Impact of size of the tumor, persistence of estrogen receptors, progesterone receptors, HER2neu receptors and Ki67 values on positivity of axillar lymph nodes at patients with early breast cancer with clinically negative axillar examination

Aim: The aim of the study was to identify factors that influence the positivity on axillar status at patients with early breast cancer with clinical negative axilla, at which were done radical surgery to breast but also radical lymphadenectomy of axillar lymph nodes.Material and methods: In the study were included 81 surgically treated patients with early breast cancer during 08-2015 to 05-2017 year. All the cases have been analyzed by standard histological analysis including macroscopic and microscopic analysis on standard H&E staining. For determining of molecular receptors immunostaining by PT LINK immunoperoxidase has been done for HER2neu, ER, PR, p53 and Ki67.   Results: Patients age ranged between 31-73 years, average of 56.86 years. The mean size of the primary tumor in the surgically treated patient was 20.33 + 6.0 mm. On dissection from the axilary pits there were taken out 5 to 32 lymph nodes, an average of 14. Metastases have been found in 1 to 7 lymph nodes, an average 0.7. In only 26 (32.1%) of the patients have been found metastases in the axillary lymph nodes. The univariant regression analysis showed that the size of tumor and presence of HER2 neu receptors on cancer cell influence on the positivity of the axillary lymph nodes. The presence of the estrogen receptors, progesterone receptors  showed that they do not have influence on the positivity for metastatic deposits in axillary lymph nodes. Multivariant model and logistic regression analysis as independent significant factors or predictors of positivity of the axillary lymph nodes is influenced from the tumor size only.Conclusion: Our study showed that the involving of the axillary lymph nodes is mainly influenced from the size of the tumor and presence of HER2neu receptors  in the univariant analysis points the important influence of positivity in the axillary lymph nodes but only size of the tumor in multivariate regressive analysis

Presentation of the Molecular Subtypes of Breast Cancer Detected By Immunohistochemistry in Surgically Treated Patients

INTRODUCTION: The detection of estrogen, progesterone and HER-2 neu receptors on the surface of the tumour cell is a significant prognostic factor, alone or in combination. The presence or absence of receptors on the surface of the tumour cell is associated with the conditional gene expression in the tumour cell itself. Based on these genetically determined expressions of the tumour cell, five molecular subtypes of breast cancer have been classified on the St. Gallen International Expert Consensus in 2011 that can be immunohistochemically detected, with each subtype manifesting certain prognosis and aggression.AIM: Analyzing the presentation of molecular subtypes of breast cancer that are immunohistochemically detected in surgically treated patients at the Clinic for Thoracic and Vascular Surgery.MATERIAL AND METHODS: We used the international classification on molecular subtypes of breast cancer which divides them into: Luminal A (ER+ and/or PR+, HER-2 negative, Ki-67 < 14%), Luminal B with HER-2 negative (ER+ and/or PR+, HER-2 negative, Ki-67 ≥ 14%), Luminal B with HER-2 positive (ER+ and/or PR+, HER-2+, any Ki-67), HER-2 enriched (ER-, PR-, HER-2+), and basal-like (triple negative) (ER-, PR-, HER-2 negative, CK5/6+ and/or EGFR+). A total of 290 patients, surgically treated for breast cancer, were analysed during 2014.RESULTS: In our analysis, we found that Luminal A was present in 77 (26.55%) patients, Luminal B HER-2 negative was present in 91 (31.38%) patients, Luminal B HER-2 positive was present in 70 (24.14%) patients, HER-2 enriched was present in 25 (8.62%) patients and basal-like (or triple negative) was present in 27 (9.31%) patients.CONCLUSION: Detecting the subtype of breast cancer is important for evaluating the prognosis of the disease, but also for determining and providing an adequate therapy. Therefore, determining the subtype of breast cancer is necessary for the routine histopathological assay

