International Journal of Cancer Management
Volume:16 Issue: 1, Dec 2023

Brachial plexus injury (BPI) is not acommoncomplication of surgery and anesthesia, whichmayhappen with varied mechanisms like over-abduction, no appropriate positioning, and upper limb stretching. The overall prognosis of BPIs iscommonly satisfactory, but the poor function of the upper limb may not be fully recovered in all cases and may end in the permanent sequel in serious injuries.

This study reported a woman with breast cancer. She developed a right brachial plexopathy following a modified radical mastectomy. Upon conservative treatment, full recovery was achieved and normal function of the right upper limb was observed 3 months following the operation.

The arm’s extremely abnormal positioning during intraoperative manipulation and axillary retraction or hyper abduction can lead to BPI. Nerve injury can occur even in diabetic patients, whose blood glucose is well controlled and have no other risk factors. If the nerve structure is intact, spontaneous recovery can be expected with conservative management.

Intramedullary ependymoma (IE) is adults’ mostcommon intramedullary spinal tumor. Tumors usually extend one to eight segments in the cervical region. In this case report, wereported a patient with massive IE spanning from the fourth ventricle to the T4 segment of the spinal cord, which surgically treated with laminectomy from occiput to T4

A 42-year-old man who is a known case of IE with progressive upper extremities paraesthesia and gait disturbance. Four years ago he refused surgery and presented with dysphagia. The patient’s MRI demonstrated an intramedullary spinal cord tumor extending from the fourth ventricle to T4.

massive spinal ependymoma is a rare, benign, slow-growing tumor, and patients present symptoms years before diagnosis. Upon confirmation of the diagnosis, the tumor must be surgically removed.

Skin cancer is the most common cancer in Iran. Given the importance of early diagnosis in treating early tumors, knowledge of the demographic and pathological findings of the disease is helpful.

The aim of present study was to investigate the incidence, trend and risk factors of melanoma in Iranian childhood and adolescents.

The present retrospective study was performed between 2005 and 2013 on registered data in the National Cancer Registry System, Iran. The age group studied was patients 18 years or younger. Data included demographic status, risk factors, clinical and histopathological characteristics, and stage.

The results showed that 8 (57.1%) of 14 patients were males. The mean age of the study population was 8.71 ± 6.02 years (range, 1-15 years). Ten (71.4%) patients were of Fars ethnic groups. In terms of tumor invasiveness, 13 (92.9%) patients were invasive and one (7.1%) patient was in situ. The growth phase of melanoma was vertical in 13 (92.9%) patients and radial phase in one (7.1%) patient. In terms of lymph node metastasis, it was observed in only one patient. Surgical treatment was performed on all patients. Melanoma histology was nodular in 3 patients and unspecified or unregistered in the rest. The most area of the tumor was in the head/neck and lower limbs.

According to the results, regardless of the differences in the specific coverage of the Iranian people, the distribution and statistical characteristics of malignant melanoma in Iran are almost similar to other countries in the world. Wider studies are recommended to confirm the findings of the present study.

With the improvements in neoplasm treatments and the increased survival of patients with neoplastic diseases, we have entered a new era of having to deal with the complications of senile patients. The issue of bone fusion or the side effects of its delay, such as malunion or infections, are among the concerns for any surgery in patients whose bone marrow is affected by treatment orwhosebonemarrowbloodflowis impaired. The left internalmammary artery (LIMA) is used for coronary artery bypass graft (CABG) surgery with its 2 - 3 times longer lifespan compared to saphenous vein grafts, but its harvest from the sternum affects the sternum blood flow and the outcome of its use is still not identified in patients undergoing bone marrow transplant. This case report is the first report on this issue.

A 60-year-old man with diffuse large B cell lymphoma who had undergone bone marrow transplant a year before had then developed chest pain, which was diagnosed as vessel disease; he was selected for CABG surgery. The LIMA was harvested during the surgery and the left anterior descending artery (LAD) was anastomosed. The saphenous vein graft was also anastomosed to the diagonal artery, obtuse marginatus (OM), posterior descending artery (PDA), and posterior left ventricle (PLV). After the surgery, the patient was followed up for six months, during which time no specific incidents occurred and no sternum-related complications were observed either.

In this case report, the use of LIMA in a patient who had undergone a bone marrow transplant and CABG surgery was not associated with any increase in sternum-related complications.

P21 protein is a cyclin-dependent kinase inhibitor and has a crucial function as a cell cycle regulator in malignant tissues. Thus, its association with aggressive characteristics of malignant lesions is suggested.

We evaluated the expression level of P21 in gastric cancers and its association with the histopathological findings of cancer.

This cross-sectional study was performed on gastric adenocarcinomas from radical gastrectomy. The histopathological examination was assessed by Hematoxylin & Eosin. The immunohistochemistry technique was then used to assess the expression of the P21 marker.

P21 positivity was revealed in 28 specimens of the cancerous lesions with an overall prevalence of 70.0% in our population. There was no association between P21 positivity and tumor-related characteristics, including tumor location, type, grade and stage, as well as the size of the cancerous lesion. P21 positivity could not be related to perineural or lymphovascular invasion of the tumor (P-value > 0.05).

In our population, the expression of P21 may not be prognostic or predict tumor biological behavior among patients with gastric adenocarcinomas.

Informal caregivers provide long-term support and care for cancer patients and they do not receive enough support from the family and the health system; as a result, they suffer from a lot of caregiver burden.

In the current study, we investigated the effect of the Benson relaxation technique on caregiver burden in informal caregivers of cancer patients.

This randomized clinical trial with a control group was conducted on 113 caregivers, who scored X  48 from the Novak and Guest caregiver burden inventory. They were randomly divided into intervention group (n = 57) and control group (n = 56). The intervention group performed Benson relaxation twice a day for 20 minutes each time for 1 month. The control group did not receive any intervention. Then, after 1 month, Novak and Guest caregiver burden questionnaire was completed by both groups. The conceptual framework for this study was based on the general system theory modified by Ludwig Von Bertalanffy.

The mean score of the total caregiver burden before the intervention in the intervention and control groups was 71.16 ± 14.42 and 74.47 ± 15.16, respectively. After the intervention, the mean score of the total care burden in the intervention and control groups changed to 57.21 ± 14.66 and 75.47 ± 13.94, respectively. Data analysis shows a significant decrease in the intervention group (P = 0.000).

The results showed that the Benson relaxation technique as a cheap and non-pharmacological method effectively reduces the caregiver burden in informal caregivers of cancer patients.

Prostate cancer is one of the most common cancers worldwide. The proper management of this cancer during the coronavirus disease 2019 (COVID-19) or similar outbreaks could be a serious challenge. Proper timing of surgery, radiotherapy, and other medical modalities are essential in providing the most effective treatment.

This systematic review aimed at evaluating the proper management of prostate cancer during the COVID-19 outbreak.

This study was conducted from 2019 to 2022. An internet search was conducted using the keywords: Diagnosis, management, radical prostatectomy, radiotherapy, hormone ablation therapy, chemotherapy and prostate cancer, and COVID-19. The visited databases included PubMed, Scopus, Web of Sciences, Google Scholar, and Scientific Information Database. The review was performed based on the preferred reporting items for a systematic review and meta-analyses (PRISMA) guidelines.

Postponing the biopsy for up to three months and adopting of non-invasive diagnostic methods were likely reasonable during the COVID-19 pandemic. Patients with cancer weremoreprone to severe injuries and weremorelikely to have serious complications. Surgery, radiation therapy, brachytherapy, palliative radiation, hormone ablation therapy, and chemotherapy were among the pre-institutional treatments that had to be performed according to medical protocols as well as health and professional guidelines.

It was recommended that the prostate cancer screening should not be performed for asymptomatic men during the COVID-19 outbreak. It was also suggested that the treatment should be performed in the shortest possible time and in the safest way.

The coronavirus disease 2019 (COVID-19) mainly causes pulmonary disease. However, extrapulmonary manifestations, which affect the gastrointestinal tract and hepatobiliary system, have been reported.

Here we reported a 4-year-old boy with acute lymphoblastic leukemia and abdominal pain who had acute necrotic pancreatitis secondary to COVID-19.

According to the COVID-19 epidemic, if drug-induced pancreatitis is ruled out, viral causes, especially COVID-19, should be considered.

The utilization of molecular techniques in detecting cancer has resulted in an improved prediction of outcomes. Oral squamous cell carcinoma (OSCC) is a prevalent illness that is frequently detected in its late stages. Therefore, finding molecular biomarkers that lead to the early detection of OSCC is of great importance.

This study aimed at evaluating the expression levels of long non-coding RNA (LncRNA) gastric carcinoma highly expressed transcript 1 (GHET1) and lncRNA ZXF2 in OSCC patients and their relationship with clinical pathology variables due to biomarker discovery and early diagnosis of OSCC.

Tissue sampling was performed after selecting 30 OSCC patients and 30 healthy individuals from Emam-Khomeini Hospital, Tehran, Iran. Then, RNA extraction and cDNA synthesis were performed from these samples, using the relevant kits and their quantity and quality were measured, using nanodrop and agarose gel electrophoresis, respectively. For molecular biomarker identification and validation, real-time PCR (RT-PCR) was utilized to assess the expression of lncRNA GHET1 and lncRNA ZXF2. Data analysis was done, using GraphPad prism V.8 software.

The results showed that the expressions of both lncRNA GHET1 and lncRNA ZXF2 in OSCC tumor tissue increased compared to normal tissue (P < 0.0001). Receiver operating characteristic (ROC) analysis indicated that lncRNA GHET1 and lncRNA ZXF2 have the capability to be employed as biomarkers for OSCC detection. However, no significant relationship was observed between lncRNA GHET1 and lncRNA ZXF2 expressions with clinicopathological variables such as tumor stage and grade as well as patients’ age.

LncRNA GHET1 and lncRNA ZXF2 have the potential to be used as biomarkers in the early detection of OSCC and evaluating their expression in clinical settings are recommended. The use of these biomarkers in the early detection of OSCC can prevent the high mortality rate of OSCC patients. In the current study, the important role of the studied lncRNAs in OSCC diagnosis was shown. However, further studies are needed to confirm this.

Cervical cancer is prevalent cancer among women that correct diagnosis has very important role in its treatment.

The aim of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in comparison with surgical staging. Also, we compared the accuracy of physical examination with surgical pathology.

