Research Unit 03 UR 08 13

Sousse, Tunisia

Research Unit 03 UR 08 13

Sousse, Tunisia
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Missaoui N.,Research Unit 03 UR 08 13 | Missaoui N.,Farhet Hached University Hospital | Abdelkrim S.B.,Farhet Hached University Hospital | Abdelkader A.B.,Farhet Hached University Hospital | And 5 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2011

Introduction: The aim of this study was to survey the clinical and pathological features of breast cancer in the Center of Tunisia. Design: Characteristics of all breast cancer cases diagnosed in the Pathology Department, Farhet Hached Hospital, Sousse, Tunisia during a 15-year period (1993-2007) were analyzed. Results: A total of 2,404 new cases of breast cancer were recorded, only 48 being diagnosed in men. The age-standardized incidence rate was 0.7 and 29.2 per 100,000 in men and women, respectively, with median ages of 48.0 and 64.5 years. Invasive ductal carcinoma was the most common (2,012 cases). Stage II was the most frequent (47.7%) followed by advanced stages (Stage III and IV, 41%). Conclusion: Cancer of the breast remains the most common cancer in the absence of specific screening measures among Tunisian women. Our study justifies the need to plan and develop effective programs aiming at the control and prevention of the spread of breast cancer in Tunisia.


Missaoui N.,Research Unit 03 UR 08 13 | Trabelsi A.,University of Sousse | Hmissa S.,Research Unit 03 UR 08 13 | Hmissa S.,University of Sousse | And 5 more authors.
Pathology Research and Practice | Year: 2010

Uterine cervix cancer is an important public health problem in developing countries. However, there is a substantial lack of inter-observer diagnostic reproducibility for its precursor lesions (CIN1). The study was performed to evaluate the usefulness of p16INK4A overexpression as a surrogate marker for uterine cervix precancerous lesions and high-risk human papillomavirus (HPV) infection.We conducted a retrospective study of 87 uterine cervix specimens, including 7 normal tissue samples, 17 benign lesions, 34 precancerous lesions, 22 invasive squamous cell carcinomas (SCC), and 7 adenocarcinomas. Immunohistochemistry was used to find p16INK4A overexpression. HPV infection was detected by PCR.No immunoreactivity for p16INK4A was detected in normal tissue or benign lesions. p16INK4A immunoreactivity was focal in CIN1, whereas strong and diffuse immunoreactivity for p16INK4A was uniformly observed in both the nucleus and the cytoplasm of all CIN2 and 3, as well as in those of invasive SCC and adenocarcinomas. A statistically significant association was observed between p16INK4A overexpression, lesion grade, and high-risk HPV infection (p<0.0001).p16INK4A overexpression is a useful additional marker for the interpretation of problematic uterine cervical lesions and can help to reduce the variability during evaluation of suspicious biopsies of the uterine cervix. © 2010 Elsevier GmbH.


Al Moustafa A.-E.,ABS Research and Development | Al Moustafa A.-E.,McGill University | Al Moustafa A.-E.,Concordia University at Montréal | Al Moustafa A.-E.,Syrian Research Cancer Center | And 9 more authors.
Human Vaccines and Immunotherapeutics | Year: 2014

Human papillomavirus (HPV) infections are estimated to be the most common sexually transmitted infections worldwide. Meanwhile, it is well established that infection by high-risk HPVs is considered the major cause of cervical cancer since more than 96% of these cancers are positive for high-risk HPVs, especially types 16 and 18. Moreover, during the last 2 decades, numerous studies pointed-out the possible involvement of high-risk HPV in several human carcinomas including head and neck, colorectal and breast cancers. The association between high-risk HPVs and cervical cancer and potentially other human malignancies would necessitate the introduction of vaccines which were generated against the 2 most frequent high-risk HPVs (types 16 and 18) worldwide, including the Middle East (ME) as well as North African countries. The presence of high-risk HPVs in the pathogenesis of human cancers in the ME, which is essential in order to evaluate the importance of vaccination against HPVs, has not been fully investigated yet. In this review, we present an overview of the existing epidemiological evidence regarding the presence of HPV in human cancers in the ME and the potential impact of vaccination against HPV infections and its outcome on human health in this region. © 2014 Landes Bioscience.


