Journal of Current Oncology and Medical Sciences
Volume:3 Issue: 4, Autumn 2023

 Melanoma is considered the most lethal skin cancer, with poor prognosis in advanced stages. The 2018 World Health Organization (WHO) Classification classified melanoma in nine different subgroups depending on the cumulative sun damage, with its respective genetic alterations, which are necessary to investigate for targeted therapies. Nevertheless, the epigenetic alterations aren’t included at all in the new molecular classification. Understanding the molecular mechanisms associated with melanoma pathogenesis and its poor prognosis.

 To analyze the molecular mechanisms implicated in melanoma carcinogenesis, we reviewed the most recent papers using PubMed database and Google Scholar, the search was carried out using the following medical subject headings (MeSH) in the search engine: “melanoma epigenetic mechanisms”, “miRNAs and melanoma”, immunology and melanoma”, “melanoma pathogenesis”, in combination with boolean connectors ‘AND’ and ‘OR’. A total of 83 articles were reviewed, published between 2000 and 2022.

 Given the importance of genetic and epigenetic mechanisms implicated in prognosis and progression of cancer, this paper aims to review the literature about its respective regulators, and how they have a relationship between them in several metabolic, apoptotic, physiological, and biological processes. It is essential to understand the molecular and immunological mechanisms involved in melanoma pathogenesis and how the alteration of any of them leads to the genesis of cancer, with the aim of fostering the development of novel targeted therapy strategies.

 Liver steatosis has a wide range of conditions from simple steatosis to non-alcoholic steatohepatitis, fibrosis, and eventually cirrhosis. Several panels and scoring systems have been introduced to differentiate steatosis with or without advanced fibrosis and also the degree of fibrosis. This study aimed to evaluate eleven different scoring panels in patients with steatosis and compare their results with Fibro Scan.  

 The study was performed on 122 NAFLD patients who were confirmed by ultrasound. The patients were referred to the gastroenterologist in Razi hospital in the north of Iran from September 2017 to April 2018. All patients underwent Fibro Scan. Multiple scoring systems were calculated using the laboratory values. These results were compared with the results of Fibro Scan. AUC for each panel was calculated.

 In This study, 62 (50.8%) were men. The mean age of the patients was 47.1±11.7 years.  There were significant differences between patients with or without advanced fibrosis in three panels of APRI, NIPPON, and FIB4 (p=0.03, p=0.01, p=0.005, respectively). AUROC for APRI, NIPPON, and FIB4 were, 0.695 (CI=0.58-0.8, p=0.001), 0.642 (CI: 0.5-0.74, p=0.015) and 0.684 (CI: 0.5-0.7, p=0.002), respectively. None of the other panels had enough sensitivity for the diagnosis of advanced fibrosis.

 Given the cost-effectiveness of panels, their ease of calculation, and noninvasiveness, FIB4, NIPPON and APRI can be used as useful tools for following, and also for predicting progression to advanced fibrosis.

Breast cancer is the most common malignancy occurring worldwide in females but primary squamous cell carcinoma represents a very rare variant of breast carcinoma, accounting for less than 0.1%. Mostly it is grayish-white in colour with an ill-defined cut surface and has cystic areas of foci of necrosis macroscopically. Squamous elements in these neoplasms can range from well to poorly differentiated. The majority was moderately differentiated and showed cystic degeneration correlating with the macroscopic appearance.

A 45-year-old female presented to us with a painless progressive lump involving all quadrants of left breast that at presentation had involved the whole breast and was associated with foul-smelling discharge. The patient had toxic features and was taken up for toilet mastectomy. The wound was left open for a delayed closure. The histopathological report suggested triple negative squamous cell carcinoma involving the breast.

Squamous cell carcinoma is commonly seen in the skin and lung, it rarely originates in breast tissue. There are reports that it may develop within a previous benign lesion such as an epidermal cyst or chronic inflammatory lesions. It may also mimic benign breast disease resulting in inappropriate or delayed management. Clinically and radiologically it is indistinguishable from adenocarcinoma, the most common presentation being cystic lesion. Because of limited data and few case reports worldwide, management strategies have been controversial. Total mastectomy with axillary clearance is usually done. As it is locally advanced, conservative surgery is not feasible most of the time. Radiotherapy has been used in locally advanced cases, though not much useful.

Very rare incidence along with nonspecific presentation poses a major challenge in the diagnosis of primary SCC.

