Is it possible that we can increase the lymph node number in cases with rectum tumor receiving neoadjuvant therapy?

Background: Though the recommended sampled lymph node number in colorectal carcinomas is at least 12, due to shrinkage after preoperative neoadjuvant chemoradiotherapy (NCRT), it can be difficult to attain that number. Aim: Our aim is to increase the lymph node number by applying alcohol fixation on the formalin-fixed resection materials of the patients that received or not received neoadjuvant therapy and to evaluate the changes in staging due to obtained lymph nodes. Settings and Design: Non-randomized controlled trial. Materials and Methods: Lymph node dissection was performed in the resection materials with rectum tumor which were formalin- and afterwards, alcohol-fixed. The number of lymph nodes obtained by both of the methods and status of metastasis were evaluated statistically. Results: Of the total 76 rectal tumors, 57 had and 19 had not received NCRT. The number of lymph node was adequate in 89.5% cases with no NCRT and in 63.2% cases with NCRT. While no change was observed after the alcohol fixation in the cases fulfilling adequacy criterion among those with no NCRT (p = 1.000), the adequacy rate increased from 63.2% to 87.7% in those with NCRT (p < 0.001). Although statistically insignificant, there was a change in pN stage in eight cases. In three of them, the stage varied from pN0 to pN1c, and in five cases, from pN1a to pN1b. Conclusion: Using solutions as alcohol during fixation might facilitate the identification of metastatic lymph nodes, might change the stage of the disease and therefore, might affect the patient-based therapy.

Mitotic Activity in Gastrointestinal Stromal Tumors: Can we use Phosphohistone H3 Immunohistochemistry Instead of Hematoxylin and Eosin for Mitotic Count?

Objectives: In gastrointestinal stromal tumors (GIST), malignancy potential is determined by the prognostic disease risk stratification based on mitosis, tumor size, and location. Phosphohistone H3 (PHH3) is an immunohistochemical marker showing mitotic activity in cells. In this study, we aimed to evaluate mitosis in GIST with PHH3, compare the results with hematoxylin and eosin (HE) stained slides, and examine its relationship with other prognostic data. Methods: Clinicopathological findings and survival were determined in GIST cases diagnosed between 2006 and 2017. The prognostic risk score was calculated according HE- and PHH3-based mitosis. The cases were classified as Group I: HE + and PHH3 + and Group II: HE + and PHH3-. They were also grouped as those diagnosed before and after 2012 and the staining results of HE and PHH3 were re-analyzed. Results: Ninety-eight cases were included in the study. Mitosis was detected with both HE and PHH3 in 63.3% of the cases (62/98 cases) (Group I) while in 36.7% of cases, it was detected with HE but not with PHH3 (Group II). In only two cases, the risk score changed with PHH3 (very low → intermedier grade). The ratio of HE + and PHH3 + cases in 2012 and after was significantly higher than HE + and PHH3 - cases. A statistically significant relation was found between HE- and PHH3-based risk scores (p<0.05). There was a significant difference between HE-based risk score groups in terms of survival (p<0.05), while no difference was observed between the PHH3-based risk score groups (p>0.05). Conclusion: In GIST cases, PHH3 can be used to determine mitosis in more recent blocks, taking into account the technical conditions of the laboratory, but it does not seem to be superior to mitosis detected by HE. Research should continue on new survival determinants for GIST.

Clinicopathological Evaluation of 15 Ectopic Adrenal Tissues.

BACKGROUND: Ectopic adrenal tissue is a rare condition associated with embryological development defects seen in many different areas in the abdomen and pelvis. Here, we aimed to discuss the clinicopathological features of ectopic adrenal tissues diagnosed in our clinic, in light of the literature. METHODS: We included cases of ectopic adrenal tissues incidentally detected in the specimens from patients undergoing operation for various diagnoses during 2012- March 2020. The cases were examined according to gender, age, location and accompanying pathological diagnoses. During this period, 15 cases of ectopic adrenal tissues (6 paratubal, 3 paraovarian, 2 paratesticular, 1 spermatic cord, 1 paraaortic, 1 liver capsule, 1 omentum) were detected accompanied by two endometrial carcinomas, two serous cystadenomas, one seminoma, one mixed germ cell tumor, one bilateral ovarian serous carcinoma and hepatic high-grade colon adenocarcinoma metastasis. RESULTS: In this report, the fifth ectopic adrenal tissue accompanying a malignant testicular tumor, the fifth and sixth ectopic adrenal tissues occurring with ovarian serous cystadenoma, the first case observed with serous cystadenocarcinoma and the first case detected with hepatic adenocarcinoma metastasis are presented. Our cases are mostly women and adult men. CONCLUSION: Ectopic adrenal tissues can lead to hormonal problems and also to adrenal cortex and medulla neoplasms. Microscopically, they may be confused with clear cell gynecological and germ cell tumors. If the ectopic focus is misdiagnosed as an implant, a benign entity may be incorrectly reported as malignant. Also, it is important to prevent mis-staging in malignancies. For precise diagnosis, an immunopanel such as inhibin, melan A, and calretinin can be performed.

