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Chromogenic in Situ Hybridization Technique versus Immunohistochemistry in Assessment of HER2/neu Status in 448 Iraqi Patients with Invasive Breast Carcinoma

BACKGROUND: The rapidly growing knowledge regarding factors controlling tumour growth, with the new modalities of therapy acting on the biological activity of the tumours draw the attention of most cancer researches nowadays and represent a major focus for clinical oncology practice. For the detection of HER2/neu protein overexpression and gene amplification, immunohistochemistry (IHC) and in-situ hybridisation (ISH) is the recommended techniques, respectively, with high concordance between the two techniques. The current United Kingdom recommendations for HER2/neu testing are either for a two-tier system using IHC with reflex ISH testing in equivocal positive cases, or a one-tier ISH strategy. AIM: To compare the results of HER2/neu gene status in patients with breast carcinoma obtained by chromogenic in situ hybridisation with those obtained by immunohistochemistry, and to compare these results with hormonal receptors expression by immunohistochemistry and with age of patients.METHODS: Immunohistochemistry technique was used for evaluation of status of estrogen receptors (ER) and progesterone receptors (PR) and HER2/neu protein expression in 448 Iraqi patients with invasive breast carcinoma with different grades and histological types and then chromogenic in situ hybridization (CISH) technique was applied for all scores of HER2/neu to detect the gene status and compare the results in all negative, equivocal and positive cases by immunohistochemistry (IHC). The cases were referred from different centres, and IHC and CISH techniques were done in central public health laboratory in Baghdad over 28 months, from July 2013 to November 2015. A comparison of the results was made to find the relationship between HER2/neu and hormone receptors status and other clinical parameters like patients age. RESULTS: The mean age of the study cases was 49.08 years, ranging from 24 to 83 years. Of the 448 cases of breast carcinoma, 44 (9.8%) cases were of score 0 by IHC, none of them (0%) showed HER2/neu gene amplification by CISH. 71(15.8%) cases were of score 1 by IHC, 15 (21.12%) of them showed HER2/neu gene amplification by CISH, all were of low amplification. There were 306 (68.3%) cases of score 2 by IHC, of which 102 (33.33%) cases showed HER2/neu gene amplification by CISH, with 79 (25.81%) of them with low amplification and 23 (7.51%) cases with high amplification, while only one case (0.32%) remained in equivocal category. In score 3, all the 27 (6.0%) cases showed gene amplification with 12 (44.44%) cases with low amplification and 15 (55.55) cases with high amplification with overall percentage of gene amplification in score 3 of 100%. There was a significant inverse relationship between hormone receptors (ER and PR) status and HER2/neu gene amplification. No significant relationship was found between the patient’s age and HER2/neu gene amplification.CONCLUSION: Although immunohistochemistry is a widely used, less expensive and reliable test, we strongly advice performance of chromogenic in situ hybridization in assessment of HER2/neu gene status in all cases diagnosed with breast carcinoma as significant number of cases that were reported as negative by immunohistochemistry showed positive amplification by chromogenic in situ hybridization and can get benefit from anti-HER2 targeted treatments.

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Publication Date
Fri Sep 01 2017
Journal Name
Gulf Journal Of Oncology
Clinical and Pathological Characteristics of Triple Positive Breast Cancer among Iraqi Patients

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 th

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Publication Date
Thu Oct 13 2016
Journal Name
Brazilian Journal Of Oral Sciences
Expression of TIMP-2 in HPV-16 infected oral squamous cell carcinoma in patients in Iraq

Aim: To determine the expression of tissue inhibitors of metalloproteinases (TIMP-2) in oral squamous cell carcinoma (OSCC) and the difference in its expression level between positive and negative HPV-16 (human papilloma virus- 16) OSCC patients. Methods: This study was conducted on 33 biopsies obtained from patients with OSCC and 10 normal oral mucosa as controls. In situ hybridization (ISH) was used to investigate the presence of HPV-16, while immunohistochemistry (IHC) was used to estimate the expression level of TIMP-2. Results: The TIMP-2 was expressed in 27 (81.8%) of OSCC sections with no significant difference between its expression level in HPV-16 positive and HPV-16 negative OSCC cases (p=0.058). TIMP-2 was found to be hig

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Macrovascular and microvascular complications in type 2 diabetic Iraqi patients treated by metformin and glibenclamide versus metformin and sitagliptin

Background: In type 2 diabetes mellitus there is a progressive loss of beta cell function. One new
approach yielding promising results is the use of the orally active dipeptidyl peptidase-4 (DPP-4)
inhibitors for type 2 diabetes mellitus.
Objective: This study aims at comparing the possible occurrence of macrovascular & microvascular
complications in Iraqis patients with type 2 diabetes mellitus using two combinations of drugs
metformin + glibenclamide and metformin + sitagliptin.
Methodology: Sixty eight T2DM patients and 34 normal healthy individuals as control group were
enrolled in this study and categorized in to two treatment groups. The group 1 (34 patients ) received
metformin 500 mg three times daily

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Publication Date
Thu Mar 09 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Evaluation of Mg, Cu, Zn, Cr and Mn Concentrations in Iraqi patients’ female with Breast Cancer.

