Ipatia A Doussis-Anagnostopoulou

National and Kapodistrian University of Athens, Athínai, Attica, Greece

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Publications (15)82.25 Total impact

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    ABSTRACT: ABSTRACT E2F-1 is the best described member of the E2F-1 family of transcriptional factors and it is particularly interesting in view of its often opposing roles. Our purpose was to examine the immunohistochemical expression of E2F-1 in Hodgkin lymphoma (HL) and to correlate it with proliferation and apoptosis of the tumor, clinicopathological parameters and patient outcome, as well as with the expression of the downstream molecules p53 and p21. The median percentage of E2F-1-expressing HRS cells was 80.2 %. A significant positive correlation was found between expression of E2F-1 and p53 (p= 0.034). Following stratification of our cases, within the group harboring functional p53, a statistically significant inverse correlation was identified between E2F-1 and Topo IIa (p= 0.019). E2F-1 is upregulated in the context of HL and its expression is inversely associated with proliferation. It seems that functional p53 can modulate the relationship between E2F-1 expression and tumor kinetics in HL.
    Leukemia and Lymphoma 06/2014; 56(3):1-29. DOI:10.3109/10428194.2014.930850 · 2.89 Impact Factor
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    ABSTRACT: Angiogenesis leads to new blood vessel formation and is implicated in both physiological and pathological situations. The vascular endothelial growth factor (VEGF) family is the major mediator of this process. The aim of our study was to evaluate the expression of VEGF-A, vascular endothelial growth factor receptor-1 (VEGFR-1) and VEGFR-2 and their correlation with clinicopathological parameters and prognosis in patients with classical Hodgkin lymphoma (cHL), since the role of angiogenesis in this tumor still remains unclear. The immunohistochemical expression of VEGF-A, VEGFR-1 and VEGFR-2 was examined in 194 patients with cHL. The neoplastic Hodgkin Reed–Sternberg (HRS) cells expressed VEGF-A, VEGFR-1 and VEGFR-2 in 90.3%, 97.2% and 94.1% of cases, respectively. Only the expression of VEGFR-2 was positively correlated with serum albumin levels ≥ 4 g/dL. No correlation with patient outcome was observed. All three molecules were statistically correlated with ramifications of blood vessels. Summarizing, our results are not sufficient to consider VEGF-A and/or VEGF receptors as prognosticators in cHL.
    Leukemia and Lymphoma 03/2014; 55(3). DOI:10.3109/10428194.2013.813629 · 2.89 Impact Factor
  • E C Georgiadi · N Sachinis · G Dimtsas · T P Vassilakopoulos · C Kittas · I A Doussis-Anagnostopoulou
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    ABSTRACT: Purpose: Apoptosis is a type of programmed cell death (PCD) with specific morphologic changes in the dying cell. Since classical Hodgkin's lymphoma (cHL) is characterised by abnormalities in the apoptotic pathways, apoptosis may play a central role in its pathogenesis. Our purpose was to estimate the apoptotic process in cases of cHL using 3 different, widely accepted methods, comparing their results as well as with those found in the literature. Methods: Detection of apoptosis was performed in 76 cases of cHL, using morphological criteria, TUNEL assay (TUNEL apoptotic index; T-AI) and immunohistochemical detection of active caspase 3 (casp3-AI) on paraffin embedded sections. Results: When both apoptotic (MA) and mummified (mummi-I) cells were evaluated by morphological apoptotic index (morph-AI), the median value was 10.3%, while for MA and mummi-I the results were 3.4% and 6%, respectively. T-AI and casp3-AI values were 10.9% and 1.9%, respectively. Morph-AI was significantly higher in the mixed cellularity (MC) subtype (p7equals;0.047rpar;, while MA was significantly higher in the male subgroup (p7equals;0.03). MA was strongly correlated with casp37horbar;AI (p=0.01). Conclusion: Detection of apoptosis has become an important parameter in understanding tumor pathology and in designing antitumor treatment. A combination of methods is proposed in order to estimate accurately this form of cell death.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 10/2012; 17(4):746-752. · 0.74 Impact Factor
