RESUMO
Hepatocellular carcinoma [HCC] is a fatal malignancy. Effective curative surgery is achieved when HCC is detected earlier. Proteosomes, the main non-lysosomal proteolytic structures organising the cellular mechanisms of cleaving proteins, can be considered a tumour marker in many kinds of malignancies. The aim of this study was to assess the plasma proteosome level in HCC and cirrhosis and, accordingly, evaluate its potential diagnostic ability in the detection of HCC in cirrhosis. This study included 60 patients, divided into two groups: the HCC group and the liver cirrhosis group. Twenty normal subjects served as a control group. Serum levels of proteosome and alpha-foetoprotein [AFP] were measured using the enzyme-linked immunosorbent assay [ELISA] technique. Plasma proteosome levels were significantly higher in patients with HCC and in patients with cirrhosis without HCC when compared to controls individually [p > 0.002 and p > 0.001, respectively] but did not reach a significant differentiating level between them [area under curve [AUC] = 0.641, p = 0.061]. Moreover, the plasma proteosome level was not correlated with the severity of HCC by the Milan criteria or with AFP level. In addition, it was not significantly related to laboratory or Child-Pugh scoring. Moreover, the combined use of plasma proteosome level and AFP measurements for the diagnosis of HCC was not effective. In this study, the plasma proteosome level was comparably recorded in both patients with cirrhosis and patients with HCC [mean value +/- standard deviation were 5.796 +/- 1.46 and 7.176 +/- 2.48 microgml[-1], respectively], not reaching a significant differentiating level between them, although predictability of HCC using the plasma proteosome level was significant [p = 0.017]
RESUMO
Muslims constitute more than 20% of the world's population and have a significant share of its cancer cases. Many Muslim cancer patients witness the fasting month of Ramadan but we do not know which individuals elect to fast. Cross-sectional study conducted among Muslim cancer patients at the National Cancer Institute [NCI], Egypt, during Ramadan, Hijri 1430 [the month of fasting] August-September 2009. One-hundred and two patients being treated at the NCI were interviewed. The most common diagnoses were breast cancer [31%], acute leukemia [24%], colorectal cancer [7%], non-Hodgkin lymphoma [5%], bladder cancer [4%], lung cancer [4%], and laryngeal cancer [4%]. The two sexes were equally represented and so were metastatic and nonmetastatic diseases. The outpatient: inpatient ratio was 3:1. Treatments being received by these patients included chemotherapy, radiotherapy, hormonal therapy, and nonspecific therapy in 42%, 31%, 10%, and 17%, respectively. Other concomitant diseases were present in 22% of the patients. While 40% of patients did not fast at all during Ramadan, 36% and 24% were partial and complete fasters, respectively. Female patients, those with performance status [PS] 0 to 1, those whose disease was a nonmetastatic solid tumor, and those receiving non-intravenous chemotherapy as outpatients were more likely to be fasting than their corresponding counterparts. Being a female, having PS 0 to 1, and receiving treatment as an outpatient were the only factors that were significant on multivariate analysis. Only 46% of patients sought the treating oncologist advice on whether they could fast. Most cancer patients fast during Ramadan, but only half of them discuss the issue with their oncologists. We hope that our study stimulates more research on this topic