To investigate the concentration and role of certain important elements in 30 patients women with breast cancer (without treatment, with treatment, and treated but recancer) by using statistical analysis. The serum concentration of some important elements (Mg, Cu, Zn, Cr, and Mn) of the patients with breast cancer, and (7) healthy control women it is found that: there is a significant increase in the concentration of (Mg, Zn, and Mn), but significant decrease in Cu concentration in all breast cancer patients compared with the healthy control. And significantly higher in Cr concentration in notreated and treated with recancer, but lower in treated patients as compared with healthy control.

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Publication Date
Wed Nov 20 2024
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of serum and salivary ceruloplasmin level in patients with oral lichen planus

Background: Oxidative stress is a deleterious process that can be an important mediator of damage to cell structures and consequently various disease states. Exposure to free radicals from a variety of sources has led organisms to produce a series of defense mechanisms. The antioxidant ceruloplasmin is a copper-containing ferroxidase that can oxidize ferrous iron (Fe2+) to its nontoxic ferric (Fe3+) form. Ferrous iron (Fe2+) is extremely damaging because of its ability to generate toxic free radicals. Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease of unknown etiology. Previous studies reported that reactive oxygen species may be involved in the pathogenesis of lichen planus. The aim of this study was to estimate the

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of stressful life events for patients with substance abuse in Baghdad city

Objective: The present study aims to assess the stressful life events for patients with substance abuse in Baghdad city.
Methodology: A descriptive study was carried out at (Baghdad teaching hospital and Ibn-Rushed Psychiatric hospital).
Starting from 1
st of December 2012 to 3
rd of July 2013, A non-probability (purposive) sample of 64 patients that
diagnosed with substance abuse, the data were collected through the use of semi-structured interview by
questionnaire, which consists of three parts sociodemographic data, medical information, and Life events scale
consists of 49-items distributed to six domains including, family and social domain, health domain, security, legal and
criminal domain, work and school do

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Publication Date
Wed Oct 24 2018
Journal Name
Al-kindy College Medical Journal
Echocardiographic assessment of Left Ventricular Dyssynchrony in Hypertensive Patients with Normal Systolic Function

Background: Normal Left Ventricular systolic function is present in nearly 50% of patients with congestive heart failure, the majority of such patients have systemic hypertension. Recent studies have demonstrated Left Ventricular dyssynchrony among patients with heart failure and normal systolic function. The co-existence between Left Ventricular dyssynchrony and hypertension with normal systolic function (with no clinical evidence of heart failure) is less well understood.

Objective:

To assess the Left Ventricular dyssynchrony among hypertensive patients with normal systolic function by using Tissue doppler imaging.To find out the associations between the LV dyssynchrony and other global

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Publication Date
Tue Jul 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Assessment of Inhaler Misuse in Asthmatic Patients.

Back ground: Metered dose inhalers (MDIs) are important devices used in treatment of asthma. It has got lots of benefits and some drawbacks depending on usage technique, with proper technique and training the drawbacks can be minimized.

Objectives:  Estimate the percentage of asthmatic patients using the metered dose inhalers improperly both in technique and dose, and detect the main factors associated with its improper use.

J Fac Med Baghdad

2014; Vol.56, No .2

Received Dec .2013

Accepted Mar. 2014

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Publication Date
Sun Apr 04 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Iraqi Breast Cancer: A Review on Patients' Demographic Characteristics and Clinico-Pathological Presentation.

Background: Breast Cancer is the commonest type of malignancy in Iraq. The Iraqi Cancer Registry displays an obvious trend for the disease to affect younger women with advanced stages at the time of presentation. This report presents a review on the main demographic characteristics and clinicopathological parameters in Iraqi patients diagnosed with breast cancer.
Patients & Methods: The study was carried out on 721 out of a total of 5044 patients (14.3%) who complained of palpable breast lumps that were diagnosed as cancer. The procedure for tumor nuclear DNA Ploidy assessment was performed by means of Image Cytometry. Immuno-cytochemical and  histochemical assays were applied for the determination of

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Publication Date
Wed Apr 03 2013
Journal Name
Iraqi Journal Of Medical Sciences