Asian Pacific Journal of Cancer Prevention
Asian Pacific Organization for Cancer Prevention (아시아태평양암예방학회)
Health Sciences > Development of Pharmaceutical
The Asian Pacific Journal of Cancer Prevention is a monthly electronic journal publishing papers in all areas of cancer control. Its is indexed on PubMed (Impact factor for 2014 : 2.514) and the scope is wide-ranging: including descriptive, analytical and molecular epidemiology; experimental and clinical histopathology/biology of preneoplasias and early neoplasias; assessment of risk and beneficial factors; experimental and clinical trials of primary preventive measures/agents; screening approaches and secondary prevention; clinical epidemiology; and all aspects of cancer prevention education. All of the papers published are freely available as pdf files downloadable from www.apjcpcontrol.org, directly or through PubMed, or obtainable from the first authors. The APJCP is financially supported by the UICC Asian Regional Office and the National Cancer Center of Korea, where the Editorial Office is housed.
KSCI
Volume 17 Issue sup3
Molecular Involvement and Prognostic Importance of Fms-like Tyrosine Kinase 3 in Acute Myeloid Leukemia
Shahab, Sadaf;Shamsi, Tahir S.;Ahmed, Nuzhat 4215
https://doi.org/10.7314/APJCP.2012.13.8.4215 PDF KSCI
AML (Acute myeloid leukemia) is a form of blood cancer where growth of myeloid cells occurs in the bone marrow. The prognosis is poor in general for many reasons. One is the presence of leukaemia-specific recognition markers such as FLT3 (fms-like tyrosine kinase 3). Another name of FLT3 is stem cell tyrosine kinase-1 (STK1), which is known to take part in proliferation, differentiation and apoptosis of hematopoietic cells, usually being present on haemopoietic progenitor cells in the bone marrow. FLT3 act as an independent prognostic factor for AML. Although a vast literature is available about the association of FLT3 with AML there still is a need of a brief up to date overview which draw a clear picture about this association and their effect on overall survival.
Current Status of Knowledge, Attitude and Practice (KAP) and Screening for Cervical Cancer in Countries at Different Levels of Development
Raychaudhuri, Sreejata;Mandal, Sukanta 4221
Cancer of the uterine cervix is a worldwide menace taking innumerable womens' lives. The literature is vast and a large number of studies have been conducted in this field. Analyses have shown significant differences exist in terms of screening and HPV testing facilities among high income and low to middle income countries. In addition, acute lack of awareness and knowledge among the concerned population is particularly noted in rural areas of the low income countries. A detailed review of Indian case studies revealed that early age of marriage and childbirth, multiparity, poor personal hygiene and low socio-economic status among others are the principal risk factors for this disease. This review concludes that a two pronged strategy involving strong government and NGO action is necessary to minimize the occurrence of cervical cancer especially in low and medium income countries.
Omics of Cancer
Bhati, Aniruddha;Garg, H.;Gupta, A.;Chhabra, H.;Kumari, A.;Patel, T. 4229
With the advances in modern diagnostic expertise for cancer, certain approaches allowing scanning of the complete genome and the proteome are becoming very useful for researchers. These high throughput techniques have already proven power, over traditional detection methods, in differentiating disease sub-types and identifying specific genetic events during progression of cancer. This paper introduces major branches of omics-technology and their applications in the field of cancer. It also addresses current road blocks that need to be overcome and future possibilities of these methods in oncogenic detection.
Reliability and Validity of the Quality of Life-Family Version (QOL-FV) in Turkish Family Caregivers of Patients with Cancer
Okcin, Figen;Karadakovan, Ayfer 4235
Objectives: Family caregivers (FCs) are often the primary source of social and emotional support for cancer patients and play a major role in how well they manage their illness. The aim of this study was to create an Turkish version of the Quality of Life - Family Version (QOL-FV) and to evaluate its psychometric properties in a sample of FCs of cancer patients. Materials and Methods: This study was carried out with the FCs of 218 patients with cancer. Data were collected with a Demographic Questionnaire and the QOL-FV and The Multidimentional Scale of Perceived Social Support (MSPSS). The QOL-FV was developed by Ferrell and Grant and is composed of 4 subdimensions. Linguistic validity, translation, back translation, and content validity were tested with expert opinions. Test-retest reliability, and internal consistency reliability were assessed. Construct validity was tested by factor analysis and with the scale of the MSPSS. Results: The family caregivers were between the ages of 46-56 (32.6%), a great number of them being male (52.8%). The scale is made up of four subdimensions. The result of the test-retest analysis of this scale was calculated as r:0.86. As a result of the reliability analysis, six items were eliminated from the scale, factor analyses were fulfilled according to varimax transformation through the method of principal components. Four new subdimensions were restrustured at the end of the analysis. The scale of Cronbach ${\alpha}$ coefficient was calculated as 0.90. Concurrent validity showed low correlations with the MSPSS (r=0.29). Conclusions: The QOL-FV, adapted into Turkish, was found to have sufficient reliability and validity.
Serum Kynurenic Acid: Possible Association with Invasiveness of Non-small Cell Lung Cancer
Sagan, Dariusz;Kocki, Tomasz;Kocki, Janusz;Szumilo, Justyna 4241
The lung adenocarcinoma is considered more aggressive than other types of non-small cell lung cancer. As metabolites of tryptophan degradation along the kynurenine pathway, including kynurenic acid, have been shown to induce immunosuppression and facilitate escape of tumor cells from immune surveillance, a hypothesis was set up that differences in biological behavior between types of lung cancer may be associated with altered activity of the kynurenine metabolic pathway. The aim of the study was to determine kynurenic acid levels in the serum of patients with bronchial adenocarcinoma for comparison with other types of non-small cell lung cancer. A total of 227 patients with non-small cell lung cancer were enrolled in the study, including 71 with adenocarcinoma and 96 with squamous cell carcinoma. Serum kynurenic acid concentration was determined with use of high performance liquid chromatography and fluorometry. The level of kynurenic acid in the serum of patients with adenocarcinoma was significantly higher than in those with squamous cell lung cancer ($107.1{\pm}62.8$ pmol/ml; 95%CI: 92.4 to 132.3 pmol/ml versus $82.1{\pm}47.6$ pmol/ml; 95%CI: 78.5 to 91.2 pmol/ml, respectively; p = 0.027). Differences between other histological types of lung cancer were insignificant. We conclude that increased activity of kynurenine metabolic pathway manifested by elevated serum kynurenic acid level may be one of the factors associated with clinically distinct biological behavior of adenocarcinoma, in particular high invasiveness and rapid progression.
Prevalence of Smoking among Female Medical Students in Saudai Arabia
Azhar, Ahmad;Alsayed, Nouf 4245
Background: Women make up half of the world's population, and comprise 20% of the world's one billion smokers. The aim of this study was to assess the prevalence of smoking among female medical students in comparison to female non-medical students, and to assess the importance of medical education and knowledge in decreasing the prevalence of smoking among female university students in Saudi Arabia. Method: We used a self-administered questionnaire to collect cross-sectional data from a randomly selected sample of 320 female students attending King Abdul-Aziz University, Jeddah. Medical students comprised 50% of the sample. Results: A total of 310 students (96.9%) completed and returned the questionnaire. The prevalence of smoking was higher in non-medical female students (4.2%) compared to medical female students (0.32%) (P < 0.001). Conclusion: The prevalence of smoking is low among female medical students compared to female non-medical students, presumably because of their awareness, level of education, and knowledge of the risks to health associated with smoking. Our study highlights the need for increased knowledge, health education, and awareness of the risks of smoking to reduce smoking among female university students.
Association between Trace Element and Heavy Metal Levels in Hair and Nail with Prostate Cancer
Karimi, Golgis;Shahar, Suzana;Homayouni, Nasim;Rajikan, Roslee;Bakar, Nor Faizah Abu;Othman, Mohd Sham 4249
While associations between trace elements and heavy metals with prostate cancer are still debatable, they have been considered as risk factors for prostate cancer. Thus, this study aimed to detect any links between selected minerals and heavy metals including Se, Zn, Cu, Mn and Fe with prostate cancer. A case control study was carried out among 100 subjects (case n=50, control n=50), matched for age and ethnicity. Trace elements and heavy metals level in hair and nail samples were determined by ICP-MS. Mean selenium levels in hair and nail of the cases were significantly lower as compared to controls. A similar trend was noted for zinc in both hair and nail samples, whereas the mean level of copper was significantly higher in cases than controls. Similar elevation was noted for iron and manganese (p<0.05 for all parameters). Low levels of selenium and zinc and high levels of copper, iron and manganese appear to be associated with the risk of prostate cancer. Further studies to elucidate the causal mechanisms and appropriate chemopreventive measures are needed.
Radioimmunoimaging with Mixed Monoclonal Antibodies of Nude Mice Bearing Human Lung Adenocarcinoma Xenografts
Duan, Dong;Li, Shao-Lin;Zhu, Yu-Quan;Zhang, Tao;Lei, Cheng-Ming;Cheng, Xiang-Hua 4255
The present study was conducted to evaluate radioimmunoimaging (RII) and in vivo distribution of mixed antibodies $^{99m}Tc$-EGFR-mAb and $^{99m}Tc$-CD44-mAb in nude mice bearing human lung adenocarcinoma xenografts. Single and mixed applications of the two radiolabeled monoclonal antibodies (mAbs) were compared. Direct labeling of $^{99m}Tc$ was applied to radiolabel the EGFR and CD44 mAbs. The properties of the radiolabeled antibodies were then characterized. RII and assessment of the distribution of the antibodies in nude mice bearing lung adenocarcinoma xenografts were achieved by applying separate and combined doses of $^{99m}Tc$-EGFR-mAb and $^{99m}Tc$-CD44-mAb. The labeling rates of $^{99m}Tc$ for EGFR-mAb and CD44-mAb were $91.5%{\pm}3.8%$ and $92.3%{\pm}4.1%$ respectively, with specific activities of 2.8 and $2.9MBq/{\mu}g$, respectively, and radiochemical purities (RCP) of 96.5% and 96.2%. The radioactivity uptake of the combined application of both radiolabeled antibodies was clearly higher than with a single application of either alone. The relative values of target-to-nontarget (T/NT) measured through the regional interest (ROI) technique were $5.59{\pm}0.42$ (mixed antibodies), $2.78{\pm}0.20$ ($^{99m}Tc$-EGFR-mAb), and $2.28{\pm}0.16$ ($^{99m}Tc$-CD44-mAb) in the RII. The body distribution of the radiolabeled antibodies and their imaging results were basically identical. Application of the mixed antibodies with $^{99m}Tc$-EGFR-mAb and $^{99m}Tc$-CD44-mAb can increase the radioactivity uptake of tumor tissue, leading to more ideal target-to-nontarget ratios, and therefore superior results.
A GFP-labeled Human Colon Cancer Metastasis Model Featuring Surgical Orthotopic Implantation
Chen, Hong-Jin;Yang, Bo-Lin;Chen, Yu-Gen;Lin, Qiu;Zhang, Shu-Peng;Gu, Yun-Fei 4263
Colorectal cancer has become a major disease threatening human health. To establish animal models that exhibit the characteristics of human colorectal cancer will not only help to study the mechanisms underlying the genesis and development effectively, but also provide ideal carriers for the screening of medicines and examining their therapeutic effects. In this study, we established a stable, colon cancer nude mouse model highly expressing green fluorescent protein (GFP) for spontaneous metastasis after surgical orthotopic implantation (SOI). GFP-labeled colon cancer models for metastasis after SOI were successfully established in all of 15 nude mice and there were no surgery-related complications or deaths. In week 3, primary tumors expressing GFP were observed in all model animals under fluoroscopy and two metastatic tumors were monitored by fluorescent imaging at the same time. The tumor volumes progressively increased with time. Seven out of 15 tumor transplanted mice died and the major causes of death were intestinal obstruction and cachexia resulting from malignant tumor growth. Eight model animals survived at the end of the experiment, 6 of which had metastases (6 cases to mesenteric lymph nodes, 4 hepatic, 2 pancreatic and 1 mediastinal lymph node). Our results indicate that our GFP-labeled colon cancer orthotopic transplantation model is useful with a high success rate; the transplanted tumors exhibit similar biological properties to human colorectal cancer, and can be used for real-time, in vivo, non-invasive and dynamic observation and analysis of the growth and metastasis of tumor cells.
Acceptance of Human Papillomavirus Vaccine by Adolescent Girls and Their Parents in Turkey
Kilic, Ayse;Seven, Memnun;Guvenc, Gulten;Akyuz, Aygul;Ciftci, Seval 4267
Purpose: The aim of this study was to identify the opinions of Turkish adolesecent girls and their parents about HPV vaccination and the consistency. Methods: This descriptive study covered 301 girls and their parents. Questionnares were developed by the researchers based on findings within the literature and applied for data collection. Results: The mean age was 19.4 for girls, 44.2 for mothers and 47.9 for fathers. It was found that 43.5 percent of girls and 31.9 percent of mothers wish to be vaccinated against HPV. Also, 45.5 percent of mothers and 44.9 percent of fathers wish for their daughters to be vaccinated against HPV. A moderate consistency was found between mothers and fathers; a low consistency was found between fathers and girls, and between mothers and girls. Conclusions: The study indicates that an appropriate background has been partially provided about the acceptability of the vaccine between parents and their daughters in Turkey. However, the vast majority of adolescent girls and parents are indecisive or reluctant about HPV vaccination. This study also showed that the decisions of adolescents about vaccination may be affected by the opinions of the parents.
Breast, Cervical, and Colorectal Cancer Screening Status of a Group of Turkish Women
Gulten, Guvenc;Memnun, Seven;Ayse, Kilic;Aygul, Akyuz;Gulcin, Akcan 4273
Introduction: The aim of the study was to determine the breast, cervical, and colorectal cancer screening rates and the influencing factors in a group of Turkish females. Methods: This descriptive study was conducted in a School of Nursing. The study sample consisted of 603 females who were the mothers/neighbors or relatives of the nursing students. Data collection forms were developed by the investigators after the relevant literature was screened and were used to collect the data. Results: Of the women aged 30 and over, 32.8% had undergone a pap smear test at least once in their life. Of those aged 50 and over, 48.2% had undergone mammography at least once and FOBT had been performed in 12% of these women in their life. Having heard of the screening tests before, knowing why they are done, and having information on the national cancer screening program were important factors influencing the rates of women having these tests done. Discussion: The results of this study show that the rates of women participating in national cervical, breast, and colorectal cancer screening programs are not at the desired levels. Having heard of the screening tests before, knowing why they are done, and having information on the national cancer screening program were important factors influencing the rates of women having these tests done. It is suggested that written and visual campaigns to promote the service should be used to educate a larger population, thus increasing the participation rates for cancer screening programs.
Incidence and Survival Rates among Pediatric Osteogenic Sarcoma Cases in Khon Kaen, Thailand, 1985-2010
Wiromrat, Pattara;Jetsrisuparb, Arunee;Komvilaisak, Patcharee;Sirichativapee, Winai;Kamsa-Ard, Supot;Wiangnon, Surapon 4281
Background: Osteosarcoma is the most common bone cancer in children, responsible for a high rate of amputation and death. This is the first long-term, population-based, epidemiologic and survival study in Thailand. Objective: To study the incidence and survival rates of pediatric osteosarcoma in Khon Kaen. Method: Childhood osteosarcoma cases (0-19 years) diagnosed between 1985-2010 were reviewed. The data were retrieved from the population-based data set of the Khon Kaen Cancer Registry and medical records from Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. All cases were censored until the end of April 2012. The age-standardized incidence rate (ASR) was calculated using the standard method. Survival experience was analyzed using the standard survival function (STATA 9.0) and presented with a Kaplan-Meier curve. Results: 58 cases were enrolled. The overall ASR was 14.1 per million. Males and females were equally affected. The peak incidence was for 15-19 year-olds in both sexes (ASR=10.4 per million in males and 8.5 in females). The 5-year overall survival rate was 27.6% (95% CI: 15.8-40.8%). The median survival time was 1.6 years (95% CI: 1.2-2.1). In a subgroup analysis, the patients who received only chemotherapy survived longer (5-year survival 45.7%, median survival time 4.1 years, p=0.12). Conclusion: The incidence rate for childhood osteosarcoma was slightly less than those reported for Western countries. The survival rate was also lower than reports from developed countries. Further evaluation of the treatment protocol and risk factor stratification is needed.
Community-Based Cross-Sectional Study of Carcinogenic Human Liver Fluke in Elderly from Surin Province, Thailand
Kaewpitoon, Soraya J.;Rujirakul, Ratana;Ueng-Arporn, Naporn;Matrakool, Likit;Namwichaisirikul, Niwatchai;Churproong, Seekaow;Wongkaewpothong, Patcharaporn;Nimkuntod, Porntip;Sripa, Banchob;Kaewpitoon, Natthawut 4285
Background: Opisthorchis viverrini infection is a serious public-health problem in Southeast Asia. It is associated with a number of hepatobiliary diseases and the evidence strongly indicates that liver fluke infection is the etiology of cholangiocarcinoma. Objectives: This study aimed to determine Opisthorchis viverrini infection in elderly people in Surin province, Northeastern Thailand. Methods: A community-based cross-sectional survey was conducted among 333 elderly in 17 districts of Surin province, during one year period from January to December 2011. O. viverrini infection was determined using Kato's Thick Smear technique and socio-demographic were collected using predesigned semi-structured questionnaires, respectively. Results: A total of 333 elderly including 116 males and 217 females were selected from different study sites. Overall intestinal parasitic infection was 16.2%, predominantly in O. viverrini (9.91%) and followed by Strongyloides stercolaris (4.80%) and hookworm (1.50%), respectively. The O. viverrini infection was found higher in males (13.8%) than females (7.83%), and frequently in elderly 60-70 year old with 14.2%. Chi-square testing indicated that education and occupation were significantly associated with O. viverrini infection (P value = 0.02). The distribution of O. viverrini infection was found in 11 districts which was covered 64.7% of the studies areas. The highest prevalence was found in Thatum with 39.1%, and followed by Sangkha (24.0%), Buachet (21.1%), Samrong Thap (19.1%), Si Narong (15.0%), and Ratanaburi (13.3%) districts. Conclusion: This findings stress that O viverrini is still a problem in Thailand. We confirmed, for the first time, the high endemicity of human O. viverrini infections in elderly in Surin province of Thailand, underlying the fact that mass treatment and health education are urgently required.
Understanding Breast Cancer Screening Practices in Taiwan: a Country with Universal Health Care
Wu, Tsu-Yin;Chung, Scott;Yeh, Ming-Chen;Chang, Shu-Chen;Hsieh, Hsing-Fang;Ha, Soo Ji 4289
While the incidence of breast cancer (BC) has been relatively low in Asian countries, it has been rising rapidly in Taiwan. Within the last decade, it has replaced cervical cancer as the most diagnosed cancer site for women. Nevertheless, there is a paucity of studies reporting the attitudes and practices of breast cancer screening among Chinese women. The aim of this study is to assess Taiwanese women's knowledge of and attitudes toward BC screening and to identify potential factors that may influence screening behavior. The study population consisted of a sample of 434 Taiwanese women aged 40 and older. Despite access to universal health care for Taiwanese women and the fact that a majority of the women had heard of the breast cancer screening (mammogram, clinical breast exams, etc.), the actual utilization of these screening modalities was relatively low. In the current study, the majority of women had never had mammograms or ultrasound in the past 5 years. The number one most reported barriers were "no time," "forgetfulness," "too cumbersome," and "laziness," followed by the perception of no need to get screened. In addition, the results revealed several areas of misconceptions or incorrect information perceived by study participants. Based on the results from the regression analysis, significant predictors of obtaining repeated screening modalities included age, coverage for screening, barriers, self-efficacy, intention, family/friends diagnosed with breast cancer. The findings from the current study provide the potential to build evidence-based programs to effectively plan and implement policies in order to raise awareness in breast cancer and promote BC screening in order to optimize health outcomes for women affected by this disease.
Human Embryonic Stem Cells - a Potential Vaccine for Ovarian Cancer
Zhang, Zu-Juan;Chen, Xin-Hua;Chang, Xiao-Hong;Ye, Xue;Li, Yi;Cui, Heng 4295
Objective: To investigate the therapeutic potential of human embryonic stem cells (hESCs) as a vaccine to induce an immune response and provide antitumor protection in a rat model. Methods: Cross-reactivity of antigens between hESCs and tumour cells was screened by immunohistochemistry. Fischer 344 rats were divided into 7 groups, with 6 rats in each, immunized with: Group 1, hESC; Group 2, pre-inactivated mitotic NuTu-19; Group 3 PBS; Group 4, hESC; Group 5, pre-inactivated mitotic NuTu-19; Group 6, PBS; Group 7, hESC only. At 1 (Groups 1-3) or 4 weeks (Groups 4-6) after the last vaccination, each rat was challenged intraperitoneally with NuTu-19. Tumor growth and animal survival were closely monitored. Rats immunized with H9 and NuTu-19 were tested by Western blot analysis of rat orbital venous blood for cytokines produced by Th1 and Th2 cells. Results: hESCs presented tumour antigens, markers, and genes related to tumour growth, metastasis, and signal pathway interactions. The vaccine administered to rats in Group 1 led to significant antitumor responses and enhanced tumor rejection in rats with intraperitoneal inoculation of NuTu-19 cells compared to control groups. In contrast, rats in Group 4 did not display any elevation of antitumour responses. Western blot analysis found cross-reactivity among antibodies generated between H9 and NuTu-19. However, the cytokines did not show significant differences, and no side effects were detected. Conclusion: hESC-based vaccination is a promising modality for immunotherapy of ovarian cancer.
