Iranian Journal of Pathology最新文献

Background & objective: Cervical cancer spreads to the pelvic lymph nodes, leading to a high incidence of cancer recurrence and unfavorable survival rates. Therefore, there is an urgent need to detect new predictive biomarkers for the early assessment of pelvic lymph node status in patients with cervical cancer. The current study aimed to assess the expression of FABP4, GINS2, and CBX7 in cervical cancer tissue to detect their prognostic and predictive roles in developing lymph node metastases in patients with that cancer type.

Methods: We collected the tissues from patients with cervical cancer and evaluated the expression of FABP4, GINS2, and CBX7 using immunohistochemistry. We evaluated the association between their expression and clinicopathological and prognostic parameters.

Results: A high expression of FABP4 and GINS2 and a low expression of CBX7 were found to be positively associated with the old age group, large tumor size, high grade and lymphovascular involvement, para-uterine organ infiltration, advanced FIGO stage, chemotherapeutic resistance, and tumor recurrence.

Conclusion: We demonstrated the oncogenic roles of FABP4 and GISN2 in addition to the on-co-suppressive roles of CBX7 in cervical cancer and their association with poor clinicopathological criteria and poor survival. Our results may indicate that FABP4, GISN2, and CBX7 could be considered predictive biomarkers of the occurrence of lymph node metastases in the cancer of the cervix preoperatively, which could be beneficial in the accurate preoperative design therapy.

Breast sarcoma is a rare but aggressive tumor. There are few case reports in the literature and several aspects of this disease are still not completely comprehended. Therefore, reporting new cases can help to enrich the literature. We report a patient with breast mass and pus secretion from her right breast, misdiagnosed as an abscess and mistreated by antibiotics. The patient was referred for an ultrasound examination and mammography, and a needle biopsy was performed that suggested an aggressive tumor. By the pathologist's suggestion, a total mastectomy of the right breast was performed with the excision of sentinel nodes. A pathological examination revealed a high-grade undifferentiated pleomorphic sarcoma (UPS) without vascular or lymph node invasion as the final diagnosis. The patient underwent postoperative chemotherapy and is currently in good condition. This case emphasizes considering this rare tumor when approaching a breast mass. Performing surgery with adequate resection margin can improve the patient's prognosis. Some suggested breast UPS cases with lung and brain metastasis would be more aggressive tumors than other breast sarcomas. Total mastectomy with negative margins and free-of-tumor lymph nodes may be the key to improve prognosis in such patients.

Background & objective: Providing equitable access to good quality, timely, and affordable laboratory testing has always been a top priority for the Ministry of Health and Medical Education (MoH-ME) and the Reference Health Laboratory (RHL). Considering the significant role of medical laboratories in disease surveillance, RHL developed a strategic plan to manage laboratory services during the COVID-19 pandemic based on the "Strategic Framework for strengthening health laboratory services, 2016-2020" proposed by the World Health Organization (WHO). This article describes the steps taken to establish the strategic framework in Iran.

Methods: Firstly, a National Laboratory Committee was formed in MoH-ME and a situation analysis was conducted to explore the strengths, weaknesses, opportunities, and threats in different components of our laboratory system. Gaps and resources needed to address those gaps were determined; then, RHL outlined operational processes and mechanisms for monitoring the activities.

Results: The WHO strategic roadmap and its six strategic goals concerning leadership, quality, human resources, safety and security, laboratory networking, and rational use of laboratory testing, helped us to promote national laboratory services in accordance with health system requirements in the COVID-19 pandemic.

Conclusion: The establishment of a national molecular laboratory network with more than 500 laboratories from different sectors may result in timely access to countrywide laboratory services and would be beneficial for future COVID-19 and/or other viral outbreaks. Continual evaluation of the COVID-19 laboratories' performance, production of PCR test kits by the local manufacturers, and development of a platform for virtual training would be other accomplishments that Iran achieved in coping with the recent pandemic.

Background & objective: This study aimed to determine the incidence of microRNA (miRNA; miR-1290) in the serum of oral squamous cell carcinoma (OSCC) patients compared to a control group using the qualitative real-time polymerase chain reaction (PCR) method.

