Search PubMed⌕ Search

Biomedical subjects

A J Marrogi

Publications and source records attributed to A J Marrogi.

At least 37 records · Page 2Linked to original sources

p53 and PCNA coexpression of 81 pleural and peritoneal effusion specimens: an immunohistochemical study.

Several studies have indicated that wild type p53 plays an important role in controlling cell growth and acts as a cyclin modifier. Abnormalities in p53 induce the overexpression of proliferating cell nuclear antigen. The aim of this study is to correlate immunocytochemically the expression of mutant p53 and the proliferative index (PI) as indicated by image analysis of PCNA immunoreactivity in 81 cases of pleural and peritoneal effusions. There was a strong correlation (r = 73%) between p53 immunoreactivity and PCNA PIs. Forty-three (71%) cases indicated p53 immunostaining out of 61 cases with PCNA immunoreactivity, forty of which (93%) proved to have a diagnosis of malignancy using histological or clinical data. Furthermore, 7 malignant cases showed PCNA reactivity but no p53 immunostaining. An additional four malignant cases indicated no reactivity for either p53 or PCNA. Also, there was a significant difference in the PCNA PI between benign and malignant effusions (p < 0.001). These clinical observations confirm the function of wild p53 as a check point during cell cycling, and as a strong negative feedback effect on PCNA expression. Furthermore, such co-expression represents a significant indicator for malignancy.

Antibodies, Monoclonal↗

Epidermal growth factor receptor expression by acoustic neuromas.

Antibodies directed against epidermal growth factor receptor (EGFr) impede proliferation and induce differentiation of EGFr-positive cancers. To explore the effectiveness of anti-EGFr monoclonal antibodies on acoustic neuromas (ANs), we first sought to evaluate EGFr expression by ANs. The records of all patients with the diagnosis of AN at our institution from January 1989 to July 1994 were reviewed. Immunohistochemical analysis for EGFr was performed on formalin-fixed, paraffin-embedded archival surgical specimens. Skin, liver, and placenta were used as positive tissue controls. Purified rabbit immunoglobulin G replacing the experimental antibody acted as a negative control, and normal eighth cranial nerve was evaluated for background staining. Slides were scored as 0, +, ++, or and for percentage of positive cells by two pathologists, with Antoni A and Antoni B areas scored separately. Results demonstrate that most tumors are revealed to be EGFr positive with a mild degree of staining. Antoni A areas generally have greater staining than Antoni B regions, while normal eighth cranial nerves demonstrate minimal background staining. These results suggest that ANs express low levels of EGFr, with Antoni A areas having the highest levels. While further studies may more accurately quantitate EGFr levels in these tumors, the clinical efficacy of anti-EGFr-based therapies for ANs seems doubtful.

Adolescent↗

Role of Borrelia burgdorferi in the pathogenesis of morphea/scleroderma and lichen sclerosus et atrophicus: a PCR study of thirty-five cases.

Morphea (localized scleroderma), and lichen sclerosus et atrophicus (LSA) share common features with acrodermatitis chronica atrophicans (ACA), a known chronic form of borreliosis. These include similar histologic findings such as diffuse dermal fibrosis. These observations have led several investigators to consider the possibility of Borrelia burgdorferi (Bb) as a common etiologic factor among all of these diseases. The aim of this study is to investigate the role of Bb in the pathogenesis of morphea and LSA, by assaying for its presence in lesional skin biopsies from patients with these diseases. We utilized the nested polymerase chain reaction (PCR) technique to selectively amplify a longer segment of a Bb-specific somatic gene, on DNA from paraffin-embedded, formalin-fixed tissues. The results revealed no Bb-specific DNA sequence in 28 specimens of morphea/scleroderma and 7 of LSA with varying stages of disease. Furthermore, confirmatory Southern blot of the PCR product, resulted in similar findings. These data seriously question the role played by this spirochete in the pathogenesis of morphea and LSA, at least in the southeastern part of the USA.

Adult↗

An immunohistochemical study of leu 7 and PCNA expression in thyroid neoplasms.

