Cervical cancer continues to be a major public health problem affecting large numbers of women in many developing countries. Limitations of various screening modalities and the lack of ready availability of a cost-effective point-of-care screening tool have hindered the efficient implementation of population-based screening programs in these settings. It has not proved possible for many countries to adopt cytology as a screening modality due to inadequate infrastructure and trained manpower. However, recent developments, notably design and testing of a low-cost HPV test kit and initiatives by countries like India in developing and putting into operation a framework for large-scale screening of women, have raised hopes that cervical cancer control may be possible even in resource-constrained locations. With the advent of HPV vaccination, primary prevention of cervical cancer also seems a distinct possibility. However, wide availability and acceptability of vaccination is still an unresolved issue for developing countries. The possible future effects of vaccination on test characteristics of various screening strategies also need to be evaluated. This review gathers information on the current status of cervical cancer screening with a special focus on low resource settings. It revisits the strengths and limitations of the available screening modalities for cervical cancer viz. cytology, visual methods and HPV testing, in the context of their applicability in developing countries. In addition, the role of newer HPV-detection methods, for instance DNA, RNA and protein-based techniques, in triage of screen-positive women is discussed. The contemporary issue of impact of HPV vaccination on cervical cancer screening is also addressed briefly. The main highlight of the review is the reference to ‘operational framework guidelines’ for population-based cervical cancer screening, which have recently been formulated and are in the process of being implemented in India. The guidelines may serve as a model for other similar low-resource settings where implementation of cancer screening is desired.
Cholangiocarcinoma is a malignant neoplasm originating from biliary epithelial cells. The incidence and mortality of this cancer are rising in the world. Currently, cholangiocarcinoma is accepted as a stem cell disease with many risk factors. Diagnosis is relatively simple but therapy is extremely difficult. Surgery is the mainstay of treatment for early stage patients. Endobiliary approaches, chemotherapy and radiotherapy are other therapeutic approaches.
Cratoxylum formosum Dyer is the Thai vegetable which commonly consumed a fresh leaves. In this study, we extracted Cratoxylum formosum with water and tested the extract for genotoxicity and anti-genotoxicity effects. We carried out the experiment using micronucleus test and comet assay in TK6 cells. In micronucleus experiment, we used cytokinesis-block proliferation technique to stop cell division which produced a cell at binucleated (BNC) stage. The comet assay was carried out after pre-treatment the cell with C. formosum for 18 h. The results revealed not increased the micronucleus frequency of C. formosum at concentration ranging from 50-150 μg/ml. In contract, it showed that the combination between C. formosum at various concentrations (25, 50, 75, 100, 150 and 200 μg/ml) and mitomycin C could decrease significantly in frequency of micronuclei. The mean of micronucleus frequency in the sample were 23.17 ±3.33, 23.33 ±4.72, 21.00 ±3.61, 11.33 ±3.21, 16.67 ±2.08, and 23.33±1.53 MN/ 1,000 BNC, respectively whereas the MMC-treated group was 33.67 ± 8.96 MN/ 1,000 BNC. The comet assay result showed that pre-treatment with Cratoxylum formosum (25, 50, 100, 200 μg/ml) could inhibit the hydrogen peroxide induced DNA damage by 6.95, 12.99, 17.61, and 26.39 respectively.
Globally, Cancer is the ever-increasing health problem and most common cause of medical deaths. In Libya, it is an important health concern, especially in the setting of an aging population and limited healthcare facilities. Therefore, the goal of this research is to map of the county’ cancer incidence rate using the Bayesian method and identify the high-risk regions (for the first time in a decade). In the field of disease mapping, very little has been done to address the issue of analyzing sparse cancer diseases in Libya. Standardized Morbidity Ratio or SMR is known as a traditional approach to measure the relative risk of the disease, which is the ratio of observed and expected number of accounts in a region that has the greatest uncertainty if the disease is rare or small geographical region. Therefore, to solve some of SMR’s problems, we used statistical smoothing or Bayesian models to estimate the relative risk for stomach cancer incidence in Libya in 2007 based on the BYM model. This research begins with a short offer of the SMR and Bayesian model with BYM model, which we applied to stomach cancer incidence in Libya. We compared all of the results using maps and tables. We found that BYM model is potentially beneficial, because it gives better relative risk estimates compared to SMR method. As well as, it has can overcome the classical method problem when there is no observed stomach cancer in a region.
Background: Cancer is emerging as a major cause of morbidity and mortality in low and middle-income countries. Cancer registry figures help for planning and delivery of health services. This paper provided the first results of cancer incidence and mortality [Crude (CR) and age-standardized (ASR)] rates (world-standard population) of Trivandrum district, South India and compared with other registries under the network of National Cancer Registry Programme (NCRP), Government of India. Materials and Methods: Trivandrum district cancer registry encompasses a population of 3.3 million, compiles data from nearly 75 sources (hospitals and diagnostic laboratories) and included under the NCRP in 2012. During 2012-2014, registry recorded 15,649 incident cases and 5667 deaths. Proportion of microscopic diagnosis was 85% and ‘Death certificate only’ was 8%. Results: Total cancer incidence (CRs) rates were 161 and 154 (ASR: 142.2 and 126) and mortality rates were 66 and 49 (ASR: 54 and 37) per 105 males and females respectively. Common cancers in males were lung (ASR:19), oral cavity (ASR:15), colo-rectum (ASR:11.2), prostate (ASR:10.2) and lymphoma (ASR:7) and in females, breast (ASR:36), thyroid (ASR:13.4), cervix-uteri (ASR:7.3), ovary (ASR:7) and colo-rectum (ASR:7). Nationally, the highest CRs for breast, prostate, colo-rectum, corpus-uteri and urinary bladder cancers and low incidence of cervix-uteri cancer were observed in Trivandrum. Conclusion: Cancer incidence (CR) in Trivandrum was the highest in both genders in India (except Aizwal). This is mainly due to the highest life-expectancy in Kerala. Also, an epidemiologic transition in cancer pattern is taking place and is changing to more similar to "western" jurisdictions.
Background: Cancer survival depends on loss to follow-up (LFU) and non-proportional hazards (non-PH). If LFU is high, survival will be over-estimated. If hazard is non-PH, rank tests will provide biased inference and Cox-model will provide biased hazard-ratio. We assessed the bias due to LFU and non-PH factor in cancer survival and provided alternate methods for unbiased inference and hazard-ratio. Materials and Methods: Kaplan-Meier survival were plotted using a realistic breast cancer (BC) data-set, with >40%, 5-year LFU and compared it using another BC data-set with <15%, 5-year LFU to assess the bias in survival due to high LFU. Age at diagnosis of the latter data set was used to illustrate the bias due to a non-PH factor. Log-rank test was employed to assess the bias in p-value and Cox-model was used to assess the bias in hazard-ratio for the non-PH factor. Schoenfeld statistic was used to test the non-PH of age. For the non-PH factor, we employed Renyi statistic for inference and time dependent Cox-model for hazard-ratio. Results: Five-year BC survival was 69% (SE: 1.1%) vs. 90% (SE: 0.7%) for data with low vs. high LFU respectively. Age (<45, 46-54 & >54 years) was a non-PH factor (p-value: 0.036). However, survival by age was significant (log-rank p-value: 0.026), but not significant using Renyi statistic (p=0.067). Hazard ratio (HR) for age using Cox-model was 1.012 (95%CI: 1.004 -1.019) and the same using time-dependent Cox-model was in the other direction (HR: 0.997; 95% CI: 0.997- 0.998). Conclusion: Over-estimated survival was observed for cancer with high LFU. Log-rank statistic and Cox-model provided biased results for non-PH factor. For data with non-PH factors, Renyi statistic and time dependent Cox-model can be used as alternate methods to obtain unbiased inference and estimates.
