فهرست مطالب

Cancer Management - Volume:14 Issue: 9, Sep 2021

International Journal of Cancer Management
Volume:14 Issue: 9, Sep 2021

  • تاریخ انتشار: 1400/07/24
  • تعداد عناوین: 8
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  • Masoomeh Raoufi, Robab Anbiaee, Zohre Soltani, Fatemeh Shojaeian, Seyed Amir Ahmad Safavi Naini * Page 1
    Background

     Breast and thyroid cancers remain among the most common malignancies in women. In previous studies, the co-occurrence of thyroid and breast cancers has been reported.

    Objectives

     The aim of this study was to evaluate and compare the risk and incidence of incidental thyroid nodules (ITNs) between patients with breast cancer and healthy controls, based on the Thyroid Imaging Reporting and Data System (TI-RADS).

    Methods

     This case-control study was conducted on 140 patients with breast cancer and 140 cancer-free women in a similar age range. Thyroid ultrasonography (US) was performed before the onset of treatment. The risk stratification of thyroid nodules was based on the TI-RADS.

    Results

     The mean age of the participants was not significantly different between the case (43.35 ± 7.85 years) and control (42.11 ± 3.69 years) groups (P = 0.094). Invasive ductal carcinoma was the most frequent type of breast cancer in the patients. Normal thyroid US findings were significantly less frequent in patients with breast cancer (35.7%) compared to the healthy controls (76.4%) (P = 0.001). On the other hand, thyroid nodules were more frequent in the patients and associated with a higher risk of malignancy (i.e., high TI-RADS scores) compared to healthy women (P = 0.001 and P = 0.001, respectively). Besides, patients with breast cancer showed more thyroid abnormalities in the US examinations.

    Conclusions

     A higher frequency of ITN, with an elevated TI-RADS score, which raised the suspicion of malignancy, was seen in patients with breast cancer. Overall, patients with breast cancer may benefit from a regular thyroid US examination.
     

    Keywords: Early Detection of Cancer, Ultrasonography, Thyroid Nodule, Thyroid Neoplasms, Breast Neoplasms
  • Nima Mousavi Darzikolaee, Mohsen Rajaeinejad *, Borna Farazmand, Reza Ghalehtaki, Hasan Jalaeikhoo Page 2
    Background

     There is some evidence that showed that the high level of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) is associated with poor survival in several malignancies including colorectal cancer (CRC); however data on the significance of these markers to predict response to systemic therapy is limited.

    Objectives

     The aim of this study was to assess the role of pretreatment NLR and PLR in predicting response to first line chemotherapy in CRC patients with synchronous metastases.

    Methods

     Clinical records of 81 CRC patients with synchronous liver metastases, who underwent upfront chemotherapy, were included in this retrospective study. The optimal cut of value for NLR and PLR was determined according to receiver operating characteristic (ROC) curve analysis. Correlation between response to chemotherapy and NLR or PLR was evaluated.

    Results

     The optimal cut off for NLR and PLR was 2.666 and 182.589, respectively. Patients with low NLR had significantly higher objective response (complete response + partial response) compared to patients with high NLR (54.3% versus 13%, respectively, P: < 0.001). In patients with low PLR, 41.2% had objective response compared to 13.3% of patients with high PLR (P = 0.012). The univariate analysis determined that, both NLR and PLR are significantly associated with better objective response, but in multivariate analysis, only NLR was identified as an independent predictive marker of response [odds ratio = 4.55; P = 0.013].

    Conclusions

     Results of this study indicate that, measuring NLR might provide us an inexpensive method to predict response to first-line chemotherapy in CRC patients with synchronous liver metastases.

    Keywords: Chemotherapy, Platelet-Lymphocyte Ratio, Clinical Response, Metastatic Colorectal Cancer, Neutrophile-Lymphocyte Ratio
  • Shahnaz Sharifi, Sara Sohrabvandi *, Vahid Mofid *, Elham Khanniri, Nasim Khorshidian, Saeideh Esmaeili, Mahdi Shadnoush, Mohammad Hadizadeh, AmirMohammad Mortazavian Page 3
    Background

     Milk and dairy products are the main sources of essential nutrients particularly for children. However, milk and dairy products can be contaminated with chemical hazards and contaminants which pose serious health risks for consumers. These toxic compounds are entered into the food chain through contaminated soil, water, and air and their presence even at low levels would result in metabolic disorders.

    Objectives

     The aim of this study was to determine the level of lead in pasteurized milk and different dairy products in high-consumed brands in Tehran.

