Background The commonest type of thyroid malignancy is papillary thyroid carcinoma (PTC), either in adults or the pediatric population. Checkpoint kinase 2 (Chk2) is an important signal transduction protein that orchestrates DNA damage responses together with p53, the guardian of the genome. Aim Assessment of Chk2 expression in PTC in comparison to normal thyroid tissue control and correlation of this expression with the studied clinico-pathological parameters and with p53 positivity in these tumors. Patients and methods For 83 specimens (65 specimens of PTC tissue and 18 controls of normal thyroid tissue) that underwent thyroidectomy, immunohistochemical staining for Chk2 and p53 was done, evaluated and correlated with each other. Results High Chk2 expression was seen in 70.8% of PTC cases, while only 33.3% of the normal thyroid tissue control showed high Chk2 expression ( P =0.009). Positive p53 was detected in 56.9% of PTC cases. High Chk2 expression was significantly correlated with p53 positivity ( P =0.036). Conclusion Chk2 is a promising diagnostic biomarker for differentiation between benign and malignant thyroid tumors. Concomitant expression of Chk2 and p53 support dysregulation of the DNA damage response pathway in PTC.
Background Thymomas are unique thymic epithelial tumors, displaying a range of types. Although all of these are considered malignant, they vary in biological behavior and aggressiveness, which reflects in therapeutic approaches and treatment regimens. EZH2 is implicated in carcinogenesis, angiogenesis, and tumor progression. Current work aimed to assess the diagnostic significance of EZH2 immunoexpression in thymic epithelial tumors, and to evaluate its relation to Ki-67 immunohistochemical expression. Materials and methods Seventy cases diagnosed as thymomas were retrieved from the Tanta University, Pathology Department, and private laboratories from November 2023 to November 2024. Cases were classified as: thymoma type A (five cases), thymoma type AB (10 cases), thymoma type B (35 cases), including thymoma type B1 (five cases), thymoma type B2 (15 cases), thymoma type B3 (15 cases), thymoma type C (20 cases). Immunostaining was performed using EZH2 and Ki-67 antibodies. Results EZH2 distinguished thymoma type C from type B3 at cut-off value of more than 70%, with a sensitivity of 95.0%, and a specificity of 93.33%. Moreover, EZH2 distinguished thymoma types B3 and type C from other types at a cut-off value of more than 30%, with a sensitivity of 97.14%, and aspecificity of 94.29%. Mean Ki-67 percentage area was 18.95 ± 0.95 in thymoma type C, 15.50 ± 0.73 in thymoma type B3. A significant relation was detected between EZH2 expression and Ki-67 percentage area. Conclusion EZH2 may be a valuable marker in detecting aggressive thymoma subtypes, highlighting its role in tumor classification. Incorporating EZH2 into standard diagnostic workup could improve patient stratification and guide personalized treatment strategies for thymic epithelial tumors.
Background: Diffuse Large B-Cell Lymphoma (DLBCL) is the most common type of lymphoma in Egypt. The prognosis of this tumor is represented by clinical and histopathological assessment. FOXP1 was examined as a tumor suppressor in epithelial malignancies and as oncogene in certain large B-cell lymphomas. Certain subtypes of DLBCL cell lines expresses smaller FOXP1 isoforms has a bad prognosis. Also, Both Notch1 and Notch2 control the expression of numerous proto-oncogenes. Notch signaling plays a role in hematopoiesis and angiogenesis in addition to differentiation, proliferation, and death. Aim: In this study, FOXP1 and Notch2 immunohistochemistry staining were evaluated for the prognosis of the cancer. Methods: Blocks of 48 formalin-fixed paraffin-embedded tissues blocks diagnosed as diffuse large B cell lymphoma are immune stained for FOXP1 and Notch2. Results: FOXP1 showed an associated aggressiveness of the course of lymphoma, but no relation to the outcome of the disease. On the other hand, Notch2 staining showed a favorable prognosis in males. Neither expression was associated with the rate of relapse. Conclusion: Both immune staining gives importance to possible epigenetic control and more research is needed to examine gender differences in lymphoma prognosis.
