MIDDLE EAST JOURNAL OF CANCER
Year:2018 | Volume:9 | Issue:2|Papers Count:12

Background: Anthracycline therapy for acute leukemia may be associated withsignificant morbidity and mortality in children or elderly patients that have a degreeof heart failure. Patients with prior anthracycline exposure, those with pre-existingheart disease, or who have received the total anthracycline dose present an increasedrisk for cardiotoxicity. Therefore, new chemotherapy regimens in these situations wouldbe life saving for leukemia patients. We have conducted a systematic review of possiblestrategies for rescue regimens without anthracycline in refractory acute leukemiapatients. Methods: We gathered the data from 5 creation databases and relevant websiteuntil August 2016. We selected randomized clinical trials or other studies that usedanthracycline-free chemotherapy regimens to treat acute refractory leukemia inchildren and adults. The quality of the studies was evaluated according to theCochrane risk of the polarization tool. All stages of the review were independentlyconducted by two authors. We obtained data from 75 main clinical trials. Results: There were 75 trials included from which 4 were considered to be at lowrisk for bias. Most trials showed that the improvement did not reach statisticalsignificance. Conclusion: Evidence existed to support the use of the combination of fludarabine, cytarabine, and filgrastim, ICE-rituximab chemotherapy regimens, or monoclonalantibodies such as tyrosine kinase inhibitors (Sorafenib) useful for acuterefractory/relapsed leukemia. These drugs are used as first salvage regimens orclofarabine and cladribine for acute myeloid leukemia in patients for whom combinedanthracycline chemotherapy is inappropriate.

Background: Angiogenesis is the process of new blood vessels formation thatcontribute to tumor growth and metastasis. Endothelial cell-selective adhesion moleculeis one of the proteins that expresses in vascular endothelial cells. In vitro and animalstudies have shown involvement of this protein in physiological and pathologicalangiogenesis. von Willebrand factor is a protein expressed by endothelial cells andmegakaryocytes that has a role in blood clotting processes. In the current study, weinvestigate the expression of endothelial cell-selective adhesion molecule and vonWillebrand factor in carcinoma mammae specimens and explore their correlationwith tumor growth and metastasis. Methods: We obtained 79 specimens from paraffin blocks of patients diagnosedwith invasive breast carcinoma of no special type. The slides from these specimens werethen stained with endothelial cell-selective adhesion molecule, von Willebrand factor, and Ki-67 antibodies to assess vascular numbers and cell proliferation. Results: We found a total of 31 (39%) low vascularity and 48 (61%) high vascularitysamples from endothelial cell-selective adhesion molecule staining. There were 34 (43%)low vascularity and 45 (54%) high vascularity samples by von Willebrand factorstaining. There was a significant correlation of blood vessel numbers in the endothelialcell-selective adhesion molecule-stained samples with tumor volume, metastasis to lymphnodes, and proliferation cells. The von Willebrand factor-expressed samples only hada significant correlation of vascular number with tumor volume. Conclusion: Endothelial cell-selective adhesion molecule and von Willebrandfactor as the endothelial cell expressed proteins play a role in the angiogenesis processof breast cancer. However, endothelial cell-selective adhesion molecule expression ismore consistent than von Willebrand factor in predicting the presence or absence ofmetastatic breast cancer.

Introduction: Esophageal squamous cell carcinoma is among the leading causesof cancer related deaths within gastrointestinal tumors. There is a growing body ofevidence that shows an association between Epstein Barr virus infection and thedevelopment of malignancies such as B-cell non-Hodgkin’ s lymphoma, Hodgkin’ sdisease, and Burkett’ s lymphoma. However its potential association with esophagealsquamous cell carcinoma is controversial. Therefore, in the present study, we haveexplored the association of Epstein Barr virus with pathological information andclinical outcomes of 108 esophageal squamous cell carcinoma patients. Methods: There were 48% female and 52% male patients with a mean age of59. 2± 11. 1 years who enrolled in this study. Patients had the following tumor stages: T1 (5. 6%), T2 (21. 3%), and T3 (71. 3%). A total of 32. 4% had lymph node metastases. In order to explore whether patient characteristics might influence clinical outcome, we analyzed data on progression-free survival and overall survival according topatients’ clinicopathologic features. Results: An association existed between tumor size, node and metastasis status, andstage with shorter overall and progression-free survival. We observed that 6. 5% of patientshad Epstein Barr virus. All patients infected with Epstein Barr virus had T2 and T3disease. Conclusion: Our findings demonstrated the presence of Epstein Barr virus in6. 5% of Iranian patients and its potential link with tumor size. Additional studies in multicentersettings should be conducted to determine the association of Epstein Barr viruswith development and progression of esophageal squamous cell carcinoma.

