Oral Cavity Cancer Tissues Differ in Isotopic Composition Depending on Location and Staging

The aim of this paper was to characterise the isotopic composition of oral squamous cell carcinoma (OSCC) specimens of different areas of the oral cavity. Secondly, we assessed whether there was a correlation between clinical stages of OSCC and isotopic abundance. The IRMS procedure was performed on 124 samples derived from 31 patients with OSCC of 15 N and 13 C to assess the isotopic composition. From each individual, four samples from the tumour, two from the margins, and two samples of healthy oral mucous membranes were derived. The two samples from the tumour and two samples from the margin were additionally subjected to histopathological assessment. Then, statistical analysis was conducted. Tumour infiltration tissues of the lower lip were characterised by higher mean δ13C values compared to samples derived from cancers of the other oral cavity regions (-23.82 ± 1.21 vs. -22.67 ± 1.35); (p = 0.04). The mean percentage of nitrogen content in tumour tissues was statistically higher in patients with the most advanced cancers (11.89 ± 0.03%) versus the group of patients with II and III stage cancers (11.12 ± 0.02%); (p = 0.04). In patients at stage IV, the mean δ13C value in the cancer samples equalled -22.69 ± 1.42 and was lower than that in patients at less severe clinical stages (p = 0.04). Lower lip cancer tissues differed in the isotopic abundance of carbon in comparison with tissues derived from the group of combined samples from other locations. Values of δ13C observed in specimens derived from lower lip cancers were similar to those observed in healthy oral mucous membranes. Cancer tissues obtained from patients in the last stage of OSCC had a different isotopic composition in comparison with those obtained from earlier stages. To confirm these observations, further research on larger groups of patients is needed.

Microanatomical study of arachnoid granulations and meningeal architecture around Meckel's cave

Although the microanatomy of Meckel's cave (MC) has been well studied, there are still controversies regarding the meningeal architecture of the space. Moreover, there are only general mentions of the arachnoid granulations near MC in just a few sources. This study is aimed at determining the frequency, location, and anatomical variability of the main clusters of arachnoid granulations around MC. The dissection involved 26 isolated specimens of MC fixed in formalin (neutral buffered, 10%). This number included five freshly harvested specimens examined histologically. Additional paraffin block with MC horizontal section was taken from our neuroanatomical collection. Carefully selected anatomical and histological techniques were applied to assess the complex relationships between the arachnoid granulations and adjacent structures. Arachnoid granulations were found around MC in all specimens with different anatomical variations. The main clusters of arachnoid granulations were close to the trigeminal ganglion and its divisions. The dorsolateral wall of MC was a thick layer formed by interweaving bundles of collagen fibers arranged in various directions. The entire MC was surrounded by a dural sleeve (envelope). This sleeve separated MC from the lateral sellar compartment. At its anterior (rostral) end, it formed a cribriform area pierced by individual fascicles of the trigeminal nerve's primary divisions. The connective tissue forming the sleeve was not only continuous with the epineurium but also shifted to the perineuria surrounding individual nerve fascicles. The meningeal architecture around MC has a complex and multilayer arrangement with a collagenous sleeve closely related to the trigeminal ganglion. Arachnoid granulations are typically found around MC.

G870A Polymorphic Variants of CCND1 Gene and Cyclin D1 Protein Expression as Prognostic Markers in Laryngeal Lesions

CCND1 gene encodes Cyclin D1 protein, the alternations and overexpression of which are commonly observed in human cancers. Cyclin D1 controls G1-S transition in the cell cycle. The aim of the study was to assess utility of the genotyping and protein expression in predicting the susceptibility of transformation from normal tissue to precancerous laryngeal lesions (PLLs) and finally to laryngeal cancer (LC). Four hundred and thirty-five patients (101 with LC, 100 with PLLs and 234 healthy volunteers) were enrolled in the study. Cyclin D1 expression was examined by immunohistochemistry and G870A polymorphism of gene CCND1 by PCR-RFLP technique. We confirmed association between the A allele and risk of developing LC from healthy mucosa (p = 0.006). Significantly higher expression of Cyclin D1 was observed in LC compering with PLLs (p < 0.0001) and we found that it could be a predictive marker of shorter survival time. To sum up, in the study population CCND1 gene polymorphism A870G and Cyclin D1 expression have a significant impact on the risk of developing PLLs and LC, and, therefore, Cyclin D1 could be a useful marker for the prediction of survival time in LC, whereas CCND1 gene polymorphism does not have a direct impact on patients’ outcome.

Ovarian carcinoma in children with constitutional mutation of SMARCA4: single-family report and literature review

Ovarian carcinoma is an extremely rare malignancy in children, often developing on the underlying inherited background. Female carriers of pathogenic germline mutations of SMARCA4 are at risk of an aggressive type of undifferentiated ovarian cancer called small cell carcinoma of the ovary, hypercalcemic type (SCCOHT). Regardless of age of the patient, stage of the disease, and oncological treatment, the prognosis for SCCOHT is poor. Therefore, early intervention with risk-reducing surgeries is recommended for these patients. In this study, we report genetic testing of a family with two children carrying pathogenic germline mutations of SMARCA4 and summarize the course of SCCOHT in all pediatric patients reported in the literature with constitutional defects identified within the SMARCA4 locus.

Characteristic of Oral Squamous Cell Carcinoma Tissues Using Isotope Ratio Mass Spectrometry

Overall prognosis for patients with oral squamous cell carcinomas (OSSC) is still unfavourable. However, there is a hope that a novel diagnostic method may establish better cancer biology characteristics. The aim of this study was to evaluate the isotope ratio of nitrogen and carbon in OSSC as compared to margin and healthy tissue. A total of 18 patients with OSSC were included in the study. Specimens collected covered: four tumour, four margin and two healthy oral mucosa samples. The samples underwent further procedures: lyophilization and isotope ratio mass spectrometry. Measurements of the ratio of stable isotopes of nitrogen ¹⁵N/¹⁴N and carbon ¹³C/¹²C were performed. It is noticeable that the highest average nitrogen concentration was observed in tumour 12 ± 0.4% and the lowest in healthy tissues 8 ± 0.9% (p < 0.00001). The highest average carbon content was observed in healthy tissues 57 ± 2.2% and the lowest in tumour 46 ± 1.3% (p < 0.00001). Moreover, values of ¹⁵N/¹⁴N expressed in delta notation were the highest in healthy tissues 9.84 ± 0.61 and the lowest in tumour 8.92 ± 0.58. Values of ¹³C/¹²C tended to be higher in tumour −22.2 ± 0.89 and the lowest in healthy tissues −23.7 ± 1.2. Tumour tissues differ in isotopic composition from tissues taken from margin and healthy tissues taken from distant oral mucosa.

Bilateral pseudocyst of the auricles in a 4-week neonate-case report and world literature review

Pseudocyst of the auricle is a rare, idiopathic disease clinically manifesting as a painless edema of the upper-lateral parts of the auricle. Due to the rarity of the disease, auricular pseudocyst is often misdiagnosed. The confirmation of a diagnosis of auricular pseudocyst is most commonly made on the basis of clinical manifestations. The etiology of the disease remains unknown, and this frequently hinders both proper diagnosis and prevention. We report a case of a 4-week neonate admitted to the Department of Pediatrics, Rheumatology and Environmental Diseases of the Chair of Pediatry, Jagiellonian University, Medical College in Krakow with bilateral pseudocyst with very early presentation that was less prominent after birth and well presented in the second week of life. The surgical treatment was successful. One month after treatment the infant was admitted again to the hospital with hypertension and edema of feet and hands. Treatment with amlodipine was implemented resulting in a normalization of blood pressure. The diagnosis of pseudohypoaldosteronism type I was confirmed.

