فهرست مطالب

  • Volume:6 Issue: 1, 2015
  • تاریخ انتشار: 1393/10/24
  • تعداد عناوین: 12
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  • Elham Haem, Seyyed Taghi Heydari, Najaf Zare, Kamran B. Lankarani, Esmat Barooti, Farkhondeh Sharif Pages 1-9
    Background
    This study evaluated the role of family history of cancer and gynecologic factors in relation to the etiology of ovarian cancer in a low socioeconomic population in Iran.
    Methods
    From 2007-2009 we conducted a screening program on women with insurance coverage provided by the Imam Khomeini Relief Foundation. A total of 26788 women participated in this study of whom 76 cases had ovarian cancer and 26712 were considered as controls. We used rare event logistic (ReLogit) regression analysis with a prior correction method that used the Zelig package in R to obtain odds ratio estimates and confidence intervals.
    Results
    Ovarian cancer was more frequent among postmenopausal than premenopausal (odds ratio: 2.30; confidence interval: 1.17-4.49) women. We observed increased risk for this disease in women with histories of hormone replacement therapy compared to those with no history (odds ratio: 2.36; confidence interval: 1.13-4.91). A greater increase in ovarian cancer was observed in women with family histories of breast (odds ratio: 2.88; confidence interval: 1.44-5.77), ovarian (odds ratio: 11.27; confidence interval: 5.63-22.54) and all cancer sites (odds ratio: 2.95; confidence interval: 1.71-5.08). However, the use of oral contraceptive pills was significantly associated with lower risk for ovarian cancer (odds ratio: 0.47; confidence interval: 0.28-0.79). There was no association between ovarian cancer and age, marital status, occupation, education level, age at menarche, age at first pregnancy and number of pregnancies.
    Conclusion
    Ovarian cancer was considered a rare event. Thus we deemed it necessary to explore the associated risk factors using ReLogit with a prior correction method. The risk factors for ovarian cancer were menopause, history of hormone replacement therapy and family history of cancer of the breast, ovaries and other sites. Oral use of contraceptive pills showed a protective effect on risk for ovarian cancer.
  • Nadia A. Abd El Moneim, Hisham El Masry, Mina Mamdouh Sorial, Taha I. Hewala, Amira Embaby, Salah Sheweita Pages 11-20
    Background
    The main function of the pineal hormone melatonin which is mediated via its two receptors, MTNR1A and MTNR1B, is to mediate dark signals in addition to anti-oxidation, immune system enhancement, protection from radiation, and anti-cancer functions. A common single nucleotide polymorphism in the MTNR1B gene is rs#10830963, which is well known as a risk factor for type 2 diabetes mellitus. This study intends to figure out the role of melatonin and its receptor MTNR1B gene rs#10830963 polymorphism in breast cancer incidence, diagnosis and prognosis.
    Methods
    This study included 43 females with breast cancer and 45 apparently normal healthy females. Restriction fragment length polymorphism-PCR was used for amplification and genotyping of the MTNR1B gene rs#10830963 polymorphism in whole blood. Serum melatonin levels were measured using a ready-for-use radioimmunoassay kit.
    Results
    For the MTNR1B gene rs#10830963 polymorphism, we observed a significantly higher GG genotype frequency among cases (72.1%) than controls (13.3%), with a diagnostic sensitivity of 83.78% and specificity of 76.47%. The cases had a frequency of 11.6% for the CC genotype and 16.3% for the CG genotype which was significantly lower compared to controls that had a 44.4% frequency of the CC genotype and 42.2% frequency of the CG genotype. The GG genotype had a significant association with larger tumor volume (P=0.048). Serum melatonin levels were significantly lower among breast cancer patients than controls. Using the ROC curve analysis, serum melatonin showed a significant AUC (72.6%, P39.5 pg/ml.
    Conclusion
    The risk for breast cancer incidence increased as the serum levels of melatonin decreased and in females homozygous for the G allele (GG genotype) of the MTNR1B gene rs#10830963 polymorphism. The GG genotype was found to be associated with increased breast tumor volume as a marker of a poor prognosis breast cancer.