Introduction: The 12-items Smoking Self-Efficacy Questionnaire (SEQ-12) has been shown to be a valid and reliable instrument to assess confidence in one’s ability to refrain from smoking. However, although such measures have been validated worldwide, most of them have not been culturally and linguistically adapted for use among Malay communities. The objective of this study was therefore to modify the SEQ-12 according to the Bruneian context for cultural adaptation for use among Bruneian adolescents, and assess the validity and reliability of the Malay translated version among secondary students. Methods: The original English version of the SEQ-12 was modified according to Bruneian context, translated and back-translated into and from the Malay language. The Malay version was then pre-tested and finally distributed to 40 purposively selected students in two secondary schools in Bandar Seri Begawan, Brunei Darussalam. Reliability was determined using Cronbach’s alpha for internal consistency, while to assess the construct validity, an exploratory principle component factor analysis with varimax rotation was applied. Test-retest reliability was assessed with the students and tested using the intraclass correlation coefficient (ICC). Results: In total, 31 students participated with the initial questionnaire and the test-retest reliability. Exploratory factor analysis revealed two factors, representing two constructs as in the original questionnaire. Cronbach’s alpha co-efficients for the first and second factors were 0.87 and 0.92, respectively. The test-retest reliability test showed an ICC of 0.98 (95%CI: 0.96, 0.99). Conclusions: The Malay version of the M-SEQ-12 is a valid and reliable scale, with potential applications in both research and clinical settings. It is a useful instrument for measuring self-efficacy regarding avoidance of smoking among Bruneian secondary students. Further analysis is necessary to assess the concurrent validity of the M-SEQ-12.
Consumption of fluke-free fish is the most important factor in controlling Opisthorchis viverrini (OV) infection in endemic areas such as northeast Thailand and thereby reducing the risk of cholangiocarcinoma. Cooking fish is the best way to avoid infection; however, the cultural practice of eating raw or fermented fish is difficult to change. We investigated the food preparation process, using freezing, heating and fermentation to kill OV metacercariae in fish. Uncooked cyprinid fish infected with OV were divided into three groups: refrigerated at 4 oC for 24, 48 or 72 h (control group); frozen at -20 oC for 24, 48 or 72 h; or heated by microwaving (at 400 or 800 W) or boiling at 90 oC for 1, 5 or 10 min. Moreover, pickled (fermented) fish were divided into two groups: refrigerated at 4 oC (control) or frozen at -20 oC for 24 or 48 h. The infectivity of recovered metacercariae was confirmed by infecting hamsters with OV and then evaluating the recovery of adult worms after 1 month. We found that a heating process, by boiling or microwaving at 400 or 800 W for at least 5 min, could kill OV metacercariae, and freezing pickled fish at -20 oC for 48 h could kill OV metacercariae in all sizes of fish. The present study found that heating and freezing processes, as well as the fermentation process under optimal conditions, could kill OV metacercariae in a timely manner. This knowledge is valuable for implementation in endemic areas to control OV infection and cholangiocarcinoma.
Background: Oral squamous cell carcinoma (OSCC) is one of the most common forms of cancer occurring worldwide. PEG10 is well known as a paternally expressed gene from a newly recognized imprinted region at human chromosome 7q21. Previous study had demonstrated that the significant expression of PEG10 was found in radioresistant OSCC cell line and its expression was significantly associated with poor survival in several cancers. Therefore it has been evaluated as a potential marker in OSCC patients undergoing radiotherapy. Objective: This study was conducted to analyze the mRNA expression of PEG10 in OSCC and its expression in relation to clinicpathological features, radiotherapy treatment response and survival. Methods: This study included tissue specimens obtained via biopsy of 118 patients with OSCC who were recommended for radiotherapy treatment and 80 healthy control tissues analysis of mRNA expression of PEG10 was done by real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Patients were treated with 70 Gy of radiation dose by shrinking field technique using Cobalt-60 teletherapy machine. Results: Significantly higher mRNA expression of PEG10 was found in OSCC patients when compared with matched controls. High level of PEG10 mRNA expression showed a significant correlation with lymph node metastasis (p = 0.0047) and tumor stage (p = 0.0499). Multivariate Cox regression analysis revealed that high level of mRNA expression of PEG10 was significantly associated with poor survival (p < 0.05). Our research demonstrated that the expression of PEG10 was higher in radioresistant tumor. Conclusion: We observed significantly increased expression of PEG10 in context of lymph node status, advanced stage and poor survival in our study. Thus PEG10 gene can be used as potential predictive and prognostic biomarker in OSCC patients undergoing radiotherapy.
Background: Obesity is associated with poor outcomes in patients with breast cancer expressing hormone receptors, but this association is not well established for triple-negative breast cancer. In this study, we investigated the influence of body mass index (BMI) in triple-negative breast cancer outcomes. Methods: This is a descriptive and analytical retrospective cohort study at the Regional Oncology Center Hassan II-Oujda. We identified 115 patients with triple-negative breast cancer, met the criteria for inclusion, treated between January 2009 and December 2011. The clinicopathological characteristics were collected to assess the association between BMI and overall survival and disease-free survival at 5 years, using the Kaplan-Meier and Cox model. Results: Data analysis focused on 115 patients, 34 patients (28.7%) were normal weight (BMI < 25) and 82 patients (71.3%) were overweight (BMI ≥ 25). The rates of overall mortality and progression at 5 years were 37.4% and 69.6% respectively. After adjusting for clinicopathological variables and menopausal status, overweight was associated with OS (HR: 2.903, 95% CI: 1.551- 5.432, p = 0.001) and DFS (HR:1.899, 95% IC: 1.05 – 3.433, p=0.034) in all patients with triple-negative breast cancer. When stratified by menopausal status, overweight was associated with DFS and OS (HR : 3.242, 95% CI: 1.249 to 8.412, p = 0.016) and (HR : 2.752, 95% CI: 1.267 to 5.978, p = 0.011) respectively in pre-menopausal women. By cons, BMI was not associated with DFS or OS in postmenopausal women. Conclusions: Overweight is an independent prognostic factor for OS and DFS at 5 years in all patients with triple-negative breast cancer, and menopausal status may be a mitigating factor. Premenopausal women with overweight are at greater risk of death and progression than women with normal weight. Once validated, these results should be considered in the development of prevention programs.