Experimental autoimmune myocarditis in rats and therapeutic histamine H1 - H4 receptor inhibition

Myocarditis, a life threatening disease, is still not adequately treated. Histamine plays an important role in physiology and pathophysiology of cardiovascular system. All four histamine receptors (H₁R - H₄R), are present in the heart. Experimental autoimmune myocarditis (EAM) was used to investigate which histamine receptor had a greater impact on the disease's progression. EAM was evoked in Lewis rats by porcine myosin immunization. Mepyramine, ranitidine and ciproxifan were used to inhibit H₁R, H₂R and H₃R receptors, respectively, and 2,4-diaminopyrimidines: ST994, ST1012, ST1006 were ligands of H₄R. Quinapril, an ACE inhibitor, served as a reference drug. Drugs were administered daily, either from 0 - 2 weeks or from 2 to 4 weeks post EAM induction. Cardiac dysfunction developed with significant decreases in left ventricular ejection fraction and fractional shortening due to dilatation and wall thickening. EAM rats treated with mepyramine and ST994 in weeks 0 - 2 had the lowest decreases. These treated with ST994, ST1012 or quinapril performed much better the following 2 weeks without therapy than did the other groups. On autopsy their hearts were smaller, less fibrotic, histopathological changes in them of a lower grade. When the treatment started with 2 weeks' delay, the ST994-treated EAM rats showed the highest median survival. H₄ receptor antagonism inhibits heart remodelling, preserves heart contractility, improves survival and may be of potent therapeutic relevance in human clinics. The blockade of H₁ receptor inhibits heart dilatation but does not prolong the life.

The first investigation of Wilms' tumour atomic structure-nitrogen and carbon isotopic composition as a novel biomarker for the most individual approach in cancer disease

The paper describes a novel approach to investigating Wilms' tumour (nephroblastoma) biology at the atomic level. Isotope Ratio Mass Spectrometry (IRMS) was used to directly assess the isotope ratios of nitrogen and carbon in 84 Wilms' tumour tissue samples from 28 cases representing the histological spectrum of nephroblastoma. Marked differences in nitrogen and carbon isotope ratios were found between nephroblastoma histological types and along the course of cancer disease, with a breakout in isotope ratio of the examined elements in tumour tissue found between stages 2 and 3. Different isotopic compositions with regard to nitrogen and carbon content were observed in blastemal Wilms' tumour, with and without focal anaplasia, and in poorly- and well-differentiated epithelial nephroblastoma. This first assessment of nitrogen and carbon isotope ratio reveals the previously unknown part of Wilms' tumour biology and represents a potential novel biomarker, allowing for a highly individual approach to treating cancer. Furthermore, this method of estimating isotopic composition appears to be the most sensitive tool yet for cancer tissue evaluation, and a valuable complement to established cancer study methods with prospective clinical impact.

Matrix metalloproteinases MMP1, MMP2, MMP9 and their tissue inhibitors TIMP1, TIMP2, TIMP3 in head and neck cancer: an immunohistochemical study

INTRODUCTION

Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes implicated in the invasion and metastasis of many kinds of cancer because of their ability to degrade components of extracellular matrix. Specific tissue inhibitors of matrix metalloproteinases (TIMPs) regulate their activity. MMPs and TIMPs were identified in many neoplasm, including cancers of head and neck, lung, breast and colon cancer. In most researches a strong relation between MMPs and TIMPs expression and a clinical course of disease was observed, although there were many discrepancies between the authors. The aim of this research was to evaluate the expression of MMP1, MMP2, MMP9 and TIMP1, TIMP2, TIMP3 in head and neck cancer and to investigate the prognostic impact of these factors in patients with these tumors.

MATERIAL AND METHODS

210 patients with head and neck cancer that underwent surgical treatment with at least a 5-year follow-up were included in the study. Immunohistochemical studies were performed on formalin fixed, paraffin embedded sections by using monoclonal antibodies against MMP1, MMP2, MMP9 and TIMP1, TIMP2, TIMP3 antigens and Dako EnVision detection system.

RESULTS

For all of the markers diffusion, cytoplasmatic staining of tumor cells and some surrounding stromal cells was observed. There was a correlation between TIMP2 and TIMP3 overexpression and tumors staged as III/IV (p=0,037 and p=0,022, respectively). Also, we observed a strong association between MMP2 expression and the presence of nodal metastases (p=0,013). It was found that the TIMP2 overexpression was significantly more frequent in the tumors of patients facing nodal recurrences during the follow-up period (p=0,05). Positive immunostainings of MMP1, MMP2, MMP9 and TIMP1, TIMP2 were significantly related to the higher tumor grade (G3). Specially strong correlation was seen between high TIMP2 expression and low histological differentiation (G3) (p<0,001). In univariate analysis the overall survival rate was shorter in cases with positive MMP2 and/or MMP9 expression. Patients with TIMP2 positive expression diminished both overall and disease-free survival (p=0,049). In multivariate analysis positive TIMP2 and MMP2 expressions were independent prognostic factors for overall survival. Only advanced nodal metastatic tumors (N3) were related to disease free survival.

CONCLUSIONS

Our data suggest the conclusion that imbalance between matrix metalloproteinases and their inhibitors play the important role in progression of head and neck cancer and patients' prognosis.

Molecular and immunohistochemical expression of apoptotic proteins Bax, Bcl-2 and Caspase 3 in infantile hemangioma tissues as an effect of propranolol treatment

BACKGROUND

Infantile hemangiomas (IHs) are the most common benign tumors of childhood. They are characterized by a unique clinical course with two phases, proliferation and involution, which are followed by regression. The therapy of infantile hemangiomas was revolutionized in 2008 by the introduction of propranolol, however, the mechanism of its influence on hemangiomas remains unclear.

METHODS

The study included 71 patients with IHs, 27 of whom were treated with propranolol while the remaining 44 were used as a comparative group. The expression of Bcl-2, Bax and Caspase3 was determined with immunohistochemistry and mRNA of Bax, Bcl-2 and Caspase3 were assessed with the use of RT-PCR.

RESULTS

Both methods revealed a statistically significant decrease in Bcl-2 expression and an increase in Bax in IHs tissues after propranolol treatment.

CONCLUSIONS

The results obtained for Bax and Bcl-2 proteins may indicate a link between the effect of propranolol and apoptosis. Higher Bax and lower Bcl-2 expression in the propranolol treated group indicates a strong pro- apoptotic action countering any anti-apoptotic activity; apoptosis was indicted in IH tissue as a potential result of propranolol treatment, with potential clinical impact in other tumors.

Hepatoblastoma Biology Using Isotope Ratio Mass Spectrometry: Utility of a Unique Technique for the Analysis of Oncological Specimens

INTRODUCTION

Hepatoblastoma is the most common primary liver tumor in children. However, it occurs rarely, with an incidence of 0.5-1.5 cases per million children. There is no clear explanation of the relationship between clinicopathologic features, therapy, and outcome in hepatoblastoma cases, so far. One of the most widely accepted prognostic factors in hepatoblastoma is histology of the tumor. The aim of the study was to determine the potential differences in biology of hepatoblastoma histological subtypes at the atomic level using the unique method of isotope ratio mass spectrometry, which is especially valuable in examination of small groups of biological samples.

