Histopathological Analysis in Testicular Tumors: 10 Years of Experience

Introduction. This study aims to review the morphological and immunohistochemical features of testicular tumors and compare them with prognostic parameters. Methods. Testicular tumors diagnosed between January 2011 and September 2021 were reviewed. Patient age, tumor subtype, size, spread, lateralization, number of foci, and immunohistochemical results were recorded. Results. A total of 121 tumors were detected, of which 108 (89%) were germ cell tumors (GCTs). Of the germ cell tumors, 70 (65%) were found to be pure type, and 38 (35%) were mixed germ cell tumors. The ratio of pure seminoma among GCTs was 56/108 (52%). Lymphatic/vascular invasion (LVI) was detected in 48/121 (40%), rete testis invasion in 32/121 (26%), hilar soft tissue invasion in 10/121 (8%), epididymal invasion in 5/121 (4%), and spermatic cord invasion in 5/121 (4%) patients. Lymphatic/vascular invasion was observed in 6 (22%) of 27 germ cell tumors smaller than 3 cm in size, and rete testis invasion was observed in 2 (7%), while in 40 (55%) of the 73 germ cell tumors of 3 cm and above, lymphatic/vascular invasion was seen, and 26 (36%) of them had rete testis invasion. Immunohistochemical results contributed significantly to the determination of tumor components and rates, especially in mixed germ cell tumors. Conclusion. Most of the tumors were germ cell tumors, and the majority were seminomas. Lymphatic/vascular invasion and rete testis invasion rates increase as the tumor diameter increases, which is more evident when the 3 cm cut-off value is taken into account (P < 0.005).

Expression of endocan and vascular endothelial growth factor and their correlation with histopathological prognostic parameters in pheochromocytoma

OBJECTIVE

Endocan and vascular endothelial growth factor (VEGF) are markers expressed in various cancer types that are highly vascular, and they have prognostic significance for these cancers. In this study, we aimed to show the expression of endocan and VEGF in pheochromocytoma tumor tissues and to evaluate their correlations with histopathological parameters.

MATERIAL AND METHODS

Thirty-eight patients who had been operated for pheochromocytoma were included in the study. As the control group, 28 subjects whose specimens contained normal adrenal medulla tissue were included. The formalin-fixed paraffin-embedded specimens of pheochromocytoma patients were evaluated for Pheochromocytoma of the Adrenal gland Scaled Score (PASS). Sections were then stained for immunohistochemical analysis. The degree of endocan and VEGF positivity was determined by the proportion of stained cells on a negative to strong scale.

RESULTS

Endocan (p < 0.001) and VEGF (p = 0.004) expressions were found to be significantly higher in the pheochromocytoma group than in the control group. In the pheochromocytoma group, total PASS score (r = 0.714; p < 0.001) and most of the PASS score components were positively correlated with the level of endocan expression. Median Ki-67 index (p = 0.010), total PASS score (p < 0.001), tumor cell spindling (p = 0.048), and nuclear pleomorphism (p = 0.030) were higher in pheochromocytoma with VEGF expression than in those without.

CONCLUSION

If our findings are supported by studies with a larger sample size, we think that endocan has the potential to be used both as a tumor marker and in predicting malignancy potential in patients with pheochromocytoma, and that the detection of VEGF expression in these tumors is also associated with an increase in malignancy potential.

Comparison of the effects of alpha lipoic acid and dexpanthenol in an experimental tracheal reconstruction animal model

OBJECTIVES

To investigate the positive effects of intraperitoneal administration of alpha-lipolic acid (ALA) and dexpanthenol (DXP) on wound healing after tracheal surgery in rats.