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    ABSTRACT: To correlate the immunohistochemical expression of topoisomerase IIalpha (topoIIalpha) in Hodgkin's lymphoma (HL) with clinicopathological parameters, the expression of Ki-67 and the outcome of patients, who had been homogenously treated with ABVD or equivalent regimens. Immunohistochemistry using the monoclonal antibody Ki-S1 (topoIIalpha) was performed in 238 HL patients. MiB1 (Ki-67) expression was evaluated in 211/238. The mean +/- SD percentage of topoIIalpha- and Ki-67-positive Hodgkin-Reed-Sternberg (HRS) cells was 63 +/- 19% (5%-98%) and 73 +/- 19% (8%-99%), respectively. The median percentage of topoIIalpha-positive HRS cells was 64% (interquartile range, 51-78%). There was no correlation between topoIIalpha expression and patient characteristics. TopoIIalpha and Ki-67 expression were correlated (Spearman's Rho 0.255, P < 0.001). TopoIlalpha expression within the highest quartile of this patient population was predictive of failure free survival (FFS) (10-year rates 82 +/- 3% vs 68 +/- 7%, P = 0.02 for patients falling into the quartiles 1-3 and 4 respectively). In multivariate analysis topoIIalpha expression was independently predictive of FFS. TopoIIalpha was expressed in all cases of HL showing a correlation with Ki-67 expression. Under current standard therapy including drugs inhibiting its activity, topoIIalpha was an independent adverse predictor of FFS with no statistically significant correlation with other established prognostic factors.
    Clinical Cancer Research 03/2008; 14(6):1759-66. DOI:10.1158/1078-0432.CCR-07-1395 · 8.72 Impact Factor
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    ABSTRACT: The ontogeny of the innervation of human lymphoid organs has not been studied in detail. Our aim was to assess the nature and distribution of parenchymal nerves in human fetal thymus and spleen. We used the peroxidase immunohistochemical technique with antibodies specific to neuron-specific enolase (NSE), neurofilaments (NF), PGP9.5, S100 protein, and tyrosine hydroxylase (TH) and evaluated our results with image analysis. In human fetal thymus, NSE-, NF-, S100-, PGP9.5-, and TH-positive nerves were identified associated with large blood vessels from 18 gestational weeks (gw) onwards, increasing in density during development. Their branches penetrated the septal areas at 20 gw, reaching the cortex and the corticomedullary junction between 20 and 23 gw. Few nerve fibers were seen in the medulla in close association with Hassall's corpuscles. In human fetal spleen, NSE-, NF-, S100-, PGP9.5-, and TH-positive nerve fibers were localized in the connective tissue surrounding the splenic artery at 18 gw. Perivascular NSE-, NF-, S100-, PGP9.5-, and TH-positive nerve fibers were seen extending into the white pulp, mainly in association with the central artery and its branches, increasing in density during gestation. Scattered NSE-, NF-, S100-, PGP9.5-, and TH-positive nerve fibers and endings were localized in the red pulp from 18 gw onward. The predominant perivascular distribution of most parenchymal nerves implies that thymic and splenic innervation may play an important functional role during intrauterine life.
    Journal of Histochemistry and Cytochemistry 09/2007; 55(8):813-20. DOI:10.1369/jhc.6A7168.2007 · 1.96 Impact Factor
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    ABSTRACT: The significance of angiogenesis in Hodgkin's lymphoma (HL) is not well defined. The aim of this study was to evaluate various morphometric characteristics of microvessels in lymph node sections of 286 patients with HL at diagnosis and investigate their relationship with clinicopathologic parameters and prognosis. Microvessel density (MVD), total vascular area (TVA) and several size- and shape-related microvascular parameters were quantitated--after anti-CD34 immunohistochemical staining--in the region of most intense vascularization, using image analysis. An increase in microvessel caliber parameters (area, perimeter, major and minor axis length) and a decrease in MVD were noted with increasing stage. An inverse relationship was recorded between MVD and the number of involved sites (NIS) and LDH. In univariate analysis, overall disease-specific survival was adversely affected by MVD and TVA, whereas inferior failure-free survival (FFS) was associated with the presence of more flattened vessel sections. Multivariate analysis disclosed that the extent of angiogenesis (MVD/TVA), age and the NIS independently affected overall survival. Accordingly, FFS was independently linked to the shape of microvessels and albumin levels or the NIS. In conclusion, our data support the view that angiogenesis in HL provides independent prognostic information, requiring the concomitant evaluation of quantitative and qualitative aspects of microvascular network.
