Ahmed El May

Institut Salah-Azaïz de Cancerologie, Tunis-Ville, Tūnis, Tunisia

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Publications (54)45.8 Total impact

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    ABSTRACT: Background: In the Tunisian population, as yet a limited number of BRCA1/2 germline mutations have been reported in hereditary breast and/or ovarian cancer. These mutations are located in a few exons of BRCA1/2. The aim of the present study was to search for these mutations in 66 unrelated patients with hereditary breast and/or ovarian cancer in order to assess the interest in such a targeted approach for genetic testing in Tunisia. Materials and methods: Blood specimens from the 66 Tunisian patients, with family history of breast and/or ovarian cancer, were collected at the Salah Azaiz Cancer Institute of Tunis. The exons 5, 20 and part of exon 11 of BRCA1 as well as part of exons 10 and 11 of BRCA2 were analyzed by Sanger sequencing. Results: 12 patients had deleterious mutations in the BRCA1 or BRCA2 genes (18%), including a novel frame-shift mutation of BRCA1 (c.3751dup; 3780insT). Four distinct BRCA1 mutations were detected eight patients: c.5266dup (5382insC) and c.211dup (330insA) each in three patients, c.3751dup (3870insT) and c.4041_4042del (4160delAG) each in one patient. The four remaining cases all carried the same BRCA2 mutation, c.1310_1313del (1538delAAGA). Besides these deleterious mutations, eight polymorphisms and unclassified variants were detected, one of them being never reported (BRCA1c.3030T>G, p.Pro1010Pro). Conclusion: In this study, we show that targeting relevant exons in BRCA1 and BRCA2 genes allows detection of a substantial percentage of mutations in the Tunisian population. Therefore such an approach may be of interest in genetic testing of high-risk breast and ovarian cancer families in Tunisia.
    No preview · Article · Nov 2014 · Bulletin du cancer
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    ABSTRACT: The contribution of BRCA1/BRCA2 mutations to hereditary breast cancer in the Tunisian population has not been accurately estimated. The purpose of our study was: (i) to estimate the incidence and spectrum of pathogenic mutations in BRCA1/2 genes in early onset and familial breast/ovarian cancer among Tunisian women. (ii) To identify predictive factors for BRCA1/2 mutations, we screened the entire coding sequences and intron/exon boundaries of BRCA1/BRCA2 genes in 48 patients by direct sequencing. 12 pathogenic mutations were detected (25%); 3 in BRCA1 (c.211dupA in 4 families, c.5266dupC in 3 families and c.1504_1508delTTAAA in one family) and 2 novel mutations in BRCA2 (c.1313dupT in 2 families and c.7654dupT in 2 families). We also identified 23 different polymorphisms and unclassified variants. These results indicate that our population has a spectrum of recurrent BRCA mutations.
    No preview · Article · Dec 2013 · Clinical Genetics
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    ABSTRACT: Obesity is a public health problem that contributes to morbidity and mortality from diabetes, heart disease, stroke, and cancers. The purpose of this investigation was to analyse the link between obesity-induced oxidative stress, renal steatosis, and kidney dysfunction, as well as the protective effect of grape seed and skin extract. Rats were fed a standard diet or a high-fat diet for 6 weeks and were either treated or not treated with grape seed and skin extract. Fat-induced oxidative stress was evaluated in the kidney with a special emphasis on transition metals. High-fat diet induced triglyceride deposition and disturbances in kidney function parameters, which are linked to an oxidative stress status and depletion of copper from the kidney. Grape seed and skin extract abrogated almost all fat-induced kidney disturbances. Grape seed and skin extract exerted potential protection against fat-induced kidney lipotoxicity and should find potential application in other kidney-related diseases.
    No preview · Article · Mar 2013 · Applied Physiology Nutrition and Metabolism
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    ABSTRACT: Abstract Many researchers have focused on the preventive and curative effects of garlic (Allium sativum), particularly on cardiovascular diseases and cancer. However, its impacts on the male reproductive system have not been clearly defined. In this study, the effect of chronic consumption of two garlic fractions was tested: one soluble in water (aqueous solution obtained by grinding and centrifugation) and the other one precipitated by ethanol (alcoholic precipitate obtained by precipitation of the aqueous solution), on different variables of male rats' reproductive functions. These two fractions were targeted to try to identify the nature of the active garlic compounds responsible for the different modifications observed on testicular parameters. The observation of seminiferous tubules of rats treated with garlic fractions showed an increased number of tubules deprived of spermatozoa. In addition, garlic fractions induced apoptosis of testicular germ cells (TdT-mediated dUTP-X nick-end labeling [TUNEL] approach) and a decrease of serum testosterone levels and seminiferous tubule DNA concentrations. In summary, our histological and molecular results suggest that one or several substances, soluble in water and precipitated by alcohol, impaired spermatogenesis.
    No preview · Article · Jan 2013 · Journal of medicinal food
