Relationship between the Expression of the Thymidylate Synthase and the Prognosis of Gastric Cancer Patients Treated with Combinational Chemotherapy Regimen Including Fluorouracil, Docetaxel and Cisplatin.

Background: Thymidylate synthase is one of the target enzymes of 5-fluorouracil. However, the clinical and prognostic significance of TS expression in gastric cancer has remained controversial. In this study, the expression of thymidylate synthase was evaluated in gastric cancer patients treated with combinational chemotherapy; moreover, the association between TS expression and clinicopathologic characteristics and overall survival of the patients were also assessed. Materials and Methods: In this descriptive study, 89 pathological samples were gathered from patients at Kermanshah hospitals during 2008-2017. The survival status of patients was recorded and their overall survival was evaluated individually. Results: The average survival period for low and high thymidylate synthase groups was 54 and 50 months, respectively, meaning higher survival time in the lower thymidylate group. But this difference was not statistically significant (log Rank=0.88). In addition, sex, stage, recurrence, and survival had no significant difference between the low and high expression of thymidylate synthase groups (p=0.89). Conclusion: The results clearly indicated that the level of thymidylate synthase is not a significant modulator of 5- fluorouracil in gastric cancer patients. Nevertheless, evaluation of the level of the enzymes and markers as well as their effects are highly recommended for accurate selection of chemotherapeutical strategies.

The Role of Human Epidermal Growth Factor Receptor (HER2/neu) in the Prognosis of Patients with Gastric Cancer.

Objective: Gastric cancer is one of the oncological challenges, and tendency toward target therapy in this cancer has been increased. Controversy still exists on prognostic value of HER2/neu expression and its relationship with clinicopathological characteristics and survival of gastric cancer patients. In this regard, the present study examined the status of HER2/neu in patients with gastric cancer and its prognostic effects. Methods: Pathological samples of 97 gastric cancer patients diagnosed over the last 8 or 9 years (from 2008 to the end of 2017) and treated with 5-fluorouracil, Docetaxel, and Cisplatin (TCF) were studied in this investigation. Patients were assigned to two groups according to their HER2/neu status. First group included patients with positive HER2/neu (Score 3) and second group involved patients with negative HER2/neu (Score 0 and 1). Patients were compared in terms of disease stage, survival rate, and mortality. Results: The mean age of patients was 58 years old. There were 75 men and 22 women in this study. In terms of disease stage, 4, 21, 41, and 31 patients were in stage I, II, III, and IV, respectively. Using IHC method, it was found that 27, 23, 25, and 22 patients had HER2/neu expression with score 0, score +1, score 2+ and score+3, respectively. We discovered that expression of positive HER2/neu was associated with male sex. We also observed that survival and mortality rates following treatment initiation were significantly different between HER2/neu positive and negative gastric cancer patients (P<0.01). Conclusion: Evaluation of HER2/neu status in gastric cancer patients showed that HER2/neu 3+ expression could reduce the patients' survival. Therefore, it is recommended that patients who may benefit from trastuzumab, be treated. A clinical multi-center trial should be also considered for use of this drug in adjuvant cases.

The effect of catalase C262T gene polymorphism in susceptibility to ovarian cancer in Kermanshah province, Western Iran.

Ovarian cancer has a heterogeneous biology and behaviour. Oxidative stress can initiate chronic inflammation, which can sequentially facilitate chronic diseases, including cancer. Oxidative stress may arise when there is extra reactive oxygen species (ROS) production and/or inadequate defence mechanisms. There are some antioxidant defences that can fight against oxidative damage, including catalase (CAT) enzyme. We sought to evaluate the association of CAT C262T gene polymorphism with increased risk of ovarian cancer. A total of 74 paraffin-embedded ovarian cancer blocks were taken from the archive of Imam-Reza Hospital, Kermanshah University of Medical Sciences, between 2010 and 2014. Also, 153 blood samples were harvested from healthy volunteers. For genotyping of CAT C262T, we designed allele-specific polymerase chain reaction (AS-PCR). 'T' allele of CAT C262T showed a protective effect against the risk of ovarian cancer [OR = 0.4 (95% CI 0.25-0.6), p value <.001]. Calculating adjusted odds ratio showed the distribution of alleles and genotypes was not affected by age. The present study reported a significant association between the distribution of CAT C262T gene polymorphism and ovarian cancer for the first time in a sample of the Iranian population. Impact Statement What is already known on this subject: Ovarian cancer has a heterogeneous biology and behaviour at the clinical, cellular and molecular aspects. Ovulation releases follicular fluid containing reactive oxygen species which is related to changes in the microenvironment, such as inflammation, that could be a factor in early ovarian carcinogenesis. There are some antioxidant defences that can protect cells against oxidative damage, including catalase (CAT). Different studies investigated the relationships between CAT C262T polymorphism and several diseases. Belotte et al. ( 2015 ), for the first time, indicated no significant association between CAT C262T and the risk of ovarian cancer, while they showed this SNP is associated with poor survival and therefore may serve as a prognostic factor for ovarian cancer. What the results of this study add: In the present study, 'T' allele of CAT C262T showed a protective effect against the risk of ovarian cancer. Calculating adjusted odds ratio showed that the distribution of alleles and genotypes is not affected by age. What the implications are of these findings for clinical practice and/or further research: Pair-wise genetic analyses using SNPSTATS software showed that this genotyping was more compatible with recessive models, i.e. two copies of the associated variant are required to increase the risk of ovarian cancer. Further research about other antioxidant genes in a larger population is needed to predict the risk of ovarian cancer and survival rate of patients.

Stevens-Johnson Syndrome Patient Received Combination Chemotherapy Gemcitabine, Cisplatin, and 5-FU for Biliary Tract Cancer.

Stevens-Johnson syndrome has been an acute, usually self-limiting disease of the skin and mucous membranes. This case report has presented an evidence of the development Stevens - Johnson syndrome associated with combination chemotherapy administration of 5FU, gemcitabin and cisplatin in a patient with biliary tract cancer. Our case was a 54-year-old woman patient, a case of biliary tract cancer who has developed more severe symptoms of Stevens-Johnson syndrome. Diagnosis has confirmed by skin biopsy of an affected area .The patient has improved with supportive care, and during 25 day occurred recovery. Although Stevens-Johnson syndrome has been a rare toxicity, physicians should pay a special attention to the monitoring of biliary tract cancer patients on combination chemotherapy with 5FU, cisplatin and gemcitabin.