This retrospective cross-sectional study was performed on women who had cervical cancer from the start of 2017 to the end of 2021. Age, tumor pathology report (squamous cell carcinoma, clear cell carcinoma, adenocarcinoma, and small cell carcinoma), stage of the tumor, involvement of vagina, uterine, and parametrium, cervical stroma invasion, mass size, pelvic and abductor lymph node metastasis were extracted from the patient’s data and all were evaluated. The pathology report was considered as the gold standard.

Eighty women with cervical cancer were evaluated and the mean age was 47.3 years. There was a statistically significant difference between the different prevalence of disease stages (P-value = 0.035) and also stage diagnosis between the three methods (P-value = 0.0004). The diagnostic accuracy of physical examination and MRI in terms of vaginal involvement, parametrium involvement, and uterine involvement were 97.5% and 98.7%; 98.7% and 96.2%; 94.9% and 93.6%; respectively.

Magnetic resonance imaging is a good method for the assessment of the clinical staging of cervical cancer and its accuracy is more than 94% in the diagnosis of different parts of cervical cancer involvement.

Liver cancer accounts for more than 700,000 deaths each year making it the third leading cause of cancer-related deaths worldwide. Late diagnosis of the disease is the reason behind most deaths. Driver mutations are genetic alterations in tumor cells, which are responsible for the development of liver cancer; therefore, the identification of genetic biomarkers is necessary for the prediction and early diagnosis of liver cancer.

The main objective of this study is to identify pathogenic alleles that may act as potential biomarkers for the prediction of liver cancer. It also identifies the role of novel genes in liver cancer that are not known to cause the disease.

The mutation data of non-coding variants were downloaded from the catalogue of somatic mutations in cancer (COSMIC) databases. Different bioinformatics tools were, then, used to retrieve mutations in liver cancer. The genetic alterations in hepatocellular carcinoma (HCC) were analyzed.

The present study successfully identified pathogenic alleles (consistent mutations) along with a set of novel genes that might be involved in the development of liver cancer. It identified non-coding mutations near human genes and transcription factor binding sites of HepG2 cells. This study also identified mutations near the genes that are involved in the Ras/MAFK signaling pathway of the Hepatitis B virus.

The pathogenic alleles identified in this study may provide targeted therapy for the treatment of liver cancer. The identification of novel genes may help to understand the progression of liver cancer at the molecular level. The identified driver mutations may act as potential biomarkers and therapeutic targets for early prediction and treatment of liver cancer.

There are diverse lesions originating from the paranasal sinuses and nasal cavity. Tobacco use, alcohol consumption, and malnutrition have been identified to play a role in the development of head and neck carcinomas. Recently, fungi and viruses have been recognized as potential causes of nasal cavity and paranasal tumors.

This study aimed at specifying the prevalence of Aspergillus andhumanpapillomavirus (HPV) infections in the epithelial tumors of nasal cavity and paranasal sinuses.

In this cross-sectional study, 57 paraffin-embedded tissue samples of malignant and benign lesions of the paranasal sinuses and nasal cavity were evaluated for the presence of Aspergillus and HPV DNA by nested polymerase chain reaction (nPCR) technique with specific primers.

Despite the absence of angular hyphae (acute angle) of the fungus on histopathological slides, overall, 10 (17.54%) out of 57 paraffin-embeddedsamples were found to be positive for Aspergillus species. However, HPV-DNAwas not found in any of the samples.

Our data suggest that fungal infections (especially aspergillosis) as an etiological factor can be contributed to the development of sinonasal cancer and, therefore, they should be considered in the management of patients with sinonasal cancer. In addition, PCR can provide an alternative to culture-dependent identification methods.

Acute radiodermatitis (ARD) is a common side effect of breast cancer radiotherapy. It includes erythema, burning sensation, swelling, epilation, desquamation, ulceration, or necrosis. So far, there has been no consensus about the best practice in preventing /treating ARD.

This is the first study to assess the efficacy of topical phenytoin in the prevention and treatment of ARD.

This prospective randomized double-blind trial was a placebo-controlled study. A total of 70 patients with breast cancer were included. They were referred for breast radiotherapy after radical mastectomy. Patients were randomly assigned to either the topical phenytoin or placebo group. Both ointments were applied twice and daily on affected areas of the chest. Acute radiodermatitis was evaluated every week, for 5 weeks, during radiotherapy. A blinded-to-treatment physician used the “(radiation therapy oncology group) RTOG dermatitis scoring” to do so.

During the first 3 weeks, ARD was neither severe (RTOG < 2) nor statistically different between the two treatment groups (P > 0.05). However, after the 3rd week, the ARD score was lower in phenytoin group than in the placebo group (P < 0.05).

Phenytoin topical ointment could postpone the occurrence and/or decrease the severity of ARDin patients with breast cancer.

Coronavirus disease 2019 (COVID-19) is a devastating viral pandemic infecting millions of people with a wide range of symptoms from fever to death. It has been suggested that immunocompromised patients are at a higher risk of severe disease, poor clinical outcomes, and mortality. However, these patients’ risk factors and COVID-19-related outcomes are not well characterized.

We evaluated the COVID-19-related outcomes among immunocompromised patients ranging from solid tumors, hematological malignancies, and HIV to autoimmune disease and transplant recipients who received immunosuppressive agents. We also aimed at finding risk factors related to mortality among immunocompromised patients with COVID-19.

This cross-sectional study was conducted in Khansari Hospital, Iran between March and November 2021. We included immunocompromised patients with nasal swab positive SARS-CoV-2 polymerase chain reaction (PCR) results in the study. Patient outcomes, including hospitalization ward and the mortality rate, were assessed till three months after COVID-19 infection were evaluated in all patients. Moreover, the relation between risk factors and the rate of the mortality rate was analyzed in immunocompromised patients with COVID-19.

A total number of 74 immunocompromised patients with solid tumors, hematologic malignancies, autoimmunediseases, acquired immunodeficiencies, and solid-organ transplant recipients were included in the study. Results indicated that the male gender and ICU hospitalization significantly increase the mortality risk. Surprisingly, chemotherapy is associated with a lower risk of mortality.

Identifying the risk factors can improve the decision-making on cancer patients’ management during the COVID- 19 infection. A further large cohort of patients would be required to identify risk factors relating to poor clinical outcomes and mortality rates in immunocompromised patients with COVID-19.

Cancer recurrence is an important care challenge for breast cancer survivors. It is necessary to understand and identify the barriers and facilitators that affect the decision to start retreatment by those facing breast cancer recurrence compared to factors affecting their decision to start the initial treatment, which is different.

This study is part of a qualitative study with a grounded theory approach, which was conducted to explain the facilitating and inhibiting factors affecting the decision to start retreatment in survivors of breast cancer recurrence, using a qualitative content analysis method.

This study was conducted based on the experiences of 16 patients with breast cancer recurrence and 2 oncologists to confirm the findings of the effective inhibiting and facilitating factors in patients’ decisions to start retreatment for breast cancer recurrence in one of the hospitals in Tehran, Iran. The samples were selected, using the purposeful sampling method trying to have maximum diversity. Data were collected through in-depth semi-structured telephone interviews from November 2020 to November 2021 and analyzed, using the conventional content analysis method following the Elo and Kyngas method, which includes 3 phases, including the preparation phase, the organizing phase, and the reporting phase. Credibility, transferability, dependability, confirmability, and authenticity were used for determining the trustworthiness of data.

Both groups of inhibiting and facilitating factors were divided into 5 categories, including individual factors, social factors, family factors, illness characteristics, and treatment-related factors. Also, each category included sub-categories in two groups of inhibiting and facilitating factors affecting the decision to start treatment again.

Based on the results of the present study, it is necessary to increase the awareness of patients with breast cancer by the treatment staff about the possibility of recurrence and to know the factors influencing their decision-making process to start retreatment. Nurses should play the role of advisors, educators, and supporters of the patients in this field.

Context:

 Lung cancer (LC) is one of the common diseases in the pulmonary system, which is defined as the uncontrolled growth of cells in the lung tissue.

The present investigation was conducted with the aim of the prevalence of LC in Iran by meta-analysis method.

In this meta-analysis study, the articles that were conducted to determine age-standardized incidence rates (ASRs) in the field of LC were included in the study. The inclusion criteria included determining the number of ASRs in Iranian LC patients, reporting the sample size in men and women groups, and publishing articles between 2000 and January 2023. Data were analyzed, using CMA software.

In this meta-analysis study, 889 articles were found in the initial search, and after the final search, 23 articles were included in the meta-analysis stage. Out of the 22 final articles, the prevalence of LC was 3.7% (95% CI, 2.6 - 5.3) in women and 7.1% (95% CI, 5.7 - 9) in males.

Considering that the incidence rate of LC in this study was high, it is essential to carry out necessary preventive interventions in this field.

Cancer disease is considered one of the basic health problems in the world, which threatens the health of human life. It causes numerous personal, family and social damages in physical, psychological, and social dimensions.

The present study aimed at investigating health literacy and cognitive dysfunction on the quality of life of cancer survivors to make better decisions for the daily functioning, quality of life, and work capacity of cancer survivors so that their lives can be spent with more peace and less stress.

With a descriptive correlational design, 350 cancer survivors of the Cancer Research Center of Shahid Beheshti University of Medical Sciences (Shohaday Tajrish Hospital) from September to November 2021, who had been treated for at least one year, volunteered online and in person. Cognitive failure (Broadbent et al., 1982), cancer health literacy test (Dumenci et al., 2014), and quality of life of adults surviving cancer (Avis et al, 2005).

Pearson correlation showed a negative relationship between cognitive dysfunction and quality of life; so, path analysis showed that 25% of the quality of life is explained by cognitive dysfunction, but cancer health literacy was not correlated with the quality of life of cancer survivors.

According to the findings, the optimization of cognitive functions after treatment was emphasized to increase the quality of life of cancer survivors.

Internal mammary lymph nodes (IMNs) are a potential site of metastasis for breast cancer. Targeting IMNs as part of a comprehensive regional nodal irradiation comes at the cost of higher unwanted doses to critical nearby organs at risk. Thus, the efficacy and safety of different radiotherapy techniques for the coverage of this area remain elusive.

We present a dosimetric comparison between partially wide tangents (PWT) and direct photon/electron (P/E) portals in terms of target volume coverage and normal tissue sparing.

Patients with left-sided breast cancer, who were referred to our clinic for post-lumpectomy or post-mastectomy radiotherapy, underwent computed tomography (CT) simulation. The left breast and IMNs, heart, lung, right breast, and esophagus were contoured. Dosimetric comparisons were based on dose-volume histograms (DVHs) generated for all of the aforementioned organs. A subgroup analysis was also performed based on patients’ type of surgical treatment.

