فهرست مطالب

  • Volume:5 Issue: 2, 2014
  • تاریخ انتشار: 1393/01/31
  • تعداد عناوین: 10
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  • Ahmad Nasser, Ara Khosravi, Mohammad Taha Gomravi, Reza Azizian Pages 55-56
    Tregulatory cells play a crucial role in immunological unresponsiveness to self- antigens and in suppressing excessive immune responses deleterious to the host. T regulatory cells are produced in the thymus as a functionally mature subpopulation of T cells. They can be induced from naive T cells in the periphery and express their marker as a forkhead/winged helix transcription factor called FoxP3. In patients with lymphomas where T regulatory cells serve as suppressor anti-tumor cytotoxicity, decreased numbers of T regulatory cells are associated with a favorable prognosis. In contrast, in patients with lymphomas where T regulatory cells function as anti-tumor cytotoxic agents, enhanced numbers of T regulatory cells are associated with a favorable prognosis. Tumors actively promote the accumulation of these cells through several mechanisms that involve activation of naturally occurring T regulatory cells as well as conversion of non-T regulatory cells into T regulatory cells. Tumor-derived prostaglandin E2 can increase T regulatory cell activity and induce a regulatory phenotype in CD4+CD25+T cells. On the other hand, a balance between T regulatory and Th17 cells is essential for maintaining homeostasis of anti-tumor immunity. Accelerating processes such as increasing the amounts of IL-6 or IL-17 can enhance FoxP3 T regulatory cell expression and result in a lymphoma or inactivation of T cell CD4+. This effect is the reason for malignancy and a reduction in anti-tumor immune response. In this systematic review we intend to analyze this relationship. We have collected and analyzed the majority of recently published articles on the role of T regulatory cells as a review article.
  • Indu Maniketh, Gayatri Ravikumar, Julian A. Crasta, Rekha Prabhu, Elizabeth Vallikad Pages 67-73
    Background
    This study assesses the expressions of estrogen and progesterone receptors in endometrioid carcinomas of the endometrium and their association with established clinicopathological prognostic parameters.
    Methods
    We reviewed the pathology and medical records from 45 cases of endometrioid endometrial carcinomas that were seen from 2006 to 2011 for relevant clinical and histological parameters. Grade I and stage IA tumors were analyzed and compared with higher grades and stages IB- IV. Estrogen and progesterone immunostained slides were analyzed.
    Results
    Patients’ age ranged from 32 to 77 years (mean: 58.13 years). Postmenopausal bleeding was the most common presenting complaint seen in 75.6% of cases. Associated co-morbidities such as diabetes, hypertension and other malignancies were seen in 88% of cases. Myometrial invasion of less than 50% of myometrial thickness was seen in 70.5% cases. There were 40% of tumors classified as FIGO grade 1 and 65.85% were FIGO stage IA. Estrogen and progesterone expressions were seen in 40 (90%) cases, predominantly in FIGO stage I disease. However there was no statistically significant association of estrogen and progesterone expression with any of the clinicopathological prognostic factors. In 23 of the 30 cases that had follow up data, there was no evidence of disease. Of these, only one case was negative for both hormone receptors. Progesterone positivity alone was seen in 87% of cases with no evidence of disease.
    Conclusions
    Nuclear immunostaining with estrogen and progesterone was seen in the majority of cases (90%). Although we have observed a linear increase in progesterone receptor positivity with disease-free survival, this finding needs to be confirmed with additional, larger studies.
  • Kholoud Abu Obead, Sameer Yaser, Maysaa Khattab, Faisal Al-Badainah, Laila Saqer, Nehaya Al-Dosouqi Pages 75-82
    Background
    The purposes of this study were to examine the impact of chemotherapy treatment on Jordanian cancer patients’ fatigue and to correlate their fatigue with selected sociodemographic variables at the beginning of treatment and after four weeks of treatment.
    Methods
    This was a single group quasi-experimental correlational design study that enrolled 43 patients diagnosed with cancer who required chemotherapy treatment. Fatigue was measured according to the Piper Fatigue Scale (PFS) before starting chemotherapy treatment and after four weeks of receiving the first dose of chemotherapy. Data were collected over a period of four weeks and analyzed with descriptive statistics, the paired-sample t-test, and Pearson product-moment correlation.
