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

Circulating miR-499a levels could be a useful biomarker, discriminating acute MI within 12 hours from healthy subjects. Its variant rs3746444 A/G is associated with increased susceptibility to acute MI and CAD in Egyptian population.

and 6 Pulmonologist, Ministry of Health, EgyptStem cell transcriptional signature activation is an essential event in the development of cancer. This study aimed to investigate the differential expression profiles of three pluripotency-associated genes, OCT4, NANOG and SOX2, G-protein-coupled chemokine receptor 4 (CXCR4) and the ligand CXCL2, and alpha-fetoprotein (AFP) in hepatogenic differentiated stem cells and in sera of hepatitis C virus (HCV) and HCV-induced hepatocellular carcinoma (HCC) patients. Mesenchymal stem cells derived from umbilical cord blood were differentiated using hepatogenic differentiation media. Serum specimens were collected from 96 patients (32 cirrhotic HCV, 32 early HCC and 32 late HCC) and 96 controls. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed for relative quantification of the six target genes using the Livak method. In silico network analysis was also executed to explore the pluripotency and tumorigenetic regulatory circuits in liver cancer. The expression levels of all genes declined gradually during the stages of stem cell differentiation. On univariate and multivariate analyses, NANOG, CXCR4 and AFP were significantly upregulated in late clinical stage HCC patients. In contrast, SOX2 and CXCL2 were markedly overexpressed in cirrhotic patients and could be used for clear demarcation between cirrhotic and HCC patients in our cases. In conclusion, our data highlight the potential role of the SOX2 stem cell marker and CXCL2 chemokine in liver cell degeneration and fibrogenesis in HCV-induced hepatic cirrhosis in our sample of the Egyptian population. In addition, the significant association of NANOG and CXCR4 high expression with late HCC could contribute to the acquisition of stem celllike properties in hepatic cancer and dissemination in late stages, respectively. Taken together, our results could have potential application in HCC prognosis and treatment.

Background: Multiparameter flow cytometry is the most important method for the lineage assignment and maturational analysis of acute leukemias (AL) cells. The multi parametric immunophenotyping analysis allows the detection of aberrant antigen expression and the analysis of heterogeneity and clonality of malignant cells in AL. The aim of the work is to study the immunophenotypes of blasts from patients with AL and determine the frequency of aberrant markers. Subjects and Methods: Retrospective study to analyze immunophenotypic data of de novo 144 AL patients who were diagnosed in Clinical Pathology Department, Sohag University. Results: We found that 61.8% of AL patients were classified as acute myeloblastic leukemia (AML) while 38.9% classified as acute lymphoblastic leukemia (ALL). The commonest FAB subtype in AML group was AML-M2 (31.8%) followed by M4-M5 27.3%. As regard ALL, there were 85.7% with B-ALL and 14.3% with T-ALL. The aberrancy expressions were found in 66 of AL cases (45.8%), CD7 was the most commonly expressed lymphoid antigen in AML (25%), CD13 was the most commonly expressed myeloid antigen in ALL (39.3%). Conclusion: The multi parametric immunophenotyping analysis of AL is sufficient for diagnosis and classification of leukemia. The frequencies of aberrant markers in AL were matched with many published data.

Background: The most common causes of microcytic hypochromic anemia are iron deficiency anemia (IDA) and the beta-thalassemia trait (β-TT). The aim of the work is to compare the validity of the various simple indices to differentiate between iron deficiency anemia and β-thalassemia trait. Subjects and methods: A total of 2000 individuals were screened, by complete blood picture, measurement of serum iron, serum ferritin and hemoglobin separation; 224 patients were detected as having hypochromia and microcytosis.Among them 166 cases were IDA and 58 cases were β-TT. We calculated 11 discrimination indices. The number of correctly identified cases were determined, sensitivity, specificity, positive and negative predictive value and Youden's index (YI) of each discrimination index was calculated. Results: The percentage of correctly diagnosed patients is highest for Matos and Carvalho index (MCI) (95.5%) which is closely followed by Red cell distribution width index (RDWI) (93.7%). The third high index was Green and King (GKI) (91.9%). Sensitivity, specificity of MCI for detection of IDA was found 98.8%, 87.9% respectively. For β-TT, sensitivity and specificity was found 86.2% and 98.8% respectively. The YI of MCI was found 85.9%. It is followed by RDWI; its sensitivity and specificity for detection of IDA was found 97.6%, 85.3%. For β-TT, sensitivity and specificity was found 82.7% and 97.6% respectively. The YI of RDWI was 81.6%. Conclusion: Matos and Carvalho index and RDWI are easily available automated cell-count-based indices coming out as good discriminator between IDA and β-TT in our study.