1
|
Valian H, Hassan Emami M, Heidari A, Amjadi E, Fahim A, Lalezarian A, Ali Ehsan Dehkordi S, Maghool F. Trend of the polyp and adenoma detection rate by sex and age in asymptomatic average-risk and high-risk individuals undergoing screening colonoscopy, 2012-2019. Prev Med Rep 2023; 36:102468. [PMID: 37869540 PMCID: PMC10587514 DOI: 10.1016/j.pmedr.2023.102468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
Adenoma detection rate (ADR) is an imperative quality measure for colorectal cancer (CRC) screening. This retrospective observational study aimed to determine the trend of polyp detection rate (PDR) and ADR in asymptomatic average- and high-risk participants in different age groups who underwent screening colonoscopy over the seven years from April 2012 to March 2019 in a tertiary gastroenterology referral center of Iran. Of 1676 participants, 51.8 % were men (mean age 52.3 years). The overall PDR and ADR were 22.7 %, and 13.5 %, respectively. Both Polyps and adenomas were more common in age groups 51-59 and ≥60 years in high-risk patients than in the corresponding groups of average-risk patients (p < 0.05). Also, both PDR and ADR were more frequent in men than in women among all studied age groups, but it was statistically significant only for the youngest age group (16.8 % versus 10.5 %, p < 0.05) for PDR and the oldest age group (19.7 % versus 13 %, p < 0.05) for ADR, respectively. The trend of total ADR was upward over 7 years in both average-risk (6.7 % to 13.3 %) and high-risk (9.8 % to 27 %) groups and across all age groups in both sexes. Multivariable logistic regression revealed that high-risk individuals had an elevated risk of adenoma compared with average-risk patients (OR: 1.6, p = 0.006). Substantial variation in thresholds of polyp and adenoma detection by age, sex, and risk categories emphasizes the need for a risk-adapted approach to CRC screening and prevention programs.
Collapse
Affiliation(s)
- Hengameh Valian
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Emami
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aida Heidari
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Sciences and Technologies, University of Isfahan, Isfahan, Iran
| | - Elham Amjadi
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Fahim
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Anasik Lalezarian
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Fatemeh Maghool
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Sciences and Technologies, University of Isfahan, Isfahan, Iran
- Department of Family Medicine, University of Debrecen, Debrecen, Hungary
| |
Collapse
|
2
|
Bampidis V, Azimonti G, Bastos MDL, Christensen H, Dusemund B, Durjava M, Kouba M, López‐Alonso M, López Puente S, Marcon F, Mayo B, Pechová A, Petkova M, Ramos F, Sanz Y, Villa RE, Woutersen R, Brantom P, Chesson A, Westendorf J, Manini P, Casanova JO, Dusemund B. Safety and efficacy of a feed additive consisting of Macleaya cordata (Willd.) R. Br. extract and leaves (Sangrovit® extra) for all poultry species (excluding laying and breeding birds) (Phytobiotics Futterzusatzstoffe GmbH). EFSA J 2023; 21:e08052. [PMID: 37304353 PMCID: PMC10251260 DOI: 10.2903/j.efsa.2023.8052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
Following a request from the European Commission, EFSA was asked to deliver a scientific opinion on the safety and efficacy of Macleaya cordata (Willd.) R. Br. extract and leaves (Sangrovit® Extra) when used as a zootechnical feed additive (functional group: other zootechnical additives) for all poultry species (excluding laying and breeding birds). The additive is standardised to contain a concentration of the sum of the four alkaloids sanguinarine, chelerythrine, protopine and allocryptopine of 1.25%, with 0.5% sanguinarine. Owing to the presence of the DNA intercalators sanguinarine and chelerythrine, a concern for genotoxicity was identified. The EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP) had no safety concerns when the additive is used at the recommended level of 150 mg/kg complete feed (corresponding to 0.750 mg sanguinarine/kg complete feed) for chickens for fattening and other poultry species for fattening. No conclusion can be drawn for poultry reared for laying/breeding. The use of Sangrovit® Extra in poultry species for fattening at the maximum recommended level was considered of low concern for consumers. The additive was shown to be irritant to the eyes but not irritant to skin or a skin sensitiser. The FEEDAP Panel could not exclude the potential of the additive to be a respiratory sensitiser. When handling the additive, exposure of unprotected users to sanguinarine and chelerythrine may occur. Therefore, to reduce the risk, the exposure of users should be reduced. The use of Sangrovit® Extra as a feed additive under the proposed conditions of use was considered safe for the environment. The additive Sangrovit® Extra had the potential to be efficacious in improving performance of chickens for fattening at 45 mg/kg complete feed. This conclusion was extended to chickens reared for laying/breeding and extrapolated to all poultry species for fattening or reared for laying/breeding.
Collapse
|
3
|
Expression and Prognostic Significance of Stem Cell Marker CD133 in Survival Rate of Patients with Colon Cancer. Oncol Ther 2022; 10:451-461. [PMID: 35980560 DOI: 10.1007/s40487-022-00205-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/08/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Today, colon cancer is one of the most common types of gastrointestinal cancer worldwide. CD133 as a known cancer stem cell marker has been found effective in cell proliferation and differentiation in various cancers, including colon cancer. We aimed to investigate the relationship between CD133 expression in colon cancer with prognostic factors and survival rate of patients with colon cancer by immunohistochemistry. METHODS Formalin-fixed paraffin-embedded (FFPE) tissue was taken from patients with colon cancer. Histopathology examination was done using hematoxylin and eosin staining. Immunohistochemistry was performed to determine CD133 expression. Association between CD133 expression and clinicopathological profile was then assessed. RESULTS There was a statistically significant association between CD133 protein expression and sex , cancer stage, and lymphatic invasion (p = 0.044, p = 0.131, and p = 0.002, respectively). However, no significant correlation was identified between CD133 expression and other factors, including age of patients with colorectal cancer (CRC) (p = 0.267), tumor location (p = 0.494), tumor differentiation grade (p = 0.263), neural tissue invasion, and 5-year survival (p = 0.054). CONCLUSION CD133 is a useful predictive or prognostic biomarker for CRC in clinical assessment and may serve as a potential therapeutic target for CRC.
Collapse
|
4
|
Rasmussen PV, Dalgaard F, Gislason GH, Brandes A, Johnsen SP, Grove EL, Torp-Pedersen C, Dybro L, Harboe L, Münster AMB, Pedersen L, Blanche P, Pallisgaard JL, Hansen ML. Gastrointestinal bleeding and the risk of colorectal cancer in anticoagulated patients with atrial fibrillation. Eur Heart J 2022; 43:e38-e44. [PMID: 32030399 DOI: 10.1093/eurheartj/ehz964] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/24/2019] [Accepted: 12/31/2019] [Indexed: 12/17/2023] Open
Abstract
AIMS Gastrointestinal bleeding (GI-bleeding) is frequent in patients with atrial fibrillation (AF) treated with oral anticoagulation (OAC) therapy. We sought to investigate to what extent lower GI-bleeding represents the unmasking of an occult colorectal cancer. METHODS AND RESULTS A total of 125 418 Danish AF patients initiating OAC therapy were identified using Danish administrative registers. Non-parametric estimation and semi-parametric absolute risk regression were used to estimate the absolute risks of colorectal cancer in patients with and without lower GI-bleeding. During a maximum of 3 years of follow-up, we identified 2576 patients with lower GI-bleeding of whom 140 patients were subsequently diagnosed with colorectal cancer within the first year of lower GI-bleeding. In all age groups, we observed high risks of colorectal cancer after lower GI-bleeding. The absolute 1-year risk ranged from 3.7% [95% confidence interval (CI) 2.2-6.2] to 8.1% (95% CI 6.1-10.6) in the age groups ≤65 and 76-80 years of age, respectively. When comparing patients with and without lower GI-bleeding, we found increased risk ratios of colorectal cancer across all age groups with a risk ratio of 24.2 (95% CI 14.5-40.4) and 12.3 (95% CI 7.9-19.0) for the youngest and oldest age group of ≤65 and >85 years, respectively. CONCLUSION In anticoagulated AF patients, lower GI-bleeding conferred high absolute risks of incident colorectal cancer. Lower GI-bleeding should not be dismissed as a benign consequence of OAC therapy but always examined for a potential underlying malignant cause.
Collapse
Affiliation(s)
- Peter Vibe Rasmussen
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark
| | - Frederik Dalgaard
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark
| | - Gunnar Hilmar Gislason
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Noerre Alle 20, 2200, Copenhagen, Denmark
- The Danish Heart Foundation, Vognmagergade 7, 1120, Copenhagen, Denmark
| | - Axel Brandes
- Department of Cardiology, Odense University Hospital, Kloevervaenget 47, 5000, Odense, Denmark
| | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Moelleparkvej10, 9000, Aalborg, Denmark
| | - Erik Lerkevang Grove
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark
| | - Christian Torp-Pedersen
- Departments of Clinical Investigation and Cardiology, Nordsjaellands Hospital, Kongens Vænge 2, 3400 Hillerød, Denmark
- Department of Cardiology, Aalborg University Hospital, Hobrobej 18-22, 9000 Aalborg, Denmark
| | - Lars Dybro
- Bristol-Myers Squibb and Pfizer, Denmark. Hummeltoftevej 49, 2830, Virum and Lautrupvang 8, 2750 Ballerup, Denmark
| | - Louise Harboe
- Bristol-Myers Squibb and Pfizer, Denmark. Hummeltoftevej 49, 2830, Virum and Lautrupvang 8, 2750 Ballerup, Denmark
| | - Anna-Marie Bloch Münster
- Unit for Thrombosis Research, Hospital of SouthWest Denmark, Department of Regional Health Research, University of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark
| | - Lasse Pedersen
- Department of Surgical Gastroenterology, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Paul Blanche
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark
- Department of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, Entrance B, 2nd floor, 1014 Copenhagen, Denmark
| | - Jannik Langtved Pallisgaard
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark
| | - Morten Lock Hansen
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark
| |
Collapse
|
5
|
Hoseini B, Rahmatinejad Z, Goshayeshi L, Bergquist R, Golabpour A, Ghaffarzadegan K, Rahmatinejad F, Darrudi R, Eslami S. Colorectal Cancer in North-Eastern Iran: a retrospective, comparative study of early-onset and late-onset cases based on data from the Iranian hereditary colorectal cancer registry. BMC Cancer 2022; 22:48. [PMID: 34998373 PMCID: PMC8742430 DOI: 10.1186/s12885-021-09132-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 12/21/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The incidence rate of colorectal cancer (CRC) is increasing among patients below 50 years of age. The reason for this is unclear, but could have to do with the fact that indicative variables, such as tumour location, gender preference and genetic preponderance have not been followed up in a consistent mann er. The current study was primarily conducted to improve the hereditary CRC screening programme by assessing the demographic and clinicopathological characteristics of early-onset CRC compared to late-onset CRC in northeast Iran. METHODS This retrospective study, carried out over a three-year follow-up period (2014-2017), included 562 consecutive CRCs diagnosed in three Mashhad city hospital laboratories in north-eastern Iran. We applied comparative analysis of pathological and hereditary features together with information on the presence of mismatch repair (MMR) gene deficiency with respect to recovery versus mortality. Patients with mutations resulting in absence of the MMR gene MLH1 protein product and normal BRAF status were considered to be at high risk of Lynch syndrome (LS). Analyses using R studio software were performed on early-onset CRC (n = 222) and late-onset CRC (n = 340), corresponding to patients ≤50 years of age and patients > 50 years. RESULTS From an age-of-onset point of view, the distribution between the genders differed with females showing a higher proportion of early-onset CRC than men (56% vs. 44%), while the late-onset CRC disparity was less pronounced (48% vs. 52%). The mean age of all participants was 55.6 ± 14.8 years, with 40.3 ± 7.3 years for early-onset CRC and 65.1 ± 9.3 years for late-onset CRC. With respect to anatomical tumour location (distal, rectal and proximal), the frequencies were 61, 28 and 11%, respectively, but the variation did not reach statistical significance. However, there was a dramatic difference with regard to the history of CRC in second-degree relatives between two age categories, with much higher numbers of family-related CRCs in the early-onset group. Expression of the MLH1 and PMS2 genes were significantly different between recovered and deceased, while this finding was not observed with regard to the MSH6 and the MSH2 genes. Mortality was significantly higher in those at high risk of LS. CONCLUSION The variation of demographic, pathological and genetic characteristics between early-onset and late-onset CRC emphasizes the need for a well-defined algorithm to identify high-risk patients.
