Imunoterapia com células CAR-T como nova perspectiva de tratamento da leucemia linfoblástica aguda recidivada/refratária / Immunotherapy with CAR-T cells as a new treatment perspective for relapsed/refractory acute lymphoblastic leukemia

Introdução: O tratamento da leucemia linfoblástica aguda (LLA) atualmente baseia-se em quimioterapia e/ou transplante de células tronco hematopoiéticas; entretanto, uma nova terapia vem se tornando promissora: a imunoterapia com células T modificadas geneticamente que expressam um receptor de antígeno quimérico (CAR-T) visando antígenos específicos presente em blastos de LLA, gerando resultados promissores em crianças e adultos com doença recidivada e refratária (r/r). Objetivo: Discorrer sobre a LLA e descrever a imunoterapia com CAR-T, como inovação terapêutica no tratamento da LLA de linhagem B. Método: Foi realizada uma revisão bibliográfica por meio de publicações indexadas nas bases de dados Scielo e Pubmed, utilizando os descritores: leucemia linfoblástica aguda de células B; células CAR-T; receptores de antígeno quimérico, recidivados/refratários; imunoterapia. Resultados: As altas taxas de remissão completa (42% até 100%) e parcial (28,5%) da LLA (r/r) tratadas com CAR-T, possibilitam um aumento considerável da sobrevida geral comparado a outros tratamentos convencionais. Efeitos desfavoráveis, tais como síndrome da liberação de citocinas (CRS) (0 até 90%) e neurotoxicidade (NT) (0 até 29%) podem ser vistos, sendo manejáveis, não prejudicando o desfecho do tratamento. Conclusão: A LLA é uma doença grave, de difícil tratamento e prognóstico reservado. A imunoterapia vêm se mostrando promissora à essa enfermidade, principalmente em casos de doença r/r se mostrado uma ferramenta poderosa que permite o foco específico de células malignas por meio de engenharia de células T

Introduction: The treatment of acute lymphoblastic leukemia (ALL) is currently based on chemotherapy and/or hematopoietic stem cell transplantation; however, a new therapy is becoming promising: immunotherapy with genetically modified T cells that express a chimeric antigen receptor (CAR-T) targeting specific antigens present on ALL blasts, reaching promising results in children and adults with relapsed and refractory disease (r/r). Objective: To discuss ALL and describe immunotherapy with CAR-T as a therapeutic innovation in the treatment of B-lineage ALL. Method: A literature review was carried out through publications indexed in the Scielo and Pubmed databases, using the following descriptors: B-cell acute lymphoblastic leukemia; CAR-T cells; chimeric antigen receptors, relapsed/refractory; immunotherapy. Results: The high rates of complete (42% to 100%) and partial remission (28.5%) of ALL (r/r) treated with CAR-T allows a considerable increase in overall survival compared to other conventional treatments. Unfavorable effects such as cytokine release syndrome (CRS) (0 to 90%) and neurotoxicity (NT) (0 to 29%) can be seen, being manageable, not impairing the treatment outcome. Conclusion: ALL is a serious disease, with a difficult treatment and poor prognosis. Immunotherapy has shown benefits for this disease, especially in cases of r/r ALL, showing itself to be a powerful tool that allows the specific focus of malignant cells through T cell engineering.

Hallazgos Inmunofenotípicos, Morfológicos y Citogenéticos de las Leucemias Linfoblásticas Agudas en Pediatría / Immunophenotypic, Morphological and Cytogenetic Findings of Acute Lymphoblastic Leukemia in Pediatrics

Introducción: Las leucemias linfoblásticas agudas (LLA) son proliferaciones clónales malignas de células en distintos grados de diferenciación y representan las neoplasias más frecuentes en la edad pediátrica. El objetivo de este estudio es determinar las principales características inmunofenotípicas, biológicas y moleculares de las LLA en nuestro medio. Métodos: Se realiza un estudio retrospectivo, de tipo no experimental, descriptivo, y longitudinal de los pacientes diagnosticados de LLA durante el periodo comprendido entre 2004 a 2009 en el Instituto Oncológico Nacional "Dr. Juan Tanca Marengo" Solca, Guayaquil. Resultados: Se analizaron un total de 316 pacientes, con una edad promedio de 6 años. Por sus características morfológicas fueron clasificados como FAB L1 en 90.5 % de los casos (n=286). En base a su inmunofenotipo 91.8 % (n=290) de los mismos correspondieron a una LLA de fenotipo B y un 8.2 % (n=26) a una de fenotipo T, el con un predominio de la variedad B común. Se reportaron 45 casos de translocaciones, siendo a más común la t(12;21). En relación al cariotipo este se reportó como normal en 229 casos (72.5 %) y se evidenciaron gran variabilidad de alteraciones en el restante 27.5 %, prevaleciendo las hiperdiploidías. Conclusión: Una mejor clasificación y estatificación de los pacientes, por medio de la correlación de los hallazgos inmunofenotípicos, morfológicos y citogenéticos permitirá establecer nuevas estrategias terapéuticas con una mejor sobrevida.

