MIDDLE EAST JOURNAL OF CANCER
Year:2018 | Volume:9 | Issue:1|Papers Count:11

The estimated incidence of colorectal cancer (CRC) is expected to increase by 60% with over 2.2 million new cases and 1.1 million deaths by 2030. 1, 2 In keeping with this global escalation of CRC, the pedagogy of curative therapies has also been revolutionized. Innovations in bioengineering technologies show tremendous progress in the surgical treatments of CRC with a significant impact on postoperative recovery time, the amount of surgical trauma, and cancer-related morbidity and survival.

Background: This comprehensive meta-analysis aimed to determine the impact of red meat consumption on breast cancer risk in premenopausal women.Methods: We conducted a systematic search in major electronic databases (MEDLINE, Scopus, and Science Direct) until January 1st, 2016 for all the case control and cohort studies that addressed the association between red meat consumption and breast cancer risk. The full-texts of the retrieved articles were reviewed by two independent authors. The quality of the studies was assessed using a score assigned to each item according to STROBE statement. We used the random effects model to obtain summary measures of odds ratio or relative risk with 95% confidence interval.Results: Out of the 513 retrieved studies, 17 (9 case-control and 8 cohort) were entered into the meta-analysis. These studies analyzed 26675 cases of breast cancer and over 943557 control or comparison subjects. The results of the random effects met aanalysis indicated a significant association between red meat consumption and breast cancer risk (relative risk: 1.269; 95% confidence interval: 1.117, 1.441; P -value for heterogeneity=0.002). The pooled relative risk was 1.087 (95% confidence interval: 0.999, 1.183) for cohort studies and 1.548 (95% confidence interval: 1.255, 1.909) for case-control studies.Conclusion: The results of this meta-analysis showed that the women who consumed red meat had an increased risk of breast cancer. Further studies are required to investigate this association.

Background: Tumor cells express PD-1 ligands to bind PD-1 on immune cells and escape immune responses. In the present study, we aimed to investigate whether single nucleotide polymorphisms at positions PD1.3 (+7146, rs11568821) G/A, and PD1.5 (+7785 C/T, rs2227981) may be considered risk factors for susceptibility to nonsmall cell lung cancer in the Iranian population.Methods: This study enrolled 206 histopathologically confirmed lung cancer patients and 173 age/sex matched healthy controls. We performed PCR-RFLP to determine the genotypes of the extracted genomic DNA.Results: The frequencies of PD1.3 GG, GA and AA genotypes were 171 (83%), 31 (15%) and 4 (1.9%) out of 206 patients, and 144 (83.2%), 26 (15%), and 3 (1.7%) out of 173 controls, respectively. The frequencies of PD1.5 CC, CT and TT genotypes were 78 (37.9%), 100 (48.5%), and 28 (13.6%) in patients, and 60 (34.7%), 89 (51.4%), and 24 (13.9%) in controls. There were no significant differences in genotype analysis between patients and controls at positions PD1.3 (P=0.98) or PD1.5 (P=0.80). No significant differences existed in the frequencies of alleles and haplotypes between the two groups (P>0.05).Conclusion: Our data have indicated no association between PD1.3 (+7146) G/A and PD1.5 (+7785) C/T with susceptibility to non-small cell lung cancer. Investigation of other PD1 genetic variations and emerged haplotypes are required to completely define the role of PD1 genetic variations in susceptibility to lung cancer.

Background: Radiotherapy, as an adjuvant treatment, plays a well-known role in prevention of loco regional recurrence in breast cancer patients. This study aims to investigate the impact of radiotherapy in patients with N1 disease.Methods: In this retrospective study, we reviewed the characteristics and treatment outcomes of 316 patients with a biopsy proven diagnosis of breast carcinoma and 1-3 positive axillary lymph nodes. The patients received treatment between 1995 and 2014. The patients had a median follow-up of 60 (range: 6-182) months.Results: This study was conducted on 316 patients with a median age of 48 (range: 26-86) years. Among patients, 215 underwent modified radical mastectomy and 101 had breast-conserving surgery before adjuvant treatment. Indeed, 259 patients received radiotherapy (radiation group) and 57 did not (control group). There was loco regional recurrence in one control group patient and two patients in the radiation group. Multivariate analysis results indicated hormone receptor status as an independent prognostic factor for the 5-year disease-free survival rate. Estrogen and progesterone receptor negativity (HR=1.80, 95% CI: 1.02-3.19, P=0.043) also had a negative influence on the 5-year disease-free survival rate. However, radiotherapy had no significant effect on disease-free survival (P=0.446) and overall survival (P=0.058) rates.Conclusion: The results showed that adjuvant radiotherapy had no prognostic impacts on loco regional and distant disease control in breast cancer patients with N1 disease.