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    ABSTRACT: Aim: The objective is to report the correlation between pathology and molecular subtype classifications of breast cancer in Tunisian women. Methods: This retrospective study concerned data of 966 breast cancer cases collected from 2007 to 2009 at Salah Azaiz Institute of Tunis. These cases were classified by an immunohistochemistry test for estrogen and progesterone receptors and human epidermal growth factor receptor 2 (HER2) status in the four molecular subtypes, namely luminal A, luminal B, HER2+ and triple negative. The molecular classifications were correlated with the clinicopathological characteristics of the tumors. Results: Luminal A (50.7% of cases) was the most common subtype, with triple negative subtype 22.5%, luminal B 13.4% and HER2+ 13.4%. Triple negative and HER2+ subtypes were significantly associated with large tumor size (>5 cm, P < 0.001), younger age (<40 years, P < 0.03) and high grade (P < 0.001). Conversely, there was no correlation with the lymph node status. Conclusion: Our data demonstrated that the luminal A subtype, associated with a favorable prognosis, was the most frequent subtype in the Tunisian population; however the triple negative subtype occurred at a high incidence in Tunisia compared to Western countries. The molecular subtypes are correlated to the tumor size, histological grade and patient's age.
    No preview · Article · Nov 2012 · Asia-Pacific Journal of Clinical Oncology
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    ABSTRACT: Le mélanome muqueux primitif de la fosse nasale est une tumeur maligne très agressive, rare, constituant 1% de l'ensemble des mélanomes. Sa symptomatologie est non spécifique et son diagnostic est anatomo-pathologique, appuyé par l'immunohistochimie. Son traitement est essentiellement chirurgical basé sur une résection large de la tumeur. Le pronostic est défavorable, caractérisé par des récidives et des métastases fréquentes et un taux de survie bas. Nous rapportons dans ce travail un nouveau cas de mélanome malin primitif de la fosse nasale, tout en précisant les caractéristiques de cette tumeur.
    Preview · Article · Oct 2012 · Pan African Medical Journal
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    ABSTRACT: Le mélanome muqueux primitif de la fosse nasale est une tumeur maligne très agressive, rare, constituant 1% de l’ensemble des mélanomes. Sa symptomatologie est non spécifique et son diagnostic est anatomo-pathologique, appuyé par l’immunohistochimie. Son traitement est essentiellement chirurgical basé sur une résection large de la tumeur. Le pronostic est défavorable, caractérisé par des récidives et des métastases fréquentes et un taux de survie bas. Nous rapportons dans ce travail un nouveau cas de mélanome malin primitif de la fosse nasale, tout en précisant les caractéristiques de cette tumeur.
    Preview · Article · Jul 2012 · Pan African Medical Journal
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    ABSTRACT: In the management of patients with differentiated thyroid cancer (DTC), abnormalities detected on planar whole body scan and 131I-SPECT are difficult to interpret because of a lack of anatomical landmarks and limited specificity. Integrated 131I-SPECT-CT imaging has an additional value for characterization of equivocal tracer uptake seen on planar imaging as well as for precise localization. We illustrate through an observation the incremental diagnostic value of 131I-SPECT-CT images in the diagnosis of a cervical lymph node mimicking a physiological uptake on planar views. A 35-year-old Tunisian female was followed for papillary thyroid carcinoma, for which she underwent total thyroidectomy and iratherapy. Three years after a complete remission, the thyroglobulin (Tg) level on TSH stimulation increased. Diagnostic planar images with 131I did not disclose any obvious pathological foci. Furthermore, we noticed an increased 131I-uptake in the left sub-mandibulary area, which suggested a salivary physiological activity. SPECT-CT of the neck and chest were then performed with a Symbia T camera. Fused images demonstrate that this activity corresponds to a cervical lymph node closely adjacent to sub-mandibulary gland. Management of the patient was then changed. In selected patients with DTC, hybrid imaging should be used as a complementary to planar imaging in terms of diagnostic accuracy, because of superior focus localization and additional anatomic information derived from the CT component. Integrated SPECT-CT is then a useful tool, especially in cases of unclear diagnoses, precising anatomical localization of areas of increased 131I-uptake and distinguishing malignant lesions from normal physiological uptakes. This is particularly important in an oncologic center, as ours, where we don’t yet have a positron emission tomography (PET) camera is not yet available.
    No preview · Article · Oct 2011 · Medecine Nucleaire
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    ABSTRACT: Because nasopharyngeal carcinoma (NPC) has a close association with Epstein-Barr virus (EBV), measuring serum EBV DNA and anti-EBV serum marker concentrations could be a feasible method for NPC diagnosis, monitoring and probably screening especially in a community at risk. The aim of this study was to determine the EBV pattern in sporadic NPC and in high risk NPC Tunisian families in order to evaluate their risk factors and help for NPC screening. The rates of anti-EBV antibodies and EBV DNA were determined in the serum of 47 healthy members randomly selected from 23 NPC multiplex families with two or more affected members, 93 healthy Tunisian community controls chosen with the same age, sex and geographic origin as unaffected individuals and 66 EBV positive sporadic NPC patients whose serum was available before and after treatment. Unexpectedly, significant lower concentrations of anti-EA (Early Antigen) IgG and anti-VCA (Viral Capsid Antigen) IgG were found in unaffected members from NPC families than in healthy controls while viral loads were negative in all the tested sera. For sporadic NPC patients, anti-EA IgG and anti-VCA IgA concentrations were significantly higher than in healthy controls and these rates decreased after treatment. The level of EBV DNA load varied according to the condition of the tumour. This study suggests that in the Tunisian NPC families, screening for malignancy is based on serum concentrations but not on EBV DNA load while in the sporadic NPC group, serologic markers and EBV DNA load are complementary for diagnosis and follow-up.
    No preview · Article · Jul 2011 · Archives of Oto-Rhino-Laryngology

