Published in 2016

Immunohistochemical study of prognostic relevance of nestin and survivin expression in astrocytic glioma

Astrocytoma immunohistochemistry survivin Anatomy

Authors: A Abdelrahman, H Abdel-Aziz, A Hegazy, AM Mohamed

Journal: Journal of Interdisciplinary Histopathology

Description:

Background: Identification of the cellular origin of astrocytic gliomas is a step for improving the treatmentstrategies. Tumor stem cells have been detected in different neoplasms and have a major role in tumor initiation,progression, and therapy resistance. Objective: The study aimed to investigate the expression of nestin andsurvivin in different grades of astrocytic glioma as well as evaluation of their prognostic role in relation toother prognostic parameters. Materials and Methods: Immunohistochemical expressions of nestin andsurvivin were evaluated in 40 paraffin blocks of different grades of astrocytic glioma and correlated with otherprognostic parameters. The obtained data were statistically analyzed. Results: The cases included 10 lowgrade, 12 anaplastic, and 18 glioblastoma multiforme. There was a significant correlation between each ofnestin and survivin with the histological grade of astrocytoma and tumor size (P < 0.001). Nestin was stronglycorrelated to survivin index (P < 0.001). The univariate analysis showed that high histological grade, high nestinscore, and high survivin index were significantly correlated with overall survival (OS). Multivariate analysis forall investigated cases proved the independent prognostic significance of the nestin expression (P = 0.011).Conclusion: Nestin and survivin are adverse prognostic markers for astrocytic glioma that increase significantlywith tumor progression and associated with poor OS. Therefore, nestin and survivin could be used to predicthigh-risk group of astrocytoma with unfavorable outcome.

Published in 2016

Prognostic Value of Immunohistochemical Expressions of the Stem Cell Biomarker "LGR5" and the Proliferation Biomarker "TPX2" in Colorectal Carcinoma

Anatomy Pathology Histology

Authors: O Harb, A Hegazy, L Gertallah, R Haggag, S El Shorbagy

Journal: Journal of Tumor 2016 June; 4(3): 426-434

Description:

AIM: Colorectal carcinoma (CRC) is the commonest and most deathly malignant gastrointestinal tumors. Carcinogenic process starts in a group of cancer cells, called cancer stem cells (CSCs) having the ability to start and maintain tumor growth and invasion. In order to detect and remove colon CSCs, a selective biomarker “LGR5 (leucine-rich-repeat-containing G-protein-coupled receptor 5)” might be required. At the same time, an abnormal expression of TPX2 (targeting protein for xenopus kinesin-like protein 2) has been found to be related to the development and progression of tumors. We aimed to evaluate the immunohistochemical expressions of LGR5 and TPX2 in CRC in a trial to clarify their relations to proliferation and metastasis of CRC, and hence its prognosis. MATERIALS AND METHODS: Immunohistochemical staining of both LGR5 and TPX2 was assessed in sections from sixty paraffin blocks of CRC. The relationships between their levels of expressions with the clinicopathological parameters and patient outcome were statistically analyzed. RESULTS: The immunoexpression of LGR5 in CRC was significantly positively correlated with location of the tumor, grade, stage, local recurrence, lymph node and distant metastasis (P <0.001). The expression of TPX2 in CRC was also found to be significantly correlated with the previous parameters (P < 0.001). Both biomarkers were up-regulated in CRC than in the adjacent non tumorous tissues. High LGR5 and TPX2 immunohistochemical expressions were strongly correlated with worse 3-year overall survival (OS), local recurrence free survival (LRFS) and distant metastases free survival (DMFS) (P < 0.001). CONCLUSIONS: High immunohistochemical expressions of both LGR5 and TPX2 and the positive correlation between both of them represent signs of poor prognosis of CRC.

