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Ghasemi-Kebria F, Fazel A, Semnani S, Etemadi A, Naeimi-Tabiei M, Hasanpour-Heidari S, Salamat F, Jafari-Delouie N, Sedaghat S, Sadeghzadeh H, Akbari M, Mehrjerdian M, Weiderpass E, Roshandel G, Bray F, Malekzadeh R. Breast cancer incidence trends in Golestan, Iran: An age-period-cohort analysis by ethnic region, 2004-2018. Cancer Epidemiol 2024; 89:102525. [PMID: 38228040 DOI: 10.1016/j.canep.2024.102525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND We aimed to examine the effects of age, diagnosis year (calendar period) and birth year (cohort) on the incidence trends of breast cancer among Golestan women, Northeast Iran, 2004-2018. METHODS Incidence data were obtained by residential status (urban/rural) and ethnic region (Turkmens/non-Turkmens). We calculated age-standardized incidence rates (ASRs) per 100,000 person-years. The estimated annual percentage change (EAPC) were calculated, and age-period-cohort (APC) models fitted to assess non-linear effects of period and cohort as incidence rate ratios (IRRs). RESULTS The total number of female breast cancer cases in Golestan, 2004-2018, were 3853, with an overall ASR of 31.3. We found higher rates in urban population (40.5) and non-Turkmens region (38.5) compared to rural area (20.8) and Turkmens region (20.2), respectively. There were increasing trends in incidence rates overall (EAPC= 4.4; 95%CI: 2.2, 6.7), with greater changes in rural areas (EAPC=5.1), particularly among non-Turkmens (EAPC=5.8). The results of the APC analysis indicate the presence of significant non-linear cohort effects with increasing IRRs across successive birth cohorts (IRR=0.1 and IRR= 2.6 for the oldest and the youngest birth cohorts vs. the reference birth cohort, respectively). CONCLUSION We found increasing trends in breast cancer incidence among Golestan women over the study period, with disparities in patterns and trends by residence area and ethnic region. The observed cohort effects suggest an increasing prevalence of key risk factors for breast cancer in this Iranian population. Further investigations are warranted to clarify the relationships between determinants such as reproductive factors and ethnicity in the region.
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Affiliation(s)
- Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | | | - Susan Hasanpour-Heidari
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Faezeh Salamat
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nastaran Jafari-Delouie
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - SeyedMehdi Sedaghat
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hamideh Sadeghzadeh
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahnaz Akbari
- Deputy of Treatment, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahshid Mehrjerdian
- Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France.
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Gholami Chahkand MS, Esmaeilpour Moallem F, Ghasemi-Kebria F, Malekzadeh R, Roshandel G, Taher M. Descriptive Epidemiology of Early-Onset Gastrointestinal Cancers in Iran, 2014-2018. Middle East J Dig Dis 2024; 16:28-33. [PMID: 39050103 PMCID: PMC11264827 DOI: 10.34172/mejdd.2024.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/11/2023] [Indexed: 07/27/2024] Open
Abstract
Background We aim to present incidence rates and geographical distribution of most common early-onset gastrointestinal cancers (EOGICs), including early-onset esophageal cancer (EOEC), gastric cancer (EOGC) and colorectal cancer (EOCRC) in Iran, 2014-2018. Methods Data on new cases of EOEC, EOGC and EOCRC were obtained from publicly available annual reports of the Iranian National Population-based Cancer Registry (INPCR). Incidence rates were calculated using the population data available from the Statistical center of Iran. We considered the World standard population for calculation of age-standardized incidence rates (ASR). We also calculated 95% confidence intervals (CIs) for ASR. All rates are presented per 100000 person-years. Results Overall, 19,679 new cases of EOGIC were registered by the INPCR between 2014 and 2018. The ASRs (95% CI) of EOEC, EOGC and EOCRC were 0.49 (95% CI: 0.47-0.51), 1.67 (1.63-1.71), and 3.07 (3.01-3.13) per 100,000 person-years, respectively. Our findings indicate decreasing and constant trends in the ASR of EOEC and EOGC during the study period, 2014-2018. There was an increasing trend in the ASR of EOCRC. We also found geographical disparities in the incidence rates of EOGICs across provinces of Iran, suggesting the highest ASRs of EOEC in Golestan (1.3), EOGC in Ilam (2.99) and EOCRC in Ilam (4.49). Conclusion Our findings suggested that the incidence rate of EOCRC is consistently increasing. We also found variations in the incidence of EOGICs among different provinces. Further investigations are recommended to clarify the time trends and risk factors of EOGICs in Iran.
