Indian journal of cancer最新文献

Background: The integration of molecular features into the already existing pathological classification of endometrial carcinomas will offer significant prognostic information. As the literature search reveals, there are no studies from India that have classified these carcinomas based on molecular subtypes. The aim of the study was to classify endometrial carcinomas into four subtypes based on their molecular and immunohistochemical features and to find out the association of each of these molecular subtypes with the other pathological parameters.

Methods: A prospective study was done on 37 consecutive cases of fresh hysterectomy specimens, biopsy-proven as endometrial carcinomas between November 2019 and August 2020. Three immunohistochemical markers ( p53 , mismatch repair proteins, MutS homolog6 and Postmeiotic seggregation 2 respectively[ MSH6 , and PMS2] ), along with DNA (deoxyribonucleic acid) sequencing of selected regions of the POLE gene was performed in each of the 37 cases. Endometrial carcinomas were subclassified into four subtypes, and the association of each of these four subtypes with the other pathological parameters was also explored. Statistical analysis was done using the IBM Statistical Package for the Social Science (SPSS) Version 20.0 software (IBM SPSS, USA).

Results: Among the 37 cases studied, eight (21.6%) cases were p53 abnormal, eight (21.6%) cases showed MMR-D (mismatch repair deficient), one case (2.7%) showed mutation of POLE , and 21 cases (56.8%) were assembled under p53 wild-type. Higher grade endometrial carcinomas showed more (80.0%) p53 abnormal ( P < 0.001). All the p53 wild-type (100%) were of Type 1 endometrial carcinoma subtype ( P = 0.001) and low-grade type (90.5%; P = 0.005).

Conclusion: Our study confirms that the type of carcinoma and grade correlates with p53 expression, p53 abnormal being associated with higher grade and type 2 endometrial carcinomas, whereas p53 wild-type is associated with low-grade and type 1 endometrial carcinoma. There was only one case of the POLE subtype identifiable in our study.

Hemangiopericytoma (HPC) is a rare tumor originating from Zimmerman pericytes. It constitutes less than 1% of all intracranial tumors. Because of the high recurrence rates, radiotherapy (RT) is a vital step in the treatment, but the timing and dose remain uncertain. We presented a 39-year-old patient with a high-grade hemangiopericytoma located at the skull base. The patient presented with a severe headache. Cranial magnetic resonance imaging (MRI) revealed a mass of size of 60 × 50 mm. A subtotal resection was performed that confirmed the diagnosis of HPC. The patient received 66 Gy postoperative RT. Adjuvant sunitinib treatment was initiated after RT. The complete regression was achieved in the third month after RT. The patient has a complete response for 25 months. To our knowledge, this case is one of the rare cases in the literature in which immediate RT and adjuvant chemotherapy were used in combination with surgery. Although HPC is a radio- and chemo-resistant disease, a trimodality treatment approach can provide the patients with a complete response. In particular, patients with high-grade and inoperable tumors and patients who undergo subtotal resection should be evaluated for trimodal therapy.

Background: Long-term survivors of Hodgkin lymphoma (HL) are at risk of developing a range of late effects, with a second malignant neoplasm and cardiovascular diseases being the leading causes of death in these patients. The present study aims to evaluate the late side effects in children with HL.

Materials and methods: Out of 53 HL patients, we assessed the long-term effects of childhood HL survivors (HLSs; n = 50) diagnosed between 1998 and 2019. Patient data related to chronic health conditions, and sociodemographic characteristics were compared with their siblings ( n = 56).

Results: The cumulative overall survival (OS) at 1, 5, and 10 years from diagnosis was 98.1 ± 1.9%, 93.3 ± 3.8%, and 93.3 ± 3.8%, respectively. Groups of HLSs and their siblings were matched according to age and gender. Compared with siblings, survivors had will be changed as 'a higher frequency of nephrotoxicity ( P = 0.02)', cardiotoxicity ( P = 0.12), thyroid dysfunction ( P = 0.001), health care service usage ( P < 0.01), limitation of physical function ( P = 0.01), and pulmonary disease ( P = 0.01). The control group of siblings had a higher incidence of marital status ( P < 0.01), parenthood ( P = 0.01), and smoking habit ( P = 0.03). Thyroid dysfunction was associated with neck radiotherapy ( P < 0.01). No secondary neoplasm was detected. In relapsed, refractory setting ( n = 10), autologous transplantation ( n = 9) is performed after a complete remission. Brentuximab vedotin with or without bendamustine and rituximab is also used in selected patients.

