ABSTRACT
Background: Breast cancer is the most common malignancy in female worldwide. Ultrasound (US) is a safe and easily available modality for evaluation of breasts in females of all age groups. It can detect characteristic features of breast malignancy with high degree of accuracy. This study was undertaken with the aims to evaluate the ultrasonographic features of malignant breast mass, to identify the most commonly encountered gray scale ultrasound findings and to study the role of Doppler ultrasound in those cases.Methods: The study was conducted in Dr B. Borooah Cancer Institute, Guwahati from January 2018 to January 2019. Gray scale ultrasound including Doppler study was done in all the female patients coming with palpable breast lump or with nipple discharge and images were archived. The archived images of a total number of 108 patients with biopsy report positive for malignancy were retrospectively studied and the ultrasound findings were evaluated.Results: Most common gray scale ultrasound features for malignant breast masses were hypoechoic mass, taller than wide, irregular shape, having spiculated margins, neither posterior acoustic enhancement nor shadowing, presence of intralesional microcalcifications and surrounding echogenic halo. Hypervascularity, noticeable difference in waveform pattern between central and peripheral vessels, high resistance flow pattern with absent or reversal of diastolic flow were the common Doppler findings.Conclusions: Combination of Doppler with gray scale ultrasound has emerged as a very important technique in diagnosing malignant breast mass with high accuracy.
ABSTRACT
Background: Carcinoma of the gall bladder (GB) is the commonest malignancy of the biliary tract. Ultrasound (US) guided Fine Needle Aspiration Cytology (FNAC) plays a major role in early detection of malignancy in a suspicious GB lesion. The aim of this study was to evaluate the safety and diagnostic accuracy of US guided FNAC in detection of GB malignancy, to find the association of gall stones with GB malignancy, to study the ultrasound pattern of GB malignant mass and demographic profile of the disease in North eastern India.Methods: The study was conducted retrospectively in Dr. B. Borooah Cancer Institute, Guwahati from January 2016 to December 2017. A total number of 173 patients suspected to have GB malignancy were subjected to US guided FNAC.Results: Total 161 patients were positive for malignancy with significant female majority. There were 124 female (77.02%) and 37 males (22.98%) in the range of 29 to 82 years. Male female ratio was 1:3.5. One was diagnosed as xanthogranulomatous cholecystitis and another was chronic cholecystitis. FNAC remained inconclusive in 2 patients. There was no major procedure related complication. Adenocarcinoma was the most common malignancy found in 146 patients (98.68%). Cholelithiasis was associated in 88.19% of malignant lesions.Conclusions: US-guided FNAC is a safe, highly accurate and reliable procedure for early detection of GB malignancy.
ABSTRACT
Background: Promoter methylation of tumor suppressor genes (TSGs) is a well-reported portent in carcinogenesis; hence, it is worthy to investigate this in high-risk Northeast population of India. The study was designed to investigate methylation status of 94 TSGs in esophageal squamous cell carcinoma (ESCC). Further, the effect of OPCML promoter methylation on gene expression was analyzed by immunohistochemistry. Moreover, in silico protein–protein interactions were examined among 8 TSGs identified in the present study and 23 epigenetically regulated genes reported previously by our group in ESCC. Materials and Methods: Methylation profiling was carried out by polymerase chain reaction array and OPCML protein expression was examined by tissue microarray-based immunohistochemistry. Results: OPCML, NEUROG1, TERT, and WT1 genes were found hypermethylated and SCGB3A1, CDH1, THBS1, and VEGFA were hypomethylated in Grade 2 tumor. No significant change in OPCML expression was observed among control, Grade 1, and Grade 2 tumor. Conclusively, hypermethylation of the studied OPCML promoter in Grade 2 tumor produced no effect on expression. Unexpectedly, OPCML expression was downregulated in Grade 3 tumor in comparison to other groups signifying that downregulation of OPCML expression may lead to higher grade of tumor formation at the time of diagnosis of ESCC in patients. Significant interactions at protein level were found as VEGFA:PTK2, CTNNB1:CDH1, CTNNB1:VEGFA, CTNNB1:NEUROG1, CTNND2:CDH1, and CTNNB1:TERT. These interactions are pertinent to Wnt/β-catenin and TGF-β-Smad pathways. Conclusions: Deranged OPCML expression may lead to high-grade ESCC as well as epigenetically regulated genes, that is, CDH1, CTNNB1, CTNND2, THBS1, PTK2, WT1, OPCML, TGFB1, and SMAD4 may alter the Wnt/β-catenin and TGF-β-Smad pathways in ESCC. Further study of these genes could be useful to understand the molecular pathology of ESCC with respect to epithelial-mesenchymal transition (EMT) mediated by Wnt/β-catenin and TGF-β signaling pathways
ABSTRACT
Background: Micralbuminuria (MA) is an early sign of incipient renal damage and cancer patients are at the risk of developing kidney diseases due to the use of nephrtoxic chemotherapeutic agents. Methods: A pilot study of urinary microalbumin on 41 patients with borderline serum creatinine was carried out at regional cancer centre of North-East India during the period from June to August 2014. The patients whose serum creatinine levels were between 1.2 mg/dl to 1.3 mg/dl were considered as borderline for the present study. The assays were performed with a dimension Rxl max random access biochemistry analyzer. Results: Out of 41 cases, 22 (53.6%) had MA, M:F = 1.75, <45 years 3 (13.6%) patients, in 45 years - 65 years 17 (77.2%) patients, and >65 years 2 (9.0%) patients were detected with urinary microalbumin. Chi square test showed P = 0.695 (Fisher’s exact P value). Conclusion: Testing of urinary microalbumin can be done in cancer patients with borderline serum creatinine level in order to identify patients at risk of developing kidney disease.
