Asian Pacific Journal of Cancer Prevention

Newman, Kam;Maness-Harris, Lori;El-Hemaidi, Ihab;Akhtari, Mojtaba 1081

https://doi.org/10.7314/APJCP.2012.13.4.1081 PDF KSCI

Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematologic neoplasms characterized by morphologic dysplasia, aberrant hematopoiesis and peripheral blood refractory cytopenias. MDS is recognized to be associated with an increased risk of symptomatic anemia, infectious complications and bleeding diathesis, as well as a risk of progression to acute myeloid leukemia, particularly in patients with a high IPSS score. The advent of use of hematopoietic growth factors such as granulocyte colony-stimulating factor (G-CSF) and recombinant erythropoietin (EPO) has improved symptoms in MDS patients in addition to some data that suggest there might be an improvement in survival. G-CSF is an effective therapeutic option in MDS patients, and it should be considered for the management of refractory symptomatic cytopenias. G-CSF and EPO in combination can improve outcomes in appropriate MDS patients such as those with lower-risk MDS and refractory anemia with ring sideroblasts (RARS). This article reviews use of growth factors for lower-risk MDS patients, and examines the data for G-CSF, EPO and thrombopietic growth factors (TPO) that are available or being developed as therapeutic modalities for this challenging disease.

Raychaudhuri, Sreejata;Mandal, Sukanta 1093

https://doi.org/10.7314/APJCP.2012.13.4.1093 PDF KSCI

Background: Cervical cancer is common among women worldwide. A multitude of risk factors aggravate the disease. This study was conducted to: (1) determine the prevalence and (2) make a comparative analysis of the socio-demographic and behavioural risk factors of cervical cancer and knowledge, attitude and practice between rural and urban women of North Bengal, India. Study Design: Community-based cross-sectional study. Methods: A survey (first in North Bengal) was conducted among 133 women in a rural area (Kawakhali) and 88 women in an urban slum (Shaktigarh) using predesigned semi-structured questionnaires. The respondents were informed of the causes (including HPV), signs and symptoms, prevention of cervical cancer and treatment, and the procedure of the PAP test and HPV vaccination. Results: The prevalence of risk factors like multiparity, early age of marriage, use of cloth during menstruation, use of condom and OCP, early age of first intercourse was 37.2%, 82%, 83.3%, 5.4%, 15.8% and 65.6% respectively. Awareness about the cause, signs and symptoms, prevention of cervical cancer, PAP test and HPV vaccination was 3.6%, 6.3%, 3.6%, 9.5% and 14.5% respectively. Chi-square testing revealed that in the study population, significant differential at 5% exists between rural and urban residents with respect to number of children, use of cloth/sanitary napkins, family history of cancer and awareness regarding causes of cervical cancer. Regarding KAP, again using chi-square tests, surprisingly, level of education is found to be significant for each element of KAP in urban areas in contrast to complete absence of association between education and elements of KAP in rural areas. Conclusions: A large number of risk factors were present in both areas, the prevalence being higher in the rural areas. The level of awareness and role of education appears to be insignificant determinants in rural compared to urban areas. This pilot study needs to be followed up by large scale programmes to re-orient awareness campaigns, especially in rural areas.

Mu, Xian-Min;Shi, Wei;Sun, Li-Xin;Li, Han;Wang, Yu-Rong;Jiang, Zhen-Zhou;Zhang, Lu-Yong 1097

https://doi.org/10.7314/APJCP.2012.13.4.1097 PDF KSCI

Background/Aim: Pristimerin isolated from Celastrus and Maytenus spp can inhibit proteasome activity. However, whether pristimerin can modulate cancer metastasis is unknown. Methods: The impacts of pristimerin on the purified and intracellular chymotrypsin proteasomal activity, the levels of regulator of G protein signaling 4 (RGS 4) expression and breast cancer cell lamellipodia formation, and the migration and invasion were determined by enzymatic, Western blot, immunofluorescent, and transwell assays, respectively. Results: We found that pristimerin inhibited human chymotrypsin proteasomal activity in MDA-MB-231 cells in a dose-dependent manner. Pristimerin also inhibited breast cancer cell lamellipodia formation, migration, and invasion in vitro by up-regulating RGS4 expression. Thus, knockdown of RGS4 attenuated pristimerin-mediated inhibition of breast cancer cell migration and invasion. Furthermore, pristimerin inhibited growth and invasion of implanted breast tumors in mice. Conclusion: Pristmerin inhibits proteasomal activity and increases the levels of RGS4, inhibiting the migration and invasion of breast cancer cells.

Gadgil, Anita;Roy, Nobhojit;Sankaranarayanan, Rengaswamy;Muwonge, Richard;Sauvaget, Catherine 1105

https://doi.org/10.7314/APJCP.2012.13.4.1105 PDF KSCI

Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

Ng, Char Hong;Pathy, Nirmala Bhoo;Taib, Nur Aishah;Mun, Kein Seong;Rhodes, Anthony;Yip, Cheng Har 1111

https://doi.org/10.7314/APJCP.2012.13.4.1111 PDF KSCI

The ER-/PR+ breast tumor may be the result of a false ER negative result. The aim of this study was to investigate whether there is a difference in patient and tumor characteristics of the ER-/PR+ phenotype in an Asian setting. A total of 2629 breast cancer patients were categorized on the basis of their age, ethnicity, tumor hormonal receptor phenotype, grade and histological type. There were 1230 (46.8%) ER+/PR+, 306 (11.6%) ER+/PR-, 122 (4.6%) ER-/PR+ and 972 (37%) ER-/PR-. ER-/PR+ tumors were 2.5 times more likely to be younger than 50 years at diagnosis (OR: 2.52; 95% CI: 1.72-3.67). Compared to ER+/PR+ tumors, the ER-/PR+ phenotype was twice more likely to be associated with grade 3 tumors (OR:2.02; 95%CI: 1.00-4.10). In contrast, compared to ER-/PR- tumors, the ER-/PR+ phenotype was 90% less likely to be associated with a grade 3 tumor (OR: 0.12; 95%CI:0.05-0.26), and more likely to have invasive lobular than invasive ductal histology (OR: 3.66; 95%CI: 1.47-9.11). These results show that the ER-/PR+ phenotype occurs in a younger age group and is associated with intermediate histopathological characteristics compared to ER+/PR+ and ER-/PR- tumors. This may imply that it is a distinct entity and not a technical artifact.

Kang, Jin-Seok;Kim, Tae-Myoung;Shim, Tae-Jin;Salim, Elsayed I.;Han, Beom-Seok;Kim, Dae-Joong 1115

https://doi.org/10.7314/APJCP.2012.13.4.1115 PDF KSCI

Diallyl sulfide (DAS), a flavoring compound derived from garlic, is considered to have cancer chemopreventive potential in experimental animals and humans. This study was designated to examine possible chemopreventive effects of DAS on colon carcinogenesis using genetically engineered transgenic $Apc^{Min/+}$ mice, a well-established animal model for familial adenomatous polyposis (FAP) and sporadic colorectal cancer. Male C57BL/6J-$Apc^{Min/+}$ mice were divided into three groups. Animals of group 1 were placed on the basal diet (AIN-76A) as non-treated controls. Animals of groups 2 and 3 were given DAS-containing diets (in doses of 100 and 300 ppm, respectively). All mice were sacrificed at the end of week 10 of the experiment. Histopathological investigation revealed that the incidence of colonic polyps was decreased dose-dependently by 19% (13/16) in group 2 and by 32% (13/20) in group 3 compared to the 100% incidence (10/10) in group 1. The multiplicity of colonic polyps per mouse was also slightly decreased by DAS treatment ($1.88{\pm}0.35$ in group 2 and $1.63{\pm}0.36$ in group 3) compared to $2.00{\pm}0.39$ in group 1. On the other hand, there were no significant differences in the numbers of total polyps per mouse in the small intestine between the groups. Taken together, we suggest that DAS may exert promising inhibitory effects on colon carcinogenesis in the transgenic $Apc^{Min/+}$ mice.

Zheng, Jing;Hu, Jian-Da;Chen, Ying-Yu;Chen, Bu-Yuan;Huang, Yi;Zheng, Zhi Hong;Liu, Ting-Bo 1119

https://doi.org/10.7314/APJCP.2012.13.4.1119 PDF KSCI

Background: The effect and possible mechanism of traditional Chinese medicine, baicalin, on the PI3K/Akt signaling pathway in drug-resistant human myeloid leukemia HL-60/ADR cells have been investigated in this current study. Methods: HL-60/ADR cells were treated by 20, 40, $80\;{\mu}mol/L$ baicalin followed by cell cycle analysis at 24h. The mRNA expression level of the apoptosis related gene, Bcl-2 and bad, were measured by RT-PCR on cells treated with $80\;{\mu}mol/L$ baicalin at 12, 24 and 48hr. Western blot was performed to detect the changes in the expression of the proteins related to HL-60/ADR cell apoptosis and the signaling pathway before and after baicalin treatment, including Bcl-2, PARP, Bad, Caspase 3, Akt, p-Akt, NF-${\kappa}B$, p-NF-${\kappa}B$, mTOR and p-mTOR. Results: Sub-G1 peak of HL-60/ADR cells appeared 24 h after $20\;{\mu}mol/L$ baicalin treatment, and the ratio increased as baicalin concentration increased. Cell cycle analysis showed 44.9% G0/G1 phase cells 24 h after baicalin treatment compared to 39.6% in the control group. Cells treated with $80\;{\mu}mol/L$ baicalin displayed a trend in decreasing of Bcl-2 mRNA expression over time. Expression level of the Bcl-2 and PARP proteins decreased significantly while that of the PARP, Caspase-3, and Bad proteins gradually increased. No significant difference in Akt expression was observed between treated and the control groups. However, the expression levels of p-Akt, NF-${\kappa}B$, p-NF-${\kappa}B$, mTOR and p-mTOR decreased significantly in a time-dependent manner. Conclusions: We conclude that baicalin may induce HL-60/ADR cell apoptosis through the PI3K/AKT signaling pathway.

Cheah, Yong Kang;Naidu, Balkish Mahadir 1125

https://doi.org/10.7314/APJCP.2012.13.4.1125 PDF KSCI

Objective: The objective of present study is to investigate the determinants of smoking behaviour among adults in Malaysia. Method: Findings of the Third National Health and Morbidity Survey (NHMS-3) by the Ministry of Health, Malaysia, were used. The sample consisted of 34,539 observations. A logistic regression model was thus applied to estimate the probability to participate in smoking. Results: Age, income, gender, marital status, ethnicity, employment status, residential area, education, lifestyle and health status were statistically significant in affecting the likelihood of smoking. Specifically, youngsters, low income earners, males, unmarried individuals, Malays, employed individuals, rural residents and primary educated individuals were more likely to smoke. Conclusion: In conclusion, socio-demographic, lifestyle and health factors have significant impacts on smoking participation in Malaysia. Based on these empirical findings, several policy implications are suggested.

Zhou, Shi-Fu;Shi, Wei-Feng;Meng, Dong;Sun, Chun-Lei;Jin, Jian-Rong;Zhao, Yu-Tian 1131

https://doi.org/10.7314/APJCP.2012.13.4.1131 PDF KSCI

Objective: To evaluate interoperative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications, cosmetic outcome and recurrence events. Methods: From June 2007 to Dec 2011, 143 early breast cancer patients received breast conservative surgery. Seventy-two (study group) received interoperative radiotherapy, compared with 71 patients (control group) given routine radiotherapy. Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up. Results: The average wound healing time was 13~22 d in the study group and 9~14 d in the control group. In the study group, 2 patients developed lyponecrosis, 16 patients showed wound edema while no such side effects were found in the control group. No infection or hematomas were found in either group. In the study group (59 cases), overall cosmetic outcome in 53 patients was graded as excellent or good, and in 6 as fair or poor. Meanwhile in the control group (56 cases), 42 patients were graded as excellent or good, and 14 as fair or poor (P=0.032). After a follow-up from 3 to 54 months (median: 32 months), two patients (2.78%) in study group developed local relapses, one of them (1.39%) died, 2 patients (2.78%) developed bone metastases. In control group, one patient (1.41%) developed local relapse, 2 patients (2.82%) developed bone metastases, and no one died. Conclusion: Intraoperative radiotherapy is safe and reliable with good cosmetic outcome.

Ma, Xue-Lei;Xiao, Zhi-Lan;Liu, Lei;Liu, Xiao-Xiao;Nie, Wen;Li, Ping;Chen, Nian-Yong;Wei, Yu-Quan 1137

https://doi.org/10.7314/APJCP.2012.13.4.1137 PDF KSCI

Introduction: Recent studies have shown that circulating tumor cells (CTCs) play potential roles as diagnostic and prognostic biomarkers with various cancer types. The aim of this study was to comprehensively and quantitatively summarize the evidence for the use of CTCs to predict the survival outcome of lung cancer patients. Materials and Methods: Relevant literature was identified using Medline and EMBASE. Patients' clinical characteristics, overall survival (OS) and progression-free survival (PFS) together with CTC positive rates at different time points (before, during and after treatment) were extracted. A meta-analysis was performed to clarify the prognostic role of CTCs and the correlation between the CTC appearance and clinical characteristics. Results: A total of 12 articles containing survival outcomes and clinical characteristics and 15 articles containing only clinical characteristics were included for the global meta-analysis. The hazard ratio (HR) for OS predicted by pro-treatment CTCs was 2.61 [1.82, 3.74], while the HR for PFS was 2.37 [1.41, 3.99]. The HR for OS predicted by post-treatment CTCs was 4.19 [2.92, 6.00], while the HR for PFS was 4.97 [3.05, 8.11]. Subgroup analyses were conducted according to histological classification and detection method. Odds ratio (OR) showed the appearance of pro-treatment CTCs correlated with the lymph node status, distant metastasis, and TNM staging, while post-treatment CTCs correlated with TNM staging only. Conclusion: Detection of CTCs in the peripheral blood indicates a poor prognosis in patients with lung cancer.

Li, Bai-Rong;Zhou, Guo-Wu;Bian, Qi;Song, Bin 1145

https://doi.org/10.7314/APJCP.2012.13.4.1145 PDF KSCI

Aim: To clarify any association between the hOGG1 Ser326Cys polymorphism and susceptibility to gastric cancer. Methods: A meta-analysis based on 11 eligible case-control studies involving 5,107 subjects was carried out to summarize the data on the association between hOGG1 Ser326Cys polymorphism and gastric cancer risk. Results: No association was found between hOGG1 Ser326Cys polymorphism and gastric cancer risk (dominant model: OR = 0.95, 95% CI: 0.83-1.09, p = 0.486, ph (p values for heterogeneity) = 0.419; additive model: OR = 1.02, 95% CI: 0.81-1.30, p = 0.850, ph = 0.181; recessive model: OR = 1.09, 95% CI: 0.80-1.48, p = 0.586, ph = 0.053). Subgroup analysis based on ethnicity (Asian and Caucasian) and smoking status (ever smoker and never smoker) did did notpresent any significant association. Sensitivity analysis did not perturb the results. Conclusions: This study strongly suggested there might be no association between the hOGG1 Ser326Cys polymorphism and gastric cancer risk. However, larger scale studies are needed for confirmation.

Chansaenroj, Jira;Theamboonlers, Apiradee;Chinchai, Teeraporn;Junyangdikul, Pairoj;Swangvaree, Sukumarn;Karalak, Anant;Takahashi, Masayoshi;Nikaido, Masaru;Gemma, Nobuhiro;Poovorawan, Yong 1151

https://doi.org/10.7314/APJCP.2012.13.4.1151 PDF KSCI

High-risk human papillomavirus (HPV) genotypes are the major cause of cervical cancer. Hence, HPV genotype detection is a helpful preventive measure to combat cervical cancer. Recently, several HPV detection methods have been developed, each with different sensitivities and specificities. The objective of this study was to compare HPV high risk genotype detection by an electrochemical DNA chip system, a line probe assay (INNO-LiPA) and sequencing of the L1, E1 regions. A total of 361 cervical smears with different cytological findings were subjected to polymerase chain reaction-sequencing and electrochemical DNA chip assessment. Multiple infections were found in 21.9% (79/361) of the specimens, most prevalently in 20-29-year olds while the highest prevalence of HPV infection was found in the 30-39-year age group. The most prevalent genotype was HPV 16 at 28.2% (138/489) followed by HPV 52 at 9.6% (47/489), with the other types occurring at less than 9.0%. The electrochemical DNA chip results were compared with INNO-LiPA and sequencing (E1 and L1 regions) based on random selection of 273 specimens. The results obtained by the three methods were in agreement except for three cases. Direct sequencing detected only one predominant genotype including low risk HPV genotypes. INNO-LiPA identified multiple infections with various specific genotypes including some unclassified-risk genotypes. The electrochemical DNA chip was highly accurate, suitable for detection of single and multiple infections, allowed rapid detection, was less time-consuming and was easier to perform when compared with the other methods. It is concluded that for clinical and epidemiological studies, all genotyping methods are perfectly suitable and provide comparable results.

Schofield, Deborah;Callander, Emily;Kimman, Merel;Scuteri, Joe;Fodero, Lisa 1159

https://doi.org/10.7314/APJCP.2012.13.4.1159 PDF KSCI

Research on radiation oncologists has indicated that there is a shortage in supply of specialist workers in this field internationally, and also within Australia. However, there are no current estimates as to what the future Australian radiotherapy workforce will look like. This paper aims to review the current status and capacity of the three main disciplines that make up the radiation oncology workforce in Australia and project the workforce supply and demand for 2014 and 2019. Using data on the workforce from a survey of all radiotherapy facilities operating in Australia in 2008 a workforce model was constructed. This study found that there will be a future shortfall of radiation oncologists, radiation therapists and radiation oncology medical physicists working in radiation oncology treatment. By 2014 there will be 109 fewer radiation oncologists than what will be demanded, and by 2019 this figure will increase to a shortfall of 155 radiation oncologists. There was a projected shortfall of 612 radiation therapists by 2014, with this figure slightly decreasing to a shortfall of 593 radiation therapists in 2019. In 2014, there was projected to be a deficit of 104 radiation oncology medical physicists with a persisting shortfall of 78 in 2019. This future projected shortage highlights the need for radiation oncology workforce planning.

Xia, Pu;Ma, Ming-Feng;Wang, Wei 1167

https://doi.org/10.7314/APJCP.2012.13.4.1167 PDF KSCI

Background: Helicobacter pylori infection leads to many upper gastrointestinal diseases. Migrant workers are the main part of floating population in China. However, up to now, their health status has not been a focus of attention. Methods: In order to assess the status of H. pylori infection among migrant workers in Shijiazhuang, over five years we interviewed 324 individuals between 2007 and 2011. Each underwent a rapid urease test to identify H. pylori infection and socio-demographic indicators were collected using a survey questionnaire. Results: Our results showed that family income (P = 0.003), dietetic hygiene (P = 0.005), education (P = 0.004) and marital status (P = 0.007) were associated with H. pylori infection. Conclusion: We found that migrant workers had little basic knowledge of H. pylori and their prevalence of infection remains high. Therefore, we need to promote education and awareness of H. pylori and to ensure access to diagnosis and treatment for infected workers.

