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1.  Effects of Chrysin-PLGA-PEG Nanoparticles on Proliferation and Gene Expression of miRNAs in Gastric Cancer Cell Line 
Background
Recently, Chrysin, as a flavone, has revealed cancer chemo-preventive activity. The present experiment utilized the PLGA-PEG-chrysin complex, and free chrysin, to evaluation of the expression of miR-22, miR-34a and miR-126 in human gastric cell line.
Objectives
The purpose of this study was to examine whether nano encapsulating chrysin improves the anti-cancer effect of free chrysin on AGS human gastric cell line.
Methods
Properties of the chrysin encapsulated in PLGA-PEG nanoparticles were investigated by SEM, H NMR, and FTIR. The assessment of cytotoxicity on the growth of the human gastric cell line was carried out through MTT assay. After treating the cells with a prearranged amount of pure and encapsulated chrysin, RNA was extracted and the expressions of miR-22, miR-34a and miR-126 were measured by using real-time PCR.
Results
With regard to the amount of the chrysin loaded in PLGA-PEG nanoparticles, IC50 value was significantly decreased in nanocapsulatedchrysin, in comparison with free chrysin. This finding has been proved through the further increase of miR-22, miR-34a and miR-126 gene expression of nanocapsulatedchrysin, in comparison with free chrysin.
Conclusions
In this study, we revealed that the PLGA-PEG-chrysin is more effective than free chrysin in inhibiting the growth of human gastric cell line.
doi:10.17795/ijcp-4190
PMCID: PMC5056017  PMID: 27761206
Gastric Cancer; Micro RNA; Chrysin, PLGA-PEG; Real-Time PCR
2.  Malignant Tumors of Tongue in Iranian Population 
Background
The incidence of oral cancers varies from one country to another, which can be clarified by the difference in the distribution of the risk factors and the possible etiologies. Tongue is a main segment of oral cavity and malignant lesions of this region accounts for nearly 30% of all oral cancers.
Objectives
In the present study, we evaluated the pattern of tongue cancer in Iranian population and compared these findings with those previously reported in the other countries.
Methods
In this multicenter, retrospective cross-sectional study recorded cases of the malignant tongue tumors in the cancer research center (CRC) of Shahid Beheshti University of Medical Sciences were extracted. The patient records and their microscopic reports were retrieved from the archives and age, sex and microscopic types were evaluated. It is to be noted that the CRC has been serving as a cancer registry center for major hospitals all over the country since the year of 2003. Thus, the obtained statistics are highly reliable.
Results
During the years 2003 to 2008, a total number of 952 new cases of the tongue cancer were recorded in the CRC. Most cases are diagnosed in the sixth and seventh decades of life. 450 cases (47.2%) occurred in men and 489 cases (51.36%) in women. Four different types of malignant lesions (epithelial, salivary gland, hematopoietic and mesenchymal) were diagnosed. Epithelial tumors were the most prevalent malignancies (93%) of which squamous cell carcinoma (SCC) made up 87.39% of all lesions. Salivary gland tumors had the second place with 3.15% of the total lesions.
Conclusions
In Iranian population, squamous cell carcinoma is the most prevalent malignancy of tongue and it is notable that the ratio of female to male population was equal. These lesions were prevalent in the sixth and seventh decades of life. Thus screening examination of tongue by dentist especially in elderly patients is necessary for early detection of cancerous lesions.
doi:10.17795/ijcp-4467
PMCID: PMC5056019  PMID: 27761209
Malignant Tongue Tumor; Cancer in Iran; Prevalence; Carcinoma, Squamous Cell
3.  Evaluation of MAGE-1 Cancer-Testis Antigen Expression in Invasive Breast Cancer and its Correlation with Prognostic Factors 
Background
Aberrant expression of cancer-testis antigens (CTA) in breast carcinoma tissue, and its natural expression in the testis, the tissue away from the immune system, makes them good candidates for cancer immunotherapy and vaccines designing.
Objectives
The aim of this study was to assess the expression of a CTA (MAGE-1) in invasive breast cancer and its correlation with prognostic factors.
Methods
Paraffin blocks of breast cancer tissues from 113 patients operated in 2011 - 2013 were stained for MAGE-1expression by immunohistochemistry (IHC). The associations of MAGE-1 expression with known prognostic factors were assessed by statistical analysis using SPSS 16.
Results
MAGE-1 expression was found in cancer cell cytoplasms of 30.1% of patients, with different degrees of intensity, (23.9% moderate and 6.2% strong). Nuclear staining turned positive in 31.8%, stratified from moderate in 26.5%to to strong in 5.3%. There was a significant association between the number of lymph nodes involved and both nuclear (P = 0.042) and cytoplasmic (P = 0.003) MAGE-1 expression. There was also a significant correlation between the nuclear expression of MAGE-1 and tumor size (P = 0.018). Cytoplasmic expression of MAGE-1 increased with increasing pathologic grade of tumors although the association was not statistically significant (P = 0.119).
