The present study aimed to assess the correlation between vascular endothelial growth factor (VEGF) overexpression and the grade, size, and recurrence of transitional cell carcinoma (TCC) in the south of Iraq, which includes regions that have been exposed to high levels of depleted uranium. The study also sought to evaluate whether there is any biomarker in the expression that could be correlated with the increased incidence of this type of cancer in the exposed areas. Samples of formalin-fixed and paraffin-embedded tissue from 54 patients (41 males and 13 females) with TCC and from 32 patients with benign bladder lesions (cystitis) used as controls were included in this study. The avidin-biotin complex method was used for immunohistochemical detection of VEGF. VEGF immunoexpression was positive in 77.77% of TCC but was not found in benign bladder lesions (cystitis) (P<0.05). VEGF immunostaining was positively correlated with grade, stage, and recurrence of TCC but the findings were not statistically significant (P>0.05). These findings support the role of VEGF in the carcinogenesis of TCC regarding evolution, behavior, and aggressiveness. Hence, VEGF could be considered as a poor prognostic parameter in bladder cancer. No positive correlation between immunohistochemical expression and the high incidence of TCC was detected (R=<0.3). The study further concludes that immunohistochemical expression of the VEGF gene in TCC bladder cancer does not differ from similar cancers found in other parts of the world where there has been no known exposure to depleted uranium.

BackgroundColorectal carcinoma (CRC) is the seventh-most common malignancy and is the main cause of death in Iraq. The incidence of this cancer has increased sharply after the invasion of Iraq in 2003.AimTo estimate immunohistochemical expression of vascular endothelial growth factor (VEGF) in CRC in relation to other parameters, such as grade and stage of tumour.MethodsFormalin fixed, paraffin-embedded blocks from 52 patients (27 male and 25 female) with CRC were included in this study. A group of 22 patients with non-cancerous colonic tissues were included as a control group. Avidin–biotin complex method was employed for immunohistochemical detection of VEGF.Results VEGF immuno-expression was positive in 51.9% of CRC, while it was 18.2% in the normal colonic tissue (p <0.05). VEGF immunostaining was positively correlated with grade of colonic malignancy (p <0.05).ConclusionThese findings provide further evidence for the role of VEGF in the carcinogenesis of CRC. However, VEGF could not be well correlated with stage of tumour and hence may be a poor prognostic parameter of state of malignancy of colonic carcinoma.

BackgroundAmongst the extensive literature on immunohistochemical profile of breast cancer, very little is found on populations exposed to a potential risk factor such as depleted uranium. This study looked at the immunohistochemical expression of HER-2/neu (c-erbB2) and p53 in different histological types of breast cancer found in the middle Euphrates region of Iraq, where the population has been exposed to high levels of depleted uranium.FindingsThe present investigation was performed over a period starting from September 2008 to April 2009. Formalin-fixed, paraffin-embedded blocks from 70 patients with breast cancer (62 ductal and 8 lobular carcinoma) were included in this study. A group of 25 patients with fibroadenoma was included as a comparative group, and 20 samples of normal breast tissue sections were used as controls. Labeled streptavidin-biotin (LSAB+) complex method was employed for immunohistochemical detection of HER-2/neu and p53.The detection rate of HER-2/neu and p53 immunohistochemical expression were 47.14% and 35.71% respectively in malignant tumors; expression was negative in the comparative and control groups (p < 0.05).HER-2/neu immunostaining was significantly associated with histological type, tumor size, nodal involvement, and recurrence of breast carcinoma (p < 0.05), p53 immunostaining was significantly associated with tumor size, nodal involvement and recurrence of breast cancer (p < 0.05). There was greater immunoexpression of HER-2/neu in breast cancer in this population, compared with findings in other populations.Both biomarkers were positively correlated with each other. Furthermore, all the cases that co-expressed both HER-2/neu and p53 showed the most unfavorable biopathological profile.ConclusionP53 and HER-2/neu over-expression play an important role in pathogenesis of breast carcinoma. The findings indicate that in regions exposed to high levels of depleted uranium, although p53 and HER-2/neu overexpression are both high, correlation of their expression with age, grade, tumor size, recurrence and lymph node involvement is similar to studies that have been conducted on populations not exposed to depleted uranium. HER-2/neu expression in breast cancer was higher in this population, compared with results on non-exposed populations.

Epstein-Barr virus (EBV) is the causative agent of infectious mononucleosis and is implicated in the development of several human malignancies, such as nasopharyngeal carcinoma (NPC) and Hodgkin's Lymphoma (HL). While the incidence of Hodgkin's Lymphoma in Iraq is not yet investigated, according to the WHO Hodgkin's Lymphoma is one of the 10 most frequent types of cancer in Iraq (http://www.who.int/disasters/repo/10062.pdf). The present study aimed to determine the association between HL and EBV in middle Euphrates region of Iraq, and to determine whether it is related to certain age group or specific histologic subtypes. It also aims to compare the pattern with other developing or developed countries. This retrospective study includes 86 formalin-fixed paraffin-embedded tissue blocks from HL patients, these were compared with 35 patients with Reactive Follicular Hyperplasia, that were age and gender matched. All the samples belonged to the period between Jan.2008 to April2010. The presence of EBV DNA was investigated by polymerase chain reaction (PCR), while the expression of the oncogenic protein (LMP-1) in Reed-Sternberg cells by immunohistochemistry (IHC). The mean age group of HL patients was 28.5 old years with a median of 25 years old. There were 49 males and 37 females. Age group of 16-45 years was the largest one and represented 66.2%. The third decade took the peak incidence (26/86, 30.2%). patients aged less than 16 years were 17.5%, while 16.3% of patients were more than 45 years old. Mixed cellularity HL was the most common subtype represented 47.6% of all the cases, followed by nodular sclerosis (33.7%) while the lymphocyte-rich, and lymphocyte depleted subtypes were (8.1%, 7%) respectively, whereas Lymphocyte Predominant was seen in 3.48% of cases. EBV DNA was detected in 39.5% of the cases, while the expression of LMP-1 in Reed Sternberg cells was found in 85.3% of the EBV-positive HL. The highest rate of EBV was seen in the children age group (less than 16 years; 53.3%), while the lowest rate was among young adults (16-45 years; 35.08%). Older age group (more than 45 years) has a rate of EBV presented (39.5%) which was higher than the young adult patients, but lower than the children age group. Histologically, the most frequent viral association was observed in mixed cellularity subtype (56.1%), followed by lymphocyte-rich and lymphocyte depleted subtypes (42.9%, 33.3%) respectively. The least frequency of association was in nodular sclerosis type (20.7%), while lymphocyte predominant subtype showed negative relationship with EBV-positive HL. EBV positive cases were mostly males (40.81%) compared to females (37.8%). Citation Format: Dhiya S. Al-Shumary, Karrar A.A. Ali Beg, Alae A. Yaseen, Salman A. Al-Jibouri, Kaswer M. Al-Toriahi. Detection of EBV nucleic acid and expression of oncogenic protein LMP-1 in Reed-Sternberg cells of Hodgkin's lymphoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4782. doi:10.1158/1538-7445.AM2013-4782 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.