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Biomedical subjects

E Sivridis

Publications and source records attributed to E Sivridis.

At least 19 recordsLinked to original sources

Hypoxia inducible factors 1alpha and 2alpha are associated with VEGF expression and angiogenesis in gallbladder carcinomas.

AIMS: To investigate the significance of the hypoxia inducible factors HIF-1alpha and HIF-2alpha in gallbladder adenocarcinomas and their relation to angiogenesis and to the expression of VEGF, an angiogenic factor transcriptionally regulated by HIFalphas. METHODS: HIF-1alpha and 2alpha expression was assessed immunohistochemically in 60 patients with early gallbladder adenocarcinomas, treated with surgery alone. In addition, the vascular density (VD) and the expression of the angiogenic factors VEGF and thymidine phosphorylase (TP) were examined. The results were correlated with clinico-pathological features and prognosis. RESULTS: Overexpression of HIF-1alpha and 2alpha was significantly associated with increased tumor angiogenesis and VEGF expression, while HIF-2alpha was linked with upregulation of TP. None of these factors were associated with T-stage and tumor grade. Although HIFs did not relate significantly with prognosis, patients with HIF-1/2 expression who failed to switch-on VEGF or intratumoral angiogenesis had a favorable outcome. CONCLUSION: Hypoxia inducible factors are upregulated in a large proportion of gallbladder adenocarcinomas, a feature strongly related to increased expression of VEGF and intensified angiogenesis.

Adenocarcinoma↗

Comparison of angiogenic activity after urethral reconstruction using free grafts and pedicle flap: an experimental study.

PURPOSE: An experimental study was undertaken in order to estimate the angiogenic activity in different free grafts and pedicle flap in urethral reconstruction in an animal model. METHODS: Twenty-eight white New Zealand rabbits were randomly divided into five groups (O, A, B, C and D). A ventral urethral defect was created in all groups. In the group O, (n = 4), a simple closure of the defect was performed. Free penile skin graft (group A, n = 6), buccal mucosal graft (group B, n = 6), bladder mucosal graft (group C, n = 6), and pedicle penile skin graft (group D, n = 6) were used to bridge the urethral defect as an onlay patch. The animals were euthanized on the 21st postoperative day. The angiogenic activity was assessed with immunohistochemistry, using the anti-CD31 MoAb and the alkaline phosphatase antialkaline phosphatase procedure. The native vascularity of penile skin as well as buccal and bladder mucosa was assessed in rabbits from group O (n = 3). Statistical analysis was performed using one-way ANOVA. RESULTS: The angiogenesis seen with a magnification of x 200 in groups O, A, B, C, and D was 34.1 +/- 4.1 (mean +/- SD), 61.7 +/- 6.4, 94.3 +/- 6.4, 91.5 +/- 7.2, and 30.8 +/- 5.2 vessels per optical field, respectively. There were statistically significant differences (p < 0.001) between group O and groups A, B, C and between group A and groups B, C, D, but not (p > 0.5) between groups B and C and groups O and D. The native vascularity of penile skin, buccal mucosa and bladder mucosa was 23.3 +/- 3.0, 24.6 +/- 3.7 and 17.0 +/- 2.6 vessels per optical field, respectively. CONCLUSION: Buccal and bladder mucosal grafts exhibit a higher angiogenic activity than free and pedicle penile skin flap when transplanted in urethral defects. As the buccal mucosal graft showed the higher angiogenic activity and its harvesting is easier than bladder mucosa, we propose that in urethral reconstruction surgery the use of this graft might offer more reliable results.

Animals↗

Angiogenic effect of intramuscular administration of basic and acidic fibroblast growth factor on skeletal muscles and influence of exercise on muscle angiogenesis.

BACKGROUND: Angiogenic factors which control the angiogenic process represent a promising strategy for restoration of blood flow, but require further evaluation before clinical use. Exercise has also been reported to induce neovascularisation in muscles. OBJECTIVES: To evaluate the angiogenic effects of basic fibroblast growth factor (b-FGF) and acidic fibroblast growth factor (a-FGF) on rat gastrocnemius muscle, when administered intramuscularly, and to compare them with those obtained by daily exercise. METHODS: Forty nine rats were allotted to the following groups: A, controls; B, exercise by swimming; C1 and C2, intramuscular injection of b-FGF and a-FGF respectively; D1 and D2, b-FGF and a-FGF injection in combination with exercise. The antibody mouse anti-rat CD31 was used to evaluate the numbers of blood vessels present in histological preparations of gastrocnemius muscle. RESULTS: Significant increases in the numbers of blood vessels of the right gastrocnemius muscles in groups C1 and D1 were observed compared with controls (p<0.05). There was only a slight increase in angiogenesis in the left gastrocnemius muscle of groups C1 and D1 compared with controls (p>0.05), and there was a decrease in angiogenesis in the gastrocnemius muscle of the swimming group compared with controls. CONCLUSION: The intramuscular administration of b-FGF, but not a-FGF, induced significant local angiogenesis in gastrocnemius muscle at the site of injection.

