Iranian Journal Of Pathology
Volume:12 Issue: 2, Spring 2017

The role of synchronized expression pattern of cytokeratin (CK) 7 and CK20 in the prognosis of colon adenocarcinoma is unclear. The current study aimed at determining the relationship between the expression of cytokeratins 7 and 20 and prognostic factors in colon adenocarcinoma.
In the current cross sectional Study, 52 archival samples of colon adenocarcinoma with different histopathologic differentiation were examined immunohistochemically to analyze the expression of Ck7 and Ck20. The relationship between cytokeratin expression and prognostic factors, such as histopathologic differentiation, lymph node involvement, and depth of invasion, were assessed.
CK7-/CK20 was the most prevalent pattern in the current study. The difference among histopathologic grade, lymph node involvement, and depth of invasion in different CK7/CK20 expression patterns was insignificant (P=0.26, P=0.46, and P=0.22, respectively).
No relationship was observed between CK7/CK20 expression and prognostic factors in colon adenocarcinoma, in the current study

Nonalcoholic fatty liver diseases (NAFLD) is the major cause of hepatocellular carcinoma and increases the risk of mortality. Understanding the trends of its clinical and biochemical changes is essential to identify patients with NAFLD that are at the greatest risk of nonalcoholic steatohepatitis (NASH) and cirrhosis in Iran.
Patients with NAFLD confirmed by ultrasonography were enrolled into the current study. They had negative serologic markers of viral or autoimmune hepatitis, no findings in favor of metabolic liver disease, and had not received medications that affect liver, such as silymarin and Ursobil. Biochemical and clinical symptoms and histological variables were evaluated for each patient. Descriptive statistics were used to compute all variables.
A total of 206 patients, including 109 male and 97 female, with the mean age of 41.2 years were enrolled. The number of patients without obesity and diabetes were 34 (16.4%) and 48 (23.1%), respectively. Sleep disorder, delayed sleep, daytime sleepiness, and late dinner were noticeably common in patients with NAFLD. Furthermore, anxiety, thirst sensation, bloating, warming sensation, defecation disturbances, and upper abdominal pain were common among patients with NAFLD.
NAFLD is a heterogeneous disorder with vast clinical presentations. It seems that anxiety and gastrointestinal problem are common among such patients. Moreover, inadvertent sleep could have a considerable effect on developing NAFLD. Patients with diabetes have more severe NAFLD, based on clinical and histological findings.

Thyroid hormones have an important role in the regulation of lipid metabolism. Subclinical hypothyroidism (SCH), defined as a mild increase in thyroid-stimulating hormone (TSH) and normal level of thyroxine (T4), could be associated with altered lipid profile. The current study aimed at assessing the association between SCH and changes in lipid profile.
Data of 53 patients with SCH and 53 euthyroid cases were collected from Besat Hospital in Hamadan, Iran, in 2013. The age range of the cases was 18 to 60 years, and the groups were matched in terms of gender, age, and body mass index (BMI). SCH was defined as a TSH value of 4.2 to 10 mU/L, and normal T4 as 0.8 to 2.8 ng/dL. Control cases had a normal TSH ranging from 0.5 to 4.2 mU/L. The total serum cholesterol (TCHOL), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels in both groups were examined and the results were recorded.
Participants with SCH had significantly higher LDL and lower HDL levels than the control group regardless of age group and gender (P-value SCH is associated with dyslipidemia, and biochemical screening for thyroid dysfunction is recommended in all patients with dyslipidemia.

Bacterial, contamination of blood components are a significant risk for transfusion reactions. Inherently, platelet concentrates (PCs) are vulnerable to bacterial contamination, due to the storage condition of processed PCs at room temperature, which provide very suitable conditions for the proliferation of microorganisms.
The current study aimed at investigating the transfusion associated septic reaction rate in patients with hemato-oncological diseases in Imam Khomeini Hospital, Tehran, Iran, and identifying the contaminating bacteria.
A total of 3056 adult patients of the Cancer Center of Imam Khomeini Hospital in Tehran transfused with PCs were studied based on the clinical symptoms of septic transfusion reaction from June 1, 2010 to May 31, 2011. Patient presented with the criteria of reaction and the residual components were evaluated for bacterial contamination by Bac T/Alert system.
Patients with leukemia or lymphoma transfused with random-donor PCs were evaluated the signs and symptoms of transfusion reaction occurred only in 12 (%0.4) cases. Automated cultivation found 3 positive blood cultures. Among these a male recipient was categorized as possible septic transfusion reaction and Citrobacterfreundii was isolated from blood sample.
Appropriate clinical utilization of PCs transfusion, and ongoing vigilance to recognize, investigate, promptly treat, and report all suspicious transfusion reactions are necessary to manage the transfusion complication including transfusion-transmitted infections (TTI).

