Journal de recherche translationnelle en oncologie

Oral cancer is the most common Cancer in Indian Males. Risk factors include tobacco use, heavy alcohol use and human papillomavirus (HPV) infection. Symptoms include a sore that doesn't heal, a lump or a white or red patch on the inside of the mouth. Late stage tongue cancer is defined as any cancer in stage 4 which is unresectable. This happens either because of an increased size or early involvement of posterior part of tongue. Treatment includes surgery and radiation therapy. In some cases, chemotherapy may be required. Palliation in this condition is limited to nasogastric tube, pain management and Tracheostomy. Aspiration pneumonia is a progressive condition which keeps on increasing as the mobility of tongue decreases gradually. This becomes increasingly intolerable for patients as the tumour growth enhances. These patients have an extremely debilitating and limited life. Field cancerisation is very common in these patients leading to a very high incidence of recurrence. The conventional treatment modalities like chemotherapy and Radiotherapy are again not very effective and addition of Radiotherapy leads to an extensive side effects. There is inability to swallow solids more than liquids. Speech is badly affected, mucositis and xerostomia are common side effects. Long term effects include cricopharygeal stenosis. Most patients are at a disadvantage regarding their quality of life after palliative radiotherapy for tongue cancer. Lasers and light source technologies can be applied to a wide variety of open and laparoscopic surgeries, as well as other procedures encountered by general surgeons and other medical professionals. The ability to produce highly precise and controllable effects on tissues, and the potential to facilitate complex dissection make these devices a welcome addition to the armamentarium of the surgeon, who is skilled in their use. Each laser wavelength has a characteristic effect on tissue. The combination of the laser tissue interaction, the selection of the appropriate delivery systems and laser parameters determines the ultimate effects of laser use on the conduct and outcomes of surgery. The use of laser to ablate the tumors was used in late stage tongue cancers. Laser ablation of late stage cancers of tongue is used for debulking the tumor in a blood less manner. Laser ablation destroys the Tumour thermally over a real time basis. The use of real time imaging allows a constant monitoring of the destroyed area. There was a marked increase in quality of life. Which was apparent within a week? There was also a marked increase in the life span of patients. Conclusion: Laser ablation offers a viable alternative for palliation in late stage Tongue cancer. The Palliation achieved depends on age of patient and involvement of volume of the tongue.

The new modality oft the dedicated Mamma-CT is offering a robust and comfortable Examination of the breast. It is working without any compression and produces 3D-images of the breast without any superimposions. Therefore it is avoiding two of the major problems of conventional mammography: Pain for the examined women and superimposion of glandular tissue. Adding a very short examination time, extremely high resolution oft he acquired images and the facultativ usage of contrast-media, the new technology oft the Mamma-CT emerges to be one of the greatest invention of senological diagnostics in the last years. Despite the first impression of being nothing more, than a nice tool for further assessment and an evaluation method for complex microcalcifications or multifocal findings, the Mamma-CT has a lot of possibilities in daily routine and turns out to becoming a real problem solver. Due to its robustness, short examination time, high resolution of 0.15mm in an isotropic manner, great comfort and usability of contrast media it fills the great gap between conventional Mammographie / tomosynthesis / contrast-Mammographie (TiCEM) and MRI. Even more it has the potential of becoming the reference modality for patients with Breast-implants or the clinic of secreting/bleeding mamilla. In the first case, the Mamma-CT offers high-end imaging of the breast AND the implants in one exam - without any compromise in sensitivity / specifity or risk of damaging the implants due to compression. In the second case, the mammo-CT can be used as a 3D-high-resolution-imaging tool for a classic galactrography – a complete new way of diagnosing intraductal tumors, like papillomas. This talk shows the technological background, the physics and advantages of this modality. It helps you to compare it to the traditional technologies and classify it in the setup of a multimodality approach in modern senological diagnosis. It gives also some breathtaking examples of this fascinating modality and cases out of daily routine.

