1.Pattern of lymph node metastasis and p53 abnormal (p53abn) expression in preoperative early-stage endometrial cancer: A 5-year institutional experience.
Angeli Anne C. ANG ; Carolyn R. ZALAMEDA-CASTRO ; Cecile C. DUNGOG ; Michele H. DIWA ; Karen Cybelle J. SOTALBO
Acta Medica Philippina 2026;60(8):98-106
BACKGROUND
Early-stage endometrial cancer often presents with favorable survival rates, but high-risk factors, including TP53 mutations and high-grade serous pathology, can lead to recurrence and poor prognosis. The standard primary treatment for endometrial cancer is surgical staging, and lymph node metastases significantly impact adjuvant therapy decisions. The subgroup of p53-abnormal (p53abn) indicates the worst prognosis and potential benefits from adjuvant chemotherapy. Molecular classification, while recommended, faces practical challenges due to resource constraints.
OBJECTIVESThe study aimed to assess the incidence of p53 abnormal expression in clinical stage 1 endometrial cancer cases that underwent surgery at a government tertiary hospital, and assess its relationship with clinicopathologic factors and pelvic and paraaortic lymph node metastasis (LNM).
METHODSA cross-sectional retrospective analysis was conducted on clinical early-stage endometrial cancer cases that underwent surgical primary treatment between January 2018 and December 2022. Patient records were reviewed to gather demographics, surgical information, and pathological evaluations. Preoperative clinical staging was determined through imaging, and surgical staging involved comprehensive lymphadenectomy. Immunohistochemistry studies for p53 were carried out on formalin-fixed paraffin-embedded tissue samples.
RESULTSA total of 233 endometrial cancer cases were included. The mean age at diagnosis was 53.7 years. Common comorbidities included hypertension (47.2%) and dyslipidemia (20.6%). Most cases were endometrioid histology (82.8%) and low-grade tumors (85.8%). Tumor grade (p=0.010), myometrial invasion (pCONCLUSION
Tumor grade, myometrial invasion, and LVSI were all significantly associated with lymph node involvement. While p53 immunohistochemical stains show promise in predicting metastasis and has been associated with tumor aggressiveness, this should still be correlated with clinicopathological parameters to carry out a more accurate risk stratification of early-stage patients.
Therapeutics ; Survival Rate ; Risk Factors ; Recurrence ; Prognosis ; Pathology ; Endometrial Neoplasms ; Immunohistochemistry ; Tumor Suppressor Protein P53 ; Lymph Node Excision ; Risk Assessment
2.Role of caffeine and ethanol in modulating expression of Receptor Activator of Nuclear Factor κβ (RANK) and Osteoprotegerin (OPG) during orthodontic tooth movement: An in vivo study.
Ardiansyah S. PAWINRU ; Eka ERWANSYAH ; Eddy Heriyanto HABAR ; Abul FAUZI ; AMINULLAH ; Gita GAYATRI ; Yustisia PUSPITASARI ; Ita Purnama ALWI ; Andi Husnul HASANAH
Acta Medica Philippina 2026;60(8):115-122
BACKGROUND AND OBJECTIVES
Orthodontic tooth movement is driven by bone remodeling influenced by systemic factors, including caffeine and ethanol. This study aimed to investigate the effects of caffeine and ethanol on the expression of Receptor Activator of Nuclear Factor κβ (RANK) and Osteoprotegerin (OPG), key bone remodeling biomarkers, during orthodontic tooth movement.
METHODSA laboratory experimental study was conducted on 30 male Wistar rats divided into three groups: K1 (orthodontic force only), K2 (force + caffeine), and K3 (force + ethanol). Orthodontic force was applied using Ni-Ti coil springs. Caffeine and ethanol were administered orally daily. On days 7 and 14, maxillary tissues were collected and analyzed via immunohistochemistry for RANK and OPG expression. Data were analyzed using One-Way ANOVA and Independent Sample T-tests with significance at pRESULTS
Caffeine and ethanol administration increased RANK and OPG expression compared to controls; however, only the ethanol group showed a significant increase in RANK expression on day 14 (p = 0.044). OPG expression was significantly higher in treatment groups at both time points (pCONCLUSION
Caffeine and ethanol modulate bone remodeling marker expression during orthodontic force application, with ethanol significantly increasing RANK expression at later stages. Further studies are needed to clarify the clinical implications for orthodontic treatment.
