Clinical Breast Cancer Registry of IR. Iran (CBCR-IR): Study Protocol and First Results.

BACKGROUND: Breast cancer (BC), as a significant global health problem, is the most common cancer in women. Despite the importance of clinical cancer registries in improving the quality of cancer care and cancer research, there are few reports on them from low- and middle-income countries. We established a multicenter clinical breast cancer registry in Iran (CBCR-IR) to collect data on BC cases, the pattern of care, and the quality-of-care indicators in different hospitals across the country. METHODS: We established a clinical cancer registry in 12 provinces of Iran. We defined the organizational structure, developed minimal data sets and data dictionaries, verified data sources and registration processes, and developed the necessary registry software. During this registry, we studied the clinical characteristics and outcomes of patients with cancer who were admitted from 2014 onwards. RESULTS: We registered 13086 BC cases (7874 eligible cases) between 1.1.2014 and 1.1.2022. Core needle biopsy from the tumor (61.25%) and diagnostic mammography (68.78%) were the two most commonly used diagnostic methods. Stage distribution was 2.03% carcinoma in situ, 12% stage I, 44.65% stage II, 21.32% stage III, and 4.61% stage IV; stage information was missing in 1532 patients (19.46%). Surgery (95.01%) and chemotherapy (79.65%) were the most common treatments for all patients. CONCLUSION: The information provided by this registry can be used to evaluate and improve the quality of care for BC patients. It will be scaled up to the national level as an important resource for measuring quality of care and conducting clinical cancer research in Iran.

Primary retroperitoneal mucinous cystadenoma in a female patient: A case report.

INTRODUCTION: Primary retroperitoneal mucinous cystadenoma is an extremely uncommon tumor occurring mostly in females. The histogenesis of PRMC remains unclear and Open surgery is the most impressive treatment. CASE PRESENTATION: We present a 20-year-old Iranian woman with history of intermittent abdominal pain. In physical examination, her abdomen had a mildly asymmetrical distention and a round shape mass was palpated in right abdomen also she had a mild tenderness in right abdomen. Radiologic assessment revealed a right retroperitoneal smooth cystic mass (20 × 15 cm) without invasive features. The patient underwent complete surgical excision of the tumor by a laparotomic approach because of its size. The lesion was gently dissected from the contiguous organs and removed completely without spillage of its content. In microscopic investigations, sections showed a unilocular cyst with fibrous wall lined via monolayered bland looking columnar mucinous epithelium and no atypia or stromal invasion was presented. Diagnosis of a PRMC was made. The patient has discharged without any complications in 2 days' postoperative course. DISCUSSION: Generally, cysts are asymptomatic and are found fortuitously after a routine checkup assessment. Symptoms and signs related to this cyst are mainly because of their huge size and compression effect. Radiological assessments are effective in specifying the lesion preoperatively; although, the final diagnosis always needs histopathological verification. CONCLUSION: When the tumor is diagnosed, full resection should be considered because of the infectious or malignant potential of the tumor.

Ten-year data analysis of digestive system malignancies in Babol, North of Iran: 2008-2017.

BACKGROUND: Unlike some regions of the world where digestive system cancers are not considered as important health problems, these neoplasms are among the most common malignancies in the northern region of Iran. METHODS: This observational analytical study was carried out based on data collected by the Cancer Registration Center affiliated to the Vice Chancellery for Health of Babol University of Medical Sciences, North of Iran, during 2008-2017. Crude incidence rate (CR), and age-standardized incidence rate (ASR) have been calculated for different GI cancers, based on the primary involved site; and have been compared in different years, patients' age, gender and place of residence. RESULTS: Totally, 4332 records were related to digestive system cancers. Mean age of patients was 63.48±14.73 years; men (2743; 63.3%) were more affected than women (1589; 36.7%) (p<0.001). The most incident malignancies of digestive system were from stomach, colorectal and esophagus in men; and colorectal, stomach and esophagus in women, respectively. These three cancers accounted for 3725 (85.98%) of total GI malignancies. The mean age of patients in various types of GI cancers was statistically different (p<0.001). Age- standardized incidence rate showed different values in different years; from 521.40 (95% CI: 462.79-580.00) in year 2016 to 1834.33 (95% CI: 1637.36-2031.29) in year 2008. CONCLUSION: Gastric, esophageal and colorectal cancers were the most prevalent digestive system malignancies in Babol, North of Iran, and accounted for about 86% of all GI tract cancers. A considerable variation has been found in incident gastrointestinal cancers in different years.

