International Journal of Cancer Management
Volume:17 Issue: 1, Dec 2024

Lung cancers, such as non-small cell lung cancer (NSCLC), are the most common malignancy and leading cause of cancer-related death worldwide. MicroRNAs (miRNAs) play a role in the occurrence of lung cancer by targeting both tumor suppressor genes and oncogenes. Among them, miR-128, miR-335-5p, and miR-1254 are mainly reported to function in regulating lung cancer cell behavior.

The aim of the study was to investigate the existence and expression levels of miRNA-128, miR-335-5p, and miR-1254 as well as mRNA and protein expression levels of VEGF and mRNA expression levels of K-RAS in both peripheral blood and cancerous tissue of NSCLC patients compared to the healthy subjects.

Blood and tissue samples were collected from 50 healthy donors and 50 NSCLS patients. The serum level of VEGF was measured using the commercial enzyme-linked immunosorbent assay (ELISA). The mRNA expression levels of K-RAS and VEGF, as well as the expression of miRNA-128, miR-335-5p, and miR-1254, were determined, using real-time PCR.

Lower mRNA expression levels of miRNA-128, miR-335-5p, and miR-1254, as well as higher mRNA expression levels of VEGF and K-RAS, were detected in both peripheral blood and tissue samples from NSCLC patients compared to those of the healthy subjects. The VEGF protein levels in the peripheral blood of the patients were also found to be significantly lower than those in the healthy subjects.

The findings from this study suggest that miR-335-5p, miR-1254, and miR-128, may contribute to the pathogenesis and tumorigenesis of NSCLC at least in part by modulation of proliferation, migration, and angiogenesis via targeting VEGF and K-RAS signaling pathways. K-RAS and VEGF may be target genes for miR-335-5p, miR-1254, and miR-128 in NSCLC patients.

Erectile dysfunction (ED) is a common side effect of prostate cancer treatment, affecting up to 50% of patients after radiation therapy.

This study aims to analyze the correlation between the dose received by the penile bulb (PB) and ED in men who underwent definitive radiation therapy for early-stage prostate cancer without androgen deprivation therapy.

The study included 40 patients who received 3D conformal radiation therapy (3D-CRT) for localized prostate cancer and were reported to be potent before treatment, as determined by the International Index of Erectile Function (IIEF-15) questionnaire. The dose to the PB was measured using dose volume histograms (DVHs), and the IIEF-15 questionnaire was completed again 3 months after 3D-CRT. The Pearson correlation coefficient and linear regression test were used to examine the correlation between the ED score and PB doses. Statistical significance was considered if the P value was less than 0.05.

The mean age of the patients was 75.5 ± 5.70 years. The average ED score based on the questionnaire was 15 ± 10.55. Twenty percent of the patients had moderate ED, while 80% had mild ED (all patients reported a decrease in potency after 3D-CRT). However, the correlation between the ED score and the PB mean dose was not statistically significant.

This study revealed ED in all prostate cancer patients after 3D-CRT, but no significant correlation was found between the dose received by the PB and radiotherapy-induced impotence.

As cancer incidences rise within the Saudi population, effective pain management remains a critical component of oncological care. Analgesic adherence is vital for managing cancer-related pain, yet it is often inadequately addressed in clinical practice, leading to diminished quality of life of patients.

This study aimed to assess the level of adherence to analgesic medications among Saudi cancer patients and to identify demographic and health-related factors that may influence adherence.

In a cross-sectional study at King Abdulaziz Medical City, 132 oncology patients were sampled randomly. Data were collected through an online survey incorporating demographic queries and the Morisky Medication Adherence Scale (MMAS-8). SPSS 26 facilitated the statistical analysis, with descriptive statistics and Spearman’s Rho tests determining the significance of the findings.

Among participants, 52.2% were married, 51.5% were unemployed, and 80.4% reported substantial social support. Health insurance was prevalent among 79.5% of patients. Low adherence was observed in 94.6% of patients, with only 0.8% showing high adherence. The primary reasons for non-adherence included forgetting (54.5%) and fear of side effects (38.6%). Age and the number of medications were significantly correlated with adherence levels, highlighting the multifactorial nature of medication adherence in this patient population.

The research highlights a concerning level of low adherence to analgesics among Saudi oncology patients, suggesting an urgent need for targeted interventions. Strategies to improve adherence should focus on education regarding the importance of pain management and addressing patients' concerns about medication side effects and dependency, as well as personalized medication management plans to accommodate the complexities of handling multiple medications. These findings are instrumental for oncology healthcare providers to optimize pain management strategies and enhance patient outcomes.

Wilm’s tumor (WT) is a common renal malignancy in children. Adult extrarenal WT involving the uterus is extremely rare. Herein, we reported a case of uterine WT in an old woman who was primarily diagnosed with carcinosarcoma.

A 63-year-old woman presented with abdominal pain and radiologic evidence of pelvic mass originating from the uterus, which was suggestive of sarcoma. Her Serum levels of Cancer Antigen 125 (CA125), Human Epididymis protein 4 (HE4), Cancer Antigen 19-9 (CA19-9), and Alpha Fetoprotein (AFP) were found to be elevated. She underwent total hysterectomy, bilateral salpingo-oophrectomy, and omentectomy. Pathologic examination of the specimens revealed a large uterine mass with serosal surface and omental invasion. The initial diagnosis was carcinosarcoma based on the mixed epithelial and mesenchymal components observed on microscopic examination. Triphasic components of papillary, primitive tubules, and glomeruloid structures, along with mesenchymal and blastemal elements were identified upon second opinion. An immunohistochemistry (IHC) study revealed positive reactions for WT1, CKAE1 /AE3, EMA, Glypican-3, and CD56 in all components of the tumor cells. P53 expression was normal. GATA3, ER, PR, and CD10 were negative. The final diagnosis was changed to WT.

Uterine WT is an extremely rare malignancy, which could be associated with elevated serum AFP. Diagnosis and treatment of these rare tumors pose challenges for both pathologists and clinicians.

Electrochemical therapy (EChT) is a well-known tumor destruction method, but entering byproducts into the peripheral blood can be a concern. In recent decades, the electrical impedance spectroscopy (EIS) technique has been noticed to help significantly analyze biological materials in real time.

This study aimed to investigate the role of the EIS technique for the first time in real-time monitoring of peripheral blood after EChT.

This clinical trial study was conducted on 19 women with breast cancer who were routinely treated with EChT between 2022 and 2023 at Shohadaye Tajrish Hospital, Tehran, Iran. Accurate real-time monitoring of dielectric properties of peripheral blood, including Hematologic Factors, blood ions, apoptosis of peripheral blood mononuclear cells, and the balance of peripheral blood properties before and after EChT was measured using EIS in the frequency range of 1 Hz to 500 kHz.

peripheral blood impedimetric parameters before and after EChT, based on EIS findings, were similar at all measured frequencies. EIS analysis did not show a significant difference in the mean level of potassium, sodium and calcium ions in the peripheral blood before and after EChT. Also, there was no significant difference in the level of red blood cells (RBC), platelets, and hemoglobin (HGB) before and after EChT. Although the level of white blood cells (WBC) after EChT decreased by about 15%, this difference was not statistically significant. In addition, peripheral blood smear showed no changes in the appearance of peripheral blood cells, and peripheral blood properties were maintained in balance after EChT.

EIS can be used as a real-time method to monitor the patient's peripheral blood status without disturbing hematological factors and peripheral blood balance during EChT in breast cancer patients.

Pediatric cancers account for nearly 2% of all cancers worldwide. In 2018, there were approximately 200,000 newly diagnosed cases of childhood cancer.

The aim of this study was to assess the need for a national pediatric cancer registry based on case incidence.

This pilot study was conducted on 100 children with cancer who were treated in a recently established pediatric hematology oncology department of Golestan Hospital. Demographic and epidemiological data were collected and analyzed using SPSS software version 25.

Sixty-four percent of children with cancer were girls, and the average age of the patients was 7.6 ± 0.42 years. The most common types of cancer diagnosed were leukemia, brain tumor, lymphoma, and retinoblastoma respectively. Metastasis was confirmed in 11 cases. The most prevalent clinical manifestations of cancer included fever, weakness, loss of appetite, paleness, and weight loss.

The results of this study align with global rates and data. Based on the findings, the authors emphasize the necessity and priority of establishing a pediatric cancer registry in Iran's health ministry. Therefore, all healthcare workers and specialists in pediatric hematology and oncology should make concerted efforts to establish this registry.

Effective cervical intraepithelial neoplasia (CIN) treatment and detection of high-risk recurrence patients is very important.

The present study aimed to compare the recurrence rate of CIN after loop electrosurgical excision procedure (LEEP) versus cold knife conization (CKC).

This cross-sectional study involved 329 patients who underwent either LEEP (294 cases) or CKC (35 cases) in the colposcopy clinic of referral hospitals between March 2016 and March 2021. The study population was followed up every six months for two years after their first conization to monitor for any recurrence of the disease.

There was no significant difference between the two groups regards. Thirty-two patients experienced recurrence within two years after surgery. The rate of CIN recurrent was 30 (10.2%) cases in the LEEP group and 2(5.7%) cases in the CKC group, with no significant differences (P-value = 0.553, RR = 1.78; 95% CI = 0.44-7.15).

The present study compared the benefits and harms of LEEP and CKC. The recurrence rate and surgical complications associated with both methods appeared to be similar with no significant differences. However, further high-quality and comprehensive research with a long-term follow-up is necessary to confirm our findings.

