Ki 67: Are we counting it right?

Evaluation of USP22 and Ki-67 expression in oral squamous cell carcinoma: An immunohistochemical study

Background and Aim

USP22 is a positive regulator in tumor growth, its depletion leads to cell cycle arrest at G1 phase. USP22 over expression was positively correlated with proteins involved in proliferation and negatively correlated with tumor suppressor protein tumor supprn. Ki-67 expression is associated with USP22 over expression in oral squamous cell carcinoma (OSCC) and also in cervical and prostate cancers. The aim of this study is to evaluate the expression of USP22 and Ki-67 in OSCC by using an immunohistochemical staining procedure.

Materials and Methods

Immunohistochemistry was used to determine the expression of USP22 protein in 50 archival tissue blocks of histopathologically diagnosed OSCC and 15 normal oral mucosa tissue blocks. The histopathological correlation of USP22 with Ki-67 was done.

Results

Expression of USP22 and Ki-67 was seen in the nuclei of epithelial cells. Statistical analysis of the mean expression of USP22 in OSCC and normal tissue showed a significant difference (P = 0.000000119). A significant difference was also observed in Ki-67 between OSCC and normal tissue (P = 0.00000086). Correlation test showed a weak correlation (R = 0.19) between USP22 and Ki-67 expression of group 1. Similarly, a weak correlation (R = 0.51) was observed in group 2.

Conclusion

A statistically significant difference in the expression of USP22 and Ki-67 was observed between normal mucosa and OSCC. It can be used in early diagnosis of OSCC but its use as a prognostic indicator is questionable and should be exemplified with a larger study sample.

Unusual bilateral kidney and duodenal plasmablastic lymphoma presentation in an elderly patient: A case report

The present report described the case of a 71-year-old man who was admitted to the emergency department with a 7-day history of progressive left flank pain and tarry stool. Bedside point-of-care ultrasound of the left kidney showed lobulated ill-defined hypoechoic foci in the perirenal spaces with mild hydronephrosis. Subsequent contrast-enhanced abdominal computed tomography revealed lobulated low-density lesions in the bilateral perirenal space and paraaortic space. The patient was subsequently admitted to the internal medicine department of the hospital. Renal and duodenal biopsies were arranged, and pathology reports were consistent with the findings of plasmablastic lymphoma (PBL). This unusual presentation of flank pain and tarry stool caused by recurrent PBL highlighted that genitourinary or gastrointestinal manifestations could occur in cases of PBL recurrence. The patient received intensive chemotherapy regimens comprising a combination of etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin hydrochloride for aggressive non-Hodgkin's lymphoma to achieve a good response.

Cynara Scolymus (Artichoke) Improves Liver Regeneration after Partial Liver Resection in Rats

Objective: Liver regeneration is necessary to restore hepatic mass and functional capacity after partial hepatectomy (PH). Cynara scolymus (CS) is a pharmacologically important plant that contains phenolic acids and flavonoids, and experimental studies have indicated that it has antioxidant and hepatoprotective effects. The aim of this study was to investigate the role of CS in liver regeneration after PH in rats. Methods: A total of 36 Wistar albino rats weighing 280.5 ± 18.6 g were used. CS leaf extract was administered after partial hepatectomy. The rats were sacrificed at postoperative day 14, and the histological changes were assessed. The mitotic index (MI), nucleus size, hepatocyte size, and binucleation rate (BR) of hepatocytes were assessed using hematoxylin-eosin (H&E) staining. Results: The rats that received CS extract had significant differences in liver regeneration markers, including the hepatocyte size, mitotic index, and Ki-67 proliferation index (p

No differences in histopathological degenerative changes found in acute, trauma-related rotator cuff tears compared with chronic, nontraumatic tears

PURPOSE

Acute trauma-related rotator cuff tears are believed to have better healing potential than chronic tears due to less degenerative changes of the tendons. However, the histopathological condition of tendons from trauma-related tears is not well investigated. The purpose of this study was to explore specific histopathological features in tendons from acute trauma-related full-thickness rotator cuff tears and to compare them to findings in tendons from nontraumatic, chronic tears.

METHODS

In a prospective cohort study, 62 previously asymptomatic patients [14 women, median age 61 years (range 42-75)] with trauma-related full-thickness rotator cuff tears were consecutively included. Arthroscopic repair was performed within 30 (median, IQR 25-37) days after the injury. During surgery, tissue biopsies were harvested from the supraspinatus tendons in 53 (86%) of the patients. In addition, similar biopsies were harvested from 10 patients undergoing surgery for chronic tears without history of trauma. All tissue samples were examined by a well-experienced pathologist under light microscope. Tendon degeneration was determined using the Bonar score whereas immunostaining was used for proliferation (Ki67), inflammation (CD45), apoptosis (p53) and haemosiderin staining to study traces of bleeding.

RESULTS

The median (IQR) Bonar score for the acute trauma-related biopsies was 10.5 (7.5-14.5) compared to 11 (5-12.8) for the control group with no statistically significant difference between the groups. No statistically significant between-group difference was found for the inflammatory index whereas tendons from patients with trauma-related full-thickness rotator cuff tears had statistically significantly higher apoptosis [3.1 (0.5-8.9) vs. 0.1 (0-1.5), p = 0.003] and proliferation [4.0 (1.8-6.9) vs. 0.4 (0-2.0), p = 0.001) indices than those undergoing surgery for chronic tears. Positive haemosiderin staining was found in 34% of tissue samples from patients with trauma-related tears compared to 10% in the control group (n.s).

CONCLUSION

This study suggests that there is no difference with regard to degenerative changes between supraspinatus tendons harvested from patients with acute, trauma-related rotator cuff tears and patients with nontraumatic, chronic tears.

LEVEL OF EVIDENCE

II.

The Challenge of Evaluating Response to Peptide Receptor Radionuclide Therapy in Gastroenteropancreatic Neuroendocrine Tumors: The Present and the Future

The NETTER-1 study has proven peptide receptor radionuclide therapy (PRRT) to be one of the most effective therapeutic options for metastatic neuroendocrine tumors (NETs), improving progression-free survival and overall survival. However, PRRT response assessment is challenging and no consensus on methods and timing has yet been reached among experts in the field. This issue is owed to the suboptimal sensitivity and specificity of clinical biomarkers, limitations of morphological response criteria in slowly growing tumors and necrotic changes after therapy, a lack of standardized parameters and timing of functional imaging and the heterogeneity of PRRT protocols in the literature. The aim of this article is to review the most relevant current approaches for PRRT efficacy prediction and response assessment criteria in order to provide an overview of suitable tools for safe and efficacious PRRT.