Retrospective analysis of negative cytology results correlated with a positive high-risk in the human papillomavirus result and subsequent results of patients over a period of three years.

This research paper evaluates the efficacy of co-testing in precluding cervical cancer, with a particular focus on distinguishable outcomes of the human papillomavirus (HPV) vs. cytology tests. A retrospective review of 5948 patients, who tested positive for high-risk HPV but showed negative cytologic findings, revealed that 15.006% tested positive in subsequent screenings. A comparative analysis of various commercial HPV tests highlighted the precision of mRNA-based HPV testing by Aptima (Hologic) in reducing the likelihood of false-negative cytology. The paper challenges the conviction that a negative cytology alone suffices advocating for a condensed testing interval in instances of positive HPV outcomes, thereby facilitating earlier intervention and optimal preventive care. These findings unveil an exigency for reconsidering preventive strategies based on test outcomes.

Organization of the 43rd European Congress of Cytology in the SARS-CoV-2 pandemic period: A report.

The 43rd European Congress of Cytology in Wroclaw, Poland, was held as a hybrid meeting in the Fall of 2021. After nearly 2 years without in-person cytology conferences, the 43rd Congress represents 1 of the first major international scientific meetings to occur during the severe acute respiratory syndrome-coronavirus 2 pandemic. Since March 2020, the pandemic situation substantially modified the organization of scientific meetings because of both domestic and international travel restrictions, new health standards, and concern among participants, resulting in new alternative forms of virtual conferencing. Cancer (Cancer Cytopathol) 2022;130:000-000.

ARID1A/BAF250a is significantly overexpressed in primary invasive breast cancer.

BACKGROUND: ARID1A (also known as BAF250a, p270 or SMARCF1) is a major component of the mammalian SWI/SNF family that is involved in the regulation of the chromatin structure. ARID1A gene mutations have been associated with many types of malignancies, including breast cancer. This study aimed to explore the expression of BAF250a protein in breast cancer and its association with the clinical and pathological characteristics and prognosis of breast cancer. METHODS: We assessed the BAF250a expression in 119 invasive breast carcinomas samples and 92 healthy control and correlated this expression pattern with various clinical and pathologic parameters including histologic type and grade, tumor size, lymph node status, estrogen receptor (ER) status, progesterone receptor (PR) status. Immunohistochemical analysis of BAF250a, ER, PR, was carried out, and evaluation of stainings was performed. RESULTS: The mean value of BAF250a expression in the experimental group was higher than in healthy control (P=0.001). The expression is unrelated to age, menopausal status, lymph node status, tumor size and location, grade and histologic type of tumor, and hormonal status (ER, PR). CONCLUSIONS: These data suggest that BAF250a is overexpressed in breast cancers. BAF250a may play context-dependent tumor-promoting and tumor-suppressive roles in cancer.

Comparison of the ICC location in the gallbladder wall in patients with cholelithiasis and patients with non-calculous changes.

Interstitial cells of Cajal (ICC) were first described by Santiago Ramon y Cajal over 100 years ago. They are thought to play an important role in the regulation of gastrointestinal motility. There is increasing evidence that the decline in their number in the gallbladder wall contributes to the formation of concrements. The aim of the study was to determine the exact location of interstitial cells of Cajal in the gallbladder wall in patients with calculous and non-calculous cholecystitis. Sixty-eight patients were examined, of whom 50 were cases of cholelithiasis and 18 were of non-calculous cholecystitis. The technique of immunohistochemistry with the CD117 antibody was used to determine the cells of Cajal, while to distinguish them from mast cells the technique with mast cell tryptase (MCT) was applied. Redistribution of the interstitial cells of Cajal from the muscle membrane to lamina propria of mucous tissue was observed in the cases of cholelithiasis, while in the group of non-calculous cholecystitis most of the ICC was located within the muscle tissue.