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Affiliation(s)
| | - Fatemeh Esmaeilpour Moallem
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Taher
- Division of Gastroenterology and Hepatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Zamani N, Szymiczek A, Shakeri R, Poustchi H, Pourshams A, Narod S, Malekzadeh R, Akbari MR. A Single nucleotide polymorphism in the ALDH2 gene modifies the risk of esophageal squamous cell carcinoma in BRCA2 p.K3326* carriers. PLoS One 2023; 18:e0292611. [PMID: 37943872 PMCID: PMC10635553 DOI: 10.1371/journal.pone.0292611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/24/2023] [Indexed: 11/12/2023] Open
Abstract
Esophageal squamous cell carcinoma (ESCC) has a very high incidence rate in northeastern Iran. Our team previously reported the BReast CAncer gene 2 (BRCA2) p.K3326* mutation as a moderately penetrant ESCC susceptibility variant in northern Iran (odds ratio (OR) = 3.64, 95% confidence interval (CI) = 1.74-7.59, P = 0.0003). Recently, it has been reported that aldehydes can induce BRCA2 haploinsufficiency in cells with a heterozygous pathogenic BRCA2 mutation and predispose them to carcinogenic effects. Based on this observation, we speculate that dysfunctional variants in Aldehyde Dehydrogenase 2 Family Member (ALDH2) may result in aldehyde-induced BRCA2 haploinsufficiency and increase cancer risk in BRCA2 mutation carriers. In support of this hypothesis, our team recently reported the breast cancer risk modifying effect of an ALDH2 common polymorphism, rs10744777, among Polish carriers of the BRCA2 p.K3326* mutation. In the current case-control study, we aimed to investigate the ESCC risk modifying effect of this ALDH2 polymorphism among BRCA2 p.K3326* mutation carriers. We assessed the interaction between the ALDH2 rs10744777 polymorphism and BRCA2 p.K3326* mutation in ESCC risk by genotyping this ALDH2 variant in the germline DNA of 746 ESCC cases and 1,373 controls from northern Iran who were previously genotyped for the BRCA2 p.K3326* mutation. Among a total of 464 individuals with TT genotype of the ALDH2 rs10744777 polymorphism, which is associated with lower ALDH2 expression, we found 9 of 164 cases versus 3 of 300 controls who carried the BRCA2 p.K3326* variant (OR = 5.66, 95% CI = 1.22-26.2, P = 0.018). This finding supports our hypothesis that the ALDH2-rs10744777 TT genotype may be a significant risk modifier of ESCC in individuals with a BRCA2 p.K3326* mutation.
