Role of Krüppel-like factor 4 and heat shock protein 27 in cancer of the larynx.

Late detection and lack of standard treatment strategies in larynx cancer patients result in high levels of mortality and poor prognosis. Prognostic stratification of larynx cancer patients based on molecular prognostic tumor biomarkers may lead to more efficient clinical management. Krüppel-like factor 4 (KLF4) and Heat Shock Protein 27 (HSP27) have an important role in tumorigenesis and are considered promising candidate biomarkers for various types of cancer. However, their role in larynx carcinoma remains to be elucidated. The present study aimed to determine KLF4 and HSP27 expression profiles in laryngeal tumors. The protein and mRNA expression levels of KLF4 and HSP27 were evaluated by immunohistochemical and reverse transcription-polymerase chain reaction analyses in 44 larynx carcinoma samples and 21 normal tissue samples, and then correlated with clinical characteristics. A differential expression of KLF4 and HSP27 was observed between normal and tumor tissues. The protein and mRNA expression levels of KLF4 were significantly decreased in larynx squamous cell carcinoma (LSCC) compared with normal tissue, whereas HSP27 was significantly overexpressed in tumor tissues compared with normal tissues, at the protein and mRNA levels. KLF4 expression decreased gradually with tumor progression whereas HSP27 expression increased. A significant difference was observed between stages I and IV. KLF4 and HSP27 exhibit opposite functions and roles in the carcinogenic process of LSCC. Their role in laryngeal cancer initiation and progression emphasizes their use as potential future targets for prognosis and treatment. KLF4 and HSP27 expression levels may act as potential biomarkers in patients with cancer of the larynx.

Gastric Adenocarcinoma Secondary to Primary Gastric Diffuse Large B-cell Lymphoma.

Despite the decreasing incidence and mortality from gastric cancer, it remains a major health problem worldwide. Ninety percent of cases are adenocarcinomas. Here, we report a case of gastric adenocarcinoma developed after successful treatment of prior primary gastric diffuse large B-cell lymphoma (DLBCL). Our patient was an elderly man with primary gastric DLBCL in whom complete remission was achieved after R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone plus rituximab) chemotherapy. Helicobacter pylori infection persisted despite adequate treatment leading to sustained chronic gastritis. The mean time to diagnose metachronous gastric carcinoma was seven years. We believe that a combination of many risk factors, of which chronic H. pylori infection the most important, led to the development of gastric carcinoma following primary gastric lymphoma. In summary, patients who have been successfully treated for primary gastric lymphoma should be followed up at regular short intervals. H. pylori infection should be diagnosed promptly and treated aggressively.

Fish oil attenuates neurologic severity of antiphospholipid syndrome in a mice experimental model.

INTRODUCTION: Murine experimental models of antiphospholipid syndrome (eAPLS) showed neurologic dysfunction and therapeutic effect of the anticoagulant enoxaparin is well established. Omega-3 fatty acids and curcumin, tested in neuroinflammation and auto-immunity diseases, might be interesting therapeutic candidates. The aim of this study was to evaluate the effects of these candidates on neurologic severity in eAPLS. METHODS: One month after immunization of BALB/c mice with beta-2-glycoprotein I, daily treatments were initiated with enoxaparin (1 mg/kg), omega-3 fatty acids (0.5 g/kg), and curcumin (200 mg/kg) for 3 months. RESULTS: Mortality was significantly decreased by enoxaparin and omega-3 treatments. Fish oil and curcumin group exhibited the highest mean of swimming behavior in forced swim test in surviving mice. Mice under omega-3 fatty acids or curcumin presented low anxiety-like behavior in the elevated plus-maze test. Cerebral histopathology revealed heavy inflammatory infiltrates in cortical and subcortical regions with vacuolization, swelling, and degeneration of astrocytes in the control group, with aggravation under curcumin; no infiltrate was retrieved in enoxaparin and omega-3 groups. CONCLUSION: Our study is the first to demonstrate a potential therapeutic effect of omega-3 fatty acids in eAPLS. Enoxaparin and omega-3 fatty acids combination would be interesting for further investigation.