Concurrent Weekly Cisplatin Versus Triweekly Cisplatin with Radiotherapy in the Treatment of Cervical Cancer: A Meta-analysis Result
Hu, Yan;Cai, Zhi-Qiang;Su, Xiao-Yan 4301
Aims: To evaluate the adverse effect and survival outcome of weekly and triweekly cisplatin with radiotherapy in treatment of cervical cancer. Methods: After an extensive literature search between 1995-2011, we analyzed 7 studies to compare weekly cisplatin and triweekly cisplatin combined radiotherapy. Results: Our analysis established that weekly cisplatin has a lower risk of hematologic toxicity than triweekly cisplatin with concurrent radiotherapy in the treatment of cervical cancer. However, there were no differences in progression free survival and overall survival between weekly cisplatin and triweekly cisplatin (p>0.05). Conclusions: Weekly cisplatin combined with concurrent radiation has lower risk in hematologic toxicity than triweekly cisplatin, but does not improve survival. Triweekly cisplatin treatment has longer intervals and is therefore more convenient. Clinicians and patients can choose either weekly cisplatin or triweekly cisplatin combined radiotherapy for cervical cancer.
Association Between TP53 Arg72Pro Polymorphism and Hepatocellular Carcinoma Risk: A Meta-analysis
Xu, Chang-Tao;Zheng, Fang;Dai, Xin;Du, Ji-Dong;Liu, Hao-Run;Zhao, Li;Li, Wei-Min 4305
Background: Previous studies on the association between the TP53 Arg72Pro polymorphism and hepatocellular carcinoma (HCC) risk obtained controversial findings. This study aimed to quantify the strength of the association by meta-analysis. Methods: We searched PubMed and Wangfang databases for published studies on the association between the TP53 Arg72Pro polymorphism and HCC risk, using the pooled odds ratio (OR) with its 95% confidence intervals (95% CI) for assessment. Results: 10 studies with a total of 2,026 cases and 2,733 controls were finally included into this meta-analysis. Overall, the TP53 Arg72Pro polymorphism was not associated with HCC risk (all P values greaterth HCC risk in Caucasians in three genetic models (For Pro versus Arg, OR = 1.20, 95%CI 1.03-1.41; For ProPro versus ArgArg, OR = 1.74, 95%CI 1.23-2.47; For ProPro versus ArgPro/ArgArg, OR = 1.85, 95%CI 1.33-2.57). However, there was no significant association between the TP53 Arg72Pro polymorphism and HCC risk in East Asians (all P values greater than 0.10). No evidence of publication bias was observed. Conclusion: Meta-analyses of available data suggest an obvious association between the TP53 Arg72Pro and HCC risk in Caucasians. However, the TP53 Arg72Pro polymorphism may have a race-specific effect on HCC risk and further studies are needed to elucidate this possible effect.
Posttraumatic Growth and Social Support in Turkish Patients with Cancer
Tanriverd, Derya;Savas, Esen;Can, Ganime 4311
Posttraumatic growth (PTG) is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. The need to understand PTG in relation to actual changes in an individual's life has recently been raised. Little is known about the role of social support in the experience of positive outcomes. The purpose of this study is to investigate the role of perceived social support in enhancing PTG in cancer patients. This study involved 105 cancer patients. The data were collected using a questionnaire that determined the socio-demographic features, posttraumatic growth inventory (PTGI) and perceived social support. Participants reported relatively high levels of PTG and social support. Total perceived social support, support from family, and friends were significantly positive associated with the development of PTG among cancer patients. Accordingly, the social surroundings of the patient should be informed about the importance of social support and how it helps the patient; they should be made aware of necessity of social support.
MDM2 T309G has a Synergistic Effect with P21 ser31arg Single Nucleotide Polymorphisms on the Risk of Acute Myeloid Leukemia
Ebid, Gamal T.;Sedhom, Iman A.;El-Gammal, Mosaad M.;Moneer, Manar M. 4315
Background: The P53 tumor suppressor gene plays a pivotal role in maintaining cellular homeostasis by preventing the propagation of genome mutations. P53 in its transcriptionally active form is capable of activating distinct target genes that contribute to either apoptosis or growth arrest, like P21. However, the MDM2 gene is a major negative regulator of P53. Single nucleotide polymorphisms (SNP) in codon Arg72Pro of P53 results in impairment of the tumor suppressor activity of the gene. A similar effect is caused by a SNP in codon 31 of P21. In contrast, a SNP in position 309 of MDM2 results in increased expression due to substitution of thymine by guanine. All three polymorphisms have been associated with increased risk of tumorigenesis. Aim of the study: We aimed to study the prevalence of SNPs in the P53 pathway involving the three genes, P53, P21 and MDM2, among acute myeloid leukemia (AML) patients and to compare it to apparently normal healthy controls for assessment of impact on risk. Results: We found that the P21 ser31arg heterozygous polymorphism increases the risk of AML (P value=0.017, OR=2.946, 95% CI=1.216-7.134). Although the MDM2 309G allele was itself without affect, it showed a synergistic effect with P21 ser/arg polymorphism (P value=0.003, OR=6.807, 95% CI=1.909-24.629). However, the MDM2 309T allele abolish risk effect of the P21 polymorphic allele (P value=0.71). There is no significant association of P53 arg72pro polymorphism on the risk of AML. Conclusion: We suggest that SNPs in the P53 pathway, especially the P21 ser31arg polymorphism and combined polymorphisms especially the P21/MDM2 might be genetic susceptibility factors in the pathogenesis of AML.
Awareness of General Public Towards Cancer Prostate and Screening Practice in Arabic Communities: a Comparative Multi-Center Study
Arafa, Mostafa A.;Rabah, Danny M.;Wahdan, Iman H. 4321
The current study aimed at exploring the knowledge and beliefs of men aged forty years and over towards prostate cancer screening and early detection in three Arab countries. The field work was conducted in three countries; Saudi Arabia, Egypt and Jordan, during the period February through December 2011. Our target population were men aged 40 years and over. It was a population-based cross sectional study comprising 400 subjects at each site. In addition to socio-demographic data, history of the present and past medical illness, practice history of prostatic cancer examination, family history of cancer prostate; participants were inquired about their knowledge and attitude towards prostate cancer and screening behavior using two different likert scales. The percentage of participants who practiced regular prostate check up ranged from 8-30%. They had poor knowledge and fair attitude towards prostate cancer screening behavior, where the mean total knowledge score was $10.25{\pm}2.5$, $10.76{\pm}3.39$ and $11.24{\pm}3.39$ whereas the mean total attitude score was $18.3{\pm}4.08$, $20.68{\pm}6.4$ and $17.96{\pm}5.3$ for Saudi Arabia, Egypt and Jordan respectively. The respondents identified the physicians as the main sources of this information (62.4%), though they were not the main motives for regular checkup. Knowledge was the only significant predictor for participants' attitude in the multiple regression models. Participants' attitudes depends mainly on level of knowledge and quantity of information provided to the patients and their families. Such attitudes should rely on a solid background of proper information and motivation from physicians to enhance and empower behaviors towards prostate cancer screening practices.
Meta-analysis of Associations between the MDM2-T309G Polymorphism and Prostate Cancer Risk
Chen, Tao;Yi, Shang-Hui;Liu, Xiao-Yu;Liu, Zhi-Gang 4327
The mouse double minute 2 (MDM2) gene plays a key role in the p53 pathway, and the SNP 309T/G single-nucleotide polymorphism in the promoter region of MDM2 has been shown to be associated with increased risk of cancer. However, no consistent results were found concerning the relationships between the polymorphism and prostate cancer risk. This meta-analysis, covering 4 independent case-control studies, was conducted to better understand the association between MDM2-SNP T309G and prostate cancer risk focusing on overall and subgroup aspects. The analysis revealed, no matter what kind of genetic model was used, no significant association between MDM2-SNP T309G and prostate cancer risk in overall analysis (GT/TT: OR = 0.84, 95%CI = 0.60-1.19; GG/TT: OR = 0.69, 95%CI = 0.43-1.11; dominant model: OR = 0.81, 95%CI= 0.58-1.13; recessive model: OR = 1.23, 95%CI = 0.95-1.59). In subgroup analysis, the polymorphism seemed more likely to be a protective factor in Europeans (GG/TT: OR = 0.52, 95%CI = 0.31-0.87; recessive model: OR = 0.58, 95%CI = 0.36-0.95) than in Asian populations, and a protective effect of the polymorphism was also seen in hospital-based studies in all models (GT/TT: OR = 0.74, 95%CI = 0.57-0.97; GG/TT: OR = 0.55, 95%CI = 0.38-0.79; dominant model: OR = 0.69, 95%CI = 0.54-0.89; recessive model: OR = 0.70, 95%CI = 0.51-0.97). However, more primary studies with a larger number of samples are required to confirm our findings.
Markers of Bone Metastases in Breast and Lung Cancers
Bilgin, Elif;Yasasever, Vildan;Soydinc, Hilal Oguz;Yasasever, Ceren Tilgen;Ozturk, Nakiye;Duranyildiz, Derya 4331
Aim and Background: The aim of the present study was to evaluate correlations between serum osteocalcin, osteoprotegerin and NTX (Cross-linked N-telopeptides of Type I Collagen) and urinary NTX in breast and lung cancer patients with bone metastases. These four markers are considered to have important roles in bone formation, resorption and metastases. Methods: Four markers were determined in the sera of 60 breast cancer and 21 lung cancer patients and healthy controls (n=30). Serum levels were studied using ELISA and EIA. Results: The median levels of serum osteoprotegerin (p<0.001) and osteocalcin (p=0.003) were higher in patients. Significant correlations were observed between the serum NTX-osteocalcin (r=0.431; p<0.001), serum NTX-osteoprotegerin (r=0.42; p=0.003) and serum NTX - urine NTX (r=0.255; p=0.022). Conclusion: We conclude that osteocalcin, osteoprotegerin and NTX are independent diagnostic tools. Due to the ease of urine collection, urine NTX may be applied routinely to allow early detection of bone metastases and indicate progression of the disease.
Sirolimus and Non-melanoma Skin Cancer Prevention after Kidney Transplantation: A Meta-analysis
Gu, Yu-Hong;Du, Jia-Xin;Ma, Man-Ling 4335
Background: Whether sirolimus is useful in the prevention of non-melanoma skin cancer (NMSC) remains unclear and we therefore performed this meta-analysis of randomized controlled trials to test the hypothesis that Sirolimus-based immunosuppression is associated with a decrease in NMSC. Methods: The main outcomes were NMSC, squamous-cell carcinoma and basal-cell carcinoma. The pooled risk ratio (RR) with its 95% confidence interval (95%CI) were used to assess the effects. Results: 5 randomized trials involving a total of 1499 patients receiving kidney transplantation were included. Patients undergoing Sirolimus-based immunosuppression had much lower risk of NMSC (RR = 0.49, 95%CI 0.32-0.76, P = 0.001). Subgroup analyses by tumor type showed that Sirolimus-based immunosuppression significantly decreased risk of both squamous-cell carcinoma (RR = 0.58, 95%CI 0.43-0.78, P < 0.001) and basal-cell carcinoma (RR = 0.56, 95%CI 0.37-0.85, P = 0.006). The quality of evidence was high for NMSC, and moderate for squamous-cell carcinoma and basal-cell carcinoma. No evidence of publication bias was observed. Conclusion: High quality evidence suggests that Sirolimus-based immunosuppression decreases risk of non-melanoma skin cancer, and Sirolimus has an antitumoral effect among kidney-transplant recipients.
Reduced Expression of Limd1 in Ulcerative Oral Epithelium Associated with Tobacco and Areca Nut
Maiti, Guru Prasad;Ghosh, Amlan;Chatterjee, Ramdas;Roy, Anup;Sharp, Tyson V.;Roychoudhury, Susanta;Panda, Chinmay Kumar 4341
Purpose: The aim of this study was to cast light on initiating molecular events associated with the development of premalignant oral lesions induced by tobacco and/or areca nut. Method: Immunohistochemical analyses of cell cycle regulatory proteins (LIMD1, RBSP3, p16, RB, phosphorylated RB, p53), EGFR and SH3GL2 (EGFR associated protein) were performed with inflammatory/ulcerative epithelium and adjacent hyperplastic/mild dysplastic lesions. Results: No change in expression of the proteins was seen in inflammatory epithelium. Reduced nuclear expression of LIMD1 was evident in ulcerative epithelium. In hyperplastic lesions, reduced expression of RBSP3, p16, SH3GL2 and overexpression of p-RB and EGFR were apparent. Reduced nuclear expression of p53 was observed in mild dysplastic lesions. Conclusion: Our data suggest that inactivation of LIMD1 in ulcerative epithelium might predispose the tissues to alterations of other cell cycle regulatory and EGFR signaling proteins needed for the development of premalignant oral lesions.
Trends of Breast Cancer and its Management in the Last Twenty Years in Aden and Adjacent Governorates, Yemen
Harhra, Nasser Aa;Basaleem, Huda O. 4347
Background: Breast cancer is the most common cancer of women and the principal cause of death in middle aged women. The objective of this study was to describe the trend of breast cancer and its management in Aden and adjacent south-eastern governorates of Yemen during the last 20 years. Patients and Methods: This is a retrospective analysis of previous studies on patients with breast cancer in Aden and adjacent south-eastern governorates, Yemen (January 1989 through December 2007). The studied variables were: sex, age, time and type of presentation, disease stage, pathological types and the performed surgical treatment. The sources of information were the treatment registry of Aden health office, archives of Al-Gamhouria teaching hospital; major referral and other public and private hospitals in Aden and Aden Cancer Registry. Results: The total number of patients was 476, 99% being females. The age range was 19-88 years. The most affected age was 30-50 years (60.5%), 95% presenting after one month of having breast symptoms. Forty-five percent presented with signs of advanced local disease, while 59.2% had palpable axillary lymph nodes on presentation. Early breast cancer (stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%. Invasive ductal carcinoma was the commonest pathology (89.3%). The main surgical treatment was mastectomy (modified radical mastectomy (50%). Conclusion: Breast cancer is predominantly a disease of young with late presentation and advanced disease. Improving health awareness and earlier diagnosis of the disease by health education, encouraging breast self-examination, and providing the mammography equipment and mammary clinics in hospitals are recommended. Establishment of oncology and radiotherapy centers in Aden is a necessity.
Non-enzymatic Antioxidant Status and Biochemical Parameters in the Consumers of Pan Masala Containing Tobacco
Shrestha, Raj;Nepal, Ashwini Kumar;Lal Das, Binod Kumar;Gelal, Basanta;Lamsal, Madhab 4353
Background: Tobacco consumption is one of the leading causes of oral submucous fibrosis, oral cancer and even premature death. The present study was designed to compare the biochemical parameters and non-enzymatic antioxidant status and the lipid peroxidation products in pan masala tobacco users as compared with age-matched non-user controls. Methods: Pan masala and tobacco users of age $33.2{\pm}9.94$ years and age-matched controls ($31.2{\pm}4.73$ years) were enrolled for the study. Plasma levels of vitamin E, vitamin C, albumin, bilirubin, uric acid, glucose, urea, creatinine, aspartate amino transferase (AST), alanine amino transferase (ALT) were measured by standard methods. Serum malondialdehyde (MDA) levels were estimated as a measure of lipid peroxidation. Results: In the pan masala tobacco users, as compared to the controls, the level of vitamin C ($68.5{\pm}5.9$ vs $97.9{\pm}9.03{\mu}mol/L$, $p{\leq}0.05$) vitamin E ($18.4{\pm}5.3$ vs $97.9{\pm}9.03{\mu}mol/L$, $p{\leq}0.001$), albumin ($37.5{\pm}7.01$ vs $44.3{\pm}9.99g/L$, $p{\leq}0.001$), and malondialdehyde ($10.8{\pm}1.29$ vs $1.72{\pm}1.15nmol/ml$, $p{\leq}0.001$) were found to be significantly altered. Malondialdehyde was significantly correlated with vitamin E (r=1.00, p<0.001) and vitamin C (r=1.00, p<0.001) in pan masala tobacco users. Serum levels of AST ($31.0{\pm}16.77$ IU) and ALT ($36.7{\pm}31.3$ IU) in the pan masala tobacco users were significantly raised as compared to the controls (AST, $25.2{\pm}9.51$ IU, p=0.038; ALT, $26.2{\pm}17.9$ IU, p=0.038). Conclusion: These findings suggest that pan masala tobacco users are in a state of oxidative stress promoting cellular damage. Non-enzymatic antioxidants are depleted in pan masala tobacco users with subsequent alteration in the biochemical parameters. Supplementation of antioxidants may prevent oxidative damage in pan masala tobacco users.
Are there Time-period-related Differences in the Prophylactic Effects of Bacille Calmette-Guérin Intravesical Instillation Therapy in Japan?
Okamura, Takehiko;Ando, Ryosuke;Akita, Hidetoshi;Hashimoto, Yoshihiro;Iwase, Yutaka;Naiki, Taku;Kawai, Noriyasu;Tozawa, Keiichi;Kohri, Kenjiro 4357
Objective: The guidelines on indications for prophylactic use of Bacille Calmette-Gu$\acute{e}$rin (BCG) against non-muscle-invasive bladder cancer (NMIBC) have changed over the years. In order to assess the impact on outcome, the present retrospective comparison of BCG efficacy by time period with Japanese patients was conducted. Patients and Methods: A total of 146 cases of NMIBC treated with BCG since February 1985 were retrospectively evaluated. All patients received 80 mg of BCG (Tokyo 172 strain) six to eight times a week for prophylactic use. Comparison was made among three historical groups (Group A: 1980's, 39 cases; Group B: 1990's, 61 cases; Group C: 2000's, 46 cases). Results: In total, recurrence was seen in 55 of the 146 cases (37.7%), and progression in 14 (9.6%), 1 patient dying of cancer. These overall results were similar to those outlined in previous reports. However, the outcomes of this time-period-based analysis indicated a tendency for a shorter time to recurrence in patients after 2000, although a log-rank test showed no significance (P=0.229). Seven of the cases featuring progression (i.e., half of all such cases) were among the 46 Group C patients (15.2%). Excluding these progressive cases, there was no significant difference among the remaining 132 patients in the three groups. Conclusion: This study results revealed a tendency for a lower non-recurrence rate after 2000 in our series. This could stem from a number of factors, including changes in BCG indication criteria and the evolution of histopathological diagnostic criteria.
Up-regulation of NICE-3 as a Novel EDC Gene Could Contribute to Human Hepatocellular Carcinoma
Wei, Yuan-Jiang;Hu, Qin-Qin;Gu, Cheng-Yu;Wang, Yu-Ping;Han, Ze-Guang;Cai, Bing 4363
The epidermal differentiation complex (EDC) contains a large number of gene products which are crucial for the maturation of the human epidermis and can contribute to skin diseases, even carcinogenesis. It is generally accepted that activation of oncogenes and/or inactivation of tumor suppressor genes play pivotal roles in the process of carcinogenesis. Here, NICE-3, a novel EDC gene, was found to be up-regulated in human hepatocellular carcinoma (HCC) by quantitative real-time RT-PCR. Furthermore, overexpression of exogenous NICE-3 by recombinant plasmids could significantly promote cell proliferation, colony formation and soft agar colony formation in Focus and WRL-68 HCC cell lines. Reversely, NICE-3 silencing by RNA interference could markedly inhibit these malignant phenotypes in YY-8103 and MHCC-97H cells. Moreover, cell cycle analysis of MHCC-97H transfected with siRNA by flow cytometry showed that NICE-3 knockdown may inhibit cell growth via arrest in G0/G1 phase and hindering entry of cells into S phase. All data of our findings indicate that NICE-3 may contribute to human hepatocellular carcinoma by promoting cell proliferation.
