فهرست مطالب

  • Volume:13 Issue: 4, 2020
  • تاریخ انتشار: 1399/03/11
  • تعداد عناوین: 7
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  • Susan Alizadeh Fard* Page 1
    Background

    Pain experience is still the most important problem in women with breast cancer that could lead to psychological problems. There is notable literature that revealed perceived injustice, time perspective, and pain catastrophizing are associated with the same psychological variables and health-related behaviors.

    Objectives

    This study aimed at predicting pain catastrophizing based on a perceived injustice and past time perspective in women with breast cancer.

    Methods

    The present study was descriptive-correlational in terms of method. The statistical population consisted of all women aged 20 to 50 years with a breast cancer diagnosis in 5 hospitals in Tehran, Iran (Emam Khomeini, Hazraterasol, Mohebmehr, Shahram, and Khatam). A total of 142 voluntary patients were selected through the available sampling method. The instruments of the study included the Zimbardo Time Perspective Inventory (ZTIP), The Injustice Experiences questionnaire (IEQ), and the Pain Catastrophizing scale (PCS). The data was analyzed, using Pearson correlation and step by step regression and path analysis.

    Results

    The results showed that perceived injustice, past negative, and past positive had a significant relationship with pain catastrophizing. The perceived injustice, past negative, explained approximately 72% of the variance of pain catastrophizing. Also, perceived injustice is a mediator variable between past negative and pain catastrophizing.

    Conclusions

    Overall, the results of this study support the role of past negative time perspective and perceived injustice in predicting pain catastrophizing in women with breast cancer. Since pain is experienced in a complex social and cultural milieu, there is a great value for identifying variables that might mitigate or exacerbate perceived pain and could contribute greatly to the development of more effective psychosocial treatments. Therefore, dealing with past negative time perspective and perceived injustice can prevent pain catastrophizing and, consequently, perceived pain and its intensity could be decreased.

    Keywords: Breast Cancer, Women, Pain Catastrophizing, Perceived Injustice, Past Time Perspective
  • Mohammad Houshyari, Afshin Rakhsha, Mohammadreza Khademi, AmirShahram Yousefi Kashi* Page 2
    Background

    Breast cancer is the most frequent diagnosed visceral cancer with 13400 new cases annually among Iranian women. Modified radical mastectomy (MRM) was the old standard surgical treatment in patients with breast cancer from 70 years ago and breast-conserving surgery (BCS) with adjuvant radiotherapy was the standard treatment from 30 years ago.

    Objectives

    In this matched historical cohort study, we compared two types of therapy for breast carcinoma: breast-conserving therapy (BCT), and MRM.

    Methods

    Medical records of 6000 patients with breast cancer from the database of Cancer Research Center of Shahid Beheshti University of Medical Sciences were reviewed and 1310 patients who had been treated by BCT (group A) or MRM (group B) were selected based on a time- stratified 1:1 between September 2002 and December 2014 as 10 baseline variables. By log-rank test analysis, their local recurrence (LR), disease free survival (DFS) and overall survival (OS) were evaluated and compared.

    Results

    In groups A and B, the median age at the diagnosis time was 48.11 and 48.64 years old, respectively. Median follow-up time was 71 months since April 2015. 1.68% of patients in group A and 1.07% of patients in group B had local recurrence during the five years of follow up, (P = 0.173). In the group A and B, five years DFS were 87.94% and 80.46%, (P < 0.001) and five years OS were 89.31% and 83.02%, respectively (P = 0.041).

    Conclusions

    The findings of this study showed that 5-year DFS and 5-year OS in BCT group were better than in the MRM group. Longer follow-up time of the patients to compare 10-year DFS and 10-year OS or even 20-year OS between two groups is recommended.

    Keywords: Breast Cancer, Survival, Modified Radical Mastectomy, Breast-Conserving Therapy
  • Niusha Nobari, Nakisa Niknejad, Jalal Poorolajal, Maryam Vaezi, Fatemeh Nili *, Issa Jahanzad Page 3
    Background

    Determining prognostic factors of endometrial cancer is important for the management of this disease.