Objective: Pap smear test is an appropriate screening method for early diagnosis of cervical cancer and reduction of mortality. This study targeted effects of group counseling based on the Health Belief Model on cervical cancer screening practices of Iranian rural women. Method: This quasi-experimental study was conducted on 80 rural women under coverage of the health care centers in rural areas in the city of Kabudrahang, Iran, in 2015. The data collection tool was a researcher-made questionnaire covering demographic information, Health Belief Model (HBM) constructs and screening performance. Data were collected using a multi-stage sampling method. Group counseling was conducted based on the Health Belief Model and the GATHER steps in three sessions for the intervention group. Counseling included an introduction to cervical cancer, disease symptoms, warning signs and prevention approaches. Pap smear testing in both intervention and control groups was evaluated two months after the group counseling. Results: Before the intervention, there was no significant difference between both groups in the HBM constructs and performance. After the intervention, a significant difference was seen in the perceived susceptibility (P<0.001), severity (P=006), benefits (P=012), barriers (P<0.001), and self-efficacy (P=002). Two months after the intervention, 17 patients (42.5%) in the intervention group, and 4 patients (10%) in the control group had undergone a Pap smear test (P<0.001). Conclusion: Design and implementation of counseling programs based on the HBM can modify the beliefs of rural women regarding cervical cancer screening and increase their performance.
Background: Data mining, a new concept introduced in the mid-1990s, can help researchers to gain new, profound insights and facilitate access to unanticipated knowledge sources in biomedical datasets. Many issues in the medical field are concerned with the diagnosis of diseases based on tests conducted on individuals at risk. Early diagnosis and treatment can provide a better outcome regarding the survival of lung cancer patients. Researchers can use data mining techniques to create effective diagnostic models. The aim of this study was to evaluate patterns existing in risk factor data of for mortality one year after thoracic surgery for lung cancer. Methods: The dataset used in this study contained 470 records and 17 features. First, the most important variables involved in the incidence of lung cancer were extracted using knowledge discovery and datamining algorithms such as naive Bayes, maximum expectation and then, using a regression analysis algorithm, a questionnaire was developed to predict the risk of death one year after lung surgery. Outliers in the data were excluded and reported using the clustering algorithm. Finally, a calculator was designed to estimate the risk for one-year post-operative mortality based on a scorecard algorithm. Results: The results revealed the most important factor involved in increased mortality to be large tumor size. Roles for type II diabetes and preoperative dyspnea in lower survival were also identified. The greatest commonality in classification of patients was Forced expiratory volume in first second (FEV1), based on levels of which patients could be classified into different categories. Conclusion: Development of a questionnaire based on calculations to diagnose disease can be used to identify and fill knowledge gaps in clinical practice guidelines.
Background: In its standard form, the parametric survival model assumes that the shape parameter is constant and the scaling parameter is not. This article focuses on how a model with a non-constant shape parameter could make differences in oncology studies and lead to more precise results. Materials and Methods: Online data for part of a large clinical trial conducted by the Radiation Oncology Group in the United States available online on UMass Amherst`s website were employed. The full study included patients with squamous cell carcinoma from fifteen sites in the mouth and throat, although only data on three sites in the oropharynx reported by the six largest institutions were considered here. To identify clinical, pathological and biological characteristics of patients which might have had an effect on their survival, we compared Weibull distributions once with a constant shape parameter and again with a non-constant shape parameter. Analyzes were performed using SAS university edition. The level of significance was set at P ≤ 0.05. Results: Based on the model with a constant shape parameter only the patient status was identified as a risk factor and the AIC of this model was 2152.4, but based on the model with a non-constant shape parameter, sex, patient status, stage of the tumor and the institute at which the patient had been treated were significant, with an AIC of 2150.1. Conclusion: On the basis of the AIC, the second model with a non-constant shape parameter was suggested to be more accurate for identifying risk factors, leading to more precise results.
Background: The Human Papillomavirus (HPV) is a DNA tumor virus that causes epithelial proliferation. There are more than 100 HPV subtypes, of which 13 subtypes are regarded as high risk subtypes that can cause cancers of epithelial mucosal surfaces. High risk human papilloma viruses (HR-HPV) subtypes 16 and 18 plays a major role in the etiology of cervical cancer worldwide. Therefore, the aim of this study was to screen for the existence of HPV16 and HPV18 among Yemeni women with cervical lesions. Methodology: Formalin fixed paraffin wax processed tissue blocks were retrieved for 200 patients (150 were previously diagnosed with cervical cancer and the remaining 50 were diagnosed with different benign conditions). Results: Of the 200 cervical cancer tissue specimens, HR-HPV 16 was identified in 74/200 (37%) samples and couldn’t be recognized in 126/200(63%) tissue samples. HR-HPV 18 was identified in 32/200 (16%) specimens and couldn’t be recognized in 168/200(84%) tissue specimens. Conclusion: HR-HPV subtypes were prevalent among Yemeni women with cervical cancer, with significant increase of HR-HPV subtype 16 over the HR-HPV subtype 18.
Background: Breast cancer is one of the most important diseases affecting physical, psychological and social health of women. This study aimed to determine managerial self-efficacy regarding chemotherapy-related symptoms and related risk factors in Iranian patients. Materials and methods: This descriptive-analytical cross-sectional study was conducted on 150 patients with breast cancer referred to medical centers of Urmia in 2016 with a convenience sampling method . The data collection instrument was the symptom-management self-efficacy scale-breast cancer (SMSES-BC) questionnaire whose validity and reliability was evaluated for the first time for Iranians. Data were analyzed using SPSS software version 20. Results: Most of the patients were in the age range of 41-49 years. Lowest scores were in the areas of emotional and interpersonal disorders and the highest scores in the area of managing chemotherapy-related symptoms. The mean score of self-efficacy chemotherapy-related symptoms was 168.0±25.4. There were significant relationships between age, education, economic status, marital status and life status and self-efficacy chemotherapy-related symptoms. In addition, a positive significant correlation for each of the subscales. Conclusion: It should be noted that interventional efforts for improving managerial self-efficacy of symptoms, especially management of interpersonal and emotional disorders in these patients are necessary.
Background: The aim of the present study was to investigate any prognostic value of pre-treatment anemia, leukocytosis and thrombocytosis in patients with advanced pretreated NSCLC. Methods: A randomized, multicenter phase II study comparing the IGF-1R modulator AXL with standard docetaxel in the treatment of previously treated stage IIIB or IV NSCLC patients was conducted in 2011-2013. Clinical and laboratory data were collected, including serum values for hemoglobin (Hgb), white blood cells (WBC) and platelets (Plt) at baseline. These hematological parameters were studied in relation to overall survival using Kaplan–Meier product-limit estimates and multivariate Cox proportional hazards regression models. Results: The median overall survival for all patients was 8.9 months. Patients with leukocytosis (WBC > 9 x 109/L) had a significantly shorter median overall survival (4.2 months) as compared with those with a WBC ≤ 9 x 109/L at baseline (12.3 months) with a corresponding of HR 2.10 (95% CI: 1.29-3.43). Patients with anemia (Hgb < 110 g/L) had a non-significant (p = 0.097) shorter median overall survival (6.1 months) as compared with their counterparts with Hgb ≥ 110 g/L at baseline (9.4 months). As for thrombocytosis (Plt > 350 x 109/L), there was no statistically significant impact on overall survival. Leukocytosis retained its prognostic significance in a multivariate model where other clinical factors such as age, sex and WHO performance status were taken into consideration (HR: 1.83, 95% CI: 1.06-3.13, p = 0.029). Conclusion: Pre-treatment leukocytosis is a strong and independent prognostic marker for shorter overall survival in previously treated stage IIIB or IV NSCLC patients receiving docetaxel or AXL1717. Combined use of pre-treatment leukocytosis assessments together with established prognostic factors such as performance status could be of help when making treatment decisions in this clinical setting.