Mucinous cystadenocarcinoma of breast in a 69-year-old woman with positive hormone receptors, the first case reported.

BACKGROUND: Mucinous cystadenocarcinoma is a relatively uncommon histological subtype of breast cancer that is a cystic form of papillary mucinous carcinoma.  It is regularly negative for estrogen and progesterone receptors and it is most often diagnosed in older than 55-60 years old. The incidence of breast mucinous cystadenocarcinoma is about 1-6% of primary breast cancers. Here, we present a case of breast mucinous cystadenocarcinoma of left breast in a 69-year-old female which is positive for estrogen and progesterone receptors. CASE PRESENTATION: In this article, we describe a case of a-69-year-old female with a painful mass in her left breast. Based on intraoperative pathology consult, neoplastic tissue mostly floating in mucinous lakes with invasion to surrounding stroma was seen. Immunohistochemistry profile showed positive estrogen and progesterone receptors and negative for HER2. CONCLUSION: Mucinous cystadenocarcinoma of breast is typically triple negative for hormone receptors. But ER and PR positive variant of this tumor is rare, giving the chance of a better prognosis for the patient with hormonal therapy.

Semi-surgical percutaneous dilatational tracheostomy vs. conventional percutaneous dilatational tracheostomy: A prospective randomized trial.

BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is a common surgical procedure in the ICU. The present study was conducted to compare semi-surgical percutaneous dilatational tracheostomy (SSPDT) with conventional percutaneous dilatational tracheostomy (CPDT). METHODS: The present randomized clinical trial was conducted on 160 patients hospitalized in the medical intensive care units (ICUs) with an indication for tracheostomy and were systematically divided into two equal groups of 80. In the CPDT group, after a small incision, a 16-gauge needle was blindly inserted into the trachea and the guidewire was placed inside the lumen. A stoma was created by passing a single dilator over the guidewire. In the SSPDT group, a transverse incision (2 cm) was made 1 cm below the cricoid, and the tracheal ring was then fully reached by releasing the subcutaneous tissues using the index figure, and PDT was then performed. The two groups were compared in terms of their tracheostomy complications (including bleeding, pneumothorax, stoma infection and accidental decannulation) and duration of the procedure. RESULTS: The two groups were homogeneous in terms of age, gender, mean APACHE score (P>0.05). There were no significant differences between the two groups in terms of the mean time from tracheal intubation to tracheostomy (P=0.869). The duration of the procedure was 5.16±1.72 minutes in the SSPDT group and 6.42±1.71 in the CPDT group (P<0.001). The complication rate was 7(8.75%) in the SSPDT group and 16(20%) in the CPDT group (P=0.043). CONCLUSION: SSPDT is safer and has fewer complications than CPDT in ICU patients.

RNA Sequencing of Early-Stage Gastric Adenocarcinoma Reveals Multiple Activated Pathways and Novel Long Non-Coding RNAs in Patient Tissue Samples.

BACKGROUND: Gastric cancer is among the most common cancers worldwide that currently lacks effective diagnostic biomarkers and therapeutic targets. Next-generation RNA sequencing is a powerful tool that allows rapid and accurate transcriptome-wide profiling to detect differentially expressed transcripts involved in normal biological and pathological processes. Given the function of this technique, it has the potential to identify new molecular targets for the early diagnosis of disease, particularly in gastric adenocarcinoma. METHODS: In this study, whole-transcriptome analysis was performed with RNA sequencing on tumoral and non-tumoral tissue samples from patients with early-stage gastric cancer. Gene ontology and pathway enrichment analysis were used to determine the main function of the specific genes and pathways present in tissue samples. RESULTS: Analysis of the differentially expressed genes revealed 5 upregulated and 234 downregulated genes in gastric cancer tissues. Pathway enrichment analysis revealed significantly dysregulated signalling pathways, including those involved in gastric acid secretion, drug metabolism and transporters, molecular toxicology, O-linked glycosylation of mucins, immunotoxicity, metabolism of xenobiotics by cytochrome P450, and glycosylation. We also found novel downregulated non-coding RNAs present in gastric cancer tissues, including GATA6 antisense RNA 1, antisense to LYZ, antisense P4HB, overlapping ACER2, long intergenic non-protein coding RNA 2688 (LINC02688) and uncharacterized LOC25845 (PP7080). CONCLUSION: The transcriptomic data found in this study illustrates the power of RNA-sequencing in discovering novel genes and tumorigenic pathways involved in human carcinogenesis. The anomalies present in these genes may serve as promising tools for the development of accurate diagnostic biomarkers for the detection of early-stage gastric cancer.