Bridging neighboring civilizations at academic grounds: a story of Zygmunt Albert - Rector illustrissimus ac magnificus Academiae Medicae Wratislaviensis - a pathologist who visualized gamma-glutamyl transpeptidase.

The life stories can constitute more than simple biographies to remain great lessons of honesty, grit and steadfastness in keeping standards of medical science within a strong moral fiber and flexible wiseness in hard terms like in case of Zygmunt Albert (1908-2001). This eminent pathologist histochemically visualized tissue distribution of gamma-glutamyl transpeptidase in liver and other organs under various conditions. He was also deeply involved in experimental pathology of liver, particularly in his comprehensive studies on chrysoidin-induced hepatoma that should bear eponymic name Albert's hepatoma. As he had both German and Polish roots, he became an eminent personage that wisely and consequently bridged neighboring civilizations in hard terms of escalation of hate in prewar times, during World War II and in postwar period. After he meticulously recorded Nazi crimes in Lvov, he appealed for justice in case of Nazi massive murders of Lvov Professors. He obtained his Associate Professorship in Anatomical Pathology in Lvov (Lemberg) and was one of rebuilders of Medical Faculty in postwar Wroclaw (Breslau) to serve as the first Rector Magnificus of Medical Academy of Wroclaw.

Clinical validation of nuclear factor kappa B expression in invasive breast cancer.

Breast cancer is the most commonly diagnosed cancer in Polish women. The expression of transcription nuclear factor kappa B, a key inducer of inflammatory response promoting carcinogenesis and cancer progression in breast cancer, is not well-established. We assessed the nuclear factor kappa B expression in a total of 119 invasive breast carcinomas and 25 healthy control samples and correlated this expression pattern with several clinical and pathologic parameters including histologic type and grade, tumor size, lymph node status, estrogen receptor status, and progesterone receptor status. The data used for the analysis were derived from medical records. An immunohistochemical analysis of nuclear factor kappa B, estrogen receptor, and progesterone receptor was carried out and evaluation of stainings was performed. The expression of nuclear factor kappa B was significantly higher than that in the corresponding healthy control samples. No statistical difference was demonstrated in nuclear factor kappa B expression in relation to age, menopausal status, lymph node status, tumor size and location, grade and histologic type of tumor, and hormonal status (estrogen receptor and progesterone receptor). Nuclear factor kappa B is significantly overexpressed in invasive breast cancer tissues. Although nuclear factor kappa B status does not correlate with clinicopathological findings, it might provide important additional information on prognosis and become a promising object for targeted therapy.

Anaplastic thyroid carcinoma with rapid thyrotoxicosis - a case report and the literature review.

INTRODUCTION: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies and constitutes approximately 1.6-5% of the malignant neoplasms of the thyroid gland. ATC usually manifests itself with the local symptoms due to a rapidly enlarging thyroid mass, and as other thyroid cancers, has only seldom been reported to cause thyrotoxicosis. Up to now only 9 cases of ATC with concomitant thyrotoxicosis have been described. CASE REPORT: We report a rare case of a 66-year-old woman, who had had the preexisting large, euthyroid multinodular goiter for almost 50 years. She was consulted by a doctor because of a 4-week history of thyrotoxicosis, symptoms of the congestive heart failure and a rapid increase in the size of the goiter. Thyroid hormone levels were consistent with a hyperthyroid state. The fine-needle aspiration biopsy confirmed a diagnosis of the anaplastic thyroid carcinoma, the small cells variant. The 99m Tc-pertechnetate scintigraphy visualized non-homogenous tracer distribution with hot nodules. She was given a doxorubicin (20 mg/week) and required the continuous antithyroid treatment. The patient died a one year after the first symptoms of the disease occurred. DISCUSSION: The association between ATC and a thyrotoxic state is very rare. In most cases, thyrotoxicosis concomitant with ATC was thought to be a result of the destruction of the thyroid follicles by the rapid infiltration with malignant cells, resulting in the leakage of preformed hormones to the circulation. In that case the most probable cause of thyrotoxicosis was the multinodular goiter coexisting with ATC. A simultaneous onset of tumor growth, thyrotoxicosis and a relatively long survival time of our patient is worth to notice and discuss.

