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.