A549, a human lung adenocarcinoma cell line, is a KRAS mutant cell used for over 5 decades as a type II alveolar cell and non-small cell lung adenocarcinoma model. Cyclin-dependent kinase inhibitor 2 A ( CDKN2A ) and cyclin-dependent kinase inhibitor 2 B ( CDKN2B ) are protein-coding genes in the INK4-ARF locus and function as tumor suppressors and negative regulators of the cell cycle. These genes have been reported to be deleted in the A549 cell line. The Long non-coding RNA ANRIL is located in the antisense direction of CDKN2B and shares a bidirectional promoter with CDKN2A . ANRIL is a negative regulator of the INK4-ARF locus genes and has an oncogenic role in cancers. ANRIL deletion in the A549 cell line has not been reported to date.

Herein, the presence of ANRIL was investigated in the A549 cell line.

In this study, the A549 cell line from 2 different sources was tested for the presence of the INK4-ARF locus genes by polymerase chain reaction (PCR) using specific primers at both DNA and RNA levels. We compared our findings with Calu-6, MRC-5, and HepG2 cell lines.

Our analysis revealed that all protein-coding genes in the INK4-ARF locus, including CDKN2A and CDKN2B , were deleted in the A549 cell lines. Furthermore, we observed that ANRIL was entirely deleted in the A549 cells. The evaluated locus and all of its genes are present and expressed in other investigated cell lines.

For the deletion of ANRIL in the A549 cell line, 2 scenarios are possible: First, from a structural point of view, the deletion of the protein-coding genes in the antisense of ANRIL in the INK4-ARF locus implies the possibility of a concurrent loss of ANRIL with the deletion of these genes in the A549 cell line. Second, as cancer cell lines are genetically unstable and are always susceptible to the acquisition of new mutations, ANRIL loss may have occurred later, following a novel genetic alte RNA tion in a population derived from a mutated cell.

The overall survival rates are below 10% in patients with metastatic renal cell carcinoma (RCC) posing a significant health challenge. There is a pressing need for novel and simple predictors of metastasis in patients with RCC to aid in early detection, thereby having prognostic and therapeutic implications.

To assess the efficacy of various inflammatory markers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), Systemic Inflammatory Response Index (SIRI), and Systemic Immune-Inflammatory Index (SII), in predicting metastasis amongst individuals diagnosed with RCC.

A retrospective study was undertaken at a tertiary hospital, focusing on individuals diagnosed with RCC. Patients were divided into two groups: Those with and without metastases. Patient demographics and clinical, pathological, and laboratory data were collected. The researchers evaluated the predictive capabilities of NLR, PLR, SIRI, and SII using ROC curves, with cut-off points determined via the Youden Index.

Of the 91 patients, 25 (27.5%) had metastatic RCC. Significant differences in NLR (P = 0.047), PLR (P = 0.004), SIRI (P = 0.006), and SII (P = 0.005) were noted between metastatic and non-metastatic groups. The ROC analysis showed that SIRI and SII had the highest predictive capacity with areas under the curve (AUCs) of 0.687 and 0.693, respectively. Logistic regression demonstrated NLR, PLR, SII, and SIRI as independent predictors of metastasis in RCC, with a combined predictive accuracy of 83.5%.

Neutrophil-lymphocyte ratio, PLR, SIRI, and SII are reliable predictors of metastasis in RCC, with their combined use enhancing predictive accuracy. These hematological parameters can be easily derived from routine blood tests, could help in the early diagnosis of metastases, and tailor the management of RCC, improving patient outcomes. Further multicentric studies are recommended to validate these findings and help integrate them into clinical practice.

Radical cystectomy plays the main role in the treatment of muscle-invasive and high-grade bladder cancers; however, it still has significant rates of perioperative complications and mortality. The risk of complications is higher in elderly patients with multiple comorbidities. In certain patients, due to simultaneous comorbidities, it becomes challenging to perform long-term orthotopic radical cystectomy surgery.

In this article, we analyzed a 61-year-old man who was a candidate for radical cystectomy surgery due to muscle-invasive bladder cancer. However, due to simultaneous comorbidities and the lengthy surgery time, it was not feasible to perform orthotopic surgery in a single stage. Consequently, the patient's surgery was carried out in two separate stages.

Conducting a radical cystectomy in two stages may aid in minimizing surgical complications, thus enabling patients to benefit from the advantages of urinary diversion through an orthotopic neobladder.

Lung cancer stands as the leading cause of cancer-related deaths worldwide. Over the past three decades, the advent of tyrosine kinase inhibitors (TKIs) has marked a significant turning point in the treatment of non-small cell lung cancer (NSCLC) harboring EGFR mutations. Notably, high response rates have been observed in cases with exon 19 deletions (Del19) and Exon 21 substitution L858R mutations. Conversely, the G719X mutation on exon 18 is less prevalent, with variable sensitivity across different generations of TKIs. Afatinib, a second-generation inhibitor, gained FDA approval for the initial treatment of EGFR-mutant metastatic NSCLC in 2013, though its role remains incompletely understood within a multidisciplinary treatment framework, particularly in combination with surgery. However, the standard daily dose of 40mg Afatinib has demonstrated poor tolerability, often resulting in adverse events such as diarrhea and skin toxicity, leading to treatment discontinuation. A recent strategy involving a weekly dose of 280mg Afatinib has shown promising outcomes and a reduced risk of adverse events.

This case report highlights a 50 - year-old female diagnosed with stage IVa right lung adenocarcinoma metastasizing to the left lung (cT3N0M1a), revealing the rare EGFR-G719C (exon18) mutation. Following this diagnosis, the patient underwent open lobectomy. Nine months post-surgery, a treatment approach involving 280mg weekly Afatinib was initiated. Subsequently, the patient was closely monitored for 16 months with no signs of recurrence.

EGFR G719C exhibits sensitivity to Afatinib, endorsing the use of Afatinib with fewer adverse events compared to the traditional daily dosage. Our case further advocates for collaborative strategies between medical oncologists and surgeons in the management of advanced-stage NSCLC.

Since nurses play a central role in communicating with physicians, patients, and patients' families, special attention should be paid to their role in delivering bad news.

This review aims at describing and highlighting the role of nurses in announcing bad news to patients and families.

This was an integrated review. To collect data, a literature search was conducted in the Persian and English databases of Magiran, Scientific Information Base (SID), Scopus, Google Scholar, Web of Science, and PubMed. Eligibility criteria included publishing in English and Persian between January 1, 1980, and January 1, 2022, describing the role of nurses in delivering bad news to the patient and family. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were used to screen and select relevant studies. Critical appraisal tools provided by the Joanna Briggs Institute (JBI) were used for quality assessment. The collected data were analyzed, using constant comparative methods.

Of the 453 unique records screened, only 26 met the eligibility criteria. The results show that delivering bad news is a team process, in which nurses have several roles. Their main roles were classified into 4 categories: Manager, facilitator, educator, and supporter/advocate, and 74 subordinate roles.

The role of nurses in delivering bad news to patients and their families is important. Their behavior and communication skills significantly affect how they receive this news. Neglecting the role of nurses in this process can damage the patient's trust and understanding of the quality of care. Therefore, nurses should be trained in delivering bad news and supporting patients and families in difficult situations.

Context: 

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive fibrotic interstitial disease with unknown cause and pathogenesis. Idiopathic pulmonary fibrosis patients are more likely to be concomitant with lung cancer (LC) than normal older smoking men. Currently, there is no unified expert consensus on the diagnosis and treatment of IPF combined with lung cancer (IPF-LC) patients.

Evidence Acquisition: 

We performed a computerized search of PubMed database with keywords: Idiopathic pulmonary fibrosis complicated with LC and therapy.

Idiopathic pulmonary fibrosis is an independent risk factor for LC, and there are similar genetic mutations, epigenetic changes, and signaling pathways between IPF and LC. Acute exacerbation of IPF (AE-IPF) poses a significant challenge in the treatment of IPF-LC patients, as surgery, chemotherapy, and targeted therapy may all trigger AE-IPF leading to patient death. The clinical benefits of anti-fibrotic therapy drugs such as nintedanib or combined therapy targeting lung fibrosis and LC are expected to outweigh adverse reactions.

Combination therapy may be an effective strategy for treating IPF-LC in the future, and there is an urgent need to develop appropriate preclinical animal models and conduct more clinical studies to find safe and effective new strategies for treating IPF-LC.

Struma ovarii is a rare ovarian tumor characterized by containing either entirely or predominantly thyroid tissue (> 50%). It accounts for less than 1% of all ovarian tumors and approximately 3% of ovarian teratomas. The condition was first described by Von Klden in 1895.

In this report, we described a 50-year-old Afghan menopausal woman who referred to our hospital with a 5-month history of weight loss, anorexia, hyperthyroidism, abdominal distension and sinus tachycardia. Abdominal radiological findings revealed left adnexal large multilocular cystic lesion and the patient’s CA-125 serum level was high. Preoperatively, the clinicians suggested a diagnosis of ovarian cancer based on the symptoms, radiological findings and high level of CA-125 serum. However, postoperatively, histopathological examination revealed the lesion to be a benign struma ovarii.

Association of struma ovarii with CA-125 and hyperthyroidism is an extremely rare case and are usually misdiagnosed preoperatively due to nonspecific clinical manifestations, and indistinguishable imaging studies, and should be kept in the differential diagnosis of all ovarian cystic lesions. An exact diagnosis is only made by postoperative histopathological examination, and complete surgical resection of the lesion is considered the optimal treatment.

Endometrial stromal sarcoma (ESS) is an uncommon condition that accounts for approximately 0.2% of all reproductive tract malignancies. Among the various subtypes of ESS, low-grade extrauterine endometrial stromal sarcoma (LG-EESS) is even rarer and has only been reported in a limited number of case studies.

We reported a case of LG-EESS in a 35-year-old woman with a five-year history of stage IV endometriosis. The patient presented with chronic abdominopelvic pain and dysmenorrhea. Transvaginal ultrasound showed bilateral tubo-ovarian complexes with multicystic structures, while MRI revealed solid lesions with T1 iso signal, T2 hypersignal, and diffusion restriction, indicating metastatic implantation extending to the peritoneum and subhepatic region. A core needle biopsy confirmed LG-EESS, and immunohistochemistry showed CD10 positivity, aiding in the diagnosis and distinguishing it from other tumors.