Succinate Dehydrogenase Complex Iron Sulfur Subunit B (SDHB) Immunohistochemistry in Pheochromocytoma, Head and Neck Paraganglioma, Thoraco-Abdomino-Pelvic Paragangliomas: Is It a Good Idea to Use in Routine Work?

BACKGROUND: In this study, we aimed to detect Succinate Dehydrogenase Complex Iron Sulfur Subunit B (SDHB) frequency in paragangliomas and pheochromocytomas (PPGL) with immunohistochemistry; compare with Pheochromacytoma of the Adrenal Gland Scaled Score (PASS) classification and analyse the differences between pheochromocytoma (Pheo), head-neck paragangliomas (HNPGL) and thoraco-abdominal-pelvic paraganglioma (TAPPGL) sub-groups. METHODS: A total 114 PPGL cases (73 HNPGL, 15 TAPPGL and 27 Pheo belonging to 112 cases) are included. Immunohistochemically, SDHB and Ki-67 are investigated and malignancy risks are determined by PASS classification. Results are assessed statistically with chi-square test and p <0,01 is considered significant. RESULTS: SDHB mutations are observed in 20 of 114 (17.54 %) PPGL cases, 3 (11,12%) of which is Pheo, 12 (16,44) is HNPGL, and 5 (35,71%) is TAPPGL (P <0,02). While 15/82 (18,29%) cases with SDHB mutations do not have a malignancy potential according to PASS classification, 5/32 (15,63%) cases has (p=0,73). TAPPGL, HNPGL and Pheo sub-groups have a significant difference between SDHB expression (p <0,02), malignancy potential according to PASS classification (p <0,0001) and Ki-67 proliferation index (p <0,0001). CONCLUSION: To identify patients for molecular pathological examination, routine application of SDHB immunohistochemistry to PPGL tumors are suggested especially in HNPGLs.

Extramedullary myeloma in ectopic parathyroid adenoma: A case report.

Extramedullary myeloma, a subgroup of multiple myeloma, is a rare condition characterised by extra-skeletal infiltration of clonal plasma cells. Although parathyroid adenoma's co-morbidity with multiple myeloma is common, extramedullary myeloma, an ectopic parathyroid adenoma has not been reported in the literature. This is the first study in literature that presents extramedullary myeloma that infiltrated ectopic parathyroid adenoma in the mediastinum after multiple myeloma treatment. In its course of relapse, the extramedullary myeloma created mass effect and no laboratory findings were present due to its non-secretory nature.

The impact of sarcopenia on pathologic complete response following neoadjuvant chemoradiation in rectal cancer.

PURPOSE: The role of sarcopenia in pathologic complete response (pCR) following neoadjuvant chemoradiotherapy (nCRT) in non-metastatic locally advanced rectal cancer is currently unknown. The present study investigates the association between sarcopenia and post-nCRT pCR. METHODS: The data of patients operated on following nCRT between January 2013 and January 2020 were collected retrospectively. Sarcopenia was diagnosed based on the calculation of the skeletal muscle index (SMI) from computed tomography carried out at the time of the initial diagnosis. A statistical analysis was then conducted for predictors of pCR. RESULTS: The study included 61 patients with an average age of 57.3 years, 28 of whom formed the non-sarcopenic group (NSG) and 33 the sarcopenic group (SG). Of the patients, 32.7% were at clinical stage 2, and 67.3% were at clinical stage 3. Pathologic data following a mesorectal excision revealed a pCR rate of 21.4% in the NSG compared with 3% in the SG, which was a statistically significant difference (p = 0.025). The TNM downstaging rate was higher in the NSG than in the SG, although the difference was not statistically significant (50% vs. 33.3%, p = 0.28). A univariate analysis revealed the factors affecting pCR to be non-sarcopenia (p = 0.025), age < 61 years (p = 0.004), interval to surgery ≥ 8 weeks (p = 0.029), and serum CEA < 2.5 ng/ml (p = 0.035). CONCLUSION: Sarcopenia was found to be a negative marker of pCR following nCRT in non-metastatic locally advanced rectal cancer.