Animals↗

Endometrial carcinoma and diabetes revisited.

OBJECTIVE: To investigate whether endometrial adenocarcinomas are intrinsically different in diabetic as compared to non-diabetic patients. METHODS: A series of 208 patients with histologically confirmed endometrial adenocarcinomas were divided into groups of diabetic (n = 63) and non-diabetic (n = 145) patients. The two groups were compared in terms of tumor morphology, FIGO stage, clinical risk factors and 12-year survival. RESULTS: A history of a second neoplasia was significantly more frequent in diabetic than in non-diabetic patients (p = 0.001), but other endometrial cancer associated characteristics, such as tumor morphology, FIGO stage, obesity, hypertension, nulliparity, estrogen use and menopausal status did not differ between the groups. More importantly, the two groups had a similar 12-year survival rate (p = 0.8742). CONCLUSIONS: A second neoplasia occurred significantly more frequently in diabetic than in non-diabetic patients with endometrial carcinoma, but long-term survival and other clinical and histological features were the same in the two groups. These results indicate that endometrial adenocarcinoma is not intrinsically different in diabetic patients.

Adenocarcinoma↗

LYVE-1 immunohistochemical assessment of lymphangiogenesis in endometrial and lung cancer.

AIMS/METHODS: Normal and malignant pulmonary and endometrial tissues were analysed for lymphatic vessels to assess the process of lymphangiogenesis and its role at these sites, using specific immunostaining for LYVE-1 and the panendothelial marker CD31. RESULTS: Lymphatics were clearly demonstrated in some normal tissues (myometrium, bronchial submucosa, and intestinal submucosa), but not in others (endometrium and alveolar tissue). LYVE-1 positive lymphatic vessels were detected at the tumour periphery of endometrial and lung carcinomas, but not within the main tumour mass. Double staining for LYVE-1 and the MIB1 proliferation marker revealed a higher proliferation index in lymphatic endothelial cells at the invading front of endometrial carcinomas, compared with myometrial areas distal to the tumour. Lung and endometrial carcinomas did not have an intratumorous lymphatic network. CONCLUSIONS: Although lymphangiogenesis may occur at the invading tumour front, incorporated lymphatics do not survive. Therefore, the dissemination of cancer cells through the lymphatics may occur by invasion of peripheral cancer cells into the adjacent normal lymphatics, or through shunts eventually produced at the invading tumour front as a consequence of active angiogenesis and lymphangiogenesis.

Adenocarcinoma↗

Proliferating fibroblasts at the invading tumour edge of colorectal adenocarcinomas are associated with endogenous markers of hypoxia, acidity, and oxidative stress.

BACKGROUND: Stroma frequently forms at sites of active tumour invasion, and may be important for tumour growth and progression. The term "stromatogenesis" is used to describe this unique process that involves host peritumorous fibroblasts and is very different to reactive fibrosis. AIMS/METHODS: To investigate the activation status of host fibroblasts at the invading tumour edge, assessed as MIB1 proliferation index and thymidine phosphorylase (TP) expression. Results were related to vascular density and certain properties of invading cancer cells-MIB1 proliferation activity, TP expression, expression of endogenous markers of hypoxia (hypoxia inducible factor-1alpha; HIF1alpha) and acidity (lactate dehydrogenase-5; LDH5). Standard immunohistochemical techniques were applied to 150 colorectal adenocarcinomas. RESULTS: Normal fibroblasts at the tumour edge had a median MIB1 index of 2%-significantly higher than normal submucosal fibroblasts (0.3%) and significantly lower than cancer cells (40%). Normal peritumorous fibroblasts with a proliferation rate above the median strongly expressed TP and were supported by an increased vascular network. Cancer cells close to these fibroblasts had a high MIB1 proliferative index, high HIF1alpha and LDH5 reactivity, and a clear trend to extramural extension. All associations were significant. CONCLUSIONS: These results suggest that activated fibroblastic status at the invading tumour front sets the stage for stromatogenesis and new blood vessel formation, facilitating deep transmural invasion in colorectal adenocarcinomas. This complicity of peritumorous fibroblasts in the overall aggressiveness/invasive and metastatic ability of colorectal tumours, occurring within the framework of cancer-stromal cell interactions, is probably favoured by the altered microenvironmental conditions of hypoxia and acidity.