Introduction: Acute lymphoblastic leukemias (ALL) are malignant clonic proliferations of cells at different degrees of differentiation and represent the most frequent neoplasms in pediatric age. The objective of this study is to determine the main immunophenotypic, biological and molecular characteristics of ALL in our environment. Methods: A retrospective, non-experimental, descriptive and longitudinal study of patients diagnosed with ALL during the period between 2004 and 2009 is carried out in the pediatric area of the National Oncology Institute "Dr. Juan Tanca Marengo "Solca, Guayaquil. Results: A total of 316 patients were analyzed, with an average age of 6 years. Due to their morphological characteristics, they were classified as FAB L1 in 90.5% of cases (n = 286). According to their immunophenotype, 91.8% (n = 290) of them corresponded to an ALL of the phenotype B and 8.2% (n = 26) to one of the phenotype T, with a predominance of the common variety B. 45 cases of translocations, the most common being t (12; 21). In relation to the karyotype, this was reported as normal in 229 cases (72.5%) and there was a great variability in the alterations in the rest of 27.5%, with hyperdiploidías prevailing. Conclusion: A better classification and staging of patients, through the correlation of immunophenotypic, morphological and cytogenetic findings, will allow the establishment of new therapeutic strategies with better survival.

Sacubitril/Valsartan in Asian Patients with Heart Failure with Reduced Ejection Fraction

The Prospective comparison of Angiotensin Receptor-neprilysin inhibitor (ARNI) with Angiotensin converting enzyme inhibitor (ACEI) to Determine Impact on Global Mortality and morbidity in Heart Failure (HF) trial (PARADIGM-HF) showed that adding a neprilysin inhibitor (sacubitril) to a renin-angiotensin system blocker (and other standard therapy) reduced morbidity and mortality in ambulatory patients with chronic HF with reduced ejection fraction (HFrEF). In PARADIGM-HF, valsartan combined with sacubitril (a so-called ARNI) was superior to the current gold standard of an ACEI, specifically enalapril, reducing the risk of the primary composite outcome of cardiovascular (CV) death or first HF hospitalization by 20% and all-cause death by 16%. Following the results of PARADIGM-HF, sacubitril/valsartan was approved by American and European regulatory authorities for the treatment of HFrEF. The burden of HF in Asia is substantial, both due to the huge population of the region and as a result of increasing CV risk factors and disease. Both the prevalence and mortality associated with HF are high in Asia. In the following review, we discuss the development of sacubitril/valsartan, the prototype ARNI, and the available evidence for its efficacy and safety in Asian patients with HFrEF.

Actualización en el uso de inhibidores de la neprilisina y del receptor de angiotensina II: onda expansiva en el beneficio sobre distintas entidades / Update on the use of neprilysin inhibitors and angiotensin II receptor: shock wave for the benefit of different entities

Resumen La insuficiencia cardiaca es una de las principales enfermedades a nivel cardiaco debido a su mayor riesgo de mortalidad y de hospitalizaciones por descompensaciones agudas o por presencia de novo de falla cardiaca, por eso en los últimos años se desarrollaron a partir de estudios clínicos randomizados, medicamentos que mejoraran estos eventos, a partir del estudio PARADIGM-HF. Con el surgimiento de sacubitril/valsartan se evaluó su efecto en diferentes escenarios, así el enfoque de este artículo se basa en la revisión de artículos con el objetivo de analizar la importancia de los efectos be neficiosos del sacubitril/valsartan en comparación con enalapril en diferentes análisis y subestudios basado en el estudio PARADIGM-HF, en los cuales se evaluó el impacto del sacubitril/valsartan en diabetes mellitus tipo 2, en la función renal, hipertensión arterial, a nivel de mortalidad y seguridad, a nivel de edad, de hiperkalemia e hiperkalemia severa, en los factores asociados con la falta de cumplimiento durante el período de ejecución antes de la aleatorización y la influen cia en el beneficio estimado de sacubitril/valsartan en el ensayo PARADIGM-HF, eficacia de sacubitril/valsartan con dosis metas bajas, tolerabilidad y seguridad en el inicio de sacubitril/valsartan en insuficiencia cardiaca, efectos de sacubitril/ valsartan asociado a antagonistas de receptores de mineralocorticoides en la reducción de hiperkalemia, implicaciones en el pronóstico de los pacientes con insuficiencia cardiaca con fracción de eyección reducida con los cambios de pépti dos natriuréticos, eficacia y seguridad de sacubitril/valsartan en distintos rangos de edades, efecto del fármaco sobre la terapia de fondo utilizada en insuficiencia cardiaca y eficacia e influencia de sacubitril/valsartan en la fracción de eyección y desenlace primario.

