Journal of Pathology and Translational Medicine

Original Articles

P2X₇ Receptor Expression in Coexistence of Papillary Thyroid Carcinoma with Hashimoto's Thyroiditis: Ji Hyun Kwon, Eun Sook Nam, Hyung Sik Shin, Seong Jin Cho, Hye Rim Park, Mi Jung Kwon; Korean J Pathol. 2014;48(1):30-35. Published online February 25, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.1.30

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Background

This study was aimed at investigating the relation of P2X₇ receptor (P2X₇R) expression with the clinicopathological features of papillary thyroid carcinoma (PTC) coexisting with Hashimoto's thyroiditis (HT).

Methods

We examined 170 patients (84, PTC with HT; 86, PTC without HT). P2X₇R expression was examined by immunohistochemical methods. The staining intensity and patterns were evaluated and scored using a semi-quantitative method.

Results

The PTC with HT group was more likely to contain women and had less extrathyroid extension, lymph node (LN) metastasis, lymphovascular invasion, and recurrence than the PTC without HT group. Patients positive for P2X₇R had significantly higher frequencies of lymphovascular invasion, extrathyroid extension, LN metastasis, and absence of HT. As shown by multivariate analysis, the expression of P2X₇R was significantly higher if HT was absent and extrathyroid extension was present. In the PTC with HT group, the expression of P2X₇R was significantly higher in patients with tumor multifocality, lymphovascular invasion, and extrathyroid extension. In the PTC without HT group, the expression of P2X₇R was significantly higher in women and those having tumor multifocality.

Conclusions

Coexistence of PTC with HT is associated with good prognostic factors, and P2X₇R expression in PTC was correlated with poor prognostic factors and the absence of HT.

