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.
Abstract
Praise be to Allah and prayers and peace be upon our Prophet, Muhammad, his family and all of his companions,
This research addresses the issue of judge's preaching to the litigants and witnesses; it is a very significant issue since the judge cannot know the insides and facts, but it issues judgments based on the hearings. Since people are originally wrong-doing and ignorant, they, therefore, commit injustice, oppression, false adversarial, and false testimony. However, some people can possibly retreat and return to the right, after being inattentive or recalcitrant, by preaching. This fact led scholars to talk about the judge's preaching to litigant and witnesses and this research is conducted
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The research derives its importance from the fact that it is related to the developments in the concepts and areas of marketing in various fields, and it has a role in identifying the gain of new markets, where it is specialized to provide a political product and identify the mechanism of marketing the p
... Show MoreThyroid disease is a common disease affecting millions worldwide. Early diagnosis and treatment of thyroid disease can help prevent more serious complications and improve long-term health outcomes. However, thyroid disease diagnosis can be challenging due to its variable symptoms and limited diagnostic tests. By processing enormous amounts of data and seeing trends that may not be immediately evident to human doctors, Machine Learning (ML) algorithms may be capable of increasing the accuracy with which thyroid disease is diagnosed. This study seeks to discover the most recent ML-based and data-driven developments and strategies for diagnosing thyroid disease while considering the challenges associated with imbalanced data in thyroid dise
... Show MoreThe current study deals with the performance of constructed wetland (CW) incorporating a microbial fuel cell (MFC) for wastewater treatment and electricity generation. The whole unit is referred to as CW-MFC. This technique involves two treatments; the first is an aerobic treatment which occurs in the upper layer of the system (cathode section) and the second is anaerobic biological treatment in the lower layer of the system (anode section). Two types of electrode material were tested; stainless steel and graphite. Three configurations for electrodes arrangement CW-MFC were used. In the first unit of CW-MFC, the anode was graphite plate (GPa) and cathode was also graphite plate (GPc), in the second CW-MFC unit, the anode was stainless st
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