Expression of cytokeratin 7/20 and Ki67 in Helicobacter pylori-associated gastritis and intestinal metaplasia.

INTRODUCTION: Cytokeratins (CKs) have been associated with precancerous and cancerous gastric lesions in patients with Helicobacter pylori-associated chronic gastritis, making them useful for diagnosing epithelial tumors. METHODOLOGY: A retrospective study was conducted utilizing 200 formalin-fixed paraffin-embedded gastric biopsy samples collected from the lesser curvature of the stomach. Samples from the control group, patients with H. pylori infection, and patients with H. pylori-associated gastritis, with complete and incomplete intestinal metaplasia (IM) were immunostained. Monoclonal antibodies were utilized to determine the expression of CK7, CK20, and Ki-67. RESULTS: Patients infected with H. pylori had strong CK20 expression on the surface, and weak CK7 expression on the surface and deep glands; while non-specific chronic gastritis patients had weak focal CK7 expression and strong CK20 expression. The normal gastric mucosa of patients in the control group had relatively weak CK7 expression, restricted to a few cells in the neck and deep glands. CK20 showed diffuse strong reactivity on the surface. On the other hand, patients with complete IM showed a CK7 staining pattern that was either negative or weakly focal on the surface and crypts associated with diffuse surface CK20 and focal crypt staining corresponding to gastric type IM. The Ki67 proliferating index was low (≤ 15%) in H. pylori infected patients, high (> 30%) in patients with incomplete IM, and intermediate (16-30%) in patients with complete IM. CONCLUSIONS: These results indicate a significant link between the expressions of CK7/CK20 and Ki67 in patients afflicted with H. pylori and IM.

Stromal CD10 expression in gastric adenocarcinoma.

Gastric adenocarcinoma is a malignant neoplasm of the gastric mucosa composed of neoplastic cells and supporting stroma as with any neoplasm. Stromal myofibroblasts have an essential role in creating the tumor-promoting environment. They express certain substances, such as CD10. In this study, stromal CD10 expression was investigated by immunohistochemistry in gastric carcinoma, and its association with specific clinicopathological parameters was analyzed. Formalin-fixed paraffin-embedded blocks of 80 gastric adenocarcinoma cases were collected retrospectively in a private laboratory of the Rizgary Teaching Hospital for 2 years (January 2018-January 2020). Finally, the immunohistochemical study of CD10 expression in stromal cells was performed. According to the results, stromal CD10 immunoreactivity was detected in 15% of the cases. Furthermore, a statistically significant correlation was observed between stromal CD10 and the tumor type (P=0.015). However, no statistically significant relationship was identified between stromal CD10 expression and patients' age, gender, lymphovascular invasion, lymph node status, and tumor stage and grade. The results suggest a statistically significant positive correlation between stromal CD10 expression and tumor type.

Immunohistochemical Expression of CDX2 in Gastric Carcinoma.

Background & Objective: Gastric cancer (GC) persists to be a major health issue globally, and the need to investigate new molecular markers for improving the survival of patients continues. CDX2 is a homeobox caudal protein family member encoded by the CDX2 gene and is probably playing a role in intestinal epithelial differentiation and proliferation. This study aimed to assess the expression of this protein in gastric cancer cells in addition to its correlation with multiple clinicopathological parameters. Methods: This observational retrospective study was carried out on 80 gastric cancer cases in Erbil, Iraq. CDX2 protein immunoexpression in tumor cells, as well as its correlation with several clinicopathological criteria, were investigated. Results: CDX2 was detected in 38.75% of GC patients. We found a significant correlation between CDX2 expression and the age of patients (P=0.02). Even though the protein was more expressed in tumors with negative lymphovascular invasion and intestinal GC, there was no significant correlation between the expression of this protein and invasion. In addition, CDX2 expression was not significantly correlated with patient gender, tumor grade, nodal status, and tumor stage. Conclusion: CDX2 expression was observed to be downregulated in younger patients. It could be due to the higher frequency of diffuse GC, in which CDX2 is expressed less than the intestinal type, in younger individuals.

Immunohistochemical expression of ATRX in gliomas.

Glioma is one of the primary tumors of the central nervous system that occurs in the spinal cord or brain and the origin of the tumor is from glial cell cells. The most common site of glioma tumors is the brain. Glioma accounts for 30% of all central nervous system tumors and 80% of malignant brain tumors. Alpha-thalassemia/mental retardation syndrome X-linked (ATRX) mutations are frequently distinguished in gliomas. Current research is an attempt to assess ATRX immunoexpression in different types of gliomas diagnosed, in Erbil-Iraq, and to evaluate its association with patient's age, gender, tumor location, grade and type. From January 2015 to January 2017, we reviewed and analyzed 97 cases of glioma. Immunohistochemical staining, for ATRX, was performed using an automated immunostainer technique. According to the WHO grading system for brain tumors, 16 (16.5%) cases were grade I gliomas, 27 (27.8%) were grade II, 10 (10.3%) were anaplastic gliomas (grade III), and 44 (45.3%) cases were glioblastomas WHO (grade IV). Positive ATRX immunoexpression was demonstrated in 27 (27.8%) cases. The highest rates of ATRX expression (55.6%) were among 30-39 years' age group, supratentorial (34.2%), and among grade II and III tumors (40.7% and 30% respectively). A significant association was observed between ATRX expression and patient's age, tumor location, tumor type and grade (p-values 0.010, 0.004, 0.004, and 0.037 respectively). No significant association was found between ATRX expression and patient's gender (p-value 0.097). It was found that ATRX is frequently expressed in grade II and III astrocytomas and was significantly related to the patient's age, tumor location, type and grade, so it can be used as a good diagnostic and prognostic indicator for glioma.

