Immunohistochemistry in Bladder Cancer: Diagnostic, Prognostic, and Molecular Subtyping Applications | Chapter 2 | Newer Frontiers in Urology, Volume II

 

Introduction: Immunohistochemistry (IHC) has evolved from a primarily diagnostic adjunct to a central component of precision oncology in bladder cancer. By bridging histomorphology with molecular characterisation, IHC contributes to diagnosis, prognostication, staging, and therapeutic decision-making. However, variability in marker selection, interpretation, and standardisation remains a challenge in routine practice.

 

Aim: This chapter aims to provide a focused overview of the role of IHC in bladder cancer, addressing current gaps in consistent application while highlighting its diagnostic utility, prognostic and predictive significance, role in molecular subtyping, and integration with emerging technologies.

 

Key Points: IHC facilitates accurate detection of carcinoma in situ, molecular luminal–basal subtyping, and refined staging using markers such as CK20, GATA3, CK5/6, and smoothelin. Prognostic markers, including Ki-67 and p53, and predictive biomarkers such as PD-L1 and HER2, demonstrate increasing clinical relevance, with reported diagnostic and prognostic accuracies supporting their use in selected settings. The integration of multi-marker panels, digital pathology, and molecular diagnostics enhances reproducibility and precision, though limitations related to inter-observer variability, assay standardisation, and evolving biomarker validation persist.

 

Conclusion: IHC remains a cornerstone of bladder cancer pathology, underpinning diagnostic accuracy and therapeutic stratification. With ongoing innovations in biomarker discovery, artificial intelligence, and standardisation, IHC continues to evolve as a critical platform for translational and clinical application in urologic oncology.

 

 

Author(s) Details

Vijayanand Mani
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Bhavyadeep Korrapati
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Vivek Meyyappan
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Velmurugan Palaniyandi
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Hariharasudhan Sekar
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Sriram Krishnamoorthy
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-68-8/CH2

Using Immunohistochemistry to Manage Diagnostic Challenges in Pediatric Small Round Cell Tumours | Chapter 12 |Medical Science: Updates and Prospects Vol. 3

 

Background: Pediatric small round cell tumours (SRCTs) are a group of aggressive cancers that look very similar under the microscope, making them difficult to tell apart based on appearance alone. An accurate diagnosis is critical because each type requires different treatment. Immunohistochemistry (IHC) has emerged as an essential adjunct in the diagnostic workup, enabling precise lineage assignment through the detection of differentiation-specific antigens. Despite its widespread use, diagnostic ambiguity persists, particularly in resource-limited settings where antibody panels may be restricted or tissue preservation suboptimal.

 

Aim: This study aimed to test how effective a standard panel of immunohistochemistry (IHC) stains is at providing a definitive diagnosis for these challenging tumours.

 

Methods: A prospective study was conducted on 100 children with SRCTs. Cases were included if they showed histological evidence of a malignant SRCT on haematoxylin and eosin (H&E)-stained sections, had adequate formalin-fixed paraffin-embedded (FFPE) tissue for a complete immunohistochemical (IHC) workup. After an initial review under the microscope, all cases were tested with a targeted IHC panel designed to identify different tumour lineages (including CD99, myogenin, CD45, and synaptophysin).

 

Results: Initial microscopic examination failed to provide a specific diagnosis in 71% of cases, labelling them only as "undifferentiated." The IHC panel successfully resolved 99% of all cases, providing a specific diagnosis. The Ewing sarcoma family (50%) was the most common tumour, followed by embryonal rhabdomyosarcoma (17%).

 

Conclusion: A systematic IHC panel is a highly effective and essential tool for diagnosing pediatric SRCTs. It resolves the vast majority of ambiguous cases, ensuring that children receive the correct diagnosis as the crucial first step towards appropriate therapy. Study limitations include a single-centre, prospective design, which may introduce selection bias, as evidenced by a high proportion of bone and soft tissue tumours. Future investigation should involve multicenter cohorts with more diverse tumour types to validate the generalizability of these findings.

 

 

Author(s) Details

Divya Jain
Department of Pathology, Government Medical College, Alwar, India.

 

Achin Gupta
Department of Anaesthesia, Govt Medical College, Alwar, India.

 

Neeraj Raman
Department of Microbiology, Govt Medical College, Alwar, India.

 

Amandeep
Department of Pediatrics, Government Medical College, Alwar, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v3/6878

Incidental Identification of Krukenberg’s Tumour (KT): A Histopathological Perspective | Chapter 2 | Medical Science: Updates and Prospects Vol. 2

 

Krukenberg’s tumour (KT) is a metastatic ovarian malignancy characterised by bilateral ovarian enlargement and a nodular pattern of infiltration on radiology. KTs can be synchronous, where the metastasis is discovered within 3 months of the diagnosis of the primary tumour, or metachronous, where the metastasis is found after 3 months, frequently after the completion of initial therapy. This case report discusses an incidental diagnosis of Krukenberg’s Tumour (KT). A 48-year-old female was incidentally diagnosed with a Krukenberg tumour, involving the entire uterus, uterine leiomyomas, bilateral ovaries and fallopian tubes without any gross enlargement or cystic change in the ovaries. The patient underwent surgery to alleviate the symptoms associated with multiple uterine fibroids detected on ultrasound. She underwent a total abdominal hysterectomy with removal of both the adnexa, along with myomectomy. However, when the ovaries are not enlarged, and complaints of abdominal discomfort or pain are attributable to a fibroid, the possibility of a Krukenberg tumour is seldom considered. Under such circumstances, histopathology examination serves as the only tool to clinch the diagnosis because of its characteristic microscopic features. Recognition of KT is of paramount importance, as it alters both the management approach and prognostic outlook. Furthermore, it is also crucial to exclude mimics, especially tumours with mucinous differentiation, using ancillary techniques like special stains, immunohistochemistry and previous historical details for confirmation.

