Immunohistochemical and electron microscopic morphometric image analysis of hepatocellular carcinoma in association of HCV infection.

Early detection of hepatocellular carcinoma (HCC) is crucial for successful therapy. The present work examined the value of ultrastructural morphometric image analysis of hepatocyte nuclei in patients with chronic hepatitis C virus (HCV) versus HCC cases with chronic HCV and the corresponding surgical tumor-free safe margins (TFMs), to highlight any early predictive signs of neoplastic cellular transformation. This work also performed an immunohistochemical assessment of cytokeratin 19 (CK19) and Ki-67-positive cells to visualize any associated proliferative activity in the examined groups. The results showed significant decrease in the hepatocyte nuclear surface areas in the HCC and TFMs versus those in the HCV cases. The hepatocyte nucleolar surface area was significantly increased in the HCC cases versus that in the HCV cases. This increase was associated with a significant increase in Ki-67-positive cells in the HCC cases compared to those in the other groups. Conversely, the mean number of CK 19-positive cells was significantly reduced in the HCC cases compared to the cell numbers in TFMs and HCV cases with severe hepatic fibrosis. Liver progenitor cells (LPCs) were discerned in the reactive ductules and canaliculo-ductular junctions that characterized TFMs. LPCs were sporadically distributed in the liver lobules and reactive bile ductules in the HCC samples. In conclusion, CK 19 represents an important marker for distinguishing between dysplastic and malignant liver nodules. Electron microscopic morphometric image analysis may be considered as adjunct factor for assessing hepatocyte malignant transformation. Wider scale studies are needed to authenticate these results.

HER-2 Immunohistochemical Expression in Bone Sarcomas: A New Hope for Osteosarcoma Patients.

BACKGROUND: Osteosarcoma and chondrosarcoma, remain the most common primary bone tumours. Questions have been raised about the prognostic influence of HER-2 in bone sarcomas, but so far the results have been debatable. The her-2 expression is possibly a predictor of chemotherapy response. AIM: In this study, we investigated the extent of HER-2 expression in bone sarcomas, and attempted to correlate it with pertinent variables that will help to provide better treatment options, especially for metastatic ones. MATERIAL AND METHODS: Fifty-two cases of bone sarcomas (32 osteosarcoma cases and 20 chondrosarcoma ones) were studied for HER-2 immunohistochemical expression then correlation with all available clinicopathologic features was done. RESULTS: Most of the osteosarcoma cases exhibited membranous staining (78.1%). Strong staining was observed (score 3+) in 34.4%; while 21.9% showed moderate staining (score 2+); and 21.9% displayed weak staining (score 1+), on the other hand, no staining was detected in 7 out of 32 cases (21.9%) (score 0). As regards chondrosarcoma, the absence of staining in all examined cases was noted. Immunohistochemical HER-2 overexpression correlated significantly with osteosarcoma site with P value = 0.004, with variation relating HER-2 intensity score to the site of osteosarcoma (P = 0.051). A statistically significant negative correlation was detected between HER-2 expression and the presence of metastasis at time of diagnosis (P = 0.006), A significant correlation was also found regarding HER-2 score and presence of metastasis with P value = 0.046 as more than half of cases with no metastasis at diagnosis (17/28 cases, 60.7%) showed positive intensity score. A statistically significant correlation was detected between HER-2 expression and patients' age (P = 0.044). Also, HER-2 expression significantly correlated to histopathological detection of fibrous tissue, with P value = 0.033. Higher scores of HER-2 expression were associated with a significantly better differentiation (P = 0.038) since detection of wide areas of osteoid were associated with higher HER-2 scores. CONCLUSION: Further research would still be needed to delineate HER-2 role being a new hope for therapeutic targeting in bone sarcoma patients, mainly osteosarcoma in contrast to chondrosarcoma that didn't express HER-2 at all.

Ablative CO2 fractional resurfacing in treatment of thermal burn scars: an open-label controlled clinical and histopathological study.

INTRODUCTION: Burn scars can cause permanent disfiguring problems with limited treatments available. OBJECTIVES: To assess and correlate the clinical and histopathological effects of fractional CO2 laser on thermal burns in a controlled study. METHODS: Fifteen patients 11 with hypertrophic and four with keloidal scars received three CO2 fractional laser sessions every 4-6 weeks. Half of the scar was untreated as a control. Clinical evaluation by Vancouver, PSOAS scores, and photography before, monthly, and 3 months after the last laser session was performed. Ten patients were evaluated histopathologically by standard H&E, Masson trichrome, and Elastica von Gieson special stains. RESULTS: Hypertrophic scars (HTSs) showed textural improvement and a significant decrease of Vancouver, POSAS observer, and patient scores by the end of follow-up period in the laser-treated area (P = 0.011, 0.017 and 0.018, respectively) unlike keloidal scars. Histopathology revealed significant decrease in scar thickness in HTSs only (P < 0.001) as well as a significant decrease in collagen bundle thickness and density in the upper dermis in both types of scars. CONCLUSIONS: Fractional CO2 laser is a possible safe and effective modality for the treatment of hypertrophic burn scars with improvement achieved both clinically and histopathologically.