Vol 9 No 3 (2017)

Original Articles

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    Background: Burden of cancer is increasing worldwide, especially in the low and middle income countries (LMICs), including Iran. Several reports have been published about cancer statistics in Iran, although they had shortcomings and provided variable results. We reported the most valid cancer statistics about Iran.Methods: We used Globocan database and reported age standardize incidence rate (ASR), mortality rate (ASMR), and five-year prevalence of cancer in Iran in 2012, and compared it with the results of 2008. We also provided the projection of cancer incidence for 2035 and estimated the life time cancer risks by age 75. Results: ASRs per 100,000 were 134.7 for men and 120.1 for women. The most common cancers were breast (ASR 28.1), colorectal (ASR 10.5), stomach (ASR 9.7) cancers in women and stomach (ASR 20.6), bladder (ASR 13.2), prostate (ASR 12.6) cancers in men. The ASR was about 19% higher in 2012 (127.7/100,000) compared to 2008 (107.3/100,000). ASR of all cancer sites will increase about 2.17 times by 2035. ASMR was about 20% higher in men (90.4/100,000) than women (72.7/100,000) in 2012. The highest ASMRs was observed for breast cancer (9.9/100,000) in women and stomach cancer (17.3/100,000) in men. Five-year prevalence of all cancers was 79,194 for men and 90,521 for women in 2012. Lifetime risk of occurrence of all types of cancer was 25%. In other words, 1 in 4 Iranian people will be diagnosed with cancer before the age of 75 years. Conclusion: Stomach and breast cancers were the most common cancers in Iranian men and women, respectively. Iran and other LMICs will experience major increase in the incidence and mortality of cancer in the next decades. They need to collocate further resources for cancer surveillance system and monitor the cancer statistics for evidence based cancer control program.
  • XML | PDF | downloads: 271 | views: 495 | pages: 23-31
    Background: Hypoxia is a common phenomenon in cancer cells, related to angiogenesis and cell proliferation the hypoxia-inducible factor family (HIFs) is the primary transcriptional factor to hypoxic stress. Cancer-testis (CT) antigens are almost expressed in male germ cells, aberrantly expresses in some malignancies as well. The CT gene, TSGA10, prevents the nuclear accumulation of HIF-α and may be involved in organ-specific regulation of hypoxic gene expression during sperm maturation. TSGA10 is supposed to regulate the HIF expression in germ cells and cancer cells. The HIF-α subunit has three isoforms, involved in oxygen transport, angiogenesis and tumor metastasis, which their detection is the subject of the current study.Methods: Three cell lines, MCF7, MDA-MB-231 and HeLa were cultured, passaged and categorized into normal and synchronized groups. The cells were subjected to RNA extraction and reverse-transcribed into cDNAs. Real time RT-PCR was performed to amplify TSGA10 and HIF-α isoforms and HPRT, as the normalizer gene, using appropriate primers. The REST and SPSS software were used for statistical analysis. Results: The expression of three isoforms of HIF-α in HeLa cell line was higher than MCF7, and MCF7 was higher than MDA-MB-231. Moreover, the expression relationship between HIF-α isoforms and TSGA10 was evaluated in each three cell lines as well. The results were significant in all cases with P =0.01. Before and after synchronization in each three cell lines, the isoform expressions of HIF-α and TASGA10 were evaluated, and the results were revealed their dependent expression. The relationship between HIF-α isoforms and TSGA10 expression was compared with each other. The cell lines with less TSGA10 expression had the higher expression of HIF-α isoforms and vice versa, according to the extent of TSGA10.Conclusion: The significant relationship between expressions of TSGA10 and HIF-α isoforms is confirmed. 
  • XML | PDF | downloads: 380 | views: 757 | pages: 32-41
    Background: The authors selected European Organization for Research and Treatment (EORTC) C30 and EORTC QLQ CR29 to specify bowel, bladder, and sexual dysfunction of Iranian colorectal cancer patients.Methods: A sample of 100 patients with colorectal cancer attending Iran Cancer Institute from March 2012 to March 2013 at first-line chemotherapy in the adjuvant or palliative settings participated in the study. Patients responded to the study questionnaires at the beginning and after 3-4 cycles of chemotherapies. Responses to the core questionnaire (QLQ-C30) and the QLQ-CR29 were linearly converted into 0-100 scores, using the EORTC guidelines. Correlations between the QLQ-C30 and QLQ-CR29 were examined, using Pearson’s product moment correlation in order to assess construct validity. Known groups’ comparon examined the ability of EORCT-CR29 to dtinguh between subgroups of patients with and without a stoma. Sensitivity to changes over time was examined by the response to chemotherapy in palliative or neoadjuvant settings. Internal constency was measured using Cronbach’s alpha coefficient with estimates of a magnitude of 0.7.Results: The mean age of patients was 53.6. Based on clinical and pathologic staging, 60% of the patients had presented while their cancer was in stage IV with dtant metastas at the time of referring to the clinic. Thirty-three percent of patients, almost all from rectal tumor group, had a permanent ostomy. In general, the correlation between the EORTC QLQ-C30 and QLQ-CR29 was in the expected directions, demonstrating that functional scales of both questionnaires had a positive correlation with each other while negative correlation was observed between functional and symptom subscales. In addition, the QLQ-CR29 differed considerably between patients with and without a stoma.The QLQ-CR29 results showed improved functioning scores after treatment and at the same time symptoms decreased. The Cronbach’s alpha for the scales ranged from 0.48-0.77.Conclusion: In general, the Iranian version of the EORTC QLQ-CR29 worked well and now could be used in outcome studies in colorectal cancer.

