فهرست مطالب

Middle East Journal of Cancer - Volume:6 Issue: 3, 2015
  • Volume:6 Issue: 3, 2015
  • تاریخ انتشار: 1394/04/15
  • تعداد عناوین: 11
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  • Fatemeh Sari Aslani, Azarmidokht Momeni, Mozhdeh Momtahan, Mozhgan Akbarzadeh Jahromi, Amir Reza Dehghanian, Dorna Motevali Pages 135-142
    Background
    Ovarian cancer comprises a heterogeneous group of neoplasms. The prognosis cannot be predicted by histopathologic examination alone. The aim of this study is to evaluate p53, PTEN, and β-catenin expressions in primary ovarian carcinomas in an attempt to find a possible relationship with morphologic parameters and clinical findings.
    Methods
    The study included 100 epithelial ovarian tumors (borderline and carcinomas) from affiliated hospitals of Shiraz university of medical sciences during 2007-2013. Immunohistochemical staining for p53, PTEN, and β-catenin was performed on 65 serous, 18 mucinous, 10 endometrioid, 5 clear cell, and 2 mixed tumors.
    Results
    p53 expression pattern in serous carcinoma significantly differed from endometrioid carcinomas. Strong positivity (2+) in >50% of the tumor cells favored serous carcinoma. PTEN expression significantly differed in mucinous and serous carcinomas as well as in endometrioid carcinoma and borderline endometrioid tumor. There was significantly decreased β-catenin expression in the carcinomas compared with borderline tumors. In all of the different subtypes of ovarian carcinomas, we observed a significant association with decreased β-catenin expression to tumor grade as well as in serous carcinomas with increased nuclear grade, mitosis, and tumor grade. There was no significant relation between expressions of p53, PTEN, and β-catenin in epithelial ovarian tumors to FIGO staging, response to chemotherapy, serum CA- 125 marker, and tumor recurrence.
    Conclusion
    p53 and PTEN are helpful in differentiation of some epithelial ovarian tumor subtypes. In serous carcinomas, diminished expression of β-catenin is associated with higher tumor and nuclear grade. This expression is significantly different in borderline and carcinomas.
    Keywords: Epithelial ovarian tumor, Phosphatase, tensin homolog (PTEN), Tumor suppressor p53, Beta, catenin
  • Reza Vojdani, Bita Geramizadeh, Vahid Mohammadkarimi, Abdolrasoul Talei, Alireza Rezvani, Gita Dorniani, Akbar Safaei, Samaneh Ahsant, Azadeh Piran, Sedighe Tahmasebi Pages 143-150
    Background
    Breast cancer is the most common cause of cancer in women. This tumor is hormone dependent tumor and oncologists use estrogen receptor (ER), progesterone receptor (PR) and HER2 for treatment of this malignancy. Androgens like testosterone and their receptors (AR) have a role in the pathophysiology of breast cancer but their clinical values are not clear.
    Method
    AR expression was evaluated in 49 patients with breast cancers using immunohistochemistry. Testosterone was evaluated with ELISA. The relation of clinical characteristics and biomarkers with AR and testosterone were analyzed. According to the percentage of stained cells AR categorized to: AR-absent (0%), AR-poorly (1%-10%), AR-moderately (>10%-50%), and AR-highly (>50%) positive.
    Results
    Among 49 patients with breast cancer, 34% were AR-positive and 44% of ERpositive and 22% of ER negative patients were AR-positive. There was no significant association between mean of testosterone and AR, ER, PR and HER2. AR was positive more frequently but not significantly statistically in older patients and patients less than 45 years of age. Testosterone level was higher in ER positive patients than ER negative and lower in AR positive patients than AR negative patients, but these findings were not statistically significant. ten persent of breast cancers were triple negative and AR was negative in all of them.
    Conclusion
    Androgens and AR have role in pathophysiology of breast cancer and in the future one can use the potency of this pathway for the treatment of breast cancer.
    Keywords: Testosterone, AR, ER, PR, Triple negative, Breast cancer
  • Farideh Jowkar, Maryam Sadat Sadati, Fatemeh Sari Aslani, Iman Ahrari Pages 151-156
    Background
    Cutaneous malignancies are common in dermatologic practice. Due to their relation to sun exposure the characteristics of these malignancies can differ in various geographic locations. This study intends to determine the characteristics of surgically treated cutaneous malignancies and various surgical modalities that have been applied.
    Methods
    This was a retrospective study of patients with cutaneous malignancies who underwent surgery over a six-year period. Data regarding the general information, type of malignancy, location, surgical margin involvement and specific surgical modalities were recorded and analyzed.
    Results
    A total of 432 patients were included. Basal cell carcinoma was the most common malignancy (82.8%) followed by squamous cell carcinoma (13.4%). Lentigo maligna, keratoacanthoma, basosquamous carcinoma, sebaceous carcinoma and Bowen’s disease accounted for the minority of cases. Patient's mean age was 65.7 years and the most common location was the nose and cheeks. The mean diameter was 2.97 cm. Excision was performed with safe margins. Incomplete excision was seen in 14% of basal cell and 15% of squamous cell carcinoma cases. The most common type of defect closure was a simple closure (43.9%).
