BACKGROUND:Osteosarcoma and chondrosarcoma, remain the most common primary bone tumours. Questions have been raised about the prognostic influence of HER-2 in bone sarcomas, but so far the results have been debatable. The her-2 expression is possibly a predictor of chemotherapy response.AIM:In this study, we investigated the extent of HER-2 expression in bone sarcomas, and attempted to correlate it with pertinent variables that will help to provide better treatment options, especially for metastatic ones.MATERIAL AND METHODS:Fifty-two cases of bone sarcomas (32 osteosarcoma cases and 20 chondrosarcoma ones) were studied for HER-2 immunohistochemical expression then correlation with all available clinicopathologic features was done.RESULTS:Most of the osteosarcoma cases exhibited membranous staining (78.1%). Strong staining was observed (score 3+) in 34.4%; while 21.9% showed moderate staining (score 2+); and 21.9% displayed weak staining (score 1+), on the other hand, no staining was detected in 7 out of 32 cases (21.9%) (score 0). As regards chondrosarcoma, the absence of staining in all examined cases was noted. Immunohistochemical HER-2 overexpression correlated significantly with osteosarcoma site with P value = 0.004, with variation relating HER-2 intensity score to the site of osteosarcoma (P = 0.051). A statistically significant negative correlation was detected between HER-2 expression and the presence of metastasis at time of diagnosis (P = 0.006), A significant correlation was also found regarding HER-2 score and presence of metastasis with P value = 0.046 as more than half of cases with no metastasis at diagnosis (17/28 cases, 60.7%) showed positive intensity score. A statistically significant correlation was detected between HER-2 expression and patients’ age (P = 0.044). Also, HER-2 expression significantly correlated to histopathological detection of fibrous tissue, with P value = 0.033. Higher scores of HER-2 expression were associated with a significantly better differentiation (P = 0.038) since detection of wide areas of osteoid were associated with higher HER-2 scores.CONCLUSION:Further research would still be needed to delineate HER-2 role being a new hope for therapeutic targeting in bone sarcoma patients, mainly osteosarcoma in contrast to chondrosarcoma that didn’t express HER-2 at all.
Abbreviations: HGUC, high-grade urothelial carcinoma; UT, urinary tract; TPS, the paris system; N/C, nuclear cytoplasmic ratio; SHGUC, suspicious for high grade urothelial carcinoma; LGUN, low grade urothelial neoplasia IntroductionFor any reporting system to be successful and be applied in daily practice, it must be based on consensus, evidence, inclusion, acceptance, and understanding. 1 The main goal of urinary cytology is the detection of urothelial carcinoma that is clinically significant, namely highgrade urothelial carcinoma (HGUC). Therefore, the understanding of this disease, and particularly its pathogenesis, was crucial in the process of creating The Paris System for Reporting Urinary Cytology. A program to address standardization of urine cytology reporting similar to the Bethesda System for Reporting Cervical Cytology and the Bethesda System for Reporting Thyroid Cytology was conceived at the 18th International Congress of Cytology in Paris in May 2013 where eminent cytopathologists, surgical pathologists, and urologists assembled and formed the Paris System Working Group With support from both the International Academy of Cytology and the American Society of Cytopathology, committees were formed to discuss the existing controversies, questions and published literature in the field of urinary tract (UT) cytology, aiming at forming an international consensus on reporting UT specimens. In late 2015, the consensus group published their guidelines, known as The Paris System (TPS) for Reporting Urinary Cytology. VI. High Grade Urothelial Carcinoma (HGUC).VII. Other malignancies, primary and metastatic. 3-5 Non-diagnostic or unsatisfactoryIt was decided in The Paris System that any sample with atypical, suspicious or malignant cells should be called adequate and reported. So the question of inadequacy comes only when the sample does not show any findings indicative of any disease process. Studies on volume, types of sample, sampling method, and cellularity of urine samples are limited and conclusions are varied. 5 There is a common misperception that cells in body fluids are solutes in a homogenous solution. However, urine is a heterogeneous mixture of non-solute particulates: crystals, microorganisms, decaying cell remnants, and cells. It is heterogeneous because the particulates are not evenly distributed throughout the volume. Cells are denser than most aqueous solutions, so they sink. If only the supernatant, which is acellular or paucicellular, is examined because the first drops of a urine stream were not captured in the specimen container or because the specimen was inadvertently decanted, the results will be suboptimal. 6 It has also been stated that if urothelial cells are obscured by any inlammation, blood, mucin, lubricant etc, then the sample should be called inadequate. TPS has proposed that in instrumented specimens, 2600cells or at least 20 cells in 10 HPF may be taken as adequacy criteria. So when there are 10-20 cells/10 HPF should be reported as "satisfactory but limited by low cellular...
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