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Affiliation(s)
- Neda Zamani
- Women’s College Research Institute, University of Toronto, Toronto, Canada
- Faculty of Medicine, Institite of Medical Science, University of Toronto, Toronto, Canada
| | - Agata Szymiczek
- Women’s College Research Institute, University of Toronto, Toronto, Canada
| | - Ramin Shakeri
- Digestive Disease Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Hossein Poustchi
- Digestive Disease Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Akram Pourshams
- Digestive Disease Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Steven Narod
- Women’s College Research Institute, University of Toronto, Toronto, Canada
- Faculty of Medicine, Institite of Medical Science, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Reza Malekzadeh
- Digestive Disease Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad R. Akbari
- Women’s College Research Institute, University of Toronto, Toronto, Canada
- Faculty of Medicine, Institite of Medical Science, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Ghasemi-Kebria F, Jafari-Delouie N, Semnani S, Fazel A, Etemadi A, Norouzi A, Khandoozi R, Besharat S, Shokouhifar N, Mirkarimi H, Sedaghat S, Mansoury M, Mehrjerdian M, Weiderpass E, Roshandel G, Bray F, Malekzadeh R. Colorectal cancer incidence trends in Golestan, Iran: An age-period-cohort analysis 2004-2018. Cancer Epidemiol 2023; 86:102415. [PMID: 37442047 DOI: 10.1016/j.canep.2023.102415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND We investigated the effects of factors including age, birth year (cohort) and diagnosis year (period) on colorectal cancer (CRC) incidence trends in Golestan, Northeast of Iran, 2004-2018. METHODS We obtained data on incidence cases of CRC from the Golestan Population-based Cancer Registry by sex and area of residence (urban/rural). Age-standardized incidence rates (ASRs) were calculated using the World standard population and presented per 100,000 person-years. We calculated the estimated annual percentage change (EAPC) with 95 % confidence intervals (95 % CI) fitted age-period-cohort (APC) models to assess non-linear period and cohort effects as incidence rate ratios (IRRs). RESULTS Overall, 2839 new cases of CRC (ASR = 13.7) were registered in the GPCR over 2004-2018. Our findings suggested significantly increasing trends in CRC incidence rates from 2004 to 2018 (EAPC = 3.7; 95%CI: 0.4, 7.1), with the greatest changes occurring in rural women (EAPC= 4.7; 95%CI: 0.4, 9.2). We observed a strong cohort effect with a consistent increase in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924) (IRR= 0.1 versus the reference birth cohort of 1955) through to the most recent cohort born in 1983 (IRR= 1.9). The largest cohort effects were found among rural females (IRR = 0.0, and IRR = 2.5 for the oldest and the youngest birth cohorts vs. the reference birth cohort, respectively). CONCLUSION The increasing trends in CRC rates in Golestan are largely driven by generational changes in exposure to underlying risk factors. Further investigations are warranted to deliver effective prevention strategies for the control of CRC in Golestan.
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Affiliation(s)
- Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nastaran Jafari-Delouie
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Alireza Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Reza Khandoozi
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sima Besharat
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nesa Shokouhifar
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Honyehsadat Mirkarimi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mohsen Mansoury
- Office of the Statistics and Information Technology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahshid Mehrjerdian
- Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France.
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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5
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Ghasemi-Kebria F, Semnani S, Fazel A, Etemadi A, Amiriani T, Naeimi-Tabiei M, Hasanpour-Heidari S, Salamat F, Jafari-Delouie N, Sedaghat S, Sadeghzadeh H, Akbari M, Mehrjerdian M, Weiderpass E, Roshandel G, Bray F, Malekzadeh R. Esophageal and gastric cancer incidence trends in Golestan, Iran: An age-period-cohort analysis 2004 to 2018. Int J Cancer 2023; 153:73-82. [PMID: 36943026 DOI: 10.1002/ijc.34518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023]
Abstract
Golestan province in the northeast of Iran is part of the Asian esophageal cancer belt and is known as a high-risk area for esophageal (EC) and gastric cancers (GC). Data on incident cases of EC and GC during 2004 to 2018 were obtained from the Golestan Population-based Cancer Registry (GPCR). The age-standardized incidence rates (ASRs) were calculated and presented per 100 000 person-years. The estimated annual percentage change (EAPC) with 95% confidence interval (95% CI) were calculated. We also fitted age-period-cohort (APC) models to assess nonlinear period and cohort effects as incidence rate ratios (IRRs). Overall, 3004 new cases of EC (ASR = 15.7) and 3553 cases of GC (ASR = 18.3) were registered in the GPCR. We found significant decreasing trends in incidence rates of EC (EAPC = -5.0; 95% CI: -7.8 to -2.2) and less marked nonsignificant trends for GC (EAPC = -1.4; 95% CI: -4.0 to 1.4) during 2004 to 2018. There was a strong cohort effect for EC with a consistent decrease in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924; IRR = 1.9 vs the reference birth cohort of 1947) through to the most recent cohort born in 1988 (IRR = 0.1). The marked declines in EC incidence rates in Golestan relate to generational changes in its underlying risk factors. Despite favorable trends, this population remains at high risk of both EC and GC. Further studies are warranted to measure the impact of the major risk factors on incidence with a view to designing effective preventative programs.
