TY - JOUR A1 - Bohnert, Simone A1 - Trella, Stefanie A1 - Preiß, Ulrich A1 - Heinsen, Helmut A1 - Bohnert, Michael A1 - Zwirner, Johann A1 - Tremblay, Marie-Ève A1 - Monoranu, Camelia-Maria A1 - Ondruschka, Benjamin T1 - Density of TMEM119-positive microglial cells in postmortem cerebrospinal fluid as a surrogate marker for assessing complex neuropathological processes in the CNS JF - International Journal of Legal Medicine N2 - Routine coronal paraffin-sections through the dorsal frontal and parieto-occipital cortex of a total of sixty cases with divergent causes of death were immunohistochemically (IHC) stained with an antibody against TMEM119. Samples of cerebrospinal fluid (CSF) of the same cases were collected by suboccipital needle-puncture, subjected to centrifugation and processed as cytospin preparations stained with TMEM119. Both, cytospin preparations and sections were subjected to computer-assisted density measurements. The density of microglial TMEM119-positive cortical profiles correlated with that of cytospin results and with the density of TMEM119-positive microglial profiles in the medullary layer. There was no statistically significant correlation between the density of medullary TMEM119-positive profiles and the cytospin data. Cortical microglial cells were primarily encountered in supragranular layers I, II, and IIIa and in infragranular layers V and VI, the region of U-fibers and in circumscribed foci or spread in a diffuse manner and high density over the white matter. We have evidence that cortical microglia directly migrate into CSF without using the glympathic pathway. Microglia in the medullary layer shows a strong affinity to the adventitia of deep vessels in the myelin layer. Selected rapidly fatal cases including myocardial infarcts and drowning let us conclude that microglia in cortex and myelin layer can react rapidly and its reaction and migration is subject to pre-existing external and internal factors. Cytospin preparations proved to be a simple tool to analyze and assess complex changes in the CNS after rapid fatal damage. There is no statistically significant correlation between cytospin and postmortem interval. Therefore, the quantitative analyses of postmortem cytospins obviously reflect the neuropathology of the complete central nervous system. Cytospins provide forensic pathologists a rather simple and easy to perform method for the global assessment of CNS affliction. KW - cerebrospinal fluid KW - forensic neuropathology KW - forensic neurotraumatology KW - immunohistochemistry KW - immunocytochemistry KW - biomarker Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-325009 VL - 136 IS - 6 ER - TY - JOUR A1 - Kneitz, Hermann A1 - Rose, Christian A1 - Glutsch, Valerie A1 - Goebeler, Matthias T1 - Recurrence of a cellular blue nevus with satellitosis — a diagnostic pitfall with clinical consequences JF - Dermatopathology N2 - Blue nevus is a benign melanocytic lesion, typically asymptomatic and of unknown etiology. Several histologic and clinical variants have been distinguished, the most frequent being common blue nevus, cellular blue nevus, and combined blue nevus. Although melanocytic nevi with a satellite lesion are usually suggestive of locally advanced malignant melanoma, very few cases of blue nevi with satellite lesions have been reported. The diagnosis of common or cellular blue nevi is generally straightforward; however, the presence of structures such as irregular edges or satellitosis are highly suggestive for malignancy, and differential diagnoses such as locally advanced malignant melanoma and malignant blue nevus should be considered. Recurrent blue nevi can display atypical features not seen in the primary lesion, such as pleomorphism and mitotic activity. They usually tend to follow a benign course; however, in some cases, recurrence may indicate malignant transformation. We here report the unique case of a 64-year-old woman with a recurrent cellular blue nevus accompanied by satellite lesions. Such a biological behavior resulting in a clinical presentation as a melanoma-like lesion is a rarity in blue nevus and has not been described before. KW - common blue nevus KW - cell rich blue nevus KW - satellitosis KW - immunohistochemistry KW - skin Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-297436 SN - 2296-3529 VL - 9 IS - 4 SP - 361 EP - 367 ER - TY - JOUR A1 - Schümann, Franziska Lea A1 - Groß, Elisabeth A1 - Bauer, Marcus A1 - Rohde, Christian A1 - Sandmann, Sarah A1 - Terziev, Denis A1 - Müller, Lutz P. A1 - Posern, Guido A1 - Wienke, Andreas A1 - Fend, Falko A1 - Hansmann, Martin-Leo A1 - Klapper, Wolfram A1 - Rosenwald, Andreas A1 - Stein, Harald A1 - Dugas, Martin A1 - Müller-Tidow, Carsten A1 - Wickenhauser, Claudia A1 - Binder, Mascha A1 - Weber, Thomas T1 - Divergent effects of EZH1 and EZH2 protein expression on the prognosis of patients with T-cell lymphomas JF - Biomedicines N2 - T-cell lymphomas are highly heterogeneous and their prognosis is poor under the currently available therapies. Enhancers of zeste homologue 1 and 2 (EZH1/2) are histone H3 lysine-27 trimethyltransferases (H3K27me3). Despite the rapid development of new drugs inhibiting EZH2 and/or EZH1, the molecular interplay of these proteins and the impact on disease progression and prognosis of patients with T-cell lymphomas remains insufficiently understood. In this study, EZH1/2 mutation status was evaluated in 33 monomorphic epitheliotropic intestinal T-cell lymphomas by next generation sequencing and EZH1/2 and H3K27me3 protein expression levels were detected by immunohistochemistry in 46 T-cell lymphomas. Correlations with clinicopathologic features were analyzed and survival curves generated. No EZH1 mutations and one (3%) EZH2 missense mutation were identified. In univariable analysis, high EZH1 expression was associated with an improved overall survival (OS) and progression-free survival (PFS) whereas high EZH2 and H3K27me3 expression were associated with poorer OS and PFS. Multivariable analysis revealed EZH1 (hazard ratio (HR) = 0.183; 95% confidence interval (CI): 0.044–0.767; p = 0.020;) and EZH2 (HR = 8.245; 95% CI: 1.898–35.826; p = 0.005) to be independent, divergent prognostic markers for OS. In conclusion, EZH1/2 protein expression had opposing effects on the prognosis of T-cell lymphoma patients. KW - T-cell non-Hodgkin's lymphomas KW - PTCL KW - epigenetics KW - EZH1 KW - EZH2 KW - H3K27me3 KW - immunohistochemistry KW - next generation sequencing Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-252155 SN - 2227-9059 VL - 9 IS - 12 ER - TY - JOUR A1 - Tolstik, Elen A1 - Ali, Nairveen A1 - Guo, Shuxia A1 - Ebersbach, Paul A1 - Möllmann, Dorothe A1 - Arias-Loza, Paula A1 - Dierks, Johann A1 - Schuler, Irina A1 - Freier, Erik A1 - Debus, Jörg A1 - Baba, Hideo A. A1 - Nordbeck, Peter A1 - Bocklitz, Thomas A1 - Lorenz, Kristina T1 - CARS imaging advances early diagnosis of cardiac manifestation of Fabry disease JF - International Journal of Molecular Sciences N2 - Vibrational spectroscopy can detect characteristic biomolecular signatures and thus has the potential to support diagnostics. Fabry disease (FD) is a lipid disorder disease that leads to accumulations of globotriaosylceramide in different organs, including the heart, which is particularly critical for the patient’s prognosis. Effective treatment options are available if initiated at early disease stages, but many patients are late- or under-diagnosed. Since Coherent anti-Stokes Raman (CARS) imaging has a high sensitivity for lipid/protein shifts, we applied CARS as a diagnostic tool to assess cardiac FD manifestation in an FD mouse model. CARS measurements combined with multivariate data analysis, including image preprocessing followed by image clustering and data-driven modeling, allowed for differentiation between FD and control groups. Indeed, CARS identified shifts of lipid/protein content between the two groups in cardiac tissue visually and by subsequent automated bioinformatic discrimination with a mean sensitivity of 90–96%. Of note, this genotype differentiation was successful at a very early time point during disease development when only kidneys are visibly affected by globotriaosylceramide depositions. Altogether, the sensitivity of CARS combined with multivariate analysis allows reliable diagnostic support of early FD organ manifestation and may thus improve diagnosis, prognosis, and possibly therapeutic monitoring of FD. KW - coherent anti-Stokes Raman scattering (CARS) microscopy