There is a complicated interaction between leishmaniasis and the host immune cells, and also between the host immune cells. These interactions have fundamental effects on the outcome of the disease.
The current study aimed at characterizing the number, distribution, co-localization, and interrelation of 4 types of inflammatory cells in different clinical forms of dry-type cutaneous leishmaniasis (CL).
Thirty-nine cases of CL were studied. The cases were classified clinically as 14 cases of acute leishmaniasis with indurated papules, nodules, and plaques with central crust formation 2 years, and 12 cases of lupoid leishmaniasis with characteristic papules around previous scars of CL > 2 years. Paraffin-embedded blocks were stained with hematoxylin and eosin (H&E) and also stained immunohistochemically for CD4, CD8, CD68, and CD1a.
In acute CL, there was a significant correlation between CD68 macrophages and CD1a epidermal dendritic cells (DCs); the population of CD68 macrophages and CD1a epidermal DCs increased in parallel.
In lupoid CL, there was a significant correlation between CD1a epidermal DCs, and CD1a dermal DCs and population of CD1a epidermal DCs; the number of CD1a dermal DCs increased in parallel.
The result of the current study could be used as a baseline to design and study the new targeted therapy of synergistic effects of macrophages and DCs to phagocytizing leishmania bodies; and/or suggestion planning of individualizing setup of vaccine by autologous interaction of macrophages and DC in CL.

The assessment of human epidermal growth factor receptor 2 (HER2) status has become of great importance in the diagnosis of breast cancer. The aim of this study was to investigate the diagnostic value of quantitative Polymerase Chain Reaction (qPCR) and Chromogenic In Situ Hybridization (CISH) to assess HER2 status of biopsy specimens.
To elucidate the status of HER2 gene amplification, biopsies of breast carcinoma from 120 patients with 2 IHC status were analyzed by qPCR and CISH.
The results of the two experiments were compared, and it was depicted that the concordance rate between CISH and qPCR assays was 88.1%.The quantification of HER2 gene with CISH and qPCR showed that there was a significant correlation (p value= 0.0001 and r= 0.808).
The results of this research support the idea that qPCR is a precise and reproducible technique, which can be employed as a supplementary method to evaluate HER2 status.

According to reports, a serine protease inhibitor (Maspin) suppresses metastasis, invasion and angiogenesis in breast and prostate cancers. Silibinin is a natural polyphenolic flavonoid with anti-cancer activity. We assessed the effects of silibinin on cell viability, maspin and ERα gene expression in MCF-7 cell line.
The human MCF-7 breast cancer cell line was cultured in Dulbecco’s Modified Eagle’s Medium (DMEM) and treated with different concentrations of silibinin (100-600 μg/mL) for 24, 48 and 72 hours. The cytotoxic effect of silibinin on MCF-7 viability was determined using Methyl-Thiazolyl-Tetrazolium (MTT) assay by IC50 determination. The fold changes of Maspin and ERα expression were determined by reverse-transcription real-time Polymerase Chain Reaction (PCR). All experiments on the cells were performed in triplicates.
The maximum inhibitory effect of silibinin on cell viability was observed at 600 μg/mL after 72-hour incubation (p = 0.001). Incubation of the cells with silibinin for 48 and 72 hours significantly decreased IC50 values to 250 and 207 μg/mL (p = 0.005 and p= 0.006), respectively. The expression of maspin and ERα in the treated cells compared to controls was significantly decreased following treatment with different concentrations of silibinin during a 24-hour period.
Silibinin reduces both maspin and ERα gene expression in MCF-7 cell line. The therapeutic effect of silibinin on the treatment of breast cancer may be mediated by the reduction of ERα expression. For verifying this hypothesis and the possible therapeutic implication of silibinin on breast cancer, further studies in this direction are necessary.

