Osteopontin expression correlates with invasiveness in cervical cancer.

AIM: Osteopontin is a secreted, integrin-binding glycophosphoprotein that is overexpressed in many types of cancers and appears to be involved in carcinogenesis and cancer progression. To understand the role of osteopontin in carcinogenesis of cervical cancer, this study was designed to determine whether osteopontin is expressed in cervical cancer and carcinoma in situ (CIS) tissue as well as in normal cervical tissue. METHODS: The expression of osteopontin was immunohistochemically analysed from 68 normal cervix, 55 CIS and 52 invasive cervical cancer tissues using a paraffin-embedded tissue array. Immunostaining was evaluated by intensity and the percentage of stained cells. RESULTS: Osteopontin expression in normal, CIS and cervical cancer tissues was two of 68 (2.9%), 43 of 55 (78.2%) and 46 of 52 (88.4%), respectively (P < 0.01). High intensity (strong positive)/high proportion (more than 50%) staining seen in CIS and cervical cancer tissue samples was 45 of 55 (81.8%)/22 of 55 (40.0%) and 50 of 52 (96.2%)/31 of 52 (59.7%), respectively (P = 0.029 and P = 0.054). There was no significant correlation between the immunostaining score and stage and the immunostaining score and survival. CONCLUSION: Osteopontin may have a potential use as a diagnostic factor for cervical cancer and osteopontin expression is closely correlated with carcinogenesis and invasion of cervical cancer.

BAG-1 expression in normal endometrium, endometrial hyperplasia and endometrial cancer.

BACKGROUND: BAG-1 (Bcl-2-associated athanogene 1) is a BCL-2 binding anti-apoptotic protein that may play a role in carcinogenesis. The purpose of this study is to compare the expression rate of BAG-1 in normal endometrium, endometrial hyperplasia and endometrial cancer, and further to determine a correlation between BAG-1 expression and clinicopathological parameters, and overall survival. METHODS: Tissue samples from 43 patients who were diagnosed with endometrial cancer, tissue samples from 20 patients with endometrial hyperplasia and tissue samples from 20 normal patients were included in the study. Immunohistochemical analyses were performed using a polyclonal anti-BAG-1 antibody from paraffin-embedded blocks. RESULTS: Cytoplasmic BAG-1 expression of the normal endometrium, endometrial hyperplasia and endometrial cancer samples was 4/20 (20%), 3/20 (15%) and 27/43 (62%), respectively. Nuclear BAG-1 expression was 17/20 (85%), 12/20 (60%) and 16/43 (37%), respectively. Cytoplasmic BAG-1 expression correlated with cancer grade (p=0.02). The mean survival of patients with positive/negative cytoplasmic BAG-1 expression and nuclear BAG-1 expression was 49.4/45.4 and 54.0/41.1 months, respectively, but there was no statistical difference for survival (log-rank p=0.31, p=0.55). CONCLUSION: Cytoplasmic BAG-1 is more frequently expressed in endometrial cancer tissues than in normal and endometrial hyperplasia tissues (p=0.0007), and its expression correlates with cancer grade. Nuclear BAG-1 is more frequently expressed in the normal endometrium and hyperplasia tissues than in endometrial cancer tissues (p=0.002). Neither cytoplasmic nor nuclear BAG-1 expression is associated with survival.

Prenatal diagnosis of a large subchorionic placental cyst with intracystic hematomas. A case report.

A large intrauterine cyst containing a heterogenous mass was found by ultrasound in the placenta of a 35-year-old gravida 2 para 1 woman. The cyst, measuring 10.9 x 10.1 cm with a heterogenous mass shadow, was attached near the placental cord insertion site. The woman delivered a healthy female baby weighing 3,330 g by cesarean section without complication. A histopathological examination revealed that the lesion was a subchorionic cyst and contained an internal hematoma. Large subchorionic cysts are extremely rare, and secondary hemorrhage within the cyst has not been reported. In this article, we report the case of a woman with a large subchorionic cyst complicated by an intracystic hematoma and review its clinical significance.

Significance of CD44v6 expression in gynecologic malignancies.

