Anil Kumar Bahadur

SERUM LIPID PROFILE AND ITS RELATIONSHIP WITH HOST IMMUNITY IN CARCINOMAS OF THE BREAST AND UTERINE CERVIX

Carcinomas of the uterine cervix and breast, which have a different etiopathogenesis, are the most common malignancies among Indian women. Between these two cancers a comparative study was undertaken in which serum lipids were assessed along with host immunity. Thirty randomly selected cases each of breast and cervical carcinoma, and 20 matched healthy control women were studied by means of standard procedures. Significantly higher (P < 0.001) mean levels of triglycerides (x = 192.1 mg/dl, SD ± 113.5) and total cholesterol (x = 212.9 mg/dl, SD ± 49.78) were observed in breast cancer as compared to controls or cervical cancer patients. Patients with cervical cancer had low mean values of all lipid fractions. Women with the above malignancies also showed a significantly decreased CD3+ and CD4+ population (P < 0.001), while there was a significant increase in CD8+ cells (P < 0.005) compared to normal controls. Interestingly, a significant relationship (P < 0.05) was observed between CD8+cells and LDL-cholesterol among the cancer patients (r = 0.3652 and r = 0.4298 for carcinomas of breast and cervix, respectively).

Management of chronic hemorrhagic radiation proctitis

Rectal bleeding secondary to radiation proctitis is the most dreaded complication of pelvic radiotherapy. Its management remains a perplexing problem despite the availability of multiple treatment modalities. Patients are usually managed on a “hit and miss” basis at most centers. Steroid, 5‐aminosalicylic acid, short chain fatty acids and sucralfate enemas, hyperbaric oxygen therapy, and topical application of 4% formaldehyde all have been used with varying results. Surgical procedures such diversion colostomy or resection of involved segment have been proposed for refractory bleeding. Endoscopic methods are being increasingly adopted in the form of bipolar electrocoagulation, heat probe coagulation, photoablation, Nd:YAG laser and preferably argon plasma coagulation. The utility of conservative approaches remains far below desirable levels. Onset of hemorrhagic recurrence represents a major obstacle that leads to a need for repeated therapeutic sessions and sometimes invocation of radical techniques. This review discusses various treatment modalities and aims to identify their efficacy and limitations. A critical review was conducted of published reports regarding management of chronic hemorrhagic radiation proctitis (CHRP). Although there are few prospective randomized trials, enough evidence is available to conclude that argon plasma coagulation represents the current treatment of choice.

Malignant fibrous histiocytoma of the chest wall masquerading as medullary breast carcinoma: a case report.

BACKGROUND Cytologic diagnosis of malignant fibrous histiocytoma can be problematic, as these neoplasms are known to mimic multiple other conditions. CASE A fine needle aspirate from a 60-year-old woman was diagnosed at 2 institutions as medullary carcinoma of the breast. The patient received neo-adjuvant chemoradiotherapy before the tumor war excised. Gross pathologic examination and histomorphology on routine staining were compatible with the cytologic diagnosis. The accurate diagnosis of pleomorphic-storiform-type malignant fibrous histiocytoma was a surprise and was established with immunocytochemical stains. In retrospect, it was thought that clinical and radiologic overlap, creating a high index of suspicion for a breast neoplasm and compounding the cytologic appearance of a medullary carcinoma with spindle cell metaplasia and syncytial cells, was responsible for the error. CONCLUSION This case highlights a potential cytodiagnostic pitfall and the importance of establishing a definitive tissue diagnosis in the face of equivocal cytologic findings.

Sex hormone binding globulin in breast cancer

The present study was undertaken to determine the significance of sex hormone binding globulin, the major and specific binding protein for testosterone and estradiol, in breast cancer. Among breast cancer patients, lower serum levels of Sex hormone binding globulin and higher levels of testosterone were observed. Sex hormone binding globulin showed an inverse relationship with testosterone and total cholesterol, and a direct relation with HDL-cholesterol. By the western blot analyses, Sex hormone binding globulin was detected in all biological samples that we examined. In the breast tumor tissue sections, immuno-staining for Sex hormone binding globulin was confined in cell cytoplasm and 29% cases were positive, which showed no association with the investigated prognostic markers of breast cancer such as ER and HER-2/neu over-expression. In this study, decreased circulating levels of Sex hormone binding globulin in breast cancer patients possibly indicate higher bioavailable estrogens.

