bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between calreticulin and glucagon-like peptide-1 expressions with prognostic factors in high-grade gliomas
Authors: Baran Oguz , Akgun Mehmet Yigit , Kayhan Ahmet , Evran Sevket , Ozbek Arif , Akyoldas Goktug , Samanci Mustafa Yavuz , Demirel Nail , Sonmez Derya , Serin Huriye , Kocak Ayhan , Kemerdere Rahsan , Tanriverdi Taner
Published: March 2024

Objective:

The aim of this study is to present the expressions of Calreticulin (CALR) and Glucagon-like peptide-1 (GLP-1) in high-grade gliomas and to further show the relation between the levels of these molecules and Ki-67 index, presence of Isocitrate dehydrogenase (IDH)-1 mutation, and tumor grade.

Patients and Methods:

A total of 43 patients who underwent surgical resection due to high-grade gliomas (HGG) (grades III and IV) were included. The control group comprised 27 people who showed no gross pathology in the brain during the autopsy procedures. Adequately sized tumor samples were removed from each patient during surgery, and cerebral tissues were removed from the control subjects during the autopsy procedures. Each sample was stored at −80°C as rapidly as possible until the enzyme assay.

Results:

Patients with high-grade gliomas showed significantly higher levels of CALR and significantly lower levels of GLP-1 when compared to control subjects (P = 0.001). CALR levels were significantly higher, GLP-1 levels were significantly lower in grade IV gliomas than those in grade III gliomas (P = 0.001). Gliomas with negative IDH-1 mutations had significantly higher CALR expressions and gliomas with positive IDH-1 mutations showed significantly higher GLP-1 expressions (P = 0.01). A positive correlation between Ki-67 and CALR and a negative correlation between Ki-67 and GLP-1 expressions were observed in grade IV gliomas (P = 0.001).

Conclusions:

Our results showed that higher CALR and lower GLP-1 expressions are found in HGGs compared to normal cerebral tissues.
Lymphoepithelial carcinoma of tongue - Devil in garbs of Hodgkin lymphoma: A case report and review of literature
Authors: Karki Diksha , Kamboj Meenakshi , Pasricha Sunil , Mandal Ghanashyam , Yadav Vishal , Arora Vikas
Published: March 2024

Lymphoepithelial carcinoma (LEC) of head and neck region predominantly arises in salivary gland, oral cavity, oropharynx, nasal cavity, paranasal sinuses, and larynx; those arising from tongue are rare. Morphologically, it is a poorly differentiated squamous cell carcinoma, with early regional and distant metastasis. Diagnosis of LEC can sometimes be challenging especially in small biopsy and more so when seen at unusual location. Combination of morphology and immunohistochemistry (IHC) helps the diagnosis. Herein, we report a rare third case of LEC arising from lateral border tongue, diagnosed in a 36-year-old male. The presented case highlights challenges faced during diagnosis in small biopsy. Treatment of LECs comprises of surgery followed by radiotherapy or combined chemoradiation. Though, almost 70% of LEC of oral cavity region present with cervical nodal metastasis, their prognosis remains favorable.
Recurrent mucinous cystic neoplasm of the mesentery in a young nullipara mimicking as ovarian carcinoma
Authors: Jaiswal Riddhi , Dubey Deval B. , Singh Richa , Mishra Ashutosh
Published: March 2024

Inroduction:

Mucinous cystic neoplasms are rare tumors. They may originate from either ovaries, pancreas, or other intra-abdominal sites, but rarely from the mesentery.

Case History:

A 22-year-old nulliparaous woman, who had undergone laparascopic bilateral cystectomy for recurrent ovarian mass, presented with pain in abdomen, backache, and menstrual irregularities. Provisionally diagnosed as ovarian carcinoma, she underwent bilateral salpingo-oophorectomy and sigmoid colectomy. However, the histopathological examination revealed mucinous cystic neoplasm of the mesentery.

Discussion:

Thus, complete resection of the cysts with meticulous gross and histopathological examination remains the gold standard to differentiate mucinous cystic neoplasm (MCN) of the mesentery from its mimics, especially malignant counterparts, enabling clinicians to adequately manage such patients. Here, we present a case of recurrent MCN of mesentery (mesocolon), mimicking as ovarian carcinoma confirmed on histopathological examination, in a young adult.
Postgraduate teaching–learning pattern for radiation oncology students in India – A survey-based analysis
Authors: Janaki Manur G. , Arul Ponni TR
Published: March 2024

Context:

Teaching and training in Radiation Oncology is only at postgraduate level with 8–10 hours of theory sessions during undergraduate course. Uniform training during the post-graduation course across the country is a major challenge as many new concepts are introduced.

Aim:

This study is an effort to look into various aspects of training in terms of teaching–learning and assessment. In addition, we aim to look into innovative methods that can be implemented across the country.

Settings and Design:

This is a survey-based analysis.

Methods and Materials:

Postgraduate teaching institutes in Radiation Oncology were obtained from the National Medical Council and National Board of Examination websites. A questionnaire was created with Google form and sent to the heads of departments across the country. The data were entered on a spreadsheet and the responses were analyzed using Microsoft Excel sheet.

Results:

Thirty-five out of 87 institutes responded out of which 40% were government institutes. Twenty-six (74%) offered MD seats with 14 (40%) having less than five teachers and 13 (37.14%) with 5–10 teachers. With uniform teaching learning method across the country, there was wide variation in formative assessment patterns. There was consensus regarding inadequate exposure in research methodology and statistics.

