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Journal of Oncology Translational Research

ISSN: 2476-2261

Open Access

Current Issue

Volume 6, Issue 4 (2020)

    Short Communication Pages: 1 - 1

    Clinicopathological and Cyclin D1, E-cadherin, EGFR, HER- 2, Ki67, and p53 immunomarkers correlation in Gall bladder cancer cases and its precursor lesions

    Anshoo Agarwal

    Background:

    The Indian Council of Medical Research in India has reflected that the occurrence of Gall bladder carcinoma (GBC) is predominantly higher in northern India. Reports from ICMR suggests that the incidence of GBC corresponds to 3.6 per million in males and 7.4 per million in females in Delhi, India, as compared to 1.13 per million in the US. The incidence is high in females and it represent almost three fourths of GBC victims and their highest incidence rate occur in this region, yet only few immunomarker studies are available from this high-predisposing region. GBC has also been reported to show a variable expression pattern among different ethnic groups. GBC results via the dysplasia-metaplasia sequence and the 5-year survival rate for GBC is 32% and for the advanced stage it is only 10%. Current studies have focused on the importance of Cyclin D1, E-cadherin, EGFR, HER-2, Ki67, and p53 immunomarkers in the development and prognosis of GBC. One of the most genetic aberrations is ascribed to be HER-2 in GBC. HER-2 and other immunomarkers Cyclin D1, E-cadherin, EGFR, Ki67, and p53 can be easily assessed by standard immunohistochemistry methods. However, concrete results have not been obtained due to a limited number of respectable GBC cases presented at the hospitals. We, therefore, attempt to evaluate the immune-expression of these markers in GBC cases and determine their prognostic value in the selected GBC cohort.

    Material and Methods:

    30 resected GBC cases were collected from the Gall bladder lesion cases. Histological type, and differentiation grading of all specimens was obtained from H&E-stained slides. Immunohistochemistry Formalin-fixed (10%), paraffin-embedded GBC were sectioned (3–5 μm thick) and were treated with ready-to-use monoclonal antibodies Cyclin D1, E-cadherin, EGFR, HER- 2, Ki67, and p53 c-erbB-2 of (Dako® Corporation, Carpinteria, Calif., USA) were used as the primary antibody. Scoring was based on the Herceptest TM (Dako) criteria; semi-quantitative analysis of the stain intensity was carried out. The number of Immunomarker-stained cells in representative microscopic fields was counted.

    Results:

    The average age of the patient cohort was 53 years, and 55% of them were females. 62% of cases had gallstones of different sizes and the average tumor size was 45 mm. All the cases were mostly histologically proved to be adenocarcinoma. About 11/30 of the patients showed staining for HER-2 , and 10/30 of the tumor cases showed positivity for p53, 14/30 of the tumor cases showed positivity for Cyclin D1,12/30 of the tumor cases showed positivity for E-cadherin, 113/30 of the tumor cases showed positivity for EGFR, and 17 /30 of the tumor cases showed positivity for Ki67 .Contingency table analysis by χ2 tests showed that HER-2, Cyclin D1, E-cadherin, EGFR, positivity showed significance with sex (p = 0.02). On the other hand, Ki67, and p53-positive cases did not show any significance with clinicopathological factors. HER-2, Cyclin D1, E-cadherin, EGFR, Ki67, and p53 showed statistical significance. Hence their expressions are considered to be significant prognostic factors in the selected GBC cohort.

    Conclusions:

    Consequently, it can be summed up that there is an important need to search for immuno- markers of GBC, which will not only diagnose and prognosticate the disease but also help in choosing the appropriate mode of therapy and may give us an opportunity to make our basic understanding of GBC pathology clearer. Thus, our study assesses the expression of important immunomarkers involved in the pathogenesis of GBC, correlates it with clinicopathological parameters and establishes it as an independent prognostic factor in GBC.

    Short Communication Pages: 2 - 2

    Malignant tumor regression balancing internal energies and chakras energies replenishment

    Huang Wei Ling

    Introduction: Spontaneous tumor regression was defined differently for many types of cancer by several researchers during the last century. Spontaneous regression is partial or complete disappearance of primary tumor tissue or its metastases in patients who have never been treated. According to traditional Chinese medicine (TCM), malignant tumor has a cause energies deficiencies and Heat retention.

    Purpose: to demonstrate that malignant tumor can regress in to benign or disappear completely only balancing internal energies, taking out Heat retention and replenishment the chakras energies deficiencies with highly diluted medications.

    Methods: Three clinical cases reports. All three patients with cancer diagnoses (case one: thyroid; case two: uterus; case three: lungs). All three patients were found to be at their lowest level of energy (through radiesthesia), rating one out of eight. Treatment consisted in re-establish the equilibrium between Yin, Yang, Qi, Blood and taking out Heat retention through Chinese dietary counselling, auricular acupuncture with apex-ear bloodletting, homeopathy according to the Constitutional Homeopathy of Five Elements Based on Traditional Chinese Medicine and crystal-based medication.

    Results: The first two case reports were cured of their cancer condition without any treatment by Western medicine, only with the treatment done. The third patient, though, was already under radiotherapy and chemotherapy but through the treatment previously described the metastasis disappeared and he achieved a better physical and emotional health state.

