Actinic keratosis (AK) is a chronic and recurrent disease and in this double-blind, half face, placebo controlled study we attempt to examine the efficacy of a topical treatment containing 2,4,6-octatrienoic acid and anthraquinone knipholone for the prevention of new AK lesion formations. New lesion onset was detected with methyl-5-aminolevulinic acid and Wood’s lamp after 6 months of treatment (T1) and 12 months after treatment end (T2). Absence of new lesion at T1, was 86.11% in active treatment side while 77.78% in placebo side. At T2 the percentage was higher in skin treated with active product (83.33% of subjects) compared to placebo (63.89% of subjects). Taking into consideration the number of new lesions during the study period, at T1 the new AK lesions were not statistically significantly influenced by the treatments, while at T2, AK lesions were detected in 30.55% of placebo-treated area while in the contralateral part the lesions were 13.89%. The reduction induced by active treatment was statistically significant. The product containing 2,4,6-octatrienoicienoic acid and anthraquinone knipholone is effective in reducing new AK lesion formation in subjects with a history of AKs.

Background: The aim of this study was to investigate the prognostic role of mammalian target of Rapamycin (mTOR) and C-X-C chemokine receptor type 4 (CXCR4) in diffuse large-B-cell lymphoma (DLBCL) patients.
Patients and methods: This retrospective study was collected data from 64 de novo DLBCL patients, who received standardized R-CHOP therapy at two oncology centers. CXCR4 and mTOR expressions were assessed by immunohistochemistry.
Results: Out of the 64 DLBCL patients, 40 patients were positive for CXCR4 (62.5%) and 35 patients for mTOR (54.7%) expressions. CXCR4 expression was positively correlated with mTOR expression (r = 0.7; p <.001). While mTOR expression was significantly associated with high lactate dehydrogenase level (p =.03) and number of extranodal sites one or more (p =.02), CXCR4 expression was significantly associated with high IPI score (p <.001) and ECOG PS (p =.005). Furthermore, the expression levels of mTOR and CXCR4 were significantly associated with older ages and poor response to treatment (p =.04, <.001 and.04,.03, respectively). After a median Follow up of 22 months, mean ± SD overall survival (OS) was 65.391 ± 4.705. Kaplan-Meier analysis showed that patients positive for mTOR and CXCR4 expression had shorter DFS (p =.01 &.02) and OS (p =.02 &.04). Multivariate analysis showed that CXCR4 and mTOR positivity is an independent prognostic factor for significantly poorer DFS (p =.03, and.02 respectively) but not for OS (p =.09 and.08 respectively) in the DLBCL pateints.
Conclusion: Our results indicate that the expression of CXCR4 and mTOR may be poor prognostic biomarkers in DLBCL.

Background: The prognostic value of Platelet-to-lymphocyte ratio (PLR) in patients with non-small-cell lung cancer (NSCLC) is still indistinct. We conducted this study to assess the prognostic significance of pretreatment PLR in patients with unresectable NSCLC.
Aim of the Work: To assess the prognostic significance of pre-treatment PLR in patients with NSCLC.
Material and Methods: We retrospectively reviewed 130 patients treated for NSCLC with definitive/palliative chemotherapy and/or radiotherapy in Ain-Shams Universit hospital, Clinical Oncology department between January 2014 and December 2016. Pre-treatment CBC was available for the 130 patients to calculate PLR by dividing the absolute platelet count by the absolute lymphocytic count.
Results: Out of 130 patients with available pre-treatment complete blood picture, population age ranged from 23 to 87 years. Male to female ratio was 4.8:1. Adenocarcinoma presents 51% of cases. Unresectable stage II and stage III present 2% and 27% respectively, while Stage IV presents 69%. Using a cut-off value of 150, a statistically significant correlation between baseline PLR > 150 and presence of distant metastases was found (p =.043); with a trend towards less advanced stage disease among group of patients with baseline PLR < 150 (p =.064). High PLR > 150 was significantly associated with poor overall survival (OS) (median OS: 10.33 months; 95% CI: 6.23-14.42, compared to patients with PLR < 150; (median OS: 24.63 months, 95% CI:11.5-37.76, p =.008), but not PFS. In multivariate analysis, PLR < 150 was an independent good prognostic factor for OS; (HR = 0.549; 95% CI: 0.314-0.958; p =.035).
Conclusion: High PLR is associated with poor OS in patients with unresectable NSCLC.