LINC02688 and PP7080 as novel biomarkers in early diagnosis of gastric cancer.

Despite considerable progress in gastric cancer screening, prevention, and treatment, it remains a major cause of morbidity and mortality worldwide. Due to late diagnosis of the disease, early potential diagnostic biomarkers are needed. Accumulating evidence indicates that non-coding RNAs have potential applications as diagnostic and prognostic biomarkers in gastric cancer. Herein, we investigated the expression levels of two novel non-coding RNAs, long intergenic non-protein coding RNA 2688 (LINC02688) and LOC25845 (PP7080) by real-time PCR for the first time in 47 gastric cancer patients. We found significant downregulation of LINC02688 and LOC25845 (PP7080) with 3.44 and 2.2-fold decrease, respectively in tumoral tissues in comparison with their adjacent non-tumoral counterparts (P < 0.0001). Our data also indicates that more than 96% and 88% of patients showed unchanged or decreased expression of LINC02688 and LOC25845 (PP7080), respectively. As most gastric cancer patients showed lower expression of these two lncRNAs, no significant association between clinicopathological features of the patients and the level of LINC02688 and LOC25845 (PP7080) expression could be detected. Furthermore, ROC curve analysis indicated that LINC02688 and PP7080 can serve as good predictive biomarkers for distinguishing tumoral tissues from their adjacent non-tumoral counterparts. Taken together, our findings suggested that these two novel tumor suppressor non-coding RNAs may act as novel diagnostic biomarkers for diagnosis of carcinogenesis event even at earlier stages of gastric adenocarcinoma.

Association of sonic hedgehog signaling pathway genes IHH, BOC, RAB23a and MIR195-5p, MIR509-3-5p, MIR6738-3p with gastric cancer stage.

Gastric cancer is the leading cause of cancer-related mortality worldwide. Given the importance of gastric cancer in public health, identifying biomarkers associated with disease onset is an important part of precision medicine. The hedgehog signaling pathway is considered as one of the most significant widespread pathways of intracellular signaling in the early events of embryonic development. This pathway contributes also to the maintenance of pluripotency of cancer stem cells pluripotency. In this study, we analyzed the expression levels of sonic hedgehog (Shh) signaling pathway genes IHH, BOC, RAB23a and their regulatory miRNAs including MIR-195-5p, MIR-509-3-5p, MIR-6738-3p in gastric cancer patients. In addition, the impact of infection status on the expression level of those genes and their regulatory miRNAs was investigated. One hundred samples taken from 50 gastric cancer patients (50 tumoral tissues and their adjacent non-tumoral counterparts) were included in this study. There was a significant difference in all studied genes and miRNAs in tumoral tissues in comparison with their adjacent non-tumoral counterparts. The lower expression of IHH, BOC, RAB23, miR-195-5p, and miR-6738-3p was significantly associated with more advanced cancer stage. Additionally, IHH upregulation was significantly associated with CMV infection (P < 0.001). Also, receiver operating characteristic (ROC) curve analysis indicated that mir-195 was significantly related to several clinicopathological features including tumor stage, grade, age, gender, and infection status of gastric cancer and can be considered as a potential diagnostic biomarker for gastric cancer. This study confirms the important role of Shh signaling pathway genes in gastric cancer tumorigenesis and their potential as novel molecular biomarkers and therapeutic targets.

