MIDDLE EAST JOURNAL OF CANCER
Year:2020 | Volume:11 | Issue:1|Papers Count:15

Background: A slight increase in the childhood cancer trend has been observed for the past few decades. Non-ionizing radiation is one of the environmental factors linked to childhood cancers. This review is conducted to assess the association between non-ionizing radiation and childhood cancer based on all original studies to date. Methods: A systematic search was conducted on the titles and abstracts pertaining to non-ionizing radiation and childhood cancers using the PubMed, Scopus, SAGE and ScienceDirect databases from inception up to November 2018. Quality of each article was appraised using the Newcastle-Ottawa Scale, meta-analysis was performed with Review Manager, and fixed effects were used to estimate the pooled OR of the selected studies. Results: A total of 15 articles met all the selection criteria. Twelve articles were included in the meta-analysis. Pooled risk estimates of the 12 studies, obtained via fixed effects model, showed that children exposed to 0. 2 μ T or more of EMF non-ionizing radiation run 1. 33 times higher risks of contracting childhood cancer compared to those with less than 0. 2 μ T exposure (95% CI: 1. 10, 1. 60). The studies were statistically homogeneous (chi-squared P=0. 71, I2=0%), and there was no evidence of publication bias. Conclusion: It cannot be concluded that children exposed to non-ionizing radiation have higher risks of childhood cancer compared to those who were not exposed as claimed by the previous reviews. However, concerns about non-ionizing radiation exposure and childhood cancer should not be neglected.

Background: Acute myeloid leukemia (AML) may originate from the combination of genetic susceptibility factors and environmental exposure. The aim of this study was to investigate the association of GSTM1 and GSTT1 null genotypes and CYP1A1*2A allele with susceptibility to AML in an Iranian population. Method: In this case-control study, 200 patients with AML and 200 normal individuals as controls were included. GSTM1 and GSTT1 null genotypes were amplified using multiplex PCR and CYP1A1*2A polymorphisms were genotyped by PCR-RFLP. Result: The frequency of GSTM1 null genotype was significantly higher in the control group compared to the case group. The frequency of GSST1 null genotype was significantly lower in the controls. No association was observed between the studied CYP1A1*2A variant and the risk of acute myeloid leukemia. The combination of GSTT1 null genotype and CYP1A1 *2A AA and AC alleles further increased the risk of AML. Conclusion: GSTT1 null genotype can increase the risk of AML, particularly when combined with CYP1A1*2A allele. GSTM1 null genotype can also play a protective role and reduce the risk of AML. However, further studies are required on a larger number of patients.

Background: Gastric cancer is the second global leading cause of death from cancer and the most common gastrointestinal cancer in Iran. This condition is usually diagnosed at advance stages where treatment options are limited. Recently, heat shock proteins (HSPs) have been reported to be overexpressed in a wide range of malignancies and considered as promising candidate biomarkers and therapeutic targets for gastric adenocarcinoma. The aim of the present study was to compare HSPs protein expression between non-tumoral and tumoral sections from patients with gastric adenocarcinoma and determine HSPs protein expression correlation with histological stage, tumoral grade and prognosis. Methods: Immunohistochemistry was used to assess the expression levels of HSP-27, 70 and-90 proteins on both tumoral and non-tumoral (margin of tumor as control group) sections in 80 patients with gastric adenocarcinoma. Further analyses were histology, grade and stage of tumor (Tumor, node, and metastasis), HSPs expression level, clinicopathological significances, and survival rate. Results: The expression of HSPs was significantly increased in tumoral sections compared with non-tumoral sections (P<0. 001). The HSP27 expression was correlated with tumors on the corpus of stomach (P=0. 049). Patients younger than 63 years revealed higher expression levels of HSP70 (P=0. 040). High expression levels of HSP90 were further assessed in well-differentiated and intestinal types of tumors (P=0. 009 and P=0. 019). Overexpressed levels of HSP27 and 90 were associated with the reduced survival rate of patients (P=0. 017 and P=0. 018). Conclusion: HSP27 and HSP 90 are potential prognostic biomarkers of patients’ survival rate. Patients harboring positive HSP27 and HSP 90 expression display worse disease-free survival compared to those with negative HSP27 and HSP 90 expression. Differential expression of HSPs may play crucial roles in the initiation and progression of gastric cancer and can be exploited as future therapeutic targets.