Oral tongue Squamous Cell carcinoma (SCC) commonly involves males between the sixth to eighth decades of life. Major risk factors are tobacco usage and alcohol consumption. The increasing number of patients developing oral tongue cancer without these well-known risk factors suggests that a viral infection, such as Human Papillomavirus (HPV), may be responsible for this increase, by acting as an oncogenic agent. This study investigated the prevalence of HPV infection and its clinicopathologic significance in oral tongue SCCs.
Material and Tissue blocks from a total of 50 cases (patients with oral tongue SCC) and 50 controls (palatine tonsillar tissues with benign diagnosis) were selected. DNA was extracted from tumoral and non-tumoral tissue blocks. Detection of common HPV DNA by nested Polymerase Chain Reaction (PCR), and high-risk genotypes, HPV 16 and HPV 18, by conventional PCR, was achieved and the results correlated with clinicopathological parameters.
Of the 50 patients (18 males and 32 females with a mean age of 57.36±12.18 years, and age range of 27 to 86 years), 7 (14%) had HPV positive results. None of the control group subjects had HPV DNA positive results (P-value of 0.012). The HPV genotype 16/18 was not detected in positive cases. No statistically significant association was found between HPV status and gender, age, tumor grade, tumor stage or lymph node involvement.
Although there was a significantly higher prevalence of HPV in oral tongue SCC, its association with carcinogenesis in this area requires further studies.

Clear Cell Renal Cell Carcinoma (CCRCC) is the most common adult renal neoplasm. Staging and grading of RCC are important predictors of survival. Fuhrman nuclear grading is widely used for CCRCC, the subjective nature of which has prompted more objective methods to evaluate nuclear features. Furthermore, Ki-67, a reliable marker of cellular proliferation may provide another variable for assessment of the biological behavior of RCC. The aim of this research was to study nuclear morphometry and Fuhrman nuclear grading of clear cell RCC, and to assess their relationship with the Ki-67 index.
Hematoxylin and eosin slides of forty cases of CCRCC were retrieved and studied for pathologic variables, including Fuhrman nuclear grade, pathological tumor and node stage. Nuclear morphometric analysis was performed using computer-assisted image analysis. The relationship between Fuhrman nuclear grading, pathologic stage, tumor size, nuclear morphometry and proliferative index were analyzed.
According to Fuhrman grading, four (10%) cases were grade I, 23 (57.5%) were grade II, 12 (30%) were grade III, and one (2.5%) was grade IV. Moderate to high correlation was seen between Fuhrman nuclear grade and mean nuclear area, perimeter, diameter, length, nuclear roundness factor and Ki -67, with a P value of The CCRCC is an extremely heterogenous disease and clinical outcome is unpredictable despite several validated prognostic factors. The widely used Fuhrman nuclear grading is subjective, while nuclear morphometry, using computer assisted image analysis, can ensure more objective assessment. The Ki-67 index could provide reliable information and compliment the other prognostic parameters.

The HER-2 gene is an important on co protein overexpressed in many types of cancers. The current study hypothesized that curcumin downregulates HER-2 and inhibits the signal transduction pathway of PI3K/Akt, MAPK, and activation of NFκB, which could be useful to treat overexpressed-HER-2 hepatocellular carcinoma (HCC).
In the current study, 40 male NMRI (Naval Medical Research Institute) mice were divided into 4 groups of 10 as follow: Group1 (control group) only received 5 mL/kg corn oil, group 2 (poisoned group) received 30 mg/L arsenic (As2O3) dissolved in water, group3 (curcumin treated), and group 4 (curcumin and arsenic treated) received 10 to 20mg/5mL/kg for 60 days. Once experimental period was completed, liver samples were collected. The analysis of the gene expression was performed by real-time polymerase chain reaction (PCR) technique.
Gene expression analysis showed that curcumin had significantly downregulated the activity of HER-2, in poisoned mice.
According to the current study results, it could be concluded that curcumin has the inhibitory potential toward HER-2-overexpressed HCC.

Due to the importance of Pseudomonas aeruginosa in severe inpatient infections and high mortality, the need for an efficient vaccine against these bacteria is increasing. In this regard, the general outer membrane porin of the most problematic microorganism P. aeruginosa, outer membrane protein F (OprF), is a good vaccine candidate.
The databank of NCBI was used to retrieve protein sequences recorded for OprF in P. aeruginosa.The current study aimed at investigating the conservation of the OprF in 150 reference sequences, clinical, and environmental strains of P. aeruginosa from different countries via bioinformatic tools.T-COFFEE and PRALINE software were used for alignment.
Of these, 134 strains were isolated from clinical specimens and other strains from environmental samples. Evaluation of alignment by the mentioned software clearly showed that this protein was conserved. Antigenicity and grand average of hydropathicity were favorable.
Conservation of OprF in all pathogenic and environmental strains of P. aeruginosa indicated that it can be considered as a good immunogen; however, the protectivity of OprF should be validated experimentally.

