Skip to main content
Erschienen in: Oral and Maxillofacial Surgery 4/2022

24.11.2021 | Original Article

Immunohistochemical comparative analysis of IMP-3 and KI-67 in actinic cheilitis and lower lip squamous cell carcinoma

verfasst von: Adriana Costa de Souza Martins Câmara, Amanda Katarinny Goes Gonzaga, Joabe dos Santos Pereira, Salomão Israel Monteiro Lourenço Queiroz, Éricka Janine Dantas da Silveira, Leão Pereira Pinto, Lélia Batista de Souza

Erschienen in: Oral and Maxillofacial Surgery | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Abstract

Actinic cheilitis (AC) and lower lip squamous cell carcinoma (LLSCC) exhibit epithelial alterations mainly associated with chronic ultraviolet ray exposure. Currently, it is impossible to predict which AC cases will progress to LLSCC; thus, biomolecular markers have been studied. The aim of this study was to evaluate the immunoexpression of IMP-3 and KI-67 in AC and LLSCC. Forty AC and 40 LLSCC cases were submitted to peroxidase method and quantitatively analyzed, using the following scores: 0 (0% positive cells), + 1(≤ 30%), + 2 (> 30% to ≤ 60%), and + 3 (> 60%). Results were submitted to non-parametric Mann–Whitney (U) test. A p value < 0.05 was considered to indicate statistical significance. IMP-3 immunoexpression was observed in 26 AC cases, with predominance of the score 1 (35% of cases). This protein was also positive in 22 LLSCC cases, with predominance of the score 3 (37.5% of cases). Immunoexpression of KI-67 was observed in all studied cases, with predominance of the score 2 (70% of AC cases and 57.5% LLSCC cases). The association between IMP-3 and Ki-67 immunoexpression, AC dysplastic severity and LLSCC tumoral grade revealed no significant differences. The present results demonstrate that IMP-3 and Ki-67 immunoexpression are frequent in AC and in LLSCC. Moreover, these proteins could be involved in lower lip carcinogenesis process.
Literatur
1.
Zurück zum Zitat Lopes MLD de S, de Oliveira DHIP, Sarmento DJ de S, Queiroz LMG, Miguel MC da C, da Silveira ÉJD (2016) Correlation between cell cycle proteins and hMSH2 in actinic cheilitis and lip cancer. Arch Dermatol Res 308(3): 165–71 Lopes MLD de S, de Oliveira DHIP, Sarmento DJ de S, Queiroz LMG, Miguel MC da C, da Silveira ÉJD (2016) Correlation between cell cycle proteins and hMSH2 in actinic cheilitis and lip cancer. Arch Dermatol Res 308(3): 165–71
2.
Zurück zum Zitat Lopes MLD de S, Nonaka CFW, Queiroz LMG, de Souza LB, Miguel MC da C, da Silveira EJD (2016) Pattern of galectins expression in actinic cheilitis with different risks of malignant transformation. J Oral Pathol Med 45(8):621–6. Lopes MLD de S, Nonaka CFW, Queiroz LMG, de Souza LB, Miguel MC da C, da Silveira EJD (2016) Pattern of galectins expression in actinic cheilitis with different risks of malignant transformation. J Oral Pathol Med 45(8):621–6.
3.
Zurück zum Zitat Salihu S, Guven O, Gllareva E, Prekazi M, Salihu L (2014) A clinical study on survival rate of patients with squamous cell carcinoma of the lower lip in Kosovo. J Cranio-Maxillofacial Surg 42(8): 1773–7 Salihu S, Guven O, Gllareva E, Prekazi M, Salihu L (2014) A clinical study on survival rate of patients with squamous cell carcinoma of the lower lip in Kosovo. J Cranio-Maxillofacial Surg 42(8): 1773–7
4.
Zurück zum Zitat Jiang Z, Lohse CM, Chu PG, Wu CL, Woda BA, Rock KL et al (2008) Oncofetal protein IMP3: a novel molecular marker that predicts metastasis of papillary and chromophobe renal cell carcinomas. Cancer 112(12):2676–2682CrossRefPubMed Jiang Z, Lohse CM, Chu PG, Wu CL, Woda BA, Rock KL et al (2008) Oncofetal protein IMP3: a novel molecular marker that predicts metastasis of papillary and chromophobe renal cell carcinomas. Cancer 112(12):2676–2682CrossRefPubMed
5.
