Iranian Journal of Pathology最新文献

Background & objective: Antibiotic resistance in urinary tract infection (UTI) is increasing nowadays, therefore, the aim of this study was to evaluate the resistance patterns of many pathogens toward several antibiotics that are in common use in our hospitals.

Methods: Subculture and identification of pathogenic bacteria were performed on 1148 hospitals' bacterial primary cultures which were considered positive for UTI. An antibiotic sensitivity test was performed by using the disc diffusion method. The rates of resistance were statistically analyzed and correlated with the types of antibiotics and bacteria.

Results: It was found that 1148 out of 2087 urine samples were UTI positive, the majority of cases (76%) were from females (P<0.0001). Escherichia coli and Klebsiella were the most isolated Gram-negative bacteria, while Staphylococcus spp. was the most isolated Gram-positive pathogen. E. coli showed the highest resistance rate among all bacteria, while Streptococcus spp. was the most sensitive. The highest resistance was noticed to be against gentamicin and ampicillin, while the most effective drugs were imipenem and amikacin. There was a significant difference in resistance rates among the different bacterial categories (P<0.0001), while no significant difference was noticed in resistance rates among antibiotics categories (P>0.05).

Conclusion: Elevated rates of antibiotic resistance were noticed in this study in UTI-causing bacteria; therefore, it is highly important at least to every general hospital to investigate the antibiotic resistance rates occasionally to determine the proper antimicrobial treatment as well as re-evaluate antibiotics which were considered as empirical.

Background & objective: Colorectal cancer is the second reason for cancer-associated death. The prognosis of the malignancy is defined by TNM scoring. However, tumor grading, lymphovascular invasion, perineural invasion, and tumor buddings may affect its prognosis. This study aimed to assess the prognostic and histologic impact of tumor budding in colorectal adenocarcinoma.

Methods: This study is a retrospective cohort of 192 patients with colorectal adenocarcinoma. All four stages of colorectal adenocarcinoma patients were included, but the patients in stages I and II were also analyzed separately. We used pathology reports to extract the histopathologic data. The prognostic values were extracted by calling the patients.

Results: Less than half of the patients were in stages I and II of the disease. According to our analysis, tumor extension and lymphovascular invasion were correlated with tumor budding count in patients in stages I and II, and lymphovascular invasion, tumor grade, tumor stage, lymph node involvement, tumor extension, tumor site, metastasis, and five-year survival were correlated with tumor budding within all stages.

Conclusion: It is recommended that tumor budding count should be assessed and reported in pathology reports of adenocarcinomas due to its high correlation with poor prognosis.

The effectiveness of immunotherapy for most cancer patients remains low, with approximately 10-30% of those treated surviving. Thus, much effort is being put into finding new ways to improve immune checkpoint therapy. Our review concludes that inhibition of proprotein convertase subtilisin/Kexin type 9 (PCSK9), which plays a critical role in regulating cholesterol metabolism, can cause movement of T cells toward tumors, with increased sensitivity to immune checkpoint therapies. We searched PubMed, NCBI, Scopus, and Google Scholar for the published articles without limitations on publication dates. We used the following terms: "PCSK9", "Cancer", "Immune Checkpoint", and "Cancer Prognosis" in the title and/or abstract. Our search initially revealed 600 records on the subject and stored them in the used databases under EndNote X8 management software. A total of 161 articles were selected and through a careful review, 76 were included in our research. We concluded that PCSK9 reduces the number of LDL receptors (LDL-R) on the cell surface, which is linked to its ability to regulate cholesterol levels in the body. Also, we discuss how suppressing PCSK9 leads to the MHC-1 accumulation on the surface of cancer cells, which results in T lymphocyte invasion. Finally, we believe that inhibiting PCSK9 may be an effective strategy for improving cancer immunotherapy.

Primary periocular histiocytoid carcinoma is a very rare malignant tumor. Until now, less than 50 cases have been reported in the English literature. It is characterized by resistant epiphora, limitation in extraocular motility, and ptosis. The definitive diagnosis of this lesion is made based on detecting histological histiocytoid features along with tracing positivity of specific biomarkers using immunohistochemistry. However, pathologists may be faced with two major obstacles in the diagnosis of this tumor including distinguishing it from metastatic histiocytoid lesions and also from benign mimics such as reactive inflammatory lesions. Here, we describe a case of primary periocular histiocytoid carcinoma located on the eyelid as well as review the literature to clarify the histopathological and diagnostic features of this tumor.

Background & objective: Breast cancer is thought to arise from non-invasive breast lesions, such as atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). DCIS is considered a direct precursor of invasive carcinoma. The morphological features alone do not reflect the biological truth of this disease. Therefore, we investigated features of carcinoma in situ and the invasive components in women diagnosed with breast cancer.

