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Context: Primary hyperparathyroidism (PHPT) can occur due to a neoplastic process or hyperplasia. While the disease presentation is predominantly asymptomatic in developed countries, this is not the case yet in India. Differentiation of the type of lesion can only be done based on histomorphology but has its own challenges. Immunohistochemical markers like Ki-67 have been studied to aid in diagnosis but data on this is sparse from India. Aims: The aim of this study is to assess the clinical, biochemical and pathological profile of PHPT and to analyse the differences in immunohistochemical marker Ki-67 among the various lesions. Setting and Design: A descriptive study was carried out on 38 PHPT patients who were treated at our institute from January 2011 to March 2021. Materials and Methods: Post-surgery, the causative lesions were categorised as adenoma (31), hyperplasia (5) and carcinoma (2). Clinical, biochemical, radiological and histopathological features of all lesions were collected and analysed. Ki-67 proliferation index was calculated. The various parameters were compared across the three groups of lesions and correlated with Ki-67 index. Results: Out of 38 patients, 37 were symptomatic with skeletal symptoms being the most common followed by renal symptoms. There was no difference in clinical or biochemical parameters among the three types of lesions. Significant negative correlation was seen between serum iPTH and serum 25-OH Vitamin D levels (P0.006) The median Ki-67 index was found to be 0.40% in hyperplasia, 0.49% in adenoma and 5.84% in carcinoma. Conclusion: PHPT still presents as an overtly symptomatic disease in India. Diagnosis of the nature of lesion depends on the accurate application of morphological criteria. A high Ki-67 index was not found to be an absolute marker of carcinoma, as it was also seen in a small proportion of atypical adenomas. [ABSTRACT FROM AUTHOR]

Objectives: Going back to the basics of urinary bladder neoplasms and correlation of histopathological diagnosis with age, sex, clinical features, smoking in tribal population of India in today’s day and age. Along with that we are also determining the role of p53 and Ki67 immunomarkers in grading and staging of Urinary Bladder Neoplasms and their correlation with history of smoking. Materials and Methods: This retrospective study was done in a tertiary care hospital affiliated with medical college in tribal region of India. Total 72 cases of transurethral resection of bladder tumors and bladder biopsies were studied over a period of 2 years. The histopathological grading and staging was done according to the WHO/ISUP 2016 classification. The histopathological diagnosis was further correlated with age, sex, clinical features, and history of active smoking. Along with that immunomarkers p53 and Ki-67 were done and correlated with grading and staging of tumors and with history of smoking. The cut-off used was more than 20% positivity for high expression and < 20% for low expression. For descriptive, data median (Interquartile Range) and ratio were used. For categorical variables percentage (%), Fisher exact test and Chisquare test were used. Results were evaluated with SPSS software program. P < 0.05 was considered statistically significant. Results: Out of 72 cases studied, 66 cases were neoplastic. Out of them, bladder neoplasms were common in age group of 41–60 years and there was a male preponderance. Most common clinical feature was hematuria. Smoking was not a risk factor for the development of bladder neoplasms but bladder neoplasms in smokers were associated with higher grading and staging. The most common neoplasm was High Grade Papillary Carcinoma (43.05%). Stage T1 and Stage T2 were seen in 3.03% and 27.8% of cases. P53 and Ki-67 immunomarkers showed higher expression in tumors of higher grade and stage. Conclusion: The take away from this study is bladder neoplasms that are quite versatile and histopathology is the gold standard to confirm these. However, p53and ki-67 gives important information regarding prognosis of tumors and helps in stratification of patients in high risk and low risk groups. Development of bladder carcinoma was independent of history of smoking; however, smoking is associated with higher grading and staging of bladder neoplasms and is also associated with higher expression of p53 and Ki-67 immunomarkers. [ABSTRACT FROM AUTHOR]

