Journal of Oncology http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Primary Circulating Prostate Cells Are Not Detected in Men with Low Grade Small Volume Prostate Cancer Tue, 19 Aug 2014 07:13:49 +0000 http://www.hindawi.com/journals/jo/2014/612674/ Objective. To determine if primary circulating prostate cells (CPCs) are found in all men with prostate cancer. Methods and Patients. A prospective study, to analyze all men with an elevated PSA between 4.0 and 10.0 ng/mL undergoing initial biopsy. Primary CPCs were obtained by differential gel centrifugation and detected using standard immunocytochemistry using anti-PSA; positive samples underwent a second process with anti-P504S. A malignant primary CPC was defined as PSA (+) P504S (+) and a test positive if 1 cell/4 mL was detected. Biopsy results were registered as cancer/no-cancer, number of cores positive, and percent infiltration of the cores. Results. 328/1123 (29.2%) of the study population had prostate cancer diagnosed on initial biopsy, and 42/328 (12.8%) were negative for primary CPCs. CPC negative men were significantly older, and had lower PSA levels, lower Gleason scores, and fewer positive cores and with infiltration by the cancer. 38/42 (91%) of CPC negative men complied with the criteria for active surveillance in comparison with 34/286 (12%) of CPC positive men. Conclusions. Using primary CPC detection as a sequential test to select men with an elevated PSA for biopsy, the risk of missing clinically significant prostate cancer is minimal when the patient is primary CPC negative; less than 0.5% of all primary CPC negative men had a clinically significant prostate cancer. Nigel P. Murray, Eduardo Reyes, Cynthia Fuentealba, Nelson Orellana, and Omar Jacob Copyright © 2014 Nigel P. Murray et al. All rights reserved. A Case-Control Study of the Role of Human Papillomavirus in Oesophageal Squamous Cell Carcinoma in Australia Mon, 28 Apr 2014 11:45:58 +0000 http://www.hindawi.com/journals/jo/2014/236482/ Objective. We investigate the prevalence of human papillomavirus (HPV) in oesophageal squamous cell carcinoma (OSCC) tissues compared to oesophageal tissue from healthy controls, in an Australian cohort. Methods. We conducted a hospital-based case-control study of 99 patients with OSCC and 100 healthy controls to examine the presence of HPV DNA. Paraffin tissues were tested using the PapType high-risk HPV detection and genotyping kit and with INNO-LiPA HPV Genotyping Extra. The biopsy samples were tested for HPV using a PCR-ELISA method based on the L1 consensus primer set PGMY09-PGMY11. Results. HPV DNA of the oncogenic genotype 16 was detected in 1/99 case specimens, a rate of 1010 per 100,000 (95% CI: 30–5500). All control specimens were negative for HPV. Significantly higher rates of smoking, other aerodigestive cancers, and mortality were seen among cases than controls. A pooled analysis of this study and the only other Australian case-control study found that 9/321 cases and 0/155 controls were positive for HPV. The pooled odds ratio for HPV being a risk factor for OSCC was 9.35 (95% CI: 0.47–190.33). Conclusion. Our results suggest that in this multifactorial cancer HPV may be an additional risk factor; although a larger, better powered study is needed. Surabhi S. Liyanage, Eva Segelov, Aisha Malik, Suzanne M. Garland, Sepehr N. Tabrizi, Eleanor Cummins, Holly Seale, Bayzidur Rahman, Aye Moa, Andrew P. Barbour, Philip J. Crowe, and C. Raina MacIntyre Copyright © 2014 Surabhi S. Liyanage et al. All rights reserved. Intensive Care Unit Admission after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Is It Necessary? Tue, 22 Apr 2014 00:00:00 +0000 http://www.hindawi.com/journals/jo/2014/307317/ Introduction. Cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a new approach for peritoneal carcinomatosis. However, high rates of complications are associated with CS and HIPEC due to treatment complexity; that is why some patients need stabilization and surveillance for complications in the intensive care unit. Objective. This study analyzed that ICU stay is necessary after HIPEC. Methods. 39 patients with peritoneal carcinomatosis were treated according to strict selection criteria with CS and HIPEC, with closed technique, and the chemotherapy administered were cisplatin 25 mg/m2/L and mitomycin C 3.3 mg/m2/L for 90-minutes at 40.5°C. Results. 26 (67%) of the 39 patients were transferred to the ICU. Major postoperative complications were seen in 14/26 patients (53%). The mean time on surgical procedures was 7.06 hours (range 5−9 hours). The mean blood loss was 939 ml (range 100–3700 ml). The mean time stay in the ICU was 2.7 days. Conclusion. CS with HIPEC for the treatment of PC results in low mortality and high morbidity. Therefore, ICU stay directly following HIPEC should not be standardized, but should preferably be based on the extent or resections performed and individual patient characteristics and risk factors. Late complications were comparable to those reported after large abdominal surgery without HIPEC. Horacio N. López-Basave, Flavia Morales-Vasquez, Carmen Mendez-Herrera, Silvio A. Ñamendys-Silva, Kuauhyama Luna-Ortiz, German Calderillo-Ruiz, Jesús Cabrera Rojas, Erika Ruiz-Garcia, Angel Herrera-Gomez, Juan M. Ruiz-Molina, and Abelardo Meneses Garcia Copyright © 2014 Horacio N. López-Basave et al. All rights reserved. Indicators of Psychiatric Disorders in Different Oncology Specialties: A Prevalence Study Mon, 14 Apr 2014 08:58:55 +0000 http://www.hindawi.com/journals/jo/2014/350262/ Objective. This study evaluated the prevalence of various indicators of psychiatric disorders in Brazilian outpatients with cancer and assessed possible associations with sociodemographic indicators. Materials and Methods. A total of 1,385 patients were evaluated using the following instruments: Patient Health Questionnaire-4 (PHQ-4), Generalized Anxiety Disorder (GAD-7), Fagerström Test for Nicotine Dependence (FTND), and Fast Alcohol Screening Test (FAST). Results. The sample was composed of both genders with a slight predominance of women (55.8%), subjects with incomplete/completed elementary school (59%), married (67.4%), with children (94%), not active from a labor viewpoint (61.6%), and following some type of religion (79.5%). The prevalence of anxiety for the total sample varied between 21.5 and 27.4%. The prevalence of depression was 21.1%, tobacco abuse/dependence was 40.2%, and alcohol was 20.3%. Women had significantly higher levels of anxiety and depression than men. Men had higher levels of substance abuse/dependence indicators than women. Conclusion. These results are consistent with the literature, which attests to the high prevalence of psychiatric disorder indicators in cancer patients, especially compared to the general population. Manuela Polidoro Lima and Flávia L. Osório Copyright © 2014 Manuela Polidoro Lima and Flávia L. Osório. All rights reserved. Androgen Deprivation Therapy and Cardiovascular Risk in Chinese Patients with Nonmetastatic Carcinoma of Prostate Mon, 07 Apr 2014 08:15:05 +0000 http://www.hindawi.com/journals/jo/2014/529468/ Background. Androgen deprivation therapy (ADT) in nonmetastatic prostate cancer is unclear. Recent data suggests possible increase in the cardiovascular risks receiving ADT. The aim of the study was to investigate the cardiovascular outcomes in a cohort of Chinese nonmetastatic prostate cancer patients with no previously documented cardiovascular disease. Methods and Results. 745 patients with no previously documented cardiovascular disease and/or diabetes mellitus diagnosed to have nonmetastatic prostate cancer were recruited. Of these, 517 patients received ADT and the remaining 228 did not. After a mean follow-up of 5.3 years, 60 patients developed primary composite endpoint including (1) coronary artery disease, (2) congestive heart failure, and (3) ischemic stroke. Higher proportion of patients on ADT (51 patients, 9.9%) developed composite endpoint compared with those not on ADT (9 patients, 3.9%) with hazard ratio (HR) of 2.06 (95% confidence interval (CI): 1.03–3.24, ). Furthermore, Cox regression analysis revealed that only the use of ADT (HR: 2.1, 95% CI: 1.03–4.25, ) and hypertension (HR: 2.0, 95% CI: 1.21–3.33, ) were independent predictors for primary composite endpoint. Conclusion. ADT in Chinese patients with nonmetastatic prostate cancer with no previously documented cardiovascular disease was associated with subsequent development of cardiovascular events. Gang Huang, Chun-Yip Yeung, Ka Kui Lee, Jianxiong Liu, Kwan Lun Ho, Ming-Kwong Yiu, Karen Siu-Ling Lam, Hung-Fat Tse, Thomas Yau, and Chung-Wah Siu Copyright © 2014 Gang Huang et al. All rights reserved. Endoscopic Oncology Mon, 31 Mar 2014 13:45:47 +0000 http://www.hindawi.com/journals/jo/2014/785043/ Everson L. A. Artifon, Takao Itoi, Jose G. de la Mora Levy, and Juan J. Vila Copyright © 2014 Everson L. A. Artifon et al. All rights reserved. Pathogenesis and Nomenclature of Odontogenic Carcinomas: Revisited Sun, 30 Mar 2014 09:19:53 +0000 http://www.hindawi.com/journals/jo/2014/197425/ Odontogenic carcinoma is rare group of malignant epithelial odontogenic neoplasms with characteristic clinical behavior and histological features, which requires an aggressive surgical approach. The pathogenesis of this rare group remains still controversial and there have been many varied opinions over the classification of this rare group of lesions. As there have not been many reviews on odontogenic carcinoma, the existing knowledge is mostly derived from the published case reports. This review is discussing the pathogenetic mechanisms and is updating the knowledge on nomenclature system of less explored odontogenic carcinomas. This review might throw light on the pathogenesis and nomenclature system of odontogenic carcinoma and this knowledge may be applied therapeutically. Swagatika Panda, Sujit Ranjan Sahoo, Gunjan Srivastav, Subrat Padhiary, Kanika Singh Dhull, and Sonia Aggarwal Copyright © 2014 Swagatika Panda et al. All rights reserved. The Efficacy of Bisphosphonates in Preventing Aromatase Inhibitor Induced Bone Loss for Postmenopausal Women with Early Breast Cancer: A Systematic Review and Meta-Analysis Wed, 26 Mar 2014 11:28:57 +0000 http://www.hindawi.com/journals/jo/2014/625060/ Objectives. We aim to determine the efficacy of bisphosphonates in preventing aromatase inhibitor induced bone loss (AIBL) in postmenopausal women with early breast cancer. The secondary objective was to determine the safety of bisphosphonates. Materials and Methods. We searched electronic databases in a time period of 1995 January to 2013 June. Random effects meta-analytical models were used; between study heterogeneity and publication bias was assessed. Results. A total of six eligible studies reported the BMD T score of LS at 12 months and from that 3 trials of Zoledronic acid compared the change in BMD in immediate ZOL versus delayed ZOL done with subgroups like patients with normal BMD at baseline (OR = 5.402, 95% CI = 1.329–21.959, value = 0.018) and osteopenic BMD at baseline (OR = 4.008, 95% CI = 2.249–7.143, value = 0.0002). Both had a significant decrease in BMD that favoured the delayed ZOL; 3 trials of risedronate and ibandronate also had a significant decrease in BMD in AIs alone group. Immediate ZOL versus delayed ZOL also showed increased risk of getting an ADR in immediate group. Conclusion. Third generation bisphosphonates has an effect on BMD of patients who are on treatment of AIs in breast cancer. Furthermore, the patients treated with immediate ZOL had a significantly high risk of musculoskeletal ADR’s than patients with delayed ZOL. Pooleriveetil Padikkal Anagha and Suchandra Sen Copyright © 2014 Pooleriveetil Padikkal Anagha and Suchandra Sen. All rights reserved. Disseminated Tumor Cells in Bone Marrow of Gastric Cancer Patients: Correlation with Tumor Hypoxia and Clinical Relevance Tue, 11 Feb 2014 09:20:44 +0000 http://www.hindawi.com/journals/jo/2014/582140/ Aim. The evaluation of the clinical relevance of disseminated tumor cells (DTCs) in bone marrow (BM) of patients with gastric cancer (GC) and their association with primary tumor hypoxia. Patients and Methods. 