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Affiliation(s)
- Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Taghi Amiriani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Susan Hasanpour-Heidari
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Faezeh Salamat
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nastaran Jafari-Delouie
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Hamideh Sadeghzadeh
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahnaz Akbari
- Deputy of Treatment, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahshid Mehrjerdian
- Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Sheikh M, Roshandel G, McCormack V, Malekzadeh R. Current Status and Future Prospects for Esophageal Cancer. Cancers (Basel) 2023; 15:765. [PMID: 36765722 PMCID: PMC9913274 DOI: 10.3390/cancers15030765] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Esophageal cancer (EC) is the ninth most common cancer and the sixth leading cause of cancer deaths worldwide. Esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) are the two main histological subtypes with distinct epidemiological and clinical features. While the global incidence of ESCC is declining, the incidence of EAC is increasing in many countries. Decades of epidemiologic research have identified distinct environmental exposures for ESCC and EAC subtypes. Recent advances in understanding the genomic aspects of EC have advanced our understanding of EC causes and led to using specific genomic alterations in EC tumors as biomarkers for early diagnosis, treatment, and prognosis of this cancer. Nevertheless, the prognosis of EC is still poor, with a five-year survival rate of less than 20%. Currently, there are significant challenges for early detection and secondary prevention for both ESCC and EAC subtypes, but Cytosponge™ is shifting this position for EAC. Primary prevention remains the preferred strategy for reducing the global burden of EC. In this review, we will summarize recent advances, current status, and future prospects of the studies related to epidemiology, time trends, environmental risk factors, prevention, early diagnosis, and treatment for both EC subtypes.
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Affiliation(s)
- Mahdi Sheikh
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 69007 Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan 49341-74515, Iran
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 69007 Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 14117-13135, Iran
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7
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Collatuzzo G, Etemadi A, Sotoudeh M, Nikmanesh A, Poustchi H, Khoshnia M, Pourshams A, Hashemian M, Roshandel G, Dawsey SM, Abnet CC, Kamangar F, Brennan P, Boffetta P, Malekzadeh R. Meat consumption and risk of esophageal and gastric cancer in the Golestan Cohort Study, Iran. Int J Cancer 2022; 151:1005-1012. [PMID: 35489023 PMCID: PMC9543688 DOI: 10.1002/ijc.34056] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/12/2022]
Abstract
Red meat and processed meat are associated with some gastrointestinal cancers. Our study aims to investigate the association of different meat types with esophageal and gastric cancer (EC, GC) in a high-risk population. The Golestan Cohort Study (GCS) is a population-based cohort of 50 045 individuals aged 40 to 75 from northeast Iran. Detailed data on different exposures were collected using validated questionnaires. We considered quintiles of meat consumption, using grams and density (g/1000 kcal/day). We calculated intake of red, processed, organ and white meat, as well as total red meat, including the first three. We used proportional hazards regression models to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the association between meat types and cancer. During 12 years of follow-up, out of 49 585 participants (57.4% women), 369 developed EC (48.2% women) and 368 developed GC (27.5% women), including 309 esophageal squamous cell, 20 esophageal adenocarcinomas, 216 cardia and 95 non-cardia GC. No association was found for EC except for red meat among females (HR for one quintile increase 1.13, 95% CI = 1.00-1.27). The risk of GC increased for intake of total red meat (HR 1.08, 95% CI = 1.00-1.17) and red meat separately (HR 1.09, 95% CI = 1.00-1.18). The HR for red meat and non-cardia GC was 1.23 (95% CI = 1.02-1.48). No associations were observed for other types of meat. In conclusion, in this high-risk population red meat intake is associated with GC, but not EC, suggesting a substantial role of this modifiable factor in determining the burden of GC.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Masoud Sotoudeh
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Arash Nikmanesh
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Masoud Khoshnia
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
