IRANIAN JOURNAL OF PATHOLOGY (IJP)
Year:2006 | Volume:1 | Issue:1|Papers Count:9

The rapidly expanding fields of pharmacogenomics and pharmacodiagnostics have presented the pathology laboratories with many challenges and opportunities. As custodians of patient tissues, these laboratories are in the logical position to perform biomolecular testing for proper management of patients. In order to meet these challenges, the pathology laboratories of the twenty-first century should design and execute a biomarker-friendly, standardized tissue handling, including fixation and processing, to ensure uniform protection of macromolecules for clinically useful molecular assays. This important pre-analytic phase cannot be successful if tissues are handled in the traditional manner that includes the use of conventional fixation and processing. The recent progress in fixation and processing methods are rapidly replacing the time-honored routine formalin fixation and overnight processing. In this article we describe our experience with such system that not only produces good histomorphology but also preserves high quality RNA, DNA, and proteins in paraffin embedded material.

Objective: Breast cancer comprise approximately one third of malignant cases in women and is considered as the most common invasive condition in women at an age range of 15-54 years and as the second most prevalent cause of mortality at an age range of 55-74 years. Tumor inhibiting factor p53 is a vital homeostatic regulator and its inactivation at the related gene or molecule could lead to tumor growth and development in various tissues. Therefore, in this research study it was tried to evaluate the diagnostic methods Ag-NOR and p53 immunohistochemistry in malignancy of mammary gland using cytochemical staining methods and its relationship with tumor grade. Materials and Methods: In this research study, 50 referred breast specimens to Deaprtment of Pathology (Sina Hospital, Hamedan) were studied. They were processed as usual and 3 micrometer sections were prepared from related blocks. Then, staining methods for nucleolus organizing regions (Ag-NOR) and p53 immunohistochemistry were applied. Out of these specimens, 41 had malignancy (40 cases of invasive ductal carcinoma and 1 case of invasive lobular carcinoma) and 9 cases were normal. The latter cases were compared with malignant ones. Tumor grade in studied individuals was I (3 cases; 7.3%), II (23 cases; 56.1%), and III (15 cases; 36.6%) respectively. Results: Statistical analysis of data showed that there is only a significant difference regarding frequency distribution of cluster shape and there is no such difference for satellite shape, satellite size, and cluster size. In addition, staining intensity for p53+, p53++, and p53+++did not show any significant difference in various grades of the disease. Using Spearman regression analysis, it was found out that there was a relationship between p53 negative and p53+ (r=0.723) (p<0.01) and between p53+ and p53++ (r=0.78). Furthermore it was found out that a higher expression of p53 protein is negatively correlated with darklystained granules using silver nitrate method.Conclusion: These findings showed that higher expression of p53 protein is negatively correlated with darkly-stained granules using Ag-NOR method and this may indicate its antitumor activity. It appears that this method is an essential tool for evaluation of normal and malignant cases of breast tissue regarding its replication pattern and intensity and expression of those chromosomal segments which are involved in encoding of ribosomal RNA.

Objective: Since colposcopy biopsy test plays a significant role in the evaluation of cervix, especially in patients with an abnormal result of Pap smear test, therefore, this research study was conducted to compare the results of Pap smear and colposcopy directed punch biopsy tests at Firoozgar and Akbarabady hospitals from 2001 to 2003. Materials and Methods: This cross-sectional study was carried out on 80 convenientlysampled women at different ages with an abnormal result of Pap smear test. In this respect, colposcopy directed biopsy was taken from suspicious areas of these patients. Results: A positive predictive value equal to 67.5% was found in patients with an abnormal result of Pap smear and colposcopy directed biopsy tests which confirmed the reliability of the study. Conclusion: These findings strongly suggest the necessity to obtain cervicovaginal smears from all sexually active women and for this purpose colposcopy directed biopsy is the best choice for evaluation of patients with an abnormal result of Pap smear test.

Objective: Transitional cell carcinoma (TCC) of the urinary bladder is the second common cancer of the genitourinary tract. Several parameters such as clinical and pathological parameters, molecular factors, and etc play a role in determination of prognosis and type of treatment. In this research study, the relationship between grade and MDM2 oncoprotein overexpression in TCC of bladder was evaluated. Material and Methods: This cross-sectional study was carried out on 75 paraffin embedded tissue blocks (deposited in Pathology Department) from patients with TCC of urinary bladder from 2002 to 2005. In this respect, 3 mm sections were taken from each block. In one of the sections, grade of tumor was determined according to WHO/ISUP criteria using hematoxylin-eosin staining method. In another section, percent of MDM2 positive cells were determined by microscopic observation of 100 cells in each section using immunohistochemical technique and specific antibody. Results: Mean of MDM2 positive cells was %9.08±4.7. In addition, mean of MDM2 positive cells in low malignant potential tissue (grade I), low grade tissue (grade II), and high grade tissue (grade III) was %3.6±2.2, %8.2±3.5, and %13.1±3.4 respectively. Meanwhile, a significant relationship was found out between grade and overexpression of MDM2 oncoprotein (p=0.012).Conclusion: Overexpression of MDM2 oncoprotein exhibits a direct relationship with grade of TCC of the urinary bladder. The obtained results were consistent with the most previous studies. Therefore, through performing studies with a greater follow-up and entailing a larger population of patients, overexpression of MDM2 oncoprotein could be used as a prognostic parameter in TCC of urinary bladder.