Conclusions
CTA MAGE-1 has significant association with some prognostic factors in breast cancer and may have the role of a prognostic factor.
doi:10.17795/ijcp-4404
PMCID: PMC5056020  PMID: 27761208
Breast Cancer; Cancer-Testis Antigens; MAGE-1; Immunohistochemistry
4.  Are Estrogen Receptor Genomic Aberrations Predictive of Hormone Therapy Response in Breast Cancer? 
Context
Breast cancer is the most common cancer in women worldwide. Estrogen receptor (ER) positive breast cancer constitutes the majority of these cancers. Hormone therapy has significantly improved clinical outcomes for early- and late-stage hormone receptor positive breast cancer. Although most patients with early stage breast cancer are treated with curative intent, approximately 20% - 30% of patients eventually experience a recurrence. During the last two decades, there have been tremendous efforts to understand the biological mechanisms of hormone therapy resistance, with the ultimate goal of implementing new therapeutic strategies to improve the current treatments for ER positive breast cancer. Several mechanisms of hormone therapy resistance have been proposed, including genetic alterations that lead to altered ER expression or ERs with changed protein sequence.
Evidence Acquisition
A Pubmed search was performed utilizing various related terms. Articles over the past 20 years were analyzed and selected for review.
Results
On the basis of published studies, the frequencies of ESR1 (the gene encoding ER) mutations in ER positive metastatic breast cancer range from 11% to 55%. Future larger prospective studies with standardized mutation detection methods may be necessary to determine the true incidence of ESR1 mutations. ESR1 amplification in breast cancer remains a controversial issue, with numerous studies either confirmed or challenged the reports of ESR1 amplification. The combination of intra-tumor heterogeneity regarding ESR1 copy number alterations and low level ESR1 copy number increase may account for these discrepancies.
Conclusions
While numerous unknown issues on the role of ESR1 mutations in advanced breast cancer remain, these new findings will certainly deepen current knowledge on molecular evolution of breast cancer and acquired resistance to hormone therapy.
doi:10.17795/ijcp-6565
PMCID: PMC5056018  PMID: 27761212
Estrogen Receptor; ESR1 Amplification; ESR1 Mutation; Breast Cancer; Hormone Therapy
5.  The Relationship Between Risk Factors and Survival in Adult Acute Lymphoblastic Leukemia 
Background
Acute lymphoblastic leukemia (ALL) is aggressive cancer, especially in adults as only 20-40% is cured with current treatment regimens.
Objectives
The aim of this study is to evaluate prognostic factors and their effects on survival in ALL patients in the Northeast of Iran.
Methods
In a descriptive and retrospective study from 2009 to 2015, 48 ALL patients referred to hematology-oncology clinic. Age, sex, fever, blood group, type of ALL and consumption of amphotericin B, forms of cytogenetic, survival in the patients, WBC, hemoglobin, and platelet were checked in the first referral for every patient. The mean follow-up was 27.3 months in which 28 patients (59.3%) died. overall survival (OS) was plotted by GraphPad Prism 5 and the Log-rank test was used for analysis of survival with risk factors.
Results
The mean age for all the ALL patients at diagnosis was 32.3 years (range, 15-71 years), and 81.3% were male. Of all patients, 62.5% had fever and 25% consumed amphotericin B. 1-, 2-, 3-, 4-, 5-year OS rates were 62.2%, 52.7%, 40.6%, 39.1%, 22.2%, respectively. 75%, 29.2% and 39.6% of patients had WBC < 20 × 103/μl, Hb < 7 g/dL and platelet < 30 × 103/μL, respectively. There was a significant difference in survival based on age (P = 0.000).
Conclusions
Based on the results, age > 35 years is the most prognostic factor in ALL patients. Also, patients who received amphotericin B had lower life expectancy because these patients were suffering from fungal infection or due to lack of response to antibacterial drugs, they have been treated with amphotericin B.
doi:10.17795/ijcp-5045
PMCID: PMC5056011  PMID: 27761210
Acute Lymphoblastic Leukemia; Survival; WBC; Age, Northeastern Iran
6.  Designing and Psychometric Evaluation of Adjustment to Illness Measurement Inventory for Iranian Women With Breast Cancer 
Background
Cancer diagnosis for everybody may be perceived as crisis and breast cancer, as the most common malignancy in women, can influence their well-being and multiple aspects of their health. So understanding that how women in various contexts and communities adjust to the illness is necessary to facilitate this adjustment and improve their quality of life.
Objectives
The aim of this study was to: 1) identify the core components of coping strategies to adjust to the illness in Iranian women with breast cancer perspective, 2) to develop and determine psychometric properties of a native self-report instrument to assess coping behaviors and measure the degree of adjustment with the breast cancer.
