Vol 15 No 2 (2023)

Original Articles

  • XML | PDF | downloads: 100 | views: 141 | pages: 67-80
    Background: Gastric cancer (GC) patients have a poor prognosis mainly due to late diagnosis. We aimed to study the prognostic effects of various biomarkers, including HER2, CD34, p53, Ki67, Cox2, MMP7, and vimentin in GC.Methods: We performed immunohistochemistry (IHC) to examine the expression of potential biomarkers in 140 GC patients. CD34 protein expression was quantified to assess angiogenesis through scoring microvessel density (MVD). We used a multivariable Cox-proportional hazard model to estimate hazard ratios (HRs) representing the prognostic role of the biomarkers and the clinicopathological parameters.Results: Patients diagnosed at the advanced tumor stage exhibited a significantly higher risk of mortality than those diagnosed at the early stages (HR = 5.96, CI: 3.73 – 9.51). We also observed higher risks of mortality in patients with high MVD-CD34 (HR = 5.35, CI: 2.36 – 12.12), HER2-positive (HR = 2.82, CI: 1.69 – 4.37), p53-positive (HR = 4.03, CI: 2.53 – 6.4), high Ki67 (HR = 4.34, CI: 2.64 – 7.13), high Cox2 (HR = 4.77, CI: 2.39 – 9.49), high MMP7 (HR = 2.75, CI: 1.53 – 4.94), and high vimentin (HR = 3.78, CI: 1.7 – 8.39) tumors compared to their corresponding reference groups. The association was statistically significant for HER2, p53, Ki67, Cox2, and MVD-CD34 among those diagnosed in an early stage.Conclusion: Overall, evaluation of tumor biomarkers in GC patients can result in more precise estimates of prognosis, especially in early-stage tumors. These biomarkers could potentially be considered for targeted therapy of GC patients to improve their survival.
  • XML | PDF | downloads: 65 | views: 82 | pages: 81-93
    Breast cancer is the most common malignancy among women, and early diagnosis and targeted therapy have garnered significant attention. Non-coding RNAs have emerged as potential diagnostic, prognostic, and treatment biomarkers for breast cancer. This study aimed to evaluate the expression of non-coding RNAs, specifically miR-506 and circular RNA 000284, and their target gene SNAIL-2 in breast tumors compared to normal controls. The study also focused on clinicopathological characteristics, and plasma was monitored for expression of circ0000284 to identify a possible accessible cancer-related marker. Using the SYBR-Green Real-time PCR technique, total RNA was extracted from 80 breast tumors and normal adjacent tissues, and circ0000284, miR-506, and SNAIL2 expression were analyzed. The results showed overexpression, down-regulation, and up-regulation of circRNA 000284, miR-506, and SNAIL-2 gene, respectively. These expression changes were associated with advanced stages of the disease and lymph nodal involvement, which are signs of a poor prognosis. Additionally, a positive direct correlation was observed between circRNA000284 expression in tumors and plasma. Moreover, it was discovered that circ-0000284 sponged miR-506, causing up-regulation of SNAIL-2 as its mRNA target. The upregulation of SNAIL-2 as an epithelial-mesenchymal-transition (EMT)factor leads to poor prognosis in breast cancer and is epigenetically regulated by miR-506 and circRNA 000284. Therefore, the overexpression of circRNA000284 in plasma could be considered an indicator of lymph nodal involvement and advanced stages of cancer, and nominated as a poor prognostic biomarker for future considerations.
  • XML | PDF | downloads: 55 | views: 101 | pages: 130-139
    Introduction: Mutations occurring in the CDH1 gene elevate the susceptibility to the development of hereditary diffuse gastric cancer (HDGC) as well as lobular breast cancer (LBC). LBCs with CDH1 germline mutations are classified as hereditary breast cancers, devoid of any indication of gastric carcinoma. As prophylactic gastrectomy is a recommended course of treatment for individuals with CDH1 mutations, it is advised that genetic testing be conducted for those who meet the criteria established by the National Comprehensive Cancer Network (NCCN). This study aimed to screen patients with HDGC for CDH1 testing and clinical management for the prevention of HDGC. Moreover, patients with LBC are tested for CDH1 mutation. Materials and Methods: In this multicenter study, thirty-one patients with HDGC were selected among 615 patients and admitted for CDH1 mutation testing. PCR for all 16 exons of CDH1 and Sanger sequencing were performed. Patients with LBC who are negative for BRCA1/2 were also included in this study regardless of gastric cancer history. Results: The results showed that 5.04% of patients with DGC were identified as HDGC of which 9.6% of individuals had a pathogenic CDH1 mutation and only 15.38% of cases with a family history carried germline mutation in CDH1. Furthermore, 7.6% of patients with LBC and negative for a family history of gastric cancer have CDH1 mutation. Discussion: All patients who met the NCCN criteria were not CDH1 mutation-positive, indicating other genes should be involved in DGC. Moreover, patients with LBC and negative for BRCA1/2 are recommended for testing the mutation in CDH1.
  • XML | PDF | downloads: 29 | views: 43 | pages: 140-150
    Background and Objectives: The non-surgical treatment outcome of gastroesophageal junction (GEJ) adenocarcinoma remains to be defined. We aimed to assess the outcomes of definitive chemoradiation (CRT) of GEJ tumors. Methods: In this retrospective cohort, we evaluated 50 patients with non-metastatic adenocarcinoma of GEJ (Siewert's type I and II) treated by chemoradiation without surgery from 2008 to 2017. The reasons for not undergoing surgery were patient refusal, medical unfitness, de novo metastasis in pre-op restaging, and tumor unresectability or progress at the time of operation. The primary outcome was overall survival; secondary outcomes were progression-free survival and local and distal recurrence. Results: The 1-year, 2-year, and 3-year overall survival rates were 53%, 26%, and 12%, respectively. The 1-year, 2-year, and 3-year progression-free survival rates were 44%, 18%, and 10%, respectively. The univariate Cox regression analysis with log-rank test showed that age group and the reason for not undergoing surgery, histologic grade, radiotherapy duration, and distant recurrence had an almost significant association with overall survival. However, after multivariate analysis, the only independent predictor of survival was a distant failure (P=0.031). Conclusion: Although the outcomes of non-surgical treatments are disappointing in GEJ adenocarcinomas, a few patients may experience long-term survival using definitive CRT. This option should be discussed with all patients who are not candidates for surgery.