- Golestan Research Center of Gastroenterology and HepatologyGolestan University of Medical SciencesGorganIran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Maryam Hashemian
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
- Department of Biology, School of Art and SciencesUtica CollegeUticaNew YorkUSA
| | - Gholamreza Roshandel
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
- Golestan Research Center of Gastroenterology and HepatologyGolestan University of Medical SciencesGorganIran
| | - Sanford M. Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
| | - Christian C. Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural SciencesMorgan State UniversityBaltimoreMarylandUSA
| | - Paul Brennan
- Section of GeneticsInternational Agency for Research on CancerLyonFrance
| | - Paolo Boffetta
- Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
- Stony Brook Cancer CenterStony Brook UniversityStony BrookNew YorkUSA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
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8
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Evaluation of the association between centrosome amplification in tumor tissue of breast cancer patients and changes in the expression of CETN1 and CNTROB genes. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2021.101481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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9
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Establishment of a Rehabilitation Center for Patients with Prostate Cancer. Nephrourol Mon 2022. [DOI: 10.5812/numonthly.121625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Prostate cancer is one of the leading causes of mortality in Iran and is the third most common cancer in male population. Objectives: The present study aimed to evaluate the necessity and efficacy of establishing a specific rehabilitation center for patients with prostate cancer. Methods: In this basic-applied research, we proposed the establishment of a rehabilitation center to support and decrease the complications of various treatments in patients with prostate cancer. After entering the rehabilitation process, a well-educated nurse and general physician trained in one of the similar European centers supported the patients to help themselves cope with unresolvable symptoms. To evaluate the patients’ satisfaction with the services offered by this rehabilitation center, the patients were asked to fill the Prostate Cancer-Related Quality of Life Questionnaire seven months after the first session. Results: In this study, 133 patients with prostate cancer (71 persons in the control group and 62 persons in the conservative treatment group) underwent the analysis. The participants’ mean age was 62.8 ± 2.31 years in the control group and 63.3 ± 4.54 years in the treatment group (P = 0.613). Moreover, the participants’ mean lifestyle scores were 5.3 ± 2.5 and 5.8 ± 2.8 in the control and treatment groups before the supportive care, respectively (P = 0.460). However, following the intervention, the scores were 5.3 ± 2.1 and 7.6 ± 1.9 in the control and treatment groups, respectively (P = 0.001). The mean lifestyle score was significantly higher after supportive care in the treatment group (P = 0.001). Conclusions: A prostate cancer-specified rehabilitation center providing supportive care by an educated healthcare professional can significantly improve the quality of life of patients with prostate cancer.
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Zafarzadeh A, Taghani JM, Toomaj MA, Ramavandi B, Bonyadi Z, Sillanpää M. Assessment of the health risk and geo-accumulation of toxic metals in agricultural soil and wheat, northern Iran. ENVIRONMENTAL MONITORING AND ASSESSMENT 2021; 193:750. [PMID: 34697651 DOI: 10.1007/s10661-021-09530-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/08/2021] [Indexed: 06/13/2023]
Abstract
The current work was conducted to study the concentrations of heavy metals (HMs) in farming soil and wheat and compute their geological and health indexes, including geo-accumulation index (Igeo), chronic daily intake (CDI), hazard index (HI), hazard quotient (HQ), and cancer risk (CR). In general, 256 samples were collected from agriculture soil (AS) and wheat in Kalaleh and Aq Qala areas, northern Iran. The average rates of Cd, Cu, Pb, and Zn were detected to be 0.28, 25.24, 15.44, and 60.33 mg·kg-1, respectively, for AS and 0.01, 8.85, 0.73, and 33.81 mg·kg-1 for wheat, respectively. Based on the results, the HQ and HI levels for investigated HMs were lower than l. So, the health risk of HMs exposure for adults and children was low. CR levels for Pb in AS for both children and adults were observed greater than the threshold value. Accordingly, lead-contaminated soil will be carcinogenic if ingested by children. On the other hand, the exposure to Pb (through wheat) and Cd (through both soil and wheat) had the acceptable CR level for all groups. As a result, for an extended period, there are no significant health consequences for children and adults.
