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Correlation of tumor-associated macrophage density and proportion of M2 subtypes with the pathological stage of colorectal cancer

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1878-1889页

作者： Fouzia Fazal Muhammad Arsalan Khan Sumayya Shawana Rahma Rashid muhammed mubarak Department of Pathology Jinnah Medical and Dental CollegeKarachi 74800SindhPakistan Department of General Surgery Sindh Institute of Urology&Transplantation(SIUT)Karachi 74200SindhPakistan Department of Pathology Bahria University of Health SciencesKarachi 74400SindhPakistan Department of Pathology SIUTKarachi 74200SindhPakistan

BACKGROUND Colorectal cancer(CRC)is a prevalent global malignancy with complex prognostic ***-associated macrophages(TAMs)have shown paradoxical associations with CRC survival,particularly concerning the M2 *** We aimed to establish a simplified protocol for quantifying M2-like TAMs and explore their correlation with clinicopathological *** A cross-sectional study included histopathological assessment of paraffinembedded tissue blocks obtained from 43 CRC *** CD68 and CD163 immunohistochemistry,we quantified TAMs in tumor stroma and front,focusing on M2 ***,histopathological,and clinical parameters were *** TAM density was significantly higher at the tumor front,with the M2 proportion three times greater in both *** tumor front had a higher M2 proportion,which correlated significantly with advanced tumor stage(P=0.04),pathological nodal involvement(P=0.04),and lymphovascular invasion(LVI,P=0.01).However,no significant association was found between the M2 proportion in the tumor stroma and clinicopathological *** Our study introduces a simplified protocol for quantifying M2-like TAMs in CRC tissue *** demonstrated a significant correlation between an increased M2 proportion at the tumor front and advanced tumor stage,nodal involvement,and *** suggests that M2-like TAMs might serve as potential indicators of disease progression in CRC,warranting further investigation and potential clinical application.

关键词： Colorectal cancer Macrophages Tumor stroma M2 subset Tumor front Tumor stage Lymphovascular invasion Prognosis Tumor-associated macrophages Immunohistochemistry

Changes in the terminology and diagnostic criteria of non-alcoholic fatty liver disease:Implications and opportunities

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World Journal of Gastrointestinal Pathophysiology 2024年第1期15卷 1-8页

作者： muhammed mubarak Javed I.Kazi Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200Pakistan

Fatty liver disease(FLD)is a highly prevalent pathological liver *** has many and varied etiologies and has heterogeneous clinical course and *** proper nomenclature and classification have been problematic since its initial ***,it was divided into two main categories:Alcoholassociated liver disease and nonalcoholic FLD(NAFLD).Among these,the latter condition has been plagued with nomenclature and classification *** two main objections to its use have been the use of negative(non-alcoholic)and stigmatizing(fatty)terms in its *** attempts were made to address these issues but none achieved universal *** recently,NAFLD has received a new nomenclature from an international collaborative effort based on a rigorous scientific *** has been renamed steatotic liver disease(SLD),and NAFLD as metabolic dysfunction-associated *** dysfunction-associated steatohepatitis was chosen as the replacement terminology for non-alcoholic *** is a significant positive change in the nomenclature and categorization of FLD and will likely have a major impact on research,diagnosis,treatment,and prognosis of the disease in the future.

关键词： Fatty liver disease Metabolic syndrome Non-alcoholic fatty liver disease Steatotic liver disease Steatohepatitis

Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra

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World Journal of Transplantation 2024年第1期14卷 84-95页

作者： muhammed mubarak Amber Raza Rahma Rashid Fnu Sapna Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Thrombotic microangiopathy(TMA)is an uncommon but serious complication that not only affects native kidneys but also transplanted *** review is specifically focused on post-transplant TMA(PT-TMA)involving kidney transplant *** reported prevalence in the latter population varies from 0.8%to 14%with adverse impacts on both graft and patient *** has many causes and associations,and the list of etiologic agents and associations is growing *** pathogenesis is equally varied and a variety of pathogenetic pathways lead to the development of microvascular injury as the final common ***-TMA is categorized in many ways in order to facilitate its ***,more than one causes are contributory in PT-TMA and it is often difficult to pinpoint one particular cause in an individual ***,the hallmark lesions are endothelial cell injury and intravascular thrombi affecting the *** diagnosis and classification of PT-TMA are imperative for optimal outcomes but are challenging for both clinicians and *** Banff classification has addressed this issue and has developed minimum diagnostic criteria for pathologic diagnosis of PT-TMA in the first *** of the condition is also challenging and still largely *** varies from simple maneuvers,such as plasmapheresis,drug withdrawal or modification,or dose reduction,to lifelong complement blockade,which is very expensive.A thorough understanding of the condition is imperative for an early diagnosis and quick treatment when the treatment is potentially *** review aims to increase the awareness of relevant stakeholders regarding this important,potentially treatable but under-recognized cause of kidney allograft dysfunction.

