Survivin immunohistochemical expression in hepatocellular carcinoma: correlation with tumour differentiation and proliferation

Recently, survivin was shown to inhibit apoptosis and accelerate cancer cell proliferation as well. The expression of survivin may be of prognostic significance and therapeutic relevance in many cancers. This study investigated the expression of survivin in hepatocellular carcinoma [HCC]; correlated results with tumour differentiation and proliferation [topoisomerase II alpha] and compared the expression with the surrounding cirrhotic liver tissue. The expression of survivin and topoisomerase II alpha was evaluated by immunohistochemistry in 20 cases of HCC and 20 liver cirrhosis tissues. The relationships between two survivin scoring methods - topoisomerase II alpha nuclear labelling index [LI] and tumour differentiation - were analysed. Eighteen [90%] HCC cases expressed survivin. Median survivin nuclear LI was 75% and 6.5% in HCC and cirrhotic liver tissue, respectively. Median survivin weighted score was 8 and 0 in HCC and cirrhotic liver tissue, respectively. Survivin expression was significantly higher in HCC than in cirrhotic liver tissue [p < 0.001]. Median survivin expression L1 was 83% and the weighted score was 12 in moderately differentiated HCC versus 33% and 4, respectively in well-differentiated HCC with statistically significant P< 0.001. Median topoisomerase II alpha LI was 22.5% and 3% in HCC and cirrhotic liver tissue respectively, with a statistically significant difference [p < 0.001]. Median topoisomerase II alpha was 27.5, 9% in moderately and well-differentiated HCC respectively, with a statistically significant difference [p < 0.001]. The increase in survivin nuclear expression in HCC correlates significantly with the increase in topoisomerase II alpha nuclear expression [p < 0.001, r = 0.987]. Both survivin scoring methods were sensitive in discriminating between studied groups; however, nuclear LI showed more specificity. Both survivin and topoisomerase II alpha expressions were significantly higher in HCC than in cirrhotic liver tissue and correlated significantly with tumour de-differentiation in HCC cases. Survivin nuclear LI correlated significantly with tumour cell proliferation

study of duodenal intraepithelial lymphocytic population and its relation to coeliac disease in a cohort of patients in the Nile delta of Egypt

Coeliac disease is the permanent intolerance to dietary gluten, the major protein component of wheat. Recent epidemiological studies have provided evidence showing that this disorder is common in various parts of the world. The counting and the immunoprofile of intraepithelial lymphocytes of the small bowel have been proposed as methods to measure mucosal infiltration in gluten-sensitive patients. The aim of the present study was to quantify and define the immunohistochemical profile of intraepithelial lymphocytes in the duodenal mucosa of patients suffering non-ulcer dyspepsia, and compare them with known cases of coeliac disease. Archival paraffin wax embedded duodenal sections from 50 endoscopic biopsies were stained using CD3, CD4, and CDS antibodies. Sections were obtained from 24 patients with confirmed coeliac disease, 20 patients with non-ulcer dyspepsia, and 6 patients with functional dyspepsia as control. Patients with non-ulcer dyspepsia were on gluten containing diets. The number of intraepithelial lymphocytes was quantified in five different villi by counting the number of lymphocytes/100 epithelial cells in each villus, and calculating the mean. Endomysial antibodies and testing for Helicobacter pylori were done in all cases. A positive correlation was observed between the degree of villous atrophy and CD3, CD4, and CD8+ intraepithelial lymphocytes. A positive correlation was also observed with the lamina propria lymphoid aggregates. H. pylori infection had a positive correlation with the degree of lymphoid aggregation in the lamina propria. Although the difference between potential coeliac disease and non-coeliac controls was significant, these lesions overlapped considerably. Clinicians as well as pathologists should increase the index of suspicion of coeliac disease. The frequent occurrence of duodenal intraepithelial lymphocyte expansions in other diseases may justify the use of immunohistochemical examination of duodenal biopsy specimens from patients suffering from dyspepsia