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Affiliation(s)
- Ali Zafarzadeh
- Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Golestan, Iran
- Environmental Health Engineering Department, Faculty of Health, Golestan University of Medical Sciences, Golestan, Iran
| | - Jomeh Mohammad Taghani
- Environmental Health Engineering Department, Faculty of Health, Golestan University of Medical Sciences, Golestan, Iran
| | - Mohammad Amin Toomaj
- Environmental Health Engineering Department, Faculty of Health, Golestan University of Medical Sciences, Golestan, Iran
- School of Civil Engineering and Surveying, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia
| | - Bahman Ramavandi
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Ziaeddin Bonyadi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Environmental Health Engineering Department, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mika Sillanpää
- Environmental Engineering and Management Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
- Faculty of Environment and Labour Safety, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
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Roshandel G, Ferlay J, Ghanbari-Motlagh A, Partovipour E, Salavati F, Aryan K, Mohammadi G, Khoshaabi M, Sadjadi A, Davanlou M, Asgari F, Abadi H, Aghaei A, Ahmadi-Tabatabaei SV, Alizadeh-Barzian K, Asgari A, Asgari N, Azami S, Cheraghi M, Enferadi F, Eslami-Nasab M, Fakhery J, Farahani M, Farrokhzad S, Fateh M, Ghasemi A, Ghasemi-Kebria F, Gholami H, Golpazir A, Hasanpour-Heidari S, Hazar N, Hoseini-Hoshyar H, Izadi M, Jahantigh M, Jalilvand A, Jazayeri SM, Kazemzadeh Y, Khajavi M, Khalednejad M, Khanloghi M, Kooshki M, Madani A, Mirheidari M, Mohammadifar H, Moinfar Z, Mojtahedzadeh Y, Morsali A, Motidost-Komleh R, Mousavi T, Narooei M, Nasiri M, Niksiar S, Pabaghi M, Pirnejad H, Pournajaf A, Pourshahi G, Rahnama A, Rashidpoor B, Ravankhah Z, Rezaei K, Rezaianzadeh A, Sadeghi G, Salehifar M, Shahdadi A, Shahi M, Sharifi-Moghaddam F, Sherafati R, Soleimani A, Soltany-Hojatabad M, Somi MH, Yadolahi S, Yaghoubi-Ashrafi M, Zareiyan A, Poustchi H, Zendehdel K, Ostovar A, Janbabaei G, Raeisi A, Weiderpass E, Malekzadeh R, Bray F. Cancer in Iran 2008 to 2025: Recent incidence trends and short-term predictions of the future burden. Int J Cancer 2021; 149:594-605. [PMID: 33884608 DOI: 10.1002/ijc.33574] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/25/2021] [Accepted: 03/12/2021] [Indexed: 12/21/2022]
Abstract
Policymakers require estimates of the future number of cancer patients in order to allocate finite resources to cancer prevention, treatment and palliative care. We examine recent cancer incidence trends in Iran and present predicted incidence rates and new cases for the entire country for the year 2025. We developed a method for approximating population-based incidence from the pathology-based data series available nationally for the years 2008 to 2013, and augmented this with data from the Iranian National Population-based Cancer Registry (INPCR) for the years 2014 to 2016. We fitted time-linear age-period models to the recent incidence trends to quantify the future cancer incidence burden to the year 2025, delineating the contribution of changes due to risk and those due to demographic change. The number of new cancer cases is predicted to increase in Iran from 112 000 recorded cases in 2016 to an estimated 160 000 in 2025, a 42.6% increase, of which 13.9% and 28.7% were attributed to changes in risk and population structure, respectively. In terms of specific cancers, the greatest increases in cases are predicted for thyroid (113.8%), prostate (66.7%), female breast (63.0%) and colorectal cancer (54.1%). Breast, colorectal and stomach cancers were the most common cancers in Iran in 2016 and are predicted to remain the leading cancers nationally in 2025. The increasing trends in incidence of most common cancers in Iran reinforce the need for the tailored design and implementation of effective national cancer control programs across the country.