Background: As a major tumor suppressor gene, P53 plays a principal role in the apoptosis of cancer cells. Harmine is a harmal-derived alkaloid with antioxidant and anticancer properties. This study was designed to assess the ability of harmine to express P53 gene and stimulate apoptosis in breast cancer cell line. Methods: MCF-7 cell line was cultured and treated with harmine. Half maximal inhibitory concentration (IC50) assay was carried out through MMT method following 24 h of treatment. Flow cytometry technique was employed to measure apoptotic cells and real-time PCR was performed to estimate P53 gene expression in tumor cells. Results: The IC50 for the harmine extract in MCF-7 cells was 30 μ M. Harmine administration in all treated groups resulted in a significant increase in apoptosis and P53 gene expression in MCF-7 cells (P < 0. 00001). Conclusions: It seems that harmine administration is able to induce apoptosis in MCF-7 cells through the up-regulation of P53 expression.

Background: Abnormal expressions of microRNAs are related to various cancers such as breast cancer for which paclitaxel is widely used as a chemotherapeutic agent. We aimed to investigate the effect of paclitaxel treatment on the expression level of miR-199a-5p and miR-10b, involved in epithelial-mesenchymal transition (EMT) process in breast cancer cell lines. Methods: Human breast cancer cell lines BT-474, SKBR-3, MDA-MB-231, and MCF-7 were cultured and MTT assay was used to determine IC50 of paclitaxel. RNA was extracted, cDNA was synthesized, and the expression level of miRNAs and genes was quantitatively determined using real-time PCR. Results: After treatment with paclitaxel, the expression level of miR-199a-5p significantly decreased in MCF-7 and SKBR-3 cell lines, while it increased in MDA-MB-231 and BT-474. The expression level of miR-10b was also significantly reduced in MCF-7, MDA-MB-231, and SKBR-3 and increased in BT-474 cell lines following treatment with paclitaxel. Our results further indicated that paclitaxel reduced the expression level of vimentin and MMP-9 in MDA-MB-231 cell line. Conclusion: Our findings revealed the increased expression of EMT-inhibitor miR-199a-5p and the decreased expression of metastamir miR-10b after treatment of MDA-MB-231 metastatic breast cancer cell line. Reduced expressions of vimentin and MMP-9 were also observed, corroborating the inhibition of metastasis markers in this type of breast cancer. The therapeutic effect of paclitaxel may in part be due to the change in the balance of EMT-promoting and EMT-inhibiting miRNAs.

Background: Detecting non-small-cell lung cancer at an early stage has become a great challenge due to the lack of a specific non-invasive marker. MicroRNAs are small, non-coding RNA molecules that play a role in carcinogenesis and cancer progression, as indicated by their abnormal expression in the patients’ plasma. Herein, we investigated the plasma level of circulating miRNA-30a and miRNA-221 as non-invasive markers for an early detection of non-small-cell lung cancer. Method: A cross-sectional study was conducted at Assiut University Hospital, Egypt, to investigate miRNA-30a and miRNA-221 expression via quantitative real-time PCR in the plasma of patients with non-small-cell lung cancer (n=70) and healthy controls (n=34). Receiver operating curves were used to evaluate the diagnostic value of miRNA-221 and miRNA-30a in non-small-cell lung cancer. The relationship between both markers and patient clinical parameters was further assessed. Result: Circulating plasma miRNA-30a and miRNA-221 levels were significantly higher in the non-small-cell lung cancer patients compared with those in the healthy controls (P<0. 05). There was a significant difference regarding the plasma miRNA-30a level among the three groups (the highest levels were recorded in adenocarcinoma, followed by large cell carcinoma and squamous cell carcinoma). ROC curve analysis of miRNA-30a and miRNA-221 showed that specificity and sensitivity were 60% and 80%, and 40% and 75%, respectively. Conclusion: miRNA-30a and miRNA-221 may be non-invasive biomarkers for early detection and screening or therapeutic targets in patients with NSCLC. Future studies are warranted regarding the use of biomarkers as therapeutic targets.

