RESUMO
Prostate cancer is the most common malignancy in men and the second leading cause of cancer death in the Western world. P53 alterations are the most frequent genetic changes in human cancers. Mutation of the p53 gene has been implicated in the development of >50% of all human cancers. The current study aims at evaluating the immuno-histochemical expression of p53 protein in patients with cancer of prostate, as prognostic parameter in correlation with other parameters including PSA receptors, and to correlate the results with those of other studies. Fifty two cases of prostate carcinoma in which the PSA receptor status was previously tested by immuno-histochemical staining, were included in this retrospective study. The prostate carcinoma specimens include 16 cases were obtained from needle biopsies, 34 cases were from Transurethral Resection of the Prostate [TURP], and 2 were obtained from open prostatectomy specimens. The blocks of these cases were collected from Al-Jumhuri Teaching hospital in the western side of Mosul city, northern Iraq, and from some private laboratories, during the period extending from 7[th] April 2010 to 7[th] June 2010. Sections from formalin fixed paraffin embedded biopsy blocks were taken on clean slides and stained with H and E, then examined under light microscope. Grading of the cases was done according to Gleason grading system. The expression of p53 protein was evaluated immuno-histochemically; the findings were correlated with the age of the patients, Gleason score, tumor differentiation and the Prostatic Surface Antigen [PSA] receptor status.P53 expression was detected in 15 cases of prostate carcinoma [29%]. The patients age ranged from 41-90 years, [mean =68.05 +/- 2.1 years]. Most of them were in the 6[th] decade, P53 expression has a statistically significant relationship with patients' age [P value < 0.05]. A statistically significant direct relationship was found between p53 expression and different Gleason scores of prostate carcinoma [P value <0.01]. It was highest in Gleason scores 9 and 10 [60%, 80%], respectively, while Gleason scores 3 and 5 failed to demonstrate positivity [0%]. An inverse relationship was found between p53 expression and tumor differentiation, which was statistically significant [P value < 0.05]. P53 had higher expression in poorly differentiated adenocarcinoma of prostate [48.2%]. Positive expression of p53 was inversely significantly associated with positive monoclonal and polyclonal antibodies PSA receptors cases. Most of monoclonal and polyclonal antibodies PSA receptors positive cases of prostate carcinoma [90.4%, 96.1%], respectively failed to show p53 expression positivity [76.6%, 72%], respectively, [P <0.01, <0.05], respectively. In conclusion, P53 expression has been found 29% of prostate carcinoma in Mosul city. P53 expression is directly correlated with the age of the patients and Gleason score, while inversely correlated with tumor differentiation of prostate carcinoma. Also, this study revealed a significant inverse relationship between p53 expression and monoclonal and polyclonal antibodies PSA receptors status
RESUMO
The aims of this study are to identify the Immunohistochemical [IHC] expression of Glial Fibrillary Acidic Protein [GFAP] in different types of neuroepithelial tumors in Mosul city and to correlate the results with grade of tumor, with the results of other studies and to assess the diagnostic role of GFAP in the diagnonsis of neuroepithelial tumors and their differentiation from neuroglial tumors. This study included 56 cases of neuroepithelial tumors. 22 cases were collected during the period extending from October 2007 to May 2008. [The rest of the cases were retrieved from a filing system extending back to 2004]. In addition to two miscellaneous tumors, [one meningioma and the other secondary adenocarcinoma]. All cases were obtained from Al- Jamhuri Teaching Hospital in the western side of Mosul City, Northern Iraq and some private laboratories. Typing and grading of the tumors were done according to World Health Organization [WHO] classification system. IHC procedure was done for GFAP using polyclonal antibodies and chromogen visualizing system. A semi-quantitative histochemical score was used to record the results of GFAP staining according to the system established by Catherine L. Nutt et al. Thirty seven cases were diagnosed as astrocytoma, while 8 cases out of ependymoma, 4 cases of oligodendroglioma, and three cases medulloblastoma were shown. In addition, this study revealed that one case for each of: oligoastrocytoma, Medulloepithelioma, atypical rhabdoid tumor and astroblastoma. Glial Fibrillary Acidic Protein [GFAP] was expressed in 85.7% of neuroepithelial tumors. Higher GFAP positivity was found in glioma than other types of neuroepithelial tumors [P value <0.05]. On the other hand, GFAP was expressed in [36%] of astrocytoma. In oligodendroglioma, 3 cases out of 4 were positive while all cases of ependymoma were positive. In addition, oligoastrocytoma was positive while the remaining cases of neuroepithelial tumors were negative. In general, each type of glioma had special staining pattern of GFAP. GFAP status was found to be inversely related with the grade of glioma [P value <0.05]. GFAP is expressed more frequently in glioma than in other neuroepithelial tumors and this result is similar to many other studies done outside Iraq and it is correlated inversely with the grade of tumor. So, it is a valid supplementary diagnostic procedure for neuroepithelial tumors and a reliable marker to differentiate between glial from non-glial tumors on one hand and between different types of glial tumors on the other hand