Our case highlights the potential utility of preoperative diagnostic imaging, particularly MRI, in the evaluation of LG-EESS. Additionally, it emphasizes the importance of considering the possibility of extrauterine ESS, as this tumor exhibits histopathological features and clinical behavior similar to its uterine counterpart.

Context: 

Adoptive T-cell therapy with chimeric antigen receptor (CAR) has shown tremendous progress in hematological cancers. However, some obstacles, such as high price tag, cytokine release syndrome, inability to penetrate solid tumors, and manufacturing complexity limit the wide application of this therapy. Natural killer (NK) cells can kill target cells via mechanisms similar to those of CD8+ cytotoxic T cells; therefore, CAR-NK cell therapy is a promising strategy for cancer treatment.

Evidence Acquisition:

 In this manuscript, all articles published in English regarding CAR-NKs and their application for the treatment of different types of cancers were collected from several databases, including PubMed, Scopus, and Google Scholar, using related keywords such as "Cancer, CAR construction, NK cells, and CAR-NK cells".

Compared with CAR-T cells, CAR-NK cells have several advantages, including less toxicity, a high potential opportunity for universal off-the-shelf manufacturing, increased infiltration into solid tumors, overcoming resistant tumor microenvironment, and absence of graft-versus-host disease (GVHD).

In this review, we discuss NK cell biology, the source of CAR-NK cells, CAR structure, advances, challenges, and ways to overcome these challenges in CAR-NK cell therapy. Furthermore, we have summarized and highlighted some preclinical and clinical studies in this field.

Ganglioneuromas (GNs) are benign tumors composed of gangliocytes and mature stroma which is usually asymptomatic. The GNs are differentiated neuronal tumors without immature elements and can arise from peripheral autonomic ganglion sites. The main treatment for that is complete surgical excision. In the case of tumor resection, chemotherapy and radiotherapy are not indicated.

The 12-year-old boy was referred to Abouzar Hospital in Ahvaz with complaints of cough, cold, and shortness of breath. Based on abdominal and pelvic CT scans, a heterogeneous hypodense mass (135 × 105 mm) was observed in the left upper region. The pathology of it was ganglioneuroma. Then the patient underwent surgery with a midline incision extending to the 6 - 7 intercostal space. Finally, the patient was discharged with good general condition.

The most effective treatment for ganglioneuroma is complete surgical removal of the mass. This study highlights the importance of imaging in diagnosing ganglioneuroma as a tumor located in the posterior mediastinum.

Context: 

The review of palliative care (PC) policies was introduced as one of the four main components of the WHO PC strategy. Considering that eastern Meditranian region countries (EMRCs) has made efforts to establish and develop PC in recent years, coordinated data collection provides a clearer picture of needs, challenges, and barriers at the regional level.

The aim of this study was to analyze PC policies related to cancer in the EMRCs.

A scoping review was conducted and reported following the PRISMA extension guidelines for scoping reviews (PRISMA-ScR). Scopus, Medline, Embase, ScienceDirect, PubMed, Web of Science, Google Scholar, and ProQuest were searched to identify relevant articles published in English and no limit time considered PC related policies in EMRCs. A Walt and Gilson model (context, content, process and actors) was used as a framework for analyzing and summarizing findings

Out of the 43 papers included in this study, 38 (88.37%) were journal articles. The studies covered countries such as Egypt, Jordan, Saudi Arabia, Lebanon, Cyprus, Oman, United Arab Emirates, Palestine, and Iran. The extracted policies were classified into leadership and commitment of policy makers, affordable access (in context), providing integrated patient-family oriented services, improving the quality of care, creating the possibility of information-sharing (in content), Focus/invest in specialized training, capacity building in society (in process), and involve all stakeholders (in actors).

The results of the present study provide a clear picture of how policies are made in the field of PC design and development in EMRCs. Before establishing such a system, it is essential to consider a wide range of economic, social, cultural, and political factors, mainly included in the four axes of Walt and Gilson's policy triangle. The results of this research can be used in policy making, design and formulation, as well as in decisions related to PC system programs.

Childhood cancer is significant due to its high prevalence and its impact on the entire family, resulting in various psychological, social, economic, and communication challenges for the families.

The aim of this study was to explore the barriers and facilitators to pediatric oncology social work practices in Iran.

This qualitative study used a content analysis method and involved 19 pediatric oncology social workers. We used a purposeful sampling method until data saturation was reached. Data were collected through semi-structured interviews and field observations and then analyzed.

This study demonstrated that the factors influencing social workers' practice include personal characteristics and interpersonal communication at the micro level, while barriers mainly consist of cultural, social, economic, organizational, and structural dimensions at the macro level.

In order to better support children with cancer and their families, policymakers and health system managers need to give special attention to the status of social workers. Strengthening support systems and addressing the challenges they face can be effective in protecting the professional practices of these caregivers.

Granulomatous mastitis (GM) is a chronic inflammatory disorder affecting breast tissue, with a high recurrence rate.

Regarding this impotence, this paper aims at proposing a retrospective approach to compile an extensive dataset of clinical information as well as to identify potential risk factors associated with GM recurrence.

For this purpose, data on pathologically-confirmed cases of GM were retrospectively collected from the medical archives of the Shahid Beheshti Cancer Research Center, Iran, from March 2020 to February 2023. Then, the descriptive statistics were utilized to analyze demographic information, disease-related variables, patient-related variables, and details regarding treatment modalities. Evaluation of disease recurrence occurred 24 months following the initial GM diagnosis through clinical assessments, ultrasound, or mammography. Among the 100 accessible patients, 33 experienced recurrences within 24 months.

According to the obtained results, factors significantly associated with recurrence included body mass index (28.31 vs. 26.05), history of breastfeeding and its duration (22.44 months vs. 16.95 months) (90.9% vs. 72.7%), abortion, pain (72.7% vs. 46.3%), erythema nodosum (51.5% vs. 16.4%), hypertension (18.2% vs. 3%), thyroid disease (33.3% vs. 14.9%), rheumatologic disease (69.7% vs. 13.4%), dermal involvement (51.5% vs. 10.9%), joint involvement (85.9% vs. 39.4%), and the combined treatment modalities (45.5% vs. 11.9%). Moreover, the predictive model exhibited an overall accuracy of 83.3%.

Finally, it can be concluded that abortion history, breastfeeding and its duration, combined treatment, pain, erythema nodosum, hypertension, thyroid or rheumatologic disease, dermatologic or joint signs, and Body Mass Index (BMI) could be the significant factors related to the recurrence of GM. Thus, special attention to these factors and management of baseline disease may have a predictive effect on the relapse of idiopathic granulomatous mastitis (IGM).

Esophageal squamous cell carcinoma (ESCC) is one of the most lethal types of cancer. Late diagnosis significantly decreases patient survival rates.

The study aimed to identify survival groups for patients with ESCC and find predictive biomarkers of time-to-death from ESCC using state-of-the-art deep learning (DL) and machine learning algorithms.

Expression profiles of 60 ESCC patients, along with their demographic and clinical variables, were downloaded from the GEO dataset. A DL autoencoder model was employed to extract lncRNA features. The univariate Cox proportional hazard (Cox-PH) model was used to select significant extracted features related to patient survival. Hierarchical clustering (HC) identified risk groups, followed by a decision trees algorithm which was used to identify lncRNA profiles. We used Python.3.7 and R.4.0.1 software.

Inputs of the autoencoder were 8,900 long noncoding RNAs (lncRNAs), of which 1000 features were extracted. Out of the features, 42 lncRNAs were significantly related to time-to-death using the Cox-PH model and used as input for clustering of patients into high and low-risk groups (P-value of log-rank test = 0.022). These groups were then labeled for supervised HC. The C5.0 algorithm achieved an overall accuracy of 0.929 on the test set and identified four hub lncRNAs associated with time-to-death.

Novel discovered lncRNAs lnc - FAM84A-1 , LINC01866 , lnc - KCNE4-2 and lnc - NUDT12-4 implicated in the pathogenesis of death from ESCC. Our findings represent a significant advancement in understanding the role of lncRNAs on ESCC prognosis. Further research is necessary to confirm the potential and clinical application of these lncRNAs.

The cumulative dose-volume histogram (DVH) parameters for organs at risk (OAR) and the target volume, obtained from external beam radiotherapy (EBRT) and brachytherapy (BT), are commonly calculated manually in clinical practice.

This study aims at comparing the manual and automatic methods for calculating cumulative DVH parameters of OAR and the target volume in patients with cervical cancer.

The cumulative DVH of EBRT and BT methods for target volume and OAR, including rectum, bladder, and sigmoid was calculated manually, using the EQD2 (equivalent dose in 2 Gy fractions) formula. In the automatic method, dosimetric data were collected as DICOM files and entered into SagiPlan ® BT software. Using the BED/EQD2 summation feature, the BT and EBRT plans were summed, and the cumulative DVH parameters were extracted. The results were compared with the manual method.

In 32 cervical cancer samples, dosimetric comparisons showed significant differences between manual (EQD2) and automatic (SagiPlan ® ) calculations for rectum (mean dose 69.15 vs. 71.92 Gy, P < 0.01), bladder (mean dose 81.87 vs. 84.47 Gy, P < 0.01), and sigmoid (mean dose 69.84 vs.73.15 Gy, P < 0.01). However, the cumulative dose to the target tissue was similar between the two methods (mean dose 86.9 vs. 86.91, P = 0.21). Automatic calculations indicated higher doses of the OARs, suggesting potential underestimation by manual methods.

In clinical practice, when designing BT planning for cervical cancer, it is recommended to input the patient’s EBRT design data into the planning software to determine the cumulative dose received by the target and OARs.

