कैंसर विज्ञान एवं चिकित्सा

Objective: Immunohistochemical fatty acid synthase expression is a prognostic marker in several cancers and is related to cancer aggressiveness. Here, we analyzed fatty acid synthase expression as an indicator of adjuvant chemotherapy for distal bile duct and ampullary cancer cases.
Methods: Forty-three cases of distal bile duct cancer and thirty-seven ampullary cancer cases resected between 2000 and 2017 were examined. We investigated immunohistochemical fatty acid synthase expression in resected specimens and the involvement of lymph nodes. We compared these findings with patient prognosis using medical history of postoperative adjuvant chemotherapy. Patient survival was expressed by the Kaplan-Meyer method and analyzed by a log-rank test.
Results: There were twenty-two fatty acid synthase-positive cases for distal bile duct cancer and seventeen for ampullary cancer. For distal bile duct cancer cases, the relapse-free survival and overall survival of fatty acid synthase-positive cases were shorter than those for fatty acid synthase-negative cases (p=0.0094 and p=0.0327, respectively). For ampullary cancer cases, the relapse-free survival and overall survival of fatty acid synthase-positive cases were also shorter than those for fatty acid synthase-negative cases (p=0.0225 and p=0.0103, respectively). Adjuvant chemotherapy occurred in twelve of the twenty-two fatty acid-positive distal bile duct cancer cases and in eight of the seventeen fatty acid-positive ampullary cancer cases. Relapse-free survival and overall survival of cases with adjuvant chemotherapy did not differ from those without adjuvant chemotherapy in both distal bile duct cancer and ampullary cancer.
Conclusion: Although fatty acid synthase expression was a prognostic factor in bile duct cancer and ampullary cancer, it was not an indicating marker for adjuvant chemotherapy.

Projective: HIF-1α is highly expressed in the triple negative breast cancer cell line (MDA-MB-231), which is lack of the expression of ER,PR and HER2 and exhibits high invasive and metastatic ability. Previous study detected that siRNA targeting HIF-1α in MDA-MB-231 restrained the cell growth and the abilities of immigration and invasion, and promoted apoptosis. UCH-L3 protein was found to be one of the differential proteins detected by Bidirectional gel Electrophoresis and Proteomics in the cells with HIF-1α siRNA cells comparing to no-siRNA cells. The objective of this study is to probe the effect of UCH-L3 on the biological behaviors of the triple negative breast cancer cell line (MDA-MB-231).
Methods: Over or blocking expressions of UCH-L3 were established by the transfections with lentiviral constitutive vector and siRNA targeting UCH-L3 respectively. Real time quantitative PCR and Western blot or Co-ip were used to detect the mRNA and proteins. CCK8, and clone formation assays were to evaluate the cell growth and clonality. Matrigel Transwell and Would Scratch assay were used to estimate the cell invasion and mobility.
Results: The over-expression of UCH-L3 inhibited the cell growth and clonality, weaken the abilities of cell immigration and invasion, and lowered the expression of free and ubiquitined HIF-1α in MDA-MB-231 cells with lentiviral vector comparing to those in the cells with control vector. Application of proteolytic enzyme inhibitor, MG132 increased the protein level of UCH-L3 but still decreased the protein level of HIF-1α in the cells with UCH-L3 over-expression. Blocking UCH-L3 expression by siRNA technique increased the expression of HIF-1α properly.
Conclusion: high expression of UCH-L3 showed an inhibitory effect on the biological behaviors of triple negative breast cancer cell and negative effect on HIF-1α expression, implying that UCH-L3 likely to be a therapeutic strategy for triple negative breast cancer.