Introduction: Gastric cancer (GC) is the fourth most common type of neoplasm and the second cause of malignancy-related death across much of the world. Complex multi-factorial processes are involved in its genesis, classified in two determinant clusters: non-genetic and genetic . Variation in CDH1 gene expression may play an important role in increasing risk of diffuse and intestinal subtypes of GC. This tumor suppressor gene, located on chromosome 16q22.1, encodes a trans membrane glycoprotein called epithelial cadherin (E-cadherin). Materials and Methods: In this historical cohort study, from June 2004 to Journey 2005 we collected 50 samples from Kurdish patients with stage II pathologically diagnosed gastric cancer that underwent surgery. Tumor tissues were paraffin-embedded along with 54 control samples from non-ulcer dyspepsia (NUD) cases undergoing upper gastrointestinal endoscopy. Three biopsies were captured by endoscopy from each individual’s gastric antrum. Result: The mean age of the patients was 59.5±2 years. Some 23 cases (53.4%) had the CC genotype, 19 AC and 1 AA. H.pylori infection was noted in 30 patients (69%). Survival rates of gastric cancer patients were 90.7% in the first year, 39.5% in the second year and 6.9% in the third year. Female patients had higher survival rates (P=0.004). Conclusion: In this study we found that frequencies of -160(C>A) CDH1 genotypes were not?? comparable in H.pylori-infected and H.pylori-uninfected subjects in both case and control groups. These findings suggest that -160 (C>A) CDH1 polymorphism is not related with H.pylori infection susceptibility. In addition we found no significant relationship between the CDH1 -160(C/A) promoter polymorphism with predisposition to gastric cancer.
Background: Metastasis is important in survival and the quality of life of female breast cancer patients. This study was run in order to investigate metastasis and its related factors in female breast cancer patients in Kerman province from 2005 to 2015. The aim of this study was to investigate the factors associated with secondary metastasis in female breast cancer patients in the largest province of Iran (Kerman). Materials and Methods: In this case-control study, medical records of women diagnosed with breast cancer between the years of 2005 to 2015 were studied. Among them, 200 breast cancer patients with secondary metastasis were randomly selected as cases and 400 patients without metastasis were selected as the control group. Backward logistic regression, chi-square test, t-test and Mann-Whitney-U test were performed for comparing the two groups in SPSS 22. Results: Disease stage at diagnosis was significantly associated with secondary metastasis (p<0.001). Female patients with stage III breast cancer at the time of diagnosis had a higher chance OR=9.11 (CI 95%=2.99-27.76) of metastasis than women with stage 0 and 1 at diagnosis. Also, patients from rural areas had a higher chance for metastasis OR=1.89 (CI 95%=1.04-3.41). Other factors such as age, tumor size, tumor grade at diagnosis, hormone receptor status of estrogen and progesterone and Her-2 showed no significant association with metastasis (p>0.05). Conclusion: Stage at diagnosis and the residential location of patients were the most important factors related to secondary metastasis. These results emphasize the importance of early diagnosis, adequate education and awareness for breast cancer screening.
Background: The objective of this study is to determine the influence of dental students’ knowledge and attitude regarding human papillomavirus infection of cervical cancer on willingness to pay for vaccination. Basic research design: A convenience sampling method was used. The minimal sample size of 136 was calculated using the Raosoft calculator with a 5 % margin of error and 95% confidence level. Participants: The study population were all final year dental students from the School of Dentistry. Methods: A self-administered questionnaire was used to measure knowledge levels and attitudes regarding human papillomavirus vaccination. Contingent valuation was conducted for willingness to pay for vaccination. Main outcome measures: The Center for Disease Control and Prevention has stated that human papillomavirus are associated with oropharynx cancer and the American Dental Association insist on expanding public awareness of the oncogenic potential of some HPV infections. Thus, as future dental practitioners, dental students should be aware of human papillomavirus and their links with cancer and the benefits of vaccination. Results: Knowledge on HPV and cervical cancer did not impact on attitudes towards vaccines. However, significant correlation existed between knowledge and willingness to pay for vaccination. Conclusions: Dental students’ knowledge on HPV and cervical cancer has no influence on their attitude towards HPV vaccines. However, their willingness to pay for HPV vaccination is influenced by their knowledge of cervical cancer and HPV vaccination.
Accumulating evidence indicates that lncRNAs may have potential as new biomarkers to predict prognosis of different human cancers. HOTAIR lncRNA, transcribed from the human HOX locus, has been suggested to regulate gene expression of important target genes and up-regulation has been noted in malignancies. The role of HOX transcript antisense RNA in acute myeloid leukemia (AML) was investigated in the present case control study. HOTAIR expression was evaluated in blood samples of twenty five de novo AML patients and fifty healthy controls using real-time quantitative reverse transcription-PCR (qRT-PCR). Our results demonstrated no significant differences in HOTAIR lncRNA expression level between AML patients and healthy individuals. The obtained data indicate that HOTAIR is not an informative and reliable biomarker for AML diagnosis, although our results should be confirmed in further studies.
Background: A longer lifespan and changing lifestyle-related and reproductive risk factors have led to an increased incidence of breast cancer in Brazil. There have been few studies about associations of specific risk factors with molecular subtypes of the disease. The aim of the present study was to identify factors that modulate the risk of triple negative breast cancer. Materials and Methods: A case-case analysis was performed. Data for 236 breast cancer patients from two reference centres in North-eastern Brazil were applied to assess the association of risk factors with triple negative breast cancer relative to the luminal A subtype. Molecular subtypes were defined by expression status of hormone receptors and amplification of HER2. Nominal logistic regression was used to estimate odds ratios and to generate a model of independent variables. Results: Smoking and body mass index were differentially associated with likelihood of triple negative breast cancer compared to the Luminal A subtype (p= 0.013; p= 0.004): Women who ever smoked some time in their lives were 4.016 (OR= 0.249; CI 95%: 0.09- 0.71) times less likely to have triple negative breast cancer. Obese and overweight patients, respectively, were 4.489 (CI 95%: 1.32- 15.28) and 1.340 (CI 95%: 0.38- 4.69) times more likely to have triple negative breast cancer. Conclusions: Case-case analysis with the Luminal A subtype as the reference group indicated that smoking and body mass index are differentially associated with risk of triple negative breast cancer.
Background: DNA ploidy analysis of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer samples by flow cytometry (FCM) has been established as an aid to prognostic assessment. Liquid based cytology (LBC) increases diagnostic specificity by using ancillary techniques that provide information beyond morphology. The present study was undertaken to assess DNA ploidy in LBC samples as an adjunct for early detection of cervical pre-cancer and cancer. Methods: DNA ploidy assessment was performed on LBC samples of 50 cases and 31 controls. Cell pellets were obtained by centrifugation and stained with Telford reagent. At least 20,000 R1 gate (G0-G1) events were acquired on a BD FACSCalibur by using a 575±10 nm filter. Results: Mean diploid G1 values were lowered significantly (p<0.01) while diploid S values were significantly elevated (p<0.01) in both high grade squamous intraepithelial lesions (HSILs) and squamous cell carcinomas (SCCs) as compared to controls. Receiver operating curve (ROC) analysis of the diploid G1 value was found to have significant diagnostic potential (AUC=0.682, Z=2.00, p=0.046) for distinction between control and low grade squamous intraepithelial lesion (LSIL) at a cut off value of ≤91.6 with a sensitivity and specificity of 50.0 and 87.1%, respectively. Conclusions: ROC analysis of diploid G1 and diploid S values allows discrimination between LSIL and HSIL with sensitivities and specificities of 65 and 100% and 70 and100%, respectively, and between LSIL and SCC cases with values of 71.4 and 100% and 64.3 and 100%, respectively.