METHODS

The study was carried out at Necmettin Erbakan University, Konya, Turkey, from January 2014-2019. A total of 30 healthy and adult Sprague-Dawley type female rats were included in the study. For the experiment, rats were randomly divided into 3 groups: ALA group (n=10), DXP group (n=10), and control group (n=10). After trachea surgery, 100 mg/kg/day ALA was given to group ALA and 100 mg/kg/day intraperitoneal DXP to group DXP for 15 days, and the rats were sacrificed on the 21st day. The excised tracheal sections were evaluated and graded for inflammatory cell infiltration, angiogenesis, fibroblast proliferation, collagen deposition, and epithelial regeneration to evaluate wound healing.

RESULTS

Inflammation was found to be less in both the ALA and DXP groups. With the Mann-Whitney test, it was determined that inflammation was less in the ALA group than in the DXP group (C-D [p=0.097] and C-A [p=0.024]). On the other hand, no statistically significant difference was found in epithelial regeneration (p=0.574; >0.05), angiogenesis (p=0.174; >0.05), fibroblast proliferation, and collagen deposition (p=0.102; >0.05).

CONCLUSION

Alpha-lipolic acid injected intravenously after tracheal reconstruction in patients can prevent restenosis by reducing inflammation without adversely affecting wound healing.

Expression of the angiogenesis markers endocan in Cushing's syndrome due to cortisol producing adenoma

PURPOSE

In this study, we aimed to investigate the endocan expression in tissue samples of patients diagnosed with Cushing's syndrome (CS) due to Cortisol-Producing-Adenoma (CPA) and compare it with normal adrenal cortex tissue, and also to evaluate the correlations of endocan expression with clinical and histopathological features.

METHODS

11 patients who were operated for CS due to CPA between 2009-2021 and 14 control subjects with normal adrenal cortex were included in the study. Demographic, laboratory and clinicopathological data of the patients were recorded. Sections of 4-5 µm thickness were taken from paraffin blocks of patients diagnosed with CS due to CPA and control subjects with normal adrenal cortex tissue. The sections were then stained in a closed system automatic immunohistochemical staining device to perform immunohistochemical analysis. The endocan positive grade were determined based on the proportion of stained cells on a scale of negative to strong.

RESULTS

The number of subjects with positive endocan expression and the mean endocan expression level in the CS group were significantly higher than the control group (p = 0.005, p < 0.001, respectively). No correlation was found between endocan expression and clinical and histopathological features.

CONCLUSION

According to the results of our study, endocan overexpression in CPA tissues may be related to the hormonal functionality of CPA.

Could immune cells be associated with nephropathy in Fabry disease patients?

BACKGROUND

In Fabry Disease (FD), although the primary factor initiating kidney damage is glycosphingolipid accumulation, secondary conditions such as increased inflammation and fibrosis may cause this damage to progress. These processes may be induced by immune cells. Therefore, we aimed to investigate the peripheral lymphocyte subgroup analysis of the patients with FD and compare these results with healthy individuals. In addition, we performed T, B, NK, and plasma cell analyses in kidney biopsy materials and compared these kidney biopsy results with the biopsy results of patients whose kidney functions were impaired after 4 years of regular ERT.

MATERIALS AND METHODS

18 FD and 16 healthy individuals were included in the study. T-B lymphocyte and NK-cell populations were determined. We performed kidney biopsies (KBx) on 13 patients with FD prior to ERT. Of these, 4 patients had rebiopsy after 4 years of regular ERT. Immunohistochemical staining was performed to define immune cell infiltration.

RESULTS

There was no statistically significant difference in terms of total, helper and cytotoxic T-lymphocyte and CD3^-CD16⁺CD56⁺ natural killer (NK)-cell count (p = 0.20; p = 0.12; p = 0.76; p = 0.75, respectively).According to KBx findings prior to ERT, all patients had interstitial fibrosis (IF), podocyte vacuoles (PV), and podocyte inclusion (PI), CD3, CD4, CD8, CD16, and CD56 positivity at different levels. None of the patients had CD19, CD20, and CD138 positivity at the first biopsies. When we compared the first and the second KBx results of the two progressors, we also demonstrated that CD3⁺4⁺T-cells infiltration remained the same, whereas CD8⁺T cells, CD16⁺ and 56⁺NK-cells infiltration were significantly decreased. In contrast, CD20⁺B cells and CD138⁺plasma cell infiltration were significantly increased despite 4 years of ERT (15 fold and sixfold, respectively). The CD20⁺B and CD138⁺ plasma cells and IF were positively correlated with proteinuria.

