فهرست مطالب mahsa molaei

Overexpression of human leukocyte antigen G (HLA-G) in several malignant tumors has been reported. The aim of our study was to investigate HLA-G expression in colorectal cancer tumors and determine HLA-G expression relation between clinico-pathological characteristics and survival time.
HLA-G expression was evaluated by immunohistochemistry (IHC) using anti-HLA-G antibody in 100 primary tumors of colorectal cancer with different stages.
Our results showed that 25% of the colorectal cancer tissues had positive HLA-G expression and 75% no stained with anti-HLA-G antibody. The HLA-G expression in advanced stages (III and IV) was more prevalent than those in earlier clinical stages (I and II) (P = 0.0001). Results showed that HLA-G expression can serve as an independent factor for overall survival (OS). In this study, patients with HLA-G expression had significantly shorter survival time than those with negative expressions (P = 0.023).
HLA-G expression can serve as an independent factor for OS and its expression may be directly related to aggressive tumor behavior via escape from the host antitumor immune defense. Protein expression of HLA-G correlates with poor prognosis in colorectal cancer.

Helicobacter pylori (H. pylori) is the cause of most cases of peptic ulcers and gastric cancers and cause some of the most important cause of stomach cancer and lymphoma. The objective of this study was to evaluate the time trend of Helicobacter pylori prevalence and presence of intestinal Metaplasia over the period of 7 years in gastritis Iranian patients.
In this cross-section study data related to H. pylori and intestinal Metaplasia (IM) among 14¡860 consecutive gastritis patients¡ who referred to the gastrointestinal department of Tehran’s Taleghani Hospital in Iran¡ was examined across the sex and age group.
The overall prevalence rate among patient with H. pylori infection was 83.5% (12406/14860) and 11¡394 (84.1%) of them were related to the gastritis. The prevalence rate of H. pylori among patient with gastritis significantly higher )p The results of this study showed that the prevalence of H. pylori infection in Iranian population has declined in recent years; nevertheless it seems to be highly prevalent in Iran. We also find a significant positive relationship between H. pylori infection and IM with gastritis. There is no association between sex and infection but in contrast with the most studies its prevalence decreased with age.

This study used the OLGA system to characterize the histology pattern of gastritis in dyspeptic outpatients with a mean age of 45 years from regions with different gastric cancer risks. Several classification systems have been purposed for understanding the status of the gastric mucosa. Currently, the Sydney system is the most widely employed. Nevertheless, the applicability of the Sydney system in therapeutic and prognostic areas is a matter of debate. Given this shortcoming an international group of gastroenterologists and pathologists developed a new system named Operative Link on Gastritis Assessment (OLGA). Patients and In this cross-sectional comparative study the OLGA system was used to characterize the histology pattern of gastritis in 685 dyspeptic patients referring to the department of gastroenterology of a training hospital. No significant correlation was found between active inflammation and total OLGA score (P > 0.05). Also, no statistically significant correlation was found between activity and intestinal metaplasia, dysplasia, atrophy, and cancer (P > 0.05). Even though, there is a positive correlation between mild chronic inflammation and total OLGA score, no correlation has been identified between chronicity and dysplasia or cancer (P > 0.05). Nearly, In all cases with no dysplasia OLGA score was zero but all patients with gastric cancer OLGA score was more than two. Generally, the activity is not a useful factor in predicting prognosis and its loss of relation with total OLGA score does not make OLGA score any less predictable.

To induce acute colitis progresses to chronicity in C57BL/6 mice by dextran sulfate sodium. Murine models are essential tools to understand IBD pathogenesis. Among different types of chemically induced colitis models, the dextran sulfate sodium (DSS)-induced colitis model is the most common model of IBD, due to its simplicity. Patients and Male C57BL/6 mice 6–8 weeks old, were collected and matched by age with controls. C57BL/6 mice treated with 2 cycles of 3.5% DSS for 4 days and 4 days of pure water between each cycle. After that, mice were sacrificed and the entire colon was removed. Small sections of the colon were fixed in formaldehyde, embedded in paraffin and sectioned with a microtome. Sections were stained with hematoxylin eosin to analyses the degree of inflammation. After the first cycle oral administration of DSS, mice with severe and visible rectal bleeding and diarrhea entered into the acute phase. After day 4-5, bleeding and diarrhea were improved and mice entered into the chronic phase with peak levels of weight loss. Macroscopically, the inflammation was predominantly located in the distal colon. Microscopically, examination of the distal colon sections showed a decrease number of goblet cells, loss of crypts, signs of surface epithelial regeneration and moderate to severe infiltration of inflammatory cells in the mucosa. In order to achieve an experimental colitis model, our protocol is recommended for future therapies in IBD experimental modeling.