Background: Endoscopic ultrasound (EUS) has gradually become the main stream method of the diagnosis and local treatment of pancreatic tumors. Endoscopic ultrasound (EUS) is frequently used in making the cytological diagnosis of pancreatic cancer and its great role in the pre-operative staging of pancreatic tumors.
Objective: To evaluate the role of EUS in diagnosis and treatment of pancreatic tumors prospectively for 2 years study 2014-2015.
Patients and methods: Prospective study including 70 patients who presented with pancreatic tumors underwent EUS at the endoscopy unit at Faculty of Medicine Cairo University and National Cancer Institute, Cairo University.
Results: Out of 70 patients; median age was 55 years (range 32-73 years). Males were 32 (46%) and females were 38 (54%). Jaundice was the main symptom 47 (67%), clay colored stool 46 (65.7%), dark urine 47 (67%) and abdominal pain 50 (71%). There were 20 patients with benign disease and 50 patient with malignant disease. The following results showing the accuracy of the EUS in detecting malignant pancreatic tumors; Sensitivity: 96.0%, specificity: 75%, PPV: 90.6%, NPV: 88.2%, accuracy: 90.0%.
Conclusion: EUS can clarify locoregional spread when CT/MR are equivocal. EUS Elastography is a new application in the field of the endosonography and seems to be able to differentiate fibrous and benign tissue from malignant lesions. The combination of superior detection, good staging, tissue diagnosis and potential therapy makes EUS guided FNA a cost-effective modality.

Background: Obstructive jaundice is a common problem in the medical and surgical gastroenterological practice. Malignant obstructive jaundice can be caused by cancer head of pancreas, periampullary carcinoma, carcinoma of the gall bladder and cholangiocarcinomas.
Objective: To review the etiological spectrum of malignant obstructive jaundice in NCI Cairo university during a period of 3 years (2008 till 2010).
Patients and methods: Retrospective study including 232 patients who presented with malignant obstructive jaundice between (2008 to 2010). Data were collected from the biostatistics and cancer epidemiology department.
Results: Out of 232 patients; 156 (67.2%) were male and 76 (32.8%) were female; the median age of the study population was 49 years (range 19-80 years). Our results indicate that the expression of CXCR4 and mTOR may be poor prognostic biomarkers in DLBCL. The commonest cause of malignant obstructive jaundice was pancreatic head cancer, 72% (167/232), followed by the ampullary carcinoma 15% (36/232). The last cause was cholangiocarcinoma 12.5% (29/233). Regarding the commonest symptom; clay colored stools (98.7%) was more frequent in patients with malignant disease whereas abdominal pain (97.7%) was 2nd common symptom.
Conclusion: Obstructive jaundice is more common among males and cancer head of pancreas is the commonest malignancy. US, ERCP and CT-Scan are important diagnostic modalities for evaluation of patient with obstructive jaundice with ERCP having the additional advantage of being therapeutic as well.

Background: Aromatase inhibitors (AIs) represent an effective endocrine treatment for hormone receptor-positive postmenopausal breast cancer patients with early stage or metastatic disease.
Objective: Assessment of Cardiotoxicity in Hormone positive Postmenopausal Breast Cancer Patients receiving AIs (upfront or switch therapy).
Methods: This cross sectional study included 123 postmenopausal breast cancer patients presented to the Clinical Oncology Department, Ain Shams University (Cairo, Egypt) in the interval from August 2016 to June 2017 with hormone receptor positive receiving Aromatase Inhibitors, To assess cardiotoxicity in these patients, they were subjected to blood pressure and lipid profile measurement, electrocardiography (ECG), and electrocardiography (ECHO) and classified into patients had Nolvadex then A.I (arm 1) and others had upfront A.I (arm 2).
Results: The age of patients ranged from 41 years to 85 years with mean age of 61 years. Seventy one patients (57.7%) showed cardiotoxicity as assessed by ECHO. They showed significant correlation with rising age above 62 years, IHD, history of HTN and DM (p value:.001,.001,.017 and 0.035 respectively). However, correlation between cardiotoxity and blood pressure changes, lipid profile changes and ECG findings and ECHO changes in switch therapy and upfront A.I were not statistically significant (p value =.275,.116,.081 and.761 respectively).
Conclusion: Assessment of cardiotoxicity in hormone positive postmenopausal breast cancer patients receiving Aromatase Inhibitors showed evidence of cardiotoxicity in half the patients (57.7%) as detected by ECHO only. They showed statistically non significant correlations either recievied switch therapy or upfront A.I.