Methods
The present exploratory mixed method study was conducted in two consecutive stages: 1) the hermeneutic phenomenological study was done to explore the life experiences of coping styles to adjust with the breast cancer using in-depth interviews with patients that lead to item generation; 2) psychometric properties (validity and reliability) of the instrument were evaluated recruiting 340 eligible women. The item pool was reduced systematically and resulted in a 49-item instrument.
Results
From the qualitative stage, item pool containing 78 items related to coping strategies to adjust with the breast cancer. After eliminating unwanted statements from the results, qualitative and quantitative face and content validity, the 10 factors extracted employing construct validity were: feeling of guilt, abstention-diversion, role preservation and seeking support, efforts for threat control, confronting, fear and anxiety, role wasting, maturation and growth, isolation, and fatalism. These factors accounted for the 59.1% of variance observed. The Cronbach reliability test was carried out and alpha value of 10 factors was calculated from 0.78 to 0.87 confirming all factors were internally consistent. The scale’s stability was tested using the test-retest method.
Conclusions
The 49-item AIMI-IBC revealed acceptable psychometric properties. This instrument provides healthcare professionals to systematically assess the coping strategies of Iranian women with breast cancer and measure the degree of adjustment with illness.
doi:10.17795/ijcp-5461
PMCID: PMC5056016  PMID: 27761211
Breast Cancer; Inventory; Psychometric; Adjustment; Iran
7.  Alanine to Serine Variant at Position 986 of Calcium Sensing Receptor and Colorectal Cancer Risk 
Background
With regard to the effect of calcium against colorectal cancer (CRC) and considering the key role of calcium sensing receptor (CaSR) in calcium homeostasis, this study investigated whether CaSR gene rs1801725 or A986S variant was associated with susceptibility to CRC risk.
Methods
This study was conducted as a case-control study and 303 cases with CRC and 354 controls were enrolled. All 657 subjects were genotyped for CaSR gene A986S variant using PCR-RFLP method.
Results
No significant difference was observed for the A986S variant of CaSR gene in either genotype or allele frequencies between the cases and the controls and this lack of difference remained non-significant even after adjustment for age, BMI, sex, smoking status, and family history of CRC. No evidence for the effect modification of the association A986S variant and CRC by BMI, sex, or tumor site was also observed. Furthermore, the risk of obesity in relation to the A986S variant in the controls and the cases was separately analyzed and we observed no significant difference between normal weight (BMI < 25kg/m2) and overweight/obese (BMI ≥ 25kg/m2) subjects.
Conclusions
Our findings do not support a role for effect of the CaSR gene A986S variant on CRC risk; nevertheless, this finding requires confirmation and the role of the gene variant in carcinogenesis needs to be further investigated.
doi:10.17795/ijcp-8098
PMCID: PMC5056015  PMID: 27761213
Calcium Sensing Receptor Gene; Colorectal Cancer; RFLP; Variant
8.  Cancer Screening, Effective or Harmful? 
doi:10.17795/ijcp-7616
PMCID: PMC5038868  PMID: 27703651
9.  Rhabdomyosarcoma of Cervix: A Case Report 
Introduction
Rhabdomyosarcoma has known as a highly malignant soft tissue sarcoma. It has been the most common soft tissue sarcoma in childhood, accounting for about 3 to 4 % of all cases of childhood cancer. Rhabdomyosarcoma was rare in adults, accounting for 3% of all soft-tissue sarcomas. embryonal rhabdomyosarcoma of female genital tract including uterine cervix in an adult was rare.
Case Presentation
This study has reported a 33-year-old woman presented with abnormal vaginal discharge. Gynecologic examination revealed a cervical mass with grape- like feature protruding into vagina with posterior- superior vaginal wall involvement. Biopsy has performed and pathologic examination was consistent with embryonal botryoid type rhabdomyosarcoma. She has undergone the staging work up measurements including thoracic computed tomography (CT) scan, abdominopelvic magnetic resonance imaging (MRI), bone scan and bone marrow examination. In exception of abdominopelvic MRI, with 2 suspicious pelvic lymph nodes in addition of cervical mass, all others were normal. Radical hysterectomy with lymph node debulking and ovarian preservation has performed. Final results have shown embryonal botryoid type rhabdomyosarcoma of cervix. ovaries, endometrium, parametrium, and follopian tubes were unremarkable. Pelvic lymph nodes pathology and intraabdominal fluid cytology were negative for malignancy. Lymphovascular invasion was identified. She has advised for adjuvant chemotherapy.