    Methods

     A total of 38 samples (18 pasteurized milk and 20 dairy products from the most-consumed brands) were analyzed using graphite furnace atomic absorption spectroscopy for quantification of lead level. Hazard quotient (HQ) and carcinogenic risk (CR) were used to assess health risk and carcinogenic risk.

    Results

     The results showed that the levels of lead in all pasteurized milk samples and dairy products were below the allowable limit. HQ was less than 1 in all samples and CR was in the range of 10-8 to 10-7 and both were at acceptable levels.

    Conclusions

     It can be concluded that there was no risk of carcinogenicity in pasteurized milk samples and dairy products for children and adults. However, due to the higher consumption of milk by children and their greater susceptibility, the level of heavy metals should be monitored by health agencies.

    Keywords: Health Risk, Pasteurized Milk, Lead, Heavy Metals, Dairy Products
  • Zahra Tahmasebi Fard *, Maryam Khayamzadeh, Mahshid Zarei Page 4
    Background

     The role of carcinogenic viruses in developing breast cancer has not yet been identified. Many studies have examined the association between breast cancer and human cytomegalovirus (HCMV), but conflicting results have been reported.

    Objectives

     The aim of this study was to evaluate the levels of IgM & IgG antibodies against HCMV by identifying the viral genome in the breast tissue of women with breast cancer.

    Methods

     A total of 60 patients with breast cancer and 60 healthy individuals (40 cases with fibroadenoma and 20 healthy samples) were selected. Serum levels of IgM & IgG antibodies against HCMV were measured by ELISA, and after DNA extraction from the breast tissue, the presence of the cytomegaloviruses (CMV) genome was assessed by Real-Time PCR.

    Results

     Real-time PCR results showed that 20 samples of breast cancer tissue and 5 samples of fibroadenoma were positive for CMV genome (P = 0.001, OR: 5.50, CI 95%: 1.90 - 15.89). All samples had CMV-IgG antibody in their serum, but their mean serum level was higher in the cancer group (48.27 ± 15.99 U/mL) than the control group (40.11 ± 18.01 U/mL) (P = 0.004). However, CMV-IgM anti-viral antibody was positive in 5 cases with cancer and 3 cases in the control group. The mean serum concentration of this antibody was higher in the cancer group (6.60 ± 6.75 U/mL) than the control group (4.92 ± 3.03 U/mL) (P = 0.099).

    Conclusions

     Increased serum levels of anti-CMV antibodies in patients with cancer, as well as the presence of viral genomes in some cases, indicate the carcinogenesis effect of the virus.

    Keywords: ELISA, Real-Time PCR, HCMV DNA, Breast Cancer
  • Sedigheh Ghasemian Dizaj Mehr *, Hale Ayatollahi, Afshin Mohammadi, Siamak Naji Haddadi, Farzaneh Rashidi Fakari Page 5
    Introduction

     A struma ovarii is a benign monodermal teratoma, composed of mature thyroid tissue. The presentation of this disease with pseudo-Meigs’ syndrome [characterized by ascites, pleural effusions, and elevated cancer antigen-125 (CA-125) levels] may result in an advanced ovarian cancer misdiagnosis.

    Case Presentation

     The patient was a 54-year-old woman with dyspnea, abdominal distention, and pseudo-Meigs’ syndrome. She had a final diagnosis of struma ovarii, misdiagnosed as advanced ovarian cancer. She is currently asymptomatic (after surgery) and has a normal CA-125 level.

    Conclusions

     The preoperative diagnosis of struma ovarii is difficult, and if it presents with pseudo-Meigs’ syndrome, it may be initially misdiagnosed as advanced ovarian cancer. Using the frozen-section procedure, unnecessary extensive surgeries can be prevented.

    Keywords: Pseudo-Meigs’ syndrome, Monodermal teratoma, Struma ovarii
  • Kazem Nejati *, Sedigheh Fekri Aval, Mohammadreza Alivand, Abolfazl Akbarzadeh, AmirAhmad Arabzadeh Page 6

    Context:

     Breast cancer (BC) is the most common cancer in women worldwide. Hereditary susceptibility created by mutations in autosomal dominant genes is responsible for 5 to 10% of all BC cases in women. Recent studies have identified genes associated with increased risk for aggressive BC, providing the basis for better risk management.

    Evidence Acquisition: 

    The latest information in National Center for Biotechnology Information (NCBI), Google Scholar, ScienceDirect, and Scopus were the main databases for finding articles. A combination of keywords of ‘metastasis’, ‘invasion’, ‘aggressive breast cancer’, ‘prognostic factor’, ‘mutation’, and ‘cancer treatment’ was searched in the databases to identify related articles. Titles and abstracts of the articles were studied to choose the right articles.

