Bone marrow micro-metastases in clinically stage I-III HER2/Neu positive breast cancer

Patients with breast cancer should have a favorable outcome when diagnosed early. Occult distant metastases, especially in the Bone Marrow [BM] was claimed to be responsible for tumor relapse in certain cases, especially in HER-2/neu expressing tumors. Such an occult metastases may be detected by PCR techniques for a BM aspirate, which is the aim of this study. Between May 2004 and May 2005, PCR technique was used to determine the tumor HER-2/neu status of 37 patients, attending Suez Canal University Hospital for the treatment of stage I-III breast cancer. BM and peripheral blood of those positive patients were examined by the same technique for the presence of micro-metastases. Correlation between tumor characteristics and the HER-2/neu status was done. Fifteen patients were tumor HER-2/neu positive, which correlated with stage and number of positive lymph nodes. BM micro-metastases were detected in 7 patients, with no correlation to the tumor characteristics. Additionally, HER-2/neu positive tumor cells were detected in the peripheral blood of 6 patients. BM micro-metastases can be detected in HER-2/neu positive non-metastatic breast cancer that may be predicted by the peripheral blood not the primary tumor characteristics

Protein C and its plasma inhibitor in patients with bilharzial liver fibrosis

Protein C [PC] activity ad its plasma inhibitor were measured using chromogenic substrate methods in 30 patients suffering from bilharzial liver fibrosis [BLF] with and without ascites. PC activity in bilharzial patients was significantly lower than in the control group; the reduction was more marked in patients with ascites. Moreover, PC activity significantly correlated with both serum albumin and plasma antithrombin III. Thus PC activity is reduced in BLF proportionally to the impairment of the liver synthetic function. The reduction in PC activity probably reflects a protective effect of the deficiency of multiple clothing factors. PC inhibitor unexpectedly was found to be normal in all bilharzial patients with accelerated fibrinolysis; these findings suggest that PC inhibitor is not an important factor for the enhanced fibrinolysis in BLF. Therefore hemostatic disturbances in BLF should deserve attention, as most patients are in a very delicate hemostatic balance