Introduction: The aims of this study were to investigate the immunohistochemical expression of cyclooxygenase-2 (COX- 2) and vascular endothelial growth factor-C (VEGF-C), their correlation with lymphangiogenesis, angiogenesis and clinicopathological significance in human gastric cancer. Material and methods: Tissue samples of gastric cancer of 60 patients, who underwent Billroth II resection, were analyzed. The expression of COX-2 and VEGF-C proteins was calculated using a semi-quantitative immunoreactive score method. Quantitative analysis of lymphangiogenesis and angiogenesis was performed according to the method described by Weidner. Lymphangiogenesis was evaluated by immunostaining with D2-40. Angiogenesis was assessed by CD105 immunostaining. Results: There was a statistically significant difference in the mean values of COX-2 (p< 0.01) and VEGF-C (p< 0.05) between gastric cancer samples and in control samples. Angiogenesis was significantly higher in neoplastic tissue then in control group (p<0.001). Expression of COX-2 showed a significant positive linear correlation with angiogenesis (p<0.05). However, COX-2 did not correlate with VEGF-C or lymphangiogenesis. There was an association between VEGF-C and lymphangiogenesis, but without statistical significance. Lymphangiogenesis significantly correlated with lymph node metastasis (p=0.007). Expression of COX-2 showed significant correlation with type of Bormann’s classification (p=0.019) and depth of invasion (p=0.03). Conclusions: The tumor cells are the major source of COX-2 and VEGF-C in gastric carcinomas. Their correlation did not show that COX-2 overexpression promotes tumor lymphangiogenesis through augmentation of VEGF-C. The results of this study suggest that neoangiogenesis is a dominant process during tumor progression, whereas lymphangiogenesis plays an important role in lymph node metastasis. Keywords: angiogenesis, CD105, COX-2, D2-40, gastric cancer, lymphangiogenesis, VEGF-C

Introduction: to evaluate the frequency and significance of immunohistochemistry-based molecular subtypes of breast cancer and investigate their association with traditional pathological features for breast cancer among Bosnian women. Materials and methods: this study included 100 female patients with primary invasive breast cancer. Immunohistochemical analyses for estrogen receptor (ER), progesterone receptor (PR), HER-2 and Ki-67 were performed to define four biological subtypes: luminal A, luminal B, HER-2-positive and triple-negative. Results: the frequency of luminal A, luminal B, HER2-positive and triple-negative subtypes of breast cancer was 44%, 39%, 11% and 6%, respectively. Molecular subtypes of breast cancer among Bosnian women showed to be independent of traditional pathological features (p>0.05). Ki-67 showed significant di erence regarding luminal B tumor type, where high (≥14%) Ki-67 score was predominantly represented in 36 (92.3%) cases (p<0.001). Conclusion: immunohistochemistry-based molecular subtypes of breast cancer in Bosnian women somehow vary in pathological features, i.e. luminal A subtype in this sample comprised mostly ductal histological type, moderate di erentiation with the involvement of lymph nodes, known as worse prognostic factors, although with no statistical significance.

Aim: Identification of risk factors for adverse outcome in acute kidney injury (AKI) provides the knowledge necessary to make important medical decisions. Sepsis, as the most important cause of AKI, deserves special attention in evaluating AKI prognosis. The present study aimed to identify risk factors for renal function non-recovery and in-hospital death in AKI patients. Additionally, we evaluate baseline characteristics and clinical outcomes of patients with septic AKI compared to patients with non-septic AKI. Methods: This prospective study included one hundred hospitalized patients diagnosed with AKI. Baseline physiological and laboratory parameters, as well as renal function outcome and in-hospital death of AKI patients, were evaluated. Results: Patients with septic AKI had significantly higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (p<0.001), erythrocyte sedimentation rate (ESR) (p<0.001) and white cell counts (p=0.017), higher levels of ferritin (p<0.001), C-reactive protein (CRP) and fibrinogen (p<0.001) as well as significantly lower serum albumin values (p<0.01) compared to patients with non-septic AKI. Risk factors for adverse renal outcome were increased APACHE II score (p<0.01) and ESR (p<0.05), higher values of CRP (p<0.01) and serum ferritin (p<0.05), as well as hypoalbuminemia (p<0.01). By multivariate analysis, APACHE II score was the independent risk factor for non-recovery of renal function (95% CI 0.788-0.956, p꞊0.004) and in-hospital mortality (95% CI 1.057-9.075, p꞊0.039), while sepsis (95% CI 0.128-0.967, p=0.043) was predictive of renal function non-recovery in AKI patients. Conclusion: Acute-phase reactants, APACHE II score, and sepsis are useful in predicting the adverse clinical outcome in AKI patients.

Introduction: The lymphatic vasculature is an important route for the metastatic spread of human cancer. However, the extent to which this depends on lymphangiogenesis or on invasion of existing lymph vessels remains controversial. The goal of this study was to investigate the existence of lymphangiogenesis in invasive breast carcinoma: by measuring the lymphatic vessels density (LVD) and lymphatic endothelial cell proliferation (LECP) and their correlation with various prognostic parameters in breast cancer, including lymphovascular invasion (LVI).Methods: Lymphatic vessels density was investigated in 75 specimens of invasive breast carcinoma by immunostaining for D2-40 using the Chalkley counting method. Endothelial proliferation in lymphatic vessels was analyzed by dual-color immunohistochemistry with D2-40 and Ki-67.Results: Decrease of intra and peritumoral LVD in invasive breast carcinoma compared to fibrocystic breast disease was detected (p=0.002). Lymphatic endothelial cell proliferation was significantly higher in invasive breast cancer (p=0.008) than in the fibrocystic breast disease. LECP showed a correlation with histological grade of the tumor (p=0.05). Involvement of axillary lymph nodes with metastatic tissue was in strong correlation only with existence of lymphatic vascular invasion (p=0.0001).Conclusion: These results suggest that development of breast cancer promotes proliferation of lymphatic endothelial cells whose level correlates with histological grade of tumor, but in a scope that is insufficient to follow growth of tumor tissue that invades them and destruct them. This might explain the decrease of lymphatic vessels density.