Prognostic Significance of Substance P and Neurokinin-1 Receptor in Bladder Cancer.

Background: Bladder cancer is one of the most common genitourinary cancers with significant mortality. Finding reliable tumor markers and potential drug targets can improve early diagnosis, prognosis, and more effective therapeutic protocols. Previous studies have reported the involvement of the substance P (SP)/neurokinin-1 receptor (NK-1R) system in cancers. The potential prognostic role and the interaction of SP and NK-1R in bladder tumor are yet to be elucidated. Methods: Serum samples from 22 primarily diagnosed patients with bladder cancer as well as 22 healthy controls were examined for SP level using ELISA method. Tissue distribution of NK-1R in tumor samples and their adjacent normal tissues was evaluated through immunohistochemistry. Results: Serum SP levels in patients with bladder cancer were higher than the healthy group (p< 0.001) and had a significant correlation with NK-1R staining intensity (p< 0.001), percentage of stained cells (p< 0.001), and NK-1R tissue distribution. Also, the immunoreactivity of NK-1R in cancer samples increased significantly without correlation with tumor characteristics. However, no significant association was found between SP and NK-1R levels with clinical characteristics including tumor size (p= 0.33), tumor stage (p= 0.29), grade (p= 0.93), NK-1R staining intensity (p= 0.53), and percentage of stained cells (p= 0.32). Discussion: According to our findings, despite the lack of association between SP and NK-1R with clinical characteristics of bladder cancer, their serum levels were higher in patients with bladder cancer. Further studies are needed to confirm the potential prognostic role of SP and NK-1R in bladder cancer.

Association of a variant in the tumor necrosis factor alpha gene with risk of cervical cancer.

Tumor necrosis factor alpha (TNF-α) is a pro-inflammatory cytokine involved in the regulation of the immune system and potentially the progression of cervical neoplastic lesions. In this study, we aimed to explore the possible relationship between polymorphisms of the TNF-α gene and susceptibility to cervical cancer. The relationship between a single nucleotide polymorphism (SNP) in the TNF-α gene (rs1800629) and the risk of cervical cancer was evaluated in a total of 445 subjects with (n = 153), or without (n = 292) cancer. Genotyping was performed using a Taq-Man based real time PCR method. Logistic regression analysis showed that individuals with AG/AA genotypes had an increased risk of cervical cancer compared to those with a GG genotype (OR 3.79, 95% CI 2.4-5.7, < 0.001). Our findings demonstrated that a genetic variant in the TNF-α gene (rs1800629) was associated with increased level and risk of developing cervical cancer, suggesting its potential use as a genetic risk factor for cervical neoplasia.

Ischemic colitis due to antiphospholipid antibody syndrome.

INTRODUCTION: Portal system ischemia may present insidiously which may aggravates the prognosis. CASE PRESENTATION: A 26-year old man presented with watery diarrhea and generalized abdominal pain for 3 months. On physical examination, moderate splenomegaly was noticeable. Stool exam and culture was negative except for blood in stool. Colonoscopy was in favor of inflammatory bowel disease although the patient symptoms have worsened despite treatment. Abdominopelvic computed tomography (CT) showed thromboses in portal and superior mesenteric veins and as the ill patient evolved signs of peritonitis, he underwent laparotomy during which, total colectomy was performed due to significant bowel necrosis. The cause of venous thrombosis of the portal system revealed to be Factor V Leiden and the presence of antiphospholipid syndrome. CONCLUSION: High mortality rates of portal and mesenteric thromboses despite therapy urge the need for early clinical suspicion, careful assessment of the differential diagnoses and timely treatment for fewer adverse events. Although the therapeutic plan is challenging, anticoagulation, angiography and surgical resection increase survival.

Association of TNF-308 G>A polymorphism located in tumor necrosis factor a with the risk of developing cervical cancer and results of pap smear.

