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Prognostic Relevance of VEGF-A and COX-2 in StageIV Non-Hodgkin’s Lymphoma (NHL) Patients

Reham Rashed¹, NaglaaMostafaa¹, Reem Nabil¹, Mohamed Ghareeb², and Dalia Ibraheem²

Departments of: ¹Clinical Pathology; ²Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt

E-mail: Reham_r9@yahoo.com

Abstract: Background: NHL comprises 85% of all lymphomas and 3-4% of all cancers around the world. Angiogenesis is required for tumor growth and metastasis, as an important component in the control of cancer progression. Inflammation is an important factor in the cancer phenomenon with COX-2 playing an important role in malignant cell proliferation. Objective: To observe the expression level of the angiogenetic factor VEGF-A, the inflammatory mediator COX-2 in NHL patients and their prognostic relevance. Methods: The patients were recruited from the Medical Oncology Department, National Cancer Institute, Cairo University over a period of 2 years. The methods we used were Immunohistochemical staining for VEGF-A and COX-2 in BMB samples of 40 adult patients with NHL stage IV. Results: The study revealed no significant difference between VEGF-A and COX2 markers expression (positive coexpression 10/40 (25%), negative coexpression 5/40 (12.5%) and single marker expression 25/40 (62.5%) (P=0.09). A statistically significant difference between males (37.5%) and females (6.3%) as regards positive coexpression was found (P=0.025). Although positive coexpression was higher with the lower age group and absence of B symptoms, yet showing statistically non-significant difference (P= 0.072 and 0.09 respectively). There was a higher TLC mean and a higher lymphocyte count in the positive VEGF-Aexpressors versus negative ones, with a non-significant difference (P=0.065). A statistically significant difference between positive coexpressors group with the single positive and the double negative groups regarding TLC (P=0.036) was detected, also higher lymphocyte count among positive coexpressors compared to the other groups, with non-significant difference (P= 0.077). A near significant difference between patients with positive VEGF-A expressoion (71.4%) and negative ones (42.1%) as regards response to treatment (P=0.06). Finally, no statistical significant difference was found for positive and negative VEGF-A, COX-2 expression, positive and negative coexpression as regards overall survival (P=0.117, 0.84, 0.28 and 0.25 respectively). Conclusion: Our findings couldn’t identify the association between VEGF-A and COX2 with prognosis of NHL, controversially, a better response to treatment in positive VEGF-Aexpressors than non expressors and in non coexpressors to VEGF-A and COX2. So, further studies with larger number of patients are required to clarify the association between the inflammatory mediator and the angiogenetic factor and to assess their role in the response to treatment for the possibility to use modifying drugs and improve the response in NHL patients.

[Reham Rashed, Naglaa Mostafaa, Reem Nabil, Mohamed Ghareeb, and Dalia Ibraheem. Prognostic Relevance of VEGF-A and COX-2 in StageIV Non-Hodgkin’s Lymphoma (NHL) Patients. Cancer Biology 2016;6(3):1-10]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 1. doi:10.7537/marscbj060316.01.

Keywords: VEGF-A, COX-2, NHL, Angiogenesis

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Organizational factors affecting empowerment from the perspective of nursing staff in hospitals of Medical Sciences of Yazd Shahid Sadoghei in 2013-2014

Hajeye Fatemeh Mollahoseini Bajeghani¹, Seyed Ali Naji² (corresponding author)

¹Department of Nursing and Midwifery, Khorasgan Branch, Islamic Azad University, Isfahan, Iran.

²Faculty of Department of Nursing and Midwifery, Khorasgan Branch, Islamic Azad University, Isfahan, Iran.

Abstract: Introduction: Capability as a motivational and hopefulness structure is consist of strengthening the staff, nowadays known as a major element in the efficiency of organizations. Health –care organizations can access to capability of the staff; specially nurses with providing those resources, supports, opportunities and necessary information. Nurses’ capability in the organization is effective for higher productivity. Materials & Methods: The present research is descriptive. The sample consists of 185 nursing staff of three training hospitals of Yazd. The tool of gathering data is a two-part questionnaire including demographic data and 39 researcher-made questions about personal and organizational factors which effect on personal capability from nurses point of view. And Likret scale was used to answer. Data were analyzed in descriptive comprehensive level by using “SPSS” software “22” version. Results: The results show that nurses’ attitude toward job professionally is positive but their attitude about their real position at the organizational level is not. Meanwhile their attitude in terms of individual factors of under controlling environment barriers is negative but their attitude toward work importance that engage employee is positive. Discussion & Conclusion: From nurses’ point of view, their actual position and also the security and health of employee is not considered and nurses and their managers must step forward to identify the actual position and health. The purpose: This research was carried out in 2016 with the aim of investigation of the factors affecting the capability of nurses from their views in the training hospitals of Shahid Sadoughi Medical Science University of Yazd.

