Prognostic Value of BCL2 in Women Patients with Invasive Breast Cancer

Background: Breast cancers are heterogeneous, making it essential to recognize several biomarkers for cancer outcome predictions especially in young women where the classical prediction parameters are not suitable. The goal from this study is to evaluate the impact of B cell lymphoma 2 (BCL2), P53 and Ki-67 proteins expression on survival in young women patients with invasive ductal carcinoma. Patients and methods: Samples and clinical data from 238 patients were collected between 2003 and 2017. They were selected according to 2 criteria: age ≤40 years old and most of them are affected by an Invasive Ductal Carcinoma. We evaluated BCL2, P53 and ki-67 expression by immunochemistry test, and then we assessed correlations of these biomarkers expression with patient's clinicopathological characteristics and survival. Results: Triple negative breast cancer group showed a high frequency among our cohort but we emphasize an almost equitable distribution among all molecular groups. Contrary to other studies which reported that luminal A was correlated with better prognosis, our analysis demonstrated that luminal A is correlated with the Scarff, Bloom and Richardson (SBR) grading 2 or SBR grading 3. To better investigate the prognosis, we analyze three biomarkers known by their impact on physiopathology behavior on breast cancer BCL2, ki-67and P53. BCL2 is the more relevant one, it was correlated with molecular subtypes (p=0.0012) and SBR grading (p=0.0016). BCL2 seems to be the good prognostic biomarker related to survival (p=0.004) with a protective role among patients when endocrine therapy is not provided and Lymph Node (LN) involvement is positive (p=0.021, p=0.000 respectively). Conclusions: The classical prognostic parameters based mainly on the molecular classification in breast cancer seem insufficient in the case of young women. BCL2 protein expression analysis provides a better prognostic value. BCL2 should be clinically associated in current practice when young women specimens are diagnosticated.

[Malignant para-testicular tumors. Apropos of 3 unusual cases]. / Les tumeurs malignes para-testiculaires. A propos de trois cas rares.

Three uncommon cases of malignant para-testicular tumors are described. The first one was a malignant mesothelioma discovered after cervical node biopsy, the second, a high grade lipoblastic liposarcoma and the third a malignant mesenchymoma with 4 components. The literature is reviewed with special regard to these 3 types.

[Detection of diabetes in obese patients. Systematic study of induced hyperglycemia with assays of blood insulin, glycosylated hemoglobin A1c and cutaneous biopsy in 46 patients]. / Dépistage du diabète chez l'obèse. Etude systématique de l'hyperglycémie provoquée avec dosages de l'insulinémie, de l'hémoglobine glycosylée A1c et de la biopsie cutanée chez quarante-six patients.

Glycoregulation and insulin secretion abnormalities and micro-angiopathy were systematically investigated in 46 patients (6 men and 40 women; mean age 34.8) seeking medical attention for obesity. In all patients, a three-hour oral glucose tolerance test (OGTT) with 50 g glucose, with concomitant plasma insulin determinations, Hb A1c assay and skin biopsy (SB) at the medial aspect of the arm (optic microscopy study, PAS stain) were performed. We obtained 46 Hb A1c assays, 45 OGTT, 43 insulin determinations and 42 SB. In 40 patients, all four studies were available. We consider as abnormal blood glucose greater than 7.8 mmol at 120 mn with intermediate measurement greater than 10.1, insulin greater than 64 mcU with a maximum delayed after the 60th mn, Hb A1c greater than 6.3% and SB score greater than 10 (evaluating basement membrane thickness, endothelium swelling, aspect of pericytes, perivascular infiltration and percentage of capillaries involved). We observed 6 abnormal OGTT, 12 dysinsulinisms (DI), 5 Hb A1c greater than 6.3% and 17 SB greater than or equal to 10 with typical diabetic microangiopathy. Out of 40 fully investigated patients, 14 were normal for all criteria, 12 had only one abnormality (12 SB, 5 DI, 1 OGTT), 6 had 2 abnormalities (2 SB + DI, OGTT + DI, SB + OGTT, SB + Hb A1c, DI + Hb A1c) and 2 had 3 abnormalities (SB + DI + Hb A1c, OGTT + DI + Hb A1c).(ABSTRACT TRUNCATED AT 250 WORDS)