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Objectives/Hypothesis: To investigate the diagnostic accuracy of the established patterns of intraepithelial microvasculature of narrow-band imaging (NBI) in diagnosing upper aerodigestive tract neoplasm of the squamous epithelium for detecting high-grade dysplasia, carcinoma in situ, and carcinoma in oral leukoplakia. Study Design: Retrospective case-control study. Methods: Using histopathological findings as the standard, clinical diagnosis of oral leukoplakia and 3 different but established NBI criteria were compared and evaluated statistically. Results: A total of 414 patients, including 365 males and 49 females, with mean age of 52.15 ± 10.75 years, were enrolled. The odds ratio of detecting high-grade dysplasia and carcinomatous lesions by twisted elongation of intraepithelial papillary capillary loop (IPCL) and IPCL pattern destruction was 95.53 (confidence interval 95%: 42.19–216.29), and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.62%, 94.56%, 74.32%, 97.06%, and 93.0%, respectively, which were significantly better than the other two established NBI criteria (p < 0.001). Conclusions: The NBI images of twisted elongation of IPCL and IPCL pattern destruction are indicators of high-grade dysplasia or carcinomatous lesions in oral leukoplakia.

Hwang C-C, Pintye M, Chang L-C, Chen H-Y, Yeh K-Y, Chein H-P, Lee N & Chen J-R (2011) Histopathology59, 984–992 Dual-colour chromogenic in-situ hybridization is a potential alternative to fluorescence in-situ hybridization in HER2 testing Aim: Dual-colour chromogenic in-situ hybridization (dc-CISH) is an emerging methodology for characterizing genomic alterations. This study was aimed at evaluating the performance of a dc-CISH kit (ZytoVision) in determining human epidermal growth factor receptor 2 (HER2) status in breast cancer. Methods and results: Two hundred and twenty-eight invasive breast carcinomas arranged in tissue microarrays were analysed in parallel with dc-CISH, fluorescence in-situ hybridization (FISH), and immunohistochemistry. Of 227 tumours with available FISH and dc-CISH results, HER2 amplification and non-amplification were detected in 49 (21.6%) and 178 (78.4%) tumours, respectively, by both assays. The concordance between dc-CISH and FISH results showed 100% agreement (κ-coefficient = 1.00). Immunohistochemically, 162 (71%), 25 (11.0%) and 41 (18%) tumours were scored 0/1+, 2+, and 3+, respectively. The corresponding results with both FISH and dc-CISH demonstrated HER2 amplification in two (3.2%), nine (36%) and 38 (93%) tumours, respectively. Complete consensus among these three methods was observed in 197 cases, representing 98% of all 3+ and 0/1+ tumours (κ-coefficient = 0.92). Confirmatory testing of 25 2+ tumours showed complete consensus between FISH and dc-CISH. Conclusions: dc-CISH is a promising alternative to FISH in HER2 testing, and the single-institute incidence of HER2 amplification in breast cancer in Taiwan is 21.2%.

Background and objective: Binding of Toll-like receptors (TLRs) to microbial or endogenous ligands activates and triggers the associated signalling pathway, which leads to the production of inflammatory cytokines and type I interferons. The extent of TLR pathway activation may vary with the ligands present in different pleural diseases. Methods: The relative mRNA expression levels of TLRs and their adaptors in pleural fluid were determined by PCR and gel electrophoresis in 36 transudative, 25 infectious and 39 malignant pleural effusions. Results: The relative mRNA expression levels of TLR8 and myeloid differentiation factor 88 were low in infectious effusions and that of ras-related C3 botulinum toxin substrate 1 was low in malignant pleural effusions. Different cellular components correlated significantly with the relative mRNA expression of TLRs or their adaptors in pleural effusions with different aetiologies. Conclusions: The relative mRNA expression profiles of TLRs and their adaptors in pleural fluid differ among transudative, infectious and malignant pleural effusions.

Background and objective: Cancer cells are larger in size and more rigid than blood cells. As the size and rigidity of cells contribute to blood viscosity, an association may exist between high pleural fluid viscosity and cancer cells in pleural effusions. The aim of this study was to determine the correlation between pleural fluid viscosity and cell constituents or laboratory data in pleural diseases with different aetiologies. Methods: Fluid viscosities were determined in pleural effusions obtained via thoracocentesis. Pleural fluid viscosities were correlated with the laboratory data and with the percentages of different cellular constituents as assessed by cytological examination. Results: Pleural fluid viscosity was highest in malignant pleural effusions with positive results on cytological examination, and was correlated with the percentages of tumour cells (Spearman's rho = 0.24, P = 0.037) and mitotic figures (rho = 0.23, P = 0.041) in the exudates. Multivariate logistic regression analysis showed that pleural fluid viscosity was a significant determinant of positive results on cytological examination (odds ratio (OR) 6.26, 95% confidence interval (CI) 1.32–29.8), as were the levels of protein (OR 1.48, 95% CI 1.01–2.16) and LDH (OR 1.001, 95% CI 1–1.002). Conclusion: High pleural fluid viscosity may suggest a potential diagnosis of malignant pleural effusion.