Methods: Blood serum samples were obtained from patients diagnosed with OSCC and confirmed through biopsy. The samples were collected from patients referred to the Mashhad Dental Faculty and Ghaem Hospital. The OSCC group consisted of 17 patients, while the healthy group included 15 individuals. RNA was extracted from the patient samples, and samples with an A260/280 ratio between 1.8 and 2.0 (indicating acceptable RNA quality) were immediately converted into complementary DNA (cDNA) using albumin and cDNA reference genes. The SYBR green real-time reverse transcriptase PCR method was used to measure the presence of miR-1290 in the blood samples.

Results: A total of 32 patients were examined in this study, including 17 women (53.1%) and 15 men (46.9%). The mean age was 46.7 years in the healthy group and 54.6 years in the SCC group, indicating a significant difference (P<0.05). The expression level of the miR-1290 gene was higher in patients with SCC compared to the healthy group (P=0.000). While the expression level of miR-1290 was higher in grade 3 and advanced stage than in grades 2 and 1 and early stage, the differences were not statistically significant (P=0.173 and P=0.564 for grade and stage, respectively).

Conclusion: The expression level of miR-1290 may increase in SCC patients compared to healthy individuals, making it a potential circulating biomarker. Further investigations for diagnostic utility would be warranted.

Background & objective: Cerebrospinal fluid (CSF) analysis is helpful in the diagnosis of infections of the central nervous system (CNS), especially after neurosurgical procedures. This study aimed to evaluate the diagnostic value of CSF markers for diagnosis of post-neurosurgical meningitis (PNM).

Methods: Patients with neurosurgical procedures whose CSF was obtained for any reason (meningitis and non-meningitis) during 2020 and 2022, at Imam Khomeini Hospital Complex, Tehran, Iran, were included. Serum and CSF lactate dehydrogenase (LDH), glucose, protein, white blood cells (WBC), red blood cells (RBC), and CSF/serum glucose and LDH ratio were compared between the patients who were diagnosed with PNM and those without meningitis.

Results: A total of 115 patients were included, of whom 23 patients were diagnosed with PNM and 92 with non-meningitis. No significant differences were observed in patients' age, gender, and underlying diseases between the two groups. Findings showed a significantly (P=0.029) lower level of the mean CSF glucose (59.5 mg/dL ±33.9) in patients with meningitis than in patients without meningitis (76.8 mg/dL ± 37.5). The mean CSF/serum glucose ratio was 43.7% in the meningitis group and 56.3% in the non-meningitis group (P=0.008). The mean WBC count and neutrophil dominance were significantly higher in the meningitis group. No significant differences were observed in CSF LDH, Protein, and RBC between the two groups.

Conclusion: A CSF glucose level of less than 60 mg/dL, a CSF/serum glucose ratio of less than 0.44, and a higher CSF WBC and neutrophil count can help diagnose PNM.

Background & objective: Diabetic patients often develop lesions called non-diabetic renal diseases (NDRD), whose prognostic and therapeutic implications vary from diabetic nephropathy (DN). Since early identification of NDRD is associated with a better prognosis, we aimed to understand its spectrum.

Methods: One hundred and thirty-four patients were included in a cross-sectional study. Their clinical, and laboratory data and indications for biopsy were recorded. Two cores of renal tissue were studied under light microscopy and immunofluorescence; patients were classified into NDRD, NDRD+DN, and DN groups.

Results: Of all the patients studied, five were diagnosed with type 1 diabetes mellitus (DM1), and the rest were type 2 diabetes mellitus (DM2). Overall, the male-to-female ratio was 3:1. The Mean age of NDRD patients was the greatest, and males were predominant in all three groups. CKD was the most common presentation. Except for significantly greater proteinuria and hematuria in the DN and NDRD groups respectively, others were not different. Infection-related glomerulonephritis was the most common lesion among the NDRD+DN group, whereas IgA nephropathy and acute tubulointerstitial nephritis were frequent in the NDRD group.

Conclusion: Based on our findings, renal biopsy should be considered in all those diabetic patients with lesser onset duration presenting with hematuria, no/minimal retinopathy, and minimal proteinuria. A precise diagnosis helps in providing timely therapy for NDRD and prolonging renal and patient survival.