Metastatic Bone Disease as Seen in Our Clinical Practice - Experience at a Tertiary Care Cancer Center in Pakistan
Qureshi, Asim;Shams, Usman;Akhter, Azra;Riaz, Sabiha 4369
Aim: Metastatic tumor of bone is the most common malignancy involving bone and is an important predictor of prognosis in advanced cancers. The prognosis depends upon the primary site of origin and the extent of disease. In current study, we present the pattern and distribution of metastatic bone disease seen in the leading cancer care center of Pakistan, Shaukat Khanum Cancer Hospital & Research Center (SKMCH & RC), Lahore. Materials & Methods: All cases of bony metastatic disease were included that presented in the Pathology Department, from Jan 2005 to July 2011. Patients of all ages and both sexes were included. Primary bone tumors, lymphomas, sarcomas and other malignancies were excluded. The data were recorded and analyzed with SPSS 16.0. Results: A total of 146 cases of metastatic bone disease were included in the study. Out of the total cases, 79 were male and 67 were female. Age range 25-82 years (median 52). Hip bone was the most frequent bone involved, with femur and vertebrae as second and third in the list. The commonest bone involved in males was vertebrae with 23 cases and in females was hip bone with 22 cases. Regarding primary site, cancers of breast, prostate and gastrointestinal tract were at the top of the list with prostate and breast being the most frequent primary sites of metastasis in males and females respectively. Conclusion: Bone metastasis is an important entity to consider in the differential diagnosis whenever a bony tumor especially carcinoma present in older age. Our data are comparable with international findings and the literature available regarding the site and distribution of skeletal metastatic lesions. A slight deviation noted was more common bony metastatic lesions with ovarian primaries in females and gastrointestinal tract cancers in males in our study.
Impact of Chemotherapy on Hypercalcemia in Breast and Lung Cancer Patients
Hassan, Bassam Abdul Rasool;Yusoff, Zuraidah Binti Mohd;Hassali, Mohamed Azmi;Othman, Saad Bin;Weiderpass, Elisabete 4373
Introduction: Hypercalcemia is mainly caused by bone resorption due to either secretion of cytokines including parathyroid hormone-related protein (PTHrP) or bone metastases. However, hypercalcemia may occur in patients with or without bone metastases. The present study aimed to describe the effect of chemotherapy treatment, regimens and doses on calcium levels among breast and lung cancer patients with hypercalcemia. Methods: We carried a review of medical records of breast and lung cancer patients hospitalized in years 2003 and 2009 at Penang General Hospital, a public tertiary care center in Penang Island, north of Malaysia. Patients with hypercalcemia (defined as a calcium level above 10.5 mg/dl) at the time of cancer diagnosis or during cancer treatment had their medical history abstracted, including presence of metastasis, chemotherapy types and doses, calcium levels throughout cancer treatment, and other co-morbidity. The mean calcium levels at first hospitalization before chemotherapy were compared with calcium levels at the end of or at the latest chemotherapy treatment. Statistical analysis was conducted using the Chi-square test for categorical data, logistic regression test for categorical variables, and Spearman correlation test, linear regression and the paired sample t tests for continuous data. Results: Of a total 1,023 of breast cancer and 814 lung cancer patients identified, 292 had hypercalcemia at first hospitalization or during cancer treatment (174 breast and 118 lung cancer patients). About a quarter of these patients had advanced stage cancers: 26.4% had mild hypercalcemia (10.5-11.9 mg/dl), 55.5% had moderate (12-12.9 mg/dl), and 18.2% severe hypercalcemia (13-13.9; 14-16 mg/dl). Chemotherapy lowered calcium levels significantly both in breast and lung cancer patients with hypercalcemia; in particular with chemotherapy type 5-flurouracil+epirubicin+cyclophosphamide (FEC) for breast cancer, and gemcitabine+cisplatin in lung cancer. Conclusion: Chemotherapy decreases calcium levels in breast and lung cancer cases with hypercalcemia at cancer diagnosis, probably by reducing PTHrP levels.
Comparison Different Methods of Intraoperative and Intraperitoneal Chemotherapy for Patients with Gastric Cancer: A Meta-analysis
Huang, Jin-Yu;Xu, Ying-Ying;Sun, Zhe;Zhu, Zhi;Song, Yong-Xi;Guo, Peng-Tao;You, Yi;Xu, Hui-Mian 4379
Purpose: To investigate the efficacy and safety of intraperitoneal chemotherapy (IPC) for patients with gastric cancer and to compare effects between different regimens of IPC. Method: Randomized controlled trials comparing the effects of surgery plus intraperitoneal chemotherapy with surgery alone or comparing the efficacy between different regimens of intraperitoneal chemotherapy were searched for in Medline, Embase, Pubmed, the Cochrane Library and the Chinese BioMedical Disc and so on by two independent reviewers. After quality assessment and data extraction, data were pooled for meta-analysis using RevMan5.16 software. Tests of interaction were used to test for differences of effects among subgroups grouped according to different IPC regimens. Results: Fifteen RCTs with a total of 1713 patients with gastric cancer were included for quality assessment and data extraction. Ten studies were judged to be of fair quality and entered into meta-analysis. Hyperthermic intraoperative intraperitoneal chemotherapy (HR=0.60, P<0.01), hyperthermic intraoperative intraperitoneal chemotherapy plus postoperative intraperitoneal chemotherapy (HR=0.47, P<0.01) and normothermic intraoperative intraperitoneal chemotherapy (HR=0.70, P=0.01) were associated with a significant improvement in overall survival. Tests of interaction showed that hyperthermia and additional postoperative intraperitoneal chemotherapy did not impact on its effect. Further analysis revealed that intraperitoneal chemotherapy remarkably decrease the rate of postoperative hepatic metastasis by 73% (OR=0.27, 95% CI=0.12 to 0.67, P<0.01). However, intraperitoneal chemotherapy increased risks of marrow depression (OR=5.74, P<0.01), fever (OR=3.67, P=0.02) and intra-abdominal abscess (OR=3.57, P<0.01). Conclusion: The present meta-analysis demonstrates that hyperthermic intraoperative intraperitoneal chemotherapy and normothermic intraoperative intraperitoneal chemotherapy should be recommended to treat patients with gastric cancer because of improvement in overall survival. However, it is noteworthy that intraperitoneal chemotherapy can increase the risks of marrow depression, intra-abdominal abscesses, and fever.
Survival of Patients with Lung Cancer, Yazd, Iran
Zahir, Shokouh Taghipour;Mirtalebi, Maryammosadate 4387
Background: Lung carcinoma is the leading cause of cancer mortality worldwide. Although the 5-year survival rate nearly tripled from 5-15% over the last 25 years, the estimated number of deaths still exceeds 1.3 million annually. The overall 5-year survival of lung cancer is only 10% in Europe and 15% in the United States. The aim of the current study was to determine the long-term survival and the effect of certain prognostic factors on survival of patients with lung cancer in Yazd city, Iran. Methods: In this cross-sectional descriptive study, we retrospectively reviewed hospital records and follow-up data of 148 patients with histological proven lung cancer using the cancer data registered between 1998 and 2005 in the pathology department of Shahid Sadoughi educational hospital, Yazd, Iran. Data were extracted from patient documents that included sex, age, clinical manifestations, histopathological report of the tumor and type of treatment given. Results: Overall survival time in all patients was 8.5 months after diagnosis and there was no significant difference in survival according to sex (p=0.958). Histological analysis revealed that squamous cell carcinoma was the most common histologic type (35%). Kaplan-Meier statistical methods estimated the average survival time for SCC to be better (22.6 months) in comparison with the other types of histology (all of them below 10 months). There was a trend towards significance between type of histology and duration of survival (p=0.08). Conclusion: It is reasonable to expect that early lung cancer detection, and appropriated treatment, may improve surgical morbidity and mortality. Low survival of lung cancer in our center patients show our shortages in screening programs for early diagnosis. Designing studies with larger sample size that take some other variables like staging of patients is now necessary.
Amelioration of 1,2 Dimethylhydrazine (DMH) Induced Colon Oxidative Stress, Inflammation and Tumor Promotion Response by Tannic Acid in Wistar Rats
Hamiza, Oday O.;Rehman, Muneeb U.;Tahir, Mir;Khan, Rehan;Khan, Abdul Quaiyoom;Lateef, Abdul;Ali, Farrah;Sultana, Sarwat 4393
Colon cancer is the third most common malignant neoplasm in the world and it remains an important cause of death, especially in western countries. The toxic environmental pollutant, 1, 2-dimethylhydrazine (DMH), is also a colon-specific carcinogen. Tannic acid (TA) is reported to be effective against various types of chemically induced toxicity and also carcinogenesis. In the present study, we evaluated the chemopreventive efficacy of TA against DMH induced colon toxicity in a rat model. Efficacy of TA against the colon toxicity was evaluated in terms of biochemical estimation of antioxidant enzyme activities, lipid peroxidation, histopathological changes and expression of early molecular markers of inflammation and tumor promotion. DMH treatment induced oxidative stress enzymes (p<0.001) and an early inflammatory and tumor promotion response in the colons of Wistar rats. TA treatment prevented deteriorative effects induced by DMH through a protective mechanism that involved reduction of oxidative stress as well as COX-2, i-NOS, PCNA protein expression levels and TNF-${\alpha}$ (p<0.001) release. It could be concluded from our results that TA markedly protects against chemically induced colon toxicity and acts plausibly by virtue of its antioxidant, anti-inflammatory and antiproliferative activities.
Glutathione-S-Transferase T1 Polymorphism is Associated with Esophageal Cancer Risk in Chinese Han Population
Weng, Yuan;Fei, Bojian;He, Ping;Cai, Ming 4403
Background: Glutathione-S-Transferase T1 (GSTT1) gene has been shown to be involved in the development of esophageal cancer. However, the results have been inconsistent. In this study, the authors performed a meta-analysis to clarify the association between GSTT1 polymorphism and esophageal cancer risk among Chinese Han population. Methods: Published literature from PubMed, the China National Knowledge Infrastructure and Wanfang Data were searched. Pooled odds ratio (OR) and 95% confidence interval (95%CI) was calculated using a fixed- or random-effects model. Results: Eleven studies with a total of 2779 individuals were included in the meta-analysis. The results showed that GSTT1 null genotype was significantly associated with esophageal cancer risk in Chinese (OR = 1.31, 95%CI 1.12 to 1.53, p = 0.001). Further sensitivity analyses confirmed the significant association. The cumulative meta-analysis showed a trend of an obvious association between GSTT1 null genotype and esophageal cancer risk as information accumulated by year. Conclusions: This meta-analysis suggests a significant association of GSTT1 null genotype with esophageal cancer risk in the Chinese Han population.
Estimation of Superoxide Dismutase and Glutathione Peroxidase in Oral Submucous Fibrosis, Oral Leukoplakia and Oral Cancer - A Comparative Study
Gurudath, Shubha;Ganapathy, K.S.;D., Sujatha;Pai, Anuradha;Ballal, Sushmini;Asha, M.L. 4409
Present study was undertaken to estimate and compare erythrocyte superoxide dismutase (E-SOD) and Glutathione peroxidase (GPx) levels in oral submucous fibrosis, oral leukoplakia and oral cancer patients and age/sex matched healthy subjects, 25 in each group. Statistically significant (P<0.001) decrease in E-SOD and GPx levels were observed in OSF, oral leukoplakia and oral cancer groups as compared to the control group. Oral leukoplakia group showed lower levels in comparison with OSF (P>0.05). Oral cancer group had the lowest levels amongst the study groups. Imbalance in antioxidant enzyme status may be considered as one of the factors responsible for the pathogenesis of cancer and may serve as a potential biomarker and therapeutic target to reduce the malignant transformation in oral premalignant lesions/conditions.
Prognostic Significance of GSTP1, XRCC1 and XRCC3 Polymorphisms in Non-small Cell Lung Cancer Patients
Ke, Hong-Gang;Li, Jun;Shen, Yi;You, Qing-Sheng;Yan, Yu;Dong, Han-Xuan;Liu, Jun-Hua;Shen, Zhen-Ya 4413
Aim: Individual differences in chemosensitivity and clinical outcome in non-small cell lung cancer (NSCLC) patients treatment with platinum-based chemotherapy may be due to genetic factors. Our study aimed to investigate the prognostic role of GSTP1, XRCC1 and XRCC3 in NSCLC patients treated with chemotherapy. Methods: A total of 460 cases were consecutively selected from The Affiliated Hospital of Nantong University between Jan. 2003 to Nov. 2006, and all were followed-up until Nov. 2011. Genotyping of GSTP1 Ile105Val, XRCC1 Arg194Trp, XRCC1 Arg399Gln and XRCC3 Thr241Met was conducted by duplex polymerase-chain-reaction with confronting-two-pair primer methods. Results: Patients with GSTP Val/Val exhibited a shorter survival time, and had a 1.89 fold greater risk of death than did those with the IIe/IIe genotype. For XRCC1 Arg194Trp, the variant genotype Trp/Trp was significantly associated with a decreased risk of death from NSCLC when compared with the Arg/Arg. Individuals carrying XRCC1 399Gln/Gln genotype had a longer survival time, with a lowered risk of death from NSCLC. Conclusion: This study indicated that GSTP1 Ile105Val, XRCC1 Arg194Trp and XRCC1Arg399Gln genes have a role in modifying the effect of platinum-based chemotherapy for NSCLC patients in a Chinese population. Our findings provide information for therapeutic decisions for individualized therapy in NSCLC cases.
Relationship Between GSTT1 Gene Polymorphism and Hepatocellular Carcinoma in Patients from China
Chen, Jie;Ma, Liang;Peng, Ning-Fu;Wang, Shi-Jun;Li, Le-Qun 4417
Objective: The results from studies on associations of the glutathione S-transferase T1 (GSTT1) gene polymorphism and hepatocellular carcinoma (HCC) risk in Chinese populations are still conflicting. This meta-analysis was performed to evaluate the relationship in detail. Methods: Eligible reports were recruited into this meta-analysis from the databases of PubMed, Embase, Cochrane Library and CBM-disc (China Biological Medicine Database). Results were expressed with odds ratios (OR) for dichotomous data, and 95% confidence intervals (CI) were also calculated. Results: Eighteen investigations were identified for the analysis of association between polymorphic deletion of GSTT1 and HCC, consisting of 2,693 patients with HCC and 4,696 controls. Null genotype of GSTT1 was associated with HCC susceptibility in Chinese (OR=1.53, 95%CI: 1.28-1.82; P<0.00001). Conclusion: The GSTT1 null genotype is associated with HCC susceptibility in Chinese.
Association of XPD and XRCC1 Genetic Polymorphisms with Hepatocellular Carcinoma Risk
Guo, Lian-Yi;Jin, Xu-Peng;Niu, Wei;Li, Xiao-Fei;Liu, Bao-Hai;Wang, Yu-Lin 4423
Aim: XRCC1 and XPD are two major repair genes involved in nucleotide excision repair (NER), which is reported to be associated with risk of several cancers. We explored the association of XRCC1 and XPD polymorphisms with the risk of HCC. Methods: A total of 410 cases with HCC and 410 health controls were collected. XRCC1 Arg194Trp, XRCC1 Arg399Gln, XPD Lys751Gln and XPD Asp312Asn genotyping was performed by duplex polymerase-chain-reaction with the confronting-two-pair primer (PCR-CTPP) method. Results: XRCC1 194Trp/Trp was strongly significantly associated with an increased risk of HCC cancer when compared with the wide-type genotype (OR=2.26, 95% CI=(1.23-5.38). Individuals carrying the XRCC1 399Gln/Gln showed increased risk of HCC (OR=1.74, 95%CI=1.06-2.74). The XPD 751Gln/Gln and Gln allele genotype were associated with strong elevated susceptibility to HCC (OR=3.51 and 1.42, respectively). Conclusion: These results suggest that polymorphisms in XRCC1 and XPD may have functional significance in risk of HCC.
Knowledge, Perception, Practice and Barriers of Breast Cancer Health Promotion Activities among Community Pharmacists in Two Districts of Selangor State, Malaysia
Beshir, Semira A.;Hanipah, Monalina A. 4427
Breast cancer is the most common cancer and the leading cause of cancer death among women in Malaysia. Despite the campaigns undertaken to raise the awareness of the public regarding breast cancer, breast cancer screening rates are still low in the country. The community pharmacist, as one of the most accessible healthcare practitioners, could play a role in the provision of breast cancer health promotion services to the community. However, there are no documented data regarding the community pharmacists' involvement in breast cancer related health promotion activities. Hence, this study was conducted to examine self-reported knowledge, practice and perception of community pharmacists on provision of breast cancer health promotion services and to investigate the barriers that limit their involvement. This cross-sectional survey conducted between May to September 2010, included a sample of 35 community pharmacists working in the districts of Hulu Langat and Sepang in state of Selangor. A 22-item validated questionnaire that included both closed and Lickert scale questions was used to interview those pharmacists who gave their informed consent to participate in the study. The data was analysed using SPSS. Only 11.3% of the community pharmacists answered all the questions on the knowledge section correctly. The mean overall knowledge of the community pharmacists on risk factors of breast cancer and screening recommendations is 56%. None of the respondents was currently involved in breast cancer health promotion activities. Lack of time (80%), lack of breast cancer educational materials (77.1%) and lack of training (62.9%) were the top three mentioned barriers. Despite these barriers, 94.3% (33) of the community pharmacists agreed that they should be involved in breast cancer health promotion activities. Hence, there is need to equip community pharmacists with necessary training and knowledge to enable them to contribute their share towards prevention and screening of breast cancer.
Nature of Lesions Undergoing Radical Nephrectomy for Renal Cancer
Mustafa, Gunes;Ilhan, Gecit;Necip, Pirincci;Kerem, Taken;Kadir, Ceylan 4431
Aim: The aim of the present study was to evaluate retrospectively histopathologically-diagnosed lesions that were detected in the kidney after radical nephrectomy for a preoperative diagnosis of kidney cancer. Methods: The medical records of 83 patients (51 male, 32 female) were included. Preoperative staging was accomplished by various methods including physical examination, blood hemography and biochemistry, abdominal ultrasonography (US), chest x-ray, abdominal computed tomography (CT) and abdominal magnetic resonance imaging (MRI). Results: Totals of 70 patients underwent radical nephrectomy and 13 nephron sparing surgery. Of the 83 patients, 70 had malignant lesions (renal cell carcinoma, squamous cell carcinoma or other malignancies) 13 had a variety of benign lesions, the most frequently detected being oncoytoma (6), angiomyolipoma (3), xanthogranulamatous pyelonephritis (2), cortical cyst (1) and chronic pyelonephritic change (1). Conclusion: It was concluded that in spite of great technological developments regarding radiological imaging modalities such as US, CT and MRI, benign lesions might still be detected pathologically in patients who undergo radical nephrectomy with the preoperative diagnosis of renal cancer. But, all renal masses should be regarded as malignant and should be managed surgically otherwise proven benign.
Silencing of Twist Expression by RNA Interference Suppresses Epithelial-mesenchymal Transition, Invasion, and Metastasis of Ovarian Cancer
Wang, Wen-Shuang;Yang, Xing-Sheng;Xia, Min;Jiang, Hai-Yang;Hou, Jian-Qing 4435
Purpose: This study aimed to explore the role of the Twist gene in the epithelial-mesenchymal transition of ovarian cancer. Methods: An RNA interference plasmid expressing a small interfering RNA (siRNA)-targeting Twist (Twist siRNA vector) was designed, constructed, and transfected into the human ovarian cancer cell line A2780. Transfection efficiency was assessed under a fluorescence microscope. Changes in the expression of Twist mRNA in A2780 after transfection with the pGenesil Twist shRNA plasmid were analyzed through RT-PCR. MTT assays and adhesion experiments were applied to determine changes in proliferation and adhesion ability of A2870 after transfection with the Twist shRNA plasmid. Changes in the expression of the E-cadherin and N-cadherin proteins in A2780 after transfection with the Twist shRNA plasmid were analyzed using Western blotting. Result: The restructuring plasmid pGenesil-Twist shRNA was constructed successfully. After 48 h of culture, 80% of the cells expressed high-intensity GFP fluorescence and stability. The expression of Twist decreased significantly after the transfection of the Twist shRNA plasmid (P<0.05). Proliferation of the transfected Twist shRNA cells showed no difference with that of the A2780-nontransfection or A2780-si-control groups (P>0.05) but the adhesion ability of A2780 decreased dramatically (P<0.05). Expression of the E-cadherin protein increased, whereas that of the N-cadherin protein decreased compared with that in the A2780-nontransfection or A2780-si-control groups (P<0.05). Conclusion: Twist is essential for epithelial-mesenchymal transition, invasion, and metastasis of ovarian cancer.
Meta-analysis of the Relation Between the VDR Gene TaqIpolymorphism and Genetic Susceptibility to Prostate Cancer in Asian Populations
Guo, Ya-Jie;Shi, Ze-Ming;Liu, Jun-Da;Lei, Ning;Chen, Qiu-Hong;Tang, Ying 4441
Background: Polymorphisms of the Taq I gene have been associated with prostate cancer risk. Methods:We applied a fixed-effects model to combine odds ratios (ORs) and 95% confidence intervals (95% CI). The Egger's test was carried out to evaluate potential publication bias. Results: A total of 10 case-control studies enrolling 1,141 prostate cancer patients and 1,685 controls were included in this meta-analysis. Compared with the T allele, the OR for the C allele was 0.81 (0.70-0.94). The ORs for CT and CC+CT genotypes were 0.86 (0.74-1.01) and 0.84 (0.73-0.97) compared to wide type genotype (homozygote TT). Conclusions: The present meta-analysis suggests that the TF gene Taq I polymorphism may reduce the prostate cancer risk in Asian populations.
