Middle East Journal of Cancer
Volume:15 Issue: 1, Jan 2024

MicroRNAs (miRNAs) regulate gene expression and various cellular activities. They also hold significant importance in the progression and development of human malignancies. Among these, miRNA-484 and the Fis-1 gene have been identified as having substantial roles in lung cancer. This study aims to ascertain miRNA-484 and Fis-1 gene expression levels in non-small cell lung cancer (NSCLC) patients. In this case-control study, 45 pairs of tumor tissues and their corresponding healthy margin tissues were surgically obtained from NSCLC patients and promptly preserved in liquid nitrogen after excision. Total RNA extraction was performed using TRIzol, followed by cDNA synthesis using a designated kit. Afterward, we used quantitative reverse transcription polymerase chain reaction (qRT-PCR) to measure the expression levels of miRNA-484 and the Fis-1 gene. Furthermore, the clinicopathological characteristics of the NSCLC patients were assessed. Our findings revealed an upregulation of miRNA-484 expression and downregulation of Fis-1 gene expression in NSCLC tissues compared with non-tumor tissues. Additionally, significant correlations were observed between miRNA-484 and Fis-1 gene expression levels and clinicopathological features of the patients, including factors such as lymph node involvement and distant metastasis. These findings suggest the potential utility of Fis-1 and miR-484 as prognostic and diagnostic markers in NSCLC.

Neuroblastoma is the most common extracranial solid tumor in children. MYCN gene amplification (MNA) is an independent prognostic factor for rapid tumor progression and poor prognosis, regardless of age and clinical stage. Gain of the MYCN gene locus on the short arm of chromosome 2 can also be found in neuroblastoma. In this retrospective descriptive analysis of genetic alterations in neuroblastoma tumor samples, both before and after standard chemotherapy, we examined the MYCN gene copy number status in 20 neuroblastic tumor samples using the fluorescence in situ hybridization (FISH) method. We also evaluated its relationship with clinical variables and tumor maturation after standard chemotherapy treatment. Additionally, we compared disease outcomes among different MYCN copy number categories. Among the tumor samples, four (25%) exhibited increased MYCN copy numbers, 20% showed MYCN amplification, and 5% displayed MYCN gain. We observed decreased survival rates in advanced stages of neuroblastoma. Furthermore, in male patients, we noted an association between increased MYCN copy number and metastatic tumors. We found that increased MYCN copy number is moderately associated with an immature phenotype and correlated with lower event-free survival. However, we did not detect a statistically significant difference.

Neurogenic locus notch homology 4 (Notch-4) is crucial in maintaining stem cells. Special AT-rich sequence-binding protein 2 (SATB-2) is a transcription factor that binds to the nuclear matrix and serves various functions, including brain development. Glutaminase-1 (GLS-1) plays a pivotal role in cancer cell metabolism, growth, and proliferation. This study aims to assess the expression of these markers in colorectal cancer, establishing correlations with clinicopathological characteristics and patient survival. In this retrospective study, we retrieved and analyzed 68 formalin-fixed, paraffin-embedded blocks of primary colorectal adenocarcinoma, not otherwise specified cases, and adjacent normal mucosa. Notch-4, SATB-2 and GLS-1 expressions were analyzed using immunohistochemistry at the Zagazig School of Medicine, Egypt. High expressions of Notch-4 and GLS-1 and low expression of SATB-2 were observed in colonic adenocarcinoma but not in adjacent non-neoplastic mucosa (P < 0.001). High expressions of Notch-4 and GLS-1, along with low expression of SATB-2, were associated with a higher tumor grade, advanced stage (P < 0.001), lymphovascular invasion, lymph node metastasis, and poor disease-free survival and overall survival rates (P < 0.001). High expression of Notch-4 and GLS-1 is correlated with a poor prognosis in colorectal cancer, while high expression of SATB-2 is associated with a favorable prognosis for colorectal carcinoma. These markers can aid in predicting tumor prognosis and guiding targeted therapy for colorectal carcinoma.

