BackgroundThe tumor microenvironment including immune surveillance affects malignant melanoma (MM) behavior. Nuclear factor κB (NF-κB) stimulates the transcription of various genes in the nucleus and plays a role in the inflammatory process and in tumorigenesis. CD8+ T cells have cytotoxic properties important in the elimination of tumors. However, inhibitory receptors on the cell surface will bind to programmed death-ligand 1 (PD-L1), causing CD8+ T cells to lose their ability to initiate an immune response. This study analyzed the association of NF-κB and PD-L1 expression levels and CD8+ T-cell counts with depth of invasion of acral MM, which may be a predictor of aggressiveness related to an increased risk of metastasis.MethodsA retrospective cross-sectional study was conducted in the Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin Hospital using 96 cases of acral melanoma. Immunohistochemical staining was performed on paraffin blocks using anti–NF-κB, –PD-L1, and -CD8 antibodies and invasion depth was measured using dotSlide-imaging software.ResultsThe study showed significant associations between the individual expression of NF-κB and PD-L1 and CD8+ T-cell number, with MM invasion depth. NF-κB was found to be a confounding variable of CD8+ T-cell number (p < .05), but not for PD-L1 expression (p = .154). Through multivariate analysis it was found that NF-κB had the greatest association with the depth of invasion (p < .001), whereas PD-L1 was unrelated to the depth of invasion because it depends on the number of CD8+ T cells (p = .870).ConclusionsNF-κB plays a major role in acral MM invasion, by decreasing the number of CD8+ T cells in acral MM.

Leiomyoma is a benign tumor of smooth muscle origin. Primary leiomyoma of the adrenal gland is very rare. Adrenal tumors are often diagnosed during the ultrasound or computerized tomography (CT) study as incidentaloma. According to the literature review, up to 2018, the largest size of adrenal leiomyoma which had ever been reported was 12 × 10 × 8 cm in dimension (Maher et al.). Herein, we report the largest adrenal leiomyoma with the tumor mass of 600 g (14,1x11,4x10,1 cm) from a female patient admitted to our hospital.

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Latar belakang: Aktivitas fisik sangat dianjurkan dalam program pencegahan, pengobatan, dan rehabilitasi, yang bertujuan untuk mempromosikan kesehatan khususnya kesehatan kardiovaskular. Selain meningkatkan fungsi jantung, ternyata aktivitas fisik juga dapat mengakibatkan kematian mendadak. Pada atlet kematian mendadak sering kali terjadi saat pertandingan olahraga dengan penyebab terbanyak adalah infark miokard. Diduga, pola latihan tanpa hari istirahat turut berperan dalam terjadinya kerusakan otot jantung dan kematian mendadak dalam pertandingan. Penelitian ini bertujuan untuk mempelajari adaptasi otot jantung terhadap aktivitas fisik aerobik dan anaerobik yang dilakukan setiap hari tanpa hari istirahat. Metode: Jaringan otot jantung berasal dari tikus yang diberi aktivitas fisik aerobik dan anaerobik menggunakan treadmill selama 1,3,7 dan 10 hari tanpa hari istirahat. Kemudian dilakukan analisis gas darah dan pemeriksaan hematologi sebagai parameter hipoksia dan adaptasi sistemik tubuh terhadap aktivitas fisik, dan gambaran histopatologi otot jantung sebagai parameter terjadinya kerusakan sel otot jantung. Hasil: Hasil penelitian menunjukkan bahwa aktivitas fisik aerobik dan anaerobik mengakibatkan terjadinya hipoksia sistemik dan menimbulkan respon adaptasi. Kerusakan sel otot jantung terjadi pada hari ke-10 pada kedua kelompok perlakuan, dengan tingkat kerusakan yang lebih berat pada kelompok aktivitas fisik anaerobik. Tingkat protein jaringan pada kelompok anaerobik meningkat secara progresif pada hari ke-10. Kesimpulan: Aktivitas fisik mengakibatkan terjadinya hipoksia dan adaptasi sistemik. Aktivitas fisik aerobik dan anaerobik yang dilakukan selama 10 hari tanpa hari istirahat mengakibatkan kerusakan sel otot jantung.