Characteristics of Invasive Breast Ductal Carcinoma, NOS, Diagnosed in a Tertiary Institution in the East Coast of Malaysia with a Focus on Tumor Angiogenesis
Ch'ng, Ewe Seng;Sharif, Sharifah Emilia Tuan;Jaafar, Hasnan 4445
Background: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis. This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus on the relationship between tumor angiogenesis and clinicopathological factors. Methods: Clinicopathological data were retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductal carcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantified as microvessel density. Results: At least 50% of 94 cases of invasive breast ductal carcinoma in the study were advanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positive lymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesterone receptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triple negative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density was observed in the younger patient age group (p=0.012). There were no significant associations between microvessel density and other clinicopathological factors (p>0.05). Conclusions: Majority of the breast cancer patients of this institution had advanced stage disease with poorer prognostic factors as compared to other local and western studies. Breast cancer in younger patients might be more proangiogenic.
Tanshinone II-A Inhibits Angiogenesis through Down Regulation of COX-2 in Human Colorectal Cancer
Zhou, Li-Hong;Hu, Qiang;Sui, Hua;Ci, Shu-Jun;Wang, Yan;Liu, Xuan;Liu, Ning-Ning;Yin, Pei-Hao;Qin, Jian-Min;Li, Qi 4453
Angiogenesis plays a significant role in colorectal cancer (CRC) and cyclooxygenase-2 (COX-2) appears to be involved with multiple aspects of CRC angiogenesis. Our aim was to investigate the inhibitory effects of Tan II-A (Tanshinone II-A, Tan II-A) on tumor growth in mice, as well as alteration of expression of COX-2 and VEGF in CRC. We established the mice xenograft model of C26 CRC cell line, and injected 0.5, 1, 2mg/kg of Tan II-A and 1mg/kg of 5-FU in respectively in vivo. Then, we assayed tumor weight and volume, and evaluated microvascular density and expression of VEGF. COX-2 promoter and COX-2 plasmids were transfected into HCT-116 cells, followed by detection of COX-2 promoter activity by chemiluminescence, and detection of COX-2 mRNA expression by fluorescence quantitative PCR. Taken together, the results showed Tan II-A could inhibit tumor growth and suppress the VEGF level in vivo. HCT-116 cell experiments showed marked inhibitory effects of Tan II-A on COX-2 and VEGF in a dose-dependent manner. The results indicate that Tan II-A can effectively inhibit tumor growth and angiogenesis of human colorectal cancer via inhibiting the expression level of COX-2 and VEGF.
Do Saudi Nurses in Primary Health Care Centres have Breast Cancer Knowledge to Promote Breast Cancer Awareness?
Yousuf, Shadia Abdullah;Al Amoudi, Samia Mohammed;Nicolas, Wafa;Banjar, Hasna Erfan;Salem, Safaa Mohammed 4459
Background: Breast cancer is one of the leading causes of death among cancer patients in Saudi Arabia. It is known that nurses play a key role in promoting breast cancer awareness among women in any society. Nurses in primary health care centres (PHCC) have more direct contact with general population. This study aimed to investigate nurse knowledge of breast cancer and practice of early screening in PHCC in Jeddah city. Methods: A cross-sectional study was conducted using a self-administered questionnaire to assess the general knowledge of breast cancer, risk factors, and practice of 210 PHCC nurses. Data were analysed using SPSS v.16. Results: The mean age of the PHCC Nurses was 36.9 (SD ${\pm}8.6$). Only 11% percent scored <50% of the total score for general epidemiological knowledge on breast cancer, about 35% scored <50% of the total score for breast cancer risk factors. Sixty seven percent scored >75% of the total score on breast cancer signs. Majority of nurses 62.8% practiced BSE, but only 4% practiced regularly every month. Some 28% practiced once per year. About 81% of the nurses had not had a clinical breast examination and only 14% had had a mammography. The results of the study failed to show any correlation between the knowledge scores with age, education, year of experience, family history of BC and marital status of the nurses. Conclusion:The results from the study reflect that there is a need to provide continuing nursing education programmes for PHCC nurses to improve their breast cancer knowledge and practice.
Lack of Association of Glutathione S-transferase M3 Gene Polymorphism with the Susceptibility of Lung Cancer
Feng, Xu;Dong, Chun-Qiang;Shi, Jun-Jie;Zhou, Hua-Fu;He, Wei;Zheng, Bao-Shi 4465
Objective: The conclusions of published reports on the relationship between the glutathione S-transferase M3 (GSTM3) A/B gene polymorphism and the risk of lung cancer are still debated. This meta-analysis was performed to evaluate the association between GSTM3 and the risk of lung cancer. Methods: Association investigations were identified from PubMed, Embase, and Cochrane Library, and eligible studies were included and synthesized using a meta-analysis method. Results: Eight reports were included into this meta-analysis for the association of GSTM3 A/B gene polymorphism and lung cancer susceptibility, covering 1,854 patients with lung cancer and 1,926 controls. No association between the GSTM3 A/B gene polymorphism and lung cancer was found in this meta-analysis (B allele: OR = 1.25, 95% CI: 0.89-1.76, P = 0.20; BB genotype: OR = 1.53, 95% CI: 0.71-3.32, P = 0.28; AA genotype: OR = 0.85, 95% CI: 0.59-1.23, P = 0.39). Conclusions: The GSTM3 A/B gene polymorphism is not associated with lung cancer susceptibility. However, more studies on the relationship between GSTM3 A/B gene polymorphism and the risk of lung cancer should be performed in the future.
LINE-1 and Alu Methylation Patterns in Lymph Node Metastases of Head and Neck Cancers
Kitkumthorn, Nakarin;Keelawat, Somboon;Rattanatanyong, Prakasit;Mutirangura, Apiwat 4469
Background: The potential use of hypomethylation of Long INterspersed Element 1 (LINE-1) and Alu elements (Alu) as a biomarker has been comprehensively assessed in several cancers, including head and neck squamous cell carcinoma (HNSCC). Failure to detect occult metastatic head and neck tumors on radical neck lymph node dissection can affect the therapeutic measures taken. Objective: The aim of this study was to investigate the LINE-1 and Alu methylation status and determine whether it can be applied for detection of occult metastatic tumors in HNSCC cases. Methods: We used the Combine Bisulfite Restriction Analysis (COBRA) technique to analyse LINE-1 and Alu methylation status. In addition to the methylation level, LINE-1 and Alu loci were classified based on the methylation statuses of two CpG dinucleotides in each allele as follows: hypermethylation ($^mC^mC$), hypomethylation ($^uC^uC$), and 2 forms of partial methylation ($^mC^uC$ and $^uC^mC$). Sixty-one lymph nodes were divided into 3 groups: 1) non-metastatic head and neck cancer (NM), 2) histologically negative for tumor cells of cases with metastatic head and neck cancer (LN), and 3) histologically positive for tumor cells (LP). Results: Alu methylation change was not significant. However, LINE-1 methylation of both LN and LP was altered, as demonstrated by the lower LINE-1 methylation levels (p<0.001), higher percentage of $^mC^uC$ (p<0.01), lower percentage of $^uC^mC$ (p<0.001) and higher percentage of $^uC^uC$ (p<0.001). Using receiver operating characteristic (ROC) curve analysis, $%^uC^mC$ and $%^mC^uC$ values revealed a high level of AUC at 0.806 and 0.716, respectively, in distinguishing LN from NM. Conclusion: The LINE-1 methylation changes in LN have the same pattern as that in LP. This epigenomic change may be due to the presence of occult metastatic tumor in LN cases.
Absence of P53 Gene Mutations in Exons 5 - 7 Among Breast Cancer Patients of Bengalee Hindu Caste Females, West Bengal, India
Roy, Abhishikta Ghosh;Sarkar, B.N.;Roy, Rakesh;Rao, V.R.;Bandyopadhyay, A.R. 4477
Background: The high incidence and relatively good prognosis of breast cancer has made it the most prevalent cancer in the world today. A large number of distinct mutations and polymorphisms in the p53 gene have been reported worldwide, but there is no report regarding the role of this inherited susceptibility gene in breast cancer risk among the Bengalee Hindu Caste females of West Bengal, India. Aim of the Study: We investigated the distribution and the nature of p53 gene mutations and polymorphisms in exons 5-7 in a cohort of 110 Bengalee Hindu breast cancer patients and 127 age, sex and caste matched controls by direct sequencing. Results: We did not observe any mutations and polymorphisms in our studied individuals. Conclusion: We therefore conclude that mutations in exons 5-7 of p53 gene are rare causes of breast cancer among Bengalee Hindu caste females, and therefore of little help for genetic counseling and diagnostic purposes.
Association of Chemotherapy-induced Leucopenia with Treatment Outcomes in Advanced Non-small-cell lung Cancer Cases Receiving the NP Regimen
Huang, Cheng-Suo;Liu, Lin;Liu, Jie;Chen, Zhen;Guo, Jun;Li, Chang-Zheng;Zhou, Deng-Guang;Wang, Zhe-Hai 4481
Background: Chemotherapy induced leutropenia has been shown to be associated with improved treatment outcomes in selected solid tumors. We studied the association of chemotherapy induced leutropenia with treatment related outcomes in advanced non-small-cell lung cancer. Methods: This is a prospective analysis of patients receiving chemotherapy for advanced NSCLC at the Shandong Cancer Hospital from 2005-07.The chemotherapy included cisplatin $35mg/m^2$, IV on $d_{1,2}$ and vinorelbine $25mg/m^2$ IV on $d_{1,8}$ every 21 days. Patients were stratified into three groups (A) those experiencing grades 0 leucopenia, group (B) grades 1-2 and group (C) grades 3-4. The outcomes studied were response rate (RR), disease control rate (DCR), and time to progression (TTP). Results: 128 patients were studied. The RRs in groups A, B and C were 30.8%, 56.8% and 71.4%, respectively, p=0.010. The DCRs were 61.5%, 83.8% and 92.9%, respectively, p=0.009 and the median TTPs were 150 days (95%CI: 91-209), 189 days (95%CI: 181-197) and 207 days (95%CI: 172-242), p=0.009. The differences in RR and TTP were significant. In patients whose CIL kept on 10 days at least, the TTP was significantly prolonged, p=0.0213, and the same was the case for those experiencing grades 1-2 leucopenia and ECOG 0, p=0.0412. Conclusions: Occurrence of CIL correlated with RR and TTP in patients with advanced NSCLC receiving cisplatin and vinorelbine chemotherapy, especially in patients experiencing grades 1-2 leucopenia and ECOG 0, and the same for those with CIL persisting for 10 days at least. CIL could be a biological measure of drug activity and a marker of efficacy.
Anal Cancer Screening by Modified Liquid-Based Cytology in an HIV Clinic
Patarapadungkit, Natcha;Koonmee, Supinda;Pasatung, Emorn;Pisuttimarn, Pornrith;Mootsikapun, Piroon 4487
This study aimed to screen for anal cancer and to determine its cytomorphology using liquid-based cytology (LBC) with specimens preserved in 95% ethyl alcohol. Anal swabs were collected for cytological examination from 177 adult, HIV-infected patients. After collection, sample slides were reviewed and classified according to their cytomorphology using the modified Bethesda 2001 system. An abnormal anal Pap smear was found in 26.0% of the patients. The diagnoses were: 66.7% negative for intraepithelial lesions (NIL), 14.1% with atypical squamous cells of undetermined significance (ASC-US), 10.7% (19) with low-grade squamous intraepithelial lesions (LSIL), and 1.13% with high-grade squamous intraepithelial lesions (HSIL). The cytological evaluation was an unsatisfactory result only with 6.67%. The present modified LBC using 95% ethyl alcohol as the preservative could thus be used for anal cancer screening. The number of SILs in Thai HIV-infected patients is lower than that in Western countries. We found anal cytology a satisfactory tool for early screening and detection of anal dysplasia commonly found in high-risk, HIV-infected patients.
Determination of Information and Support Needs of First Degree Relatives of Women with Breast Cancer
Andic, Saadet;Karayurt, Ozgul 4491
Background: Breast cancer is the most frequent type of cancer among women in the world and the most common cause of deaths from cancer in females. In Turkey, breast cancer comes first in the list of the most frequent ten cancer types seen in women. As the incidence rate of breast cancer is high, many women having breast cancer in the family experience the breast cancer at secondhand. This study was carried out in an attempt to determine the information and support needs of women whose first-degree relatives have breast cancer and to what extent these needs are met. Methods: The research sample consisted of 156 women. Questionnaire Form and Information and Support Needs Questionnaires were used as the data collection tools. Results: Information need score averages ($x^-:3.72{\pm}0.19$) of women included in the research sampling were found to be higher than their score averages of support needs ($x^-:3.24{\pm}0.41$). Conclusion: Information needs which were indicated by women as very important were related to treatment, symptoms of breast cancer and breast self examination (BSE), while support needs which were indicated by women as very important were learning how to perform BSE, women's anxiety for themselves and their relatives regarding breast cancer and having their breasts examined by a health professional. It is recommended that nurses and other medical staff should give information to women whose first-degree relatives have breast cancer about the disease, its etiology, scanning, diagnosis, treatment options and protection as well as prevention.
Time Trends of Esophageal Cancer Mortality in Linzhou City During the Period 1988-2010 and a Bayesian Approach Projection for 2020
Liu, Shu-Zheng;Zhang, Fang;Quan, Pei-Liang;Lu, Jian-Bang;Liu, Zhi-Cai;Sun, Xi-Bin 4501
In recent decades, decreasing trends in esophageal cancer mortality have been observed across China. We here describe esophageal cancer mortality trends in Linzhou city, a high-incidence region of esophageal cancer in China, during 1988-2010 and make a esophageal cancer mortality projection in the period 2011-2020 using a Bayesian approach. Age standardized mortality rates were estimated by direct standardization to the World population structure in 1985. A Bayesian age-period-cohort (BAPC) analysis was carried out in order to investigate the effect of the age, period and birth cohort on esophageal cancer mortality in Linzhou during 1988-2010 and to estimate future trends for the period 2011-2020. Age-adjusted rates for men and women decreased from 1988 to 2005 and changed little thereafter. Risk increased from 30 years of age until the very elderly. Period effects showed little variation in risk throughout 1988-2010. In contrast, a cohort effect showed risk decreased greatly in later cohorts. Forecasting, based on BAPC modeling, resulted in a increasing burden of mortality and a decreasing age standardized mortality rate of esophageal cancer in Linzhou city. The decrease of esophageal cancer mortality risk since the 1930 cohort could be attributable to the improvements of socialeconomic environment and lifestyle. The standardized mortality rates of esophageal cancer should decrease continually. The effect of aging on the population could explain the increase in esophageal mortality projected for 2020.
Post-operative Treatment with Cisplatin and Vinorelbine in Chinese Patients with Non-small Cell Lung Cancer: A Clinical Prospective Analysis of 451 Patients
Wang, Jing;Liu, Feng;Huang, Deng-Xiao;Jiang, Bin 4505
Purpose: To determine the efficacy of post-operative chemotherapy with cisplatin plus vinorelbine (NP) in Chinese patients with non-small cell lung cancer (NSCLC). Methods: A total of 451 patients with NSCLCs at stages I, II, and IIIA after surgical resection were treated with cisplatin plus vinorelbine for 4 cycles or volunteers observed between January 2002 and November 2004 and were followed for five years. The therapeutic efficacy was evaluated with reference to overall survival (OS) and disease-free survival (DFS), and adverse effects were also recorded. Potential factors affecting the lengths of OS and DFS were analyzed by multivariate analysis. Results: Most patients (86.7%) completed at least 4 cycles of treatment. Patients with chemotherapy survived significantly longer than those in the observation group (p<0.001). The absolute improvements in the 2 and 5-year OS were 3.8% [hazard ratio (HR) =0.674, 95% confidence interval (CI): 0.554-0.820, P<0.0001] and 13.0% (HR=0.732, 95% CI: 0.579-0.926, P=0.009), respectively. The improvement at 4-year DFS was 2.1% (HR=0.327, 95% CI: 0.214-0.500, P<0.0001). Stratification analysis revealed that older age, histological type, pathological degree, but not the gender and smoking status, are independent factors affecting the length of survival in this population. Many patients (63.3%) had grade 1-III tolerable adverse effects, and there was no treatment-related death. Conclusions: Post-operative chemotherapy with NP regimen is effective and tolerable in Chinese patients with NSCLC.
Causes of Delay in Seeking Treatment in Patients with Breast Cancer in Iran: a Qualitative Content Analysis Study
Rastad, Hadis;Khanjani, Narges;Khandani, Behjat Kalantari 4511
Background: In the Middle East, including Iran, breast cancer is the most frequent malignancy among women. Without treatment, a malignant breast tumor advances in stage, diminishing a woman's chances of survival. In this study we aimed to gain insight into the causes of delay in seeking treatment in patients with breast cancer. Methods: The participants in this qualitative, content analysis study were 10 women in whom a diagnosis of breast cancer in the stages of II b, III or IIV had been made. They were selected from patients of a major oncology clinic in Kerman, Iran. Data were collected by means of semi-structured interviews that lasted between 20 to 30 minutes. Sampling was discontinued when data saturation was achieved. Content analysis was conducted by classifying the data into themes and sub-themes. Results: The results of our study revealed several factors that interfered with patients' professional consultation seeking and prompt treatment. These factors included; lack of knowledge, fear of being diagnosed with cancer, not seeing oneself at risk, mental preoccupation and wrong diagnosis by physicians. Conclusions: This study suggests that women and even physicians need further information about breast cancer symptoms. Women need encouragement to seek medical advice when they encounter suspicious symptoms. Additionally, women may benefit from awareness of the pros of early detection and reassurance about the improvements in the success of breast cancer treatment.
Epidemiological Pattern of Breast Cancer in Iranian Women: Is there an Ethnic Disparity?
Taheri, Neger Sadat;Nosrat, Sepideh Bakhshandeh;Aarabi, Mohsen;Tabiei, Mohammad Naeimi;Kashani, Elham;Rajaei, Siamak;Besharat, Sima;Semnani, Shahryar;Roshandel, Gholamreza 4517
Introduction: Northeastern Iran is known as a high risk area of upper gastrointestinal cancers. Recent reports have suggested a declining trend for these cancers as well as an increase in the incidence of other malignancies including breast cancer. Our present aim was to describe the epidemiological pattern of breast cancer in this region during 2004-2009. Methods: All new cancer cases from public and private diagnostic and therapeutic centers of Golestan province were registered. A structured questionnaire was prepared and used based on the standerds of the International Association of Cancer Registries. The international classification of diseases for oncology was considered for coding. Age standardized incidence rates (ASR) of breast cancer were calculated. Results: A total of 11,038 new cancer cases were registered during 2004-2009, of which, 1,101 (10%) were females with breast cancer. The median age of the breast cancer patients was 46 years. The ASR for breast cancer was 28 per 100,000 person-years. We found an unusual rapid increase in breast cancer rate at the age of 25 years. The ASR of breast cancer was significantly lower in females from Turkmen ethnicity and those from rural areas(P value <0.01). Conclusion: Our study showed high rate of breast cancer in Golestan province of Iran. We found an unusual peak of breast cancer in young women. So, the age of starting screening programs may need to be revised in this area. The rate of breast cancer was significantly lower in women from Turkmen ethnicity. Further studies are warranted to clarify the role of important determinants, especially regarding the ethnic disparity, on breast cancer in this region.
Improved Accuracy of Cytodiagnosis using the Kato Self-Collection Devise: the Usefulness of Smear Preparation in Liquid-based Cytology Methods
Okayama, Kaori;Okodo, Mitsuaki;Fujii, Masahiko;Kumagai, Tomoko;Yabusaki, Hiromi;Shiina, Yoshio;Iwami, Fumihiro;Teruya, Koji;Hatta, Kenmei 4521
Object: In the present study, we compared the positive cytodiagnostic test rates with discrepancies using self-collection devices for cervical cancer screening. We made this survey to examine whether or not our self-smear preparation method using the Kato self-collection device contributed to an improved rate of detecting atypical cells compared with existing recommended preparation methods. Methods: Specimens were collected at 14 facilities handling self-collection methods, and samples were collected by a physician in 2 facilities. The chisquared test was performed using the SPSS ver. 20 statistical software to determine the relationships between the positive cytodiagnostic rate, specimen preparation methods, and self-collection devices. Results: Collecting cells using the Kato self-collection device and preparing liquid-based specimens, we obtained a significantly higher rate of positive cytodiagnosis and our results were equal to those obtained with the direct method. Conclusions: Taking into consideration increased needs for screening using the self-collection method in future, with even more improved test accuracy, a screening test that is acceptable to society needs to be established.
