Middle East Journal of Cancer
Volume:12 Issue: 2, Apr 2021

We conducted the present meta-analysis to delineate the prognostic significance of epithelial to mesenchymal transition- transcription factors in carcinoma patients.

For the determination of the pooled hazard ratio (HR) values based on the fixed- effects model, in this retrospective study, we employed comprehensive meta-analysis software.

This retrospective analysis identified the expression patterns of 6645 patients in 36 studies. Expression of TWIST1 correlated with the least prognosis rate (HR= 2.129, 95% CI= 1.373 - 3.302) as compared to SNAIL1 (HR= 1.804, 95% CI= 1.151 - 2.827), SLUG (HR= 1.724, 95% CI= 0.992 - 2.997) and ZEB1 (HR= 1.590, 95% CI= 1.358 - 1.861).

These findings suggested the implication of TWIST1 as an effective biomarker for an early tumor diagnosis and therapy for metastasis.

Evaluation of cancer cervix prognosis is highly needed for novel targeted therapy and improved outcomes. Nucleolar and spindle associated protein 1 (NUSAP1) is a novel biomarker that has roles in spindle formation and mitotic progression. Maternal embryonic leucine zipper kinase (MELK) is involved in cell cycle control and carcinogenesis. The L1 cell adhesion molecule (L1-CAM) plays an essential role in cell migration. This study aimed to investigate NUSAP1, MELK, and L1CAM immunohistochemical expression in cancer cervix tissues and detect their prognostic roles. In this prospective cohort study, we evaluated NUSAP1, MELK, and L1CAM expressions of sections from 62 cervical carcinoma cases using immunohistochemistry. NUSAP1, MELK, and L1CAM expression correlated with tumor high grade, advanced FIGO stage, poor survival rates, and higher recurrence rate after successful therapy (p <0.001). Expression of NUSAP1, MELK, and L1CAM in cancer cervix was associated with poor prognosis.

Human interleukin-24 (IL-24) is a cytokine belonging to the interleukin-10 (IL-10) family of cytokines, also known as melanoma differentiation-associated gene 7, due to its discovery as a tumor-suppressing protein. A tumor-suppressing protein, IL-24 is produced by a variety of cells, including cancerous and non-cancerous healthy cells. The aim of the present study was to evaluate serum IL-24 concentrations in different cancers and compare them with non-cancerous inflammations.

In this case-control study, we divided a total of 200 subjects into five groups of 40 control subjects without cancer and without Helicobacter Pylori (H. Pylori) infection, patients with gastric cancer and H. Pylori infection, patients with H. Pylori infection without cancer, and patients with breast cancer and without H. Pylori infection. We measured the serum IL-24 level using specific enzyme-linked immunosorbent assay (ELISA) kit; we analysed the data with SPSS software.

The level of IL-24 was significantly higher in breast cancer group (160.65±55pg/mL) (mean± SD) followed by gastric cancer with (76.2±16.27 pg/mL) (mean±SD) and without (72.5±17.84 pg/mL) (mean± SD) H. Pylori infection groups. The level of IL-24 in H. Pylori infected patients and controls were (32.78±12.96 pg/mL) (mean±SD) and (27.4±8.5 pg/mL (mean±SD)), respectively.

The mechanisms by which IL-24 is produced may be different between immune and cancer cells and serum IL-24 is more likely generated by immune cells than tumor cells. In breast cancer patients, estrogen or other sex hormones may provoke IL-24 production.

