• Title/Summary/Keyword: premalignant lesion

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Premalignant Lesions of Gallbladder Carcinoma and Treatment (담낭암 발생 관련 질환과 치료)

  • Yun, Sung-Su
    • Journal of Yeungnam Medical Science
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    • v.23 no.2
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    • pp.152-161
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    • 2006
  • Carcinoma of the gallbladder is an uncommon but highly malignant tumor with a poor five year survival rate. Early detection is very important for successful treatment because this tumor is very hard to cure in cases where it has advanced beyond the reach of surgical treatment. The purpose of this review was to evaluate risk factors for carcinoma of the gallbladder and determine the best management approach.. Solitary polys, more than one cm are considered to be predisposing factors for gallbladder carcinoma when they are found to be echopenic, sessile, and with a high cell density. Anomalous union of the pacreato-biliary duct(AUPBD) without a choledochal cyst is also considered to increase risk for gallbladder carcinoma. A polyps size of more than one cm and an AUPBD are indications for prophylactic cholecystectomy. The presence of gallstones is a well-established risk factor for the development of gallbladder carcinoma; risk appears to correlate with the stone size and the duration of chronic cholecystitis. Metaplastic changes of the gallbladder epithelium present with chronic cholecystitis and may indicate a premalignant lesion. Abnormal forms of cholecystitis such as xanthogranulomatous or a porcelain gallbladder also have malignant potential; cholecystoenteric fistula as well as bacterial infection of the gallbladder(typhoid, helicobacter species) also has malignant potential. In this review, the risk factors associated with carcinoma of the gallbladder are summarized with special attention to gallstones, polyps, AUPBD, and chronic inflammation.

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Improved Detection of Helicobacter pylori Infection and Premalignant Gastric Mucosa Using Conventional White Light Source Gastroscopy

  • Matrakool, Likit;Tongtawee, Taweesak;Bartpho, Theeraya;Dechsukhum, Chavaboon;Loyd, Ryan A;Kaewpitoon, Soraya J;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2099-2103
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    • 2016
  • Background: The gold standard diagnosis of H. pylori related gastritis is evidence of bacteria on histopathological examination of gastric mucosa. Our aim was to study the correlation between gastric mucosal morphology and histopathological severity of H. pylori related gastritis. Materials and Methods: Division was made on morphological features into:Type 1, showing regular arrangement of red dots; Type 2, showing cleft-like appearance; Type 3, with a mosaic appearance; and Type 4, having a mosaic appearance with focal or diffuse hyperemia. Results: Types 1 and 2 gastric mucosal morphologies were statistically significant in predicting an H. pylori negative status (137/145, p<0.01), while Types 3 and 4 were significant a positive status (139/155, p<0.01). The sensitivity, specificity, positive and negative predictive values of Type 3 and 4 morphologies for predicting H. pylori positive were 94.6%, 89.5%, 89.7% and 94.5%, respectively, with a good correlation with inflammation grading (p<0.01). Conclusions: Our study suggests that gastric mucosal morphology can be reliably identified using conventional white light source gastroscopy with good correlation between findings and inflammation grading.

Acupuncture Application Case Report for Symptom Relief of Oral Leukoplakia (구강 백반증의 증상 완화에 대한 침치료 적용 사례)

  • Park, Sung-gu;Jo, Eun-hee;Choi, Hangyul;Hong, Jieun;Park, Min-cheol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.2
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    • pp.97-101
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    • 2020
  • Oral leukoplakia is the most common premalignant lesion of the oral mucosa. This case report presents the effect of acupuncture on Oral leukoplakia. The 67 years old male patient who has suffered for 2 years was treated with Right side Saam acupucture Damjeonggyeok(BL66, GB43, LI1, GB44) without other treatment. Acupuncture was performed for 15 minutes. The effect of acupuncture was evaluated as photographic change and visual analog scale(VAS) of subjective symptoms in oral cavity. After 87th acupunture treatment during 226 days, Leukoplakias were decreased at the right side of ventral tongue and the left border of the tongue and the lower lip. Furthermore, ulcer, erosion at the left border of the tongue were disappeared and VAS of Burning pain in the tongue decreased from 8 to 2. Although acupuncture is unusual treatment for Oral Leukoplakia, this case report suggested the effectiveness of using Damjeonggyeok on Oral Leukoplakia according to Saam acupuncture method.

