Clinical significance of T-bet, GATA-3, and Bcl-6 transcription factor expression in bladder carcinoma

International audienceBackground: The aim of this study was to investigate the clinical significance of three immune cell-related transcription factors, T-bet, GATA-3 and Bcl-6 in bladder cancer in Tunisian patients.Methods: Expression of T-bet, GATA-3 and Bcl-6 genes was assessed using RT-qPCR in 65 bladder cancers from patients: 32 being diagnosed as low-and medium-grade, 31 as high-grade, 25 as muscle invasive stage and 39 as non-muscle invasive stage. Gene expression was statistically correlated according to the grade, the stage, tobacco consumption, the BCG response and disease severity.Results: T-bet levels in patients with high-grade bladder cancer were significantly elevated compared to patients with low-or medium-grade bladder cancer (p = 0.005). In invasive carcinoma (T2-T4), the T-bet levels were significantly higher than in superficial non-invasive bladder tumors (Tis, Ta, and T1) (p = 0.02). However, T-bet is predictive of the response to BCG. Its expression is high in good responders to BCG (p = 0.02). In contrast, the expression of GATA-3 and Bcl-6 in non-invasive carcinoma (p = 0.008 and p = 0.0003) and in patients with low-and medium-grade cancers (p = 0.001 and p < 0.0001) is significantly higher than in invasive bladder tumors and in patients with high-grade bladder carcinoma, respectively. In addition, heavy smokers, whose tumors express low levels of GATA-3 and Bcl-6, are poor responders to BCG (p = 0.01 and p = 0.03). Finally, better patient survival correlated with GATA-3 (p = 0.04) and Bcl-6 (p = 0.04) but not T-bet expression.Conclusions: Our results suggest that T-bet expression in bladder tumors could be a positive prognostic indicator of BCG therapy, even if high levels are found in high-grade and stage of the disease. However, GATA-3 and Bcl-6 expression could be considered as predictive factors for good patient survival

Schwannoma of the eyelid: Apropos of two cases

Schwannoma, also referred to as neurilemmoma, is a benign tumor of peripheral nerve arising from Schwann cells that form the neural sheath. Schwannoma of ophthalmic interest is rare although it has been reported in relation with the orbit, and less frequently with the uveal tract and conjunctiva. Isolated eyelid schwannoma is extremely uncommon. Up until now, only eight cases have been reported in literature. Herein, we report two cases of eyelid schwannoma

Schwannoma of the eyelid: Apropos of two cases

Schwannoma, also referred to as neurilemmoma, is a benign tumor of peripheral nerve arising from Schwann cells that form the neural sheath. Schwannoma of ophthalmic interest is rare although it has been reported in relation with the orbit, and less frequently with the uveal tract and conjunctiva. Isolated eyelid schwannoma is extremely uncommon. Up until now, only eight cases have been reported in literature. Herein, we report two cases of eyelid schwannoma

La valeur pronostique du PASS score dans la distinction entre phéochromocytome bénin et malin

International audienceBACKGROUND: Differentiating malignant from benign pheochromocytoma has been challenging when based on histologic features. This is due to the definition of malignant pheochromocytoma which are defined by the presence of metastases. A PASS score was developed and according to many authors, a PASS score> =4 identified potentially malignant tumors.AIM: To assess the prognostic value of PASS score in differentiating benign pheochromocytomas from malignant ones.METHODS: The records of 11 patients with tumors diagnosed as "pheochromocytoma" were identified from 1970 to 2010 in the files of the pathology, intern medicine and biochemistry departments of the Charles Nicolle hospital and Pasteur Institute. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the diagnostic performance of PASS. The logistic model was developed using the 11 predictive variables. Its performance was evaluated by calculating the area under the ROC curve and comparing it with that of the PASS.RESULTS: In benign tumors, The PASS score was =4 in 6 cases. In malignant tumors, the PASS score was >=4 in both cases. According to the ROC curve analysis, a PASS equal or superior to 4 identifies malignant pheochromocytoma with a sensitivity of 50% and a specificity of 45%.CONCLUSION: I think that PASS score, despite its low sensitivity, may help to reserve the more aggressive treatment and narrow follow up for potentially malignant tumors. Widespread of this called score with complete clinical data will help to validate these findings and to add other prognostic factors of value that could be a part of this scaled score such as immunohistochemical findings.Prérequis : La distinction entre phéochromocytome bénin et malin peut se révéler délicate sur le plan morphologique. Cette difficulté découle de la définition même des phéochromocytomes malins dont le diagnostic repose sur la présence de métastases. Un score de PASS a été développé afin de contribuer à cette distinction. Un score de PASS >4 est corrélé à un haut potentiel de malignité.But: Etudier la valeur pronostique du score de PASS afin de différencier les phéochromocytomes bénins et les phéchromocytomes malins.méthodes: Nous rapportons une étude à propos de 11 patients présentant des phéochromocytomes diagnostiqués entre 1970 et 2010. Des courbes ROC ont été utilisées afin d’évaluer le potentiel diagnostique du score de PASS. Ce modèle logistique a été développé en utilisant 11 variables prédictives. Sa performance a été évaluée en calculant l’aire comprise sous la courbe ROC.résultats: Dans les tumeurs bénignes, le sore de PASS était <4 dans 3 cas et ≥4 dans 6 cas. Dans les tumeurs malignes, le score de PASS était ≥4 dans les 2 cas. L’analyse de la courbe ROC a permis d’établir qu’un score ≥ à 4 permettait d’identifier les phéochromocytomes malins avec une sensibilité de 50% et une spécificité de 45%.Conclusion: Le score de PASS peut contribuer au diagnostic des phéochromocytomes malins et ce malgré sa faible sensibilité.Cependant, ce score pourrait être enrichi par de nouveaux items tel que les données imunohistochimiques permettant ainsi d’améliorer sa sensibilité