Immunohistochemical expression of p53 and c-erbB2 proteins in breast cancer in Egypt.

The purpose of the present study was to estimate p53 and c-erbB2 expression in an Egyptian cohort and assess their relationships with other indicators of aggressive disease. Additionally, the frequency of both oncogenes was compared to that reported in other breast cancer populations. Paraffin-embedded tissue sections obtained from 210 invasive ductal carcinomas were evaluated immunohistochemically for p53 and c-erbB2 oncoproteins using CM-1 polyclonal antibody and mAb1 monoclonal antibody, respectively. Tumor proliferation was also assessed using PC10 anti-PCNA (proliferation cell nuclear antigen) monoclonal antibody. Chi square test was used to assess the relationship between p53 and c-erbB2 and their associations with other prognostic factors. The results revealed that p53 and c-erbB2 were equally expressed, each accounting for 40% of the total cases (84 out of 210) Immunoreaction for p53 and/or c-erbB2 was demonstrated in 65% (136 out of 210) and 15% (32 out of 210) were positive for both oncogenes. Poor histologic grade was more significantly associated with p53 expression (P = 0.0001) than c-erbB2 expression (P = 0.01). The latter was also significantly associated with premenopausal status (P = 0.01) and large tumor size (P = 0.003). Both p53 and c-erbB2 oncoproteins were found to be unrelated to each other, nodal status or PCNA immunostaining. These data suggest that p53 and c-erbB2 oncogenes correlate with poor prognostic features of breast cancer. The differences between the frequency of p53 and c-erbB2 expression observed in this study and in the reports of Western authors will hopefully stimulate investigation of these oncogenes using molecular biologic techniques and matched comparative Egyptian and European breast cancer groups.

Altered endometrial progesterone/oestrogen receptor ratio in luteal phase defect.

The total oestrogen and progesterone receptor levels (TER, TPR) were measured in endometrial biopsy samples of 10 infertile patients with luteal phase defect (LPD) and compared to those of controls. Serum levels of progesterone (P), obtained in the luteal phase, were also measured. Midluteal phase P values were significantly decreased in LPD cycles; however some overlap of values existed. LPD cycles had significantly lower endometrial TER and TPR concentrations than did control cycles. TPR/TER ratio was found to be a reliable test for diagnosis; having a sensitivity, and specificity of 90% and the odds ratio of 81. The TPR/TER ratio for inphase endometria ranged between 1.13 and 58.22, with 95% confidence. It seems that abnormal folliculogenesis, as a cause of LPD, results in wide ranges of endometrial TER and TPR concentrations, yet with well defined alteration in TPR/TER ratio. Summation of the results of the present study along with those previously reported, indicates that TPR/TER ratio may be of great value in characterisation of a well defined endometrial receptor imbalance in luteal phase defect, whatever the underlying aetiology.

Anticardiolipin and antinuclear antibodies in patients with unexplained recurrent abortions.

In a controlled study on a resident population in Kuwait, 103 patients with unexplained recurrent spontaneous abortions were investigated for the frequency of positive tests for anticardiolipin antiobodies (ACA) and antinuclear antibodies (ANA). The frequency of ACA was significantly (P<0.001) higher in patients (32.0%) than in controls (7.1%). Only four patients (3.8%) were positive for both IgG and IgM ACA. The frequency of positive tests for ANA was also significantly (P<0.001) higher in patients (13.6%) than in controls (1.2%). No difference was found between first and second trimester aborters in the frequency of positive tests for either ACA or ANA. Primary aborters did not differ from secondary aborters in the frequency of ACA. However, secondary aborters had significantly higher frequency of ANA. There was no concordance between ACA and ANAN positive tests. These results suggest that ACA may be associated with some cases of unexplained recurrent abortions and that tests for both IgG and IgM isotypes should be carried out in the investigations of these patients.