  • No preview · Article · Apr 2011 · La Tunisie médicale
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    ABSTRACT: Introduction The angiosarcoma of the breast is a rare vascular tumor representing 0,04% of breast cancers and 3 to 9% of the mammary sarcomas. Patients and methods The authors report 10 cases of breast angiosarcoma (eight women and one man) collected in the Salah Azaiez institute of Tunis, between 1977 and 2007. Results The mean age of patients was 40. The apparition of a breast nodule was the aim of consultation of all our patients. The mean size of tumor was 5,5 cm. The mammography showed a well-limited rounded dense opacity in five cases. Eight patients had a mastectomy associated in four cases to radiotherapy and in one cases to chimiotherapy. The conservative treatment has been indicated in two cases. For eight patients, histological exam has concluded to an angiosarcoma. The follow-up of the patients varied from 4 months to 13 years. Two patients have been lost of view since the establishment of the diagnosis of the angiosarcoma. Four patients developed neither recurrence nor metastasis. Two patients developed local recurrences at 8 and 18 months. An other patient developed some bony metastases after an evolution of 29 months. Conclusion Angiosarcoma of the breast is a rare conjunctive tumor and is a serious differential diagnosis problem with benign angioma.
    No preview · Article · Mar 2011 · Imagerie de la Femme
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    ABSTRACT: Inflammatory myofibroblatic tumor is a recently caracterized solid mesenchymal tumor. They are frequently localised in the lung. However, the head and neck forms are uncommon. To report a new case of inflammatory myofibroblastic tumor of the larynx. This 47-year old man presented with dysphonia without dyspnea. Laryngoscopy showed a tumor of anterior vocal cord. CT scan of larynx confirmed diagnosis. The patient had a cordectomy. Histology concluded to the diagnosis of inflammatory myofibroblastic tumor. No relapses have been noted after 4 months. Only a few cases of laryngeal inflammatory myofibroblastic tumor have been reported in the literature. Clinical presentation depends of tumor location. Radiological images are not specific and diagnosis is based on histology. The expected course is essentially marked by the risk of local recurrences. Surgical excision seems to be the treatment of choice.
    No preview · Article · Dec 2010 · La Tunisie médicale
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    ABSTRACT: The impact of garlic, known for its antioxidant activities, on iron metabolism has been poorly investigated. The aim of this work was to study the effect of crude garlic pre-treatment on iron-mediated lipid peroxidation, proliferation and autophagy for 5 weeks. Rats were fed distilled water or garlic solution (1 g/kg body weight) by gavage for the first 3 weeks as pre-treatment and received a basal diet supplemented or not with ferrous sulfate (650 mg Fe/kg diet) for the last 2 weeks of treatment. Immunohistochemistry labeling and ultrastuctural observations were used to evaluate the iron deleterious effects in the liver. Iron supplementation induced cell proliferation predominantly in non parenchymal cells comparing to hepatocytes, but not apoptosis. In addition, iron was accumulated within the hepatic lysosomes where it triggers autophagy as evidenced by the formation of autophagic vesicles detected by LC3-II staining. It also induced morphologic alterations of the mitochondrial membranes due to increased lipid peroxidation as shown by elevated iron and malondialdehyde concentrations in serum and tissues. Garlic pre-treatment reduced iron-catalyzed lipid peroxidation by decreasing the malondialdehyde level in the liver and colon and by enhancing the status of antioxidants. In addition, garlic reduced the iron-mediated cell proliferation and autophagy by lowering iron storage in the liver and protected mitochondrial membrane. Based on these results, garlic treatment significantly prevented iron-induced oxidative stress, proliferation and autophagy at both biochemical and histological levels due to its potent free radical scavenging and antioxidant properties.
    No preview · Article · Oct 2010 · Journal of molecular histology