Yang, Zheng-Ming;Tao, Hui-Min;Ye, Zhao-Ming;Li, Wei-Xu;Lin, Nong;Yang, Di-Sheng 1171

https://doi.org/10.7314/APJCP.2012.13.4.1171 PDF KSCI

Objective: The current study aimedto screen for possible factors which affect prognosis of chondrosarcoma. Methods: Thirty seven cases were selected and analyzed statistically. The patients received surgical treatment at our hospital between December 2005 and March 2008. All of them had complete follow-up data. The survival rates were calculated by univariate analysis using the Kaplan-Meier method and tested by Log-rank. ${\chi}^2$ or Fisher exact tests were carried out for the numeration data. The significant indexes after univariate analysis were then analyzed by multivariate analysis using COX regression model. Based on the literature, factors of gender, age, disease course, tumor location, Enneking grades, surgical approaches, distant metastasis and local recurrence were examined. Results: Univariate analysis showed that there were significant differences in Enneking grades, surgical approaches and distant metastasis related to the patients' 3-year survival rate after surgery (P<0.001). No significant difference was not found in gender, age, disease course, tumor location or local recurrence (P>0.05). Multivariate analysis showed that Enneking grade (P=0.007) and surgical approaches (P=0.010) were independent factors affecting the prognosis of chondrosarcoma, but distant metastasis was not (P=0.942). Conclusion: Enneking grades, surgical approaches and distant metastasis are risk factors for prognosis of chondrosarcoma, among which the former two are independent factors.

Mooi, Lim Yang;Yew, Wong Teck;Hsum, Yap Wei;Soo, Khoo Kong;Hoon, Lim Saw;Chieng, Yeo Chew 1177

https://doi.org/10.7314/APJCP.2012.13.4.1177 PDF KSCI

Protein kinase C (PKC) has been implicated in carcinogenesis and displays variable expression profiles during cancer progression. Studies of dietary phytochemicals on cancer signalling pathway regulation have been conducted to search for potent signalling regulatory agents. The present study was designed to evaluate any suppressive effect of maslinic acid on PKC expression in human B-lymphoblastoid cells (Raji cells), and to identify the PKC isoforms expressed. Effects of maslinic acid on PKC activity were determined using a PepTag$^{(R)}$ assay for non-radioactive detection of PKC. The highest expression in Raji cells was obtained at 20 nM PMA induced for 6 hours. Suppressive effects of maslinic acid were compared with those of four PKC inhibitors (H-7, rottlerin, sphingosine, staurosporine) and two triterpenes (oleanolic acid and ursolic acid). The $IC_{50}$ values achieved for maslinic acid, staurosporine, H-7, sphingosine, rottlerin, ursolic acid and oleanolic acid were 11.52, 0.011, 0.767, 2.45, 5.46, 27.93 and $39.29\;{\mu}M$, respectively. Four PKC isoforms, PKC ${\beta}I$, ${\beta}II$, ${\delta}$, and ${\zeta}$, were identified in Raji cells via western blotting. Maslinic acid suppressed the expression of PKC ${\beta}I$, ${\delta}$, and ${\zeta}$ in a concentration-dependent manner. These preliminary results suggest promising suppressive effects of maslinic acid on PKC activity in Raji cells. Maslinic acid could be a potent cancer chemopreventive agent that may be involved in regulating many downstream signalling pathways that are activated through PKC receptors.

Xu, Guan-Jun;Cai, Sheng;Wu, Jian-Bing 1183

https://doi.org/10.7314/APJCP.2012.13.4.1183 PDF KSCI

Objective: To observe the effect of insulin-like growth factor-1 (IGF-1) on bone morphogenetic protein (BMP)-2 expression in hepatocellular carcinoma SMMC7721 cells. Methods: Cells were divided into blank control, IGF-1, IGF-1 + SB203580, and SB203580 groups. SB203580 was used to block the p38 MAPK signaling pathway. Changes in the expression of BMP-2, p38 MAPK, and phosphorylated p38, MERK, ERK and JNK were determined using reverse transcription polymerase chain reactions (RT-PCR) and Western blot analysis. Results: Protein expression of phosphorylated BMP-2, MERK, ERK, and JNK was significantly up-regulated by IGF-1 compared with the control group ($1.138{\pm}0.065$ vs. $0.606{\pm}0.013$, $0.292{\pm}0.005$ vs. $0.150{\pm}0.081$, $0.378{\pm}0.006$ vs. $0.606{\pm}0.013$, and $0.299{\pm}0.015$ vs. $0.196{\pm}0.017$, respectively; P<0.05). Levels of BMP-2 and phosphorylated MERK and JNK were significantly reduced after blocking of the p38MAPK signaling pathway ($0.494{\pm}0.052$ vs. $0.165{\pm}0.017$, $0.073{\pm}0.07$ vs. $0.150{\pm}0.081$, and $0.018{\pm}0.008$ vs. $0.196{\pm}0.017$, respectively; P<0.05), but such a significant difference was not observed for phosphorylated ERK protein expression ($0.173{\pm}0.07$ vs. $0.150{\pm}0.081$, P>0.05). Conclusion: IGF-1 can up-regulate BMP-2 expression, and p38 MAPK signaling pathway blockage can noticeably reduce the up-regulated expression. We can conclude that the up-regulatory effect of IGF-1 on BMP-2 expression is realized through the p38 MAPK signaling pathway.

Park, Bo-Young;Choi, Kui-Son;Lee, Yoon-Young;Jun, Jae-Kwan;Seo, Hong-Gwan 1187

https://doi.org/10.7314/APJCP.2012.13.4.1187 PDF KSCI

This study was conducted to determine the use of screening for stomach, liver, colorectal, breast, and cervical cancers, which are included in the Korean National Cancer Screening Programme. In 2011 the National Cancer Centre in Korea conducted a nationwide, population-based, cross-sectional interview survey using multi-stage random sampling. Participants included 4,100 cancer-free men 40 years and over of age and women over 30 years of age. The lifetime screening rates for stomach, liver, colorectal, breast, and cervical cancers were 76.2%, 54.3%, 56.1%, 79.0%, and, 74.8%, respectively. The rates of recommended screening for stomach, liver, colorectal, breast, and cervical cancers were 64.6%, 22.9%, 35.3%, 60.4%, and 62.4%, respectively. More than 70% of all screening was attributed to organised cancer screening programmes. The main reason given for non attendance was 'no symptoms'. A greater effort is needed to increase screening rates, especially for liver and colorectal cancers.

Nilaweera, Riw;Perera, S.;Paranagama, N.;Anushyanthan, As 1193

https://doi.org/10.7314/APJCP.2012.13.4.1193 PDF KSCI

Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but they are largely preventable. There are limited data on knowledge and practices on screening methods of breast and cervical cancers among female health care workers in Sri Lanka, in spite of having an organized screening programme islandwide. A cross-sectional survey was conducted among 219 female health care workers including public health midwives (68.9%) selected from 6 districts in Sri Lanka using convenient sampling methods. A self-administered questionnaire was used as a pre-test in a capacity building training programme to collect the data. The mean (SD) duration of work experience of the respondents was 12 years and 52.5% were aged over 35 years. Most (76.7%) were married, and afamily history of cancer was reported by 24.2%. Over 98% knew about self breast examination. Even though 84.1% practiced it, only 47.9% practiced it on a monthly basis. Clinical breast examination and mammography were known by 94.1% and 64.3% respectively. Only 19.2% had undergone a clinical braest examination within one year and 3.6% had ever undergone a mamography. Only 76.3% knew that a Pap smear detects precancerous stage of cervical cancer. Among 169 married workers, 73.4% had never had a Pap smear and only 17.2% had got it done within the preceding 5 years. Among the reasons for not doing a pap smear within 5 years, 47.0% belived it as not nescessary, 17.3% due to fear/dislike, 23.2% as not having symptoms, 3% had not known about it and 3% not known about availability of services. The study findings suggest that the knowledge and practices on breast and cervical cancer screening methods among female health care workers need to be improved. Considering the role that health care workers play in communicating health behaviors to the general public, strengthening health education interventions for this group of females is essential.

Liu, Ai-Na;Sun, Ping;Liu, Jian-Nan;Ma, Jin-Bo;Qu, Hua-Jun;Zhu, Hua;Yu, Cai-Yan;Zhang, Liang-Ming 1197

https://doi.org/10.7314/APJCP.2012.13.4.1197 PDF KSCI

Objective: To study the relationship between clinical pathologic characteristics, treatment modalities and prognostic factors in HER-2 (Human Epidermal growth factor Receptor-2) overexpressed breast carcinoma. Materials and Methods: Major clinico-pathological factors including therapeutic modalities and survival status of 371 breast cancer patients with HER2 over-expression, teated at Yantai Yuhuangding Hospital from March of 2002 to December of 2010 were retrospectively studied, with special attention focused on survival-related factors. Results: The median age of the total 371 patients in this study was 48 years at time of diagnosis, among which, the leading pathological type was infiltrating ductal carcinoma (92.5%); 62.8% presented with a primary tomor larger than 2 cm in diameter at diagnosis, 51.0% had axillary lymph node (ALN) metastases; ER (Estrogen receptor)/PR (Progesterone receptor) double negative occured in 52.8% of cases, and PCNA (proliferation cell nuclear antigen) (+++) was found in 55.1%. HER-2 overexpressed patients were usually in advanced stage when the diagnosis was made (72.8% at stages IIA~IIIC). The prognosis and survival were assessed in 259 patients with complete follow-up data. 5-year DFS (disease-free survival) and OS (overall survival) rate was 68.0% and 78.0% respectively. Univariate analysis revealed that age, tumor size, ALN metastases, LVSI (lymph-vascular space involvement), PCNA status, hormonal therapy, chemotherapy cycles, and HER-2 overexpression, correlated closely with the prognosis. ALN metastases, LVSI, PCNA status and chemotherapy cycles were independent predictors of survival. Conclusions: HER-2 overexpressed breast cancer has special clinical and pathological characteristics, with advanced clinical stages and high rate of ER/PR double negative. Lymph node metastases, LVSI, PCNA and chemotherapy cycles are independent predictors of prognosis.

Yang, Zhen;Zhang, Xie-Fu;Liu, Hong-Xiang;Hao, Yong-Shun;Zhao, Chun-Lin 1203

https://doi.org/10.7314/APJCP.2012.13.4.1203 PDF KSCI

Background: Previous studies concerning the association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and colorectal cancer risk in Asian populations generated conflicting results. A meta-analysis was therefore performed to allow a more reliable estimate of any link. Methods: Relevant studies concerning the association between the MTHFR C677T polymorphism and risk of colorectal cancer were included into this meta-analysis. The quality of the studies was assessed according to a predefined scale. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined for this gene-disease association using fixed or random effect models according to the heterogeneity between included studies. Results: Finally, 21 studies with a total of 6692 cases and 8266 controls were included. Meta-analyses showed that there was an obvious association of the MTHFR 677T allele with decreased risk of colorectal cancer (OR = 0.91, 95%CI=0.85-0.98, P=0.011). Subgroup analyses by country further identified this association, with dietary folate as the main source of heterogeneity. Conclusion: The MTHFR 677T allele is associated with a lower risk of colorectal cancer in Asian populations, and there is effect modification by population plasma folate.

Kim, Mi-Yeong;Kang, Sung-Yoon;Lee, Suh-Young;Yang, Min-Suk;Kim, Min-Hye;Song, Woo-Jung;Kim, Sae-Hoon;Kim, Yo-Jung;Lee, Keun-Wook;Cho, Sang-Heon;Min, Kyung-Up;Lee, Jong-Seok;Kim, Jee-Hyun;Chang, Yoon-Seok 1209

https://doi.org/10.7314/APJCP.2012.13.4.1209 PDF KSCI

Background and Aim: Oxaliplatin hypersensitivity is a well-known adverse reaction but the prevalence varies and data for frequency and clinical features have not been reported for Korea. Here we evaluates the prevalence and risk factors for hypersensitivity reactions to oxaliplatin after chemotherapy. Methods: Clinical information on all patients treated with oxaliplatin was retrospectively reviewed in electronic medical records between August 2009 and July 2010 in Seoul National University Bundang Hospital. Patients who experienced hypersensitivity reactions to oxaliplatin were compared with those who did not. Results: A total of 393 patients received oxaliplatin, with 42 (10.7%) experiencing hypersensitivity reactions including three cases of anaphylaxis. Median cycle of the first hypersensitivity reaction was 8. Reactions correlated with lower dexamethasone doses. Other variables were not significant. Conclusions: The prevalence of hypersensitivity reactions was 10.7%, symptoms being mostly mild and cutaneous. Lower dexamethasone doses could be a predictor for hypersensitivity reactions to oxaliplatin.

Saleh, Amyza;Yang, Yi-Hsin;Ghani, Wan Maria Nabillah Wan Abd;Abdullah, Norlida;Doss, Jennifer Geraldine;Navonil, Roy;Rahman, Zainal Ariff Abdul;Ismail, Siti Mazlipah;Talib, Norain Abu;Zain, Rosnah Binti;Cheong, Sok Ching 1217

https://doi.org/10.7314/APJCP.2012.13.4.1217 PDF KSCI

Background and Aim: Less than 50% of oral cancer cases are diagnosed at early stages of the disease and this is in part due to poor awareness and lack of knowledge on the signs and symptoms of oral cancer. This study sought to measure the baseline awareness of oral cancer in Malaysia and aimed to increase public awareness and knowledge of oral cancer using a mass media campaign. Methods: Baseline awareness and impact of the campaign was measured using self-administered questionnaires sent via email to individuals. The campaign was aired on two national television channels and the reach was monitored through an independent programme monitoring system. Results: 78.2% of respondents had heard of oral cancer, and this increased significantly after the campaign. However, the ability to recognize signs and symptoms remains unchanged. We found that the level of awareness differed between the distinct ethnic subgroups and the reach of the campaign was not uniform across all ethnicities. Conclusion: This substantial study to measure the oral cancer awareness in Malaysia provides important baseline data for the planning of public health policies. Despite encouraging evidence that a mass media campaign could increase the awareness of oral cancer, further research is required to address the acceptability, comprehensiveness and effectiveness. Furthermore, different campaign approaches may be required for specific ethnic groups in a multi-ethnic country such as Malaysia.

Usta, Yasemin Yildirim;Demir, Yurdanur;Yagmuroglu, Huriye 1225

https://doi.org/10.7314/APJCP.2012.13.4.1225 PDF KSCI

Objective: The aim of this study was to investigate the meaning of "positive attitude" for medical surgical nurses in caring for cancer patients. Methods: A qualitative method was used in this qualitative descriptive study with data from nurses who had volunteered to participate in an in-depth interview that was conducted between January and February 2012. A total of 10 nurses in general medical and surgical wards of a district hospital were interviewed. Results: The study used three broad themes to describe this multifaceted construct: showing empathy, seeing positively and behaving positively. The nurses were aware of their attitudes towards being positive with cancer patients and its significance in support for cancer patients. Conclusions: The findings of this study can serve as a platform upon which educational and other support programmes can be developed in order to meet the needs of those general nurses working with cancer patients. Future studies are recommended to examine nurses' beliefs about cancer that are thought to affect positive attitudes toward cancer patients.

Guan, Cheng-Nong;Zhang, Pei-Wen;Lou, Hai-Qing;Liao, Xiang-Hui;Chen, Bao-Ying 1231

https://doi.org/10.7314/APJCP.2012.13.4.1231 PDF KSCI

Objective: The aim of this study was to explore the expression of DLC-l in breast carcinoma and any association with tumor metastasis. Methods: 51 surgical specimens of human breast carcinoma, divided into high invasive and low invasive groups according to their clinicopathological features, 30 cases of adjacent normal tissue and 28 benign breast lesions were examined by qRT-PCR for expression of DLC-1. Results: Expression level of DLC-1 in adjacent normal tissue and benign breast lesion specimens was higher than that in breast carcinoma (P<0.0001); the values in the high invasive group with synchronous metastases were also lower than in the low invasive group (P=0.0275). The correlation between DLC-1 expression level and tumor progression and metastasis of breast cancer was negative. Conclusion: As an anti-oncogene, DLC-1 could play an important part in breast carcinoma occurrence, progression, invasiveness and metastasis. Detecting the changes of the expression of DLC-1 in the breast carcinoma may contribute to earlier auxiliary diagnosis of invasiveness, metastasis and recrudescence.

Kaewpitoon, Natthawut;Kaewpitoon, Soraya J.;Ueng-Arporn, Naporn;Rujirakul, Ratana;Churproong, Seekaow;Matrakool, Likit;Auiwatanagul, Suprakrit;Sripa, Banchob 1235

https://doi.org/10.7314/APJCP.2012.13.4.1235 PDF KSCI

Background: Opisthorchis viverrini infection is a serious public-health problem in Southeast Asia. It is associated with a number of hepatobiliary diseases and the evidence strongly indicates that liver fluke infection is the etiology of cholangiocarcinoma. Objectives: This study aimed to investigate Opisthorchis viverrini metacercarial infection in cyprinoid fish collected from 32 districts of Nakhon Ratchasima province, Northeastern Thailand during one year period from February 2010 to February 2011. Methods: A cross-sectional study was conducted, data being collected with pepsin-HCl digestion and stereomicroscope, respectively. Analysis was performed using SPSS Windows Version 12.0. Results: A total of 640 Cyprinidae family fish including 5 species were collected from different study sites, and investigated for O. viverrini metacercariae. The infection rate was 12.3% (79/640), predominantly in Cyclocheilichthys armatus, C. repasson, Puntioplites proctzysron, Hampala macrolepitota and Hampala dispar, respectively. The prevalence of O. viverrini metaceria in Nakhon Ratchasima area was 78.1%, predominantly in Sida and KiaKham Thale So. Conclusion: This findings stress that natural fish species in rural communities are still a source of O viverrini infection and put local people at risk, therefore public awareness and prevention campaigns are urgently required.

Sonmezer, Hacer;Cetinkaya, Fevziye;Nacar, Melis 1241

https://doi.org/10.7314/APJCP.2012.13.4.1241 PDF KSCI

Aim: In this study we aimed to investigate the healthy life-style behaviour of Turkish women and establish influencing features. Methods: This descriptive study performed by a questionnaire method was conducted in a primary health care centre, in an urban region in Kayseri, Turkey. Every midwife region belonging to the health care centre was accepted as a cluster, and a sample of 450 women between ages 18-64, was gathered from 9 midwife regions. The Health Promotion Life-style Profile (HPLP) was applied to evaluated the healthy lifestyle behaviour of 421 women that could be reached. T test, Tukey HSD with ANOVA, and chi square tests were used for analysis. Results: The mean total HPLP was $126.8{\pm}19.2$ (interpersonal support subscale, $74.3{\pm}14.1$; nutrition subscale, $73.6{\pm}12.6$; self-actualisation subscale, $70.6{\pm}11.9$; stress management subscale, $63.4{\pm}13.0$; health responsibility subscale, $61.2{\pm}13.2$; and exercise subscale, $47.1{\pm}15.0$). There was no statistically significant variation when evaluated for age, marital state, family type, economic status, and perception of self-health, smoking, and BMI. HPLP was high in people with an education of primary school and lower in university graduates, in people who lived mostly in the city centre and in individuals with chronic diseases. In conclusion, it was established that the health promoting behaviour in Turkish women is, in general, at a medium level, and women should be enlightened in order to develop and increase the habit of health preservation and promotion.

