Background 1. Incidence Anal canal cancer is a relatively rare tumor, representing approximately 1. It is approximately 20 to 30 times rarer than colon cancer, but its annual incidence is increasing, reaching up to cases, with a female predominance 2. There is an important geographic variation regarding its incidence, as well as histopathological type. The mainstay of the treatment is represented by chemo-radiotherapy, radical surgery being reserved to residual tumor or recurrences.
In the adult organism Bcl-2 expression is colorectal cancer jokes confined to cells that are rapidly dividing and differentiating. In lymphocytes, Bcl-2 is highly expressed in T-cells, pro-B cells and mature B-cells where lifespan hpv urothelial carcinoma extended while downregulated in germinal center B-cells where apoptosis forms part of the developmental pathway in order to select only cells producing antibodies with high avidity Overexpression of Bcl-2 is common in many types of cancer, including non-Hodgkin's lymphoma and leukaemias, adenocarcinomas e.
Among the latter, strong Bcl-2 positivity has particularly been demonstrated in gastrointestinal stromal tumor, solitary fibrous tumor, and synovial sarcoma, while fibromatosis and "malignant fibrous histiocytoma" are usually negative. Among malignant lymphomas, Bcl-2 protein overexpression is often caused by chromosomal translocation 14;18 with Bcl-2 gene rearrangement.
This is especially seen in hpv urothelial carcinoma lymphoma. Bcl-6 in ggl limf Bcl-6 in limfom folicular ALK anaplastic large cell lymphoma kinase is a protein, hpv urothelial carcinoma, a transmembrane receptor tyrosin kinase, presumably receptor for the growth factor pleiotrophin.
In normal tissues, ALK protein is expressed by only few cells within the developing and mature nervous hpv urothelial carcinoma glial cells, neurons, endothelial cells and pericytes ; ALK gene is translocated in ALCL, but also in inflammatory myofibroblastic tumor and in diffuse large B cell lymphoma DLBCL.
They also produce more autoantibodies than normal CD5 negative B-cells. Lack of CD5 in the latter signifies a worse prognosis.
CD5 has been detected in some cases of thymic carcinoma and atypical thymoma.
Other carcinomas are CD5 negative. CD5 in normal T cells CD5 in MZL CD10 CD10 is a single-chain cell surface glycoprotein, kDa, also designated common acute lymhoblastic leukaemia antigen CALLA CD10 is present on the hpv urothelial carcinoma surface of bone marrow stem cells and myelopoietic cells including neutrophilsfollicular centre cells, few mature Blymphocytes; CD10 is also found in enterocytes in the upper part of the intestinal tract brush border,in liver bile canaliculikidney glomerular and proximal tubular cellspulmonary alveolar cells, myoepithelial cells of breast.
CD10 is found in some cases of diffuse large B-cell lymphoma, and mantle cell lymphoma; small lymphocytic lymphoma, marginal zone lymphoma, and lymphoplasmacytoid hpv urothelial carcinoma are negative.
CD20 appears on the surface of the pre-B lymphocyte between the time of light chain rearrangement and expression of intact surface immunoglobulin and is lost just before terminal B-cell differentiation into plasma cells. Plasma cell neoplasms are as a rule CD20 negative. CD20 normal CD20 in CLL CD23 - low affinity IgE receptor, Leu, FceRII; - In humans, main cellular expression of CD23 is found in B-lymphocytes strong expression in activated germinal center B-cells, weaker staining of resting mantle zone B-cellsmonocytes, follicular dendritic cells FDCs hpv urothelial carcinoma in the apical light zone of the germinal center; - CD23 is typically expressed in chronic lymphocytic leukemia CLL - the strongest expression is characteristically present in proliferation centers.
Some cases of mycosis fungoides can have significant CD30 expression; Expression of CD30 has also been demonstrated in embryonal carcinoma and some seminomas. CD45 is lost in megakaryocytes and plasma cells. It is not detected on differentiated cells of other tissues. CD45 has intrinsic tyrosine phosphatase activity and is essential for development and effector functions, playing hpv urothelial carcinoma important role in signal transduction, inhibition or upregulation of various immunological functions.
Cancerul de canal anal - aspecte legate de diagnostic și tratament
CD45 is detected in the large majority of haematolymphoid neoplasms, i. CD antibodies detect a glycoprotein with a molecular weight of approximately kD, localized in the cytoplasm, often with relation to lysosomes.
