Immunohistochemical expression of matrix metalloproteinase-7 in human colorectal adenomas using specified automated cellular image analysis system: a clinicopathological study

To evaluate the immunohistochemical expression of matrix metalloproteinase-7 [MMP-7] in colorectal adenomas, and to correlate this expression with different clinicopathological parameters. The study was retrospectively designed. Thirty three paraffin blocks from patients with colorectal adenoma and 20 samples of non-tumerous colonic tissue taken as control group were included in the study. MMP-7 expression was assessed by immunohistochemistry method. The scoring of immunohistochemical staining was conducted utilizing a specified automated cellular image analysis system [Digimizer]. The frequency of positive immunohistochemical expression of MMP-7 was significantly higher in adenoma than control group [45.45% versus 10%] [P value < 0.001]. Strong MMP-7 staining was mainly seen in adenoma cases [30.30%] in comparison with control [0%] the difference is significant [P < 0.001]. The three digital parameters of MMP-7 immunohistochemical expression [Area [A], Number of objects [N], and intensity [I]] were significantly higher in adenoma than control. Mean [A and I] of MMP-7 showed a significant correlation with large sized adenoma [>/= 1cm] [P < 0.05], also a significant positive correlation of the three digital parameters [A, N, and I] of MMP-7 expression with villous configuration and severe dysplasia in colorectal adenoma had been identified [P < 0.05]. MMP-7 plays an important role in the growth and malignant conversion of colorectal adenomas as it is more likely to be expressed in advanced colorectal adenomatous polyps with large size, severe dysplasia and villous histology. The use of automated cellular image analysis system [Digmizer] to quantify immunohistochemical staining yields more consistent assay results, converts semi-quantitative assay to a truly quantitative assay, and improves assay objectivity and reproducibility

Immunohistochemical expression of PCNA and CD34 in colorectal adenomas and carcinomas using specified automated cellular image analysis system: a clinicopathologic study

To evaluate the immunohistochemical expression of proliferating cell nuclear antigen [PCNA] and CD34 in colorectal adenomas and carcinomas, and to correlate this expression with different clinicopathologic parameters. The study was retrospectively designed. A total of 86 tissue samples, including 33 paraffin blocks from patients with colorectal adenomas, 33 paraffin blocks from patients with colorectal adenocarcinomas, and a control group of 20 samples of nontumerous colonic tissue, were included in the study. From each block, 3 sections of 5 micro m thickness were taken, 1 section was stained with hematoxylin and eosin [H and E] and the other 2 sections were stained immunohistochemically for PCNA and CD34. Scoring of the immunohistochemical staining was performed using a specified automated cellular image analysis system [Digimizer]. PCNA expression was significantly increased in a sequence of normal mucosa-adenoma-carcinoma. It was significantly higher in adenomas >/= 1 cm and those with severe dysplasia, and it showed a significant positive correlation with grade and lymph node involvement in colorectal carcinoma. CD34 showed significantly higher expression in carcinoma than adenoma and in adenoma than in the control group. CD34 expression showed a significant correlation with adenomas carrying severe dysplasia and large-sized adenomas [>/= 1cm]. It was significantly correlated with tumor grade, lymphovascular invasion, and lymph node involvement in colorectal carcinoma. PCNA plays an important role in colorectal neoplastic progression and can be utilized as ancillary marker for the risk of malignant transformation in colorectal adenomas as it correlates with high grade dysplasia and size. Intratumoral quantification of the mean [A and N] of CD34 in colorectal carcinoma reflects the grade of tumors and can predict lymph node involvement and lymphovascular invasion, to make a useful additional prognostic factor

An appraisal of urine cytology in the diagnosis of transitional cell carcinoma of the urinary bladder