89 resected specimens were used. DTCs were detected using immunocytochemistry, the level of tumor hypoxia using NMR spectroscopy, CD68, CD34, VEGF, and VEGFR-1 (Flt-1) expression using immunohistochemistry, and MMP-2 and MMP-9 activity using zymography. Results. DTCs were detected in 51.4% of GC patients with M0. There was significant correlation between frequency of DTCs in BM and level of tumor hypoxia (). DTCs presence was accompanied with Flt-1 positivity of BM. The correlation between DTCs and tumor VEGF expression in patients with M0 was shown (). Activity of MMP-2 and MMP-9 in BM was linked with DTCs in patients with M0 (). Overall survival (OS) of patients with M0 and DTCs was shorter than that of patients without DTCs (patients in both groups were operated only) (). Conclusion. Appearance of DTCs correlates with hypoxia level in primary tumors. Detection of DTCs in GC patients may be relevant indicator for adjuvant chemotherapy using. Larissa Bubnovskaya, Antonina Kovelskaya, Lilya Gumenyuk, Irina Ganusevich, Lesya Mamontova, Victor Mikhailenko, Dmitry Osinsky, Sergej Merentsev, and Sergej Osinsky Copyright © 2014 Larissa Bubnovskaya et al. All rights reserved. Nuclear Pattern of CXCR4 Expression Is Associated with a Better Overall Survival in Patients with Gastric Cancer Mon, 10 Feb 2014 13:02:56 +0000 http://www.hindawi.com/journals/jo/2014/808012/ Introduction. Previous studies have shown that stromal-derived factor-1 (CXCL12) and its receptor, CXCR4, play a crucial role in metastasis of various tumors. Similarly, it has been cleared that CXCR4 is expressed on the cell surface of gastric cancers. However, nuclear expression of CXCR4 and its clinical importance have not been yet studied. Materials and Methods. Herein, we studied the expression of CXCR4 in gastric samples from patients with gastric adenocarcinoma as well as human gastric carcinoma cell line, AGS, by employing RT-PCR, immunohistochemistry, and flow cytometry techniques. Results. RT-PCR data showed that CXCR4 is highly expressed on AGS cells. This was confirmed by IHC and FACS as CXCR4 was detected on cell membrane, in cytoplasm, and in nucleus of AGS cells. Moreover, we found that both cytoplasmic and nuclear CXCR4 are strongly expressed in primary gastric cancer and the cytoplasmic pattern of CXCR4 tends to be associated with a shorter overall survival than nuclear staining. In conclusion, we present evidence for the first time that both cytoplasmic and nuclear expression of CXCR4 are detectable in gastric cancer tissues. However, the role of both cytoplasmic and nuclear CXCR4 needs to be further elucidated. Bahram Nikkhoo, Ali Jalili, Shohreh Fakhari, Farshad Sheikhesmaili, Fardin Fathi, Daem Rooshani, Mohammad Ali Hoseinpour Feizi, and Mehrnoush Nikzaban Copyright © 2014 Bahram Nikkhoo et al. All rights reserved. Predictors of Venous Thromboembolic Events Associated with Central Venous Port Insertion in Cancer Patients Sun, 09 Feb 2014 08:49:29 +0000 http://www.hindawi.com/journals/jo/2014/743181/ Insertion of central venous port (CVP) catheter in the cancer population is associated with increased incidence of venous thromboembolic events (VTE). However, trials have shown limited benefit of antithrombotic treatment to prevent catheter-related venous thrombosis. This prospective observational cohort study was designed to assess the incidence of VTE closely related to CVP implantation in patients with cancer and undergoing chemotherapy, and to identify a high risk subgroup of patients. Between February 2006 and December 2011, 1097 consecutive cancer patients with first CVP implantation were included. Catheter-related VTE were defined as deep venous thrombosis in the arm, with or without pulmonary embolism (PE), or isolated PE. The incidence of CVP-associated VTE was 5.9% (IC95 4.4–7.3%) at 3 months, and 11.3% (IC95 9.4–13.2%) at 12 months. The incidence of any VTE was 7.6% (IC95 6.0–9.3%) at 3 months, and 15.3% (IC95 13.1–17.6%) at 12 months. High Khorana risk score and lung cancer were significant predictors of 3 month VTE. In conclusion, this large cohort study of patients with first CVP catheter implantation confirms the high incidence of VTE associated with the CVP implantation and allow identifying high risk patients who may benefit from thromboprophylaxis. Christine Hohl Moinat, Daniel Périard, Adrienne Grueber, Daniel Hayoz, Jean-Luc Magnin, Pascal André, Marc Kung, and Daniel C. Betticher Copyright © 2014 Christine Hohl Moinat et al. All rights reserved. Prognostic Role of 14F7 Mab Immunoreactivity against N-Glycolyl GM3 Ganglioside in Colon Cancer Thu, 30 Jan 2014 12:03:00 +0000 http://www.hindawi.com/journals/jo/2014/482301/ Purpose. To assess the prognostic role of 14F7 Mab immunoreactivity, against N-Glycolyl GM3 ganglioside, in patients with colon cancer (CC) and to evaluate the relationship between its expression and clinicopathological features. Methods. Paraffin-embedded specimens were retrospectively collected from 50 patients with CC operated between 2004 and 2008. 