Krüppel-like factor 4: A new potential biomarker of lung cancer.

Lung cancer is most prevalent human cancer worldwide. However, no molecular markers are currently available for predicting lung cancer prognosis. Therefore, identifying novel biomarkers may be useful for improving clinical diagnosis and patient stratification. Krüppel-like factor 4 (KLF4) is a transcription factor with opposing roles in different human cancers. Its overexpression in several cancers is correlated with a poor prognosis. However, the expression and role of KLF4 in lung cancer remains to be elucidated. The aim of this study was to determine the profile of KLF4 expression in different types of lung cancer. The KLF4 protein expression level was tested and evaluated by immunohistochemical analysis in 47 lung tumors and normal tissues, and then correlated with clinical characteristics. A differential expression of KLF4 was observed between normal tissue and each of the lung cancer types. A significant decrease in KLF4 expression was observed in non-small-cell lung cancer (NSCLC) compared with that in normal tissue, while significant overexpression was detected in small-cell lung cancer. Furthermore, a higher rate of expression was observed in stage II, III and IV disease compared with stage I disease in NSCLC tissues. KLF4 expression was not found to be associated with age or gender. Our results suggested that the KLF4 protein level may be a potential biomarker in patients with advanced lung cancer.

Evidence of a Role for Fibroblast Transient Receptor Potential Canonical 3 Ca2+ Channel in Renal Fibrosis.

Transient receptor potential canonical (TRPC) Ca(2+)-permeant channels, especially TRPC3, are increasingly implicated in cardiorenal diseases. We studied the possible role of fibroblast TRPC3 in the development of renal fibrosis. In vitro, a macromolecular complex formed by TRPC1/TRPC3/TRPC6 existed in isolated cultured rat renal fibroblasts. However, specific blockade of TRPC3 with the pharmacologic inhibitor pyr3 was sufficient to inhibit both angiotensin II- and 1-oleoyl-2-acetyl-sn-glycerol-induced Ca(2+) entry in these cells, which was detected by fura-2 Ca(2+) imaging. TRPC3 blockade or Ca(2+) removal inhibited fibroblast proliferation and myofibroblast differentiation by suppressing the phosphorylation of extracellular signal-regulated kinase (ERK1/2). In addition, pyr3 inhibited fibrosis and inflammation-associated markers in a noncytotoxic manner. Furthermore, TRPC3 knockdown by siRNA confirmed these pharmacologic findings. In adult male Wistar rats or wild-type mice subjected to unilateral ureteral obstruction, TRPC3 expression increased in the fibroblasts of obstructed kidneys and was associated with increased Ca(2+) entry, ERK1/2 phosphorylation, and fibroblast proliferation. Both TRPC3 blockade in rats and TRPC3 knockout in mice inhibited ERK1/2 phosphorylation and fibroblast activation as well as myofibroblast differentiation and extracellular matrix remodeling in obstructed kidneys, thus ameliorating tubulointerstitial damage and renal fibrosis. In conclusion, TRPC3 channels are present in renal fibroblasts and control fibroblast proliferation, differentiation, and activation through Ca(2+)-mediated ERK signaling. TRPC3 channels might constitute important therapeutic targets for improving renal remodeling in kidney disease.

Hypothyroidism and its rapid correction alter cardiac remodeling.

