[Evaluation of retinoblastoma expression in benign and malignant thyroid neoplasms]

Several factors are involved in the thyroid tumourigenic process. The role of Retinoblastoma [Rb] tumor suppressor gene mutation in thyroid carcinogenesis has been discussed. In this study we investigated the expression of Retinoblastoma gene in thyroid neoplasms and its association with clinical and histological findings, to evaluate its ability in distinguishing benign and malignant thyroid neoplasms and as a prognostic factor. The present cross sectional study investigated Avidin - Biotin immunohistochemistry using the Dako Rb - 1 clone in a series of 200 formalin - fixed, paraffin - embedded thyroid lesions, including 39 benign and 161 malignant neoplasms. Nuclear immunoreactivity in more than 10% of tumor cells was assessed as positive. Rb was positive in 74.2% of follicular adenoma, 87.5% of hurthle cell adenoma, 46.2% of papillary carcinoma, 66.7% of follicular carcinoma, 29.4% of medullary carcinoma and 50% of anaplastic carcinoma. Overall Rb nuclear immunoreactivity was observed in 76.9% of benign tumors and 45.9% of malignant lesions. No significant difference in Rb expression between follicular adenoma and follicular carcinoma was seen; also no association was found between Rb expression and invasiveness in malignant tumors. The results of this study indicate that Rb gene expression in benign thyroid tumors is significantly higher than in malignant ones [P=0.001], an association observed particularly in women. Rb gene inactivation is likely to play a role in malignant evolution of thyroid neoplasms and considering female predominance in thyroid tumors, Rb immunohistochemistry can potentially aid in the distinction between benign and malignant thyroid tumors in conjunction with morphology, but it is not helpful in differentiation between follicular adenoma and follicular carcinoma

[Expression of Nm23 marker in benign and malignant thyroid neoplasms immunohistochemical]

Several prognostic factors affect the outcome of thyroid carcinomas including tumor stage and distant metastases. Nm23 is a metastasis suppressor gene and has a crucial role in the control of metastatic potential of several carcinomas. The aim of our study is to evaluate expression of nm23 marker in benign and malignant thyroid neoplasms using the immunohistochemistry method and to elucidate its relationship with tumor size, vascular or capsular invasion and lymph node involvement. In a descriptive study, 200 paraffin blocks comprising of 38 benign and 162 malignant thyroid neoplasms stained with nm23 marker were studied. Cytoplasmic staining in more than 10% of cells was considered as positive. The relationship between nm23 and tumor size, vascular or capsular invasion, lymph node involvement was analysed using SPSS 11.5 software [p=0.05]. There was 40% positive incidence of nm23 in follicular adenoma, 87.5% in hurthle cell adenoma, 67.2% in papillary carcinoma, 66.7% in follicular carcinoma, and 64.7% in medullary carcinoma. In follicular adenoma, frequency of nm23 positive tumors was directly correlated to tumor size [p=0.04]. There are no statistically significant correlation between nm23 and tumor size, vascular or capsular invasion or lymph node involvement in malignant thyroid neoplasms. In papillary and medullary carcinoma, negative predictive value of nm23 for lymphnode involvement was over 80%. Also in follicular carcinoma, sensitivity and negative predictive value of nm23 for vascular invasion were approximately 90%. Lack of significant correlation between nm23 and tumor invasiveness [and probably metastasis] factors, demonstrate that although nm23 is a potentially metastasis suppressor gene, whereas in many other tumors it may play a different role in thyroid neoplasms, a role which necessitates further studies to be conducted

[Prevalence of Cox2 marker in benign and malignant thyroid neoplasms with immunohistochemistry method]

