[Metastatic non-small cell lung cancer: a tunisian retrospective study about 100 cases]

Background: Background: Non-small cell lung cancer [NSCLC] is the most common histologic form, leading causes of cancer death among masculine population. Half of CNPC was metastatic at diagnosis

Aim: To report the epidemiologic, anatomoclinic profile, therapeutic protocols and results of a retrospective study of non-small cell lung cancer [NSCLC] initially metastatic

Methods: our retrospective study include patients with NSCLC histologically confirmed with inaugural metastasis collected from January 1999 to december 2012. We had analysed epidemiologic, anatomopathologic data [TNM 2009], therapeutic protocols and results in term of overall survival, median survival and event free survival

Results: 100 case of NSCLC have been collected, mea nage was 57 years [22 to 81] and sex -ratio was 4,6. The majority of cases [74%] had a good performance statut [PS

Conclusion: Despite therapeutic progress in management of NSCLC, the prognosis of metastatic forms still reserved with a poor mean survival reported in litterature [12 years] valideted in our study. This push us to improve research mainly since advent of targeted therapy which still a promising way in the management of these tumors

[Ki-67: role in diagnosis, prognosis and follow-up after treatment of breast cancers]

Aim: To evaluate the literature data about diagnostic value, prognosis value and interest in follow-up of Ki-67 antibody after treatment for breast cancer

Methods: We performed a literature search in pubmed using the keywords: Ki-67, anti-Ki-67, breast cancer, prognosis, proliferation, chemotherapy, hormone therapy

Results: Ki-67 is routinely used as a static marker of proliferative activity and in follow-up-monitoring before and after treatment by chemotherapy and more recently hormonotherapy. Ki-67 was also used at a cut-off of 14% to differentiate between luminal A and B breast cancers. A high Ki-67 expression is probably related to a poorer prognosis but also a better response to neoadjuvant chemo and/or targeted therapy. More recently, genomic analysis is more reliable to classify the molecular breast cancer subtypes avoiding the possible cases of discordant Ki-67 rate. Ki-67 is also interesting in predicting histological response to neoadjuvant chemo and hormone therapy

Conclusion: Ki-67 evaluated by immunohistochemistry is important in routine in countries without bimolecular plateforms despite technical insufficiencies. When available, genomic grading is better to classify molecular subtypes and determine breast cancer prognosis in adjuvant and neoadjuvant setting

[Conserving surgery for breast cancer]

Breast cancer is the first women's cancer. Conserving surgery associated with radiotherapy, is in progress. Her indications are frequent. The result local control and global survival am the same as radical surgery

Serum calcium, phosphorus and protien changes in cancer patients undergoing abdominal surgery

To report the serum calcium, phosphorus and protein abnormalities in cancer subjects during abdominal surgery. 41 patients are collected [32 F/9 M] with a mean of age 57.78 +/- 12.7 years, who had undergone abdominal surgery. Serum samples were obtained on the day before surgery and on days 3 and 8 post surgery for measurement of serum total calcium, protein, and phosphorus. The different parameters studied fall significantly at day 3 and increase at day 8 postsurgery in all patients. The means levels of total calcium, phosphorus and protein before surgery are 2,04 +/- 0,2 mmol/l, 1,12 +/- 021 mmol/l and 55 +/- 7 g/l vs 1,9 +/- 0,26 mmol/l, 0,98 +/- 0,18 mmol/l and 50 +/- 8 g/l at day 3 post surgery. Post operative hypocalcemia was attributed to the fall in protein and the decrease in phosphorus may be resulted from renal losses of phosphorus due to extracellular volume expansion

Use of common seric tumor markers in patients with solid cancers

Seric tumour markers [STM] are molecules that theoretically indicate the presence of malignancy, and largery used for monitoring response to therapy and early detection of relapse. This article describes the use and limitations of common SMT in patient with solid tumors. Excepting prostate specific antigen [PSA] and thyroglobulin, STM are not poorly sensitive or specific for screening and diagnosis of cancers. Alpha foetoprotein [AFP] is however used to screen hepatocellular carcinoma in high risk patients with suspect masses. Beta subunit of human chorionic gonadotrophin [beta-HCG] is frequently used for the diagnosis and management of gestational trophoblastic disease, while combined AFP and beta-HCG dosage is a good adjunct in the evaluation and treatment of non seminomatous germ cell tumors. PSA is used for screening and follow up of prostate cancer. Ca 125 is useful for evaluating pelvic masses in postmenopausal women and monitoring response to therapy in women with ovarian cancer, while Ca 15 3 is used to follow response to therapy in patients with breast cancer