Conclusions
This case has reminded that embryonal rhabdomyosarcoma could occur in uncommon site and older female. Longer follow up of these cases has required due to lack of survival data for embryonal rhabdomyosarcoma of this site and age group.
doi:10.17795/ijcp-4383
PMCID: PMC5038840  PMID: 27703644
Rhabdomyosarcoma; Cervix; Embryonal Botryoid Type
10.  Lactobacilli Differentially Modulate mTOR and Wnt/ β-Catenin Pathways in Different Cancer Cell Lines 
Background
Lactobacilli are a group of beneficial bacteria whose anti cancer effects have been evaluated in different cancer cell lines as well as animal models and human subjects. Such anti cancer effects can be exerted via different mechanisms such as modulation of immune response as well as inhibition of pathogens colonization. In addition, lactobacilli have direct cytotoxic effects against cancer cells which may be exerted through modulation of expression cancer related pathways.
Objectives
The aim of this study is to find the mechanism of anti cancer effects of two lactobacilli strains, Lactobacillus. crispatus (LC) and Lactobacillus. rhamnosus (LR).
Materials and Methods
We analyzed expression of some mTOR and Wnt/ β-catenin pathways genes in three cancer cell lines (HeLa, MDA-MB-231 and HT-29) following treatment with LC and LR culture supernatants.
Results
Of note, the expression of CCND1 as a marker of cell proliferation, survival, and angiogenesis, has been decreased following LR treatment in all cell lines. In addition, the expression of SFRP2, an antagonist of Wnt pathway, has been increased in HT-29 following LR treatment and in HeLa cells following LR and LC treatments. Furthermore, we have demonstrated the downregulation of S6K1 expression, a marker of poor prognosis, following LR treatment in HT-29 and following LR and LC treatments in MDA-MB-231 cell line.
Conclusions
Consequently, lactobacilli can modulate expression of mTOR and Wnt/ β-catenin pathways genes in cancer cell lines in a strain specific as well as cell type specific manner.
doi:10.17795/ijcp-5369
PMCID: PMC5038836  PMID: 27703648
Cancer; mTOR; Wnt/ β-Catenin; Lactobacillus crispatus; Lactobacillus rhamnosus
11.  A Rare Presentation of Primary Nasopharyngeal Carcinoma (NPC) in Mediastinum 
Introduction
Nasopharyngeal carcinoma among the children has been rare accounting for only 1% of all pediatric malignancies. Both genetic and environmental factors have contributed to the development of nasopharyngeal carcinoma. Among the children there was a higher rate of undifferentiated histology. The mean age of nasopharyngeal carcinoma diagnosis has been 11 years old age; and the most common site was nasopharynx. Palpable lymphadenopathy, dysphasia and neural defect were common associated signs.
Case Presentation
A 15-year-old boy has presented with a mass that located near by the heart in the left side of mediastinum with invasion to anterior mediastinum from two years ago. In biopsy, nasopharyngeal carcinoma, non-keratinizing type, has diagnosed while there was no involvement of nasopharyngeal region. Patient has treated by 70 Gy (2.0 Gy/fraction) radiotherapy plus concomitant chemotherapy with base of docetaxel. But the mass had no regression. Then, the patient has treated with Cisplatin 100 mg/m2 IV on days 1, 22, and 43 with radiation, then cisplatin 80 mg/m2 IV on day 1 plus fluorouracil (5-FU) 1000 mg/m2/day by continuous IV infusion on days 1 - 4 every 4wk for 3 cycles and after remission interferon beta has added to treatment for 6 months duration as a maintenance therapy. After 1 year follow up; the patient was in complete remission. In the course of therapy, only hypothyroidism has occurred.
Conclusions
Nasopharyngeal carcinoma in childhood, without nasopharyngeal involvement, initially could be detected in other sites such as pericardium. Also good results could be respected by cisplatin and 5-fluorouracil based neoadjuvant chemotherapy before radiotherapy plus interferon beta as a maintenance therapy in childhood aggressive nasopharyngeal carcinoma.
doi:10.17795/ijcp-4277
PMCID: PMC5055759  PMID: 27761207
Nasopharyngeal Carcinoma; Radiotherapy Resistant; Neoadjuvant Chemotherapy; Interferon
12.  Anti-Proliferative Activity of λ-Carrageenan Through the Induction of Apoptosis in Human Breast Cancer Cells 
Background
Sulfated Polysaccharides (SPs) possess spectrum of pharmacological and therapeutic properties that could attributed to their origins variation, chemical structures and biological activities. Various studies have shown the impact of SPs on proliferation in different cancer cell lines.
Objectives
In this study, we have evaluated the biological effects of λ-carrageenan, a highly SP, extracted from the red seaweed Laurencia papillosa, on MDA-MB-231 cancer cell line.
Materials and Methods
MDA-MB-231 cells have treated with λ-carrageenan, the viability and apoptosis have assessed by the appropriate florescent probes on flow cytometer. The expression levels of mRNA of apoptotic genes have detected by real-time PCR analysis.
Results
Our results have indicated that the signaling pathway of λ-carrageenan inhibited the proliferation of MDA-MB-231 cells by up-regulating the pro-apoptotic genes caspase-8, caspase-9, caspase-3 which have been resulting the increased levels of active caspase-3 protein. Furthermore, This SP had that capacity to disrupt the mitochondrial function by altering the bax/bcl-2 ratio of expression which has considered an important element in apoptosis induction.
