Turk patoloji dergisi最新文献

{"title":"Immunohistochemical Analysis of the Extrinsic Apoptosis Process in the Non-Neoplastic and Neoplastic Prostate.","authors":"Ayşe Burcu Ileri,&nbsp;Reşit Doğan Köseoğlu,&nbsp;Fatma Markoç,&nbsp;İlker Etikan,&nbsp;Doğan Atilgan,&nbsp;Faik Alev Deresoy","doi":"10.5146/tjpath.2017.01409","DOIUrl":"https://doi.org/10.5146/tjpath.2017.01409","url":null,"abstract":"<p><strong>Objective: </strong>Deviations in the apoptotic process have been demonstrated in prostate carcinogenesis. We aimed to evaluate especially the process of extrinsic apoptosis in the spectrum of neoplastic lesions of the prostate epithelium so as to reveal the variations in the apoptotic process.</p><p><strong>Material and method: </strong>The study included 20 benign prostatic hyperplasia, 8 high-grade prostatic intraepithelial neoplasia and 82 prostatic carcinoma patients. Immunohistochemistry was performed on sections obtained from materials of suprapubic prostatectomy, tru-cut biopsy, transurethral resection and radical prostatectomy. While Fas and FasL were evaluated in glandular and stromal areas, DcR1 and FLIP were evaluated in only glandular areas. Intensity and extent of immunostaining for Fas and FasL antibodies were separately scored and both scores were summarized. The total score of ≥ 4 both for Fas and FasL, expressions of FLIP and DcR1determined in more than 5% of glandular areas were accepted as positive.</p><p><strong>Results: </strong>Glandular FasL positivity was observed in 63.8 and 20% of the cases with prostatic carcinoma and benign prostatic hyperplasia, respectively (p=0.001). The loss of stromal Fas expression in PCa was obvious (p < 0.001). FLIP positivity was more frequently seen in high-grade prostatic intraepithelial neoplasia and PCa.</p><p><strong>Conclusion: </strong>In prostatic carcinoma, decreased stromal Fas expression, contrary to higher glandular FasL positivity, supports the assertion that sensitivity of epithelial and stromal cells to apoptosis and their protective pathways against apoptosis undergo alterations. Increased FLIP expressions in high-grade prostatic intraepithelial neoplasia and prostatic carcinoma can also be interpreted accordingly.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"19-28"},"PeriodicalIF":1.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2017.01409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35577343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dedifferentiated Liposarcoma of the Gastroesophageal Junction.","authors":"Gökçe Aşkan,&nbsp;Pelin Bağci,&nbsp;Meera Hameed,&nbsp;Olca Baştürk","doi":"10.5146/tjpath.2014.01297","DOIUrl":"https://doi.org/10.5146/tjpath.2014.01297","url":null,"abstract":"<p><p>Liposarcoma is one of the most common sarcomas in adults, but very rarely presents as a primary in the upper gastrointestinal system. Herein, we present a 71-year-old male patient who underwent wedge excision biopsy twice and then fine needle aspiration and total gastrectomy for a recurrent gastroeosophageal junction mass. In microscopic sections, both well-differentiated and dedifferentiated components were seen. Tumor cells were positive for MDM2, CDK4 and negative for CD117, DOG1, CD34, SMA, Desmin, S-100, HMB45, SOX10, AE1/AE3, CAM5.2, CK18. Fluorescence in situ hybridization (FISH) was performed and MDM2 gene (12q15) amplification was detected. According to these findings, a diagnosis of dedifferentiated liposarcoma was supported. We believe this is the first reported case of dedifferentiated liposarcoma of the gastroesophageal junction.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"104-107"},"PeriodicalIF":1.