HER-2 positivity and correlations with other histopathologic features in breast cancer patients-hospital based study

To review HER-2 status and its correlation with all other prognostic histopathological features of all Breast Cancer [BC] patients diagnosed between January 2000 and December 2004 at King Abdul Aziz University Hospital [KAUH] in the western region of Saudi Arabia. Histopathology specimens were examined by Immunohistochemistry [IHC] and labeled as HER-2/neu positive when Hercep Test score was three plus [3+]. HER-2/neu was reported only in 145 patients out of 260. Out of 145 patients, it was positive in 41 patients [28.3%], negative in 104 patients [71.7%]. Correlations between HER-2/neu status and age, race and other prognostic histopathologic features revealed: No correlation with age [or <40 Y vs >40 Y with a p-value of 0.552], race [Saudis vs Non-Saudis with a p-value of 0.133], histopathology subtype [p=0.980], tumor size [p=0.455], number of positive lymph nodes [p=0.660], tumor grade [p=0.062], lymphovascular invasion [p=0.055] and progesterone receptor [PR] status [p=0.069] but positive correlation only with estrogen receptor status [ER] [p=0.003]. HER-2/neu over expression was positive in 28.3% of the tested specimens of BC which is consistent with what was reported in literature. It was found to correlate inversely with ER status. Routine testing is mandatory because of its prognostic value and impact on further management

Factors delaying the diagnosis of cancer in children

In this study, an interview questionnaire including the patient's age, the number of siblings as well as the order of the patient among them, the level of education of the parents and the primary complaint was administered to 150 patients and their families. 59% of the patients were younger than 5 years and 66% were males. 73% of the parents were illiterate and only 17% of them were colleague graduate. The primary complaint was fever and/or fatigue in 42% of the patients, mass in abdomen in 21% and lump in the neck in 18.5%, respectively. The patients included in the current study had leukemias and lymphomas [45%] as well as solid tumor [45%]. The delayed diagnosis was represented in an interval of more than three weeks between the first appearance of symptoms or signs and the diagnosis. Only 41 patients were diagnosed within the first 3 weeks of onset of symptoms

Parental factors in childhood malignancies

The current study included 125 children with cancer, in addition to 125 age and sex matched healthy children as a control group. 49% of the cancer patients were coming from rural places versus 35.2% of the controls, this difference was statistically significant. As regards the degree of consanguinity, there was a statistically significant high prevalence of first degree of consanguinity among children of cancer group than the controls; this was the same for children with solid tumors, but not for those with lymphoma and leukemia. The present study showed an increased percentage of parental exposures to pesticides, paints and dyes as well as maternal exposures to irradiation among children in the cancer group. However, this difference was mot statistically significant, may be due to the small number of the study group. However, there was a significant increase of the parental exposure to motor exhaust products in the cancer group

Effect of pegylated interferon on non responders and relapsers with interferon

To assess whether a combination of pegylated interferon [interferon conjugated with polyethylene glycol] and ribavirin can improve the response rate in patients with chronic hepatitis C who either did not respond to [Non-responders], or had relapsed after responding to [Relapsers] standard interferon and ribavirin combination therapy. In this prospective study, 20 chronic hepatitis C patients [comprising 16 Non-responders and 4 Relapsers to previous treatment with alpha interferon and ribavirin], were treated with pegylated interferon-2b weekly and ribavirin daily for one year. Eleven patients had genotype 4, eight were of genotype 1 and one patient had genotype 3. Response to treatment was determined based on normalisation of liver enzymes and negative viral load [assessed using qualitative HCV RNA PCR] at end of treatment [ETR] and 6 months off treatment [SVR]. Seven patients [35%] achieved normalisation of liver enzymes and negative viral load at the end of treatment. However, only 2 patients [10%] managed to retain these levels after six months off treatment. The latter two patients had been previous Relapsers. Combination of pegylated interferon and ribavirin may be beneficial in previous relapsers with standard interferon-ribavirin combination therapy, but is unlikely to achieve sustained virological response in non-responders

Chemoembolization in metastatic liver neoplasms: KAUH experience

To assess the results of chemoembolization in this pilot study for patients with unresectable metastatic liver neoplasms. Patients with unresectable liver metastases secondary to different primary tumors who did not have decompesated liver disease underwent selective intra-arterial chemotherapy consisting of 5-flourouracil, adriamycin and cisplatin followed by embolization of the feeding artery using Poly Vinyl Alcohol Particles [PVAP]. Courses of treatment were given every four to six weeks for a minimum of three courses. Eight patients with bilateral multiple or diffuse liver metastasis underwent chemoembolization. Five out of eight patients had good palliation of symptoms and improvement in their quality of life. Their average duration of palliation was 7.2 months. Median survival for all patients was seven months. Seven patients died within the first year from a diagnosis of liver metastasis. The last patient with carcinoid syndrome is still alive 36 months after diagnosis. Selective intra-arterial chemotherapy followed by embolization in this pilot study with unresectable liver metastases gives palliation of symptoms and improvement in the quality of life for almost half of our patients but for a short duration. Patients with neuroendocrine tumors may have longer duration of palliation and survival. Further randomized trials with a higher number of patients would be worthwhile pursuing