Abstract Descriptores: sacubitril/valsartan, enalapril, insuficiencia cardiaca, péptidos natriureticos Heart failure is one of the main diseases at the cardiac level due to its higher risk of mortality and hospitalizations due to acute decompensation or de novo heart failure, which is why in recent years they were developed from randomized clinical trials. medicines that will improve these events, from there and from the PARADIGM-HF study. From the emergence of sacubitril / valsartan its effect was evaluated in different scenarios, hence the focus of this article was based on the review of articles and with the aim of analyzing the importance of the beneficial effects of sacubitril / valsartan compared to enalapril in different analyzes and substudies from the PARADIGM-HF study, which will evaluate the impact of sacubitril / valsartan in type 2 diabetes mellitus, in renal function, arterial hypertension, in terms of mortality and safety, in terms of age, hyperkalemia and severe hyperkalemia, in the factors associated with non-compliance during the execution period before randomization and the influence on the estimated benefit of sacubitril / valsartan in the PARADIGM-HF trial, efficacy of sacubitril / valsartan with low target doses , tolerability and safety at the onset of sacubitril / valsartan in heart failure, effects of sacubitril / valsartan associated with antag of mineralocorticoid receptors in the reduction of hyperkalemia, implications in the prognosis of patients with heart failure with reduced ejection fraction with changes in natriuretic peptides, efficacy and safety of sacubitril / valsartan in different age ranges, effect of the drug on the background therapy used in heart failure and the efficacy and influence of sacubitril / valsartan on the ejection fraction and primary outcome.

Effects of benzo(a)pyrene on expressions of insulin-degrading enzyme and neprilysin in neuroglia cells / 北京大学学报(医学版)

OBJECTIVE@#To investigate effects of benzo(a)pyrene (BaP) on expressions of insulin-degrading enzyme (IDE) and neprilysin (NEP) which have the ability to degrade β-amyloid (Aβ) in neuroglia cells.@*METHODS@#Primary mix-neuroglia cells were cultured from newborn SD rats. After exposure to BaP, Aβ1-42 oligomer or Aβ1-42 fiber individually or jointly for 24 h, the cell survival rate was measured by cell counting kit-8 (CCK-8). Afterwards, the primary mix-neuroglia cells were divided randomly into six groups: Control group, BaP group (2.00 μmol/L), Aβ1-42 oligomer group (20.00 mg/L), BaP plus Aβ1-42 oligomer group, Aβ1-42 fiber group (20.00 mg/L) and BaP plus Aβ1-42 fiber group, of which BaP was pretreated for 12 h followed by cotreatment with different aggregated Aβ1-42. The expressions of IDE and NEP were measured by quantitative real-time polymerase chain reaction (qRT-PCR) for mRNA level and Western blotting for protein level.@*RESULTS@#The cell survival rate showed no significant differences after treatment with BaP (≤20.00 μmol/L), Aβ1-42 oligomer (20.00, 40.00 mg/L), Aβ1-42 fiber (20.00, 40.00 mg/L) or cotreatment with BaP and Aβ1-42 oligomer or BaP and Aβ1-42 fiber. Compared with the control group, expressions of IDE and NEP in BaP-treated alone group had no obvious change; however, exposure to Aβ1-42 oligomer alone significantly increased the mRNA and protein level of IDE (P<0.05), and the BaP pretreatment could significantly inhibit the up-regulated expressions of IDE by Aβ1-42 oligomer (P<0.05); on the other hand, exposure either to Aβ1-42 fiber alone or under the BaP pretreatment did not change the mRNA and protein level of IDE and NEP obviously.@*CONCLUSION@#On the premise of no significant change of cell survival rate, BaP pretreatment inhibited the up-regulated expressions of IDE in primary mixed neuroglia cells under cotreatment with Aβ oligomer, indicating that BaP may disturb degradation of Aβ oligomer and cause deposition of β-amyloid and further induce cognitive decline and acceleration of Alzheimer.