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2014.01297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33387688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumorous Conditions of the Hand: A Retrospective Review of 402 Cases.","authors":"Ali Cavit,&nbsp;Haluk Özcanli,&nbsp;Mesut Sançmiş,&nbsp;Güzide Ayşe Ocak,&nbsp;Elif İnanç Gürer","doi":"10.5146/tjpath.2017.01413","DOIUrl":"https://doi.org/10.5146/tjpath.2017.01413","url":null,"abstract":"<p><strong>Objective: </strong>Knowledge concerning treatment and care of hand lesions is often based on small case series, case reports and a few large general case series. The aim of this study is to present our experience with hand tumors' and tumor-like lesions' incidence, age range and localizations.</p><p><strong>Material and method: </strong>Between 2006-2016, 402 patients operated and histopathologically diagnosed with bone and soft tissue tumorous conditions of the hand were evaluated retrospectively.</p><p><strong>Results: </strong>Three hundred sixty one out of 402 cases (89.8%) were soft tissue tumors and 41 cases (10.2%) were osseous tumors of the hand. A total of 10 malignant tumors (2.5%) were encountered in the hand. The average age of the patients was 41.9 years (ranged from 1 to 83 years). Among 361 soft tissue tumors, only 6 cases (1.6%) were malignant and they were squamous cell tumors (n=5) and synovial sarcoma (n=1). The most common soft tissue pathology was ganglion cyst (n=125). The most common bone tumor was enchondroma, diagnosed in 26 patients (6.4% of all patients). Primary malignant bone tumors were extremely rare in the hand; one osteosarcoma and one chondrosarcoma were reported. Metastatic tumors to the hand were seen in two patients; and they were lung carcinoma and chondrosarcoma metastasis.</p><p><strong>Conclusion: </strong>Up-date knowledge and a thorough understanding of the nature and demographic characteristics of the tumorous conditions of the hand are crucial for accurate diagnosis and appropriate treatment.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"66-72"},"PeriodicalIF":1.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2017.01413","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35474043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study.","authors":"Güldal Esendağlı,&nbsp;F Göknur Akarca,&nbsp;Serdar Balcı,&nbsp;Asuman Argon,&nbsp;Selma Şengiz Erhan,&nbsp;Nesrin Turhan,&nbsp;Neslihan İnce Zengin,&nbsp;Sevinç Hallaç Keser,&nbsp;Betül Çelik,&nbsp;Tangül Bulut,&nbsp;Samir Abdullazade,&nbsp;Esra Erden,&nbsp;Berna Savaş,&nbsp;Temmuz Bostan,&nbsp;Özgül Sağol,&nbsp;Anıl Aysal Ağalar,&nbsp;Nuray Kepil,&nbsp;Yıldırım Karslıoğlu,&nbsp;Armağan Günal,&nbsp;Fatma Markoç,&nbsp;Burcu Saka,&nbsp;Gonca Özgün,&nbsp;Şükrü Oğuz Özdamar,&nbsp;Burak Bahadır,&nbsp;Esin Kaymaz,&nbsp;Emre Işık,&nbsp;Semin Ayhan,&nbsp;Deniz Tunçel,&nbsp;Banu Özgüven Yılmaz,&nbsp;Sevinç Çelik,&nbsp;Tuba Karabacak,&nbsp;İpek Erbarut Seven,&nbsp;Çiğdem Ataizi Çelikel,&nbsp;Zuhal Gücin,&nbsp;Özgür Ekinci,&nbsp;Gülen Akyol","doi":"10.5146/tjpath.2017.01404","DOIUrl":"https://doi.org/10.5146/tjpath.2017.01404","url":null,"abstract":"<p><strong>Objective: </strong>As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols.</p><p><strong>Material and method: </strong>With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages.</p><p><strong>Results: </strong>Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories.</p><p><strong>Conclusion: </strong>The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute's oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"41-48"},"PeriodicalIF":1.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2017.01404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35577341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Twist-1, E-cadherin and EZH2 in Prostate Cancer: An Immunohistochemical Study.","authors":"Aziza E. Abdelrahman, Shimaa A Arafa, R. Ahmed","doi":"10.5146/tjpath.2017.01392","DOIUrl":"https://doi.org/10.5146/tjpath.2017.01392","url":null,"abstract":"OBJECTIVE\u0000There is an urgent need to identify molecular biomarkers rather than clinical markers to distinguish aggressive prostate cancer from the indolent majority for proper treatment and accurate prediction of prognosis. We aimed to investigate the immunohistochemical expression of epithelial-mesenchymal transition (EMT)-related molecules (Twist-1 and E-cadherin) and the stem cell marker EZH2 in prostate cancer and to assess their ability to identify the high-risk patients, in a trial to explore their prognostic implications.