Objective: Approximately 15-20% of clinically recognizable pregnancies end in spontaneous abortion. The incidence of chromosomal abnormalities in those abortions is as high as 50%.A modest but clinically important proportion of spontaneous abortions is caused by a balanced chromosomal aberration in one of the parents. This results from the production of gametes and embryos with unbalanced chromosome sets. The clinical consequences of such abnormal gametes include sterility, recurrent abortions, and giving birth to malformed children. Until now, no such studies have been done in Khozestan province. Therefore, the purpose of this study was to evaluate the frequency and nature of chromosomal abnormalities that lead to recurrent abortions in Khozestan province, which should help physicians working in the region to realize the contribution of chromosomal abnormalities to cases of repeated fetal loss. Also it compares our region to other countries and research centers. This research study evaluated 142 cases with repeated abortion during 1-year period of the study. Methods and Materials and methods: For routine cytogenetic analysis, 3 ml of peripheral blood was incubated in complete lymphocyte culture medium and colchicine was added at prophase stage for fixing chromosomes. Then, they were categorized by G-banding method.Results: A total of 116 cases with a history of recurrent abortions were examined in this research study. The age of the referred women ranged from 20 to 43 years with an average of 28 years (SD=4.75). Meanwhile, the age of referred men ranged from 22 to 44 years and with an average of 32.8 years (SD=4.86). The number of previous abortions varied from 2 to 5 abortions (an average of 2.82 abortions per case). In addition, 8 females (12.7%) and 6 males (11.3%) were found to have abnormal karyotypes. These abnormalities were four balanced translocations, one deletion, one inversion and eight mosaic condition. Among cases with abnormal karyotype, the average of maternal age was 29 years (SD=3.25). Meanwhile, the average number of abortions for cases with abnormal karyotype was 3.07 (SD=0.83).Conclusion: The correlation for maternal age and chromosomal abnormality was P=0.083 and for the number of abortions and chromosomal abnormality was P=0.107.

Objective: Helicobacter pylori have a well-established role in the development of gastric cancer. In vitro studies reveal increased proliferation of the gastric mucosa in the presence of H. pylori infection. It has been also shown that production of some cytokines, such as interleukin-1 beta (IL-1b) is increased in H. pylori infection. In addition, IL-1b increases proliferation of gastric epithelial cell in culture study. In this study, the effect of transforming growth factor beta (TGF-b) on gastric epithelial cell proliferation has been examined. Materials and methods: AGS cells were cultured with TGF-b. DNA synthesis was evaluated by bromo-deoxyuridine (BrdU) test and total viable cell numbers by MTT assay. Results: TGF-b decreased DNA synthesis and cell numbers. This effect was both time and dose-dependent (p<0.05). Both tests, BrdU test & MTT assay revealed this suppressive effect, but it was more evident in BrdU test.Conclusion: TGF-b suppresses proliferation of malignant gastric epithelial cells. It appears that modulatin of tyrosine kinase activity is essential to anti-proliferative effect of TGF-b. Decreased gastric epithelial proliferation due to TGF-b may contribute to the decreased risk of gastric cancer and precancerous lesions in H. pylori-infected individuals or slowing the progression of disease in gastric cancer patients.

Objective: To investigate the presence of Helicobacter pylori in sinonasal mucosa of patients with chronic sinusitis. Design: A prospective case-control study. Materials and methods: Mucosal specimens were collected from the mid-third middle meatus and lateral side of mid-cornea. H. pylori has been investigated using PCRa fter DNA extraction and urease test. Results: H. pylori was not found in any of the sample taken from both groups (case and control patients). Conclusion: This is the first reported study to investigate the presence of H. pylori in sinonasal mucosa in Iran. In this study, H. pylori was not determined in these sites, although its possible presence could not be excluded. Thus, further investigation on more patients and application of sensitive diagnostic techniques are recommended.

Objectives: Immunodeficiency duo to HIV infection can produce unusual diseases in infected individuals & CD4 count is the main predictor of disease progression. In this study clinical syndromes resulting in admition, are considered according to CD4 count for the better diagnosis and treatment of clinical problems in HIV infected patients. Material & Methods: This is a cross - sectional study that was performed since March 2002 to March 2003 in Kermanshah Sina Hospital. HIV infection was confirmed with positive duble ELISA and Western Blot. CD4 count was measured by flucytometery, clinical syndromes were collected with final diagnosis, and the rest of the data were gathered according to the patients' interviews. Statistical analysis was performed by SPSS 11.5.Results: During this study, 72 out of 215 admssions were enrolled. All of them were male with the mean age of 33.4 9.1 years. 64 cases (88.9%) were addicted and 40 cases (55.6%) had prison history. Clinical and/or laboratory indicators of AIDS were observed in 32 cases (44.4%). The average of CD4 count was 356/mL. Patients with lymphadenopathy, neurologic and pneumonia syndromes had the least count of CD4 with the averages of 90, 241 and 269/mL and patients with sepsis, endocarditis and hepatitis syndromes had the highest CD4 average count of 646, 394 and 373/mL respectively. Statistically correlations were observed between pneumonia syndrome with CD4<200/mL (Pvalue=0.005), and addiction history (Pvalue =0.0001). Suffering from hepatitis syndrome was also statistically correlated with being at prison.Conclusion: High prevalence of AIDS in our study was a trait which means high prevalence of asymptomatic HIV infection in general population. Also in patients with CD4<200/mL, especially those who are addicted, pneumonia syndrome may occur. Lymphadenopathy, neurologic and pneumonia syndromes are more common in CD4<300/ L whereas sepsis, Endocarditis and hepatitis syndromes are common in CD4>300/mL, that shows the effect of CD4 count in appearance of clinical syndrpmes. Unsafe injections in prisons may cause acquisition of viral hepatitis in these patients.