Background: Breast cancer, the most frequent cancer among women, is also the leading cause of cancerrelated deaths among women. In resource poor settings, it is often diagnosed late due to low rates of screening. To more successfully support breast cancer prevention, it is vital to know the reason women do not utilize breast cancer screening. Hence, this study assessed utilization of breast cancer screening services and associated factors among women attending Centre Hospital University Kigali (CHUK), Rwanda.
Methods: A cross-sectional study was conducted among 384 women who were selected consecutively as they came to the hospital. A pre-tested structured questionnaire was used to collect data. Both descriptive and inferential statistics were utilized during data analysis.
Results: The utilization of breast cancer screening was low at 35.2%. After running multivariable analysis the following factors were independently associated with utilization: respondents aged 30-39 years [AOR=3.62; 95%CI=1.80-7.29; p<0.001] and 40 years and above [AOR=4.37; 95%CI=1.68-11.33; p=0.003], single/widowed respondents [AOR=4.41; 95%CI=1.54-12.64; p=0.006], moderate level of breast cancer screening awareness [AOR=3.95; 95%CI=2.16 - 7.20; p>0.001], high level of screening awareness [AOR=17.23; 95%CI=7.62 - 38.99; p<0.001] and respondents who agreed that there was regular follow up by nurses at the health facilities [AOR=3.05; 95%CI=1.31 - 7.10; p=0.010].
Conclusion: Majority of women had not had screening for breast cancer of which a significant number were not even aware of breast cancer screening. The study found different factors associated with utilization of breast cancer screening including awareness. There is need to intensify efforts towards promoting awareness and screening of breast cancer.

Background: Breast cancer is the most common malignancy in women and the leading cause of cancer deaths worldwide. In Ethiopia breast cancer is among the most prevalent cancer and occurs at young age. It usually presents at an advanced stage.
Objective: To describe the frequency, stages, histological patterns, staging and grading of breast cancers among Ethiopian women in three Hospital in Addis Ababa, Ethiopia.
Methods: A prospective study of 197 patients who presented to three hospital with breast cancer and underwent surgery from December 2013-December 2015. Tissue were fixed in 10% formalin solution and paraffin embedded. Hematoxylin and Eosin (H&E) stained slides were prepared in all cases and reviewed and classify according to the WHO.
Results: The mean ± SD age of the participants was 44.77 ± 13.6 and the median was 42 years. Most patients were aged less than 50 years (70.6%) at the time of diagnosis. 57.4% were pre-menopausal and 42.6% were postmenopausal. The duration of symptom before presentation ranged from 2 to 48 months with mean ± SD 18.11 ± 13.2 months. Invasive ductal carcinoma was the commonest (79.2%) histologic type of breast cancer. Of all patients, (46.2 %) of patients had grade 2, while (36.5%) of the cases were grade 3 or poorly differentiated tumors. Most patients (70%) presented with advanced stage (III and IV) and more than (90 %) tumor were >2 cm in size.
Conclusion: Our study shows breast cancer is a common disease that affects young Ethiopian women, and that there is a significant delay in presentation and advanced stage presentation is a major concern. It should be recognized that breast cancer is a disease with a serious public health implication.

Background: Breast cancer is an emerging non-communicable disease in Ethiopia. The aim of the study was to assess the impact of breast cancer in Tigray, Northern Ethiopia.
Methods: Retrospective secondary data were scanned from health management information system data base (e-HMIS) at Tigray Regional Health Bureau from 2011-2017. Data abstraction and analysis were conducted from June to July 2018. Scanned data were filtered in Excel- sheet and exported to SPSS version 21 for further statistical analysis. Finally, descriptive statistics were used to display finding of impact of breast cancer in terms of its morbidity and mortality rate using table and line graph.
Results: A total of 4630 cancer cases were registered during the study period. Of which, 1250 (26.9%) were new cases of breast cancer. high proportion of breast cancer morbidity and mortality was observed in age category of 15 years of age and above in both men and women. Over all breast cancer mortality was 2.3% during the study period. The trend of breast cancer morbidity was picked by nearly half and its mortality rate by 12.7% in year 2017 when compared with base line data in 2011.
Conclusion: The study finding revealed that high breast cancer morbidity and mortality trend were observed. This high impact might result additional burden causing maternal illness and death in addition to communicable disease. Therefore, other systematic studies needed to identify its indigenous predictors for initiating appropriate interventions efficiently.

Microwave ablation (MWA) of lung lesions under guidance of computed tomography (CT) and SIRIO system (Sistema robotizzato assistito per il puntamento intraoperatorio) is providing accurate and real time visualization system. We present a case of 65 y male patient with multiple metastatic lung lesions from gluteal mesenchymal tumor confirmed histopathologically, MWA of two lesions under general anesthesia using double lumen endotracheal tube to exclude LT lung. Complete ablation of lesions was achieved, post-procedure pneumothorax was treated by (Heimlich valve) insertion, 24 hours follow up revealed complete resolution of pneumothorax. In this case report we found that the total procedure time and the total effective radiation dose of the whole procedure were reduced in compared with a previous case of MW ablation of similar sizes lesions under CT guidance only.