Clinicopathological Impact of FOXM1 and MMP-9 Immunohistochemical Expression in Different Grades of Intracranial Meningioma.

OBJECTIVES: To find predictive biomarkers for recurrence and progression of meningioma. BACKGROUND: Despite great advances in meningioma treatment, the prognosis remained unfavorable due to the high recurrence rate. METHODS: In this study, we evaluated the immunohistochemical expression of FOXM1, MMP-9, and Ki67 in 50 cases of intracranial meningioma to detect its potential role in meningioma progression, recurrence, and patients' survival. RESULTS: Strong FOXM1 expression was detected in 20% of the cases and was significantly associated with meningioma grade (P= 0.002) and peritumoral brain edema (PTBE; P<0.001). Strong MMP-9 expression was noted in 32% of the cases and was significantly associated with meningioma grade and PTBE (P<0.001, P<0.001, respectively). High Ki67 was noted in 50% and significantly associated with tumor grade and PTBE (P<0.001, P= 0.002, respectively). The follow-up period revealed that meningiomas with strong FOXM1, strong MMP-9, and high Ki67 expression were associated with tumor recurrence, shorter OS, and recurrence-free survival. Furthermore, up-regulation of FOXM1 and MMP-9 expression had a significant relation with poor clinical response to the therapy (P= 0.010, P= 0. 001, respectively). However, high Ki67 cases were more sensitive to clinical therapy (P= 0.005). CONCLUSION: Strong FOXM1, strong MMP-9, and high Ki67 in meningiomas indicate highly aggressive tumors with a shortened survival rate, dismal outcome, and high risk of recurrence after the standard protocol of therapy.

Pancreatic cyst fluid interleukin-1 beta (IL-1ß) level in predicting the risk of malignancy in pancreatic cysts.

Pancreatic cystic lesions (PCLs) may be accidentally discovered in up to 13.5% of cases. These PCLs are of multiple types, including mucinous cysts (intra-ductal papillary mucinous neoplasms [IPMN] and mucinous cystic neoplasms [MCN]) that have a risk of malignant transformation. The difficulty in differentiation between the various PCLs and their unpredictable risk of malignant transformation makes their management difficult. The new diagnostic tools of PCLs often include endoscopic ultrasound guided fine needle aspiration (EUS-FNA) for pancreatic cyst fluid analysis. This study aimed to determine if cystic fluid IL-1ß can predict the risk of malignancy and the degrees of dysplasia of pancreatic cysts. The study included 50 PCL patients. They were subjected to radiological, biochemical, serological, and histopathological examinations. Pancreatic cyst fluid IL-1ß was analyzed using an ELISA. Our data indicated that cyst fluid IL-1 ß can differentiate between benign and malignant cysts at cut-off value >150 pg/ml; with sensitivity and specificity of 84.00% and 56.00% respectively. Also, cyst fluid IL-1 ß can differentiate between mucinous and non- mucinous pancreatic cysts at cut-off value >150 pg/ml; with a sensitivity and specificity of 83.33% and 53.78%, respectively. However, cyst fluid IL-1 ß cannot differentiate between degrees of dysplasia of IPMN. In conclusion, our study suggested that pancreatic cyst fluid IL-1ß can differentiate between.

Immunohistochemical expression of cancer stem cell related markers CD44 and CD133 in endometrial cancer.

The goal of this study was to detect the presence of cancer stem cell markers CD44 and CD133 in immunohistochemically stained samples of endometrial cancer and correlate their expression with clinicopathological variables to identify the impact of CD44 or CD133 expression on tumor behavior and endometrial carcinogenesis. Marker expression was analyzed in 62 endometrial cancer samples (57 endometrioid carcinoma and 5 carcinosarcoma) and 15 proliferative endometrium samples. We detected CD133 and CD44 expression in 87.09% and 79.03% respectively of the studied endometrial cancers, and the expression was significantly different from the normal group. CD44 expression decreased with myometrial invasive depth and lymph-vascular space invasion (LVSI), and these inverse relationships were significant (p=0.034, p=0.019, respectively). CD133 was more expressed by early stage tumor (FIGO I-II) compared with those having FIGO III to IV stage disease (p=0.021). The most notable conclusion of the present study is that CD44 and CD133 might participate in early-stage endometrial cancer carcinogenesis, and their overexpression may facilitate the early diagnosis of endometrial cancers. Analysis of our results supports the hypothesis that CD44 expression tends to decrease as the disease becomes invasive and progressive. So, we concluded that CD44 down-regulation might warn of a more aggressive course and may have a link with poorly prognosis carcinosarcomas. Further examination of the expression and function of CD44 and CD133 with a greater number of carcinosarcomas is warranted.

Human giardiasis as an etiology of skin allergy: the role of adhesion molecules and interleukin-6.

The role of adhesion molecules; the intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) as mediators in development of skin allergy caused by giardiasis and the controlling role of the cytokine interleukin (IL)-6 over these adhesion molecules were studied. The work included 25 symptomatic giardiasis patients with skin allergy manifested by diffuse urticaria, pruritus, wheal and erythema, and had positive serum anti-Giardia immunoglobulin (Ig) E measured as mean optical density (OD) value by enzyme linked immunosorbent assay (ELISA), employed as an evidence of allergic sensitization (G.I). They were compared with 30 symptomatic giardiasis patients (G.II) and 20 apparently healthy control subjects (G.III), both latter groups had negative serum anti-Giardia IgE. The mean OD value of anti-Giardia IgE was significantly increased in G.I (P < 0.01) & insignificantly different in GIII (P > 0.05) compared with G.III. Serum levels of soluble forms of adhesion molecules; sICAM-1 & sVCAM-1, and IL-6 were determined by ELISA. sICAM-1 & sVCAM-1 serum levels were significantly increased (P < 0.001) in G.I compared with G.III and showed insignificant difference (P > 0.05) between Gs. II & III. Serum IL-6 significantly increased in G.I (P < 0.001) & G.II (P < 0.05) compared with G.III, and was significantly higher (P < 0.001) in G.I than G.II. Serum IL-6 correlated positively with serum sICAM-1 (P < 0.01) and sVCAM-1 (P < 0.001) in G.I. The results are discussed.