The Prognostic Implication of CD49d Expression by Flow Cytometry and Trisomy 12 Detection by Fluorescent in situ Hybridization in Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is the most common chronic lympho‑proliferative disorder. This study done to detect the level of cluster of differentiation (CD)49d in CLL patients by flow cytometry and itscorrelation with the prognosis (survival) and with (trisomy12) detected by fluorescent in situ hybridization (FISH).Methods:Clinico-hematological profiles done to fourty CLL patients. CD49d tested by flow cytometry and trisomy12 was detected by FISH.Results:CLL patients classified according to modified Rai staging system into: low risk 12.5%, intermediate risk 22.5% and high risk 65%. CD49d and trisomy12 positivitywere detected in 29Original Research Article patients (72.5%) and 22 patients (55%), respectively. There was a significant positive correlation between the percentage of trisomy12 and of CD49d cells in CLL patients (P =0.034). And also, between CD49d and CD38 (P =0.034). On the other hand, there was no significant relation between both CD49d and trisomy12 expression and modified Rai staging system.As regard to overall survival (O.S) and disease free survival (DFS), both CD49d, trisomy12 positive cases were associated with shorter disease free, and overall survivals compared to the negative cases.Regarding to the relation between the use of combination of fludarabine, cyclophosphamide, and rituximab (FCR) as a standard treatment in CLL and OS and DFS of patients in our study, we found that FCR account for the better outcome associated with its use.Conclusion:CLL B-cell membrane expression of CD49d as measured by flow cytometry is a powerful prognostic parameter in patients with CLL. Its positive correlation with the trisomy12 and CD38 and the association of both CD49d and trisomy12 with short survival times indicate that they may have roles in the prognosis of CLL

Role of fluorescence in situ hybridization in the diagnosis of malignant biliary stricture

Introduction: Biliary stricture is a fixed narrowing of a focal segment of the bile duct that result in proximal biliary dilatation and clinical features of obstructive jaundice. A wide spectrum of hepatobiliary and pancreatic diseases, both benign and malignant, can result in the development of biliary strictures. Although trans abdominal ultrasound, computed tomography, and magnetic resonance imaging are sensitive for detecting bile duct pathology, they do not reliably distinguish strictures as being malignant or benign. FISH utilizes fluorescently labeled DNA probes to chromosomal centromeres or unique loci to detect cells that have numerical or structural abnormalities indicative of malignancy

Aim of the study: To evaluate the accuracy of FISH in the diagnosis of malignant biliary stricture

Patient and methods: Forty eight patients with indeterminate bile duct stricture presented with obstructive jaundice were prospectively enrolled and underwent ERCP and FISH over a period of 20 month from June 2013 to February 2015. Four patients were excluded because of loss follow-up. Thus, 44 patients were included in data analysis [17 males and 27 females]

Results: The final diagnosis of stricture type was 32 malignant and 12 benign cases. FISH was positive in 30 cases and negative in 14 cases, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93.75, 100.00, 100.0, 85.7, 95.5 and 0.969 respectively

Conclusion: FISH increase the diagnostic accuracy of malignant biliary stricture. The sensitivity of FISH could improve the clinical management of patients being evaluated for malignant bile duct stricture by enabling a definitive diagnosis at an earlier stage in the clinical evaluation

Antiapoptotic effect of carvedilol and vitamin E in diabetic nephropathy and cardiomyopathy

Oxidative stress plays a dominant role in the pathogenesis of diabetes mellitus. Bcl-2 gene has close connection with antioxidant stress destruction in many diseases including diabetes. BcI-2 gene also has anti apoptotic effect. Carvedilol, is novel beta-adrenoreceptor blocker, which has antioxidant and free radical scavenger properties. In physicochemical, biochemical and cellular assay carvedilol inhibited the formation of reactive oxygen radicals and lipid peroxidation and prevented the depletion of endogenous antioxidants. Moreover, it was reported that carvedilol enhanced the expression of Bcl-2 gene which has antioxidant and anti-apoptotic effects. There are few researches on the effect of Carvedilol on diabetic cardiomyopathy and nephropathy. Whether carvedilol can improve cardiac or renal function in diabetic animal models and the ability of carvedilol to express the Bcl-2 gene and compare its antioxidant effect with a traditional antioxidant like vitamin E is our aim of the current study. In this study we used streptozotocin to induce diabetes mellitus in male albino rats, we investigated carvedilol-administrated in healthy and streptozotocin-induced diabetic rats for 6 weeks as well as vitamin E to compare their effects on biochemical parameters [blood glucose level, lipid profile, serum levels of thiobarbetioric acid [TBAS] and total antioxidant status [TAOS], renal function tests, creatinin phosphokinase [CPK], expression of Bcl-2 protein in the cardiac and renal tissues and histopathological examination in the cardiac and renal tissues. The study showed that, the diabetic rats not only had cardiac and renal dysfunction, high levels of blood glucose and lipid peroxide, lower levels of TAOS, but also showed lower expression of Bcl-2 protein. Carvedilol and vitamin E treatments improved renal and cardiac functions, lowered blood glucose, serum lipids and lipid peroxide, increased levels of TAOS and expression of Bcl-2 protein in healthy rats as well as diabetic rats. In addition they have protective effects on cardiac and renal tissues. These results indicated that carvedilol and vitamin E partly improve cardiac and renal function via their antioxidant properties in diabetic rats