    Conclusion: balancing internal energies and taking out Heat retention through Chinese dietary counselling, auricular acupuncture with apex ear bloodletting and replenishment the chakras energies meridians with highly diluted medications can induce malignant tumor regression according to these three cases reports. More studies should be done with more patients and with different kinds of tumors to have more data and confirmation of these results.

    Short Communication Pages: 3 - 3

    Expression of HER-2 and Ki-67 in Non-neoplastic and Preneoplastic Lesions of Gallbladder

    Anshoo Agarwal

    Gall-Bladder Cancer (GBC) is a neoplasm common in certain parts of the world. The various studies reported vary due to geographical and racial differences. North India presents itself as a major center for this fatal cancer with a varied gene and protein expression profile. The pathogenesis of GBC is a much talked about phenomenon and often reports the immune-expression of Ki67 and HER-2. HER2 is an oncoprotein which is overexpressed in some malignancies including breast and GIT. HER2 and Ki67 are overexpressed in gallbladder cancer and in precancerous lesions. In our study, we have attempted to identify the immune-expression of HER-2 and Ki67 in Gall Bladder lesion (Non-neoplastic and pre-neoplastic) cases. The primary reasons for twisted results seen in the different studies can be credited to the source of antibodies used for immunohistochemistry, race of the patient cohort, and criteria used to adjudge positivity in the stained samples .A number of recent studies have identified different immunomarkers overexpression giving rise to their oncogenic potential in non-neoplastic and preneoplastic lesions and has relation with GBC development and progression to Gall bladder carcinoma. The present study was undertaken to assess pattern and level of expression of HER2 in metaplasia, dysplasia, and different type of gallbladder lesions, which would determine its suitability as a prognostic biomarker in neoplastic transformation of gallbladder epithelium. The study was undertaken to find the expression and significance of Ki-67 index and HER2 in these lesions.

    Conclusions:

    Our study conducted is an immunohistochemical study of non-neoplastic and preneoplastic lesions of Gall bladder lesions suggesting the prognostic role of Ki67 and HER2. We found Ki67 and HER-2 as an independent prognostic factor indicating progression in its severity. In the past, the treatment for all sorts of gall bladder lesions used to be identical. However, improvements in molecular techniques, has a unique molecular signature. It is therefore important for identifying the gall-bladder lesions which may transform into malignancies later. Therefore, our study may be critical to define prospective patient subsets that may be at risk of developing gall bladder carcinoma.

    Short Communication Pages: 4 - 4

    Novel, Safe, Cheap, and, easily to get ʻ Vinegar as a decalcifying agent ʼ for bone tissue Histopathological demonstration

    Nesreen M. Safwat

    Bone is the strongest part in the human and animals, as well examination and reporting any histopathological changes of the different bone tissues is quite difficult than any other tissues, and to obtain satisfactory paraffin or celloidin of bone, the inorganic calcium must be removed (Jimson et al., 2012) through the decalcification process. There are numbers of decalcifying agents used in both veterinary pathology and histology research laboratories (Gayle Callis, 1998). So choosing the appropriate one depend upon some factors such as; time for decalcification with ribboning of sections, good nuclear staining and minimal edema (Bancroft and Gamble, 2016). I used a novel, household, safe solution which is the commercial table vinegar; the method was: an egg as a model (outer egg shell), sunken into commercial table vinegar solution Hienz ®, the decalcification resulted after only one day. After that a rabbit mandible was used to monitor the effect of vinegar on bone sample and inspected daily, the results come matching the outer egg shell but it took 28 days. So, I conclude that; may use the commercial table vinegar which contain 4-8 % acetic acid as a novel, safe, cheap, available decalcifying agent in both histology and pathology laboratories.

    Short Communication Pages: 5 - 5

    A novel mounting medium preserving stained tissue slides: in comparison with DPX©

    Nesreen M. Safwat

    The mounting medium is a solution used to adhere the coverslip to the slide to preserve and support stained tissue sections. The most popular mounting media used in laboratories for histopathology is a mixture of Distyrene (a polystyrene), a Plasticiser (tricresyl phosphate), and Xylene called DPX mounting medium that preserves stains and dries quickly. In this study a novel mixture was used replacing DPX; a mixture of extra pure benzene and Expanded Polystyrene Foam (EPF) which mixed together forming adhesive material used to adhere the coverslip with the clean, stained tissue slides, then examined under light microscopy by using different objective lenses magnification in comparison with DPX which cover the same stained tissue sections. Stored for one year to monitor the fading effect of the new mountant on the stained tissue sections. In conclusion Getting the same results of DPX, specially is a simple mixture can be made by any technician in any laboratory for histopathology as well as the time elapsed for drying of the new mounting medium is much more rapid in comparison with DPX and also the spread of EPF in many daily use product make the mixture also available and recycled in a good way as EPF used in floatation devices, egg cartons, sandwich and hamburger boxes, coffee cups and plates. Finally when I made comparison between this new mixture and DPX using the same tissues, the great results was the same, also when the colours has been measured by image analyser software to the record the difference.

    Short Communication Pages: 6 - 6

    Mental maps: glandular epithelial anomalies and the importance of differential diagnostics

    Claudia Angelica Peña Peña

    Mind Mapping is necessary to diagnose mainly differential diagnoses in medicine, pathology and citology. The presence of glandular epithelial abnormalities on conventional as well as liquid-based cervical cytology often causes difficulty for morphological interpretation, for these anomalies are associated with various benign and malign processes of the epithelium of the endocervix. Amongst endocervical lesions there is a benign group with morphological (architectural and cellular) similarities with neoplasia (adenocarcinoma). To help in its differential diagnosis and to show the course followed by this topic research, here we review neoplasia-like lesions, endocervical dysplasia and in situ adenocarcinoma.