Cancer is cell fleeing from death by blocking the intrinsic and extrinsic pathways of cell death programs. In the present work, the experimental formula was designed to remove these blockers. It was applied on 120 Swiss albinomice which were inoculated intraperitoneally and subcutaneously with Ehrlich Ascites Carcinoma cells; 1 × (10⁶) cell/mouse. The activity of the cell death programs of the tumor was detected by measuring the volume of Ascites fluid, counting the number of dead cancer cells, measuring the size of the tumor, detecting the positive reaction of caspase enzyme in cancer cells and presence of macrophages and apoptotic bodies in tumor tissue. The experimental formula succeeded in removing the blockers of the cell death program in cancer cells returning the cell death program to work again. Cancer is a serious problem; it is more dangerous than nuclear bombs. The World Health Organization in 2015 reported that 8.8 million people around the world died from cancer. In 2017, more than 14 million new cases were reported globally and may rise to over 21 million cases by 2030. In (2018), 9.6 million deaths were recorded globally. There are many types of cancer treatments like surgery, radiation, monoclonal therapy, adoptive cell transfer, target therapy, an angiogenesis inhibitor, hormone therapy, stem cell transplant and gold nanoparticles. But for all types of treatment out there, they all have serious side effects and they are unable to save all cancer patients. Cancer is difficult to treat.

Both Breast and Uterus are highly sensitive to hormonal influences, normally related to their reproductive functions. Due to abundant Receptors in their tissues, hormones are capable of eliciting profound changes of breast and uterine tissues, including neoplasms. Prevention and therapy of Breast and Endometrial Cancers using hormones as an adjuvant therapy is successful but challenging as there are side effects to be avoided. Tamoxifen (Tam) is a non-steroidal synthetic triethylene estrogen derivative used successfully in the adjuvant therapy and prophylaxis of breast cancer. It binds to Estrogen Receptors(ER) in a manner similar to estradiol inducing a binding of Tam-ER complexes to the nuclear DNA resulting in a decrease of available unbound ER, exerting an antagonistic, antiestrogenic effect on breast tissue. Its effect on the uterus is more complicated as Tam acts both as an antagonist and an agonist of Estrogen. In the uterus the agonist effect is manifested by endometrial polyps, hyperplasia, leiomyomas, adenomyosis and occasional neoplasia. In the largest study published so far, endometrial tissue (from biopsies and Hysterectomies) from 700 patients treated with Tam for Breast cancer, 64% showed normal cycling or inactive/atrophic endometrium ; 24% had endometrial benign polyps with cystic glandular and/or mild hyperplastic glands, displaying a different histologic pattern from endometrial polyps seen in patients not treated with Tam; in 4.7% of cases, frankly malignant changes were identified, the majority serous carcinoma of high grade, less than one third low grade endometrioid carcinoma. The malignant endometrial tissue was found in polyps, not associated with hyperplastic or atypical glands as it is most often seen in endometrioid carcinoma of patients not treated with Tam. Endometriosis carcinoma is the most common gynecological cancer in the USA and in most of the industrialized world; its relationship with hyperestrogenism is well established although the carcinogenic mechanism is not yet clarified. Many reports of individual cases of high grade endometrial cancer including very aggressive carcinosarcomas have also been reported in Tam treated patients. Endometrial cancers were seen more often in older patients, and in those treated for a longer duration. Despite these unfavorable side effects Tam is still used for its beneficial effect in preventing and treating breast cancer. Recently however it was established that Aromatase Inhibitors (A.I.) stop the production of estrogen in post-menopausal women by blocking the enzyme Aromatase which turns androgens to estrogens, resulting in a decrease of the available Estrogen to stimulate ER positive breast cancer cells. The use of A.I. is therefore less associated with estrogen-agonist side effects; it may however have other side effects such as cardiac anomalies and osteoporosis. Tam and A.I. are still both considered effective and may be used in the prevention and adjuvant therapy of Breast Cancer.

