FNA biopsy is well known method for the first step evaluation of thyroid nodules, it is the "gold standard" for diagnosis and surgical approach of nodular goiter. Despite the high sensitivity and specificity of the method there are grey zone in the diagnosis of thyroid nodules, mainly due to the heterogeneous group of Bethesda category AUS/FLUS. There are also some difficulties in diagnosis of PTC, especially FVPTC, even on histologic sections. The limited studies exist that specifically address details of cytologic features associated with cytohistologic discrepancy. Cell-block is very helpful in the diagnosis of papillary thyroid carcinoma and the carcinoma of undefined category; as the papillary configuration and nuclear features were more obvious, also immunocytochemical markers are applicable for ancillary studies. The BRAF mutation detection, which is associated with papillary microcarcinomas and cancer, can be yield for preoperative diagnosis, as well as for prognostic marker and as therapeutic target for farther management.
Background: The progression of endometrial pathologies, from benign hyperplasia to malignant adenocarcinoma, involves complex interactions between the immune microenvironment, hormonal receptor dynamics, and systemic conditions. This study aims to evaluate immune markers, such as M1/M2 macrophage ratios and tumour-infiltrating lymphocytes (TILs), alongside estrogen (ER) and progesterone (PR) receptor expression in different endometrial conditions. Methods: This retrospective study included 120 cases categorised into three groups: endometrial hyperplasia without atypia, hyperplasia with atypia, and endometrial endometrioid adenocarcinoma. Immune markers (M1/M2 ratio, TILs) and hormonal receptors (ER, PR) were assessed using immunohistochemistry. Statistical comparisons were conducted across diagnostic groups stratified by age and systemic conditions. Results: The M1/M2 Ratio declined progressively from hyperplasia without atypia (mean: 2.0) to adenocarcinoma (mean: 0.5, p < 0.01), indicating a shift from a pro-inflammatory to an immunosuppressive microenvironment. TILs %: Minimal in hyperplasia without atypia (0%), increasing significantly in adenocarcinoma (mean: 15%, p < 0.01). ER/PR expression decreased from hyperplasia without atypia (ER: 80%, PR: 70%) to adenocarcinoma (ER: 30%, PR: 20%, p < 0.01). Premenopausal women exhibited higher receptor expression than postmenopausal women (p < 0.05). Conclusion: This study demonstrates the critical role of immune and hormonal markers in the progression of endometrial diseases. The decline in M1/M2 ratios, rising TILs, and reduced ER/PR expression correlate with disease severity and systemic conditions. These findings suggest the potential of targeting the immune microenvironment and hormonal pathways for personalised therapeutic strategies. Future research should explore the molecular mechanisms underlying these changes and validate these biomarkers in prospective studies.
Breast cancer is the most common malignancy in women worldwide with more than 2.2 million newly diagnosed cases and more than 650,000 deaths annually. Triple-negative breast cancer accounts for 15-20% of all breast cancer cases and is characterized by aggressive behavior. Androgen receptor is considered as a possible new biomarker and potential therapeutic target in the treatment of breast cancer. Androgen receptor inhibitors may be considered a therapeutic option for specific subtypes of breast cancer. It plays a particularly important role in the carcinogenesis of triple-negative breast cancer. However, the issue of its active implementation in management is still controversial. Ovarian cancer is a gynecological malignancy diagnosed at an advanced stage in most cases and has different cellular origin, histological characteristics and therapeutic response. Epidemiological and experimental evidence suggests the involvement of androgens in the development of ovarian tumors. However, the influence of the androgen receptor in patients with epithelial ovarian tumors is still a subject of active study. Some studies have shown that androgen receptor overexpression is associated with good survival rates. There are also studies that show no significant association between steroid receptor expression and overall survival.
Endometrial Metaplasia is the process in which normal endometrioid glands are undergoing replacement by other types of benign epithelium. Endometrium can show us a diversity of metaplastic changes. Modified differentiation of Endometrial cells can be due to the presence of degenerative/reparative, hormonal or neoplastic processes. The presence of Epithelial Metaplasia can signify other concomitants benign and malignant processes. Endometrial metaplasia can be either a single process or present with other histopathological changes. There are different types of endometrial metaplasia but the most common is tubal metaplasia. The second most common can be squamous metaplasia, transitional cell metaplasia, arias-Stella reaction/changes, cellular eosinophilic changes and mucinous metaplasia. different types of metaplasia can show us the various type and intensities of expression for P16, Cyclin E, Cyclin A, Ki67, B catenin, ER, CDX2, CD10, P63. The role and importance of distinct types of endometrial metaplasia in the relapse of cancer and neoplastic progression are still unknown. There is the clinical opinion that behind every single metaplastic process there is stem cell reprogramming but the phenomenon of endometrial metaplasia needs more thorough studies.