The management of locally advanced cervical cancer (stages IB2 to IIB) remains controversial, particularly in regions with limited radiotherapy (RT) resources. While chemoradiation therapy (CRT) is the standard treatment in many Western countries, neoadjuvant chemotherapy followed by radical surgery (NACT-RS) has emerged as an alternative approach.

The comparative effectiveness and safety of NACT-RS versus CRT in terms of side effects and recurrence rates remain unclear, necessitating further investigation.

A cohort study was conducted from 2020 to 2023, involving 68 patients with cervical carcinoma (stages IB2 to IIB). The patients were stratified into two treatment groups: Neoadjuvant chemotherapy followed by radical surgery (N = 17) and CRT (N = 51). The study compared pathology reports, short-term treatment complications, and one-year recurrence rates between the two groups.

Minor complications occurred in 41.2% of the NACT-RS group and 39.2% of the CRT group (P = 0.886), while major complications were observed in 23.5% and 25.5% of the groups, respectively (P = 0.872). All NACT-RS patients responded to chemotherapy with significant tumor size reduction (47.7 ± 8.0 vs. 11.2 ± 8.6, P < 0.001) and resolution of vaginal involvement. During the one-year follow-up, no recurrences were observed in the NACT-RS group, compared to eight out of 51 (16.7%) in the CRT group (P = 0.186).

The similar short-term complication rates and potentially lower one-year recurrence rate in the NACT-RS group suggest that this approach may be a viable alternative to CRT, particularly for young patients with bulky tumors and in areas with limited RT facilities.

In recent decades, laparoscopy and robotic surgery are mostly used for the treatment of endometrial cancer. Laparoscopic surgery's popularity has grown due to rapid postoperative recovery and reduced post-surgical morbidity and complications compared with open surgery.

This study aimed to compare laparoscopic surgery and laparotomy in terms of their advantages and disadvantages for treating early-stage endometrial cancer in a population of Iranian patients in a referral center of gyneco-oncology.

In this cohort study at Imam Hossein Medical Center in Tehran, Iran, from 2019 to 2022, early-stage endometrial cancer patients were included. Advanced disease, patients with medical comorbidity not suitable for laparoscopy, previous surgery for endometrial cancer, and prior chemotherapy or radiotherapy for treatment of the endometrial cancer were excluded from the study. The study compared two groups regarding operative findings, including FIGO stage, grade, postoperative complications, and hospitalization days.

The study included 17 patients in the laparoscopic group with a mean age of 56 (+ 12.5) years old and 44 patients in the laparotomy group with a mean age of 57 (+10.2) years old. Two groups were well-matched in terms of Body Mass Index and menopausal status. The median intraoperative blood loss was significantly in terms of statistical less in the laparoscopic group (200 mL versus 500 mL, P = 0.001). Four (23.5%) patients in the laparoscopic group needed intraoperative blood transfusion versus 22 (50.0%) in the laparotomy group, P = 0.061. Hospital stay days were shorter in the laparoscopic group, with a median of three versus six days (P < 0.001).

In conclusion, the minimally invasive operation caused less blood loss, hospital stay, and blood transfusion in comparison to laparotomy in Iranian endometrial cancer patients, confirming the preferred method of laparoscopy in these patients.

Despite medical advancements and treatment development, children with cancer experience a wide range of symptoms related to the disease and treatment side effects. Providing palliative care is essential to improve the quality of life for both the child and the family. Given limited available resources, cost-effective service packages can address this need.

This study aimed to develop an essential palliative care package for children with cancer in Iran.

The study was under Health System Research and employed an exploratory mixed method design in three phases. The initial stage involved two sub-studies including a review of literature and a qualitative study. In the subsequent phases, the package draft was compiled and validated using the Delphi technique with input from 12 experts.

The essential palliative care package for children with cancer comprised two main components: INPUT, including dimensions related to medicine, human resources, equipment, and service delivery setting. INTERVENTION, encompasses physical, psychological, social, spiritual symptom management, and growth and development.

Customized for Iran's social and cultural context, this essential service package provides safe, efficient, convenient, and affordable care. Physicians and nurses with primary training can integrate it into primary care including home care, emphasizing the importance of palliative care.

The prognosis of thyroid cancer treatment is unsatisfactory in the presence of different independent parameters, such as older age, which may worsen the quality of life and mental health of patients. It is necessary to improve the quality of life and mental health of patients with thyroid cancer.

This study evaluated the nurse-led care impact as psycho-oncological support on anxiety and quality of life of patients with a history of thyroid cancer, comparing it to a consultant-led usual care and a non-care.

Patients received half an hour of nurse-led care (NC cohort, n = 105), or consultant-led usual care (UC cohort, n = 125), or did not receive healthcare professional-led care (PO cohort, n = 135) at the institute during treatment and a follow-up period of 12 months. The EORTC QLQ-C30 Chinese version was used to assess the quality of life. Anxiety and depression were evaluated, using the Hospital Anxiety and Depression Scale.

Before the healthcare professional-led care, the quality of life scale score was 35 (36 - 33) and all patients had definitive anxiety and depression (scale score ≥ 11). After 12 months of the healthcare professional-led care, patients in the NC cohort showed improved quality of life and decreased anxiety and depression as compared to them before the healthcare professional-led care conditions and those of patients in the UC and PO cohorts after 12 months of the healthcare professional-led care (P < 0.001 for all). A higher number of patients survived in the NC cohort than in the UC (P = 0.0327) and PO (P = 0.0014) cohorts. Personal satisfaction of patients was higher in the NC cohort than in the UC and PO cohorts (P < 0.001 for both). Patient satisfaction was higher in the UC cohort than in the PO cohort (P < 0.001).

Supportive cancer care after surgery or during follow-up is necessary in patients with thyroid cancer. Nurse-led care had beneficial effects on the quality of life, psychological conditions, survival, and personal satisfaction of patients with thyroid cancer during the follow-up period.

In recent years, the application of herbal compounds in cancer treatment has shown significant progress. Curcumin (CUR), a natural polyphenol, demonstrates potent anti-cancer effects against various cancers, including breast cancer (BC). Curcumin targets a range of molecular pathways, contributing to the inhibition of cancer cell proliferation, metastasis, and angiogenesis, and promoting apoptosis.

This study aimed to assess the effect of CUR on BC cells, focusing on alterations in the expression levels of Mir-15a and Bcl-2 through the apoptotic pathway.

The cytotoxicity of CUR was evaluated using an MTT assay. Changes in the expression of Mir-15a and Bcl-2 genes were analyzed by real-time PCR, and cell apoptosis was measured using flow cytometry. Data analysis was conducted using SPSS.

The MTT assay results indicated that cell viability decreased as CUR concentration increased (5 – 25 µM). Real-time PCR results showed a significant decrease in the expression of Mir-15a and Bcl-2 (P < 0.05). Flow cytometry findings demonstrated that CUR treatment at the IC50 concentration for 48 hours induced apoptosis in 75.9% of MCF-7 cells.

Our study provides a crucial foundation indicating that CUR induces apoptosis in MCF-7 cells by modulating the expression of Mir-15a.

More than 90% of cervical cancers are related to chronic inflammation caused by HPV. Several studies have shown that laboratory hematological parameters can detect the severity of systemic inflammation.

Our current cohort study investigated the predictive role of pretreatment hematological parameters for response to definitive chemoradiotherapy in patients with locally advanced cervical cancer (LACC).

Prospectively, patients with LACC who candidates for definitive chemoradiation at Shohadaye Haftom-e-Tir and Firozgar Hospitals (Tehran, Iran) were included in our study between April 2021 and December 2022. Hematological parameters were obtained from the blood sample test and peripheral blood smear before treatment. All patients diagnosed in stage IB to IVA received a similar treatment protocol and follow-up. Patients were divided into complete clinical (CR) and non-complete clinical responses (Non-CR). Leukocyte, Lymphocyte, neutrophil, platelet, hemoglobin (Hb), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR), were documented and then compared between two groups of responders. We used receiver operating characteristic (ROC) analysis to investigate the predictive value of these hematological parameters.

Out of 34 patients who met the inclusion criteria, 25 (73/5%) patients were complete responders and 9 (26.5%) were non-complete responders. The average number of neutrophils, leukocytes, and NLR was significantly higher among Non-complete responders. Hemoglobin in patients with non-complete responses was significantly lower than that of the other group of responders. Receiver operating characteristic curve analysis showed that the optimized cut-off values for pretreatment Hb and NLR were 11 and 2.1, respectively. Neutrophil-to-lymphocyte ratio cut-off point > 2.1 is significantly associated with larger tumor size, low Hb, high platelet, and high leukocyte.

hematological markers such as NLR can be a simple and inexpensive predictive factor to evaluate therapeutic response to chemoradiation in LACC patients.

Leukemia progression is intricately linked to interactions with neighboring cells within the bone marrow microenvironment (BMM), and small extracellular vesicles (sEVs) emerge as vital mediators in facilitating these interactions.

This study examined the proliferation effects of sEVs-derived from acute myeloid leukemia (AML) in the HL60 cell line on the cell cycle progression of bone marrow mesenchymal stem cells (BM-MSCs), a key element of the BMM.

Small extracellular vesicles were isolated from the HL60 cell line supernatant, using the ExoCib kit, and characterized through flow cytometry, transmission electron microscopy (TEM), dynamic light scattering (DLS), and bicinchoninic acid (BCA) protein assay. bone marrow mesenchymal stem cells were cultured and treated with various concentrations (20 μg/mL, 50 μg/mL, and 80 μg/mL) of AML-derived sEVs for 24, 48, and 72 hours. The effects on cell proliferation and viability were assessed, using methylthiazole tetrazolium test (MTT) and Ki-67 assays, while cell cycle progression and apoptosis were analyzed via flow cytometry. RT-qPCR was performed to evaluate the expression levels of CCND1, CDK4, CDK6, and AKT1 genes.

