Histopathological characteristics of breast cancer and evaluation of ER alpha and Her-2neu using immunohistochemical and RT-PCR techniques

Oestrogen receptor [ER] and HER [human epidermal growth factor receptor] family signaling pathways are fundamental to guide treatment and determine prognosis. Categorizing breast cancer tumors as ER and Her-2 positive or negative is usually performed by immunohistochemistry [IHC], however the technique lacks standardization in handling tissues, staining techniques, and scoring systems. The current study aimed to compare the conventional IHC and the RT-PCR techniques in assessing the ER-alpha status in breast cancer. It also validates the application of RT-PCR technique in detecting the Her-2/neu status. The study included 40 patients with IDC [NOS] [invasive ductal carcinoma; not otherwise specified]. Breast tissue specimens were collected at the time of the elective surgery. Specimens were subjected to routine pathological examinations. ER alpha and PR receptor status; assessed by immunohistochemical staining. RNA was extracted, reverse transcribed, and amplified by PCR using ER alpha and HER-2 specific primers. Relative expression was detected

role of angiogenesis assessment in the prognosis of breast carcinoma and in the evaluation of the therapeutic effect of "shark care" drug as an angiogenesis inhibitor

There is still uncertainty about angiogenesis as a prognostic factor in breast cancer. To evaluate the prognostic value of microvascular density [MVD] in breast carcinoma and soluble vascular cell adhesion molecule-1 [sVCAM-1], leptin, estradiol and total testosterone as angiogenic markers. Efficacy of shark care drug was assessed by patient's overall survival. 30 premenopausal breast cancer patients [group II] and 15 controls [group I]. Group II was subgrouped into 15 patients receiving chemotherapy alone [IIA] and 15 patients receiving chemotherapy + shark care drug [IIB]. After modified radical mastectomy, microvessels were counted by staining tissues for factor VIII. For surrogate markers, enzyme-linked immunosorbant assay or radiommunoassay kits were used. A high MVD was found only in areas of carcinoma. MVD and sVCAM-1 correlated significantly with each other and with lymph node involvement. After the follow-up, all subgroup IIB patients were alive compared to 66.6% of subgroup IIA [p=0.02]. A high MVD may be a poor prognostic marker of breast carcinoma and a target for antiangiogenic therapy sVCAM-1 is useful for diagnosis and for monitoring response to therapy. Chemotherapy + shark care drug seem to ameliorate the outcome of these patients

Clinical features and ultrasonography in risk assessment of renal cortical scarring: correlation with Tc99m-DMSA renal scan

The aim of this study was to assess the usefulness of clinical features in risk assessment of renal cortical scarring and to determine the sensitivity of renal ultrasound in defection of renal scars in relation to DMSA scan. Ninety-six children [192 kidneys] with bacteriologically proven UTI were included in the study. All patients underwent ultrasonography using Siemens Negra multiprobe machine and DMSA scan. The latter imaging was performed 3 hours after IV injection of Tc99m-DMSA, using a dual head ADAC vertex plus Gamma camera with high-resolution collimator. The dose was calculated according to the child's weight using the equation: child dose = child weight x 5 / 70. Planar images were acquired in anterior, posterior, right posterior and left posterior oblique projections for 500 K counts each. If ectopic or ptosed kidney was detected, anterior oblique projections were added. Studies were reported by a nuclear medicine consultant and a scan was reported as positive for the presence of cortical scar[s] if there was distortion [depression] in the normal kidney contour or focal or diffuse reduction in cortical tracer uptake. Split renal function was calculated and normal differential function was regarded in the range of 45-55%. The results showed that, out of our patient population, 84 were girls [87.5%] and 12 were boys [12.5%]. They were divided according to their age into two groups: preschool age group [1-4 years old] [24 children; 25%] and school age group [72 children, 75%]. Sixteen children were found to have focal or diffuse renal scarring by DMSA study [16.6%], however Ultrasonography detected 8 cases [8.3%] with renal scars out of these 16 cases i,e. the ultrasound sensitivity was 50% of that of DMSA. Eight of these 16 cases had bilateral abnormalities and 8 with unilateral abnormality [24 kidneys; 12.5%]. Twelve were in the school age group and 4 were of the preschool age group. All 16 children with scars had symptoms of upper VTI. Loin pain was more consistent with renal scarring than fever. Nevertheless, many children [44] with upper UTI symptoms did not develop renal scarring. None of the 36 children with no symptoms suggesting the presence of upper UTI [i.e. only lower UTI] had renal scarring on DMSA study

Conclusion: we concluded that patients with only lower UTI are much less prone to development of renal scarring, and that ultrasonography sensitivity is not good enough in detecting renal scars and at the present time should not replace DMSA in evaluation of renal scarring