Zhao, Yang;Wang, Jingwen;Tanaka, Tsutomu;Hosono, Akihiro;Ando, Ryosuke;Soeripto, Soeripto;Triningsih, F.X. Ediati;Triono, Tegu;Sumoharjo, Suwignyo;Astuti, E.Y. Wenny;Gunawan, Stephanus;Tokudome, Shinkan 1247

https://doi.org/10.7314/APJCP.2012.13.4.1247 PDF KSCI

Background: Helicobacter pylori is an important gastrointestinal pathogen related to the development of not only atrophic gastritis and peptic ulcer, but also gastric cancer. Human leukocyte antigens (HLA) may play particular roles in host immune responses to bacterial antigens. This study aimed to investigate the association between HLA-DQA1 and DQB1 genotypes and haplotypes vs H. pylori infection in an Indonesian population. Methods: We selected 294 healthy participants in Mataram, Lombok Island, Indonesia. H. pylori infection was determined by urea breath test (UBT). We analyzed HLA-DQA1 and DQB1 genotypes by PCR-RFLP and constructed haplotypes of HLA-DQA1 and DQB1 genes. Multiple comparisons were conducted according to the Bonferroni method. Results: The H. pylori infection rate was 11.2% in this Indonesian population. The DQB1*0401 genotype was noted to be associated with a high risk of H. pylori infection, compared with the DQB1*0301 genotype. None of the HLA-DQA1 or DQB1 haplotypes were related to the risk of H. pylori infection. Conclusions: The study suggests that HLADQB1 genes play important roles in H. pylori infection, but there was no statistically significant association between HLA-DQA1 or DQB1 haplotypes and H.pylori infection in our Lombok Indonesian population.

Wu, Qiao;Liu, Chang-Zheng;Tao, Lian-Yuan;Yu, Lan;Liu, Wei;Chen, Song-Sen;He, Xiao-Dong 1253

https://doi.org/10.7314/APJCP.2012.13.4.1253 PDF KSCI

The 14-3-3 proteins are highly conserved, ubiquitous molecules involved in a variety of biologic phenomena, such as cell cycle control, and apoptosis. However, their expression in cholangiocarcinoma has not been previously characterized. In this paper, immunohistochemistry using specific anti-14-3-3 monoclonal antibodies was performed on formalin-fixed;, paraffin embedded archival tissue from 86 patients of cholangiocarcinoma. We also examined the correlation between expression and survival rate and clinicopathologic factors such as tumor location, tumor size, pathologic differentiation, lymphatic permeation, lymph node metastasis, and tumor stage. Positive 14-3-3 proteins expression was observed for 6 isoforms (${\beta}$, ${\sigma}$, ${\gamma}$, ${\theta}$, ${\delta}$, ${\eta}$) of these proteins in 86 patients of cholangiocarcinoma. ${\beta}$ and ${\sigma}$ isoform immunoreactivity was correlated with lymph node metastasis, tumor stage and patients' survival rate. In addition, ${\delta}$ isoform immunoreactivity showed trends with tumor location, tumor size, pathologic differentiation and tumor stage, while the ${\theta}$ isoform was correlated with pathologic differentiation. These results indicated that upregulated expression of some isoforms of 14-3-3 may be a common mechanism for evading apoptosis in cholangiocarcinoma, so that targeting 14-3-3 may be a novel promising strategy for the treatment of this tumor.

Yahyapour, Yousef;Shamsi-Shahrabadi, Mahmoud;Mahmoudi, Mahmoud;Siadati, Sepideh;Shahryar, Shefaei Shahryar;Shokri-Shirvani, Javad;Mollaei, Hamid;Monavari, Seyed Hamid Reza 1261

https://doi.org/10.7314/APJCP.2012.13.4.1261 PDF KSCI

Introduction: HPV has been found repeatedly in esophageal squamous cell carcinoma (ESCC) tissues. However, reported detection rates of HPV DNA in these tumors have varied markedly. Differences in detection methods, sample types, and geographic regions of sample origin have been suggested as potential causes of variation. We have reported that infection of HPV DNA in ESCC tumors depends on anatomical sites of esophagus of the patients from Mazandaran, north of Iran. Materials and Methods: HPV DNA was examined in 46 upper, 69 middle and 62 lower third anatomical sites of esophageal squamous cell carcinoma specimens collected from Mazandaran province in north Iran, near the Caspian Littoral as a region with high incidence of ESCC. HPV L1 DNA was detected using Qualitative Real time PCR and MY09/MY11 primers. Results: 28.3% of upper, 29% of middle and 25.8% of lower third of ESCC samples were positive for HPV DNA. 13.6% for males and 14.1% for females were HPV positive in all samples. Conclusions: HPV infection is about one third of ESCC in this area. Findings in this study increase the possibility that HPV is involved in esophageal carcinogenesis. Further investigation with a larger sample size is necessary.

Zhou, Yi-Li;Zhang, Wei;Gao, Er-Li;Dai, Xuan-Xuan;Yang, Han;Zhang, Xiao-Hua;Wang, Ou-Chen 1267

https://doi.org/10.7314/APJCP.2012.13.4.1267 PDF KSCI

Background and Objective: The optimal resection extent for clinically unilateral papillary thyroid microcarcinoma (PTMC) remains controversial. The objective was to investigate risk factors associated with occult contralateral carcinoma, and put emphasis on the predictive value of preoperative BRAF mutation. Materials and Methods: 100 clinically unilateral PTMC patients all newly diagnosed, previously untreated were analyzed in a prospective cohort study. We assessed the T1799A BRAF mutation status in FNAB specimens obtained from all PTMC patients before undergoing total thyroidectomy (TT) and central lymph node dissection (CLND) for PTMC. Univariate and multivariate analyses were used to reveal the incidence of contralateral occult cancer, difference of risk factors and predictive value, with respect to the following variables: preoperative BRAF mutation status, age, gender, tumor size, multifocality of primary tumor, capsular invasion, presence of Hashimoto thyroiditis and central lymph node metastasis. Results: 20 of 100 patients (20%) had occult contralateral lobe carcinoma. On multi-variate analysis, preoperative BRAF mutation (p = 0.030, OR = 3.439) and multifocality of the primary tumor (p = 0.004, OR = 9.570) were independent predictive factors for occult contralateral PTMC presence. However, there were no significant differences between the presence of occult contralateral carcinomas and age, gender, tumor size, capsular invasion, Hashimoto thyroiditis and central lymph node metastasis. Conclusions: Total thyroidectomy, including the contralateral lobe, should be considered for the treatment of unilateral PTMC if preoperative BRAF mutation is positive and/or if the observed lesion presents as a multifocal tumor in the unilateral lobe.

Lohsiriwat, Varut;Prapasrivorakul, Siriluck;Suthikeeree, Wanwarang 1273

https://doi.org/10.7314/APJCP.2012.13.4.1273 PDF KSCI

Purpose: The incidence of colorectal cancer (CRC) has been increasing in Asian countries including Thailand. Double contrast barium enema (DCBE) is one of the investigation tools used in CRC screening. This study aimed to determine the incidence of colorectal neoplasm detected at screening by DCBE in Thai people. Methods: The computerized radiology database of screening DCBE in Thai adults between June 2009 and October 2011 at the Faculty of Medicine, Siriraj Hospital, was reviewed. DCBE examination performed in a surveillance program after curative CRC resection or the removal of colorectal polyps was also considered as a screening DCBE. Results: A total of 819 screening DCBEs performed during this 28-month period were analyzed. The mean age of patients was $59.8{\pm}13.6$ years. Of the total, 467 (57%) were male. A family history of CRC and a previous history of curative CRC resection or polyp removal were noted in 34 patients (4%) and 124 patients (15%), respectively. A total of 31 patients (3.8%; 95%CI = 2.7%-5.3%) were reported to have colorectal polyp or mass demonstrated on DCBE. Of these, follow-up endoscopy was performed in 20 cases (65%). According to pathological results, the incidence of advanced adenoma and CRC detected at screening DCBE was 0.7% (95%CI = 0.3%-1.6%; n=6) and 0.4% (95%CI = 0.1%-1.1%; n=3), respectively. Conclusions: The screening DCBE performed in Thai adults had a diagnostic yield of 0.7% for advanced adenoma and 0.4% for CRC.

Akkuzu, Gulcihan 1277

https://doi.org/10.7314/APJCP.2012.13.4.1277 PDF KSCI

Aim: Studies have shown effects of surgery, radiation and chemotherapy on quality of life in cases of gynaecological cancer. Very few studies are available examining the quality of life of individuals in Turkey who have been diagnosed with gynaecological cancer and undergoing treatment. Method: This study was performed to evaluate the quality of life of such patients using the EORTC-QLQ-C30 Quality of Life Index. Chi-square Yates, Mann-Whitney-U tests and variance analysis used for statistical analizing. Results: The EORTC-QLQ-C30 Quality of Life Index mean points for "general well-being and quality of life" of the patients were found to be $60.5{\pm}25.0$. In the sub-groups of the Quality of Life Index determined fatigue ($60.1{\pm}24.8$), economic difficulties ($46.9{\pm}33.3$), pain and loss of appetite ($42.9{\pm}27.8$; $42.9{\pm}34.0$) and insomnia ($40.1{\pm}34.0$) were the symptoms most reported to have a negative effect on quality of life. Statistical significance was noted for marital status and income status (p<0.05) but not educational level. Conclusion:Determination of quality of life of women with a diagnosis of gynaecological oncological disease who are undergoing chemotherapy enables provision of a more comprehensive and higher quality of care.

Inal, Ali;Kaplan, M. Ali;Kucukoner, Mehmet;Urakci, Zuhat;Karakus, Abdullah;Isikdogan, Abdurrahman 1281

https://doi.org/10.7314/APJCP.2012.13.4.1281 PDF KSCI

Background: Platinum-hased chemotherapy for advanced non-small cell lung cancer (NSCLC) is still considered the first choice, presenting a modest survival advantage. However, the patients eventually experience disease progression and require second-line therapy. While there are reliable predictors to identify patients receiving first-line chemotherapy, very little knowledge is available about the prognostic factors in patients who receive second-line treatments. The present study was therefore performed. Methods: We retrospectively reviewed 107 patients receiving second-line treatments from August 2002 to March 2012 in the Dicle University, School of Medicine, Department of Medical Oncology. Fourteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Result: The results of univariate analysis for overall survival (OS) were identified to have prognostic significance: performance status (PS), stage, response to first-line chemotherapy response to second-line chemotherapy and number of metastasis. PS, diabetes mellitus (DM), response to first-line chemotherapy and response to second-line chemotherapy were identified to have prognostic significance for progression-free survival (PFS). Multivariate analysis showed that PS, response to first-line chemotherapy and response to second-line chemotherapy were considered independent prognostic factors for OS. Furthermore, PS and response to second-line chemotherapy were considered independent prognostic factors for PFS. Conclusion: In conclusion, PS, response to first and second-line chemotherapy were identified as important prognostic factors for OS in advanced NSCLC patients who were undergoing second-line palliative treatment. Furthermore, PS and response to second-line chemotherapy were considered independent prognostic factors for PFS. It may be concluded that these findings may facilitate pretreatment prediction of survival and can be used for selecting patients for the correct choice of treatment.

Kassim, Saba;Salam, Mohamed;Croucher, Ray 1285

https://doi.org/10.7314/APJCP.2012.13.4.1285 PDF KSCI

Background: The Fagerstrom Test for Cigarette Dependence (FTCD) (formally FTND) is widely used for measuring physical dependence on nicotine. Objective: To explore the cross cultural validity and reliability of FTCD amongst Arabic speaker cigarette consumers who chew khat leaf, a stimulant green leaf. Methods: The psychometric properties of the FTCD were assessed in a subsample (91regular cigarette smokers) of purposively selected 204 UK-resident Yemeni khat chewers recruited during random visits to khat sale outlets. Data were collected via a structured face-to-face interview. Data analyses included descriptive tests and factor analysis. Results: Two factors were obtained by a principle axis factor analysis and these were termed as urgency of restoring the level of nicotine after abstinence during sleeping and maintaining the level of nicotine during waking. The internal reliability (Cronbach's alpha coefficient) of the whole FTCD is low (.68) as well as for the two subscales (.60) and (.62) respectively. Conclusion: The psychometric properties of the Arabic version of the FTCD scale in this sample of Yemeni khat chewers who smoked regularly confirmed what has been established in other cultural settings. The findings of this study have yet to be cross validated amongst other appropriately representative sample of Arabic speakers.

Hematulin, Arunee;Meethang, Sutiwan;Ingkaninan, Kornkanok;Sagan, Daniel 1289

https://doi.org/10.7314/APJCP.2012.13.4.1289 PDF KSCI

The use of herbal products as radiosensitizers is a promising approach to increase the efficacy of radiotherapy. However, adverse effects related to the use of herbal medicine on radiotherapy are not well characterized. The present study concerns the impact of Derris scandens Benth extract on the radiosensitivity of Hep-2 laryngeal cancer cells. Pretreatment with D. scandens extract prior to gamma irradiation significantly increased clonogenic survival and decreased the proportion of radiation-induced abnormal nuclei of Hep-2 cells. Furthermore, the extract was found to enhance radiation-induced G2/M phase arrest, induce Akt activation, and increase motility of Hep-2 cells. The study thus indicated that D. scandens extract potentiates radioresistance of Hep-2 cells, further demonstrating the importance of cellular background for the adverse effect of D. scandens extract on radiation response in a laryngeal cancer cell line.

Yao, Lei;Li, Fu-Jun;Tang, Zhi-Qiang;Gao, Shuang;Wu, Qe-Quan 1297

https://doi.org/10.7314/APJCP.2012.13.4.1297 PDF KSCI

Aims: Primary hepatocellular carcinoma (HCC) is a common malignancy often related to hepatitis viral infection. Smad4 is known to mediate the TGF-${\beta}$ pathway to suppress tumorigenesis. However, the function of Smad4 in HCC is still controversial. In this study we compared levels of Smad4 in HCC tissues with or without hepatitis virus infection and adjacent normal-appearing liver. Methods: Samples from HCC patients were analyzed for Smad4 protein and mRNA expression by immunohistochemistry (IHC), RT-PCR and Western blotting. Results: We found that tumor tissues expressed less Smad4 mRNA and protein than the adjacent tissues. Most HCC tumor tissues were negative for Smad4 in IHC staining, while the majority of adjacent tissues were positively stained. Interestingly, protein levels were higher in HCC tissues with viral hepatitis than those without virus infection. Suppression of expression appeared closely related to HCC, so that Smad4 appears to function as a tumor suppressor gene (TSG). Conclusion: Patients with hepatitis viral infection, at higher risk for HCC, exhibited increased Smad4 protein expression suggesting hepatitis virus may modulate Smad4 expression, which is functionally distinct from its putative role as a TSG. Smad4 expression may thus be an applicable marker for diagnosis and/or a target to develop therapeutic agents for HCC.

Jaafar, Hasnan;Sharif, Sharifah Emilia Tuan;Murtey, Mogana Das 1305

https://doi.org/10.7314/APJCP.2012.13.4.1305 PDF KSCI

Breast cancer cells undergo transformation when they spread into surrounding tissues. Studies have shown that cancer cells undergo surface alterations and interact with the surrounding microenvironment during the invasion process. The aim of the present study was to analyse these cancer cell surface alterations and interactions of cancer cells and stroma. Twenty 1-methyl-1-nitrosourea-induced breast cancer samples taken from five rats were fixed in McDowell-Trump fixative and then washed in 0.1 M phosphate buffer. The samples were then treated with osmium tetroxide before being washed in distilled water and subsequently dehydrated through graded ethanols. The dehydrated samples were immersed in hexamethyldisilazane (HMDS), then following removal of excess HMDS, the samples were air dried at room temperature in a dessicator. The dried samples were mounted onto specimen stubs and coated with gold coater before being viewed under a scanning electron microscope. We detected the presence of membrane ruffles on the surface of cancer cells and the formation of unique surface membrane protrusions to enhance movement and adhesion to the surrounding stroma during the process of invasion. Advancing cancer cells demonstrated formation of lamellipodia and invadopodia. The stroma at the advancing edge was desmoplastic with many collagen fibres laid down near the cancer cells. Our data suggest that all of these abnormalities could act as hallmarks of invasiveness for breast cancer.

Aleem, Aamer;Diab, Abdul Rahman Al;Alsaleh, Khalid;Algahtani, Farjah;Alsaeed, Eyad;Iqbal, Zafar;El-Sherkawy, Mohamed Sherif 1311

https://doi.org/10.7314/APJCP.2012.13.4.1311 PDF KSCI

Objectives: Thrombotic risk is increased in patients with cancer and there are important implications for those who suffer a venous thromboembolism (VTE). We undertook this study to determine the frequency, clinical patterns, and outcome of VTE in Saudi patients with cancer. Methods: Cancer (solid tumors and lymphoma) patients who developed VTE from January 2004 to January 2009 were studied retrospectively. Demographics and clinical characteristics related to thrombosis and cancer were evaluated. Results: A total of 701 patients with cancer were seen during the study period. VTE was diagnosed in 47 (6.7%) patients (median age 52, range 18-80 years). Lower limb DVT was the most common type, seen in 47% patients, followed by PE in 19%, and 19% patients had both DVT & PE. Thrombosis was symptomatic in 72% patients while it was an incidental finding on routine workup in 28%. Cancer and VTE were diagnosed at the same time in 38% of patients, and 47% patients developed VTE during the course of disease after the cancer diagnosis. The majority of VTE post cancer diagnoses occurred during the first year (median 4 months, range 1-14). Additional risk factors for VTE were present in 22 (47%) patients and 14 (30%) of these patients were receiving chemotherapy at the time of thrombosis. Only 5 (10.6%) patients were receiving thrombo-prophylaxis at the time of VTE diagnosis. Most common types of tumors associated with thrombosis were breast cancer, non-Hodgkin's lymphoma and lung cancer. The majority of the affected patients (79%) had advanced stage of cancer. After a median follow-up of 13 (range 0.5-60) months, 38 (81%) patients had died. There was no difference in the mortality of patients with symptomatic or asymptomatic thrombosis (82% vs 78.6%). Conclusions: Thrombotic complications can develop in a significant number of patients with cancer, and almost half of the patients have additional risk factors for VTE. Thrombosis is usually associated with advanced disease and can be asymptomatic in more than a quarter of cases. Thromboprophylaxis in cancer patients is under-utilized. Community based studies are needed to accurately define the extent of this problem and to develop effective prophylactic strategies.

