Showing 150 results for Cancer
Azim Motamedfar , Mohammad Momen Gharibvand, Mohammadghasem Hanafi , Fatemeh Neghab,
Volume 81, Issue 5 (8-2023)
Abstract
Background: The aim of the present study is to determine the accuracy of ultrasound imaging in the diagnosis of metastatic lymph nodes compared to postoperative pathology samples of patients with papillary thyroid cancer.
Methods: This study was carried out using a descriptive and analytical epidemiological method on 103 known patients with papillary thyroid cancer who referred to Imam and Golestan hospitals in Ahvaz for neck ultrasound from September 2021 to August 2022. A total of 103 patients (including 94 women (91.3%) and 9 men (8.7%)) with papillary thyroid cancer with an average age of (39.8±11.9) were included in the study. The average tumor size in these patients was estimated to be (16.8±10mm). The ultrasound results of these patients before surgery were compared with the pathology results of these patients after surgery.
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Results: According to the obtained results, metastatic involvement of cervical lymph nodes was diagnosed in 36.6% of patients (38 people). Of these, 30.7% of patients (32 people) were real positive. The results of ultrasound before surgery were shown as false positive in 9.5% of patients (6 people). Lymphatic metastasis was not seen in 58.4% of patients (60 people) before surgery, which was consistent with the pathology result after surgery (true negative). The positive predictive value of examining metastatic lymph nodes by ultrasound was estimated at 84.2% and the negative predictive value at 92.3%. The diagnostic accuracy of ultrasound was 89%, the sensitivity rate was 86%, and the specificity rate was 90% with the area under the curve AUC=0.884 and P<0.001. Ultrasound accuracy is not affected by tumor size, Hashimoto's thyroiditis and metastasis location (P<0.05). In patients with Hashimoto's thyroiditis, the tumor size increases significantly more than 10 mm.
Conclusion: Ultrasound alone has an acceptable diagnostic accuracy in detecting metastatic lymph nodes caused by papillary thyroid cancer. However, the incidence of false negative error increases as the tumor size decreases.
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Mostafa Kazemi , Mohammad Hossain Dadkhah Tehrani , Ali Asghar Khaleghi, Masoud Mohammadi ,
Volume 81, Issue 9 (12-2023)
Abstract
Background: Prostate cancer is one of the most common cancers in the world, which is associated with a high prevalence, especially in the elderly male population. Treatment options for non-metastatic prostate cancer usually include active surveillance, radiotherapy and surgery, so the aim of the present study is a systematic review of brachytherapy in the treatment of prostate cancer.
Methods: The study conducted is a systematic review article in which a review of the treatment of prostate cancer with brachytherapy has been done. The information used is taken from articles published in Persian and English in Google scholar, SID and PubMed databases from 2000 to 2022. The selected keywords in this article included Brachy therapy, Prostate cancer, Radio therapy, Prostate neoplasms, High dose rate, Low dose rate and External beam radio therapy. Selection of studies was done according to PRISMA guidelines.
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Results: Brachytherapy can be classified into 2 types of permanent implantation and temporary implantation based on the length of the treatment period. In permanent brachytherapy implants for prostate cancer, iodine (125I) or palladium (103Pd) are used as radioactive sources for low dose rate cases and for high dose rate brachytherapy. Iridium (192Ir) is used. Brachytherapy is usually used in two ways, either as a monotherapy in which LDR and HDR are used to treat some low-risk patients, or as a booster treatment after other treatments such as EBRT, which here may be part of the treatment process before, after, or during treatment. In contrast to brachytherapy alone, brachytherapy plus EBRT is an appropriate approach in patients with intermediate-risk and high-risk disease. In high-risk patients, the combined use of EBRT and HDR-BT can lead to better results than EBRT alone. Brachytherapy treatment is not suitable for every disease.
Conclusion: One of the main advantages of this treatment method is the ability to administer a high dose of radiation while minimizing radiation exposure to adjacent healthy organs. Since optimal dose distribution occurs in the treatment, quality treatment can be ensured. The results obtained from both forms of brachytherapy are generally suitable and comparable to other treatment methods with fewer side effects.
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Ahmad Tahmasebi-Ghorrabi , Zahra Heydarifard, Behrouz Nemati, Majid Davari, Alireza Delavari, Hamideh Salimzadeh , Ali Akbari Sari ,
Volume 81, Issue 9 (12-2023)
Abstract
Background: Screening is a cost-effective method for prevention, early detection of the disease and reducing the burden of the third deadliest cancer in the world, i.e. colorectal cancer. This study aimed to analyze the cost-effectiveness of colonoscopy screening compared to sigmoidoscopy for colorectal cancer in high-risk individuals in Iran.
Methods: This economic evaluation study was conducted using the cost-effectiveness method between July 2016 and February 2017. Evaluation of the effectiveness of screening methods was done using a systematic review. Cost evaluation was also done using the costs obtained from the tariff approved by the Iranian Ministry of Health in 2015 for colonoscopy and sigmoidoscopy. Finally, the combined model of decision tree and Markov was used to evaluate the cost effectiveness. Incremental Cost Effectiveness Ratio (ICER) formula was used for cost effectiveness analysis considering the final outcome of 5-year survival of high-risk individuals. Excel and TreeAge software were used for data analysis.
