Correlative study of sonological appearance of BI-RADS 4 and above breast lumps with histopathology and immunohistochemistry markers

Background: Breast cancer is clinically categorized into 4 major subtypes, ER (+), PR (+), Her2 (+), and TNBC. Although the correlation between sonographic features of breast cancer and immunohistochemistry markers expression is found, it is not still very clear; thus, this study aimed to investigate the ultrasound features of breast cancer and analyze the correlation between them. Methods: This was a prospective study, in which patients with breast lumps were sonologically categorized as BI-RADS 4 and above. Percutaneous biopsy was done. Histopathology and immunohistochemistry markers were correlated with ultrasound findings. Results: ER (+), PR (+) tumors were associated with irregular shape. ER (+), PR (+), and Her2 (+) tumors were associated with indistinct margin. TNBC tumor was associated with microlobulated margin. TNBC cases had more posterior acoustic enhancement. Conclusions: Young female with ultrasound features of oval/round shape, micro-lobulated margin, abrupt tumor interface, showing posterior acoustic enhancement, absence of microcalcification was significantly associated with TNBC. Tumor with an irregular shape, indistinct margin, hyperechoic halo, no change in posterior acoustic feature, and presence of microcalcification were significantly associated with ER (+) cancers. Tumor with irregular shape, indistinct margin, and no change in the posterior acoustic feature was significantly associated with PR (+) cancers. Tumour with indistinct margin, and hyperechoic halo is significantly associated with Her2 (+) cancers. Tumor with irregular shape, indistinct margin, hyperechoic halo, and no posterior acoustic feature was associated with NTNBC.

Differential expression of FAM83A and β-catenin in cervical lesions / 安徽医科大学学报

Objective @# To investigate the expression difference and potential clinical significance of 83 sequence similar member A (FAM83A) and β-catenin in cervical lesions．@*Methods @#ALCAN and GEPIA2. 0 online data- bases were used to analyze the difference of FAM83A expression in normal cervix and cervical squamous cell carci- noma ( CSCC) and the relationship between FAM83A expression and the prognosis of CSCC patients，LinkedOmics database was used to analyze FAM83A mRNA co-expression genes，and R language was used for KEGG enrichment analysis．Immunohistochemistry was used to detect FAM83A and β-catenin expression in 60 cases of normal cervix， 80 cases of low-grade squamous intraepithelial lesion ( LSIL) ，90 cases of high-grade squamous intraepithelial le- sion (HSIL) and 70 cases of cervical squamous cell carcinoma ( CSCC) ．The relationship between FAM83A ，β - catenin expression and clinicopathological features and the correlation between FAM83A and β-catenin expression were analyzed. @*Results @# UALCAN database analysis showed that FAM83A was highly expressed in CSCC tissues， and GEPIA 2. 0 database analysis suggested that those with high FAM83A expression had a poor prognosis．Linke- dOmics database performing KEGG enrichment analysis suggested that expression of FAM83A was positively correla- ted with aberrant activation of Wnt / β-catenin signaling pathway． The expression rate of FAM83A in CSCC was higher than that in LSIL and normal cervical tissues (P＜0. 001) ，but there was no significant difference compared with HSIL (P = 0. 401) ; the expression of FAM83A was not correlated with age (P = 0. 231) ，but was significant- ly different from the correlation with differentiation (P = 0. 001) and clinical stage (P = 0. 038) ．The abnormal ex- pression rate of β-catenin in CSCC was higher than that in LSIL and normal cervical tissues (P＜0. 001) ，but there was no significant difference compared with HSIL (P = 0. 734) ; the expression of β-catenin was not related to age (P = 0. 088) ，related to differentiation (P = 0. 001) and clinical stage (P＜0. 001) ，and FAM83A was positively correlated with β-catenin expression (P ＜0. 05 ) ．@*Conclusion @#FAM83A and β-catenin are highly expressed in both HSIL and CSCC tissues，and there is a positive correlation between the expression of FAM83A and β-catenin. The high expression of FAM83A has some correlation with the prognosis of CSCC patients and can be used as a po- tential marker to determine the prognosis of CSCC.

