HER2 Status and Its Heterogeneity in Gastric Carcinoma of Vietnamese Patient

BACKGROUND: Human epidermal growth factor receptor 2 (HER2) is related to the pathogenesis and poor outcome of numerous types of carcinomas, including gastric carcinoma. Gastric cancer patients with HER2 positivity have become potential candidates for targeted therapy with trastuzumab. METHODS: We investigated 208 gastric cancer specimens using immunohistochemistry (IHC), fluorescence in situ hybridization and dual in situ hybridization (ISH). We also investigated the concordance between IHC and ISH. The correlation between HER2 status and various clinicopathological findings was also investigated. RESULTS: In total, 15.9% (33/208) and 24.5% (51/208) of gastric cancers showed HER2 gene amplification and protein overexpression, respectively. A high level of concordance between ISH and IHC analyses (91.3%, κ = 0.76) was found. A significant correlation between HER2 status and intestinal-type (p < .05) and differentiated carcinomas (p < .05) was also noted. The HER2 heterogeneity was high in gastric cancers; we found 68.8% phenotypic heterogeneity and 57.6% genotypic heterogeneity. Heterogeneity in HER2 protein expression and gene amplification showed a close association with diffuse histologic type and IHC 2+. CONCLUSIONS: HER2 protein overexpression and gene amplification were detected in 24.5% and 15.9% of gastric cancer specimens, respectively. Intestinal-type showed a higher level of HER2 protein overexpression and gene amplification than diffuse type. HER2 status also showed a significant relationship with well- and moderately-differentiated carcinomas. The ratio of phenotypic and genotypic heterogeneity of HER2 was high in gastric carcinomas and was associated with HER2 IHC 2+ and diffuse histologic type.

Application of neuropsychological battery tests in post-stroke dementia diagnosis among patients over 60 years old

Background: In Vascular Dementia (VaD) patients, the causes of blood vessels were common, and preventable and treatable, so that it is very important to detect and diagnose in the early stages of the disease. Diagnosis of dementia is based on clinical symptoms, and neuropsychological tests are useful tools. Objectives: (1) To evaluate the severity of VaD and Vascular Cognitive Impairment (VCI) after the 1st ischemic stroke in patients over 60 years old. (2) To make observations on the clinical features of post stroke dementia in these patient groups using neuropsychological battery. Subjects: 94 patients with 1st acute ischemic stroke, who were over 60 years old, conscious and literate, and cooperated well with physicians. A standard evaluation protocol was conducted at one month after an ischemic stroke for all the patients. Method: Prospective study. Data was analyzed by using SPSS software version 13.0. Results and conclusions: The rates of VCI and VaD after the first ischemic stroke were 21.3% and 25.5%, respectively. Clinical determinants of dementia were: visuoconstruction (65% patients), visual motor speed (50%), memory disorders (more than 40%, in which visual memory 45.8% and verbal memory 41.6%), executive function (37.5%), and language skill (37.5%). The attention and language functions were less affected (only 25% of the patients). Mini mental state examination score can be used to evaluate and classify clearly 3 groups: VaD, VCI patients and normal people.

Clinical characteristics of poststroke dementia patients with age of 60 years and older

Background: Dementia is one of the major causes of dependency after stroke. The prevalence of poststroke dementia (PSD)defined as any dementia occurring after stroke is likely to increase in the future.Objectives: This study have two purposes: 1) Clinical study of MCI and dementia after the first stroke of patients with age of 60 years and older; 2) Overview on clinical characteristics of memory disorders. Subjects and method: 30 patients with were diagnosed with the first ischemic stroke in Huu nghi hospital together with the same number in the control group were involved in this study. The subjects in the two groups were all satisfied with included/excluded criteria diagnosis. Clinical diagnosis of new - onset dementia or other mental disorders was determined using neuropsychological tests. Results: Many functions of the brain were impaired including: logical memory, visiospatial skills, executive function were statistically reduced in the research group compared to the control. However, language function was also impacted but not as much as others. The frequency of the poststrocke dementia in this study was 12.3% while the poststrocke mild cognitive impairment rate was 47%. Conclusions: Global cognitive functioning together with memory state was significantly declined in the ischemic stroke compared to the control group.