Status of Her2 over expression in muscle invasive urothelial bladder carcinoma: report of 21 cases

Invasive urothelial bladder carcinomas have a poor prognosis even with cystectomy and chemotherapy. A high number of these patients have Her2 overexpression. The goal of this study is to assess the Her2 status in muscle invasive urothelial bladder carcinoma, to evaluation heterogeneity and discordance with metastases. We retrospectively analyzed 21 specimens of transurethral resection or cystectomy in patients with invasive urothelial bladder carcinoma. We selected one representative section from primary tumors and metastases for immunohistochemistry analysis. Staining was evaluated according to the same criteria of breast cancer. A chromogenic in situ hybridization [CISH] was performed in case of 2+ score or in heterogeneous samples. Median age of our patients was 62 years. Intratumoral heterogeneity was observed in 2 cases [less than 1%]. One case showed a Her2 3+ score [high grade, pT2 stage] and 3 cases showed a 2+ score [all low grades, stage T2, T4, M1, respectively]. Two metastatic lymph nodes scored 1+ for the first [primary 1+] and 2+ for the second [primary 1+]. Two cases showed CISH gene amplification. The first one scored 2+ and had area of 3+ score. The second one scored 1+ and had area with 2+ score. Four patients died from disease, one of them had Her2 3+ score. Her2 overexpression can be observed in muscle invasive urothelial bladder carcinoma in an important number of patients. Evaluation criteria must be standardized, especially with heterogeneous cases. Metastases tests can also readdress the expression of Her2, which gives the patient a supplementary therapeutic tool

[Hepatic steatosis in chronic hepatitis B: Prevalence, risk factors, and impact on fibrosis and therapeutic response]

Steatosis is a common injury in chronic hepatitis C, but this association has not been sufficiently studied in chronic hepatitis B. To evaluate the prevalence of hepatic steatosis in chronic hepatitis B and determine its association with various histologic, biochemical, virological, and metabolic diseases, and its effect on fibrosis and therapeutic response. Our study was compiled 133 patients with chronic hepatitis B who received no antiviral therapy and who had a liver biopsy. Our patients were divided into 2 groups: 51 patients [38.3%] had steatosis [Group I], while 82 [61.7%] had no steatosis [Group II]. In group l, the average age, BMI, cholesterol, triglycerides, and glucose were significantly higher than the group without steatosis in univariate study [P <0.05]. In multivariate analysis, only high BMI and hypertriglyceridemia were included. No significant difference between the two groups was observed in the rate of transaminases, HBeAg status, viral load [P> 0.05]. Steatosis doesn't influence fibrosis stage and therapeutic response. During chronic hepatitis B, steatosis appears to be the result of metabolic factors of the host rather than the effect of the virus. Hepatic steatosis does not seem to influence the progression of liver fibrosis, or therapeutic response, however, the role of steatosis should be better studied by prospective longitudinal clinical studies on large populations of patients

steatohepatite non alcoolique: Une pathologie emergeante et potentiellement grave

Nonalcoholic steatohepatitis is an acquired liver disease, usually metabolic coracterised by histologic lesions with steatosis, intralobular necrosis and inflammatory infiltrates. Liver biopsy finding are identical to those seen in alcoholic hepatitis. Nonalcoholic steatohepatitis is increasingly, reported in industrial countries because of an increase of the prevalence of obesity and diabetes wich are the most commonly risk factors of this disease. The diagnosis of nonalcoholic steatohepatilis is based of a confrontation between clinical and anatomic data and an exclusion of an excessive intake of alcohol and other hepatic disease. Liver biopsy has a prognosis and histologic benefit especially when there is risk factors of fibrosis.This disease is potentialy severe with a potential risk for progression to cirrhosis. Progress in pathogenesis is noted but no definite therapy exist.The aim of this review is to indicate current knowledge for the gravity of nonalcoholic steatohepatitis and its consequence and to understand the pathogenesis to prevent cirrhosis