Diagnostic value of endoscopic ultrasound-guided tissue acquisition with rapid on-site evaluation performed by endoscopists in immunohistochemistry-required solid pancreatic lesions / 中华胰腺病杂志

Objective:To evaluate the diagnostic value of rapid on-site evaluation (ROSE) performed by endoscopists for solid pancreatic lesions requiring tissue for immunohistochemistry (IHC) staining with different approach of endoscopic ultrasound-guided tissue acquisition (EUS-TA).Methods:After screening 1 573 cases who underwent EUS-TA operation at the Endoscopy Center of Peking Union Medical College Hospital between August 2018 and October 2022, a total of 65 cases of solid pancreatic lesions whose diagnosis rely on IHC staining was collected and summarized with clinical data of each case. Among 65 cases, there were 46 cases of pancreatic neuroendocrine tumors (PNETs), 13 cases of pancreatic solid pseudo-papillary tumors (SPTs), and 6 cases of lymphomas and mesenchymal. Patients were categorized into ROSE group (36 cases) and non-ROSE group (29 cases) according to the presence or absence of endoscopists performed ROSE during EUS-TA operation. They were further divided into subgroups of FNA-ROSE (26 cases), FNB-ROSE (10 cases), FNA-non-ROSE (24 cases) and FNB-non-ROSE (5 cases) according to the type of EUS-TA. Diagnostic accuracy and IHC success rate were compared between different groups and subgroups. Binomial logistic multifactorial regression analysis was used to evaluate the influence of ROSE and EUS-TA type on diagnostic accuracy and IHC success rate.Results:There were no statistically significant differences between ROSE group and non-ROSE group in terms of age, gender, bilirubin level, CA19-9 level, lesion site, lesion size, composition ratio of diagnosis, and surgical rate. The differences in mean size of lesions, needle gauge, location of puncturation, and number of needle pass between subgroups were not statistically significant. The diagnostic accuracy was 88.9% in ROSE group and 79.3% in non-ROSE group, and the difference between the two groups was statistically significant ( P=0.023). The diagnostic accuracy of FNA-ROSE group was higher than that of FNA-non-ROSE group (88.5% vs 75.0%), but the difference was not statistically significant ( P>0.100). The differences in diagnostic accuracy and success rate of IHC between FNB-ROSE group and FNB-non-ROSE group were not statistically significant. Binomial logistic multifactorial regression analysis did not reveal any independent influences on diagnostic accuracy. Conclusions:ROSE performed by endoscopists improved diagnostic accuracy of EUS-TA in solid pancreatic lesions requiring IHC staining, and therefore is potentially valuable for improving the diagnostic efficiency of EUS-TA for such diseases.

Expression and Clinical Significance of KIF11,β-catenin and GSK-3β in Cervical Cancer / 医学研究杂志

Objective To investigate the expression of kinesin family member 11(KIF11),β-catenin and glycogen synthase ki-nase-3β(GSK-3β)in cervical cancer and its clinical significance.Methods The expression of KIF11,β-catenin and GSK-3β in 102 cases of cervical cancer,52 cases of high-grade squamous intraepithelial lesion(HSIL)and 46 cases of low-grade squamous intra-epithelial lesion(LSIL)and 40 cases of chronic cervicitis were detected by immunohistochemistry,to analyze the relationship between the expression of the three indicators and the clinicopathological characteristics of cervical cancer patients,and to analyze the correlation be-tween the three indicators.COX proportional hazards model was used to analyze the prognostic factors of cervical cancer patients.Results With the progression of cervical lesions,the positive rates of KIF1 1 and β-catenin increased gradually,while the positive rates of GSK-3β decreased gradually(P＜0.05).The positive expressions of KIF11,β-catenin and GSK-3β in cervical cancer tissues were significantly different in International Federation of Gynecology and Obstetrics(FIGO)stage,differentiation degree and lymph node metastasis(P＜0.05),but there was no significant difference among different ages and pathological types(P＞0.05).The expression level of KIF11 was positively correlated with β-catenin(r=0.461,P＜0.05),and the expression level of β-catenin was negatively correlated with GSK-3β(r=-0.692,P＜0.05).The expression level of KIF11 was negatively correlated with GSK-3β(r=-0.336,P＜0.05).The average survival time of patients with positive expression of KIF11 and β-catenin was shorter than that of pa-tients with negative expression,and the average survival time of patients with positive expression of GSK-3 β was longer than that of pa-tients with negative expression of GSK-3β.COX regression analysis showed that FIGO stage,lymph node metastasis,KIF11 and β-catenin were independent risk factors for the prognosis of cervical cancer patients,and GSK-3β was an independent protective factor.Conclusion KIF11,β-catenin and GSK-3β are abnormally expressed in the tissues of cervical cancer patients.KIF11 may be in-volved in the regulation of Wnt/β-catenin pathway in the development of cervical cancer.The combined detection of KIF11 may provide a new reference for the diagnosis and prognosis of cervical cancer.