Cancer treatment has witnessed a profound transformation in recent decades, with combination therapy emerging as a beacon of hope for patients. This review delves into the groundbreaking synergy between immunotherapy and targeted oncolytic viruses, offering a glimpse into the future of cancer conquering. Traditional methods like surgery, radiation, and chemotherapy have limitations, especially in advanced or metastatic cancers. Immunotherapy, inspired by the body's innate defenses, leverages the immune system to selectively identify and eradicate cancer cells. Immune checkpoint inhibitors, such as pembrolizumab and nivolumab, have showcased remarkable success in clinical trials, unlocking the potential of the immune system against once-intractable cancers. In tandem, oncolytic viruses exhibit precision targeting, minimizing harm to healthy tissues. Notably, herpes simplex virus type 1 (HSV-1) has proven effective against various malignancies. The fusion of immunotherapy and oncolytic viruses represents a paradigm shift in cancer treatment, harnessing the strengths of each modality. This review explores mechanisms, recent developments, clinical triumphs, and the challenges of combination therapy. The dynamic synergy of these two approaches promises to revolutionize cancer treatment, transforming it from an insurmountable foe into a manageable condition.

Multiple Primary Malignant Tumors (MPMT) are two or more distinct primary cancers in a single patient, either occurring simultaneously (synchronous) or at different times (metachronous). MPMTs are very rare, with an incidence of 0.73% to 11.7% among cancer patients. Breast and lung cancers are the most common malignancies in women, but their coexistence as MPMT is uncommon.

We report the case of a 51-year-old non-smoking woman who had a productive cough with bloody sputum for a week, after a two-month history of dry cough. She was diagnosed with a high-grade, poorly differentiated non-keratinizing squamous-cell carcinoma in the right lung. A PET scan also revealed a poorly defined soft tissue mass in the central sector of the right breast, which was confirmed to be a primary invasive ductal carcinoma.

The etiology and pathogenesis of MPMT are unclear, but several factors such as genetic predisposition, environmental exposure, immunodeficiency, and treatment-related effects have been proposed. The diagnosis and management of MPMT are challenging, as they require careful evaluation of each tumor and individualized treatment plans. The prognosis of MPMT depends on the stage and histology of each tumor, as well as the patient’s performance status and comorbidities.

This case report highlights the rare occurrence of synchronous primary malignancies in the lung and breast, underreported in the medical literature. This case adds to the existing knowledge of MPMT and may stimulate further research on this topic. Clinicians should be aware of the possibility of MPMT in cancer patients and perform thorough investigations to rule out secondary or metastatic tumors.

Introduction:

 Female infertility is responsible for approximately half of all cases of infertility and one of the causes of infertility in women is related to ovarian disorders.  Anti-Müllerian Hormone (AMH) is one of the clinical markers of ovarian reserve. Physical activity may affect the reproductive system and AMH concentration in serum. We aim to evaluate the relationship between physical activity and reproductive determining fertility and anti-mullerin hormone (AMH)  in infertile women in northern Iran.

Materials and methods: 

This cross-sectional study included 234 women aged 18–45 referred to the Infertility Clinic of the Al-Zahra Hospital, Rasht, Iran. The reproductive characteristics and the amount of physical activity of the patients were recorded. Exclusion criteria included menopause, cancer, underlying endocrine diseases, use of hormonal drugs, diagnosis of PCOS based on Rotterdam criteria, any ovarian and uterine surgery, and endometriosis.

Results: 

As expected, we observed significantly lower AMH concentrations in older participants. There was no association between reproductive determinants and AMH level (P> 0.05). We observed lack of physical activity as well as vigorous physical activity, is associated with lower AMH concentration (P= 0.025, and P= 0.039 respectively).

Conclusion:

 In this study, AMH levels appear to be significantly lower in patients with a lack of physical activity as well as vigorous physical activity. The results of this study showed that by improving lifestyle, including the appropriate amount of physical activity, it may be possible to improve the results of infertility treatments. However, a larger study is needed to verify the findings of this study.

Apigenin is a member of the flavonoid family that has been used in medicine for a long time. Apigenin is one of the compounds that has been used for a long time to treat various disorders and diseases. Apigenin is chemically known as 4',5,7, trihydroxyflavone and belongs to the family of flavones. Apigenin has many pharmacological activities such as anti-inflammatory, anti-viral, anti-bacterial, etc. Various studies have shown that apigenin plays an important role in suppressing diseases such as Parkinson's, Alzheimer's, inflammatory diseases, and different types of cancers. In the present study, various therapeutic properties, biological effects, and the effect of apigenin on different cancers are discussed. Different studies have been conducted on the anti-cancer effect of apigenin. It has been proven that apigenin has inhibitory effects on various cancers including lung, stomach, neuroblastoma, thyroid, liver, skin, and prostate cancer through different signaling pathways. In general, it can be mentioned that the anti-cancer properties of apigenin are due to its effects in various signaling pathways such as angiogenesis, tumor suppressor genes, apoptosis, cell cycle and nuclear factor kappa B (NF-κB), Janus kinase/signal transducer and activator of transcription (JAK/STAT3), phosphoinositide 3-kinase /protein kinase B /mammalian target of rapamycin (PI3K/AKT/mTOR), mitogen-activated protein kinase/ estrogen receptor 2 (MAPK/ER2), Wnt/B-catenin pathways.