Ovarian Metastasis and other Ovarian Neoplasms in Women with Cervical Cancer Stage IA-IIA
Ngamcherttakul, Vijit;Ruengkhachorn, Irene 4525
Objectives: To determine the prevalence and predicting factors of ovarian metastasis, and evaluate the histology of other ovarian neoplasms in women with early-stage cervical cancer. Methods: The medical records of women with cervical cancer stage IA-IIA who underwent primary surgical treatment at Siriraj Hospital, Mahidol University from January 2007 to December 2011 were used for the study. Demographic, clinical and histopathologic data of the women who underwent salpingo-oophorectomy were reviewed. Results: Of 264 women, the mean age was 52.3 years. The types of hysterectomy procedures were composed of 210 radical hysterectomy, 9 modified radical hysterectomy, 40 simple hysterectomy, and 5 abandoned hysterectomy. The prevalence of ovarian metastasis was 0.76% (2/264). All of ovarian metastatic patients were older than 60 years old, postmenopause, and had macroscopical stage IB1 cervical cancer. Others ovarian tumors were found in 7 patients including 1 synchronous ovarian carcinoma, 1 serous cystadenoma, 1 fibroma, and 4 teratoma. Conclusions: In cases of early-stage cervical carcinoma of the population studied, ovarian preservation could be another option in <60-year-old patients, with non-neuroendocrine cell type, stage IA, and no extracervical or ovarian lesions.
Intervention Effects of Nedaplatin and Cisplatin on Proliferation and Apoptosis of Human Tumour Cells in Vitro
Su, Xiang-Yu;Yin, Hai-Tao;Li, Su-Yi;Huang, Xin-En;Tan, Hua-Yang;Dai, Hong-Yu;Shi, Fang-Fang 4531
Objective: To study synergistic effects of nedaplatin and cisplatin on three human carcinoma cell lines (esophageal carcinoma cell line Eca-109, ovarian carcinoma Skov-3 and cervical carcinoma Hela). Methods: Inhibition effects were evaluated by MTT assay and cell apoptosis was detected by flow cytometry. In addition, changes of Ki-67, Bax and Bcl-2 at mRNA and protein levels were quantified by RT-PCR and Western blotting. Results: Growth inhibition in each cell lines was dose-dependent after exposure to nedaplatin or cisplatin alone. The interaction of the two drugs was synergistic at higher concentrations according to the median-effect principle. The inhibition rates with nedaplatin, cisplatin and combined treatment were $41.9{\pm}4.1%$, $47.4{\pm}2.9%$, $52.5{\pm}0.9%$(Eca-109), $39.0{\pm}1.26%$, $45.0{\pm}1.45%$, $56.2{\pm}1.44%$ (Skov-3) and $44.8{\pm}2.11%$, $46.9{\pm}0.99%$, $56.6{\pm}1.83%$ (Hela) respectively, with increase in apoptosis. Compared with the nedaplatin or cisplatin alone treatment group, the combinative treatment group's Ki-67 and bcl-2 mRNA (protein) expression was decreased while that of Bax mRNA (protein) was increased. Conclusion: Compared to the effects of nedaplatin or cisplatin alone at high concentrations, combination of nedaplatin and cisplatin at low concentrations proved to be much more effective for inhibition of proliferation and the induction of apoptosis in the Eca-109, Skov-3 and Hela cell lines.
Role of Endoscopic Ultrasound in Evaluation of Pancreatic Neuroendocrine Tumors - Report of 22 Cases from a Tertiary Center in Iran
Haghighi, Shirin;Molaei, Mahsa;Foroughi, Forough;Foroutan, Mojgan;Dabiri, Reza;Habibi, Effat;Alizadeh, Amir Houshang Mohammad 4537
Background: The pancreatic neuroendocrine tumor (pNET) is relatively rare and generally felt to follow an indolent course. EUS has an important role in detection of pNET. This is a review of clinical and radiological presentation and pathologic reports of 22 patients with pNET. Patients and methods: In this study we analyzed clinical and radiological presentations and pathologic reports of all relevant cases who were referred to Taleghani hospital for 3 years since 2008. Results: A total of 22 patients 28-74 years old (mean=49) were enrolled between 2008 and 2011. Among the total, 13 (59%) were male, 9 (41%) were female and 16 (72.7%) had functional tumors. The results of CT were negative in 12 (54%) cases but EUS was capable of detecting the lesions in these patients, cysts being found in 4 (19%) patients. Conclusion: EUS is a highly sensitive procedure for the localization of functional pNETs and especially insulinomas. Nonfunctional tumors were detected in more advanced and late stages and cystic lesions were more common in this group.
Elevated Serum Haptoglobin is Associated with Clinical Outcome in Triple-Negative Breast Cancer Patients
Tabassum, Umaira;Reddy, Obula;Mukherjee, Geetashree 4541
Background: Breast cancer is the most common malignancy with the highest incidence rates among women worldwide. Triple-negative breast cancer (TNBC) disease is diagnosed more frequently in younger women, and is associated with a poor prognosis. Elevated levels of serum haptoglobin protein (Hp) are observed in many malignant diseases including breast cancer. We evaluated the expression and prognostic value of Hp among patients with TNBC. Materials and Methods: Serum Hp levels were determined by Elisa in 41 patients with TNBC and 10 normal individuals. Hp status was correlated with other clinico-pathological parameters including patient survival. Results: Of the 41 patients with TNBC, Hp over expression was detected in 24 (59%) by Elisa. Hp up-regulation was confirmed by Elisa based quantification in the serum of 41 TNBC patients against lower grades and 10 normal individuals. Survival analysis revealed that Hp ($p=2.016{\times}10^{-5}$), stage ($p=2.166{\times}10^{-5}$), distant metastasis ($p=2.217{\times}10^{-5}$), tumor size ($p=1.053{\times}10^{-5}$), and tumor grade (p=0.001), correlated with patient survival on univariate analysis. Multivariate analysis revealed that Hp (p=0.001), and grade of the disease (p=0.008) were independent predictors of survival. Conclusion: Our results indicate that serum levels of Hp may play a role as a potential serum biomarker and prognostic indicator among TNBC patients. Thus, Hp may present a new promising prognostic biomarker in TNBC patients, but independent validations are now necessary for confirmation.
Serum Level of MMP-3 in Patients with Oral Squamous Cell Carcinoma - Lack of Association with Clinico-pathological Features
Tadbir, Azadeh Andisheh;Purshahidi, Sara;Ebrahimi, Hooman;Khademi, Bijan;Malekzadeh, Mahzad;Mardani, Maryam;Taghva, Masumeh;Sardari, Yasaman 4545
Background: MMP-3 is a proteolytic enzyme of the matrix metalloproteinase family. Protein degradation which is their fundamental action regulates different activities of tumor cell such as their growth, differentiation, apoptosis, migration, invasion, angiogenesis as well as their resistance to the immune system. Aim: The aim of this study was to determine MMP-3 serum levels in patients with OSCC and investigate if they correlate with clinicopathological features. Method and materials: Using an ELISA kit, we assessed and compared the circulating levels of MMP-3 in blood serum of 45 oral squamous cell carcinoma patients with 45 healthy control samples. Results: The serum MMP-3 level in OSCC patients was significantly higher ($9.45{\pm}4.6$ ng/ml) than healthy controls ($5.9{\pm}3.6$ ng/ml, p<0.001), especially in females and in older patients. However, there was no apparent correlation in serum MMP-3 concentration with the clinico-pathological features such as tumor location, stage, tumor size, nodal status, distant metastasis, histological grade and smoking. Discussion: This result suggests that the measurement of serum MMP-3 concentration might be helpful to diagnose OSCC but not to predict prognosis.
Impact of CYP2D6 Polymorphisms on Tamoxifen Responses of Women with Breast Cancer: A Microarray-based Study in Thailand
Sukasem, Chonlaphat;Sirachainan, Ekaphop;Chamnanphon, Montri;Pechatanan, Khunthong;Sirisinha, Thitiya;Ativitavas, Touch;Panvichian, Ravat;Ratanatharathorn, Vorachai;Trachu, Narumol;Chantratita, Wasun 4549
This study was designed to investigate the frequency of CYP2D6 polymorphisms and evaluate the association between genetic polymorphisms of CYP2D6 and tamoxifen therapeutic outcome in Thai breast cancer patients. We recruited 48 breast cancer patients who received adjuvant tamoxifen for evaluating CYP2D6 genetic polymorphisms using microarray-based technology. Associations between genotypes-phenotypes and disease free survival were analyzed. Median follow up time was 5.6 years. The mean age of the subjects was 50 years. The 3 common allelic frequencies were 43.8% ($^*10$), 36.5 ($^*1$) and 10.4% ($^*2$) which are related to extensive metabolizer (EM) and intermediate metabolizer (IM) with 70.8% and 29.2 %, respectively. No association between CYP2D6 genotypes and DFS was demonstrated. Nevertheless, exploratory analysis showed statistically significant shorter DFS in the IM group of post-menopause patients (HR, 6.85; 95%CI, 1.48-31.69; P=0.005). Furthermore, we observed statistically significant shorter DFS of homozygous $CYP2D6^*10$ when compared with heterozygous CYP2D6*10 and other genotypes (P=0.005). $CYP2D6^*10$ was the most common genotype in our subjects. Post-menopause patients with homozygous $CYP2D6^*10$ and IM have shorter DFS. To confirm this relationship, larger samples and comprehensively designed trials in Thailand are required.
Oleuropein Induces Anti-metastatic Effects in Breast Cancer
Hassan, Zeinab K.;Elamin, Maha H.;Daghestani, Maha H.;Omer, Sawsan A.;Al-Olayan, Ebtesam M.;Elobeid, Mai A.;Virk, Promy;Mohammed, Osama B. 4555
Breast cancer causes death due to distant metastases in which tumor cells produce matrix metalloproteinase (MMP) enzymes which facilitate invasion. Oleuropein, the main olive oil polyphenol, has anti-proliferative effects. This study aimed to investigate the effect of oleuropein on the metastatic and anti-metastatic gene expression in the MDA human breast cancer cell line. We evaluated the MMPs and TIMPs gene expression by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) in treated and untreated cells. This study demonstrated that OL may induce anti-metastatic effects on human breast cancer cells. We found that TIMP1,-3, and -4 were over-expressed after all periods of incubation in treated cancer cells compared to untreated cells, while MMP2 and MMP9 genes were down-regulated, at least initially. Treatment of breast cancer cells with oleuropein could help in prevention of cancer metastasis by increasing the TIMPs and suppressing the MMPs gene expressions.
Psychological Treatment for Pain Among Cancer Patients by Rational-Emotive Behavior Therapy - Efficacy in both India and Iran
Mahigir, Foroogh;Khanehkeshi, Ali;Karimi, Ayatollah 4561
The aim of the present study is to find out the influence of rational-emotive behavior therapy (REBT) on pain intensity among cancer patients in India and Iran. The study followed a quasi-experimental, pre-post test, carried out with a sample of 88 cancer patients, aged 21-52 years, referred to the Baharat cancer hospital of Mysore in India and Shahidzade hospital of Behbahan in Iran. They were randomly assigned to the experimental (n=India 21; Iran 22) and control (n=India 22; Iran 23) groups. Pain was measured with the McGill Pain Questionnaire-MPQ (1975), the intervention by REBT has given to the experimental group for 45 days (ten sessions) and at the end of intervention, the pain of patients was again evaluated. Concerning to hypothesis of the study, two independent sample T test and three ways mixed ANOVA is used to analyze the data. Results showed that the experimental group in post test had less pain than the control group, but there were no statistically significant differences between Indian and Iranian patients in pain perception. With respect the outcome of study, it has realized that REBT can be used in hospitals and other psychological clinics to reduce the pain of cancer patients.
Clinicopathologic Importance of Women with Squamous Cell Carcinoma Cytology on Siriraj Liquid-Based Cervical Cytology
Ruengkhachorn, Irene;Laiwejpithaya, Somsak;Leelaphatanadit, Chairat;Chaopotong, Pattama 4567
Objectives: The purposes of this study were to determine the prevalence and predictive value to detect significant neoplasia and invasive lesions, and to evaluate the correlation between clinical and histopathology of women with squamous cell carcinoma (SCCA) on Siriraj liquid-based cervical cytology (Siriraj-LBC). Methods: The computerized database of women who underwent Siriraj-LBC at Siriraj Hospital, Mahidol University from January 2007 to December 2010 were retrieved. The hospital records of women with SCCA cytology were reviewed. Results: The prevalence of SCCA cytology was 0.07%. A total of 86 women, mean age was 58.1 years. Sixty-one women (70.9%) were post-menopausal. Overall significant pathology and invasive gynecologic cancer were detected in 84 women (97.7%) and 71 women (82.5%), respectively. The positive predictive values for detection of significant neoplasia and invasive lesion were 97.7% and 82.6%, respectively. The cervical cancer was diagnosed in 69 women and among these 58 women were SCCA. Thirteen women (15.1%) had cervical intraepithelial neoplasia (CIN) 3 and two women (2.3%) had cervicitis. The sensitivity and specificity of colposcopy for cervical cancer detection in SCCA cytology were 83.3% and 75%, respectively. Median follow up period was 17.6 months and 64 patients were alive without cytologic abnormality. Conclusions: The final histopathology of SCCA cytology in our populations demonstrated a wide variety, from cervicitis to invasive cancer and the most common diagnosis was invasive cervical cancer. Colposcopy with biopsy and/or endocervical curettage and loop electrosurgical excision procedure should be undertaken to achieve histologic diagnosis.
Clinicopathological Features in Bilateral Breast Cancer
Baykara, Meltem;Ozturk, Selcuk Cemil;Buyukberber, Suleyman;Helvaci, Kaan;Ozdemir, Nuriye;Alkis, Necati;Berk, Veli;Koca, Dogan;Coskun, Ugur;Oksuzoglu, Berna;Uncu, Dogan;Arpaci, Erkan;Ustaalioglu, Basak Oven;Demirci, Umut;Kucukoner, Mehmet;Dogu, Gamze Gokoz;Alici, Suleyman;Akman, Tulay;Ozkan, Metin;Aslan, Ulku Yalcintas;Durnali, Ayse Gok;Benekli, Mustafa 4571
Introduction and Purpose: The frequency of bilateral breast cancer is 1.4-11.0% among all breast cancers. It can present as synchronous (SC) or metachronous (MC). Data regarding clinical course of bilateral breast cancer are scarce. In this study, we therefore evaluated demographic, pathological and clinical characteristics, treatments and responses in bilateral breast cancer cases; making distinctions between metachronous-synchronous and comparing with historic one-sided data for the same parameters. Materials and Methods: One hundred fifty bilateral breast cancer cases from ten different centers between 2000 and 2011 were retrospectively scanned. Age of the cases, family history, menopausal status, pathological features, pathological stages, neoadjuvant, surgery, adjuvant and palliative chemotherapy/radiotherapy were examined in the context of the first and second occurrence and discussed with reference to the literature. Results: Metachronous and synchronous groups showed similar age, menopausal status, tumor type, HER2/neu expression; the family history tumor grade, tumor stage, ER-negativity rate, local and distant metastases rates, surgery, adjuvant chemotherapy application rates were identified as significantly different. Palliative chemotherapy response rate was greater in the metachronous group but median PFS rates did not differ between the groups. Conclusion: Although bilateral breast cancer is not frequent, MC breast cancer is different from SC breast cancer by having more advanced grade, stage, less ER expression, more frequent rates of local relapse and distant metastasis and better response to chemotherapy in case of relapse/metastasis.
Prostate Cancer in Younger and Older Patients: Do We Treat Them Differently?
Situmorang, Gerhard Reinaldi;Umbas, Rainy;Mochtar, Chaidir A.;Santoso, Rachmat Budi 4577
Diagnostic and therapeutic strategies of prostate cancer may largely influenced by patients' age at presentation. This study is aimed to evaluate the characteristics, diagnostic and treatment strategies in prostate cancer patients in our centres. A cross-sectional analytic study of prostate cancer data in two main referral cancer centres, Cipto Mangunkusumo General Hospital and Dharmais National Cancer Centre from 1995-2010, was therefore performed. Patients were divided into 2 sub-populations; below 60 years (younger patients) and 75 years old and above (older patients). PSA levels, diagnostic modalities, Gleason score and therapeutic options were analysed for both and compared using bivariate analysis. 152 patients were <60 years and 210 were ${\geq}75$ years. There was no statistical difference in mean PSA level (797.9ng/mL vs 345.3 ng/mL, respectively; p>0.05) and diagnosis was made by biopsy in majority of patients in both groups (68.2% and 71.6% in younger and older groups respectively). Most presented with an advanced disease stage (65.1% and 66.0%, respectively) and there was no statistically significant difference in mean Gleason scores f (8.1 vs 7.7; p>0.05). Primary androgen deprivation therapy (PADT) was the main treatment for overall patients (48.0% and 50.7%, respectively). Radiotherapy and radical prostatectomy are the main therapeutic modalities for younger patients with local and locally advanced disease (39.6% and 35.4% respectively), while the majority of older patients with the same disease stage were treated with radiotherapy and PADT (45.8% and 39.0% respectively). Differences observed in treatment modalities were statistically significant (p<0.0003). We conclude that there is no difference in disease clinical aggressiveness of the two groups but significant differences were observed in therapeutic strategies utilised with younger and older patients.
Molecular Characterization of FLT3 Mutations in Acute Leukemia Patients
Ishfaq, Mariam;Malik, Arif;Faiz, Mariam;Sheikh, Ishfaq Ahmad;Asif, Muhammad;Khan, Muhammad Nasrullah;Qureshi, Muhammad Saeed;Zahid, Sara;Manan, Abdul;Arooj, Mahwish;Qazi, Mahmood Husain;Chaudhary, Adeel;Alqahtani, Mohammed Hussain;Rasool, Mahmood 4581
Fms-like tyrosine kinase 3 (FLT3) performs a vital role in the pathogenesis of hematopoietic malignancies. Therefore in recent times, the focus of several studies was on use of FLT3 as a prognostic marker. The present study investigated the molecular characterization and incidence of FLT3 mutations in acute leukemia patients in Pakistan. A total of 55 patients were studied, of which 25 were suffering from acute lymphoblastic leukemia (ALL) and 30 were suffering from acute myeloid leukemia (AML). The polymerase chain reaction demonstrated FLT3/ITD mutations in 1 (4%) of 25 ALL patients, a male with the L2 subtype. In AML cases the rate was 4 (13.3%) of 30, three males and one female. The AML-M4 subtype was found in three and the AML M2 subtype in the other. In the AML cases, a statistically significant (p=0.009) relationship was found between WBC (109/L) and FLT3/ITD positivity. However, no significant relationship was found with other clinical parameters (p>0.05). In acute myeloid leukemia (AML) $FLT3/ITD^+$ mutation was more prevalent in elderly patients 31-40 age groups, 21-30 and 51-60 age groups respectively. In acute lymphoblastic leukemia (ALL) statistically no significant relationship was found between clinical features and FLT3/ITD positivity (p>0.05). However, in acute lymphoblastic leukemia (ALL) $FLT3/ITD^+$ mutation was more commonly found in age groups of 21-30.
Poor Treatment Outcome of Neuroblastoma and Other Peripheral Nerve Cell Tumors May be Related to Under Usage of Radiotherapy and Socio-Economic Disparity: A US SEER Data Analysis
Cheung, Rex 4587
Purpose: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) neuroblastoma (NB) and other peripheral nerve cell tumors (PNCT) outcome data. This study found under usage of radiotherapy in these patients. Materials and methods: This study analyzed socio-economic, staging and treatment factors available in the SEER database for NB and other PNCT. For the risk modeling, each factor was fitted by a generalized linear model to predict the outcome (soft tissue specific death, yes/no). The area under the receiver operating characteristic curve (ROC) was computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate the modeling errors. Risk of neuroendocrine (other endocrine including thymus as coded in SEER) death was computed for the predictors. Results: There were 5261 patients diagnosed from 1973 to 2009 were included in this study. The mean follow up time (S.D.) was 83.8 (97.6) months. The mean (SD) age was 18 (25) years. About 30.45% of patients were un-staged. The SEER staging has high ROC (SD) area of 0.58 (0.01) among the factors tested. We simplified the 4-layered risk levels (local, regional, distant, un-staged/others) to a simpler 3-tiered model with comparable ROC area of 0.59 (0.01). Less than 50% of PNCT patients received radiotherapy (RT) including the ones with localized disease. This avoidance of RT use occurred in adults and children. Conclusion: The high under-staging rate may have precented patients from selecting definitive radiotherapy (RT) after surgery. Using RT for, especially, adult PNCT patients is a potential way to improve outcome.
Comparison of Teaching about Breast Cancer via Mobile or Traditional Learning Methods in Gynecology Residents
Alipour, Sadaf;Moini, Ashraf;Jafari-Adli, Shahrzad;Gharaie, Nooshin;Mansouri, Khorshid 4593
Introduction: Mobile learning enables users to interact with educational resources while in variable locations. Medical students in residency positions need to assimilate considerable knowledge besides their practical training and we therefore aimed to evaluate the impact of using short message service via cell phone as a learning tool in residents of Obstetrics and Gynecology in our hospital. Methods: We sent short messages including data about breast cancer to the cell phones of 25 residents of gynecology and obstetrics and asked them to study a well-designed booklet containing another set of information about the disease in the same period. The rate of learning derived from the two methods was compared by pre- and post-tests and self-satisfaction assessed by a relevant questionnaire at the end of the program. Results: The mobile learning method had a significantly better effect on learning and created more interest in the subject. Conclusion: Learning via receiving SMS can be an effective and appealing method of knowledge acquisition in higher levels of education.