Background: Moroccan cancer patients usually have to go through several steps before they are diagnosed. It is important to assess factors associated with diagnosis delay for lymphomas, which might have significant effects on survival. The aim of this study was to determine factors leading to late diagnosis of lymphomas. Methods: A cross-sectional study was conducted with three hematology centers in Morocco in 2008, to analyze the impact of sociodemographic and clinical factors on delay-time from symptoms to diagnosis. Results: A total of 151 patients were included in the study. Late delay was significantly associated with gender, (for men compared to women: OR=2.46; 95% CI: 1.06-5.74), to marital status (not married: OR=2.50; 95% CI: 1.06-5.92) and low socioeconomic level (OR=5.82; 95% CI: 2.23-15.17). Late medical delay was significantly associated with having three or more medical visits before diagnosis (Adjusted OR=5.67; 95% CI: 2.55-12.59). Late total delay was observed for patients with three children or less (adjusted OR=4.39; 95% CI: 1.32-14.56), those who were non-married (adjusted OR=2.49; 95% CI: 1.07-5.81), had a non Hodgkin’s lymphoma (Adjusted OR=2.08; 95% CI: 1.06-4.00) or featuring three or more medical visits before the diagnosis (Adjusted OR=2.13; 95% CI: 0.99-5.88). Conclusion: This analysis provides a basis for understanding the sources, extent, and root causes of lymphoma diagnostic delays. The findings appear crucial for system-wide interventions aimed to facilitate clinical management of patients with lymphoma and to improve prognosis and quality of life.
Background: Cancer is one of the leading causes of death throughout the world. The indicators of cancer by site are significant to identify the problem of cancer. The purpose of this retrospective study is to perform the incidence of all cancers both in males and females over the ten years in Nepal. Methods: The data collected from all the seven hospital based cancer registries of Nepal have taken for the study. This retrospective study has presented the number of cases, frequencies, and crude incidence of all cancers by sex and site. Results: A total of 55,931 cancer cases with known age were registered throughout the hospital based seven cancer registries of Nepal from 2003 to 2012. Throughout the ten years, Lung (incl. trachea and bronchus) cancer (19.08%) was the major cancer in males followed by stomach cancer (7.86%) and Pharynx cancer (5.4%). Similarly, Cervix cancer (21.9%) was the most common cancer in females followed by breast (15.48%) and Lung (incl. trachea and bronchus) cancer (10.47%) over the ten years. This retrospective study presented the distribution of the cancer site over the ten years in Nepal. Conclusion: This retrospective study showed that lung cancer is the major cancer in male while in female cervix uteri is the most common cancer ranging from 2003 to 2012.
Background: Breast cancer is the most common cancer in Myanmar women. Revealing the hormonal receptor status, human epidermal growth factor receptor 2 (HER2) and Ki-67 expression is useful for estimating patient prognosis as well as determination of treatment strategy. However, immunohistochemical features and classification of molecular subtypes in breast cancers from Myanmar remain unknown. Methods: The clinicopathological features of 91 breast cancers from Myanmar women were examined. Immunohistochemistry was performed on tissue specimens with antibodies to estrogen receptor (ER), progesterone receptor (PgR), HER2, Ki-67, cytokeratin (CK)5/6 and CK14. Immunohistochemistry-based molecular subtyping was conducted. Results: Breast cancers in Myanmar women were relatively large, high grade with frequent metastatic lymph nodes. Of the 91 patients, tumors with ER positive, PgR positive, and HER2 positive were 57.1%, 37.4%, and 28.6%, respectively. The most prevalent subtype was luminal B (HER2-) (39.6%), followed by HER2 (22.0%), triple negative (TN)-basal-like (12.1%), luminal A (11.0%), TN-null (8.8%) and luminal B (HER2+) (6.6%). The mean Ki-67 expression of 91 cases was 33.9% (33.9% ± 19.2%) and the median was 28% (range; 4%-90%). The mean Ki-67 expression of luminal A, luminal B, HER2 and TN-basal-like/ null was 7%, 30%, 40%, and 57%/43%, respectively. A higher Ki-67 expression significantly correlated with a higher grade, larger size and higher stage of malignancy. Conclusions: We, for the first time, investigated the histopathological features of breast cancers from Myanmar women. Myanmar breast cancers appeared to be aggressive in nature, as evidenced by high frequency of poor-prognosis subtypes with high level of Ki-67 expression.
Background: Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in developing countries. Training women how to carry out breast self-examination (BSE) can help them to be alert to any abnormalities in their breasts to speedily seek medical consultation. Health behavior may be influenced by level of awareness about breast cancer. Methods: A cross-sectional community- based study aimed to assess the level of knowledge about breast cancer risk factors, early warning signs, screening approaches and related predictors. Also, to determine the extent of practice of breast self- examination (BSE) among rural women, Minia in the period from February to May 2016. A total of 600 women were randomly included in the study. A questionnaire included socio-demographic characteristics and information related to their knowledge about breast cancer. Data analysis was carried out using SPSS version 19. Results: Moderate and high knowledge scores were presented by 46.9 %. Nearly 40% of participants had the knowledge that smoking increased the likelihood of cancer breast and almost 30% of them affirmed that being obese or having a positive family history of cancer breast made them vulnerable to cancer breast. It was found that 28.7% and 18.2% of them knew that aging and nulliparity increased the likelihood of breast cancer. Participants with better knowledge score were 4.8 times more likely to practice BSE. Conclusion: This study revealed poor knowledge among rural women regarding cancer breast. BSE and clinical breast examination were not well practiced. It is recommended to create awareness programs about breast cancer and regular patterns of BSE.
Background: Carboplatin is a drug that is used for treatment of many types of cancer. However, it may produce serious nephrotoxicity. Candesartan is angiotensin II receptor antagonist employed mainly for control of hypertension. Coenzyme Q10 (CoQ10) is a fat-soluble substance which was proven to have potent antioxidant and anti-inflammatory properties. Aim: Our aim was to study the effects of candesartan and/or CoQ10 on carboplatin-induced nephrotoxicity in mice. Methods: Sixty mice were divided into 6 equal groups: Control untreated; carboplatin; carboplatin + candesartan; carboplatin + CoQ10; carboplatin + carboxymethyl cellulose; and carboplatin + candesartan + CoQ10 group. Kidney weight/body weight ratio, blood urea, serum creatinine, creatinine clearance, urinary N-acetyl beta-D-glucosaminidase (NAG), gamma glutamyl transpeptidase (GGT) and the urinary albumin excretion rate (UAER) were determined. Renal tissue catalase (CAT), glutathione reductase (GR), nuclear factor (erythroid-derived 2)-like 2 (Nrf2), heme oxygenase-1 (HO-1), transforming growth factor beta-1 (TGF-β1), tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) were also determined, along with mitochondrial complex I activity. In addition, portions of the kidney were subjected to histopathological and immunohistochemical examination. Results: Candesartan and/or CoQ10 induced significant improvement of renal and mitochondrial functions with significant increase in tissue CAT, GR, Nrf2 and HO-1 content associated with significant decrease in the kidney weight/body weight ratio, tissue TGF-β1, TNF-α and IL-6 and alleviation of the histopathological and immunohistochemical changes as compared to carboplatin alone group. These effects were more significant in candesartan/CoQ10 combination group compared to either candesartan or CoQ10 alone. Conclusion: Candesartan/CoQ10 combination might represent a beneficial therapeutic modality for amelioration of carboplatin-induced nephrotoxicity.