    Leukemia 07/2005; 19(6):894-900. DOI:10.1038/sj.leu.2403690 · 10.43 Impact Factor
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    ABSTRACT: We developed a clinical prediction rule for bone marrow involvement (BMI) in Hodgkin lymphoma based on 826 patients and validated it in 654 additional patients. Independent prognostic factors for BMI were x1, B symptoms; x2, stage III/IV prior to bone marrow biopsy; x3, anemia; x4, leukocytes fewer than 6 x 10(9)/L; x5, age 35 years or older; and x6, iliac/inguinal involvement. Each factor was graded as x(i)=1, if present, or x(i)=0, if absent. A simplified score Zs=8x1+6x2+5x3+5x4+3x5+3x6-8 was assigned to each patient. The sensitivity, specificity, and positive and negative predictive value of this prediction rule was 97.8%, 51.5%, 10.6%, and 99.8%, respectively. In the validation group, they were 98.1%, 40.3%, 12.7%, and 99.6%. According to Zs value, 3 risk groups for BMI were defined: low risk (Zs<0, 44% of patients, 0.3% risk), standard risk (Zs, 0-9; 37% of patients; 4.2% risk), and high risk (Zs>or=10, 20% of patients, 25.5% risk). Patients with low risk (stage IA/IIA without anemia and leukopenia; stage IA/IIA, younger than 35 years, with either anemia or leukopenia but no inguinal/iliac involvement; and stage IIIA/IVA without any of these 4 risk factors) do not need bone marrow (BM) biopsy. Patients with standard risk should be staged with unilateral biopsy, but patients with high risk may benefit from bilateral biopsy.
    Blood 03/2005; 105(5):1875-80. DOI:10.1182/blood-2004-01-0379 · 10.45 Impact Factor
  • Clinical Cancer Research 12/2003; 9(14):5430-1; author reply 5431. · 8.72 Impact Factor
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    ABSTRACT: Vascular endothelial growth factor (VEGF) is involved in tumour angiogenesis, an important process for the growth and metastatic potential of solid tumours. Numerous studies have demonstrated up-regulation of VEGF at both mRNA and protein level in various tumours and a correlation with advanced stage and prognosis has been demonstrated in some cases. Limited information exists about its role in lymphoid malignancies and in particular, Hodgkin's disease. The present study examined the immunohistochemical expression of VEGF using the monoclonal antibody VG1 in a series of 61 cases of Hodgkin's disease, including both classical Hodgkin's disease and the nodular lymphocyte predominance variant, and correlated these results with microvessel density, using an anti-CD31 monoclonal antibody. In 41 cases (70.6%) of classical Hodgkin's disease and one of the three cases of nodular lymphocyte predominance Hodgkin's disease, the neoplastic Reed-Sternberg and Hodgkin cells expressed VEGF. The staining observed was cytoplasmic, either diffuse or with a focal paranuclear distribution. Macrophages were always positive, while reactive lymphocytes showed occasional positivity. A variable amount of strong extracellular staining was also observed in the tissue stroma and intravascular plasma staining was prominent. There was no statistically significant relationship between VEGF expression and the subtype of Hodgkin's disease or microvessel density. In vitro studies using the Reed-Sternberg cell lines L428 and KM-H2 were also performed in both normoxia and hypoxia and VEGF protein production was assessed by flow cytometry (FACS), immunoassay of cell culture supernatant, and RT-PCR. Analysis by FACS demonstrated a subset of cells in both cell lines reacting with VG1 and analysis of secreted VEGF (pg/ml per 1x10(6) cells) in cell culture supernatant confirmed the normoxic production in both cell lines and significant hypoxic induction (p<0.005). Additionally, both cell lines expressed VEGF mRNA, as demonstrated using the RT-PCR method. In conclusion, neoplastic cells express VEGF in Hodgkin's disease, as is the case in solid tumours, and this expression may be induced by hypoxia. The presence of VEGF in reactive macrophages and in the extracellular matrix might facilitate tumour progression.