Collapse
Affiliation(s)
- Benyamin Hoseini
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Rahmatinejad
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ladan Goshayeshi
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Robert Bergquist
- Formerly UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
- Ingerod, SE-454 94, Brastad, Sweden
| | - Amin Golabpour
- School of Paramedical , Shahroud University of Medical Sciences, Shahroud, Iran
| | - Kamran Ghaffarzadegan
- Pathology Department, Education and Research Department, Razavi Hospital, Mashhad, Iran
| | - Fatemeh Rahmatinejad
- Department of Health Information Technology, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Darrudi
- Department of Health Information Technology, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Saeid Eslami
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
| |
Collapse
|
6
|
Mohammadi M, Mirzaei H, Motallebi M. The role of anaerobic bacteria in the development and prevention of colorectal cancer: A review study. Anaerobe 2021; 73:102501. [PMID: 34906686 DOI: 10.1016/j.anaerobe.2021.102501] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/15/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023]
Abstract
Colorectal cancer (CRC) is the third most frequently diagnosed cancer in both males and females in the Unites States. Colonoscopy is considered a safe method for screening this disorder; however, it can be challenging for patients. As research on microbiota, especially anaerobic microbiota, has expanded substantially, new links have been determined between anaerobic bacteria and CRC progression. These associations can be useful in screening CRC in the near future. This review discusses current research investigating the presence of anaerobic bacteria, including Bacteroides fragilis, Peptostreptococcus anaerobius, Clostridium septicum, Porphyromonas gingivalis, Fusobacterium nucleatum, and Parvimonas micra in CRC and presents an overview about their mechanisms of action. We also discuss the current anaerobic probiotics used for the treatment and prevention of CRC.
Collapse
Affiliation(s)
- Mehrdad Mohammadi
- Department of Immunology and Microbiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Mitra Motallebi
- Department of Immunology and Microbiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
| |
Collapse
|
7
|
Borah G, Bharali MK. Green tea catechins in combination with irinotecan attenuates tumorigenesis and treatment-associated toxicity in an inflammation-associated colon cancer mice model. J Egypt Natl Canc Inst 2021; 33:17. [PMID: 34308509 DOI: 10.1186/s43046-021-00074-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Administration of green tea (GT) catechins has been reported to ensue antitumor activity in combination with chemotherapeutic drugs against different cancer types. Irinotecan (IRN) is a highly effective chemotherapeutic drug against various types of cancer including colon cancer along with its analogous dose-limiting side effects viz. diarrhea, neutropenia, leucopenia, and non-alcoholic fatty liver disease (NAFLD) as major toxicities. METHODS In this study, we investigated the antitumor effects of GT alone or in combination with IRN in inflammation-associated colon cancer mouse model induced by azoxymethane (AOM) and dextran sulfate sodium (DSS). We also evaluated the effect of GT- on IRN-induced toxicity and histopathological alterations. Animals were divided into six groups (n = 5 per group). After induction of cancer model, animals were treated with GT and/or IRN. We observed the inflammation, tumor progression, and ameliorative effects of GT and IRN alone or in combination. RESULTS Because of antioxidant potential of GT, IRN-induced toxicity ameliorative effect of GT was also studied in combined treated groups. It was found that co-administration of IRN and GT significantly decreased number of tumors and simultaneously was found to ameliorate diarrhea along with leucopenia and neutropenia. Besides these, mitigation of adenomatous characters and NAFLD was also observed in the IRN- and GT-treated group when analyzed histologically. CONCLUSIONS GT significantly reduced the toxicity induced by IRN in terms of diarrhea, neutropenia, leucopenia, and NAFLD and works as an effective anticancer agent as it mitigates histopathology of colon adenocarcinoma.
Collapse
Affiliation(s)
- Gaurab Borah
- Cell & Molecular Biology Section, Department of Zoology, Rajiv Gandhi University, Rono Hills, Doimukh, Itanagar, Arunachal Pradesh, 791112, India
| | - Manuj Kumar Bharali
- Cell & Molecular Biology Section, Department of Zoology, Rajiv Gandhi University, Rono Hills, Doimukh, Itanagar, Arunachal Pradesh, 791112, India.
| |
Collapse
|
8
|
Shariati A, Razavi S, Ghaznavi-Rad E, Jahanbin B, Akbari A, Norzaee S, Darban-Sarokhalil D. Association between colorectal cancer and Fusobacterium nucleatum and Bacteroides fragilis bacteria in Iranian patients: a preliminary study. Infect Agent Cancer 2021; 16:41. [PMID: 34108031 PMCID: PMC8191199 DOI: 10.1186/s13027-021-00381-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/31/2021] [Indexed: 12/02/2022] Open
Abstract
Background and aim Recent studies have proposed that commensal bacteria might be involved in the development and progression of gastrointestinal disorders such as colorectal cancer (CRC). Therefore, in this study, the relative abundance of Fusobacterium nucleatum, Bacteroides fragilis, Streptococcus bovis/gallolyticus, and Enteropathogenic Escherichia coli (EPEC) in CRC tissues, and their association with clinicopathologic characteristics of CRC was investigated in Iranian patients. Moreover, the role of these bacteria in the CRC-associated mutations including PIK3CA, KRAS, and BRAF was studied. Method To these ends, the noted bacteria were quantified in paired tumors and normal tissue specimens of 30 CRC patients, by TaqMan quantitative Real-Time Polymerase Chain Reaction (qPCR). Next, possible correlations between clinicopathologic factors and mutations in PIK3CA, KRAS, and BRAF genes were analyzed. Results In studied samples, B. fragilis was the most abundant bacteria that was detected in 66 and 60% of paired tumor and normal samples, respectively. Furthermore, 15% of the B. fragilis-positive patients were infected with Enterotoxigenic B. fragilis (ETBF) in both adenocarcinoma and matched adjacent normal samples. F. nucleatum was also identified in 23% of tumors and 13% of adjacent normal tissue samples. Moreover, the relative abundance of these bacteria determined by 2-ΔCT was significantly higher in CRC samples than in adjacent normal mucosa (p < 0.05). On the other hand, our findings indicated that S. gallolyticus and EPEC, compared to adjacent normal mucosa, were not prevalent in CRC tissues. Finally, our results revealed a correlation between F. nucleatum-positive patients and the KRAS mutation (p = 0.02), while analyses did not show any association between bacteria and mutation in PIK3CA and BRAF genes. Conclusion The present study is the first report on the analysis of different bacteria in CRC tissue samples of Iranian patients. Our findings revealed that F. nucleatum and B. fragilis might be linked to CRC. However, any link between gut microbiome dysbiosis and CRC remains unknown.
Collapse
Affiliation(s)
- Aref Shariati
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam Razavi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsanollah Ghaznavi-Rad
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Arak University of Medical Sciences, Arak, Iran
| | - Behnaz Jahanbin
- Department of Pathology, Cancer Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
| | - Abolfazl Akbari
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Norzaee
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. .,Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
9
|
A systematic review and meta-analysis of the DNA methylation in colorectal cancer among Iranian population. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
10
|
Wong SW, Ling DY, Yeow RQ, Chong RW, Aziz MRA, Aziz NA, Poh KS, Roslani AC. Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: an institutional cohort study. Singapore Med J 2021; 62:636-641. [PMID: 34005846 DOI: 10.11622/smedj.2021051] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to investigate the clinicopathological patterns and survival outcomes of young-onset colorectal cancer (CRC) in Malaysia. METHODS The study consisted of 206 patients with young-onset CRC (age < 50 years at diagnosis) and 1,921 patients with late-onset CRC (age ≥ 50 years at diagnosis) diagnosed during 2002-2016. The clinicopathological characteristics of patients with young-onset CRC were compared with those of patients with late-onset CRC during 2009-2013. Kaplan-Meier survival analysis was performed to determine the overall survival (OS) and disease-specific survival (DSS) in these patients. RESULTS The overall proportion of young-onset CRC was 10.7%. Mean age for young-onset CRC was 39.5 ± 7.4 years, with male-to-female ratio of 1.2:1.0. There were more Malay patients with young-onset CRC than late-onset CRC (44.0% vs. 19.9%, p = 0.004). Most CRC were diagnosed at advanced stage in both groups. However, young-onset CRC showed more aggressive tumour characteristics, such as poorer differentiation and mucinous subtype. Despite such differences, OS and DSS in both groups were similar (five-year OS for young-onset CRC vs. late-onset CRC: 44.2% vs. 49.0%, p = 0.40; five-year DSS for young-onset CRC vs. late-onset CRC: 48.8% vs. 57.6%, p = 0.53; mean survival of young-onset CRC vs. late-onset CRC: 4.9 years vs. 5.4 years, p = 0.15). Advanced stage at diagnosis and treatment modality were independent prognostic factors. CONCLUSION The unique ethnic and histological differences between patients with young- and late-onset CRC suggest that young-onset CRC may represent a distinct entity. However, despite such differences, prognosis between both groups were equivalent.
