Pre-Exposure Prophylaxis and Treatment with Tixagevimab/Cilgavimab for COVID-19 among Immunocompromised Pediatric Patients

Background: Patients treated with hemato-oncological malignancies (HO) or undergoing cellular therapies such as hematopoietic stem cell transplantation (HSCT) or chimeric antigen receptor T cells (CAR-T) were significantly affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the success of SARS-CoV-2 vaccination, immunocompromised patients remain at increased risk for severe coronavirus disease (COVID-19), rendering this group of population a high priority for additional prevention and treatment options. Tixagevimab and Cilgavimab (TIXA/CILGA, AZD7442, Evusheld®) is a combination of two fully human, long-acting monoclonal antibodies. TIXA/CILGA have been approved as pre-exposure prophylaxis and treatment in patients at risk of severe disease with impaired vaccine response. Our objective was to describe the efficacy and safety among immunocompromised pediatric patients. Methods: This was an observational multicenter cohort study of immunocompromised pediatric patients receiving TIXA/CILGA conducted at nine Polish centers of Pediatric Oncology, Hematology and Bone Marrow Transplantation. We analyzed patients in two groups; those treated with HO and those undergoing cellular therapies: HSCT or CAR-T cells. In addition, two other cohorts were identified: patients given TIXA/CILGA as pre-exposure prophylactic and therapeutic intervention. Results: A total of 78 patients were evaluated during the study period: 69 (88.5%) received TIXA/CILGA as pre-exposure prophylaxis and 9 (11.5%) as a treatment strategy. A total of 52 (66.6%) patients were treated with standard chemotherapy at HO departments; 21 (27%) underwent HSCT, and 5 (6.4%) received CAR-T cell therapy. All children with COVID-19 receiving TIXA/CILGA presented a mild degree of severity. The most common clinical manifestations were fever, cough and coryza. At least one adverse event (AE) was reported in two (3.8%) patients excluding standard injection site reactions. Reported AEs were mild or moderate in intensity. One child reported mild myalgia and one reported moderate bone pain and weakness. Conclusions: In our observational multicenter cohort study, we explored the use of TIXA/CILGA as pre-exposure prophylaxis and treatment for COVID-19 among immunocompromised pediatric patients. While our findings suggest a potential benefit in preventing and managing COVID-19 in this vulnerable population, it is important to note the study's non-comparative design. Our results highlight the need for well-designed clinical trials to confirm these observations and further assess the efficacy and safety of TIXA/CILGA in immunocompromised children.

The Immunohistochemical Expression of Epithelial-Mesenchymal Transition Markers in Precancerous Lesions and Cervical Cancer

In the epithelial-mesenchymal transition (EMT) process, cells lose their epithelial phenotype and gain mesenchymal features. This phenomenon was observed in the metastatic phase of neoplastic diseases, e.g., cervical cancer. There are specific markers that are expressed in the EMT. The aim of this study was to determine the localization of and associations between the immunohistochemical (IHC) expression of TWIST, SNAIL, and SLUG proteins in precancerous lesions and cervical cancer. The IHC analysis disclosed higher expressions of EMT markers in precancerous lesions and cervical cancer than in the control group. Moreover, stronger expression of TWIST, SNAIL, and SLUG was observed in cervical intraepithelial neoplasia grade 3 (CIN3) vs. CIN1, CIN3 vs. CIN2, and CIN2 vs. CIN1 cases (p < 0.05). In cervical cancer, IHC reactions demonstrated differences in TWIST, SNAIL, and SLUG expression in grade 1 (G1) vs. grade 2 (G2) (p < 0.0011; p < 0.0017; p < 0.0001, respectively) and in G1 vs. grade 3 (G3) (p < 0.0029; p < 0.0005; p < 0.0001, respectively). The results of our study clearly showed that existing differences in the expression of the tested markers in precancerous vs. cancerous lesions may be utilized in the diagnosis of cervical cancer. Further studies on bigger populations, as well as in comparison with well-known markers, may improve our outcomes.

The Expression of Testin, Ki-67 and p16 in Cervical Cancer Diagnostics

Testin is a protein expressed in normal human tissues, being responsible, with other cytoskeleton proteins, for the proper functioning of cell−cell junction areas and focal adhesion plaques. It takes part in the regulation of actin filament changes during cell spreading and motility. Loss of heterozygosity in the testin-encoding gene results in altered protein expression in many malignancies, as partly described for cervical cancer. The aim of our study was the assessment of the immunohistochemical (IHC) expression of testin in cervical cancer and its analysis in regard to clinical data as well the expression of the Ki-67 antigen and p16 protein. Moreover, testin expression was assessed by Western blot (WB) in commercially available cell lines. The IHC analysis disclosed that the expression of testin inversely correlated with p16 (r = −0.2104, p < 0.0465) and Ki-67 expression (r = −0.2359, p < 0.0278). Moreover, weaker testin expression was observed in cancer cases vs. control ones (p < 0.0113). The WB analysis of testin expression in the cervical cancer cell lines corresponded to the IHC results and showed a weaker expression compared to that in the control cell line. When we compared the expression of testin in cervical cancer cell lines, we found a weaker expression in HPV-negative cell lines. In summary, we found that the intensity of testin expression and the number of positive cells inversely correlated with the expression of Ki-67 (a marker of proliferation) and p16 (a marker of cell cycle dysregulation). This study shows that the combined assessment of testin, Ki-67 and p16 expression may improve cervical cancer diagnostics.

Comparison of TMA Technique and Routine Whole Slide Analysis in Evaluation of Proliferative Markers Expression in Laryngeal Squamous Cell Cancer

BACKGROUND/AIM

Comparison of the expression of Ki-67, MCM3, 5, 7 and MTI/II proteins using immunohistochemistry (IHC) on whole section (WS) and tissue microarray (TMA) of laryngeal squamous cell carcinoma (LSCC) samples.

MATERIALS AND METHODS

A total of 51 archival paraffin blocks of LSCC were used. TMAs were prepared from 1.5 mm core punches. IHC reactions were performed using antibodies against Ki-67, minichromosome maintenance proteins (MCM3, 5, 7) and metallothionein (MTI/II).

RESULTS

Spearman rank correlation test revealed moderate positive correlation in the case of Ki-67: WS vs. TMA (r=0.38, p=0.07) and strong positive correlation in regard to the rest of tested markers: MCM3, WS vs. TMA (r=0.49, p=0.0004); MCM5, WS vs. TMA (r=0.61, p<0.0001); MCM7, WS vs. TMA (r=0.59, p<0.0001); MTI/II, WS vs. TMA (r=0.66, p<0.0001). Mann Whitney U-test showed no significant differences in the case of Ki-67 and MCM5. Moreover, Bland-Altman test showed a low level of bias in regard to Ki-67, WS vs. TMA and MCM5, WS vs. TMA.

CONCLUSION

TMA may be an effective and reliable method of assessment of Ki-67 and MCM5 expression in LSCC.