Serum Gastrin and the Pepsinogen I/II Ratio as Markers for Diagnosis of Premalignant Gastric Lesions

  • Shafaghi, Afshin;Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Sharafkhah, Maryam;Mesbah, Alireza;Askari, Kurosh;Geranmayeh, Siamak;Mehrvarz, Alireza;Souti, Fatemeh;Sokhanvar, Homayoon;Fakhrieh, Saba;Aminian, Keyvan;Yousefi-Mashhour, Mahmud;Khosh-Sorur, Mahmud;Rasoulian, Javid
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3931-3936
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    • 2013
  • Background: Iran is a country with very high incidences of stomach cancer, especially in Northern parts. Here we assessed prognostic value of serum screening biomarkers among people >50 years old for early detection of precancerous lesions in a hot spot for gastric carcinoma in Guilan Province, North Iran. Methods: A cross-sectional population-based survey was conducted on 1,390 residents of Lashtenasha city with the mean age (SD) of 61.8 (9.02) years old (50.8% females) to assess the association of gastrin and the pepsinogen (PG) I/II ratio with premalignant gastric lesions. Blood samples were taken for CBC, blood group, and serologic exams (PGI, PGII, and gastrin 17) from each subject. Expert gastroenterologists performed upper GI endoscopy and ROC curves were generated to determine appropriate cutoff points. Results: Mean values of PGI, PGII, PGI/PGII and gastrin were significantly different between patients with and without atrophy or metaplasia (P<0.05). To diagnose atrophy and intestinal metaplasia, a significantly higher AUC was observed for the PGI/PGII ratio (70 and 72%, respectively) compared to the PGI (56, 55%), PGII (63, 64%) and gastrin (59, 61%) (all p<0.001). Conclusions: Biomarker tests such as the PGI/II ratio can be used in the screening and diagnosis of subjects at high gastric cancer risk in our region.

Classification and Clinical Implications of Precancerous Lesions in the Stomach (위에서 전암병변의 분류와 임상적 의의)

  • Kim, Kyoung-Mee
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.46-50
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    • 2009
  • During carcinogenesis, precancers (premalignant lesions) are the morphologically identifiable lesions that precede invasive cancers. In theory, the successful treatment of precancers would result in the eradication of most human cancers. Despite the importance of these lesions, there has been no effort to list and classify all of the precancers. In 2001, the NCI sponsored a workshop on the classification of precancers. When considering all the possible classes of precancers, it is worth noting that not all precancers are neoplastic. In fact, precancers need not progress to cancer, and precancerous lesions often have a high rate of regression. Thus, the following five classes were adopted: 1) acquired microscopic precancers; 2) acquired large lesions with microscopic atypia; 3) Precursor lesions occurring with inherited hyperplastic syndromes that progress to cancer; 4) acquired diffuse hyperplasias and diffuse metaplasias; and 5) currently unclassified entities. In this review paper, precancerous lesions of the stomach are classified and their clinical significance is described.

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Detection of Epstein-Barr virus in the inflammatory and neoplastic uterine cervical lesions (자궁경부의 염증 및 종양병변에서 Epstein-Barr 바이러스의 검출)

  • Jeong, Hye-Jin;Lee, Eung-Seok;Lin, Zhen-Hua;Park, Seol-Hee;Kang, Jae-Sung;Kim, In-Sun
    • The Korean Journal of Cytopathology
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    • v.12 no.2
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    • pp.73-80
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    • 2001
  • The prevalence of Epstein-Barr virus(EBV) in the uterine cervix was investigated to define the possible etiologic role in cervical carcinogenesis. The viral genotyping and LMP-1 30bp deletion were also stooled. The materials included 169 uterine cervical swabs(152 within normal limits, 12 atypical squamous cells of uncertain significance, 3 low grade intraepithelial lesions, and 2 high grade squamous intraepithelial lesion) and 104 uterine cervical tissues obtained from hysterectomy specimens(32 carcinoma in situ, 9 microinvasive squamous cell carcinomas, 37 invasive squamous cell carcinomas, 7 adenocarcinomas, 7 adenosquamous carcinomas, and 12 cervicitis). EBV detected by PCR for EBNA-1 was positive in 52(56.5%) of 92 invasive and noninvasive cervical carcinomas, and 80(48.8%) of 164 inflammatory or normal cervices. The viruses detected in carcinomas were all type A, and LMP-1 30bp deletion form was more frequent in premalignant and malignant cervical lesions than in nonneoplastic cervices. From the above results, it may be concluded that EBV is one of common viruses detected in uterine cervix of Korean women, and type A virus and LMP-1 30bp deletion form may have a role in cervical carcinogenesis.

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Suitability/Unsuitability of Cell Proliferation as an Indicator of Malignant Potential in Oral Lichen Planus: an Immunohistochemical Study

  • Zargaran, Massoumeh;Jamshidi, Shokoofeh;Eshghyar, Nosratollah;Moghimbeigi, Abbas
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6979-6983
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    • 2013
  • Background: Oral lichen planus (OLP) is categorized as premalignant lesion although its malignant potential is a matter of controversy. The objective of this study was to investigate Ki67 expression in OLP, oral epithelial dysplasia and oral squamous cell carcinoma (OSCC). Materials and Methods: Expression of Ki67 was evaluated through immunohistochemistry (IHC) in groups of A (17 cases of epithelial hyperplasia), B (16 cases of OLP), C1 (10 cases of mild epithelial dysplasia), C2 (10 cases of severe epithelial dysplasia), D1 (10 cases of well-differentiated OSCC), and D2 (10 cases of poorly-differentiated OSCC). Results: There was a significant difference in Ki67 expression based on quantitative analysis among the six studied groups as well as group B compared bilaterally with groups C2, D1 and D2 (p< 0.0001). However, there was no significant difference between groups B and C1 or between groups D1 and D2 (p> 0.05). Conclusions: Based on the results of the present study it may not be possible to definitely consider malignant transformation potential for OLP. However, expression of Ki67 was significantly higher in OLP than that of epithelial hyperplasia with no significant difference from that of mild epithelial dysplasia. This should be considered by clinicians to carefully and regularly follow up OLP lesions to detect potential subtle changes at an early stage.

