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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
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
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Publication Date
Mon Jul 01 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Frequency of Salivary Human Cytomegalovirus in Iraqi Patients with Chronic Periodontitis

Background: Periodontitis is a chronic inflammatory disease which is initiated by an infection of the oral microorganisms and it involves the humoral and cellular characteristics of the host response. The periodontal disease is found to develop due to a series of interactions among the periodontotrophic herpes viruses, the periodontopathic bacteria and the host immune reactions.Recent studies have demonstrated that various human viruses, especially human cytomegalovirus seems to play a part in the pathogenesis of periodontitis. Periodontitis is an infectious disease involving specific bacteria and viruses.
Objectives: The present study was initiated to evaluate the percentage of human cytomegalovirus in periodontitis patients and dete

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Publication Date
Wed Aug 30 2023
Journal Name
Baghdad Science Journal
Biochemical Action of Vaccines in Iraqi Patients with COVID-19 Infection

      The aim of the present study is to compare the biochemical action of the three vaccines taken in Iraq: Pfizer Biontech, AstraZeneca Oxford and Sinopharm based on biochemical parameters. Seventy COVID-19 Iraqi patients ( males and females ) were participated in the present study and classified into 7 groups : Gc :  COVID-19 patients ( without vaccine ) , Gp1: COVID-19 patients took one dose of Pfizer Biontech, Gp2 : COVID-19 patients took two doses of Pfizer Biontech, Ga1 : patients took one dose of AstraZeneca Oxford vaccine , Ga2: patients took two doses of AstraZeneca Oxford vaccine , Gs1 : patients took one dose of Sinopharm vaccine and Gs2:

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Publication Date
Tue Jul 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Molecular Characterization of Dystrophin Gene in Iraqi Patients with Muscular Dystrophy.

Background: Dystrophinopathies are the commonest forms of muscular dystrophy and comprise clinically recognized forms, Duchenne Muscular Dystrophy (DMD), and Becker Muscular Dystrophy (BMD). Mutations in the dystrophin gene which consist of large gene deletions (65%), duplications (5%) and point mutations (30%) are responsible for reducing the amount of functional dystrophin protein in skeletal muscle fibers.  This study concentrate mainly at the spectrum of deletions in the 'distal hot spot' region of the DMD/BMD gene in Iraqi DMD/BMD patients using multiplex PCR technique

Objectives: The aim of this study was to investigate the rate, and distribution of deletions in 10 exons of Dystrophin

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Publication Date
Wed Mar 15 2023
Journal Name
Bionatura
Evaluation of serum Interleukin 36 in Iraqi patients with Rheumatoid arthritis

Rheumatoid arthritis is a worldwide inflammatory chronic autoimmune disease with varying severity. Due to no definitive cure for this disease, current therapies aim to decrease the pain and slow further damage. The interleukin (IL)‐36 cytokine was little known for its role in rheumatoid arthritis; this research aimed to evaluate the serum IL36 levels in RA patients compared to healthy controls. This study included 80 patients with rheumatoid arthritis registered at the Rheumatology Clinic in Baghdad teaching hospital. The patients were divided into three groups based on the treatments received. Group 1 included patients treated with biological therapy (etanercept, adalimumab), Group2 patients with non-biological treatment (methotr

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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Science
Identification of Genomic Markers By RAPD-PCR Primers in Iraq Breast Cancer Patients

Random Amplification of Polymorphic DNA (RAPD) analysis was used in this study to direct the attention toward increasing the efficiency of early diagnosis of breast cancer in clinical laboratories at Iraq using recent PCR-dependent protocols and investigate DNA polymorphisms in addition to the detection of genomic markers. Blood samples were collected from 12 diagnosed females with breast cancer (malignant) patients, 12 females with breast benign tumor and 12 controls (normal females). DNA was extracted and RAPD-PCR was performed. The results showed unique profiles of amplified DNA fragments produced in genomic DNA of breast tumors by an arbitrary primers of A8, A11, A12, A13, A15 and A18. Out of the 6 primers used, 1 primer produced mon

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Publication Date
Wed Mar 01 2017
Journal Name
International Journal Of Cardiology
The role of myocardial performance index in assessment of left ventricular function in patients with valvular mitral regurgitation

Background: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca

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Publication Date
Fri Jan 13 2023
Journal Name
World Academy Of Sciences Journal
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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Barriers to Baseline Needs for Early Detection of Breast Cancer among Iraqi Female Patients

Background: Breast Cancer is the most common malignancy among the Iraqi population; the majority of cases are still diagnosed at advanced stages with poor prospects of cure. Early detection through promoting public awareness is one of the promising tools in its control. Objectives: To evaluate the baseline needs for breast cancer awareness in Iraq through exploring level of knowledge, beliefs and behavior towards the disease and highlighting barriers to screening among a sample of Iraqi women complaining of breast cancer. Methodology: Two-hundred samples were enrolled in this study; gathered from the National

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Publication Date
Fri May 25 2018
Journal Name
Open Public Health Journal
Comparative Study on the Clinicopathological Profiles of Breast Cancer Among Iraqi and British Patients

Background: Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middleaged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK. Objective: To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns. Methods: This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive b

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