Iranian Journal of Pathology最新文献

Background & objective: While there are fast advances in the detection and management of bladder carcinoma, the number of deaths remains high. Therefore, the identification of an effective biomarker predicting tumor progression in cancer bladder patients is a crucial issue. This study aimed to identify TIPE2 and CD36 expressions in cancer bladder and examine their relationship with clinicopathological data and prognosis.

Methods: Using immunohistochemistry, 60 specimens of bladder urothelial cancer (UC) for the expression of TIPE2 and CD36 were studied and compared with the clinicopathologic parameters and survival data. Furthermore, the association between TIPE2 and CD36 expression and Vimentin expression to elucidate the influence of TIPE2 and CD36 on the epithelial-mesenchymal transition (EMT) were investigated in UC.

Results: TIPE2 expression was associated with lower stages and prolonged disease-free survival (DFS) and overall survival (OS). Therefore, TIPE2 may be considered a good indicator of UC prognosis. CD36 immuno-positivity was associated with high tumor grade, stages, shorter OS, and DFS. Therefore, the immune positivity of CD36 may be a poor prognostic marker for UC patients. Furthermore, Vimentin expression was directly correlated with CD36 expression and inversely correlated with TIPE2 expression.

Conclusion: TIPE2 and CD36 may be novel biomarkers for predicting tumor metastasis and prognosis in patients with bladder UC and hold promise as therapeutic targets.

Urinary tract infections (UTIs) caused by Trichosporon are a significant concern for hospitalized patients and those with weakened immune systems. This narrative review study aims to provide a comprehensive overview of UTIs caused by Trichosporon, including its frequency, risk factors, laboratory diagnostic aspects, drug resistance, and the importance of accurate identification in clinical settings. A search of international databases was conducted to identify relevant studies, and it was found that Trichosporon asahii, specifically the G1 type, is the predominant causative agent of UTIs among various Trichosporon species. Prolonged hospitalization and immunosuppressive drug use were identified as significant risk factors for this fungal infection. Conventional methods for laboratory identification are commonly used. Still, rapid and accurate tools such as Matrix-Assisted Laser Desorption-Ionisation-Time of Flight Mass Spectrometry (MALDI-TOF MS) and DNA sequencing can improve the diagnostic process. Against all T. asahii isolates for which this triazole, polyene, and echinocandin were tested, voriconazole demonstrated the most potent in vitro activity, while amphotericin B had high MIC values and echinocandins had inherent resistance. This review provides valuable insights into the clinical significance and management of UTIs caused by Trichosporon.

Background & objective: Triple-negative breast cancer (TNBC) is an aggressive subtype lacking estrogen, progesterone, and HER2 receptors, often leading to poor prognosis due to high recurrence and metastasis. FOXP3 expression, associated with suppressed anti-tumor immunity, is a potential prognostic marker in TNBC. However, the association between FOXP3 expression and disease-free survival (DFS) in TNBC remains controversial. This study aims to explore the relationship between FOXP3 expression and DFS in TNBC patients, contributing to the understanding of its prognostic significance.

Methods: This retrospective study included 47 TNBC patients. Immunohistochemistry examination assessed FOXP3 expression, which was then categorized into low and high expression based on an optimal cut-off point. Univariate and multivariate analyses were conducted using Cox regression test to determine association between variables and DFS. Survival analysis was assessed using the Kaplan-Meier method and the log-rank test.

Results: All patients were female mostly over 50 years old (66%). The majority had tumors >2 cm (87.2%) and LVI (66%). High-grade tumors (grade 3) were predominant (93.6%). Most patients showed moderate TIL levels (91.5%). No significant associations were found between FOXP3 expression and age (p=0.253), tumor size (p=0.308), lymph node status (p=0.466), tumor grade (p=0.476), LVI (p=0.422), patient's stage (p=0.644), and TILs (p=0.783). However, high FOXP3 expression was significantly associated with worse DFS (p=0.019). Additionally, a higher stage was associated with worse DFS (p=0.002).

Conclusion: High FOXP3 expression is associated with lower DFS in TNBC patients. FOXP3 expression was not associated with age, tumor size, lymph node status, tumor grade, LVI, TILs, or cancer stage.

