HER2 overexpression and correlation with other significant clinicopathologic parameters in Ivorian breast cancer women.

BACKGROUND: The overexpression of HER2 is associated with worse prognosis of breast cancer which responds favourably to anti-HER2 therapy. The objective of this study was to determine the frequency of HER2 and its association with clinicopathologic factors in breast cancer in Ivory Coast. METHODS: The study included 608 patients who were histologically diagnosed with invasive primary breast carcinoma. The immunohistochemistry testing for ER, PR, and HER2 was performed on the formalin fixed paraffin-embedded blocks of breast tissue of these patients. The analysis of variance and the Chi-Square Test were used to examine the association of the HER2 status with clinicopathologic prognostic features. RESULTS: The average age of patients was 47 ± 11 years. Among 608 patients, 355 (58.4%) were premenopausal. Invasive ductal carcinoma of no specific type (511 cases, 84.1%) was the most frequent histologic type. Grade II tumors were 59.8%. The positivity of ER, PR, and ER/PR was 334 cases (54.9%), 252 cases (41.4%), and 356 cases (58.5%), respectively. HER2 was overexpressed in 105 cases (17.3%). The overexpression of HER2 was significantly correlated with Nottingham grade (p = 0.007). No association was observed between HER2 expression and age (p = 0.568), menopausal status (p = 0.929), histologic type (p = 0.666), ER (p = 0.137), PR (p = 0.396), and ER/PR (p = 0.134). CONCLUSION: Breast cancer occurs in young women. HER2 status is closely related to Nottingham grade. The immunohistochemical analysis of HER2 has prognostic and therapeutic implications, and thus, contributing to efficient clinical management of patients.

Immunohistochemical determination of estrogen and progesterone receptors in breast cancer: relationship with clinicopathologic factors in 302 patients in Ivory Coast.

BACKGROUND: Breast cancer is a heterogeneous and a hormone-dependent disease. The detection of the estrogen receptor (ER) and progesterone receptor (PgR) is crucial for prognostic evaluation and treatment choice of breast cancer for clinical practice. The purpose of this study was to evaluate the expression of the hormonal receptors, their distribution, and their correlation with clinicopathologic prognostic parameters for the improvement of the patients' treatment in Ivory Coast. METHODS: The 20-month prospective study included 302 patients who were diagnosed with primary invasive breast carcinomas at the Central Laboratory in Abidjan. The paraffin-embedded blocks of these patients were examined by immunohistochemistry to assess the ER and PgR status. The one-way analysis of variance and Chi-Square Test were used to analyze the data. RESULTS: The mean age of patients at diagnosis was 48 ± 11 years. The majority of the women were premenopausal in 180 cases (59.9%). The predominant histologic type was invasive ductal carcinoma not otherwise specified (IDC NOS) in 247 cases (82%). Tumor grade 2 was more frequent in 166 cases (55%). Among 302 patients, 169 (56%) and 154 (49%) expressed ER and PgR respectively. The ER+PgR+ group with 131 cases (43%) was predominant, followed by 116 cases (38%) of ER-PgR-. The expression of ER and PgR was correlated with the age of the patients (p = 0.026) and the tumor grade (p = 0.0004). However, there was not statistically significant correlation between ER/PgR and the menopausal status of patients (p = 0.149), nor between ER/PgR and the histologic type (p = 0.523). CONCLUSION: The ER+PgR+ and ER-PgR- are the most common subgroups in women with breast cancer in Ivory Coast. The hormonal receptor status is associated with the age and the histologic grade in breast cancer patients. The systematic use of hormonal treatment should be reevaluated. A further study should be done to investigate the reasons of high rate of ER-PgR- in breast cancer patients in Ivory Coast.

A rare testicular tumor: primary carcinoid tumor.