Animals ; Tooth Movement Techniques ; Tooth Movement ; Osteoprotegerin ; Role ; Movement ; Ethanol ; Bone Remodeling ; Caffeine ; Immunohistochemistry
3.Pattern of lymph node metastasis and p53 abnormal (p53abn) expression in preoperative early-stage endometrial cancer: A 5-year institutional experience.
Angeli Anne C. ANG ; Carolyn R. ZALAMEDA-CASTRO ; Cecile C. DUNGOG ; Michele H. DIWA ; Karen Cybelle J. SOTALBO
Acta Medica Philippina 2026;60(8):98-106
BACKGROUND
Early-stage endometrial cancer often presents with favorable survival rates, but high-risk factors, including TP53 mutations and high-grade serous pathology, can lead to recurrence and poor prognosis. The standard primary treatment for endometrial cancer is surgical staging, and lymph node metastases significantly impact adjuvant therapy decisions. The subgroup of p53-abnormal (p53abn) indicates the worst prognosis and potential benefits from adjuvant chemotherapy. Molecular classification, while recommended, faces practical challenges due to resource constraints.
OBJECTIVESThe study aimed to assess the incidence of p53 abnormal expression in clinical stage 1 endometrial cancer cases that underwent surgery at a government tertiary hospital, and assess its relationship with clinicopathologic factors and pelvic and paraaortic lymph node metastasis (LNM).
METHODSA cross-sectional retrospective analysis was conducted on clinical early-stage endometrial cancer cases that underwent surgical primary treatment between January 2018 and December 2022. Patient records were reviewed to gather demographics, surgical information, and pathological evaluations. Preoperative clinical staging was determined through imaging, and surgical staging involved comprehensive lymphadenectomy. Immunohistochemistry studies for p53 were carried out on formalin-fixed paraffin-embedded tissue samples.
RESULTSA total of 233 endometrial cancer cases were included. The mean age at diagnosis was 53.7 years. Common comorbidities included hypertension (47.2%) and dyslipidemia (20.6%). Most cases were endometrioid histology (82.8%) and low-grade tumors (85.8%). Tumor grade (p=0.010), myometrial invasion (pCONCLUSION
Tumor grade, myometrial invasion, and LVSI were all significantly associated with lymph node involvement. While p53 immunohistochemical stains show promise in predicting metastasis and has been associated with tumor aggressiveness, this should still be correlated with clinicopathological parameters to carry out a more accurate risk stratification of early-stage patients.
Therapeutics ; Survival Rate ; Risk Factors ; Recurrence ; Prognosis ; Pathology ; Endometrial Neoplasms ; Immunohistochemistry ; Tumor Suppressor Protein P53 ; Lymph Node Excision ; Risk Assessment
4.Role of caffeine and ethanol in modulating expression of Receptor Activator of Nuclear Factor κβ (RANK) and Osteoprotegerin (OPG) during orthodontic tooth movement: An in vivo study.
Ardiansyah S. PAWINRU ; Eka ERWANSYAH ; Eddy Heriyanto HABAR ; Abul FAUZI ; AMINULLAH ; Gita GAYATRI ; Yustisia PUSPITASARI ; Ita Purnama ALWI ; Andi Husnul HASANAH
Acta Medica Philippina 2026;60(8):115-122
BACKGROUND AND OBJECTIVES
Orthodontic tooth movement is driven by bone remodeling influenced by systemic factors, including caffeine and ethanol. This study aimed to investigate the effects of caffeine and ethanol on the expression of Receptor Activator of Nuclear Factor κβ (RANK) and Osteoprotegerin (OPG), key bone remodeling biomarkers, during orthodontic tooth movement.
METHODSA laboratory experimental study was conducted on 30 male Wistar rats divided into three groups: K1 (orthodontic force only), K2 (force + caffeine), and K3 (force + ethanol). Orthodontic force was applied using Ni-Ti coil springs. Caffeine and ethanol were administered orally daily. On days 7 and 14, maxillary tissues were collected and analyzed via immunohistochemistry for RANK and OPG expression. Data were analyzed using One-Way ANOVA and Independent Sample T-tests with significance at pRESULTS
Caffeine and ethanol administration increased RANK and OPG expression compared to controls; however, only the ethanol group showed a significant increase in RANK expression on day 14 (p = 0.044). OPG expression was significantly higher in treatment groups at both time points (pCONCLUSION
Caffeine and ethanol modulate bone remodeling marker expression during orthodontic force application, with ethanol significantly increasing RANK expression at later stages. Further studies are needed to clarify the clinical implications for orthodontic treatment.
