Showing papers by "Robert Higgins published in 2022"

Prognostic value of the 1-minute sit-to-stand test on postoperative complications in people with lung cancer elected for lung surgery

Abstract: Background: Preoperative physical function is a predictor of postoperative complications (PCs) in people undergoing lung resection for non-small cell lung cancer (NSCLC). We aim to evaluate whether the preoperative performance in the 1-minute sit-to-stand test (1-MSTST) – a simple test of physical function – is a prognostic marker of PCs. Methods: We included patients prior to lung resection for NSCLC from two hospitals (Genk, Belgium and Perth, Australia). Before surgery, the 1-MSTST was assessed twice with 15 minutes rest in between, and the best was used for analysis. PCs were prospectively recorded and graded with the Clavien-Dindo classification. Receiver Operating Characteristic (ROC) analysis was performed and the area under the curve (AUC), sensitivity and specificity were calculated. Data of both centres were combined following analysis that demonstrated similar characteristics and findings in both centres. Results: We recruited 32 participants (20 male; age 66±9yr) who underwent video-assisted thoracic surgery (78%) or thoracotomy (22%). The median [interquartile range] number of repetitions on the 1-MSTST was 27 [21 to 28]. PCs were reported in 13 participants. Cut-off values of 22 repetitions (AUC 0.65; sensitivity 62%; specificity 79%) and 59% predicted (AUC 0.60; sensitivity 38%; specificity 95%) were identified. Conclusion: The preoperative assessment of the 1-MSTST has an acceptable discriminative ability to predict the risk of postoperative complications in patients with NSCLC. A cut-off of 22 repetitions or 59% predicted on the 1-MSTST has prognostic value to assess risk of PCs in people undergoing surgery for NSCLC.

Case Report: Neuroblastoma-Like Schwannoma in a Domestic Short-Haired Cat

Abstract: An axillary mass was detected in a 6-year-old, neutered, male, domestic short-haired cat during a wellness exam. Gross examination following surgical removal revealed a discrete, deep subcutaneous, discoid mass that was between 0.5- and 0.7-cm-in-diameter and diffusely firm and white. Histologically, the mass was well-demarcated, partially encapsulated, and expanded the panniculus carnosus. It was composed of tightly packed, giant rosettes of radially arranged fusiform cells stacked in one to 10 layers with peripherally palisading nuclei and with centrally oriented, fibrillary, cytoplasmic processes, and collagenous fibers. Laminin immunoreactivity and ultrastructural examination highlighted a continuous basal lamina outside the plasma membrane of each neoplastic cell. Neoplastic cells were immunoreactive for GFAP, S100, periaxin, and Sox-10 and were immunonegative for synaptophysin, smooth muscle actin, and pancytokeratin. Collective findings were consistent with a diagnosis of neuroblastoma-like schwannoma. This is the first veterinary report of this rare variant of benign schwannoma.

Nerve Fiber Immunohistochemical Panel Discriminates between Nerve Sheath and Perivascular Wall Tumors

Abstract: Simple Summary Soft-tissue sarcomas are classified as nerve sheath tumors if originating within nerves. However, tumors of the nerves still pose a frequent challenge for diagnostic veterinary pathologists since identifying nerve histomorphology based only on the examination of hematoxylin-and-eosin-stained sections is often insufficient. In addition, there are no robust tumor-related biomarkers for a reliable diagnosis of nerve sheath tumors. Improving the anatomo-pathological diagnosis of nerve sheath tumors will contribute to a more accurate classification of soft-tissue sarcomas and their prognosis, ultimately aiding clinicians in making informed decisions for their patients. This current immunohistochemical study explores a combined panel of laminin, Sox-10 and periaxin-1 as an ancillary diagnostic approach to confirm the diagnosis of suspect nerve sheath tumors. The study demonstrates that this panel discriminates reliably between soft-tissue subtypes such as nerve sheath tumors and perivascular wall tumors. Abstract Benign and malignant nerve sheath tumors (NST) pose a major challenge in routine diagnostic anatomic pathology because of shared histomorphological features with other soft-tissue tumors (STT). As a result, NST are often diagnosed as STT, a broad category that encompasses various entities including perivascular wall tumors (PWT) and that represents approximately 15% of all skin tumors in dogs. Immunohistochemistry (IHC) can assist the identification of histologic subtypes of STT. This IHC pilot study applies various markers largely expressed by peripheral nerves to twelve benign and six malignant NST and determines the intratumoral protein expression of laminin, periaxin-1, Sox-10 and S-100 in the NST subtypes. Furthermore, this study assesses the usefulness of peripheral nerve markers applied to diagnostic work cases and demonstrates the relevance of laminin expression patterns, periaxin-1 and Sox-10 in assisting the differentiation of NST from other STT, in particular from PWT.