Middle East Journal of Cancer
Volume:12 Issue: 3, Jul 2021

Glioblastoma multiforme (GBM) is the most common primary malignat brain tumor in adults. The modulation of miRNA expression is considered both as controlling groundwork for cancer development and invasion and as a potential application in GBM-targeted therapies either perse or combined with chemo-or radiotherapy. The c-myc overexpression is tightly correlated with GBM progressing growth and malignancy. There is ample evidence showing that microRNAs (miRNAs) are linked to the pathogenesis of several malignancies. However, little is known about the potential role of miRNAs in GBM development. We conducted the present study to find out whether the miR-561 inhibits GBM cells proliferation and survival via controlling the expression of c-myc.
In this in vitro study, the U87 cell line was used as a template for lentiviral vector “pCDH-miR-561” construction. HEK293 cell line was transfected with pCDHmiR- 561 and its viability (MTT assay) and apoptosis rates (flow cytometry) were monitored. c-myc expression was monitored employing q-RT PCR. In order to search for possible miR-561p targets, we utilized bioinformatics tools of TargetScan and DAVID.
Our results confirmed that the overexpression of the miR-561 inhibits cell proliferation and promotes cell apoptosis in GBM cancer cells, which is tightly correlated with the downregulation of c-myc.
These findings proposed that the miR-561 has promising qualifications to suppress U87 growth and proliferation via tuning the c-myc, which then makes it a useful model for GBM treatment.

Gene alterations are required for the development of gastric cancer, which are influenced by environmental and host factors. We conducted the present study to find the status of Helicobacter pylori (H. pylori) infection and its association with altered genes P53, hMLH1, and HER2 in gastric cancer patients and to analyze their correlation with clinical, pathological, and environmental factors.
This was a cross-sectional study. For genetic (P53 and hMLH1) study of the gastrectomized tissue DNA extraction and optimization, we performed PCR amplification and DNA sequencing. HER2 was studied by immunochemical technique. The results were matched with tumor status, age and sex, smoking, and H. pylori antibody status of the patients to find their association.
The mean age of the patients was 52.91 (±13.94) years. Among the 45 patients selected for genetic tests, 12 aged 40 or more and 33 aged over 40. Among the genes, 33(73.3%) in P53 and 17(37.7%) in hMLH1 were mutated and 11(24.2%) in HER2 were found to be overexpressed. Chi square and regression analysis showed that they all had associations with H. pylori positivity (P < 0.05, odds ratio >1). hMLH1 was associated with the location of the tumor, smoking, sex, blood group, and age, and P53 was found to be affected by extra salt intake, sex, blood group, and age of the patients (P ≤ 0.05 ).
Genetic mutation was found in nearly all the patients with gastric cancer, which was significantly associated with H. pylori infection. Mass eradication of this organism might play a role in reducing cancer incidence in Bangladesh.

MicroRNAs are involved in response to therapeutic agents and have the ability to regulate the expression level of the targets associated with cancer growth and progression. As a dangerous signal in tumor cells, increased expression level of MHC class I chain-related protein A (MICA) could activate the immune system and induce responses to tumor cells. We conducted the present research to study the effect of linoleic acid (LA) and docetaxel alone or in combination with miR-106b, miR-20a, and MICA expression level in metastatic gastric cancer (GC) cell line MKN-45.
The study was an in vitro study using the gastric cancer cell line MKN- 45, which was cultured and treated with docetaxel and LA. Subsequently, the expression level of miR-106b, miR-20a, and MICA were assessed with quantitative real-time polymerase chain reaction.
MiR-106b decreased in LA and LA/docetaxel (P < 0.0001 and P = 0.002),and increased in docetaxel alone (P = 0.01). Meanwhile, miR-20a significantly decreased in docetaxel and LA/docetaxel (P < 0.0001), increased in LA treatment (P = 0.02). Regarding MICA, it significantly decreased in all the treated cells (P < 0.0001, P<0.0001, and P=0.0002 for docetaxel, LA and docetaxel/LA, respectively) but with different reduction intensities.
Using LA or docetaxel alone had a different effect on miR-106b, miR-20a, and MICA expression level, yet in a simultaneous treatment, their positive effects were intensified. LA enhanced the effect of docetaxel concerning the expression level of miR-106b, miR-20a, and MICA and vice versa, which suggested that LA could be employed as an effective complementary agent in GC along with docetaxel.