In recent years, the role of micro-RNAs in the cancer pathophysiology has attracted a great deal of scientific attention. MiRNAs regulate a variety of cellular functions, such as apoptosis, differentiation and migration by targeting oncogenic or tumor suppressor genes. We conducted the current study to assess the expression of miR-107, Krüppel-like factor 4 (KLF4) and death-associated protein kinase (DAPK1) genes in malignant and normal colon tissues and also colorectal cancer (CRC) model cells exposed to oxaliplatin and 5-FU chemotherapy agents.
In this case-control study, the tissue samples from CRC patients were collected during colonoscopy process in 2013 -2016 at Imam Reza hospital. Subsequently, the expression levels of miR-107, KLF4, and DAPK1 were detected with quantitative Real-Time PCR. Furthermore, in the in vitro phase of this study, we investigated the changes in the expression level of miR-107, KLF4 and DAPK1 transcripts after oxaliplatin and 5-FU treatment.
Unlike miR-107, the expression levels of KLF4 and DAPK1 genes decreased in the tumor samples compared to those in the marginal specimens. In addition, both oxaliplatin and 5-FU significantly increased the expression level of miR-107. There were significant correlations between the expression levels of miR-107, KLF4, and DAPK1genes and clinicopathological features, for instance lymph node metastasis and cell differentiation.
The current study suggested a tumor suppressor role for KLF4 and DAPK1 in CRC. The altered expression of miR-107, KLF-4, and DAPK1 genes in CRC tumors and healthy tissues could be utilized for CRC diagnosis and prognosis. Furthermore, the studied genes could be considered as potential therapeutic targets in CRC.

Paclitaxel is widely used as an adjuvant therapy in the treatment of breast cancer, yet its effectiveness decreases due to resistance problems. We conducted the present study to identify the potential paclitaxel resistance biomarkers and therapeutic targets in breast cancer employing bioinformatics approach.
The present systematic bioinformatic study included a microarray data obtained from Gene Expression Omnibus database, which are respectively cell lines and tumor data from patients. We carried out Gene ontology, Kyoto Encyclopedia Genes, and Genome pathway enrichment analysis with The Database for Annotation, Visualization and Integrated. The protein-protein interaction network was analyzed with STRING-DB and visualized with Cytoscape. We confirmed of the reliability of the hub genes in paclitaxel sensitive and resistant breast cancer cells utilizing ONCOMINE. The prognostic value of the hub genes was evaluated using Kaplan-Meier survival curves.
Gene ontology analysis revealed that differential expressed genes take part in cell adhesion, located in cellular component and paly a negative role in the regulation of reactive oxygen species. The protein-protein interaction network analysis, confirmed with ONCOMINE and Kaplan Meier survival, revealed three hub genes (TIMP1, HK2, and IGFBP7). Kyoto Encyclopedia Genes and Genome pathway enrichment analysis revealed the regulation of HIF-1 signaling pathway. Kaplan Meier survival plot showed that patients with high mRNA of TIMP1, HK2, and IGFBP7 had significantly worse overall survival than those in the low expression level group.
TIMP1, HK2, and IGFBP7 are not only biomarkers, but also potential targets to circumvent paclitaxel resistance in breast cancer.

Amygdalin is a glycoside ingredient of rosacea plants that exerts an antitumor effect by blocking the growth of the tumor cells. Therefore, we aimed to use the Armeniacae semen, a member of the Rosacea family, which contains a large amount of the amygdalin, to evaluate its antiproliferative effect on MCF-7, MDA-MB-231, and T47D breast cancer cell lines.

In this experimental study, we prepared the aqueous, ethyl acetate, and hydro-alcoholic extracts of the Armeniacae semen. The MCF-7, MDA-MB-231, and T47D cell lines were treated with different doses of the extracts for 12, 24, 36, and 48 hours; cell viability was investigated with MTT test and cell apoptosis was detected by use of double staining fluorescent. Cell cycle progression was analyzed using a BD Cycle TEST PLUS DNA Kit. We also assessed Bcl2, Bax, and caspase-3 mRNA expression.

The best IC50s belonged to hydro-alcoholic extract of the Armeniacae semen in all three cell lines for the 48-hour treatment. We observed a significant increase in Bax and caspase-3 mRNA expression and a noticeable reduction in Bcl2 mRNA compared with the controls. Application of amygdalin to MCF-7, MDA-MB-231, and T47D cell lines increased the number of G0/G1 cells and reduced the number of cells at G2/M phasecompared to the controls.