Zurück zum Zitat Lu D, Vohra P, Chu PG, Woda B, Rock KL, Jiang Z (2009) An oncofetal protein IMP3: a new molecular marker for the detection of esophageal adenocarcinoma and high-grade dysplasia. Am J Surg Pathol 33:521–525CrossRefPubMed Lu D, Vohra P, Chu PG, Woda B, Rock KL, Jiang Z (2009) An oncofetal protein IMP3: a new molecular marker for the detection of esophageal adenocarcinoma and high-grade dysplasia. Am J Surg Pathol 33:521–525CrossRefPubMed
6.
Zurück zum Zitat Bellezza G, Prosperi E, Del Sordo R, Colella R, Rulli A, Sidoni A (2016) imp3 is strongly expressed in malignant phyllodes tumors of the breast: an immunohistochemical study. Int J Surg Pathol 24(1):37–42CrossRefPubMed Bellezza G, Prosperi E, Del Sordo R, Colella R, Rulli A, Sidoni A (2016) imp3 is strongly expressed in malignant phyllodes tumors of the breast: an immunohistochemical study. Int J Surg Pathol 24(1):37–42CrossRefPubMed
7.
Zurück zum Zitat Gong Y, Woda BA, Jiang Z (2014) Oncofetal protein IMP3, a new cancer biomarker. Adv Anat Pathol 21(3):191–200CrossRefPubMed Gong Y, Woda BA, Jiang Z (2014) Oncofetal protein IMP3, a new cancer biomarker. Adv Anat Pathol 21(3):191–200CrossRefPubMed
8.
Zurück zum Zitat Hwang YS, Xianglan Z, Park KK, Chung WY (2012) Functional invadopodia formation through stabilization of the PDPN transcript by IMP-3 and cancer-stromal crosstalk for PDPN expression. Carcinogenesis 33(11):2135–2146CrossRefPubMed Hwang YS, Xianglan Z, Park KK, Chung WY (2012) Functional invadopodia formation through stabilization of the PDPN transcript by IMP-3 and cancer-stromal crosstalk for PDPN expression. Carcinogenesis 33(11):2135–2146CrossRefPubMed
9.
Zurück zum Zitat Hwang YS, Ahn SY, Moon S, Zheng Z, Cha IH, Kim J et al (2016) Insulin-like growth factor-II mRNA binding protein-3 and podoplanin expression are associated with bone invasion and prognosis in oral squamous cell carcinoma. Arch Oral Biol 69:25–32CrossRefPubMed Hwang YS, Ahn SY, Moon S, Zheng Z, Cha IH, Kim J et al (2016) Insulin-like growth factor-II mRNA binding protein-3 and podoplanin expression are associated with bone invasion and prognosis in oral squamous cell carcinoma. Arch Oral Biol 69:25–32CrossRefPubMed
10.
Zurück zum Zitat Li H-G, Han J-J, Huang Z-Q, Wang L, Chen W-L, Shen X-M (2011) IMP3 is a novel biomarker to predict metastasis and prognosis of tongue squamous cell carcinoma. J Craniofac Surg 22(6):2022–2025CrossRefPubMed Li H-G, Han J-J, Huang Z-Q, Wang L, Chen W-L, Shen X-M (2011) IMP3 is a novel biomarker to predict metastasis and prognosis of tongue squamous cell carcinoma. J Craniofac Surg 22(6):2022–2025CrossRefPubMed
11.
Zurück zum Zitat Li S, Cha J, Kim J, Kim KY, Kim HJ, Nam W et al (2011) Insulin-like growth factor II mRNA-binding protein 3: a novel prognostic biomarker for oral squamous cell carcinoma. Head Neck 33(3):368–374PubMed Li S, Cha J, Kim J, Kim KY, Kim HJ, Nam W et al (2011) Insulin-like growth factor II mRNA-binding protein 3: a novel prognostic biomarker for oral squamous cell carcinoma. Head Neck 33(3):368–374PubMed
12.