Reviews

  • XML | PDF | downloads: 55 | views: 61 | pages: 94-102
    Chemotherapy-induced alopecia (CIA) is one of the side effects of chemotherapy that is the most traumatic aspect of treatment for more than half of the patients. CIA is associated with increased psychosocial stress regarding body image, self-esteem, and sexuality. It is estimated that 60-85% of individuals who received chemotherapy treatment for cancer experienced some degree of CIA. Various techniques have been used to prevent CIA, including scalp compression, scalp cooling, and medical treatments. Herein, we provide a review of scalp cooling methods, advantages and disadvantages, requirements, and related papers.
  • XML | PDF | downloads: 63 | views: 134 | pages: 114-129
    Breast cancer is a prevalent disease worldwide and the accurate diagnosis and prognosis of breast cancer are essential for the development of effective treatment plans. Pathology remains the gold standard for diagnosis and prognosis but with limitations such as time-consuming manual scoring and some error-prone results. Recently, deep learning techniques, especially convolutional neural networks (CNN), have been proposed for the interpretation of immunohistochemistry (IHC) results in breast cancer. The objective of this systematic review is to critically assess the existing literature on computer-aided systems for the interpretation of IHC results in breast cancer based on deep learning algorithms.  We included studies with models that use novel approaches such as deep learning for quantitative measurements of immunohistochemically stained Ki-67, ER, PR, and HER2 images. We systematically searched PubMed, Scopus, and web of science up to September 2022. 15 studies (seven HER2, seven Ki67, and one ER/PR scoring studies) met our inclusion criteria. Various AI-based assays have been developed for different applications in breast pathology, including diagnostic and prognostic applications, as well as predictive values and responses to treatment. These algorithms have shown promise in improving the accuracy of breast cancer diagnosis and prognosis. It is essential to consider the differences in training and inter-observer variability while designing tools, and there is an urgent need to integrate the detection and analysis of various biomarkers at the same place and time to facilitate the formation of patients' reports and treatment.

Brief Communications

  • XML | PDF | downloads: 55 | views: 118 | pages: 103-113
    Background: Breast cancer is the most prevalent cancer among women. This cancer could be easily intervened and even treated if it is diagnosed in the early stages. A screening program has been provided by the World Health Organization (WHO) to diagnose this cancer in the early stages and treat it successfully. Women refuse to undergo mammography for various reasons such as lack of knowledge about the necessity of doing mammography, low educational level, low household income, and woman’s unemployment, having no medical insurance, having no family history of breast diseases, and a woman’s lack of breast problems. This study aims to investigate the effective factors in performing screening mammography among women. Methods: All the clients referring to the mammography center were included in the study to determine the desired sample size. In total, 150 individuals were selected and questions were asked of them. The questionnaire consisted of 17 items. In the first part of the questionnaire, demographic information including age, educational level, occupation, place of residence, insurance status, and monthly household income was asked. The second part included women’s fertility history in terms of number of children, using hormonal methods of contraception, and other information like history of breast cancer and family history of breast cancer. In the last part, women under study were divided into 2 groups, one of them had done screening mammography before coming to the hospital and another group did not. We asked the second group about their reasons for refusing to do mammography in the past and we asked from first group about the source of information they had about doing mammography. The data were entered into SPSS software and analyzed. Results: There was no significant correlation between doing screening mammography and educational level, age, place of residence, having health insurance, being employed and type of occupation, number of children, income level, using contraceptive methods, and family history of breast cancer. A significant correlation was observed between performing screening mammography and women’s history of benign tumors (p<0.05, X2=7.44). A significant correlation was found between performing screening mammography and women’s history of a malignant tumor (p<0.05 and X2=7.143)