Collapse
Affiliation(s)
- Sui-Weng Wong
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Dao-Yao Ling
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Ri-Qi Yeow
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Ro-Wan Chong
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | - Nora Abdul Aziz
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Keat-Seong Poh
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | |
Collapse
|
11
|
Kedar I, Walsh L, Levi GR, Lieberman S, Shtaya AA, Nathan SN, Lagovsky I, Tomashov-Matar R, Goldenberg M, Basel-Salmon L, Katz L, Aleme O, Peretz TY, Hubert A, Rothstein D, Castellvi-Bel S, Walsh T, King MC, Pritchard CC, Levi Z, Half E, Laish I, Goldberg Y. A novel founder MSH2 deletion in Ethiopian Jews is mainly associated with early-onset colorectal cancer. Fam Cancer 2021; 21:181-188. [PMID: 33837488 DOI: 10.1007/s10689-021-00249-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
Lynch syndrome is an inherited cancer predisposition syndrome caused by germline defects in any of the mismatch repair (MMR) genes. Diagnosis of carriers makes precision prevention, early detection, and tailored treatment possible. Herein we report a novel founder deletion of 18,758 bp, mediated by Alu repeats on both sides, detected in Ethiopian Jews. The deletion, which encompasses exon 9-10 of the MSH2 coding sequence, is associated mainly with early-onset MSH2/MSH6-deficient colorectal cancer (CRC) and liposarcoma. Testing of 35 members of 5 seemingly unrelated families of Ethiopian origin yielded 10/21 (48%) carriers, of whom 9 had CRC. Age at first tumor diagnosis ranged from 16 to 89 years. Carriers from the oldest generations were diagnosed after age 45 years (mean 57), and carriers from the younger generation were diagnosed before age 45 years (mean 30). Awareness of this founder deletion is important to improve patient diagnosis, institute surveillance from an early age, and refer patients for genetic counseling addressing the risk of bi-allelic constitutional MMR deficiency syndrome.
Collapse
Affiliation(s)
- I Kedar
- The Raphael Recanati Genetics Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
| | - L Walsh
- Departments of Medicine and Genome Sciences, University of Washington, Seattle, WA, USA
| | - G Reznick Levi
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - S Lieberman
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - A Abu Shtaya
- Department of Internal Medicine, Carmel Medical Center, Haifa, Israel
| | - S Naftaly Nathan
- The Raphael Recanati Genetics Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
| | - I Lagovsky
- The Raphael Recanati Genetics Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
| | - R Tomashov-Matar
- The Raphael Recanati Genetics Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
| | - M Goldenberg
- The Raphael Recanati Genetics Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
| | - L Basel-Salmon
- The Raphael Recanati Genetics Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L Katz
- Department of Gastroenterology and Hepatology, Hadassah Medical Center, Jerusalem, Israel
| | - O Aleme
- Genetics Institute, Emek Medical Center, Afula, Israel
| | - T Yablonski Peretz
- Sharett Institute of Oncology, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - A Hubert
- Gastrointestinal Cancer Center, Sharett Institute of Oncology, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | | | - S Castellvi-Bel
- Gastroenterology Department, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Clínic, Barcelona, Spain
| | - T Walsh
- Departments of Medicine and Genome Sciences, University of Washington, Seattle, WA, USA
| | - M C King
- Departments of Medicine and Genome Sciences, University of Washington, Seattle, WA, USA
| | - C C Pritchard
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Z Levi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Gastroenterology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - E Half
- Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel
| | - I Laish
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Gastroenterology Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Y Goldberg
- The Raphael Recanati Genetics Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
12
|
Soodejani MT, Mirzaei H, Manesh MM, Tabatabaei SM, Ghaderi A. Incidence of Colorectal Cancer and Adenomatous Polyps After a Two-Step Screening in Isfahan Province, Iran in 2018. J Gastrointest Cancer 2021; 51:850-854. [PMID: 31656018 DOI: 10.1007/s12029-019-00313-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of this study was to estimate the incidence of colorectal cancers in Iran. The results of this study are based on a screening program that is being implemented in Isfahan province. MATERIAL AND METHODS In this study, about 137,000 people were screened for colorectal cancer and adenomatous polyps in 2 steps during the year 2018. RESULTS Based on the findings of this study, the incidence of adenomatous polyps was reported to be 389 (95% CI, 365-422) per 100,000 population. The incidence of adenomatous polyps was reported to be 483 (95% CI, 446-520) and 316 (95% CI, 286-346) in men and women, respectively (p < 0.001). Also, the incidence of colorectal cancer was reported to be 33 (95% CI, 23-42) per 100,000 population. The incidence of colorectal cancer in men and women was reported to be 41 (95% CI, 30-51) and 26 (95% CI, 17-34), respectively, indicating a statistically non-significant difference (p = 0.29). CONCLUSION Based on the result of this study, despite a low participation rate of the target population in the screening program, the incidence of adenomatous polyps and colorectal cancer is relatively high in the average-risk population.
Collapse
Affiliation(s)
- Moslem Taheri Soodejani
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Mirzaei
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Marzieh Mahmoodi Manesh
- Department of Epidemiology and Biostatistics, School of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyyed Mohammad Tabatabaei
- Medical Informatics Department, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Imam Reza Hospital Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran.
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Azimeh Ghaderi
- Department of Fighting Against Disease, Najaf Abad Health Services Center, Isfahan University of Medical Sciences, Najaf Abad, Iran
| |
Collapse
|
13
|
Yari A, Afzali A, Aalipour M, Nakheai M, Zahedi MJ. KRAS and BRAF mutations in Iranian colorectal cancer patients: A systematic review and meta-analysis. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 11:355-369. [PMID: 33680376 PMCID: PMC7911761 DOI: 10.22088/cjim.11.4.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Mutations in the EGFR signaling pathway play an important role in the development of colorectal cancer (CRC). Mutations in these genes, like KRAS and BRAF, affect the treatment strategies and associated with poor prognosis and relative resistance to anti-EGFR therapies. Our aim was to conduct a systematic and meta-analysis on all studies that have been conducted on the prevalence of these gene mutations in Iranian CRC patients. Methods: Four science citation index databases (MEDLINE, EMBASE, Web of Science and Cochrane library) and local databases were searched up to March 2018 with related keywords. Two reviewers independently screened and extracted the data. Quality of all included studies was assessed using an adapted checklist from STROBE. A random-effect model was used to calculate the total prevalence of KRAS and BRAF mutations in CRC subjects by the event rate (ER). Meta-regression was utilized to explore heterogeneity causes. Results: In total, from 573 records, 23 eligible studies (2662 patients) were included for data extraction and analysis. In 18 of 23 included studies, the prevalence of KRAS mutations was 33.9% (95% CI=30.1-37.9) with I2=65.17 (p<0.001). The occurrence of KRAS mutations in codon 12 and 13 was 76.9% (95% CI = 70.4-82.3%) with I2=84.88 (p<0.001) and 23.5% (95% CI=17.9-30.3) with I2=85.85 (p<0.001), respectively. In 9 of 23 studies, the BRAF mutation rate was 3.2% (95% CI=0.003-13.6) with I2=88.61 (p<0.001). Conclusion: The prevalence of these mutations in CRC patients shows a significant difference in the different regions of Iran, which is probably due to environmental and racial factors.
Collapse
Affiliation(s)
- Abolfazl Yari
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran.,Department of Medical Genetics, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Asiyeh Afzali
- Department of Medical Laboratory of Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Aalipour
- Department of Immunology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehran Nakheai
- Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Javad Zahedi
- Gastroenterology and Hepatology Research Center, Department of Internal Medicine, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
14
|
Safari M, Mahjub H, Esmaeili H, Abbasi M, Roshanaei G. Determining the Risk Factors Affecting on Death Due to Colorectal Cancer Progression: Survival Analysis in the Presence of Competing Risks. J Gastrointest Cancer 2021; 53:348-355. [PMID: 33656691 DOI: 10.1007/s12029-021-00609-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE In survival analysis, some patients may be at risk of more than one event, for example cancer-related death and cancer-unrelated death. In this case, if the aim of study becomes to assess the impact of risk factors on different causes of death, the competing risk model should be used rather than classical survival model. The aim of the present study is to determine the risk factors for related and unrelated mortality in patients with colorectal cancer using competing risk regression models. METHODS The present retrospective cohort study was carried out on 310 CRC patients. Death due to cancer progression was considered as the interest event, and death due to unrelated cancer was considered as a competing event. Two most popular methods, cause-specific and subdistribution hazard regression model, were used to determine the effect of covariates on incidence and cause-specific hazard. Data analysis was performed using R3.6.2 software and cmprsk and survival packages. RESULTS The mean (SD) of patients' age was 55.84 ± 13.2 years and 53.9% of them were male. BMI, T and N stage had a significant effect on both incidence and cause specific hazard of cancer-related death. CONCLUSION The results of this study showed that cancer-related death is strongly correlated with under-weight (BMI < 18.5) and advanced clinical stage of the disease in patients with colorectal cancer. So, in the presence of competing events, both types of regression hazard models should be applied to permit a full understanding of the impact of covariates on the incidence and the rate of occurrence of each outcome.
Collapse
Affiliation(s)
- Malihe Safari
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Mahjub
- Research Center for Health Sciences, Department of Biostatistics, Faculty of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Habib Esmaeili
- PhD in Mathematics, Principal Statistician and Project Lead, Staburo GmbH, Munich, Germany
| | - Mohammad Abbasi
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ghodratollah Roshanaei
- Associate Professor in Biostatistics, Department of Biostatistics, School of Public Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| |
Collapse
|
15
|
Saadati HM, Okhovat B, Khodamoradi F. Incidence and Risk Factors of Colorectal Cancer in the Iranian Population: a Systematic Review. J Gastrointest Cancer 2021; 52:414-421. [PMID: 33392963 DOI: 10.1007/s12029-020-00574-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Colorectal cancer (CRC) is one of the most common cancers in the world. The aim of this study was to investigate its incidence and risk factors in the Iranian population. METHODS A literature search was conducted in PubMed, Web of Science, Scopus, SID, and Magiran from inception until 2019. Studies that reported the incidence rate and risk factors of colorectal cancer were included in this review. RESULTS Twenty-one articles that reported the incidence rate and 13 that reported the risk factors were included. The incidence rate was different according to the population type, gender, age, and study year in different regions. The main risk factors for colorectal cancer were high consumption of red meat and fried food and low intake of fruits and vegetables, diabetes, a positive family history, and obesity. CONCLUSION The incidence of CRC has a marked variation in different parts of Iran, and various risk factors are associated with colorectal cancer. According to incidence rate and various risk factors, precise planning is needed to control colorectal cancer in the future.
