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Item Comparative efficacy of visual inspection with acetic acid versus cytology for cervical cancer screening in Ogbomoso, Nigeria(Medip Academy, 2017) Abiodun, A. B.; Durodola, A. O.; Ajani, M . A.; Amole, I. O.; Abiodun, A. D.; Oluwasola, A. O.Screening test for cervical cancer using visual inspection with acetic acid (VIA) has been advocated by World Health Organization as a suitable, low cost and feasible alternative modality for control of cervical cancer in resource-poor settings as compared to cytological and colposcopic screening. The need for reproducibility, accuracy and comparable efficacy will influence the acceptability of VIA as primary screening modalities for cervical cancer. Methods: A cross–sectional comparative study conducted at BUTH. Data were obtained from 318 consenting women aged 30–65 years using a systematic random sampling method and an interviewer–administered structured questionnaire. Pap smear samples were taken followed by visual inspection with acetic acid. Using Statistical Package for Social Sciences (SPSS) version 23.0, Frequencies were obtained and Chi-square test (X2 ) was used to compare rates and proportions with the level of statistical significance set at less than 0.05. Results: Positive results for premalignant cervical lesion was 1.3% and 4.1% for VIA and Pap smear respectively (X2=4.52; p=0.034). The sensitivity of VIA was 7.7% with positive predictive value of 25% while specificity was 99.0% with a negative predictive value of 96.2%. The prevalence of abnormal cervical lesion in the population studied was 4.1% (95% CI 2.2% – 6.9%). Conclusions: The detection rate for pre-cancerous lesions of the cervix using VIA was significantly lower than that of Pap smear in this study. There may be needed to exercise caution in adopting VIA as primary screening modality for cervical cancer.Item Pattern of triple negative epithelial ovarian cancer in indigenous African women.(F1000 Research Ltd, 2016-09) Ajani, M. A.; Salami, A. A.; Awolude, O. A.; Oluwasola, A. O.Triple negative epithelial ovarian cancer (TNEOC) refers to ovarian carcinomas that do not express estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor- type 2 (HER-2/neu). The aim of this study is to determine the pattern of triple negative epithelial ovarian cancer in indigenous African women. Methods: We performed a retrospective review of ER, PR and HER-2/neu expression in 90 Nigerian patients with histologically diagnosed epithelial ovarian cancer. Lack of expression of ER, PR and HER2/neu antigens was used to determine carcinomas that are among the TNEOC. We also compared the clinicopathological parameters (age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade and histological subtype) in patients with TNEOC and non- TNEOC . Results: Thirty-eight (42.2%) of the 90 tumours diagnosed as EOC were negative for ER, PR and HER2/neu expression. There was no significant association between TNEOC with other parameters such as age, FIGO stage and histological grade. Sixteen (66.7%) of the 24 mucinous carcinomas were triple negative, while only 21 (33.3%) of the 63 serous carcinomas were triple-negative and one (50%) of the two endometrioid carcinomas was triple negative. There was a significant association between triple-negative tumours and histological subtypes of EOC (p = 0.034). Conclusions: A subtype of epithelial ovarian cancer that is negative for ER, PR and HER-2/neu has been discovered in indigenous African women. TNEOC expression is high and is comparable to the triple negative breast cancer subtype seen in people of African ancestry. Future study of TNEOC in a large sample size should be considered.Item The expression status of human epidermal growth factor receptor 2 in epithelial ovarian cancer in Ibadan, Nigeria(Medpharm Publications, 2016) Ajani, M. A.; Salami, A.; Awolude, O.A.; Oluwasola, A. O.; Akang, E. E. U.It has been proposed that the overexpression of the human epidermal growth factor receptor 2 (HER2/neu proto oncogene) could be a possible therapeutic target in epithelial ovarian cancer, as has been the case in breast carcinomas. However, there is lack of knowledge on the status of the gene in neoplasms which occur in black women. The objective of this study was to determine HER2/neu expression status in EOC in black women. Method: Ninety cases of EOC were evaluated for HER2/neu protein expression using immunohistochemistry. Results: HER-2/neu expression was observed in 33 of the 90 cases (37%), of which 15 EOC cases (17%) were weakly or moderately positive, and 18 (20%) strongly positive. A significant association was not found between HER-2/neu expression and age, International Federation of Gynecologists and Obstetrics (FIGO) stage, grading and histological subtypes (p-values of 0.463, 0.360, 0.975 and 0.168, respectively). However, there were more cases of advanced stage disease (III/IV) with HER-2 expression than early-stage EOC (I/II). In this study, 21%, 36% and 42% of HER2/neu-positive tumours were grades 1, 2 and 3, respectively. A higher proportion of serous carcinomas (as opposed to mucinous carcinomas) was also observed to be HER2/neu positive. Conclusion: HER2/neu expression was observed to increase with advanced stages of cancer, and was more commonly seen in serous, rather than in mucinous, carcinomas.