Upper Airway Nerve Block for Rigid Bronchoscopy in the Patients with Tracheal Stenosis: A Case Serie.

BACKGROUND: Rigid bronchoscopy is often used to diagnose and treat the location of resection of the tracheal stenosis. It is a selective procedure for the dilatation of tracheal stenosis, especially when accompanied by respiratory distress. OBJECTIVES: We introduced patients who were diagnosed with tracheal stenosis and candidate for rigid bronchoscopy dilatation by the upper airway nerve blocks. METHODS: This prospective observational study was conducted on 17 patients who underwent dilatation with rigid bronchoscopy in tracheal stenosis at Hospitals affiliated with Babol University of Medical Sciences from 2002 to 2017. The patients were given three nerve blocks, 6 bilateral superior laryngeal nerve block, bilateral glossopharyngeal nerve block, and recurrent laryngeal nerve block (transtracheal) before awake rigid bronchoscopy using 2% lidocaine. We evaluated the demographic data, the cause of tracheal stenosis, the quality of the airway nerve block (Intubation score), patients' satisfaction from bronchoscopy and thoracic surgeons' satisfaction. Complications of nerve blocks were recorded. RESULTS: From 2002 to 2017, 17 patients (14 were male and 3 were) female with tracheal stenosis who were candidates for dilatation with bronchoscopy and accepted the upper nerve block were included. The quality of the block was acceptable in 16 (94%) patients. 15 patients received fentanyl, and only two patients did not need to intravenous sedation. The mean age of patients was 29.59 ± 11.59. The average satisfaction of the surgeon was 8.82 ± 1.13 and the satisfaction of patients with anesthesia was 8.89 ± 1.16. There was one serious complication (laryngospasm) in one patient. CONCLUSIONS: The upper airway nerve block method is a suitable anesthesia technique for patients with tracheal stenosis who are candidates for the tracheal dilatation with rigid bronoscopy, especially when the patient has respiratory distress and has not been evaluated before surgery.

Association of CYP1A1 M2 (A2455G) Polymorphism with Susceptibility to Breast Cancer in Mazandaran Province, Northern Iran: A Case-control Study.

BACKGROUND: Breast cancer is one of the most frequent women malignancies in the world. The cytochrome P450 1A1 (CYP1A1) is a key enzyme in xenobiotics metabolism. Moreover, CYP1A1 plays a critical role in the etiology of breast cancer by involving in 2-hydroxylation of estrogen. Therefore, single-nucleotide polymorphisms (SNPs) of its coding gene have been verified to be important in cancer susceptibility. The aim of the study was to evaluate the association of CYP1A1 M2 (A2455G) includes rs1048943 of this SNP polymorphism with the risk of breast cancer in Mazandaran province. METHODS: Ninety-six breast cancer patients with known clinicopathological characters and 110 healthy women as control were genotyped for CYP1A1 M2 polymorphisms by the restriction fragment length polymorphism technique. RESULTS: The analysis of CYP1A1 gene (polymorphism M2) showed that the frequency of homozygous wild genotypes (AA), heterozygous (AG), and mutant genotype (GG) in the patient group, respectively, 78%, 22%, and 0%, and also the frequency of genotypes AA, AG, and GG in healthy included 82%, 16%, and 2%, respectively. Statistical analysis by Logistic regression model at P < 0.05 showed no significant correlation between polymorphisms in CYP1A1M2 and breast cancer risk (odds ratio = 0.84, confidence interval = 0.33-2.17). CONCLUSIONS: The results indicated that the M2 allelic genotypes were significantly associated neither with breast cancer risk nor with clinicopathological characteristics in Mazandaran province.

CDX1/2 and KLF5 Expression and Epigenetic Modulation of Sonic Hedgehog Signaling in Gastric Adenocarcinoma.

