Expression of CD34 in gastric cancer and its correlation with histology, stage, proliferation activity, p53 expression and apoptotic index

The formation of new blood vessels is essential for tumor growth and progression. Until today there are only few studies of the immunohistochemical assessment of angiogenesis in gastric cancer by the evaluation of the expression of CD34 antigen. The aim of this study was to analyze the relationship between microvessel density (MVD) expressed as the mean count of CD34 immunostained vessels and clinicopathologic features of gastric tumors (the histological type according to the Lauren classification, tumor grade G; presence of lymph node metastases N; depth of tumor invasion; stage of disease (UICC-AJCC 1988 1992), p53 expression, tumor cell proliferative activity described as the Ki67 labelling index and apoptotic index of tumor cells TUNEL method). We assessed formalin-fixed, paraffin-embedded tissue samples obtained during potentially radical gastrectomy from 58 patients with primary gastric adenocarcinoma. The representative tissue blocks from each tumor were used for the immunohistochemical assay and examined by two pathologists independently. MVD was counted in five tumor areas of the most intensive neovascularization (x 200 field by light microscopy) and the mean counts were recorded. The mean MVD (CD34 expression value+/-SD) in this study was 43,15+/-19,8 per x 200 field. The study demonstrated the statistically significant correlation between MVD and two main histological parameters: tumor grading (p < 0.001) and tumor histological type according to Lauren s classification (p<0.05). In well and moderately differentiated tumors (G1/2) MVD was significantly lower in comparison to the group of poorly differentiated cancer G3 (mean value: 31,62 vs. 49,89). MVD was higher in diffuse type of gastric cancer comparing to intestinal type (50.05+/-19,03 vs. 39.17+/-20,09). However, the authors failed to find a significant correlation between MVD and other investigated histopathological features in malignant gastric tumors. The close relationship between CD34 immunostaining, gastric cancer tumor vascularity and main histological parameters was shown in this study. It can be stated that analysis of expression of angiogenesis in gastric cancer may be helpful for better estimation of hematogenous recurrence and the selection of the group of patients for adjuvant antiangiogenic treatment.

Primary cutaneous marginal zone B-cell lymphoma in a patient with chronic lymphocytic leukaemia

Primary cutaneous marginal zone B-cell lymphoma (PCMZL) is a low-grade malignant lymphoma that presents in the skin with no evidence of extracutaneous localization at diagnosis. We present an 80-year-old woman with B-cell chronic lymphocytic leukaemia (CLL) who developed multifocal PCMZL lesions 14 months after CLL diagnosis. PCMZL was clonally similar to the original bone marrow (BM) CLL cells. The specific translocation t(14;18) (q32;q21) with breakpoints in IGH and BCL2 loci was found in a skin specimen, but was absent in BM and peripheral blood (PB) cells. In contrast, a 13q deletion was found in BM and PB CLL cells. The patient was treated with chlorambucil and complete response of PCMZL was achieved. To our knowledge this is the first patient with CLL in whom PCMZL has been diagnosed.

Cytogenetic changes in two cases of subependymal giant-cell astrocytoma

Cytogenetic analysis of subependymal giant-cell astrocytomas (SEGAs) from two patients presenting the clinical symptoms of tuberous sclerosis complex (TSC) revealed clonal chromosomal changes, resulting in the partial loss of chromosome 22q in both tumors. Immunohistochemically, tumors exhibited features of glial differentiation, while ultrastructural studies identified the characteristic paracrystalline inclusions within the tumor cells. To our knowledge, it is the first cytogenetic description of SEGAs associated with TSC.