Citations

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Research Progress in the Relationship Between P2X7R and Cervical Cancer
Yiqing Tang, Cuicui Qiao, Qianqian Li, Xiaodi Zhu, Ronglan Zhao, Xiaoxiang Peng
Reproductive Sciences.2023; 30(3): 823. CrossRef
Warthin-like papillary thyroid carcinoma: a case report and comprehensive review of the literature
Abdel Mouhaymen Missaoui, Fatma Hamza, Wafa Belabed, Manel Mellouli, Mohamed Maaloul, Slim Charfi, Issam Jardak, Tahya Sellami-Boudawara, Nabila Rekik, Mohamed Abid
Frontiers in Endocrinology.2023;[Epub] CrossRef
Mapping the path towards novel treatment strategies: a bibliometric analysis of Hashimoto’s thyroiditis research from 1990 to 2023
Manping Guo, Qingna Li, Xingfang Liu, Yiming Wang, Qiaoning Yang, Rui Li, Yang Zhao, Chenfei Li, Song Sheng, Hangkun Ma, Zhenghong Li, Rui Gao
Frontiers in Endocrinology.2023;[Epub] CrossRef
Association between Hashimoto thyroiditis and clinical outcomes of papillary thyroid carcinoma: A meta-analysis
Qizhi Tang, Weiyu Pan, Liangyue Peng, Francis Moore
PLOS ONE.2022; 17(6): e0269995. CrossRef
Hashimoto’s Thyroiditis Minimizes Lymph Node Metastasis in BRAF Mutant Papillary Thyroid Carcinomas
Peter P. Issa, Mahmoud Omar, Yusef Buti, Chad P. Issa, Bert Chabot, Christopher J. Carnabatu, Ruhul Munshi, Mohammad Hussein, Mohamed Aboueisha, Mohamed Shama, Ralph L. Corsetti, Eman Toraih, Emad Kandil
Biomedicines.2022; 10(8): 2051. CrossRef
Overexpression of PD-L1 in Papillary Carcinoma and Its Association with Clinicopathological Variables
Servet KOCAÖZ, Gülay TURAN
Düzce Tıp Fakültesi Dergisi.2021; 23(3): 252. CrossRef
Effect of P2X7 receptor on tumorigenesis and its pharmacological properties
Wen-jun Zhang, Ce-gui Hu, Zheng-ming Zhu, Hong-liang Luo
Biomedicine & Pharmacotherapy.2020; 125: 109844. CrossRef
P2X7 in Cancer: From Molecular Mechanisms to Therapeutics
Romain Lara, Elena Adinolfi, Catherine A. Harwood, Mike Philpott, Julian A. Barden, Francesco Di Virgilio, Shaun McNulty
Frontiers in Pharmacology.2020;[Epub] CrossRef
The P2X7 Receptor in Inflammatory Diseases: Angel or Demon?
Luiz E. B. Savio, Paola de Andrade Mello, Cleide Gonçalves da Silva, Robson Coutinho-Silva
Frontiers in Pharmacology.2018;[Epub] CrossRef
Patients with Oncocytic Variant Papillary Thyroid Carcinoma Have a Similar Prognosis to Matched Classical Papillary Thyroid Carcinoma Controls
Azadeh A. Carr, Tina W.F. Yen, Diana I. Ortiz, Bryan C. Hunt, Gilbert Fareau, Becky L. Massey, Bruce H. Campbell, Kara L. Doffek, Douglas B. Evans, Tracy S. Wang
Thyroid.2018; 28(11): 1462. CrossRef
Extracellular purines, purinergic receptors and tumor growth
F Di Virgilio, E Adinolfi
Oncogene.2017; 36(3): 293. CrossRef
Multifaceted Effects of Extracellular Adenosine Triphosphate and Adenosine in the Tumor–Host Interaction and Therapeutic Perspectives
Paola de Andrade Mello, Robson Coutinho-Silva, Luiz Eduardo Baggio Savio
Frontiers in Immunology.2017;[Epub] CrossRef
Potential role of P2X7R in esophageal squamous cell carcinoma proliferation
André A Santos, Angélica R Cappellari, Fernanda O de Marchi, Marina P Gehring, Aline Zaparte, Caroline A Brandão, Tiago Giuliani Lopes, Vinicius D da Silva, Luis Felipe Ribeiro Pinto, Luiz Eduardo Baggio Savio, Aline Cristina Abreu Moreira-Souza, Robson C
Purinergic Signalling.2017; 13(3): 279. CrossRef
Potential relationship between Hashimoto's thyroiditis and BRAFV600E mutation status in papillary thyroid cancer
Rui‐chao Zeng, Lang‐ping Jin, En‐dong Chen, Si‐yang Dong, Ye‐feng Cai, Guan‐li Huang, Quan Li, Chun Jin, Xiao‐hua Zhang, Ou‐chen Wang
Head & Neck.2016;[Epub] CrossRef
Papillary thyroid carcinoma in Hashimoto’s thyroiditis as an incidental finding
Al Mogrampi Saad, A. Krexi, N. Papoulidis, M. Verroiotou, D. Michalakis, I. Fardellas
Hellenic Journal of Surgery.2016; 88(1): 47. CrossRef
Association of Hashimoto's thyroiditis and thyroid cancer
Salem I. Noureldine, Ralph P. Tufano
Current Opinion in Oncology.2015; 27(1): 21. CrossRef
Cribriform-morular variant of papillary thyroid carcinoma: a study of 3 cases featuring the PIK3CA mutation
Mi Jung Kwon, Young-Soo Rho, Jin Cheol Jeong, Hyung Sik Shin, Jong Seok Lee, Seong Jin Cho, Eun Sook Nam
Human Pathology.2015; 46(8): 1180. CrossRef
Understanding the roles of the P2X7 receptor in solid tumour progression and therapeutic perspectives
Sébastien Roger, Bilel Jelassi, Isabelle Couillin, Pablo Pelegrin, Pierre Besson, Lin-Hua Jiang
Biochimica et Biophysica Acta (BBA) - Biomembranes.2015; 1848(10): 2584. CrossRef
Purinergic signaling pathways in endocrine system
Ivana Bjelobaba, Marija M. Janjic, Stanko S. Stojilkovic
Autonomic Neuroscience.2015; 191: 102. CrossRef
P2X7 receptor stimulates breast cancer cell invasion and migration via the AKT pathway
JIYI XIA, XIAOLAN YU, LI TANG, GANG LI, TAO HE
Oncology Reports.2015; 34(1): 103. CrossRef
Regulation of the P2X7R by microRNA-216b in human breast cancer
Luming Zheng, Xukui Zhang, Feng Yang, Jian Zhu, Peng Zhou, Fang Yu, Lei Hou, Lei Xiao, Qingqing He, Baocheng Wang
Biochemical and Biophysical Research Communications.2014; 452(1): 197. CrossRef

