sadegh sedaghat

Breast cancer management depends on molecular subtypes. The aim was to compare disease-free survival (DFS) among the different subgroups. Overall survival (OS) is a secondary endpoint.

This cross-sectional study was done on breast cancer women that were treated in our center, from 2009 to 2015. Breast cancer molecular subtypes were determined based on clinicopathological criteria recommended by St Gallen and include; luminal A, luminal B Her- 2-neu positive, luminal B Her-2-neu negative, Her-2 enriched and triple negative. Patients with metastasis at diagnosis or those without follow-up were excluded. Patients were followed-up from 12 to 132 months. Cox regression analysis was used for analogy of DFS and OS between the subgroups.

Out of three hundred patients, 221 were enrolled with median age of 47 years old (26 to 83). Luminal B, Her-2 negative was the most common subgroup with 83 patients (35.5%). Five and 10 years PFS were 95% and 81% for luminal A, were 95.5% and 92% for luminal B Her-2 positive, were 92% and 91% for luminal B Her-2 negative, were both 84% for triple negative and were 76% and 74% for Her-2 enriched subgroups, respectively. With multivariate analysis, the stage of tumor (HR=5.9 CI=1.06-32.69) and triple negative subgroup (HR=5.2 CI=1.33-20.31) were independent factors for recurrence.

Based on the results of this study, the triple-negative breast cancer and possibly Her-2 enriched subgroup have a shorter DFS than luminal breast cancers. Also, the stage of tumor is an independent factor for recurrence.

Obesity and iron deficiency (ID) are two forms of the most usual nutritional disorders worldwide. Some studies have discovered a correlation between ID and obesity although more investigation is required. This study was aimed to determine the association between obesity and ID anemia (IDA) in Iranian childbearing age women.

This cross‑sectional study was done on 256 women of reproductive age in northern Iran. The anthropometric measurements including height and weight were measured, and body mass index (BMI) was calculated. Low blood index of the hemoglobin (Hb), mean cell volume (MCV), and mean corpuscular hemoglobin (MCH) were evaluated with ferritin, serum iron, and total iron‑binding capacity. Baseline data were expressed as means ± standard deviations. Chi‑square test was applied to compare the categorical variable. Differences between the two groups were evaluated with independent samples t‑test. A value of P < 0.05 was considered as statistically significant.

Obesity was in urban women higher than rural women (55.1% vs. 44.9%), and this difference was significant (P < 0.021). There was found no association between hematological characteristics and BMI. The data showed that only 13.4% of obese women and 17.1% of the women with normal weight had IDA (odds ratio = 0.75; 95% confidence interval: 0.39–1.49, P > 0.05).

According to the results of this study, it seems that the relationship between obesity and IDA is controversial. Hence, further studies are needed to be done.

Bone lesion in multiple myeloma (MM) is most commonly presented as a lytic lesion in this disease. Determination of extent of bone lesions in MM is necessary to follow-up the patients. Whole body bone scan with 99m, Tc-methylene diphosphonate (MDP) has a lower sensitivity than other modalities.
From the patients with MM admitted to Ayatollah Rouhani Hospital of Babol-Iran from 2009 to 2015, who had undergone whole body bone scan during diagnostic process, were entered into the study. Findings of bone scan were compared with MRI.
Of the 19 patients, sixteen (84.2%) of them had positive finding in bone scan, fifteen (78.9%) had MRI of the spine. While of the thirteen patients who had positive finding in MRI, seven (53.8%) had more positive finding in thorcolumbosacral MRI than in bone scan.
99m-Tc MDP bone scan is a sensitive but insufficient method for detecting bone lesions in MM.