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Affiliation(s)
- Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
- Iranian National Population-Based Cancer Registry Secretariat, Cancer Office, Deputy of Health, Ministry of Health, Tehran, Iran
| | - Jacques Ferlay
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Ali Ghanbari-Motlagh
- National Cancer Management Committee, Deputy of Health, Ministry of Health, Tehran, Iran
| | - Elham Partovipour
- Iranian National Population-Based Cancer Registry Secretariat, Cancer Office, Deputy of Health, Ministry of Health, Tehran, Iran
| | - Fereshteh Salavati
- Iranian National Population-Based Cancer Registry Secretariat, Cancer Office, Deputy of Health, Ministry of Health, Tehran, Iran
| | - Kimia Aryan
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gohar Mohammadi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Khoshaabi
- Iranian National Population-Based Cancer Registry Secretariat, Cancer Office, Deputy of Health, Ministry of Health, Tehran, Iran
| | - Alireza Sadjadi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fereshteh Asgari
- Iranian National Population-Based Cancer Registry Secretariat, Cancer Office, Deputy of Health, Ministry of Health, Tehran, Iran
| | - Hakimeh Abadi
- Booshehr Cancer Registry, Booshehr University of Medical Sciences, Booshehr, Iran
| | - Abbas Aghaei
- Cancer and Immunology Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | | | - Abbasali Asgari
- Shahrekoord Cancer Registry, Shahrekoord University of Medical Sciences, Shahrekoord, Iran
| | - Noorali Asgari
- Zabol Cancer Registry, Zabol University of Medical Sciences, Zabol, Iran
| | - Soheyla Azami
- Saveh Cancer Registry, Saveh Faculty of Medical Sciences, Saveh, Iran
| | - Maria Cheraghi
- Cancer Research Center, Cancer Registry Section, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Floria Enferadi
- Khorasan-North Cancer Registry, Khorasan-North University of Medical Sciences, Bojnord, Iran
| | | | - Jila Fakhery
- Khoy Cancer Registry, Khoy Faculty of Medical Sciences, Khoy, Iran
| | - Mohsen Farahani
- Arak Cancer Registry, Arak University of Medical Sciences, Arak, Iran
| | - Solmaz Farrokhzad
- Qazvin Cancer Registry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mansooreh Fateh
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahrood, Iran
| | - Ali Ghasemi
- Birjand Cancer Registry, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hajar Gholami
- Ardabil Cancer Registry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Arash Golpazir
- Kermanshah Cancer Registry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Susan Hasanpour-Heidari
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Narjes Hazar
- Department of Community Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mohsen Izadi
- Gerash Cancer Registry, Gerash Faculty of Medical Sciences, Gerash, Iran
| | - Mahdi Jahantigh
- Zahedan Cancer Registry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ahmad Jalilvand
- Zanjan Cancer Registry, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Yasan Kazemzadeh
- Khomein Cancer Registry, Khomein Faculty of Medical Sciences, Khomein, Iran
| | - Maryam Khajavi
- Dezful Cancer Registry, Dezful University of Medical Sciences, Dezful, Iran
| | - Maryam Khalednejad
- Alborz Cancer Registry, Alborz University of Medical Sciences, Karaj, Iran
| | - Marziyeh Khanloghi
- Nishabour Cancer Registry, Nishabour Faculty of Medical Sciences, Nishabour, Iran
| | - Maryam Kooshki
- Lorestan Cancer Registry, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Amineh Madani
- Abadan Cancer Registry, Abadan Faculty of Medical Sciences, Abadan, Iran
| | - Mahdi Mirheidari
- Qom Cancer Registry, Qom University of Medical Sciences, Qom, Iran
| | | | - Zeinab Moinfar
- Tehran Cancer Registry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Morsali
- Asadabad Cancer Registry, Asadabad Faculty of Medical Sciences, Asadabad, Iran
| | | | - Tahereh Mousavi
- Babol Cancer Registry, Babol University of Medical Sciences, Babol, Iran
| | - Maboobeh Narooei
- Iranshahr Cancer Registry, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Mohammad Nasiri
- Shooshtar Cancer Registry, Shooshtar Faculty of Medical Sciences, Shooshtar, Iran
| | - Sharareh Niksiar
- Hamedan Cancer Registry, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Mehdi Pabaghi