    The Journal of Pathology 08/2002; 197(5):677-83. DOI:10.1002/path.1151 · 7.43 Impact Factor
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    ABSTRACT: Interleukin-10 (IL-10) is a pleiotropic cytokine which increases bcl-2 levels and protects cells from steroid or doxorubicin-induced apoptosis. Hodgkin and Reed-Sternberg (HRS) cells bear functional IL-10 receptors. Thus serum IL-10 (sIL-10) might inhibit apoptosis in HRS cells, which could occur as a result of either chemotherapy or the crippled immunoglobulin genes. We determined sIL-10 levels in 122 patients with Hodgkin's lymphoma (HL), treated with ABVD or equivalent regimens with or without radiotherapy, and correlated them with presenting clinical and laboratory features, as well as failure-free survival (FFS) and overall survival. Elevated sIL-10 levels ( > or = 10 pg/mL) were detected in 55 patients (45%), and were correlated with advanced stage and elevated serum b2-microglobulin levels. At 7 years FFS was 85% vs. 63% for patients with normal vs. elevated sIL-10 levels, respectively (p=0.01); overall survival was 97% vs. 73% (p=0.005). Multivariate analysis with Cox's proportional hazards model demonstrated that elevated sIL-10 levels were the strongest independent predictor of FFS, and were also associated with inferior overall survival. We conclude that sIL-10 levels are elevated in 45% of patients with HL, and are associated with inferior FFS and overall survival, independently of other established prognostic factors.
    Haematologica 04/2001; 86(3):274-81. · 5.81 Impact Factor
  • Ipatia A Doussis-Anagnostopoulou · Sami Remadi · Helen Turley · Patrizia Gindre · Margaret Comley · Bettina Borisch · Kevin C Gatter
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    ABSTRACT: The catabolic enzyme thymidine phosphorylase (TP) plays a crucial role in nucleic acid metabolism by regulating the availability of thymidine. Platelet-derived endothelial cell growth factor (PD-ECGF) is an angiogenic factor that was recently shown to be TP. The angiogenic properties of PD-ECGF/TP are attributable to a reduction of thymidine levels that results in a promotion of endothelial cell proliferation. Early studies showed a higher concentration of TP in macrophages than in parenchymal cells and in neoplastic than in nonneoplastic tissues. We examined the immunohistochemical expression of PD-ECGF/TP in reactive lymphoid tissues (lymph node and tonsil), as well as in a series of 20 cases of Hodgkin's disease and 31 cases of non-Hodgkin's lymphomas. Macrophages, sinus lining cells, and cells with dendritic morphology, of both follicular dendritic and interdigitating reticular cell type, presented a prominent nuclear and cytoplasmic positivity in reactive lymphoid tissue and in malignant lymphomas. Small lymphocytes and the neoplastic population were always negative, whereas endothelial staining was variable and showed no correlation to the type or grade of the lymphomas. In Hodgkin's disease (with the exception of the nodular lymphocyte predominance type) and some cases of high-grade non-Hodgkin's lymphomas, the positive dendritic cells formed a dense meshwork closely surrounding the neoplastic population. Our results suggest that the reported upregulation of PD-ECGF/TP activity in lymphoid malignancies is attributable to the nonneoplastic population, especially to cells of dendritic morphology.
    Human Pathlogy 11/1997; 28(10):1146-51. DOI:10.1016/S0046-8177(97)90252-5 · 2.77 Impact Factor
  • Sami Remadi · William Mac Gee · Ipatia Doussis-Anagnostopoulou · Sophie Diebold Berger · Awatef Ismail
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    ABSTRACT: A case of papillary cystic tumor (PCT) of the pancreas in a 40-yr-old woman is reported. This rare neoplasm was discovered fortuitously by a CT-scan examination for a palpable abdominal uterine leiomyoma. Percutaneous fine-needle aspiration (FNA) of the pancreatic mass was performed under CT-scan guidance. Cytologic examination of the material gave the diagnosis of PCT, which was confirmed by histologic examination of the resected tumor. Immunohistochemical staining showed a high degree of positivity to wide-spectrum anticytokeratin and anticytokeratin 20, and a weak positivity to anti-NSE antibody. In addition, the tumor cells were highly reactive for progesterone antibody, while they were negative for estrogen. These findings suggest a ductal origin for PCT, and also suggest that sex hormones may play a role in its growth, but not in its genesis. We emphasize the value of FNA cytologic features in the diagnosis of these rare tumors.