The usefulness of periostin determination in gynecology and obstetrics

Periostin (POSTN) is a multifunctional glycoprotein that belongs to the group of extracellular matrix (ECM) proteins. Due to the molecular structure, cellular interactions, tissue locations as well functions of POSTN, we realize that its pivotal role is organization and regulation of ECM microenvironment. In available databases there is a lack of data summarizing current knowledge about POSTN expression in the field of gynecology and obstetrics. We conducted a search in PubMed of the National Library of Medicine and Google Scholar. Databases were extensively searched for all original and review articles/book chapters published in English until December 2019 and related to periostin expression. All relevant articles were reviewed and presented as appropriate. In the field of POSTN expression there is only one paper evaluating its involvement in cervical cancer cell metabolism and only two studies analyzing its myometrial commitment: maintenance during pregnancy and induction of parturition in physiology as well control of fibroids biology in pathology. Much more attention has been devoted to the expression of described protein in the endometriosis, and above all in ovarian cancer. Finally, a few studies carried out among pregnant women were presented. In this review study we presented current knowledge about periostin expression in the field of gynecology and obstetrics. Many achieved results are interesting and further studies are needed to verify some hypotheses. Structure, signaling pathways as well many functions of periostin are well-described. However, as it was clearly shown there is a lot of unknown issues which are waiting to be explored.

Effect of Physical Training on the Levels of Sex Hormones and the Expression of Their Receptors in Rats With Induced Mammary Cancer in Secondary Prevention Model - Preliminary Study

BACKGROUND/AIM

Breast cancer is the most common malignant tumor among women worldwide. In previous work, we presented results of physical activity in primary prevention in a model of induced mammary gland cancer. In the present study, we assessed the influence of physical activity on sex hormone levels (estradiol and progesterone) and the expression of their receptors (ER, PR), as well as the level of apoptosis of tumor cells in secondary prevention.

MATERIALS AND METHODS

Fifty 1-month-old female Sprague-Dawley rats received intraperitoneal injection of 180 mg/kg body weight of N-methyl-N-nitrosourea (MNU) for tumor induction. Three months after the administration of MNU, rats were divided into four groups: low-intensity, moderate-intensity, and high-intensity physical training groups (combined as PT) and a sedentary control (SC) group. Physical training was conducted 5 days per week with a three-position treadmill according to a precisely described protocol. The entire training was completed by 32 rats from which tissue and blood were collected for further analysis. Immunohistochemistry for ER and PR expression, terminal deoxynucleotidyl transferase dUTP nick-end labeling method for detection of apoptosis, and enzyme-linked fluorescent assay for detection of plasma hormone levels (estradiol and progesterone) were performed. Statistical analysis used p<0.05 as the significance level.

RESULTS

Significantly stronger expression of ER and PR was found in the SC in comparison to the PT group (p=0.035 and p=0.036, respectively). No statistically significant differences were found in estradiol or progesterone concentrations between SC and PT groups. Apoptosis was non-significantly increased in the PT group in comparison with the SC group. Stronger apoptosis in the PT group correlated positively with the level of training intensity (r=0.35, p=0.05).

CONCLUSION

Physical training may reduce ER and PR expression in breast cancer cells, and reduce cell sensitivity to pro-proliferative and anti-apoptotic effects of estrogens, ultimately leading to apoptosis.

The Role of Testin in Human Cancers

Testin is a protein expressed in almost all normal human tissues. It locates in the cytoplasm along stress fibers being recruited to focal adhesions. Together with zyxin and vasodilator stimulated protein it forms complexes with various cytoskeleton proteins such as actin, talin and paxilin. They jointly play significant role in cell motility and adhesion. In addition, their involvement in the cell cycle has been demonstrated. Expression of testin protein level correlates positively with percentage of cells in G1 phase, while overexpression can induce apoptosis and decreased colony forming ability. Decreased testin expression associate with loss by cells epithelial morphology and gain migratory and invasive properties of mesenchymal cells. Latest reports indicate that TES is a tumor suppressor gene which can contribute to cancerogenesis but the mechanism of loss TES gene expression is still unknown. Some authors point out hypermethylation of the CpG island as a main factor, however loss of heterozygosity may also play an important role [4, 5]. The altered expression of testin was found in malignant neoplasm, i.a. ovarian, lung, head and neck squamous cell cancer, breast, endometrial, colorectal, prostate and gastric cancers [1-9]. Testin participate in the processes of tumor growth, angiogenesis, and metastasis [10]. Many researchers stated involvement of testin in tumor progression, what suggest its potential usage in immunotherapy [7, 11]. Understanding the molecular functions of testin may be crucial in development personalized treatment. In the present manuscript up-to-date review of literature can be found.

Expression of p16 and SATB1 in Invasive Ductal Breast Cancer - A Preliminary Study

BACKGROUND/AIM

An impaired cell-cycle control and genetic material organization are crucial elements of carcinogenesis. p16 is a tumor suppressor protein which decelerates promotion of the cells from G₁ to S phase, whereas special AT-rich sequence-binding protein 1 (SATB1) is a nuclear matrix protein that binds to specific regions of the DNA and ensures its proper organization and function. Increased levels of both markers are observed in various types of cancers. The aim of this study was to investigate the expression of p16 and SATB1 proteins in regard to expression of the Ki-67 antigen and available clinicopathological data (i.a. receptor status, staging and grading).

MATERIALS AND METHODS

The study was performed on 130 samples of archived invasive ductal breast cancers. Immunohistochemical reactions were performed on freshly prepared tissue microarrays and subsequently scanned by a histologic scanner. Reactions were evaluated separately in the cytoplasm (p16c, SATB1c) and nucleus (p16n, SATB1n, Ki-67) with use of a quantification software under researcher supervision.

RESULTS

Expression was observed for Ki-67 in 100%, p16c in 90%, p16n in 89.2%, SATB1c in 98.5% and SATB1n in 87.7% of cancer cases. Statistical analysis showed strong positive correlations: p16c vs. p16n and SATB1c vs. SATB1n (p<0.001 for both) and weak positive correlations: p16c vs. SATB1c and p16c vs. SATB1n (p=0.008, p=0.027; respectively). Expression of p16n was stronger in G₁ vs. G₂ (p=0.034) while Ki-67 expression was stronger in cases with negative progesterone receptor status (p=0.011). All other analyzed associations were statistically insignificant.

CONCLUSION

A weak association between immunohistochemical expression of p16 and SATB1 indicated limited possibility of their independent usage. Further studies concerning determination of a wider panel of proteins controlling cell cycle should be considered.

Matrix metalloproteinases-2, -7 and tissue metalloproteinase inhibitor-1 expression in human endometrium

INTRODUCTION

Endometrium undergoes regular, cyclic tissue remodeling mostly associated to the endocrine system status. It is well-known fact that steroid hormones are strongly responsible for changes in endometrium. The precise mechanism of their action is still under investigation. The aim of the study was to evaluate the expression of metalloproteinases 2 and 7 (MMP-2, -7) and tissue inhibitor of metalloproteinase 1 (TIMP-1) in human endometrium in relation to serum concentrations of estradiol and progesterone during different phases of menstrual cycle.

MATERIAL AND METHODS

The study material consisted of 52 biopsy samples; 12 obtained in the proliferative phase, 11 in the secretory phase and 29 during menstruation. Expression of MMP-2, MMP-7 and TIMP-1 was assessed by immunohistochemistry. Serum concentrations of estradiol and progesterone at time of biopsy were evaluated by immunochemistry assay. Results of the study were statistically assessed by linear regression model.

RESULTS

Increased serum concentration of estradiol was associated with increased MMP-2 expression in proliferative phase but decreased in secretory phase and during menstruation. No significant relationship was found between progesterone concentration and MMP-2 expression. Moreover, no difference in the expression of MMP-7 and TIMP-1 in the endometrium in relation to hormone levels and menstrual cycle phases were observed.

CONCLUSIONS

The results of the study indicate that estradiol influence MMP-2 expression in the endometrium depends on the phase of menstrual cycle. Such relationships were not found for MMP-7 and TIMP-1 and further tests clarifying association between estradiol and MMPs are needed.