The Contribution of Additional Sampling in Cholecystectomy Materials: A Multicenter Prospective Study.

OBJECTIVE: Cholecystectomy materials are frequently encountered in routine practice. The aim of this study was to determine the true frequency of gallbladder lesions, the diagnostic consistency, and standardization of reports after macroscopic sampling and microscopic evaluation based on previously defined criteria. MATERIAL AND METHOD: 14 institutions participated in the study within the Hepato-Pancreato-Biliary Pathology Study Group. Routinely examined cholecystectomies within the last year were included in the study in these institutions. Additional sampling was performed according to the indications and criteria. The number of blocks and samples taken in the first macroscopic examination and the number of blocks and samples taken in the additional sampling were determined and the rate of diagnostic contribution of the additional examination was determined. RESULTS: A total of 5,244 cholecystectomy materials from 14 institutions were included in the study. Additional sampling was found to be necessary in 576 cases (10.98%) from all institutions. In the first macroscopic sampling, the mean of the numbers of samples was approximately 4 and the number of blocks was 2. The mean of the numbers of additional samples and blocks was approximately 8 and 4, respectively. The diagnosis was changed in 144 of the 576 new sampled cases while the remaining 432 stayed unaltered. CONCLUSION: In this study, it was observed that new sampling after the first microscopic examination of cholecystectomy materials contributed to the diagnosis. It was also shown that the necessity of having standard criteria for macroscopic and microscopic examination plays an important role in making the correct diagnosis.

Clinicopathologic Characteristics of Gallbladder Adenomyomas and the Contribution of Macroscopic Sampling in Adenomyoma Diagnosis.

OBJECTIVE: Adenomyoma, a reactive and hamartomatous lesion of the gallbladder, is included in the differential diagnosis of several benign and malignant lesions. Macroscopic sampling is very important in the determination of these lesions. The agreed macroscopy protocol in recent years has been prepared by the Hepatopancreatobiliary Pathology Working Group. We aimed to evaluate the clinicopathologic properties of adenomyoma cases in the gallbladder and the contribution of new macroscopy techniques to the diagnosis of adenomyoma in the pre-protocol and post-protocol parts of a one-year period. MATERIAL AND METHOD: Two institutes were included in the study. Adenomyoma cases diagnosed in the pre-protocol and post-protocol periods of one year duration were included in the study. Slides and demographic properties of the cases were reexamined. RESULTS: While adenomyoma was present in 22 of 1879 gallbladder before the protocol, it was observed in 32 of 1781 gallbladders in the post-protocol period. 17 of the cases were male and 37 were female. The mean age of the cases was 51.8. 52% of the lesions were located in the fundus. A gallstone was observed in 37 cases, and cholesterolosis in 14 cases. In the comparison of the two periods, the number of cases was lower in the post-protocol period but a 0.6% increase in the diagnosis of adenomyoma was found. CONCLUSION: Adenomyoma is one of the lesions of the gallbladder that should be recognized but can be easily overlooked macroscopically. When we conducted the sampling according to the last protocol, the increase in the diagnosis of adenomyoma showed that adequate and accurate sampling was very useful for the detection of adenomyoma in the gallbladder.

Endobronchial ultrasound-guided transbronchial fine needle aspiration: Determinants of adequacy.

