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Prediction of response to neoadjuvant treatment is an important part of treatment of patients with breast cancer. This study aimed to assess changes in serum levels of Cytokeratin 18 during neoadjuvant chemotherapy in patients with locally advanced breast cancer and its association with neoadjuvant treatments.

This research was performed on newly diagnosed breast cancer patients referred to Omid Radiotherapy Center and radiotherapy and oncology departments of Emam Reza and Ghaem hospitals, in Mashhad, Iran. Serum levels of M30 and M65 fragments of Cytokeratin 18 were measured before and 24 hours after the first course of neoadjuvant chemotherapy. Changes in serum levels of Cytokeratin 18 and its fragments and their correlation with pathologic response were analyzed.

Pre- and post-chemotherapy levels of M30 were respectively 223.9±18.94 and 250.7±23.92 U/L (P=0.24). For M65, these levels were respectively 301.5±313.9 and 330.2±352.2 U/L (P=0.1). Changes in M30 level during chemotherapy in patients with and without pathologic complete response were -20±92.69 and 43.1±106.5, respectively (P=0.1). For M65, these changes were respectively -247±55 and 76±240 (P=0.1). Baseline levels of M30 and M65 had no relation with menopausal status, tumor grade, hormone receptor status, Ki67 expression, molecular subtype, and stage.

Our findings showed statistically insignificant changes in the level of Caspase-cleaved- (M30) and uncleaved- (M65) cytokeratin 18 fragments (apoptotic and necrotic indicators, respectively) during neoadjuvant chemotherapy in patients with breast cancer. There was no notable relationship between tumor-related factors and either baseline levels or serum changes of CK18 fragments. Also, there was no correlation between M30/M65 level and pathologic response to neoadjuvant chemotherapy.

Lung cancer (LC) is a global public health priority. In this study, the epidemiology and current trends of primary LCs were investigated in northeast of Iran.

Demographic and pathologic records of primary LCs during 1985-2012 in Mashhad (capital of northeast of Iran) were reviewed. Data were obtained from archives of the largest referral oncologic hospital and the only private outpatient radiation-oncologic clinic in the region. To investigate trends, study duration was classified into 3 periods: 1985-1995, 1995-2005, and 2005-2012. Patients were placed in one of these 3 groups, based on the date of their pathologic diagnosis. Data were analyzed by SPSS 16 software. T test, chi-squared, and ANOVA tests were used for data analysis, and statistical significant level was set at < 0.05.

Among 939 cases with pathologic diagnosis of primary LC, male-to-female ratio was 2.36. Mean±SD age at diagnosis was 61.47±12.01 years in males and 58.45±12.75 in females (p=0.001). Squamous cell carcinoma (SCC) was the most frequent pathologic subtype. Mean age at diagnosis and rate of smokers were unchanged during the study (p= 0.978 and 0.153, respectively). Relative frequency of leading pathologic subtypes changed in 3 intervals (p<0.001): it was increasing in adenocarcinoma and large cell carcinoma and decreasing in SCC and small cell lung cancer (SCLC). There were statistically significant differences in the mean age at diagnosis (p<0.001), rate of smokers (p<0.001), and male-to-female ratio (p=0.011) between leading pathologic subtypes.

Similar to universal picture, rate of adenocarcinoma in northeast of Iran was rising during recent decades, especially among younger patients, women, and nonsmokers. These trends are indicative of changes in exposures and smoking habits and reveal the need for regional studies in these contexts.

Conservative treatment in early-stage breast cancer is considered a standard approach. Breast preserving surgery with adjuvant radiotherapy is as effective as mastectomy in the early stages of breast cancer to control local disease and distant metastasis and maintain the overall survival rate. Minimally invasive surgery for the treatment of axillary spread and new techniques of breast preservation surgery will probably lead to a reduction in mastectomy-related complications. However, the complications of adjuvant radiotherapy remain a challenge. Cutaneous, cardiac, and pulmonary toxicity are the main complications of adjuvant breast irradiation. The multidisciplinary features (systemic treatment, endocrine therapy, and surgery), patient profile (history of underlying diseases, age, and habits), and irradiation-associated parameters are the factors affecting safe adjuvant radiotherapy. Advances in irradiation techniques and facilities related to the preservation of organs at risk (such as IGRT, tracing and tracking systems, and respiratory gating) are modern tools for reducing the risk of toxicity. Reported data from clinical trials or retrospective surveys greatly help physicians in consulting the patients on the efficacy and potential side effects of treatment and leads to the improvement of the decision making process.

Breast cancer is the first leading cause of cancer-related deaths in women. Ki-67 is being used for evaluation of the prognosis of patients with breast cancer. The aim of the current study was to explore the association of the involvement of axillary lymph nodes status with the expression of Ki-67 in patients with breast cancer. A total of 449 patients were enrolled followed by evaluation of the association of Ki67 levels with demographic, pathologic, and survival data of patients, using Chi-square, logistic regression models, student t test and Mann-Whitney. We observed a significant relationship between the expression level of Ki-67 and stage of tumor (P = 0.012), positive progesterone receptor (P = 0.003), and subtype pathologic features (P < 0.05). Also, a significant difference was detected between Her2 and expression level of Ki-67 (P = 0.015). Survival analysis showed the association for Ki-67 (P = 0.02), age (P = 0.005), stage of tumor (P < 0.05), lymph node involvement (P = 0.001), and the Her2 (P = 0.024) with clinical outcome (e.g., overall survival or disease free survival) of patients with breast cancer. The results of this study demonstrated that the overexpression of Ki-67 was associated with large tumors, progesterone receptor expression, and stage of tumor, but it was not related with lymph node involvement.