The Impact of Exercise Training on Breast Cancer

BACKGROUND/AIM

Physical exercise is increasingly considered by many authors to be a factor reducing the risk of cancer development and premature cancer-related death. Data indicate higher cure rates and longer times of survival in cancer patients who regularly exercise.

MATERIALS AND METHODS

A total of 50 female Sprague-Dawley rats were used in the experiment. Animals at 1 month of age were intraperitoneally injected with N-methyl-N-nitrosourea. Three months following drug administration, rats underwent supervised physical training. The animals were divided into four groups: control untrained group and 3 groups trained with different intensities - i.e. low, moderate and high. Routine histopathological examination of tumors was performed and mitotic activity was assessed by immunohistochemical expression of the Ki-67 antigen.

RESULTS

Ki-67 antigen expression was observed in all analyzed tumors. The increase in Ki-67 antigen expression correlated positively with the increase in training intensity.

CONCLUSION

It can be assumed that low-intensity physical training is safe for patients with breast cancer. However, moderate- and high-intensity training may induce tumor cell proliferation worsening patients' prognosis.

Correlation of Pyruvate Kinase M2 Expression with Clinicopathological Data in Ovarian Cancer

BACKGROUND/AIM

It has been shown in many studies that expression of pyruvate kinase (PK) enzyme plays a key role during cellular metabolism. There is evidence that cancer cells manifesting very dynamic proliferation may control their division in various mechanisms, i.a. by expression of PKM2 isoform. The exact role of PKM2 in ovarian cancer (OC) cells and cancer associated fibroblasts (CAFs) have not been elucidated.

MATERIALS AND METHODS

The present study was focused on analysis of PKM2 expression in cancer cells and CAFs in 97 OC cases, mostly of serous histological type. Moreover, relationships between expression of PKM2 and proliferation (Ki-67; MCM-2, -3, -7; cyclin D1), vascular (CD31, D2-40) and mesenchymal (Vim and αSMA) markers as well as receptors (ER, PR, HER2, EGFR) were examined. All observations were evaluated in regard to available clinicopathological data.

RESULTS

The expression of PKM2 was disclosed only in cytoplasm of OC cells. No statistically significant correlation between PKM2 and tested markers was found. In regard to available clinicopathological data only an increasing trend of PKM2 expression with increasing grade of histological malignancy G was found (p=0.07).

CONCLUSION

Due to achieved results concerning expression of PKM2 there is a lack of evidence for its diagnostic and prognostic usage in OC.

Circulating tumor cells in urological cancers

Circulating tumor cells (CTC) represent a very small subpopulation of the cancer cells found in the bloodstream of patients in the metastatic phase of neoplastic disease. Due to the timeline of the disease, they are regarded as a negative prognostic marker. This study focused on determining CTC percentages; these values vary be-tween different types of cancer. In addition to their diagnostic use, CTCs may also be used to treat the disease. Calculating CTC population size and analyzing their biology in patients in advanced stages of cancer may prove valuable in creating a molecular profile for the disease. This would strongly encourage diagnostics and enable personalized treatment. We here present an analysis of recent data on CTCs in urological cancers and their potential uses.

Carvedilol Inhibits Matrix Metalloproteinase-2 Activation in Experimental Autoimmune Myocarditis: Possibilities of Cardioprotective Application

AIMS

Acute myocarditis is a potentially lethal inflammatory heart disease that frequently precedes the development of dilated cardiomyopathy and subsequent heart failure. At present, there is no effective standardized therapy for acute myocarditis, besides the optimal care of heart failure and arrhythmias in accordance with evidence-based guidelines and specific etiology-driven therapy for infectious myocarditis. Carvedilol has been shown to be cardioprotective by reducing cardiac pro-inflammatory cytokines present in oxidative stress in certain heart diseases. However, effects of carvedilol administration in acute myocarditis with its impact on matrix metalloproteinases' (MMPs) activation have not been elucidated.

METHODS AND RESULTS

Carvedilol in 3 doses (2, 10, and 30 mg/kg) was given daily to 3 study groups of rats (n = 8) with experimental autoimmune myocarditis by gastric gavage for 3 weeks. In comparison to untreated rats (n = 8) with induced myocarditis, carvedilol significantly prevented the left ventricle enlargement and/or systolic dysfunction depending on the dose in study groups. Performed zymography showed enhanced MMP-2 activity in untreated rats, while carvedilol administration reduced alterations. This was accompanied by prevention of troponin I release and myofilaments degradation in cardiac muscle tissue. Additionally, severe inflammatory cell infiltration was detected in the nontreated group. Carvedilol in all doses tested, had no impact on severity of inflammation. The severity of inflammation did not differ between study groups and in relation to the untreated group.

CONCLUSIONS

The protective effects of carvedilol on heart function observed in the acute phase of experimental autoimmune myocarditis seem to be associated with its ability to decrease MMP-2 activity and subsequently prevent degradation of myofilaments and release of troponin I while not related to suppression of inflammation.

Impact of Physical Training on Sex Hormones and Their Receptors During N-Methyl-N-nitrosourea-induced Carcinogenesis in Rats

BACKGROUND/AIM

The risk of breast cancer is related to duration of exposure to sex hormones, especially estrogen. The aim of this study was to assess the impact of physical training (PT) on estrogen and progesterone levels and expression of their receptors during carcinogenesis induced by N-methyl-N-nitrosourea (MNU) in rats.

MATERIALS AND METHODS

Fifty female Sprague-Dawley rats were intraperitoneally administered MNU and divided into four groups: low-, moderate-, and high-intensity PT, and no PT (control). Plasma levels of sex hormones and tissue expression of their receptors were quantified and statistically analyzed.

RESULTS

In the group of rats subjected to PT, a significantly higher progesterone level was observed. The highest progesterone level was noted in the low-intensity PT group. An increase in apoptosis of MNU-induced tumor cells was also demonstrated in the PT groups.

CONCLUSION

PT stimulates apoptosis of tumor cells without an increase in their proliferative activity. The increase in apoptosis of tumor cells correlates positively with the progesterone level.

Podoplanin Expression Correlates with Disease Progression in Mycosis Fungoides

The aim of this study was to investigate the role of lymphangiogenesis in the clinical progression and outcome of mycosis fungoides. Immunohistochemistry and Western blot techniques were used to assess the expression of podoplanin and vascular endothelial growth factor C in mycosis fungoides. Expression of vascular endothelial growth factor C measured by immunohistochemistry was significantly higher in mycosis fungoides samples in comparison with control cases (chronic benign dermatoses) (p = 0.0012). Increased expression of podoplanin was found in advanced vs. early mycosis fungoides (p < 0.0001), and was positively correlated with cutaneous and nodal involvement (p < 0.001, p < 0.0001; respectively). Higher podoplanin expression was also significantly associated with shorter survival (p < 0.001). Strong positive correlation was observed between expression of podoplanin analysed by immunohistochemistry and Western blot (r = 0.75, p < 0.0001). A similar association was shown regarding expression of vascular endothelial growth factor C (r = 0.68, p = 0.0007). In conclusion, these results suggest that increased expression of podoplanin is associated with poor clinical course, as well as shorter survival, of patients with mycosis fungoides.