Monoclonal Antibody (MoAb) HNK, or anti-leu-7, is reactive with several neuroendocrine and nonneuroendocrine tumors. The aim of this study is to examine anti-leu-7 reactivity in thyroid neoplasms and its relationship to cellular proliferation as determined by anti-PCNA reactivity. The expression of anti-leu-7 in 56 thyroid neoplasms (24 papillary carcinomas, 14 follicular carcinomas, two medullary carcinomas and 16 follicular adenomas) was examined immunohistochemically. Papillary and follicular thyroid carcinomas reacted with anti-leu-7 in a membranous and cytoplasmic pattern in 88% and 93% of cases, respectively. The adjacent benign tissues were nonreactive. Only eight cases diagnosed as follicular adenomas were reactive with anti-leu-7. Furthermore, the mean proliferative index (PI), as measured by the percentage of nuclei immunoreactive with anti-PCNA, was greater than 30% in all thyroid neoplasms reactive with anti-leu-7. The PI was 58% for papillary carcinomas and 68% and 48% for follicular carcinomas, and follicular adenomas, respectively. Lesions originally classified as follicular adenomas that were nonreactive with anti-leu-7 had a PI of 24% and were reclassified as hyperplastic nodules. These data suggest that anti-leu-7 may be useful for characterizing thyroid neoplasia.

Adenoma↗

In situ use of suicide genes for cancer therapy.

Gene therapy has now become a standard experimental approach for treating cancers that have failed conventional therapies. As the understanding of the molecular nature of carcinogenesis develops, new approaches are being taken to directly target tumor cells, thus bypassing the difficulties of killing cells that are resistant to chemotherapy and radiation. One emerging gene therapy approach has been through the genetic modification of tumor cells with a suicide gene such as the herpes simplex virus thymidine kinase gene (HSV-TK) and ganciclovir (GCV) therapy. Death of tumor cells modified with the HSV-TK gene leads to killing of unmodified in situ tumor cells in a phenomenon termed the "bystander effect." The basis both for this effect and other gene therapy trials underway for the treatment of cancer will be discussed.

Cell Death↗

Immunihistochemical detection of Bcl-2 in AIDS-associated and classical Kaposi's sarcoma.

Kaposi's Sarcoma (KS) is an angioproliferative disease that is characterized by proliferation of spindle-shaped cells predominantly of vascular endothelial cell origin, neoangiogenesis, inflammatory cell infiltration, and edema. Although the lesions of classical KS and AIDS-associated KS (AIDS-KS) share common histological features, AIDS-KS occurs at a markedly higher frequency with a more aggressive clinical course. Immunohistochemical analyses of 26 evolutionarily staged AIDS-KS lesions derived from HIV-infected patients demonstrate significant cytoplasmic levels of Bcl-2, a protooncogene known to prolong cellular viability and to antagonize apoptosis. Bcl-2 expression increases as the pathological stage of KS advances. Immunohistochemical analyses of classical KS lesions demonstrate prevalent expression of Bcl-2 as well, indicating that upregulation of Bcl-2 may be important in the pathogenesis of both classical and AIDS-associated KS. Coexpression of Bcl-2 and factor VIII-related antigen in spindle-shaped cells present within KS lesions suggests that Bcl-2 is upregulated within the vascular endothelial spindle-shaped cells of KS. The consequences of upregulated Bcl-2 expression within KS lesions may be prolonged spindle cell viability which, when coupled with dysregulated cellular proliferation due in part to synergistic activities of inflammatory and angiogenic cytokines and HIV-1 Tat protein, may result in the maintenance, growth, and progression of KS.

Acquired Immunodeficiency Syndrome↗

In vivo analysis of the 'bystander effect': a cytokine cascade.

The "bystander effect" refers to the death of unmodified tumor cells when in contact with ganciclovir (GCV)-exposed, herpes simplex virus-thymidine kinase (HSV-TK)-modified tumor cells. Although the exact mechanism or mechanisms involved in mediating the bystander effect in vivo are unknown, our findings suggest that an intact host immune system is required for the phenomenon to occur. The present study was designed to establish the effect of HSV-TK-modified tumor cells and GCV on the tumor and its microenvironment in vivo. In sublethally irradiated and immunodeficient Balb/c mice, the bystander effect was observed to be diminished or abrogated. Histopathologic examination of the tumor mass from immunocompetent mice demonstrated centralized hemorrhagic tumor necrosis (38%) after inoculation of the HSV-TK-modified tumor cells and GCV in tumor-bearing mice compared with the control mice (5%), indicating that cytokines such as tumor necrosis factor-alpha (TNF-alpha) were being released locally. This hypothesis was underscored using reverse transcriptase polymerase chain reaction (RT-PCR), by the demonstration of cytokine mRNA expression in mice treated with HSV-TK-expressing tumors and GCV. Semiquantitative PCR analysis for TNF-alpha using PCR-MIMIC on tumor samples from mice treated on days 1 and 4 showed a two-fold increase in the level on mRNA expression. Also, immunohistochemical staining for TNF-alpha showed that mononuclear inflammatory cells infiltrating the tumor were its source. Finally, characterization of tumor-infiltrating lymphocytes (TIL) in experimental animals demonstrated a two- to three-fold increase in the number of macrophages and T cells compared with control animals. These results demonstrate that, in vivo, the bystander effect is mediated in part by an antitumor response through the release of cytokines. Further, the cytokine milieu and tumor microenvironment can be modulated following injection of HSV-TK cells and GCV to enhance the host immune response, which is of potential use in clinical trials.

