Malignancy rates in thyroid nodules: a long-term cohort study of 17,592 patients.

Objectives: Ultrasound diagnosis of thyroid nodules has greatly increased their detection rate. Their risk for malignancy is estimated between 7 and 15% in data from specialized centers which are used for guidelines recommendations. This high rate causes considerable anxiety to patients upon first diagnosis.

Papillary Thyroid Cancer and Coexisting Autoimmune Thyroiditis.

Histological findings often display an association between papillary thyroid carcinomas (PTC) and autoimmune thyroiditis (AIT) and so differ significantly from follicular thyroid carcinomas (FTC). The aim of this interdisciplinary, retrospective study was to evaluate the association of AIT in patients with PTC and FTC and a control group of benign nodular goiters. One hundred thyroidectomies with histologically confirmed differentiated thyroid carcinomas, 67 with PTC and 33 with FTC, were submitted for examination.

Low Malignancy Rates in Fine-Needle Aspiration Cytologies in a Primary Care Setting in Germany.

Background: Reported results for thyroid nodule fine-needle aspiration (FNA) cytology mainly originate from tertiary centers. However, thyroid nodule FNA cytology is mainly performed in primary care settings for which the distribution of FNA Bethesda categories and their respective malignancy rates are largely unknown. Therefore, this study investigated FNA cytology malignancy rates of a large primary care setting to determine to what extent current evidence-based strategies for the malignancy risk stratification of thyroid nodules are applied and applicable in such primary care settings.

Evaluation of a Two-Year Routine Application of Molecular Testing of Thyroid Fine-Needle Aspirations Using a Seven-Gene Panel in a Primary Referral Setting in Germany.

Background: Major differences with respect to the diagnostic performance of a "ruling in" approach in the presurgical diagnosis of indeterminate thyroid fine-needle aspirations (FNAs) have been reported. Therefore, the aim of this prospective multicenter study was to investigate the specific diagnostic impact of mutation testing using a seven-gene panel in a routine primary referral setting analyzing FNAs from endocrinology and nuclear medicine practices in Germany.

Methods: RNA and DNA was extracted from 564 routine air-dried FNA smears obtained from 64 physicians and cytologically graded by one experienced cytopathologist.

[Fine-needle aspiration cytology of thyroid nodules: molecular diagnostics in a routine diagnostic setting].

Background And Objective: Results for the detection of point mutations and rearrangements have thus far been obtained by fresh material of fine needle aspiration cytology (FNAC). After a first retrospective study we report on the diagnostic detection in routinely obtained, consecutive air-dried FNAC smears.

Methods: RNA and DNA was extracted from 154 consecutive routine air-dried FNAC smears: 80 with microfollicular proliferation (MFP), 45 with follicular neoplasia (FN), 26 with the cytological diagnosis of papillary carcinomas (PTC) and 3 which were suspicious for malignancy.

Analysis of DNA mismatch repair gene expression and mutations in thyroid tumours.

Alterations of DNA mismatch repair genes, primarily demonstrated in hereditary nonpolyposis colorectal carcinomas, were reported to be of relevance for the progression of several sporadic tumours. In this study, the expression and mutations of MLH1, MSH2, PMS1 and PMS2 in a panel of thyroid tumours, including nodular hyperplasia, follicular adenomas and carcinomas, were investigated. The expressions of MLH1, MSH2 and PMS1 were generally higher in malignant tumours than in benign lesions (p < 0.

Cytokeratin expression correlates with aneuploidy in cytological specimens of melanoma metastases.

It has been postulated that the high malignancy of melanomas could be connected with an increased cytokeratin (CK) expression. In order to define the relationship between CK expression and genetic instability of melanoma metastases, ploidy-related parameters were compared in cytological specimens of CK-positive and CK-negative melanoma metastases. CK expression was investigated immunohistochemically in 35 melanoma liver metastases and in 52 melanoma lymphatic metastases.

The value of ultrasound-guided fine-needle aspiration cytology of the breast: 354 cases with cytohistological correlation.

Background: Fine-needle aspiration cytology has a high rating in the assessment of breast lesions in many countries. We want to present the results of close cooperation between experienced radiologists and cytopathologists in the diagnosis of breast lesions.

Materials And Methods: Fine-needle aspiration cytology (FNAC) from 354 breast lesions assessed under ultrasound guidance were analysed retrospectively.