Conclusion:

There is uniformity in teaching learning methods with differing patterns of formative assessment. Innovative methods focusing on affective and skill domains with competency-based medical education will help in bringing out a competent radiation oncologist.
Low-grade malt lymphoma of the nasopharynx in young adults: Successful treatment of a rare diagnosis at a rare site by radiotherapy
Authors: Singh Sankalp , Bhatnagar Sharad , Bisht Niharika , Kapoor Amul , Mishra Prabha Shankar , Lohia Nishant
Published: March 2024

Introduction:

Mucosa Associated Lymphoid Tissue (MALT) lymphoma is the third most common subgroup of Non-Hodgkin’s lymphoma and is the most common type of primary extranodal lymphoma. They are rarely found in the nasopharyngeal region and their mean age at presentation is the sixth decade of life.

Materials and Methods:

We present the clinical, pathological, treatment and 5-year follow-up data of 5 cases of nasopharyngeal MALT lymphoma treated with definitive radiotherapy at our hospital, between 2009 and 2011.

Results:

The average age of diagnosis was 27 years which is more than a decade earlier than what has been reported previously. Clinical symptoms included nasal obstruction, tinnitus and hearing loss. All five patients had locoregional disease. They were treated by definitive radiotherapy to a dose between 30 to 40 Gy. At 5 years of follow-up, 4 patients were in complete remission while one had disease relapse.

Conclusion:

The younger age of presentation compared to older reports in this rare subsite was an interesting finding in our study. The authors speculate that rising levels of particulate air pollution may have played a part in the etiology in this younger population. Our series shows that despite the younger age, the disease displays an indolent course and responds well to radiotherapy alone as the primary treatment. Recurrence or disseminated disease is also highly treatable with systemic chemotherapy.
Postoperative chemoradiotherapy in patients with locally advanced gastric cancer with poor pathologic response to neoadjuvant chemotherapy
Authors: Gal Omer , Lewin Ron , Perl Gali , Ulitzky Olga , Brenner Baruch , Kundel Yulia
Published: March 2024

Purpose:

To evaluate the effect of postoperative chemoradiotherapy (CRT) in patients with locally advanced gastric cancer (LAGC) who respond poorly to neoadjuvant chemotherapy (ChT).

Materials and Methods:

The database of a tertiary medical center (2009–2020) was retrospectively reviewed for patients with LAGC in whom the initial treatment strategy consisted of perioperative ChT and surgery. Those who were subsequently referred for postoperative CRT because of a poor pathologic primary-tumor response (ypT3-4, ypN2-3, R1 resection) were selected for the study. CRT consisted of 45 Gy in 25 fractions of 1.8 Gy combined with capecitabine 825 mg/m2 twice daily on radiotherapy days or continuous infusion of 5-fluorouracil 180 mg/m2/day.

Results:

The cohort included 26 patients of median age 61 years with LAGC (clinical stage IIA–III) after surgery with D1–D2 lymphadenectomy. R0 resection was achieved in 15 (58%). The pathological stage was III in 69% (IIA–IVA). Treatment was well tolerated. During a median follow-up time of 39 months, recurrences were documented in 14 patients (54%): 11 distant and 3 locoregional. Median progression-free survival was 23 months, and median overall survival was 65 months. Estimated 5-year survival rates were 42 and 54%, respectively.

Conclusions:

This small retrospective study suggests that in patients with LAGC who show a poor pathologic response to neoadjuvant ChT, a good outcome relative to reference arms in randomized trials can still be achieved with the addition of postoperative CRT. Further studies of the benefit of a tailored adaptive treatment approach to LAGC based on the response to neoadjuvant ChT are warranted.
Ossifying fibroma mimiking jaw tumour: A radiographic dilema
Authors: Khan Saba , Gautam Nishita , Sharma Tulika , Pooja S Dhakad
Published: March 2024

Fibro-osseous lesions (FOLs) of the craniomaxillofacial region comprise a group of developmental, dysplastic, and neoplastic alterations. FOLs include ossifying fibromas (OF), cemento-ossifying fibroma (COF), familial gigantiform cementoma (FGC), fibrous dysplasia (FD), and cemento-osseous dysplasia (COD). Evidence suggests that some FOL, especially FD and OF may have a risk of spontaneous malignant transformation. This report documents a rare case of malignant transformation of ossifying fibromas of the jaw and the probable cause for same. Although it is rare, the clinician should have a complete follow up to observe such changes among the patients having FOLs.
Carcinoma stomach in Eastern India—An audit from a tertiary health care center
Authors: Banik Arijit , Biswas Linkon , Saha Asis , Ojha Debankan
Published: March 2024

Background:

In spite of declining incidence and fatality over the past decade, stomach cancer still remains a global health issue due to its aggressiveness and heterogeneity. There is wide variation in the epidemiology of stomach cancer, not only worldwide but also among different regions of India. However, there is very limited data available for the Indian population.

Aims and Objective:

This study was aimed at establishing the incidence and role of risk factors, analyzing the symptoms, stage of disease, and mode of various surgical treatments of patients in the eastern region of India, and comparing them with the results of other studies in India and regions outside India.

Methods and Material:

An audit of the database of carcinoma stomach patients attending the radiotherapy and surgery outpatient department (OPD) between January 2020 and June 2021 was performed. Demographic, clinical, and treatment-related data were collected and analyzed with respect to other regions of India and the worldwide pattern of carcinoma stomach.

Results:

The mean age of the study population was 58 years with male dominance (70%). The antrum was the most common (60%) primary site, and stage III was the most common (47.6%) stage at presentation. Around 73.4% of patients underwent radical surgery. Most patients (50%) had an eventless post-operative period, and 76% received peri-operative chemotherapy. Also, 20% of patients received adjuvant chemoradiation.