Is the ABCB1 gene associated with the increased risk of gastric cancer development?--preliminary research

One of the most common malignant diseases, both worldwide and in Poland, is gastric cancer. The pathogenesis of gastric cancer development is not entirely clear. Next to the environmental risk factors, such as Helicobacter pylori infection or dietary habits, the host genetic factors as predispositions to gastric cancer development are discussed. A transmembrane protein that could be associated with predisposition to cancer development is P-glycoprotein (P-gp). Physiologically, P-gp is present in normal tissue of the gastrointestinal tract, where it plays a protective role by transporting xenobiotics from a cell into extracellular environment. P-gp is encoded by the highly polymorphic ABCB1 gene. The most frequent polymorphisms at positions 1236, 2677, and 3435 may affect both the function and amount of protein, thereby leading to a loss of its physiological function, which could increase the predisposition to development of many diseases, including cancer. In this study, the potential significance of the ABCB1 gene in the development and progression of gastric cancer was evaluated. In 19 tissue samples collected from patients with gastric cancer, the ABCB1 gene polymorphisms were identified at positions 1236 and 2677 by automated sequencing and SNP 3435 by the RFLP method. The relative level of ABCB1 expression was measured in 10 samples of gastric cancer and morphologically normal tissues by real-time PCR. For SNPs at positions 1236, 2677, and 3435, no statistically significant differences in genotype frequencies between gastric cancer patients and healthy individuals were found. However, genotype TT for all studied polymorphisms occurred more frequently in the group of gastric cancer patients (31.6, 26.3, 42.1%, respectively) than in the group of healthy individuals (14.6, 13.5, 21.9%, respectively). The lowest relative expression levels of ABCB1 mRNA were observed for genotypes CC of SNP 1236, CC of SNP 3435, and GG of SNP 2677 (median: 0.215, 0.160, 0.160, respectively). There was a tendency that mutant homozygote TT for SNPs at positions 1236, 2677, and 3435 occurred more frequently in the subgroup of patients with Tis or stage I of TNM classification (SNP 1236 p = 0.0760; SNP 2677 p = 0.0813; SNP 3435 p = 0.0760) than in the subgroup of patients with stage II or III. Also the expression levels were lowest (median 0.740) in the group of patients with the less advanced clinical stage of cancer (Tis or I). Preliminary research showed that the ABCB1 gene polymorphisms at positions 1236, 2677, and 3435 were not related to an increased susceptibility of gastric cancer development. However, they may be associated with the inhibition of gastric cancer progression.

The activity of thymidine phosphorylase correlates with tumor size and lymph nodes status in breast carcinoma

The platelet-derived endothelial cell growth factor (PD-ECGF) is one of the potent angiogenic factors. Recently, its homology with thymidine phosphorylase (dThdPase), an enzyme involved in pyrimidine nucleoside metabolism, has been shown. In the present study, dThdPase activity was evaluated spectrophotometrically in 43 breast carcinomas and in 19 cases of non-neoplastic breast tissues. The mean dThdPase activity in breast cancer was almost six fold higher than in normal, non-neoplastic breast tissues (1.92 and 0.29 mumol thymine (T) x mg prot.-1 x h-1 respectively). The enzyme activity significantly correlated with axillary lymph node status (p = 0.0076) and with tumor size (p = 0.0099). Besides, the intratumoral microvessel density (MD) was evaluated using the CD 31 mouse anti-human monoclonal antibody, and there was no correlation between the level of enzymatic activity and a number of microvessels. The positive significant correlation of thymidine phosphorylase activity with prognostic factors in breast cancer patients with no relation to the number of microvessels needs further examination to confirm the prognostic significance of the level of dThdPase.

Expression of the latent membrane protein of Epstein-Barr virus in Hodgkin's disease. Age and subtype distribution in Polish patients

We examined immunohistochemically 135 cases of HD (4, lymphocytic predominance (LP); 34, mixed cellularity (MC); 90, nodular sclerosis (NS) and 7, lymphocytic depletion (LD) for the presence of EBV latent membrane protein (LMP). Ten patients were younger than 14 years, 55 were young adults (15-34 years), 45 were 35-49-years old and 26 were older than 50 years. The average LMP-immunopositivity was 33% of all HD cases. The highest proportion of LMP-immunopositivity was found in the MC subtype (61.8%), followed by the NS (NS 1-25%, NS 2-26%) and the LD subtype (14%), but none in the LP subtype of HD. The differences between LMP-immunopositivity in the MC and NS subtypes were statistically significant in children and young adults (p < 0,01). The LMP-positivity was mainly associated with the MC subtype which occurred predominantly in children, while the lowest proportion of LMP-positive cases was found in the young adult group. This report supports a notion that there are regularities in age and subtype distribution of EBV in HD.

