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.
Introduction: Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) are involved in the progression of several tumors, including breast cancer. Our aim was to investigate the association of immunohistochemical expression of protein MMP-2, and -9 and tissue inhibitors TIMP-1,-2,-3 by tumoral cells in the process of angiogenesis and to define their relation with clinicopathological features for breast cancer. Methods: Immunohistochemical analysis of MMP-2,-9, TIMP-1,-2,-3, endoglin/CD105, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status was performed on 79 tissue samples of breast cancer with axillary lymph node dissection. Results: Statistically significant difference was found between mean age of patients and tissue inhibitors of metalloproteinase (TIMP-1) expression status (p=0.008), i.e., women with TIMP-1 negative tumors were on average younger (mean age 46.5) compared to women with TIMP-1 positive tumors (mean age 58.1); TIMP-2 expression status showed association with ER status (p=0.017), while TIMP-3 negative tumors were on average more frequently ER and PR negative (p=0.016; p=0.027). Status of protein expression of MMP-9 was associated with TIMP-1 protein expression status (p=0.033), i.e., breast cancers with overexpression of protein MMP-9 were more frequently TIMP-1 protein positive. Conclusion: Only TIMPs were associated with clinicopathological features for breast cancer. TIMP-2 expression was associated with worse (TIMP-2 positive tumors were frequently ER-negative), while TIMP-3 expression in tumoral cells was associated with better clinicopathological features for breast cancer (TIMP-3 positive tumors were frequently ER and PR positive).
Introduction: Sister Mary Joseph Nodule (SMJN) is a metastatic umbilical lesion secondary to a primary malignancy of any viscera, stomach and colon being most common in men, and ovary in women. Case report: In this article, we present the case of SMJN in a 54-year old female patient. An urgent diagnostic workup was performed with a computerized tomography of abdominal cavity and pelvis showing an expansive tumorous formation covering uterus with a carcinomatosis of peritoneum. After biopsy, immunohistochemical profile suggested adenocarcinoma of the ovarian origin. The patient was then referred to the Oncology Consilier of Gynecology Department and further continued followed by the Oncology team.
There are differences with respect to the commonly isolated Malassezia species, not only between healthy individuals and the patients with various skin diseases, but also between different countries. We investigated the species composition of Malassezia microflora on the skin of patients with Malassezia-associated diseases and of healthy subjects (HS). Two hundred and fifty skin scrapings from patients with pityriasis versicolor (PV), seborrheic dermatitis (SD), atopic dermatitis (AD), psoriasis (PS), and healthy subjects (HS), fifty each, were inoculated into Sabouraud dextrose agar and into modified Dixon agar and identified using conventional culture-based methods. In PV and PS lesions, the most common species was M. globosa (62% and 52%, respectively), while M. restricta was predominant in SD lesions (28%). M. sympodialis was the most common species recovered from AD (52%) and healthy trunk skin (30%). Fewer cultures were positive for Malassezia growth in patients with AD than in patients with other skin conditions, and even in controls. Our data are in agreement with other studies and suggest that the pathogenic species of PV is M. globosa. The evidence that any given species is clinically important in the pathogenicity of SD, AD and PS is still lacking.
The genus Malassezia comprises lipophilic species, the natural habitat of which is the skin of humans and other warm‐blooded animals. However, these species have been associated with a diversity of dermatological disorders and even systemic infections. Pityriasis versicolor is the only cutaneous disease etiologically connected to Malassezia yeasts. In the other dermatoses, such as Malassezia folliculitis, seborrheic dermatitis, atopic dermatitis, and psoriasis, these yeasts have been suggested to play pathogenic roles either as direct agents of infection or as trigger factors because there is no evidence that the organisms invade the skin. Malassezia yeasts have been classified into at least 14 species, of which eight have been isolated from human skin, including Malassezia furfur, Malassezia pachydermatis, Malassezia sympodialis, Malassezia slooffiae, Malassezia globosa, Malassezia obtusa, Malassezia restricta, Malassezia dermatis, Malassezia japonica, and Malassezia yamatoensis. Distributions of Malassezia species in the healthy body and in skin diseases have been investigated using culture‐based and molecular techniques, and variable results have been reported from different geographical regions. This article reviews and discusses the latest available data on the pathogenicity of Malassezia spp., their distributions in dermatological conditions and in healthy skin, discrepancies in the two methods of identification, and the susceptibility of Malassezia spp. to antifungals.
Introduction: There are limited numbers of studies which focused on the identification of Malassezia yeasts to a species level in onychomycosis. Therefore, the aim of our study was to determine the prevalence and species composition of Malassezia yeasts in patients with clinically suspected onychomycosis and to examine if the range of species varies with patient gender, age, site of involvement and clinical pattern of onychomycosis. Methods: Specimens were taken from 785 patients presenting signs of onychomycosis and then incubated on Sabouraud dextrose agar and modified Dixon agar. The yeasts isolated were identified according to their macroscopic and microscopic features and physiological characteristics. Results: Malassezia species were diagnosed both by microscopy and culture in fourteen (1.8%) patients. M. globosa was the predominant, if not only, species identified from nail samples. Mixed cultures were observed in five cases: in 4 cases Malassezia was co-isolated with Candida albicans and in one case with dermatophyte. Fingernails were affected more frequently than toenails (85.7%) and distolateral subungual onychomycosis was the most common clinical type (78.6%). Conclusion: No significant differences were found in the distribution of Malassezia species isolated according to demographic parameters.
Background : Controversy exists regarding the topography of lymph vessels in breast cancer, their usefulness as prognostic factors and whether active lymphangiogenesis occurs within the tumour. The goal was to investigate the presence of intratumoural lymphatic vessels, the existence of lymphangiogenesis and their role in tumour dissemination. Materials and methods: Lymphatic vessel distribution was investigated in 75 specimens of invasive breast carcinoma by immunostaining using a D2-40 antibody. Intratumoural and peritumoural lymphatic vessel density (LVD) was assessed using the Chalkley counting method and correlated with clinicopathologic parameters. Endothelial cell proliferation in lymphatic vessels was analyzed by dual-color immunohistochemistry with D2-40 and Ki-67. Results: We demonstrated the existence of intratumoural lymphatic vessels in invasive breast carcinoma. Intratumoural LVD was significantly lower (p=0, 0001) compared to peritumoural. Decrease of intra and peritumoural LVD compared to fibrocystic breast disease was observed (p=0,002). The density of intratumoural lymphatic vessels was correlated with the expression of progesterone receptors in breast cancer (p=0,036). Intratumoural endothelial cell proliferation in lymphatic vessels was minimal. Conclusion: Intratumoural lymphatic vessels are present in breast cancer. High intratumoural LVD is correlated with the expression of the progesterone receptor and thereby it may possibly serve as an indicator of a low destructive potential of the tumour, and vice versa. Whether they are tumour induced and newly formed or not is beyond the scope of this study and does not change the fact that they are tumour-associated and do not constitute a risk factor for tumour metastasis. Key words: breast carcinoma, intratumoural lymphatic density, lymphangiogenesis, progesterone
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.
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