Background: There are limited data in the literature comparing the efficacy of aromatase inhibitors in postmenopausal hormonal receptor positive early breast cancer patients.
Aim of study: To compare the efficacy of letrozole and anastrozole in hormone-receptor positive postmenopausal breast cancer patients.
Methods: A retrospective study with a mean follow-up period of 64 months (about 5 years) for 74 files of early invasive postmenopausal breast cancer hormonal receptor positive patients; 39 received letrozole and 35 received anastrozole, considering TTP as primary end point, and OS as second end points.
Results: Letrozole is not superior to anastrozole during the first 55 months of treatment (80% PFS at 5th year), and 80% OS benefit at 6th year. Overweight patients had better (90% PFS at 5th year) than obese patients (60% PFS at 5th year).
Conclusion: Letrozole is not superior to anastrozole in efficacy in early invasive hormonal receptor positive breast cancer postmenopausal patients during the first 5 years of treatment; however, Letrozole 2nd line after tamoxifen is superior to anastrozole 2nd line after tamoxifen in treating obese patients with early invasive hormone receptor positive breast cancer.

Background and aim: Mucoepidermoid carcinoma is a common salivary tumor that affects both adults and children. Proliferation is one of the most fundamental biological processes of growth and maintenance of tissue homeostasis. CD-44 may be used as an indicator of aggressive behavior of some human malignancy. Multidrug resistance is one of the major obstacles for successful cancer chemotherapy. The present study was carried out for evaluation of the biological rules and the clinicopathological significance of Ki-67, CD-44 and MDR-1 expression in the different histopathological grades of MECs.
Patients and methods: Eighty paraffin embedded MEC tissues were collected and classified to three groups according to their histological grades. Tissue sections were stained with Ki-67, CD-44 and MDR-1 then examined microscopically and analyzed statistically.
Result: High grade MEC cases showed the highest expression for Ki-67, CD-44 and MDR-1. Additionally, significant differences were found between the histopathological grades as well as between lymph node stages of the studied cases and the expression of the three utilized markers.
Conclusion: Ki-67, CD-44 and MDR-1can be used to evaluate the degree of differentiation and to predict the prognosis of MECs, furthermore, high grade MEC cases with high proliferative indices might be resistant to chemotherapy.

It is known that cervical cancer cells express IL-2 receptor (IL-2R) and those high doses induce cell death. To identify the type of cell death two cervical cancer cell lines, CALO and INBL, were cultured with 100 IU/ml of IL-2. Our results showed the presence of apoptotic cell death by the significant expression of phosphatidylserine on the external surface of cellular membranes, the presence of a typical DNA fragmentation and the activation of caspase 3. We also observed that the expression of COX I, COX II and COX III was not significantly altered while that of COX IV was completely inhibited. An increased expression of cytochrome-C by confocal microscopy was observed. Finally, we speculate that the clinical effect and toxicities of IL-2 used in cancer therapies is mostly due to its apoptotic effect on the cancer cells themselves rather than, as thought, the cytotoxic contribution of leukocytes.

Objective: The aim of the study is to assess the physical, financial, emotional and social impact of breast cancer on women in North east Nigeria.
Methods: A qualitative transcendental phenomenological study design was adopted, using face-to face unstructured interview to collect data from 22 respondents who were recruited via purposive non-probability sampling technique. The interviews were recorded, transcribed verbatim and further analyzed using thematic analysis method into themes and sub-themes.
Results: The result revealed excruciating pains that does not abate completely as the main physical impact, expensive cost of treatment as the major financial impact and crying as the major emotional impact of breast cancer on women. However, been diagnosed with breast cancer had no any consequences on participants’ relationship with spouse or family members.
Conclusion: Breast cancer causes pain, makes women to cry and the treatment is very expensive but it does not cause relationship problems. There is therefore the need for Government and Non-governmental policies to be geared towards supporting women with breast cancer to overcome these challenges.