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A 43-year-old male patient who had an advanced stage of nasopharyngeal carcinoma developed after administration of cisplatin an acute renal failure until he required hemodialysis and his renal failure was permanent. The renal biopsy examination indicated partial recovery of the proximal tubule, but renal function did not recover.

Tumor Lysis Syndrome (TLS) is a major oncological emergency involving metabolic perturbations. It occurs when tumor cells release their contents into the bloodstream, either spontaneously or in response to therapy. TLS is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia following massive lysis of malignant cells. Although this syndrome is well described, it is rarely seen or suspected in solid malignancies. The frequency and severity of TLS is partly dependent upon the biology of the disease and type of therapy administered. We report in this work two cases of tumor lysis syndrome occurring after chemotherapy for endocrine colon carcinoma with small metastatic cells.

Human leukocyte antigens G and E (HLA-G and HLA-E) are nonclassical major histocompatibility complex (MHC) class I molecules. These molecules play an important role in immune surveillance by inhibiting natural killer and cytotoxic T cells responsible for immune escape. The expression of HLA-G and HLA-E has been associated with several diseases including tumor. The main objective of the study is to evaluate the impact of three HLA-G 3'UTR potential polymorphisms: +3187 A > G (rs9380142), +3142 G > C (rs1063320), +2960 14-base pair (bp) Insertion/Deletion (Ins/Del) (rs66554220), and the HLA-E*01:01/01:03 A > G (rs1264457) polymorphism in Tunisian breast cancer population. A total of 355 patients and 381 controls were genotyping for HLA-G and HLA-E polymorphisms using a Taq Man assay. +3142 C allele and +3142 C/C genotype were significantly associated with increased risk of breast cancer (p = 0.00002; OR = 1.58; 95% CI = 27-1.97) (49% versus 35%; p = 0.0001; OR = 1.79; 95% CI = 1.32-2.44). In addition, Del allele and the homozygous state for Del/Del genotype confer a risk for breast cancer (52% versus 45%, p = 0.006; OR = 1.33, 95% CI = 1.08-1.64) (28% versus 22%, p = 0.039; OR = 1.43, 95% CI = 0.90-2.25). However, no statistical significant differences were reported for HLA-G + 3187 A > G and HLA-E variations and breast cancer in a Tunisian population. The found results indicate that HLA-G may play an important role in the breast cancer.

The MHC class I chain-related molecule A (MICA) is a ligand for the activating natural killer (NK) cell receptor NKG2D. A part from its genetic diversity, MICA is characterized by the presence of membrane-bound and soluble isoform (sMICA) and by the propensity to elicit antibody-mediated allogeneicity (MICA Abs). Altogether such properties are important in the cancer setting. Here, we investigated whether MICA polymorphism, serum level of sMICA and MICA antibodies (Abs) may influence nasopharyngeal carcinoma (NPC) risk. 274 NPC naïve of treatment patients and 275 healthy individuals, all originating from Tunisia were included and genotyped. Among them, 160 sera from patients and 51 from controls were analyzed for the sMICA level by ELISA and were tested for the presence of MICA Abs by Luminex assay. The statistical analysis showed that: (1) we extend and confer our previous finding concerning Val/Val association with risk of NPC (

The pathogenic mechanisms underlying Schizophrenia (SZ), one of the most frequent mental disorders, are complex and poorly understood. Several evidences suggest that inflammatory processes may underpin some of its neurobiological correlates. The aim of this study was: (i) to analyze the potential association between circulating levels of the C-reactive protein (CRP), a crucial inflammatory marker, and Schizophrenia in Tunisian patients and healthy controls (HC) cohorts; (ii) to investigate the genetic diversity of three CRP variants (rs1417938, rs1130864 and rs1205) and; (iii) to analyze a potential relationship between expression and genetic data and clinical and socio demographical characteristics. CRP polymorphisms were exanimated for 155 patients and 203 HC by taqMan5′-nuclease. High-sensitivity CRP (hs-CRP) serum level was measured in 128 clinically stable out-patient SZ patients and 63 HC subjects via an automated biochemical analyzer. We found that hs-CRP levels were significantly higher in SZ patients as compared to HC. No significant differences were found when the proportions of CRP variants were compared in patients and HC. Further analysis according to clinical and socio demographical characteristics revealed a positive association with age and hypertension. Our data on an original Tunisian sample confirm the previous finding in others population groups.