    Short Communication Pages: 7 - 7

    Tips in breast cancer surgery ;

    Suheil Simaan

    Breast Cancer (BC) is the most common cancer in women accounting for about 30% of all female cancers. The average age of incidence varies among countries .While it is 62 years in the US, it is 48 years in the Arab countries. According to a recent statistics by me in Syria for example, 20% of cases occurred below the age of 40 (vs. 8% in the US). This has an important implication. A significant percentage of our BC cases occur at fertile age with high level of estrogen especially in pregnancy resulting in aggressive cancer. In dealing with breast cancer, we should be thinking of its biology. It is a slow growing cancer. By the time it is discovered mammo graphically (5 mm), it is 5 years old. Survival depends on the following five factors: 1. Size of lesion, 2. Grade, 3. Lymph node status, 4. Hormone receptor status, 5. Age of patient.

    Short Communication Pages: 8 - 8

    Tricks in breast cancer surgery

    Suheil Simaan

    Breast Cancer (BC) is the most common cancer in women accounting for about 30% of all female cancers. The average age of incidence varies among countries .While it is 62 years in the US, it is 48 years in the Arab countries. According to a recent statistics by me in Syria for example, 20% of cases occurred below the age of 40 (vs. 8% in the US). This has an important implication. A significant percentage of our BC cases occur at fertile age with high level of estrogen especially in pregnancy resulting in aggressive cancer. In dealing with breast cancer, we should be thinking of its biology. It is a slow growing cancer. By the time it is discovered mammo graphically (5 mm), it is 5 years old. Survival depends on the following five factors: 1. Size of lesion, 2. Grade, 3. Lymph node status, 4. Hormone receptor status, 5. Age of patient.

    Short Communication Pages: 9 - 9

    Clinical and pathological characteristics of Breast Cancer in Syria

    Suheil Simaan

    As indicated by the National Cancer Registry of Syrian MOH, commonest cancers seen and treated were breast, colorectal and carcinoma, followed by leukemia (adult and children) and lymphoma (Adult and children). Bladder, stomach and prostate were less common. According to our MOH Cancer Registry, supported 8000 carcinoma cases collected from several Hospitals in Syria, BC accounted for half-hour of female cancers in Syria. Age: Median =49 years Crude Incidence Rate: 29 per 100,000 Age Standardized Incidence Rate: 43 per 100,000 Histopathology: infiltrating duct carcinoma (70 %) Unfortunately, thanks to our present national crisis and war resulting into scarcity of resources and disruption of the health system that resulted in limited of human resources, movements of patients, damaged health facilities, and unavailability of health data system. Of these factors limited the role of the national cancer registry and its functionality. The last statistics available are dated in 2009, and no statistics or reports were produced then.

    Short Communication Pages: 10 - 10

    Uterine pathology of Tamoxifen-treated Breast Cancer patients

    Liane Deligdisch

    Both Breast and Uterus are highly sensitive to hormonal influences, normally related to their reproductive functions. Due to abundant Receptors in their tissues, hormones are capable of eliciting profound changes of breast and uterine tissues, including neoplasms. Prevention and therapy of Breast and Endometrial Cancers using hormones as an adjuvant therapy is successful but challenging as there are side effects to be avoided. Tamoxifen (Tam) is a non-steroidal synthetic triethylene estrogen derivative used successfully in the adjuvant therapy and prophylaxis of breast cancer. It binds to Estrogen Receptors(ER) in a manner similar to estradiol inducing a binding of Tam-ER complexes to the nuclear DNA resulting in a decrease of available unbound ER, exerting an antagonistic, antiestrogenic effect on breast tissue. Its effect on the uterus is more complicated as Tam acts both as an antagonist and an agonist of Estrogen. In the uterus the agonist effect is manifested by endometrial polyps, hyperplasia, leiomyomas, adenomyosis and occasional neoplasia. In the largest study published so far, endometrial tissue (from biopsies and Hysterectomies) from 700 patients treated with Tam for Breast cancer, 64% showed normal cycling or inactive/atrophic endometrium ; 24% had endometrial benign polyps with cystic glandular and/or mild hyperplastic glands, displaying a different histologic pattern from endometrial polyps seen in patients not treated with Tam; in 4.7% of cases, frankly malignant changes were identified, the majority serous carcinoma of high grade, less than one third low grade endometrioid carcinoma. The malignant endometrial tissue was found in polyps, not associated with hyperplastic or atypical glands as it is most often seen in endometrioid carcinoma of patients not treated with Tam. Endometriosis carcinoma is the most common gynecological cancer in the USA and in most of the industrialized world; its relationship with hyperestrogenism is well established although the carcinogenic mechanism is not yet clarified. Many reports of individual cases of high grade endometrial cancer including very aggressive carcinosarcomas have also been reported in Tam treated patients. Endometrial cancers were seen more often in older patients, and in those treated for a longer duration. Despite these unfavorable side effects Tam is still used for its beneficial effect in preventing and treating breast cancer. Recently however it was established that Aromatase Inhibitors (A.I.) stop the production of estrogen in post-menopausal women by blocking the enzyme Aromatase which turns androgens to estrogens, resulting in a decrease of the available Estrogen to stimulate ER positive breast cancer cells. The use of A.I. is therefore less associated with estrogen-agonist side effects; it may however have other side effects such as cardiac anomalies and osteoporosis. Tam and A.I. are still both considered effective and may be used in the prevention and adjuvant therapy of Breast Cancer.