This study aims to compare the performance of intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) in treating laryngeal cancer. In this retrospective dosimetric study, 15 patients diagnosed with locally advanced laryngeal cancer (LALC) were selected. The dosimetric performance of the two techniques was analyzed using 6 MV X-rays, based on dose-volume histograms for primary and boost planning target volumes (PTVp and PTVb, respectively), relevant organs at risk (OARs), mean Dose (Dmean), maximum Dose (Dmax), 95% Dose (D95), 2% Dose (D2%), 5% Dose (D5%), monitor units per segment (MU/segment), number of MU/cGy, treatment delivery time, along with conformity and homogeneity indices. Both techniques were able to achieve favorable equivalent uniform doses and low doses to OARs. The average total number of monitor units for IMRT was significantly greater than that for VMAT (1724.5 ± 249.5 and 475.3 ± 47.0, respectively for PTVp and 601.4 ± 81.7 and 458.0 ± 62.6, respectively for PTVb). The modulation factor (MU/cGy) of IMRT was significantly greater than that for VMAT for both the primary and the boost phases. The mean treatment delivery time for all cases of IMRT was significantly longer than that of VMAT. The primary distinction between IMRT and VMAT in the treatment of LALC is that VMAT requires significantly fewer monitor units (one-third) compared with IMRT. This reduction contributes to a decrease in treatment time, which in turn positively impacts patient comfort and the accuracy of treatment.

Detecting breast cancer in its early stages remains a significant challenge in the present context and is a leading cause of death among women, primarily due to delayed identification. This paper presents a practical and accurate approach based on deep learning to identify breast cancer in cytology images. The analytical approach leverages knowledge from a related problem through a technique known as transfer learning. Convolutional neural networks (CNNs) are employed due to their remarkable performance on large datasets. Image classification architectures such as Google network (GoogleNet), Visual geographical group network (VGGNet), residual network (ResNet), and dense convolution network (DenseNet) are utilized in this approach. By applying transfer learning, the images are classified into two categories: those containing cancer cells and those without them. The performance of the proposed ensemble method is evaluated using a breast cytology image dataset. The results of our proposed ensemble framework outperform conventional CNN models in terms of precision, recall, and F1 measures, achieving an impressive 86% prediction accuracy. Visual representations of validation graphs for each classifier demonstrate that the ensemble framework surpasses the performance of pre-trained CNN architectures. Combining the outcomes of conventional CNN architectures into an ensemble framework enhances early breast cancer detection, leading to a reduction in mortality through timely medical interventions.

Radiotherapy is associated with a high risk of heart disease in patients with left-sided breast cancer. Previously, the entire heart was considered an organ at risk (OAR) during planning. Studies have shown that the effect of radiation therapy depends on the dose to specific heart substructures. However, the tolerance dose of the left anterior descending coronary artery (LAD), an important cardiac substructure, is yet to be determined. This study aims to verify the feasibility of reducing the LAD dose with appropriate dose-volume constraints for patients undergoing left whole-breast radiotherapy, without compromising the target dose coverage, using tomotherapy techniques. This retrospective study generated tomohelical and tomodirect plans initially without considering the LAD as OAR in the treatment planning. To reduce the LAD dose, plans were regenerated by including the LAD as an OAR with appropriate dose constraints. The dose-volume histogram parameters of these plans were compared with those of the initial plans of the respective types. Tomohelical plans showed a 4.4% reduction in maximum dose and a 3.8% reduction in V15 for LAD, while tomodirect plans registered a 3% reduction in V15, with the conformity index remaining constant. Based on the LAD dosimetric results, considering the LAD as an OAR is associated with lower LAD doses without compromising the target volume coverage. It is feasible to reduce the LAD dose without compromising target volume coverage or affecting other OAR doses in patients with left breast cancer, using tomotherapy techniques.