    Results

     Mutations in breast cancer type 1 susceptibility protein (BRCA1) and breast cancer type 2 susceptibility protein (BRCA2) genes are two central players related to the high risk of BC. Mutation in tumor protein p53 (TP53) is another important mutation that leads to triple-negative BC. Although the majority of BC types are not associated with high-throughput mutant genes such as BRCA1, BRCA2, and TP53, they are associated with low-throughput genes, including DNA repair protein Rad50 (RAD50), Nijmegen breakage syndrome gene (NBS1), checkpoint kinase 2 (CHEK2), BRCA1-interacting protein 1 (BRIP1), E-cadherin gene (CDH1) and PALB2, UCHL1, aldehydedehydrogenase1A3 (ALDH1A3), androgen receptor (AR), 5-bisphosphate 3-kinase (PIK3CA), phosphatidylinositol-4, and luminal gene expression that are generally mutated in the global population. High tumor mutational burden (TMB) was associated with improved progression-free survival.

    Conclusions

     The lymph node status, early tumor size, ER, PR, human epidermal growth factor receptor-2 (HER2), and Ki-67 are conventional prognostic factors for BC. However, these factors cannot exactly predict the aggressive behavior of BC. Hence, in this review, we discussed new prognostic factors of aggressive BCs that are useful for the treatment of patients with BC.

    Keywords: Cancer Treatment, Mutations, Metastases, Prognostic Factors, Aggressive Breast Cancer
  • Ahmad R Mafi *, Hasan Barati, Keyvan Ramezani Page 7
    Introduction

     Extraosseous Ewing sarcomas (EESs) are rare tumors that originate from soft tissues. Upper extremity EESs account for about 3% of all cases. Here we reported a case of ESS of the upper limb whose management became complicated due to the COVID-19 pandemic.

    Case Presentation

     A 27-year-old female with EES of the right deltoid region presented after 3 months delay when the tumor had reached a huge size. Neoadjuvant therapy was initiated for her with acceptable results, however, her surgical treatment was postponed 3 times due to the cancellation of elective operations in the hospital as well as her involvement with COVID-19 infection. She developed multiple pulmonary metastases shortly after the surgery and passed away within a fortnight due to respiratory complications.

    Conclusions

     Although not “emergent” by definition, surgical treatment of patients with cancer, especially those who suffer from malignancies with high metastatic potential such as Ewing sarcoma (including EES), should not be considered as “elective” since the disease may progress in a short time and become incurable.

    Keywords: COVID 19, Ewing Sarcoma, Extraosseous
  • Alireza Negahi, MohammadEsmaeil Akbari *, Paniz Motaghi O, Atieh Akbari, Hooman Riazi, Mahnaz Akbari, Najmeh Dabbagh, Jalil Beheshti Page 8
    Background

     Adequate treatment for all resectable early gastric cancers (EGCs) is gastrectomy with regional lymphadenectomy. The number of positive resected lymph nodes during lymphadenectomy can be a reliable predictor of survival of GC.

    Objectives

     We aimed at assessing the prognostic significance of Dissected Lymph Node Count (DLNC), positive LNC (PLNC), and Lymph Node Ratio (LNR) in patients with EGC.

    Methods

     In the current retrospective cohort, 201 patients with resectable EGC were included. Demographic variables, clinicopathological characteristics of tumors (including numbers of total dissected nodes and positive, negative nodes), history of receiving adjuvant cancer therapies, and 1- and 5-year survivals were noted.

    Results

     DLNC, PLNC, and LNR were associated with differentiation and depth of tumor, lymph node status, and risk of death (P-value for all < 0.05). There was no correlation between either of these measures with preoperative symptoms, lymphovascular invasion, and recurrence. DLNC, PLNC, and LNR showed prognostic significance only in patients, who did not receive comprehensive therapy (P-value < 0.001 for all). A significantly higher LNR was seen in patients with more than 1-year survival compared to others (P-value = 0.011). A significantly lower DLNC and higher PLNC were seen in patients, who survived over 5 years (P-value of 0.002 and 0.047, respectively).

    Conclusions

     LNR, DLNC, and PLNC are significant prognostic factors for EGC. According to our findings, choosing the optimal approach, through which fewer negative lymph nodes are dissected, is crucial in increasing overall survival and extended lymphadenectomy cannot necessarily benefit patients.

    Keywords: Locoregional Dissection, Overall Survival, Lymph Node Count, Lymph Node Ratio, Lymph Node Resection, Lymphadenectomy, Gastric Cancer