Clinical, Histopathological, and Immunohistochemical Characteristics of Predictive Biomarkers of Breast Cancer: A Retrospective Study.

Background/Aim: Breast cancer is a complex disease with variability in clinical manifestation, response to current therapy, and biochemical and histological features among various subgroups. Histologic grading and immuno-histochemical evaluation of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 proliferation index play a crucial role in increasing the differential diagnostic value among various types of breast carcinoma. The aim of this study was to determine the histopathological and immuno-histochemical characteristics of breast tumors from a University Laboratory of Pathology in Greece. Patients and Methods: The study included female patients over 18 years of age, whose histopathological and immunohistochemical reports were stored in the archives of the First Department of Pathology of National and Kapodistrian University of Athens. The study involved 197 female patients with a median age of 70 years and median tumor size of 2.6 cm. Results: Most tumors were located at the left breast and ductal carcinoma was the most common histologic type (35.5%). Most tumors had histologic grade 2 (106, 53.8%), and were classified as TNM stage IIA (65, 33%). Most grade 1 and 2 tumors exhibited high expression of PR, whereas most grade 3 tumors had no PR expression. Moreover, patients with triple-negative cancer presented with grades 2 and 3 at a lower percentage compared to patients without a triple-negative phenotype (p=0.001). Conclusion: The study provided valuable insights into the histopathological and immuno-histochemical characteristics involved in the development and progression of breast cancer.

Unravelling the Role of P300 and TMPRSS2 in Prostate Cancer: A Literature Review.

Prostate cancer is one of the most common malignant diseases in men, and it contributes significantly to the increased mortality rate in men worldwide. This study aimed to review the roles of p300 and TMPRSS2 (transmembrane protease, serine 2) in the AR (androgen receptor) pathway as they are closely related to the development and progression of prostate cancer. This paper represents a library-based study conducted by selecting the most suitable, up-to-date scientific published articles from online journals. We focused on articles that use similar techniques, particularly those that use prostate cancer cell lines and immunohistochemical staining to study the molecular impact of p300 and TMPRSS2 in prostate cancer specimens. The TMPRSS2:ERG fusion is considered relevant to prostate cancer, but its association with the development and progression as well as its clinical significance have not been fully elucidated. On the other hand, high p300 levels in prostate cancer biopsies predict larger tumor volumes, extraprostatic extension of disease, and seminal vesicle involvement at prostatectomy, and may be associated with prostate cancer progression after surgery. The inhibition of p300 has been shown to reduce the proliferation of prostate cancer cells with TMPRSS2:ETS (E26 transformation-specific) fusions, and combining p300 inhibitors with other targeted therapies may increase their efficacy. Overall, the interplay between the p300 and TMPRSS2 pathways is an active area of research.

Association Between ERG/PTEN Genes and Pathologic Parameters of Prostate Cancer With an Emphasis on Gleason Score: A Literature Review.

BACKGROUND/AIM: The purpose of this article was to review the association between the ETS-related gene (ERG) and the phosphatase and tensin homolog (PTEN) genes with pathologic parameters of prostate cancer, emphasizing on Gleason score. MATERIALS AND METHODS: We performed a PubMed-based search of the literature emphasizing on articles that use pathological techniques, and especially on those that report the use immunohistochemical staining and FISH to investigate the association between ERG and PTEN mutations with the histopathologic parameters of prostate cancer. RESULTS: ERG expression is frequently marked in patients with prostate cancer, usually due to the occurrence of the TMPRSS2:ERG gene fusion. Although some studies reported a potential link between the expression of ERG and Gleason score, there is no strong evidence supporting this finding. On the contrary, there is more solid evidence correlating loss of PTEN expression with worse prognosis and higher Gleason scores. Few studies correlate the over-expression of ERG gene with the loss of PTEN expression. Finally, PTEN and ERG have been studied as potential therapeutic targets, and several promising results have been reported. CONCLUSION: Although, at some degree, ERG expression seems to be associated with the morphological features of prostate cancer, different studies reported controversial results. However, expression of PTEN is more clearly associated with the pathology and clinical course of the disease. More research is required to elucidate the role of these molecules in the molecular pathology of prostate cancer, as well as their potential use as therapeutic targets.

"Starting from the Image": A Tele-pathology Pre-graduate Course Aimed at Motivating Medical Students.