Background: Detection of circulating DNA can be applied for the diagnosis of many malignant neoplasms, including the hepatocellular carcinoma (HCC). The molecular pathogenesis of HCC is complex, involving different genetic and epigenetic alterations, chromosomal aberrations, gene mutations and altered molecular pathways. RASSF1A is a well-established tumor suppressor gene which suffers frequent inactivation due to promoter hypermethylation of CPG islands in multiple tumors including HCC, resulting in the reduction or loss of gene expression. Objective: To examine the role of circulating RASSF1A as a non-invasive diagnostic marker for HCC. Participant and Methods: A total of 45 HCC patients with a background of HCV infection, 40 cases of HCV infection without tumours and 40 apparently healthy controls were subjected to full history taking, clinical examination, routine laboratory investigations, assessment of serum AFP and detection of circulating hypermethylated RASSF1A gene by methylation-sensitive restriction enzyme digestion and real-time PCR. Results: The level of hypermethylated RASSF1A was significantly elevated in the HCC group as compared to the HCV and control groups (p=0.001 for both). Copy number in serum was associated with increased tumor size (p value <0.001). On the other hand, no significant correlation was observed between RASSF1A and AFP (p=0.5). Using ROC curve analysis, the best cut-off for circulating serum RASSF1A to differentiate the HCC group was 8 copies/μl. Conclusion: The presence of hypermethylated RASSF1A in serum may be a useful and informative biomarker for HCC diagnosis and might be introduced as a screening method for populations at risk of HCC development.
Objective: This study was aimed to assess oral cancer awareness among a selected Sudanese population and to evaluate their knowledge and treatment seeking behavior. Methods: A questionnaire- based survey was performed on the general population who attended the oral cancer awareness campaigns carried between 2015 and 2016 in different geographic areas of the Sudan. It was focusing on general awareness of oral cancer, oral cancer risk factors, oral cancer clinical signs/symptoms and treatment seeking behavior. Data were entered by Microsoft excel 2007 and analyzed by SPSS (version 20) using chi square test with P value Result: There were 1,370 participants, 634(46.3%) were males and 736(53.7%) were females. The responses of participants revealed that 66.6% have heard about oral cancer and the media was the common source of information (75.7%). Of all participants only 45.3% mentioned that they don’t have enough knowledge on oral cancer. Some participants believe that oral cancer is treatable (66.5%) whilst 30.4% respond by I don’t know. More than 80% of the respondents were aware that smokeless tobacco (toombak) is a risk factor for oral cancer. While 60.1% were aware of alcohol as a risk factor and 66.2% were aware of smoking as a risk factor. When qui square test was done, smokers were found to be the least to seek help in comparison to non-smokers. The same result was obtained from alcohol consumers but it was different in snuff dippers, as the latter response was similar to that of the non-snuff dippers. Conclusion: This study revealed a level of around 66.6% of oral cancer awareness in different states of Sudan. Counseling sessions should be conducted when necessary with further investigations to find out the reasons behind the continued practice of high risk habits, despite knowledge.
Background: Dihydropyrimidine dehydrogenase (DPD) is a crucial enzyme in the catabolism of 5-fluorouracil (5-FU), a drug that is frequently used in cancer therapy. Patients with deficient DPD activity are at risk of developing severe 5-FU–associated toxicity. One possible cause of deficiency is genetic polymorphisms in the DPD gene, such as IVS14+1G>A. Aim: The present study was conducted to screen for the IVS14+1G>A polymorphism in cancer patients receiving 5-FU and a control group. Methods: A total of 40 cancer patients (30 colorectal cancer (CRC) and 10 breast cancer patients) were enrolled in this study. One hundred healthy controls were also tested using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). DNA sequence analysis was carried out to confirm the presence of the IVSI14+1G>A polymorphism. Results: Only one CRC patient showed heterozygous IVS14+1G>A polymorphism in the DPD gene. Conclusion: The results of this study demonstrated a very low frequency of the IVS14+1G>A polymorphism among Jordanian patients with colorectal and breast cancer.
Acute myeloid leukemia (AML), is a clonal disorder caused by acquired somatic mutations and chromosomal rearrangements. According to some evidence, progression of hematolymphoid malignancies depends on the induction of new blood vessel formation under the influence of acute leukemia. Various factors are produced by cancer cells under hypoxic conditions to increase vascular formation. Among these, vascular endothelial growth factor (VEGF) plays a crucial role. Cytotoxicity and anticancer effects of arsenic trioxide (ATO) have been reported in many cancers. Sorafenib, known as an angiogenic inhibitor, decreases leukemic cell survival. The aim of this study was to indicate combination effects of ATO and sorafenib in two AML cell lines, KG-1 and U937. Effective doses was determined by MTT assay for both single and combination treatments. Percentages of apoptotic cells were evaluated by Annexin V FITC staining and mRNA levels of VEGF isoforms and receptor expression were investigated by Real-Time PCR. Our data show that sorafenib (5μM and 7μM in KG-1 and U937 cell lines respectively), ATO (1.618μM and 1μM in KG-1 and U937 cell lines respectively), and also their combination significantly increased the percentage of apoptotic cells. In addition the mRNA level of VEGF isoforms was downregulated in the U937 cell line while upregulated in KG-1 cells. Taken together, our results suggest that the VEGF autocrine loop may have an influence on AML development and progression and could be consider as a therapeutic target. The combination of sorafenib as a VEGF inhibitor with ATO synergistically inhibits cell proliferation and promotes apoptosis.
Background: In Korea, the national cancer database was constructed after the initiation of the national cancer registration project in 1980, and the annual national cancer registration report has been published every year since 2005. Consequently, data management must begin even at the stage of data collection in order to ensure quality. Objectives: To determine the suitability of cancer registries’ inquiry tools through the inquiry analysis of the Korea Central Cancer Registry (KCCR), and identify the needs to improve the quality of cancer registration. Methods: Results of 721 inquiries to the KCCR from 2000 to 2014 were analyzed by inquiry year, question type, and medical institution characteristics. Using Stata version 14.1, descriptive analysis was performed to identify general participant characteristics, and chi-square analysis was applied to investigate significant differences in distribution characteristics by factors affecting the quality of cancer registration data. Results: The number of inquiries increased in 2005–2009. During this period, there were various changes, including the addition of cancer registration items such as brain tumors and guideline updates. Of the inquirers, 65.3% worked at hospitals in metropolitan cities and 60.89% of hospitals had 601–1000 beds. Tertiary hospitals had the highest number of inquiries (64.91%), and the highest number of questions by type were 353 (48.96%) for histological codes, 92 (12.76%) for primary sites, and 76 (10.54%) for reportable. Conclusions: A cancer registration inquiry system is an effective method when not confident about codes during cancer registration, or when confronting cancer cases in which previous clinical knowledge or information on the cancer registration guidelines are insufficient.
