Online Journal of Health and Allied Sciences
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Chief Editor: B. S. Kakkilaya
ISSN: 0972-5997
Frequency: Quarterly
Language: English
Open Access Peer-reviewed journal
Web site: https://www.ojhas.org/
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Browsing Online Journal of Health and Allied Sciences by Author "Amita, K"
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Item Effectiveness of International System for Reporting Serous Fluid Cytology in Routine Practice – A Cross Sectional Study at a Tertiary Care Centre(Light House Polyclinic, 2024-01) Amita, K; Suresh, R; Kalappa, P; Sanjay, MAbstract: Background: To standardize the reporting pattern across various institutions, recently the international system for reporting serous fluid cytology (ISRSFC) was introduced. The objective of the present study was to classify serous fluids into various categories as per the ISRSFC, derive the risk of malignancy for each category and determine the diagnostic efficacy of fluid cytology when ISRSFC was applied. Methodology: Cross-sectional study involving 235 cases of serous effusion over a duration of two years. All the cases were reclassified as per ISRSFC into five categories. Descriptive statistics was derived. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) was determined in 74 cases wherein final diagnosis was confirmed by clinical findings, radiology, or cell block. Results: Out of total 235 cases of fluid examined, distribution of cases in the diagnostic categories were as follows, 11 (4.6%) in nondiagnostic (ND), 208 (88.51%) in negative for malignancy (NFM), 5 (2.12%) in atypia of undetermined significance (AUS), 2 (0.85%) in suspicious for malignancy (SFM) and 9(3.82%) in malignant (MAL)category. Out of 208 cases of NFM, mesothelial cells were seen in only 8 (3.8%) cases. The risk of malignancy was 0% each in ND and NFM, 40% in AUS, 100% each in SFM and MAL. Sensitivity and specificity of fluid cytology was 100% and 96.6% respectively while PPV and NPV was 81.81% and 100 % respectively. Conclusion: ISRSFC is easy to apply and has high diagnostic efficacy. Most of the serous effusions fall in negative for malignancy category. Mesothelial cells are not important for specimen adequacy.Item Evaluation of Efficacy of IAC Yokahama Reporting System For Breast Cytology – A Single Institutional Experience.(Light House Polyclinic, 2023-03) Amita, K; Dhanlakshmi, B; Sanjay, M.Purpose: Breast fine needle aspiration cytology (FNAC) has a long history of providing accurate, rapid and cost-effective diagnosis of palpable breast lesions. Recently, International Academy of Cytology (IAC) at Yokohama proposed a new reporting system for breast cytology, in order to bring uniformity across the globe. Any new classification system needs to be validated for its practical applicability. Objectives: This study was conducted to categorize the breast lesions as per this classification and further determine the diagnostic efficacy and risk of malignancy in each category. Material and methods: This was a cross sectional observational analytical study. All the cases presenting to cytology OPD from Janurary 2020 upto December 2022, (N=296) with breast lesions for FNAC were included in the study. All the cases were divided into five categories as per the newly proposed IAC Yokohama reporting system. The risk of malignancy for each category was determined and diagnostic efficacy was evaluated.Results:The sample were distributed as follows: insufficient material 4.39%, benign 66.21%, atypical 10.47%, suspicious for malignancy 1.35% and malignancy 17.56%. Histopathology was obtained in 88 cases, out of which 82 (93.18%) showed concordant diagnosis. The sensitivity and specificity were 85.71% and 98.11% respectively. Risk of malignancy (ROM) in each category was as follows-benign (0.01%), atypia (71.4%), suspicious (100%) and malignancy (96.66%) respectively.Conclusion:The high efficacy of FNAC obtained in the present study, when IAC Yokohama reporting system was applied, confirms the usefulness of this scheme in reporting breast lesions. A risk-based stratification is essential in the present era to guide and alert the clinician about the subsequent management plan and the ROM.Item Prognostic Significance of Lymphatic Vessel Density by D2-40 Immune Marker and Mast Cell Density in Invasive Breast Cancer: A Cross Sectional Study at Tertiary Care Hospital in South India.