MATERIAL/METHODS

Twenty-four measurements of nitrogen stable isotope ratio, carbon stable isotope ratio and total carbon to nitrogen mass ratio in fetal and embryonal hepatoblastoma tissue were performed using a Sercon 20-22 Continuous Flow Isotope Ratio Mass Spectrometer (CF-IRMS) coupled with a Sercon SL elemental analyzer for simultaneous carbon-nitrogen-sulfur (NCS) analysis.

RESULTS

A difference of about 1.781‰ in stable nitrogen isotope 15N/14N ratio was found between examined hepatoblastoma histological subtypes.

CONCLUSIONS

The prognosis in liver tumors cases in children may be challenging particularly because of the lack of versatile methods of its evaluation. Isotope ratio mass spectrometry allows one to determine the difference between hepatoblastoma histological subtypes and clearly indicates the cases with the best outcome.

Chloroquine treatment reduces the number of cutaneous HLA-DR+ and CD1a+ cells in patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can be exacerbated by exposure to ultraviolet radiation (UVR). The number and phenotype of antigen presenting cells in the skin play a role in cutaneous immune response generation. Although antimalarials are widely used in SLE treatment, their mode of action is not completely elucidated. The aim of our study was to determine the effect of chloroquine treatment on HLA-DR+ and CD1a+ cell number in locally irradiated (three minimal erythema doses of UVB) and normal appearing skin in SLE patients and healthy subjects. A significantly higher number of HLA-DR+ and CD1a+ cells were found in both locations in SLE patients compared with controls. Following three months of daily chloroquine treatment (250 mg), the HLA-DR+ and CD1a+ cell counts were significantly reduced in both irradiated and unirradiated sites of SLE patients, although still higher than in controls. Chloroquine treatment reduces the number of antigen presenting cells in the skin of SLE patients, and this effect may explain the antimalarials beneficial immunoregulatory and anti-inflammatory properties.

Evaluation of potential prognostic value of Bmi-1 gene product and selected markers of proliferation (Ki-67) and apoptosis (p53) in the neuroblastoma group of tumors

INTRODUCTION

Cancer in children is a very important issue in pediatrics. The least satisfactory treatment outcome occurs among patients with clinically advanced neuroblastomas. Despite much research, the biology of this tumor still remains unclear, and new prognostic factors are sought. The Bmi-1 gene product is a currently highly investigated protein which belongs to the Polycomb group (PcG) and has been identified as a regulator of primary neural crest cells. It is believed that Bmi‑1 and N-myc act together and are both involved in the pathogenesis of neuroblastoma. The aim of the study was to assess the potential prognostic value of Bmi-1 protein and its relations with mechanisms of proliferation and apoptosis in the neuroblastoma group of tumors.

MATERIAL/METHODS

29 formalin-fixed and paraffin-embedded neuroblastoma tissue sections were examined using mouse monoclonal antibodies anti-Bmi-1, anti-p53 and anti-Ki-67 according to the manufacturer's instructions.

RESULTS

There were found statistically significant correlations between Bmi-1 expression and tumor histology and age of patients.

CONCLUSIONS

Bmi-1 seems to be a promising marker in the neuroblastoma group of tumors whose expression correlates with widely accepted prognostic parameters. The pattern of BMI-1 expression may indicate that the examined protein is also involved in maturation processes in tumor tissue.

[Evaluation of the expression of selected pro- and anti-apoptotic factors in syncytiotrophoblasts of human placenta and changes observed after vitamin supplementation]

AIM

The main aim of the study was to estimate expression of Bcl-2 and Bax proteins in syncytiotrophoblast in placenta obtained from pregnancies complicated by hypertension and to compare results with group supplemented by antioxidants.

MATERIAL AND METHOD

The study was performed in High Risk Department of Medical University Lodz. 3 groups of pregnant women were compared: I-pregnancy complicated by hypertension, II pregnancy complicated by hypertension treated by oral administration of antioxidants--vitamin C and vitamin E.III-rd group consisted of healthy women. After delivery incision from central part of placenta was taken on obtained slides due to immunohistochemical reactions the character intensity surface affected by reaction and expression of two proteins involved into process of apoptosis was measured- anti-apoptotic Bcl-2 and pro-apoptotic Bax. In every slide ten of random choosen fields were evaluated in 200x zoom using semi-quantative method.

RESULTS

Highest value of Bcl-2 character was found in I-st group, the lowest in III-rd group- healthy women. The lowest intensity surface affected and expression of the reaction was found in II group- treated by antioxidants. The highest value of Bax reaction character and intensity was found in III group comparing to others. The lowest mean surface of syncytiotrophoblast affected by Bax reaction was found in II group. In III-rd group expression of reaction was higher than in both other groups.

CONCLUSIONS

In the base of Bcl-2 reaction in syncytiotrophoblast no influence of antioxidants supplementation on apoptosis process that occurs by this path was found. Antioxidants supplementation decrease Bax activity in syncytiotrophoblast, that suggests restriction of apoptosis process despite of changes connected to hypertension.

[Evaluation of cyclin E expression in endometrial hyperplasia and cancer in postmenopausal women]

OBJECTIVES

The aim of present study was to determine expression of cyclin E in endometrial hyperplasia without atypia, atypical endometrial hyperplasia and endometrial cancers in comparison with expression of cyclin E in atrophic endometrium of postmenopausal women. We have also estimated relationship between cyclin E expression and prognostic factors for endometrial cancer such as: histological type, cancer stage and histological grade.

MATERIAL AND METHODS

154 women were enrolled into study Women were divided into 4 groups. The first group consist of 38 women with endometrial hyperplasia without atypia, the second group consist of 18 women with atypical endometrial hyperplasia. The third group comprise 62 women with endometrial cancer and the forth 36 women with atrophic endometrium. Cyclin E expression was estimated in formalin-fixed, paraffin-embedded tissues obtained from enrolled women with the use of immunohistochemical techniques. We estimated labelling index (LI) - the number of cells that stained for cyclin E in relation to all cells at the certain field of view.

RESULTS

Medians of labelling indices of cyclin E in atrophic endometrium, endometrial hyperplasia with atypia, atypical endometrial hyperplasia end endometrial cancer were 13.7%, 34.7%, 62%, 72.2% respectively These differences were statistically significant. In our study we haven't found relationship between cyclin E expression and histological type of tumour (p = 0.186), cancer stage (p = 0.186) and histological grade (p = 0.539) CONCLUSIONS: In the carcinogenesis of endometrial tumours in postmenopausal women there is a progressive disorder in mechanisms regulating cell cycle. It seems impossible to use cyclin E as prognostic factor for endometrial cancer.

[Evaluation of COX-2 protein expression in melanocytic nevi in children]

Melanocytic skin tumors can be divided into benign nevi and malignant which take the form of melanoma. Melanocytic nevi are common in both adults and children. It is widely acknowledged that they are one of the risk factors of the formation of melanoma. However, melanoma among children is rare. In addition, differentiation of benign and malignant melanocytic tumors is often challenging. Recent studies suggest that COX-2 protein maybe useful in excluding malignant transformation of melanocytic lesion. The aim of the study was to evaluate the occurrence and differences of reactions with COX-2 in groups of nevi in children and melanoma adults.

MATERIAL AND METHODS

The study included 75 common nevi and 43 atypical nevi incised in children and 15 cases of melanoma removed in adults. Paraffin blocks were used to make a preparations with routine hematoxylin and eosin staining (H + E) and immunohistochemistry. The results were statistically analyzed.

