Adenocarcinoma is the most frequent pathology diagnosed in patients with pancreatic mass lesions, and it must be differentiated into benign and inflammatory tumors.The aim of the study was to define the efficacy of ultrasound, computed tomography (US/CT) and fine-needle aspiration biopsy (FNAB) in the assessment of pancreatic mass lesions.Material and methods. The study population comprised 150 consecutive patients with heterogeneous pancreatic mass lesions treated at our department between 1999 and 2004. Imaging examinations with US/CT and FNAB were carried out in all the patients. The final nature of the tumor was established based on histopathology in patients who underwent surgery or based on the follow-up course in patients who were not referred to surgical exploration. The sensitivity and specificity of US/CT and FNAB were calculated by comparing the clinical diagnosis resulting from US/CT interpretation and FNAB results obtained before treatment with the final diagnosis.Results. FNAB appeared to be a safe and relatively simple procedure with no remarkable complications. Malignant tumors were finally diagnosed in 99 (66%), and benign were finally diagnosed tumors in 51 (34%) patients. The sensitivity and specificity were calculated to be 90% and 77.3% for US/CT and 86.9% and 100% for FNAB, respectively.Conclusions. The imaging examination with US/CT is a relatively reliable method for the differential diagnosis of pancreatic mass lesions. A positive FNAB has still remained the most accurate diagnostic method.
Colorectal cancer constitutes 10% of all malignant neoplasms and is the fourth most common cancer in men and the third most common cancer in women, worldwide (second most common in Poland). Unfortunately, despite large scale screening programs, changes in diet and lifestyle, colorectal cancer incidence rates for both male and female patients has increased.The aim of the study was to analyze the influence of preoperative radiotherapy (RTH) on the survival and local recurrence rate of patients with rectal cancer, subject to surgical treatment with postoperative (adjuvant) chemotherapy (CTH).Material and methods. The study group comprised 132 patients, including 53 females and 79 males. Patients were divided into the following groups: I - 70 patients treated by means of preoperative radiotherapy, II - 62 patients treated by means of surgery alone. Patients qualified to radiotherapy were diagnosed with stage B (39 patients) and stage C (31 patients) cancer, according to Duke's classification (CT).The patients received 5 Gy each day for a period of 5 days (25 Gy altogether), and underwent surgery. Postoperative pathomorphology demonstrated the following: group I comprised 39 patients with stage B and 31 patients with stage C cancer, whereas group II comprised 34 and 28 patients, respectively. Patients with stage B and C (both groups) received postoperative chemotheraphy - six courses of 5-FU 435 mg/kg/d with leucovorin 20 mg/m2.Results. Kaplan-Meier's survival analysis was applied in each group, according to the following: grade of tumor (pT), lymph node involvement (pN, pN "+",pN "-"), type of surgical resection, stage of cancer, administration of radiotherapy, and presence of local recurrence. Result analysis point to the existing correlation between radiotherapy and the five-year survival rate (p=0.031), and local recurrence (stage B: p=0.1; stage C: p=0.049).Conclusions. Preoperative radiotherapy, considering prospective studies and our own study render hope for better prospects of treating rectal carcinoma in the future, and better 5-year survival rates. Analysis of the five-year survival rates, local recurrences, and distant complications confirmed the effectiveness and safety of preoperative radiotherapy in the treatment of rectal cancer, considering B and C patients.
Two molecules - vascular endothelial growth factor involved in new vessels formation and survivin - antiapoptotic protein, reported to be associated with worse prognosis in various malignancies have been chosen for the study. Both are potential target for novel therapiesThe aim of the study was to determine the immunostaining of VEGF and survivin in gastric carcinoma and to analyse their relationship to the selected clinicopathological features and survival.Material and methods. Formalin-fixed, paraffin-embedded sections from 41 gastric adenocarcinomas were used for immunohistochemical reaction with monoclonal antibodies against vascular endothelial growth factor and survivin. The results were compared with selected clinicopathological features and survival.Results. Positive immunohistochemical reaction for vascular endothelial growth factor and survivin was revealed in 24 (58,53%) and 30 (73,17%), gastric carcinomas respectively. Vascular endothelial growth factor-negative gastric carcinomas were significantly more common in cases without metastases to regional lymph nodes and distant organs and in less advanced cases. Similar, distant metastases were also statistically less common in survivin-negative carcinomas. The differences in immunohistochemical reactions for survivin between less and more advanced cases almost reach statistical significance. The only factors significantly influenced 1, 2 and 3-year survival were vascular endothelial growth factor and survivin status. Statistically significant higher percentage of survival was noted in patients with vascular endothelial growth factor- and survivin-negative tumors.Conclusions. It seems that vascular endothelial growth factor and survivin play role in local invasion and spread of gastric adenocarcinoma and negatively influences survival. However, further studies are required to assess their true usefulness in the clinical practice.
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