[Usefulness of colposcopy in inflammatory cervico-vaginal smears: apropos of 140 cases]. / Apport de la colposcopie dans les frottis cervico-vaginaux inflammatoires: a propos de 140 cas.

BACKGROUND: The cervical cancer is the second most frequent cancer of the woman in Tunisia. It is considered as a sexual transmissive desease due to the involvement of the HPV. AIM: The purpose of our study is to proove that an inflammatory cervical smear should be considered as a positive test and must lead to other investigations. METHODS: It is a prospective study over 140 cases of inflammatory cervical smears (without atypical cells) diagnosed during a year period from june 2001 to june 2002. These patients had a systematic colposcopy with the biopsy of suspicious lesions. RESULTS: The mean age of our patients is 42 years. 68.57% of them are in active genital period. The colposcopy was normal in 10% of our patients. It showed benign lesions such as: ectropion in 22.85%, colpitis in 14.28%, cervical polypus in 5%, normal transformation zone in 8.57%, but also suspicious lesions such as : atypical transformations grade I (ATGI) in 25.71% and atypical transformations grade II (ATGII) in 13.57%. The biopsies made on 89 patients showed dysplasia and carcinoma in 18.57% of them. A case of in situ carcinoma, a microinvasif epidermoid carcinoma and an invasif glandular carcinoma were diagnosed. CONCLUSION: Colposcopy is an ambulatory investigation. It makes a minutious study of the cervix and diminishes the rate of false negative made by the cervical smear.

A mouse model of basal-like breast carcinoma with metaplastic elements.

Breast cancers arising in carriers of germline BRCA1 mutations frequently have a basal-like phenotype. Basal-like cancers are characterized by high histological grade, central necrotic areas, foci with metaplastic differentiation, lack of hormone receptor and HER2 (ErbB2) expression, and consistent positivity for basal markers, including CK5/6, CK14, and EGFR. We have used germline manipulation to generate a conditional mouse model of Brca1 deficiency. Transgenic expression of Cre recombinase in the mammary gland of these mice results in deletion of exons encoding the C-terminus of Brca1 and leads to tumour formation when combined with heterozygosity for a p53 mutation. Histologically, these mammary gland tumours were characterized by high histological grade, central necrotic areas, and presence of homologous metaplastic elements. These metaplastic elements consisted of neoplastic spindle cells or squamous cell differentiation in the form of keratin pearls or individual cell keratinization. Immunohistochemical analysis revealed expression of basal-like markers in all cases. The tumour phenotype generated in our mouse model was compared with published data on human basal-like breast carcinomas and also with metaplastic breast cancers with a basal-like phenotype; the comparison showed that we have generated a mouse model of basal-like breast cancer, which should prove useful in testing new and targeted treatments for this type of breast cancer.