Background/Aim: The tumor immune microenvironment plays a critical role in colorectal cancer (CRC) progression and patient prognosis. This study aimed to evaluate the prognostic significance of the Immunoscore based on CD3+ and CD8+ T-cell infiltration and to investigate its association with clinicopathological parameters, tumor budding, and other microenvironment-related prognostic indicators in colorectal adenocarcinoma. Methods: This retrospective observational study included 31 Egyptian patients diagnosed with sporadic colorectal adenocarcinoma who underwent surgical resection between January 2021 and December 2023. Histopathological assessment included tumor grading, TNM staging, tumor budding, lymphocytic reactions, tumor stroma percentage, and Glasgow microenvironment score (GMS). Immunohistochemical staining for CD3 and CD8 was performed on formalin-fixed paraffin-embedded tissue sections. The Immunoscore was calculated according to the validated society for immunotherapy of cancer algorithm using CD3+ and CD8+ T-cell densities in both the tumor core and invasive margin. Statistical analyses and ROC curve assessments were performed to evaluate prognostic and diagnostic performance. Results: Higher Immunoscore levels showed significant associations with adverse clinicopathological features, including tumor budding, lymph node ratio, advanced TNM stage, perineural invasion, serosal invasion, tumor size, and stromal-related parameters (P<0.05). Significant correlations were also observed with Crohn’s-like reaction, peritumoral lymphocytic reaction, periglandular lymphocytic reaction, and KM score. ROC curve analysis demonstrated excellent diagnostic performance for several immune-related parameters, particularly tumor stroma ratio, tumor-infiltrating lymphocytes, Glasgow microenvironment score, and tumor budding-associated Immunoscore, with high AUC values. Conclusion: The Immunoscore represents a robust prognostic biomarker in colorectal adenocarcinoma and provides valuable insight into the tumor immune microenvironment. Integration of Immunoscore with tumor budding and stromal parameters may improve risk stratification and support more personalized prognostic assessment in CRC patients.
Background In Egypt, gastric cancer represents a significant and increasing health burden. Abnormalities in Human Leukocytes Antigen class I (HLA-I) and class II (HLA-II) expression on tumor cells have been widely implicated in immune evasion. Moreover, the cellular components of the tumor microenvironment are known to contribute to tumor promotion, progression, angiogenesis, and suppression of anti-tumor immune responses. However, the specific role of HLA-I and HLA-II in modulating these microenvironmental processes remains inadequately understood. Aims To investigate the nature of inflammatory cell infiltration and the roles of HLA-I and HLA-II in the microenvironment of chronic gastritis and gastric carcinoma (GC). Patients and methods This retrospective study included GC tissues from 64 patients, along with 32 matched samples of adjacent nontumorous tissue. Additionally, 65 gastric tissue samples from patients with chronic gastritis were analyzed. Immunohistochemical evaluation of CD3, CD4, CD8, CD20, CD68, HLA-I, and HLA-II expression was performed in both chronic gastritis and GC microenvironments. Results A significant increase in CD4 + and CD68 + cell infiltration was observed in the tumor microenvironment, with higher counts associated with unfavorable histopathological parameters. HLA-I and HLA-II expression levels were significantly elevated in the GC microenvironment compared with chronic gastritis. Positive expression of HLA-I and HLA-II in tumor tissues correlated with adverse prognostic histological features. Conclusion CD68 + macrophages, along with HLA-I and HLA-II expression within the tumor microenvironment, may contribute to the pathophysiology of gastric cancer among Egyptian patients. These findings may pave the way for future studies and novel therapeutic strategies targeting the immune microenvironment and warranting validation in larger cohorts.