Conclusions
The presented results have signposted that λ-carrageenan was a promising bioactive polymer which could be a potential candidate in preventing or treating breast cancer.
doi:10.17795/ijcp-3836
PMCID: PMC5055760  PMID: 27761203
Anti-Proliferation; λ-Carrageenan; Apoptosis; Breast Cancer; MDA-MB-231
13.  CT Simulation to Evaluate of Pelvic Lymph Node Coverage in Conventional Radiotherapy Fields Based on Bone and Vessels Landmarks in Prostate Cancer Patients 
Background
Radiotherapy is the gold standard for treatment of prostrate cancer as it can cover an adequate area of tissues at risk for metastasis.
Objectives
We evaluated the Pelvic lymph node coverage of conventional radiotherapy fields based on bone and vessels landmarks using computed tomography (CT) simulation in patients with prostate cancer referred to Shohada-e-Tajrish hospital.
Patients and Methods
In this cross sectional study, 40 patients with prostate cancer at the Stage T1c to T3b were studied. Pelvic lymph nodes were contoured by using pelvic vessels as surrogate markers. The distances were measured at different points of anterior-posterior (AP) and lateral fields and distances > 5 mm or more between the contoured nodes and the field borders.
Results
Mean and standard deviation of the aortic bifurcation from the superior border was 4.73 ± 1.16 cm, the distance of common iliac bifurcation from the superior border was 1.11 ± 1.25 cm, the mean (SD) distance of right external iliac from the lateral border of AP field was 2.06 ± 0.48 cm and for left external iliac artery was 1.90 ± 0.56 cm. The distance of the external iliac artery from the anterior border of the lateral field was 2.30 ± 0.74 cm. The distance of the external iliac artery from pelvic rim was 0.59 ± 0.59 cm, distance of bifurcation of iliac from sacroiliac joint was 0.82 ± 1.01 cm, the size of the pelvic rim was 12.30 ± 0.64 cm, sacral width was 8.29 ± 1.01 cm, anterior promontory symphysis distance was 12.02 ± 0.92 cm and posterior promontory symphysis distance was 10.98 ± 0.73 cm.
Conclusions
We observed that conventional radiotherapy using CT simulation based on bone and vessels landmarks provided adequate coverage of pelvic lymph nodes in our patients with prostate cancer.
doi:10.17795/ijcp-6233
PMCID: PMC5038838  PMID: 27703649
Prostate Cancer; Radiotherapy Planning; Computed Tomography (CT) Simulation; Pelvic Vessels; Pelvic Lymph Nodes
14.  Psychological Predictors of Prostate Cancer Screening Behaviors Among Men Over 50 Years of Age in Hamadan: Perceived Threat and Efficacy 
Background
Prostate cancer is the fourth most common cancer worldwide and is the second most lethal cancer.
Objectives
The aim of this study was to investigate psychological predictors of prostate cancer screening behaviors among men over 50 years of age in Hamadan.
Materials and Methods
This cross-sectional study was carried out on 200 men over 50 years of age in Hamadan, west of Iran. Participants were recruited with a cluster sampling method. The subjects completed a self-administered questionnaire including demographic characteristics, prostate cancer screening behaviors and psychological factors related to prostate cancer. Data was analyzed by SPSS-18 using chi-square, fisher exact test, and logestic regression.
Results
According to the results, 8.5 and 7.5 percent of participants reported history of digital rectal exam and prostate-specific antigen test, respectively. Also, the subjects reported 18.5%, 49.3% and 50.3% of receivable scores of knowledge, perceived threat, and perceived efficacy of prostate cancer screening behaviors, respectively. There was a significant association between prostate cancer screening behaviors and age groups (P < 0.05).
Conclusions
The results showed that providing analytical studies in this field helps to surface the hidden aspects of this context and the health care providers and administrators will hopefully consider them in planning for identification of psychological factors, such as barriers and facilitators factors.
doi:10.17795/ijcp-4144
PMCID: PMC5055754  PMID: 27761205
Neoplasms; Prostate; Prostate-Specific Antigen; Fear
15.  The Role of Psychological Hardiness and Marital Satisfaction in Predicting Posttraumatic Growth in a Sample of Women With Breast Cancer in Isfahan 
Background
Posttraumatic growth (PTG) refers to positive psychological change experienced as a result of the struggle with highly challenging life circumstances. PTG in cancer survivors is related to several psychosocial factors such as psychological hardiness and marital satisfaction.
Objectives
The purpose of this study was to examine the prediction of posttraumatic growth based on psychological hardiness and marital satisfaction.
