Expression of p53 and bcl-2 and response to preoperative chemotherapy and radiotherapy for locally advanced squamous cell carcinoma of the oesophagus.

AIMS: To investigate the immunohistochemical expression of p53 and bcl-2 proteins in squamous cell carcinoma (SCC) of the oesophagus and to assess whether expression of these oncoproteins can be used to stratify patients into groups with a favourable or unfavourable response to preoperative chemo/radiotherapy. METHODS: The initial diagnostic biopsy and the corresponding resected samples were obtained from 22 consecutive patients with SCC. All patients underwent preoperative chemo/radiotherapy. Tumour sections were incubated with a monoclonal antibody directed against p53 (DO-7). Twenty four non-neoplastic oesophageal biopsy specimens immunostained for p53 served as controls. Twelve randomly chosen sections from the 22 SCC samples were immunostained to test for bcl-2 protein expression. RESULTS: After chemo/radiotherapy, 12 (55%) of the 22 patients had no evidence of tumour in the resected oesophagus. Before chemoradiotherapy, however, 17 (77%) patients were p53 positive. After treatment, residual carcinoma was detected in seven (41%) of the 17 p53 positive patients. All non-responsive cases had the same p53 immunopattern as before treatment. Bcl-2 immunoexpression was detected in six (50%) of 12 patients. Residual tumour was detected in the residual oesophagus in two (33%) of the six bcl-2 positive patients. After treatment, bcl-2 expression was no longer detected in the residual neoplastic cells of a previously bcl-2 positive tumour. Using Fisher's exact test no significant association was found between oncoprotein expression and response to preoperative treatment. CONCLUSION: This study confirms the observation that p53 protein is frequently expressed in SCCs of the oesophagus, probably as a result of a mutation of the TP53 gene. However, no significant association was found between oncoprotein expression and response to chemo/radiotherapy. Anticancer agents do not seem to modify the expression of p53 and bcl-2 proteins.

[Clinical, histological and ultrastructural study of a case of giardiasis]. / Studio clinico, istologico ed ultrastrutturale di un caso di Giardiasi.

A case is described concerning an adult male whose work create a risk for infestation by Giardia. The patient had a long history of diarrhea with malabsorption which was resistant to the common therapies. Only after a EGDS examination the diagnostic possibility of infestation by parasites could be proposed; this was confirmed by means of ultrastructural examination of biopsy material. The Authors suggest that in case of inexplicable malabsorption and/or chronic diarrhea, one must always take into consideration in differential diagnosis the possibility of an infestation by Giardia especially when there is a history which could be suggestive for such an infestation (immunodeficiency, homosexuality, frequent trips to foreign countries).

[Melanoblastoma of the meninges. Immunohistochemical and ultrastructural study of a case]. / Il melanoblastoma delle meningi. Studio immunoistochimico ed ultrastrutturale di un caso.

Primary diffuse melanoblastomatosis of the leptomeninges is an uncommon disease and are not associated with any specific clinical or radiologic features. Diagnosis is usually post-mortem and first regard the interpretation of malignant melanoblastomatosis as a primary neoplasm; the situation is complicated by the fact that a primary melanoma, in this site, may metastasize to extraneural organs and a detailed dissection of the entire body, including the orbital contents, aims to reveal no primary tumor outside the nervous system. Differential diagnosis is V.S. others pigmented tumors of the C.N.S. Electronmicroscopic and immunohistochemical analysis were performed and confirmed the diagnosis.

[Histological, ultrastructural and clinical study of a malignant adrenal neoplasm producing minor mineralocorticoids]. / Studio istologico, ultrastrutturale e clinico di neoplasia maligna surrenalica con produzione di mineralcorticoidi minori.

The authors describe a case of an adrenal tumor of unusual dimensions with a benign histological appearance. After a short period diffuse metastases developed. The metastases should the features a poorly differentiated carcinoma. The size of the tumor appears to be a useful element of judgement in differential diagnosis between adenoma and carcinoma of the adrenal glands.