Background: Though the incidence of colorectal carcinoma (CRC) is relatively uncommon in Nigeria, compared to the developed countries, recent studies indicate an increasing trend. Our patients often present at an earlier age, which has important implications for the pathogenesis in Nigeria. MLH1, MSH2, MSH6, PMS2 are the commonly mutated MMR genes in descending order of frequency, with PMS1 and MLH3 mutations being very rare. This study attempts to determine the significance of microsatellite instability (MSI) in colorectal carcinogenesis using immunohistochemistry (IHC) for detection of defects of DNA mismatch repair gene (MMR) amongst cases diagnosed at University College Hospital (UCH) Ibadan, Nigeria. Methodology: Suitable consecutive CRC cases identified from UCH, Ibadan, Pathology Department, 2006 files were stained with MMR IHC antibody panel (MLH1, MSH2, MSH6, PMS2). Stained sections were reviewed for nuclear reactivity and graded according to staining intensity (weak +, moderate ++, strong +++, very strong ++++). Result: IHC was performed on 26 cases. The age range is 22-74 years with 9 cases <40 years. One case with no reactivity with any of the antibody was considered unsuitable. Two cases with only PMS2 nuclear reactivity but no reaction with other antibodies were considered equivocal. Five cases had no nuclear reactivity with single antibody: MLH1 (2); MSH2 (3); and one case had no nuclear reactivity with MLH1 & MSH2. These six cases included 3 cases aged 22, 27 and 32 years with tumors showing no nuclear reactivity for MSH2 and (MLH1 & MSH2) respectively. Conclusion: Though the number cases tested are small, the identification of the loss of MMR gene protein (MLH1 and MSH2) by IHC, indicating MSI, in a significant number of the 26 cases tested (23%), particularly young individuals, suggests that defects of DNA mismatch repair genes are important factors in colorectal carcinogenesis in Nigerians.

Background: The use of endoscopes for visualization of gastric mucosa has improved over times and in taking biopsy for histology. The study sets out to determine the histopathological pattern of gastritis in dyspeptic patients and correlate the histological detection of H. pylori with that of urease breath test (UBT). Method: Prospective study of 118 consecutive patients with chronic dyspepsia who underwent upper gastrointestinal endoscopic examination and UBT using heliprobe. Biopsy of gastric antrum were taken at endoscopy and sent for histopathological analysis. Routine H&E and Giemsa stains were used. Results were recorded and analysed on the basis of sex, age, histology and UBT for H. pylori. Result: There were 118 patients who had endoscopy comprising 58 males and 60 females with male to female ratio of 1:1. Histology revealed varying degrees of chronic gastritis with or without H. pylori, activity, metaplasia, ulceration and dysplasia. Sixty eight (61%) of our patients were positive for H. pylori histologically. Of the first consecutive 66 patients, histology showed 38(57.6%) positive and 28(42.6%) negative; UBT, 46(69.6%) were positive for H. pylori and 20(30.4%) negative. There was a strong correlation between the true positive and true negative patients for the first 66 consecutive cases for both histology and UBT based diagnosis for detecting H. pylori. (Correlation coefficient=0.862, p=0.01). Conclusion: The study showed that histology and UBT are both useful for H. pylori detection. Large multi centre studies should be done to adopt the non-invasive UBT in resource poor economies for the eradication of H. pylori.

Background: Cancers and other non-communicable diseases were thought to be unimportant public health problems in developing countries because of the overwhelmingly high prevalence of communicable diseases. However, with improved health care facilities and extensive national immunization programmes, coupled with generally improving socio-economic status, malignant diseases are beginning to account for a significant percentage of childhood morbidity and mortality. The study aims to determine the morphological pattern, burden and demographic characteristics of paediatric solid malignancies seen at the University of Ilorin Teaching Hospital between January 1979 and December 2006. Methodology: The demographic characteristics of all cases of malignant solid neoplasms seen in children between the ages of 0 and 15 years were retrieved from the archives and recorded. The histopathological, cytological and the post-mortem slides of the recorded cases were retrieved and reviewed. Special staining techniques were employed where necessary. Results: Three hundred and twenty four cases of childhood solid malignant neoplasms were diagnosed over the study period. The prevalence of childhood malignant solid tumours in Ilorin is 311 per million children. The commonest tumour in this study is lymphoma representing 55.56% of total paediatric malignant solid neoplasms seen. Burkitt's lymphoma constituted the largest single entity (80% of all lymphomas). This was followed by nephroblastoma, retinoblastoma and bone tumours which accounted for 8.33%, 7.72% and 4.63% respectively. Intracranial tumours were relatively rare. Conclusion: The pattern of paediatric malignant solid neoplasms seen in Ilorin is similar to what obtains in other parts of Nigeria and African countries. Burkitt's Lymphoma is the commonest childhood malignancy in this study. Nephroblastoma is the second commonest childhood malignant solid neoplasm in Ilorin as against what was observed in other centres such as Ibadan, Ife and Jos where retinoblastoma is the second commonest after lymphoma.

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