Qu, Kai;Liu, Si-Nan;Chang, Hu-Lin;Liu, Chang;Xu, Xin-Sen;Wang, Rui-Tao;Zhou, Lei;Tian, Feng;Wei, Ji-Chao;Tai, Ming-Hui;Meng, Fan-Di 1317

https://doi.org/10.7314/APJCP.2012.13.4.1317 PDF KSCI

Biliary tract cancers, broadly described as malignancies that arise from the biliary tract epithelia, are usually divided into two major clinical phenotypes: cholangiocarcinoma and gallbladder cancer, differing in etiopathogenesis, risk factors, and perhaps molecular and genetic signatures. Atypical symptoms and lack of tumor biomarkers make it difficult to diagnose in early stages. At the time of presentation, few patients are candidates for potentially curative surgical resection. We here assessed and compared features of a total of 150 cases divided into extra- and intrahepatic cholangiocarcinomas and gallbladder cancers (GBC). Althought there were no significant differences in serum tumour marker levels, GBC patients had the poorest prognosis. Furthermore, gallbladder cancer respond poorly to chemotherapy or radiation therapy and approximately half of untreated patients died within 10 months. Therefore, treatment for patients with gallbladder cancer is still in challenge. Outcomes and survival of these patients had improved little over the past three decades - a period in which new successful treatments have greatly contributed to the prolonged patient survival for many other cancers.

Khanra, Kalyani;Panda, Kakali;Bhattacharya, Chandan;Mitra, A.K.;Sarkar, Ranu;Bhattacharyya, Nandan 1321

https://doi.org/10.7314/APJCP.2012.13.4.1321 PDF KSCI

Background: DNA polymerase beta ($pol{\beta}$) is a key enzyme in the base excision repair pathway. It is 39kDa protein, with two subunits, one large subunit of 31 kDa having catalytic activity between exon V to exon XIV, and an 8 kDa smaller subunit having single strand DNA binding activity. Exons V to VII have double strand DNA binding activity, whereas exons VIII to XI account for the nucleotidyl transferase activity and exons XII to XIV the dNTP selection activity. Aim: To examine the association between $pol{\beta}$ polymorphisms and the risk of ovarian cancer, the present case control study was performed using 152 cancer samples and non-metastatic normal samples from the same patients. In this study, mutational analysis of $pol{\beta}$ genomic DNA was undertaken using primers from exons IX to XIV - the portion having catalytic activity. Results: We detected alteration in DNA polymerase beta by SSCP. Two specific heterozygous point mutations of $pol{\beta}$ were identified in Exon 9:486, A->C (polymorphism 1; 11.18%) and in Exon 11:676, A->C (polymorphism 2; 9.86%). The correlation study involving polymorphism 1 and 4 types of tissue showed a significant correlation between mucinous type with a Pearson correlation value of 4.03 (p=0.04). The association among polymorphism 2 with serous type and stage IV together have shown Pearson ${\chi}^2$ value of 3.28 with likelihood ratio of 4.4 (p=0.07) with OR =2.08 (0.3-14.55). This indicates that there is a tendency of correlation among polymorphism 2, serous type and stage IV, indicating a risk factor for ovarian cancer. Conclusion: Hence, the results indicate that there is a tendency for $pol{\beta}$ polymorphisms being a risk factor for ovarian carcinogenesis in India.

Rao, Qun-Xian;Yao, Ting-Ting;Zhang, Bing-Zhong;Lin, Rong-Chun;Chen, Zhi-Liao;Zhou, Hui;Wang, Li-Juan;Lu, Huai-Wu;Chen, Qin;Di, Na;Lin, Zhong-Qiu 1325

https://doi.org/10.7314/APJCP.2012.13.4.1325 PDF KSCI

Tumor formation and growth is dictated by a very small number of tumor cells, called cancer stem cells, which are capable of self-renewal. The genesis of cancer stem cells and their resistance to conventional chemotherapy and radiotherapy via mechanisms such as multidrug resistance, quiescence, enhanced DNA repair abilities and anti-apoptotic mechanisms, make it imperative to develop methods to identify and use these cells as diagnostic or therapeutic targets. Aldehyde dehydrogenase 1 (ALDH1) is used as a cancer stem cell marker. In this study, we evaluated ALDH1 expression in CaSki, HeLa and SiHa cervical cancer cells using the Aldefluor method to isolate ALDH1-positive cells. We showed that higher ALDH1 expression correlated with significantly higher rates of cell proliferation, microsphere formation and migration. We also could demonstrate that SiHa-ALDH1-positive cells were significantly more tumorigenic compared to SiHa-ALDH1-negative cells. Similarly, SiHa cells overexpressing ALDH1 were significantly more tumorigenic and showed higher rates of cell proliferation and migration compared to SiHa cells where ALDH1 expression was knocked down using a lentivirus vector. Our data suggested that ALDH1 is a marker of cervical cancer stem cells and expand our understanding of its functional role.

Stakleff, Kimberly Sloan;Sloan, Tricia;Blanco, Denise;Marcanthony, Sharon;Booth, Tristan D.;Bishayee, Anupam 1333

https://doi.org/10.7314/APJCP.2012.13.4.1333 PDF KSCI

Epithelial ovarian cancer represents the most lethal gynecological cancer, and the high mortality rate makes this malignancy a major health concern. Poor prognosis results from an inability to detect ovarian cancers at an early, curable stage, as well as from the lack of an effective therapy. Thus, effective and novel strategies for prevention and treatment with non-toxic agents merit serious consideration. Resveratrol, obtained from grapes, berries, peanuts and red wine, has been shown to have a potent growth-inhibitory effect against various human cancer cells as well as in in vivo preclinical cancer models. The objective here was to evaluate potential antitumor effects of resveratrol in both in vitro and in vivo NuTu-19 ovarian cancer models. In vitro an invasion assay was performed. After 48 h, the numbers of viable cells that invaded the extracellular matrix layer were reduced by 94% with resveratrol in comparison to control. For the in vivo anti-tumor assessment, 10 rats were injected with NuTu-19 cells into the ovarian bursa. Thereafter, half were provided with a diet mixed with a dose of 100 mg resveratrol/kg body weight/day for 28 days. Following sacrifice, anticancer effects were assessed by histological evaluation of ovarian as well as surrounding tissues, and immunohistochemical detection of cell proliferation and apoptosis, but there were no observable differences between the control and resveratrol-treated groups for any of the biological endpoints. While resveratrol is effective in suppressing the in vitro cellular invasion of NuTu-19 ovarian cancer cells, these effects do not appear to impact on in vivo NuTu-19 ovarian cancers in rats.

Hassan, Usman;Mushtaq, Sajid;Mamoon, Nadira;Asghar, Asghar Hussain;Ishtiaq, Sheeba 1341

https://doi.org/10.7314/APJCP.2012.13.4.1341 PDF KSCI

Introduction: Diffuse large B-cell lymphomas (DLBCL) can be divided into germinal centre (GC-DLBCL) and post germinal centre (post GC-DLBCL) groups by applying immunohistochemical antibodies. As these subgroups respond differently to chemotherapy, it is possible at diagnosis to select a poor prognostic subgroup for aggressive treatment. Objective: To determine the frequencies of GC-DLBCL and post GC-DLBCL in patients by immunohistochemistry (IHC) and the clinical response after six cycles of chemotherapy. Subjects and Methods: In this descriptive study conducted in AFIP and CMH, Rawalpindi and NORI, Islamabad, from September 2010 to September 2011, a total of 75 pretreatment cases of DLBCL diagnosed during the study period were included. Cases were segregated in to GC-DLBCL and post GC-DLBCL groups according to results of immunohistochemistry markers CD10, BCL6 and MUM1. Immediate clinical response was assessed after 6 cycles of chemotherapy. Response was divided into complete response, partial response, stable disease or relapse or progression. Results: The mean age was $54.2{\pm}15$. Males were 53 (70.7%). Forty (53.3%) cases comprised the GC-DLBCL group; 25(62.5%) of them showed a complete response. Most patients of the post GC-DLBCL 19(54%) showed relapse/progression. Results of immediate clinical response in both prognostic subgroups were significant (p<0.05). Results regarding positivity with immunohistochemical antibodies CD10 (p 0.011), BCL6 (p 0.013) and MUM1 (p 0.000) regarding immediate clinical response were also significant. Conclusion: GC-DLBCL group shows better response to CHOP chemotherapy regimen. Immunohistochemistry should be used to further classify DLBCL as this can enable us to select aggressive group for aggressive treatment. This manuscript is important because the study is the first to becarried out exclusively in Pakistan or our part of the world.

Cheng, Bian-Qiao;Jiang, Yi;Li, Dong-Liang;Fan, Jing-Jing;Ma, Ming 1349

https://doi.org/10.7314/APJCP.2012.13.4.1349 PDF KSCI

Increasing evidence has revealed that thy-1 was a potential stem cell marker of liver cancer, but no data have been shown on how thy-1 regulates the pathophysiology of liver cancer, such as proliferation, apoptosis, invasion and migration. We previously demonstrated that thy-1 was expressed in about 1% of hepg2 cells, thy-1+hepg2 cells, but not thy-1-, demonstrating high tumorigenesis on inoculation $0.5{\times}10^5$ cells per BACA/LA mouse after 2 months. In the present study, our results showed that higher expression of thy-1 occurs in 72% (36/50 cases) of neoplastic hepatic tissues as compared to 40% (20/50 cases) of control tissues, and the expression of thy-1 is higher in poorly differentiated liver tumors than in the well-differentiated ones. In addition, thy-1 expression was detected in 85% of blood samples from liver cancer patients, but none in normal subjects or patients with cirrhosis or hepatitis. There was a significant negative correlation between thy-1expression and E-cadherin expression (a marker of invasion and migraton), but not between thy-1 expression and AFP expression in all the liver cancer and blood samples. We further investigated the relationship between thy-1 and E-cadherin in liver cancer hepg2 cell line which was transfected with pReceiver-M29/thy-1 eukaryotic expression vector followed by aspirin treatment. Lower expression of E-cadherin but higher expressions of thy-1 were detected in hepg2 cells transfected with pReceiver-M29/thy-1. Taken together, our study suggested that thy-1 probably regulates liver cancer invasion and migration.

Liu, Chuan;Wang, Ying;Wang, Qing-Shui;Wang, Ya-Jie 1355

https://doi.org/10.7314/APJCP.2012.13.4.1355 PDF KSCI

Background: The cell cycle checkpoint kinase 2 (CHEK2) gene I157T variant may be associated with an increased risk of breast cancer, but it is unclear whether the evidence is sufficient to recommend testing for the mutation in clinical practice. Materials and Methods: We systematically searched PubMed, Embase, Elsevier and Springer for relevant articles published before Nov 2011. Summary odds ratio (OR) and 95% confidence interval (95% CI) incidence rates were calculated using a random-effects model with STATA (version 10.0) software. Results: A total of fifteen case-control studies, including 19,621 cases and 27,001 controls based on the search criteria, were included for analysis. A significant association was found between carrying the CHEK2 I157T variant and increased risk of unselected breast cancer (OR = 1.48, 95% CI = 1.31-1.66, P < 0.0001), familial breast cancer (OR = 1.48, 95% CI = 1.16-1.89, P < 0.0001), and early-onset breast cancer (OR = 1.47, 95% CI = 1.29-1.66, P < 0.0001). We found an even stronger significant association between the CHEK2 I157T C variant and increased risk of lobular type breast tumors (OR = 4.17, 95% CI = 2.89-6.03, P < 0.0001). Conclusion: Our research indicates that the CHEK2 I157T variant may be another important genetic mutation which increases risk of breast cancer, especially the lobular type.

Aswakul, Pitulak;Prachayakul, Varayu;Lohsiriwat, Varut;Bunyaarunnate, Thirapol;Kachintorn, Udom 1361

https://doi.org/10.7314/APJCP.2012.13.4.1361 PDF KSCI

Background: Results of screening colonoscopy from Western countries reported adenoma detection rates (ADRs) of 30-40% while those from Asia had ADR as low as 10%. There have been limited data regarding screening colonoscopy in Thailand. The objectives of this study were therefore to determine polyp and adenoma detection rates in Thai people, to evaluate the incidence of colorectal cancer detected during screening colonoscopy and to determine the endoscopic findings of the polyps which might have some impact on endoscopists to perform polypectomy. Materials & Methods: This study was a retrospective electronic chart review of asymptomatic Thai adults who underwent screening colonoscopy in our endoscopic center from June 2007 to October 2010.Results: A total of 1,594 cases were reviewed. The patients had an average age of $58.3{\pm}10.5$ years (range 27-82) and 55.5% were female. Most of the cases (83.8%) were handled by staff who were endoscopists. A total of 488 patients (30.6%) were reported to have colonic polyps. Left-sided colon was the most common site (45.1%), followed by right-sided colon (36.5%) and the rectum (18%). Those polyps were removed in 97.5% of cases and 88.5 % of the polyps were sent for histopathology (data lost 11.5%). Two hundred and sixty three cases had adenomatous polyps, accounting for 16.5 % ADR. Advanced adenomas were detected in 43 cases (2.6%). Hyperplastic polyps were mainly located distal to the splenic flexure of the colon whereas adenomas were found throughout the large intestine. Ten cases (0.6%) were found to have colorectal cancer. Four advanced adenomas and two malignant polyps were reported in lesions ${\leq}$ 5 mm. Conclusion: The polyp detection rate, adenoma detection rate, advanced adenoma detection rate and colorectal cancer detection rate in the screening colonoscopy of Thai adults were 30.9%, 16.5%, 2.6% and 0.6% respectively. Malignant transformation was detected regardless of the size and location of the polyps. Therefore, new technology would play an important role indistinguishing polyps.

He, Qiang;You, Hong;Li, Xin-Min;Liu, Tian-Hui;Wang, Ping;Wang, Bao-En 1365

https://doi.org/10.7314/APJCP.2012.13.4.1365 PDF KSCI

The high mobility group box-1 (HMGB1) protein and NALP3 inflammasome have been identified to play important roles in inflammation and cancer pathogenesis, but the relationships between the two and cancer remain unclear. The current study investigated the relationship between HMGB1 and the NALP3 inflammasome in THP-1 macrophages. HMGB1 was found unable to activate the NALP3 inflammasome and failed to induce the release of the IL-$1{\beta}$ and IL-18 in THP-1 macrophages. HMGB1 was also found significantly enhanced the activity of ATP to induce IL-$1{\beta}$ and IL-18 by the induction of increased expression of pro-IL-$1{\beta}$ and pro-IL-18. This process was dependent on activation of RAGE, MAPK p38 and NF-${\kappa}B$ signaling pathway. These results demonstrate that HMGB1 promotes the synthesis of pro-IL-$1{\beta}$ and pro-IL-18 in THP-1 macrophages by the activation of p38 MAPK and NF-${\kappa}B$ through RAGE. HMGB1 likely plays an important role in the first step of the release of the IL-$1{\beta}$ and IL-18, preparing for other cytokines to induce excessive release of IL-$1{\beta}$ and IL-18 which promote inflammation and cancer progression.

Kim, Ji-Man;Kim, Hee-Moon;Jung, Bo-Young;Park, Eun-Cheol;Cho, Woo-Hyun;Lee, Sang-Gyu 1371

https://doi.org/10.7314/APJCP.2012.13.4.1371 PDF KSCI

Background: Economic status is known to be directly or indirectly related to cancer incidence since it affects accessibility to health-related social resources, preventive medical checkups, and lifestyle. This study investigates the relationship between cancer incidence and family income in Korea. Methods:Using the Korean National Health Insurance cancer registration data in 2009, the relationship between their family income class and cancer risk was analyzed. The age-standardized incidence rates of the major cancers were calculated for men and women separately. After adjusting for age, residential area, and number of family members, cancer risks for major cancers according to family income class were estimated using a logistic regression model. Results: In men, the risk of stomach cancer for Income Class 5 (lowest) was 1.12 times (95% CI 1.02-1.23) higher than that of Income Class 1 (highest), for lung cancer 1.61 times (95% CI 1.43-1.81) higher, for liver cancer 1.22 times (95% CI 1.08-1.37) higher, and for rectal cancer 1.37 times higher (95% CI 1.18-1.59). In women, the risk of stomach cancer for Income Class 5 was 1.22 times higher (95% CI 1.08-1.37) than that for Income Class 1, while for cervical cancer it was 2.47 times higher (95% CI 2.08-2.94). In contrast, in men, Income Class 1 showed a higher risk of thyroid cancer and prostate cancer than that of Income Class 5, while, in women the same was the case for thyroid cancer. Conclusions: The results show the relationship between family income and cancer risk differs according to type of cancer.

Qin, Yi;Chen, Jing;Li, Li;Liao, Chun-Jie;Liang, Yu-Bing;Guan, En-Jian;Xie, Yu-Bo 1377

https://doi.org/10.7314/APJCP.2012.13.4.1377 PDF KSCI

Morphine is not only an analgesic treating pain for patients with cancer but also a potential anticancer drug inhibiting tumor growth and proliferation. To gain better insight into the involvement of morphine in the biological characteristics of gastric cancer, we investigated effects on progression of gastric carcinoma cells and the expression of some apoptosis-related genes including caspase-9, caspase-3, survivin and NF-${\kappa}B$ using the MGC-803 human gastric cancer cell line. The viability of cells was assessed by MTT assay, proliferation by colony formation assay, cell cycle progression and apoptosis by flow cytometry and ultrastructural alteration by transmission electron microscopy. The influences of morphine on caspase-9, caspase-3, survivin and NF-${\kappa}B$ were evaluated by semi-quantitative RT-PCR and Western blot. Our data showed that morphine could significantly inhibit cell growth and proliferation and cause cell cycle arrest in the G2/M phase. MGC-803 cells which were incubated with morphine also had a higher apoptotic rate than control cells. Morphine also led to morphological changes of gastric cancer cells. The mechanism of morphine inhibiting gastric cancer progression in vitro might be associated with activation of caspase-9 and caspase-3 and inhibition of survivin and NF-${\kappa}B$.

Kim, Im-Ryung;Cho, Ju-Hee;Choi, Eun-Kyung;Kwon, In-Gak;Sung, Young-Hee;Lee, Jeong-Eon;Nam, Seok-Jin;Yang, Jung-Hyun 1383

https://doi.org/10.7314/APJCP.2012.13.4.1383 PDF KSCI

Objectives: Regardless of its negative impact on quality of life, little is known about the importance of alopecia from the patients' perspective. This study aimed to explore the whole experience of chemotherapy-induced alopecia among Korean breast cancer patients including perception, attitudes, preparedness, and changes after alopecia. Methods: Patients expected to experience or had experienced alopecia were recruited at a tertiary hospital in Seoul, Korea. Semi-structured in-depth interviews were performed in 21 patients. Recurrent issues were identified and placed into thematic categories. Results: All patients think that appearance is important and they pay attention to how they look like. They had negative perceptions about alopecia. Patients were not well prepared for alopecia, and experienced substantial physical, psychological and social distress. Lack of information and limited social support combined with negative images of cancer made it difficult for patients to overcome the trauma and deterred them from usual daily activities resulting in poor quality of life. Conclusions: Patients were not well prepared for alopecia and negative perceptions, lack of preparedness, and limited social support and resources increased alopecia-related distress. Educational programs for preparing patients to cope with alopecia distress and advocate activities to change people's negative perception about alopecia are needed to reduce the burden imposed by alopecia in cancer patients.