  • No preview · Article · Jul 2010 · La Tunisie médicale

  • No preview · Article · Apr 2010 · La Tunisie médicale
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    ABSTRACT: The aim of this review is to study natural history, presentation, treatment and prognosis of head and neck liposarcomas. We carry a retrospective study about 15 patients diagnosed and treated in our department between 1969 and 2001. Therapeutic modalities included surgery, radiotherapy and chemotherapy. Tumors were mostly localized at the neck (4 cases) and the scalp (3 cases). Cervical lymphadenopathy was found in 1 case. Chest X-ray found showed metastases in 2 cases. Histological types of liposarcomas were the following: myxoid (5 cases), well differentiated (4 cases), pleomorphic (4 cases), round cell (1 case) and dedifferentiated (1 case). Twelve patients underwent surgery. Complete excision was performed in 7 cases. In the other 5 cases, exeresis was incomplete and 4 of them received postoperative radiotherapy. Three patients were not operated because of vascular involvement (1 case) or metastasis (2 cases), and they all received radiotherapy alone. After initial treatment, complete remission was achieved in 7 cases (46.7%). A recurrence occurred in 8 cases (53.3%). Two of these patients were reoperated and another one received chemotherapy. In the other 5 cases, the tumor was uncontrollable and no additional treatment has been proposed. Five-year survival rate was 87% for patients who underwent surgery alone, 75% for those who underwent surgery and postoperative radiotherapy, and 0% for those treated by radiotherapy alone. The mainstay of treatment of head and neck liposarcomas is surgical excision and the prognosis is largely determined by the histological grade and the clinical stage.
    No preview · Article · Oct 2009 · Auris, nasus, larynx

  • No preview · Article · Oct 2009 · Journal de Chirurgie

  • No preview · Article · Oct 2009 · Journal de Chirurgie
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    ABSTRACT: Oral tongue cancer remains an aggressive tumour in Tunisia, and patients often present with locally advanced disease, leading to high mortality. The molecular pathway of its tumorigenesis is not yet understood. This study aimed to assess the biologic significance of p53, heat shock protein 70 (Hsp70), Ki67, and CD34 and their influence on survival in patients with tongue cancer. Archival tissues from 68 patients with squamous cell carcinoma of the tongue were examined for p53, Hsp70, Ki67, and CD34 by immunohistochemistry and correlated with 5-year survival. p53 and Ki-67 were detected in 55% and 77% of tumours, respectively; a significant association between p53 and Ki67 expression was found (p = .038). Forty-seven percent of cases of tongue cancer expressed Hsp70, and only 9% of tumours expressed CD34 angiogenic factor. No significant correlation was noted between survival and expression of p53, Hsp70, Ki67, and CD34 in patients. None of the markers p53, Hsp70, Ki67, and CD34 demonstrated prognostic significance for 5-year survival in patients with squamous cell carcinoma of the tongue.
    No preview · Article · May 2009 · Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
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    ABSTRACT: Swyer syndrome is a distinct type of pure gonadal dysgenesis characterized by a 46 XY karyotype in female phenotypic patients. It shows an abnormality in testicular differentiation. It is usually revealed by primary amenorrhea. The tumor that usually develops in Swyer syndrome is gonadoblastoma. Although gonadoblastoma is considered benign, the risk of malignant germ cell tumor development is high. The aim of this report is to stress on the risk of occurrence of malignant germ cell tumors on these dysgenesic gonads. We present the clinical, sonographic and endocrine findings in the case of a 13 year-old phenotypic young girl with a 46 XY karyotype and gonadal dysgenesis. The patient underwent surgery for adnexal torsion. An examination of the gonads revealed gonadoblastoma associated to dysgerminoma. The treatment and the follow up are detailed. The presence of Y chromosome in the karyotype of a patient presenting a gonadal dysgenesis must lead to prophylactic bilateral gonadectomy in order to avoid a malignant transformation. Gonadectomy must be followed by a hormone replacement therapy.
    No preview · Article · Aug 2008 · La Tunisie médicale

Publication Stats

234 Citations
45.80 Total Impact Points


  • 1998-2014
    • Institut Salah-Azaïz de Cancerologie
      Tunis-Ville, Tūnis, Tunisia
  • 2013
    • Faculty of Medecine of Tunis
      Tunis-Ville, Tūnis, Tunisia
  • 2011-2013
    • University of Tunis El Manar
      • Faculty of Medicine
      Tunis-Ville, Tūnis, Tunisia
  • 1985
    • Faculté de Médecine Dentaire de Monastir
      Al Munastīr, Al Munastīr, Tunisia