Association of hormone receptors and human epidermal growth factor receptor-2/neu expressions with clinicopathologic factors of breast carcinoma: a cross-sectional study in a tertiary care hospital, Kabul, Afghanistan

BACKGROUND

Breast cancer (BC) is one of the major causes of death worldwide. It is the most common cause of death before the age of 70 years. The incidence and mortality of BC are rapidly increasing, posing great challenges to the health system and economy of every nation.

METHODOLOGY

A cross-sectional analytical study was conducted at the Department of Pathology and Clinical Laboratory of the French Medical Institute for Mothers and Children (FMIC) to demonstrate the association of human epidermal growth factor receptor 2 (Her2/Neu) and estrogen receptor (ER)/ progesterone receptor (PR) with clinical as well as pathological parameters among women with BC. A consecutive nonprobability sampling method was used for this study over a span of one and a half years.

RESULTS

One hundred twenty participants diagnosed with breast cancer were included in the study. The mean age at diagnosis was 44.58 ± 11.16 years. Out of the total patients, 68 (56.7%) were above 40 years old, 108 (90%) were married, 94 (78.3%) were multiparous, and 88 (73.3%) had a history of breastfeeding. 33.3% of cases were within the age range of menopause (40-50 years). The positive expression rates of ER, PR, and Her2/neu were found to be 48.8%, 44.6%, and 44.6%, respectively, and Her2/neu overexpression was found to be higher among ER/PR-negative cases.

CONCLUSION

In our study, we demonstrated that among Afghan women, grade II invasive ductal carcinoma, not otherwise specified, was the most common type of BC and frequently affected women above the age of 40. We also revealed that the percentage of negative ER (50.4%), negative PR (54.4%), and concordant ER/PR-negative cases were high compared to other possibilities. Additionally, the study revealed that expression of Her2/neu was in contrast with the expression of ER and PR receptors. The findings of our study still support the importance of performing immunohistochemical stains for hormonal receptor classification in terms of better clinical outcomes and prognosis.

Relationship of age and gender with cytopathological findings of thyroid nodules diagnosed by FNAC: a retrospective study

In Afghanistan, there are no reliable epidemiological data available about thyroid cytopathology and its possible relationship with the age and gender of patients. Therefore, we conducted this study to outline this relationship and the importance of fine needle aspiration cytology in this regard. A retrospective review study was conducted including 686 consecutive medical records of thyroid nodules diagnosed by fine needle aspiration cytology in a span of five years. Out of 686 consecutive patients with thyroid nodules included in this study, 566 were females and 120 were males. Most of the thyroid nodules diagnosed were benign lesions with female predominance. These nodules were commonly arising in between 3rd and 6th decades of life in both the genders with mean age of 42 ± 13 years in females and 52 ± 15 years in males. Thyroid malignancy was commonly diagnosed in middle-age females, however in males, it was frequently diagnosed in older age with a peak at 7th decade. Most of the malignant nodules were solid and complex with no purely cystic nature. In both the genders, thyroid nodules were commonly arising in the right thyroid lobe (52.3%), followed by left (35.7%), isthmus (8.7%) and bilateral (3.2%). Fine needle aspiration cytology remains the modality of choice for the diagnostic evaluation of nodular lesions of thyroid. In contrast to the data reported around the world, thyroid malignancies, in our study, were diagnosed in relatively older age groups with peak incidence in the 5th decade of life for females and 7th decade for males.

Risk factors associated with esophageal cancers, diagnosed at tertiary level in Afghanistan: a descriptive cross-sectional study

Background:

Worldwide, esophageal cancer (EC) is a common cancer in term of incidence and mortality and is the 4th common cancer in Afghanistan. Current study aimed to evaluate the profile of risk factors for EC among patients diagnosed at tertiary level in Afghanistan.

Methodology:

A descriptive cross-sectional study was carried out between January 2019 up to February 2021 including all esophageal cancers diagnosed at pathology department of French Medical Institute for Mothers and Children, Afghanistan.

Result:

240 diagnosed cases were analyzed, in which 59.40% of squamous cell carcinoma and 41.07% Adenocarcinoma. Both histopathological type of were predominantly diagnosed in males. The majority of the patients were residents of rural areas. More than 80% of the patients were illiterate with only less than 2% completing higher education. Majority of the patients were laborers and farmers while less than 10% were employed. According to income assessment, more than 80% were from low-income household, the rest from middle-income and none from high-income family. Oral snuff consumption was noted in 33.9% of squamous cell carcinoma patients and 40% adenocarcinoma patients whereas, family history of esophageal cancer was observed in 37.8% and 36.7% in both types of carcinomas, respectively. More than 60% of both types of carcinomas patients were hot tea drinkers.

Conclusion:

Current study demonstrated that most patients diagnosed with esophageal cancers were male, uneducated, belongs to low-income groups, lives in rural areas. These findings suggest distribution of esophageal cancer in specific socioeconomic groups, clearly demonstrating the need further analytical study.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-022-10228-9.

Mathematical analysis of a model for AVL-HIV co-endemicity

A model for the transmission dynamics of Anthroponotic Visceral Leishmaniasis (AVL) and human immunodeficiency virus (HIV) in a population is developed and used to assess the impact of the spread of each disease on the overall transmission dynamics. As for other vector-borne disease models, the AVL component of the model undergoes backward bifurcation when the associated reproduction number of the AVL-only sub-model (denoted by RL) is less than unity. Uncertainty and sensitivity analyzes of the model, using data relevant to the dynamics of the two diseases in Ethiopia, show that the top three parameters that drive the AVL infection (with respect to the associated response function, RL) are the average number of times a sandfly bites humans per unit time (σV), carrying capacity of vectors (KV) and transmission probability from infected humans to susceptible sandflies (β2). The distribution of RL is RL∈[0.06,3.94] with a mean of RL=1.08. Furthermore, the top three parameters that affect HIV dynamics (with respect to the response function RH) are the transmission rate of HIV (βH), HIV-induced death rate (δH), and the modification parameter for the increase in infectiousness of AIDS individuals in comparison to HIV infected without clinical symptoms of AIDS (ωH). The distribution of RH is RH∈[0.88,2.79] with a mean of RH=1.46. The dominant parameters that affect the dynamics of the full VL-HIV model (with respect to the associated reproduction number, RLH, as the response function) are the transmission rate of HIV (βH), the average number of times a sandfly bites humans per unit time (σV), and HIV-induced death rate (δH) (the distribution of RLH is RLH∈[0.88,3.94] with a mean of RLH=1.64). Numerical simulations of the model show that the two diseases co-exist (with AVL dominating, but not driving HIV to extinction) whenever the reproduction number of each disease exceeds unity. It is shown that AVL can invade a population at HIV-endemic state if a certain threshold quantity, known as invasion reproduction number, exceeds unity.