Background: Breast cancer can be categorized into different histopathological subtypes based on gene expression profiles. This study aims to evaluate the clinic opathological features and overall survival of various subtypes of breast cancer to assist diagnosis and guide treatment.Methods: The clinic opathologic features of 1095 patients with breast cancer diagnosed over a 10–year period between 2001 and 2011 were analyzed. The Kaplan–Meier method was used to analyze disease-free survival and overall survival. Calculation of the hazard ratio was conducted by multivariate Cox regression.Results: According to the clinic opathologic characteristics of 1095 cases, there were 42% luminal A subtype, 19.2% luminal B, 23% triple negative, and 15% HER2+. The lowest (46.88 ± 12.59 years) and highest (50.54 ± 12.32 years) mean ages were in the triple negative and HER2+groups, respectively. There was a significant correlation between histology subtype and age, BMI, lymph node, type of surgery, and stage of disease. There was significantly shorter overall survival and disease free survival in HER2+breast cancer patients (P<0.001). Multivariate analysis showed that age had the highest hazard ratio of 2.481 (95% Confidence Interval: 1.375-4.477).Conclusion: The results of this study showed the importance of clinicopathological studies of molecular types which help early diagnosis and identification of the best strategy to treat breast cancer.

Background: IMOD™, a selenium enriched extract of the plants Tan acetum vulgare, Urtica dioica, and Rosa canina, has an excellent effect on oxidative stress. In this study, we investigated the radio protective effects of this immunomodulatory drug on human peripheral blood lymphocytes.Methods: Peripheral blood samples obtained from venipuncture of the brachial vein were treated with IMOD™ (5, 10, 15, 20 ml) for 30 min and Cobalt 60 γ-rays (0.25, 0.5, 1, 2 Gy) as the test groups and cultured with the control. We used the micronuclei assay, cell death detection, and cell toxicity assay to analyze the treatment effects.Results: The frequency of micronuclei were 1.66 (0 Gy), 5.33 (0.25 Gy), 9.67 (0.5 Gy), 17.67 (1 Gy), and 23.67 (2 Gy) in the irradiated lymphocytes (P<0.001). The percentage of micronuclei frequency reduced to 20%, 26.83%, 37.68%, 16%, and 20.47% with IMOD™. Apoptosis and necrosis decreased significantly in the IMOD™ treated groups (P<0.05).Conclusion: IMOD™ may protect these cells against ionizing radiation.

Background: Quality of life has become a part of the evaluation criteria for cancer therapy. The aim of this study was to evaluate the quality of life in breast cancer patients under chemotherapy regimens that contained doxorubicin and cyclophosphamide (AC) compared to paclitaxel and gemcitabine (PG).Methods: This cohort study evaluated 100 women with breast cancer treated by doxorubicin and cyclophosphamide or gemcitabine and paclitaxel regimens. We used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 to assess health related quality of life at the beginning and end of chemotherapy. Data were analyzed by the independent t-test at a significance level of 0.05.Results: Most of the 100 patients were married (68%), aged 41-50 years (36%), non-college educated (76%), and had insurance (97%). The mean quality of life scores at the first session of chemotherapy and prior to the onset of treatment-related adverse events were 71.33 for the doxorubicin and cyclophosphamide groups and 71.15 for the gemcitabine and paclitaxel groups. Analysis of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 at the last chemotherapy session showed that the quality of life in both groups deteriorated as a result of side effects. The mean of quality of life scores at the first session of chemotherapy were 66.49 for the doxorubicin and cyclophosphamide group and 59.99 for the gemcitabine and paclitaxel group.Conclusion: Strategies to improve the emotional and role functions of the patients who undergo treatment should be given priority. Financial difficulties faced by breast cancer patients should be addressed from a policy making level at the initiating health financing system.