Background In the world, colorectal cancer (CRC) is thought to be the primary cause of cancer death. The molecular etiology of sporadic CRC has identified many carcinogenic pathways. Patients and methods Fifty CRC patients were enrolled in this retrospective study. The mutational status of KRAS, BRAF, and PIK3CA was examined using the high-resolution melting (HRM) assay. Immunohistochemistry (IHC) was used to detect loss of the mismatch repair (MMR) proteins. Association with clinicopathologic characteristics were analyzed. Results In this study, the deletion rate of the MMR protein was 8/50 (16%). KRAS gene mutation was detected in 14/50 (28%) of studied cases. Mutation rate of BRAF was 6% (3/50), while mutation rate of PIK3CA was 20% (10/50). Eight percent of studied cases showed concomitant mutations. Significant association was detected between mutated KRAS and younger age ( P =0.007) and right colon location ( P =0.000). BRAF mutation significantly associated with right colon location ( P =0.015), tumor type ( P =0.017). No significant association was detected between PIK3CA gene mutation and various clinicopathological parameters ( P >0.05). dMMR cases associated with lower patient age ( P =0.021), right colon location ( P =0.021) and higher TILs ( P =0.016). The mutation rate of KRAS was higher in pMMR cases. Patients with multiple mutations had higher grade, mucoid adenocarcinoma type and exhibit right colon location. Conclusion dMMR protein is associated with a low rate of KRAS gene mutation and frequent BRAF and PIK3CA gene mutations. The prognostic significance of gene mutations in CRC patients should be evaluated while taking into account the concurrent mutation statuses of KRAS, BRAF, and PIK3CA.
Background Oral squamous cell carcinoma (OSCC) has a disabling poor prognostic outcome representing a common locally aggressive head and neck cancer with high metastatic potential. Investigating prognostic new perspectives in depth taking into consideration the critical role of the tumor microenvironment will have a major impact on the improvement of patient care and outcome. Aim To assess the value of CD163 tumor associated macrophages (TAMs) immunohistochemical expression and tumor budding (TB) in OSCC. Patients and methods A total of 60 cases diagnosed as OSCC (39 biopsies and 21 radical specimens) were assessed for histopathological parameters according to the fifth WHO-Head and Neck tumors and tumor infiltrating lymphocytes (TILs) recorded as(0–10%) as low and TILs (11–100%) as high. TB score (TBS) values as low (0–4 buds), intermediate (5–9 buds) and high (>10 buds). Immunohistochemical staining for CD163 was preformed on all cases and evaluated expression in TAMs as (0) for no positive cells, (1+) score when 1–25% positive TAMs were seen, (2+) score recorded when 26–50% positive TAMs seen and (3+) score when greater than 50% positive TAMs present. Results CD163 expression showed a statistically significant correlation with poor prognostic parameters in all cases as histologic grade ( P =0.009), the worst pattern of invasion (WPOI) ( P =0.001), and Perineural invasion ( P =0.024). Tumor stage and size in radical specimens exhibited a positive significance with CD163-TAMs expression having a P value of less than 0.001 and 0.008, respectively. TBS recorded a significant correlation with tumor grade ( P =0.001), WPOI ( P =0.001), and the mean expression for CD163-expression ( P =0.043). Conclusion CD163 TAMs higher expression is significantly correlated to poor pathological parameters including (tumor size, grade, WPOI, perineural invasion, TB, stage). A higher TBS is significantly correlated to higher tumor grade and WPOI. CD163 + TAMs and TBS are poor prognostic parameters in OSCC. CD163 TAMs expression can represent a potential therapeutic target.
Background Expression of BMI1 and GATA3 in the breast can provide complementary prognostic implications as BMI1 is often a marker of stemness and tumor progression, while GATA3 positivity can provide a better prognosis and a more differentiated tumor state. Materials and methods Seventy cases of invasive breast carcinoma were tested for BMI1 and GATA3 immunohistochemical expression. Moreover, histopathological features and ER, PR, HER2-status, including available chromogenic in situ hybridization and Ki67 results, molecular subclassification were evaluated. Results BMI1 and GATA3 were expressed in 72.9 and 77.1 of our cases, respectively. However, no statistically significant correlation was observed between the expression of both markers and tumor stage, histological subtype, lymphovascular or perineural invasion, or molecular subtype. Conclusion The complementary, combined applications of BMI1–GATA3 immunostaining failed to be a prognostic factor among Egyptian breast cancer females. Identifying differences between populations and their response to anticancer drugs would help predict potential resistance to chemotherapy and thus help select the most suitable anticancer treatment. Therefore, additional studies are necessary to definitively evaluate the clinical utility of the combination of CSC marker BMI1 and GATA3 in breast cancer.