ПолициÑтична бубрежна болеÑÑ‚ - приказ на пациент

Was to present disease, over a patient review of policystic kidney disease, that need hospitalization many times – because of complications that follow it (uroinfection, calculosis, anaemia, chronical kidney insufficiency, hypertension, and cistes crack with hematury at first). Disease is with progressive development presented in worsened kidney function of other hospitalisations of a patient.Laboratory exams show (kidney test's at first) disorder in kidney function. That manifest in this concrete case with enlargement of concentration of excretory products in serum (in our case it is: total phenols – 1,0 mg%; kreatinin – 6,1 mg%; and urea – 228 mg%. There were leukocytes and proteins in urine attend. Sedimentation is much hastened (80/122), and anaemia is attend too.Radiological exams show – cistes attend in kidney – tissue pressing it together with all elements. We need this exams to confirm diagnosis of policistic kidney disease. Another elements to put this diagnosis are: big and different kidney, lumbal ache that intensified in movement, family history, hematury and uremy signes (anorexia, nausea, vomitus).ОÑновната цел на изработката на овој труд беше, да Ñо презентирање на иÑтиот дадеме приказ на ова заболување, кое изиÑкува повеќекратна хоÑпитализација на иÑтиот пациент, поради компликациите кои го придружуваат (уроинфекција, калкулоза, анемија, бубрежна инÑуфициенција, хипертензија и ред Ñе – руптура на циÑтите Ñо хематурија. Заболувањето има прогреÑивен тек, што Ñе гледа од влошувањето на бубрежната функција при повторните хоÑпитализации на пациентот.ЛабораториÑки претраги – а пред Ñе бубрежните теÑтови – укажуваат на пореметување на бубрежната функција, што во конкретниов Ñлучај Ñе манифеÑтира Ñо зголемување на концентрацијата на екÑкреторните продукти во Ñерумот (во нашиов Ñлучај тие изнеÑуваат: вкупни феноли – 1.0 мг%; креатинин – 6.1 мг%; а уреа - 228 мг%). Во урината Ñе приÑутни и леукоцити а и протеини. Седиментацијата е Ñилно забрзана (8/122), а приÑутна е и анемија.Радиолошките иÑпитувања укажуваат на приÑуÑтво на циÑти во бубрежниот паренхим, кого го  Ð·Ð°ÐµÐ´Ð½Ð¾ Ñо Ñите негови ÑоÑтавни елементи.Овие иÑпитувања Ñлужат за потврдување и уточнување на дијагнозата на полициÑтичната бубрежна болеÑÑ‚. ОÑтанатите податоци за поÑтавување на оваа дијагноза Ñе: големи и нееднакви бубрези, лумбална болка која Ñе заÑилува при движење, фамилијарноÑÑ‚, хематурија и знаци на уремија (губиток на апетит, гадење, повраќање)

СамоубиÑтвата во Скопје и околината во текот на 1979 година

The aim of our examination was to establish the number of suicides, oldness, sex, professions, calendar and meteorological time, place, manner and means of execution. Our basic duty was to analyse this phenomenon, which number rise slowly, from the year (by years), and find means to prevent.We used general returns about all executed suicides in Skopje and surroundings in the 1979 year by, SVR Skopje, that disposes of the special evidence for suicides. Ð¦ÐµÐ» на нашите Ñогледувања беше да Ñе Ñогледа и проучи: бројот на ÑамоубиÑтвата, полот и возраÑта на луѓето што извршиле ÑамоубиÑтво, календарÑко и мтеоролошко време во моментот на извршувањето како и дејноÑта (занимањето) на тие луѓе. При овие иÑпитувања, дојдовме до мошне интреÑни разултати. Проучувањата ги базиравме врз општите податоци за Ñите извршени ÑамоубиÑтва во текот на 1979 година во Скопје и околината, добиени од СВР Скопје, а до потполни податоци доаѓавме Ñо анктетирање – директно на членовите на потеÑното или поширокото ÑемејÑтво на луѓето кои што извршиле ÑамоубиÑтво, како и на луѓето кои во моментот на ÑамоубиÑтвото биле во непоÑредна близина. При тоа кориÑтевме Ñпецијален прашалник за анкетирање, кој е изготвен и ни е даден на раÑполагање од Ñтрана на тимÑка група при Клиника за нервни и душевни болеÑти при МедицинÑкиот факултет во Скопје, која интердиÑциплинарно ги проучува ÑамоубиÑтвата како појава