RESUMEN
AIMS: To evaluate the interobserver variation in the diagnosis of cervical intraepithelial lesions, including the new category "borderline abnormalities of uncertain significance" (BAUS) which has not been tested before. METHODS: Biopsy specimens of 122 patients were reviewed by five histopathologists and the diagnoses subjected to kappa statistical analysis. RESULTS: There was poor interobserver agreement in all categories, particularly between BAUS and normal tissue. CONCLUSIONS: The current guidelines for the histological diagnosis of cervical intraepithelial neoplasia and BAUS are poorly reproducible.
Asunto(s)
Cuello del Útero/patología , Displasia del Cuello del Útero/patología , Neoplasias del Cuello Uterino/patología , Biopsia , Femenino , Humanos , Variaciones Dependientes del Observador , Papillomaviridae , Infecciones por Papillomavirus/patología , Infecciones Tumorales por Virus/patología , Neoplasias del Cuello Uterino/clasificación , Displasia del Cuello del Útero/clasificaciónRESUMEN
Because the risk factors for human immunodeficiency virus (HIV) infection and hepatitis B (HBV) are similar and therefore coinfection is not uncommon, a detailed histological and immunohistochemical study of chronic hepatitis B infection in a group of 20 HIV positive Caucasian males (who did not have AIDS) and 30 HIV negative controls were undertaken. Using both the conventional histological classification and the Knodell histological activity index it was shown that HIV negative patients were more likely to have active disease and also more scarring than HIV positive patients. Hepatitis B surface antigen (HBsAg) expression was not significantly different between the two groups but expression of hepatitis Be antigen (HBeAg) and HBV-DNA polymerase was greater in those who were HIV positive. HIV positive patients are therefore more likely to have immunohistochemical markers of active viral replication, although histologically, liver disease is less severe. These findings have important implications for assessing the biopsy specimens in this group of patients and for treatment strategies aimed at improving their immune function.
Asunto(s)
Seropositividad para VIH/patología , Hepatitis B/patología , Hígado/patología , Adulto , ADN Polimerasa Dirigida por ADN/análisis , Seropositividad para VIH/complicaciones , Hepatitis B/complicaciones , Hepatitis B/inmunología , Antígenos de Superficie de la Hepatitis B/análisis , Antígenos e de la Hepatitis B/análisis , Virus de la Hepatitis B/enzimología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The suggested link between angiogenesis in breast cancer and metastasis remains unsubstantiated. We tested this relationship in primary breast carcinomas from 37 patients with a median follow-up 9.5 years (Cohort 1) and 50 patients with a median follow-up of 1.5 years (Cohort 2). Angiogenesis was assessed by counting vessel density after immunohistochemical staining of vascular endothelium for factor VIII. Patients were grouped according to whether metastasis (defined as spread to axillary lymph nodes, distant sites or both) had occurred. The mean +/- SD scores in Cohort 1 when metastasis was absent and present, respectively, were 15.6 +/- 4.9 (n = 21) and 14.1 +/- 3.7 (n = 16). In Cohort 2 the scores were 15.4 +/- 5.8 (n = 26) and 14.5 +/- 4.9 (n = 24). There was no significant difference between these scores in either cohort. Multivariate analysis demonstrated lymph node involvement (P < 0.001) and tumour size (P < 0.001) but not angiogenesis score (P > 0.05) to predict distant metastasis. This evidence argues against any prognostic significance of angiogenesis in breast carcinoma.
Asunto(s)
Neoplasias de la Mama/irrigación sanguínea , Carcinoma/irrigación sanguínea , Neovascularización Patológica/patología , Anciano , Mama/irrigación sanguínea , Neoplasias de la Mama/epidemiología , Carcinoma/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Ganglios Linfáticos/patología , Metástasis Linfática , Persona de Mediana Edad , Neovascularización Patológica/epidemiología , Pronóstico , Análisis de RegresiónRESUMEN
A 67-year-old woman developed three separate pelvic malignancies forty years after undergoing radiotherapy for a squamous cell carcinoma of the cervix. Although previous exposure to ionising radiation is associated with certain malignancies, review of the literature indicates that there is no strong evidence to support such an association with urothelial or colorectal malignancy.