101
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Mishra A, Gill J, Mishra Y, Medhashri S. Relationship between tumor microenviroment and development and progression of cancer: A Review. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx510.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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102
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Gill J, Mishra A, Medhashri S, Kaur P, Mishra Y. Role of Intensity Modulated Radiotherapy with Concurrent and Adjuvant Chemotherapy With Temozolamide in Glioblastoma Multiforme. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx512.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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103
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Gill J, Mishra A, Kaur P, Medhashri S, Mishra Y. A Qualitative Study on Views and Perspectives of Non-Governmental Organisations on Implementation of Personalised Medicine in Cancer Patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx508.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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104
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Maiti R, Mishra B, Sanyal S, Mohapatra D, Mishra A. Effect of carbamazepine and oxcarbazepine on serum neuron-specific enolase in focal seizures: A randomized controlled trial. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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105
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Patra J, Basu A, Mishra A, Dhal NK. Bioconversion of Municipal Solid Wastes for Bioethanol Production. ACTA ACUST UNITED AC 2017. [DOI: 10.13005/bbra/2554] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
ABSTRACT: The use of dilute acid (H2SO4, 3%) and alkali (NaOH, 3%) pretreatment methods has some potential how ever to date, these methods effectively increase ethanol production of municipal solid waste (MSW). Enzymatic hydrolysis was carried out with Aspergillus niger, Aspergillus fumigatus and Trichoderma reesei. Finally, the fermentation was done by sugar three ethanologenic yeasts, Saccharomyces cerevisiae, pichia stipitis, canida shehatae for bioethanol production.The highest ethanol yield (22.32%) v/v. was obtained with a pre-hydrolysis treatment consisting of NaOH at 3% concentration, followed by Pichia stipitis and enzymatic hydrolysis with Aspergillus niger. Pre-hydrolysis treatment consisted Enzymatic hydrolysis was carried out with Alkali pretreated wastes yield more sugar as compared to acid treatment using produced more ethanol than others at each time point. The experimental results observed that 80% of the cellulose converted to glucose from the waste which can be easily fermented to production. of ethanol. The ability focus on related environmental issues, such as sustainable waste management, climate change, land use and biodiversity, are discussed.
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Taskesen E, Mishra A, van der Sluis S, Ferrari R, Veldink JH, van Es MA, Smit AB, Posthuma D, Pijnenburg Y. Susceptible genes and disease mechanisms identified in frontotemporal dementia and frontotemporal dementia with Amyotrophic Lateral Sclerosis by DNA-methylation and GWAS. Sci Rep 2017; 7:8899. [PMID: 28827549 PMCID: PMC5567187 DOI: 10.1038/s41598-017-09320-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 07/26/2017] [Indexed: 12/13/2022] Open
Abstract
Frontotemporal dementia (FTD) is a neurodegenerative disorder predominantly affecting the frontal and temporal lobes. Genome-wide association studies (GWAS) on FTD identified only a few risk loci. One of the possible explanations is that FTD is clinically, pathologically, and genetically heterogeneous. An important open question is to what extent epigenetic factors contribute to FTD and whether these factors vary between FTD clinical subgroup. We compared the DNA-methylation levels of FTD cases (n = 128), and of FTD cases with Amyotrophic Lateral Sclerosis (FTD-ALS; n = 7) to those of unaffected controls (n = 193), which resulted in 14 and 224 candidate genes, respectively. Cluster analysis revealed significant class separation of FTD-ALS from controls. We could further specify genes with increased susceptibility for abnormal gene-transcript behavior by jointly analyzing DNA-methylation levels with the presence of mutations in a GWAS FTD-cohort. For FTD-ALS, this resulted in 9 potential candidate genes, whereas for FTD we detected 1 candidate gene (ELP2). Independent validation-sets confirmed the genes DLG1, METTL7A, KIAA1147, IGHMBP2, PCNX, UBTD2, WDR35, and ELP2/SLC39A6 among others. We could furthermore demonstrate that genes harboring mutations and/or displaying differential DNA-methylation, are involved in common pathways, and may therefore be critical for neurodegeneration in both FTD and FTD-ALS.