    Objectives

    The aim of this study was to identify the association between tumor- infiltrating lymphocytes (TILs) and programmed cell death protein-1 (PD-1) expression in intra-tumoral inflammatory cells and clinicopathological features of endometrial carcinoma.

    Methods

    This observational study was conducted on 56 patients who underwent hysterectomy with diagnosis of endometrial carcinoma and available 5-year follow-up data from 2006 to 2013 in Imam Khomeini Hospital, Tehran, Iran. The TILs scoring was calculated based on the mean percentage of stroma occupied by mononuclear inflammatory cells at the invasive border of the tumor in H & E stained slides in 10 representative high-power fields. The mean number of CD3, CD8, and PD-1 positive lymphocytes in 10 high-power fields, as well as cyclo-oxygenase-2 (COX-2) expression, were assessed.

    Results

    TILs were significantly higher in endometrioid carcinoma compared to non-endometrioid carcinomas (P = 0.001). There was no significant association between TILs percentage, myometrial invasion, lymphovascular invasion, and tumor grade (P > 0.05). High TILs tumors showed better prognosis (P = 0.046). On the immunohistochemical (IHC) study, TILs were higher in endometrioid tumors compared to non-endometrioid tumors (P < 0.05). The expression of PD-1 was higher in endometrioid tumors compared to non-endometrioid carcinomas (P = 0.001). The COX-2 expression was not associated with prognosis and the other clinicopathologic features.

    Conclusions

    High TILs and PD-1 expression were associated with better prognosis in endometrial carcinoma. Endometrioid carcinomas had a higher TILs, CD3, CD8, and PD-1 lymphocytes. This study failed to identify a clinically significant cut off for these inflammatory biomarkers.

    Keywords: Prognosis, Endometrial Carcinoma, Tumor Infiltrating Lymphocyte, Clinicopathologic Features
  • Asiie Olfatbakhsh*, Shahpar Haghighat, Fateme Sari, Toktam Beheshtian, Esmat Alsadat Hashemi, Maryam Jafari Page 4
    Background

    Axillary lymph node (LN) status plays an important role in the local and systemic treatment of patients with breast cancer. Preoperative axillary ultrasound (AUS) is routinely used for the evaluation of axillary lymph nodes as a non-invasive method.

    Objectives

    The purpose of this study was to evaluate the sensitivity and specificity of axillary ultrasound in comparison with pathology in a referral breast center.

    Methods

    During a cross-sectional study all patients with breast cancer presenting to the imaging department between September 2015 and August 2016 were evaluated for axillary lymph node status by ultrasound. After comparing these results with the pathology of LNs, the sensitivity, specificity, and accuracy of the ultrasound in the diagnosis of axillary lymph node involvement were measured.

    Results

    Overall 140 patients were enrolled in the study. The mean age of patients was 48.87 (± 10.46) years with an age range between 25 - 81 years. The sensitivity, specificity, and accuracy of the ultrasound were reported as 56%, 88%, and 76%, respectively. The highest sensitivity rate was related to AUS + Physical examination (PE) with 70%. The best specificity was for AUS, about 88%, and the accuracy of AUS+PE was the highest about 80%.

    Conclusions

    The sensitivity of the AUS in the diagnosis of axillary involvement in the Motamed Cancer Institute was moderate and the specificity was good. The combination of physical examination and ultrasound could improve the sensitivity in comparison to each one alone. If both are suspicious, axillary dissection could be considered when fine needle aspiration (FNA) or core needle biopsy (CNB) of the lymph node is not available.

    Keywords: Breast Cancer, Ultrasonography, Axilla, Lymph Node
  • Priyanka Shirish Alurkar, Anshul Singh*, Krishna Sharan, Anusha Reddy, Shirley Lewis, Umesh Velu, Priyanka Augustine Page 5
    Background

    MD Anderson dysphagia inventory (MDADI) is a dysphagia-specific quality of life (QOL) questionnaire for patients with head and neck (H&N) cancer.

    Objectives

    This study aimed at ascertaining the impact of dysphagia on the QOL of patients undergoing radiation therapy for H&N cancer with curative intent.

