Breast Pathology
Primariadewi Rustamadji; Elvan Wiyarta; Ineke Anggreani
Abstract
Background & Objective: Patients undergoing neoadjuvant chemotherapy (NC) for invasive breast cancer (IBC) therapy need biomarkers to track their progress. Because of the relationship between NFkB, Survivin, and Cyclin D1 with NC resistance, the different expression levels of each of these biomarkers ...
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Background & Objective: Patients undergoing neoadjuvant chemotherapy (NC) for invasive breast cancer (IBC) therapy need biomarkers to track their progress. Because of the relationship between NFkB, Survivin, and Cyclin D1 with NC resistance, the different expression levels of each of these biomarkers can be different between pre- and post-NC in IBC. However, no research has examined the correlation between these biomarkers before and after the NC expression. This study aimed to determine the correlation among them.Methods: Biomarkers expression (low and high) was used to classify 30 samples. ER, PR, HER2, Ki-67 status, tumor grade, age, and NC response were assessed. The amounts of Survivin, Cyclin D1, and NFkB were evaluated using immunohistochemistry, and samples were classified based on the cut-off. Chi-square and linear regression were used to evaluate the data.Results: No significant association was found with the changes in the expression of Survivin, Cyclin D1, and NFkB, both before and after the NC. Significant moderate correlations were shown between before and after the NC Survivin expression (r = 0.513) and Cyclin D1 expression (r = 0.543). The correlation between expression of NFkB before and after the NC was not significant.Conclusion: The high potential of these proteins as prognostic indicators was demonstrated by the strong positive association between the expression of Survivin and Cyclin D1 before and after the NC. This upregulation of biomarkers indicates chemoresistance in developing IBC in the presence of NC.
Breast Pathology
Rashim Sharma; Poonam Abhay Elhence; Meenakshi Rao; Sudeep Khera; Deepak Vedant; Ramkaran Chaudhary; Puneet Pareek; Jeewan Ram Vishnoi; Sanjeev Misra
Abstract
Background & Objective: Breast cancer is the leading cancer among Indian women and accounts for about 25% of all cancer cases worldwide. The present study aimed to assess Programmed Death Ligand-1 (PD-L1) expression in tumoral cells and tumor-infiltrating lymphocytes (TILs) and evaluate their correlations ...
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Background & Objective: Breast cancer is the leading cancer among Indian women and accounts for about 25% of all cancer cases worldwide. The present study aimed to assess Programmed Death Ligand-1 (PD-L1) expression in tumoral cells and tumor-infiltrating lymphocytes (TILs) and evaluate their correlations with the Ki-67 labelling index in invasive breast carcinomas (IBC).Methods: This descriptive observational study was conducted during 2016-2018 and included all diagnosed cases of IBC. The relationships between PD-L1 expression, TILs, hormone receptors, Ki-67, and clinicopathological parameters were studied in IBC. Statistical analysis was performed by SPSS version 23.Results: Out of 114 evaluated cases, 33.33% (N=38) showed PD-L1+ expression in tumor cells and 47.37% (N=54) had PD-L1+ expression in TILs. A high Ki-67 index was observed in 96 cases. Moreover, 49 patients were estrogen receptor (ER)- and 65 were ER+. We observed that 22 of 49 ER- and 49 of 65 ER+ subjects showed PD-L1+ expression, respectively.Conclusion: Our results showed a significant relationship between PD-L1 expression in tumoral cells and TILs, as well as between Ki-67 and TILs. In addition, an inverse correlation was noted between PD-L1 expression and ER. The PD-L1 expression in tumors and TILs and correlation with high Ki-67 may prove the importance of PD-L1 in targeted chemotherapy. An inverse relationship between PD-L1 and ER expression in tumoral cells suggests scope for immunotherapy in ER- IBC. However, further research with more cases is required.
Moeinadin Safavi; Jahanbanoo Shahryari; Mohammadmehdi Moeini Aghtaei; Hossein Nikpour
Volume 11, Issue 3 , July 2016, , Pages 255-260
Abstract
Desmoplastic small round cell tumor (DSCRT) is a rare variant of sarcoma with a highly aggressive behavior. It usually affects abdominal cavity and has a male predominance. Its correct diagnosis and treatment is sophisticated and requires an experienced multidisciplinary team. Hereby we present a 25 ...
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Desmoplastic small round cell tumor (DSCRT) is a rare variant of sarcoma with a highly aggressive behavior. It usually affects abdominal cavity and has a male predominance. Its correct diagnosis and treatment is sophisticated and requires an experienced multidisciplinary team. Hereby we present a 25 yrold man from Kerman Province in 2013 with abdominal mass and ascites who underwent sonograghy guided percutaneous needle biopsy which was misleading and inconclusive for diagnosis. Thus an open biopsy was fulfilled which revealed solid nests of small round cells with hyperchromatic nuclei and clear cytoplasm surrounded by a desmoplastic stroma suggestive for DSCRT. The diagnosis was confirmed by positive immunohitochemical reaction for cytokeratin, desmin and neuron specific enolase(NSE).Ultimately the patient underwent chemotherapy on the basis of P6 protocol without surgical debulking.Diagnosis and treatment of DSCRT could be a dilemma due to its rarity, various clinicopathologic mimickers and lack of a consensus about its management.
Rajyashri Sharma; Huma Firdaus; Veena Maheshwari; Kafil Akhtar; Shahid Ali Siddiqui
Volume 7, Issue 4 , September 2012, , Pages 224-230
Abstract
Background & Objective:the present study was undertaken to ascertain the incidence of early, advanced cancer cervix and its recurrence and role of chemotherapy in locally advanced cancer cervix.