Cytotoxicity, Toxicity, and Anticancer Activity of Zingiber Officinale Roscoe Against Cholangiocarcinoma
Plengsuriyakarn, Tullayakorn;Viyanant, Vithoon;Eursitthichai, Veerachai;Tesana, Smarn;Chaijaroenkul, Wanna;Itharat, Arunporn;Na-Bangchang, Kesara 4597
Cholangiocarcinoma (CCA) is an uncommon adenocarcinoma which arises from the epithelial cells of the bile ducts. The aim of the study was to investigate the cytotoxicity, toxicity, and anticancer activity of a crude ethanolic extract of ginger (Zingiber officinale Roscoe) against CCA. Cytotoxic activity against a CCA cell line (CL-6) was assessed by calcein-AM and Hoechst 33342 assays and anti-oxidant activity was evaluated using the DPPH assay. Investigation of apoptotic activity was performed by DNA fragmentation assay and induction of genes that may be involved in the resistance of CCA to anticancer drugs (MDR1, MRP1, MRP2, and MRP3) was examined by real-time PCR. To investigate anti-CCA activity in vivo, a total of 80 OV and nitrosamine (OV/DMN)-induced CCA hamsters were fed with the ginger extract at doses of 1000, 3000, and 5000 mg/kg body weight daily or every alternate day for 30 days. Control groups consisting of 10 hamsters for each group were fed with 5-fluorouracil (positive control) or distilled water (untreated control). Median $IC_{50}$ (concentration that inhibits cell growth by 50%) values for cytotoxicity and anti-oxidant activities of the crude ethanolic extract of ginger were 10.95, 53.15, and $27.86{\mu}g/ml$, respectively. More than ten DNA fragments were visualized and up to 7-9 fold up-regulation of MDR1 and MRP3 genes was observed following exposure to the ethanolic extract of ginger. Acute and subacute toxicity tests indicated absence of any significant toxicity at the maximum dose of 5,000 mg/kg body weight given by intragastric gavage. The survival time and survival rate of the CCA-bearing hamsters were significantly prolonged compared to the control group (median of 54 vs 17 weeks). Results from these in vitro and in vivo studies thus indicate promising anticancer activity of the crude ethanolic extract of ginger against CCA with the absence of any significant toxicity. Moreover, MDR1 and MRP3 may be involved in conferring resistance of CCA to the ginger extract.
Weighted Gene Co-expression Network Analysis in Identification of Endometrial Cancer Prognosis Markers
Zhu, Xiao-Lu;Ai, Zhi-Hong;Wang, Juan;Xu, Yan-Li;Teng, Yin-Cheng 4607
Objective: Endometrial cancer (EC) is the most common gynecologic malignancy. Identification of potential biomarkers of EC would be helpful for the detection and monitoring of malignancy, improving clinical outcomes. Methods: The Weighted Gene Co-expression Network Analysis method was used to identify prognostic markers for EC in this study. Moreover, underlying molecular mechanisms were characterized by KEGG pathway enrichment and transcriptional regulation analyses. Results: Seven gene co-expression modules were obtained, but only the turquoise module was positively related with EC stage. Among the genes in the turquoise module, COL5A2 (collagen, type V, alpha 2) could be regulated by PBX (pre-B-cell leukemia homeobox 1)1/2 and HOXB1(homeobox B1) transcription factors to be involved in the focal adhesion pathway; CENP-E (centromere protein E, 312kDa) by E2F4 (E2F transcription factor 4, p107/p130-binding); MYCN (v-myc myelocytomatosis viral related oncogene, neuroblastoma derived [avian]) by PAX5 (paired box 5); and BCL-2 (B-cell CLL/lymphoma 2) and IGFBP-6 (insulin-like growth factor binding protein 6) by GLI1. They were predicted to be associated with EC progression via Hedgehog signaling and other cancer related-pathways. Conclusions: These data on transcriptional regulation may provide a better understanding of molecular mechanisms and clues to potential therapeutic targets in the treatment of EC.
Analysis of Esophageal Cancer Time Trends in China, 1989-2008
Zhao, Jun;He, Yu-Tong;Zheng, Rong-Shou;Zhang, Si-Wei;Chen, Wan-Qing 4613
National cancer incidence data were utilized to analyze trends in esophageal cancer incidence in China in order to provide basic information for making cancer control strategy. We retrieved and re-sorted valid esophageal cancer incidence data from National Central Cancer Registry Database over 20 years period from 1989 to 2008. Crude incidence and age-standardized incidence rates were calculated for analysis, with annual percent change estimated by Joinpoint software for long term trend analysis. The crude incidence rate of esophageal cancer was found to have remained relatively stable in both urban and rural areas over the 20 year period. Age standardized incidence rate (ASR) in cancer registration areas decreased from 39.5/100,000 in 1989 to 23.0/100,000 in 2008 in all areas (AAPC=-3.3%, 95% CI:-2.8~-3.7). The trend was no change in urban areas and 2.1% average annual decrease observed in rural aras. Before the year of 2000, esophageal cancer incidence rates significant decreased with 2.8% annually and then the rates kept stable. Over 20 years from 1989 to 2008, esophageal cancer age standardized incidence rate in cancer registration areas decreased with time. However, esophageal cancer is still a big issue and efforts for control should be continuously enhanced. Cancer registration is playing an important role in cancer control with the number of registries increasing and data quality improving in China.
Is Level V Dissection Necessary for Low-risk Patients with Papillary Thyroid Cancer Metastasis in Lateral Neck Levels II, III, and IV
Yu, Wen-Bin;Tao, Song-Yun;Zhang, Nai-Song 4619
Whether it is beneficial to dissect level V in papillary thyroid cancer (PTC) patients with positive lateral neck lymph nodes at levels II-IV is still controversial, especially for low risk cases. In this study, we reviewed the medical records of 47 patients who underwent 47 ipsilateral selective lateral neck dissections (levels II-IV) for previously untreated papillary thyroid carcinomas between October 2006 and October 2008 to assist in establishing the optimal strategy for lateral neck dissection in low risk PTC patients with clinically negative level V nodes. All 47 patients were confirmed to have positive lymph nodes pathologically. Seventeen (36.12%), 36 (76.6%), and 34 (72.34%) patients had positive lymph nodes in levels II, III, and IV, respectively. The mean number of pathologically positive lymph nodes was 1.7 in level II, 2.9 in level III, 2.8 in level IV. No death and distant metastasis were recorded during follow up period. Just 2 patients exhibited recurrence to lymph nodes, and only one showed nodal recurrence in ipsilateral level V, who had positive lymph nodes in all of levels II, III, and IV at initial neck surgery. In conclusion, for PTC low risk patients with clinically negative lymph nodes in level V, non-performance of level V dissection would still achieve good survival results as traditional modified radical neck dissection, with a "wait and see" strategy to be recommended.
Risk of Treatment Related Death and Febrile Neutropaenia with Taxane-Based Adjuvant Chemotherapy for Breast Cancer in a Middle Income Country Outside a Clinical Trial Setting
Phua, Chee Ee;Bustam, Anita Zarina;Yusof, Mastura Md.;Saad, Marniza;Yip, Cheng-Har;Taib, Nor Aishah;Ng, Char Hong;Teh, Yew Ching 4623
Background: The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxane-based chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years. This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC). Patients and Methods: Patients who were treated with adjuvant taxane-based chemotherapy for early breast cancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry. The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as death occurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment. FN was defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$. Results: A total of 622 patients received adjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4 taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimen employed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there was no TRD. Conclusion: Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.
MTHFR Gene Polymorphisms are Not Involved in Pancreatic Cancer Risk: A Meta-analysis
Tu, Yu-Liang;Wang, Shi-Bin;Tan, Xiang-Long 4627
Purpose: Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms have been reported to be associated with pancreatic cancer, but the published studies have yielded inconsistent results. This study assessed the relationship between MTHFR gene polymorphisms and the risk for pancreatic cancer using a meta-analysis approach. Methods:A search of Google scholar, PubMed, Cochrane Library and CNKI databases before April 2012 was performed, and then associations of the MTHFR polymorphisms with pancreatic cancer risk were summarized. The association was assessed by odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias was also calculated. Results: Four relative studies on MTHFR gene polymorphisms (C667T and A1298C) were included in this meta-analysis. Overall, C667T (TT vs. CC:OR=1.61,95%CI=0.78-3.34; TT vs. CT: OR=1.41,95%CI=0.88-2.25; Dominant model:OR=0.68,95%CI=0.40-1.17; Recessive model: OR=0.82,95%CI=0.52-1.30) and A1298C (CC vs. AA:OR=1.01,95%CI=0.47-2.17; CC vs. AC: OR=0.99,95%CI=0.46-2.14; Dominant model:OR=1.01, 95%CI=0.47-2.20; Recessive model: OR=1.01,95%CI=0.80-1.26) did not increase pancreatic cancer risk. Conclusions: This meta-analysis indicated that MTHFR polymorphisms (C667T and A1298C) are not associated with pancreatic cancer risk.
Tobacco Control Law Enforcement and Compliance in Odisha, India - Implications for Tobacco Control Policy and Practice
Panda, Bhuputra;Rout, Anita;Pati, Sanghamitra;Chauhan, Abhimanyu Singh;Tripathy, Asima;Shrivastava, Radhika;Bassi, Abhinav 4631
Introduction: Tobacco use is a leading cause of deaths and disabilities in India, killing about 1.2 lakh people in 2010. About 29% of adults use tobacco on a daily basis and an additional 5% use it occasionally. In Odisha, non-smoking forms are more prevalent than smoking forms. The habit has very high opportunity cost as it reduces the capacity to seek better nutrition, medical care and education. In line with the WHO Framework Convention on Tobacco Control (FCTC), the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indian national law on tobacco control. The Government of Odisha has shown its commitment towards enforcement and compliance of COTPA provisions. In order to gauge the perceptions and practices related to tobacco control efforts and level of enforcement of COTPA in the State, this cross-sectional study was carried out in seven selected districts. Materials and methods: A semi-structured interview schedule was developed, translated into Odiya and field-tested for data collection. It mainly contained questions related to knowledge on provisions of section 4-7 of COTPA 2003, perception about smoking, chewing tobacco and practices with respect to compliance of selected provisions of the Act. 1414 samples were interviewed. Results: The highest percentage of respondents was from the government departments. 73% of the illiterates consumed tobacco as compared to 34% post graduates. 52.1% of the respondents were aware of Indian tobacco control laws, while 80.8% had knowledge about the provision of the law prohibiting smoking in public places. However, 36.6% of the respondents reported that they had 'very often' seen tobacco products being sold 'to a minor', while 31.2% had seen tobacco products being sold 'by a minor'. In addition, 24.8% had 'very often' seen tobacco products being sold within a radius of 100 yards of educational institutions.
Lung Cancer in Malabar Cancer Center in Kerala - A Descriptive Analysis
Bhaskarapillai, Binukumar;Kumar, Saina Sunil;Balasubramanian, Satheesan 4639
The burden of lung cancer in terms of mortality is the highest among all types of cancers globally. The present study aimed to evaluate lifestyle related habits, clinico-pathological profile and treatment details of lung cancer patients who were registered at Malabar Cancer Centre (MCC), Kerala, during the calendar year 2010. A retrospective evaluation was made from medical records to gather data from 281 registered lung cancer cases in 241 males and 40 females, with a male to female ratio of 6.03: 1. Approximately 89% of the cases were above 50 years of age. Among males about 91% of the cases were smokers and 62% of them had a chronic smoking habit. Adenocarcinomas, squamous cell carcinomas, non-small cell carcinomas and small cell cancers accounted for 10.7, 13.9, 17.0 and 5.7% respectively. Out of 281 cases around 67% were diagnosed with distant metastasis and the remainder had regional lymph node involvement. However, no statistically significant difference was observed for secondary site of tumor according to gender. As majority of the cases reported at MCC were in an advanced stage of the disease, histology of the secondary site from supraclavicular lymph nodes or liver was taken for diagnosis. Initiation of population based screening for early detection of cancer, and primary and secondary prevention strategies for reducing the prevalence of tobacco consumption are high priorities to reduce the lung cancer burden in Kerala.
Metaplastic Breast Carcinoma: Case Series and Review of the Literature
Esbah, Onur;Turkoz, Fatma P.;Turker, Ibrahim;Durnali, Ayse;Ekinci, Ahmet S.;Bal, Oznur;Sonmez, Ozlem Uysal;Budakoglu, Burcin;Arslan, Ulku Y.;Oksuzoglu, Berna 4645
Metaplastic breast carcinoma (MpBC) is a rare disease entity, accounting for less than 1% of all breast carcinomas. Furthermore, it is a heterogenous disease with different subgroups, including malignant epithelial (carcinoma) and stromal (sarcoma) features. Here we evaluated, retrospectively, 14 female MpBC patients admitted to Ankara Oncology Training and Research Hospital between 2005 and 2011. Median age was 45.5 (range:16.0-76.0) and tumor size 57.5 mm (range: 20.0-80.0 mm). Histopathological subtypes were as follows: 5 carcinosarcoma, 5 squamous and 4 adenosquamous carcinoma. All but one with upfront lung metastasis, had their primary breast tumor operated. Axillary lymph nodes were involved in 64.3%. The most common sites of metastasis were lungs and brain. Chemotherapy including antracycline, taxane and even platinium was planned for adjuvant, neoadjuvant and palliative purposes in 9, 3 and 1 patient, respectively. Median cycles of chemotherapy was 6 (range:4-8). Median follow-up of the patients was 52 months (95%CI 10.4-93.6 month). Median 3 year progression free survival (PFS) and overall survival (OS) in this patients cohort were 33% and 56%, respectively. In conclusion, MpBC is a rare and orphan disease without standardized treatment approaches and the prognosis is poor so that larger studies to investigate different treatment schedules are urgently needed.
Does the Success of a School-based HPV Vaccine Programme Depend on Teachers' Knowledge and Religion? - a Survey in a Multicultural Society
Woo, Yin Ling;Razali, Sharina Mohd;Chong, Kuoh Ren;Omar, Siti Zawiah 4651
Organized introduction of prophylactic human papillomavirus (HPV) vaccination can reduce the burden of cervical cancer in developing countries. One of the most effective ways is through a national school-based program. Information on teachers is therefore important since this group may have a disproportionate influence in the success of any implementation. Objective: To assess teachers' knowledge and perception of HPV, cervical cancer and HPV vaccine prior to commencing a school-based HPV vaccination program in a multiethnic, predominantly Muslim country. Factors associated with acceptability of the vaccine were identified. Method: A bilingual questionnaire was applied to 1,500 secondary school teachers from 20 urban schools in Malaysia. Data collected were analyzed using SPSS version 17. Results: 1,166 questionnaires were returned. From this group, 46.1% had never heard of HPV while 50.9% had never had a pap smear. However, 73.8% have heard of the HPV vaccine with 75% agreeing to have it. 96% considered themselves religious with 79.8% agreeing to have the vaccine. Conclusions: A national school-based HPV immunization program can be implemented effectively in a multiethnic, cultural and religious country despite limited knowledge of HPV-related pathology among teachers. In addition, the perception that religion has a negative influence on such a program is unwarranted.
Inhibitory Effects of Opuntia humifusa on 7, 12-Dimethyl-benz[a]anthracene and 12-O-tetradecanoylphorbol-13-acetate Induced Two-stage Skin Carcinogenesis
Lee, Jin-A;Jung, Bock-Gie;Lee, Bong-Joo 4655
Opuntia humifusa, member of the Cactaceae family, was previously demonstrated to have radical scavenging, anti-inflammatory and anti-proliferative effects in in vitro models. It was suggested that O. humifusa could function in the prevention of carcinogenesis. To investigate the in vivo chemopreventive effect of O. humifusa, mice were fed a diet containing either 1% or 3% following 7, 12-dimethylbenz[a] anthracene (DMBA) and 12-O-tetradecanoylphorbol-13-acetate (TPA) induction of skin carcinogenesis. Significant decrease in the numbers of papilloma and epidermal hyperplasia were observed in mice fed with O. humifusa, compared to the control group. O. humifusa also upregulated high total antioxidant capacity and level of phase II detoxifying enzyme such as superoxide dismutase and glutathione S-transferase activity in the skin. Lipid peroxidation activity level was measured in skin cytosol and significantly inhibited in 3% OH fed group compared to the control group. These results suggest that O. humifusa exerts chemopreventive effects on chemical carcinogenesis in mouse skin and that prevention effects are associated with reduction of oxidative stress via the modulation of cutaneous lipid peroxidation, enhancing of total antioxidant capacity especially in phase II detoxifying enzyme system and partial apoptotic influence.
Development of a Sampling Strategy and Sample Size Calculation to Estimate the Distribution of Mammographic Breast Density in Korean Women
Jun, Jae Kwan;Kim, Mi Jin;Choi, Kui Son;Suh, Mina;Jung, Kyu-Won 4661
Mammographic breast density is a known risk factor for breast cancer. To conduct a survey to estimate the distribution of mammographic breast density in Korean women, appropriate sampling strategies for representative and efficient sampling design were evaluated through simulation. Using the target population from the National Cancer Screening Programme (NCSP) for breast cancer in 2009, we verified the distribution estimate by repeating the simulation 1,000 times using stratified random sampling to investigate the distribution of breast density of 1,340,362 women. According to the simulation results, using a sampling design stratifying the nation into three groups (metropolitan, urban, and rural), with a total sample size of 4,000, we estimated the distribution of breast density in Korean women at a level of 0.01% tolerance. Based on the results of our study, a nationwide survey for estimating the distribution of mammographic breast density among Korean women can be conducted efficiently.
First Trial of Cervical Cytology in Healthy Women of Urban Laos using by Self-sampling Instrument
Nabandith, Viengvansay;Pholsena, Vatsana;Mounthisone, Phouthasone;Shimoe, Kyoko;Kato, Saiko;Aoki, Kunio;Noda, Sadamu;Takamatsu, Reika;Saio, Masanao;Yoshimi, Naoki 4665
Cervical cancer is the most common cancer in Laos women and a screening programme, even with the PAP smear test (PAP test), has yet to be established for routine use. The Pap test is accepted as the most appropriate for cervical cancer screening in some settings but it is not commonly available in Laos hospitals, because there are few cytopathologists and gynecologists have little experience. As a pilot program, seminars for the PAP test were given in 2007 and 2008, and then PAP tests were carried out using self-sampling instrument (Kato's device) with 200 healthy volunteers in Setthathirath hospital, Laos, in 2008. The actual examination number was 196, divided into class I 104 (53.1%), class II 85 (43.3%), class IIIa 4 (2.0%), class IIIb 1 (0.5%), and class V 1 (0.5%) by modified Papanicolau classification. Four cases had menstruation. There were 6 cases with epithelial cell abnormalities including malignancy. There were 7 cases with fungus and 2 cases with trichomonas in Class II. More than 70% volunteers felt comfortable with the Kato's device and wanted to use it next time, because of the avoidance of the embarrassment and a low cost as compared with pelvic examination by gynecologists. This first trial for PAP test for healthy Laos women related to a hospital found three percent to have abnormal cervical epithelial cells. Therefore, this appraoch using a self-sampling device suggests that it should be planned for cervical cancer prevention in Laos.
Safety Assessment of Ovarian Cryopreservation and Transplantation in Nude Mice Bearing Human Epithelial Ovarian Cancer
Zhu, Gen-Hai;Wang, Sheng-Tan;Yang, Zhao-Xin;Cai, Jun-Hong;Chen, Chun-Ying;Yao, Mao-Zhong;Hong, Lan;He, Guo-Li;Yang, Shu-Ying 4669
Objective: Nude mice with orthotopic transplantation of human ovarian epithelial cancer were used to investigate screening criteria for paraneoplastic normal ovarian tissue and the security of the freezing and thawing for ovarian tissue transplantation. Methods: Expression of CK-7, CA125, P53, survivin, MMP-2/TIMP-2 in paraneoplastic normal ovarian tissues were detected by RT-PCR as well as immunohistochemistry. The tissues of the groups with all negative indicators of RT-PCR, all negative indicators of immunohistochemistry, negative expression of CK-7, CA125 and survivin, positive expression of CK-7, CA125 and survivin, cancer tissues and normal ovarian tissues of nude mice were used for freezing and thawing transplantation, to analyze overt and occult carcinogenesis rates after transplantation. Results: When all indicators or the main indicators, CK-7, CA125 and survivin, were negative, tumorigenesis did not occur after transplantation. In addition the occult carcinogenesis rate was lower than in the group with positive expression of CK-7, CA125 and survivin (P<0.01). After subcutaneous and orthotopic transplantation of ovarian tissues, rates did not change (P>0.05). There was no statistical significance among rates after transplantation of ovarian tissues which were obtained under different severity conditions (P>0.05). Conclusion: Negative expression of CK-7, CA125 and survivin can be treated as screening criteria for security of ovarian tissues for transplantation. Immunohistochemical methods can be used as the primary detection approach. Both subcutaneous and orthotopic transplantation are safe. The initial severity does not affect the carcinogenesis rate after tissue transplantation. Freezing and thawing ovarian tissue transplantation in nude mice with human epithelial ovarian carcinoma is feasible and safe.
