Innovations in Analytical Oncology - Status quo of Mass Spectrometry-Based Diagnostics for Malignant Tumor
Pages 74-80
Sen Takeda, Kentaro Yoshimura and Kenzo Hiraoka
DOI: http://dx.doi.org/10.6000/1927-7229.2012.01.01.11
Published: 25 June 2012

Abstract: Recent innovations in mass spectrometry make it possible to diagnose malignant tumors through a rapid, non-destructive and less-expensive way. One of the important facets in this achievement lies in the development of several superior ionization techniques that are essentially derivatives of two authentic methods; matrix-assisted laser desorption ionization (MALDI) and electrospray ionization (ESI). In this review article, we introduce a novel cancer diagnostic system based on probe electrospray ionization (PESI) and logistic regression algorithm. This method uses a very fine needle with a tip diameter of several hundreds nm, which serves as a sampling as well as ionization device. Only a few picolitre (pL) of sample are sufficient to acquire mass spectra for making a diagnosis. Furthermore, as this method does not require any sample pre-treatments that often disorganize the original molecular composition of samples, it has a potential in delineating substances that have been missed by conventional analytical methods. By implementing this technology, we have successfully made in situ diagnosis of malignant tumors in human tissues and in living animals. On the other hand, there are two promising and competitive diagnostic methods; one is desorption ionization mass spectrometry (DESI-MS), and the other is rapid evaporation ionization mass spectrometry (REI-MS) coupled with electrical surgical knife. They are also promising technologies in the new era of analytical oncology. We compare these three methods briefly and attempt to give a new perspective in cancer diagnostics.

Imaging Analysis of Ameloblastoma of Mandible – 5 Cases
Pages 164-168
S. Jayachandran and Khushboo Singh

DOI: http://dx.doi.org/10.6000/1927-7229.2012.01.02.5
Published: 01 December 2012

Abstract: Ameloblastoma is the most common odontogenic tumor of the jaws. It is seen in all age groups but the lesion is most commonly diagnosed in the third and fourth decades. It is often asymptomatic, presents as a slowly enlarging swelling or an incidental finding on a radiograph. Radiologically, usually appears as multilocular radiolucency with well defined and corticated borders but can also presents as unilocular radiolucency. Other radiological findings commonly associated are tooth displacement, and root resorption. Computed tomography (CT) shows cortical expansion and in some cases even cortical perforation. Ameloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. In this paper, we report 5 cases of ameloblastoma of mandible collected over the period of 8 months with various imaging findings and their analysis using panoramic radiograph under conventional radiography and CT scan under advanced imaging which may further aid in optimal treatment planning and outcome.

Reflectance Confocal Microscopy – Real-Time In Vivo Imaging of Basal and Squamous Cell Carcinomas
Pages 155-163
Anna Haydee Chacon, Uzma Farooq, Katlein Franca, Jennifer Ledon, Jessica Savas, and Keyvan Nouri
DOI: http://dx.doi.org/10.6000/1927-7229.2012.01.02.4
Published: 01 December 2012

Abstract: Reflectance and confocal microscopy (RCM) is an in vivo non-invasive imaging tool that captures horizontal images of the epidermis and superficial dermis at nearly the same resolution of routine histopathology. Due to the overlying superficial scaling, RCM characterization of squamous cell carcinomas (SCCs) and associated keratinizing tumors is difficult to visualize due to the obscure appearance of underlying structures. To date, although an increasing frequency of abnormal RCM features are observed across the spectrum, only a few authors have described the features of SCCs. One recent study suggested a disarranged and atypical honeycomb pattern along with round nucleated cells within the spinous/granular layers and round vessels traversing through dermal papilla as key features of SCC.

Meanwhile several RCM features have been linked to basal cell carcinomas (BCCs) regardless of type including:

1. oVariable architectural disarray of the epidermis
2. oA uniform pattern of elongated monomorphic nuclei polarized along the same axis
3. oAbundant vessels with prominent tortuosity
4. oMononuclear inflammatory infiltrate admixed with carcinoid basal cells
5. oTightly packed cells in the papillary dermis with a nodular/cord-like growth pattern
6. oPalisading tumor cell nuclei
7. oPeri-tumoral dark cleft-like spaces representing mucinous edema
8. oThe presence of bright dendritic cells and melanophages in pigmented BCC

Our objective is to identify and describe characteristic RCM findings of SCCs and BCCs by imaging biopsy-proven lesions and reviewing the most recent literature. We will also explain how these features may facilitate diagnosis and recognize future trends for research. Applications of RCM criteria concerning surgical management of these lesions will also be discussed.

Prostate Cancer Treatment on the Basis of an Individual Risk Profile; Can we Reduce Overtreatment?
Pages 10-16
Eelco R.P. Collette and Monique J. Roobol

DOI: http://dx.doi.org/10.6000/1927-7229.2013.02.01.2
Published: 31 January 2013

Abstract: Prostate cancer (PCa) is the most prevalent cancer in male population with an incidence rate of 93 per 100.000 men in Europe and is the sixth leading cause of cancer related deaths in men. In the last two decades the incidence of PCa has increased, which is related to widespread prostate-specific antigen (PSA) based screening and increased life expectancy. Mortality rates of prostate cancer have been reduced due to improvement in treatment and/or the widespread screening activities. Major down sides of screening are the potential risks of overdiagnosis and subsequent overtreatment. Approximately 50% of PCa cases detected through screening are potentially overdiagnosed and hence do not require active treatment. However, in clinical practice men with a potentially non-life-threatening cancer (indolent cancer) are often treated actively resulting in unnecessary suffering from serious side effects coinciding with active treatment. The way out of this dilemma is two-fold. First, the actual diagnosis could be delayed or even avoided and second, radical treatment could be delayed or avoided for patients with low-risk PCa. To better predict the presence of a (potentially indolent) prostate cancer nomograms have been developed. These multivariate prediction tools can be of aid in avoiding unnecessary biopsies reducing overdiagnosis, or identifying potentially indolent prostate cancer after diagnosis and hence adapt the treatment strategy. In this expert opinion we discuss the available tools and their performance in reducing the unwanted side effects of prostate cancer screening. In addition, we provide an overview of strategies concerning optimisation and individualisation of treatment, to reduce overtreatment of prostate cancer.