Identification of neprilysin as a potential target of arteannuin using computational drug repositioning

ABSTRACT The discovery of arteannuin (qinghaosu) in the 20th Century was a major advance for medicine. Besides functioning as a malaria therapy, arteannuin is a pharmacological agent in a range of other diseases, but its mechanism of action remains obscure. In this study, the reverse docking server PharmMapper was used to identify potential targets of arteannuin. The results were checked using the chemical-protein interactome servers DRAR-CPI and DDI-CPI, and verified by AutoDock Vina. The results showed that neprilysin (also known as CD10), a common acute lymphoblastic leukaemia antigen, was the top disease-related target of arteannuin. The chemical-protein interactome and docking results agreed with those of PharmMapper, further implicating neprilysin as a potential target. Although experimental verification is required, this study provides guidance for future pharmacological investigations into novel clinical applications for arteannuin.

Condiciones de salud bucodental en niños menores de catorce años con leucemia linfoblástica aguda, antes del tratamiento de quimioterapia en el instituto del cáncer (SOLCA), Cuenca / Oro-dental health conditions in children under fourteen years who suffer acute linphoblastic leukemia (all) before receiving treatment and assist to the institute of cancer in Cuenca city (SOLCA)

Los objetivos de esta investigación son: establecer las condiciones de salud bucodental y las características sociodemográficas de los niños con Leucemia Linfoblástica Aguda (LLA) menores de 14 años que acuden al Instituto del Cáncer de Cuenca (SOLCA) y compararlos con los niños sanos que asisten a la clínica de Odontopediatría de la Facultad de Odontología de la Universidad de Cuenca; previo a que los niños reciban sus tratamientos respectivos. Se realiza un estudio analítico transversal en 32 niños con LLA y 32 niños sanos, emparejados por edad y sexo. Las características generales y sociodemográficas de los niños fueron aproximadamente similares; en la talla del rango de edad: > 4 a 7 años, se encontró que la diferencia estadística (X²) fue significativa p < 0,03, la talla fue mayor para el grupo con LLA. En lo que se relaciona a ingesta de medicamentos, exposición a factores ambientales y servicios básicos, las diferencias fueron estadísticamente significativas entre los dos grupos con valores de p= < 0,00; p= < 0,000; p= < 0,002 respectivamente; el grupo con LLA resultó ser más vulnerable que el grupo sano. Al comparar las manifestaciones bucales diagnosticadas entre los dos grupos, las diferencias estadísticas (X²) fueron significativas en lo que se refiere a equimosis, palidez de las mucosas, sangrado espontáneo de las encías en una o dos piezas dentarias, petequias y ganglios linfáticos palpables, con valores de p= < 0,01; p= < 0,001; p= <0,01; p= < 0,005; p= < 0,005 para cada uno. Los niños con LLA presentaron manifestaciones bucales en mayor porcentaje que los niños sanos. La diferencia de medias (prueba T) del I. Gingival Löe y Silness fue significativamente mayor en el grupo de niños con LLA que en el grupo control, 0,97±0,56 vs. 0,43±0,4, p= < 0,00. Este estudio revela que los niños con LLA constituye una población vulnerable a sufrir lesiones estomatológicas y que es prioritario que la atención odontológica sea incluida en los protocolos de atención del paciente infantil oncológico

The objectives of this research are: to establish the oro-dental health conditions and the socio-demographic features of children who suffer acute linphoblastic leukemia (ALL) who are under fourteen years of age and assist to the institute in cancer of Cuenca city (SOLCA) and to compare them with healthy children who assist to the Odontopediatric Clinic of the Dentistry School of the University of Cuenca; before all children receive their respective treatment. This is an analytical transversal study, which includes 32 children suffering ALL and 32 healthy children; coupled by age and gender. The sociodemographic features of ALL children were approximately the same. The age scale is : >4-7 years old; in which we found a significative difference p < 0,03;being greater for the group. In relation to medicines intake; exposition to environmental factors and basic social services, the differences were statistically significative between the two groups with p valves: p=< 0,00; and p < 0,02 for each one. The ALL group is more vulnerable than the healthy group. Comparing the oro-dental lesions between the two groups, the differences were statistically significative (X²) refering to: ecchymosis, mucose pallor, spontaneous bleeding of gums in one or two teeth units, petechiaes and lymph node enlargement, the following p values: were obtained p=< 0,01; p=< 0,001; p=< 0,005 for each one. The ALL children group showed a larger frequence of oro-dental pathological signs, compared to the healthy children group. The mean difference ( T test) of the Loe y Silness Gingival Index was significantly higher in the ALL group than in the control group: 0,97 0,56 vs. 0,43 0,4; p=< 0,00. This research proves that children who suffer ALL, are vulnerable to present estomatological lesions; and therefore it becomes a priority to include dental care in the guideliness of medical care for children who suffer oncological conditions.