Relationship between DNA mismatch repair genes expression, Ku-genes expression and ploidy-related parameters in the progression of pigmented lesions of the skin.

Defects of DNA repair systems in cutaneous tumours are related to DNA mismatch repair genes (MLH1, MSH2, PMS1, PMS2) and Ku70/80 genes involved in double- strand repair. In this study we investigated the statistical relationship between these systems and DNA-ploidy-related parameters in 19 naevus cell naevi, 23 lentigos maligna, 76 primary melanomas and 31 melanoma metastases, applying the correlation coefficient according to Spearman. In naevi significant correlations were found between Ku70/80 gene expression and some ploidy-related parameters.

Comparative study of p63 and p53 expression in tissue microarrays of malignant melanomas.

p63 is a known homologue of p53. In contrast to p53, however, p63 mutations are rarely seen in tumours. There have been several reports that p63 plays a regulatory role in the normal differentiation of cells, whereas its role in tumour biology must still be elucidated.

mRNA detection of tumor-rejection genes BAGE, GAGE, and MAGE in peritoneal fluid from patients with ovarian carcinoma as a potential diagnostic tool.

Background: It has been found that the members of the BAGE, MAGE, and GAGE gene families are expressed almost exclusively in neoplastic tissues. Normal tissues, except testis and placenta, are negative. Therefore, the expression of these genes may serve as a useful diagnostic marker in detecting malignant disease.

Downregulation of the retinoblastoma gene expression in the progression of malignant melanoma.

The retinoblastoma gene is a cell cycle regulator preventing cells from entering into S-phase. An altered expression of the retinoblastoma gene has been reported in the majority of human malignancies. The main aim of this study was to investigate retinoblastoma gene expression in the full spectrum of melanoma progression from naevus to melanoma metastases by applying immunohistochemistry and RT-PCR.

Fine needle aspiration of the thyroid: can an image processing system improve differentiation?

Objective: To differentiate thyroid nodules by means of fine needle aspiration with subsequent computer-aided diagnosis.

Study Design: Fine needle aspiration biopsies obtained from 137 patients for whom histopathologic diagnosis was available were investigated: 16 hyperplastic nodules (12%), 39 adenomas (28%), 25 follicular thyroid carcinomas (18%), 19 follicular variants of papillary thyroid carcinoma (14%) and 38 papillary thyroid carcinomas (28%). From each stained specimen 100 cell scenes were scanned and analyzed, constituting a total of 62,325 cell images.

p16 alterations and retinoblastoma protein expression in squamous cell carcinoma and neighboring dysplasia from the upper aerodigestive tract.

The progression potential of preinvasive epithelial lesions is usually evaluated by assessing the degree of histologic dysplasia. We examined p16, retinoblastoma protein (pRb), and proliferating cell nuclear antigen (PCNA) immunophenotypes in 57 cases of previously untreated squamous cell carcinoma (SCC) of the upper digestive tract and in the neighboring normal and dysplastic epithelia. Tissue samples were examined for homozygous deletion of exon 2 of the p16 gene using polymerase chain reaction (PCR) analysis.

Relation between DNA ploidy status and the expression of the DNA-mismatch repair genes MLH1 and MSH2 in cytological specimens of melanoma lymph node and liver metastases.

DNA-mismatch repair is essential for preventing genetic instability, and its important protective role has been demonstrated in several tumors. The main aim of this study was to investigate the expression of MLH1 and MSH2 (on the RNA level) in melanoma liver and lymph node metastases, and to define the relation between DNA ploidy status and mismatch repair gene expression. MLH1 was found in 29/33 melanoma lymph node and in 5/17 melanoma liver metastases.

Radiation induced early nuclear changes in cytologic brush specimens from the upper aerodigestive tract.

Objective: To evaluate the feasibility of DNA image cytometry to assess radiation induced early nuclear changes in cytologic smears from the upper aerodigestive tract.

Methods: 100 cytologic brush specimens from 50 postoperatively irradiated patients with upper aerodigestive tract carcinoma were examined Smears were taken from clinically inconspicuous mucosa from the former tumor site and from a control region (contralateral side). Cellular DNA was quantified using the CAS 200 image analysis system on Feulgen stained slides.

p53 and MDM2 protein expression in squamous cell carcinoma and neighboring dysplasia from the upper aerodigestive tract.

