Introduction: Gastric cancer is a malignant tumour with a fifth position amid all cancers and its mortality rate is third globally. The most common distant mode of metastasis is Peritoneal Dissemination (PD). There is a positive correlation between serum Cancer Antigen 125 (CA125) level and PD in cases of malignant gastric neoplasm. Aim: To study the demographic features, the macroscopic and microscopic features of malignant gastric neoplasm and the relation of serum CA125 level with PD in cases of gastric cancer. Materials and Methods: This cross-sectional observational study was conducted for two years from January, 2018 to January, 2020 on 120 cases at Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal (India). Detailed history taking, clinical examination, routine investigation was done. Peripheral blood sample for CA125 assay was collected. PD was identified through Ultrasonography (USG) or Computed Tomography (CT) or intraoperatively during open surgery. The gastrectomy specimens were sent for gross examination, staging and histopathology. Microsoft excel 2016 and SPSS 18 was used. Chi-square test was used for the comparison between the groups. A p-value of <0.05 was considered significant. The sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were used for elective assessment. Results: This study comprised 120 cases with mean age of presentation as 54.3 years and male: female ratio of 2.3:1. Fifty cases (41.6%) were identified as tubular (solid)-poorly differentiated adenocarcinoma with 59 cases (49.2%) of stage IIIA and 52 cases (43.3%) of stage IV. The sensitivity and specificity of CA125 was 81.8% and 85.7%. The PPV and NPV were 56.2% and 95.4%. Conclusion: Early detection of peritoneal disease will help the clinicians to stratify the treatment of gastric cancers. Higher sensitivity suggests that preoperative serum CA125 is a promising tool to predict PD which aids in subsequent alternative mode of treatment, lesser morbidity and better survival of patients.
Introduction: In systemic malignancies, thyroid carcinoma represents only 1%, but it is the most common endocrine malignancy with poor prognosis. Fine Needle Aspiration (FNA) is considered a requisite tool in providing a rational advent for the clinical management of these nodules. However, when solely based on cytopathological assessment, FNA leads to imprecise biopsy results in 10-20% of all cases. So, immunohistochemical markers, Galectin-3 (Gal-3) and Cytokeratin 19 (CK19) have received considerable attention as diagnostic marker for thyroid cancer. Aim: To study the expression of Gal-3 and CK19 in different thyroid neoplasms. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital from January 2019 to January 2021 on 120 cases. The thyroidectomy specimens received were fixed in 10% buffered formalin followed by gross examination. The paraffin embedded tissue blocks were subsequently stained for Haematoxylin and Eosin stain (H&E) followed by histopathological reporting. Qualitative immunohistochemical assessment of the marker Gal-3 and CK19 was performed on representative histologic sections of the thyroid neoplasms. Data were analysed using Graph Pad Instat 3. Results: The positive expression of Gal-3 was significantly more in malignant tumours (87.5%) than in benign (36.0%) (p-value <0.001). In Papillary Thyroid Carcinomas (PTC) and in Follicular Variant of Papillary Thyroid Carcinomas (FVPTC) expression of Gal-3 was notably higher than in Follicular Adenoma (FA) (p-value=0.01 and p-value=0.0001, respectively). Follicular Thyroid Carcinomas (FTC) had higher expression FA (p-value=0.003). In malignant tumours (71.8%), positive expression of CK19 was significantly more than benign tumours (24.0%) (p-value <0.001). Significant difference in expression of CK19 was seen between PTC and FTC (p-value=0.019). Between PTC and FA, differences in expression were significant (p-value <0.001). Significant difference in expression was also seen between FVPTC and FTC (p-value=0.032) as well as with FA (p-value=0.028). Conclusion: The most sensitive marker is Gal-3 for the diagnosis of thyroid malignancies. When combined with CK19, the specificity increases in identifying the thyroid cancers. More combination of markers together with Gal-3 and CK19 can be useful in the distinction between malignant and benign thyroid tumours because it is essential for further treatment and long-term management of the patient.
The thoracic cavity consists of the mediastinum located centrally which is bordered by two pleural cavities laterally. The major organs included are the thymus gland, the heart, the lungs, the tracheobronchial tree, lymph nodes and vessels. The lesions originating from the various organs are diverse and occasionally some lesions occurring are extremely rare. The aim was to study demographic features, anatomical site and histological findings of the cases. This was a prospective evaluation of the intrathoracic lesions in a tertiary care center from June 2018 to June 2020. This comprised of patient’s age and sex, the clinical characteristics and location of the tumour, the duration of the lesion and the histopathological findings along with Immunohistochemistry (IHC). This case series describes 10 cases of intrathoracic lesions originating from mediastinal soft tissue, thymus gland, lungs and heart. Patient’s age ranged from five months old to 48 years old with males and females equally affected. All the patients have undergone treatment and were followed-up as well. Intrathoracic lesions are unusual tumours with varied histology. These intrathoracic lesions require a multidisciplinary approach. These lesions should be examined well to determine the source of the lesion for a conclusive diagnosis. Radiological correlation along with histopathology and immunohistochemistry assists in accurate diagnosis.
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