Background: Spatial analysis is one of the required tools of epidemiology and public health sciences. This study intends to detect significant clusters of breast cancer cases in Kurdistan Province, Iran.Methods: We obtained data that pertained to breast cancer cases during 2005-2014 from the Health Deputy at Kurdistan University of Medical Sciences. After application of spatial scan statistics to detect the purely spatial (aggregation of cases in particular locations of space) and space-time (diseases clusters in space that depend on the time period) clusters, we calculated the population attribution risk (%) values to better distinguish the detected clusters.Results: We observed that the second secondary purely spatial cluster (P=0.0051) had the highest population attribution risk (%) of 3.8 and the primary space-time unadjusted cluster (P=0.0019) had the lowest population attribution risk (%) of 0.67 of all the detected clusters.Before we applied the adjustment, both the space-time and purely spatial clusters had similar locations. However, after adjustment for age, the space-time clusters location shifted and population attribution risk (%) values changed (between 0.02 and 0.4).Conclusion: Population attribution risk (%) value differences and clusters’ temporal and spatial variations before and after adjustments can represent disease interventions impact. Additional studies should be conducted to strengthen the registering and reporting system to determine other influencing factors.

Background: Cancer is the second leading cause of death worldwide and the third in Iran. Among cancers, cervical cancer is the third leading cause of death in women. Thus, recognizing the epidemiology and trends of cervical cancer can be effective for planning and policy-making. This study aims to investigate the incidence and trends of cervical cancer in Iran due to the few studies that have addressed this issue and the unclear trend for cervical cancer in Iran.Methods: This study re-analyzed existing data from the cancer data recording system in Iran during years 2003 to 2009. We used available data from the National Cancer Registry and Center for Disease Control of the Ministry of Health, Treatment and Medical Education. Stata software (version 11) was used for data analysis and the significance of the incidence trend diagram was derived with WINPEPI software.Results: Assessment of the National Cancer Registry statistics from 2003 to 2009 showed an increased trend in cervical cancer from 2003 to 2008 and a decreased trend from 2008 to 2009. During this period, there were 4273 cases of cervical cancer registered. From these, 394 cases were registered in 2003 which peaked at 907 cases in 2009. The registered cancer cases had an approximately 3-fold increase during this period. Most provinces reported an increased trend of incidence in cervical cancer.Conclusion: Based on the results of this study, the incidence of cervical cancer is increasing in Iran, especially in the central regions of the country. Therefore, considering the growing trend of cancer, we recommend early detection through screening programs, public awareness, and public training programs that particularly target high risk populations.

Solitary fibrous tumor is a rare tumor of the salivary gland. To date, 27 cases have been reported. The clinical and radiological features are the same as other lesions of the parotid gland. Hence, light microscopy and immunostaining is important to confirm the diagnosis. Fine needle aspiration cytology yield depends on the area sampled and can be inconclusive in many cases. Treatment of choice is complete surgical excision with regular long-term follow up. Most cases are benign, however three malignant cases have been reported. Here, we report a case of solitary fibrous tumor in the parotid gland seen in a 14-year old female diagnosed by histopathological examination and immunohistochemistry analysis.

Colonic type villoglandular adenocarcinoma of the lower genital tract is an extremely rare condition. Its origin is not clearly understood; however, the cloacal remnants are the more accepted source for this carcinoma. We report the case of a 67-year-old female patient who presented with a 1.2 cm polypoidal nodule at the right side of the fourchette. Morphologic studies revealed a colonic type mucinous adenocarcinoma that arose from within a villous adenoma. Immunohistochemical staining showed positive cytokeratin 7, cytokeratin 20, carcinoembryonic antigen, P53, and progesterone receptor, but negative for estrogen receptor and caudal type homeobox transcription factor 2. Extensive work-up failed to reveal other primary cancers in this patient. Ultimately, she underwent a radical vulvectomy. No recurrence was seen in eight months follow up of this patient after surgery. Careful, thorough histological evaluation and clinical clues enable correct diagnosis of the rare colonic type vulvar villoglandular adenocarcinoma. Due to rarity of this tumor, its management is questionable. Therefore, additional investigation is necessary for its management.