Expression of the P65 gene in gastric cancer and in tissues with or without Helicobacter pylori infection

A 65-kDa tumor-associated protein (P65) is a potential non- specific tumor marker expressed by many types of tumor cells. Our recent studies indicate that P65 gene expression is connected with poor prognosis for the patients with colorectal cancer. In the present study P65 gene expression was determined by means of RT-PCR in the group of 22 gastric cancer and adjacent normal gastric mucosa. Its presence was correlated with some parameters of clinical staging. P65 gene expression was also determined in 102 tissue antral gastric endoscopic biopsy specimens from the patients suspected of H. pylori infection. The presence of H. pylori infection was determined by urease test. We found that in the group of gastric cancers, similarly to colorectal cancer, P65 gene expression was connected with poor clinicopathological parameters as T3, lymph nodes and distant metastases. There was no dependence between P65 gene expression and H. pylori infection. However, more often P65 gene expression was detected in the group of infected men than women. There was also a statistically significant dependence between age and P65 gene expression in the group of people above 60 years old. It could be then postulated that P65 gene expression is connected with poor prognosis for the patients suffering from gastric cancer and that this expression does not depend on H. pylori infection.

Neuronal loss and apoptosis in experimental Creutzfeldt-Jakob disease in mice

One of the hallmarks of prion disease--neuronal cell loss, may be accomplished by apoptosis. The aim of this study was to estimate the neuronal cell loss in mice brains with experimental Creutzfeldt-Jakob disease (CJD) and control mice in the comparison with the apoptosis appeared by in situ end labelling (TUNEL) in function of time of post-incubation period and developing of the spongiform changes. The number of neurons was considerably lower in terminally sick animals (20-21 week of incubation period) than in control mice. The mean value of loss of neuronal cell was 32%. The greatest loss (55%) of neurons was noted in the septal nuclei of the paraterminal body and the least lost (16%) in the hypothalamus. We report here, that apoptotic cells are readily detectable in CJD-affected mice brains in time-dependt manner after infection of Fujisaki strain, but the number of apoptotic cells detected by in situ end labelling does not well correlate with the extensiveness of neuronal loss. The degree of apoptosis corresponds to the well developed spongiform changes.

The infrequent simultaneous genetic alterations in glioblastoma multiforme (LOH 10, 17, 19q, TP53 mutation and EGFR amplification) with short clinical course

We described the case of an unusual, complex genetic alteration in 57 year-old male patient with glioblastoma multiforme (GBM) with short survival (6 and half months). Alterations consisted of p53 mutation, LOH 10, LOH 17, LOH 19q and EGFR amplification. LOH1p, LOH 9 and LOH 13 were negative. Immunohistochemical study did not correlate with molecular results. The overexpression of TP53 protein and RB protein was detected only in small percentage of cells and interestingly the overexpression of EGFR was present only focally. Immnunostainings for PTEN, P16, PI3-K were negative. Additionally, we observed an overexpression of IGFB2 protein. This case indicates the accumulation of molecular changes in glioblastoma multiforme in patient with short survival.

