Evaluation of different p16 immunostaining methods and the prognostic role of p16/Ki-67 combined expression in non-muscle invasive bladder cancers.

There are many scoring methods evaluating the expression of p16 in the bladder immunohistochemically. In this study our aim was to determine an optimal p16 scoring method by discussing different staining methods related with p16 expression in bladder cancers and to establish the association of p16 and Ki-67 expressions, alone or in combination, with recurrence and progression. Ninety patients undergoing their first transurethral resection for bladder cancer and newly diagnosed papillary urothelial carcinoma (pTa and pT1) were included in the study. Four different scoring methods were used for p16 (p16a, p16b, p16c, p16d). The patients were divided into two groups based on recurrence and progression. There was a statistically significant difference between recurrence and abnormal p16d staining (p = 0.005). In other staining patterns of p16, there was no statistically significant difference in terms of recurrence or progression.In the multivariate logistic regression analysis, combined Ki-67 ≥ 10 and abnormal p16d staining was found to be the only independent predictive factor for recurrence (OR = 2.26, 95% CI: 0.13-46.41, p = 0.035) and no independent predictive factor for progression was found. Determining an adequate expression scoring by taking normal transitional epithelial staining pattern as a reference would be an objective approach in p16 evaluation. Moreover, it was found that evaluating p16d and Ki-67 in combination would be significant in predicting recurrence in pTa and pT1 urothelial carcinomas.

Diagnostic and prognostic importance of the neutrophil lymphocyte ratio in breast cancer.

BACKGROUND: The aim of this study was to determine diagnostic and prognostic roles of the neutrophil to lymphocyte ratio (NLR) in breast cancer patients. To date, data are limited on associations of primary breast carcinoma (PBC) and benign proliferative breast disease (BPBD) with preoperative NLR values. MATERIALS AND METHODS: Our study covered of 120 female patients with PBC and 50 with BPBD. Diagnostic values of NLR were estimated using sensitivity, specificity and areas under receiver operating characteristic curves (AUC). RESULTS: NLR values were significantly higher in the PBC patients than in those with BPBD, with an AUC of 0.668 in the PBC case. The optimal cut-off for NLR was 2.96 and this was validated in the testing set, giving a sensitivity and a specificity of 79.7% and 76.2%, respectively, in PBC patients. CONCLUSIONS: Preoperative high NLR is a significant diagnostic predictor of distinction of breast cancer from BPBD and elevated NLR is also an important prognostic marker for primary invasive breast cancer.

The role of the actinomyces in obstructive tonsillar hypertrophy and recurrent tonsillitis in pediatric population.

OBJECTIVE: To determine the prevalence of tonsillar Actinomyces in subjects with recurrent tonsillitis and those with obstructive tonsillar hypertrophy, and to determine the association between the presence of Actinomyces and tonsillar volume, and crypt abscess. SUBJECTS AND METHODS: A prospective designed cross-sectional study consisted of 90 children subjects who underwent tonsillectomy or adenotonsillectomy for recurrent tonsillitis and obstructive tonsillar hypertrophy. The subjects of recurrent tonsillitis (Group A) and obstructive tonsillar hypertrophy (Group B) were compared to the presence of Actinomyces. The relationship between the presence of Actinomyces and the presence of crypt abscess, and tonsillar volume were also compared. RESULTS: Actinomyces was found to be significantly more prominent in obstructive tonsillar hypertrophy group (61.5%) compared to recurrent tonsillitis group (26.6%) (p<0.001). Additionally, the mean tonsillar volume was significantly higher in tonsils with Actinomyces than those without (p<0.001). The histopathological study revealed that there was no significant inflammatory response to the existence of Actinomyces. CONCLUSION: According to the presented study, Actinomyces was seen more prominent in subjects with obstructive tonsillar hypertrophy compared those with recurrent tonsillitis. Furthermore Actinomyces had a pathological influence on tonsil size. This study showed there was a significant relation between Actinomyces and enlargement of tonsillar tissue. However, how causes tonsillar hypertrophy is not understood yet in tonsillar disease.

Fibrous pseudotumors of tunica albuginea, tunica vaginalis and epididymis: report of two cases.

We describe two rare cases of fibrous pseudotumor of the paratesticular region. In the first case, five nodules arising from the tunica albuginea of right testicle causing scrotal, enlargement raising after urinary tract infection were seen. In the second case, multiple nodules arising tunica albuginea, tunica vaginalis and epididymis raising after left varicocelectomy operation were observed. The histology showed a paucicellular fibroblastic proliferation of cells within a hyalinized collagenous fibrous stroma containing numerous thin-walled blood vessels accompanied by lymphocytes and plasma cells in tumor tissues in both cases. Tumors in both cases were successfully resected. After operation, both patients had an uneventful recovery without any complications.