Coexpression of epidermal growth factor receptor with related factors is associated with a poor prognosis in non-small-cell lung cancer

The epidermal growth factor receptor (EGFR) is commonly expressed in non-small-cell lung cancer (NSCLC) and promotes a host of mechanisms involved in tumorigenesis. However, EGFR expression does not reliably predict prognosis or response to EGFR-targeted therapies. The data from two previous studies of a series of 181 consecutive surgically resected stage I-IIIA NSCLC patients who had survived in excess of 60 days were explored. Of these patients, tissue was available for evaluation of EGFR in 179 patients, carbonic anhydrase (CA) IX in 177 patients and matrix metalloproteinase-9 (MMP-9) in 169 patients. We have previously reported an association between EGFR expression and MMP-9 expression. We have also reported that MMP-9 (P=0.001) and perinuclear (p)CA IX (P=0.03) but not EGFR expression were associated with a poor prognosis. Perinuclear CA IX expression was also associated with EGFR expression (P<0.001). Multivariate analysis demonstrated that coexpression of MMP-9 with EGFR conferred a worse prognosis than the expression of MMP-9 alone (P<0.001) and coexpression of EGFR and pCA IX conferred a worse prognosis than pCA IX alone (P=0.05). A model was then developed where the study population was divided into three groups: group 1 had expression of EGFR without coexpression of MMP-9 or pCA IX (number=21); group 2 had no expression of EGFR (number=75); and group 3 had coexpression of EGFR with pCA IX or MMP-9 or both (number=70). Group 3 had a worse prognosis than either groups 1 or 2 (P=0.0003 and 0.027, respectively) and group 1 had a better prognosis than group 2 (P=0.036). These data identify two cohorts of EGFR-positive patients with diametrically opposite prognoses. The group expressing either EGFR and or both MMP-9 and pCA IX may identify a group of patients with activated EGFR, which is of clinical relevance with the advent of EGFR-targeted therapies. © 2004 Cancer Research UK

O OR RI IG GI IN NA Immunohistochemical evaluation of the tumor neoangiogenesis as a prognostic factor for gastric cancers

Abstract Introduction. The angiogenesis, the process by which new blood vessels are formed, plays an essential role in the survival of the malignant cells, in the local expansion and tumor invasion, as well as in the appearance of distant metastases. Material and methods. We evaluated the relation between MVD, the VEGF expression, the clinicopathologic factors and the survival in patients with gastric cancer. A prospective study has been carried out, regarding the evolution and aggressiveness of the gastric cancer, with a duration of 5 years, 61 patients that underwent a surgery for gastric cancer being included in the study. The immunohistochemical reactions for CD34 and VEGF were performed for all gastric cancers cases included in the study group. Results. MVD has shown in the gastric carcinomas an average value significantly higher in comparison to the normal mucosa (38.7 vs. 12.5, p&lt;0.001 ES). In the intestinal type we have noticed a much lower average MVD than the average MVD in the diffuse type of gastric carcinomas (36.8 vs. 41.6) (p = 0.02478 S). The anaplastic carcinoma and the signet ring cell carcinoma are detaching themselves as histological forms associated to an intense neoangiogenesis activity. The neoangiogenesis activity is correlated with: the histologic grade, the lymphovascular invasion, the level of extend, the lymph node metastasizing, the distant metastasizing and the TNM stage. The positive immunoreactions for VEGF are significantly more frequent in the gastric carcinomas, in comparison to the normal gastric mucosa (65.6% vs. 6.5%, p&lt;0.001 ES). The immunoreactions to the VEGF protein were positive in 71.1% of the intestinal carcinomas, significantly more frequent in comparison to the diffuse type carcinomas (52.9%) (p = 0.018178 S). Our results show a tight correlation between the histologic grade, the level of the tumor invasion and the VEGF expression. Conclusions. Our results prove the major correlation between the VEGF expression and the 5-year survival rate of the patients with gastric cancer, the survival rate for the carcinomas with VEGF +~++ being significantly lower than for the VEGF negative ones (12.5% vs. 23.8%) (p = 0.027983 S).Our study proves a tight correlation between the VEGF expression and the MVD (p = 0.03986 S), these factors playing an important role in the tumoral biologic conduct, in the progression and the prognostic

The Impact Of Introducing Virtual Slides As A Replacement For Powerpoint Presentations In The Students’ Microscopy Labs

INTRODUCTION / BACKGROUND: The medical school students in Timisoara, Romania have been studying pathology slides in microscopy labs according to a protocol which uses classical PowerrPoint presentations as guides for understanding the microscopic features of diseases, followed by individual examination of the glass slides under the microscope. AIMS: We aimed to assess the impact of replacing those presentations with virtual slides (VS). METHODS: In the middle of the semester, for the benign tumors microscopy lab, which is presented over the course of 2 weeks, we used 3 VS, while the other 3 slides were presented in the classical PowerPoint manner. All attending students from the 3rd year of the Medical School of the University of Medicine and Pharmacy “Victor Babes” Timisoara were asked to fill out an anonymous questionnaire at the end of the lab, in which they graded the difficulty in identifying lesions, chose the best/least understood lesion and pointed out the best manner of presentation. RESULTS: 431 valid questionnaires were collected. 52.9% of the students indicated one of the 3 VS as the best understood lesion, while 59.62% chose a different VS as a least understood one. One VS was also the top best (113/332 votes) while another the least understood (34/126 votes) lesion. 74.01% students agreed that VS helped them understand the microscopic criteria better, while 74.71% would like VS to be used in the labs to come. CONCLUSION: VS were appreciated by the students as a novelty and a more impressing way of studying pathology slides, but did not dramatically improve the easiness with which they identify and understand the lesions