This study showed that the hydro-alcoholic extract of Prunus armeniaca had antitumor effects on breast cancer cell lines as it inhibited the cell cycle at G0/G1 phase and apoptosis induction in the MCF-7, MDA-MB-231, and T47D cell lines.

Given the prognostic importance of cytogenetic aberrations in plasma cell neoplasms, the present retrospective study was conducted to analyze cytogenetic abnormalities in plasma cell myeloma cases in a single center in the Middle East.
In this retrospective cross-sectional study, we selected 42 patients referred to the molecular and cytogenetic department from 2013 to 2016 for initial assessment by immunohistochemical, flow cytometric, and cytogenetic studies. Chromosomal analysis was performed after a 72-hour unsynchronized culture and Giemsa banding; the result was reported according to ISCN 2016.
32.5% of the patients showed an abnormal karyotype, of whom 53.8% were hyperdiploid and the rest were assigned to the non-hyperdiploid group. The gain of 1q and monosomy 13/ deletion 13q were the most common structural abnormalities accounting for 38.4% and 30.7%, respectively. t(11;14) was the only detected 14q32 rearrangement observed in 15.4% of the cases. The mean survival time in normal, hyperdiploid, and non-hyperdiploid groups was 29.5±1.7, 16.6±2.9 and 6.1±2.1 months, respectively.
Cytogenetic abnormalities of plasma cell myeloma in this center were relatively similar to previous reports in the literature; moreover, hyperdiploidy was the most common cytogenetic aberration. As no cryptic aberration could be identified, we recommend the use of more precise techniques such as FISH in addition to conventional G banding to detect cryptic aberrations. Survival of the non-hyperdiploid group was the worst.

Breast cancer is a common disease among women around the world. In Iran, it is the most prevalent cancer diagnosed in women. The objective of this study was to assess the cure rate of patients and the associated risk factors.

A retrospective cohort study was conducted on 446 patients with breast cancer admitted to the Shahid Ramezanzadeh Radiotherapy Center. Using R 3.2.2 software, the Kaplan-Meier curve, log-rank test, and cure joint frailty model were utilized in the analysis.

Of the 446 patients, 17.3% died, 20% experienced relapse, and 62.7% were censored. The 1-5-7-year disease-free survival rates were 95.3%, 73.4%, and 69.3%, respectively. In the cure model, stage, involved lymph node, and surgery were statistically significant. In the recurrence model, stage, involved lymph node, lymphovascular invasion, and hormone therapy were statistically significant. In the death model, stage, lymphovascular invasion, and involved lymph node had a statistically significant effect on the survival time.

The cure joint frailty model is a good model when there is a high fraction of patients who do not experience any recurrence or death. In addition, this model allows for the separate estimation of explanatory variable effect on recurrence, death, and cure. The findings of our study can be conducive to preventing the unfavorable effects of breast cancer and increasing the survival of patients.

Women with breast cancer undergo painful and distressing treatment procedures. Hypnotherapy and cognitive-behavioral therapy (CBT) could be considered as an effective therapy. In this clinical trial, 50 women aged 25 to 65 were assigned to three groups (CBT, hypnosis, and control groups). Eight one-hour treatment sessions were run for each of the hypnosis and CBT groups. We utilized The European Organization for Research and Treatment of Breast Cancer-specific Quality of Life (QoL), The European Organization for Research and Treatment of Cancer QoL questionnaires, and The Hospital Anxiety and Depression Scale for the evaluation of the QoL, anxiety, and depression at the beginning and end of the treatment, as well as six months post-treatment. The improvements in the stress, depression, and qoL amongst the three groups were significant, although these improvements in CBT group were more than those in hypnosis group, and in hypnosis and CBT groups were not significant. Physical functioning, body image, sexual functioning, arm symptoms, breast symptoms, future perspective, pain, digestive problems, and functional scale significantly changed in CBT and hypnosis groups (p <0.05). Memory and social functioning; however, did not change in the groups and across the three groups. In addition, sleeping disorders and emotional malfunctioning were recovered only in the hypnosis group, which was statistically significant. We found hypnosis exclusively effective on reducing certain problems of breast cancer patients, such as sleeping disorders and emotional malfunctioning; therefore, it is suggested as an efficient solution for these patients’ problems.

