BackgroundHuman epididymis protein 4 (HE4) is a novel and specific biomarker for ovarian cancer. The aim of this study is to evaluate a new tumor marker, HE4, in comparison with CA125 in diagnosis of epithelial ovarian cancer (EOC) and benign gynecological diseases.MethodsCA125 and HE4 serum levels were determined in 30 patients with epithelial ovarian cancer (21 serous, 6 endometrioid and 3 mucinous tumors), 20 patients with benign gynecological diseases (8 patients with ovarian cyst, 5 patients with endometriosis, 4 patients with fibroid and 3 patients with pelvic inflammatory disease) and 20 healthy women. CA125 and HE4 cut-offs were 35 U/ml and 150 pmol/l, respectively.ResultsSerum HE4 and CA125 concentrations were significantly higher in the ovarian cancer patients compared with those seen in patients with benign disease or in the healthy controls (p = 0.001 and p < 0.001 respectively). In the receiver operating characteristic analysis (ROC), the area under the curve (AUC) values for HE4 was 0.96 (95% confidence interval, 0.9-1.0) and CA125 was 0.82 (95% confidence interval, 0.7-0.94). Compared to CA125, HE4 had higher sensitivity (90% vs. 83.3%), specificity (95% vs. 85%), PPV (93.1% vs. 80.7%) and NPV (92.7% vs. 87.2%), the combination of HE4 + CA125 the sensitivity and PPV reached 96.7% and 97% respectively.ConclusionMeasuring serum HE4 concentrations along with CA125 concentrations may provide higher accuracy for detecting epithelial ovarian cancer.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1060413168685759

Angiotensin converting enzyme (ACE) gene polymorphism was previously studied in some cardiovascular diseases. There are only few studies which investigated this polymorphism in patients with rheumatic heart disease (RHD). The results of these investigations are inconsistent. Furthermore, gene polymorphism distribution is different in various ethnic populations. We conducted this study to demonstrate this gene polymorphism in Egyptian children with RHD. Leukocytes DNA was extracted from 139 patients with RHD and 79 healthy control children. After amplification by the PCR, the products were separated by electrophoresis in 6% polyacrylamide gel and visualized after ethidium bromide staining with UV light. The PCR product is a 190-bp fragment in the absence of the insertion (D allele) and a 490-bp fragment in the presence of the insertion (I allele). Gene polymorphism was as follows: DD gene when lane contains only 190-bp fragment, II gene when lane contains only 490-bp fragment and ID gene when lane contains both fragments. We found that gene polymorphism in both control and patients groups followed the following order of distribution from highest to lowest: ID, II, DD gene. The frequency in control group was 49.4, 36.7, and 13.9%, respectively. In patients groups, the gene frequency was 42.5, 30.9, and 26.6%, respectively. DD gene frequency differs significantly between the two groups. We concluded that patients with RHD have a higher ACE-DD genotype than normal control. ACE-DD genotype may be a risk factor for RHD in Egyptian children.

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There is no gold standard method for detecting latent tuberculosis infection (LTBI) in end stage renal disease (ESRD), the use of tuberculin skin test(TST) remains controversial due to its high rate of false results, new interferon gamma release assays have been developed for diagnosing LTBI as the QuantiFERON-TB Gold test(QFT-G). The aim of this work:-was to evaluate the value of Quantiferon-TB Gold test and compare its performance with tuberculin skin test in the diagnosis of latent tuberculosis infection among ESRD patients receiving hemodialysis(HD). Patients and Methods:-60 ESRD patients undergoing HD and 40 healthy controls were subjected to TST and QFT-G to diagnose Latent TB infection. Results:-QFT-G and TST were positive in 31.7 % and 45 % of patients respectively. The overall agreement was 73.3% (statistically significant with moderate agreement, p=0.001 & k=0.44), while it was 70% in BCG vaccinated patients (statistically significant with fair agreement, p=0.003 & k=0.37) and 80% in non BCG vaccinated patients (statistically significant with moderate agreement, p=0.001 & k=0.56). There were no statistically significant differences between patients and controls as regards age, sex, duration of hemodialysis and history of contact to known TB patients. Conclusion:-We conclude that QFT-G test shows overall moderate agreement with TST and it could be used in screening of LTBI in ESRD patients simultaneously with TST and QFT-G test is more specific and accurate than TST in BCG vaccinated patients as BCG vaccination reduces their agreement, increasing the risk of TST false positive results rather than QFT-G positivity but relatively high cost and need for laboratory instruments is a limitation of QFT-G test Copy Right, IJAR, 2013,. All rights reserved.