The cardiovascular effects of mild and overt thyroid disease include a vast array of pathological changes. As well, thyroid replacement therapy has been suggested for preserving cardiac function. However, the influence of thyroid hormones on cardiac remodeling has not been thoroughly investigated at the molecular and cellular levels. The purpose of this paper is to study the effect of hypothyroidism and thyroid replacement therapy on cardiac alterations. Thirty Wistar rats were divided into 2 groups: a control (n = 10) group and a group treated with 6-propyl-2-thiouracil (PTU) (n = 20) to induce hypothyroidism. Ten of the 20 rats in the PTU group were then treated with L-thyroxine to quickly re-establish euthyroidism. The serum levels of inflammatory markers, such as C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL6) and pro-fibrotic transforming growth factor beta 1 (TGF-ß1), were significantly increased in hypothyroid rats; elevations in cardiac stress markers, brain natriuretic peptide (BNP) and cardiac troponin T (cTnT) were also noted. The expressions of cardiac remodeling genes were induced in hypothyroid rats in parallel with the development of fibrosis, and a decline in cardiac function with chamber dilation was measured by echocardiography. Rapidly reversing the hypothyroidism and restoring the euthyroid state improved cardiac function with a decrease in the levels of cardiac remodeling markers. However, this change further increased the levels of inflammatory and fibrotic markers in the plasma and heart and led to myocardial cellular infiltration. In conclusion, we showed that hypothyroidism is related to cardiac function decline, fibrosis and inflammation; most importantly, the rapid correction of hypothyroidism led to cardiac injuries. Our results might offer new insights for the management of hypothyroidism-induced heart disease.

Schistosomiasis manifesting as a colon polyp: a case report.

INTRODUCTION: Schistosomiasis is a rare disease with a common intestinal involvement. However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation. CASE PRESENTATION: We describe the case of a 20-year-old Ethiopian woman living in Lebanon who presented with nonspecific abdominal symptoms. Her biochemical profile was normal in addition to the results of her stool and urine tests. A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon. Pathology revealed a hamartomatous polyp but it was full of partially calcified parasitic eggs of Schistosoma mansoni compatible with chronic schistosomiasis. CONCLUSIONS: She was treated with two doses of praziquantel and showed immediate marked clinical improvement. This unusual case will give us the opportunity to discuss schistosomiasis, its occurrence in colon polyps, clinical significance and the various means of management.

Idiopathic retroperitoneal fibrosis presenting as recurrent scrotal edema: Report of a case and review of the literature.

Primary or idiopathic retroperitoneal fibrosis, first described by Ormond in 1948, is a rare and elusive diagnosis, requiring a high level of suspicion. Patients usually present with entrapment of retroperitoneal organs, the most common being the ureters, causing hydronephrosis and acute kidney injury. Here, we present the case of a 56-year-old male presenting for recurrent and intermittent scrotal edema. Upon routine laboratory workup, he was found to have an elevated creatinine level. Imaging showed encasement of bilateral ureters. Bilateral ureteral stents were placed with relief of his obstructive uropathy, followed by normalization of creatinine. The patient later underwent laparoscopic release of retroperitoneal adhesions. Biopsies taken from the operative site showed fibroblast proliferation and elements of acute and chronic inflammation. With further workup of etiologies being negative, he was diagnosed with idiopathic retroperitoneal fibrosis.

A collaborative nationwide lymphoma study in Lebanon: incidence of various subtypes and analysis of associations with viruses.

Incidence of various Hodgkin (HL) and non-Hodgkin lymphoma (NHL) subtypes and association with viruses in Lebanon are not known. We undertook a nationwide study of 272 patients diagnosed with lymphoma in 2007. HL comprised 32.7 % (n = 89) of cases while NHL represented 67.3 % (n = 183). Consistent with the literature, nodular sclerosis was the most predominant HL subtype (n = 57/89). Among NHL, B-cell NHL represented 88 % (n = 161/183), T-cell NHL 9 % (n = 17/183), whereas in 2.7 % it was not classifiable. The B-cell NHL comprised predominantly diffuse large B-cell lymphoma (46 %) and follicular lymphoma (23 %). 81 cases were reviewed by a panel of pathologists with 87.6 % concordance rate. Serology was negative for hepatitis C in 122 tested cases. HIV was positive in 2 cases. Two adult T-cell leukemia/lymphoma were HTLV-I positive. EBV IgG were positive in 88.5 % of cases. 38 EBV seropositive cases [27 NHL (24 B-cell, 3 T-cell) and 11 HL] were studied for EBV genome expression using EBV-encoded RNA (EBER)-in situ hybridization. EBER expression was positive in 8 (21 %) cases (6 HL, 2 T-cell NHL). The distribution of lymphoma subtypes in Lebanon appears similar to that of Western countries. The high rate of EBV positivity in HL and T-cell lymphoma by EBER deserves further investigation.