Material and Methods: The present study was conducted in the Departments of Obstetrics & Gynaecology, ...
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Background & Objective:the present study was undertaken to ascertain the incidence of early, advanced cancer cervix and its recurrence and role of chemotherapy in locally advanced cancer cervix.
Material and Methods: The present study was conducted in the Departments of Obstetrics & Gynaecology, Pathology and Radiotherapy and the specimens examined in the Department of Pathology of Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India from July 2009 to July 2010.One hundred histologically confirmed carcinoma cervix cases were divided into two groups. I: Study group of cases receiving different types of chemotherapy and II: Control group comprised of cases on pre and postoperative radiotherapy and surgery. Patients were staged and locally advanced inoperable cases (Stage IB-IVA) were given different types of chemotherapy. Thereafter subjective and objective assessment was made according to World Health Organization (WHO) criteria of tumor response.
Results: Majority of cases (60.0%) presented in stage IIB of disease by International Federation of Gynecology and Obstetrics (FIGO) classification. Commonest symptom was postmenopausal vaginal bleeding, 70.0% cases. 68.0% & 56.0% cases showed complete response (CR) on chemotherapy and radiotherapy respectively. Stage IIB patients showed the best response with CR in 70.0% & partial response (PR) in 16.7% cases. Colposcopic evaluation on 12 -18 months follow up showed 08 to be disease free, with decrease in size of tumor.
Conclusion: Chemotherapy is an effective mode of therapy and can be considered as an adjunct to surgery or radiotherapy to improve the overall survival of cancer cervix patients.
Kazem Anvari; Abdolazim Sedighi Pashaki; Mahmoud Reza Kalantari; Mehdi Seilanian Toosi; Mohammad Reza Ghavam Nasiri; Hamid Reza Raziee
Volume 4, Issue 1 , January 2009, , Pages 32-37
Abstract
Background and Objective: Approximately half of patients with diffuse large B-cell lymphoma are cured with current chemotherapy regimens. The purpose of this study was to evaluate Bax and Bcl2 expression and their relationship with the response to chemotherapy. Materials and Methods This study ...
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Background and Objective: Approximately half of patients with diffuse large B-cell lymphoma are cured with current chemotherapy regimens. The purpose of this study was to evaluate Bax and Bcl2 expression and their relationship with the response to chemotherapy. Materials and Methods This study was a prospective analysis on 44 patients with diffuse large B-cell lymphoma. Their specimens were stained with immunohistochemistery method for Bax and Bcl2. The relationship between Bax/Bcl2 expression and the response to chemotherapy as well as some other prognostic factors were assessed. Results: Out of 44 patients, 29 were Bax+ and 15 Bax-, 31 Bcl2+ and 13 Bcl2-. We found a statistically significant relationship between IPI score and the response to chemotherapy (P = 0.002). The response rates were relatively better (but not significant) in cases with Bax + compared to Bax – and in patients with Bcl2- compared to Bcl2 + tumors. The combination of immunohistochemistery results for Bcl2 and Bax could predict relatively higher response rates in a way that those with Bax+ Bcl2- had a higher response compared to Bax- Bcl2+ ( 57%% VS.22%, p=0.15). Conclusion: Although we found a relatively higher responses in our cases with Bax + vs. Bax - and in those with Bcl2- vs. Bcl2 +, the differences were not statistically significant. We suggest further studies to confirm whether the Bcl2 and Bax expressions have any effect on the response to chemotherapy and whether they could be considered as predictor factors for chemotherapy response.
Robab Anbiaee; Payam Azadeh; Abdollah Fazlalizadeh
Volume 1, Issue 3 , June 2006, , Pages 105-108
Abstract
Background and Objective: It is well known that menstrual period and ovarian function are affected by chemotherapy. Although breast cancer is the most common cause of chemotherapy in women and ovarian hormones have very important direct and indirect effects on overall survival, disease-free survival, ...
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Background and Objective: It is well known that menstrual period and ovarian function are affected by chemotherapy. Although breast cancer is the most common cause of chemotherapy in women and ovarian hormones have very important direct and indirect effects on overall survival, disease-free survival, and life quality of patients, but few studies have addressed the frequency and related factors of ovarian failure in breast cancer patients after receiving conventional regimens of chemotherapy. Therefore, the risk of ovarian failure after conventional chemotherapy regimens for breast cancer (with and without taxans) and the factors that influence ovarian function due to chemotherapy including patient’s age and type and dosage of drugs were investigated in this study. Materials and Methods: The cross sectional protocol of this study was conducted on 81 premenopausal breast cancer patients with regular menstruation that were candidates for chemotherapy and had not any history of prior hormonal therapy or chemotherapy. Alteration of menstrual cycles and ovarian function were evaluated by measuring blood levels of FSH and LH. Then, the role of patient’s age, type and dosage of drugs were analyzed on ovarian function. Results: Out of a total of 81 patients evaluated, 44 (54.3%) were found to suffer from ovarian failure after chemotherapy. There was also no significant difference for the risk of ovarian failure between two major groups of chemotherapy regimens. In addition, the probability of ovarian failure increased after increasing the dosage of the drug. Meanwhile, patients over 40 years were more sensitive to chemotherapy than younger ones. Conclusion: It is concluded that patient’s age is the most important factor determining the risk of chemical castration. In this respect, addition of taxans to conventional chemotherapy does not increase the risk of chemical castration.