Introduction to Cancer
David E. Thurston, Ilona Pysz in Chemistry and Pharmacology of Anticancer Drugs, 2021
The multiple genetic changes that result in cancer may take many years to accumulate. During this time, the biological behavior of the premalignant cells slowly changes from the properties of normal cells to cancer-like properties. Premalignant tissue can have a distinctive appearance under the microscope, and among the distinguishing traits are an increased number of dividing cells, variation in nuclear size and shape, variation in cell size and shape, loss of specialized cell features, and loss of normal tissue organization. Dysplasia is an example of an abnormal type of excessive cell proliferation characterized by a loss of normal tissue arrangement and cell structure in premalignant cells. These early neoplastic changes are distinct from hyperplasia, a reversible increase in cell division caused by an external stimulus, such as a hormonal imbalance or chronic irritation. The most severe cases of dysplasia are referred to as carcinoma in situ, meaning an uncontrolled growth of cells that remains in the original location and has not progressed to invading other tissues. Nevertheless, a carcinoma in situ may develop into an invasive malignancy and is usually removed surgically, if possible. The various mechanisms of cellular DNA damage are described below.
The Reproductive System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Several neoplastic disorders affect the female reproductive organs, the most frequent being cervical carcinoma. Cervical carcinoma is closely associated with a history of early and frequent coitus and multiple sex partners, and trauma from viral and bacterial infections is thought to be related to the neoplastic process. On the continuum from normal to invasive cancer, minimal cervical dysplasia is the first histologic change seen, indicating abnormal cell proliferation in the lower third of the epithelium, most of such lesions reverting to normal. Severe dysplasia is abnormal proliferation in two-thirds of the epithelium, and it is felt that most severe dysplasias progress to carcinoma in situ.
Endoscopic screening for upper gastrointestinal malignancy
David Westaby, Martin Lombard in Therapeutic Gastrointestinal Endoscopy A problem-oriented approach, 2019
Most techniques are at present concentrating on laser-induced fluorescence. Panjepour et al. [27] have successfully identified high-grade dysplasia in Barrett’s oesophagus using this technique. Thirty-six patients were studied and the area of Barrett’s oesophagus interrogated using a nitrogen-pumped dye laser emitting 410-nm light in 5-ns pulses. This was used to excite tissue autofluorescence which was collected by a fibre bundle and analysed by a spectrograph (Fig. 5.14). Both emitting and collecting fibres were included in a flexible fibreoptic probe (1.7 mm). The endoscopist passed this through the biopsy channel of the endoscope and placed the end just touching the tissue. It must be noted that the fluorescence intensity is strongly affected by the probe placement against the tissue. Multiple measurements were taken and a histological biopsy was taken from the sites of spectral measurement. A mathematical model on differential normalized fluorescence was developed. Using this method, seven patients were detected to have high-grade dysplasia, and all correlated completely with the biopsy samples. All six patients with low-grade dysplasia were also correctly identified. Non-dysplastic Barrett’s mucosa was identified in 16 of 23 patients (70%). An accompanying editorial [28] puts this paper in context, and suggests that a more user friendly system is required. It would be preferable if it was incorporated directly into the endoscope and real-time imaging and analysis required.
Prevalence of human papillomavirus infection in Brazilian women living with HIV: a systematic review and meta-analysis
Published in Expert Review of Anti-infective Therapy, 2022
Brenda Evelin Barreto da Silva, Lígia Mara Dolce de Lemos, Marcus Vinicius de Aragão Batista, Carlos Anselmo Lima, Paulo Ricardo Martins-Filho, Victor Santana Santos
Data were extracted using standardized tables and included author, publication year, Brazilian state and region, study design, characteristics of the studied subjects, study setting (inpatient or outpatient), HPV detection method (polymerase chain reaction [PCR], PCR and sequencing, PCR and hybridization, PCR-restriction fragment length polymorphism [RFLP] and hybridization), pregnancy status (non-pregnant, pregnant, both pregnant and non-pregnant and unknown), sample size, number of HPV-positive samples, the proportion of cases with high-risk HPV, HPV genotypes identified and frequency. In addition, we extracted the proportion of HR HPV by type of cervical lesion. For the analysis, we categorized the cervical lesions as: (i) negative for intraepithelial lesion or malignancy (NILM), (ii) dysplasia, which included low- and high‐grade squamous intraepithelial cervical lesions and atypical squamous or glandular cells, and (iii) carcinoma, when invasive cervical cancer had occurred. These categories were based on the cytological and/or histological findings reported by the included studies.
Long term outcomes of sporadic large fundic gland polyps: a single-center experience
Published in Scandinavian Journal of Gastroenterology, 2021
Abdul Mohammed, Rajat Garg, Sushrut Trakroo, Amandeep Singh, Madhusudhan R. Sanaka
Our study has many limitations. First, with retrospective studies, temporal relationship is frequently difficult to assess. Although our study indicated that obesity could be a potential risk factor in developing FGPs, direct causation cannot be validated. Similarly, reflux-like symptoms appear to be predominantly associated with large sporadic FGPs. However, this is likely related to the widespread use of PPIs in patients with GERD. Second, three patients in our study cohort developed dysplasia on follow-up. We cannot sufficiently explain these findings, but the number of study subjects affected is significantly low enough to be entirely due to chance. Third, our research data is derived from a population without dysplasia at index endoscopy. It does not represent the entire population of patients with fundic gland dysplasia. Fourth, the prevalence of sporadic FGPs in our study is higher (3.3%) when compared to reported literature. This is likely related to selection bias. Finally, since there are no guidelines pertaining to the follow-up of large FGPs, all of our study population did not undergo follow-up endoscopy procedures. Hence, the natural history of all polyps cannot be elucidated.
Colorectal cancer surveillance with chromoendoscopy in inflammatory bowel disease: results from a real-life experience
Published in Scandinavian Journal of Gastroenterology, 2021
Cristina Rubín de Célix, María Chaparro, José Andrés Moreno, Cecilio Santander, Javier P. Gisbert
The patients’ characteristics were analyzed in a univariate study according to whether they showed dysplasia or not. Regarding qualitative variables, percentages were calculated (95% confidence interval). As for quantitative variables, arithmetic mean and standard deviation were calculated. Categorical variables were compared by chi-square test (χ2), while quantitative variables were tested by either Student’s t-test or Wilcoxon according to whether the values followed a normal distribution or not. In the multivariate study, the development of dysplasia was considered as the dependent variable, while the independent variables were those which had shown statistical significance in the univariate study, as well as those variables which were clinically relevant. Clinical and demographic variables were included in the multivariate study, and the data for each patient were analyzed. On the other hand, morphologic and histologic characteristics of the detected polyps were analyzed by chromoendoscopy.
Related Knowledge Centers
- Epithelial Dysplasia
- Histology
- Histopathology
- Multicystic Dysplastic Kidney
- Neoplasm
- Hyperplasia
- Myelodysplastic Syndrome
- Metaplasia
- Fibrous Dysplasia of Bone
- Hip Dysplasia