فهرست مطالب

  • Volume:5 Issue: 4, 2014
  • تاریخ انتشار: 1393/07/18
  • تعداد عناوین: 8
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  • Santhi Sarojam, Sangeetha Vijay, Sureshkumar Raveendran, Jayadevan Sreedharan, Geetha Narayanan, Hariharan Sreedharan Page 185
    Background
    Fms-like tyrosine kinase 3 is a tyrosine kinase receptor that plays anJavascript: FormatThis (''B'') important role in proliferation and differentiation of hematopoietic stem cells. Internal tandem duplication and tyrosine kinase domain mutation are the two most common types of fms-like tyrosine kinase 3 mutationsfrequently reported in acute myeloid leukemia associated with pathogenesis of this disease. The present study investigates the prevalence and distribution pattern in different acute myeloid leukemia sub- and cytogenetic groups، the association with clinical parameters and the prognostic importance of these mutations in acute myeloid leukemia patients from South India.
    Methods
    Mutation analysis was performed in 276 de novo acute myeloid leukemia patients by polymerase chain reaction restriction fragment length polymorphism using specific restriction enzymes followed by sequencing to confirm the mutations. Kaplan Meier survival analysis was performed to detect the prognosis.
    Results
    Fms-like tyrosine kinase 3 internal tandem duplication mutations were observed in 20%، tyrosine kinase domain mutation in 4% and dual mutations in 0. 3% of the analyzed cases. The internal tandem duplication mutations ranged from 15-107 nucleotides with the majority at the juxta membrane domain of the receptor. Three types of tyrosine kinase domain point mutations were identified: D835Y، D835H and D83 V. We observed a significant association between fms-like tyrosine kinase 3 mutations and increased WBC and LDH counts (P<0. 001) and blast percentage but not with age، gender and FAB subtypes. A significant association with normal karyotype was observed for the mutants (P=0. 002). Survival analysis revealed that the fms-like tyrosine kinase 3 gene mutation was a negative prognostic marker for acute myeloid leukemia patients. The risk stratified analysis showed the mutation to be a risk factor for the intermediate karyotype group، especially for those with normal cytogenetics.
    Conclusion
    Our results indicate that the presence of an fms-like tyrosine kinase 3 mutation can serve as a valuable prognostic marker in this subgroup of patients، allowing stratification for risk-directed therapy.
  • Farina M. Hanif, Abbas Ali Tasneem, Nasir Hassan Luck, Zaigham Abbas, Syed Mujahid Hassan, Muhammed Mubarak Page 197
    Background
    Transarterial chemoembolization is the preferred treatment for unresectable, intermediate-stage hepatocellular carcinoma. Survival after transarterial chemoembolization can be highly variable. The purpose of this study is to identify the factors that predict overall survival of patients with unresectable hepatocellular carcinoma who undergo transarterial chemoembolization as the initial therapy.
    Methods
    We included patients who underwent transarterial chemoembolization from 2007 to 2012 in this study. Patient’s age, gender, cause of cirrhosis, Child-Turcotte-Pugh score, model of end-stage liver disease score, Cancer of the Liver Italian Program score, Okuda stage, alpha- fetoprotein level, site, size and number of tumors were recorded. Radiological response to transarterial chemoembolization was assessed by computerized tomography scan at 1 and 3 months after the procedure. Repeat sessions of transarterial chemoembolization were performed according to the response. We performed survival assessment and all patients were assessed for survival at the last follow-up.
    Results
    Included in this study were 71 patients of whom there were 57 (80.3 %) males, with a mean age of 51.9±12.1 years (range: 18-76 years). The mean follow-up period was 12.5±10.7 months. A total of 31 (43.7%) patients had only one session of transarterial chemoembolization, 17 (23.9%) underwent 2 and 11 (15.5%) had 3 or more sessions. On univariate analysis, significant factors that predicted survival included serum bilirubin (P=0.02), esophageal varices (P=0.002), Cancer of the Liver Italian Program score (P=0.003), tumor size (P=0.005), >3 sessions of transarterial chemoembolization (P=0.006) and patient''s age (P=0.001). Cox regression analysis showed that tumor size of 1 transarterial chemoembolization session (P=0.004) were associated with better survival.
    Conclusion
    Our study demonstrates that survival after transarterial chemoem- bolization is predicted by tumor size, Cancer of the Liver Italian Program classification, bilirubin 3 transarterial chemoembolization sessions.
  • Mozhgan Rasti, Rita Arabsolghar, Sajad Azmand Page 207
    Background
    Many breast cancer tumor suppressor genes have been reported to undergo hypermethylation, including ER, RASSF1A, HIC, CDH1, GSPT1, APC, TWIST and CCND2. We first determined the promoter methylation of the above eight tumor suppressor genes as epigenetic markers of breast cancer in three cell lines with different ER status.
    Methods
    This study was an experimental study performed on three cell lines: ER-positive MCF-7, ER-negative MDA-MB-468 and the ER- and HER2-positive breast cancer cell line (BT-474). For this purpose DNA was extracted from these cell lines and gene promoter methylation was analyzed by methylation-specific PCR.