Major problems haunt the physicians who need to delineate the best management strategy for their patients with thyroid nodule is the identification of the most aggressive cases, especially among papillary thyroid cancers, which would benefit from more aggressive therapy and follow up. Beyond its strong correlation with PTC, the BRAF mutation is well described to associate with poor prognosis. The aim of our study was to identify BRAF antibody expression in different hystotypes of the thyroid nodules and assessment of it expression according to the tumor aggressiveness. Immunohistochemical staining was performed in 54 of surgically resected thyroid nodules, including malignant and benign cases, grouped according to the tumor aggressiveness. We have used selected thyroid specific markers: BRAF antibody, CD-56, CK-19, HBME-1 and KI-67. Adenomatous hyperplasia's and follicular lesions doesn't reveal positivity to the expression of BRAF antibody. Encapsulated papillary carcinomas included in our work revealed negative or very poor positivity of BRAF antibody. This fact strengthen the hypothesis that encapsulated papillary carcinomas have an indolent behavior and is genetically distinct from infiltrative tumors. We revealed 55,5% positivity of BRAF antibody in the cases of papillary microcarcinomas, this fact creates a need for more cautious approach to this type of tumors. The degree of BRAF antibody expression increased with a rising of tumor aggressiveness in our histopathologic groups (P<0,005). All cases of papillary carcinoma with multinodular involvement and extrathyroid extension revealed moderate or strong positivity of BRAF antibody expression.
Despite advances in detection and treatment of breast cancer, mortality from this disease remains high. According to contemporary point of view the reason for this lies in fact, that in addition to intertumor heterogeneity, there is also a high degree of intratumor diversity in cancer cell population. For most cancers it is less clear which cells within the tumor clone possess tumor-initiating cell function. During studying oncogenesis and maligniяation processes a pool of cancer cells with stem characteristics - cancer stem cells (CSC) was identified. Indeed, the specifications of them let us conclude, that exactly these cells comprise the leading substrate for cancer initiation and self-renewal. Breast carcinomas have been reported to contain a subpopulation of CD44(+)/CD24(-)/low cancer cells, which are capable of generating tumors even when implanted in very low numbers. Exactly these cells are considered to be CSCs in different subtypes of breast cancer and cancers with CD44(+)/CD24(-)/low phenotype are confirmed to have a poor prognosis (but some controversies remain concerning this issue). The aim of the review was to assess the current literature published on the breast cancer stem cells. There are not so many studies, revealing the diversity of cancer stem cells in different types, different sizes and different grade of breast cancers. CSC distribution in breast cancer with lymph node involvement, metastasizing and chemoresistant cases, existence of circulating tumor cells in not studied precisely. So the concept of cancer stem cells in breast cancer is still a topic for discussions. This can bring light to a better understanding of the pathological process in breast cancer and ways to target it.
Endometrial Carcinoma is the most common gynaecological malignancy in the female population and is considered as incidentally the second gynaecological malignancy worldwide. Based on 2018 data more than 380 000 new cases were diagnosed worldwide and almost 90 000 of them had a lethal outcome. Interaction between cancer cells and their microenvironment regulates cancer progression in multiple types of cancer. It has great value in developing endometrial cancer and its progression respectively. There is no sufficient research data about the consequences and mechanisms which are participating in endometrial cancer progression and what determines its aggressive behaviour. Molecular signals derived from stromal cells and/or extracellular matrix plays a crucial role in malignancy. The cancer microenvironment is composed of cellular components and noncellular components (extracellular matrix)as well. Cancer cell invasion and metastasizing are some of the leading reasons why endometrial cancer is hardly sensitive to the treatment and has worse overall prognoses. Identification of Signaling pathways of the local microenvironment and peptides synthesized by stromal cells has a critical role in the modification of potentially significant biomarkers for endometrial cancer metastases and high-grade malignancy. In consideration of all of the mentioned microenvironment of endometrial cancer and its single components needs deeper examination while it has a critical value in understanding cancer aetiology, progression and its prognoses.
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