Background: Thyroid transcription factor-1 (TTF-1) is a protein that is well known to be expressed immunohistochemically in normal and neoplastic thyroid and pulmonary tissues. However; increasing studies have showed its expression in normal tissues and tumors of other organs including endometrium. These facts are important to be considered in the use of this marker in the differential diagnosis of carcinoma of unknown origin and make it important to use it as a part of a panel of immunohistochemical stains. In this setting Cytokeratin 7 and 20(CK-7&CK-20) are important since they have different coordinate expression profile in different organs and tumors.Obejectives: This study is designed to assess expression of TTF-1, CK-7 and CK-20 in neoplastic and nonneoplastic endometrium.Patients and Methods: Thirty six cases have been studied including 23 case of endometrial carcinoma and 13 cases of non-neoplastic endometrium including cases of irregular secretory endometrium, simple hyperplasia, complex hyperplasia, complex atypical hyperplasia, and atrophic endometrium.The study performed in the Baghdad medical city from May 2013 to December 2013Results: Two cases out of 23 cases of endometrial carcinoma (8.7%) showed expression of TTF-1 and none of the non-neoplastic endometrial cases showed any expression. Twenty one (91.3%) of 23 cases of endometrial carcinoma and all non-neoplastic endometrial cases showed expression for cytokeratin 7 with different scores.Neither neoplastic nor non-neoplastic endometrium showed expression for cytokeratin 20.Conclusion:We concluded that although TTF-1 regarded as a marker for thyroid and pulmonary tissues (and tumors); other tumors “including cases of endometrial carcinomas can showed TTF-1 expression. CK7+ve/CK20-ve profile of endometrial carcinoma is important to consider in assessment of carcinoma of unknown origin especially if combined with TTF-1.
IDH1 (isocitrate dehydrogenase 1) mutation might be encounter in the low-grade glioma occurs in early stages of development and directs the progression of the tumor to a higher grade. Aim of the study was to assess the frequency of IDH1 mutation in Iraqi patients with gliomas by immunohistochemical study, to correlate its immunoreactivity with some clinicopathological parameters. The study did on formalin fixed, paraffin embedded tumor tissue from 66 patients with different grades of intracranial gliomas of both gender and all age groups in the Baghdad city were collected in this retrospective and prospective randomized study. Ten normal brain tissue samples in form of paraffin blocks took from forensic medicine unit. New technique used, which is manual tissue microarray Immunohistochemical detection of IDH1 antibodies did by Dako autostainer link 48. Positive cytoplasmic IDH1 staining was found in 38 (57.6%) of cases of glioma. In adult gliomas, secondary glioblastoma multiforme, low grade astrocytoma and oligodendroglial tumors had the greatest values of IDH1 positivity (87%, 80% and 72.72% respectively) followed by anaplastic astrocytoma (42%), then primary glioblastoma multiforme (26%). Males and females expressed the IDH1 equally. The conclusions from the work were IDH1 mutation commonly existed in adult gliomas, low-grade gliomas and secondary glioblastoma, it had no role in pediatric gliomas, and it could be a diagnostic and prognostic marker.
Background: Checkpoint inhibitors (PD-1, PD-L1) are revolutionizing the oncology disease management process. Despite the fact that gastric cancer is a common malignancy with a poor prognosis, relatively little attention has been drawn and attracted to the treatment and diagnosis of this disease by using checkpoint inhibitor. James P. Allison and Tasuku Honjo were awarded the the Nobel Prize in Physiology and Medicine for their developments in fundamental science enabling checkpoint inhibitor therapies. Checkpoint inhibitor overexpression has been related to gastric cancer progression and clues for developing therapeutic goals as well as may provide diagnostic markers for gastric cancer. Aims: The aims of this study are firstly to detection of Checkpoint Inhibitors (PD-1, PD-L1) as novel diagnostics and prognostics markers first time in the world. Secondly, to investigate the validity of using (a modified tissue ELISA method) as a rapid, sensitive, low cost and specific diagnostic method in patients with gastric cancer. Patients and methods: Thirty gastric cancer patients were among patients who attending the Histopathology section -GIT hospital and Histopathology department- Teaching laboratories/ medical city teaching complex Baghdad / Ministry of Health, during the period from August 2020 to April 2021. Another 30 patients diagnosed with benign tumor, In addition, 30 apparently healthy people were chosen as a healthy control group. For these three groups, PD-1, PD-L1, using tissue ELISA technique was carried out. Results: The current study showed that the mean values of PD-1 in tissues of gastric cancer patients (133.413±53.126) was significantly higher (P=0.0001) in it in comparison to both benign tumor group (29.905±12.634) and control healthy group (21.775±12.489); for PD-L1 that the mean values of PD-L1 in tissues of gastric cancer patients (151.175±47.641) was significantly higher (P=0.0001) in it in comparison to both benign tumor group (72.565±9.945) and control healthy group (82.102±12.642); using receiver operating characteristic curve (ROC) area, which showed that area under the curve for PD-1 was (1.000) (p value 0.0001), while area under the curve for PDL-1 was (0.913) (p value 0.0001) and The cut off value for PD-1 associated with highest sensitivity and specificity (100%) was 40.2 ng/ml. The cut off value for PDL-1 associated with sensitivity (80%) and specificity (80%) was 51.6ng/ml. Conclusions: The present study showed that Checkpoint inhibitors (PD-1, PD-L1) values were significantly higher in patients affect with malignant gastric adenocarcinoma which may check a possible role of this marker in the progressing of the disease, furthermore the maximum sensitivity obtained from Checkpoint inhibitors (PD-1, PD-L1) was by using a cut off values equal to (40.2 ng/ml; 51.6 ng/ml) respectively. Therefore, Checkpoint inhibitors (PD-1, PD-L1) may be promising diagnostic tools especially at early stages and among patients at in promotion risk. Keywords: Checkpoint inhibitors (PD-1, PD-L1), gastric cancer.
Background: One of the most common malignancies involving the gastrointestinal tract is gastric cancer. It is categorized as an aggressive disease with poor treatment outcome, as most patients remain undetected until later stages, a multifactorial disease involving both genetic and environmental factors in etiology; a wide variance in the occurrence of gastric cancer in various geographical regions (Abdi-Rad et al., 2006, Abuderman, 2019). Checkpoint inhibitor therapy is revolutionizing the oncology disease management process. despite the fact that gastric cancer is a common malignancy with a poor prognosis, relatively little attention has been drawn and attracted to the treatment and diagnosis of this disease by checkpoint inhibitor therapy (Kang YK, 2017). Objectives: The aims of this study To compare between (a modified ELISA method) and immunohistochemistry (IHC) for those immunological markers PD-1, PD-L1 as a best rapid, sensitive and specific diagnostic methods in patients with Gastric Cancer. Patients and methods: Thirty gastric cancer patients were included, they were among patients who attending the Histopathology department -GIT hospital and Histopathology department- Teaching laboratories/ medical city teaching complex Baghdad / Ministry of Health, during the period from August 2020 to April 2021.
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