Patients and Methods
A total of 120 women with breast cancer were recruited from several hospitals in Isfahan using convenience sampling. Participants completed the research questionnaires including the posttraumatic growth inventory (PTGI), the Ahvaz psychological hardiness scale and the Enrich’s marital satisfaction scale (EMS). Statistical analysis including means, standard deviation, Pearson’s correlation and multiple regression analysis were carried out using SPSS software (version 16).
Results
Results indicated that the majority of patients with cancer experienced posttraumatic growth. Findings also showed that psychological hardiness, marital satisfaction and longer time since diagnosis of cancer significantly predicted posttraumatic growth.
Conclusions
This study highlights the significant role of psychological hardiness and marital support in personal growth of breast cancer survivors.
doi:10.17795/ijcp-4080
PMCID: PMC5055761  PMID: 27761204
Breast Cancer; Psychosocial Factors; Posttraumatic Growth
16.  Immunohistochemistry Study of P53 and C-erbB-2 Expression in Trophoblastic Tissue and Their Predictive Values in Diagnosing Malignant Progression of Simple Molar Pregnancy 
Background
Finding a tumor marker to predict the aggressive behavior of molar pregnancy in early stages has yet been a topic for studies.
Objectives
In this survey we planned to study patients with molar pregnancy to 1) assess the p53 and c-erbB-2 expression in trophoblastic tissue, 2) to study the relationship between their expression intensity and progression of a molar pregnancy to gestational trophoblastic neoplasia, and 3) to determine a cut off value for the amount of p53 and c-erbB-2 expression which might correlate with aggressive behavior of molar pregnancy.
Patients and Methods
In a prospective cross sectional study by using a high accuracy technique EnVision Tm system for immunohistochemistry staining of molar pregnancy samples, we evaluated p53 and c-erbB-2 expression in cytotrophoblast and syncytiotrophoblast and the correlation of their expression with progression of molar pregnancy to gestational trophoblastic neoplasia (GTN). Normal prostatic tissue and Breast cancer tissue were used as positive controls.
Results
We studied 28 patients with simple molar pregnancy (SMP) and 30 with GTN. Cytotrophobalst had significantly higher expression of p53 and c-erbB-2 and syncytiotrophoblast had greater expression of p53 in GTN group as compared to SMP group. The cut off values for percentage of p53 positive immunostained cytotrophoblast and syncytiotrophoblast were 5.5% and 2.5%. In c-erbB-2 positive membranous stained cytotrophoblast the cut off was 12.5%.
Conclusions
Our data suggests that over expression of p53 and c-erbB-2 is associated with malignant progression of molar pregnancy. We encountered that high expression of p53 and c-erbB-2 in trophoblastic cells could predict gestational trophoblastic neoplasia during the early stages.
doi:10.17795/ijcp-4115
PMCID: PMC5038832  PMID: 27703642
Complete Hydatiform Mole; P53; C-erbB-2; Prognosis
17.  Genetic Variations in Leptin and Leptin Receptor and Susceptibility to Colorectal Cancer and Obesity 
Background
Colorectal cancer (CRC) is the second most commonly diagnosed cancer and the fourth leading cause of cancer-related mortality around the world.
Objectives
With regard to the role of obesity in colorectal cancer (CRC) and the role of leptin in obesity, we investigated whether leptin (LEP) and leptin receptor (LEPR) gene variants are associated with CRC risk.
Patients and Methods
We evaluated LEP (rs7799039) and LEPR (rs1137101) gene variants by using PCR-RFLP method in 261 cases with CRC and 339 controls.
Results
No significant difference was found for rs7799039 and rs1137101gene variants between the cases with CRC and controls. However, the LEPR rs1137101 “GG” genotype compared with “AA” genotype and “AA + AG” genotype was associated with increased risks for obesity, and the differences remained significant after adjustment for confounding factors including age, sex, smoking status, and NSAID use (P = 0.015; OR = 2.42, 95%CI = 1.19 - 4.93 and P = 0.016; OR = 2.28, 95%CI = 1.17 - 4.48, respectively). In addition, the LEPR “G” allele compared with the “A” allele was associated with an increased risk for obesity (P = 0.024; OR = 1.44, 95%CI = 1.05 - 1.98).
Conclusions
Consistent with most previous studies, our findings found no association between LEP (rs7799039) and LEPR (rs1137101) gene variants and CRC risk. However, the LEPR rs1137101 “GG” genotype compared with the “AA” genotype and “AA+AG” genotype was associated with a 2.42-fold and a 2.28-fold increased risk for obesity, respectively.
doi:10.17795/ijcp-7013
PMCID: PMC5038839  PMID: 27703650
Colorectal Cancer; LEP; LEPR; Variant
18.  Adenosine Deaminase Activity in Chronic Lymphocytic Leukemia and Healthy Subjects 
Background
B cell chronic lymphocytic leukemia is one of the most frequent hematologic malignancies in the world. Cellular surface CD markers and serum Beta-2-microglobulin may be used as a prognostic tool in CLL patients.
Objectives
In the present study we introduce serum adenosine deaminase as a diagnostic marker in CLL.
