. Patients with aneuploid tumours had positive axillary nodes and distant metastases more often than those with diploid tumours. Aneuploid tumours were more common in postmenopausal than premenopausal women. The S-phase fraction (SPF) was significantly higher in aneuploid than in diploid tumours and positive axillary lymph nodes were found in 26 per cent of the patients who had a tumour with a SPF below the median (4.8 per cent) and in 48 per cent of those with tumours with SPF values above the median. At the primary clinical investigation 2 per cent of the patients with diploid tumours and 6 per cent of those with aneuploid tumours had distant metastases. During the follow-up, the proportion of patients with distant metastases increased to 42 and 72 per cent, respectively. With a follow-up of 11.5 years, the DNA aneuploidy of the tumour showed a significant association with decreased survival. Thirty-three per cent of patients with diploid and 65 per cent of patients with aneuploid tumours had died from breast cancer during the follow-up (P less than 0.001). All patients with hypertetraploid or multiploid tumours died from breast cancer. High SPF values were associated more closely with distant metastases or death during the follow-up than low SPF values. Our results suggest that DNA ploidy measured by flow cytometry from paraffin embedded tissue blocks of human breast cancer can be used to predict the aggressiveness of the tumour and the survival of the patients.

Aged↗

PubMed1989

Melanosis coli. Prevalence, distribution, and histologic features in 200 consecutive autopsies at Kuopio University Central Hospital.

The occurrence of large-bowel melanosis was evaluated by microscopy in 200 large bowels at autopsy. Melanin was seen as yellow-brown pigment in the macrophages of the lamina propria. The pigment stained with diastase-alcian blue PAS, Fontana, and iron stains. One hundred nineteen of 200 (59.5 percent) bowels showed melanosis, which was equally common in both sexes. Usually more than one segment was involved (most commonly, four segments). Melanosis was common in the proximal part of the colon, but much rarer in distal parts (sigmoid and rectum). Affected segments were successive; negative segments between positive ones were exceptional. If the rectum was affected, all five proximal segments were affected in 11 of 12 cases. The intensity of melanosis was directly related to the number of segments involved. In the oral part of the colon, affected males had a higher intensity of melanosis than affected women, but about the same intensity in the sigmoid and rectum. The fraction of patients with melanosis increased with age. Of men and women in the age group of 20 to 54 years, 32 and 44 percent were affected, and above the age of 75 years, 76 and 67 percent, respectively.

Adult↗

PubMed1989

Target tissue morphology and serum biochemistry following 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure in a TCDD-susceptible and a TCDD-resistant rat strain.

The mode of action of the highly toxic environmental contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is unknown. It was recently discovered that two strains of rat, Long-Evans (L-E) and Han/Wistar (H/W), differ widely in susceptibility to TCDD. Employing this strain divergence as a probe, the present study set out to assess the role of various biochemical and morphological effects in TCDD lethality. In the main experiment, the rats were treated once ip with 0,5,50, or (H/W) 500 micrograms/kg TCDD and killed 1 to 16 days postexposure. Several target organs were evaluated by light microscopy and a number of serum lipid and carbohydrate parameters as well as a few major regulatory hormones were analyzed. The results demonstrated that most alterations caused by TCDD were essentially similar in both strains. TCDD reduced circulating thyroxine to a slightly greater extent and more permanently in the sensitive L-E strain. Moreover, a highly significant interaction on thyroid-stimulating hormone was found among strain, dose, and time. Serum concentrations of corticosterone and free fatty acids were increased only in the L-E rats given 50 micrograms/kg TCDD, i.e., at an apparent LD100 dose level for this strain. Yet, the most striking interstrain difference was seen in the liver which was distinctly affected after Day 4 in L-E rats given 50 micrograms/kg TCDD but only marginally affected in rats from any H/W group. The lesion, while showing no necrotic cell changes, was suggestive of plasma membrane damage, possibly reflecting the production of free radicals. The relation of the findings to possible mechanisms of TCDD action is discussed.

Animals↗

PubMed1989

General principles of grading lesions in diagnostic histopathology.

The principles behind grading histological samples by any method describing them is outlined. The estimation of the variation of measurement allows the number of falsely graded cases to be estimated, and thus makes it possible to compare grading methods in respect to their sensitivity, specificity, and efficiency. The approach is especially suitable for situations in which measurements are made on histological sections, but can also be applied in traditional subjective grading. The approach also makes it possible to estimate the grading performance by such methods as DNA-cytometry, flow cytometry, immunohistochemistry, and nucleic acid in situ hybridisation.

Humans↗

PubMed1989

Volume corrected mitotic index (M/V-INDEX). The standard of mitotic activity in neoplasms.

Estimation of mitotic activity by counting the number of mitotic figures per high power fields is subject to many sources of error. The microscope fields vary in size in different microscopes, which makes comparisons arbitrary. Also the areas covered by neoplastic and non-neoplastic tissue in the microscope image vary in different tumors. We found that each microscope could easily be characterized in terms of the size of the microscope field at 40x objective magnification (usually at ocular magnification of 10x). We also found that the number of mitotic figures can be related to the area covered by neoplastic tissue in the microscope field. The resulting index, the volume corrected mitotic index (M/V-index) will express the mitotic activity as the number of mitotic figures per square millimeter of neoplastic tissue in the microscope fields. The M/V-index will not be subject to the variation in volume fractions of neoplastic tissue between different neoplasms. With the M/V-index the mitotic activity as measured in different microscopes can be compared reliably. The value of the method is demonstrated in a series of ovarian tumors.

Adenocarcinoma↗

PubMed1989

Sources and nature of variation in DNA analysis of follicular thyroid adenoma.

We investigated the sources and nature of variation that may occur in the DNA analysis of thyroid adenomas from cytological and histological samples. Imprints and smears gave identical results. However, the nuclear area was higher in smears where the optical density of the nuclei was lower. In measuring imprints, the interactive selection of nuclei was preferred to the automatic, because the risk of measuring nuclear fragments or undesired objects was thus avoided. The reproducibility and the variation of the DNA measurements depended on the degree of observer training in quantitative pathology, the method of field selection, and the type of instrumentation. Biological variation in the spatial distribution of nuclei with different ploidy values in some adenomas seemed to hide the influence of section thickness on measurements. Our data seem to suggest that it is best to apply a constant section thickness and 5 micron sections seem acceptable.

Adenoma↗