Urine cytology has an acceptable sensitivity, and specificity that justifies its use in the current diagnostic protocol. In Iraq transitional cell carcinoma [TCC] constitute about 62.1% of bladder cancer [which ranks the third according to the results of Iraqi Cancer Registry 1995-1997]. Urine cytology used in the primary diagnosis, follow up, and in the screening programs of asymptomatic but high-risk patients. This study was conducted on 93 patients, diagnosed or clinically suspected to have TCC of the urinary bladder attending to the Urological department in AL-Kadhimiya Teaching Hospital, AL-Yarmouk Teaching Hospital, and Baghdad Medical City. During the period from July 2004 to July 2005. 76 were males and 17 were females. Urine cytological examination was done to those patients using two types of stain hematoxylin and eosin, and papanicoloau stain] to detect malignant cells with the identification of the degree of differentiation, if possible, the cytological findings were correlated with the hisiopathological findings. And the cytological findings compared regarding each type of stain. Mean age of the patients was 59 year. Male.female ratio was 4.4:1. Main clinical presentation was hematuria [45.8%] of the total. Urine cytological examination has a sensitivity of 87.7%, specificity of 100% with an overall accuracy of 78% in the detection of TCC of urinary bladder. The main chief complaint of patients with TCC was haematuriawitch constitute 45.8% of the total. The percentage of highgrade cases in urine cytology was higher than that in histopathology.the percentage of cases of TCC diagnosed by papanicoloau stain was more than that diagnosed by II and E [73.24% by pap stain versus 70.42% by H and E]. Urine cytology has an acceptable sensitivity, specificity and an overall accuracy in the diagnosis of TCC of urinary bladder, and it offers a good chance for determination of the grade of the tumor especially in high grade tumor. Pap stain was better in the diagnosis of TCC

Cytological and immunocytochemical study of bronchial wash in bronchogenic carcinoma

Carcinoma of the lung has became the most common type of cancer since 1985 and the most common cause of cancer death in both males and females. To assess the diagnostic accuracy of bronchial wash cytology and application of immunocytochemical methods, using two tumor markers [low molecular weight cytokeratin and epithelial membrane antigen] for more accurate and precise diagnosis of lung tumors. Fifty fifes suspected lung cancer cases according to their clinicoradiological examinations were included in this study. Bronchial wash cytology was performed for all the 55 patients. Smears were stained by conventional cytological stain inaddition to immunocytochemial staining using low molecular weight cytokeratin and epithelial membrane antigen. The final results of bronchial wash were compared to histopathological results and final clinical diagnosis as. Cytological smears of bronchial wash revealed the presence of malignant cells in 33 cases [60%]. The sensitivity of bronchial wash cytology was 82.5%; the specificity was 100.0%, with overall accuracy of 87.3%. Using cytokeratin staining, 26 cases [47%] were positive for malignant cells, and 29 were negative. The sensitivity, specificity and overall accuracy were 65%, 100%, and 74.5% respectively. With EMA staining, 19 cases [27%] were positive for malignant cells and 36 were negative. The sensitivity, specificity and overall accuracy were 47.5%, 100%, and 61.8% respectively. Combined use of CK and EMA raised the sensitivity to 72.5%, specificity of 100% and overall accuracy of 80%. Combined use of monoclonal antibodies and conventional cytology raised the sensitivity to 95%, specificity 100%, with overall accuracy of 96.3%. Using more than one monoclonal antibody, or using combined conventional cytology and immunocytochemistry increase the sensitivity for detection of malignant cells in bronchial wash smears

Choledochocele [type 111 choledochal cyst]: case report and literature review

A twenty-nine year old female, presented with intermittent Jaundice and right hypochondrial pain. On laparatomy a cystic mass at the terminal common bile duct found. Histopathological examination revealed Choledochocele [Type III choledochal cyst]. No post operative complications were encountered. Previously 48 similar cases have been reported in the literature

Diagnostic accuracy and sensitivity of sputum cytology in the diagnosis of lung cancer

Of 102 consecutive patients with histologically proven carcinoma of the lung, three sputum samples were examined cytologically. The overall, sensitivity of sputum cytology in detection of malignant cells was 0.8 with an accuracy of 77.4% The sensitivity increased from 0.66 to 0.8 when three sputum samples rather than one were examined. The cytologic typing accuracy for squamous cell carcinoma was 89% with a sensitivity of 0.91, for adenocarcinoma 64.3% with a sensitivity of 0.74. for small cell carcinoma 85. 7% with a sensitivity of 0.87, and for large cell carcinoma 50% with a sensitivity of 0.66. Most of the diagnoses that were at variance with histology were found to be associated predominantly with carcinoma of the large cell type and with poorly differentiated adenocarcinoma