Beyond the obvious: unveiling primary effusion lymphoma in a 76-year-old female with multifaceted clinical presentation

Primary effusion lymphoma (PEL) is an exceptionally rare and challenging entity to diagnose, characterized by the development of lymphomatous effusions in body cavities without a solid tumour mass. Here, we present a case of PEL in a 76-year-old retired professor with a complex medical history including diabetes, hypertension, and bilateral total knee replacement surgery. The patient initially presented with dry cough and breathlessness, which led to the discovery of a right pleural effusion exhibiting lymphocytic predominance with high ADA but lacking malignant cells. Prompt initiation of empiric anti-tubercular therapy (ATT) resulted in symptomatic improvement and resolution of the effusion. However, subsequent admission to the emergency room due to vomiting, weakness, and walking difficulties unveiled a positive rapid antigen test for COVID-19 and identified moderate right-sided pleural effusion. Additional investigations including positron emission tomography–computed tomography (PET-CT), magnetic resonance imaging (MRI) brain, and cell block analysis unveiled intriguing findings, prompting further evaluation and immunohistochemical (IHC) analysis. IHC markers revealed CD20+, Ki-67 proliferation index of 80%, CD79a+, CD 3 -, CD138-, CD30-, and CD10-, indicative of atypical B cell proliferation. Importantly, the presence of human herpes virus-8 (HHV-8) was confirmed through LANA1 staining, solidifying the diagnosis of primary effusion lymphoma. This case highlights the diagnostic challenges encountered and emphasizes the importance of comprehensive evaluation and IHC profiling confirmation in establishing an accurate diagnosis of PEL.

Differentiation of Breast Cancer Immunohistochemical Status Using Digital Mammography Radiomics Features

Purpose: Discriminating breast cancer Hormonal Receptor (HR), human epidermal growth factor receptor (Her2) and Triple Negative (TN) status using mammography radiomic features. Materials and Methods: We used an open-source database enrolling 71 patients with confirmed breast cancer. It includes bilateral mammograms Craniocaudal (CC) and Mediolateral Oblique (MLO) as well as the breast cancer molecular status such as HR, Her2 and TN. We extracted a set of 486 quantitative descriptors from the original and the wavelets of the CC and the MLO mammograms. Using the training set (ntrain=48), we performed the features selection following two steps: (i) first, univariable feature selection had been implemented with correlation statistical test to eliminate redundancy between mammogram features. (ii) In second part, we used Support Vector Machine Recursive Feature Elimination (SVM-RFE) method in 10-folds Cross-Validation repeated 10 times. Also, we applied the Synthetic Minority Oversampling Technique to tackle the issue of imbalanced classes. After that, we carried out three binary molecular classification (HR vs non-HR, Her2 vs non-Her2, TN vs non-TN) using Logistic Regression. These classifications were performed using respectively CC and MLO features individually and in two combinations: sum “CC+MLO” and concatenation “CC and MLO”. After the validation step (ntest=17), Accuracy and Under Receiver Operating Characteristic curve (AUC) were adopted to assess the proposed model performance. Results: Accuracies and AUCs recorded for three molecular classes in validation step were respectively ranging from 0.69/0.75 to 0.88/0.90, 0.52/0.53 to 0.64/0.63 and 0.70/0.70 to 0.79/0.77 for Her2, HR, TN. The best performances achieved for HR and Her2 classification were CC image features and “CC and MLO” features for TN. There is a strong representation of wavelets features based in the features selected. Conclusion: Our results suggest that mammographic quantitative features especially wavelet-based could be used to differentiate the breast cancer molecular subtype

The Expression of P63 Marker in Malignant and Benign Breast Tumors

This is a retrospective study conducted on Sudanese patients from January 2021 to May 2021 at the radiation and isotope center in Khartoum. In this study we aimed to determine the expression of P63 marker in malignant and benign breast tumors. One hundred paraffin-embedded blocks previously diagnosed as breast tumors were collected. The study included 65 (65%) samples of malignant and 35 (35%) benign samples. All these samples were Immunohistochemically stained by using monoclonal antibodies (by indirect streptavidin-biotin technique) for p63. All immune-stained slides were scored as either positive or negative. Data collected from patient file and results were analyzed using social science statistic web SPSS computer program.

Ewing’s sarcoma or peripheral primitive neuroectodermal tumor at the base of tongue: a rare location case report

Peripheral primitive neuroectodermal tumor now termed as Ewings sarcoma/PNET, representing a family of tumors with varying degrees of neuronal differentiation and genetic rearrangements. Most common sites are extraosseous involving trunk and lower limb. Base of tongue is a very rare site for Ewing’s/PNET, hence in view of rarity of the location as an uncommon presentation, the case has been reported for the better understanding and supporting the literature with the similar finding. A 68 years old female patient presented with the complaint of difficulty in swallowing since 3 months. On examination growth was identified at the left side base of tongue. Biopsy was processed and stained with H&E and other relevant markers. Differentials on the basis microscopic examination were lymphoma, neuroendocrine tumor and primitive neuroectodermal tumor. Various immunohistochemical markers to rule out the given differential were used. The tumor was positive for CD 99 and vimentin. The case was repored as PNET. Peripheral PNET is a challenging topic. Wide range of extraosseous locations have been observed but head and neck being less reported needs to be studied for understanding the behavior of this highly malignant disease in this rare location so that patient can be benefitted by advanced multimodality treatments including surgery, chemotherapy and radiotherapy.