Background Neoadjuvant chemotherapy (NACT) refers to the systemic treatment of Breast cancer (BC) before definitive surgical therapy to downstage the tumor, facilitate less extensive surgery on the breast and/or axilla, and reduce postoperative complications such as lymphedema. Clinico-pathologic features such as age, radiological tumor size, focality, histologic type, grade, Duct carcinoma in situ (DCIS), tumor-infiltrating lymphocytes (TILs), and the biological subtypes of the tumor based on the pre-NACT core needle biopsy evaluation play a crucial role in predicting the response to NACT. Aim To assess histopathological parameters before and after NACT and their potential predictive value for NACT response in different biological BC subtypes. Patients and methods This study covered a total of 99 cases who received NACT. Revision of H&E slides, along with immunohistochemically stained slides of pre-NACT core biopsy of these cases were applied to confirm the diagnosis, classify BC into different biologic subtypes as per the established surrogate markers, and record relevant prognostic histopathological findings. Tumor histologic subtype, grade, DCIS, and TILs were evaluated. Post-NACT specimens’ H&E slides were also examined to assess and determine NACT response. Results Pathological complete response (pCR) was achieved in 17.17% of the studied cases. Achieving pCR was statistically significant related to the absence of pre-NACT DCIS ( P 0.01), higher values of continuous and categorical TILs ( P 0.002 and 0.01, respectively), human epidermal growth factor receptor 2 (Her2) positive expression ( P <0.001), and high Ki67 greater than or equal to 20% ( P 0.05). Most pCR cases corresponded to the luminal B (HR+/Her2+) subtype, followed by Her2-enriched subtype. Moreover, pCR showed no significant relation to the age of disease onset, pre-NACT tumor size, pre-NACT histologic type, or grade. Conclusion This study suggests that pre-NACT TILs and Ki67 could be potential strong predictors of NACT response, thus emphasizing their vital role in BC cases.
Background and objectives In Egypt, colorectal cancer (CRC) ranks first among digestive system cancers, necessitating the search for potential prognostic and therapeutic targets. We aimed to study the immunohistochemical expression of hypoxia-inducible factor-1 alpha (HIF-1α), B cell lymphoma-2 (Bcl-2) and cathepsin D (CD) in cases of colorectal carcinoma, which may facilitate the development of targeted therapies and potential prognostic and/or diagnostic factors. Patients and methods A total of 60 colorectal carcinoma cases were immunohistochemically stained by HIF-1α, Bcl-2, and CD. Results HIF-1α was detected in 60% of the cases studied, while 40% showed no expression. A statistically significant correlation was found between HIF-1α expression and how deeply the tumor had invaded (T stage) ( P =0.023). Bcl-2 was present in 38.3% of the cases. However, no link was found between Bcl-2 expression and any of the clinical or pathological characteristics examined. CD immunohistochemical expression was positive in 90% of cases. The correlation between the expression of CD and the site of the tumor was statistically significant, since the left-sided colon has the highest positive CD expression (40.7%) ( P =0.001). Cases presented clinically with bleeding per rectum showed the highest positive CD expression, (51.7%) ( P =0.021), also cases with histologic grade II (38 out of 44 cases) showed the highest positive CD expression ( P= 0.035). Conclusion Based on our current understanding of the literature, there are no prior studies that have investigated the determination of the interplay of hypoxia, apoptosis resistance, and invasive behavior among colorectal carcinoma patients. Therefore, our results indicated that while Bcl-2, CD, and HIF-1α are all involved in various aspects of cancer development, they do not appear to be strongly linked in their expression patterns within CRC. But, HIF-1α and CD protein expressions are strongly related to diagnosis of high-risk CRC cases being correlated to higher T stage and higher grading.