Collapse
Affiliation(s)
- Hossein Mozafar Saadati
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Batool Okhovat
- Tehran West Health Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Khodamoradi
- Department of Community Medicine, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran. .,Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran. .,, Tehran, Iran.
| |
Collapse
|
16
|
Khoshdel A, Alimohammadi M, Sepandi M, Alimohamadi Y, Jalali P, Janani M. Spatio-temporal analysis of colorectal cancer using a geographic information system in the Iranian military community during the period 2007-2016. BMJ Mil Health 2020; 166:e8-e12. [PMID: 30772838 DOI: 10.1136/jramc-2018-001151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Colorectal cancer (CRC) is one of the most prevalent cancers among Iranian people. The study of spatio-temporal distribution of disease has an important role in the design of disease prevention programmes. The purpose of the current study was to describe the spatio-temporal distribution of CRC in the Iranian military community as a sample of the Iranian population. METHODS In the current ecological study, all registered cancer cases in the Iranian military community during the period 2007-2016 were considered. To identify hotspots, Getis-Ord Gi statistics were used. All analyses were performed using ArcGIS 10.5 and Excel 2010. RESULTS The highest incidences of CRC in 2007-2008, 2009-2010 and 2011-2012 were recorded in Kermanshah province. The highest incidences of CRC in 2013-2014 were seen in Kermanshah, Ghilan, Tehran and North Khorasan. In 2007-2008 and 2009-2010, hotspots were detected in West Azarbayjan. In 2011-2012, hotspots were detected in Zanjan and Qazvin. In 2013-2014, a hotspot was detected in Qazvin. Finally, West Azerbaijan was the hotspot for CRC in 2015-2016. CONCLUSIONS The incidence of CRC in men was higher than in women. Also it appeared that North and North West Iran were risk areas for this disease, and so these areas should be considered in the design of disease prevention programme for this cancer type. Additionally, the determination of individual risk factors in the aforementioned geographical areas can play an important role in the prevention of this type of cancer.
Collapse
Affiliation(s)
- Alireza Khoshdel
- Military Epidemiology Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - M Alimohammadi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Sepandi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Y Alimohamadi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - P Jalali
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Janani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
17
|
Firouraghi N, Bagheri N, Kiani F, Goshayeshi L, Ghayour-Mobarhan M, Kimiafar K, Eslami S, Kiani B. A spatial database of colorectal cancer patients and potential nutritional risk factors in an urban area in the Middle East. BMC Res Notes 2020; 13:466. [PMID: 33008452 PMCID: PMC7532552 DOI: 10.1186/s13104-020-05310-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/25/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Colorectal cancer (CRC) is the third most common cancer across the world that multiple risk factors together contribute to CRC development. There is a limited research report on impact of nutritional risk factors and spatial variation of CRC risk. Geographical information system (GIS) can help researchers and policy makers to link the CRC incidence data with environmental risk factor and further spatial analysis generates new knowledge on spatial variation of CRC risk and explore the potential clusters in the pattern of incidence. This spatial analysis enables policymakers to develop tailored interventions. This study aims to release the datasets, which we have used to conduct a spatial analysis of CRC patients in the city of Mashhad, Iran between 2016 and 2017. DATA DESCRIPTION These data include five data files. The file CRCcases_Mashhad contains the geographical locations of 695 CRC cancer patients diagnosed between March 2016 and March 2017 in the city of Mashhad. The Mashhad_Neighborhoods file is the digital map of neighborhoods division of the city and their population by age groups. Furthermore, these files include contributor risk factors including average of daily red meat consumption, average of daily fiber intake, and average of body mass index for every of 142 neighborhoods of the city.
Collapse
Affiliation(s)
- Neda Firouraghi
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Nasser Bagheri
- Visualization and Decision Analytics (VIDEA) Lab, Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Fatemeh Kiani
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Ladan Goshayeshi
- Department of Gastroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Khalil Kimiafar
- Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Eslami
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Behzad Kiani
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
| |
Collapse
|
18
|
Anti-Mutagenicity and Apoptotic Effects of Teucrium polium L. Essential Oil in HT29 Cell Line. Jundishapur J Nat Pharm Prod 2020. [DOI: 10.5812/jjnpp.79559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives: Regarding the high prevalence of cancer in Iran and the cytotoxic properties of T. polium, the current study aimed to investigate the cytotoxic and anti-mutagenicity effect of T. polium essential oil (TpEO) on human colon adenocarcinoma cell line (HT29). Methods: HT29 cells were cultured in L-glutamine, RPMI Sigma (1640), with 10% of FBS (fetal bovine serum). Then, the cultures were incubated with 5% CO2 at 37°C, and MTT assay was used to recognize cell proliferation under the inhibitory influence of TpEO. The cell cycle progression was monitored by Sub-G1 apoptosis assay using flow cytometry. Eventually, the anti-mutagenicity property was evaluated using the Ames test employing TA100 and exposure to sodium azide as the carcinogenic substance. Results: The cytotoxic effect of TpEO on HT29 cells was 66.867 ± 1.37 µg/mL. Cultured HT29 cells treated with TpEO exhibited morphological features of apoptosis. TpEO preventive effect was about 78.18%. Conclusions: This study showed that TpEO may be useful for treating colon cancer.
Collapse
|
19
|
Gohari N, Saadat I. CDKN1B 109VG and CDKN2A (540CG & 580CT) polymorphisms and susceptibility to colorectal cancer: A case-control study of the Iranian population. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
20
|
Forouzesh F, Ghiaghi M, Rahimi H. Effect of sodium butyrate on HDAC8 mRNA expression in colorectal cancer cell lines and molecular docking study of LHX1 - sodium butyrate interaction. EXCLI JOURNAL 2020; 19:1038-1051. [PMID: 32788915 PMCID: PMC7415931 DOI: 10.17179/excli2020-2010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022]
Abstract
Colorectal cancer (CRC) is the third most common type of cancer and the fourth leading cause of cancer related deaths worldwide. The Histone Deacetylase 8 (HDAC8) gene is a gene with unique features which can be used as a potential target for drug design. The LHX1 transcription factor is an important transcription factor for this gene. The aim of this study was to investigate the effect of sodium butyrate (NaB) as a histone deacetylase inhibitor (HDACi) on the expression of the HDAC8 gene in the colorectal cancer cell line, and the molecular docking of the LHX1 transcription factor with NaB. For this purpose, HCT-116 and HT-29 cell lines were treated with different concentrations of NaB (6.25 mM to 150 mM) at 24, 48 and 72 hours. Subsequently, RNA was extracted from the treated and untreated cells and cDNA was synthesized. Quantitative Real-Time-PCR was done to investigate the mRNA expression of HDAC8. Molecular docking was also performed to investigate the interaction between NaB and LHX1. Based on Real-time-PCR results, the concentration of 150 mM of NaB after 24 hours in HT-29 and HCT-116 cell lines caused a significant reduction in mRNA expression of HDAC8 (P<0.05). After 48 hours of treatment, there was a significant decrease in the mRNA expression of HDAC8 at all concentrations (P<0.05). The docking results showed that LHX1 and NaB interacted best at the lowest energy levels. Our results also showed that NaB bonded strongly to LHX1. In addition, our results demonstrated that NaB bound to the LHX1 transcription factor and inhibited the function of this factor and consequently decreased the transcription from the HDAC8 gene which resulted in cell death. Future studies are needed to assess the likely molecular mechanisms of NaB action on gene expression.
Collapse
Affiliation(s)
- Flora Forouzesh
- Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mahsa Ghiaghi
- Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hamzeh Rahimi
- Department of Molecular Medicine, Pasteur Institute of Iran, Tehran, Iran
| |
Collapse
|
21
|
Jalilzadeh N, Samadi N, Salehi R, Dehghan G, Iranshahi M, Dadpour MR, Hamishehkar H. Novel nano-vehicle for delivery and efficiency of anticancer auraptene against colon cancer cells. Sci Rep 2020; 10:1606. [PMID: 32005894 PMCID: PMC6994674 DOI: 10.1038/s41598-020-58527-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 12/29/2019] [Indexed: 01/02/2023] Open
Abstract
The aim of this study is to devise, prepare and characterize nano encapsulated auraptene (AUR) and evaluate cytotoxic and apoptotic effects on HT-29 colon cancer cells. Herein, AUR nano formulations were prepared by triblock (PCL-PEG-PCL) and pentablock (PLA-PCL-PEG-PCL-PLA) biodegradable copolymers in order to increase AUR bioavailability as an anticancer agent. The preparation of nano particles (NPs) was done with rotor stator homogenization (RSH) and Ultrasonic homogenization (USH) methods. The physicochemical characteristics of prepared nanoparticles (NPs) were studied using HNMR, FTIR, GPC, DLS and SEM techniques. The smaller hydrodynamic size (110 nm) and polydispersity index (PDI: 0.288) as well as higher cellular uptake (89%) were observed in PB NPs rather than TB NPs. The highest cytotoxic and apoptotic effects were observed in AUR loaded PB NPs compared to AUR loaded TB NPs and free AUR obtained by MTT assay, cell cycle arrest, Annexin V-FITC, DAPI staining and RT-PCR techniques. Real time PCR results indicated that Bax /Bcl2 expression ratio as an apoptosis predicting criterion, in free AUR, AUR loaded TB and AUR loaded PB have increased 6, 9 and 13 times, respectively (p value < 0.05). In conclusion, using biodegradable nano-vehicles for sustained delivery of natural anti-cancer compounds may open new perspectives for treatment of cancer patients.
