The study aimed to evaluate the effects and relationships between mast cells in the matrix, mast cell enzymes tryptase and chymase, epithelial proliferation, microvascular density, and bone destruction in cholesteatoma. Thirty-five biopsies diagnosed with cholesteatoma and seven healthy skin tissues taken from the retro-auricular region for control were evaluated. Immunohistochemical studies were performed with CD117, CD34, Ki-67, chymase, and tryptase antibodies, in a single session for all cases and the control group. The relationship between erosion size and antibody load was determined. The mean cholesteatoma epithelium Ki-67 was higher than the control group (p < 0.001). CD117-positive mast cells, chymase-positive mast cells, tryptase-positive mast cells, and microvessel density were significantly higher in the cholesteatoma matrix compared to the control group (p < 0.002, p < 0.001, p < 0.005). In the group with bone erosion scores of two and above, immunohistochemical markers tended to be higher. A positive correlation was found between CD117 and chymase, tryptase, and microvessel density; between tryptase, chymase, and microvessel density; and between chymase and microvessel density. CD117-positive mast cells and chymase-positive mast cells stimulate angiogenesis, increase the epithelium’s proliferative capacity in the cholesteatoma matrix, and form cholesteatoma. The increased proliferation of cholesteatoma epithelium and increased vascular density in the matrix exacerbate bone erosion.
There are conflicting data regarding the prognostic effect of microvascular density (MVD) in breast cancer and its molecular subtypes. It is thought that high levels of FOXP3 + T cells in breast cancer are associated with poor prognosis. However, data regarding FOXP3 show significant variability in the literature. In our study, we aim to measure MVD and FOXP3 + T cells in breast cancer cases and investigate their relationship with each other and their effects on breast cancer patients’ clinical and prognostic features. In our study, the results of 207 female breast cancer patients whose excisional tumoral tissue was obtained are presented. The study evaluated the findings under a light microscope using antibodies against CD34 for measuring MVD and FOXP3 for measuring FOXP3-positive T cells. CD34 ≥ 17 was categorized as high MVD, and CD34 < 17 was classified as low MVD. FOXP3 + cell count ≥ 20/mm2 was categorized as high FOXP3 positivity and < 20/mm2 as low FOXP3 positivity. The SPSS program (version 22) was used to evaluate the results statistically, and p < 0.05 was considered significant. The median age was 54.0 (27–86) years, and the median follow-up period was 60.0 (IQR: 42.6–86.5) months. In the high MVD group, a higher progesterone receptor (PR) positivity rate was detected (p = 0.035). High FOXP3 positivity was significantly associated with high nuclear grade (p = 0.003). High FOXP3 positivity was significantly associated with PR negativity and high Ki67 values (p = 0.009, p = 0.012, respectively). No statistically significant correlation was found between MVD elevation and FOXP3 positivity (r = 0.063, p = 0.36). A weakly significant positive correlation was detected between high Ki67 and FOXP3 positivity (r = 0.0146, p = 0.04). A weak inverse correlation was detected between high FOXP3 positivity and PR percentage values (r=-0.182, p = 0.01). While there was no significant difference in disease-free survival in cases with high MVD and high FOXP3 + T cells compared to groups with low levels, the results were not mature enough because the median values in overall survival could not be reached. A significant correlation was found between high FOXP3 positivity and some aggressive tumor features; no effect on survival was detected. In contrast to literature data on luminal A breast cancer, high MVD in the luminal B (HER2-) subgroup was associated with a lower risk of recurrence. Our study is the first in the literature to evaluate the relationship between MVD measured using CD34 and FOXP3 positive T cells in breast cancer. Our study found no correlation between MVD and FOXP3 positivity, while literature data show significant correlations in some other cancers.