Introduction Acral melanoma (AM) has a poor prognosis since it is easily metastatic and resistant to chemo and immunotherapy. Cyclooxygenase-2 (COX-2) is an enzyme that plays a role in the carcinogenesis process. The increased expression of COX-2 has an impact on increasing levels of Myeloid-Derived Suppressor Cell (MDSC), which is a key regulator of immune. The increase in MDSC produces Transforming Growth Factor β1 (TGF-β1), which will suppress Natural Killer (NK) cells and Dendritic Cells (DC) function so that tumor cells are spared from the immune systems and are easier to invade surrounding tissues. Purpose This study aimed to determine the role of COX-2 and TGF-β1 on the depth of invasion on AM. Materials and Methods This study was a cross-sectional observational study on 40 paraffin blocks of AM cases during 2014–2019 in the Department of Pathology Anatomy, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Bandung. The depth of invasion of all samples was measured by dotSlide imaging software and the immunohistochemical staining of COX-2 and TGF-β1 was performed. The association between COX-2 and TGF-β1 expression and AM depth of invasion were analyzed using Mann Whitney. Results The result showed a significant association between COX-2 and TGF-β1 expression and depth of invasion on AM. COX-2 expression had a significant association with TGF-β1 expression (0.0001). Through multivariate analysis, it was found that COX-2 had the greatest association with the depth of invasion (p=0.0001). Conclusion The findings showed that increasing expression of COX-2 in AM is associated with the depth of invasion by increasing TGF-β1 and it might play important roles during the invasion process of AM.

BACKGROUND: Cytological and molecular examinations are among the most important examinations in cancer diagnosis. 96% alcohol is a fixative solution commonly used by clinicians for cytological samples because of its accessibility and affordability. Cellblock preparation from cytology specimen may increase morphology detail and may be used for further biomarker analysis. E-cadherin is an adhesion protein expressed in the cell membrane of most carcinoma. Ki67 is a protein expressed in nuclei of malignant cells that used as a proliferation marker. AIM: This study was designed to investigate the effect of fixation duration in 96% alcohol on protein preservation for immunohistochemistry (IHC) evaluation compared to 10% neutral buffered formalin (NBF) as the gold standard. METHODS: Twenty-five fine-needle aspiration biopsy (FNAB) specimen diagnosed as carcinoma were fixed in 10% NBF and 96% alcohol for 1 hour, 6 hours, 24 hours, 48 hours and 72 hours. Cell blocks preparation were made from those 6 groups of specimens. E-cadherin and Ki67 IHC were done to cell blocks section and evaluated. The data were statistically analysed using the Friedman test with p-value < 0.05 of a significant level. RESULTS: There were significant differences between E-cadherin and Ki67 expression in cell block preparation from 96% alcohol-fixed cytology specimen for 1 hour, 6 hours, 24 hours, 48 hours and 72 hours to 10% NBF (p = 0.0001). CONCLUSION: The result indicated that 96% alcohol is not suitable as a fixative solution for cell block preparation in E-cadherin and Ki-67 IHC examination.

Background: Breast carcinoma is a cancer with the highest number in women, Luminal B is the highest number of all types of invasive breast carcinoma in the world.  Invasive  breast carcinoma of luminal B is breast carcinoma with hormone-receptor positive (estrogen-receptor and/or progesterone-receptor positive), and either HER2 positive or HER2 negative with high levels of Ki-67. Determining the aggressiveness factor in  invasive breast carcinoma is very important. PD-L1 is a checkpoint in the cancer cell immunity cycle that affects the aggressiveness of tumour cells and CD133 is a cancerous stem cell marker that plays a role in proliferation, renewal and invasion of tumour cells. This study aims to determine the relationship of PD-L1 and CD133 expression with metastasis in the invasive breast   carcinoma of Luminal B subtype. Methods: This study was an observational analytic study with a case control design to analyze 40 cases of invasive  breast carcinoma Luminal B subtype, then divided into 2 groups, metastasis and nonmetastasis groups of 20 cases respectively. Then, all samples were performed by PD-L1 and CD133 immunohistochemistry staining, and then were associated with metastasis. All data were analyzed statistically, tested with a value of p < 0.05 from a significant level then processed with SPSS 24.0 for Windows. Results: The results of this study indicate that there is a significant relationship in PD-L1 (p = 0.013), CD133 (p = 0.020) with metastasis. PD-L1 expression affects the incidence of metastasis more strongly than the CD133 expression, the high CD133 expression has the greatest risk of metastasis, compared to the high expression in PD-L1 (PD-L1 Odds Ratio : OR CD133 = 7.364 : 12,667). Conclusions: The more increase in expression of PD-L1 and CD133 which demonstrated the more tendency for metastasis shows that PD-L1 had the most influence on metastasis.

We conclude that the expression of the RAC1, RHOA, and CXCR4 proteins and their interactions play a role as risk factors of NAC infiltration.