ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 *Habib Thameur Hospital, Tunisia Background & objectives: Immunoscore (IS), based on the evalua- tion of the immune infiltrate in the centre of the tumour and its inva- sive margin, is reported to be related to colorectal carcinomas (CRC) progression. Our study aimed to assess its prognostic value in CRC. Methods: A total of 104 tumour specimens from patients after curative resection were reviewed. An immunohistochemical study (anti-CD3, anti-CD8) was carried out in the areas of "Hot Spot" in the centre of the tumour and its invasive margin. IS was calculated by the method described by Galon et al. The prognostic value was assessed through a survival study. Results: The mean age of patients was 61.6 years. IS was I0 in 19.2%, I1 in 15.4%, I2 in 26%, I3 in 16.3% and I4 in 23.1%. Two groups were identified: low IS (≤ 2: I0-I2) and high IS (>2: I3 and I4). A predominance of low IS (60.6%, n= 63) was noted. Our study had shown that low IS significantly deteriorates overall survival while high IS enhances survival significantly (p <0.001). We found a correlation between low IS and advanced pT stage (p = 0.026) but IS was not correlated with age, tumour size, tumour grade, vascular emboli, perineural invasion, metastasis and pTNM stage. Conclusion: Increasing evidence demonstrates that the evolution of CRC is strongly dependent on the complex tumour microen- vironment, particularly the immune system cells. Immunoscore is, therefore, a potential prognostic factor for time to recurrence, overall and disease-free survival in CRC together with its predic- tive value of response to chemotherapy particularly in stage III. Its reproducibility and reliability allow its introduction into daily practice for a better therapeutic management. E-PS-06-079 Skeletal metastases as first clinical manifestation of malignant tumours of digestive system – a single centre experience R. Janković*, J. Jevtic, L. Simic, S. Rajkovic, G. Djuricic, D. Ris- tic, J. Sopta *University of Belgrade, Faculty of Medicine, Institute of Pathol- ogy, Belgrade, Serbia Background & objectives: Skeletal metastases are the most frequent malignant bone tumours. The aim of our study is to determine fre- quency of skeletal metastases as first clinical presentation of malignant tumours of digestive system. Methods: All biopsies taken at the Institute for Orthopedic Sur- gery “Banjica”, Belgrade over the 10-years period (2010-2019) were reviewed using histopathology reports from the files of the Institute of Pathology, Faculty of Medicine, University of Belgrade. Selected histological slides were re-examined. Clinical data were also analysed. Results: A total of 110 cases of skeletal metastases of digestive tumours were analysed. The vast majority of patients were males (77.3%). The average age of patients was 62.8±9.8 years. Most of the patients had skeletal metastases as first sign of malignant dis- ease (91,82%). Different imaging methods confirmed solitary skel- etal lesions in 65.4% cases. Metastases of digestive tract carcinomas were localized in the axial skeleton in 42.1%, appendicular skeleton in 46.7%, in both localization in 10,2%. The most common clinical presentation of skeletal metastases were pain (75.4%), mobility difficul- ties (28.2%) and pathological fracture (24.5%). Duration of symptoms before diagnosis was between 4-12 months (37.4% of patients). Conclusion: Skeletal metastases of visceral carcinomas are com- mon. In our study skeletal metastases were the first sign of malig- nant tumours of digestive tract in the vast majority of patients. It is unusual finding that patients had no preexisting gastrointestinal symptoms. This finding is very important because skeletal metas- tases are accepted as poor prognostic indicator. Early diagnosis through screening programs is highly important in future manage- ment and treatment decisions. E-PS-06-082 Gastric epithelial dysplasia (intraepithelial neoplasia): from an impression to an algorithm S. Mozgovoi*, A. Shimanskaya, M. Parygina, V. Rubtsov, A. Kononov *Omsk State Medical University, Russia Background & objectives: Epithelial dysplasia/intraepithelial neoplasia refers so-called marked gastric precancerous lesions. In the last revision of the WHO classification (2019), the term «dysplasia» was reintroduced, the terms indefinite dysplasia, intramucosal carcinoma and suspicion for invasive carcinoma are also used. Methods: In order to evaluate an agreement level of specialists in the practical use of the WHO-2019 studies were carried out with group of pathologists with international participation. Selection of diagnostic patterns are identified by examining the biopsy material for the identification of three diagnostic signs of gastric epithelial dysplasia: epithelial atypia, differentiation gradient disorder (cell maturation) and histoarchitectonic disorganization. Results: The agreement level was carried out using the Cohen’s kappa (k). Verbal designation of patterns was accompanied by demonstration of images, discussion of the expert consent criterion, evaluation of the level of reproducibility of identification of patterns from the position of personal assessment in a face-to- face and remote mode, as well as the calculation of individual indicators in group training in comparison with reference variant. A poor level of interexpert agreement was found: general k = 0.2. After comments and discussion (master class) the expert consent criterion increased dramatically: general k = 0.83. However, this level of agreement reflected, rather, «diagnostic conformism» - experts reproduced the opinion of the moderator. Conclusion: A schematic representation of diagnostic patterns, the application of which is described by the algorithm of actions, is support in making a diagnostic decision. The testing of the pictograms and algorithm allowed to reach a good level of agreement (k = 0.65). Usage of the proposed combinations of tissue and cellular patterns makes it possible to increase the accuracy and, most importantly, the reproducibility of diagnosis. Such approach probably reflects the new education standard for practical usage. E-PS-06-083 Crohn’s disease discovered through a herpetic superinfection: about a case M. Alaya*, B. Chelly, A. Ayari, H. Azouz, A. Zehani, I. Chelly, K. Bellil, S. Haouet *Department of Pathology, La Rabta Hospital, Tunis, Tunisia Background & objectives: Herpetic viral superinfection in patients with chronic inflammatory bowel disease (IBD) is rare and responsible for outbreaks of IBD. This study aims to highlight the anatomo-clinical particularities of the association of IBD and herpes viral infections of the digestive tract. Methods: We report a case collected in December 2011 in the Pathological Anatomy department of La Rabta Hospital. Results: The patient was female, 21 years old and hospitalized for the first time in gastrology department due to liquid diarrhea S238