Background & Objective: Breast cancer is the leading cancer among Indian women and accounts for about 25% of all cancer cases worldwide. The present study aimed to assess Programmed Death Ligand-1 (PD-L1) expression in tumoral cells and tumor-infiltrating lymphocytes (TILs) and evaluate their correlations with the Ki-67 labelling index in invasive breast carcinomas (IBC). Methods: This descriptive observational study was conducted during 2016-2018 and included all diagnosed cases of IBC. The relationships between PD-L1 expression, TILs, hormone receptors, Ki-67, and clinicopathological parameters were studied in IBC. Statistical analysis was performed by SPSS version 23. Results: Out of 114 evaluated cases, 33.33% (N=38) showed PD-L1+ expression in tumor cells and 47.37% (N=54) had PD-L1+ expression in TILs. A high Ki-67 index was observed in 96 cases. Moreover, 49 patients were estrogen receptor (ER)- and 65 were ER+. We observed that 22 of 49 ER- and 49 of 65 ER+ subjects showed PD-L1+ expression, respectively. Conclusion: Our results showed a significant relationship between PD-L1 expression in tumoral cells and TILs, as well as between Ki-67 and TILs. In addition, an inverse correlation was noted between PD-L1 expression and ER. The PD-L1 expression in tumors and TILs and correlation with high Ki-67 may prove the importance of PD-L1 in targeted chemotherapy. An inverse relationship between PD-L1 and ER expression in tumoral cells suggests scope for immunotherapy in ER- IBC. However, further research with more cases is required. [ABSTRACT FROM AUTHOR]

Introduction: Immunohistochemical evaluation of Ki-67 is widely used for estimation of tumour proliferation in breast cancer. Till date, no specific method or a cut-off point for Ki-67 exists. Aim: To perform a comparative analysis between different scoring patterns and mean Ki-67 value and association of mean Ki-67 with other prognostic markers like tumour size, lymph node status, tumour stage and grade and different molecular subtypes of breast cancer. Materials and Methods: A cross-sectional study was conducted at Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India, between August 2019 to August 2021. Total of 50 new diagnosed cases of breast cancer were studied for the histologic type, grade and stage of the tumour. Immunohistochemistry for Oestrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal Growth Factor Receptor 2 (HER2) and Ki-67 was performed. Association of Ki-67 with other prognostic markers like tumour size, lymph node status, tumour stage and grade and different molecular subtypes of breast cancer was evaluated by expressing Ki-67 as a continuous variable (mean±SD) and also by dividing Ki-67 into different scoring patterns (I: =14%, >14%, II: =15%, 16-30%, >30% and III: <20%, 20-50%, =50%). Statistical tests like Kruskal-Wallis test (mean Ki-67 with tumour size, tumour grade and molecular subtypes), Mann-Whitney Rank Sum test (mean Ki-67 with lymph node status) and one way Analysis of Variance (ANOVA) (mean Ki-67 with staging) respectively. Results: Out of 50 patients, 40 (80%) were older than 50-yearold. Twenty six (52%) cases affected the left breast. A total of 49 (98%) were diagnosed as Invasive Ductal Carcinoma (IDC). Among them 26 (52%) cases were of grade III and 25 (50%) cases were of Luminal A. Mean Ki-67 and molecular subtypes of breast cancer had statistically significant association (p=0.002). No association was found between mean Ki-67 and tumour size (p=0.608), lymph node status (p=0.506) stage (p=0.979) and grade (p=0.095) of the tumour. Although scoring pattern I and III had no remarkable findings. Notably, scoring pattern II showed higher tumour sizes, lymph node positivity, higher stage and grade and basal-like tumours demonstrated a higher Ki-67 index. Conclusion: Evaluation of Ki-67 as a continuous variable yielded significant association with other prognostic markers of breast cancer. There was no single "best" scoring pattern identified. A direct association of Ki-67 was found with molecular subtypes of breast cancer. [ABSTRACT FROM AUTHOR]