Adenocarcinoma↗

Angiogenesis and vascular survival ability in ovarian adenocarcinomas.

This study was designed to investigate the prognostic relevance of ovarian tumour angiogenesis in terms of tumour angiogenic activity (TAA) and vascular survival ability (VSA), i.e. the ability of newly formed vessels to survive once incorporated into the main tumour mass. TAA was assessed at the edge of the invading tumour, while VSA was evaluated in inner tumour areas, always in comparison with the invading edge. A series of 46 ovarian grade-1 adenocarcinomas of the endometrioid and the serous cell type was assessed. Endothelial cells were revealed after using a standard immunohistochemical technique and the CD31 antibody. Vascular density was, in general, higher at the periphery of the tumour than in the inner tumour areas, although in both cases, a rich vascular supply was associated with a poor survival. By combining counts at the tumour edge versus inner tumour areas (edvin), four groups of tumour vascularity emerged: edvin type 1 (low TAA/low VSA), edvin type 2 (low TAA/high VSA), edvin type 3 (high TAA/low VSA) and edvin type 4 (high TAA/high VSA). Edvin type-4 tumours were related to the most unfavourable prognosis. It is concluded that VSA and TAA are complementary procedures in assessing ovarian tumour vasculature and, therefore, prognosis, and by combining the two parameters, a more precise impression of the state of vascularisation in the ovary is obtained, which may prove useful in designing anti-angiogenic therapies.

Adenocarcinoma↗

Extramedullary plasmacytoma: report of two cases with uncommon presentation.

Lymph node infiltration by monoclonal plasma cells can occur either in aggressive forms of myeloma or may represent regional extension of extramedullary plasmacytomas, whereas lymph node plasmacytoma presenting as a solitary extramedullary plasmacytoma is very unusual. We report two cases of lymph node plasmacytomas without systemic disease diagnosed after surgical excision. Clinical remission was achieved after local radiotherapy although one patient relapsed with multifocal extramedullary plasmacytomas 20 months after radiotherapy.

Abdominal Neoplasms↗

Tumour angiogenic activity and vascular survival ability in bladder carcinoma.

BACKGROUND: Tumour angiogenic activity (TAA) is an important prognostic factor in many human tumours, including transitional cell carcinomas of the urinary bladder. The new tumour vessels are formed in the invading tumour front. This peripheral tumour area is internalised as soon as the growing tumour forms a new front. AIMS: To investigate and compare TAA with the ability of the tumour vasculature to survive (VSA) in inner tumour areas. METHODS: Fifty one cystectomy specimens with transitional cell carcinoma of the urinary bladder were studied. Sections were stained immunohistochemically for endothelial cells and proliferation activity, using the monoclonal antibodies CD31 and MIB-1, respectively. TAA was studied at the invading tumour edge-designated as the mean number of blood vessels in three "hot spots" at this site. VSA was assessed by comparing the vascular density in peripheral and inner tumour areas. RESULTS: High TAA at the invading tumour edge significantly correlated with lymph node involvement, but not with patient survival. Extensive lymphocytic infiltration was more frequent in tumours with high TAA. VSA was significantly higher in tumours of high proliferation index, high histological grade, advanced T stage, and poor prognosis. However, there was no association with metastasis to regional lymph nodes. CONCLUSION: VSA and TAA provide a more complete profile of the tumour vasculature and are associated with aggressive tumour behaviour in transitional cell carcinomas of the urinary bladder. The qualitative information provided by VSA may be important for the identification of angiogenic tumours with differential responses to various antiangiogenic treatments.

Adult↗

Proliferative activity in postmenopausal endometrium: the lurking potential for giving rise to an endometrial adenocarcinoma.

