Upregulated EMMPRIN/CD147 might contribute to growth and angiogenesis of gastric carcinoma: a good marker for local invasion and prognosis

Tumour growth depends on angiogenesis, which is closely associated with vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs). Extracellular MMP inducer (EMMPRIN) was reported to involve in the progression of malignancies by regulating expression of VEGF and MMPs in stromal cells. To clarify the role of EMMPRIN in progression and angiogenesis of gastric carcinoma, expression of EMMPRIN, ki-67, MMP-2, MMP-9 and VEGF was examined on tissue microarray containing gastric carcinomas (n=234) and non-cancerous mucosa adjacent to carcinoma (n=85) by immunohistochemistry. Additionally, microvessel density (MVD) was assessed after labelling with anti-CD34 antibody. Extracellular MMP inducer expression was compared with clinicopathological parameters of tumours, including levels of ki-67, MMP-2, MMP-9 and vascular endothelial growth factor (VEGF), MVD as well as survival time of carcinoma patients. Gastric carcinoma cell lines (HGC-27, MKN28 and MKN45) were studied for EMMPRIN expression by immunohistochemistry and Western blot. Extracellular MMP inducer expression was gradually increased from normal mucosa to carcinomas through hyperplastic or metaplastic mucosa of the stomach (P<0.05). There was strong EMMPRIN expression in all gastric carcinoma cell lines despite different levels of glycosylation. Extracellular MMP inducer expression was positively correlated with tumour size, depth of invasion, lymphatic invasion, expression of ki-67, MMP-2, MMP-9 and VEGF of tumours (P<0.05), but not with lymph node metastasis, UICC staging or differentiation (P>0.05). Interestingly, there was a significantly positive relationship between EMMPRIN expression and MVD in gastric carcinomas (P<0.05). Survival analysis indicated EMMPRIN expression to be negatively linked to favourable prognosis (P<0.05), but not be independent factor for prognosis (P>0.05). Further analysis showed three independent prognostic factors, depth of invasion, lymphatic and venous invasion, to influence the relationship between EMMPRIN expression and prognosis. Upregulated expression of EMMPRIN possibly contributes to genesis, growth and local invasion of gastric carcinomas. Altered EMMPRIN expression might enhance growth, invasion and angiogenesis of gastric carcinoma via upregulating MMP expression of both stromal fibroblasts and gastric cancer cells and could be considered as an objective and effective marker to predict invasion and prognosis

Three portable tonometers, the TGDc-01, the ICARE and the Tonopen XL, compared with each other and with Goldmann applanation tonometry

Three portable tonometers, the TGDc-01, the ICARE and the Tonopen XL, were compared with each other and to Goldmann applanation tonometry in a large group of healthy subjects and patients with ocular hypertension or glaucoma (n = 103). Measurements performed with the ICARE and the Tonopen XL were in good agreement with that of the Goldmann tonometer. Intraocular pressure (IOP) values measured with the TGDc-01 were significantly lower and showed more variability. The 95% limits of agreement (portable tonometer - Goldmann) were -17 to +10 mmHg for the TGDc-01, -6 to +7 mmHg for the ICARE and -6 to +8 mmHg for the Tonopen. Corneal thickness could not explain the differences between an IOP measured with the portable tonometers and an IOP measured with the Goldmann tonometer. Patient comfort was slightly higher for ICARE when compared with the Tonopen

Comparison of the ICare (R) rebound tonometer with the Goldmann applanation tonometer by experienced and inexperienced tonometrists

© 2008 The Royal College of OphthalmologistsPurpose To assess the agreement between ICare® rebound tonometer and Goldmann applanation tonometer in the hands of experienced and inexperienced tonometrists. Patients and methods Two tonometrists, experienced with both Goldmann applanation tonometry (GAT) and ICare® Tonometry (ICT) measured intraocular pressure (IOP), in a masked fashion, in 100 patients. In another series of 58 patients, ICT was performed by an inexperienced tonometrist and GAT by an experienced tonometrist. Results In approximately 80% of patients, the difference in IOP between GAT and ICT was 2 mmHg in group 1 and 3 mmHg in group 2. The 95% limits of agreement were - 4.0–4.4 mmHg in group 1 and - 6.0–5.0 mmHg in group 2. Conclusion ICT compares reasonably with GAT, in both experienced and inexperienced hands. Its ease of use, portability, and sterility make it an attractive tonometer. Its degree of accuracy in inexperienced hands would make it a useful instrument for health care workers with limited ophthalmic experienceL M Abraham, N C R Epasinghe, D Selva and R Casso

A review of clinical and molecular prognostic factors in osteosarcoma

Traditional prognostic determinants in osteosarcoma have included demographics (age, sex), tumour size, site, stage, and the response to chemotherapy. Many of these are determined using varying techniques and units of measurement, which can make comparison between studies diYcult. The absence of survival diVerence between limb sparing surgery and amputation has been repeatedly demonstrated in primary disease, and even in the setting of pathological fracture. On the other hand, there is still some controversy over the existence of increased local recurrence for limb-sparing surgery, and the implications of this. Commonly used prognostic determinants such as metastases, and response to chemotherapy enable a high degree of prognostic accuracy but usually at a late stage in the course of disease. Leading on from this, there is a need to uncover molecular pathways with speciWc inXuence over osteosarcoma progression to facilitate earlier treatment changes. Some important pathways are already being deWned, for example the association of CXCR4 with metastases on presentation, the likelihood of doxorubicin resistance with positive P-glycoprotein, and the reduced survival prediction of over expressed survivin. It is anticipated that the future of osteosarcoma treatment will involve treatment tailored to the molecular proWle of tumours at diagnosis, adjuvant therapy directed towards dysfunctional molecular pathways rather than the use of cytotoxics, and a more standardised approach to the measurement of clinical prognostic factors