Nestin expression as an indicator of cervical cancer initiation.

Nestin is an intermediate filament protein expressed in proliferating cells during embryonic development of the central nervous system (CNS) and considered to be a neuronal stem cell/progenitor cell marker. This study investigated the difference of nestin expression between pre-cancer (carcinoma in situ - CIS) and cancer of cervix in 129 tissues (49 normal cervix, 41 CIS, and 39 invasive cervical cancer) through the use of a paraffin-embedded tissue array. Immunostaining was evaluated by intensity, proportion of stained cells, and pattern of expression. The expression of nestin was positive in 63.4% (26/41) for CIS and 43.6% (17/39) for invasive cervical cancer, but only 26.5% (13/49) for normal tissues (p = 0.002). Strong positive staining/large proportion staining were 53.7% (22/41) / 36.6% (15/41), 15.4% (6/39) / 61.5% (24/39) in the CIS and invasive cervical cancer tissues, respectively (p = 0.043, p < 0.001). The diffuse stain with basal layer was positive in 90.2% (37/41) for CIS, but only 24.5% (12/49) of the samples were positive in normal tissues (p < 0.001). Based on these results, the authors suggest that nestin expression seems to participate in the step of cancer initiation and could potentially be a useful marker in the early detection of cervical cancer.

Expression of pituitary tumor-transforming gene in endometrial cancer as a prognostic marker.

The pituitary tumor-transforming gene (PTTG) is a novel oncogene expressed abundantly in most tumors, regulates basic fibroblast growth factor secretion, and induces angiogenesis. The objective of this study is to compare the expression rate of PTTG in endometrial cells, to correlate the level of expression of PTTG with the clinicopathologic parameters and overall survival, and to evaluate the possible use of PTTG as a prognostic marker of endometrial cancer. Forty patients diagnosed with endometrial cancer, 20 patients with endometrial hyperplasia, and 20 patients with normal endometrial tissues were included in the study. Immunohistochemical analyses on paraffin-embedded blocks were performed using a polyclonal anti-PTTG antibody. The decrease in expression of cytoplasmic and nuclear PTTG seen for endometrial cancer cells was statistically significant (P < 0.05). Cytoplasmic PTTG expression correlated with expression of progesterone receptor (P = 0.009) and FGF-2 (P = 0.007) but not with other parameters such as the expression of estrogen receptor, tumor grade, and surgical stage. Nuclear PTTG expression did not correlate with any parameters. The mean survival of patients with positive and negative cytoplasmic PTTG expression was 40.8 and 48.6 months (P = 0.78). In nuclear PTTG expression, the survival was 20.0 and 51.8 months, respectively (P = 0.04). Cytoplasmic PTTG expression was not associated with survival. Patients with nuclear PTTG overexpression showed a significant decrease in survival. The use of PTTG as a prognostic marker for endometrial cancer needs further investigation.

Epstein-Barr virus and CD21 expression in gastrointestinal tumors.

Epstein-Barr virus (EBV) was found in 7-17% of gastric adenocarcinomas, including lymphoepithelioma-like carcinomas, although its significance has not been clear. In addition, 20-30% of malignant lymphomas arising in the gastrointestinal tract have been known to express the EBV genome. Several lines of evidence indicate that EBV has been shown to infect both B lymphocytes and squamous epithelial cells via CD21 molecule in vivo and in vitro. The expression of CD21 in EBV-associated gastrointestinal tumors, however, has remained controversial. To determine the presence of CD21, an EBV receptor, in the EBV-associated gastrointestinal tumors, we, first, examined the EBV genome in sixty seven patients with either gastrointestinal adenocarcinomas or malignant lymphomas using in situ hybridization (ISH) for EBV-encoded small RNAs (EBERs) and PCR for EBNA-1. Then, the investigation of CD21 expression was performed only in the EBV-positive tumors with immunohistochemical method for CD21 antigen on paraffin sections. EBERs were detected in 6 out of 26 gastric adenocarcinomas, 2 of 24 colonic adenocarcinomas, and 8 of 17 malignant lymphomas. EBERs were more prevalent in the malignant lymphomas originating from the small and large intestine (6/6) than from the stomach (2/11), and were detected in both B and T cell phenotypes. EBNA-1 was amplified in 11 of 16 EBERs-positive cases. Interestingly, however, none of the EBV-positive six gastric adenocarcinomas and eight malignant lymphomas expressed the CD21 on the cell surfaces or cytoplasm of both tumor cells and adjacent normal epithelial cells. These results suggest that EBV infection in the gastrointestinal malignancies would be mediated via different routes besides the CD21 or a new receptor distinct from CD21.

Fine needle aspiration cytology of primary pulmonary paraganglioma. A case report.

BACKGROUND: Primary pulmonary paragangliomas are rare tumors. To our knowledge, there is no prior report on fine needle aspiration cytology (FNAC) in pulmonary paraganglioma. CASE: A 34-year-old man presented with an incidentally found solitary pulmonary mass. FNAC showed papillarylike clusters of epithelioid cells with round to oval nuclei, evenly dispersed chromatin, micronucleoli and occasional anisonucleosis. These cytologic features were suggestive of a sclerosing hemangioma or bronchioloalveolar carcinoma. A right lower lobectomy revealed a primary pulmonary paraganglioma. CONCLUSION: The possibility of pulmonary paraganglioma should be considered in the differential diagnosis of FNAC showing pseudopapillary clusters of epithelioid cells.