ABSTRACT
Background: Breast cancer plays major public health in Egyptian women. In upper Egypt, There is an increase in the incidence of breast cancer compared to other Egyptian areas without know the reasons. In this study, we aimed to evaluate the potential of HER-2/neu status as one of the important markers to classify the women suffering from breast cancer in upper Egypt and monitoring the responsiveness to different therapies. Settings and Design: The present study was performed on 67 female breast cancer patients in the South Egypt Cancer Institute to evaluate HER-2/neu gene amplification and expression. Patients and Methods: Tissue samples were used for immunohistological analysis of endocrine receptors, HER-2/neu, and HER-2/neu gene amplification. In addition, the blood samples were also used to determine HER-2/neu gene expression. Statistical Analysis: All statistical analyses were performed using Chi-square test. The statistical difference is considered statistically significant at P < 0.05. Results: There was a statistically significant association between HER-2/neu gene expression and the age of patients. There is decrease in the level of HER-2/neu mRNA expression in group treated with chemotherapy and group treated with chemotherapy and radiotherapy compared to each group baseline level of HER-2/neu mRNA expression before treatment. On the contrary, the group treated with chemotherapy, radiotherapy, and hormonal therapy revealed increase on the level of HER-2/neu mRNA expression when compared with their baseline for the same patients before treatment. Conclusion: We need further studies on the large group of upper Egypt breast cancer patients to confirm that the level of HER-2/neu mRNA expression can be used as a marker for classified them and their response to different treatment
ABSTRACT
Cirrhotic patients frequently undergo screening endoscopy for the presence of varices. In the future, this social and medical burden will increase due to the greater number of patients with chronic liver disease and their improved survival. In this study, our aim was to develop a predictive model using independent risk factors for the presence of varices in the enrolled patients. 200 patients with liver cirrhosis with no history of variceal haemorrhage were subjected to clinical examination; laboratory investigations [CBC, Liver biochemical profile, serum urea and creatinine], modified Child-Pugh score and MELD score were calculated. Abdominal ultrasonography and Doppler study of the portal and splenic veins studying the liver size, the presence of periportal thickening, hepatic veins flow pattern, the splenic longest axis and volume, the presence of ascites and collaterals. Portal vein and splenic vein diameter, patency, cross sectional area, mean flow velocity, blood flow volume congestion index and direction of flow of portal vein were calculated. Platelets count/Splenic diameter ratio and Right liver lobe diameter/ albumin ratio were calculated for all patients. Upper endoscopy was done where oesophageal varices were graded according to modified Thakeb classification. This study revealed that 83% of patients had oesophageal varices; 52% had small sized oesophageal varices and 31% had large sized oesophageal varices. In patients with varices; 12% had biphasic and 22.9% had monophasic hepatic veins flow pattern, with p value of 0.002. Portal vein direction of flow was bidirectional in 22.9% and Hepatofugal in 9.6% with a p value of 0.004. The portal vein velocity of 9.3 +/- 2.3cm/ sec with a p value of <0.001 and the ascites was present in 77% of patients with a p value of 0.005. In patients with large sized varices; shrunken liver was present in 83.1% of patients with a p value of 0.005 and serum albumin <2.5gm/dl with a p value of 0.008. Hepatic veins flow pattern [biphasic and monophasic], portal vein direction of flow [hepatofugal and bidirectional], decreased portal vein velocity and the presence of ascites [moderate and marked] were the significant variables for prediction of presence of varices. Shrunken liver and the low serum albumin were the significant variables for prediction of large varices