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At least 1,135 records · Page 63Linked to original sources
PubMed1994

The pathologist and the residual tumor (R) classification.

The R classification, adopted in 1987 by the UICC, denotes absence or presence of residual tumor after treatment. Residual tumor may be localized in the area of the primary tumor and/or as distant metastases. R0 corresponds to resection for cure or complete remission. R1 to microscopic residual tumor, R2 to macroscopic residual tumor. The R classification takes into account clinical and pathological findings. A reliable classification requires the pathological examination of resection margins. The R classification has considerable clinical significance, particularly being a strong predictor of prognosis. General and specific procedures for performing pathological R classification on resection specimens of different organs will be described. New methods in R classification comprise imprint cytology, cytolocial examination of ascites, examination of bone marrow biopsy. The importance of these methods will have to be established in the future.

Humans↗
PubMed1985

Prognosis in colorectal carcinoma. A reassessment of the pathologist's role.

The prognostic significance of some pathologic features was evaluated in a series of 177 patients with colorectal carcinoma consecutively treated by curative resection in a department of Surgery from 1960 to 1981. There were 90 men and 87 women with a mean age of 59.2 +/- 12.8 and a range from 23 to 88 years. Current follow-up information was obtained in 92.7% of the patients. Pathologic staging as classified according to a modification of Dukes' original scheme was found to be the most important prognostic factor. Evaluation of lymphatic and venous invasion, histologic differentiation, and site of tumors also provided valuable prognostic information. Size, configuration, mucin-producing ability and the morphologic evaluation of the so-called "host immunologic response" were found to be irrelevant for the prognosis when the influence of the other indices was controlled.

Adult↗
PubMed2002

[Management of the dead fetus' body during the pre-or perinatal period: fetal pathologist or fetal physician?].

What's about a practitian that have to care a non-existent and still dead patient? What's about a patient that only exists through pictures and pathology? What's about the expectation of the parents and medical team when the questions are mainly restricted to the cause of the death? Responses to these questions represent the aim of this paper that tries to delineate the ambiguity that exists between the facts and their consequences.

Autopsy↗
PubMed2002

The role of pathologists in the quality control of diagnosis and treatment of rectal cancer-an overview.

Pathological examination of the rectal cancer resection specimen has an increasingly important role in influencing decisions about clinical management. Standardisation of the examination procedures and reporting are necessary. To evaluate the relevant pathological factors, data from randomised clinical trials with adequate follow-up are necessary. From a recently closed trial on the treatment of rectal cancer (preoperative radiotherapy or total mesorectal excision (TME) surgery alone?), the pathological data were used to evaluate the importance of pathological factors, like circumferential margin and tumour, lymph nodes, metastasis (TNM) stage. Furthermore, it was possible to evaluate the surgical procedures and correlate these findings to clinically relevant endpoints. In this review, we describe the standard evaluation of a rectal cancer specimen with special attention to preoperative irradiated specimens.

Humans↗
PubMed1985

The clinical significance of minimal breast cancer: a pathologist's viewpoint.

We can draw the following conclusions about minimal breast cancer: The concept of minimal breast cancer as a stage of cancer that is 95% curable is a valid one, if minimal breast cancer is defined by strict parameters. Both 0.5 and 1.0 cm have been defined as the upper limit of size for minimal invasive cancer. Some data indicate that 0.5 cm is the preferable dividing line and that 1-cm cancers are no longer minimal. Other data suggest that the most important factor is axillary lymph node status. One-centimeter cancers are probably 95% curable if axillary lymph nodes are negative. Cancers of 0.5 cm and smaller in size are probably not 95% curable if axillary lymph nodes are involved. Carcinoma in situ appears to be highly curable, even if axillary lymph nodes are involved. Minimal breast cancer should include lobular carcinoma in situ (lobular neoplasia) and ductal carcinoma in situ regardless of nodal status, and (tentatively) invasive carcinoma smaller than 1 cm in total diameter, if axillary lymph nodes are not involved. Many cases of minimal breast cancer are asymptomatic. If special screening is not used, less than 10% of women with breast cancer will be at the minimal stage when diagnosed. Screening programs can increase this ratio to as much as one third of patients, perhaps even more. While serious questions about cost effectiveness of mass screening remain, screening programs appear to represent the best way of detecting minimal breast cancer. Screening programs should include careful history and physical examination, of course. The role of mammography is still controversial. It is probable that at least 50% of all minimal cancers would be missed without mammography. After a period of significant worry about the risk of radiation, opinion seems to be changing now and many authors are willing to accept the fact that mammography is of more benefit than risk for younger women. The HIP study would indicate that the risk/benefit ratio becomes favorable at age 50. Many authorities would now comfortably include mammography in the screening of women age 40 or older. Some authors believe that the benefits of mammography outweight the risks for patients of all ages. This question needs to be tested, and several randomized prospective clinical trials now in progress are doing just that. The legitimate worry over the risks of mammography should not obscure a very important fact.(ABSTRACT TRUNCATED AT 400 WORDS)

