Predicting prognosis in lung cancer: Use of proliferation marker, Ki67 monoclonal antibody

An investigation was carried out to assess the prognostic significance of proliferation marker Ki67 in a group of lung cancer patients treated by surgery (limited disease). Tissue was not available for Ki67 immunostaining in inoperable group. The diagnosis is established by bronchial biopsy which does not carry enough tissue for frozen section and counting. This study is supplemented by estimating the prognostic significance of histological sub-types in the operable group and in a group of inoperable patients with extensive disease. These are usually treated by radiotherapy and/or chemotherapy. In all, 267 patients were studied including 105 treated by surgery. These patients attended King\u27s College and Brompton Hospital, UK, between 1986 and 1989. With regard to proliferation marker Ki67 done for the surgical group, only patients with Ki67 scores of less than 5% did survive significantly longer than the rest. Histology did not make any significant contribution in determining prognosis in both operable and inoperable groups. Although follow-up is limited (mean 20 months), Ki67 antibody seems promising in identifying low and high grade disease in the initial stage of lung cancer. It may prove useful for category of patients with high scores to be placed on chemotherapy/radiotherapy. Results suggest that in the case of lung tumour, proliferative activity is a better prognostic indicator than histological type

Association of Epstein Barr Virus (EBV) with nasopharyngeal carcinoma (NPC)

Aim: To observe the frequency of nasopharyngeal carcinoma (NPC) and its association with Epstein Barr Virus (EBV) infection. Setting: This study included consecutive cases of nasopharyngeal carcinoma, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi in the period of two years (1996-97). Methods: These tumors were initially evaluated on H&E stained sections. The tumors showing evidence of keratinization were excluded from the study. The Epstein Barr Virus was detected with the help of Polymerase chain reaction in formalin fixed, paraffin embedded tissue sections. Results: During the study period, seventeen cases of nasopharyngeal carcinoma were diagnosed which comprised 0.3% of all malignant tumors. The age ranged from 5 years to 70 years with male to female ratio of 2.4:1. The NPC was more prevalent in adults (71%) as compared to children (29%) under 15 years. Six cases (35%) exhibited positive signal for Epstein Barr Virus. Conclusion: Nasopharyngeal carcinoma is an infrequent tumor. The prevalence of Epstein Barr virus infection in nasopharyngeal carcinoma is quite low as compared to other regions of the world

Risk factors for cardiovascular disease in school children--a pilot study.

OBJECTIVE: To assess the frequencies of risk factors for cardiovascular disease in school children. The information may help in designing interventions aimed at modifying unhealthy lifestyle in children, which may reduce the later incidence of cardiovascular disease in adults. METHODS: A cross-sectional study was conducted on 206 students (ages 14-18 years), enrolled in higher secondary school. Students were interviewed about their lifestyles, family history of cardiovascular disease and its risk factors. Moreover, they were assessed for height, weight and blood pressure. RESULTS: Twenty nine percent of the children were physically inactive, 31% were taking unhealthy diet daily, 21% were overweight (BMI \u3e or = 25) and 6% were smokers. History of paternal smoking was reported by 36% of the children, and among them 76% of fathers smoked in the presence of their children. Family history of cardiac disease, hypertension and diabetes were positive in 4%, 23% and 16% of the children respectively. Overall, 58% of the children had at least one modifiable risk factor. CONCLUSION: Majority of the children had modifiable risk factors for cardiovascular disease. Prevention efforts are required early in life, using strategies for behavioral modification and health promotion

Morphological pattern and frequency of thyroid tumors

Objective: The present study was done to evaluate the frequency of thyroid cancer and to find out the prevalence of histological types of thyroid tumor with respect to age and sex group.Setting: This study included consecutive cases of malignant tumors of thyroid gland, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997).Methods: These cases were evaluated on H & E stained sections from paraffin embedded 10% buffered formalin fixed tissue blocks. Special stains and immunohistochemical analysis were performed whenever required.Results: A total of 8541 malignant tumors were diagnosed in a period of 3 years which included 103 (1.2%) cases of thyroid cancer. Thyroid tumors were more prevalent in females with female to male ratio of 2.6:1. Papillary carcinoma (69%) was the most common histological type of thyroid tumors, followed by follicular carcinoma (11.6%), medullary carcinoma (9.7%), anaplastic carcinoma (5.9%), non-Hodgkin\u27s lymphoma (2.9%) and unclassified tumors (0.9%) in order of frequency.Conclusion: Thyroid cancer was more common in females. Papillary carcinoma was the most common histological type of thyroid tumors in females as well as in males. Papillary carcinoma was more prevalent in third, fourth and fifth decades of life while follicular and anaplastic carcinomas were more frequent after the fourth decade of life

p53 and PCNA expression in benign, atypical and malignant meningiomas

Objective: Alterations: p53 genes are turning out to be the most common genetic alterations in human cancers. Due to long half-life of mutated p53, its detection is possible by immunohistochemistry. Proliferating cell nuclear antigen (PCNA) is expressed by dividing cells, hence has been shown to correlate with prognosis. We have used monoclonal antibodies protein DO-7 (p53) and PC10 (PCNA) to see whether their expression correlates with histological grading in meningethelial tumour.Material and Methods: a Twenty nine meningiomas (20 benign, 7 atypical and 2 malignant) were selected from the records of our laboratory. p53 and PCNA expression was sought by immunohistochemistry using Peroxidase Anti Peroxidase (PAP) technique.Results: Four benign and 2 atypical meningiomas showed weak staining for p53. Both malignant meningiomas showed strong positivity for p53. Six benign meningiomas had less than 5% PCNA positivity, one 10% positivity and three showed 20% positivity. PCNA positivity ranged for 10-80% in atypical meningiomas. In two malignant meningiomas PCNA positivity was 70% and 90%.Conclusion: It is worthwhile to include p53 and PCNA expression along with histologic assessment in predicting outcome of meningiomas. A larger series with complete follow-up is essential in assessing value of these markers which unfortunately remains a dream in our country