Animals↗

The role of cytokines in mediating the bystander effect using HSV-TK xenogeneic cells.

We have previously demonstrated that genetically modified syngeneic murine tumor cells (KBALB) expressing the herpes simplex virus thymidine kinase gene (HSV-STK) can kill nearby unmodified tumor cells in the presence of ganciclovir (GCV). The killing was mediated by a 'bystander effect' as evidenced by the prolonged animal survival when syngeneic HSV-TK gene-modified tumor cells were inoculated into mice with an intraperitoneal tumor. In this study we investigated whether irradiated xenogeneic HSV-TK gene-modified tumor cells, a human colon carcinoma cell line (HCT) transfected with the HSV-TK gene, can mediate the 'bystander effect' when used in vitro and in vivo. In vitro experiments indicate that irradiated HSV-TK gene-modified xenogeneic cells (HCT) can mediate a bystander effect on the adjacent cells when the tumor population consisted of as few as 10% of the HSV-TK expressing HCT tumor cells. In vivo, animal survival experiments demonstrate that the xenogeneic gene-modified tumor cells could generate the 'bystander effect' in mice with intraperitoneal tumors as evidenced by prolonged animal survival. In addition, histologic examination of the tumors from experimental animals showed extensive tumor necrosis 3 days post HSV-TK/GCV treatment in comparison to control animals. To evaluate the cause of necrosis in vivo, we assayed for cytokines, which may be involved in mediating this process, by performing RT-PCR and immunohistochemistry on tumor RNA and tumor cells, respectively. Production of IL-1 alpha and IL-6 mRNA within the experimental tumors was observed by RT-PCR. However, mRNA expression for other cytokines including IFN-gamma, IL-2 and IL-4 was not present. Immunohistochemical analysis for IL-1 alpha protein showed reactivity within the infiltrating mononuclear cells indicating the release of this soluble factor. These results indicate that the bystander effect can be generated using irradiated xenogeneic cells both, in vitro and in vivo. Furthermore, this process is mediated by the release of cytokines such as IL-1 alpha, IL-6 which enhances the bystander effect in vivo by immunostimulation.

Animals↗

Tumor oncogenic expression in malignant effusions as a possible method to enhance cytologic diagnostic sensitivity. An immunocytochemical study of 87 cases.

The diagnostic ability of cytological preparations can be hampered by specimen inadequacy and the presence of representative cells, which may result in a diagnostic accuracy of only 70%. An immunocytochemical battery (ICC), which included anti-p53, anti-c-erbB-2, and B72.3 MoAbs, was used to enhance sensitivity in 87 specimens of body effusions. Thirty-six cases were positive for malignancy using conventional cytology. Forty cases were negative and 11 cases were inconclusive or had an equivocal diagnosis. Sensitivity was 65%, and there was a negative predictive value (NPV) of 62%. p53 was expressed in 50 cases (56%, sensitivity = 83%, NPV = 73%), and B72.3 MoAb was positive in 36 cases (37%, sensitivity = 66%, NPV = 64%). Forty-eight cases (56%) displayed reactivity with anti-c-erbB-2 (sensitivity = 75%, NPV = 63%). The authors concluded that application of an ICC panel of anti-p53, B72.3 and c-erbB-2 to complement conventional cytology increases sensitivity to 98% (P < .0005) with an NPV of 96% (P = .001).

Adult↗

Chronic hepatitis C. Analysis of host immune response by immunohistochemistry.