RESULTS

Positive reactions were observed in both melanocytic nevi and melanoma. Differences between benign and malignant melanocytic tumors were statistically significant. Differences within melanocytic nevi were not statistically significant.

CONCLUSIONS

The reactions of COX-2 are present in all nevi and do not allow to differentiate between their various types. COX-2 has potential utility in the differentiation of benign and malignant melanocytic tumors.

Evaluation of the psychological state of patients with advanced cancer and the impact of support on their emotional condition

AIM OF THE STUDY

The aim of the study was to evaluate the patient's psychological state in the advanced stage of cancerous disease and to assess the effect of sustenance provided by the nursing personnel upon the emotional state of the patient.

MATERIAL AND METHODS

The study group comprised 46 subjects treated in palliative care medical wards in Łódź. The data were collected in accordance with the HADS-M questionnaire as well as a self-developed survey. The information obtained was analysed by means of Pearson χ(2) test.

RESULTS

The results obtained indicate that most subjects undergo mood aggravation. 76.2% of patients were diagnosed with depressive states. Only 19.6% of the population under investigation showed no signs of anxiety states. The study demonstrates irritation to be yet another unfavourable emotional state coupled with the advanced stage of cancerous disease with as few as 4.4% (4.2%) respondents claiming not to suffer any such symptoms. The patients highly prize the support they receive and it notably improved their well-being. Social support is essential in the advanced stage of the disease. Less severe mental disorders were noted in people who have received all kinds of support.

[Expression of metalloproteinase MMP-9 and tissue inhibitor of metalloproteinase TIMP-2 in placenta of pregnant women with intrauterine growth restriction]

INTRODUCTION

The development of pregnancy depends on many factors, among other the implantation and the development of the placenta and placental vascularity The correct course of these processes depends on the proper activity of the enzymes degradating elements of extracellular matrix and basal membrane - metalloproteinases.

OBJECTIVES

Assessment of the expression of MMP-9 and TIMP-2 in the placenta of women with intrauterine fetal growth restriction.

MATERIAL AND METHODS

Two study groups were distinguished - with untreated IUGR and with IUGR treated with the acetylsalicylic acid and L-arginine and the control group with correct fetal growth and course of pregnancy Marked microscope preparations from placental samples were made with specific antibodies for MMP-9 and TIMP-2.

RESULTS

The greatest intensity of the reaction and the villous TIMP-2 expression was characteristic of the group with untreated IUGR. Strongest expression MMP-9 was observed in the control group. The smallest surface of the trophoblast with positive MMP-9 reaction appeared in the group with untreated IUGR.

CONCLUSIONS

High MMP-9 activity in the placenta correlates with its correct structure and function. Application of IUGR treatment reduces the expression of TIMP-2 in the placental villi.

The use of computer image analyses in the assessment of chosen histoclinical features of nephroblastoma cells in children

The goal of the research was to assess the nuclear morphometric discriminant function (MV(f)) in the analyzed group of nephroblastomas and to evaluate its potential prognostic value. We found a statistically important correlation between favourable histology of Wilms' tumours (according to SIOP 93-01 and SIOP 2001 classifications of kidney tumours of childhood) and low values of MV(f) discriminant function, which was also associated with the best prognosis for the patients. We believe that MV(f) assessment may be a helpful tool in making prognosis in doubtful cases of nephroblastomas in children.

Minichromosome maintenance 2 (MCM2) is a new prognostic proliferative marker in Wilms tumour

OBJECTIVE

We examined expression of minichromosome maintenance 2 (MCM2) by immunohistochemistry in nephrectomy specimens of children with nephroblastoma treated according to the Society International d'Oncologie Pediatrique (SIOP) scheme to determine its potential prognostic significance.

MATERIAL AND METHODS

18 children with nephroblastoma, 9 females and 9 males, 2 months to 7 years of age, treated in the Department of Oncology and Paediatric Surgery, Medical University of Lodz, during the period 1994-2006 were analysed. Children were treated by neoadjuvant chemotherapy and subsequent nephrectomy according to SIOP protocols -93 and 2001 and followed up from 2 to 11 years. The tumour stage and classification in nephrectomy specimens were established according to the revised 2001 SIOP working classification of renal tumours of childhood.

RESULTS

In low risk nephroblastoma MCM2 expression was low, ranging from 0% in two cases of completely necrotic nephroblastoma to 5% in one child with cystic partially differentiated nephroblastoma. In mesoblastic nephroma, which is a distinct type of neoplasm with a low malignant potential and the most common congenital renal neoplasm, MCM2 expression was variable ranging from 2-5% in 2 children with stage I disease to 70% in one child with stage III disease In intermediate risk nephroblastoma MCM2 expression was low (10%) in one case of regressive type nephroblastoma and stage II disease and intermediate to high in children with epithelial type nephroblastoma, ranging from 40-50% in one case with stage I disease to 70% and 70-100% in 2 children with stage I and stage IV disease, respectively. In high risk nephroblastoma (7 children with nephroblastoma blastemal type) MCM2 expression was intermediate to high, ranging from 40 to 90%. MCM2 expression tends to be lower in children with less advanced stage of disease (stage II) and higher in more advanced disease (stage III and IV). Two children with blastemal type and high (> 60% MCM2) died of disease within 2-4 years from diagnosis and one child was lost to follow-up. Both children who died were older 8.5 yo M and 7 yo M and presented with advanced disease stage IV or III with anaplasia.

CONCLUSION

MCM2 is a promising prognostic factor in WT treated according to the SIOP scheme.

Histoclinical study of nephroblastoma in relation to current and previous SIOP Classification of Renal Tumors of Childhood

Histological classifications are essential for prognosis in children malignancies. Currently, the histological type of tumor is one of the main prognostic factors in this group. We investigated histoclinical features of nephroblastoma in relation to SIOP 93-01 and SIOP 2001 Classifications of Renal Tumors of Childhood. We examined all the routinely available histological features and histological nephroblastoma types and investigated their influence on patients' survival with the use of log-rank test and Kaplan-Meier method. The results of statistical analysis indicated that SIOP 93-01 more precisely separated nephroblastoma types according to their biology and malignant potential. We also observed that epithelial type of nephroblastoma showed a mixture of results typical for both intermediate and high risk tumors. What is more, we noticed statistically important correlations between developmental defects found in patients with nephroblastoma and tumor volume and the course of disease.