Conclusion:

Our analysis suggests that there are certain differences (like dietary habits), as well as similarities (like socio-demographic factors), among the risk factors of carcinoma in this part of the country than other parts. Further studies into the risk factors and different clinical presentations are required for prevention and early detection.
Myelomatous pleural effusion in multiple myeloma- A rare presentation
Authors: Pradeep Ingale Yaminy , Mayuri R Kulkarni , Sourabh S Patil , Nirali M Patel
Published: March 2024

Multiple myeloma is a malignant plasma cell condition that mostly affects the skeletal system and bone marrow. Pleural effusions are uncommon and typically result from other conditions coexisting with multiple myeloma. Malignant myelomatous pleural effusions are rare complications of multiple myeloma, occurring in less than 1% of patients and are associated with poor prognosis having mean survival of less than 4 months. The present case report is a 41-year-old multiple myeloma patient who developed bilateral pleural effusion at a disease relapse. Chemotherapeutic regimen of cyclophosphamide, bortezomib, and dexamethasone given. Despite a positive response to treatment, the patient’s condition worsened over the course of following month and he eventually passed away. Myelomatous pleural effusion indicates poor prognosis and early consideration helps in quick diagnosis and initiation of treatment which may help in improving prognosis.
Effect of age of tobacco initiation and number of failed quit attempts on maintenance of tobacco abstinence
Authors: Kumari Laxmi , Sood Meenakshi , Gupta Sandhya
Published: March 2024

Background:

The decision to make a quit attempt is the first step toward the tobacco cessation process. It is well established in the literature that if someone does not take tobacco till the age of 21 years then his chances of remaining tobacco-free for life are higher than his counterparts who start tobacco at early developmental ages.

Methodology and Tools:

The present study was conducted among 400 university undergraduate students. A cross-sectional survey design was used, multi-stage sampling was done, and four colleges were selected via random sampling. The motivation to quit tobacco, tobacco craving, and maintenance of tobacco abstinence was assessed via contemplation ladder, tobacco craving questionnaire Short Form, and smoking abstinence questionnaire. To validate subjective data, a urine cotinine test was performed.

Results:

The age of tobacco initiation significantly impacts intentions to quit tobacco and tobacco craving levels. The number of unsuccessful quit attempts was also significantly associated with the maintenance of tobacco abstinence. The failed quit attempts play a vital role in altering tobacco cravings and make the withdrawals more complicated to handle for recent tobacco quitters.
A comparison of the WHO 2004 and WHO 2017 thyroid tumor classifications
Authors: Patel Nirali , Bavikar Rupali , Lad Yesha Parimalbhai , Singh Madhuri , Dharwadkar Arpana , Viswanathan Vidya
Published: March 2024

Introduction:

The category of borderline malignancy or unknown malignant potential was added to the WHO’s 2017 classification of thyroid tumours. A new histological variety of papillary tumours and Hurthle cell tumours was given as a separate entity. The classification has also adopted the Turin criteria for histological diagnosis of poorly differentiated cancer (PDC).

Settings and Design:

Descriptive study

Methods and Material:

From July 2018 to June 2022, 200 thyroid neoplasm patients at a tertiary care facility in western Maharashtra were participated in the prospective research over a period of 4 years.

Statistical Analysis Used:

The descriptive statistics were used to analyse the collected data.

Aim:

This study was undertaken to compare the old (2004) and new (2016) WHO classifications and their importance in the treatment of thyroid malignancies.

Results:

Out of 200 cases, the age range of 31 to 40 years had the greatest number of cases. The ratio of females to males was 5:1. In our study, according to the WHO 2004 classification, malignant tumours comprised 57.5% of the cases, while benign tumours 42.5% of the cases. When tumours were subcategorized, the most frequent benign tumour was follicular adenoma (43.5%) and malignant tumour was papillary thyroid carcinoma (37%). Malignant tumours made up 47.5% of the cases when the tumours were reclassified using the revised WHO 2017 classification, followed by borderline tumours with 27.5% of the cases and benign tumours with 25% of the cases. The most frequent borderline tumour was NIFTP (Noninvasive follicular thyroid neoplasm with papillary-like nuclear features) (17.5%), the most prevalent malignant tumour was papillary carcinoma (including its variant) (32%), and the most frequent benign tumour was follicular adenoma (27%).

Conclusion:

We concluded that the inclusion of the Boderline Category in the new WHO classification significantly improved thyroid cancer management. WHO 2017 classification prevents under diagnosis (in the case of benign tumors) and over diagnosis (in the case of malignant tumors).
Survival analysis in association with GST gene polymorphism and Treatment outcomes of Gemcitabine and Cisplatin/Carboplatin-based chemotherapy among patients with Gallbladder Carcinoma
Authors: Feroz Zainab , Kumar Rishabh , Tiwari Sonia , Kumar Munish
Published: March 2024

Purpose:

Majority of the gallbladder cancer (GBC) cases are diagnosed at an advanced stage where chemotherapy alone (or in combination with other treatment methods) is mainly opted as therapeutic approach. However, success or failure of this approach largely depends on the interindividual genetic differences. Careful consideration on the genetic association could assist in the evaluation of patient’s treatment response and survival rate. Hence, the present study aims to investigate the survival of patients with GBC and their treatment response to gemcitabine and cisplatin/carboplatin-based chemotherapy in association with Glutathione S-transferase (GSTs) gene polymorphism.

Material and Methods:

A total of 216 histologically confirmed cases of gallbladder cancer were recruited. A total of 180 patients were treated with gemcitabine and cisplatin/carboplatin-based chemotherapy. GSTM1, GSTT1, and GSTP1 genotypes were determined by multiplex PCR and by PCR restriction fragment length polymorphism (PCR-RFLP), respectively. The influence of genetic polymorphism on overall survival was analyzed by Kaplan–Meier method, survival rate difference was analyzed by log-rank test, and hazard ratio for mortality outcomes was estimated using Cox regression method.

