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Tankova L, Nakov R, Stoilov G, Gegova A, Nakov V, Gerova V, Terziev I, Kovatchki D. Endorectal power Doppler ultrasonography is a reliable method for evaluation of rectal cancer angiogenesis. Eur Rev Med Pharmacol Sci 2019; 23:1661-1667. [PMID: 30840290 DOI: 10.26355/eurrev_201902_17127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We aimed to assess the preoperative rectal cancer angiogenesis with Endorectal Power Doppler Ultrasonography by using the Power Doppler Vascularity Index (PDVI) calculated by imaging analysis software, and to compare it with the microvessel density (MVD) in surgical specimens PATIENTS AND METHODS: This study included 110 patients (39 females; mean age 61.5 years) with rectal cancer. Immunohistochemical staining of surgical specimens with anti-CD-31 antibody was used for MVD evaluation. The PDVI of each tumor was calculated using Endorectal Power Doppler with computer-assisted quantification of colour pixels. RESULTS Mean MVD - 163 ± 69 microvessels/mm2 (50-328) was used as a cutoff point, differentiating two groups of tumors with high (> 160 mm2) and low (≤ 160 mm2) angiogenic activity. Mean PDVI of 8.9 ± 6.0% (0-27.3) was used as a cutoff point, dividing two groups of tumors with high (> 8%) and low (≤ 8%) PDVI. The MVD and the PDVI showed a good positive correlation (r = 0.438, p = 0.002). Patients with low PDVI had 25 months longer overall survival (p < 0.05) than patients with high PDVI. Patients with low MVD had 36 months longer survival (p < 0.05). CONCLUSIONS Endorectal Power Doppler Ultrasonography is a reliable and noninvasive method for assessment of the extent of rectal cancer angiogenesis. Tumor angiogenesis assessed by the PDVI correlated with histological MVD determination and could predict survival rates. Endorectal Power Doppler examination is a useful and reproducible method for in vivo preoperative quantitative assessment of tumor vascularization.
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Affiliation(s)
- L Tankova
- Clinic of Gastroenterology, "Tsaritsa Yoanna" Hospital, Medical University Sofia, Sofia, Bulgaria.
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Tchernev G, Tronnier M, Ananiev J, Taneva T, Patterson JW, Gulubova M, Trafeli JP, Gegova A, Harrell M, Guarneri C, Wollina U, Cardoso JC, Kanazawa N, Zisova L, Forsea AM, Zouboulis CC. Atypical fibroxanthoma-a diagnosis of exclusion! Wien Med Wochenschr 2013; 163:380-6. [PMID: 23319144 DOI: 10.1007/s10354-012-0173-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 12/25/2012] [Indexed: 11/26/2022]
Abstract
Fibrohistiocytic tumors of the skin comprise a large range of lesions. One such tumor is the atypical fibroxanthoma (AFX), which is widely considered as a "pseudomalignant" tumor. It is derived from fibroblasts and expresses a variety of histiocytic markers. We present a case of AFX, localized in the right temporal region of the scalp, successfully treated with surgical excision. Immunohistochemical staining helps differentiate this tumor from others in the clinical differential diagnosis, including malignant melanoma, squamous cell carcinoma, and other nonmelanocytic spindle cell tumors such as leiomyosarcoma, rhabdomyosarcoma, angiosarcoma, liposarcoma, and dermatofibrosarcoma protuberans. Historically, AFX was believed to be a superficial variant of malignant fibrous histiocytoma (MFH). However, MFH is now considered a more generalized term for a sarcomatous neoplasm of the subcutaneous tissue. The histopathology of MFH shares features with some malignant mesenchymal neoplasms such as liposarcoma, leiomyosarcoma, rhabdomyosarcoma, and angiosarcoma, but can be differentiated using immunohistochemistry and/or electron microscopy. More recently, the examples of MFH that do not exhibit a more specific line of differentiation have been reclassified as undifferentiated pleomorphic sarcoma (UPS). Many authors currently cannot draw a distinction between AFX and UPS. The clinical and histopathological differences between AFX and UPS are often difficult to delineate. It is probable that they represent two poles of the same disease. Surgical excision in the patient we describe resulted in excellent aesthetic results with lack of recurrence in the 7-month postoperative period.
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Affiliation(s)
- Georgi Tchernev
- Polyclinic for Dermatology and Venereology, Medical Faculty, University Hospital Lozenetz, Sofia University, Bulgaria.