  • Mona M. Sayed, Mohamed I. El, Sayed, Alia M. Attia, Mostafa E. Abdel, Wanis Pages 21-27
    Background
    The use of shorter radiotherapy schedules has an economic and logistic advantage for radiotherapy departments, as well as a high degree of patient convenience. The aim of this study is to assess the acute and short-term late toxicities of a hypofractionated radiotherapy schedule with a concomitant boost.
    Methods
    We enrolled 57 eligible patients as group A. These patients received 42.5 Gy in 16 fractions of 2.66 Gy each to the whole breast over 3.2 weeks. A concomitant electron boost of 12 Gy in 16 fractions was also administered which gave an additional 0.75 Gy daily to the lumpectomy area for a total radiation dose of 54.5 Gy. Toxicity was recorded at three weeks and at three months for this group as well as for a control group (group B). The control group comprised 76 eligible patients treated conventionally with 50 Gy to the whole breast over five weeks followed by a sequential electron boost of 12 Gy in 2 Gy per fraction.
    Results
    There were no statistically significant differences observed in the incidence of acute skin toxicity, breast pain, and edema recorded at three weeks or pigmentation and fibrosis recorded at three months between the two groups (P0.05).
    Conclusion
    The results of this study suggest there are no increased acute and short- term late toxicities affiliated with the hypofractionated schedule plus a concomitant boost as prescribed compared to the conventional fractionation of adjuvant breast radiotherapy. Large randomized trials and long-term follow-up are needed to confirm these favorable findings.
  • Rasoul Esmaeili, Masoud Seyedin Khorasani, Alireza Monsef Pages 29-34
    Background
    Basal cell carcinoma is the most common form of skin cancer in men. Increased marker expressions of apoptosis and cell proliferation have been found in the majority of basal cell carcinomas. Our purpose was to determine whether any correlation between immunohistochemical expressions of P53 and Ki-67 in different histopathological variants of basal cell carcinoma and patient’s age, gender and tumor localization existed.
    Methods
    We evaluated basal cell skin specimens obtained from 100 previously diagnosed cases of basal cell carcinoma at the Dermatology Clinic of Farshchian Hospital, Hamadan, Western Iran. At first the specimens were fixed by formalin and stained by hematoxylin-eosin. Histopathological types of the tumor were determined. Immunohistochemical expressions of Ki- 67and P53 were examined. Clinical features of the patients such as age, gender, and lesion site were collected from their files.
    Results
    The specimens were obtained from 62 (62%) men and 38 (38%) women with an age range of 22-107 years. Of basal cell carcinoma specimens, 76% expressed P53 and 60% expressed Ki-67. There was strong staining intensity of P53 protein in 70% and Ki-67 antigen in 30% of specimens. Strong staining intensity of Ki-67 in patients of lower ages was significantly correlated. There was no statistically significant correlation between these markers and other variables (P>0.05).
    Conclusion
    This study highlighted the value of P53 and Ki-67 markers in basal cell carcinoma. We did not observe any significant difference between the histopathological types based on the P53 and Ki-67 expressions and their staining intensities.
  • Shapour Omidvari, Samira Razzaghi, Ali Zamani, Hamid Nasrolahi, Sayed Hasan Hamedi, Ahmad Mosalaei, Niloofar Ahmadloo, Mansour Ansari, Saeedeh Pourahmad, Mohammad Mohammadianpanah Pages 35-42
    Background
    The present study aimed to investigate the rate and time of ovarian function restoration in breast cancer patients between 40 and 60 years of age who were in menopause (biochemically documented) and received letrozole after chemotherapy. We intended to further clarify the management strategy for breast cancer patients with different menopausal status.
    Methods
    We prospectively measured the effects of replacing tamoxifen with letrozole on ovarian function recovery in 90 women from two age groups (40-50 and 51-60 years). All had breast cancer and were treated by chemotherapy. Patients had laboratory documentation of menopause (FSH >40 mIU/ml and estradiol <20 pg/mL). Patients did not have menstruation for at least one year. Study patients received letrozole. At three month intervals, we checked their FSH and estradiol levels.