Results:

GBC patients having genotype GSTP1 (AG + GG) showed poor 3-year survival rate of 0.8% compared to 10.9% of GSTP1 (AA) genotype (χ2 = 6.456, P = 0.011). The multivariate Cox regression results showed that the death risk was significantly higher in GSTP1 (AG + GG) genotype (HR = 3.858, P = 0.050). We found no association of GSTM1 and GSTT1 gene polymorphism with the survival; however, the combined genotypes of GSM1/GSTP1, GSTT1/GSTP1, and GSTM1/GSTT1/GSTP1 were associated with survival (P = 0.053, 0.006, and 0.058, respectively). Increased death hazard was noted by the genotype combinations of GSTM1+/GSTP1AG + GG (HR = 3.484, P = 0.024), GSTM1-/GSTP1AG + GG (HR = 2.721, P = 0.014), GSTT1+/GSTP1AG + GG (HR = 20.690, P = 0.001), and GSTT1-/GSTP1AA (HR = 26.111, P < 0.0001). Our findings indicate that chemotherapy treatment response of GSTP1 (AG + GG) has 1.62-fold increased risk for progression compared to GSTP1 (AA) genotype (p = 0.018); however, none of the genotypes showed association with overall survival and death risk after chemotherapeutic treatment.

Conclusion:

We found that the presence of GSTP1 (
AG + GG) genotype showed survival disadvantage and poor treatment outcomes in response to gemcitabine and cisplatin/carboplatin-based chemotherapy. This could serve as biomarker, and future research in pharmacogenomics will definitely pave the way for the development of better treatment approach for GBC.
Immune checkpoint inhibitors: Assessment of the performance and the agreement of iRECIST, irRC, and irRECIST
Authors: Yirgin Inci Kizildag , Dogan Izzet , Engin Gulgun , Vatansever Sezai , Erturk Sukru Mehmet
Published: March 2024

Introduction:

Immunotherapy has become more widely accepted and used by medical oncologists. Radiologists face challenges in assessing tumor response and becoming more involved in the management of treatment. We aimed to assess the agreement between immune-related response criteria (irRC), immune-related RECIST (irRECIST), and immune RECIST (iRECIST) to correlate the response measured by them with overall survival (OS), and to determine the confirmation rate of progressive disease (PD).

Methods:

A total of 43 patients (28 men, 15 women; average age = 54.6 ± 15.7 years) treated with immunotherapy were included in this study. Pairwise agreements between iRECIST, irRC, and irRECIST were calculated using Cohen’s kappa statistics. The correlation of the criteria-based response and OS was evaluated using the Kaplan–Meier method and log-rank test. A confirmation rate with 95% confidence intervals (CI) was calculated in patients with PD.

Results:

The kappa values between iRECIST and irRC, iRECIST and irRECIST, and irRC and irRECIST were 0.961 (almost perfect; P < 0.001), 0.961 (almost perfect; P < 0.001), and 0.922 (almost perfect; P < 0.001), respectively. The Kaplan–Meier method and log-rank test showed for each criterion a statistically significant correlation with OS (P < 0.05). The confirmation rates of PD for irRC, irRECIST, and iRECIST were 95% (19/20; 95% CI = 76.4–99.1%), 90% (18/20; 95% CI = 69.9–97.2%), and 90.5% (19/21; 95% CI = 71.1–97.4%), respectively.

Conclusion:

There was an almost perfect and statistically significant agreement between iRECIST, irRC, and irRECIST. The measurements performed with them significantly correlated with the OS; their confirmation rates were similar. iRECIST and irRECIST might be favored over irRC because of their relative ease of use.
Non-operative management in low-lying rectal cancers undergoing chemoradiation
Authors: Datta Debanjali , Engineer Reena , Saklani Avanish , D’souza Ashwin , Baheti Akshay , Kumar Suman , Krishnatry Rahul , Ostwal Vikas , Ramaswamy Anant , Patil Prachi
Published: March 2024

Purpose:

To evaluate the outcomes of post-neoadjuvant chemoradiation (NACTRT) wait-and-watch Strategy (WWS) in distal rectal cancers.

Materials and Methods:

All consecutive patients from December 2012 to 2019 diagnosed with distal rectal tumors (T2-T4 N0-N+) having a complete or near-complete response (cCR or nCR, respectively) post-NACTRT and wishing for the non-surgical treatment option of WWS were included in this study. Patients were observed with 3 monthly magnetic resonance imaging (MRIs), sigmoidoscopies, and digital rectal examination for 2 years and 6 monthly thereafter. Organ preservation rate (OPR), local regrowth rate (LRR), non-regrowth recurrence-free survival (NR-RFS) and overall survival (OAS) were estimated using the Kaplan–Meier method, and factors associated with LRR were identified on univariate and multivariate analysis using the log-rank test (P < 0.05 significant).

Results:

Sixty-one consecutive patients post-NACTRT achieving cCR[44 (72%)] and nCR[17 (28%)], respectively, were identified. All patients received pelvic radiotherapy at a dose of 45–50Gy conventional fractionation and concurrent capecitabine. An additional boost dose with either an external beam or brachytherapy was given to 39 patients. At a median follow-up of 39 months, 11 (18%) patients had local regrowth, of which seven were salvaged with surgery and the rest are alive with the disease, as they refused surgery. The overall OPR, NR-RFS, and OS were 83%, 95%, and 98%, respectively. Seven (11%) patients developed distant metastasis, of which six underwent metastatectomy and are alive and well. LRR was higher in patients with nCR versus cCR (P = 0.05).

