Trends in breast and cervical cancer in India under National Cancer Registry Programme: An Age-Period-Cohort analysis.

BACKGROUND: Trend analysis in cancer quantifies the incidence rate and explains the trend and pattern. Breast and cervical cancers are the two most common cancers among Indian women which contributed 39.4 % to the total cancer in India for the year 2020. This study aimed to report the time trends in cancer incidence of breast and cervical cancer using Age-Period-Cohort (APC) model from five Population Based Cancer Registries (PBCRs) in India for the period of 1985-2014. METHOD: Age-Period-Cohort model was fitted to five PBCRs of Bangalore, Chennai, Delhi, Bhopal and Barshi rural for breast and cervical cancer for 25-74 age-groups. The Estimated Annual Percent Change (EAPC) was calculated. Rate Ratio (RR) of cohort effects were estimated with a constraint of period slope to be zero (p = 0) since cohort has a stronger association with incidence than period. RESULT: A significant increase was noted in breast cancer in all PBCRs (EAPC, Range: Delhi, 1.2 % to Bangalore, 2.7 %) while significant decrease in cervical cancer (EAPC, Range: Bangalore -2.5 % to Chennai, -4.6 %) from all the PBCRs including Barshi rural during the period. RR estimates for breast cancer showed increasing trend whereas cervical cancer showed decreasing trend in successive birth cohorts across all five PBCRs. CONCLUSION: In both breast and cervical cancers, a significant age, cohort and period effect was noted in Bangalore, Chennai and Delhi. Despite period effect, the cohort effect was predominant and it may be attributed to the generational changes in risk factors among cancer breast and cervix.

Expression of p-16, Ki-67 and p-53 markers in dysplastic and malignant lesions of the oral cavity and oropharynx.

BACKGROUND: Understanding the markers for predicting degree of dysplasia and progression to malignancy can help early identification and prompt treatment of patients with oral cancers. In this study, we aim to identify and characterize different tumor suppressor genes such as p-53 and p-16 and proliferation marker Ki-67 in defining stages of dysplasia of oral mucosa and grading of tumor. SETTINGS AND DESIGN: Oral biopsy tissues (for neoplastic lesions) received for histopathological evaluation were included in the study. The sections were processed for H&E staining, and 112 cases were chosen for immunohistochemical study. The data were analyzed by Chi-square and z-tests using software SPSS. RESULTS: We found significant correlation between degree of dysplasia and p-16 immunoexpression with 16.7% of cases showing positivity in oral intraepithelial neoplasia (OIN) I cases as compared to 25% in OIN II and 77.8% in OIN III. Ki-67 immunoexpression correlated significantly with both histological type and grade of tumor with increased expression and intensity seen in malignant cases (66.3%) as compared to benign (10%) and premalignant cases (37%) and higher Ki-67 immunoexpression in poorly differentiated tumors (75%) than well-differentiated tumors (12.2%). Regarding p-53 immunoexpression, positive staining was seen in only malignant cases and premalignant cases. CONCLUSIONS: Ki-67 and p-16 can be useful as a marker of degree of dysplasia and transformation to malignancy. Ki-67 can also serve as a marker of degree of differentiation of tumors. Hence, they can serve as important ancillary markers to analyze the transition to carcinoma, dysplasia and progression of tumor.

Cytomorphological variables of hepatic malignancies in fine needle aspiration smears with special reference to grading of hepatocellular carcinoma.

