Apoptotic activity in Libyan breast cancer

Abstract

BackgroundWe evaluated the relationship of the apoptotic activity index (AI) and the standardized mitotic-apoptotic ratio (SMI/AI) with clinicopathological features and prognosis in Libyan female breast cancer (BC) patients. We then compared our results with corresponding results in Finnish and Nigerian female BC patients.MethodsHistological samples of breast carcinoma from 130 patients were retrospectively studied: an estimation of the apoptotic activity per square millimeter (expressed as apoptotic activity index (AI)), and standardized mitotic-apoptotic ratio (SMI/AI) was made, and the results compared with the clinicopathological features and the patient’s survival.ResultsThere was a statistically significant correlation between the AI and most of the clinicopathological features; the strongest association was observed for clinical stage lymph node (LN) status (P = 0.005). There were also correlations between AI and histological grade (P = 0.035), large tumor size (P = 0.011) and the clinical stage (P = 0.009). There were, however, prominent AI differences between Libyan, Nigerian and Finnish populations. The mean values of AI and SMI/AI in Libyan BC patients were 12.8 apoptotic figures per square millimeter and 2.8, respectively. The Libyan AI is slightly higher than in Nigeria, but much higher than in Finland. The differences between countries are seen throughout the samples as well as being present in certain subgroups. The survival analysis indicated that short survival time was associated with high apoptotic indices values and so can identify aggressive tumors and provide significant prognostic support. The cutoff (4 and 18 apoptosis/mm2) of AI might be applied as a quantitative criterion for Libyan BC to separate the patients into good, moderate and bad prognosis groups.ConclusionsThe results indicated that the differences in AI among the three countries may be due to the known variation in the distribution of genetic markers in these populations. Improvement in health care and introduction of screening programs, however, could be very helpful in the Libyan population.

The search for optimal cutoff points for apoptosis and proliferation rate in prognostification of early stage breast cancer patients treated with anthracyclines in adjuvant settings

“…Nonetheless, it is worth noteworthy that our results are in agreement with those presented by some other authors [10], who have demonstrated statistical trend (but not significance) towards higher apoptosis in pathological responders after neoadjuvant chemotherapy based on ATC (see Table 1). On the other hand, some researchers have shown significant correlation between low AI and better treatment outcome of BC patients [8,11]. Their results are also slightly similar to those presented by us, because in our analysis, the subgroup of women with quite good prognosis (DFS = 84.6 %) was characterized by the lowest AI.…”

“…As indicated by the present analysis (Table 2) and other studies [6][7][8][9][10][11]22], tumors with low AI are characterized by lower clinical stage and grade, slower proliferation, HR positivity, CK5/6 negativity, lower expression of TOPOIIα and P53. On the other hand, there are also some studies in which lack of correlation between apoptosis level Fig.…”

“…On the other hand, key processes responsible for antitumor activity of ATC (DNA intercalation, topoisomerase IIα poisons, and generation reactive oxygen species (ROS)) are followed by cell death [5] and theoretically, a greater proportion of apoptotic cells in tumors should result in better responsiveness to ATC. There are some studies [6][7][8][9][10][11][12] concerning clinical potential of this biomarker for neoadjuvant ATC-based chemotherapy, but their results are contradictory (Table 1). To the best of our knowledge, there are no data concerning prognostic value of apoptosis level for adjuvant ATC-based chemotherapy in patients with BC.…”

Estimation of tubular differentiation in female libyan breast cancer

“…The differences between African and European breast cancers have recently emerged [16,[21][22][23][24]. This study is a part of our effort to further clarifying the biology of Libyan BC and to comparing our results with the corresponding results of North European, and Central African female BC patients.…”

“…The distribution of age, axillary lymph node status, stage, histological type, and histological grades are shown in ( Table 1). Mean nuclear area, mitotic and apoptotic indices were evaluated from H & E sections as described earlier [16,17].…”