Can p53 expression and staining intensity correlate with histopathological prognostic parameter and clinical staging in head and neck squamous cell carcinoma?

Background: In recent years, p53 has emerged as an important tool for not only diagnosis and predicting prognosis in head and neck squamous cell carcinoma. The aim of this study was to find the role of p53 staining intensity in determining prognosis. Materials and Methods: Fifty histopathologically proven cases of squamous cell carcinoma of head and neck were studied. The findings of the study were analyzed particularly in reference to p53 expression and their correlation with age, sex, anatomical site, tumor size, histological grading, vascular, peri-neural, muscle invasion, lymph node metastasis and staining intensity.Results: Immunopositivity rate of p53 was 64% with percentage positive cells varying from 5-76% with mild, moderate and strong staining intensity. A positive correlation of p53 independently was seen with oral cavity, grade, lymph node metastasis and pathological staging.Conclusion: p53 immunoexpression is an important independent variable of prognostication.</p

Sclerosing Stromal Tumor of Ovary: A Case Report

Sclerosing stromal tumor (SST) is an extremely rare and distinctive sex cord stromal tumor which occurs predominantly in the second and third decades of life. We report a case of a 32-year-old woman who developed a sclerosing stromal tumor of ovary and presented with irregular menstruation and pelvic pain. Her hormonal status was normal but CA-125 was raised. She was suspected to have a malignant tumor on computed tomography and underwent bilateral salpingo-oopherectomy. It is therefore necessary to keep in mind the possibility of sclerosing stromal tumor in a young woman

Immunohistochemical Expression of HER2/Neu in Urothelial Carcinoma: A Cross-sectional Study

Introduction: Urothelial Carcinoma (UC) is a disease with significant mortality, estimated to be the ninth most common cause of cancer worldwide and the thirteenth most common cause of death from cancer. It has a significant impact on public health and will continue to do so due to the high prevalence of smoking. To combat the growth of urothelial cancer, awareness regarding primary prevention must be underscored, and smoking cessation programs need to be encouraged and supported. Aim: The aim of this study is to determine the expression of Human Epidermal Receptor 2 (HER2)/neu in UC and its association with age, size, type, grade, and invasion of the tumour. Materials and Methods: This cross-sectional study was conducted at the Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research (a tertiary care centre) in Amritsar, Punjab, India, from January 1st, 2019, to December 31st, 2020. Fifty histopathologically proven cases of UC were examined. HER2/neu expression was studied using immunohistochemistry, and its correlation with age, size, type, grade, and invasion was analysed. The findings of the study were statistically analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0, a statistical program for Microsoft Windows. Results: A total of 50 patients were analysed for the study (40 males and 10 females, with a mean age of 60.4 years at presentation). Nineteen cases were low-grade, and 31 cases were high-grade, with high-grade cases being more invasive. Thirteen cases showed HER2/neu expression, of which 11 were high-grade, indicating a statistically significant relationship between grade and HER2/neu expression. Similarly, expression was higher in cases with lamina propria and muscularis propria invasion. Out of the 34 cases showing lamina propria invasion, 10 cases were positive for HER2/neu expression, constituting 29.4%. Among the 42 cases involving muscularis propria in the biopsy, 16 cases showed muscularis propria invasion by the tumour, with four cases (25%) being positive for HER2/neu expression. Conclusion: The expression of HER2/neu increases with grade and shows more positive expression in high-grade invasive tumours involving lamina propria or muscularis propria. This indicates that HER2/neu protein overexpression is associated with aggressive disease and serves as a negative prognostic marker. Targeted therapy against HER2/neu may prove to be beneficial in such patients

