Image analysis and Ki-67 expression in urothelial dysplasia and carcinoma

Background/aim: Cancer of the urinary bladder is a worldwide disease in which transitional cell carcinoma is the most common histologic type. The diagnosis of dysplasia is particularly important, as it is the precursor of invasive carcinoma. The present study aimed to investigate the role of image analysis together with Ki-67 immunostaining in bladder dysplasia and invasive urothelial carcinoma

Materials and methods: This study was carried out in 80 urinary bladder paraffin blocks that were selected from the Department of Pathology of Kasr El-Aini Hospital, Cairo University, Egypt. The studied cases were divided into four groups: six cases of normal bladder mucosa, 12 cases of chronic cystitis, 18 cases of epithelial dysplasia, and 44 cases with transitional cell carcinoma. Morphometric analysis and Ki-67 expression were studied in all cases using an image analysis system

Results: All morphometric parameters, DNA index, and proliferating cells' percent and Ki-67 index were increasing from normal, chronic cystitis, dysplasia to carcinoma cases. However, nuclear area, length, size, and epithelial stromal ratio showed significant differences between dysplasia and carcinoma cases [P<0.05]. High-grade carcinoma showed significant enlargement of nuclear area and size, as compared with low-grade carcinoma. DNA index and proliferating cells' % showed a significant difference between dysplasia and carcinoma cases. Both parameters were significantly higher in high-grade carcinoma. Normal bladder and chronic cystitis cases exhibited negative stain for Ki-67. However, all cases of dysplasia and carcinoma exhibited a positive stain for Ki-67. The carcinoma cases showed a significantly higher Ki-67 index [68%] than the dysplastic cases [34%]

Conclusion: The present study revealed the usefulness of image analysis together with Ki-67 expression in discriminating cases of bladder dysplasia and carcinoma

Expression of estrogen receptors in epithelial ovarian carcinoma

Background/aim: epithelial ovarian cancer accounts for ?3% of female cancers. Steroid hormones such as estrogen and progesterone are thought to play an important role in the process of carcinogenesis of ovarian tumors. There are two subtypes of the nuclear estrogen receptor [ER-alpha and ER-beta] encoded by separate genes. This work aimed to evaluate the expression pattern of ER-alpha and ER-beta in epithelial ovarian carcinoma and their correlation with tumor histopathological parameters and proliferating cell nuclear antigen expression as a proliferation marker

Materials and methods: a total of 50 cases of epithelial ovarian carcinoma were included in this study. All cases were female patients who underwent oophorectomies or subtotal or total hysterectomies with oophorectomies. Surgical specimens were sent to Pathology Department at Kasr El-Aini hospitals and to private laboratories. The cases were graded and staged according to WHO systems. The cases were stained by hemotoxylin and eosin for histopathological grading, and they were immunohistochemically stained for ER-alpha, ER-beta, and proliferating cell nuclear antigen using streptavidin-biotin technique

Results: in this study, 56% of cases were positively stained for ER-alpha. It is significantly correlated with both of the tumor histological type and proliferative state of the tumors. There was a significant inverse correlation between ER-alpha expression and the tumor histological grade. Approximately 62% of cases were positively stained for ER-beta. There was a significant inverse correlation between ER-beta positivity and both of the tumor stage and proliferative state of ovarian carcinoma cases

Conclusion: the loss of ER-beta, not ER-alpha, expression in ovarian tumors may be a feature of malignant transformation suggesting its potential role as tumor suppressor gene. Determination of ER subtypes may improve response to hormonal therapy using a selective ER modulator in selected cases of ovarian carcinoma

Assessment of metabolic syndrome in obese children and adolescents

The dramatic increase in the prevalence of childhood obesity and its resultant co morbidities are associated with significant increase in the prevalence of the metabolic syndrome in children and adolescents. To detect the prevalence of metabolic syndrome [MS] among obese children and adolescents attending to Suez Canal University Hospital. The study was done on 84 obese child and adolescent. All of them were subjected to history taking, clinical examination and laboratory investigations for assessment of metabolic syndrome among them. The prevalence of the metabolic syndrome was 53.3% and there were statistically significant relationship between its prevalence and the degree of obesity [p<0.05]. Each component of metabolic syndrome gets worse with increasing the degree of obesity. The prevalence of the metabolic syndrome is high among obese children and adolescents, and it increases with worsening obesity

Immunohistochemical study of metallothionein isoform ii in hyperplastic, dysplastic and neoplastic prostatic lesions

Metallothioneins [MTs] constitute a family of several intracellular, low molecular-weight proteins with a high affinity to various heavy metals. They are involved in metalloregulatory functions such as cell proliferation, growth, and differentiation. The goals of the present study were to investigate the expression of MT in hyperplastic, dysplastic and neoplastic prostatic lesions and to correlate its expression with histologic grade of prostatic carcinoma. This study was performed on Formalin fixed and paraffin embedded tissue blocks from 8 patients with benign prostatic hyperplasia [BPH], 6 patients with prostatic intraepithelial neoplasia [PIN] and 30 patients with prostatic carcinoma [PC] using streptavidin-biotin technique. The histologic grade was defined and the carcinoma cases were divided into 8 low grade [Gleason 2-4], 12 moderate grade [Gleason 5-6] and 10 high grade [Gleason 7-10] carcinoma. Normal and benign prostatic tissues showed patchy MT staining of epithelial cells. All cases of PIN, 20 out of 30 PC cases [66.7%] showed positive staining for MT. MT expression significantly increased from low to high grade tumours. The proportion of MT positively stained cells was directly correlated with histologic grade of PC. The epithelial cells lack uniformity in staining intensity, but the percentage of strongly positive cells increased with increasing the histologic grade of PC. The high incidence of MT expression in PIN in this study suggests that it is associated with early prostate tumorigenesis. Also MT expression was directly correlated with histologic grade of PC suggesting that MT may be a useful marker for predicting prognosis of cancer prostate