Expression of SOX18 in Mycosis Fungoides

SOX18 is a transcription factor involved in the development of hair follicle, blood and lymphatic vessels, as well as regenerative processes. In addition, accumulated data indicate the role of SOX18 in tumourigenesis. So far, no studies on the role of SOX18 expression in mycosis fungoides (MF), the most common primary cutaneous T-cell lymphoma, have been performed. Therefore, we evaluated SOX18 expression in MF at the mRNA and protein level. SOX18 expression was observed predominantly on the blood and lymphatic vessels, in the intratumoural and peritumoural microenvironment of MF. The intra-tumoural, but not peritumoural, expression of SOX18 correlated positively with the advancement of the disease, cutaneous involvement and extracutaneous meta-stases at the protein level (p < 0.001, p < 0.001, p = 0.004; respectively). Significantly lower SOX18 mRNA expression was correlated with lymph node involvement (p = 0.01). In conclusion, we hypothesize that SOX18, as a marker of neovascularization, may be involved in the progression of MF.

Can obstructive intralymphatic granulomas be the cause of cheilitis granulomatosa?

Cheilitis granulomatosa (ChG), also known as Miescher's cheilitis, is an uncommon, immunologically mediated nonnecrotizing granulomatous inflammatory disease characterized by recurrent, painless swelling of the lips. The aim of the study was a pathomorphological and immunohistochemical assessment of cases clinically classified as ChG to investigate potential pathological mechanisms of ChG symptoms and to verify the hypothesis of intravascular granulomas as a cause of lymphatic vessel obstruction and localized edema in ChG. We report 6 patients with ChG who clinically presented localized edema of the lips. Lip biopsy with pathomorphological and immunohistochemical examination was performed in all cases. We found discrete, non-necrotizing granulomas which were adjacent to numerous blood and lymphatic vessels. The lumen of lymphatic channels was dilated and was either empty or contained lymph and few macrophages or was completely occluded by nearby granulomas. All patients demonstrated a characteristic pattern of lymphangiectasia and perivascular lymphatic aggregates with evidence of non-necrotizing granulomas. None manifested intralymphatic granulomas. These results do not support the view that lymphatic vessel obstruction is caused by intravascular histiocytic granulomas described as the main part in the etiology of lymphatic edema in ChG. However, perivascular granulomas and dilation of lymphatic vessels confirm presence of inflammatory lymphostasis in all studied cases of ChG.

Expression of Cell Cycle-Related Proteins p16, p27, p53 and Ki-67 in HPV-positive and -negative Samples of Papillomas of the Upper Respiratory Tract

BACKGROUND

The role of human papillomavirus (HPV) infection as an etiological factor of respiratory tract papillomas has been described in numerous studies, however its role in malignant transformation has not been clearly defined. Depending on their oncogenic potential they have been classified as low- and high-risk HPVs. We analyzed the expression of four cell cycle-related proteins in order to understand the processes leading to malignant transformation.

MATERIALS AND METHODS

Fifty-six cases of pharyngeal and laryngeal papillomas were analyzed. Nested multiplex polymerase chain reactions to detect the presence of the HPV types, as well as immunohistochemical reactions were performed for the detection of cell cycle-related proteins p16, p27, p53 and Ki-67.

RESULTS

The presence of HPVs 6/11 and 16 was confirmed in 10/56 cases. The expression of all analyzed cell cycle-related proteins was increased in HPV-infected papillomas.

CONCLUSION

HPV infection of the upper respiratory tract may influence the expression of cell cycle-related proteins, that could indicate its possible role in the process of malignant transformation.

SOX18 Expression in Non-melanoma Skin Cancer

BACKGROUND/AIM

SRY-related HMG box protein 18 (SOX18) is a transcription factor involved in a range of physiological processes, including differentiation of endothelial cells during new vessel formation. Numerous studies are being conducted to determine its role in carcinogenesis.

MATERIALS AND METHODS

Thirty-five cases of squamous cell carcinoma (SCC), 61 cases of basal cell carcinoma (BCC), 15 cases of actinic keratosis (AK) and 15 normal skin (NS) cases were examined in the study. Expression of SOX18 was investigated with immunohistochemistry and light optic microscopy. The obtained results were subjected to statistical analysis including available clinicopathological data.

RESULTS

Nuclear expression of SOX18 was shown in vascular endothelial cells, basal layer cells of NS epidermis, as well as in AK, BCC and SCC cancer cells. Expression of SOX18 in SCC, BCC and AK cells was significantly higher than in NS (p<0.01, p<0.001 and p<0.01, respectively). Additionally, higher expression of SOX18 in BCC than in SCC cells (p<0.001) was observed.

CONCLUSION

SOX18 may play a role in the development of BCC and SCC. Further studies with the use of additional markers tested at the mRNA and protein level are necessary for better explanation of SOX18 function in cancer transformation.

Expression of Metallothionein and Vascular Endothelial Growth Factor Isoforms in Breast Cancer Cells

BACKGROUND

Metallothioneins (MTs) are low-molecular-weight and cysteine-rich proteins that bind heavy metal ions and oxygen-free radicals. MTs are commonly expressed in various tissues of mammals and are involved in regulation of cell proliferation and differentiation, and may be engaged in angiogenesis. Expression of MTs has been studied in many cancer types, especially breast cancer. The research results indicate that MTs may play important, although not yet fully known, roles in cancer angiogenesis. The aim of this study was to analyze the level of gene expression of selected MT isoforms induced with zinc ions in correlation with vascular endothelial growth factor (VEGF) isoforms in in vitro models of breast cancer.

MATERIALS AND METHODS

The studies were carried out in three breast cancer cell lines (MCF-7, SK-BR-3, MDA-MB-231). An epithelial cell line derived from normal breast tissue (Me16c) was used as a control. The levels of expression of selected MT isoforms and selected genes involved in angiogenesis were studied with real-time PCR.

RESULTS

Expression of different MT isoforms was induced by zinc ions to differing degrees in individual breast cancer cell lines. An increase in the expression of some MT isoforms was associated with a slight increase in the level of expression of VEGFA.

CONCLUSION

The research results may indicate certain correlation between an increased expression of selected MT isoforms and a pro-angiogenic factor VEGF in specific types of breast cancer cells.

Augmentation of the hard palate thin masticatory mucosa in the potential connective tissue donor sites using two collagen materials-Clinical and histological comparison

BACKGROUND

Due to the similarity of keratinized gingival and palatal mucosa the latter can pose as a potential donor site for gingival recession coverage. However, its availability is restricted and a thin transplant bears the risk of being rejected. The aim of the present study was to compare the clinical and histological results of thin palatal mucosa augmentation, using lyophilized Biokol^® xenogenous collagen sponge and a suspension of xenogenous Gel 0^® pure collagen with non-augmented tissue from the same patients.

MATERIALS AND METHODS

Ten patients simultaneously underwent bilateral augmentation procedures using Biokol^® and Gel 0^® collagen material. The donor sites were augmented 8 weeks prior to the harvesting of the connective tissue graft (CTG) for the gingival recession coverage procedures. Prior to the implantation of the collagen material and during the course of harvesting the augmented CTG, tissue specimens were taken for histological examination. Prior to the commencement of the study and after it, the parameters of palatal gingival thickness at 4mm (PGT1), and at 8mm apical to the gingival margin (PGT2) around the teeth neighboring the operating fields were determined.

RESULTS

In both groups the palatal mucosa had thickened significantly in both measuring sites. An intergroup comparison revealed greater thickening of the masticatory mucosa in the Biokol^® group at both measuring points. The histological image of the grafts, obtained from sites augmented using both test methods, revealed a typical pattern of mature fibrous connective tissue. No epithelial cells were found.

