The significance of squamous differentiation in endometrial carcinoma: data from a Gynecologic Oncology Group study

Article Abstract:

Cancers are classified in many different ways, including on the basis of their appearance under the microscope. Two important classifications are adenocarcinoma, which is a cancer with the cellular appearance of glandular cells, and squamous cell carcinoma, in which the cells are in patterns reminiscent of scales. As is the case with many systems of classification, the two are not mutually exclusive, and it is possible to have regions of squamous differentiation within an adenocarcinoma. Unfortunately, the proper way to classify such cases is not always clear, and has resulted in some confusion, particularly when data such as survival rates are grouped into classes that are erroneous to begin with. The term ''adenosquamous carcinoma'' was coined to indicate a mixed cancer in which the squamous component appeared malignant, and an adenoacanthoma was supposed to be a adenocarcinoma with a benign-appearing squamous component. Unfortunately, not all pathologists evaluating cancers used these terms in the same way, adding to the confusion. The authors of the present article propose that the confusion be eliminated by using the term ''adenocarcinoma with squamous differentiation'' to apply to all adenocarcinomas with a squamous component, regardless of the appearance of the squamous cells. To illustrate the usefulness of the classificatory terminology, the cases of 456 women with endometrial adenocarcinoma were compared with those of 175 with endometrial adenocarcinoma with squamous differentiation. The biological behaviors of these two classes of cancer were similar but not identical. Statistical analysis showed that the patients with adenocarcinoma with squamous differentiation enjoyed a slight survival advantage over women with endometrial carcinoma without a squamous component. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Terminology, Endometrial cancer, Tumors, Adenocarcinoma

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Determinants of gastroesophageal junction incompetence: hiatal hernia, lower esophageal sphincter, or both?

Article Abstract:

A combination of a hiatal hernia and reduced lower esophageal sphincter (LES) pressure may contribute to the development of gastroesophageal sphincter incompetence. Patients with gastroesophageal sphincter incompetence often suffer from heartburn and inflammation of the esophagus caused by reflux of the acidic juices of the stomach. A study compared LES pressure in 34 patients with a suspected hiatal hernia to LES pressure in 16 healthy individuals. Twenty patients were diagnosed with a hiatal hernia on the basis of a series of radiographic studies. The average LES pressure of the patients diagnosed with a hiatal hernia was lower than that of the patients who were not diagnosed with a hiatal hernia and of the healthy individuals. Among patients with a hiatal hernia, reflux of the acidic juices of the stomach increased with the diameter of the hernia.

Abnormalities, Complications and side effects, Esophagogastric junction, Hiatal hernia

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