BACKGROUND: The evaluation and management of discrete hepatic masses is a clinical problem. Ultrasound guided fine needle aspiration cytology (FNAC) is a rapid, accurate and safe diagnostic procedure that can be used in various neoplastic and non-neoplastic diseases of the liver. AIM: To evaluate the cytomorphological features of hepatocellular carcinoma. MATERIALS AND METHODS: Ultrasound-guided fine needle aspiration was performed on 52 patients clinically suspected of having hepatic lesion. RESULTS: Malignancy was detected in 50 cases. The primary malignancies consisted of 15 cases of hepatocellular carcinoma (HCC), 4 cases of cholangiocarcinoma and 2 of hepatoblastoma. There were 29 metastatic lesions, which included 26 cases of adenocarcinoma, 2 cases of squamous cell carcinoma and 1 of lymphoma. The key diagnostic features for HCC were trabecular arrangement, polygonal cells with eosinophilic and granular cytoplasm, hyperchromatic nuclei with macronucleoli. Atypical naked hepatocytic nuclei and malignant cells separated by sinusoidal capillaries were also commonly seen. The sensitivity and specificity of FNA for malignancies was found to be 96% and 100% respectively, yielding a positive predictive value of 100% and negative predictive value of 50%. CONCLUSIONS: There was a very good correlation of cytological criteria and histopathological diagnosis in hepatocellular carcinoma of various grades as well as in differentiating primary from metastatic tumors. It is recommended that image directed FNAC should be the primary diagnostic modality for assessing potential malignancy in any patient with a localized hepatic mass.

Skeletal angiomatosis - rare cause of bone destruction: a case report with review of literature.

Classification of skeletal angiomatosis into aggressive and nonaggressive types is on the basis of their clinical behavior and pattern of skeletal involvement (regional and disseminated). Gorham's disease (massive osteolysis) is an aggressive form of skeletal angiomatosis that shows regional involvement, frequently involving the shoulder and hip areas. Cystic angiomatosis is a nonaggressive form of skeletal angiomatosis with multifocal involvement, predominantly affecting the trunk bones. The imaging modalities gave the diagnosis of cystic angiomatosis of humerus showing multicystic lytic areas. The histopathological differential diagnosis was cystic angiomatosis and Gorham's disease, as microscopically both are indistinguishable from each other. Both represent a complex network of dilated thin-walled capillaries growing in the marrow space associated with the destruction of bone and infiltration into the adjacent soft tissues. The case is presented because of its extreme rarity and due to the diagnostic dilemma, whether to label it as Gorham's disease or as cystic angiomatosis. Considering the site involved and its aggressiveness, the diagnosis is in favor of Gorham's vanishing bone disease as cystic angiomatosis is multicentric and nonaggressive, involving mostly vertebrae and skull with multicystic lytic lesions.

Congenital epulis of the newborn: a case report with review of literature.

Congenital epulis, also known as congenital gingival granular cell tumor, is a rare benign intraoral tumor found only in the new born. It can be solitary or multiple and may occur in the mandible, maxilla or tongue and may or may not be associated with other congenital anomalies. The size of the mass varies and if very large may interfere with respiration and feeding at birth, thus necessitating the immediate surgical resection at birth to maintain patency of the airways. Antepartum detection by careful imaging and coordination of multidisciplinary team of maternal-fetal medicine, neonatal-perinatal medicine, anesthesiology and otolaryngology and finally the histopathologists who confirm the diagnosis is essential as the histology differentiates it from other congenital intraoral masses like haemangioma, fibroma, rhabdomyoma, rhabdomyosarcoma, lymphangioma, osteogenic and chondrogenic sarcomas.

Transformation of solitary osteochondroma calcaneum to chondrosarcoma--a case report.

Solitary osteochondroma of calcaneum is an uncommon benign tumor. Its malignant transformation to chondrosarcoma is rarely encountered. Pain and recent enlargement are clinical manifestations of this complication. Magnetic resonance imaging is a valuable tool to detect this change.

Breast lesions in young females--a 20-year study for significance of early recognition.

The aim of this case series is to evaluate the pattern of breast lumps in males and females with special reference to spectrum of lesions in females below 40 years of age. A 20 years retrospective study was undertaken from the records of the department of Pathology, Bhopal. The lesions were classified into benign and malignant. In young females histological pattern was analyzed in various age groups. A total of 1824 cases were studied. 1724 (94.5%) cases were seen in females and 100 (5.5%) in males. There were 1276 (74%) females below 40 years of age and 448 (26%) were above 40 years of age. In young females 1136 (89%) lesions were benign and 140 (11%) were malignant lumps. Fibrocystic disease in 60 (49%) cases constituted the largest group of benign lumps followed by 30 (24.5%) cases of inflammatory lesion in older females. The mean age of malignant tumors was 34.1 in young females and 51.4 in females above 40. Infiltrating duct carcinoma constituted 83.5% of malignant tumors in young females and 86.1% in older females.