A Multi-institutional Study of Interlaboratory Variance in the Estrogen and Progesterone Receptor Assays

Purpose The expression of hormone receptors is the most reliable factor for predicting the responsiveness to hormonal therapy At present, immunohistochemistry (IHC) is considered as a practically reliable method. This study was designed to examine the interlaboratory variance in immunohistochemical assays for estrogen receptor (ER) and progesterone receptor (PR) in Korea Methods The Korean Study Group for Breast Pathology (KSGBP) made a questionnaire to know the current situation in HR assay in Korea. The questionnaire was sent to the members of KSGBP by e-mail, which were included eight questions relating to tissue handling, ER/PR IHC procedure and interpretation method. Forty laboratories replied with the completed questionnaire Results All 40 laboratories were using formalin as a fixative. Pretreatment was performed using six different methods including autoclave (25%), microwave (30%) and full autostainer (15%). Primary antibodies for ER were SP1 in 40%, 6F11 in 27.5% and 1D5 in 32.5%. Primary antibodies for PR were more variable (seven clones) than those for ER Interpretation method used was Allred system in 20%, modified Allred system in 15%, report the % of positive tumor cells in 45%, positive/negative in 15% and others in 5% The expression rate of ER was ranged from 45.6% to 93% (mean 635%) and the expression rate of PR was ranged from 27% to 90% (mean 59 1%) The differences according to the numbers of breast cancer in each institute, primary antibodies, detection systems and interpretation methods did not influence to the expression rate of ER/PR, statistically (p>0 05) Conclusion In Korea, the interlaboratory variance in ER/PR IHC procedure was too huge to make a standardized method We suggest the proper quality control program such as ER/PR staining with positive internal and external controls and negative control might be better to aim at getting similar results among the different laboratones rather than trying to standardize the procedure.Yun YH, 2007, BREAST CANCER RES TR, V106, P245, DOI 10.1007/s10549-006-9490-7UMEMURA S, 2006, BREAST CANC, V13, P232JOO HJ, 2006, MANUAL QUALITY CONTR, P139Goldhirsch A, 2005, ANN ONCOL, V16, P1569, DOI 10.1093/annonc/mdi326Mann GB, 2005, J CLIN ONCOL, V23, P5148, DOI 10.1200/JCO.2005.02.076Rudiger T, 2002, AM J SURG PATHOL, V26, P873Rhodes A, 2001, AM J CLIN PATHOL, V115, P44Fitzgibbons PL, 2000, ARCH PATHOL LAB MED, V124, P966Rhodes A, 2000, J CLIN PATHOL, V53, P292Rhodes A, 2000, J CLIN PATHOL, V53, P125Harvey JM, 1999, J CLIN ONCOL, V17, P1474Taylor CR, 1999, AM J CLIN PATHOL, V111, P443Barnes DM, 1998, EUR J CANCER, V34, P1677Barnes DM, 1996, BRIT J CANCER, V74, P1445Alberts SR, 1996, CANCER, V78, P764GREENE GL, 1982, J STEROID BIOCHEM, V16, P353GREENE GL, 1980, P NATL ACAD SCI-BIOL, V77, P5115

A study of indicators to predict the early graft function after canine orthotopic whole liver transplantation