KW - Raman micro-spectroscopy KW - cardiovascular diseases KW - Fabry Disease (FD) KW - Gb3 and lyso-Gb3 biomarkers KW - multivariate data analysis KW - immunohistochemistry Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-284427 SN - 1422-0067 VL - 23 IS - 10 ER - TY - JOUR A1 - Glutsch, Valerie A1 - Wobser, Marion A1 - Schilling, Bastian A1 - Gesierich, Anja A1 - Goebeler, Matthias A1 - Kneitz, Hermann T1 - PRAME expression as helpful immunohistochemical marker in rhabdoid melanoma JF - Dermatopathology N2 - Background: Rhabdoid melanoma is a rare variant of malignant melanoma with characteristic cytomorphologic features. Due to the potential loss of conventional melanocytic markers, histopathologic diagnosis is often challenging. We hypothesize that immunostaining for PReferentially expressed Antigen in MElanoma (PRAME) might have the potential to uncover the melanocytic origin of these dedifferentiated tumors. Methods: Four cases of rhabdoid primary melanomas were assessed by immunohistochemistry for expression of PRAME and conventional melanocytic markers. Immunohistochemical expression patterns were analyzed in the rhabdoid primaries and, if available, associated metastases. Results: All four cases of rhabdoid primary melanomas showed a strong nuclear positivity for PRAME, while the expression of conventional melanocytic markers S100, MART-1, SOX-10 and HMB-45 was variable between the analyzed cases. Conclusions: In summary, we report four cases of rhabdoid primary melanoma with high to intermediate expression of PRAME despite the partial and variable loss of other melanocytic markers. Hence, PRAME might facilitate the recognition of this highly aggressive entity to avoid misdiagnosis due to histopathologic pitfalls. KW - PRAME KW - rhabdoid differentiation KW - rhabdoid melanoma KW - immunohistochemistry KW - melanocytic markers Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-284115 SN - 2296-3529 VL - 9 IS - 2 SP - 148 EP - 157 ER - TY - JOUR A1 - Janjetovic, Snjezana A1 - Lohneis, Philipp A1 - Nogai, Axel A1 - Balci, Derya A1 - Rasche, Leo A1 - Jähne, Doris A1 - Bokemeyer, Carsten A1 - Schilling, Georgia A1 - Blau, Igor Wolfgang A1 - Schmidt-Hieber, Martin T1 - Clinical and biological characteristics of medullary and extramedullary plasma cell dyscrasias JF - Biology N2 - Background: Extramedullary plasma cell (PC) disorders may occur as extramedullary disease in multiple myeloma (MM-EMD) or as primary extramedullary plasmocytoma (pEMP)/solitary osseous plasmocytoma (SOP). In this study, we aimed to obtain insights into the molecular mechanisms of extramedullary spread of clonal PC. Methods: Clinical and biological characteristics of 87 patients with MM-EMD (n = 49), pEMP/SOP (n = 20) and classical MM (n = 18) were analyzed by using immunohistochemistry (CXCR4, CD31, CD44 and CD81 staining) and cytoplasmic immunoglobulin staining combined with fluorescence in situ hybridization (cIg-FISH). Results: High expression of CD44, a cell-surface glycoprotein involved in cell-cell interactions, was significantly enriched in MM-EMD (90%) vs. pEMP/SOP (27%) or classical MM (33%) (p < 0.001). In addition, 1q21 amplification by clonal PC occurred at a similar frequency of MM-EMD (33%), pEMP/SOP (57%) and classical MM (44%). Conversely, del(17p13), t(4;14) and t(14;16) were completely absent in pEMP/SOP. Besides this, 1q21 amplification was identified in 64% of not paraskeletal samples from MM-EMD or pEMP compared to 9% of SOP or paraskeletal MM-EMD/pEMP and 44% of classical MM samples, respectively (p = 0.02). Conclusion: Expression of molecules involved in homing and cytogenetic aberrations differ between MM with or without EMD and pEMP/SOP. KW - plasma cell disorder KW - multiple myeloma KW - extramedullary KW - immunohistochemistry KW - cytogenetics Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242592 SN - 2079-7737 VL - 10 IS - 7 ER - TY - JOUR A1 - Beer, Katharina A1 - Härtel, Stephan A1 - Helfrich-Förster, Charlotte T1 - The pigment-dispersing factor neuronal network systematically grows in developing honey bees JF - The Journal of Comparative Neurology N2 - The neuropeptide pigment-dispersing factor (PDF) plays a prominent role in the circadian clock of many insects including honey bees. In the honey bee brain, PDF is expressed in about 15 clock neurons per hemisphere that lie between the central brain and the optic lobes. As in other insects, the bee PDF neurons form wide arborizations in the brain, but certain differences are evident. For example, they arborize only sparsely in the accessory medulla (AME), which serves as important communication center of the circadian clock in cockroaches and flies. Furthermore, all bee PDF neurons cluster together, which makes it impossible to distinguish individual projections. Here, we investigated the developing bee PDF network and found that the first three PDF neurons arise in the third larval instar and form a dense network of varicose fibers at the base of the developing medulla that strongly resembles the AME of hemimetabolous insects. In addition, they send faint fibers toward the lateral superior protocerebrum. In last larval instar, PDF cells with larger somata appear and send fibers toward the distal medulla and the medial protocerebrum. In the dorsal part of the medulla serpentine layer, a small PDF knot evolves from which PDF fibers extend ventrally. This knot disappears during metamorphosis and the varicose arborizations in the putative AME become fainter. Instead, a new strongly stained PDF fiber hub appears in front of the lobula. Simultaneously, the number of PDF neurons increases and the PDF neuronal network in the brain gets continuously more complex. KW - apis mellifera KW - circadian clock KW - immunohistochemistry KW - larval and pupal development KW - neuroanatomy Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-257300 VL - 530 IS - 9 ER - TY - JOUR A1 - Bohnert, Simone A1 - Georgiades, Kosmas A1 - Monoranu, Camelia-Maria A1 - Bohnert, Michael A1 - Büttner, Andreas A1 - Ondruschka, Benjamin T1 - Quantitative evidence of suppressed TMEM119 microglial immunohistochemistry in fatal morphine intoxications JF - International Journal of Legal Medicine N2 - The aim of this pilot study was to investigate the diagnostic potential of TMEM119 as a useful microglia-specific marker in combination with immunostainings for phagocytic function and infiltrating capacity of monocytes in cases of lethal monosubstance intoxications by morphine (MOR), methamphetamine (METH), and of ethanol-associated death (ETH) respectively. Human brain tissue samples were obtained from forensic autopsies of cases with single substance abuse (MOR, n = 8; ETH, n = 10; METH, n = 9) and then compared to a cohort of cardiovascular fatalities as controls (n = 9). Brain tissue samples of cortex, white matter, and hippocampus were collected and stained immunohistochemically with antibodies against TMEM119, CD68KiM1P, and CCR2. We could document the lowest density of TMEM119-positive cells in MOR deaths with highly significant differences to the control densities in all three regions investigated. In ETH and METH deaths, the expression of TMEM119 was comparable to cell densities in controls. The results indicate that the immunoreaction in brain tissue is different in these groups depending on the drug type used for abuse. KW - immunohistochemistry KW - drug abuse KW - forensic neuropathology KW - neuroinflammation KW - neurotoxicity KW - microglia Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-266934 SN - 1437-1596 VL - 135 IS - 6 ER - TY - JOUR A1 - Essig, Fabian A1 - Babilon, Lilith A1 - Vollmuth, Christoph A1 - Kollikowski, Alexander M. A1 - Pham, Mirko A1 - Solymosi, László A1 - Haeusler, Karl Georg A1 - Kraft, Peter A1 - Stoll, Guido A1 - Schuhmann, Michael K. T1 - High mobility group box 1 protein in cerebral thromboemboli JF - International Journal of Molecular Sciences N2 - High-mobility group box 1 protein (HMGB1) is a damage-associated molecular pattern (DAMP) involved in neutrophil extracellular trap (NET) formation and thrombosis. NETs are regularly found in cerebral thromboemboli. We here analyzed associated HMGB1 expression in human thromboemboli retrieved via mechanical thrombectomy from 37 stroke patients with large vessel occlusion. HMGB1 was detected in all thromboemboli, accounting for 1.7% (IQR 0.6–6.2%) of the total thromboemboli area and was found to be colocalized with neutrophils and NETs and in spatial proximity to platelets. Correlation