    Results
    At three months after beginning letrozole, 12 patients in the younger age group had laboratory ovarian function restoration, among which three had vaginal bleeding. In the older group, 8 patients had increased estradiol levels; however, there was no evidence of vaginal bleeding in this group. At 6, 9 and 12 months, no ovarian function restoration was seen in the older group. However in younger patients, 4 had laboratory evidence of ovarian function restoration at 6 months, 2 at 9 months and 1 patient showed laboratory ovarian function restoration at 12 months of follow-up. Totally, there was a significant difference in the occurrence of ovarian function restoration between the two groups (P=0.03).
    Conclusion
    A remarkable portion of women with chemotherapy-induced amenorrhea may develop ovarian function restoration. Therefore, endocrine therapy using aromatase inhibitors in patients with chemotherapy-induced amenorrhea should be followed by a regular hormonal study.
  • Aliakbar Taherian, Seyed Mostafa Mostafavi Zadeh, Hossein Ghani, Tahere Khamechian Pages 43-50
    Background
    ST6Gal1, Cox-2 and HB-EGF genes are involved in different tumors and their enhanced expressions often correlate with poor prognosis. In this study we assay the expressions of these genes by reverse transcriptase-PCR in 54 breast cancer samples.
    Methods
    Tissue samples were either formalin-fixed for histopathological examination or frozen for reverse transcriptase-PCR. Image program was used for the densitometry of the image of the gels and the expression of different genes was normalized with beta actin expression. The student''s t-test and correlation matrix were used for data analyses.
    Results
    We observed significantly higher expressions of ST6Gal1 (P= 0.040), Cox- 2 (P= 0.001) and HB-EGF (P= 0.009) in the tumor region compared to the margin samples. A significant correlation was found between HB-EGF and Cox-2 expression (P= 0.001). There was a positive correlation between total score, tumor size, histology grade and nuclear grade but there was a reverse correlation between age and tumor size, histology grade and total score.
    Conclusion
    Expressions of ST6Gal1, Cox-2 and HB-EGF in breast tumor samples in this and a number of other studies emphasize their role as important markers in breast cancer. The use of medications to inhibit either their individual expressions or the possible inhibition of all three genes may improve patient survival and prevent metastasis.
  • Amr Idris Pages 51-56
    A desmoplastic small round cell tumor is a malignant tumor of the abdominal and pelvic cavities. This tumor involves serosal surfaces such as the peritoneum, pleura, and scrotum. In this case report a 28-year old male presented with a desmoplastic small round cell tumor located in the abdomen along with urological symptoms. When the diagnosis was completed, the patient’s tumor had metastasized to the liver and retroperi- toneal lymph nodes. This case not only has exemplified that this tumor is rare and fatal but its prompt diagnosis is critical. However it is most likely that the diagnosis of this tumor is found when it has metastasized and this is unfortunately very late.
  • Waseem Raja Dar Pages 57-60
    Multiple myeloma is a neoplastic plasma cell dyscrasia. Patients usually present with bone pain, anemia, hypercalcemia and renal failure. Unusual presentations include progressive bilateral carpal tunnel syndrome, polyarthritis, amyloidosis of the tongue, and involvement of pulmonary parenchyma. Early diagnosis is important for timely therapy. We present the case of a patient with clinical features of portal hypertension that ultimately proved to be multiple myeloma.
  • Sonia Chabbra, Rajneesh Kalra, Shivani Malik, Sunita Singh, Gurpreet Singh, Pansi Gupta, Rajeev Sen Pages 61-64
    Unilateral malignant pleural effusion as an initial manifestation that leads to the diagnosis of an underlying acute lymphoblastic leukemia is a rare event. Early and accurate diagnosis of this case is important for prompt and adequate therapy. We present the case of an18-year-old male who presented to the emergency department with severe respiratory distress. Chest X-ray revealed a unilateral massive right-sided pleural effusion. Cytological examination of the pleural fluid led to the diagnosis of underlying acute lymphoblastic leukemia. Subsequent hemogram, bone marrow aspirate and flow cytometry analysis confirmed the diagnosis of T-lineage acute lymphoblastic leukemia. The patient underwent induction chemotherapy which led to significant clinical improvement due to resolution of the pleural effusion. The patient is on follow up at present. This case report exemplifies and highlights the importance of cytopathological analysis of body cavity fluids in the diagnosis of underlying unsuspected malignancies.
  • Bita Geramizadeh, Shahrzad Yazdanpanah, Ali Aryafar Pages 65-66
  • Calendar of Events
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