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Aya Alsayed,1 Salem E Salem,1 Mostafa M El Serafi,1 Mona S Abdellateif,2 Abdel-Rahman N Zekri,3 Marwa Mohanad,4 Abeer A Bahnassy5 1Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, 11976, Egypt; 2Medical Biochemistry and Molecular Biology, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, 11976, Egypt; 3Molecular Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, 11976, Egypt; 4Biochemistry Department, College of Pharmaceutical Sciences and Drug Manufacturing, Misr University for Science and Technology, Giza, 12945, Egypt; 5Pathology Department, National Cancer Institute, Cairo University, Cairo, 11976, EgyptCorrespondence: Abeer A BahnassyPathology Department, National Cancer Institute, Cairo University, Cairo, EgyptFax +20 223644720Email chaya2000@hotmail.ComBackground: Microsatellite instability (MSI) and circulating tumor cells (CTCs) play important roles in the diagnosis, prognosis and management of colorectal cancer (CRC) patients.Methods: CTCs and MSI were assessed in the blood and representative tumor tissues of 100 CRC patients by flow cytometry (FCM) and PCR amplification. The data were correlated to relevant clinicopathological features of the patients, progression-free survival (PFS) and overall survival (OS) rates.Results: MSI-high was detected in 44 (44.0%) patients, MSI-low in 37 (37%), and microsatellite stable (MSS) in 19 (19.0%) patients (P=0.007). The baseline CTCs count (< 4 cells/7mL blood) was reported in 39% of the patients, and CTCs ≥ 4 cells/7mL blood in 61% of the patients (P=0.028). Improved PFS and OS rates were associated significantly with MSI-high (P< 0.001), decreased CTC levels during the course of treatment (P< 0.001) and post-treatment CTCs (P=0.008). There was no significant association between MSI-high and PFS or OS in early-stage patients (P=0.187 and P=0.187; respectively); however, it was associated significantly with better PFS and OS in late-stage patients (P< 0.001). Multivariate analysis showed that only a change in serial CTC levels is considered an independent prognostic factor for OS (P< 0.012). Post-treatment CTCs level, serial CTCs level changes during the course of treatment, lymph nodes and distant metastasis were independent prognostic factors for PFS (P< 0.001, P= 0.047, P=0.001 and P< 0.001; respectively).Conclusion: MSI and CTCs could be used as accurate, reliable and sensitive diagnostic and prognostic biomarkers for CRC patients’ survival rates and outcomes.Keywords: circulating tumor cells, microsatellite instability, colorectal cancer, response to treatment, survival rates

Invasive lobular carcinoma of the breast is the second most common type of invasive breast carcinoma. Invasive lobular carcinoma has an unusual pattern of metastases, which poses a diagnostic challenge for both clinicians and pathologists. We herein present three cases of breast invasive lobular carcinoma presented with metastasis to unusual sites, namely, uterus, colon and stomach. We recommend a higher index of suspicion in any case with breast cancer developing gastrointestinal tract or genital tract symptoms.

Background: A study of the pattern of the eye diseases is very essential because while some eye conditions are only causing of ocular morbidity, others invariably lead to blindness. However, some conditions are curable, others are largely preventable. Objective: The aim of this study was to determine the pattern of different eye diseases among patients attending the Ophthalmic Outpatient Clinic of Al-Zahraa University Hospital. Subjects and methods: This study was carried out on 500 patients recruited from the Outpatient Clinic of the Ophthalmology Department, AL-Zahraa University Hospital. The study was performed from December 2018 to August 2019. All participants were subjected to fulfilling a pre designed questionnaire including questions about demographic data, a detailed ophthalmological history and a complete Ophthalmological Examination. Results: Retinal diseases (20.2%) were the most common eye diseases among the studied group followed by errors of refraction (19.6%), cataract (19.4%), dry eye (12.8%) and intravitreal injection (6.4%). There was a significant difference between male and female population regarding ocular trauma and different eye diseases. Also, there was a significant difference between occupation groups regarding diagnosis of different eye diseases and between age groups regarding diagnosis of different eye diseases. Conclusion: It could be concluded that due to the presence of a variety of ocular disorders that affect different anatomical parts of the eye, routine clinical examination and screening programs to decrease the incidence and prevalence of ocular morbidity are required.