Endogenous avidin biotin activity (EABA) in thyroid pathology: immunohistochemical study

<p>Abstract</p> <p>Background</p> <p>Immunohistochemical methods based on the high affinity of avidin and biotin (e.g. ABC, LSAB) are characterized by high sensitivity and are widely used for detection of immunologic reaction. However, a non-specific reaction, observed in frozen tissues and in paraffin-embedded material, increasing after heat induced epitope retrieval (HIER), and caused either by endogenous biotin or any another chemical compound with high affinity for avidin, may lead to diagnostic mistakes. The aim of our investigation is to study presence of endogenous avidin biotin activity (EABA) in thyrocytes originating from various thyroid pathological lesions (neoplastic and non-neoplastic).</p> <p>Materials and methods</p> <p>The immunohistochemical study was performed on paraffin-embedded specimens of surgically resected thyroid tissue from 97 patients with thyroid diseases: 65 patients with papillary carcinoma (PTC), 11 patients with nodular goiter in whom features of benign papillary hyperplasia were found, 9 with lymphocytic thyroiditis (LT), 8 with follicular adenoma, and 4 patients with follicular carcinoma. In PTC immunohistochemical study was performed both in primary tumors and in lymph node metastases. After HIER, incubation with streptavidin from LSAB+ (DakoCytomation) kit was done.</p> <p>Results</p> <p>Strong cytoplasmic EABA was observed in 56 of 65 (87.5%) PTC and in oxyphilic cells in 8 of 9 cases of LT. Significant correlation between EABA in primary PTC tumor and EABA in lymph node metastases was stated. Normal surrounding thyroid tissues showed absence or weak EABA. Aberrant intranuclear localization of biotin was noted in morules of cribriform-morular variant of PTC. No statistically significant correlation between patient's age, sex, metastases presence and EABA was observed.</p> <p>Conclusion</p> <p>Among thyroid lesions, false positive reactions are highly probable in papillary thyroid carcinoma and in lymphocytic thyroiditis if immunohistochemical detection is used on systems containing (strept)avidin. The most probable reason is the high endogenous biotin content.</p

Częstość występowania mutacji somatycznych RAS w raku rdzeniastym tarczycy — analiza populacji polskiej

Introduction: Somatic RET mutations are detectable in two-thirds of sporadic cases of medullary thyroid cancer (MTC). Recent studies reported a high proportion of RAS somatic mutations in RET negative tumours, which may indicate RAS mutation as a possible alternative genetic event in sporadic MTC tumorigenesis. Thus, the aim of the study was to evaluate the frequency of somatic RAS mutations in sporadic medullary thyroid cancer in the Polish population and to relate the obtained data to the presence of somatic RET mutations.Material and methods: Somatic mutations (RET, RAS genes) were evaluated in 78 snap-frozen MTC samples (57 sporadic and 21 hereditary) by direct sequencing. Next, three randomly selected RET-negative MTC samples were analysed by the next generation sequencing.Results: RAS mutation was detected in 26.5% of 49 sporadic MTC tumours. None of all the analysed samples showed N-RAS mutation. When only RET-negative samples were considered, the prevalence of RAS mutation was 68.7%, compared to 6% observed in RET-positive samples. Most of these mutations were located in H-RAS codon 61 (72%). None of 21 hereditary MTC samples showed any RAS mutations.Conclusions: RAS mutations constitute a frequent molecular event in RET-negative sporadic medullary thyroid carcinoma in Polish patients. However, their role in MTC tumorigenesis remains unclear. (Endokrynol Pol 2015; 66 (2): 121–125)Wstęp: Somatyczne mutacje proto-onkogenu RET wykrywane są w trzech czwartych wszystkich sporadycznych raków rdzeniastych tarczycy (MTC). Ostatnie badania wykazały, że mutacja genu RAS jest również częstym wydarzeniem w sporadycznych guzach MTC, co może oznaczać, że mutacje genów z rodziny RAS są alternatywnym wydarzeniem molekularnym w kancerogezie sporadycznej postaci tego raka. Z tego względu celem niniejszej pracy było oszacowanie częstości występowania mutacji genów RAS w sporadycznym raku rdzeniastym tarczycy w populacji polskiej i odniesieniu częstości ich występowania do obecności mutacji somatycznych proto-onkogenu RET.Materiał i metody: Materiał do badań stanowiło 78 fragmentów guza raka rdzeniastego tarczycy (57 próbek postaci sporadycznej i 21 dziedzicznej MTC). Analizowano mutacje genu RET, H-RAS, K-RAS i N-RAS metodą bezpośredniego sekwencjonowania a także 3 próbki raka sporadycznego, wybrane losowo, zostały zeskwencjonowane metodą głębokiego sekwencjonowania (Illumina).Wyniki: Mutację genów RAS wykryto w 26,5% z 49 przeanalizowanych guzów sporadycznej postaci MTC. Natomiast, gdy tylko brano pod uwagę próbki RET-negatywne, częstość występowania mutacji genów RAS wynosiła 68,7% w porównaniu z 6% obserwowanych w guzach RET-pozytywnych. Nie wykryto, w żadnej z próbek, mutacji genu N-RAS. Najczęściej wykrywaną mutacją była zmiana w kodonie 61 genu H-RAS (72%). Nie wykryto mutacji genów RAS w żadnej z próbek dziedzicznego guza raka tarczycy.Wnioski: Mutacje somatyczne genów RAS są częstym wydarzeniem obserwowanym w RET-negatywnych sporadycznych rakach rdzeniastych tarczycy w populacji polskiej. Jednakże rola tych mutacji w rozwoju rdzeniastego raka tarczycy nie jest do końca poznana. (Endokrynol Pol 2015; 66 (2): 121–125

Neuroendocrine neoplasms of the small intestine and the appendix - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours).

This study presents the revised Polish guidelines regarding the management of patients suffering from neuroendocrine neoplasms (NENs) of the small intestine and appendix. The small intestine, especially the ileum, is the most common location for these neoplasms. Most are well differentiated and slow growing. Their symptoms may be atypical, which can result in delayed or accidental diagnosis. Appendicitis is usually the first manifestation of NEN in this location. Typical symptoms of carcinoid syndrome occur in approximately 20-30% of patients suffering from small intestinal NENs with distant metastases. The main cause of death in patients with carcinoid syndrome is carcinoid heart disease. The most useful laboratory test is the determination of chromogranin A, while concentration of 5-hydroxyindoleacetic acid is helpful in the diagnostics of carcinoid syndrome. For visualisation, ultrasound, computed tomography, magnetic resonance imaging, colonoscopy, video capsule endoscopy, double-balloon enteroscopy, and somatostatin receptor scintigraphy may be used. A detailed his-tological report is crucial for the proper diagnostics and therapy of NENs of the small intestine and appendix. The treatment of choice is surgical management, either radical or palliative. The pharmacological treatment of the hormonally active and non-active small intestinal NENs as well as NENs of the appendix is based on long-acting somatostatin analogues. In patients with generalised NENs of the small intestine in progress during the SSA treatment, with good expression of somatostatin receptors, the first-line treatment should be radio-isotope therapy, while targeted therapies, such as everolimus, should be considered afterwards. When the above therapies are exhausted, in certain cases chemotherapy may be considered