\u0000\u0000\u0000MATERIAL AND METHOD\u0000Immunohistochemical expression of Twist-1, E-cadherin and EZH2 in 50 specimens of prostate cancer and 20 cases of benign prostatic hyperplasia were studied. The relationship between their expression and the clinicopathological variables, biochemical recurrence, and biochemical progression-free survival were investigated.\u0000\u0000\u0000RESULTS\u0000Our results revealed that high Twist-1, as well as high EZH2 expression, was strongly associated with higher pre-treatment PSA level, Gleason score ≥7, advanced tumor stage, lymph node involvement, distant metastasis and biochemical progression. Aberrant E-cadherin expression was significantly associated with higher pre-treatment PSA level, Gleason score ≥7, advanced tumor stage, lymph node involvement, and distant metastasis. A significant positive correlation between Twist-1 and EZH2 expression was found (p < 0.001), while E-cadherin expression showed a negative correlation with both markers (p < 0.001). A significant association was found between high Twist-1, high EZH2& aberrant E-cadherin expression, and shorter biochemical progression-free survival.\u0000\u0000\u0000CONCLUSION\u0000The high Twist-1 expression, aberrant E-cadherin and high EZH2 expression in primary prostate cancer are considered as adverse prognostic markers of an aggressive tumor with high metastatic potential. Assessment of their expression level would contribute to the accurate prediction of biochemical progression.","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":"262 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122843594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programmed Death Ligand 1 (PD-L1) Expression in Malignant Mesenchymal Tumors.","authors":"Kemal Kösemehmetoğlu,&nbsp;Ece Özoğul,&nbsp;Berrin Babaoğlu,&nbsp;Gaye Güler Tezel,&nbsp;Gökhan Gedikoğlu","doi":"10.5146/tjpath.2017.01395","DOIUrl":"https://doi.org/10.5146/tjpath.2017.01395","url":null,"abstract":"<p><strong>Objective: </strong>Programmed death ligand 1 (PD-L1) found on tumor cells has recently been reported to have a key role in the development and dissemination of many tumors, such as lung and breast carcinomas. In this study, we retrospectively analyzed PD-L1 expression among different types of sarcomas.</p><p><strong>Material and method: </strong>Tissue microarrays of 3-4 mm diameter were composed from paraffin blocks of 222 various sarcomas. Slides prepared from microarrays were stained for PD-L1 antibody (Cell Signaling, E1L3N®) using Leica Bond Autostainer. Any membranous staining over 5% of the cells was regarded as positive. Quantitative real-time PCR with TaqMan gene expression assays for PDL1 was performed using whole sections from FFPE tissue of PD-L1 positive cases, by normalizing absolute values to β-actin. Relative expression level of mRNA of PDL1 was calculated and scored using Log102(threshold cycle of b-actin - threshold cycle of PDL1).</p><p><strong>Results: </strong>Immunohistochemically, PD-L1 expression was present in 34 of 222 (15%) sarcomas. 