CONCLUSION

Augmentation of thin masticatory mucosa using Biokol^® or Gel 0^® collagen materials resulted in a significant thickening of the mucosa, which could be demonstrated to be greater in the first group.

Expression of SATB1, MTI/II and Ki-67 in Mycosis Fungoides

BACKGROUND/AIM

A genome organizer protein, special AT-rich sequence binding protein 1, (SATB1), was recently shown to play an important role in the development and spread of various malignancies. Metallothioneins I and II (MTI/II) are multifunctional proteins involved, among others, in cell proliferation and apoptosis resistance in tumors. The role and relevance of these factors in mycosis fungoides (MF), the most common primary cutaneous T-cell lymphoma, is not fully understood. The aim of the present analysis was to evaluate the expression and potential correlation of SATB1, MTI/II and Ki-67 with clinicopathological data in MF.

MATERIALS AND METHODS

We performed immunohistochemical analysis for SATB1, MTI/II and Ki-67 on 90 cases of MF and 19 controls (chronic benign dermatoses). The expression of SATB1 and Ki-67 was analyzed in cancer cell nuclei, whereas nuclear and cytoplasmic expressions of MTI/II were scored separately (nMT, cMT; respectively).

RESULTS

We recorded a significantly higher expression of SATB1 and cMT in MF compared to the control group (p<0.002, p=0.04, respectively, Student's t-test). We also noted significant differences in the mean (±SD) expression of nMT and cMT in advanced MF compared to early MF, (1.4±1.3 vs. 0.9±0.9, 4.1±3.8 vs. 2.5±2.9, respectively; p=0.04 for both). Similarly, Ki-67 expression was significantly higher in advanced MF (p<0.01). The expression of SATB1, cMT and Ki-67 was significantly higher in more infiltrating skin lesions (p<0.001, p=0.08 and p<0.001, respectively). Regarding extracutaneous involvement, a higher expression of SATB1, nMT, cMT and Ki-67 was found in patients with clinical or histological involvement of lymph nodes (N1-3 vs. N0) (p<0.001, p=0.002, p<0.001 and p=0.1, respectively). A marked correlation was observed between SATB1 and Ki-67 (Spearman correlation test: r=0.53, p<0.001). No associations between SATB1, nMT and cMT expression and demographic data nor overall survival were found.

CONCLUSION

Our study provides data on the differences in the expression of SATB1 and cMT regarding differential diagnosis of MF and tumor-node-metastasis-blood staging. Additionally, our report documented significantly different expression levels of MTI/II and Ki-67 according to the advancement of the disease. In view of these data, the role of studied factors in the development of this type of cutaneous T-cell lymphoma is postulated. Our results indicate that both SATB1 and MTI/II may be of diagnostic value, but our study revealed no prognostic significance; however, given the small number of reports focusing on this topic, further studies are required.

Metallothioneins in Normal and Cancer Cells

Metallothioneins (MTs) are low molecular weight proteins, which are present in almost all types of organisms. In mammals, four main MT isoforms designated from MT-1 to MT-4 were identified. Their biological role, according to their characteristic structure, was shown to be mostly associated with cellular metabolism of metal ions, especially zinc. Moreover, the available evidence suggests broad regulatory properties of MTs in the control of cell senescence and various pathological processes including neurodegeneration, cardiovascular pathology, metabolic disorders, and various malignancies. This extensive review provides general in formation on the structure of MT family members and the cellular functions of MT-1, MT-2, and MT-4 isoforms as well as insights into divergent biological roles of MT-3. Due to the involvement of MT molecules in various processes related to carcinogenesis, an organ-specific presentation of current data concerning their potential impact on the progression of various tumors is given. The regulatory role of MT family members in the function of the immune system is also discussed in depth.

Histopathological case report of high grade salivary duct carcinoma

The case of a 39-year-old man with slowly growing mass in the superior part of left parotid region is described. Patient presented neurological symptoms including hypomobility of lower left eyelid and inability of complete closure of left side eyelids resulting in conjunctivitis and hyperlacrimation. Routine physical examination supported by image and laboratory tests was performed. Pathomorphological results of hematoxylin and eosin staining as well immunohistochemical examination in view of clinical presentation pointed to diagnosis of high grade salivary duct carcinoma. Rare incidence, histological view similar to breast cancer and body localization are sufficient reasons for further analyses and descriptions of this type of lesions.

[Angiogenesis and lymphangiogenesis in primary cutaneous T-cell lymphomas]

Primary cutaneous T-cell lymphomas are a group of rare hematologic malignancies, derived from mature T lymphocytes and initially developing only in the skin. The most common lymphomas representing this group are mycosis fungoides and Sezary syndrome. Mycosis fungoides is an indolent disease with a chronic course and characteristic evolution of the skin lesions from erythematous patches, through plaques to tumors. Sezary syndrome is characterized by an aggressive course and a triad of symptoms (erythroderma, generalized lymphadenopathy, and the presence of atypical cells in the skin, lymph nodes and peripheral blood). The etiopathogenesis of cutaneous lymphomas is not fully understood, but a few studies on angiogenesis and lymphangiogenesis in these malignancies indicate a significant role in their development and progression. Angiogenesis is a process of formation of new blood vessels from existing ones. Lymphangiogenesis is a similar process concerning lymphatic vasculature. Development of new vessels is a complex process composed of several successive stages: migration, proliferation, and differentiation of endothelial cells, extracellular matrix degradation and formation and stabilization of new vessels, regulated by growth factors, cytokines and other proteins. Both phenomena are essential in the development and progression of solid tumors and hematological malignancies. Therapeutic strategies involving the inhibition of tumor angiogenesis and lymphangiogenesis are a promising new direction of studies in antitumor therapy, requiring further experiments.

Plasminogen Activation System in Rectal Adenocarcinoma

BACKGROUND

The purpose of the present study was to determine the extent of expression of proteins that are the elements of the plasminogen activation system, i.e. urokinase plasminogen activator (uPA), receptor of uPA (uPAR), plasminogen activating inhibitor-1 (PAI-1) and tissue plasminogen activator (tPA) in the primary site of rectal adenocarcinoma, as well as in lymph node metastases, and their correlation with clinical and pathological data.

MATERIALS AND METHODS

The study material consisted of archival paraffin blocks from 108 patients with confirmed oncological diagnosis, treated in 2002 and 2003 in the Lower Silesian Oncology Centre in Wroclaw. This material was used for immunohistochemical reactions with antibodies against uPA, uPAR, PAI-1 and tPA. The extent of expression was evaluated semi-quantitatively based on the immunoreactive score according to Remmele and Stegner. The obtained results were correlated with clinical and pathological data: stage of the disease (modified Dukes' classification of Astler and Coller), grade of histological malignancy, event-free survival and overall survival.

RESULTS

It was found that cytoplasmic expression of uPA, uPAR, PAI-1 and tPA was higher in cells of tumor and metastases of perienteric lymph nodes in comparison to normal rectal tissues. Positive correlation was shown between expression of PAI-1 and tPA, uPA and uPAR, as well uPA and PAI-1 (r=0.70, r=0.77 and r=0.34, respectively; p<0.05 for all). Additionally, in patients with low and moderate expression of uPA and uPAR, the overall survival rate was higher in comparison to patients with high expression of the studied markers.

CONCLUSION

The intensity of expression of uPA and uPAR might be a prognostic factor of survival time for patients with primary rectal adenocarcinomas.

