Immunohistochemical characterization of urothelial carcinoma.

From the archive of BB Biocyt company, 32 urinary bladder carcinomas (urothelium carcinomas, UC) and 7 cases of chronic cystitis were selected and examined in semiserial sections for the following antigens: 1) cell proliferation marker Ki-67 (expressed in the nuclei), 2) cell cycle regulator p16/INK4a polypeptide (expressed in the cytoplasm and nuclei), 3) urothelium marker p63 (expressed in the nuclei), 4) cytokeratin 7 (CK7). 5) cytokeratin 20 (CK20) and 6) high molecular weight cytokeratin (HMWCK). Invasive urothelium carcinomas showing a high grade dysplasia (invasive HG UC) comprised over the half (20 out of 32) of the investigated tumours. Microinvasion to lamina propria (seen in three HG papillary carcinomas) was regarded as an early infiltration even when the position of muscular layer could not be determined. Classical invasion across the urinary bladder wall and/or to surrounding tissues was found in 17 cases of low-differentiated HG UCs. The rest (9 out of 32 neoplasms) were either non-invasive papillary carcinomas of high (non-invasive HG UC, 5 cases) or low malignant potential (noninvasive LG UC, 4 cases). Finally, 3 cases were papillary urothelium neoplasms of low malignant potential (PUNLMP). HMWCK was present in all invasive tumours, whereas the frequency of other urothelium markers ranged from 65 to 88 %. Nevertheless, at least two markers were expressed in each invasive tumour. Staining for Ki-67 antigen was positive in over 50 % of the nuclei of HG UCs, while in the LG UCs, the frequency of positive Ki-67 staining did not exceed 25 %. In PUNLMP, the positive rate of Ki-67 stained dysplastic cells was below 10 %. The staining for p16 antigen did not correlate with the degree of dysplasia within urothelium tumours. For routine diagnostic, we recommend to combine the Ki-67 staining with detection of HMWCK. In cases of chronic cystitis, which developed urothelial hyperplasia and/or squamous metaplasia, the presence of p63 antigen was a relevant marker confirming the urothelial origin of the altered transitional cells (Tab. 6, Fig. 4, Ref. 69).

Expression pattern of anti-apoptotic protein survivin in dysplastic nevi.

UNLABELLED: The anti-apoptotic protein survivin was detected in a panel of 27 dysplastic nevi. From each representative paraffin block 4 mm sections were cut and stained with anti-survivin antibody (DAKO, Clone 12C4). In each section, the labeling intensity, the subcellular location of survivin antigen, the percentage of labeled cells and the degree of dysplasia were assessed. Survivin was present in 23 out of 27 cases (85.2%), but absent in 4/27 cases (14.8%). Positive staining was confined to the cytoplasm (C) of nevus cells only in 18 cases (66.7%), while cytoplasmic as well as nuclear positivity (NC) was found in 5 cases (18.5%). In no case solely nuclear staining could be seen. Furthermore, in 4 out of 5 cases (80%) with NC staining, severe dysplasia was found. Our data point at usefulness of survivin staining, otherwise rarely performed in dysplastic nevi. We confirm the importance of nuclear location of the survivin antigen, which may be helpful for assessing the possible progression to melanoma. KEYWORDS: survivin, immunohistochemistry, nevi, dysplasia, melanoma.

[Detection of regulatory protein p16/INK4A in the dysplastic cervical squamous cell epithelium is a diagnostic tool for carcinoma prevention]. / Detekcia regulacného proteínu p16/INK4A v dysplastickom dlazdicovom epiteli krcka maternice ako diagnostický nástroj prevencie karcinómu.

Parallel sections from 423 randomly selected blocks representing biopsies of 178 women with the diagnosis of cervical dysplasia and/or erosion were stained for p16 polypeptide. The p16/INK4A (inhibitory kinase 4) protein is a cellular division regulator, expression of which increases in the presence of oncoprotein E7, encoded by human papillomavirus (HPV). Expression of p16 protein was seen in the nuclei and cytoplasm of dysplastic squamous epithelium cells as well as in carcinoma cells. In 16.6% of erosion cases, the p16 antigen was present in the basal and suprabasal layer of the surrounding squamous epithelium revealing features of CIN I/LSIL. In CIN I/LSIL as classified by HE staining, the p16 antigen was found in 65 out of 80 (81%) cases. The p16 protein was typically seen in dysplastic basal and suprabasal cells encompassing a confluent layer in the lowest third segment of stratified epithelium. In CIN II and CIN III grouped as HSIL, the positive rate of p16 antigen presence was 95% (in 45 cases out of 47) and/or 100% (in each of 27 cases), respectively. The typical sign of p16 antigen distribution in HSIL was its staining over two thirds and/or throughout the whole dysplastic epithelium. Extensive staining for p16 antigen was registered within nuclei as well as cytoplasm of neoplastic cells in all 6 cervical squamous cell carcinomas, which were examined in many sections when being used as positive controls. Based on our experience, we consider the p16 antigen staining a helpful tool indicating dysplastic cells and estimating their extent.