CONCLUSIONS

The progression of FD nephropathy and proteinuria is increased despite a long-term ERT. Immune cells, primarily B and plasma cells, might cause these unwanted consequences.

Prevalence of sicca symptoms and Sjögren's syndrome in coeliac patients and healthy controls

Objective: There has been no previous study comparing the frequency of sicca symptoms and Sjögren's syndrome (SS) in coeliac patients (CPs) and healthy controls (HCs) using a tight screening method. The aim of this study was to compare the frequency of sicca symptoms and SS in HCs and CPs.Method: The study included 80 CPs and 100 HCs. This study was designed as a case-control study with four phases. The frequency of SS in CPs and HCs was defined according to the 2002 American-European Consensus Group (AECG) and 2012 American College of Rheumatology (ACR) classification criteria. The frequency of sicca symptoms and SS was compared between CPs and HCs.Results: Ocular and oral symptoms occurred in 22% and 26% of CPs, respectively, compared to 13% and 10% of HCs, respectively. Proportions with oral symptoms were statistically significantly different between CPs and HCs (p = 0.005), whereas there was no significant difference for ocular symptoms (p = 0.113). According to ACR and AECG criteria, the prevalence of SS was 3.8% and 5.0% in CPs and 3.0% and 2.0% in HCs, respectively.Conclusion: Although oral symptoms were more frequent in CPs than in HCs, the frequency of SS was not different between the groups. The increased frequency of oral symptoms may be related to reasons other than autoimmunity.

Effect of sumac extract on serum oxidative status, RANKL/OPG system and alveolar bone loss in experimental periodontitis in rats

Objectives

Sumac (Rhus coriaria L.) is widely used spice which has several properties such as antioxidant, anti-inflammatory and antimicrobial. The purpose of this animal study was to evaluate the effects of sumac extract on levels of receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) expression, serum oxidative status, and alveolar bone loss in experimental periodontitis.

Material and Methods

Twenty-four Wistar rats were separated into three groups: non-ligated (NL, n=8), ligature only (LO, n=8), and ligature and treated with sumac extract (S, n=8) (20 mg/kg per day for 11 days). A 4/0 silk suture was placed around the mandibular right first molars subgingivally; after 11 days, the rats were sacrificed, and alveolar bone loss was histometrically measured. The detection of RANKL and OPG were immunohistochemically performed. Levels of serum total antioxidant status (TAS)/total oxidant status (TOS), and oxidative stress index (OSI) were also analyzed.

Results

Alveolar bone loss was significantly greater in the LO group compared to the S and NL groups (p<0.05). The number of inflammatory cell infiltrate (ICI) and osteoclasts in the LO group was significantly higher than that of the NL and S groups (p<0.05). The number of osteoblasts in the LO and S groups was significantly higher than that of the NL group (p<0.05). There were significantly more RANKL-positive cells in the LO group than in the S and NL groups (p<0.05). OPG-positive cells were higher in S group than in LO and NL groups (p<0.05). TOS and OSI levels were significantly reduced in S group compared to LO group (P<0.05) and TAS levels were similar in S and NL group (p>0.05).

Conclusions

The present study showed that systemic administration of sumac extract may reduce alveolar bone loss by affecting RANKL/OPG balance, TOS and OSI levels in periodontal disease in rats.