As indicated by the National Cancer Registry of Syrian MOH, commonest cancers seen and treated were breast, colorectal and carcinoma, followed by leukemia (adult and children) and lymphoma (Adult and children). Bladder, stomach and prostate were less common. According to our MOH Cancer Registry, supported 8000 carcinoma cases collected from several Hospitals in Syria, BC accounted for half-hour of female cancers in Syria. Age: Median =49 years Crude Incidence Rate: 29 per 100,000 Age Standardized Incidence Rate: 43 per 100,000 Histopathology: infiltrating duct carcinoma (70 %) Unfortunately, thanks to our present national crisis and war resulting into scarcity of resources and disruption of the health system that resulted in limited of human resources, movements of patients, damaged health facilities, and unavailability of health data system. Of these factors limited the role of the national cancer registry and its functionality. The last statistics available are dated in 2009, and no statistics or reports were produced then.

Breast Cancer (BC) is the most common cancer in women accounting for about 30% of all female cancers. The average age of incidence varies among countries .While it is 62 years in the US, it is 48 years in the Arab countries. According to a recent statistics by me in Syria for example, 20% of cases occurred below the age of 40 (vs. 8% in the US). This has an important implication. A significant percentage of our BC cases occur at fertile age with high level of estrogen especially in pregnancy resulting in aggressive cancer. In dealing with breast cancer, we should be thinking of its biology. It is a slow growing cancer. By the time it is discovered mammo graphically (5 mm), it is 5 years old. Survival depends on the following five factors: 1. Size of lesion, 2. Grade, 3. Lymph node status, 4. Hormone receptor status, 5. Age of patient.

Breast Cancer (BC) is the most common cancer in women accounting for about 30% of all female cancers. The average age of incidence varies among countries .While it is 62 years in the US, it is 48 years in the Arab countries. According to a recent statistics by me in Syria for example, 20% of cases occurred below the age of 40 (vs. 8% in the US). This has an important implication. A significant percentage of our BC cases occur at fertile age with high level of estrogen especially in pregnancy resulting in aggressive cancer. In dealing with breast cancer, we should be thinking of its biology. It is a slow growing cancer. By the time it is discovered mammo graphically (5 mm), it is 5 years old. Survival depends on the following five factors: 1. Size of lesion, 2. Grade, 3. Lymph node status, 4. Hormone receptor status, 5. Age of patient.

Mind Mapping is necessary to diagnose mainly differential diagnoses in medicine, pathology and citology. The presence of glandular epithelial abnormalities on conventional as well as liquid-based cervical cytology often causes difficulty for morphological interpretation, for these anomalies are associated with various benign and malign processes of the epithelium of the endocervix. Amongst endocervical lesions there is a benign group with morphological (architectural and cellular) similarities with neoplasia (adenocarcinoma). To help in its differential diagnosis and to show the course followed by this topic research, here we review neoplasia-like lesions, endocervical dysplasia and in situ adenocarcinoma.

The mounting medium is a solution used to adhere the coverslip to the slide to preserve and support stained tissue sections. The most popular mounting media used in laboratories for histopathology is a mixture of Distyrene (a polystyrene), a Plasticiser (tricresyl phosphate), and Xylene called DPX mounting medium that preserves stains and dries quickly. In this study a novel mixture was used replacing DPX; a mixture of extra pure benzene and Expanded Polystyrene Foam (EPF) which mixed together forming adhesive material used to adhere the coverslip with the clean, stained tissue slides, then examined under light microscopy by using different objective lenses magnification in comparison with DPX which cover the same stained tissue sections. Stored for one year to monitor the fading effect of the new mountant on the stained tissue sections. In conclusion Getting the same results of DPX, specially is a simple mixture can be made by any technician in any laboratory for histopathology as well as the time elapsed for drying of the new mounting medium is much more rapid in comparison with DPX and also the spread of EPF in many daily use product make the mixture also available and recycled in a good way as EPF used in floatation devices, egg cartons, sandwich and hamburger boxes, coffee cups and plates. Finally when I made comparison between this new mixture and DPX using the same tissues, the great results was the same, also when the colours has been measured by image analyser software to the record the difference.