    Short Communication Pages: 11 - 11

    How to Return the Death Programs of Cancer Cells to Work again and Cure Cancer within a short time

    Mahmoud Saad Mohamed El-Khodary

    Cancer is cell fleeing from death by blocking the intrinsic and extrinsic pathways of cell death programs. In the present work, the experimental formula was designed to remove these blockers. It was applied on 120 Swiss albinomice which were inoculated intraperitoneally and subcutaneously with Ehrlich Ascites Carcinoma cells; 1 × (10⁶) cell/mouse. The activity of the cell death programs of the tumor was detected by measuring the volume of Ascites fluid, counting the number of dead cancer cells, measuring the size of the tumor, detecting the positive reaction of caspase enzyme in cancer cells and presence of macrophages and apoptotic bodies in tumor tissue. The experimental formula succeeded in removing the blockers of the cell death program in cancer cells returning the cell death program to work again. Cancer is a serious problem; it is more dangerous than nuclear bombs. The World Health Organization in 2015 reported that 8.8 million people around the world died from cancer. In 2017, more than 14 million new cases were reported globally and may rise to over 21 million cases by 2030. In (2018), 9.6 million deaths were recorded globally. There are many types of cancer treatments like surgery, radiation, monoclonal therapy, adoptive cell transfer, target therapy, an angiogenesis inhibitor, hormone therapy, stem cell transplant and gold nanoparticles. But for all types of treatment out there, they all have serious side effects and they are unable to save all cancer patients. Cancer is difficult to treat.

    Short Communication Pages: 12 - 12

    The Mamma-CT. Senological diagnostics in a new dimension.

    Karsten Ridder

    The new modality oft the dedicated Mamma-CT is offering a robust and comfortable Examination of the breast. It is working without any compression and produces 3D-images of the breast without any superimposions. Therefore it is avoiding two of the major problems of conventional mammography: Pain for the examined women and superimposion of glandular tissue. Adding a very short examination time, extremely high resolution oft he acquired images and the facultativ usage of contrast-media, the new technology oft the Mamma-CT emerges to be one of the greatest invention of senological diagnostics in the last years. Despite the first impression of being nothing more, than a nice tool for further assessment and an evaluation method for complex microcalcifications or multifocal findings, the Mamma-CT has a lot of possibilities in daily routine and turns out to becoming a real problem solver. Due to its robustness, short examination time, high resolution of 0.15mm in an isotropic manner, great comfort and usability of contrast media it fills the great gap between conventional Mammographie / tomosynthesis / contrast-Mammographie (TiCEM) and MRI. Even more it has the potential of becoming the reference modality for patients with Breast-implants or the clinic of secreting/bleeding mamilla. In the first case, the Mamma-CT offers high-end imaging of the breast AND the implants in one exam - without any compromise in sensitivity / specifity or risk of damaging the implants due to compression. In the second case, the mammo-CT can be used as a 3D-high-resolution-imaging tool for a classic galactrography – a complete new way of diagnosing intraductal tumors, like papillomas. This talk shows the technological background, the physics and advantages of this modality. It helps you to compare it to the traditional technologies and classify it in the setup of a multimodality approach in modern senological diagnosis. It gives also some breathtaking examples of this fascinating modality and cases out of daily routine.

    Case Report Pages: 13 - 13

    Palliative Management of Late Stage Tongue Cancer by Laser: Experience of twenty patients

    Dilip Pawar

    Oral cancer is the most common Cancer in Indian Males. Risk factors include tobacco use, heavy alcohol use and human papillomavirus (HPV) infection. Symptoms include a sore that doesn't heal, a lump or a white or red patch on the inside of the mouth. Late stage tongue cancer is defined as any cancer in stage 4 which is unresectable. This happens either because of an increased size or early involvement of posterior part of tongue. Treatment includes surgery and radiation therapy. In some cases, chemotherapy may be required. Palliation in this condition is limited to nasogastric tube, pain management and Tracheostomy. Aspiration pneumonia is a progressive condition which keeps on increasing as the mobility of tongue decreases gradually. This becomes increasingly intolerable for patients as the tumour growth enhances. These patients have an extremely debilitating and limited life. Field cancerisation is very common in these patients leading to a very high incidence of recurrence. The conventional treatment modalities like chemotherapy and Radiotherapy are again not very effective and addition of Radiotherapy leads to an extensive side effects. There is inability to swallow solids more than liquids. Speech is badly affected, mucositis and xerostomia are common side effects. Long term effects include cricopharygeal stenosis. Most patients are at a disadvantage regarding their quality of life after palliative radiotherapy for tongue cancer. Lasers and light source technologies can be applied to a wide variety of open and laparoscopic surgeries, as well as other procedures encountered by general surgeons and other medical professionals. The ability to produce highly precise and controllable effects on tissues, and the potential to facilitate complex dissection make these devices a welcome addition to the armamentarium of the surgeon, who is skilled in their use. Each laser wavelength has a characteristic effect on tissue. The combination of the laser tissue interaction, the selection of the appropriate delivery systems and laser parameters determines the ultimate effects of laser use on the conduct and outcomes of surgery. The use of laser to ablate the tumors was used in late stage tongue cancers. Laser ablation of late stage cancers of tongue is used for debulking the tumor in a blood less manner. Laser ablation destroys the Tumour thermally over a real time basis. The use of real time imaging allows a constant monitoring of the destroyed area. There was a marked increase in quality of life. Which was apparent within a week? There was also a marked increase in the life span of patients. Conclusion: Laser ablation offers a viable alternative for palliation in late stage Tongue cancer. The Palliation achieved depends on age of patient and involvement of volume of the tongue.

