Bilharziasis and bladder cancer: a time trend analysis of 9843 patients

To explore any changes in bladder carcinoma during 37 years period, in regard to: its frequency, bilharzia association, histological profile and demographic data. This is a retrospective study on 9843 patients treated at the National Cancer Institute [NCI], Cairo University, during the years 1970-2007. Three groups were selected: series [A] included 3212 patients during 1970-1974, series [B] 3988 patients during 1985-1989 and series [C] 2643 patients during 2003-2007. For statistical analysis, data of series [A], [B] and [C] were compared to determine the significance of difference [p value 0.005]. A significant decline of the relative frequency of bladder cancer was observed from 27.63% in the old series to 11.7% in the recent series. Bilharzia association dropped from 82.4% to 55.3%. There was a significant rise of transitional cell carcinomas from 16.0% to 65.8%, becoming at present the most common tumor type, with a significant decrease in squamous cell carcinomas from 75.9% to 28.4%. There was an increase in the median age of patients from 47.4 years to 60.5 years and a decrease of male: female [M/F] ratio from 5.4 to 3.3. The decline in the relative frequency of bladder cancer is associated with a decline in bilharzia egg positivity in the specimen and is probably related to better control of bilharziasis in the rural population in Egypt. This was accompanied by a change in the histological profile of tumors, with significant predominance of transitional cell carcinoma and an increase in the age of patients, a pattern rather similar to that in western reports

Immunophenotyping, MIB-1, p53 and mast cell tryptase in large cell non-Hodgkin's lymphoma

The aim of the present study was to explore by immunohistochemical methods, on lymph node and infiltrated bone marrow bioposies. the potential value of MIB-l proliferation rate. p53 overexpression and Mast cell tryptase [MCT] as possible prognostic fators for large cell lymphomas on 69 adult patients for whom paraffin blocks, clinical data and survival information were available. In the reviewed series, large cell lymphoma included: 84.1% large B-cell lymphoma. 11.6% peripheral T-cell lymphoma and 4.3% anaplastic large cell lymphoma. MIB-1 labeling was quantitated by image analysis and cases were classified as either of low or high proliferation rate taking MIB-l count of 50% as a cutoff value. For p53, nuclear immunoreactivity equal to or more than 20% were considered overexpression or positive. As for MCT, presence of> 5 mast cells/hpf was recorded as high count while counts <5 mast cells/hpf were considered low counts. In the L.N. biopsies examined the mean MIB-l labeling rate was 48.5%. p53 positive tumors contributed 33.3% of cases while high MCT counts were detected in 43.5% of cases. High MIB-l rate, p53 positivity and MCT counts showed a statistically significant relation to high lPl and were associated ".ith poor response to therapy and unfavorable 2-year overall survival and hence were considered risk factors. Additionally, high MCT count was found to show a strong relation with T-cell phenotype and extranodal forms. Bone marrow biopsies were examined to detect infiltrated cases. B.M. infiltration was detected in 15 cases whose levels of MIB-l and p53were in accordance to the corresponding L.N. values.MCT counts in B.M. biopsies were within the high count group but were lower than corresponding L.N. values and were strongly related to T-cell phenotype. It is concluded that MIB- 1. p53 and MCT are valuable prognostic factors which could serve as a guideline for treatment by identifying unfavorable cases for more intensive therapy

Immunohistochemichal and DNA image cytometry study of melanocytic lesions of the conjunctiva and eye globe

In this study, 25 conjunctival naevi and 25 conjunctival and choroidal melanomas were retrospectively collected and subjected to immunohistochemical staining using monoclonal antibodies S- 100 protein and HMB-45 using biotin streptavidin amplified system. Also, a quantitative DNA analysis was performed using Feulgen stain and measured by the CAS 200D image analyzer. Studied cases included 17 benign naevi, 8 dysplastic naevi and 25 malignant melanomas. S-100 protein and HMB-45 were highly sensitive markers to identify malignant melanoma of conjunctiva [sensitivity 100% for both]. Conjunctival naevi were 100% protein, while only four cases of dysplastic melanocytic naevi [DMN] were positive for HMB-45 [50% of DMN]. Aneuploidy was detected in 22 cases of malignant melanomas and only nine cases, eight DMN and one compound naevus [CN], showed aneuploid DNA distribution pattern and four of them were positive for HMB-45 and all for S-100 protein