Expression of MCM-3 and MCM-7 in Primary Cutaneous T-cell Lymphomas

BACKGROUND/AIM

Primary cutaneous T-cell lymphomas is a group of rare non-Hodgkin lymphomas, originally affecting the skin. Increased proliferation activity is a hallmark of diverse tumors and the proliferation rate, measured by the expression of various markers has a predictive value regarding the malignancy course. The aim of the present study was to evaluate the prognostic value and the potential correlation between the expression of proliferation markers Ki-67, MCM-3 and MCM-7, and clinicopathological data for different types of primary cutaneous T-cell lymphomas.

MATERIALS AND METHODS

Immunohistochemical reactions were performed on paraffin blocks obtained from 90 patients with mycosis fungoides (MF) and 21 patients with other CTCL (oCTCL), in comparison to 19 patients with benign inflammatory dermatosis (lichen planus, eczema), serving as control.

RESULTS

Statistically significant differences in the expression of Ki-67, MCM-3 and MCM-7 were observed between oCTCL vs. the control group (29% vs. 5%; 17% vs. 5%; 13% vs. 1.5%, respectively, ANOVA with Scheffé post-hoc test: p<0.01). In both, MF and oCTCL Ki-67 expression highly correlated with the expression of MCM-3 (r=0.83; p<0.001 and r=0.91; p<0.001, respectively) and MCM-7 (r=0.84; p<0.001 and r=0.87; p<0.01, respectively; Pearson correlation test). Similarly, a strong positive correlation was observed between MCM-3 and MCM-7 (r=0.81, p<0.001 and r=0.85, p<0.001). Regarding the MF group, Ki-67 and MCM-3 expression was significantly higher in advanced compared to early stages (11% vs. 3% and 15.5% vs. 5.0%, respectively, Student's t-test: p<0.05). Advanced MF had also significantly higher labeling indexes for Ki-67, MCM-3 and MCM-7 compared to benign inflammatory dermatoses (Student's t-test: p<0.01, p<0.001 and p=0.02, respectively). Considering skin involvement in MF, T1b had a significantly higher expression of Ki-67, MCM-3 and MCM-7 than T1a (p<0.001 for all comparisons) with similar observations between T2b and T2a (p=0.02; p<0.01; p=0.01, respectively, Student's t-test test). Regarding extracutaneous involvement, only MCM-3 expression in MF showed a positive relationship with both nodal and distant metastases (ANOVA with Scheffé post hoc test: p<0.01, p<0.01, respectively). Higher Ki-67 and MCM-3 expression correlated with shorter survival in MF, although the latter did not reach statistical significance (10-year survival 0.38 vs. 0.82, p=0.02, and 0.46 vs. 0.81, p=0.06, respectively; log rank test).

CONCLUSION

All studied proliferation markers may had predictive values regarding the disease severity and prognosis. Further studies are required to analyze their implementation into patient stratification and treatment process such that will improve prognosis in CTCL.

Increased skeletal muscle expression of VEGF induced by massage and exercise

INTRODUCTION

Numerous investigations have been carried out to describe the role of massage in preparing for and restoring efficiency after physical exercise. Furthermore, vascular endothelial growth factor (VEGF) enhances blood vessel growth, and in effect contributes to the regeneration of tissues. Since its expression in active skeletal muscles has not been yet determined, the aim of this study was to investigate whether muscle massage performed before and during running exercise affects the expression of VEGF-A in muscles.

MATERIAL AND METHODS

The study was carried out on 75 adult Buffalo rats subjected to running exercise training for 10 weeks. Rats were massaged prior (group PM) or during exercise (group M) or were not massaged (group C). The massage consisted of spiral movements along the plantar surface of flexor digitorum brevis muscle. After 1, 3, 5, 7 and 10 week of training, five rats from every group were anesthetized and immunohistochemistry, Western blot, and PCR analyses were performed on obtained muscle tissue to determine VEGF-A expression.

RESULTS

After the first week of training, a significant increase of VEGF-A gene expression analyzed by qPCR in muscle tissue was observed in the PM group, whereas in the third week, the predominant growth of studied marker was seen in the M group. Increased VEGF-A expression on the protein level was observed in both massaged groups following the first week. A moderate positive correlation was found between the expression of the VEGF-A gene and protein in all experimental groups (r = 0.389).

CONCLUSION

Short-term repeated massage may contribute to processes of creation of new and development of already existing vascular networks in the skeletal muscle tissue during increased exercise.

Expression of EMT Markers SLUG and TWIST in Breast Cancer

BACKGROUND

The epithelial-mesenchymal transition (EMT) has been observed in progression of in situ breast cancer to the invasive form and might be initiated by snail family zinc finger 2 (SLUG) and twist family bHLH transcription factor 1 (TWIST) protein overexpression. During this phenomenon, cells lose their epithelial phenotype and acquire mesenchymal features. The aim of the study was to examine the association of EMT markers SLUG and TWIST with clinicopathological data and the possibility of using these proteins as prognostic markers of breast cancer.

MATERIALS AND METHODS

Immunohistochemical analysis (IHC) of SLUG and TWIST expression was performed on archival paraffin samples of 19 cases with fibrocystic breast changes (control group), 148 cases of invasive ductal breast cancer (IDC) and 26 of invasive lobular breast cancer (ILC). Laser capture microdissection for isolation of cells from 17 frozen samples of IDC was employed and subsequently SLUG and TWIST mRNA expression in cancer and stromal cells was detected separately by real-time polymerase chain reaction.

RESULTS

SLUG and TWIST expression in IDC was significant higher in stromal cells regardless of the method of quantification used (p<0.001 for SLUG mRNA, and p<0.0001 for SLUG IHC, TWIST IHC and TWIST mRNA expression). Positive correlation of SLUG and TWIST protein and mRNA expression was observed in stromal cells of IDC (r=0.347; p<0.0001 and r=0.704; p<0.01, respectively). Expression of TWIST protein in IDC was higher in cancer cells of cases with shorter event-free survival period, as well as in stromal cells of cases with shorter overall survival period (p<0.05 for both).

CONCLUSION

Stromal cells could play a role in the regulation of EMT in breast cancer.

Increase of nuclear expression of metallothionein I/II in neoplastic transformation of the endomnetrium

OBJECTIVES

The aim of our study was to investigate the expression of epidermal growth factor receptor (EGFR), metallothionein (MT) 1/11, and Ki-67 antigen in endometrial cancer We analyzed cytoplasmic (cMT) and nuclear (nMT) metallothionein fractions separately Moreover we evaluated the relationships between expressions of the above mentioned proteins and compared them with clinicopathologic data.

MATERIAL AND METHODS

The study material included paraffin-embedded endometrial cancer samples from 84 patients. The control group consisted of 52 non-neoplastic endometrium samples. Immunohistochemical reactions were performed using monoclonal antibodies against EGFR, MT 1/11 and Ki-67. Expression intensity of the tested proteins was assessed by computer image analysis software. Chi-square, Spearman's correlation, Mann-Whitney and Kruskal-Wallis tests were used for statistical analysis with Statistica 8.0 PL.

RESULTS

Strong expression of nMT was revealed in endometrial cancer cells in relation to benign hyperplasia (p<0.0017) and normal cells (p<0.001) of the endometrium. Statistically significant but weaker expressions in analogous relationships were observed for cMT Moreover higher grade of histological malignancy G was positively associated with increased expression of nMT (p=0.009).

