bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pattern of expression of CDX2 in colorectal cancer and its role in prognosis
Authors: Singh Jagdeep , Rajesh NG , Dubashi Biswajit , Maroju Nanda Kishore , Ganesan Prasanth , Matta Kiran Kumar , Charles I , Kayal Smita 
Published: December 2022

Background:
CDX2, a nuclear protein, is essential for the proliferation and development of intestinal epithelial cells and is frequently down-regulated during tumorigenesis. We have evaluated the pattern of CDX2 expression in all stages of colorectal cancer (CRC) and its association with prognosis.

Methods:
We performed CDX2 staining by immunohistochemistry (IHC) on the available biopsy blocks of patients of CRC registered in our institute from January 2014 to January 2018. CDX2 scoring was done using the semi-quantitative method.

Results:
A total of 286 patients were registered during the study period, of which only 110 biopsy blocks were available for staining. Of 110 patients, 77 (70%) had colon cancer and 33 (30%) had rectal cancer. The median age was 54.2 years, with 62 (56.4%) being male and 48 (43.6%) female with a male to female ratio of 1.3:1. In the study cohort, 33 (30%) patients had stage II disease, 30 (27.3%) had stage III, and 47 (42.7%) had stage IV. Seventy-three (66.4%) were positive for CDX2 and 37 (33.4%) were negative. Loss of CDX2 expression was significantly associated with advanced stage, rectal site, poor grade of differentiation, and presence of lymphovascular invasion. With a median follow-up of 16 months, progression-free survival (PFS) at 2 years was 30% for CDX2-negative patients compared to 67% for CDX2-positive patients (P = 0.009), whereas the overall survival (OS) at 2 years was 46% for CDX2-negative versus 77% for CDX2-positive patients (P = 0.01).

Conclusion:
Loss of CDX2 expression is associated with advanced stage, higher tumor grade, presence of LVSI, worse PFS, and OS and thereby functions as a poor prognostic factor in CRC.
Spermatocytic tumor of testis
Authors: Rabade Katha , Panjwani Poonam K. , Menon Santosh , Prakash Gagan , Pal Mahendra , Bakshi Ganesh , Desai Sangeeta 
Published: December 2022

Background:
Spermatocytic tumours are a rare subset of testicular tumours seen in elderly patients with distinct clinicopathological features and a favourable outcome. The typical presentation and characteristic histological features usually suffice for the diagnosis. Most of the cases are amenable to surgical excision. However, occasional cases which have a sarcomatous transformation may behave more aggressively and warrant adjuvant therapy.

Methods:
We present the clinicopathological features of a series of 26 cases diagnosed as Spermatocytic tumour at our tertiary cancer institute from 2002-2019.

Results:
Twenty-four of these cases had the typical cytological features of a spermatocytic tumour while two cases showed sarcomatous change, one with rhabdomyosarcomatous differentiation and the other being an undifferentiated spindle cell sarcoma. Although the tumor can show varied patterns, the tripartite cytomorphology is typical in all cases.

Conclusions:
Careful note of these patterns and variations in histology is essential to prevent an erroneous diagnosis of other testicular neoplasms and guide the therapy.
Validity and reliability of the Hindi version of the Summated Xerostomia Inventory-5 among head and neck cancer irradiated patients in Delhi, India
Authors: Gupta Sakshi , Dhawan Pankaj , Tandan Piyush , Jain Meena 
Published: December 2022

Objectives:
To cross-culturally adapt and determine reliability and validity of the Hindi version of the Summated Xerostomia Inventory (SXI-H).

Background:
Xerostomia is common among older individuals and patients with head and neck radiation or autoimmune diseases, and it can affect their oral as well as systemic quality of life. To assess the perception of this condition, SXI-H can be used.

Materials and Methods:
This was a multi-centric cross-sectional observational study of volunteers suffering from hypo-salivation in three tertiary care cancer hospitals in Delhi, India. The English version of Summated Xerostomia Inventory (SXI-5) was translated into Hindi according to standard guidelines and field tested. The Hindi version of SXI-5 (SXI-H) was tested on 120 patients with xerostomia. All the participants signed the informed consent form before being interviewed with SXI-H. Thirty participants were interviewed again after 15 days. A global question was asked for criteria validity. Data were analyzed through IBM SPSSTM Statistics for windows version 24. Significance was set at P ≤ 0.05.