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Results: The effectiveness of sigmoidoscopy and colonoscopy in increasing 5-year survival is 11 and 15.7%, respectively, and colonoscopy screening is 4.7% more than sigmoidoscopy. The cost of colonoscopy and sigmoidoscopy screening was calculated as 1000 and 19920 billion Rials, respectively. Based on cost-effectiveness analysis, the cost of treating patients in the case of screening with colonoscopy and sigmoidoscopy is lower than without screening. The ICER ratio of colonoscopy and sigmoidoscopy compared to no screening was -4/441/389/160 and -4/757/954/940 Rials respectively, and colonoscopy compared to sigmoidoscopy was -3/699/785/880 Rials, respectively. Finally, the use of colonoscopy leads to spending 3/699/785/880 Rials less in exchange for obtaining 4722 additional survivals with the prevention of colorectal cancer compared to sigmoidoscopy.
Conclusion: Screening by colonoscopy and sigmoidoscopy methods are effective in reducing the incidence and death of colorectal cancer compared to no screening. Screening by colonoscopy is a dominant option for the high-risk population in Iran. Colonoscopy screening is more cost effective compared to sigmoidoscopy. However, decisions about colorectal cancer screening and screening methods depend on local resources and personal preferences.
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Jamshid Ansari, Milad Pezeshki, Azam Ahmadi, Ali Chehrei,
Volume 81, Issue 9 (12-2023)
Abstract
Background: Lung cancer has the highest incidence and mortality rate of all cancers worldwide. In Iran, it is one of the commonly diagnosed malignancies, and its frequency is increasing rapidly. Genetic variants in DNA repair genes are linked to differences in efficiency of repairing DNA damage, which can influence lung cancer susceptibility. EXO1 is a key gene involved in the mismatch repair pathway. The K589E polymorphism in EXO1 may alter the DNA repair activity of the encoded protein and impact lung cancer risk. The aim of this study was to investigate associations between the K589E polymorphism in EXO1 and lung cancer risk in the Iranian population, and evaluate its potential as a prognostic biomarker.
Methods: This case-control study was conducted to investigate EXO1 K589E variant with susceptibility to lung malignancy in the Iranian population. One hundred patients with lung cancer as a patient group and 100 healthy individuals from Khansari Hospital located in Markazi province were studied, from January 2020 to May 2022. DNA extraction from blood samples of participants was done using a kit. Genotype determination of both patient and control groups was done using PCR-RFLP technique. Finally, statistical results were analyzed using SPSS software and the logistic regression method.
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Results: Genotype and allele frequency analysis showed the AA genotype (P=0.004, OR=5.391, 95% CI: 1.690-17.200) and A allele (P=0.010, OR=2.851, 95% CI: 1.291-6.300) were correlated with susceptibility to lung cancer. On the other hand, people carrying the G variant allele had a lower risk of lung cancer.
Conclusion: In summary, this study found the AA genotype and A allele of K589E in EXO1 are correlated with risk of lung cancer in Iranians, while the G allele has protective effects. The K589E polymorphism may serve as a prognostic biomarker for lung cancer susceptibility, but more studies with high population size are required.
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Saeedeh Keyvani-Ghamsari , Kiana Nouri, Ali Khaleseh Nejad , Shokoufeh Hassani,
Volume 81, Issue 11 (2-2024)
Abstract
Today, despite vast advances in cancer diagnosis and treatment, breast cancer is still the leading cause of cancer-related deaths in women. Various factors such as race, age, family history, mutation in the BRCA1/2 gene, diet, inactivity, alcohol consumption, and estrogen levels have been identified as risk factors for breast cancer. In recent years, microbiota has also been recognized as a new risk factor in breast cancer. In fact, the change in the microbial balance that occurs due to many environmental and internal factors of the body can be effective in the spread of cancer by affecting the intracellular pathways and signals. Studies have shown that intestinal dysbiosis affects the spread of breast cancer by affecting the metabolism and production of estrogen, or mechanisms unrelated to estrogen, such as the production of microbial metabolites that affect the immune system and lead to chronic inflammation. In addition, it has been proven that the breast tissue also has its microbiota, the types of which are different in healthy people, patients, even in different stages of breast cancer, and its subgroups. In such a way that a large amount of Proteobacteria, Firmicutes, Lactobacillus, and Actinobacteria are observed in healthy breasts, while their ratio changes in cancerous tissues. Considering the relationship between microbiota and breast cancer, maintaining a healthy microbiota is a new and significant approach to reducing the risk of developing, spreading, and managing this cancer. In this regard, compounds such as probiotics that can affect the balance of intestinal microbiota are considered as an effective approach to prevent and treat breast cancer. Probiotics can stimulate the growth of beneficial bacteria and inhibit the growth of harmful bacteria by causing physicochemical changes and affecting the metabolism of the intestinal microbiota. Furthermore, the consumption of probiotics can prevent the proliferation of cancer cells and reduce the tumor size by balancing the immune system, reducing inflammation, and inducing apoptosis in the cancer cells. This study describes the importance of microbiota in breast cancer, the difference between microbiota in a healthy person and a sick person, and the role of probiotics in the treatment of breast cancer.
