GI, Liver & Pancreas Pathology
Shruti Tadachina; Sheela Devi Shivalingaiah; Mahesh Shetty
Abstract
Background & Objective: Colorectal carcinoma (CRC) is one of the most common cancers worldwide. The interaction of programmed cell death receptor 1 (PD-1) and programmed death ligand 1 (PD-L1) plays an important role by inhibiting the immune mechanism by which cancer cells escape antitumor immunity. ...
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Background & Objective: Colorectal carcinoma (CRC) is one of the most common cancers worldwide. The interaction of programmed cell death receptor 1 (PD-1) and programmed death ligand 1 (PD-L1) plays an important role by inhibiting the immune mechanism by which cancer cells escape antitumor immunity. Immunotherapy using checkpoint inhibitors is a growing treatment modality in many cancers; one such is anti-PD1/PD-L1. The present study aimed to study the immunohistochemical (IHC) expression of PD-L1 in CRC and evaluate the association of PD-L1 expression in CRC with various known clinicopathological parameters.Methods: It was a 2-year prospective study and included 34 colectomy specimens diagnosed as colorectal adenocarcinoma. The expression of PD-L1 was evaluated on tumor cells & tumor-infiltrating immune cells (TIICs) and correlated with various clinicopathological parameters.Results: Immunohistochemical expression of PD-L1 on tumor cells and tumor microenvironment in CRC revealed positivity in 17.65% of cases each. The PD-L1 expression on tumor cells was associated with lymphovascular invasion (LVI) and perineural invasion (PNI) with P- values of 0.012 and 0.005, respectively, while PD-L1 expression on TIICs was associated with tumor budding with P-value 0.022.Conclusion: IHC expression of PD-L1 on tumor cells and immune cells was associated with some known poor prognostic factors. Since anti-PD1/PD-L1 is used for targeted therapy, it may be beneficial and economically feasible to evaluate PD-L1 in CRC and establish its role as a prognostic factor.
Sheela devi C S; Suchitha Satish; Veerendrasagar Sahukar
Abstract
Background and objective: Clear Cell Renal Cell Carcinoma (CCRCC) is the most common adult renal neoplasm. Staging and grading of RCC are important predictors of survival. Fuhrman nuclear grading is widely used for CCRCC, the subjective nature of which has prompted more objective methods to evaluate ...
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Background and objective: Clear Cell Renal Cell Carcinoma (CCRCC) is the most common adult renal neoplasm. Staging and grading of RCC are important predictors of survival. Fuhrman nuclear grading is widely used for CCRCC, the subjective nature of which has prompted more objective methods to evaluate nuclear features. Furthermore, Ki-67, a reliable marker of cellular proliferation may provide another variable for assessment of the biological behavior of RCC. The aim of this research was to study nuclear morphometry and Fuhrman nuclear grading of clear cell RCC, and to assess their relationship with the Ki-67 index. Methods: Hematoxylin and eosin slides of forty cases of CCRCC were retrieved and studied for pathologic variables, including Fuhrman nuclear grade, pathological tumor and node stage. Nuclear morphometric analysis was performed using computer-assisted image analysis. The relationship between Fuhrman nuclear grading, pathologic stage, tumor size, nuclear morphometry and proliferative index were analyzed. Results:According to Fuhrman grading, four (10%) cases were grade I, 23 (57.5%) were grade II, 12 (30%) were grade III, and one (2.5%) was grade IV. Moderate to high correlation was seen between Fuhrman nuclear grade and mean nuclear area, perimeter, diameter, length, nuclear roundness factor and Ki -67, with a P value of < 0.05. Conclusion: The CCRCC is an extremely heterogenous disease and clinical outcome is unpredictable despite several validated prognostic factors. The widely used Fuhrman nuclear grading is subjective, while nuclear morphometry, using computer assisted image analysis, can ensure more objective assessment. The Ki-67 index could provide reliable information and compliment the other prognostic parameters.