关键词： Thrombotic microangiopathy Microvascular injury Anemia Thrombocytopenia Kidney allograft failure

Expanding role and scope of artificial intelligence in the field of gastrointestinal pathology

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Artificial Intelligence in Gastroenterology 2024年第2期5卷 10-19页

作者： muhammed mubarak Rahma Rashid Fnu Sapna Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Digital pathology(DP)and its subsidiaries including artificial intelligence(AI)are rapidly making inroads into the area of diagnostic anatomic pathology(AP)including gastrointestinal(GI)*** is poised to revolutionize the field of diagnostic ***,AP has been slow to adopt digital technology,but this is changing rapidly,with many centers worldwide transitioning to *** with advanced techniques of AI such as deep learning and machine learning,DP is likely to transform histopathology from a subjective field to an objective,efficient,and transparent *** is increasingly integrated into GI pathology,offering numerous advancements and improvements in overall diagnostic accuracy,efficiency,and patient ***,AI in GI pathology enhances diagnostic accuracy,streamlines workflows,provides predictive insights,integrates multimodal data,supports research,and aids in education and training,ultimately improving patient care and *** review summarized the latest developments in the role and scope of AI in AP with a focus on GI *** main aim was to provide updates and create awareness among the pathology community.

关键词： Gastrointestinal pathology Digital pathology Artificial intelligence Machine learning Deep learning Precision diagnostics

Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

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World Journal of Transplantation 2024年第1期14卷 154-163页

作者： Ameet Kumar Jesrani Syed M Faiq Rahma Rashid Tariq Ali Kalwar Rehan Mohsin Tahir Aziz Nida Amin Khan muhammed mubarak Department of Radiology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Transplantation Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Urology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term *** and novel ultrasound-based investigations are being increasingly used for this purpose with variable *** To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological *** This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the Departments of Transplantation and Radiology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan,from August 2022 to February *** consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this *** and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic *** The mean age of all patients was 35.32±11.08 *** these,126(81.8%)were males and 28(18.2%)were *** mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 *** allograft biopsy results showed chronic changes in 55(37.66%)*** sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft *** can be of great help during the routine follow-up of kidney transplant recipients for screening a

关键词： Shear wave Sonoelastography Resistive index Chronic allograft changes Biopsy Histopathology

Clinicopathological features and medium-term outcomes of histologic variants of primary focal segmental glomerulosclerosis in adults:A retrospective study

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World Journal of Nephrology 2024年第1期13卷 14-24页

作者： Nazarul Hassan Jafry Shumaila Manan Rahma Rashid muhammed mubarak Department of Nephrology Sindh Institute of Urology and TransplantationSindhKarachi 74200Pakistan Department of Pathology Sindh Institute of Urology and TransplantationSindhKarachi 74200Pakistan

BACKGROUND The Columbia classification identified five histological variants of focal segmental glomerulosclerosis(FSGS).The prognostic significance of these variants remains *** To evaluate the relative frequency,clinicopathologic characteristics,and medium-term outcomes of FSGS variants at a single center in *** This retrospective study was conducted at the Department of Nephrology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan on all consecutive adults(≥16 years)with biopsy-proven primary FSGS from January 1995 to December *** subjects were treated with steroids as a first-line *** response rates,doubling of serum creatinine,and kidney failure(KF)with replacement therapy were compared between histological variants using ANOVA or Kruskal Wallis,and Chi-square tests as *** were analyzed by SPSS version 22.0.P-value≤0.05 was considered *** A total of 401 patients were diagnosed with primary FSGS during the study *** these,352(87.7%)had a designated histological *** not otherwise specified(NOS)variant was the commonest,being found in 185(53.9%)patients,followed by the tip variant in 100(29.1%)***(COL),cellular(CEL),and perihilar(PHI)variants were seen in 58(16.9%),6(1.5%),and 3(0.7%)patients,*** and PHI variants were excluded from further analysis due to small patient *** mean follow-up period was 36.5±29.2 *** response rates of variants,patients with TIP lesions achieved remission more frequently(59.5%)than patients with NOS(41.8%)and COL(24.52%)variants(P<0.001).The hazard ratio of complete response among patients with the COL variant was 0.163[95%confidence interval(CI):0.039-0.67]as compared to patients with *** TIP variant showed a hazard ratio of 2.5(95%CI:1.61-3.89)for complete remission compared to the NOS ***,progressive KF was observed more frequently in patients with the COL variant,43.