Acute lymphoblastic leukemia (ALL) is known as a sort of malignancy in the blood lymphoid progenitors, specifically in B and T precursors of the lymphocyte. Autophagy is a protected hemostatic and catabolic process during evolution, through which lysosomes degrade the cytoplasmic components, such as redundant or dysfunctional organelles and misfolded proteins. We conducted the present study to investigate the link between gene expression changes of BECN1, MAP1LC3B, and P62 as the main regulators of remission and response to chemotherapy in ALL patients with minimal/measurable residual disease in ALL.
In this case-control study, BECN1, MAP1LC3B, and P62 gene expression were assessed in 30 ALL patients at the diagnosis phase, 18 patients on day 15 of the therapy, and 11 controls employing qRT-PCR.
The results revealed that BECN1and MAP1LC3B gene expression levels were significantly lower in ALL patients; whereas, P62 gene expression levels were significantly higher than the controls (P < 0.05). We found that the expression level of the BECN1 and P62 genes increased and decreased respectively in patients on day 15 of the therapy compared with newly diagnosed ALL patients. Nevertheless, neither BECN1 nor P62 genes were significantly different at the rate of 0.73-fold (P > 0.05).
Our study demonstrated the relationship between autophagy-related markers, such as BECN1, MAP1LC3B, and P62 with pathogenesis in Iranian children with ALL. We found that BECN1and MAP1LC3B genes significantly decreased in newly diagnosed ALL patients and may play a part in ALL pathogenesis.

Breast carcinoma is the most prevalent malignancy in females globally and also the leading cause of cancer-related mortality. The immunohistochemistry (IHC)-based molecular subtyping has put newer insights into the biological behaviour and clinical management of breast carcinoma. We conducted the present study to correlate the four IHC-based molecular subtypes: Luminal A, Luminal B, Human epidermal growth factor receptor 2 positive, and triple negative breast carcinoma with various clinicopathological parameters amongst the industrial population of Haryana.
This cross-sectional study was conducted on 92 cases of invasive breast carcinoma, who underwent modified radical mastectomy over a period of 2.5 years with the prior approval of Institutional Ethical Committee at ESIC Medical College and Hospital, Faridabad. We performed routine histopathological examination along with IHC (Estrogen receptor, Progesterone receptor and Human epidermal growth factor receptor 2) study. The correlation of the four molecular subtypes with various clinicopathological parameters were also studied. We analysed the data using SPSS software.
The mean age of the patients in this study was 47 years with a maximum number of cases in the 3rd and 4th decade of their life. The most common subtype was luminal B (40.9%) with the maximum number of cases presenting in stage II (53.26%) and with grade II (51.1%). Triple-negative breast cancer was found to be associated with brisk mitosis, lymphovascular invasion (66.67%), necrosis (77.78%), and ductal carcinoma in situ (66.67%). These findings were clinically significant. (P<0.05)
The early age of presentation of breast carcinoma in the industrial population would warrant the need to focus on various molecular subtypes and clinicopathological parameters that may have different prognostic implications in this population.

Triple-negative breast cancers (TNBC) are the tumors lacking expression of estrogen receptors, progesterone receptors, and human epidermal growth factor 2. The highest level of androgen receptors (AR) expression belongs to the Luminal androgen receptor subtype. AR is expressed in 70 to 90% of primary breast cancers. The biological role of AR in breast cancer continues to emerge. The overexpression of epidermal growth factor receptor (EGFR) has been previously studied in TNBC, where it was found to be associated with poor prognosis. In the evaluation of neovascularization, CD105 (endoglin) was found to be superior to CD34 and CD31 owing to its greater affinity for endothelial cells in tumor-related angiogenic tissue. We conducted the present work to assess the expression profile of androgen receptor in TNBC cases and its correlation with other clinicopathological parameters, EGFR and CD 105, in order to evaluate its clinical significance.
This retrospective study included 50 histologically confirmed breast cancer patients who were proven to be triple-negative based on immunohistochemical study. Formalin-fixed tissue blocks with tumor were chosen for immunohistochemical staining for AR, EGFR, CD105, and Ki 67.
Positive AR expression was associated with older age, postmenopausal status, negative nodes, and grade II tumors. AR was inversely correlated with EGFR, while there was no correlation between AR and both Endoglin and Ki 67.
AR-positive TNBC may be a subtype of breast cancer with unique characteristics that could make it ideal for antiandrogen endocrine therapy. EGFR and Endoglin's distinct expression indicated that they might be unique biomarkers for targeted therapy and prognosis.