CONCLUSIONS

Expression of nMT remains in distinct correlation with neoplastic transformation of the endometrium and histologic grades. Our results clearly indicate a need for further research on metallothionein expression in tumor cells.

The effect of physical training on the N-methyl-N-nitrosourea-induced mammary carcinogenesis of Sprague-Dawley rats

The impact of physical activity on carcinogenesis has been demonstrated in many studies. Taking into account the discrepant results of physical exercise on the cell proliferation and apoptosis of breast cancer, we aimed to examine the impact of physical training on N-methyl-N-nitrosourea-(MNU)-induced mammary carcinogenesis. Fifty female rats were divided into four groups according to the intensity of physical activity they undertook. The number of developed tumors, tumor volume, and histopathological diagnoses were noted. Apoptosis and cell proliferation were studied by the number of TUNEL-positive and Ki-67-expressing cells. We demonstrated a statistically significant decrease in the tumor number between all trained groups and the control group. The results were most pronounced in the group with a moderate intensity of training. Moreover, we showed a decrease in tumor volume as training intensity increased, though the differences were not statistically significant. The mean number of TUNEL-positive cancer cells was significantly higher in the training groups than in the control group. These data suggest that physical training, especially of moderate intensity, may alleviate MNU-induced mammary carcinogenesis. The results could suggest that physical exercise-induced apoptosis may be a protective mechanism.

Massage may initiate tendon structural changes--a preliminary study

BACKGROUND

Physical exercise is now a widely known and studied factor of the proper functioning of living organisms. Many questions remain unanswered concerning various aspects of the changes in the morphology of structures subjected to chronic physical exercise.

MATERIALS AND METHODS

This study was conducted on fifty Buffalo strain rats, randomly divided into two equal (experimental and control) groups. All animals were subjected to physical training on a running track for 10 weeks, whereas only in the experimental group, massage was additionally applied five-times per week.

RESULTS

An increase in the percentage of collagen fibers in tendons with the smallest diameter (≤100 nm) was observed only in the experimental group in week 3, followed by a decrease in weeks 5 and 7. A subsequent repeated increase was observed in week 10 of the study. No significant differences were observed for either study group in the number of collagen fibers based on fiber diameter (101-200 nm, 201-300 nm and 301-400 nm).

CONCLUSION

The results of this preliminary study showed that long-term massage performed during running training may initiate for small structural changes in the rat tendon. Further morphological studies with prolonged observation periods are recommended.

Metallothioneins in the lung cancer

Metallothioneins (MTs) are low weight proteins involved in several key cellular processes such as metal ions homeostasis, detoxification and scavenging of free radicals. Four groups of MTs are distinguished: MT-1, MT-2, MT-3 and MT-4. Regardless of the type, MTs are characterized by high content of cysteine, responsible for their biological properties such as binding of relevant zinc and copper ions, as well as toxic ions such as lead and cadmium. MTs were additionally shown to protect cells against oxidative stress damage and participate in differentiation, proliferation and/or apoptosis of normal and cancer cells. Many studies of different neoplasms showed association of elevated MTs levels with occurrence of chemo- and radiotherapy resistance and poor patients' outcome. In this review, we summarize and discuss the potential mechanism of action of metallotioneins in lung physiology and pathology.

Expression of the MT1 melatonin receptor in ovarian cancer cells

Ovarian cancer (OC) is the leading cause of death among women with genital tract disorders. Melatonin exhibits oncostatic properties which it may effect through binding to its membrane receptor, MT1. The aim of this study was to determine the expression of MT1 in OC cells and to correlate this with clinical and pathological data. Immunohistochemistry was performed on 84 cases of OC. Normal ovarian epithelial (IOSE 364) and OC (SK-OV-3, OVCAR-3) cell lines were used to examine the MT1 expression at protein level using the western blot and immunofluorescence technique. The expression of MT1 was observed as cytoplasmic-membrane (MT1_CM) and membrane (MT1_M) reactions. A positive correlation between MT1_CM and MT1_M was found in all the studied cases. There were no significant differences between the expression of MT1_CM, MT1_M, and histological type, staging, grading, presence of residual disease, or overall survival time. Immunofluorescence showed both MT1_M and MT1_CM expression in all the tested cell lines. Western blot illustrated the highest protein level of MT1 in IOSE 364 and the lowest in the OVCAR-3. The results indicate the limited prognostic significance of MT1 in OC cells.

Clinical studies monitoring circulating and disseminated tumor cells in gastrointestinal cancers

Circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) are responsible for the development of metastatic disease, and may also hold the key to determining tailored therapies of advanced cancer disease. Our review summarizes the prognostic significance of the detection of CTCs and DTCs in various gastrointestinal cancers with an overview of their possible use as prognostic biomarkers. This could be used inthe future as a starting point for new clinical trials focusing on the predictive potential of circulating and disseminated tumor cells.

Expression of SATB1 protein in the ductal breast carcinoma tissue microarrays - preliminary study

Special AT-rich sequence-binding protein 1 (SATB1) is a nuclear matrix protein which interacts with specific regions of DNA, ensuring its proper organization and function in the cell. The expression of SATB1 was primarily found in thymocytes, but its increased levels were observed in various types of cancers. However, the knowledge of the function and application possibilities of this protein is still limited. The aim of this study was to investigate the expression of SATB1 protein using immunohistochemistry and tissue microarray (TMA) technique and determine its possible relationship with the proliferative marker Ki-67, estrogen a (ER) and progesterone (PR) receptors as well as grade of histological malignancy (G). The study was performed on material of 48 archival invasive ductal breast cancers (IDC). The TMAs were prepared with the use of 0.6 mm diameter punches. Immunohistochemical reactions were carried out using antibodies against Ki-67, ER, PR and SATB1 proteins. The intensity of the nuclear reaction was evaluated using a light microscope and computer-assisted image analysis. Expression of Ki-67 and SATB1 protein was observed in 89.58% and 31.25% of cancer cases, respectively. 62.5% of tumors were classified as ER-positive, and 47.92% as PR-positive. Statistical analysis showed a moderate positive correlation between Ki-67 and SATB1 expression (r = 0.291, p = 0.045 independently on the receptor status, and r = 0.392, p = 0.032 in ER-negative tumors). The expression of the Ki-67 antigen increased with higher grade of histological malignancy (G). The results suggest that SATB1 protein may play an indirect role in the cell proliferation and should be evaluated in relation to the other markers. Further studies concerning determination of its role in cancer progression and metastasis, in terms of application as therapeutic target and prognostic marker, are recommended.

SOX18 expression predicts response to platinum-based chemotherapy in ovarian cancer

BACKGROUND

SOX18 is a transcription factor known to be involved in blood and lymphatic vessel, hair follicle development, and wound healing processes. In addition, it has been reported that SOX18 may influence cancer growth. The role of SOX18 expression in ovarian cancer (OC) has not been determined.

MATERIALS AND METHODS

SOX18 expression was assessed in 85 OC cases using immunohistochemical methods and in ovarian cancer cell lines on the mRNA and protein level.

RESULTS

SOX18 was expressed in cancer cell nuclei as well as the cytoplasm. Higher nuclear SOX18 expression was associated with presence of residual disease following surgical treatment (p=0.0158) and advanced disease stage (p=0.0056). Univariate survival analysis revealed that high SOX18 (p=0.0125) expression, presence of residual disease (p<0.0001) and advanced disease stage (p<0.0324) predicted poor patient outcome.

CONCLUSION

SOX18 may be a new predictive marker for OC.

