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   Table of Contents - Current issue
Coverpage
November-December 2019
Volume 8 | Issue 6
Page Nos. 215-262

Online since Tuesday, November 19, 2019

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ORIGINAL ARTICLES  

Expression patterns of cofilin and scinderin in breast cancer and their association with clinicopathological features in Iranian patients Highly accessed article p. 215
Parisa Nourmohammadi, Mojtaba Saffari, Mohammad Hasan Sheikhha, Sara Tutunchi, Bahareh Nourmohammadi, Amirnader Emami Razavi, Reza Shirkoohi, Nasrin Ghasemi
DOI:10.4103/ccij.ccij_52_19  
Background: Cofilin-1 (CLF1) and scinderin (SCIN) are significant actin-binding proteins that are involved in the regulation of the actin polymerization dynamics. Overexpression of CLF1 and SCIN has been associated with aggressive and tumorigenesis characteristics of various cancer types. The aim of the present study was to investigate the expression of CFL1 and SCIN genes in breast cancer cells and their association with clinicopathological features. Materials and Methods: In this study, 65 breast cancer tissues were randomly selected, and quantitative real-time polymerase chain reaction was performed to measure the expression level of CFL1 and SCIN genes in breast tumors. Then, the association of CFL1 and SCIN expression level with clinicopathological features was assessed using Prism 5 software. Results: Overexpression of CFL1 and SCIN was observed to be statistically significantly associated with tumor stage and lymph node involvement (P < 0.05). However, no association was found between the expression of the mentioned genes and tumor grade, tumor size, and patient age. Conclusion: The results of this study suggest that as CFL1 and SCIN genes may play a role in the development of breast cancer; they have the potential to be examined as new biomarkers to predict the progression of the mentioned disease.
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Are genetic polymorphisms of glutathione S-Transferase P1 gene associated with urothelial carcinoma of the urinary bladder? p. 222
Vikas Rampal, Benedict Paul Samuel, Sumita Danda, Santosh Kumar, Antony Devasia, Nitin Sudhakar Kekre
DOI:10.4103/ccij.ccij_84_19  
Background: Polymorphisms in genes encoding glutathione S-transferase (GST) may affect susceptibility to develop urothelial carcinomas (UCs). One of the extensively studied genes in this group is GST P1 (GSTP1), but studies of the relationship of polymorphisms of GSTP1 and UC of the bladder have been equivocal. Hence, we assessed the association between genetic polymorphism of GSTP1 gene and the development of UC of the urinary bladder. Materials and Methods: This prospective, case–control study was conducted in the departments of urology and clinical genetics at a tertiary care teaching hospital in South India, which included 52 patients with histopathologically confirmed UC bladder and matched with 46 controls from August 2012 to July 2013. The study participants provided a single venous blood sample for extraction of genomic DNA. Laboratory personnel was blinded to sample groups. The primary outcome of the study was to detect association of genetic polymorphism of GSTP1 gene with UC of the bladder. The secondary outcome was to assess if the risk of urothelial bladder cancer is increased in smokers with polymorphism of GSTP1 gene. Statistical Analysis Used: We used the Chi-square or Fisher's (F) exact test to compare discrete variables. Unconditional logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals. Results: Although the heterozygous polymorphic genotype ile/val (AG) was seen more frequently in cancer group (34.6% vs. 23.9%), the difference was not statistically significant (P = 0.202). None of the smokers had homozygous polymorphic valine allele and GSTP1 did not add to the susceptibility of UC bladder even among smokers. Conclusions: A lack of association between GSTP1 313 G/G polymorphism and urothelial cancer of bladder was observed.
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Expression of epidermal growth factor receptor in squamous cell carcinoma of uterine cervix p. 227
Shakti Kumar Yadav, Alekh Verma, Namrata Sarin, Sompal Singh
DOI:10.4103/ccij.ccij_69_19  
Context: Cervical cancer is one of the most important cancer deaths among females. Epidermal growth factor receptor (EGFR) plays a role in cell differentiation, cell motility, neovascularization, invasion, metastasis, and resistance of cancer cells to chemotherapeutic agents and radiation. Tyrosine kinase inhibitors and anti-EGFR monoclonal antibodies have shown better response in various invasive tumors. Aims: The aim of the study is to evaluate EGFR expression in squamous cell carcinoma (SCC) of the cervix and to assess its relation to tumor characteristics. Settings and Design: This was a retrospective, case–control study. Subjects and Methods: Formalin-fixed paraffin-embedded tissues from 30 cases with SCC along with 20 age-matched cases with normal cervix as controls were obtained from the archives. EGFR expression was analyzed in both cases and controls. Statistical Analysis Used: The Chi-square test was used to compare and find the association between the variables. Statistical analysis was done using the IBM SPSS (IBM, Armonk, NY, USA) software and P < 0.05 was considered significant. Results: Strong EGFR expression was present in 93.4% of the cases, while 6.6% of cases showed moderate expression. Strong EGFR expression was associated with the tumor size of >4 cm size. There was no association of EGFR expression with tumor grade, tumor stage, and lymph node metastasis. Conclusions: The present study showed that a significantly higher number of cases of invasive SCC of uterine cervix show increased EGFR expression. The EGFR expression is associated with tumor size.
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Genitourinary tract cancers: Frequency and demographic characteristics p. 232
Zahra Tolou_Ghamari, Hamid Mazdak, Masih Saboori, Mehrdad Mohammadi Sichani
DOI:10.4103/ccij.ccij_81_19  
