Background: Breast cancer is the most common malignancy affecting the Iraqi population and the leading cause of cancer related mortality among Iraqi women. It has been well documented that prognosis of patients depends largely upon the hormone receptor contents and HER-2 over expression of their neoplasm. Recent studies suggest that Triple Positive (TP) tumors, bearing the three markers, tend to exhibit a relatively favorable clinical behavior in which overtreatment is not recommended. Aim: To document the different frequencies of ER/PR/HER2 breast cancer molecular subtypes focusing on the Triple Positive pattern; correlating those with the corresponding clinico-pathological characteristics among a sample of Iraqi patients diagnosed with the disease. Patients and Methods: This retrospective study involved 570 female patients diagnosed with breast cancer who visited the Main Referral Center for Early Detection of Breast Cancer and the National Cancer Research Center. The requested data was mainly extracted from an established information system database, developed by the principal author over a 4-years period from 2012 to 2016. The registered information comprised data related to clinical presentation, diagnostic and pathologic findings. ER, PR and HER2 status were analyzed immunohistochemically and the detected profiles were correlated with the corresponding clinico-pathological characteristics. Results: The rates of ER (+), PR (+) and HER-2 (+) tumors were 66.8%, 64% and 29.3% respectively. The tumor marker expression status was documented in eight subtypes; 83 cases (14.6%) of the examined breast carcinomas were categorized as ER+/PR+/HER2+ (Triple Positive/Luminal B), 89 cases (15.6%) were ER-/PR-/HER2- (Triple Negative), 241 (42.2%) were ER+/PR-/HER2- (Luminal A) while 67 (11.8%) showed ER-/PR-/HER2+ expression (HER-2 variant). No significant variations were noted when comparing age, menopausal status and tumor grade of Luminal B pattern to Luminal A and the rest of the studied subtypes. Although our data revealed a statistical difference with respect to the distribution of tumor types; where infiltrative ductal carcinoma constituted the major histology among patients with Triple Positive/Luminal B subtype (86.7% as compared to 67.6% in Luminal A), nevertheless, more than two third of those patients (67.4%) were diagnosed at earlier stages (I and II) compared to 55.2% of those in the remaining groups. Conclusions and Recommendations: Our findings support the hypothesis that the Triple Positive subtype might be driven primarily by the hormone receptor status. Further comprehensive surveys are recommended to focus on the intrinsic interactions and tumor cell heterogeneity of that pattern to avoid overtreatment and predict accurate response to therapy.
This research aims to test the relationship between "relational leadership as an independent variable and organizational energy as a dependent variable. The current research variables are among the recent and important variables for the development of organizations, and for the purpose of explaining the relationship and influence between the variables, a set of goals has been formulated, including providing the interested and scientific and theoretical information explaining the nature of the variables The research, and the extent to which its causes are reflected in the research sample to increase the interest of the research organization’s organization and make it more appropriate to the required performance in light of a cha
... Show MoreThe Experiment was carried out to determine the level vibration transfer in three axes Horizontal X, Lateral Y and Vertical Z direction to seat driver tractor, Vector sum of vibration and Daily Vibration Exposure (8 hours) in seat driver tractor, and vibration in steering wheel tractor, Heart Rate, Systolic and Diastolic blood pressure and temperature were measure to all Drivers before and after used Chisel plow in operation tillage. Statistical analysis system was used, Split-Split Plot Design under Randomized Complete Block Design, Three factors were used in this experiment included Two types of Soil Moist and Dry soil which represented main plot, Three Velocity Tractor was second factor included 1.6,3.5 and 5.4 km/hr and Three Drivers Tr
... Show MoreInflammation of the tonsils could be described as acute tonsillitis, mainly due to infection. Recurrent tonsillitis could be defined as 3-7 episodes during the first 3 years of age. Vitamin D, which is a neuro-hormone with pleiotropic biological activities may modulate the immune response by alleviation, and stimulation of Th1 and Th2 cell proliferation, respectively, that influence the stimulation, synthesis, and secretion of both pro and anti-inflammatory cytokines. In this study we aimed to shed light on the levels of vitamin D in children with different episodes of tonsillitis in association with levels of interleukins (TNFα, IL-2, IL-4, IL-10). Blood samples were collected from 48 participants in 3 groups: control, acute tonsilliti
... Show MorePermanent deformation, fatigue and thermal cracking are the three typical distresses of flexible pavement. Using hydrated lime (HL) into the conventional limestone mineral additive has been widely practiced, including in Europe, to improve the mechanical properties of hot mix asphalt (HMA) concrete and as the result the durability of the constructed pavement. Large number of experimental studies have been reported to find the optimum addition of HL for the improvement on HMA concrete mechanical properties, moisture susceptibility and fatigue resistance. Pavement in service is under complex thermomechanical stress-strain conditions due to coupled atmospheric and surrounding environment temperature variation and the traffic loading. To predic
... Show MoreThe aim of the research is to identify the international accounting standards and accounting standards for Islamic banks, and to analyze the most important problems in the application of Islamic accounting standards, as well as to analyze some of the principles and methods used in the application of accounting standards in Islamic banks. The research was built on three hypotheses, the first being (there is a tangible impact on the application of international accounting standards for banks’ management of liquidity, achieving profits, maintaining property rights and fulfilling their obligations), and the second (the bank facing obstacles using Islamic accounting standards, as it is expected that when using Islamic accounting standar
... Show MoreThis research is a study of the difficulties of learning the Arabic language that faces Arabic language learners in the Kurdistan Region, by revealing its types and forms, which can be classified into two categories:
The first type has difficulties related to the educational system, the source of which is the Arabic language itself, the Arabic teacher or the learner studying the Arabic language or the educational curriculum, i.e. educational materials, or the educational process, i.e. the method used in teaching.
The second type: general difficulties related to the political aspect, the source of which is the policy of the Kurdistan Regional Government in marginalizing the Arabic language and replacing the forefront of th
... Show MoreThe aim of the present research is to illustrate γ-ray levels emitting from soil and bitumen producing from 238U, 232Th, and 40K along Abu-Jir Fault Zone. in the area extended from Al-Marj valley to Abu-Jir village using scintillometer device. Such study is important in environmental assessment to buildup data base about radioactivity. The concentration of natural radionuclides in the study area was determined to be occurring mostly in the clay minerals and organic matter. A high purity germanium spectrometer was used to detect the activity of these elements which ranged between 00.6±18.1- 1526±102, 0- 8.4±1.4, and 70.1±10.9- 328.2±73 in soil, and 28.2±5.6- 94±22.1, 0- 2.2±0.5, and 38.4±7.9- 70.1±10.9 in bitumen for 226Ra
... Show Morethe traumatic memory of their ancestors. The novel navigates sites of trauma, memory, and blues music while resisting the bourgeoisie-capitalist relationships that permeated not only white society but also African American communities. Jones’s novel presents the plight of an African American woman, Ursa, caught between the memory of her enslaved foremothers and her life in an emancipated world. The physical and spiritual exploitation of African American women who bear witness to the history of slavery in Corregidora materializes black women’s individuality. This article is framed by trauma studies as well as the Marxists’ concepts of commodification, accumulation, and production. Ursa, one of the Corregidora women, represents
... Show More