One of the most dramatic advances in the field of liver diseases in the twentieth century is the successful transplantation of the human liver, now on a worldwide scale. With the developments of new surgical techniques, transplantation immunology, and the capability to prevent and to control infections, it has been developed and become an acceptable therapy for patients with irreversible fiver diseases. After transplantation, it is of paramount importance to predict the function of allograft, which affects the result of transplantation and patient's survival. After transplantation, the first two or three days are always characterized by a marked elevation of transaminase levels and hepatocellular failure. Poor early graft function(PEGF) has a clinical spectrum characterized by varying degrees of coma and renal failure associated with lactic acidosis, persistent coagulopathy, poor bile production and marked elevations of ALT and AST. The occurrence of PEGF is unpredictable : its most severe form, requiring retransplantation and termed primary nonfunction(PNF), is seen following approximately 10 % of transplant procedures. Possible etiologic factors include liver disease in the donor, technical errors, ischemic injury, and immunologic damage. Ischemic injury is inherent in the process of organ retrieval, storage, and implantation and is considered as the main factor to contribute to PEGF. Protocol biopsies of liver allografts obtained during backtable preparation and 1 to 2 hours after revascularization in the recipients have detailed the sequential histologic events that occur after reperfusion. Once the liver is revascularized, quick assessment of its quality from metabolic studies is far more practical than a postperfusion biopsy. The purpose of this experiment is to observe whether protocol biopsy of allografts(during backtable procedure and 2 hours after revascularization), serum 1actate, serum ammonia and arterial pH would be used as the indicators of initial graft function after canine orthotopic whole liver transplantation. The experiment consisted of ten cases of orthotopic whole liver transplantation in mongrel dogs using venovenous bypass. The arterial blood were taken as just after anesthesia, anhepatic period, 15 minutes, 2 hours, and 6 hours after reperfusion in recipients. Protocol biopsies of allograft were taken at backtable preparation and 2 hours after reperfusion. We grouped the recipients according to the result of survival time(group A ;short survival time group, B ; long survival time group) and according to the degree of preservation injury(group C ; histologically no preservation injury group, D ; histologically preservation injury group). And we analysed the change of parameters (serum lactate, ammonia, ALT, AST, arterial pH, histologic finding) between group A and B and between group C and D. To evaluate the statistical significance, we used the SAS program and IBM - PC. In conclusion, we found out that preservation injury seen in protocol biopsy would be one of the indicators to predict the initial function of allograft and the pattern of change of serum lactate and blood ammonia are another possible indicators. And we also found out that immediate correction of metabolic acidosis which usually happens just after reperfusion would be related to the result of transplantation.One of the most dramatic advances in the field of liver diseases in the twentieth century is the successful transplantation of the human liver, now on a worldwide scale. With the developments of new surgical techniques, transplantation immunology, and the capability to prevent and to control infections, it has been developed and become an acceptable therapy for patients with irreversible fiver diseases. After transplantation, it is of paramount importance to predict the function of allograft, which affects the result of transplantation and patient's survival. After transplantation, the first two or three days are always characterized by a marked elevation of transaminase levels and hepatocellular failure. Poor early graft function(PEGF) has a clinical spectrum characterized by varying degrees of coma and renal failure associated with lactic acidosis, persistent coagulopathy, poor bile production and marked elevations of ALT and AST. The occurrence of PEGF is unpredictable : its most severe form, requiring retransplantation and termed primary nonfunction(PNF), is seen following approximately 10 % of transplant procedures. Possible etiologic factors include liver disease in the donor, technical errors, ischemic injury, and immunologic damage. Ischemic injury is inherent in the process of organ retrieval, storage, and implantation and is considered as the main factor to contribute to PEGF. Protocol biopsies of liver allografts obtained during backtable preparation and 1 to 2 hours after revascularization in the recipients have detailed the sequential histologic events that occur after reperfusion. Once the liver is revascularized, quick assessment of its quality from metabolic studies is far more practical than a postperfusion biopsy. The purpose of this experiment is to observe whether protocol biopsy of allografts(during backtable procedure and 2 hours after revascularization), serum 1actate, serum ammonia and arterial pH would be used as the indicators of initial graft function after canine orthotopic whole liver transplantation. The experiment consisted of ten cases of orthotopic whole liver transplantation in mongrel dogs using venovenous bypass. The arterial blood were taken as just after anesthesia, anhepatic period, 15 minutes, 2 hours, and 6 hours after reperfusion in recipients. Protocol biopsies of allograft were taken at backtable preparation and 2 hours after reperfusion. We grouped the recipients according to the result of survival time(group A ;short survival time group, B ; long survival time group) and according to the degree of preservation injury(group C ; histologically no preservation injury group, D ; histologically preservation injury group). And we analysed the change of parameters (serum lactate, ammonia, ALT, AST, arterial pH, histologic finding) between group A and B and between group C and D. To evaluate the statistical significance, we used the SAS program and IBM - PC. In conclusion, we found out that preservation injury seen in protocol biopsy would be one of the indicators to predict the initial function of allograft and the pattern of change of serum lactate and blood ammonia are another possible indicators. And we also found out that immediate correction of metabolic acidosis which usually happens just after reperfusion would be related to the result of transplantation

