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  • 1
    Online Resource
    Online Resource
    Poorly differentiated clusters and tumor budding are important prognostic factors in colorectal carcinomas
    Association of Basic Medical Sciences of FBIH ; 2021
    In:  Bosnian Journal of Basic Medical Sciences ( 2021-09-03)
    Details
    In: Bosnian Journal of Basic Medical Sciences, Association of Basic Medical Sciences of FBIH, ( 2021-09-03)
    Abstract: The aim of our study was to assess the prognostic value of the two new grading systems based on the quantification of tumor budding - TB (GBd) and poorly differentiated clusters - PDCs (PDCs-G) in colorectal carcinomas (CRC). We performed a retrospective study on 71 CRC patients who underwent surgery at the Emergency County Hospital, Timișoara. CRC cases were classified based on haematoxylin-eosin slides, using the conventional grading system, GBd and PDCs-G, respectively. We used two-tier and three-tier grading schemes for each system. Subsequently,  we evaluated  associations with other prognostic factors in CRC. Based on the three-tier GBd (GBd-3t)  most cases (34/69, 49.27%) were classified as G3Bd-3t, while based on the conventional grading system, the majority of the cases (55/69, 79.71%) were considered G2. On the other hand, based on the three-tier PDCs-G system (PDCs-G-3t), most cases (31/69, 44.93%) were PDCs-G2-3t. We also noted a more significant association of GBd-3t with other prognostic parameters analyzed, as compared to the conventional grading system. Nodal status, tumor stage, and lymphovascular invasion were strongly correlated with GBd-3t (p=0.0001). Furthermore, we noted that PDCs-G-3t correlated more significantly than the conventional grading system with nodal status (p 〈 0.0001), tumor stage (p=0.0003), lymphovascular invasion (p 〈 0.0001), perineural invasion (p=0.005) and the tumor border configuration (p 〈 0.0001).  High GBd and PDCs-G grades correlate directly with other negative prognostic factors in CRC.Thus, these new parameters/classification methods could be used as additional tools for risk stratification in patients with CRC.
    Type of Medium: Online Resource
    ISSN: 1840-4812 , 1512-8601
    URL: Article
    DOI: 10.17305/bjbms.2021.6110
    Language: Unknown
    Publisher: Association of Basic Medical Sciences of FBIH
    Publication Date: 2021
    detail.hit.zdb_id: 2548947-1
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  • 2
    Online Resource
    Online Resource
    Colorectal Carcinomas: Searching for New Histological Parameters Associated with Lymph Node Metastases
    MDPI AG ; 2023
    In:  Medicina Vol. 59, No. 10 ( 2023-10-02), p. 1761-
    Details
    In: Medicina, MDPI AG, Vol. 59, No. 10 ( 2023-10-02), p. 1761-
    Abstract: Background and Objectives: Colorectal cancer (CRC) continues to be an essential public health problem. Our study aimed to evaluate the prognostic significance of classic prognostic factors and some less-studied histopathological parameters in CRC. Materials and Methods: We performed a retrospective study on 71 colorectal carcinoma patients who underwent surgery at the “Pius Brînzeu” County Clinical Emergency Hospital in Timișoara, Romania. We analyzed the classic parameters but also tumor budding (TB), poorly differentiated clusters (PDCs) of cells, tumor-infiltrating lymphocytes (TILs), and the configuration of the tumor border on hematoxylin–eosin slides. Results: A high degree of malignancy (p = 0.006), deep invasion of the intestinal wall (p = 0.003), an advanced stage of the disease (p 〈 0.0001), lymphovascular invasion (p 〈 0.0001), perineural invasion (p 〈 0.0001), high-grade TB (p 〈 0.0001), high-grade PDCs (p 〈 0.0001), infiltrative tumor border configuration (p 〈 0.0001) showed a positive correlation with lymph node metastases. Conclusions: The analyzed parameters positively correlate with unfavorable prognostic factors in CRC. We highlight the value of classic prognostic factors along with a series of less-known parameters that are more accessible and easier to evaluate using standard staining techniques and that could predict the risk of relapse or aggressive evolution in patients with CRC.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina59101761
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2088820-X
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  • 3
    Online Resource
    Online Resource
    Management of HER2-Positive Breast Cancer for a Young Patient with Visceral Crisis—The Adjuvant Role of Lifestyle Changes
    MDPI AG ; 2022
    In:  Current Oncology Vol. 29, No. 3 ( 2022-03-10), p. 1890-1901
    Details