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107
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Chennakesavulu S, Mishra A, Sudheer A, Sowmya C, Suryaprakash Reddy C, Bhargav E. Pulmonary delivery of liposomal dry powder inhaler formulation for effective treatment of idiopathic pulmonary fibrosis. Asian J Pharm Sci 2017; 13:91-100. [PMID: 32104382 PMCID: PMC7032187 DOI: 10.1016/j.ajps.2017.08.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 06/14/2017] [Accepted: 08/10/2017] [Indexed: 11/30/2022] Open
Abstract
Dry powder inhaler Liposomes were prepared to investigate the effectiveness of pulmonary delivery of Colchicine and Budesonide for Idiopathic Pulmonary fibrosis. Budesonide (BUD) and Colchicine (COL) liposomes were prepared by thin layer film hydration method (TFH) using 1,2-Dipalmitoyl-sn-glycero-3- phosphoglycerol sodium (DPPG), Hydrogenated Soyaphosphotidylcholine (HSPC), Soyaphosphatidylcholine (SPC), cholesterol (CHOL) and drug in different weight ratios. The optimum lipid composition for BUD (74.22 ± 0.97%) was DPPG: HSPC: CHOL (4:5:1) and for COL (50.94 ± 2.04%) was DPPG: SPC: CHOL (3:6:1). These compositions retained drug for a longer period of time so selected for further study. Liposomes were found to be spherical in shape with mean size below 100 nm. Liposomes lyophilized using Mannitol as carrier and cryoprotectant showed high entrapment efficiency (97.89 - 98.6%). The powder was dispersed through an Andersen cascade impactor to evaluate the performance of the aerosolized powder. It was found that prepared liposomal dry powder inhaler (DPIs) sustained the drug release up to 24 hours. Optimized Budesonide DPI Formulation B2 (86.53 ± 1.9%), Colchicine DPI Formulation C2 (90.54 ± 2.3 %) and BUD and COL DPI Combination M2 (89.91 ± 1.8%, 91.23 ± 1.9%). Histopathological results, measurements of lung hydroxyproline content, Myeloperoxidase activity indicated that liposomal dry powder inhaler administration attenuates lung fibrosis induced by bleomycin. Long term stability studies indicated that lyophilised BUD and COL liposomes were stable for 6 months at (25 °C ± 2 °C, 60% ± 5% RH) and refrigerated conditions (2 - 8 °C). These results supported that combination of budesonide and colchicine liposomal dry powder inhaler pulmonary drug delivery for treatment of idiopathic Pulmonary Fibrosis exhibits prolonged drug retention at targeted site and reduces the systemic exposure.
