Vitamin D receptor gene methylation in hepatocellular carcinoma.

Worldwide, hepatocellular carcinoma (HCC) is the major subtype of primary liver cancers. HCC is typically diagnosed late in its course. With respect to cancer, the genomic actions of vitamin D are mediated through binding to the Vitamin D Receptor (VDR), which allows it to modulate the expression of genes in a cell-and tissue-specific manner. Epigenetics is a rapidly evolving field of genetic study applicable to HCC. Changes in DNA methylation patterns are thought to be early events in hepatocarcinogenesis. Curcumin has great potential as an epigenetic agent. Accordingly, the current study has been designed to study the methylation status of VDR gene promoter for the first time in HCC aiming to find its clinical significance and potential screening role in chronic Liver Disease (CLD). Additionally, we aimed to investigate, the effect of Curcumin on HCC cell line, aiming to discover new therapeutic targets through epigenetics. This study was conducted on 45 formalin-fixed, paraffin-embedded liver tissue blocks including 15 HCC samples (group A), 15 CLD samples (group B) and 15 apparently normal tissue taken from around benign lesions (group C). Methylation Specific Restriction Digestion and qPCR were done on all samples after DNA extraction. The percentage of VDR gene promoter methylation was significantly higher in the HCC group compared to both CLD and control groups (p < 0.01). VDR promoter methylation by (MS-qPCR) was decreased and the relative expression of VDR by (qRT-PCR) was markedly increased in a dose-dependent fashion in cells grown in Curcumin-adequate medium. In conclusion, this study may open a new gate for the use of VDR promoter methylation as a potential biomarker in HCC.

Bcl-2 may play a role in the progression of endometrial hyperplasia and early carcinogenesis, but not linked to further tumorigenesis☆.

The role of Bcl-2 in initiation and progression of endometrial carcinoma is still with inconsistent results. The aim of this study is to determine the role of Bcl-2 in endometrial tumorigenesis. It is a retrospective cross sectional study. We used 100 endometrial paraffin embedded specimens for Bcl-2 oncoprotein immunohistochemical staining; 20 samples of normal endometrium, 40 specimens of endometrial hyperplasia (simple, complex and atypical) and 40 specimens of endometrioid adenocarcinoma. The results were statistically analyzed. There was a significant increase in Bcl-2 staining from normal through complex and atypical hyperplasia into well differentiated adenocarcinoma (P =0.002, P =0.0008 and P =0.0001, respectively). There was a significant difference between the staining of different types of endometrial hyperplasia; as it up streamed from the simple through the complex up to the atypical types (P <0.05). Bcl-2 staining showed no significant correlation with the moderately, poorly differentiated and the different stages of adenocarcinoma (P =0.6, P =0.29 and P =0.1 respectively). These results might indicate a substantial role for Bcl-2 as one of the initiating drives for endometrial tumorigenesis, but not in further tumor progression.

Comparison between phenol red chromo-endoscopy and a stool rapid immunoassay for the diagnosis of Helicobacter pylori in patients with gastritis.

Helicobacter pylori infection is a widespread problem all over the world. Non-invasive techniques are demanded for rapid diagnosis and treatment follow up. The aim of this study was to compare the diagnostic value of phenol red chromo-endoscopy and stool (Rapid Strip HpSA) for H. pylori detection with reference to histopathology as the gold standard. A total of 80 adult patients with dyspepsia were enrolled on this study. Patients underwent phenol red chromo-endoscopy. Multiple Gastric biopsies were taken and examined for H. pylori detection. Stool sample was collected from every patient for Rapid Strip HpSA test. The study included 38 males (47.5%) and 42 females (52.5%) with their ages ranged between 19 and 56 years. According to histopathology, 71 patients (88.8%) were H. pylori positive and 9 (11.2%) were negative, most of biopsies showed inflammation with variable degree of activity, which showed significant statistical correlation with the density of H. pylori (P < 0.05). Phenol red chromo-endoscopy had 90.1% sensitivity, 88.9% specificity, 98.5% positive predictive value (PPV), 53.3% negative predictive value (NPV) and 90% accuracy. Rapid Strip HpSA had a sensitivity 93%, 77.8% Specificity, 97.1% PPV, 58% NPV and 91.3% accuracy. In conclusion; Phenol red chromo endoscopy was more specific and less sensitive than the rapid stool Rapid Strip HpSA® test regarding the detection of H. pylori infection with reference to histopathology as a gold standard, yet both showed high diagnostic accuracy; thus they can be used as reliable diagnostic tools for H. pylori infection in cases contraindicated for gastric biopsy.

Placenta accreta is associated with decreased decidual natural killer (dNK) cells population: a comparative pilot study.

OBJECTIVE: Placenta accreta is a general term describes abnormal adherent placenta to the uterine wall. When the chorionic villi invade the myometrium, the term placenta increta is appropriate. Nowadays, it is one of the increasing causes of materno-fetal morbidities and mortality. The aim of this research was to evaluate density of decidual natural killer cells (dNK, CD56+(bright)) in decidua basalis in patients with placenta accreta. STUDY DESIGN: We recruited 76 patients from Ain Shams Maternity Hospital between June 2012 to August 2013, they were divided into study subgroup (A) which included 10 patients who underwent cesarean hysterectomy due to unseparated placenta accreta, study subgroup (B) included 16 patients with separated placenta accreta, a comparison group included 25 patients with placenta previa and a control group included 25 patients with normally situated placenta. All patients underwent elective cesarean delivery. Decidual biopsies were taken during the operation. An immunohistochemical staining for (dNK, CD56+(bright)) and a semi quantitative scoring were done. One-way ANOVA and Fisher Exact tests were used for statistical correlation. RESULTS: The mean dNK cells scores were (0.4±0.5, 1.9±1, 3.3±0.5 and 3.5±0.5) for study subgroups (A), (B) comparison and control groups respectively) with a highly significant statistical difference (P<0.001). There was a significant statistical difference between study subgroups (A) and (B) P=0.002 .There was an insignificant statistical correlation between dNK scores and number of previous uterine scars (P=0.46). CONCLUSION: These findings suggest that low dNK score was associated with cases of morbidly adherent placenta accreta.