Background: To investigate the predictive and prognostic effects of clinicopathologic and immunohistochemical (IHC) features in patients with gastrointestinal stromal tumours (GISTs). Materials and Methods: Fifty-six patients who were diagnosed with GIST between 2002 and 2012 were retrospectively evaluated. Relationships between clinicopathologic/immunohistochemical factors and prognosis were investigated. Results: Median overall survival (OS) of the whole study group was 74.9 months (42.8-107.1 months), while it was 95.2 months in resectable and 44.7 months in metastatic patients respectively (p=0.007). Epitheliolid tumor morphology was significantly associated with shortened OS as compared to other histologies (p=0.001). SMA(+) tumours were significantly correlated with low (<10/50HPF) mitotic activity (p=0.034). Moreover, SMA(+) patients tended to survive longer and had significantly longer disease-free survival (DFS) times than SMA (-) patients (37.7 months vs 15.9 months; p=0.002). High Ki-67 level (${\geq}30%$) was significantly associated with shorter OS (34 vs 95.2 months; 95%CI; p=0.001). CD34 (-) tumours were significantly associated with low proliferative tumours (Ki-67<%10) (p=0.026). Median PFS (progression-free survival) of the patients who received imatinib was 36 months (27.7-44.2 months). CD34 (-) patients had significantly longer PFS times than that of negative tumours; (50.8 vs 29.8 months; p=0.045). S100 and desmin expression did not play any role in predicting the prognosis of GISTs. Multivariate analysis demonstrated that ${\geq}10/50HPF$ mitotic activity/HPF was the only independent factor for risk of death in GIST patients. Conclusions: Despite the negative prognostic and predictive effect of high Ki-67 and CD34 expression, mitotic activity remains the strongest prognostic factor in GIST patients. SMA positivity seems to affect GIST prognosis positively. However, large-scale, multicenter studies are required to provide supportive data for these findings.
Colorectal cancer is one of the most common cancers. Due to demographic changes, it is predicted that the incidence of this cancer will increase. Variations of its incidence rate among geographical areas are due to various contributing factors. Since there have been a lack of studies on this topic in our country, the present assessment of spatial patterns of colorectal cancer incidence in Iran was performed. In this ecological study, the new cases of colon cancer were extracted from Cancer Registry Center report of the Health Deputy of Iran in 2009. The reported incidences of the disease were standardized on the basis of the World Health Organization population and the direct method. Then the data were inserted into the GIS software, and finally, using the analysis of hot spots (Getis-Ord Gi) high-risk areas were drawn. Provinces that are higher or lower than the national average (1.9 SD) were considered hot spots or cold spots, significant at the level of 0.05. A total of 6,210 cases of colorectal cancer were registered in Iran in 2009, of which 3,727 were in men and 2,783 in women (age-standardized rates of 11.3 and 10.9 per 100,000 population, respectively). The results showed that in central and northern Iran including Isfahan, Qom, Tehran, Qazvin and Mazandaran significant hot spots in men were present (p <0.05). In women also we have high incidence in northern and central states: Mazandaran province (p<0.01) and the province of Tehran (p<0.05) had higher incidences than the national average and were apparent as significant hot spots. Analysis of the spatial distribution of colorectal cancer showed significant differences between different areas pointing to the necessity for further epidemiological studies into the etiology and early detection.
Enayatrad, Mostafa;Mirzaei, Maryam;Salehiniya, Hamid;Karimirad, Mohammad Reza;Vaziri, Siavash;Mansouri, Fiezollah;Moudi, Asieh
Asian Pacific Journal of Cancer Prevention
/
v.17
no.sup3
/
pp.39-42
/
2016
Cancer is a major public health problem in Iran. The aim of this study was to evaluate trends in incidence of ten common cancers in Iran, based on the national cancer registry reports from 2004 to 2009. This epidemiological study was carried out based on existing age-standardized estimate cancer data from the national report on cancer registry/Ministry of Health in Iran. The obtained data were analyzed by test for linear trend and $P{\geq}0.05$ was taken as the significant level. Totals of 41,169 and 32,898 cases of cancer were registered in men and females, respectively, during these years. Overall age-standard incidence rates (ASRs) per 100,000 population according to primary site weres 125.6 and 113.4 in males and females, respectively. Between 2004 and 2009, the ten most common cancers (excluding skin cancer) were stomach (16.2), bladder (12.6), prostate (11), colon-rectum (10.14), hematopoeitic system (7.1), lung (6.1), esophagus (6.4), brain (3.2), lymph node (3.8) and larynx (3.4) in males; and in females were breast (27.4), colon-rectum (9.3), stomach (7.6), esophagus (6.4), hematopoeitic system (4.9), thyroid (3.9), ovary (3.6), corpus uteri (2.9), bladder (3.2) and lung (2.6). Moreover, results showed that skin cancer was estimated as the most common cancer in both sexes. The lowest and the highest incidence in females and males were reported respectively in 2004 and 2009. Over this period, the incidence of cancer in both sexes has been significantly increasing (p<0.01). Like other less developed and epidemiologically transitioning countries, the trend of age-standardized incidence rate of cancer in Iran is rising. Due to the increasing trends, the future burden of cancer in the Iran is going to be acute with the expected increases in aging populations. Determining and controlling potential risk factors of cancer should hopefully lead to decrease in its burden.
