Iraqi Journal of Cancer and Medical Genetics

Background: Prostatic adenocarcinoma may spread to bladder or vice versa, this is because of the anatomical proximity of these two organs. The differentiation between these two tumors is critical for therapeutic and prognostic implication.
Aim of study: Evaluate the usefulness of a panel of immunohistochemical markers (CK7, CK20, HMWCK34 βE12 and PSA) in differentiation between challenging cases of high grade urothelial and poorly differentiated prostatic carcinoma with morphological overlapping.
Material and methods: A total of 40 cases (20 cases poorly differentiated prostatic adenocarcinoma and 20 cases high grade urothelial carcinoma) were collected from archive of teaching laboratory of Al Yarmouk teaching hospital and private laboratories for the period from January 2015 to July 2017.All formalin fixed paraffin embedded tissue block were stained immunohistochemically with a panel of marker (CK7, CK20, HMWCK34 βE12 and PSA) and scoring was performed.
Results: For prostatic adenocarcinoma, 17 out 20 (85%) were positive for PSA, while only two cases (10%) of urothelial carcinoma cases showed weak and focal staining for this marker (the pvalue was <0.0001). In contrast, 16 out of 20(80%) of the urothelial carcinoma cases were positive for CK34βE12 in comparison to only one case (5%)of prostatic carcinoma showed positive expression for this marker (the p value was highly significant <0.0001). Regarding CK7and CK20: combined expression of both markers was noticed in 17 cases (85%) of urothelial carcinoma compared to only 2 cases(10%) of prostatic adenocarcinoma and the difference was highly significant(p value <0.0001). negative expression for both markers was noticed in 18 cases (90%) of prostatic adenocarcinoma compared to only 2 cases (10%) of urothelial carcinoma and the difference was highly significant( p value < 0.0001).CK7 positivity alone was noted in 17 cases(85%) of urothelial carcinoma while only 2 cases (10%) of prostatic carcinoma show positivity for this marker and the p value was highly significant (p value < 0.0001).18 cases (90%) of urothelial carcinoma showed positive expression for CK20 alone compared to only to 3 cases (15%) of prostatic carcinoma (p value < 0.0001).
Conclusion: Using CK7 or CK20 alone will not be helpful for differentiation between prostatic carcinoma and high grade urothelial carcinoma, while combined expression of both markers(CK7 and CK20) is very useful in ruling out carcinoma of the prostate, since, it is very rare for both markers to show positive expression in prostatic carcinoma.In difficult cases that show negative expression of both marker, CK34βE12 remain the most valuable marker for urothelial origin while, PSA immunohistochemical marker remains the most helpful marker to prove the prostatic origin of metastatic carcinoma.

Taraxacum officinale (Dandelion) represent a potentially novel non-toxic alternative to conventional cancer therapy toward many cancers particularly breast cancer. This study was conducted to detect the cytotoxic activity of T. officinale whole plant ethanolic extract on human breast cancer (MCF-7) cells in vitro compared to human hepatic (WRL-68) cells using MTT assay. Graphed 6 prism program including non-linear regression with one –way ANOVA followed by Dennett’s multiple comparison test to obtain data represent the mean+ SD. The results revealed high toxicity of the extract against MCF-7 cells with IC50 (190.5 μg.ml-1) and showed high-reduced activity toward WRL-68 cells with high IC50 value while the lowest viability (21.57±5.322) appeared in MCF-7 cells under treatment with 400 μg.ml-1 compared with high viability in WRL-68 cells. The study concluded that T. officinale extract has a valuable source of anticancer drugs with safe and selective activity on cancer cells in comparison to human normal cells.