    Conclusion
    Basal cell carcinoma is the most common type of cutaneous malignancy. Surgery yields a satisfactory response as treatment for this cutaneous malignancy.
    Keywords: Epidemiology, Surgery, Cutaneous malignancies
  • Abeer Ibrahim, Anwar Amin, Rehab Hassan Pages 157-164
    Background
    Preoperative determination of the extent of viable residual tumor is an important issue after neoadjuvant treatment. On the other hand, retrospective data suggest that breast-conserving surgery is feasible up to stage IIIA breast cancer without preoperative therapy.
    Methods
    We retrospectively analyzed 164 patients who underwent breastconserving surgery followed by adjuvant chemotherapy and/or endocrinal therapy with whole breast radiation between 2005 and 2012. Of those, 116 patients had stages I and II (group 1) breast cancer, whereas 48 patients had stage IIIA (group 2).
    Results
    After a median follow-up of 40.4 months, 18 (15.5%) patients in group- 1and 8 (16.6%) in group-2 developed ipsilateral breast tumor recurrence (P=0.77). Mean time to tumor recurrence was 19 months in group 1 and 17 months in group 2 (P=0.5). However we found more ipsilateral breast tumor recurrence in hormone negative tumors (P=0.002), high grade tumors (P=0.021), young age (P=0.017) and lymph node positive cases (P=0.011). We observed no significant difference between N1 and N2 lymph node status (P=0.241).
    Conclusion
    Our data suggest that breast-conserving surgery with R0 resection is feasible in stage IIIA cases whenever cosmetic appearance can be maintained as long as surgery will be followed by radiotherapy and chemotherapy. A prospective study with larger numbers is recommended for further evaluation of this issue.
    Keywords: BCS, Stage IIIA, Tumor size, Neoadjuvant chemotherapy
  • Saeed Shakeri, Hossein Zeighami, Mehdi Salehipour, Hossein Beik Mohammadloo, Aria Shakeri, Arash Shakeri, Shahryar Zeighami Pages 165-170
    Background
    This study compared the early success, complication and patient satisfaction rates of modified extraperitoneal radical cystectomy (Mainz II urinary diversion) with standard intraperitoneal radical cystectomy (continent ileocecal urinary diversion) in a group of patients with muscle invasive urothelial carcinoma of the urinary bladder.
    Methods
    From September 2009 until November 2013, this randomized study enrolled 60 patients with muscle invasive transitional cell carcinoma of the urinary bladder who underwent radical cystectomy and urinary diversion. The patients were randomly allocated to two groups via block randomization. Group A included 30 patients (28 men and 2 women) who underwent modified small incision extraperitoneal radical cystectomy with a Mainz II urinary diversion. Group B included 30 patients (27 men and 3 women) who had classic intraperitoneal radical cystectomy and ileocecal continent diversion. The data were extracted and analyzed. The patients were followed for one year after surgery.
    Results
    Group A patients had a mean age of 61.47±8.63 years. Group B patients had a mean age of 60.77±6.82 years. There were no statistically significant differences in blood loss, electrolyte and acid-base abnormalities, and early post- operative complication rates between the two groups. However, surgical and hospitalization times were significantly shorter in group A (P<0.001). In addition, patients were mobilized earlier and had shorter nothing by moth time. Patient satisfaction rate was significantly more in group A.
    Conclusion
    Small incision extraperitoneal radical cystectomy and Mainz II urinary diversion is a safe, less complicated, effective and more rapid technique with excellent short term outcome. It seems this technique is a reliable alternative for continent urinary diversion in selected bladder cancer patients, mainly in those with urethral involvement.
    Keywords: Mainz II, Radical cystectomy, Bladder tumor
  • Mehdi Dehghani, Nematollah Hafezi, Reza Vojdani, Mani Ramzi, Mojtaba Karimi, Habib Nourani, Maryam Zakerinia, Zahra Bahador Pages 171-177
    Background
    Over the past decade, survival from advanced colorectal cancer is increasing. Therefore patients have more exposure to chemotherapy and related toxicities. This study determines how hematologic toxicity patterns affect therapy and care.
    Methods
    From April 2010 to March 2013, we enrolled 127 patients with stages IIb to IV colorectal cancer. Patients underwent complete blood count monitoring prior to and during each cycle of FOLFOX4 chemotherapy. Granulocyte colony stimulating factor was injected if their white blood cells were below 3.5×109/L.
    Results
    The most common hematologic toxicities were grades 1-2 for hemoglobin (76.83%) and leukopenia (26.48%). The least common hematologic toxicity was thrombocytopenia (4.69%) for all grades of platelet toxicity. The median granulocyte colony stimulating factor injection was 3.33 per 12 cycles.