The Effectiveness of Crataegus orientalis M Bieber. (Hawthorn) Extract Administration in Preventing Alveolar Bone Loss in Rats with Experimental Periodontitis

The purpose of this animal study was to evaluate the effects of hawthorn (Crataeus orientalis M Bieber.) extract on serum oxidative status and alveolar bone loss in experimental periodontitis. Twenty-seven Wistar rats were assigned to one of the following groups: non- ligated+placebo (saline) (NL, n = 9), ligature only+placebo (saline) (LO, n = 9), and ligature and treated with hawthorn extract in saline (H, n = 9) (100 mg/kg orogastrically, once a day for 11 days). Periodontitis was induced by submerging a 4/0 silk ligature in the sulcus of the mandibular right first molars of rats, and the animals were sacrificed after 11 days. Micro-CT examinations were performed for linear and volumetric parameter assessment of alveolar bone. Periodontal tissues were histopathologically examined to assess the differences among the study groups. Levels of serum total antioxidant status (TAS)/total oxidant status (TOS), and oxidative stress index (OSI) were also analyzed. Alveolar bone loss was significantly reduced by hawthorn administration compared to LO group (p<0.05). The number of inflammatory cells and osteoclasts in the LO group was significantly higher than that of the NL and H groups (p< 0.05). The number of osteoblasts in the LO and H groups was significantly higher than that of the NL group (p<0.05). TOS and OSI levels were significantly reduced in H group compared to LO group (P <0.05) and TAS levels were similar in H and NL group (p< 0.05). Hawthorn extract showed inhibitory effect on periodontal inflammation and alveolar bone loss by regulating TAS, TOS and OSI levels in periodontal disease in rats when administered systemically.

Relationship of preoperative neutrophil lymphocyte ratio with prognosis in gastrointestinal stromal tumors

OBJECTIVE

Gastrointestinal stromal tumors are believed to play a role in immunosuppression with their local effect. In some cancers with associated inflammation, an increased pretreatment neutrophil lymphocyte ratio is considered as an indicator of poor prognosis. The aim of our study was to assess the relationship of increased blood neutrophil lymphocyte ratio with disease prognosis in patients with gastrointestinal stromal tumors.

MATERIAL AND METHODS

The data of 78 patients who underwent surgery with the diagnosis of primary gastrointestinal stromal tumor in our clinic were evaluated retrospectively. The preoperative neutrophil lymphocyte ratio in the peripheral blood was determined. The neutrophil lymphocyte ratio and its relationship with tumor risk and prognosis were compared. The data were evaluated by Pearson's correlation analysis and the Welch ANOVA test.

RESULTS

The preoperative neutrophil lymphocyte ratio was significantly increased in the high-risk groups (p<0.05). An increased preoperative neutrophil lymphocyte ratio was associated with shorter survival (r=-0.32, p=0.009). In addition, an increase in the neutrophil lymphocyte ratio was associated with an increase in the mitotic activity of the tumor (r=-0.364, p=0.025).

CONCLUSION

The preoperative neutrophil lymphocyte ratio in gastrointestinal stromal tumors can be used as an indicator of high-risk tumors and poor prognosis.

Chemoprotective effect of vitamin E in cyclophosphamide-induced hepatotoxicity in rats

Cyclophosphamide (CP) has a range of adverse effects on liver tissue in humans and animals. Administering an antioxidant with CP might reduce such side effects. Therefore, we examined the role of vitamin E in CP-induced liver toxicity in rats. Male Wistar albino rats were divided into four groups, each of seven rats: control, CP only, CP + vitamin E, and vitamin E only groups. The rats were administered treatments intraperitoneally for 7 days. Then the serum malondialdehyde (MDA), alanine aminotransferase (ALT), aspartate transaminase (AST), and lactate dehydrogenase (LDH) levels were determined while the livers were removed, tissue was prepared using routine histological procedures, sections were stained using hematoxylin and eosin, and the terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL) method was applied. Histopathologically, CP caused hydropic degeneration, necrosis, pleomorphism, and mitotic activity. The number of TUNEL-positive cells and the MDA and ALT levels were significantly higher in the CP group. The antioxidant effects of vitamin E significantly decreased the number of TUNEL-positive cells and the ALT and MDA levels, and normalized the liver histopathology. CP induces apoptosis, has toxic effects on liver tissue, and changes the histological structure. The administration of vitamin E prevented the liver tissue damage caused by CP.

