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In Vivo Detection of Multidrug-Resistance Related Proteins in Locally Advanced Breast Cancer Using 99mTc-MIBI SPECT/CT Imaging: Correlation with Clinical Outcomes.
No full textOBJECTIVE: Neoadjuvant chemotherapy (NACT) is widely used for treating locally advanced Breast cancer (LABC). However, development of multidrug resistance (MDR) is the main underlying factor for chemoresistance. Technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) is a substrate for MDR. This study aimed to analyze the relationship between expression of MDR-related proteins (P-gp and Bcl-2) and 99mTc-MIBI uptake and retention in BC tumor cells, pathologic response to NACT, disease free survival (DFS) and overall survival (OS). METHODS: prospective analysis recruited 31 patients with LABC who received NACT between January 2019 and March 2020. 99mTc-MIBI planar and SPECT/CT imaging was conducted before and after NACT. Qualitative and quantitative analyses were performed, pre and post-NACT early and delayed lesion to non-lesion (LNL) ratios, and retention index (RI) of 99mTc-MIBI were calculated. Expression of P-gp and Bcl-2 in tumor cells was determined by immunohistochemistry. RESULTS: Quantitively, inter-reader ICC for SPECT/CT based quantification was consistently higher than that of planar images. Post-NACT LNL ratios were significantly higher in patients with pathologic persistent disease (PPD). A change in RI between pre- and post-NACT scans demonstrated a significant association with DFS with a hazard ratio of 0.7 (95%CI: 06-1.0). Qualitatively, SPECT/CT was significantly more accurate compared to planar imaging in identifying residual viable tumor (81% compared to 57%). Her2neu positivity and high post-operative Bcl-2 and P-gp were associated with worse DFS. A significant association was found between increased expression of post-NACT Bcl-2 and PPD, advanced tumor stage and poor OS. CONCLUSION: 99mTc-MIBI SPECT/CT based qualitative evaluation of BC response to NACT is more accurate than planar imaging. Post-NACT MIBI retention is positively correlated with P-gp and Bcl-2 expression. 99mTc-MIBI SPECT/CT may predict MDR development. High post-NACT Bcl-2 expression is significantly associated with advanced tumor stage and OS. High post-NACT P-gp expression has a worse impact on pathologic response and DFS
الطيب صالح ناقداً
No full textEltyeb Salih is a international author and novelist. The pulpits of the
international novel knew him through his novel Season of Migration to the
North and others. His literal participations in Arabic and international forums
confirmed his wide knowledge and his abundant memorization of Arabic
poetry especially that of his master Elmutanabi as he used to refer to him.
In addition to the novelistic heritage which he left, literature also enjoyed a
great achievement through his weekly essay in Elmajala magazine under the
title “ Towards a Distant Horizon” . His writings were compiled in the folds of “
Selections” which are the source for the study of “ Eltyeb Sahih as a critic”.
The research aims at acquaintance with Salih’s wide knowledge and its
impact on the formation of his literal character along with a trial to reveal his
critical method and the exploration of the most important issues which he
treated critically. Resultantly, the aim is to add a scientific material in the field
of literature and criticism to the Sudanese library according to the integrative
method which is concerned with the historical, artistically and psychologica
features.
The study of Eltyeb Salih is achieved via addressing his persona
characteristics , his deep knowledge and the impact of the environment on his
words, and based on that is the address of his critical method and its
characteristics. Added to that his criticism of poetry and prose and the debate
he provoked with Taha Hussein, Mahmood Shaker and others about
Elmutanabi. The final part of this study treats the critical visions about Salih
which are presented by some critics such as Mohammed Elmecci Ibrahim,
Abdalla Hamadanlla and Mokhtar Ajouba. The research concludes with
findings and the most important one is that Eltyb Salih didn’t intend to adopt
a certain critical school but his criticism is mainly based on the tasty
impressionistic method and the artistically one