    In: Current Oncology, MDPI AG, Vol. 29, No. 3 ( 2022-03-10), p. 1890-1901
    Abstract: The safety profile and effectiveness of existing anti-HER2-targeted therapies have not been evaluated in patients with breast cancer and visceral crisis. We report the case of a 26-year-old woman who was diagnosed with advanced HER2-positive breast cancer and initially treated with curative intent therapy in a neoadjuvant setting, using Trastuzumab and Pertuzumab in combination with Docetaxel; her cancer recurred two years later, with liver metastases and pulmonary lymphangitic carcinomatosis, causing visceral crisis. Furthermore, the patient’s clinical status worsened when she developed respiratory failure, hepatomegaly and a severe hepatocytolysis. Since the patient was free of disease more than six months, we started with Paclitaxel half dose because of the hepatic dysfunction, and we gradually reintroduced Trastuzumab and then Pertuzumab. In the meantime, the patient changed her lifestyle by increasing her consumption of fresh fruits and vegetables and fiber and reducing her intake of processed meat, dairy and sugar. As a result, the patient showed a significant improvement in her respiratory symptoms and liver tests in less than two months. Imaging reevaluation showed partial remission of liver metastases and pulmonary lymphangitic carcinomatosis. She underwent seven months of dual anti-HER2 blockade before relapsing cerebrally. Our results suggest that the sequential combination therapy with Trastuzumab, Pertuzumab and Paclitaxel presented in this study, associated with a healthy lifestyle, may be a good management for recurrent HER2-positive breast cancer with pulmonary visceral crisis and severe liver dysfunction.
    Type of Medium: Online Resource
    ISSN: 1718-7729
    URL: Article
    DOI: 10.3390/curroncol29030154
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2270777-3
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  • 4
    Online Resource
    Online Resource
    Three‐Dimensional Virtual Pathology Specimens: Decrease in Student Performance upon Switching to Digital Models
    Wiley ; 2022
    In:  Anatomical Sciences Education Vol. 15, No. 1 ( 2022-01), p. 115-126
    Details
    In: Anatomical Sciences Education, Wiley, Vol. 15, No. 1 ( 2022-01), p. 115-126
    Abstract: Several alternatives to formalin‐stored physical specimens have been described in medical literature, but only a few studies have addressed the issue of learning outcomes when these materials were employed. The aim of this study was to conduct a prospective controlled study to assess student performance in learning anatomic pathology when adding three‐dimensional (3D) virtual models as adjunct teaching materials in the study of macroscopic lesions. Third‐year medical students (n = 501) enrolled at the Victor Babes University of Medicine and Pharmacy in Timisoara, Romania, were recruited to participate. Student performance was assessed through questionnaires. Students performed worse with new method, with poorer results in terms of overall (mean 77.6% ±SD 11.8% vs. 83.6% ±10.5) and individual question scores (percentage of questions with maximum score 34.6% ±25.6 vs. 47.7 ± 24.6). This decreased performance was generalizable, as it was observed across all language divisions and was independent of the teaching assistant involved in the process. In an open‐ended feedback evaluation of the new 3D specimens, most students agreed that the new method was better, bringing arguments both for and against these models. Although subjectively the students found the novel teaching materials to be more helpful, their learning performance decreased. A wider implementation as well as exposure to the technique and use of virtual specimens in medical teaching could improve the students’ performance outcome by accommodating the needs for novel teaching materials for digital natives.
    Type of Medium: Online Resource
    ISSN: 1935-9772 , 1935-9780
    URL: Issue
    URL: Article
    DOI: 10.1002/ase.v15.1
    DOI: 10.1002/ase.2041
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2403787-4
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  • 5
    Online Resource
    Online Resource
    Poorly differentiated clusters: prognostic significance in colorectal carcinomas
    Termedia Sp. z.o.o. ; 2019
    In:  Polish Journal of Pathology Vol. 70, No. 4 ( 2019), p. 235-245
    Details
    In: Polish Journal of Pathology, Termedia Sp. z.o.o., Vol. 70, No. 4 ( 2019), p. 235-245
    Type of Medium: Online Resource
    ISSN: 1233-9687
    URL: Article
    DOI: 10.5114/pjp.2019.93125
    Language: Unknown
    Publisher: Termedia Sp. z.o.o.