 

 

Author(s) Details

 

Kriti Chauhan
Metropolis Healthcare Ltd., India.

 

Aastha Sharma
Metropolis Lab Pvt. Ltd., India.

 

Gagandeep Singh
Dr. Singh Path Lab, Ropar, Punjab, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v2/6598

 

Implementing p53 Expression in Colorectal Cancers in Ugandan Patients | Chapter 6 | Medical Research and Its Applications Vol. 10

 

Aim: The aim of the study was to determine the association of p53 expression with grade, stage, LVI status, histopathological subtype and topography of CRC.

 

Introduction: The topography of colon tumours is also different with right-sided colon tumours more commonly observed in developed high-income countries whilst many Sub-Saharan African countries report a high proportion of left-sided colon tumours, especially rectal tumours. In Uganda, the Kampala Cancer Registry has reported a steady increase in colorectal cancer (CRC) in the past 20 years, however, is still lower compared to developed high-income countries. Colon tumour topography varies as well; in industrialized high-income countries, right-sided colon tumours are more frequently detected than in developing low-income ones. In colorectal cancer (CRC), the p53 gene is often altered. This leads to the production of an aberrant protein, which can be detected early by immunohistochemistry. A poor prognosis and reduced survival have been associated with the detection of p53 in malignant cells.

 

Methods: During the period 2008 to 2021, immunohistochemistry was carried out on 51 patients’ paraffin-embedded tissue blocks of CRC. TP53 expression was detected using the indirect immunoperoxidase method which uses monoclonal antibody p53, DAKO Agilent USA, Clone DO-7. The grade and histopathological subtypes of CRC were evaluated using the haematoxylin and eosin stain. The demographic data and topography of the tumours were obtained from the clinical patients’ files and the Kampala Cancer Registry.

 

Results: Out of 51 patient tissue blocks that were studied, 27(52.9%) expressed p53 in the nucleus of malignant CRC cells. There were 20(74.1%) left-sided colon tumours and 7(25.9%) right-sided colon tumours that expressed p53 and this reached statistical significance (p=0.0004). The presence of p53 expression was also significantly associated with the presence of lymphovascular invasion (p=0.0561) and the classical adenocarcinoma histological subtype (p=0.0000). There was a negative correlation between CRC grade and p53 expression (r=-0.1189; p=0.4059) and between CRC stage and p53 expression (r=-0.1702; p=0.2324). The present study did not evaluate the role of radiotherapy in the response to rectal tumours that have positive p53 expression, however, future studies may evaluate this role in Ugandan patients. Similar to other parts of the world in Ugandan patients, p53 expression is more commonly present in left-sided colon tumours.

 

Conclusions: The intensity of p53 expression is not influenced by stage and grade of CRC. Similar to other parts of the world, p53 expression is more commonly present in left-sided tumours. Therefore these findings support the theory, that right-sided colon tumours have a different pathogenesis than left-sided colon tumours, and hence have a different prognosis. Further studies should be carried out to determine the types of genetic mutations or epigenetic factors responsible for the difference in prognosis between left-sided and right-sided CRC in Ugandan patients.

 

 

Author(s) Details

Richard Wismayer

Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda, Department of Surgery, Faculty of Health Sciences, Equator University for Science and Technology, Masaka, Uganda, Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Julius Kiwanuka

Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

Henry Wabinga

Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Michael Odida

Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda and Department of Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda.

 

Please see the link:- https://doi.org/10.9734/bpi/mria/v10/1176

 

Correlation of the Expression of Vascular Endothelial Growth Factor with Clinical Staging and Outcome in Patients Affected with Colorectal Carcinoma: A Study from Uganda | Chapter 8 | Medicine and Medical Research: New Perspectives Vol. 2

Introduction: Invasion and metastasis are the most life-threatening aspects of the colorectal neoplastic process. Many studies have shown that invasion, metastasis, and solid tumour growth are dependent on new blood vessel formation from established vasculature. According to data from the Kampala Cancer Registry in Uganda, the number of instances of colorectal cancer (CRC) has increased in this area, and patients are presenting at an advanced stage and younger ages.  A relationship between tumour growth, distant metastasis, and a poor prognosis with an increased expression of VEGF has been reported in studies.

 

Aim: The aim of this study was to analyse the correlation of VEGF with the clinicopathological characteristics of Ugandan patients with colorectal cancer.

 

Methods: Immunohistochemistry was carried out on fifty-two patients’ paraffin-embedded tissue blocks of CRC between 2008–2021. VEGF expression was detected using the indirect immunoperoxidase method which used monoclonal antibody VEGF, DAKO Agilent USA, Clone VG1, and reference M7273. The haematoxylin and eosin stains were used to evaluate the grade, lymphovascular invasion status, and histopathological subtypes of CRC. The demographic data, staging, and topography of the tumours were obtained from the clinical patients’ files and the Kampala Cancer Registry. The biopsy specimens were obtained during colonoscopy and the resected colorectal specimens at operation. Using a standard pretested Data Extraction Form, data for all tissue samples was extracted from the clinical patients’ files in the respective hospitals and the Kampala Cancer Registry.