The Association Between HSP90/topoisomerase I Immunophenotype and the Clinical Features of Colorectal Cancers in Respect to KRAS Gene Status.

AIM: The aim of this study was to investigate heat shock protein 90 (HSP90) and topoisomerase I (Topo I) expression and the association between both proteins and clinicopathological parameters of colorectal cancer (CRC), in order to describe their role in tumor biology regarding to Kirsten Ras (KRAS) - positive/negative cases. MATERIALS AND METHODS: Expression of HSP90 and Topo I, and KRAS gene mutations were estimated in primary CRCs. RESULTS: HSP90/Topo I immunophenotype correlated with gender, Duke staging, tumor grade and lymph node metastasis (p<0.01). Positive correlation was found between KRAS mutation and HSP90 expression (p=0.02). HSP90, Topo I expression, and co-expression of HSP90/Topo I correlated with unfavorable parameters of CRCs in respect to KRAS gene status (p<0.001). CONCLUSION: Our results revealed that cooperation between HSP90 and Topo I expression exists in CRCs, independently of KRAS gene status, suggesting that co-expression of both proteins might be considered as a double target on individual tumor cells.

Bethesda System in the evaluation of thyroid nodules: Review.

Fine needle aspiration (FNA) biopsy is an important and widely accepted method used in the diagnosis of patients with thyroid nodules.The lack of consistency in reporting FNA taken from the thyroid gland has led to divergences in the calculation of the sensitivity and specificity of the method. Discrepancies depend on what was considered to be true or false negative/positive. This resulted in confusion among doctors, who had to decide how to manage the patient with constantly changing positive or negative results of the FNA. The problem was solved in 2007, when "The Bethesda System for Reporting Thyroid Cytopathology" (TBSRTC) was introduced. Generally, TBSRTC, compared to previous systems, results in reducing the number of non-diagnostic/indeterminate cases and enables a better clinical usefulness of the results of the FNA of the thyroid gland. This is probably due to the introduction of more standard criteria for interpreting and reporting. TBSRTC improves communication between cytopathologists, reduces the number of unnecessary operations on benign lesions, and makes it possible to perform the operation on time in patients with malignant lesions and predict the risk of thyroid cancer. It provides a simple and reliable exchange of data not only between various laboratories but also between institutions throughout the world. Research shows that all indicators of malignancy calculated for all categories have similar value to the recommended rate of malignancy.

Influence of feature set reduction on breast cancer malignancy classification of fine needle aspiration biopsies.

Grading of breast cancer malignancy is a key step in its diagnosis, which in turn helps to determine its prognosis and a course of treatment. In this paper, we consider the application of pattern recognition and image processing techniques to perform computer-assisted automatic breast cancer malignancy grading from cytological slides of fine needle aspiration biopsies. To determine a classification of the malignancy of the slide, a feature set is first determined from imagery of the slides. In this paper we investigated the nature of a wide set of features extracted from biopsy images to determine their discriminatory power and cross-correlation. Feature vector reduction is studied using a correlation map of the features, determining discriminatory power using the Kolmogorov-Smirnov test, significant feature selection, and stepwise feature selection. The reduction of the feature vector simplifies the complexity of classification scheme and does not impair the classification accuracy. In some cases a decrease of the error rate is noted. Based on this analysis, we present an improved classification system for cancer malignancy grading.

A giant pleural poorly differentiated synovial sarcoma (PDSS) in a 64-year-old woman.