Collapse
Affiliation(s)
- Nazila Jalilzadeh
- Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Samadi
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roya Salehi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | | | - Mehrdad Iranshahi
- Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Dadpour
- Department of Horticulture, Faculty of Agriculture, University of Tabriz, Tabriz, Iran
| | - Hamed Hamishehkar
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
22
|
Survival Prediction in Patients with Colorectal Cancer Using Artificial Neural Network and Cox Regression. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.81161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
23
|
Mansour-Ghanaei F, Varshi G, Joukar F, Ashoobi MT, Esmaeilpour J, Gharibpoor A, Daryakar A, Mansour-Ghanaei R, Balou HA, Saedi HS, Mavaddati S, Sepehrimanesh M. Prevalence of pre-cancerous colon lesions in referred patients under patronage of a local relief foundation in Guilan province. J Med Life 2019; 12:133-139. [PMID: 31406514 PMCID: PMC6685299 DOI: 10.25122/jml-2018-0074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Colon cancer is the most commonly diagnosed gastrointestinal cancers in developed countries with varied incidence and the onset age of disease worldwide. Overall, 161 participants who were under patronage of a local relief foundation and referred to the endoscopy ward of Razi Hospital affiliated to the Guilan University of Medical Sciences. These patients have been aged more than 50 or more than 40 years with history of colorectal cancer in their first-degree family were enrolled from March 2016–March 2017. Demographic information were collected. Colonoscopy was performed and histopathological evaluation of observed lesions and polyps was done. Most of participants were female (113 individuals, 70.2%) and aged 50–60 years (83 individuals, 51.6%). Seventy-four (46%) had certain lesions. Most of colonoscopy findings were observed in the ascending colon in which depressed polyps and diverticulum were most frequent. However, rectum showed the most histological findings. All polyps of descending and ascending colons were neoplastic, while most of rectal polyps were non-neoplastic. Male patients, who were aged more than 60 years and smokers had significant higher percentage of both lesions and polyps in their colon (p<0.05). Moreover, significant positive association was detected between exposure to harmful industries and having polyps (p=0.01). We found male gender, higher age, smoking, and exposure to harmful industries as important risk factors for having colorectal lesions, which must be confirmed in further studies.
Collapse
Affiliation(s)
- Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Gharmohammad Varshi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Taghi Ashoobi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Javad Esmaeilpour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Gharibpoor
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Arash Daryakar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Roya Mansour-Ghanaei
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Heydar Ali Balou
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Saeidi Saedi
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Masood Sepehrimanesh
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
24
|
Abolhassani M, Asadikaram G, Paydar P, Fallah H, Aghaee-Afshar M, Moazed V, Akbari H, Moghaddam SD, Moradi A. Organochlorine and organophosphorous pesticides may induce colorectal cancer; A case-control study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 178:168-177. [PMID: 31004929 DOI: 10.1016/j.ecoenv.2019.04.030] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/06/2019] [Accepted: 04/08/2019] [Indexed: 05/15/2023]
Abstract
OBJECTIVES Among the numerous agents, genetic factors and environmental elements such as pesticides have an important role in colorectal cancer (CRC) incidence. The present study aimed to investigate the probable-role of some organochlorine pesticides (OCPs) and organophosphorous pesticides (OPPs) in patients with CRC. METHODS In this case-control study, 42 patients with CRC and 30 healthy subjects were selected. The serum levels of some OCPs (α-HCH, β-HCH, γ-HCH, 2,4 DDE, 4,4 DDE, 2,4DDT and 4,4DDT) were measured by gas chromatography (GC) method. Serum levels of malondialdehyde (MDA), and total antioxidant capacity (TAC) as well as the enzyme activity of acetylcholinesterase (AChE) and arylesterase activity of Paraoxonase-1 (PON-1) were evaluated in all participants. The methylation specific PCR (MSP) assay was used for determining the methylation status of CpG island of p16 and MGMT genes in CRC patients. RESULTS The mean serum levels of each OCPs were significantly higher in the patient group compared to the control group (P < 0.001). The AChE and arylesterase activity of PON-1 in the patient group were significantly lower than the control group (P < 0.001). The mean serum levels of MDA and TAC in the serum of the patient group were significantly higher than the control group (P < 0.001 and P < 0.002, respectively). The current findings demonstrated significantly hypermethylation of p16 promoter in CRC patients. CONCLUSION Regarding the higher levels of OCPs in CRC patients, along with hypermethylation of the p16 promoter gene, diminishing in AChE and PON-1 activity and increasing in oxidative stress factors, the role of OCPs and OPPs in the CRC progression in the South-East of Iran may be assumed.
Collapse
Affiliation(s)
- Moslem Abolhassani
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamreza Asadikaram
- Department of Clinical Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran; Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman, Iran.
| | - Parisa Paydar
- Department of Clinical Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Fallah
- Department of Clinical Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Vahid Moazed
- Hematology and Oncology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamed Akbari
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran; Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Sodaif Darvish Moghaddam
- Gastroenterology and Hepatology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Afshin Moradi
- Cancer Research Center, Shohada Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| |
Collapse
|
25
|
Geravand M, Fallah P, Yaghoobi MH, Soleimanifar F, Farid M, Zinatizadeh N, Yaslianifard S. INVESTIGATION OF ENTEROCOCCUS FAECALIS POPULATION IN PATIENTS WITH POLYP AND COLORECTAL CANCER IN COMPARISON OF HEALTHY INDIVIDUALS. ARQUIVOS DE GASTROENTEROLOGIA 2019; 56:141-145. [PMID: 31460576 DOI: 10.1590/s0004-2803.201900000-28] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 06/05/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Colorectal cancer is one of the most commonly diagnosed cancers around the world. One of the factors involved in the development of colorectal cancer is the changes in the normal flora of the intestine. OBJECTIVE In this study, the mean copy number of Enterococcus faecalis in people with polyps and people with colorectal cancer has been evaluated in comparison with healthy controls. METHODS In this study, 25 patients with colorectal cancer and 28 patients with intestinal polyps were selected and stool specimens were taken. In addition, 24 healthy individuals were selected as control group. Extraction of bacterial DNA from the stool sample were performed. The molecular methods of PCR for confirmation of standard strain and absolute Real Time PCR (qRT-PCR) method were used to evaluate the number of Enterococcus faecalis in the studied groups. RESULTS The results of this study indicate that the mean copy number of Enterococcus faecalis in patients with colorectal cancer was 11.2x109 per gram of stool, and in patients with polyps was 9.4x108 per gram of stool. In healthy people, this number was 9x108 per gram of stool. There was a significant difference between the implicit copy numbers in the three groups. (P<0.05). CONCLUSION Enterococcus faecalis in faecal flora of people with colorectal cancer was significantly higher than those with polyps and healthy people. This could potentially signify the ability of this bacterium to induce colorectal cancer. More studies are needed to prove this theory.
Collapse
Affiliation(s)
- Maryam Geravand
- Alborz University of Medical Sciences, School of Medicine, Student Research Committee, Karaj, Iran
| | - Parviz Fallah
- Alborz University of Medical Sciences, School of Paramedical Sciences, Department of Hematology, Karaj, Iran
| | - Mojtaba Hedayat Yaghoobi
- Alborz University of Medical Sciences, School of Medicine, Department of Infectious Disease, Karaj, Iran
| | - Fatemeh Soleimanifar
- Alborz University of Medical Sciences, Dietary Supplements and Probiotic Research Center, Karaj, Iran
| | - Malihe Farid
- Alborz University of Medical Sciences, Social Determinants of Health Research Center, Karaj, IR Iran.,Alborz University of Medical Sciences, Faculty of Medicine, Karaj, IR Iran
| | - Nazi Zinatizadeh
- Alborz University of Medical Sciences, School of Medicine, Student Research Committee, Karaj, Iran
| | - Somayeh Yaslianifard
- Alborz University of Medical Sciences, Dietary Supplements and Probiotic Research Center, Karaj, Iran.,Alborz University of Medical Sciences, School of Medicine, Department of Microbiology, Karaj, Iran
| |
Collapse
|
26
|
Mansori K, Solaymani-Dodaran M, Mosavi-Jarrahi A, Motlagh AG, Salehi M, Delavari A, Hosseini A, Asadi-Lari M. Determination of effective factors on geographic distribution of the incidence of colorectal cancer in Tehran using geographically weighted Poisson regression model. Med J Islam Repub Iran 2019; 33:23. [PMID: 31380313 PMCID: PMC6662539 DOI: 10.34171/mjiri.33.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Indexed: 01/05/2023] Open
Abstract
Background: This study aimed to determine effective factors on geographic distribution of the Incidence of Colorectal Cancer (CRC) in Tehran, Iran using Geographically Weighted Poisson Regression Model. Methods: This ecological study was carried out at neighborhood level of Tehran in 2017-2018. Data for CRC incidence was extracted from the population-based cancer registry data of Iran. The socioeconomic variables, risk factors and health costs were extracted from the Urban HEART Study in Tehran. Geographically weighted Poisson regression model was used for determination of the association between these variables with CRC incidence. GWR 4, Stata 14 and ArcGIS 10.3 software systems were used for statistical analysis. Results: The total number of incident CRC cases were 2815 in Tehran from 2008 to 2011, of whom, 2491 cases were successfully geocoded to the neighborhood. The median IRR for local variables were : unemployed people over 15 year old (median IRR: 1.17), women aged 17 years or older with university education (median IRR: 1.17), women head of household (median IRR: 1.06), people without insurance coverage (median IRR: 1.10), households without daily consumption of milk (median IRR: 0.85), smoking households (median IRR: 1.07), household's health expenditure (median IRR: 1.39), disease diagnosis costs (median IRR: 1.03), medicines costs of households (median IRR: 1.05), cost of the hospital (median IRR: 1.09), cost of medical visits (median IRR: 1.27). Conclusion: The spatial variability was observed for most socioeconomic variables, risk factors and health costs that had effects on CRC incidence in Tehran. Spatial variability is necessary when interpreting the results and utterly helpful for implementation of prevention programs.
Collapse
Affiliation(s)
- Kamyar Mansori
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.,Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Solaymani-Dodaran
- Minimally Invasive Surgery Research Center, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Alireza Mosavi-Jarrahi
- Department of Health and Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ganbary Motlagh
- Department of Radiotherapy, Shahid Baheshti University of Medical Sciences, Tehran Iran
| | - Masoud Salehi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hosseini
- Department of Geography and Urban Planning, University of Tehran, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.,Oncopathology Research Centre, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
27
|
Rezasoltani S, Khatibi S, Pezeshkiyan Z, Nazemalhosseini-Mojarad E, Sharafkhah M, Sadeghi A, Asadzadeh Aghdaei H, Zali MR. Investigating the TLR9 mRNA Expression Level in Different Histological Types of Colorectal Polyps. Asian Pac J Cancer Prev 2019; 20:2299-2302. [PMID: 31450898 PMCID: PMC6852833 DOI: 10.31557/apjcp.2019.20.8.2299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Indexed: 01/14/2023] Open
Abstract
Toll-like receptor 9 (TLR9) is a cellular DNA receptor of the innate immune system which plays a pivotal role in inflammatory response. Recently, changing expression levels of TLR9 has been observed in a wide range of cancer cells; however, there is little information about colorectal polyps. Herein, we assessed the mRNA expression of TLR9 in different colorectal polyp types compared to normal group in order to investigate its expression level during CRC initiation. Fifty-four biopsy samples from colorectal polyp patients and from 20 healthy subjects were collected. The mucosal mRNA expression level of TLR9 gene was identified by real time PCR. Fold change of gene expression was evaluated by 2-ΔΔct method. There was a significant relationship between the lower expression of TLR9 gene in the polyp cases compared to normal individuals (P value = 0.0005), Also, decreased TLR9 mRNA expression was obtained in adenomas in contrast to hyperplastic and normal groups (P value = 0.0008). Based on the current results, we hypothesized that aberrant surface expression of TLR9 on tumor cells may promote the growth and invasion of colorectal polyps. Further, TLR9 modulation may have an important impact on the development of novel therapeutic strategies.