    Publication Date: 2019
    detail.hit.zdb_id: 2048446-X
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  • 6
    Online Resource
    Online Resource
    Comparative Evaluation of Breast Ductal Carcinoma Grading: A Deep-Learning Model and General Pathologists’ Assessment Approach
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 14 ( 2023-07-10), p. 2326-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 14 ( 2023-07-10), p. 2326-
    Abstract: Breast cancer is the most prevalent neoplasia among women, with early and accurate diagnosis critical for effective treatment. In clinical practice, however, the subjective nature of histological grading of infiltrating ductal adenocarcinoma of the breast (DAC-NOS) often leads to inconsistencies among pathologists, posing a significant challenge to achieving optimal patient outcomes. Our study aimed to address this reproducibility problem by leveraging artificial intelligence (AI). We trained a deep-learning model using a convolutional neural network-based algorithm (CNN-bA) on 100 whole slide images (WSIs) of DAC-NOS from the Cancer Genome Atlas Breast Invasive Carcinoma (TCGA-BRCA) dataset. Our model demonstrated high precision, sensitivity, and F1 score across different grading components in about 17.5 h with 19,000 iterations. However, the agreement between the model’s grading and that of general pathologists varied, showing the highest agreement for the mitotic count score. These findings suggest that AI has the potential to enhance the accuracy and reproducibility of breast cancer grading, warranting further refinement and validation of this approach.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13142326
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 7
    Online Resource
    Online Resource
    Multiple Primary Tumors Originating From the Prostate and Colorectum A Clinical-Pathological and Therapeutic Challenge
    SAGE Publications ; 2021
    In:  American Journal of Men's Health Vol. 15, No. 5 ( 2021-09), p. 155798832110448-
    Details
    In: American Journal of Men's Health, SAGE Publications, Vol. 15, No. 5 ( 2021-09), p. 155798832110448-
    Abstract: Considering that the incidence of colorectal (CRC) and prostatic cancer (PC) increases with age, metachronous and synchronous tumors can often affect the same patient. Despite the importance of this subject for the diagnosis and management of oncologic patients, in medical literature the data are scarce. The aim of the study was to evaluate the incidence and the characteristics of double/multiple primary malignant tumors (D/MPMTs) with colorectal and prostatic origin, in patients admitted to a reference hospital in West Romania. A 4-year retrospective observational study (2016–2019) was conducted by analyzing the medical records of all patients admitted in the hospital. Demographic and clinical data, as well as tumor-related parameters, were extracted. We identified 413 consecutive hospitalized patients with PC, and 21 (5%) of them also had a primary CRC. At the time of diagnosis, the mean age of the patients with PC was 71.2 ± 6 years, and 71.8 ± 10 years for patients with CRC. Synchronous PC and CRC tumors were identified in 3/21 cases and metachronous tumors in 18/21 cases. Prostate cancer was the first tumor to be diagnosed in 13/18 cases and CRC in 5/18 cases. The most frequent subtype of PC was acinar adenocarcinoma (90%) and for CRC cases, conventional adenocarcinoma (90%). Prostate and colorectal cancers tend to co-occur in a single patient. The diagnosis of one of these two types of tumors should imply the screening for the other one, because these patients require a multidisciplinary and personalized approach.
    Type of Medium: Online Resource
    ISSN: 1557-9883 , 1557-9891
    URL: Article
    DOI: 10.1177/15579883211044881
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2275106-3
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  • 8
    Online Resource
    Online Resource
    Different disease characteristics in young patients with colorectal cancer: a large retrospective study in a city in Romania
    SAGE Publications ; 2021
    In:  Journal of International Medical Research Vol. 49, No. 5 ( 2021-05), p. 030006052110166-
    Details
    In: Journal of International Medical Research, SAGE Publications, Vol. 49, No. 5 ( 2021-05), p. 030006052110166-
    Abstract: In 2018, colorectal cancer (CRC) was the second most frequent malignancy in Romania after lung cancer. Although CRC is typically encountered in patients 〉 50 years old, CRC's global incidence among younger adults has been increasing. We aimed to compare the disease characteristics of patients with CRC aged ≤50 years with those 〉 50 years old. Methods We retrospectively evaluated data from patients with CRC who underwent standard surgery at “Pius Brinzeu” Emergency County Hospital, Timisoara, Romania. Patients were divided into two groups: Group 1 (patients ≤50 years old) and Group 2 (patients 〉 50 years old). Six parameters were analyzed (sex, residence location, age, tumor localization, microscopic findings, pathological staging). Results Data on age-related CRC were available for 1380 patients treated from January 2012 to December 2018. Group 1 included 120 patients while group 2 included 1260 patients. Significantly more Group 1 patients presented with advanced CRC compared with Group 2 patients (94.2% vs. 87.4%). Furthermore, CRC in younger adults was more likely to be diagnosed at an advanced stage. Conclusions Monitoring the CRC incidence in younger adults is essential to assess whether screening practices require changes and to raise awareness among clinicians of the increasing CRC incidence among younger patients.
    Type of Medium: Online Resource
    ISSN: 0300-0605 , 1473-2300
    URL: Article
    DOI: 10.1177/03000605211016630
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2082422-1
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