Positive peritoneal cytology is a critical factor in prognosis. Peritoneal lavage is associated with long-term survival in patients with gastric cancer. Diagnostic peritoneal lavage (DPL) is a method for diagnosing visceral injury in trauma patients. This study aimed to investigate the usage of DPL in staging the work-up of patients with gastric cancer.
In this prospective study, we enrolled gastric cancer patients referring to Cancer Institute; they underwent DPL and washing specimen was sent for cytology review. After DPL, all patients underwent staging laparoscopy (SL) via the same abdominal incision.
DPL and SL were successful in all patients. There were six (11%) cases of peritoneal seeding discovered in SL; all of these patients had positive peritoneal cytology on DPL. Also, four patients showed positive cytology in the absence of positive SL. Thus, sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of DPL were 100 % (95% CI: 54.1-100), 91.6 % (95%: 79.2-97.5), 100 % (95%CI: 85.3-100), and 60 % (95%CI: 37-79.3). The accuracy of DPL in determining the peritoneal dissemination of gastric cancer was 92.31% (95% CI: 81.5-97.9).
DPL had an excellent ability to find peritoneal dissemination in a gastric cancer patient, which is of great value in the setting of low-resource countries.

The variety of neoadjuvant treatments concerning rectal cancer has led to acute complications. The present study aimed to evaluate and compare the acute complications of short-course (SC) and long-course (LC) radiotherapy. We studied 100 patients suffering from rectal cancer, who referred to Nemazee Hospital before their surgery, in this cross-sectional study. The patients were divided into two categories: SC (25 grays radiotherapy at 5 fractions in 5 days) and LC (chemoradiotherapy with a dose of 45-50.4 grays in 25- 28 fraction in 5-6 weeks with concurrent Capecitabine (825 mg / m2) twice daily and five days a week). Subsequently, we evaluated them for acute complications in the SC group 10-14 days after the end of the treatment and in the LC group at intervals of the treatment, the end of it and 2 weeks afterwards. In the LC group compared to the SC group, the percentage of patients with grade 1 diarrhea, grade 2 colitis and grade 1 cystitis at the end of the treatment was statistically different (p <0.001, P=0.046, P=0.036 ). In addition, the total number of the patients with grade 1 and 2 dermatitis was higher in the LC group compared with that in the SC group (P=0.046). We observed no significant differences between the two groups concerning the severe acute complications (P>0.05). This study implied that there were no significant differences regarding severe acute complication between the two groups.

Several studies have reported the anticancer effect of phycocyanin C, a natural extract isolated from the algae Arthrospira platensis. However, its therapeutic effects on the growth of breast cancer and its metastasis have not been determined yet.
In this case-control study, we employed phycocyanin C for the treatment of 4T1 breast tumor as an applicable experimental animal model for human mammary cancer and metastasis. BALB/c mice were injected subcutaneously (s.c) into the 4th abdominal mammary fat pad with 1×106 4T1 cells. We randomly divided the mice into two groups; one group of mice were injected with PBS as the control, and the other group was intraperitoneally injected with phycocyanin C (80 mg/kg daily for 20 days). Tumor growth and metastasis were assessed in both groups.
Phycocyanin C significantly inhibited 4T1 breast tumors growth (P<0.05). The mean tumors volumes at the control group were 2.73 times higher than those of the treatment group. In addition, phycocyanin C treatment could significantly inhibit the formation of metastasis colonies at vital organs like spleen, liver, and lung. Moreover, the survival rate of the tumor-bearing mice increased after about 22 days by phycocyanin C treatment in comparison with the control.
This is the first report demonstrating the anticancer effects of phycocyanin C on 4T1 breast tumor in vivo. Overall, our findings provided convincing evidence for the application of phycocyanin C as an anticancer therapeutic agent.

