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Şabrātah, Libya

Boder J.M.E.,University of Turku | Abdalla F.B.E.,University of Turku | Elfageih M.A.,National Cancer Institute | Abusaa A.,African Oncology Institute | And 2 more authors.
Oncology Letters | Year: 2011

The present study evaluated the incidence of breast cancer in Libya and described the clinicopathological and demographic features. These features were then compared with corresponding data from patients from sub-Saharan Africa (Nigeria) and Europe (Finland). The study consisted of 234 patients with breast carcinoma, admitted to the African Oncology Institute in Sabratha, Libya, during the years 2002- 2006. The pathological features were collected from pathology reports, patient histories from hospital files and the Sabratha Cancer Registry. The demographic differences between the Libyan, Nigerian and Finnish populations were prominent. The mean age of breast cancer patients in Libya was 46 years which was almost identical to that of Nigeria, but much lower than that of Finland. The Libyan breast cancer incidence was evaluated as 18.8 per 100,000 female individuals. This incidence was markedly higher in Finland, but was also high in Nigeria. Libyan and Nigerian breast cancer is predominantly of premenopausal type and exhibits unfavorable characteristics such as high histological grade and stage, large tumor size and frequent lymph node metastases. However, the histological types and histopathological risk features show similar importance regarding survival as European breast cancer cases. Survival in Libya ranks between the rates of survival in Nigeria (lowest) and Finland (highest). In conclusion, in Libya and other African countries, premenopausal breast cancer is more common than postmenopausal breast cancer. However, the opposite is true for Europe. Population differences may be involved, as suggested by the known variation, in the distribution of genetic markers in these populations. Different types of environmental impacts, however, cannot be excluded.

Abdalla F.B.E.,University of Turku | Abdalla F.B.E.,African Oncology Institute | Boder J.M.E.,University of Turku | Buhmeida A.,University of Turku | And 4 more authors.
Anticancer Research | Year: 2010

Background: The sensitivity for identification of malignant cells in conventional fine-needle aspiration biopsy (FNAB) investigation is about 80%. This percentage is dependent on the number of examined cells, type of breast cancer, and experience of the examiner. The aim of our study was to estimate the supporting value of image DNA cytometry of FNAB of the breast, and do so by using different sampling methods. Materials and Methods: This retrospective study was based on 41 cases with an available histological diagnosis: 18 benign lesions and 23 malignant tumours were examined. The smears were submitted to image DNA analysis in a three-step protocol: (i) smears stained with HE method were destained and (ii) then restained with Feulgen staining for DNA and (iii) finally analysed using image cytometry. Results: All non-malignant cases had diploid histogram. However, a few of them had one or two cells of >5c category. Most histologically malignant cases were aneuploid. Only three invasive ductal carcinomas showed diploid histograms. All samples with aneuploid histograms were malignant. Conclusion: The results confirm earlier published data in the Finnish population and indicate that image DNA cytometric analysis of nuclear content is a useful marker for identification of malignant cells in FNAB, especially after free cell sampling. The method can be used to increase the cytological sensitivity and specificity in doubtful breast lesions.

El Gehani K.,University of Benghazi | Al-Kikhia L.,University of Benghazi | Mansuri N.,African Oncology Institute | Syrjanen K.,University of Turku | And 2 more authors.
Libyan Journal of Medicine | Year: 2011

Background: Among the patients with bladder cancer, a group is still at risk of disease recurrence, progression, and death from their cancer after curative treatment. Angiogenesis is a crucial pathogenic mechanism for this type of urothelial carcinoma and is a potential therapeutic target. Objectives: To quantify tumor angiogenesis in bladder cancer and determine whether it correlates with tumor stage and grade. Patients and methods: A series of 42 archival samples from carcinomas of the urinary bladder were graded, staged, and analyzed for microvessel density (MVD) by a double immunohistochemical technique using Factor VIII (FVIII) and CD31 antibodies. The correlation between MVD and histopathological grade and tumor stage was evaluated. Results: FVIII and CD31 immunoreactivity was observed in 100% of cases and more intensely with CD31. Significantly higher MVD was determined in invasive tumors than in superficial tumors (pB0.05). MVD increased with tumor grade and stage (pB0.05); MVD was not affected by age or sex of the patients. Conclusion: These data demonstrate that MVD in bladder carcinoma correlates with the tumor grade and stage. Quantification of tumor angiogenesis may allow selection of the type of treatment for bladder cancer patients. © 2011 K. El Gehani et al.

Ermiah E.,African Oncology Institute | Abdalla F.,University of Turku | Abdalla F.,Misurata Cancer Institute | Alshrad M.,African Oncology Institute | And 3 more authors.
Oncology (Switzerland) | Year: 2012

Background: We evaluated the relation of nuclear DNA content and clinicopathological features and prognosis in primary breast cancer of female Libyan patients with variable stage and grade and different treatment regimes. Patients and Methods: Histological samples from 104 patients of breast carcinoma were retrospectively studied by computerized nuclear DNA cytometry. Isolated nuclei from paraffin sections were stained with Feulgen stain and DNA was measured using a computer-assisted image analysis cytometry system. In each case, 200 nuclei were measured and the DNA histograms, S phase fraction (SPF) and number of cells above 5c and 9c were determined. We applied different approaches in the analysis of DNA to compare the DNA histograms with different clinicopathological features and survival. Results: The mean of DNA ploidy mode for all tumors was 3.43; 82.7% of tumors were aneuploid and 17.3% were diploid. The median SPF was 3.5% for DNA diploid and 13.5% for DNA aneuploid tumors. DNA aneuploid tumors and high SPF were associated with advanced stage, distant metastasis, high histological grade and lymph node involvement. The SPF was also associated with large tumor size and with younger patients (<50 years). In the overall population (median follow-up 51 months), patients with aneuploid DNA histograms and high SPF values had shorter survival times than those with diploid DNA histograms and low SPF values (p = 0.001, p < 0.0001, respectively). Also, short survival was associated with a multiploid DNA histogram and with DNA aneuploid cells ≥5 cells (p < 0.0001, p = 0.001, respectively). In a Cox multivariate analysis, DNA ploidy (p = 0.010), age (p = 0.038) and clinical stage (p = 0.001) were independent predictors of overall survival, and DNA ploidy (p = 0.018) and clinical stage (p = 0.001) also proved to be independent predictors of disease-specific survival. The SPF cutoff point of 11% might be applied to separate patients into good and poor prognosis groups. Conclusions: DNA image cytometry with careful analysis of the histograms may provide valuable prognostic information in Libyan breast cancer, with potential clinical implications in patient management, particularly in predicting the patients at high risk for metastasis and recurrence who should be considered as candidates for combined adjuvant therapy. Copyright © 2012 S. Karger AG, Basel.

Moona M.S.,African Oncology Institute | Hussain A.,African Oncology Institute | Mehdi I.,African Oncology Institute
Jamahiriya Medical Journal | Year: 2010

A 45 year Libyan female was diagnosed to have invasive lobular carcinoma of the right breast. Following Surgery and adjuvant treatment she progressed with brain metastasis after 4 years. She developed right lobe thyroid swelling after 5 years. Right thyroid lobectomy was done and histopathology revealed a metastatic carcinoma from the breast. We present this rare unusual case of female breast cancer with brain metastasis, who subsequently developed metastasis to the thyroid gland. Metastasis to thyroid is rare and has rarely been reported. This is the first case reported from this institute.

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