No Association between Egg Intake and Prostate Cancer Risk: A Meta-analysis
Xie, Bo;He, Huadong 4677
Objective: Egg consumption has been suggested to increase the risk of colorectal and some other cancers. The present study summarized and quantified the current evidence relating dietary intake of eggs and prostate cancer. Materials and methods: Literature searches were conducted to identify peer-reviewed manuscripts published up to July 2012. Twenty manuscripts from nine cohort studies and 11 case-control studies were identified. Summary risk estimates with 95% confidence intervals (CIs) were calculated for case-control and cohort studies separately. Results: Neither the case-control not the cohort studies showed any association of prostate cancer incidence with egg consumption (case-control studies: odds ratio 1.09, 95% CI 0.86-1.31; cohort studies: relative risk 0.97, 95% CI 0.97-1.07). The results were consistent in subgroup analysis. Furthermore, no association was observed between egg consumption and prostate cancer-specific mortality. Conclusions: Our analyses provided no evidence of a significant influence of egg consumption on prostate cancer incidence and mortality. However, more studies, particularly large prospective studies, are needed.
Transforming Growth Factor Beta-1 C-509T Polymorphism and Cancer Risk: A Meta-analysis of 55 Case-control Studies
Liu, Yang;Lin, Xian-Fan;Lin, Chun-Jing;Jin, Si-Si;Wu, Jin-Ming 4683
Aim: To investigate the association of transforming growth factor-beta 1 (TGF-${\beta}1$) C-509T polymorphism and susceptibility to cancer by means of meta-analysis. Methods: An extensive search was performed to identify eligible case-control studies investigating such a link. The strength of the association between TGF-${\beta}1$ C-509T polymorphism and cancer risk was assessed by pooled odds ratios (ORs) and 95%confidence intervals (95%CIs) in fixed or random effects models. Results: 55 published case-control studies with a total number of 21,639 cases and 28,460 controls were included. Overall, there was no association between TGF-${\beta}1$ C-509T and cancer risk in all genetic comparison models (TT vs. CC: OR=1.01, 95%CI=0.89-1.15; T vs. C: OR=1.01, 95%CI=0.94-1.07). However, a stratified analysis by cancer type indicated -509 T allele was significantly associated with decreased risk of colorectal cancer (CRC) (TT vs. CT/CC: OR=0.85, 95%CI=0.76-0.95), especially for Caucasians (TT vs. CT/CC: OR=0.83, 95%CI=0.71-0.98) and for population-based studies (TT vs. CT/CC: OR=0.78, 95%CI=0.68-0.89). Conclusion: This meta-analysis suggested that TGF-${\beta}1$ C-509T polymorphism might contribute to a decreased risk on colorectal cancer susceptibility, especially for Caucasians.
Genetic Variation in PDCD6 and Susceptibility to Lung Cancer
He, Yan-Qi;Zhou, Bin;Shi, Shao-Qing;Zhang, Lin;Li, Wei-Min 4689
Lung cancer is the most common type of cancer and one of the leading causes of death in the world. Genetic factors play an important role in its development. PDCD6, the encoding gene for programmed cell death protein 6, may function as a tumor suppressor gene. Non-small cell lung cancer (NSCLC) contributes about 80% to newly histologically diagnosed lung cancer patients. To explore the relationship between PDCD6 and NSCLC, we examined two single nucleotide polymorphisms(rs3756712 G/T andrs4957014 G/T, both in the intron region) of the PDCD6gene.A hospital-based case-control study was carried out including 302 unrelated NSCLC patients and 306 healthy unrelated subjects. Significantly increased NSCLC risk was found to be associated with the T allele of rs4957014 (P=0.027, OR=0.760, 95%CI=0.596-0.970). The genotype and allele frequencies of rs3756712 did not shown any significant difference between NSCLC group and controls (P=0.327, OR=0.879, 95%CI=0.679-1.137). In conclusion, we firstly demonstrated the association between the PDCD6 gene and risk of NSCLC in a Chinese Han population.
Urinary Concentrations of Human Epidydimis Secretory Protein 4 (He4) in The Diagnosis of Ovarian Cancer: A Case-Control Study
Macuks, Ronalds;Baidekalna, Ieva;Donina, Simona 4695
Objective: To analyze differential diagnostic accuracy of urinary human epidydimis secretory protein 4 (HE4) in patients with ovarian tumors. Materials and methods: In the case-control study 23 patients with ovarian cancer, 37 patients with benign ovarian tumors and 18 women in the control group were included. Serum CA125 values and urinary concentrations of HE4were assessed quantitatively. Urinary creatinine concentrations and glomerular filtration rate were also determined and used to calculate ratios to HE4. Results: Higher urinary HE4 concentrations were observed in patients with late stage ovarian cancer (p=0.001) and also in patients with early stage ovarian cancer when compared to patients with benign ovarian tumors (p=0.044). On analysis where all ovarian cancer patients were included, higher diagnostic accuracy was observed with calculated ratio of HE4 to glomerular filtration rate (GFR) to unchanged urinary HE4 concentrations -AUC 0.861 vs. 0.858. When discriminatory accuracy was calculated for urinary HE4/GFR ratio and unchanged urinary HE4 concentrations, the last demonstrated a higher area under the curve - 0.701 vs. 0.602. The urinary HE4/creatinine ratio had lower discriminatory characteristics than unchanged concentrations of urinary HE4. However, HE4 serum concentration was more accurate for discrimination of patients with benign and malignant ovarian tumors when compared to urinary HE4 and CA125 in sera (AUCs were 0.868 for serum HE4 and 0.856 and 0.653 for urinary HE4 and CA125, respectively). Conclusions: Ovarian cancer patients have higher urinary concentrations of human epidydimis secretory protein 4 than patients with benign ovarian tumors. Urinary HE4 has comparable discriminatory accuracy with serum HE4 for benign and malignant ovarian tumors and can be recommended as a non-invasive ovarian cancer risk assessment method.
Effect of Portal Vein Chemotherapy on Liver Metastasis after Surgical Resection of Colorectal Cancer
Yu, Dong-Sheng;Li, Ying;Huang, Xin-En;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Cao, Jie;Xu, Xia;Xiang, Jin;Wang, Guo-Ping 4699
Objective: To explore the effect of portal vein chemotherapy on liver metastasis after surgical resection of colorectal cancer. Methods: Patients fulfilling the eligibility criteria were assigned to receive either surgery plus 1-week continuous infusion of 5-FU (study group) or surgery alone (observational group). Patients in the study group received portal vein chemotherapy, whereby 5-FU (1000 mg/d) and heparin (5000 IU/d) infusion was initiated from the day of surgery and lasted for 7 consecutive days. Liver metastasis was monitored during five years follow-up postoperatively. Results: Sixty four patients were recruited and assigned to the study group (12 with colon and 20 with rectal cancer) or the control group (10 with colon and 22 with rectal cancer). Liver metastasis rate was 12.5% in study and 25.0% in observational group, the difference being significant (P<0.01). Conclusion: Portal vein chemotherapy could be an effective treatment in preventing liver metastasis after surgical resection of colorectal cancer.
Comparison of Vinorelbine, Ifosfamide and Cisplatin (NIP) and Etoposide and Cisplatin (EP) for Treatment of Advanced Combined Small Cell Lung Cancer (cSCLC) Patients: A Retrospective Study
Luo, Jie;Wu, Feng-Ying;Li, Ai-Wu;Zheng, Di;Liu, Jin-Ming 4703
Objective: To compare efficacy and safety profile of vinorelbine, ifosfamide and cisplatin (NIP) with etoposide and cisplatin (EP) in the treatment of advanced combined small cell lung cancer (c-SCLC). Methods: From January 2006 to December 2010, 176 patients with advanced c-SCLC were enrolled. The primary endpoint was overall survival (OS) and the secondary endpoints were progression free survival (PFS), response rate (RR) and toxicity. Results: Overall RR was 30.0% in the NIP and 38.5% in the EP group; there was no significant difference (P=0.236). The PFS in the EP group was little longer than that of NIP group, with 6.5 months for EP and 6.0 months for NIP group, but the difference was statistically non-significant (P=0.163). The median OS and one year survival rates were 10.4 months and 36.3% for NIP group, and 10.8 months and 49.0% for EP respectively, EP showing a survival benefit, although this was not statistically significant. Both groups well tolerated the adverse effects. The incidence of grade I-II leucopenia and alopecia in the NIP group was significantly higher than that of EP group (32.5% vs. 10.4% (P<0.001, 35.0% vs. 12.5%, P<0.001). Conclusion: the ORR, PFS and OS in NIP were slightly inferior to traditional regimen EP. The toxicity of NIP can be considered tolerable. The usage of three drugs combination in the treatment of mixed SCLC remains uncertain. Nevertheless, the results need to be further confirmed by large, prospective clinical trials.
Prognostic Significance of Annexin A1 Expression in Pancreatic Ductal Adenocarcinoma
Chen, Cong-Ying;Shen, Jia-Qing;Wang, Feng;Wan, Rong;Wang, Xing-Peng 4707
Annexin A1 is a 37-kDa calcium- and phospholipid-binding protein of the annexin superfamily considered to play an important role in tumorigenesis. However, associations with clinicopathological features in pancreatic ductal adenocarcinoma (PDAC) cases have yet to be fully defined. We therefore investigated the prognostic value of annexin A1 protein as a PDAC biomarker in 83 tumor and matched non-cancerous tissues or normal pancreas tissues. Expression was analyzed using real-time RT-PCR, Western blotting and immunohistochemistry. In non-tumor tissue, myoepithelial cells showed no or weak expression of annexin A1 while expression was strong and sometimes even located in the nuclei of endothelial cells in tumor tissue. High expression was significantly associated with advanced stage (P <0.05) and a worse overall survival (P <0.05). These results provide new insights to better understand the role of annexin A1 in PDAC survival, and might be relevant to prediction of prognosis and development of more effective therapeutic strategies aimed at improving survival.
Dietary Patterns and Risk of Colorectal Cancer: A Systematic Review of Cohort Studies (2000-2011)
Yusof, Afzaninawati Suria;Isa, Zaleha Md.;Shah, Shamsul Azhar 4713
Objectives: This systematic review of cohort studies aimed to identify any association between specific dietary patterns and risk of colorectal cancer (CRC). Dietary patterns involve complex interactions of food and nutrients summarizing the total diet or key aspects of the diet for a population under study. Methods and materials: This review involves 6 cohort studies of dietary patterns and their association with colorectal cancer. An exploratory or a posteriori approach and a hypothesis-oriented or a priori approach were employed to identify dietary patterns. Results: The dietary pattern identified to be protective against CRC was healthy, prudent, fruits and vegetables, fat reduced/diet foods, vegetables/fish/poultry, fruit/wholegrain/dairy, healthy eating index 2005, alternate healthy eating index, Mediterranean score and recommended food score. An elevated risk of CRC was associated with Western diet, pork processed meat, potatoes, traditional meat eating, and refined grain pattern. Conclusion: The Western dietary pattern which mainly consists of red and processed meat and refined grains is associated with an elevated risk of development of CRC. Protective factors against CRC include a healthy or prudent diet, consisting of vegetables, fruits, fish and poultry.
Factors Associated with Cervical Cancer Screening Amongst Women of Reproductive Age from Yucatan, Mexico
Conde-Ferraez, Laura;Allen, Rosa Etelvina Suarez;Martinez, Jorge Ramiro Carrillo;Ayora-Talavera, Guadalupe;Gonzalez-Losa, Maria del Refugio 4719
This study aimed to analyse the participation of women of reproductive age in a cancer screening program, and survey reasons for non-screening in a region from Mexico with high cervical cancer mortality. A total of 281 obstetric patients from a previous HPV study in a social security hospital during 2008-2009 were included. Reasons for not participating in the screening were directly asked. HPV positive patients were invited to participate in an informative workshop, and they filled in a knowledge questionnaire. The women ranged in age from 14-47 years; 123 (43.8%) had never participated in screening, of which 97 (78.9%) had their first sexual intercourse 2 to 10 years ago, resulting in 25% HPV positive. Screening history was strongly associated with 2 or more gestations (OR=10.07, p=0.00) and older age (OR=6.69 p=0.00). When 197 women were contacted and interviewed, reasons referred for non-screening were ignorance, lack of interest or time, recent sexual onset, shame and fear. More than 50% of the workshop participants showed knowledge of HPV, while 38.9% and 25% knew about Pap smear and cervical cancer. A high percentage of women of reproductive age have never had a Pap smear. Promoting the screening program in medical facilities seems to be important in this population. New approaches to inform vulnerable individuals on the benefits of screening need to be implemented, especially for young women.
Genetic Polymorphism of Glutathione S-transferases M1 and T1, Tobacco Habits and Risk of Stomach Cancer in Mizoram, India
Malakar, Mridul;Devi, K. Rekha;Phukan, Rup Kumar;Kaur, Tanvir;Deka, Manab;Puia, Lalhriat;Barua, Debajit;Mahanta, Jagadish;Narain, Kanwar 4725
Aim: The incidence of stomach cancer in Mizoram is highest in India. We have conducted a population based matched case-control study to identify environmental and genetic risk factors in this geographical area. Methods: A total of 102 histologically confirmed stomach cancer cases and 204 matched healthy population controls were recruited. GSTM1 and GSTT1 genotypes were determined by PCR and H. pylori infections were determined by ELISA. Results: Tobacco-smoking was found to be an important risk factor for high incidence of stomach cancer in Mizoram. Meiziol (local cigarette) smoking was a more important risk factor than other tobacco related habits. Cigarette, tuibur (tobacco smoke infused water) and betel nut consumption synergistically increased the risk of stomach cancer. Polymorphisms of GSTM1 and GSTT1 genes were not found to be directly associated with stomach cancer in Mizoram. However, they appeared to be effect modifiers. Persons habituated with tobacco smoking and/or tuibur habit had increased risk of stomach cancer if they carried the GSTM1 null genotype and GSTT1 non-null genotype. Conclusion: Tobacco smoking, especially meiziol is the important risk factor for stomach cancer in Mizoram. GSTM1 and GSTT1 genes modify the effect of tobacco habits. This study is a first step in understanding the epidemiology of stomach cancer in Mizoram, India.
Tobacco-Related Chronic Illnesses: A Public Health Concern for Jamaica
Crawford, Tazhmoye V.;McGrowder, Donovan A.;Barnett, Jasper D.;McGaw, Barbara A.;McKenzie, Irving F.;James, Leslie G. 4733
Background: Tobacco use is a leading cause of preventable morbidity and mortality from non-communicable diseases. The objectives of the study were to determine the percentage of annual income used to purchase tobacco-related products and treat tobacco-related illnesses, and assess the characteristics of smokers and their awareness of the health-related risks of smoking. Method: Stratified and snowball sampling methods were used to obtain information (via a 17-item, close-ended questionnaire) from 85 adult respondents (49 males and 36 females). The instrument comprised of demographic characteristics, smoking behavioural/lifestyle, health, and micro socio-economics. Results: There were no significant differences between individuals who were affected by chronic obstructive pulmonary disorder (COPD) (14.1%) and cardiovascular disease (18.8%). It was found that respondents spend 30-39% of their annual income on tobacco-related products. Forty percent (40.0%) and 41.7% of respondents with lung cancer and COPD respectively spend more than 50% of their annual income to treat these diseases. The majority (80%) of those who continues to consume tobacco-related products were uncertain as to why they were doing it. Not all the smokers were aware of the dangers of tobacco consumption despite their level of education. Conclusion: The majority of the respondents who had tobacco-related illnesses such as lung cancer and COPD spend a significant amount of their income on their health care. Not all the smokers were aware of the dangers of tobacco consumption despite their level of education. This suggests the need for increase public awareness where both smokers and non smokers are being fully or adequately informed about the dangers or health risks of tobacco consumption.
Involvement of FoxM1 in Non-Small Cell Lung Cancer Recurrence
Xu, Nuo;Wu, Sheng-Di;Wang, Hao;Wang, Qun;Bai, Chun-Xue 4739
Background: Predictive biomarkers for lung cancer recurrence after curative tumor resection remain unclear. This study set out to assess the role of FoxM1 in the recurrence of non-small cell lung cancer. Methods: Immunohistochemistry for FoxM1 expression was performed on paraffin-embedded tumor tissues from 165 NSCLC patients. Association of FoxM1 expression with clinicopathological parameters and disease free survival were evaluated. Results: Our results indicated FoxM1 expression to be significantly associated with poorer tissue differentiation (P =0.03), higher TNM stage (P <0.01), lymph node metastasis (P <0.01), advanced tumor stage (P <0.01), and poorer disease free survival (P <0.01). Multivariable analysis showed that FoxM1 expression increased the hazard of recurrence (hazard ratio= 1.96, 95% CI, 1.04-3.17, P <0.05), indicating that FoxM1 is an independent and significant predictor of lung cancer recurrence. Conclusion: Therefore, FoxM1 is an independent risk factor for recurrence of NSCLC. Elevated FoxM1 expression could be used as an indicator of poor disease free survival.
Diagnostic Value of Fluorescence in Situ Hybridization Assay in Malignant Mesothelioma: A Meta-analysis
Wan, Chun;Shen, Yong-Chun;Liu, Meng-Qi;Yang, Ting;Wang, Tao;Chen, Lei;Yi, Qun;Wen, Fu-Qiang 4745
The diagnosis of malignant mesothelioma (MM) remains a clinical challenge and the fluorescence in situ hybridization (FISH) assay has been reported to be one promising tool. The present meta-analysis aimed to establish the overall diagnostic accuracy of FISH for diagnosing MM. After a systematic review of English language studies, the sensitivity, specificity and other measures of accuracy of FISH in the diagnosis of MM were pooled using random-effects models. Summary receiver operating characteristic curves were applied to summarize overall test performance. Nine studies met our inclusion criteria, the pooled sensitivity and specificity for FISH for diagnosing MM being 0.72 (95% CI 0.67-0.76) and 1.00 (95% CI 0.98-1.00), respectively. The positive likelihood ratio was 34.5 (95% CI 14.5-82.10), the negative likelihood ratio was 0.24 (95% CI 0.16-0.36), and the diagnostic odds ratio was 204.9 (95% CI 76.8-546.6), the area under the curve being 0.99. Our data suggest that the FISH assay is likely to be a useful diagnostic tool for confirming MM. However, considering the limited studies and patients included, further large scale studies are needed to confirm these findings.
Combined EGFR and c-Src Antisense Oligodeoxynucleotides Encapsulated with PAMAM Denderimers Inhibit HT-29 Colon Cancer Cell Proliferation
Nourazarian, Ali Reza;Najar, Ahmad Gholamhoseinian;Farajnia, Safar;Khosroushahi, Ahmad Yari;Pashaei-Asl, Roghiyeh;Omidi, Yadollah 4751
Colon cancer continues to be one of the most common cancers, and the importance and necessity of new therapies needs to be stressed. The most important proto-oncogen factors for colon cancer appear to be epidermal growth factor receptor, EGFR, and c-Src with high expression and activity leading to tumor growth and ultimately to colon cancer progression. Application of c-Src and EGFR antisense agents simultaneously should theoretically therefore have major benefit. In the present study, anti-EGFR and c-Src specific antisense oligodeoxynucleotides were combined in a formulation using PAMAM dendrimers as a carrier. Nano drug entry into cells was confirmed by flow cytometry and fluorescence microscopy imaging and real time PCR showed gene expression of c-Src and EGFR, as well as downstream STAT5 and MAPK-1 with the tumor suppressor gene P53 to all be downregulated. EGFR and c-Src protein expression was also reduced when assessed by western blotting techniques. The effect of the antisense oligonucleotide on HT29 cell proliferation was determined by MTT assay, reduction beijng observed after 48 hours. In summary, nano-drug, anti-EGFR and c-Src specific antisense oligodeoxynucleotides were effectively transferred into HT-29 cells and inhibited gene expression in target cells. Based on the results of this study it appears that the use of antisense EGFR and c-Src simultaneously might have a significant effect on colon cancer growth by down regulation of EGFR and its downstream genes.
Impact of Low Versus Conventional Doses of Chemotherapy During Transcatheter Arterial Chemo-embolization on Serum Fibrosis Indicators and Survival of Liver Cancer Patients
Kong, Wei-Dong;Cao, Jian-Ming;Xu, Jian;Chen, Bo;Yang, Tao;Xu, Tan-Tan;Lu, Guang-Ming;Li, Jun;Huang, Xin-En 4757
Objectives: To explore the impact of low- vs conventional-dose chemotherapy via transcatheter arterial chemo-embolization (TACE) on serum fibrosis indicators and treatment efficacy of hepatocellular cancer patients (HCC). Materials and Methods: Patients fulfilling the eligibility criteria were assigned to TACE in Group A (with low-dose chemotherapy) or Group B (conventional-dose chemotherapy). Four serum fibrosis related indicators, hyaluronic acid(HA), human pro-collagen type-III (hPC-III), laminin (LN), and collagen type-IV(IV-C) before TACE were compared with the values 7 days after TACE. The response rate and survival time were also compared between the two groups. Results: Fifty patients with HCC were enrolled in this study, including 25 in Group A and 25 in Group B. No significant differences were detected between the two groups in the four indicators before TACE. After TACE, the value of the four serum indicators increased significantly in Group B. However, no significant differences regarding these four indicators were found in Group A after TACE. Significant differences were demonstrated between the two groups after TACE, but median survival time and 1 or 2 year overall survival rates did not differ (P>0.05). Conclusions: Low-, compared with conventional-dose chemotherapy exerts the same impact on the variation of fibrosis related indicators and has no influence on median survival time and survival rate after TACE in HCC patients.