    Conclusion
    Anemia and leukopenia are the most common hematologic abnormalities expected with FOLFOX4 chemotherapy regimens for colorectal cancer. The most important factor for predicting hematologic toxicities in patients who receive chemotherapy for colorectal cancer is the number of chemotherapy cycles.
    Keywords: Colorectal cancer, Chemotherapy, FOLFOX4, Granulocyte colony stimulating factor, Hematologic toxicities
  • Rahul Gandhi, Abhishek Singh Nayyar, Rahul Bhowate, Sweta Gandhi, Girish Dongerwar Pages 179-187
    Background
    Although Color Doppler Ultrasonography (CDUS) is useful in the diagnosis of various diseases of the head and neck, flow signals in oral malignant masses are less studied; hence the present study assesses the usefulness of Color Doppler Ultrasonography in quantifying oral squamous cell carcinoma (OSCC) vascularization. In addition, we determine the hemodynamic parameters by spectral analysis obtained during a Color Doppler Ultrasonography procedure. We have studied the usefulness of Color Doppler Ultrasonography in mapping oral squamous cell carcinoma of the buccal mucosa, tongue and lip.
    Methods
    This case-control study enrolled 60 subjects aged 20-70 years. Group A constituted 30 cases diagnosed with oral squamous cell carcinoma and Group B constituted 30 healthy controls. Ultrasonographic investigation of each mass was performed. The spectral waveform (time-velocity Doppler spectrum) of the flow signal was analyzed for the pulsatility index, resistive index, peak systolic velocity (m/sec), and end diastolic velocity (m/sec). All patients had real-time, gray-scale sonography and Color Doppler Ultrasonography with spectral wave analysis.
    Results
    The mean value for the resistive index in patients with oral squamous cell carcinoma was 0.40±0.14 whereas for healthy subjects, it was 0.83±0.07. The mean pulsatility index value in malignant patients was 0.86±0.20 while for healthy subjects, it came-out to be 2.61±0.77.
    Conclusion
    These Doppler indices have been shown to be sensitive and specific for the diagnosis of malignant oral tumors. Although Color Doppler Ultrasonography cannot replace histopathological procedures, it plays a definite role as an adjunct to clinical evaluation of oral squamous cell carcinoma patients.
    Keywords: Oral cancer, Color Doppler Ultrasonography, Pulsatility index, Resistivity index
  • Firouz Amani, Mohammad Sadrkabir, Saeid Sadeghieh Ahari, Saeid Barzghari, Abbas Yazdanbod, Ahmad Sabzevari, Moghgan Hadavi Pages 189-193
    Background
    Gastric cancer is the fifth most common cancer in the world and the third leading cause of death from cancer worldwide. This study aims to assess the epidemiology of gastric cancer in Ardabil Province, Iran.
    Methods
    This was a descriptive cross-sectional study performed on 1056 patients with gastric cancer registered in the Ardabil Cancer Registry. Data were collected by a checklist and analyzed by statistical methods in SPSS version 19.
    Results
    Out of 1056 cases, 37% were smokers and 80.9% were illiterate. There were 73.1% male cases. Adenocarcinoma was the most common (89.5%) type of cancer and prevalent in males. The tumors were mostly located in the gastric cardia. Most cases were from rural areas.
    Conclusion
    Results showed that the incidence of gastric cancer in Ardabil Province was higher in males compared to females. Compared to the country standards the incidence of gastric cancer was higher.
    Keywords: Gastric cancer, Adenocarcinoma, Epidemiology, Ardabil
  • Gajender Singh, Ashima Batra, Sant Prakash Kataria, Hemant Yadav, Rajeev Sen Pages 195-198
    Subcutaneous metastatic nodules are an uncommon first sign of underlying cancer. Cutaneous metastasis occurs in 0.8% to 4% of all cancer patients and less than 5% in those with lung cancer. These metastases are usually single or multiple painless nodules that may be mobile or fixed. Cutaneous metastases from the lung are not very common and indicate a worse prognosis. The limited literature on skin metastases from a primary lung suggests that if other extracutaneous metastases exist, median survival does not exceed three months; however, if the skin is the only site of metastatic disease, survival can reach ten months. Fine needle aspiration cytology is an excellent noninvasive method for early diagnosis of subcutaneous nodules, which in the presence of characteristic cytomorphology obviates the need for more invasive methods and surgery. Once diagnosed, the aim is to start treatment as soon as possible before widespread visceral metastases occur. Although the response to chemotherapy is poor, possibly due to poor blood supply to the skin, monitoring response to chemotherapy is easier when such lesions are present.We hereby describe the case of a 38-year-old male who presented with a mass in the right lung along with a nodule on his scalp. Fine needle aspiration cytology from both sites revealed cytological features of adenocarcinoma.
    Keywords: Adenocarcinoma, Lung, Metastasis, Cutaneous, Fine needle aspiration cytology
  • Katsuya Narisada Pages 199-200
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