BACKGROUND: This study aims to evaluate the factors influencing the adequacy of endobronchial ultrasound-guided transbronchial fine needle aspiration specimens. METHODS: A retrospective analysis of 1,700 endobronchial ultrasound-guided transbronchial fine needle aspiration samples obtained from 822 patients (500 males, 322 females; mean age 56±13 years; range 16 to 83 years) was performed between March 2011 and March 2014 at our center. Variables potentially associated with sampling adequacy, such as all cytological materials and procedure notes (lymph node and/or lesion size, localization, needle pass number, and slide number) were examined. RESULTS: The overall specimen adequacy was 79.8%. The specimen adequacy was associated with needle pass number (p≤0.001). Adequacy rate was 66.9% for one needle pass and 85.8% for three needle passes. According to the sampling regions, adequacy rates showed a difference [69.2%-85.8%; (p≤0.005)]. In the multivariate logistic regression analysis of subcarinal (7) lymph node station, patient age (odds ratio, 0.983; 95% confidence interval, 0.966-1.000; p=0.049) and number of slides (odds ratio, 1.240; 95% confidence interval, 1.062-1.448; p=0.006) were independent determining factors of specimen adequacy. While independent determinants of specimen adequacy for the right paratracheal (4R) region were lymph node size (odds ratio, 1.486; 95% confidence interval, 0.973-2.268; p=0.067) and number of slides (odds ratio, 1.418; 95% confidence interval, 1.146-1.756; p=0.001), they were lymph node size (odds ratio, 1.594; 95% confidence interval, 0.960-2.645; p=0.071) and number of needle passes (odds ratio, 2.277; 95% confidence interval, 1.360-3.811; p=0.002) for the right interlobar (11R) region. Independent determinant of specimen adequacy for the left paratracheal (4L) lymph node station was the number of needle passes (odds ratio, 1.656; 95% confidence interval, 0.955-2.869; p=0.072). CONCLUSION: During endobronchial ultrasound-guided transbronchial fine needle aspirations, particularly when rapid on site evaluation cannot be applied, consideration of factors affecting adequacy according to lymph node localizations may increase the chance for obtaining materials with suitable quality for cytologic evaluation.

A Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study.

OBJECTIVE: As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols. MATERIAL AND METHOD: With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages. RESULTS: Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories. CONCLUSION: The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute's oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.

Review of Hydatid Cyst with Focus on Cases with Unusual Locations.

OBJECTIVE: This study has been conducted so as to contribute to health statistics of hydatid cyst by the data obtained from our clinic, and to discuss hydatid cysts in unusual locations. MATERIAL AND METHOD: Cases diagnosed as hydatid cyst at Dr. Lutfi Kirdar Kartal Research and Education Hospital Pathology Clinic between 2007 and 2015 have been evaluated based on criteria such as age, sex and location. RESULTS: A total of 364 cases, 209 females and 155 males, have been included in the study. The subjects in the cases are aged between 4 and 81 (mean: 38.84). Regarding the sites, 254 (69.8℅) of the cases are located in liver, and 53 (14.6℅) in the lung. Fifty-seven cases (15.6℅) have been detected in unusual sites other than the lung or liver. The rate of isolated organ involvement, other than the lung and liver, has been found to be 10.3℅. CONCLUSION: Since hydatid cyst can be found in all the body sites, it should be taken into account in the differential diagnosis of all cystic lesions.

Clinicopathological features and pituitary homeobox 1 gene expression in the progression and prognosis of cutaneous malignant melanoma.

The evidence that PITX1 (pituitary homeobox 1) is a significant tumor suppressor in human cancer remains largely circumstantial, but it clearly warrants further study as little is known about the tumor-inhibitory roles of PITX1 in cutaneous malignant melanoma. The aims of this study were to investigate PITX1 gene expression in patients with cutaneous malignant melanoma and to evaluate its potential relevance to clinicopathological characteristics and tumor cell proliferation. Clinicopathological findings of patients with cutaneous malignant melanoma were analyzed retrospectively. PITX1 and Ki-67 expression were detected by immunohistochemistry in malignant melanoma and healthy tissue samples from each patient. Labeling indices were calculated based on PITX1 gene and Ki-67 expression. The correlation between PITX1and Ki-67 expressions was analyzed in cutaneous malignant melanoma cases. The relationship between PITX1 expression intensity and clinicopathological characteristics was also analyzed. PITX1 expression was observed in all (100%) normal healthy skin tissue samples. In addition, PITX1 expression was found in 56 (80%) and was absent in 14 (20%) of the 70 cutaneous malignant melanoma cases. Ki-67 positive expression was only detected in the 14 (20%) PITX1-negative cases. PITX1-positive tumor cells were observed on the surface, but Ki-67 positive tumor cells were observed in deeper zones of the tumor nests. PITX1 expression was downregulated in human cutaneous malignant melanoma lesions compared with healthy skin tissue, but Ki-67 expression was upregulated in concordance with the progression of cutaneous malignant melanoma. PITX1 expression may be involved in tumor progression and is a potential tumor suppressor gene and prognostic marker for cutaneous malignant melanoma.