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Positive staining is seen in different types of macrophages of monocyte lineage and antibodies also reacts with myeloid precursor cells in the bone marrow. Expressed in fibrous-histiocytic tumours and Langerhans cell histiocytosis, subtypes of myeloid leukaemia depending on the Ab usedsome epithelial neoplasms, epithelioid cells of some malignant melanomas CD68 in celule Kupffer CD31 transmembrane glycoprotein, kDa, also designated platelet-endothelium cell adhesion molecule PECAM-1belonging to the immunoglobulin super family.
CD31 is strongly expressed in hpv urothelial carcinoma cells and weakly expressed in megakaryocytes, platelets, occasional plasma cells, lymphocytes especially marginal zone Hpv urothelial carcinoma, peripheral T-cells and neutrophils.
CD31 is expressed in the vast majority of all types of vascular neoplasms, such as hemangioendothelioma, angiofibroma, hemangioma, and angiosarcoma.
CD 31 is also expressed in most cases of Kaposi sarcoma CD31 in hemangioendoteliom infiltrativ in intestin CD34 CD34 also named myeloid progenitor cell antigen is a heavily glycosylated type I transmembrane protein, kDa; role in adhesion; CD34 is found in most endothelia, expressed on the luminal surface and membrane processes interdigitating between endothelial cells, but is absent from large veins and arteries.
CD34 is detected in myeloid blasts in myelodysplastic syndrome and acute myeloid leukaemia; Also expressed in lymphoblasts in most cases of B-acute lymphoblastic leukaemia. This is tissue-specific and present only in endothelial cells, megakaryocytes and thrombocytes FVIII is expressed in most tumours with hpv urothelial carcinoma differentiation.
In angiosarcoma, Kaposi sarcoma and Dabska tumour, the antigen can be demonstrated in a majority of, but not not all, cases Due to the specificity of the antigen, rather than the sensitivity, FVIII is often a part of the panel for the identification of benign and malignant vascular neoplasms, along with CD31 and CD The protein is a tyrosine kinase growth factor receptor for stem cell factor SCF ; CD is expressed in mast cells, melanocytes and interstitial cells of Cajal; The hpv urothelial carcinoma particularly the mast cells show a strong membrane as well as cytoplasmic staining.
The CK family is a highly complex multigene family of polypeptides, the molecular weight of which ranges from 40 to 68 kDa. Until now, 20 distinct CKs have been revealed excluding the so-called trichocytic keratins present in hair and hpv urothelial carcinoma epithelia only.
Clone CAM 5. The p63 gene is located at chromosome 3q and belongs nigeria-u the p53 gene family.
The same tumours are usually expressing cytokeratin 5. However, p63 often shows a more extended reaction. An important criterion for the diagnosis of prostate adenocarcinoma is the absence of basal cells.
Cancerul de canal anal - aspecte legate de diagnostic și tratament
Hpv urothelial carcinoma these can be difficult to identify in routine sections, immunohistochemical identification of p63 and cytokeratin 5 may increase the sensitivity and specificity. Since negative staining for high molecular weight cytokeratin HMW-CK in atypical prostate glands may not be sufficient for a definitive diagnosis of malignancy, p63 may enhance the ability to diagnose limited prostate cancer.
A cocktail staining is applicable. The combination of p63 and HMW-CK increases the sensitivity of basal cell detection P63 is used in identifying invasive foci in breast carcinomas which lack the myoepithelial cell layer.
P63 in prostata normala CEA A glycoprotein comp of Ig superfamily adhesion molecule ; In normal adult tissue, CEA is expressed in the apical border and, to a lesser extent in the cytoplasm, of the columnar cells hpv urothelial carcinoma colon, small intestine, and stomach surface epithelium, mucous neck cells and weakly in pyloric mucous hpv urothelial carcinomapancreatic ducts, secretory epithelia hpv urothelial carcinoma sweat glands, squamous epithelial cells of the tongue, esophagus and uterine cervix, and urothelium.
The prostate is negative apart from urothelium lined secretory ducts. CEA is expressed in epithelial cell membranes and in the cytoplasm of the cells in almost all cases of colorectal adenocarcinoma as well as a high proportion of adenocarcinomas of the salivary glands, esophagus, stomach, biliary tract, pancreas, small intestine, lung, uterine cervix and ovary mucinous type. CEA in colon normal Cadherins Cadherins are a family of calcium-dependent transmembrane cell adhesion glycoproteins.
In connecting cells they comprise a part of the zonula adherens and desmosomes.
The following tumours are almost always positive: adenocarcinoma of colorectum, stomach, pancreas, prostate, endometrium, uterine cervix, and thyroid. Among ovarian carcinomas, the mucinous type is almost always positive, while varying positivity is seen in the hpv urothelial carcinoma types.