Germ cell tumors of the central nervous system

To elucidate the clinicopathological characteristics of the intracranial germ cell tumors, retrospectively examined were 13 cases that were histologically confirmed in Asan Medical Center between January 1990 and August 1992. Germ cell tumors of the central nervous system consisted of 10 cases of germinomas, one cases of endodermal sinus tumor, one embryonal carcinoma, and one mixed germ cell tumor(immature teratoma + choriocarcinoma + embryonal carcinoma). All the germinomas presented during the first three decades of life, and they were most common in the second decade with median age of 12 and were equally divided between the sexes. Germinomas were located almost exclusively in midline structures, particularly suprasellar area and/or pineal region. Occasionally, germinomas occured away from the midline in such sites as the thalamus or basal ganglia. in the suprasellar location the triad of diabetes insipidus, visual defect and hypopituitarism was typically produced. Cytological examinations of CSF or intraoperative aspiration were much useful in the diagnosis of germinomas. Histological features of the germ cell tumors were generally agreed with serum or CSF levels of tumor markers such as HCG, AFP and CEA. However, two of ten germinomas disclosed discrepency between them. Therefore, stressed was the importance of collective consideration for both tissue diagnosis and tumor marker studies. Most germ cell tumors responded to radiation therapy with or without adjuvant chemotherapy following initial surgical biopsy, at least for the short-term follow-up periods.To elucidate the clinicopathological characteristics of the intracranial germ cell tumors, retrospectively examined were 13 cases that were histologically confirmed in Asan Medical Center between January 1990 and August 1992. Germ cell tumors of the central nervous system consisted of 10 cases of germinomas, one cases of endodermal sinus tumor, one embryonal carcinoma, and one mixed germ cell tumor(immature teratoma + choriocarcinoma + embryonal carcinoma). All the germinomas presented during the first three decades of life, and they were most common in the second decade with median age of 12 and were equally divided between the sexes. Germinomas were located almost exclusively in midline structures, particularly suprasellar area and/or pineal region. Occasionally, germinomas occured away from the midline in such sites as the thalamus or basal ganglia. in the suprasellar location the triad of diabetes insipidus, visual defect and hypopituitarism was typically produced. Cytological examinations of CSF or intraoperative aspiration were much useful in the diagnosis of germinomas. Histological features of the germ cell tumors were generally agreed with serum or CSF levels of tumor markers such as HCG, AFP and CEA. However, two of ten germinomas disclosed discrepency between them. Therefore, stressed was the importance of collective consideration for both tissue diagnosis and tumor marker studies. Most germ cell tumors responded to radiation therapy with or without adjuvant chemotherapy following initial surgical biopsy, at least for the short-term follow-up periods

유방의 소엽상피내암과 침윤성 소엽암의 영상의학적 소견 비교

Purpose To investigate the usefulness of imaging features for differentiating between small lobular carcinoma in situ (LCIS) and invasive lobular carcinoma (ILC). Materials and Methods It included 52 female with LCISs (median 45 years, range 32?67 years) and 180 female with ILCs (median 49 years, range 36?75 years), with the longest diameter of ≤ 2 cm, who were evaluated between January 2012 and December 2016. All the female underwent mammography and ultrasonography. Twenty female with LCIS and 150 female with ILC underwent MRI. The clinical and imaging features were compared, and multivariate analysis was performed to identify the independent predictors of LCIS. Female with LCIS were also subgrouped by lesion size and compared with the female with ILC. Results Multivariate analysis showed that younger age (odds ratio [OR] = 1.100), smaller lesion size (OR = 1.103), oval or round shape (OR = 4.098), parallel orientation (OR = 5.464), and isoechotexture (OR = 3.360) were significant independent factors predictive of LCIS. The area under the receiver operating characteristic curve for distinguishing LCIS from ILC was 0.904 (95% confidence interval, 0.857?0.951). Subgroup analysis showed that benign features were more prevalent in female with smaller LCISs (≤ 1 cm) than in those with ILC. Conclusion Small LCISs tend to demonstrate more benign features than small ILCs. Several imaging features are independently predictive of LCIS

Cystic Lymphangioma of the Colon

Lymphangiomas are benign tumors of lymphatic vessels, that are more commonly found in the pediatric age group. The presence of a lymphangioma in the colon is rare. Chisholm and Hillkowitz reported the first case of colonic lymphangioma of the rectum in 1931. We have recently encountered two patients in whom a cystic lymphangioma was found in the colon.Lymphangiomas are benign tumors of lymphatic vessels, that are more commonly found in the pediatric age group. The presence of a lymphangioma in the colon is rare. Chisholm and Hillkowitz reported the first case of colonic lymphangioma of the rectum in 1931. We have recently encountered two patients in whom a cystic lymphangioma was found in the colon

A DNA Topoisomerase II Inhibitor Results in Ex Vivo Differentiation of THP-1 Cells and Activation of Dendritic Cells

Abstract Background/aim: Effective ex vivo maturation of dendritic cells (DCs) can increase the efficiency of cancer immunotherapy. We aimed to identify novel chemicals with the potential to differentiate and activate immature DCs (iDCs) to mature DCs (mDCs). Materials and methods: The expression of surface markers on THP-1 monocytes treated with the screened compounds was analyzed using FACS. Subsequent DC subset analysis and secreted cytokine profiling were also performed. Results: FACS analysis showed that THP-1 cells treated with amsacrine hydrochloride, a DNA topoisomerase II inhibitor, exhibited the typical phenotype of conventional DCs (cDCs). The expression of DC activation markers was also increased after amsacrine treatment. The profile of cytokines produced by THP-1 cells treated with amsacrine was similar to that of mDCs. Conclusion: Amsacrine has an ex vivo capability of differentiating THP-1 monocytes into cDCs. As amsacrine has been used as a stable chemotherapeutic agent in humans, it can be useful for producing mDCs for cancer immunotherapy