The proliferation effects of AML-derived sEVs on BM-MSCs were both dose- and time-dependent, with optimal effects observed at 50 μg/mL after 48 hours. Flow cytometry analysis revealed a significant increase in the G1 phase, showing a 1.8-fold change compared to the control group (P < 0.0001). RT-qPCR results demonstrated a significant upregulation of CCND1 (3.5-fold, P < 0.0001), CDK4 (3.2-fold, P < 0.0001), CDK6 (2.5-fold, P < 0.0001), and AKT1 (3.2-fold, P < 0.0001) expression levels, along with increased Ki-67 (2.3-fold, P < 0.0001) levels. Moreover, treatment with 50 μg/mL of AML-derived sEVs resulted in a notable reduction in BM-MSC apoptosis (0.57-fold decrease, P < 0.0001).

Our findings revealed that AML extracellular vesicles could alter the gene expression associated with the proliferation of BMSCs to increase their proliferation by stimulating the cell cycle of MSCs through the G1 phase.

Studying microvessel density (MVD) as an angiogenesis indicator enhances insights into tumor diversity, predicting invasive or metastatic tendencies. It assists in tailoring treatment approaches based on angiogenesis expression in different tumors.

This study aimed at assessing MVD using the CD31 marker and its associated factors in individuals with endometrial malignancies.

This cross-sectional study involved 118 patients with endometrial cancer (EC) at Imam Hussein Educational and Medical Center, Tehran, Iran spanning from 2018 to 2023. Data, gathered from patient medical files using a researcher-made checklist, included a quantitative assessment of angiogenesis using the CD31 endothelial marker for MVD. Linear regression models were utilized to identify predictors of MVD-CD31 in patients with EC.

Patients had a mean age of 57.35 ± 11.16 years. The overall mean MVD-CD31 was 157.06 ± 94.31 (range, 32 - 385). Those with over 50% invasion depth exhibited a higher MVD-CD31 (79.59 units) compared to those with no invasion depth (P = 0.003). Higher MVD-CD31 levels were also associated with lymph node involvement and metastasis to other organs (P < 0.001). In comparison to grade 1 tumors, grade 2 tumors showed elevated MVD-CD31 (mean difference: 64.85, P = 0.007). Clear cell carcinoma tumor type had significantly higher MVD-CD31 than low-grade endometrioid carcinoma (mean difference: 225.84, P = 0.005).

Our results suggest that some tumor characteristics such as invasion depth, lymph node involvement, tumor grade, and tumor type may play a role in angiogenesis in patients with EC. These findings suggest that tumor features play a crucial role in modulating angiogenesis in EC.

Despite substantial efforts to leverage natural killer (NK) cells in cancer immunotherapy, challenges associated with limited cell numbers and sources persist. In this study, our objective is to differentiate NK cells from cord blood hematopoietic stem cells (CB-HSCs) and assess their anti-tumor effects.

Cord blood samples were obtained from pregnant women undergoing normal delivery. Mononuclear cells (MNC) were isolated by gradient centrifugation. Subsequently, HSCs were isolated using the MACs cell separation kit. The isolated HSCs were cultured in NK cell differentiation and expansion media for 21 days and 7 days, respectively. The NK cells were examined for expression of activating markers, cytokine secretion and cytolytic effects by flow cytometry, ELISA and XTT tests, respectively.

High-purity HSCs and NK cells were obtained in this study. The CB-HSCs-derived NK cells exhibited significantly higher expression of NKG2D, NKp30, NKp44 and NKp46 receptors (at day 28 of treatment) after treatment by IL-15 and IL-2, compared to the early differentiated NK cells (day 21). NK cells derived from CB-HSCs treated with the combination of IL-15 and IL-2 could robustly lyse breast cancer MCF-7 and K562 cells. Also, the obtained NK cells were able to release higher amounts of TNF-α and IFN-γ cytokines in response to tumor cell experiences.

Our findings showed that functionally active CB-HSCs-derived NK cells can be successfully generated ex vivo using a cytokine cocktail without a need for stroma for potential use in the cancer immunotherapy.

Ultrasonography (US) plays a crucial role in managing recurrent and persistent tumors in thyroid cancer, the most common endocrine malignancy, affecting approximately half a million people worldwide annually.

This study investigates the use of local US criteria to differentiate between post-operative changes (such as seroma, granulation tissue, and surgical material), residual normal thyroid tissue, tumor remnants, metastatic adenopathy, and nonspecific lesions after thyroidectomy in patients with thyroid cancer.

A total of 177 thyroid cancer patients (76.3% female) were referred to the US and followed up for a final histopathological diagnosis. US results were compared with needle biopsy findings.

Histopathology confirmed 95.8% (113/118) of the US-identified lesions as malignant and 78.6% (44/56) as benign. In total, 125 lesions were malignant, while 49 were benign. The US had a sensitivity of 90.4%, specificity of 89.8%, diagnostic accuracy of 90.23%, positive predictive value (PPV) of 95.76%, and negative predictive value (NPV) of 78.57%. The positive and negative likelihood ratios were 8.9 and 0.11, respectively. Vascular patterns had the highest sensitivity, specificity, and accuracy among the parameters studied, but shape and echogenicity were unsatisfactory.

Our results demonstrated that the US has around 90% sensitivity and specificity in identifying malignancy in postoperative thyroid cancer patients. These findings suggest that neck US is an effective technique for diagnosing thyroid bed lesions.

The objective of this study was to utilize random forest methodology to develop a practical diagnostic function for predicting lymph node metastasis in patients diagnosed with breast cancer.

The research data of this retrospective cohort study was obtained through a comprehensive analysis of telephone interviews and medical records of 241 patients with breast cancer referred to the hospitals affiliated with Mazandaran University of Medical Sciences between 2016 and 2022. The data analysis method used in this study was random forest analysis to identify the influential factors associated with lymph node metastasis using R software.

The mean age of diagnosis for patients was 52.03 ± 10.932. Based on the random forest analysis outcomes, an accuracy rate of 72.2% has been attained. The influential factors in our study included grade, tubule formation, skin involvement, p53 marker, margin involvement, nuclear pleomorphism, Ki67, tumor location, estrogen receptor (ER), and (progesterone receptor) PR markers. These factors were determined to have a significant impact based on the mean accuracy reduction index. Furthermore, the variables that demonstrated significance based on the mean Gini reduction index included age, grade, tubule formation, tumor size, nuclear pleomorphism, disease level, mitosis, skin involvement, tumor location, and margin involvement.

The utilization of the random forest algorithm, which demonstrates a favorable level of discriminative capability, may serve as a suitable approach for predicting metastasis in patients with breast cancer. Furthermore, by identifying these factors, experts can employ effective strategies to mitigate the condition.

Although vitamin D has been known as an effective substance in bone homeostasis, recent studies indicated a number of other biological properties attributed to vitamin D. Patients, who are candidates for hematopoietic stem cell transplantation (HSCT), were shown to be at high risk of vitamin D deficiency.

This study aimed at exploring the association between serum levels of vitamin D and biochemical markers among HSCT candidates.

Totally, 214 patients, aged 18 to 65 years, were recruited in the current cross-sectional study. Within 24 hours of admission to the Bone Marrow Transplant ward, baseline clinical and demographic characteristics of study participants, serum levels of vitamin D, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin, albumin, total protein, CRP-albumin ratio (CAR), and body mass index (BMI) were assessed. Participants were divided into 4 groups based on their serum vitamin D levels: Subjects with deficient, insufficient, sufficient, and optimal levels of vitamin D.

Across the 4 defined categories of serum vitamin D levels, there was no significant difference in terms of BMI, laboratory parameters, inflammatory factors, and biochemical markers. This lack of significant variation remained in both unadjusted and adjusted models.

These observations indicate a lack of significant association between serum vitamin D levels and BMI, inflammatory factors, and biochemical markers in individuals undergoing evaluation for HSTC.

This study investigated complications and 30-day readmission rates following lobectomy for lung cancer in a pre-enhanced recovery after surgery (ERAS) program setting at the University Medical Center Ho Chi Minh City, aiming to identify key areas for improvement.

A retrospective analysis was conducted on 99 patients who underwent lobectomy for lung cancer. Data on patient demographics, surgical details, and postoperative outcomes were collected. Complications were categorized using the Clavien-Dindo classification system, and statistical analyses were performed using STATA software.

Among the 99 surveyed patients, 53.5% were male, and 46.5% were female, with the majority being over 60 years old. The postoperative complication rate was 19.2% (30.9% reduction with multimodal pain relief, P = 0.001), and the 30-day readmission rate was 13.1% (19.4% reduction with physical therapy before surgery, P = 0.008). High-risk complication factors included open surgery (42.9%) compared to video-assisted thoracoscopic surgery (VATS) (11.8%) (P = 0.026) and vomiting after surgery (46.7%, P = 0.008).

The findings underscore the necessity of integrating ERAS principles to enhance postoperative care and outcomes in lung cancer surgery. Implementing ERAS protocols could potentially reduce complications and readmissions, improving patient experiences and surgical efficacy. Future research will focus on applying these insights within the ERAS framework to optimize lobectomy outcomes.

Renal cell carcinoma (RCC) is the 9th most common cancer in men and the 14th most common in women. To date, there remains considerable uncertainty regarding factors that influence the survival of RCC patients.

This study aimed to determine the clinicopathologic characteristics and outcomes of RCC over a 15-year period in northeast Iran.

Data were collected from RCC patient records at Omid and Imam Reza Hospitals and Reza Radiation Oncology Center from 2001 to 2016. Demographic and clinicopathological data were extracted from patient records, and the current status of participants was assessed through telephone follow-ups. Overall and disease-free survival were analyzed using SPSS version 20.