[Hajeye Fatemeh Mollahoseini Bajeghani, Seyed Ali Naji. Organizational factors affecting empowerment from the perspective of nursing staff in hospitals of Medical Sciences of Yazd Shahid Sadoghei in 2013-2014. Cancer Biology 2016;6(3):11-18]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 2. doi:10.7537/marscbj060316.02.

Key word: effective organizational factors, staff point, training hospitals.

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Immunohistochemical Expression of P63 In Urothelial Carcinoma

Afaf T. Elnashar¹, Noha ED Hassab El-Naby¹, Ola M. Nageeb¹ and Atef G. Abd El Wahab²

¹Pathology and ²Urology Departments, Sohag University Hospital

elnasharafaf@yahoo.com

Abstract: Introduction: Urothelial carcinoma is the most common histologic type of urinary bladder cancerin Egypt. Detection of high-grade urothelial carcinoma is important for modification of therapy and improving the prognosis. P63 is expressed at high levels in the basal layers of different epithelial tissues, including the urothelium. Aim of the work: to study the diagnostic and prognostic value of p63 expression in urothelial carcinoma (UC). Material and Methods: Fifty cases of bladder urothelial carcinoma were involved in the study; 12 cases of non-invasive UC, (3 HG& 9 LG), and 38 cases of invasive UC (30 HG & 8 LG). Sixteen cases of UC showed Bilharziasis. All the specimens were stained with p63 using immunohistochemical technique. Results: P63 was expressed in 28/38 cases (73.7%) of invasive UC and in all cases of non-invasive UC, and also in 16/17 (94%) low-Grade and in 24/33 (72.7%) of high-grade UC, with a statistically significant relation between p63 expression and both invasion (p>0.001) and the tumor grade (p>0.034). Conclusion: P63 can be used as a diagnostic and a prognostic factor for high grade invasive UC.

[Afaf T. Elnashar, Noha ED Hassab El-Naby, Ola M. Nageeband Atef G. Abd El Wahab. Immunohistochemical Expression of P63 In Urothelial Carcinoma. Cancer Biology 2016;6(3):19-26]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 3. doi:10.7537/marscbj060316.03.

Key words: P63, urothelialcarcinoma (UC), High Grade (HG), Low Grade (LG)

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Possible Role of Anti-Inflammatory cytokine Gene Polymorphism in AML Susceptibility, Egypt

Reham Rashed¹, Roxan Ezzat¹, Nevine Fawzy¹, and Hanan Ezzat²

Departments of ¹Clinical Pathology; ² Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt

Reham_r9@yahoo.com

Abstract: Background: Acute myeloid leukemia (AML) is a cytogenetically and molecularly heterogeneous diseases and characterization of transforming genetic events is becoming increasingly important. Interleukins (ILs) are a diverse set of small cell signaling protein molecules. Single nucleotide polymorphisms (SNPs) of ILs alter their function, increasing susceptibility to different diseases. Methods: We investigated the association between polymorphism in interleukin-10 (IL-10) -819T/C (rs 1800871) and the risk of AML in the Egyptian population. DNA was isolated from bone marrow of 80 newly diagnosed adult AML patients, and 85 age and sex matched controls. Genetic analysis of IL-10 SNPs at -819T/C was assayed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: Genetic analysis of IL-10 revealed that the Egyptians have high -819 T allele frequencies in apparently healthy controls while -819CC genotype and the -819C allele frequencies in the AML group were higher than in the controls (P=0.000086). The study suggested that subjects carrying the rs 1800871 CC genotype and C allele had a significantly increased risk for AML. Conclusion: IL-10 SNP at -819 was associated with enhanced AML risk, suggesting that rs1800871 provides clue for future studies and early detection of AML.

[Reham Rashed, Roxan Ezzat, Nevine Fawzy and Hanan Ezzat. Possible Role of Anti-Inflammatory cytokine Gene Polymorphism in AML Susceptibility, Egypt. Cancer Biology 2016;6(3):27-33]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 4. doi:10.7537/marscbj060316.04.