Ewing’s sarcoma or peripheral primitive neuroectodermal tumor at the base of tongue: a rare location case report

Peripheral primitive neuroectodermal tumor now termed as Ewings sarcoma/PNET, representing a family of tumors with varying degrees of neuronal differentiation and genetic rearrangements. Most common sites are extraosseous involving trunk and lower limb. Base of tongue is a very rare site for Ewing’s/PNET, hence in view of rarity of the location as an uncommon presentation, the case has been reported for the better understanding and supporting the literature with the similar finding. A 68 years old female patient presented with the complaint of difficulty in swallowing since 3 months. On examination growth was identified at the left side base of tongue. Biopsy was processed and stained with H&E and other relevant markers. Differentials on the basis microscopic examination were lymphoma, neuroendocrine tumor and primitive neuroectodermal tumor. Various immunohistochemical markers to rule out the given differential were used. The tumor was positive for CD 99 and vimentin. The case was repored as PNET. Peripheral PNET is a challenging topic. Wide range of extraosseous locations have been observed but head and neck being less reported needs to be studied for understanding the behavior of this highly malignant disease in this rare location so that patient can be benefitted by advanced multimodality treatments including surgery, chemotherapy and radiotherapy.

Histomorphological spectrum of gastrointestinal stromal tumors: an institutional experience

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the abdominal area. They can involve any portion of the gastrointestinal (GI) tract, omentum, mesentery, retroperitoneum, and other sites. They form 1-2% of the histologic types of gastrointestinal tract tumors. Aims and objectives were to analyze and correlate morphological, clinical and histomorphology features of gastrointestinal tumors presenting at different sites. Methods: This was a retrospective observational study for six years. Medical records of the histopathologically diagnosed GIST cases were reviewed for patient demographics and clinical presentation, and tumor findings were noted. Results: Of the 28 patients, ages ranged from 28 to 80 years. Symptoms ranged from abdominal pain, epigastric discomfort, mass, upper/lower gastrointestinal bleeding, rectal bleeding, anemia, weight loss, and small bowel obstruction. Sites involved were the small bowel, stomach, mesentery, rectum, duodenum, greater omentum, and retroperitoneum. Of 28 cases of GIST, 25 cases showed both c-KIT and DOG-1 positivity, 1 case showed only c-KIT positivity, 1 case showed only DOG-1 positivity, and 1 case was both c-KIT and DOG-1 negative. Conclusions: GISTS are unpredictable mesenchymal tumors. Common sites are the stomach and small gut. Mesenteric and omental GIST are rare. Spindle cell morphology was more commonly present.

The expression of autophagy and apoptosis in the epithelial tissue of oral submucous fibrosis / 中国现代医生

Objective To examine the expression of autophagy marker proteins LC3,P62 and apoptotic protein caspase-3 in oral submucous fibrosis(OSF)and investigate their relationship in epithelial mucosa.Methods To collect buccal mucosal specimens from 90 patients with OSF who underwent tissue pathological biopsy in the Department of Stomatology,Xiangya Hospital,Central South University from 2016 to 2019.There were divided into early stages of OSF group,moderately stages of OSF group,and advanced stages of OSF group.At the same time,30 healthy individuals without oral mucosal diseases were collected as control group.Compare the thickness of the epithelial cell layer using HE staining,and detect the expression of LC3,P62,and caspase-3 in the buccal mucosa epithelium of each group by immunohistochemistry.Results HE staining showed that compared to normal oral mucosa in control group,epithelial cell layer thickness of OSF patients was significantly reduce(P<0.05).Immunohistochemical staining showed that the expressions of LC3 and caspase-3 increased and P62 expression decreased significantly in the early stages of OSF group,moderately stages of OSF group,and advanced stages of OSF group(P<0.05).Their expressions were related to the mouth opening of patients with oral submucous fibrosis(P<0.05).In addition,the expression levels of LC3 and caspase-3 were positively correlated(r=0.320,P<0.05),the expression levels of P62 and caspase-3 were negatively correlated(r=-0.554 P<0.001),and the expression levels of LC3 and P62 were negatively correlated(r=-0.710,P<0.001).Conclusion Autophagy and apoptosis may be related to the occurrence and development of OSF,and the combined detection of LC3,P62,and caspase-3 is of great significance for the diagnosis of OSF.