There are believed to be several risk factors affecting the prognosis of breast cancer through their effect on the growth rate of tumour. In the present study, we investigated estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and tumor protein P53 (TP53) as well-known biomarkers, particularly in breast cancer prognosis, associated with age.

In a case-control study, 406 breast cancer patients were considered retrospectively. In order to extract the clinical and pathologic data, we employed the patients’ records. The extracted information was compared between two groups: for patients under 40 (group I) and above 40 years of age (group II). Herein, the researchers performed statistical analysis using SPSS Ver16.

The most prevalent type of cancer in both groups was found to be invasive ductal carcinoma. The major method of treatment was modified radical mastectomy. According to our observations, grade 3 breast cancer was more common in group I. Lymph node involvement significantly increased in group I, while oestrogen and progesterone receptor expressions were less in this group. HER2, TP53, and Ki-67 oncogenes were overexpressed in group I compared with group II.

Expression of HER2, TP53, and Ki-67 biomarkers and a reduction in the number of hormonal receptors in younger patients (<40YO) indicated that breast cancer might be more invasive in younger women with breast cancer and therefore, they might have poorer prognosis and less favourable outcomes.

Previous studies have demonstrated that clinicopathological features of colorectal cancer (CRC) could be diverse in different CRC patients groups. The present study aimed to analyze the association between clinicopathological characteristics and the risk factors in different CRC patients groups, which is categorized by sex, family history, age, and also primary tumor site in the Iranian CRC patients.
In this cross-sectional study, we included 304 patients with CRC. The data of clinicopathological features were collected from documented pathology reports. Subsequently, we carried out multiple analyses to discover the association among these elements.
Our analysis demonstrated that there was a significant difference between men and women regarding the mean age at diagnosis, tumor locations, mean size of tumors, positive family history, smoking status, and physical activity (P <0.05). Out of all the patients, 22.4% had a positive family history of cancer. The patients with a positive family history just have lower mean age, body mass index (BMI), and higher physical activity compared with patients without family history of cancer (P <0.001). 31.9% of the patients were in the age group of below 55 and 68.1% were in the age group of 55. The majority of our patients in 0.05).
Gaining information about the association between clinicopathological characteristics and the risk factors in CRC could provide a better understanding of disease pathogenesis and consequently, improve the management of diseases.

Breast cancer (BC) is the most prevalent cancer in women and the second most common cancer in the world. Two million new cases were reported in 2018. The aim of this study was to investigate the changing trend of BC in the people of Ardabil during 2003-2016.

In this cross-sectional descriptive study, we analyzed BC incidence rates using population-based cancer registries stratified by city, age group, gender, and disease grading. We analyzed the collected data by statistical methods in SPSS version 21.

The mean age of patients was 48.4±13.1. Of all patients, 98.5% were female, and most were aged 40-60 (56%). The most of BC cases was registered in year 2011 with the most incidence rate about 10.41 per 100000 and the most of cases with 71.5% was registered in Ardabil city. The incidence rate of BC reached from 4.13 per 100000 in 2003 to 6.93 in 2016. The annual percentage change during the study years was 4.1%.

Results showed that the incidence rate of BC during study years had an increasing trend in Ardabil’s people and reached from 4.13 per 100000 in year 2003 to 6.93 per 100000 in year 6.93 with Annual percentage change about 4.1%. The trend of BC incidence increased during 2003-2011 and then, decreased during 2011-2016.

Providing palliative care (PC) is increasing by the increase in the number of people with life-threatening diseases and determined the benefits of these services in the community. Access to palliative care is a patient’s rights and ethical responsibility. Thus it is necessary to integrate into all level of the health system, including the primary health care. This study was conducted to assess the requirements for the integration of PC into the primary health care.