Background: Effective treatments for cholangiocarcinoma (CCA) are still lacking. There are promising results of checkpoint inhibitor programmed cell death ligand-1 (PD-L1) activities in early phase trials. This study aimed to investigate the expression of PD-L1 and its relation to possible treatments for CCA. Methods: Formalin-fixed paraffin-embedded tumor samples from 46 patients with cholangiocarcinoma were retrieved. PD-L1 expression was evaluated by immunohistochemistry using anti-PD-L1 antibody, clone 5H1. A PD-L1 positive response on tumor cells was defined as >1% of tumor cell membranes stained. The association between PD-L1, clinico-pathological characteristics was analyzed using Fisher’s exact test, and survival analysis was done with the Cox regression model. Results: Out of 46 samples, 32 (70%) had positive PD-L1 expression in tumor cell membranes. The median level of PD-L1 expression was 1.75% (0-34.7). PD-L1 expression was significantly associated with stage IV disease (OR 3.98, p=0.046) and a high neutrophil/lymphocyte ratio (OR 5.36, p=0.018). PD-L1 positivity was associated with worse overall survival compared with those with a PD-L1 negative tumor but did not reach a level of significance (7.2 vs. 7.9 months, p=0.32). Conclusion: PD-L1 is widely expressed in CCA but was not predictive for overall survival. PD-L1 positivity was (7.2 and 7.9 months, p=0.32). Significantly associated with stage IV disease and a high neutrophil/lymphocyte ratio.
Epstein-Bar virus (EBV) is considered to be intimately associated with development of nasopharyngeal carcinoma (NPC), the most common and high incidence cancer of the head and neck in Asian countries, especially in Vietnam. In this study, we validated associations between highly conserved segments of the EBV genome, including EBNA-1, EBNA-2, LMP-1, LMP-2 and nasopharyngeal cancer, with the aim of applications with non-invasive brush samples for early diagnosis and as a prognostic biomarker. The polymerase chain reaction (PCR) was performed to assess the presence of EBNA-1, EBNA-2, LMP-1, LMP-2 in nasopharyngeal brush samples from Vietnamese NPC patients and non-cancer controls. Positive rates for EBNA-1, EBNA-2, LMP-1, LMP-2 were 46.3%, 49.5% and 45.3%, and 47.4%, respectively, in cancer cases, much higher than the low frequencies found in non-cancer samples. Notably, at least one of the four (PI ≥ 0.25) was found in 57. 9%. Significance was reached when computing the odds ratio (OR) and relative risk (RR). Our detection of candidate genes. in nasopharyngeal brush samples collected from Vietnamese patients reduces the need for invasive biopsies and fulfills the characteristics of a non-invasive, specific screening method suitable for routine, NPC risk assessment for EBV-infected populations. Notably, this procedure may be useful for confirmatory screening with large oral brush swabs.
Methods: Colonoscopy is a technique for examine colon cancer, polyps. In endoscopy, video capsule is universally used mechanism for finding gastrointestinal stages. But both the mechanisms are used to find the colon cancer or colorectal polyp. The Automatic Polyp Detection sub-challenge conducted as part of the Endoscopic Vision Challenge (http://endovis.grand-challenge.org). Method: Colonoscopy may be primary way of improve the ability of colon cancer detection especially flat lesions. Which otherwise may be difficult to detect. Recently, automatic polyp detection algorithms have been proposed with various degrees of success. Though polyp detection in colonoscopy and other traditional endoscopy procedure based images is becoming a mature field, due to its unique imaging characteristics, detecting polyps automatically in colonoscopy is a hard problem. So the proposed video capsule cam supports to diagnose the polyps accurate and easy to identify its pattern. Existing methodology mainly concentrated on high accuracy and less time consumption and it uses many different types of data mining techniques. To analyse these high resolution video scale image we have to take segmentation of image in pixel level binary pattern with the help of a mid-pass filter and relative gray level of neighbours. This work consists of three major steps to improve the accuracy of video capsule endoscopy such as missing data imputation, high dimensionality reduction or feature selection and classification. The above steps are performed using a dataset called endoscopy polyp disease dataset with 500 patients. Our binary classification algorithm relieves human analyses using the video frames. SVM has given major contribution to process the dataset. Results: In this paper the key aspect of proposed results provide segmentation, binary pattern approach with Genetic Fuzzy based Improved Kernel Support Vector machine (GF-IKSVM) classifier. The segmented images all are mostly round shape. The result is refined via smooth filtering, computer vision methods and thresholding steps. Conclusion: Our experimental result produces 94.4% accuracy in that the proposed fuzzy system and genetic Fuzzy, which is higher than the methods, used in the literature. The GF-IKSVM classifier is well-organized and provides good accuracy results for patched VCE polyp disease diagnosis.
Background: One of the most important aetiologies of cervical cancer is Human Papillomavirus (HPV) infection. While vaccination is an effective way in preventing high risk HPV infection, HPV vaccine uptake rate in Hong Kong has been low. Considering the proven effectiveness of HPV vaccination and the low vaccination uptake rate in Hong Kong, this study was conducted to compare the knowledge, attitude and practice towards HPV vaccination for cervical cancer prevention between medical and non-medical students in the University of Hong Kong. Methods: A total of 420 full time undergraduates from the University of Hong Kong were recruited and evaluated. Questionnaires covering demographics, sexual risk profile, knowledge, attitude and practice towards HPV vaccination were applied, with the Chi-square test analysis. Results: Medical students had more comprehensive knowledge than their non-medical counterparts on HPV vaccination, including the carcinogenicity of HPV (P<0.001), available vaccines on the market (P<0.001) and the outcome of vaccination (P<0.001). In particular, senior medical students (Year 3 or above) were shown to be more knowledgeable than their juniors (below Year 3) with statistical significance (P<0.001). Positive attitudes toward HPV vaccination were observed more frequently among medical students when compared to non-medical students, especially regarding the usefulness of HPV vaccination in males (P<0.001). However, there was no significant difference in the vaccination rate between medical and non-medical students (P=0.671), suggesting an importance for factors other than knowledge, such as cost of vaccination and anxiety of side effects. Conclusions: Medical students in Hong Kong, especially those in senior years, had more comprehensive knowledge and positive attitudes towards HPV vaccination than non-medical students. Yet, there was no significant difference in the practice of HPV vaccination between medical and non-medical students. In addition to medical education, other factors such as health beliefs, risk perception and financial considerations, may have a role in determining HPV vaccination for cervical cancer prevention.