Familial adenomatous polyposis (FAP) is an autosomal dominant inherited disease caused by germline mutation in Adenomatous Polyposis Coli (APC) gene. FAP accounts less than 1% of all colorectal cancers incidence. Patients generally present hundreds to thousands of adenomas in colon and rectum and develop colorectal cancer by age 35 – 40 if left untreated. A milder form of FAP with fewer numbers of polyps (< 100) is Attenuated FAP (AFAP) and in comparison with classical FAP, it usually diagnosed at an older age. Approximately 15% – 20% of FAP patients are ‘‘de novo’’ cases without any family history of the disease and novel APC mutations account for approximately 25% of FAP cases. In our study, we reported a novel missense mutation at the APC gene in a denovo patient with AFAP like phenotype.

The objective of this study was to evaluate the time trend of Helicobacter pylori (H. pylori) prevalence and presence of intestinal Metaplasia over the period of seven years among gastritis Iranian patients. H. pylori is the major causal factor in chronic gastritis. Its acquisition leads to a chronic, usually lifelong, inflammation of the gastric mucosa, which may gradually progress to atrophy with intestinal metaplasia in a significant proportion of infected individuals. Patients and H. pylori and intestinal Metaplasia data among 14,860 consecutive gastritis patients, who referred to the gastrointestinal department of Tehran’s Taleghani Hospital in Iran from 2008 to 2014, was examined by sex and age group. The patients were divided into six age groups (16-30, 30-40, 40-50, 50-60 and >70). The chi-square test was used to compare the qualitative variables. The overall prevalence rate among patient with H. pylori infection was 83.5% 12406/14860) and 11,394 (84.1%) of them were related to the gastritis. The prevalence rate of H. pylori among patient with severe gastritis was significantly higher (P<0.05) compared to mild and moderate gastritis. In addition, the prevalence of H. pylori decreased with age and has been declined in recent years. The presence of intestinal metaplasia increased with age (P<0.05). The results of this study showed that the prevalence of H. pylori infection in Iranian population has been declined in recent years; nevertheless it seems to be highly prevalent in Iran. We also find a significant positive relationship between H. pylori infection and gastritis. There is no association between sex and infection, however in contrast with the most studies its prevalence decreased with age.

Coeliac disease (CD) is an autoimmune disorder which leads to chronic inflammation of the gut. Untreated CD is associated with upper gastrointestinal malignancies, Small-bowel lymphoma and adenocarcinoma are recognized complications of untreated coeliac disease (CD). We report the case of a 43-year-old male suffering from CD who was treated with a gluten-free diet one year, presenting with complaints of intractable nausea and vomiting. After several studies, He underwent push enteroscopy, which identified one large mass lesion in the third part of duodenum. However, histopathological examination showed adenocarcinoma. Subsequently, a duodenal segment resection was performed. After surgery, the patient recovered well and left our hospital in good condition. Clinicians should take into small bowel adenocarcinoma is rare but associated with CD particularly in CD patients with worrying symptoms such as nausea and vomiting unresponsiveness to treatment and these patients should be screened for long term complications like malignancy.

HNPCC (hereditary non-polyposis colorectal cancer) is the most common type of hereditary colorectal cancers. Germ line mutations in different DNA mismatch repair genes (MMR) and microsatellite instability (MSI) are associated with HNPCC. But still there has not been any report from Iran. The purpose of this study is to evaluate MSI and MMR gene mutation among a group of Iranian patients with the clinical diagnosis of HNPCC. In this cross-sectional study 94 patients (m/f=1.41) who fulfilled at least on of the Bethesda criteria were assessed. MSI analysis was performed in all cases. SSCP was used as screening test in all cases to select highly probable MMR mutation for DNA sequencing. Information analyzed by Chi2, Fisher exact, independent t-test with SPSS16 and EPI6 soft wares. MSI analysis shows 41.5% MSI-H, 17% MSI-L, and 41.5% MSS in this study. There were 18 (19.1%) band shift in SSCP results, which was include 8 mutations after DNA sequencing. ‍ The pattern of MMR mutations in Iranian patients differs from the reports of other countries. The evaluation of the histopathology and clinical features of colorectal cancer burdens in Iran and also the frequency additional HNPCC genes remain as a point of concern.