Nuclear p 53 protein expression in endometrial hyperplasia

In this study, sixty-three women with endometrial hyperplasia were diagnosed out of 120 cases of perimenopausal bleeding. ABC immunohistochemical method was used for the detection of p53 protein expression in formalin fixed paraffin embedded endometrial tissue sections. The results showed that nullipara smokers and those presenting by irregular bleeding showed a significant increase in the number of cases with adenomatous hyperplasia. The number of cases showing p53 over expression was significantly higher among those with atypical adenomatous hyperplasia. Also, the number of cases with p53 overexpression was significantly higher among nullipara smokers and cases with irregular uterine bleeding, history of previous D and C or history of previous progesterone hormone therapy. One of the +ve adenomatous cases developed -ve expression after six month of progesterone therapy

Immunophenotyping and genotyping lymphoproliferative lesions of the skin

Various samples from lymphoproliferative diseases in the skin were analyzed by PCR with probes of T cell receptor. Phenotyping was done on frozen sections applying monoclonal antibodies for LCA, CD2, CD3, CD4, CD5, CD7, CD8, CD15, CD20, CD30, and Ki67. The panel for paraffin-embedded material includes monoclonal antibodies for LCA, CD45RO, CD43, CD20 and CD15. It was concluded that diagnostic criteria of MF were based on CD4+ and CD8- with negativity of CD7 +/- CD5. Therefore, phenotyping is helpful in the following conditions: Establish malignant criteria in some early lymphoproliferative lesions and help to rule out malignancy in benign cellular lesions, confirm malignant criteria in clinicopathologic diagnosed cases and help to differentiate between T and B cell neoplasms

Correlation of estrogen receptor status with pathological features in breast carcinoma

Qualitative and quantitative estimation of estrogen receptor [ER] was done by the immuno-peroxidase method in 50 cases of carcinoma of the breast including: 42 duct carcinomas 5 labular carcinoma, one mucinous carcinoma, one tubular carcinoma and one adenoid cystic carcinoma. Antiestradiol was used as the primary antibody. The results of immunocytochemistry were expressed as simple percentage of positive tumor cells/total number of tumor cells with readings below 20% regarded as negative. The intensity of cytoplasmic staining was evaluated on a scale of negative [-] through [+++]. In invasive duct carcinoma, 29/42 cases [69.0%] were positive for estrogen receptor with an average of 73.56% + ve tumor cells [++] average intensity of reaction. All 5 cases of labular carcinoma were positive for ER [100%] with an average of 88.7+ve tumour cells and [+++ to ++] higher intensity of reaction. The differences between duct carcinoma and labular carcinoma of the same grades [two and three] was satistically significant. There was also a significant difference between low grade tumours [grade one and two] collectively and high grade tumours [grade three] in duct carcinoma. No correlation was found between estrogen receptor content and tumor site, size of lymph node status.

Changes in nuclear size and DNA content of carcinoma of cervix after fractionated irradiation

The effect of conventional fractioned irradiation [5 Fr of 2.00 Gy/week] on the nuclear size and DNA content of squamous cell carcinoma of the cervix was evaluated in 6 patients. Three consecutive biopsies were taken from each patient; prior to irradiation, after 20.00 Gy and after 40.00 Gy. The nuclear diameter was measured using eyepiece micrometer. Cytophotometric DNA analysis was made on Feulgen-stained sections. A total of 1800 tumor nuclei and 1200 normal epithelium nuclei were examined; 100 nuclei per sample. Progressive increase in the nuclear size was observed in tumor cells with increase of the dose. In normal cells, however, this increase was only observed after the high dose. Prior to irradiation, the distribution of DNA content in tumor nuclei showed a primary mode between the diploid and tetraploid range. After irradiation, however, an irregular DNA distribution was observed with disappearance of primary mode, a wide scatter over the extreme values and a relative increase of the mean value. Normal nuclei showed only a slight increase of DNA mode after irradiation. The radiobiologic explanations of these changes are presented together with their possible clinical implications, particularly in predicting tumor responsiveness to radiotherapy

Hibiscus pigment, a specific stain for nuclear chromatin

A new nuclear stain was prepared as a crude extract of Hibiscus subdariffa, and was found to have a wide application on different types of cells. The stain works at an acid PH [2.0], Chromatin stained red when treated directly with the extract, and turned blue when this was followed by lead nitrate. Methods of staining and purification of an acetone insoluble, but water sluble, crystalline fraction of the red pigment of hibiscus flower have been described and called [Hibiscin]