histo

• What will you be able to do after this session?

  Interpret staining patterns of selected tissues
• What does the Nottingham Prognostic Index predict?

  Breast cancer prognosis
• What parameters does the Nottingham Prognostic Index take into account?

  Tumour grade and tumour stage
• How is the Nottingham Prognostic Index calculated?

  NPI = [0.2 x S] + N + G
• What does 'S' represent in the Nottingham Prognostic Index formula?

  Size of the index lesion in centimetres
• What does 'N' represent in the Nottingham Prognostic Index formula?

  Node status
• What does 'G' represent in the Nottingham Prognostic Index formula?

  Grade of tumour
• How is tumour size approximated in the Nottingham Prognostic Index?

  By T stage of TNM
• What is the classification for N in the Nottingham Prognostic Index?

  0 nodes = 1, 1-3 nodes = 2, >3 nodes = 3
• What are the grades of tumour in the Nottingham Prognostic Index?

  Grade I = 1, Grade II = 2, Grade III = 3
• What is the size classification for T1 in breast cancer staging?

  T1 < 2 cm
• What is the size classification for T2 in breast cancer staging?

  T2 2-5 cm
• What is the size classification for T3 in breast cancer staging?

  T3 > 5 cm
• What does N1 indicate in breast cancer staging?

  1-3 nodes
• What does N2 indicate in breast cancer staging?

  Up to 9 local lymph nodes
• What does N3 indicate in breast cancer staging?

  10 or more lymph nodes or spread to collarbone/armpit
• What does Tis indicate in breast cancer staging?

  Carcinoma in situ
• What are the classifications for Nottingham Prognostic Index (NPI)?

  NPI I < 2.4, NPI II > 2.4 but < 3.4, NPI III > 3.4 but < 5.4, NPI IV > 5.4
• What is the significance of Ki-67 in breast cancer?

  Ki-67 > 15% is a poor prognostic indicator
• What does Ki-67 indicate in terms of cell cycle?

  Present in Late G1, S, G2, and M phases
• What does pan-cytokeratin staining confirm?

  Cells are epithelial
• What is the use of pan-cytokeratin in lymph nodes?

  Confirms metastatic disease from epithelial cancer
• What does p53 staining indicate?

  Normal tissue shows mostly negative staining
• What does p53 status indicate about tumour sensitivity?

  p53 proficient tumours are more sensitive
• What happens in p53-positive tumours?

  Dominant negative mutation leads to non-functional p53
• What is the role of basal markers like p63?

  Basal cells are lost in some epithelial cancers
• What is the implication of PD-L1-positive tumour cells?

  They down-regulate T-cell responses
• What is the significance of complete or incomplete membrane staining in tumours?

  Considered positive if complete or incomplete
• What is the role of anti-PD-L1/PD-1 in treatment?


  Enhances immune recognition of the tumour
• What does a strong-mod staining in tumour indicate?


  Use anti-PD-L1/PD-1 treatment
• What is the significance of histological stains like H&E?

  Stains acidic components and highlights cytoplasm
• What does the Alcian blue stain indicate?

  Stains mucins in the GI tract
• What is the purpose of the Papanicolaou stain?

  Used for cervical cancer screening
• What are the stages of tissue processing from sample receipt to slide preparation?

  1. Sample receipt
  2. Fixation
  3. Dehydration
  4. Clearing
  5. Embedding
  6. Sectioning
  7. Staining
  8. Mounting
• What are the diagnostic applications of the following markers?

  • ER/PR stain in breast cancer
  • Ki-67 (or PCNA) stain in any tumour
  • Pan-cytokeratin stain in lymph node biopsy
  • p16 stain in cervical biopsy
  • Basal cell markers (prostate, epithelial pre-cancer)
  • Immune checkpoint inhibitors
  • Pap stain interpretation
  • Alcian blue and Masson trichrome applications in diagnostics
• What will later lectures cover regarding tumour markers?

  • FISH/Immuno for common tumour markers
  • EGFR and Her-2
  • Mutation analysis of oncogenes predicting responses
• What is the role of tumour suppressor genes (TSGs)?

  Regulate normal cell growth
• How do TSGs become inactivated in cancer?

  Through deletion or mutation
• What is a tumour suppressor gene?

  A gene that reduces tumour cell probability
• What is the famous TSG frequently mutated in cancers?

  p53 (TP53)