Pathological effects and motor response threshold changes following radiofrequency application at various distances from the L-5 nerve root: an experimental study.

OBJECT: Radiofrequency (RF) ablation is a minimally invasive technique often used percutaneously in the treatment of many conditions such as spasticity, pain, and osteoid osteoma. The purpose of this study was to assess the value of motor response threshold (MRT) as an indirect indicator of the RF generator's electrode to nerve distance, and to evaluate the effects of RF at various distances from a nervous structure. METHODS: The L-5 nerve root was studied in 102 Sprague-Dawley rats (sham contralateral side). Motor response thresholds at 0, 2, 4, 5, and 6 mm from the nerve root were assessed before and after RF application for 2 minutes at 80° C on Days 0 and 7. Radiofrequency was applied 0, 2, 4, 5, and 6 mm away from L-5 and with the addition of interposed cortical bone. The effects of RF application on MRT were studied, and subsequent nerve injury was evaluated using light microscopy pathological examination. RESULTS: There is a significant correlation between MRT and the distance between the electrode tip and L-5, with MRT less than 0.5 V when the electrode was in direct contact with the root. Electrical and pathological changes following RF application were more pronounced at 0 mm, with worsening seen on Day 7. Radiofrequency at 2 and 4 mm produced fewer electrical and histological deleterious effects on the nerve on Days 0 and 7, with an obvious improvement on Day 7. At 5 mm, electrical and histological abnormalities were minimal on Day 0 and were fully reversible on Day 7. At 6 mm and with interposed cortical bone, MRT and pathological findings were unchanged on Days 0 and 7. CONCLUSIONS: The MRT proved to be a useful and reliable tool in decreasing nerve morbidity following RF ablation in animals and may be used in humans for the same purpose. It serves as an indirect indicator of the proximity of the RF generator's electrode tip to any adjacent motor nervous structure. A minimum safe distance of 5 mm between the electrode tip and the nerve is required to avoid irreversible nerve injury, unless a bony wall is interposed between them, thus serving as a nerve shield. In medical conditions that require RF ablation of the nerve, such as spasticity and pain, the MRT must be lower than 0.5 V. When a nerve lesion is to be avoided such as in cases of osteoid osteoma, an MRT higher than 2.5 V is considered safe, reflecting a distance greater than 5 mm.

A 5-year survey of biopsy proven kidney diseases in Lebanon: significant variation in prevalence of primary glomerular diseases by age, population structure and consanguinity.

BACKGROUND: Differences in epidemiology of kidney disease across the Middle East may arise from variations in indication for biopsy, environmental exposure and socio-economic status. The Lebanese population is composed of different ethnicities, with distinct ancestry and religion, enabling comparison of their effect on the prevalence of kidney disease within a confined geographic setting and uniform practices. Here we report 5 years' detailed epidemiology of renal diseases, based on histological diagnosis, in a sample from three large pathology centres in Lebanon. METHODS: Records of renal biopsies analysed at the American University of Beirut Medical Center, Hotel Dieu de France Hospital and the Institut National de Pathologie from January 2003 till December 2007 were retrospectively examined. We recorded the following data for each patient: age, gender, indication for renal biopsy and histopathological diagnosis. Religious affiliation and parents' consanguinity were recorded when feasible. RESULTS: The mean age at renal biopsy was 36.76 ± 20 years (range 1-84). The most common diagnosis was mesangioproliferative glomerulonephritis (GN; 20%), followed by focal segmental glomerulosclerosis (13.2%). While there were no differences in age, gender or indications for biopsy among different religious affiliations, mesangioproliferative GN was significantly more frequent among Muslims (P = 0.039) and offspring of consanguineous unions (P = 0.036). On the other hand, focal segmental glomerulosclerosis was most prevalent in Christians (P < 0.001). CONCLUSIONS: Variation in the distribution of diagnoses between Muslim and Christian groups likely reflects differences in population structure and ancestry. In particular, the increased prevalence of mesangioproliferative GN among offspring of consanguineous unions in Muslims suggests a recessive genetic component to this disease which may be identified via homozygosity mapping. These findings have important implications for formulating renal health policies and designing research studies in this population.