Materials and Methods
Blood samples were collected from B-CLL and healthy subjects. White blood cell, red blood cell and platelet count and blood Erythrocyte sedimentation rate was recorded and serum Beta-2-microglobulin, Lactate dehydrogenase and total ADA enzyme activity were determined.
Results
Serum ADA activity was significantly higher in patients group than that of controls. ADA had a significant and direct correlation with B2M, WBC, LDH and ESR. However, there was not any relation between ADA and the stages of disease. Diagnostic cut-off, sensitivity and specificity of the serum ADA test were 27.97 U/L, 91% and 94%, respectively.
Conclusions
A higher ADA activity in patients group and its correlation with CLL markers were seen in our study. High diagnostic value of serum ADA in our study suggests that it might be considered as a useful screening tool among the other markers in CLL.
doi:10.17795/ijcp-5069
PMCID: PMC5038830  PMID: 27703646
Adenosine Deaminase; Beta-2-Microglobulin; Chronic Lymphocytic Leukemia; Diagnostic Value
19.  Stevens-Johnson Syndrome Patient Received Combination Chemotherapy Gemcitabine, Cisplatin, and 5-FU for Biliary Tract Cancer 
Stevens-Johnson syndrome has been an acute, usually self-limiting disease of the skin and mucous membranes. This case report has presented an evidence of the development Stevens - Johnson syndrome associated with combination chemotherapy administration of 5FU, gemcitabin and cisplatin in a patient with biliary tract cancer. Our case was a 54-year-old woman patient, a case of biliary tract cancer who has developed more severe symptoms of Stevens-Johnson syndrome. Diagnosis has confirmed by skin biopsy of an affected area .The patient has improved with supportive care, and during 25 day occurred recovery. Although Stevens-Johnson syndrome has been a rare toxicity, physicians should pay a special attention to the monitoring of biliary tract cancer patients on combination chemotherapy with 5FU, cisplatin and gemcitabin.
doi:10.17795/ijcp-4211
PMCID: PMC5038831  PMID: 27703643
Stevens-Johnson Syndrome; Malignancy; Chemotherapy
20.  Central Nervous System Toxoplasmosis in Relapsed Hodgkin’s Lymphoma: A Case Report 
Introduction
Patients with immunosuppression have an increased incidence of toxoplasmosis characterized by involvement of the central nervous system. Only a few cases of toxoplasmosis associated with immunosuppressive agents have been reported. Such cases have been reported in immune suppressed patients outside the Iran, but a search of the literature has not revealed any previous reports from this country.
Case Presentation
We described a 17- year -old male, a known case of Hodgkin’s lymphoma with the diagnosis of central nervous system (CNS) toxoplasmosis.
Conclusions
As a conclusion, CNS toxoplasmosis should be considered in the differential diagnosis of immunosuppressed patients who present with neurological manifestations.
doi:10.17795/ijcp-5810
PMCID: PMC5098589  PMID: 27822344
Toxoplasmosis; Central Nervous System; Hodgkin’s Disease
21.  The Prognostic Value of Age, Sex, and Subsite in Cutaneous Head and Neck Melanoma: A Clinical Review of Recent Literature 
Context
Cutaneous head and neck melanoma is a challenging disease owing to its aggressive nature and often times advanced stage at presentation. Age, sex, and subsite are three prognostic indicators which can be determined prior to treatment or testing, and can allow the practitioner to counsel the patient before initiating therapy.
Evidence Acquisition
A PubMed search was conducted utilizing various terms relating to the subject matter. Articles over the past 25 years were analyzed and appropriately selected for review.
Results
It appears that patients older than 65 have a decreased overall 5 year survival compared to their younger counterparts. Male patients have poorer prognosis compared to female patients as noted by the decreased overall survival, decreased disease specific survival, and shorter time to distant metastasis. Scalp subsite was most uniformly accepted as having the worst prognosis in the head and neck, and may even serve as an independent prognostic indicator.
Conclusions
Advanced age, male sex, and scalp subsite all portend poor prognosis in patients with cutaneous head and neck melanoma.
doi:10.17795/ijcp-5079
PMCID: PMC5038835  PMID: 27703647
Melanoma; Sub-Site; Age; Prognostic Factor; Sex
22.  The Islamic Perspective of Spiritual Intervention Effectiveness on Bio-Psychological Health Displayed by Gene Expression in Breast Cancer Patients 
Background
During the last two decades, there have been spiritual/religious interventions in cancer patients to prevent or treat a range of physical problems, including managing chronic pain, coping with the disease, boosting hope and mental health. Although societies are of different faiths and belief systems, what they all share is spirituality.
Objectives
Upon this we put forward the hypothesis of changes in gene receptor expressions as a result of spiritual intervention for the first time in the world.
