1.Phyllodes tumours of the breast: retrospective analysis of a University Hospital’s experience
Toh YF ; Cheah PL ; Looi LM ; Teoh KH ; Tan PH
The Malaysian Journal of Pathology 2016;38(1):19-24
Taking cognizance of the purported variation of phyllodes tumours in Asians compared with Western
populations, this study looked at phyllodes tumours of the breast diagnosed at the Department of
Pathology, University of Malaya Medical Centre over an 8-year period with regards to patient
profiles, tumour parameters, treatment offered and outcome. Sixty-four new cases of phyllodes
tumour were diagnosed during the period, however only 30 (21 benign, 4 borderline and 5 malignant)
finally qualified for entry into the study. These were followed-up for 4-102 months (average = 41.7
months). Thirteen cases (8 benign, 3 borderline, 2 malignant) were Chinese, 9 (all benign) Malay,
7 (4 benign, 1 borderline, 2 malignant) Indian and 1 (malignant) Indonesian. Prevalence of benign
versus combined borderline and malignant phyllodes showed a marginally significant difference
(p=0.049) between the Malays and Chinese. Patients’ ages ranged from 21-70 years with a mean of
44.9 years with no significant difference in age between benign, borderline or malignant phyllodes
tumours. Except for benign phyllodes tumours (mean size = 5.8 cm) being significantly smaller
at presentation compared with borderline (mean size = 12.5 cm) and malignant (mean size = 15.8
cm) (p<0.05) tumours, history of previous pregnancy, breast feeding, hormonal contraception and
tumour laterality did not differ between the three categories. Family history of breast cancer was
noted in 2 cases of benign phyllodes. Local excision was performed in 17 benign, 2 borderline and
3 malignant tumours and mastectomy in 4 benign, 2 borderline and 2 malignant tumours. Surgical
clearance was not properly recorded in 10 benign phyllodes tumours. Six benign and all 4 borderline
and 5 malignant tumours had clearances of <10 mm. Two benign tumours recurred locally at 15
and 49 months after local excision, however information regarding surgical clearance was not
available in both cases. One patient with a malignant tumour developed a radiologically-diagnosed
lung nodule 26 months after mastectomy, was given a course of radiotherapy and remained well
8-months following identification of the lung nodule.
2.Correlation of p16INK4a immunoexpression and human papillomavirus (HPV) detected by in-situ hybridization in cervical squamous neoplasia
Cheah PL ; Koh CC ; Nazarina AR ; Teoh KH ; Looi LM
The Malaysian Journal of Pathology 2016;38(1):33-38
Persistence and eventual integration of high-risk HPV (hrHPV) into the cervical cell is crucial
to the progression of cervical neoplasia and it would be beneficial to morphologically identify
this transformation in routine surgical pathology practice. Increased p16INK4a (p16) expression is a
downstream event following HPV E7 binding to pRB. A study was conducted to assess the correlation
between hrHPV detection using a commercial in-situ hybridization assay (Ventana INFORM HPV
ISH) and p16 immunoexpression (CINtec Histology Kit) in cervical squamous intraepithelial lesions
and squamous carcinoma. 27 formalin-fixed, paraffin-embedded cervical low-grade squamous
intraepithelial lesions (LSIL), 21 high-grade squamous intraepithelial lesions (HSIL) and 51 squamous
carcinoma (SCC) were interrogated. hrHPV was significantly more frequent in HSIL (76.2%) and
SCC (88.2%) compared to LSIL(37.0%). p16 expression was similarly more frequent in HSIL
(95.2%) and SCC (90.2%) compared to LSIL(3.7%). That the rates of hrHPV when compared with
p16 expression were almost equivalent in HSIL and SCC while p16 was expressed in only 1 of the
10 LSIL with hrHPV, are expected considering the likelihood that transformation has occurred in
HSIL and SCC but does not occur in majority of LSIL.
3.Quality Of Life amongst Post Coronary Artery Bypass Patients at the National Heart Institute, Malaysia
Ho SE ; Noor Siah AA ; Zaidah Z ; Teoh KH ; Gurbinder JS ; Ismail MS ; Choy YC ; Mazeni A
Medicine and Health 2010;5(2):77-85
Coronary Artery Bypass Grafting (CABG) surgery has increased the survival rate for individuals suffering from myocardial infarction or coronary ischemia. The present
study aimed to examine the perception of quality of life amongst post CABG patients at the National Heart Institute Malaysia. A total of 69 post CABG patients, were studied
using the Medical Outcomes Short Form 36 (SF-36). The findings showed that post CABG respondents possessed good level of quality of life (SF-36) physically and
mentally. There were significant differences between the role physical in the physical functioning domains of quality of life with gender (t=0.286, p<0.05). Duration of physical exercises of more than 20 minutes have positive effects on both physical (t=2.738, p<0.05) and mental components (t=7.326, p<0.05). The level of income influenced both the physical component (F=3.100, p<0.05), and mental component (F=4.272, p<0.05). Post CABG patients were found to have high quality of life post operatively.
They were able to make comprehensive lifestyle changes through frequent physical exercises to accommodate their needs.