14F7 Mab staining was determined by immunohistochemistry technique and its relation with survival and clinicopathologic features was evaluated. Results. The reactivity of 14F7 Mab was detected in all cases. Most cases had high level of immunostaining (70%) that showed statistical correlation with TNM stage . In univariate survival analysis, level of 14F7 Mab immunoreactivity , TNM Stage and lymphovascular invasion were significant prognostic factors for overall survival. Among these variables, level of 14F7 Mab immunoreactivity and TNM stage were independent prognostic factors on multivariate analysis. Conclusions. This study is the first approach on the prognostic significance of 14F7 Mab immunoreactivity in patients with colon adenocarcinoma and this assessment might be used in the prognostic estimate of CC, although further studies will be required to validate these findings. Tania Lahera, Adanays Calvo, Griselda Torres, Charles E. Rengifo, Santiago Quintero, María del Carmen Arango, Debora Danta, José M. Vázquez, Xiomara Escobar, and Adriana Carr Copyright © 2014 Tania Lahera et al. All rights reserved. Evaluation of p53, HoxD10, and E-Cadherin Status in Breast Cancer and Correlation with Histological Grade and Other Prognostic Factors Thu, 30 Jan 2014 10:05:52 +0000 http://www.hindawi.com/journals/jo/2014/702527/ Background. Study of tumor molecular characteristics is necessary to understand both the risk of breast cancer recurrence and the response to therapy. Aims. To evaluate p53, HoxD10, and E-cadherin status in breast cancer and to correlate with histological grade and other prognostic factors. Material and Methods. The study was conducted in 60 cases of invasive ductal carcinoma NOS with 20 cases belonging to each grade and evaluation of p53 was done by IHC and that of HoxD10 and E Cadherin status by PCR and correlation was done with histological grade and other prognostic factors. Result. p53 expression was seen in 71.67% (43/60) of the tumors. HoxD10 gene was downregulated in 46.67% (28/60) of the tumors. p53 overexpression and lower HoxD10 mRNA levels showed statistically significant association higher histological grade of the tumor (). CDH1 gene mutation was seen in 60% (15/25) of the tumors. No significant association was found between p53 expression, HoxD10 gene, CDH1 gene mutation, and other prognostic factors. Conclusion. p53 over expression and lower HoxD10 mRNA levels were found to be significantly associated with higher grade tumours. This suggests that p53 and HoxD10 gene play an important tumor suppressor role and the loss of which results in breast cancer progression. Preethi Sekar, Jyotsna Naresh Bharti, Jitendra Singh Nigam, Ankit Sharma, and Priyanka Bhatia Soni Copyright © 2014 Preethi Sekar et al. All rights reserved. Ethanolic Neem (Azadirachta indica) Leaf Extract Prevents Growth of MCF-7 and HeLa Cells and Potentiates the Therapeutic Index of Cisplatin Thu, 30 Jan 2014 08:09:28 +0000 http://www.hindawi.com/journals/jo/2014/321754/ The present study was designed to gain insight into the antiproliferative activity of ethanolic neem leaves extract (ENLE) alone or in combination with cisplatin by cell viability assay on human breast (MCF-7) and cervical (HeLa) cancer cells. Nuclear morphological examination and cell cycle analysis were performed to determine the mode of cell death. Further, to identify its molecular targets, the expression of genes involved in apoptosis, cell cycle progression, and drug metabolism was analyzed by RT-PCR. Treatment of MCF-7, HeLa, and normal cells with ENLE differentially suppressed the growth of cancer cells in a dose- and time-dependent manner through apoptosis. Additionally, lower dose combinations of ENLE with cisplatin resulted in synergistic growth inhibition of these cells compared to the individual drugs (combination index <1). ENLE significantly modulated the expression of bax, cyclin D1, and cytochrome P450 monooxygenases (CYP 1A1 and CYP 1A2) in a time-dependent manner in these cells. Conclusively, these results emphasize the chemopreventive ability of neem alone or in combination with chemotherapeutic treatment to reduce the cytotoxic effects on normal cells, while potentiating their efficacy at lower doses. Thus, neem may be a prospective therapeutic agent to combat gynecological cancers. Chhavi Sharma, Andrea J. Vas, Payal Goala, Taher M. Gheewala, Tahir A. Rizvi, and Arif Hussain Copyright © 2014 Chhavi Sharma et al. All rights reserved. Incidence of Mast Cells in Oral Squamous Cell Carcinoma: A Short Study Thu, 23 Jan 2014 00:00:00 +0000 http://www.hindawi.com/journals/jo/2014/614291/ Mast cells are regarded as complex and multifunctional cells, playing a significant role in immunopathology and a substantial role in tumor angiogenesis. Angiogenesis is a complex process that is tightly regulated by various growth factors in which mast cells act directly by releasing angiogenic factors and henceforth promoting tumor growth and metastasis. The aim of this study is to evaluate the number of mast cells in tissue sections of oral squamous cell carcinoma (OSCC) in comparison with normal mucosa. A total of 40 cases (20 OSCC and 20 normal mucosa) were stained with 1% toluidine blue and the quantitative analysis was done by using light microscope under 400x magnification. A significant increase in the mast cell count was observed in the sections of OSCC when compared to normal mucosa suggesting their contributing role in tumor growth and progression. A. Anuradha, B. Kiran Kumar Naik, G. Vijay Srinivas, Ramisetty Sabitha Devi, and H. K. Puneet Copyright © 2014 A. Anuradha et al. All rights reserved. AR-A 014418 Used against GSK3beta Downregulates Expression of hnRNPA1 and SF2/ASF Splicing Factors Thu, 02 Jan 2014 13:02:49 +0000 http://www.hindawi.com/journals/jo/2014/695325/ Glioblastoma is one of the most aggressive forms of primary brain tumors of glial cells, including aberrant regulation of glycogen synthase kinase 3β (GSK3β) and splicing factors deregulation. Here, we investigate the role of small molecule AR-A014418 and Manzamine A against GSK3 kinase with factual control on splicing regulators. AR-A 014418, 48 hrs posttreatment, caused dose (25–100 μM) dependent inhibition in U373 and U87 cell viability with also inhibition in activating tyrosine phosphorylation of GSK3alpha (Tyr 279) and beta (Tyr 216). Furthermore, inhibition of GSK3 kinase resulted in significant downregulation of splicing factors (SRSF1, SRSF5, PTPB1, and hnRNP) in U87 cells with downregulation of antiapoptotic genes such as BCL2, BCL-xL, Survivin, MCL1, and