Cytokeratin 5/6 expression in benign and malignant breast lesions

<b>Background:</b> Cytokeratin s (CK) are used for the fingerprinting of carcinomas in general. In breast tissue, the luminal epithelial cells express CK 8/18, CK 7 and CK 19, while basal/myoepithelial cells express CK 5/6, CK 14 and CK 17. <b>Material and Methods:</b> Immunohistochemical staining for cytokeratin 5/6 was applied on cell block sections of 23 cases of benign and 25 cases of malignant breast lesions using avidin biotin peroxidase technique. The distribution and intensity of staining was recorded and graded semiquantitatively. <b>Result:</b> All benign lesions showed positive immunoreaction, with the staining index varying from 6-9, except lactating adenoma. The malignant lesions comprised three cases of ductal carcinoma in situ (DCIS) and 22 cases of infiltrating ductal carcinoma, not otherwise specified, IDC (NOS). None of the DCIS cases showed a positive immunoreaction. Among the IDC (NOS) lesions, six cases of grade III breast carcinoma exhibited a positive immunohistochemical reaction, the staining index of which varied from 2-6. The staining reaction in the malignant lesions was only cytoplasmic and the intensity was significantly less than that of benign lesions. <b>Conclusion:</b> CK 5/6 expression breast carcinoma implies a &#x2032;basal like&#x2032; molecular phenotype and is associated with poor prognosis. This antibody is also used as a component of panels to differentiate benign and malignant breast lesions

Hypoxia-induced factor-1 alpha, vascular endothelial growth factor expression in BRCA1-related breast cancer: A prospective study in tertiary care hospital

Introduction: Breast cancer is the commonest cause of death among middle aged women. BRCA1 associated tumors carry a poor prognosis. Angiogenesis is considered necessary for tumor growth and for its metastasis. Hypoxia stimulates HIF-1α which then activates transcription of various proangiogenic cytokines like VEGF. In the present study we examined HIF-1α expression, sVEGF levels and BRCA1 mutations and their relation with clinicopathological parameters. We also determined whether the angiogenic markers have different role in angiogenesis in BRCA1 related cancers as compared to sporadic breast cancers. Materials and Methods: The study was conducted on 50 cases of breast cancer specimens. Histopathological typing and grading was done followed by immunohistochemistry for BRCA1 and HIF-1α. VEGF was done in the serum by ELISA. Results: All the tumors were infiltrating ductal carcinoma NOS. 16 cases were reported grade II and 34 cases as grade III. On immunohistochemistry, 27 cases showed BRCA1 positivity and HIF-1α was positive in 39 cases. sVEGF levels were increased in 21 cases (42%). BRCA1 positivity, HIF-1α expression and increased VEGF levels were significantly associated with higher grade and lymph node metastasis. There was significant correlation of BRCA1 positivity with increased HIF-1α expression (P = 0.009) and increased sVEGF levels (P = 0.005). Conclusion: Our findings suggest that BRCA 1 positive tumors have unique molecular profile and different mechanism of tumorigenesis. Such tumors are associated with increased HIF-1α expression and VEGF levels

Correlation between histopathological and endoscopic findings of non-malignant gastrointestinal lesions: an experience of a tertiary care teaching hospital from Northern India

Background: Gastrointestinal tract endoscopy along with biopsy is an established procedure for investigating a wide range of gastrointestinal conditions especially inflammatory and malignant diseases. The aim was to study and categorizing the morphological lesions of non-malignant origin at various sites of gastrointestinal tract and to compare with its endoscopic findings.Materials and Methods: This study was conducted on 280 benign GI biopsies received in the Department of Pathology of Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India.Results: Maximum cases (39%) were observed in the age group of 41-60 years. Male patients outnumbered the females (male to female ratio was 1.4:1). There were total 33 esophageal biopsies amongst which the most common lesion was non-specific esophagitis with least common being Barrett’s esophagus. Correlating the results of endoscopic and histopathological features of acute and chronic gastritis a positive predictive value of 80% with sensitivity of 44.4% was seen. Total 83 duodenal biopsies were analyzed with non-specific duodenitis being the most commonly diagnosed lesion followed by celiac disease. Correlation of endoscopic and histopathological findings in celiac disease revealed a sensitivity of 50% and positive predictive value of 42.86%. In both sigmoid colon and rectum, non-specific colitis was the commonest diagnosis followed by ulcerative colitis. Endoscopic findings were correlated with the histopathological features in ulcerative colitis, revealing a sensitivity of 57.14% along with the positive predictive value of 80%.  Conclusion: Histopathology remains the gold standard for diagnosing a case along with endoscopic findings and endoscopic findings alone cannot make the final diagnosis.</p