Tumor necrosis factor a (TNFa) is an inflammatory cytokine that plays a crucial role in the immune response and the progression of cervical lesions. There is a growing body of data evaluating the value of a genetic variant in the TNFa gene with the risk of developing cervical cancer. The aim of this study was to explore the association of a variant, TNF-308 G>A, residing in the TNFa gene with cervical cancer. A total of 91 women with cervical cancer and 161 women as the control group were recruited. DNA was extracted, and Taqman®-probes-based assay was used for genotyping. Our results showed that the minor allele frequency was 0.3 in total population, and the frequency of minor allele A was more in the case group compared with the control. The regression models in different genetic models also revealed that the allele A is a potential risk factor for the development of cervical cancer. In particular, in the dominant model, patients with AG and AA genotypes had a higher risk of developing cervical cancer with odds ratio (OR) of 2.75 (95% confidence interval [CI]: 1.57-4.83, <0.001) and OR of 7.27 (95%CI: 2.5-20.8, <0.001), compared with the GG genotype. Moreover, a similar outcome was obtained for smear test results. Our study demonstrated that TNF-308 G>A located on TNF-a was associated with the risk of cervical cancer, supporting further studies in a larger population and multicenter setting to show the value of emerging markers as risk stratification biomarkers in cervical cancer.

Prolonged survival of a patient with pelvic recurrence of ovarian malignant mixed mullerian tumor after chemoradiotherapy.

INTRODUCTION: Malignant Mixed Mullerian Tumor (MMMT) is a very rare tumor, accounting for less than 1% of all ovarian cancers. CASE PRESENTATION: We present a 64-year-old woman with stage III MMMT of ovary that was treated with platinum-based chemotherapy after optimal cytoreductive surgery. After 25 months of being disease free, she had a pelvic recurrence and a good response to chemoradiotherapy. CONCLUSIONS: Optimal cytoreductive surgery and chemotherapy may be the best treatment in MMMT but more discussion and experiences are needed regarding the effectiveness of radiotherapy.

Immunohistochemical study of p53, Ki-67, MMP-2 and MMP-9 expression at invasive front of squamous cell and verrucous carcinoma in oral cavity.

Squamous cell carcinoma (SCC) is the most common malignancy in the oral cavity. Verrucous carcinoma (VC) is a lower grade subtype of SCC with pathological similarities but different management. Tumor invasive front (TIF) is a dynamic location in the differentiation of malignancies. p53 is a tumor suppressor and Ki-67 a proliferation marker. Matrix metalloproteinases 2 and 9 are involved in the tumor invasiveness. We assessed these markers in TIF of oral SCC and VC to find more precise grading scales. We studied the expression of markers in the invasive front of 42 cases of SCC (21 high and 21 low grade), 20 cases of VC and 8 cases of normal oral mucosa using immunohistochemistry. There were significant differences among the study groups regarding the number of cells expressing p53, MMP-2 and 9. Except for Ki-67, other studied markers can be used for the histological grading of SCC and its differentiation from VC. MMP-9 is the most reliable one for invasive SCC grading. The extent of the expression of these markers is related to the infiltration pattern of SCC at the invasive front. The less invasive nature of VC can be associated with the expression pattern of these markers.

Immunohistochemical comparison of the expression of p53 and MDM2 proteins in ameloblastomas and keratocystic odontogenic tumors.

OBJECTIVE: Ameloblastoma and keratocystic odontogenic tumor (KOT) is characterized by a benign but locally invasive behavior with a high risk of recurrence. MDM2 (murine double minute 2), an amplifier of cell proliferation, and p53, a tumor suppressor gene, are overexpressed in some odontogenic lesions. The aim of this study was to compare the expression of MDM2 and p53 in ameloblastoma and KOT as 2 lesions with similar biologic behavior, by immunohistochemistry. METHODS: The expressions of MDM2 and p53 proteins were determined in 39 ameloblastomas (15 follicular types, 15 plexiform types, and 9 unicystic types) and 15 KOTs. RESULTS: P53 protein was expressed in 100% of KOTs and 77.8% of ameloblastomas, and MDM2 was detected in 74.8% of ameloblastomas and 80% of KOTs. There was no statistical difference between MDM2 and p53 expressions in different subtypes of ameloblastomas and also when KOTs were compared with them (P > 0.05). There was a significant difference between immunohistochemical reactivity of MDM2 among subtypes of ameloblastomas (P < 0.05). MDM2 and p53 expressions were positively correlated. CONCLUSIONS: Overexpression of p53 and MDM2 is associated with the pathogenesis and oncogenesis of ameloblastomas and KOT. Overexpression of these markers can contribute to similar biologic behavior of these lesions.