Serum Her-2/Neu a potential biomarker in breast cancer patients: correlation with the clinico-pathological parameters

Background: Breast cancer is the most common malignancy in women, and a major cause of mortality and morbidity despite the advances in diagnosis and treatment. There is evidence that changes in HER2 protein expressions are associated with breast cancer progression

Objective: To investigate whether measuring this tumour marker in serum of breast cancer patients before and after treatment might also be useful markers in the diagnosis, screening and monitoring the malignant tumour progression and response to therapy

Methods: Serum samples were obtained from [28] apparently healthy women [Control Group] with a mean age of 40.9 +/- 7.6 years and [60] female patients complaining from primary breast cancer [Patients Group] with a mean age of 48.3 +/- 8.9 years. They were divided according to their clinical end point into: Pre-Surgical Group, Post-Surgical Group and post- chemotherapy Group. Serum Her-2/nue level was measured using ELISA kits

Results: Level of Her2/neu [3130.4 pg/ml] was significantly higher in after 6 cycles of chemotherapy group than each of control [1400.8 pg/ml], before surgery [1597 pg/ml] and after surgery [1487.4 pg/ml] [P <0.05]. Her2/neu is effective test only after 6 cycle chemotherapy with an accuracy of 95.2%. The best performance for Her2neu was observed at values >/= 1464 pg/ml [sensitivity = 95% and specificity = 6 1%]. There were significant influences of the studied personal and the pathological characteristics of the tumour upon the biomarker levels where the levels were significantly higher with the increase of tumour pathological stage and in the presence of positive status for Her2neu receptors [P <0.05]

Conclusion: In this study there was a statistically significant association between tissue HER-2/neu and serum HER-2 /neu levels in the extracellular domain. It could be concluded that using serum Her-2/neu in patients after six cycles chemotherapy could predict response to therapy

Significance of cervical cytology screening [Pap Smear] in the detection of precancerous cervical lesions

The incidence of cancer of the cervix is comparatively low in Iraq, as in most Islamic countries Pre invasive lesions of the uterine cervix can be detected by Pap smears in their preclinical course, a fact which documents the significant role of cervical cytology in gynecological practice. To emphasize the role of cervical cytopathology [Pap smears] in the detection and follow up of various cervical lesions that may predispose to cervical carcinoma with special emphasis on Cervical Intraepithelial Neoplastic [CIN] conditions or dysplasias. This retrospective study was performed on 1500 women aged 20 years and above who attended the private clinical laboratory of the senior investigator during the period between [May 2000 to May 2001], Cases were randomly selected. All relevant clinico-pathological data were recorded within a standardized interview report. After careful examination of the external genitalia, a Pap smear was obtained using Ayre's wooden spatula. Results were recorded and statistically analyzed. Cytological diagnosis revealed: 1065 cases [71,01%] of non specific cervicitis. 392 cases [26.13%] of specific cervicitis. 30 cases [2%] of cervical polyp. 172 cases [11.47%] of CIN[1] [mild dysplasia]. 31 cases [2.07%] of CIN[2] [moderate dysplasia]. 10 cases [0.67%] of CIN[3] [severe dysplasia]. According to the Bethesda system, atypical squamous cells of undetermined significance [ASCUS] was the most common epithelial cell abnormality representing [24.27%] of total group studied, while low grade squamous intraepithelial lesions [LGSIL] and atypical glandular cell of undetermined significance [AGUS] represented [13.27%] and [16.2%] of total group studied respectively. High grade squamous intraepithelial lesions [HSIL] were detected in [2.73%] of the examined smears. Clinical examination revealed that the grades of CIN were higher in patients with older age groups and a statistically significant correlation was shown between parity and the severity of cervical lesions. Cervical erosions, hypertrophy and congestion were reported in a significant proportion of cases among our study population. Pap smear cytology remains as one of the most effective tools used in the early detection and follow up of many gynecological disorders specifically precancerous lesions of the uterine cervix. Cytological diagnosis of these lesions with treatment of the associated inflammations could be helpful in preventing their progression into more serious cervical pathology

Fine needle aspiration cytology versus histopathology in diagnosing lymph node lesions

Fine needle aspirates [FNA] of superficial lymph nodes were obtained from 150 patients complaining of lymphadenopathy. Cytological findings were analysed in correlation with the corresponding histopathological diagnosis of the same excised nodes. Benign lesions were found in more than half of the patients [55.3%], the majority of which were nonspecific reactive hyperplasia followed by tuberculous lymphadenitis. Lymphomas constituted the main pathology in malignant involvement [26.0%], while metastatic lesions formed 16.7% and leukaemia 2.0%. The results of FNA compared favourably with those of tissue biopsies, with an accuracy rate of 89.6% for malignant lymphadenopathy. The appropriate use of FNA may obviate the need for an open biopsy