The article presents the rare case of a 64-year-old woman, who was admitted to our thoracic surgery department with a giant tumor in a right hemithorax measuring 88 mm × 137 mm × 188 mm, revealed by a thoracic CT scan. An anterolateral thoracotomy with a radical tumor resection was performed. The final pathological diagnosis of the poorly differentiated synovial sarcoma (PDSS) was made. The adjuvant radiotherapy of 60 Gy in 30 fractions was applied postoperatively. One year after operation patient remains in good health. The literature review on pleural synovial sarcoma has been shortly presented.

A massive bleeding from a gastrointestinal stromal tumor of a Meckel's diverticulum.

INTRODUCTION: Meckel's diverticulum is the most common congenital anomaly of the gastro intestinal tract, present in about 2% of population. CASE OUTLINE: The article presents the case of a 44-year-old otherwise healthy man with anemia, who was diagnosed lower gastrointestinal bleeding. An abdominal CT scan revealed a clearly demarcated solid tumor in hypogastric region, measuring 65 x 45 mm. A laparotomy through lower midline incision was performed. A surgical resection of a lesion of a Meckel's diverticulum was carried out and a final diagnosis of gastrointestinal stromal tumor was made.The patient made an uneventful recovery. CONCLUSION: The preoperative diagnosis of a complicated Meckel's diverticulum may be challenging. CT is usually an adequate method to diagnose tumors arising from Meckel's diverticulum.

Somatostatin expression in the pancreatic cells of smoking and non-smoking chronic pancreatitis patients with or without diabetes.

OBJECTIVES: The aim of the analysis is to determine the location and degree of the hormone immunoreactivity in tissues of patients with chronic pancreatitis and diabetes. METHODS: The study was performed on 11 non-smoking and 12 smoking patients with chronic pancreatitis (CP) with/without diabetes. The hormone was located in the pancreatic tissues by means of the immunohistochemical method using somatostatin antibodies. The histopathological evaluation of the hormone expression intensity in tissue sections was carried out using the semi-quantitative method and was calculated by means of a digital image analysis. RESULTS: The hormone's strong immunohistochemical reaction and the modified D-cell location may be a result of the pancreatic tissue fibrosis process prevention in patients with CP. Changes in the intensity of SS immunoreactivity and the D-cell distribution in the pancreas of patients with CP and diabetes may possibly result from the additional hormone compensatory effect in the excessive glucagon secretion inhibition. Smoking patients with diabetes showed significantly higher hormone immunostaining in the pancreas compared to non-smoking patients without diabetes and healthy persons. CONCLUSIONS: The severity of histopathological changes in smoking CP patients indicates that the cigarette smoke components may further exacerbate the inflammatory reactions. Patients with CP were found to have a strong immunohistochemical reaction to SS and changes in the distribution of D cells when compared to healthy patients. The strongest immunohistochemical SS reaction has been identified in the pancreatic tissue from smoking patients with diabetes.

Expression of Androgen Receptor in Estrogen Receptor-positive Breast Cancer.

OBJECTIVES: The aim of the study was to estimate the implications of androgen receptor (AR) expression in estrogen receptor (ER)-positive subset of invasive breast carcinoma patients. PATIENTS AND METHODS: We assessed the AR expression in a subset of 96 predominantly ER-positive invasive breast carcinomas and correlated this expression pattern with several clinical and pathologic parameters: histologic type and grade, tumor size, lymph node status, progesterone receptor (PgR) status, and human epidermal growth factor receptor type 2 (HER2) overexpression and evaluated the association of these parameters with 10-year survival using univariate and multivariate analyses. Data used for analysis were derived from medical records. Immunohistochemical analysis for AR, ER, PgR, and HER2 were carried out and semiquantitative evaluation of stainings was performed. RESULTS: AR expression was demonstrated in 43.7% of patients. AR was significantly related to well-differentiated tumors and positive PgR/HER2 status. No statistical difference was demonstrated in AR expression in relation to tumor size, lymph node status, menopausal status, and tumor histologic type. AR expression was not an independent prognostic factor related to 10-year survival in ER-positive cancers. In multivariate analyses, older age at diagnosis, larger tumor size, and positive lymph node status were significantly associated with poorer 10-year survival. CONCLUSIONS: AR expression is significantly associated with ER/PgR/HER2 status and positively related to well-differentiated tumors. Although AR status in ER-positive cancers is not an independent prognostic factor, it might provide important additional information on prognosis and become a promising object for targeted therapy.

