Relation of cyclooxygenase-2 expression with premalignant gastric lesions.

INTRODUCTION: We studied the relation between premalignant gastric lesions and cyclooxygenase-2 (COX-2) expression. METHODS: The study included 254 patients, who were histo- logically diagnosed with chronic active gastritis, atrophy, dys- plasia and metaplasia. Gastric biopsy specimens of the patients were histopathologically examined in terms of the presence of Helicobacter pylori (H. pylori) infection, atrophy The Operative Link for Gastritis Assessment ; (OLGA staging system), dysplasia (Vienna classification), and metaplasia (Sydney classification). COX-2 expression was investigated by immunohistochemical staining. COX-2 immunoreactivity score was calculated as the product of staining intensity and staining area. A score of >1 was defined as COX-2-positive expression. RESULTS: Of these patients, 84 (33.1%) had negative COX-2 expression (Score 0 and Score 1) and 170 (66.9%) had positive COX2 expression (Score 2 and Score 3). We found that in patients with a moderate-marked metaplasia, or with moderate-severe atrophy, a higher OLGA stage, or with dysplasia, the COX-2 expression was found to be higher than those with mild lesions. In 59.8% of the patients H. pylori was positive. While, the rate of severe atrophy was higher in H. pylori-positive patients ; no significant difference was determined between the H. pylori-positive and H. pylori-negative patients regarding age, smoking status, intestinal metaplasia grade, dysplasia, and COX-2 expression. CONCLUSION: We found a relation between the level of COX-2 expression and the grade of premalignant gastric lesions. COX-2 plays an important role in the gradual process resulting eventually in gastric cancer.

High risk HPV in situ hybridization, p16 INK 4A, and survivin expressions in cervical carcinomas and intraepithelial neoplasms: evaluation of prognostic factors.

BACKGROUND: Cervical carcinoma (CC) is one of the most important health problems of adult women in developing countries. CC is the second most common carcinoma of the women worldwide. Efficient screening and early therapeutic programmes are vital because of the higher burden of the disease. MATERIALS AND METHODS: The authors included a total of 53 cases in this study. Distribution of diagnoses among cases was as follows: cervical intraepithelial neoplasm (CIN) (n=44), squamous cell carcinoma (SCC) (n=7), adenocarcinoma in situ (n=1), and condyloma accuminatum (n=l). Presence, density, and nuclear identification form of human papilloma virus (HPV) DNA in relation with host cell DNA were evaluated by in situ hybridization (ISH) and p16 and survivin by immunohistochem- ical methods (IHC). RESULTS: The authors determined that the presence, density, and nuclear identification form of high risk HPV DNA had diagnostic and prognostic importance in CC and CIN (p < 0.05). p16 and survivin also had diagnostic significance. Since p16 and survivin expressions signalled progressive oncogenic events, p16 and survivin were persistent HPV markers (for p16, p < 0.001, for survivin p < 0.01). The authors determined that expressions, density, and prevalence of all three markers showed correlation with increasing CIN grade (for p 16, p < 0.001, for survivin, p < 0.01, for HPV, p = 0.002). The episomal pattern which is the independent visit of Hr HPV DNA to host cell DNA, signalled early HPV infection (p = 0.001). When it is integrated into host cell DNA, especially if HPV DNA signal intensity and prevalence increases, then this signal signifies persistent HPV infection (p = 0.001). CONCLUSION: With the aid of these findings, the authors determined that HPV is infectious in CIN I and proliferative (neoplastic) in CIN II-CIN III lesions.