Biopsy↗
PubMed2007

Technology insight: will systems pathology replace the pathologist?

By using systems pathology, it might be possible to provide a predictive, personalized therapeutic recommendation for patients with prostate cancer. Systems pathology integrates quantitative data and information from many sources to generate a reliable prediction of the expected natural course of the disease and response to different therapeutic options. In other words, through the integration of relatively large data sets and the use of knowledge engineering, systems pathology aims at predicting the future behavior of tumors and their interaction with the host. In this Review, we introduce the methods used in systems pathology and summarize a recent study providing the first evidence of a concept for this strategy. The results show that systems pathology can provide a personalized prediction of the risk of recurrence after prostatectomy for cancer.

Humans↗
PubMed2004

The role of translation in neoplastic transformation from a pathologist's point of view.

Increased cell proliferation, which is a hallmark of aggressive malignant neoplasms, requires a general increase in protein synthesis and a specific increase in the synthesis of replication-promoting proteins. Transient increase in the general protein synthesis rate, as well as preferential translation of specific mRNAs coding for growth promoting proteins (e.g. cyclin D1), takes place during normal mitogenic response. A number of extensively studied growth signal transduction pathways (Ras, PI3K, MAPK, mTOR-dependent pathways) activate the function and expression of various components of the translational machinery. In abnormal situations, constitutive activation of signal transduction pathways (e.g. oncogenic activation of Ras or Myc) leads to continuous upregulation of key elements of translational machinery. On the other hand, tumor suppressor genes (p53, pRb) downregulate ribosomal and tRNA synthesis, and their inactivation results in uncontrolled production of these translational components. During recent years, a significant effort has been dedicated to determining whether expression of translation factors is increased in human tumors using clinical biopsy specimens. The results of these studies indicate that expression of particular translation initiation factors is not always increased in human neoplasms. The pattern of expression is characteristic for a particular tumor type. For example, eIF-4E is usually increased in bronchioloalveolar carcinomas but not in squamous cell carcinomas of the lung. Interestingly, in certain highly proliferative and aggressive neoplasms (e.g. squamous cell carcinoma of the lung, melanoma), the expression of eIF-4E is barely detectable. These findings suggest that mechanisms for increasing general protein synthesis in various neoplasms differ significantly. Finally, the possibility of qualitative alterations in the translational machinery, rather than a simple increase in the activity of its components, is discussed along with the possibility of targeting those qualitative differences for tumor therapy.

Animals↗
PubMed2006

Information literacy for speech-language pathologists: a key to evidence-based practice.

PURPOSE: In this tutorial, we review the tenets of information literacy (IL) that parallel and intersect with new American Speech-Language-Hearing Association (ASHA) certification standards requiring clinicians to engage in evidence-based practice (EBP). METHOD: A review of the literature on EBP in medical and allied health areas was conducted through an online database search. The Information Literacy Competency Standards for Higher Education (American Library Association, 2004) are used as a framework for outlining IL practices that will aid in EBP. RESULTS: Current strategies are contrasted with more desirable strategies. Potential barriers to the utilization of information-literate procedures in locating sources of reliable clinical evidence are discussed together with potential solutions. CONCLUSION: Suggestions for more efficient information searches by clinicians, as well as a proposed discipline-wide agenda for increasing clinicians' IL skills during and after entry-level graduate training, are provided.

American Speech-Language-Hearing Association↗