Missaoui N.,Research Unit 03 UR 08 13 | Hmissa S.,Research Unit 03 UR 08 13 | Hmissa S.,University of Sousse | Trabelsi A.,University of Sousse | And 3 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2010

Introduction: Uterine cervix cancer is the second most commonly diagnosed cancer among women worldwide. Design: In order to review the clinical and pathological features of cervix cancer in the center of Tunisia, a retrospective study was carried out on 410 cancer cases diagnosed in the Pathology Department, Farhet Hached University Hospital, Sousse, Tunisia (1993-2006). Results: The mean age was 52.1 years. Of the 410 patients, 90.5% had squamous cell carcinoma and 7.3% had adenocarcinoma. One hundred thirty-eight patients were identified as being in early stages (0 and I) (33.6%) and 58.2% in advanced stages (II-IV). Therapy consisted mainly in combination of radiotherapy and surgery in early stages (28.8%), and radiotherapy alone or associated with the chemotherapy in advanced stage (29.7%). Surgery was the only treatment in 29.5% of cases. Conclusion: A relatively large proportion of patients presented in stages II to IV, compared to only 36% with early stages, emphasizing the need to reinforce the early detection of this cancer and its precursor lesions in the center of Tunisia.


Missaoui N.,Research Unit 03 UR 08 13 | Jaidaine L.,University of Sousse | Abdelkader A.B.,University of Sousse | Trabelsi A.,University of Sousse | And 3 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2011

Introduction: Significant variation in colorectal cancer incidence rates and trends has been observed across countries. Data from Tunisia are sparse. In this paper, we analyzed trends in incidence rates of the colorectal cancer over a 15-year period, 1993-2007, in Central Tunisia. Design: Five-year age-specific rates, crude incidence rates, world age-standardized rates, and annual percent change were calculated using annual data on population size and its estimated age structure. Results: A total of 1,443 incident cases of colorectal cancer were registered, with a male to-female sex ratio of 1.1:1. The world age-standardized rate was 10.0 per 100,000 among females and 11.7 among males. Over time, there were significant increasing trends by +2.6% (95% CI: 0.1%, 5.1%) and +5.3% (95% CI: 2.7%, 7.9%) for females and males, respectively. Conclusion: The absence of a screening program for colorectal cancer could explain the increasing trends observed among males and females in Central Tunisia. Our findings point the need to plan and develop effective programs aimed at the control and prevention of the spread of colorectal cancer in Tunisia.


Missaoui N.,Research Unit 03 UR 08 13 | Missaoui N.,University of Sousse | Trabelsi A.,University of Sousse | Parkin D.M.,Queen Mary, University of London | And 6 more authors.
International Journal of Cancer | Year: 2010

In this article, we analyzed trends in incidence rates of the major cancer sites for a 14-year period, 1993-2006, in the Sousse region localized in the centre of Tunisia. Five-year age-specific rates, crude incidence rates (CR), world age-standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size and its estimated age structure. A total of 6,975 incident cases of cancer were registered, with a male to-female sex ratio of 1.4:1. ASRs showed stable trends (-0.1% in males, and +1.0% in females). The leading cancer sites in rank were lung, breast, lymphoma, colon-rectum, bladder, prostate, leukemia, stomach and cervix uteri. For males, the incidence rates of lung, bladder and prostate cancers remained stable over time. While, cancers of colon-rectum showed a marked increase in incidence (APC: +4.8%; 95% CI: 1.2%, 8.4%) and non-Hodgkin's lymphoma (NHL) showed a notable decline (APC: -4.4%; 95% CI: -8.2, -0.6). For females, cancers of the breast (APC: +2.2%; 95% CI: 0.4%, 4.0%) and corpus uteri (APC: +7.4%; 95% CI: 2.8%, 12.0%) showed a marked increase in incidence during the study period, while the cervix uteri cancer decreased significantly (APC: -6.1%; 95% CI: -9.2%, -3.0%). The results underline the increasing importance of cancer as a cause of mortality and morbidity in Tunisia. Our findings justify the need to develop effective program aiming at the control and prevention of the spread of cancer amongst Tunisian population. Copyright © 2010 UICC.


Missaoui N.,Research Unit 03 UR 08 13 | Missaoui N.,University of Sousse | Khouzemi M.,University of Sousse | Landolsi H.,Research Unit 03 UR 08 13 | And 8 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2011

Objective: In this paper, we analyzed the frequency of childhood cancer in the Center of Tunisia during 1993-2006. Design: The different types of cancer were grouped according to the International Classification for Cancer in Children. The general and specific frequencies by age and by sex were analyzed. Results: A total of 727 new cases of childhood cancer were registered, with a male to-female sex ratio of 1.7/1. Leukemias had the highest frequency (27%) and, of these, lymphoid leukemias were the most prevalent (73.5%). Thereafter, in descending order of frequency, were lymphomas (25.7%), tumors of the central nervous system (CNS, 9.2%), neuroblastomas (7.7%), sarcomas (6.9%), carcinomas (6.3%), bone tumors (5.8%), nephroblastomas (5.5%), and germinal cell tumors (2.6%). The highest frequency of cancer was found at age 10-14 years (34.9%). Leukemias were the most frequent in age groups 1-4 and 5-9 years, whereas, neuroblastomas and lymphomas were the most frequent at age under one year and 10-14 years, respectively. Of those cases of solid tumors, 55.8% were diagnosed as having advanced stages of the disease. Conclusion: Leukemias, lymphomas, and CNS tumors were the principal cancers in the Center of Tunisia. A childhood cancer registry with high-resolution data collection is advocated for in-depth analysis of pediatric malignancies.