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Key Words
- BLM, Bleomycin
- Budesonide
- Colchicine
- DE, Drug entrapment
- DPI, Dry Powder Inhaler
- EPC, Egg phosphatidyl choline
- FPF, Fine particle fraction
- HDPE, High density polyethylene
- Idiopathic Pulmonary fibrosis
- Liposomal dry powder inhaler
- M2, Mixture of BUD & COL (Optimized formulation)
- MDI's, Metered Dose Inhalers
- MMAD, Mean Median Aerodynamic diameter
- PBS, Saline Phosphate buffer
- PVC, Poly vinyl chloride
- Pulmonary drug delivery
- SLS, Sodium lauryl sulphate
- UV, Ultraviolet
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Mishra A, Datta S, Malik A, Garg A, Nair D, Nair S, Mair M, Bal M, Agarwal J, Chaturvedi P. Role of microscopic spread beyond gross disease as an adverse prognostic factor in oral squamous cell carcinoma. Eur J Surg Oncol 2017; 43:1503-1508. [DOI: 10.1016/j.ejso.2017.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 04/10/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022] Open
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109
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Kumar A, Vijayakumar P, Gandhale PN, Ranaware PB, Kumar H, Kulkarni DD, Raut AA, Mishra A. Genome-wide gene expression pattern underlying differential host response to high or low pathogenic H5N1 avian influenza virus in ducks. Acta Virol 2017; 61:66-76. [PMID: 28161961 DOI: 10.4149/av_2017_01_66] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The differences in the influenza viral pathogenesis observed between different pathogenic strains are associated with distinct properties of virus strains and the host immune responses. In order to determine the differences in the duck immune response against two different pathogenic strains, we studied genome-wide host immune gene response of ducks infected with A/duck/India/02CA10/2011 and A/duck/Tripura/103597/2008 H5N1 viruses using custom-designed microarray. A/duck/India/02CA10/2011 is highly pathogenic virus (HP) to ducks, whereas A/duck/Tripura/103597/2008 is a low pathogenic (LP) virus strain. Comparative lung tissue transcriptome analysis of differentially expressed genes revealed that 686 genes were commonly expressed, 880 and 1556 genes are expressed uniquely to infection with HP and LP virus, respectively. The up-regulation of chemokines (CCL4 and CXCR4) and IFN-stimulated genes (IFITM2, STAT3, TGFB1 and TGFB3) was observed in the lung tissues of ducks infected with HP virus. The up-regulation of other immune genes (IL17, OAS, SOCS3, MHC I and MHC II) was observed in both infection conditions. The expression of important antiviral immune genes MX, IFIT5, IFITM5, ISG12, β-defensins, RSAD2, EIF2AK2, TRIM23 and SLC16A3 was observed in LP virus infection, but not in HP virus infection. Several immune-related gene ontology terms and pathways activated by both the viruses were qualitatively similar but quantitatively different. Based on these findings, the differences in the host immune response might explain a part of the difference observed in the viral pathogenesis of high and low pathogenic influenza strains in ducks.
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110
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Mishra A, Kumar J, Singh T, Varde PV, Bhattacharya S. Production of radioisotopes Sm153 and Lu177 in Dhruva. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s41872-017-0015-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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111
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Taneja N, Sethuraman N, Mishra A, Mohan B. The 2002 Chandigarh cholera outbreak revisited: utility of MALDI-TOF as a molecular epidemiology tool. Lett Appl Microbiol 2017; 62:452-8. [PMID: 27198622 DOI: 10.1111/lam.12574] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 04/09/2016] [Accepted: 04/14/2016] [Indexed: 11/26/2022]
Abstract
UNLABELLED In July 2002, an outbreak of cholera occurred in north India with two separate geographical foci. Pulsed field gel electrophoresis (PFGE) was previously used in typing a representative sample of these isolates. This study evaluates the usefulness of MALDI-TOF as an epidemiological tool for typing Vibrio cholerae isolates in comparison with PFGE and Amplified fragment length polymorphisms (AFLP). Forty-six isolates of V. cholerae isolated from stool of patients affected in the July 2002 outbreak were typed using MALDI-TOF. To validate its utility, clinical and environmental isolates previously characterized by PFGE and AFLP were included for dendrogram analysis. All 46 isolates were correctly identified by MALDI-TOF to species level. Two distinct clades appeared on dendrogram using MALDI-TOF corresponding to the two geographical foci of the outbreak. For the study of evolution of organisms from environment, AFLP was superior as it clearly demarcated clinical and environmental isolates. The outbreak was not due to a single clone but due to multiple clones circulating simultaneously, as was seen with PFGE also. SIGNIFICANCE AND IMPACT OF THE STUDY MALDI-TOF appears to be a highly discriminatory, cost-effective and rapid epidemiological typing technique that can be used in the investigation of cholera outbreaks.