 

Results: Out of fifty-two CRC participants, there were 7(43.7%) participants with stage IV disease compared to 2(12.5%) with stage I disease and this reached statistical significance (p=0.0479). There were 11(68.8%) participants with grade II disease compared to 2(12.5%) with grade I disease from those that stained positively for VEGF (p=0.0012). Classical adenocarcinoma constituted 13(81.3%) participants compared to 3(18.8%) mucinous adenocarcinomas and signet ring colorectal carcinoma from those that stained positively for VEGF (p=0.0000). CRC grading was negatively correlated with VEGF-1 expression (r=-0.0565) (p=0.7091). The mechanism responsible for increasing the results of chemotherapy with anti-VEGF therapy is not entirely understood. However, tumour apoptosis may be increased with the inhibition of angiogenesis.

 

Conclusions: There was a tendency to increase the expression of VEGF with increasing stages of CRC. A poor prognosis and increased VEGF-1 expression were substantially correlated with the existence of metastases. More effective medical interventions for colorectal cancer in Uganda are required, utilizing chemotherapy and anti-VEGF drug combinations.

 

Author(s) Details

 

Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda, Department of Surgery, Faculty of Health Sciences, Equator University for Science and Technology, Masaka, Uganda, Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda, Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda and Department of Surgery, Mulago National Referral Hospital, Kampala, Uganda.

 

Julius Kiwanuka
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

 

Josephat Jombwe
Department of Surgery, Mulago National Referral Hospital, Kampala, Uganda.

 

Emmanuel Elobu
Department of Surgery, Mulago National Referral Hospital, Kampala, Uganda.

 

Henry Wabinga
Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

 

Michael Odida
Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda and Department of Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v2/1622

Assessment of CDX2 Expression as a Prognostic Marker in Colorectal Adenocarcinoma Patients from Uganda | Chapter 5 | Medicine and Medical Research: New Perspectives Vol. 2

 

Aim: The objective of this study was to determine the association between CDX2 and clinicopathological features of colorectal adenocarcinoma in Ugandan patients.

Introduction: Colorectal cancer (CRC) is one of the major cancer types worldwide. Although the burden of CRC is highest in developed countries, the Kampala Cancer Registry in Uganda, reports a steady rise in the incidence of early-onset CRC. Molecular markers such as CDX2 represent a bowel-specific tumour suppressor which inhibits the dissemination and progression of colorectal cancer. Recent advances in the field of cancer biology have introduced novel biomarkers such as CDX2 that hold promise in guiding personalized therapeutic decisions and have revolutionised prognostication. In developed high-income countries, the reduced expression of CDX2 identifies a sub-group of patients linked to a poor outcome.

Methodology: During the period 2008 to 2021, immunohistochemistry was carried out on 55 patients’ paraffin-embedded tissue blocks of CRC. CDX2 expression was detected using the indirect immunoperoxidase method which uses monoclonal antibody CDX2, DAKO Agilent USA, and Clone DAK-CDX2. The grade, LVI status and histopathological subtypes of CRC were evaluated using the haematoxylin and eosin stain. The demographic data, topography and stage of the tumours were obtained from the clinical patients’ files and the Kampala Cancer Registry.

Results: Out of 55 CRC participants that were studied, the mean age (SD) was 52.4 (15.8) years and the loss of CDX2 expression was 18.9% overall. Lack of CDX2 expression was significantly associated with lymphovascular invasion (LVI) (p=0.005). There were 55.6% that presented with poorly-differentiated adenocarcinoma compared to 22.2% presenting with well-differentiated adenocarcinoma in those that exhibited a lack of CDX2 expression, however, this was not statistically significant (p=0.126). In those exhibiting a lack of CDX2 expression, there were 40% of participants presented with stage IV disease compared to 20% of CRC participants with stage I disease (p=0.329). There was a negative correlation between the CRC grade and CDX2 expression (r=-0.0235) which did not reach statistical significance (p=0.8729). The findings in the present study in Ugandan patients, in keeping with previous studies in the West found that loss of CDX2 expression was associated with poor prognostic markers such as lymphovascular invasion. These findings from colorectal cancer patients in Uganda are testimony to the role of loss of CDX2 as a poor prognostic factor in colorectal adenocarcinoma.

Conclusions: Loss of CDX2 expression is associated with poor prognostic markers such as the presence of lymphovascular invasion in Ugandan patients. Loss of CDX2 expression is more frequently seen in advanced-stage colorectal cancer (CRC) because it is linked to a biologically aggressive tumor. More research in Uganda is required to determine how chemotherapy affects CDX2-negative tumors and how this relates to survival.

Author(s) Details

 

Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda, Department of Surgery, Faculty of Health Sciences, Equator University for Science and Technology, Masaka, Uganda, Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

 

Julius Kiwanuka
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

 

Henry Wabinga
Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

 

Michael Odida
Department of Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v2/1619

 

Role of Tumor-Associated Macrophages in Different Grades of Oral Squamous Cell Carcinoma: An Institutional Study | Chapter 3 | Disease and Health Research: New Insights Vol. 9

Aims: This study aims to evaluate the expression of Tumor-Associated Macrophages (TAMs) in different grades of Oral Squamous Cell Carcinoma (OSCC) and determine the association between TAM expression and clinical parameters such as local recurrence and metastasis.