Results:
Overall SXI-H score of sample was 11.48 ± 2.29. Cronbach's α value was 0.81. The correlation between the SXI-H summary score and the standard question was 0.79 (95% CI 0.65–0.74). It was found that the intra-class correlation coefficient value for the test–retest reliability was 0.90 and scores for individual question ranged from 0.41 to 0.76.

Conclusion:
The SXI-H demonstrated excellent psychometric properties and can be considered a valid tool for assessing xerostomia in a dry mouth patient.
Oral health knowledge and practices among healthcare students of Al-Jouf province, Saudi Arabia
Authors: Yadiki Josna Vinutha , Alruwaili Faris Alturqi K. 
Published: December 2022

Aim of the Study:
Oral disease has an inverse relationship with good oral health practices. The present study was aimed at assessing the level of oral health knowledge and practices among healthcare students of Al-Jouf province, Saudi Arabia.

Methodology:
All male and female students from the first to the fifth year of studying in different colleges (medical, dental, and college of allied health sciences) in Jouf University were included as the study sample. The study included 20 structured questions. Among the 20 questions, 12 related to oral health practices and 8 related to oral health knowledge.

Results:
Chi-squared test was used to determine the association among variables, and Pearson correlation analysis was used to determine the correlation between the scores of oral health knowledge and oral health practices. One-way analysis of variance (ANOVA) was done to see if there was any statistically significant association (P > 0.05) of knowledge and practice scores with level, gender, and college of study. The overall mean oral health knowledge score was 4.9 ± 2.3. The range for oral health practice score was from 0 to 12, and the overall mean score was 6.8 ± 2.9.

Conclusion:
Our observations concluded that the overall knowledge level of the students toward oral health was low, and visiting a dentist for regular dental checkup were not given importance by the students. Health practices of students and their knowledge towards oral health determines what and how they educate their patients in the future to create better oral health in society.
Impact of radical dose escalation by endoluminal brachytherapy and induction chemotherapy in the definitive treatment of locally advanced esophageal cancer - A retrospective study
Authors: Raghunath Suresh , Tiwari Richa , Rashmi S. , Geetha S N , Sulthana Raahin , Madabhavi Irappa 
Published: December 2022

Background:
The loco-regional recurrence rate remains the main concern in the treatment of esophageal cancer. However, there are controversial data regarding the benefit of dose escalation in the treatment of esophageal cancer. The study examines the implications of dose escalation with endoluminal brachytherapy after induction chemotherapy and definitive chemoradiation in cases of carcinoma esophagus.

Material and Methods:
Total 31 biopsy-proven patients with inoperable, locally advanced esophageal cancer of stage IIA-IIIB were enrolled from January 2006 till December 2018. All patients underwent two cycles of three weekly induction chemotherapy followed by definitive external beam radiotherapy of 45-50.4 Gray (Gy) at 1.8 Gy per fraction along with chemotherapy, followed by intraluminal brachytherapy boost of two fractions with 5 Gy each. Overall survival (OS) was censored at death or the last follow-up.

Results:
Of 31 patients, 26 (83.97%) received concurrent chemotherapy and 30 (96.77%) completed radiation therapy. At the end of 3 months, 10 (32.2%), 13 (41.9%), 5 (16.1%), and 3 (9.6%) had complete response, partial response, stable disease, and progression of the disease, respectively. Distal failure was seen in five (16.1%) cases. The median OS was 28 months. OS at 2 years and 5 years was 20 (64.5%) and 9 (28.3%), respectively. At the end of 3 months, 17 (54.8%) of patients had no dysphagia, four (12.9%) of patients had improvement of more than 2 points in dysphagia score, five (16.1%) of patients had no change in the score and five (16.1%) of the patients had worsening of the dysphagia score by 1 point. Median dysphagia-free survival was 10.7 months, eight (25.8%) developed dysphagia after the dysphagia-free interval and two (6.4%) had worsening of dysphagia after treatment. There were no reported grade III or grade IV acute toxicities.