Collapse
Affiliation(s)
- Sama Rezasoltani
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Khatibi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Pezeshkiyan
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Nazemalhosseini-Mojarad
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Sadeghi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
28
|
Abbaszadegan MR, Moghbeli M. Genetic and molecular origins of colorectal Cancer among the Iranians: an update. Diagn Pathol 2018; 13:97. [PMID: 30579343 PMCID: PMC6303916 DOI: 10.1186/s13000-018-0774-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 12/05/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one the leading causes of cancer related deaths among Iranians. Despite the various progresses in new therapeutic methods, it has still a low rate of survival. This high ratio of mortality is mainly related to the late diagnosis, in which the patients refer for treatment in advanced stages of tumor. MAIN BODY: colorectal cancer progression is largely associated with molecular and genetic bases. Although Iran has a high ratio of CRC mortality, there is not an efficient genetic panel for detection and prognosis. Therefore, it is critical to introduce new diagnostic markers with ability to detect in early stages. CONCLUSION Present review summarizes all of the genetic and epigenetic factors which are reported in CRC until now among the Iranian patients to pave the way of incorporation of new ethnic specific markers into the clinical practice and development of new targeted therapeutic methods.
Collapse
Affiliation(s)
| | - Meysam Moghbeli
- Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
29
|
Salehi F, Ahmadi A, Ahmadi Soodejani SS, Shahini Shams Abadi M. THE CHANGING TREND OF MORTALITY CAUSED BY GASTROINTESTINAL CANCERS IN IRAN DURING THE YEARS 2006-2010. ARQUIVOS DE GASTROENTEROLOGIA 2018; 55:237-241. [PMID: 30540084 DOI: 10.1590/s0004-2803.201800000-60] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/29/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cancers are one of the most important causes of death in the world. According to their high incidence and mortality, gastrointestinal cancers have particular importance among other cancers. OBJECTIVE Therefore, this study was conducted to investigate the mortality change trends of gastrointestinal cancers in Iran. METHODS This study was performed by analyzing the reported mortality data in 29 provinces of Iran in 2006-2010. Mortality trend of gastrointestinal cancers was drawn for both sexes in the study years and disaggregated by age groups and their frequency distribution. The WinPepi software was used for analysis. RESULTS In the years 2006-2010, the mortality rate of, gastric, colorectal, liver and pancreatic cancers, has significantly increased. Totally, gastrointestinal mortality is higher in men than women. Also, the results showed that by increasing age, death from these cancers also increased. CONCLUSION The most important causes of death from gastrointestinal cancers were gastric, liver and colorectal cancers in Iran and because of their increasing trend in the country, performing preventive interventions for the cancers' risk factors is necessary.
Collapse
Affiliation(s)
- Fatemeh Salehi
- Shahrekord University of Medical Sciences, Modeling in Health Research Center, Shahrekord, Iran
| | - Ali Ahmadi
- Shahrekord University of Medical Sciences, Modeling in Health Research Center, Shahrekord, Iran.,Shahrekord University of Medical Sciences, Department of Epidemiology and Biostatistics, Shahrekord, Iran
| | | | | |
Collapse
|
30
|
Dkk-3 as a potential biomarker for diagnosis and prognosis of colorectal cancer. Med J Islam Repub Iran 2018; 32:86. [PMID: 30788323 PMCID: PMC6377052 DOI: 10.14196/mjiri.32.86] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Indexed: 01/05/2023] Open
Abstract
Background: The Dickkopf 3 (Dkk-3) protein is a member of the Dkk family known as Wnt signaling inhibitor. The level of DKk-3 changes in a wide range of cancers, such as colorectal cancer, lung cancer, prostate cancer, and bladder cancer, is proposed as a biomarker for diagnosis and prognosis of many cancers. The present study was conducted to evaluate the serum level of Dkk-3 as a cancer biomarker and to determine their prognostic value in colorectal cancer (CRC) patients and healthy matched controls.
Methods: A total of 30 colorectal cancer patients at different stages of the disease and healthy matched controls with no history of inflammatory and autoimmune disease or cancer were enrolled in the study. The level of Dkk-3 was assessed serologically using enzymelinked immunosorbent assay (ELISA) method, moreover, relevance of these markers with patients’ clinicopathological features was subsequently assessed. Means comparison and ROC curves analysis were done using SPSS software. P-value ˂0.05 was considered significant in all the tests.
Results: In this study, it was revealed that serum level of Dkk-3 was significantly (p<0.001) lower in patients compared to the healthy controls. Statistical analysis showed that serum level of Dkk-3 has 78% specificity and 77% sensitivity (AUC= 0.782, 95% CI) for diagnosis of colorectal cancer.
Conclusion: Dkk-3 protein can be considered as a potential biomarker for diagnosis and possibly the prognosis of colorectal cancer.
Collapse
|
31
|
Mansori K, Solaymani-Dodaran M, Mosavi-Jarrahi A, Motlagh AG, Salehi M, Delavari A, Asadi-Lari M. Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models. J Prev Med Public Health 2018; 51:33-40. [PMID: 29397644 PMCID: PMC5797719 DOI: 10.3961/jpmph.17.167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 12/11/2017] [Indexed: 02/01/2023] Open
Abstract
Objectives The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The Besag-York-Mollié (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in atrisk areas.
Collapse
Affiliation(s)
- Kamyar Mansori
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Solaymani-Dodaran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Mosavi-Jarrahi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Ganbary Motlagh
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Salehi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
32
|
Esghaei M, Ghaffari H, Rahimi Esboei B, Ebrahimi Tapeh Z, Bokharaei Salim F, Motevalian M. Evaluation of Anticancer Activity of Camellia Sinensis in the Caco-2 Colorectal Cancer Cell Line. Asian Pac J Cancer Prev 2018; 19:1697-1701. [PMID: 29938468 PMCID: PMC6103574 DOI: 10.22034/apjcp.2018.19.6.1697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: Colorectal cancer (CRC) is widespread across the world. While conventional anticancer treatments can help the affected patients, cells of vital organs such as the kidney, lungs, bladder and nervous system may suffer from side effects of chemotherapeutic drugs, so that it is necessary to search for alternatives. From ancient times, attention has focused on medicinal plants and natural products. In the current work, Camellia sinensis, whose leaves are used to produce green tea was evaluated for anticancer effects in cell culture. Materials and Methods: A hydroalcoholic extract of Camellia sinensis young leaves was prepared by percolation and compared with Cisplatin as a known anticancer drug for effects on two cell lines: Caco-2, colon carcinoma cells, and mouse normal fibroblasts (L929). Cytotoxicity of 50, 100, 200, 400 and 800 µg/ml of Camellia sinensis extract was evaluated by MTT assay and aquaporin 5 (AQP5), detected as a biomarker for surviving cells using immunofluorescence microscopy. Results: MTT assays with hydroalcoholic extract of Camellia sinensis showed considerable inhibition of growth of Caco-2 cells, significant at 800 µg/ml (P<0.05), with little effect on L929 cells. Levels of aquaporin 5 protein decreased in Caco-2 cell culture following green tea extract treatment. Conclusion: According to the results of the current study, Camellia sinensis is a medicinal plant with potent anticancer influence which might be specific.
Collapse
Affiliation(s)
- Maryam Esghaei
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | | | |
Collapse
|
33
|
Beiranvand S, Zarea K, Ghanbari S, Tuvesson H, Keikhaei B. Ten years incidence of cancer in Iran; a systematic review and meta-analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2018. [DOI: 10.1016/j.cegh.2017.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
34
|
Sohrabi M, Gholami A, Azar MH, Yaghoobi M, Shahi MM, Shirmardi S, Nikkhah M, Kohi Z, Salehpour D, Khoonsari MR, Hemmasi G, Zamani F, Sohrabi M, Ajdarkosh H. Trace Element and Heavy Metal Levels in Colorectal Cancer: Comparison Between Cancerous and Non-cancerous Tissues. Biol Trace Elem Res 2018; 183:1-8. [PMID: 28795369 DOI: 10.1007/s12011-017-1099-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 07/10/2017] [Indexed: 11/30/2022]
Abstract
Cases of colorectal cancer (CRC) have increased dramatically in Middle Eastern and other Asian countries. Many studies indicate an important role of environmental factors, including trace elements as an etiology of cancer. This study aims to assess the concentration of eight trace elements in cancerous and adjacent non-cancerous tissues in case of CRC. In a cross-sectional study, conducted between March 2015 and February 2016, zinc (Zn), chromium (Cr), manganese (Mn), tin (Sn), copper (Cu), aluminum (Al), lead (Pb), and iron (Fe) levels were evaluated among patients suffering from CRC. All the patients underwent a full colonoscopy. Multiple samples were taken from cancerous lesions and adjacent healthy tissues that kept a minimum distance of 10 cm from the lesions. These specimens were kept at -80 °C. The classic flame atomic absorption spectroscopy (FAAS) method was applied in this study. The mean age of the study population was 55.6 ± 12.8. The median of Zn, Cr, Cu, Al, and Pb in cancerous tissues was significantly higher than that of healthy tissues (P < 0.05). Nevertheless, the median of Mn, Sn, and Fe was significantly lower than that of non-cancerous tissues (P < 0.05). Between colon and rectal specimens, we did not find a difference between Cr and Al levels and Zn, Sn, and Cu levels in cancerous and healthy tissues, respectively. We revealed that gender and history of smoking may influence the level of some trace elements. We revealed that the levels of eight elements were significantly different for cancerous and healthy tissues. This may play a role in developing CRC. These findings reflect the importance of environmental pollution in this setting.
