Search

Introduction: Colorectal Carcinoma (CRC) is a multi-step process that occurs due to the accumulation of several genetic alterations. The most important alterations are related to the rat sarcoma viral oncogene homolog (RAS) and Rapidly Accelerated Fibrosarcoma (RAF), which have been implicated as key intermediates in the RAS-mediated signalling cascade. However, the levels of Kristen Rat Sarcoma Virus (KRAS) and v-raf Murine Sarcoma Viral Oncogene Homolog (BRAF) protein expression and their prognostic evaluation in CRC patients remain unknown. Aim: To investigate the immunohistochemical expression of KRAS and BRAF proteins in CRC. Materials and Methods: The present institutional-based cross-sectional observational study was conducted in a tertiary care centre in West Bengal, specifically in the Department of Pathology in collaboration with the Department of Surgery at Murshidabad Medical College and Hospital, Berhampore, West Bengal, India. A total of 26 CRC cases were enrolled in the present study, received over a period of one and a half years from January 2021 to June 2022. The parameters studied included demographic and clinical information of the patients, histopathological findings, pathological grade and stage of carcinoma, and immunohistochemical findings for KRAS and BRAF. For statistical analysis, data were entered into Microsoft (MS) Excel. Descriptive measures such as mean±Standard Deviation (SD), range, and percentage were used. The Chi-square test was used to determine the significance of the study. Results: A total of biopsy-proven CRC specimens were studied, consisting of 17 male patients (65.38%) with a male-to-female ratio of 1.9:1. The most common age group involved was 51-60 years (38%). Conventional adenocarcinoma accounted for the majority of cases (85%), with mucinous carcinoma comprising the remaining 15%. Among the 26 cases, 15 (58%) showed KRAS positivity, which was significantly associated with tumour grade and stage. Most of the cases were BRAF-negative. Out of the 21 cases where either KRAS or BRAF or both were positive, 20 cases showed high T stage (T3 and T4) and/or metastatic lesions (p-value 0.001). All four cases that were negative for both BRAF and KRAS belonged to the low T stage. Conclusion: A significant correlation was observed between the expression of KRAS and high-grade, high pathological Tumour, Node, Metastasis (TNM) T stage (T3 and T4) CRC. Therefore, KRAS Immunohistochemistry (IHC) biomarkers should be included in the standard diagnostic protocol for colorectal cancer, as they help identify KRAS-positive CRC cases that are resistant to targeted immunotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Mast cells are found in areas rich in connective tissues and beneath epithelial surfaces. Mast cells have been extensively studied for their orchestration of allergic reactions and autoimmunity. Mast cells infiltrate various prostatic lesions in varying concentrations. Autopsy specimens had not been investigated extensively in the previous literature. Aim: To find out a quantitative estimation of mast cells and the association of the number of mast cells in various prostatic lesions that included both inflammatory and neoplastic lesions in autopsy cases. Materials and Methods: A cross-sectional, analytical study was carried out in the Department of Pathology, R.G. Kar Medical College and Hospital, Kolkata, India from April 2017 to March 2018. Sixty autopsy specimens of the prostate were dissected from the deceased males above 30 years of age. Four to six paraffin embedded sections from different lobes and peri-urethral areas were taken. Haematoxylin and Eosin (H&E) stained sections for histopathological diagnosis and toluidine-blue stain after water mounting to demonstrate mast cells by its metachromasia were performed. Mast cell densities were estimated by a light microscope under high power magnification (400X) on an average of 100 fields. Gross and microscopic findings were recorded. Data analysis correlation was done using Statistical Package for the Social Sciences (SPSS) software version 18.0. Mean and standard deviations were determined for different prostatic lesions. Group means were compared using the student's t-test. For statistical significance p-value of less than 0.05 was considered. Results: A total of 60 autopsy specimens of the prostate were studied comprising 8 (13.5%) specimens of normal prostate, which acted as a control, 6 (10%) specimens of prostatitis, 27 (45%) specimens of Benign Hypertrophy of Prostate (BHP), 12 (20%) specimens of BHP with Prostatic Intraepithelial Neoplasia (PIN), 3 (5%) specimens of prostatitis with focal PIN and 4 (6.5%) specimens of prostatic adenocarcinoma. Mast Cell Density (MCD) was higher in prostatitis {6-8 per High Power Fields (HPF)}, compared to normal (1-3/HPF) and BHP (3-5/HPF), lowest in adenocarcinoma (1-2/HPF) and intermediate in PIN (2-4/HPF). Conclusion: Mast cell density was the lowest in prostatic adenocarcinoma and significantly higher in prostatitis, probably due to a lack of antitumour immunity in higher grades, whereas it was significantly higher in chronic non specific prostatitis possibly because of inflammatory response. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer continues to be the most common cancers among women in India. The Triple Negative Breast Cancer (TNBC) is a heterogeneous group of malignancy which is often aggressive and has a worse prognosis. Aim: The aim of this study was to assess the hormone receptor and HER2/neu status with platinum based chemotherapy in TNBC. Materials and Methods: The study was analysed retrospectively in a tertiary care centre of West Bengal from Januay 2017 to December 2019. Forty TNBC patients of Locally Advanced Breast Cancer (LABC) cases who received carboplatin along with neoadjuvant chemotherapy (study group) were compared with other group of 64 TNBC patients (control group) who did not receive any chemotherapy making a total of 104 cases of TNBC patients who were selected for the study. All the patients in both the groups had modified radical mastectomy. The study group of 40 TNBC patients who received chemotherapy also showed pathological partial response. Master chart was prepared comprising patient’s age, menopausal status, family history, therapy history, histo-morphological features, hormone receptor and HER2/ neu status after platinum added chemotherapy. Oestrogen Receptor (ER)/Progesterone Receptor (PR) were considered positive, if >1% tumour cell nuclei were immunoreactive and negative, if it was otherwise. HER-2/neu score of 3+ was taken as positive by Immunohistochemistry (IHC) method. Statistical analysis for descriptive purposes, percentages and mean were calculated. Comparison of both the groups was done by Pearson’s Chi-squared and Fisher’s-exact test. Significance level was considered at p-value <0.05. Results: TNBC patients (NACT group) showed hormone receptor positivity of 21 cases (52.50%) after chemotherapy along with carboplatin. HER2/neu positivity was detected in 9 (22.5%) cases. Non-NACT (64) cases were considered as control group for comparison. The effect of NACT in TNBC patients was found to be statistically significant with respect to change in HER2/ neu (p=0.033, p<0.05) and ER status (p<0.05) while change in PR status was found to be statistically insignificant. Conclusion: The study showed significant alteration in hormonal and HER2/neu receptor status in TNBC patients receiving platinum added neoadjuvant chemotherapy. This study found statistical significance and justifies re-evaluation of these Hormone Receptor (HR) and HER2/neu markers in residual tumour after chemotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Vascular Endothelial Growth Factor (VEGF), a promoter of angiogenesis, is a promising target for antiangiogenic therapy in ovarian cancer. In our study, we examined the expression of VEGF in the spectrum of epithelial ovarian neoplasms (benign, borderline and malignant) by Immunohistochemistry (IHC). Aim: Diagnosing ovarian epithelial neoplasms, examining the expression of VEGF in benign, borderline and malignant neoplasms and correlating it with histological grade and stage of malignant cases. Materials and Methods: This is a Cross-sectional, Observational study where, total of 50 cases of surface epithelial ovarian neoplasms were examined for expression of VEGF by IHC. Scoring for VEGF expression was done for each case. Results: A total of 42 of the 50 cases (84%) showed VEGF expression. Out of the 42 positive cases, 19 were high VEGF expressors and 23 were low VEGF expressors. VEGF expression was significantly higher in carcinomas as compared to benign and borderline neoplasms (p=<0.001). All neoplasms of serous morphology were positive for VEGF. High VEGF expression was significantly associated with high grade (p=0.003) and stage (p=0.001) of disease. Conclusion: Ovarian surface epithelial neoplasms significantly express VEGF. Though, some VEGF expression was noted in benign and some borderline neoplasms, high VEGF expression was noted only in carcinomas and one case of borderline serous papillary tumour. Thus, these results suggest that epithelial ovarian tumours are candidates for VEGF targeting therapy as most of them are dependent on VEGF for progression. [ABSTRACT FROM AUTHOR]

Solid Pseudopapillary Tumour (SPT) is a rare and distinctive pancreatic exocrine neoplasm. Even Rarely, such primary SPT may originate from ectopic pancreatic tissues. We are hereby presenting one such unique case, where a 50-year-old female presented with pain and a mid-abdominal lump. Radiology revealed a well-defined outline located adjacent to the tail of pancreas. The excised mass was 19×14×7cm in dimension having zones of haemorrhage, necrosis and cystic spaces filled with necrotic debris. Microscopic examination confirmed the diagnosis of SPT. SPT originating in extrapancreatic location may mimic an ovarian cystic tumours or mesenteric cysts, its proper identification is crucial. [ABSTRACT FROM AUTHOR]