Histopathologic Predictors of Lymph Node Metastasis and Prognosis in Tonsillar Squamous Cell Carcinoma: Dong Jin Lee, Mi Jung Kwon, Eun Sook Nam, Ji Hyun Kwon, Jin Hwan Kim, Young-Soo Rho, Hyung Sik Shin, Seong Jin Cho; Korean J Pathol. 2013;47(3):203-210. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.203

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Abstract PDF

Background

Risk factors for lymph node metastasis in tonsillar squamous cell carcinoma (TSCC) need to be established to determine the degree of surgery required to achieve high curative rates. However, little is known currently about the histopathological features predicting prognosis, specifically in TSCC.

Methods

This study included 53 patients who underwent surgical resection with neck dissection. Clinicopathological factors investigated included age, gender, alcohol use, tobacco consumption, tumor stage, adjacent structure involvement, cell differentiation, squamous dysplasia, in situ carcinoma associated with primary invasive cancer, carcinoma in situ skip lesions, necrosis, invasive front, depth of invasion, and lymphatic, muscle, or perineural invasion.

Results

Contralateral cervical metastasis was associated with higher T stages and soft palate invasion. Lymphatic and muscle invasion were associated with ipsilateral cervical metastasis. Advanced T stage, invasion to the base of tongue, and skip lesions were associated with decreased disease-free survival. Advanced T stage and skip lesions were associated with worse overall survival.

Conclusions

Advanced T stage and soft palate invasion may predict a high risk of contralateral nodal metastasis. T stage and skip lesion are worse prognostic factors in TSCC and should be commented in pathology reports.

Citations

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OpenAi’s ChatGPT-4, BARD and YOU.com (AI) and the Cancer Patient, for Now, Caveat Emptor, but Stay Tuned
Glenn Tisman, Raju Seetharam
Digital Medicine and Healthcare Technology.2023;[Epub] CrossRef
Comprehensive Transcriptome Analysis Reveals the Distinct Gene Expression Patterns of Tumor Microenvironment in HPV-Associated and HPV-Non Associated Tonsillar Squamous Cell Carcinoma
Reham M. Alahmadi, Najat Marraiki, Mohammed Alswayyed, Hatim A. Khoja, Abdullah E. Al-Anazi, Rawan M. Alahmadi, Meshael M. Alkusayer, Bandar Alosaimi, Maaweya Awadalla
Cancers.2023; 15(23): 5548. CrossRef
Predictors of contralateral‐bilateral nodal disease in oropharyngeal cancer: A National Cancer Data Base Study
Masanari G. Kato, Mark A. Ellis, Shaun A. Nguyen, Terry A. Day
Head & Neck.2018; 40(2): 338. CrossRef
Clinical implication of programmed cell death-1 ligand-1 expression in tonsillar squamous cell carcinoma in association with intratumoral heterogeneity, human papillomavirus, and epithelial-to-mesenchymal transition
Mi Jung Kwon, Young-Soo Rho, Eun Sook Nam, Seong Jin Cho, Hye-Rim Park, Soo Kee Min, Jinwon Seo, Ji-Young Choe, Eun Soo Kim, Bumjung Park, Mineui Hong, Kyueng-Whan Min
Human Pathology.2018; 80: 28. CrossRef
Comparison of the eighth version of the American Joint Committee on Cancer manual to the seventh version for colorectal cancer: A retrospective review of our data
Guo-Jun Tong, Gui-Yang Zhang, Jian Liu, Zhao-Zheng Zheng, Yan Chen, Ping-Ping Niu, Xu-Ting Xu
World Journal of Clinical Oncology.2018; 9(7): 148. CrossRef
HIPK2 Overexpression and Its Prognostic Role in Human Papillomavirus-Positive Tonsillar Squamous Cell Carcinoma
Mi Jung Kwon, So Young Kang, Eun Sook Nam, Seong Jin Cho, Young-Soo Rho
BioMed Research International.2017; 2017: 1. CrossRef
Frequent hepatocyte growth factor overexpression and low frequency of c-Met gene amplification in human papillomavirus–negative tonsillar squamous cell carcinoma and their prognostic significances
Mi Jung Kwon, Dong Hoon Kim, Hye-Rim Park, Hyung Sik Shin, Ji Hyun Kwon, Dong Jin Lee, Jin Hwan Kim, Seong Jin Cho, Eun Sook Nam
Human Pathology.2014; 45(7): 1327. CrossRef
CT and MR imaging findings of palatal tumors
Hiroki Kato, Masayuki Kanematsu, Hiroki Makita, Keizo Kato, Daijiro Hatakeyama, Toshiyuki Shibata, Keisuke Mizuta, Mitsuhiro Aoki
European Journal of Radiology.2014; 83(3): e137. CrossRef