BMI1. Similarly, downregulation of splicing factors was also observed in U373 glioma cell after using SiRNA against AKT and GSK3beta kinase. In addition, potential roles of AR-A014418 in downregulation of splicing factors were reflected with decrease in Anxa7 (VA) variant and increase in Anxa7 WT tumor suppressor transcript and protein. The above results suggest that inhibition of GSK3beta kinase activation could be the beneficial strategy to inhibit the occurrence of alternative cancer escape pathway via downregulating the expression of splicing regulators as well as apoptosis. Ajay K. Yadav, Vidhi Vashishta, Nidhi Joshi, and Pankaj Taneja Copyright © 2014 Ajay K. Yadav et al. All rights reserved. Detection of TP53 R249 Mutation in Iranian Patients with Pancreatic Cancer Mon, 30 Dec 2013 13:10:58 +0000 http://www.hindawi.com/journals/jo/2013/738915/ The TP53 gene encodes tumor protein p53 which play a major role in the etiology of pancreatic cancer. The important role of codon 249 of TP53 for binding of p53 to its sequence-specific consensus site in DNA has been revealed by crystallography’s studies, and mutation at this codon was detected in the plasma of some human cancers. The TP53 Mut assessor software within the International Agency for Research on Cancer (IARC) TP53 Database was performed to evaluate every possible mutation at codon 249. DNA was extracted from the plasma of 133 pancreatic cancer patients and 85 noncancer-bearing individuals. Exon 7 in TP53 was amplified, and mutation at R249 was identified by the endonuclease cleavage of HaeIII. The group of patients showed a frequency of 11% (22 of 133 samples) R249 mutation compared to 3.5% (3 of 85 samples) in the group of control which was significant (). This mutation demonstrated statistically significant association with pancreatic cancer risk in unadjusted odds ratio (OR: 3.74, 95% CI: 1.1–13.2; ); however when adjusted for confounding factors, it was marginally significant because of lower control samples. These findings demonstrate that mutation at R249 of TP53 can be considered for increasing risk of pancreatic cancer that needs more research. Ashraf Mohamadkhani, Elnaz Naderi, Maryam Sharafkhah, Hamid Reza Fazli, Malihe Moradzadeh, and Akram Pourshams Copyright © 2013 Ashraf Mohamadkhani et al. All rights reserved. Serum p53 Antibody Is Not Associated with p53 Immunoreactivity in Patients with Pancreatobiliary Cancers Wed, 18 Dec 2013 15:48:14 +0000 http://www.hindawi.com/journals/jo/2013/170625/ Background. Recent diagnostic imaging tests contribute to improving the diagnosis of pancreatobiliary cancers. However, it is not practical to perform these tests for all patients as screening. Thus, less-invasive and simple screening tests are still required. A method to detect the IgG antibody induced in serum against the p53 protein accumulating due to p53 gene mutation, as a biomarker, was developed around 1990. Method. 35 patients with pancreatic cancer, 12 patients with biliary tract cancer, and 31 patients with benign pancreatobiliary diseases were entered into this study. Measurement of serum anti-p53 antibody was conducted in all patients. In addition, the rate of p53 protein overexpression was examined in those cases that could be examined pathologically. Result. Among all patients in the pancreatic cancer and biliary tract cancer groups, there was no patient with serum anti-p53 antibody positive value that exceeded the standard value. The rate of p53 protein overexpression was 48.0% in the patients with pancreatobiliary cancers and 0% in the benign pancreatobiliary diseases group. Conclusion. Serum anti-p53 antibody measurement does not contribute to the diagnosis of pancreatobiliary cancers. Instead, traditional p53 immunostaining still appears to be valuable in combination with standard procedures. Junko Umeda, Takao Itoi, Atsushi Sofuni, Fumihide Itokawa, Toshio Kurihara, Takayoshi Tsuchiya, Kentaro Ishii, Shujiro Tsuji, Nobuhito Ikeuchi, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Toshitaka Nagao, Hisashi Oshiro, and Fuminori Moriyasu Copyright © 2013 Junko Umeda et al. All rights reserved. Antiproliferative and Apoptotic Effects of a Specific Antiprostate Stem Cell Single Chain Antibody on Human Prostate Cancer Cells Tue, 10 Dec 2013 17:48:09 +0000 http://www.hindawi.com/journals/jo/2013/839831/ Prostate stem cell antigen (PSCA) is a highly glycosylated cell surface protein which is overexpressed in several malignancies including prostate, pancreas, and urinary bladder cancers. Tumor suppression has been reported by anti-PSCA antibody. Small and high affinity single chain antibodies (scFv) have been introduced as effective agents for cancer immunotargeting approaches. In the present study, we used a phage antibody display library of scFv and selected two antibodies against two immunodominant epitopes of PSCA by panning process. The reactivity of the scFvs for the corresponding epitopes was determined by phage ELISA. The binding specificity of antibodies to PSCA-expressing prostate cancer cell line, DU-145, was analyzed by flow cytometry. The antiproliferative and apoptotic induction effects were evaluated by MTT and Annexin-V assays, respectively. Results represented functional scFv C5-II which could bind specifically to DU-145 cells and significantly inhibited the proliferation of these cells (61%) with no effect on PSCA-negative cells. The antibody also induced apoptosis in the PSCA expressing cells. The percentage of the apoptotic cells after 24 hrs of exposure to 500 scFv/cell was 33.80%. These results demonstrate that the functional anti-PSCA scFv C5-II has the potential to be considered as a new agent for targeted therapy of prostate cancer. Foroogh Nejatollahi, Soghra Abdi, and Mahdi Asgharpour Copyright © 2013 Foroogh Nejatollahi et al. All rights reserved. Gastroduodenal Outlet Obstruction and Palliative Self-Expandable Metal Stenting: A Dual-Centre Experience Sun, 10 Nov 2013 10:59:03 +0000 http://www.hindawi.com/journals/jo/2013/167851/ Background. Self-expandable metal stents (SEMs) are increasingly being utilised instead of invasive surgery for the palliation of patients with malignant gastroduodenal outlet obstruction. Aim. To review two tertiary centres’ experience with placement of SEMs and clinical outcomes. Methods. Retrospective analysis of prospectively collected data over 12 years. Results. Ninety-four patients (mean age, 68; range 28–93 years) underwent enteral stenting during this period. The primary tumour was gastric adenocarcinoma in 27 (29%) patients, pancreatic adenocarcinoma in 45 (48%), primary duodenal adenocarcinoma in 8 (9%), and cholangiocarcinoma and other metastatic cancers in 14 (16%). A stent was successfully deployed in 95% of cases. There was an improvement in gastric outlet obstruction score (GOOS) in 84 (90%) of patients with the ability to tolerate an enteral diet. Median survival was 4.25 months (range 0–49) without any significant differences between types of primary malignancy. Mean hospital stay was 3 days (range 1–20). Reintervention rate for stent related complications was 5%. Conclusion. The successful deployment of enteral stents achieves excellent palliation often resulting in the prompt reintroduction of enteral diet and early hospital discharge with minimal complications and reintervention. Nik S. Ding, Sina Alexander, Michael P. Swan, Christopher Hair, Patrick Wilson, Emma Clarebrough, and David Devonshire Copyright © 2013 Nik S. Ding et al. All rights reserved. Efficacy of Goshajinkigan for Oxaliplatin-Induced Peripheral Neuropathy in Colorectal Cancer Patients Thu, 07 Nov 2013 09:34:18 +0000 http://www.hindawi.com/journals/jo/2013/139740/ Objective. To evaluate the efficacy of Goshajinkigan for oxaliplatin-induced peripheral neuropathy in colorectal cancer patients. Patients. Colorectal cancer patients () who received ≥4 weeks of Goshajinkigan for oxaliplatin-induced peripheral neuropathy during chemotherapy at Kyoto Prefectural University of Medicine were (Goshajinkigan group) compared to 44 patients who had not received Goshajinkigan during the same period (non-Goshajinkigan group). Main Outcome Measures. The effect of Goshajinkigan was graded as curative, effective, stabilizing, or deleterious. The relationships between the grade of peripheral neuropathy and the dose of oxaliplatin in the Goshajinkigan and non-Goshajinkigan groups were evaluated. Results. The effect of Goshajinkigan on peripheral neuropathy in the Goshajinkigan group was curative, effective, stabilizing, and deleterious in 3.4, 20.7, 69.0, and 6.9% of patients, compared to the effect in the non-Goshajinkigan group (4.5, 15.9, 45.5, and 34.1%). The ratio of deleterious effects was significantly different between these two groups (). A Kaplan-Meier analysis in relation to the cumulative dose of oxaliplatin showed that the incidence of grade 3 peripheral neuropathy tended to be less in the Goshajinkigan group (). There were no significant differences in time to treatment failure and severe adverse events between these two groups. Conclusions. Goshajinkigan prevented exacerbation of oxaliplatin-induced peripheral neuropathy. This trial is registered with UMIN000009956 Naohisa Yoshida, Toyoshi Hosokawa, Takeshi Ishikawa, Nobuaki Yagi, Satoshi Kokura, Yuji Naito, Masayoshi Nakanishi, Yukihito Kokuba, Eigo Otsuji, Haruo Kuroboshi, Masafumi Taniwaki, Tetsuya Taguchi, Hajime Hosoi, Terukazu Nakamura, and Tsuneharu Miki Copyright © 2013 Naohisa Yoshida et al. All rights reserved. Proteomics of Uveal Melanoma: A Minireview Tue, 03 Sep 2013 08:34:37 +0000 http://www.hindawi.com/journals/jo/2013/820953/ Uveal melanoma (UM) continues to be associated with a high mortality rate of up to 50% due to metastatic spread primarily to the liver. Currently there are relatively effective treatments for the primary tumor, though the management of the metastatic disease remains inadequate. Conventional diagnostic tools have a low sensitivity for detecting metastasis, and early detection of metastatic spread would allow more treatment options that could ultimately increase survival of UM patients. Advanced proteomic methods have already helped to find potential biomarkers associated with UM pathogenesis and metastasis. In the present review we discuss the field of proteomics in relation to studies elucidating biomarkers of UM, where proteins such as S-100β, osteopontin (OPN), and melanoma inhibitory activity (MIA) have been shown to be associated with metastasis. Søren K. O. Abildgaard and Henrik Vorum Copyright © 2013 Søren K. O. Abildgaard and Henrik Vorum. All rights reserved. Endoscopic Submucosal Dissection for Large Colorectal Tumor in a Japanese General Hospital Thu, 29 Aug 2013 14:32:20 +0000 http://www.hindawi.com/journals/jo/2013/218670/ Background and Aims. Endoscopic submucosal dissection (ESD) is not widely used in large colorectal lesions because of technical difficulty and possible complications. We aimed to examine the efficacy and safety of ESD for large colorectal neoplasms. Patients and Methods. During the past 5 years, 608 cases of colorectal neoplasm (≧20 mm) were treated by ESD. They were divided into Group A (20–49 mm, 511 cases) and Group B (≧50 mm, 97 cases). Results. The average age, lesion size, and procedure time were 67.4 years, 30.0 mm, and 60.0 min in Group A, and they were 67.1 years, 64.2 mm, and 119.6 min in Group B. En bloc resection rates were 99.2% and 99.0% (), and complication rates were 4.1% and 9.9% (). Complications in Group A consisted of perforation (2.7%), bleeding (1.2%), and ischemic colitis (0.2%). Those in Group B were perforation (8.2%) and bleeding (1.0%). Two cases in Group A and none in Group B required emergency surgery for perforation. Conclusions. There was no difference in efficacy between Groups A and B. Complications were more frequent in Group B, but all perforations in Group B were successfully managed conservatively. ESD