AIMS: To investigate proliferation in disease free postmenopausal endometrium and that harbouring endometrial adenocarcinoma-is there a dynamic, yet lurking, potential for atrophic endometrium to give rise to endometrial adenocarcinoma? MATERIAL/METHODS: The study comprised 84 disease free endometria from asymptomatic postmenopausal women who had undergone hysterectomy for prolapse, and 50 endometrioid cell type endometrial adenocarcinomas with adjacent uninvolved postmenopausal endometrium. The non-neoplastic tissues were separated histologically into active, inactive, and mixed forms, although only the first two categories were studied immunohistochemically for oestrogen and progesterone receptors (ERs, PRs), epidermal growth factor receptor (EGFR), Ki-67, and angiogenic activity. RESULTS: All postmenopausal endometria were atrophic, but only 42 were inactive; of the remaining samples, 22 were weakly proliferative and 20 were mixed active and inactive. In contrast, the non-neoplastic component of 43 of the 50 endometrial adenocarcinomas examined was of the active form; four specimens were of the pure and 39 of the mixed form. Interestingly, high ER and PR expression was seen in active and inactive endometria, but only the former were EGFR positive and had high proliferative (Ki-67) and angiogenic activity. A similar trend was also shown by the non-neoplastic atrophic endometrium adjacent to endometrial adenocarcinoma. CONCLUSIONS: At least half of the disease free postmenopausal atrophic endometria show a weak proliferative pattern, either diffuse or focal, probably as a response to continuous low level oestrogenic stimulation. These tissues have a latent, although very small, carcinogenic potential, as demonstrated by the immunohistochemical profile and their frequent association with adjacent endometrial adenocarcinoma.

Adenocarcinoma↗

New insights into the normal menstrual cycle-regulatory molecules.

Although the growth and regression of the endometrium is primarily a function of the ovarian hormones, recent studies indicate a potential autocrine/paracrine role for regulatory molecules. Thus, growth factors, angiogenesis stimulating factors and proliferating cell markers are high in the proliferative phase endometrium contributing to its regeneration. At the same time, other proteins promote endometrial cell survival by preventing extracellular matrix degradation and apoptosis. As glandular proliferation persists in the early secretory phase of the menstrual cycle, the activity of some proteins stimulating growth remains unchanged, but declines significantly thereafter, shifting the balance between proliferation and apoptosis in favour of apoptosis. During this period, several other regulatory substances are expressed at high levels, suggesting a role in endometrial maturation. If, however, implantation of a fertilized ovum fails to take place, menstruation occurs probably as the result of matrix metalloprotinases which antagononizes the anti-degradation factors (inhibitors of metalloproteinases). This review examines the changing endometrial patterns of a normal menstrual cycle in relation to these regulatory molecules.

Apoptosis↗

Lactate dehydrogenase-5 (LDH-5) overexpression in non-small-cell lung cancer tissues is linked to tumour hypoxia, angiogenic factor production and poor prognosis.

Lactate dehydrogenase-5 (LDH-5) catalyses the reversible transformation of pyruvate to lactate, having a principal position in the anaerobic cellular metabolism. Induction of LDH-5 occurs during hypoxia and LDH-5 transcription is directly regulated by the hypoxia-inducible factor 1 (HIF1). Serum LDH levels have been correlated with poor prognosis and resistance to chemotherapy and radiotherapy in various neoplastic diseases. The expression, however, of LDH in tumours has never been investigated in the past. In the present study, we established an immunohistochemical method to evaluate the LDH-5 overexpression in tumours, using two novel antibodies raised against the rat muscle LDH-5 and the human LDH-5 (Abcam, UK). The subcellular patterns of expression in cancer cells were mixed nuclear and cytoplasmic. In direct contrast to cancer cells, stromal fibroblasts were reactive for LDH-5 only in a minority of cases. Serum LDH, although positively correlated with, does not reliably reflect the intratumoral LDH-5 status. Lactate dehydrogenase-5 overexpression was directly related to HIF1alpha and 2alpha, but not with the carbonic anhydrase 9 expression. Patients with tumours bearing high LDH-5 expression had a poor prognosis. Tumours with simultaneous LDH-5 and HIF1alpha (or HIF2alpha) overexpression, indicative of a functional HIF pathway, had a particularly aggressive behaviour. It is concluded that overexpression of LDH-5 is a common event in non-small-cell lung cancer, can be easily assessed in paraffin-embedded material and provides important prognostic information, particularly when combined with other endogenous markers of hypoxia and acidity.

Adult↗

Molecular analysis of local relapse in high-risk breast cancer patients: can radiotherapy fractionation and time factors make a difference?

