Medical registries provide highly reliable data, challenged hierarchically only by randomized controlled trials. Although registries have been used in several fields of medicine for more than a century and a half, their key role is frequently overlooked and poorly recognized. Medical registries have evolved from calculating basic epidemiological data (incidence, prevalence, mortality) to diverse applications in disease prevention, early diagnosis and screening programs, treatment response, health care planning, decision making and disease control programs. Implementing, maintaining and running a medical registry requires substantial effort. Developing the registry represents a complex task and is one of the major barriers in widespread use of registries. Medical registries have potential to evolve to a next generation by taking benefit from recent semantic web technology developments. This paper is aimed at providing a summary of the basic information available on medical registries and to highlight the progress and potential applications in this field.

Using data from a pilot study conducted in North-Western Romania, we aimed to estimate the prevalence of abnormal cytology and positive high-risk human papillomavirus (hr-HPV) test results in an ethnically diverse screening population and to assess the agreement between cytology and hr-HPV testing to evaluate the feasibility of integrating the latter as a primary test in the national cervical cancer screening program. The cross-sectional pilot study included Roma women, other ethnic minorities, and women in rural remote areas. Samples were taken for liquid-based cytology and hr-HPV testing (Hybrid Capture 2 DNA test) by a mobile health unit. The prevalence of positive screening results and the agreement between cytology and hr-HPV testing were estimated by κ coefficient. A total of 1019 women were included in the study. The population prevalence of positive screening results was similar for both tests (12%). The prevalence of abnormal cytology increased with increasing age, whereas the prevalence of positive hr-HPV test showed a bimodal age pattern. Substantial differences in the prevalence of abnormal cytology were found by ethnicity, with highest prevalence in Romanian women (14%), followed by Roma women (6%) and women of other ethnicities (5%) (P = 0.002). Similar ethnic differences in the prevalence of positive hr-HPV test were not observed. The overall agreement of positive screening results between the two methods was fair (κ = 0.25; 95% confidence interval = 0.18–0.30, P < 0.001) and ranged from poor to substantial depending on the age group. The prevalence of abnormal cytology result was high and similar to the prevalence of positive hr-HPV test result, which could allow for the implementation of hr-HPV testing as a primary test in the cervical cancer screening program in Romania.

The aim of this study was to determine the incidence trends of cutaneous melanoma (CM) and squamous cell carcinoma (SCC) in Cluj County, from 1998 to 2011, and the 5-year net survival between 2006 and 2010. Data on all cases of CM and SCC between 1998 and 2011 were obtained from Cluj Cancer Registry. Incidence rates were age standardized by the direct method Age Standardized Incidence Rate (ASIR), using the world standard population. Trends and annual percentage change (APC) of incidence rates were calculated by joinpoint regression analysis. The Pohar-Perme estimator was used to examine the 5-year net survival of cases diagnosed during 2006–2010 and followed up until December 2015. A total of 580 cases of CM and 397 cases of SCC were reported. During 1998–2011, the ASIR of CM increased significantly by 7.8% APC in male patients and by 7.42% APC in female patients, and the ASIR for SCC increased by 9.40% APC in male patients. In female patients, the incidence of SCC increased by 12.65% APC during 2002–2011. The 5-year net survival during 2006–2010 was 0.64 in men and 0.75 in women for CM and 0.86 and 1.00, respectively, for SCC. Survival rates showed an improving trend during 2006–2010, and were generally lower in men. Survival from both entities decreased with age and was lower in rural areas and in advanced stages in both sexes. This study reveals a rising incidence of cutaneous cancers in concordance with international trends. These data support the important role of primary and secondary prevention of skin cancers, focusing not only on melanoma, due to its lower survival, but also on SCC, in order to reduce their burden.