Practical Value of Environment-friendly Sample Release Agent Combined with Ultrasound in the Preparation of Pathological Tissue Sections / 中山大学学报(医学科学版)

ObjectiveTo explore the practical value of environment-friendly sample release agent combined with ultrasound in the preparation of pathological tissue sections. MethodsFrom February 2013 to December 2022， 2 518 pathological specimens submitted by Foshan Municipal Hospital of Traditional Chinese Medicine were selected as the study objects. Two samples of the same specimen were randomly divided into two groups： the environment-friendly fast group， in which the pathological tissue sections were made by using the environment-friendly sample release agent combined with ultrasound； and the traditional group， in which formaldehyde， ethanol and xylene were used to make slices in the conventional way. The differences of hematoxylin （HE） staining effect， immunohistochemistry （IHC） staining effect and MDM2 gene detection result of atypical lipomatous tumor/highly differentiated liposarcoma （ALT/WDL） tissue sections between the two groups were compared. Results① The wax of the two groups' pathological tissues was dehydrated well and the tissue hardness was moderate. After HE staining， the sections of the two groups were intact， without cracks and tremor marks， and the contrast between nucleus and cytoplasm was appropriate， with good transparency， uniform staining， and no tissue loss. The excellent rate and score of HE staining in the environmental fast group were higher than those in the traditional group， but the difference was not statistically significant （χ2 = 3.125，P1 = 0.070；t = 0.965，P2 = 0.334）. ②After IHC staining of the two groups of sections， the positive location of the cells was accurate， the staining was specific and uniform， the staining intensity was moderate， the staining sensitivity was good， and there was no tissue loss. The excellent rate of IHC staining and the positive rate of IHC staining in the environmental fast group were lower than those in the traditional group， but the difference was not statistically significant （χ12 = 2.769，P1 = 0.092；χ22 = 0.800，P2 = 0.375）. ③The background and outline of the two groups of WDL tissue sections were clear， the staining was uniform， the cells were clear and visible， the nuclear boundary was clear， the hybridization signal was clear and bright under the background fluorescence， and there was no miscellaneous signal. The two groups of sections were hybridized successfully， and MDM2 showed positive amplification. The number of cells successfully hybridized in the environment-friendly fast group was lower than that in the traditional group， but the difference was not statistically significant （t = 1.414，P = 0.230）. ConclusionsThe tissue treatment method of using environment-friendly sample release agent combined with ultrasound can ensure the detection effect of HE staining， IHC staining and MDM2 gene detection of pathological tissue sections， and is more efficient and environment-friendly， suitable for promotion and use in hospitals at all levels.

Effects of Vitamin D On Cisplatin Induced Heart and Lung Toxicity in Albino Rat

Background: While Cisplatin (CP) is a powerful DNA alkylating agent used to treat many malignancies, its clinical use is linked to a number of negative side effects. It has been proposed that vitamin D can shield biological systems against harm caused by CP. The current study’s objective was to look into how vitamin D protects the rat heart and lung against cisplatin-induced damage. Material and methods: Thirty adult male Albino rats; 180–220 g body weight were allocated into 3 groups; Group I (n=10) receiving saline, Group II (n=10); rats receiving CP (single dose of 6.5 mg/kg intraperitoneal) and Group III (n=10); receiving CP and 50 ng/kg/day alfacalcidol. Results: Alterations included a significant increase in malondialdehyde (MDA) level in the CP group compared with the other groups (p value for comparing between control and each other group, statistically significant at p < 0.05). Histopathologically, CP induced severe changes were observed. However, the CP-induced disturbances significantly improved by treatment with Vitamin D. Conclusion: According to this study, CP treatment significantly harmed rats’ hearts and lungs; however, treatment with vitamin D significantly lessened these harms.

Células tumorales circulantes en una paciente con sospecha clínica de mieloma múltiple / Circulating tumor cells in a patient with clinical suspicious of multiple myeloma

