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Journal : Bioscientia Medicina : Journal of Biomedicine and Translational Research

Differential Roles of CD117 and Ki67 in Gastrointestinal Stromal Tumors: Diagnostic Utility Versus Prognostic Power Fitri Nur Handriyani; Noza Hilbertina; Henny Mulyani; Loli Devianti; Avit Suchitra; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1337

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the digestive tract, primarily driven by mutations in KIT or PDGFRA genes. CD117 (c-KIT) expression is a key diagnostic marker, while the Ki67 labeling index reflects cellular proliferation. Risk stratification, often using modified NIH criteria based on tumor size, mitotic rate, and location, guides prognosis and treatment. This study investigated the distinct roles of CD117 and Ki67 expression in relation to risk stratification in GIST patients. Methods: This cross-sectional analytical study examined 27 GIST cases diagnosed between January 2021 and December 2024 from three Indonesian hospitals. Formalin-fixed paraffin-embedded tissues were analyzed using immunohistochemistry for CD117 (clone YR145) and Ki67 (clone K2). CD117 positivity was defined as ≥5% tumor cell staining, and high Ki67 expression as >10% nuclear staining. Risk stratification utilized the modified NIH criteria. The Chi-square test assessed correlations (p<0.05 significance). Results: The cohort predominantly comprised patients >50 years (66.7%), males (59.3%), with gastric tumors (51.9%), large tumor size (>5cm in 96.3%), spindle cell morphology (77.8%), and high mitotic rates (74.1%). Most cases (85.2%) were classified as high-risk. CD117 was positive in 81.5% (22/27) of cases but showed no significant correlation with risk stratification (p=0.561). High Ki67 expression was found in 74.1% (20/27) of cases and demonstrated a significant positive correlation with high-risk stratification (p=0.002). The combination of CD117 and Ki67 status also showed a significant association with risk stratification (p=0.001). Conclusion: While CD117 expression remains a cornerstone for GIST diagnosis and targeted therapy selection, it did not correlate significantly with risk stratification in this cohort. Conversely, a high Ki67 labeling index was significantly associated with high-risk GIST, underscoring its potential as a valuable prognostic marker alongside established risk stratification parameters.
Investigating the Landscape of Programmed Death-Ligand 1 (PD-L1) in Thymic Tumors: Implications for Histopathological Classification and Staging Rio Hendra; Noza Hilbertina; Henny Mulyani; Tofrizal; Afriani; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1338

Abstract

Background: Thymic epithelial tumors (TETs) are uncommon malignancies originating in the mediastinum, characterized by considerable histopathological diversity and variable clinical trajectories. Programmed Death-Ligand 1 (PD-L1), an immune checkpoint protein, is implicated in mechanisms of tumor immune evasion. This study aimed to investigate the correlation between PD-L1 immunoexpression and distinct histopathological types, as well as the Masaoka-Koga stage, in TETs. Methods: This cross-sectional investigation analyzed 29 archival cases of TETs diagnosed between January 2019 and December 2024 at the Anatomical Pathology Laboratory of Dr. M. Djamil General Hospital Padang. Samples were procured via consecutive sampling from formalin-fixed paraffin-embedded (FFPE) tumor tissues. Histopathological classification was reassessed according to the WHO 2021 criteria. PD-L1 expression was evaluated immunohistochemically and quantified using the Tumor Proportion Score (TPS). Masaoka-Koga staging was determined from clinical records. Statistical analysis of correlations was performed using the Chi-square test. Results: PD-L1 immunoexpression was detected in the preponderance of cases. Low positive PD-L1 expression (TPS 1-49%) was observed in 82.8% of TETs, while high positive expression (TPS ≥50%) was noted in 10.3%. Thymic carcinoma constituted the most prevalent histopathological category (51.7%), and the majority of patients (91.7%) presented at an advanced Masaoka-Koga stage. Statistical analysis did not demonstrate a significant correlation between PD-L1 expression levels and histopathological type (p=0.195). Furthermore, no significant association was identified between PD-L1 expression and Masaoka-Koga stage (p=0.800). Conclusion: This study indicated that while PD-L1 is frequently expressed in TETs within this cohort, its expression level did not exhibit a significant correlation with specific histopathological subtypes or the Masaoka-Koga clinical stage. Further investigations incorporating larger sample sizes are warranted to delineate the precise role of PD-L1 within the complex biological spectrum of thymic neoplasms.
Unraveling the Angiogenic Landscape in Endometrioid Endometrial Carcinoma: VEGF Expression, Histopathological Differentiation, and Lymphovascular Invasion as Key Players Mustika Sari; Aswiyanti Asri; Tofrizal; Henny Mulyani; Syamel Muhammad; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1340