Collapse
Affiliation(s)
- Masoudreza Sohrabi
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Gholami
- Department of Public Health, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Yaghoobi
- Division of Gastroenterology, Department of Medicine, Faculty of Health Science, Mc Master University, Hamilton, Canada
| | - Maryamosadat Mirasgari Shahi
- Department of Analytic Chemistry, Faculty of Basic Sciences, Tehran Islamic Azad University, North Branch, Tehran, Iran
| | - Solmaz Shirmardi
- Department of Analytic Chemistry, Faculty of Basic Sciences, Tehran Islamic Azad University, North Branch, Tehran, Iran
| | - Mehdi Nikkhah
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Kohi
- Department of Analytic Chemistry, Faculty of Basic Sciences, Tehran Islamic Azad University, North Branch, Tehran, Iran
| | - Delaram Salehpour
- Department of Analytic Chemistry, Faculty of Basic Sciences, Tehran Islamic Azad University, North Branch, Tehran, Iran
| | - Mahmood Reza Khoonsari
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamrez Hemmasi
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoudreza Sohrabi
- Department of Analytic Chemistry, Faculty of Basic Sciences, Tehran Islamic Azad University, North Branch, Tehran, Iran.
| | - Hossein Ajdarkosh
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
35
|
Mansori K, Mosavi-Jarrahi A, Ganbary Motlagh A, Solaymani-Dodaran M, Salehi M, Delavari A, Sanjari Moghaddam A, Asadi-Lari M. Exploring Spatial Patterns of Colorectal Cancer in Tehran City, Iran. ASIAN PACIFIC JOURNAL OF CANCER PREVENTION : APJCP 2018; 19:1099-1104. [PMID: 29699370 PMCID: PMC6031791 DOI: 10.22034/apjcp.2018.19.4.1099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives: Colorectal cancer (CRC) may now be the second most common cancer in the world. The aim of this
study was to determine whether clusters of high and low risk of CRC might exist at the neighborhood level in Tehran
city. Methods: In this study, new cases of CRC provided from Cancer Registry Data of the Management Center of
Ministry of Health and Medical Education of Iran in the period from March 2008 to March 2011 were analyzed. Raw
standardized incidence rates (SIRs) were calculated for CRC in each neighborhood, along with ratios of observed to
expected cases. The York and Mollie (BYM) spatial model was used for smoothing of the estimated raw SIRs. To
discover clusters of high and low CRC incidence a purely spatial scan statistic was applied. Results: A total of 2,815
new cases of CRC were identified and after removal of duplicate cases, 2,491 were geocoded to neighborhoods. The
locations with higher than expected incidence of CRC were northern and central districts of Tehran city. An observed
to expected ratio of 2.57 (p<0.001) was found for districts of 2, 6 and 11, whereas, the lowest ratio of 0.23 (p<0.001)
was apparent for northeast and south areas of the city, including district 4. Conclusions: This study showed that there
is a significant spatial variation in patterns of incidence of CRC at the neighborhood level in Tehran city. Identification
of such spatial patterns and assessment of underlying risk factors can provide valuable information for policymakers
responsible for equitable distribution of healthcare resources.
Collapse
Affiliation(s)
- Kamyar Mansori
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Outcomes of Neoadjuvant Radiochemotherapy of Locally Advanced Rectal Adenocarcinoma: Results of 8 Year Experience in Iran Cancer Institute. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.12339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
37
|
Vahdatimanesh Z, Zendehdel K, kbari Sari AA, Farhan F, Nahvijou A, Delavari A, Daroudi R. Economic burden of colorectal cancer in Iran in 2012. Med J Islam Repub Iran 2017; 31:115. [PMID: 29951416 PMCID: PMC6014770 DOI: 10.14196/mjiri.31.115] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Indexed: 11/18/2022] Open
Abstract
Background: Colorectal cancer is one of the most common cancers in Iran. However little is known about the economic burden associated with this cancer in Iran. The aim of this study was to estimate the economic burden of colorectal cancer in Iran in the year 2012. Methods: We used the prevalence-based approach and estimated direct and indirect costs of all colorectal cancer cases in 2012. To estimate the total direct costs, we model the treatment process of colorectal cancer patients in initial and continuing phase in Iran. Then the average cost of each treatment in each phase was multiplied by the number of patients who received the treatment in the country in 2012. We used the human capital method to estimate the indirect costs. We extracted data from several sources, including national cancer registry reports, hospital records, literature review, occupational data, and interviews with experts. Results: The incidence and 5-year prevalence of colorectal cancer in Iran in 2012 were 7,163 and 22,591 individuals respectively. The economic burden of colorectal cancer in Iran was US$298,148,718 in 2012. Most of the cost (58%) was attributed to the mortality cost, and the direct medical cost accounted for 32.14 percent of the estimated total cost. The majority of the direct medical cost was associated with chemotherapy costs (50%). Conclusion: The economic burden of colorectal cancer in Iran is substantial and will increase in the future years.
Collapse
Affiliation(s)
- Zahra Vahdatimanesh
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran, Cancer Biology Centre, Cancer Institute of Iran, Tehran Universiy of Medical Sciences, Tehran, Iran
| | - Ali A kbari Sari
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshid Farhan
- Radiotherapy Oncology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rajabali Daroudi
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
38
|
Detection Rate, Anatomic Sites, and Pathologic Types of Colorectal Cancer During Colonoscopy Procedures. Surg Laparosc Endosc Percutan Tech 2017; 27:394-399. [DOI: 10.1097/sle.0000000000000456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
39
|
|
40
|
Omran S, Barakat H, Muliira JK, McMillan S. Dietary and Lifestyle Risk Factors for Colorectal Cancer in Apparently Healthy Adults in Jordanian Hospitals. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:447-453. [PMID: 26700179 DOI: 10.1007/s13187-015-0970-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Colorectal cancer (CRC) is a frequently occurring cancer in Jordan. CRC risk is expected to continue rising due to dietary patterns, sedentary lifestyle, and other practices. The aim of this study was to describe the prevalence of dietary and lifestyle risk factors for CRC among patients attending outpatient gastroenterology clinics in Jordan. A descriptive, cross-sectional design was used to collect data from 713 asymptomatic participants. Data was collected using a self-report questionnaire measuring sociodemographic characteristics, dietary habits, physical activity, and lifestyle risk factors of CRC. The mean age of participants was 57.0 ± 8.56 years. The majority of participants were male (71.8 %) and with less than secondary school formal education (60.7 %). The commonest risk factors for CRC among the participants were overweight or obesity (76.1 %), lack of exercise (71.6 %), limited consumption of vegetables (70.8 %), smoking (60.6 %), over consumption of red meat (56.3 %), and diabetes mellitus (24.1 %). Dietary and lifestyle risk factors for CRC are prevalent in Jordan and likely to fuel an upsurge CRC if population-wide educational interventions are not implemented. There is need for greater attention and emphasis on strategies to educate the general population about healthy dietary and lifestyle habits as means of preventing CRC in Jordan.
Collapse
Affiliation(s)
- Suha Omran
- Adult Health Department/Faculty of Nursing, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan, 22110.
| | - Husam Barakat
- Gastroenterology Department/Ibn AlHaytham Hospital, Amman, Jordan
| | - Joshua Kanaabi Muliira
- Adult Health Department/ College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Susan McMillan
- College of Nursing, University of South Florida, Tampa, FL, USA
| |
Collapse
|
41
|
RON as a potential diagnostic and prognostic biomarker in colorectal cancer. Meta Gene 2017. [DOI: 10.1016/j.mgene.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
42
|
Opium Use and Risk of Lower Gastrointestinal Cancers: Population-Based Case-Control Study in South of Iran. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.8227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
43
|
Hessami Arani S, Kerachian MA. Rising rates of colorectal cancer among younger Iranians: is diet to blame? ACTA ACUST UNITED AC 2017; 24:e131-e137. [PMID: 28490936 DOI: 10.3747/co.23.3226] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Colorectal cancer (crc) is one of the most prevalent cancers in the world. Although the incidence of crc is currently very low in the older Iranian population compared with Western populations, young Iranians show a rising trend of crc-that is, the age-adjusted rate is close in the young Iranian population compared with the U.S. population, and the rate in older Iranians is much lower. METHODS To assess a putative relationship between diet and a rising rate of crc in younger Iranians, a combined text word and mesh heading search strategy identified relevant studies through Google Scholar and medline. RESULTS A critical look at diet among Iranians shows major issues that might be raising the risk for crc. There are also scenarios other than diet for the rise, such as the young age structure of the country. However, the actual scenario is more complex. CONCLUSIONS In Iran, crc is one of the most common incident cancers and a common cause of cancer death. Primary and secondary prevention-with attention to a healthy lifestyle, physical activity, and screening-should be enhanced in the general population.
Collapse
Affiliation(s)
| | - M A Kerachian
- Medical Genetics Research Center, Mashhad University of Medical Sciences.,Cancer Genetics Research Unit, Reza Radiation Oncology Center; and.,Department of Medical Genetics, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
44
|
Fateh A, Feizi MAH, Safaralizadeh R, Azarbarzin S. Importance of miR-299-5p in colorectal cancer. Ann Gastroenterol 2017; 30:322-326. [PMID: 28469363 PMCID: PMC5411383 DOI: 10.20524/aog.2017.0139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/07/2017] [Indexed: 12/13/2022] Open
Abstract
Background MicroRNAs (miRNAs) are effective regulators of gene expression that play a pivotal role in the pathogenesis of colorectal cancer (CRC) and various other cancers. The high prevalence of aberrant miRNA expression in CRC suggests that they can be used as biomarkers and anticancer molecules for therapeutic purposes. There is evidence that microRNA-299-5p (miR-299-5p) is associated with vital cell processes (e.g. epithelial-mesenchymal transition, proliferation, and tumorigenicity) and its improper expression with tumorigenesis in many types of human cancer. This prospective study investigated the contribution of miR-299-5p to CRC tumorigenesis. Methods The real-time reverse transcription-polymerase chain reaction was used to examine miR-299-5p expression levels prospectively in 40 sample pairs of CRC tissue and adjacent noncancerous tissue (>2 cm from cancer tissue). The ability of miR-299-5p to function as a tumor marker was also examined. Results The expression levels of miR-299-5p were significantly downregulated in the group of CRC samples compared with matched noncancerous tissue samples. No significant relationship was found between miR-299-5p expression levels and clinicopathological features. Receiver operating characteristic analysis gave an area under the curve of 71% for miR-299-5p with 68% sensitivity and 78% specificity (P=0.001). Conclusion The miRNA miR-299-5p may be considered as a tumor marker in CRC and could be of assistance as a potential predictive biomarker in the diagnosis of this cancer.
