Hormone-receptor expression status of epithelial ovarian cancer in Ibadan, South-western Nigeria.

INTRODUCTION: Epidemiological evidence strongly suggests that steroid hormones are implicated in the pathogenesis of ovarian cancer. Estrogen receptor (ER) and Progesterone receptor (PR) are prognostic indicators for a number of epithelial tumors and may play the same role in ovarian cancers. This study aims to evaluate the expression of ER and PR in epithelial ovarian cancer (EOC) in an African population and compare it with other prognostic factors such as age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade and histological subtype. METHODS: Ninety cases of histologically confirmed EOC were reviewed. Immunohistochemistry was used to assess their ER and PR expression status and was then compared with other demographic variables using statistical methods, with level of significance set at p < 0.05. RESULTS: 30.2% and 8.3% of serous and mucinous carcinomas respectively were ER positive while 41.2% and 22.5% of both tumour types were PR positive. One of the two endometrioid carcinomas showed PR expression but neither were positive for ER. The only case of Brenner tumour in the series was ER positive but negative for PR. There was a significant association between ER and the histological subtypes (p = 0.042) while no significant association was found between PR expression and histological subtypes (p = 0.650). No significant association was found between hormone receptor status, age and stage of the EOC. CONCLUSION: The study showed a lower ER expression in serous carcinoma compared to large cohorts from developed countries. Future translational studies could be used to determine response of EOC to endocrine therapy.

Pattern of triple negative epithelial ovarian cancer in indigenous African women.

Background: Triple negative epithelial ovarian cancer (TNEOC)  refers to ovarian carcinomas that do not express estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor- type 2 (HER-2/neu).  The aim of this study is to determine the pattern of triple negative epithelial ovarian cancer in indigenous African women. Methods: We performed a retrospective review of ER, PR and HER-2/neu expression in 90 Nigerian patients with histologically diagnosed epithelial ovarian cancer. Lack of expression of ER, PR and HER2/neu antigens was used to determine carcinomas that are among the TNEOC. We also compared the clinicopathological parameters (age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade and histological subtype) in patients with TNEOC and non- TNEOC . Results: Thirty-eight (42.2%) of the 90 tumours diagnosed as EOC were negative for ER, PR and HER2/neu expression. There was no significant association between TNEOC with other parameters such as age, FIGO stage and histological grade. Sixteen (66.7%) of the 24 mucinous carcinomas were triple negative, while only 21 (33.3%) of the 63 serous carcinomas were triple-negative and one (50%) of the two endometrioid carcinomas was triple negative. There was a significant association between triple-negative tumours and histological subtypes of EOC (p = 0.034). Conclusions: A subtype of epithelial ovarian cancer that is negative for ER, PR and HER-2/neu has been discovered in indigenous African women. TNEOC expression is high and is comparable to the triple negative breast cancer subtype seen in people of African ancestry. Future study of TNEOC in a large sample size should be considered.

Clinicopathological features of gastric carcinoma in Ibadan, Nigeria, 2000-2011.

AIM: The most recent study on the clinicopathological features of gastric carcinoma from the University College Hospital (UCH), Ibadan, was done in 2000. The aim of this study is to update the knowledge on the clinicopathological features of gastric carcinoma diagnosed in the Pathology Department of the UCH Ibadan between 2000 and 2011. MATERIALS AND METHODS: This was a 12-year retrospective review of clinical and demographic data and the histopathological features of gastric cancers diagnosed at the Pathology Department of the UCH. The chi square test, Fisher's exact test, and the t-independent test were used as applicable in the statistical analyses. RESULTS: A total of 117 cases of gastric carcinoma were histologically diagnosed at the Pathology Department of UCH, Ibadan in this period giving a relative ratio frequency of 1.38% for all cancers. It represented 18.4% of all gastrointestinal tract malignancies diagnosed in the same period. There was a male preponderance with male:female ratio of 1.72:1; the middle-aged and elderly made up about 76.1% of cases. The disease was clinically and histologically advanced in 92.8% of cases. Gastric tumours were predominantly antral/ pyloric in 80% of cases and exophytic in 62.3% of cases. The intestinal histotype constituted 47.0% cases although a rise in the diffuse histological type was observed. CONCLUSION: There is a decline in the relative ratio frequency of gastric carcinoma in Ibadan; and a fall in the rate of the intestinal type of gastric carcinoma relative to the diffuse type when compared to previous studies from our centre.

Mammographic parasitic calcifications in South West Nigeria: prospective and descriptive study.

INTRODUCTION: Lymphatic filariasis caused by nematode parasite Wuchereria bancrofti and Brugia Malayi is endemic in the tropics. In Nigeria, 25% of the population is infected. Lymph edema and elephantiasis are the predominant manifestations. Its infrequent manifestation is in the breast. This paper discusses the epidemiology, reviews literature, imaging options and mammographic appearances of these parasitic nematodes. METHODS: This prospective descriptive study reports on 39 cases of parasitic calcifications seen during mammography in the Radiology Department, University College Hospital between 2006 and 2012 in Ibadan, South West Nigeria. Each mammogram was reported by MO and ATS: assigned a final Bi-RADs category. Parasitic calcifications were further evaluated for distribution, and types of calcification. RESULTS: A total of 527 women had mammography done between 2006 and 2012. Thirty-nine women (7.4%) had parasitic breast calcifications. The ages of the women ranged between 38-71 years--mean of 52.36±8.72 SD. Twenty-three (59%) were post-menopausal, 16(41%) were pre-menopausal. The majority (31; 79.5%) were screeners while 8(20.5%) were follow up cases. Approximately half (51.3%) of the women had no complaints. Pain (23.1%) was the commonest presentation in the remaining half. Solitary calcifications were predominant (20) while only 3 cases had 10 calcifications. Left sided calcifications (53.8%) were the majority. Calcifications were subcutaneous in 2/3rds of the women (66.7%) while the Yoruba tribe (84.6%) was principal. CONCLUSION: Parasitic breast calcifications can be misdiagnosed on mammography for suspicious micro-calcification. This publication should alert radiologists in a tropical country like Nigeria to increase diagnostic vigilance thereby preventing unnecessary anxiety and invasive work-up procedures.