Diagnostic Features of Fine Needle Aspiration Cytology of Pleomorphic Adenoma, Adenoid Cystic Carcinoma, and Mucoepidermoid Carcinoma of Salivary Gland.: Eun Sook Nam, Won Bo Jo, Jung Ho Han, Insun Kim; Korean J Cytopathol. 1990;1(1):60-67.

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Abstract PDF: The evaluate the diagnostic findings of salivary gland tumors, we reexamined aspiration cytology smears of 7 cases of pleomorphic adenoma, 3 cases of adenoid cystic carcinoma, and 3 cases of mucoepidermoid carcinoma, performed during April 1986 to March 1990, which were comfurmed by surgical excision and histologic diagnosis. The results obtained are summarized as follows : 1. All cases of pleomorphic adenoma showed branching cellular clusters of epithelial and myoepithelial cells. Acellular elements including myxomatous and chondroid components were observed. There were no cellular pleomorphism and nucleoli. Keratinizing squamous epithelial cells and keratin pearls were noted. 2. The smears of adenoid cystic carcinoma showed cell balls or cell cords containing a central hyaline core. Nuclear atypism and the nucleoli were frequently observed. There were no keratinizing squamous epithelial cells. 3. The smears of mucoepidermoid carcinoma showed mainly sheets or clusters of intermediate cells and some mucin-producing cells. Some nuclear pleomorphism was observed. Mucinous material and many inflammatory cells were present in the background.

Case Reports

Osteoclast-like Giant Cell Tumor of the Parotid Gland Accompanied with Carcinoma ex Pleomorphic Adenoma.: Mi Jung Kwon, Eun Sook Nam, Seong Jin Cho, Hyung Sik Shin, Ji Hyun Kwon, Young Soo Rho; Korean J Pathol. 2011;45:S84-S88.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S84

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Abstract PDF

The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.

Citations

Citations to this article as recorded by

Tumeur à cellules géantes de type ostéoclastique de la parotide
S. Rammeh, I. Hergli, M.K. M’farrej, N. Znaidi, S. Nechi, R. Zermani
Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale.2014; 115(3): 185. CrossRef

A Case of Paraduodenal Pancreatitis and Immunohistochemical Analysis.: Mi Jung Kwon, Eun Sook Nam, Seong Jin Cho, Hyung Sik Shin, Joo Seop Kim, Doo Jin Kim; Korean J Pathol. 2010;44(2):199-203.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.199

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Abstract PDF: Paraduodenal pancreatitis (PP) is a rare, distinct form of chronic pancreatitis, and it is related to alcohol abuse in middle-aged men. A 36-year-old man with a history of chronic recurrent pancreatitis for 4 years and alcohol abuse for 15 years presented with abdominal pain. Computed tomography revealed a multilocular cystic mass 3.2 x 3 x 3 cm in size and it was located within the muscular layer of the duodenal wall. The cysts were lined by a single layer of eosinophilic cuboidal epithelial cells that stained positively for mucin (MUC)1, MUC6, cytokeratin (CK)7 and CK19 and they stained negatively for MUC2, MUC5AC and CK5/6. Mild, chronic inflammatory reaction around the cystic wall, Brunner's gland hyperplasia and several clusters of heterotopic pancreatic tissue were noted. We report here on a case of PP and we demonstrated that the pancreatitis was of pancreatic ductal cell origin according to the MUC and CK expression patterns we observed on the immunohistochemical analysis.