A total of 230 RCC patients were enrolled in this study. The majority of patients were male, with a mean age of 56.78 years. Overweight status was common among patients, and pain was the most frequently reported symptom. The most common histologic subtype was clear cell carcinoma. The median follow-up period was 10.50 months, with overall survival rates at 1, 3, 5, and 10 years being 74.8%, 52.2%, 44.8%, and 39.6%, respectively. The mean overall and disease-free survival rates were approximately 24 and 25 months, respectively. Survival was significantly associated with RCC histologic subtype, disease stage, hemoglobin level, and underweight status. In contrast, sex, type of surgery, and chemotherapy regimen did not significantly impact survival.

Renal cell carcinoma patient survival was influenced by histologic subtype, disease stage, low hemoglobin levels, and underweight status.

Breast cancer (BC) is the most common type of cancer among Iranian women. The cost of breast cancer treatment is high, and many families struggle to afford it.

This study was conducted with the aim of determining the out-of-pocket (OOP) health expenditure and factors affecting it in BC patients in Shahid Jalil Hospital affiliated to Yasuj University of Medical Sciences, Iran.

This study was conducted in a cross-sectional descriptive-analytical way. Based on the inclusion criteria, the health expenditure of 82 patients with BC were collected. The data was gathered from Shahid Jalil Hospital, affiliated with Yasuj University of Medical Sciences. It includes inpatient and outpatient information from the Iran Health Insurance Organization, as well as patient-declared costs in 2022. The study data analyzed using descriptive statistics methods including frequency, percentage, mean and standard deviation, and stepwise linear regression to investigate the effect of variables on the amount of OOP health expenditure in SPSS 21 software.

The OOP expenses for BC patients accounted for 32.89% of the total direct medical expenses. Of the OOP costs, 47.18% were attributed to drug expenses, 16.19% to laboratory costs, 11.74% to imaging expenses, 11.20% to visit costs, 8.40% to hospitalization expenses, 2.84% to doctor’s services, and 2.45% to physical therapy-related expenses. Factors such as age, place of residence, occupation, education, and household income were among the factors that had a significant effect on OOP payments (P < 0.05). Marital status, housing situation, and social coverage had no significant effect on patients' OOP payments (P > 0.05).

BC patients incur a lot of expenses, and about 32.89% of these expenses are OOP payments. It is essential for insurance organizations to increase their coverage, while also requiring additional support from the government for patients with breast cancer in obtaining necessary medication and medical supplies.

In recent decades, timely diagnosis, advancements in the pharmaceutical industry, and the introduction of new treatments have led to a significant increase in the number of cancer survivors. Just as the physical and mental well-being of cancer patients is essential, providing psychological care for survivors is equally important.

In the realm of community mental health, cognitive function, and health literacy play crucial roles in the quality of life of cancer survivors. Furthermore, recognizing and addressing gender differences in this context can be a valuable means of enhancing and improving survivors' quality of life.

This study employed a descriptive correlational design involving 437 cancer survivors (319 female and 118 male) from the Cancer Research Center of Shahid Beheshti University of Medical Sciences (Shohada-E-Tajrish Hospital). Participants, who had completed their last treatment at least one year prior, volunteered to participate between September 1 and January 30, 2022. They responded to three assessments: The Cognitive Failure Questionnaire, the cancer health literacy Test, and the quality of life in adult cancer survivors survey.

Multiple regression analysis showed that about 58% of the quality of life of cancer survivors is explained by cognitive function failure. Still, in the group of men, 30% of the quality of life can be predicted based on insufficient cognitive function and health literacy.

Based on the findings, it was emphasized on cognitive function training and health literacy in both genders to increase the life of patients with cancer.

Colorectal cancer is one of the top 5 common cancers in Iran with over 1.9 million new cases. Completeness of pathology reports is one of the key factors of cancer care management. So, sufficient reporting of pathological factors is vital for optimum diagnosis, projection of prognosis and patient care.

To support epidemiological research, we determined the completeness of colorectal cancer pathology reports at the nationwide level.

Accessing to the text of pathology reports from a web-based application that was created by the Iranian National Population-Based Cancer Registry (INPCR) was considered the most complete and reliable. We requested that the INPCR extracts their pathology records for manual review for colorectal cancer (ICD-10 code ‘C18’, ‘C19’, ‘C20’, and ‘C21').

Exclusion criteria were applied and 2092 pathology reports were analyzed. The mean age of patients was 61 years; 56% were male. A vast number of colorectal cancer cases were at T3-stage (colon 68.4%, rectal 58.6%) and N0-stage (colon 55.7%, rectal 57%). Information on key prognostic factors, such as lymphovascular and perineural was frequently lacking (22.7% and 35.7% missing, respectively). On the other hand, Tumor type and tumor grade had a high percentage of reporting (100% and 100%, respectively). In addition, our study revealed a low rate of overall complete reporting (colon 0.2%, rectal 1.1%).

Optimum diagnosis, prediction of prognosis, and patient care require sufficient reporting of pathological factors, so efforts should be made to improve the reporting of overall pathology factors of Colorectal cancer (CRC).

Acute myeloid leukemia (AML) is a type of blood cancer with diverse genetic pathogenesis. The identification of potential molecular biomarkers could improve the AML diagnosis and targeted therapy. Recently, competing endogenous RNAs (ceRNAs) became an active area in cancer research to determine molecular mechanisms underlying tumor development.

The aim of the present study was to investigate the key molecular biomarkers that are closely related to AML through bioinformatics analysis.

In this research, the RNA-seq data of 151 AML patients and 151 corresponding health samples were retrieved from The Cancer Genome Atlas (TCGA) database and GTEx Portal (genotype-tissue expression), respectively. After that we screened the differentially expressed long non-coding RNAs (lncRNAs), microRNAs (miRNAs), and mRNAs by “limma” package in R to construct the co-expression network ceRNA (miRNA-lncRNA-mRNA) with weighted gene co-expression network analysis (WGCNA) package in R and Cytoscape (version 3.7.2) software, respectively. Then the relevant modules were identified and functional enrichment analysis was used to uncover the modules that are biologically related to AML cancer.

Based on our bioinformatics studies, we constructed a significant module which contain 333 genes. Among them, five up-regulated miRNAs with the highest GS (gene significant), include hsa-miR-374B, hsa-miR-553, hsa-miR-3679, hsa-miR-548L, hsa-miR-597 and five down-regulated miRNAs with the lowest GS including hsa-miR-3934, hsa-miR-4746, hsa-miR-466, hsa-miR-6722, hsa-miR-4490. For protein-coding genes (PCGs), the top-five up-regulated PCGs with the highest GS were AMIGO3, H2AC17, SPACA5, GPR21, and OR13C3. The top-five down-regulated PCGs with the lowest GS were XBP1, TOMM6, TREX1, TNFRSF6B, and BOLA2. Among the lncRNAs, the five up-regulated lncRNAs with the highest level of GS were GREP1, ZBTB20-AS2, LINC01596, LINC00345, and RMRP. The five down-regulated lncRNAs with the lowest GS were LINC01609, LINC01707, LINC02270, LINC02309, and LINC02243. These lncRNAs can serve as potential biomarkers to distinguish between AML and normal samples.

Finally, considering the role of ceRNA network in various biological processes, examining the role of ceRNAs in AML may provide a deeper insight into molecular mechanisms underlying the pathogenesis of cancer. This understanding may propose potential biomarkers for diagnosis and therapeutic interventions.

The management of ureteric obstruction secondary to pelvic malignancies (UOPM) presents a significant challenge.

Our study aimed to assess the factors affecting the feasibility of interventions for patients with UOPM - including retrograde and antegrade double J (DJ) stenting, and percutaneous nephrostomy (PCN) insertion.

We conducted a retrospective analysis of patients who underwent intervention for UOPM over two years, from January 2022 to December 2023. Patients were categorized into groups based on intervention type: Group 1: Retrograde DJ stenting, group 2: Antegrade DJ stenting, and group 3: PCN insertion. Demographic, clinical, radiological, cystoscopic, and laboratory data were compared between the three groups. Analysis of Variance (ANOVA), logistic regression, and marginal mean plots were utilized for statistical analysis.

Fifty–nine patients were included in the study, consisting of 14 males and 45 females, and the mean age of the study population was 60.1 ± 10.8 years. Retrograde DJ stenting was successfully achieved in 59.3% of patients, with 10.2% undergoing antegrade DJ stenting and 30.5% needing PCN insertion. Serum albumin (P = 0.04), serum creatinine (P = 0.02), albumin creatinine ratio (P < 0.001), and severity of hydroureteronephrosis (HDUN) (P = 0.02) were significantly associated with intervention outcomes. There was an increased likelihood of PCN insertion in higher serum creatinine and lower serum albumin levels. Multinomial logistic regression with univariate and multivariate analysis revealed significance among the above-mentioned variables.

Even though DJ stenting remains common, a significant proportion of patients require PCN insertion. Serum albumin, serum creatinine, albumin creatinine ratio, and HDUN severity are significant predictors of intervention success. Further research is warranted to validate these findings and enhance management strategies for UOPM.

The advances in the treatment of non-small cell lung cancer (NSCLC) have yielded notable progress through targeted therapies and immunotherapies. Lycopene, a carotenoid pigment found in tomatoes, has demonstrated potential pharmacological effects, particularly in attenuating oxidative stress and inflammation.

This study aims at investigating the synergistic effects of combining lycopene with NK cell therapy to address these challenges in NSCLC treatment.

Human cell lines (HUVEC, BEAS-2B, NCI-H460, and A549) were cultured, and NK cells were isolated, using a specific kit. A variety of assays, including colony formation, CCK-8, FACS detection, RT-qPCR, IFN-γ, CD107α secretion, and ELISA, were employed to assess the impact of Lycopene on NSCLC cells and NK cells both individually and in combination.

