Expression of cyclin-D1 and apoptosis regulating protein BCL-2 in infiltrating ductal breast carcinoma [NOS]

Breast carcinoma is the most frequently diagnosed carcinoma affecting females contributing for about 30% of all female cancers in Egypt Estrogen and progesterone receptors [ER and PR] have been used as tools to identify patients eligible for adjuvant treatments, yet they present some limits, as the existence of dysfunctional receptors made some ER positive tumours non-responsive to antiestrogen therapy. In breast cancer, Bcl-2 expression has been reported to be associated with better outcomes in patients treated with either hormone- or chemo-therapy. Also, the expression of the protein cyclin D1 is detected in up to 50% of primary breast cancers. Cyclin D1 over expression has been strongly associated with well-differentiated, estrogen receptor-positive ductal tumors The present work aimed at determining the expression of cyclin D1 and bcl-2 proteins in some cases of infiltrating breast ductal carcinoma not otherwise specified [NOS,] and to assess any possible relationship between each marker and estrogen receptor status of the tumour tissue. Thirty cases of infiltrating ductal carcinoma [IDC], not otherwise specified [NOS], 17 cases of which were associated with axillary lymph node metastases, in addition to 5 cases of florid epithelial hyperplasia were included in the study. For all studied cases routine histopathological examination and immunohistochemical staining by ER, bcl-2 and cyclin D1 antibodies were done. ER status showed positive ER immunoreactivity in 21 cases [70%] out of 30 [2 cases/2 were grade I, 14 cases /18 were grade II and 5 cases/10 were grade III]. Positive Bcl-2 immunoreactivity was observed in 23 cases of the 30 IDC cases [76.66%]: 2 cases/2 were of grade I, 16 cases/18 of grade II and 5 cases/10 were of grade III. o A statistically significant relation was found between bcl-2 immunoreactivity and ER expression in the malignant cases [p<0.0001]. Cyclin D1 expression was detected in 20 cases of IDC [66.66%], staining was nuclear and diffuse: 2 cases out of 2 of WD carcinoma and 4 cases of MD carcinoma out of 18 showed strong staining [score 1], 10 cases of MD carcinoma out of 18 showed moderate staining [score 2], and 4 cases out of 10 of PD carcinoma showed weak staining [score 3].All the cyclin D1 positive 20 cases were also ER positive [100%]. A statistically significant relation was found between cyclin D1 immunoreactivity and ER expression [p<0.0004]. Bcl-2 was strongly associated with ER positivity in the majority of breast carcinomas but over expression of cyclin D1 protein correlated with poor prognosis and it was demonstrated that its over expression distinguished malignant breast carcinomas from premalignant breast lesions as the less differentiated high grade tumors exhibited a more intense nuclear stain and the non-neoplastic epithelial components were not stained

updated research on calretinin immunohistological marker staining and ultrastructural verification of some cases of epitheliod malignant mesothelioma

Diagnosis of malignant mesothelioma is frequently a difficult problem for clinicians and pathologists alike. The diagnosis of malignant mesothelioma is dependent on assessment of clinical and radiological findings in conjunction with pleural fluid cytology and pleural biopsy. Immunohistochemical stains have proved most useful in most cases, but despite many antibodies showing potential, it is generally agreed that no one antibody shows absolute specificity or sensitivity for either tumor. Electron microscopy [EM] has been a classic gold standard tool used to confirm or identify mesothelial differentiation either focal or wide spread in most cases. However, prospective studies, which address the diagnostic accuracy of EM through a long series of unselected, clinically well- documented mesotheliomas, are lacking. Poorly differentiated cases need combinations of a mucin stain, IHC, and EM examination to confirm their mesothelial origin. Retrospective 15 cases of epitheliod mesothelioma were selected from the files of Pathology Department, Faculty of Medicine, Alexandria University; 10 cases were CT-guided needle biopsies and 5 cases were surgical specimens. Histopathological examination by routine stain using H and E revealed tumour cells showing staining by PASD was negative in all pleural cases and focally positive in the peritoneal case. Immunohistochemical staining by anti - calretinin showed 13 positive cases with nuclear and cytoplasmic brown staining [86.6%], one case / 15 [6.6%] was score 1,4 cases / 15 [26.66%] were score 2 and 8 cases / 15 [53.33%] were score 3. The 2 negatively - stained cases [13.3%] were subjected to further examination by EM. The micrographs showed tiny intracytoplasmic lumina having a microvillous border. The microvilli appeared long slender and curved disclosing their mesothelial origin

Immune detection of neuron specific enolase and human chorionic gonadotropin in some cases of high grade transitional cell carcinoma of the urinary bladder