Backgrounds: Recently Hong Kong Liver Cancer (HKLC) staging system has been proposed for staging of hepatocellular carcinoma (HCC), and has been shown to provide better prognostic ability than the Barcelona Clinic Liver Cancer (BCLC) system. However, the HKLC system lacks external validation, and its applicability remains uncertain. The present study was aimed to evaluate the prognostic performance of HKLC in HCC patients treated with curative intent. Methods: Medical records of HCC patients treated with either resection or radiofrequency ablation (RFA) from 2011 to 2016 were retrospectively reviewed. The overall survival and the prognostic ability of the HKLC and BCLC system were evaluated. Results: 79 HCC patients were included, of which 64.56% had Child A cirrhosis. Chronic viral hepatitis B infection was the leading cause of HCC, followed by chronic viral hepatitis C infection, alcohol and alcohol with HBV or HCV infection. According to the BCLC system, 82.28% were in stage 0-A, and according to the HKLC system, 93.67% were in stage I-IIb. RFA and liver resection were the primary treatment in 56.96% and 43.04%, respectively. The 5-year survival rate of patients in HKLC stage I, IIa and IIb were 81.64%, 61.66%, and 54.42%, respectively (P<0.001). Whereas, the 5-year survival rate of patients in BCLC stage 0, A and B were 60.00%, 75.90%, and 26.65%, respectively (P=0.053). The AUROC curve of the HKLC and BCLC for the entire cohort was 0.77 and 0.64, respectively (P=0.15). Subgroup analysis showed the AUROC curve of the HKLC and BCLC for the patients with viral-associated HCC was 0.79 and 0.68, respectively (P=0.02). Conclusions: Applying the HKLC staging system provides a good discriminative ability for survival prediction in HCC patients treated with curative intent. Comparing with the BCLC system, the HKLC system tends to yield better prognostic accuracy, particularly in viral-associated HCC.
Backgrounds: Cisplatin (CDDP) is a choice of anti-cancer drug for cancer chemotherapy with serious side effects such as nephrotoxicity. It seems that age is an important factor influencing the side effects of CDDP. This study was designed to determine the role of age and gender simultaneously in CDDP induced renal toxicity. Methods: 40 Wistar male and female rats were assigned as 6 groups in 3 different age categories (10, 16, and 20 weeks old). The single dose of CDDP (7.5 mg/kg, ip) was administrated, and a week later measurements were performed. Results: Body weight changes in male (not in female) animals aged 16 and 20 weeks were more than 10 weeks old animals (P<0.05). In male rats, the serum levels of creatinine (Cr) and blood urea nitrogen (BUN), and Cr-clearance in aged 10 weeks, normalized kidney weight (KW) in aged 20 weeks, and serum nitrite, aspartate aminotransferase (AST) and malondialdehyde (MDA) levels and kidney tissue damage score (KTDS) in rats aged 16 weeks were significantly altered (P<0.05). Gender difference in serum level of Cr, BUN and nitrite, and Cr-clearance were observed in animals aged10 weeks (P<0.05). Conclusion: The side effects of CDDP are gender depended, and may be different at various ages.
Despite impressive advances in the therapeutic approches, the long-term survival rate of acute myeloid leukemia (AML) is considered to be significantly low as a result of resistance to the treatment and desease relapse. Among multitude oncogenic proteins invovlved in aquisition of chemo-resistance phenotype, osteopontin (OPN) recently attracted tremendous attentions. In spite of the well-defined association between OPN expression and cure rate in solid tumors, there is a scarcity of analysis on the role of this protein in AML. Based on the critical role of OPN in cell survival, it seems reasonable to hypothesize that the high expression of OPN isoforms may participate in disrupting the regulation of apoptosis in AML cells and it s relapse. To investigate the association between induction of apoptosis and OPN isoform expression, two distinct AML cell lines (KG-1 as a leukemic stem cell model and U937) were treated with chemotherapy drugs and the cell viability and apoptosis were evaluated by MTT and annexin/PI assay. After determination suitable drugs doses, the mRNA expression level of OPN and OPN-related genes were investigated. Our results demonstrated for the first time that the acquired up-regulation of OPN-b and c isoforms might prevent conventional chemotherapy regimen-induced apoptosis in AML cells. Moreover, the resulting data revealed that up-pregulation of OPN-b and c in AML cells was concurrently associated with the up-regulation of AKT, VEGF, CXCR4, STAT3 and IL-6 expression. To sum up, this study suggest that OPN-b and c isoforms could be considered as a unique beneficial molecular biomarker which is associated with chemoresistance. Hence, this isoforms are considerable as a potential moleculare candidate for detection of minimal residual disease (MRD) and determination of remission in AML patients. Furthure evaluation with quantative Real tim PCR on patient sample to comfim this finding seems to be be nessesary.
Background: Tumor budding has recently been reported as an independent adverse prognostic factor for colorectal adenocarcinomas and other types of carcinoma in the digestive tract. This study aimed to evaluate the prognostic value of tumor budding in patients with early-stage cervical adenocarcinomas and any associations with other clinical and pathological features. Methods: Histological slides of patients with early-stage (IB-IIA) usual-type endocervical adenocarcinoma who underwent radical hysterectomy and pelvic lymph node dissection, without preoperative chemotherapy, between January 2006 and December 2012 were reviewed. Tumor budding was evaluated in routinely-stained sections and defined as detached single cells or clusters of fewer than 5 cells in a tumor invasive front and was stratified based on the number of bud counts in 10-high-power fields as low (follow-up outcomes were assessed. Results: Of 129 patients, a high tumor bud count was observed in 15 (11.6%), positively associated with histologic grade 3 (p<0.001), invasive pattern C (Silva System) (p=0.004), lymph node metastasis (p=0.008), stage IB2-IIA (p=0.016), and tumor size >2 cm (p=0.036). Kaplan-Meyer analysis showed a significant decrease in both disease-free survival and cancer-specific survival for patients with a high tumor bud count (p=0.027 and 0.031, respectively). On multivariate analysis, histologic grade 3 was the only independent predictor for decreased disease-free survival (p=0.004) and cancer-specific survival (p=0.003). Conclusions: A high tumor budding count based on assessment of routinely-stained sections was found to be associated with decreased disease-free and cancer-specific survival in patients with early-stage cervical adenocarcinomas. However, it was not found to be an independent prognostic predictor in this study.
Background: Polymorphisms in glutathione S-transferase (GST) genes may contribute to breast cancer risk. The aim of this study was to investigate any association of two common GSTO1 A140D and GSTO2 N142D gene polymorphisms with breast cancer risk in an Iranian population followed by a protein structure analysis. Materials and Methods: In the case-control study, 303 subjects comprising 153 women with breast cancer and 150 healthy controls were included. Genotypes of GSTO1 A140D and GSTO2 N142D polymorphisms were assessed by PCR-RFLP. Bioinformatics tools were employed to evaluate the damaging effects of A140D and N142D on the structures of GSTO1 and GSTO2 proteins. Results: Our genetic association study revealed that the GSTO1 A140D polymorphism was associated with breast cancer in a dominant model (OR= 1.75, 95%CI= 1.07-2.86, p= 0.026). Also, the A allele was significantly associated with breast cancer risk (OR= 1.69, 95%CI= 1.09-2.60, p= 0.018). With regard to the N142D polymorphism, there were significant associations between the GG genotype (OR= 2.20, 95%CI= 1.14-4.27, p= 0.019) and the G allele (OR= 1.47, 95%CI= 1.06-2.05, p= 0.021) and risk of breast cancer. Structural analysis revealed that A140D and N142D polymorphisms cause changes in both primary and secondary structures of GSTO1 and GSTO2, respectively. Conclusion: Based on our results, GSTO1 A140D and GSTO2 N142D polymorphisms could be genetic risk factors for breast cancer, but further studies with larger sample sizes focusing on different ethnicities are needed to obtain more comprehensive results.