فهرست مطالب

Cancer Management - Volume:9 Issue: 1, Feb 2016

International Journal of Cancer Management
Volume:9 Issue: 1, Feb 2016

  • تاریخ انتشار: 1395/02/03
  • تعداد عناوین: 12
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  • Shahpar Haghighat, Mohammad Esmaeil Akbari, Parvin Yavari, Mehdi Javanbakht, Shahram Ghaffari Page 2
    Background
    Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease.
    Objectives
    We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer.
    Patients and
    Methods
    This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years (QALY) and lifetime costs.
    Results
    The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int. $ 37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int. $ 141,641 and Int. $ 389,148 respectively.
    Conclusions
    Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making.
    Keywords: Cost Effectiveness, Screening, Mammography, Iran, QALY
  • Arezoo Nabizadeh, Taravat Bamdad, Ehsan Arefian, Seyed Hadi Razavi Nikoo Page 3
    Background
    Beclin1 is an important, primary molecule for autophagy.
    Objectives
    It is suggested that the control of the autophagy path increases the sensitivity of tumor cells to VSV.
    Materials And Methods
    In this study, the degree of Beclin1 gene expression in two cell lines, HeLa and A549, has been examined and the percentage of living cells subsequent infection with virus has been evaluated by MTT assay method.
    Results
    The results showed that the degree of Beclin1 gene expression in HeLa cells in comparison with A549 cells has reduced, and the sensitivity of these cells to vesicular stomatits virus (VSV) oncolysis is more than A549.
    Conclusions
    It seems that by using some methods for reducing autophagy, it is possible to make tumor cells more sensitive to virotherapy and even other treatments.
    Keywords: Autophagy, Vesicular Stomatitis Virus, Beclin1, Virotherapy
  • Pezhman Mahmoodi, Hossein Motamedi, Masoud Reza Seyfi Abad Shapouri, Mahjabin Bahrami Shehni, Mohammad Kargar Page 4
    Background
    Cervical cancer is one of the important reasons of mortality among females. Prevention, early diagnosis and immediate treatment can affect the rate of mortality in this cancer and several epidemiological studies have shown a strong relationship between human papilloma viruses (HPVs) and cervical cancer.
    Objectives
    The present study was conducted to survey HPV infections in a women population with cervical cancer and cervical dysplasia/metaplasia in southwest of Iran.
    Materials And Methods
    72 paraffin-embedded cervical biopsies which had been previously archived from women with cervical cancer and cervical dysplasia were examined by polymerase chain reaction (PCR). Afterward, the detected HPV strains were typed by restriction fragment length polymorphism (RFLP) analysis of PCR amplicons.
    Results
    60 out of 72 samples had necessary requirements and HPV DNA was detected in 43.3% of these samples. Most HPV positive samples belonged to women aged from 48 to 63 years. On the other hand, HPV infection among patients with squamous cell carcinoma (SCC) was 48.78% and in women with dysplasia/metaplasia was 26.66%. The most prevalent type of the human papilloma virus was HPV16 (100%).
    Conclusions
    Knowing the most prevalent type of the human papilloma viruses circulating in the population (HPV16) can be applied in the future screening and managing programs of this major disease and also in vaccination against the prevalent types of the virus. Meanwhile, it seems that more studies should be performed to determine the role of different risk factors involved in development of the disease, especially those related with social behaviors and traditions with respect to different areas.
    Keywords: Human Papilloma Viruses, Cervical Cancer, PCR, RFLP
  • Somayeh Parvizi, Ghorban Mohammadzadeh, Maryam Karimi, Mozhgan Noorbehbahani, Alireza Jafary Page 5
    Background
    Transforming growth factor-β1 (TGF-β1) has a critical role in breast cancer initiation and progression.
    Objectives
    We have investigated the possible differences in two promoter polymorphisms (-509C/T and -800G/A) of TGF-β1 gene between breast cancer cases and controls.
    Patients and
    Methods
    A total of 100 patients with confirmed breast cancer and 100 subjects without breast cancer was selected. Two promoter polymorphisms (-509C/T and -800G/A) of TGF-β1 gene were genotyped using PCR-based restriction fragment length polymorphism (RFLP) method.