Methodology: The study was conducted on fifty tumor biopsy samples of OSCC in T1N0M0 and T2N0M0 stages. Additionally, ten biopsy specimens of normal oral mucosa, collected during minor oral surgical procedures with patient consent, were included as controls. TAM infiltration was evaluated using Hematoxylin & Eosin (H&E) staining and immunohistochemistry (IHC) techniques. The data were statistically analyzed using SPSS software.

Results: The findings revealed that TAMs, particularly those of the M2 phenotype, were associated with local recurrence, metastasis, and survival in OSCC cases. Higher TAM expression was correlated with shorter survival rates and increased aggressiveness of the tumor. A statistically significant correlation was observed between TAM expression and TNM staging (p < 0.0001). TAM infiltration was found to increase from well-differentiated to poorly differentiated OSCC, indicating a potential role in tumor progression. Moreover, a significant difference in TAM expression was noted between OSCC tissues and normal oral mucosa (p < 0.002).

Conclusion: The study highlights the significant role of TAMs in OSCC progression and their potential as prognostic markers. Since metastases are a principal cause of mortality in cancer patients, understanding TAM-mediated tumor invasion and metastasis is crucial for developing new therapeutic targets. Future research should employ advanced diagnostic methods, such as specific IHC markers (e.g., CD68), with larger sample sizes to validate these findings.

 

Author (s) Details

 

Sreepreeti Champatyray
Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India.

 

Saurjya Ranjan Das
Department of Anatomy, Institute of Medical Sciences & Sum Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India.

 

Dhiren Kumar Panda
Department of Anatomy, Institute of Medical Sciences & Sum Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v9/2475

A Distinctive Case Report Highlighting the Occurrence of a Rare Gigantic Adrenal Myelolipoma in a Patient with Sickle Cell Anaemia | Chapter 10 | Medical Science: Trends and Innovations Vol. 5

Adrenal myelolipomas (AMLs) are rare slow-growing non-malignant tumors that comprise both adipose and haematopoietic tissue and are caused by metaplasia of the reticuloendothelial cell. It is a type of incidentaloma which is an uncommon adrenal mass usually asymptomatic and identified during imaging investigation for reasons other than adrenal gland disorders. Myelolipomas vary in size but can be as large as 30 cm. These large myelolipomas can cause pressure on nearby structures resulting in clinical symptoms and signs.

This case report and literature review detail the diagnostic, medical and surgical management of a 14-year-old male with sickle cell anaemia who had a giant adrenal myelolipoma which was symptomatic. He had a one-week history of bilateral leg swelling and physical examination showed a mass in the right lumbar region. Abdominopelvic ultrasound revealed a suprarenal right-sided mass displacing the right kidney downwards. It was characterized as encapsulated, echo-complex, rounded and well-defined. The mass was also exerting pressure on the upper part of the kidney, and significantly compressing the inferior vena cava. A computed tomography (CT) scan revealed a large mass tenanting the right adrenal gland. He subsequently had an exploratory laparotomy with excision of the adrenal tumour. Immunohistochemistry analysis of the mass confirmed the diagnosis of an adrenal myelolipoma.

Conclusively, the diagnosis of an adrenal myelolipoma necessitates a high index of suspicion, a detailed medical history, a thorough physical examination, imaging studies and a meticulous histopathology investigation. Surgical intervention is the primary treatment method, while effective postoperative care ensures rapid recovery with minimal complications.

 

Author (s) Details

 

Udochikwuka Patience Ikejiaku
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State, Nigeria.

 

Chidinma Adaobi Udah
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State, Nigeria.

 

Johnpatrick Uchenna Ugwoegbu
Department of Radiology, Federal Teaching Hospital, Owerri, Imo State, Nigeria.

 

Emeka Nwolisa
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State, Nigeria.

 

Uzoma Onwukwe
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State, Nigeria.

 

Lilian Ezeuko
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State, Nigeria.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v5/4208

Pathological and Immunohistochemical Studies on Horn Cancer in Bovines | Chapter 6 | Advanced Research in Biological Science Vol. 9

Background: An investigation was carried out on twelve clinical cases of neoplasm of horn in bovines of Durg, Dhamtari and Rajnandgaon districts of Chhattisgarh suspected of bovine horn core carcinoma (squamous cell carcinoma) revealed the cytology, pathomorphology and immunohistochemical (IHC) expression of Pan-cytokeratin (Pan-CK), p53 gene, epidermal growth factor receptor (EGFR) and p16 gene in tumourous growth at horn in bovines.

 

Results: Eight out of 12 cases (66.66%) were confirmed as SCC of horn on the basis of histopathological and immunohistochemical analysis. Cytological examination of tumours by Papanicolaou staining revealed variation in shape and size of cells and altered nuclear details. Grossly neoplasms of horn revealed unilateral large cauliflower like growths at the base. SCCs were classified as well, moderately and poorly differentiated types on the basis of histopathology and immunohistochemistry (IHC). Well differentiated SCCs (n=4; 50%) were characterized by severe keratinization of horn epithelium with concentric arrangement forming keratin pearls also called as “cell nests”. Tumour islands of irregular shape observed in the horn epithelium invaded deep into dermis layer. Moderately differentiated SCCs (n=2; 25%) characterized by small keratin pearl formations and mitotic figures. Poorly differentiated SCCs of horn (n=2; 25%) revealed absence of distinctive keratin pearls although deep invasion from primary site was observed. SCC of horn revealed strong immunohistochemical staining of Pan-CK, p53 and EGFR and negative to p16. Highest immunohistochemical expression was observed in Pan-CK which confirmed the tumours were of epithelial origin and EGFR immunoexpression was confirmatory for malignancy and degree of metastasis. Neoplasms were confirmed as SCC by immunoexpression of Pan-CK, EGFR and p53 in malignant tumours including both well and poorly differentiated SCC of horn.