In the tele-course entitled "Starting from the image", medical students are confronted with practical tasks in relevant professional contexts. Initially, a macroscopic or microscopic image of a patient case is presented to learners who then receive relevant information on the patient's history, clinical findings, and other laboratory tests. A pathologist actively discusses the pathological findings; then, a clinician explains their implications for the patient's individualized treatment and prognosis. In this way, pathology's interaction with other medical specialties is highlighted. Students declared that through these simulated professional practice experiences, they strengthened their decision-making skills. Educators should consider upgrading from information-based teaching to practice-focused instruction.

Experiential student study groups: perspectives on medical education in the post-COVID-19 period.

BACKGROUND: Undergraduate medical curricula often fail to integrate experiential learning methodologies. Thus, a pilot series of interactive pathology lessons was designed and implemented in an attempt to promote experiential learning. METHODS: Thirty pre-graduate medical students voluntarily participated in the interactive study groups at the First Department of Pathology of the National and Kapodistrian University of Athens, Medical School. A questionnaire was designed to investigate the satisfaction of students regarding their participation in pathology study groups and to identify the characteristics that shape students' perceptions of the foundations of medical education. Descriptive statistics (mean values) were used to describe the students' evaluations of the pathology study groups, and thematic analysis was conducted to investigate the data collected using open-ended questions. RESULTS: Interactions with the professor and the option of co-observing the slides using dual-view optical microscopes and virtual slides were each evaluated as "Excellent" by ≅ 95% of the students. Four overarching themes were identified regarding the core characteristics of medical education according to the students' perspectives: 1) educational background in medical education, 2) interaction with educators in medical education, 3) educational material in medical education and 4) assessment in medical education. CONCLUSIONS: The high rates of acceptance of the pathology study groups reflect the desire and need for active learning methodologies to be implemented in modern medical education. Nearly all the students mentioned the need for practical skill acquisition, the integration of theory into practice and ethics in medical education. The success of these optional pathology study groups highlights the need for similar modalities to be incorporated into the main medical education curriculum.

Asynchronous E-learning after synchronous E-learning in the pathology course. When is the proper time for this transition?

BACKGROUND: Recordings of live streaming e-lessons of pathology at medical school of National and Kapodistrian University of Athens, Greece are uploaded to the e-class portfolio of each student enrolled in the course. We measured the number of views each video received and noticed that this number exceeded the number of enrolled students. Our main aim was to investigate the correlation between the upload of an educational video and the views it got so as to determine when the proper time is for professors to e-share or upload an educational video for the students. MATERIALS AND METHODS: We measured the number of views of the recorded e-lessons when all videos were uploaded, with a frequency of 15 days. We used analysis of variances statistical analysis to find the significance of the amount of time each video had been uploaded on the virtual platform of the course. We also applied t-tests to assess the significance of alteration of the number of views related to the amount of time until the examinations. RESULTS: Time was a statistically significant factor in the impact of an educational video. The two-factor analysis without interaction measured P ≃ 0.001, proving the strong correlation between time and the increase of views. As the examination date was approaching, there was a statistically significant increase in the number of views of the videotaped e-lessons. Almost 50% of the views of each of the videos took place in the two-week examination period of the course. CONCLUSIONS: The educational videos that contained the core learning concepts of the pathology course should be uploaded first. The complex learning points of the pathology course must be available at the beginning of the semester. Additionally, recordings of videos covering the complex learning points of the course should be uploaded as an additional tool of asynchronous e-learning for the students who choose to watch their former e-lessons to prepare for the examinations.

Evaluating e-Learning in the Pathology Course During the COVID-19 Pandemic.

Purpose: Synchronous and asynchronous e-learning is a promising and effective educational method for the delivery of medical lessons. Due to the public health measures implemented during the COVID-19 pandemic, our Pathology Department faced the challenge of a total online transition of the lessons. Therefore, the aim is to evaluate the aspects of the applied e-learning method they received. Materials and Methods: At the end of the semester when e-learning was applied, we designed a structured questionnaire consisting of 17 items via Google Forms, which took the students between 5 and 7 minutes to complete. Of the 257 students registered on the Pathology course in the fifth semester, 207 students (80.5%) returned completed valid questionnaires. Results: Fifteen of the seventeen components of the e-learning Pathology questionnaire were evaluated highly by the vast majority of the students. The two remaining items, the HIPON platform and the Microlabs e-lessons, were evaluated highly by almost half the students. Approximately 93% of medical students answered that e-learning could be integrated with real class lessons in the medical curriculum: 62.8% (N = 130) of students answered to a great extent, and 30.4% (N = 63) answered to a small extent. Statistically significant differences were found between the demographic characteristics of the participants (gender, permanent residence, working status) and their evaluation of the e-learning items. Conclusion: E-learning was successfully implemented for the delivery of the pathology lessons and was widely accepted by the students, providing evidence for its future integration into the medical curriculum. Our findings illuminate various aspects of the students' experience with e-learning, and we strongly recommend that the students' evaluation and perspective be taken into consideration by the faculty in the development of policies for higher-quality medical education.