Context: As one of the most common cancers in clinical practice, genitourinary system tumors are reported to grow worldwide. Aims: We aimed to describe the frequency and demographic characteristics of such cancers' in Isfahan Province/Iran. Materials and Methods: Information related to the genitourinary system tumors was collected from the Isfahan Cancer Registry. The cancer sites studied were defined according to the International Classification of Diseases (ICD-O; Third Edition) and recorded by associating topography code. Statistical Analysis Used: The statistical analyses of d-Base were performed using Microsoft Excel and SPSS v. 20 (Chicago, IL, USA) for windows. Results: Among all registered patients with genitourinary cancers, there were 3024 cases with genital system cancers and 2117 cases with urinary system cancers. The frequency of males versus female genital system cancers was (n = 1808 vs. n = 1216; P = 0.01), respectively. The frequency of bladder and kidney cancer was 1655 and 404 cases, respectively. Conclusions: According to the analysis, there were higher frequency of ovary and prostate cancer in male and females correspondingly. Associated with the urinary system, cancers of bladder and kidney were higher than others. Further advanced study associated with drug therapy and surgical management seems to be advantageous.
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Radiation-induced complication after radiotherapy in patients with head-and-neck cancers p. 236
Elaheh Kazemi, Farid Zayeri, Ahmad Reza Baghestani, Mohsen Bakhshandeh, Maryam Hafizi
DOI:10.4103/ccij.ccij_62_19  
Background: Exposure of nontarget organs such as the thyroid gland (as a normal and high radiosensitive tissue) to radiation during radiotherapy for patients with head-and-neck cancers remains unavoidable. Hypothyroidism is the most common radiation side effect on the thyroid gland. In this study, we used the parameters of thyroid gland (triiodothyronine [T3], thyroxine [T4], and thyroid-stimulating hormone [TSH]) measurements before and after radiotherapy for patients with head-and-neck cancers. Materials and Methods: In the first step, descriptive statistics for predictors and response variables were performed. In the next step of data analysis, a multivariate linear mixed-effects model was fitted simultaneously for three response variables in order to study the trend of thyroid gland parameters. Results: The results indicated that there was a significant decreasing trend in TSH from 1.74 at baseline to 0.65 at the end of the study, and there was a significant increasing trend in T4 from 8.63 at baseline to 9.38 at the end of the study. Conclusions: There were significant changes in thyroid gland parameters after radiotherapy treatment for patients with head-and-neck cancers. Thus, preventative strategies are needed to reduce this complication. The patients with head-and-neck cancers who received radiotherapy treatment should be evaluated regularly and repeatedly during the radiotherapy treatment period.
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The correlation between overexpression of GATA-1 variants valine 205 methionine and R216Q with occurrence, prognosis, and therapeutic approaches for immune thrombocytopenic purpura p. 241
Mohammad Bagher Mohammadi, Gholam Abas Kaydani, Ali Amin Asnafi, Najmaldin Saki
DOI:10.4103/ccij.ccij_78_19  
Objective: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder that is characterized by symptoms of hemorrhage and thrombocytopenia due to the production of autoantibody against platelet glycoproteins. The occurrence of gene defects caused by mutation has been recently identified as a main factor in the onset of megakaryocytic disease. Materials and Methods: To conduct this study, 140 patients and controls with no history of platelet disorders were selected. After the collection of samples, the prevalence of GATA-1 gene mutations was evaluated using polymerase chain reaction technique, which was confirmed by sequencing. Result: The results revealed no significant information on the occurrence of valine 205 methionine (V205M) and R216Q variants in ITP patients. However, data analysis indicated clinically significant differences between control group and ITP patients in some hematological parameters such as red blood cell, hemoglobin, hematocrit, and lymphocyte count. Conclusion: V205M and R216Q mutations were not detected in ITP patients.
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Prognostic significance of epidermal growth factor receptor gene mutations and human epidermal growth factor 2 expression in breast carcinoma metastatic to the liver p. 247
Tugba Biri Yilmaz, Ayse Nur Akatli, Emine Samdanci, Nese Karadag Soylu, Harika Gozukara Bag, Nusret Akpolat
DOI:10.4103/ccij.ccij_70_19  
Background: Breast cancer is the most prevalent cancer among females, and metastatic disease is not curable and is treated palliatively. Members of the ErbB family have an important role in the development and progression of breast cancer. The aim of this study was to determine the relationship between epidermal growth factor receptor (EGFR) gene mutation, human epidermal growth factor 2 (HER2) expression, hormone receptor statuses, and clinicopathological parameters in liver metastases from breast cancer. Materials and Methods: This study included 41 patients diagnosed with liver metastasis from breast carcinoma, based on morphological and immunohistochemical findings, in our pathology laboratory between 2011 and 2018. EGFR gene mutations were analyzed by polymerase chain reaction (PCR) in these cases. Results: EGFR gene mutation analysis was performed by PCR, and no mutations were detected. HER2 and ER statuses of the primary breast tumor were available in 23 cases. HER2 status conversions were present in 9 cases (39.1%); however, this was not statistically significant (P = 0.197). Estrogen receptor (ER) conversions were present in 4 cases (17.4%); however, this was not statistically significant (P = 1.000). Progesterone receptor (PR) conversions were detected in 10 cases (45.5%). There were 10 (45.5%) cases with PR-positive primary tumors and PR-negative liver metastases. No cases with a PR-negative primary tumor developed a PR-positive liver metastasis (P = 0.02). Conclusions: No EGFR gene mutations were detected in any of our cases by PCR. There was no statistically significant relationship between clinicopathological parameters and EGFR mutation. The comparison of ER, PR, and HER2 expression between the primary tumor and metastases revealed status conversions in some cases. However, only PR conversion was statistically significant. Studies on EGFR gene mutations that include larger series are warranted to identify the candidates who can benefit from targeted therapies.
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CASE REPORTS Top

