Savvas Papadopoulos, Petroula Arapantoni-Dadioti, Konstantinos Sfikas, Artemis Stylianidou, Helen Trichia, Eleftheria Katsamagou, Vaia Baleki and Johannes Noe
Newly diagnosed invasive breast cancers should be evaluated for Human Epidermal Growth Factor Receptor 2 (HER2) status by immunohistochemistry (IHC) and/or in situ hybridisation (ISH) to determine eligibility for trastuzumab or other HER2-targeted therapies. Previous reports of high discordance rates between IHC and ISH have raised concerns over the accuracy of HER2 testing, especially when IHC is conducted locally. This study aimed to determine the rate of false-negative IHC results at three pathology centres (one central, two local) in Greece by central retesting of 240 prospectively collected invasive breast cancers scored as IHC 0/1+ at initial testing. All samples were from female patients (median age 58.0 years). Initial IHC tests utilised either the CB11 (159/239; 66.5%) or 4B5 (80/239; 33.5%) antibodies and were scored as 0 in 105/240 cases (43.8%) and 1+ in 135/240 cases (56.3%). All samples were centrally retested by automated silver in situ hybridisation (SISH). Of 237 samples with SISH staining suitable for assessment, 223 (94.1%; 95% confidence interval 90.3–96.5%) were classed as SISH-negative (HER2:chromosome enumeration probe 17 (CEP17) <1.8). Eight tested SISH-positive (HER2:CEP17 >2.2), providing a false-negative rate of 3.4%. A further four samples (1.7%) exhibited equivocal amplification status (HER2:CEP17 1.8–2.2) and two (0.8%) showed polysomy of chromosome 17. The proportion of SISH-negative results did not significantly differ between the IHC 0 and 1+ subgroups (95.2% vs. 93.2%; p=0.505). In conclusion, the low observed rate of false-negative IHC results in this study supports the use of IHC for initial HER2 status assessment in local or central laboratories in Greece.
Konstantinos Mattas, George Botzoris and Basil Papadopoulos
The determination of the optimal circular path has become widely known for its difficulty in producing a solution and for the numerous applications in the scope of organization and management of passenger and freight transport. It is a mathematical combinatorial optimization problem for which several deterministic and heuristic models have been developed in recent years, applicable to route organization issues, passenger and freight transport, storage and distribution of goods, waste collection, supply and control of terminals, as well as human resource management. Scope of the present paper is the development, with the use of fuzzy sets, of a practical, comprehensible and speedy heuristic algorithm for the improvement of the ability of the classical deterministic algorithms to identify optimum, symmetrical or non-symmetrical, circular route. The proposed fuzzy heuristic algorithm is compared to the corresponding deterministic ones, with regard to the deviation of the proposed solution from the best known solution and the complexity of the calculations needed to obtain this solution. It is shown that the use of fuzzy sets reduced up to 35% the deviation of the solution identified by the classical deterministic algorithms from the best known solution.
S M Yasir Arafat, Konstantinos Papadopoulos, Mohammad S I Mullick and Md. Saleh Uddin
Life is full of stressors, which have to be confronted efficiently to grow up. However, reaction to stressors is personalized, complex and coordinated. Vulnerable persons adjust poorly to stressors and express inappropriate responses, while resilient persons practice adaptive physiological and psychological responses. Promotion of resiliency is an intricated issue, which demands strategies at both macro and micro-level. Microlevel strategies are focused on the community, family and individual level, while macrolevel strategies formulate the principles. Nevertheless, prediction of vulnerability and resiliency is really a challenge, as different persons facing same stressors react differently. Some are growing as resilient and others as vulnerable. We aimed to discuss resiliency, vulnerability, importance in relation to health outcome, promotion of resiliency and controversies of vulnerability and resiliency.