Biologic markers in breast cancer: An update

The ability to diagnosis breast cancer at an earlier stage and the development of a wider range of treatment options have stimulated the search for more refined criteria to select the subgroup of patients who develop recurrent disease despite the absence of nodal involvement at the time of tumor resection. Such criteria include biologic parameters of prognostic relevance, especially those that can be applied to routinely processed tissue sections, as they allow a correlation with established histologic features of prognostic relevance. The biologic parameters can be divided into those which are intrinsic characteristics of the tumors cells and those related to the interaction of tumor and the immediate microenvironment, the latter factors influencing invasiveness and metastatic potential. Steroid hormone receptor expression, tumor growth fraction estimation, growth factors and their receptors, and tumor suppressor gene proteins can now be assessed by immunostaining of routinely processed tissue sections. Whereas the assessment of other parameters such as bcl-2 and Bax proteins, nm23 metastasis suppressor gene expression, vimentin, and other genes related to cyclin- dependent kinase activity can also he done immunohistochemically, their worthiness as prognostic parameters require further studies. Factors related to tumor-stromal interaction include angiogenesis, adhesion molecules, cytoskeletal proteins, extracellular matrix proteins and proteases, all of which are potentially useful prognostic indices and also hold promise for newer avenues of therapeutic intervention.link_to_subscribed_fulltex

Vascular and myometrial changes in the human uterus at term

At term, amniotic fluid contents may mediate the onset of labor through the activation of amniotic fluid macrophages and their migration into the myometrium. To test this concept, the authors examine the histological changes that occur in myometrial biopsies at term prior to (n = 53) and during (n = 15) labor. Biopsies were stained with an antimacrophage antibody, anti-CD34 (endothelial cells), and anti-caspase 3 (apoptotic cells). The samples showed a variable inflammatory infiltrate of neutrophils and macrophages, with a greater infiltrate in the samples obtained during labor (P <. 001, Fisher exact test). Prior to labor, there were prominent changes in the myometrial fibers that reflected shearing, shrinkage, edema, and particularly apoptosis; endothelial cells of thin-walled vessels prominent in the biopsies displayed marked nuclear biotinylation, and the vascular lumen contained fibrin and platelet thrombi, microparticles, desquamated endothelial cells, amniotic squamous cells, and mucoid material. These changes were also present in samples obtained during labor. In an additional 10 patients in labor with male fetuses, myometrial samples were examined for the presence of macrophages carrying a Y chromosome indicative of a fetal origin, but none were observed. These findings suggest that endothelial cell damage and amniotic fluid embolism are very common at term prior to clinical labor and provide a mechanism by which surfactant protein A and phospholipids present in the amniotic fluid may access myometrial cells and provoke the inflammatory response that occurs during parturition. The authors' studies give no support to the suggestion that fetal macrophages might invade the human myometrium at term

Ultra-rapid microwave variable pressure-induced histoprocessing: Description of a new tissue processor

We describe a new method of ultra-rapid histoprocessing that reduces the processing times for needle and endoscopic biopsies to 30 min and that of other surgical biopsy tissue blocks of up to 4 mm thick to 120 min. The MicroMED U R M Histoprocessor, which combines microwave irradiation with precise computer control of power, time, temperature, vacuum, and pressure, when used with a 1-step dehydrating/clearing reagent, consistently produces rapidly processed tissues with optimal cytomorphology and improved tissue sectioning properties. Staining properties are excellent with no deleterious effects on routine staining, histochemistry, or immunohistochemistry. This new processing technique represents a major change from conventional tissue processing and eliminates the use of hazardous reagents such as xylene. The ease of application and speed of this technique can significantly reduce turnaround times in diagnostic laboratories