Lycopene exhibited limited cytotoxicity towards normal human cells and demonstrated moderate efficacy against NSCLC cells. Notably, it significantly enhanced NK cell viability and proliferation. The combination of lycopene with NK cells yielded a synergistic effect, characterized by improved killing efficiency, diminished colony formation, and elevated secretion of IFN-γ and CD107α. Mechanistically, the study explored the NF-κB signaling pathway, uncovering an upregulation of key RNA transcripts implicated in NK cell activation.

This study provides valuable insights into the potential of integrating lycopene and NK cell therapy to enhance NSCLC treatment. The observed synergistic effects, especially the activation of the NF-κB signaling pathway, indicate a promising direction for further translational research. While acknowledging the study's limitations, including the moderate efficacy of lycopene against NSCLC cells, our findings underscore the potential of lycopene as an adjuvant in precision medicine for NSCLC. Further optimization and mechanistic investigations are necessary to fully realize the therapeutic potential of this combination.

Glioblastoma (GBM) is characterized by an unfavorable prognosis and a mere 5.8% 5-year survival rate. The balance between oxidation and reduction within GBM plays a crucial role in its onset and progression, yet the underlying mechanisms remain unclear.

This study aimed to investigate the role of the sulfoxide-domain containing protein 12 (TXNDC12) in maintaining the oxidation-reduction equilibrium within GBM cells.

Bioinformatics analysis was employed to assess the significance of TXNDC12. Knockdown experiments on U251 and A172 cells to evaluate the impact on cell proliferation in vitro. Additionally, in vivo experiments with stable A172 cells to measure tumor growth reduction.

The findings indicate that perturbing TXNDC12 expression through knockdown impeded the proliferation of U251 and A172 cells in vitro. Mechanistic investigations revealed that reducing TXNDC12 expression led to an imbalance in the oxidation-reduction dynamics of GBM.

This study highlights TXNDC12 as a potential therapeutic target for GBM. Inducing an imbalance in tumor cell oxidation-reduction processes may represent a novel strategy for advancing cancer treatment.

The caregivers of cancer patients go through numerous changes in their lives, caused by the complexity of cancer care, which then influence their quality of life (QoL). In this context, the sense of coherence (SoC) has been introduced as individuals' capacity to adapt to complex situations.

This study aimed at examining the relationship between QoL and SoC among the caregivers of cancer patients.

This descriptive correlational study was performed on the caregivers of cancer patients referred to a teaching hospital in Tehran, Iran. In total, 200 eligible caregivers, selected by purposive and convenience sampling from September to December 2022, completed the research instrument comprised of a researcher-made demographic-clinical information form, the SoC Scale (13-item), and WHOQoL-BREF. The data were analyzed by the SPSS 20 software. To investigate the relationship between caregivers’ SoC and QoL, first, the correlation was determined, and afterward, the significant variables were analyzed, using multiple linear regression.

The overall mean score of QoL among the caregivers was 52.12 ± 14.45. In this way, the highest and lowest values were associated with the domains of physical health and social relationships, receiving the mean scores of 55.19 ± 11.46 and 38.40 ± 10.08, respectively. The overall mean score of SoC was also equal to 49.71 ± 9.34. As well, the results of the study demonstrated a significant positive correlation between SoC and QoL (r = 0.585, P < 0.001) as well as its 3 domains. Considering the demographic and clinical factors, the regression outcomes revealed that SoC was a predictor of QoL in the caregivers of cancer patients (P < 0.001, Β = 0.65). Among the demographic factors, a significant correlation was accordingly observed between age, marital status, income level, employment status, and QoL and some of its domains (P < 0.05).

It was argued that SoC could be a positive predictor and a protective factor for QoL among the caregivers of cancer patients. In this vein, it was recommended to give a boost to the SoC dimensions during oncology and palliative care via an interdisciplinary approach and a variety of interventions. Upon developing QoL in the caregivers, QoL among the cancer patients could be then promoted.

The analysis methods for breast cancer (BC) data have also advanced alongside medical advancements in the treatment of the disease.

This study tried to investigate the factors affecting the survival rate of BC patients using the cured model based on Kumaraswamy's defective distribution.

A retrospective study collected data on 2 574 BC patients between September 2013 and September 2020, including demographic, clinicopathological, and biological characteristics. The best model for predicting cure was chosen based on AIC.

The selected cure model revealed that age (P = 0.046), tumor histologic grade (P = 0.0.38), tumor size (P = 0.0.41), HER2 status (P = 0.001), KI67 levels (P = 0.027), P53 status (P = 0.029), and hormone therapy (P = 0.039) were significant variables. The estimated cured rate of this data was 0.82.

Considering that the advanced cured model has the highest accuracy in identifying the factors affecting the survival rate of BC patients and more risk factors have become significant in this model, it is recommended to pay special attention to patients aged over 60 with poorly differentiated historical grade, T3 tumor size, HER2 positive status, KI67 levels below 20%, negative P53 status, and no hormone therapy received in the process of disease prognosis.

Hypo-pharyngeal squamous cell carcinoma (H-SCC) is a rare type of head and neck malignancy often necessitating extensive surgical resection and subsequent reconstruction.

This study presented a 10-year retrospective analysis of reconstructive surgeries following the resection of H-SCC.

A cross-sectional study was conducted on H-SCC patients who underwent reconstructive surgery after either laryngopharyngoesophagectomy (13 cases, 42%) or pharyngolaryngectomy (18 cases, 58%). Various reconstructive techniques were employed, including gastric pull up (12 cases, 39%), pectoralis major myo-cutaneous flap (PMMCF) (11 cases, 35%), and free flaps such as jejunum (2 cases, 6%), ileocecal (2 cases, 6%), or antero-lateral thigh (ALT) (4 cases, 13%).

The study included 31 patients with a mean age of 56.26 ± 3.98 years, predominantly male (64%). Smoking habit was observed in 22 (71%) patients. The total complication rate was 48% including 2 (6%) cases of flap loss, 2 (6%) cases of cervical anastomosis leak, 1 (3%) case of hematoma, 2 (6%) cases of neck wound infection, 5 (16%) cases of pneumonia, and 3 (10%) cases of pleural effusion, with a mortality rate of 16%. GPU and PMMCF had total number of post operative complications of 12 and 6, respectively. ALT flap, jejunal flap and ileocecal flap had 3, 2 and 1 total complications, respectively. Severe stenosis at cervical anastomosis was found in 4 (13%) patients after GPU and not other techniques.

Advances in microvascular anatomy knowledge have led to the evolution of reconstructive techniques. The study suggests that in upcoming years, the free flap techniques hold promise as a preferred method for hypo-pharyngeal reconstruction.

The reports of Iranian Pediatric Langerhans Cell Histiocytosis (LCH) are rare and there is no specific survival rate for those cases.

This study was designed as a hospital-based project for evaluating the epidemiological data and survival rates of the mentioned patients.

This was a cross-sectional descriptive study that enrolled patients younger than 15 years old with approved LCH malignancy. Data was gathered based on a unique questionnaire and analyzed by SPSS Software version 25.

There were 32 cases (male/female ratio = 0.88) who were categorized as high risk (n = 18), moderate (n = 9) and low risk (n = 5), respectively. The mean age of patients was 5.1 years and the common chief complaint in them was bone pain, with the skeleton site of involvement. The 5-years overall and event-free survival rates were 93.3% and 72.9%, respectively.

The suggestion is to provide a national registry for pediatric LCH followed by designing future projects around affective genes on the treatment response of the mentioned patients. In that way, we can improve the survival rate of these patients and decrease mortality.

Gastric adenocarcinoma is among the most prevalent cancers associated with a high mortality rate. The multidrug neoadjuvant chemotherapy administered before and after surgery has attracted attention as a beneficial standard of care for managing this malignancy.

This study assessed the pathologic response of patients with gastric cancer who were treated with fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT).

Patients with pathologically confirmed gastric adenocarcinoma without distant metastases were enrolled in this retrospective cohort study conducted at Imam Reza and Ghaem hospitals in Mashhad. Data regarding demographics, tumor status, treatment toxicity, and pathology results were collected using a predesigned questionnaire after four cycles of FLOT neoadjuvant chemotherapy. SPSS-26.0 was utilized to analyze the data, and a significance level of P < 0.05 was applied.

We evaluated data from 53 cases with a mean age of 51.1 ± 9.7 years. Diffuse adenocarcinoma was the most common finding in histology (54.7%). Pathologic complete response was observed in 16 (30.2%) patients. Most (69.8%) patients received only 7 out of 8 planned cycles. Concerning surgical margin, 46 (86.8%) patients achieved R0 tumor resection. Pathologic complete response was not significantly linked with age (P = 0.91), sex (P = 0.65), performance status (P = 0.2), tumor histology (P = 0.14), tumor grading (P = 0.07), tumor location (P = 0.8), and the number of neoadjuvant chemotherapy cycles (P = 0.9).

Our findings demonstrated the relative clinical efficacy of neoadjuvant chemotherapy with the FLOT regimen administered before and after surgery. However, due to chemotherapy-related side effects, patients may not adhere to all eight prescribed cycles of chemotherapy.

The axillary lymph node status in breast cancer is a major prognostic factor in survival and establishing a personalized treatment scheme. The ultrasound-guided fine needle aspiration (US-FNA) is a method for taking a lymph node sample. It allows physicians to decide how to manage the axilla.

This study was conducted to investigate the sensitivity of the US-FNA technique on suspicious axillary lymph nodes with a thickness of 3 to 6 mm in breast cancer patients.

In a cross-sectional study, all the patients were subjected to preoperative ultrasound evaluation of the axilla to determine the presence of lymph nodes suspicious of malignancy. In cases where the suspicious lymph node cortex size was between 3 and 6 mm, US-FNA was performed. After surgery, the frozen section of the biopsy sample was examined histologically and compared with fine needle aspiration (FNA) cytology results.