Cytologic-Radiologic Correlation Using Transthoracic CT-Guided FNA for Lung and Mediastinal Masses: Our Experience

Background and Objectives. Thoracic lesions account for various benign and malignant conditions. Of these lung carcinoma (mainly primary) is the most common carcinoma in the world. The present study was undertaken to know the pathological spectrum of thoracic lesions and to correlate cytoradiological findings. Materials and Methods. The present study was conducted in a tertiary care center of North India on 74 patients over an 18-month period. CT guided transthoracic FNAC (TTFNA) was carried out, and aspirates were drawn, examined, and compared with radiological diagnoses. Results. The diagnostic accuracy for FNA in the present study was calculated to be 95.94% (using cytology as the gold standard). The predominant lesion was malignancy (85.1%), followed by suspicions of malignancy and inflammatory pathology (5.40% each). By cytology, the most common malignant lesion was adenocarcinoma (48%) followed by squamous cell carcinoma (40%), small cell carcinoma (8%), and undifferentiated carcinoma (4%). Cytoradiological correlation was found to be 89.2% in the present study. Conclusion. Present study thus concludes that TT FNA of thoracic lesions is a simple, safe, economically prudent technique associated with low morbidity and leading to quick and early diagnosis

Immunohistochemical expression of Ets-related gene-transcriptional factor in adenocarcinoma prostate and its correlation with Gleason score

Background: Prostate carcinoma is the second leading cause of cancer-related deaths in males worldwide. The burden is expected to grow 1.7 million new cases and 499,000 new deaths by 2030. In developing countries such as India, prostate carcinoma will show an increase by 140% in the next few years. Although the diagnosis of prostate carcinoma can usually be made on histological features, now a days many immunohistochemical (IHC) markers are used to distinguish it from benign mimickers as well as in predicting prognosis and treatment. Out of these markers, Ets-related gene (ERG product) is a proto-oncogene which participates in chromosomal translocations and is frequently over expressed in prostate carcinoma which harbors ERG-transmembrane protease, serine 2 fusion. Materials and Methods: Fifty cases of carcinoma prostate diagnosed in needle biopsies and prostatic chips, in the Department of Pathology of a tertiary care teaching hospital in Punjab, India, were included in the present study. The slides were observed under the light microscope, and Gleason scoring was done using the 2005 International Society of Urological Pathology modified Gleason system. IHC study for ERG expression was done on all the cases, for which anti-ERG monoclonal rabbit clone antibody EP111 (Dako, Denmark) was used. Lymphocytes and endothelial cells were taken as in built positive controls for staining. The intensity of ERG positivity was scored as no staining (0), weak staining (+1), moderate staining (+2) and intense staining (+3). The H score was then calculated by multiplying the intensity of the stain with the percentage (0-100) of the cells showing that staining intensity. The H-score has a range of 0-300. The relationship between IHC expression and clinico-pathological parameters was compared and analyzed using Chi-square test. P < 0.05 was considered statistically significant. Results: Majority of patients included in the study were in the age group of 61-80 (84% of the total). When ERG expression was studied with age-specific rates, it was not found to be statistically significant. The most common pattern noted in the present study was 4 + 3, constituting 36% of total, followed by 3 + 4 constituting 32%. Calculating the score, the majority of patients had a Gleason score of 5-8, constituting 76% of total. Out of the total fifty cases of prostate carcinoma, ERG was positive in 29 cases (58%) and negative in 21 cases (42%). Fourteen out of 21 (48%) of the ERG positive cases had an intensity score of 3. When the ERG intensity was correlated with the Gleason score group, it was seen that patients having Gleason score 7-8 showed ERG positivity in 19 out of 38 cases (50%), with 11/19 (57%) cases showing an ERG intensity score of 3. The Gleason score group 9-10 showed ERG positivity in 83% (10/12) cases, 20% (2/10) cases showing intensity score of 3. This correlation was found to be statistically significant. Conclusion: ERG immunostaining was performed in a small Indian cohort of prostate cancer patients, diagnosed in trucut biopsy specimens and prostatic chips. ERG expression was found in 58% patients. An increase in the ERG expression was observed with an increase in Gleason score. The intensity of ERG expression, however, decreased with an increasing Gleason score