Esophageal squamous cell carcinoma (ESCC) accounts for 80% of all esophageal cancers worldwide. It is the most common histological type of esophageal carcinoma in low-resource countries. ESCC is prevalent in Asian countries, accounting for more than 95% of esophageal cancers. The epidermal growth factor receptor (EGFR) is involved in cancer development, as its gene is often mutated and/or amplified in cancer cells. According to recent statistics, esophageal cancer is the eighth most common cancer in Iran.
In this retrospective study, we assessed EGFR overexpression, using immunohistochemistry (IHC) in 68 patients with ESCC, undergoing neoadjuvant chemoradiotherapy and esophagectomy in 2011-2014. The treatment protocol included external beam radiotherapy (40 Gy), concomitant with cisplatin 20mg/m2 and 5- fluorouracil (5-FU) 1000 mg/m2 for 4 consecutive days during the first and fourth weeks of treatment. To compare the two groups (EGFR positive and negative) in terms of complete pathologic response, Chi-square test was performed using SPSS version 16.
The median age of the patients was 59 years (range: 27–70 years), with a female-to-male ratio of 1.06. Overall, 70% of the subjects showed EGFR overexpression. Complete pathologic response to neoadjuvant treatment was significantly higher in EGFR-positive patients (40% vs. 15.8%, P = 0.05). In all cases, 1- and 3-year overall survival rates were 86.6% ± 4.1 and 48% ± 6.9, respectively. The 1- and 3-year disease free survival rates were calculated as 71.8% ± 5.4 and 44.3% ± 6.5, respectively. The overall survival rate was relatively higher in cases with EGFR overexpression, although the difference was not statistically significant (5-year survival rate: 47.9 ± 8.2 vs. 30.9 ± 13, P = 0.23).
EGFR overexpression was reported in the majority of patients with ESCC in northeastern Iran. Moreover, EGFR overexpression was significantly associated with complete pathologic response.

The presence of estrogen receptor alpha has been reported in the cell and tissue levels in gastric cancer; however, its impact on patients' survival remains unclear. The aim of this study was to investigate the expression of estrogen receptor in gastric carcinoma as well as its relationship with the clinicopathologic findings of the patients.

The study was performed on 100 endoscopic biopsies of gastric adenocarcinoma for estrogen receptor expression using an immunohistochemical method, and their relationship with the clinicopathologic findings of the patients, such as age, gender, tumor site, size, grade, depth of tumor invasion (T), and lymphatic status (N), were analyzed using independent sample t-test and Pearson Chi-square test. A P < 0.05 was considered significant in all analyses.

Using an immunohistochemical method on endoscopic biopsies of 74 males and 26 females with the mean age of 63 years, estrogen receptor was found to be positive in 41% of patients. No significant difference was found between estrogen receptor expression and other clinicopathologic findings (P = 0.75). There was a significant difference between estrogen receptor (+) and estrogen receptor (−) groups in nodal involvement (P = 0.001). The estrogen receptor (+) patients had more number of lymph nodes involved.

This study showed that lymph node involvement has a significant relationship with estrogen receptor expression. However, no significant relationship was found between estrogen receptor expression and other clinicopathologic findings such as age, gender, tumor site in stomach, tumor size, tumor grade, and T-stage.

Many aspects of epidemiological and clinicopathological features of gestational trophoblastic disease (GTD), one of the important subject in gynecology oncology, needs to be defined so as to recommend the best approach and management toward it. In the present study, we evaluated 10-years incidence of throphoblastic diseases in north east of Iran in prospective epidemiological and clinicopathological study.

We reviewed the registered histopathology database archive (120 records) related to throphoblastic diseases of the Ghaem Hospital, Mashhad University of Medical Sciences from 2001 to 2010.

Evaluation of the pathological reports revealed 5 (4.2%) choriocarcinom and 115 (95.8%) of hydatidiform mole (HM), with complete and partial HM diagnosis in 29 (25.2%) and 86 (74.8%) patients, respectively. The pregnancy rate of HM patients (2.72 ± 1.86) and choriocarcinoma patients (3.56 ± 2.8) was not significantly different ( P = 0.61). There was no statistical significant difference between the number of pregnancies in HM (2.90 ± 3.13) and choriocarcinoma (3.84 ± 3.80) patients ( P = 0.46). The ratio of complete to partial mole increased with age, although this correlation was not significant. Most patients in both the groups had no history of abortion. O positive was the predominant blood group among the studied patients.

Throphoblastic diseases occur during the fertility age mostly, and there is an increased risk with more previous pregnancies; ultrasound sonography is a useful method for primary diagnosis of this disease. Further pathological studies are needed to define the mole type.