As the prostate adenocarcinoma is one of the most common malignant tumors in males, looking for a marker to effectively predict aggressiveness and metastatic potential in an apparently localized cancer in initial needle biopsy specimens can help the clinicians to make more appropriate decision for treatment, planning, and choosing appropriate targeted therapy. The present study assessed the value of Endothelin-1 expression to predict prognosis of prostatic cancer
In a cross sectional study, 83 patients who underwent radical prostatectomy in Hasheminejad Kidney Center in 2008 through 2012 were assigned to two groups including 43 with and 40 without extra-prostatic extension (EPE). Endothelin-1 staining was performed on Paraffin Embedded blocks of preoperative needle biopsies.
The expression of Endothelin-1 increased in 72% of patients in the group with EPE (P Correlation of Endothelin-1 expression in needle biopsy specimens in expected with extra-prostatic extension of tumor in radical prostatectomy specimens, perineurial invasion and serum PSA level at the time of diagnosis.

Regarding the importance of histologic examination of testicular biopsy for clinical planning of infertility, the current study was conducted to compare 2 separate histologic examination of testicular biopsy. Also, some cases with known fertility outcome were followed and their histological patterns were also compared with those of the outcome.
The current study was conducted on testicular biopsies of 924 males evaluated for infertility from 1990 to 2013, retrieved from the archive of pathology department of Shahid Beheshti Hospital, Babol, Northern Iran. All slides were reviewed by a pathologist unaware of the original results. Data including age, histological pattern of spermatogenesis (pure and mixed), smoking, and the history of ejaculatory duct obstruction were retrieved from the pathology archive. In some cases, the outcome was also compared with that of the histological pattern. All analyses were executed using SPSS version 22 statistical software. To analyze the data, t test, Chi-square test, one-way ANOVA, and the least significant difference (LSD) test were used.
Results and Out of the 924 testicular biopsies, 34 (3.7%) cases had different reports from original reading. LSD analysis indicated Sertoli cell only syndrome (SCO) as the most common histological pattern. There was a significant difference between the mean age of cases with SCO and that of the ones with hypospermatogenesis (HYPO) (P =0.03). Obstruction was higher in pure pattern (P=0.04). The pregnancy rate was higher in the wives of males with obstructive infertility than the ones with non-obstructive infertility. SCO was the most common histological pattern of testicular biopsy during 23 years. Pure patterns were more than mixed patterns, and the mean age was lower in mixed patterns. Also, pure patterns were the most common findings in the cases with obstructive infertility.

The Helicobacter pylori prevalence has continuously decreased during recent years in Iran. The current study aimed at determining H. pylori prevalence in Neyshabur city, Northeast Iran, during 2010-2015.

The current epidemiologic survey was conducted in Neyshabur from 2010 to 2015 to determine the prevalence of H. pylori infection. A total of 11596 participants (3681 male with the mean age of 31.7±6.2 years and 7915 female with mean age of 68.3±4.7 years) were included. The enzyme-linked immunosorbent assay kits for the detection of H. pylori and Stat Fax 3200® Microplate Reader (USA) with a sensitivity of 95% and specificity of 98% were used. Titers above 12 units were considered positive for IgG, IgA, and IgM (negative 12 U). The Chi-square t test and F test were used to analyze data.

The overall IgA, IgG, and IgM seropositive samples among the study participants were 852 (7.2%), 9000 (72.8%), and 1256 (5.2%), respectively. The IgA seropositivity was significantly high among the age group above 51 years, compared with the other age groups. Moreover, the IgG and IgM seropositivity were significantly high among the age groups 41 to 50 and 31 to 40 years respectively, compared with the other age groups. There was no significant difference between male and female cases regarding IgA and IgG seropositive samples, but IgM level was significantly higher among females, compared with that of the male cases. Furthermore, there was no significant alteration in IgA, IgG, and IgM seropositivity during 2010-2014 in Neyshabur.

The prevalence of H. pylori in Neyshabur was high in the healthy population. Furthermore, the H. pylori prevalence did not change from 2010 to 2014 in the studied city. Effective approaches to improve health, educational, and socioeconomic status should be implemented to minimize and control H. pylori infection.