Introduction: Oral Squamous Cell Carcinoma (OSCC) is the most common oral malignancy. Despite advancements in cancer therapeutics, early diagnosis, and prognosis of OSCC remains challenging. Evaluating clinicopathological characteristics, molecular biomarkers and their expression helps comprehend biological traits and tumour behaviour, which is crucial for early diagnosis and favourable prognosis. Aim: To evaluate the immunohistochemical expressions of B-cell Lymphoma 2 (BCL-2) and Ki-67 in OSCC and to correlate their molecular expressions with clinicopathological tumourigenic parameters. Materials and Methods: This cross-sectional study was conducted at Ramaiah Hospital, Bangalore, Karnataka, India, over a period of two years from June 2017 to May 2019 on 60 radical resection specimens of OSCC. After gross specimen examination, multiple representative tissue bits were obtained and subjected to Haematoxylin and Eosin (H&E) staining and staged. Immunohistochemical detection of BCL-2 and Ki-67 expression, semi-quantitative and intensity assessment of staining was performed. Data were analysed using statistical software R-version 4.0.1. The p=0.05 was considered statistically significant. Results: The mean age was 57.88±13 years, and a large proportion were females (49, 81.67%). Mean BCL-2 and Ki-67 expression (%) were 24.58±11.29 and 29.5±17.21, respectively. The correlation of BCL-2 (p<0.001) and Ki-67 (p<0.001) expression with histological grades was statistically significant. The correlation of BCL-2 and Ki-67 expression with gross/clinicopathological features was not significant. A positive moderately strong significant correlation existed between BCL-2 and Ki-67 expression (p<0.001). Conclusion: The BCL-2 and Ki-67 expression is independent of clinicopathological features of OSCC but is directly associated with increasing tumour grades. There is a direct moderately strong correlation between BCL-2 and Ki-67, indicating adverse clinical outcome. Their early identification is critical for effective therapeutic intervention and desirable prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Mantle Cell Lymphoma (MCL) is a relatively rare Non-Hodgkin Lymphoma (NHL) of mature B cells forming 5-7% of NHL. SOX11 has emerged as a useful antibody in the diagnosis of MCL with prognostic significance. Aim: To evaluate the immunomorphologic features and significance of SOX11 expression in MCL at a tertiary care cancer institute. Materials and Methods: This was a descriptive study which was conducted at a tertiary care cancer centre in Southern India over a period of five years from January 2013 to December 2017. Seventy six cases of newly diagnosed MCL with paraffin blocks were included in the study. Immunohistochemistry (IHC) with a panel of antibodies including SOX11 was carried out on Formalin Fixed Paraffin Embedded (FFPE) sections. Morphologic, immunologic findings were analysed and correlated with clinical data and survival, using Chi-square and independent sample t-test to compare data and Kaplan Meir method with Log Rank test for survival analysis. Results: MCL formed 5.8% of NHL with a striking male predominance (M:F ratio, 4:1), with mean age of 58 years at presentation and females at a younger age. Nearly 80% of patients presented at an advanced stage. Cervical lymphadenopathy was the commonest presenting feature, followed by involvement of the gastrointestinal tract. There were 59 cases of classic and 17 cases of blastoid and pleomorphic MCL, with diffuse pattern being the most common in 36 (47.4%) cases. In the present study 64 (92.4%) cases expressed SOX11 and showed heterogeneous staining with high expression in 34 (53.1%) cases and low expression in 30 (46.9%) cases. Ki-67 proliferation of more than 30% was seen in 52 (68.4%) cases and 30% or less in (24) 31.6% cases. None of these findings had statistically significant correlation with survival, though high Ki-67, high MCL International Prognostic Index (MIPI) and blastoid/pleomorphic cases had relatively worse Overall Survival (OS). Conclusion: MCL is a disease of the elderly and in the present study it affected females at a slightly younger age as compared to males. SOX11 expression was heterogeneous in neoplastic cells and was complementary to cyclin D1 for diagnosis of MCL however the staining intensity had no effect on survival. [ABSTRACT FROM AUTHOR]

Background: Definite data regarding the incidence and distribution of renal tumours in eastern India is not known. For better management, as it is essential to identify patients with poor prognosis, prognostic factors like stage, nuclear grade and their relationship to molecular markers are also unclear in this region. The purpose of our study was to assess the spectrum of adult renal tumours with respect to age and sex and to correlate Fuhrman nuclear grading with Ki-67 labeling index in a tertiary care hospital in eastern India. Methods: All adult patients with kidney tumour referred to our hospital who were preoperatively diagnosed and undergone surgical resection were included. Distribution of histological subtypes of kidney tumours according to age and sex were done by Hematoxylin and Eosin stain. Fuhrman grading, performed by ocular morphometry and derivation of Ki-67 labeling index (LI), were done in malignant cases only. Correlation of Fuhrman grading and KI-67 LI were done individually. Results: Among total 36 cases, 3 were benign and 33 were malignant. Among the malignant cases: Fifteen, twelve, four and two cases were of Fuhrman grade I, II, III, IV with mean Ki67 labeling index of 6.5, 18.2,44 and 76 respectively. Statistical correlation between mean Ki-67 LI and Fuhrman grading revealed significant correlation between Grade I and II, II and III and combined Grade I,II and III,IV tumours. Conclusion: Malignant Kidney tumours, especially, grade I RCC were commonest tumour. Fuhrman grading correlated well with Ki-67 labeling index. A 2-tier system for grading is proposed for better correlation with proliferation. [ABSTRACT FROM AUTHOR]