analysis revealed that the detection of HMGB1 was strongly related to the number of neutrophils (r = 0.58, p = 0.0002) and platelets (r = 0.51, p = 0.001). Our results demonstrate that HMGB1 is a substantial constituent of thromboemboli causing large vessel occlusion stroke. KW - acute ischemic stroke KW - thromboemboli KW - HMGB1 KW - neutrophils KW - platelets KW - immunohistochemistry Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-265568 SN - 1422-0067 VL - 22 IS - 20 ER - TY - JOUR A1 - Frings, Verena Gerlinde A1 - Goebeler, Matthias A1 - Schilling, Bastian A1 - Kneitz, Hermann T1 - Aberrant cytoplasmic connexin43 expression as a helpful marker in vascular neoplasms JF - Journal of Cutaneous Pathology N2 - Background Gap junctions consisting of connexins (Cx) are fundamental in controlling cell proliferation, differentiation, and cell death. Cx43 is the most broadly expressed Cx in humans and is attributed an important role in skin tumor development. Its role in cutaneous vascular neoplasms is yet unknown. Methods Fifteen cases each of cutaneous angiosarcoma (cAS), Kaposi sarcoma (KS), and cherry hemangioma (CH) were assessed by immunohistochemistry for expression of Cx43. Expression pattern, intensity, and percentage of positively stained cells were analyzed. Solid basal cell carcinomas served as positive and healthy skin as negative controls. Results Most cases of cAS presented with a strong Cx43 staining of almost all tumor cells, whereas endothelia of KS showed medium expression and CH showed mostly weak expression. In comparison with KS or cAS, the staining intensity of CH was significantly lower (P ≤ 0.001). All tissue sections of both cAS and KS were characterized by a mostly diffuse, cytoplasmic staining pattern of the vascular endothelia. None of those showed nuclear staining. Conclusion The high-to-intermediate expression of Cx43 observed in all cases of cAS and KS suggests that this Cx may play a role in the development of malignant vascular neoplasms and serve as a helpful diagnostic marker. KW - Kaposi sarcoma KW - cutaneous angiosarcoma KW - Cx43 KW - hemangioma KW - immunohistochemistry Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-258412 VL - 48 IS - 11 ER - TY - JOUR A1 - Meyer, Malin Tordis A1 - Watermann, Christoph A1 - Dreyer, Thomas A1 - Wagner, Steffen A1 - Wittekindt, Claus A1 - Klussmann, Jens Peter A1 - Ergün, Süleyman A1 - Baumgart-Vogt, Eveline A1 - Karnati, Srikanth T1 - Differential expression of peroxisomal proteins in distinct types of parotid gland tumors JF - International Journal of Molecular Sciences N2 - Salivary gland cancers are rare but aggressive tumors that have poor prognosis and lack effective cure. Of those, parotid tumors constitute the majority. Functioning as metabolic machinery contributing to cellular redox balance, peroxisomes have emerged as crucial players in tumorigenesis. Studies on murine and human cells have examined the role of peroxisomes in carcinogenesis with conflicting results. These studies either examined the consequences of altered peroxisomal proliferators or compared their expression in healthy and neoplastic tissues. None, however, examined such differences exclusively in human parotid tissue or extended comparison to peroxisomal proteins and their associated gene expressions. Therefore, we examined differences in peroxisomal dynamics in parotid tumors of different morphologies. Using immunofluorescence and quantitative PCR, we compared the expression levels of key peroxisomal enzymes and proliferators in healthy and neoplastic parotid tissue samples. Three parotid tumor subtypes were examined: pleomorphic adenoma, mucoepidermoid carcinoma and acinic cell carcinoma. We observed higher expression of peroxisomal matrix proteins in neoplastic samples with exceptional down regulation of certain enzymes; however, the degree of expression varied between tumor subtypes. Our findings confirm previous experimental results on other organ tissues and suggest peroxisomes as possible therapeutic targets or markers in all or certain subtypes of parotid neoplasms. KW - peroxisomes KW - parotid gland KW - salivary KW - tumors KW - pleomorphic adenoma KW - mucoepidermoid carcinoma KW - acinic cell carcinoma KW - differential expression KW - immunohistochemistry KW - mRNA Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-261047 SN - 1422-0067 VL - 22 IS - 15 ER - TY - JOUR A1 - Franke, Maximilian A1 - Bieber, Michael A1 - Stoll, Guido A1 - Schuhmann, Michael Klaus T1 - Validity and Efficacy of Methods to Define Blood Brain Barrier Integrity in Experimental Ischemic Strokes: A Comparison of Albumin Western Blot, IgG Western Blot and Albumin Immunofluorescence JF - Methods and Protocols N2 - The clinical and preclinical research of ischemic strokes (IS) is becoming increasingly comprehensive, especially with the emerging evidence of complex thrombotic and inflammatory interactions. Within these, the blood brain barrier (BBB) plays an important role in regulating the cellular interactions at the vascular interface and is therefore the object of many IS-related questions. Consequently, valid, economic and responsible methods to define BBB integrity are necessary. Therefore, we compared the three ex-vivo setups albumin Western blot (WB), IgG WB and albumin intensity measurement (AIM) with regard to validity as well as temporal and economic efficacy. While the informative value of the three methods correlated significantly, the efficacy of the IgG WB dominated. KW - IgG KW - albumin KW - immunohistochemistry KW - Western blot KW - stroke KW - tMCAO KW - blood brain barrier KW - neuroinflammation Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234214 SN - 2409-9279 VL - 4 IS - 1 ER - TY - JOUR A1 - Adam, Pia A1 - Kircher, Stefan A1 - Sbiera, Iuliu A1 - Koehler, Viktoria Florentine A1 - Berg, Elke A1 - Knösel, Thomas A1 - Sandner, Benjamin A1 - Fenske, Wiebke Kristin A1 - Bläker, Hendrik A1 - Smaxwil, Constantin A1 - Zielke, Andreas A1 - Sipos, Bence A1 - Allelein, Stephanie A1 - Schott, Matthias A1 - Dierks, Christine A1 - Spitzweg, Christine A1 - Fassnacht, Martin A1 - Kroiss, Matthias T1 - FGF-Receptors and PD-L1 in Anaplastic and Poorly Differentiated Thyroid Cancer: Evaluation of the Preclinical Rationale JF - Frontiers in Endocrinology N2 - Background Treatment options for poorly differentiated (PDTC) and anaplastic (ATC) thyroid carcinoma are unsatisfactory and prognosis is generally poor. Lenvatinib (LEN), a multi-tyrosine kinase inhibitor targeting fibroblast growth factor receptors (FGFR) 1-4 is approved for advanced radioiodine refractory thyroid carcinoma, but response to single agent is poor in ATC. Recent reports of combining LEN with PD-1 inhibitor pembrolizumab (PEM) are promising. Materials and Methods Primary ATC (n=93) and PDTC (n=47) tissue samples diagnosed 1997-2019 at five German tertiary care centers were assessed for PD-L1 expression by immunohistochemistry using Tumor Proportion Score (TPS). FGFR 1-4 mRNA was quantified in 31 ATC and 14 PDTC with RNAscope in-situ hybridization. Normal thyroid tissue (NT) and papillary thyroid carcinoma (PTC) served as controls. Disease specific survival (DSS) was the primary outcome variable. Results PD-L1 TPS≥50% was observed in 42% of ATC and 26% of PDTC specimens. Mean PD-L1 expression was significantly higher in ATC (TPS 30%) than in PDTC (5%; p<0.01) and NT (0%, p<0.001). 