RESUMO
OBJECTIVES: To study the differential expression of oestrogen receptor (ER) subtypes in human urinary bladder tissue using immunohistochemistry (IHC) methods and to explore their correlation with various measures of lower urinary tract symptoms (LUTS). METHODS: In this prospective case-control study, the case group comprised 34 patients with bothersome LUTS who underwent transurethral resection of prostate (TURP), while the control group comprised 19 age-matched, otherwise healthy patients who underwent cystoscopy to investigate microscopic haematuria. Cystoscopy and bladder biopsy were performed in both groups. IHC evaluation of biopsy specimens was carried out for ER subtypes (ER-α and ER-ß) and for Ki 67 in semi-quantitative fashion. Correlations of receptors with various measures of benign prostatic hyperplasia (BPH)/LUTS were also assessed. RESULTS: Expression of ER-α (in both epithelial and stromas cells) was statistically significantly greater in the case group than in the control group, but ER-ß expression was not significantly different between the groups. Ki 67 expression was also significantly greater in the case group. Comparison of clinical variables according to receptor status showed that International Prostate Symptom Score (IPSS), post-void residual urine volume (PVR) and prostate volume were significantly associated with epithelial and stromal ER-α; however, ER-ß was associated only with PVR. CONCLUSION: We found significant correlation between bladder ER levels (specifically ER-α) and various clinical measures of BPH. We conclude that ER-α is the key mediator that could be responsible for various clinical measures of BPH/LUTS.
Assuntos
Receptor alfa de Estrogênio/metabolismo , Receptor beta de Estrogênio/metabolismo , Sintomas do Trato Urinário Inferior/etiologia , Hiperplasia Prostática/cirurgia , Bexiga Urinária/metabolismo , Biomarcadores/metabolismo , Biópsia por Agulha , Estudos de Casos e Controles , Seguimentos , Humanos , Imuno-Histoquímica , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Estudos Prospectivos , Hiperplasia Prostática/complicações , Hiperplasia Prostática/patologia , Valores de Referência , Resultado do Tratamento , Bexiga Urinária/patologiaRESUMO
PURPOSE: Estrogens act through interaction with 2 receptor subtypes, ER alpha (ERα) and ER beta (ERß), in human prostate. The aim of the present study was to semiquantitatively assess the differential expression of ER subtypes in human benign prostatic hyperplasia (BPH) by use of immunocytochemistry (IHC) methods and to explore their relationship with various measures of BPH. MATERIALS AND METHODS: A total of 45 patients with BPH undergoing transurethral resection of the prostate and 22 patients with bladder cancer with normal prostate undergoing surveillance cystoscopy were studied as cases and controls, respectively. Quantitative immunolabeling of ER subtypes was scored by use of a semiquantitative scale. Also, correlations were assessed between ER levels in prostate and various measures of BPH. RESULTS: Overall, we found strong immunostaining for ERα in stroma and for ERß in epithelium, respectively. The IHC score for ERα differed significantly between BPH patients and controls in both stroma (p≤0.001) and epithelium (p=0.008), respectively. The ERß IHC score was also significantly higher in the epithelium of BPH patients (p=0.01). Also, we found a significant correlation between prostatic ER levels and various clinical measures of BPH. CONCLUSIONS: ERs may play an important role in the pathogenesis of BPH.
Assuntos
Hiperplasia Prostática/metabolismo , Receptores de Estrogênio/metabolismo , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Estudos de Casos e Controles , Estradiol/sangue , Receptor alfa de Estrogênio/metabolismo , Receptor beta de Estrogênio/metabolismo , Humanos , Antígeno Ki-67/metabolismo , Masculino , Pessoa de Meia-Idade , Próstata/metabolismo , Hiperplasia Prostática/patologia , Hiperplasia Prostática/cirurgia , Testosterona/sangue , Ressecção Transuretral da Próstata/métodosRESUMO
Primary spermatic cord malignant mesothelioma is an extremely rare tumour with only 12 cases reported so far. It is an aggressive tumour with a high recurrence rate. A 45-year-old man presented with a slow growing right inguinal swelling for the past 1 year. Physical examination revealed a well-circumscribed, hard, non-reducible swelling palpable along the medial extent of the inguinal canal with no cough impulse. Fine-needle aspiration cytology suggested metastatic carcinoma. Contrast-enhanced CT of the thorax and abdomen did not reveal any primary. Right high inguinal orchidectomy was performed at another institution. Postoperative histopathological examination (HPE) and immunohistochemistry suggested biphasic malignant mesothelioma with resected margin positive. The patient was referred to us for revision surgery and adjuvant therapy. Postoperative course was uneventful. Currently, he is undergoing radiotherapy.Surgery is the first-line treatment. Patients should receive adjuvant radiotherapy and/or chemotherapy and long-term follow-up surveillance.
Assuntos
Neoplasias dos Genitais Masculinos/terapia , Mesotelioma/terapia , Cordão Espermático/patologia , Cordão Espermático/cirurgia , Quimiorradioterapia , Terapia Combinada , Neoplasias dos Genitais Masculinos/diagnóstico por imagem , Humanos , Masculino , Mesotelioma/diagnóstico por imagem , Pessoa de Meia-Idade , Orquiectomia , Resultado do TratamentoRESUMO
Background: Breast cancers have been subclassified on the basis of molecular expression. This study evaluates the receptor expression in breast carcinoma by immunohistochemistry and classifies them into various subtypes. A comparison with other regions was also made. Methods: This prospective study included all the patients of breast carcinoma who had undergone the surgical treatment of mastectomy at SMSMC from January 2014 to June 2017. Immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) was studied and subtypes were determined. Comparison of the receptor expression and patterns was done in different age groups and with other regions. Results: ‘A total of 496 cases were included in this study. The mean age at diagnosis was 48.2 years. Most of the patients (60.3%) were less than 50 years old whereas 39.7% were above 50 years. By Bloom Richardson scoring 28.7%, 56.8% and 14.5% tumours were classified as Grade I, Grade II and Grade III respectively. ER, PR and HER2neu receptor positivity was seen in 57.5%, 44.1% and 26.6% respectively. The most common molecular subtype was luminal A (41.7%) followed by triple negative subtype (30.8%). Luminal B and HER2neu overexpressing types were 15% and 12.5% respectively. Conclusion: Immunohistochemical markers act as surrogate markers for molecular classification of breast cancers. Hormone receptor expression at our institute was comparable with other studies from India. Luminal A is the most common occurring subtype of breast cancer presenting at our institute.