One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was $47.3{\pm}10.2$. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ${\geq}3months$. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.
This study aimed to modify behavior regarding liver fluke and cholangiocarcinoma prevention in Chumphuang district, Nakhon Ratchasima province, Thailand through integrated learning. A total of 180 participants were included through purposive selection of high-risk scores on verbal screening. Participants attended the health education program which applied the health belief model included family based, knowledge station based, academic merit based and community based learning. Data were collected using a questionnaire composed of 4 parts: 1) personal information, 2) knowledge, 3) perceived susceptibility, severity, benefits, and barriers, 4) practice regarding liver fluke and cholangiocarcinoma prevention. The result revealed that the majority were female (79.9%), age ${\geq}60$ years old (33.2%), primary school educational level (76.1%), and agricultural occupation (70.1%). The mean scores of knowledge, perception, and practice to liver fluke and cholangiocarcinoma prevention, before participated the integrative learning were low, moderate, and low, respectively. Meanwhile, the mean score of knowledge, perceived susceptibility, severity, benefits, and barriers, and practice regarding liver fluke and cholangiocarcinoma prevention, were higher with statistical significance after participation in the integrated learning. This finding indicates that health education programs may successfully modify health behavior in the rural communities. Therefore they may useful for further work behavior modification in other epidemic areas.
Background: During the follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. Methods: From March 1991 to March 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic methods at Yeungnam University hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months and, divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated for age, sex, child-pugh score, liver cirrhosis, and level of AFP. Results: Pulmonary metastasis was found in 18.0% (26/144), of which 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of the patients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. There was more likelihood for lung metastasis after TAE. but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. Conclusions: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. Child-pugh class was the only related clinical preciptating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-ups may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.
Kaku, K.;Ikeguchi, A.;Ogino, A.;Osada, T.;Hojito, M.;Shimada, K.
Asian-Australasian Journal of Animal Sciences
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v.17
no.7
/
pp.1026-1032
/
2004
In this study, we assess the recent changes in the amount of excretion by the livestock industry, and discuss the effects of increasing the ratio of cultivated land on the reduction of surplus nitrogen from a cost-performance perspective. Nitrogen has contributed to acidification of ecosystems and nitrate concentrations in groundwater, especially in Europe. Therefore, we assessed the level of nitrogen waste from the domestic Japanese livestock industry, including cattle, swine and poultry during the period 1987-2001. This assessment assumed that 40% of the nitrogen from the domestic livestock industry was emitted as gas into the air and that 60% of the nitrogen was contained in manure used on domestic cultivated land. Nitrogen excreted from livestock, excluding gas emission, decreased by 11% from 0.504 million tons to 0.447 million tons during 1993-2001. Thus, the peak period of nitrogen excretion from livestock is already past in Japan. However, the area of cultivated land under management also decreased during 1990-2000. In addition, the area of paddy and upland fields left unplanted for a year increased during 1990-2000. Therefore, if all manure from the domestic livestock industry had been utilized on the fields as organic fertilizer, but not on arable land left uncultivated for the past year, the nitrogen per net area of cultivated land would have increased by 5%, from 125 to 131 N kg/ha, during 1990-2000. To reduce the nitrogen ratio on cultivated land through the planting of feed grain to utilize the nitrogen, a comparison of the cost performance of feed grains indicated that barley would be more suitable than wheat, rice or soybean. Had barley been planted in 100% of the land left fallow for the past year in 2000, 4% (20,000 tons) of the nitrogen from livestock waste would have been used in the harvest, and the nitrogen per land unit would have not increased but decreased from 125 to 121 N kg/ha during the same decade. Furthermore, when converted into Total Digestible Nutrients, 7% of imported feed corn could have been replaced with the harvested barley in 2000. Planting barley on this fallow land had three benefits; reducing the risk of manure overload on the land, slowing down the decrease in cultivated land, and raising the feed self-sufficiency ratio. Thus, it would be beneficial to plant feed grain such as barley in land left fallow for the past year through utilization of manure.