Animals ; Tooth Movement Techniques ; Tooth Movement ; Osteoprotegerin ; Role ; Movement ; Ethanol ; Bone Remodeling ; Caffeine ; Immunohistochemistry
5.Aggressive gliomatosis peritonei associated with mature cystic teratoma: A case report.
Loryli Jan V. HAMOY ; Maria Lilibeth L. SIA SU
Philippine Journal of Obstetrics and Gynecology 2025;49(3):171-176
Gliomatosis peritonei (GP) is a condition characterized by the dissemination of mature glial tissues throughout the peritoneal cavity. It is usually associated with immature ovarian teratoma but presents with mature cystic teratoma (MCT) in 1% of cases. GP, associated with MCT, is a benign disorder. The majority of cases remain asymptomatic and rarely recur. Here, we present a case of a 22-year-old woman with a history of abdominal enlargement and severe abdominal pain who underwent exploratory laparotomy, peritoneal fluid cytology, bilateral salpingo-oophorectomy, appendectomy, omental biopsy, and Jackson-Pratt drain insertion with histopathologic result of GP with MCT. A month later, the patient had a recurrence of abdominal enlargement, necessitating a second surgery. Immunohistochemistry for histopathologic evaluation and diagnostic imaging are crucial in confirming the diagnosis and guiding the treatment strategy. A multidisciplinary team approach in monitoring and comprehensive support is significant in optimizing outcomes for patients with aggressive GPs associated with MCT. Further research and clinical experience are essential to establish a standardized guideline to improve the management and clinical outcome of this condition.
Human ; Female ; Young Adult: 19-24 Yrs Old ; Salpingo-oophorectomy ; Peritoneal Cavity ; Appendectomy ; Abdominal Pain ; Ascitic Fluid ; Immunohistochemistry
6.Clinicopathological Features and HOX Transcript Antisense RNA In Situ Hybridization Detection of Myxopapillary Ependymoma.
Yu-Han ZHANG ; Zheng WANG ; LU JUN-LIANG ; Da-Chun ZHAO ; Zhen HUO
Acta Academiae Medicinae Sinicae 2025;47(1):35-41
Objective To summarize the clinicopathological features,immunohistochemical characteristics,HOX transcript antisense RNA(HOTAIR)in situ hybridization status,treatment,and prognosis of myxopapillary ependymoma(MPE). Methods A total of 17 patients diagnosed with MPE based on pathological evidence in the Department of Pathology of Peking Union Medical College Hospital from November 2006 to July 2023 were selected,and the clinicopathological data of these patients were collected.Immunohistochemical staining for trimethylation at lysine 27 of histone H3 (H3K27me3),glial fibrillary acidic protein(GFAP),and epithelial membrane antigen(EMA)and alcian blue-periodic acid Schiff(AB-PAS)staining were performed in all the patients.Sixteen patients with spinal ependymomas were selected as the control group.Tissue microarrays were prepared from 17 MPE patients and the control group.HOTAIR ISH was performed and semi-quantitatively scored,and the scores of the two groups were compared by the Wilcoxon rank-sum test. Results The 17 MPE patients aged 14-64 years,with the mean age of(37.48±16.10)years and the male-to-female ratio of 0.7∶1.Their clinical manifestations mainly included lumbosacral and lower limb pains.Microscopically,tumor cells were arranged in a papillary pattern around fibrovascular axis,with abundant myxoid materials,and tumor cells were arranged in a loose meshwork in some patients.The immunohistochemical staining results showed that 17(100%),10(58.82%),and 8(47.06%)patients expressed GFAP,EMA,and D2-40,respectively,and 2(11.76%)patients lacked expression of H3K27me3.AB-PAS staining showed blue myxoid materials in all the 17(100%)patients.HOTAIR was expressed in both MPE and control groups,with higher semi-quantitative score in the MPE group than in the control group(P=0.004).Twelve patients were followed up,with a median follow-up period of 65.50 months,during which three patients showed recurrence.Conclusions MPE exhibits typical pathological features,and the combination with immunohistochemical staining for GFAP and EMA as well as AB-PAS staining facilitates diagnosis of this disease.A small number of patients loss the expression of H3K27me3.HOTAIR is highly expressed in MPE but lacks specificity,which limits its auxiliary diagnostic value.The overall prognosis of MPE is favorable,with a few patients experiencing recurrence.