Conclusion:

The WWS is a safe non-operative alternative management for selected patients attaining cCR/nCR after NACTRT with excellent outcomes.
Salivary transforming growth factor beta in oral submucous fibrosis: A diagnostic and predictive marker
Authors: Rai Arpita , Parveen Shama , Shree Priya , Ahmed Tanveer , Ali Sher , Kaur Mandeep , Sircar Keya , Sybil Debora , Chandra Akhilesh
Published: March 2024

Context:

Growth factors and cytokines like transforming growth factor beta (TGF-β) play a key role in the pathogenesis of oral submucous fibrosis.

Aims:

To elucidate the role of Salivary TGF-β isoforms as a predictive and diagnostic marker for oral submucous fibrosis.

Settings and Design:

A total of 30 OSMF and 10 control patients were included in this study, and their clinic-epidemiological data was recorded.

Methodology:

The expression of TGF-β genes—TGF-β1, TGF-β2, TGF-β3—was studied by a real-time polymerase chain reaction in tissue and saliva. Patients were given medicinal intervention for 12 weeks along with jaw-opening exercises. Expression of salivary TGF-β genes was studied at 12 weeks.

Statistical Analysis Used:

SPSS software version 20.

Result:

Expression of salivary TGF beta isoforms in OSMF was more than in the control group. There was an increase in salivary TGF-β1, β2, β3 expressions with increasing clinical grades of OSMF and advancing the stage of the disease. Expression of all the TGF beta isoforms was decreased after treatment with statistically significant results. Statistically significant correlations were found between the mean difference of TGF-β1 and the mean difference between mouth opening and tongue protrusion.

Conclusion:

Salivary TGF-β isoforms may be used in diagnosis, risk assessment, and screening of the entire population at risk of OSMF after its clinical validation. However, adequate sample size and segmental assessment of the expression of TGF-β isoforms are needed for further evaluation.
Splenic B-cell lymphoma/leukemia with prominent nucleoli: A three-case series of the newly named old entity and review of literature
Authors: Rai Varnika , Saha Anurag , Gondha Shweta , Manimaran Poornima , Sawhney Jyoti
Published: March 2024

Context:

Splenic B-cell lymphoma/leukemia with prominent nucleoli (SBLPN) aka hairy cell leukemia variant (HCL-v) is a rare B-cell chronic lymphoproliferative disorder. The main diagnostic challenge is to differentiate SBLPN from Classical hairy cell leukemia (HCL-c), as the former faces inferior responses to therapies and a poor prognosis.

Aims:

The aim is to discuss the clinic-hematological and immunophenotyping findings of three cases of SBLPN.

Settings and Design:

This is a retrospective observational study.

Methods and Material:

From the year 2011 to 2021, flow cytometry of all the cases with HCL diagnosis was reviewed, and three cases with negative or dim CD25 and hematological presentation matching with SBLPN were picked up.

Statistical Analysis Used:

Descriptive statistics is used.

Results:

All the cases were male. The age ranges from 43 to 64 years. Median hemoglobin concentration, total leucocyte count, and platelet count were 8.6 g/dL, 6.9 × 109/L, and 53 × 109/L, respectively. The atypical cells were medium to large. All three showed prominent nucleoli. Bone marrow biopsies showed an interstitial pattern of infiltration in all the cases. The hairy cells were positive for CD20, CD11c, and CD103. CD25 was dim positive in one case. Annexin A1 was negative in all three cases. BRAF V600E mutation analysis was done in one case and turned out negative for the mutation.

Conclusions:

SBLPN is a rare entity, usually on-flow cytometry CD25 negative. However, in dim CD25-positive cases, BRAFV600E mutational analysis helps in discerning SBLPN diagnosis and differentiating it from HCL-c.
Serum total oxidant and anti-oxidant status in children with cancer
Authors: Yilmaz Yasin , Dincaslan Handan , Ozdemir Sonay Incesoy , Tuncer Gul Hatice Erkol , Tanrioveri Bugra , Kutukcu Hatice Busra , Tacyildiz Nurdan , Unal Emel Cabi
Published: March 2024

Background:

Oxidative stress has a potential role in carcinogenesis. Anti-oxidant enzymes have a neutralizing effect on both cancer initiation and progression. We aimed to assess the oxidant and anti-oxidant levels of pediatric cancer patients and to compare the levels in healthy controls.

Materials and Methods:

The study involved 105 pediatric cancer patients (40 undergoing chemotherapy, 65 survivors) and 40 healthy children. The serum total oxidant status (TOS) and total anti-oxidant status (TAS) were measured.

Results:

The oxidative stress index was significantly lower in pediatric cancer patients compared to the levels in the controls (0.20 ± 0.07 vs. 0.26 ± 0.10; P = 0.001). The mean serum TAS level was significantly higher in patient groups compared to the level in the control (1.87 ± 0.48 vs. 1.63 ± 0.32 mmol/L, P = 0.001). The TAS level of children with cancer in survivors was also found to be significantly higher compared to the levels in the control group (1.85 ± 0.45 vs. 1.63 ± 0.32 mmol/L, P = 0.005). Radiotherapy, surgery, relapsed disease, presence of metastases, and receiving enteral nutritional support caused no change in the TAS/TOS level.

Conclusion:

It has been revealed for the first time that the serum total anti-oxidant level was high in children undergoing chemotherapy and the survivor group as well. Moreover, the oxidative stress index was low in children with cancer. Longitudinal prospective studies are needed to reveal the alterations in oxidant status among children with cancer.
Comparison of clinical outcomes of robotic-assisted and video-assisted esophagectomy for esophageal cancer
Authors: Yüksel Sercan , Topal Uğur , Songür Mehmet Z. , Çalıkoğlu İsmail , Karaköse Erdal , Ercan Erdal , Teke Zafer , Bektaş Hasan
Published: March 2024

Introduction:

Robotic-assisted minimally invasive esophagectomy (RAMIE) is a recently developed technique for the treatment of resectable esophageal cancer. The present study compares the outcomes of RAMIE and video-assisted thoracoscopic esophagectomy (VATE).