Keywords: Il-10; · gene polymorphism; · Disease association; · acute myeloid leukemia

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Radiotherapy alone versus concomittent chemoradiation in Early Stage Nasopharyngeal Carcinoma

Ahmad Z. Alattar 1, Abdel Raouf saied 2 Khaled M. El-Gerby3

1Clinical Oncology & Nuclear Medicine and, ENT, Radiology departments. Faculty of Medicine, Zagazig University, Egypt.

ahmedenbedo@hotmail.com

Abstract: Purpose: Early stage nasopharyngeal carcinoma (NPC) is usually treated with radiotherapy (RT) alone and carries a treatment failure rate of 15% to 30%. The benefit of concurrent chemoradiotherapy (CCRT) in early stage NPC is unclear. The purpose of this work is to evaluate the outcome in early stage NPC after CCRT. This randomized trial compared CCRT versus radiotherapy alone in patients with early stage NPC. Patients and methods: Forty - four patients presented with early stage NPC (stage I and II) disease according to the American Joint Committee on Cancer (AJCC) NPC staging system. Patients were treated between 2008 and 2012. Twenty-two of these patients were treated with radiotherapy alone and 22 with CCRT. Radiotherapy was administered at 1.8 Gy per fraction per day for 5 days per week for a total dose of 70.2 Gy. Chemotherapy consisting of cisplatin weekly with radiotherapy. Results: Forty- four patients were registered and eligible for primary analysis for locoregional control, toxicities and survival after radiotherapy alone or CCRT. The 3- year locoregional control rate in the radiotherapy group was 90.9 % (median follow- up period 32months) and was 100 % in the CCRT group (median follow-up period 28 months) (P > 0.05) The disease free survival rate (DFS) at 3 years for the radiotherapy group was 90.9 % and 95.5 % for the CCRT group. (P > 0.05). Conclusion: In the present study it was concluded that chemoradiotherapy was superior to radiotherapy alone for patients with stage II NPC with respect to locoregional control and survival.

[Ahmad Z. Alattar. Concurrent Chemotherapy – Radiotherapy Compared With Radiotherapy alone in Early Stage Nasopharyngeal Carcinoma. Cancer Biology 2016;6(3):34-41]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 5. doi:10.7537/marscbj060316.05.

Key words: Nasopharyngeal carcinoma, radiotherapy, chemoradiation

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Evaluation of TAZ and PKM2 expression in gastric signet ring cell carcinoma

Aliaa Atef, MD and Mohammed Alrashidy, MD.

Department of Pathology, Faculty of medicine, University of Tanta, Egypt.

dr-aliaaatef@hotmail.com

Abstract: Background: Gastric cancer is the fourth most common cancer and the second cause of cancer-related death worldwide. Signet ring cell carcinoma SRCC is a histologic subtype characterized by poor differentiation, strong invasive tendency and poor prognosis. Transcriptional coactivator with PDZ-binding motif (TAZ) is known to bind to a variety of transcription factors to control cell differentiation and organ development. PKM2 (M2 isoform of pyruvate kinase) was identified as a driver of aerobic glycolysis, leading to cell growth and tumor development. Materials and methods: This study was carried out on 46 gastric SRCC cases received as paraffin blocks and as fresh specimens. Results: The immunohistochemical expression of TAZ was positive in the cytoplasm and nuclei of 38 out of 46 (82.6%) gastric SRCC samples. PKM2 expression was also investigated in all 46 gastric SRCC cases. PKM2 expression was positive in 40 (87%) out of 46 cases. PKM2 expression was positive in gastric SRCC compared to negative adjacent normal gastric glands from the same patients. Conclusions: These results show that TAZ and PKM2 might be considered as targets for the treatment of gastric SRCC in the future.

[Aliaa Atef and Mohammed Alrashidy. Evaluation of TAZ and PKM2 expression in gastric signet ring cell carcinoma. Cancer Biology 2016;6(3):42-49]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 6. doi:10.7537/marscbj060316.06.

Keywords: TAZ, PKM2, Signet ring cell carcinoma

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In vitro Study of Inhibition Effect of Propolis on Growth of Hepatocellular carcinoma cell lines (HepG 2 )

Lina Abdul-Fattah Kurdi

Faculty of Sciences - Al Faisaliah- King Abdul Aziz University, Department of Biology " Zoology"

