1.Diagnosis of intraoperative squash cytology in brain tumors
Enkhee O ; Tsetsegdelger M ; Bolortuya B ; Enkhbat TS ; Khusyan KH ; Tuul B ; Bayarmaa E
Mongolian Medical Sciences 2014;170(4):14-18
Background: The intraoperative smear cytology (squash preparation) is fairly accurate, simple, reliabletool for rapid intraoperative diagnosis of neurosurgical biopsies [1]. In the early 1930s, Dr Eisenhardtand Cushing introduced intraoperative cytological investigations for rapid examination of neurosurgicalspecimens and guidance of surgical treatment [2]. Besides rapid decision making during neurosurgicalprocedures, it is also to be ensured that minimum injury is caused to the normal brain structuressurrounding the intracranial neoplasm. It has become necessary for pathologists to train themselves inthe interpretation of cytomorphological features of various central nervous system lesion and used inmany neurosurgical units of all over the world [3]. Thus, to begin doing intraoperative squash cytology inour practice is the aim of this study.Aim: To study the diagnostic accuracy of squash cytology in the intraoperative diagnosis of centralnervous system tumorsMaterials and Methods: The material for this study was obtained from 30 cases of nervous systemneoplasms sent for intraoperative consultation from State Third Central Hospital, Shashtin to the thirdsection of National Center for Pathology between 7th of November 2013 to 28th of March 2014. Squashpreparation was performed on all cases and stained with hematoxylin and eosin. The diagnosis given onsquash cytology was then compared with final diagnosis given on paraffin-embedded sections.Results: Of total 30 cases of primary central nervous system tumors, neuroepithelial tumors are thelargest category of tumors (50%). The accuracy of squash cytology was 82.1%.Conclusion: This is the first study in our country where intra-operative squash cytology in brain tumorwas done and diagnostic accuracy was 82.1% as very good category. There were 4 cases had diagnosticdiscrepancy.
2.Immunohistochemical study of cervical lymph node metastases of unknown primary origin
Enkhee O ; Tuul B ; Bold M ; Bulgan P ; Ulambayar E ; Odkhuu J ; Bayarmaa E
Mongolian Medical Sciences 2013;166(4):21-26
Introduction. Cancer of unknown primary (CUP) is histologically defined as the presence of a metastasis of lymph node without detection of the primary tumor [1]. Approximately 3–15% of all cancers are designated as CUP [3. 4]. The diagnosis, treatment and monitoring of patients with laterocervical metastases of unknown primary involves a wide range of oncologic entities [5]. While we were studying patho-histological examination of cervical lymphadenopathy in Mongolian, werevealed unknown primary tumor. This is a goal of our study. Objectives of study are followings to differentiate whether primary lymphoma or metastatic cancer of cervical lymph node metastasis of unknown primary tumor and to reveal primitive origin of tumor using by basic and additional immunohistochemical markers.Goal.To determine the conclusive diagnosis in cervical lymph node metastasis of unknown primary origin by immunohistochemical techniqueMaterials and Methods. In this study, we examined immunohistochemically 30 cases of outpatient head and neck surgical unit of the National Cancer Center and dentistry and oral maxillofacial surgical unit of the State Central Hospital which were diagnosed as cervical lymphadenopathy. For immunohistochemical study, we applied an immunohistochemical panel in accordance with avidinbiotin- peroxidase complex method and used a basic and additional antibodies represented by CK(pancytokeratin), LCA, synaptophysin, chromogranin and HMB45. Result. In our study, there was 63.3% lymphoma, 36.7% metastatic cancer. Among them, there were 4 of digestive tract adenocarcinoma, 3 of squamous cell carcinoma /2-esophagus, 1-nasopharyngeal/, 2 of neuroendocrine tumor and 1 of melanoma.Distribution by age groups shows that 20-29 years were 4(13.3%), 30-39 years were 10 (33.3%), 40-49 years were 8 (26.7%), 50-59 years were 3 (10%), over60 years were 5 (16.7%). Gender distribution showed an increased incidence of males (56.7%, 17 cases) compared with females (43.3%, 13 cases).Conclusion: In our study, B cell lymphoma and digestive tract adenocarcinoma were the most common. In further, it is necessary to introduce an immunohistochemical method in patho-histological practice.
3.Expression of the WT1 protein and Ki67 proliferation index in brain glioma
Enkhee O ; Gheeyoung C ; Tuul B ; Bayarmaa E
Mongolian Medical Sciences 2019;187(1):17-22
Introduction:
Wilms’ tumor 1gene was originally discovered as mutated in nephroblastoma, a common pediatric kidney cancer also known as Wilms’ tumor. This gene’s product alteration was indicating the safety of WT1 immunotherapy as well as a potential therapeutic response to its application in patients with glioma.
Goal:
Our aim was to further elucidate the role of WT1 as a diagnostic and prognostic marker in brain glioma in
neuropathology field.
Materials and Methods:
In this study, formalin fixed paraffin embedded blocks of 135 patients with brain glioma were selected. After tissue preparation for WT1 immunohistochemical evaluation, 2 tissue preparations were excluded due to unsatisfactory amount of tissue. Therefore, data about tissue specimens from 133 patients were included in statistical analysis.