A total of 102 patients were examined in the study. FNA test results indicated that 46 subjects had axillary malignant tissue, and benign cases summed 56. Also, the final results of frozen section surgical histopathology identified 46.1% of patients with involved lymph nodes. The sensitivity and specificity of FNA were 93.62% and 96.36%, respectively. Also, the overall diagnostic accuracy was 95.1%.

This study showed that the sensitivity, specificity, and accuracy were more than 90% for the ultrasound-guided FNA test in identifying involved lymph nodes in patients with breast cancer. Therefore, the results of this test can be considered clinically reliable. However, there is still a need to examine the sensitivity and specificity of this method in identifying lymph node involvement.

Renal cell carcinoma (RCC) is an aggressive cancer prevalent worldwide.

We investigated whether preoperative serum levels of plateletcrit (PCT) can predict tumor stages and pathological grades in patients, who were operated on for T1-4, N0, and M0 RCC. Additionally, we compared it with neutrophil to lymphocyte ratio (NLR).

We conducted a retrospective evaluation of 196 patients, who had undergone nephrectomy (radical or partial) for T1-4, N0, and M0 RCC at our hospital from January 2016 to December 2022. Based on their histopathology results, tumor stages (T) and WHO-ISUP grades (G) were identified. The patients were separated into two categories depending on their T-stage (T1 - T2 and T3 - T4) and pathological grade (G1 - 2 and G3 - 4). The study compared the NLR, PCT, and their combined values to determine their role in predicting aggressiveness based on pathological stage and grade of tumors.

The mean cut-off values for NLR and PCT were found to be 2.108 and 0.273, for the high tumor stage and 2.237 and 0.252 for high-grade tumors, respectively. The statistical analysis showed that NLR (P = 0.031) and PCT (P = 0.006) were significant predictors of high tumor stage, while only PCT (P = 0.022) was a significant predictor of high WHO-ISUP grade. The combination of both NLR and PCT helps improve the sensitivity for detecting high-grade tumors.

NLR and PCT can be predictive markers of the tumor stage. However, only PCT can predict the tumor grade in patients with RCC. In addition, combining the PCT and NLR scores improved the predictive ability of each parameter, especially for identifying high-grade tumors.

Kidney cancer in adults includes malignant tumors originating from the parenchyma and pelvis and is the most lethal urogenital cancer. Available data in Iran indicate that the incidence and pattern of this cancer are changing.

Our study aimed to present an updated incidence rate of kidney cancer in Iran and its 31 provinces and their trends, and climate zones distribution of the disease.

In this study, the age standard incidence rate (ASIR) of kidney cancer based on provinces, age groups, and gender has been calculated using the available data in the national cancer registration system of the Ministry of Health from 2003 to 2016.

Overall ASIR of kidney cancer was 1.28 per 100,000 from 2003 to 2016. ASIR of this cancer in men has increased from 0.96 in 2003 to 3.66 in 2016 and similarly, reached from 0.61 in 2003 to 2.24 in 2016 in women. Fars, Yazd, Tehran and Isfahan provinces had the highest ASIR in Iran. Hot climate zones are associated with a higher incidence of kidney cancer while moderate climate is linked to the lower incidence rates in Iran.

Although the incidence rate of kidney cancer in Iran and its provinces is low, the increasing trend is concerning particularly among men. Therefore, it is crucial to develop cost-effective screening tests and implement control and prevention programs in the high-incidence provinces.

Breast cancer (BC) poses a significant health concern for females, often resulting in complications such as lymphedema due to treatment effects.

This study examines the link between lymphedema and the number of removed negative axillary lymph nodes (LNs) after sentinel lymph node biopsy (SLNB) in BC patients.

A prospective study from 2016 to 2019 included 150 eligible women out of 1 600 BC patients who underwent axillary sentinel node biopsy (SNB). The prognostic value of isolated negative nodes and BMI in predicting lymphedema post-SLNB was analyzed.

Among 950 women receiving radiotherapy, 4% developed lymphedema. Notably, patients with lymphedema were younger (average age 53.34 years). BMI didn't differ significantly, but the number of removed sentinel LN-negatives was crucial. Patients with 4 - 5 nodes removed had an 89.47% likelihood, while those with 1 - 3 nodes had zero incidence.

BC-related lymphedema significantly impacts patient well-being. Our study establishes a direct correlation between the number of removed negative LNs and the severity of edema, emphasizing the need for further research.

Pain has been known as one of the most common, persistent, and complex symptoms of patients with lung cancer.

The aim of this research is to study the relationship between attitude to pain and the prevalence and method of pain control in patients with lung cancer.

This descriptive cross-sectional study was performed through the census method in patients suffering from lung cancer in Ilam Province. For data collection, while interviewing the patients and studying their files, instruments were used including demographic characteristics form, brief pain inventory, and pain attitude questionnaire. Data analysis was performed by SPSS v.16 through descriptive statistical tests (mean, percentage, and standard deviation) and analytical tests (independent t -test, ANOVA, and linear regression).

Considering the severity of pain, 12 (18.8%) patients had mild pain, 43 (67.2%) had moderate pain, and 9 (14.1%) had severe pain, and all of them reported some degree of pain. According to the findings, mean ± SD of the total score of the questionnaire was 77.15 (3.18), where the minimum and maximum acquired scores were 72 and 85, respectively. Also, no significant relationship was found between any of the dimensions of the attitude to pain questionnaire and the severity of pain. Further the mean ± SD of attitude to pain was 76.58 (2.81), 77.09 (3.28), and 78.22 (3.23) for mild, moderate, and severe pain, respectively.

In this study, there was no relationship between pain severity and attitude to pain, which may have been due to the small sample size or the specificity of the study in the group of lung cancer patients. Accordingly, conducting further studies in this regard with a larger sample size is suggested.

Breast cancer (BC) is the leading cause of cancer-associated mortality in women worldwide. However, the molecular mechanism underlying the process is still unclear. In this regard, bioinformatics studies play a decisive role in facilitating the path of biological investigations and can ultimately lead to the identification of better molecular candidates for further study.

Due to the abnormal expression of many coding and non-coding genes in all types of cancers and their relationship with various mechanisms of carcinogenesis, this study aimed at evaluating the expression levels of certain coding and non-coding genes involved in BC based on bioinformatics findings and laboratory investigations.

Gene expression dataset, module extraction, functional enrichment analysis, protein-protein interaction network construction, and RT-qPCR were performed based on bioinformatics methods and laboratory investigations. Additionally, the promoter region mutations of these genes were investigated, using sequencing of extracted DNAs from formalin-fixed paraffin-embedded (FFPE) tumor tissues.

A module was selected as a candidate for further investigation. Estrogen receptor 1 (ESR1) and forkhead box A1 (FOXA1) showed the highest degrees in the PPI network with 9 and 7 links, respectively. Furthermore, the expression levels of the FOXA1 gene, RNA component of mitochondrial RNA processing endoribonuclease (RMRP), and nuclear enriched abundant transcript 1 (NEAT1) were significantly upregulated in the tumor group compared to the control group (in order, P = 0.044, P = 0.014, and P = 0.0004). The tumors of patients with positive metastasis displayed significantly higher levels of NEAT1 and RMRP expression compared to those of negative metastasis samples (P < 0.05). Moreover, the expression level of RMRP dramatically decreased in HER2-positive patients compared to negative samples (P = 0.011). Finally, no mutations were observed in the promoter sequencing of positive metastasis samples compared to normal samples.

The upregulation levels of all three examined genes may correlate with BC progression. Therefore, they could potentially be used as biomarkers for detecting BC development.

Meningiomas are the most prevalent primary intracranial tumors, which are treated with surgical resection. This procedure may result in cranial defects, leading to significant functional and aesthetic impairments. Lately, acrylic cranioplasty has emerged as a promising technique for repairing these defects.

The current retrospective review investigated patients, who underwent reconstructive cranioplasty following meningioma surgery between November 2021 and March 2023.

Thirteen patients, who underwent cranioplasty surgery to repair extensive skull defects following meningioma surgery, were included as subjects. Eleven patients were female and all of them had a history of using progesterone contraception for 10 to 30 years. Two patients were male and had comorbid diabetes mellitus. Patients’ ages varied between 39 and 59 years old. The interval between craniectomy and cranioplasty was about 45 days. The material used for cranioplasty was polymethyl methacrylate prostheses. It started with a CT scan to determine the location and size of the skull defect. We reconstructed the defect, using computer-aided design and computer-aided manufacturing (CAD/CAM) to produce a prosthesis that was specific to each patient. This 3D-printed prosthesis was designed to manufacture a mold, which was sterilized and intraoperatively used.

We conducted post-operative surgery follow-up for up to 3 months. After 1 month of post-operative surgery follow-up, 2 out of our 13 patients developed cerebrospinal fluid leakage.

Acrylic cranioplasty using CAD/CAM technology and 3D printing has shown potential for producing patient-specific implants to repair extensive skull defects. However, careful monitoring for post-operative complications is essential.

The issue of truth-telling by healthcare providers is critically important, and it has legal and ethical implications.

This study was conducted to investigate the perceptions and preferences of patients, families, and healthcare providers related to truth disclosure to identify barriers to this important aspect of communication.

A total of 27 participants (4 patients, 7 family members, 4 physicians, and 12 nurses) were recruited by purposeful sampling. Data were collected through in-depth, semi-structured interviews and analyzed by qualitative thematic analysis.

Three main themes and eight sub-themes emerged from the data: (1) truth shock: Patient inability to face the truth, family inability to handle the truth; (2) secrecy during treatment and recovery: Withholding critical information from patients and families; family confusion about the patient’s condition; families preventing truth disclosure to the patient; family fear of the truth’s impact on the patient; and (3) patient's right to information: Lack of patient awareness of their rights; the importance of informing patients about their condition.

The findings of this study suggest that healthcare providers can deliver bad news to patients and their families more effectively and satisfyingly using an approach based on culture, patient preferences, and ethical values