Publications by authors named "Loay M Gertallah"

9 Publications

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Choosing the Appropriate Individualized Adjuvant Chemotherapy in Stage III Colon Cancer Patients Under and Over 70 Years.

J Gastrointest Cancer 2021 Jul 20. Epub 2021 Jul 20.

Clinical Oncology & Nuclear Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Background: Colon cancer is one of the leading causes of cancer-related deaths worldwide. The increased incidence of comorbid diseases in elderly patients above 70 leads to the need of less aggressive strategies to be used in the adjuvant setting of stage III colon cancer.

Method: Our prospective cohort study was performed in the period from April 2017 to March 2020. Seventy-five patients with newly diagnosed stage III colon cancer received adjuvant chemotherapy after surgery. Patients who either received adjuvant chemotherapy less than 3 months due to intolerability or toxicity from medications or who have more than one type of cancers or metastatic disease from the start were excluded from the study. Patients' clinicopathological characteristics in relation to oxaliplatin- and non-oxaliplatin-based chemotherapeutic regimens were analyzed with survival assessment.

Results: In our study, patients above 70 had better overall survival (OS) in the non-oxaliplatin chemotherapy group (p-value = 0.032) in contrast to OS in patients under 70 which was better in the oxaliplatin group (p-value < 0.001). By comparing the OS between the two age groups, the OS was better in patients < 70 years (p-value = 0.001). Additionally, we found that the DFS in patients above 70 was better in oxaliplatin-based regimens than in the non-oxaliplatin group (p-value = 0.011) with better survival rates (81.8% vs 15.7%), and markedly high DFS in patients under 70 for oxaliplatin based regimens (p-value < 0.001), with survival rates (31.1% vs 0%). By comparing the DFS between the two age groups, the DFS was better in patients < 70 years (p-value < 0.001). The disease recurrence was in favor of the non-oxaliplatin group with significant p-value = 0.003, while mortality occurred more in the oxaliplatin group (p-value < 0.001).

Conclusions: The appropriate selection of a personalized strategy for treatment of stage III colon cancer plays an important role in the outcome of the disease. Our findings supported the use of oxaliplatin-based chemotherapy as a standard treatment option in the adjuvant management of stage III colon cancer patients in all age groups. The benefit of non-oxaliplatin-based chemotherapy was limited to patients above 70 which might be an effective option for elderly patients.
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http://dx.doi.org/10.1007/s12029-021-00666-2DOI Listing
July 2021

Prognostic and clinic-pathological significances of HOXB8, ILK and FAT4 expression in colorectal cancer.

Contemp Oncol (Pozn) 2020 30;24(3):183-192. Epub 2020 Oct 30.

Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Introduction: HOXB8 is a protein that was found to promote cancer proliferation and invasion. ILK is a protein kinase which has a role in carcinogenesis. FAT4 is a tumor homologue that has a role in EMT and autophagy regulation.

Aim Of The Study: To identify expression of Human HOXB8, Integrin-linked kinase (ILK1) and FAT homolog 4 (FAT4) in colorectal cancer (CRC) correlating their expression with pathological, prognostic and clinical parameters of CRC.

Material And Methods: We assessed the expression of HOXB8, ILK and FAT4 in fifty CRC patients and ten samples from nearby non-neoplastic colonic mucosa using immunohistochemistry.

Results: The expression of HOXB8 and ILK in CRC was positively associated with high tumor grade, advanced tumor stage, lymph node involvement ( < 0.001), occurrence of distant metastases ( = 0.003 and 0.024 respectively), higher incidence of tumor recurrence ( = 0.03, < 0.001 respectively), worse survival rates ( = 0.038 and 0.003 respectively). The expression of FAT4 in CRC was correlated with lower grade, early stage of the tumor, absence of lymph node involvement ( < 0.001) and lack of distant metastases ( = 0.011). High FAT4 expression was associated with absence of tumor recurrence ( < 0.001) and favorable survival rates ( < 0.001 and 0.003).

Conclusions: High immunohistochemical expression of HOXB8 and ILK in addition to low immunohistochemical expression of FAT4 was associated with unfavorable prognostic and pathological parameters of CRC.
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http://dx.doi.org/10.5114/wo.2020.100281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670183PMC
October 2020

TFAP2B, AP-1 and JAZF1 Expression in Tissues of Papillary Thyroid Carcinoma Patients; Clinical, Pathological and Prognostic Values.