Introducción: La circulación de células tumorales en la sangre periférica, conocido como carcinocitemia, es un fenómeno raro y muy poco comunicado en la literatura científica y su diagnóstico diferencial puede constituir un desafío en la práctica clínica. Objetivos: Describir las causas más frecuentes de carcinocitemia, los retos diagnósticos que representa y contribuir a elevar el índice de sospecha de esta entidad. Presentación del caso: Paciente femenina de 71 años de edad que acude por dolores óseos y palidez cutánea. En el examen de sangre periférica se observa células de gran tamaño que recordaron células plasmáticas. El inmunofenotipo por citometría de flujo fue sugestivo de mieloma múltiple isotipo IgM. El ultrasonido de mamas y la tomografía de tórax mostraron lesión tumoral en la mama izquierda. El estudio inmunohistoquímico de la biopsia de médula ósea fue compatible con adenocarcinoma de mamas. La paciente falleció sin haber comenzado tratamiento específico. Conclusiones: Se presenta paciente con células circulantes tumorales secundaria a adenocarcinoma de la mama donde la inmunohistoquímica de la biopsia de médula ósea descartó el diagnóstico de mieloma múltiple sospechado clínica, radiológicamente, por la morfología celular y el inmunofenotipo(AU)

Introduction: The circulating tumor cells in peripheral blood, known as carcinocythemia is a rare and poorly documented phenomenon, that can be a challenge diagnosis. Objectives: To describe the most frequents causes of carcinocythemia, the diagnosis challenges that it represents and to contribute raising awareness of this entity. Case presentation: Female patient, 71-year-old who complained bone pain and skin pale. The peripheral blood smear showed big size cells mimicking plasma cells. The immunophenotype by flow cytometry suggested IgM isotype multiple myeloma. Breast ultrasound and thorax tomography showed a tumor in the left breast. The bone marrow biopsy immunohistochemical was compatible with adenocarcinoma of breast. The patient died short after before receive specific treatment. Conclusions: We present a patient with circulating tumor cells secondary to breast adenocarcinoma where the bone marrow biopsy immunohistochemical ruled out multiple myeloma diagnosis suspected by clinical, image studies, cell morphology and immunophenotype(AU)

Interpretation on the international consensus of the pathological diagnosis of unilateral primary aldosteronism / 中华内分泌代谢杂志

Unilateral primary aldosteronism (UPA) is a common form of PA that is surgically curable by adrenalectomy of the overactive gland. Pathological evaluation of resected adrenals is crucial in the diagnosis of UPA, and its subsequent treatment and follow-up as well. Histomorphological evaluation is the basis for the pathological diagnosis of UPA, and the wide use of aldosterone synthase immunohistochemical staining in recent years has greatly improved the pathological diagnosis of UPA. However, there is a lack of standardized nomenclature and diagnostic criteria. Therefore, consensus on the histopathologic diagnosis of UPA were developed by an international group of pathologists led by Tracy Ann Williams, and published in J Clin Endocrinol Metab, 2021. This article will elaborates on the key points in the consensus to advance the understanding and overall improve clinical mangement of UPA.

Estrogen and progesterone hormone receptor status in pre-menopausal and postmenopausal women with invasive ductal carcinoma in a private tertiary hospital in Cebu City, Philippines: A retrospective study

OBJECTIVE@#This study was conducted to determine the difference of hormone receptor status between pre-menopausal and postmenopausal women diagnosed with invasive ductal carcinoma in the local setting. @*METHODS@#This retrospective descriptive study used data gathered from chart review of premenopausal and postmenopausal female patients diagnosed with invasive ductal carcinoma by tissue biopsy and underwent determination of hormone receptor status (estrogen and progesterone receptor) by immunohistochemical staining (ICA) using biopsy samples taken from June 2016 to December 2019 at Cebu Velez General Hospital, Cebu City. The significance of the difference in the hormone receptor status with menopausal status was analyzed using Fisher’s exact test.@*RESULTS@#Comparing the two groups, 25 (60%) of the pre-menopausal women and 37 (73%) of the post-menopausal women were determined as hormone sensitive, while 17 (40%) pre-menopausal women and 14 (27%) post-menopausal women were hormone resistant. The Fisher’s exact test did not detect a statistically significant difference in the hormone receptor status of pre-menopausal and post-menopausal breast cancer patients.@*CONCLUSION@#There is no significant difference on the hormonal receptor status among pre-menopausal and post-menopausal women diagnosed with invasive ductal carcinoma. Thus, the need for hormone receptor status determination in these patients should be emphasized to aid in proper diagnosis, prognostication, and treatment planning.