Bone is the strongest part in the human and animals, as well examination and reporting any histopathological changes of the different bone tissues is quite difficult than any other tissues, and to obtain satisfactory paraffin or celloidin of bone, the inorganic calcium must be removed (Jimson et al., 2012) through the decalcification process. There are numbers of decalcifying agents used in both veterinary pathology and histology research laboratories (Gayle Callis, 1998). So choosing the appropriate one depend upon some factors such as; time for decalcification with ribboning of sections, good nuclear staining and minimal edema (Bancroft and Gamble, 2016). I used a novel, household, safe solution which is the commercial table vinegar; the method was: an egg as a model (outer egg shell), sunken into commercial table vinegar solution Hienz ®, the decalcification resulted after only one day. After that a rabbit mandible was used to monitor the effect of vinegar on bone sample and inspected daily, the results come matching the outer egg shell but it took 28 days. So, I conclude that; may use the commercial table vinegar which contain 4-8 % acetic acid as a novel, safe, cheap, available decalcifying agent in both histology and pathology laboratories.

Gall-Bladder Cancer (GBC) is a neoplasm common in certain parts of the world. The various studies reported vary due to geographical and racial differences. North India presents itself as a major center for this fatal cancer with a varied gene and protein expression profile. The pathogenesis of GBC is a much talked about phenomenon and often reports the immune-expression of Ki67 and HER-2. HER2 is an oncoprotein which is overexpressed in some malignancies including breast and GIT. HER2 and Ki67 are overexpressed in gallbladder cancer and in precancerous lesions. In our study, we have attempted to identify the immune-expression of HER-2 and Ki67 in Gall Bladder lesion (Non-neoplastic and pre-neoplastic) cases. The primary reasons for twisted results seen in the different studies can be credited to the source of antibodies used for immunohistochemistry, race of the patient cohort, and criteria used to adjudge positivity in the stained samples .A number of recent studies have identified different immunomarkers overexpression giving rise to their oncogenic potential in non-neoplastic and preneoplastic lesions and has relation with GBC development and progression to Gall bladder carcinoma. The present study was undertaken to assess pattern and level of expression of HER2 in metaplasia, dysplasia, and different type of gallbladder lesions, which would determine its suitability as a prognostic biomarker in neoplastic transformation of gallbladder epithelium. The study was undertaken to find the expression and significance of Ki-67 index and HER2 in these lesions.

Conclusions:

Our study conducted is an immunohistochemical study of non-neoplastic and preneoplastic lesions of Gall bladder lesions suggesting the prognostic role of Ki67 and HER2. We found Ki67 and HER-2 as an independent prognostic factor indicating progression in its severity. In the past, the treatment for all sorts of gall bladder lesions used to be identical. However, improvements in molecular techniques, has a unique molecular signature. It is therefore important for identifying the gall-bladder lesions which may transform into malignancies later. Therefore, our study may be critical to define prospective patient subsets that may be at risk of developing gall bladder carcinoma.

Introduction: Spontaneous tumor regression was defined differently for many types of cancer by several researchers during the last century. Spontaneous regression is partial or complete disappearance of primary tumor tissue or its metastases in patients who have never been treated. According to traditional Chinese medicine (TCM), malignant tumor has a cause energies deficiencies and Heat retention.

Purpose: to demonstrate that malignant tumor can regress in to benign or disappear completely only balancing internal energies, taking out Heat retention and replenishment the chakras energies deficiencies with highly diluted medications.

Methods: Three clinical cases reports. All three patients with cancer diagnoses (case one: thyroid; case two: uterus; case three: lungs). All three patients were found to be at their lowest level of energy (through radiesthesia), rating one out of eight. Treatment consisted in re-establish the equilibrium between Yin, Yang, Qi, Blood and taking out Heat retention through Chinese dietary counselling, auricular acupuncture with apex-ear bloodletting, homeopathy according to the Constitutional Homeopathy of Five Elements Based on Traditional Chinese Medicine and crystal-based medication.