Introduction The papillary thyroid carcinoma (PTC) is considered the most common form of thyroid cancer; its nuclear characteristics are the most diagnostic feature, but some of these characteristics may be found in other thyroid tumors, making its diagnosis a challenge. Aim Assess the diagnostic utility of NPC2 and CD56 in differentiating PTC from other thyroid lesions that share the same characteristics. Materials and methods Seventy tissue blocks representing benign (20 fibroadenoma and 10 nodular hyperplasia) and malignant thyroid lesions (30 PTC and 10 follicular carcinoma) were randomly selected for the current study. Institutional Review Board, Minya University has reviewed and approved the submitted research proposal “Approval No. 404/04/2021.” Results 51.4% of the various thyroid lesions under investigation have strong NPC2 expression. A significant association was found between NPC2 expression and histologic subtype (P<0.001), PTC versus non-PTC lesions (P<0.001) and patients’ sex (P=0.044). Regarding PTC patients, NPC2 was found to be highly expressed in 83.3% of cases, and a statistically significant association was found between NPC2 expression and pathological tumor stage (P=0.013). CD56 negative expressions were found in 48.6% of all the studied cases. A statistically significant association was found between CD56 expression and histologic subtype, benign versus malignant lesions and PTC versus non-PTC lesions (P<0.001, 0.001, and 0.001). CD56 negative expression was found in 86.7% of PTC cases. A statistically significant association was found between CD56 expression and site of lesion and lymph node metastasis in PTC cases (P=0.029 and 0.009, respectively). Conclusion NPC2 and CD56 can be useful immunohistochemical markers in differentiating PTC from other thyroid mimics.
Background Laryngeal squamous cell carcinoma (LSCC) accounts for one-third of head and neck cancers with significant morbidity and mortality burdens, accounting for about 2.4% of newly diagnosed malignancies worldwide each year. Early disease accurate diagnosis is needed to improve patients’ care and outcomes. Intensified work has been implemented to study the diagnostic role of tumor microenvironment, which is the role of cancer-associated fibroblasts. Aim To assess the diagnostic role of α-smooth muscle actin (α-SMA) stromal immunohistochemical expression in the detection of superficial invasive LSCC. Patients and methods This study included 108 cases of Laryngeal biopsy samples further divided into four groups: group 1: 32 cases of superficial invasive LSCC, group 2: 20 cases of laryngeal high-grade dysplasia, group 3: 36 cases of pseudoepitheliomatous hyperplasia with or without low-grade dysplasia, and group 4: 20 cases of invasive LSCC. Immunohistochemical staining and evaluation for α-SMA in the studies cases was done. Results In the current study, α-SMA was significantly expressed in the stoma of superficial invasive LSCC cases, seen in (28/32) 87.5% and in all cases of invasive LSCC cases (20/20) 100% with P value less than 0.001, compared to complete negative stromal labeling for α-SMA in all cases of high-grade dysplasia group (0/20), and rarely in pseudoepitheliomatous hyperplasia with or without (low-grade dysplasia) group (2/36) 5.6%. In superficial invasive LSCC cases, α-SMA diffuse and focal stromal pattern of expression was predominately seen in most of the cases 21/32 (65.7%) of this group as well as in invasive LSCC cases (18/20) 90%. The pattern of α-SMA stromal expression in superficial invasive LSCC cases as diffuse and focal was significantly correlated to the desmoplastic and mixed stromal reactional patterns versus scattered/negative α-SMA expression pattern in inflammatory only stromal reaction with P value 0.013. Tumor-infiltrating lymphocytes (TILs) amount seen in the superficial invasive LSCC group displayed a statistically significant inverse relation with the pattern of expression of α-SMA, showing low TILs with diffuse α-SMA positive pattern and scattered/negative α-SMA stromal labeling pattern with high TILs having P value 0.003. Conclusion α-SMA immunohistochemical labeling for stromal cancer-associated fibroblasts plays a diagnostic role in identifying the invasion for superficial invasive LSCC, aiding in early accurate detection of this burdening disease. The α-SMA interstitial expression pattern is related to the desmoplastic and mixed pattern of stromal reaction and inversely correlated to the TILs level.
