Diagnostic accuracy of multitarget stool DNA testing for colorectal cancer screening: A systematic review and meta-analysis / Precisión diagnóstica de las pruebas de DNA en heces con objetivos múltiples para la detección del cáncer colorrectal: una revisión sistemática y un metaanálisis

Introduction: This study aimed to collect and summarize test data and conduct a meta-analysis, with respect to the Multitarget Stool DNA test sensitivity and specificity, compared to colonoscopy. Material and methods: All manuscripts were screened for eligibility according to inclusion criteria. Participants were a normal population at an average risk of developing CRC. Intervention was Stool based and DNA panel tests compared with colonoscopy, and outcome was detection of CRC and any pre-cancerous lesions. Inter-study and inconsistency (using the I-squared test) were assessed. Results: Meta-analyses of the Mt-sDNA test showed a combined sensitivity of 89%, 51%, and 76% for the detection of CRC, advanced adenoma (AA), and combined CRC and AA, respectively. The overall specificity was 91%, 89%, and 90% for the detection of CRC, AA, and combined CRC and AA, respectively. Conclusion: Mt-sDNA had significantly acceptable diagnostic accuracy for CRC and AA diagnosis, but still has lower sensitivity and specificity than colonoscopy.(AU)

Introducción: Este estudio tuvo como objetivo recopilar y resumir los datos de las pruebas y realizar un metaanálisis con respecto a la sensibilidad y especificidad de la prueba de DNA en heces multiobjetivo, en comparación con la colonoscopia. Material y métodos: Todos los manuscritos fueron examinados para determinar su elegibilidad de acuerdo con los criterios de inclusión. Los participantes eran una población normal con un riesgo promedio de desarrollar CRC. La intervención se basó en heces y pruebas de panel de DNA en comparación con la colonoscopia, y el resultado fue la detección de CRC y cualquier lesión precancerosa. Se evaluaron la inconsistencia entre estudios y la inconsistencia (mediante la prueba de I cuadrado). Resultados: Los metaanálisis de la prueba Mt-sDNA mostraron una sensibilidad combinada del 89%, 51% y 76% para la detección de CRC, adenoma avanzado (AA) y CRC y AA combinados, respectivamente. La especificidad general fue del 91%, 89% y 90% para la detección de CRC, AA y CRC y AA combinados, respectivamente. Conclusión: Mt-sDNA tuvo una precisión diagnóstica significativamente aceptable para el diagnóstico de CRC y AA, pero aún tiene una sensibilidad y especificidad más bajas que la colonoscopia.(AU)

Comparative analysis of selected cagPAI genes and different vacA genotypes in Iranian and Turkish H. pylori-positive patients suffering from gastric adenocarcinoma and active chronic gastritis.

BACKGROUND/AIM: Helicobacter pylori is a pathogen that colonizes a majority of the world's population. Genetic diversity within the virulence genes of bacteria such as cagPAI and vacA may have a modified effect on the pathogenic potential of the bacteria. This study aimed to investigate which genes can be suggested as potentially related virulence factors for H. pylori-associated active chronic gastritis and stomach adenocarcinoma in the northwest of Iran and south of Turkey. MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded stomach biopsy tissue samples were obtained from Iranian and Turkish patients from selected geographical regions. The prevalence of selected cagPAI genes and vacA genotypes were studied in H. pylori-positive samples by using polymerase chain reaction and specific primers. RESULTS: Out of 320 patients, H. pylori was detected in 28.43% of patients. We found that the vacAs1, vacAm2, and cagA genes with mean prevalences of 82.41%, 71.42%, and 69.23%, respectively, were dominant in Iranian and Turkish patients. CONCLUSION: In the south of Turkey and northwest of Iran the studied genes were homogeneous and there were no significant differences in bacterial genetics. The results of this study indicate that cagA and vacAs1 are dominant genes in people with gastric disorders in our selected geographical regions.

Co-delivery of IL17RB siRNA and doxorubicin by chitosan-based nanoparticles for enhanced anticancer efficacy in breast cancer cells.

Overexpression of IL17RB is associated with poor prognosis and short survival of the breast cancer patients.IL17RB/IL17B signaling triggers a substantial increase in the cell growth, proliferation and migration through the activation of NF-κB as well as the up-regulation of the Bcl-2. In this study we designed carboxymethyl dextran (CMD) Chitosan nanoparticles (ChNPs) to encapsulated IL17RB siRNA and doxorubicin (DOX) as an anticancer drug. Then we investigated the efficiency of the simultaneous delivery of drug/siRNA on viability and gene expression of MDA-MB361 cell lines. Furthermore the efficacy of dual agent nanoparticles to induce apoptosis and inhibit migration of breast cancer cells was assessed by Annexin-V and wound healing assays respectively. Our results showed that DOX-siRNA-CMD-ChNPs had about 114nm size; with polydispersity index and zeta potential about 0.3 and 10.1mV respectively. Fourier transform infrared spectroscopy (FTIR) confirmed the formation of DOX-siRNA-CMD-ChNPs complex. In addition IL17RB siRNA had significant effect on DOX-induced cytotoxicity in MDA-MB361 cells. Furthermore treatment with dual agent nanoparticles resulted in a significant silencing of NF-κB and Bcl-2 relative gene expression, apoptosis induction and migration inhibition in MDA-MB361 cells. In conclusion, co-delivery of IL17RB siRNA and DOX can be considered as an effective system for the treatment of breast cancer.

Association of TNF-α -857 Polymorphism with Inflammatory Bowel Disease in a Group of Iranian Azeri Individuals.