    Results
    The allele frequencies were 63% for C allele and 37% for T allele of SNP -509C/T and 66% for G allele and 34% for A allele of SNP -800G/A. Although no significant difference has observed between two groups, according to the genotype distribution, However, the TT genotype of -509 and AA genotype of -800 was significantly associated with breast cancer risk [odds ratio (OR) = 2.409; 95% confidence interval (CI) = 1.087 - 5.337, P = 0.030; and OR = 2.383; CI = 1.039 - 5.40, P = 0.040, respectively]. In addition, a multinomial logistic regression model shown, homozygous of -800 G/A (OR = 0.570; 95% CI = 0.362 - 0.896, P = 0.015); and HDL-C (OR = 0.935; 95% CI = 0.906 - 0.965, P
    Conclusions
    Our results indicated that among two promoter polymorphisms of the TGF-β1gene, -800G/A compared to -509C/T is more associated with breast cancer.
    Keywords: Transforming Growth Factor, Β1, Breast Cancer, Polymorphism
  • Mahmoud Parvin, Parto Sabet-Rasekh, Parastoo Hajian, Peyman Mohammadi Torbati, Parisa Sabet-Rasekh, Hamidreza Mirzaei Page 6
    Background
    The most common malignancy in the urinary system has been bladder cancer and the most predominant histologic subtype has been transitional cell carcinoma (TCC). There were many molecular risk factors, related with poor prognosis. One of these factors was expression of epidermal growth factor receptor (EGFR).
    Objectives
    The aim of this study was to evaluate the prevalence of the epidermal growth factor receptor in transitional cell carcinoma of bladder and its relationship with other prognostic factors.
    Patients and
    Methods
    This analytic descriptive study has performed with 61 patients with TCC of bladder after radical cystectomy whom have been hospitalized in Labbafinejad hospital in Tehran, Iran between 2007 and 2010. We have used Chi-square and t-test to analyze our data samples.
    Results
    Records of 61 patients have studied. Fifty three of the total samples were positive for EGFR expression (86.9%). Fifty samples of these fifty-three belonged to men and three others were women’s samples (P = 0.46). Among the group with EGFR expression the results were as follows: 25 patients (47.2%) were 60 years old or less and 28 patients (52.8%) were older than 60 (P = 0.023), 16 patients (30.2%) had invasion to lamina properia, and the rest of them had invasion to deeper layers (P = 0.56). For most patients we could not determine the invasion of tumoral cells into the lymph nodes (Nx) (P = 0.067). Thirty four patients (64.2%) had not lymphovascular invasion (P = 0.44) and in forty three of patients (81.1%), perineural invasion have not seen (P = 0.23). Finally, 36 patients (67.9%) were grade 3 (P = 0.27).
    Conclusions
    In this study we have concluded that most patients had EGFR positive expression. Also, except for the age, there was not any significant relation between expression of EGFR and the other prognostic factors such as, gender, invasion of the tumor into the layers, involving the lymph nodes, lymphovascular or perineural invasion, and grading.
    Keywords: Epidermal Growth Factor Receptor, Prognostic Factors, Transitional Cell Carcinoma
  • Yugantara R. Kadam, Sanjay R. Quraishi, Randheer V. Dhoble, Minaxi R. Sawant, Alka D. Gore Page 7
    Background
    Cancer is a leading cause of death globally. Every year, millions of cancer patients could be saved from premature death and and suffering if they had timely access to early detection and treatment. There are two main components of early detection: early diagnosis and screening. In India, cancers of cervix, breast, mouth/oropharynx are the most frequent cancers in women. These cancers are amenable to early detection. More than two third of the cancer patients are already in an advanced and incurable stage at the time of diagnosis.
    Objectives
    This study was designed with the aim to know the reasons for non availment of cancer screening procedures and early diagnostic facilities.
    Materials And Methods
    This cross-sectional study was planned in Sangli, Miraj and Kupwad Corporation area during October 2013 - March 2014 by a pretested questionnaire. Women of 25 years and above were study subjects selected randomly from a cluster sample of ward with estimated sample size of 559 women. Statistical analysis was done with the help of IBM SPSS 22.
    Results
    Nearly 74% of women said that cancer is curable. For awareness about signs and symptoms, risk factors and screening test 82.3% women scored less than 50% of total score. Only 17.7% women had awareness score more than 50%. But their attitude score was > 50% in 85.2% of women. For practice score, 24.4% women scored > 50%. Significant association was found between awareness, attitude and practice scores and education, occupation and history of cancer in family, friends and neighborhood of respondents.