Hossein Eskandari, Faramarz Sohrabi , Adeleh Rezagholizadeh Shirvan , Mohammad Asgari , Neda Shahvaroughi Farahani ,
Volume 81, Issue 12 (3-2024)
Abstract
Background: The experience of existential distress, along with other forms of distress, is one of the common experiences in end-of-life patients. Therefore, the purpose of this research is to review related studies and conceptualize existential distress in palliative care of cancer patients.
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Methods: This study was a systematic review, which was conducted from May 1 to July 31, 1402 at Allameh Tabatabai University and search strategy was written and performed in MEDLINE, Web of Science/PubMed and Scopus databases from the beginning of 2003 to the end of 2022. The inclusion criteria included all quantitative, qualitative, mixed and review studies that focused on the experience of adult patients. Lack of access to the full text of the article and studies in non-English language, clinical trial (randomized and non-randomized), letter to the editor, case report and protocol were excluded from the list of studies. After removing duplicate articles, two research authors reviewed the studies independently according to the inclusion and exclusion criteria, and the differences between them were resolved by discussion.
Results: After searching, screening and selecting articles based on inclusion and exclusion criteria, finally 22 articles were included in the study, of which three were review articles, eight were quantitative and 11 were qualitative. Terminally cancer patients experience existential distress, and the data are significant for estimating the prevalence of these symptoms, especially in the severe category. In addition to examining the prevalence of this symptom, patients have described their experience of existential distress in several categories: Feelings of loneliness and isolation (or loss of support system), relationship concerns (concerns about family, changes in relationships, and conflictual relationships), loss of control/autonomy (physical control, cognitive and emotional control), burden on others, loss of sense of continuity (loss of roles, pleasurable activities and sense of self), uncompleted life tasks, hopelessness/helplessness, dissolving of the future, uncertainty and frightening ambiguity, feeling guilt/ regret about the past, lack of meaning, inevitable thoughts of death.
Conclusion: It seems that the themes raised beyond cultural differences show the universal human suffering, whose accurate conceptualization can help to develop effective therapeutic interventions to reduce existential distress.
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Fatemeh Khaksarmadani, Azim Motamedfar, Mohammad Momen Gharibvand,
Volume 82, Issue 3 (6-2024)
Abstract
Background: Breast cancer ranks as one of the most prevalent cancers among women worldwide and remains a major cause of mortality. The axillary lymph node (ALN) status, especially in the absence of distant metastasis, is a significant prognostic indicator in breast cancer management. Non-invasive methods, such as ultrasound, have gained prominence in the diagnostic landscape, particularly for evaluating dense breast tissue where traditional imaging may have limitations. This study was conducted to assess the diagnostic accuracy of ultrasound in detecting malignant ALNs among breast cancer patients.
Methods: This descriptive-analytical study was conducted on 150 women diagnosed with breast cancer who visited Golestan Hospital in Ahvaz, Iran, between 2021 and 2022. Patients were initially examined clinically, and subsequently, ALN evaluations were performed using a GE S6 logic ultrasound machine. Key radiologic parameters including lymph node size, morphology, cortical thickness, and vascular distribution were assessed. Stata software was used for data analysis, and pathology results were considered the gold standard to determine ultrasound’s sensitivity and specificity in detecting malignancy.
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Results: We found 77.7% of the 150 patients had metastatic ALNs, indicating a high rate of lymphatic spread in this population. Ultrasound showed a sensitivity of 86.09% and a specificity of 51.52% in detecting malignant nodes. Radiological signs of cancer, like abnormal morphology and increased cortical thickness, were strongly linked to positive pathological findings. This shows that ultrasound is a useful tool for diagnosis.
Conclusion: The results indicate that ultrasound, as a non-invasive and accessible modality, can serve as a valuable diagnostic tool for identifying malignant ALNs in breast cancer patients. Integrating ultrasound with physical examination could enhance diagnostic precision, potentially reducing the need for invasive procedures such as biopsies. However, more research is necessary to establish the role of ultrasound in clinical protocols and investigate its potential to guide customized treatment strategies. Such advancements could optimize patient outcomes, enhance resource allocation, and ultimately contribute to more effective breast cancer management.
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Solmaz Ohadian Moghadam , , Mohsen Ayati, Erfan Amini , Faeze Salahshour, Mohsen Shiraghaei ,
Volume 82, Issue 5 (8-2024)
Abstract
Background: Sarcopenia is the degenerative loss of skeletal muscle mass, which is known as a poor postoperative outcome in various cancer types. Radical cystectomy (RC) is often associated with high mortality rates, and sarcopenia is hypothesized to aid in risk stratification. Hence, this study assessed the role of Sarcopenia as an indicator of postoperative outcomes and survival rates in patients undergoing RC for bladder cancer.