Author(s) Details:

Vivek Kumar,
Department of Veterinary Pathology, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Anjora, Durg- 491001, Chhattisgarh, India.

Dhananjay Kumar Jolhe,
Department of Veterinary Pathology, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Anjora, Durg- 491001, Chhattisgarh, India.

Ratan Chandra Ghosh,
Department of Veterinary Pathology, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Anjora, Durg- 491001, Chhattisgarh, India.

Rukmani Dewangan,
Department of Veterinary Surgery & Radiology, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Anjora, Durg- 491001, Chhattisgarh, India.

Prashant M. Sonkusale,
Department of Veterinary Pathology, Nagpur Veterinary College, Maharashtra Animal & Fisheries Science University, Nagpur- 440007, Maharashtra, India.

Sonu Sharma,
Dr. Lal Path Labs, Path Vets Veterinary Diagnosis, Chittranjan Park, New Delhi-110019, India.

Please see the link here: https://stm.bookpi.org/ARBS-V9/article/view/13646

Renal Leiomyosarcoma with Mixoid Component: Case Report and Literature Review | Chapter 11 | Advanced Concepts in Medicine and Medical Research Vol. 1

 Primary leiomyosarcoma is an intensely rare entity establishing only 0.5–1% of all invasive renal tumors. It is commonly diagnosed after histological test because it does not have any distinguishing diagnostic countenance clinically and radiologically. At times, it is difficult to differentiate leiomyosarcoma from the sarcomatoid renal container carcinoma even all the while histological examination as both tumors have pivot-shaped atypical containers. Moreover, some epithelial tombstones can be present in pure smooth influence sarcomas, while some smooth muscle tombstones are positive in carcinomas. An intensely uncommon condition is leiomyosarcoma that develops in the renal stomach. A patient with an obstructive grain-related abandoned renal colic was admitted to ward with a filling defect in the renal stomach, which was originally misdiagnosed as a blood clot. After visual test of the renal pelvis and a examination of the exophytic lesion, leiomyosarcoma was determined expected the cause. Laparoscopic radical nephrectomy was performed, histological and immunohistochemical examination rooted the lesion expected a leiomyosarcoma with mixomatoid component. No adjuvant situation was performed, and the patient remains active 6 years later surgery without repetition. Herein we provide literature review, consideration of the diagnosis and situation scenario of the patient with renal stomach leiomyosarcoma with mixomatoid component.

Author(s) Details:

Krivoborodov G. G.,
Department of Urology and Andrology, Pirogov Russian National Research Medical University, Ministry of Health, Russia and Russian Clinical and Research Center of Gerontology, Russia.

Bolotov A. D.,
State Budgetary Institution of Healthcare of Moscow (City Clinical Hospital no 1 Named after N.I. Pirogov), Russia.

Efremov N. S.,
Department of Urology and Andrology, Pirogov Russian National Research Medical University, Ministry of Health, Russia and Russian Clinical and Research Center of Gerontology, Russia.

Please see the link here: https://stm.bookpi.org/ACMMR-V1/article/view/12315

HER2/neu over Expression: A Prognostic Marker and a Possible Therapeutic Target in Ovarian Carcinoma- An Outlook for the Future | Chapter 4 | Novel Research Aspects in Medicine and Medical Science Vol. 2

 Background: Ovarian tumor is the 2nd most common tumor of gynaecological origin. Its prognosis is weak due to allure presentation in the leading stages and the 5-year survival rate is <50% accompanying the available cures. So, there is a constant need for new organic markers. The friendship between HER2/neu overexpression and ovarian malignancy has been studied, but the results are still contentious. Therefore, this study was aimed at judging the association of HER2/neu accompanying the clinicopathological features of epithelial ovarian cancers (EOC).Objective(s):1. To evaluate HER2/neu over verbalization as a prognostic marker for epithelial ovarian tumor.2. To find out the partnership of HER-2/neu overexpression with chemotherapy reaction in epithelial ovarian cancer.Methodology: It was a anticipated study with a determinable correlational study design of 90 epithelial ovarian cancer (EOC) cases presenting to Fauji Foundation Hospital, Rawalpindi middle from two points Nov 2018 to Oct 2019. Immunohistochemistry (IHC) was applied for HER2/neu verbalization and IHC 3+ patients were considered HER2 beneficial. The association of HER2/neu accompanying clinicopathological factors of ovarian malignancy e.g. stage, grade, pretreatment CA-125 levels and with a destructive agent response were determined.Results: Mean age of diagnosis was 53 ± 8.022 age. Mean pre-treatment CA-125 level was 1262 ± 1683 and 81.1% (n=73) had raised pre-situation CA-125 levels.Most of the patients bestowed with state-of-the-art stage i.e. stage III (56.7%, n=51) and high grade that is grade III (54.4%, n=49). Most common histological type visualized was high grade serous malignant growth (51.1%). It was seen that 24.4% (n= 22) of the tumors over meant HER2/neu, 65.6% (n=59) were HER2/neu negative, whereas 10% (n=9) were uncertain for HER2/neu expression. Overall, 72.2% patients had light sensitive affliction. According to HER2/neu status, 20% HER2/neu definite patients had platinum delicate disease & 3.3% had opposing disease inasmuch as 47.8% HER2/neu negative patients had platinum impressionable disease & 10% were light resistant.There was a statistically significant partnership of HER2/neu expression accompanying grade (p 0.040) and pre-treatment CA-125 levels (p 0.032) inasmuch as our study failed to show significant union between stage (p 0.383) and a destructive agent response (p 0.055).Conclusion: Our study showed that, like other tumors, HER2/neu was positive in 24.4% victims and its union with grade & pre-situation CA-125 level was statistically significant, but we could not authenticate its union with a destructive agent response. However, this result needs to be ratified in a larger study society and patients need to be made inquiries for longer event to conduct survival reasonings so as to establish HER2/neu as a prognostic indicator for epithelial ovarian cancer.