Celiac disease has been reported to be associated with gastric abnormalities. The aim of this study was to assess the relationship between the prevalence of celiac disease and Helicobacter pylori infection in an Iranian population of 250 patients. Biopsies were taken from the gastric antrum and duodenum. Morphology and histology were evaluated using the updated Sydney system and modified Marsh criteria, respectively. To simplify the interpretation of gastric lesions we classified gastritis in macroscopic and microscopic stages. Serology for anti-tissue transglutaminase antibody was performed to determine the presence of celiac disease. Among 250 patients, 232 (93%) had histological evidence of Helicobacter pylori infection. Histological abnormalities (Marsh I to IIIc) were present in 24 (10%). Of 24 patients, 20 (83%) with histological abnormalities were infected with Helicobacter pylori. Of 250 patients, 25 (10%) had a positive anti-tissue transglutaminase antibody. Of 25 anti-tissue transglutaminase antibody positive patients, 9 (3.6%) had microscopic and macroscopic enteritis (Marsh I to IIIc). Clinical presentation of celiac disease was not distinguishable from cases infected with Helicobacter pylori. Histology, even in patients with positive serology, was non-specific and unhelpful. We found a high prevalence of Helicobacter pylori infection and chronic gastritis, but neither was associated with celiac disease, in agreement with studies in Western populations.

Skin metastasis from abdominal cancers occurs as infiltration or paraneoplastic syndromes. Liver and lung are the most common locations of distant metastases of colorectal cancer (CRC), but CRC skin metastases are very rare. Case Reports: We describe a 55- year old patient with wide spread cutaneous metastasis from a previously treated known case of adenocarcinoma of the colon. Interestingly, liver and lung, as the most common site of metastasis of CRC, had not been involved.

Although, skin metastasis is a worse prognostic factor, its occurrence in CRC patient doesn’t necessarily present end stage disease. So, it could be treated by early diagnosis of susceptible cutaneous lesions.

elongation of the gastric foveolae along with hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. Esophagogastroduodenoscopy in a 47-year-old woman without any history of gastric operation revealed a pedunculated polyp approximately 2 cm in diameter, in a background of erythematous gastric folds along the anterior wall of the fundus. Polypectomy was performed, with endoscopic impression of hyperplastic or fundic gland polyp, without any complications. Histopathological findings were consistent within gastritis cystic polyposa(GCP). A mild Helicobacter pylori colonization in gastric pits was seen. GCP could occur in an unoperated stomach and treated by endoscopic polypectomy. However, removal and histopathologic confirmation of these lesions are necessary.

The purpose of this study was to assess the incidence of 16bp insertion of intron 3 p53 in gastritis lesion and its correlation with clinicopathological aspects. p53 alterations have been implicated in the development of gastric malignancies.Patients and 97 gastritis and normal adjacent tissues were investigated for p53 gene analysis using PCR-sequencing of intron3 and immunohisthochemistry technique. All of samples express p53 protein. In addition 64.9% of patients had no insertion and 7.2% had homozygous insertion while the others were heterozygous. This alteration has no association with clinicopathological findings. Most of our patients had no insertion but an insertion frequency obtained here was found to be higher than those reports in a previous work on colorectal and esophageal cancer. It is possible that the polymorphism has correlation with gastritis and maybe with gastric cancer development. If so, this alteration associates with as yet unknown molecular and /or clinical factors which are involved in the (dys) regulation of p53 expression and function, and exerts its effects during gastritis development through them.

Colorectal cancers often arise from benign polyps. Adenomatous polyps and serrated polyps progress step by step to adenocarcinoma and change to malignant cancers. Genetic and epigenetic changes have relationship with specific stages in polyp-adenocarcinoma progression and colorectal cancer histopathological changes. In this study we applied immunohistochemistry (IHC) staining in sporadic colorectal polyps to assay functional status of MLH1, MSH2, MSH6, and PMS2 proteins. In this cross-sectional study we assessed all patients with sporadic colorectal polyps admitted and performed polypectomy in gastrointestinal department of Taleghani Hospital from 2004 to 2008. IHC was abnormal in 6.8%, 4.5%, 3%, and 4.8% for MLH1, MSH2, MSH6, and PMS2, respectively. In all cases with abnormal PMS2, MLH1 was abnormal, while the same story happened with abnormal MSH2 and MSH6 (p<0.001). IHC staining results showed significant differences according to polyp location, and mean age of the patient (p<0.05). Meanwhile, adenomatous polyps and serrated adenoma polyps showed significant differences when MLH1 and PMS2 were considered (p<0.05). IHC staining is suggested for serrated adenoma specially those in left colon. However, IHC staining for right-sided polyps may not have increased benefits for patient's management.

Germline mutations in MMR genes are reported to be present in more than 70% of HNPCC cases. But, there is a paucity of data regarding the importance of defect of MMR system in the gastric cancer in general. So, in this study, we used IHC stain forMLH1,MSH2, PMS2 andMSH6 to reveal profile ofMMR expression in patients with gastric cancer. This study was performed on 134 patients with gastric cancer who had undergone surgical resection from January 2001 to December 2005. For comparative analyses chi-square test or Fisher's exact test and t-test were used. Through IHC assay, all of samples from patients had normal stain for MSH2 and MSH6. Except in 5 cases (3.7%) IHC stains for MLH1 and in 4 cases (3%) IHC stains for PMS2 were normal. In comparative analyses there were not any significant difference in variables between subgroups of IHC result.Although, genetic factors are cause of gastric cancer in few patients, and germline mutation may increase the risk of gastric cancer. In this study 3.7% of cases with gastric cancer had abnormalMMR proteins function. It seems that MLH1 and PMS2 have a major role in MMR functions in Iranian patients with gastric cancer, to further clarify this issue, more resrarchers should be done.