Methods: This cross-sectional research was carried out between January 2022 and January 2023 on 30 patients with bladder cancer who were candidates for RC and referred to the urology clinic of Imam Khomeini Hospital in Tehran. One week before surgery, the cross-sectional area of the psoas muscle was measured using MRI to estimate muscle volume, and the sarcopenia index was calculated. Muscle area evaluation was performed by calculating the cross-sectional area of the left and right psoas muscles on MRI. The psoas muscle area was calculated by excluding blood vessels, bony structures, and intermuscular fat regions based on fat signals. The calculated psoas muscle area was then normalized to the patient's height in square meters. To improve the quality of reporting on surgical complications, the patients were re-examined and the duration of patients' hospital stays was measured.
Results: The mean sarcopenic index for the patients was 1264.6 ± 591.5 mm²/m². Seven patients (24.1%) were smokers, while 22 patients (75.9%) were non-smokers. During the 10-month follow-up period, 25 patients (83.3%) remained alive, and 5 patients (16.7%) passed away. The mean value of sarcopenic index in patients with localized cancer was higher than those with advanced cancer, but this difference was not statistically significant. Data analysis revealed a significant association between higher mortality rates and the presence of locally advanced bladder tumors (P = 0.046). Additionally, a reduced sarcopenic index in this study was significantly correlated with lymphovascular invasion. In this study, no correlation was found between perioperative complications and sarcopenic index.
Conclusion: To conclude, a significant association was observed between a reduction in the sarcopenic index and lymphovascular invasion; however, no connection was identified between mortality rates and postoperative complications following RC.
Mohammad Masud Khubiari , Simin Najafgholian, Bahareh Abbasi, Ramin Parvizrad, Reza Aghbozorgi,
Volume 82, Issue 5 (8-2024)
Abstract
Background: Emergency Departments (EDs) visits reflect medical needs and demands or the only care available to patients. Many ED visits are potentially preventable with access to high-quality, community-based health care. Given the higher incidence of emergency conditions in patients with cancer the global increase in cancer will pose a challenge for emergency services. Therefore, this study was conducted with the aim of epidemiological investigation of emergency department visits by cancer patients in several centers.
Methods: In this cross-sectional study, the triage form and hospital file of known patients with various cancers, who visited in Eds of valiasr and Amir al Momenin hospitals in Arak, Hazrat Rasool Akram and Lolagar hospitals in Tehran, and Shahid Sadouqi and Shah vali hospitals in Yazd, From April to September 2017. To measure the urgency of ED visits, the emergency severity index and triage form were used, and the outcome of the emergency visit was extracted from the patient's file and recorded in the data collection checklist. Multivariate logistic regression analysis was used to examine the association of patient, hospital and potentially preventable factors.
Results: In this study, 1107 patients, 550 men (%49.7) and 577 women (%50.3) with cancer were were studied. Age 65 and older had the most emergency visits. The most common reason for patients to visit was: pain in different organs (18.2%), fever (8.7%), weakness and malaise (7.5%). A total of 617 (55.7%) visits were potentially preventable. Age 17 years and younger (OR, 3.172; 95% (CI), 2.409-4.021) and presence of more than 1 comorbidity (OR, 3.610; 95% (CI), 3.611-4.521) were positively associated with potentially preventable visits.
Conclusion: In this study, 50.7% of ED visits among patients with cancer were identified as potentially preventable, and the most common reason for patient visits was general and non-specific symptoms such as pain, weakness, and malaise. These findings highlight the need for palliative care and evidence-based interventions in outpatient settings.
Navid Kalani , Lohrasb Taheri , Fatemeh Eftekharian, Ali Talebi, Marzieh Haghbeen,
Volume 82, Issue 6 (9-2024)
Abstract
Background: Breast cancer is the most common cancer diagnosed in women. Epidemiological studies have led to the hypothesis that vitamin D may reduce the risk of breast cancer. This study aimed to investigate the association between vitamin D deficiency and breast cancer.
Methods: This case-control study was conducted on 59 patients referred to Khatam Al-Anbia Comprehensive Cancer Clinic in Jahrom city between May 2021 and March 2022. Thirty patients with pathologically confirmed ductal or lobular breast cancer in situ or invasive in one or both breasts, with no previous history of the disease and within two months of their breast cancer diagnosis, were considered as the case group. Thirty women without breast cancer who had been referred for breast screening examination were considered as the control group. Both groups were matched for demographic characteristics and age. The data collection tools in this study included demographic information and clinical history of the patients and serum vitamin D levels. Data analysis was performed using SPSS software, version 21 (IBM SPSS, Armonk, NY, USA) and descriptive statistics (mean, percentage, and standard deviation) and inferential statistical tests (logistic regression, Kolmogorov-Smirnov). The significance level was considered to be P<0.05.
Results: The mean age of the patients participating in the case group was 52.17±10.6 and in the control group was 51.24±9.7. There was no statistically significant difference in age (P=0.654). There was also no significant difference between the two groups in terms of body mass index and different body index classifications, menopause age, and age of onset of menstruation. The number of months of breastfeeding in the control group was significantly higher than the case group (P=0.001). The results of logistic regression showed that, on the other hand, there was no significant relationship between the type of pathology of the disease and serum vitamin D levels.
Conclusion: The results of the present study showed that vitamin D deficiency can be a poor prognostic factor in the course of breast cancer.