A Case of Idiopathic Pulmonary Hemosiderosis

Idiopathic pulmonary hemosiderosis(IPH) is a relatively rare disease of unknown etiology characterized pathologically by recurrences of intraalveolar pulmonary hemorrhage. Clinical features include hemoptysis, iron deficiency anemia and pulmonary parenchymal infiltrations on chest radiograph. Hemosiderin-laden macrophages are demonstrated by examination of sputum or lung biopsy specimens. We diagnosed IPH by lung biopsy in 9 year-old girl who had had recurrent hemoptysis, iron deficiency anemia and diffuse pulmonary infiltrates on chest radiograph and report this case with brief literature review.Idiopathic pulmonary hemosiderosis(IPH) is a relatively rare disease of unknown etiology characterized pathologically by recurrences of intraalveolar pulmonary hemorrhage. Clinical features include hemoptysis, iron deficiency anemia and pulmonary parenchymal infiltrations on chest radiograph. Hemosiderin-laden macrophages are demonstrated by examination of sputum or lung biopsy specimens. We diagnosed IPH by lung biopsy in 9 year-old girl who had had recurrent hemoptysis, iron deficiency anemia and diffuse pulmonary infiltrates on chest radiograph and report this case with brief literature review

Fine Needle Aspiration Cytology of Salivary Gland Tumors:Comparison with Histologic Findings

We reviewed twenty fine needle aspiration biopsies of salivary gland lesions performed between April 1992 and March 1993, which were confirmed by surgical excision. Sixteen cases were benign lesions:10 pleomorphic adenomas, 3 Warthin's tumors, 1 monomorphic adenoma, 1 benign lymphoepithelial lesion and 1 lymphoepithelial cyst. Malignant lesions were four cases:3 mucoepidermoid carcinomas, and 1 malignant mixed tumor. Preoperative fine needle aspiration cytologic findings were compaired with pathologic diagnosis of the surgically resected specimen in all cases. Overall accuracy was 80%. False negativity and positivity were 5% (1 case) and 0%, respectively. Fine needle aspiration biopsy for diagnosis of salivary gland lesion appears to be a simple, safe, and cost saving diagnistic method with relatively high accuracy.We reviewed twenty fine needle aspiration biopsies of salivary gland lesions performed between April 1992 and March 1993, which were confirmed by surgical excision. Sixteen cases were benign lesions:10 pleomorphic adenomas, 3 Warthin's tumors, 1 monomorphic adenoma, 1 benign lymphoepithelial lesion and 1 lymphoepithelial cyst. Malignant lesions were four cases:3 mucoepidermoid carcinomas, and 1 malignant mixed tumor. Preoperative fine needle aspiration cytologic findings were compaired with pathologic diagnosis of the surgically resected specimen in all cases. Overall accuracy was 80%. False negativity and positivity were 5% (1 case) and 0%, respectively. Fine needle aspiration biopsy for diagnosis of salivary gland lesion appears to be a simple, safe, and cost saving diagnistic method with relatively high accuracy

Clinico-cytopathologic analysis of 574 Pericardial Effusion Specimens: Application of the international system for reporting serous fluid cytopathology (ISRSFC) and long-term clinical follow-up

Abstract Introduction: A pericardial effusion (PE) has a variable etiology and the primary role is diagnosis of metastatic malignancy. We analyzed the PE cytology in a large cohort in accordance with the international system for reporting serous fluid cytopathology (ISRSFC) and evaluated the long-term patient outcomes. Methods: PE specimens from 2010 to 2014 with an available clinical history, cytologic data, and pericardial biopsy results were collected. Results: A total of 574 PE specimens were obtained from 486 patients, representing 1.5% (574/38,589) of all body fluid specimens. Three hundred and eighty-two (66.6%) cases were "negative," 54 (9.4%) cases were "atypia of undetermined significance," 10 (1.7%) cases were "suspicious for malignancy," and 128 (22.3%) cases were "malignancy". The most common origin for malignant PE was the lung (82.1%), in both men (70.5%) and women (50.6%). Breast cancer (20%) in women and gastric cancer (4.9%) in men were the second most common malignant PE, respectively. The mean interval from the occurrence of malignant PE to death was 10.06 months (range; 0-116.03 months, median 3.5 months), and the 1-year survival rate was 16.7%. In addition, the 1-year survival rates after malignant PE onset were 0% for gastric cancer, 13.9% for lung cancer, 19.8% for breast cancer, and 21.1% for the other cancers (p = 0.011). Conclusion: Our present study is the first to our knowledge to classify the pericardial fluid from 574 cases in accordance with the recently published ISRSFC, and to present the long-term outcomes of patients with malignant PE at the same time. Moreover, we report for the first time that it is gastric and not lung cancer patients that have the poorest prognosis after the occurrence of malignant PE