Iranian Journal Of Pathology
Volume:7 Issue: 3, Summer 2012

EGFR and HER-2 are two members of ERbB/HER family of Type I Transmembrane growth factor receptors. Cox2 is an enzyme responsible for the conversion of arachidonic acid to prostaglandins, which has a major role in angiogenesis and can modelate tumor growth. The aim of this study was to determine the level of expression of EGFR, HER-2 and Cox2 in colorectd cancer. IHC study was performed in paraffin-embedded blocks of 47 patients underwent colectomy due to colorectal cancer in Modarres Hospital, Tehran, Iran from 2008 to 2009. Three separated pathologists analyzed the slides after complete IHC staining for EGFR, HER-2 and COX-2. EGFR, HER-2 and Cox2 revealed over expression in colorectal cancer as 80.9%, 25.5% and 72.4% respectively, EGFR revealed no statistically significant association with clinicopathologic parameters, but Cox2 overexpression exhibited statistically significant association with higher stages tumors (III, IV) (P value: 0.037) and tumor with lymph node metastasis(P= 0.005). On the other hand, HER2 overexpression showed statistically significant association with lower grade (well and moderately differentiation) tumors (P= 0.042). According to over expression of three markers, EGFR, HER-2, and COX-2 in colorectal cancers, using drugs that act against these receptors and investigation of survival improvement of patients with these drugs in other studies are recommended.

Immunohistochemical tests are one of the most important tests, which are under study to determine the prognosis of the cancers such as transitional cell carcinoma. By the time, flexible cystoscopy and urine cytology are the routine tests for following up the patients with transitional cell carcinoma, which are both operator dependent. On the other hand, cystoscopy is an invasive method, and urine cytology is a method with low sensitivity. The aim of this study was to determine CK20 in patients with transitional cell carcinoma of bladder and its relation with prognostic factors, which are the stage and the grade of the tumor. Our study was done in Mostafa Khomeini Hospital from 2007 to 2010 on the 2001 to 2009 stored information files, included 53 patients diagnosed as transitional cell carcinoma of bladder (TCC) of different stages and grades that were underwent total cystectomy. Immunohistochemical staining was performed on tissue sections with specific CK20 antibody. Then the samples were studied by light microscope so positive and negative cases were identified. According to statistical analysis there were significant reverse relationship between CK20 and stage, and significant reverse relationship between CK20 and grade (P= 0.000). Immunohistochemical study of patients with transitional cell carcinoma of bladder in order to identify CK20 can be a useful method to determine the prognosis of these patients.

Ovarian cancer is one of most common causes of cancer related women’s mortalities. Human papilloma virus is a known factor concerning cervical cancer but its role in causing ovarian cancer is not yet verified. A few studies also identified HPV DNA in ovarian carcinoma tissues. However, some studies did not detect HPV DNA in ovarian carcinoma tissues. In this article, we investigated the potential role of high risk HPVs in the ovarian epithelial carcinoma. Fifty archived epithelial ovarian cancer paraffin blocks were collected. Then, 30 non-malignant ovarian blocks used as control. These samples were histopathologically were confirmed by a pathologist and the proper blocks for DNA extraction and PCR were sorted. PCR was conducted deploying highly specific primers for high-risk types of HPV (18 and 16) according to the instructions of manufacturer company. High-risk oncogenic sequences were identified in 4 (5%) of the 80 studied samples. Of the 4 HPV positive cases, there was 1 case with normal tissue, 1 case of mucinous cyst adenocarcinoma, and 2 cases of serous cyst adenocarcinoma Surprisingly, our findings could not support any association between high-risk oncogenic human papilloma virus (18 and 16) and malignant ovarian epithelial cancer. Therefore, that HPV is highly unlikely to play any causal role in the pathogenesis of epithelial ovarian neoplasia.

