MUC1 and bcl-2 expression in preinvasive lesions and adenosquamous carcinoma of the lung.

BACKGROUND: Adenosquamous carcinoma of the lung involves both adenocarcinoma and squamous cell carcinoma, each comprising at least 10% of the tumor. Atypical adenomatous hyperplasia (ADH), bronchiolar columnar cell dysplasia (BCCD), basal cell dysplasia (BCD), columnar cell dysplasia (CCD), bronchial epithelial dysplasia with transitional differentiation (BEDT) and squamous dysplasia (SD) are preinvasive lesions. The aim of this study is to define the preinvasive lesions and evaluate the role of MUC1, bcl-2, and the preinvasive and invasive components of adenosquamous carcinoma. METHODS: A group of 31 patients with adenosquamous carcinoma of the lung were selected. The ratio of squamous to glandular differentiation, the associated preinvasive lesions, the features of peritumoral tissue, the stroma of the tumor, necrosis, perineural and vascular invasion were analyzed. For the immunohistochemical study, blocks containing squamous cell carcinoma, adenocarcinoma and preinvasive lesions were selected. MUC1 and bcl-2 analyses were performed by the immunoperoxidase method using the avidin-biotin complex. RESULTS: Associated preinvasive lesions amd SD, BCCD, BEDT, AAH and CCD were observed in 24, 6, 3, 1 and 6 cases, respectively. Expression for MUC1 was positive in the squamous component of 30 cases, the adenocarcinoma component of 27 cases and in 34 preinvasive lesions. A strong correlation was found between MUC-1 expression in the squamous component and tumor localization (p = 0,01). The positive expression of Bcl-2 in the adenocarcinomatous component was correlated with the presence of preinvasive lesions (p = 0,01). CONCLUSIONS: Squamous dysplasia was the most frequent preinvasive lesion of adenosquamous carcinomas. MUC1 and bcl-2 expression levels were strongly associated with preinvasive lesions in adenosquamous carcinomas.

Breast tuberculosis.

Breast tuberculosis is a rare form of tuberculosis. Of all the breast diseases treated surgically, tuberculosis is seen in the range between 0.025% and 0.1%. This ratio is higher in undeveloped countries. We presented five cases with breast tuberculosis. Their ages were between 20 and 63 years. All of them had children and were breastfeeding. The cause of admission to the hospital was swelling in four of them and pain in the remainder. All of the lesions were unilateral. One case had received antituberculosis treatment for pulmonary tuberculosis 10 years ago. AAFB was not detected in sputum, breast discharge, urine and tissue culture in all the cases. Diagnosis was made histopathologically from the excisional biopsy material. Caseating granulomatosis was also found in axillary lymph nodes in three cases. Antituberculosis therapy was planned as 2HRZE/4HR for all of the cases. Three of them completed the therapy without any complaints. One case left the hospital without permission. The last one is now undergoing resistant tuberculosis treatment for pulmonary disease without any complaint of her breast. As a conclusion, although tuberculosis of breast is extremely rare, it should be kept in mind particularly in developing and undeveloped countries.

Clinical importance of correlations between p53 immunoreactivity and clinicopathological parameters in lung carcinoma.

Many studies have revealed the frequency of p53 abnormalities in lung cancer. However, clinico-pathological studies of p53 abnormalities have yielded conflicting results. We examined the p53 immunoreactivity and studied the correlations of p53 status and clinicopathological parameters in 76 primary lung cancers. By using DO-7 antibody, different degrees of p53 immunoreactivity was detected in 8 of 30 small cell lung cancer (SCLC, 26.6%) and 22 of 46 non-small cell lung cancer (NSCLC, 47.8%), 6 of 19 adenocarcinoma, 16 of 27 epidermoid carcinoma cases. In the whole group, no correlation was detected between the p53 status and the histological types of tumor, local tumor invasion, nodal status, and distant metastasis and patient characteristics, such as age, gender or smoking habit. P53 status was also found to have no effect on survival. However, in the NSCLC group, there was a significantly higher p53 immunoreactivity in well- and moderately-differentiated tumors (p<0.05). Patients with p53 immunoreactivity had a poor therapeutic response in the whole group. We concluded that, although p53 immunreactivity may be found in NSCLC, this does not correlate with clinicopathological parameters except therapeutic response. In SCLC p53 immunreactivity can be negligible.