Breast cancer in the Maghreb : epidemiology and control strategies. Review.

Breast cancer is the most common cancer diagnosed in women in the Maghreb and around the world. It's the most common cause of cancer deaths. It represents a major public health problem because of its frequency, morbidity and mortality that it generates as well as the cost of the therapies used. Epidemiological data are similar in the 3 countries of the Maghreb (Tunisia, Morocco, and Algeria). Currently, the incidence of breast cancer is lower than in developed countries, but is increasing steadily, and projections for the coming years predict that rates will be closer to the European ones. The diagnosis is often done at advanced stages compromising the prognosis of the patients. Strategies to combat this cancer remain insufficient and further efforts are needed to improve the situation.

Assessment and biological significance of JC polyomavirus in colorectal cancer in Tunisia.

PURPOSE: Several reports have indicated the presence of JC polyomavirus (JCV) in many human tumors, including colorectal cancers (CRCs). The presence of JCV infection in CRC patients has not been investigated in African countries. METHODS: We examined the prevalence and the biological significance of JCV in Tunisian CRC patients. The presence of JCV was assessed by polymerase chain reaction (PCR) in a series of 105 CRCs and 89 paired non-tumor colonic mucosa samples from Tunisian patients. Results were correlated with the clinicopathological features and immunohistochemical expression of ß-catenin, p53, and the proliferation marker Ki-67. RESULTS: JCV DNA was detected in 58.1% (61/105) of CRC and in only 14.6% (13/89) of paired non tumor colonic mucosa samples (p=0.03). The presence of JCV was significantly correlated with tumor differentiation (p=0.03). Moreover, JCV presence was significantly correlated with nuclear accumulation of ß-catenin (p=0.008) and p53 accumulation (p=0.0001). Multivariate logistic regression analysis showed that tumor differentiation, ß-catenin and p53 accumulation were independent parameters significantly associated with the presence of JCV in CRC (p=0.04; p=0.05; p=0.001, respectively). CONCLUSION: We support a role of JCV in colorectal carcinogenesis in Tunisian patients, especially of well differentiated morphology.

Assessment of the role of histopathology and DNA image analysis in the diagnosis of molar and non-molar abortion: a study of 89 cases in the center of Tunisia.

This study retrospectively evaluated the histopathological criteria commonly used in the literature on the diagnosis of hydatidiform mole, in correlation with the diagnosis rendered previously. The molar and non-molar cases seen in the first-trimester of pregnancy were separately reviewed by two pathologists. The correlation between the consensual histological diagnosis and the ploidy status was then evaluated. We retrospectively studied 89 specimens of abortus conception, including 35 complete hydatidiform moles (CHM), 12 partial hydatidiform moles (PHM), and 42 hydropic abortions (HA). The final histopathological diagnosis was compared with the results of DNA content detected by imaging analyzer (Samba 200), studying all cases of molar pregnancy and 4 cases of HA (initially diagnosed as molar pregnancies). In the consensus histological diagnosis, the cases were reclassified as follows: 30 CHM (initial diagnosis (ID): 27 CHM and 3 PHM), 12 PHM (ID: 6 PHM and 6 CHM), and one case with a persistent problem in differentiating PHM from HA and 46 HA (ID: 42 HA, 2 CHM, and 2 PHM). An agreement between the two pathologists was reached in 77 cases (K=0.72, 0.52, and 0.9, respectively, for CHM, PHM, and HA). The ploidy study demonstrated diploidy in 56.6% (17/30) of CHM and triploidy in 58.3% (7/12) of PHM. In the 4 cases of HA studied, 3 were diploid and 1 case was aneuploid. Our study demonstrated that several histopathological criteria could be used for the distinction between PHM, CHM, and HA. However, the study of DNA cannot be the technique of choice to distinguish between these entities. Some cases remain problematic since the morphological criteria are not easily reproducible. New sensitive techniques might resolve these dilemmas.