ABSTRACT
Aims Difficulties in diagnosis of phyllodes tumour are well known. Our aim was to observe whether the expressions of satb1, survivin, and ki-67 were helpful in differentiating fibroadenoma and phyllodes tumour. Settings and design Retrospective. Methods and material Paraffin embedded tissue samples from 60 female patients with phyllodes tumour and 60 female patients with fibroadenoma were studied. Expression of the gene products was studied and confirmed using immunohisto chemical and western blot analysis. Statistical analysis used The statistical analysis was performed using Fisher's exact test to find out the significant changes. Results Statistically significant difference was observed in Satb1, survivin expression between fibroadenoma and benign phyllodes cases. The difference between the Ki-67 expression in fibroadenoma and benign phyllodes cases was not statistically significant. Conclusions Our finding of strong stromal expression of satb1 and survivin in phyllodes as compared to fibroadenoma can be helpful for the development of additional diagnostic and prognostic indicators for otherwise difficult cases. Such immunochemical markers can be used to elucidate cellular basis of tumour behaviour. Validation of such immunochemical test in future will reduce diagnostic uncertainty in this rare tumour. In addition to that such parameters may serve as a therapeutic target that could increase effectiveness of chemotherapy or radiation therapy. A study with large number of samples along with clinical and follow-up data is required for confirmation.
ABSTRACT
Infertility is on the rise in today's world. A subnormal sperm count is frequently encountered in infertile couples. Clomiphene citrate, 1-[p-(beta-diethyl aminoethoxy) phenyl]-1,2-diphenyl chloroethylene, is an orally active nonsteroidal agent distantly related to diethylstilbestrol. It is thought to stimulate pituitary gonadotropin release by excluding estradiol from hypothalamic receptor sites. This interaction neutralizes the normal negative feedback control of estrogen and results in enhanced secretion of LH-RH, FSH-RH and gonadotropins. Testosterone is produced by the Leydig cells in response to LH secretion. The concentration of testosterone in the tubular environment is believed to maintain the gametogenic function of the testis. Clomiphene citrate in the dose of 25 mg daily for 25 days with five days rest was administered to 25 extreme oligozoospermic men (group I) and 40 moderate oligozoospermic men (group II) the cycle being continued for three months). Repeat semen analysis was done at the end of three months and all the routine seminal parameters were reevaluated. The data thus obtained was analyzed using Student's paired 't' test. The mean sperm count in Group I increased from 3.84 +/- 0.32 to 8.2 +/- 1.58 (P < 0.05) and in Group II from 13.05 +/- 0.48 to 24.55 +/- 1.73 (P < 0.001). The mean motile sperm count in Group I increased from 1.74 +/- 0.25 to 3.92 +/- 0.83 (P < 0.05) and in Group II from 8.27 +/- 0.40 to 10.05 +/- 0.56 (P < 0.01). Thus clomiphene citrate exerts its effect on spermatogenesis by raising the endogenous serum FSH, LH and testosterone levels to initiate and maintain gametogenesis (10). Researchers opined that this increase in endogenous gonadotrophins manifests itself in improving the sperm count, sperm motility and to certain extent morphology of the sperms, when there is no end-organ pathology.