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Fateme Sadat Zendehdel, Seyyed Abdolhamid Angaji , Behnaz Beikzadeh, Behzad Narouie , Mahdi Mohammadi,
Volume 82, Issue 6 (9-2024)
Abstract
Background: Clear renal cell carcinoma (ccRCC) is the most common malignant kidney tumor and has a high mortality rate. The pathogenesis of this cancer is complex and efficient biomarkers for its diagnosis and prediction are limited. This study aimed to identify predictive genes in ccRCC through analysis and laboratory validation ccRCC is the most common malignant kidney tumor and has a high mortality rate.
Methods: The present study was a case-control study in which samples were taken from patients and healthy individuals from Labafi Nejad Hospital in Tehran between October 2012 and April 2014, and laboratory tests were performed on the samples.
First, genes with differential expression in ccRCC patients were identified by bioinformatics using gene expression profile data from the Gene Expression Omnibus (GEO) database with accession number GSE213324. Data analysis was performed using Galaxy web server, protein-protein interactions were checked using Cytoscape and STRING app software, and finally two genes were selected for real-time PCR testing.
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Results: Analysis identified 4,065 genes with differential expression in RCC tissues compared to healthy tissues. These genes are involved in immune responses and renal disease pathways, suggesting their potential role in disease development. After constructing the protein-protein interaction network and identifying differentially expressed genes in kidney tissue and blood, two genes, MTTP and CALCA, were selected for further investigation. In the Mann-Whitney U test, the expression of the CALCA gene decreased significantly in the patient group (P<0.05). On the other hand, the MTTP gene showed a decrease in expression, but not significantly. The AUC calculated to evaluate the diagnostic accuracy for the CALCA gene was 0.64 and significant (P<0.05), demonstrating its potential as a useful biomarker for ccRCC diagnosis. However, the AUC for the MTTP gene was not significant.
Conclusion: The reduction in CALCA expression could serve as a useful biomarker for diagnosing ccRCC.
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Bahar Rostamizadeh, Alireza Jalali-Zand , Kamran Qhaedi, Rozita Nasiri,
Volume 82, Issue 8 (11-2024)
Abstract
Background: Insects and arthropods, along with their products, have been used as medicinal sources since ancient times, that is called entomotherapy. Cancer is one of the major problems in medical science, for which a drug has not yet been discovered to control it quickly and accurately. Arthropods have been medicinal sources since ancient times and they especially Insects have a high potential for insect therapy because of the biodiversity. This research investigates the effect of insect body extracts and arthropods in inhibiting the growth of cancer cells or tumours, specifically on the breast cancer cell line, MCF7002E
Methods: The basic and applied study was conducted in Isfahan from 2018 to 2023. In this research, six species of insects, namely Gryllotalpa sp., Polyrhachis sp., Dolichovespula sp., Apis mellifera, Periplaneta americana, Drosophila melanogaster, and one species of Chilopoda, Scolopendra sp., were used. The samples were washed with distilled water and 70% alcohol, then frozen and powdered and prepared in 1% DMSO at eight concentrations of 62.5, 125, 250, 500, 1000, 2000, 4000, 8000 μg/ml and were evaluated for the control of two lines of breast cancer cells MCF-7 by the MTT test was performed to check the effect of doses. The affected doses of insects and centipedes were performed in 6 replicates and three times to MCF-7 cells. IC50 and LD50 were calculated by Prism version six software to check the effect of concentrations determine the effective dose and choose the best extract to control the growth of MCF-7 breast cancer cells.
Results: Scolopendra sp., Drosophila melanogaster, Periplaneta americana, Polyrhachis sp., Apis mellifera, and Gryllotalpa sp. are the most effective species, respectively, in inducing apoptosis and cell death in MCF-7 cancer cell line. Dolichovespula sp. had the least effect. Scolopendra sp. at a concentration of 500 μg/litre induced cell death in more than 50% of MCF-7 cancer cells.
Conclusion: The results of the application of seven different genera of arthropods and insects showed that these genera have excellent therapeutic potential, particularly in the treatment of MCF-7 cancer cells.
Fatemeh Kiaee, Kiyana Bahani, Heshmat Shahi,
Volume 82, Issue 11 (2-2025)
Abstract
Background: Helicobacter pylori (H. pylori) infection is the most common infection worldwide and results in chronic gastritis, and rarely gastric carcinoma. Chronic inflammation, which is a major engine of disease development. Is dominantly controlled by adaptive and humoral immunity. This study reveals the intricate IL-21 and IL-23 relationship in H.pylori associated diseases as well as inflammatory GI disorders, as the crtically govern the differentiation and activity of T helper 17 (TH17) cells in the gastric mucosa. Understanding these cytokines pathways is essential for comprehending the immune pathogenesis of H. pylori infection and its outcome.
Methods: A literature search was conducted in the PubMed database using the MESH keywords "Helicobacter pylori" "Interleukin 21," "Interleukin 23," and "gastric cancer" to identify relevant English-language studies. Articles that were reviews, case reports, or letters to the editor were excluded.