    Conclusions
    Low awareness is the main barrier for undergoing cancer screening and early detection. There is a need of effective health education programme.
    Keywords: Early Detection of Cancer, Screening, Awareness, Attitude, Practice
  • Mahmoud Khodadost, Parvin Yavari, Behnam Khodadost, Masoud Babaei, Fatemeh Sarvi, Seyed Reza Khatibi, Saeed Barzegari Page 8
    Background
    Accurate cancer registry and awareness of cancer incidence rate is essential in order to define strategies for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increase the accuracy of cancer incidence estimation.
    Objectives
    This study aimed to estimate the esophagus cancer incidence by capture-recapture method based on Ardabil population-based cancer registry data.
    Patients and
    Methods
    Total new cases of esophagus cancer reported by three sources of pathology reports, medical records, and death certificates to Ardabil province cancer registry center in 2006 and 2008 were enrolled in the study. All duplicated cases between three sources were identified and removed using Excel software. Some characteristics such as name, surname, father’s name, date of birth and ICD codes related to their cancer type were used for data linkage and finding the common cases among three sources. The incidence rate per 100,000 was estimated based on capture-recapture method using the log-linear models. We used BIC, G2 and AIC statistics to select the best-fit model.
    Results
    After removing duplicates, total 471 new cases of esophagus cancer were reported from three sources. The model with linkage between pathology reports, medical record sources and independence with the death certificates source was the best fitted model. The reported incidence rate for the years 2006 and 2008 was 18.77 and 18.51 per 100,000, respectively. In log-linear analysis, the estimated incidence rate for the years 2006 and 2008 was 49.71 and 53.87 per 100,000 populations, respectively.
    Conclusions
    Based on the obtained results, it can be concluded that none of the sources of pathology reports, death certificates and medical records individually or collectively were fully covered the incidence cases of esophagus cancer and need to apply some changes in data abstracting and case finding.
    Keywords: Capture, Recapture, Esophagus Cancer, Completeness, Esophageal Neoplasm
  • Ali Sanjari Moghaddam, Milad Nazarzadeh, Rezvan Noroozi, Hossein Darvish, Alireza Mosavi Jarrahi Page 9
    Context: Known polymorphisms of DNA repair genes can be associated with the risk of many types of cancer. There is no consensus regarding association between XRCC1 and OGG1 with breast cancer (BC).
    Objectives
    The aim of this study is to collect relevant published studies systematically.
    Data Sources: Sixty-two publications were identified through searching PubMed, PubMed Central, ISI web of knowledge, and reference list of related articles.
    Study Selection: We performed a systematic review according MOOSE guideline criteria. All longitudinal cohort and case-control studies investigating association of any type and grade of breast cancer with XRCC1 and OGG1 gene and their polymorphisms were eligible for initial inclusion.
    Data Extraction: Two authors screened titles and abstracts and extracted all needed information from eligible studies. Four research methodological components causing bias for the association between gene polymorphisms and breast cancer risk, including source of controls sampling, population ethnicity, sample size of studies and menopausal status of cases and controls was used for assessment of quality of studies
    Results
    A total of 14,793 breast cancer cases and 15,409 controls were included in assessment of XRCC1 Arg194Trp. Four studies showed significant association and one study showed protective effect of XRCC1 Arg194Trp and BC. A total of 7,716 cases and 7,370 controls were included for XRCC1 Arg280His. Only one study showed significant association of XRCC1 Arg280His and breast cancer (OR = 1.82 (1.06 - 3.15). A total of 27,167 cases and 31,998 controls were included to estimate association between XRCC1 Arg399Gln polymorphism and breast cancer. Seven studies showed significant association and one showed protective effect of XRCC1 Arg399Gln and BC. A total of 9,417 cases and 11,087 controls were included for OGG1 Ser326Cys. Among studies focused on OGG1 Ser326Cys, none showed significant association with breast cancer.
    Conclusions
    Systematic search of major databases identify many studies addressing the relationship between BC and susceptible alleles in the base excision repair genes and the fact that there are many variations in the magnitude of association depending on inheritance model and the population of the study.
    Keywords: Polymorphisms, Breast Neoplasms, OGG1, XRCC1
  • Sanaz Tabarestani, Abolfazl Movafagh Page 10
    Context: Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by overproduction of immature and matured myeloid cells in the peripheral blood, bone marrow and spleen.