One third of the cases of transitional cell carcinoma [TCC] ectopically produce trophoblastic hormones, which is specifically correlated with the stage and grade of the tumour. The larger clinical studies have shown that human chorionic gonadotrophin [HCG] expression correlates with tumours of poor prognosis, which subsequently metastasize or fail to respond to radiotherapy. Expression of neuron specific enolase [NSE] as a marker of neuroendocrine differentiation was not only observed in small cell carcinoma of the bladder, but also in advanced cases of TCC, though it was neither correlated significantly to grade or stage of malignancy. The material of the present work included 20 cases of TCC of different grades, all were retrospective cases obtained from the files of the Pathology Department, Faculty of Medicine, Alexandria University. Representative sections from the formalin-fixed paraffin blocks were cut into thin sections of about 5 microns thick, and examined by H and E stain to determine the grade of the tumour as well as its stage of invasion. Chosen sections were mounted on coated slides for immunohistochemical staining using anti-beta hCG and NSE using streptavidine biotin complex technique, followed by semi-quantitative assessment of immunohistochemically positive cells. Histopathologic examination of the included cases using Hand E revealed that 10 cases exhibited papillary pattern, whereas 10 other cases were of non-papillary pattern. One case was considered as papillary urothelial neoplasm of low malignant potential [PUNLMP], 2 cases were of grade I, 3 cases were of grade II, and 14 cases were of grade III. Multinucleated giant cells were encountered in 4 cases of high grade TCC Two cases were superficial papillary tumours [pTa], 6 cases were invading the lamina propria [p T 1] and 12 cases were invasive tumours [p T 2-4]. Immunohistochemical staining for HCG-beta revealed 11 positive cases [55%] and 9 negative cases [45%]. About 10 of the positively stained cases [71.4%] were of high grade carcinomas versus one positive case [16.7%] of low grade carcinoma [P = 0.024 asterisk]. Immunohistochemical staining by NSE revealed 4 positive cases [20%] appeared as focal brown cytoplasmic staining, all detected in poorly differentiated high grade carcinomas [grade III]. No significant correlation was seen between reaction to HCG and NSE staining [p = 0.53]. In the present study positive immunoreactivity to hCG was seen in the poorly differentiated high grade urothelial tumours [10 cases of grade III and one case of grade II], whereas almost all the tumours categorized as papillary urothelial neoplasm of low malignant potential [PUNLMP], all grade I cases and 2 out of 3 cases of grade II urothelial carcinomas were negatively stained. i. e, reaction to HCG was significantly correlated to the grade of carcinoma [p = 0.024 asterisk]. Similarly, the intensity of staining of the cytoplasm increased significantly with the increase of the grade of the tumour [p= 0.031 asterisk] as well as the stage of infiltration [p = 0.0005 asterisk]. in the present study, where only 4 cases out of 20 [20%] of the included cases[all were of grade III] were positively stained by NSE

Detection of the value of C-MYC oncoprotein in relation to estrogen receptor status as a prognostic factor in cases of grade I endometroid carcinomas versus endometrial hyperplasias

The mechanism of progression from endometrial hyperplasia to carcinoma, together in association with estrogen receptor have not been fully elucidated, also, c-myc oncoprotein expression may play a role in this progress. The aim of this study was to evaluate the expression of c-myc oncoprotein sequentially during the menstrual cycle as well as in some cases of endometrial hyperplasias and carcinomas, correlating it to estrogen receptor status. This study included tissue specimens obtained from 30 female patients, classified as normal cycle cases [10], endometrial hyperplasias [10], and endometrial carcinoma cases [10]. Tissue blocks from all cases were examined by H and E, as well as by immunohistochemical techniques using c-myc and estrogen receptor antibodies. The obtained results were evaluated statistically. Ten cases of normal cyclic endometrium [5 proliferative and 5 secretory] showed distinct, diffuse nuclear immunoreactivity to ER in the proliferative cases, while only 2 of the secretory cases showed focal weak staining pattern. As for c-myc, staining was strong nuclear in proliferative cases and moderate cytoplasmic in secretory cases. Immunoreactivity to ER was seen in 8 cases of endometrial hyperplasia, it was diffuse and strong in 2 cases of simple hyperplasia, moderate in 4 cases of complex hyperplasia without atypia and weak in 2 cases of atypical biopsies. As for c-myc, all hyperplastic cases were positive and showed cytoplasmic staining, moderate in simple cases and weak in complex cases with or without atypia. ER immunostaining was seen in 6 cases of endometriod carcinoma of which 3 were of grade I, 2 were of grade II, and one case was of grade III. On the other hand, all cases of carcinoma were positively stained by c-myc. Strong nuclear and cytoplasmic staining was observed in grade III cases, whereas only cytoplasmic staining was seen in lower grades. C-myc expression in normal cyclic endometrium appeared to be altered according to phases. During progression from hyperplasia to carcinoma, c-myc played a role in the development of carcinoma with the induction by estrogen leading to neoplastic transformation