Effect of intratumoral lymphocyte density on the disease-free survival and overall survival in malignant epithelial tumors of the ovary.

Malignant epithelial ovarian tumors are the fifth most common cancer of females which has the highest mortality rate among gynecological malignancies. Tumor-specific or related antigens that induce an immune response have been defined in tumors. Intratumoral T lymphocytes recognize these antigens and induce a cytolytic activity. Vascular endothelial growth factor (VEGF) is a potent angiogenic factor expressed in many tumors. In this study, we studied the relation between clinicopathological findings and intratumoral T lymphocyte and VEGF expressions in malignant epithelial ovarian tumors. The presence of VEGF in ovarian surface epithelial carcinomas and CD3, CD4 and CD8 antibodies in tumor-infiltrated lymphocytes were investigated in 63 cases with an immunohistochemical method. Positive-stained intratumoral lymphocytes were graded on a scale of 0 to 3 (0 --> 0, +1 --> < or = 5, +2 --> 6-19, +3 --> > or = 20). VEGF was assessed according to the staining intensity (0: negative, +1: weak, +2: moderate, +3: strong). CD3 positivity was observed in intratumoral lymphocytes in all cases while only CD4 and CD8 positivities were observed in 30% and 80%, respectively. VEGF was positive in 73% of the cases. No significant relation was observed between VEGF expression and presence of intratumoral T lymphocyte and clinicopathological parameters. Moreover, they did not have any significant effect on disease-free survival and overall survival.

Expression of cyclooxygenase-2 and inducible nitric oxide synthase in ovarian surface epithelial carcinomas: is there any correlation with angiogenesis or clinicopathologic parameters?

Cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) products have been implicated in the regulation of immune system, tumor cell apoptosis, and angiogenesis in many human tumors. In this study, we investigated the expression of COX-2 and iNOS in ovarian carcinomas by immunohistochemistry and correlated the results with other prognostic parameters. Specimens from 100 ovarian carcinomas were studied by immunohistochemistry for COX-2 and iNOS expression, and angiogenesis microvessel density (MVD) was evaluated by CD34-stained microvessels. High COX-2 expression was observed in 85% of carcinomas. No correlation was found between COX-2 expression and clinicopathologic variables. Patients with high COX-2-expressed tumors had shorter overall survival, but it is not statistically significant. Expression of iNOS in serous and low-grade carcinomas was significantly higher than that in nonserous and high-grade carcinomas (P < 0.05). There was a positive correlation between COX-2 and iNOS expression (P= 0.009). No correlation of COX-2 and iNOS expression with MVD was found. Expression of iNOS showed no effect on survival of the patients. We found that iNOS expression might act in the first steps of carcinogenesis, whereas COX-2 expression was seen in more advanced tumors. Shorter overall survival of patients with high COX-2 expression might indicate new targets for therapy.

Proliferating cell nuclear antigen (PCNA) and Ki-67 in epithelial ovarian tumours: correlation with DNA flow cytometric analysis.

AIMS: The aim of the present retrospective study was to evaluate the prognostic significance of Ki-67 and Proliferating cell nuclear antigen (PCNA) immunostaining and DNA content measured by flow cytometry (FCM) in epithelial ovarian tumours. Further, we compared these variables with histopathologic features and each other. METHODS: We used immunohistochemical methods on paraffin embedded tissue sections of 67 surgically resected epithelial ovarian neoplasms, diagnosed between 1987-1998, (benign serous n=12, benign mucinous n= 15, borderline mucinous n=3, malignant serous n= 15, malignant mucinous n=8, malignant endometrioid n=10, clear cell n=3 and malignant Brenner n= 1) for the presence of PCNA and Ki-67 reactivity. Samples from malignant and borderline tumours were also examined for DNA ploidy and S-phase fraction (SPF) by flow cytometry. Five malignant tumours were excluded because there was not sufficient tissue for flow cytometric analysis. CONCLUSION: There was no significant correlation between DNA ploidy, SPFs derived from FCM analysis, and proliferative activity, determined by PCNA and Ki-67 and the known histopathologic parameters of prognostic significance in ovarian epithelial malignancies.

Bcl-2 and p53 expression in insular and in well-differentiated thyroid carcinomas with an insular pattern.

Expression of p53 and bcl-2 oncogenes was investigated in poorly differentiated, so-called insular carcinomas of the thyroid gland and also in the follicular and papillary carcinomas with an insular component. Hematoxylin-eosin sections of 217 thyroid carcinomas were reevaluated for insular carcinoma and also for thyroid carcinomas with an insular component. Immunohistochemical staining method was used for detecting p53 and bcl-2 expression on paraffin blocks of three pure insular, five follicular or papillary thyroid carcinomas with a major insular component (more than 50%) and six with a minor insular component (20-50%). Flow cytometry was also performed in these cases. None of the cases showed p53 immunoreactivity. Bcl-2 expression was observed in all cases and the most intense staining was seen in insular areas. All the cases were diploid. We suggest that bcl-2 plays a role in loss of differentiation of thyroid carcinomas.

Proliferating activity in differential diagnosis of benign phyllodes tumor and cellular fibroadenomas: is it helpful?

Benign phyllodes tumors and fibroadenomas are two types of fibroepithelial tumors of breast that are usually difficult to differentiate. The purpose of this study is to evaluate the proliferative activity of these tumors and to find out if it helps in differential diagnosis. Thirty-one benign phyllodes tumors and twelve cellular fibroadenomas were retrieved from the archives of Pathology Department of Akdeniz University, School of Medicine. Proliferating activity of epithelial and stromal cells were evaluated by using labeling index (LI) of proliferating cell nuclear antigen (PCNA) and Ki-67 antigen by immunohistochemistry. The results were compared with other clinicopathologic findings. There was not any significant difference between the proliferating activity of phyllodes tumor and cellular fibroadenomas. Mean LI of PCNA was 28.01 (+/-22.85) in stromal cells and 56.57 (+/-30.98) in epithelial cells of phyllodes tumor where it was 28.92 (+/-24.02) and 62.53 (+/-32.56) in fibroadenomas. Ki-67 indices were 0.05 (+/-0.19) in stromal cells, 2.65 (+/-12.53) in epithelial cells of phyllodes tumors and 0.0 (+/-0) in stromal cells, 0.43 (+/-0.63) in epithelial cells of fibroadenomas. There was no correlation between the diameter of tumors and proliferating activity in both groups. Proliferating activity, determined by immunohistochemistry with PCNA and Ki-67 antibodies did not reveal significant difference between phyllodes tumor and fibroadenoma.

Benign persistent papular acantholytic and dyskeratotic eruption of the vulva: a case report.

We report a case of 44-year-old woman with persistent pruritic papules on the left and right labium majus of the vulva. Histopathologic examination of the vulvar biopsy specimen revealed a suprabasal separation of the epidermis with acantholysis and dyskeratosis.