Background: Chronic lymphocytic leukemia (CLL) is the most frequent lymphoproliferative disorder in western world. Its main characteristic is proliferation of mature looking lymphocytes in bone marrow, blood and lymphoid tissues. Diverse clinical course, ranging from indolent course to aggressive disease could be seen .So, many efforts focus on finding reliable indicators that can help to predict the outcome or explain CLL clinical variability. Certain surface proteins such as CD38, CD49d and ZAP-70 are expressed on leukemic cell population and they are widely used as well-established prognosticators. Novel Markers such as CD27 has been emerged, but still there is controversy about its exact role in CLL prognosis. CD27 molecule is a member of the TNF receptor family, related to leukemic cells adherence to stromal cells, and to CLL prognostic factors. This study aimed to assess the immunohistochemichal expressions of CD27 in bone marrow biopsies of CLL patients and correlate it to the clinicopathological parameters.
Methods: Cross sectional study was done on forty bone marrow paraffin blocks of untreated patients with CLL, collected from teaching laboratories of Medical City and National Center of Hematology, from November 2016 to June 2018. Immunohistochemical staining for CD27, CD38 antibodies were studied in relation to clinicopathological details.
Results: Positive result of CD27 was found in (77.5%) of cases, with moderate intensity in (87.1%), score (1) in (61.3%) of cases. CD27 was significantly associated with Binet stage C, Rai stage IV , Hb level less than 10 g/dl and diffuse bone marrow involvement with ( P =0.021, 0.001, 0.018, and 0.001 respectively). No association could be established between CD27 and the well-established CD38 in our study group. The sensitivity of CD27 was (100%) for CLL high risk patients (Binet stage C). Specificity = 33.3% and accuracy of CD27 marker was 55%.
Conclusions and recommendations: Immunohistochemistry can be used reliably to assess the expression of CD markers. Positive expression of CD27 in CLL cases significantly correlated with more advanced stage and CLL histological type of poor prognosis. We recommend further prospective studies to address if there is possible correlation between CD27 in CLL and chemosensitivity and other prognostic indicators.

The study was carried out to measure the erythropoietin hormone level and a number of the hematological variables (rednblood cells, platelets, monocytes and lymphocytes) and biochemical variables (erythropoietin, alkaline phosphatase, alanine transaminase and aspartate transaminase) for two types of leukemia (lymphoid leukemia and myeloid leukemia). Enzyme Linked Immune Sorbent Assay (ELISA) was used to detect level of erythropoietin in patients with lymphoid and myeloid, leukemia and control group , liver enzymes activity were measured including alkaline phosphatase (ALP) alanine transaminase (ALT) and aspartate transaminase (AST). Also estimated some hematological variables were estimated: red blood cells, platelets, lymphocytes and monocytes, as well as, ABO blood groups in all studied groups. The statistical analysis showed significant (P< 0.05) increase in the level of erythropoietin, liver enzymes, lymphocytes and monocytes number in patients with lymphoid and myeloid leukemia when compared with the control group. While, there was a decrease (P< 0.05) in red blood cells count and platelets count in the patients groups compared with the healthy group. Also, the results from statistical analysis revealed that there was a strong correlation between ABO blood groups and leukemia.

Prostate cancer (PCa) and benign prostatic hyperplasia (BPH), were investigated in both AL-Basra and Missan provinces–Iraq. The study provides data relating serum selenium (Se), arsenic(As), zinc(Zn), and copper(Cu) levels to activity of Glutathione–S– transferase (GST), Malondialdehyde (MDA); and prostate specific antigen (PSA) . sixty patients (30 patients with BPH mean age 56.40 ± 9.74 years and 30 patients with PCa mean age 57.55 ± 9.15 years) and thirty healthy controls mean age (54.150 ± 7.856) years were participated in the study. The results revealed a highly significant difference (P<0.001) in MDA, PSA, and Se levels; significant different in GST, Zn, and Cu/Zn ratio levels. No statistical significant difference was found in mean age, As, Cu, and E2 in BPH as compared to control group. Also, there was no statistical significant difference in mean age, and E2 level in PCa patients when compared to control group, while there was a highly significant difference (p<0.001) in MDA, PSA, GST, Se, As, Zn, and Cu/Zn ratio levels; and significant difference in Cu and testosterone levels were detected in PCa patients as compared to control group. Correlations studies indicated a significant correlation between MDA and ) PSA, GST, Se, As ,Zn ,Cu, Cu/Zn, Testosterone, and E2) in BPH and PCa patients. In conclusion, trace elements which used in this study (Zn, As, Se, and Cu) can be used as a bioindicator for prostate illness. Serum MDA may be considered a marker for predicting prostate cancer as a compliment to PSA.