[Clinical epidemiology of primary lung in Tunisia. 100 cases]

Lung cancer is frequent and its incidence is increasing in Tunisia and in all over the world. Few published Tunisian studies have described epidemiology of lung cancer. To report the clinical features and outcomes of lung cancer in Tunisia from a retrospective review of 100 consecutive patients seen in F.S.I. hospital in La Marsa. a retrospective study was carried out 100 cases of bronchial carcinoma seen in pulmonology department between 2000 and 2004. We analysed diagnosis modalities. histological subtypes, staging of the disease, treatment strategies and survival. Survival rates were calculated using Kaplan-Meier method. mean age was 59.5 years, sex-ratio at 19. 92%of patients were smokers; the average of tobacco consumption was 48.5 PY. The diagnosis was histologically proven in 90%of the cases. Specimen were obtained by bronchoscop [53.4%of cases], fine-needle lung biopsy [30%], metastasis biopsy [7.7%], surgical biopsy [7.7%] and more rarely by thoracoscopy [1.2%]. Histologically, 39%were squamous carcinomas, 30%adenocarcinomas and 8.7%small cell carcinomas. 51%of non small cell lung carcinomas were stage IV. 26%stage IIIB, 9%stage IIIA and 14%were stage I or II. 6 of 10 patients with small cell carcinomas were with disseminated disease. 18 of 21 patients with resectable tumors receive surge. Patients with locally advanced tumors received combined chemotherapy and radiotherapy. 14 of 46 stage IV patients received palliative chemotherapy. Survival rate was 18%at 2 years

Dermatofibrosarcoma Protuberans of the Breast

Dermatofibrosarcoma protuberans is a superficial mesenchymal cutaneous tumor of essentially local malignancy, located more often in the trunk and extremities. This tumor is usually diagnosed after multiple recurrences. We report two cases of rare mammary localisations of dermatofibrosarcoma protuberans in 2 patients aged 39 and 43 years respectively, the two lesions sized 35 x 45 mm were treated by wide excision and reconstruction with a dorsal flap; in the second case

Profil serique de la lacticodeshydrogenase et de ses isoenzymes dans le cancer du nasopharynx

Our prospective study included 41 patients, from 13 to 70 years old, and present a nasopharyngeal carcinoma confirmed histologically, during the period going from September 1999 to March 2000, and 45 healthy controls. A blood sample was collected from each patient before any treatment, as well as controls to measure serum LDH and its isoenzymes. Two groups of patients were selected after a period varying from 12 to 37 months with a mean of 29 months: 29 with favourable evolution, 12 with non favourable evolution. The mean serum total LDH and its isoenzymes values were significantly higher in patients than those in controls with values of variable p of 0,001 to 0,05. A significant correlation was found between ganglionnary extension and serum values of total LDH, LDH3 and LDH5. No significant difference were observed between the means serum total LDH before treatment and the clinical evolution of patients. Diagnostic contribution of total LDH is limited, by its ubiquitary character, but could constitute for LDH3 a good marker of the disease progression

Seric neuron specific enolase in pediatric neuroblastoma. Retrospective results about 21 patients

To report the results of seric neuron specific enolase in pediatric neuroblastoma. Our retrospective study concerns 21 children treated in our institution from 1992 to 1998 for neuroblastoma. Seric NSE was determined by immunoenzymology technique at different stages of the disease and the treatment Mean value for the 39 dosages of the whole patients was 127.9 ng/ml with a sensitivity of 56 percent five patients has presented normal values. Mean value for the 18 patients in stage IV was 132.38 ng/ml. we also observed in 3 patients, an evolution of the seric NSE parallel to this of the disease under chemotherapy. NSE represents a moderate sensitive and specific tumor marker for pediatric neuroblastoma. However, it represents a good value in prognosis and follow-up after chemotherapy