Background: Glutathione reductase is an important enzyme in oxidative metabolismthat provides reduced glutathione from its oxidized form in the cells. The role ofoxidative stress in tumor tissues has led us to investigate the gene expression and activityof this enzyme in tumor and adjacent resected margins of colorectal cancer tissues, one of the most common malignancies in humans. Methods: We conducted this study on 15 Iranian colorectal cancer patients. RNAwas extracted from fresh colon tissues that included tumor and anatomically normalmargin tissue. Expression of the glutathione reductase gene was determined using realtimePCR by the Δ Δ Ct relative quantification method. The gene expression results werestandardized with glyceraldehyde 3-phosphate dehydrogenase as the endogenousreference gene. In addition, we measured enzyme activity of glutathione reductase witha commercial kit based on a colorimetric assay. Results: The tumor tissue had higher expression of glutathione reductase comparedto the margin tissue (P=0. 005). There was significantly greater glutathione reductaseenzyme activity in the tumor tissue (116. 9± 34. 31 nmol/min/ml) compared to the noncancerousadjacent tissues (76. 7± 36. 85 nmol/min/ml; P=0. 003). Conclusion: These data showed increased glutathione reductase expression andenzyme activity in colorectal tumor tissue. Given the key role of glutathione insynthesis of dNTPs for DNA repair with the glutaredoxin system, the increasedglutathione reductase expression and activity might be a reflection of hyperactivity ofthis enzyme in DNA synthesis and the repair process in colorectal cancer cells.

Background: Breast cancer is the second leading cause of cancer death after lungcancer. Discovering molecular biomarkers is necessary for disease management thatincludes prognosis prediction and preventive treatment. The aim of this study is toevaluate the expression value of p53 and PTEN as molecular biomarkers of breast cancerand their relation with clinicopathological characteristics. Methods: In this study, 100 breast cancer and 20 normal samples were subjectedto investigation. Total RNA was isolated and we measured RNA expression by realtimeRT-PCR. Data were analyzed by REST 2009 and SPSS. Results: Gene expression results showed up-regulation of P53 in 53 breast cancersubjects and PTEN in 52 breast cancer subjects compared with normal controls. However, there was lower P53 expression in 25 breast cancer samples compared tonormal tissues. PTEN expression was lower in 26 breast cancer samples than normaltissues. p53 showed a significant relationship to HER2 receptor (P=0. 024) andmenopausal status (P=0. 013); no significant relationships existed with other clinicopathologicalparameters (P>0. 05). PTEN had the only significant correlation withlymphatic invasion (P=0. 046) without any relation with other clinicopathologicalfeatures (P>0. 05). PTEN expression had no significant association with p53 expressionin the studied population (P=0. 074). Conclusion: Combined detection of PTEN and p53 may have the potential toestimate the pathobiological behavior and prognosis of breast cancer. Due to theheterogeneous nature of cancer and the presence of different factors involved in theclinical situation of breast cancer, we suggest a study of a larger population and morebiomarkers.