Author(s) Details:

Sharmin Arif,
Department of Oncology, Fauji Foundation Hospital, Rawalpindi, Pakistan.

Fauzia Abdus Samad,
Department of Oncology, Fauji Foundation Hospital, Rawalpindi, Pakistan.

Syed Abdus Samad,
Department of Oncology, Fauji Foundation Hospital, Rawalpindi, Pakistan.

Anum Khan,
Department of Oncology, Fauji Foundation Hospital, Rawalpindi, Pakistan.

Asif Riaz,
Department of Oncology, Fauji Foundation Hospital, Rawalpindi, Pakistan.

Rimsha Zahid,
Department of Oncology, Fauji Foundation Hospital, Rawalpindi, Pakistan.

Please see the link here: https://stm.bookpi.org/NRAMMS-V2/article/view/11800

Innovative Diagnostic Method Using Immunocytochemistry (Estrogen Receptor) for Diagnosis and Management of Breast Cancer | Chapter 15 | Current Progress in Medicine and Medical Research Vol. 9

This study proposed to evaluate the influence of Immunocytochemistry (ICC) on Fine Needle Aspiration Cytology (FNAC) using estrogen receptor (ER), in diagnosing conscience lesions, equating them to success standard Core Needle Biopsy with Immunohistochemistry (IHC). A total of 50 samples were composed and analyzed utilizing both FNAC and Core Needle Biopsy methods.For FNAC, the results demonstrated superior depiction: Sensitivity=100%, Specificity=100%, Diagnostic Accuracy=100%, Positive Predictive Value (PPV)=100%, and Negative Predictive Value (NPV)=100%.Similarly, the results for ICC using ER were too favorable: Sensitivity=100%, Accuracy=100%, Positive Predictive Value= 100% and Negative Predictive Value=100%.These verdicts suggest that ICC utilizing ER could be a part of a trustworthy alternative to the gold-standard demonstrative tests. This technique substantiates particularly valuable in positions where capability disadvantages prevent the use of the standard test. However, it is necessary to note that further studies with a best sample size are essential to generalize these results.Furthermore, this study complicated the utilization of theme dossier analysis on FNAC reports. The study revealed that nearly 11.35% of the dataset contained beneficial words, signifying that normalization processes can abridge the data and manage valuable for assisting dispassionate chart reviews and clinical resolution support systems.

Author(s) Details:

Rohith R. Nair,
J.S.S. Medical College, Mysore, Karnataka- 570015, India.

Sonali Nandish,
Department of Computer Science and Engineering, JSS Science and Technology University, Mysore, Karnataka - 570006, India.

R. J. Prathibha,
Department of Information Science and Engineering, JSS Science and Technology University, Mysore, Karnataka - 570006, India.

N. M. Nandini,
Department of Pathology, JSS Medical College and Hospital, Constituent of JSSAHER, Mysore, Karnataka - 570004, India.

Please see the link here: https://stm.bookpi.org/CPMMR-V9/article/view/11699

CD163 as a Novel Predictive Biomarker for Classical Hodgkin’s Lymphoma in patient from Saudi Arabia | Chapter 3 | Perspective of Recent Advances in Medical Research Vol. 10

 The overexpression of the CD163 irritant by tumor-mixed macrophages (TAMs) in the Hodgkin's lymphoma (HL) is considered to be a meaningful predictive biomarker for risk stratum. This is most likely on account of a single nucleotide polymorphism (SNP) at the deoxyribonucleic acid promoter. The aim of this backward-looking case control study was to create a deoxyribonucleic acid expression sketch of a specific biomarker to predict the effect and survival of victims with classic HL (CHL) in Saudi Arabia. The protein expression of CD163 was investigated utilizing immunohistochemistry (IHC). To assess risk stratum, a prognosis index was premeditated for the CD163 protein. This antigen's selected SNPs were genotyped in 100 CHL cases and controls. The study revealed that the CD163 protein verbalization level was significantly equated with disease relapse (DR) and overall continuation (OS), (P <0.001). In addition, the CD163 index threshold (15.0) was erect to be considerably correlated with the relapse rate (P= 0.022). CD163 promotor SNP (rs75608120) shown a significant equivalence with the DR (P=0.032) but not accompanying OS. We concluded that CD163 is a specific biomarker and allure overexpression by TAMs is significantly guide DR and reduced OS.

Author(s) Details:

Huda Al Sayed Ahmed,
Pathology and Laboratory Services Department, Johns Hopkins Aramco Healthcare, 1709, Dhahran, Saudi Arabia.

Wasim Fawzi Raslan,
Pathology and Laboratory Services Department, Johns Hopkins Aramco Healthcare, 10613 Dhahran, Saudi Arabia.

