Majalah Patologi Indonesia

The Von Hippel-Lindau Gene Product (Pvhl) Expression Profile in Pancreatic Ductal Adenocarcinoma and Non-Neoplastic Pancreatic Tissue and Its Correlation with Clinicopathological Factors

2023-11-07T18:00:15+00:00

Introduction

Pancreatic malignancy, primarily Pancreatic Ductal Adenocarcinoma (PDAC), presents a significant challenge due to its aggressive nature and late-stage diagnosis. This study explores the role of von Hippel-Lindau gene product (pVHL) in PDAC and non-neoplastic pancreatic tissues, investigating their relationship with PDAC clinicopathological characteristics.

Method

This research was carried out at the Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital. The cases analyzed spanned from January 2012 to September 2023. Immunohistochemistry of pVHL was used, and the Histoscore/H-score calculations were utilized to classify pVHL expression as either high or low.

Results

A total of 54 cases of PDAC and non-neoplastic pancreatic tissue exhibited varying levels of pVHL expression. Cases of PDAC with positive surgical margin, absence of lymphovascular and perineural invasion, pT2, pN0, M0 stage, and survival exceeding 7 months were the profiles in which low pVHL expression was detected. Significant result was found on the correlation between pVHL with pN status.

Conclusion

The levels of pVHL expression varied between PDAC and non-neoplastic pancreatic tissue. There were no differences in the clinicopathological profile of PDAC tumors, except for pN stage. Further research, with a larger sample size, is needed to determine pVHL's diagnostic value and its expression in different clinicopathological profiles.

The Association between Matrix Metalloproteinase-9 (MMP-9) Immunohistochemical Expression and Gleason Grading System International Society of Urological Pathology (ISUP) in Prostate Adenocarcinoma

2023-09-12T09:27:01+00:00

Background

Prostate cancer is the fourth ranked malignancy and the eighth leading mortality worldwide. The Gleason grading system is used to evaluate the tumor grade. The highest the score, the worst and the most aggressive the nature of the tumor, which associated with invasive behaviour. In prostate carcinoma, Matrix Metalloproteinase-9 (MMP-9) is involved in all stages of cancer cell progression include proliferation, angiogenesis, apoptosis, epithelial-mesenchymal transition (EMT) and metastasis. MMP-9 degrade the surrounding tumor matrix and neural tissue during perineural invasion in prostate carcinoma which is a prerequisite for invasion and metastasis. The aim of this research is to evaluate the correlation of MMP-9 immunohistochemical expression with the Gleason Grading System International Society of Urological Pathology (ISUP) of prostate adenocarcinoma.

Methods

Cross sectional analytic study of 32 samples were diagnosed with prostate adenocarcinoma at H. Adam Malik General Hospital Medan. Staining was performed using a polyclonal antibody rabbit MMP-9 immunohistochemistry (Bioenzy) which would appear positive in the cytoplasm and in stroma of the tumor cell at a dilution of 1: 100 (overnight). MMP-9 expression was assessed semi quantitatively based on intensity and tumor cell distribution with four-tier expression categories. Data analysis was tested with the Kruskal-Wallis test.

Results

Most cases (56,25%) were strongly positive with MMP-9 and MMP-9 immunohistochemical expression has a significant relationship with Gleason Grading ISUP System of prostate adenocarcinoma (p:0.001).

Conclusion

There was a significant association between MMP-9 immunohistochemical expression and the Gleason Grading ISUP System of prostate adenocarcinoma.

Keyword: Prostate adenocarcinoma, ISUP, Gleason grading, matrix metalloproteinase-9

Immunohistochemistry Profile of Neuroendocrine Tumor of Five Years’ Experience at Tertiary Referral Hospital in Palembang

2024-05-03T08:23:08+00:00

Background

Neuroendocrine tumors (NET) are a type of uncommon neoplasms originating from the neuroendocrine cell system. Recent decades, the prevalence of NET gradually increases, attributing partially to the utilization of advanced detection procedures using modern methodologies.

Objective

The aim of this research was to assess the profile of neuroendocrine tumors of 5 years experiences in our hospital.

Methods

In this retrospective cross-sectional study, a thorough examination was performed on a total of 71 cases obtained from archives of the Department of Anatomic Pathology Mohammad Hoesin Hospital, over the period from 2017 to 2021. The Chi-square test was used for data analysis. Bivariate analysis was performed using binary logistic regression tests to investigate the correlation between the independent variables, including gender and tumor site, and the dependent variables.

