The Rate of Phosphatase and Tensin (PTEN) Gene Expression Loss in Prostate Cancer and its Link to Tumor Upgrading.

PURPOSE: Recent studies have provided reliable evidence for a relationship between loss of PTEN gene expression and prognosis in patients suffering from prostate cancer, although the results have been somewhat diverse in different populations. We aimed to assess PTEN gene expression loss by immunohistochemistry in prostate cancer and also its link to tumor upgrading in a group of affected patients undergoing radical prostatectomy. MATERIALS AND METHODS: This cross-sectional study was performed on 58 tissue samples sourced from the patients with prostate cancer and undergoing radical prostatectomy. TRUS-guided needle biopsies of the cancer tissue samples with histological grade groups of I to IV (the Gleason scores of 6 to 8) were prepared as the study samples. 29 patients with Gleason score (6 to 8) whose tumors on needle biopsy upgraded to Gleason score 7, 8 or 9 at prostatectomy (cases) were compared with 29 patients with Gleason scores of 6, 7 or 8 on both biopsy and prostatectomy samples (controls). Immunohistochemistry (IHC) technique was employed to determine PTEN gene expression status. RESULTS: Loss of PTEN gene expression was found in 62.1% of upgraded cases compared with 27.6% of controls, indicating a statistically significant difference, revealing a meaningful association between the loss of PTEN gene expression and tumor upgrading. Furthermore, we demonstrated that deletions of PTEN gene expression and increased Gleason score in control and upgraded case groups, did not reach statistical significance. CONCLUSION: A high rate of PTEN gene expression loss can be detected in prostate cancer tumor tissue, and this loss of gene expression is associated with tumor upgrading.

Status of Inflammatory and Coagulation Factors in COVID-19 and Its Relation with the Disease Severity.

Background: The role of activation of inflammatory processes in the exacerbation of COVID-19 disease has been fully confirmed. In addition, the occurrence of thromboembolic events in patients with COVID-19 is expected even long after recovery from the disease. However, which factors are essentially prognostic for this disease is still not theoretically agreed upon. What we did in the present study was to evaluate the prognostic role of some inflammatory and coagulation factors in predicting the severity of COVID-19 disease. In this study, the need for ICU admission was considered as a symbol of disease severity. Materials and Methods: Forty-six cases were studied in this cross-sectional study. Patients over 18 years of age with a definitive diagnosis of COVID-19 were assessed in terms of coagulation profiles and inflammatory and cytokine markers. Regarding laboratory data, serum levels of D-dimer, protein S, protein C, FDP, and fibrinogen were measured using an automated coagulation analyzer, and serum levels of interleukin-6 were measured using the ELISA technique. Results: In total, 21 patients (45.7%) were admitted to the ICU due to the severity of the disease. In comparing inflammatory and coagulation factors between the two groups of patients, with and without ICU admission, a significant difference was revealed between fibrinogen (P=0.023), D-dimer (P=0.047), protein C (P=0.001), and protein S level (P=0.014). The decrease in protein C level had the highest value for predicting the severity of the disease and therefore the need for ICU admission. Conclusion: Among various inflammatory and coagulation factors, the role of fibrinogen, D-dimer, protein C, and protein S in predicting the severe form of COVID-19 and the patient's need for ICU admission was confirmed.

Diagnostic Utility of Combined CEA, CA15-3 and CA125 Biomarkers and Cytomorphology in Suspicious and Malignant Serosal Fluid.

BACKGROUND & OBJECTIVE: Early detection of malignancies in the serous fluids has been remained an issue. A classic diagnostic tool for the ascites and pleural effusions is cytologic study (morphology) with approximately 98% specificity for the detection of cancer cells. This study aimed to evaluate the diagnostic value of three complementary markers in the serosal fluids of patients with malignant cytology and suspected cases. METHODS: Seventy two patients with serosal effusion treated in three teaching hospitals were studied. The cases underwent a diagnostic workup to determine the pleural effusion malignancy and etiologies. Complementary markers, including CEA, CA15-3, and CA125 were measured in serosal fluids of three categories of benign, suspicious, and malignant. The study was carried out by Chemiluminescence immunoalayzer. The morphologies were re-evaluated by a consulting Cytopathologist. RESULTS: Of 72 serosal fluid specimens, 41 (56.9%) were related to pleural effusion and 31 (43.1%) were related to ascites. The sensitivity of CEA, CA125, and CA15-3 biomarkers were 64, 84, and 68%, respectively, and the specificity of each test was 100, 86, and 96%, respectively. This was statistically achieved for the combination of the area of markers below the curve (AUC), 0.93 and 90% sensitivity and 91% specificity. CONCLUSION: The results suggest that complementary CA125, CA15-3, and CEA markers assayed with well-developed immunoassay method might be useful in the differentiation between malignant and benign effusions while combined with conventional cytology. CA125 yielded a significant correlation between cytomorphology and biomarkers based on the correlation coefficient analysis.

Inter-observer Variability in Histomorphological Evaluation of Non-neoplastic Liver Biopsy Tissue and Impact of Clinical Information on Final Diagnosis in Shahid Beheshti University of Medical Sciences Affiliated Hospitals.