Original Articles

The Expressions of E2F1 and p53 in Gastrointestinal Stromal Tumors and Their Prognostic Significance.: Mi Jung Kwon, Eun Sook Nam, Seong Jin Cho, Hye Rim Park, Hyung Sik Shin, Jong Seok Lee, Chan Heun Park, Woon Geon Shin; Korean J Pathol. 2009;43(3):212-220.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.212

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Abstract PDF

BACKGROUND
E2F1 plays a critical role in the G1-to-S phase transition by inducing various genes that encode S phase-activating proteins and that modulate such diverse cellular functions as DNA synthesis, mitosis and apoptosis. The purpose of this study was to assess the E2F1 expression in relation to the clinicopathologic parameters and other tumor markers in gastrointestinal stromal tumors.
METHODS
Immunohistochemical stainings for obtaining the E2F1, p53, and Ki-67 labeling indices were performed on a tissue microarray of 72 gastrointestinal stromal tumor specimens. The clinicopathologic parameters that were analyzed including the risk grade system by Miettinen et al. and the disease-free survival (DFS) rate.
RESULTS
1) An E2F1 expression was correlated with a larger tumor size, a p53 expression and a shorter period of DFS (p=0.014, p=0.007, and p=0.039). 2) A p53 expression was significantly associated with a high risk grade, a larger tumor size, high mitotic counts and a shorter period of DFS (p=0.003, p=0.044, p<0.001, and p<0.0001). 3) A high-risk grade and the epithelioid type were significantly associated with a shorter period of DFS (p=0.0006 and p=0.0008).
CONCLUSIONS
E2F1, as well as p53, may be a potentially novel independent prognostic factor for predicting a worse outcome for those patients suffering with Gastrointestinal stromal tumors.

Citations

Citations to this article as recorded by

Comparison of tissue microarray and full section in immunohistochemistry of gastrointestinal stromal tumors
Mi Jung Kwon, Eun Sook Nam, Seong Jin Cho, Hye Rim Park, Hyung Sik Shin, Jun Ho Park, Chan Heun Park, Won Jae Lee
Pathology International.2009; 59(12): 851. CrossRef

Infantile Myofibromatosis(Congenital Generalized Fibromatosis): Associated with multiple congenital malformations and basaloid follicular hamartomas in the skin.: Eun Sook Nam, Yoo Hun Kim, Han Kyeom Kim, Insun Kim, Je Geun Chi; Korean J Pathol. 1995;29(6):776-782.

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Abstract PDF: Infantile myofibromatosis with systemic involvement is a very rare disease and is characterized by numerous nodules composed of spindle cells of a myofibroblastic nature. There are often disseminated throughout the subcutis, muscle, skeleton and viscera. We report an autopsy case of infantile myofibromatosis in a stillborn female fetus of 32 weeks of gestation. The nodules, Imm to 2 cm, were found over the whole body and viscera. The involved viscera were the heart, tongue, esophagus, gastrointestinal tract, portal areas of the liver, spleen anc pancreas. There were also associated malformations, viz., frontal meningoencephalocele, flexion defer-mities, syndactyly, cleft palate, agenesis of corpus callosum, pachygyria, diaphragmatic hemia, renal hypoplasia, etc. Multiple basaloid follicular hamartomas of the skin were noted on the face and extremeties. There are no previous reports in the literature of infantile myofibromatosis in conjunction with the above skin lesion and congenital malformations.

Correlation of Tumor Angiogenesis and nm23-H1 Expression with Lymph Node Metastasis in Proper Muscle Gastric Cancer.: Eun Sook Nam, Gu Kang, Hyung Sik Shin, Young Eui Park; Korean J Pathol. 1997;31(5):410-416.