The ultrastructural study of primary intracranial germ cell tumours

We describe here ultrastructural and clinicopathological features of five primary intracranial germinomas. By electron microscopy, two major tumour components were defined as large, well differentiated tumour cells and non-neoplastic cells such as macrophages, astrocytes and lymphocytes. Nuclei of the tumour cells often presented irregularly contoured nuclear membranes with oval indentations and, occasionally, cytoplasmic invagination. Some of them constituted unusual conformational changes of nuclear membranes rarely described as intranuclear pockets. Desmosome-like intercellular junctions were observed in several neoplastic cells. Nucleoli were composed of a loose, fragmented nucleolonema whereas elongated, anastomosing and rope-like nucleolonemas, described previously as characteristic for germinomas were not seen. Typically, the cytoplasm contained glycogen particles. Most tumour cells had villous cytoplasmic projections sometimes intermingled with similar projections of macrophages. Scattered astrocytes typically containing abundant glial filaments were adjacent to primary tumour cells.

Clinicopathological analysis of pilocytic astrocytomas and gangliogliomas in children

We present here a clinico-pathological analysis of 58 pilocytic astrocytomas (PA) and 11 gangliogliomas (GG) based on an analysis of neuronal markers (GFAP, SYN, NFP) in these two groups of neoplasms. During the retrospective review of 58 cases recognized primarily as PA, 11 verified neoplasms demonstrated strong reaction for SYN or NFP or for both antibodies. These cases were reclassified as gangliogliomas. None of 11 tumors recognized as GG were further reclassified as PA. The overall 5-year survival was 88.89% in PA and 70.00% in GG group.

Extent of spontaneous apoptosis in gastric cancer: relation to proliferative index, p53 expression, CD 34 expression and histopathological features

Gastric cancer, characterized by poor prognosis, remains a global health problem. Thus, it is important to describe the biological factors which can affect the prognosis in this disorder. The aim of our study was the determination of the relationship between apoptotic index (AI) and other clinicopathological features (Ki67 labeling index = Ki-67 LI, neovascularity defined as CD-34 immunoreactivity - intratumoral microvessel density = IMVD, p53 immunopositivity, grade of malignancy, histological type, depth of tumour invasion, lymph node status) in 49 cases of gastric carcinoma. Recognition of apoptotic cells was performed applying the terminal deoxynucleotydil transferase mediated dUTP-digoxigenin nick end labeling technique (TUNEL). Among the tumours, 30 were intestinal type and 19 were diffuse type, including 17 cases of well and moderately differentiated tumours (G1 and G2) and 32 poorly differentiated tumours (G3). Apoptotic index was determined in all the examined tumours, and the mean value of AI was 5.8% +/- 4.7%. We found a significant relationship between AI, grade of malignancy and Ki-67 LI. Significantly higher AI -8.1% +/- 5.7% was observed in G1-G2 tumours in comparison to 4.7 +/- 3.8% (p<0.05) in G3 tumours. In tumours with high proliferative potential (above mean value of Ki-67 LI -29.77% +/- 24.9%) we observed higher apoptotic index, mean value 7.9% +/- 5.7%, and in tumours with low proliferation (Ki-67 LI below 29%) mean AI was 4.4% +/- 3.7% (p<0.05). The p53 positive immunoreactivity was found in 30 out of 49 cases (mean AI = 6.75% +/- 4.8%). No apparent correlation between AI, histopathological type of gastric cancer, lymph node status and p-53 and CD-34 immunoreactivity was found.

Apoptosis in relation to neuronal loss in experimental Creutzfeldt-Jakob disease in mice

Apoptosis constitutes a genetically determined process to eliminate superfluous or damaged cells in tissues. Deficiencies in apoptosis regulation are involved in different pathologies including prion diseases. Some experimental studies show that neuronal loss--one of the hallmarks of prion diseases may be accomplished by apoptosis. We evaluated twenty five mice infected experimentally with the Fujisaki strains of CJD and sacrified sequentially in one week intervals. Apoptotic cells in various brain regions were detected by in situ end labelling (TUNEL) and electron microscopy in comparison with neuronal cell loss. The number of labelled cells per brain was very low--from a few labelled cells 6 weeks after inoculation to a maximum of 14 in the terminal stage. The number of neurones counted in 8 selected areas were considerably lower in terminally sick animals (20 and 21 week of incubation period) than in control mice. The mean value of loss of neuronal cells was 32%. The greatest loss (55%) of neurones was noted in the septal nuclei of the paraterminal body and the least lost (16%) in the hypothalamus. Compared to the extensive neuronal loss (30-50%), the number of apoptotic cells detected by in situ end labelling seems to be very low, and the process of neuronal death become more intensive during the progression of the disease.