Cytochrome P450 2E1 (CYP2E1) is a detoxifying enzyme that belongs to the phase I metabolism of xenobiotics. This enzyme is encoded by a highly polymorphic gene whose common polymorphism corresponds to the substitution of cytosine (C) and thymine (T) at position -1019 (rs2031920). This polymorphism has been identified in several cancers including nasopharyngeal cancer (NPC). The study involved 124 patients with nasopharyngeal carcinoma, compared with 166 healthy controls. The presence or absence of the polymorphism is determined by PCR-RFLP. The frequency comparison between the two groups is determined by the χ(2) test. The analysis of our results showed a significant difference between the two groups regarding the mutant genotype (C2/C2) (5% vs. 0.5%, P=0.04) and has a risk factor for NPC in Tunisia (OR=8.39; CI 95% [0.99-388.1]). Also, the C2 allele was significantly associated with the group of patients than the control group (6% vs. 2%, P=0.016) and increased three times the risk of NPC in Tunisia (OR=2.99, CI 95% [1.12-8.79]). Our results confirm the results reported in other populations and emphasize the importance of the involvement of this gene in the development of detoxification of the NPC, which seems more and more strongly associated with environmental factors.

The major histocompatibility complex class I-related chain A (MICA), expressed on cell surface, plays an important role in the elimination of both virus-infected cells and tumor through the activation of the natural killer (NK) receptor NKG2D. A polymorphic change from methionine (Met) to valine (Val) at amino acid position 129 categorizes MICA alleles into strong and weak binders for the NKG2D receptor and has been found in a variety of immune-related disorders. In this study, we investigated the potential interaction between genetic polymorphism of MICA and the development of breast cancer. We recruited 192 unrelated Tunisian women affected by breast cancer and 205 controls age-matched women, all genotyped for MICA-129 Met/Val (rs 1051792). A significant association was found between the Val allele and Val/Val genotype and the risk of breast cancer (p = 0.002, OR = 1.64, 95% CI = [1.17-2.27]; p = 0.002, OR = 1.88, 95% CI = [1.24-2.87], respectively). After stratification with clinical-pathology parameters, we found that 71% of women aged lower than 40 years had a Val/Val genotype versus 49% (p = 0.014). About 72% of these patients having a family history of cancers had a Val/Val genotype (p = 0.04). These results suggest that tumor escape mechanism because of failure in order to activate NK cells by MICA-129 Val allele may play a role in individual susceptibility for breast cancer development in Tunisian women.

Nasopharyngeal carcinoma (NPC) is a complex multifactorial disorder involving both genetic and environmental factors. Genetic predisposition linked to the immune system has been associated with various tumors. This involves genetic diversity of the genes encoding the molecules of the immune response such as inflammation and anti-tumor surveillance. In this work, we examined the impact of the immunogenetic diversity on the risk of the NPC in different populations studied. These data show that the interindividual variability of the genetic regulation of immune processes increases the risk of NPC in individuals previously predisposed due to other risk factors (genetic / environmental). This synthesis, in addition to the predictive aspects, could provide innovative research for the development of new therapeutic approaches.

Helicobacter pylori (HP) chronic gastritis can lead to precursor stages of gastric cancer. New biological markers have been proposed to study the gastric mucosal state. We evaluate biological results in comparison with histological ones in a dyspeptic population. Forty nine dyspeptic patients underwent endoscopy with gastric biopsies for histological examination. Blood samples were obtained to measure levels of gastrin 17 (G17), pepsinogen 1 (PG1), pepsinogen 2 (PG2) and the rate of anti-HP IgG antibodies. Four patients have a healthy gastric mucosa and 45 have a gastritis (32 have a nonatrophic gastritis and 13 an atrophic one). An increase in the level of PG2 and a decrease of the PG1/PG2 ratio were noticed in the group of subjects with a nonatrophic gastritis compared to the healthy mucosa group. The decrease of the PG1/PG2 ratio was more important in the corpus atrophic gastritis group than in the antrum restricted atrophic gastritis one. In conclusion, in front of dyspeptic patients, we advice to practice in first intention the measurement of the serological level of G17, PG1, PG2 and anti-HP IgG antibodies.

Resume Devant la frequence non negligeable des formes cliniques atypiques et la toxicite des traitements prescrits, il est necessaire de confirmer le diagnostic des leishmanioses par l'examen parasitologique. Le but de notre travail est d'evaluer l'apport diagnostique de la mise en culture au cours des leishmanioses viscerales et cutanees. Il s'agit d'une etude prospective realisee chez 72 sujets atteints de leishmaniose viscerale et 105 patients atteints de leishmaniose cutanee ayant beneficie d'une mise en culture systematique des prelevements pathologiques (moelle osseuse et sang peripherique dans la leishmaniose viscerale et suc dermique dans la leishmaniose cutanee) sur le classique milieu NNN. Les resultats observes montrent qu'au cours de la leishmaniose viscerale, la sensibilite de la culture de la moelle osseuse est de 73,6 %, celle du sang peripherique est de 54,1 %, alors que dans la leishmaniose cutanee la sensibilite de la culture est de 83,8 %. La mise en culture a permis l'amelioration de la sensibilite de l'examen parasitologique de 25 % au cours de la leishmaniose viscerale et de 16,1 % au cours de la leishmaniose cutanee ; cependant les auteurs insistent sur la necessite de garder les cultures un mois avant de rendre un resultat negatif ; en effet 2 cultures de la moelle osseuse, 4 cultures du sang peripherique et 3 cultures de suc dermique ne se sont positivees qu'apres 4 semaines d'incubation.