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Abstract PDF: We studied clinicopathologic features of 44 cases of PM (proper muscle) gastric cancer, correlated the lymph node metastasis and found the result of immunohistochemical staining for tumor angiogenesis using antibodies to Factor VIII-related antigen and nm23-H1, known as meatastasis inhibitory substance. The results were as follows: 1) The average age of these 44 cases of PM gastric cancer was 55.1 years old (range 35-81). The ratio of male to female was 2.2 : 1. The tumor was located at the antrum of stomach in 72.7% of the cases. The average size of the tumor was 4.1 cm (range 0.6-9). The gross features were comprised of Borrmann type I (6.8%), II (29.6%), III (56.8%), IV (6.8%), respectively. The microscopic type was a diffuse type in 70.5% and an intestinal type in 29.5%. There were lymph node metastasis in 25 of the 44 cases (56.8%). 2) The microvessel count was higher in the lymph node positive group (average 69.3) than in the lymph node negative group (average 45.6) (P=0.004). There was a higher microvessel density in diffuse type, over 4 cm of tumor size, proximally located tumor, older than 50 years, Borrmann type II and IV, but there was no statistically significant correlation. 3) The more decreased expression of nm23-H1 was found in the lymph node positive group (56.0%) than in the lymph node negative group (31.6%), but showed no statistical significance (P=0.0142). There was no significant correlation between the expression of nm23-H1 and the other clinicopathologic factors. We suggest that the microvessel count of the tumor angiogenesis may be a prognostic factor for predicting lymph node metastasis and also help to determine the therapeutic modalities of PM gastric cancer.

Cyclin D1 Expression in 101 Cases of Breast Carcinoma.: Duck Hwan Kim, Eun Sook Nam, Hyung Sik Shin, Jin Woo Ryu, Jai Hyang Go, Young Lyun Oh, Sang Yong Song, Dae Shick Kim, Min Chul Lee; Korean J Pathol. 1998;32(4):266-272.

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Abstract PDF: Cyclin D1, a cell cycle regulator essential for G1 phase progression, is a candidate proto-oncogene implicated in pathogenesis of several human carcinomas including breast carcinoma. We studied the cyclin D1 expression in 101 cases of primary breast carcinoma tissues. The overexpression of cyclin D1 was immunohistochemically demonstrated in 34 (37.8%) of 90 cases of invasive breast carcinoma. Positive cyclin D1 staining was seen in 32 of 79 invasive ductal carcinomas, and 2 of 3 mucinous carcinomas. All 5 medullary carcinomas, 2 invasive lobular carcinomas, and 1 metaplastic carcinoma were negative. Cyclin D1 overexpression was observed in 9 of 11 ductal carcinoma in situ (DCIS). Normal epithelial components, either ductal or lobular, were not immunoreactive for cyclin D1. No significant correlations were observed between cyclin D1 immunoreactivity and other parameters including tumor size, clinical stage, nuclear or histologic grades, lymphatic or angioinvasion, lymph node metastasis, and immunohistochemical status of progesterone receptor, p53 and c-erbB-2. The overexpression of cyclin D1 was positively correlated with estrogen receptor status (p=0.025). Based on our results, the cyclin D1 protein aberration may play a role in tumorigenesis of breast carcinoma, but does not seem to have prognostic value in invasive breast carcinoma without hormonal treatment.

Epstein-Barr Virus and p53 in Laryngeal and Nasopharyngeal Carcinomas.: Eun Sook Nam, Duck Hwan Kim, Hyung Sik Shin, Young Euy Park, Young Sik Kim, Insun Kim; Korean J Pathol. 1998;32(8):551-562.

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Abstract: To investigate the correlation between EBV infection and p53 overexpression in laryngeal carcinomas (LC) and nasopharyngeal carcinomas (NPC) in Korea, we analyzed 37 laryngeal squamous cell carcinomas and 33 nasopharyngeal (11 squamous cell and 22 undifferentiated) carcinomas. We used the immunohistochemistry and polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) for p53 overexpression and p53 gene mutation, respectively, and EBER-1 in situ hybridization and PCR using primer for EBNA-1 and EBNA-2 type 1 and 2 for prevalence and the subtype of EBV. The results were as follows; 1) The p53 expression was found in 43.2% of squamous cell LCs, in 54.6% of squamous cell NPCs and in 22.7% of undifferentiated NPCs. The p53 gene mutation was detected in 6 of 23 squamous cell LCs and 3 of 14 undifferentiated NPCs. 2) EBV was detected more frequently in undifferentiated NPCs (95.5%) than in squamous cell NPCs (63.6%) and squamous cell LCs (37.0%). Only type 1 was found in squamous cell LCs and NPCs, whereas both type 1 and type 2 were detected in undifferentiated NPCs. 3) There was no difference according to EBV infection (EBV+ ; 7 cases, EBV- ; 7 cases) in the cases with p53 protein overexpression but mutaion. From the above results, it can be concluded that squamous cell LCs and NPCs are associated with both p53 and EBV, whereas undifferentiated NPCs are more closely associated with EBV than p53. In Korea, both type 1 and 2 are detected in undifferentiated NPCs. Also, our result suggests that EBV infection does not seem to contribute to p53 overexpression. The interrelationship between EBV infection and p53 remains to be further defined.

