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Matsuyama-shi, Japan

Hida A.I.,Red Cross | Bando K.,Saiseikai Imabari Hospital | Sugita A.,Ehime University | Maeda T.,Ehime Prefectural Central Hospital | And 10 more authors.
Journal of Clinical Pathology | Year: 2015

Aims: Personalised breast cancer therapy requires pathological characterisation of tumours. The proliferative index, based on Ki67, is pivotal, but a standard method has not been established. Here we look for an easy and practical way to evaluate Ki67. Methods: Immunohistochemical staining of estrogen receptors, progesterone receptors, HER2 and Ki67 (MIB-1) was performed on resected specimens from 406 primary invasive ductal carcinomas. Ki67 labelling index (LI) from manual counting was compared with visual assessment using a 5-grade scale (Eye-5). Next, 10 pathologists evaluated 100 samples with marked hot spots by using Eye-5. Another 100 samples without marking were also assessed by eight pathologists. One year later, two pathologists reviewed 222 cases with Eye-5. Prognosis was analysed among estrogen receptorpositive cases with postoperative endocrine therapy. Results: Eye-5 showed good correlation to LI. All 136 cases of score 4-5 had LI >20% and all 56 cases of score 1 had LI<20%, which means that manual counting was not necessary for about half of the cases. Interobserver and intraobserver variability was low even when a hot spot was not fixed. Eye-5 also correlated with histological grade and lymph node metastasis. Combining Eye-5 and histological grade created a new algorism to predict LI, which allows 80% of all cases (74% of luminal cases) without manual counting. Cases of Eye-5 score 1-2 had significantly better survival than score 3-5. Conclusions: Visual assessment of Ki67 by a 5-grade scale (Eye-5) is fast, easy, and reliable with acceptably low interobserver and intraobserver variability. Eye-5 can replace LI in many luminal tumours, and is a strong candidate as a standard method of evaluating Ki67. Source

Saito Y.,National Cancer Center Hospital | Uraoka T.,Okayama University | Yamaguchi Y.,Shizuoka Cancer Center Hospital | Hotta K.,Saku Central Hospital | And 12 more authors.
Gastrointestinal Endoscopy | Year: 2010

Background Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, although it is not widely used in the colorectum because of technical difficulty. Objective To examine the current status of colorectal ESDs at specialized endoscopic treatment centers. Design and Setting Multicenter cohort study using a prospectively completed database at 10 specialized institutions. Patients and Interventions From June 1998 to February 2008, 1111 colorectal tumors in 1090 patients were treated by ESD. Main Outcome Measurements Tumor size, macroscopic type, histology, procedure time, en bloc and curative resection rates and complications. Results Included in the 1111 tumors were 356 tubular adenomas, 519 intramucosal cancers, 112 superficial submucosal (SM) cancers, 101 SM deep cancers, 18 carcinoid tumors, 1 mucosa-associated lymphoid tissue lymphoma, and 4 serrated lesions. Macroscopic types included 956 laterally spreading tumors, 30 depressed, 62 protruded, 44 recurrent, and 19 SM tumors. The en bloc and curative resection rates were 88% and 89%, respectively. The mean procedure time ± standard deviation was 116 ± 88 minutes with a mean tumor size of 35 ± 18 mm. Perforations occurred in 54 cases (4.9%) with 4 cases of delayed perforation (0.4%) and 17 cases of postoperative bleeding (1.5%). Two immediate perforations with ineffective endoscopic clipping and 3 delayed perforations required emergency surgery. Tumor size of 50 mm or larger was an independent risk factor for complications, whereas a large number of ESDs performed at an institution decreased the risk of complications. Limitations No long-term outcome data. Conclusions ESD performed by experienced endoscopists is an effective alternative treatment to surgery, providing high en bloc and curative resection rates for large superficial colorectal tumors. © 2010 American Society for Gastrointestinal Endoscopy. Source

Shien K.,Organization Shikoku Cancer Center | Yamashita M.,Organization Shikoku Cancer Center | Okazaki M.,Organization Shikoku Cancer Center | Suehisa H.,Organization Shikoku Cancer Center | And 2 more authors.
General Thoracic and Cardiovascular Surgery | Year: 2011

We report an extremely rare case of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma with a pulmonary arteriovenous fistula (PAVF). A 60-year-old woman with vulvar carcinoma was admitted to our hospital for further examination of an abnormal shadow on chest computed tomography (CT). She showed hypoxemia in the arterial blood gas analysis. 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) showed consolidations in the left lower lobe and soft-tissue density lesions in the anterior mediastinum. Each lesion showed heterogeneous FDG uptake. Although needle biopsy of these lesions was performed, a pathological diagnosis was not obtained. For the evaluation of hypoxemia, chest contrast-enhanced CT was performed, and a PAVF in the consolidation of the left lower lobe was revealed. For diagnostic and therapeutic purposes, we performed left lower lobectomy under video-assisted thoracoscopic surgery. In the surgical specimen the PAVF measured 3 cm, and histopathological examination revealed pulmonary MALT lymphoma adjacent to the PAVF. © 2011 The Japanese Association for Thoracic Surgery. Source

Nasu J.,Organization Shikoku Cancer Center | Hori S.,Organization Shikoku Cancer Center | Asagi A.,Organization Shikoku Cancer Center | Nishina T.,Organization Shikoku Cancer Center | And 6 more authors.
Gastric Cancer | Year: 2010

Early gastric cancer (EGC) has a favorable prognosis after surgical gastrectomy. For intramucosal EGC with little risk of lymph node metastasis, endoscopic mucosal resection (EMR) is an accepted treatment method. Herein we document a noteworthy case of small undifferentiated gastric cancer with nodal metastasis. A 60-year-old Japanese woman underwent gastrectomy with D2 lymph node dissection for the treatment of EGC in the lower gastric body. Histological examination revealed that signet-ring cell carcinoma was located in approximately one-third of the superficial portion of the mucosal layer, with a tumor size of 13 mm. No lymphatic invasion, venous invasion, or fibrosis was observed in the submucosal layer. This case had nodal metastasis and was finally diagnosed as stage IB (T1N1M0) according to the Japanese Classification of Gastric Carcinoma (JCGC). The patient is alive without recurrence 6 years after treatment. © 2010 The International Gastric Cancer Association and The Japanese Gastric Cancer Association. Source

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