    Results
    The study included 17 (39.5%) males and 26 (60.5%) females with a mean age of 45.98 years. Most (n=17) were diagnosed with breast cancer. Obesity was present in about 64.4% of patients. The majority (46%) received an anthracycline-based regimen. There were statistically significant differences between respondents’ total mean scores of fatigue pre-treatment and four weeks following chemotherapy treatment (t= -2.31, df=42, P<0.05). In addition, significant differences were found in the scores for behavioral, affective, sensory, and cognitive dimensions subscales (t= -2.24, -2.19, - 2.4, -2.4, df=42, P<0.05) between pre-treatment and four weeks after receiving the first dose of chemotherapy treatment. We observed a significant negative relationship between fatigue scores and hemoglobin levels (r= -0.04, P<0.01).
    Conclusion
    Cancer-related fatigue is common among cancer patients who received chemotherapy and result in substantial adverse physical, behavioral, cognitive and affective consequences for patient. Given the impact of fatigue, treatment options should be routinely considered in the care of patients with cancer.
  • Mona Mahmoud Sayed Pages 83-89
    Background
    A significant number of patients who receive palliative irradiation for painful bone metastases experience pain flare، defined as a distressing transient increase in pain not immediately controlled by additional analgesics. This pain is postulated to be due to edema at the onset of radiotherapy. This study aims to compare the incidence of bone pain flare among patients who receive steroid prophylaxis to those with no prophylaxis treatment.
    Methods
    From June 2011 to June 2013، 147 eligible patients with painful bone metastases entered into this phase 3 prospective study. We divided patients into two groups. Group A received 8 mg dexamethasone one hour prior to irradiation during the treatment time and for three days afterwards. Group B received no prophylaxis treatment. All patients received radiotherapy at a dose of 2000 Gy/5 fractions. The development of flare was recorded in each group and several factors were examined to determine the presence of an influence on this incidence.
    Results
    Group A included 68 patients، 11 (16. 2%) of whom developed bone pain flare while group B comprised 79 patients، 30 (38%) with bone pain flare. These results indicated that steroid prophylaxis made a statistically significant difference in decreasing pain flare incidence (P=0. 0033). No steroid related complications were reported by any of the patients. None of the factors assessed showed a statistically significant effect on flare development (P>0. 05).
    Conclusion
    Administration of 8 mg of dexamethasone an hour prior to irradiation for the treatment period and three days afterwards is effective in significantly decreasing the incidence of pain flare. Dexamethasone is well tolerated and may be recommended for all adult patients who undergo palliative bone irradiation who have no contraindi- cation to this treatment. Larger phase 3 randomized trials are needed to confirm these findings.
  • Abdolazim Sedighi Pashaki, Ehsan Akbari Hamed, Kamal Mohammadian, Mohammad Abbasi, Afsane Maddah Safaei Torogh, Mohammad Babaei, Mohamamad Hadi Gholami, Alireza Khoshghadam Pages 91-96
    Background
    Central nervous system tumors account for 2%-5% of all malignancies in humans. These tumors account for 2% of all pediatric cancers. The worldwide incidence of primary central nervous system tumors is estimated at 3.9 (males) and 3.2 (females) per 100000 person-years. The incidence of brain tumor cases has been reported as 3.67% of all malignancies and 4% of all cancer mortalities in Iran. The five most common histological types of brain tumor in Iran according to different case studies are; meningioma, astrocytoma, glioblastoma, pituitary adenoma and ependymoma. The aim of this study is to determine the histopathological pattern and characteristics of patients with brain tumors who have referred to the Mahdieh Radiotherapy Department, Hamadan, Iran.
    Methods
    This descriptive, retrospective study was performed at the Mahdieh Radiotherapy Department, between 2005 and 2012. We included 220 patients who referred to the Radiotherapy Department with diagnoses of primary brain tumor in this study.