A total of 30 patients (10 with breast conserving surgery and 20 with modified radical mastectomy) were included. The P/E plan provided a higher coverage of the left breast (P-value of CTV V105%: < 0.001) and IMNs with a P-value of 0.087 regarding the mean dose received by IMNs, and also less volume of the heart (P-value of Heart V30Gy: 0.021), and lungs (P-value of Lung V20Gy: 0.003) were irradiated. However, these advantages came at the cost of a higher dose to the esophagus and right breast and more hotspots compared to the PWT technique.

The P/E technique had advantages regarding target volume coverage and toxicity regardless of the type of surgery. Based on the results of this study, overall, the P/E portal is superior to the PWT for radiotherapy of breast cancer with internal mammary node inclusion. However, the appropriate treatment plan should be decided on a case-by-case basis.

Esophageal cancer is an invasive tumor with rapid growth and a poor prognosis. The annual incidence of esophageal cancer in the United States is 6 per 100 000 men and 1.6 per 100 000 women. This is different in the case of Iran, and the number of patients in the country is higher than in other countries. In this evaluation, the researchers present the experience with open Transhiatal Esophagectomy (Orringer) technique outcomes.

This study aimed at evaluating the Orringer technique and its complications in patients with esophageal cancer for 25 years at the Cancer Research Center of Shahid Beheshti University of Medical Sciences.

This is a descriptive study conducted from the beginning of 1988 to 2016. In this study, 114 patients with a mean age of 55 years and a gender classification of 60% male and 40% female were evaluated.

After resection, more than 98% of patients were in the T3 N1 - N3 stage. There were 4 mortalities: 2 were due to descending aorta tearing, 1 was due to tracheobronchial tearing, and 1 was pneumonia From 40 cases of pleural effusion, only 5 cases (12.5%) needed a thoracotomy tube. Only 2 patients needed intervention from 30 patients with dysphagia; 1 case was relieved by balloon dilatation and the other needed a free jejunal flap. Five-year survivals were 30% and 20% versus 48% and 23% in the neoadjuvant and non-neoadjuvant groups, respectively.

The present studyandother experiencesshowedthat non-radical surgery such as the Orringer technique is acceptable and compassable compared to radical surgery in 3 fields.

The genotypic distribution of human papillomavirus (HPV) needs to be determined with detail as it is an important issue when it comes to public health and preparing vaccines since the HPV type may be different in various areas.

This study aimed at reporting the frequency of HPV types among women in Sari in the north of Iran.

From 2018 October to 2019 April, 50 sterile swabs of vaginal and cervical discharge of women with genital warts, which were performed by a gynecologist, were examined to determine the prevalence of HPV genotyping by using polymerase chain reaction (PCR).

From 50 vaginal swab samples of patients with genital warts, the frequency distribution of types of HPV in women with genital warts included 5 patients (10.0%) with 2 high-risk serotypes as simultaneous serotypes 4% (16, 18), 4% (18, 35), 2% (66, 67), 1 patient (2%) HPV 33, 1 patient (2%) HPV 34, 1 patient (2%) 1 patient (2%) HPV 35, 2 patients (4%) HPV 66, 1 patient (2%) HPV 67, and 1 patient (2%) HPV 68.

Since HPV genotype varies in diverse areas, these results can be used for screening, management, and vaccination of the target population against the common types of virus in Sari.

Idiopathic Granulomatous Mastitis (IGM) is a benign disease; it can clinically and radiologically mimic the symptoms of breast cancer.

Due to the rare and limited number of studies in Iran, this study was designed and conducted to evaluate patients’ clinical characteristics and treatment management with IGM.

In this cross-sectional and retrospective descriptive-analytic study, we studied the medical records of 293 patients with IGM, such as demographic information, characteristics of breast lesions, type of treatment, complications, and their outcome, which were recorded in the Cancer Research Centers of Shahid Beheshti University of Medical Sciences (SBMU) from 2010 to 2019. The patients were contacted by telephone to visit clinically or collect additional information. Data were analyzed by SPSS software version 24.

The mean age of patients was 39.21 (ST = 8.29) years. Breast involvement in 236 cases (80.5%) was unilateral, and in 50 cases (17.1%), the involvement was Pere pri-Areola. The most common type of treatment was conservative therapy (analgesia + drainage) (178 cases, 60.8%), which was the primary treatment in our study; 66 patients (22.5%) received antibiotic therapy + analgesia + drainage, and 41(14%) cases received corticosteroid in addition to this treatment. Totally, 132 cases (79.5%) were completely cured with the performed treatments, 17 cases (5.8%) had a recurrence of symptoms, and 14.7% of the patients were still receiving treatment. Recurrence after 1 year in patients who had a longer duration of disease (more than 12 months) was higher than in those who had a shorter period (less than 12 months) (15.3% vs. 5.1%, P = 0.004). Also, the highest recurrence rate was in the group receiving corticosteroids compared to the group receiving the usual treatment and usual treatment plus antibiotics. This relationship was statistically significant (22.0% vs. 9 % and 6.1%, respectively, P = 0.032). Complications (scar or breast skin color change) were significantly higher in patients without a pregnancy history than in patients who had pregnancy (50.0% vs. 22.8%, P = 0.030). Also, these complications were significantly higher in patients who had a longer duration of disease (more than 12 months) than in shorter periods of disease (less than 12 months) (31.4% vs. 17.3%, P = 0.005).

The results of our study and its comparison with the results of other studies still emphasize the uncertainty of the etiology of IGM disease and its treatment, but to some extent, our study has shown that conservative treatment (drainage with analgesic drugs) is one of the best treatment options. Also, corticosteroid therapy is associated with a higher recurrence rate, but in some cases is necessary and recommended in many studies.

In recent decades, many long non-coding RNAs (lncRNAs) have been reported to play a prominent role in tumorigenesis and the progression of human cancers, including gastric cancer (GC), a leading cause of cancer death in Iranian men and women. Studies have demonstrated that thymopoietin antisense transcript 1 (TMPO-AS1) was upregulated in different cancers by acting as an oncogenic lncRNA.

This study aimed to evaluate the expression of lncRNA TMPO-AS1 in Iranian patients with GC.

In order to conduct the present study, 40 gastric tumor samples and 40 marginal noncancerous counterparts were collected. The characteristics of patients’ samples were recorded, and the TMPO-AS1 expression levels were evaluated by qRT-PCR analysis. The Cancer Genome Atlas (TCGA) data for TMPO-AS1 were used and analyzed through GEPIA and TANRIC online tools. Receiver operating characteristic (ROC) curve analysis was used to estimate the diagnostic value. Student t-test, one-way ANOVA, and chisquare test were accomplished via SPSS software.

Our data demonstrated that TMPO-AS1 was overexpressed in cancerous tissues compared to adjacent nonmalignant ones (P = 0.0076). None of the demographic and clinicopathological data were associated with TMPO-AS1 expression levels. The TCGA data demonstrated that TMPO-AS1 was upregulated in GC tissues in comparison to adjacent nonmalignant ones (P = 0.001). ROC curve analysis suggested that TMPO-AS1 expression levels could discriminate GC tumor tissues from normal ones (AUC = 0.699, P = 0.001).

Altogether, in our study, we demonstrated that lncRNA TMPO-AS1 may be considered a biomarker in Iranian patients with GC. However, further investigations are required to confirm the potential application of this lncRNA in diagnosis, prognosis, and therapeutic applications of GC.

Gastric cancer is one of the most common cancers among Iranian men and women.

The aim here was to investigate different histopathologic types and features of this cancer in association with selected prognostic variables.

A retrospective cross-sectional study was performed to reevaluate the pathologic samples of 100 cases of gastric cancer referred to Shohadaye Tajrish Hospital, Tehran, Iran from 2017 to 2022.

We evaluated 100 cases of gastric cancer in this study. They had a mean age of 62.4 ± 13.44 years old (range 28 - 84 years) and were mostly men (n = 66, 66 %). On histopathologic evaluation, tubular carcinoma was the most common type (n = 45, 45%). We found a statistically significant correlation between the histologic type and perineural invasion (P-value = 0.024), lymphovascular invasion (P-value < 0.001), tumoral involvement of surgical margin (P-value = 0.012 ), infiltration depth of the primary tumor (pT) (P-value = 0.049) , number of metastatic lymph nodes (pN) (P-value = < 0.001) , tumor location in the antrum (P-value=0.033) and body (P-value = 0.013) , and tumor size (P-value = 0.002 and P-value = 0.031 in small and large size groups respectively).

According to the findings, histologic type of gastric cancer correlates with perineural invasion, lymphovascular invasion, tumoral involvement of the surgical margin, pT, pN, and tumor location and size.

The present study evaluated purified protein derivative (PPD) changes based on mediastinal lymph node density.

This cross-sectional observational studywasperformedon130 patientswhowere referred toValiasrandAmirAl-Momenin Hospitals in Arak, Iran for a CT scan for non-infectious and non-tumor reasons. The gender of the patients was recorded, and they then underwent non-contrast CT, and their mediastinal lymph node density was measured and recorded based on the Hounsfield units. Patients were evaluated for changes in the tuberculin test. The induration diameter obtained from the tuberculin test was recorded for each individual. Data analysis was then carried out using SPSS software ver. 20.

There was a positive correlation between mediastinal lymph node density and tuberculin test induration diameter, so larger induration diameter in the tuberculin test results in increasing lymph node density result (r = 0.416, P < 0.001). There was a negative correlation between mediastinal lymph node density and age, i.e., mediastinal lymph node density decreased with increasing age (P < 0.001, r = -0.616). Lymph node density was higher in men than in women (P = 0.022).

There is a positive correlation between the mediastinal lymph node density and the tuberculin test induration diameter, and the tuberculin test induration diameter increases with increasing lymph node density. There is a negative correlation between the mediastinal lymph node density and age, i.e., the mediastinal lymph node density decreases with increasing age. Lymph node density was also higher in men than in women. Therefore, the results can help ensure an earlier diagnosis of pulmonary tuberculosis, and measuring the mediastinal lymph node density is recommended.

 The algorithmic classification of infected and healthy individuals by gene expression has been a topic of interest to researchers in numerous domains, including cancer. Several studies have presented numerous solutions, such as neural networks and support vector machines (SVMs), to classify a diverse range of cancer cases. Such classifications have provided some degrees of accuracy, which highly depend on optimization approaches and suitable kernels.