Increase of nuclear expression of metallothionein I/II in neoplastic transformation of the endomnetrium.

OBJECTIVES: The aim of our study was to investigate the expression of epidermal growth factor receptor (EGFR), metallothionein (MT) 1/11, and Ki-67 antigen in endometrial cancer We analyzed cytoplasmic (cMT) and nuclear (nMT) metallothionein fractions separately Moreover we evaluated the relationships between expressions of the above mentioned proteins and compared them with clinicopathologic data. MATERIAL AND METHODS: The study material included paraffin-embedded endometrial cancer samples from 84 patients. The control group consisted of 52 non-neoplastic endometrium samples. Immunohistochemical reactions were performed using monoclonal antibodies against EGFR, MT 1/11 and Ki-67. Expression intensity of the tested proteins was assessed by computer image analysis software. Chi-square, Spearman's correlation, Mann-Whitney and Kruskal-Wallis tests were used for statistical analysis with Statistica 8.0 PL. RESULTS: Strong expression of nMT was revealed in endometrial cancer cells in relation to benign hyperplasia (p<0.0017) and normal cells (p<0.001) of the endometrium. Statistically significant but weaker expressions in analogous relationships were observed for cMT Moreover higher grade of histological malignancy G was positively associated with increased expression of nMT (p=0.009). CONCLUSIONS: Expression of nMT remains in distinct correlation with neoplastic transformation of the endometrium and histologic grades. Our results clearly indicate a need for further research on metallothionein expression in tumor cells.

Research on genesis of adipocytic metaplasia in uterine fibroids.

The genesis of lipoleiomyoma has not been explained yet. Immunohistochemical examinations were performed on 17 lipoleiomyomas in women aged 43-82 (mean age: 51 ±9 years). Four types of myomas were distinguished: 1) pure leiomyoma, 2) fibroleiomyoma, 3) hyalinizing leiomyoma, 4) strongly hyalinized myoma, along with three degrees of progression of adipocytic metaplasia: 1) up to 25% of lipocytes, 2) up to 50% of lipocytes, and 3) over 50% of lipocytes in the analyzed sample, along with three degrees of progression of adipocytic metaplasia: 1) up to 25% of lipocytes, 2) up to 50% of lipocytes, and 3) over 50% of lipocytes in the analyzed sample. A positive correlation was found between the age of women and rate of development of metaplasia (r = 0.51, p = 0.035) as well as with activity of the estrogen receptor in the primary tumor (r = 0.53, p = 0.03). New mucous perivascular tissue was reported among 11.8% of patients and on this basis lipocytes were formed. The appearance of subendothelial granular cells of large blood vessels with a positive reaction for smooth muscle actin (SMA) and CD68 was reported in 17.7%. Results of immunohistochemical research seem to confirm that lipocytes de novo come from the primal pluripotent cells of the tumor stroma and not from the fatty degeneration of myocytes.

Morphometric differentiation of squamous cell carcinoma and adenocarcinoma of the cervix.