Large primary breast tumours and extensive lymph node involvement are linked to a high rate of local recurrence after surgery. In 10-20% of such high-risk breast cancer patients, local relapse will occur despite postoperative radiotherapy. In the present study, we investigated whether molecular features, such as angiogenesis, cancer cell proliferation, steroid receptor expression, c-erbB-2 oncoprotein overexpression, p53 protein nuclear accumulation or bcl-2 antiapoptotic protein expression, can predict failure of local therapy. We further examined as to which subgroups of patients could benefit from altered fractionation schemes of radiotherapy. In univariate analysis, high intratumoural angiogenesis, c-erbB overexpression and mutant-p53 nuclear accumulation were significantly associated with increased relapse rate (P=0.0002, 0.009 and 0.05, respectively). In multivariate analysis, the microvessel density and the c-erbB-2 status were independent and significant factors related to local relapse (P=0.001, t-ratio 3.36 and P=0.02, t-ratio 2.26, respectively). Hypofractionated and accelerated radiotherapy supported with amifostine (HypoARC regimen) was significantly more effective than standard radiotherapy in cases with high cancer cell proliferation index, c-erbB-2 and p53 overexpression. High angiogenesis, however, was linked with local relapse regardless of the radiotherapy regimen.

Breast Neoplasms↗

Vascular endothelial growth factor (VEGF) expression in operable gallbladder carcinomas.

AIM: To investigate the angiogenic and prognostic role of vascular endothelial growth factor (VEGF) in operable gallbladder carcinomas. METHODS: Sixty patients with early gallbladder carcinomas, treated with surgery alone, were investigated immunohistochemically for the expression of VEGF, thymidine phosphorylase (TP) and new blood vessel formation. The results were correlated with clinico-pathological features and prognosis. RESULTS: An increased VEGF secretion in gallbladder carcinomas was significantly associated with increased angiogenesis but not with patients survival, although high angiogenesis did relate with poor prognosis. TP was also associated with angiogenesis, but only the combined VEGF/TP expression was associated with unfavourable survival. Histological grade was another independent factor of prognosis. CONCLUSION: Both VEGF and TP expression are associated with high rate of angiogenesis, a factor directly associated with prognosis. The combined expression of these angiogenic factors confer a particularly poor post-operative outcome, speculature.

Adult↗

Hypoxia inducible factor 1alpha and 2alpha overexpression in inflammatory bowel disease.

AIMS: Hypoxia inducible factors 1alpha and 2alpha (HIF1alpha and HIF2alpha) are hypoxia regulated transcriptional factors, which control the expression of a variety of genes responsible for angiogenesis, glycolysis, and the inhibition of apoptosis. Because angiogenesis and tissue regeneration are integral components of the inflammatory process, this study was designed to investigate the role of HIFalpha molecules in inflammatory bowel disease. METHODS: Surgical specimens from patients with active ulcerative colitis (UC) and Crohn's disease (CD) were assessed immunohistochemically for HIF1alpha and HIF2alpha reactivity, and the expression of these molecules was compared with the expression of the angiogenic factors thymidine phosphorylase (TP), vascular endothelial growth factor (VEGF), and VEGF-KDR activated vasculature. The vascular density of the lesions was also assessed using anti-CD31 immunostaining. RESULTS: HIF1alpha was expressed focally (epithelial cells, stromal fibroblasts, and myocytes) in both UC and CD, whereas HIF2alpha was expressed focally in UC and diffusely in CD. TP expression was uniformly positive in both diseases. VEGF expression was absent in CD, and weakly positive in UC. The VEGF-KDR reactivity of the submucosal vasculature was only slightly increased in UC and CD compared with normal tissue. The inflammatory cells stained with HIF2alpha and TP in all cases, but the reactivity was generalised in CD and focal in UC. In both diseases, vascular density was significantly higher than that seen in normal tissue. CONCLUSIONS: The discordant expression of HIF2alpha and VEGF in CD suggests an inherent deficiency of the intestine to respond to various stresses by the induction of VEGF. This finding should be investigated further.

Adult↗

Cystosarcoma phyllodes in a 13-year-old Muslim girl treated with conservative surgery: a case report.

Phyllodes tumor of the breast is an unusual tumor with an incidence of 1 in 100,000. In particular, it is a very rare neoplasm in adolescent girls and young women. The authors present a case of a 13-year-old adolescent girl with a large unilateral palpable mass in her right breast. The diagnosis of cystosarcoma phyllodes was made in a frozen section after wide local excision. The management and the cytological and histological characteristics are described with particular reference to the very unusual clinical presentation in this patient.

Adolescent↗