Humans
;
Ependymoma/metabolism*
;
Male
;
Adult
;
Female
;
Adolescent
;
Middle Aged
;
In Situ Hybridization
;
Young Adult
;
RNA, Antisense/genetics*
;
Immunohistochemistry
;
Prognosis
7.Value of Ultrasonographic Features Combined With Immunohistochemistry in Predicting Axillary Lymph Node Metastasis in Middle-Aged Women With Breast Cancer.
Qian-Kun CHANG ; Wen-Ying WU ; Chun-Qiang BAI ; Zhi-Chao DING ; Wei-Fang WANG ; Ming-Han LIU
Acta Academiae Medicinae Sinicae 2025;47(4):550-556
Objective To investigate the value of ultrasonographic features combined with immunohistochemistry in predicting axillary lymph node metastasis in middle-aged women with breast cancer.Methods A retrospective analysis was conducted on 827 middle-aged female breast cancer patients who underwent surgical treatment at the Affiliated Hospital of Chengde Medical University from June 2017 to June 2023.Ultrasonographic and immunohistochemical information was collected,and the patients were randomly allocated into a training set(579 patients)and a validation set(248 patients).Univariate and multivariate Logistic regression analyses were performed to identify ultrasonographic and immunohistochemical risk factors associated with axillary lymph node metastasis in these patients,and a nomogram model was developed.Receiver operating characteristic curves and calibration curves were established to evaluate the performance of the nomogram model,and clinical decision curves were built to assess the clinical value of the model.Results The maximum diameter,morphology,boundary,calcification,and expression of human epidermal growth facor receptor 2 and Ki-67 in breast cancer lesions were identified as risk factors for predicting axillary lymph node metastasis in middle-aged women.The areas under the curve of the nomogram model on the training and validation sets were 0.747(0.707-0.787)and 0.714(0.647-0.780),respectively.Calibration curves and clinical decision curves indicated good consistency and performance of the model.Conclusion The nomogram model constructed based on ultrasonographic features and immunohistochemistry of the primary breast cancer lesion demonstrates high value in predicting axillary lymph node metastasis in middle-aged women with breast cancer.
Humans
;
Female
;
Breast Neoplasms/diagnostic imaging*
;
Middle Aged
;
Lymphatic Metastasis/diagnostic imaging*
;
Axilla
;
Retrospective Studies
;
Nomograms
;
Ultrasonography
;
Immunohistochemistry
;
Lymph Nodes/diagnostic imaging*
;
Risk Factors
;
Ki-67 Antigen
8.SMARCB1 (INI-1)-deficient sinonasal carcinoma:A case report and its clinical implications on diagnosis and management.
Dianne Mae TAN ; Glezette Anne ALTARES ; Rose Lou Marie AGBAY ; Jose CARNATE JR.
Philippine Journal of Pathology 2025;10(2):63-67
SMARCB1 (INI-1)-deficient sinonasal carcinoma is a rare, poorly differentiated, and locally aggressive neoplasm. Frequently, this disease entity mimics benign head and neck conditions, making diagnosis and management challenging. We report the case of a 66-year-old female who presented with a right nasal mass on endoscopy. Microscopy revealed well-defined nests of plasmacytoid tumor cells infiltrating a desmoplastic stroma, with areas of necrosis and focal hemorrhage. Based on the histomorphology and immunohistochemistry studies, the case was signed out as SMARCB1 (INI-1)-deficient sinonasal carcinoma. This is the first reported case in the Philippines based on a search of local journal databases. Recent advancements in therapeutics highlight the importance of providing molecular characterization of these tumors.
Human ; Carcinoma ; Hemorrhage ; Immunohistochemistry ; Endoscopy
9.Metastatic adenocarcinoma presenting as an orbital mass with orbital apex involvement: Application of immunohistochemistry in diagnostic ophthalmic pathology.
Farida Marcelle VERGARA ; Stacey COHITMINGAO ; Earl SARABOSING
Philippine Journal of Ophthalmology 2025;50(2):117-121
OBJECTIVE
To report a case of orbital apex syndrome due to metastatic adenocarcinoma of the orbit in an adult male.