 This study aimed at proposing a method to classify cancer-prone and healthy cases under breast cancer and colorectal cancer (CRC), using machine learning methods efficiently, increasing the accuracy of the classification process.

 This study presented an algorithm to diagnose individuals prone to breast cancer and CRC. The novelty of this algorithm lies in its suitable kernel and the feature extraction approach. By the application of this algorithm, this study first identified the genes closely associated with these types of cancers and, then, tried to find individuals susceptible to the concerned cancers using SVM. The present study highlighted the indirect gene expressions associated with these cancers, which might show health status complications for the patients. To this end, the algorithm consists of SVMs in conjunction with the k-fold method for validation.

 The results confirmed the superior performance of this approach, compared to the common neural networks. The algorithm’s identification accuracy values were 98.077% and 99.806% for breast cancer and CRC, respectively. The graphic representation of the cause-effect relationships was also provided to help researchers better understand the trend of cancer or other types of diseases.

 The feature extraction method highly affects the accuracy of the classification. In addition, relying on indirect disease-triggering genes’ expressions highlights a cause-effect relationship between genes and diseases. Such relationships can form Markov models in the clinical domain leading to treatment paths and prediction of patient outcomes.

Context: 

Existential guilt is an important concept in cancer patients. However, the literature shows that the components of this concept are not well defined and specified. Hence, this study aimed at enhancing understanding of the characteristics of existential guilt and its differentiation from other similar concepts in the field of cancer.

Evidence Acquisition: 

Focusing on cancer patients, Walker & Avant's approach was followed to clarify and analyze the concept of existential guilt. So, Web of Sciences (ISI), PubMed, ProQuest, Scopus, PsycINFO databases, and Google Scholar were searched, using 'existential guilt', 'guilt', and 'cancer' keywords to identify relevant studies with no time limitation. After screening and evaluation, 58 articles were identified, of which 26 were analyzed.

 Initially, definitions, characteristics, antecedents, and consequences of the existential guilt concept were introduced. Then, a case model was explained to create a more clarified understanding of the concept and, eventually, some implications for the approach to cancer patients were proposed.

 The existence of different definitions and separate research pathways about the concept of existential guilt may indicate a sense of scatteredness. However, as shown in this study, one can come to a widely accepted understanding as well as a differential understanding of this concept; this clarification can, in turn, result in efficient and comprehensive psychological attention to cancer patients. Indeed, this concept analysis can pave the way for clinical interventions, operationalization, and research on this topic and population

Context:

 One of the most common cancers in men is prostate cancer, which can lead to death. Immune checkpoint inhibitors (ICIs) are drugs that have been proposed in recent years as proposed treatments for prostate cancer.

 The aim of this study was to review the efficacy and tolerability of ICIs in these patients.
Data Sources: From January 1, 1990, to January 1, 2022, using the keywords in checkpoint inhibitors, prostate cancer, efficacy, and tolerability, systematically reviewed databases such as PubMed, ClinicalTrial.gov, Web of Science, Scopus, Cochrane Library, ScienceDirect and Google Scholar based on the protocol registered in Prospero were identified as CRD42021252562.

 Out of 690 studies found, 43 studies were reviewed for evaluation in terms of inclusion criteria, and finally 6 studies were included in the design. In the analysis of selected studies, 1 800 patients were studied, and the range of sample size was from 23 to 799. According to the results of the meta-analysis, there was no significant difference in death risk compared to ICI + radiotherapy with radiotherapy + placebo (HR: 0.96, 95% CI: 0.74, 1.23, P = 0.74). Combined results from 2 clinical trials demonstrated that the risk of death in the radiotherapy + ICI group was less than in the group just treated with radiotherapy (HR: 0.69, 95% CI: 0.61, 0.77, (P < 0.001), 0.77, P < 0.001). To evaluate tolerability, the results showed a non-significant difference between the groups considering the overall prevalence of treatment-related side effects (RR: 1.59, 95% CI: 0.75, 3.39, I2 = 98%).

 The present meta-analysis showed that the use of safety checkpoint inhibitors has been associated with improved survival without progression, but their effect on increasing overall survival has not been confirmed.

Context: 

The accuracy of narrow-band imaging (NBI) is a technology imaging for the assessment of lung cancer.

 We aimed at summarizing the diagnostic profile of NBI for the early diagnosis of airway cancer lesions.

 We used PubMed, Scopus, and EMBASE databases to search for eligible studies published up to October 2022. Eligible studies have investigated the diagnostic profile of bronchoscopy NBI for the early diagnosis of lung cancer. The index test was NBI bronchoscopy, and the reference test was the histopathological results of lung cancer based on the World Health Organization (WHO) classification. In eligible studies, the detected lesions were confirmed by histopathology. We extracted true positive (TP), true negative (TN), false positive (FP), and false negative (FN) from the eligible studies to calculate the diagnostic profile of NBI. the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) assessment was used as a tool to assess the risk of bias. A random-effects model was used to pool the summary receiver operating characteristic curve, specificity, and sensitivity.

 Five studies were included, involving 1267 subjects with 1850 biopsy specimens. The overall pooled sensitivity and specificity for NBI bronchoscopy for the early detection of airway cancer lesions were 98% (95% confidence interval [CI]: 89% - 100%) and 77% (95% CI: 62% - 88%), respectively. All I2 values for sensitivity and specificity were 35.93% and 85%, respectively, with a P-value of 0.001. The positive LR was 4.35 (95% CI: 2.51 - 7.54, P < 0.001), and the negative LR was 0.03 (95% CI: 0.01 - 0.14, P = 0.006). The area under the receiver operating characteristic curve was 0.95 (95% CI: 0.92 - 0.96).

 Narrow-band imaging bronchoscopy can be used as a diagnostic modality for the early diagnosis of airway cancer lesions with good diagnostic accuracy.
Keywords

 Bladder cancer is one of the most common cancers worldwide and also in Iran. Understanding of bladder cancer epidemiology is of great value for policymakers and assists in the prevention and early detection of the disease.

 The aim of the present study was to report national and subnational incidence trends of bladder cancer in Iran between 2003 and 2015.

 This study investigated the age-standardized incidence rates (ASIRs) per annum of bladder cancer from 2003 to 2015 in Iran using the data from the cancer registration system of the Ministry of Health and Medical Education of Iran. The crude incidence rates were calculated by dividing incident cases by the country and province population, which were provided by the Statistic Center of Iran. Age standardization was performed using the WHO standard population, and ASIRs were compared by age, sex, and province.

 The ASIR of bladder cancer increased from 8.35 in 2003 to 13.57 in 2015 in men. The ASIR of bladder cancer also showed a mild increase in females, 2.12 in 2003 versus 2.86 in 2015. The province of Yazd had the highest rate of bladder cancer in men, and West Azerbaijan had the highest rate for women (15.13 and 7.79 per 100,000), while Sistan va Baluchestan and Ilam had the lowest ASIRs for men and women (3.01 and 0.96 per 100,000, respectively).

 The increasing trend of bladder cancer incidence in Iran, despite the clear decreasing global trend accompanying to ongoing aging of the population highlights the diseases as a potential health problem in the upcoming years in Iran. Therefore, it is necessary for health organizations to implement effective research and control programs in the country to prevent further increases in disease burden.

 Colorectal cancer (CC) is one of the most important causes of death due to cancer in the world. The association of blood groups with CC in many races has been reported in previous studies. So far, no study has evaluated the relationship between blood group type, tumor location, and polyp type.

 This study aimed at evaluating the association of the ABO blood group and CC, tumor location, and polyp type.

 In this case-control study, 802 subjects (401 cases and 401 controls), who underwent surgery at our medical centers between 2014 and 2021, were included. The case group was selected from the hospital records of patients with CC, and the controls were selected from non-cancer patients who were admitted to the same centers for reasons other than cancer. Patients’ demographic characteristics and clinical and pathology findings were extracted from the medical profile, and blood group information was extracted from the blood bank. Multivariate logistic regression analysis was used for the predictive variables of CC.

 The risk of CC in patients with blood type A was significantly higher than non-A. While the risk of developing CC in patients with blood type O was significantly lower than non-O O. The risk of developing neoplastic polyps was significantly higher in patients with blood type A compared to non-A. The results of multivariate analysis showed that ABO blood type A (OR Adju: 1.66) and O (OR Adju: 0.78) and neoplastic polyp type (OR Adju: 1.36) were associated with CC.

 The results of this study showed that ABO blood group type was significantly related to CC and polyp type.

 The aim of this study was to evaluate and analyze disease-free survival (DFS) and overall survival (OS) after intensity-modulated radiotherapy (IMRT) for Iranian patients with nasopharyngeal carcinoma (NC).

 In this historical cohort study, 65 non-metastatic patients treated for NC with IMRT were selected and reviewed at the Shohadai-e-Tajrish Hospital between October 2017 and October 2019. Chemotherapy was given either as induction, concurrent, or adjuvant therapy in all cases. Three years of DFS and OS were calculated according to Kaplan-Meier and compared with the Pearson Correlation Test.

 The mean age of patients was 43.38 years. The three-year DFS and OS rates were 95.72%, 92.32%, 72.73%, 73.26%, and 100%, 84.61%, 90.90%, and 79.41% in stage I, II, III, and IV patients, respectively (P = 0.119, P = 0.155). The total three-year DFS rate and the total three-year OS rate were 76.47% and 84.60% in all cases. Based on the Pearson Correlation Test, it was a significant correlation between the duration of IMRT time and three-year DFS (correlation=0.138, P = 0.017) and the number of concurrent cycles of chemotherapy with IMRT (correlation=0.375, P = 0.002). It was not a significant correlation between total time duration, MRI response, induction chemotherapy, age, sex, and the three-year DFS. There was a significant correlation between total time duration and three-year OS (correlation=0.263, P = 0.040) and the number of concurrent cycles of chemotherapy with IMRT and three-year OS (correlation=0.334, P = 0.007). It was not a significant correlation between the duration of IMRT time, MRI response, induction chemotherapy, age, sex, and the three-year OS.

 Our findings showed that IMRT with concurrent chemo-radiotherapy has the three-year DFS and OS, which were comparable with the other published results. We emphasize the number of concurrent cycles of chemotherapy with IMRT, which have an important role in both three-year DFS and OS. The duration of IMRT time has also an important role in the three-year DFS but not in the three-year OS. A longer follow-up for the patients to evaluate 10-year DFS and OS is recommended.