    Results
    Our results showed that all studied genes were hypermethylated in ER- negative MDA-MB-468 cells. We detected hypermethylation of GSPT1, RASSF1A and CCND2 genes in these three cell lines. In addition, the ER-positive MCF-7 cells showed methylation of TWIST and APC genes.
    Conclusion
    The numbers of methylated molecular biomarkers is increased with tumor progression.This finding may be important in breast cancer therapy for different ER status.
  • Sedigheh Tahmasebi, Behnam Dalfardi, Majid Akrami, Arash Talei, Abdolrasoul Talei, Alireza Rasekhi Page 215
    Background
    The axillary lymph node stage is one of the single most important determinants in the prognosis of breast cancer patients. The disadvantages of the two previous methods used for evaluating axillary node metastasis, i.e., axillary lymph node dissection and sentinel lymph node biopsy, have directed researchers to investigate new techniques for this purpose. The aim of the current study was to evaluate the clinical usefulness of axillary ultrasonography in detecting axillary metastasis.
    Methods
    This study was conducted during a 12-month period. The breast cancer cases included in this study were all clinically diagnosed as stages I and II, with no prior treatment to the axillary region by surgery and/or chemo-radiotherapy. Excluded from the study group were patients with palpable axillary lymph nodes, those who had major organ failure or concomitant malignancy. All included patients with non-palpable axillary lymph nodes underwent axillary ultrasound examination. An ultrasound- guided core needle biopsy was performed on patients with suspected metastasis.
    Results
    There were 125 female patients with a mean age of 49.6 years included in this study. From these, 16 (12.8%) cases had positive axillary sonographic findings. Pathologic evaluation of tissue specimens (taken by ultrasound-guided core needle biopsy) in 10 (62.5%) out of 16 patients were positive, and in the patient group of 6 (37.5%) cases, studies were negative. Axillary ultrasonography had a sensitivity of 35.7%, specificity of 93.8%, positive predictive value of 62.5%, and negative predictive value of 83.5%.
    Conclusion
    The axillary ultrasonogram is a reliable technique in the determination of axillary nodal metastatic involvement in breast cancer patients. By use of this method a significant amount of complications and costs related to the previous techniques can be avoided.
  • Narayanan O. Navya, Kanapilly F. Magdalene, Gopinath P. Satheesh Page 221
    Hashimoto’s thyroiditis, the most common autoimmune thyroid disease, is due to destruction of the thyroid gland by autoantibodies. Various types of thyroid malignancies may arise in Hashimoto’s thyroiditis. Follicular carcinomas, papillary carcinomas, lymphomas, medullary carcinomas and hurthle cell neoplasms may develop in Hashimoto’s thyroiditis. We present a rare case report of a 35-year-old female who presented with hypothyroidism of a two-year duration. A diagnosis of Hashimoto’s thyroiditis was made for which she was under treatment. Due to the recent increase in size of the thyroid, a fine needle aspiration cytology was done. A preoperative diagnosis of Hurthle cell neoplasm was made based on fine needle aspiration cytology findings. The total thyroidectomy specimen revealed Hashimoto’s thyroiditis with synchronous papillary carcinoma and Hurthle cell carcinoma, which is a very rare occurrence.
  • Mohammad Mehdi Hosseini, Shahrokh Jahanbini, Sara Pakbaz, Shahryar Zeighami Page 225
    Bilateral ovarian dermoid tumor with invasion to surrounding organ is a rare entity. We report the case of a 63-year-old woman with prolonged dysuria and hematuria who had bilateral ovarian dermoid cysts with urinary bladder involvement.
  • Bita Geramizadeh, Golsa Shekarkhar, Shahram Bolandparvaz Page 229
    Cervical and supraclavicular lymph nodes metastases generally arise from carcinomas of the head and neck. Metastases to cervical lymph nodes from the prostate are very rare. The common site for lymph node metastasis from the prostate is infradiaphrag- matic. Herein, we report a 69 year-old male who presented with cervical lymph node enlargement in the setting of prostate cancer. This type of presentation although rare, may warrant investigating the prostate as a source of metastasis in cases where the head and neck are free from carcinoma.
  • Veena Gupta, Rajeev Sen, Ashima Batra, Promil Jain Page 233
    Primitive neuroectodermal tumors of the kidney are rare tumors representing about 1% of all sarcomas. Extraskeletal primitive neuroectodermal tumors may be found in the genitourinary tract, the testes, ovaries, uterus, or pancreas. Renal primitive neuroec- todermal tumors are frequently aggressive and almost 30% of all newly diagnosed cases present with distant metastases. Surgical intervention, intensive chemotherapeutic drugs and radiation therapy are the best choices for management. We discuss the case of a 22-year-old male who presented with a left renal mass. He underwent nephrectomy followed by histopathological examination. Microscopic and immunohistochemical examination revealed a primitive neuroectodermal tumor.