Correlation between Biological Classification and Stromal Reaction in Breast Cancer

Background: Breast cancer is the most common cancer and a major cause of death from cancer in women. Understanding the factors, which can predict directly and indirectly the final fate of patients, can be useful in clinical decision-making and treatment choices.Materials and Methods: In a retrospective descriptive-analytic study, 108 pathological samples of patients with primary breast cancer collected during 2011-2017 from the department of pathology in Imam Hossein Hospital (Tehran Iran). Classified regarding the association of stromal reactions in tumor tissue including necrosis rate, lymphocyte infiltrating rate, and tumor desmoplasia with different types of breast tumors including four groups of Basal like, HER2/neu, Luminal B, and Luminal A based on biological biomarkers.Results: Mean age of the patients was 50.84±13.25 years. No significant relationship was found between age and type of groups. Majority of patients (60%) were in the pathological grade 2. A significant relationship was observed between three groups of Luminal B, and Basal-like with Grade 2 (p<0.05). Most patients suffered from intermediate desmoplasia which was significant only between three groups of Luminal B, HER2/neu and Basal-like (p<0.05). In terms of tumor necrosis, the majority of patients in the HER2/neu and Basal-like groups indicated non-extensive necrosis, which was significant (p>0.05). In both groups of Luminal A and Luminal B, most patients had no necrosis while the relationship between necrosis and pathological type of tumor was significant only in the Luminal B group (p>0.05). No significant relationship was found between the number of lymphocytes and the type of tumor.Conclusion: This study indicated the relationship between pathological types of breast cancers based on biomarkers with pathological grade, necrosis ratio and tumor desmoplasia. Determination of the pathological type of tumor based on the status of biological markers (HER-2/neu PR, ER, Ki67) in patients with breast cancer is recommended for making decision about therapeutic plan

Effects of cerebrolysin on functional outcome of patients with traumatic brain injury: a systematic review and meta-analysis

Background: Traumatic brain injury (TBI) remains a main public health problem being associated with high mortality and morbidity. The functional outcome of TBI remains unfavorable despite several surgical and medical therapies. Cerebrolysin is a neuropeptide with potential neuroregenerative entities. Objective: The aim of the current systematic review and meta-analysis was to investigate the effects of cerebrolysin on functional outcome in patients with moderate and severe TBI. Data sources: Online databases used included Medline, Scopus, EMBASE, Google Scholar, Web of Science, and Cochrane Library. Study eligibility criteria: All the relevant studies with randomized clinical trial and cohort design evaluating the effects of intravenous cerebrolysin vs placebo on functional outcome of patients with TBI within the English literature up to October 2018 were included. Study appraisal and synthesis methods: The articles were reviewed by two independent authors and the data were extracted to a data sheet. I-2 and Cochran's Q-statistics were used to assess heterogeneity. Based on the presence of significant heterogeneity across included studies, data were pooled using random-effects model with Dersimonian-Laird method and presented as standardized mean differences (SMDs) and corresponding 95% CI. Results: Five articles (5,685 participants) were included in the current meta-analysis. The overall pooled findings using random-effects models among patients with TBI indicated that intravenous administration of cerebrolysin significantly increased Glasgow Outcome Scale score (SMD = 0.30; 95% CI: 0.18 to 0.42; P<0.001; I-2: 87.8%) and decreased modified Rankin Scale score (SMD =-0.29; 95% CI: -0.42 to 0.16; P=0.05; I-2: 89.6%). Limitations: The results are mainly based on cohort studies and there is a lack of clinical trials in the literature. There is also heterogeneity among the studies regarding the dosage and duration of administration and the measurement of functional outcome. Conclusion: The results of the current study revealed that intravenous administration of cerebrolysin is associated with improved functional outcome in patients with TBI measured by the Glasgow Outcome Scale and the modified Rankin Scale scores