The Relation between Plasma Levels of Thrombomodulin and Endothelial Dysfunction in Syrian Children with Acute Lymphoblastic Leukemia
Pages 131-134

Rana Aldabbas and Jumana Alsaleh
DOI: http://dx.doi.org/10.6000/1927-7229.2017.06.03.2

Published: 31 August 2017

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.
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An Inquiry on the Social and Education Status of Women from Northern Cameroon Suffering Cervical Cancer and the State of Knowledge of their Disease
Pages 142-147

Armel Herve Nwabo Kamdje, Georges Kalgong, Richard Simo Tagne, Jeremie Mbo Amvene and Charlette Nangue

DOI: http://dx.doi.org/10.6000/1927-7229.2017.06.03.3

Published: 14 December 2017

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.

Association between Molecular Subtypes and Survival in Patients with Breast Cancer
Pages 135-141

Mehmet Fuat Eren, Ayfer Ay Eren, Birsen Yücel, Seher Bahar, Ahmet Cinkaya, Rayna K. Matsuno and Nuran Beşe
DOI: http://dx.doi.org/10.6000/1927-7229.2017.06.03.3

Published: 31 August 2017

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.

Emerging Role of ¹⁷⁷Lu in Nuclear Oncology: A Brief Review
Pages 148-153

Khan Anna and Chadha D. Vijayta
https://doi.org/10.6000/1927-7229.2017.06.04.2

Published: 14 December 2017

Abstract: With the innovations in nuclear medicine techniques, Lutetium 177 (¹⁷⁷Lu) has epitomized as a revolutionary theranostic agent- with both scintigraphic and therapeutic properties. The present review focusses on the introduction of ¹⁷⁷Lu as a promising modality for tumor diagnosis and therapy in widespread metastases . Being a shorter β-range emitter providing better irradiation of smaller tumor volumes, ¹⁷⁷Lu- based PRRT is being increasingly used in patients with somatostatin receptor positive neuroendocrine tumors. Clinical trials with ¹⁷⁷Lu–DOTATATE and ¹⁷⁷Lu–DOTATOC have gained considerable interest in recent years with successful tumor regression in patients with malignant metastatic neuroendocrine tumors. Especially, therapy with ¹⁷⁷Lu-DOTATATE PRRT has reported to significantly improve the quality of life of Gastroenteropancreatic NET patients because of higher affinity of DOTATATE for the somatostatin type 2 receptors. In addition, this review also sheds light on the diagnostic and palliative aspects of ¹⁷⁷Lu which also serves to be an attractive candidate for the preparation of radiopharmaceuticals for radiation synovectomy of small to medium sized joints. Enlisting all the said features, ¹⁷⁷Lu is strongly emerging as a promising theranostic agent that could possibly endow Nuclear Medicine an edge over other conventional therapies in near future.

Keywords: Theranostic agent, somatostatin receptor, radionuclide therapy, radioimmunotherapy, imaging agent.