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Tankova L, Berberova M, Purvanov P, Tsankov T, Gegova A. Complicated small bowel diverticulosis--a case report and literature review. Chirurgia (Bucur) 2007; 102:603-606. [PMID: 18018364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We report herein the case of a small bowel diverticulum perforation which has caused peritonitis and consequently has led to operation. The patient, a 79-year old woman, was hospitalized due to etiological clarifying and specifying of a newly diagnosed diffuse liver pathology. During the hospital stay, she has received severe abdominal pain with features of peritonitis. Suspecting perforated appendicitis she has undergone an operation. The explorative laparotomy has identified a purulent exudation in the abdominal cavity, resulting from a perforated inflammatory jejunal diverticulum and multiple middle-size diverticula all along the small bowel and the colon. The reported case as well as the review of the literature have shown that various and sometimes potentially fatal complications could occur even for such a relatively banal insignificant entity as is diverticular disease in elderly patients.
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Affiliation(s)
- L Tankova
- Clinical Centre of Gastroenterology, Medical University Hospital Queen Joanna, Sofia, Bulgaria.
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Kadiyska T, Yakulov T, Kaneva R, Nedin D, Alexandrova A, Gegova A, Savov A, Mitev V, Kremensky I. Vitamin D and estrogen receptor gene polymorphisms and the risk of colorectal cancer in Bulgaria. Int J Colorectal Dis 2007; 22:395-400. [PMID: 16788818 DOI: 10.1007/s00384-006-0163-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2006] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Different epidemiological studies report the protective effect on colorectal cancer (CRC) exerted by vitamin D(3) intake, estrogen replacement therapy, and increase of the risk of microsatellite instability (MSI) in CRC by withdrawal of estrogens. The aim of our study was to search for association between CRC and polymorphisms in estrogen receptor-alpha (ER-alpha) and Vitamin D receptor (VDR) genes. MATERIALS AND METHODS We analyzed the PvuII and XbaI polymorphisms from the ER-alpha gene and the BsmI polymorphism of the VDR gene in 140 patients with CRC (subsequently divided according to their MSI status) and 94 controls. RESULTS We have demonstrated that the presence of the PvuII pp genotype increased the risk of developing MSI(+) tumors about three times compared to MSI(-) tumors [odds ratio (OR)=3.09, 95% confidence interval (CI) 0.88-10.91]. The effect of the XbaI xx genotype was similar (OR=2.08, 95% CI 0.49-8.81). Our results for the VDR BsmI polymorphism showed an increased risk for CRC in bb carriers (OR=1.8, 95% CI 0.81-4.05). CONCLUSION We conclude that PvuII and XbaI polymorphisms in the ER-alpha gene were associated with the risk of developing MSI in CRC patients. The BsmI polymorphism in the VDR gene was linked to the risk of developing CRC.
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Affiliation(s)
- Tanya Kadiyska
- Laboratory of Molecular Pathology, University Hospital of Obstetrics and Gynecology, Maichin Dom, 2 Zdrave street, Sofia 1431, Bulgaria.
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Iarŭmov N, Shtŭrbanov I, Terziev I, Evtimov R, Gegova A. [Papillary and cystic tumor of pancreas--Frantz's tumor]. Khirurgiia (Mosk) 2004; 60:15-7. [PMID: 16042057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The aim of the authors is to introduce one rare known pathology which the Frantz's tumor is, his clinical characteristic, clinical signs, diagnostic and treatment. We have observed two separate cases of this illness in Clinic of Surgery (University Hospital "Queen Yoanna") in comparison with evidence of famous world surgeons. We have made an attempt to introduce one disease, which even though not often observed is significant by the fact that affect young women (girls) and only surgical resection is a treatment of choice.
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Iarŭmov N, Terziev I, Gachev N, Gegova A, Vasilev N, Evtimov R, Stoianov S. [Surgical treatment of complicated gastrointestinal forms of non-Hodgkin lymphomas]. Khirurgiia (Mosk) 2003; 58:7-9. [PMID: 12515011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Authors represent their experience in surgical treatment of gastrointestinal forms of No-Hodgkin's lymphomas (NHL) combined with adjuvant therapy. We also represent an Ann Arbor Staging System and an Updated Kiel Classification. From 1991 to 2001 we analyzed 39 patients with different localization of gastro-intestinal NHL's lymphomas. In this aspect more common are stomach's lymphomas--27 patients (71%); small bowel's lymphomas--3 patients (8%); more uncommon are the localizations in colon--3 patients (8%), predominantly in caecum and right colon; rectum--3 patients (5%). Add to thus we described one mechanical icterus caused lymphoma, one multi-lobular spleen lymphoma and one case of anterior abdominal wall lymphoma. All patients underwent surgery. Eight of them were operated as an emergency cases. Operative treatment of NHL isn't radical but in combination with adjuvant therapy can be life saving event in complicated forms.