5/13 (39%) undifferentiated pleomorphic sarcomas, 6/18 (33%) malignant peripheral nerve sheath tumors, 5/16 (31%) dedifferentiated liposarcomas, 4/19 (21%) rhabdomyosarcomas, 2/16 (13%) epithelioid sarcomas, 2/15 (13%) leiomyosarcomas, 3/26 (12%) synovial sarcomas, 1/18 (6%) myxoid liposarcoma, 1/2 (50%) extraskeletal myxoid chondrosarcoma, 1/3 (33%) alveolar soft part sarcoma, 1/3 (33%) parachordoma/myoepithelioma, 1/5 (20%) pleomorphic liposarcoma, 1/7 (14%) angiosarcoma, 1/8 (13%) Ewing sarcoma showed PD-L1 expression. Cases of solitary fibrous tumor/hemangiopericytoma (18), desmoplastic round cell tumor (14), Ewing-like sarcoma (6), epithelioid hemangioendothelioma (5), clear cell sarcoma (4), myxofibrosarcoma (4), low grade fibromyxoid sarcoma (2) were all negative. Tumor-infiltrating hematopoietic cells were positive for PD-L1 in 32 cases (15%) with only 2 cases overlapping with PD-L1 staining in tumoral cells. Sixteen of 34 (47%) immunohistochemically PD-L1 positive cases showed significant but low-level PD-L1 mRNA overexpression.</p><p><strong>Conclusion: </strong>We have shown PD-L1 expression in a subset of sarcomas, both at the protein and mRNA level. High-grade pleomorphic sarcomas tend to show more frequent PD-L1 expression. Clinical trials are necessary to further assess the effect of anti PD-L1 drugs on sarcomas showing PD-L1 expression.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"192-197"},"PeriodicalIF":1.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2017.01395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35339127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Cutting-Needle Biopsy Be an Alternative to Excisional Biopsy in Lymph Node Pathologies?","authors":"Aydan Kiliçarslan,&nbsp;Mehmet Doğan,&nbsp;Nuran Süngü,&nbsp;Emre Karakök,&nbsp;Leman Karabekmez,&nbsp;Mesut Akyol,&nbsp;Hayriye Tatli Doğan","doi":"10.5146/tjpath.2016.01393","DOIUrl":"https://doi.org/10.5146/tjpath.2016.01393","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to compare cutting-needle biopsy (CNB) diagnoses with excisional biopsy diagnoses of enlarging lymph nodes and to determine the diagnostic value of CNB.</p><p><strong>Material and method: </strong>Out of the 291 cases that underwent CNB from lymph nodes between 2010 and 2016, 60 were included in the study in which pathological lymph nodes were excised after CNB. Demographic information, pathology and imaging reports, the diameters of the lymph nodes and the length of the CNBs of these cases were obtained from the hospital registry system. Diagnoses of the CNBs and excisional biopsies were then compared.</p><p><strong>Results: </strong>According to the excisional biopsy diagnosis, 7 of the 60 cases (11.7%) were benign and 53 of them (88.3%) were malignant. 28 (53%) of the malignant cases were diagnosed as Hodgkin's lymphoma while the others (47%) got a non-Hodgkin's lymphoma diagnosis. In the 8 non-diagnostic CNBs, 3(37%) of them were found to be benign/reactive, while 5 (63%) were diagnosed as malign lymphoma in excisional biopsy. Similarly, 7(64%) of the 11 cases diagnosed as benign/reactive in CNB, were found to be malignant with excisional biopsy. When CNB and excisional biopsy were compared, sensitivity and specificity were 90% and 100%; positive predictive value (PPV) and negative predictive value (NPV) were 100% and 0%, respectively, and the diagnostic accuracy rate (DV) was 86.5%. The mean diameter of the benign lymph nodes was 26.1 mm and the mean diameter of the malignant ones was 35.6 mm. There was no significant difference between malignant and benign lymph node size (p > 0.05). There was also no statistically significant difference between CNB length and correct diagnosis (p=0.233).</p><p><strong>Conclusion: </strong>CNB is a non-invasive procedure. It is an alternative to excisional biopsy because of its low morbidity and low cost. However, the sensitivity of CNB is lower than its specificity, and we recommend the surgical excision of lymph nodes with a clinically strong neoplasm suspicion because of the presence of false negatives in 7 cases.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"235-239"},"PeriodicalIF":1.