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Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer with fewer treatment options than other types of invasive breast cancer due to the loss of the estrogen, progesterone receptors and low levels of the HER2 protein, resulting in a poor prognosis for these patients. Here, we found that the expression of the lncRNA, ZFAS1, was significantly downregulated (∼3.0-fold) in blood samples of TNBC patients (n=40) compared to matched healthy controls (n=40). Functionally, silencing of ZFAS1 promoted cell proliferation and colonization of human MDA-MB-231 TNBC cells by inhibiting the expression levels of the cyclin-dependent kinase (CDK) inhibitors p21 (CDKN1A) and p27 (CDKN1B) compared to the scrambled siRNA control cells. Further, we found that downregulation of ZFAS1 led to decreased protein levels of the epithelial markers, E-cadherin, Claudin-1, and Zo-1, with increased protein levels of the mesenchymal markers, Slug and ZEB1. In addition, by utilizing the bioinformatic tools such as RAID v2.0 (RNA Interactome Database Version 2.0), AnnoLnc (Annotate human lncRNA database), and GEPIA (Gene Expression Profiling Interactive Analysis), we identified a strong negative correlation between ZFAS1 and signal transducer and activator of transcription 3 (STAT3) gene expression (R = -0.11, p-value = 0.0002). Further, we observed that decreased ZFAS1 expression significantly (p 0.05) increased STAT3 and phosphorylated STAT3 (at Ser727 residue) protein levels in TNBC cells. The composite data indicate that ZFAS1 may function as a tumor-suppressor lncRNA with potential as a diagnostic/prognostic marker and may offer a new target for the treatment of TNBC patients.

Papillary neoplasm of breast comprises of seven separate heterogeneous entities ranging from benign, atypical and malignancy including non-invasive and invasive carcinoma. Papillary carcinoma (PC) is seen more commonly in older postmenopausal women with favorable prognosis. PC breast typically presents with bloody nipple discharge and an abnormal mass with radiologic features of intraductal mass. Encapsulated PC and solid PC is to be treated as in situ carcinoma, but distinction of invasive PC from non invasive carcinoma is critical both at microscopic and molecular level. So, surgical excision should be the choice of definitive diagnostic technique in papillary neoplasm instead of core needle biopsy. Furthermore, treatment guidelines for invasive PC also have been framed, but incidence of recurrence and death attributable to various subtypes of carcinoma remained same. So, this is important topic to be addressed to understand the need for further management and outcome of the disease.

Breast cancer remains the most common malignancy among the Indian female population. The p16 and p53 genes are frequently mutated in breast cancer. Therefore, we aimed to evaluate the prognostic significance of p16 and p53 overexpression in breast cancer and their correlation with various traditional prognostic parameters. Total of 100 confirmed cases of breast cancers were selected. Patients who underwent chemotherapy treatment were excluded from the study. Estrogen receptor (ER), progesterone receptor (PR), and Her2neu immunohistochemistry were performed. The p16 and p53 immunohistochemistry was performed on all cases and association with various clinicopathologic parameters was determined. The mean age of carcinoma breast was 53.3+11.6 with age ranging from 28 to 82 years. On histopathological examination, 93% of cases were of invasive ductal cell carcinoma (IDC) with majority of grade I (43%). Only 14% of cases showed positive p53 expression and 19% of cases showed positive p16 expression. P16 was seen in a very significant correlation with p53 expression in all breast carcinoma cases (

Squamous cell carcinoma (SCC) has many histologic variants, such as clear cell SCC, signet ring SCC, basaloid SCC, desmoplastic SCC, verrucous and pigmented SCC, among others. Pigmented SCC is a rare histopathological variant with oral mucosa being common site of origin.

Objective Cancer incidence across the geographical area is mercurial and factors like dietary habits, environment, social structure, genetics govern relative incidence. Malwa region of Punjab is one such geographical area of India speculated to have a higher incidence of cancer. The current analysis was done to assess the occurrence of cancer in the region and to analyze the trends and types of carcinoma with age, gender, site, and histopathological type, and to compare with the trends mentioned in the literature. Methods A retrospective analysis was done to collect and collate 2088 cancer patients' pathological records for three years at a tertiary treatment center. The collated data was digitized and used to create tables and histograms. Result Of the 2088 cancer cases, the leading cancer site was breast (24.7%) in females, followed by cancer of female genetic tract (18.9%), whereas in males, the most common site involved was head and neck (17.5%) followed by esophagus (10.3%). The leading cancer type for males was squamous cell carcinoma and for females was infiltrating ductal cell carcinoma. Breast carcinoma was most commonly seen cancer (40.5%) followed by female genital tract carcinoma and esophageal carcinoma in female patients. Whereas in males, head and neck carcinoma was most commonly identified (37.5%) followed by the gastrointestinal tract and esophageal carcinoma. This higher incidence may be attributed to better medical facilities, cancer awareness, and novel government schemes. Conclusion Based on our comprehensive analysis, we conclude that there was a change in trends of all types of carcinomas in males and females except breast carcinoma, which was seen as the most common carcinoma in female patients. Our findings suggest and support the strong implementation of cancer awareness programs and epidemiological studies to know the changing trends of risk factors in the region.