P504S (AMACR) is a mitochondrial enzyme expressed in renal cell carcinoma. Some of immunohistochemical markers in renal cell tumors are independent prognostic factor and show relation with histologic grading. AMACR expression increases with higher histological grading in different tumors; however, in RCC it is not obvious. In this study, we tried to investigate if any relation existed between nuclear grading in renal cell carcinoma and P504S. Fort five cases of formalin fixed paraffin embedded tissue of renal cell carcinoma with different nuclear grades were selected and immunostained using primary antibody to P504s and quantified with H-Score, multiplicative (Mqs) and Additive quick score (Aqs). P504S was positive in 37 out of 45 (82%) cases. (Mean ± SD) of H-Score: grade I =182±44. II=218±161, III=215±55, IV=190. Mean ± SD of Add quick score: grade I= 6.6± 1.8, II= 7.24±1.4, III= 7.78±1.2, IV= 8. Mean ± SD of Multi quick score: grade I= 9± 5.6, II= 11.38±5, III =12.89±4.7, IV= 12. (Aqs Vs H- Score: r = 0.701, P < 0.007), (Mqs Vs H-Score: r = 0.808, P < 0.001) P504S is one of the important immunohistochemical markers in primary and metastatic RCC. Our results show that there is no statistically correlation between histological grade of RCC and AMACR staining in semi – quantitative measurement. We suggest AMACR staining to be used as a diagnostic immunohistochemical marker in conjunction with other markers in differential diagnosis of metastatic renal papillary and even clear cell carcinoma.

Post exercise proteinuria and increased urinary Gamma-Glutamyl transferase (GGT) levels can be indicative of exercise-induced renal damage. The aim of this investigation was to study the effect of one session of intensive training on renal tubular injury markers and compare their values to those 6 hours after training, for evaluating tubular damage after intensive training. In this cross-sectional study with pre- and post- test design, 10 elite volunteer male athletes were selected and participated in one training session (2 hours). Urine samples were collected before training, one hour after training, and 6 hours after training. Urinary protein, creatinine, and GGT values were measured through laboratory methods and then Pr/Cr and GGT/Cr ratios were computed. There were significant differences between values of protein, urine Pr/Cr ratio, GGT and creatinine in the three sampling phases (P<0.05). However, no significant differences were observed between values for GGT/Cr ratio. There were significant differences between the mean values of creatinine, protein, GGT, and Pr/Cr ratio within pre-exercise and 1 hour post-exercise values and Pr/Cr ratio values in pre-exercise and 6 hours post-exercise (P<0.05). It seems that a session of karate training does not result in permanent renal damage and for evaluation of tubular function, it is better to get the urine sample for urinary marker at least 6 hours after exercise.

Pertussis is a highly contagious, vaccine-preventable disease. Determination of the seroepidemiology of pertussis makes possible the evaluation of pertussis immunity in a population. In this study, we determined the seroprevalence of Bordetella pertussis IgG antibodies in different age groups in Tehran, Iran. Overall, 1101 subjects between ages of 8 months and 20 years were tested for the presence of pertussis toxin (PT), filamentous hemagglutinin (FHA) and different lipopolysaccharides (LPS) antibodies by ELISA. The overall prevalence of pertussis antibodies was 48% and the mean antibody level was 44± 47.7 U/ml. Over half (53.1%) of the children aged 8 months to 6 years were negative for pertussis antibodies. Pertussis antibodies rates and levels were significantly different between age groups (P < 0.001) and their significant elevations were observed with increasing age. Up to half of the vaccinated children lacked an antibody response to vaccine, so using a more immunogenically effective vaccine to ensure sufficient immunity is essential. We showed that B. pertussis infection is on the rise in Iranian adolescents and young adults. Booster vaccination of this age group appears to be the most logical approach to disease prevention in adolescents and control the circulation of the organism.