Background & objective: The purpose of this research was to determine the frequency of algD, pslD, and pelF genes in biofilm formation among MDR and non-MDR clinical strains of Pseudomonas aeruginosa in Khorramabad, Iran (2024).

Methods: This cross-sectional study included all Pseudomonas aeruginosa isolates collected from various clinical samples in Khorramabad teaching hospitals in 2024. After confirming the isolates and determining their antibiotic resistance patterns using the disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines, algD, pelF, and pslD genes were detected by PCR.

Results: The highest sensitivity was observed to imipenem (75%) and meropenem (71.3%), while the greatest resistance was recorded against ciprofloxacin, ceftazidime, and tobramycin 45 (56.25%). The frequencies of the algD, pelF, and pslD genes were 88.8, 76.3, and 96.3%, respectively. A significant association was found between the PelF and algD genes with multidrug resistance (MDR) (P<0.05).

Conclusion: The presence of multi-drug resistance (MDR) in this study indicates the need for serious measures to control infections caused by this bacterium. Further research is recommended to explore the contribution of biofilm-associated genes to the development of multi-drug resistance (MDR).

Background & objective: This study aimed to evaluate the expression patterns of epidermal growth factor receptor (EGFR) in patients with triple-negative breast cancer (TNBC) in Kerman, Iran, and investigate its association with various clinicopathological factors.

Methods: A retrospective cross-sectional study was conducted on 54 TNBC patients diagnosed between 2013 and 2022. Immunohistochemistry (IHC) was performed to assess EGFR expression levels in tumor tissue samples. Patients were classified as EGFR-positive or EGFR-negative based on IHC staining results. Clinicopathological data, including age, tumor grade, vascular invasion, lymph node involvement, Ki-67 proliferation index, presence of necrosis, ductal carcinoma in situ (DCIS), and microcalcifications, were collected. Statistical analyses were performed to examine the association between EGFR expression and clinicopathological variables.

Results: EGFR expression was positive in 61.1% of the patients. A significant association was found between EGFR positivity and higher tumor histologic grade (P = 0.045), with 69.7% of EGFR-positive patients exhibiting grade III tumors compared to 38.1% in the EGFR-negative group. Although not statistically significant, EGFR-positive patients tended to be younger (median age 44 years) than EGFR-negative patients (median age 52 years) (P = 0.157). The Ki-67 proliferation index was higher in EGFR-positive patients (median 60.0%) compared to EGFR-negative patients (median 47.5%).

Conclusion: EGFR expression is significantly associated with higher tumor grade, suggesting a correlation with more aggressive tumor behavior. EGFR may serve as a potential prognostic marker and therapeutic target in TNBC. Further research with larger cohorts is recommended to validate these findings and explore the implications of EGFR-targeted therapies in TNBC management.

Background & objective: Angiosarcomas (AS) are rare, aggressive malignant tumors characterized by marked histopathologic heterogeneity, often mimicking other neoplasms and complicating diagnosis. This 16-year retrospective study aimed to evaluate the clinicopathological spectrum of AS, with particular emphasis on diagnostic challenges and strategies for accurate identification.

Methods: We retrospectively reviewed 11 histologically confirmed cases of AS diagnosed at our institution between January 2008 and December 2023. The data collected included patient demographics, clinical presentation, tumor location, histopathologic features, immunohistochemical (IHC) profiles, treatment modalities, and clinical outcomes.

Results: Patient ages ranged from 25 to 62 years, with a slight female predominance (male-to-female ratio, 0.8:1). Tumor locations were variable, and histologic patterns ranged from well-differentiated, low-grade vascular proliferations resembling hemangiomas to poorly differentiated neoplasms mimicking pleomorphic undifferentiated sarcomas. IHC findings demonstrated overlapping marker expression, including cytokeratin (CK) positivity, which may lead to misdiagnosis as carcinoma, and loss of H3K27me3 expression, which can raise suspicion for malignant peripheral nerve sheath tumors (MPNST). Several cases also exhibited morphologic features closely resembling epithelioid hemangioendothelioma.

Conclusion: Angiosarcoma poses considerable diagnostic difficulty due to its morphologic variability and overlapping immunophenotypic profiles. Accurate diagnosis necessitates a multidisciplinary approach, integrating clinical, radiologic, and pathologic data. This study highlights the importance of diagnostic vigilance and comprehensive evaluation when assessing vascular neoplasms.