Results: The first two case reports were cured of their cancer condition without any treatment by Western medicine, only with the treatment done. The third patient, though, was already under radiotherapy and chemotherapy but through the treatment previously described the metastasis disappeared and he achieved a better physical and emotional health state.

Conclusion: balancing internal energies and taking out Heat retention through Chinese dietary counselling, auricular acupuncture with apex ear bloodletting and replenishment the chakras energies meridians with highly diluted medications can induce malignant tumor regression according to these three cases reports. More studies should be done with more patients and with different kinds of tumors to have more data and confirmation of these results.

Background:

The Indian Council of Medical Research in India has reflected that the occurrence of Gall bladder carcinoma (GBC) is predominantly higher in northern India. Reports from ICMR suggests that the incidence of GBC corresponds to 3.6 per million in males and 7.4 per million in females in Delhi, India, as compared to 1.13 per million in the US. The incidence is high in females and it represent almost three fourths of GBC victims and their highest incidence rate occur in this region, yet only few immunomarker studies are available from this high-predisposing region. GBC has also been reported to show a variable expression pattern among different ethnic groups. GBC results via the dysplasia-metaplasia sequence and the 5-year survival rate for GBC is 32% and for the advanced stage it is only 10%. Current studies have focused on the importance of Cyclin D1, E-cadherin, EGFR, HER-2, Ki67, and p53 immunomarkers in the development and prognosis of GBC. One of the most genetic aberrations is ascribed to be HER-2 in GBC. HER-2 and other immunomarkers Cyclin D1, E-cadherin, EGFR, Ki67, and p53 can be easily assessed by standard immunohistochemistry methods. However, concrete results have not been obtained due to a limited number of respectable GBC cases presented at the hospitals. We, therefore, attempt to evaluate the immune-expression of these markers in GBC cases and determine their prognostic value in the selected GBC cohort.

Material and Methods:

30 resected GBC cases were collected from the Gall bladder lesion cases. Histological type, and differentiation grading of all specimens was obtained from H&E-stained slides. Immunohistochemistry Formalin-fixed (10%), paraffin-embedded GBC were sectioned (3–5 μm thick) and were treated with ready-to-use monoclonal antibodies Cyclin D1, E-cadherin, EGFR, HER- 2, Ki67, and p53 c-erbB-2 of (Dako® Corporation, Carpinteria, Calif., USA) were used as the primary antibody. Scoring was based on the Herceptest TM (Dako) criteria; semi-quantitative analysis of the stain intensity was carried out. The number of Immunomarker-stained cells in representative microscopic fields was counted.

Results:

The average age of the patient cohort was 53 years, and 55% of them were females. 62% of cases had gallstones of different sizes and the average tumor size was 45 mm. All the cases were mostly histologically proved to be adenocarcinoma. About 11/30 of the patients showed staining for HER-2 , and 10/30 of the tumor cases showed positivity for p53, 14/30 of the tumor cases showed positivity for Cyclin D1,12/30 of the tumor cases showed positivity for E-cadherin, 113/30 of the tumor cases showed positivity for EGFR, and 17 /30 of the tumor cases showed positivity for Ki67 .Contingency table analysis by χ2 tests showed that HER-2, Cyclin D1, E-cadherin, EGFR, positivity showed significance with sex (p = 0.02). On the other hand, Ki67, and p53-positive cases did not show any significance with clinicopathological factors. HER-2, Cyclin D1, E-cadherin, EGFR, Ki67, and p53 showed statistical significance. Hence their expressions are considered to be significant prognostic factors in the selected GBC cohort.

Conclusions:

Consequently, it can be summed up that there is an important need to search for immuno- markers of GBC, which will not only diagnose and prognosticate the disease but also help in choosing the appropriate mode of therapy and may give us an opportunity to make our basic understanding of GBC pathology clearer. Thus, our study assesses the expression of important immunomarkers involved in the pathogenesis of GBC, correlates it with clinicopathological parameters and establishes it as an independent prognostic factor in GBC.