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Abstract : Knowledge and Behavior of Women on Cervical Cancer in the Northern Region of Cameroon
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Abstract: Background: Cervical cancer is a major cause of women death worldwide. The reduction of the mortality and morbidity of this pathology depends on the early detection based on powerful suitable screening methods, that will lead to optimal treatment strategies. However in some rural region of developing countries, it is very difficult to get access to standard screening methods, alternative screening methods, cheaper and easy to handle are then useful. Objective: The aim of this work was to test the sensitivity and specificity of VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol iodine) as a diagnostic test of cervical cancer compared to the Pap Smear, evaluating the feasibility in health formation in the North Cameroon region, of implementing epidemiological surveillance of cervical cancer based on early diagnosis using the VIA-VILI association Method: 309 women age 20 to 62 years were recruited in this study, 307 were included in the statistical analyzes. Each woman was screened for cervical cancer by a conventional Smear and visual inspection with acetic acid 5% and the lugol solution. Results: We found in our study a prevalence of precancerous lesions of cervix at 12.70%. The risks factors of cervical cancer identified are age, matrimonial status, age of first sexual intercourse and parity. The association of VIA and VILI showed a sensitivity, specificity, positive and negative predictive value respectively about 93.58%; 97.01%; 82.01%, 99.04%. Conclusion: Compared to PAP Smear, VIA or VILI could be used as an alternative screening methods for cervical cancer in developing countries, where it is difficult to access to more accurate test such as colposcopy and biopsy. Keywords: Sensitivity, specificity, diagnosis, VIA-VILI, cervical cancer.Download Full Article |
Abstract : The Relation between Plasma Levels of Thrombomodulin and Endothelial Dysfunction in Syrian Children with Acute Lymphoblastic Leukemia
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Abstract: Background: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancies, representing nearly one-third of all pediatric cancers. Thrombomodulin is a membrane glycoprotein expressed on endothelial cells, Its plasma level depends on the integrity of the endothelium. Soluble thrombomodulin is derived from injured endothelial cells or proteolytically cleaved from thrombomodulin by proteases. In the past, the endothelium was considered to be inert, described as a 'layer of nucleated cellophane', with only non-reactive barrier properties. However, it is now becoming clear that endothelial cells actively and reactively participate in hemostasis and immune and inflammatory reactions. They regulate vascular tone via production of nitric oxide, endothelin and prostaglandins. Severe endothelial dysfunction is present during the acute phase of acute lymphoblastic leukemia and it result from the disease itself, from treatment, or from other conditions (e.g. sepsis). Objective:The aim of this study was to determine the level of serum soluble thrombomodulin as a marker of endothelial activation in children with ALL at time of diagnosis and after the chemotherapy. Methods and Materials: A case - control study included Thirty patients with ALL and twenty healthy children. We analyzed serum soluble thrombomodulin levels by enzyme-linked immunosorbent assay. Results: In children with acute lymphoblastic leukemia, there was a significant increase in soluble thrombomodulin levels during the acute phase of the disease and during treatment. Conclusion: severe endothelial dysfunction is present during the acute phase of ALL and during treatment and appears to result from the disease itself and from the treatment. Keywords: Acute lymphoblastic leukemia (ALL), thrombomodulin, endothelial dysfunction, children, chemotherapy. |
Abstract : Association between Molecular Subtypes and Survival in Patients with Breast Cancer
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Abstract: Background: Aim of this study is to classify intrinsic subtypes and evaluate the differences in clinical/pathological characteristics and survival outcomes among the molecular types. Patients and Methods: Breast cancer subtypes were classified according to the 2013 St. Gallen Consensus. Five molecular subtypes were determined, Luminal A, Luminal B-like HER2 negative, Luminal B-like HER2 positive, HER2 positive, and triple negative. Data was obtained from the records of patients with invasive breast cancer retrospectively. The differences in clinical/pathological parameters, overall survival and disease-free survival among the molecular subtypes were analyzed. The Kaplan-Meier method, log-rank test and Cox regression tests were used to compare groups. Results: The median follow-up period is 48 months. The Luminal B-HER2 negative was the most prevalent type (26.6%). Patient demographics, tumor characteristics and survival data were analyzed. The Luminal A and Luminal B-HER2 negative subtypes had significantly higher overall survival and disease-free survival rates. Multivariate Cox analysis revealed that tumor stage, more than 3 positive axillary lymph node involvement, and breast cancer subtype as significant factors for overall survival and disease-free survival (p<0.05). Triple Negative subtype had a higher relative hazard of local recurrence and distant metastasis (HR=2.69, 95% CI=1.47; 4.95). Conclusions: Breast cancer subtype has significant impact on overall survival and disease-free survival rates. While Luminal A and luminal B HER2 negative subtypes have better outcome, triple negative and HER2- subtypes remain poor. Keywords: Breast cancer, molecular subtypes, radiotherapy, survival.Download Full Article |
Abstract : An Inquiry on the Social and Education Status of Women from Northern Cameroon Suffering Cervical Cancer and the State of Knowledge of their Disease
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Abstract: Background: Cervical cancer is a major cause of women death worldwide. The reduction of the mortality and morbidity of this pathology depends on the early detection based on powerful suitable screening methods, that will lead to optimal treatment strategies. However in some rural region of developing countries, it is very difficult to get access to standard screening methods, alternative screening methods, cheaper and easy to handle are then useful. Objective: The aim of this work was to test the sensitivity and specificity of VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol iodine) as screening test of cervical cancer compared to the Pap Smear, evaluating the feasibility in health formation in the North Cameroon region, of implementing epidemiological surveillance of cervical cancer based on early diagnosis using the VIA-VILI association Method: 309 women age 20 to 62 years were recruited in this study, 307 were included in the statistical analyzes. Each woman was screened for cervical cancer by a conventional Smear and visual inspection with acetic acid 5% and the lugol solution. Results: We found in our study a prevalence of precancerous lesions of cervix at 12.70%. The risks factors of cervical cancer identified are age, matrimonial status, age of first sexual intercourse and parity. The association of VIA and VILI showed a sensitivity, specificity, positive and negative predictive value respectively about 93.58%; 97.01%; 82.01%, 99.04%. Conclusion: Compared to PAP Smear, VIA or VILI could be used as an alternative screening methods for cervical cancer in developing countries. However, histology test was recommended to use a « Gold Standard » to evaluate the test accuracy of VIA/VILI because it can be used to diagnose cancer, while PAP smear cannot. Keywords: Sensitivity, specificity, diagnosis,VIA-VILI, cervical cancer. Download Full Article |
