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Abstract: Context. Malignant pleural mesothelioma (MPM) is a rare tumor with poor prognosis. Several studies have analyzed potential prognostic markers, but histologic type remains the single most important prognostic factor. Histologic subtypes of epithelioid MPM seem to have prognostic and therapeutic implications. Interobserver agreement in histologic pattern classification should be high. Objective. To assess interobserver and intraobserver reproducibility in histologic differentiation between the main types of MPMs, and in further subtyping of epithelioid-type mesothelioma. Design. One representative hematoxylin-eosin-stained slide was selected from the archive for each of 200 patients with MPM. They were reviewed independently by 3 pathologists and classified according to the current World Health Organization classification of pleural tumors. After the first round of evaluations, a consensus meeting was organized where problems were addressed and representative images for each histologic category were selected. Two months later, cases were reevaluated by all 3 pathologists. Results. After the first round, overall interobserver agreement for histologic subtyping of mesothelioma was fair (k, 0.36). The agreement was increased to substantial (k, 0.63) in the second round. Improvement was found in interobserver agreement for all types of MPM, and for most epithelioid subtypes. Conclusions. Moderate to substantial agreement in histologic typing and subtyping of MPM can be achieved. However, training with additional clarification of diagnostic criteria, their strict application, and help from consensus-based illustrative images is needed.
Keywords: connective and soft tissue neoplasms -- pathology, malignant pleural mesothelioma, histopathology
Published in DiRROS: 30.11.2020; Views: 5929; Downloads: 451
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Published in DiRROS: 26.11.2020; Views: 1966; Downloads: 1149
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Abstract: This article analyzes the availability of different diagnostic procedures of non-small cell lung cancer (NSCLC) and the reimbursement landscape of drugs for NSCLC in countries of central and southeastern Europe (CEE). A survey was conducted by the Central European Cooperative Oncology Group. Results of the survey show that both availability and reimbursement of diagnoses of molecular alterations in NSCLC, the detection of which is essential for therapeutic decisions, varies widely between countries of CEE. Not only is "reflex" testing often substituted by analyses performed only "on demand," but reimbursement of such assessments varies widely between unavailability and payments by the health care system or even pharmaceutical companies. It was concluded that a structured access to testing and reimbursement should be the aim in order to provide patients with appropriate therapeutic options. Implications for Practice. This article provides an overview of the limitations in lung cancer treatment in countries of central and southeastern Europe, as well as the reimbursement status of various lung cancer treatment regimens in these countries, which directly impacts treatment options.
Keywords: Non-small cell lung carcinoma -- diagnosis -- economics -- Europe, molecular diagnostic techniques, precision medicine, Central Europe, Southeastern Europe, reimbursement
Published in DiRROS: 09.11.2020; Views: 1466; Downloads: 346
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Abstract: A questionnaire on biomarker testing previously used in central European countries was extended and distributed in Western and Central European countries to the pathologists participating at the Pulmonary Pathology Society meeting 26-28 June 2019 in Dubrovnik, Croatia. Each country was represented by one responder. For recent biomarkers the availability and reimbursement of diagnoses of molecular alterations in non-small cell lung carcinoma varies widely between different, also western European, countries. Reimbursement of such assessments varies widely between unavailability and payments by the health care system or even pharmaceutical companies. The support for testing from alternative sources, such as the pharmaceutical industry, is no doubt partly compensating for the lack of public health system support, but it is not a viable or long-term solution. Ideally, a structured access to testing and reimbursement should be the aim in order to provide patients with appropriate therapeutic options. As biomarker enabled therapies deliver a 50% better probability of outcome success, improved and unbiased reimbursement remains a major challenge for the future.
Keywords: lung neoplasms -- diagnosis -- therapy -- Europe, lung cancer, predictive testing
Published in DiRROS: 21.09.2020; Views: 1637; Downloads: 1055
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Abstract: Ambrozijske podlubnike uvrščamo med najpomembnejše tujerodne invazivne organizme. Še posebej uspešna pri osvajanju novih območij pa je vrsta Xyosandrus germanus, ki je bila leta 2000 prvič najdena tudi v Sloveniji. Namen naše naloge je bil potrditi razširjenost in ugotoviti velikost populacije X. germanus v revirju Šentvid (KE ZGS Škofljica). Vrsto smo spremljali s pomočjo pasti iz odpadnih plastenk, ki smo jih naredili sami. Postavljene so bile v treh različnih gozdnih sestojih, in sicer smo v vsakem sestoju postavili štiri pasti z različnimi vabami (etanol, denaturiran etanol, kombinacija etanola in %-pinena ter kontrolna past brez vabe), v zbirni posodi je bil konzervans etilen glikol. Pasti smo spremljali osem tednov, v obdobju med 26. 4. 2017 in 20. 6. 2017, jih tedensko praznili, ulov pa determinirali v Laboratoriju za ekološke raziskave - entomologija, Oddelka za gozdarstvo in obnovljive gozdne vire BF. Ujeli smo 11.460 osebkov X. germanus, kar je v skupnem ulovu pomenilo kar 90,09 % celotnega ulova hroščev oziroma 95,30 % celotnega ulova podlubnikov. Tako številčen ulov kaže na to, da je populacija X. germanus na raziskovalnem območju velika. Poleg vrste X. germanus smo potrdili še enega tujerodnega ambrozijskega podlubnika, in sicer vrsto Gnathotrichus materiarius. Naši rezultati kažejo, da ni večjih razlik v učinkovitosti privabljanja vrste X. germanus med testiranimi vabami. Glede na število ujetih osebkov vrste X. germanus pa lahko trdimo, da so tudi doma narejene pasti iz odpadnih plastenk lahko primerno orodje za spremljanje tujerodnih ambrozijskih podlubnikov.
Keywords: gozdovi, ambrozijski podlubniki, invazivne tujerodne vrste, Xylosandrus germanus, spremljanje, pasti, vabe, Slovenija
Published in DiRROS: 09.09.2020; Views: 5473; Downloads: 1691
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