Background: The identification of genetic changes in preinvasive epithelial lesions may provide markers for a better assessment of the progression potential.

Materials And Methods: p53, MDM2 and PCNA immunophenotypes were examined in 57 cases of squamous cell carcinoma (SCC) of the upper aerodigestive tract and the adjacent normal and dysplastic epithelia.

Results: PCNA index increased with increasing grade of dysplasia.

Comparison of the DNA content in liver cell adenoma, hepatocellular carcinoma and regenerative nodules.

With regard to neoplasms of hepatocytes, diagnostic pitfalls have been reported for differentiation of liver cell adenoma (LCA) from well differentiated hepatocellular carcinoma (HCC). Since cytophotometric analysis of the DNA content with the help of image analysis has proven to be of diagnostic value in various neoplasms, we examined its ability to discriminate between LCA and HCC as well as regenerative liver nodules. The material investigated consisted of 54 cases of HCC, 10 benign liver tumours and 10 cases suspicious for HCC.

Proliferative activity in the progression of pigmented skin lesions, diagnostic and prognostic significance.

Proliferative compartments of a tumour can be determined cytophotometrically, by in situ hybridisation or by immunohistochemical detection of Ki67 antigen. The main objective of this study was to analyse the proliferative activity during the progression of pigmented skin lesions with respect to differential diagnostic and prognostic applications. The material investigated consisted of 209 pigmented skin lesions (31 naevi, 30 dysplastic naevi, 106 primary melanomas, 20 lymphatic and 22 organ melanoma metastases).

Relationship between GAGE-1/-2 expression, EBV infection and interferon-gamma expression in undifferentiated carcinoma of nasopharyngeal type.

GAGE-1/-2 proteins are novel tumour markers, functionally related to tumour rejection. The objective of the present study was to identify the existence of a relationship between GAGE-1/-2 expression, Epstein Barr Virus (EBV) infection and viral infection-induced cytokine expression in cultivated tumour cells and archival specimens of undifferentiated carcinoma of nasopharyngeal type (UCNT). PCR and in situ hybridization techniques were employed.

Prognostic significance of newly defined ploidy related parameters in melanoma.

5c exceeding rate is the parameter, most frequently showing prognostic impact. The CAS200 image analyzer makes possible the measurement of additional parameters defining single subfractions of cells, as for example the ratios of diploid, aneuploid, tetraploid, octaploid and 16-ploid cells. The main objective of this study was to define the prognostic significance of these new parameters in 106 primary melanomas with known survival time.

Comparison of the DNA content in the different steps of cutaneous carcinoma progression.

The main aim of this study was to check the application of ploidy related parameters for differential diagnosis between solar keratosis, Bowen's disease and squamous cell carcinoma of the skin. 10 specimens of normal epidermis, 68 solar keratoses, 50 cases of Bowen's disease and 10 squamous cell carcinomas (SCC) were stained with Feulgen and their ploidy status was evaluated with a CAS200 image analyzer. Significant and highly significant differences between groups investigated not only for 5c exceeding rate, but also for the ratios of diploid, aneuploid, tetraploid, octaploid and 16-ploid cells are demonstrated.

Myoepithelial sialadenitis versus low-grade non-Hodgkin's lymphoma of the salivary gland in FNAB: is discrimination by means of an image processing system possible?

The diagnosis of myoepithelial sialadenitis (MESA) in fine needle aspiration biopsy may be difficult. There is a dense lymphocytic infiltration in the gland and discrimination between a hyperimmune reaction and a low grade non-Hodgkin's lymphoma (NHL) of B-cell origin may be impossible. To get additional diagnostically helpful criteria, texture feature analysis on routinely obtained FNAB's of the salivary gland was applied.

Relevance of ploidy related parameters for prognosis in malignant fibrous histiocytomas.

Ploidy associated parameters were determined in 161 malignant fibrous histiocytomas (MFH) by DNA image cytometry. The rate of euploid cases in MFH with histopathological grade I was 42%, grade II 16% and grade III 6%. Univariate analyses showed that cases with a low percentage of diploid cells (< 40%) and cases with high rates of aneuploid cells between 4c and 8c (> 9%), octaploid cells (> 0%) and 16-ploid cells (> 0%), high 2.