BACKGROUND Crohn’s disease(CD)patients with intestinal involvement often require surgical intervention due to resistance to medical therapy.Postoperative recurrence remains a significant challenge,with the Rutgeerts ...BACKGROUND Crohn’s disease(CD)patients with intestinal involvement often require surgical intervention due to resistance to medical therapy.Postoperative recurrence remains a significant challenge,with the Rutgeerts score commonly used to predict endoscopic recurrence.AIM To evaluate the relationship between microscopic and macroscopic pathological findings in resected intestinal specimens and the Rutgeerts score to predict endoscopic recurrence in CD patients.METHODS This retrospective cohort study included 32 patients over 18 years of age with intestinal CD who underwent surgery at General Surgery Clinic of Ankara Bilkent City Hospital between November 2019 and October 2023.Resection specimens were histopathologically re-examined,and postoperative colonoscopy reports were classified according to the Rutgeerts score.The association between pathological findings and endoscopic recurrence was analyzed statistically.RESULTS No significant association was found between macroscopic findings and Rutgeerts scores or endoscopic recurrence(P>0.05).However,the presence and severity of neutrophilic cryptitis(P=0.035)and crypt abscesses(P=0.010)in microscopic findings were significantly associated with higher Rutgeerts scores,indicating a parallel increase with endoscopic recurrence.Other microscopic findings showed no significant correlation with Rutgeerts scores or endoscopic recurrence(P>0.05).CONCLUSION The presence of neutrophilic cryptitis and crypt abscesses in resected intestinal specimens of CD patients increases the likelihood of endoscopic recurrence.Early postoperative medical treatment and close endoscopic follow-up may benefit high-risk patients to prevent recurrence,with treatment decisions made by a weekly multidisciplinary council involving General Surgery,Gastroenterology,and Radiology.展开更多
Mallory-Denk Bodies(MDB) are important as investigators,suggesting MDB as an indicator of the histologic severity of chronic hepatitis,causes of which include hepatitis C,primary biliary cirrhosis(PBC),and nonalcoholi...Mallory-Denk Bodies(MDB) are important as investigators,suggesting MDB as an indicator of the histologic severity of chronic hepatitis,causes of which include hepatitis C,primary biliary cirrhosis(PBC),and nonalcoholic fatty liver disease(NAFLD).Matteoni et al scored MDB in patients with NAFLD as none,rare and many,and reported that MDB plays a prominent role in this classification scheme in an earlier classification system.In this study,we evaluated 258 patients with chronic hepatitis due to metabolic,autoimmune and viral etiologies.Liver biopsy samples were evaluated with hematoxylin and eosin,periodic acid-Schiff-diastase,Gordon and Sweet's reticulin,Masson's trichrome,and iron stains.Both staging and grading were performed.Additionally,MDB were evaluated and discussed for each disease.We examined patients with nonalcoholic steatohepatitis(NASH;50 patients),alcoholic hepatitis(10 patients),PBC(50 patients),Wilson disease(WD;20 patients),hepatitis B(50 patients),hepatitis C(50 pati-ents) and hepatocellular carcinoma(HCC;30 patients).Frequency of MDB was as follows;NASH:10 patients with mild in 60% and moderate in 40% and observed in every stage of the disease and frequently seen in zone 3.PBC:11 patients with mild in 10%,moderate in 70%,and cirrhosis in 20%,and frequently seen in zone 1.WD:16 patients with moderate and severe in 60% and cirrhosis in 40% and frequently seen in zone 1.Hep B:3 patients with mild in 66% and severe in 34%.Hep C:7 patients with mild in 40% and moderate in 60% and observed in every stage.HCC:3 patients with hep B in 2 patients.We found that there is no relationship between MDB and any form of chronic hepatitis regarding histologic severity such as alcoholic steatohepatitis and NAFLD and variable zone distribution by etiology.展开更多
BACKGROUND Pancreatic,periampullary/ampullary,and choledochal adenocarcinomas are aggressive malignancies with a poor prognosis.Immune checkpoint blockade is a promising treatment option for several tumor types.H long...BACKGROUND Pancreatic,periampullary/ampullary,and choledochal adenocarcinomas are aggressive malignancies with a poor prognosis.Immune checkpoint blockade is a promising treatment option for several tumor types.H long terminal repeatassociating 2(HHLA2),which is analogous to programmed death-ligand 1(PDL1),is a recently discovered member of the B7/cluster of differentiation 28 family and is expressed in many malignancies.AIM To analyze the expression of HHLA2 and its association with the pathologic biomarkers that predict sensitivity to immunotherapy.METHODS Ninety-two adenocarcinoma cases located in the pancreas,ampulla,and distal common bile duct were identified.This study assessed 106 pancreaticoduodenectomy and distal/total pancreatectomy samples that were delivered to Ankara City Hospital between 2019 and 2021.Immunohistochemistry was conducted to examine the expression of DNA mismatch repair(MMR),PD-L1,and HHLA2 proteins.RESULTS Patients with high HHLA2 expression had a higher mean age than those with low expression.Low HHLA2 expression was associated with high perineural invasion.HHLA2 expression was low in pathological stage T3(pT)3 cases and high in pathological stage T1,T2,and T4 cases.There was no correlation between HHLA2 expression and the expression of MMR proteins and PD-L1.CONCLUSION Evaluation of HHLA2 expression in microsatellite stable and PD-L1-negative tumors may be useful for predicting the response of individuals to immunotherapy and may serve as a novel therapeutic target for immunotherapy in advanced-stage disease.展开更多