Conclusion:
The protocol has shown an acceptable survival and dysphagia-free interval. The study suggests intraluminal brachytherapy with induction chemotherapy and definitive chemoradiation is a feasible option in locally advanced esophageal cancer.
Comparative analysis of cytomorphology of thyroid lesion on conventional cytology versus liquid-based cytology and categorize the lesions according to The Bethesda System for Reporting Thyroid Cytopathology
Authors: Alam M Qamar , Pandey Pinki , Ralli Megha , Singh Chauhan Jitendra Pratap , Aggarwal Roopak , Chaturvedi Vineet , Kapoor Asttha , Trivedi Kapil , Agarwal Savita 
Published: December 2022

Introduction:
Thyroid nodules are a common disorder of the thyroid. Most of these are benign and only 5%–30% are malignant. Fine-needle aspiration cytology (FNAC) plays a vital role in differentiating benign from malignant and hence directing toward timely intervention. Liquid-based cytology (LBC) has been recently started in sampling thyroid lesions and has shown good results. The aim of our study was to compare the cytomorphology of thyroid lesions by conventional smear (CS) and LBC method and categorize the lesions according to TBSRTC (The Bethesda System for Reporting Thyroid Cytopathology).

Materials and Methods:
A prospective study was conducted from January 2018 to June 2019 on 131 patients. Thyroid FNAC samples were taken to prepare 2–5 slides for conventional reporting and one sample for LBC preparation by SurePath method. Staining with hematoxylin and eosin, May–Grünwald–Giemsa, and Papanicolaou stain was done. Cases were reported by TBSRTC and compared.

Results:
The nonneoplastic lesions constituted the major proportion on both CS (83.2%) and LBC (73.2%). The neoplastic lesions constituted only 9.9% of all the diagnosis both on CS and LBC smear. The kappa agreement between CS and LBC cytology as per The Bethesda System for Reporting Thyroid Cytopathology came out to be 0.715, which was statistically significant.

Discussion:
Colloid appearance was statistically significant on comparison by both methods. The comparison of ill formed epithelioid granulomas was statistically significant in autoimmune thyroiditis cases. In malignancy cases, nuclear and cytoplasmic details were crisper on CS. Cytoplasm appeared fragile and fragmented on LBC smears.
Chemoradiotherapy for elderly patients with rectal cancer
Authors: Uslu Gonca H. , Rakici Sema Y. 
Published: December 2022

Introduction:
The incidence of cancer, particularly rectal cancer (RC), in older adults is gradually increasing. The aim of the present study was to evaluate radiotherapy (RT) and chemoradiotherapy (CRT) results, clinicopathological features, and survival factors in older patients with RC.

Methods:
We evaluated patients aged ≥65 years with RC treated at a radiation oncology clinic. The demographic, clinical, and histopathological data of the patients were obtained by reviewing their medical records. The toxicity criteria of the Radiation Therapy Oncology Group were applied.

Results:
Among 401 patients with RC, 183 (45.6%) were older adults (65–92 years). Furthermore, 122 (66.7%) patients had clinically stage 3 and above RC, and 183 and 91 patients received RT and neoadjuvant CRT, respectively. Surgical treatment was performed for 116 (63.4%) patients, 41 (34.4%) and 76 (65.6%) of whom underwent postoperative CRT and preoperative RT, respectively. Grade 3 or higher toxicity was observed in 22 (18.9%) patients during CRT. RT was performed in 64 patients (35%) at a 1–15-day interval. The mean follow-up duration was 34.7 (range, 1.4–149.0) months. The 2- and 5-year overall survival (OS) rates were 71.4 and 37.4%, respectively, and the 2- and 5-year disease-free survival (DFS) rates were 65.7 and 35.3%, respectively. OS was 49.4 and 34.9 months for patients aged 65–74 and ≥75 years, respectively. Survival was shorter in patients with the advanced geriatric disease (p = 0.013). In the multivariate analysis, factors affecting overall and DFS were age, distance from the tumor to the anal canal, and metastasis (p < 0.05).

Conclusion:
The results of this study suggested that the selection of treatment modalities for older patients with RC should be based on performance status and not age. RT and CRT were safe treatment modalities for older patients with RC, particularly for those who could not undergo surgery.
Axillary management in patients with breast cancer and positive axilla at diagnosis. Experience in a Spanish university hospital with a 5-year follow-up
Authors: Jiménez-Gómez Marta , Loro-Pérez Jorge , Vega-Benítez Victor , Hernández- Hernández Juan Ramon , Aguirre Nuria Argudo 
Published: December 2022

ABSTRACT

Background:
Axillary lymph node dissection (ALND) was the standard in breast cancer with axillary involvement until recently. Along with the number of metastatic nodes, axillary positivity was considered a main prognostic factor and scientific evidence shows that the administration of radiotherapy on ganglion areas decreases the risk of recurrence even in positive axilla. The objective of this study was to evaluate the axillary treatment in patients with positive axilla at diagnosis, the evolution of them over time, and to assess patient’s follow-up with the aim of avoiding the morbidity associated with axillary dissection.

