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Abstract: Background: Cervical cancer is a major cause of women death worldwide. The reduction of the mortality and morbidity of this pathology depends on the early detection based on powerful suitable screening methods, that will lead to optimal treatment strategies. However in some rural region of developing countries, it is very difficult to get access to standard screening methods, alternative screening methods, cheaper and easy to handle are then useful. Objective: The aim of this work was to test the sensitivity and specificity of VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol iodine) as screening test of cervical cancer compared to the Pap Smear, evaluating the feasibility in health formation in the North Cameroon region, of implementing epidemiological surveillance of cervical cancer based on early diagnosis using the VIA-VILI association Method: 309 women age 20 to 62 years were recruited in this study, 307 were included in the statistical analyzes. Each woman was screened for cervical cancer by a conventional Smear and visual inspection with acetic acid 5% and the lugol solution. Results: We found in our study a prevalence of precancerous lesions of cervix at 12.70%. The risks factors of cervical cancer identified are age, matrimonial status, age of first sexual intercourse and parity. The association of VIA and VILI showed a sensitivity, specificity, positive and negative predictive value respectively about 93.58%; 97.01%; 82.01%, 99.04%. Conclusion: Compared to PAP Smear, VIA or VILI could be used as an alternative screening methods for cervical cancer in developing countries. However, histology test was recommended to use a « Gold Standard » to evaluate the test accuracy of VIA/VILI because it can be used to diagnose cancer, while PAP smear cannot. Keywords: Sensitivity, specificity, diagnosis,VIA-VILI, cervical cancer. Download Full Article |
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Abstract: Angioimmunoblastic T-cell lymphoma (AITL) comprehends 20% of the peripheral T-cell lymphomas (PTCL). Although rare, its clinical features may overlap with many other inflammatory, infectious or neoplastic disorders. Therefore, that patients are often diagnosed with advanced stage disease, which contributes for the disease´s dismal prognosis. The clinical presentation of AITL is frequently an assemblage of symptoms including generalized and painful lymphadenopathy, multiple cutaneous alterations, hypergammaglobulinemia, fever, loss of weight and significant autoimmune phenomena. Recent advances in AITL biology have implicated a cell with T-follicular helper phenotype as the origin of the disorder. This rare type of T lymphocyte has a peculiar capacity of interact with microenviroment, which results in an important production of cytokines, explaining the clinical findings of this type of lymphoma. In addition to its pathologic features, AITL can be distinguished from other T-cell lymphomas based on gene expression arrangement, suggesting that AITL has a uniquebiology. Moreover, somatic mutations in the epigenetic regulators DNMT3A, TET2, IDH2, and, especially, in the multifunctional RHOA GTPase gene, have emerged as very consistent genetic abnormalities in AITL. Considering its low incidence, the development of clinical trials in AITL is a challenging matter. Furthermore, the majority of data available originates from studies that contain other subtypes of PTCL, making prognosis analysis and treatment decision a tough work. In this review, we discuss the biological and clinical aspects of AITL and the alternatives for frontline treatment and the management of relapsed disease. Keywords: Angioimmunoblastic T-cell lymphoma, T-follicular helper cells, gene expression profiling, TET2 mutation, RHOA GTPase mutation, relapsed disease.Download Full Article |
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Abstract: Background: Aim of this study is to classify intrinsic subtypes and evaluate the differences in clinical/pathological characteristics and survival outcomes among the molecular types. Patients and Methods: Breast cancer subtypes were classified according to the 2013 St. Gallen Consensus. Five molecular subtypes were determined, Luminal A, Luminal B-like HER2 negative, Luminal B-like HER2 positive, HER2 positive, and triple negative. Data was obtained from the records of patients with invasive breast cancer retrospectively. The differences in clinical/pathological parameters, overall survival and disease-free survival among the molecular subtypes were analyzed. The Kaplan-Meier method, log-rank test and Cox regression tests were used to compare groups. Results: The median follow-up period is 48 months. The Luminal B-HER2 negative was the most prevalent type (26.6%). Patient demographics, tumor characteristics and survival data were analyzed. The Luminal A and Luminal B-HER2 negative subtypes had significantly higher overall survival and disease-free survival rates. Multivariate Cox analysis revealed that tumor stage, more than 3 positive axillary lymph node involvement, and breast cancer subtype as significant factors for overall survival and disease-free survival (p<0.05). Triple Negative subtype had a higher relative hazard of local recurrence and distant metastasis (HR=2.69, 95% CI=1.47; 4.95). Conclusions: Breast cancer subtype has significant impact on overall survival and disease-free survival rates. While Luminal A and luminal B HER2 negative subtypes have better outcome, triple negative and HER2- subtypes remain poor. Keywords: Breast cancer, molecular subtypes, radiotherapy, survival.Download Full Article |
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Abstract: Effect of angular variation to dose received and its clinical correlation was studied in 36 ca.cervix patients. Angular variation results in dose variation but its impact needs to be studied. Keywords: CA Cervix, LDR ICBT, Angular variation.Download Full Article |
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Abstract: Ki-67 index is one of important markers that is correlated with chemotherapy response and prognosis of breast cancer patients. However, Ki-67 index is not easily provided and are limited by intra-observer error and potentially subjective decision making. We performed this study to develop an objective auto-analysis system to count Ki-67 indices. A total of185 invasive breast cancer cases were used. Immunohistochemical staining was performed using auto-stainer and MIB-1 antibody. The results were stored digitally by virtual microscopy and auto-analyzed by Genie/Aperio software (Vista, CA, USA). As for Ki-67 indices, a good correlation was observed between direct ocular observations and auto-analysis techniques (r = 0.94, p < 0.001). The index examined by auto-analysis was significantly correlated with nuclear atypia, mitotic counts, and nuclear grade of pT1 breast cancers. Auto-analysis of 5 high power fields was better correlated with nuclear grade than that of whole fields. Further, the Ki-67 index was better correlated with mitotic counts than with nuclear atypia.Auto-analysis can provide results concordant with those obtained by direct ocular observation in a short time. Auto-analysis is more likely to result in an objective observation and provide a means by which to standardize methods for immunohistochemical Ki-67 indices of breast cancer. Keywords: Breast cancer, Ki-67, auto-analysis, virtual microscopy, immunohistochemistry, prognosis, objective analysis, nuclear grade. Download Full Article |