BACKGROUND & OBJECTIVE: Liver biopsy is the main method for grading and staging liver disorders, but the effects of clinical information and optimal biopsy specimen size on interpretation remain contentious. The aim of the study was to evaluate the impact of clinical information and quality of liver specimen on inter-observer agreement for liver disease. METHODS: A total of 289 consecutive biopsy specimens from 2010 to 2017 were re-evaluated by five pathologists using the modified Ishak and non-alcoholic fatty liver diseases (NAFLD) activity score (NAS) systems. Detailed clinical information was extracted from medical records of patients and the size of all liver biopsy samples was recorded. RESULTS: Full agreement between primary diagnosis and final diagnosis was obtained in 214 cases (74%). The remaining cases, namely 22 (7.6%) and 53 (18.3%) biopsies had minor and major diagnostic discrepancies, respectively. The results showed that the overall agreement was significantly higher in cases with complete clinical information than patients without any clinical information and even with partial clinical information (P<0.001). Interestingly, no significant difference in inter-observer agreement was achieved with a length over 20 mm (P=0.181). However, the inter-observer variation significantly decreased when the number of portal tract was more than 10 (P=0.001). CONCLUSION: This study identified the impact of clinical information and the number of portal tracts as the key factors to diagnosis. Therefore, request forms for liver biopsies should always be accompanied with the clinical history. Moreover, adequacy of biopsy specimens is very useful for accurate evaluation of samples by pathologists.

Evaluation of the Standardization in Semen Analysis Performance According to the WHO Protocols Among Laboratories in Tehran, Iran.

BACKGROUND AND OBJECTIVE: Infertility refers to the failure in achieving pregnancy of a couple after one year of regular sexual intercourse without using a protection method. The purpose of this research work was to evaluate the current status of the test and quality control performance in semen analysis in selected laboratories. MATERIAL AND METHODS: The semen analysis was performed in the Laboratory of Andrology in terms of macroscopic examination which include volume, color, viscosity, pH and acidity, and in terms of microscopy: the rate of sperm movement, the exact number of sperms per ml of semen, the percentage of sperm viability and movement, the presence of germ cells and white blood cells. Several questions for each part of the test were selected and answered by the director of the laboratories or andrology section supervisor. RESULTS: There was a wide range in the performance of selected medical laboratories in Tehran regarding the standards of semen analysis according to the World Health Organization (WHO) Laboratory Manual for the examination and processing of human semen, fifth edition in 2010. They followed the instructions related to the sample collection in about 70% of the evaluated parameters, initial macroscopic examination in about 87% of the selected subjects, and the microscopic evaluation of sperm in about 65% of the test parameters. CONCLUSION: some laboratories do not follow the instructions of the WHO in performing semen analysis, and most of them do not follow the suggested methods in all parts of the test.

Optimal number of biopsies and impact of testicular histology on the outcome of testicular sperm extraction.

PURPOSE: To determine the optimal number of biopsies in patients with non-obstructive azoospermia (NOA) who undergo testicular sperm extraction (TESE), and assess the impact of testicular histology on outcome. MATERIALS AND METHODS: Seven hundred and forty-one patients with NOA who underwent TESE in our institution were enrolled in the study. Testicular sperm extraction was performed applying an open surgical technique on the larger testis. The number of biopsies varied according to the presence or absence of spermatozoa. No further biopsies were obtained once spermatozoa were detected. If no spermatozoa were seen, the procedure was continued to a maximum number of 5 biopsies, including a single biopsy of the contralateral testis. RESULTS: Spermatozoa were obtained in 330 (44.5%) patients after a single biopsy. The success rate increased to 381 (51.4%), 416 (56.1%), 433 (58.4%), and 441 (59.5%) after the second, third, fourth, and contralateral sampling, respectively. Multiple sampling increased the success rate; however, success rate did not increase considerably after the third sampling. Performing contralateral testicular biopsy was advantageous in patients with uniform or mixed pattern hypospermatogenesis. CONCLUSION: We recommend performing at least 3 biopsies in patients with NOA who undergo TESE. Further biopsies may also be advantageous when the NOA is a consequence of either uniform or mixed pattern hypospermatogenesis.

Neuroprotective effects of the polyphenolic antioxidant agent, Curcumin, against homocysteine-induced cognitive impairment and oxidative stress in the rat.

Aging is the major risk factor for neurodegenerative diseases and oxidative stress is involved in the pathophysiology of these diseases. In this study, the possible antioxidant and neuroprotective properties of the polyphenolic antioxidant compound, Curcumin against homocysteine (Hcy) neurotoxicity was investigated. Curcumin (5 and 50mg/kg) was injected intraperitoneally once daily for a period of 10 days beginning 5 days prior to Hcy (0.2 micromol/microl) intrahippocampal injection in rats. Biochemical and behavioral studies, including passive avoidance learning and locomotor activity tests were studied 24h after the last Curcumin or its vehicle injection. We detected Malondialdehyde (MDA) and Super oxide anion (SOA) in rats' hippocampi. Results indicated that Hcy could induce lipid peroxidation and increase MDA and SOA levels in rats' hippocampi. Additionally, Hcy impaired memory retention in passive avoidance learning test. However, Curcumin treatment decreased MDA and SOA levels significantly as well as improved learning and memory in rats. Histopathological analysis also indicated that Hcy could decrease hippocampus cell count and Curcumin inhibited this toxic effect. These results suggest that Hcy may induce lipid peroxidation in rats' hippocampi and polyphenol treatment (Curcumin) improved learning and memory deficits by protecting the nervous system against Hcy toxicity.