Toll-like Receptor 5 Agonism Protects Mice from Radiation Pneumonitis and Pulmonary Fibrosis
Wang, Zhi-Dong;Qiao, Yu-Lei;Tian, Xi-Feng;Zhang, Xue-Qing;Zhou, Shi-Xiang;Liu, Hai-Xiang;Chen, Ying 4763
Radiation pneumonitis and pulmonary fibrosis are the main complications with radiotherapy for thoracic neoplasms, directly limiting the efficient dose in clinical application and currently there are few medicines that effectively function as radioprotectants. However, a TLR5 agonist, CBLB502, was confirmed to have protective efficacy against hematopoietic and gastrointestinal radiation syndromes in mice and primates. This study points to a new direction for protection against thoracic radiation-induced pulmonary syndromes and skin injury by CBLB502. We utilized the TUNEL assay, pathological analysis and immunohistochemistry to obtain evidence thatCBLB502 could alleviate the occurrence of radiation pneumonitis and pulmonary fibrosis as well as radiation-induced skin injury. It may thus play a promising role in facilitating clinical radiotherapy of thoracic neoplasms.
Healthy Lifestyle Changes During the Period Before and After Cancer Diagnosis Among Breast Cancer Survivors
Wang, Hsiu-Ho;Chung, Ue-Lin 4769
Aims: The purpose of the present study was to investigate healthy lifestyle changes during the period before and after breast cancer diagnosis in Taiwan. Materials and Method: Lifestyle changes during the period before and after cancer diagnosis were assessed by convenience sampling with a structured questionnaire for breast cancer survivors. Results: A total of 235 breast cancer survivors completed the healthy lifestyle scale. The mean values before and after breast cancer diagnosis of the participants were 3.27 and 3.73. The final five dimensions for the period before breast cancer diagnosis were: had not experienced stress; had exercised; had maintained sleep quality; had maintained body weight; and had maintained relationships. The final five dimensions for the period after breast cancer diagnosis were: sleep quality; had not experienced stress; relationship; had exercised; and had maintained body weight. A paired-t test was applied to examine the differences before and after cancer diagnosis, revealing that the total average scores of the participants on the healthy lifestyle scale clearly differed statistically (t= -17.20, p<0.01); and the nine dimensions before and after testing also demonstrate a marked statistical difference (p<0.01). Conclusions: These findings are helpful in understanding the healthy lifestyle changes during the period before and after cancer diagnosis among breast cancer survivors. It is expected that these results can offer references of self-care for this group of patients.
Clinical Study on Safety and Efficacy of Qinin® (Cantharidin Sodium) Injection Combined with Chemotherapy in Treating Patients with Gastric Cancer
Zhan, Yi-Ping;Huang, Xin-En;Cao, Jie;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Xu, Xia;Xu, Lin;Xiang, Jin;Ye, Li-Hong 4773
Objectives: To assess the efficacy, side effects, and the impact on quality of life with $Qinin^{(R)}$ (Cantharidin sodium) injection combined with chemotherapy for gastric cancer patients. Method: A consecutive cohort of 70 patients were divided into two groups: experimental group with cantharidin sodium injection combined with chemotherapy, while the control group received chemotherapy alone. After more than two courses of treatment, efficacy, quality of life and side effects were evaluated. Results: The response rate of experimental group was not significantly different from that of the control group (P>0.05), but differences were significant in clinical benefit response and KPS score. In addition, gastrointestinal reactions and the incidence of leukopenia were lower than in the control group (P<0.05). Conclusions: $Qinin^{(R)}$ (Cantharidin sodium) injection combined with chemotherapy enhances clinical benefit response, improving quality of life of gastric cancer patients and reducing side effects of chemotherapy. Thus $Qinin^{(R)}$ (Cantharidin sodium) injection deserves to be further investigated in randomized control clinical trails.
Clinical Study of Thalidomide Combined with Dexamethasone for the Treatment of Elderly Patients with Newly Diagnosed Multiple Myeloma
Chen, Hai-Fei;Li, Zheng-Yang;Tang, Jie-Qing;Shen, Hong-Shi;Cui, Qing-Ya;Ren, Yong-Ya;Qin, Long-Mei;Jin, Ling-Juan;Zhu, Jing-Jing;Wang, Jing;Ding, Jie;Wang, Ke-Yuan;Yu, Zi-Qiang;Wang, Zhao-Yue;Wu, Tian-Qin 4777
Objective: To investigate the relationship between the efficacy and safety of different doses of thalidomide (Thal) plus dexamethasone (Dex) as the initial therapy in elderly patients with newly diagnosed multiple myeloma (MM). Methods: Clinical data of 28 elderly patients with newly diagnosed MM who underwent the TD regimen as the initial therapy were analyzed retrospectively. The patients were divided into two groups according to the maximal sustained dose of Thal: lower dose (group A) and higher dose (group B). The overall response rate (ORR), progression free survival (PFS), overall survival (OS), and adverse events (AES) were compared between the two groups. Results: A total of 28 patients were followed up with a median of 18 months. The ORR was 60.1%. The median response time and PFS were 2.0 and 17.0 months, respectively. The mean sustained dose of Thal in group B was significantly higher than group A (292.9 mg v 180.4 mg, P=0.01). There was no significantly difference in ORR (57.1% v 64.3%, P=1.00) and PFS (9.63months v 17.66 months, P=0.73) between groups A and B. During the follow up, only five patients died (<40%) and, therefore, median OS values were not available. It is estimated, however, that the mean survival time in the two groups was 35.6 and 33.4 months (P>0.05), respectively. All of the patients tolerated the treatment well. The incidence of AES in patients with a grading above 3 in group B was significantly higher than in group A (P=0.033). Conclusions: The TD regimen results in a high response rate and manageable AES as the initial therapy in elderly patients with MM. TD should be considered as the front line regimen for the treatment of elderly patients with MM in areas with financial constraints. The clinical response can be achieved at a low dose Thal with minimal toxicity.
Association Between XRCC1 Gene Polymorphisms and Risk of Glioma Development: A Meta-analysis
Sun, Jian-Ying;Zhang, Chun-Yang;Zhang, Zhen-Jun;Dong, Yan-Fang;Zhang, An-Long;Wang, Zhi-Wei;Mei, Xiao-Long 4783
Objective: Previous studies of the association between X-ray cross-complementing group 1 (XRCC1) gene polymorphisms and the gliomas risk have yielded conflicting results, and thus a meta-analysis was performed to provide a more accurate estimation. Methods: A computerized literature search of 5 electronic databases was conducted to identify the relevant studies. Fixed or random effect models were selected based on the heterogeneity test. Publication bias was estimated using Begg's funnel plots and Egger's regression test. Results: A total of 11 studies (3,810 cases and 6,079 controls), 7 studies (2,928 cases and 5,048 controls), and 4 studies (1,461 cases and 2,593 controls) were finally included in the analyses of the association between XRCC1 Arg399Gln, Arg194Trp, and Arg280His polymorphisms and glioma risk, respectively. The pooled results showed that GlnGln carriage was associated with moderately increased risk of gliomas in Asians (GlnGln vs. ArgArg, OR=1.490, 95%CI 1.031-2.153; GlnGln/ArgGln vs. ArgArg, OR=1.321, 95%CI 1.037-1.684), whereas a marginal association was revealed in Caucasians. For the Arg194Trp polymorphism, although a significant association was shown in the homozygous genotype comparisons (TrpTrp vs. ArgArg, OR = 2.209, 95%CI 1.398-2.945), no significant link was found on subgroup analysis stratified by ethnicity. With regard to the Arg280His polymorphism, no significant association was found in each comparison. No particular study was found to significantly influence the pooled results, and no potential publication bias was detected. Conclusions: This meta-analysis suggested that the XRCC1 Arg399Gln polymorphism is moderately associated with increased risk of gliomas in Asians, while Arg194Trp and Arg280His polymorphisms demonstrated no significant influence. Due to the limited studies and the potential confounders, further studies are needed to confirm these results.
Use of Complementary and Alternative Medicine Among Breast Cancer Survivors in Taiwan
Aims: The purpose of this study was to investigate complementary and alternative medicine use among breast cancer survivors in Taiwan. Materials and Methods: This study employed a descriptive research design approach to detail the CAM use among the target population. Convenience sampling was used along with a structured questionnaire. Results: A total of 230 breast cancer survivors completed the use CAM scale. Prayer, reading books, taking antioxidants, eating various grains, and maintaining a vegetarian diet proved to be the five most frequently used CAM practices among patients in our study. More than 50.0% of the participants reported praying occasionally. More than 40.0% of participants read books occasionally, and 38.7% stated that they occasionally take antioxidants. Conclusions: These results provide more insight into CAM use for nurses who care for breast cancer patients.
Microarray Analysis of the Hypoxia-induced Gene Expression Profile in Malignant C6 Glioma Cells
Huang, Xiao-Dong;Wang, Ze-Fen;Dai, Li-Ming;Li, Zhi-Qiang 4793
Hypoxia is commonly featured during glioma growth and plays an important role in the processes underlying tumor progression to increasing malignancy. Here we compared the gene expression profiles of rat C6 malignant glioma cells under normoxic and hypoxic conditions by cDNA microarray analysis. Compared to normoxic culture conditions, 180 genes were up-regulated and 67 genes were down-regulated under hypoxia mimicked by $CoCl_2$ treatment. These differentially expressed genes were involved in mutiple biological functions including development and differentiation, immune and stress response, metabolic process, and cellular physiological response. It was found that hypoxia significantly regulated genes involved in regulation of glycolysis and cell differentiation, as well as intracellular signalling pathways related to Notch and focal adhesion, which are closely associated with tumor malignant growth. These results should facilitate investigation of the role of hypoxia in the glioma development and exploration of therapeutic targets for inhibition of glioma growth.
Health Behavior after A Multiprofessional Intervention and Training for Ongoing Volunteer-Based Community Health Programme Intervention in the North-East of Thailand: What Changed and What not?
Saranrittichai, Kesinee;Senarak, Wiporn;Promthet, Supannee;Wiangnon, Surapon;Vatanasapt, Patravoot;Kamsa-ard, Supot;Wongphuthorn, Prasert;Moore, Malcolm Anthony 4801
This qualitative research within the project entitled "Multiprofessional Intervention and training for Ongoing Volunteer-based Community Health Programs in the Northeast of Thailand (MITV-NET)" was aimed at explaining changes of health behavior of community people in the Northeast after the intervention. The participants comprised 15 community volunteers and 27 villagers. Data were collected by indepth interview, focus group discussion, participation and non-participation observation, and note taking. Analyses were conducted in parallel with data collection, through content and comparative analysis. It was found that the health behavior fell into 2 categories: easy-to-change. The former involved fun activities joined by community people that improved their health or made them recover from illnesses after a short period without becoming addicted. These activities could be done by themselves, for example, exercising and cooking. The difficult-to-change health behavior is habitual, for example, chewing betel nuts or eating uncooked food. The following factors were found affecting behavioral changes: 1) underlying disease; 2) enjoyment in doing activities; 3) habitual behaviour; 4) improved health in a short period; 5) ability of community leaders and volunteers; and 6) community health-supporting resources. It is suggested that improving people's health requires cooperation of community people through fun activities and some initial external support. People who persist in bad habits should be encouraged to stop by showing them health deteriorating effects.
Characterization and Resistance Mechanisms of A 5-fluorouracil-resistant Hepatocellular Carcinoma Cell Line
Gu, Wei;Fang, Fan-Fu;Li, Bai;Cheng, Bin-Bin;Ling, Chang-Quan 4807
Purpose: The chemoresistance of human hepatocellular carcinoma (HCC) to cytotoxic drugs, especially intrinsic or acquired multidrug resistance (MDR), still remains a major challenge in the management of HCC. In the present study, possible mechanisms involved in MDR of HCC were identified using a 5-fluorouracil (5-FU)-resistant human HCC cell line. Methods: BEL-7402/5-FU cells were established through continuous culturing parental BEL-7402 cells, imitating the pattern of chemotherapy clinically. Growth curves and chemosensitivity to cytotoxic drugs were determined by MTT assay. Doubling times, colony formation and adherence rates were calculated after cell counting. Morphological alteration, karyotype morphology, and untrastructure were assessed under optical and electron microscopes. The distribution in the cell cycle and drug efflux pump activity were measured by flow cytometry. Furthermore, expression of potential genes involved in MDR of BEL-7402/5-FU cells were detected by immunocytochemistry. Results: Compared to its parental cells, BEL-7402/5-FU cells had a prolonged doubling time, a lower mitotic index, colony efficiency and adhesive ability, and a decreased drug efflux pump activity. The resistant cells tended to grow in clusters and apparent changes of ultrastructures occurred. BEL-7402/5-FU cells presented with an increased proportion in S and G2/M phases with a concomitant decrease in G0/G1 phase. The MDR phenotype of BEL-7402/5-FU might be partly attributed to increased drug efflux pump activity via multidrug resistance protein 1 (MRP1), overexpression of thymidylate synthase (TS), resistance to apoptosis by augmentation of the Bcl-xl/Bax ratio, and intracellular adhesion medicated by E-cadherin (E-cad). P-glycoprotein (P-gp) might play a limited role in the MDR of BEL-7402/5-FU. Conclusion: Increased activity or expression of MRP1, Bcl-xl, TS, and E-cad appear to be involved in the MDR mechanism of BEL-7402/5-FU.
(-)-Epigallocatechin-3-Gallate Induces Apoptosis and Inhibits Invasion and Migration of Human Cervical Cancer Cells
Sharma, Chhavi;Nusri, Qurrat El-Ain;Begum, Salema;Javed, Elham;Rizvi, Tahir A.;Hussain, Arif 4815
Invasion and metastasis are the major causes of cancer-related death. Pharmacological or therapeutic interventions such as chemoprevention of the progression stages of neoplastic development could result in substantial reduction in the incidence of cancer mortality. (-)-Epigallocatechin-3-gallate (EGCG), a promising chemopreventive agent, has attracted extensive interest for cancer therapy utilizing its antioxidant, anti-proliferative and inhibitory effects on angiogenesis and tumor cell invasion. In this study, we assessed the influence of EGCG on the proliferative potential of HeLa cells by cell viability assay and authenticated the results by nuclear morphological examination, DNA laddering assay and cell cycle analysis. Further we analyzed the anti-invasive properties of EGCG by wound migration assay and gene expression of MMP-9 and TIMP-1 in HeLa cells. Our results indicated that EGCG induced growth inhibition of HeLa cells in a dose- and time-dependent manner. It was observed that cell death mediated by EGCG was through apoptosis. Interestingly, EGCG effectively inhibited invasion and migration of HeLa cells and modulated the expression of related genes (MMP-9 and TIMP-1). These results indicate that EGCG may effectively suppress promotion and progression stages of cervical cancer development.
Clinical Predictive Value of Serum Angiogenic Factor in Patients with Osteosarcoma
Chen, Zhe;Chen, Qi-Xin;Hou, Zhao-Yang;Hu, Jiong;Cao, Yan-Guang 4823
Objective: To explore serum angiogenic factor expression in patients with osteosarcoma and its relationship with metastasis. Methods: Immunohistochemistry was used to test the expression of CD34 and FVIII-Rag in osteosarcoma tissues of 36 patients (osteosarcoma group) and microvessel density (MVD) was also recorded. In addition, ELISA was used to test the level of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor-${\beta}1$ (TGF-${\beta}1$) and endostatin (ES) in the osteosarcoma group and in a control group. Results: VEGF and ES level were significantly higher than in the control group before operation (P<0.01), VEGF, bFGF and TGF-${\beta}1$ correlating with the ES level (P<0.01). Serum VEGF and ES levels of osteosarcoma patients before surgery were closely related to relapse and metastasis; moreover, serum VEGF increased with MVD (P<0.01). Postoperative VEGF and ES levels were lower than the preoperation values (P<0.01); ES level in relapse group was significantly higher than that of the non-relapse group (P<0.01). Conclusion: Preoperative serum VEGF and postoperative ES levels have great predictive value with regard to relapse of osteosarcoma patients.
Gelsolin Induces Promonocytic Leukemia Differentiation Accompanied by Upregulation of p21CIP1
Shirkoohi, Reza;Fujita, Hisakazu;Darmanin, Stephanie;Takimoto, Masato 4827
Tumor suppressor genes have received much attention for their roles in the development of human malignancies. Gelsolin has been found to be down-regulated in several types of human cancers, including leukemias. It is, however, expressed in macrophages, which are the final differentiation derivatives for the monocytic myeloid lineage, implicating this protein in the differentiation process of such cells. In order to investigate the role of gelsolin in leukaemic cell differentiation, stable clones over-expressing ectopic gelsolin, and a control clone were established from U937 leukaemia cells. Unlike the control cells, both gelsolin-overexpressing clones displayed retarded growth, improved monocytic morphology, increased NADPH and NSE activities, and enhanced surface expression of the ${\beta}$-integrin receptor, CD11b, when compared with the parental U937 cells. Interestingly, RT-PCR and western blot analysis also revealed that gelsolin enhanced p21CIP1 mRNA and protein expression in the overexpressing clones. Moreover, transient transfection with siRNA silencing P21CIP1, but not the control siRNA, resulted in a reduction in monocytic differentiation, accompanied by an increase in proliferation. In conclusion, our work demonstrates that gelsolin, by itself, is capable of inducing monocytic differentiation in U937 leukaemia cells, most probably through p21CIP1 activation.
High Dose Rate Cobalt-60 After Loading Intracavitary Therapy of the Uterine Cervical Carcinoma in Srinagarind Hospital, Analysis of Residual Disease
Pesee, Montien;Krusun, Srichai;Padoongcharoen, Prawat 4835
Objectives: To evaluate residual disease in uterine cervical cancer patients treated with teletherapy using combined high dose rate Cobalt-60 brachytherapy. Materials and Methods: A retrospective study of uterine cervical cancer patients, FIGO stages IB-IVB (International Federation of Gynecologists and Obstetricians recommendations), treated by radiotherapy alone between April 1986 and December 1988 was conducted and the outcomes analysed. The patients were treated using teletherapy 50 Gy/25 fractions, five fractions per week to the whole pelvis together with HDR Cobalt -60 afterloading brachytherapy of 850 cGy/fraction, weekly to point A for 2 fractions. Results: The study covered 141 patients with uterine cervical cancer. The mean age was 50.0 years with a range of 30-78 years. The mean tumor size was 4.1 cm in diameter (range 1-8 cm). Mean follow - up time was 2.94 years (range 1 month-6.92 years). The overall incidence of residual locoregional disease was 3.5%. Residual disease, according to stage IIB, IIIB and IVA was present in 2.78%, 3.37% and 50.0%. It was noted that there was no evidence of residual disease in stage IB and IIA cases. Conclusion: Combined teletherapy along with high dose rate Cobalt -60 brachytherapy of 850 cGy/fraction, weekly to point A for 2 fractions resulted in overall 3.5% residual disease and a 96.5% complete response. The proposed recommendation for improving outcome is initiation of measurements for early detection of disease.
Should Male Circumcision be Advocated for Genital Cancer Prevention?
Morris, Brian J.;Mindel, Adrian;Tobian, Aaron A.R.;Hankins, Catherine A.;Gray, Ronald H.;Bailey, Robert C.;Bosch, Xavier;Wodak, Alex D. 4839
The recent policy statement by the Cancer Council of Australia on infant circumcision and cancer prevention and the announcement that the quadrivalent human papillomavirus (HPV) vaccine will be made available for boys in Australia prompted us to provide an assessment of genital cancer prevention. While HPV vaccination of boys should help reduce anal cancer in homosexual men and cervical cancer in women, it will have little or no impact on penile or prostate cancer. Male circumcision can reduce cervical, penile and possibly prostate cancer. Promotion of both HPV vaccination and male circumcision will synergistically maximize genital cancer prevention.
Spatial -Temporal Biphasic Carcinogenesis - A New Theory of the Cancer System
Zhang, Jing-Yao;Liu, Chang 4843
Cancer is now a worldwide problem. Although we have obtained a deeper understanding of the disease with the help of the science and technology, we still cannot reach the essence of cancer. Based on the former theory of carcinogenic and researches, we submit a new theory called "Spatial -Temporal Biphasic Carcinogenesis" to explain its development from the viewpoints of time and space.
Chemotherapy Through a Combination of Fasting and Chronopharmacology
Vijayarathna, Soundararajan;Sasidharan, Sreenivasan 4847