Result and Discussion

Out of the 71 recorded samples, 69 samples were subjected to be analyzed while the remaining samples were excluded due to have incomplete data. Four different antibodies were evaluated to find the association between these antibodies and tumor with location (chromogranin, P=0.792; synaptophysin, P=0.100; Ki-67, P=0.026; CD56, P=0.511) and gender (chromogranin, P=0.627; synaptophysin, P=0.929; Ki-67, P=0.315; CD56, P=0.524). Conclusion: The study showed synaptophysin has the highest positive rate on NET diagnosis. There is no association was found between chromogranin, synaptophysin, and CD56 staining to tumor location, except for Ki-67. Similarly, no association was found between staining performance (chromogranin, synaptophysin, Ki-67, CD56) with gender.

Histopathological Profile Of Extranodal Lymphoma: A Retrospective Study For 5 Years In Tertiary Care Hospital

2023-11-13T15:33:48+00:00

Introduction

Extranodal lymphomas account for 30% of all lymphomas. The diverse location and various clinical manifestation of extranodal lymphoma lead to difficulty in diagnosis. The different types of extranodal lymphoma behave and respond differently to therapy. The information regarding the incidence of extranodal lymphoma is still limited, hence further study is needed.

Methods

Descriptive observational research design with a retrospective approach. This study used data from anatomical pathology examinations at the Dr. Soetomo General Academic Hospital, Surabaya, over a 5-year period, with the diagnosis of lymphoma originating from organs other than lymph nodes and no prior history of lymphoma in the lymph node.

Result

As many as 379 cases were diagnosed as lymphoma originating from extranodal. The highest age group was 51-60 years old (27.70%), male patient is slightly higher (55.91%) and the highest location is in the head and neck region (48.11%). On anatomical pathology examination, the most common diagnosis were high grade B cell NHL (48.11%).

Conclusion

This study showed the incidence of extranodal lymphoma, with the majority of cases occurring in the fifth decade of life, with M:F ratio is 1.33:1 and the most common location was in the head and neck area. The most common histological diagnosis was high grade B cell NHL, with DLBCL being the most common subtype. This study provided initial information on the epidemiology of extranodal lymphoma at Dr. Soetomo General Academic Hospital in Surabaya. Further research is needed to determine the relationship between variables and patient survival.

Correlation between Poly ADP Ribose Polymerase (PARP) expression with Chemotherapy Response in Ovarian Carcinoma

2024-01-08T03:37:36+00:00

Background

Germline mutations in BRCA1 and BRCA2 are high risk factors for ovarian and breast cancer. The risk of ovarian cancer in BRCA1 mutation carriers is 16-68% and 11-30% in BRCA2 mutation carriers.^1,2 The enzyme poly ADP ribose polymerase (PARP) plays an important role in DNA damage repair and genome stability and cancer cells change its regulation as a way for tumor cells to survive cell death due to chemotherapeutic agents.^3,4 Positive PARP expression is associated with high-grade tumors. advanced stage and is an indicator of aggressive disease. The aim of this study was to examine the relationship between PARP expression and the response to chemotherapy in ovarian carcinoma.

Methods

A cross sectional study was conducted using 34 samples of paraffin blocks and slides of ovarian carcinoma from oophorectomy and biopsy of patients registered at the Anatomical Pathology Department Faculty of Medicine Sriwijaya University/Dr. Mohammad Hoesin Hospital Palembang for the period January 2019 to December 2021. Each sample was stained by PARP monoclonal antibody. Qualitative interpretation by assessing semi-quantitatively, namely assessing the area/proportion (P) and intensity (I) of the polished, the score is obtained by multiplying the area by the intensity, the results are grouped into 2, score 0-4 was a weak expression, score 6 was a strong expression. Analysis of the relationship between PARP expression and response to chemotherapy was performed using Chi-square test and Spearmann correlation.

Results

Chi-square test showed that there was a significant relation PARP expression with chemotherapy response, age, CA 125 levels post chemotherapy and stage with p values were 0.008, 0.005, 0.020 dan 0.006 respectively. There was no relation between PARP expression with histopathology subtype with p values was 0.053.

Conclusion

There is a significant correlation between PARP expression with chemotherapy response, age, CA 125 levels post chemotherapy and stage in ovarian carcinoma

Clinicopathological Characteristics of Prostate Adenocarcinoma at Hasan Sadikin General Hospital from 2016-2023

2023-10-23T10:39:35+00:00

Background

Prostate adenocarcinoma (PA) ranks as the fifth most prevalent malignancy in men and the fifth leading cause of death in Indonesia. The growing number of elderly population and increased use of Prostate Specific Antigen (PSA) testing have led to a threefold rise in Prostate Carcinoma (PC) incidence in recent years. This study aims to profile the clinicopathological characteristics of PA cases at Hasan Sadikin General Hospital (RSHS) in Bandung during the period 2016-2023.