53% of PDTC samples had PD-L1 expression ≤5%. FGFR mRNA expression was generally low in all samples but combined FGFR1-4 expression was significantly higher in PDTC and ATC compared to NT (each p<0.001). No impact of PD-L1 and FGFR 1-4 expression was observed on DSS. Conclusion High tumoral expression of PD-L1 in a large proportion of ATCs and a subgroup of PDTCs provides a rationale for immune checkpoint inhibition. FGFR expression is low thyroid tumor cells. The clinically observed synergism of PEM with LEN may be caused by immune modulation. KW - tyrosine kinase inhibitor (TKI) KW - immune checkpoint inhibitor (ICI) KW - immunohistochemistry KW - immunotherapy KW - PD-L1 KW - FGFR Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-244653 SN - 1664-2392 VL - 12 ER - TY - JOUR A1 - Bohnert, Simone A1 - Seiffert, Anja A1 - Trella, Stefanie A1 - Bohnert, Michael A1 - Distel, Luitpold A1 - Ondruschka, Benjamin A1 - Monoranu, Camelia-Marie T1 - TMEM119 as a specific marker of microglia reaction in traumatic brain injury in postmortem examination JF - International Journal of Legal Medicine N2 - The aim of the present study was a refined analysis of neuroinflammation including TMEM119 as a useful microglia-specific marker in forensic assessments of traumatic causes of death, e.g., traumatic brain injury (TBI). Human brain tissue samples were obtained from autopsies and divided into cases with lethal TBI (n = 25) and subdivided into three groups according to their trauma survival time and compared with an age-, gender-, and postmortem interval-matched cohort of sudden cardiovascular fatalities as controls (n = 23). Brain tissue samples next to cortex contusions and surrounding white matter as well as samples of the ipsilateral uninjured brain stem and cerebellum were collected and stained immunohistochemically with antibodies against TMEM119, CD206, and CCR2. We could document the highest number of TMEM119-positive cells in acute TBI death with highly significant differences to the control numbers. CCR2-positive monocytes showed a significantly higher cell count in the cortex samples of TBI cases than in the controls with an increasing number of immunopositive cells over time. The number of CD206-positive M2 microglial cells increased survival time-dependent. After 3 days of survival, the cell number increased significantly in all four regions investigated compared with controls. In sum, we validate a specific and robustly expressed as well as fast reacting microglia marker, TMEM119, which distinguishes microglia from resident and infiltrating macrophages and thus offers a great potential for the estimation of the minimum survival time after TBI. KW - cerebrospinal fluid KW - forensic neuropathology KW - forensic neurotraumatology KW - immunohistochemistry KW - biomarker Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235346 SN - 0937-9827 VL - 134 ER - TY - JOUR A1 - Essig, Fabian A1 - Kollikowski, Alexander M. A1 - Pham, Mirko A1 - Solymosi, László A1 - Stoll, Guido A1 - Haeusler, Karl Georg A1 - Kraft, Peter A1 - Schuhmann, Michael K. T1 - Immunohistological analysis of neutrophils and neutrophil extracellular traps in human thrombemboli causing acute ischemic stroke JF - International Journal of Molecular Sciences N2 - Ischemic stroke caused by thromboembolic occlusion of large cerebral arteries, such as the internal carotid (ICA) and/or the middle cerebral artery (MCA), is treated by mechanical thrombectomy (MT). MT allows salvage of the vessel-occluding thrombemboli, which most frequently originate from the left atrium or the left ventricle of the heart or from sites of plaque rupture within large arteries above the heart. Clot composition may influence the efficacy of (intravenous) thrombolysis and MT, respectively. We analyzed 37 human thrombemboli obtained from acute ischemic stroke patients during MT with special emphasis on histological staining of neutrophils and neutrophil extracellular traps (NETs). We found neutrophils as the main cellular component of cerebral thrombemboli but encountered considerable morphological heterogeneity. Neutrophils accumulated in the border region of fibrin-rich structures indicating possible interaction of neutrophils with distinct structural thrombembolus components. Web-like NETs were found in 35 of 37 thrombemboli in varying amounts. NETs were almost exclusively found within fibrin-rich areas. Importantly, stroke etiology, age and present oral anticoagulation was associated with morphological patterns and the amount of neutrophils. Correlation of histological data and imaging data revealed that relative Hounsfield units of cerebral thrombemboli positively correlated with the amount of red blood cells. In summary, our results demonstrate that neutrophils and NETs are substantial constituents of cerebral thrombemboli and contribute to their structural complexity. KW - acute ischemic stroke KW - thrombemboli KW - neutrophils KW - NETs KW - immunohistochemistry Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236192 SN - 1422-0067 VL - 21 IS - 19 ER - TY - THES A1 - Groth, Sofie Claire T1 - Korrelation der Elastizität von Rückenmarksgewebe und histologischen Veränderungen in einem Tiermodell der Multiplen Sklerose T1 - Correlation of elasticity of spinal cord tissues and histological changes in an animal model of multiple sclerosis N2 - Multiple Sklerose ist eine der häufigsten und bedeutsamsten entzündlichen Autoimmunerkrankungen bei jungen Erwachsenen. Obwohl die klassischen Kennzeichen der Krankheit wie Infiltration von Immunzellen, Demyelinisierung, Astrogliose und axonale Schädigung bekannt sind, sind die genauen Ursachen und die zugrundeliegende Pathophysiologie noch nicht geklärt. In der Fachliteratur wurden bereits biomechanische Veränderungen mit histologischen Veränderungen im ZNS in Verbindung gebracht. Der genaue Zusammenhang und das Ausmaß zwischen den mechanischen Gewebeeigenschaften und den zugrundeliegenden histologischen Veränderungen wurde bis heute jedoch nur wenig erforscht. Die vorliegende Arbeit untersuchte in ihrem methodischen Rahmen den möglichen Zusammenhang zwischen den mechanischen Veränderungen des Gewebes und den zugrundeliegenden histologischen Gewebeveränderungen in den unterschiedlichen Krankheitsstadien der EAE, dem Tiermodell der MS. Die hier dargestellten Experimente konnten demonstrieren, dass das ZNS-Gewebe durch zunehmende Zelldichte steifer wird, während es bei fortschreitender Demyelinisierung zur Erweichung des Gewebes kommt. Ferner wurden die mechanischen Gewebeeigenschaften in den unterschiedlichen Krankheitsstadien der EAE durch die Astrogliose und die Mikroglia/Makrophageninfiltration beeinflusst. N2 - Multiple sclerosis is one of the most frequent and significant autoimmune inflammatory diseases in young adults. Although the classic hallmarks of the disease, such as immune cell infiltration, demyelination, gliosis and axonal damage, are known, the causes and underlying pathophysiology remain largely elusive. In recent studies biomechanical changes have already been associated with histological changes in the CNS. However, the correlation between tissue stiffness and the underlying structural changes is currently poorly understood. In this thesis I investigated how tissue stiffness is linked to the underlying structural changes during the different stages of an experimental autoimmune encephalomyelitis mouse model of MS. My data indicate that an increase in cell density leads to an increase in the CNS tissue stiffness, while demyelination reduces tissue stiffness. Furthermore, the mechanical properties were influenced by gliosis and microglia / macrophage infiltration. KW - Multiple Sklerose KW - Experimentelle autoimmune Enzepahlomyelitis KW - Biomechanische Eigenschaften KW - Immunhistochemie KW - Multiple sclerosis KW - Experimental autoimmune encephalomyelitis KW - Biomechanical properties KW - immunohistochemistry Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-179370 ER - TY - JOUR A1 - Otto, Wolfgang A1 - Rubenwolf, Peter C. A1 - Burger, Maximilian A1 - Fritsche, Hans-Martin A1 - Rößler, Wolfgang A1 - May, Matthias A1 - Hartmann, Arndt A1 - Hofstädter, Ferdinand A1 - Wieland, Wolf F. A1 - Denzinger, Stefan T1 - Loss of aquaporin 3 protein expression constitutes an independent prognostic factor for progression-free survival: an immunohistochemical study on stage pT1 urothelial bladder cancer JF - BMC Cancer N2 - Background: Treatment of patients with stage pT1 urothelial bladder cancer (UBC) continues to be a challenge due to its unpredictable clinical course. Reliable molecular markers that help to determine appropriate individual treatment are still lacking. Loss of aquaporin (AQP) 3 protein expression has previously been shown in muscle-invasive UBC. The aim of the present study was to investigate the prognostic value of AQP3 protein expression with regard to the prognosis of stage pT1 UBC. Method: AQP 3 protein expression was investigated by immunohistochemistry in specimens of 87 stage T1 UBC patients, who were diagnosed by transurethral resection of the bladder (TURB) and subsequent second resection at a high-volume urological centre between 2002 and 2009. Patients underwent adjuvant instillation therapy with Bacillus Calmette-Guerin (BCG). Loss of AQP3 protein expression was defined as complete absence of the protein within the whole tumour. Expression status was correlated retrospectively with clinicopathological and follow-up data (median: 31 months). Multivariate Cox regression analysis was used to assess the value of AQP3 tumour expression with regard to recurrence-free (RFS), progression-free (PFS) and cancer-specific survival (CSS). RFS, PFS and CSS were calculated by Kaplan-Meier analysis and Log rank test. Results: 59% of patients were shown to exhibit AQP3-positive tumours, whereas 41% of tumours did not express the marker. Loss of AQP3 protein expression was associated with a statistically significantly worse PFS (20% vs. 72%, p=0.020). This finding was confirmed by multivariate Cox regression analysis (HR 7.58, CI 1.29 - 44.68; p=0.025). Conclusions: Loss of AQP3 protein expression in pT1 UBC appears to play a key role in disease progression and is associated with worse PFS. Considering its potential prognostic value, assessment of AQP3 protein expression could be used to help stratify the behavior of patients with pT1 UBC. KW - urothelial bladder carcinoma KW - progression KW - transitional cell carcinoma KW - bacillus calmette guerin KW - water channels KW - follow up KW - in vitro KW - recurrence KW - growth KW - T1 KW - tumor KW - proliferation KW - stage pT1 KW - aquaporin 3 protein KW - immunohistochemistry Y1 - 2012 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-135679 VL - 12 IS - 459 ER - TY - JOUR A1 - Weigand, Isabel A1 - Ronchi, Cristina L. A1 - Rizk-Rabin, Marthe A1 - Dalmazi, Guido Di A1 - Wild, Vanessa A1 - Bathon, Kerstin A1 - Rubin, Beatrice A1 - Calebiro, Davide A1 - Beuschlein, Felix A1 - Bertherat, Jérôme A1 - Fassnacht, Martin A1 - Sbiera, Silviu T1 - Differential expression of the protein kinase A subunits in normal adrenal glands and adrenocortical adenomas JF - Scientific Reports N2 - Somatic mutations in protein kinase A catalytic α subunit (PRKACA) were found to be causative for 30-40% of cortisol-producing adenomas (CPA) of the adrenal gland, rendering PKA signalling constitutively active. In its resting state, PKA is a stable and inactive heterotetramer, consisting of two catalytic and two regulatory subunits with the latter inhibiting PKA activity. The human genome encodes three different PKA catalytic subunits and four different regulatory subunits that are preferentially expressed in different organs. In normal adrenal glands all regulatory subunits are expressed, while CPA exhibit reduced protein levels of the regulatory subunit IIβ. In this study, we linked for the first time the loss of RIIβ protein levels to the PRKACA mutation status and found the down-regulation of RIIβ to arise post-transcriptionally. We further found the PKA subunit expression pattern of different tumours is also present in the zones of the normal adrenal cortex and demonstrate that the different PKA subunits have a differential expression pattern in each zone of the normal adrenal gland, indicating potential specific roles of these subunits in the regulation of different hormones secretion. KW - kinases KW - immunohistochemistry Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-157952 VL - 7 IS - 49 ER - TY - JOUR A1 - Israel, Ina A1 - Ohsiek, Andrea A1 - Al-Momani, Ehab A1 - Albert-Weissenberger, Christiane A1 - Stetter, Christian A1 - Mencl, Stine A1 - Buck, Andreas K. A1 - Kleinschnitz, Christoph A1 - Samnick, Samuel A1 - Sirén, Anna-Leena T1 - Combined [\(^{18}\)F]DPA-714 micro-positron emission tomography and autoradiography imaging of microglia activation after closed head injury in mice JF - Journal of Neuroinflammation N2 - Background Traumatic brain injury (TBI) is a major cause of death and disability. Neuroinflammation contributes to acute damage after TBI and modulates long-term evolution of degenerative and regenerative responses to injury. The aim of the present study was to evaluate the relationship of microglia activation to trauma severity, brain energy metabolism, and cellular reactions to injury in a mouse closed head injury model using combined in vivo PET imaging, ex vivo autoradiography, and immunohistochemistry. Methods A weight-drop closed head injury model was used to produce a mixed diffuse and focal TBI or a purely diffuse mild TBI (mTBI) in C57BL6 mice. Lesion severity was determined by evaluating histological damage and functional outcome using a standardized neuroscore (NSS), gliosis, and axonal injury by immunohistochemistry. Repeated intra-individual in vivo μPET imaging with the specific 18-kDa translocator protein (TSPO) radioligand [\(^{18}\)F]DPA-714 was performed on day 1, 7, and 16 and [\(^{18}\)F]FDG-μPET imaging for energy metabolism on days 2–5 after trauma using freshly synthesized radiotracers. Immediately after [\(^{18}\)F]DPA-714-μPET imaging on days 7 and 16, cellular identity of the [\(^{18}\)F]DPA-714 uptake was confirmed by exposing freshly cut cryosections to film autoradiography and successive immunostaining with antibodies against the microglia/macrophage marker IBA-1. Results Functional outcome correlated with focal brain lesions, gliosis, and axonal injury. [\(^{18}\)F]DPA-714-μPET showed increased radiotracer uptake in focal brain lesions on days 7 and 16 after TBI and correlated with reduced cerebral [\(^{18}\)F]FDG uptake on days 2–5, with functional outcome and number of IBA-1 positive cells on day 7. In autoradiography, [\(^{18}\)F]DPA-714 uptake co-localized with areas of IBA1-positive staining and correlated strongly with both NSS and the number of IBA1-positive cells, gliosis, and axonal injury. After mTBI, numbers of IBA-1 positive cells with microglial morphology increased in both brain hemispheres; however, uptake of [\(^{18}\)F]DPA-714 was not increased in autoradiography or in μPET imaging. Conclusions [\(^{18}\)F]DPA-714 uptake in μPET/autoradiography correlates with trauma severity, brain metabolic deficits, and microglia activation after closed head TBI. KW - neuroinflammation KW - TBI KW - immunohistochemistry KW - weight drop KW - PET KW - diffuse KW - focal KW - TSPO KW - autoradiography KW - IBA-1 Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-146606 VL - 13 IS - 140 ER - TY - JOUR A1 - Kämmerer, Ulrike A1 - Gires, Olivier A1 - Pfetzer, Nadja A1 - Wiegering, Armin A1 - Klement, Rainer Johannes A1 - Otto, Christoph T1 - TKTL1 expression in human malign and benign cell lines JF - BMC Cancer N2 - Background Overexpression of transketolase-like 1 protein TKTL1 in cancer cells has been reported to correlate with enhanced glycolysis and lactic acid production. Furthermore, enhanced TKTL1 expression was put into context with resistance to chemotherapy and ionizing radiation. Here, a panel of human malign and benign cells, which cover a broad range of chemotherapy and radiation resistance as well as reliance on glucose metabolism, was analyzed in vitro for TKTL1 expression. Methods 17 malign and three benign cell lines were characterized according to their expression of TKTL1 on the protein level with three commercially available anti-TKTL1 antibodies utilizing immunohistochemistry and Western blot, as well as on mRNA level with three published primer pairs for RT-qPCR. Furthermore, sensitivities to paclitaxel, cisplatin and ionizing radiation were assessed in cell survival assays. Glucose consumption and lactate production were quantified as surrogates for the “Warburg effect”. Results Considerable amounts of tktl1 mRNA and TKTL1 protein were detected only upon stable transfection of the human embryonic kidney cell line HEK293 with an expression plasmid for human TKTL1. Beyond that, weak expression of endogenous tktl1 mRNA was measured in the cell lines JAR and U251. Western blot analysis of JAR and U251 cells did not detect TKTL1 at the expected size of 65 kDa with all three antibodies specific for TKTL1 protein and immunohistochemical staining was observed with antibody JFC12T10 only. All other cell lines tested here revealed expression of tktl1 mRNA below detection limits and were negative for TKTL1 protein. However, in all cell lines including TKTL1-negative HEK293-control cells, antibody JFC12T10 detected multiple proteins with different molecular weights. Importantly, JAR and U251 did neither demonstrate an outstanding production of lactic acid nor increased resistance against chemotherapeutics or to ionizing radiation, respectively. Conclusion Using RT-qPCR and three different antibodies we observed only exceptional occurrence of TKTL1 in a panel of malignant human cell lines in vitro. The presence of TKTL1 was unrelated to either the rate of glucose consumption/lactic acid production or resistance against chemo- and radiotherapy. KW - RT-qPCT KW - immunohistochemistry KW - TKTL1 KW - cancer cell lines Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-126397 VL - 15 IS - 2 ER - TY - THES