AMPK expression patterns are significantly associated with poor prognosis in breast cancer patients.

Many investigators have examined the functions of AMP-activated protein kinase (AMPK) in cancer biology and its anti-neoplastic features in cancer models. The goal of this research is to assess the association of the immunohistochemical expression of AMPK in human mammary tumours with the clinical data of breast cancer patients. 449 cases of previously diagnosed breast cancer, and 27 tissue samples of fibroadenomas and normal breast were utilized for detection of AMPK expression using tissue microarrays and immunohistochemistry. Brownish nuclear and cytoplasmic staining were present in epithelial cells and stromal cells in 333 (74.16%) and 348 (77.5%) cancer cases respectively indicating AMPK expression. Twenty two (81.48%) control cases showed AMPK immunoexpression in both epithelial and stromal cells. Significant statistical association has been found between advanced stages of breast cancer and increased intensity of AMPK immunostaining only in epithelial cells (p-value=0.0001). Histotypes have been correlated with AMPK immunostaining in epithelial cells only (p-value=0.029). Low AMPK immunostaining scores were more dominant in DCIS, ductal and mixed type's ductal and mucinous histotypes, while high intense staining was more common in the lobular type. Furthermore, breast tumour cases with lymph node metastases showed significant AMPK expression in both epithelial and stromal cells (p-value=0.0001 and p-value=0.026). Low scores of AMPK immunostaining were common in breast cancer cases with positive vascular invasion (p-value=0.007) and disease recurrence (p-value=0.008). No significant differences in survival behavior distributions were observed for the different categories of AMPK immunostaining in epithelial and stromal cells. In conclusion, our results showed decreased AMPK expression in breast cancer in comparison with the control group. AMPK expression was significantly correlated with some clinicopathological factors like advanced stage, lymph node involvement, vascular invasion and disease recurrence which give indications for poor clinical outcomes. Immunohistochemical staining of AMPK protein is a valuable method which could predict cases of breast cancer with poor prognosis.

Histopathological findings in goiter: A review of 624 thyroidectomies.

OBJECTIVES: To identify the histopathological patterns of goiter in thyroidectomy specimens and their frequency in relation to age and gender of the patients. METHODOLOGY: We present a retrospective data of 624 thyroidectomy specimens diagnosed over a period of six year (2007-2012) at the Department of Pathology, Holy Family Hospital, Rawalpindi, Pakistan. RESULTS: A total of 624 consecutive thyroidectomy specimens were selected. Patient's age ranges from 11-89 years, 541 females and 83 males. There were 512 (82%) non-neoplastic lesions, which includes; 475 (76.1%) multi-nodular goiter (MNG), 16 (2.6%) Hashimoto thyroiditis, 11 (1.8%) colloid goiter, 4 (0.6%) toxic goiter, 2 (0.3%) chronic lymphocytic thyroiditis, 2 (0.3%) tuberculous thyroiditis and 2 (0.3%) miscellaneous. From 112 (18%) neoplastic lesions, 43 (6.9%) were adenomas (41 females and 2 males) and 69 (11.0%) were carcinomas (58 females and 11 males). Peak age for thyroid malignancy was 3rd to 4th decades. The histological subtypes of thyroid carcinomas includes, 35 (5.6%) follicular variant of papillary carcinoma (FVPC), 15 (2.5%) well-differentiated tumor of uncertain malignant potential (WDT-UMP), 6 (1%) medullary carcinomas, 6 (1%) papillary carcinomas, 3 (0.5%) anaplastic carcinomas, 2 (0.3%) follicular carcinomas and 2 (0.3%) other carcinomas. Twenty-nine (4.6%) neoplastic lesions were associated with MNG, includes; 2 (3.5%) follicular adenomas, 3 (0.5%) WDT-UMP and 4 (0.6%) FVPC. CONCLUSIONS: MNG is common and FVPC is the common thyroid cancer seen in females. The overall frequency of thyroid cancer is 11%. Follicular adenoma and FVPC appears to be associated with long standing MNG of iodine deficiency.

Leptin expression is substantially correlated with prognosis of urinary bladder carcinoma.

This study examined leptin expression in cases of bladder cancer and its diagnostic and prognostic usefulness in bladder malignancies.A set of 128 urinary bladder cancer cases and 24 normal specimens of bladders were employed for an immunohistochemical investigation of leptin expression in tissue microarrays.Leptin was up-regulated during transformation and was identified as brown cytoplasmic granules in the malignant urothelium of 123 (96%) bladder neoplasms, of which 68 (53.1%) cases showed high levels (moderate to strong) of staining. Strong staining was found to be associated with high stages (P = 0.001), muscularis propria infiltration (P < 0.001), vascular invasion (P < 0.03), lymph node involvement (P < 0.02), metastases (P < 0.05), and mortality (P < 0.03). Furthermore, various important survival distributions were detected with leptin expression in the malignant urothelium (P < 0.03).These pilot results suggest that leptin might be a valid marker for predicting the stage and bad prognoses in bladder carcinoma.