21 February 2024 in Clinical and Experimental Obstetrics & Gynecology
Background: To emphasize the effect of molecular markers on prognosis in endometrial cancer, in addition to the International Federation of Gynecology and Obstetrics (FIGO) 2009 classification. Methods: The records of 160 patients with endometrial cancer between 2008 and 2022 were retrospectively reviewed. Staging was done according to FIGO 2009 criteria. Patients were divided into 4 groups according to molecular classification. If one had polymerase epsilon (POLE) mutation, the patient was included in POLE ultramutated (POLEmut) group. In case of intakt POLE, but abnormal staining of mismatch repair (MMR), the group was diagnosed as mismatch repair defciency (MMRd). If there was only p53 abnormal results detected, that group was p53-abnormal (p53mut). If no mutation at all, that group was categorized as non-specific molecular profile (NSMP). The Kaplan-Meier method was used to evaluate overall survival and progression-free survival. Survival rates were compared for molecular markers. Results: According to the molecular analysis, 4 patients (2.5%) were classifed as POLEmut group, 53 patients (33.1%) in the MMRd group, 18 patients (11.3%) had p53mut, and 85 patients (53.1%) into the NSMP group. 5-year overall survival was 79.4%, 5-year progression-free survival was 90%. 5-year overall survival was 75% in POLEmut group, 84.9% in MMRd group, 38.9% in p53mut group and 84.7% in NSMP group (p = 0.001). 5-year progression-free survival was 100% in POLEmut group, 96.2% in MMRd group, 77.8% in p53mut group and 88.2% in NSMP group (p = 0.082). Conclusion: Our study shows the prognostic value of the molecular endometrial cancer classification. Patients with p53mut have a poor progression-free survival, POLEmut endometrial cancer have a good prognosis. In this study, we wanted to demonstrate the importance of molecular markers in endometrium cancer and their contribution to prognosis.
31 March 2023 in Eskisehir Medical Journal, Eskisehir City Hospital
Introduction: The diagnosis of chronic lymphocytic leukemia/ small lymphocytic lymphoma (CLL/SLL), which also includes atypical forms, can be very difficult. The aim of this study is to compare immunohistochemical (IHC) and flow cytometric (FC) immunophenotyping methods in the CLL/SLL, the most common mature B-cell leukemia/lymphoma of adults, in bone marrow biopsy. In these two methods, it is to determine the minimum panels that can differentiate CLL/SLL from other mature B-cell leukemia/lymphomas. Material and Method: The study included 68 adult patients diagnosed with mature B cell leukemia/lymphoma. Final diagnoses were made on the basis of peripheral smear, bone marrow aspirate, bone marrow biopsy, IHC and FC analysis, clinical and genetic studies. Cell counts, final diagnosis and immunophenotyping were compared with both methods. Cytogenic findings were evaluated. The sensitivity, specificity, positive and negative predictive values of IHC and FC results for CLL/SLL were calculated. Results: CLL/SLL was diagnosed in 64.7% of the cases and non- CLL/SLL in 35.29% of the cases. The median age was 66.50 years, 69.18% male and 30.82% female. The diagnosis compatibility in FC and IHC was found to be highest in hairy cell leukemia/lymphoma with 100%, and in CLL/SLL with 90%. In other lymphomas, a definitive diagnosis could only be made with biopsy. Immunophenotyping made with CD23+CD43+CD5+LEF-1 in the bone marrow biopsy showed a sensitivity of 95.45% (range, 84.53-99.44%) and a specificity of 100.00% (range, 85.75-100.00%) for CLL/SLL. Immunophenotyping made with CD23+CD43+CD5+CD200+ in FC showed a sensitivity of 100.00% (range, 91.96-100.00%) and a specificity of 82.61% (range, 61.22-95.05%) for CLL/SLL. Conclusion: This was the most extensive study to have compared immunophenotyping in IHC and FC in bone marrow biopsies of mature B cell leukemia/lymphoma. The addition of LEF-1 to the CD23(+), CD43(+), CD5(+) panel in IHC and the addition of CD200 to the same panel in FC will be extremely helpful in the differential diagnosis of typical/atypical CLL/SLL from mature B cell leukemia/lymphoma.