Immunohistochemical expression of MGMT in Gliomas.

Glioma is one of the main tumors of the central nervous system occurring in the spinal cord or brain, and is the origin of glioma tumors. The most common site of glioma is the brain. Glioma accounts for 30% of all central nervous system tumors and 80% of malignant brain tumors. O6-methylguanine-DNA methyltransferase (MGMT) gene mutations have been identified in many human cancers including gliomas. This study aimed to evaluate the immune expression of MGMT in different gliomas and its relationship with different clinicopathological parameters. From January 2015 to January 2017, 97 cases of glioma were retrieved from the Rizgary Pathology Center in Erbil-Iraq. The tumors were typed and graded according to the 2007 World Health Organization Brain Tumor Classification. Immunohistochemical staining was done for MGMT using monoclonal Antibodies via the automated immunostainer technique. Positive MGMT immunoexpression was observed in 60 (61.9%) cases. Significantly high rates of MGMT immunoexpression were demonstrated among the 2 age groups: 45-54 years and 25-34 years (23.3% and 21.7% respectively). Most positive cases were observed among the supratentorial tumors (81.7%) and dominant grade IV gliomas (48.4%) with no significant association. Immunohistochemically, MGMT is frequently expressed in gliomas particularly in glioblastomas with bimodal age association.

Effect of local propolis irrigation in experimental periodontitis in rats on inflammatory markers (IL-1ß and TNF-α) and oxidative stress.

AIMS: The present study aimed to investigate the efficacy of local use of propolis (PRO) as a monotherapy or adjunctive therapy to scaling and root planning (SRP) in the treatment of ligature-induced periodontitis (LIP) in rats by evaluating inflammatory markers and oxidative stress. SETTINGS AND DESIGN: The present study was carried out at Hawler Medical University, College of Dentistry, and the animals used in the study were rats that were housed in an animal facility at the College of Medicine. The experimental part of the study was carried between December 2016 and August 2017. SUBJECTS AND METHODS: In total, 125 rats were equally divided into 5 groups of 25 animals: the control group (C) with no experimental periodontitis or treatment (gp1), LIP treated by local irrigation with a vehicle (dimethyl sulfoxide + physiological saline solution) group (gp2); LIP treated by SRP with vehicle irrigation group (gp3); LIP treated by local irrigation with 10% PRO extract group (gp4); and LIP treated by SRP with 10% PRO extract irrigation group (gp5). Experimental periodontitis was induced by placing a silk ligature around the cervix of the mandibular incisor for 4 weeks. After removal of the ligature, SRP was performed in gp3 and gp5. Five rats from each group were euthanized on days 0, 3, 7, 14, and 21 after local treatment. Intracardiac blood samples were obtained for analysis of the inflammatory cytokines interleukin-1 beta (IL-1ß) and tumor necrosis factor alpha (TNF-α) and oxidative stress, which were represented by the expression of serum malondialdehyde (MDA). STATISTICAL ANALYSIS USED: Data were analyzed statistically by analysis of variance followed by Tukey's test (P < 0.05). RESULTS: Gp5 demonstrated significantly lower IL-1ß, TNF-α, and MDA serum levels than the other treatment groups at all experimental time points (P < 0.05). No significant differences were found when PRO was used as a monotherapy (P > 0.05). CONCLUSIONS: Local use of a PRO extract was effective as an adjunctive treatment with SRP in a rat model of experimental periodontitis via anti-inflammatory and antioxidative activities.

Oral and maxillofacial pathology submitted to Rizgary Teaching Hospital: a 6-year retrospective study.

INTRODUCTION: The majority of surveys concerning oral pathology accessions have focused on specific pathological categories or particular age groups, and few studies have analysed the whole range of specimens submitted for histopathological examination. An analysis of all oral pathology submitted to the Department of Histopathology in Rizgary Teaching Hospital in Erbil, Iraq, during the 6-year period 2008-2013, was performed. METHODS: Histopathology samples (excluding smears) from the maxillae, mandible, salivary glands, the lips and oral mucosa, the tongue, the hard and soft palate and uvula, and the pillars of the fauces were included. The specimens were grouped into six diagnostic categories: oral mucosal and skin pathology; benign neoplasms; malignant neoplasms; non-neoplastic salivary gland disorders; cysts; and miscellaneous pathology. RESULTS: The total number of oral and maxillofacial specimens was 616 of 20,571 specimens. One-third of the oral and maxillofacial specimens were in the mucosal and skin pathology category, followed by benign neoplasms (24.2%) - of which 26.8% were odontogenic tumours and 42.6% were salivary gland tumours - and malignant neoplasms (n = 100, 16.2%). Neoplastic (n = 62) and non-neoplastic (n = 41) salivary gland disorders accounted for 16.7% (n = 103) of the specimens submitted, whereas odontogenic cysts (n = 34) and tumours (n = 40) comprised 5.5% and 6.5% of all biopsies. CONCLUSIONS: Many of our findings are consistent with those reported in the literature. However, a relatively larger proportion of neoplastic lesions were found in our cohort and in other Iraqi centres. Of concern to practising clinicians in Iraq is that one in 10 biopsies submitted was a squamous cell carcinoma and three in 20 accessions were malignant.