Expression and significance of HGAL and LMO2 in follicular lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of HGAL and LMO2 expression and compare with CD10 and bcl-6 in follicular lymphoma (FL).</p><p><b>METHODS</b>63 cases of FL were collected from Guangdong General Hospital. The expression of HGAL, LMO2, CD10 and bcl-6 was assessed by immunohistochemistry.</p><p><b>RESULTS</b>The expression rates of HGAL, LMO2, CD10 and bcl-6 were 98.4% (62/63), 82.5% (52/63), 82.5% (52/63) and 87.3% (55/63), respectively. The expression rate of HGAL was higher than those of LMO2, CD10 and bcl-6, but the differences were not significant (P>0.05). There was no significant difference in HGAL, LMO2 and bcl-6 expression among FL1, FL2 and FL3 cases. The CD10 expression rate of FL1-3A cases was significantly higher than that of FL3B cases(P<0.01).</p><p><b>CONCLUSIONS</b>HGAL and LMO2, especially HGAL, can be used in FL particularly high grade FL as useful germinal center marker.</p>

Expression of CD10 in tumor-associated fibroblast of cancerized or recurrent colorectal adenomas / 浙江大学学报·医学版

To investigate the expression of CD10 in tumor-associated fibroblasts (TAF) in colorectal adenomas and its relation to cancerization and recurrence of adenoma.Tissue samples of low-grade adenoma (=50), high-grade adenoma (=50) and colorectal adenocarcinoma (=50) were collected, and tissue samples at the distal margin of corresponding colorectal lesions were taken as controls. The expression of CD10 in the stromal TAFs, and the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells were detected by immunohistochemistry (Envision). The correlation of CD10 expression in stromal TAFs with the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells was analyzed by Spearmen. One hundred samples of low-grade colorectal adenoma were collected, including 57 non-recurrent cases and 43 recurrent cases (16 cases of recurrent adenoma and 27 cases of recurrent adenocarcinoma); the expression of stromal TAF CD10 were determined and compared among groups.There was no TAF in normal colorectal mucosa. The expression rates of TAF CD10 in low-grade adenoma, high-grade adenoma and colorectal adenocarcinoma were 22%, 50% and 78%, respectively (all<0.05). The expression of Ki-67 and β-catenin in low-grade adenoma, high-grade adenoma, colorectal adenocarcinoma was on a rising trend (all<0.01). The expression of CyclinD1 in high-grade adenoma was higher than that in colorectal adenocarcinoma and low-grade adenoma (all>0.05). The expression of p53 in colorectal adenocarcinoma and high-grade adenoma was higher than that in low grade adenoma (all<0.01). The expression of TAF CD10 was correlated with the expression of p53, Ki-67 and β-catenin-nucleus(=0.264、0.307、0.320, all<0.01),but not correlated with CyclinD1 and β-catenin-membrane (=0.012、-0.073, all>0.05). The TAF CD10 level was significantly higher in low-grade adenoma with recurrence than that in those without recurrence (<0.05).The expression of CD10 in recurrent colorectal adenocarcinoma was higher than that in recurrent adenoma (<0.05).The expression of TAF CD10 is increased gradually in the process of adenoma-cancer, indicating that it may play an important role in the canceration of adenoma. Adenomas with high expression of CD10 TAF are likely to be recurrent and cancerized, and detection of TAF CD10 combined with p53, Ki-67 and β-catenin may be of value in predicting canceration or recurrence of colorectal adenoma.

