Análisis de la expresión inmunohistoquímica de OVOL1 como herramienta diagnóstica de invasión en las neoplasias escamosas de la superficie ocular / OVOL1 immunohistochemical expression is a useful tool to diagnose invasion in ocular surface squamous neoplasms

Antecedentes y objetivos OVOL1 es un gen que regula negativamente la transformación mesenquimática, la cual permite a las células epiteliales invadir el estroma. Por otro lado, regula negativamente la c-Myc, que tiene un efecto positivo sobre la proliferación celular. El objetivo de este estudio es evaluar la expresión de OVOL1 y c-Myc en neoplasias escamosas de la superficie ocular (NESO). Pacientes y métodos Estudio de cohorte transversal de 36 muestras que incluían 6 papilomas escamosos, 19 neoplasias intraepiteliales conjuntivales, 6 carcinomas escamosos y 7 conjuntivas normales, que fueron evaluadas mediante técnica inmunohistoquímica contra OVOL1 y c-Myc. La expresión de ambos marcadores fue analizada usando el H-score (intensidad 1-3 multiplicado por el porcentaje de células positivas) Resultados Un 98 y un 100% de las NESO y un 57 y un 71% de las conjuntivas normales expresaron OVOL1 y c-Myc, respectivamente; sin embargo, el promedio del H-score de OVOL1 y c-Myc fue mayor en las NESO que en las conjuntivas normales (p=0,0001 en ambos). Dentro de las NESO, OVOL1 demostró un H-score mayor en las neoplasias intraepiteliales conjuntivales y los papilomas, en comparación con el carcinoma escamoso (p<0,01). c-Myc no mostró diferencias entre los grupos de NESO. Un H-score menor de 35 diferencia un carcinoma escamoso de los otros grupos de NESO con una sensibilidad del 83,3% y una especificidad del 100%. Conclusiones La expresión de OVOL1 es útil para diferenciar un carcinoma escamoso de una neoplasia intraepitelial conjuntival y un papiloma. OVOL1 podría jugar un rol en la capacidad de invasión de las neoplasias escamosas y lo ubica como un potencial blanco terapéutico (AU)

Background and objectives OVOL1 is a gene that negatively regulates mesenchymal transformation, which allows epithelial cells to invade the stroma. On the other hand, it negatively regulates c-Myc, which has a positive effect on cell proliferation. The aim of this study is to evaluate the expression of OVOL1 and c-Myc in ocular surface squamous neoplasia (OSSN). Patients and methods Cross-sectional cohort study of 36 samples including 6 squamous papillomas, 19 conjunctival intraepithelial neoplasms, 6 squamous carcinomas and 7 normal conjunctivae were evaluated using immunohistochemistry against OVOL1 and c-Myc. The expression of both markers was analysed using the H-score (intensity 1-3 multiplied by the percentage of positive cells). Results Percentages of 98 and 100 of the OSSN, and 57 and 71% of the normal conjunctivae expressed OVOL1 and c-Myc respectively, however, the mean H-score of OVOL1 and c-Myc was higher in the OSSN than in normal conjunctivae group (P=.0001 in both). Within the OSSN, OVOL1 demonstrated a higher H-score in the conjunctival intraepithelial neoplasms and papilloma, compared to the squamous carcinoma (P<.01) group. c-Myc did not show differences between the OSSN groups. An H-score lower than 35 differentiates a squamous cell carcinoma from other OSSN lesions with a sensitivity of 83.3% and a specificity of 100%. Conclusions The expression of OVOL1 is a useful tool to differentiate between a squamous carcinoma of conjunctival intraepithelial neoplasms and papilloma. OVOL1 could play a role in the invasiveness of squamous neoplasms and places it as a potential therapeutic target (AU)

OVOL1 immunohistochemical expression is a useful tool to diagnose invasion in ocular surface squamous neoplasms.

BACKGROUND AND OBJECTIVES: OVOL1 is a gene that negatively regulates mesenchymal transformation, which allows epithelial cells to invade the stroma. On the other hand, it negatively regulates c-Myc, which has a positive effect on cell proliferation. The aim of this study is to evaluate the expression of OVOL1 and c-Myc in ocular surface squamous neoplasia (OSSN). PATIENTS AND METHODS: Cross-sectional cohort study of 36 samples including 6 squamous papillomas, 19 conjunctival intraepithelial neoplasms, 6 squamous carcinomas and 7 normal conjunctivae were evaluated using immunohistochemistry against OVOL1 and c-Myc. The expression of both markers was analysed using the H-score (intensity 1-3 multiplied by the percentage of positive cells). RESULTS: Percentages of 98 and 100 of the OSSN, and 57 and 71% of the normal conjunctivae expressed OVOL1 and c-Myc respectively, however, the mean H-score of OVOL1 and c-Myc was higher in the OSSN than in normal conjunctivae group (P=0.0001 in both). Within the OSSN, OVOL1 demonstrated a higher H-score in the conjunctival intraepithelial neoplasms and papilloma, compared to the squamous carcinoma (P<0.01) group. c-Myc did not show differences between the OSSN groups. An H-score lower than 35 differentiates a squamous cell carcinoma from other OSSN lesions with a sensitivity of 83.3% and a specificity of 100%. CONCLUSIONS: The expression of OVOL1 is a useful tool to differentiate between a squamous carcinoma of conjunctival intraepithelial neoplasms and papilloma. OVOL1 could play a role in the invasiveness of squamous neoplasms and places it as a potential therapeutic target.