Gastric cancer is among the commonplace causes of cancer death worldwide. Sonic hedgehog (Shh) signaling is an important pathway which may be dysregulated in many cancers.CDX1/2, and KLF5are key transcription factors involved in Shh pathway and cancer stem cells. The aim of this study was to investigate the expression and epigenetic alterations of these genes in gastric cancer patients. DNA methylation's modifications of CDX1, KLF5 and CDX2 genes alongside with the expressions of these genes in gastric cancer tissues and their non-tumoral counterparts (margin tissues) were analyzed using methylation specific sequencing, and Real time PCR Taq man assays, respectively. The expression of CDX1 (P = 0.002) and KLF5 (P = 0.010) were decreased significantly, but it was considerably increased for CDX2 (P = 0.001). Relatively, the results for the regulatory region methylation status of each CpG site had shown a notable fluctuation in these genes with no significant difference in most places. The creation of metastatic lymph nodes in patients was significantly associated with increased expression of CDX2 gene. The modifications of these genes expression can be considered as a cancer biomarker in future studies. Methylation of the investigated genes is not the main mechanism of gastric cancer development.

Epigenetic alterations of CYLD promoter modulate its expression in gastric adenocarcinoma: A footprint of infections.

Gastric cancer (GC) is one of the most common causes of cancer-related death in the world, with multiple genetic and epigenetic alterations involved in disease development. CYLD tumor suppressor gene encodes a multifunctional deubiquitinase which negatively regulates various signaling pathways. Deregulation of this gene has been found in different types of cancer. This study aimed to evaluate for the first time the CpG island methylation pattern of CYLD gene promoter, and its expression level in gastric adenocarcinoma. CYLD messenger RNA expression and promoter methylation in 53 tumoral and their non-neoplastic counterpart tissues were assessed using quantitative polymerase chain reaction and bisulfite sequencing. Also, we investigated the impacts of the infectious agents including Helicobacter pylori (H. pylori), EBV, and CMV on CYLD expression and promoter methylation in GC. Results showed that the expression level of CYLD was downregulated in GC, and was significantly associated with gender (female), patient's age (<60), high grade, and no lymph-node metastasis (p = 0.001, 0.002, 0.03, and 0.003, respectively). Among the 31 analyzed CpG sites located in about 600 bp region within the promoter, two CpG sites were hypermethylated in GC tissues. We also found a significant inverse association between DNA promoter methylation and CYLD expression (p = 0.02). Furthermore, a direct association between H. pylori, EBV, and CMV infections with hypermethylation and reduced CYLD expression was observed (p = 0.04, 0.03, and 0.03, respectively). Our findings indicate that CYLD is downregulated in GC. Infectious agents may influence CYLD expression.

CTNNBIP1 downregulation is associated with tumor grade and viral infections in gastric adenocarcinoma.

Gastric cancer is a life-threatening disease; resulting from interaction among genetic, epigenetic, and environmental factors. Aberrant dysregulation and methylation changes in Wnt/ß-catenin signaling downstream elements are a prevalent phenomenon encountered in gastric tumorigenesis. Also, viral infections play a role in gastric cancer development. CTNNBIP1 (ß-catenin interacting protein 1) gene is an antagonist of Wnt signaling which binds to the ß-catenin molecules. The CTNNBIP1 function as tumor suppressor gene or oncogene in different types of cancer is controversial. Moreover, its function and regulatory mechanisms in gastric cancer progression is unknown. In the present study, we examined CTNNBIP1 gene expression, the methylation status of the regulatory region of the gene, and their association with Epstein-Barr virus (EBV), and cytomegalovirus (CMV) and Helicobacter pylori infections in human gastric adenocarcinoma tissues in comparison with their adjacent nontumoral tissues. Our data revealed a significant downregulation of CTNNBIP1 in gastric tumors. Female patients showed lower level of CTNNBIP1 than males (p < 0.05). Also, decreased expression of CTNNBIP1 was markedly associated with well-differentiated tumor grades (p < 0.05). No methylation change was observed between tumoral and nontumoral tissues. Additionally, CTNNBIP1 down regulation was significantly associated with CMV infection (p < 0.05). In the absence of EBV infection, lower expression of CTNNBIP1 was observed. There was no association between H. pylori infection and CTNNBIP1 expression. Our findings revealed the tumor suppressor role for CTNNBIP1 in gastric adenocarcinoma. Interestingly, EBV and CMV infections modulate CTNNBIP1 expression.

Prevalence of multiple infections and the risk of gastric adenocarcinoma development at earlier age.