Sun, Xiu-Wei;Feng, Zhan-Jun;Huang, Peng;Hao, Wang;Sui, Xing-Ling 1389

https://doi.org/10.7314/APJCP.2012.13.4.1389 PDF KSCI

Objective: To discuss the significance of DOG1, CD117 and PDGFRA in the diagnosis of gastrointestinal stromal tumors (GISTs), and analyze their correlations with clinicopathological features and risk ranking. Method: DOG1, CD117 and PDGFRA were detected with IHC Envision ldpe-g-nvp in 63 GISTs and 43 cases of non-GISTs, and analyzed for relations with clinicopathological factors (gender, age, location, tumor size, mitotic phase, histology) and risk degree. Results: The positive expression rate of DOG1, CD117 and PDGFRA in GISTs was 84.1% (53/63), 90.5% (57/63), 53.2% (33/63), respectively. Among the 6 CD117 negative cases, all were DOG1 positive and 5 were PDGFRA positive. Rates in patients with non-GISTs was 11.6%, 16.3%, 6.98%, respectively. Expression of DOG1 and PDGFRA demonstrated no significant variation with gender, age, position, tumor size, mitotic phase, histology, and risk rank. However, CD117 was related with position and histology (P=0.008 and P=0.045), those in the mesentery having a higher positive rate than those derived from stomach, small intestine, colon and rectum (50.0% vs 94.7%, P=0.008). Furthermore CD117 was also highly expressed in spindle and epithele types. Conclusions: DOG1 had a good sensitivity and specificity as a kind of newly discovered marker, especially for KIT negative GISTs. However, DOG1, CD117 and PDGFRA cannot be used for assessing the rish of patients.

Cheng, Dong-Dong;Yang, Qing-Cheng;Zhang, Zhi-Chang;Yang, Cui-Xia;Liu, Yi-Wen 1395

https://doi.org/10.7314/APJCP.2012.13.4.1395 PDF KSCI

Background: Histone deacetylase (HDAC) inhibitors have been reported to induce cell growth arrest, apoptosis and differentiation of tumor cells. The present study aimed to examine the effects of trichostatin A (TSA), one such inhibitor, on the cell cycle, apoptosis and invasiveness of osteosarcoma cells. Methods: MG-63 cells were treated with TSA at various concentrations. Then, cell growth and apoptosis were determined by 3-(4, 5-dimethyl-2-thiazolyl)-2H-tetrazolium bromide (MTT) and TUNEL assays, respectively; cell cycling was assessed by flow cytometry; invasion assays were performed with the transwell Boyden Chamber system. Results: MTT assays revealed that TSA significantly inhibited the growth of MG-63 cells in a concentration and time dependent manner. TSA treated cells demonstrated morphological changes indicative of apoptosis and TUNEL assays revealed increased apoptosis of MG-63 cells after TSA treatment. Flow cytometry showed that TSA arrested the cell cycle in G1/G2 phase and annexin V positive apoptotic cells increased markedly. In addition, the invasiveness of MG-63 cells was inhibited by TSA in a concentration dependent manner. Conclusion: Our findings demonstrate that TSA inhibits the proliferation, induces apoptosis and inhibits invasiveness of osteosarcoma cells in vitro. HDAC inhibitors may thus have promise to become new therapeutic agents against osteosarcoma.

Liu, Lin-Na;Guo, Zhi-Wei;Zhang, Yan;Qin, Hua;Han, Yan 1401

https://doi.org/10.7314/APJCP.2012.13.4.1401 PDF KSCI

Aim: To investigate the protective effect of purified fraction 1 polysaccharide extracted from Rheum tanguticum RTP1 on irradiation-induced immune damage in mice. Methods: Kunming mice were randomly divided into five groups: normal group (NC), irradiation control group (IC), RTP1 low dose (200 mg/kg), middle dose (400 mg/kg) and high dose (800 mg/kg) groups. RTP1 was adminstered by the gastric route for 14 d, mice in the NC and IC groups being given by 0.9% sodium chloride solution in the same way. The mice in all groups except NC group were irradiated with 2.0 Gy $^{60}Co{\gamma}$-ray on the fourteenth day. Immune indives of non-specific immune function, cellular immunity and humoral immunity were assessed at the 24th hour after radiation. Results: Compared with the IC group, the spleen index, thymus index, rate of carbon clearance, phagocytic function of macrophages, lymphocyte proliferation, hemolysin value of blood serum and NK activity were increased markedly (P < 0.05 or P < 0.05). Conclusion: RTP1 has an obvious protective effects on damage in ${\gamma}$-ray radiated mice.

Mansour-Ghanaei, Fariborz;Sokhanvar, Homayoon;Joukar, Farahnaz;Shafaghi, Afshin;Yousefi-Mashhour, Mahmud;Valeshabad, Ali Kord;Fakhrieh, Saba;Aminian, Keyvan;Ghorbani, Kambiz;Taherzadeh, Zahra;Sheykhian, Mohammad Reza;Rajpout, Yaghoub;Mehrvarz, Alireza 1407

https://doi.org/10.7314/APJCP.2012.13.4.1407 PDF KSCI

Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.

Roder, David;Silva, Primali de;Zorbas, Helen;Kollias, James;Malycha, Peter;Pyke, Chris;Campbell, Ian;Webster, Fleur 1413

https://doi.org/10.7314/APJCP.2012.13.4.1413 PDF KSCI

Background: Previous studies generally indicate that synchronous bilateral breast cancers (SBBC) have an equivalent or moderately poorer survival compared with unilateral cases. The prognostic characteristics of SBBC would be relevant when planning adjuvant therapies and follow-up medical surveillance. The frequency of SBBC among early breast cancers in clinical settings in Australia and New Zealand was investigated, plus their prognostic significance, using the Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand, which covered an estimated 60% of early invasive lesions in those countries. Design: Rate ratios (95% confidence limits) of SBBC were investigated among 35,370 female breast cancer cases by age of woman, histology type, grade, tumour diameter, nodal status, lymphatic/vascular invasion and oestrogen receptor status. Univariate and multivariable disease-specific survival analyses were undertaken. Results: 2.3% of cases were found to be SBBC (i.e., diagnoses occurring within 3 months). The figure increased from 1.4% in women less than 40 years to 4.1% in those aged 80 years or more. Disease-specific survivals did not vary by SBBC status (p=0.206). After adjusting for age, histology type, diameter, grade, nodal status, lymphatic/vascular invasion, and oestrogen receptor status, the relative risk of breast cancer death for SBBC was 1.17 (95% CL: 0.91, 1.51). After adjusting for favourable prognostic factors more common in SBBC cases (i.e., histology type, grade, lymphatic/vascular invasion, and oestrogen receptor status), the relative risk of breast cancer death for SBBC was 1.42 (95% CL: 1.10, 1.82). After adjusting for unfavourable prognostic factors more common in SBBC cases (i.e., older age and large tumour diameter), the relative risk of breast cancer death for SBBC was 0.98 (95% CL: 0.76, 1.26). Conclusions: Results confirm previous findings of an equivalent or moderately poorer survival for SBBC but indicate that SBBC status is likely to be an important prognostic indicator for some cases.

Choi, Jin-Young;Chang, Yoon-Jung;Hong, Young-Seon;Heo, Dae-Seog;Kim, Sam-Yong;Lee, Jung-Lim;Choi, Jong-Soo;Kang, Ki-Mun;Kim, Si-Young;Jeong, Hyun-Sik;Lee, Chang-Geol;Choi, Youn-Seon;Lim, Ho-Yeong;Yun, Young-Ho 1419

https://doi.org/10.7314/APJCP.2012.13.4.1419 PDF KSCI

Objectives: To investigate in depth the use of complementary and alternative medicines (CAMs) by cancer patients at the end-of-life (EOL) and how they communicate with physicians about them. Design and location: In 17 hospitals in Korea between January and December 2004 we identified 4,042 families of cancer patients. Results: The prevalence of CAM use among cancer patients at the EOL was 37.0%, and 93.1% had used pharmacologic types of agents. The most frequent motive for CAM use was the recommendation of friends or a close relative (53.4%) or a physician (1.6%). Only 42.5% discussed CAM use with their physicians. Satisfaction with CAMS was recalled for 37.1%. The most common reason given for that satisfaction was improvement of emotional or physical well-being, while ineffectiveness was the most common reason given for dissatisfaction. The average cost of CAM during the last month of life was $US 900. CAM use was associated with longer disease periods, primary cancers other than liver, biliary, and pancreatic, and need of support from physicians or religion. Conclusions: CAM use among cancer patients at the EOL was common, not discussed with physicians, and associated with expectation of cure. Expectations were generally unmet while the treatments were a financial burden. Further studies evaluating the effects of CAM at the EOL and factors that enhance communication with the physician are needed.

Li, Hong-Li;Huang, Ding-Zhi;Deng, Ting;Zhou, Li-Kun;Wang, Xia;Bai, Ming;Ba, Yi 1425

https://doi.org/10.7314/APJCP.2012.13.4.1425 PDF KSCI

Cyclin L2 is a novel member of the cyclin family, recently implicated in the regulation of cell cycle progression and/or transcriptional regulation. The present study was undertaken to investigate the effects of overexpression on tumor cell growth and chemosensitivity in human gastric cells in vitro. Cyclin L2 was transfected into human gastric cancer cell line BCG823 and expressed with a mammalian expression vector pcDNA3.1. The effects and mechanisms of cyclin L2 on cell growth, cell cycling and apoptosis were studied. Compared to control vectors, overexpression of cyclin L2 inhibited the growth of BCG823 cells and enhance their chemosensitivity to fluorouracil, docetaxel and cisplatin. The anti-proliferative effects of cyclin L2 could be due to G0/G1 arrest and apoptosis. Cyclin L2 induced G0/G1 arrest and apoptosis involved upregulation of caspase-3 and down regulation Bcl-2 and survivin. The results indicated that overexpression of cyclin L2 protein may promote efficient growth inhibition and enhance chemosensitivity to chemotherapeutic agents in human gastric cancer cells by inducing G0/G1 cell cycle arrest and apoptosis.

Wang, Li-Meng;Xie, Kun-Peng;Huo, Hong-Nan;Shang, Fei;Zou, Wei;Xie, Ming-Jie 1431

https://doi.org/10.7314/APJCP.2012.13.4.1431 PDF KSCI

The growth of many breast tumors is stimulated by IGF-1, which activates signal transduction pathways inducing cell proliferation. $ER{\alpha}$ is important in this process. The aim of the study was to investigate relationships in vitro among inhibitory effects of luteolin on the growth of MCF-7 cells, IGF-1 pathway and $ER{\alpha}$. Our results showed that luteolin could effectively block IGF-l-stimulated MCF-7 cell proliferation in a dose- and time-dependent manner and block cell cycle progression and induce apoptosis evidenced by the flow cytometric detection of sub-G1DNA content. Luteolin markedly decreased IGF-l-dependent IGF-IR and Akt phosphorylation without affecting Erk1/2 phosphorylation. Further experiments pointed out that $ER{\alpha}$ was directly involved in IGF-l induced cell growth inhibitory effects of luteolin, which significantly decreased $ER{\alpha}$ expression. Knockdown of $ER{\alpha}$ in MCF-7 cells by an $ER{\alpha}$-specific siRNA decreased the IGF-l induced cell growth inhibitory effects of luteolin. $ER{\alpha}$ is thus a possible target of luteolin. These findings indicate that the inhibitory effect of luteolin on the growth of MCF-7 cells is via inhibiting IGF-l mediated PI3K-Akt pathway dependent of $ER{\alpha}$ expression.

Kye, Su-Yeon;Yun, E-Hwa;Park, Kee-Ho 1439

https://doi.org/10.7314/APJCP.2012.13.4.1439 PDF KSCI

Objective: This paper aimed to determine the relationship between cancer information scanning and seeking experience of adolescents and cancer preventive behavior, perceived cancer risk, and levels of cancer-related knowledge. Methods: The study sample comprised 1,000 second-year students from 6 high schools: the general and vocational school systems were each represented by 1 boys', 1 girls', and 1 coeducational high school. In July 2011, trained researchers visited each classroom, explained the purpose of the study, distributed questionnaires to the students who agreed to participate, instructed them to complete the survey by self-reporting, and collected the completed questionnaires. Results: The students who attended general high schools (as compared with vocational high schools), earned higher grades, consumed more vegetables, had a higher perceived cancer risk, and answered the cancer-related questions more correctly had more cancer information scanning and seeking experience. Conclusion: These results reinforce the importance of cancer prevention health education. Furthermore, the results may help in preparing a strategy that enables people to acquire accurate cancer-related information easily and quickly.

Parajuly, Shyam Sundar;Lan, Peng Yu;Yun, Ma Bu;Gang, Yang Zhi;Hua, Zhuang 1447

https://doi.org/10.7314/APJCP.2012.13.4.1447 PDF KSCI

Aim: To evaluate the differential diagnostic potential of lesion stiffness assessed by the sonoelastographic strain index ratio (SR) and elastographic color scoring system (UE) for breast lesions. Materials and Methods: Three hundred and forty two breast masses (158 benign and 184 malignant) from 325 consecutive patients (mean age 44.2 years; range 16-81)who had been scheduled for a sonographically guided core biopsy were examined proposed by Itoh et al, with scoring 1-3=benign and 4-5=malignant. Strain and area ratios of each lesion were calculated within the same machine. Histological diagnosis was used as the reference standard. The area under the curve (AUC) and cut-off point were obtained by receiver operating curve and the cross table Fischer Test was carried out for assessing diagnostic value. Sensitivity, specificity, PPV, NPV, accuracy and false-discovery rates were compared. Results: The mean strain ratios for benign and malignant lesions were 1.87 and 7.9 respectively. (P<0.0001). When a cutoff point of 3.54 was used, SR had a sensitivity of 94.6%, a specificity 94.3%, a PPV of 95.1%, an NPV of 93.7% and an accuracy of 94.4%. The AUC values were 0.90 for the 5 point scoring system (UE) and 0.96 for the strain index ratio. The overall diagnostic performance was SR method was better (P<0.05). Conclusions: Strain ratio measurement could be another effective predictor in elastography imaging besides 5 the point scoring system for differential diagnosis of breast lesions.

Anderson-Jackson, Lennox;McGrowder, Donovan A.;Alexander-Lindo, Ruby 1453

https://doi.org/10.7314/APJCP.2012.13.4.1453 PDF KSCI

Background: Prostate cancer is the most common malignant tumour in men and the second most common cause of male cancer death. The study examines the clinicopathological features of patients with prostate cancer consecutively diagnosed at a private Diagnostic Radiology Centre in Western Jamaica over a 6-year period. Method: The medical records, including the pathology reports of 423 consecutive patients who had transrectal ultrasonography (TRUS) - guided prostate biopsy between January 2006 and December 2011 were reviewed. Results: The mean age at diagnosis of the 191 men with prostate adenocarcinoma was $68.5{\pm}0.59$ years with the majority in the 70 - 79 year age group (43.5%). Moderately differentiated carcinomas (Gleason score of 6) comprised the largest group with 72 cases (37.9%); poorly differentiated cancers with Gleason scores of 8 - 10 comprised 49 cases (25.8%). The PSA levels increased with Gleason score. The mean PSA levels for men with Gleason score of 6 was $50.1{\pm}30.0$ ng/mL compared with $136.5 {\pm}59.9$ ng/mL in patients with Gleason score of 8 and $140.5{\pm}31.8$ ng/mL in patients with Gleason score of 9. Perineural invasion was present in 7.85% of the cases overall; high-grade prostatic intraepithelial neoplasia (HGPIN) was present in 4.71% of the biopsies. Conclusion: Although the majority of patients had moderate, and moderate to poor differentiated carcinomas, the number with poorly differentiated carcinoma was high. This is a reflection of the patients' late clinical presentation at the time of diagnosis.

Zhou, Xiao-Hui;Tang, Li-Na;Yue, Lu;Min, Da-Liu;Yang, Yi;Huang, Jian-An;Shen, Zan 1457

https://doi.org/10.7314/APJCP.2012.13.4.1457 PDF KSCI

Purpose: Non small cell lung cancer (NSCLC) is the leading worldwide source of cancer-related deaths. Although some drugs targeting EGFR mutations have been developed, most advanced cases are still incurable. New targets for anticancer drugs are demanded. The kringle 1 domain of hepatocellular growth factor alpha chain (HGFK1) is a potent anti-angiogenesis factor. It has also emerged as a potential anticancer factor in hepatocellular carcinoma (HCC). The expression of HGFK1 protein in patients with NSCLC has not been reported to date. Method: Here, we assessed HGFK1 expression by Western blotting in 103 cases with advanced NSCLC to investigate the impact of HGFK1 on survival. Results: Results revealed 33 (30.1%) patients were classified as high expressors, this being significantly associated with less remote metastasis (P = 0.002) but not with lymph node metastasis (P = 0.062). There was also a significant association between HGFK1 expression and tumor size (P = 0.025) as well as clinical stage (P = 0.012). Kaplan-Meier survival analysis showed that both overall survival (OS) and progression free survival (PFS) of patients with HGFK1 expression were longer than those of patients without HGFK1 expression (P = 0.004 and P = 0.001 respectively). HGFK1 reversed gefitinib inhibition in the resistent NSCLC cell line A431/GR but did not inhibit the proliferation of NSCLC cells A431 and A431/GR directly. Reversion of gefitinib inhibition in A431/GR cells by HGFK1 was related to decreased phosphorylation of ERK and STAT5. Conclusions: HGFK1 may be a useful prognostic factor of advanced NSCLC patients and a potential drug for gefitinib resistant patients.

Reis, Nesrin;Bebis, Hatice;Kose, Sevinc;Sis, Asli;Engin, Raziye;Yavan, Tulay 1463

https://doi.org/10.7314/APJCP.2012.13.4.1463 PDF KSCI

Objective: The aims of this study were to explore Turkish women's knowledge, behavior and beliefs related to cervical cancer and screening. Methods: The study was performed in two cities in the East of Turkey between September 2009 and April 2010, with a sampling group of 387 women. Data were collected by means of an interview form with the Health Belief Model Scale for Cervical Cancer and Pap Smear Test - Turkish Version. Results: Women in the research group were found to have poor knowledge, inadequate health behavior and low/medium level false beliefs regarding cervical cancer screening. There was relation between health beliefs and characteristics of women and particularly education (F = 10.80, p = 0.01). Similarly, it was found that Pap smear barriers were influenced by demographic characteristics and that women with low-level education (p = 0.001), divorced women (p = 0.05), women with low-income(p = 0.05), women who gave their first birth when they were 18 or younger (p = 0.05) and women not applying any contraceptive method at all (p = 0.01) were determined to have negative Pap smear barriers. Conclusions: Primarily the knowledge, attitudes and beliefs of women in the target group should be evaluated to increase their participation in cervical cancer screening and to prepare effective education strategies.

Li, Xin-Qiu;Ke, Xian-Zhu;Wang, Yu-Ming 1471

https://doi.org/10.7314/APJCP.2012.13.4.1471 PDF KSCI

Background and Aim: Currently available systemic therapies for malignant melanoma produce low response rates in patients, and more effective treatment modalities are clearly needed. The tumor necrosis factor (TNF)-related apoptosis-inducing ligand has a significant impact on therapy for patients with X-linked inhibitor of apoptosis protein-downregulation malignant melanoma. The primary objective of this study was to assess its therapeutic potential. Materials and Methods: We employed a conditionally replicating oncolytic adenoviral vector, named CRAd5.TRAIL/siXIAP, with the characteristics of over-expression of the therapeutic gene TRAIL and downregulation of XIAP in one vector. B16F10-luc cells were employed to detect anti-tumor activity of CRAd5.TRAIL/siXIAP in vitro and in vivo. Results: CRAd5.TRAIL/siXIAP enhanced caspase-8 activation and caspase-3 maturation in B16F10 cells in vitro. Furthermore, it more effectively infected and killed melanoma cells in vitro and in vivo than other adenoviruses. Conclusion: Taken together, the combination of upregulation of TRAIL and downregulation of siXIAP with one oncolytic adenoviral vector holds promise for development of an effective therapy for melanomas and other common cancers.

