Cadherin switch (CS) outlined by downregulation of E-cadherin and upregulation of N-cadherin is an established epithelial-mesenchymal transition (EMT) hallmark, being a common signature in wound healing and carcinogenesis. It is intriguing to explore the EMT-associated CS pattern in precancerous phases as well as variably aggressive bladder cancer categories. In this study, we tested CS signified by a reduction in urothelial cells E-cadherin expression and/or aberrant N-cadherin expression in proliferative epithelial changes (PEC) associating inflammation, nonmuscle-invasive bladder cancer (NMIBC), and muscle-invasive bladder cancer (MIBC). Immunohistochemical study of both E-cadherin and N-cadherin was performed for 60 cases: 15 PEC, 8 NMIBC, and 37 MIBC. CS patterns were analyzed: abnormal CS patterns were expressed as deviated, hybrid, co-negative, and full CS patterns. E-cadherin expression was significantly preserved in PEC (86.7%) followed by NMIBC (62.5%) and then MIBC (37.8%) (P = 0.004), whereas N-cadherin showed obvious aberrant expression in MIBC (51.4%) as compared with PEC (33.3%) and NMIBC (25%). In the MIBC group, abnormal cadherin patterns were the highest (70.3%) and was associated with adverse prognostic indicators. In the context of NMIBC progression to MIBC, combined E and N-cadherin evaluation showed highest sensitivity (70.3%) and NPV (31.3%), whereas aberrant expression of N-cadherin presented highest specificity (75%) and positive predictive value (90.5%). For cancer prediction, combined E-cadherin and N-cadherin evaluation showed the highest sensitivity (64.4%); abnormal E-cadherin offered highest specificity (86.7%), positive predictive value (92.9%), and negative predictive value (40.6%). In posttherapy follow-up setting, a metastable EMT signature in the form of partial CS was noted and might reflect resistant dormant populations.

Introduction: In Egypt, few epidemiologic reports have highlighted the national and regional epidemiologic data regarding primary CNS tumors. In this study we aim to identify the frequency of various primary CNS tumors and to demonstrate the age group distribution, gender, topographic data and the different histopathologic types among our patients. Materials and Methods: Data on all cases of primary CNS neoplasms received at Pathology department of Ain Shams University Specialized hospital in addition to a referral neuropathology lab during the period from 2010 to 2015 were collected with a total number of 996 cases. The patients were divided according to their age into two main groups, pediatric group including children and adolescents (from 0-18 years), and adult group (> 18 years). Patients' demographic data and histopathologic tumor types were analyzed. Result: Frequency of primary CNS tumors among males was higher than females (51.7% vs. 49.3% respectively). Regarding patient age, frequency among adults was (89.4%) compared to pediatric age group (10.6%). Gliomas were the most common primary CNS tumors in adults (35%) followed by meningiomas (33.3%) then pituitary adenomas (15.6%); while in pediatric group embryonal tumors (17%) were the second most common following gliomas (59.4%). Conclusion:This study highlighted the frequency, spectrum and prominent features of primary CNS tumors among Egyptian patients, in comparison to many worldwide reports. This study recommends the establishment of specialized national center for CNS tumors in Egypt; this will provide efficient registry system and accurate data analysis for these tumors.

Background: Despite widespread concern in public health regarding the increasing prevalence and burden of smoking and mental disorders, little is known about the double burden of these problems in Arab countries. Aim: To describe pattern and identify determinants of smoking among mentally ill male patients in El

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Background & objectives: Presence of TILs in breast cancer indicates better therapeutic responses to neoadjuvant chemotherapy (NAC), increased pCR and improved outcome. We aim at evaluation of TILs in breast cancer biopsies in correlation with pathological response after NAC in locally advanced breast cancer Methods. This study was conducted at Ain Shams university hospital and Maadi Military hospital in Egypt. 45 Female patients with locally advanced breast cancer were treated with NAC; pathological response was assessed. Tumours were categorized into: luminal A, luminal B, Her2 enriched and TNBC. Assessment of TILs (CD4 and CD8 lymphocytes) was based on Immuno-Oncology Biomarker Working Group guidelines. Results: Tumours were classified into high and low TIL groups using the interquartile range cutoff (29%). High CD4 group showed increased pCR (p = 0.003) and smaller residual tumours (p = 0.04). High CD8 group showed a significant association with smaller residual tumours (p = 0.003). At follow-up of 24-months, CD4 and CD8 high groups showed significantly higher 2-years DFS. The difference between CD4 high and low groups was significant in regards to estrogen receptor status, showing higher levels in hormone-negative tumors (p = 0.029). Patients with Her2 subtype showed higher CD4 (p = 0.007) and CD8 expression (p = 0.018). In CD4 & CD8 low groups, more patients developed local recurrence and distant metastasis (p = 0.025). Conclusion: We concluded that TILs may predict response to NAC and overall prognosis of breast cancer. The evaluation of TILs in correlation with mor-How to cite this paper: El-Mahdy, M.M., Ibrahim, R.A., Hamed, R.M., Elkady, M.S., Bayoumy, W.A., Elsayed, Z.M. and Ezz-El-Din, M.M. (2020)

Introduction A putative role for progesterone in the growth of meningioma has been suggested. The aim of this study was to attest the role of progesterone receptor (PR) in predicting the biological behaviour of meningioma. Materials and methodsThe immunohistochemical expression of PR in meningioma was studied. Cell kinetic using the Ki-67/MIB-1 labelling index (LI) was evaluated and correlated to PR expression.Results This study included 30 cases of meningioma, 15 (50%) recurrent and 15 (50%) nonrecurrent. PR expression was significantly more common in benign meningioma (BM) than atypical meningioma (AM) and malignant meningioma (MM). The mean Ki-67/MIB-1 LI was significantly the highest in MM, high in AM and lowest in BM. In PR-negative meningioma, the mean Ki-67/MIB-1 LI was significantly higher compared with PR-positive meningioma. In the recurrent group, PR was more frequently immunonegative and the mean Ki-67/MIB-1 LI was higher than that in the nonrecurrent group. The difference in PR expression between nonrecurrent and recurrent cases was significant only in BM. The difference in Ki-67/MIB-1 LI was significant only when the recurrent meningioma was compared with nonrecurrent tumour, irrespective of the grade.Conclusion BM expresses PR more than AM and MM. The absence of this expression in BM implies a likely risk for recurrence. Ki-67/MIB-1 LI is valuable to predict tumour grade and the overall risk of recurrence. However, it must be interpreted with caution in BM.

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