A1 - Stein, Roland Gregor T1 - Immunhistochemische Marker für die Prognose und Proliferation in Ependymomen bei Kindern und Erwachsenen T1 - Immunohistochemical markers for prognosis and proliferation in ependymomas of children and adults N2 - Zur Identifizierung geeigneter Routinemarker für die Prognose von Ependymompatienten führten wir immunhistochemische Untersuchungen und statistische Auswertungen an Ependymomen und Daten von 32 Erwachsenen und 23 pädiatrischen Patienten durch. Davon wurden bei drei Tumoren auch Rezidive untersucht, so dass insgesamt 59 Ependymome in die Untersuchung eingeschlossen wurden. Im Einzelnen handelte es sich um 11 myxopapilläre Ependymome, 6 Subependymome, 19 Ependymome und 23 anaplastische Ependymome. Die größten Fallgruppen bildeten pädiatrische Patienten unter drei Jahren und Erwachsene zwischen 50 und 70 Jahren. Bei Kindern war mit 45,8% die infratentorielle, bei Erwachsenen mit 65% die spinale Tumorlokalisation am häufigsten. Die untersuchten spinalen Ependymome entsprachen zu gleichen Teilen myxopapillären Ependymomen WHO Grad I und Ependymomen WHO Grad II. In supratentorieller Lage fanden sich mit 67% überwiegend anaplastische Ependymome WHO Grad III. Auch bei den infratentoriell gelegenen Ependymomen waren mit 63% die Mehrzahl anaplastische Ependymome, daneben fanden sich 29,6% Ependymome WHO Grad II. Beim Vergleich des von uns definierten und bestimmten Ki67-Scores als Zeichen für die Ependymomproliferation und der immunhistochemischen Positivität für HCK fiel nach Anwendung des Chi-Quadrat-Tests mit p=0,067 ein deutlicher Trend zu schwächerer punktförmiger Positivität bei höherem Ki67-Score auf. Dieser Trend setzte sich in der Erwachsenengruppe separat fort, während er in der Kindergruppe allein nicht nachweisbar war. In der Erwachsenengruppe war mit 28% ein deutlicher Anteil myxopapillärer Ependymome vorhanden, welche bei den Kindern nur 8% ausmachten.Möglicherweise spielt die veränderte HCK-Expression in der Subgruppe der myxopapillären Ependymome eine Rolle. Unsere Untersuchungen zeigten außerdem mit p=0,057 einen deutlichen Trend zu längerem Überleben bei immunohistochemischer DBC1-Negativität. Die Multivarianzanalyse mittels Cox-Regression wies eine Positivität für DBC1 als unabhängigen Risikofaktor für eine kürzere Überlebenszeit nach. Des Weiteren konnte eine mit p=0,013 signifikante Korrelation zwischen immunhistochemischer Positivität für DBC1 und höherem Ki67-Score gezeigt werden. Auch mit höherem WHO-Grad korrelierte die DBC1-Positivität mit p=0,009. Besonders infratentoriell gelegene Ependymome zeigten DBC1-Reaktivität. Hier treten bekannterweise häufiger anaplastische Ependymome mit höherem Proliferationsindex auf. Unsere Ergebnisse legen somit die Eignung des Markers DBC1 als immunhistochemische Routineuntersuchung für die Beurteilung der vom Resektionsstatus unabhängigen Prognose und Überlebenszeit von Ependymompatienten nahe. N2 - Immunohistochemical markers for prognosis and proliferation in ependymomas of children and adults KW - Ependymom KW - Langfristige Prognose KW - Überlebenszeit KW - Proliferation KW - Hirntumor KW - Immunhistochemie KW - immunohistochemistry KW - ependymoma KW - brain tumor KW - prognosis KW - proliferation Y1 - 2012 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-71082 ER - TY - THES A1 - Schmelter, Christopher Michael T1 - Charakterisierung genetischer Aberrationen in Follikulären Lymphomen Grad 3B durch Fluoreszenz in situ Hybridisierung T1 - Characterization of Genetic Aberrations in Follicular Lymphoma Grade 3B by Fluorescence in situ Hybridization N2 - Das Follikuläre Lymphom (FL) ist nach dem Diffusen großzelligen B-Zell-Lymphom (DLBCL) das häufigste Non-Hodgkin-Lymphom in der westlichen Welt. Die aktuelle WHO-Klassifikation für Tumoren der Hämatopoetischen und Lymphoiden Gewebe aus dem Jahr 2008 unterteilt dieses maligne Lymphom nach Histologie und Wachstumsmuster in vier Gruppen, FL 1 bis FL 3A und FL 3B. Obwohl die FL 1 und FL 2 zu den indolenten Tumoren gezählt werden, und FL 3A und FL 3B tendenziell eher als aggressiv gelten, so wurde in einigen Studienarbeiten gezeigt, dass das FL 3A aufgrund seiner immunhistologischen und genetischen Charakteristika, insbesondere dem Vorhandensein der BCL2/IGH t(14;18)(q32;q21) Translokation, eher den low-grade-Lymphomen (FL 1 und FL 2) nahe steht, während das FL 3B durchaus Eigenschaften des DLBCL, wie das Fehlen einer BCL2/IGH-Translokation und das vermehrte Auftreten von Aberrationen des BCL6-Gens, zeigt. In verschiedenen Arbeiten wurde des Weiteren eine Einteilung in reine FL 3B und FL 3B mit Anteilen eines DLBCL (+ DLBCL) vorgenommen, da sich auch diese beiden Subgruppen durch unterschiedliche Proteinexpression und genetische Eigenschaften auszeichnen würden. Laut den bislang in der Literatur vorliegenden (spärlichen) Daten zeigen FL 3A und FL 3B unterschiedliche Antigen-Profile und offenbar auch unterschiedliche (primäre) genetische Veränderungen, wobei gerade für das FL 3B nur wenige Daten vorliegen. Während Grad 3A-Tumoren einige Ähnlichkeiten zu den FL 1 und 2 zeigen, scheint das FL 3B im Immunphänotyp wie in der Genetik eher dem DLBCL zu ähneln. Allerdings lässt sich bei kritischer Durchsicht der Literatur erkennen, dass die meisten Fälle eines FL Grad 3 entweder gar nicht den Graden 3A oder 3B zugeordnet, beziehungsweise in diese unterschieden wurden, oder häufig bereits einen zusätzlichen diffusen Wachstumstyp aufweisen, nach den Regeln der WHO-Klassifikation für Tumoren der Hämatopoetischen und Lymphatischen Gewebe (2008) also als DLBCL mit einem zusätzlichen follikulären Wachstumsanteil klassifiziert würden. Somit sind die Daten insbesondere über die rein follikulär wachsenden FL 3B äußerst spärlich. Die vorliegende Arbeit beschäftigt sich mit der immunhistochemischen und genetischen Charakterisierung der FL 3B. Von besonderem Interesse war die Bestimmung der Häufigkeit der BCL2/IGH t(14;18)(q32;q21), BCL6/IGH t(3;14)(q27;q32) und MYC/IGH t(8;14)(q24;q32) Translokationen in den verschiedenen Typen der FL. Weiterhin sollte der Frage nachgegangen werden, ob die Anwendung der Tissue Microarray (TMA)-Technik und der Fluoreszenz in situ Hybridisierung (FISH) an TMAs robuste Daten zu dieser Fragestellung liefern kann. In einem ersten Schritt wurden vorhandene TMAs von FL, DLBCL und MALT-Lymphomen mit break-apart-Sonden für BCL2, BCL6, MYC und IGH hybridisiert, und die gewonnenen Ergebnisse mit Daten der konventionellen Zytogenetik abgeglichen. Hierdurch sollte nachgewiesen werden, dass die FISH in Kombination mit der TMA-Technik eine valide Testmethode zur Aufdeckung der gesuchten chromosomalen Aberrationen darstellt, die in Sensitivität und Spezifität der klassischen Zytogenetik nicht nachsteht. In einem zweiten Schritt wurden FL aus dem Archiv des Pathologischen Instituts der Universität Würzburg anhand der aktuellen WHO-Kriterien in die Grade 1, 2, 3A und 3B eingeteilt (und reklassifiziert). Diese Tumoren wurden im TMA und im Vollschnitt durch immunhistochemische Färbungen auf ihre Protein-Expression und mittels FISH auf ihre genetischen Eigenschaften untersucht und charakterisiert. N2 - Follicular lymphoma (FL) and Diffuse Large B-cell lymphoma (DLBCL) each account for approximately 30 % to 40 % of all Non-Hodgkin-lymphomas (NHL) in the Western world, thus representing the most frequent subtypes of NHL. FL are homogenously characterized by their follicular growth pattern, and the current WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues recommends their subclassification into 3 grades (FL grade 1, 2 and 3) according to the number of centroblasts. FL grade 3 have gained considerable interest because of their unresolved status as indolent or aggressive neoplasms, and their varying immunophenotypic, cytogenetic and possibly clinical features. FL grade 3 can be further distinguished into two subtypes, FL grade 3A (FL 3A, with centrocytes) and FL grade 3B (FL 3B, without centrocytes). FL 3A shows overlapping morphological and genetic features to FL 1 and FL 2, whereas FL 3B is poorly characterized on the genetic level. Almost all available data have been generated from FL 3B with an additional DLBCL component. Purely follicular FL 3B, on the other hand, is a rare neoplasm. The cytogenetic constitution of purely follicular FL3B is largely unknown. In the present work, therefore, we set out to define immunophenotypic and cytogenetic data of FL 3B, especially also paying attention to their sometimes difficult delineation from FL 3A and related variants. We