Conclusions: Increased number of chronic health conditions and social problems point to the significance of long-term follow-up of HLSs. We are currently preparing a survivorship guideline appropriate for Turkey's conditions.

Implications for cancer survivors: Renal, heart, pulmonary impairment, thyroid dysfunction, limitation in physical functioning, and deterioration in social status (marriage, having children, education).

Using one's own immune system for curing cancer has been an active field of research in cancer biology and therapeutics. One such opportunity in cellular immunotherapy is adoptive cell transfers. With the recent approval of CAR-T therapy as a cancer treatment, a whole new paradigm of cancer treatment has opened-up, with a ray of hope for relapsed/refractory cancer patients. Despite promising clinical outcomes, the therapy is in its early phase and remains out of reach for most patients due to its high cost and logistic challenges. In India, these therapies are unavailable and further confounded by the economic challenges and a large population. In this review, we discuss various aspects of T-cell immunotherapies with a special focus on CAR-T in the Indian scenario. We touch upon the basic scientific aspects, mechanism of action, manufacturing, clinical aspects and commercial aspects of the CAR-Tcell therapies and its future worldwide and in India.

Background: To determine the contribution to diagnostic rates of the evaluation of the sonographic characteristics of lymph nodes with EBUS together with vascularity.

Methods: In the present study, patients who underwent the Endobronchial ultrasound (EBUS) procedure were evaluated retrospectively. Patients were classified as benign or malignant by using the sonographic features of EBUS. EBUS-Transbronchial Needle Aspiration (TBNA) confirmed histopathologically with lymph node dissection or in cases where no disease progression was observed clinically or radiologically in at least 6 months of follow-up. Malignant lymph node diagnosis was based on histological examination.

Results: Evaluation was made of 165 patients comprising 122 (73.9%) males and 43 (26.1%) females with a mean age of 62.0 ± 10.7 years. Malignant disease was diagnosed in 89 (53.9%) cases and benign disease in 76 (46.1%) cases. The success level of the model was seen to be approximately 87%. The Nagelkerke R 2 value was calculated as 0.401. The probability of malignancy increased 3.86-fold (95% CI: 2.61-5.11) in lesions of diameter ≥20 mm compared to lesions <20 mm, 2.58-fold (95% CI: 1.48-3.68) in lesions not determined with central hilar structure (CHS) compared to those determined with CHS, 6.85-fold (95% CI: 4.67-9.03) in lymph nodes observed with necrosis compared to those without necrosis, and 1.51-fold (95% CI: 0.41-2.61) in lymph nodes with a vascular pattern (VP) score of 2-3 compared to those with a VP score of 0-1.

Conclusion: Visualization of coagulation necrosis with EBUS-B mode and the determination of VP 2-3 in power Doppler mode were seen to be the most important criteria of malignancy.

Background: Breast cancer is the most common cancer diagnosed in women worldwide. Social media channels are a significant source of health information including breast cancer. YouTube has a broad range of educational materials on various health issues in many languages. However, the accuracy of these videos is contentious. This study aimed to examine the accuracy of the most viewed Hindi videos on YouTube related to breast cancer.

Methods: On YouTube, the "Breast Cancer-Hindi" term was searched for the 50 most viewed Hindi videos. To evaluate the videos' quality and reliability, global quality scores (GQS) and DISCERN (quality criteria for the assessment of written health information), and for credibility and usefulness Journal of the American Medical Association (JAMA) tool were used. Popularity was measured using a video power index (VPI). Comparisons of scores were made between professionals' and consumers' videos. Two health researchers independently rated the videos and their correlation was calculated for agreement.

Results: Of all the 50 videos viewed, 23 (46%) each were uploaded by consumers and professionals. GQS median 3 (1-5), DISCERN median 13 (5-23), JAMA median 2 (0.50-4), and VPI median 90.7 (50-96.93) were reported. All scores of professionals were higher than consumers at a significant level ( P < 0.05). A significant correlation was found between both observers ( P < 0.01).

Conclusion: YouTube has some good quality and reliable videos on breast cancer in the Hindi language. These videos are mostly of professionals in comparison with consumers with wide viewership. However, they are limited in numbers; therefore, health professionals should upload more videos with accurate information to spread awareness about breast cancer.