Substance P and Thiorphan Synergically Enhance Angiogenesis in Wound Healing

Impaired angiogenesis is a common pathological characteristic of chronic wounds. Therefore, the regulation of angiogenesis is important for proper tissue repair. It was reported that substance P (SP) accelerates wound healing in a skin injury model. SP is degraded by neutral endopeptidase (NEP). Our study shows that systemic co-treatment of SP and thiorphan, an inhibitor of NEP synergically increased the number of α-smooth muscle actin positive-blood vessels in skin wounds. However, there was no synergic improvement in wound contraction and extracellular matrix deposition. Therefore, inhibition of endogenous NEP activity by thiorphan treatment might modulate the effects of SP treatment specifically on accelerating angiogenesis during wound healing. However, the molecular mechanism(s) of the synergic increase in angiogenesis by SP and thiorphan treatment is still unknown.

Bone Marrow Flow Cytometry in Staging of Patients With B-cell Non-Hodgkin Lymphoma

BACKGROUND: Bone marrow biopsies are routinely performed for staging patients with B-cell non-Hodgkin lymphoma (NHL). In addition to histomorphological studies, ancillary tools may be needed for accurate diagnosis. We investigated the clinical utility of multiparameter flow cytometric examination of bone marrow aspirates. METHODS: A total of 248 bone marrow specimens from 232 patients diagnosed with B-cell NHL were examined. Monoclonal antibodies directed against CD19, CD20, CD10 (or CD5), and kappa and lambda immunoglobulins were used. Multi-stage sequential gating was performed to select specific cells of interest, and the results were compared with bone marrow histology. RESULTS: The concordance rate between histomorphology and flow cytometry was 91.5% (n=227). Eight cases (3.2%) were detected by flow cytometry alone and were missed by histomorphology analysis, and 6 of these 8 cases showed minimal bone marrow involvement (0.09-2.2%). The diagnosis in these cases included large cell lymphoma (n=3), mantle cell lymphoma (n=3), and mucosa-associated lymphoid tissue (MALT) lymphoma (n=2). Thirteen cases were histopathologically positive and immunophenotypically negative, and the diagnoses in these cases included diffuse large cell lymphoma (n=7), T-cell/histiocyte-rich large B-cell lymphoma (n=2), anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma (n=1), follicular lymphoma (n=1), MALT lymphoma (n=1), and unclassifiable lymphoma (n=1). CONCLUSIONS: Multi-color flow cytometry can be a useful method for assessing bone marrow in staging NHL and also plays a complementary role, especially in detecting small numbers of lymphoma cells.

Colonic Endometriosis / 대한소화기학회지

No abstract available.

Recurrent Müllerian adenofibroma of uterus: a clinicopathologic study of 7 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of recurrent Müllerian adenofibroma (MAF) of the uterus.</p><p><b>METHODS</b>Clinicopathologic information of 7 cases of recurrent MAF of uterus was retrieved from January 1992 to April 2006 and compared with 12 cases of MAF without recurrence and 14 cases of low-grade Müllerian adenosarcoma (MAS). EnVision immunohistochemistry of estrogen receptor (ER), progesterone receptor (PR), smooth muscle actin (SMA), CD10, Ki-67 and p53 were performed in all cases.</p><p><b>RESULTS</b>All cases of recurrent MAF of the uterus were polypoid, lobulated, and broad based mass arising from the corpus or cervix. Microscopically, the tumor consisted of benign epithelial and mesenchymal components with low mitotic activity ( ≤ 1/10 HPF). The clinical and pathologic features of 3 recurrent tumors were similar to their primary tumors, while 4 cases of recurrent tumor presented with focally higher cellularity and mitotic activity, meeting the diagnostic criteria of adenosarcoma. The stromal expression patterns of ER, PR, SMA and p53 in recurrent MAF were similar to those of clinically benign MAF and low-grade MAS. Negative or focally positive stromal cell expression of CD10 was seen infrequently in recurrent MAF (1/7) and clinically benign MAF (1/12). In contrast, a moderate to strong CD10 staining was frequently seen in MAS (9/14, P < 0.05). The difference of Ki-67-labeling index between MAF and MAS did not reach a statistical significance (P > 0.05). Ki-67-labeling index increased in areas of periglandular stromal cuffing as compared with interglandular areas in all MAS cases, but it was not observed in either recurrent MAF or clinically benign MAF cases.</p><p><b>CONCLUSIONS</b>Recurrent MAF may be associated with aggressive behavior. It is difficult to distinguish MAF from low-grade MAS. CD10 and Ki-67 staining pattern in stromal cells may be helpful for the differential diagnosis.</p>

Immunohistochemical expression of CD-10, BCL-6 and MUM-1 antibodies and immediate clinical response in patients of diffuse large B-cell lymphomas after six cycles of chemotherapy