    Evidence Acquisition: A hallmark of CML is the presence of (9; 22) (q34; q11) reciprocal translocation, which is cytogenetically visible as Philadelphia chromosome (Ph) and results in the formation of BCR-ABL1 fusion protein. This fusion protein is a constitutively active tyrosine kinase which is necessary and sufficient for malignant transformation. The introduction of imatinib, a BCR-ABL1- targeting tyrosine kinase inhibitor (TKI) has revolutionized CML therapy. Subsequently, two other TKIs with increased activity against BCR-ABL1, dasatinib and nilotinib, were developed and approved for CML patients. Nevertheless, CML therapy faces major challenges.
    Results
    The first is the development of resistance to BCR-ABL1 inhibitors in some patients, which can be due to BCR-ABL1 overexpression, differences in cellular drug influx and efflux, activation of alternative signaling pathways, or emergence of BCR-ABL1 kinase domain mutations during TKI treatment. The second is the limited efficiency of BCR-ABL1-TKIs in blast crisis (BC) CML. The third is the insensitivity of CML stem cells to BCR-ABL1 inhibitors. Conventional chemotherapeutics and BCR-ABL1 inhibitors which act by inhibiting cell proliferation and inducing apoptosis, are ineffective against quiescent CML stem cells.
    Conclusions
    A better understanding of the mechanisms that underlie TKI resistance, progression to BC, genomic instability and stem cell quiescence is essential to develop curative strategies for patients with CML.
    Keywords: Chronic Myeloid Leukemia, BCR, ABL1, Tyrosine Kinase Inhibitors, Imatinib
  • Ramanujam Sathyanarayanan, Venkatachalam Suresh, Beena Agnes Therese Thomas Page 11
    Introduction
    Polymorphous low-grade adenocarcinoma (PLGA) has been known as a comparatively less aggressive malignant tumor that predominantly occurs in the minor salivary glands. It has presented as a painless, slow growing tumor in the oral cavity. It has been reported to occur rarely in the palate and the prognosis of this lesion is far better than adenocarcinoma as the regional metastasis would be very minimal. A clear difference between the biologic behaviors of adenocarcinoma and PLGA has been reported in literature.
    Case Presentation
    A 63-year-old female reported at our institute with a swelling in relation to her upper left back region of her jaw for three months, gradual in onset and associated with pain. After clinical and radiological examination, the differential diagnosis were consolidated abscess or minor salivary gland tumor. An incisional biopsy was done and the lesion was diagnosed as PLGA. The lesion was treated by wide excision and reconstruction with immediate obturator. The post-operative follow up showed no evidence of recurrence and the healing was satisfactory.
    Conclusions
    The site of predilection of PLGA is more in favor of palate (49 - 77.8%) followed by either upper lip or buccal mucosa (7.4 - 13.4%). There are sporadic reports of metastasis sometimes even transformation to a high grade adenocarcinoma, sometimes ending in mortality. Cervical lymph node metastasis is rare with reported incidence of 5 - 15% and is more commonly seen in recurrent tumor than the initial diseases. Extra palatal PLGAs present with significant papillary growth or arising from ventral surface of tongue frequently metastasize to cervical lymph nodes. Distant metastasis is very rare with an incidence of 7.5% and the site involved is the lung which is attributed to the inadequate control of the disease.
    Keywords: Adenocarcinoma, Minor Salivary Gland, Salivary Gland Neoplasms
  • Abdolhasan Talaiezadeh, Nastaran Ranjbari, Mohammad Bakhtiari Page 12
    Introduction
    Cystic lymphangiomas of abdomen has mostly involved mesentery and retro peritoneum that should be considered as a differential diagnosis of abdominal masses. Pancreatic lymphangiomas were extremely rare that should be differentiated from neoplastic pancreatic cysts. Patients have commonly presented with epigastric pain and a relevant palpable epigastric mass.
    Case Presentation
    A 65-year-old lady who has presented with epigastric pain, then during investigations, a cystic tumor which located in the tail of pancreas, has found. Whereas definite diagnosis of tumor with routine procedures was impossible, the tumor has completely resected by distal pancreatectomy and splenectomy. Pathology and IHC was suggestive of benign lymphangioma.
    Conclusions
    According to this presentation diagnosis of cystic lymphangioma of the tail of pancreas should be considered as a differential diagnosis of pancreatic cystic lesions and complete excision has been the treatment of choice.
    Keywords: Pancreas, Lymphangioma, Neoplasms