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2016.01393","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35339125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are CD68 and Factor VIII-RA Expression Different in Central and Peripheral Giant Cell Granuloma of Jaw: An Immunohistochemical Comparative Study.","authors":"Soudabeh Sargolzaei,&nbsp;Nasim Taghavi,&nbsp;Farzaneh Poursafar","doi":"10.5146/tjpath.2017.01401","DOIUrl":"https://doi.org/10.5146/tjpath.2017.01401","url":null,"abstract":"<p><strong>Objective: </strong>Central giant cell granuloma and peripheral giant cell granuloma of the jaw and oral cavity are identical in histopathologic features, although they are different in pathogenesis and clinical behavior. The aim of present study was to compare CD 68 and factor VIII related antigen (VIII-RA ) immunoreactivity in central giant cell granuloma and peripheral giant cell granuloma to determine the biologic nature and clinical behavior of these lesions which may lead to a better or new treatment modality.</p><p><strong>Material and method: </strong>CD68 and factor VIII-RA expression were examined immunohistochemically in 22 cases of central giant cell granuloma (10 aggressive and 12 non- aggressive ) and 19 cases of peripheral giant cell granuloma. The Kruskal-Wallis test followed by the Dunn test was used for data analysis.</p><p><strong>Results: </strong>CD68 expression was observed in approximately 100% of multinucleated giant cells and 50% of mononuclear cells. Overexpression of factor VIII-RA in the endothelial cells of capillary like vessels in the periphery of the lesions was prominent. A statistical significant difference for CD68 intensity score in mononuclear cells among three groups (P=0.016) was observed. Indeed, factor VIII-RA intensity score in the endothelial cells of central giant cell granuloma and peripheral giant cell granuloma showed significant difference (P=0.004).</p><p><strong>Conclusion: </strong>These findings support the histiocyte/macrophage nature of multinucleated giant cells and mononuclear cells. Overexpression and high intensity score of CD68 in mononuclear cells and the high intensity score of factor VIII-RA in endothelial cells represent less aggressive behavior in central giant cell granuloma.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"49-56"},"PeriodicalIF":1.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2017.01401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35339106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and Treatment Reproducibility of Cervical Intraepithelial Neoplasia / Squamous Intraepithelial Lesion and Factors Affecting the Diagnosis.","authors":"Arzu Sağlam,&nbsp;Alp Usubütün,&nbsp;Anıl Dolgun,&nbsp;George L Mutter,&nbsp;M Coşkun Salman,&nbsp;Olcay Kurtulan,&nbsp;Aytekin Akyol,&nbsp;Eylem Akar Özkan,&nbsp;Sema Baykara,&nbsp;Dilek Bülbül,&nbsp;Zerrin Calay,&nbsp;Funda Eren,&nbsp;Derya Gümürdülü,&nbsp;Nihan Haberal,&nbsp;Şennur Ilvan,&nbsp;Şeyda Karaveli,&nbsp;Meral Koyuncuoğlu,&nbsp;Bahar Müezzinoğlu,&nbsp;Kamil Hakan Müftüoğlu,&nbsp;Özlem Özen,&nbsp;Necmettin Özdemir,&nbsp;Elif Peştereli,&nbsp;Çağnur Ulukuş,&nbsp;Osman Zekioğlu","doi":"10.5146/tjpath.2017.01400","DOIUrl":"https://doi.org/10.5146/tjpath.2017.01400","url":null,"abstract":"<p><strong>Objective: </strong>Inter-observer differences in the diagnosis of HPV related cervical lesions are problematic and response of gynecologists to these diagnostic entities is non-standardized. This study evaluated the diagnostic reproducibility of \"cervical intraepithelial neoplasia\" (CIN) and \"squamous intraepithelial lesion\" (SIL) diagnoses.</p><p><strong>Material and method: </strong>19 pathologists evaluated 66 cases once using H&E slides and once with immunohistochemical studies (p16, Ki-67 and Pro-ExC). Management response to diagnoses was evaluated amongst 12 gynecologists. Pathologists and gynecologists were also given a questionnaire about how additional information like smear results and age modify diagnosis and management.