Interleukin 17 (IL17) is a pro-inflammatory cytokine with pivotal modulatory effects on antitumor immune responses and has been reported to play a particularly important role in the occurrence and development of bladder cancer. We aimed to investigate the possible influence of IL17 genetic variations on loci rs22775913 and rs763780 with genetic susceptibility to bladder cancer in southern Iran.
In this case-control study, we enrolled 180 patients with urothelial bladder cancer (mean age 64 years) and 180 age/gender matched healthy controls without any family history of cancer and autoimmune disorders. Genomic DNA was extracted from peripheral whole blood and genotyping was performed using PCR-RFLP method.
Genotype distributions in both the patients and controls were in agreement with Hardy-Weinberg equilibrium. The frequency of GG, GA, and AA genotypes for IL17A were 87 (48.3%), 72 (40%), and 21 (11.7%) among patients; and 92 (51.1%), 75 (41.6%), and 13 (7.3%) in the controls. The frequency of AA, AG, and GG genotypes for IL17F in both the patients/controls were 160 (88.9%)/ 158 (87.8%), 16 (8.9%)/ 21 (11.7%), and 4 (2.2%)/ 1 (0.5%), respectively. Statistical analysis revealed no significant differences between the two groups regarding the frequency of genotypes and alleles (P>0.05).
Our data collectively suggested that genetic variations on loci rs22775913 and rs763780 of IL17 genes were not associated with bladder cancer susceptibility in the Iranian population. Our finding has to be confirmed in different ethnic groups.

Breast cancer (BC) is the most prevalent cancer among women worldwide with significant incidence and death rates. Nowadays, researchers hold that tumor formation, failure in therapy, and disease progression are all related to the presence of a small fraction of cancer cells with self-renewal capability known as “breast cancer stem cells” (BCSCs). Therefore, the study of this cancer cell population can be conducive to eradicating the tumor. The objective of the present study was to survey the existence and in vitro isolation of human BCSCs.
An in vitro research study was conducted under controlled laboratory settings to isolate, enrich, and identify breast cancer stem cells. Briefly, fresh breast tumors were carried to the lab immediately after surgery, followed by mechanical and enzymatic digestion (2 mg/ml collagenase I). Then, digested samples were passed through cell strainers (70 and 40 μm), and obtained cell suspension was cultured under the serum-free medium supplemented with growth factors for 21 days. The expression of cluster of differentiation 44 (CD44) and cluster of differentiation 24 (CD24) surface markers was assessed using immunocytochemistry, and stem cell gene expression was analyzed via RT-PCR.
BCSCs were able to survive in serum-free conditions and form floating spheres in vitro. Cells obtained from mammospheres expressed CD44 as the membranous and cytoplasmic pattern while CD24 expression was negative. Also, octameter-binding transcription factor 4 and SOX2 gene expression was observed in BCSCs.
The presence of stem cells was confirmed in Iranian women BC, and an efficient in vitro mammosphere culture model was used to enrich and propagate BCSCs. In our opinion, this in vitro model could be a suitable method for isolating and enriching BCSCs.

Chromosomal aberrations which occur in different hematologic malignancies are believed to be highly applicable for identifying the prognosis and treatment protocols. We conducted the present study to investigate the chromosomal and molecular abnormalities in bone marrow of acute myeloid leukemia (AML), acute lymphoid leukemia (ALL), and myelodysplastic syndrome patients.
We performed this cross-sectional study in molecular pathology and cancer research center of Mashhad University of Medical Sciences (MUMS), during 2017-2019; the total number of our cases was 252. We did all the molecular and cytogenetic tests on these patients. SPSS V.16 software was utilized for the analysis of our data.
In this research, the ALL patients were meaningfully younger than AML ones. There were significant associations between karyotype patterns and types of malignancy; normal diploid was more frequent in myelodysplastic syndrome (P<0.05). Among numerical abnormalities, trisomy 3 and monosomy 14 were the most prevalent ones.
The results of similar studies from different areas with different ethnics would help to identify new parameters for prognosis determination. Cytogenetic analysis is highly applicable for leukemia diagnosis and prognosis.