    Volume 7, Issue 1 (2021)

      Short Communication Pages: 13 - 13

      Enhanced Recovery after Surgery (ERAS) pathways for patients with bone cancer who will undergo primary hip or knee arthroplasty, using large endoprosthesis

      Maria Bourazani

      Orthopedic prosthesis is widely used to restore joint function, relieve pain and improve the patient’s quality of life. Endoprosthesis are used in reconstructive
      orthopedic surgery of large joints and in orthopedic surgical oncology after tumor resection (bone cancer). Enhanced Recovery after Surgery pathways (ERAS)
      are applied to oncology patients undergoing primary THA or TKA; and through evidenced practices are used by the multidisciplinary team, with the aim of
      reducing the length of stay (LOS) in hospital. ERAS pathways have been reported to reduce postoperative stress, to promote fast recovery, without increasing
      complications or re-admissions. At the same time, ERAS pathways have been reported to increase patient satisfaction and surgical outcomes and reduce
      hospital costs.
      Aim: Implementing ERAS pathways for oncology patients with bone cancer who will undergo primary hip or knee arthroplasty, using large endoprosthesis.
      Methods: Review in databases: PubMed, Elsevier, Cochrane and Google Scholar using keywords.
      Conclusion: A lot of studies have shown that ERAS pathways are associated with reduced LOS in hospital, decreased complications, lower perioperative
      stress levels, and better surgical outcomes, at lower in-hospital cost. ERAS pathways are involving the surgeon, the anesthesiologist, the perioperative nurse,
      the physiotherapist, and when is needed the psychologist and the nutritionist as a multidisciplinary team. ERAS pathways include various techniques in three
      phases, preoperative, intraoperative and postoperative. However, anesthesia plays a key-role as it affects immediate recovery, patient satisfaction, postoperative
      complications such as delirium and nausea-vomiting (PONV), and in some cases with serious results.

      Short Communication Pages: 1 - 1

      Method proposed to prevent early (and maybe late) relapses in breast and other cancers

      Michael Retsky

      My colleagues and I have been studying a bimodal relapse pattern in breast cancer. This project started in 1993 when data from Italy and UK showed an
      unexpected bimodal relapse pattern in breast cancer. It seemed that 50 to 80% of all relapses in patients treated only with surgery occurred in an early wave
      of relapses in the first three years post-surgery. We have proposed a reasonable explanation over the years. It appears that the surgery to remove a primary
      tumor causes systemic inflammation for a week. During that time, dormant single malignant cells and avascular deposits escape from dormancy and appear as
      relapses within three years. The multi-national authors of these reports include medical oncologists, surgeons, anesthesiologists, physicists and other scientists
      from several fields. A potential solution seems to exist based on our analysis, data, and retrospective studies. That therapy is the common inexpensive analgesic
      ketorolac administered as iv at the time of surgery and perhaps as oral drug for a few days after surgery. We edited a book in 2017 that was published by
      Springer-Nature (1) and a number of papers including one recently published (2). Other reports support this and suggest mechanisms (3-5). We now show data
      that predicts this is a process that applies to many solid and other cancers. Based on data from lung cancer, inflammation level on the first day post-surgery
      predicts outcome. We propose that this disruptive innovation will result in a paradigm shift in oncology. In a recent development we are now working on a method
      to prevent late relapses as well. This would suggest that persons who are at risk of late relapse and going to have planned surgery for health or cosmetic reasons
      should have perioperative ketorolac just as if the surgery was for cancer.

      Short Communication Pages: 2 - 2

      Local and systemic inflammatory markers as prognostic and predictive markers in locally advanced triple negative breast cancer