Zurück zum Zitat Lin C-Y, Chen S-T, Jeng Y-M, Yeh C-C, Chou H-Y, Deng Y-T et al (2011) Insulin-like growth factor II mRNA-binding protein 3 expression promotes tumor formation and invasion and predicts poor prognosis in oral squamous cell carcinoma. J Oral Pathol Med 40(9):699–705CrossRefPubMed Lin C-Y, Chen S-T, Jeng Y-M, Yeh C-C, Chou H-Y, Deng Y-T et al (2011) Insulin-like growth factor II mRNA-binding protein 3 expression promotes tumor formation and invasion and predicts poor prognosis in oral squamous cell carcinoma. J Oral Pathol Med 40(9):699–705CrossRefPubMed
13.
Zurück zum Zitat Gonzalez-Moles MA, Ruiz-Avila I, Gil-Montoya JA, Esteban F, Bravo M (2010) Analysis of Ki-67 expression in oral squamous cell carcinoma: Why Ki-67 is not a prognostic indicator. Oral Oncol 46(7):525–530CrossRefPubMed Gonzalez-Moles MA, Ruiz-Avila I, Gil-Montoya JA, Esteban F, Bravo M (2010) Analysis of Ki-67 expression in oral squamous cell carcinoma: Why Ki-67 is not a prognostic indicator. Oral Oncol 46(7):525–530CrossRefPubMed
14.
Zurück zum Zitat Humayun S, Prasad Vr. Expression of p53 protein and ki-67 antigen in oral premalignant lesions and oral squamous cell carcinomas: an immunohistochemical study. Natl J Maxillofac Surg. 2011;2(1):38. Humayun S, Prasad Vr. Expression of p53 protein and ki-67 antigen in oral premalignant lesions and oral squamous cell carcinomas: an immunohistochemical study. Natl J Maxillofac Surg. 2011;2(1):38.
15.
Zurück zum Zitat Dwivedi N, Chandra S, Kashyap B, Raj V, Agarwal A (2013) Suprabasal expression of Ki-67 as a marker for the severity of oral epithelial dysplasia and oral squamous cell carcinoma. Contemp Clin Dent 4(1):7–12CrossRefPubMedPubMedCentral Dwivedi N, Chandra S, Kashyap B, Raj V, Agarwal A (2013) Suprabasal expression of Ki-67 as a marker for the severity of oral epithelial dysplasia and oral squamous cell carcinoma. Contemp Clin Dent 4(1):7–12CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Bianco BC, Scotti FM, Vieira DSC, Biz MT, Castro RG, Modolo F (2015) Immunohistochemical expression of matrix metalloproteinase-1, matrix metalloproteinase-2 and matrix metalloproteinase-9, myofibroblasts and Ki-67 in actinic cheilitis and lip squamous cell carcinoma. Int J Exp Pathol 96(5):311–318CrossRefPubMedPubMedCentral Bianco BC, Scotti FM, Vieira DSC, Biz MT, Castro RG, Modolo F (2015) Immunohistochemical expression of matrix metalloproteinase-1, matrix metalloproteinase-2 and matrix metalloproteinase-9, myofibroblasts and Ki-67 in actinic cheilitis and lip squamous cell carcinoma. Int J Exp Pathol 96(5):311–318CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Salvadori G, dos Santos JN, Martins MAT, Vasconcelos AC, Meurer L, Rados PV et al (2014) Ki-67, TGF-B, and elastin content are significantly altered in lip carcinogenesis. Tumor Biol 35(8):7635–7644CrossRef Salvadori G, dos Santos JN, Martins MAT, Vasconcelos AC, Meurer L, Rados PV et al (2014) Ki-67, TGF-B, and elastin content are significantly altered in lip carcinogenesis. Tumor Biol 35(8):7635–7644CrossRef
18.
Zurück zum Zitat Kujan O, Oliver RJ, Khattab A, Roberts SA, Thakker N, Sloan P (2006) Evaluation of a new binary system of grading oral epithelial dysplasia for prediction of malignant transformation. Oral Oncol 42(10):987–993CrossRefPubMed Kujan O, Oliver RJ, Khattab A, Roberts SA, Thakker N, Sloan P (2006) Evaluation of a new binary system of grading oral epithelial dysplasia for prediction of malignant transformation. Oral Oncol 42(10):987–993CrossRefPubMed
19.