Hereditary non-polyposis colorectal cancer is the most common cause of early onset of hereditary colorectal cancer. In the majority of Hereditary non-polyposis colorectal cancer families, microsatellite instability and germline mutation in one of the DNA mismatch repair genes in clouding MSH2, MLH1, MSH6 and PMS2 are found. The Objective of this study was to determine the involvement of mismatch repair genes mutations in Iranian population, and microsatellite instability profile in patients with colorectal cancer. We analyzed 592 patients with colorectal cancer. The entire coding sequence of each gene was analyzed using direct sequencing. We were able to find three novel MLH1 germline mutations in three Iranian patients suffering from Hereditary non-polyposis colorectal cancer. The first was a transversion mutation c.346A>C (T116P), which occured in the highly conserved HATPase-c region of MLH1 protein. The second was also a transversion mutation c.736A>T (I246L), which caused an amino acid change of Isoleucine to Leucine. The third mutation (c.2145,6 delTG) was frame shift mutation, and resulted in an immature stop codon in five codons downstream. All of these three mutations were detected in MLH1 gene. In all patients, an abnormal expression of MMR proteins was related to the above mutations. MSI assay revealed high instability in microsatellite for two patients and microsatellite stability for one patient. These novel mutations may imply the different characteristics of hereditary non-polyposis colorectal cancer in Iranian population as compared to reports from the western countries.

The aim of this study was to present the demographic and clinical characteristics of patients with gastric polypoid lesions and to study the histopathologic features of these lesions. The frequency of gastric polyps is gradually increasing due to the widespread use of endoscopic examinations.Patients and Clinical and endoscopic features of 100 gastric polyposis patients (with 107 polypectomy specimens) were retrospectively studied. All the specimens were histologically re-evaluated by two pathologists. 107 specimens of gastric polypoid lesions were identified in 100 patients. There were 73 men and 27 women with a median age of 49 years. The most frequent presenting symptom was dyspepsia (76%). The most common location was antrum followed by the cardia. The frequencies of hyperplastic polyps, fundic gland and adenomatous polyps were 69.2 %, 6.6 %, and 4.7 % respectively. We also detected an inflammatory fibroid polyp, a carcinoid tumor and a case of leiomyoma in polypoid lesions. In 16.8% of cases histologic evaluation revealed only foveolar hyperplasia, intestinal metaplasia or edematous mucosa. Mild dysplastic changes were observed within three hyperplastic polyps and high grade dysplasia in two adenomas. Hyperplastic polyps are the most frequently identified gastric polyps in our population. These polyps may contain foci of dysplasia. Presence of these changes as well as other unusual tumors with polypoid appearance can only be confirmed by histological examination. Therefore, endoscopic polypectomy is a safe procedure for both the diagnosis and treatment of gastric polypoid lesions.

There is evidence of a possible etiological role of human papillomaviruses (HPVs) in the development of colorectal cancer. Loss of p53 tumor suppressor gene function has been found in many malignancies and it can occur in a variety of ways, including gene mutation and interaction with the E6 protein of oncogenic HPVs. The objective of this study was to determine the prevalence of HPV infection and p53 overexprssion in colorectal cancer (CRC) tissue samples and its association with tumor histopathologic characteristics.60 tissue sections from patients with CRC were investigated by immunocytochemistry techniques for aberrant expression of p53 using the streptavidin-biotin-peroxidase method with monoclonal antibodies. The HPV status was also analyzed using type-specific primers for HPV16/18 by polymerase chain reaction (PCR).Overall, 21 (35%) of 60 patients were found positive for HPV DNA; HPV 18 was detected in 19 (32%) and HPV16 in 11 (18%) of 60 samples. An abnormal expression of tumor-suppressor protein p53 was observed in 29 (48%) samples. p53 overexpression was observed in 15 (71%) of 21 HPV-positive and in 14 (36%) of 39 HPV-negative patients (p=0.009). Similar significant difference was found in p53 overexpression in HPV18-positive patients (p=0.007) but not in those positive for HPV 16 (p=0.261). HPV DNA presentation was not significantly associated with histopathologic characteristics including tumor stage (p=0.509), grade (p=0.668), peri-neural invasion (p=0.265) and lympho-vascular invasion (p=0.275).p53 inactivation caused by HPV infection may play a role in the pathogenesis of colorectal cancer. There is no association between HPV infection and histopathologic characteristics.