文摘BACKGROUND Crohn’s disease(CD)patients with intestinal involvement often require surgical intervention due to resistance to medical therapy.Postoperative recurrence remains a significant challenge,with the Rutgeerts score commonly used to predict endoscopic recurrence.AIM To evaluate the relationship between microscopic and macroscopic pathological findings in resected intestinal specimens and the Rutgeerts score to predict endoscopic recurrence in CD patients.METHODS This retrospective cohort study included 32 patients over 18 years of age with intestinal CD who underwent surgery at General Surgery Clinic of Ankara Bilkent City Hospital between November 2019 and October 2023.Resection specimens were histopathologically re-examined,and postoperative colonoscopy reports were classified according to the Rutgeerts score.The association between pathological findings and endoscopic recurrence was analyzed statistically.RESULTS No significant association was found between macroscopic findings and Rutgeerts scores or endoscopic recurrence(P>0.05).However,the presence and severity of neutrophilic cryptitis(P=0.035)and crypt abscesses(P=0.010)in microscopic findings were significantly associated with higher Rutgeerts scores,indicating a parallel increase with endoscopic recurrence.Other microscopic findings showed no significant correlation with Rutgeerts scores or endoscopic recurrence(P>0.05).CONCLUSION The presence of neutrophilic cryptitis and crypt abscesses in resected intestinal specimens of CD patients increases the likelihood of endoscopic recurrence.Early postoperative medical treatment and close endoscopic follow-up may benefit high-risk patients to prevent recurrence,with treatment decisions made by a weekly multidisciplinary council involving General Surgery,Gastroenterology,and Radiology.
文摘Mallory-Denk Bodies(MDB) are important as investigators,suggesting MDB as an indicator of the histologic severity of chronic hepatitis,causes of which include hepatitis C,primary biliary cirrhosis(PBC),and nonalcoholic fatty liver disease(NAFLD).Matteoni et al scored MDB in patients with NAFLD as none,rare and many,and reported that MDB plays a prominent role in this classification scheme in an earlier classification system.In this study,we evaluated 258 patients with chronic hepatitis due to metabolic,autoimmune and viral etiologies.Liver biopsy samples were evaluated with hematoxylin and eosin,periodic acid-Schiff-diastase,Gordon and Sweet's reticulin,Masson's trichrome,and iron stains.Both staging and grading were performed.Additionally,MDB were evaluated and discussed for each disease.We examined patients with nonalcoholic steatohepatitis(NASH;50 patients),alcoholic hepatitis(10 patients),PBC(50 patients),Wilson disease(WD;20 patients),hepatitis B(50 patients),hepatitis C(50 pati-ents) and hepatocellular carcinoma(HCC;30 patients).Frequency of MDB was as follows;NASH:10 patients with mild in 60% and moderate in 40% and observed in every stage of the disease and frequently seen in zone 3.PBC:11 patients with mild in 10%,moderate in 70%,and cirrhosis in 20%,and frequently seen in zone 1.WD:16 patients with moderate and severe in 60% and cirrhosis in 40% and frequently seen in zone 1.Hep B:3 patients with mild in 66% and severe in 34%.Hep C:7 patients with mild in 40% and moderate in 60% and observed in every stage.HCC:3 patients with hep B in 2 patients.We found that there is no relationship between MDB and any form of chronic hepatitis regarding histologic severity such as alcoholic steatohepatitis and NAFLD and variable zone distribution by etiology.
文摘BACKGROUND Pancreatic,periampullary/ampullary,and choledochal adenocarcinomas are aggressive malignancies with a poor prognosis.Immune checkpoint blockade is a promising treatment option for several tumor types.H long terminal repeatassociating 2(HHLA2),which is analogous to programmed death-ligand 1(PDL1),is a recently discovered member of the B7/cluster of differentiation 28 family and is expressed in many malignancies.AIM To analyze the expression of HHLA2 and its association with the pathologic biomarkers that predict sensitivity to immunotherapy.METHODS Ninety-two adenocarcinoma cases located in the pancreas,ampulla,and distal common bile duct were identified.This study assessed 106 pancreaticoduodenectomy and distal/total pancreatectomy samples that were delivered to Ankara City Hospital between 2019 and 2021.Immunohistochemistry was conducted to examine the expression of DNA mismatch repair(MMR),PD-L1,and HHLA2 proteins.RESULTS Patients with high HHLA2 expression had a higher mean age than those with low expression.Low HHLA2 expression was associated with high perineural invasion.HHLA2 expression was low in pathological stage T3(pT)3 cases and high in pathological stage T1,T2,and T4 cases.There was no correlation between HHLA2 expression and the expression of MMR proteins and PD-L1.CONCLUSION Evaluation of HHLA2 expression in microsatellite stable and PD-L1-negative tumors may be useful for predicting the response of individuals to immunotherapy and may serve as a novel therapeutic target for immunotherapy in advanced-stage disease.