Zurück zum Zitat Caldeira PC, Abreu MHNG, Carmo MAV do. Binary system of grading oral epithelial dysplasia: evidence of a bearing to the scores of an immunohistochemical study. J Oral Pathol Med. 2012;41(6):452–3. Caldeira PC, Abreu MHNG, Carmo MAV do. Binary system of grading oral epithelial dysplasia: evidence of a bearing to the scores of an immunohistochemical study. J Oral Pathol Med. 2012;41(6):452–3.
20.
Zurück zum Zitat Nankivell P, Williams H, McConkey C, Webster K, High a, MacLennan K, et al. Tetraspanins CD9 and CD151, epidermal growth factor receptor and cyclooxygenase-2 expression predict malignant progression in oral epithelial dysplasia. Br J Cancer. 2013;109(11):2864–74. Nankivell P, Williams H, McConkey C, Webster K, High a, MacLennan K, et al. Tetraspanins CD9 and CD151, epidermal growth factor receptor and cyclooxygenase-2 expression predict malignant progression in oral epithelial dysplasia. Br J Cancer. 2013;109(11):2864–74.
21.
Zurück zum Zitat Bryne M (1998) Is the invasive front of an oral carcinoma the most important area for prognostication? Oral Dis 4(2):70–77CrossRefPubMed Bryne M (1998) Is the invasive front of an oral carcinoma the most important area for prognostication? Oral Dis 4(2):70–77CrossRefPubMed
22.
Zurück zum Zitat Clauditz TS, Wang CJ, Gontarewicz A, Blessmann M, Tennstedt P, Borgmann K, Tribius S, Sauter G, Dalchow C, Knecht R, Münscher A, Wilczak W (2013) Expression of insulin-like growth factor II mRNA-binding protein 3 in squamous cell carcinomas of the head and neck. J Oral Pathol Med 42(2):125–132CrossRefPubMed Clauditz TS, Wang CJ, Gontarewicz A, Blessmann M, Tennstedt P, Borgmann K, Tribius S, Sauter G, Dalchow C, Knecht R, Münscher A, Wilczak W (2013) Expression of insulin-like growth factor II mRNA-binding protein 3 in squamous cell carcinomas of the head and neck. J Oral Pathol Med 42(2):125–132CrossRefPubMed
23.
Zurück zum Zitat Kurokawa H, Matsumoto S, Murata T, Yamashita Y, Tomoyose T, Zhang M et al (2003) Immunohistochemical study of syndecan-1 down-regulation and the expression of p53 protein or Ki-67 antigen in oral leukoplakia with or without epithelial dysplasia. J Oral Pathol Med 32(9):513–521CrossRefPubMed Kurokawa H, Matsumoto S, Murata T, Yamashita Y, Tomoyose T, Zhang M et al (2003) Immunohistochemical study of syndecan-1 down-regulation and the expression of p53 protein or Ki-67 antigen in oral leukoplakia with or without epithelial dysplasia. J Oral Pathol Med 32(9):513–521CrossRefPubMed
24.
Zurück zum Zitat Müeller-Pillasch F, Lacher U, Wallrapp C, Micha a, Zimmerhackl F, Hameister H, et al. Cloning of a gene highly overexpressed in cancer coding for a novel KH-domain containing protein. Oncogene. 1997;14(22):2729–33. Müeller-Pillasch F, Lacher U, Wallrapp C, Micha a, Zimmerhackl F, Hameister H, et al. Cloning of a gene highly overexpressed in cancer coding for a novel KH-domain containing protein. Oncogene. 1997;14(22):2729–33.
25.
Zurück zum Zitat Fadare O, Liang SX, Crispens MA, Jones HW, Khabele D, Gwin K et al (2013) Expression of the oncofetal protein IGF2BP3 in endometrial clear cell carcinoma: assessment of frequency and significance. Hum Pathol 44(8):1508–1515CrossRefPubMedPubMedCentral Fadare O, Liang SX, Crispens MA, Jones HW, Khabele D, Gwin K et al (2013) Expression of the oncofetal protein IGF2BP3 in endometrial clear cell carcinoma: assessment of frequency and significance. Hum Pathol 44(8):1508–1515CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Schaeffer DF, Owen D a DR, Lim HJ, Buczkowski AK, Chung SW, Scudamore CH, et al. Insulin-like growth factor 2 mRNA binding protein 3 (IGF2BP3) overexpression in pancreatic ductal adenocarcinoma correlates with poor survival. BMC Cancer. 2010;10:59. Schaeffer DF, Owen D a DR, Lim HJ, Buczkowski AK, Chung SW, Scudamore CH, et al. Insulin-like growth factor 2 mRNA binding protein 3 (IGF2BP3) overexpression in pancreatic ductal adenocarcinoma correlates with poor survival. BMC Cancer. 2010;10:59.
