Introduction: The lack of local epidemiologic data, and the progress of current diagnosis and treatment methods motivated us to evaluate our patients from the perspective of tumor vasculogenesis. The metastatic potential of the choroidal melanoma is well known, and the vasculogenesis is a promoter of it, making early diagnosis and treatment a necessity.
Material and method: In this paper we present 21 cases of choroidal malignant melanoma from 2005 to 2009. For all the patients the treatment was the enucleation of the eye, followed by histopathologic examination and imunohistochimic staining. Tumor vasculature was followed with immune-staining: CD31, CD105, SMA, Collagen IV. The results were digitalized and analyzed with the ImageJ software to demonstrate vasculogenesis.
Results: Vessels with CD31 positivity were dominant at the periphery, while CD105 positive new vessels were predominant centrally in the tumor mass. Collagen IV staining presented fragmentation and pluristratification of the vascular basal membranes, and the vascular smooth muscle was barely noticeable in the central areas.
Conclusions: The lesion of the vascular wall is evident, signaling the modification of the structure and proportion of the elements. The difference between the peripheral and central area is evident, well documented immunohistochemically and morphometrically. The differences are statistically significant.
Tag Archives: angiogenesis
Alternative Therapeutic Strategy in Peripheral Arterial Disease of Lower Limbs
Background: Treatment in peripheral artery disease consists mostly in symptoms management and measures to stop the progression of atherosclerosis. New therapeutic opportunities are opened by current research; they are based on angiogenesis induced by stem cell therapy and growth factor administration. Bone marrow is a rich tissue in cells and growth factors, and it was observed that in bone fracture hematoma, the angiogenesis is induced currently as a vascular response to injury.
Case report: A 42 year-old male patient with peripheral artery disease. The diagnosis was confirmed through angiography, and the surgeon confirmed the impossibility of revascularization. In consequence, the patient was proposed for vasodilatation treatment with prostaglandins. After one month with no improvement, the patient insisted to find a new possibility of treatment, thus we decided to use adult self stem cells from bone marrow. Sixty ml bone marrow aspirate was taken under local anesthesia from the iliac crest and injected intramuscular in the middle outer part of the thigh and gastrocnemian area in 38 injection sites. The patient was followed up for 6 months and we observed an improvement of clinical symptoms, walking perimeter and ankle brachial index.
Conclusion: This is the first case where we tried an innovative therapeutic strategy in a young patient with no other revascularization opportunity, with a benefic result.
Preliminary Results on Clinico-pathological and Immunohistochemical Features of Malignant Melanomas
Objective: To perform a retrospective clinico-pathological and immunohistochemical analysis of malignant melanomas.
Methods: One-hundred sixty consecutive cases diagnosed in the Department of Pathology of the County Emergency Clinical Hospital of Tîrgu Mureş, Romania, between January 2000 – December 2009, were used. Of these, 47 cases were melanoma metastases that were excluded from the study; this research was focused on the study of 113 primary melanomas (PMs). In 20 cases of PMs (11 cutaneous, 5 choroidal, and 4 melanomas of the anal canal) immunohistochemical stains were performed using the antibodies p53, Ki67, ER (estrogen receptor), CD8 and CD31.
Results: Cutaneous PMs prevailed (83%) followed by choroidal (11%), digestive tract (4%) and nasal mucosa PMs (2%). Independent of their location, PMs predominantly affected females (58%) over age 50. Regarding cutaneous cases, lower limbs (49%) were more affected, followed by the head and neck (18%) and the trunk (18%). We noted negativity or low p53-nuclear positivity in cutaneous and digestive tract PMs; p53 was overexpressed in choroidal melanomas. On the other hand, although the proliferative index Ki67 was also quite low in cutaneous PMs, its percentage increased in choroidal and digestive tract PMs. CD8 was positive in cutaneous PMs and negative in choroidal and digestive tract cases. While in cutaneous PMs we noted a predominated angiogenesis by intussusception, in digestive tract melanomas there was a predominance of sprouting and pseudoglomeruloid mechanisms.
Conclusions: Choroidal PMs display the highest p53 and Ki-67 expression, compared to cutaneous MMs. Tumor angiogenesis seems to present a specific pathway in cutaneous PMS compared to the gastrointestinal cases.
The Importance of Vascular Endothelial Growth Factor as a Marker of Angiogenesis and Lymphangiogenesis in Non-small Cell Lung Cancer
Lung cancer is the main cause of cancer death both in men and women. In spite of progress seen in the early diagnosis of lung cancer, and implementation of new treatment principles for these patients, 5 year survival of non-small cell lung cancer patients undergoing surgery is low. Introduction of anti-angiogenic therapy administered concomitantly with conventional chemotherapy agents represented practically the first success seen in the treatment of lung cancer in the last 20 years. The aim of this paper is to review the literature informations about the importance of VEGF (vascular endothelial growth factor) as a marker of angiogenesis in patients with non-small cell lung cancer. Therefore, we practiced a literature review about these topics : the importance of VEGF in tumor angiogenesis and lymphangiogenesis in patients with non-small cell lung cancer and his importance as a prognostic factor at these patients, the prognostic impact of serum levels of VEGF and of the cellular expression of VEGF at these patients and also we reviewed the value of the antiangiogenic therapy.