Abdel Halim Salem Deifalla,
Department of Anatomy, College of Medicine and Medical Sciences, Saudi Arabia.

Mohammad Dahmani Fathallah,
Department of Higher Studies, Arabian Gulf University, 26671 Manama, Bahrain.

Please see the link here: https://stm.bookpi.org/PRAMR-V10/article/view/9481

Connexin26 is Present in Rat Cardiomyocytes and Rat Cardiomyocyte Extracellular Vesicles| Chapter 5 | Current Overview on Disease and Health Vol. 7

 In this episode, we describe the results obtained from our two, currently published studies that aimed to demonstrate the appearance of Cx26 and its immunolocalization in informer cardiomyocytes, in differentiated (d)H9c2 cardiac rat containers and in extracellular vesicles from dH9c2 cell light in weight. Connexins (Cxs) are a family of membrane-traversing proteins, expressed easily intimidated and named according to their microscopic weight. They are famous to form gap junctions, sheath channels mediating container-cell communication, which play an essential part in the propagation of energetic activity in the heart. Cx26 has existed described in any of tissues and its mutations are frequently guide deafness and skin diseases. Only currently, Cx26 has been described in the essence, at level of vessels and cardiomyocytes, and allure localization is scattered all over the container at the level of different subcellular compartments apart from at the intercalated discs as is the case for the other cardiac Cxs. The working characterization of Cx26 in cardiomyocytes debris poorly understood due to this current discovery in the courage tissues. However, the peculiar localization at the level of extracellular vesicles suggested a particular role for cardiac Cx26 in bury-cellular communication in a break junction liberated manner.

Author(s) Details:

Alessandra Falleni,
Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Antonella Cecchettini,
Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Margherita Bernardeschi,
Italian Institute of Technology, Center for Materials Interfaces, Smart Bio-Interfaces, Pontedera, Italy.

Stefania Moscato,
Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Letizia Mattii,
Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Please see the link here: https://stm.bookpi.org/CODH-V7/article/view/9079

Study of IDH1 (R132H) Mutation and Expression of ATRX Marker in Correlation with the Histopathological Grading in Gliomas| Chapter 8 | Challenges and Advances in Pharmaceutical Research Vol. 6

 Background: Primary malignant brain tumours are the third leading cause of cancer-related death and morbidity globally. IDH1 mutation has also been shown to be a predictive factor in more recent WHO classifications of CNS tumours. In gliomas, the presence of an IDH1 change increases progression-free survival. Similar to this, improved outcomes in astrocytic malignancies are linked to ATRX mutations. The goal of the current study is to evaluate the relationship between IDH1 mutation, ATRX expression, and histopathological grading in glial tumours, which will enable us grade glial tumours more accurately in light of recent molecular developments.

The main goal is to comprehend how the histopathological grades of glial tumours correlate with the expression of IDH1 and ATRX on immunohistochemistry. The current study will be conducted over a two-year period in the Histopathology and Immunohistochemistry division of the Pathology Department at Jawaharlal Nehru Medical College in Sawangi (Meghe), in coordination with the Department of Neurosurgery at Acharya Vinoba Bhave Rural Hospital in Sawangi (Meghe). About 45 to 50 resected samples from suspected instances of glial tumours received at the J.N.M.C.'s Department of General Pathology will be used in this investigation. In order to gain a better understanding, we will compare the link between IDH1 mutation and ATRX expression with the histopathological grades in glial tumours and current molecular developments on immunohistochemistry using a well-tabulated master chart. Results: A master chart with properly tabulated data will show the observations. Conclusion: Based on the research's findings, a conclusion will be drawn.

Author(s) Details:

Pooja Jha,
Jawaharlal Nehru Medical College (DMIMS), Sawangi (M), Wardha, India.

Samarth Shukla,
Department of Pathology, Jawaharlal Nehru Medical College (DMIMS), Sawangi (M), Wardha, India.

Sunita Vagha,
Department of Pathology, Jawaharlal Nehru Medical College (DMIMS), Sawangi (M), Wardha, India.

Ravindra P. Kadu,
Department of Pathology, Jawaharlal Nehru Medical College (DMIMS), Sawangi (M), Wardha, India.

Sourya Acharya,
Department of Medicine, Jawaharlal Nehru Medical College (DMIMS), Sawangi (M), Wardha, India.

Please see the link here: https://stm.bookpi.org/CAPR-V6/article/view/8096

Study on Diagnostic and Prognostic Significance of E-Cadherin and Vimentin in Oral Cancer Metastasis | Chapter 10 | Current Practice in Medical Science Vol. 2

Background: To determine how the expression of E-cadherin and vimentin affects epithelial-to-mesenchymal transition in precancerous and cancerous lesions of the oral cavity and oropharynx, as well as to predict invasiveness based on the distinct pattern of expression of these two proteins.

Materials and methods: Haematoxylin and eosin sections, as well as immunohistochemistry expression of E-cadherin and vimentin, were used to investigate biopsies and samples from the oral cavity and oropharynx for any premalignant lesions and invasive epithelial squamous lesions where necessary. Patients' follow-up and therapy-related changes were also examined during the trial.