P.O. Box. 4938, Jeddah 21412

dr.lina_kurdi@hotmail.com

Abstract: This study was primarily concerned with gauging the in-vitro inhibitory effect of Propolis on the growth of liver cancer cell lines, compared to the standard anti-neoplastic agent, Dacarbazine. The results of treatment with three (3) concentrations of Propolis (50,100 and 200 μg /ml), treatment with Dacabazine and combined treatment with Propolis and Dacarbazine demonstrate the morphological closeness of the inhibitory impact exerted by each treatment on the growth of liver cancer cell lines (HepG2), after incubation for 48 and 72 hours. Comparison of the inhibitory impact of various treatments demonstrated remarkable, concentration-proportional improvements as a result of the treatments under study. Upon calculation of the lethal inhibitory concentration that inhibits 50% of the cells (IC₅₀) and 90% of the cells (IC₉₀), the best result was posted by treatment with Dacarbazine, followed by the combined treatment with both Dacarbazine and Propolis, followed by treatment with Propolis per se, respectively. Based on the foregoing, we propose to use Propolis in conjunction with chemotherapeutic agents in the treatment of cancer patients, being a strong anti-neoplastic agent and because of the in-vitro prophylactic impact exerted by its components, which is attributable to its anti-oxidant and anti-neoplastic properties. 

[Lina Abdul-Fattah Kurdi. Study of Inhibition Effect of Propolis on Growth of Hepatocellular carcinoma cell lines (HepG 2) (In vitro). Cancer Biology 2016;6(3):50-67]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 7. doi:10.7537/marscbj060316.07.

Key Words: Propolis, Dacarbazine, Liver cancer cell lines, Apoptosis

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Volumetric modulated arc therapy versus Intensity-modulated radiation therapy of head-and-neck cancer: A comparative dosimetric study (Egyptian experience)

Wael H. Elsawy; Hesham A, El Ghasaly; Amin E. Amin; Nashwa E. Nawar; Ahmed Ali E.

ahmedali161984@gmail.com

Abstract: Background: Radiation therapy is an important treatment modality for head and neck carcinoma but the main challenge is to deliver high radiation dose to the target with maximal sparing of the organs at risk which are in close proximity to the disease the aim of this work was to compare two treatment modalities, Volumetric modulated arc therapy (VMAT) and Intensity-modulated radiation therapy (IMRT), by dosimetric evaluation of both plan as regard dose distribution within the target volume, dose received by the organ at risk (OARs) and treatment delivery time. Methods: 38 patients of locally advanced head and neck carcinoma were randomized into two groups. Group A: 38 patient were prospectively selected to be planned with IMRT planning system to deliver a total dose 70 Gray to GTV. Group B: all patients in group A will be replanned using VMAT planning system to deliver the same dose to GTV then both plans were compared dosimetricaly. Results: this dosimetric study revealed that VMAT technique had a significantly better dose distribution than IMRT as regard both dose homogeneity and conformity indices also VMAT technique provided a significantly better sparing of OARs than IMRT technique with significant reduction in treatment delivery time by more than 40%. Conclusion: VMAT technique providea better dose distribution and better target coverage than IMRT with better sparing of OARs than IMRT technique with significant reduction in treatment delivery time which is a major advantage of the VMAT technique over IMRT technique which is more comfortable to the patient and reduce the intrafractional movement, also allow higher number of patients to be treated per day so VMAT is considered as a more advantageous radiation treatment technique than IMRT for treatment of head and neck carcinoma.

[WaelH. Elsawy; Hesham A, El Ghasaly; Amin E. Amin; Nashwa E. Nawar; Ahmed Ali E. Volumetric modulated arc therapy versus Intensity-modulated radiation therapy of head-and-neck cancer: A comparative dosimetric study (Egyptian experience). Cancer Biology 2016;6(3):68-77]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 8. doi:10.7537/marscbj060316.08.

Key words: Volumetric modulated arc therapy, Intensity-modulated radiation therapy, dose homogeneity and conformity indices, comparative dosimetric study, head-and-neck cancer

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Clinico-Pathological Study of Breast Cancer; 5 Years Experience at Clinical Oncology Department Zagazig University

Ahmad Z. Alattar¹, Hassan A. Saad ², and Khaled M. El-Gerby ³

¹Clinical Oncology & Nuclear Medicine, ²General surgery, ³Radiology Departments, Faculty of Medicine, Zagazig University