 Despite the high prevalence of head and neck cancers in Iran, no studies have been conducted to investigate the relationship between vitamin D levels and these cancers. Many Iranians suffer from vitamin D deficiency, which underscores the importance of conducting these studies in Iran.

 This study aims at investigating the relationship between vitamin D levels and laryngeal cancer.

 This 1: 1 matched case-control study included 216 patients in Mashhad, Iran, who had not consumed vitamin D supplements for 3-months before study onset. Participants were grouped in 2 categories; the case group, which consisted of patients with laryngeal cancer whose squamous cell carcinoma was confirmed pathologically for the first time (new cases), and the control group, which consisted of individuals who did not have any cancer at the time of the study, confirmed by indirect laryngoscopy, and were identical to the patient group in terms of other risk factors for laryngeal cancer (smoking and alcohol abuse). First, the relevant checklist (including age, occupation, consumption of tobacco, alcohol use, etc., history of contact with mustard gas, wood, stone, metal, and cement industry, as well as history of reflux in the individual and cancer in relatives) was completed for all case and control group members. After taking blood samples, they were evaluated for serum levels of vitamin D3. Data were analyzed using chi-square, Mann-Whitney U or independent sample t-tests. Logistic regression was also used to determine the relation between vitamin D level and laryngeal cancer.

 Mean age, sex and risk factors of laryngeal cancer were not significantly different between the two groups. Vitamin D level was significantly lower in patients with laryngeal cancer compared to control group (16.02 ± 3.62 ng/mL vs 25.19 ± 3.40 (P < 0.001)). Logistic regression analysis showed that vitamin D level is independently related to laryngeal cancer and has a protective effect on this neoplasm (OR = 0.54, 95%CI: 0.46 - 0.63, P < 0.001).

 A lower vitamin D level may be related to laryngeal cancer. However, the role of vitamin D deficiency as a risk factor for head and neck cancers and whether the treatment of this condition could prevent the incidence of such cancers is a matter of future investigations.

 Breast cancer is still a major contributing factor to the burden of the disease worldwide. A single-stage implant-based reconstruction (IBR) lowers tissue morbidity, thus increasing overall aesthetic outcome and patient satisfaction.

 Because of the high price of ADM and the lack of insurance coverage in Iran, we aimed at examining the results of using TIGR® mesh in patients with breast cancer.

 This quasi-experimental study was conducted in Iran (Tehran) from 2016 to 2018. About 140 eligible patients with breast cancer were included and their information was collected and analyzed prospectively during the 3 years that they were referred to the surgery center in Tehran. The reconstruction was performed, as either direct-single staged, implant + TIGR MESH, or delayed-multistage. Patient satisfaction was calculated after 1 year of follow-up, using Body Checking Questionnaire (BCQ) by applying the VAS scale. All statistical analyses were performed at a 95% significance level, using SPSS statistical software version. (Evidence-based medicine level: Level III, a prospective cohort).

 The results of our study showed slightly more short-term complications than other studies due to the surgical team’s first experience in the surgery. Complications were infection (7.1%), epidermal necrosis (15.9%), and severe capsular contracture (14.2%). Seven patients (6.2%) had full-thickness skin necrosis, and the prosthesis was finally removed. The use of the TIGR Mesh did not increase the rate of complications, and only 5 implant losses in this group and 2 in the tissue expander group were reported. The levels of patients’ satisfaction in IBR and delayed-multistage groups were 44.4% and 12.7%, respectively.

 Our results showed that placement of TIGR MESH for lower pole support during IBR does not increase the complication rate. Additionally, patients’ satisfaction levels increased compared to traditional methods of reconstruction.

 Hematologic malignancies are the fifth most common malignancies worldwide. Pulmonary symptoms are among the patient’s common complaints. Early diagnosis based on patient symptoms, laboratory testing, and imaging may lead to an appropriate therapeutic approach.

 To evaluate thoracic computed tomography (CT) scan findings in known cases of hematologic malignancy with acute respiratory symptoms.

 A cross-sectional study was conducted on 200 patients with hematologic malignancies admitted to Khansari cancer center for acute pulmonary symptoms, from December 2019 to May 2020. Collected data included demographic data, physical examination, laboratory tests and findings of thoracic CT images. Descriptive analysis and chi-Square test were performed to analyze the data using SPSS version 20.

 Non-Hodgkin lymphoma was the most common malignancy, accounting for 48% of total cases. The most common radiological findings included atelectasis (49%), followed by pleural effusion (42%), mediastinal lymphadenopathy (38.5%), consolidation (37%), and ground-glass opacities (33.5%). Mediastinal lymphadenopathy was more prevalent in patients diagnosed with lymphoma. Among pulmonary pathologies, pneumonia was the most prevalent disease (41.5%), followed by small airway disease (13.5%), mediastinal lymphadenopathy (12.5%), chronic pulmonary disease (6.5%), and pulmonary metastasis (6%). Normal thoracic CT scan was detected in 20% of participants. Overall assessment of clinical symptoms, laboratory tests, and imaging findings did not lead to the diagnosis of acute lung involvement in 5.5% of study participants, because complete clinical data were not available in some participants.

 Assessment of the most common thoracic imaging findings in patients diagnosed with hematologic malignancies, may help make better diagnosis and planning of a rapid therapeutic approach.

 Breast cancer (BC) is a leading cause of cancer-related deaths among women worldwide, and its incidence has increased in Iran over recent years.

 In this study, we aimed at assessing the completeness of BC pathology reports in the population-based cancer registration system and perform a spatial analysis of the incidence of this cancer in Iran in 2016 to help policymakers develop targeted interventions.

 We conducted a retrospective descriptive analysis, using secondary data from the Integrated Cancer Information Management System, and obtained 13789 BC pathology reports from all provinces in Iran in 2016. Pathology data, including tumor type, tumor site, tumor size, pathologic T stage, pathologic N stage, and tumor grade were examined for completeness by age group.

 Pathology reports from 4000 women with BC in 2016 from across all provinces of Iran were selected for this study. The completeness of tumor type, tumor site, tumor size, pathologic T stage, pathologic N stage, and tumor grade increased with aging. In addition, the completeness of pathology reports varied across different variables. Accordingly, the tumor grade and pathologic T stage had the highest and lowest completeness rates (100 % versus 27.4%), respectively. Spatial analysis revealed significant high-risk areas for BC incidence, including Isfahan, Markazi, Chaharmahal and Bakhtiari, and Kohgiluyeh and Boyer-Ahmad provinces in central Iran. In contrast, North Khorasan was identified as a low-risk area.

 Considering the incompleteness of the pathology report in most of the tumor variables in the BC registry, we recognize the gaps to improve pathology data. To ensure effective interventions for BC control, tailored preventive measures are needed, particularly for high-risk areas. Continuous evaluation and data completion, including standard cellular pathology reports, are necessary for accurate BC control in Iran.

 Prostate cancer (PC) is one of the most common cancers worldwide. Recently, multiparametric magnetic resonance imaging (mpMRI) has been used to diagnose PC in suspected patients. Prostate Imaging Reporting & Data System (PI-RADS) was developed and applied as a criterion for detecting lesions suspicious of PC. Various studies have been conducted to determine the negative predictive value of non-suspicious mpMRI (PI-RADS 1 or 2). However, the results of these studies have been limited and different.

 This study was conducted to determine the PC rate in patients with PI-RADS 2 lesions in mpMRI and the factors related to clinically significant prostate cancer (CsPC) diagnosis in these lesions.

 By referring to the archive department of Shahada-e-Tajrish, Rasul-e-Akram, Treata, and Payambaran hospitals, among the patients suspected of PC who underwent biopsy and had elevated prostate-specific antigen (PSA) serum levels, the prostate biopsy samples of 330 patients were consecutively included in the study. Frequency of samples diagnosed with PC and its histological characteristics, including mass location, Gleason score (GS), Gleason group (GG), percentage of G4 and G5 cells, sample size, percentage of involvement of sample with cancer tissue, and invasion to the surrounding tissues were examined. Adenocarcinoma samples were divided into low-risk, intermediate-to-high-risk groups based on D'Amico criteria and the relationship between age, PSA total (PSAt), PSA density (PSAd), prostate volume, and the presence of a PI-RADS 3 or 4 lesion at the same time with the rate of diagnosed CsPCs were reviewed.

 The data from 709 tissue samples were collected, among which 249 were from the right inner part, 249 were from the left inner part, and 211 biopsy samples were from the peripheral portion of the prostate. Among these, 390 tissue samples in mpMRI studies were PI-RADS 2, and 319 were PI-RADS 3 or 4. The mean age of the patients was 64.78 ± 37.55. The mean PSAd, PSAt, and prostate volume were 0.15 ± 0.11, 8.73 ± 6.43, and 61.18 ± 25.76, respectively. Seventy-five samples were diagnosed with adenocarcinoma, of which 48% are in PI-RADS group 2, and 52% are in PI-RADS group 3 - 4 (P-value = 0.263). Comparing the histological characteristics of adenocarcinoma samples between the two groups showed that only the amount of GG was significantly higher in the samples with PI-RADS 3 and 4 (P-value = 0.035). Adenocarcinomas diagnosed in 72.2% of cases in PI-RADS 2 samples and 84.6% of PI-RADS 3 and 4 samples were clinically significant, and no significant difference was seen between the two groups (P-value = 0.38). The amount of PSAt in PI-RADS 2 adenocarcinoma samples was significantly higher in clinically significant carcinomas than in low-risk carcinomas (P-value = 0.045).

 The results of the present study showed that PI-RADS 2 lesions should be considered for biopsy when there is clinical suspicion of PC. PSA levels can effectively determine the need for biopsy in PI-RADS 2 lesions.

 The radiation resistance process is a major problem in radiotherapy. Proteomics is a useful method to determine the molecular mechanism of biological and medical events. Protein-protein interaction (PPI) network is a suitable method for proteomics data interpretation.

 Assessment of proteomics data about the radiation resistance process in human cell lines via PPI network analysis is the aim of this study.

 Proteomic data were extracted from literature and the differentially expressed proteins (DEPs) were included in the PPI network via the STRING database by Cytoscape software. The network was analyzed and the central nodes were introduced. The central nodes were assessed via action map analysis and gene ontology enrichment.