      Lamiss Mohamed Sad, Ayman Elsaka, Yomna Zamzam and Walid Ahmed Almorsy

      Introduction: Local inflammatory markers have been defined as prognostic and predictive markers in triple negative markers as proved by many studies. The
      prognostic and predictive value of systemic inflammatory markers such as neutrophil lymphocyte ratio (NLR) and lymphocyte monocyte ratio (LMR) remain to
      be elucidated.
      Aim of study: To evaluate pathological complete response (PCR) to neoadjuvant chemotherapy in locally advanced cancer breast in relation to tumor infiltrating
      lymphocytes(TILs), neutrophil lymphocyte ratio and lymphocyte monocyte ratio as well as overall survival and disease free survival. Patients and methods: In
      Tanta university Hospital, oncology department form January 2012 to December 2013, 67 patients with locally advanced TNBC stage IIB, IIIB 0r IIIC using TNM
      8th edition. All patients received neoadjuvant chemotherapy in the form of dose dense AC followed by paclitaxel (adriamycin and cyclophosphamide 60 mgm/
      m2 and 600 mgm/m2 respectively the cycle is repeated every 2 weeks for 4 cycles followed by paclitaxel 175mgm/m2 every 2 weeks for 4 cycles). All cycles with
      G-CSF support. Pretreatment TILs, NLR and LMR were evaluated with PCR and as prognostic factor of survival. Results: Low NLR has been detected in 74.6%
      of cases and has been associated with high TILs and this was statistically significant (p value=0.03). High LMR was observed in 80.6% of cases and correlated
      significantly with TILs (p value=0.003). Pathological CR was found to be associated with high TILs, low NLR and high LMR. In our study we evaluated the pre
      neoadjuvant systemic and local inflammatory markers as prognostic marker we found that in multivariate analysis, the lymphocyte monocyte ratio maintained
      their statistical significance with overall survival. While tumor infiltrating lymphocyte maintained their statistical significance as prognostic factors with overall
      survival and disease free survival. Conclusion: Systemic inflammatory markers can be used as marker of pathological complete response in locally advanced
      triple negative breast6 cancer with neoadjuvant chemothe.

      Short Communication Pages: 3 - 3

      Information Needs of Breast Cancer Patients at Cancer Diseases Hospital, Lusaka, Zambia

      Beauty Lilala Namushi, Marjorie Kabinga Makukula and Patricia Katowa Mukwato

      Background: Breast Cancer is that the second commonest cancer worldwide and therefore the second commonest among Zambian women. Breast cancer
      diagnosis being a stressful experience, causes psychological and emotional disruption which will be abated by meeting information needs of the affected
      patients. In light of the escalating cases of carcinoma among the Zambian women, the study examined a special aspect of cancer management which is typically
      neglected in most cases.
      Aim: the most objective of the study was to assess information needs of carcinoma patients at the Cancer Diseases Hospital in Lusaka, Zambia employing a
      modified structured interview schedule adopted from the Toronto Information Needs Questionnaire-Breast Cancer (TINQ-BC).
      Methods: A descriptive cross-sectional design was used to elicit the information needs of breast cancer patients. One hundred and ten (97% response rate)
      participants were selected using simple random sampling method and data was collected using a modified structured interview schedule adopted from the
      Toronto Information Needs Questionnaire-Breast Cancer (TINQ-BC). Stata 10.0 (StataCorp, 2008) was employed for all quantitative data analysis and graphical
      presentation of data.
      Results: The overall score for information needs was obtained by adding the scores across all the five information needs categories which were further divided
      into three categories namely: low important scores, of but 50%, moderately important many 50% - 70% and highly important scores ranged above 70% of the
      200 total scores. Out of the 110 participants recruited, 88 (80%) indicated that the information across the five categories was moderately important. Logistic
      regression of information needs and posited determinants revealed that anxiety levels; education level; presence of co-morbidity; and being on treatment were
      significant determinants of patients’ informational needs (Effect’s p ≤ 0.05).
      Conclusion: The findings of this study support the idea that breast cancer patients are seeking more information on their illness; hence information provision is
      one of the most important factors for providing top quality cancer care across the entire cancer continuum. Therefore, appreciating the information needs of breast
      cancer patients is substantial in improving care.

      Short Communication Pages: 4 - 4

      Methodology for In Silico Modeling of p210BCR-ABL Oncoprotein Isoforms found in Chronic Myelogenous Leukemia

      Nadeem Kizilbash, Jamal Alruwaili, Hassan M. Khachfe, Jaweria Ambreen and Shumaila Asif

      Chronic Myelogenous Leukemia (CML) affects the hematopoietic stem cells of the bone marrow. It develops as a chromosomal abnormality due to the presence
      of the Philadelphia chromosome carrying the BCR-ABL oncogene. This gene expresses two oncoprotein isoforms, b2a2 and b3a2, produced by the head-to-tail
      fusion of p160BCR and p145ABL proteins. The two oncoproteins differ in amino sequence by a 25 residue insertion and a Glu903Asp substitution. In silico
      modeling, using the PSIPRED server has provided the secondary structural elements of the two oncoprotein isoforms. This program normalizes the amino acid
      sequences generated by PSIBLAST and then uses a neural network to produce the secondary structure. Chronic Myelogenous Leukemia (CML) develops when
      a single, hematopoietic stem cell acquires a Philadelphia (Ph) chromosome carrying the BCR-ABL fusion oncogene which gives its progeny an advantage for
      proliferation over normal RBCs and allows the Ph-positive clone gradually to displace normal RBCs during hematopoiesis. The abnormal Ph chromosome is
      produced by the translocation between chromosomes. The major consequences of Philadelphia translocation is the fusion of the ABL gene on chromosome 9 with
      the BCR gene on chromosome 22. The BCR-ABL fusion oncogene encodes new fusion proteins of 190, 210 and 230 kDa molecular weight. The p210BCR-ABL
      isoforms have an increased level of tyrosine kinase activity, which is important for the development of the disease. The production of fusion proteins increases
      the diversity of proteinprotein binding domains associated with tyrosine kinase activity.