Fan, Wei-Dong;Zhang, Xian-Quan;Guo, Hui-Lin;Zeng, Wei-Wei;Zhang, Ni;Wan, Qian-Qian;Xie, Wen-Yao;Cao, Jin;Xu, Chang-Hua 1477

https://doi.org/10.7314/APJCP.2012.13.4.1477 PDF KSCI

Squamous cell carcinoma and adenocarcinoma are the major histological types of non-small cell lung cancer. Because they differ on the basis of histopathological and clinical characteristics and their relationship with smoking, their etiologies may be different; for example, different tumor suppressor genes may be related to the genesis of each type. We used microarray data to construct three regulatory networks to identify potential genes related to lung adenocarcinoma and squamous cell carcinoma and investigated the similarity and specificity of them. In the network, some of the observed transcription factors and target genes had been previously proven to be related to lung adenocarcinoma and squamous cell carcinoma. We also found some new transcription factors and target genes related to SCC. The results demonstrated that regulatory network analysis is useful in connection analysis between lung adenocarcinoma and squamous cell carcinoma.

Liu, Ai-Jun;Zong, Hong;Yang, Guang-Zhong;Zhai, Yu-Hua;Li, Li-Hong 1483

https://doi.org/10.7314/APJCP.2012.13.4.1483 PDF KSCI

Objective: To determine the characteristics of oligoclonal bands that are frequently detected by serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE) after stem cell transplantation. Methods: We retrospectively analyzed 56 patients with multiple myeloma (MM) undergoing transplantation, and standard immunofixation electrophoresis was used to identify and quantify paraproteins. Results: The median follow-up was 35 months (range, 10-76months) and 21 patients relapsed. Twelve (25.0%) demonstrated oligoclonal bands after a median time 1.4 months (range, 1-3months), with a median duration of 5.8 months (range, 1-15months). The majority patients with oligoclonal bands had normal quantities of immunoglobulins and the one year event free survival (EFS) was 92%, even higher than for patients without OBs (P=0.002). Conclusion: Oligoclonal bands frequent develop post-transplantation in MM cases. In the vast majority of patients, they may not represent relapsed disease, and more likely represent a transient phenomenon representing recovery of impaired immunoglobulin production.

Zhao, Yi-Bing;Wang, Jin-Hua;Chen, Xiao-Xiang;Wu, Yu-Zhong;Wu, Qiang 1487

https://doi.org/10.7314/APJCP.2012.13.4.1487 PDF KSCI

Objective: To compare the clinical efficacy of concurrent chemoradiotherapy, neoadjuvant chemotherapy, and intracavity brachytherapy in comprehensive treatment for young patients with stage Ib2 cervical cancer. Methods: One hundred and twelve young patients with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January 2003 to June 2005. They were categorized into three groups according to preoperative regimens, including the concurrent chemoradiotherapy group (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.

Inal, Ali;Kaplan, M. Ali;Kucukoner, Mehmet;Urakci, Zuhat;Karakus, Abdullah;Nas, Necip;Guven, Mehmet;Isikdogan, Abdurrahman 1491

https://doi.org/10.7314/APJCP.2012.13.4.1491 PDF KSCI

Background: Previous studies have pointed to many different prognostic factors for small cell lung cancer (SCLC) but diabetes mellitus (DM) has not been clearly or consistently identified as of prognostic value. The aim of this study was to investigate the prognostic significance of the characteristics of patients and clinical laboratory tests in SCLC. Specifically, we investigated that the impact of DM for survival in the patients receiving first-line etoposide plus cisplatin (EP) chemotherapy. Methods: We retrospectively reviewed 161 patients with SCLC with a focus on DM and other potential prognostic variables were chosen for univariate and multivariate analyses with respect to survival. Result: Among the sixteen variables of univariate analysis, five were identified to have prognostic significance: performance status (PS) (p<0.001), stage (p=0.001), DM (p=0.005), serum albumin (p<0.001) and hemoglobin levels (p=0.03). Multivariate analysis showed PS, stage and serum albumin level to be independent prognostic factors for survival (p=0.02, p=0.02 and p=0.009 respectively), but DM was not an independnet factor. Conclusion: In conclusion, PS, stage and serum albumin level were identified as important prognostic factors, while DM at the time of diagnosis of SCLC did not have prognostic importance for survival.

Kye, Su-Yeon;Yun, E-Hwa;Park, Kee-Ho 1495

https://doi.org/10.7314/APJCP.2012.13.4.1495 PDF KSCI

Objective: Improvements in diet can decrease the cancer rates. The aim of the present study was to determine the relationships between self-perception of diet quality and personality, impulsiveness, stress, coping strategy, sense of coherence, self-efficacy, and social support. Methods: This cross-sectional study was conducted using a multiple-stratified random sampling method based on the Korea Census of 2007. In October 2009, investigators conducted 15-minute face-to-face interviews with 1,530 South Korean volunteers who ranged from 30 to 69 years of age without a history of cancer. Results: Respondents were more likely to perceive that they consumed a healthy diet if they were older than 50 years, lived with a partner, had a monthly family income greater than $4,000 USD, had a low perceived risk of cancer, consumed less alcohol, exercised regularly, had a less agreeable or conscientious personality, had low stress levels, had a high sense of coherence or self-efficacy, and had ample social support. Conclusion: Psychosocial factors, such as personality, stress, sense of coherence, self-efficacy, and social support, are associated with the self-perception of diet quality. Analysis of the factors that contribute to a perceived healthy diet could assist with the design of educational campaigns.

He, Lin;Bi, Juan-Juan;Guo, Qian;Yu, Yin;Ye, Xiu-Feng 1505

https://doi.org/10.7314/APJCP.2012.13.4.1505 PDF KSCI

To aim of this was to observe emodin-mediated cytotoxicity and its influence on Rad51 and ERCC1 expressionin non-small cell lung cancer (NSCLC). NSCLC cells were cultured in vitro with emodin at various concentrations (0, 25, 50, 75 and $100\;{\mu}mol/L$) for 48h and the proliferation inhibition rate was determined by the MTT method. Then, NSCLC were treated with emodin (SK-MES-1 $40\;{\mu}mol/L$, A549 $70\;{\mu}mol/L$) or $20\;{\mu}mol/L$ U0126 (an ERK inhibitor) for 48 h, or with various concentrations of emodin for 48 h and the protein and mRNA expressions of ERCC1 and Rad51 were determined by RT-PCR and Western blot assay, respectively. Emodin exerted a suppressive effect on the proliferation of NSCLC in a concentration dependent manner. Protein and mRNA expression of ERCC1 and Rad51 was also significantly decreased with the dose. Vacuolar degeneration was observed in A549 and SK-MES-1 cell lines after emodin treatment by transmission electron microscopy. Emodin may thus inhibited cell proliferation in NSCLC cells by downregulation ERCC1 and Rad51.

Ni, Shao-Zhong;Cao, Hong-Yong;Chen, Zheng;Zhu, Yi;Xu, Ze-Kuan 1511

https://doi.org/10.7314/APJCP.2012.13.4.1511 PDF KSCI

Objective: The present study aimed to investigate the influence of siRNA interference with a proliferation-inducing ligand (APRIL) gene on gastric carcinoma sgr-7901 cell apoptosis. Correlations between APRIL silencing and tyrosine kinase (trka) expression were also explored. Methods: Two APRIL-silencing siRNA vectors were constructed, and transfected into human gastric carcinoma sgr-7901 cells, expression before and after transfection being detected using RT-PCR and western blot analyses. The expression of 15 trka genes was detected using RT-PCR and apoptotic rates of sgr-7901 were assessed by flow cytometry. Results: The expression levels of receptor trka genes were significantly decreased, and the apoptotic rate of sgr-7901 was significantly increased after transfection (P < 0.05). Conclusion: APRIL gene silencing can increase the apoptotic rate of gastric carcinoma cells, and inhibit the expression of receptor trka genes. There is a correlation between the signaling pathways of APRIL and trka.

Wang, Zhao-Yang;Zhou, Jing;Luo, Li;Huang, Ying-Long;Dong, Pei-De 1515

https://doi.org/10.7314/APJCP.2012.13.4.1515 PDF KSCI

Aim: We conducted a prospective study in an Chinese population to detect the association between GSTM, GSTT and GSTP gene polymorphisms and survival of gastric cancer. Methods: A prospective follow-up study with 317 gastric cancer patients was conducted between January 2003 and January 2005. GSTM1, GSTT1 and GSTP1 genotyping was performed using ABI TaqMan Gene Expression assays. Results: Of 317 patients, 5 were lost to follow-up due to migration, while the remaining 302 patients completed the study. The median follow-up time was 34.2 months (range: 2 to 60 months), during which a total of 120 (39.1%) died of gastric cancer. The GSTT1-null genotype showed a significant increased risk of death from gastric cancer, with an HR (95% CI) of 1.59 (1.04-3.58). Moreover, we found individuals carrying null-GSTM1 and null-GSTT1 had a moderate higher risk of death from gastric cancer, with an HR of 1.92 (1.05-3.65). Conclusion: This study reported the carriage of null GSTT1 and null GSTM1 might be linked to the higher death risk from gastric cancer in Chinese population.

Chen, Qiang;Luo, Zhao-Yun;Lin, Min;Lin, Qi-Li;Chen, Chan-Yu;Yang, Chun;Xie, Long-Xu;Li, Hui;Zheng, Jia-Kun;Yang, Li-Ye;Ju, Gui-Zhi 1519

https://doi.org/10.7314/APJCP.2012.13.4.1519 PDF KSCI

Background: Human papillomavirus (HPV) infection is the main cause of cervical cancer. Limited epidemiologic data of HPV prevalence are available for women attending hospitals in southern China. This study aimed to evaluate the profiles of HPV infection and cytology status in gynecological outpatients in Chaozhou City. Methods: A total of 2833 eligible women were enrolled. The HPV GenoArray test was used for HPV detection and genotyping. Nearly one half of the HPV positive women received liquid-based cytology test. Logistic regression analysis was performed to assess the predictable effects of age and genotype for categories of abnormal cytology. Results: The prevalence of overall, high-risk, and low-risk HPV infection were 24.5%, 19.5% and 8.4%, respectively. A U-shaped age-specific prevalence curve was observed in overall HPV and high-risk HPV, but not in low-risk HPV, which declined with age increasing. The 6 most common high-risk HPV type in descending order, were types 52, 16, 58, 18, 68, and 33. Age and HPV genotype were both important determinants of abnormal cytology incidence, the older women (>45 years) and those infected with HPV type 16 and/or 18 having the highest risk for abnormal cytology. Conclusion: Our findings support the hypothesis that second-generation HPV prophylactic vaccines including HPV-52 and -58 may offer higher protection for women residing in Chaozhou and neighboring cities in Guangdong.

Oh, In-Hwan;Yoon, Seok-Jun;Yoon, Tai-Young;Choi, Joong-Myung;Choe, Bong-Keun;Kim, Eun-Jung;Kim, Young-Ae;Seo, Hye-Young;Park, Yoon-Hyung 1525

https://doi.org/10.7314/APJCP.2012.13.4.1525 PDF KSCI

Cigarette smoking is one of the most important public health concerns in Korea and worldwide. A number of studies have been conducted to measure the health and economic burden of smoking, but these did not reflect recent changes such as the decrease in smoking rate and the increase in the incidence of cancer. The purpose of this study was to provide up-to-date estimates of the health and economic burden of cancer caused by smoking and to compare the results with those of previous studies. Cancer-related burden was assessed with nationally representative data such as claims data from the National Health Insurance Corporation, and cause of death records from the National Statistical Office and the Korea Health Panel. We determined the smoking-attributable burden by multiplying the smoking-attributable fraction by the total burden. As a result, the burden of major cancers due to smoking was found to be substantial despite a recent sharp decrease in smoking by the Korean population. The total economic cost reaches $2,234.0 million in males and $870.0 million in females. Also, the health burden of cancers due to smoking is 2,038.9 disability adjusted life years (DALYs) per 100,000 individuals in men and 732.2 DALYs per 100,000 individuals in women. Among all cancers, cancers of the trachea, lungs and bronchus are the leading causes of health and economic burden. The huge burden caused by cancers linked to smoking makes it imperative that adequate policies to decrease the prevalence of smoking be developed, particularly considering the recent increase in smoking rate among women.

Zare, Najaf;Doostfatemeh, Marzieh;Rezaianzadeh, Abass 1533

https://doi.org/10.7314/APJCP.2012.13.4.1533 PDF KSCI

In general, breast cancer is the most common malignancy among women in developed as well as some developing countries, often being the second leading cause of cancer mortality after lung cancer. Using a parametric log-logistic model to consider the effects of prognostic factors, the present study focused on the 5-year survival of women with the diagnosis of breast cancer in Southern Iran. A total of 1,148 women who were diagnosed with primary invasive breast cancer from January 2001 to January 2005 were included and divided into three prognosis groups: poor, medium, and good. The survival times as well as the hazard rates of the three different groups were compared. The log-logistic model was employed as the best parametric model which could explain survival times. The hazard rates of the poor and the medium prognosis groups were respectively 13 and 3 times greater than in the good prognosis group. Also, the difference between the overall survival rates of the poor and the medium prognosis groups was highly significant in comparison to the good prognosis group. Use of the parametric log-logistic model - also a proportional odds model - allowed assessment of the natural process of the disease based on hazard and identification of trends.

Salehimarzijarani, Babak;Dadvar, Zohreh;Mousavi, Mirhadi;Mirsattari, Dariush;Zali, Mohammad Reza;Alizadeh, Amir Houshang Mohammad 1539

https://doi.org/10.7314/APJCP.2012.13.4.1539 PDF KSCI

Cholangitis is relatively uncommon but associated mortality is high due to the predisposition in people with underlying disease. For this recognition of contributing risk factors is necessary. Therefore, the present descriptive-analytical cross-sectional survey was designed to determine contributing risk factors for post-ERCP cholangitis in patients with pancreatic cancer. From 2005 to 2010, 110 consecutive cases of pancreatic cancer attending to a tertiary referral centre (Taleghani Hospital), Tehran, Iran were recruited. The patients all underwent stenting via endoscopic retrograde cholangiopancreatography (ERCP). On univariate analysis, a metallic stent type (95% confidence interval (CI) 1.025-11.34, P=0.037), having no jaundice (1.44-2.22, P=0.009), having no pain (1.32-1.91, P=0.026), a history of prior ERCP (1.16-10.37, P=0.020), and having a proximal biliary stone (1.002-5.93, P=0.046) were related to cholangitis. However on multivariate analysis, none of these factors were found to be contributing risk factors. Cholangitis is avoidable with adequate biliary drainage. Because success rates are higher and complication rates lower for endoscopists performing large volumes of ERCP, performance of the procedure should be concentrated as much as possible in institutions with endoscopists having adequate experience. Patients with a high risk for complications may be best served by referral to an advanced center.

Fouladi, Nasrin;Pourfarzi, Farhad;Amani, Firooz;Ali-Mohammadi, Hossein;Lotfi, Ilshan;Mazaheri, Effat 1543

https://doi.org/10.7314/APJCP.2012.13.4.1543 PDF KSCI

Breast cancer accounts for about 26% of all newly diagnosed cancers in women aged 20 to 59 years. As part of a basic program for cancer control, the present cross sectional descriptive study was conducted with the objective of determining the epidemiology of breast cancer in Ardabil province during 2003-2010. Necessary information on 469 recorded cases of breast cancer in the registry were collected by check list from patient's files and then analyzed by statistical methods with SPSS.16 software. Some 455 of the patients (97%) were female, 329 (70.1%) residing in Ardabil. The mean age was $46.8{\pm}13.6$ and most were in the age group of 40 - 60. The most prevalent pathologic form was infiltrative ductal carcinoma with 316 cases (67.4%), the largest proportion being grade II (30.6%), but very many belonged to grades III and IV (40.5%). Breast cancer in Ardabil province appeared to slightly increase over the period studied. The results were similar to other places in Asia. With regard to this, more widespread studies are required to determine factors influencing the prevalence at low age and also how to promote early detection.

Tachfouti, N.;Belkacemi, Y.;Raherison, C.;Bekkali, R.;Benider, A.;Nejjari, C. 1547

https://doi.org/10.7314/APJCP.2012.13.4.1547 PDF KSCI

Background: Lung cancer is the leading cause of cancer morbidity and mortality. Its management has a significant economic impact on society. Despite a high incidence of cancer, so far, there is no national register for this disease in Morocco. The main goal of this report was to estimate the medical costs of lung cancer in our country. Methods: We first estimated the number of annual new cases according to stage of the disease on the basis of the Grand-Casablanca-Region Cancer Registry data. For each sub-group, the protocol of treatment was described taking into account the international guidelines, and an evaluation of individual costs during the first year following diagnosis was made. Extrapolation of the results to the whole country was used to calculate the total annual cost of treatments for lung cancer in Morocco. Results: Overall approximately 3,500 new cases of lung cancer occur each year in the country. Stages I and II account for only 4% of cases, while 96% are diagnosed at locally advanced or metastatic stages III and IV. The total medical cost of lung cancer in Morocco is estimated to be around USD 12 million. This cost represents approximately 1% of the global budget of the Health Department. According to AROME Guidelines, about 86% of the newly diagnosed lung cancer cases needed palliative treatment while 14% required curative intent therapy. The total cost of early and advanced stages lung cancer management during the first year were estimated to be 4,600 and 3,420 USD, respectively. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco. A substantial proportion of the burden of lung cancer could be prevented through the application of existing cancer control knowledge and by implementing tobacco control programs.

Dogan, Mutlu;Karabulut, Halil G.;Tukun, Ajlan;Demirkazik, Ahmet;Utkan, Gungor;Yalcin, Bulent;Dincol, Dilek;Akbulut, Hakan;Icli, Fikri 1553

https://doi.org/10.7314/APJCP.2012.13.4.1553 PDF KSCI

Introduction: Antimetabolites may cause severe toxicity and even toxic death in cancer patients. Our aim was to evaluate the relationship between antimetabolite toxicity and pharmacogenetics in patients with severe clinical toxicity or alanine transaminase (ALT) elevation after fluorouracil (5FU), capecitabine or methotrexate administration. Patients and Methods: Cancer patients with severe antimetabolite toxicity were evaluated for methylenetetrahydrofolate reductase (MTHFR) gene C667T, thymidilate synthase (TS) gene 5´UTR variable number of tandem repeats (VNTR), dihydroprymidine dehydrogenase (DPYD) gene IVS14+1G/A, Xeroderma pigmentosum (XPD) gene Lys751Gln and X-ray repair cross-complementing group 1 (XRCC1) gene Arg399Gln polymorphisms. Results: Eighteen patients were enrolled, with a male/female ratio of 0.8. They had osteosarcoma in methotrexate group (n=7), gastrointestinal malignancies in 5FU group (n=9) and breast cancer in the capecitabine group (n=2). Mucositis and dermatitis occurred in all groups, together with ALT elevation in the methotrexate group and 2 toxic deaths were encountered. DPYD, TS, MTHFR, XPD and XRCC1 gene polymorphism rare allele frequencies were observed to be higher than in the general population. Conclusion: Pharmacogenetics might contribute to tailored therapy.