Background: The breast cancer susceptibility gene (BRCA1) encodes a tumor suppressor protein which plays a vital role in the DNA damage repair and transcriptional regulation among other functions. Bioinformatics is a newly-emerged discipline that uses computer, mathematics, and statistics in molecular biology in order to analyze the large amounts of biological data quickly, freely, and accurately. Methods: The BRCA1 transcript (mRNA) levels were checked by using real-time quantitative polymerase chain reaction (RT-qPCR) in four sporadic breast cancer cell lines: MCF-7, T47D, MDA-MB-231, and MDA-MB-468 compared to the normal breast tissue. Bioinformatics tools were also used to compare and analyze different aspects of BRCA1 transcripts (multiple different mRNAs produced by a single gene) and splice variants (multiple proteins encoded by the same gene). Results: The level of BRCA1 mRNA was overexpressed in the studied breast cancer cell lines relative to the normal breast cDNA. Also, the bioinformatics software tools provided many important features of this gene that would help explain numerous controversial laboratory findings. Conclusions: The data presented here support a role for BRCA1 overexpression in the pathogenesis of sporadic breast cancer. The bioinformatics analysis of BRCA1 mRNA and protein variants can provide information essential for cancer diagnosis or therapy. The biological data gained from these tools can help authors make better decisions before launching expensive experiments.

Background: Today, cancer is one of the serious health issues worldwide. In USA, colorectal cancer is the third cause of death. Reportedly, some risk factors, including family history of colorectal cancer, age, and infectious diseases can deteriorate the progression of colorectal cancer. One of the most common specifications in all gram-negative bacteria is bacterial cell wall, known lipopolysaccharide. Moreover, LPS probably can affect some microRNAs and cancer progression. We studied the effects of LPS on microRNA-9,-192, and-205 expressions in colorectal cell lines [SW480, HCT116], which are considered oncogene. Methods: SW480 and HCT116 cell lines were treated with LPS to analyze microRNA-9,-192, and-205 expressions by quantitative real-time PCR in 48 hours at 10 ug/L of LPS. Results: Quantitative real-time PCR illustrated that microRNA-9,-192, and-205 were upregulated after treating LPS. There was an increase in microRNA-9 level, six and eight times in SW480 and HCT116 cell lines, respectively. Furthermore, upregulation in the expression of microRNA-192, six times in HCT116 and four times in SW480 was observed. Moreover, there was an upregulation expression [almost four times in both cell lines] in microRNA-205. Our results show that treating LPS increases microRNA-9,-192 and-205, which may be related to cancer in colorectal cell lines [SW480 and HCT116]. Conclusion: Therefore, disrupting the balance of bacterial flora can be influential in colorectal cancer progression and increase the chances of getting colorectal cancer that further investigation is required.

Background: Breast cancer is the second cause of death among women. Ultrasound (US) imaging is the most common technique for diagnosing breast cancer; however, detecting breast lesions in US images is a difficult task, mainly, because it provides low-quality images. Consequently, identifying lesions in US images is still a challenging task and an open problem in US image processing. This study aims to develop an automated system for the identification of lesions in US images Method: We proposed an automatic method to assist radiologists in inspecting and analyzing US images in breast screening and diagnosing breast cancer. In contrast to previous research, this work focuses on fusing information extracted from different frames. The developed method consists of template matching, morphological features extraction, local binary patterns, fuzzy C-means clustering, region growing, and information fusion-based image segmentation technique. The performance of the system was evaluated using a database composed of 22 US videos where 10 breast US films were obtained from patients with breast lesions and 12 videos belonged to normal cases. Results: The sensitivity, specificity, and accuracy of the system in detecting frames with breast lesions were 95. 7%, 97. 1%, and 97. 1%, respectively. The algorithm reduced the vibration of the physician’ s hands’ while probing by assessing every 10 frames regardless of the results of the prior frame; hence, lowering the possibility of missing a lesion during an examination. Conclusion: The presented system outperforms several existing methods in correctly detecting breast lesions in a breast cancer screening test. Fusing information that exists in frames of a breast US film can help improve the identification of lesions (suspect regions) in a screening test.