Immunohistochemical Survey of Invasive Ductal Carcinoma of the Breast, using ER, PR, HER2 and KI-67 biomarkers, in Uyo, Nigeria

Background: Breast's Invasive Ductal Carcinoma (IDC), which is the commonest type of malignancy in females worldwide, can be characterized using immunohistochemistry in view of personalized cancer therapy. In this study, we aimed to determine the pattern of immunohistochemical profiles of IDC using oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 receptor (HER2) and proliferative index (Ki-67) biomarkers in our tertiary healthcare facility in Uyo, Akwa Ibom State, Nigeria given the dearth of its data in our environment. Materials and methods: We carried out a retrospective hospital-based immunohistochemical study of archival IDC tissue blocks over a four- and half-year period. Using systematic random sampling method, 64 formalin fixed paraffin embedded (FFPE) IDC tissue blocks were selected for this study. We carried out immunohistochemical evaluation using ER, PR, HER2 and Ki-67 biomarkers. Subsequently, we presented the results and classification schemes as text, tables, graphs, and photomicrographs. Results: We found that the proportion of expressions were ER-negative (88.7%), PR-negative (87.3%), HER2-negative (68.3%) and Ki-67 (<20%) being 83.6% respectively. The immunohistochemical-based classification which was done using combined immunohistochemical profiles of ER/PR/HER2 and ER/PR/HER2/Ki-67 biomarkers respectively, revealed five immunohistochemical-based subtypes. These subtypes were ER-positive luminal A (ER+/±PR+/HER2-) [5.56%], ER-positive luminal B (ER+/±PR+/HER2+) [5.56%], HER2-overexpression (ER-/±PR+/HER2+) [16.66%], Triple negative (ER-/PR-/HER2-) [66.67%] and Unclassified subtypes (ER-/PR+/HER2-) [5.56%]. Furthermore, these five subtypes were further subcategorized into low (Ki-67 <20%) and high (Ki-67 ≥20%) proliferation subtypes accordingly. Conclusion: The commonest pattern of immunohistochemical profile expression of IDC in Uyo was found to be the Triple negative subtype.

Immunohistochemical Markers in the Differential Diagnosis of Melanoma and Nevus in Humans

SUMMARY: Immunohistochemistry allows in situ detection of cell and extracellular components through specific antibodies. The objective was to compare the immunohistochemical expression patterns of the S-100, HMB-45 and MART-1 proteins for differential diagnosis of malignant melanoma and melanocytic nevus in human skin biopsies. Thirty-nine biopsies of human tissue were used. They were divided into two groups: 19 in malignant melanoma and 20 in melanocytic nevi. Next, the samples were fixed with paraformaldehyde and processed following the protocol for inclusion. Then, immunohistochemical staining was performed. Finally, the histological and qualitative analysis of the samples was carried out. S-100, HMB-45, and MART-1 markers showed positive immunoreaction in melanoma biopsies. HMB-45 marker was generally present with weaker expression than S-100 and MART-1 in melanocytic nevus biopsies. No expression pattern was observed which specifically associates one or more markers with some types of histopathological diagnosis. Immunohistochemistry is fundamental in differential diagnosis of melanomas and melanocytic nevi. However, there is no antibody or set of antibodies which allows unequivocal diagnosis between melanoma and nevus. It is therefore necessary to analyze with care the expression pattern and location of the lesion using standard morphological characteristics.

RESUMEN: La inmunohistoquímica permite la detección in situ de componentes celulares y extracelulares a través de anticuerpos específicos. El objetivo de nuestro estudio fue comparar los patrones de expresión inmunohistoquímica de las proteínas S-100, HMB-45 y MART-1 para el diagnóstico diferencial de melanoma maligno y nevo melanocítico en biopsias de piel humana. Se utilizaron treinta y nueve biopsias de tejido humano, las que fueron divididas en dos grupos: 19 en melanoma maligno y 20 en nevos melanocíticos. A continuación, las muestras se fijaron con paraformaldehído y se procesaron siguiendo el protocolo convencional para su inclusión. Luego, se realizó la tinción inmunohistoquímica. Finalmente, se realizó el análisis histológico y cualitativo de las muestras. Los marcadores S-100, HMB- 45 y MART-1 mostraron inmunorreacción positiva en biopsias de melanoma. El marcador HMB-45 estuvo generalmente presente con una expresión más débil que S-100 y MART-1 en biopsias de nevo melanocítico. No se observó ningún patrón de expresión que asocie específicamente uno o más marcadores con algunos tipos de diagnóstico histopatológico. La inmunohistoquímica es fundamental en el diagnóstico diferencial de melanomas y nevos melanocíticos. Sin embargo, no existe ningún anticuerpo o panel de anticuerpos que permita un diagnóstico inequívoco entre el melanoma y el nevo. Por tanto, es necesario analizar con cuidado el patrón de expresión y la localización de la lesión utilizando características morfológicas estándar.

