Ksenija Marjanović

Giant paraovarian myxoma

We present an extremely rare case of a successfully operated giant (6700 g) paraovarian myxoma and uterus myomatosus in a 49‐year‐old woman. Preoperative examination (biochemical investigations, ultrasound and computed tomography scan) and perioperative findings did not identify a malignant tumor so that total abdominal hysterectomy/bilateral salpingo‐oophorectomy and tumorectomy was chosen to treat the patient. Histologically, the tumor was clearly differentiated from the surrounding tissue. In solid regions there were spindle‐shaped cells arranged in sheaves and within the profuse, well‐vascularized myxomatous stroma there were star‐shaped cells. Immunohistochemical analysis showed that tumor cells were positive to vimentin and smooth muscle actin. Electron microscopic analysis showed that tumor cells had ultrastructural characteristics that corresponded to cells in fibroma and thecoma in a profuse intercellular matrix, which confirmed the result of light microscopy.

Expression of proinflammatory cytokine interleukin-6 in tissue samples of human prostate obtained by needle biopsy.

Interleukin-6 (IL-6) has been associated with the development of prostate cancer. The aim of the study was to clarify whether IL-6 expression in prostate tissue could be a useful marker in differentiation of prostate diseases in small foci by pathologist visual scoring. Archival paraffin-embedded specimens of benign prostate hyperplasia (BPH), high-grade prostatic intraepithelial neoplasia (PIN), prostatitis and prostate adenocarcinoma were studied by immunohistochemistry with a mouse monoclonal antibody IL-6 using the streptavidin-biotin method. Significantly, lower IL-6 immunoreactivity was observed in normal epithelial cells (p=0.000) and basal cells (p=0.000) in the samples of prostate adenocarcinoma in comparison to the samples with BPH, PIN and prostatitis. There was no significant difference in IL-6 expression in malignant and premalignant cells (p=0.814) as well as in stromal cells among the four diagnoses (p=0.22). IL-6 was expressed in normal epithelial cells, premalignant epithelial cells and malignant epithelial cells as well as in stromal cells. However, in our research IL-6 was of limited utility as a single marker for differential diagnosis of the prostate diseases in small foci needle biopsy by pathologist visual scoring. The standardization of immunohistochemical (IHC) staining protocol for IL-6 is required to determine IL-6 expression in order to avoid possible misinterpretation of the IHC results.

Prognostic role of Nectin-4 expression in luminal B (HER2 negative) breast cancer

Nectins are Ca2+-independent immunoglobulin (Ig) superfamily proteins that participate in the organization of epithelial and endothelial junctions and regulate several cellular activities including the entry of some viruses. Nectin-4 has recently been shown as a metastasis-associated protein in several cancers. In the following study, we have evaluated the expression of Nectin-4 inthe luminal B HER2 negative subtype breast cancer. The study group consisted of 147 patients presenting with primary unilateral breast carcinoma with no evidence of distant metastases. Nectin-4 protein expression was assessed by immunohistochemistry and the results were correlated with the clinical data using Kaplan-Meier curves, univariate and multivariate stepwise proportional-hazard analysis (Cox model). Nectin-4 overexpression was significantly correlated with the tumour size (p<0.05; Fishers Exact Test), also Nectin-4 expression was negatively associated with overall survival, disease free survival and distant relapse free survival with the same significance (p<0,001; Kaplan-Meier, Cox model). We did not find statistically significant correlation between Nectin-4 and age, ER, PR, age, lymph node metastasis, tumour differentiation, histologicalsubtype and Ki-67proliferation index. We suggest that Nectin-4 is a relevant prognostic factor and a therapeutic target in luminalB (HER2 negative) breast cancer.