Materials and Methods
In this study, the spiritual intervention was conducted on 57 volunteer females with early breast cancer involvement. Blood samples were collected prior to and after the spiritual intervention to analyze the changes in dopamine gene receptor expressions as the main site of effect. In order to administer the spiritual intervention backed by Quran, Islam and international standards, issues, with emphasis on peace, human growth and perfection, accepting God as an eternal source of power and kindness to build trust and reduce stress, were selected. They included prayer, patience, reliance, self-sacrifice and forgiveness, altruism and kindness, remission and repentance, thankfulness, zikr (mantra), meditation, and death concept.
Results
Obtained results from peripheral blood mononuclear cell samples analyzed by real time-PCR showed significant reduction in dopamine gene receptor (DRD1-5) expressions in comparison with those of pre-test scores and the control group.
Conclusions
Spiritual intervention based on Islamic principals can bring back mental health, increase hope and quality of life and eventually change dopamine gene receptor expressions resulting in reduction of cell proliferation, thus better prevention and management in breast cancer patients compared to other forms of treatment.
doi:10.17795/ijcp-6360
PMCID: PMC4951763  PMID: 27482335
Spiritual Intervention; Islamic Perspective; Gene Expression; Breast Cancer
23.  Cancer Screening, Effective or Harmful? 
doi:10.17795/ijcp-6633
PMCID: PMC4951765  PMID: 27482336
24.  The Effect of Complete Decongestive Therapy on Edema Volume Reduction and Pain in Women With Post Breast Surgery Lymph Edema 
Background
Upper extremity lymph edema is the most common side effect of breast cancer treatment that may produce significant physical and psychological morbidity. Pain is the frequent symptom of lymph edema that causes impairment of activities in daily life.
Objectives
The aim of this study was assessment of the effect of complex decongestive therapy (CDT) on upper extremity lymph edema and pain in women with post breast surgery lymph edema.
Patients and Methods
In this quasi- experimental research with before- after design, 36 women with moderate lymph edema after breast surgery participated in the program. Edema volume was measured by water displacement method; pain values were evaluated by visual analog scale (VAS). Data were recorded before intervention and 2 and 4 weeks after it. CDT included the first phase (intensive phase) and the second phase (maintenance phase). Each phase lasted 2 weeks. After use of Shapiro Wilk test for normality, analysis of variances with GEE and repeated measurements were used to analyze the data.
Results
After one month doing CDT program, significant decrease of edema was noticed (P < 0.0001), also pain decreased during 2 and 4 weeks after intervention (P < 0.0001).
Conclusions
This study indicated that CDT program is effective in reducing lymph edema volume and pain in women with moderate post breast surgery lymph edema. It seems that raising patients’ awareness and training healthcare professionals regarding lymph edema preventive strategies have an important role in earlier and better combating this complication.
doi:10.17795/ijcp-4209
PMCID: PMC4951770  PMID: 27482330
Breast Cancer; Lymph Edema; Complex Decongestive Therapy; Pain
25.  Evaluation of the Prevalence Rate and the Prognostic Effect of Human Papilloma Virus Infection in a Group of Patients With Oral Cavity Squamous Cell Carcinoma 
Background
Squamous cell carcinoma (SCC) is the most common malignancy of the oral cavity. A relationship between the human papilloma virus (HPV) infection and the prognosis of oral cavity SCC (OCSCC) has been discussed before.
Objectives
We investigated the prevalence rate of HPV status in patients with OCSCC, and its effects on clinicopathological characteristics of tumors and patients’ prognosis.
Patients and Methods
Sections of formalin-fixed, paraffin-embedded tissue blocks from 114 histopathologically confirmed OCSCC cases were investigated in this study. Polymerase chain reaction (PCR) was applied to evaluate the HPV status in the samples.
Results
Fifteen (13.16%) cases were identified as HPV positive. The detected viral subtypes in this study were the subtypes 6 and 11. The stage and especially lymph node stage was significantly higher in the HPV positive group compared to the HPV negative group (P = 0.04). Disease free survival (DFS) was remarkably lower in the HPV positive group compared to the HPV negative group (13.9 vs. 49.9 months, P = 0.02). Overall survival (OS) was also significantly inferior in the HPV positive group (15.7 vs. 49.6 months, P = 0.01). In the current study, no significant differences were observed between two groups in relation to the variables of age, gender, tumors site, tumor size, tumor grading and also the recurrence rate.
Conclusions
The observed higher mortality rate among the HPV positive group indicates the poorer prognosis of this group in comparison with the HPV negative patients. The incidence rate of HPV infection was low in the studied samples; however, interaction of subtypes 6 and 11 of HPV in poorer prognosis of the patients and a carcinogenic role of HPV in OCSCC cannot be ruled out.
doi:10.17795/ijcp-3998
PMCID: PMC5038837  PMID: 27703640
Oral Cavity Squamous Cell Carcinoma; Human Papilloma Virus, Polymerase Chain Reaction; Prognosis; Iran

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