Results: IL-23 significantly exacerbates both intestinal and gastric inflammatory responses by stimulating T cells particularly Th17 cell subsets, through the mediation of STAT3 signaling pathways and reducing IL-10 production, while T cells lacking the IL-23 receptor promote Treg expansion and intestinal homeostasis. IL-21 is implicated in chronic inflammation of the gastric and intestinal mucosa, with elevated levels observed in ulcerative colitis patients, contributing to the recruitment of inflammatory cells, increased inflammation, and angiogenesis. This particular cytokine plays an essential role in the recruitment of inflammatory cells, the increase of tissue inflammation, and the promotion of pathological angiogenesis. Moreover, IL-21 exerts influence over B cell differentiation and the production of antibodies, establishing a connection to humoral immune responses within chronic inflammations.
Conclusion: CD4+ T helper 17 (Th17) cells exhibit both antimicrobial and pathogenic immune functions in the gastrointestinal environment. These processes are interconnected, as cytokines such as IL-21 and IL-23 are essential for Th17 cell maintenance and support humoral immune responses. A comprehensive understanding of the dynamic immunological interactions in H. pylori-related and inflammatory gastrointestinal diseases may facilitate the development of novel immunology-based therapeutic interventions.
Seyede Hakimeh Sajadi, Mohadeseh Karimi ,
Volume 82, Issue 12 (3-2025)
Abstract
Background: Approximately 16% of all female cancers. Due to its high prevalence and considerable impact on patient survival, comprehensive evaluation of histopathological and molecular features is crucial for improving disease management. This study aimed to analyze the histopathological spectrum and immunohistochemical (IHC) molecular subtypes of invasive breast tumors in an Iranian population, with the ultimate goal of guiding tailored therapeutic strategies.
Methods: This retrospective cross-sectional study was conducted between 2021 and 2023 at Shahid Mohammadi Hospital, Bandar Abbas, Iran. Initially, 110 female patients diagnosed with invasive breast carcinoma were evaluated. After applying exclusion criteria (bilateral breast cancer, in-situ carcinoma, prior neoadjuvant chemotherapy, or inadequate pathological specimens), 10 patients were excluded, leaving 100 cases for final analysis. Demographic and clinical data were collected from medical records, while histopathological assessment was performed using hematoxylin-eosin (H&E) staining. Immunohistochemistry was applied to evaluate estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 expression, enabling classification into molecular subtypes: Luminal A, Luminal B, HER2-enriched, and Basal-like. Tumor grade and stage were determined according to AJCC/UICC criteria. Statistical analysis was performed using SPSS v21, with significance set at P<0.05.
Results: The patients’ ages ranged from 26 to 73 years, with a mean age of 49.5 years. Histopathologically, invasive ductal carcinoma accounted for 89% of cases, followed by lobular (5%), medullary (3%), and other rare subtypes (3%). Molecular classification revealed 9% Luminal A, 65% Luminal B, 11% HER2-enriched, and 15% Basal-like. A significant association was found between tumor grade and molecular subtype (P=0.001). Luminal B tumors showed the highest frequency of grade III lesions, axillary lymph node metastasis, and advanced tumor stage (II-III), indicating more aggressive biological behavior compared to Luminal A.
Conclusion: This study confirmed that invasive ductal carcinoma is the predominant histological type of breast cancer, with Luminal B being the most prevalent molecular subtype in the studied population. The findings highlight the importance of molecular profiling for accurate prognostication and treatment planning. In particular, the aggressive features of Luminal B tumors emphasize the need for more intensive therapeutic approaches. Incorporating routine IHC-based subtyping into breast cancer management protocols could significantly enhance patient outcomes and support the implementation of precision oncology in Iran.
Babak Hooshmand-Moghadam , Abbas Ali Gaeini,
Volume 82, Issue 12 (3-2025)
Abstract
Background: As survival rates among breast cancer patients improve, cardiovascular disease (CVD) has emerged as a leading cause of long-term morbidity and mortality in postmenopausal survivors. This epidemiological transition from oncologic risk to cardiometabolic vulnerability reveals a critical yet underexplored dimension of survivorship care. Structured exercise training represents a promising intervention, and this narrative review-grounded in a systematic literature search investigates the effects of aerobic, resistance, and combined training modalities on cardiovascular health in postmenopausal women with breast cancer. The review synthesizes evidence across physiological mechanisms, clinical outcomes, and implementation challenges to provide a comprehensive perspective on exercise oncology in this underserved population.
Methods: A systematic search of reputable international databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar as well as Persian databases SID and Magiran was conducted to identify relevant human studies, clinical trials, and randomized controlled trials published between January 2000 and April 2025. Screening, selection, and synthesis of the studies were performed in Iran between October 2024 and January 2025.
Results: Accumulating evidence supports that structured exercise especially combined aerobic and resistance training exerts substantial cardioprotective effects through multiple mechanisms, including reductions in systemic inflammation, improvements in body composition, regulation of blood pressure, enhancement of cardiorespiratory fitness, and improved left ventricular function. Combined interventions consistently outperformed single-modality programs, underscoring the importance of integrative approaches in oncologic rehabilitation. Despite this promise, persistent barriers such as limited access to trained personnel, lack of individualized protocols, and weak institutional support impede translation into routine practice. Notably, few existing reviews have bridged mechanistic, clinical, and operational domains in this population, highlighting a significant gap in the literature.