Asian Pac J Cancer Prev 2020 Aug 1;21(8):2415-2421. Epub 2020 Aug 1.

Department of Biology, College of Science, University of Hafr Al Batin, Hafr Al Batin, Saudi Arabia.

Objective: Transcription factor activating protein 2 B (TFAP2 B) is a transcription factor that regulates many steps of embryogenesis, cell growth, apoptosis and recently oncogenesis and cancer progression. AP-1 is a transcription factor that is a downstream molecule of the MAPK signaling pathway. Juxtaposed with zinc finger gene 1 (JAZF1) is a recently detected transforming growth factor which has a role in carcinogenesis. Hence the present study aimed to assess those markers expression in tissues from patients with such cancer correlation their expression with clinic-pathological findings of the tumor and prognostic and follow-up findings of patients.

Methods: We have collected tissue samples from papillary thyroid cancer patients and adjacent non-neoplastic tissues from 80 patients. We assessed the expression of TFAP2B, AP-1 and JAZF1 using immunohistochemistry.

Results: Expression of TFAP2B was positively associated with lymph nodes metastases (p=0.003), distant metastases (p=0.002), recurrence of the tumor (p=0.002), unfavourable disease-free survival rate (p=0.003). AP-1 expression is positively associated with advanced stage (p=0.002), presence of extra-thyroid invasion (p=0.005), recurrence of the tumor (p=0.005), unfavorable disease-free survival rate (p=0.01). JAZF1 expression is negatively associated with huge tumor size (0.023), vascular invasion (p=0.007) and unfavorable overall survival rate (p=.030).

Conclusion: High expression levels of TFAP2B and AP-1 and low expression levels of JAZF1 were associated with unfavourable pathological, prognostic parameters and dismal patient's outcome.
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http://dx.doi.org/10.31557/APJCP.2020.21.8.2415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771927PMC
August 2020

Prognostic and clinicopathological values of tissue expression of MFAP5 and ITM2A in triple-negative breast cancer: an immunohistochemical study.

Contemp Oncol (Pozn) 2020 3;24(2):87-95. Epub 2020 Jul 3.

Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Introduction: Triple-negative breast cancer (TNBC) is a markedly aggressive molecular subtype of breast cancer; there is an urgent need to clarify the molecular mechanisms underlying the progression and metastases of BLBC, in order to find a novel targeted therapy. Microfibrillar-associated protein 5 (MFAP5) plays an essential role in the regulation of cell behaviour and survival. Integral membrane protein 2A (ITM2A) is a type II transmembrane protein, which is a member of a family of autophagy related proteins.The aim of this study was to assess the expression of MFAP5 and ITM2A proteins in tissues of BLBC using immunohistochemistry, in order to correlate the expression with clinicopathological and prognostic parameters of such aggressive cancer.

Material And Methods: The present study included sections from archived paraffin blocks retrieved from 120 patients with TNBC. We collected cases from three years, i.e. from 2016 to 2019. We assessed expression of MFAP5 and ITM2A using immunohistochemistry.

Results: High expression of MFAP5 and low expression of ITM2A was associated with advanced stage ( = 0.007), higher grade of tumour ( = 0.005 and = 0.004, respectively), the presence of lymph nodes metastases ( < 0.001 and = 0.002, respectively), lower three-year RFS rate ( < 0.001 and = 0.016, respectively), and lower three-year OS rate ( < 0.001).

Conclusions: MFAP5 and ITM2A are novel prognostic biomarkers for breast cancer and might be considered as promising therapeutic targets for patients with breast cancer, particularly TNBC molecular subtype, in the future.
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http://dx.doi.org/10.5114/wo.2020.97520DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7403766PMC
July 2020

The Diagnostic Value of Arginase-1, FTCD, and MOC-31 Expression in Early Detection of Hepatocellular Carcinoma (HCC) and in Differentiation Between HCC and Metastatic Adenocarcinoma to the Liver.

J Gastrointest Cancer 2020 Mar;51(1):88-101

Department of Medical Oncology, Faculty of Medicine, Zagazig University Zagazig, Zagazig, Egypt.

Background: Early detection of small HCC and differentiation between HCC from AC metastatic to the liver is very essential for surgical pathologists, due to different treatment modalities. Immunohistochemistry plays a very important role in such conditions. In our study, we aimed to identify the diagnostic benefits of Arginase-1, FTCD& MOC-31 in the early detection of HCC in normal or cirrhotic liver, differentiation between HCC and metastatic ACs to the liver, and for early detection of small micro-metastases from ACs to liver.

