Evaluation of the sensitivity and specificity of immunohistochemical markers in the differential diagnosis of effusion cytology

To evaluate the sensitivity and specificity of Calretinin and Carcinoembryonic antigen as immunocytochemical markers in distinguishing mesothelial cells from metastatic adenocarcinoma cells in effusion cytology. This study included 50 patients who presented with effusions [26 pleural and 24 peritoneal], at Al-Kadhimya Teaching Hospital who were selected according to their preliminary diagnosis from 1[st] December 2010 to 30[th] June 2011. Effusion fluids were aspirated and processed for both conventional cytological methods using Papanicolaou-stain and immunocytochemical staining with anti Calretinin and Carcinoembryonic antigen. The sensitivity of cytology for detection of malignant cells was 77%, with 100% specificity and 86% accuracy. Calretinin was observed to be a specific [100%] and sensitive [90%] marker for mesothelial cells [of benign etiology]. Carcinoembryonic antigen exhibited 70% sensitivity and 100% specificity for adenocarcinoma cells. When the results of both cytology and immunocytochemistry were considered in conjunction, the sensitivity for the detection of malignancy increased to 97%, with 100% specificity and 98% accuracy. Calretinin and Carcinoembryonic antigen were found to be useful markers for differentiating reactive mesothelial cells from metastatic adenocarcinoma cells in smears prepared from body fluids. Also, the combination of both cytology and immunocytochemical studies using the two markers can greatly enhance the diagnostic accuracy, sensitivity and specificity in malignant effusions.

Immunohistochemical expression of Ki-67, PCNA and CD34 in astrocytomas: a clinicopathological study

To assess the immunohistochemical expression of Ki-67 and Proliferating Cell Nuclear Antigen [PCNA] as proliferative markers to study proliferative activity and CD34 as an endothelial cell marker in order to study vascular proliferation in astrocytomas in correlation with some clinicopathological parameters [age, gender, site of the tumor, and tumor grade]. A retrospective study wherein a total of 51 formalin-fixed paraffin-embedded brain astrocytoma excisional biopsies covering the period of June 2009 to February 2011 were retrieved from the archival materials of the Specialized Surgical Hospital in Medical City in Baghdad, Iraq. The histopathological diagnosis had been revised and all cases were stained by immunohistochemical technique with Ki-67, PCNA, and CD34 tumor markers. Values were considered statistically significant when p<0.05. Fibrillary astrocytoma [WHO grade II] was found to be the most common type among astrocytic tumors with the peak age incidence of astrocytomas found in the second and fifth decades of life, and a slight male predominance had been identified. There was a significant correlation between the age of the patients and the grade of the tumor, Ki-67 and PCNA labeling indices, and microvessel density [MVD] detected by CD34 [p<0.05]. There was a highly significant correlation between Ki-67 and PCNA labeling indices in astrocytomas [p<0.001]. A significant correlation was found between Ki- 67, PCNA labeling indices, and MVD [microvessel density] detected by CD34, and between the clinicopathological variables of astrocytomas [age and grade of tumor]. Hence, Ki-67 and PCNA, as markers for proliferation, and MVD as a marker of angiogenesis, could be used as ancillary methods in the differentiation of borderline grades of astrocytomas

Bcl-2 expression in CagA strain H. pylori gastritis [immunohistochemical and insitu hybridization study]