performed a detailed immunohistochemical and molecular investigation of purely follicular FL 3B. In this study, we also included FL with large centrocytes (FL LCC) and FL, in which a straightforward and reproducible distinction between grades 3A or 3B was not possible (FL 3U). Moreover, we analyzed FL 1, FL 2, FL 3A and FL 3B + DLBCL, with regard to their delineation from purely follicular FL 3B. The study focussed on the expression of immunohistochemical markers and the examination of translocations involving the BCL2, BCL6, and MYC gene loci via FISH. To ensure homogenous and rapid sample processing, we constructed tissue microarrays (TMAs). To obtain insights in the reliability of FISH analysis performed on TMAs, we initially investigated B-NHL samples, whose genetic aberrations previously have been well-defined and characterized by chromosome banding approaches. KW - B-Zell-Lymphom KW - Lymphom KW - Non-Hodgkin-Lymphom KW - Zentroblastisches Lymphom KW - Fluoreszenz-in-situ-Hybridisierung KW - Immuncytochemie KW - Genetik KW - Follikuläres Lymphom KW - Grad 3B KW - FISH KW - Immunhistochemie KW - Genetik KW - follicular lymphoma KW - grade 3B KW - FISH KW - immunohistochemistry KW - genetics Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-57649 ER - TY - THES A1 - Lohr, Andreas T1 - Risikostratifikation grosszelliger B-Zell Non-Hodgkin Lymphome anhand immunhistochemischer Parameter T1 - Risk-stratification of diffuse large B-cell lymphomas by immunohistochemical parameters N2 - Die diffusen großzelligen B-Zell-Lymphome (DLBCL) stellen den häufigsten Typ aller Non-Hodgkin-Lymphome dar, sind aber morphologisch, immunologisch, genetisch und klinisch eine sehr heterogene Gruppe. Aufgrund dieser Heterogenität von DLBCL wurde in mehreren Studien untersucht, ob eine molekulare Heterogenität der Tumoren vorläge, bzw. versucht, eine molekulare Reklassifikation zu erreichen. Resultat dieser Bemühungen war eine Unterscheidung bzw. Definition einer Keimzentrums- ähnlichen (GCB-cell-like) Gruppe und einer aktivierten B-Zellen-ähnlichen (ABC-like) Gruppe, die sich in ihrem Ansprechen auf übliche Therapieschemata, mit einer deutlich besseren Prognose für die GCB-like-Gruppe, unterschieden. Die hierbei angewendete Microarray-Technologie hat den entscheidenden Nachteil, dass hierfür qualitativ hochwertige RNA zur Verfügung stehen muss. Neu ist der Ansatz, unterschiedliche Proteinexpressionsmuster am Paraffinmaterial zur Unterscheidung prognostisch relevanter Gruppen heranzuziehen. Die hierbei erzielten Daten sind allerdings in Ihren Aussagen hinsichtlich der prognostischen Wertigkeiten widersprüchlich. In der vorliegenden Arbeit wurden zunächst verschiedene biologische Parameter am Paraffinmaterial hinsichtlich ihrer prognostischen Wertigkeit in der Risikostratifikation von DLBCL untersucht. In einem ersten Schritt wurden klinische Daten von 99 de novo entstandenen großzelligen B-Zell-Lymphomen erhoben, bei denen es sich um 84 DLBCL und um elf DLBCL mit einer weiteren Komponente eines follikulären Lymphoms Grad 3B bzw. auch um vier Fälle mit ausschließlich follikulärem Wachstumsmuster handelte. Die Klassifikation der Fälle nach dem Internationalen Prognostischen Index (IPI) sowie der einzelnen klinischen Parameter des IPI zeigte eine deutliche prognostische Relevanz. In einem zweiten Schritt wurden immunhistochemische Färbungen mit verschiedenen Antikörpern durchgeführt und auf ihre prognostische Bedeutung überprüft. Als negative prognostische Parameter erwiesen sich die Negativität für CD10 sowie BCL-6, also Antigene, die mit einer Keimzentrumszell-Differenzierung assoziiert werden, sowie eine Überexpression von MUM-1, das mit einer postfollikulären Differenzierung assoziiert wird. Weiterhin konnte gezeigt werden, dass einer Expression von BCL-2 und einem Ki67-Index von unter 80 % eine negative prognostische Bedeutung zukommt. Die Stratifikation der Fälle in einen GCB- und einen ABC- Typ anhand des Hans-Klassifikators zeigte nur eine schwache Korrelation zur Überlebenswahrscheinlichkeit. In einem dritten Schritt wurde gezeigt, dass die kombinierte Analyse jeweils zweier Parameter eine relative Abhängigkeit ihrer Expression von der Expression weiterer Marker erkennen ließ. Aus diesem Grunde wurde ein Modell einer sequentiellen Addition negativer prognostischer Indikatoren entwickelt, in der bei Anwesenheit einer negativen Variable (CD10-Negativität, BCL-6 < 20%, BCL-2 positiv, MUM-1≥ 50% und Ki67 < 80%) ein negativer Faktor gewertet und die Summe dieser als Risiko-Score angegeben wurde. Die Stratifikation der Patienten anhand dieses „kombinierten immunhistochemischen Risiko-Scores“ zeigte drei prognostisch deutlich unterschiedliche Gruppen: In der Gruppe von Patienten ohne Risikofaktoren verstarb lediglich eine Patientin (die eine Behandlung abgelehnt hatte); in der Hochrisikogruppe (Score 5) verstarben alle Patienten innerhalb eines Jahres. Die multivariate Analyse des Scores ergab dabei eine Unabhängigkeit von den Parametern des IPI. In der intermediären Gruppe mit einem Risiko-Score von 1-4 zeigten sich der IPI sowie eine LDH-Erhöhung und das Vorhandensein einer B-Symptomatik als geeignete Parameter, um hier eine weitere Stratifizierung durchzuführen. Die vorliegende Arbeit stellt somit eine Erweiterung der publizierten Ansätze einer Erfassung prognostischer Indikatoren in kombinierten Algorithmen dar. Eine Verifizierung der gezeigten Ergebnisse in einer homogen behandelten Patientengruppe innerhalb einer klinischen Studie muss Ziel weiterer Untersuchungen sein. N2 - Diffuse large B-cell Lymphomas (DLBCL)are heterogeneous in morphologic, immunologic, genetic and clinical features. In different studies a molecular reclassification of this hetreogeneous group has been tried to establish, defining a germinal center B-cell-like group (GCB)and a activated B-cell-like group (ABC), with a better prognosis for the GCB-like group in responding to chemotherapy. Another way to differentiate prognostically relevant groups in DLBCL is by getting different protein expression patterns by using paraffin embedded material. In this study different biological parameters were analysed for their prognostic relevance. Clinical data of 99 de novo large B-cell lymphomas was collected, including 84 DLBCL, 11 DLBCL with a component of a follicular lymphoma grade 3B and 4 lamphomas with only a follicular growth pattern. Classification using the International Prognostic Index and its items in particular showed a significant clinical relevance. In a second step immunohistochemically revealed antibodies were examined for their prognostically relevance. As negative prognostic factors were found CD10-negativity and bcl-6, both beeing associated with a germinal center- differentiation. Another negative prognostic factor was MUM-1-overexpression, beeing associated with a postfollicular differentiation. Expression of bcl-2 und a Ki67-index below 80% indicated a negative prognosis as well. Stratification by using the Hans-Classificator showed a non-significant correlation of overall survival. In a third step a combined analysis of the parameters by looking for prognostic significance showed that the expression of one parameter was dependent of the expression of other parameters. Therefore a score was developed by using a sequentially addition of every negative prognostic factor (CD10-negativitiy, bcl-6 <20%, Bcl-2-positivity, MUM-1 >=50% and Ki67 <80%). Stratification of the patients using this "combined immunohistochemical risc score" showed three significantly different groups: In the group without any risc factor only one patient died (who had denied any treatment), in the high risk group (score 5) all patients died within one year. Multivariate analysis of the score showed independence of the IPI-parameters. In the intermediate risk group (score 1-4) the IPI-parameters as well as high LDH-levels and any B-symptoms were useful to make a further risk stratification. The present study extends the studies published trying to find prognostic indicators in combined algorithms. Verification of the presented results by a homogeneous treated patient group using a controlled clinical study has to be evaluated in further studies. KW - B-cell Lymphome KW - Überleben KW - immunhistochemisch KW - großzellige KW - Risiko KW - DLBCL KW - immunohistochemistry KW - risk KW - stratification KW - b-cell lymphomas Y1 - 2007 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-23654 ER - TY - THES A1 - Stettner, Georg Martin T1 - Immunhistologische und morphometrische Untersuchung der Ependymome im Kindesalter in Korrelation zu den klinischen Befunden T1 - Immunohistochemical and morphometric investigation of ependymomas of childhood and correlation with clinical findings N2 - In der vorliegenden Arbeit wurden der klinische Verlauf der Tumorerkrankung von 40 Kindern, die an einem Ependymom erkrankten, erfasst und 58 Tumorproben mittels immunhistochemischer Methoden untersucht. Im Mittelpunkt dieser Untersuchungen standen die Überprüfung der p53-Akkumulation, der Proliferationsaktivität mit Hilfe des Antikörpers MIB-1 sowie der Expression von HLA-DR durch Tumorzellen und eine Einschätzung der prognostischen Aussagekraft dieser Faktoren. Weiterhin wurde die EMA-Expression untersucht und eine Schwerpunkt auf die Analyse von Verteilung und Proliferationsaktivität der Zellen des Mikroglia(MG)/Makrophagen-Systems in kindlichen Ependymomen gelegt. Das mittlere Alter bei Diagnosestellung lag bei 61 Monaten (8 Monate bis 15 4/12 Jahre, Median: 41 Monate), eine Geschlechtspräferenz lag nicht vor. 22,5% der Primärtumoren waren supratentoriell, 60% infratentoriell und 17,5% spinal lokalisiert. 