GLUT 1 expression is a supportive mean in predicting prognosis and survival estimates of endometrial carcinoma.

OBJECTIVES: This study will investigate the phenotype of Glucose transporter 1 (GLUT1) in endometrial cancer and the association of its expression with tumor's clinicopathological factors. MATERIAL AND METHODS: Standard immunohistochemistry (IHC) staining protocol was utilized to identify the location and expression pattern of GLUT1 in a panel of 71 endometrial carcinomas compared to 30 normal tissues using tissue microarrays. RESULTS: High scores of GLUT1 staining are more frequent in cancer cases, it was recognized in 64 (90%) endometrial cancers and 12 (40%) control cases. Tissue histotype (cancer versus non-cancerous) was associated with IHC staining of GLUT1 (p = 0.000). Significant association between strong GLUT1 staining of malignant epithelial cells and stage of tumor (p = 0.000) was observed, advanced disease stages were more prevalent with high GLUT1 staining in malignant epithelial cells. There is also a significant association between high scores of GLUT1 staining and location of expression in transformed epithelium, cytoplasmic and membranous (p = 0.000), 100% of cases with cytoplasmic and membranous expression showed high GLUT1 staining scores. Considerable varied survival models were observed with positive GLUT 1 neoplasm regarding diagnosis, grade, stage, differentiation, and recurrence (p-values 0.000, 0.000, 0.000, 0.002, and 0.000 respectively). Survival estimates are considerably healthier in positive GLUT1 staining cases of endometrial carcinoma, which have low grade, low stage and no recurrence. CONCLUSIONS: GLUT1 expression has been found upregulated in endometrial carcinoma. IHC staining of GLUT1 can be a supportive mean in predicting prognosis and survival estimates of endometrial carcinoma with specific clinical factors.

Immunhistochemical expression of GLUT1 is associated with low grade and low stage of urinary bladder cancer.

Many studies described glucose transporter 1 (GLUT1) as a fundamental player in cancer metabolism, which can be employed as a prognostic biomarker that may help in new treatment strategy development. This study will describe the pattern of GLUT1 expression in urinary bladder cancer and try to associate it with tumor clinicopathologic factors. Standard immunohistochemistry (IHC) staining protocol was utilized to identify the location and expression pattern of GLUT1 in a panel of 128 urinary bladder carcinoma compared to 24 normal tissues using tissue microarrays. GLUT1 expression was found up-regulated significantly in cancer cases, and it was found in 111 (86.7%) urinary bladder cancers compared to 4 (16.6%) of control cases (P < 0.05). Positive GLUT1 immunohistochemical staining was significantly correlated with low grade, low stage, and non-muscularis propria invasive urinary bladder cancer cases (P < 0.05). Log-rank test and Kaplan Meier survival curves displayed significant poor survival in stage III and stage IV patients (P < 0.05); mean survival is lowest at 29.924 months in stage IV patients. Similarly, significantly better survival is observed in low-grade tumors (P < 0.05). Urinary bladder cancer showed increased GLUT1 expression compared to a control group. IHC staining of GLUT1 can be a supportive tool in predicting prognostic and survival estimates of urinary bladder tumors with specific clinical and morphologic characteristics.

Expression of leptin in colorectal adenocarcinoma showed significant different survival patterns associated with tumor size, lymphovascular invasion, distant metastasis, local recurrence, and relapse of disease in the western province of Saudi Arabia.

