International Journal of Cancer Management
Volume:3 Issue: 3, Summer 2010

The concept of stem cells, cells that can self-renew and differentiate, was initially postulated by Pappenheim in 1917 and their existence has since been shown in many different tissues [1]. The original ideas for cancer stem cells came in remarkable papers by Southham et al and Hamburger et al which showed that cancer cells had varying tumor-initiating capacities [2, 3]. Later, John Dick’s lab isolated acute myeloid leukemia stem cells in 1994 and acute lymphocytic leukemia stem cells soon thereafter [4, 5]. Since then, cancer stem cells have been isolated in many solid tumors; in brain, head and neck, breast and prostate cancer [6-15].The cancer stem cell model represents a paradigm shift in our understanding of carcinogenesis and tumor cell biology. In this model, tumors originate in either tissue stem cells or their immediate progeny through dysregulation of the normally tightly regulated process of self-renewal. Consequently, tumors contain a cellular subcomponent that retains key stem cell-like properties. These properties include self-renewal, tumor regeneration, and differentiation [16]. Despite the mounting evidence in support of the CSC model, there is some controversy regarding the similarities and differences between cancer and somatic stem cells [17]. Significantly, some recent reports have claimed that unlike somatic stem cells, CSCs may not be rare subpopulations within tumors in some cancers [17]. In response, Weinberg comprehensively argues that the CSC model rests on solid experimental foundations and that the differences in the observed frequencies of CSCs within tumors reflects the various cancer types and hosts used to assay these cells and. The existence of CSCs has fundamental implications for cancer risk assessment, early detection, prognostication, and prevention. Control of many stem cell phenotypes depends on epigenetic reprogramming; thus epigenetic transformation of CSCs has become a very promising area of basic and preclinical molecular-targeted prevention science. An important characteristic of these cells is their ability to restrict DNA damage sustained during radiation or chemotherapy [18, 19] and their ability to effectively pump out chemotoxic agents through a wide range of active membrane transporters. As a result, many current therapeutic agents are only able to reduce the bulk of the cancer cells while residual CSCs are able to regenerate the cancer. In addition, cancer stem cells are implicated in developing drug resistant progeny in some cancers such as chronic myeloid leukemia (CML) [20].

The metabolically active tumor cells may be characterized by a pronounced adenosine release that regulates the growth and development of the tumor. Consequently, the expression pattern of defined receptor subtypes will be an important determinant for specific effects of adenosine on the control of tumor cell growth. In recent studies, the expression profile, signal transduction, molecular function and cell growth modulation of adenosine receptors in the human breast cancer cell lines has been reported. To investigate the possible roles of adenosine receptors in other types of human cancers, in this study, we characterized the expression profile of adenosine receptors in two different human cancer cell lines: prostate carcinoma cell line (Du-145) and lung adenocarcinoma cell line (Calu-6). Our purpose is to test the hypothesis that diverse human cancer cell lines, according to their adenosine receptor subclass status, would show differential growth modulation. RNA was extracted and reverse transcribed to cDNA. PCR primers were synthesized from human adenosine receptor cDNA sequences. PCR was performed under optimized condition for each receptor subtype. The PCR products were separated on agarose gels. All two human cancer cell lines studied contained detectable amounts of mRNA specific for adenosine receptor except A3 subtypes. In conclusion the differentially expressed genes identified in this study might provide new insights into the possible roles of adenosine receptors on cell growth and development.

Cervical cancer is one of the prevalent and mortal cancers. The aim of the study is to assess knowledge، attitude and practice of women toward this cancer and Pap smear. We carried out a cross-sectional study among 402 women through a questionnaire with 5 socio-demographic parameters and 14 questions about knowledge، attitude and practice. We aimed to know how knowledge، attitude and practice are affected by socio-demographic status and how practice is affected by knowledge and attitude. The mean score was 4. 09. Knowledge and age did not correlate directly. Old aged women had the best knowledge. As the number of children rose، knowledge deteriorated، vice versa about the age of marriage and education. The clerks were better than housewives and businesswomen. Just 3. 5% did not consider the regular Pap as necessary (with the lower educational level). Almost 99% intended to get more information. The minority (28. 1%) had the incorrect attitude toward the curability of the cancer. Most of the women referred to do Pap due to health center personnel’s advice. About 80% had undesired practice. The educated ones had more appropriate and optimistic incorrect attitude compared to the uneducated ones. As more years pass from the age of marriage، practice gets worse. All the newly married women had the desired practice، correct attitude and intended to get more information. All the women who knew it unnecessary had undesired practice. Women with the desired practice had 9% more correct attitude and 9% more optimistic incorrect attitude compared to the undesirably practicing ones. Totally، practice is not much influenced by attitude.