BACKGROUND: Primary carcinoid tumors are rare and constitute 0.23% of all testicular tumors. We report a case of primary carcinoid tumor of testicular localization, with a review of the literature. CASE PRESENTATION: A 29-year-old man, without specific ascendants, consulted the urology department for progressive scrotal swelling of 6 months, associated with pain. After surgery, histology showed diffuse tumor proliferation composed of small round monotone cells with hyperchromatic nuclei evoking undifferentiated carcinoma. Immunohistochemistry showed that tumor cells were positive for chromogranin A and negative for placental alkaline phosphatase and α-fetoprotein. CONCLUSION: Primary neuroendocrine carcinoma of the testis is a very rare malignant tumor. Immunohistochemistry contributes to its diagnosis in relation to other metastatic neuroendocrine carcinomas, carcinoid tumor teratomas, seminoma, and Sertoli cells.

Immunohistochemical Evaluation of Ki-67 and Comparison with Clinicopathologic Factors in Breast Carcinomas

Background: Patients primarily received tamoxifen based on their menopausal status due to the lack of immunohistochemistry. A recent study has shown that hormonal receptors were not correlated with menopausal status, and thus, indicating that they present limited therapeutic and prognostic significance in breast cancer management. This study aimed to evaluate Ki-67 value and analyze its association with clinicopathologic parameters in breast cancer patients. Methods: The formalin-fixed paraffin-embedded breast tissue blocks of 125 patients with primary breast carcinomas were subjected to immunohistochemical analysis using Ventana Benchmark® GX automated immunostainer. Analysis of variance and Chi-2 test were used to examine the relationship between Ki-67 and clinicopathologic variables. Results: The mean age of 125 patients included in the study was 47.7 years. The average score of Ki-67 was 56.0%. 84.8% of patients showed Ki-67 ≥ 14%. Mean scores of Ki-67 were correlated with grade (p = 0.006), PR (p = 0.026), histological type, ER, combined ER/RP, and molecular subtype (p < 0.001). Ki-67 was independent of HER2 (p = 0.402) and menopausal status (p = 0.471). The frequency of Ki-67 according to St Gallen 2011 was associated with histological type (p = 0.005), grade (p = 0.005), ER (p < 0.001), combined ER/PR (p = 0.004), and molecular subtype (p = 0.004). There was no significant relationship between the distribution of Ki-67 and the age of the patients (p = 0.859), menopausal status (p = 0.979), PR (p = 0.149), and HER2 (p = 0.597). Conclusion: Ki-67 is useful for treatment decisions in primary breast cancer patients. The high value of Ki-67 was associated with adverse clinicopathologic factors. The increased Ki-67 value should be carefully investigated in triple negative patients.

[Rare pancreatic tumor detected unexpectedly in a child in the Ivory Coast]. / Tumeur pancréatique rare de découverte fortuite chez un enfant en Côte d'Ivoire.

Solid pseudopapillary tumor of the pancreas (SPTP) is rare. It most often affects young women. It was first described by Frantz in 1959, but its pathogenesis remains unclear. This tumor has a good prognosis. Treatment is based on radical surgery. We here report the case of a 11-year old girl with SPTP. Symptomatology was acute, including compression syndrome and epigastralgias. Clinical examination showed a solid mass in the left hypochondrium. Scan showed mixed mass structure of the pancreas tail. Left splenopancreatectomy was performed. The diagnosis was confirmed by histological examination using immunohistochemistry. Long-term follow-up showed no recidivism. The study had a follow-up period of two and a half years. This study and literature review aimed to highlight the role of radiological examination in the diagnosis and underline the importance of radical surgery in the treatment of these tumors with a low degree of malignancy.

Breast Cancer Molecular Subtypes Defined by ER/PR and HER2 Status: Association with Clinicopathologic Parameters in Ivorian Patients.