We conducted the present study to analyze the clinicopathologic features of patients with malignant ovarian germ cell tumor (MOGCT) with recurrence after 2 and 5 years.
In this retrospective and analytical-descriptive study, the obtained data included: age, tumor size, histopathological type, tumor stage, lymph node involvement, laterality of tumor, tumor necrosis, and mitosis. We also evaluated the Cox Regression analysis between these variables with recurrence after 2 and 5 years.
According to our exclusion criteria, we eliminated 81 cases. These cases consisted of the subjects with dysgerminoma (48.1%), immature teratoma (22.2%), yolk sac (16%), mix germ cell (11.1%), non-gestational choriocarcinoma (1.2%), and embryonal carcinoma (1.2%). We did not observe pure polyembryoma or polyembryoma in combination with mixed germ cell. All the patients received the treatment. The patients’ mean age was 23.3±8.4 years. MOGCT reoccurred in 10 patients after 2 years and in 13 patients after 5 years (10 cases in the first 2 years, and 3 new cases in the next 3 years). Most of the cases (64.2%) were diagnosed to be at stage 1. The Cox regression analysis between positive lymph node and the recurrence of MOGCT after 2 years and between stage IV of disease and the recurrence after 2 years were significant. The Cox regression analysis between laterality, mitosis and necrosis in pathologic slides of the recurrence after 2 and 5 years was not significant.
Stages and involvement of lymph nodes are two major factors concerning the recurrence of MOGCT. Most recurrences occur in the first 2 years. Pathologic features (mitosis and necrosis) of MOGCt in the time of diagnosis not correlated with the recurrence of the disease.

Despite the high prevalence of acute radiation dermatitis (ARD) in breast radiation treatment, data about its prevention is inconsistent. We conducted the present research to investigate whether the use of topical corticosteroids with different potencies or moisturizing cream could prevent ARD.
In this double-blind randomized trial, 120 patients, who had undergone breast conserving surgery for breast cancer, were randomly assigned to use Mometasone 0.1% cream or hydrocortisone 1% cream or moisturizing base cream from the first day of radiotherapy throughout the entire course. CTCAE v. 4 scale was utilized to score the grade of ARD. The outcomes were analysed with relevant statistical methods.
105 subjects were analysed. Mometasone delayed the incidence of grade 1 ARD in a week. However, no differences were observed among the groups concerning the incidence of the maximum ARD grade (χ2 (6, N= 104)=8.12, P=0.2). Moreover, the timing of the maximum ARD was not significantly different among the groups (χ2 (4, N =84) = 2.87, P=0.58).
This study demonstrated that the application of corticosteroid creams (hydrocortisone 1% or Mometasone 0.1%) does not result into a significant difference concerning the timing and incidence of ARD occurrence when compared with daily skin care and use of emollient.

Acute myeloid leukaemia (AML) in the elderly is not strong enough to tolerate aggressive chemotherapy. We conducted the present study to compare the efficacy and safety of low-dose cytarabine (LDAC) with best supportive care (BSC) in Egyptian patients.
A prospective randomized study included 60 eligible patients aged over 60 years with newly diagnosed AML. They were randomized to receive LDAC or BSC. The overall survival (OS) was the primary endpoint, while the secondary endpoint was to compare the quality of life in the form of a length of hospital stays (LOHS), mode and frequency of admission in the two studied groups.
Herein, 30 patients received LDAC and 30 patients received BSC. The mean survival time was 7.5 months in the BSC group compared with 10.2 months in the LDAC group. Even though the median OS was 8.4 months in the BSC group, it did not reach in the LDAC group; HR= 2.047, CI 95% (0.541-7.743) (P=0.2). There was a statistically significant association with LDAC and the frequency of hospital admission through the emergency department (ED) due to neutropenic fever and prolonged LOHS (P<0.001, P<0.002, and P<0.001, respectively). Meanwhile, the admission through the outpatient clinic (OPC) and for transfusion support were statistically insignificant in the two groups (P< 0.12 and P< 0.6, respectively).
Despite, there were no OS statistically significant benefits of the use of LDAC over BSC in our patients, poor quality of life in the form of frequent admission through the ED, more incidence of neutropenic fever, and prolonged LOHS were reported more to patients received LDAC.

Bone metastases are believed to be the complications of cancer occurring in 20-75% of patients with advanced tumors. External beam radiation therapy (EBRT) is recommended in case of symptomatic bone metastases. Preventing skeletal-related events (SREs) and pain through early treatment of bone metastases is to be studied. We conducted the present study to investigate EBRT in asymptomatic bone metastases.
A retrospective cohort study for patients with bone metastases without symptoms, who were treated with EBRT, formed group A. Group B comprised the patients who did not receive EBRT. The time from diagnosis to onset of the 1st SRE was recorded for both groups. The follow-up period was three years. Pain was moderate to severe when rated as 5/10.
Asymptomatic bone metastases were found in 200 patients. They were free from pain or pathological fractures. They were divided into two groups of A and B. The overall demographics and disease characteristics were well-balanced for the two groups. The two groups were more or less similar concerning the mean age and sex, with no statistically significant differences; the mean age in groups A and B was 57 years. For both groups, the mean time from the occurrence of asymptomatic bony metastases to the onset of SRE were about 33 and 19 months for groups A and B, respectively, which is statistically significant.
Prophylactic EBRT of metastatic breast and prostate cancer patients should be considered in order to delay the onset of SREs and improve the quality of life.