Method:

Patients undergoing minimally invasive esophageal surgery between December 2020 and September 2022 were included in the study, while those undergoing conventional surgery were excluded. The patients were divided into two groups, as those undergoing RAMIE (Group 1) and those undergoing VATE (Group 2). The demographic and clinical characteristics, intraoperative parameters, pathological data, and postoperative parameters of the groups were compared.

Results:

A total of 28 patients were included in the study, with 13 patients in Group 1 and 15 patients in Group 2. The gender distribution was similar (P = 0.488), and the mean age was 64.7 and 59.0 years in Groups 1 and 2, respectively (P = 0.068). The majority of the sample was in the ASA2 category (46.2% vs. 66.7%, P = 0.341); Ca19.9 levels were higher in Group 1 than in Group 2 (25.7 vs. 13.7, P = 0.027); preoperative Hb was lower in Group 1 than in Group 2 (10.9 g/dL vs. 12.2 g/dL, P = 0.043); the most commonly performed surgery was the McKeown procedure (69.2% vs. 66.7%, P = 0.492); an intraoperative feeding jejunostomy was placed only in Group 2; the operation time was similar between the groups (338.5 min vs. 340 min, P = 0.916); and the distribution of tumor localizations was similar between the groups (P = 0.407). In terms of tumor histology, squamous cell carcinoma (SCC) was the most common tumor type in the two groups (84.6% vs. 80%, P = 0.636); the tumor diameter was similar between the groups (14.9 vs. 18.1, P = 0.652); the number of removed lymph nodes was similar between the groups (24.9 vs. 22.5, P = 0.419); and the number of metastatic lymph nodes was higher in Group 2 (0.08 vs. 1.07, P = 0.27). One patient in Group 2 underwent repeat surgery due to suspected ischemic anastomosis; the distribution of postoperative complications according to the Clavien–Dindo classification system was similar in the two groups (P = 0.650); there was no early mortality within the first 30 days in either group; one patient in Group 2 was re-admitted within 90 days of discharge with decreased oral intake; the length of hospital stay was shorter in Group 1 (9 days vs. 16.5 days, P = 0.006); and the patients in Group 2 more often received neoadjuvant therapy in proportion to the disease stage (15.4% vs. 60%, P = 0.016).

Conclusion:

Robotic procedures can be safely performed in esophageal cancers with complication rates and oncological radicality similar to those of other minimally invasive techniques.
Clinical and histopathological spectrum of cranial small round cell tumors: An experience from a tertiary care center
Authors: Gupta Pooja , Siraj Fouzia , Shankar K.B , Rawat Manish , Mankotia Dipanker S. , Yadav Vivek , Dagar Amit
Published: March 2024

Background:

Small round cell tumors (SRCTs) are a group of malignant neoplasms with minimal or no differentiation, characterized by the presence of round cells with high nuclear-cytoplasmic ratio. Although SRCTs can occur in any part of the body, involvement of central nervous system (CNS) is uncommon.

Aim:

We aimed to study the clinicopathological spectrum of cranial SRCT diagnosed in our institute over a period of four years (2016–2019).

Material and Methods:

A retrospective review of medical records (2016–2019) with a morphological diagnosis of cranial SRCT was made. Both intra-axial and extra-axial tumors were included. A total of 60 cases were retrieved, and the clinical and histopathological features were studied. Special cytochemical staining and immunohistochemistry were performed, where needed.

Results:

The mean age at presentation was 18.4 years (range, 1–60 years), with a male-to-female ratio of 2.5:1. The most common site was posterior fossa of brain (n = 28, 47%), followed by dorso-lumbar spine (n = 9, 15%). The most common type of tumor was medulloblastoma (n = 29, 48.3%), followed by Ewing sarcoma (ES)/peripheral primitive neuroectodermal tumor (pPNET) (n = 11, 18.3%), non-Hodgkin lymphoma (NHL) (n = 9, 15%), neuroblastoma (n = 3, 5%), and CNS embryonal tumor, NOS (n = 2, 3.3%). One case each of atypical teratoid rhabdoid tumor (ATRT), rhabdomyosarcoma, pineoblastoma, melanoma, rhabdomyosarcoma, and undifferentiated pleomorphic sarcoma was also documented.

Conclusions:

SRCTs have a variable age of presentation. Their incidence in CNS is low as compared to other organ systems. On light microscopy, the histopathology of these lesions is overlapping, posing a great diagnostic dilemma for the pathologist. The use of ancillary techniques like immunohistochemistry helps in arriving at the correct diagnosis. Treatment strategy and tumor prognosis also vary along the entire spectrum of SRCT, thus making exact characterization essential for proper management.
Protective effects of Panax Ginseng against 131I-induced genotoxicity in patients with differentiated thyroid cancer
Authors: Omrani Vida , Fardid Reza , Alavi Mehrosadat , Haddadi Golamhassan , Takhshid Mohammad Ali
Published: March 2024

Background:

Radioiodine (131I) therapy (RAIT) is associated with oxidative stress (OS)-induced DNA damage in patients with differentiated thyroid cancer (DTC). The goal of this study was to evaluate the possible ameliorating effects of Panax Ginseng (PG) on RAIT-induced genotoxicity in patients with DTC.