[Systemic sclerosis and scleroderma circumscripta--disturbances of selected serum parameters which are responsible for vascular changes and CD34 expression in involved skin]

Scleroderma is a connective tissue disease characterized by fibrosis confined only to skin (scleroderma circumscripta, morphea) or to skin and internal organs (systemic sclerosis, SSc) as a result of vascular changes, immune dysfunction and increased production of collagen and other extracellular matrix (ECM) components. Both types of scleroderma present clinical and histological similarities in skin changes but their pathogenic relationship is still not elucited. The aim of our study was to evaluate vascular changes in both types of scleroderma on the basis of: serum levels of gelatinases--MMP-2 and MMP-9, vascular endothelial growth factor (VEGF) and its soluble receptor 2 (sVEGFR2) and expression of CD34 antigen in skin changed samples. The following patients were involved in the study: 34 patients with SSc, 31 with morphea and 15 healthy controls. Serum levels of selected parameters were estimated by ELISA method; whereas CD34 antigen immunoexpression was performed by immunohistochemistry. Serum level of MMP-9 was statistically significantly higher in SSc and morphea patients compared to the control group (848.6 ng/ml; 844.4 ng/ml vs. 535.9 ng/ml; p<0.05). Statistical analysis revealed that mean serum levels of MMP-2 was significantly (p<0.05) higher in SSc group compared to morphea and control group (240.4 ng/ml vs. 208.1 ng/ml; 211.9 ng/ml) and VEGF was higher in morphea group compared to the control group (422.2 pg/ml vs. 188.7 pg/ml). Statistically significant difference between ratio VEGF/sVEGFR2 of mean serum levels in SSc patients and the control group (0.038 pg/ml vs. 0.018 pg/ml) and positive correlation between serum levels of MMP-9 and sVEGFR2 only in control group (r=0.143) were obtained. Possitive CD34 expression was found in vascular endothelial cells cytoplasm. Mean value of immunoexpression of CD34 was statistically significantly higher in the control group (2.8 +/- 0.42) compared to SSc group (1.59 +/- 0.69) and morphea (1.42 +/- 0.50) (p<0.001). There was no statistically significant difference between immunoexpression of CD34 in skin samples of both types of scleroderma (p=0.27). The obtained results seem to confirm pathogenic similarities in endothelial cells disturbances in both types of scleroderma--SSc and morphea.

[Analysis of TIMP-1, TIMP-2 and TIMP-3 expression as a prognostic factor of laryngeal cancer progression]

INTRODUCTION

Tissue inhibitors of matrix metalloproteinases (TIMPs) are natural regulator of activity of matrix metalloproteinases, that are responsible for ECM degradation. TIMPs have been identified in various carcinomas and in most of them dependence between TIMPs and clinical course of the disease have been observed.

AIM

Of the research was to evaluate expression of TIMP-1, TIMP-2 and TIMP-3 in laryngeal cancer and to asses the prognostic significance of these factors.

MATERIAL AND METHOD

104 patients with laryngeal cancer, that underwent surgical treatment were included in the study. Only cases with at least a 5-year follow-up were included. Immunohistochemical studies were performed on formalin fixed, paraffin embedded sections by using monoclonal antibodies against TIMP-1, -2 and -3 antigens and ABC detection system. Results. TIMPs expression was cytoplasmatic, mainly in cancer cells, but also in some stromal cells. TIMP-1 and TIMP-2 correlated with grading (TIMP-1 p = 0,05; TIMP-2 p = 0,001). There was an association between TIMP-2 and TIMP-3 expression and tumor size (TIMP-2 p = 0,037; TIMP-3 p = 0,022). TIMP-3 expression correlated with clinical stage of the disease (p = 0,037). There was an association between TIMP-2 expression and nodal recurrence (p = 0,05). Both overall and disease-free survival were shorter in cases with positive TIMP-2 expression (p = 0,049).

CONCLUSIONS

Our results demonstrate that there is an association between TIMPs expression and clinicopathological features of laryngeal cancer. Moreover TIMP-2 could be an important marker in prognosis of laryngeal cancer patients.

[Alterations of cell cycle regulating proteins: Rb, p21 and p16 in laryngeal cancer]

In cell cycle, most of the regulatory actions occur at the so-called restriction point (R) in the late G1 phase. Tumor suppressor genes; Rb, p53 and p21 are among the most important of the agents suppressing transition through R point. Changes in the expression of Rb (retinoblastoma) gene correlate with the presence of Rb protein and they are believed to be an early event in carcinogenesis. This issue seems to be not plainly defined in laryngeal cancer. P21 with p16, cyclin D1 and Rb genes that play a critical role in the regulation of the G1-S transition of the cell cycle, are frequently altered in several neoplastic entities. Our purpose was to investigate the possible prognostic value of p21, p16 and Rb proteins in patients with laryngeal cancer. 67 patients with laryngeal cancer was multi-variously analysed. Paraffin-embedded tissue sections were immunohistochemically stained with a monoclonal antibody raised against p21, p16 and Rb proteins using standard immunohistochemistry techniques. Low intensity (< or = 10%, 7/67) of p21 protein expression was significantly correlated with histological grading (p < 0,01) and overall and disease free survival (p < 0,05). We did not observed any correlation between p21 expression and T, N and M status and local or nodal recurrences. Absence of p16 protein expression was observed in 35/67 (52,2%) cases and was significantly correlated with N status (p = 0,03) and nodal recurrences (p = < 0,01). By univariate analysis expression of p16 protein was related with quicker relapse. Rb protein was absent in 7/67 cases (10,4%) and was related to T3 and T4 primary tumour size (p < 0,05). We did not observed any correlation between Rb and other clinocopathological features (p > 0,05). Our study has identified p21 protein expression as important biological marker which may indicate the progression of laryngeal squamous cell carcinoma. P16 protein has a prognostic value in assessment of disease free survival. Based on this findings it can be deduced that investigation of Rb, p16 and p21 proteins makes it easier to understand the process of cancerogenesis in laryngeal cancer and to establish its prognostic value further research and observations need to be attempted.

[Expression of adhesion molecule ICAM-1 in patients with nasal polyps]

INTRODUCTION

Nasal polyposis is a chronic inflammatory disease of the nasal mucosa. The prevalence of nasal polyps seems to vary between 1 and 4% of the population. The pathogenesis of nasal polyps is still not entirely known and has been debated for many years. The aim of the present study was to evaluate the expression of adhesion molecule ICAM-1 in patients with nasal polyps.

MATERIALS AND METHODS

53 patients with nasal polyposis were selected and divided into two groups--allergic and non-allergic. Patients with allergy were distinguished from those without allergy on the basis of positive allergy skin tests to dust and serum levels of IgE. Immunohistochemical studies with monoclonal antibody against ICAM-1 antigen (NCL-CD54, Novocastra) using immunoperoxidase method were performed to evaluate expression of ICAM-1.

RESULTS

Immunoexpression of ICAM-1 was present on some epithelial cells and on fibroblast, inflammatory cells and endothelium in the submucosa. The mean +/-SD values of the immunoexpression of ICAM-1 were significantly increased in dust-sensitive patients compared with dust-tolerant patients (1.93 +/- 0.83 vs 0.83 +/- 0.73 (p < 0.001).

CONCLUSIONS

This research suggests that ICAM-1 plays an important role in the pathogenesis of nasal polyps and the allergic mechanism may play a fundamental role in this process. However, further examinations to confirm this need to be undertaken.

Estimation of diagnostic value of chosen markers of neural differentiation in neuroblastoma group of tumors and pPNETs

Neuroblastoma and peripheral PNETs both are typical examples of wide group of small round blue cell tumors of childhood. Matured neuroblastoma show typical clinical presentation and easy to interpret microscopic picture. Unfortunately in everyday practice much commonly appeared less differentiated neuroblastomas with difficult to predict clinical behavior and impossible to diagnose in routine stain histologic view. Peripheral PNETs are found as morphologically similar entities to some neuroblastoma subtypes but they are treated as separate CD99 positive group of tumors with different biology and clinical behavior. The aim of our study was to estimate the usefulness of neural markers expression (Neuroblastoma Marker, neurospecyfic enolase and neurofilaments) in routine separation between neuroblastoma tumors and pPNETs and between neuroblastoma subtypes according to currently used classification of those entities. We investigated 63 tumor tissue samples and found differences in expression of investigated markers between both neuroblastoma subgroups and neuroblastoma group of tumors and pPNETs.