Case Report

Lymphoepithelioma-like Carcinomas of the Stomach Report of 4 cases associated with Epstein-Barr virus.: Eun Sook Nam, Duck Hwan Kim, Hye Kyung Ahn, Hyung Sik Shin, Young Sik Kim, Han Kyum Kim, Insun Kim; Korean J Pathol. 1998;32(9):680-686.

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Abstract: Lymphoepithelioma-like carcinoma (LELC) that histologically resembles nasopharyngeal lymphoepithelioma has been reported in various sites including the stomach, salivary gland, lung, skin, thymus, tonsil and uterine cervix. LELC of the stomach was rarely reported after the first report by Burke et al. in 1990. More than 60% of them were associated with Epstein-Barr virus (EBV). Most commonly affecting elderly Asians with slight male predominance (M/F ; 1.2/1), it usually is located in the proximal portion of the stomach and distinguished from lymphoid-rich adenocarcinoma by the absence of definitive glandular differentiation in the LELC. We recently experienced 4 cases of LELC of the stomach associated with EBV. Patients consisted of two Korean females and two Korean males with one in 3rd decade, one in 5th decade and two in 6th decade. The tumors of all cases were located in the proximal portion of the stomach. Gross types were 1 Borrman type I, 2 Borrman type II and 1 early gastric carcinoma type IIc. The size of the tumors varied from 0.8 cm to 7 cm. Microscopic findings were similar in all 4 tumors.; The tumors were composed of syncytial nests of undifferentiated cells having vesicular nuclei with prominent nucleoli, admixed with abundant lymphoplasma cell infiltration in the stroma. Immunohistochemical staining revealed that the tumor cells were reactive for cytokeratin and the stromal lymphocytes were mostly T cells. There were dark hybridization signals in the nuclei of most of the tumor cells but no signals in the stromal lymphocytes in three cases on in situ PCR hybridization and on all cases PCR amplification for EBNA-1. It is concluded that LELCs of the stomach have distinctive histologic characteristics and the usual association with EBV. Further accumulation of these cases will define the prognosis.

Original Articles

p27Kip1 Expression and Apoptotic Index in Prostatic Adenocarcinoma.: Eun Sook Nam, Duck Hwan Kim, Hyung Sik Shin, Young Euy Park, Dae Yul Yang; Korean J Pathol. 1999;33(12):1139-1145.

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Abstract PDF: p27kip1, a cyclin dependent kinase inhibitor, has been recognized as a negative regulator of cell cycle. To investigate the role of p27kip1 on progression of cancer and apoptotic pathway, we analyzed p27kip1 expression using immunohistochemical stain in 40 cases of prostatic adenocarcinoma and apoptotic index by TUNEL method in 30 cases of prostatic adenocarinoma. Both were correlated with Gleason grade and Gleason score. Loss of p27kip1 expression was more frequent in prostatic adenocarcinomas of higher score (Gleason score 7 to 10) (60.7%) than in those of lower score (Gleason score 4 to 6) (33.3%) (p<0.05). The value of mean apoptotic index of carcinoma was 1.13+/-0.26, 1.80+/-0.91, 2.06+/-0.79, and 2.12+/-0.82 in grade 2, 3, 4, and 5, respectively, and was positively correlated with grade of carcinoma (p<0.05). Mean apoptotic index of higher Gleason score (score 7 to 10; 2.05+/-0.63) was also significantly increased than in lower Gleason score (score 4 to 6; 1.34+/-0.39) (p<0.05). Mean apoptotic index in cases with and without p27kip1 expression was 1.92+/-0.86 and 1.89+/-0.81, respectively (p>0.05). These results suggest that loss of p27kip1 expression and increased apoptotic index may be the morphologic markers to predict the behavior of prostatic adenocaricnoma. The role of p27kip1 on apoptotic pathway seems to be meager in this study and needs further study.