Helicobacter pylori and Epstein-Barr virus are well established infections for gastric cancer development. However, the role of cytomegalovirus alone or in combination with other infections is unclear. In this case-control study, the prevalence of different infections was evaluated, and their frequency was compared with clinicopathologic features among gastric cancer patients and normal volunteers from 2012 to 2017. Approximately two-thirds (61.9%) of the gastric cancer patients had at least 1 viral infection, while viral infection prevalence in normal volunteers was only 4.7% (P = 0.021). The higher infection frequency in gastric cancer patients was observed for EBV (49.2%). No CMV DNA was detected in normal volunteers. In contrast, one-fourth of the gastric cancer patients were infected with CMV. Furthermore, CMV frequency in tumoral tissues (68.75%) was significantly higher than in nontumoral tissues (12.5%) (P = 0.0311). Although H. pylori infection was significantly lower in tumoral tissues than in nontumoral tissues (P = 0.0136), all tumoral tissues had cagA, while only 61.5% of nontumoral tissues were cagA positive. CMV-infected patients were affected 14 years earlier than uninfected, and CMV-negative patients (mean age = 56 vs. 69 and 70 years; P= 7.6×10-3 and P = 2.7×10-4, respectively). Also, EBV viral load in earlier grades and stages was more than 100-fold higher than advanced grades and stages. Our results show a high level of infections in gastric cancer. The association of these infections especially with CMV contributes to gastric adenocarcinoma development at earlier age.

Overexpression of serum MicroRNA-140-3p in premenopausal women with newly diagnosed breast cancer.

AIMS: The purpose of the present study was to evaluate microRNA-140-3p expression level in breast cancer patients in comparison to healthy controls. PATIENTS & METHODS: Serum microRNA-140-3p level was quantified by realtime quantitative reverse transcription PCR in 40 women with breast cancer and 40 healthy subjects. RESULTS: Serum microRNA-140-3p level in patients compared to healthy subjects was significantly up-regulated (P = 0.01). MicroRNA-140-3p had a good diagnostic accuracy for discrimination of the two groups (AUC = 0.667; sensitivity = 70%; specificity = 50%). Serum microRNA-140-3p level was overexpressed in premenopausal patients who were ≤48 years old. ROC curve showed a similar pattern again (AUC = 0.690; sensitivity = 73%; specificity = 50%). CONCLUSIONS: microRNA-140-3p has the potential for detection of breast cancer, especially in premenopausal and in ≤48 years old women.

Citalopram and group psychotherapy in breast cancer patients: A randomized clinical trial.

Background: Depression is a common psychiatric disorder in breast cancer patients. This study was designed to evaluate the clinical efficacy of group psychotherapy on breast cancer patients with depressive disorder who took citalopram. Methods: This clinical trial was conducted on 40 breast cancer patients with depressive disorder. The control group received citalopram 20-40 mg/ day for 12 weeks and the intervention group participated in 8 sessions of group psychotherapy in addition to the same dose of citalopram. At the baseline and 3, 6, and 12 weeks after treatment, patients were followed- up. Treatment outcomes and quality of life were compared between the 2 groups. Results: Overall, the depression score of Hospital Anxiety and Depression Scale (HADS) at baseline with the mean of 11.6±1.6 was signed in the range of clinical depression and after intervention it declined to 8.8±3.6 (in the 3rd week), 7.1±3.9 (6th week), and 5.9±4.5 (12th week). Furthermore, HADS anxiety score at baseline with the mean of 12.6±2.6 was signed in the range of clinical anxiety and after intervention it declined to 9.1±3.0, 7.3±4.1, and 6.0±4.0, respectively. This improvement was significantly more in the combined therapy intervention group (p<0.001). The mean score of quality of life based on WHO QOL-BREF questionnaire increased by 1.85 fold in the case group, improved from 44.09 to 81.70, while the slight change was observed in the control group (p<0.001). During the treatment, no significant adverse drug event was observed in the 2 groups (p>0.05). Conclusion: Group psychotherapy has a significant effect on improving depression, anxiety, and quality of life in breast cancer patients.

The diagnostic value of fine needle aspiration in comparison with frozen section in thyroid nodules: A 20-year study.