52,5% der Primärtumoren waren anaplastische Ependymome (WHO Grad III), 40% Ependymome (WHO Grad II), 7,5% myxopapilläre Ependymome (WHO Grad I). Eine totale Resektion konnte in 30,8% bei Primärtumoren und in 27,3% bei Rezidivtumoren erzielt werden. Das mittlere Nachbeochtungsintervall betrug 52 Monate (6-163 Monate), das mittlere progrssionsfreie Interval (PFS) 28 Monate und der mittlere Überlebenszeitraum (OS) 64 Monate. Tumorrezidive entwickelten sich mit einer Ausnahme eines Spätrezidives nach 84 Monaten innerhalb von 36 Monaten nach der operativen Tumorentfernung. Von den klinischen Variablen weist einzig das Resektionsausmaß eine prognostische Bedeutung auf (total vs. inkomplett: p=0.035 bezüglich des mittleren PFS, p=0.12 bezüglich des mittleren OS). Alle anderen klinischen Variablen, einschließlich des Tumorgrades nach WHO, zeigen keinen Einfluss auf den Verlauf der Tumorerkrankung. p53-Akkumulation kommt in 56,9% der untersuchten Tumorproben vor und korreliert mit dem Tumorgrad nach WHO, dem MIB-1 Labeling Index (LI) und der Lokalisation. Der MIB-1 LI zeigt eine große Streubreite (1,4% - 63,3%) und weist entsprechend des untersuchten Patientenkollektivs im Gegensatz zu Ependymomen des Erwachsenenalters einen hohen Mittelwert und Median auf (21,8% bzw. 19,8%). Der MIB-1 LI korreliert statistisch signifikant mit dem WHO-Graduierungssystem, der Lokalisation und wie bereits erwähnt mit der p53-Akkumulation. Unter den immunhistochemisch untersuchten Variablen kommt lediglich dem MIB-1 LI im untersuchten Patientenkollektiv eine gewisse prognostische Aussagekraft zu. Statistische Signifikanz wird allerdings nicht erreicht (MIB-1 LI <10% vs. MIB-1 LI >10%: p=0.17 bezüglich des mittleres PFS). Erstmals wurde in 80,4% der untersuchten ependymalen Tumoren auch eine Proliferation von Zellen des MG/Makrophagen-Systems nachgewiesen. Bei weitgehend konstant niedriger absoluter Anzahl proliferierender Zellen des MG/Makrophagen-Systems existiert kein Unterschied diesbezüglich zwischen den Tumorgraden wie kürzlich bei astrozytären Tumoren nachgewiesen. Die Verteilung der Zellen des MG/Makrophagen-Systems zeigte bei sehr heterogenem Verteilungsmuster häufig eine septale Anordnung insbesondere der amöboiden MG und der Makrophagen. Es existieren unterschiedliche Verteilungsmuster mikroglialer Zellen und Makrophagen, die sich aber anderen Parametern nicht zuordnen lassen mit der Ausnahme der MG/Makrophagen-Zelldichte in Primärtumoren. Obwohl eine HLA-DR Expression durch Tumorzellen auch in anderen Neoplasien des ZNS häufig vorkommt, wurden Ependymome diesbezüglich bisher nicht untersucht. In 52,6% aller Tumorproben finden sich in der vorliegenden Arbeit HLA-DR exprimierende Tumorzellen. Eine EMA-Expression zeigt sich in 84,5% der untersuchten Fälle und ist damit ein Charakteristikum ependymaler Neoplasien, das auch als differentialdiagnostisches Kriterium angesehen werden kann. Die Ergebnisse der vorliegenden Arbeit bekräftigen den hohen prognostischen Stellenwert einer totalen Resektion in der Therapie ependymaler Tumoren des Kindesalters. Weiterhin wird die Bedeutung der Proliferationsaktivität für den klinischen Verlauf der Tumorerkrankung unterstrichen. Von großem wissenschaftlichem Interesse ist weiterhin die Klärung der Ursache und Bedeutung der häufig anzutreffenden p53-Akkumulation sowie der immunologischen Bedeutung der Zellen des MG/Makrophagen-Systems im Rahmen der Tumorabwehr. N2 - In this dissertation the tumor’s clinical course of 40 children, who developed an ependymoma, was observed and 58 tumor samples were investigated by immunohistochemical methods. p53-accumulation, proliferation (detected by the antibody MIB-1) as well as the expression of HLA-DR by tumor cells and the prognostic value of these factors had been the focus of interest. Furthermore the EMA-expression and the distribution and proliferative activity of cells belonging to the microglia(MG)/macrophage-system in childhood ependymomas was investigated. The mean age at the time of diagnosis was 61 months (8 months to 15 4/12 years, median 41 months), the male/female ratio was balanced. 22,5% of primary tumors were located supratentorial, 60% infratentorial and 17,5% spinal. 52,5% of primary tumors were anaplastic ependymomas (WHO grade III), 40% ependymomas (WHO grade II) and 7,5% myxopapillary ependymomas (WHO grade I). A total resection was achieved in 30,8% of the primary tumors and in 27,3% of recurrent tumors. The mean follow-up was 52 months (6-163 months), the median progression free survival (PFS) and the overall survival (OS) 28 and 64 months respectively. All recurrences developed within 36 months after surgery with one exception, where a recurrence occurred after 84 months. Out of the clinical parameters a prognostic value was only seen in the extent of resection (total vs. subtotal resection: p=0.035 related to the median PFS and p=0.12 related to the median OS respectively). None of the other clinical parameters including tumor grade was correlated to the course of the disease. p53-accumulation was shown in 56,9% and there were correlations with WHO-tumor grade, MIB-1 labeling index (LI) and tumor localization. There was a wide range in MIB-1 LI (1,4% - 63,3%) with a higher mean and median (21,8% and 19,8% respectively) as reported in investigations in ependymomas of adults. There were significant correlations of MIB-1 LI with WHO-tumor grade, tumor localization and p53-accumulation as above mentioned. Out of the immunohistochemical investigated factors in this study only the MIB-1 LI was of prognostic relevance, but without statistical significance (MIB-1 LI <10% vs. MIB-1 LI >10%: p=0.17 related to the median PFS). None of the other immunohistochemical investigated factors mentioned below was related to the outcome in this study. For the first time proliferation of cells belonging to the MG/macrophage-system was documented in 80,4% of ependymal neoplasm. But there was no difference between different tumor grades in relative or absolute counts of proliferating microglial cells as previously shown in astrocytic tumors. The distribution of cells belonging to the MG/macrophage-system show a very heterogeneous pattern with a likely septal arrangement of ameboid microglia and macrophages in particular. Different distribution pattern of subgroups of the microglial cells and macrophages exist, but there is no relation to other variables except the density of microglial cells and macrophages in primary tumors. Although the HLA-DR expression in CNS neoplasms is a well known phenomenon, this is the first report of HLA-DR expression in ependymomas in 52,6% of all tumor samples. As a characteristic of ependymal neoplasms an EMA-expression was detected in 84,5%. EMA-expression can therefore be used as a criteria in differential diagnosis. The results of this study confirm the prognostic importance of a total resection of childhood ependymomas. Furthermore the relevance of proliferative activity related to the clinical course was emphasized. Further studies are needed to explain the reason and meaning of p53-accumulation and to define the role of the MG/microphage-system in the immunological tumor defense. KW - Ependymom KW - Kindesalter KW - Immunhistologie KW - Prognose KW - ependymoma KW - childhood KW - immunohistochemistry KW - prognostic factors Y1 - 2003 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-6932 ER -