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Home > Androgen Receptor Expression and Associated Clinico-Pathologic Features in Primary Breast Cancer from Kenya

Androgen Receptor Expression and Associated Clinico-Pathologic Features in Primary Breast Cancer from Kenya

Thesis Info

Author

Chege, Joshua Kibera

Department

Pathology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2014

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728036695

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Introduction: Breast cancer is a heterogeneous group of diseases classified into various subtypes according to clinical, histological and molecular features as well as by the expression of prognostic and predictive biomarkers. New biomarkers are being studied which may be therapeutic targets in various breast cancer subtypes particularly triple-negative breast cancer. Recent studies show that androgen receptor (AR) expression can be used as a prognostic marker and there is evidence that anti-androgen therapy may be beneficial in oestrogen receptor negative breast cancer. Retrospective studies show that patients with breast cancers co-expressing androgen receptor and oestrogen receptor have a favourable prognosis and improved survival. On the other hand, oestrogen receptor-negative breast cancers which express the androgen receptor in the presence of the human epidermal growth factor-2 (HER2) over-expression are associated with an unfavourable prognosis. In addition there may be regional or even racial differences in the expression of the AR in breast cancer. The objective of this study was, therefore, to determine AR expression in breast cancers from Kenya and secondarily, to determine the association of AR expression with prognostic and predictive clinico-pathologic factors. Materials and Methods: The study was nested within a larger study based at AKUHN which is exploring the prevalence of triple-negative breast cancer in Kenya. Tissue blocks from 222 breast cancer specimens collected prospectively from September 2012 to March 2014 within the larger study were analysed for the presence of the androgen receptor. Tumour blocks were stained for AR on automated IHC platform. Nuclear staining of >10% was used as the cut-off for a positive AR stain. Clinical pathological features, including the ER/PR/HER2 status, were captured from data recorded in the larger study. Results: Of the total 222 cases of breast cancer analyzed for the androgen receptor, 78.8% were found to be positive for AR expression (confidence interval 72.86 – 84.01). A third of the triple-negative breast cancer cases (33%) and 94% of HER2 subtype breast cancer cases were positive for androgen receptor expression. Androgen receptor expression was significantly associated with estrogen receptor expression (p = 0.000001) and Her2 subtype of breast cancer (p = 0.04). Androgen receptor expression followed the age distribution of the sample population and tended to be inversely related to tumour grade. However these findings were not statistically significant. No association was found between androgen receptor expression, tumour stage, lymph node status or specimen type. Conclusions: The androgen receptor is expressed in 79% of
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ڈاکٹر سید معین الرحمن

بہ یادِ سید معین الرحمن
(رفیق احمد خان)
ڈاکٹر سید معین الرحمن ایک طرح سے میرے خواجہ تاش تھے، مرزا غالب اور رشید احمد صدیقی سے میرا عشق روحانی، جذباتی اور زبانی ہے اور ان کا عشق شخصی، روحانی، فکری، ادبی اور تحقیقی اوصاف کا مرقع، ان کی تن دہی، سخت کوشی، برداشت، نفاستِ طبع اور حسن آرائی و حسن آفرینی اس کی شہادتیں۔
میں اپنے احباب سے ان کی خوش اخلاقی، خوش اطواری، شائستگی اور روایتی وضع داری سے متعلق باتیں سن ہی چکا تھا، ان کی شگفتہ و مرصع اور پرمغز و پراثر نثر دل میں گھر کرچکی تھی اور ان کی سرکشیدگی اور بلند قامتی بھی میرے دل و نظر میں ایک مقام و مرتبہ وضع کرچکی تھی، خط و کتابت کا آغاز ہوا تو میرے خیالات و تصورات کو یک گونہ تقویت حاصل ہوئی، میں اپنے اندر ان کے لیے اپنائیت محسوس کرنے لگا اور یوں نیاز حاصل کرنے کی تمنا جی میں سر اٹھانے لگی۔
اس قلبی لگاؤ کا نتیجہ تھا کہ جب کبھی ان کے خلاف کوئی زہر آلودہ تحریر پڑھی تو طبیعت مکدر ہوگئی اور ان کی قدر و منزلت میں کسی طرح کی بھی کمی محسوس نہیں کی بلکہ اس میں اضافہ ہی محسوس کیا، ’’دیوانِ غالب، نسخۂ خواجہ‘‘ کے حوالے سے خواہ کچھ بھی کہا گیا یا لکھا گیا ہو مگر غالب سے غیر معمولی شیفتگی اور غالب کی طرف داری کا اس سے اچھا اور بڑا عملی ثبوت ادبی دنیا میں کم دیکھنے میں آئے گا، اس سے ہٹ کر دیکھیے تو پیش کش میں حسن اور سلیقے کا حسین امتزاج بھی کیا لائق تحسین نہیں، میر تقیؔ میر کا یہ مصرع صادق آتا ہے: ع
کس خوش سلیقگی سے جگر خوں کروں ہوں میں
۲۰۰۳؁ء میں انجمن ترقی اردو، پاکستان کی صدی منائی گئی، سرسید یونیورسٹی،...