      Short Communication Pages: 5 - 5

      Efficient method of cancer cells therapy repairing Quasi-stationary pathologic State of an organism into Stationary normal State of an organism

      M.Ponizovskiy

      The stable balance catabolic processes & anabolic processes induce cytoplasm’s basophilic chemical potential (μ) of stable basophilic coloration via staining
      of cell forming the stabile Internal Energy of cell due to resonance waves of cellular capacitors operations according to first law of thermodynamics. Just cells’
      stabile Internal Energy makes Stationary State as an organism and as well as cells of an organism in norm. The excessive shifts balance catabolic processes
      & anabolic processes into abundance anabolic processes lead to transmutation into Quasi-stationary State both cancer cells and cancer tissues exhibiting
      Warburg effect mechanism. Affecting by viral oncogenes, the excessive shifts balance catabolic processes & anabolic processes into huge anabolic processes
      result in expression nuclear activity as center anabolic processes due also to operations of excessive ROS/H2O2/free radical produced in mitochondria that exert
      irrepressible cancer proliferative processes. The method Cancer Therapy proposes combination “Prolonged medical starvation” with considerably decreased
      dosage of cytotoxic drugs. The forced inflow of substances and energy in condition of prolonged medical starvation occurs from the organism’s depots both for
      the organism metabolism and for the cancer cells metabolism. The exhausted organism’s depots in condition of prolonged medical starvation exerts mechanism
      maintenance stabile Internal Energy of an organism (temperature 36,5ºC – 37,2ºC, by which all enzymes operate) that causes shift both an organism’s metabolism
      and tumor metabolism into catabolic exergonic pathway violating anabolic endergonic processes in tumor metabolism. Thus inhibition of the abundance anabolic
      endergonic processes, which characterize cancer metabolism, results in cancer cells depression. Thereby the treatment with considerably decreased dosages of
      cytotoxic drugs in condition of depressed cancer cells’ metabolsim damage tumor metabolism and rearrange Warburg effect of cancer metabolism into Pasteur
      effect of normal tissue metabolism, causing efficiently cancer therapy. The advantage of this method of cancer treatment is that this method of cancer disease
      treatment does not intrude into the stability of Internal Medium and Internal Energy an organism and cells of an organism, does not violate defensive mechanisms
      of an organism /the cells of immune and hormonal systems/ in comparison with targeting metabolic links of anabolic processes both in the organism’s cells
      and in the tumor’s cells, causing damage of hormonal regulatory processes and protective immune processes in an organism by up-to-date chemotherapeutic
      methods which use great dosage cytotoxic drugs. Therefore the efficient method cancer therapy using decreased dosage of cytotoxic drugs against depressed
      cancer tumor does not lead to negative consequences how recurrence cancer disease after some medical remissions and resistance to cytotoxic drugs after
      long anticancer therapy.

      Short Communication Pages: 6 - 6

      Antiparkinsonian potential of cilostazol: insights into its neuroprotective effects

      Shireen A. Hedya

      Cilostazol, a 2-oxo-quinoline derivative, is a selective inhibitor of phosphodiesterase-3 that increases intracellular cAMP levels and activates protein kinase A. Cilostazol exhibited neuroprotection in focal cerebral ischemia in rats, which was attributed to its anti-apoptotic properties. Furthermore, it guarded against hypoperfusion-induced cognitive impairment resulting in protective activity in an animal model of vascular dementia. Interestingly, cilostazol proved to exert favourable effects against Alzheimer’s disease where it enhanced β-amyloid peptide degradation through autophagy modulation in N2a neuronal cells. Together, these findings further support the notion that cilostazol may possess neuroprotective effect and may show beneficial outcome in PD. The aim of this study is to explore the Neuroprotective effect of cilostazol in rotenone-induced PD model in rats. Parkinsonian rat pre-treated with cilostazol showed minimal neuronal vacuolation and minimal perivascular edema in the midbrain and striatum. Moreover, Pre-treatment of rats with cilostazol improved the motor deficits as verified by a remarkable surge in ambulation and rearing. This could be explained by the fact that cilostazol significantly raised striatal TH content as compared to the rotenone group. . In conclusion, cilostazol could be a promising candidate for PD treatment.

      Short Communication Pages: 7 - 7

      Clinical applications of immunoglobulin expression in acute myeloid leukemia

      C. Cameron Yin

      It has been assumed that immunoglobulin (Ig) can only be produced by B-cells and plasma cells. Recently, we have reported that Ig can be expressed by other types of cells such as epithelial cancer cells. In this study, we assessed Ig expression in acute myeloid leukemia (AML). We found that Ig was expressed at a high frequency and level in AML cell lines and primary myeloblasts, but not in monocytes or neutrophils from healthy controls, by RT-PCR, immunohistochemistry and flow cytometry. We further assessed rearrangements of IgG VHDJH transcripts, and found that AML-IgG had restricted or biased V usage, and its gene rearrangements showed evidence of somatic hypermutation. Anti-human IgG reduced cell viability and induced apoptosis in AML cell lines, whereas anti-human IgK increased cell migration and chemotaxis. Furthermore, using receiver operating characteristic (ROC) curve analysis, we identified two distinct groups of AML patients with different expression of Ig and different clinical outcomes. High-levels of Ig expression are associated with monocytic differentiation, multilineage dysplasia, TET2 and KRAS mutations, and poor overall survival. Our findings suggest that AML-Ig may play a role in leukemogenesis and AML progression, and it may serve as a useful molecular marker for prognostic stratification, monitoring minimal residual disease, and target therapy.