Surgery is the mainstay of the treatment of breast lesions. Diagnostic modalities and clinical examination are being used to identify the type of lesion and plan their surgical management. Management and treatment of patients if done according to guidelines and application of new techniques can provide excellent results. Patients attending surgical out patient door with breast lesions were diagnosed definitely before operative management with fine needle aspiration cytology, core needle biopsy/Excision biopsy. In our experience modified radical mastectomy with axillary lymph node dissection and thoracoabdominal skin flaps wherever needed were applied. Sentinallymphnode dissection was done followed by axillary dissection or breast conservative surgery where indicated. In clinically node negative cases of carcinoma breast, accuracy of ultrasonography guided fine needle aspiration cytology was found to be accurate in more than 80% cases. Preoperatively diagnosed benign cases underwent surgical excision. Incision and drainage were also performed as indicated. In our experience with breast lesions, surgical management that followed the recommendations resulted in a positive outcome. The use of new methods yielded excellent results with high precision.

Context: Cervical cancer is a malignant neoplasm arising mainly in the transformation zone of the cervix. Cervical cancer is the second most common cancer among women worldwide after breast cancer. Squamous cell carcinoma and adenocarcinoma constitute the greatest burden, globally as well as in India. Aims: The current study was aimed to assess the histopathological profile and its correlation with clinical findings. Settings and Design: It was a retrospective analysis of the patients of cervical carcinoma. Methods and Material: The retrospective analysis of histopathological patterns of carcinoma cervix was done. A total of 120 cervical biopsies were received, amongst which 5 biopsies were chronic cervicitis, 9 were cervical intraepithelial neoplasia (CIN) and 106 cases were of carcinoma. Further histologic subtyping of cervical carcinoma was done and was correlated with clinical presentations and stage. The collected data were analysed. Statistical analysis used: Analysis of data was done for simple means and percentages. Results: The most common age group in carcinoma cervix was fifth and sixth decade with history of bleeding per vagina being the most common clinical presentation. Squamous cell carcinoma (SCC) was the most common variant, ≥Stage III case constituted in majority and also showed poor prognosis. Conclusion: A majority of Indian women presented at later stages of cervical cancer, hence demanding the need of dedicated screening programes. Many variants present with different clinical findings especially as deep infiltrative growth patterns, hence histologic types should be kept in mind clinically while dealing with unfamiliar clinical presentations. In our experience most of the women presented in later stages and patients with ≥ stage III showed poor prognosis. Key-words: Cervix, Adenocarcinoma, Glassy cell carcinoma, Carcinoma, Endophytic growth

Anemia is growing in importance as a public health issue and a biomedical research priority in the geriatric age group but data on the causes and prevalence is not substantial. World health organization (WHO) has defined anemia as hemoglobin concentration (Hb %) below 12 g/dL in women and below 13 g/dL in men. Although it was previously believed that decline in Hb levels might be a normal consequence of aging, later suggested that anemia does reflect underlying poor health and makes elders vulnerable to adverse outcomes. Geriatric anemia has been found to be prevalent in up to 21.1% of patients in Europe and 11.0% of men and 10.2% of women of 65 years and older in the US. There is little literature that explores the various causes of anemia and its association with socio-demographic profile with underlying diseases, hence lesser research has led anemia to go undiagnosed and untreated.

Cystic lesions of the spleen are rare lesions and can be parasitic or nonparasitic. Nonparasitic cysts are of two types: primary cysts and secondary pseudocysts. Primary cysts of the spleen are very rare and are also called true, congenital, epidermoid, or epithelial cysts. Splenic cysts are usually asymptomatic and often found incidentally during imaging studies. We are presenting a case of a 19-year-old female with a large splenic cyst which was surgically treated by open splenectomy.