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Gegova A, Boshnakova T. [Multiple primary malignant neoplasms (MPMN), with case reports]. Khirurgiia (Mosk) 2003; 59:46-51. [PMID: 15584463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
In this work the authors reviewed the literature on multiple primary malignant neoplasms (MPMN). This termin includes two or more tumours with different histologic appearance developing in different organs and giving metastases. The authors present 4 case reports of MPMN payng particular attention on the importance of the correct diagnosis of the tumours for the treatment of the patients.
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Tankova L, Kadnian K, Draganov V, Damianov D, Damianov N, Penchev P, Gegova A. [Endoluminal echography in rectal cancer--preoperative staging and postoperative control]. Khirurgiia (Mosk) 2003; 59:26-30. [PMID: 15641546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The aim of this study is to determine the diagnostic potential of endoluminal echography and the pitfalls sources in the preoperative staging and postoperative follow-up in patients with rectal cancer. 245 patients with rectal carcinoma are evaluated during 10 years period (Jan. 1993-Jan. 2002 years). 96 patients are monitored in the early and late postoperative periods for the early detection of local recurrence as well as for the anorectal physiology assessment after low anterior rectal resection or coloanal anastomosis. Lineal transducer UST-657-5MHz (Aloka 620) and 10MHz miniprobe are applied. The accuracy for T-staging is 84% and for N-staging is 82%. The local recurrence is detected in 21 patients, on average 12.6 months after curative surgery. The local recurrence is more often in cases of lymph node involvement as well as if some specific echographic features for extramural vascular invasion are present. Endoluminal echography provides individual therapeutic management and postoperative control in patients with rectal cancer.
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Gegova A, Georgiev C, Momchilov M. [Oncocytoma of the pancreas. A case report]. Khirurgiia (Mosk) 2002; 57:70-2. [PMID: 12024662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
For the first time in the bulgarian literature a case with pancreatic oncocytoma is described, initially diagnosed as carcinoma. The patient survived for 13 years being nowadays in perfect condition.
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Tsvetkova A, Gavrilova E, Gegova A, Trifonov D, Ignatov P. [M. Sternalis - anomaly associated with diagnostic problems in breast cancer]. Khirurgiia (Mosk) 2002; 52:58-9. [PMID: 11247091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- A Tsvetkova
- Medical University, Department of Anatomy and Histology, Sofia, Bulgaria
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Tsvetkova A, Gegova A, Trifonov D, Ignatov P. [A variant of blood supply to the upper limb in man with a special reference to the hazards of erroneous intra-arterial administration of drugs]. Khirurgiia (Mosk) 2002; 55:56-8. [PMID: 11484255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Tsvetkova A, Gegova A, Tsvetkov M, Kolarov G, Dikova C, Ignatov P. [The diagnostic and surgical problems in ureter fissum]. Khirurgiia (Mosk) 2000; 55:41-3. [PMID: 10838819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Maĭnkhard K, Terziev I, Gegova A, Georgiev G. [Fibrous hamartoma in childhood--a report of a rare case from practice]. Khirurgiia (Mosk) 1996; 49:51-2. [PMID: 9011674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Popkhristova E, Kunev K, Gegova A, Terziev I. [Paragangliomas in the head and neck area]. Khirurgiia (Mosk) 1996; 49:57-8. [PMID: 9173180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Gegova A, Kunev K, Popkhristova E, Terziev I. [Plasmacytomas of the upper respiratory tract]. Khirurgiia (Mosk) 1995; 48:16-18. [PMID: 8691754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Nine cases of plasmocytoma of the upper airways in the current biopsy material are studied over a three-year period (1991-1993). Initially, all nine cases are clinically diagnosed as neoplasms: hemangiofibroma--one, chondrosarcoma--one, suspected carcinoma--five, and unspecified diagnosis--two. "Plasmocytoma" diagnosis is made on the ground of histological investigation of the material, supported histochemically and electron-microscopically. Some diagnostic problems (differential diagnosis inclusive) are discussed, as well as issues relating to the clinical and morphological evolution of the disease, and predilected gender and age groups.
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