Background: Placental growth factor is involved in human gastric cancer initiationand progression through stimulating the proliferation, angiogenesis, invasion andmetastasis of cancerous cells. Previous studies indicate that the expression profiles ofhsa-miR-22-3p, hsa-let-7b-3p, hsa-miR-451b, and hsa-mir-4290 change in MKN-45-derived gastric cancer stem-like cells. Therefore, this study aims to investigate the effectof PlGF knockdown on hsa-miR-22-3p, hsa-let-7b-3p, hsa-miR-451b, and hsa-mir-4290expressions in MKN-45-derived gastric cancer stem-like cells. Methods: We used a non-adhesive culture system to derive the cancer stem-likecells from MKN-45 cells. PlGF gene silencing was performed by PlGF-specificsiRNA. The transcript of PlGF and miRNAs were measured by real-time RT-PCR. Weconducted bioinformatics analyses with the online software programs TargetScan, miRanda, miRWalk, PicTar, and the Database for Annotation, Visualization, andIntegrated Discovery tools to predict miRNAs’ targets and their signaling pathways. Results: hsa-let-7b-3p had a 2. 28-fold up-regulation, whereas we observed downregulationof hsa-mir-451b (25%), hsa-mir-4290 (34%), and hsa-mir-22-3p (9%). Bioinformatics analysis results indicated that the miRNA target genes TGF-β , MAPK, and Wnt, and hedgehog signaling pathways contributed to cancer initiation andprogression by influencing different cellular behaviors. Conclusion: We suggest that PlGF signaling may influence miRNA expressionprofiles in MKN-45-derived cancer stem-like cells, which can influence the expressionsof different genes and signaling pathways. However, more empirical studies shoulddetermine the exact effect of PlGF knockdown on the expression of miRNA targetsin cancer stem-like cells to locate their actual gene targets.

Background: Matrix metalloproteinases-2 and-9 play important roles in thedevelopment of breast cancer by hydrolyzing the extracellular matrix. Since − 1306C/Tand − 1562C/T polymorphisms are located at the promoter regions of the matrix metalloproteinase-2 and-9 genes, respectively, C to T substitution may affect promoteractivity and impact the rate of extracellular matrix degradation and cancerous cellproliferation. Therefore, we aimed to determine the genotype and allele frequencies ofthese polymorphisms in Iranian healthy women and women with breast cancer. We havealso examined the correlation of genotypes with clinicopathological parameters suchas tumor type, tumor size, and metastasis to lymph nodes. Methods: This case-control study enrolled 200 women with breast cancer and 200age-matched healthy women. DNA was extracted, and we determined the genotypeand allele frequencies of − 1306C/T matrix metalloproteinase-2 and − 1562C/T matrixmetalloproteinase-9 polymorphisms by the polymerase chain reaction-restrictionfragment length polymorphism method. Additionally, tumor size (<20 mm/>20 mm), tumor type (ductal/non-ductal), and metastasis (yes/no) were determined. Results: Genotype and allele frequencies of the − 1306C/T matrix metalloproteinase-2 polymorphism showed no significant association with the occurrence ofbreast cancer. Genotype and allele distribution differed in the − 1562C/T matrix metalloproteinase-9 polymorphism and indicated a 4. 83-fold increase in the risk of breastcancer for T allele carriers. There was no likelihood of any interaction found betweenthe two polymorphisms and susceptibility to breast cancer. In addition, the − 1562C/Tmatrix metalloproteinase-9 T allele showed an association with metastasis to lymphnodes but we observed no association between the − 1306C/T matrix metalloproteinase-2 polymorphism and clinicopathological features. Conclusion: The ‒ 1562C/T matrix metalloproteinase-9 polymorphism is involvedin the pathogenesis of breast cancer in Iranian women. The T allele may increase therisk of disease.

Background: This study evaluates the predictive significance of salivary amylase, glutathione, lipid peroxides, and lactate dehydrogenase in the treatment of head andneck cancer patients who undergo curative radiotherapy/chemoradiotherapy. Methods: The volunteers for the study included head and neck cancer patients thatrequired curative radiotherapy/chemoradiotherapy. Patients provided saliva and bloodsamples before the start of radiation treatment and 24 hours after the first radiation fractionof 2 Gy (before the start of the second fraction). Samples were assessed for the levelsof blood and salivary amylase, glutathione, lipid peroxides, and lactate dehydrogenaseby standard laboratory methods. Clinical tumor radioresponse was assessed one monthafter the completion of treatment as complete responders, partial responders, andnonresponders. Results: The results indicated a significant increase in the levels of amylase, lactate dehydrogenase, and lipid peroxides; and a concomitant decrease in the levelsof glutathione P<0. 05-P<0. 0001 in saliva and blood. The correlation between thedifferences in each biochemical parameter with that of the treatment response showeda significant correlation only for the salivary lactate dehydrogenase (R2=0. 25; P<0. 02). Conclusion: The results indicate that salivary lactate dehydrogenase can be auseful predictive marker to ascertain radiation-induced tumor regression in head andneck cancers.