Adrenal cortical adenomas are common benign tumors, making up 40.48% of suprarenal lesions in Egypt, while adrenocortical carcinoma (ACC) is a rare yet aggressive malignancy with a global prevalence of 4–12 cases per million and a 5-year survival rate of 16–38%. Immune checkpoint molecule programmed death-ligand 1 (PD-L1) aids cancer immune evasion by suppressing T-cell responses, while fascin actin-bundling protein 1 (FSCN1), an action-bundling protein, promotes cell migration and tumor metastasis. Cluster of differentiation 8 + (CD8 + ) T cells, key players in antitumor immunity, target malignant cells, with their tumor infiltration being essential for effective immune responses against cancer. This study’s objective is to estimate PD-L1 and FSCN1 immunohistochemical expression in adrenocortical tumors, correlating them with CD8 + tumor-infiltrating lymphocytes (TILs) and histopathological features. The goal is to explore their roles in tumor progression, prognosis prediction, and survival outcomes. Patient and methods This retrospective study evaluates the immunohistochemical expression of PD-L1, CD8, and FSCN1 markers in cases of adrenocortical adenoma and carcinoma. Immunohistochemical staining was conducted using the standard labelled streptavidin-biotin method, with the findings analyzed about clinicopathological parameters. Results This study of 60 of adrenocortical adenomas and carcinomas found significant differences in age, tumor size, PD-L1, and FSCN1 expression, with higher levels in carcinomas. PD-L1 correlated with advanced stage and metastasis, while FSCN1 correlated with capsular and lymphovascular invasion in carcinoma cases. CD8 + TIL density showed no statistical differences but correlated with poor survival outcomes in carcinomas. Conclusion Its potential as a prognostic marker and therapeutic target is highlighted by the correlations found between greater PD-L1 expression and advanced stage, metastasis, and poor prognosis in ACC. Elevated FSCN1, linked to invasion and metastasis, shows superior diagnostic accuracy (86.7%) over PD-L1. Paradoxically, higher CD8 + TIL density associates with poor survival, likely due to immune dysfunction in the tumor microenvironment.
Background Colorectal cancer (CRC) is the third most common cancer. Tumor-associated macrophages can affect tumor cell proliferation, stromal formation and dissolution, vascularization, and both pro- and anti-neoplastic inflammation. Cluster of differentiation 68 (CD68) plays a critical role in promoting phagocytosis; however, its function in tumor immunity remains unknown. CD47, a cell-surface receptor expressed by macrophages, provides a potent ‘don’t eat me‘ signal that allows tumor cells to evade immune destruction. Purpose Investigate immunohistochemical expression of CD68 and CD47 in CRCs and its correlation with clinicopathological features. Results CD68 and epithelial expression of CD47 were significantly in favor of CRC ( P value = 0.001, <0.001, respectively) compared with adenoma specimens. Also, high epithelial CD47 was associated with the absence of gross perforation and a higher number of investigated lymph. However, low stromal CD47 was significantly correlated with less tumor metastasis and less tumor recurrence. Moreover, epithelial, and stromal CD47 expression were significantly correlated in CRC. ( P =0.033) in CRC. Conclusion Both CD68 and CD47 play a role in colorectal carcinogenesis being expressed more in CRC compared with adenoma cases. However, CD47 carries good prognostic impact when expressed by tumor cells in contrary to its stromal expression suggesting dual opposing role of CD47 in CRC according to its localization. So, future target therapy against CD68 or CD47 should be cautiously administered.
