Immunohistochemical Expression of Epidermal Growth Factor Receptor in Hepatocellular Carcinoma.

INTRODUCTION: Epidermal growth factor receptor (EGFR) signaling plays an important role in various cancers, including hepatocellular carcinoma (HCC). We aimed to evaluate immunoexpression of EGFR in HCC and surrounding non-tumor liver tissue and to correlate it to multiple clinicopathologic data. MATERIAL AND METHODS: We analyzed 60 patients with HCC for multiple clinicopathologic characteristics and survival. Presence of the immunosignal and the percentage of positive tumor cells at the whole tumor tissue sample and adjacent cirrhotic liver tissue were semi-quantitatively determined. RESULTS: Nineteen patients (31.67%) were female and 41 (68.33%) were male ranging in age from 31 to 85 years, median 61.88±10.51. Mean survival time for female patients was 8.86±1.76 months, for male 13.03±1.50 months and overall survival was 11.6051±1.19 months. The most patients had: T2 status (41.67%), no enlarged lymph nodes (90%), vascular invasion (63.33%) and well differentiated (43.33%) tumors. EGFR immunoexpression was determined in range from 0% to 100% in both tumor and non-tumor tissue with mean value of 39.58% in tumor and 86.86% in cirrhotic tissue (p<0.00). Higher percent of tumor EGFR positive cells were found in cases with higher T status, higher levels of AFP and poorly differentiated carcinoma, but not significantly. Lower percent of tumor EGFR positive cells were found in patients with vascular invasion and enlarged lymph nodes, but also not significantly. EGFR expression in tumor tissue significantly influenced survival of the patients (p<0.05). CONCLUSION: The study showed that expression of EGFR in lower percentage of tumor cells was associated to favorable prognosis, making it a potential prognostic marker and therapeutic target.

Hyperhomocysteinemia and of Methylenetetrahydrofolate Reductase (C677T) Genetic Polymorphism in Patients with Deep Vein Thrombosis.

AIM: To determine the concentration of total plasma homocysteine (tHcy) as well as different genotypes of methylenetetrahydrofolate reductase MTHFR (C677T) in healthy subjects and patients with deep vein thrombosis (DVT). MATERIAL AND METHODS: The investigation comprised a total of 160 subjects divided in two main groups: 80 healthy subjects (control group) and 80 patients with deep vein thrombosis. Concentration of tHcy was determined by spectrophotometric cyclic enzymatic method and mutation of MTHFR (C677T) gene was examined by polymerase chain reaction according to Schneider. RESULTS: The results obtained for plasma tHcy in the control group were 11.62±3.43 µmol/L, while tHcy level was significantly higher in patients with deep vein thrombosis as compared to the control group, 15.19±3.63 µmol/L (р<0.001). The analysis of the results has shown that MTHFR (C677T) genetic polymorphism was responsible for mild to moderate hyperhomocysteinemia in the majority of subjects. CONCLUSION: The level of tHcy in the examined patients was significantly higher in comparison with the control group. Multiple regression analysis has shown that tHcy level in CT and TT genotypes of MTHFR (C677T) was statistically higher in comparison with CC genotype of MTHFR (C677T) in both, the control group and the DVT patients.

Severe renal function impairment in adult patients acutely poisoned with concentrated acetic acid.

Acetic acid is a widely used organic acid with corrosive properties that depend on its concentration. If acetic acid is ingested in concentrations above 30 % it may severely damage the upper gastrointestinal tract and cause intravascular haemolysis, which can result in severe kidney and liver disorders and disseminated intravascular coagulation. In this retrospective study, we analysed acetic acid ingestion data collected at the University Clinic for Toxicology of Skopje, Macedonia from 1 January 2002 to 31 December 2011. The analysis included systemic complications, kidney damage, and the outcomes in particular. Over the ten years, 84 patients were reported at the Clinic to have ingested highly concentrated acetic acid. Twenty-eight developed kidney disorders, while the remaining 56 had no complications. Fatal outcome was reported for 11 patients, seven of whom had systemic complications and four severe gastrointestinal complications.

An epidemiologic study of some characteristics of lung cancer.

OBJECTIVE: The principal aim of this study was to determine lung cancer distribution according to some epidemiologic and demographic variables in patients diagnosed to have this disease. METHODS: The study included 1731 patients diagnosed to have lung cancer between January 1, 1990 and December 31, 1999. Data were gathered from the patients' history of disease and from the bronchoscopy Record book. Establishment of significance in analyzed differences between some statistical series was done using Pearson's chi2 test and Kolmogoroff-Smirnoff test (K-S test) for one and two samples. RESULTS: The majority of male patients (out of a total of 1523 males) were in the age range of 60 to 64 years (21.7%). The age range of 65 to 69 was predominant in the female patients (16.3%). The distribution by sex and age showed significant differences (K-S; p < 0.05). 81.4% of the male patients and 39% of the female patients were smokers. This characteristic was significantly associated with the patients' sex (chi2 = 258.12; DF = 1; p < 0.01). Bronchoscopic localization of the pathological process was not significantly correlated with the habit of cigarette smoking (Kruskal-Wallis chi2 = 1.36; DF = 2; p > 0.05). Pathohistological diagnosis and smoking were significantly correlated (chi2 = 49.37; DF = 2; p < 0.01). CONCLUSIONS: In the study period, the men fell ill seven times as frequently as the women. The pathological process was most commonly localized in the right and left upper lobes. The predominant histologic type in men was squamous cell carcinoma (SQC), and in women--adenocarcinoma (ADC). Smokers were the greatest number in the patients with SQC and small cell carcinoma. ADC was most common in nonsmokers.