Background: Psychological distress is a type of mental stress that people experiencedue to various causes. This study aims to investigate psychological distress in cancerpatients. Methods: This cross-sectional study was performed during one year on cancerpatients who referred to two academic hospitals affiliated with Mashhad University ofMedical Sciences for treatment or follow-up. We used the psychological distressquestionnaire for data collection. Results were analyzed using SPSS version 16. P<0. 05 was considered significant. Results: Patients had a mean ± SD age of 54± 15. 30 years (range: 18 to 89). The mostcommon cancers were colorectal, gastroesophageal, and breast. Patients had a meandistress thermometer score of 5± 2. 99. Out of 256 patients, 173 (67. 7%) scored 4 or higher. The distress thermometer scores were higher among females, rural residents, patientstreated within the previous month, patients with insight of their illness, those with loweducation levels and low functional status, non-smokers, and divorced patients. Asignificant relationship existed between patients who had insight of their illness, received treatment in the previous month, and low functional status with the psychologicaldistress score. The most prevalent cause of psychological distress among the participantswas fatigue (68. 8%), followed by pain (59. 4%), difficulty in transportation (59. 4%), anxiety (57. 2%), sadness (50. 4%), anger (44. 5%), and depression (43. 8%). Conclusion: The results of this study have revealed higher rates of severepsychological distress in women, rural residents, patients with low educational andfunctional status, drug abusers, and divorced patients. Therefore, early detection ofpsychological distress and appropriate interventions among these groups of patients isof cardinal importance. The most prevalent causes of psychological distress among thepatients in the current study are fatigue and pain. We recommend that supportive andpalliative care be implemented to reduce both the pain and enhance the functional statusof cancer patients.

Background: Colorectal cancer susceptibility may correlate with the Klothogene G-395A and C1818T polymorphisms. This study aims to evaluate the relationshipbetween a Klotho single nucleotide polymorphism and IGF-1 with risk of colorectalcancer. Methods: This study enrolled 60 colorectal cancer patients and 60 age-matchedhealthy persons who referred to Razi Hospital, Rasht, and Northern Iran in September2013. Patients enrolled under supervision of a gastro-intestinal specialist andaccording to the ethics right. G-395A and C1818T polymorphisms were genotypedwith polymerase chain confronting two pair primer technology. IGF-1 and certainbiochemistry analytes were assayed. Statistical analysis was used to compareappropriate relationships. Results: There were different base pair partitions for G395A and C1818T. Oddsratio and 95% confidence interval were used to analyze the correlation of genotypesand haplotypes with colorectal cancer susceptibility. The AA (odds ratio: 1. 437, 95%confidence interval: 0. 596) and GA (odds ratio: 1. 958, 95% confidence interval: 1. 133-3. 385) genotypes of the G-395A polymorphisms showed a slight relationship to therisk of colorectal cancer. The A allele had a much higher frequency in the case group(31. 2%) compared with the control group (17. 6%). There was no significantrelationship with the C1818T polymorphism between the case and control groups. Conclusion: The Klotho gene polymorphism did not significantly increase therisk of colorectal cancer. Therefore, these genotypes might not have a correlation withIGF-1.

Follicular dendritic cell neoplasms are extremely rare. Information regarding theaccurate treatment and prognosis is limited owing to their rarity; thus, this tumorencompasses a domain to be brought into focus. Clinical and pathological diagnoseswarrant a high index of suspicion as this entity is not considered in routine clinicalpractice. Histopathologically it mimics various other neoplasms which lead to higherchances of misdiagnosis at initial evaluation. Use of follicular dendritic cell immunohistochemicalmarkers CD 21 and CD 35 helps in rendering a definitive diagnosis.

Pineal region tumors are uncommon lesions in the central nervous system. Papillarytumor of the pineal region is recently recognized as a separate disease. Its incidence, treatment, and outcome are not well-defined. We have reported the case of a 6 yearold-boy with papillary tumor of the pineal region. He presented with headaches, nausea and vomiting and, after a biopsy, was referred for radiotherapy. The patientreceived 54 Gy irradiation to the pineal region followed by a chemotherapy regimenof cisplatin, vincristine, and lomostine. His tumor decreased slightly. After 4 years, thepatient has remained well and attends school. He is under routine follow-up. Wesuggest radical radiotherapy as the main treatment for papillary tumors of the pinealregion.