B-type natriuretic peptide modulates the action potential and the L-type calcium current in adult rat heart muscle cells.

Natriuretic peptides seem to be a potent regulator of cell Ca2+ signalling in their action on the cardiovascular system. It was therefore the aim of this study to investigate the effect(s) of B-type natriuretic peptide (BNP) on the action potential and the L-type calcium current (I(CaL)) in the rat left ventricular myocytes. Perforated and whole cell patch clamp technique was used to record action potential (AP) and I(CaL) in current and voltage clamp mode, respectively. At the concentration tested of 10(-7) M, BNP significantly increased the action potential duration at 50% and at 90% of repolarization by 16.85% and 1639% respectively, and the phase II slope of the AP by 52.5%; reduced the I(CaL) amplitude with a 16.17% decrease in the peak amplitude; reduced (16.51%) the inactivation time course of current decay; increased the V0.5 activation of the L-type calcium channel by 32.84% and decreased V0.5 inactivation by 34.39%. These data suggest that BNP modulates cardiomyocyte function by reducing I(CaL) and modifying the AP. This study may show a novel facet to evaluate the paracrine/autocrine effect of BNP on the normal heart function.

Epidermoid cyst of the spleen: case report.

Splenic cysts, very rare pathologies, are classified into parasitic and the highly uncommon, non parasitic cysts. Based on the presence or absence of an epithelial lining wall, the latters are classified into true cysts and false cysts. We present a case of a 23-year-old male who presented to our clinic with a several-month history of abdominal discomfort that was due to the compressive effect of a huge nonparasitic true splenic cyst.

Radiofrequency application to the growth plate in the rabbit: a new potential approach to epiphysiodesis.

BACKGROUND: Radiofrequency energy is being used more and more frequently in orthopaedics, mainly in the treatment of bone tumors. We postulated that radiofrequency ablation may produce growth plate lesions similar to those observed in the bone and conducted this study to see whether radiofrequency may be used as a technique for producing epiphysiodesis. METHODS: We randomized 60 8-week-old female New Zealand white rabbits into 3 groups. Group A was destined for a total epiphysiodesis at 60 degrees C, group B was destined for a total epiphysiodesis at 90 degrees C, and group C for a lateral hemiepiphysiodesis at 90 degrees C. Radiofrequency energy was delivered in 1 minute in all 3 groups. Using fluoroscopic imaging, radiofrequency was applied percutaneously to the left proximal tibial physis whereas the right growth plate received a sham procedure. A bicortical pin was used to evaluate the longitudinal growth rate at every monthly radiologic control, beginning 8 weeks after the procedure. Comparisons between the right and left side and between groups A and B were achieved using a paired t test. A histopathologic study was conducted in parallel to the radiographic study. RESULTS: In a radiograph at the 8-week point, pin migration was 4.74 mm on the left side compared with 9.72 mm on the right (P<0.0001), in group A. In group B, pin migration on the left was 1.37 mm compared with 5.49 mm on the right (P<0.0001). In group C, mean angular deviation was 11.6 degrees on the left compared with 1.9 degrees on the right (P=0.0001). These differences were maintained until the end of growth. Pathology specimens revealed cellular anarchy, loss of columnar stratification, and height of the physis on the left side, which occurred earlier and were more pronounced in group B than in group A. In group C, these changes involved only the lateral half of the left physis whereas its medial counterpart remained normal. There was no evidence of articular cartilage damage. CONCLUSIONS: This experimental study shows that radiofrequency can efficiently and rapidly achieve epiphysiodesis. It is one of many methods that can be used for this purpose. The development of new electrodes suitable for use on human growth plates and the elaboration of specific utilization protocols may lead to its use in children. Its simplicity and precision may lead to a quick and efficient growth arrest with little pain and postoperative disability in addition to reduced costs. CLINICAL RELEVANCE: Radiofrequency has proved to be effective in producing growth arrest in rabbits with no complications. Technical improvements and adaptations may allow its use for pediatric limb inequalities or angular deformities in the near future.