Conclusion: Exercise training is not merely an adjunct to care it is a clinically potent, physiologically grounded, and policy-relevant strategy for mitigating cardiovascular risk in postmenopausal breast cancer survivors. Given the increasing burden of CVD in this group, integrating personalized, evidence-based exercise into oncologic care pathways is both urgent and essential for advancing survivorship standards and informing future clinical guidelines.
Tahereh Parsajam , Behnam Reza Makhsoosi, Ali Najafpour, Kimia Fathi,
Volume 83, Issue 1 (4-2025)
Abstract
Background: Thyroid hormones play a key role in the development of various organs of the body. The breast and thyroid are hormone-responsive organs that are closely related to changes in endocrine activity and glandular diseases. Breast cancer is the most common cancer in women and the second leading cause of cancer-related death. Due to the inconsistencies in the relationship between breast cancer and thyroid diseases and the lack of regional data, the present study was designed and conducted with the aim of investigating the prevalence of various thyroid disorders in patients with breast cancer and its relationship with the type of breast cancer and age.
Methods: In this prospective study, we examined 50 women with breast cancer who had undergone surgery after surgery. The location of this study was Imam Reza Hospital in Kermanshah and the duration of this study was 12 months from the beginning of March 2023 to the end of March 2024. Patient information included: age, histopathological type of cancer, and thyroid test results including serum TSH, FT4, and ATPO levels, were recorded and reviewed.
Results: Based on the results obtained, it was shown that the average age of people with thyroid disorders in patients with breast cancer was 42.88 and the standard deviation was 11.313. Also, there was no significant difference between the age of people and thyroid disorders in patients with breast cancer (P-value < 0.89). In the study of thyroid disorders in patients with breast cancer, it was shown that there was a significant relationship between patients with breast cancer and the amount of TSH and the amount of FT4. This means that people with breast cancer had an increase in the amount of TSH and the amount of FT4. However, there was no significant relationship between patients with breast cancer and the amount of ATPO (P-value < 0.319).
Conclusion: Thyroid disorders are more prevalent in patients with breast cancer than in the normal population, and given the relationship between the types of thyroid disorders and the type of breast cancer histopathology, these results can be used and screening methods can be used more effectively in those who have risk factors for breast cancer for early diagnosis and treatment of the disease.
Behzad Iranmanesh, Ali Morsali, Nazanin Zeinali Nezhad ,
Volume 83, Issue 2 (5-2025)
Abstract
Background: Non-melanoma skin cancers (NMSCs) are among the most prevalent malignancies globally. Investigating their characteristics and treatment-related outcomes can significantly contribute to optimizing management strategies including surgery, chemotherapy and radiotherapy. This study aimed to examine the characteristics of NMSCs and the complications following surgical treatment (such as necrosis and bleeding).
Methods: This is a retrospective descriptive cross-sectional study which was conducted to investigate the features of patients initially diagnosed with NMSC (confirmed by histopathological examination of the lesion) at dermatology ward of Afzalipour Hospital, Kerman University of Medical Sciences, between 2018 and 2021. Inclusion criteria were definitive diagnosis (based on the result of pathology) of an NMSC and undergoing surgical management. Exclusion criteria included incomplete patient records. Relevant data were extracted and recorded using a data collection form. Finally, all collected information was statistically analyzed according to the study objectives, and the overall frequency of NMSC surgeries, as well as their frequency based on study variables, was reported descriptively.
Results: A total of 37 NMSC surgeries were performed. The majority were basal cell carcinomas located on the face. Over half of the patients were male, and most had underlying medical conditions despite lacking common risk factors such as smoking and sun exposure. The most common flap techniques used were rotational flap, island pedicle flap, and H-plasty flap. Two complications were observed: one case of bleeding at the surgical site and one case of wound edge necrosis, both occurring one week post-operation.
Conclusion: In the southeastern region of Iran, NMSCs requiring surgical treatment showed a lower prevalence than anticipated. However, their pathological and demographic characteristics were consistent with global observations. The incidence of post-surgical complications was also low. Nevertheless, future studies with larger sample sizes in this region and across the country are recommended to enhance the reliability of these findings.
Sepideh Mahdavi, Mohammad Hassan Emamian , Zahra Kordi, Mansooreh Fateh, Mostafa Enayatrad,
Volume 83, Issue 2 (5-2025)
Abstract
Background: Stomach cancer is the fifth most common cancer worldwide. This study aimed to investigate the trend in the incidence of stomach cancer in Shahroud and Meyami districts over a thirteen-year period.
Methods: This study is a cross-sectional study that examines the incidence of stomach cancer using data from the population-based cancer registry system in Shahroud and Meyami Districts in Semnan province over a thirteen-year period from the beginning of April 2010 to the end of March 2022. Age-standardized incidence rates were calculated using both the new and old-World Health Organization standard populations. Trend in cancer incidence were analyzed using Joinpoint regression.