    Results
    Between 2005 and 2012, we treated 220 new cases of primary brain tumor at Mahdieh Radiotherapy Department. The mean age at diagnosis was 39.95±15.48 years with a median age of 39 years. Patients'' ages ranged from 4 to 75 years. Among the 220 patients, 138 were male and 82 were female with a male to female ratio of 1.68. For most tumors there was a male predominance, with the exception of meningioma (M/F: 0.23), ependymoma (M/F: 1) and pituitary adenoma (M/F: 0.6). Astrocytomas, glioblastomas, high grade meningiomas and oligodendrogliomas were the four most common pathologies treated in this department. The best treatment results were achieved in patients with astrocytomas.
    Conclusion
    The present study is a retrospective radiotherapy centre-based study designed in a pioneer radiotherapy centre in Western Iran, not a prospective population study. These data have provided a baseline for further epidemiological studies. Our encouraging results in radiotherapy treatment of primary malignant tumors clearly highlight the benefits of definitive or postoperative radiation.
  • Shilpa Garg, Nisha Marwah, Gulshan Chauhan, Sumiti Gupta, Rajiv Goyal, Pushpa Dahiya, Promil Jain, Rajiv Sen Pages 97-103
    Background
    This study evaluates estrogen and progesterone expressions in patients with ovarian tumors (both benign and malignant) and their correlation with various clinicopathological prognostic parameters. Receptors for estrogen and progesterone are predictive and prognostic markers of endometrial and breast cancers. However, their clinical significance in epithelial ovarian cancer is not clear due to conflicting data from only a few immunohistochemical studies available in the literature.
    Methods
    The present study was conducted on 60 cases of ovarian tumors, 20 benign and 40 malignant. Estrogen and progesterone expressions were studied by immuno- histochemistry and correlated with various clinicopathological parameters such as, menopausal status, histological type, WHO grade and FIGO stage.
    Results
    Out of 20 benign tumors the estrogen receptor was positive in 10 (50%) and progesterone receptor was positive in 14 (70%) tumors. In 40 malignant tumors, the estrogen receptor was positive in 13 (32.5%) and progesterone receptor was positive in 11 (27.5%) cases. There was statistically significant estrogen receptor expression observed in serous tumors (P=0.001). When compared with other clinico- pathological parameters, we noted a significant association between progesterone receptor expression and favorable prognostic parameters such as young age, benign tumors and early FIGO stage.
    Conclusion
    There were variable expressions of the estrogen and progesterone receptors in ovarian tumors. Progesterone receptor expression was associated with favorable prognostic factors that included younger age, benign tumor and low FIGO stage. No such association was observed with estrogen receptor expression.
  • Gamal Abdul Hamid, Iman Bin Harize Pages 105-108
    A 61-year-old female presented with complaints of fever, general weakness and hepatosplenomegaly. She had a history of nonfamilial peripheral neurofibromatosis diagnosed as von Recklinghausen''s disease since 30 years previous. Physical examination was remarkable for skin colored cutaneous circumscribed nodules which appeared soft to the touch in both arms, the upper part of her abdomen, back, and posterior thigh. The liver was palpable 10 cm below the inferior border of the costal margin and she had evidence of significant splenomegaly. Laboratory results were as follows: hemoglobin 7.9 g/dl; ESR142 mm/hour; leukocytes 22400x109/L; neutrophils 35%; eosinophils 3%; basophils 4%; myelocytes40%; myeloblasts 14%; promyelocytes 2%; and band form 2%. The bone marrow picture was chronic myeloid leukemia in blastic form. Chest CT scan showed the presence of numerous cutaneous nodules (neurofibromatosis). A biopsy of the tissue fragment from the nodules confirmed the presence of diffuse neurofibromatosis. Bone marrow cytology that included cytogenetic and immunophenotyping confirmed the presence of chronic myeloid leukemia with a positive Philadelphia chromosome and diploidy female clone in a blastic form (acute myeloid leukemia). Addition of 600 mg oral imatinib mesylate daily for one month and reduced to 400 mg daily yields complete hematological remission and complete cytogenetic responses. This case illustrated an association between chronic myeloid leukemia, acute myeloid leukemia and neurofibromatosis in an adult.
  • Shahram Paydar, Zahra Ghahramani Pages 109-110
  • Calendar of Events
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