Materials and Methods:

Forty DTC patients who had received 131I (100 to 175 mCi) were enrolled in this study. The patients were randomly classified (n = 10) into control, placebo, PG1 groups (receiving 500 mg/day of PG for 2 days before RAIT), and PG2 group (receiving 500 mg/day of PG for 2 days before to 1 day after RAIT). Blood samples were collected before and 2 days after RAIT. Lymphocyte micronuclei (MN) frequency was measured using the MN assay. Serum total antioxidant capacity (TAC) and ischemia-modified albumin (IMA) were measured using colorimetric assays. Serum albumin, blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were measured using commercial kits.

Results:

The mean of baseline MN frequency was the same in the four groups. RAIT increased the MN frequencies to at least three times the baseline values in the control (39 ± 5) and placebo groups (38 ± 6) (P < 0.001). PG caused a significant decrease in the MN frequencies in the treated groups compared to the control and placebo groups (P < 0.001). RAIT and PG administration had no significant effects on the serum IMA, TAC, and markers of liver and kidney toxicity.

Conclusion:

PG could be considered a useful remedy for the protection against RAIT-induced chromosomal damage in DCT patients.
Breast self-examination practices among young rural women and its associated knowledge and attitudes in Tirunelveli District, Tamil Nadu
Authors: Selvam Mahalakshmi , Sundaram Suresh
Published: March 2024

Context:

Breast self-examination (BSE) is a simple and cost-effective screening procedure in downstaging breast tumors.

Aim:

To assess the BSE practices and its associated knowledge and attitudes of rural women from Tirunelveli District, Tamil Nadu during the COVID-19 pandemic.

Settings and Design:

A descriptive cross-sectional survey design was employed, and snowball sampling was used to recruit the sample of rural women from Tirunelveli.

Materials and Methods:

Women ages 18–60 willing to take part were included. Data were collected online through a self-developed questionnaire.

Statistical Analysis:

Responses were analyzed using SPSS Version 20. Descriptive statistical analysis was used to present the general details and responses of the rural women through percentages. Using the appropriate tests, the mean differences of the BSE attitudes based on the personal variables were computed using one-way ANOVA.

Results:

A total of 433 rural women (Mean age: 29.20 ± 9.35 years) from Tirunelveli responded to the online Knowledge, Attitude and Practice (KAP) questionnaire. Regular health checkups were undergone by 27.48% of women and 9.24% underwent breast cancer (BC) screening in the past. While 68.36% had heard of BC, 61% knew it could be detected in the early stages. Insufficient knowledge regarding BSE techniques was evident among the women. Knowledge about BC was highest among those earning more than 20,001 INR, women aged 36–45, widowed/separated/divorced women, and diploma graduates. Overall, BSE and BC knowledge score was low, with correspondingly low attitudes and practices.

Conclusion:

Findings showed the KAP among rural Tirunelveli women to be low.
CD146 as a prognostic marker in breast cancer: A meta-analysis
Authors: Sharma Akshita , Somasundaram Indumathi , Chabaud Marcel Blot
Published: March 2024

Background:

CD146, a cell adhesion molecule, was first discovered in melanoma. Since then, it has been established as a promoter of tumor progression and metastasis. Many recent clinical studies have associated CD146 overexpression with poor prognosis in various cancers. However, clinical relevance of CD146 in prognosis of breast cancer has been poorly studied.

Methods:

We performed meta-analysis of data of all clinical studies associated with the prognostic value of CD146 expression in breast cancer. Relevant studies were retrieved from PubMed database as per the inclusion and exclusion criteria, data were extracted independently and carefully by two reviewers with the help of standardized form, and meta-analysis was performed to correlate CD146 expression with molecular subtypes, lymph node metastasis, and overall survival in breast cancer.

Results:

Our findings suggest that CD146 expression is predominantly found in triple-negative breast cancer subtype (pooled odds ratio = 2.98, 95% confidence interval [CI] =2.19–4.05, P < .00001) and breast tumors overexpressing CD146 have a higher risk of lymph node metastasis (pooled relative risk = 1.64, 95% CI = 1.44–1.87, P < .00001). Furthermore, high expression of CD146 was associated with poor prognosis in breast cancer (pooled hazard ratio = 1.51, 95% CI = 1.21–1.87, P = .0002).

Conclusion:

Overall results suggested that CD146 may be a potential prognostic marker to predict metastatic potential and disease outcomes in breast cancer and can be used as a therapeutic target.
Prognostic factors in T4b gastric cancer after surgery: A more balanced and sequential therapy for patients?
Authors: Nakamura Naohiko , Kinami Shinichi , Kaida Daisuke , Tomita Yasuto , Miyata Takashi , Miyashita Tomoharu , Fujita Hideto , Ueda Nobuhiko , Takamura Hiroyuki
Published: March 2024

Introduction:

This study aimed to evaluate the prognostic factors in T4b gastric cancer (GC) in order to improve future therapeutic strategies.

Methods:

We retrospectively analyzed the medical records of 43 patients with advanced GC who underwent surgery and were surgically or pathologically diagnosed with T4b GC. The overall survival (OS) rate of patients with T4b GC was analyzed, and univariate and multivariate analyses were performed to identify clinicopathological factors that were independently associated with OS. In addition, we assessed the relationship between postoperative chemotherapy and laboratory parameters 4 weeks post-surgery.

Results:

The proportion of patients with invasion of cancer in organs, including the pancreas, transverse colon, and liver, were 58.1%, 18.6%, and 14.0%, respectively. The proportion of patients who exhibited distant metastases was 44.2%, and R0 resection was achieved in 30.2% of patients. A total of 69.8% of patients underwent postoperative chemotherapy. The median survival rate was 12.3 months. Upon multivariate analysis, the presence of distant metastases (P = 0.01, HR; 3.48), the use of postoperative chemotherapy (P = 0.0004, HR; 0.12), and R0 resection (P < 0.0001, HR; 0.14) were significantly correlated with OS. Patients who did not undergo postoperative chemotherapy showed significantly higher levels of inflammatory parameters and lower levels of nutritional parameters 4 weeks after surgery than those who did.