can be effective and safe for large colorectal tumors. Ken Ohata, Kouichi Nonaka, Yohei Minato, Yoshitsugu Misumi, Tomoaki Tashima, Meiko Shozushima, Takahiro Mitsui, and Nobuyuki Matsuhashi Copyright © 2013 Ken Ohata et al. All rights reserved. Neoadjuvant Chemotherapy and Targeted Therapy in Breast Cancer: Past, Present, and Future Tue, 20 Aug 2013 10:15:50 +0000 http://www.hindawi.com/journals/jo/2013/732047/ Traditionally, neoadjuvant treatment for breast cancer was preserved for locally advanced and inflammatory disease, converting an inoperable to a surgical resectable cancer. In recent years, neoadjuvant therapy has become an accepted treatment option also for lower tumor stages in order to increase the rate of breast conserving therapy and to reduce the extent of surgery. Furthermore, treatment response can be monitored, and therefore, patient compliance may be increased. Neoadjuvant trials, additionally, offer the opportunity to evaluate new treatment options in a faster way and with fewer patients than large adjuvant trials. Compared to the metastatic setting, the issue of acquired resistance and pretreatments, which may distort treatment efficacy, can be avoided. New trial designs like window-of-opportunity trials or postneoadjuvant trials provide the chance to identify tumor sensitivity or to overcome tumor resistance in early tumor stages. In particular, in HER2-positive breast cancer, the neoadjuvant approach yielded great successes. The dual HER2 blockade with trastuzumab and pertuzumab recently showed the highest pCR rates ever reported. Many new drugs are in clinical testing with the aim to further increase pCR rates. Whether this endpoint really represents a surrogate for long-term outcome is not answered yet and will be discussed in this review. Simon P. Gampenrieder, Gabriel Rinnerthaler, and Richard Greil Copyright © 2013 Simon P. Gampenrieder et al. All rights reserved. Early Pseudoprogression following Chemoradiotherapy in Glioblastoma Patients: The Value of RANO Evaluation Tue, 13 Aug 2013 13:15:26 +0000 http://www.hindawi.com/journals/jo/2013/690585/ Introduction. The aim of this study was to determine the frequency of pseudoprogression in a cohort of glioblastoma (GBM) patients following radiotherapy/temozolomide (RT/TMZ) by comparing Macdonald criterial to Response Assessment in Neuro-Oncology (RANO) criteria. The impact on prognosis and survival analysis was also studied. Materials and Methods. All patients receiving RT/TMZ for newly diagnosed GBM from January 2005 to December 2009 were retrospectively evaluated, and demographic, clinical, radiographic, treatment, and survival data were reviewed. Updated RANO criteria were used for the evaluation of the pre-RT and post-RT MRI and compared to classic Macdonald criteria. Survival data was evaluated using the Kaplan-Meier and log-rank analysis. Results and Discussion. 70 patients were available for full radiological response assessment. Early progression was confirmed in 42 patients (60%) according to Macdonald criteria and 15 patients (21%) according to RANO criteria. Pseudoprogression was identified in 10 (23.8%) or 2 (13.3%) patients in Macdonald and RANO groups, respectively. Cumulative survival of pseudoprogression group was higher than that of true progression group and not statistically different from the non-progressive disease group. Conclusion. In this cohort, the frequency of pseudoprogression varied between 13% and 24%, being overdiagnosed by older Macdonald criteria, which emphasizes the importance of RANO criteria and new radiological biomarkers for correct response evaluation. Paulo Linhares, Bruno Carvalho, Rita Figueiredo, Rui M. Reis, and Rui Vaz Copyright © 2013 Paulo Linhares et al. All rights reserved. Neoadjuvant Therapy in Operable Breast Cancer: Application to Triple Negative Breast Cancer Thu, 01 Aug 2013 10:02:17 +0000 http://www.hindawi.com/journals/jo/2013/219869/ Systemic treatment for triple negative breast cancer (TNBC: negative for the expression of estrogen receptor and progesterone receptor and HER2 amplification) has been limited to chemotherapy options. Neoadjuvant chemotherapy induces tumor shrinkage and improves the surgical outcomes of patients with locally advanced disease and also identifies those at high risk of disease relapse despite today’s standard of care. By using pathologic complete response as a surrogate endpoint, novel treatment strategies can be efficiently assessed. Tissue analysis in the neoadjuvant setting is also an important research tool for the identification of chemotherapy resistance mechanisms and new therapeutic targets. In this paper, we review data on completed and ongoing neoadjuvant clinical trials in patients with TNBC and discuss treatment controversies that face clinicians and researchers when neoadjuvant chemotherapy is employed. Foluso O. Ademuyiwa, Matthew J. Ellis, and Cynthia X. Ma Copyright © 2013 Foluso O. Ademuyiwa et al. All rights reserved. Endoscopic Detection of Early Esophageal Squamous Cell Carcinoma in Patients with Achalasia: Narrow-Band Imaging versus Lugol's Staining Tue, 09 Jul 2013 11:08:53 +0000 http://www.hindawi.com/journals/jo/2013/736756/ Chromoendoscopy with Lugol's staining remains the gold standard technique for detecting superficial SCC. An alternative technique, such as narrow-band imaging (NBI), for “optical staining” would be desirable, since NBI is a simpler technique and has no known complications. In this study, we compare NBI without magnification and chromoendoscopy with Lugol's staining for detecting high-grade dysplasia and intramucosal esophageal squamous cell carcinoma (SCC) in patients with achalasia. This was a prospective observational study of 43 patients with achalasia referred to the Gastrointestinal Endoscopy Unit of the Hospital of Clinics, São Paulo, University Medical School, Brazil, from October 2006 to February 2007. Conventional examinations with white light, NBI, and Lugol