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112
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Sabaretnam M, Mishra A, Agarwal G, Agarwal A, Verma AK, Mishra SK. Adrenocortical carcinoma in children and adults: Two decades experience in a single institution. Indian J Cancer 2017; 53:317-321. [PMID: 28071637 DOI: 10.4103/0019-509x.197737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT Adrenocortical carcinoma (ACC) occurring in children and adults show distinct characteristics. However, due to rarity of the disease no large series addressing this issue has been published. AIMS The aim of this study was to study clinico-pathologic profile and outcome of ACC in children and adults. SETTINGS AND DESIGN Tertiary referral center. Retrospective study (January 1990-June 2011). SUBJECTS AND METHODS Forty-five patients with ACC were included; 16children (aged < 18 years) and 29 adults. Clinical details, hormonal profile, operation records, pathology reports and follow-up findings were noted and compared. Survival analysis was performed using Kaplan-Meier method. Log rank test and Cox regressionan alysis were performed. RESULTS Mean age was 8 ± 5.7 (M: F = 1:2.1) in children and 44.4 ± 15 years (M: F = 1:1.1) in adult groups. Prevalence of functioning tumors was significantly high in children (87.5 vs. 31% P = 0.001), while prevalence of incidentalomas was high in adults (6.3 vs. 51.7% P = 0.05). Tumor stage distribution at presentation, mean diameter (10.9 vs. 13.7 cm), and weight (392.9 vs. 892.9 g) didn't differ significantly in two groups. Adults had better albeit non-significant 5 year overall survival (OS) than children (0 vs. 13%). On univariate analysis stage of disease (P = 0.008), surgical intervention (P = 0.004), Weiss score (P = 0.04) and hormonal secretion (P = 0.04) were significantly associated with OS in adults but not in children. No factor was found significant on multivariate analysis. CONCLUSIONS Except for high prevalence of functioning tumors in children, clinico-pathologic attributes and outcome of ACC in the two groups didn't differ significantly.
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Agarwal G, Sonthineni C, Sabaretnam M, Chand G, Mishra A, Agarwal A, Verma A, Mishra S, Agrawal V, Lal P. Frozen section histology of margins facilitates one-step safe & cost-effective breast conservation surgery. Breast 2017. [DOI: 10.1016/s0960-9776(17)30348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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114
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Agarwal G, Sonthineni C, Maylivahanan S, Chand G, Mishra A, Agarwal A, Verma AK, Mishra SK, Agrawal V, Krishnani N, Lal P. Abstract P1-11-07: Frozen section histology evaluation of surgical margins helps perform single step oncologically safe and cost-effective breast conservation surgery. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-11-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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115
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Mishra A, Rout M, Singh DR, Jana S. Influence of Density of Emulsion Explosives on its Velocity of Detonation and Fragmentation of Blasted Muckpile. CURR SCI INDIA 2017. [DOI: 10.18520/cs/v112/i03/602-608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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116
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Baker BG, Joseph L, Mishra A. An adnexal tumour masquerading as a distal interphalangeal joint ganglion. J Hand Surg Eur Vol 2017; 42:204-205. [PMID: 26642849 DOI: 10.1177/1753193415620179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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117
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Alashek W, Ehtuish E, Elhabashi A, Emberish W, Mishra A. Reasons for Unwillingness of Libyans to Donate Organs after Death. Libyan J Med 2016. [DOI: 10.3402/ljm.v4i3.4827] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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118
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Mishra A, Abuhajar R, Alsawidi K, AlAoud M, Ehtuish E. Congenital Orbital Lymphangioma in a 20-Years Old Girl A Case Report and Review of Literature. Libyan J Med 2016. [DOI: 10.3402/ljm.v4i4.4843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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119
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Mishra A, Purvar R, Malik S, Agarwal K, Gera R, Sridhar S. McCune Albright Syndrome from Gynaecological Perspective. J Obstet Gynaecol India 2016; 66:672-674. [DOI: 10.1007/s13224-016-0864-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 02/09/2016] [Indexed: 10/22/2022] Open