Conclusions:

We evaluated that the presence of distant metastases was significantly associated with a poor prognosis, and the use of postoperative chemotherapy and R0 resection was significantly associated with a better prognosis in patients with T4b GC. It would be more important for a T4b GC treatment to balance between therapeutic tolerance for postoperative chemotherapy and surgical therapeutic effect.
The modern landscape of radiotherapy in thyroid malignancies
Authors: Ghosh Adrija , Dagar Abhilash , Bharat Ram P. , Sharma Aman , Sharma Daya Nand , Mallick Supriya
Published: March 2024

Thyroid carcinoma is the most common malignancy of the endocrine system and accounts for nearly 1.5% of all new cancer cases in India. The incidence of thyroid cancers is on the rise secondary to multiple factors including the widespread use of radiological imaging. Surgery remains the cornerstone of treatment, and radioactive iodine therapy plays a pivotal role in differentiated thyroid cancer. Radiation therapy appears to be an underutilized treatment modality. In this review, we have summarized the role of radiation in the treatment of thyroid cancer.
Characteristics of patients with late recurrence endometrial cancer
Authors: Çakır İlker , Gülseren Varol , Özdemir İsa Aykut , Abacı Hüseyin , Talu Esra Canan Kelten , Çakır Zübeyde Emiralioğlu , Ata Can , Kuru Oğuzhan , Gökçü Mehmet , Sancı Muzaffer , Güngördük Kemal
Published: March 2024

Aim:

We planned this study to assess endometrial cancer (EC) patients who had late metastasis.

Materials and Methods:

This retrospective study constituted a review of the records of patients who were diagnosed with EC and underwent hysterectomy at the Gynecologic Oncology Clinic between 1996 and 2018. Relapses occurring after the first three years following primary treatment of EC are considered late recurrences. Post-relapse survival (PRS) refers to the time to the last follow-up or the patient’s death after relapse.

Results:

Late metastases were identified in 42 patients, 20 (47.6%) of whom had locoregional recurrence and 22 of whom (52.4%) had extrapelvic recurrence. Median disease-free survival (DFS) times were 61 (range: 43–78) and 65 (range: 48–81) months for the groups with locoregional and extrapelvic recurrences, respectively (P = 0.462). The 5-year PRS rate for the patients was 61.1%, with 63.8% having locoregional and 59.4% having extrapelvic late metastasis (P = 0.969).

Conclusion:

Among the patients with late metastases, those with endometrioid type EC were found to have a better prognosis. It has been shown that locoregional or extrapelvic organ recurrence does not significantly affect survival in patients with late relapse. Although our results are not statistically significant for cases of locoregional late metastases, surgical resection increases survival rates.
Bupropion Associated Immunomodulatory Effects on Peripheral Cytokines in Male with Major Depressive Disorder
Authors: Huang Chih-Chung , Chu Hsuan-Te , Lin Yu-Kai , Tsai Chia-Kuang , Liang Chih-Sung , Yeh Ta-Chuan
Published: March 2024

Background:

Experimental and clinical studies have reported increased levels of pro-inflammatory cytokines in patients with major depressive disorder (MDD), suggesting that immune system dysregulation may contribute to MDD pathophysiology.

Aim:

Due to the lack of knowledge about the immune potential of antidepressants, this study investigated the immunomodulatory effects of bupropion, a norepinephrine–dopamine reuptake inhibitor.

Methods:

This study involved 18 patients with MDD treated with bupropion (150 mg/d) for 4 weeks and 23 healthy volunteers. All participants underwent multiplex bead-based cytokine assessment before and after bupropion treatment to quantify the following cytokines: interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, interferon-γ, tumor necrosis factor-α, granulocyte colony-stimulating factor, granulocyte-macrophage CSF, monocyte chemotactic protein-1, and macrophage inflammatory protein-1β.

Results:

Four-week treatment with bupropion significantly increased the levels of IL-1β (P = 0.011), IL-4 (P = 0.019), IL-5 (P = 0.019), IL-7 (P = 0.021), and IL-8 (P = 0.023) compared to the control group. Furthermore, the percentage change in most cytokines, including anti-inflammatory cytokines such as IL-4, IL-5, IL-10, and IL-13, was significantly increased after bupropion treatment.

Conclusion:

The promoted synthesis of anti-inflammatory cytokines to surpass the pro-inflammatory cytokines may be a crucial step in the treatment of MDD patients with bupropion.
Metastatic Undiff erentiated Pleomorphic Sarcoma of Kidney: Presenting as Hematuria - A Case Report
Authors: Gurwale Sushama , Iqbal Banyameen , Choudhury Nilanjana Dhar , Gore Charusheela Rajesh
Published: March 2024

Pleomorphic undifferentiated sarcoma (PUS) is an extremely aggressive soft-tissue sarcoma that occurs most commonly in the trunk and the extremities but is extremely rare in the kidney. This entity has no distinctive clinical or radiological signs for diagnosis. It has high local recurrence and distant metastasis rates along with poor prognosis. We describe a case of PUS of the left kidney with urinary bladder metastases. Radiological investigations suggested an initial diagnosis of multifocal urothelial carcinoma; however, a definitive and confirmatory diagnosis of PUS was made on the basis of histopathological and immunohistochemical examination. Subsequently, left nephroureterectomy along with bladder cuff excision was performed and postoperative histopathology revealed PUS. Follow-up investigations revealed metastatic deposits of tumor in the base of the urinary bladder for which an endoscopic surgery of transurethral resection of the bladder tumor was performed. The histopathological findings were consistent with metastatic high-grade PUS of the kidney with metastasis to the bladder.