Status of epidermal growth factor receptors family in hormone-dependent carcinomas of the breast and prostate with reference to serum lipids and lipoproteins.

There are numerous growing evidences of resemblance between carcinomas of the breast and prostate. A total of 45 cases of these two hormone-dependent cancers along with appropriate controls were subjected for status of epidermal growth factor receptors as well as serum lipid profile. Paraffin embedded tissue sections from aforesald tumours were analysed by immunohistochemical staining for epidermal growth factor receptor (EGF-R), c-erbB-2 oncoprotein, estrogen receptor (ER) and progesterone receptor (PgR). Sera from same individuals were studied for serum lipid profile analysis. The study revealed that immunoexpression of all receptor proteins (EGF-R). c-erbB-2 was significantly higher in breast carcinoma. In addition, mean levels of triglycerides, total cholesterol, LDL-cholesterol were found to be significantly elevated while the level of HDL-cholesterol was observed to be lower among patients with breast cancer as compared to matched controls. Further, ER-positive breast cancer cases have significantly higher mean level of HDL-cholesterol when compared with ER-negative breast cancer patients. Contrary to this, no alteration in different serum lipid fractions was noticed among the patients with prostate cancer. However, a positive relationship was noticed between immunoexpressions of EGF-R and c-erbB-2 in prostate cancer.

Osteosarcoma with cutaneous-metastases : A case report

BACKGROUND Osteosarcomas, despite their aggressive nature and propensity to metastasize, only rarely give rise to skin deposits. CASE We report a case of a femoral osteosarcoma in which cutaneous scalp and neck metastases developed 3 years after treatment of the primary disease. Fine needle aspiration was pivotal in diagnosing the secondary disease. CONCLUSION Only 8 instances of cutaneous metastases from an osteosarcoma have been previously reported. We recommend early investigation of such nodules with fine needle aspiration cytology and inclusion of multiagent chemotherapy as part of the treatment protocol in all patients with osteosarcoma.

Serum lipids, lipoproteins and sex-hormone binding globulin in breast cancer.

Serum levels of various lipid parameters, i.e., triglycerides, total cholesterol, alpha lipoprotein or high density lipoprotein (HDL)-cholesterol and beta lipoprotein or low density lipoprotein (LDL)-cholesterol were measured in a total of 138 histologically proven cases of breast cancer along with 146 control women. The mean levels of serum triglycerides, total cholesterol and LDL-cholesterol were found to be significantly higher in breast cancer cases as compared to controls. However, lower mean levels of serum HDL-cholesterol and sex-hormone binding glubulin (SHBG) were observed in breast cancer patients than the control subjects. The results indicate a probable relation between serum lipids and the activity of sex-hormones. Moreover, the study reflects an overall disturbance of lipid metabolism in the pathological process of breast cancer.

SERUM OESTRADIOL IN WOMEN WITH CARCINOMAS OF THE BREAST AND UTERINE CERVIX

Endogenous oestrogens are thought to be involved in breast cancer, but few studies could show the direct relationship between hormones and pathological process of the disease. In the present study, oestradiol was estimated in the serum of pre-and postmenopausal breast cancer patients along with normal healthy controls and patients with carcinoma of the uterine cervix which is not dependent on oestrogens. Premenopausal patients with breast cancer showed higher levels of oestradiol as compared to premenopausal control women as well as cervical cancer patients. Whereas, no statistically significant differences were observed in serum oestradiol levels amongst postmenopausal groups of breast cancer, cervical cancer and normal women. The result of the study reflects the association of oestradiol as well as its difference in the pathological events of pre and postmenopausal breast cancer.

A rare case of two malignancies: Carcinoma of the breast and uterine cervix

A female patient who had two primary cancers was investigated. Biochemical analysis of patients serum for different parameters indicated an alteration in the metabolic process. Prognostically, the patient has shown favourable clinical features.