关键词： Adults Columbia classification Focal segmental glomerulosclerosis Histological variants Kidney failure Kidney failure with replacement therapy

Transitioning of renal transplant pathology from allograft to xenograft and tissue engineering pathology:Are we prepared?

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World Journal of Transplantation 2023年第3期13卷 86-95页

作者： muhammed mubarak Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

Currently,the most feasible and widely practiced option for patients with endstage organ failure is the transplantation of part of or whole organs,either from deceased or living ***,organ shortage has posed and is still posing a big challenge in this *** options being explored are xenografts and engineered/bioengineered tissues/*** small steps have been taken in this direction and sooner or later,these will become a norm in this ***,these developments will pose different challenges for the diagnosis and management of problems as compared with traditional *** approach to pathologic diagnosis of dysfunction in these settings will likely be significantly ***,there is a need to increase awareness and prepare transplant diagnosticians to meet this future challenge in the field of xenotransplantation/regenerative *** review will focus on the current status of transplant pathology and how it will be changed in the future with the emerging scenario of routine xenotransplantation.

关键词： Xenotransplantation Bioengineered tissues Pathology Allograft Xenograft

Evolution of human kidney allograft pathology diagnostics through 30 years of the Banff classification process

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World Journal of Transplantation 2023年第5期13卷 221-238页

作者： muhammed mubarak Amber Raza Rahma Rashid Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

The second half of the previous century witnessed a tremendous rise in the number of clinical kidney transplants *** activity was,however,accompanied by many issues and *** accurate diagnosis and appropriate management of causes of graft dysfunction were and still are,a big *** allograft biopsy played a vital role in addressing the above ***,its interpretation was not standardized for many years until,in 1991,the Banff process was started to fill this ***,regular Banff meetings took place every 2 years for the past 30 *** changes have taken place in the interpretation of kidney allograft biopsies,diagnosis,and classification of rejection and other non-rejection pathologies from the original Banff 93 *** review attempts to summarize those changes for increasing the awareness and understanding of kidney allograft pathology through the eyes of the Banff *** will interest the transplant surgeons,physicians,pathologists,and allied professionals associated with the care of kidney transplant patients.

关键词： Banff process Rejection Kidney allograft biopsy Transplant pathology Review

Collapsing focal segmental glomerulosclerosis: Current concepts

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World Journal of Nephrology 2012年第2期1卷 35-42页

作者： muhammed mubarak Department of Histopathology Sindh Institute of Urology and Transplantation Karachi 74200 Pakistan

Collapsing focal segmental glomerulosclerosis （cFSGS）, also known as collapsing glomerulopathy is currently classified under the rubric of FSGS. However, its de-fining morphological features are in stark contrast to those observed in most other variants of FSGS. During the early stage of the disease, the lesion is character-ized pathologically by an implosive segmental and/or global collapse of the glomerular capillary tufts, marked hypertrophy and hyperplasia of podocytes, and severe tubulointerstitial disease. With advancement of the disease, segmental and/or global glomerulosclerosis is also observed in association with the collapsing le-sions. The etiology of this enigmatic disorder is still elusive, but a growing list of diseases/conditions is being reported in association with this morphological pattern of renal parenchymal injury. The pathogenesis of cFSGS involves discreet epithelial cell injury leadingto cell cycle dysregulation and a proliferative cellularphenotype. From the clinical perspective, cFSGS is no-torious for its propensity to affect black people, a highincidence and severity of nephrotic syndrome, markedresistance to empirical therapy, and rapid progressionto end-stage renal disease. The lesion has also beenreported in transplanted kidneys either as recurrent orde novo disease, frequently leading to graft loss. Mostcases have been reported in western countries, but the lesion is also being increasingly recognized in the tropi-cal regions. The recent increase in reporting of cFSGS partly refects a true increase in the incidence and part-ly a detection bias. There is no specifc treatment for the disorder at present. Newer insights into the patho-genesis may lead to the development of targeted and specifc therapy in near future. There is an urgent need to increase awareness of the lesion among pathologists and nephrologists, especially those from developing countries, to ensure accurate diagnosis and appropriate managment. With the accumulation of

关键词： Collapsing focal segmental glomerulosclerosis End-stage renal disease Etiology Pathology Renal biopsy Prognosis