Case Reports

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    Background: Brain metastasis of nasopharyngeal carcinoma is very rare and only a few cases has been reported. Typically brain metastasis reveals after diagnosis and treatment of aggressive primary tumor. Diagnosis of metastatic nasopharyngeal carcinoma to the central nervous system at presentation is extremely rare. To the best of our knowledge, our patient is the first-ever reported case of brain metastasis of nasopharyngeal carcinoma at presentation. Case presentation: A 30-year-old woman presented with repeated and severe headache and diplopia at November 2011, and clinical examination revealed increased intracranial pressure. Brain magnetic resonance imaging revealed an enhancing mass at right frontal lobe. A thorough evaluation of whole body revealed no any other problem. Suboptimal resection of the mass by craniotomy revealed metastatic carcinoma. CEA,CK20,CK7 were negative and TTF-1 was positive. Treatment followed by whole brain radiotherapy and chemotherapy with resultant complete improvement of patient symptoms during next 2 years. 17 months after operation, patient noticed left neck adenopathy, but did not followed. Ultimately 8 months later, when she was at 5 months of her first pregnancy, fine needle biopsy of left neck mass revealed undiffentiated carcinoma. It was followed by Panendoscopy" of the head and neck and advanced nasopharyngeal cancer was revealed. Treatment conducted by chemotherapy after 24th week of pregnancy, delivery at term and radiotherapy there after.The patient is alive with no evidence of disease, 15 months after completion of radiotherapy.      Conclusions: Probability of nasopharyngeal origin should be considered at rare instances of brain metastatic carcinoma with unknown origin. Close follow up after treatment of unknown primary brain metastases is mandatory, in order to reveal and control primary site at future. Successful treatment of nasopharyngeal carcinoma at the third trimester of the pregnancy is possible and recommended.
  • XML | PDF | downloads: 266 | views: 374 | pages: 46-49
    A 35-year-old woman had a history of left breast mass without pain, discharge or weight loss. Fine needle aspiration noticed papillary carcinoma. Frozen section diagnosis was invasive carcinoma with papillary feature and free marked margin. Permanent determination on May 4, 2017, showed microinvasive papillary carcinoma with  ductal carcinoma in situ, high grade, and mucinous carcinoma. The tumor didn’t have frank invasion and metastasis. In conclusion, microinvasive papillary carcinoma is a tumor with minimal intrusion and low axillary lymph node metastasis that can combine with mucinous differentiation and/or ductal carcinoma in situ component and occur in lower ages.