Results:
In this study, out of 133 cases, 55 were astrocytomas, 42 were oligodendroglioma, 35 were glioblastoma and 1 was mixed oligoastrocytoma.WT1 immunohistochemistry expression was found in 127/6 (95.5%) samples. For the glioblastoma, WT1-expression significantly increased with patient’s age (p=0.05, table 3). WT1 expression and Ki67 proliferation index had prognostic effect in patients with brain glioma (p<0.05), and low expression mean survival was 48.5 months, high expression survival was 18.4 months respectively.
Conclusion
WT1 expression in Mongolian patients with brain glioma had significantly associated with several adverse prognostic indicators including high Ki67 proliferation index (high grade tumor) and high expression of WT1 and univariable survival.
4. THE SUCCESSFUL SURGICAL TREATMENT FOR ABDOMINAL AORTIC COARCTATION AND LEFT NEPHRECTOMY
Erdenesuren J ; Nyamsuren S ; Altankhuyag G ; Ganchudur L ; Demid-Od N ; Zorig TS ; Damdinsuren TS ; Badamsed TS ; Delgertsetseg D ; Jargalsaikhan S ; Batmunkh M ; Enkhee O
Journal of Surgery 2016;20(2):96-
Middle aortic coarctation (MAC), a variantof middle aortic syndrome, is a rare entity withonly ~200 cases described in the literature.It classically presents with early onset andrefractory hypertension, abdominal angina,and lower extremity claudication(1).A 30 years-old woman, Her systolic bloodpressure measures 180-200mm Hg and diastolicpressures measure 70mm Hg in both arms,lower extremity pressures are approximately70mm Hg. Her bilateral femoral pulses andpedal pulses are nonpalpable, but present onDoppler exam and CT-Angiography.We prepared diagnostic of CT-Angiographyand Aortography before operation. Wesuccessful operated abdominal aorticcoarctation by “Silver graft” Aortoaortic bypasson the middle aortic, left nephrectomy.She was discharged home on postoperativeday 7. Post operation is good. We werecontrolled CT-Angiography.
5.Studies on structure and maturation of the ovaries in girls
Solongo O ; Bolorzaya Ts ; Ariungerel G ; Myadagmaa D ; Enkhee N ; Dagdanbazar B
Mongolian Medical Sciences 2018;185(3):132-137
Since a human being was born, female reproductive organs, particularly the structure and function
of the ovaries are constantly changing. The findings of overseas studies referred hereunder show
that the ovarian follicular growth and atresia in young girls occur simultaneously, continuously and
actively. The histopathology and ultrasound examination of the ovaries in girls were similar in principles. We found that ovarian maturation is influenced by hormonal stimulation, not only by age. In
the most of the study, ovarian follicles were divided into two groups; as micro-cysts (<9mm) and
macro-cysts (>9mm).
In every country, physical development of inhabitants shall be researched academically in every 5 to
10 years, comparing to geography, nature, weather conditions, culture, occupation and livelihood of local residents, in connection with the social and economic development of the country; urban and
rural areas. In the studies regarding physical growth and development of Mongolian children’s body, structure and maturation of the ovaries in girls have not been determined. However, in 1996, Tuul M.
studied ovarian measurements in Mongolian adults sampling organs from cadavers. Fundamental
research determining the characteristic of ovarian structure and maturation in Mongolian girls and
comparing results with an onset of puberty is needed to be developed.
6.The study of the diagnostic value of determination of serum aquaporin-4 and glial fibrillary acidic protein in primary brain tumor
Orkhontuul Sh ; Angir-Ujin B ; Baigalmaa D ; Naranjargal D ; Enkhee O ; Tovuudorj A ; Ariunzaya B ; Tsogtsakhan S ; Enkhsaikhan L
Mongolian Medical Sciences 2021;196(2):27-31
Introduction:
According to the World Health Organization (WHO) in 2020, brain and central nervous system
(CNS) cancers account for 2% of all newly diagnosed cancers in the world and 1.5% in Mongolia.
Approximately 85-90% of all brain and other CNS tumors were diagnosed primary brain tumor. In
2019, the average 5 year survival probability was 50% for other cancers and 11% for the primary
brain tumors. There were 28 patients with primary brain tumor and 33 relatively healthy individuals
in our study.
Goal:
To study the diagnostic value of serum aquaporin-4 and glial fibrous acidic protein in the diagnosis of
primary brain cancer
Material and Methods:
The Department of Neurosurgery at Third central hospital included 28 patients with primary brain
cancer and 33 relatively healthy people. The study was conducted under the permission of the Medical
Ethics Review Committee of the Ministry of Health on June 19, 2019 №119. Serum aquaporin-4
and glial fibrous acidic protein content was determined by the ELISA kits method using the human
aquaporin-4 and glial fibrous acid protein test kit of the Chinese company “Sanlong”. The level is
assumed to be true if the p value is less than 0.05.
Results
Mean age of the all participants was 42.9±16.5, 64% female and 36% male. Serum aquaporin-4 protein
levels were 175.71±13.3 pg/ml and serum glial fibrilliary acidic protein levels were 2.682±0.218 ng/ml
in patient with primary brain tumor. Serum aquaporin-4 protein and glial fibrilliary acidic protein levels
were statistically significant high (p<0.001) in patient with primary brain tumor. Serum aquaporin-4
protein and glial fibrilliary acidic protein level differences were statistically significant (p<0.05) in benign
and malignant tumor. There was no statistically significant correlation between serum aquaporin-4
and glial fibrillary acidic protein level and primary brain tumor grade.