AIM: Variants of CD44 have been proposed to be important in cancer invasion and metastasis. The purpose of this study was to evaluate the diagnostic and prognostic value of CD44v6 expression in gynecologic malignancies. METHODS: Immunohistochemistry was used to determine the expression of CD44v6 in samples from a series of 65 cases of early cervical cancer, 76 cases of endometrial samples and 57 cases of serous epithelial ovarian tumors. We analyzed the expression of CD44v6 and correlated the findings with clinicopathological factors. RESULTS: In the cervical series, CD44v6 was detected in 60 cases of cervical cancer (92.3%). The immunoreactivity was decreased when stromal invasion reached a depth of more than 5 mm (P < 0.05). However, it was not correlated with other clinicopathological factors. In the endometrial series, CD44v6 was detected in one endometrial hyperplasia (6.7%) and in 24 endometrial cancers (100%), while it was not detected in the proliferative endometrium (P < 0.05). Immunoreactivity was decreased in grade 2 and 3 endometrial cancers compared with grade 1 (P < 0.05). In the ovarian series, CD44v6 was not detected in the benign tumors, but it was detected in four borderline malignancies (27%) and 12 carcinomas (40%). Immunoreactivity was not correlated with clinicopathological factors of ovarian cancer. CONCLUSION: CD44v6 may be involved in stromal invasion of early squamous cervical carcinomas and in the cellular differentiation of endometrial cancer. In addition, it may be useful for early diagnosis of endometrial cancer.

Occurrence of c-kit+ tumor cells in hepatitis B virus-associated hepatocellular carcinoma.

Progenitor cells, termed oval cells, are involved in the pathogenesis of hepatocellular carcinoma (HCC) in animal models. By immunolabeling for c-kit and CD34 in human hepatitis B virus-associated cirrhosis with HCC (50 cases) and those with cirrhosis alone (10 cases), we found c-kit+ tumor cells in tumor tissue in 40 of 50 HCCs. The proportion was less than 0.1% of total tumor cell volume in most HCCs. Immunostaining for c-kit also was detected in sinusoidal endothelial cells in 43 of 50 HCCs. The incidence of oval cell occurrence in the adjacent nonneoplastic tissue in cases of HCC was high (44/50). The occurrence of oval cells, c-kit+ tumor cells, and c-kit+ sinusoidal cells in cases of human hepatitis B virus-associated HCC suggests that oval cell proliferation might be associated with the development of human hepatitis B virus-associated HCC. Furthermore, the c-kit+ sinusoidal cells might have a role in angiogenesis and progression of human hepatitis B virus-associated HCC.

Accuracy and reproducibility of telecytology diagnosis of cervical smears. A tool for quality assurance programs.

We randomly selected 50 cervical smears (benign, 14; atypical squamous cells of undetermined significance [ASCUS], 5; low-grade squamous intraepithelial lesion [LSIL], 10; high-grade squamous intraepithelial lesion (HSIL), 12; squamous cell carcinoma, 6; adenocarcinoma, 3) and captured 1,181 digital images (518 MB) at a maximum resolution of 1,600 x 1,200 pixels and transmitted them by e-mail. Diagnosis of glass slides and digital images was done independently in a double-blind manner by 3 pathologists and 3 cytotechnologists, commencing with the diagnosis of digital images followed by diagnosis of glass slides 3 months later. The procedure was repeated after 3 months. Diagnoses were recorded as benign, ASCUS or atypical glandular cells of undetermined significance, LSIL, HSIL, squamous cell carcinoma or adenocarcinoma, and "inadequate for diagnosis." Diagnostic accuracy and interobserver reproducibility were analyzed using an intraclass correlation coefficient (ICC), which revealed good interobserver agreement for the first (0.72) and second (0.64) glass slide diagnoses and the first (0.72) and second (0.60) digital image diagnoses. The kappa values for intraobserver variation between first and second glass slide diagnoses and first and second digital image diagnoses showed moderate to excellent agreement. Digital images are suitable substitutes for glass slides; telecytology can be used as an alternative method for the cytologic diagnosis of cervical smears, particularly in quality assurance programs.

Practical telepathology using a digital camera and the internet.

Digital camera technology has developed rapidly and a large choice of reasonably priced, user-oriented models are now available. These can be used for both macroscopic and microscopic photography with good resolution. Internet transmission of digital images also makes it possible to consult pathologists anywhere in the world. This study tests a simple, fast, and inexpensive method for practical transmission of images for diagnosis using a digital camera and the Internet. Using a commercial digital camera mounted with a phototube adapter to a light microscope (6 images per case on average), 2210 digital images (310 Mb) from 347 cases of gastrointestinal, lung, and uterus specimens were captured. Each image, stored in medium compression JPEG (Joint Photographers Experts Group) format with 1024 x 768 pixel resolution, required approximately 5 seconds to capture after the case had been reviewed and appropriate fields for imaging selected (30 seconds per case on average). The images were transmitted from Samsung Medical Center, Seoul, to Korea University Hospital, Seoul, and John Hunter Hospital, Newcastle, Australia. Transmission was 100% successful with a total upload time of 3 hours for 310 MB of data (31 seconds per case on average). The images were downloaded in 2 hours and viewed on a 17-inch color monitor with a maximal resolution of 1280 x 1024 pixels. Telepathology diagnoses were made with 95% and 97% concurrence by two pathologists at Korea University Hospital and John Hunter Hospital, respectively. We suggest that the current level of commercial technology yields fast, convenient and economical tools for practical telepathology diagnosis.