A CYTOLOGICAL AND HISTOPATHOLOGICAL CORRELATIVE STUDY ON NEOPLASTIC LESIONS WITH MILAN SYSTEM FOR REPORTING SALIVARY GLAND CYTOPATHOLOGY.

BACKGROUND: Salivary gland tumors are rare. Nevertheless, the accurate preoperative diagnosis of the malignant potential of the lesion is essential for appropriate patient management. The recently published Milan system for reporting salivary gland cytology (MSRSGC) is an effort to provide better communication regarding the nature of lesions to clinicians. Aim: To evaluate the diagnostic utility of fine-needle aspiration cytology (FNAC) of neoplastic salivary gland lesions and the MSRSGC applicability in risk stratification. MATERIALS AND METHODS: This was a retrospective study of the cytological and histopathological correlation between neoplastic lesions of salivary gland lesions conducted over four years (August 2010 - September 2014) in two tertiary care hospitals. There were 66 cases of FNAC of salivary gland neoplasms. The sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of FNAC were analyzed. The risk of malignancy for MSRSGC was calculated. RESULTS: The overall diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values were 93.94; 95.5; 99.8; 96.8, and 98.7%, respectively. By correlating the cytological diagnosis of benign neoplasm with histopathological diagnosis, the risk of malignancy was 0% and risk of neoplasm was 100%. For cases in the category suspicious of malignancy, risk of neoplasm was 100% and risk of malignancy was 85%. CONCLUSION: The present study demonstrated that this salivary gland cytology reporting system was useful in classifying the lesions in well-delineated categories with ease. MSRSGC system of standardized reporting is helpful for guiding clinicians in appropriate management of the patient. However, many multicenter studies with large sample sizes and long-term follow-up are needed along with wide propagation of its standardized reporting format to be adopted universally.

Abnormal amyloid ß42 expression and increased oxidative stress in plasma of CKD patients with cognitive dysfunction: A small scale case control study comparison with Alzheimer's disease.

BACKGROUND: Cognitive dysfunction has been increasingly recognized in chronic kidney disease (CKD) patients. Senile plaques are important pathophysiological characteristic of cognitive dysfunction. The major component of plaques is the amyloid ß (Aß) peptide released from proteolytic cleavage of amyloid precursor protein (APP). Plasma Aß has been a focus of the growing literature on blood based biomarkers for cognitive dysfunction. Oxidative stress is prevalent in CKD and it plays an important role in cognitive dysfunction. Increased oxidative stress leads to cause cleavage of APP and Aß production. The aim of this study is to assess the antioxidant status and Aß42 levels in plasma of CKD patients with cognitive dysfunction compared to CKD without cognitive dysfunction. METHODS: A total of 60 subjects divided into 30 CKD without cognitive dysfunction and 30 CKD with cognitive dysfunction based on neuropsychological assessment tests. To compare antioxidant status and Aß42 levels in plasma, the following groups such as healthy subjects (n = 30), normocytic normochromic anemia (n = 30) and Alzheimer's disease (AD, n = 10) patients were also maintained. Plasma Superoxide dismutase (SOD), Catalase (CAT), Glutathione peroxidase (GPx), Reduced glutathione (GSH) and lipid peroxidation (LPO) were determined by spectrophotometrically. Aß level was determined by immunoblotting method. The parameters were statistically compared with healthy, normocytic normochromic anemia and AD subjects. RESULTS: Like AD subjects, significantly increased Aß and LPO level while decreased SOD, CAT, GPx and GSH levels were observed in plasma of CKD patients with cognitive dysfunction when compared to healthy, CKD without cognitive dysfunction and normocytic normochromic anemic subjects. CONCLUSION: Results suggest that elevated plasma oxidative stress and Aß were seen in CKD patients with cognitive dysfunction may be attributed to pathological changes within the brain.