The aim of the study was to define the morphometric characteristics of squamous cell carcinoma (SCC) and adenocarcinoma (AC) cells and identify opportunities to differentiate these tumors based on determination of the morphometric characteristics in order to use the results of research in the diagnosis of cervical cancer. Pap smears with two histopathologically confirmed cervix cancers were used for testing. For the morphometric assessment of cancer cells the dotSlide program was used. The mean nucleus area for AC cells was 126.62 × 10(-6) m(2), while this value for SCC was 145.07 × 10(-6) m(2) (p = 0.000132). The mean circumference of AC cells was 42.43 × 10(-6) m, while for SCC cells it was 46.67 × 10(-6) m (p = 0.00). AC cell diameter was 13.83 µm, whereas for SCC cells it was 15.36 × 10(-6) m. On average the AC cell surface area was 195.72 × 10(-6) m(2), while for SCC cells it was 249.94 × 10(-6) m(2) (p = 0.00565). The mean AC cell circumference was 54.90 µm, whereas for SCC cells it was 65.23 × 10(-6) m (p = 0.00607). The research shows that, despite the presence of statistically significant differences for each morphometric parameter, determination of cancer type cannot be used in the diagnosis.

A Comparison of IHC and FISH Cytogenetic Methods in the Evaluation of HER2 Status in Breast Cancer.

The HER2 gene is responsible for the formation of the HER2 receptor on the surface of epithelial cells. Increased numbers of this receptor are associated with a worse prognosis in cancer. Increased numbers of copies of the HER2 gene occur in about 20-30% of breast cancer patients, so determining HER2 receptor levels is important in the current diagnosis and treatment of breast cancer. One diagnostic technique is the immunohistochemical (IHC) method, which permits indirect measurement of overexpression of HER2 receptors, based on subjective determination of the intensity of the color reaction. Another technique is the use of fluorescent in situ hybridization (FISH), which permits the exact number of copies of the HER2 gene to be specified. Based on the results of FISH tests, patients can be qualified for treatment with antibodies that partially block HER2 receptors. This treatment causes inhibition of tumor growth signals. Determining the HER2 status in breast cancer with the FISH method allows the further progress of the disease to be predicted, the right treatment to be chosen and the response to the treatment to be foreseen. Because of the widespread use of the FISH and IHC methods, comparing the advantages and disadvantages of these two methods seems to be relevant.

Expression and Interactions Between Cell Adhesion Molecules CD44v6 and E-Cadherin in Human Gliomas.

BACKGROUND: Gliomas are a heterogenous group of tumors that show the same histological features but differ in their behavior. Gliomas are characterized by biological aggressiveness and extensive infiltrative growth into surrounding healthy brain tissue. OBJECTIVES: In this study we estimated CD44v6 and E-cadherin expression and correlation between CD44v6 and E-cadherin in relation to glioma malignancy. We also analyzed simultaneous expression of CD44v6 and E-cadherin in the same tumor sample in order to determine the biological tumor behavior. MATERIAL AND METHODS: Expression of CD44v6 and E-cadherin was evaluated on ninety-two formalin-fixed paraffin-embedded glioma tissue blocks using immunohistochemistry (IHC). RESULTS: CD44v6 expression was found in 71.6% of gliomas. There was a statistically significant difference between the frequency of positive cases for CD44v6 expression in low (grade I) vs. high (grade IV) as well as in grade I vs. grade II of glioma malignancy (p = 0.001). E-cadherin membrane staining was observed in 28.8% of gliomas. No significant differences were observed between E-cadherin expression and grade of gliomas (p > 0.05). However, re-expression of E-cadherin was found in grade II gliomas. In this group, E-cadherin expression was revealed in 43.3% of the cases. In order to define the relationship between CD44v6 expression and E-cadherin, we analyzed the simultaneous expression of CD44v6 and E-cadherin in the same glioma sample in the whole group and in respect to the degree of glioma malignancy. A positive correlation between studied biomarkers was observed in the analyzed gliomas (p = 0.004) but a simultaneous expression of CD44v6 and E-cadherin revealed no significant differences in respect to glioma malignancy. CONCLUSIONS: Our results showed that the level of E-cadherin might reflect different biological features of gliomas, whereas CD44v6 is associated with tumor cell malignancy. The simultaneous presence of CD44v6 and E-cadherin in a set of low-grade gliomas indicates that both these molecules might strengthen cell migration and may be a hallmark of glioma invasive growth.