The pathogenesis and perpetuation of hepatocellular injury in hepatitis C viral infection remains unclear. It has been proposed that a direct viropathic effect, the host immune response, or both mediate cell damage. To address this issue, the immunophenotype of the inflammatory infiltrate in the liver of 18 patients with abnormal liver function tests and serologically detectable hepatitis C virus antibodies was compared with seven control patients (three cases with hepatitis B virus infection, two with alcoholic hepatitis, and one patient each with primary biliary cirrhosis and autoimmune hepatitis). The immunohistochemical markers included UCHL1, L26, Ham-56, Mac-387, CD68, Leu-M1, and cathepsin B. We found that T cells represent the predominant cell type in both histopathologic patterns of hepatitis C, ie, chronic active hepatitis and chronic persistent hepatitis, but the intensity of the T-cell infiltrate displayed marked differences. B-cell infiltrates were only seen in the germinal centers of lymphoid follicles in portal tracts. Furthermore, significant numbers of CD68-positive macrophages/monocytes were seen in the more aggressive form of hepatitis C viral infection. These data suggest that the T-lymphocyte-mediated host immune response is similar in chronic active and chronic persistent hepatitis patterns of hepatitis C viral infection, but varies in its intensity. In addition, macrophages/monocytes may play a role in hepatocyte and bile duct injury in chronic hepatitis C.

Adult↗

Gastric carcinoma: recent issues in prognostic factors.

The prognosis of gastric carcinoma remains unfavorable despite a greater understanding of its molecular pathology. This retrospective study of primary gastric carcinomas was collected from one of the highest risk regions of China and examined for the oncogenetic expression of p53, c-erbB-2, and PCNA using immunohistochemistry and DNA contents by flow cytometry and image analysis. These products are reported to influence the tumor behavior. The p53 nuclear and c-erbB-2 membrane-bound stainings were seen in 58% and 34% of cases, respectively. A high PCNA index was found in 90% of the tumors. The p53 expression did not correlate with the histological differentiation, gross morphology, and depth of tumor invasion. Additionally, p53 and c-erbB-2 reactivity did not correlate with the proliferative index (PI) or S-phase DNA content. However, the mutant p53 expression was detected in the dysplastic cells adjacent to the tumor, suggesting a possible role of the oncogene in tumor pathogenesis. Mutant p53 expression can also be helpful in early detection of cases with dysplasia in well-differentiated adenocarcinomas.

Adenocarcinoma↗

Primary vs metastatic hepatic carcinoma. An immunohistochemical study of 34 cases.

The distinction between primary and metastatic hepatic epithelial malignant neoplasms can often be difficult if histologic features alone are used. The purpose of this study was to determine whether certain immunohistochemical markers could be used to aid in the diagnosis. The cases that were studied included 14 hepatocellular carcinomas, 10 cholangiocarcinomas, and seven metastatic adenocarcinomas; three cases of poorly differentiated carcinoma (not otherwise specified) were also studied. The antibodies that were chosen included alpha-fetoprotein, alpha 1-antitrypsin, monoclonal carcinoembryonic antigen, Leu-M1, B72.3, factor XIIIa, and Le(x). We found that the cases of hepatocellular carcinoma displayed cytoplasmic reactivity for alpha 1-antitrypsin, alpha-fetoprotein, and factor XIIIa. The cases of cholangiocarcinoma showed membranous and cytoplasmic reactivity for Le(x) but only cytoplasmic reactivity for Leu-M1 and B72.3, whereas the opposite pattern of staining was found in cases of metastatic adenocarcinoma. We conclude that immunohistochemical studies can be useful in the distinction of primary vs metastatic hepatic malignant neoplasms and recommend a panel of alpha 1-antitrypsin, alpha-fetoprotein, Leu-M1, B72.3, factor XIIIa, and Le(x).

Adenocarcinoma↗

Unilateral pseudo-Kaposi's sarcoma (Bluefarb-Stewart type).

Unilateral pseudo-Kaposi's sarcoma has been associated with Klippel-Trenaunay syndrome. A case is described here of a 17-year-old man in whom clinical and histopathologic findings suggested pseudo-Kaposi's sarcoma of this type. In addition to Kaposi's sarcoma, this entity should be differentiated from lymphangioendothelioma and lymphangioma. Positive factor VIII reactivity, which is evident in our case, may eliminate confusion.

Adolescent↗

Benign cutaneous histiocytic tumors in childhood and adolescence, excluding Langerhans' cell proliferations. A clinicopathologic and immunohistochemical analysis.