It is crucial for medical personnel to be aware of cancer symptoms and engage in appropriate screening practices. This study aimed to investigate the knowledge of Iranian healthcare staff regarding cancer warning symptoms, their attitudes towards cancer risk factors, and their willingness to undertake cancer screening tests. This cross-sectional study involved administering validated questionnaires to 145 medical staff. In addition to descriptive statistics, independent sample t-test and Analysis of Variance (ANOVA) were utilized to compare knowledge, attitudes, and performance of cancer screening tests. Pearson's correlation coefficient was used to determine the relationship between demographic and occupational variables and participants' knowledge and attitudes regarding cancer risk factors and screening practices. The mean knowledge and attitude scores were 7.97 ± 2.01 and 35.41 ± 4.69, respectively. Among the 125 female participants aged 25-57 years, only 44% performed monthly breast self-examinations, 22.1% sought specialist physicians for breast cancer screening, and only 20.51% of female participants over the age of 40 underwent mammography. Regarding cervical cancer screening, 27.2% had undergone annual Pap smear tests, and 17.6% referred to a specialist for annual pelvic examinations. Among staff older than 45 years (24 participants), only one had undertaken an occult blood test and colonoscopy for colorectal cancer screening. Although most healthcare workers demonstrated awareness of cancer warning signs, they did not engage in regular preventive screening practices. Regular educational programs should be implemented to encourage healthcare personnel to perform routine cancer screening.

Multiple endocrine neoplasia (MEN) is a rare inherited disease caused by multiple complex mutations in the RET gene. It is characterized by the occurrence of tumors involving more than two endocrine glands in the same patient. MEN is classified into two types: MEN type 1 (Wermer syndrome) and MEN type 2, which is further subclassified into two phenotypes: MEN 2A (Sipple syndrome) and MEN 2B (Shimcke syndrome). Sipple syndrome is the most common type of MEN type 2. It is characterized by the presence of medullary thyroid carcinoma (MTC), unilateral or bilateral pheochromocytoma, and primary hyperparathyroidism due to parathyroid cell hyperplasia or adenoma. In this article, the authors report a case of a 34-year-old Libyan woman with Rh positive B blood group who presented with an enlarged neck mass. Based on clinical, radiological, biochemical, and cytological assessments, the mass was diagnosed as MTC. Two weeks apart, the patient underwent right adrenalectomy and total thyroidectomy, while the parathyroid glands were found to be normal and preserved. In cases where a neck mass is the only symptom manifestation, it is crucial to carefully investigate for other MEN 2A findings, especially if there is a family history of MTC, to ensure a good prognosis. Patients with MEN 2A should undergo regular screening and be managed by a multidisciplinary team.

Extraskeletal Ewing sarcomas (EES) is a rare, aggressive malignancy that typically affects adolescents or young adults, primarily involving the deep soft tissues of the lower extremities and paravertebral regions. The occurrence of EES in the pancreas is even rarer. These tumors are characterized by small, round cell sarcomas displaying varying degrees of neuroectodermal differentiation, as revealed through light, electron microscopy, or immunohistochemistry. Diagnosing EES demands a high level of suspicion. Histopathologically, the presence of small round cell tumors in the pancreas, along with CD99 positivity in immunohistochemistry, assists in diagnosing EES. Molecular analysis demonstrating EWSR1 (22q12) rearrangement via interface fluorescence in situ hybridization is required to confirm the diagnosis. A comprehensive review of pancreatic EES cases revealed that the primary treatment modality typically involves surgical intervention, often complemented by chemotherapy and, in some cases, radiotherapy. In this report, we describe the case of a 28-year-old male presenting with abdominal pain and a loss of appetite, which, upon histopathological and molecular examination, was identified as EES of the pancreas. The patient underwent surgical resection of the pancreatic mass, followed by omentum, splenectomy, and chemotherapy. EES is a highly aggressive tumor with an insidious onset, and patients usually exhibit non-specific clinical symptoms. Although exceedingly rare, it should be considered in the differential diagnosis of pancreatic masses.