Open Access Original Research Article

Role of Immunohistochemistry in Diagnosis of Papillary Thyroid Carcinoma: The Use of Ck19, CD56, P63 and CD117

Azza Abdel-Aziz, Dina Abdallah

Journal of Cancer and Tumor International, Page 1-11
DOI: 10.9734/jcti/2019/v9i130097

Objective: Papillary thyroid carcinoma (PTC) is the most frequent histologic type of all thyroid malignancies. The presence of characteristic nuclear changes focally in a thyroid lesion may cause diagnostic dilemma. Immunohistochemistry may be helpful in the diagnosis of PTC yet not conclusive. The aim of this study is to test the applicability immunohistochemical markers; CK19, P63, CD56 and CD117 in distinguishing PTC from other follicular thyroid.

Methods: Fifty nine cases of unequivocal diagnosis were selected to be rolled in our study; 24 papillary carcinoma cases and 35 cases representing other follicular throid lesions. Immunohistological studies include CK19, P63, CD56 and CD117. Subsequent statistical analysis of immunohistochemical data in relation to diagnosis was performed.

Results: The diagnosis of PTC was significantly associated with Strong diffuse Ck19 expression, P63 expression and negative CD56 in relation to studied non PTC follicular thyroid lesions. On the other hand, CD117 was negative in most of the studied thyroid lesions with no significant difference between PTC and other lesions. CK19 was the most sensitive marker (91.2%) and P63 was the most specific one (87.5%), with better specificity in combining markers. Expression of CK19 and lost CD56 provided 97.1% sensitivity and 91.2% diagnostic accuracy in differentiating PTC from other studied lesions.

Conclusions: Immunohistochemical markers, Ck19, P63 and CD56 are helpful in diagnosis of PTC and their combination can further improve diagnostic accuracy. CD117 is of no value in the diagnosis of studied cases.

Open Access Original Research Article

Overexpression of Epidermal Growth Factor Receptor (EGFR) in Esophageal Squamous Cell Carcinoma and Its Correlation with Clinicopathological Characteristics in Central Uganda

Asafu M. Munema, James J. Yahaya, Robert Lukande, Sam Kalungi

Journal of Cancer and Tumor International, Page 1-10
DOI: 10.9734/jcti/2019/v9i130098

Aims: The aims of the current study were to determine the prevalence of epidermal growth factor (EGFR) receptor in patients diagnosed with esophageal squamous cell carcinoma (ESCC) as well as assessing the correlation of overexpression of EGFR with age, gender and tumor grades of the cases.

Study Design: This was a cross-sectional analytical study.

Place and Duration of Study: The study was conducted in the pathology laboratory at the department of pathology, Makerere College of Health Sciences, Kampala-Uganda for five months.

Methodology: A sample of 127 archival tissue blocks from patients with ESCC diagnosed between 2010 and 2012 were retrieved from the tissue repository and used to assess overexpression of EGFR using monoclonal mouse Anti-human wild type EGFR antibody. For association between age and overexpression of EGFR, Kruskal- Wallis H test was used and for tumor grade and sex and EGFR, Chi-Square test was performed using SPSS version 16.0. P ˂ .05 was considered statistically significant.

Results: The age range of the patients with ESCC in this study was 35-99 years with mean of 59.55 years. The peak age of the cases was 55-64 years. Males and females were 68.5% and 31.5% respectively. Moderately differentiated tumors dominated by comprising 59.9%. The prevalence of overexpression of EGFR was 61.4%. The highest overexpression of EGFR was seen in cases with grade 2 compared to grade 1 and 3 but not statistically significant (P = .255). Overexpression of EGFR was relatively higher in cases with age ≥ 50 years, but the difference was not statistically significant (P = .931). Males expressed relatively higher EGFR than females, however, the difference was not statistically significant (P = .944).

Conclusions: Majority of patients with ESCC in Uganda have moderately differentiated tumor and a significant number of them tend to show overexpression of EGFR antigen.

Open Access Original Research Article

Diagnostic Significance of Beclin-1 and Transforming Growth Factor β in Breast Cancer

Shereen Saeid Mahmoud Elshaer, Laila Ahmed Rashed, Mona Mohammed Abdel Hamid

Journal of Cancer and Tumor International, Page 1-9
DOI: 10.9734/jcti/2019/v9i130099

Background: The main cause of cancer deaths amongst women breast cancer remains a clinical and social challenge, and a serious public health problem. On a worldwide level, it continues to be a devastating disorder.BECN1  is  a  tumor  suppressor  gene  implicated  in  the  initiation  of  autophagy.  It encodes beclin-1 protein that inhibits cancer growth. There is wide disputation concerning its role in initiation, promotion of tumor and predictive importance of autophagic molecules. Transforming growth factor β (TGF-β) induces process of epithelial-mesenchymal transition (EMT) keeping, epithelial cells more motile and invasive resulting in cancer progression and metastasis.

Aim: Detection of beclin-1 expression level in metastatic and non-metastatic breast cancer patients and study its role in tumorigenesis of breast cancer through attainable association with the inflammatory cytokine, TGF-β.

