Low frequency of human T-cell lymphotropic virus 1 antibodies in Iranian gastric cancer patients in comparison to controls.

There is some evidence that human T-cell lymphotropic virus (HTLV-1) infection has a reverse association with gastric cancer (GC). Data about this association in the Iranian population are scarce. In this study we therefore assessed the frequency of anti-HTLV-1 antibody in GC patients and compare it to antibody presence in healthy individuals in Iranian population. This case control study was performed between 2008-2011 on 201 GC patients and 219 control subjects. HTLV-1 antibodies were assessed by ELISA and the positive results were confirmed by western blotting. Totals of 201 gastric cancer patients and 219 controls were enrolled in this study. The tumors in the majority of patients (45.3%) were in the distal (non-cardia) area. Mean age of patients at the time of diagnosis was 59.2±12.5 and mean age of controls was 57.7±11.3. While only one GC patient (0.5%) was positive for HTLV-1 antibody, there were four individuals (1.89%) from the control group with antibodies. In addition, smoking had statistically significant relationship with cancer (P=0.001). Our study showed that the frequency of HTLV-1 antibody in patients was lower than in controls, similar to the results obtained in Japan. Further investigations with a larger sample size are needed in order to determine the association between GC and HTLV-1 infection in Iran.

Clinical and pathology characteristics of colorectal polyps in Iranian population.

BACKGROUND AND AIM: Colon polyps are important lesions and a concern because of the potential for colorectal cancer, one of the most common causes of cancer-related deaths in Iran. The distribution of polyps in the colon may affect the efficacy of screening modalities. The aim of this study was to determine clinical and pathology characteristics of colorectal polyps in the Iranian population. METHODS: This cross sectional survey covered 856 polypectomies in 716 patients, with anatomical distribution, size and histopathology of the polyps described in 2004-2009 in the educational hospital of Taleghani in Tehran. RESULTS: Polyps were observed in 437 males and 279 females. The distribution was 3.12 percent located in the rectum, 19.6 percent in the sigmoid colon, 24.4 percent in the descending colon, 13.9 percent in the transverse colon, and 29.6 percent in the cecum and ascending colon. Some 77(9%) were non-neoplastic and 779 (91%) were neoplastic. Adenomas were present in 727 (85%) cases, of these 411 (56%) were left-sided and 316 (44% ) were right-sided. Carcinoma was observed in 52 cases, 18(34.5%) being left sided and 34(65.5% of carcinomas) right sided. Of the total, 354 were advance polyp (>1cm, villous type, high grade dysplasia), 87(34%) being found in patients under 50 years of age and 149 (58.6 %) being right sided. CONCLUSION: This study showed a significant number of adenomas and carcinomas to lie proximal to the splenic flexure. Thus, it is expected that examination of the colon limited to the splenic flexure would miss 44% of such lesions. The increasing right-sided prevalence of these lesions with age suggests that evaluation of the proximal bowel is particularly important in older people. In addition there were higher stages of dysplasia and malignancy in larger polyps.

Prevalence of colorectal cancer in relatives of Iranian patients diagnosed with colorectal cancer.

BACKGROUND: A high rate of colorectal cancer occurrence is established in individuals with a positive family history of this type of cancer. OBJECTIVES: The aim of this study was to investigate the prevalence of colorectal cancer in first degree and second degree relatives of colorectal cancer patients. METHODS: Family medical histories of 489 first degree relatives of colorectal cancer patients were obtained by a questionnaire. 249 average risk patients with no family history of colorectal cancer were included as control patients. RESULTS: In our study from a total of 489 case patients, 153 (31.3%) had at least one close relative affected by colon cancer. Case-control analysis showed an odd ratio of 3.1 (95% CI, 2.07 to 6.27) for one and 5.7 (CI, 2.39 to 13.56) for two affected relatives. Cases with a positive family history had a 3.006 times greater risk in developing colorectal cancer if a first degree relative was affected comparing with a 4.9 times greater risk if a second degree family member was diagnosed with colorectal cancer. Our study indicated a higher risk for developing colorectal cancer in male family relatives 50 years and older. Rectal area was found the most tumor side affected in case and control patients. CONCLUSION: First-degree relatives of patients with colorectal cancer had an increased risk of developing this type of cancer. The risk was greater when diagnosis was in male, elderly patients and other first-degree relatives were affected.

Colonoscopy screening results in at risk Iranian population.

OBJECTIVES: To investigate the prevalence of colorectal adenomas and other advanced lesions in first degree relatives of Iranian patients diagnosed with colorectal cancer by colonoscopy and pathologic evaluation. METHODS: Iranian colorectal cancer patients (probands) were identified through pathologic reports of the regional cancer registry. First degree relatives (siblings, parents and offspring) of probands were evaluated for the existence of polyps and precancerous lesions via colonoscopy screening. Control patients were chosen among average risk population with no family history of colorectal cancer who agreed to colonoscopy screening. RESULTS: A total of 184 subjects underwent colonoscopy screening from April 2007 to March 2009. From 90 cases among families of probands, 70 (77.8%) had a normal colonoscopy result, 18 (20%) demonstrated polyps and 2 (2.2%) were diagnosed with colorectal cancer. Colonoscopy screening in 94 average risk control patients discovered polyps in 4 (4.3%) cases and the other 90 (95.7%) patients had normal total colonoscopy results. Mean age of cases with advanced lesions was 48.4∓10.2 and 41.5∓18.4 in control patients with polyps. The incidence of polyps was significantly higher in males, and in family case patients compared to controls. CONCLUSIONS: Based on colonoscopy screening, the prevalence of colorectal adenoma and precancerous lesions in first degree relatives of patients diagnosed with colorectal cancer is significantly higher than in the average risk population.