Given the unmet needs in cancer treatment, extensive research and development has evolved to offer therapies for cancers to extend survival and minimize side effects. Immunotherapy, an approach to harness normal immune cells against cancers not only today’s breakthrough but in fact the future of oncology therapeutics. Taking into consideration the recent approvals for new lines of therapy including anti-programmed-death-1 or programmed-death-1 ligand (PD-1/PD-L1) monoclonal antibodies for the treatment of Malignant Melanoma (MM) and Non-Small Cell Lung Cancer (NSCLC), local strategies need to be established following the field experts’ concurrence. Expert input forums are among the key approaches to define locally-adapted clinical-pathways with regard to the novel treatments. To this end, a panel of Iranian medical oncology experts reviewed the available evidence, taking into consideration recent practice guidelines with regard to the treatment of MM and NSCLC in order to draw an agreed-upon approach highlighting the position of immunotherapy in their current practice. Having addressed the key questions and considering the possible limitations and challenges, the panel could reach an agreed position. This report highlights the discussions with regards to the role of immunotherapy in MM and NSCLC during the immune-oncology clinical forum (IOCF) comprising an Iranian panel of experts.

Cancers are the second most common cause of non-accidental deaths in Iran, after cardiovascular mortality. Although most cases of esophageal squamous cell carcinoma (ESCC) in the USA and western populations have been attributed to high levels of exposure to tobacco and alcohol, but in Iranian populations the other risk factors especially infectious agents have been postulated as possible causes, particularly human papillomavirus (HPV). This study aimed to determine the prevalence and the types of HPV infection in biopsy samples taken from non-cancerous esophageal lesions during upper endoscopy. A total of 80 non-cancerous esophageal samples were collected in parafinnated blocks of tissue archives in pathology. After DNA extraction, qualitative PCR (qPCR) was performed using the HPV L1 primer pairs MY09/MY11 and then genotyping was performed in HPV DNA positive by Real time PCR. From 80 cases, 29 (36.3%) were qPCR positive. Using the Real-time PCR method, a total of 14 HPV genotypes were assessed. We detected HPV-11 as a dominant type in this study and we did not find any type of HPV-16 and 18. In this study, HPV-II was the most common type in esophageal samples, in contrast we have found no oncogenic HPV like HPV 16 and 18 which are the most known responsible factors of ESCC in other countries

Gastric adenocarcinoma is the second leading cause of death due to cancer in the world and in advanced stages the prognosis is poor with current therapies. Over-expression of HER-2/neu has been seen in several cancers such as gastric cancer and its expression is associated with poor prognosis. The aim of this study is to evaluate the over-expression of HER-2/neu in gastric biopsy samples of patients with gastric carcinoma diagnosis; and to evaluate its probable relationship with clinical and pathological findings. The over-expression of HER-2/neu was examined retrospectively by immunohistochemistry method in 60 paraffin embedded samples collected in Babol, Iran, between 2010 and 2011. The over-expression of HER-2/neu has been observed in 6 patients (10%) and this over-expression was greater in the intestinal type of gastric adenocarcinoma than the diffuse type (12% vs. 6%); however, no statistically significant correlation between HER-2/neu expression and subtype, degree of differentiation, tumor type and age was observed. This over-expression was greater in differentiated types than undifferentiated types (18% vs. 5%).

Alpha thalassemia (α-thal) is relatively common worldwide. Most carriers are defective in either one or two alpha globin genes out of four functional ones, with deletions being more common than point mutations. The hematologic features are very important for the selection of the appropriate molecular tests while determining the genotype. The aim of this study was to compare hematologic features of patients with various types of α globin mutations. Hematological indices including red blood cells (RBC), hemoglobin concentration (Hb), mean cell volume (MCV), mean cell hemoglobin (MCH), Mean corpuscular hemoglobin concentration (MCHC) and percentage of Hemoglobin (HBA1, HBA2 and HBF) of seven-hundred and twenty two patients presenting ten different α-thal genotypes were considered. All patients showed reduced MCV and/or MCH values. Moreover, MCV and MCH were lower in patients with two functional alpha globin genes in comparison to patients with one mutated alpha globin gene (P value<0.001). In conclusion, MCV and MCH values can be helpful for the selection of the appropriate molecular tests to determine the genotype of alpha thalassemia carriers.