Background & objective: Accurate evaluation of the Ki-67 proliferation index is critical in the grading and prognostication of neuroendocrine neoplasms (NENs). This study aimed to compare three different methods of Ki-67 index assessment in primary gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs).

Methods: The Ki-67 proliferation index was assessed by immunohistochemical (IHC) staining in 41 cases of primary GEP-NENs. Two pathologists independently evaluated the Ki-67 index using two visual estimation methods: eyeballing and eye-counting under a light microscope. A third method involved manual counting of Ki-67-positive and -negative nuclei on a captured image using ImageJ software. Interobserver and intermethod reproducibility were analyzed using Pearson's correlation coefficient (R) and the intraclass correlation coefficient (ICC) to assess agreement among the four observers and between each observer and the manual method.

Results: The ICC among the four observers was 0.993, indicating excellent interobserver agreement. The ICC between each observer's score and the manual counting method was 0.994, also demonstrating high concordance.

Conclusion: All three methods, eyeballing, eye-counting, and manual counting using ImageJ, proved to be comparably effective in assessing the Ki-67 proliferation index in GEP-NENs. Notably, the simpler microscopic techniques of eyeballing and eye-counting showed excellent agreement with the manual image-based method, supporting their reliability in routine practice.

Background & objective: Bladder cancer is the fourth most prevalent malignancy and lacks reliable biomarkers for predicting tumor stage, grade, and clinical outcomes. This study aimed to evaluate the association between thrombomodulin (TM)-positive cell rate (PR) and tumor grade, stage, and recurrence in patients with bladder cancer.

Methods: This prospective observational pilot study was conducted at the Urology Clinic of Sina Hospital, Tehran, between March and December 2022. A total of 51 patients diagnosed with bladder cancer following cystoscopy and transurethral resection of bladder tumor (TURBT) were enrolled. Of these, 11 patients with stage T2 disease underwent radical cystectomy. TM expression was assessed by immunohistochemical staining, and the PR score was calculated. The remaining 40 patients underwent follow-up cystoscopy 3 months post-TURBT to assess for recurrence or progression. Statistical analyses were performed using SPSS version 26, with comparisons of quantitative variables conducted using ANOVA and t tests.

Results: The mean age of participants was 66.73 ± 11.00 years, and 46 were male. The mean TM PR value was 25.51 ± 6.24. No significant differences in TM PR values were observed among different tumor grades (p = 0.144) or stages (p = 0.815). Additionally, there were no significant differences in TM PR values or PR scores between patients with and without recurrence at 3-month follow-up cystoscopy (p = 0.144 and p = 0.085, respectively).

Conclusion: TM PR values did not correlate with tumor grade, stage, or recurrence in this cohort of bladder cancer patients. Further studies with larger sample sizes and longer follow-up periods are warranted.

Background & objective: Oral squamous cell carcinoma (OSCC) accounts for over 90% of oral cancers. Cytokeratin 19 (CK19), produced by suprabasal epithelial cells, reflects alterations in cellular behavior and has been associated with premalignant changes in the oral epithelium. This study aimed to evaluate the expression of CK19 in OSCC and oral epithelial dysplasia (OED) and its potential role in oral carcinogenesis.

Methods: A total of 50 samples were analyzed, including 30 OSCC cases and 10 OED cases obtained from the archives of the Department of Pathology, as well as 10 normal oral mucosa samples collected from clinically healthy areas adjacent to mucocele lesions. CK19 expression was assessed using immunohistochemistry.

Results: Positive immunoreactivity for CK19 was observed in 90% (27/30) of OSCC samples. CK19 expression in the OSCC group was significantly higher compared to the OED and normal mucosa groups. Among OSCC cases, grade III tumors exhibited stronger CK19 expression than grades I and II. Additionally, CK19 expression in grade II OSCC was higher than in the OED group.

Conclusion: The progressive increase in CK19 expression from normal mucosa to OED and OSCC supports its involvement in oral mucosal carcinogenesis. Moreover, higher CK19 expression correlated with increasing tumor grade and decreasing cellular differentiation, suggesting its potential value as a diagnostic and prognostic biomarker in OSCC.