Collapse
Affiliation(s)
- Alavieh Fateh
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| | | | - Reza Safaralizadeh
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| | - Shirin Azarbarzin
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| |
Collapse
|
45
|
Asadzadeh Aghdaei H, Nazemalhosseini Mojarad E, Ashtari S, Pourhoseingholi MA, Chaleshi V, Anaraki F, Haghazali M, Zali MR. Polyp detection rate and pathological features in patients undergoing a comprehensive colonoscopy screening. World J Gastrointest Pathophysiol 2017; 8:3-10. [PMID: 28251034 PMCID: PMC5311467 DOI: 10.4291/wjgp.v8.i1.3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/29/2016] [Accepted: 12/09/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To identify the prevalence, and clinical and pathologic characteristic of colonic polyps among Iranian patients undergoing a comprehensive colonoscopy, and determine the polyp detection rate (PDR) and adenoma detection rate (ADR).
METHODS In this cross-sectional study, demographics and epidemiologic characteristics of 531 persons who underwent colonoscopies between 2014 and 2015 at Mehrad gastrointestinal clinic were determined. Demographics, indication for colonoscopy, colonoscopy findings, number of polyps, and histopathological characteristics of the polyps were examined for each person.
RESULTS Our sample included 295 (55.6%) women and 236 (44.4%) men, with a mean age of 50.25 ± 14.89 years. Overall PDR was 23.5% (125/531). ADR and colorectal cancer detection rate in this study were 12.8% and 1.5%, respectively. Polyps were detected more significantly frequently in men than in women (52.8% vs 47.2%, P < 0.05). Polyps can be seen in most patients after the age of 50. The average age of patients with cancer was significantly higher than that of patients with polyps (61.3 years vs 56.4 years, P < 0.05). The majority of the polyps were adenomatous. More than 50% of the polyps were found in the rectosigmoid part of the colon.
CONCLUSION The prevalence of polyps and adenomas in this study is less than that reported in the Western populations. In our patients, distal colon is more susceptible to developing polyps and cancer than proximal colon.
Collapse
|
46
|
Rasouli MA, Moradi G, Roshani D, Nikkhoo B, Ghaderi E, Ghaytasi B. Prognostic factors and survival of colorectal cancer in Kurdistan province, Iran: A population-based study (2009-2014). Medicine (Baltimore) 2017; 96:e5941. [PMID: 28178134 PMCID: PMC5312991 DOI: 10.1097/md.0000000000005941] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/19/2016] [Accepted: 12/27/2016] [Indexed: 01/05/2023] Open
Abstract
Colorectal cancer (CRC) survival varies at individual and geographically level. This population-based study aimed to evaluating various factors affecting the survival rate of CRC patients in Kurdistan province.In a retrospective cohort study, patients diagnosed as CRC were collected through a population-based study from March 1, 2009 to 2014. The data were collected from Kurdistan's Cancer Registry database. Additional information and missing data were collected reference to patients' homes, medical records, and pathology reports. The CRC survival was calculated from the date of diagnosis to the date of cancer-specific death or the end of follow-up (cutoff date: October 2015). Kaplan-Meier method and log-rank test were used for the univariate analysis of survival in various subgroups. The proportional-hazard model Cox was also used in order to consider the effects of different factors on survival including age at diagnosis, place of residence, marital status, occupation, level of education, smoking, economic status, comorbidity, tumor stage, and tumor grade.A total number of 335 patients affected by CRC were assessed and the results showed that 1- and 5-year survival rate were 87% and 33%, respectively. According to the results of Cox's multivariate analysis, the following factors were significantly related to CRC survival: age at diagnosis (≥65 years old) (HR 2.08, 95% CI: 1.17-3.71), single patients (HR 1.62, 95% CI: 1.10-2.40), job (worker) (HR 2.09, 95% CI: 1.22-3.58), educational level: diploma or below (HR 0.61, 95% CI: 0.39-0.92), wealthy economic status (HR 0.51, 95% CI: 0.31-0.82), tumor grade in poorly differentiated (HR 2.25, 95% CI: 1.37-3.69), and undifferentiated/anaplastic grade (HR 2.90, 95% CI: 1.67-4.98).We found that factors such as low education, inappropriate socioeconomic status, and high tumor grade at the time of disease diagnosis were effective in the poor survival of CRC patients in Kurdistan province; this, which need more attention.
Collapse
Affiliation(s)
- Mohammad Aziz Rasouli
- Student Research Committee
- Department of Epidemiology and Biostatistics, Faculty of Medicine
| | - Ghobad Moradi
- Social Determinants of Health Research Center
- Department of Epidemiology and Biostatistics, Faculty of Medicine
| | - Daem Roshani
- Social Determinants of Health Research Center
- Department of Epidemiology and Biostatistics, Faculty of Medicine
| | - Bahram Nikkhoo
- Department of Pathology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ebrahim Ghaderi
- Social Determinants of Health Research Center
- Department of Epidemiology and Biostatistics, Faculty of Medicine
| | | |
Collapse
|
47
|
Malayeri MRM, Dadkhah A, Fatemi F, Dini S, Torabi F, Tavajjoh MM, Rabiei J. Chemotherapeutic effect of Berberis integerrima hydroalcoholic extract on colon cancer development in the 1,2-dimethyl hydrazine rat model. ACTA ACUST UNITED AC 2017; 71:225-32. [PMID: 27232632 DOI: 10.1515/znc-2015-0117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 05/01/2016] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate the efficacy of a Berberis integerrima hydroalcoholic extract as a chemotherapeutic agent in colon carcinogenesis in the rat induced by 1,2-dimethyl hydrazine (DMH). Male Wistar rats were divided into five groups: a negative control group without DMH treatment; a control group injected DMH (20 mg/kg b.w); two groups receiving B. integerrima extract (50 and 100 mg/kg b.w), concomitant with injected DMH, as chemotherapeutic groups; a positive control group receiving 5-fluorouracil (5-FU) along with DMH. The effects of the extracts were determined by assessment of hepatic malondialdehyde (MDA), glutathione (GSH), ferric reducing ability of plasma (FRAP), and the activities of hepatic glutathione S-transferase and cytochrome P450 (GST and CYP450). Additionally, colon tissues were assessed for colonic β-catenin and histopathological analysis. In DMH-treated rats, the extracts partially normalized the levels of FRAP, CYP450, β-catenin, and GST. Likewise, formation of aberrant crypt foci (ACF) in colon tissue of DMH-treated was reduced by the extracts. Thus, the extracts possess chemotherapeutic activity against colon carcinogenesis.
Collapse
|
48
|
Salimzadeh H, Bishehsari F, Delavari A, Barzin G, Amani M, Majidi A, Sadjadi A, Malekzadeh R. Cancer risk awareness and screening uptake in individuals at higher risk for colon cancer: a cross-sectional study. BMJ Open 2016; 6:e013833. [PMID: 27998901 PMCID: PMC5223631 DOI: 10.1136/bmjopen-2016-013833] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE We aimed to measure cancer knowledge and feasibility of a screening colonoscopy among a cohort of individuals at higher risk of colon cancer. METHODS This study was conducted as part of an ongoing screening cohort, in which first degree relatives (FDRs) of patients with colon cancer are invited to participate in a free of charge screening colonoscopy. We enrolled 1017 FDRs in the study between 2013 and 2014 measuring their data on demographics, cancer knowledge and colonoscopy uptake. A p value of <0.05 was considered statistically significant. RESULTS The relative's mean age was 48.7 years. Only about 28% of FDRs were aware of their increased risk for cancer, near 35.0% had ever heard about colonoscopy with 22% aware of the correct age to start screening. Comparing cancer knowledge of FDRs at high risk versus those at moderate risk, we recorded non-significant differences (p>0.05). Almost two-thirds of FDRs expressed willingness to undergo a colonoscopy and 49.2% completed the procedure, of which 12.8% had advanced neoplasm. CONCLUSIONS Our data indicated that remarkable numbers of FDRs were not still informed of their cancer risk or never received a physician recommendation for screening. The desirable uptake at first invitation, which would be higher over successive invitations, supports the feasibility of a family-based recruitment approach for early screening. This has promising implications to introduce targeted screening colonoscopy into the healthcare system in Iran and other developing nations.
Collapse
Affiliation(s)
- Hamideh Salimzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Faraz Bishehsari
- Division of Gastroenterology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Alireza Delavari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Gilda Barzin
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Mohammad Amani
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Azam Majidi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Alireza Sadjadi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| |
Collapse
|
49
|
Dolatkhah R, Somi MH, Asvadi Kermani I, Bonyadi M, Sepehri B, Boostani K, Azadbakht S, Fotouhi N, Farassati F, Dastgiri S. Association between proto-oncogene mutations and clinicopathologic characteristics and overall survival in colorectal cancer in East Azerbaijan, Iran. Onco Targets Ther 2016; 9:7385-7395. [PMID: 27994469 PMCID: PMC5153263 DOI: 10.2147/ott.s116373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Colorectal cancer (CRC) is the third-most common cancer in Iran. The increasing incidence of CRC in the past three decades has made it a major public health burden in the country. This study aimed to determine any relationship of specific mutations in CRCs with clinicopathologic aspects and outcome of patients. Materials and methods This study was conducted on 100 CRC patients by the case-only method. Polymerase chain-reaction products were analyzed by Sanger sequencing, and sequence results were compared with the significant KRAS and BRAF gene mutations in the My Cancer Genome database. Logistic regression models were used to detect associations of clinicopathologic characteristics with each of the mutations. Kaplan–Meier and Cox regression models were constructed to estimate overall survival in patients. Results A total of 26 subjects (26%) had heterozygote-mutant KRAS, and mutations were not detected in the amplified exon of BRAF in both tumor and normal tissues of the 100 CRCs. Rectal tumors had 1.53-fold higher likelihood of KRAS mutations than colon tumors, and men had 1.37-fold higher odds than women. The presence of metastasis increased the likelihood of KRAS mutations 2.36-fold over those with nonmetastatic CRCs. Compared to patients with KRAS wild-type cancers, those with KRAS mutations had significantly higher mortality (hazard ratio 3.74, 95% confidence interval 1.44–9.68; log-rank P=0.003). Conclusion Better understanding of the causality of CRC can be established by combining epidemiology and research on molecular mechanisms of the disease.
Collapse
Affiliation(s)
- Roya Dolatkhah
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Iraj Asvadi Kermani
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Bonyadi
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Bita Sepehri
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamal Boostani
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saleh Azadbakht
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nikou Fotouhi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faris Farassati
- Molecular Medicine Laboratory, University of Kansas Medical School, Kansas City, KS, USA
| | - Saeed Dastgiri
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Tabriz Health Services Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
50
|
Quality of life in patients with colorectal cancer in Iran. Arab J Gastroenterol 2016; 17:127-130. [DOI: 10.1016/j.ajg.2016.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/13/2016] [Accepted: 06/05/2016] [Indexed: 12/11/2022]
|