staining were consecutively performed, and the suspected lesions were mapped, recorded, and sent for biopsy. The results of the three methods were compared regarding sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood value, and negative likelihood value. Of the 43 patients, one was diagnosed with esophageal squamous cell carcinoma, and it was detected by all of the methods. NBI technology without magnification has high sensitivity and negative predictive value for detecting superficial esophageal squamous cell carcinoma, and it has comparable results with those obtained with Lugol's staining. Edson Ide, Fred Olavo Aragão Andrade Carneiro, Mariana Souza Varella Frazão, Dalton Marques Chaves, Rubens Antônio Aissar Sallum, Eduardo Guimarães Hourneaux de Moura, Paulo Sakai, Ivan Cecconello, and Fauze Maluf-Filho Copyright © 2013 Edson Ide et al. All rights reserved. Role of the Crosstalk between Autophagy and Apoptosis in Cancer Wed, 05 Jun 2013 14:14:31 +0000 http://www.hindawi.com/journals/jo/2013/102735/ Autophagy and apoptosis are catabolic pathways essential for organismal homeostasis. Autophagy is normally a cell-survival pathway involving the degradation and recycling of obsolete, damaged, or harmful macromolecular assemblies; however, excess autophagy has been implicated in type II cell death. Apoptosis is the canonical programmed cell death pathway. Autophagy and apoptosis have now been shown to be interconnected by several molecular nodes of crosstalk, enabling the coordinate regulation of degradation by these pathways. Normally, autophagy and apoptosis are both tumor suppressor pathways. Autophagy fulfils this role as it facilitates the degradation of oncogenic molecules, preventing development of cancers, while apoptosis prevents the survival of cancer cells. Consequently, defective or inadequate levels of either autophagy or apoptosis can lead to cancer. However, autophagy appears to have a dual role in cancer, as it has now been shown that autophagy also facilitates the survival of tumor cells in stress conditions such as hypoxic or low-nutrition environments. Here we review the multiple molecular mechanisms of coordination of autophagy and apoptosis and the role of the proteins involved in this crosstalk in cancer. A comprehensive understanding of the interconnectivity of autophagy and apoptosis is essential for the development of effective cancer therapeutics. Minfei Su, Yang Mei, and Sangita Sinha Copyright © 2013 Minfei Su et al. All rights reserved. The Haiti Breast Cancer Initiative: Initial Findings and Analysis of Barriers-to-Care Delaying Patient Presentation Wed, 05 Jun 2013 10:14:12 +0000 http://www.hindawi.com/journals/jo/2013/206367/ Background. In Haiti, breast cancer patients present at such advanced stages that even modern therapies offer modest survival benefit. Identifying the personal, sociocultural, and economic barriers-to-care delaying patient presentation is crucial to controlling disease. Methods. Patients presenting to the Hôpital Bon Sauveur in Cange were prospectively accrued. Delay was defined as 12 weeks or longer from initial sign/symptom discovery to presentation, as durations greater than this cutoff correlate with reduced survival. A matched case-control analysis with multivariate logistic regression was used to identify factors predicting delay. Results. Of patients accrued, 90 (73%) reported symptom-presentation duration and formed the basis of this study: 52 patients presented within 12 weeks of symptoms, while 38 patients waited longer than 12 weeks. On logistic regression, lower education status (OR = 5.6, ), failure to initially recognize mass as important (OR = 13.0, ), and fear of treatment cost (OR = 8.3, ) were shown to independently predict delayed patient presentation. Conclusion. To reduce stage at presentation, future interventions must educate patients on the recognition of initial breast cancer signs and symptoms and address cost concerns by providing care free of charge and/or advertising that existing care is already free. Ketan Sharma, Ainhoa Costas, Ruth Damuse, Jean Hamiltong-Pierre, Jordan Pyda, Cecilia T. Ong, Lawrence N. Shulman, and John G. Meara Copyright © 2013 Ketan Sharma et al. All rights reserved. Parameters That May Be Used for Predicting Failure during Endoscopic Retrograde Cholangiopancreatography Mon, 03 Jun 2013 14:10:08 +0000 http://www.hindawi.com/journals/jo/2013/201681/ Aim. Endoscopic retrograde cholangiopancreatography (ERCP) is frequently used for the diagnosis and treatment of hepatic, biliary tract, and pancreatic disorders. However, failure during cannulation necessitates other interventions. The aim of this study was to establish parameters that can be used to predict failure during ERCP. Methods. A total of 5884 ERCP procedures performed on 5079 patients, between 1991 and 2006, were retrospectively evaluated. Results. Cannulation was possible in 4482 (88.2%) patients. For each one-year increase in age, the cannulation failure rate increased by 1.01-fold (). A history of previous hepatic biliary tract surgery caused the cannulation failure rate to decrease by 0.487-fold (). A tumor infiltrating the ampulla, the presence of pathology obstructing the gastrointestinal passage, and peptic ulcer increased the failure rate by 78-, 28-, and 3.47-fold, respectively (). Conclusions.Patient gender and duodenal diverticula do not influence the success of cannulation during ERCP. Billroth II and Roux-en-Y gastrojejunostomy surgeries, a benign or malignant obstruction of the gastrointestinal system, and duodenal ulcers decrease the cannulation success rate, whereas a history of previous hepatic biliary tract surgery increases it. Although all endoscopists had equal levels of experience, statistically significant differences were detected among them. Emre Balik, Tunc Eren, Metin Keskin, Sedat Ziyade, Turker Bulut, Yilmaz Buyukuncu, and Sumer Yamaner Copyright © 2013 Emre Balik et al. All rights reserved.