BACKGROUND: Breast cancer is a heterogeneous disease that represents a major public health problem. The immunohistochemical determination of breast cancer subtypes with regard to estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2) status can contribute to improved selection of therapy and patientcare. The purpose of this study was to determine the prevalence of the molecular breast cancer subtypes and to assess their associations with classical clinicopathologic parameters for better therapeutic decisions in women with breast cancer in the Ivory Coast. MATERIALS AND METHODS: Formalin- fixed and paraffin-embedded blocks of patients diagnosed with primary breast carcinoma were subjected to immunohistochemical assay for the assessment of ER/RP and HER2 expression. The one-way analysis of variance evaluated the difference between breast cancer subtypes and mean age of patients. The Chi-square Test was used to compare standard clinicopathologic prognostic parameters with tumor subtypes. RESULTS: Among 302 patients, 57% were premenopausal and 43% were postmenopausal. The invasive ductal carcinoma not otherwise specified (IDC NOS) (82.8%) was the most frequent histological type, and the tumor grade 2 (56%) was predominant followed by grade 3 (20.9%). The proportion of positivity of ER, PR, and HER2 was 56%, 49%, and 15.6%, respectively. Half of patients of this study (51.6%) had luminal A breast tumor type followed by TN (32.1%). Other subtypes were luminal B (10.1% ) and non-luminal HER2+ (6.3%). CONCLUSIONS: The findings of the present study are in line with the literature and should assist in management of breast cancer in our country.

Severe skin forms of psoriasis in black africans: epidemiological, clinical, and histological aspects related to 56 cases.

Bacground. Psoriasis is an erythematosquamous dermatosis of chronic development. In sub-Saharan Africa, few studies have been focused on complicated forms of psoriasis. Objective. The aim is to describe epidemiological, clinical, and histological features of severe skin forms of psoriasis in Cote d'Ivoire. Material and Methods. The study was both cross-sectional and descriptive, that focused on patient admitted to the dermatology unit for complicated psoriasis, from January 1st, 1986, to December 31th, 2007. Results. Fifty-six patients admitted to hospital for severe skin forms of psoriasis were recorded and included in our study over 7.503 patients hospitalized during the study period. They represented 0.75% of cases. The average age was 39.6 ± 3.3 years. There were 49 male (87.5%) and 7 female patients (12.5%) with a sex ratio of 7. At socioprofessional level, 48 patients (87.5%) were from category 1. Patients' history was dominated by the psoriasis vulgaris. Physical and general signs were dominated by itching (58.9%). The three severe skin forms were observed with predominant erythrodermic psoriasis (60.7%). Fifteen patients (34.9%) were HIV positive. Conclusion. Severe skin forms of psoriasis are rare in our setting. But in the quarter of HIV-positive patients, they are dominated by the erythrodermic psoriasis.

[Descriptive epidemiology of cancers in Cote d'Ivoire]. / Épidémiologie descriptive des cancers en Côte d'Ivoire.

The cancerous disease is a real pain in developed countries due to the ageing of the population. According to the World Report Cancer in 2000, cancer tends to be a major problem of public health in the developing nations. This study research aimed at describing the epidemiological features of cancers in Cote d'Ivoire. It is a 26-year retrospective and descriptive study focusing on all cancers confirmed histologically by using the data from the registers of Anatomic Pathology laboratory of Abidjan teaching hospitals. The parameters of the study were frequency, age, sex, site and histological type. We obtained 12,841 cancers within patients aged from 2 months to 107 years old along with 51.26-year median age and 0.9 as sex-ratio. The most important cancer locations are cervix (17.41%) followed by skin (15.81%), prostate (7.73%), breast (6.88%), and stomach (6.09%). With women, the median age was 49.23 years, and the most common cancers were cervical cancer (33.25%) followed by breast cancer (12.44%) and skin cancer (10.50%). With men, the median age was 53.95 years, and the most frequent cancers were skin cancer (21.29%) followed by prostate cancer (15.69%) and stomach cancer (8.71%). Burkitt lymphoma (33.95%), retinoblastoma (10.92%) and nephroblastoma (5.88%) are the most important cancers in children. Cancers are frequent in Cote d'Ivoire. Cervical cancer, skin cancer, and prostate are updated problems with a worse prognosis. Therefore, the screening and the early diagnosis remain the best conditions to improve the prognosis of cancer.