Histological status of the liver in relation to serum aminotransferase levels in patients with chronic hepatitis C.

INTRODUCTION: The diagnosis of chronic hepatitis C is based on serological, biochemical and histological parameters. However, the correlation between the activity of liver enzymes and the degree of histomorphological damage may be very poor. It has been recognised that serum aminotransferase levels do not accurately reflect the extent of liver inflammation. OBJECTIVES: The aim of this retrospective study was to determine the predictive value of ALT, AST levels and AST/ALT ratio compared to histological grading and staging in patients with chronic hepatitis C. MATERIAL AND METHODS: We analysed data of 58 chronically HCV-infected adult patients who had udergone core needle liver biopsy. RESULTS AND CONCLUSION: In our study, most patients with chronic hepatitis C manifested with only mild histological findings. Although liver enzymes levels in general corresponded with the activity of the disease, even a normal level could not exclude a serious histological liver damage. Therefore, these facts should remind the physicians to perform a liver biopsy prior to therapy (Tab. 3, Ref. 19). Full Text (Free, PDF) www.bmj.sk.

[Morphologic study of mastocytes from skin biopsies in patients with non-systemic and systemic mastocytosis]. / Morfologická stúdia mastocytov z kozných biopsií pacientov s nesystémovou a systémovou mastocytózou.

The authors describe morphologic changes in mastocytes in the picture of transmission electron microscopy (TEM) and skin changes in patients with urticaria pigmentosa (7 causes) and systemic mastocytosis (2 causes). The presented study analyzes the changes in the cellular membrane and cytoplasmic processes, intracytoplasmic membrane structures, mitochondria, granules, and nuclei of mastocytes in patients with systemic mastocytosis. The authors evaluate these cells as being atypical, respectively immature. The study discusses the malignization of these states. (Tab. 2, Fig. 8, Ref. 16.)

Generalized melanosis with malignant melanoma metastasizing to skin--a pathological study with S-100 protein and HMB-45.

A patient with primary malignant melanoma localized to the right gluteal region is described. Four years later and after intercurrent influenza, disseminated metastases of malignant melanoma to the skin occurred. After a further 6 months melanodermia developed and lasted until the death of the patient (6 months later). Autopsy revealed melanosis of the visceral organs. Histology taken from internal organs using S-100 protein and HMB-45 melanoma methods confirmed metastases of malignant melanoma to the skin, oral cavity, palatal tonsils, nasal and nasopharyngeal mucosae, lungs, myocardium and brain. The authors discuss the mechanism of melanosis--a rare sign in patients with metastasizing malignant melanoma.

[Liver cirrhosis in surgical samples]. / Cirhózy pecene v chirurgickom materiáli.

1729 liver excisions from patients with laparotomy (1302 women, 427 men) were analyzed during 5 years (1984-1988). There were 12 cirrhoses among them (in 6 women and 6 men) with medium history of about 5 years. HBsAg was proved both according to Shikata and immunohistochemically in 4 cirrhoses, two of them were serologically positive, only one known before operation. A case of seroconversion was observed (repeated seronegativity with histochemical and immunochemical HBsAg positivity). Men: women ratio of 3:1 correlated with the literature as well as the prevalence of macronodular and mixed cirrhosis in women and micronodular cirrhosis in men. Paper points out an infection risk in surgical staff operating on cases with unrevealed HBsAg positivity.

[Quantification of metabolic substrates in the liver in neonates]. / Kvantifikácia metabolických substrátov v peceni novorodencov.

Main metabolic substrates were quantified by cytospectrophotometry in the liver of neonates, still-born and surviving till the 10th day. The surviving caused a decrease of PAS-positive diastase-digestible compounds. There was a simultaneous increase of lipids, nuclear DNA a cytoplasmic RNA in liver cells. Binucleate hepatocytes were more frequent. The results were correlated with the length of gestation and the birth weight.