Missaoui N.,Research Unit 03 UR 08 13 | Missaoui N.,French Institute of Health and Medical Research | Missaoui N.,University of Sousse | Hmissa S.,Research Unit 03 UR 08 13 | And 7 more authors.
Pathology Research and Practice | Year: 2011

Aberrant DNA methylation is an early event in carcinogenesis and could serve as an additional molecular marker for the early diagnosis. The study was performed to investigate the promoter methylation of DAPK1, CDH13, and TWIST1 genes in uterine cervix lesions in an effort to examine whether this epigenetic event is involved in the process of cervical carcinogenesis, and whether it might be used as a molecular marker of cervical lesions.We conducted a retrospective study of 60 uterine cervix specimens, including 8 normal tissue samples, 10 benign lesions, 28 precancerous lesions (CIN1-3), and 14 squamous cell carcinomas (SCC). DNA hypermethylation was investigated using methylation-specific PCR. Immunohistochemistry was used to find p16INK4A overexpression.No hypermethylated promoters were detected in normal tissues and benign lesions. However, promoter hypermethylation of CDH13, TWIST1, and DAPK1 increased progressively from CIN1 to cancer, reaching values higher than 50% for cancer. DAPK1 and CDH13 displayed a significantly increased frequency of promoter methylation with progressively more severe cervical neoplasia (p<0.05). A statistically significant association was observed between p16INK4A expression and hypermethylation of DAPK1, TWIST1, and CDH13 (p<0.0001).Hypermethylation of CDH13, DAPK1, and TWIST1 promoters is an early event in the initiation and progression of cervix neoplasia. CDH13, DAPK1, and TWIST1 genes are potential biomarkers of cervical cancer risk. © 2010 Elsevier GmbH.


Missaoui N.,French Institute of Health and Medical Research | Missaoui N.,Research Unit 03 UR 08 13 | Missaoui N.,Farhat Hached University Hospital | Hmissa S.,Research Unit 03 UR 08 13 | And 4 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2010

Introduction: Persistent human papillomavirus (HPV) infection is the primary causal agent in the development of the uterine cervix carcinoma. Nevertheless, only a minority of high-risk HPV-associated lesions progress to cervical cancer, suggesting involvement of other molecular alterations. Among putative changes, aberrant methylation might be a crucial event. Design: Paraffin-embedded samples of benign lesions, cervical intraepithelial neoplasia (CIN) and invasive squamous cell carcinomas (SCC) were analyzed for DNA 5-methylcytosine content by immunohistochemistry with anti-5-methylcytosine antibodies and by high-performance liquid capillary electrophoresis (HPCE). Results: No significant difference of DNA 5-methylcytosine content was observed between normal tissues, benign lesions, low-grade lesions and high-grade lesions (p=0.6). In contrast, DNAs extracted from invasive SCC were hypomethylated when compared with normal and preneoplastic lesions (p=0.0004). An association between global DNA hypomethylation and the SCC stage was confirmed by HPCE. Conclusions: The transition from CIN lesions to invasive carcinoma seems to be closely linked to global DNA hypomethylation, which could be a useful marker of invasive uterine cervical lesions.


PubMed | Research Unit 03 UR 08 13
Type: Journal Article | Journal: Pathology, research and practice | Year: 2010

Uterine cervix cancer is an important public health problem in developing countries. However, there is a substantial lack of inter-observer diagnostic reproducibility for its precursor lesions (CIN1). The study was performed to evaluate the usefulness of p16(INK4A) overexpression as a surrogate marker for uterine cervix precancerous lesions and high-risk human papillomavirus (HPV) infection. We conducted a retrospective study of 87 uterine cervix specimens, including 7 normal tissue samples, 17 benign lesions, 34 precancerous lesions, 22 invasive squamous cell carcinomas (SCC), and 7 adenocarcinomas. Immunohistochemistry was used to find p16(INK4A) overexpression. HPV infection was detected by PCR. No immunoreactivity for p16(INK4A) was detected in normal tissue or benign lesions. p16(INK4A) immunoreactivity was focal in CIN1, whereas strong and diffuse immunoreactivity for p16(INK4A) was uniformly observed in both the nucleus and the cytoplasm of all CIN2 and 3, as well as in those of invasive SCC and adenocarcinomas. A statistically significant association was observed between p16(INK4A) overexpression, lesion grade, and high-risk HPV infection (p<0.0001). p16(INK4A) overexpression is a useful additional marker for the interpretation of problematic uterine cervical lesions and can help to reduce the variability during evaluation of suspicious biopsies of the uterine cervix.

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