There are different prognostic factors in thyroid neoplasms. Cox2 is an enzyme which plays a role in the synthesis of prostaglandin. Increased expression of Cox2 has been reported in different kinds of cancers such as colorectal, stomach, lung, prostate, breast and thyroid. Thyroid malignancies are among the common malignancies of the endocrine system, and various molecular studies are being performed to determine their pathogenesis. To study the prevalence of Cox2 in malignant and benign neoplasms of the thyroid and its relationship with other clinical and pathological factors, we analyzed 200 paraffin blocks including 137 thyroid papillary carcinoma, 10 thyroid follicular carcinoma, 17 thyroid medullary carcinoma, 2 anaplastic cases, 27 thyroid follicular adenoma, 7 thyroid Hurthle cell adenoma using the immiunohistochemistry method for the Cox2 enzyme marker. Positive results obtained for cases Cox2 were 38.7% thyroid papillary carcinoma, 20% follicular carcinoma, 29.6% medullary carcinoma, 25.9% follicular adenoma, 28.5% hurthle cell adenoma. Statistical analysis showed no significant difference among various groups of thyroid neoplasms and expression of Cox2. Also, no relationship between vascular, lymphatic and capsule invasion and expression of Cox2 in malignant and benign neoplasms of the thyroid was found. It appears that Cox2 is not a suitable marker to distinguish between different types of thyroid neoplasm

Evalution of the relationship between vitamin d receptor gene polymorphism [FOK I] and thyroid cancer

Background and purpose: Vitamin D is an antiproliferative agent against cancer cells and regulates cell differentiation. It acts via Vitamin D Receptor [VDR]. The VDR gene contains a Start Colon Polymorphism [SCP] that can be detected with the restriction enzyme Fok I. Previous studies report an association of SCP and some diseases and some suggest that this polymorphism alters VDR function. As no studies so far have reported the association between Fok I genotype in Thyroid cancer, this study is intended to determine the association of Fok I polymorphism of VDR with thyroid cancer risks in Iranian population

Methods and Materials: 58 patients with papillary carcinoma, 13 patients with follicular carcinoma and 82 controls participated in a case-control study. A PCR-RFLP method used to determine VDR gene polymorphism in start codon characterized by the restriction enzyme Fok I. 95% confidence intervals and odds ratio were calculated for testing the relationship between Fok I polymorphism and thyroid cancer

Results: The odds ratio for the Fok I polymorphism on thyroid cancer was 0.39 [95% CI, 0.12-1.27] witch signifies no relationship between this polymorphism and the ris of thyroid cancer

Conclusion: As no relationship was found between this polymorphism and thyroid cancer, other genetic or environmental factors may be considered in thyroid cancer

[Celiac disease in Gonbad-Kavoos]

Northeast Iran has one of the highest rates of esophageal cancer in the world which is mainly squamous cell carcinoma [E SCC]. Celiac disease [CD] has been identified as a risk factor for ESCC. The aim of this study is to determine the prevalence of CD in Gonbad at northeast Iran and probable relation between celiac and ESCC. fourteen hundred inhabitants of north eastern Iran were randomly selected. The subjects underwent blood sampling for determination of IgA antibodies against tissue transglutaminase [anti- TTG]. Subjects with positive anti-TTG underwent an interview, upper endoscopy and duodenal biopsy. The duodenal biopsies were classified according to Marsh criteria. A total of 1209 subjects [female: 699] with mean age of 50 +/- 11.7 years were studied. Twelve subjects [female: 9] had a positive anti-TTG [1%]. Four patients did not accept endoscopy. Eight cases underwent endoscopy and duodenal biopsy. Four, two and two subjects had Marsh III, II and I respectively. Flatulence and diarrhea [the most symptoms] were in five and four subjects and characteristic skin manifestation was reported in three subjects. One subject was already diagnosed as CD. although prevalence of ESCC in northeast Iran is significantly higher than central Iran, the prevalence of gluten sensitive enteropathy is the same [1%]. It dose not appear that CD has any impact on the prevalence of ESCC in Iran

