Faculty of Medicine
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Item type:Publication, Correlation between PD-L1 expression and clinicopathological characteristics in triple-negative breast cancer patients(Springer, 2020-12); Ognenoska-Jankovska, BiljanaBackground & objectives: While immunotherapy is emerging as an effective treatment option for advanced triple-negative breast carcinoma (TNBC) patients, the clinicopathological significance of PD-L1 expression in TNBC remains unclear. Our objective was to investigate the association between PD-L1 expression and clinicopathological characteristics in TNBC. Methods: The study group comprised 47 TNBC patients in which PD-L1 status was evaluated by immunohistochemistry with SP142 assay on the Ventana BenchMark. All PDL1(+) tumour-associated immune cells (IC) were quantified as % of the tumour area. Tumours were classified as PDL1(+)(>=1%) or PD-L1(-)(<1%). The statistical significance of the correlation between PD-L1 status and clinicopathological characteristics was determined by chi-square test. Results: PD-L1(+) were 24(51.1%) of the 47 TNBC patients whose median age at diagnosis was 59 (range, 39-79). 53.5% (23/43) of the primary and 25%(1/4) of the metastatic TNBC cases were PD-L1(+). 21(87.5%) of the PD-L1(+) TNBC had IC1( 1 and <5%), 2(8.3%) had IC2( 5 and <10%), and 1(4.2%) had IC3( 10) score. The PD-L1(+) status significantly associated with high histological grade (G3, P=0.022), and higher proliferative index (Ki-67>35%, P=0.004), while the correlation with larger tumour size (>2 cm, P=0.055) did not reach statistical significance. No significant relationship was found between PD-L1 status and other variables such as patients` age, postoperative stage, tumour status, lymph nodal status, tumour type, vascular invasion, and p53 expression. Conclusion: Our preliminary results suggest that PD-L1 expression is associated with several high-risk clinicopathological parameters in TNBC patients. Further larger studies are warranted to clarify the clinical relevance of PD-L1 expression in TNBC patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Atypical polypoid adenomyoma of the uterus: A clinicopathological analysis of 28 cases(Springer, 2015-09); Ognenoska-Jankovska, BiljanaObjective: To investigate the clinicopathological characteristics of uterine atypical polypoid adenomyoma (APAM), including the cases with coexistent endometroid endometrial adenocarcinoma (EEA). Method: A retrospective analysis of the clinical data, morphologic features, and immunohistochemistry of 28 consecutive cases of uterine APAM diagnosed in our Department between January 2001 and December 2014 was done. Results: The mean age of the patients was 41 (range, 26–61). Only five patients were postmenopausal, and seven were undergoing evaluation for infertility. Microscopic examination disclosed endometrial glands with varying degrees of hyperplasia and cytological atypia within a myofibromatous stroma. Squamous metaplasia was present in 25(89 %), and foci of well-differentiated EEA coexisted in 5 (17.9 %) cases. In 4 (14,3 %) other patients moderately differentiated EEA was present both in APAM and endometrial fragments. Nine patients were initially treated with hysterectomy and the remaining 19 with curettage, polypectomy, or hysteroscopic transcervical resection, followed by hormonal therapy in 10 cases. There was one recurrence documented, while in 3 (13.6 %) of these patients the APAMs persisted up to 2 years. All patients except the one with advanced stage EEA (FIGO stage IIIC) were well and alive 16–147 (mean, 71) months after primary treatment. Conclusion: Although the clinical behavior of APAM is benign in most cases, it can be associated with sterility and rarely with endometrial carcinoma. Therefore a meticulous pathological evaluation of specimen of APAM is necessary for the detection of the coexistence of EEA. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Combined large-cell neuroendocrine carcinoma and endometrioid adenocarcinoma of the endometrium: A case report(Springer, 2017-08-25); Ognenoska-Jankovska, BiljanaObjective: Large cell neuroendocrine carcinoma (LCNEC) of the endometrium is a relatively rare and usually aggressive malignancy. We report a case of an endometrial tumour that was a combination of a LCNEC and endometrioid adenocarcinoma. Method: A 58-year-old woman presented with postmenopausal vaginal bleeding. Explorative curettage revealed a LCNEC of the endometrium. She underwent total abdominal hysterectomy with bilateral salpingooophorectomy and was diagnosed as having FIGO stage IB endometrial carcinoma. In spite of refusal of adjuvant therapy, and irregular follow-up, she has been well with no evidence of disease for 52 months following surgery. Results: Grossly, a polypoid neoplasm measuring 6.5 × 2.2 × 2.5 cm, infiltrating more than a half of the thickness of the myometrium of the posterior uterine wall was found. Histologically, the tumour was composed of two components: a predominant large cell high-grade neuroendocrine carcinoma and a minor superficial well-differentiated endometroid adenocarcinoma with foci of squamous differentiation. There was a differential immunoreactivity between the two components. More than 10 % of the cells of the LCNEC were positive for three neuroendocrine markers (CD56, NSE and synaptophysin), showing also diffuse positivity for cytokeratin 18, vimentin, and p16, and hormone receptor negativity, whereas the majority of the cells of endometroid carcinoma were negative for neuroendocrine markers, hormone receptor positive and only focally p16 positive. The proliferative index determined by Ki-67 was higher in LCNEC in which p53 overexpression was also present. Conclusion: Immunohistochemical analysis is helpful in diagnosing and differentiating primary LCNEC. The presented case also confirms that early-stage polypoid LCNEC may have a more favourable prognosis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation of programmed death ligand-1 (PD-L1) expression with clinicopathological features in lung carcinoma in a Macedonian population(Springer, 2022-09)