Background: Early diagnosis of hepatocellular carcinoma (HCC) is the most important step in successful treatment. However, it is usually rare due to the lack of a highly sensitive specific biomarker so that the HCC is usually fatal within few months after diagnosis. The aim of this work was to study the role of plasma nuclear factor kappa B (NF-${\kappa}B$) and serum peroxiredoxin 3 (PRDX3) as diagnostic biomarkers for early detection of HCC in a high-risk population. Materials and Methods: Plasma nuclear factor kappa B level (NF-${\kappa}B$) and serum peroxiredoxin 3 (PRDX3) levels were measured using enzyme linked immunosorbent assay (ELISA), in addition to alpha-fetoprotein (AFP) in 72 cirrhotic patients, 64 patients with HCC and 29 healthy controls. Results: NF-${\kappa}B$ and PRDX3 were significantly elevated in the HCC group in relation to the others. Higher area under curve (AUC) of 0.854 (for PRDX3) and 0.825 (for NF-${\kappa}B$) with sensitivity of 86.3% and 84.4% and specificity of 75.8% and 75.4% respectively, were found compared to AUC of alpha-fetoprotein (AFP) (0.65) with sensitivity of 72.4% and specificity of 64.3%. Conclusions: NF-${\kappa}B$ and PRDX3 may serve as early and sensitive biomarkers for early detection of HCC facilitating improved management. The role of nuclear factor kappa B (NF-${\kappa}B$) as a target for treatment of liver fibrosis and HCC must be widely evaluated.
Our recent studies conducted in South America have shown that mycotoxin contamination of red chili peppers (RCPs) may be associated with an increased risk of gallbladder cancer (GBC). Whether this relationship exists in India, a country with a high incidence of GBC and high consumption of RCPs, is unclear. We therefore measured concentrations of aflatoxins (AFs) and ochratoxin A (OTA) in RCPs from areas of low, medium, and high incidence of GBC in India, and compared these concentrations with GBC incidence in each area. Twenty-one RCP samples were collected from nine cities (eight from a low-incidence area, five from a medium-incidence area, and eight from a high-incidence area). Concentrations of AFs and OTA were measured using high-performance liquid chromatography. No significant differences in mean concentrations of AFs and OTA were found in the three areas. AFB1 levels in the low-incidence area ($10.81{\mu}g/kg$) and high-incidence area ($12.00{\mu}g/kg$) were more than 2.2 and 2.4 times higher compared with the maximum permitted level of AFB1 in spices ($5.0{\mu}g/kg$) set by the Commission of the European Communities, or that ($4.4{\mu}g/kg$) obtained in our previous study in Chile. Our results show that the mean concentrations of mycotoxins in RCPs are similar among the three areas in India with different incidences of GBC. Further studies with human subjects are needed to evaluate any association between AFB1 and GBC.
Kim, Poong Ho;Park, Yong Soo;Park, Kunbawui;Kwon, Ji Young;Yu, Hong Sik;Lee, Hee Jung;Kim, Ji Hoe;Lee, Tae Seek
Korean Journal of Fisheries and Aquatic Sciences
/
v.49
no.4
/
pp.454-459
/
2016
Pre- or post-harvest processing is required to mitigate the risk of norovirus infection mediated by shellfish or seafood. We investigated the environmental resistance of human norovirus (HuNoV) under various conditions of temperature, salinity, and pH in seawater. Male-specific coliphage (MSC) was as the reference virus for all tests. At 4℃, HuNoV GII4 spiked into seawater was continually detected by RT-PCR for 35 days, regardless of salinity or pH level. It maintained nearly stable concentrations, meaning HuNoV can sustain a viral population in seawater long enough to be accumulated by shellfish and other filter feeders during winter. MSC was also stable at 4℃ although viral infectivity dropped sharply after 28 days. The effects of salinity and pH on MSC were indistinct. At 25℃ the detectable period of HuNoV GII4 by RT-PCR in seawater decreased to about one-third or half of the period at 4℃. High salinity (32 psu) and alkaline pH (8.5) were also unfavorable for sustaining HuNoV abundance at 25℃ in seawater. The resistance patterns of MSC to high temperature, high salinity, and alkaline pH were more dramatic and viral infectivity decreased over time, almost in direct proportion to experimental days. MSC was undetectable after 12 days under all salinities and pH levels at 25℃.
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