Clinical and light-microscopic findings were reviewed in 60 benign histiocytic tumors of the skin arising in patients who were 19 years of age or younger. These lesions were placed in five categories, based on the presence or absence of Touton giant cells, the relative content of vacuolated polygonal cells and spindle cells, and the extent of stromal collagen in the proliferations. The resulting distribution included 16 cases of classic juvenile xanthogranuloma (JXG), four examples of xanthomatous JXG, 11 "transitional" JXG, 11 histiocytomas, and 18 dermatofibromas. The histological appearances of the lesions were related to the elapsed time between their clinical presentation and biopsy sampling. Intervals of 3.5, 3.5, 3.6, 7, and 13.4 months were noted for each histologic group, respectively. Hence, "early" lesions (JXG variants) showed no differences in clinical duration, but significantly longer evolutions were observed for histiocytomas and dermatofibromas. Immunohistochemical studies were conducted utilizing antibodies to several "histiocytic" markers (CD68, cathepsin B, MAC387), CD45 antigen, and S-100 protein. Cathepsin B was universally expressed by all tumors, but its intensity and scope were variable. In addition, only dermatofibromas failed to show CD68 positivity. Scattered mononuclear inflammatory cells in the lesions were CD45 reactive, whereas other cell types were not so labeled. MAC387 was absent in all cases. These findings suggest that these lesions do indeed show histiocytic differentiation, and that they are probably related to peripheral blood monocytes antigenically. Differences in the histologic appearances of these cutaneous histiocytic proliferations of childhood may simply reflect dissimilar periods of clinical growth before biopsies are performed.

Adolescent↗

Pilomatrical neoplasms in children and young adults.

Pilomatrixoma, a neoplasm of hair germ matrix origin, is one of the most common cutaneous appendage tumors in patients 20 years of age or younger. Our review of cutaneous adnexal tumors in the first 2 decades of life showed that pilomatric lesions accounted for approximately 75% of cases. We examined 76 tumors from 69 patients between the ages of 8 months and 19 years (average age, 8 years). The female-to-male ratio was 3:1. We noted a predilection for the head and neck region, as has also been reported by other investigators. Sixty-nine tumors were examples of typical or classic pilomatrixoma; four of them showed the unusual histologic feature of transepidermal elimination or perforation. None of the tumors in the typical category recurred during a follow-up period that averaged 8.7 years. Seven of the lesions with atypical histologic features were examples of aggressive pilomatrixoma (three cases) and pilomatrical carcinoma (four cases). The average age of these seven patients was similar to that of the overall group. The pilomatrical carcinomas were characterized by invasive nests of tumor cells with irregular borders, large vesicular nuclei, prominent nucleoli, multiple mitotic figures, and focal necrosis. A desmoplastic stroma surrounded the infiltrating nests of tumor. Two of the four pilomatrical carcinomas recurred 2 and 6 months, respectively, after initial excision. The aggressive pilomatrixomas had a similar infiltrative growth pattern, but they did not exhibit the same degree of worrisome cytologic features. Single cell necrosis, identifiable mitotic figures, and prominent nucleoli differentiated the atypical from the typical pilomatrixomas. One of the three aggressive pilomatrixomas recurred after 2 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Tricholemmal carcinoma: clinicopathologic study of 10 cases.

Tricholemmal carcinoma (TLC) is a cutaneous adnexal tumor with presumed external hair sheath differentiation. In order to better understand the salient features of this neoplasm, we analyzed the histologic and clinical findings in 10 cases of TLC. Eight patients were males, and two were female; they ranged in age from 55-88 years. Each tumor occurred in hair bearing, sun-exposed skin, and involved the scalp, face, trunk, or upper extremities. The lesions were usually slightly raised, pale tan or reddish, and keratotic; were usually present for less than 1 year; and measured 0.4-2.0 cm. All of them were treated by wide local excision; neither recurrence nor metastasis was reported after 11 to 92 months of clinical followup. Histologically, each TLC was composed of a lobular proliferation centered on the pilar apparatus. Cells with glycogen-rich, mucin-negative, clear or pale eosinophilic cytoplasm predominated. Brisk mitotic activity (4-39 mitoses per 10 high power fields) was typical. Involvement of the interfollicular epidermis was invariably noted, with superficial ulceration in seven tumors. Transitional zones between TLC and the adjacent epidermis were not seen, although pagetoid spread occurred in two examples. Invasion of reticular dermis was present in eight cases, with infiltration to mid-dermis in five TLC. All tumors exhibited areas of tricholemmal type keratinization; dyskeratotic cells were noted in six examples. Hyperkeratosis and parakeratosis were variably present as well. Actinic damage was a constant feature. Despite local invasion at diagnosis, the clinical course of TLC was indolent in all cases.

Aged↗