Nosocomial infections cause considerable morbidity and mortality and pose high financial burden on healthcare systems. Although surface contact, surgical incisions, wounds and catheters are responsible for a high percentage of nosocomial infections, bacterial and fungal air contaminations in hospitals have an important role in development of hospital infections. The purpose of this study was to determine the microbial profile of air contamination in some hospital wards. Furthermore, we compared the results with cultures obtained from hospitalized patients. We performed a cross-sectional analysis at Imam Hospital, Tehran, Iran. Active (Quick Take 30 pump) and passive air samplings were performed in different wards of the hospital. Air samples were cultured to detect fungi and microorganisms. The results were compared with cultures obtained from hospitalized patients at the same time. Air microbial profiles of various wards were also compared. The microbial profile of air samples showed that Micrococcus was the most common bacteria. Cladosporium was the most frequent fungi found while Aspergillus niger and Alternaria were the least frequent ones. In some wards, the results of blood cultures were similar to microbial profile of air samples. Thus, utilizing air purification systems and air sterilization is recommended. Our findings emphasized the role of regular monitoring of the biological risk for both patient and health care workers. The results would be useful in planning for employing appropriate strategies to reduce air burden in this hospital and other hospitals with similar conditions.

Gastrointestinal polyps are proliferative or neoplastic mucosal lesions. The most important point about these polyps is risk of malignancy of them. This study was performed to determine type and frequency of polyps of gastrointestinal tract in Iranian population according to their locations. Totally, 210 patients referred to Rasoul-e-Akram Hospital in years 2006-2010 and had pathology report of gastrointestinal polyps were included in the study. Frequency of gastrointestinal polyps was determined according to type, histological subtype, location, age and sex. The data was analyzed by software SPSS 16. Of participants, 129 patients were male (61.4%) and 81 (38.6%) were female. The mean age of patients was 58.4±32 yr. The mode of age interval was 70-80 yr (25.2%). The most frequent presenting symptom was lower gastrointestinal bleeding as melena or hematochezia (31%). Colon and sigmoid were site of most of gastrointestinal polyps (74.2%). The most prevalent type of gastrointestinal polyps was adenomatous polyp which was reported in 175 patients (84.3%). The most common types of colonic and gastric polyps were adenomatous and hyperplastic types respectively. Our data is highly confirmatory to previous studies regarding association of polyp with advanced age and male sex, the most prevalent symptom and site of gastrointestinal polyps, and the most common types of colonic polyps. The frequency of gastric polyps in our population differs with some studies.

Solid pseudopapillary tumors of the pancreas (SPT) are rare tumors of the pancreas with low malignancy potential and a very good prognostic outcome after surgery. The outcome after radical resection is favourable. A case of solid-pseudopapillary tumor (SPT) of the pancreas in a 20-year-old woman is presented. The patient underwent resection of the mass in the pancreatic head and pancreaticoduodenectomy (Whipple procedure) with jejunostomy tube placement. We focus on the clinical features, imaging, and histopathological characteristics of solid-pseudopapillary tumors (SPT) of the pancreas.

Giant cell carcinoma of the endometrium is a rare and an aggressive tumor that should be distinguished from other endometrial tumors with a prominent giant cell component, including trophoblastic tumors, certain primary sarcomas, and malignant mixed müllerian tumors. At present, cumulative data on this rare histological variant is limited and the prognostic significance of the presence and the extent of a giant cell component in endometrial carcinoma remain uncertain. We report giant cell carcinoma of endometrium in an Indian female, which according to our best knowledge, is the first case being reported from Indian Subcontinent.

Eosinophilic granuloma is benign end of the spectrum of the Langerhans cell histiocytosis (LCH) which is characterized by solitary or multiple lesions in bones, skin, lung, lymph node etc. Here, we present a case of a 13-year old boy with pain and swelling in the right parietal region of skull with no other complaint. A computerized tomography (CT) scan and subsequent fine needle aspiration cytology (FNAC) revealed solitary eosinophilic granuloma which was subsequently confirmed by histopathology. Minimally invasive procedures like imaging and FNAC usually suffice for diagnosing and following up of patients with this rare disease.