Carriage of Helicobacter Pylori in the human stomach is associated with increased risk of peptic ulcer disease, distal gastric adenocarcinoma and gastric B-cell mucosa associated lymphoid tissue lymphoma. To study the immunohistochemical expression of bcl-2, as apoptosis makers in the gastric mucosa of patients infected with cagA Helicobacter Pylori demonstrated by insitu hybridization method. Gastric antrum biopsies from 99 patients presented with dyspeptic symptoms [50 men, 49 women, median age 40] were analysed for the presence of H. pylori, and were classified according to updated Sydney system. Insitu hybridization technique was done to detect cagA H. pylori. Immunohistochemical expression of bcl-2 using [Avidin-Biotin method] was performed on paraffin embedded biopsy specimens. Forty four patients [44.44%] had H. pylori cagA positive starin. Atrophy of gastric mucosa was present in 14 [14.14%] patients. Intestinal metaplasia was present in 8 [8.08%] patients. The frequency of atrophy and intestinal metaplasia were significantly higher in cagA H. pylori gastritis than non-cagA H. pylori gastritis [p=0.023 and 0.041 respectively]. Bcl2 expression was not significantly higher in H. pylori gastritis than non-H. pylori gastritis [p=0.101]. Bcl2 expression was significantly higher in the presence of atrophy [p<0.001]. Bcl2 expression was significantly higher in the presence of intestinal metaplasia [p<0.001]. The rate of apoptosis decreases when lesions [gastric atrophy and intestinal metaplasia] are present

Immunohistochemical expression of estrogen and progesterone receptors in human colorectal adenoma and carcinoma using specified automated cellular image analysis system: a clinicopathological study

To evaluate the immunohistochemical expression of estrogen receptors [ER] and progesterone receptors [PR] in colorectal adenoma and adenocarcinoma and to correlate this immunohistochemical expression with different clinicopathological 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 non-tumorous colonic tissue, were included in the study. The frequency of expression of ER and PR showed a gradual increase from control through adenoma to carcinoma. The frequencies of expression of ER in the control, adenoma and carcinoma were [10%, 15.15% and 42.42% respectively, p<0.001], while the frequency of expression for PR were [10%, 24.24% and 36.36% respectively, p<0.001]. Strong ER and PR staining was mainly seen in carcinoma cases [42.42%, 36.36%, respectively] in comparison with adenoma [9.09%, 15.15%, respectively] and control [0%, 0%, respectively]. The three digital parameters of ER and PR immunohistochemical expression [Area [A], Number of objects [N], and intensity [I]] were significantly increased in a sequence of normal mucosa-adenoma-carcinoma. There was a significant positive correlation between ER and PR in adenoma [r=0.312, p=0.034] and carcinoma [r=0.321, p=0.0398]. ER and PR expression increased in a sequence of; normal colonic mucosa-adenoma-carcinoma, and a positive correlation was observed between ER and PR expression in colonic adenoma and carcinoma specimen indicating that ER and PR may play a role in colorectal carcinogenesis

Immunohistochemical expression of ki-67 and p53 in colorectal adenomas: a clinicopathological study

To evaluate the significance of P53 and Ki-67 expression as immunohistochemical markers in early detection of premalignant changes in different types of colorectal adenomas. Also, to correlate immunohistochemical expression of the two markers with different clinicopathological parameters including; age, and sex of the patient, type, site, size and grade of dysplasia of colorectal adenomas. Forty-seven polypectomy specimens of colorectal adenomas were retrieved from the archival materials of the Gastrointestinal and Hepatic Diseases Teaching Hospital in Baghdad from 2009-2010. Four ?m section specimens were stained by immunohistochemical technique with Ki-67 and P53 tumor markers. P-values<0.05 were considered statistically significant. Immunohistochemical expressions of Ki-67 and P53 had a significant correlation with the size and grade of dysplasia in colorectal adenomas. However, there was no significant correlation among the immunohistochemical expression of Ki-67 and P53 with the age and gender of the patient, and the type and site of colorectal adenomas. There was no significant correlation between Ki-67 and P53 expressions in colorectal adenomas. Villous adenomas of colorectum showed a significant correlation with the grade of dysplasia, while there was no significant correlation between size and site of colorectal adenoma with the grade of dysplasia. High grade dysplasia with significant positive immunohistochemical markers of Ki-67 and P53 could be valuable parameters for selecting from the total colorectal adenoma population, those most deserving of close surveillance in followup cancer prevention programs. It is closely linked with increasing age particularly in patients with a large size adenoma of villous component in their histology