Jasminka Stepan Giljević

TUMOR ANGIOGENESIS AND OUTCOME IN OSTEOSARCOMA

Intratumoral angiogenesis quantified by microvessel density (MVD) has been shown to be a strong prognostic indicator in a number of malignant tumors. Its association with prognosis in bone sarcomas has been subject to less extensive research. The aim of this study was to investigate prognostic significance of angiogenesis in osteosarcoma. Thirty-nine patients with osteosarcoma were included in a retrospective immunohistochemical study. Sections from diagnostic biopsies were immunostained using anti von Willebrand factor antibody and microvessels were counted at 400× magnification on 3 microscopic fields per patient. MVD was correlated with overall and disease-free survival by Kaplan–Meier and log-rank analysis. Correlation between clinicopathological variables and the degree of angiogenesis was tested using a χ2 test. Significant statistical difference was found regarding overall survival and disease-free survival between patients with high (>32.3 vessels/field) and low (≤32.3 vessels/field) microvessel counts (log-rank test p =. 0196 and p =. 0147, respectively). The rate of metastasis was significantly higher in patients with high microvessel counts (p =. 042). These findings strongly suggest that angiogenesis quantified by microvessel density is predictive of metastasis and poor prognosis in osteosarcoma.

Pseudocholinesterase activity in cerebrospinal fluid as a biomarker of solid central nervous system tumors in children.

Aim To determine the activity of pseudocholinesterase (PChE) in cerebrospinal fluid (CSF) and serum in children with solid central nervous system (CNS) tumor and to assess whether PChE activity could be a valid biomarker for solid CNS tumors in children. Methods The study and control group included 30 children each. Children in the study group had a solid CNS tumor, while those from the control group had never suffered from any tumor diseases. CSF and serum samples were collected from all participants and PChE activity was determined using the Ellman’s spectrophotometric method. PChE activity in CSF was shown as a cerebrospinal fluid/serum ratio expressed in percentage, ie, PChE CSF/serum ratio. Receiver operating characteristic (ROC) curve was used to assess whether PChE activity can be used as a biomarker for identifying children with solid CNS tumors. Results Children with solid CNS tumor had significantly higher PChE activity in CSF and serum, as well as PChE CSF/serum ratio (P = 0.001). PChE CSF/serum ratio in the study group was 2.38% (interquartile range [IQR] 1.14-3.97) and 1.09% (IQR 0.95-1.45) in the control group. ROC curve analysis of PChE CSF/serum ratio resulted in an area under the curve (AUC) value of 0.76 (95% confidence interval [CI] 0.63-0.88) and a cut-off of 1.09. Twenty five of 29 patients with elevated PChE CSF/serum ratio had a tumor, corresponding to a sensitivity of 83% and a specificity of 53%. Conclusion PChE CSF/serum ratio may be used as a test or biomarker with good sensitivity for solid CNS tumors in children.

Melanotic Neuroectodermal Tumor of Infancy of the Upper Arm: A Case Report

Objective: To present a case of a 6-month-old infant with melanotic neuroectodermal tumor of infancy (MNTI) in the upper arm. Clinical Presentation and Intervention: A 6-month-old female presented with a well-circumscribed lesion of the upper arm at the Childrens Hospital Zagreb. A biopsy was performed and microscopy revealed 2 cell populations consisting of small neuroblastic cells and larger melanin-containing epithelial cells. An excisional biopsy performed 1 month later confirmed the initial diagnosis of MNTI, but the tumor had increased in size since the initial biopsy. After complete surgical excision the patient recovered well with no recurrence. Conclusion: The MNTI located in the upper arm was diagnosed on first biopsy and surgically excised completely. The patient recovered without recurrence in a follow-up of 2.5 years.

Specificities of Autologous Haematopoietic Stem Cell Transplantation in Children: A Single Centre Experience

Autologous haematopoietic stem cell transplantation (AHSCT) is now an integral part of the treatment of high-risk solid tumours in children. However, specific characteristics and problems related to paediatric patients must be taken into account. Considering these tumours are rare, indications, efficacy and practical issues of autologous transplantation have been a topic of research and discussion