PROSTAT KARSİNOMLARINDA E-CADHERİN ve BETACATEN İN EKSPRESYONUNUN GLEASON GRADE ve DİGER PROGNOSTİK FAKTÖRLERLE KARSILASTIRILMASI

Gleason grade’i 40 yılı asan süre boyunca prostat karsinomunun en önemli prognostik faktörü olmustur. Patoloji dünyasında bu kadar uzun süre, bazı küçük modifikasyonlar dısında varlıgı sürdürebilen tek gradeleme sistemi olan Gleason grade’i bu çalısmanın tam merkezinde yer almaktatır. Bu çalısmada Gazi Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı’nda 2003-2008 yılları arasındaki 156 radikal prostatektomi olguları ele alınıp, Gleason skorları ile diger prognostik faktörler ve adezyon moleküllerinden E-cadherin ve Beta-catenin ekspresyonları arasındaki iliski çalısılmıstır. Doku mikroarray yöntemi ile immünhistokimyasal olarak degerlendirilen E-cadherin ve Beta-catenin ekspresyonlarının özellikle yüksek Gleason skoruna sahip olgularda anlamlı derecede kayba ugradıgı saptanmıstır. Ayrıca bu iki adezyon molekülünde ekspresyon kaybı gösteren olguların daha sık seminal vezikül invazyonu ve daha sık prostat dısı yayılım gösterdigi dikkati çekmistir. Tüm bu bulgular literatür ile uyumlu olarak hem E-cadherin hemde Beta-catenin’nin ekspresyon kaybının prostat karsinomu progresyonunda rolü oldugunu düsündürmektedir. Bu bulgulara ek olarak kapsül invazyonu, seminal vezikül invazyonu, prostat dısı yayılım varlıgı, perinöral invazyon ve tümör volümü gibi prognostik faktörlerin Gleason skoru ile iliskili oldukları gösterilmistir. Sonuç olarak bu çalısma prostat karsinomlarında adezyon molekülleri ve diger prognostik faktörler ile Gleason grade’i arasındaki anlamlı iliski oldugunu göstermistir.Gleason Grading System has been the most significant prognostic factor of prostatic carsinoma for over forty years. The Gleason grading system, which has not changed in years with only a few modifications in pathology. In this study, gleason grading system, as well as other prognostics factors and two adhesion molecules E-cadherin and Beta-catenin expressions were investigated in cases with radical prostatektomy in Gazi University, Faculty of Medicine faculty between 2003 and 2008. E-cadherin and Beta-catenin expressions, evaluated by immunhistochemistry with tissue microarray analyses, were significantly decreased in cases with high gleason grading scores. In addition; expression of adhesions molecules were reduced in cases with invasion of seminal vesicule and outside the prostate. All these findings were consistent with recent literature, and indicate that decreased expression of E-cadherin and Beta-catenin may play a role in progression of prostatic carsinoma. It has been showed in this study that the prognostic factors like capsuler invasion, invasion to seminal vesicule, invasion outside the prostate, perineural invasion and tumor size were correlated with high Gleason grading system scores. Finally; we found that there was a considerable relationship between adhesion molecules, other prognostic factors and Gleason Grading System

Diagnostic value of S100P, IMP3, Maspin, and pVHL in the differantial diagnosis of pancreatic ductal adenocarcinoma and normal/chronic pancreatitis in fine needle aspiration biopsy

Introduction: Differentiation between pancreatic ductal adenocarcinoma (PDAC) from benign mimickers is a well-known problem in cytological materials. Recent studies incorporated biological markers into this question and some studies showed that expression of S100P, IMP3, and maspin as well as nonexpression of von Hippel-Lindau gene product (pVHL) were significantly correlated with PDAC. In this study, we aimed to investigate diagnostic value of maspin, IMP3, S100P, and pVHL immunostaining in fine needle aspiration biopsies (FNABs) of pancreatic lesions. Materials and Method: In all, 33 cases of FNAB cell blocks of PDAC and 34 cases of surgical non-neoplastic pancreas specimens which were retrieved from the archives slides from 2007 to 2011 were included in this study. All the cases were stained with maspin, IMP3, S100P, and pVHL. Expression patterns of markers were scored and compared with benign mimickers. Test performance of each antibody and possible antibody combinations were also evaluated. Results: The study was composed of 33 PDAC and 34 control cases (8 chronic pancreatitis, 3 mucinous cystic neoplasm, and 23 nontumoral pancreatic tissue of PDAC). Diagnostic sensitivity for malignancy in S100P, IMP3, and maspin was 84.8%, 81.8%, and 87.5%, respectively. Specificity of these three markers was 100%. Sensitivity and specificity of pVHL for detecting nontumoral pancreatic tissue were 100% and 81.8%, respectively. When maspin, IMP3, and S100P expression were used together as triple test, sensitivity was 62.5% and specificity 100%. However, when any two of each three markers were evaluated (triple test/dual response), sensitivity reached 93.8% and specificity 100%. Conclusion: We observed that dual response in triple test (positive staining with two of these three markers) of maspin, IMP3, and S100P immunocytochemistry is very sensitive and specific in differential diagnosis of PDA and non-neoplastic pancreatic lesions. pVHL may have an additional role, when triple assessment is not satisfactory

Cold Injury and Perniosis (Chilblain)

Perniosis (chilblain) is inflammatory cutaneous lesions located on acral surfaces (fingers, toes, nose, aurikula) which present in association with cold exposure. They can appear as an idiopathic (primary) dermatosis or with an underlying autoimmune disease (secondary). The primary or idiopathic form is not associated with an underlying disease and is clinically indistinguishable from the secondary form. The secondary form is associated with an underlying condition such as connective tissue disease, monoclonal gammopathy, cryoglobulinemia, or chronic myelomonocytic leukemia. Histopathology cannot accurately help distinguish the primary from secondary forms of chilblains. This review aims to raise the awareness of perniosis to avoid excessive investigation and anxiety and to help patients with only appropriate simple advice and treatment. [Archives Medical Review Journal 2015; 24(4.000): 463-471