(Light House Polyclinic, 2022-03) Dhanlakshmi, B; Amita, K; Prashantha, K.Background: Tumour induced lymphangiogenesis plays a crucial role in metastasis and tumour progression. The intratumoural and peritumoral lymphatics are supposed to have different biological effects. The aim of present study was to investigate the correlation of intratumoral lymphatic vessel density (I LVD), peritumoral lymphatic vessel density (P LVD), intratumoral mast cell density (I MCD) and peritumoral mast cell density (P MCD) with prognostic parameters in primary breast carcinoma. Methods: Lymphangiogenesis was detected using D2-40 monoclonal antibody and mast cell by using toludine blue stain in 50 cases of primary breast carcinoma. Positively stained lymphatic vessels were counted at 40 x in dense lymphatic vascular foci (hot-spot) within the tumour. Chi square, ANOVA test and Pearsons correlation was applied to determine the relationship amongst various variables, with statistical significance set at p <0.05. Results: Mean P LVD was significantly higher than I LVD (6.25±21 vs 2.75±2.27,p <0.005). Significant correlation was noted between I LVD and P LVD and age, tumour laterality, tumour size and overall staging. However, there was no correlation between I LVD and P LVD with other important clinicopathologic prognostic markers like grade, lymphnode status and lymphovascular invasion. MCD was higher in both intratumoral and peritumoral location as compared to normal tissue. There was an association noted between P MCD with pathological staging and perineural invasion. However, there was no significant association of I MCD and P MCD with other prognostic markers like grade and lymphnode status. No significant correlation was noted between I LVD, P LVD, I MCD and P MCD. Conclusion: The evidences from our study support the utility of D2-40 stain in determining the lymphatic density in IBC. The study findings also establish the existence of lymphangiogenesis in both intratumoral and peritumoral location. For now, the data presented herein do not permit us to promote the utility of LVD and MCD as predictors of prognosis in invasive breast carcinoma.Item Role of Adipocyte Tissue Invasion as a Prognostic Marker in Invasive Breast Carcinoma - A Cross-Sectional Study(Light House Polyclinic, 2024-01) Amita, K; Nagaraju, P; Sunil, BK; Sanjay, MAbstract: Background: Functional lymphatics at the peritumoral site is mainly responsible for lymphovascular invasion (LVI) in breast cancer. Marginal adipose tissue invasion (ATI) leads to larger area of contact between peritumoral lymphatics and may increase chances of LVI. Objectives: To investigate whether ATI of cancer cells at the tumour margin influenced lymph node status and prognosis in patients with invasive ductal carcinoma of the breast. Materials and methods: Cross sectional study involving 33 cases of invasive ductal carcinoma diagnosed over a duration of three years. Clinicopathologic prognostic parameters in 33 cases with marginal ATI was were compared 10 patients without ATI. The value of the combination of ATI and peritumoral lymphatic vessel invasion (LVI) was also assessed. Chi square was applied to assess the statistical significance at p<0.05. Results: The frequency of axillary lymph node metastases was 63.63.7% in patients with ATI (21/33) and 0% in patients without ATI (0/10) with a p value of < .001. The frequency of peritumoral lymphovascular invasion was 88.88% in patients with ATI (24/27) and 11.1% in patients without ATI (3/27) with a p value of < 0.01. ATI was an independent factor influencing nodal metastasis. Conclusion: ATI of cancer cells at the tumour margin is one of the biologic indicators of tumour aggressiveness in invasive breast cancer. This study indicate that ATI+ cases were associated with adverse outcomes in addition to the converse. ATI should be incorporated in a standard surgical pathology report of infiltrating ductal carcinoma of the breast as ATI and peritumoral LVI will be useful in the framing therapeutic strategies and in assessment of prognosis