Methods: Expression levels of beclin-1 and TGF-β were assessed in 70 breast cancer female patients and 20 controls using quantitative real-time PCR.

Results: Beclin-1 expression levels as well as TGF-β were significantly higher in metastatic breast cancer patients and non-metastatic patients compared to controls. Positive correlation was found between beclin-1 expression level and TGF-β expression level in breast cancer patients.

Conclusion: Our results indicated that over-expression of both beclin-1 and TGF-β was associated with aggressive clinical outcomes of breast cancer patients and tumor growth. These findings suggest that beclin-1 and TGF-β are associated with tumorigenesis of breast cancer.

Open Access Original Research Article

Hypofractionation in Breast Cancer - A Retrospective Study in a Tribal Population Based Medical College in West Bengal, India

Santanu Acharyya, Bidisha Ghosh, Satadru Biswas

Journal of Cancer and Tumor International, Page 1-11
DOI: 10.9734/jcti/2019/v9i130100

Introduction: In a tribal population based area in West Bengal, India though carcinoma cervix is the commonest malignancy in female patients, yet apart from that carcinoma breast is also increasing in number in the recent years. Breast cancer accounts for approximately 26.6% of female malignancy in the radiation oncology out-patient-department of our teaching hospital.

Aims and Objectives: To compare conventional RT regimen (50 Gy in 25 fractions over 5 weeks) with one hypofractionated regimen (40Gy in 15 fractions over 3 weeks) in stage II & stage III breast cancer patients as adjuvant radiation therapy in terms of local control, survival and adverse reactions.

Materials and Methods: It is a retrospective study which has been conducted in the department of Radiotherapy in BSMC (Bankura Sammilani Medical College) spanning from May 2012 to April 2017. A total number of patients included in this study was 302, out of which thirty six patients failed to follow up. So total of 266 patients included in the study were all histologically proved carcinoma breast treated surgically (97.74% by MRM & rest by BCS) with curative intent following which RT was used as adjuvant therapy. In one group (consisting of 133 patients) conventional regimen (50Gy in 25 fractions) was used. In another group (consisting the other 133 patients) dose-schedule used was a hypofractionated one i.e. 40Gy in 15 fractions. Dose per fraction in the 1st group was 2 Gy whereas in 2nd group it was 2.66 Gy. In all patients, RT was given in 5 days a week. Systemic therapy was administered as and when indicated.

Results: 4-year disease-free-survival (DFS) in conventional group was 78.94% and in hypofractionated group was 82.70%, (p value >0.05). 4-year overall survival (OS) in conventional group was 81.20% & in hypofractionated group was 85.70%, (p value >0.05). While adverse reactions in terms of both acute & chronic radiation toxicities were considered, there was no significant difference in between the two groups.

Conclusion: There is no significant difference between the conventional regimen and this hypofractionated regimen in terms of OS DFS & adverse reactions in this tribal-based Indian population. Hence, in our institution, we usually prefer Hypofractionated radiotherapy (40Gy/15 fractions) in adjuvant settings for breast cancer patients.

Open Access Original Research Article

Metronomic Low Dose Leucovorin- Fluorouracil versus Supportive Treatment for Patients with Recurrent or Metastatic Colorectal Cancer

Hend M. Hamdey Rashed Elkalla, Mohamed Saad Elzahy, Shoukri Hassan Elazab

Journal of Cancer and Tumor International, Page 1-8
DOI: 10.9734/jcti/2019/v9i130101

Introduction: There was an improvement in therapeutic regimens for advanced colorectal cancer (CRC) in the last few decades. The low dose metronomic palliative chemotherapy in patients with advanced CRC after the failure of standard chemotherapy led to a dramatic increase in efficacy, reduction of mortality rates, and improves survival in the form of control symptoms, and enhances or improves quality of life which is an important issue in that group of patients.

Patients and Methods: We include 60 Patients with recurrent or metastatic colorectal cancer after failure of multiple lines of chemotherapy. The patients were randomized in two groups either to receive supportive treatment in group A (30 patients) or low dose weekly leucovorin 20 mg/m² plus 5-flourouracil 425 mg/m² for 3 weeks and 1 week rest in group B (30 patients). Patients in group B received palliative chemotherapy for 4 months at least.

Results: After a follow up period of 19 months, the mean time to progression (TTP) is 4.9 months for the group (A) but is higher in group (B) as it is 7.8 months and it shows a statistically significant difference (P value <0.001). Also, the mean overall survival(OS) is 15.3 months for group (A) and 18.8 months for group (B) and this is statistically significant (P value <0.002). No grade 3 or 4 toxicity was detected. After 4 months of the study, 29 patients (96.6%) still have the stable disease compared to 18 patients (60%) of group (A). After 8 months, only 12 patients (40%) of group (B) show stable disease while all patients of group (A) have disease progression.

Conclusion: We conclude that metronomic weekly leucovorin-5 FU could provide a good tolerable way to go on with chemotherapy treatment while at the same time not have major threatening side effects.