Schwannoma de párpado, a propósito de un caso / Schwannoma of the eyelid. A case report

Hombre de 57 años con historia de aumento de volumen del párpado superior izquierdo de un año de evolución. Se realizó biopsia escisional de la lesión. Posteriormente, el estudio histológico e inmunohistoquímico confirmó el diagnóstico de schwannoma. Los schwannomas son tumores benignos de las vainas de los nervios periféricos, derivados de una proliferación de las células de Schwann. La ubicación palpebral es extremadamente infrecuente. Para realizar el diagnóstico, es fundamental un estudio histopatológico e inmunohistoquímico detallado. El caso presentado refuerza la idea de que los schwannomas deben incluirse siempre en el diagnóstico diferencial de cualquier lesión palpebral sólida

The case is presented of a 57 year-old man with a one-year history of enlargement of the left upper eyelid. An excisional biopsy was performed, and the histological and immunohistochemical study confirmed the diagnosis of schwannoma. Schwannomas are benign peripheral nerve sheath tumours, derived from a Schwann cells proliferation. Eyelid involvement is extremely uncommon. To make the diagnosis, a detailed histopathological and immunohistochemical study is essential. This case suggests that schwannomas should be included within the differential diagnosis of any solid eyelid lesion

Schwannoma of the eyelid. A case report. / Schwannoma de párpado, a propósito de un caso.

The case is presented of a 57 year-old man with a one-year history of enlargement of the left upper eyelid. An excisional biopsy was performed, and the histological and immunohistochemical study confirmed the diagnosis of schwannoma. Schwannomas are benign peripheral nerve sheath tumours, derived from a Schwann cells proliferation. Eyelid involvement is extremely uncommon. To make the diagnosis, a detailed histopathological and immunohistochemical study is essential. This case suggests that schwannomas should be included within the differential diagnosis of any solid eyelid lesion.

Exploring the in situ expression of vascular endothelial growth factor and endoglin in pemphigus foliaceus variants and pemphigus vulgaris.

BACKGROUND: Erythroderma is a severe manifestation of pemphigus foliaceus (PF), a blistering disease mediated by IgG autoantibodies against desmoglein 1. Increasing evidence supports the contribution of angiogenic mediators in the pathogenesis of erythroderma. OBJECTIVE: To evaluate the in situ expression of vascular endothelial growth factor (VEGF) and endoglin in patients with PF with erythroderma. METHODS: Formalin-fixed paraffin-embedded skin samples obtained from patients with erythrodermic PF (n = 19; 12 patients with endemic PF), non-erythrodermic PF (n = 17), pemphigus vulgaris (PV; n = 10), psoriasis (n = 10) and healthy individuals (HI; n = 10) were processed in an automated immunohistochemistry platform utilizing anti-VEGF and anti-endoglin as primary antibodies. Reactivity was evaluated both manually (0 = negative; 1+ = mild; 2+ = intense) and through an automated microvessel analysis algorithm. RESULTS: Vascular endothelial growth factor expression in erythrodermic PF was higher than in non-erythrodermic PF (P = 0.034) and in HI (P = 0.004), and similar to psoriasis (P = 0.667) and PV (P = 0.667). In non-erythrodermic PF, VEGF positivity was similar to HI (P = 0.247), and lower than psoriasis (P = 0.049) and PV (P = 0.049). Both erythrodermic and non-erythrodermic PF presented similar endoglin expression (P = 0.700). In addition, endoglin positivity during erythrodermic PF was similar to psoriasis (P = 0.133) and lower than PV (P = 0.0009). Increased expression of in situVEGF suggests that healing processes are triggered in response to tissue damage led by autoantibodies in PF, especially during erythroderma. Reduced endoglin positivity suggests that an unbalanced angiogenesis may occur during erythrodermic PF. Further studies may help to confirm if the regulation of VEGF and endoglin expression in patients with PF can contribute to control the healing process and enable disease remission. CONCLUSION: Overexpression of VEGF in erythrodermic PF as well as in PV and psoriasis points out a dysregulated repair process in severe forms of these diseases and suggests VEGF and endoglin could act as prognostic markers and future therapeutic targets to enable proper healing in PF.