Background: Platelets with altered morphology or large size are more thrombogenic and are likely to be associated with increased risk of vascular disease. Platelet parameters especially high mean platelet volume (MPV) has been reported in diabetic patients as major contributing factor. The aim of the present study was to find correlation between fasting blood glucose value and hematological variables (PC and MPV), not only in diabetics, but also in the normoglycemic subjects and patients with impaired fasting blood glucose levels.Materials and Methods: In the present study 3471 subjects were analyzed retrospectively and categorized into three groups based on the fasting blood glucose levels as Group I - normoglycemics (FBG ? 109 mg/dl, n = 1158), Group II- impaired fasting blood glucose (FBG ? 126 mg/dl, n = 1158) and Group III – Diabetics (FBG ? 127 mg/dl, n = 1155).Results: We found progressive increase in value of MPV with the increasing FBG levels, in the following order: G1 (8.44 ± 0.842 fl), G2 (8.98 ± 0.898 fl), G3 (9.31 ± 0.967 fl). The platelet count however, did not show much statistical significance with rising glucose levels.Conclusions: MPV increased proportionally with increasing plasma glucose levels. Although the variation between the normoglycemics and impaired fasting group was not very significant, the parameters still showed progressive increase with rising sugar levels significant in diabetic group.Asian Journal of Medical Sciences Vol.7(1) 2015 30-33

The clear cell adenocarcinoma of ovary is a distinctive tumour. Stroma rich variants (adenocarcinofibroma) of these types of tumours are uncommon. We report a rare case of clear cell adenocarcinofibroma of ovary in 37 years of female presenting with bilateral ovarian masses. The tumour contained fibrous component and was radiologically indistinguishable from soft tissue malignancy. The serum level of CA-125 was raised. Histopathology and immunohistochemistry revealed the rare microscopic type of ovarian tumour. Because of differences in the clinical course as well as management, possibility of this unusual type of carcinoma must be ruled out.

Background.Peripheral blood count is the first investigation to be done in every patient before surgery. As strong relationship exists between cancer and immune response of the body, clinical stage at presentation and altered hematological parameters can influence the progression of cancer and vice versa.Settings and Design.It is a case control study of total 50 cases (35 cases of carcinoma breast and 15 cases of benign breast disease).Methods.A case control study was carried out; 35 cases of breast cancer patients were taken prior to surgery and chemotherapy with 15 cases of benign breast disease as control. Clinical staging according to the tumor, node, and metastasis classification (TNMc) was done and was correlated with complete blood count (CBC).Results.All the cancer patients were females with overall mean age of47.96±13.84years. Amongst all altered blood parameters, correlation of absolute lymphocytic count (pvalue 0.001) with TNMc staging was found significant. Particularly, decrease in absolute leucocytic count was observed with increase in stage of breast carcinoma.Conclusions. The stage-specific mean values of absolute lymphocytic counts of preoperative breast cancer patients can be used as an economical tool to know the evolution of disease.

Background: The bone marrow is frequently involved in variety of cases presenting with hematological and non-hematological disorders, which are diagnosed by two separate but interrelated techniques such as bone marrow aspiration (BMA) and bone marrow biopsy (BMB). Aim: This study was aimed to assess the diagnostic value of the BMA and BMB and role of both the procedures to reach final diagnosis when done simultaneously. Settings and Design: It was a prospective study. The findings of BMA smears were correlated with BMB sections and data obtained was analysed. Materials and Methods: BMA and BMB were performed on 50 patients. Criteria of inclusion included the main indications for performing this procedure, the availability of full medical records and patient consent. The patients had a male to female sex ratio of 1.6:1 and a wide age range from 4 years to 74 years. Results: In the present study, the main indications for bone marrow examination were categorized. Out of 50 cases studied, in 23 cases, a strong positive correlation between BMA and BMB was noted. However, it was found that in the cases of aplastic anaemia, different phases of myeloproliferative neoplasm (MPN), multiple myeloma, tubercular granulomas and hemato-lymphoid neoplasm, involvement of the marrow was detected better in bone marrow biopsies. Conclusion: The study concludes that preparations of aspirate and trephine biopsy are easy, rapid and complementary to each other in majority of the lesions. The advantage of both the procedures done together enabled us to study the cytomorphology of the cells along with the pattern of distribution of the cells depending on the cases, hence help in making the diagnosis accurately.

C Splenic epidermoid cysts are relatively uncommon. Most often, they are asymptomatic, but they may present with abdominal discomfort, predominantly at young ages. We are reporting a rare case of 12-years-old female child with history of dull intermittent pain, tender palpable mass in left hypochondrium on physical examination. Ultrasonography (USG) of abdomen showed large cyst in upper pole of spleen, and an X ray of chest revealed slightly raised left hemidiaphragm. Axial sections taken on computerized tomography of abdomen showed a large well defined cystic mass near upper pole of spleen, with a thin septum in it. On laparotomy, open total splenectomy was performed. Sections from cystic wall were processed and histopathological examination revealed fibrous tissue covered by stratified squamous epithelium. Although, now-a-days emphasis is being laid on minimal invasive operative procedures which preserve spleen. This case report favours total splenectomy, considering postoperative outcome. The final diagnosis always depends upon histopathological examination.