Published in 2016

Diagnostic Discrimination of Fine Needle Aspiration Specimens of Hepatic Nodules using Immunohistochemical Expression of GPC3 and EZH2

Anatomy Pathology Tumor Liver

Authors: S Elbasateeny, T Ibrahim, A Hegazy, N Shaheen

Journal: J Tumor Res. 2016; 2: 110. doi: 10.4172/jtr.1000110

Description:

The goal of the present study was to examine the immunohistochemical expression of Glypican-3 (GPC3) and Enhancer of zeste homologue 2 (EZH2) in various histological types of hepatic nodules in order to clarify their discriminatory diagnostic value. We correlated biomarkers’ expressions with the clinicopathological variables of primary liver malignancy. Biomarkers’ expression was investigated in 64 liver needle biopsies. The specimens included primary liver malignancy (57.81%), metastatic carcinomas (15.62%) and non-malignant nodules 26.56%. The expression of GPC3 was detected in 83.33% and 15.38% of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) respectively, but not expressed in any of metastatic nodules. In HCC, GPC3 was more expressed in cases with cirrhosis, large masses of tumor and high HCCs grades with statistically significant differences with P value of 0.01, 0.035 and 0.03 respectively. The EZH2 expression was detected in 91.66% of HCC, in all cases of CC and metastatic nodules and in 5.88% of non-malignant nodules. The sensitivity, specificity and diagnostic accuracy of differentiating HCCs from non-malignant nodules were 80.95%, 100% and 90.24% respectively for GPC3; and 85.71%, 95.65% and 91.89% respectively for EZH2. The sensitivity, specificity and diagnostic accuracy for differentiating HCCs from CCs were 73.33%, 90.91% and 83.78% respectively for GPC3; and 0.0%, 62.86% and 59.46% respectively for EZH2. The sensitivity, specificity and diagnostic accuracy for differentiating HCCs from metastatic nodules were 71.43%, 100% and 88.24% respectively for GPC3; and 0.0%, 68.75% and 64.71% respectively for EZH2. In conclusion, GPC3 might be used as a good biomarker for differential diagnosis of HCC from non-malignant nodules, CC and metastasis. Its overexpression might be an indication of poor HCC prognosis. On the other hand, EZH2 is not specific for HCC, but could be a reliable biomarker for discrimination of hepatic cancers compared to non-malignant nodules.

Published in 2016

Anatomy and embryology of umbilicus in newborns a review and clinical correlations

Anatomy embryology newborns clinical

Authors: AA Hegazy

Journal: Front. Med. 2016; ; 10(3), DOI 10.1007/s11684-016-0457-8

Description:

Abstract Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular ones. This article aimed to address the basic knowledge of the umbilicus in relation to clinical disorders under one integrated topic to aid physicians and surgeons in assessing newborns and infants. The umbilicus appears as early as the fourth week of fetal life when the folding of the embryonic plate occurs. The umbilicus appears initially as a primitive umbilical ring on the ventral aspect of the body. The primitive umbilicus contains the connecting stalk, umbilical vessels, vitelline duct and vessels, allantois, and loop of the intestine. Changes occur to form the definitive cord, which contains three umbilical vessels, namely, “one vein and two arteries,” embedded in Wharton’s jelly. After birth, the umbilical vessels inside the body obliterate and gradually form ligaments. Congenital disorders at the umbilicus include herniation, bleeding, and discharge of mucous, urine, or feces. Some of these disorders necessitate emergent surgical interference, whereas others may be managed conservatively. The umbilicus has many embryological remnants. Thus, the umbilicus is prone to various clinical disorders. Detecting these disorders as early as possible is essential to prevent or minimize possible complications.

Published in 2016

EVALUATION OF FASCIN AND MMP-9 EXPRESSION AS MARKERS OF INVASION IN UROTHELIAL CARCINOMA OF THE URINARY BLADDER

Anatomy Pathology Histology Immunohistochemsitry

Authors: DA Ibrahim, EH Abdelbary, AA Hegazy

Journal: Int. J. Adv. Res. 2016:4 (8). 401-408

Description:

