Immunohistochemical Expression of Surviving in Viral Hepatitis and Hepatocellular Carcinoma, a Comparative Study

Hepatocellular carcinoma (HCC) is the fifth most common neoplasm, the major cause of death in patients with cirrhosis, and the third most common cause of cancer-related death in the world. In Egypt, hepatocellular carcinoma (HCC) is the second most common cancer in men and the 6th most common cancers in women. Egypt has the highest prevalence of HCV in the world and the prevalence of HCC is increasing in the last years. Nowadays, HCV infection and its complications are among the leading public health challenges in Egypt with 13.8% of population infected and, in these patients, the risk of HCC is increased 17-fold. Glypican-3 (GPC3) is a member of heparin sulfate proteoglycan family which is linked to cell surface. It plays an important role in regulation of cell growth, differentiation, and migration. It is normally expressed in fetal liver and placenta but not in normal adult liver tissue. 8-Hydroxydeoxyguanosine (8-OHdG) is an oxidatively modified promutagenic DNA that is produced by oxygen radicals and is recognized as a useful marker in estimating DNA damage induced by oxidative stress. The present work is a retrospective, cross-sectional, study performed on 150 liver paraffin blocks that included 100 cases of chronic hepatitis C and 50 cases of hepatocellular carcinoma. These cases were collected from the Pathology Department. The 100 cases of chronic hepatitis C were graded into low grade chronic hepatitis (58) cases and high-grade chronic hepatitis (42) cases, 30 patients had cirrhosis, all in the high-grade group. The 50 cases of hepatocellular carcinoma (HCC) included 18 cases of well-differentiated HCC (grade I), 22 cases of moderately differentiated HCC (grade II) and 10 cases of poorly differentiated HCC (grade III). Among 50 cases of HCC, 44 cases showed cirrhosis in the non-neoplastic liver tissue. There was a statistically significant difference in 8-OHdG index between chronic hepatitis and hepatocellular carcinoma (P = 0.006).

Prediction of Nipple and Areola Complex Invasion in Breast Cancer Patients. Clinical and Pathological Study of Surgical Specimens

Breast conservation surgery (BCS) and nipple-areola-sparing (NAS) mastectomy have been recognized as two milestones in this period. This study included 60 Egyptian female patients with breast cancer, all of them were subjected to modified radical mastectomy operation. Methods: This study included female patients > 18 years old who have breast cancer with healthy looking non invaded skin of nipple and areola and excluded patients < 18 years old, patients unfit for surger, patients previously subjected to chemo or radiotherapy for breast cancer. We peformed clinical examination of 60 patients with breast cancer. We studied the relevant factors that affect NAC invasion such as patient’s age, menstrual state, family history, tumor size, tumor location (central vs peripheral), tumor to nipple distance, lymphovascular invasion of NAC, lymph node metastasis, histological tumor type, tumor stage, multifocal/multicentric tumors and (ER, PR, HER2) status. Result: In our study, we have shown that NAC invasion is strongly associated with: 1) Nipple retraction as a patient’s complaint;2) Tumor site;3) Tumor-nipple-distance ≤ 4 cm;4) Multifocal/multicentric tumor;5) Tumor grade (grade III tumors);6) Positive lymph node invasion;7) ER and PR receptors negativity;8) HER2 positivity. This helps in preoperative planning for selecting patients for NAS mastectomy. Conclusion: The ideal patients for NAS mastectomy are with these criteria: 1) Clinically normal nipple areola complex;2) Distance from the tumor to the nipple is >4 cm;3) No multifocal/multicentric tumor;4) Absence of lymph node invasion;5) Tumor grade (grade I, II);6) Peripheral not central tumor;7) No sub-areolar lymphovascular invasion (LVI);8) ER receptor positive;9) PR receptor positive;10) HER2 negative.