Analysis of Stair Climbing to Find an Optimum Knee Angle in Order to Reduce the Chances of Leg Muscle Fatigue and Injuries

Stair climbing is one of the unique exercises which is frequently used and helps in maintaining the leg muscles active and healthy. However, if the height of the stair is not optimum, it may cause serious injuries due to increased or decreased knee angle that may damage the human leg muscles such as quadriceps and hamstring involved in its proper function. A stair climbing leg model PASCO ME-7001 was designed to find an optimum knee angle for reducing the maximum chances of leg muscle fatigue and injuries by using the force sensors. Resultant forces applied on leg muscles i.e. hamstring and quadriceps at 4 different average angles: 40º, 57º, 68º, and 76º for four different stair heights: 3", 5", 7", and 9" respectively were studied graphically during ascending stairs. Also, the energy consumption of quadriceps is calculated for the desired 4 average angles. The optimum knee angle maybe 57-68 degrees at 5"-7" stair height for both flexion and extension of the leg during stair climbing.

A Case Study of Possibilities and Constraints in Conducting Project-Based Learning in a Lower Secondary Social Studies Classroom in Karachi, Pakistan

Project-based learning (PBL) is a teaching and learning strategy, which is gaining popularity rapidly among educators, teachers, parents and students. PBL is not a new concept: it is a well-established teaching strategy in certain parts of the world, but in some it is either alien or newly introduced. This study was conducted in one of the schools in the context of Karachi, Pakistan, which has adopted project-based learning as an initiative towards school improvement. In this context, PBL is practiced in all subject areas and has been in place for the last four years. The purpose of this study was to examine factors which facilitate or hinder the process of conducting project-based learning in a Social Studies classroom. The rationale behind this study was to get insights on how to conduct PBL in other schools as an initiative for school reform and change. To do so, the qualitative case study paradigm was employed for an in-depth investigation of the case as well as to understand the process. Data collection methods such as interviews, observations, and document analysis were used. Findings of the study disclosed that PBL in this particular context was primarily the school management's initiative. And this had consequences for its adoption process. PBL has brought tremendous changes in the school culture by engaging all the stakeholders (Director of the system, principal, vice-principal, teachers, students and parents). Findings suggest that PBL has played an important role in turning the school into a learning community. Nonetheless, factors like a prescribed syllabus and public examinations have greatly shaped the nature of PBL in this context. The findings also indicate that successful implementation of PBL is largely dependent on a thorough understanding of a teacher about the nature and expected outcomes of PBL. Finally, it is realized that students should be included in the planning of PBL activities and given some level of autonomy in the choice of topics, as this would enhance their feelings of ownership and responsibility over their learning. The study recommends that PBL can be successfully conducted and sustained in any school if the stakeholders believe in its importance and benefits. It is also important that the teachers should have a sound understanding of the concept of PBL.