Prognostic Significance of Vascular Endothelial Growth Factor (VEGF) and Her-2 Protein in the Genesis of Cervical Carcinoma.

BACKGROUND: Angiogenesis plays a pivotal role in the progression of tumours through the formation of new blood vessels. Vascular endothelial growth factor (VEGF) is a chief factor responsible for inducing and regulating angiogenesis. Additionally, the human epidermal growth factor receptor family of receptors also plays an important role in the pathogenesis of tumours. AIM: This study aimed to examine the association between VEGF and Her-2 protein expression and its correlation with clinic-pathological characteristics; in particular, prognosis. METHODS: A total of 65 cases of cervical carcinoma and 10 samples of inflammatory lesions were evaluated for VEGF and Her-2 protein expression. RESULTS: Expression of VEGF and Her-2 was detected in 63.07% and 43.07% in cervical carcinoma cases respectively whereas control cases did not show any expression. The difference in the expression pattern of both markers comparing cancer and control cases was statistically significant (p < 0.05). However, no significant difference in the expression pattern of VEGF protein was observed among the different grades and stages of tumours (p > 0.05). Comparing different grades of a tumour, expression of Her-2 was detected in 31.8% of well-differentiated tumours, 36.0 % in moderately differentiated tumours and 66.66 % in poorly differentiated cancers. The expression of Her-2 was increased in high-grade tumours, and the difference of expression level between tumour grades was statistically significant (p < 0.05). The expression level of Her-2 protein was not correlated with the stage of a tumour (p > 0.05). CONCLUSION: The present study supports earlier findings that over-expression / up-regulation of VEGF and Her - 2 is linked with poor prognosis and may play a vital role in the development and progression of cervical cancer.

Clinicopathological Significance of Vimentin and Cytokeratin Protein in the Genesis of Squamous Cell Carcinoma of Cervix.

Cervical cancer is one of the commonest types of cancers worldwide especially in developing countries. Intermediate filaments protein family has shown a role in the diagnosis of various cancers, but a few studies are available about the vimentin and cytokeratin roles in the cervical cancer. This case control study aimed to interpret the expression of vimentin and cytokeratin proteins in the development and progression of cervical cancer and its correlation with clinicopathological features. The cytoplasmic expression of vimentin was observed in 40% of cases, but not in inflammatory lesions of cervix. It was noticed that vimentin expression was increasing significantly with high grade of the tumour. Cytokeratin expression was observed in 48.33% and it was noticed that the expression was 62.5% in well differentiated (G1), 45% in moderately differentiated (G2), and 41.66% in poorly differentiated carcinoma, yet statistically insignificant. The expression of vimentin and cytokeratin proteins was not significantly associated with age groups. The current findings concluded a possible role of vimentin in the development and progression of cervical cancer and vimentin marker will be useful in the diagnosis and grading of cervical cancer.

Cytomorphology of palpable breast lesions: Diagnostic utility of FNAC in a developing country.

BACKGROUND: Breast lesions including breast cancer represent a major public health issue in Sudan. Fine-needle aspiration cytology (FNAC) is an established, simple, highly accurate, minimally invasive, and cost-effective method of diagnosing most breast lesions. The aim of this study is to document the most common breast conditions diagnosed by means of FNAC over a two-year period in Atbara, a city in north Sudan. METHODS: A retrospective, descriptive, cross-sectional, laboratory-based study in which records of all palpable breast lesions diagnosed by FNAC in the years 2012 and 2013 were reviewed and analyzed. RESULTS: The total number of cases studied was 232; most subjects, 222 (95.7%), were females. The age range was 15-90 years (mean 38.2). Painless lump was the most common 190 (81.9%) clinical presentation. The left breast was affected more often than the right breast, 56.0% vs. 40.5%. Benign conditions were 167 (72%). Malignant neoplasms were 65 (28.0%). The most important associations with malignancy were female sex, age above 35 years, multiparity, painless lump at upper outer quadrant of left breast, lump size above 2 cm and the presence of an enlarged ipsilateral axillary lymph node at presentation. CONCLUSION: In the northern part of Sudan, the prevalence of malignant breast lesions diagnosed by FNAC is more than one fourth of all cases presenting with palpable breast lumps. FNAC is a technique that is ideal for use in resource-limited health settings.

A Clinicopathological Study of Urinary Bladder Neoplasms in Patients at Three Centers in Khartoum; Sudan

OBJECTIVES:To present the histopathological pattern of urinary bladder neoplasms using the WHO/ISUP classification system and relate it to the outcome.METHODS:This study was conducted in the period from January 2004 through December 2005 at three centres in Khartoum; Sudan. One hundred and six patients with urinary bladder neoplasms were included in the study.RESULTS:The commonest affected age group was 60-80 years with male to female ratio 4.6:1. Urothelial neoplasms were found in 72 (67.9); Squamous cell carcinoma (SCC) in 26 (24.5); urothelial neoplasms with Squamous differentiation in 3 (2.8); and other types in 5 (4.7) of the patients.There were 43.4of the urothelial neoplasms graded as papillary carcinoma of high grade; 52.6papillary carcinoma of low grade;1.3papillary neoplasm of low malignant potential;1.3papilloma; and 1.3was graded as flat neoplasm.Of the SCCs; twelve (42.9) were poorly differentiated SCCs;nine (32.1) moderately differentiated; and seven (25) cases were well differentiated SCCs. Follow-up information was available in 32 patients.At last followup; fifteen (46.9) patients were dead of the disease; twelve (35.5) were alive with no evidence of disease; four (12.5) were alive with disease; and one (3.1) was alive and terminally ill Conclusion:Histological grade (P: 0.006); and muscle invasion (P: 0.002) were significantly associated with survival.A subset of the cases could not be assessed for muscle invasion due to inadequate sampling; we thus recommend proper trans-urethral bladder biopsy (TUBP) sampling