 Among the 251 queried DEPs, 171 individuals were included in the PPI network. Epidermal growth factor receptor (EGFR), fibronectin (FN1), CD44 antigen (CD44), prostaglandin G/H synthase 2 (PTGS2), CD44 antigen (CD44), prostaglandin G/H synthase 2 (PTGS2), NF-kappa-B inhibitor alpha (NFKBIA), Kelch-like ECH-associated protein 1 (KEAP1), cathepsin D (CTSD), D-3-phosphoglycerate dehydrogenase (PHGD), and 5-nucleotidase (NT5E) were introduced as the critical DEPs. Eight groups of biological terms were attributed to the introduced critical DEPs. EGFR, FN1, CD44, and PTGS2 were discriminated among the critical DEPs as the key dysregulated proteins.

 The results indicate that EGFR, FN1, CD44, and PTGS2 are the four essential proteins that are involved in radiation resistance in the radioresistant cells.

 Colon cancer is the most common gastrointestinal malignancy worldwide and accounts for more than half of all gastrointestinal tumors, with over 1 million new cases and 500 000 deaths per year.

 The purpose of our study was to compare the outcomes of laparoscopic surgery and open surgery for colon cancer surgery by evaluating the lymph nodes. It is crucial to remove an adequate number of lymph nodes, as a more extensive nodal removal has been associated with higher survival rates and fewer relapses.

 This prospective study was conducted on 120 patients (57 females and 63 males) with colon cancer, who were registered and analyzed in our unit from 2019 to 2021. Of these patients, 78 underwent open surgery and 42 underwent laparoscopic surgery. A checklist comprising 8 variables including postoperative pain, length of hospital stay, site infection during the first 30 days, number of lymph nodes removed in pathology, hemoglobin drop, anastomotic leak, urinary tract injury, and time of operation was completed for all patients. SPSS version 21 software was used for data analysis, and a P-value less than 0.05 was considered significant.

 The age of the patients was between 30 to 60 years. The variables of site infection during the first 30 days (P = 0.7), anastomotic leak complication (P = 0.5), urinary tract injury (P = 0.02), and number of lymph nodes removed (P = 0.13) were not statistically significant between the two groups of laparoscopic surgery and open surgery. However, the variables of duration of operation (P < 0.05), decrease in hemoglobin of postoperative patients compared to preoperative (P < 0.05), severe postoperative pain (P < 0.05), and number of days of hospital stay (P < 0.05) between the groups of laparoscopic surgery and open surgery were statistically significant.

 Our experience suggests that laparoscopic colectomy is a safe and feasible procedure with better short-term outcomes and comparable oncological efficacy to the open approach.

 Thyroid lymphomas are a rare finding among thyroid malignancies, and Chronic Lymphocytic B-cell (CLL-B) type of thyroid lymphoma is even more infrequent. Lymphomas compose only 2% of thyroid malignancies, with primary thyroid lymphomas constituting only 2.5% of all lymphomas. Chronic lymphocytic B-cell (CLL-B) type of thyroid lymphoma (CLL-B) is is exceptionally rare, with only 4% of cases ever reported worldwide.

 A 55-year-old female presented with a complaint of swelling over the anterior part of neck. She had a pre-existing diagnosis of CLL, fine needle aspiration biopsy (FNAB)of the swelling revealed lymphocytic proliferation, classified as Bethesda grade II. The patients was in a euthyroid state and a ‘core-needle’ biopsy was performed to confirm the diagnosis of lymphocytic infiltration of the thyroid. The patient was managed conservatively and is currently under regular follow-up.

 The occurrence of thyroid swelling in CLL is a rare phenomenon, and confirming the diagnosis through biopsy is recommended. Surgeons should be cautious not to be deceived by the rarity of the swelling and avoid unnecessary surgical interventions. Conservative management has been the prevailing approach in the literature. This case report serves to support this conservative approach and contributes to the existing literature on Thyroid lymphoma due to CLL.

Context: 

Advanced cancer is one of the most complicated conditions for both patients and their relatives. This study aimed at investigating the challenges of home parenteral nutrition (HPN) in patients with advanced cancer.

Evidence Acquisition:

 In this study, all articles published in English from 2000 to 2022 on dietary support for HPN in patients with advanced cancer were collected from several databases, including Medline, Scopus, and Google Scholar, using related keywords such as “advanced cancer” and “home parenteral nutrition”.

 The different issues of HPN were examined for different dimensions such as HPN during palliative care, deciding HPN, patients’ safety, supportive environment, and health literacy. Regarding ethical issues on HPN, 4 principles including charity, autonomy, harmlessness, and justice should be considered in patients with advanced cancer. Considering recent findings on the beneficial effects of nutrients in patients with advanced cancer, there may be a need to revise the guidelines related to parenteral nutrition support in these patients.

 Different challenges should be especially considered in adopting appropriate approaches in the field of HPN in patients with advanced cancer. More longitudinal studies in this field are needed.

 Multiple myeloma (MM) management includes primary chemotherapy, followed by autologous bone marrow transplantation (ABMT) if the bone marrow gets cleared of cancerous cells. In some cases disease relapse may occur if complete clearance is not achieved. Transplantation was primarily performed through the bone marrow; however, peripheral blood has become more favored due to its safety and convenient collection in case of appropriate bone marrow mobilization which is a challenging issue.

 The current study was aimed to investigate the effectiveness of desipramine application for bone marrow mobilization in multiple myeloma (MM) who were candidate for autologous bone marrow transplantation (ABMT).

 The current randomized clinical trial involved 122 MM patients who were candidate for ABMT. The participants were divided into two intervention groups: the first group (n = 63) received G-CSF only treatment, while the second group (n = 59) received a similar G-CSF treatment plus desipramine. The first group received 30 microgram intravenous G-CSF for five days and the second one was treated with G-CSF with similar pattern in combination with daily 100 mg desipramine initiated within three days before G-CSF treatment and continued until the last dose of G-CSF. CD34+ cells and complete blood cells and differentiation were assessed by the end of the interventions.

 The findings of the study show that the number of CD34+ cells, white blood cells (WBC) and platelet (PLT) count were remarkably higher among the patients receiving the combination therapy compared to the G-CSF only treated group (P-value < 0.001) within 5 days after the interventions; however, no significant differences were observed between the two groups when considering the stage of the disease and the frequency of chemotherapy sessions (P-value > 0.05).

 Desipramine application led to significantly increased levels of CD34+ cells as the representatives of bone marrow mobilization. Besides, the patients treated with this regimen had higher serum levels of WBC and PLT; however, the disease stage and the number of chemotherapy sessions did not affect the response to the treatment.

 With advances in healthcare options for the medical management of breast cancer, treatment decision-making has become more complex.

 Guided by self-efficacy theory, the study investigated the impact of a question prompt list (QPL) on decision-making outcomes among women with breast cancer in Iran who were post-surgery.

 A randomized controlled trial was conducted at a comprehensive cancer center in Tehran, Iran. Fifty patients were randomized to either a QPL with usual care (n = 25) or to a usual care (n = 25) condition. Data were collected pre- and post-treatment utilizing: 9-item Shared Decision-Making Questionnaire; Decision Self-efficacy Scale; and the Control Preferences Scale. Utilizing SPSS 26 software, descriptive, Shapiro-Wilk test, independent t-test, Fisher's Exact test, and Mann-Whitney U test were used.

 No differences between the usual care and QPL groups on major study constructs were found (P > 0.05).

 The QPL did not impact various decision-making outcomes among women with breast cancer post-surgery. Cross-cultural research is needed with larger samples to further examine the impact of decision aids such as QPL on decision-making outcomes for women with breast cancer.

 Cancer management has become increasingly challenging due to the emergence of a personalized approach that requires careful assessment, multidisciplinary efforts, and experienced physicians.

 Because of the COVID-19 pandemic’s effect on executing all medical meetings as well as multidisciplinary tumor boards (MTB), we decided to design, perform, and evaluate a teaching scholarship in virtual MTB for urologic cancer patients.

 In this prospective study from December 2020 to July 2022, the authors evaluated the designing, implementation, and learning efficacy of a virtual tumor board in the Urology Department of Shahid Beheshti University of Medical Sciences (SBMU). All the faculty members (N = 25) and urology residents (N = 35) were included in this investigation. To make the sessions multidisciplinary, other related departments including pathology, radio-oncology, medical oncology, radiology, and nuclear medicine were also included. Virtual tumor boards were implanted monthly in 20 sessions.

 A short interview was conducted for the needs assessment. The faculty members' and residents’ statements were divided into high, intermediate, and low importance. After implementation, a satisfaction questionnaire based on the first level of the Kirkpatrick model was recorded and the means were 76% and 71% in faculty members and residents respectively for virtual execution. The results of evaluating the intervention according to the second level of the Kirkpatrick model and through the tests before and after tumor boards were recorded and the mean differences evaluated by paired t test were statistically significant. In the last step for external evaluation, the satisfaction rate of 5 arbitrators was 75% for executing a proper virtual MTB.

 A virtual board is an effective learning method for the medical education of urology residents. It could help the practitioner to coordinate and discuss with different specialties and lead to the best decision for urologic cancer patients.

 Gastric cancer (GC) is a leading cause of cancer-related deaths, emphasizing the importance of timely diagnosis for effective treatment. Machine learning models have shown promise in assisting with GC diagnosis.

 This study aimed at comparing the performance of various feature selection methods in identifying influential factors related to GC based on lifestyle using machine learning models. The ultimate goal was to enhance early detection and treatment of the disease.

 The data of patients from Shahid Ayatollah Modarres Hospital and Shohadaye Tajrish Hospital between 2013 and 2021 were utilized. Three feature selection methods (filter, wrapper, and filter-wrapper) were employed. The k-fold method validated each model. Four classifiers k Nearest Neighbor (kNN), Decision Tree (DT), Random Forest (RF), and Gradient-Boosted Decision Trees (GBDT) compared their outputs based on feature selection methods.

 The filter-wrapper method outperformed others, achieving an area under the ROC curve and F1 score of 95.8% and 94.7%, respectively. GBDT also performed well. The wrapper and RF classifiers achieved an area under the ROC curve and F1 scores of 95.7% and 93.6%, respectively, after the filter-wrapper method. Without feature selection methods, the RF classifier had an area under the ROC curve and F1 scores of 95.6% and 91.7%, respectively, surpassing other classifiers.

 This study suggests that appropriate feature selection methods for identifying influential factors related to GC based on lifestyle can facilitate early diagnosis and treatment. The filter-wrapper method demonstrated the best performance in this regard.

Context: 

There are several neoadjuvant treatment strategies for HER2-positive breast cancer (BC). Studies have investigated different aspects of these strategies and presented different findings.

 This study aimed at collecting and interpreting economic evaluation studies related to neoadjuvant treatment strategies for HER2-positive BC.