Metaplastic meningioma with lipomatous changes

We report here relatively rare lipomatous metaplastic changes, probably related to a prolonged clinical course, in not otherwise specified transitional meningioma. This lesion appears to have evolved over 30 years, with the initial diagnosis of multiple sclerosis. Histologically, it was composed of clusters and whorls of polygonal and spindle cells characteristic for transitional meningioma, with large areas of cells with lipid cytoplasmic accumulation, closely resembling mature adipocytes. The lipidization of other brain tumors and the histogenesis of these lesions in meningiomas on the background of meningeal embryogenesis are also discussed.

p65 and c-erbB2 genes expression in breast tumors: comparison with some histological typing, grading and clinical staging

Using PCR technique we have analyzed p65 and c-erbB2 genes expression in 47 frozen tissue slides taken from patients diagnosed as ductal and lobular breast cancer, classified as G3, and in a limited panel of proliferative breast disease cases. Expression of p65 was generally connected with small tumor size and with absence of metastases in regional lymph nodes. We have found interdependence between p65 gene expression and negative states of lymph nodes. On the contrary, c-erbB2 expression was observed in patients with large tumors and with metastases to the regional lymph nodes. Between both genes (p65 and c-erbB2) opposite interdependence was found. No statistical dependence between estrogen/progesterone receptor levels and p65 or c-erbB2 expression were noticed. The presence of p65 expression appeared in the group of proliferating breast disease cases which were connected with higher risk of breast cancer. Lack of p65 expression accompanied cases which were classified as fibroadenoma.

Krabbe disease: an ultrastructural study of globoid cells and reactive astrocytes at the brain and optic nerves

We report here a detailed ultrastructural study of a brain biopsy along with post-mortem brain and optic nerve specimens from a case of Krabbe disease, a relatively rare leukodystrophy caused by a mutation in the gene for galactocerebrosidase (GALC) mapped to the 14q31 region of chromosome 14. GALC is responsible for lysosomal hydrolysis of several galactolipids including galactosylceramide, a major sphingolipids of the white matter of the central nervous system, galactosylsphingosine (psychosine) and galactosyldigluceride. The main neuropathological features such as accumulation of globoid cells, loss of myelin and marked gliosis were observed in the white matter. The monocytic origin of globoid cells was confirmed by CD-68 and ferritin-positivity and periodic acid Schiff (PAS) positivity. Ultrastructural study of the globoid cells showed the accumulation of tubular crystalloids, which are highly specific for this disease. The differences with Gaucher's disease and the pathomechanism of neuropathological damage are discussed.

Distribution of lymphomas in Poland according to World Health Organization classification: analysis of 11718 cases from National Histopathological Lymphoma Register project - the Polish Lymphoma Research Group study

Most national lymphoma registers rely on broad classifications which include Hodgkin and non-Hodgkin lymphomas (NHL), multiple myeloma and leukaemia. In Poland the National Histopathological Lymphoma Register project (NHLR) was implemented by hematopathologists in accordance with the 2008 WHO classification into haematopoietic and lymphoid tissues. We present the NHLR data and compare lymphoma distribution in Poland, Europe, as well as in North Central and South America. Records of 11718 patients diagnosed in 24 pathology departments from all over the country were retrieved and reclassified into indolent and aggressive lymphomas according to the 2008 revised WHO classification system. DLBCL (32.9%; 2587), CLL/SLL (31.84%; 2504) and MCL (9.04%; 711) were the three most frequent NHL. The ratio of indolent to aggressive NHL was 1.72; 63.25% (4809) to 36.25% (2794) of cases respectively. Multiple myeloma was less frequent as compared to the data from population-based national cancer register (13.32% vs. 28.94%). Major differences between NHLR and European and American data on NHL subtypes concered: higher incidence of aggressive B-cell lymphomas including DLBCL, lower FL and MALT incidence rate. The percentage of unclassified lymphomas in the study was minimal due to participation of hematopathologists.