Background: The main aim of the present study was to map the real high risk regions of gastric cancer (GC) using corrected data for misclassification error in all Iranian provinces. Method: In this cross-sectional study, the data were extracted from the reports of Ministry of Health and Medical Education and previous studies on correcting GC registered data including 30 provinces in 2008. The information about socioeconomic factors was extracted from the statistical centers of Iran. To estimate the model parameters, the Bayesian approach was used with regards to spatial correlation due to adjacent effects. Results: The southern and northern provinces were introduced as high-risk regions and the central provinces were introduced as low-risk regions. The mean household income was inversely associated with the risk of GC. Conclusion: The real high-risk regions of GC in Iran are the north and south border provinces which should be considered by health policy makers. It is also necessary to correct misclassified registered data which can lead to seduction in health service allocation.

Background: Up to 3% of breast cancers may be diagnosed in pregnancy, during which period radiation therapy is not preferred, yet sometimes inevitable. Due to fetal radiation sensitivity, the fetal radiation safety is of particular concern. The present study was performed to estimate fetal dose for pregnant breast cancer patients during radiotherapy using an in-house phantom. Method: The fetal dose was estimated through phantom measurement using an ion chamber dosimeter. The phantom measurement was performed by simulating treatment planning on an in-house anthropomorphic phantom which consisted of natural human bone, cork, and paraffin. The right breast and the right supraclavicular area of the phantom were irradiated under the four-field technique with 6 and 10 MV photon beams for un-wedged and wedged fields. Results: During the first trimester of pregnancy, the radiation dose delivered to the fetus was in the range of 0. 11-0. 14 Gy for a 50 Gy total tumor dose in 25 fractions. The fetal dose in the second and third trimester of pregnancy ranged from 0. 14-0. 19 Gy to 0. 22-0. 32 Gy, respectively. Conclusion: According to the results, the fetal dose is strongly dependent upon the energy beam, treatment procedure, and gestational stage.

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that almost always arise from the GI tract and account for 0. 1-3% of GI tumors. During pregnancy, GIST is highly unusual given the predilection of this tumor to appear in the fifth to seventh decade of life. The finding of GISTs outside the GI tract is also rare as the cell of origin of these tumors is believed to be the interstitial cell of Cajal, found only in the GI tract. Extra intestinal GISTs have been reported with a few cases arising from the uterus or metastatic to the ovary; however; an asymptomatic uterine GIST occurring at pregnancy as an incidental finding during cesarean section has not been reported so far. We present a 32-year-old lady who underwent an emergency caesarean section and was found to have a GIST of the uterus. The tumor was excised in toto and she started imatinib therapy postoperatively. At the end of three years of close follow-up, she has done well with no evidence of recurrence.

Metastatic tumors to the oral cavity are rare and account for only 1% of all oral cavity malignancies, and if occurs, it involves the jaws rather than the soft tissue. Diagnosis of a metastatic lesion in gingiva can be challenging owing to its rarity and atypical appearance. In this paper, we describe a rare case of breast cancer metastasis to the gingival soft tissue of mandible. A 68-year-old female referred to the department of oral and maxillofacial surgery with the chief complaint of a painful mass in the right buccal and lingual anterior region of the mandible with the mobility of the involved teeth. The patient also reported the history of a breast cancer dating back to eight years ago. Histopathologic findings and immunohistochemistry results supported a metatatic lesion. As a result, it is important to have a great clinical suspicion to diagnose such lesions in order to receive the most proper treatment to patients as soon as possible.

Breast cancer is the most common cancer and the fifth most common cause of death from cancer in women. Ovarian cancer is the deadliest type of the gynecological cancers. Concerning women with BRCA1 or BRCA2 mutation, surgical alternatives for reducing their risk of developing breast and/or ovarian cancer are prophylactic mastectomy, skin-sparing mastectomy, and prophylactic salpingo-oophorectomy. The arguments of the proponents and opponents regarding prophylactic mastectomy and salpingo-oophorectomy are presented. Prophylactic surgeries are controversial; hence, mandating immediate interventions on the policy level.

Dear Editor, The most malignant human brain tumor is glioblastoma multiform (GBM). The patients usually do not suffer this tumor more than one year. 1 It is also the most common tumor among primary brain tumors...