It was a document analysis, carried out through conventional content analysis and 10 national documents on PC, released by governmental organizations from 2010. The 4-step Scott method was used for the data validity and the coding process was done utilizing MAXQDA 10 software.

Base on the data analysis, we identified the “requirements of the integration of PC into the primary health care”, was of 4 main categories and 12 sub-categories. The categories include “principles and basics”, “legislation and policy-making”, “the establishment of PC system” and “the need for civil support”, which were extracted by reviewing the documents.

PC is believed to be in its early stages in the Iranian health system. Therefore, universal access to these services requires their provision at the community level. Thus, it is recommended that the principles and basics of PC in the country be explained and then, the necessary infrastructures of this integration be provided with the cooperation of governmental organizations, NGOs, and charities, through proper policy making.

The aim of this study was to estimate the overall survival (OS) and relapse free survival (RFS) of the non-epithelial ovarian tumors (NEOTs) of ovarian germ cell tumors (OGCT) and ovarian sex cord tumors (OSCT) in Iranian women; we also evaluated the relative prognostic factors.

In this retrospective study, we screened the documents of all the women diagnosed with OGCTs and OSCTs from 2012 to 2019. We further assessed the OS, RFS, and different prognostic factors.

A statistically significant association existed between RFS and stage of the disease at diagnosis in OSCTs group by univariate analysis and multivariate analysis (HR: 0.25 (95% CI (0.08-0.78), P=0.01) and multivariate analysis (HR: 0.27 (95% CI (0.08-0.97), P=0.04), respectively. The kaplan-meier analysis and the Log Rrank (Mantel-Cox) showed a statistically significant relationship between the stage at diagnosis and RFS in OGCT group (P=0.042). RFS was 96% for OGCT patients, and 92.7% for OSCT patients. During the follow-up, only one patient passed away in the dysgerminoma group; the OS rate was 98% for OGCT patients, and 100% for OSCT patients.

The OS and RFS obtained in this study confirmed that the ovarian germ cell and sex cord malignancies were among the highly treatable solid tumors. Stage can be proposed as the main prognostic factor; also, larger series of studies are needed for detecting the prognostic significance of serum markers.

Pancreas is an organ that is hardly affected by metastasis from other primary cancers; also, pancreatic metastasis from esophageal squamous cell carcinoma (ESCC) is an extremely infrequent entity. Metastatic esophageal cancer has a poor prognosis and the five-year survival rate is less than 5%. Here, we described a rare case of a 78-year-old woman presented with abdominal bloating, intermittent mild nausea, and loss of appetite and weight. Esophagogastroduodenoscopy revealed ESCC in the upper part of esophagus. A mass lesion between the head and body of pancreas was detected during metastatic work-up. Endoscopic ultrasound-guided fine needle aspiration was performed, morphologic features and immunohistochemistry confirmed metastatic squamous cell carcinoma from esophagus. Definitive chemoradiotherapy with curative intent was done on both oesophageal and pancreatic lesion. Interestingly, after nine months of treatment, the patient had no issues either in esophagus or in abdomen. In conclusion, local therapy could be considered as one of the best choices to improve the overall survival in ESCC with single metastasis to pancreas.

Sclerosing stromal tumor of the ovary is believed to be a rare, benign, sex cord stromal tumor occurring predominantly in younger women in the 2nd and 3rd decades of their life. The prevalent clinical presentations include pelvic or abdominal pain, mass, or menstrual changes. Even though it is occasionally accompanied by hormonal manifestations, virilization as a result of androgen production by the tumor is rare. The present research was conducted to present a rare case of bilateral sclerosing stromal ovarian tumor in a 20-year-old patient with irregular menstruation and pelvic pain. All of the sclerosing stromal tumors were benign and were treated successfully with enucleation or unilateral oophorectomy.