To determine the expression of CD-10, BCL-6 and MUM-1 in patients with diffuse large B-cell lymphoma [DLBCL] and its association with immediate clinical response after six cycles of CHOP chemotherapy. Analytical study. Armed Forces Institute of Pathology [AFIP], Rawalpindi in collaboration with Nuclear medicine, Oncology and Radiotherapy Institute [NORI], Islamabad from September 2010 to September 2011. CD-10, BCL-6 and MUM-1 antibodies were applied on cases diagnosed as DLBCL. Immediate clinical response was noted after 6 cycles of chemotherapy with the help of oncologist and divided into complete response, partial response, stable disease and relapse/ progression. Patient's age, results of expression of CD-10, BCL-6 and MUM-1 and results of immediate clinical response to chemotherapy were noted. Regarding analysis of prognostic markers [CD-10, BCL-6 and MUM-1], chi-square test was used for immediate clinical response to chemotherapy in DLBCL. CD-10 was positive in 40% cases, BCL-6 in 58.7% cases and MUM-1 was positive in 46.7% cases. About 41.3% of patients showed complete response, 10.6% partial response, 17.3% stable disease and 30.8% showed relapse/progression. CD-10 expression in DLBCL was associated with better immediate clinical response [p = 0.011] whereas MUM-1 expression in DLBCL was associated with poor immediate clinical response [p < 0.0001]. However, there was no statistically significant association of BCL-6 with immediate clinical response [p = 0.22]. DLBCL shows expression of CD-10, BCL-6 and MUM-1 in nearly fifty percent of the cases. CD-10 is associated with good whereas MUM is associated with poor response. However, there was no association of BCL-6 with immediate clinical response

Effect of neoadjuvant chemotherapy on stromal CD10 antigens in breast cancer - A preliminary study.

Introduction: CD10 is a zinc-dependent peptidase (metalloproteinase). Stromal CD10 expression in breast cancer correlates with poor prognosis, oestrogen receptor negativity and higher grade. CD10 may be a potential target of new cancer therapies as it is involved in cleavage of doxorubicin. Aim: To evaluate the effect of neo-adjuvant anthracycline-based chemotherapy on status of stromal CD10 antigens in breast cancer. Materials and Methods: Patients with invasive breast cancer scheduled for anthracycline-based neo-adjuvant chemotherapy were included in the study. Tumor stromal CD10 expression was estimated before and after 3 cycles of chemotherapy, and change in its status was correlated with clinical response to chemotherapy. Results: 16 out of the 29 patients had strong CD10 expression; in these 16 patients, 14 (87.5%) were hormone receptor negative, and 14 (87.5%) had HER-2/neu overexpression. Stromal CD10 expression remained same in 13 out of 29 cases (44.83%) after chemotherapy. There was a change in CD10 expression in the remaining 16 cases (55.17%); in 13 cases (44.83%) it decreased from its pre-chemotherapy status, while its expression increased in 3 cases (10.34%). In cases of complete and partial clinical response, there was no increase in CD10 expression. Where CD10 expression had increased after chemotherapy, there was either a minor response or no response to chemotherapy. In 13 cases where CD10 expression had decreased, 12 cases had a clinical response to chemotherapy. Conclusions: Strong CD10 expression correlates with hormone receptor negativity and HER-2/neu overexpression. Stromal CD10 expression in breast cancer is not static and changes with neo-adjuvant anthracycline-based chemotherapy. A stable or decrease in CD10 expression correlates with complete or partial clinical response, while an increase in CD10 expression appears to correlate with poor clinical response. A larger series is required to determine the clinical significance of these changes. As stromal CD10 expression and its change with chemotherapy may have a prognostic significance, they should be documented in breast cancer patients before and after chemotherapy.

An Inverse Relationship between the Expression of the Gastric Tumor Suppressor RUNX3 and Infection with Helicobacter pylori in Gastric Epithelial Dysplasia

BACKGROUND/AIMS: This study was performed to determine the association between RUNX3 expression and Helicobacter pylori infection in premalignant gastric lesions. METHODS: We examined 107 patients with gastric epithelial dysplasia who had undergone endoscopic mucosal resection or submucosal dissection. All tissue samples were evaluated by RUNX3 staining and subclassified by immunophenotype. H. pylori infection in dysplastic lesions and the normal surrounding tissue was examined by silver staining, and cagA status was assessed by polymerase chain reaction. RESULTS: The loss of RUNX3 expression was observed in 62 cases (57.9%), and an association with H. pylori infection was found in 54 cases (50.5%). The infection rate with the cagA-positive H. pylori strain was 63.0%. In RUNX3-negative lesions, the rate of H. pylori infection (p=0.03) and the frequency of category 4 lesions (according to the revised Vienna classification) were high (p=0.02). In addition, the gastric mucin phenotype was predominant. In RUNX3-negative category 4 lesions, the rate of cagA-positive H. pylori infection rate was high but not significantly increased (p=0.08). CONCLUSIONS: Infection with H. pylori is associated with inactivation of RUNX3 in early gastric carcinogenesis. This mechanism was prominent in gastric cancer with a gastric mucin phenotype.