Ultrastructural study of subependymal giant cell astrocytoma: unusual paracrystalloid inclusions in tumour cells

Subependymal giant cell astrocytoma (SEGA) is a tumour with a broad range of morphological, immunohistochemical and ultrastructural neoplastic cellular features. We report here the presence of this tumor in two 7-year-old-boys presented with a lateral intraventricular mass. Further clinical investigation confirmed the diagnosis of tuberous sclerosis. Ultrastructural and immunohistochemical investigation revealed that glial differentiation was more pronounced in these cases. Interestingly, tumour cells containing unusual paracrystalline inclusions, infrequently described in SEGA, were identified ultrastructurally. These inclusions are probably not related to other cellular organelles.

Programmed cell death (apoptosis) in Alzheimer's disease and Creutzfeldt-Jakob disease

The aim of our study was the estimation of the apoptosis process using in situ-end labelling of DNA breaks method on paraffin sections in 5 human cases of Alzheimer's disease (AD), 6 of Creutzfeldt-Jakob disease (CJD) and in 25 mice infected experimentally with the Fujisaki strain of CJD, killed sequentially at one-week intervals. The numbers of apoptotic cells in CJD-infected mice in the later stages of the disease and in terminally ill mice were progressively higher that at the early stage of the disease. Further, we found a correlation between the intensity of apoptosis and major lesions hallmark of disease--the intensity of spongiform changes in the cerebral cortex but not in the accumulation of PrP in CJD infected mice. The number of A beta-amyloid plaques in AD was not related to apoptotic index. Our study showed that apoptosis is a very important event in these neurodegenerative diseases and may become a basic mechanism in loss of neurons.

The ultrastructural study of primary intracranial germ tumors

We describe here ultrastructural and clinicopathological features of five primary intracranial germinomas. By electron microscopy, two major tumor components were defined as large, well differentiated tumor cells and non-neoplastic cells such as macrophages, astrocytes and lymphocytes. Nuclei of tumor cells were round to oval, often presented irregularly contoured nuclear membranes with oval indentations and, occasionally, cytoplasmic invagination. Some of them constituted unusual conformational changes of nuclear membranes rarely described as intranuclear pockets. Desmosome-like intercellular junctions were observed in several neoplastic cells. The nucleoli were composed of a loose, fragmented nucleolonema, whereas elongated, anastomosing and rope-like nucleolonemas, described previously as characteristic for germinomas were not seen. Most tumor cells had villous cytoplasmic projections sometimes intermingled with similar projections of macrophages. Cytoplasm contained a moderate number of mitochondria, a few lysosomes, annulate lamellae, centrioles and glycogen particles. The other distinct components of tumor were lymphocytes, macrophages and astrocytes. Scattered astrocytes typically contained abundant glial filaments adjacent to primary tumor cell. A filopodia-like processes of macrophages often interspersed between other cells, were very prominent features of germinomas. Small lymphocytes were found scattered between the tumor cells, single or in clusters.

Clinico-pathological analysis of pilocytic astrocytomas and gangliogliomas

A pathological analysis of 58 pilocytic astrocytomas (PA) and 11 gangliogliomas (GG) was performed using immunohistochemistry. Antibodies against neuronal and glial markers (GFAP, SYN, NFP) were used. An analysis of survivors using the Kaplan Meier curve was also performed and compared with the literature reports. During the retrospective review of 58 cases recognized primarily as PA, 11 verified neoplasms demonstrated strong, immunopositive reaction for SYN or NFP or both antibodies. These cases were reclassified as gangliogliomas (GG). None of the 11 tumors recognized as GG was reclassified as PA. The overall 5-year survival was 88.89% in the PA and 70% in GG groups.