Immunohistochemical nuclear staining for P53, PCNA, and Ki-67 in different histologic varients of basal cell carcinoma

Structural alternation of P53 gene is a common genetic change associated with basal cell carcinoma [BCC]. Proliferation antigens are expressed in the nuclei of cell during specific stages of the cell cycle including proliferating cell nuclear antigen [PCNA] and Ki-67. Studies have suggested that PCNA and Ki-67 are useful diagnostic tools to differentiate benign from malignant neoplasm and useful prognostic markers in malignant neoplasms. The aim of this work is to detect the expression of P53, PCNA, and Ki-67 in different histologic variants of BCCs, to study the probability of using such markers as diagnostic and prognostic tools. Thirty patients with different histologic variants of BCCs were diagnosed histopathologically. Seven skin biopsies were taken as controls. Immnunohistochemical staining for P53, PCNA, and Ki-67 detection. There is variable degree of positivity of P53, PCNA, and Ki-67 with different histologic variants of BCCs. There is high significant relation between percentage of their positive cells and both aggressiveness and recurrence of BCCs. There is positive relation between P53 and PCNA expression. PCNA expression is greater than Ki-67 in all studied variants except for the superficial variants, which were negative for P53 expression. Both the tumor suppressor gene P53 and the proliferation markers; PCNA and Ki-67 are expressed in BCCs. They are reliable prognostic markers for aggressive behavior of BCCs. They are valuable tool in prediction of possible recurrence. Their staining appeared to be superior to traditional histologic features in predicting clinical recurrence in primary BCC's and further prospective studies in a larger patient group are warranted

Intestinal ischemia - reperfusion injury: Could it affect intestinal anastamosis?

Revascularization of ischemic bowel may induce further local tissue damage due to reperfusion injury. Therefore, we aimed to investigate the effect of ischemia reperfusion injury on the healing of intestinal anastomosis in experimental models. Thirty rabbits were divided equally into three groups: a control group [Group 1]; an ischemia group [Group II], in which only the superior mesenteric artery [SMA] was occluded for 30 minutes and a profound ischemia group [Group III] in which SMA was occluded as well as collateral vessels for 30 minutes. The pulsations were seen to return to marginal vessels and the bowels began to appear pinker and healthier in all groups following the restoration of arterial flow. Then all animals underwent a 3-cm ileal resection and primary anastomosis, 10 cm proximal to the ileocecal valve. Within each group, animals were anesthetized on the fifth postoperative day. Abdominal wound healing, intra-abdominal anastomotic complications, anastomotic bursting pressure measurements and hydroxyproline content were recorded. Anastomotic dehiscence was found in 1 in group II and in 5 in group III. The mean bursting pressures of the anastomosis was 158 mmHg in group I [control group], 150 mmHg in group II and 106 mmHg in group III while the mean hydroxyproline value content was 3.09 micro-mole/g tissue in group I, 2.91 micro-mole/g tissue in group II and 1.51 micro-mole/g tissue in group III, so there was no significant difference between group I and II while there was significant difference between group I, II and group III. We conclude that, even when the intestines are well perfused and viable after revascularization, one must bear in mind that intestinal reperfusion injury may compromise anastomotic healing