Methods: This study was a cross-sectional study. The corresponding IHC slides were selected from the pathology archive and examined by the pathologist. Fifty-one samples which showed both in situ and invasive components confirmed immunohistochemically, were included in the study.

Results: In 70.6% of the cases a high grade of in situ and invasive carcinoma was observed. In 45.1% of the studied cases, a solid structure was observed in in-situ carcinoma, and no otherwise specified structure was observed in invasive carcinoma. In 74.5% of both in situ and invasive carcinoma types, ER.PR had a positive value. In 45.5% of the cases, both in situ and invasive carcinoma components show low Ki67. In 42.2%, both in situ and invasive carcinomas were Her2 negative. There was no significant difference between the grade (P=0.687), Her2 type (P=0.532), and structure (P=0.532). ER.PR (P=1.00) and Ki67 (P=0.180) of in situ and invasive carcinoma in this study.

Conclusion: Our study showed differences between in situ and invasive biomarker expression. According to our findings, owing to heterogeneity, in situ components can't be representative of invasive components for treatment choices.

Background & objective: Telomeres consist of repetitive G-rich nucleotides located at the end of each chromosome, acting as protein binding sites. The aim of this study was to examine the differences in telomere length in blood, saliva, and tissue samples at various stages of oral precancerous and cancerous lesions.

Methods: Samples of blood, tissue, and saliva were collected from patients with oral precancerous and cancerous lesions. DNA extraction was performed. Then, a TRAP assay was conducted to assess and compare the telomere length and telomerase expression.

Results: The levels of telomerase activity (TA) in the DNA samples ranged from 0.19 to 6.91 (2.05+1.37) among oral squamous cell carcinoma (OSCC) patients and from 0.17 to 4.5 (0.28+4.25) among precancerous patients. A significant difference was observed in TA levels between OSCC and precancerous samples (t=3.9691, P= 0.0000).

Conclusion: Assessing the telomerase activity is crucial for studying the behavior of carcinoma in the clinical setting. The augmented telomerase expression and the length of telomere contribute to OSCC progression. Hence, this study adds a diagnostic tool that can serve as a biomarker for the early detection and prognosis of OSCC.

Background & objective: Breast cancer (BC) is one of the most frequent tumors worldwide, accounting for 15% of all cancer-related deaths. A timely diagnosis of BC is essential for optimal treatment and increasing patients' survival rates. LRP family proteins are important components of cell-surface receptors involved in numerous biological activities. Expression of LRP is related to breast malignancy. In this study, we initially studied the expression of LRPs in BC tissues compared to normal tissues-the relation of LRP expression with relapse-free survival (RFS) and overall survival (OS). Then, we investigated the association of LRPs relation and immune infiltrating abundance.

Methods: We analyzed the LDLR family expression and prognostic value in BC by mining UALCAN, TIMER, and Kaplan-Meier plotter databases. Subsequently, we explored the association of LDLR expression and immune infiltrating abundance via the TIMER database.

Results: Expression levels of LRP1/2/4/9/10 were found to be higher in the cases with positive estrogen receptors. There was a positive association between LRP1/6 expression and the infiltration of CD8+ T cells, CD4+ T Cell, Macrophage, Dendritic Cell, and Neutrophil.

Conclusion: Our study recommends LDLR as a potential prognostic biomarker that can be promising to improve the survival of BC patients' survival. However, further investigations are needed to evaluate the studied LDLR members in more detail.

Background & objective: Hospital-acquired infections (HAIs) are a major healthcare problem in hospitalized patients, especially in developing countries, where they affect millions of patients and cause high mortality rates. This study aimed to investigate multidrug-resistant bacterial strains in NIs at Imam Khomeini University Hospital in Urmia, Iran.

Methods: This cross-sectional study was conducted using a convenience sampling method. The study population comprised all positive clinical samples from HAIs registered in the laboratory of Imam Khomeini Hospital, Urmia, Iran, in 2019. Bacteria were identified by culturing the samples on blood agar and MacConkey agar, followed by performing standard biochemical tests. Antibiotic susceptibility testing was carried out using the disk diffusion method, in accordance with CLSI guidelines.

Results: Of the 607 positive samples, the most common microorganisms isolated were Escherichia coli (27.5%), Acinetobacter baumannii (18.5%), and Klebsiella pneumoniae (15.2%). The distribution of resistance to the number of antibiotics in bacterial isolates from the samples showed that 19.8% of them were resistant to one antibiotic and 13.2% were resistant to three antibiotics. 40.5% of the samples showed no resistance to antibiotics.

Conclusion: This study highlights the critical issue of HAIs and the prevalence of multidrug-resistant bacteria in Urmia, Iran. Urgent measures, including improved hygiene, accurate diagnostics, appropriate antibiotic use, and stakeholder education, are essential. Establishing a robust HAI surveillance system is also recommended. Future efforts should aim at understanding and mitigating the spread of these pathogens.