REPRODUCIBILITY OF ESOPHAGEAL BIOPSY SAMPLING PROCEDURE

The main objective of this study was to evaluate the biopsy sampling procedure in the detection of esophageal precancerous lesions. Biopsies were taken one from the middle-third and one from the lower-third of the esopbagus of 28 subjects from a high incidence area for esophageal cancer in Henan, China. The sampling procedure was repeated on the same subjects 10 days later.During this period, all subjects followed their usual dietary habits. Histopathological analysis showed that in the second sampling from the middle-third of the esophagus, 24% of the subjects had less severe lesions,28% had more severe lesions and 48% had the same severity oflesions. From the lower-third of the esphagus,48% of the subjects had less severe lesions, 16% had more severe lesions and 32% had the same severity of lesions.These results suggest that the reproducibility of biopsy procedure could be a factor for the previously reported 'reversion' or 'progression' of precancerous lesions in follow-up studies.

mRNA expression, functional profiling and multivariate classification of colon biopsy specimen by cDNA overall glass microarray

AIM： To understand the local pathophysiological alterations and gene ontology-based functional classification of colonic biopsies into inflammatory and neoplastic diseases. METHODS： Total RNA was extracted from frozen biopsies and amplified by T7-method. Expression profile was evaluated by Atlas Glass 1K microarrays. After microarray quality control, applicable data were available from 10 adenomas, 6 colorectal adenocarcinomas （CRCs）, and 6 inflammatory bowel diseases （IBDs）. Multivariate statistical and cell functional analyses were performed. Real-time RT-PCR and immunohistochemistry were used for validation. RESULTS： Discriminant analysis of selected genes, could correctly reclassify all 22 samples using 4 parameters （heat shock transcription factor-l, bystin-like, calgranulin-A, TRAIL receptor 3）. IBD samples were characterized by overregulated chemokine （C-X-C motif） ligand 13, replication protein A1, E74-1ike factor 2 and downregu- fated TNF receptor-associated factor 6, BCL2-interacting killer genes. In adenomas upregulation of TNF receptorassociated factor 6, replication protein A1, E74-1ike factor 2 and underexpression of BCL2-associated X protein, calgranulin-A genes were found. CRC cases had significantly increased epidermal growth factor receptor, topoisomerase-1, v-jun, TNF receptor-associated factor 6 and TRAIL receptor 3, and decreased RAD51 and RAD52 DNA repair gene, protein phosphatase-2A and BCL2-interacting killer mRNA levels. Epidermal growth factor receptor RT-PCR and immunohistochemistry, topoisomerase-1 RT-PCR confirmed the chip results .CONCLUSION： Different histological alterations can be reclassified by functional, multivariate analysis using cDNA microarrays. Further studies with expanded sample number are needed for subclassification of pathological alterations.

Microscale endometrial sampling biopsy in detecting endometrial cancer and atypical hyperplasia in a population of 1551 women:a comparative study with hysteroscopic endometrial biopsy

Background:Endometrial cancer is one of the most common malignancies of the reproductive system.Effective and cost-effective screening method for populations at high risk is not available.This study aimed to investigate specimen adequacy and the influencing factors in microscale endometrial sampling biopsy and to evaluate the diagnostic accuracy and medical cost of biopsy in endometrial cancer and atypical hyperplasia screenings in comparison with hysteroscopic endometrial biopsy.Methods:A total of 1551 patients at high risk for endometrial lesions who required hysteroscopic endometrial biopsy from November 2017 to August 2018 were included.Microscale endometrial sampling biopsy was performed,followed by hysteroscopic endometrial biopsy.We evaluated the specimen adequacy and influencing factors of microscale endometrial sampling.Diagnostic consistency between microscale endometrial sampling biopsy and hysteroscopic endometrial biopsy was evaluated.The sensitivity,specificity,positive predictive value,and negative predictive value of microscale endometrial sampling biopsy in screening for endometrial cancer and atypical hyperplasia were analyzed,and the medical costs of the two procedures were compared.Results:The specimen adequacy was 81.2%.Patient age,menopausal status,endometrial thickness,and endometrial lesion type were correlated with specimen adequacy.There was good consistency in distinguishing benign and malignant endometrial diseases between microscale endometrial sampling biopsy and hysteroscopic biopsy(kappa 0.950,95%CI 0.925-0.975).The sensitivity,specificity,positive predictive value,and negative predictive value of microscale endometrial sampling biopsy were 91.7%,100.0%,100.0%,and 99.3%for endometrial cancer screening,respectively,and 82.0%,100.0%,100.0%,and 99.4%for atypical hyperplasia screening.The medical cost of endometrial sampling biopsy was only 22.1%of the cost of hysteroscopic biopsy.Conclusions:Microscale endometrial sampling biopsy is a minimally invasive alternative technique for obtaining adequate endometrial specimens for histopathological examination.It has the potential to be used in detecting endometrial cancer and atypical hyperplasia with high efficiency and low cost.