ahmedenbedo@hotmail.com

Abstract: This study was done from record of 1650 with breast cancer cases from 5759 total cancer cases between Jan 2004 to December 2008 where data retrieved between may 2015 to November 2015, and data were analyzed at December 2015. Major clinico-pathological parameters were systematically investigated in this study. Invasive duct carcinoma is the most common type (82 %) followed by invasive lobular carcinoma (12 %. MRM done in (95.4%) and BCS in (4.6%). chemotherapy was given for 95 % of patients, Doxirubicin –containing regimen was used in (76 %) of patients. hormonal treatment was given1155 patients, 76.1 %were treated with tamoxifen, while radiotherapy for 88 % of cases, the radiotherapy treated volumes according to type of breast surgery). Univariate analysis show that menopausal status & Histological tgrade & T & N & hormone receptor status & HER2 oncogen were significant while Age & histological type not significant. In histological grade: Grade II: 3, 5, 7 Year over all survival (68.9 %, 63.7%, 58.5 %). Univariate Analysis show that adjuvant treatment & adjuvant hormonal treatment were significant Type of surgery and adjuvant chemotherapy & adjuvant radiotherapy were not significant in Adjuvant hormonal treatment +ve cases 3,5,7 over all survival (70.5%, 61.2%, 58.7%). Distant Metastasis Free Survival in 3, 5.7 years DFS (72%, 59.1%, 58.7%). Adjuvant hormonal treatment: +ve cases 3,5,7 years RFS (72%, 55.7%, 54.8%).

[Ahmad Z. Alattar, Hassan A. Saad, and Khaled M. El-Gerby. Clinico-Pathological Study of Breast Cancer; 5 Years Experience at Clinical Oncology Department Zagazig University. Cancer Biology 2016;6(3):78-84]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 9. doi:10.7537/marscbj060316.09.

Keyword: breast cancer clinico-pathologic, retrospective

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Immune Thrombocytopenia: Single Institute Experience

Mohammed A. Albalawi, MD

Medicine department, College of Medicine, Taibah University.

Email: albalawi_21@hotmail.com

Abstract: Immune thrombocytopenia purpura (ITP) is a common hematological disease that is seen frequently either in the clinic or as in emergency. I am reporting my experience for one year since I joined the Saudi Germany hospital (SGH) in Madinah, KSA with patients who have immune thrombocytopenia. My review will focus mainly on ITP, revision of current guidelines with focus on definitions of refractory and severe ITP and role of bone marrow aspiration and biopsy (BMA & Biopsy) in ITP. It is a retrospective analysis of ITP patients seen in Saudi Germany Hospital (SGH) from August 2015 till July 2016. My observations are consistent with other reports of ITP in regards to incidence, sex distribution, significance of bone marrow aspiration and biopsy (BMA) in ITP patients. My concerns mainly are regarding defining severe and refractory ITP patients. In conclusion, I think the current guidelines have to be reviewed with respect of definitions of severe and refractory ITP as well as management of such patients.

[Mohammed A. Albalawi. Immune Thrombocytopenia: Single Institute Experience. Cancer Biology 2016;6(3):85-91]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 10. doi:10.7537/marscbj060316.10.

Key words: Immune thrombocytopenia purpura (ITP), refractory ITP, severe ITP, treatment of ITP, guidelines of ITP.

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Using preoperative ovarian reserve tests, patients’ age and BMI to refine the eligibility criteria for LOD to avoid iatrogenic diminished ovarian reserve

Laila Ezzat and Mohamed Salah

Obstetrics and Gynecology Department, Faculty of Medicine, Aswan University, Aswan, Egypt

E-mail address: lailaezzat972000@gmail.com

Abstract: Overview: Polycystic ovary syndrome is one of the most common causes of female infertility. According to Rotterdam Criteria, the syndrome is diagnosed by 2 or more of the following: Oligo/Anovulation, Clinical or chemical hyperandrogenism and Ultrasound features; presence of 12 or more arrested follicles ranging from 2-9 mm and/or ovarian volume more than 10 cc. Treatment options include hormonal ovulation induction and laparoscopic ovarian drilling,( LOD). LOD has been widely used to treat the syndrome. It uses electro cautery power to puncture the ovary at different points for the purpose of reducing number of arrested follicles and thus helping ovulation to resume. Although the hopeful results of the procedure in ovulation induction, a lot of debate about the harmful effects of electrocautery on ovarian reserve. A im of the work: This study aims to find the best cutoff value for patients undergoing LOD to avoid insulting their ovarian reserve and thus refining the eligibility criteria for LOD. Conclusion: ovarian reserve assessed by hormonal levels and sonography seems to be lower in patients with PCOS undergo LOD.

[Laila Ezzat and Mohamed Salah. Using preoperative ovarian reserve tests, patients’ age and BMI to refine the eligibility criteria for LOD to avoid iatrogenic diminished ovarian reserve. Cancer Biology 2016;6(3):92-96]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 11. doi:10.7537/marscbj060316.11.

Key Words: PCOS, LOD, Ovarian reserve, AMH

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