BACKGROUND: Fine needle aspiration (FNA) is the most important method in the diagnosis of thyroid nodules before surgery. Recently, the efficiency of FNA in thyroid nodule management has been debatable. On the other hand, intraoperative frozen section (FS) has been used to confirm the diagnosis of FNA and select the proper surgical approach. In this regard, the present study aimed to assess the diagnostic value of FNA as compared to FS in the diagnosis of thyroid nodules. METHODS: This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran. FNA was classified into 5 groups: benign (colloid goiter), lymphocytic thyroiditis, follicular lesions, suspicious and malignant, and FS was classified as after benign or malignant. The results of both methods were compared with each other. RESULTS: This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran. FNA was classified into 5 groups: benign (colloid goiter), lymphocytic thyroiditis, follicular lesions, suspicious and malignant, and FS was classified as after benign or malignant. The results of both methods were compared with each other. CONCLUSION: FNA was considered as a simple, less invasive and cost effective method with fewer side effects for evaluation of thyroid nodules. Particulary it had a high sensitivity and specificity in experienced and skilled hands.

Application of FT-IR spectroscopy on breast cancer serum analysis.

Breast cancer is regarded as the most malignant tumor among women throughout the world. Therefore, early detection and proper diagnostic methods have been known to help save women's lives. Fourier Transform Infrared (FT-IR) spectroscopy, coupled with PCA-LDA analysis, is a new technique to investigate the characteristics of serum in breast cancer. In this study, 43 breast cancer and 43 healthy serum samples were collected, and the FT-IR spectra were recorded for each one. Then, PCA analysis and linear discriminant analysis (LDA) were used to analyze the spectral data. The results showed that there were differences between the spectra of the two groups. Discriminating wavenumbers were associated with several spectral differences over the 950-1200cm-1(sugar), 1190-1350cm-1 (collagen), 1475-1710cm-1 (protein), 1710-1760cm-1 (ester), 2800-3000cm-1 (stretching motions of -CH2 & -CH3), and 3090-3700cm-1 (NH stretching) regions. PCA-LDA performance on serum IR could recognize changes between the control and the breast cancer cases. The diagnostic accuracy, sensitivity, and specificity of PCA-LDA analysis for 3000-3600cm-1 (NH stretching) were found to be 83%, 84%, 74% for the control and 80%, 76%, 72% for the breast cancer cases, respectively. The results showed that the major spectral differences between the two groups were related to the differences in protein conformation in serum samples. It can be concluded that FT-IR spectroscopy, together with multivariate data analysis, is able to discriminate between breast cancer and healthy serum samples.

Etiological approach of chylothorax in Babol, northern Iran.

BACKGROUND: Chylothorax results from leakage of lymph in the pleural cavity because of thoracic duct injury which is associated with severe metabolic disorders. The aim of this study was to evaluate the rate of chylothorax and its causes among hospitalized patients in Shahid Beheshti Hospital of Babol city, North of Iran. METHODS: In this cross-sectional study, all patients with chylothorax admitted to the surgery department of Shahid Beheshti Hospital during 2002-2015 were included. Information including gender, age, duration of symptoms, laboratory findings, causes of disease and the type of treatment were extracted from the patients' records. RESULTS: Of the 42 patients, 27 (64.3%) were men and 15 (35.7%) were women. The mean age of the study population was 51.03±16.95. The most common clinical symptoms were dyspnea (66.7%) and dyspnea with cough (21.4%), respectively. In all patients, the pleural fluid triglyceride level was greater than 110 mg/dl, whereas the presence of lymphatic in pleural fluid was eventful in 18 (42.8%) patients. The causes of the disease were traumatic (54.8%), non-traumatic (38.1%) and unknown (7.1%), which were not significantly correlated with gender. Nineteen (45.2%) patients were operated, 16 (38.1%) patients received supportive therapy, and 7 (16.7%) patients had the treatment of the underlying conditions and then supportive therapy. CONCLUSION: According to the results, trauma was the most common cause of chylothorax. Therefore, identification and control of the traumatic factors seem to be the steps to prevent and reduce the chylothorax incidence and its complications.