Number of mitotic figures in microscopic picture of nephroblastoma histologic types--estimation of the value of the oldest known prognostic factor

There are two main widely accepted prognostic factors in nephroblastoma group of tumors--histological type of tumor and clinical stage of disease. However nuclear anaplasia, one of the elements of Wilms' tumor microscopic picture was found as a new prognostic marker in this group of tumors. Estimation of nuclear anaplasia is an obligatory procedure in currently used therapeutic protocols. In our work we compared another element of nephroblastoma microscopic picture--number of mitoses as the oldest known indicator of activity of tumor cells with prognostic markers estimated in routine histologic examination according SIOP Protocols (histological risk, nephroblastoma type and the presence of diffuse anaplasia) and with CD44 expression--widely known marker of discussed prognostic value. We found statistically important correlation between number of mitoses and all the examined features. We believe that mitotic figure counting may become in future a helpful tool in the qualification of prognosis for individual patients in doubtful cases.

Lipofibromatosis presenting as a neck mass in eight-years old boy--a case report

Lipofibromatosis is a very rare pediatric neoplasm with a histologically distinctive fibrofatty pattern. Some of the authors believe that this term should encompass several rare soft tissue tumors of childhood and that tumors of childhood which contain fat as an integral component warrant new classification. We present a case report of a neck tumor in eight-years old boy which shares clinical and morphological features similar to those originally described by Fetch et al. with peaceable with literature results of immunohistochemical stains.

Examination of expression of WT1 gene product and CD44 adhesive molecule in nephroblastoma histologic types

In spite of success of modern pediatric oncology, cases in which we are not able to reach the prospective affirmative effect of performed therapy are still observed. The purpose of our study was to examine the expression of WT1 gene product and CD44 adhesive molecule in nephroblastoma histologic types - one of the currently used prognostic marker for this group of tumor. We found correlations between CD44 expression and histologic type of tumor. We suppose that high CD44 expression in nephroblastoma group of tumors may confirm their high malignant potential. Expression of the WT1 gene product we found in all the investigated tumor tissue samples. However we did not found statistically significant correlations between WT1 expression and histologic type of the tumor and there was no correlation between CD44 and WT1 expression in blastemal nor of epithelial component of nephroblastoma in our study. Lack of this correlation also permits to suppose that the high activity is an integral feature of all Wilms tumor cells and is not only characteristic for anaplastic and blastemal nephroblastomas.

[The implications of nasal associated lymphoid tissue in development of respiratory allergic diseases in children]

AIM

to asses the connection between the expression of costimulatory proteins associated with apoptosis of t lymphocytes of the adenoid in children with allergic rhinitis. To establish the usefulness of using the results of adenoid tissue immunohistochemical studies for prognosis in chronic respiratory allergic disease.

PATIENTS AND METHODS

prospective studies were carried out in 70 children with indications for adenectomy according to the European Pediatric ENT Association. These children had recurrent or chronic rhinitis. Two study groups were identified: Group I- 30 children with allergic rhinitis and group II- 40 children without specific IgE. Group II was subdivided according to family history of atopy: group IIa with positive family history and group IIb with negative family history. Children from group II were followed up for allergic symptoms during 36 months after adenectomy. Histopathologic and immunnohistochemical study of the adenoid tissue (from adectomy) was carried out. The expression of CD4, CD8, CD25, CD28, Cdl52 (CTLA4), Fas, FasL, bel-2 was investigated. The results were analysed statistically.

RESULTS

statistically significant differences between the studies group concerned the number of cells witch showed expression of CD28, CTLAL (CD152) and Fas-L (p<0.05). For CD25 expression statistically significant differences were evident between group I and IIb. No statistically evident differences were found in expression of Cd95 and bel-2 (p>0.05) - three years follow up of children after adenectomy and repeated investigations (every 6 months), allowed to identify specific IgE (for examined allergens) in 11 children from group IIa. These were not present before adenectomy. 3 year study results after adenectomy in children compared with immunnohistochemical investigations of adenoid tissue confirmed the correlation between CTLA4 and FasL expression in children with allergic rhinitis.

CONCLUSION

Intracellular expression of CTLA4 and FasL in T lymphocyts of the adenoid tissue may be a predictive factor in the development of respiratory allergy in children. Further studies are needed.

Estimation of prognostic value of CD44 expression in neuroblastic tumours in children

Adversities observed in treatment of children with neoplastic disease based on new diagnostic markers and new prognostic factors. Both of them allow prognosis to be established for a single patient. The aim of our study was to examine the expression of CD44 adhesion molecule in different histologic types in a neuroblastoma group of tumours (35 cases of neuroblastoma from current files and archives) and to estimate the possible prognostic value of CD44 expression by comparison with widely accepted prognostic markers and chosen histoclinical parameters (9 cases of neuroblastoma with follow-up data). We did not find a statistically significant correlation between CD44 expression and histologic type of the tumour. However, we found that all relapses appeared among patients with tumours with the strongest CD44 expression, and that in none of the investigated tumours without relapses was strong CD44 expression ever observed. We noticed CD44 expression in 88.88% of examined tissue samples which underwent statistical analysis and we found the strongest CD44 expression in tumours situated in the retroperitoneal space. Results of log-rank test and Kaplan-Meier estimation showed that a correlation between CD44 expression and survival time was close to a statistically significant value (p=0.065). We conclude that lack of a clear statistically significant correlation between CD44 expression and histoclinical parameters and currently known prognostic factors in our study is due to the presence of many CD44 isoforms, which cannot be distinguished with commercially used antibodies, but they may play a different role in pathogenesis and spread of neuroblastoma.

[The influence of ultraviolet radiation on HLA-DR+ and CD1a+ cells' number in systemic lupus erythematosus patients]

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease with complex etiology in which genetic, hormonal and environmental factors including ultraviolet radiation play an important role. Immune and inflammatory processes participate in skin lesions development and internal organ damage. Till now most of investigations estimated the role of inflammatory and immune response in skin lesions, but only scarce data evaluate these parameters in normal appearing skin in SLE patients. The aim of our study was to determine the influence of high dose UVB on the number of HLA-DR+ and CD1a+ cells in normal appearing skin of SLE patients. The study included 20 SLE patients and 14 healthy controls. The number of HLA-DR+ and CD1a+ cells were estimated by immunohistochemical method in two skin biopsies taken from non-irradiated and from irradiated sites, 24 h after exposure to 3 MED. All skin sections were stained with antibodies directed against HLA-DR antigen and CD1a molecule. The number of HLA-DR+ was statistically significantly higher in SLE patients comparing to healthy individuals, and UVB irradiation enhanced the difference. Similarly, the mean number of CD1a+ epidermal cells was significantly higher than in controls. In healthy subjects ultraviolet radiation caused migration of these cells into dermis, thus their number was lower in the epidermis. In contrast, in SLE patients under UVB CD1a+ cell count was significantly higher. The increased number of HLA-DR+ and epidermal CD1a+ cells in SLE may suggest that enhanced antigen presentation, leading to excessive cellular immune response and inflammatory reaction development, may result in induction or photoinduction of LE specific skin lesion.

Expression of Fas ligand and CTLA4 in adenoids has a predictive value for allergic rhinitis development in children

BACKGROUND

The balance of CD28/CTLA4-derived signals and Fas-dependent apoptosis activity is determined by the peripheral defense mechanisms and might play a role in the pathogenesis of allergy.