- Larestan Cancer Registry, Larestan Faculty of Medical Sciences, Lar, Iran
| | - Habibollah Pirnejad
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Azadeh Pournajaf
- Ilam Cancer Registry, Ilam University of Medical Sciences, Ilam, Iran
| | - Gita Pourshahi
- Torbatejam Cancer Registry, Torbatejam Faculty of Medical Sciences, Torbatejam, Iran
| | - Amir Rahnama
- Rafsanjan Cancer Registry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Bahman Rashidpoor
- Yasoj Cancer Registry, Yasoj University of Medical Sciences, Yasoj, Iran
| | - Zahra Ravankhah
- Esfahan Cancer Registry, Esfahan University of Medical Sciences, Esfahan, Iran
| | - Khadijeh Rezaei
- Mashhad Cancer Registry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Rezaianzadeh
- Shiraz Cancer Registry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Sadeghi
- Guilan Cancer Registry, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Salehifar
- Torbateheidarieh Cancer Registry, Torbateheidarieh University of Medical Sciences, Torbatheidarieh, Iran
| | - Athareh Shahdadi
- Jiroft Cancer Registry, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Mehraban Shahi
- Hormozgan Cancer Registry, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Roya Sherafati
- Sarab Cancer Registry, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Ali Soleimani
- Maragheh Cancer Registry, Maragheh Faculty of Medical Sciences, Maragheh, Iran
| | | | - Mohammad-Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sohrab Yadolahi
- Semnan Cancer Registry, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Aliakbar Zareiyan
- Jahrom Cancer Registry, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Raeisi
- Deputy Minister of Health, Ministry of Health, Tehran, Iran
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
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Cui Y, Guo W, Li Y, Shi J, Ma S, Guan F. Pan-cancer analysis identifies ESM1 as a novel oncogene for esophageal cancer. Esophagus 2021; 18:326-338. [PMID: 33175267 DOI: 10.1007/s10388-020-00796-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/30/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Recent studies highlight the crucial role of endothelial cell-specific molecule 1 (ESM1) in the development of multiple cancer types. However, its aberrant expression and prognostic value in human pan-cancer have largely not been described. METHODS AND RESULTS In this study, we used The Cancer Genome Atlas (TCGA) analysis databases to explore the expression level and prognostic significance of ESM1 in 33 types of human cancer. ESM1 was shown to be over-expressed in 12 cancer types, including BLCA, BRCA, COAD, CHOL, ESCA, HNSC, KIRC, KICH, LIHC, STAD, THCA, and UCEC. The expression of ESM1 was significantly correlated with the overall survival (OS) of patients in CESC, ESCA, KIRC, and KIRP. In addition, high ESM1 level indicated poor disease-free survival (DFS) of patients with ACC, ESCA, PRAD, LIHC, KIRP, and UCS. Through comparative analysis, we discovered that ESM1 was dramatically up-regulated in esophageal cancer (ESCA) and associated with worse patient OS and DFS. The elevation of ESM1 in ESCA was confirmed by the datasets from Cancer RNA-Seq Nexus (CRN) and Gene Expression Omnibus (GEO). Based on Gene Set Enrichment Analysis (GSEA), we analyzed the co-expressed genes of ESM1 in ESCA, and found that ESM1 was closely implicated in cell proliferation and migration and the regulation of Janus kinase (JAK) signaling pathway. Functionally, knockdown of ESM1 significantly suppressed cell proliferation and migration, and decreased the protein level of JAK1. CONCLUSIONS Taken together, our results suggest for the first time that ESM1 functions as an oncogene and may be a clinical biomarker and/or therapeutic target in ESCA.
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Affiliation(s)
- Yuanbo Cui
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China.
| | - Wenna Guo
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Ya Li
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Jijing Shi
- Central Lab of the First People's Hospital of Zhengzhou, Zhengzhou, 450001, China
| | - Shanshan Ma
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Fangxia Guan
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China.
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