ABSTRACT
Rosai-Dorfman Disease (RDD) is a benign condition primarily affecting the lymph nodes. The term sinus histiocytosis with massive lymphadenopathy was first used. There may be extra-nodal presentation of RDD with or without constitutional symptoms. A 10-year-old boy presented with massive bilateral cervical lymphadenopathy which mimicked the diagnosis of lymphoma. We describe here a case of RDD in a child with extra-nodal bone involvement of the wrist joint, its diagnosis by histopathological examination supported by immunohistochemistry and consequent initial management.
ABSTRACT
Background: The incidence of gall bladder cancer (GBC) is very high in this part of the world and there is little information on the descriptive epidemiology of GBC from our population. Methods: A retrospective study on the data set of hospital cancer registry was analyzed. The data set consisted of patient information registered during the period of January 2011 to December 2012. The cases included for the present study were histologically confirmed and radiologically diagnosed cases of GBC. All the cases were retrospectively analyzed for gender, age, urban-rural residences, religion of patients and their educational levels. Descriptive statistics was calculated and Chi square test was done to see the significance differences among categories. Results: A total of 837 cases of GBC were registered, F:M was 2.33, median age in females and males was 54 and 50 years respectively, majority of cases in both the genders were seen in 50-59 years of age, 81.1% patients were from rural areas and 18.8% from urban areas, Chi square on comparison with other cancers showed p<0.05, and there was no major religious and educational pattern of GBC seen in our population. Conclusion: In our population females are at high risk especially past 40 years of age and rural population with its varied environmental, lifestyles and infective agents should be investigated for possible risk factor in the causation of GBC.
ABSTRACT
Background: General dentistry care is of paramount importance in maintaining oral hygiene of cancer patients. Methods: The data of patients registered at the dental wing in a tertiary care cancer center for one year period (2013) was used for the present analysis. All the cases were retrospectively analyzed for the pattern of referral, diagnosis of different oro-dental conditions, and different interventions done for the various oro-dental conditions. Results: A total of 798 patients were referred from various oncology wings for management of oro-dental problems, 50.1% patients were referred from head and neck oncology, 31% were from radiation department, 6.2% patients were from medical oncology and palliative care department each, 4% patients were from gynecologic oncology, and 2.5% patients were from screening wing. Acute gingivitis (62%) in pre treatment and mucositis (28%) in post treatment were major symptoms and signs for referral. 47% patients were managed with tooth extraction, grinding was done on 23%, scaling were done on 12.5%, desensitization was done on 8.7% patients, filling was done on 2.5% patients, prosthesis fitting in 2.5% patients, root canal treatment in 2.2% patients, and post surgical obturator fittings in 0.75% patients. Conclusion: Majority of cancer patients were referred for oro-dental care from head and neck oncology department with head and neck cancers and extraction of tooth pre radiotherapy and chemotherapy remains an important part of oro-dental care in cancer patients.
ABSTRACT
Background: Head and Neck cancers are basically squamous cell carcinomas. It is the fifth most common cancer and the sixth most common cause of cancer mortality in the world. Incidence of cancer as a whole for all sites is fourth highest in Kamrup Urban District (KUD) in males (AAR 185.2) and second highest (AAR 156.3) in females out of all Population Based Cancer Registries (PBCR) in India. Incidence of head and neck cancers in KUD is quite high both nationally and internationally. This retrospective study was carried out to assess the incidence pattern of head and neck cancers in Kamrup Urban District of Assam, India for the period of 2009-2011. Methods: Cancer is not notifiable in India, so method of collecting information on cancer was active in PBCR Guwahati. A total of 4416 cases were registered during the three years (1st January 2009- 31st December 2011) of which 2508 were male and 1908 female. Statistical analysis used: Age Adjusted Rate (AAR), Crude Rate (CR) and Population pyramids are provided by NCRP-ICMR. Results: The relative proportion of head and neck cancers of total cancer cases registered in KUD constitutes 26% (654/2508) and 12% (225/1908) in male and female respectively. In males cancer of hypopharynx (AAR 14.7) was most common followed by tongue (AAR 9.4) and mouth (AAR 7.7). In females cancer of mouth (AAR 7.6) is most common followed by cancer of tongue (AAR 3.2). Conclusion: The pattern and incidence of various head and neck cancers is of utmost importance for primary prevention and early detection to adequately manage these cancers comprehensively in the community.