Background:Fascin and matrix metalloproteinase-9 (MMP-9) have been implicated in regulation of cell invasion and metastasis in many types of cancers. Aim: To evaluate the expression of fascin and MMP-9 in urothelial carcinoma (UC) of the urinary bladder and correlate their expression with the clinicopathological variables and to assess the relationship between them. Materials and methods: Fascin and MMP-9 immunoexpression was evaluated semiquantitatively in 60 cases of UCs according to the percentage of the positive cells. Results:Fascin and MMP-9 expression was observed in 66.7% and 60% of the studied cases of UCs respectively. The expression was significantly different from the normal urothelium. Fascin and MMP-9 expression was significantly higher with advanced tumor stage (P =0.02 and =0.01 respectively) and lymph-vascular space invasion (LVSI) (P<0.001 and =0.03 respectively). MMP-9 overexpression was significantly associated with the tumor grade (P =0.03). There was a positive correlation between fascin and MMP-9 expression (r =0.5, P =0.03). More intense immunostaining was detected at the invasive fronts compared with other areas of the tumor in 50% and 40% of UCs with positive fascin and MMP-9 expression respectively. Conclusion: Our results point to an association between increased fascin and MMP-9 expression and UC invasiveness and suggest that both markers may act in concert to mediate a more aggressive behavior through promoting tumor cell invasion.

Published in 2016

A Rare Case of Splenic Benign Mucinous Cystadenoma

Medicine Pathology Spleen Anatomy

Authors: R Hegazy, A Hegazy, S Alsayed, A Alsayed

Journal: Academia Anatomica International; Vol. 2, Issue 2

Description:

This is a report of a rare case of benign mucinous cystadenoma of the spleen. The case was preceded by a benign mucinous cystadenoma of the ovary 10 years before, accompanied by pseudomyxoma peritonei. The pancreas and peritoneum were free. The spleen showed multilocular cystic mass with smooth inner surface and profuse insipissated mucus. Microscopically, no papillary structure was found on the inner surface of cystic space which was lined by a single layer of mucin-producing epithelial cells without malignant change. The cause of such rare case remains unclear. It is suggested that it may be a part of syndrome of multiple mucin producing cysts, like that of mucoviscidosis.

Published in 2015

Repetitive Anal Intercourse as a Potential Risk for Renal Failure

Authors: -

Journal: Academia Anatomica International

Published in 2015

Immunohistochemical measurement and expression of Mcl-1 in infertile testes

Authors: Raafat Hegazy, Abdelmonem Hegazy, Mustafa Ammar, Emad Salem

Journal: Frontiers of Medicine

Published in 2015

The prognostic significance of p53, p63 and her2 expression in non-muscle-invasive bladder cancer in relation to treatment with bacille Calmette-Guerin

Authors: -

Journal: Arab Journal of Urology

Published in 2015

Role of ERG, PTEN and KI67 Proteins Expression in Prognosis of Metastatic Prostate Cancer.

Prostate Cancer diagnosis histopathology

Authors: EH Abdelbary, AA Hegazy, M Abdelgawad, RA Ahmed

Journal: International Journal of Advanced Research (2015), Volume 3, Issue 1, 296-306

Description:

Background: Prostate cancer is a leading cause of cancer-related mortality in men. Despite improvements in early detection of prostate cancer as a result of PSA screening, we still lack molecular markers to effectively distinguish patients with high risk of disease progression from the indolent majority. Aim of the work: To assess the prognostic value of ERG, PTEN and KI67 proteins expression in metastatic prostate cancer patients, as well as their relationship to clinicopathologic features of the disease. Patients and Methods: ERG, PTEN and KI67 proteins expression was assessed immunohistochemically in series of metastatic prostate cancers and their prognostic significance was evaluated. Results: High ERG score as well as high KI67 labeling index (LI) were strongly associated (P <0.001) with high pre-treatment PSA level, Gleason score ?7, advanced tumor stage, metastasis affecting both bone & lymph nodes and biochemical progression. PTEN loss was significantly associated with high pre-treatment PSA level (P ?0.001), Gleason score ?7 (P =0.002), advanced tumor stage (P =0.015), metastasis affecting both bone & lymph nodes (P =0.002) and biochemical progression (P =0.001). A significant association was found between higher KI67 LI (P ?0.001), higher ERG expression score (P =0.005) & PTEN loss (P =0.007) and shorter progression free survival. ERG expression and PTEN loss were significantly associated with KI67 LI (P =0.011 & 0.0.013 respectively), however, no relationship could be proved between both of them (P =0.256). ERG (P =0.025) was the only independent predictor for biochemical progression in multivariate analysis. Conclusions: ERG and KI67 expressions and PTEN loss have an important prognostic value in metastatic prostate cancer. Using them to differentiate between patients who are at a high or low risk of disease progression may help to identify patients who will benefit the most from treatment.