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Strong prognostic value of nodal and bone marrow micro-involvement in patients with pancreatic ductal carcinoma receiving no adjuvant chemotherapy

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World Journal of Gastroenterology 2006年第40期12卷 6515-6521页

作者： Emre F Yekebas Dean Bogoevski Michael Bubenheim Bjrn-Christian Link Jussuf T Kaifi Robin Wachowiak Oliver Mann Asad Kutup Guellue Cataldegirmen Lars Wolfram andreas erbersdobler Christoph Klein Klaus Pantel Jakob R Izbicki Department of General Visceral and Thoracic Surgery University Medical Centre of Hamburg-Eppendorf Hamburg Germany Institute of Medical Biometry and Epidemiology University Medical Centre of Hamburg-Eppendorf Hamburg Germany Institute of Pathology University Medical Centre of Hamburg-Eppendorf Hamburg Germany Institute of Immunology University of Munich Munich Germany Institute of Tumor Biology University Medical Centre of Hamburg-Eppendorf Hamburg Germany

AIM： To study the prognostic value of adjuvant chemotherapy in patients with pancreatic, ductal adenocarcinoma. METHODS： Lymph nodes from 106 patients with resectable pancreatic ductal adenocarcinoma were systematically sampled. A total of 318 lymph nodes classified histopathologically as tumor-free were examined using sensitive immunohistochemical assays. Forty-three （41%） of the 106 patients were staged as pT1/2, 63 （59%） as pT3/4, 51 （48%） as pNo, and 55 （52%） as pN1. The study population included 59 （56%） patients exhibiting G1/2, and 47 （44%） patients with G3 tumors. Patients received no adjuvant chemoor radiation therapy and were followed up for a median of 12 （range： 3.5 to 139） mo.RESULTS： Immunostaining with Ber-EP4 revealed nodal microinvolvement in lymph nodes classified as ＂tumor free＂ by conventional histopathology in 73 （69%） out of the 106 patients. Twenty-nine （57%） of 51 patients staged histopathologically as pNo had nodal microinvolvement. The five-year survival probability for pN0-patients was 54% for those without nodal microinvolvement and 0% for those with nodal microinvolvement. Cox-regression modeling revealed the independent prognostic effect of nodal microinvolvement on recurrence-free （relative risk 2.92, P = 0.005） and overall （relative risk 2.49, P = 0.009） survival. CONCLUSION： The study reveals strong and independent prognostic significance of nodal microinvolvement in patients with pancreatic ductal adenocarcinoma who have received no adjuvant therapy. The addition of immunohistochemical findings to histopathology reports stratification of patients with may help to improve risk pancreatic cancer.

关键词： Pancreatic ductal adenocarcinoma Nodal microinvolvement Micrometastases

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Assessment of Diagnostic Accuracy of Bronchoalveolar Lavage Cytology in the Diagnosis of Lung Tumors and Contribution to the Classification of Non-Small Cell Lung Cancer Entities:A Retrospective Clinocopathological Study

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Open Journal of Pathology 2013年第3期3卷 107-112页

作者： Annette Zimpfer Antonia Polak Andrea Bier Guenther Kundt Jana Kolbel Friedrich Prall Johann C.Virchow andreas erbersdobler Institute of Pathology University of RostockRostockGermany Department of Respiratory Medicine University of RostockRostockGermany Institute for Biostatistics and Informatics in Medicine and Ageing Research University of RostockRostockGermany

Background: Due to new therapeutic options in thoracic oncology, the pathological diagnosis of bronchial carcinoma has become more challenging. The majority of bronchial cancer is diagnosed from small biopsy specimens and the diagnosis often based on cytological methods. Aims: In this study, we reevaluated cytologic specimens in order to determine the diagnostic reliability of pulmonary cytopathologic techniques performed in our department. Material and methods: In our center bronchial lavage/bronchoalveolar lavage (BL/BAL) specimens are obtained both before and after forceps biopsy (FB) and subsequently processed. Retrospective data from a period of 60 months were retrieved from the institutional files. Sensitivity, specificity, as well as accuracy of cytological tumor typing were determined using histopathology of FB as gold standard. Also, the diagnostic yield of BL/BAL before and after FB was determined. Results: 678 cases were retrieved from the institutional files. The sensitivity and specificity of cytology were 83.0% and 83.4%, respectively. By FB in 3.9% of cytologically diagnosed non-small cell lung carcinomas (NSCLC) a histological assignment to a NSCLC entity was not possible. Conclusions: Cytology is a reliable diagnostic tool in the diagnosis of lung malignancies. High diagnostic accuracy is achieved by a combination of BL/BAL before and after FB. The diagnostic yield of BL/BAL after FB was significantly higher than BL/BAL before FB. Subsequent tumor typing of cytologically diagnosed NSCLC was feasible in more than 95% of cases.

关键词： Lavage Cytology Accuracy Lung Cancer NSCLC Classification

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