      Short Communication Pages: 8 - 8

      Activities of raw and partially boiled quail (Coturnix Coturnix Japonica) eggs in increasing Megakaryocyte count among Aplasia-Induced mice

      Hervae A. Ordoño, Raganit Marji Sim, Odiem Glenn Frey, Galacgac Mica Mae, Gumpad Grace Mae, Laza Abby Jane, Molina Trixie Anne, Orilla Kim Daryl and Pascual Glady Shiela

      Megakaryocytes are among the largest cells in the body formed via multiple-staged megakaryopoiesis. These precursor cells release hemostasis-essential platelets into the circulation after undergoing thrombopoiesis. The significance of megakaryocytes and platelets is immediately apparent since a wide range of patients face morbidity and mortality from bleeding due to moderate to severe thrombocytopenia. In the tropics such as the Philippines, the mosquito borne viral disease dengue has become potentially deadly due to complications of plasma leaking, severe bleeding, and organ impairment. The bleeding mechanism for dengue remains poorly understood but the World Health Organization (WHO) specified thrombocytopenia with normal platelet function as a criterion. It has become potentially deadly due to its complications of plasma leakage, severe bleeding, and organ impairment. Quail eggs are packed with nutrients such as the B vitamins (B12, B9, and B3) which are vital for megakaryopoiesis. This study alleviates the negative effects of thrombocytopenia, the emerging cases of hemolytic disorders and dengue cases through the use of quail eggs. It has an impact on decreasing the need for blood transfusions in severe cases of dengue and hematopoietic disorders. It provides a less expensive and more accessible management for people who have problems in blood cell production and formation, especially megakaryocytes.

      Short Communication Pages: 9 - 9

      Turn Around Time of Histopathological Surgical Biopsies and Delivery of Medical Services at the Jos University Teaching Hospital

      Innocent Emmanuel

      The developing world is arguably characterized by backwardness or rudimentary political, social, and economic systems of which the health system is not immune to resulting in worst health indices. Pathology services in these climes which are characterized by system delay in obtaining and processing biopsy samples and reporting the results, with consequent delay the starting of treatment. The broad objective of this research study is to determine the impact of service delivery on the turn-around time of histopathological surgical biopsies in Nigerian public Health sector with reference to the Jos University Teaching Hospital. Specifically, the objectives of this research study are to investigate the impact of reliability, assurance, tangibility, empathy and responsiveness on the turn-around time of the laboratory.

      Short Communication Pages: 10 - 10

      Prospectus of Bacteriophages as natural antimicrobial agents for plant protection: A case study

      Makari H K

      Bacteriophages are the natural omnilytics and viruses of bacteria. Phage infects the bacteria more specifically, causes lytic or lysogenic activity in cells resulting in the death of the bacteria. Investigation on phages is a fast expanding area in agricultural biotechnology and in plant protection. Ralstonia solanacearum is a Gram negative bacteria causing devasting lethality in most of the solanaceous plants including potato and ginger, resulted in heavy economic losses world-wide. The chemical method of control of this bacterium is difficult because of its drug resistance. The use of alternative bactericidal agents is now prevalent over antibiotics and synthetic chemicals. This study was aimed to find natural antimicrobial agents specifically kill the bacterial population and results in reduction of pathogenicity.  R. solanacearum strains were isolated from wilting potato and ginger crops in Hassan district, Karnataka and were characterized by biochemical test and PCR based detection.

      Short Communication Pages: 11 - 11

      Fine needle aspiration cytology of Jaw bone lesions emphasis on utility and pitfalls

      Meenakshi Chowdhary

      FNAC (Fine Needle Aspiration Cytology) of head and neck region was pioneered by Martin in the early 1930s. FNAC is a frequently used for diagnosis of abnormal masses. FNAC is minimally invasive first line investigation which can render an accurate preoperative diagnosis of intraosseous jaw lesions, especially the malignant ones in the enigmatic circle of clinic-radiological differentials. Although FNAC of intraosseous lesions is difficult to perform compared with soft tissue lesions, it still can be used for preoperative diagnosis in selected cases. Biopsy being gold standard of preoperative diagnosis would be cumbersome and traumatic when surgery is mainstay of treatment. Still, diagnostic evaluation of neoplastic and non-neoplastic lesions has increased dramatically when it comes to jaw lesions and surgery. For the diagnosis of lymph nodes, salivary glands, and thyroid and parathyroid gland diseases, FNAC have proven to be boon. It’s apt to mention that FNAC is a simple, rapid, and minimally invasive procedure in contrast to biopsy, its use in the diagnosis of odontogenic tumors including ameloblastomas. But role of FNAC in respect to typing of odontogenic tumors has not been explored much.

      Short Communication Pages: 12 - 12

      Modulation of the ROCK/Akt/eNOS pathway by simvastatin protects against 5-fluorouracil cardiotoxicity

      Radwa Nasser Muhammad

      5-Fluorouracil (5-FU) is a highly effective anticancer drug, widely incorporated in the management of different solid tumours, and is a cornerstone therapy in colorectal cancer. Its use is associated with a wide range of different toxicities, including several reports of fatal cardiotoxicity which was first reported four decades ago. Since then, only some efforts were done to understand the pathophysiology and molecular mechanisms associated with this type of toxicity, moreover; there is no effective preventive measure against this toxic effect. Until now, myocardial ischemia due to coronary vasospasm is the most accepted theory.

      Volume 8, Issue 1 (2022)

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