</p><p><strong>Results: </strong>We show moderate interobserver diagnostic reproducibility amongst pathologists. The overall kappa value was 0.50 and 0.59 using the CIN and SIL classifications respectively. Impact of immunohistochemical evaluation on interpretation of cases differed and there was lack of statistically significant improvement of interobserver diagnostic reproducibility with the addition of immunohistochemistry. We saw that choice of treatment methods amongst gynecologists varied and overall concordance was only fair to moderate. The CIN2 diagnostic category was seen to have the lowest percentage agreement amongst both pathologists and gynecologists. We showed that pathologists had diagnostic \"styles\" and gynecologists had management \"styles\".</p><p><strong>Conclusion: </strong>In summary each pathologist had different diagnostic tendencies which were affected not only by histopathology and marker studies, but also by the patient management tendencies of the gynecologist that the pathologist worked with. The two-tiered modified Bethesda system improved diagnostic agreement. We concluded that immunohistochemistry should be used only to resolve problems in select cases and not for every case.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"177-191"},"PeriodicalIF":1.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2017.01400","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35339130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance of Programmed Cell Death Ligand 1 (PD-L1), CD8+ Tumor-Infiltrating Lymphocytes and p53 in Non-Small Cell Lung Cancer: An Immunohistochemical Study.","authors":"Hayam E Rashed,&nbsp;Aziza E Abdelrahman,&nbsp;Mohamed Abdelgawad,&nbsp;Safa Balata,&nbsp;Mohamed El Shabrawy","doi":"10.5146/tjpath.2017.01398","DOIUrl":"https://doi.org/10.5146/tjpath.2017.01398","url":null,"abstract":"<p><strong>Objective: </strong>Programmed cell death ligand-1 interacts with the immune receptors on the surface of CD8+ tumor infiltrating lymphocytes and PD-1, thereby blocking its anti-tumor activity. Therapeutics suppression of this interaction will show a promise in the treatment of non-small cell lung cancer by restoring the functional anti-tumor T-cell activity. We aimed to evaluate the association between the immunohistochemical expression of PD-L1, stromal CD8+ tumor infiltrating lymphocytes and p53 with the clinicopathological characteristics, response to chemotherapy, progression-free-survival, and overall survival.</p><p><strong>Material and method: </strong>We examined the immunohistochemical expression of PD-L1, stromal CD8+ TILs, and p53 expression in 50 patients with advanced stage (III&IV) non-small cell lung cancer.</p><p><strong>Results: </strong>PD-L1 was expressed in 56% of the studied cases. PD-L1 expression was related to unfavorable response to the therapy without significant difference. PD-L1 expression was significantly associated with disease progression, poor progression-free-survival & overall survival. CD8+ TILs were high in 32% of the cases. Tumors with high CD8+ TILs showed a partial response to therapy and had a better progression-free-survival and overall survival. p53 expressed in 82% of the studied cases. There was a significant negative association between PD-L1 and CD8+ TILs (p=0.009), while a non-significant association was found between p53 and PD-L1 (p=0.183).</p><p><strong>Conclusion: </strong>PD-L1 overexpression is an unfavorable prognostic marker, while the high CD8 + TILs is a good prognostic marker in non-small cell lung cancer. PD-L1 immunohistochemical assessment may be used for the selection of patients legible for treatment with anti-PD-L1 therapy.</p>","PeriodicalId":155409,"journal":{"name":"Turk patoloji dergisi","volume":" ","pages":"211-222"},"PeriodicalIF":1.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5146/tjpath.2017.01398","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35339128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}