Zheng, Shi-Ying;Hou, Jing-Yu;Zhao, Jun;Jiang, Dong;Ge, Jin-Feng;Chen, Sheng 1557

https://doi.org/10.7314/APJCP.2012.13.4.1557 PDF KSCI

Objective: To investigate the promoter methylation status of the E-cadherin gene in non-small cell lung cancer (NSCLC) and its association with clinical pathological parameters, and to explore the relationship between downregulation of E-cadherin gene expression and the methylation status of its promoter region. Methods: Nested methylation-specific PCR was performed to examine CpG methylation within the 5' CpG island of the E-cadherin gene in lung cancer and para-cancerous tissue from 37 patients with primary non-small cell lung cancer. Quantitative real-time PCR was performed to measure the level of E-cadherin mRNA. Results: Of thirty-seven cases, 12 (32.4%) samples showed aberrant CpG methylation in tumor tissues compared with the corresponding normal tissues. In addition, a reduction in E-cadherin mRNA levels was observed in 11 of the 12 (91.7%) tumor tissues carrying a methylated E-cadherin gene. However, only 10 (43.5%) cases displayed reduced mRNA levels in tumor tissues from the remaining 23 cases (excluding 2 samples from which mRNA was unavailable) without methylation events. Downregulation of E-cadherin gene expression significantly correlated with the promoter methylation status of this gene. Conclusion: These results provide strong evidence that the methylation status of E-cadherin gene contributes to a reduction in the expression of E-cadherin mRNA, and may play a role in the development and progression of NSCLC.

Cai, Er-Hui;Gao, Yong-Xin;Wei, Zhong-Zhi;Chen, Wei-Ying;Yu, Ping;Li, Ke 1563

https://doi.org/10.7314/APJCP.2012.13.4.1563 PDF KSCI

To investigate the relationship between serum miRNA-21 (miR-21) expression in esophageal squamous cell carcinomas (ESCCs) and its clinicopathologic features, a 1:1 matched case-control study including 21 patients with ESCC and 21 age- and gender-matched healthy controls was carried out. Serum specimens were taken from all subjects. Total RNA was extracted and the stem-loop real time polymerase chain reaction was used to measure serum miR-21 in both groups. Clinical parameters were assessed to determine associations with serum miR-21 concentrations. Serum miR-21 expression in ESCC samples was significantly higher than in paired cancer-free samples (P<0.05). Metastasis was associated with mir-21 expression in serum (P<0.05), ESCC patients with metastasis having 8.4-fold higher serum miR-21 concentrations than healthy controls. There were no statistically significant associations between miR-21 expression and clinicopathologic parameters, such as gender (P>0.05), age (P>0.05), tumor location (P>0.05), cell differentiation (P>0.05), TNM staging (P>0.05), whether chemo/radiotherapy had been administered (P>0.05), or whether surgery had been performed (P>0.05). These findings suggest that the detection of microRNA-21 in serum might serve as a new tumor biomarker in diagnosis and assessment of prognosis of ESCCs.

Pandurangan, Ashok Kumar;Dharmalingam, Prakash;Sadagopan, Suresh Kumar Ananda;Ganapasam, Sudhandiran 1569

https://doi.org/10.7314/APJCP.2012.13.4.1569 PDF KSCI

Luteolin (LUT), a bioflavonoid has been used as a chemopreventive agent world-wide against chemically induced cancer. Hence we designed an experiment to assess chemopreventive action of LUT on lipid peroxidation (LPO) and glycoconjugates in azoxymethane (AOM)-induced colon carcinogenesis. Colon cancer was induced by 15 mg/body kg. body weight of AOM and administration of LUT (at the dose of 1.2 mg/kg. body weight) was till end of the study. Analysis of lipid peroxidative end products such as protein carbonyl (PC), malonadehyde (MDA) and conjucated dienes (CD) demonstrated significant increase in in AOM-induced animals with reduction by LUT (p<0.05). Increased levels of glycoconjugates such as hexose, hexosamine, sialic acid, fucose and mucoprotein were analyzed in serum and colon tissues examined histopathologically by periodic acid Schiff's (PAS) staining were also reversed by LUT l(p<0.05). The secondary marker of colon cancer mucin depleted foci (MDF) was assessed in control and experimental group of animals. A characteristic increase of MDF was observed in AOM-induced colon cancer animals. Treatment with LUT decreased the incidence of MDF. These results suggest that LUT alters the expression of glycoconjugates and suppress colon cancer. Hence, we speculate that LUT can be used as a chemopreventive agent to treat colon cancer.

Zhang, Jian-Hua;Wang, Ming-Sheng;Pan, Hai-Hong;Li, Shu-Feng;Wang, Zhong-Qiu;Chen, Wang-Sheng 1575

https://doi.org/10.7314/APJCP.2012.13.4.1575 PDF KSCI

Objectives: To obtain permeability surface (PS) values using multi-slice helical CT perfusion imaging and to evaluate the spatial distribution correlation between PS values and vascular endothelial growth factor (VEGF) expression in solitary brain metastases. Methods: Imaging was performed on 21 patients, PS values being calculated from the central, border and peripheral parts of tumours. VEGF expression was determined by immunohistochemical staining. Results: Rim enhancement was found in 16 cases, the border of the tumour featuring PS elevation with high VEGF expression in 13 cases. In the 5 cases with nodular enhancement, the border and the central part had high permeability and VEGF expression was high in all cases, the correlation being significant (P<0.01). Conclusion: VEGF expression in brain metastases positively correlates with PS values from CT perfusion imaging, so that the latter can be used in the surveillance of angiogenic activity in brain metastases.

Jiang, Hong;Wang, Xiao-Hong;Yu, Xin-Min;Zheng, Zhi-Guo 1579

https://doi.org/10.7314/APJCP.2012.13.4.1579 PDF KSCI

Objective: To assess differences in serum proteins in esophageal squamous cell carcinoma patients. Methods: 144 esophageal squamous cell carcinoma patients and 50 healthy volunteers were included in this study, with surface-enhanced laser desorption-ionization time-of-flight mass spectrometry and weak cation exchange magnetic beads. Follow-up allowed the relations between serum proteins and prognosis to be analyzed. Results: A total of 93 protein peaks were detected (molecular weight range: 1500-30000), 10 demonstrating statistically significant differences. There were no differences in protein peaks between 92 patients with a survival more than 2 years and 52 patients with survival less than 2 years. There were two significantly different protein peaks between 45 stage II patients with a survival more than 2 years and 14 stage II patients with survival less than 2 years. There was one significantly different protein peak between 22 stage III patients with a survival more than 2 years and 29 stage III patients with survival less than 2 years. Conclusion: Differences of serum proteins in esophageal squamous cell carcinoma are related to prognosis of patients. The protein fingerprint can be helpful for clinical diagnosis and treatment.

Sudarat, Nguansangiam;Somnuek, Jesdapatarakul;Nisarat, Dhanarak;Krittika, Sosrisakorn 1583

https://doi.org/10.7314/APJCP.2012.13.4.1583 PDF KSCI

Fine needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimal invasive and cost-effective method for diagnosis of salivary gland lesions. This study evaluated the accuracy and diagnostic performance of FNA cytology in Thailand. A consecutive series of 290 samples from 246 patients during January 2001-December 2009 were evaluated from the archive of the Anatomical Pathology Department of our institution and 133 specimens were verified by histopathologic diagnoses, obtained with material from surgical excision or biopsy. Cytologic diagnoses classified as unsatisfactory, benign, suspicious for malignancy and malignant were compared with the histopathological findings. Among the 133 satisfactory specimens, the anatomic sites were 70 (52.6%) parotid glands and 63 (47.4 %) submandibular glands. FNA cytological diagnoses showed benign lesions in 119 cases (89.5 %), suspicious for malignancy in 3 cases (2.2 %) and malignant in 11 cases (8.3%). From the subsequent histopathologic diagnoses, 3/133 cases of benign cytology turned out to be malignant lesions, the false negative rate being 2.2 % and 1/133 case of malignant cytology turned out to be a benign lesion, giving a false positive rate was 0.8%. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 97.0% (95% CI, 70.6%-99.4%), 81.3% (95% CI, 54.4%-96.0%), 99.1% (95% CI, 95.4%-100%), 92.9% (95% CI, 66.1%-99.8), 97.5% (95% CI, 92.8%-99.5%), respectively. This study indicated that FNA cytology of salivary gland is a reliable and highly accurate diagnostic method for diagnosis of salivary gland lesions. It not only provides preoperative diagnosis for therapeutic management but also can prevent unnecessary surgery.

Li, Hong;Hu, Yaohong;Li, Na;Zhou, Yan 1589

https://doi.org/10.7314/APJCP.2012.13.4.1589 PDF KSCI

Objective: To investigate liver fibrosis, TGF-${\beta}1$ levels and curative effects on hepatocellular carcinoma (HCC) with small and conventional dose perfusion chemotherapy by transcatheter arterial chemo embolization (TACE). Methods: Thirty-six hepatocellular carcinoma patients not indicated for surgical resection underwent super-selective transcatheter arterial chemoembolization, divided into small dose (n=15) and conventional dose (n=21) chemotherapy groups. Results: With conventional doses, four indices of liver fibrosis focusing on hyaluronate acide (HA), human procollagen type-III (hPC-III), collagen type-Ⅳ (Ⅳ-C) and transforming growth factor-${\beta}l$ (TGF-${\beta}1$) were obviously increased postoperative compared with preoperative (P<0.01); in contrast, with small doses there were no significant differences except for TGF-${\beta}1$. Five year survival demonstrated no significant differences between the two groups (P>0.05). Conclusion: To hepatocellular carcinoma patients treated by TACE, reducing doses of chemotherapy drugs can reduce progress of liver fibrosis, without impacting on five year survival.

Ji, Wen-Bin;Wang, Wei-Zheng;Sun, Song;Mi, Yu-Cheng;Xu, Qiong;Chen, Yi-Er;Yang, Song;Tao, Dan;Xu, Wei;Xu, Chao 1595

https://doi.org/10.7314/APJCP.2012.13.4.1595 PDF KSCI

The aim of this study was to explore the angiographic diagnosis and embolization therapy for renal artery pseudoaneurysms due to acute urinary tract hemorrhage after conservative medical management failed. Seven out of ten cases had fever symptoms after the kidney surgery. The pseudoaneurysms were treated with gelatin sponge and (or) spring coil and the majority demonstrated rapid blockage of hemorrhage. Angiography diagnosis and trans catheter embolization are rapid, safe and effective methods for diagnosis and treatment of renal artery pseudoaneurysms.

Akram, Muhammad;Malik, Fa;Kayani, Mahmood Akhtar 1599

https://doi.org/10.7314/APJCP.2012.13.4.1599 PDF KSCI

Objectives: Since methylenetetrahydrofolate reductase (MTHFR) maintains the balance of circulating folate and methionine and blocks the formation of homocysteine, its regulation in relation to different cancers has extensively been studied in different populations. However, information on Pakistani breast cancer patients is lacking. The MTHFR gene has two most common mutations that are single nucleotide additions which result in change of amino acids C677T to Ala222val and A1298C to Glu429Ala. Methodology: 110 sporadic breast patients with no prior family history of cancer or any other type of genetic disorders along with 110 normal individuals were screened for mutations in exons 1 to exon 9 using single strand conformational polymorphism, RFLP and sequencing analyzer. Results: The p values for the 677CC, 677CT, and 677TT genotypes were 0.223, 0.006, and 0.077, respectively. Those for the 1298AA, 1298AC, and 1298CC genotypes were 0.555, 0.009, and 0.003, respectively. Conclusions: We found an overall a significant, weak inverse association between breast cancer risk and the 677TT genotype and an inverse association with the 1298C variant. These results for MTHFR polymorphism might be population specific in sporadic breast cancer affected patients but many other factors need to be excluded before making final conclusions including folate intake, population and disease heterogeneity.

Wen, Christinal Teh Pey;Hussein, Saba Zuhair;Abdullah, Shailah;Karim, Norwahidah Abdul;Makpol, Suzana;Yusof, Yasmin Anum Mohd 1605

https://doi.org/10.7314/APJCP.2012.13.4.1605 PDF KSCI

Gelam and Nenas monofloral honeys were investigated in this study for their chemopreventive effects against HT 29 colon cancer cells. MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolim) assays showed more effective inhibition of colon cancer cells proliferation by Gelam honey with $IC_{50}$ values of 39.0 mg/ml and 85.5 mg/ml respectively after 24 hours of treatment. Alkali comet assays revealed both honeys increased DNA damage significantly in a dose dependent manner. In addition, annexin V-FITC/PI flow cytometry demonstrated that at $IC_{50}$ concentrations and above, both Gelam and Nenas honeys induced apoptosis significantlyat values higher than for necrosis (p<0.05). Measurement of prostaglandin $E_2$ ($PGE_2$) confirmed that Gelam and Nenas honeys reduced its production in $H_2O_2$ inflammation-induced colon cancer cells. In conclusion, our study indicated and confirmed that both Gelam and Nenas honeys are capable of suppressing the growth of HT 29 colon cancer cells by inducing apoptosis and suppressing inflammation.

Tao, Yue;Zhang, Meng-Li;Ma, Peng-Cheng;Sun, Jian-Fang;Zhou, Wu-Qing;Cao, Yu-Ping;Li, Ling-Jun 1611

https://doi.org/10.7314/APJCP.2012.13.4.1611 PDF KSCI

Triptolide, a diterpenoid obtained from Tripteryglum wilfordii Hook.f, has attracted interest for its antitumor activities against human tumor cell lines in recent years. This report focuses on anti-proliferative and pro-apoptotic activities in human melanoma A375 cells assessed by CCK8 assay, Hoechst 33258 staining and flow cytometry. In addition, triptolide-induced arrest in the S phase was also observed. Caspase assays showed the apoptosis induced by triptolide was caspase-dependent and probably through intrinsic apoptotic pathways. Furthermore, expression of NF-${\kappa}B$ (p65) and its downstream factors such as Bcl-2, Bcl-$X_L$ was down-regulated. Taken together, the data indicate that triptolide inhibits A375 cells proliferation and induces apoptosis by a caspase-dependent pathway and through a NF-${\kappa}B$-mediated mechanism.

Selim, Manar E.;Hendi, Awatif A. 1617

https://doi.org/10.7314/APJCP.2012.13.4.1617 PDF KSCI

Background: Gold nanoparticles have recently been investigated with respect to biocompatibility according to their interactions with cells. The purpose of this study was to examine cytotoxicity and apoptosis induction by well-characterized gold nanoparticles in human breast epithelial MCF-7 cells. Methods: Apoptosis was assessed by TUNEL, cytotoxicity by MTT assay and caspase 3, 9, p53, Bax and Bcl expression by real-time PCR assays. Results: Gold nanoparticles at up to $200\;{\mu}g/mL$ for 24 hours exerted concentration-dependent cytotoxicity and significant upregulation of mRNA expression of p53, bax, caspase-3 & caspase-9, whereas expression of antiapoptotic bcl-2 was down-regulated. Conclusion: To the best of our knowledge this is the first report showing that gold nanoparticles induce apoptosis in MCF-7cells via p53, bax/bcl-2 and caspase pathways.

Khoshnevis, N.;Ahmadizar, F.;Alizadeh, M.;Akbari, M.E. 1621

https://doi.org/10.7314/APJCP.2012.13.4.1621 PDF KSCI

Background and objectives: Weight loss and malnutrition are common among cancer patients, these two factors greatly affecting survival and quality of life during treatment. Since cancer is becoming increasingly common in the world and in order to provide better treatment measures, it is important to identify and prevent side effects. The present study has been conducted in 2010 on a sample of cancer patients in the oncology center of Shahid Beheshti University of Medical Sciences to determine the prevalence rates of malnutrition and the factors affecting it. Methods: The PG-SGA standard questionnaire was administered to 416 cancer patients to evaluate their nutrition status and determine the frequency of each malnutrition stage. Correlations and ANOVA tests were used to analyze the relationship between factors and weight loss and how they might affect the development of malnutrition. Results: The prevalence of malnutrition among the patients was 53.1% out of which 29.1% had moderate and 24% had severe malnutrition. The most common factors inducing nutritional symptoms were depression and anorexia. Some 35 % of the patients had over 5% weight loss in the last mouth. The average PG-SGA score was 10.1 with 49 being the highest. 46.1 percent of the patients scored over 9 (requiring critical nutrient intervention). Malnutrition has a high correlation with weight loss, activity limitations, nutritional symptoms, and cancer stage, but low correlation with treatment and pathologic type. Conclusion: Malnutrition has a high prevalence in Iranian cancer patients and has a close relationship with mortality, morbidity and treatment-related problems and also quality of life. Therefore, periodical assessment by PG-SGA to detect malnutrition in patients should be made so that appropriate nutritional interventions can be provided.

Al-Dubai, Sami Abdo Radman;Ganasegeran, Kurubaran;Alabsi, Aied M.;Manaf, Mohd Rizal Abdul;Ijaz, Sharea;Kassim, Saba 1627

https://doi.org/10.7314/APJCP.2012.13.4.1627 PDF KSCI

Background: Breast cancer is the most common cancer among women in Malaysia. Barriers for practicing breast self examination (BSE) await exploration. Objective: To assess the practice of BSE and its correlated factors and particularly barriers amongst urban women in Malaysia. Methods: This cross-sectional study was conducted with 222 Malaysian women using a self-administered questionnaire. Results: The mean (SD) age was 28.5 (${\pm}9.2$) years, 59.0% were university graduates. Of the total, 81.1% were aware of breast cancer and 55% practiced BSE. Amongst 45% of respondents who did not practice BSE, 79.8% did not know how to do it, 60.6% feared being diagnosed with breast cancer, 59.6% were worried about detecting breast cancer, 22% reported that they should not touch their bodies, 44% and 28% reported BSE is embarrassing or unpleasant, 29% time consuming, 22% thought they would never have breast cancer or it is ineffective and finally 20% perceived BSE as unimportant. Logistic regression modeling showed that respondents aged ${\geq}45$ years, being Malay, married and having a high education level were more likely to practice BSE (p<0.05). Conclusion: In this study sample, a significant proportion of respondents was aware of breast cancer but did not practice BSE. Knowledge, psychological, cultural, perception and environmental factors were identified as barriers. BSE practice was associated significantly with socio-demographic factors and socioeconomic status.