Abstract

Background: Endometrioid endometrial carcinoma (EEC) is a prevalent gynecological malignancy whose prognosis is influenced by factors including histopathological grade and lymphovascular invasion (LVI). Angiogenesis, crucial for tumor growth and metastasis, is significantly mediated by vascular endothelial growth factor (VEGF). This study aimed to investigate the expression of VEGF in EEC and its correlation with histopathological differentiation and LVI. Methods: This observational analytical study employed a cross-sectional design using 36 archival paraffin block samples of EEC diagnosed between January 2022 and December 2024 at the Anatomical Pathology Laboratory of Dr. M. Djamil General Hospital Padang. Cases were selected via simple random sampling from a population of 59. Histopathological grade (Grade 1, 2, or 3 based on FIGO architectural and nuclear criteria) and LVI (negative, focal, or substantial) were re-evaluated from Hematoxylin-Eosin (H&E) stained slides. VEGF expression was assessed by immunohistochemistry, scored semiquantitatively based on the percentage of positive tumor cells and staining intensity, and categorized as low or high. Data were analyzed using Chi-square tests, with p<0.05 considered statistically significant. Results: The mean age of patients was 54.36 years, with the highest prevalence in the 51-60 age group (41.7%). Grade 3 tumors were most common (38.9%), followed by Grade 2 (33.3%) and Grade 1 (27.8%). LVI was present in 47.2% of cases, predominantly focal (38.9%). High VEGF expression was observed in 58.3% of EEC cases. A statistically significant association was found between high VEGF expression and higher histopathological grade (p=0.000), with 66.7% of Grade 3 tumors showing high VEGF expression. No significant association was found between VEGF expression and LVI (p=0.080). Conclusion: High VEGF expression significantly correlated with higher histopathological grades in EEC, suggesting its role in tumor aggressiveness and dedifferentiation. However, a significant association with LVI was not established in this cohort. VEGF expression warrants further investigation as a potential prognostic biomarker and therapeutic target in EEC.
The Significance of TGF-β Expression in Predicting Lymphovascular Invasion and Lymph Node Metastasis in Colorectal Cancer Aini, Julpa Nurul; Aswiyanti Asri; Noza Hilbertina; Tofrizal; Avit Suchitra; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1182

Abstract

Background: Colorectal cancer (CRC) is a major health burden globally. The prognosis of CRC is strongly influenced by the presence of lymphovascular invasion (LVI) and lymph node (LN) metastasis. Transforming growth factor-beta (TGF-β) is a cytokine with a complex role in CRC progression. This study aimed to evaluate the significance of TGF-β expression in predicting LVI and LN metastasis in CRC. Methods: This cross-sectional study involved 50 patients diagnosed with CRC. The expression of TGF-β was assessed using immunohistochemical staining and the Allred scoring system. The relationship between TGF-β expression and the presence of LVI and LN metastasis was analyzed using the Chi-square test. Results: High TGF-β expression was significantly associated with both LVI (p = 0.011) and LN metastasis (p = 0.012) in CRC. Patients with high TGF-β expression had a higher risk of LVI and LN metastasis compared to those with low TGF-β expression. Conclusion: TGF-β expression is a significant predictor of LVI and LN metastasis in CRC. This finding has potential implications for risk stratification and treatment decisions in CRC patients.
Loss of E-cadherin Expression Stratifies Aggressive versus Non-Aggressive Papillary Thyroid Carcinoma Dwi Yanti Fioni Putri; Yenita; Aswiyanti Asri; Tofrizal; Rony Rustam; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1498

Abstract

Background: Papillary thyroid carcinoma (PTC) is generally indolent, yet specific histological subtypes defined by the World Health Organization (WHO) are linked to aggressive behavior and poor prognosis. The loss of the cell-adhesion protein E-cadherin is a hallmark of the epithelial-to-mesenchymal transition (EMT), a process implicated in tumor aggression. However, its role in stratifying PTC subtypes versus its correlation with tumor stage remains a significant controversy in the literature. This study aimed to disentangle these two parameters by clarifying the relationship between E-cadherin expression and both histological phenotype and tumor stage. Methods: This was an observational, cross-sectional pilot study on 40 randomly selected, formalin-fixed, paraffin-embedded (FFPE) PTC cases from a 2024 cohort (N=74) at a tertiary hospital in Indonesia. All cases were re-evaluated and classified according to the WHO 5th Edition (2022) criteria as non-aggressive (n=34) or aggressive (n=6). E-cadherin expression was assessed by immunohistochemistry (IHC) using a standardized semi-quantitative scoring system (product of intensity and proportion) adapted from previous studies, with inter-rater reliability assessed (Cohen’s Kappa = 0.88). Scores were dichotomized as 'High' (n=25) or 'Low' (n=15). The association between E-cadherin expression and both histological subtype and AJCC 8th Edition tumor stage (Early: I/II [n=32] vs. Advanced: III/IV [n=8]) was analyzed using Fisher's Exact Test, with Odds Ratios (OR) and 95% Confidence Intervals (CI) calculated. Results: High E-cadherin expression was observed in 62.5% of cases. A statistically significant and strong association was found between E-cadherin expression and histological subtype (p=0.021; OR 12.0; 95% CI 1.2–118.9). Low E-cadherin expression was present in 83.3% (5 of 6) of aggressive-subtype tumors, versus only 29.4% (10 of 34) of non-aggressive subtypes. In contrast, no significant correlation was found between E-cadherin expression and advanced tumor stage (p=0.126; OR 3.67; 95% CI 0.7–18.6). Conclusion: Loss of E-cadherin expression is a significant biomarker associated with high-risk, aggressive histological phenotypes in PTC. Its lack of correlation with tumor stage, confirmed by an uncertain OR, suggests E-cadherin's role is indicative of an inherent tumor biological phenotype (aggressiveness) rather than a linear marker of tumor progression (stage). This dichotomy, likely reflecting EMT/MET plasticity, positions E-cadherin IHC as a powerful ancillary tool for pathological risk stratification.