EMA is present in a variety of glandular secretory epithelia such as breast, eccrine and apocrine glands, and pancreas, whereas little or no EMA is expressed in the gastrointestinal epithelium, endocervical epithelium, and prostate glands. It is abundantly expressed in central and peripheral neural tissues, particularly in the retina and in the hpv urothelial carcinoma of the sensory pathways it is also expressed in steroid producing cells adrenal cortical cells, testicular Leydig cells, ovarian theca interna cellstesticular Sertoli cells, rete testis, ovarian surface epithelium, some neuroendocrine cells, breast glands, eccrine sweat glands, hair follicular cells, thymic epithelial cells, endometrial stromal cells, and fat cells Calretinin is also expressed by both normal and neoplastic mesothelial cells; it is an useful marker for the identification of malignant mesotheliomas of the epithelial type and for the differentiation of these malignancies of lung adenocarcinoma In calretinin positive cells, the protein is generally found in both the cytoplasm and nuclei.
Mezoteliom CDX2 Cdx2, a human homeobox gene, encodes a transcription factor, which is involved in proliferation and differentiation of intestinal epithelial cells. The CDX2 protein is widely expressed in intestinal epithelium from the duodenum to the rectum.
The majority of colorectal adenocarcinomas, a large part of gastric adenocarcinomas, carcinoids of cancerul si vitamina c GI hpv urothelial carcinoma as well as adenocarcinomas of the ovary, hpv urothelial carcinoma bladder and pancreas show CDX2 expression. Antibodies to CDX2 may be useful for identification of both primary and metastatic tumors of the gastrointestinal tract, including carcinoids Cromogranin chromogranins comprise a family of acid calciumbinding glycoproteins closely associated with the matrix of dense-core neurosecretory granules in virtually all neuroendocrine NE cells and neurons.
Probably, these proteins are involved in packaging and processing of neuropeptides and peptide hpv urothelial carcinoma.
SYP may also be detected in other neural crest derived tumours like oligodendroglioma, astrocytoma and ependymoma. Moreover synaptophysin is detected in NE tumours like pancreatic islet tumours, carcinoid and neuroendocrine carcinoma, small cell carcinoma, medullary thyroid carcinoma, and pituitary and parathyroid adenomas. Also adrenal cortical tumours stain for synaptophysin. Syn in carcinoid intestinal Actina- clona HHF35 Labels myocardial, skeletal and smooth muscle cells as well as myoepithelial cells.
Diagnostic Pathology: Cytopathology
The antibody recognizes rhabdomyosarcomas, leiomyomas and leiomyosarcomas, and also reacts with 'myofibroblasts' in the stroma of certain tumors including many carcinomas Actina - clona 1A4 This antibody labels smooth muscle cells, myofibroblasts and myoepithelial cells, and is useful for the identification of leiomyomas, leiomyosarcomas and pleomorphic adenomas Actina- LMS a smooth muscle-specific protein involved in the regulation of smooth muscle contraction.
Calponin a developmentally regulated protein thought to play a role in the hpv urothelial carcinoma of the thin filamentassociated system of smooth muscle contraction. Hpv urothelial carcinoma in leiomiom Desmin Desmin is an intermediate filament protein 53 kDa expressed in all striated muscle cells and most smooth muscle cells; Desmin play no role in contractility but serves to maintain the orientation of actin and myosin filaments and may also play a role in nuclear transcription Desmin is detected in most tumours of myogenic origin, e.
S protein may be found in the cell membranes, cytoplasm and nuclei; S beta hpv urothelial carcinoma is present in glial cells, Schwann cells and satellite cells, melanocytes, myoepithelial cells, some glandular epithelia breast, kidneyskeletal and heart muscle cells, fat cells and chondrocytes, and follicular dendritic cells.
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The immunohistochemical evaluation of S beta protein expression is important in the diagnosis of hpv urothelial carcinoma malignant tumours of unknown primary origin and should be included in the so-called primary panel. S is a very sensitive marker for malignant melanoma of all types, a negative staining is exceedingly rare. Because of its low specificity, other markers should be included in a panel for malignant melanoma, such as vimentin and Melan- A.
Vimentina Vimentin 57 kDa is the most ubiquituos intermediate filament protein and the first to be expressed during cell differentiation. All primitive cell types express vimentin but in most non-mesenchymal cells it is replaced by other intermediate filament proteins during differentiation.
Vimentin is expressed in a wide variety of mesenchymal cell types fibroblasts, endothelial cells etc. Hpv urothelial carcinoma, in non-vascular smooth muscle hpv urothelial carcinoma, vimentin is often replaced by desmin.