OBJECTIVES

The aim of the study was to investigate the expression of costimulatory and pro- and antiapoptotic molecules in adenoid T cells of children suffering from allergic rhinitis and to find out which of these molecules have a predictive value in the development of allergic rhinitis.

METHODS

The adenoids of 60 children, removed because of nasal obstruction, chronic rhinitis and recurrent respiratory infection, were evaluated. Patients were divided into two groups: group 1, suffering from chronic allergic rhinitis, and group 2, suffering from chronic rhinitis, where no specific IgE was detected, including children with a positive family history of allergy (group 2a) and children with neither a personal nor a family history of allergy (group 2b). For immunohistochemical stainings anti-CD3, anti-CD19, anti-CD4, anti-CD8, anti-CD25, anti-CD28, anti-CTLA4 (CD152), anti-bcl-2, anti-Fas, and anti-FasL antibodies were used. The number of cells expressing these molecules was identified in adenoid interfollicular spaces. The results were then analyzed in allergic and nonallergic children. During a 24-month follow-up children were re-examined for allergy and results were compared to previous immunohistochemical evaluations.

RESULTS

The expression of CD4, CD25, CD28, FasL, and CTLA4 was significantly increased in group 1 compared to group 2 (p < 0.05). However, the discriminant analysis confirmed that only CTLA4 and FasL expression fully discriminated allergic subjects from the others. During a 24-month period of observation 8 children from group 2a were also diagnosed with allergic rhinitis. All of them, especially those sensitized to mites, had an increased number of FasL+ and CTLA4+ in previously removed adenoids.

CONCLUSION

An increased number of cells with intracellular expression of FasL and CTLA4, in interfollicular spaces of adenoids, seems to be a predictive factor of the development of allergic rhinitis.

Study of insulin-like growth factor-1 (IGF-1) and platelet-derived endothelial cell growth factor (PDEGF) expression in children with infantile hypertrophic pyloric stenosis

BACKGROUND

The pathogenesis of infantile hypertrophic pyloric stenosis (IHPS) is not fully understood. Hypertrophy of the pyloric muscle is probably regulated by growth factors. Recent studies reported an increase in the local synthesis of insulin-like growth factor-1 (IGF-1). There are no reports concerning platelet-derived endothelial cell growth factor (PDEGF) playing an important role in the pathological angiogenesis. The aim of this study was to analyze the expressions of IGF-1 and PDEGF by immunohistochemistry (IHC) in the muscularis propria of the pyloric muscle in children with IHPS.

MATERIAL/METHODS

Twenty-two muscle biopsies were obtained at the time of pyloromyotomy. The control group consisted of seven children. Specimens were evaluated by routine histopathological methods and by immunohistochemistry using monoclonal mouse anti-PDEGF or -IGF-1 antibodies. Cells showing positive reaction were counted in five random 200x high-power fields. Values were expressed as the mean +/-SD of the real expression area of the analyzed marker to the total analyzed area.

RESULTS

In children with IHPS the average area of PDEGF expression was 62+/-52.5, whereas in the control group it was 15+/-12.1. The average area of IGF-1 expression was 1037+/-491.9) in study group and 259+/-221.44 in the controls. Statistically significant differences were found.

CONCLUSIONS

These results show a local increase in the expressions of IGF-1 and PDEGF in the muscularis propria of the pyloric muscle in children with IHPS, which may have implications to the pathogenesis of the disease.

Disturbances of the expression of metalloproteinases and their tissue inhibitors cause destruction of the basement membrane in pemphigoid

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease which pathogenesis is associated with destruction of the basement membrane components and the anchoring fibers. The binding of autoantibodies to antigens localized in the basement membrane of the epidermis activates a series of immunological and enzymatic phenomena that lead to blister formation. There are some data that MMPs are involved in the development of skin lesions in BP, however their exact role in this process is not fully understood. We aimed to investigate whether MMPs and their inhibitors (TIMPs), assessed by their tissue expression, are involved in the pathogenesis of BP. The localization and expression of collagenase (MMP1), gelatinase (MMP2), 92 kD gelatinase (MMP9) and stromelysin 2 (MMP10) and TIMP1, 2, 3 were examined by immunohistochemistry in skin biopsies as well as in normal human skin specimens. The study included 21 patients with BP at an active stage of the disease. The MMPs and TIMPs serum levels were measured by ELISA method. Expression of MMP1, MMP2, MMP9 and MMP10 was observed either in the whole epidermis or in the basal keratinocytes. Most of the enzymes examined, apart from TIMP3, were detected in dermal part of the blister. Expression of the majority of the enzymes examined was observed in blister fluid however, the most intense signal was noted for MMP10. In cellular infiltrate we found expression of all the MMPs and TIMPs, the most distinct for MMP1, MMP2, MMP10 and for TIMP2. In all biopsies obtained from healthy volunteers only single basal keratinocytes gave positive, weak signal for the examined proteins. The MMPs and TIMPs serum levels in the control group were normal while in some cases of BP patients they were increased. Based on the results we conclude that imbalance between these enzymes really occurs in BP and it is likely to take important part in the pathogenesis of the disease.

[Immunohistochemical analysis of the fibronectin expression and its prognostic value in patients with laryngeal cancer]

Fibronectin is one of the extracellular matrix glycoprotein, that plays an important role in cancer invasion and progression. Our purpose was to evaluate fibronectin expression and its possible prognostic value in laryngeal cancer. Forty-one patients (six female and thirty-five male) surgically treated for laryngeal cancer were included in the study. The expression and distribution of fibronectin was immunohistochemically determined by using monoclonal antibody against fibronectin. Low expression of fibronectin was detected around the individual carcinoma cells, but large amounts were present in the invasive tumour front and the cancer surrounding stroma was strongest positive for fibronectin. By univariate analysis the level of fibronectin expression on the border of the invasive tumour front was proved to be correlated with tumor stage (p = 0.03). There was a significant association between the defect of ECM and overall survival (p > 0.05). These observation indicates that testing the distribution and the expression of ECM seems to be useful to evaluate the histological grading of malignancy of laryngeal cancer and to be helpful to prognosticate the overall survival while measured on the border of tumour proliferative front in laryngeal patients. The results demonstrate that fibronectin amount may be useful in evaluating the invasion potential of the tumour.

[Assessment of apoptosis measured with TUNEL in laryngeal cancer]

Programmed cell death is a combined intracellular process. For the activation of apoptosis as proapoptotic genes and antiapoptotic ones are needed as well. There are several methods of apoptosis assessment but in laryngeal cancer prognostic value of apoptotic index is still unclear. 44 patients with laryngeal cancer who received surgical treatment in ENT Department of Medical University of Lodz were analysed. Apoptotic index (AI) was studied by TUNEL assay (TdT-mediated dUTP nick and labeling). There were assessed correlation between AI and primary tumor size and nodal status based on TNM system; local and nodal recurrences; and survival rate after surgical treatment. We observed significant correlation between AI and degree of neoplastic cell polymorphism (p=0,043) and tumor size (T feature) (p=0,01). IA was also significantly correlated with epiglottic site of tumor (p=0,036). There were no correlation between IA and N or M features, local and nodal recurrences or survival rate. Based on these findings we conclude that apoptosis index can be a valuable in prognostic assessment of patients with laryngeal cancer.