The effects of methyl methacrylate monomer on testosterone level in male rats. An experimental study.

INTRODUCTION: Methyl methacrylate (MMA) is commonly used in medicine and dentistry. The adverse effects of MMA are well described in the literature. Animal studies have largely confirmed the risks reported in clinical observations. There is no study indicating direct implication of MMA on male fertility mechanism. OBJECTIVES: The purpose of this study was to determine whether MMA is able to modify the testosterone level. METHODS: The target population consisted of 60 male Sprague-Dawley rats. They were closed in colony cages and divided into five groups: The first group (n=15) designated as the control group and four experimental groups (n=45). Experiments were conducted by exposing the four experimental groups to MMA with water at different concentrations (4% per hundred, 8% per hundred, 16% per hundred and 32% per hundred) administered per os. The exposure duration was eight months. Blood was obtained before and at the end of the exposure and the measurement of the testosterone level was made by EIA test. RESULTS: The exposure of rats at a moderate concentration of MMA (16% per hundred) showed an increase in testosterone level of 60% (p = 0.003) while the other groups showed a decrease of testosterone level. The control group showed a decrease of 44.8% (p = 0.001), the rats exposed at 4% per hundred showed a decrease of 67.7% (p = 0.000), those exposed at 8% per hundred showed a decrease of 432% (p = 0.35), the rats exposed at 32% per hundred showed a decrease of 71.7% (p = 0.002). CONCLUSION: Despite the fact that MMA at low concentration was rapidly hydrolyzed in blood due to the nonspecific carboxylesterase and metabolized at high concentration by the liver, its effects on testosterone level were significant. These preliminary results showed an interference of the MMA with the testosterone hormonal equilibrium that could be an interesting target for further investigations.

Toxic effects of methyl methacrylate monomer on male genital tissues. In vitro study in rats.

INTRODUCTION: Methyl methacrylate (MMA), a widely used monomer in dentistry and medicine has been reported to cause abnormalities or lesions in several organs. Experimental and clinical studies have documented that monomers may cause a wide range of adverse health effects such as irritation to skin, eyes, and mucous membranes, allergic dermatitis, stomatitis, asthma, neuropathy, disturbances of the central nervous system, liver toxicity, and fertility disturbances. OBJECTIVES: The purpose of this study was to determine whether MMA mixed with water at four different concentrations is able to affect the histological structure of testicular tissues and seminal vesicle on male rats. METHODS: The target population consisted of 60 male Sprague-Dawley rats. They were housed in colony cages and divided into five groups: The first group (n=15) designated as the control group and four experimental groups (n=45). Experiments were conducted by exposing the four experimental groups to MMA administered per os mixed with water at different concentrations (4% per hundred, 8% per hundred, 16% per hundred, 32% per hundred). The exposure duration was eight months. The testicles and the seminal vesicles were then extracted, dissected, fixed in Bouin liquid fixative and were submitted to the pathology laboratory (National Institute of Pathology) for histopathological examination. RESULTS: Seven out of 10 rats to which the MMA was administrated at a concentration of 32% per hundred showed partial seminal vesicle atrophy. The seminal vesicles in the remaining rats showed normal histology in all specimens. Testis, epididymis and vas deferens showed normal histology in all rats. CONCLUSION: The data in this study showed that MMA administered at high concentration is associated to seminal vesicle atrophy. These findings let us suggest that this effect could be the result of either a direct effect of MMA on testosterone levels (as shown in our first study), or through its possible action on other organs involved in testosterone metabolism and seminal vesicle trophicity such as the hypophysis.