BACKGROUND Inflammatory bowel disease (IBD) is a chronic, relapsing, inflammatory disorder of the gastrointestinal tract that includes two entities, Crohn's disease (CD) and ulcerative colitis (UC). As with other complex diseases, both genetic susceptibility and environmental factors play role in the pathogenesis of these diseases. The tumor necrosis factor α (TNF-α) gene is located in the IBD3 region on chromosome 6p21 which is a good functional candidate for involvement in susceptibility to IBD. In addition, the promoter region of TNF-α contains various polymorphisms that have shown a significant association with IBD. METHODS In this case control study we investigated the TNF-α -857 polymorphism in 109 patients (89 UC and 16 CD) who suffered from IBD and 100 healthy age, sex and ethnicity matched adults selected from the same population, as the control group. The polymorphism was checked by amplification refractory system (ARMS) and polymerase chain reaction (PCR). RESULTS Investigation of the association of TNF-α -857 gene promoter polymorphism with both types of IBD showed no significant difference in genotype and allele frequencies of this polymorphism between UC patients and controls. However, a possible association of TNF-α -857 polymorphism (p=0.03) was identified with CD. CONCLUSION TNF-α -857 polymorphism may have a role in the development of CD in the Iranian Azeri Turkish population.

Drug-related mutational patterns in hepatitis B virus (HBV) reverse transcriptase proteins from Iranian treatment-naïve chronic HBV patients.

BACKGROUND: Immunomodulators and Nucleotide analogues have been used globally for the dealing of chronic hepatitis B virus (HBV) infection. However, the development of drug resistance is a major limitation to their long-term effectiveness. OBJECTIVES: The aim of this study was to characterize the hepatitis B virus reverse transcriptase (RT) protein variations among Iranian chronic HBV carriers who did not receive any antiviral treatments. MATERIALS AND METHODS: Hepatitis B virus partial RT genes from 325 chronic in active carrier patients were amplified and directly sequenced. Nucleotide/amino acid substitutions were identified compared to the sequences obtained from the database. RESULTS: All strains belonging to genotype D.365 amino-acid substitutions were found. Mutations related to lamivudine, adefovir, telbivudine, and entecavir occurred in (YMDD) 4% (n = 13), (SVQ) 17.23% (n = 56), (M204I/V + L180M) 2.45% (n = 8) and (M204I) 2.76% (n = 9) of patients, respectively. CONCLUSIONS: RT mutants do occur naturally and could be found in HBV carriers who have never received antiviral therapy. However, mutations related to drug resistance in Iranian treatment-naïve chronic HBV patients were found to be higher than other studies published formerly. Chronic HBV patients should be monitored closely prior the commencement of therapy to achieve the best regimen option.

Acceptability and outcomes of percutaneous endoscopic gastrostomy (PEG) tube placement and patient quality of life.

BACKGROUND/AIMS: Since its description in 1980, percutaneous endoscopic gastrostomy has been a widely used method for insertion of a gastrostomy tube in patients who are unable to swallow or maintain adequate nutrition. This study aimed to assess the perspectives of patients/caregivers in our society regarding the acceptability of percutaneous endoscopic gastrostomy tube placement and to evaluate the outcomes. METHODS: One hundred consecutive adults referred to our unit to be considered for primary percutaneous endoscopic gastrostomy feeding at Imam Reza Hospital of Tabriz University of Medical Sciences were evaluated prospectively from October 2007 to June 2009. The nutritional status of patients, complications and quality of life were assessed after percutaneous endoscopic gastrostomy insertion for six months. The data were analyzed using SPSS software. RESULTS: Indications for percutaneous endoscopic gastrostomy were neurologic in 66 patients and recurrent pulmonary aspiration in 14 intensive care unit adult patients. Minor complications included percutaneous endoscopic gastrostomy site infection in 8 patients and tube blockage in 5 patients. Oral feeding was resumed in 27% of the patients and the tube was removed subsequently after 3-6 months; 42 patients died due to primary diseases (in 1-6 months). The Quality of Life Index scores pre-percutaneous endoscopic gastrostomy placement and 6 months after percutaneous endoscopic gastrostomy averaged 19.25±11.85 and 30.08±27.74, respectively. A similarly significant difference was also found between mean Quality of Life Index scores pre- and post-percutaneous endoscopic gastrostomy placement (p<0.005). CONCLUSIONS: Percutaneous endoscopic gastrostomy is a minimally invasive gastrostomy method with low morbidity and mortality rates, and is easy to follow-up and to replace when blockage occurs.

Gastrointestinal cancer occurrence in East Azarbaijan: a five year study from North Western Iran.

BACKGROUND AND AIMS: Regardless of the fact that neoplasms of the GI tract have been reported as the most common fatal cancers in east Azerbaijan, there is a serious lack of population based studies in this region. The aim of this pathology-based cancer registry report is to document epidemiologic aspects of gastrointestinal tract cancers in East Azerbaijan for further medical programs for treatment and screening of high-risk groups and study changes over time. METHODS: A survey team reviewed and collected all records of cancer cases from all referral and valid pathology laboratories, hospitals and out patient public and private clinics of East Azerbaijan province during a five year period (September 1999 to 2004). RESULTS: 5,417 new cases of histologically confirmed GI tract cancers were registered, 61.7% of the subjects being male. The mean (+/- SD) ages were 63.25+/-12.79 and 59.45+/-13.39 yr for men and women, respectively . Gastric cancer was the most common GI tract cancer with an annual ASR of 21.3 per 10(5) for males and 8.2 for females . The annual ASRs for esophagus and colorectal cancers were 9.4 and 6 in males and 7.1 and 9.2 in females. Gastric cancer was significantly more common among men although women were more likely to develop cancer in younger age. Some 14% of our subjects with colorectal cancer were under the age of 40. CONCLUSION: This first report from East Azarbaijan, suggests a need for further evaluations to map out the risk factors and interventions.