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120
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Baker B, Murphy R, Mishra A. Giant cell tumours of tendon sheath; a 10-year experience from Manchester. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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121
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Mishra A, Tiwari S, Tyagi S. Effect of Urbanization Pollution on Atmospheric Visibility in the National Capital of India: A Case Study of Republic Day. ACTA ACUST UNITED AC 2016. [DOI: 10.17485/ijst/2016/v9i39/97109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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122
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Agrawal S, Agarwal G, Mishra A, Agarwal V, Lal P, Mishra S. Locoregional Recurrence Rates (LRR) After Neoadjuvant Chemotherapy (NACT) and Locoregional Radiation Therapy (RT) According to Pathologic Response and Intrinsic Subtype in Locally Advanced Breast Cancers. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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123
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Jotwani A, Ravi S, Vallinayagam S, Ayyalusamy A, Reddy R, Mishra A, Lahiri D, Jain A, Reddy K, J N, Rawat S. Application of Lean Principles to Improve High-Precision Radiation Treatment Process and Patient Experience in a High-Volume Cancer Center. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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124
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Mishra A, Reddy IJ, Gupta PSP, Mondal S. Developmental regulation and modulation of apoptotic genes expression in sheep oocytes and embryos cultured in vitro with L-carnitine. Reprod Domest Anim 2016; 51:1020-1029. [DOI: 10.1111/rda.12789] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/07/2016] [Indexed: 11/30/2022]
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125
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Agarwal A, Pradhan R, Kumari N, Krishnani N, Shukla P, Gupta SK, Chand G, Mishra A, Agarwal G, Verma AK, Mishra SK. Molecular Characteristics of Large Parathyroid Adenomas. World J Surg 2016; 40:607-14. [PMID: 26669787 DOI: 10.1007/s00268-015-3380-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The clinical entity of large parathyroid adenomas (LPTAs) has not been well defined. It is speculated that LPTAs would have biochemical, histological, and molecular characteristics different from small adenomas. Our study aimed to find out occurrence of atypia and carcinomas in large parathyroid lesions and the presence of distinct molecular abnormalities in LPTAs. MATERIALS AND METHODS We divided the parathyroid lesions into large (>7 g, i.e., LPTAs) and small (<7 g) adenomas. We performed parafibromin, APC (adenomatous polyposis coli), galectin 3, and PGP9.5 (protein gene product 9.5) analysis by immunohistochemistry in adenomas without atypia, atypical adenomas, and carcinomas. RESULTS Mean serum calcium, alkaline phosphatase, and intact PTH were significantly higher in large parathyroid tumor group. The presence of both atypical adenoma and carcinoma was higher in large parathyroid tumor group. There was higher percentage of atypia in patients with LPTAs >10 g (33%), and 68% of tumors showed at least one marker suggestive of malignancy in this group. Detailed analysis of immunohistochemical features of LPTA >10 g revealed that six patients showed complete loss of parafibromin immunoreactivity (out of these four showed atypia), while seven showed partial loss. In histopathologically proven malignancy (n = 9), six patients showed complete loss of parafibromin staining, 5 (55%) APC negativity, and 45% showed both galectin 3 and PGP9.5 positivity. Three out of these showed all IHC markers s/o malignancy, and all of them had evidence of metastases or recurrence. 32% of atypical adenoma and 13% of atypical adenoma showed complete loss of parafibromin staining, however none developed metastases or recurrence in follow-up (median follow-up 40 months). Loss of parafibromin staining (complete or partial) was higher in LPTA group (56%) than that in small adenoma (39%); however, it was not statistically significant. APC, galectin 3, and PGP9.5 markers suggestive were higher in LPTA group but were not significant. CONCLUSION LPTAs may show some morphological and immunohistochemical features suggestive of malignancy and can be considered a separate entity. However, the immunohistochemical markers are unable to clearly segregate those LPTAs that may show premalignant potential. Further, we would like to recommend that LPTAs showing complete parafibromin loss together with atypia should be kept under close follow-up.
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