Vol 9 No 1 (2017)


Original Articles

  • XML | PDF | downloads: 285 | views: 494 | pages: 4-11
    Background: Colorectal cancer constitutes one of the most common causes of cancer mortality worldwide. The incidence of this malignancy has risen in Iran during the last years. This study aims to estimate the survival of colorectal cancer patients and its prognostic factors using parametric competing risks model.Methods: In a retrospective study, we used data from 1060 patients with colorectal cancer in the cancer registry of the Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, from 2004 to 2015. Analysis was performed using parametric competing risks model with Weibull distribution. R software was used for all analyses with significance level set at 0.05.Results: In total, 380 patients (35.8%) had died due to colorectal cancer, 49 patients (4.6%) had died for other causes, and 631 patients (59.5%) survived until the end of the study period. Mean survival for the 1060 patients was 59.96 ± 1.46 months with a median of 45.5 months. Multivariable analysis revealed factors such as age at diagnosis and body mass index (BMI) to significantly affect death by colorectal cancer (p < 0.001).Conclusion: According to the findings of the generalized Weibull parametric competing risks model, only age at diagnosis and BMI were factors influencing the survival of colorectal cancer patients in this study.
  • XML | PDF | downloads: 194 | views: 434 | pages: 12-20
    Background: Vascular endothelial growth factor (VEGF) is a key mediator of angiogenesis which could act as an invasion factor. The aim of this study was to compare the frequency of alleles and genotypes of three polymorphisms in the VEGF gene, the 460T/C, 1154G/A, and 634G/C, between female breast cancer patients and healthy women as controls.Methods: In this hospital-based case-control study, we recruited 214 pathologically proven female breast cancer cases and 161 healthy women subjects. The candidate VEGF gene polymorphisms were -634G/C (rs2010963), -460T/C (rs833061) and -1154G/A (rs1570360). Frequency of genotypes was determined by TaqMan real-time PCR allelic discrimination assay. Univariable and multivariable logistic regressions model were used to assess the odds ratios and corresponding confidence intervals.   Relative excess risk due to interaction (RERI) was used to check potential additive interactions.Results: The frequency of VEGF -1154G/A genotype in the case and control groups was 39.1 and 37.8%, respectively (P-value = 0.94). The frequency of combined -1154 AA/GA variant genotypes compared with the VEGF -1154 GG genotype in case and control groups was 48.8 and 49.4%, respectively (P-value = 0.94). Similarly, for the other two VEGF SNPs, -460T/C and -1154G/A, no significant differences were observed in genotype distributions between patients and controls. Moreover, we did not find interaction between VEGF SNPs and age for occurrence of breast cancer: RERI was 0.78 (95% CI: 0.47-2.03), attributable proportion (AP) due to interaction was 0.37 (95% CI: -0.13-0.88); and synergy index was 3.58 (95% CI: 0.12-106).Conclusion: The results suggest that none of the studied polymorphisms in the VEGF gene were associated with occurrence of breast cancer in a sample of female Iranian adults. Larger studies are warranted to confirm the results and evaluate gene-environment interactions.


  • XML | PDF | downloads: 214 | views: 429 | pages: 21-25
    Fetuin-A is a major 63-kDa plasma protein synthesized by liver cells and secreted to plasma. It has been suggested to be an extracellular adhesive molecule. In the presence of fetuin-A, breast tumor cells can join and propagate, but the mechanism is not clear. Fetuin-A mediates adhesion by calcium ions, while integrin mediates adhesion by divalent ion manganese and magnesium.Calcium-mediated adhesion is observed in metastatic or more aggressive breast tumor cell line, but not in benign or normal breast epithelial cells. Adhesion and propagation of tumor cells can be only mediated by cellular exosomes carrying histones and fetuin-A. In this article, we review fetuin A and its role in apoptosis and breast cancer.  
  • XML | PDF | downloads: 195 | views: 345 | pages: 26-39
    Nowadays, decision analysis models are extensively used in solving healthcare problems. Considering the limited resources, the results of these studies will greatly assist policymakers with resource allocation. The purpose of this study is to provide a review of different decision analysis models in healthcare systems and to compare the components used in developing these models in studies addressing cervical cancer prevention. In this comprehensive review on decision analysis models used for cervical cancer prevention, we determined that the major components of the models included costs, outcomes, cycle lengths, discount rate, and perspective. The most commonly used model found in our review was the Markov model; nevertheless, it appears that dynamic models are gaining popularity over recent years. Conclusion: Using decision analysis models and encouraging healthcare policymakers to apply the results of modeling studies will result in saving time and costs, and will facilitate decision making in healthcare issues.

Case Reports

  • XML | PDF | downloads: 153 | views: 439 | pages: 40-45
    Adrenocortical carcinomas (ACC) is an uncommon disease that accounts for only 0.02% of all cancers. Herein, this study evaluates a case of adult ACC with extension into the inferior vena cava and Cushingoid features. A 67-year-old lady was admitted to the surgery service for surgical resection of adrenal mass which was found on hypertension work-up. On physical examination, she was fat, cushingoid and had ecchymoses on her skin. The patient was hypokalemic at the time of admission. Spiral CT with contrast of the abdomen and pelvis was done and showed solid mass measuring 10x11 cm, upper to the right kidney and posterior to IVC (inferior vena cava) with anterior displacement of IVC. Microscopic diagnosis was adrenocortical carcinoma with vascular invasion and necrosis (20% of surface area) in this case. In conclusion, the hypertension can be the most common complaints in ACC patients and probably, the existence of both hypertension and hypokalemia in a case can increase suspicion of ACC that it needs to future studies with focus on these complaints.