Participation and Interactivity in Synchronous E-Learning Pathology Course During the COVID-19 Pandemic.

PURPOSE OF THE ARTICLE: Due to the COVID-19 outbreak, educational institutions had to utilize online platform solutions to deliver their curriculum. We conducted this study to explore participation and interactivity in a synchronous e-learning non-mandatory participation course in pathology at a medical school in Greece. The knowledge acquired is expected to be instrumental in the development of educational practices. MATERIALS AND METHODS: The data for this study were gathered through the recorded video archives of the synchronous e-lessons. We observed online participation at seven time points during each of the assessed e-lessons. Moreover, we identified and categorized the professor's/students' interactivity patterns according to content. RESULTS: The maximum number of students participating in the first e-lesson was N = 196. We recorded a reduction of N = 91 students, approximately 46%, in maximum student participants from the second observed e-lesson, and an additional decrease of N = 28 students, approximately 27%, from the third observation. Participation numbers continued to lessen. Even though there was a statistically significant difference in the mean percentage of students participating between the seven time points of each e-lesson, the difference in the mean percentage of students' online participation between the seven e-lessons assessed was not statistically significant. This indicates a consistent e-audience. Evidence of interactivity was summarized in a table, and each professor-students interaction was classified according to its content. We found that the professor posed questions to his students every 2-5 minutes during every synchronous e-lesson and e-tutorial observed, and students wrote 3-6 answers in chat in response to each question. Students asked more questions as more synchronous e-learning classes took place, with limited exceptions. CONCLUSION: From our perspective, our observations set the basis for further research to enhance our understanding of the aspects of the e-learning environment towards the formulation of policies for higher-quality education. PLAIN TEXT: Our pathology department places high value on the quality of education that the medical students receive. Due to the COVID-19 pandemic, our department had to deploy e-learning modalities for curriculum delivery. Thus, we conducted this research to evaluate a pathology e-learning class in terms of students' participation and the interactivity dynamics between them and the professor. We used statistics to measure participation during each e-lesson and identified recurring patterns of interactivity. We avoided imposing our predetermined interpretations of the data in this study so as to present an accurate depiction of the aspects of the e-learning environment. We were very pleased to identify a steady e-audience despite the drop-out rate from one e-lesson to the next, as well as strong, increasing interactivity patterns between the students and the professor, as students posed more and more questions from one e-lesson to the next. We are looking forward to future studies that address the e-learning procedure's challenges and provide evidence of its effectiveness and quality.

Correlation between LGR5 stem cells and location of tumor as well as age, sex and metastasis in colon adenocarcinoma.

PURPOSE: G-protein receptors belong to a large family of receptors which includes more than 800 kinds. An interest for these receptors arose upon noticing their expression on skin, intestine and breast stem cells. METHODS: We examined the tissues of 53 patients who had been diagnosed with adenocarcinoma of the colon. There were no exclusion criteria. We measured the expression levels of LGR5 by immunohistochemistry and we correlated those and the location of the colon primary tumor with the age, sex and the metastatic potential. RESULTS: The median values of the two groups- the orthosigmoid and the other colon location- were 1 and 3.5 respectively with no statistical significance and with p=0.132. Spearman Rho indicated no statistical significance between the expression of LGR5 and age with p=0.219. Moreover, the Mann-Whitney U test showed no statistical significance between LGR5 and sex with p=0.778. Fisher's test, however, showed a statistically significant result between metastasis and expression of LGR5 with p=0.025. CONCLUSION: It becomes apparent that patients with increased expression of these two markers are characterized by a more aggressive form of the disease with an increased rate of metastasis. Also, interactions on both paths lead to a simultaneous overexpression, thus proving the diversity of carcinogenic pathways. Racial and other factors are not affected, and ultimately the need to target these indicators in treatment protocols is imperative.