ABSTRACT
Background: It has been shown that colorectal carcinoma is increasing in incidence in African countries. This could be due to change in life style. Molecular patho- genesis of colorectal cancer commonly involves mutation in p53 gene which leads to expression of p53 protein in tumor cells. Expression of p53 protein has been associated with poor clinical outcome and reduced survival in patients. Objective: This was a retrospective laboratory based study carried out in the Department of Pathology Makerere University; Kampala; Uganda. The aim of the study was to evaluate the expression of p53 protein in colorectal carcinoma in Ugandan patients; specifically its association with histological types; degree of differentiation; sites of the tumor and demographic characteristics of the patients. Methods: Immuno- histochemistry was carried out on 109 patient's paraffin embedded tissue blocks of colorectal carcinoma diagnosed in the Pathology Department; Faculty of Medicine Makerere University Kampala during the period 1995 to 2005. The indirect immunoperoxidase method using monoclonal antibody p53 DO-7 and Envision + Dual link system-HRP to detect p53 expression was used. Haematoxylin and eosin stain was used for evaluation of histological types and degree of differentiation of the tumors. Topography of the tumors and demographic data were obtained from accompanying histological request forms. Results: Out of 109 patient's tissue blocks that were studied; 61 cases (56) expressed p53 protein in the nucleus of malignant cells. Right sided colonic tumors were commoner (53.2) than left sided colonic tumors (46.8). p53 protein was expressed more in left sided colonic tumors with a significant difference (p0.05); it was also expressed more in well differentiated tumors and non mucinous adenocarcinomas but with no significant difference (p0.05). p53 expression was not affected by age or sex. Conclusion: Frequency of p53 protein expression in Ugandan patients did not differ from that reported in the other parts of the world. It was expressed more in the left sided colonic tumors and this could support the hypothesis that right and left colonic tumors could have different pathogenesis and probably also responsible for difference in prognosis in these two topographic sites
Subject(s)
Colorectal Neoplasms , Genes , ImmunohistochemistryABSTRACT
Background:The Kato-Katz thick smear technique is the standard technique recommended by the World Health Organisation for the quantitative diagnosis of Schistosoma mansoni and other intestinal helminth infections.The major problem of the technique is that a few hours after the preparation of slides hookworm eggs over clear and disappear due glycerin. Objective:To illustrate clear visibility of different helminth eggs microscopically in Odongo-Aginya method; substitution of malachite green with 7.5nigrosin in 10formalin and 5eosin in 10formalin. Method: Measured; strained stool specimen was stained with mixture of nigrosin/ eosin and covered with cellophane cover slips.The prepared slide was examined immediately microscopically. Result: Slides prepared with Odongo-Aginya method can be examined immediately or later without compromising the visibility of parasite eggs and larvae. Hookworm eggs remain visible for a long time. Conclusion:The present publication shows microscopic appearance of the helminth eggs using the Odongo-Aginya modification
Subject(s)
HelminthsABSTRACT
Modified Giemsa staining has been favoured by many researchers because it is easy to perform but; like many other stains; demonstration of the bacteria depends on its morphology. It has been arged in some research circles that some of the organisms in the gastric mucosa may not be true H.pylori. Immunohisochemical techniques have been developed and make use of anti H.pylori antibody; which reacts; with somatic antigens of the whole bacteria and have been found to correlate well with the presence of the bacteria. Objective: to ascertain the efficacy of modified Giemsa stain in an African setting where H.pylori seems quite prevalent. Study design: A laboratory - based study of two diagnostic tests in which modified Giemsa stain was compared with immunohistochemistry. Methods: A total of 48 consecutive autopsy cases with no upper gastro intestinal diseases had their gastric mucosa stained for demonstration of H.pylori using both modified Giemsa and immunohistochemical staining techniques. Results: Twenty-seven cases of H.pylori were demonstrated by both techniques and 14 cases were not identified by the two staining methods. In 2 cases immunostain could not demonstrate the bacteria but they were identified with modified Giemsa stain while in 5 cases the bacteria were identified by immunostain but not with modified Giemsa stain. The sensitivity of modified Giemsa stain was 85(CI 66.5-98.8) while the specificity was 89(CI 60.4-97.8). The positive predictive value of modified Giemsa stain was 93CI 75 - 98.8) while the negative predictive value was 74(CI 48.6-89.9). The kappa statistic comparing the 2 stains was 0.69 (p-value 0.00001) giving a good agreement between the two tests. Conclusion: With the above results the modified Giemsa stain; which is readily available in most African laboratories; is recommended for diagnosis of H.pylori; a prevalent infection in Africa
Subject(s)
Helicobacter pylori , ImmunohistochemistryABSTRACT
Incidence rates of different cancers have been calculated for the population of Kyadondo county (Kampala; Uganda) for four time periods (1960-1966; 1967-1971; 1991-1994; 1995-1997); spanning 38 years in total. The period coincides with marked social and lifestyle changes and with the emergence of the AIDS epidemic. Most cancers have increased in incidence over time; the only exceptions being cancers of the bladder and penis. Apart from these; the most common cancers in the early years were cervix; oesophagus and liver; all three have remained common; with the first two showing quite marked increases in incidence; as have cancers of the breast and prostate. These changes have been overshadowed by the dramatic effects of the AIDS epidemic; with Kaposi's sarcoma emerging as the most common cancer in both sexes in the 1990s; and a large increase in incidence of squamous cell cancers of the conjunctiva. In the most recent period; there also seems to have been an increase in the incidence of non-Hodgkin lymphomas. So far; lung cancer remains rare. Cancer control challenge. With little improvement in the incidence of cancers associated with infection and poverty (liver; cervix; oesophagus); it must face the burden of AIDS-associated cancers; while coping with the emergence of cancers associated with Weternization of lifestyles (large bowel; breast and prostate)
