(24), basal cell hyperplasia (15), atypical small acinar proliferation. (ASAP) (19), high grade intra-epithelial neoplasia (PIN)(31) and adenocarcinoma (31: ...
395
P-389 Proliferative lesions of prostate - A multivariate approach for the differential diagnosis Fernanda B.C. Cavalcanti; Venancio A.E Alves; Julio C.R. Pereira; Cristina Kanamura; Alda Wakamatsu ; Luiz B. Saldanha Divis~o de Patologia, Instituto Adolfo Lutz, S~o Paulo, Brazil INTRODUCTION: In the context of many "new entities," based on numerous criteria, this study aims at selecting sets of criteria to yield diagnosis of main proliferative lesions of prostate. MATERIALS and METHODS: Casuistic: 142 biopsies, from welldefined usual prostatic hyperplasia (22), postatrophic hyperplasia (24), basal cell hyperplasia (15), atypical small acinar proliferation (ASAP) (19), high grade intra-epithelial neoplasia (PIN)(31) and adenocarcinoma (31: Gleason 2-6:19; Gleason 7-9:12) Methods: 46 histologic criteria and 34be12 immunostaining were assessed. Spearman correlation at r>0.30 selected 16 criteria for Multiple Discriminant Analysis (MDA), thus yielding the definition of three mathematical functions. RESULTS and CONCLUSIONS: The 16 histologic criteria statistically discriminant are: glandular fusion, prominent nucleoli, cristalloids, delicate chromatin in luminal cell, 34be12 immunoexpression, solid arrangement, eosinophilic secretion, stromal sclerosis, absence of luminal content, PMN, nerve invasion, papillary arrangement, 2 cell layers, basal cell visualization, n:c ratio and granular cytoplasm of luminal cell. The three discriminant functions were: "l. Adenocarcinoma": glandular fusion, prominant nucleoli and cristalloid; "2.PIN": papillary arrangement; "3. ASAP": n:c ratio, basal cell evident. The 34bel 2 immunostaining was found most helpful for discrimination from ASAP to adenocarcinoma. The validity of these simple sets of criteria will be tested a prospective cohort of needle biopsies, with clinical and surgical follow-up
P-390 Correlation of p53 expression with the clinicopathologic parameters and prognosis of renal cell carcinoma Celik Bettil MD*, Dursun Ayse MD**, Isik Ipek MD**, Oguzulgen Ibrahim MD**, Aktas Serpil Phd*** * Kirikkale State Hospital, ** Gazi University Medical School, *** Hacettepe University Dept. of Statistics Objective: P53 gene expression has been demonstrated in several tumors. This study aimed to investigated whether p53 gene expression is related to clinicopathological parameters, including patient sex, age, tumor size, cell type, capsular invasion, nuclear grade, stage and overall survival in renal cell carcinoma (RCC). Method: The immunstaining was performed on 55 RCC using an anti-p53 monoclonal antibody (DO7,Dako). 31 patients were followed-up either until time of died or median survival time of 44,0 months, ranging 3 to 104 months. Results: The p53 positivity was demonstrated in 9 patients (16,3%). Statistical analysis showed that p53 immunreactivity correlated significantly with low (GI+G2) and high (G3+G4) nuclear grades but didn't correlated with patient age, sex, tumor size, cell type (papillary vs nonpapillary or clear vs nonclear), sarcomatoid area, capsular invasion and stage. Survival time was higher in p53 negative patients (81,51 months) than taht of p53 positive patients
(31,88 months). However, no statistically significant relationship was found with survival data. Conclusion: P5 gene expression might be seen within any of the histological subtypes of RCC. Since the expression of p53 gene was unrelated to the clinicopathological features of the tumor, it has no impact on prognosis of RCC. P53 gene expression could be expected in high nuclear grades but to make a conclusion needs further studies.
P-391 Somatic mutations and loss of heterozygosity of the vhl tumor supressor gene in unclassified renal cell carcinomas Chiesa, M. Sobel, B. Brynat, A. Panizo, W.M. Lineham, M.J. Merino National Cancer Institute, Bethesda, MD Introduction: The present classification of renal epithelial tumors (Heidelberg-1997) includes an unclassifiable category that accounts for 6% to 7% of renal malignancies. These neoplasms are difficult to classify because of their lack of specific morphologic characteristics or mixed histologic patterns. Although genetic studies of clear cell and papillary renal cell carcinomas have shown a correlation between chromosomal abnormalities and histologic features, genetic aberrations of the unclassified tumors remain unknown. We studied four cases of unclassified renal cell carcinoma (URCC) to investigate the presence / absence of the VHL mutation. Methods: Four cases of URCC (3 men, 1 woman) were studied. One additional case of renal cell carcinoma, clear cell type, with a known mutation and loss of heterozygosity (LOH) at 3p was included as a positive control. Ages ranged from 42 to 65 years old. Three tumors were located in the right kidney and one in the left kidney. Tumor sizes ranged from 7 to 14 cm. Histologically the tumors showed a mixture of papillary and solid growths, high nuclear grade, and/or undifferentiated patterns. Tumor and morphologically normal cells were microdissected from paraffin-embedded tissue for PCR amplification to detect LOH at D3S1038 (3p26.1-3p25.2) and for direct DNA sequencing on both stands of all three exons of the VHL gene. Results: Wild type sequence was detected in every case. LOH was detected in case 3. The control showed LOH and C>T at nucleotide 908. Conclusion: In contrast to genetic alterations in clear cell carcinoma, inactivation of the VHL gene by somatic mutation in one allele and LOH of the other do not seem to occur in unclassified renal epithelial tumors. Correlation between VHL mutation and 3p LOH was found in three cases (cases 1, 2, and 4). However, LOH at 3p may occur occasionally in patients without mutations in the remaining allele (case 3).
P-392 Extracellular matrix proteins in glomerulonephritis CuPid S., Sdukanec-Spoljar M., Jelakovid B., Kuzmanid D., Laganovid M. University Hospital Zagreb, Zagreb, Croatia Chronic renal insufficiency develops only in those cases of glomerulopathy in which the lumina of postglomerular capillaries in the
