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Barrett's esophagus (BE) is an acquired disorder due to chronic gastroesophageal reflux. Environmental factors seem to play an important role in the pathogenesis of BE, especially in Western society. A multicenter case-control study was carried out between February 1995 and April 1999 in 8 Italian Departments of Gastroenterology gathered in a study group (GOSPE), in order to analyze the influence of some individual characteristics and life-style habits on the occurrence of BE. Three groups of patients were studied: 149 patients with BE, 143 patients with esophagitis (E) and 308 hospital controls (C) with acute, non-neoplastic, non-gastroenterological conditions. The diagnosis of BE was based on endoscopy and histology. E was defined by the Savary classification (grade I–III). Data collection was performed by using a questionnaire that focused on smoking, coffee and alcohol consumption, medical history, drugs history, gastroesophageal reflux disease (GERD) symptoms (heartburn, regurgitation) and socio-economic status. Multivariate analysis showed that the frequency of weekly GERD symptoms was significantly associated with both BE and E (p

Twenty cervical adenocarcinomas (CACs) in women aged 22 to 71 were investigated by in situ hybridization (ISH) with 6, 11, 16, 18, 31, 35 and 51 HPV biotinylated probes. Two cases, one adenocarcinoma and one adenosquamous carcinoma (in women aged 28 and 40 respectively) showed focal nuclear positivity to 16 HPV Probe in some neoplastic glands. We used ISH, rather than other hybridization techniques, in order to exclude a positivity to viral DNA, due to adjacent squamous epithelium, either normal or metaplastic, and in squamous foci within adenosquamous tumors. Reviewing the literature, we found 33 out of 98 CACs positive to viral DNA by ISH (33.6%). In spite of the differences found from author to author, a relationship between adenocarcinomas of the uterine cervix and HPV infection seems to be possible, as was demonstrated for CIN and invasive cervical carcinomas. These data could explain why the incidence of this neoplasia has tended to increase over the last few years, mainly in younger patients.

In postsurgical staging of colorectal adenocarcinomas, it is sometimes difficult to determine the range of possible venous spread. Distinguishing between the extramural veins (especially when the neoplastic embolus takes up the whole lumen and the endothelium cannot be identified) and the smallest extramural lymph nodes (when they are completely replaced by metastatic carcinoma, leaving the capsule alone) is also difficult. This work proposes a more precise definition of true venous invasion to improve histopathologic staging. Immunohistochemical techniques employing commercial antibodies against Factor VIII RAG, with and without enzymatic digestion, and UEA I lectin for residual endothelium detection, were applied, as well as antibodies against vimentin, desmin, and alpha sm-1 actin to detect wall components. The immunohistochemical evaluation of colorectal adenocarcinomas, in particular by anti-alpha sm-1 actin antibodies, permitted a reliable morphologic distinction of the true venous invasion. This factor proved to be relevant for survival rate prediction.

The authors tested Victoria blue staining in intrahepatocytic HBs Ag detection and compared the results with those obtained by the following methods: direct immunofluorescence, orcein and peroxidase-antiperoxidase (PAP). Although PAP appears to be the best technique for diagnostic research, Victoria blue is a sound method for routine diagnosis in hepatology.

To identify parameters for the malignant potential of large bowel adenomas, we used the avidin-biotin-peroxidase complex (ABC) technique. Patterns of carcinoembryonic antigen, epithelial membrane antigen, IgAs, and secretory component in 31 tubular, tubulovillous, and villous adenomas with different grading of dysplasia (mild, moderate, severe) and with early cancer were studied. All markers showed different degrees of staining intensity and various cellular localizations. We found that these variations might be related to dysplasia grading. Adenoma size did not influence the marker patterns. IgAs seemed to be the more selective among the markers studied. Our results suggested a dysplasia-carcinoma sequence instead of an adenoma-carcinoma sequence concept.

20 specimens of normal endocervix, 30 of chronic cervicitis, 20 of endocervical polyps and 10 of adenocarcinomas were histochemically investigated in order to assess their mucin pattern. Diastase periodic acid-Schiff (D-PAS), Alcian blue pH 2.5 (AB), High iron-diamine (HID) and HID followed by Alcian blue pH 2.5 (HID-AB) were used. Both the superficial and glandular epithelium of the normal endocervix contained abundant amounts of neutral mucins. Generally sialomucins were scarce and predominant over sulphomucins: the latter were in some cases absent in the proliferative phase of the menstrual cycle and increased in the secretory phase. In chronic cervicitis a slight amount of sulphomucins in the residual glandular epithelium, especially in areas presenting severe inflammation, pseudoerosion, or both was observed. Nabothian cysts mainly contained sulphomucins. In the endocervical polyps, the mucin pattern was various. In adenocarcinomas mucin secretion was usually scanty and mixed with a predominance of sialomucins. Therefore resulted: the mucin pattern of the normal endocervical epithelium is related to the menstrual cycle; the histochemical evaluation of mucous secretion, presently doesn't seem to be helpful in differentiating endocervical from endometrial adenocarcinomas.