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.

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.