Epithelioid trophoblastic tumor.

OBJECTIVE: To describe a case of epithelioid trophoblastic tumor (ETT) in a postmenopausal woman, which had several peculiar features that differentiate it from previously reported ETTs. CASE REPORT: ETT of the uterus is a rare form of trophoblastic tumor with only 100 cases distinguished until now. Our case differs from the previously reported ones due to its several exceptional features. Our patient had no history of trophoblastic or gynecological disease; is postmenopausal; had endocervical extension from the beginning; recurrences and metastasis at follow up; and had a high Ki-67 index and a normal beta-human chorionic gonadotropin value. CONCLUSION: Because precise differential diagnosis will alter the therapeutic approach and prognosis, it is necessary for treating physicians to be aware of these unusual presentations.

Histopathological analysis of vesicular and bullous lesions in Kaposi sarcoma.

BACKGROUND: In this study, the clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized. METHODS: A total of 178 biopsy materials of 75 cases diagnosed as classic-type cutaneous Kaposi sarcoma were reviewed. Twenty-five cases showing vesiculobullous features were included in the study. Tumor, epidermis, dermis, and clinical data regarding these cases was evaluated. RESULTS: Vesicular changes were observed in 21 (12%) out of 178 lesions of the 75 cases, while bullous changes were present in only 4 (2%). In all cases where vesicular and bullous changes were detected, tumor, epidermis, and dermis changes were similar. All cases were nodular stage KS lesions, whereas hyperkeratosis and serum exudation in the epidermis, marked edema in the dermis, and enlarged lymphatic vessels and chronic inflammatory response were observed. CONCLUSIONS: Our findings suggest that changes in vascular resistance occurring during tumor progression are the most important factors comprising vesiculobullous morphology. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1646397188748474.

Comparison of two experimental models for urethral stricture in the anterior urethra of the male rabbit.

OBJECTIVE: To compare 2 urethral stricture models and determine the appropriate model for the generation of urethral stricture in rabbits. METHODS: A total of 28 adult male New Zealand rabbits were included in the present study. They were separated randomly into 3 groups. Urethroscopy was performed using a pediatric resectoscope (13F). In 1 group (10 rabbits), circumferential electrocoagulation of the anterior urethra 2-3 mm long was performed until ulceration of the mucosa occurred. In the second group (10 rabbits), 2-3 mm wide resection from the anterior urethra was performed that was deep enough to expose the periurethral tissue to allow urine leakage from the lumen. The remaining 8 rabbits as the control group underwent only urethroscopy. On the 30th day, retrograde urethrography and urethroscopy were performed to evaluate urethral stricture formation. Histologic examination was done to evaluate the urethral pathologic changes. RESULTS: According to the urethrography and urethroscopy findings, no rabbits in the electrocoagulation or control group developed urethral stricture; however, significant stricture formation was observed in every case of the electroresection group. Regenerating urothelium at the luminal side of the urethra was seen in 6 rabbits in the electrocoagulation group and 4 showed normal urethra. In the electroresection group, extensive fibrosis that obstructed the urethral lumen and nodular collagen bundles in the urethral wall were seen. CONCLUSION: The electroresection method is more reliable than the electrocoagulation method in developing urethral stricture in the rabbit model. A 2-3-mm-wide resection from the anterior urethra can successfully generate urethral stricture with respect to electrocoagulation. Electroresection offers an ideal animal model for generating urethral stricture.

Gallbladder metastasis secondary to gastric cancer as a first site of recurrence presented with acute cholecystitis: case report and literature review.

Metastasis to the gallbladder from other malignancies is extremely rare and is related with a very poor prognosis. Malignant melanoma has been reported to be the most common origin of gallbladder metastasis. Although only eight cases of gallbladder metastasis originating from gastric cancer have been documented in the literature based on small series, of these cases, only one case with signet ring cell carcinoma histology has been reported previously. We report the case of a 58-year-old male with early-stage signet ring cell carcinoma of the stomach who presented with acute cholecystitis previously treated with curative gastrectomy. After laparoscopic cholecystectomy, the diagnosis of gallbladder metastasis with signet ring cell histology secondary to gastric cancer was made. To our knowledge, this is only the second case of signet ring cell carcinoma of the stomach metastasized to the gallbladder as a first site of recurrence. We suggest that for patients with gastric cancer who complain of the findings of acute cholecystitis or cholecystolithiasis, gallbladder metastasis from gastric cancer should be considered in the differential diagnosis.