Expression of p27Kip1 Protein in Colorectal Adenocarcinoma.: Hyang Im Lee, Duck Hwan Kim, Eun Sook Nam, Hye Rim Park, Seoung Wan Chae, Chul Jae Park, Jeong Rye Kim, Hyung Sik Shin; Korean J Pathol. 2000;34(2):132-137.

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Abstract PDF: p27Kip1 has been recognized as a negative regulator of cell cycle. Reduced level of p27 expression is associated with development and aggressiveness of several human tumors. To investigate the role of p27Kip1 on progression of colorectal adenocarcinoma, we studied 40 cases of human colorectal adenocarcinomas for expression of p27Kip1 protein using an immunohistochemical method, and compared these results with known prognostic parameters of colorectal adenocarcinoma. Among 40 cases of colorectal adenocarcinomas, p27Kip1 expression was detected in the nuclei of tumor cells in 14 cases (35%). The expression rate of p27Kip1 protein was significantly lower in the cases with lymph node metastasis (25.8%) than in those without lymph node metastasis (66.6%) (p<0.05). But it did not correlate with other parameters such as tumor size, histologic grade, vascular invasion, and Ki-67 labeling index. The results suggest that reduced expression of p27Kip1 protein plays a role in biologically aggressive behavior of colorectal adenocarcinoma.

Case Report

Cytologic Findings of Epithelial-Myoepithelial Carcinoma of the Salivary Gland: A Case Report.: Eun Sook Nam, Gu Kang, Hyung Sik Shin; Korean J Cytopathol. 1996;7(1):64-68.

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Abstract PDF: The report of aspiration cytologic findings of epithelial-myoepithelial carcinoma(EMC) in the salivary gland is extremely rare. We present a case of fine needle aspiration cytology(FNAC) from EMC in the right submandibular gland of a 46 years old male patient. Neck CT scan revealed a confined lesion in the submandibular gland without enlargement of the regional lymph node. FNAC from the tumor showed several three-dimensional cellular clusters with admixed normal acinar cells. They frequently formed branching tubular structures composed of two type of cells; darker cells having eosinophilic scanty cytoplasm with round dense nuclei and clear cells having abudant pale cytoplasm with vesicular nuclei at the periphery of clusters. The tumor cells of both types did not show pleomorphism or mitoses. The resected submandibular gland showed an ill-defined whitish firm tumor, measuring 2 X1.5X2cm. The histology revealed an infiltrative tumor showing characteristic two cell types in a duct-like arrangement surrounded by thin basement menbrane. An inner layer of darker cells and outer layer of clear cells were postive for cytokeratin in the former and S-100 protein in the latter on the immunohistochemical stain.

Original Article

Comparison between Transthoracic Fine Needle Aspiration Cytologyand Gun Biopsy of Pulmonary Mass.: Eun Sook Nam, Duck Hwan Kim, Hyung Sik Shin; Korean J Cytopathol. 1998;9(1):55-62.

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Abstract PDF: To compare the diagnostic yields and complication rates of transthoracic fine needle aspiration cytology(FNAC) and gun biopsy in the diagnosis of pulmonary mass, a retrospective review was performed in 125 cases. Under the fluoroscopic guide, FNAC was performed by 20G Chiba needle in 91 cases, core biopsy was done by 18.5 G vaccum needle attached with automated biopsy gun in 74 cases and both procedures were done together in 37 cases. Overall sensitivity was 88.4% in FNAC and 87.5% in gun biopsy. For malignant pulmonary tumors, correct type correlation with final diagnosis was obtained in 33(76.7%) out of 43 cases by FNAC and 30(75.0%) out of 40 cases by gun biopsy. For benign pulmonary lesions, there were correct type correlation in 14(35.0%) out of 40 cases by FNAC and 14(53.8%) out of 26 cases by gun biopsy. The complication was pneumothorax and hemoptysis. Pneumothorax occured in 11.1% of FNAC, 10.9% of gun biopsy and 10.9% of both technique, among which chest tube drainages were necessary in one patient by gun biopsy and in three patients by both technique. Although no significant difference of diagnositc accuracy and complication rate was found between FNAC and gun biopsy, gun biopsy was more helpful in the diagnosis of pulmonary benign lesions than FNAC.

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