The abnormalities of the haemoglobin divide into qualitative abnormalities and quantitative abnormalities. This variant contains polymorphisms often useful as markers of population. At present more than 693 types of abnormal haemoglobin are listed. This hemoglobinopathies can arise at reached subjects of cancerous pathologies.To bring to report association hémoglobinopathies-cancers.Our study was realized to the Institute Salah azaiz (ISA) concerning hémoglobinopathies in carcinologic environment over a period spreading out of May 2004 in February 2008. The phenotypic and biochemical study of haemoglobin revealed the presence of 328 carriers of abnormalities of the haemoglobin on a total of 10550 patients followed to ISA. 7 types of abnormalities of the haemoglobin were identified (HbS, Hb C, Hb O arab, Hb D, Hb G, fast mutant and ß thalassemia.The sickle cell line represents the most wide-spread hémoglobinopathie (51.3 %). 48.2 % of the carrier subjects of abnormalities of the haemoglobin are followed for malignant pathologies. Among these hemoglobinopathies, we revealed the presence of two fast mutants of the haemoglobin corresponding to the haemoglobin Bangkok. This type of rare mutant is described for the first time in Tunisia. According to the genotypic study by these two cases, the haemoglobin Bangkok results from the replacement at the level of the chain ß some aspartic acid by the wisteria, further to a transfer at the level of the codon 56. A phenotypic study family revealed the presence of similar transfers at certain members of the family.Our work allowed us to notice a relatively important frequency of rare abnormalities of the haemoglobin at patients presenting varied tumoral processes.

To analyze the testicular cancer (TCa) incidence, diagnosis aspects, pathologic grade, stage, and survival in Tunisian men.We studied all patients who had histopathologically confirmed TCa treated in La Rabta University-Hospital between 1991 and 2010. Baseline demographic data included age at diagnosis, year of diagnosis, clinical symptoms, stage at diagnosis, histologic type, management strategies and survival were analyzed.The incidence of TCa among Tunisians is very low; we collected only 41 cases over a period of 20 years with an average incidence of 2 new cases per year. Peak age incidence was 30-49 years. Testicular swelling was the principal complaint in 25 patients. 58.5% of tumours were rightsided and 39% were left-sided. There was bilateral involvement in only one case. The mean interval between onset of symptoms and presentation was 16.5 months (1-120). Most patients presented at stages T2 and T3 (63.4% and 26.8% respectively). Treatment consisted of radical orchidectomy in all patients and cisplatin-based chemotherapy and radiotherapy in respectively 11 and 12 patients (association in 5 patients). One patient with a tumour in an intra-abdominal testis underwent laparotomy. The most common histological types were seminomas (n=20) and mixed germ cell (n=8). Three patients died within 48 months, while half were lost to follow-up.The incidence of TCas in Tunisia remains low. Late presentation and treatment are major challenges to management. Better health funding and education regarding testicular self examination is essential.

To evaluate and assess disruptions of serum lipids at patients having a colorectal cancer.Our prospective study interested 30 patients, from 26 to 93 year old, presenting a colorectal cancer confirmed histologically, examined during the period going from March 2003 to April 2004. Thirty healthy controls were examined in parallel. All patients undergo three blood samples respectively in preoperative, 48h and 6 months after surgical operation. The analyses carried out were determination of a total serum cholesterol, HDL (high density lipoprotéin) and LDL (low density lipoprotein) cholesterol, serum triglyceride and serum apoprotein (AI and B) RESULTS: We noticed a decrease of total serum cholesterol level in 43% of the cases associated to the reduction of the HDL and the LDL cholesterol in respectively 30% and 76% of cases. The mean values of total serum cholesterol, HDL and LDL cholesterol rates were significantly lower for patients compared to those of controls (p respectively : 0.001; 0.04 and 0.001). Moreover, the level of total serum cholesterol varied significantly with tumor localization ( p= 0,02).Serum lipid disruptions affect essentially total cholesterol, HDL and LDL cholesterol. It would be therefore interesting to evaluate their rate at the basal state in order to follow their evolution after treatment in colorectal cancer.