27.
Zurück zum Zitat Feng W, Zhou Z, Peters JH, Khoury T, Zhai Q, Wei Q et al (2011) Expression of insulin-like growth factor II mRNA-binding protein 3 in human esophageal adenocarcinoma and its precursor lesions. Arch Pathol Lab Med 135(8):1024–1031CrossRefPubMed Feng W, Zhou Z, Peters JH, Khoury T, Zhai Q, Wei Q et al (2011) Expression of insulin-like growth factor II mRNA-binding protein 3 in human esophageal adenocarcinoma and its precursor lesions. Arch Pathol Lab Med 135(8):1024–1031CrossRefPubMed
28.
Zurück zum Zitat Wei Q, Yan J, Fu B, Liu J, Zhong L, Yang Q et al (2014) IMP3 expression is associated with poor survival in cervical squamous cell carcinoma. Hum Pathol 45(11):2218–2224CrossRefPubMed Wei Q, Yan J, Fu B, Liu J, Zhong L, Yang Q et al (2014) IMP3 expression is associated with poor survival in cervical squamous cell carcinoma. Hum Pathol 45(11):2218–2224CrossRefPubMed
29.
Zurück zum Zitat Nasser W, Flechtenmacher C, Holzinger D, Hofele C, Bosch FX (2011) Aberrant expression of p53, p16INK4a and Ki-67 as basic biomarker for malignant progression of oral leukoplakias. J Oral Pathol Med 40(8):629–635CrossRefPubMed Nasser W, Flechtenmacher C, Holzinger D, Hofele C, Bosch FX (2011) Aberrant expression of p53, p16INK4a and Ki-67 as basic biomarker for malignant progression of oral leukoplakias. J Oral Pathol Med 40(8):629–635CrossRefPubMed
30.
Zurück zum Zitat Birajdar SS, Radhika M, Paremala K, Sudhakara M, Soumya M, Gadivan M (2014) Expression of Ki-67 in normal oral epithelium, leukoplakic oral epithelium and oral squamous cell carcinoma. J Oral Maxillofac Pathol 18(2):169–176CrossRefPubMedPubMedCentral Birajdar SS, Radhika M, Paremala K, Sudhakara M, Soumya M, Gadivan M (2014) Expression of Ki-67 in normal oral epithelium, leukoplakic oral epithelium and oral squamous cell carcinoma. J Oral Maxillofac Pathol 18(2):169–176CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Gueiros LA, Coletta RD, Kowalski LP, Lopes MA (2011) Clinicopathological features and proliferation markers in tongue squamous cell carcinomas. Int J Oral Maxillofac Surg 40(5):510–515CrossRefPubMed Gueiros LA, Coletta RD, Kowalski LP, Lopes MA (2011) Clinicopathological features and proliferation markers in tongue squamous cell carcinomas. Int J Oral Maxillofac Surg 40(5):510–515CrossRefPubMed
Metadaten
Titel
Immunohistochemical comparative analysis of IMP-3 and KI-67 in actinic cheilitis and lower lip squamous cell carcinoma
verfasst von
Adriana Costa de Souza Martins Câmara
Amanda Katarinny Goes Gonzaga
Joabe dos Santos Pereira
Salomão Israel Monteiro Lourenço Queiroz
Éricka Janine Dantas da Silveira
Leão Pereira Pinto
Lélia Batista de Souza
Publikationsdatum
24.11.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Oral and Maxillofacial Surgery / Ausgabe 4/2022
Print ISSN: 1865-1550
Elektronische ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-021-00990-8

Weitere Artikel der Ausgabe 4/2022

Oral and Maxillofacial Surgery 4/2022 Zur Ausgabe

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.