Primary neuroendocrine tumor of breast: Diagnosing and treating a rare case p. 254
Poorva Vias, Kislay Dimri, Awadhesh Kumar Pandey, Nidhi Prinja, Ranjeev Bhagat
DOI:10.4103/ccij.ccij_79_19  
Neuroendocrine carcinoma breast is a distinct entity. Although clinical features and morphology cannot distinguish it from invasive carcinomas, immunochemistry plays an important role in it. Due to its rarity and lack of clinical data, treatment is followed on the lines of invasive breast carcinoma. Some studies have suggested the use of cisplatin and etoposide for its treatment, but none of them is standard. The prognosis is poor compared to invasive breast cancer.
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Squash cytology of langerhans cell histiocytosis of sellar region p. 257
Supriya Verma, Parinitha S Sangam, Ravikala V Rao
DOI:10.4103/ccij.ccij_66_19  
Langerhans cell histiocytosis (LCH) is a systemic disease, which usually involves the skeleton and skin of children with occasional involvement of the central nervous system (hypothalamo–pituitary axis). We report the case of a 16-year-old male with a space-occupying lesion (SOL) in the sellar region and diabetes insipidus. However, no systemic abnormality was noted. A clinical diagnosis of pituitary adenoma was given. However, on intraoperative consultation by squash smears, cells with nuclear grooves and few eosinophils were seen. Hence, a differential diagnosis of LCH was also given, which was confirmed by histopathology and immunohistochemistry. Hence, as a matter of fact, LCH should be considered as one of the rare differential diagnoses of SOL of sellar region.
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SHORT COMMUNICATION Top

Strengthening measures to eliminate cervical cancer in the South East Asian Region p. 261
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/ccij.ccij_82_19  
Cervical cancer has been identified as one of the leading cancers in the South East Asian Region (SEAR). In the year 2018 in the SEAR alone in excess of 0.16 million new cases and 0.096 million deaths have been attributed to the disease. The target for the region is to eliminate cervical cancers by the year 2030 and for the accomplishment of the same, a lot needs to be done. Screening has been identified as one of the crucial strategies to prevent the cancer and there is a definite need to implement an organized screening program in the entire nation. It is vital to understand that mere capacity building won't affect the results, instead we surely require improvement in the quality of offered services. In conclusion, elimination of cervical cancer from the region will significantly improve the quality of life of women. However, to accomplish that the need of the hour is to strengthen the immunization, screening, treatment and rehabilitation services.
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