Results: Between 2010 and 2022, a total of 474 new cases of stomach cancer were reported. The mean age at diagnosis was 69.3±12.8 years, with 70.3±12.7 years in men and 67.8±12.8 years in women. The age-standardized incidence rate based on the new WHO population was 15.1 per 100,000 people for the entire period, and 20.9 and 9.5 per 100,000 for men and women, respectively. The annual percentage change indicated a (APC: -4.60 % (95% CI: -0.08 to -9.36)) decrease per year, which was statistically significant (P=0.047), particularly in men (APC= -4.42%, (95% CI: -8.39 to -0.63, P=0.024)), whereas the decline in women was not statistically significant (APC= -4.28%, (95% CI: -10.45 to 1.79, P=0.150)). The incidence of stomach cancer increases with age, with the highest number of cases observed in the 75-79 years age group. The incidence trend in the age group 70-74 years (AAPC: -8.98% (95% CI: -2.75, -14.72 was significantly (P=0.005) decreasing.
Conclusion: The findings of this study showed that the age-standardized incidence rate of stomach cancer had a decreasing trend and that incidence increased with advancing age. Moreover, the incidence rate in men was approximately twice that in women. In men, the incidence trend showed a significant decline, whereas in women no significant change was observed.
Elham Rajaei, Tina Vosoughi, Forough Nokhostin, Hojatollah Yousefimanesh, Mahnaz Parvazi,
Volume 83, Issue 3 (6-2025)
Abstract
Background: Osteonecrosis of the jaw has recently been reported in patients receiving denosumab for cancer treatment. Accordingly, the present study aimed to determine the frequency of osteonecrosis of the jaw in cancer patients receiving denosumab.
Methods: In the present descriptive-analytical study, 62 cancer patients receiving denosumab who referred to the oncology clinic of Golestan and Shafa Hospitals in Ahvaz in 1403 were studied. The prevalence of osteonecrosis of the jaw among the studied patients was investigated and its relationship with predisposing factors, including gender, type of cancer, comorbidity, and dental caries status, was recorded and analyzed in a checklist.
Results: The prevalence of osteonecrosis of the jaw was 1.6%. There was no significant association between the incidence of osteonecrosis of the jaw and gender and comorbidities (P<0.05), but females showed a 38% higher probability of developing osteonecrosis of the jaw (95% confidence interval; 1.62-1.18, r=1.386). Breast cancer was the most common type of cancer among the study participants (61.3%), but no significant association was found between the incidence of osteonecrosis of the jaw and the incidence of the cancers studied (P-value=0.986). No significant association was found between the incidence of osteonecrosis of the jaw and dental caries (P-value=0.741). The odds of developing osteonecrosis of the jaw in patients with or without dental caries risk were reported to be 1.1 (95% confidence interval; 1.205-1.021, r=1.109).
Conclusion: Despite the lack of a significant association between the incidence of osteonecrosis of the jaw and various factors such as gender, type of cancer, comorbidities, and dental caries, there was evidence of a relative increase in the risk of osteonecrosis of the jaw in women with cancer treated with denosumab, which highlights the need for further investigation.
Mandana Pouladzadeh, Fatemeh Khazaei, Saeid Bitaraf, Hossein Karimpourian, Mahsa Mombeyni, Mohammad-Reza Mahmoudian-Sani ,
Volume 83, Issue 4 (7-2025)
Abstract
Background: Breast cancer is the most prevalent malignancy among women and remains a leading cause of cancer-related mortality worldwide. Early detection can markedly improve patient survival, yet existing screening methods often lack sufficient accuracy and sensitivity. lncRNA KCNQ1OT1 has been implicated in the initiation and progression of tumors in several cancers, including breast cancer. This study aimed to evaluate the diagnostic potential of serum lncRNA KCNQ1OT1 expression as a biomarker for early detection of breast cancer.
Methods: This case-control study was conducted at Ahvaz Jundishapur University of Medical Sciences, Shafa Hospital, Ahvaz, Iran, between September 2024 and March 2025. Serum samples were obtained from 30 patients with histologically confirmed breast cancer and 30 healthy women serving as controls. Total RNA was extracted from 500 µL of serum, and cDNA was synthesized using oligo (dT) primers. Real-Time PCR was performed in triplicate, with GAPDH as the internal control. Relative gene expression was calculated using the 2^-ΔΔCt method, and data were analyzed using the Mann-Whitney U test and ROC analysis.
Results: The patient and control groups were homogeneous for most demographic parameters, but showed significant differences in age (P=0.023) and ethnicity (P=0.004). Most patients were in stage I of the disease. The median expression of serum KCNQ1OT1 was significantly lower in patients (0.024, IQR 0.013-0.033) than in controls (0.039, IQR 0.027-0.051), indicating marked downregulation in the patient group (P=0.0003). The ROC analysis yielded an AUC of 0.82 (95% CI: 0.67-0.96, SE=0.07, P=0.0005). At an optimal cutoff value of >0.031, the sensitivity was 70%, the specificity was 95%, and the positive likelihood ratio (LR⁺) ≈ was approximately 14, demonstrating strong discriminative ability.
Conclusion: Serum KCNQ1OT1 exhibits promising diagnostic performance for identifying early-stage breast cancer and may serve as a reliable noninvasive biomarker. Larger multicenter studies incorporating molecular subtyping and tissue correlation are required to validate its clinical applicability and strengthen diagnostic accuracy.