Results: In our study, there were 64 premalignant cases and 23 malignant cases, with 65 (71.0%) men and 22 (29.0%) females. The majority of malignant cases—15, or 64.2%—occurred in the fifth and sixth decades of life, while the majority of premalignant lesions—36, or 56.4%—occurred in the fourth and fifth. Leukoplakia accounted for 14 cases (21.9%) of the 64 premalignant oral lesions, of which 3 instances also exhibited mild to severe dysplasia. Premalignant lesions had significant 4+/3+ E-cadherin expression in the majority of cases, but vimentin expression was weaker or negative in both dysplasias and carcinoma-in-situ (p=0.013). Six out of ten (60%) instances of well-differentiated cancer had a 4+ degree of E-cadherin staining, compared to zero out of ten (0%), and just one, case, respectively, of poorly differentiated carcinoma. Vimentin was expressed to a higher degree in 6/10 (60%) instances of well-differentiated oral squamous cell carcinoma than it was in 6/10 (60%) cases of poorly-differentiated carcinoma. One (1.6%) of the positive lymph node metastasis cases had high E-cadherin staining, whereas four (66.6%) had no E-cadherin staining at all. In our investigation, the differences in the immunoreactivities between CIS and microinvasive or invasive carcinomas were statistically significant (p 0.001). When invasive carcinomas were compared to dysplasias and carcinoma-in-situ, E-cadherin expression was dramatically decreased, and the difference in immunoreactivity was statistically significant (p value 0.05). It was statistically significant (p value 0.05) that vimentin expression increased as the tumour developed from dysplasias to carcinoma-in-situ to invasive carcinomas.

Conclusions: The evaluation of tumour behaviour, prognosis, survival, and patient therapy can be aided by the use of immunohistochemistry E-cadherin and vimentin stains. Future research on tumour microinvasion for early detection and patient survival can use these substances as biomarkers.

Author(s) Details:

Anjum Ara,

Department of General Pathology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.

Kafil Akhtar,

Department of Pathology Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, India.

Please see the link here: https://stm.bookpi.org/CPMS-V2/article/view/7349

Breast Cancer: Immunohistochemical and Molecular Study of the HER-2 Oncoprotein in Congolese Women | Chapter 12 | New Horizons in Medicine and Medical Research Vol. 5

 Breast cancer is a complex illness with a variety of morphological and molecular traits that influence treatment response.

The goal of this study was to look at the overexpression of HER2 in breast cancer in women in the Republic of Congo using immunohistochemistry and RT-PCR.

Materials and Methods: A cross-sectional descriptive study was conducted during an 8-month period. At the University Hospital of Brazzaville, 25 paraffin biopsies were obtained from breast cancer patients. The disease was studied from an epidemiological, clinical, histological, immunohistochemical, and molecular perspective.

The patients were 49.64 13.20 years old on average (31-80 years). The tumour was correctly localised in 60% of the patients. 76 percent of the patients had invasive nonspecific type carcinoma. The most common stage was T4b N1a M0, which accounted for 56 percent of the study participants. SBR histopronostic grade 1 was seen in 60% of patients. Positive oestrogen and progesterone receptors were found in 45 and 60 percent of people, respectively. In 12 percent (3/25) of the 25 patients evaluated for IHC, the HER2 oncoprotein was positive. The luminal group was in the majority with 32 percent. In 60 percent (15/25) of patients, RT-PCR analysis of the HER2 gene revealed overexpression, three of which were already positive for IHC. The "AmoyDx® HER2 Mutation Detection Kit" found 12 mutations, ten of which included exon 20, accounting for 83.33 percent of cases, and two of which involved exon 19, accounting for 16.67 percent of cases. The association of HER2 gene overexpression revealed a statistically significant difference between the two methods, p0.00003.

Conclusion: HER2 is a prospective therapeutic target in breast cancer since it is a prognostic and predictive sign. IHC highlighting, on the other hand, is time-consuming and prone to false negatives. As a result, molecular analysis may play a crucial role in decision-making when it comes to introducing targeted breast cancer medicines in Congo.

Author(S) Details

Anicet Luc Magloire Boumba
Faculté des Sciences de la Santé, Université Marien Ngouabi, BP : 69, Brazzaville, Congo and Zone de recherche de Pointe-Noire, Institut National de Recherche en Sciences de la Santé (IRSSA), Congo and Laboratoire d’Analyses Médicales et Morphologiques, Hôspital Général de Loandjili de Pointe-Noire (HGL), Congo.

Fabien Gaël Mouamaba
Faculté des Sciences de la Santé, Université Marien Ngouabi, BP : 69, Brazzaville, Congo and Service Anatomie et Cytologie Pathologiques, Centre Hospitalier et Universitaire de Brazzaville (CHUB), Congo.

Sidney Frousse Christian Ngatali
Faculté des Sciences de la Santé, Université Marien Ngouabi, BP : 69, Brazzaville, Congo and Laboratoire d’Analyses Médicales et Morphologiques, Hôspital Général de Loandjili de Pointe-Noire (HGL), Congo.

Dimitry Moudiongui Mboungou Malanda
Faculté des Sciences de la Santé, Université Marien Ngouabi, BP : 69, Brazzaville, Congo and Service Anatomie et Cytologie Pathologiques, Centre Hospitalier et Universitaire de Brazzaville (CHUB), Congo.

Donatien Moukassa
Faculté des Sciences de la Santé, Université Marien Ngouabi, BP : 69, Brazzaville, Congo.

Jean Félix Peko
Faculté des Sciences de la Santé, Université Marien Ngouabi, BP : 69, Brazzaville, Congo and Service Anatomie et Cytologie Pathologiques, Centre Hospitalier et Universitaire de Brazzaville (CHUB), Congo.

View Book:- https://stm.bookpi.org/NHMMR-V5/article/view/6490