    Methods

    This prospective observational study was conducted at a tertiary care hospital in India. Patients with H&N cancer meeting the selection criteria were enrolled in this study. The patients completed the MDADI questionnaire administered to them at the treatment completion and 3 to 6 months after the treatment. The chi-square test, Independent-samples t-test, and Spearman correlation coefficients were used for analysis.

    Results

    After the treatment, the total MDADI score was significantly related to the constrictor mean dose (P = 0.035) and larynx mean dose (P = 0.050). This association was maintained 3 months after the treatment by the constrictors and larynx mean dose (P < 0.05). Keeping the dose constraints for constrictors < 50 Grays (Gy) and larynx < 45 Gy resulted in a better QOL. The mean doses to the cervical esophagus did not statistically correlate with the questionnaire scores. At 6 months after the treatment, a correlation was seen only with the larynx mean doses. Spearman’s rank analysis was significantly correlated to the total as well as individual MDADI scores.

    Conclusions

    MDADI scores provided significant insights into the dysphagia-related QOL for patients with H&N cancer. Modern techniques like volumetric modulated arc therapy (VMAT) are translated into an improved QOL for patients and justify their use. Furthermore, parameters like V30/V40 would have been even more valuable and should be undertaken in future studies.

    Keywords: Dysphagia, IMRT, VMAT, DARS, MDADI
  • Bita Bitarafan*, Alireza Jahanshahi, Hajieh Shahbazian, Zahra Nooshabadi Page 6
    Background

    Thyroid cancer is one of the most common malignancies related to an endocrine disorder. Due to the widespread increase in thyroid cancer disease all over the world, cancer registries play an important task for improving survival, prevention, and control of cancer plans in developing countries.

    Objectives

    This study aimed at developing a minimum data set (MDS) for thyroid cancer registry to improve care and treatment core indicators and to revise related guidelines for thyroid cancer in Iran.

    Methods

    This research was a descriptive and cross sectional study carried out in 2015. Most of the data were collected from the patient's medical records in public hospitals of Ahvaz province, healthcare medicine centers in Ahvaz, in addition to online databases. The data were collected, using a checklist. The decision-making classic Delphi method was used to make a consensus about the data elements. The construct validity and reliability of the questionnaire were approved by the expert’s opinions in the field of endocrinology.

    Results

    Out of 251 elements of thyroid cancer discussed, 142 and 8 agreed by more than %75 and by 50% to 75% of the experts, respectively. The MDS was divided into 2 categories of identify and clinical data with 1 and 11 sections, respectively.

    Conclusions

    Comprehensive and uniform data elements about thyroid cancer was not available in Iran. This data set in the field of collecting thyroid cancer information can be useful through facilitating the exchange of health information. The determination of MDS for thyroid cancer will be an effective step to integrate and improve the management of patients’ records.

    Keywords: Iran, Minimum Data Set, Thyroid Cancer, Registry System
  • Zahra Tahmasebi Fard * Page 7
    Background

    The mechanism of the relationship between obesity and the risk of breast cancer is still unknown.

    Objectives

    The current study aimed at evaluating the relationship between the leptin receptor Q223R (Gln/Arg) polymorphism, body mass index (BMI), and histopathological changes in patients with breast cancer.

    Methods

    A total of 158 patients with breast cancer and 158 healthy subjects within the same age range were recruited. After taking blood sample, DNAs were extracted using the salting-out method. Then, the polymerase chain reaction-restriction fragment length polymorphism technique was used for genotyping. The histopathological characteristics were determined by the immunohistochemistry technique.

    Results

    Investigation of the relationship between BMI and alleles showed that the G (Arg) mutant elevated the risk of affection by 2.294 times, while the allele A had a descending effect by 0.375 times. The comparison of genotypes with histopathological changes showed a significant relationship between the GG (Arg/Arg) genotype and higher levels of progesterone receptor expression (P = 0.005), invasive type of cancer (P = 0.010), and stage of the disease (P = 0.003).

    Conclusions

    People with higher BMI who also carried G (Arg) mutant of Q223R polymorphism were more prone to breast cancer. Also, tissue changes in the ones carrying this allele were more than those harboring the wild-type A (Gln) allele.

    Keywords: Breast Cancer, RFLP-PCR, Polymorphism Q223, RS1137101