Sujatha, D.;Hebbar, Pragati B.;Pai, Anuradha 1633

https://doi.org/10.7314/APJCP.2012.13.4.1633 PDF KSCI

Introduction: The incidence of oral premalignant and malignant lesions is on the rise due to an increased number of people taking in tobacco and alcohol related habits. Material and Methods: 1028 patients with tobacco, alcohol and areca nut habits attending our Department of Oral Medicine and Radiology formed the study sample. An interviewer based questionnaire was used to record the habit details. All the patients were then examined clinically for the presence of lesions. Chi square and Fisher exact tests were used to assess the statistical significance of the study parameters. Results: Males had a higher prevalence and comprised 87.9% of the sample. The commonest habit in this study sample was smoking (39.2%) followed by smokeless tobacco use (28.1%). Out of the 1028 patients with habits 40% had no clinically detectable changes in their mucosa. Of the mucosal changes leukoplakia (14%) was the commonest. Conclusions: This study provided information about the habit trends in the patients visiting this institution. The study may serve as a useful tool in educating the patients about the deleterious effects of oral tobacco, alcohol and betel exposure.

Xu, Lu-Wei;Qian, Ming;Jia, Rui-Peng;Xu, Zheng;Wu, Jian-Ping;Li, Wen-Cheng;Huang, Wen-Bin;Chen, Xing-Guo 1639

https://doi.org/10.7314/APJCP.2012.13.4.1639 PDF KSCI

The aim of this study was to investigate the expression and significance of microsomal prostaglandin synthase-1 (mPGES-1) and Beclin-1 in the development of prostate cancer (PCa). Immunohistochemistry was performed on paraffin-embedded sections with rabbit polyclonal against mPGES-1 and Beclin-1 in 40 PCa, 40 benign prostatic hyperplasia (BPH) and 10 normal prostate specimens for this purpose. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied for mRNA expression of mPGES-1 and Beclin-1, while MTT assays were used to ascertain the best working concentration of the mPGES-1 inhibitor (CAY10526). The effect of CAY10526 treatment on expression of Beclin-1 in DU-145 cells was studied using Western blot analysis. Localization of Beclin-1 and mPGES-1 was in endochylema. Significant differences in expression was noted among PCa, BPH and normal issues (P<0.05). Beclin-1 expression inversely correlated with mPGES-1 expression in PCa tissue (P<0.05). CAY10526 could significantly block mPGES-1 expression and the proliferation of DU-145 cells (P<0.05), while increasing Beclin-1 levels (P<0.05). Overexpression of mPGES-1 could decrease the autophagic PCa cell death. Inhibiting the expression of mPGES-1 may lead to DU-145 cell death and up-regulation of Beclin-1. The results suggest that inhibition of mPGES-1 may have therapeutic potential for PCa in the future.

Wang, Xi;Wang, Shu-Sen;Peng, Rou-Jun;Qin, Tao;Shi, Yan-Xia;Teng, Xiao-Yu;Liu, Dong-Gen;Chen, Wei-Qing;Yuan, Zhong-Yu 1645

https://doi.org/10.7314/APJCP.2012.13.4.1645 PDF KSCI

Purpose: This study aimed to assess possible interactive effects of coping styles and psychological stress on depression and anxiety symptoms in Chinese women shortly after diagnosis of breast cancer. Methods: Four hundred and one patients with breast cancer were face-to-face interviewed by trained research staff according to a standardized questionnaire including information on socio-demographic characteristics, psychological stress, coping styles, and anxiety and depressive symptoms. Interactive effects were assessed by hierarchical multiple regression analyses. Results: There were significant associations of the four domains of psychological stress with anxiety and depressive symptoms except for the relationship between "worrying about health being harmed" and depressive symptoms. "Abreaction coping behavior" and "escaping coping behavior" significantly increased the level of both anxiety and depressive symptoms; whereas an "active coping style" reswulted in significant decrease. The interaction of "active coping behavior" with "worrying about health being harmed" significantly increased the risk of the anxiety symptoms, while adopting "self-relaxing coping behavior" was associated with significant decrease. The interaction of "worry about daily life and social relationship being restricted" with "escaping coping behavior" significantly increased the risk of the depressive symptoms. Conclusions: The results of this study suggest that certain coping styles might moderate the association of psychological stress with anxiety and depressive symptoms in Chinese women with breast cancer.

Chen, Hua;Shu, Hui-Min;Chang, Zhou-Lin;Wang, Zhi-Feng;Yao, Hai-Hong;Zhu, Hong-Mei;Lu, Tian-Mei;Ma, Qiang-Yan;Yang, Bin-Lie 1651

https://doi.org/10.7314/APJCP.2012.13.4.1651 PDF KSCI

Background: Our aim was to investigate the efficacy of the Pap test in combination with the ThinPrep cytological test (TCT) in screening for cervical cancer in China. Design: From March 2006 to October 2008, 988 women with the mean age $46.4{\pm}10.5$ years (range, 23-80 years) were recruited to receive cervical cancer screening. Pap test results ${\geq}$ grade III and TCT findings ${\geq}$ ASCUS/AGUS were considered abnormal. Subjects with a Pap test result ${\geq}$ grade IIb received TCT. Colposcopy and biopsies were performed in all participants, and final diagnosis was based on pathological findings. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index for predicting CIN I or above were determined. Results: The sensitivity, specificity, PPV, NPV and Youden index of the Pap test were 43.1%, 97.2%, 70.0%, 91.9%, and 40.3%, respectively. The same values for TCT in predicting CIN were 80.0%, 63.2%, 16.0%, 97.3%, and 43.2%, respectively. The two tests in combination gave values for predicting CIN of 64.8%, 87.6%, 43.6%, 94.4%, and 53.5%, respectively. Combined testing exhibited the highest Youden index (53.4%). Conclusion: The Pap test with a reduced threshold in combination with the TCT has high sensitivity and high specificity in screening for cervical cancer.

Yang, Xue-Song;Liu, Shui-Ai;Liu, Ji-Wei;Yan, Qiu 1657

https://doi.org/10.7314/APJCP.2012.13.4.1657 PDF KSCI

Fucosyltransferase IV (FUT4) has been implicated in cell adhesion, motility, and tumor progression in human epidermoid carcinoma A431 cells. We previously reported that it promotes cell proliferation through the ERK/MAPK and PI3K/Akt signaling pathways; however, the molecular mechanisms underlying FUT4-induced cell invasion remain unknown. In this study we determined the effect of FUT4 on expression of matrix metalloproteinase (MMP)-12 induced by EGF in A431 cells. Treatment with EGF resulted in an alteration of cell morphology and induced an increase in the expression of MMP-12. EGF induced nuclear translocation of nuclear factor kB (NF-${\kappa}B$) and resulted in phosphorylation of $IkB{\alpha}$ in a time-dependent manner. In addition, ERK1/2 and p38 MAPK were shown to play a crucial role in mediating EGF-induced NF-${\kappa}B$ translocation and phosphorylation of $I{\kappa}B{\alpha}$ when treated with the MAPK inhibitors, PD98059 and SB203580, which resulted in increased MMP-12 expression. Importantly, we showed that FUT4 up-regulated EGF-induced MMP-12 expression by promoting the phosphorylation of ERK1/2 and p38 MAPK, thereby inducing phosphorylation/degradation of $I{\kappa}B{\alpha}$, NF-${\kappa}B$ activation. Base on our data, we propose that FUT4 up-regulates expression of MMP-12 via a MAPK-NF-${\kappa}B$-dependent mechanism.

Wang, Jun-Jiang;Liu, Ying;Zheng, Yang;Lin, Feng;Cai, Guan-Fu;Yao, Xue-Qing 1663

https://doi.org/10.7314/APJCP.2012.13.4.1663 PDF KSCI

Background and Objective: Protein expression in colon and rectal cancer (CRC) and paired normal tissues was examined by two-dimensional gel electrophoresis (2-DE) to identify differentially expressed proteins. Materials and Methods: Five fresh colorectal cancer and paired adjacent normal tissues were obtained and differentially expressed protein spots were determined using PDQuest software, with identification on the basis of MALDI-TOF mass spectra. Results: Compared with normal colorectal mucosa, protein abnormal expression of 65 spots varying more than 1.5 times were found in 2-DE gels from colorectal cancer samples (P<0.05); forty-two proteins were up-regulated and 23 were down-regulated; twelve protein spots were identified using mass spectrometry, of which 8 were up-regulated, includimng HSPB1and Annexin A4, while 4 were down-regulated, the results being consistent with Western blot findings. Conclusions: Two-dimensional electrophoresis reference maps for CRC tissues and adjacent normal mucosa (NMC) were established and 12 differentially expressed proteins were identified. Up-regulated HSPB1 and Annexin A4 may play many important roles in the pathogenesis of colorectal cancer.

Wang, Xin-Xin;Sun, Rong-Ju;Wu, Meng;Li, Tao;Zhang, Yong;Chen, Lin 1667

https://doi.org/10.7314/APJCP.2012.13.4.1667 PDF KSCI

Objective: To explore the differential protein expression profile in EC304 gastric cancer cells induced by alphastatin. Methods: Cultured EC304 cells in the exponential phase of growth were randomly divided into alphastatin and control groups. Total proteins were extracted and the two dimensional electrophoresis (2-DE) technique was applied to analyze differences in expression with ImageMaster 2D Platinum 5.0 software. Proteins were identified using the MASCOT database and selected differently expressed proteins were characterised by western blotting and immunofluorescence. Results: $1350{\pm}90$ protein spots were detected by the ImageMaster software in the 2-DE gel images from the control and alphastatin groups. The match rate was about 72-80% for the spectrum profiles, with 29 significantly different protein spots being identified, 10 upregulated, 16 downregulated, two new and one lost. The MASCOT search scores were 64-666 and the peptide matching numbers were 3-27 with sequence coverage of 8-62%. Twenty-three proteins were checked by mass spectrometry, including decrease in Nm23 and profilin-2 isoform b associated with the regulation of actin multimerisation induced by extracellular signals. Conclusion: The proteome in EC304 cells is dramatically altered by alphastatin, which appears to play an important role in modulating cellular activity and anti-angiogenesis by regulating protein expression and signal transduction pathways through Nm23 and profilin-2 isoform b, providing new research directions for anti-angiogenic therapy of gastric cancer.

Roder, David M.;Silva, Primali De;Zorbas, Helen N.;Webster, Fleur;Kollias, James;Pyke, Chris M.;Campbell, Ian D. 1675

https://doi.org/10.7314/APJCP.2012.13.4.1675 PDF KSCI

Aim: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. Design: The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. Results: 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29; p<0.001); and (2) although not approaching statistical significance $p{\geq}0.200$), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Conclusions: Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.

Masood, Nosheen;Malik, Faraz Arshad;Kayani, Mahmood Akhtar 1683

https://doi.org/10.7314/APJCP.2012.13.4.1683 PDF KSCI

In the present case control study mRNA expression of the GSTP1 gene, encoding a phase II enzyme that detoxifies via glutathione conjugation, was investigated using semiquantitative PCR followed by SSCP for 49 confirmed head and neck (HN) cancer and 49 control samples. It was found that GSTP1 was upregulated in significantly higher number of cancers (OR 4.2, 95% CI 1.2-15.3). Grade wise correlation was also observed with more up regulation in patients with more advanced grades of HN carcinomas. We also found that 5 patients showed variation in mRNA with a larger product size than expected. Sequencing revealed insertion of an intronic segment between the $6^{th}$ and $7^{th}$ exon of the GSTP1 gene. Germline screening was performed showing mobility shifts which suggested mutation at the DNA level resulting in intronic portion retention. This study is of prime importance for drug design and treatment selection to overcome increased resistance of HN cancers to drugs due to alteration in the GSTP1 gene.

Maxwell, Annette E.;Stewart, Susan L.;Glenn, Beth A.;Wong, Weng Kee;Yasui, Yutaka;Chang, L. Cindy;Taylor, Victoria M.;Nguyen, Tung T.;Chen, Moon S.;Bastani, Roshan 1687

https://doi.org/10.7314/APJCP.2012.13.4.1687 PDF KSCI

Background: Few studies have examined theoretically informed constructs related to hepatitis B (HBV) testing, and comparisons across studies are challenging due to lack of uniformity in constructs assessed. The present analysis examined relationships among Health Behavior Framework factors across four Asian American groups to advance the development of theory-based interventions for HBV testing in at-risk populations. Methods: Data were collected from 2007-2010 as part of baseline surveys during four intervention trials promoting HBV testing among Vietnamese-, Hmong-, Korean- and Cambodian-Americans (n = 1,735). Health Behavior Framework constructs assessed included: awareness of HBV, knowledge of transmission routes, perceived susceptibility, perceived severity, doctor recommendation, stigma of HBV infection, and perceived efficacy of testing. Within each group we assessed associations between our intermediate outcome of knowledge of HBV transmission and other constructs, to assess the concurrent validity of our model and instruments. Results: While the absolute levels for Health Behavior Framework factors varied across groups, relationships between knowledge and other factors were generally consistent. This suggests similarities rather than differences with respect to posited drivers of HBV-related behavior. Discussion: Our findings indicate that Health Behavior Framework constructs are applicable to diverse ethnic groups and provide preliminary evidence for the construct validity of the Health Behavior Framework.

Cui, Yan-Hui;Liang, Hai-Jun;Zhang, Qing-Qin;Li, Si-Qing;Li, Xiao-Rui;Huo, Xiao-Qing;Yang, Qing-Hui;Li, Wei-Wei;Gu, Jian-Fa;Hua, Qin-Liang;Lu, Ping;Miao, Zhan-Hui 1693

https://doi.org/10.7314/APJCP.2012.13.4.1693 PDF KSCI

Objective: To explore the effect on radiosensitivity of arsenic trioxide ($As_20_3$) in conjunction with hyperthermia on the esophageal carcinoma EC-1 cell line. Method: Inhibition of EC-1 cell proliferation at different concentrations of $As_20_3$ was assessed using the methyl thiazolyl blue colorimetric method (MTT method), with calculation of $IC_{50}$ value and choice of 20% of the $IC_{50}$ as the experimental drug concentration. Blank control, $As_20_3$, hyperthermia, radiotherapy group, $As_20_3$ + hyperthermia, $As_20_3$ + radiotherapy, hyperthermia + radiotherapy and $As_20_3$ + hyperthermia + radiotherapy groups were established, and the cell survival fraction (SF) was calculated from flat panel colony forming analysis, and fitted by the 'multitarget click mathematical model'. Flow cytometry (FCM) was used to detect changes in cell apoptosis and the cell cycle. Results: $As_20_3$ exerted inhibitory effects on proliferation of esophageal carcinoma EC-1 cells, with an $IC_{50}$ of 18.7 ${\mu}mol/L$. After joint therapy of $As_20_3$ + hyperthermia + radiotherapy, the results of FCM showed that cells could be arrested in the $G_2$/M phase, and as the ratio of cells in $G_0/G_1$ and S phases decreased, cell death became more pronounced. Conclusion: $As_20_3$ and hyperthermia exert radiosensitivity effects on esophageal carcinoma EC-1 cells, with synergy in combination. Mechanistically, $As_20_3$ and hyperthermia mainly influence the cell cycle distribution of EC-1 esophageal carcinoma cells, decreasing the repair of sublethal damage and inducing apoptosis, thereby enhancing the killing effects of radioactive rays.

Saxena, Upma;Sauvaget, Catherine;Sankaranarayanan, Rengaswamy 1699

https://doi.org/10.7314/APJCP.2012.13.4.1699 PDF KSCI

Cervical cancer remains the most frequent cancer in women from the developing world. More than 88% of deaths occur in low-income countries, and it is predicted to climb to 91.5% by 2030. Although Pap-based screening programmes have shown to be effective in reducing the disease burden in high-resource countries, implementation and sustention of cytology-based programmes is quite challenging in low-resource settings. The present paper reviews evidence-based alternatives of screening methods, triaging algorithm, treatment of cervical precancerous lesions, and age-group at screening appropriate for low-income countries. Evidence shows that visual inspection methods using diluted acid acetic or Lugol's iodine, and HPV-DNA testing are more sensitive tests than the Pap-smear screening test. Visual inspection allows an immediate result and, when appropriate, may be immediately followed by cryotherapy, the so called "screen-and-treat" approach, achieved in a single visit, by trained nurses and midwives. Examples of cervical cancer prevention programmes in India and selected low-income countries are given.

Shaikh, Asim Jamal 1705

https://doi.org/10.7314/APJCP.2012.13.4.1705 PDF KSCI

The inception of targeted agents has revolutionized the cancer therapy paradigm, both for physicians and patients. A large number of molecular targeted agents for cancer therapy are currently available for clinical use today. Many more are in making, but there are issues that remain to be resolved for the scientific as well as social community before the recommendation of their widespread use in may clinical scenarios can be done, one such issue being cost and cost effectiveness, others being resistance and lack of sustained efficacy. With the current knowledge about available targeted agents, the growing knowledge of intricate molecular pathways and unfolding of wider spectrum of molecular targets that can really matter in the disease control, calls for only the just use of the agents available now, drug companies need to make a serious attempt to reduce the cost of the agents. Research should focus on agents that show sustained responses in preclinical data. More needs to be done in laboratories and by the pharmaceutical industries, before we can truly claim to have entered a new era of targeted therapy in cancer care.

Wahidin, Mugi;Noviani, Rini;Hermawan, Sofia;Andriani, Vita;Ardian, Ardi;Djarir, Hernani 1709

https://doi.org/10.7314/APJCP.2012.13.4.1709 PDF KSCI

Cancer is a major public health problem in Indonesia, becoming the 7th largest cause of death based on a national survey in 2007, accounting for 5.7 of all mortality. A cancer registry was started in 1970, but it was partial and was stopped mainly because no government body was responsible. Realizing the above situation, the Indonesian government established the Sub Directorate of Cancer Control within the Ministry of Health, with responsibility for developing a national cancer control program, including a cancer registry. A sustainable cancer registry was then started in 2007 within Jakarta Province, first hospital-based but then expanded to be population-based. Steps of cancer registration in Jakarta are data collection, data verification, data validation, data management and analysis, and data publication. Data collection is conducted by health facilities (hospitals, laboratories, primary health centers) at the district/municipal level, with reports to the provincial level. Data are collected passively by holding meetings every three months in the district/municipality. Verification of data is the responsibility of the medical doctor or pathologist in each data source. Data validation is conducted by a team in the cancer registry, consisting of district/municipal/province health officers, pathologists, and registrars. Data management and analyses are conducted by a cancer registry team at the provincial level, assisted by the national team. We use software named Indonesian Cancer Registry System (SRIKANDI) which is adopted from CanReg4 IARC. Data from the population-based cancer registry in Jakarta Province showed the leading cancers among females in 2005-2007 to be breast cancer, cervical cancer, ovarian cancer, colorectal cancer and among males are bronchus and lung cancer, colorectal cancer, liver cancer, pharyngeal cancer, and prostate cancer. The leading childhood cancers are leukaemia and retinoblastoma.

Caldararo, Niccolo 1711

https://doi.org/10.7314/APJCP.2012.13.4.1711 PDF KSCI

Variation in diet and the rates of colorectal cancers have confounded researchers in recent years. Comparisons of populations in different geographic locations and of different ethnic origins have shown considerable differences in disease frequency, location and relation to diet. This paper revisits an earlier comparison of Maori rates of disease and diet based on data from 20 years ago with surprising changes in disease rates today.

Asian Pacific Journal of Cancer Prevention

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Volume 13 Issue 4

Asian Pacific Journal of Cancer Prevention

Domain

Aim & Scope

2017

2016

2015

2014

2013

2012

Volume 13 Issue 4

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