ABSTRACT
Human papillomavirus (HPV) is a necessary cause of cervical cancer and its precursors. Increased expression of high-risk hrHPV viral oncogenes in abnormal cells might increase the expression of p16INK4a. We aimed to determine the role of p16INK4a in detecting hrHPV-transformed epithelial cells in liquid-based cervical cytology, and compared the results with hrHPV DNA testing by realtime polymerase chain reaction (RT-PCR). Fifty-seven cytological samples were tested for p16INK4a immunomarker and hrHPV DNA. Test performance of both tests was determined by comparing sensitivity, specificity and predictive values using available histological follow-up data as gold standard. Of 57 samples, 36 (63.2%) showed immunoreactivity for p16INK4a and 43 (75.4%) were hrHPV-infected. A fairly low concordance rate (k = 0.504) between p16INK4a immunolabelling and hrHPV DNA status was noted. For prediction of cervical intraepithelial neoplasia (CIN) II and worse lesions, p16INK4a had a sensitivity and specificity of 93.5% and 60%; whereas hrHPV DNA testing had a sensitivity and specificity of 100% and 20%. Dual testing by combining p16INK4a and hrHPV showed sensitivity and specificity of 100% and 33.3%. In conclusion, p16INK4a is useful in predicting severity of the cytological abnormalities. Although p16INK4a is more specific but less sensitive than hrHPV in detecting high-grade cervical lesions, a combination of both tests failed to demonstrate significant improvement in diagnostic sensitivity, specificity and predictive value. Larger-scale prospective studies are required to assess further whether this biomarker should be routinely used as primary screening tool independently or in combination with hrHPV testing to improve diagnostic accuracy in cervical cytology.
Subject(s)
Adenocarcinoma/diagnosis , Biomarkers, Tumor/analysis , Carcinoma, Squamous Cell/diagnosis , Cyclin-Dependent Kinase Inhibitor p16/biosynthesis , Uterine Cervical Neoplasms/diagnosis , Adenocarcinoma/virology , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/virology , DNA, Viral/analysis , Female , Humans , Middle Aged , Papillomavirus Infections , Real-Time Polymerase Chain Reaction , Retrospective Studies , Sensitivity and Specificity , Uterine Cervical Neoplasms/virology , Young AdultABSTRACT
INTRODUCTION: This study was conducted to determine the association between serum sex hormone levels and breast cancer. METHODS: The study was conducted on newly-diagnosed breast cancer patients who had not received any treatment. Controls were women not known to have any breast disease or hormone-related tumours. Serum hormones were divided into quartiles. Logistic regression adjusting for age and race were done to calculate the odds ratio (OR) and 95 percent confidence interval (CI). RESULTS: A total of 207 subjects were recruited; 73 premenopausal (37 cases, 36 controls) and 134 postmenopausal (68 cases and 66 controls) women. In the premenopausal women, only serum testosterone was positively associated with breast cancer (OR 1.72, 95 percent CI 0.40-7.40), but this was not a significant finding (p-value is 0.468). In the postmenopausal women, oestradiol, progesterone and testosterone were positively associated with breast cancer with a highest to lowest quartile OR of 1.48, 2.35 and 4.23 (95 percent CI 0.59-3.69, 1.11-4.95 and 1.52-11.78, respectively). The OR was significant for both progesterone and testosterone (p-values of 0.025 and 0.006, respectively). CONCLUSION: There were no statistically significant findings among the premenopausal cases. In postmenopausal women, serum progesterone and testosterone levels were significantly associated positively with the odds of having breast cancer.
Subject(s)
Breast Neoplasms/blood , Postmenopause , Premenopause , Progesterone/blood , Testosterone/blood , Adult , Age Factors , Breast Neoplasms/epidemiology , Case-Control Studies , Confidence Intervals , Estradiol/blood , Female , Humans , Logistic Models , Malaysia/epidemiology , Middle Aged , Odds Ratio , Prolactin/blood , Risk FactorsABSTRACT
The association of arsenical poisoning with the development of skin cancer is well-known. In Malaysia, arsenic has been shown to coexist with tin in tin-mining land. Our preliminary investigation has shown that the level of arsenic in well water from a tin-mining area is high. We report 3 patients with cutaneous lesions typical of chronic arsenical poisoning such as hyperpigmentation, keratoses and skin cancer. These patients have positive histories of previous domicility in tin-mining areas. We conclude that these patients developed chronic arsenical poisoning from drinking well water polluted with arsenic from the tin-mining soil.