Background A critical need for new therapeutic targets and more precise markers of endometrial carcinoma (EC) is required, particularly for metastatic and recurrent cases. The purpose of this work is to examine the utility of SOX10 expression in EC. In addition, we looked at estrogen receptor (ER) expression in EC and examined its correlation with clinicopathologic variables. Patients and methods This retrospective study included 108 EC hysterectomy specimens from Egyptian patients. Immunohistochemical staining for SOX10 and ER was performed using the streptavidin–biotin–peroxidase technique. The results were correlated with clinicopathologic parameters together with overall (OS) and recurrence-free survival. Results Surprisingly, SOX10 expression appeared negative in all studied EC patients. Positive ER expression was noticed in 67 (62%) cases that was closely linked to negative nodal metastasis, M0 stage, early-stage group, absence of recurrence, type I EC, and low-grade tumors. A complete response to therapy was significantly correlated with increased ER total percentage and H -score of expression. Endometrial cancer patients with early-stage diseases (T1, N0, and M0), no recurrence, type I EC, less than or equal to 50% myometrial invasion, absence of necrosis, adjacent hyperplastic endometrium, complete response to therapy, and positive ER expression exhibited better OS rates. In addition, longer recurrence-free survival was associated with cases exhibiting strong ER-dominant intensity. Conclusion ER expression in EC was correlated with a number of favorable prognostic parameters, better OS, and a complete response to therapy. These findings are therapeutically important because ER loss may help to distinguish high-risk patients for accurate personalized treatment. Moreover, the fact that SOX10 was negatively expressed in all studied cases indicated that it had no impact either on initiation or progression of EC.
Background Pancreatic cancer ranks seventh in the world for cancer-related deaths in both sexes and causes. An accurate and timely diagnosis is necessary to maximize the treatment efficacy of pancreatic tumors. This benefit has been established by endoscopic ultrasonography-fine needle aspiration cytology. Immunohistochemical staining is a useful method for diagnosis that can speed up diagnosis and improve the precision of distinguishing between pancreatic lesions. Patients and methods Our research’s objective is to determine the benefits of adding MUC5AC, P53 immunohistochemical analysis for sensitivity and specificity of the endoscopic ultrasonography-fine needle aspiration cytology (EUS-FNAC) diagnosis of pancreatic ductal adenocarcinoma (PDAC). Results The results of 141 EUS-FNAC specimens of pancreatic lesions using the Papanicolaou reporting system were as follows: 12 cases were classified as (I) nondiagnostic, 63 cases as (II) negative for malignancy, eight cases as (III) atypical, six cases as (IV) neoplastic: benign, 16 cases as (V) suspicious for malignancy, and 36 as (VI) malignant. Fifty-eight cases were identified as (III), (V), and (VI) and were subjected to further immunohistochemical staining of their cell blocks. Compared to the 68, 90, 97, and 37% of the EUS-FNAC analysis alone for the detection of PDAC, the sensitivity, specificity, positive predictive value, and negative predictive value of the combination of EUS-FNAC analysis with both P53 and MUC5AC were 86, 100, 100, and 59%. Conclusions The sensitivity and specificity of the EUS-FNAC analysis combined with both P53 and MUC5AC were significantly greater than those of the cytological analysis alone, especially in indeterminate cases; it could help enhance PDAC’s tissue diagnostic capabilities using EUS-FNAC.
Background Infiltrating immune cells have been reported as prognostic markers in many types of cancer. We aimed to assess the prognostic role of tumor-infiltrating lymphocytes, CD3+ cells, and CD8+ cells in prostatic cancer. Patients and methods Immunohistochemistry was used to determine the expression of CD3 and CD8 in 60 prostatic cancer tumor samples. We used digital pathology to calculate the densities of these markers and determined an immunoscore based on the densities of both markers in intratumoral and stromal tissues. Results Densities of CD3+ and CD8+ T cells in tumors were positively related to age and prostate-specific antigen. Immunoscore and tumor grade had a significant connection ( P =0.0003), showing an inverse relationship, as high IS values were seen in low grades (I, II), while IS values tended to decrease in high grades III, IV, and V. There was a significant correlation with perineural invasion ( P =0.0473), side of the tumor ( P =0.0007), and Gleason score ( P =0.0006). Conclusion Immunoscoring of tumor-infiltrating CD3+ and CD8+ T cells contributes to combining computed technologies of image analysis and digital pathology in individual patients’ care and transferring immunoscores from the research zone to clinical daily use.