Lymphatic differentiation in classic Kaposi's sarcoma: patterns of D2-40 immunoexpression in the course of tumor progression.

The recent development of lymphatic endothelium-specific immuno-indicators has given rise to research on the histogenesis of Kaposi sarcoma (KS), specifically focusing on its lymphatic root and differentiation. D2-40 is a new lymphatic marker that recognizes podoplanin and is easily applied to formalin-fixed paraffin-embedded human tissues. This study examined D2-40 immunoexpression in 178 classical KS lesions using immunohistochemical methods. D2-40 immunoexpression was also examined in 63 non-KS soft tissue lesions to test the reliability of D2-40 monoclonal antibody in the pathological diagnosis of KS. D2-40 immunoreactivity was detected at all of the KS lesions and in lymphangioma and nonneoplastic lymphatic endothelium. There was no significant relationship between the extent of D2-40 staining and histopathological stage; however, there was a positive correlation between the staining intensity and histopathological stage in KS cases. D2-40 immunoreactivity was detected at all histopathological stages of KS and may be added to the routine immunohistochemical panel used for the differential diagnosis of KS. Widespread D2-40 protein expression is evidence of a lymphatic origin or the differentiation of neoplastic cells in KS, and D2-40 expression increases with tumor progression.

The value of COX-2 expression in the prognostic parameters of invasive ductal carcinoma of the breast.

Cyclooxygenase is an enzyme that changes the immune response to malign cells and catalyzes prostaglandins that may have an impact on cell proliferation. The purpose of this study was to examine the relation between established clinicopathological parameters in breast carcinomas and COX-2 protein expression. COX-2, estrogen receptor (ER), progesterone receptor (PR) and c-erB-2 primary antibodies were assessed in the slides prepared from the paraffin blocks of 62 invasive ductal carcinoma cases. The relation between ER, PR, and c-erbB-2 positivity, histological grade, nuclear grade, lymphovascular invasion, tumor diameter, lymph node positivity, metastasis, and age were evaluated. The results were analyzed statistically. Cytoplasmic COX-2 expression was seen in 75.8% of all breast carcinomas. In both univariate and multivariate logistic regression analysis, there was a positive correlation between COX-2 expression and negative ER status, respectively (P=0.0173) (P=0.016). There was any statistically significant relation between PR positivity, c-erbB-2 positivity, histological grade, nuclear grade, lymphovascular invasion, tumor diameter, lymph node positivity, metastasis, and age (P≥0.05). Given that there was found a statistically significant relation between COX-2 expression and negative ER status, which is considered a poor prognostic parameter, suggests that COX-2 expression can have a place among the other prognostic parameters of breast carcinoma.

The relationship of COX-2 expression with estrogen receptor, progesterone receptor and prognostic parameters in endometrial carcinomas.

AIM: Endometrial cancer (EC), which is the most common gynecologic cancer, develops as a result of disruption of the delicate balance between cell proliferation and cell loss, or apoptosis through activation of oncogenesis, or loss of tumor suppressor genes. Among the biochemical factors proposed to give a more detailed characterization of EC biology, estrogen receptors (ER) and progesterone receptors (PR) play a major role. Most of the studies in the literature have shown increased expression of cyclooxygenase-2 (COX-2) in EC. Recent experiments suggest that COX-2 antagonizes cell apoptosis, increases the invasiveness of malignant cells and promotes angiogenesis. The aim of this study was to investigate the expression of COX-2 in EC, to study its correlation to established menstrual status, grade, myometrial invasion, lymph node status, stage and ER and PR status. MATERIAL & METHODS: The study was performed on 72 ECs. Immunohistochemically was analyzed for ER, PR, and COX-2. RESULTS: COX-2 positivity was found in 91.7% of the cases. In 61 cases (84.7%) there was ER positive staining, and in 59 cases (81.9%) PR positive staining was observed. We have not found a statistically significant relation between COX-2 and prognostic factors, ER and PR. CONCLUSIONS: A high expression rate still suggests a probable relation with endometrial carcinogenesis. If such a relation exists, new therapeutic options might be available in the future.