 In this systematic review, PubMed, Web of Science (WOS), ScienceDirect, and Scopus databases were searched without a time limit between May and October 2023. Google Scholar search engine was also used to complete the search process. Two authors independently determined the eligibility of the study. To assess the quality of the studies, the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines were used. Disagreements were resolved by discussion or consultation with a third researcher. As this review is descriptive, numerical data were not extracted for statistical analysis.

 Out of 234 studies found in the first stage, 21 studies from 14 countries were included. The strategies that have been approved by studies include THP (taxol, trastuzumab, pertuzumab), PTD (Pertuzumab in combination with trastuzumab and docetaxel), TH (docetaxel and trastuzumab), T-DM1 (trastuzumab emtansine), and HP (trastuzumab plus pertuzumab).

 The findings of this systematic review show that the reported strategies in the treatment of HER2-positive BC patients are cost-effective in different settings. While the findings of this review provide largely positive results, the characteristics of each strategy should be considered.

 Antibody is a considerable approach in the pharmaceutical industry, and many studies have been done on antibody fragment engineering.

 The objective of this study is to evaluate the interaction between antigens and antibodies, which is a necessary step for designing an efficient antibody with suitable properties for targeting cancer cells.

 In the current study, the 3-dimensional structure of the displayed-selected scFv antibody was constructed, using Sabpred Antibody Builder. The analysis of interactions between scFv and Cluster of differentiation 24 (CD24) was performed by computational docking and molecular dynamics (MD) simulation. Firstly, docking CD24 antigen to the new scFv antibody was done, using the ClusPro 2.0 web server, and residues involved in the interaction were identified. Secondly, using the GROMACS 4.5.3 package, MD simulations were performed.

 By analyzing the antigen-antibody complex, the critical amino acids involved in these interactions were recognized. Thus, 15 hydrogen bonds between amino acids in light and heavy chains of antibodies and antigens were identified; most of the amino acids belonged to the complementarity-determining regions (CDRs) regions. Tyr148, which belongs to CDR1 of the VL chain by forming 4 hydrogen bonds with amino acids of the CD24 antigen, was considered an important amino acid in the CD24-scFv complex.

 Our bioinformatics study identified critical residues involved in antigen-antibody interaction, which could be considered an effective strategy for creating novel efficient fragmented antibodies with improved affinities for the CD24 receptor.

 Differentiating types of brain tumors using magnetic resonance imaging (MRI) as a non-invasive element is essential.

 The study aimed at evaluating the difference in the first-order histogram (FOH) features obtained from apparent diffusion coefficients (ADCs) between glioblastoma (GBM) tumors with or without oligodendroglial (ODG) components.

 MRIs were taken before surgical resection of the brain tumors. The brain lesions were analyzed and ADC maps were plotted to calculate FOH. Brain lesions were surgically removed, diagnosed using pathological methods, and categorized as GBM with an ODG (GBM-ODG) or without ODG. A comparison of ADC values was performed between GBM-ODG and GBM. Receiver-operator characteristic (ROC) curves were used to determine the cut-off sensitivity and specificity values.

 In the GBM group, 26 patients were included; 20 cases were male and 6 were female; the mean ± SD of age was 54.1 ± 1.2 and 55.2 ± 1.6 years, respectively. In the GBM-ODG group, 31 patients were included; 22 cases were male and 9 cases were female; the mean ± SD of 52.1 ± 0.8 and 55.3 ± 1.5 years, respectively. The results of peritumoral edema had several significant FOHs. In the MRIs of tumor and T1W groups, the third moment and minimum-ADC had significant results, respectively. Cut-off values of the FOHs were statistically significant outcomes in the peritumoral edema region when compared between GBM-ODG and GBM categories: Median > 1.3516, normal mean > 0.6671, third moment ≤ -0.0001, 25 percentile > 0.5929, 75 percentile > 0.7336, and 95 percentile > 0.8542. The highest sensitivity and specificity values for these FOHs were higher than 80% and sometimes near 99.9%.

 The results showed that ADC values from peritumoral edema regions differ between these two types of tumors. Then, an MRI from the edematous areas is suggested when evaluating the patient's status and deciding to make interventions.

 Toxoplasma gondii (T. gondii) is the most common intracellular parasite in the human population. The anti-cancer effect of these parasites has been shown, which may be due to the presence of common antigens between the parasite and cancer cells.

 In this work, the reaction of Toxoplasma-positive human sera and Toxoplasma-negative human sera with cell surfaces of 4T1 and MCF7 cell lines have been investigated.

 4T1 and MCF7 cells were harvested from cell cultures and treated with either human Toxoplasma Positive or negative sera. The reaction of the sera was then detected using the flow cytometry method.

 Toxoplasma-positive sera reacted more strongly with both breast cancer cell lines than Toxoplasma-negative sera.

 Anti-T. gondii antibodies strongly react with breast cancer cells. These antibodies may be used for selective cancer immunotherapy in the future.

 Salivary cancers are relatively uncommon with important types of head and neck malignancies with poor prognosis in the vast majority of cases.

 Prompt diagnosis and treatment are critical to attaining a good prognosis; hence, recognition of the epidemiological characteristics is worthwhile. Accordingly, in this study, the epidemiological characteristics of cases with salivary sarcoma among Iranian patients were assessed.

 In this epidemiological study, 70 consecutive cases with salivary sarcoma in Iran within 22 provinces were assessed from 2009 to 2014. The dataset utilized in this study was sourced from the Iran National Cancer Registry (INCR). These included both parotid (n = 53) and major salivary glands (n = 17). The age, sex, anatomical location, province, and year were the main variables extracted from existing medical data.

 The present study reports 53 cases of parotid tumor sarcoma, with the mixed tumor exhibiting a predominant malignant component being the most frequently observed pathological subtype. The preponderance of these instances was noted among individuals classified as adults within the working demographic (ranging from 15 to 64 years of age). However, our age-adjusted incidence rate indicates a higher occurrence of salivary gland tumors in individuals above 64.
The study reported 17 instances of sarcomas in other major salivary glands, with the malignant type mixed tumor being the most frequently occurring subtype within this group. The gender distribution did not exhibit a statistically significant pattern.

 Thoroughly, according to the obtained results in this study, it may be concluded that salivary sarcoma in the Iranian population is usually the mixed malignant tumor subtype and there are similar patterns according to the age and sex in patients with slight male predominance (F/M ratio: 0.75).

 Laryngeal tumor is the most commonly identified malignancy in head and neck cancers, containing 2.4% of all cancers, and is the 11th most prevalent and fatal cancer in the world. Previous research has revealed that microRNAs (miRNAs) have a significant role in the progression of laryngeal tumors. Additionally, research focuses on the association with the clinical function of miRNA in malignancy.

 Based on previous research, miR-132, miR-302, miR-126, and miR-205 have potential roles in the tumor development of the LSCC. Then, in the current study, we pointed to study if there are any significant alters in the expression of microRNAs and whether they have any significant possibility as a diagnostic or prognostic factor for laryngeal squamous cell carcinoma.

 From 30 LSCC patients, we have collected tumor and marginal healthy tissues through laryngectomy. Total RNA extraction from the marginal healthy and malignancy tissues was done. Next, we control the quality of the RNAs and, then, synthesize cDNA. Lastly, the expression of the miRNAs was evaluated by qPCR. The expression level of genes and their association with the patient’s clinicopathological features were studied, using related statistical tests.

 miR-132 (P = 0.0001, fold change: 1.28) and miR-302 (P = 0.0001, fold change: 1.o5) are significantly up-regulated in tumor tissues compared to normal peripheral tissues. Furthermore, we revealed that miR-205 (P < 0.0001, fold change: 0.241) and miR-126 (P = 0.0001, fold change: 0.251) are low expressed in LSCC cancer tissue. Between these miRNAs, gust expression of the miR-205 had no relationship with clinical-pathological characteristics in malignancy tissue.

 The results of the current study showed the possibility of miR-302, miR-132, miR-126, and miR-205 as diagnostic or prognostic factors in LSCC.

 Calcified amorphous tumor (CAT) is a non-neoplastic cardiac tumor, frequently presenting as a a mass with variable sizes. Scare cases of this phenomenon have been reported so far, so its natural history and therapeutic options are still unclear. In fact, CAT diagnosing relies on pathological findings where a definite diagnosis is not reachable until the mass is removed. So, CAT is a retrospectively diagnosed following surgical intervention.

 A 72-year-old man was referred for evaluation due to complaints of dyspnea. Initial coronary examinations yielded normal findings. In echocardiography, a 56 × 34 mm mass was seen in the posterior left ventricle wall, along with severe mitral stenosis and moderate to severe mitral regurgitation. The patient subsequently underwent cardiac surgery, during which the mass was completely removed through the left atrium and mitral valve. Then the patient underwent biological heart valve replacement. Post-surgery echocardiography demonstrated the absence of any residual mass, and no complications were reported during the six months follow-up period.

 The symptoms and complications of CAT during imaging manifest as a calcified mass. Due to the diagnostic reliance on pathological evidence, surgical treatment is the preferred option for excluding any malignancy and resolve and prevent further complications. Follow-up with echocardiography is advised for monitoring.

 The gastrointestinal neuroectodermal tumor (GNET) is a rare mesenchymal tumor mainly arising in the gastrointestinal tract.

 Herein, we describe a case of GNET that had been previously diagnosed as metastatic primitive neuroectodermal tumor (PNET) to the lung and liver and received 30 cycles of adjuvant chemotherapy. The physical exam showed a palpable mass in the lower right quadrant of the abdomen. The tumor mass was composed of diffuse sheets of epithelioid tumor cells, in which osteoclast-like giant cells scattered unevenly. Immunohistochemically, the tumor cells were diffusely positive for SOX10, CD99, and CD56, patchy positive for pan-CK, and negative for desmin, HMB-45, Melan-A, and chromogranin.

 Consistent with previous studies that reported a secondary GNET following chemotherapy, we assume that the chemotherapy might trigger the tumorigenesis of GNET in this case.

 Intramedullary ependymoma (IE) is adults' most common intramedullary spinal tumor. Tumors usually extend one to eight segments in the cervical region. In this case report, we reported a patient with massive IE spanning from the fourth ventricle to the T4 segment of the spinal cord, which surgically treated with laminectomy from occiput to T4

 A 42-year-old man who is a known case of IE with progressive upper extremities paraesthesia and gait disturbance. Four years ago he refused surgery and presented with dysphagia. The patient's MRI demonstrated an intramedullary spinal cord tumor extending from the fourth ventricle to T4.

 massive spinal ependymoma is a rare, benign, slow-growing tumor, and patients present symptoms years before diagnosis. Upon confirmation of the diagnosis, the tumor must be surgically removed.