The value of dual-layer detector spectral CT in evaluation of immunohistochemical expression in breast cancer patients / 中华放射学杂志

Objective:To investigate the value of dual-layer detector spectral CT in preoperative evaluation of immunohistochemical expression levels in breast cancer patients.Methods:The clinical, pathological and imaging data of breast cancer patients who received preoperative spectral CT chest scan in Affiliated Hospital of Southwest Medical University from October 2020 to January 2021 were retrospectively analyzed. A total of 70 patients were divided into positive or negative estrogen receptor (ER) group, positive or negative progesterone receptor (PR) group, positive or negative human epithelial growth factor receptor 2 (HER2) group, and positive or negative Ki-67 group according to the immunohistochemistry. Philips workstation and Special Diagnostic Suite software were used for processing and analysis. The CT value and iodine concentration value (IC) of the lesion and the effective atomic number (Z eff) of the lesion in the arterial and venous phases were measured, and the standardized CT value (NCT), standardized iodine concentration value (NIC), slope (K) of the keV-CT value curve in the arterial and venous phases as well as the CT difference and the IC difference in the arteriovenous phase were calculated. Independent sample t test was used to compare the differences in spectral parameters between patients with positive and negative immunohistochemical parameters, and ROC curve was used to analyze the efficacy of spectral parameters in the differential diagnosis of positive and negative different immunohistochemical parameters. Results:Z eff, NIC, K value, CT value, IC value of arterial and venous phase and NCT value of venous phase in negative ER group were higher than those in positive ER group, the difference was statistically significant ( P<0.05). Z eff, NIC, K value, IC, CT difference in arteriovenous phase and IC difference in arteriovenous phase in positive HER2 group were higher than those in negative HER2 patients, the difference was statistically significant (P<0.05). The arterial K value in positive Ki-67 group was higher than that in negative Ki-67 group, the difference was statistically significant ( P<0.05). Taking arterial phase K value of 1.22 as the diagnostic threshold, it had the highest diagnostic efficiency in differential diagnosis of ER positivity versus negativity (area under curve of 0.791, sensitivity of 84.00%, specificity of 65.00%). Taking the arteriovenous phase IC difference of 0.47 mg/ml as the diagnostic threshold, it had the highest performance in differential diagnosis of HER2 positivity versus negativity (area under curve of 0.736, sensitivity of 76.32%, specificity of 65.62%). Conclusion:Dual-layer detector spectral CT has certain diagnostic value for the immunohistochemical expression of breast cancer patients, which can provide reference for clinical diagnosis and treatment.

Expression of abnormal spindle-likemicrocephaly-associated in hepatocellular carcinoma and its prognostic relationship after liver transplantation for hepatocellular carcinoma / 中华器官移植杂志

Objective:To explore the expression of abnormal spindle-like microcephaly-associated (ASPM) in liver cancer tissues and clarify its prognostic relationship with clinicopathological features of liver cancer after liver transplantation.Methods:Immunohistochemistry was employed for detecting the expression of ASPM in 72 liver cancer tissues and 36 adjacent tissues of liver cancer liver transplant recipients fulfilling the Hangzhou criterion. In conjunctions with clinicopathological data, the correlation between the expression level of ASPM in liver cancer tissues and the clinicopathological characteristics and the post-transplantation prognosis for liver cancer were statistically analyzed.Results:During a median follow-up period of 29 months, 20 patients relapsed and 8 died after transplantation. Immunohistochemical results indicated that the high-expression rates of ASPM were 58.3% and 25.0% in liver cancer and adjacent tissues ( P=0.001). The difference was statistically significant. The high-expression rate of ASPM was significantly higher in liver cancer tissues than that in adjacent tissues. The expression level of ASPM was not correlated with gender, age, smoking/alcoholic history, hepatitis history, preoperative level of alpha-fetoprotein (AFP), tumor size, tumor load or vascular tumor thrombus ( P>0.05). And the postoperative high-expression rates of ASPM were 51.0% and 76.2% in pathological differentiation type Ⅰ-Ⅱ and Ⅲ-Ⅳ groups ( P=0.049). The difference was statistically significant. The wrose pathological differentiation type of liver cancer, the higher expression level of ASPM in liver cancer tissue. In liver cancer tissues, the overall 1/3/5-year survival rates of ASPM high/low-expression group were 97.6%, 80.6%, 80.6% and 93.3%, 89.7% and 89.7% respectively ( P>0.05). There was no statistical significance. And 1/3/5-year long-term disease-free survival rates were 78.6%, 55.5%, 55.5% and 86.3%, 86.3% and 86.3% respectively ( P=0.036). The difference was statistically significant. The disease-free survival rate was lower in ASPM high-expression group and post-transplantation prognosis was worse. Conclusions:The expression of ASPM is significantly higher in liver cancer tissues than that in adjacent tissues. And the expression level of ASPM in liver cancer tissues is correlated with pathological differentiation types of liver cancer and has an impact on tumor-free survival of patients after liver transplantation for liver cancer.