Helicobacter pylori (HP) chronic gastritis can lead to precursor stages of gastric cancer. New biological markers have been proposed to study the gastric mucosal state. We evaluate biological results in comparison with histological ones in a dyspeptic population. Forty nine dyspeptic patients underwent endoscopy with gastric biopsies for histological examination. Blood samples were obtained to measure levels of gastrin 17 (G17), pepsinogen 1 (PG1), pepsinogen 2 (PG2) and the rate of anti-HP IgG antibodies. Four patients have a healthy gastric mucosa and 45 have a gastritis (32 have a nonatrophic gastritis and 13 an atrophic one). An increase in the level of PG2 and a decrease of the PG1/PG2 ratio were noticed in the group of subjects with a nonatrophic gastritis compared to the healthy mucosa group. The decrease of the PG1/PG2 ratio was more important in the corpus atrophic gastritis group than in the antrum restricted atrophic gastritis one. In conclusion, in front of dyspeptic patients, we advice to practice in first intention the measurement of the serological level of G17, PG1, PG2 and anti-HP IgG antibodies.

Soluble interleukin-2 receptor alpha (slL-2Ralpha) is a well-known indicator of T-cell activation noted to be increasing in nasopharyngeal cancer. The aims of this study were to evaluate the importance of the use of this marker in nasopharyngeal carcinoma.Our prospective study interested 45 patients (35M/10F) with a mean age of 49 years (15 to 78), presenting a nasopharyngeal carcinoma histologically confirmed and 61 healthy controls. A blood sample was collected from each patient before any treatment, as well as controls to measure sIL-2Ralpha by immunoenzymatic assay. According to the disease status after a period of follow-up ranging from three to 22 months (median 12 months), patients were divided into two groups: The remission group (n=28) represented those with favourable evolution and a second group of 15 patients with unfavourable evolution (2 death, 4 cases of persistent primary disease and 9 patients with distance metastasis). 2 patients were lost to follow-up.serum sIL-2Ralpha levels were significantly higher in patients vs healthy controls (p0.0001). The serum levels correlated with the stage T of NPC (p = 0.01). Patients having a favourable evolution have lower sIL-2Ralpha levels before treatment vs those with unfavourable evolution without statistical difference.Measurement of serum sIL-2Ralpha provides a good estimation of the nasopharyngeal tumor burden. The usefulness of this marker as a parameter to predict prognosis in NPC should be examined further.

Our prospective study interested 41 patients, from 13 to 70 years old, and present a nasopharyngeal carcinoma confirmed histologically, during the period going from September 1999 to March 2000, and 45 healthy controls. A blood sample was collected from each patient before any treatment, as well as controls to measure serum LDH and its isoenzymes. Two groups of patients were selected after a period varying from 12 to 37 months with a mean of 29 months: 29 with favourable evolution, 12 with non favourable evolution. The mean serum total LDH and its isoenzymes values were significantly higher in patients than those in controls with values of variable p of 0.001 to 0.05. A significant correlation was found between ganglionnary extension and serum values of total LDH, LDH3 and LDH5. No significant difference were observed between the means serum total LDH before treatment and the clinical evolution of patients. Diagnostic contribution of total LDH is limited, by its ubiquitary character, but could constitute for LDH3 a good marker of the disease progression.

Report epidemiological, clinical and biological aspects of nasopharyngeal carcinoma in Tunisian children.Our retrospective study from 1994 to 2001 included all children treated for nasopharyngeal carcinoma in the Salah Azaïz Cancer Institute of Tunis. Initial investigation consisted of ENT and general examination, nasopharyngeal CT-scan, abdominal echography, chest X-ray and bone scintigraphy. Biological markers included blood-count, erythrocytes sedimentation and serum lactic dehydrogenase. All children received neoadjuvant chemotherapy (adriamycin, cisplatin) and irradiation therapy.There were 48 children with a median age of 13,7 years and a sex ratio of 1,4 (28/20). Lesions are staged T2, T3 and T4 in 2,1 %, 18,7% and 79,2% of cases. All patients have cervical palpable nodes at diagnosis classified as N1 (8,3%), N2 (33.3%) and N3 (58.3%). A significant correlation was found between serum lactic dehydrogenase and the N stage (p = 0.02). After follow up, recurrence of disease was noted for three children, persistent disease for two children and metastatic disease in five cases. The overall and relapse free survival at 5 years were 79.1% and 68.9% respectively. Patients aged 13 or lower had poorer 5 overall survival rate (72.3%) than older age group (84.2%).