Methods:
A retrospective observational study of breast cancer patients diagnosed between 2010 and 2017 was performed. In total, 1,100 patients were studied, out of which 168 were women with clinically and histologically positive axilla at diagnosis. Seventy-six percent received primary chemotherapy and subsequent treatment with sentinel node biopsy, axillary dissection, or both. Patients with positive sentinel lymph node biopsy received either radiotherapy or lymphadenectomy depending on the year time they were diagnosed.

Results:
For 60 patients out of 168, neoadjuvant chemotherapy resulted in a complete pathological axillary response. Axillary recurrence was registered for six patients. No recurrence was detected in the biopsy group associated with radiotherapy. These results support the benefit of lymph node radiotherapy for patients with positive sentinel node biopsy after receiving primary chemotherapy.

Conclusion:
Sentinel node biopsy provides useful and reliable information about cancer staging and might prevent lymphadenectomy, leading to a decrease in morbidity. Pathological response to systemic treatment came out as the most important predictive factor of disease-free survival of breast cancer.
Definitive radiation therapy with dose escalation is beneficial for patients with squamous cell cancer of the esophagus
Authors: Ghosh-Laskar Sarbani , Mummudi Naveen , Kumar Saurabha , Chandre Mukesh , Mishra Shagun , Tibdewal Anil , Agarwal Jai Praklash , Patil Vijay , Noronha Vanita , Prabash Kumar , Patil Prachi , Jiwnani Sabita , Karimundackal George , Pramesh C. S. 
Published: December 2022

Objective:
We report the long term follow-up, toxicity, and outcomes of patients with localized squamous cell carcinoma of the esophagus(ESCC) who underwent definitive chemo-radiotherapy(dCRT) at our institute.

Materials and Methods:
Patients diagnosed with carcinoma post cricoid, upper cervical and thoracic oesophagus and treated with dCRT between January 2000 and March 2012 were retrospectively analyzed. Radiotherapy was delivered in two phases to a maximum dose of 63Gy in daily fractions of 1.8Gy using conventional or conformal techniques. OS and PFS were defined from date of registration and were calculated by Kaplan-Meier method with comparisons between different subgroups performed using log-rank test. All data were analysed using SPSS Version 22.

Results:
Three hundred and fourteen patients with ESCC treated with dCRT were included in this analysis. Median age at presentation was 56 years and median KPS at presentation was 70. Two-third of patients were treated with conformal technique. Median dose of radiation delivered was 60Gy(range 30.6Gy–70Gy). Neoadjuvant chemotherapy was administered in about 35% patients and 57% patients received concurrent chemotherapy. About 10% patients required hospitalization during treatment due to complications and 7 patients did not complete treatment. Grade 1/2 dermatitis and mucositis was seen in 77% and 71% patients respectively. Complete response at first follow up was observed in 56% of patients. At a median follow up of 56 months, 77 patients were alive with controlled disease. The 1- and 3-yr OS were 80% and 62% respectively. Median PFS was 28 months; 1- and 3-yr PFS were 66% and 46% respectively. A higher RT dose was found to be a significant predictor for OS and PFS on both uni- and multivariate analysis.

Conclusion:
Our study highlights that the delivery of higher RT doses (≥63Gy) is feasible in this patient group and that a higher RT dose was associated with significantly better PFS and OS.
Correlation of B-cell lymphoma 2 immunoexpression in invasive carcinoma of breast, no special type with hormone receptor status, proliferation index, and molecular subtypes
Authors: Azmat Henna , Faridi Javeria , Habib Hafiz Muhammad , Bugti Umair Jan , Sheikh Ahmareen Khalid , Riaz Syeda Kiran 
Published: December 2022

Background:
B-cell lymphoma 2 is involved in various cancers including breast carcinoma. Its expression in breast cancer has been associated with good prognostic factors such as hormone receptor expression, low Ki-67, low grade, and earlier stage. It is also considered to be an independent prognostic factor for luminal and triple-negative tumors.