 Mature cystic teratoma is a kind of ovarian germ cell tumour. Malignant transformation in it is uncommon with thyroid cancer being rarely found. Given its rarity and nonspecific symptoms, misdiagnosis and indifference when compared to other ovarian lesions is very common.

Herein we report a case of a 58 year old post-menopausal female who presented with a history of abdominal distension and loss of appetite. She was found to have an abdominopelvic mass on examination and a raised CA125 levels for which she underwent an MRI pelvis which was suggestive of an O-RADS 5 lesion for which she underwent a staging laparotomy. The final histopathology and immunohistochemistry were suggestive of papillary thyroid carcinoma arising from a mature ovarian teratoma. After a multidisciplinary tumour board analysis, she was planned to be kept under follow–up with regular serum thyroglobulin monitoring. She has no signs of disease recurrence to date.

 Struma ovarii is one type of monodermal ovarian teratoma in which the tumour contains more than 50 % thyroid tissue. Diagnosis in such cases is difficult due to the lack of typical symptoms. In most of the cases, the diagnosis is incidental. Optimal treatment is still unclear given the rarity of the disease. In a few cases, thyroidectomy was done whereas in a few others it was omitted. Further therapy may include radioiodine treatment if needed.

To the best of our knowledge there is very scant information available on the natural history, prognosis and management of papillary thyroid carcinoma arising from mature cystic teratoma ovary. Hence, a multidisciplinary treatment approach may be needed for the same.

 The COVID-19 pandemic has led to mental problems, including stress and anxiety, for people, especially pregnant women. Identifying strategies to deal with stress is important and can help pregnant mothers to adapt to stressful life factors such as the conditions of the COVID-19 pandemic. The present study was designed and implemented to investigate the relationship between anxiety and perceived- stress with the coping strategies of pregnant women referring to Al-Zahra Hospital in Rasht.  

 The current study was conducted on 221 pregnant women using a cross-sectional analysis method. The required information was collected by the self-report method through demographic questionnaires, Corona disease anxiety (CDAS), Cohen's perceived stress, and Endler and Parker's coping strategies questionnaire. Data were analyzed using SPSS version 22 software using Spearman's correlation coefficient and linear regression tests. The significance level of the tests was considered as P < 0.05.

 53.4% of women had moderate anxiety and 60.6% of pregnant women had high levels of perceived stress. There was a direct and significant correlation between anxiety-perceived stress and emotion-focused strategy (P<0.001).

 The present study showed high perceived stress and moderate anxiety in pregnant women during the COVID-19 pandemic and their relationship with emotion-focused coping strategies.

Lung cancer, also known as lung carcinoma, is a malignant tumor that begins in the lung. Lung cancer is caused by genetic damage to the DNA of cells in the airways and is often caused by cigarette smoking or inhalation of harmful chemicals. Damaged airway cells gain the ability to multiply unchecked, causing tumor growth. Without treatment, tumors spread throughout the lungs, damaging lung function. Eventually, the lung tumors metastasize and spread to other body parts. On the other hand, lung cancer or bronchogenic carcinoma refers to tumors originating in the lung parenchyma or within the bronchi. It ranks among the primary causes of cancer-related mortality globally. It is estimated that there is an increasing rate of new cases of lung cancer worldwide annually, with an approximately high mortality rate because of lung cancer. It is worth mentioning that lung cancer was a relatively uncommon condition at the beginning of the 20th century. Its dramatic rise in later decades is primarily attributable to the increase in smoking among both males and females. Treatments include surgery, chemotherapy, immunotherapy, radiation, and targeted drugs. This review article describes lung cancer's causes, pathophysiology, and presentation.

 Attention Deficit Hyperactivity Disorder (ADHD) in adulthood is associated with significant impairment in occupational, academic, and social functioning. The aim of this study is to survey the frequency of ADHD in adults referred to psychiatric clinics.

 The present cross-sectional descriptive study includes 300 patients referred to psychiatric clinics affiliated to Babol University of Medical Sciences with an age range of 18-45 years who were selected and included in the study. It is used the Adults Attention Deficit Hyperactivity Disorder self-report scale (ASRS V1.1) to diagnose Adult ADHD in these individuals. Logistic regression and P-Paired test were used to analyze the data.

 The mean age of the subjects was 30.21 ± 7 7.94. Of these, 181 (60.3%) were men and 119 (39.7%) were women. The overall prevalence of Adult ADHD in the study samples was 39.3%. In the logistic regression analysis of crude and adjusted data of study variables, no significant relationship was seen between Adult ADHD and age, education, employment status and marital status (P ≥ 0.05), but a significant relationship between Adult ADHD and consumption of Cigarettes, alcohol and drugs were observed (P ≤ 0.05).

 The findings of the present study show a relatively high prevalence of Adult ADHD among people with a history of psychiatric disorder, who are more likely to be exposed to smoking, alcohol and drug abuse.