Materials And Methods: We included 20 samples from liver cirrhosis, 10 samples from normal liver tissue, 30 samples from primary HCCs in the liver, and 30 samples from metastatic ACs to the liver. We have evaluated Arginase-1, FTCD, and MOC-31 expression using immunohistochemistry.

Results: The sensitivity of Arginase-1 expression in differentiation between HCC and metastatic carcinoma was 93.3% and the specificity was 93.3%. The sensitivity of FTCD expression in differentiation between HCC and normal or cirrhotic liver and early detection of well-differentiated HCC was 90% and the specificity was 86.7%. The sensitivity of MOC-31 expression in differentiation between HCC and metastatic carcinoma was 90% and the specificity was 90%. The sensitivity of combination of panel of Arginase 1 + FTCD + MOC 31 expression in differentiation between HCC, metastatic carcinoma, and normal and cirrhotic liver was 93.3% and the specificity was 93.3%.

Conclusions: The combination of Arginase 1 + FTCD + MOC 31 expression was helpful in diagnosing most cases of HCC and metastatic carcinoma with high sensitivity and specificity.
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http://dx.doi.org/10.1007/s12029-019-00211-2DOI Listing
March 2020

The Expression of FOXE-1 and STIP-1 in Papillary Thyroid Carcinoma and Their Relationship with Patient Prognosis.

Iran J Pathol 2018 17;13(2):256-271. Epub 2018 Jul 17.

Dept. of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Background & Objective: Most patients with papillary carcinoma of the thyroid gland (PTC) havefavorable outcome,but sinceit has severe capability to invade the nearby tissues, there isa great risk of regional and distal lymph-nodes (LNs) metastases related to poor prognostic parameters, early recurrences, and distant metastasis that lead to bad patient outcome. Discovering other prognostic biomarkers for this cancer helps to detect early recurrences, invasion, expecting patient outcome, and possible use as therapeutic-targets for it. The , with the alternative name of , is one of thetranscription factors familiesthat is huge and containsa special fork-head-domain. It has a significant role in the differentiation and maturation of thyroid-follicular cells. Stress-induced phosphor-protein-1 (STIP-1), withthe alternative name ofheat-shock-protein-(HSP)organizing protein,is a 62.6-kD protein, with three parts of tetra-trico-peptide repeats (TPR), and is capable of interaction with heat-shock proteins forming structures that haveplethora of roles in variable cellular processes;e.g., cell cycles regulations, transcriptions, and RNA splicing.The current study aimed at exploring the relationship between and expressions, the clinicopathological parameters, prognosis, and survival of patients with PTC.

Methods: The current studyexplored and expressions by the immunohistochemical methods in 36 paraffin blocks retrieved from 36 patients of PTC, analyzed the relationships between their levels of expression,clinicopathological parameters, prognosis, and survival of patients.

Results: The high expression levels forboth and in PTC were associated with larger size of the tumor, extra-thyroidal extension, vessels invasion, LNs spread ( <0.001), presence of distant metastases (P values = 0.005 and 0.012, respectively) and higher stages of the cancer (P values =0.012 and 0.042, respectively).The over-expression was associated with shortened distant metastases free survival (DMFS) and shortened five-year overall survival rates (OS) ( <0.001).

Conclusion: Patients withadvanced PTC andunfavorable prognosis had high levels of both and expressions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339506PMC
July 2018

Prognostic and Clinic-Pathological Significances of SCF and COX-2 Expression in Inflammatory and Malignant Prostatic Lesions.

Pathol Oncol Res 2019 Apr 6;25(2):611-624. Epub 2018 Nov 6.

Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

The initiation of prostatic malignancy has been linked to chronic inflammation. Stem cell factor (SCF) is an inflammatory cytokine that is specific to the c-KIT receptor which is type III receptor tyrosine kinase (RTK). Cyclooxygenases (COXs) are the main enzymes which are responsible for prostaglandins production from arachidonic acid. COX2 is an enzyme which is produced under different pathological conditions. The aim of our study; is to investigate the clinicopathological and the prognostic significance of SCF and COX-2 expression in prostatic adenocarcinoma (PC), chronic prostatitis and nodular prostatic hyperplasia (NPH) in a trial to clarify the role of inflammation as a risk factor for prostatic carcinogenesis and cancer progression. SCF and COX-2 tissue protein expression were evaluated in 50 cases of PC, 20 cases of chronic prostatitis and 10 cases of NPH using immunohistochemistry, patients were followed up for 5 years. The relationship between their levels of expressions, clinicopathological, and prognostic criteria were studied. SCF expression in PC was positively correlated with advanced patient age (p = <0.001), high level of PSA (p = 0.010), higher Gleason score (p = 0.011). COX-2 expression in PC was positively correlated with advanced patient age (p = <0.001), high level of PSA (p = 0.016), advanced D'Amico risk group (p = 0.038). High levels of expression of both SCF& COX-2 are associated with higher incidence of tumor relapse, worse disease overall survival and free survival (p < 0.001). SCF and COX-2 are associated with PC progression and associated with poor prognosis in PC patients.
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http://dx.doi.org/10.1007/s12253-018-0534-1DOI Listing
April 2019

Primary diffuse large B-cell non-Hodgkin's lymphoma of the breast-A case report and review of the literature.

Radiol Case Rep 2019 Jan 4;14(1):22-27. Epub 2018 Oct 4.

Department of Radiology, Faculty of Medicine, Zagazig University, Egypt.

Primary breast lymphoma (PBL) is considered a rare clinical entity forming about 0.4%-0.5% of all breast tumors. In this report we have presented a case of PBL in a 56-year-old female complaining of a mass in the upper medial quadrant of the breast. PBL suspicion of our case was made by breast radiology and the sure diagnosis was reached by the immunohistochemistry results; CD (cluster of differentiation) 20: was diffusely positive; Pan-CK (pan-cytokeratin): was diffusely negative in tumor cells. Hence, the case was finally diagnosed as a primary breast a primary breast diffuse large B-cell non-Hodgkin's lymphoma of lymphoma. The management and outcome of PBL and carcinoma are totally different. Accurate diagnosis of PBL by true cut needle biopsy and immunocytochemistry is important to avoid unnecessary mastectomies.
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http://dx.doi.org/10.1016/j.radcr.2018.09.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172487PMC
January 2019

SPOP, ZEB-1 and E-cadherin expression in clear cell renal cell carcinoma (cc-RCC): Clinicopathological and prognostic significance.

Pathophysiology 2018 Dec 18;25(4):335-345. Epub 2018 May 18.

Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt. Electronic address:

Background: Clear cell renal cell carcinoma (cc-RCC), is a serious cancer regarding; its fatality, liability for metastases and chemoresistance, so identification of recent therapeutic targets to improve the patients prognosis is needed. SPOP is a BTB/POZ domain containing speckle-type POZ protein, has been identified as an E3 ubiquitin ligase component. ZEB1 is an essential epithelial mesenchymal transition (EMT) activator; E-cadherin is a cell adhesion protein that had been detected in normal epithelial cells membrane.

Aim: Was to assess the tissue protein markers SPOP, ZEB1 & E-cadherin expressions in benign areas of neoplastic kidney specimens and in cc-RCC patients, then correlating their expression levels with patients clinicopathological and prognostic data.

Methods: We evaluated SPOP, ZEB-1 & E-cadherin expression using immunohistochemistry in samples from 50 cc-RCC and 20 benign areas of neoplastic kidney specimens, then we followed our patients for 5 years and finally we have analyzed correlations between the levels of markers expressions with patients clinicopathological and prognostic criteria in cc-RCC.

Results: Positive expression of SPOP & ZEB1 in addition to negative E- cadherin expression was detected in cc-RCC more than benign areas of neoplastic kidney specimens (p = 0.004 and p < 0.001 respectively). In cc-RCC Positive expression of SPOP, ZEB1 and negative E- cadherin expression was associated with higher grade (p = 0.006, 0.007 & <0.001 respectively), advanced AJCC stage (p = 0.013, 0.023 & <0.001 respectively), presence of L.N metastases (p = 0.002 = 0.010 and <0.001 respectively), distant metastases (p = 0.001, 0.003 & 0.035 respectively), poor PFS and OS rates (p < 0.001 and p = 0.013 respectively).

Conclusion: Positive expression of SPOP& ZEB1 in addition to negative E- cadherin are associated with poor prognosis in cc-RCC patients.
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http://dx.doi.org/10.1016/j.pathophys.2018.05.004DOI Listing
December 2018
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