 Breast cancer is the most common type of cancer among Iranian women with more than 10 000 cases per year.

 This study aimed at determining out-of-pocket (OOP) payments among women with breast cancer at health care centers affiliated to Iran University of Medical Sciences.

 This descriptive cross-sectional and applied study was done among 336 women with breast cancer referring to hospitals affiliated to Iran University of Medical Sciences. The data on inpatient expenses were obtained from the cost bills and the outpatient was collected, using a researcher-made questionnaire. Finally, the data were analyzed, using SPSS V2 software.

 The average monthly OOP payment for direct hospitalization costs in inpatient breast cancer patients was estimated 146 ± 47.98 dollars and the average OOP payment for direct costs of treatment in outpatients was 69 ± 102.99 dollars, and the average OOP payment for non-medical direct cost per month 34.88 ± 31.12 dollars. The results of this study showed the average OOP payment included drug costs with the rate of 37.99 ± 45.31 dollars imposed the highest medical direct costs. Among the non-medical direct costs of OOP payment for transportation, the average of 30.65 ± 103.23 dollars imposed the highest OOP payment on breast cancer patients.

 These findings show that individuals with breast cancer endure high OOP payments that could adversely affect their quality of life; hence, decision-makers should pay more attention to implementing proper policies.

Context: 

Primary brain tumor (PBT) causes poor prognosis and significant complications, which include movement problems such as balance disorders, failed return to work, and daily life activities.

 The aim of the present study is to estimate the prevalence of PBT in Iran, using a meta-analysis method.

 This meta-analysis study was conducted in Iran in 2023 and articles published until the beginning of 2023 were included in the study, using the English keywords of brain cancer, brain tumor, tumor prevalence, prevalence, cancer, nervous system cancer, and their Persian equivalents. Data analysis was carried out, using CMA software.

 After the initial search, 890 articles on BT were found, and 21 eligible articles were included in the meta-analysis. Also, the prevalence of brain cancer is 4% (95%CI: 3.3 - 4.8) in men and 2.9% (95%CI: 2.3 - 3.6) in women.

 According to the result, the BT incidence rate is 4% for males and 2.9% for females. Therefore, it is necessary to take necessary preventive measures in this regard.

 Hepatitis B virus (HBV) is still the leading cause of hepatocellular carcinoma (HCC). HBV could persist in the low replicate state that is defines as occult hepatitis B virus infection (OBI). Recently, OBI has been defined important in the development and/or exacerbation of HCC and other liver diseases.

 This study tried to determine the frequency of OBI among liver tumor samples.

 This cross-sectional study was performed among patients with HCC and intrahepatic cholangiocarcinoma (iCCA) in hospitals affiliated with Iran University of Medical Sciences. Liver tumor samples (Fresh frozen and formalin fixed paraffin embedded) were processed for isolation of DNA and then subjected to molecular assays, including PCR examinations of HBV genes (S, X, and C), determination of viral loads, detection of HBV-cccDNA, phylogenetic analysis, and assessment of mutations in HBsAg and RT regions.

 In total, there were 93 participants, including HCC (n = 60), iCCA (n = 33); among which, 15% were detected positive for OBI. The OBI among HCC and iCCA were 18.3% and 9.1%, respectively. The mean intrahepatic viral load was 1.3 × 105 ± 1.4 × 102 copies/µl, and 5 had detectable cccDNA. The OBI subjects belonged to the HBV genotype D and subgenotype D1. In the HBsAg protein, T45N (33.3%) and P105A (25%) were the most prevalent mutations. N53K (33.3%), Y54H (25%), L80I (33.3%), and A113G (25%) were missense mutations that were observed in the RT domain.

 HBV-DNA was detected among liver tumor samples with negative HBsAg status. The results of viral load and cccDNA tests are important in identification and prognosis of liver diseases. It’s needed more precise molecular and cohort studies to clarify the functions of OBI in liver diseases.

 Palliative care is one of the primary rights of children with cancer and their families. Identifying the unmet needs of palliative care for these children is important in providing high-quality care.

 The present study aimed to exploring the perception of formal and informal caregivers about the unmet palliative care needs of children with cancer and their families.

 This qualitative study was conducted from October 1, 2020, to May 15, 2021, in one of the children’s hospitals in Rasht (Northern Iran). This study enrolled 25 caregivers (nurses, doctors, grandmothers, sisters, aunts, neighbors, and parents of children with cancer) and 5 children with cancer, who met the inclusion criteria by purposeful sampling to participate in in-depth and semi-structured interviews. The interviews continued until data saturation. A directed content analysis was performed according to the Elo and Kyngas proposed approach and based on the National Consensus Project (NCP) framework. The findings were managed by MAXQDA2020 software. Guba and Lincoln criteria were used to ensure the trustworthiness of the data.

 The average age of the participants was 32.40 ± 1.4 years, and 1,450 codes were extracted. The extracted theme was “the need for holistic care”, which included 7 main categories such as “the structure and process of care”, “physical aspects of care”, “psychological aspects of care”, “social aspects of care”, “cultural aspects of care”, “care of the patient nearing the end of life”, and “spiritual, religious, and existential aspects of care”, and 23 subcategories.

 Children with cancer and their families have many physical, psychological, spiritual, and social needs. To meet these needs, it is suggested to provide the necessary infrastructure for palliative care, strive for justice in access to palliative care services for children with cancer and their families, empower caregivers, form an interdisciplinary team, and promote cultural awareness regarding cancer and end-of-life care.

 Kidney and ureter cancers are two of the most prevalent urological cancers among Iranians. However, studies on the epidemiology and incidence of these cancers are primarily regional and focus on a specific period.

 The present study investigated the trend of the incidence rate of kidney and ureter cancer in Iran from 2004 to 2016.

 In this study, information on kidney and ureter cancer cases in Iran from 2004 to 2016 was extracted from the Iranian National Cancer Registry (INCR). Crude and age-specific incidence rates (ASIR) were calculated, and the age-standardized rate (ASR) was measured, using the World Health Organization (WHO) standard population. The Joinpoint software program 4.9.0.1 was used to calculate the annual percent changes (APC) in the trend of the incidence rate of kidney and ureter cancers by age group, regional centers, and tumor grades across a 13-year period.

 During the study period, 19 659 incidences of ureter and kidney cancer occurred in Iran. The crude and ASR of kidney cancer increased from 0.98 and 1.33 per 100 000 population in 2004 to 3.1 and 3.5 per 100 000 population in 2016, respectively. In addition, the crude and ASR of ureter cancer increased from 0.04 and 0.05 per 100 000 population in 2004 to 0.9 and 1.1 per 100 000 population in 2016, respectively. The national ASR of kidney cancer APC was 22.2% (P > 0.05) from 2004 to 2006 and 4.8% (P < 0.05) from 2006 to 2016, respectively. The national ASR of ureter cancer APC was 290.8% (P < 0.05) from 2004 to 2006 and 7.5% (P < 0.05) from 2006 to 2016.

 According to the results of this study, the incidence rate of kidney and ureter cancer increased over 13 years in Iran. Hence, the implementation of epidemiological studies in various regions and provinces is crucial for gaining a comprehensive and precise understanding of the underlying causes of kidney and ureter cancer incidence.

 Several contaminants such as trace elements can pollute drinking water sources with subsequent toxic effects on humans. These compounds may also accumulate in target organs and result in carcinogenic reactions.

 The concentrations of heavy metals, including arsenic (As), nickel (Ni), zinc (Zn), aluminum (Al), copper (1), cobalt (Co), lead (Pb), cadmium (Cd), iron (Cd), tin (2), antimony (Sb), chromium (3), and mercury (Hg) were aimed to determine in the drinking water of Tehran, Iran and to assess the carcinogenic and non-carcinogenic risk for consumers.

 A total of 66 tap water samples were collected from 22 regions of Tehran and their heavy metal contents were measured by inductively coupled plasma mass spectrometry (ICP-MS). The non-carcinogenic and carcinogenic health risks were calculated, using hazard quotient (HQ) and incremental lifetime cancer risk (ILCR), respectively.

 The findings revealed that the mean concentrations of measured elements were lower than the maximum permissible limits established by Iranian National Standards, United States Environmental Protection Agency (USEPA), and the World Health Organization (WHO). HQ was less than 1 for all metals except Cr and ILCR was higher than 1× 10-4 for Cr and Cd, which may cause human health risk.

 No carcinogenic effects were posed by heavy metals contamination in the drinking water of Tehran; however, the content of Cr and Cd may cause human health risks because of the high daily intake of tap water throughout the lifetime and the tendency of these metals to accumulate in the human body organs. Therefore, implementing ongoing programs to monitor heavy metals in municipal drinking water and applying appropriate corrective actions to prevent the transfer of these pollutants to drinking water is crucial.

 Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype in women worldwide. The various alterations in the expression of different microRNAs (miRNAs) have been reported as crucial in the development of metastasis in breast tumors.

 This study investigated the effect of sodium butyrate (NaB) on cell survival, cell metastasis and expression of miR-101, ZEB1, ZEB2 and E- cadherin in MDA-MB-468 cells as a TNBC cell line.

 Cell viability was evaluated using the (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT assay), and the metastasis potential of MDA-MB-468 cells was investigated using the scratch and transwell assay. The expression of genes involved in the metastasis process was measured using real-time polymerase chain reaction (PCR).

 The MTT assay showed that NaB attenuated MDA-MB-468 cell survival dose-dependently with an IC50 value of 3.1 mM after 72 h treatment. The scratch and transwell assays also showed the anti-metastatic potential of NaB. The expression of miR-101, E-cadherin, ZEB1, and ZEB2 was significantly difference in MDA-MB-468 cells treated with 3.1 mM NaB after 72 hours (P < 0.05). E-cadherin and miR-101 were up-regulated, while the expression of ZEB1 and ZEB2 was significantly down-regulated compared to the untreated cells. This suggests that NaB increased cell attachment and prevented metastasis. In addition, NaB (IC50 value) restored the expression of miR-101, as a tumor suppressor, in MDA-MB-468 cells confirming its anti-cancer potency.

 Sodium butyrate can be used as a drug to suppress invasion and cell migration in TNBC cells. However, further studies are needed to demonstrate the putative anti-metastatic mechanism of NaB in preclinical and clinical settings.