Background: We aimed to evaluate the effect of bevacizumab-containing regimens (BCRs) on the survival of children with relapsed or refractory solid tumors.

Materials and methods: Files of children with relapsed or refractory solid tumors treated with BCR were retrospectively reviewed for age, gender, follow-up time, histopathological diagnosis, adverse events observed with BCR, number of chemotherapy protocols used before BCR, the best overall response obtained with BCR, time to progression, number of BCR courses given to patients, the status of patient at last visit, and outcome.

Results: Thirty patients (16 boys, 14 girls) were treated with BCR. The median age at diagnosis was 8.5 (2 - 17) years and at the time of the study was 11 (3-21) years. The median follow-up time was 25.7 (5-79.4) months. The median follow-up time after the start of BCR was 3.2 (1-27) months. Histopathological diagnosis was central nervous system tumors in 25, Ewing sarcoma in two, osteosarcoma in two, and rhabdomyosarcoma in one patient. BCR was given as second-line in 21, third-line in six, and fourth-line protocol in three patients. No chemotherapy toxicity was observed in 22 (73.3%) patients. The best overall response was progressive disease in 17 (56.7%), partial response in seven (23.3%), and stable disease in 6 (20%) patients at first-response evaluation. The median time until progression was 77 (12-690) days. During the study period, 17 patients died of progressive disease.

Conclusion: Our study revealed that adding antiangiogenic agent bevacizumab to cytotoxic chemotherapy provided no survival benefit in children with relapsed or refractory solid tumors.

Background: Colorectal cancer is one of the alarming health problems worldwide. Prognostic biomarkers are the key for risk stratification in patients with colon cancer and the decision to recommend adjuvant chemotherapy. It has been difficult to identify a single prognostic biomarker for colon cancer. Currently, tumor stage, tumor grade, and microsatellite instability remain the most important prognostic variables that aid in the treatment of patients with colon cancer. Some studies highlighted that CDX2 immunohistochemistry negativity is an independent prognostic factor and indicates a worse survival rate. Our aim was to study the prevalence of CDX2 biomarker expression in patients diagnosed with primary adenocarcinoma and to correlate this with the clinical profile and pathological features.

Methods: Endoscopic mucosal biopsies and resection specimens of 148 patients diagnosed with colonic adenocarcinoma were analyzed. CDX2 immunohistochemistry was performed, and the result was correlated with clinicopathological features. The results were presented as mean, frequencies, and percentages. Pearson's Chi-square test was used to assess the associations between clinicopathological parameters and CDX2 immunohistochemistry negativity.

Results: The prevalence of CDX2 expression by immunohistochemistry in colon cancer was found to be 92%. CDX2 biomarker negativity was found to be higher in left-sided colon cancers, poorly differentiated adenocarcinoma, mucinous carcinoma, and higher TNM stages.

Conclusion: CDX2-negative tumors are often associated with several adverse prognostic variables (e.g., advanced stage, poor differentiation, and metastasis). Thus, sub-classification of colon cancer based on the CDX2 biomarker aids to separate them into prognostically relevant categories.

Background: Breast cancer is the most frequent malignancy among women and its prevalence keeps growing. Today, it is important to optimize the quality of life of breast cancer patients because the survival rates increase with early diagnosis and treatments. Our aim was to examine the sleep quality of patients with breast cancer, compare them with the healthy control group, and evaluate the relationship between quality of life and mental health.

Materials and methods: This cross-sectional study included 125 patients diagnosed with breast cancer and 125 healthy control patients who were admitted to the general surgery department of a university.

Results: In 60.8% of breast cancer patients, sleep quality was poor and sleep subscale scores were high. In addition, these patients had a poorer sleep quality, higher score of anxiety and depression, and lower quality of life (in terms of physical subcomponent) compared with the control group. Moreover, although age, marital status, education status, time of cancer diagnosis, menopausal status, surgical method did not have any effect on sleep quality in patient group; low income, accompanying chronic diseases, and increased levels of anxiety and depression worsened sleep quality and increased the risk.

Conclusion: In patients with breast cancer, poor sleep quality, score of anxiety and depression were higher, and worsened the quality of life. In addition, low income, presence of concomitant chronic diseases, and anxiety score posed an increased risk for poor sleep quality. Therefore, physical and mental evaluation of breast cancer patients during and after treatment should not be ignored.