The lack of evidence for correlation of pyruvate kinase M2 expression with tumor grade in non-small cell lung cancer

BACKGROUND

Over the last years, evidence has accumulated that an increased expression of pyruvate kinase M2 isozyme (PKM2) is related to neoplastic transformation as well that its plasma concentrations might be a marker of lung cancer progression.

MATERIALS AND METHODS

In the present manuscript an immunohistochemical technique was used to detect the expression of two pyruvate kinase isoforms: PKM1 (muscle isozyme of PK) and PKM2 as well Ki-67 antigen on paraffin sections of 218 cases of non-small cell lung cancer (NSCLC) of different histological types and grades of malignancy.

RESULTS

A significant correlation between expressions of both pyruvate kinase isoforms in all NSCLC types was found (r=0.42, p<0.0001). Expression levels of PKM1 and PKM2 were independent of the histological classification of the tumor and patients' clinicopathological data.

CONCLUSIONS

PKM2 and PKM1 have no value as predictive markers of NSCLC regardless of the histological type and grade of malignancy.

Comparison of minichromosome maintenance proteins (MCM-3, MCM-7) and metallothioneins (MT-I/II, MT-III) expression in relation to clinicopathological data in ovarian cancer

BACKGROUND

Despite great progress in the understanding of ovarian cancer biology, clinicopathological data (i.e. grade, stage, histological type and residual disease after surgery) seem to be the most important prognostic factors.

MATERIALS AND METHODS

The present study aimed to investigate the relationship between expression of minichromosome maintenance proteins (MCM-3, MCM-7), metallothioneins (MT-I/II, MT-III), and Ki-67 in 103 ovarian cancer cases, mostly of the serous histological type.

RESULTS

Statistical analysis revealed strong positive correlations in the expression of MCM-3 vs. Ki-67 (r=0.492), MCM-7 vs. Ki-67 (r=0.651), and MCM-3 vs. MCM-7 (r=0.515) (all p<0.0001). The Kruskal-Wallis test showed an association of increased expression of MCM-3 and Ki-67 with increasing grade of histological malignancy (p=0.0011, p=0.029, respectively). Regarding clinical progression, cytoplasmic MT-I/II expression was significantly higher in more advanced disease stages (III+IV vs. I+II; p=0.0247).

CONCLUSION

Due to the correlations shown here, the determination of MCM proteins as proliferation markers of ovarian cancer, should be strongly considered.

Hsp-27 expression in invasive ductal breast carcinoma

The aim of this study was to determine the intensity of Hsp27 protein expression in fibrocystic breast changes (FC) and invasive ductal breast carcinoma (IDC) and to examine its impact on patients' clinico-pathological characteristics and overall survival. Immunohistochemical reactions were conducted on archival samples of 20 cases of FC and 101 cases of IDC treated in 1999-2002. Nuclear-cytoplasmic Hsp27 expression was observed in 92 (92.1%) of the examined cases of IDC, and all the cases of FC. Significantly higher Hsp27 expression was observed in G2 (p < 0.01) and G3 cases (p < 0.0001) compared to FC. HER-2 positive cases had higher Hsp27 expression (p = 0.0153), than HER-2 negative cases. Our research showed that Hsp27 could have an impact on tumor malignancy. Moreover, a positive correlation between the expression of Hsp27 and HER-2 positive cases was demonstrated.

Tissue microarray technique in evaluation of proliferative activity in invasive ductal breast cancer

AIM

Investigation of the relationship between expression of Ki-67 antigen and minichromosome maintenance 2 (MCM-2) protein by using an immunohistochemical study on whole sections (WS) and sections of invasive ductal breast cancer (IDC) obtained in the tissue microarray (TMA) technique.

MATERIALS AND METHODS

Material consisted of 51 archival paraffin blocks of IDC. Tissue microarrays were composed of 0.6 mm core punches. Reactions were performed using specific antibodies (anti-Ki-67 and anti-MCM-2). Intensity of the marker expression was evaluated using computer-assisted image analysis. For statistical purposes, three different tests were used.

RESULTS

Spearman rank correlation revealed a strong positive correlation between expression of tested markers: Ki-67 (TMA) vs. Ki-67 (WS) (r=0.91, p<0.05) and MCM-2 (TMA) vs. MCM-2 (WS) (r=0.87, p<0.05). Mann Whitney U-test showed no significant differences between the two markers in both analysed techniques. Moreover, the Bland-Altman plot demonstrated a low level of bias between the analysed methods.

CONCLUSION

This study shows that TMA could have a great potential in evaluation of proliferative activity in IDC and that MCM-2 protein might be a specific and sensitive marker of cell proliferation.

Correlation of intensity of MT-I/II expression with Ki-67 and MCM-2 proteins in invasive ductal breast carcinoma

The purpose of the study was to evaluate the clinical significance of the intensity of metallothionein (MT-I/II) expression and its relationship to two different proliferation markers, Ki-67 antigen and minichromosome maintaince 2 protein (MCM-2) in 117 patients with invasive ductal breast carcinoma (IDC). A significantly higher MT-I/II expression was noted in the grade 3 (G3) carcinomas as compared to those of G1 and G2. A positive correlation was observed between the MT-I/II expression and both proliferation markers, Ki-67 (r=0.20, p=0.0343) and MCM-2 (r=0.25, p=0.0065). Also a strong positive correlation was noted between Ki-67 and MCM-2 expression (r=0.52, p<0.0001). No significant correlations were found between the analyzed markers and tumour size, lymph node metastasis, oestrogen expression (ER), progesterone receptor (PR) or human epidermal growth-factor receptor (HER-2) expression. Out of the three studied markers only the high expression of Ki-67 exhibited a negative impact on patient overall and event free survival and was an independent prognostic factor. MT-I/II and MCM-2 protein expression was not correlated with poor patient outcome, although MCM-2 expression correlated (Fisher's exact test) positively with grade of malignancy (p=0.0018) and negatively with ER (p=0.0002) and PR (p=0.0056) expression. To conclude, MT-I/II may play a key role in IDC proliferation, but is not a useful prognostic factor of this disease.

Comparison of metallothionein (MT) and Ki-67 antigen expression in benign and malignant thyroid tumours

Thyroid carcinomas are the most frequently occurring tumours in the endocrine system. Metallothioneins (MT) and Ki-67 proteins are present in intensely proliferating cells, and their expression has been observed in numerous tumours, including thyroid tumours. The purpose of this study was to analyse the relationship between intensity of MT expression and Ki-67 antigen on one hand and histological features of the examined thyroid tumours on the other. The investigated material included 186 archival paraffin blocks with samples of various thyroid tissues, obtained from the Chair and Department of Pathomorphology, Medical University of Wroclaw. In paraffin sections, immunohistochemical reactions were performed with the use of monoclonal anti-MT (I/II) and anti-Ki-67 antibodies. Intensity of MT and Ki-67 antigen expression was evaluated using a light microscope using the semi-quantitative method of Remmele. A significant difference in MT expression was noted between different tumours of the thyroid: the highest expression was detected in follicular carcinoma and the lowest was detected in medullary carcinoma. Expression of MT was also significantly elevated in follicular carcinoma as compared to follicular adenoma. On the other hand, no significant differences were seen between expression of Ki-67 antigen in follicular adenoma and follicular carcinoma. Moreover, these investigations detected no correlation between the expression of MT and Ki-67 antigen in follicular adenoma and follicular carcinoma. In view of the obtained results, the expression of MT can be considered as a potential marker of differentiation between the two types of thyroid tumours, which are otherwise difficult to differentiate.