    Diagnostic Cytopathology 12/1996; 15(5):398-402. DOI:10.1002/(SICI)1097-0339(199612)15:5<398::AID-DC8>3.0.CO;2-8 · 1.12 Impact Factor
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    ABSTRACT: bcl-2 was originally identified as an oncogene involved in follicular lymphomas as a result of chromosomal translocation (14;18). It is now believed that bcl-2 is implicated in the regulation of cell death by inhibiting apoptosis and that its expression is not restricted to haematopoietic cells, but is also present in many epithelial and mesenchymal tissues. Recent studies have analysed the expression of this molecule in a variety of non-lymphoid malignancies including lung, breast, prostate, and nasopharyngeal carcinomas and neuroblastoma. In the present study, 50 colorectal adenomas, 10 hyperplastic polyps, and 142 carcinomas, including 25 arising from pre-existing adenomas, were examined using an antibody detecting the bcl-2 protein product. In non-neoplastic mucosa, bcl-2 was expressed in the crypt cells only, whilst the more differentiated surface epithelial cells lacked any demonstrable bcl-2. Forty-one of the 50 adenomas (82 per cent) and 48 of the 142 carcinomas were positive for bcl-2 expression. All hyperplastic polyps were negative. A reciprocal relationship was found between bcl-2 reactivity and p53 overexpression, as detected by DO7 antibody, in approximately 65 per cent of the cases. The bcl-2-positive/p53-negative subgroup showed a strong correlation (P = 0.0056) with negative lymph node status (Dukes' A and B), implying a less aggressive pathway of neoplastic transformation.
    The Journal of Pathology 05/1996; 179(1):10-4. DOI:10.1002/(SICI)1096-9896(199605)179:1<10::AID-PATH540>3.0.CO;2-1 · 7.43 Impact Factor
  • I.A. DOUSSIS-ANAGNOSTOPOULOU · S Remadi · B Czernobilsky
    Histopathology 05/1996; 28(4):372-5. DOI:10.1046/j.1365-2559.1996.d01-428.x · 3.45 Impact Factor
  • Ipatia Doussis-Anagnostopoulou · Sami Remadi · Loukas Kaklamanis · Francesco Pezzella · Kevin C. Gatter
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    ABSTRACT: The recent demonstration that the murine anti-p53 monoclonal antibody PAb248 can identify human p53 in a variety of normal tissues proves that immunohistochemical detection does not necessarily indicate the presence of mutations. PAb248 can detect p53 protein in a cytoplasmic-perinuclear localization, not previously described. The present study presents the expression of this antibody in a series of 34 cases of Hodgkin's disease, comparing it with the antibodies CM1, PAb1801, and PAb240. In all cases, PAb248 showed uniform cytoplasmic-perinuclear staining in small and medium-sized lymphocytes, while it was constantly negative in Hodgkin, Reed-Sternberg (R-S/H) cells, and variants. This pattern of staining was the opposite to that observed with the antibodies CM1, PAb1801, and PAb240, where the staining was nuclear and restricted to the R-S/H cells, with the small lymphocytes being negative. p53 can be found in different conformations and localizations, with the cytoplasmic-perinuclear localization mainly, although not exclusively, being found in normal and reactive tissues and the nuclear localization being mainly expressed by neoplastic cells. These results give further support to the theory that the R-S/H cells are the neoplastic population in Hodgkin's disease, while the surrounding lymphocytes are reactive.
    The Journal of Pathology 02/1996; 178(2):170-2. DOI:10.1002/(SICI)1096-9896(199602)178:2<170::AID-PATH448>3.0.CO;2-Z · 7.43 Impact Factor

Publication Stats

236 Citations
82.25 Total Impact Points


  • 2001–2008
    • National and Kapodistrian University of Athens
      • • Department of Medicine
      • • Division of Histology - Embryology
      Athínai, Attica, Greece
  • 1997
    • PATH
      Seattle, Washington, United States
  • 1996
    • Oxford University Hospitals NHS Trust
      Oxford, England, United Kingdom
    • Northern Inyo Hospital
      BIH, California, United States