Multivariate analysis of bcl-2, apoptosis, P53 and HER-2/neu in breast cancer: a short-term follow-up.

BACKGROUND: Several molecular genetic alterations in breast cancer, including aneuploidy, altered apoptosis, aberrant expression of p53, HER-2/neu and Bcl-2, have been associated with poor prognosis in breast cancer patients. To determine the importance of molecular-genetic factors relative to more traditional surgical-pathological prognostic factors, multivariate analysis was performed. PATIENTS AND METHODS: Ninety-four fresh tissue samples of primary breast carcinoma were studied with flow cytometry for DNA ploidy. On the same specimens, steroid hormone receptors (ER and PR) were measured in the cytosol fraction using Abbott ELISA assays. HER-2/neu was determined in the membrane fraction and mutant p53 protein in the nuclear fraction, both, by Oncogene Science ELIZA procedures. Bcl-2 and apoptosis (cell death) were measured in cell lysates by Oncogene Science & Boehringer Mannheim ELISA assays. In addition, information regarding surgical-pathological features of the tumor was obtained. Multivariate analysis using an unconditional logistic regression model was done to identify variables predictive of poor prognosis. RESULTS: Using univariate analysis, histological grade, tumor stage, lymph node status, HER-2/neu and mutant p53 were predictive of poor short-term prognosis. By multivariate analysis, tumor stage, lymph node status and HER-2/neu were independent factors. Grade subgroup analysis versus time of relapse, illustrated a predictive value of Bcl-2 in only low-grade tumors while apoptosis was significant in high-grade type. CONCLUSION: Among a panel of molecular-genetic factors investigated, HER-2/neu was the most strongly predictive of poor short-term prognosis in breast cancer. Patients with HER-2/neu-positive tumors can benefit from Herceptin therapy.

New scope in angiogenesis: role of vascular endothelial growth factor (VEGF), NO, lipid peroxidation, and vitamin E in the pathophysiology of pre-eclampsia among Egyptian females.

OBJECTIVES: The purpose of this study was to investigate the role of VEGF, NO, MDA, and Vitamin E in the pathophysiology of preeclampsia (PE) among Egyptian women. PATIENTS AND METHODS: Our study included 20 pregnant women with mild PE, 40 pregnant women with severe PE, 20 normal control women and 20 normal control pregnant women. Plasma from all women were subjected to estimation of VEGF using ELISA kit, estimation of nitrates (as end product of NO) and MDA by chemical methods and measurement of Vitamin E using HPLC. RESULTS: The obtained data from this study revealed that, VEGF may be used as a useful marker for PE which is elevated in plasma of women with PE (mild and severe) compared to controls. VEGF could differentiate between PE and controls at a cut-off value of: 70 ng/mL with a sensitivity of 95% and a specificity of 90%. Moreover, at a cut-off value of 250 ng/mL, VEGF could discriminate mild PE from severe PE with a sensitivity of 77.5% and a specificity of 85%. With respect to nitrate levels, they were significantly elevated in normal pregnant women compared with normal controls. Meanwhile, nitrate levels showed a highly significant decrease in PE in relation to both controls, explaining the vasoconstriction and high blood pressure occurring in preeclamptic women. Correlation analysis revealed significant inverse correlation between nitrate levels and VEGF. Lipid peroxidation as indicated by MDA was enhanced in preeclamptic women as compared to healthy controls. The increase in MDA levels was correlated to the severity of PE. A highly significant fall in vitamin E as an antioxidant-scavenging vitamin was seen in preeclamptic women as compared to the controls. Also, a significant drop in the vitamin level was found in severe PE in comparison to mild PE. The oxidant/antioxidant correlation was illustrated by the inverse correlation between vitamin E and MDA(r = -0.837, p = 0.000). CONCLUSION: The findings from this study indicated that VEGF may be used as a clinically useful biomarker for PE for better diagnosis, to differentiate between mild and severe PE, and may also be a target for therapeutic intervention of PE. The increase in levels of VEGF together with reduction in NO levels could confirm the existence of vascular reactivity and endothelial disturbance in PE. The decrease in the vasodilator, NO may in part lead to the vasospasm of preeclampsia, which consequently produces hypoxia. The latter may be a cause of an elevation of VEGF (angiogenic factor) levels in PE. Meanwhile, elevated levels of lipid peroxides together with impaired antioxidant defense mechanisms may play a role in the etiology of PE.

Materno-foetal transmission of hepatitis B infection.

A cross-sectional study was carried out on 352 pregnant women, chosen randomly from those admitted to the labour ward of Ain Shams University Hospitals, Abbassia, Cairo, Egypt. This study was conducted to determine the prevalence of HBsAg among pregnant women and estimate the materno-foetal transmission. The prevalence of HBsAg among studied women was 15.3%, however, 7.1% showed inconclusive positive results. The materno-foetal transmission was documented in 51.8% of positive HBSAg women. Hepatitis B infection among studied women was usually acquired after 20 years of age. Logistic regression model with stepwise forward selection, demonstrated that maternal age, past history of blood transfusion and abortions were contributing factors for +ve HBsAg maternal status, while parity and past history of abortions were contributing factors in materno-foetal transmission.