Objective:
We aimed to determine the expression of B-cell lymphoma 2 (BCL2) in different molecular subtypes of invasive ductal carcinoma of breast and its association with prognostic indicators.

Materials and Methods:
Fifty samples of invasive carcinoma of breast, no special type (NST), were categorized into molecular subtypes according to immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), and Ki-67 and then evaluated for BCL2 expression. The expression of BCL2 was correlated with ER, PR, HER2, and Ki-67 and compared between luminal and nonluminal subtypes.

Results:
The BCL2 expression was seen in 68% of the cases with a significant association with ER, PR, and luminal subtypes. No significant association of BCL2 expression was seen with grade, HER2 and Ki-67 status of the tumor, or age group of the patients. BCL2 expression is significantly associated with ER, PR, and luminal subtypes in breast cancer.

Conclusion:
BCL2 is a marker of good prognosis in invasive carcinoma of breast, NST.
Role of sonic hedgehog ligand in gastric cancer therapeutics
Authors: Akhtar Kulsum , Maqbool Irfan , Bhat Gulzar Ahmad , Bhat Ishrat Parveiz , Syed Douhath Yousuf , Niyaz Madiha , Bashir Naheena , Parray Fazl Q. , Syed Besina , Syed Mudassar 
Published: December 2022

Purpose:
The abnormal activation of the sonic hedgehog (SHH) signaling pathway is responsible for the progression of several types of cancers including Gastric Cancer (GC). SHH has been associated with the activation of different signaling pathways. Therefore, in this study, we investigated messenger RNA (mRNA) and protein expression of SHH in gastric malignancies and possible correlation with various clinicopathological parameters.

Materials and Methods:
A total of 53 surgically resected tumors and adjacent histologically normal tissues from GC patients were investigated in study subjects. A quantitative real-time polymerase chain reaction and immunohistochemistry methods were used for expression analysis of SHH.

Results:
At mRNA level, SHH was overexpressed in 60% (27/45) of GC cases as compared to their adjacent normal tissues. SHH immunohistochemical analysis revealed abundant cytoplasmic localization and overexpression in 43.39% (23/53) of GC tissues. SHH overexpression was not associated with any of the clinicopathological parameters.

Conclusion:
Our results showed that SHH is dysregulated in GC and might be considered as a biomarker for GC progression and can be used as a target in cancer therapeutics.
Estimation of salivary lactate dehydrogenase in oral squamous cell carcinoma, oral leukoplakia, and smokers
Authors: Bhuvaneswari Mahalingam , Prasad Harikrishnan , Rajmohan Muthusamy , Sri Chinthu Kenniyan Kumar , Prema Perumal , Mahalakshmi Loganathan , Kumar Gopal Shiva 
Published: December 2022

Introduction:
Lactate dehydrogenase (LDH) is an enzyme seen within every cell during their normal metabolic function. It is always confined within the cell cytoplasm and it becomes extracellular only when a cell dies. The extracellular presence of LDH is related to cell necrosis and tissue breakdown. Therefore, we designed a study to estimate and compare LDH levels in the saliva of patients with oral cancer, oral leukoplakia (OL), and smokers without lesions and in controls.

Materials and Methods:
A total of 81 subjects of both genders, between the ages of 20 and 70 years, were included in the study. The study group was divided into four: group I-controls (n = 20), Group II-smokers (n = 20), Group III-subjects with OL (n = 20), and Group IV-subjects with oral squamous cell carcinoma (OSCC) (n = 21). Five milliliters of unstimulated salivary sample was collected from each participant, and salivary LDH level was measured. The obtained values were tabulated and statistically analyzed. P < 0.05 was considered to be statistically significant.

Results:
The difference in LDH levels among the four groups was found to “BE” statistically significant. LDH values showed a marked increase in the leukoplakia group (49.79 ± 19.88 IU/L) and OSCC group (106.97 ± 32.75 IU/L) when compared to controls and smokers.

Conclusion:
We found that salivary LDH was increased in patients with leukoplakia and OSCC. Smoking alone did not produce any alterations in salivary LDH. It is possible that salivary LDH could be a potential biomarker to identify early premalignant or malignant changes in smokers.