Methods

We conducted a descriptive, cross-sectional study at RSHS in Bandung, utilizing medical records for data collection. Inclusion criteria comprised all histopathologically diagnosed PA cases between 2016 and 2023, with exclusion criteria pertaining to patients with incomplete medical records.

Results

Our study revealed an average patient age of 72±9.0 year old. The most prevalent age group was those aged 70-79 years old (n=73, 38.8%). The mean PSA level among patients was 256±375.5 ng/ml). The majority of patients were diagnosed at stage IV (n=128, 68.1%). Biopsy was the most frequently used specimen collection method (n=154, 81.9%). Most samples exhibited a Gleason Score of 9 (n=65, 34.6%), belonged to Grade Group 5 (n=84, 44.7%), and had a poorly differentiated histopathological grade (n=132, 70.2%). Approximately 68.1% of patients presented with metastatic disease, with bone metastases being the most common (n=55,70,5 %).

Conclusion

PA typically manifests in older individuals, frequently manifesting in 70-79 age group with less favorable histopathological features.

Relationship of the Number of Black Dots in the Nuclei of Argyrophilic Nucleolar Organizing Regions (AgNORs) Expressed Epithelial Cells with Nottingham Grading System in Invasive Breast Carcinoma of No Special Type (IBC-NST)

2024-08-30T09:12:00+00:00

Background

Breast cancer is a malignant disease in women. The high number of breast cancer cases is caused by multiple factors, including barriers to early detection of breast cancer, socio-economic and geographical factors, and the difficulty of affordable, timely and effective health services. IBC-NST has the highest incidence among breast cancer cases with a 10 year survival rate (65-78%). AgNORs parameters have been shown to represent a reliable tool for determining the clinical outcome of cancer diseases, being an independent prognostic factor in many types of tumors.

Method

Descriptive analytics research was carried out on slides from 31 patients with IBC-NST. Each slide was stained with H&E stainning to assess the Nottingham grading system and stained with AgNORs to assess the number of black dots in epithelial cell nuclei that expressed AgNORs. All clinicopathological data were taken from medical records/pathology archives. Logistic regression test (p<0.005) was used to assess the relationship between the number of black dots in epithelial cell nuclei expressing AgNORs and the Nottingham grading system in IBC-NST.

Results

The highest cases were in the age group ≤40-50 years (range: 50.1 years), the highest grading was in grade 3 of the Nottingham grading system (48.8%), the lowest number of black dots was 576 dots and the highest was 1,036 dots (mean 798.80, median 710.0 and standard deviation 144.71) and the highest number of black dots was in grade 3 of the Nottingham grading system.

Conclusion

Assessment of the number of black dots in the nuclei of epithelial cells expressing AgNORs associated with Nottingham grading system can be used as an indication of prognosis in patients with IBC-NST.

Higher Microvessel Density in Non-GCB Subtype of Diffuse Large B Cell Lymphoma

2023-04-12T02:57:38+00:00

Background

Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma. Based on cell of origin, DLBCL divided into 2 subtypes; germinal center B-cell-like (GCB) and non-germinal center B-cell-like (non-GCB). Tumor microenvironment (TME) plays an important role in stimulating angiogenesis and can be assessed by calculating microvessel density (MVD). Moreover, MVD is one of the most useful prognostic markers for monitoring progression and patients’ survival of malignancies. This study purpose was to determine the correlation between DLBCL subtypes with MVD.

Methods

An observational analytic study with a cross-sectional design was performed at the Anatomic Pathology Department, Medical Faculty, Sriwijaya University/Dr. Mohammad Hoesin Hospital Palembang. Purposive sampling was conducted to achieve the same proportion of GCB and non-GCB subtypes. Thirty blocks of patients diagnosed with DLBCL for the period 2017 – 2021 with complete clinicohistopathological data were attained from archive. Slides were immunostained with an anti-CD34 antibody, followed by the MVD identification by observing the morphology of stained endothelial cells, then photographed, and counted with Image J software. Data were analyzed statistically with SPSS version 26.

Results

DLBCL was diagnosed more in older patients (<60 years, 66,7%), male (60%), nodal location (53,3%), and centroblastic variant (93,3%). The distribution of high MVD tends to be higher in older patients, male, at nodal location, with centroblastic morphological variants. Although the MVDs of the DLBCL subtypes were not significantly different, a higher trend of MVD was noticed in the non-GCB subtypes.

Conclusion

Higher microvessel density was observed in the non-GCB molecular subtype.