Boric acid inhibits alveolar bone loss in rats by affecting RANKL and osteoprotegerin expression

BACKGROUND AND OBJECTIVE

The goal of the present study was to evaluate the effects of systemic boric acid on the levels of expression of RANKL and osteoprotegerin (OPG) and on histopathologic and histometric changes in a rat periodontitis model.

MATERIAL AND METHODS

Twenty-four Wistar rats were divided into three groups of eight animals each: nonligated (NL); ligature only (LO); and ligature plus treatment with boric acid (BA) (3 mg/kg per day for 11 d). A 4/0 silk suture was placed in a subgingival position around the mandibular right first molars; after 11 d the rats were killed, and alveolar bone loss in the first molars was histometrically determined. Periodontal tissues were examined histopathologically to assess the differences among the study groups. RANKL and OPG were detected immunohistochemically.

RESULTS

Alveolar bone loss was significantly higher in the LO group than in the BA and NL groups (p < 0.05). The number of inflammatory infiltrate and osteoclasts in the LO group was significantly higher than that in the NL and BA groups (p < 0.05). The numbers of osteoblasts in LO and BA groups were significantly higher compared with NL group (p < 0.05). There were significantly more RANKL-positive cells in the LO group than in the BA and NL groups (p < 0.05). There was a higher number of OPG-positive cells in the BA group than in the LO and NL groups (p < 0.05).

CONCLUSION

The present study shows that systemic administration of boric acid may reduce alveolar bone loss by affecting the RANKL/OPG balance in periodontal disease in rats.

Evaluation of TGF beta1 expression and comparison the thickness of different aorta layers in experimental diabetes

BACKGROUND

It was aimed to investigate the effects of experimental diabetes on TGF beta1 expression and tunica intima and media thickness in abdominal and thoracic aorta.

METHODS

Fourteen three months old female rats were divided into two groups, non-diabetic and streptozotocin (STZ) induced diabetic group. Hematoxylin-Eosin and Verhoeff's Van Gieson elastic staining and TGF beta1 immunohistochemistry staining were performed. Abdominal and thoracic intima and media thickness of aortas were measured with the oculometer.

RESULTS

Evaluation of intima and media thickness measurements showed no significant statistical differences between non-diabetic and diabetic groups. TGF beta1 expression increased significantly in thoracic diabetic (TD) group.

CONCLUSION

The 60 day duration of diabetes is not sufficiently enough time for the development of pathological changes that could lead to thickening in aortic intima-media layers. TGF beta1 expression was negative in the abdominal aorta that can predispose to the development of atherosclerosis, which could develop overtime. This finding may be interpreted as an appropriate basis for the development of atherosclerosis. In the thoracic aorta TGF beta1 may coordinate cellular events such as tissue repair (Fig. 5, Ref. 23).

Vasoprotection by melatonin and quercetin in rats treated with cisplatin

Cisplatin-based chemotherapy has a variety of vascular side effects. The aim of the present study was to evaluate the beneficial effect of melatonin and cisplatin on the alterations in vascular reactivity and structure of cisplatin-treated rats. Phenylephrine (PHE) and KCl-caused concentration-dependent contractions of rat aorta. Pretreatment with cisplatin increased the sensitivity but not the max response to PHE and KCl. In rats treated with melatonin or quercetin before cisplatin, the EC50 values, but not the maximal response to both agents were significantly higher than cisplatin-treated group. Compared to the control group, cisplatin-treatment significantly reduced the luminal area of the aorta. In melatonin and quercetin-treated aortas the luminal area values were significantly higher than cisplatin-treated group. The results demonstrate for the first time that melatonin and quercetin treatment may protect the aorta in cisplatin-based chemotherapy.