Diffuse large B-cell lymphoma of testis: a clinicopathologic and immunophenotypic study of 58 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic features, immunophenotype, diagnosis and differential diagnosis, and prognostic factors of testicular diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>The clinical and pathologic profiles of 58 cases of testicular DLBCL were investigated.Immunohistochemical stainings and EBER1/2 in situ hybridization were performed on formalin fixed tissues.</p><p><b>RESULTS</b>The average age of the patients was 62.1 years, and the median age was 65 years. The course of disease was short in most of the cases. Clinical stages at diagnosis were mainly stage I or II (87.9%, 51/58). Forty eight patients (82.8%) had unilateral testis involvement. Inguinal lymphadenopathy was observed in 12 (20.7%) patients and the other organs were seldom involved. Morphologically, centroblast-like neoplastic cells infiltrated interstitial tissue of testis diffusely and invaded into seminiferous tubules. Tunica albuginea and vessels were involved in 14 (24.1%) and 10 (17.2%) patients, respectively. Immunophenotype analysis showed predominant non-GCB type of DLBCL (48/58, 82.8%) by Hans classification. No EBV infection was detected. Follow-up data were available in 48 (82.8%) patients. Twenty eight patients (58.3%) died of the disease. One-year, 3-year, and 5-year overall survivals were 55.7%, 31.6% and 27.6%, respectively. Age (older than 60 years), B-symptoms, high serum level of LDH, advanced Ann Arbor stage as well as lack of combination of therapy were associated with a poor prognosis.</p><p><b>CONCLUSIONS</b>This large series of testicular DLBCL mainly present with local disease at diagnosis. Most cases show non-GCB immunophenotype. Despite early clinical stage at presentation, the prognosis is poor. Combined chemotherapy postoperation may prolong survival of the patients.</p>

Clinicopathologic characteristics of primary thyroid-like follicular carcinoma in kidney / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the clinicopathological characteristics of primary thyroid-like follicular carcinoma of the kidney.</p><p><b>METHODS</b>A case of primary thyroid-like follicular carcinoma of the kidney was studied with histology and immunohistochemical staining, and its clinical and pathological findings were further analyzed with review of the literature.</p><p><b>RESULTS</b>The patient was a 26-year-old asymptomatic woman who had a kidney mass during her annual physical examination. The tumor was well-circumscribed. Pathologically, the tumor showed follicular structures with colloid-like material in the lumina. Immunohistochemically, the tumor cells showed intense staining for CK7 and vimentin and negative for thyoid transcripation factor-1, thyroglobulin, thyoid peroxidase and RCC.</p><p><b>CONCLUSIONS</b>The diagnosis of primary thyroid-like follicular carcinoma of the kidney is based on the characteristic follicular architecture with colloid-like material, and the metastasis from a thyroid follicular carcinoma must be excluded clinically and pathologically before making the final diagnosis.</p>

Mercury induced the Accumulation of Amyloid Beta (Abeta) in PC12 Cells: The Role of Production and Degradation of Abeta

Extracellular accumulation of amyloid beta protein (Abeta) plays a central role in Alzheimer's disease (AD). Some metals, such as copper, lead, and aluminum can affect the Abeta accumulation in the brain. However, the effect of mercury on Abeta accumulation in the brain is not clear. Thus, this study was proposed to estimate whether mercury concentration affects Abeta accumulation in PC12 cells. We treated 10, 100, and 1000 nM HgCl2 (Hg) or CH3HgCl2 (MeHg) for 48 hr in PC12 cells. After treatment, Abeta40 in culture medium increased in a dose- and time-dependent manner. Hg and MeHg increased amyloid precursor protein (APP), which is related to Abeta production. Neprilysin (NEP) levels in PC12 cells were decreased by Hg and MeHg treatment. These results suggested that Hg induced Abeta accumulation through APP overproduction and reduction of NEP.