Background Renal cell carcinoma (RCC) ranks as the third most common urological malignancy worldwide, comprising ~2.2% of all cancers. The clear cell subtype, which accounts for 80–90% of RCC cases, is characterized by a wide spectrum of survival outcomes. The sex-determining region Y box (SOX) family of proteins, expressed in multiple cell types, plays a crucial role in regulating cell differentiation and fate in various physiological contexts. Among them, SOX6 and SOX9 have been implicated in the regulation of carcinogenesis in several human cancers. Aim The primary objective of this study is to investigate the immunohistochemical expression of SOX6 and SOX9 in clear cell RCC, with a focus on their potential role in tumor progression and as predictors of patient prognosis and survival. This retrospective analysis included 50 cases of clear cell RCC. Immunostaining for SOX6 and SOX9 was performed, and the results were correlated with clinicopathological features. Results SOX6 and SOX9 expression was significantly altered in RCC compared with normal renal tissue ( P <0.001). SOX9 expression showed a strong positive association with key clinicopathological factors such as tumor size, Fuhrman grade, tumor, nodal, metastasis (TNM) stage, and lymphovascular invasion ( P <0.05). Conversely, SOX6 expression exhibited a significant negative correlation with these same parameters ( P <0.05). Conclusion SOX9 and SOX6 are potentially involved in the progression of clear cell RCC and may serve as useful biomarkers for this malignancy.
Background Laryngeal carcinoma represents the most common malignancy in otolaryngological surgical practice, accounting for about one-third of all malignancies of the head and neck region. The presence of lymph node metastasis (LNM) is considered the most important predictor of survival in head and neck squamous cell carcinomas, including laryngeal cancer. Objectives In this study, we aimed to identify histopathological and radiological parameters associated with LNM in laryngeal squamous cell carcinoma (LSCC). Patients and methods This retrospective study included a total of 89 cases of LSCC who underwent laryngectomy and neck dissection in Ain Shams University Hospital. A collection of clinicoradiologic and histopathologic data, as well as a review by two independent pathologists, was done. Results In univariate analysis, radiologic evidence of thyroid cartilage involvement, pathologically proven bilaterality, larger tumor size, grade, stage, lymphovascular and perineural invasion, and margin positivity were significantly associated with LNM ( P =0.037, P =0.011, P =0.034, P =0.004, P =0.005, P <0.00001, P =0.004, and P =0.02, respectively). Using multivariate analyses, tumor bilaterality, T stage, and perineural invasion were found to be independent risk factors for LNM, with T stage being the most significant predictor. Conclusion This study found that the most important histopathologic parameters related to cervical LNM from primary LSCC cases include tumor bilaterality, size, histologic grade, lymphovascular invasion, perineural invasion, margin clearance, and tumor stage. Radiologic evidence of thyroid cartilage invasion was also considered an independent risk factor.
Aim The presented study is an electron microscopic morphometric work that aimed at reporting a normal range and average (arithmetic mean) of the glomerular basement membrane (GBM) thickness in the Egyptian population. This is important as a baseline for diagnosing renal disorders that are related to abnormalities in the GBM thickness such as Thin Basement Membrane Disease and Alport Syndrome. Patients and methods This study included 40 patients; 20 adults and 20 children (10 males and 10 females in each group). Patients were diagnosed with Minimal Change Disease or Acute Tubular Injury based on their routine histopathologic examination. Hematuria and/or diabetes mellitus were the exclusion criteria in our study. Results and conclusion The mean of the GBM thickness in adult males was 362.6093 nm (SD +/–31.13). That of adult females was 349.85 nm (SD +/–21.65). While for male children was 255.68 nm (SD +/–35.36). And female children reported 234.57 nm (SD +/–55.03). Rare segments of the GBM showed thicker or thinner measurements than the reported average were present in almost all patients in the study. Similarly, rare segments of GBM wrinkling could be encountered. However, these rare segments could be considered as a normal findings.