Subject(s)
HIV , NeoplasmsABSTRACT
The AIDS epidemic has passed its peak in Uganda; with possible consequences for the risk of cancers related to infectious agents. Objective: To compare the incidence of cancers linked to infections with HIV; before the AIDS epidemic (the 1960s); at its high point (the early 1990s) when HIV - seroprevalence and AIDS notifications peaked; and after the onset of its decline in the later 1990s. Methods: Analysis of incidence rates of infection-associated cancers in the population of Kyadondo county; in 1960-1971; 1991-1994; and 1995-1997. Comparison with data on prevalence of HIV infection; and notifications of AIDS. Results: The incidence of Kaposi's sarcoma has increased enormously since the 1960s; with a shift to earlier age at onset; and more generalised and nodal disease; there has been little change in the profile during the 1990s. There was a large increase in incidence of squamous cell carcinomas of the conjunctiva; which has continued through the 1990s. Non-Hodgkin's lymphomas showed little increase in incidence until the most recent period; in which the incidence has increased both in children (particularly Burkitt's lymphomas) and adults. Although the incidence of cervical cancer was higher in the 1990s than the 1960s; it seems doubtful that this is related to HIV infection. Certain other cancers which have been linked to AIDS in western populations (Hodgkin's disease; anal carcinoma; childhood leiomyosarcoma) show no changes in risk. Conclusion: The AIDS epidemic has dramatically changed the profile of cancer in Uganda. Trends in the AIDS-related cancers are consistent with current knowledge concerning the mechanisms behind the increased risk. The incidence of certain cancers with a viral aetiology (liver; cervix; penis; Hodgkin's disease) appears not to have been influenced by AIDS
Subject(s)
HIV , Acquired Immunodeficiency Syndrome , Disease Outbreaks , NeoplasmsABSTRACT
Thirty cases of gastric cancer were studied. Slides were stained with PAS Alcian Blue. The staining characteristics of the mucin were correlated with gross characteristics of the tumours and histological types. Due to the few cases studied; there was no observed statistical significance between the various mucin staining characteristics with the histological type; sex site of tumour and ethnicity. In 84of cases the tumour cells secreted either neutral or mixed mucins. Acid mucins were demonstrated in 5 cases only. neutral mucin is normally secreted by gastric epithelium and neck cells of gastric glands. The observation in this study suggests that those tumours which secrete neutral and mixed mucin probably arise from gastric epithelium; neck cells of gastric glands or colonic metaplasia. In those cases where the tumour produces acid mucin it is possible the tumour arose from areas of intestinal metaplasia
Subject(s)
Gastric Mucins , Stomach NeoplasmsABSTRACT
A total of 56 patients who presented for gastroscopy from 1993 to 1995 in Mulago Hospital had their gastroscopic biopsy specimens examined for Helicobacter pylori (H.pylori). H. pylori was demonstrated in 14(25) of the patients. There was no sex difference in those with H.pylori infections and the bacteria were only found in those above 22 years of age. Fifty six percent of those with the infection in which ethnicity was mentioned were Nyankole although they formed only 21of the study group. In all positive cases; H. pylori was found in the antrum with accompanying chronic atrophic gastritis
Subject(s)
Bacterial Infections , Gastritis , Helicobacter pyloriABSTRACT
A total of 56 patients who presented for gastroscopy from 1993 to 1995 in Mulago Hospital had their gastroscopic biopsy specimens examined for Helicobacter pylori (H.pylori). H. pylori infections and the bacteria were only found in those above 22 years of age. Fifty six percent of those with the infection in which ethnicity was mentioned were Nyankole although they formed only 21of the study group. In all positive cases; H.pylori was found in the antrum with accompanying chronic atrophic gastritis
Subject(s)
Helicobacter pyloriABSTRACT
Kyadondo county in Uganda is believed to have one of the highest incidence rates of cancer of the cervix in Africa and probably in the whole world. Whereas routine cytological screening using the pap smear has markedly decreased the incidence of invasive carcinoma of the cervix in the developed world; it is still the commonest cancer of women in the developing world. Risk factors for cervical carcinoma include; among others; promiscuous sexual behaviour; early age at menarche; oral contraceptive use and presence of sexually transmitted diseases such as human papillomavirus and human immunodeficiency virus. The purpose of this study was to assess the trend of incidence of cancer of the cervix over 3 time periods; 1954-60; 196870 and 1989-91. The Kampala Cancer Registry records were reviewed and cases classified as cervical cancer according to the International Classification of Diseases. The results showed that age specific incidence rates for the period 1989-91 were far above those for the 1954-60 period. They also showed that women tend to present at an early age with more advanced disease and were more likely to be diagnosed clinically in the younger age-group in the 1989-91 period than in the 1954-60 period. The above results are consistent with mechanisms that can be attributed to the incidence of HIV infection in the 1989-91 period
Subject(s)
HIV Infections , Risk Factors , Sexually Transmitted Diseases , Uterine Cervical NeoplasmsABSTRACT
A case of chemodectoma from the heart in 39 year old hypertensive female African is reported. Tumour; measuring 8 x 4 x4 cms; was found autopsy firmly attached to the interventricular muscle and completely surrounding a segment of right coronary artery. The histology of the tumour was consistent with that of chemodectoma; an observation not; to the authors knowledge; hitherto reported in man though it has been reported in dogs