Marginal zone lymphoma is a heterogeneous category of indolent non-Hodgkin lymphomas (NHLs). Splenic marginal zone lymphoma (SMZL) represent 2% of lymphoid neoplasia.1 Epidemiologic studies have linked this category of NHLs to several agents capable of establishing chronic infections in humans.2 Hepatitis C virus (HCV) infection has been linked especially with SMZL.2, 3 In this paper, we present 34 retrospectively selected cases of SMZL representing 4.65% of all lymphomas and 6.0% of all NHLs in a series of 731 consecutive lymphoma cases diagnosed between 1 January 2006 and 29 February 2016, in the Department of Pathology at the Institute of Oncology 'Prof. Dr. Ion Chiricuta', Cluj-Napoca, Romania. Data collection was performed in March and April of 2016. The number of SMZL cases was double compared with the expected incidence reported for this disease.1 Of the 17 cases with available status for viral hepatitis and human immunodeficiency virus (HIV) infection 5 cases were diagnosed with hepatitis B (HBV) or C infection (29%). All tissue samples were fixed in 10% neutral buffered formalin. For bone marrow biopsy (BMB) specimens, decalcification was performed in ethylenediaminetetraacetic acid with disodium salt acid buffer (Osteodec, Bio-Optica, Milan, Italy) for a duration of 3 h, followed by paraffin embedding. Sections were cut at 4 μm and stained using hematoxylin and eosin, and Gomori for the evaluation of fibrosis. Immunohistochemistry was performed by using the following antibodies: CD20 (mouse monoclonal antibodyL26, ABCAM (Cambridge, UK), dilution 1:50), CD3 (polyclonal rabbit anti-human antibody, clone UCHT1, Dako, Glostrup, Denmark; dilution 1:100), CD45 (mouse monoclonal antibody clone 2B11, Dako, dilution 1:100), CD10 (mouse monoclonal antibody, clone 56C6, Novocastra, Buffalo Grove, IL, USA; dilution 1:100), CD5 (mouse monoclonal antibody clone 4C7, Novocastra, dilution 1:100), CD23 (mouse monoclonal antibody, clone 1B12, Novocastra, dilution 1:50), BCL2 (mouse monoclonal antibody, clone 124, Dako, dilution 1:100), BCL6 (mouse monoclonal antibody, clone BL6.02, Thermo Scientific, Waltham, MA, USA; dilution 1:20), cyclin D1 (mouse monoclonal antibody, clone DCS-6, Santa Cruz, dilution 1:100), CD79a (mouse monoclonal antibody, clone JCB117, Dako, dilution:1:50), Ki-67 (mouse monoclonal antibody, clone MM1, dilution 1:200), CD138 (monoclonal mouse antibody, clone MI15, Dako, dilution 1:25), CD43 (mouse monoclonal antibody, clone DF-T1, Dako, dilution 1:100), CD21 (mouse monoclonal antibody, clone 2G9, Novocastra, dilution 1:20), CD35 (mouse monoclonal antibody, clone E11, ABCAM, dilution 1:50) and CD11c (mouse monoclonal antibody, clone 5D11, Novocastra, dilution 1:100). Pre-treatment of tissues with heat-induced epitope retrieval was performed. The visualizations step employed the Novolink Polymer Detection System, Novocastra. Examination of all cases was performed by a pathologist with expertize in hematopathology (BF). Screening for viral infections included the detection of the HBsAg, AgHBe antigens and anti-HBe, anti-HCV and anti-HIV 1 and 2 antibodies performed using the electrochemiluminescent immunoassay (ECLIA, Roche Diagnostics, Rotkreuz, Switzerland). Screening for hepatitis D (DELTA) included the detection of anti-HD antibodies and was performed using an enzyme-linked immunosorbent assay (ELISA). Viral load determination was performed using the real-time polymerase chain reaction(RT-PCR; Roche Diagnostics). Of the 731 lymphoma cases, Hodgkin lymphoma represented 160 cases (21.9%) and the other 571 cases were diagnosed as NHLs (78.1%). From this series, 34 cases were diagnosed as SMZL, representing 4.7% of all lymphoma cases and 6.0% of all NHLs. The SMZL cases had a male-to-female ratio of 1.8 (22 males and 12 females). The age of the patients ranged from 39 to 77 years with a median of 63 years. There was no significant difference between the median ages of males versus females (60 versus 66 years, K-sample equality-of-medians test P>0.05). The results of tests for viral hepatitis and HIV infection were available for 17 cases. Overall, five cases were diagnosed with hepatitis B or C infection (29.4%). Of these, two were anti-HCV positive (11.7%) and three (17.7%) were HBsAg positive (Table 1). All cases were HIV and HDV (Delta) negative. RT-PCR for viral load was available for one case with HCV infection (11833459 UI/ml) and one case with HBV infection (352218 UI/ml). One out of three HBV cases showed production of anti-HBe antibodies. BMB was performed on all 17 patients (Table 1). In addition, splenectomy specimens were examined from two patients, and lymph node biopsy specimens were examined from two patients. BMB showed involvement by lymphoma in all cases with a predominantly interstitial pattern of infiltration (12/17 cases, 70.6%), followed by an intrasinusoidal pattern (9/17 cases, 53%). Paratrabecular, nodular and diffuse patterns of infiltration were less represented (Table 1). Reactive T-cell infiltrates were also observed in six cases (35.3%). In three cases, focal mild fibrosis was observed. The lymphoma infiltrate consisted of atypical small lymphocytes or medium-sized lymphocytes with moderate amounts of clear cytoplasm. Two cases showed transformation to diffuse large B-cell lymphoma (DLBCL) confirmed by positive lymph node biopsies. Of the two cases with DLBCL transformation, one was HCV positive and the other was HBV positive. One case developed a recurrence in a salivary gland. Immunohistochemically, the lymphoma cells were positive for pan-B-cell markers (CD20, CD79a) and for common leukocyte antigen (CD45), and were negative for CD5, CD23 (one case had focal weak positivity), cyclin D1, CD3, CD10, CD11c (one case was positive) and CD30. Bcl2 was positive in two out of the three cases tested. One case was CD43 positive (on a recurrence in the parotid gland). Reactive T-cell infiltrates were CD3 and CD5 positive. Spleen involvement was...

Background and Objectives: The assessment of HER2 status in invasive breast carcinomas (IBCs) is critical for determining treatment strategies. The aim of this study was to evaluate the FICTION technique as a potential method for assessing HER2 status and to compare it with the standard sequential immunohistochemistry (IHC)–in situ hybridization (ISH) assays. Materials and Methods: This study included 49 patients diagnosed with invasive breast carcinomas. HER2 status was assessed using both IHC+FISH and FICTION techniques, and the results were compared. Results: Comparative analysis demonstrated an 83.67% categorical agreement between IHC and IF using the ASCO/CAP system. The percentage of cells showing any degree of HER2 protein expression was higher with IF (73.77%) than with IHC (60.71%) (p = 0.00026). The in situ hybridization assays showed an excellent agreement, with a 90% or higher concordance. The concordance of the ASCO/CAP group classification of cases using both ISH assays (FICTION and standard FISH) was high (85, 7%). Agreement was 100% for the final classification of cases (Her2 positive/negative). Conclusions: We compared standard tests for Her2 protein expression and the gene copy number with a modified FICTION protocol. The study showed moderate agreement between IHC and IF for Her2 protein and excellent agreement between FISH and FICTION ISH for the gene copy number. Final Her2 status was unaffected by low IF IHC concordance. Optimizing the FICTION protocol could improve results. Combining protein and gene assays may enhance IBC patient stratification.