A prognosis based classification of undifferentiated uterine sarcomas: Identification of mitotic index,hormone receptors and YWHAE‐FAM22 translocation status as predictors of survival

Undifferentiated uterine sarcomas (UUS) are rare tumors with a heterologous biology and a poor prognosis. The goal of this study was to examine clinicopathology, biomarkers and YWHAE‐FAM22 translocation status, in the prognosis of these tumors. Twenty‐six cases of UUS were included. All original slides were rereviewed and age at diagnosis, tumor stage, “Kurihara” diagnosis, mitotic index, presence of necrosis and grade of nuclear atypia were recorded. Additionally, a tissue microarray was constructed from 22 of the cases, and the protein biomarkers P53, P16, Ki‐67, Cyclin‐D1, ER, PR and ANLN were evaluated by immunohistochemistry. All tumors were evaluated for the presence of a YWHAE‐FAM translocation; the translocation was demonstrated in the three Cyclin‐D1 positive tumors. Follow‐up data in the form of overall survival were available on all patients. These tumors could be divided into two prognostic groups, a high mitotic index group (10 cases, M = 36.8, SD = 5.4) and a low mitotic index group (16 cases, M = 8.7, SD = 5.8). These two groups showed a statistically significant difference in prognosis. The expression of ER, PR or presence of the YWHAE‐FAM22 translocation correlated with low mitotic index and an additionally improved prognosis, although the number of cases was small. These results indicate that UUS can be divided into two prognostic groups using mitotic index as a primary criteria, followed by expression of either ER, PR or the presence of a YWHAE‐FAM22 translocation as a secondary criteria. This study demonstrates the presence of statistically significant prognostic subgroups within UUS, and provides treatment insights.     

Anti-Toxoplasma gondii Antibody Levels in Blood Supply of Shiraz Blood Transfusion Institute,Iran

Background

The prevalence of Toxoplasma gondii infection in the blood donors has been poorly studied. The aim of this study was to assess the prevalence of acute and chronic toxoplasmosis in blood products.

Methods

A total of 250 blood products (112 fresh frozen plasma and 138 packed cells) in the Blood Transfusion Institute, Shiraz, Iran were tested for specific T. gondii antibodies (IgG and IgM) by ELISA method in 2013. Positive IgG anti-T. gondii samples were further tested for IgM anti-T. gondii antibody. A positive IgG test with the negative and positive IgM test was interpreted as a chronic and acute toxoplasmosis, respectively. The relationship of jobs, blood types, sex, marital status and residency of participants with chronic toxoplasmosis prevalence were statistically analyzed by χ².

Results

Of 250 samples, 58 (23.2%) and one were positive for IgG anti-T. T. gondii (chronic) and IgM anti-T. T. gondii (acute) antibodies levels, respectively. Twenty nine (25.9%) of fresh frozen plasma (FFP) samples were positive for IgG anti-T. gondiiiand 1(0.89%) of them was positive for IgM anti-T. gondiii antibody. Thirty (21.74%) of packed cell samples were positive for IgG anti-T. gondii antibody. The prevalence of chronic toxoplasmosis was significantly higher in workers, farmers, house wives, unemployed and free jobs (P=0.007), people with low education levels (P=0.035) and B type of blood ABO system (P=0.0001). However, there were no significant differences regarding to age, sex, marital status, residency and type of blood products.

Conclusions

There were chronic and acute toxoplasmosis in blood products and the prevalence of toxoplasmosis especially chronic form was high. Therefore screening of blood for T. gondii antibodies may be considered.     

Inverse relationship between body mass index and coronary artery calcification in patients with clinically significant coronary lesions

AimsMounting data support a ‘calcification paradox’, whereby reduced bone mineral density is associated with increased vascular calcification. Furthermore, reduced bone mineral density is prevalent in older persons with lower body mass index (BMI). Therefore, although BMI and coronary artery calcification (CAC) exhibit a positive relationship in younger persons, it is predicted that in older persons and/or those at risk for osteoporosis, an inverse relationship between BMI and CAC may apply. We sought to explore this hypothesis in a large group of patients with coronary artery disease undergoing percutaneous coronary intervention (PCI).Methods and resultsWe accessed our single-center registry for 07/01/1999 to 06/30/2009, extracting data on all patients that underwent PCI. To minimize bias we excluded those at the extremes of age or BMI and non-Black/Hispanic/Caucasians, leaving 9993 study subjects (age 66.6 ± 9.9 years). Index lesion calcification (ILC) was analyzed with respect to BMI. Comparing index lesions with no angiographic calcification to those with the most severe, mean BMI decreased by 1.11 kg m^?2; a reduction of 3.9% (P < 0.0001). By multivariable modeling, BMI was an independent inverse predictor of moderate–severe ILC (m-sILC; odds ratio [OR] 0.967, 95% CI 0.953–0.980, P < 0.0001). Additional fully adjusted models identified that, compared to those with normal BMI, obese patients had an OR of 0.702 for m-sILC (95% CI 0.596–0.827, P < 0.0001).ConclusionsIn a large group of PCI patients, we identified an inverse correlation between BMI and index lesion calcification. These associations are consistent with established paradigms and suggest a complex interrelationship between BMI, body size and vascular calcification.