METHODSThis is a case report.
RESULTSA 52-year-old male presented with a subacute onset of ophthalmoplegia, ptosis, and vision loss secondary to an optic neuropathy. Orbital apex syndrome was the primary consideration. Laboratory workup ruled out infectious and inflammatory etiologies. Neuroimaging revealed an irregular, intraconal mass in the left orbit. During the disease course, a new supraorbital mass lesion was noted. Incisional biopsy, histopathology and immunohistochemistry (IHC) revealed positive Cytokeratin 7 and negative Cytokeratin 20 expression, suggestive of metastatic adenocarcinoma.
CONCLUSIONDiagnosis of orbital apex syndrome requires careful integration of clinical evaluation, laboratory testing, and imaging. When a mass lesion is present, biopsy and IHC staining can be critical in determining the primary origin of a malignancy.
Human ; Male ; Middle Aged: 45-64 Yrs Old ; Ophthalmoplegia ; Immunohistochemistry ; Adenocarcinoma
10.Expression Levels of EZH2 and KMT2D in Patients with Diffuse Large B-Cell Lymphoma and Their Relationship with Pathological Features.
Peng PENG ; Wen-Rong ZOU ; Yang-Lu BAI ; Yan GUO ; Ning ZHOU ; Xue-Jia FENG
Journal of Experimental Hematology 2025;33(3):769-776
OBJECTIVE:
To investigate the expression levels of EZH2 and KMT2D in patients with diffuse large B-cell lymphoma (DLBCL) and their relationship with pathological features.
METHODS:
84 patients with DLBCL treated in our hospital from January 2021 to June 2022 were selected as the study subjects, and clinical characteristics such as sex, age and pathological classification of the patients were collected. Immunohistochemistry was used to detecet the expression of KMT2D and EZH2 proteins in tumor tissue cells of the DLBCL patients. The differential expression of KMT2D and EZH2 in subgroups of different sexes, ages, primary sites, clinical stages, Hans subtypes, etc. were compared. The correlation between the expression of KMT2D and EZH2 protein and BCL-6, CD79A was analyzed and validated through the interaction of protein molecular structures. We followed up and recorded the survival status of the patients for 12 months, and analyzed the factors that affect the mortality of DLBCL patients.
RESULTS:
The positive rate of KMT2D and EZH2 was high (over 95%) in DLBCL patients. There was no significant difference in the expression of EZH2 and KMT2D among subgroups of different sexes, ages and stages (P >0.05). However, patients with different levels of BCL-6 and CD79A expression showed differences in EZH2 and KMT2D expression (P < 0.05). EZH2 and KMT2D were positively correlated with BCL-6 (r =0.391, r =0.332) and CD79A (r =0.309, r =0.258), respectively, and there were interactions in the protein molecular structures. The risk factors for mortality in DLBCL patients include male sex (OR =1.106, 95%CI : 1.082-1.130, P < 0.001), stage II (OR =1.778, 95%CI : 1.567-2.016, P < 0.001), stage IV (OR =2.233, 95%CI : 2.021-2.467, P < 0.001), EZH2 positive (OR =2.762, 95%CI : 1.304-5.850, P =0.008), BCL-6 positive (OR =7.309, 95%CI : 1.340-39.859, P =0.022), age≥74 years (OR =3.080, 95%CI : 1.658-5.723, P < 0.001), and 63-73 years old (OR =2.400, 95%CI : 1.564-3.682, P < 0.001), while KMT2D positive (OR =0.180, 95%CI : 0.054-0.608, P =0.006) and 41-51 years old (OR =0.406, 95%CI : 0.274-0.603, P < 0.001) were factors which could reduce the risk of mortality.
CONCLUSION
EZH2 and KMT2D are highly expressed in patients with DLBCL, and they are positively correlated with BCL-6 and CD79A, and affect the prognosis of DLBCL patients.
Humans
;
Enhancer of Zeste Homolog 2 Protein/metabolism*
;
Lymphoma, Large B-Cell, Diffuse/metabolism*
;
DNA-Binding Proteins/metabolism*
;
Female
;
Male
;
Middle Aged
;
Adult
;
Neoplasm Proteins/metabolism*
;
Aged
;
Immunohistochemistry
;
Proto-Oncogene Proteins c-bcl-6/metabolism*
;
Prognosis


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