Leptin phenotype has been suggested to be a possible biomarker for the diagnosis and prognosis of different neoplasms. Nonetheless, there are conflicts among the outcomes found in several tumors, and little is proven concerning the correlation between the phenotype of leptin and its clinical significance in colorectal carcinomas. This study will describe the phenotype of leptin in colorectal adenocarcinomas, and investigate its correlation with clinicopathological factors.Two hundred and twenty eight tissue samples include 155 colorectal carcinomas, 40 adenomas, and 33 noncancerous cases were utilized in constructing tissue microarrays which have been used in the revealing of leptin expression using leptin monoclonal antibody and immunohistochemistry staining protocol.Immunoexpression of leptin was recognized in 145 (93.5%) of colorectal tumors and 56 (76.7%) cases of control group. Histotype was considerably associated with leptin phenotype (P = .000), there is up regulation in leptin expression in colorectal carcinoma cases. Significantly higher proportion of negative leptin immunostaining cases were observed in tumors which have size more than 5 cm (P = .045). Whereas, significant different survival patterns were observed in positive cases regarding tumor size, lymphovascular invasion, distant metastasis, local recurrence and relapse of disease (P-values .046, .011, .000, .013, and .001, respectively). On the other hand, positive leptin staining colorectal tumors with size <5 cm, and with no distant metastases, local recurrence, or disease relapse had significantly better survival estimates. However, leptin immunostaining did not show noteworthy associations with age, gender, differentiation, tumor location, stage, margins involvement, lymphovascular invasion, and lymph node metastasis.The current study shows up regulation in leptin expression in colorectal adenocarcinoma compared with noncancerous control cases. Thus, immunohistochemical staining of leptin in colorectal cancer could be a helpful tool in the prediction of prognosis and survival pattern of colorectal cancer with certain clinicopathological factors (tumor size, lymphovascular invasion, distant metastasis, local recurrence, and relapse of disease).

Phosphorylated AMP-activated protein kinase expression is significantly associated with poor clinical outcomes in bladder carcinoma patients.

The phenotype of p-AMPK has been suggested as a possible marker for diagnosis and/or prognosis in tumors located in different organs. Nonetheless, there are conflicts among the outcomes found in several tumors, and little is proven concerning the correlation between the phenotype of p-AMPK and its clinical significance in urinary bladder carcinomas. Therefore, this research will define the p-AMPK expression patterns, and study the relationship between this pattern of expression, in a panel of urinary bladder carcinomas compared to normal tissues, and clinicopathological features to determine the clinical relevance and the function of p-AMPK in the evolution of bladder cancer. Furthermore, this study will evaluate p-AMPK expression as a diagnostic marker and prognosticator of long term overall survival in bladder cancer patients. This study will utilize the p-AMPK monoclonal antibody using the immunohistochemistry staining standard protocol to identify the location and expression pattern of p-AMPK, which will be graded with respect to the estimated percentage of tumor cells with positive and relative intense stain. 128 cases of urinary bladder carcinoma and 24 non-cancerous bladder tissue samples were employed for the determination of p-AMPK phenotypes applying immunohistochemical staining on tissue microarrays slides. A high score of nuclear p-AMPK immunoexpression has been found in 104 (81.3%) bladder cancer cases, while 24 (100%) control cases showed p-AMPK immunoreactivity. Strong p-AMPK immunohistochemical staining in both epithelial cells and stromal cells has been significantly linked with vascular invasion (p-value = 0.002 and p-value = 0.011 respectively). Lymph node metastasis showed significant association with p-AMPK expression in tumor epithelial cells (p-value = 0.030). The odds of low expression in epithelial cells for a positive lymph node are 3.21 times as great as the odds of low expression in epithelial cells for a negative lymph node. Our findings recommend p-AMPK as a useful biomarker in determining the prognosis of bladder cancer. These preliminary findings suggest that p-AMPK may be a valuable tissue biomarker for predicting a poor prognosis in bladder cancer.

Usefulness of crush smears intraoperative consultaion of neurological biopsis.

OBJECTIVE: To evaluate accuracy of intraoperative crush smears diagnosis of neurosurgical biopsies. DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: The Armed Forces Institute of Pathology, Rawalpindi, from February 2002 to February 2003. PATIENTS AND METHODS: One hundred, neurosurgical biopsies were received for intraoperative consultation over a period of one year. Clinical information regarding age, gender, history, and CT scan or MRI findings were recorded. Crush smears were prepared, fixed in 95% alcohol and stained with rapid haemotoxylin and eosin (H&E) stains. Diagnosis was categorized into inflammatory, benign and malignant tumours. Remaining tissue was fixed overnight in 10% formalin for histological sections. Permanent H&E sections were used as the gold standard. The average time required for intraoperative cytological diagnosis was 8 minutes. RESULTS: Out of 100 neurosurgical biopsies, crush smears of 94 were considered suitable for interpretation. There were 8 inflammatory, 41 benign and 41 malignant tumours, including 4 inconclusive. Eightyfour of the crush smears diagnosis agreed with the histological diagnosis. Overall diagnostic accuracy of crush smears was 93.3%. Diagnosis of inflammatory, benign and malignant tumours showed specificity of 98.7%, 96% and 94%, and a sensitivity of 70%, 97.5% and 95% respectively. CONCLUSIONS: Crush smears are useful in the intraoperative diagnosis of space occupying lesions of central nervous system. The crush smears cytology was found highly reliable, rapid and inexpensive mode of intraoperative diagnosis.