DNA ploidy, cyclin D1, bcl-2 and lymphocytic infiltration of the tumor microenvironment as prognostic factors in laryngeal cancer patients

The aim of this study was to evaluate correlations between DNA ploidy type, the immunostaining of cyclin D1, bcl-2 and the intensity of lymphocytic infiltration of the tumor microenvironment in relation to the histopathological G differentiation and pTNM classification. Thirty two patients were treated surgically for laryngeal cancer with total or partial laryngectomy in the Department of Otolaryngology Zabrze. The percentage of bcl-2 immunostaining was showed in 53% of the cases and was found to correlate with G differentiation and the patients' age. Cyclin D1 antigen stained positively in 24 cases (75%). Expression of cyclin D1 correlated with cancer stage. Cyclin D1 negative stain was found in T4-stage. DNA ploidy was examined in 19 cases. Aneuploidy was found in 5 cases only, while the rest were diploid. DNA ploidy value correlated with cyclin D1 expression. All paraffin sections were found to contain lymphocytic infiltrations of CD43 and CD45RO phenotype in the tumor front. Some cases showed high intensity of lymphocytic infiltrations of CD45RO phenotype. The intensity of CD43 lymphocytic infiltrations in the tumor front was related to the expression of cyclin D1 and bcl-2.

[Expression of beta-catenin protein in laryngeal squamous-cell carcinoma]

beta-catenin and APC are key components of Wnt signaling pathway. Moreover beta-catenin protein is an adhesion molecule, which exists in complex with E-cadherin. Although clinical impact of beta-catenin in laryngeal cancer is still unclear. Our purpose was to investigate an expression of beta-catenin and its possible prognostic value in laryngeal cancer. The group of 41 patients with laryngeal cancer, surgically treated with minimum 5 years observation, was multi-variously analysed. Paraffin-embedded tissue sections from each case were immunohistochemically stained with a monoclonal antibody raised against beta-catenin antigen. By univariate analysis expression of beta-catenin analysed on the front of laryngeal tumour proved to be significantly related to overall and disease free survival, which were shorter in cases with cytoplasmatic expression. Although there were co correlation with overall and disease free survival in assessment of beta-catenin examined in the middle of tumours. Expression of beta-catenin in the primary tumours was not associated with its size, nodal status, local and nodal recurrences and histological stage (grading). Analysis of beta-catenin protein expression enables the assessment of biology of laryngeal cancer and it can be a prognostic factor of overall and disease free survival, while measures on front tumour in patients with laryngeal cancer.

[Expression of the chosen proapoptotic and activation markers in adenoids in children with allergic rhinitis]

Naive T cells can become either tolerant or immune as a result of their first encounter with antigen. Apoptosis is the most important immunoregulatory mechanism leading to either regional tolerant or autoimmunity and allergy. The lymphatic structure closest to the nasal mucosa is the adenoid, the part of NALT - Nasal Associated Lymphoid Tissue. The objective of this study was to find evidence for our hypothesis that allergic sensitization can occur in adenoid. Of special interest the activity of proapoptotic markers of adenoids lymphocytes in interfollicular areas. In this study the number of cells presenting expression of chosen antigens in adenoids of 20 allergic and 20 non-allergic children were evaluated. The number of positive cell for CD3, CD4, CD8, CD25, CD28, CTLA4(CD152), Fas, FasL, bcl-2, bcl-x were determined using immunohistochemical staining techniques. The eosinophils in the interfollicular space showed a trend to be more numerous in the allergic group (p < 0.005). The number of CD4, CD28, FasL, CTLA-4 and bcl-x positive cells was higher in adenoids allergic than non-allergic children. The differences were statistically significant (p < 0.05; p < 0.001). The result of this study showed that the activity of pro-apoptotic and proliferation markers of the adenoid of allergic children was more intensive than in other children. These findings support that allergic sensitization either is related to or takes place in the adenoid.

[Expression of p16 gene and protein in the evaluation of dynamics of laryngeal cancer growth]

The p16INK4a gene, localized within chromosome 9p21, has been identified as a cyclin-dependent kinase inhibitor and may negatively regulate the cell cycle acting as a tumour suppressor. Genetic alterations involving the 9p21 region are common in human cancers. Our purpose was to investigate 9p21 LOH and expression of p16 protein and their possible prognostic value in laryngeal cancer. PCR-based techniques were used for investigating 9p21 LOH and immunohistochemical methods for p16 protein expression. 9p21 LOH was detected in 10/41 (24.4%) informative tumours and p16 protein in 11/41 (26.8%). By univariate analysis 9p21 LOH proved to be significantly related to overall survival whereas expression of p16 protein was related with quicker relapse. Analysis of 9p21 LOH enables the assessment of biology of laryngeal cancer and it is a prognostic factor of overall survival. A p16 protein has a prognostic value in assessment of disease free survival in those patients. Although clinical impact of gene and protein p16 in laryngeal cancer is still unclear.

Evaluation of CD25, CD152, Fas-ligand expression in the adenoids of allergic and non-allergic children: a pilot study

BACKGROUND

The nasal mucosa is the initial site in the upper airways of the host defence against antigen challenge. The lymphatic structure closest to the nasal mucosa is the adenoid. Apoptotic cell death is an important mechanism for maintaining homeostasis in the immune system, and for regulating the fates of lymphocytes following encounters with self and foreign antigens. This process regulates the population of lymphocytes in peripheral lymphoid organs following exposure to various allergens.

OBJECTIVES

The objectives of this study were to find evidence for the hypothesis that the development of allergic illness depends on allergic sensitisation in the adenoid.

METHODS

In this study, cellular infiltrates in the adenoids of 12 allergic and 13 non-allergic children were evaluated. The number of positive cells for CD4, CD8, CD25, CD152, and Fas-ligand were determined using immunohistochemical stainings and imaging analysis techniques.

RESULTS

There was found a higher expression of CD25, CD152 and Fas-ligand in small, activated lymphocytes, especially in the interfollicular area of allergic patients than in the control group. The expression of FasL in activated lymphocytes, as well as in macrophages, was observed. Statistical analysis has shown a significant correlation between expression of CD152 and allergic disease, and a more intense correlation between CD25, CD152 and Fas-ligand and allergic disease. There was no statistically important divergence in the CD4/CD8 ratio in different samples.

[Microvessel density and endothelial area in assessment of angiogenesis in patients with laryngeal cancer]

The growth of solid tumours and the process of metastasis are dependent on the formation of new blood vessels. Indeed, the intensity of angiogenesis has been shown to be increase in various human tumours. The main aim of this work was the assessment of angiogenesis intensity (AI) in patients with laryngeal cancer using two methods: microvessels density (MVD) and microvessels area (MVA). The group of 151 patients with laryngeal cancer, surgically treated with minimum 5 years observation, was multi-variously analysed. Paraffin--embedded tissue sections from each case were stained with a monoclonal antibody raised against FVIII and CD34 antigens. Intensity of angiogenesis (IA) was measured as microvessels density (MVD) and microvessels area (MVA) by mean of computer image analysis. There were statistically significant correlation between IA measured as MVD using CD34 and tumour size and nodal metastasis. IA described as MVA correlated with: staging, tumour size, nodal recurrences and metastasis. IA measured as MVD after using anti-FVIII correlated with tumour size and nodal metastasis. MVA correlated with staging and nodal recurrences. Overall survival was related to IA measured as MVD using anti-CD34 and anti-FVIII. Disease-free survival was related to IA measured as MVD using anti-VIII. Intensity of angiogenesis has prognostic value in patients with laryngeal cancer. Both methods: microvessels density and microvessels area seems to have similar value in assessment of angiogenesis intensity.