Thursday, February 21st, 2019


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Immunohistochemical Features of the Pseudomyxoma Peritonei Microenvironment: An Opportunity for Clinicians
Authors:  Fabio Grizzi, Ph.D., Ferdinando Carlo Maria Cananzi, M.D., Serena Battista, M.D., Tatiana Brambilla, M.D., Dorina Qehajaj, B.Sc., Maurizio Chiriva-Internati, Ph.D., Uberto Fumagalli Romario, M.D., Vittorio Quagliuolo, M.D., and Pietro Francesco Bagnoli, M.D.
  Objective: To provide new details on the pseudomyxoma peritonei (PMP) microenvironment and discuss its potential role on the clinical behavior of this tumor.
Study Design:
In the present study, in addition to routine histology, immunostains for CD68, CD3, CD20, Ki-67, CD34, LYVE-1, and the tumor-associated antigens (TAAs) pituitary-tumor transforming gene 1 (PTTG1) and squamous cell carcinoma antigen 1 (SCCA1) were explored. Fourteen consecutive patients who underwent cytoreductive surgery with hyperthermic intraoperative peritoneal chemotherapy were included in the study.
We found the presence of variable amounts and pattern distributions of CD68+ cells, CD3+ T-cells, and CD20+ B-cells in the PMP microenvironment. CD3+ lymphocytes were grouped in clusters in 7 out of 14 (50%) PMPs, while only 4 out of 14 (29%) had dispersed CD20+ lymphocytes. CD68+ macrophages were always found dispersed throughout the PMP microenvironment. PMPs have been also found highly vascularized by blood vessels when compared to LYVE-1+ lymphatic vessels, and variably proliferative as shown by different Ki- 67+ cell densities. Additionally, PMPs were immunopositive for PTTG1 and SCCA1, 2 TAAs previously associated with the progression and recurrence of various human malignancies.
Our findings highlight unknown features about PMP microenvironment organization and represent a basis for additional studies including a large cohort of patients to reveal helpful information on the clinical behavior of this tumor.
Keywords:  biomarkers, immunity, pituitary-tumor transforming gene 1, pseudomyxoma peritonei, squamous cell carcinoma antigen 1
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