[Periarteritis nodosa: gastrointestinal and cardiovascular complications. A case report]. / Périartérite noueuse: complications digestives et cardio-vasculaires. A propos d'un cas.

Polyarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving the wall of small and medium sized arteries. The histologic aspect is defined by the presence of fibrinoid necrosis and an infiltrate rich in neutrophil polynuclears in the artery wall and rare granulomas. Clinical manifestations are misleading, and more often the symptoms of the disease are retrospectively related to the PAN. The gastrointestinal involvement carries a poor prognosis. We report a clinical case of severe PAN concerning a 46-year-old woman revealed by an acute alithiasic cholecystitis, needing a cholecystectomy. A number of complications occurred during the evolution and we noticed the occurrence of cutaneous ulcers, a number of ischemic accidents like a necrosis of toes of right leg, a minimal myocardial infarction, a pneumatosis of the small intestin. Three months later, under treatment by prednisone and cyclophosphamide, the patient developped an ischemic perforation of the terminal ileum complicated by a septic peritonitis. Despite an urgent surgery a rapid and fatal evolution was observed. A discussion of the case and a review of the literature will be presented.

Prognostic significance of EGFR, p53 and E-cadherin in mucoepidermoid cancer of the salivary glands: a retrospective case series.

OBJECTIVE: Evaluate the prognostic significance of EGFR, p53 and E-cadherin known, along with histopathologic criteria, in mucoepidermoid cancer (MEC) of the salivary glands. MATERIALS & METHODS: Retrospective case series review between January 1994 and December 2002 of all patients with salivary glands mucoepidermoid cancer treated at one university hospital. Histopathology review and immunohistochemistry study for EGFR, p53 and E-cadherin was undertaken on formalin-fixed, paraffin embedded surgical specimens. Clinicopathological parameters were reviewed and survival analysis was conducted to study the prognostic significance of these factors. SETTINGS: All patients were treated by the same multidisciplinary team which included three head and neck surgeons, one plastic surgeon, two medical oncologists and one radiation oncologist at Hôtel-Dieu de France, a tertiary care university hospital of Saint-Joseph University, Beirut-Lebanon. RESULTS: Thirteen patients were treated for MEC during this period. The parotid gland was the most common site. Mean survival in this series was 61 +/- 8 months (95% CI = 46-77 months). Positive lymph nodes status was a significant predictor of poor survival. EGFR and p53 were correlated to histological grade. EGFR tended also to be more elevated in major salivary gland tumors. CONCLUSION: EGFR and p53 expressions were highly correlated to high histological grade, making them an interesting target for further investigation as prognostic factors in MEC.

Cancer incidence in postwar Lebanon: findings from the first national population-based registry, 1998.

PURPOSE: Cancer incidence rates in Lebanon have been lacking for over three decades. National data based on a total of 4388 cases diagnosed during the year 1998 were reviewed and analyzed. METHODS: Crude and age-standardized rates (ASRs) per 100,000 population were calculated and results were contrasted with estimates from developed and selected developing countries in the region. RESULTS: Among males, bladder (18.5%), prostate (14.2%), and lung cancer (14.1%) were the most frequently reported malignancies. Among females, breast cancer alone accounted for over a third of all cancers, followed by colon cancer (5.8%), and cancer of the corpus uteri (4.8%). Sex-differentials in incidence rates were highest for tobacco-related cancers (lung, larynx, and bladder). Compared with current estimates worldwide, ASRs for bladder cancer in Lebanon showed strikingly high rates. Whereas ASRs for breast and prostate cancer remained lower than those observed in developed countries, they were greater than those estimated from neighboring countries with a similar epidemiological transition as Lebanon. CONCLUSIONS: Findings of the comparative assessments most likely reflect differentials in prevalence of risk factors and lifestyle variables (e.g., lung and breast cancers) and can be partly explained by improvement in cancer detection rate in recent years (for prostate cancer). The implications of the results in light of primary prevention activities, screening practices, and research initiatives in Lebanon are discussed.