Epidemiologic feature of thyroid cancer based on cancer registry data system

This study was undertaken to define the epidemiological aspects of thyroid carcinoma in Iran, an area of endemic iodine deficiency nearly until recently. The Tehran Cancer Institute Data System Registry [TCIDSR] was used to identify patients with different histological types of thyroid cancer [TC] in Iran. Data were analyzed from 438 thyroid cancer cases identified by the TCIDSR in 1998-99. Disease prevalence was calculated by age, time and place. The TCIDSR recorded 438 primary malignancies of the thyroid gland: papillary, follicular, medullary, and anaplastic carcinomas accounted for 67.1%, 10.7%, 5.3% and 4.3% of cases, respectively. The remaining 12.6% was classified as OD [other diagnoses]. The prevalence of TC was the highest in Farsis population. The age range of patients was 8-85 yr. Mean patient age was 44.52 +/- 17.03 yr [mean +/- SD] overall, 47.74 +/- 18.10 yr in male patients and 43.04 +/- 16.34 in female patients. Anaplastic [6.5% vs. 3.3%] and medullary [10.0% vs. 3.0%] cancers were more common in men than women. Against expectation for an iodine-deficient area, the frequency distribution of tumours in our study was closer to that seen in iodine-rich areas. Additional research on the risk factors for thyroid cancer-genetic, ethnic, geographic and environmental is needed to explain the high incidence of PTC overall, and among Farsis population in particular, in Iran

Correlation between prostate needle biopsy and radical prostatectomy gleason gradings of 111 cases with prostatic adenocarcinoma

There are conflicting reports in the literature about correlation of biopsy and prostatectomy Gleason scores in prostate carcinoma. The goal of this study was to determine the correlation of grading in these two types of pathologic materials. The coupled Hematoxylin and Eosin slides of 111 patients with prostate carcinoma were collected. Gleason scores were determined. Patients who had undergone any therapy except surgery were excluded from the study. Correlation between grades was calculated by determination of correlation coefficient. Accuracy of biopsy grading in prediction of final grade was also determined by measuring the sensitivity, specificity, and positive and negative predictive values. In 50 cases [45%], grade was underestimated in the biopsy. After dividing the cases into Gleason scores of 2 to 4, 5 to 6, 7, and 8 to 10, the most of undergraded cases [84.2%] were in the first group [Gleason score 2 to 4] and this rate reached 5% in the fourth group [Gleason score 8 to 10]. The correlation coefficient measured was 0.535 in grade to grade comparing and 0.514 in group to group comparison of the specimens. In low-grade tumors, grading in biopsy, in spite of high sensitivity [90.9%], had low positive predictive value [26.3%]. There is a moderate direct linear relationship between scores in biopsy and prostatectomy specimens. But there is a high probability of underestimation of real Gleason score of the radical prostatectomy specimen in low-grade tumors. Pathologists and urologists must consider the phenomenon of undergrading in reporting prostate specimens and managing patients

[Impact of immunosuppressive treatment on liver fibrosis in autoimmune hepatitis]

Impact of treatment on progression of fibrosis in autoimmune hepatitis [AIH] is unknown. We assessed the changes in liver fibrosis before and after treatment among these patients. Nineteen AIH patients who had paired liver biopsies were studied. Of these, seven had been treated with 6 months of Cyclosporine-A and the rest with 6 months of prednisolone for induction of remission. Thereafter all had been maintained on azathioprine. Biopsy specimens before and after treatment, were reviewed by one pathologist and scored by the Ishak method. Mean fibrosis stage before and after treatment were compared. Also, factors predicting significant fibrosis [stage >/= 3] and cirrhosis [stage >/= 5] at presentation were assessed. Mean interval between biopsies was 3.38 years. Mean fibrosis stage decreased from 4.53 to 2.16 following treatment [p< 0.001]. Mean decrement in inflammatory grade was 8 scores [range: 4-10] in patients in whom fibrosis improved, and 2 scores [range: 0-4] in patients in whom fibrosis did not decrease after treatment [p< 0.001]. ALT to platelet ratio was the best predictor of significant fibrosis and also cirrhosis. Fibrosis commonly improves after immunosuppressive treatment in AIH. ALT to Platelet ratio can predict accurately the presence of significant fibrosis and cirrhosis in AIH