Usefulness of V-Y Advancement Flap for Defects after Skin Tumor Excision

  • Kwon, Ki Hyun;Lee, Dong Gwan;Koo, Su Han;Jo, Myoung Soo;Shin, Heakyeong;Seul, Jung Hyun
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.619-625
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    • 2012
  • Background After skin tumor excision on the face, extremities, or trunk, the choice of treatment for a skin defect is highly variable. Many surgeons prefer to use a local flap rather than a skin graft or free flap for small- or moderately-sized circular defects. We have used unilateral or bilateral V-Y advancement flaps, especially on the face. Here we evaluated the functional and aesthetic results of this technique. Methods All of the patients were pathologically diagnosed with squamous cell carcinoma (SCC), basal cell carcinoma (BCC), or malignant melanoma or premalignant lesion (Bowen's disease). Thirty-two patients underwent V-Y advancement flap repair (11 unilateral and 21 bilateral) from January 2007 to June 2011. We analyzed the patients' age and satisfaction, and location and size of defect. The patients were followed up for 6 months or more. Results There were 22 women and 10 men. The ages ranged from 47 to 93 years with a mean age of 66 years. The causes were SCC in 15 cases, BCC in 13 cases, malignant melanoma in 1 case, Bowen's disease in 2 cases, and another cause in 1 case. The tumor locations were the face in 28 patients, and the scalp, upper limb, and flank each in one patient. All of the flaps survived and the aesthetic results were good. Postoperative recovery was usually rapid, and no complication or tumor recurrence was observed. Conclusions The V-Y advancement flap is often used not only for facial circular defects but also for defects of the trunk and extremities. Its advantages are less scarring and superior aesthetic results as compared with other local flap methods, because of less scarification of adjacent tissue and because it is an easy surgical technique.

Effectiveness of the Microlux/DLTM Chemiluminescence Device in Screening of Potentially Malignant and Malignant Oral Lesions

  • Ibrahim, Suzan Seif;Al-Attas, Safia Ali;Darwish, Zeinab Elsayed;Amer, Hala Abbas;Hassan, Mona Hassan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6081-6086
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    • 2014
  • Background: To evaluate the effectiveness of Microlux/DL with and without toluidine blue in screening of potentially malignant and malignant oral lesions. Materials and Methods: In this diagnostic clinical trial clinical examination was carried out by two teams: 1) two oral medicine consultants, and 2) two general dentists. Participants were randomly and blindly allocated for each examining team. A total of 599 tobacco users were assessed through conventional oral examination (COE); the examination was then repeated using Microlux/DL device and toluidine blue. Biopsy of suspicious lesions was performed. Also clinicians opinions regarding the two tools were obtained. Results: The sensitivity and, specificity and positive predictive value (PVP) of Microlux/DL for visualization of suspicious premalignant lesions considering COE as a gold standard (i.e screening device) were 94.3%, 99.6% and 96.2% respectively, while they were 100%, 32.4% and 17.9% when considering biopsy as a gold standard. Moreover, Microlux/DL enhanced detection of the lesion and uncovered new lesions compared to COE, whereas it did not alter the provisional clinical diagnosis, or alter the biopsy site. On the other hand, adding toluidine blue dye did not improve the effectiveness of the Microlux/DL system. Conclusions: The Microlux/DL seems to be a promising adjunctive screening device.

Does treatment of Helicobacter Pylori Infection Reduce Gastric Precancerous Lesions?

  • Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Mojtahedi, Kourosh;Sokhanvar, Homayoon;Askari, Kourosh;Shafaeizadeh, Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1571-1574
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    • 2015
  • Background: Treatment of Helicobacter pylori (H. pylori) decreases the prevalence of gastric cancer, and may inhibit gastric precancerous lesions progression into gastric cancer. The aim of this study was to determine the effect of treatment on subsequent gastric precancerous lesion development. Materials and Methods: We prospectively studied 27 patients who had low grade dysplasia at the time of enrollment, in addition to dysplasia atrophic gastritis and intestinal metaplasia observed in all patients. All were prescribed quadruple therapy to treat H. Pylori infection for 10 days. Patients underwent endoscopy with biopsy at enrollment and then at follow up two years later. Biopsy samples included five biopsies from the antrum of lesser curvature, antrum of greater curvature, angularis, body of stomach and fundus. Results of these biopsies were compared before and after treatment. Results: Overall, the successful eradication rate after two years was 15/27 (55.6%). After antibiotic therapy, the number of patients with low grade dysplasia decreased significantly (p=0.03), also with reduction of the atrophic lesions (p=0.01), but not metaplasia. Conclusions: Treatment of H. pylori likely is an effective therapy in preventing the development of subsequent gastric premalignant lesions.