Cancer is believed to be one of the most important health problems worldwide today. In Iran, the burden of cancer is also on the rise and social support is an important aspect of modern cancer care. Therefore, we conducted the current study to determine the social needs of patients with cancer employing a qualitative content analysis.
This conventional qualitative content analysis was performed based on a descriptive explorative approach. Data saturation was achieved after interviewing 10 patients with cancer with in-depth semi- structured interviews. Data was gathered from autumn 2017 to spring 2018, from all the cancer patients who referred to three hospitals in Kerman. We utilized MAXQDA10 software for data analysis.
On average, the participants had 9 months to 4 years’ experience of cancer. The mean age of the participants was 45.7 years old. The present study revealed that the most important needs expressed by the participants were related to “organizational-therapeutic support". This main category consisted of three subcategories, including the need for financial support, inadequate environmental conditions in health care facilities, and not having the opportunity to choose.
The financial needs of cancer patients include the need for financial support from the spouse and the need for financial support from public and nongovernmental organizations. Their financial needs lead into not pursuing their treatment. Therefore, paying attention to the culture and values of patients is one of the important issues in providing care to these patients. Researchers have suggested focusing on further organizational support and ways to mitigate the needs of this group.

Breast cancer is the most frequent malignancy and the leading cause of cancer-related death among women all around the world. In Iran, the mean age of the patients is approximately 10 years younger than that in other countries. We conducted the present study to assess the risk factors of breast cancer among Iranian women in Mashhad.

This case-control study was carried out between February 2016 and January 2018 on 460 women (230 cases and 230 controls) in the academic hospitals of Mashhad. The data from our cases and controls were collected and analyzed using SPSS version 18.0 software (SPSS Inc., Chicago, IL, USA). We employed logistic regression models and frequency tables to estimate odds ratio (OR) and to examine the predictive effect of each factor on breast cancer risk. P < 0.05 was considered to be significant.

According to multivariate analysis, there was significant associations between breast cancer risk and body mass index (BMI) (Odds ratio (OR), 1.1; 95% Confidence interval (CI), 1.0-1.2), age at menarche (OR, 0.56; 95% CI, 0.47-0.68), menopausal age (OR, 1.1; 95% CI, 1.0-1.1), family history of non-breast malignancies (OR, 7.9; 95% CI, 2.2-21.1), and oral contraception pills (OR, 3.1; 95% CI, 8.34- 1.16).

This study revealed that age at menarche, family history of nonbreast cancer malignancies, BMI, menopausal age, and oral contraception pills were significantly associated with breast cancer.

Bone marrow is known as the major site of hematopoiesis. It could occur in several other tissues both during fetal development and after birth. Extramedullary hematopoiesis (EH) is known to occur in the organs of reticuloendothelial system, mainly spleen and liver. It is very uncommonly seen and reported in thyroid normally in association with anemias and myeloid metaplasias. Papillary thyroid carcinoma (PTC) is the most common type of thyroid carcinoma and the most common endocrine malignancy. Herein, we reported two cases of PTC with osseous metaplasia and EH without any other underlying hematological disorders. Even though programmed EH is required to supplement the hematopoietic activity in the bone marrow, excessive and diseaseassociated EH can occur and mediate chronic inflammation. PTC with osseous metaplasia could be regarded as a unique subtype of thyroid carcinoma, which is more aggressive. Further studies are required in this regard so that PTC with osseous metaplasia could be considered as a prognostic marker.

Glomus jugulare is known as a benign tumor that could involve in different parts of the body. The most prevalent site of involvement is head and neck area. This disease is rare and few of the cases are bilateral. However, in familial cases bilateral or multicenter lesions are even rarer, in which there is an autosomal dominant pattern of inheritance. The most efficient treatment is believed to be surgery or radiotherapy depending on the location and certain other factors, such as age and performance status. Sporadic bilateral lesion is rarely seen and most bilateral cases are familial. Herein, we reported a case of bilateral glomus jugulare of carotid with no history of this tumor in family or any other familial diseases. Our subject was a 67-year-old man. The diagnosis was made via Tru-cut biopsy. He was treated successfully by 3- dimensional conformal radiotherapy up to a dose of 60 Gy. The follow-up computed tomography scan revealed partial tumor responses. He had no family history of any systemic disease related to functional glomus jugulare, such as uncontrolled hypertention or mass in the neck. He also had no history of catecholeamine exceretion-related symptoms.