Multifactorial regression models are frequently used in medicine to estimate survival rate of patients across risk groups. However، their results are not generalisable، if in the development of models assumptions required are not satisfied. Missing data is a common problem in pathology. The aim of this paper is to address the danger of exclusion of cases with missing data، and to highlight the importance of imputation of missing data before development of multifactorial models. This study was performed on 310 breast cancer patients diagnosed in Shiraz (Southern Iran). Performing a complete-case Cox regression model، a prognostic index was calculated so as to categorise the patients into 3 risk groups. Then، applying the Multivariate Imputation via Chained Equations (MICE) method، missing data were imputed 10 times. Using imputed data sets، modelling was performed to assign patients into risk groups. Estimated actuarial Overal Survival (OS) rates corresponding to analysis of complete-case and imputed data sets were compared. Cases with at least one missing datum experienced a significantly better survival curve. Estimates derived analysing complete-case data، relative to imputed data sets، underestimated the OS rate in all risk groups. In addition confidence intervals were wider indicating loss in precision due to attrition in sample size and power. Results obtained highlighted the danger of exclusion of missing data. Imputation of missing data avoids biased estimates، increases the precision of estimates، and improves genralisability of results to other similar populations.

The best management for an ovarian mass is provided by appropriate prediction of malignancy. The aim of our study is to construct and validate a new Malignancy Probability Score based on four simple sonographic findings and age. In a cross sectional study; histopathological files of 3303 ovarian mass patients and tertiary hospitals, have reviewed within 6 years (2000-2006). Pathology, age, sonographic findings including solid area, ascetic, size and bilateralism were recorded. Logistic multivariate regression analysis SPSS18 has used to create malignancy probability scoring model. Our ovarian Malignancy Probability Score (OMPS) has constructed based on 80% of samples in a logistic regression model and has validated using the remainder of the cases. Ovarian malignancy probability score (OMPS) has calculated as follow: age × 0.062 + Tumor size (cm) × 0.012+1.172(if the tumor is solid) + 1.289(if ascites is present) +0.758(if the tumor is bilateral)Sensitivity of OMPS in prediction of malignancy with cutoff value of 3.65 score number was 77.9% and its specificity was 72.9% with Area under Curve (AUC) of 83% in ROC curve. OMPS is designed and tested in our research, to be proved as a simple and accurate clinical tool for ovarian malignancy prediction.

Breast Cancer is a life threatening disease affecting women. Awareness should be created among women for early detection of breast cancer. Nurses should provide information on BSE to women population as a part of their profession. The aim of this study was to assess the attitude and practice of nurses in imparting knowledge on BSE to female patients. This cross-sectional study was conducted among 154 nurses from different hospitals of UAE during the period June –November 2009. Self-administered questionnaire was used for data collection. Data was analysed using PASW 17 version. Age group of the participants ranged between 20 and 59 years with a mean age of 31 years and SD of 7.3 years. Majority 90.3% have positive attitude in providing knowledge regarding risk factors of breast cancer and about the purpose of performing BSE. Eighty eight point three percent of the nurses were with a positive attitude toward providing information about BSE to all females who come to the hospital irrespective of their demand. Majority, 83.8% of the nurses reported, teaching method of BSE. Among the respondents 60.4% reported that they follow up their clients after imparting knowledge on BSE. There was a statistically significant (p<0.001) positive correlation between attitude and practice. The results suggest the need of proving continuing educational programs to change the attitude and behavior towards imparting knowledge of BSE which in-turn will have a positive effect on their practice of teaching and motivating the women group to perform BSE.

Cervical cancer is one of the most common types of women’s reproductive cancers. A major risk factor for cervical cancer is exposure to a group of common sexually transmitted viruses called Human papillomavirus (HPV). The over expression of HPV 16 i.e., E6 antigen in the tumors of suspected cervical cancer tissues. however E-6 antigen has hyaluronan binding protein site. The procedure carried out by using 15 benign and 50 different grades of cervical cancer tissue samples to study the expression of HPV 16 i.e., E6 antigen and H11 antigen(HABP) by biochemical method. The HPV 16 i.e., 18KD is expressing along with hyaluronic acid binding proteins 57KD and 92KD. This shows that E-6 antigen itself reacting with hyaluronic acid binding sites. The H11 antigen (HABP) reacted with anti E-6 protein indicating hyaluronic acid binding protein 57KD and 92 KD is reacting with anti E6 antibody. These results showed a partial homology between E6 and H11 antigen (HABP). Thus the homology between the two proteins in tumor cells is an important parameter and a clinical diagnostic marker for progressive human tumors

Rahbdoid tumor of kidney (RTK) is a childhood rare neoplasm، previously thought as a sarcoma variant of Wilms’ tumor، but now is recognized as a distinct pathologic entity. We report a pathologically proved case of RTK، associated with brain mass in a 4. 5-month-old girl that has referred for gross hematuria. Shortly after initiating chemotherapy، because of retractile vomiting، convulsion، and cerebral salt wasting syndrome. A tumor mass has found in mid-brain and pons in brain CT scan. Because of association of RTK with same or other pathologic brain masses، CT or MR of brain is recommended for all pathologically proven rhabdoid tumors or for patients with neurologic symptoms.