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Introduction and Importance: Gastrointestinal bleeding is a serious health threat, especially when it originates from the small intestine, often termed small bowel bleeding (SBB). Hemangioendothelioma, a rare vascular tumor, can be a significant yet uncommon cause of gastrointestinal bleeding. This case report highlights hemangioendothelioma's diagnostic challenges and clinical significance in SBB., Case Presentation: A 16-year-old female experienced six months of intermittent massive rectorrhagia and melena, along with nausea, vomiting, loss of appetite, and abdominal pain. Initial endoscopic investigations, including colonoscopy and enteroscopy, did not identify the bleeding source. Imaging studies, including a CT scan and Meckel's scintigraphy, were also inconclusive. Persistent bleeding and a significant drop in hemoglobin levels led to exploratory laparotomy with intraoperative enteroscopy, which revealed a nodular lesion in the small intestine. Histopathological examination confirmed the lesion as hemangioendothelioma. Surgical resection of the lesion stopped the bleeding, and the patient recovered without complications, remaining asymptomatic during follow-ups at one and six months post-surgery., Clinical Discussion: Hemangioendothelioma is a rare, locally aggressive vascular tumor that can present with abdominal pain, bowel obstruction, anemia, and gastrointestinal bleeding. Due to its rarity and location, it often goes undetected in conventional endoscopy. The definitive diagnosis is made through histopathological examination, which shows characteristic endothelial cells and vascular structures. Surgical excision is the primary treatment, although there is a risk of recurrence and metastasis., Conclusion: This case underscores hemangioendothelioma's diagnostic challenges and clinical relevance in obscure gastrointestinal bleeding. Intraoperative enteroscopy plays a crucial role in the diagnosis and management. Clinicians should consider hemangioendothelioma in similar cases to ensure appropriate treatment and management., Competing Interests: Conflict of interest statement The authors have no relevant financial or nonfinancial interests to disclose., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The aim of the study was to suggest a high specific and sensitive blood biomarker for early GC diagnosis., Methods: the expression data of miRNAs and mRNAs were collected from the blood samples of the GC patients based on literature mining. Bioinformatics tools and databases (PANTHER, TargetScan, miRTarBase, miRDB, STRING, and Cytoscape) were used to predict the regulatory relationship. Subsequently, expression level of the selected miRNA was evaluated in the blood samples of gastritis patients to recognize the common miRNA between the GC and gastritis patients., Results: Analysis of 40 target genes by MCODE (installed in Cytoscape software) indicated 4 hub genes (WWP1, SKP2, KLHL42, and FBXO11) as a significant cluster in the PPI network related to miR-21, with Node Score Cutoff: 0.2, Degree Cutoff: 2 and K-Core: 2. In addition, the miRNA RT-qPCR results showed that, the expression level of miR-21 was significantly higher in gastritis group compared to the healthy group (p< 0.05)., Conclusion: the present study clearly demonstrated the increasing level of blood miR-21 among the gastritis patients infected by H. pylori . Therefore, the altered miRNAs, especially overexpression of onco-miRs, may identify a potential link between miRNAs and pathogenesis of the H. pylori -related complications.

Introduction: Familial adenomatous polyposis (FAP) may be associated with some extracolonic manifestations which in this vein, it is known as Gardner's syndrome. To our knowledge, so far, there is no report of mucinous cystadenoma in association with FAP., Case Presentation: We report a 31-year-old woman with FAP who underwent total proctocolectomy with ileal pouch-anal anastomosis 5 years earlier. During endoscopic surveillance, she was found to have a submucosal lesion in rectal cuff., Results: Endoscopic ultrasound (EUS) revealed a round submucosal anechoic lesion measuring about 3 cm originating from the second layer of the rectal cuff. Surgical resection was performed and a cystic tumor was removed. Histologic examination was consistent with mucinous cystadenoma., Conclusion: FAP can be associated with mucinous cystadenoma.

Carbon nanotubes with extraordinary properties may become a novel drug and gene delivery tool in nanomedicine; however, insufficient information is available regarding their biosafety. Therefore, this work was performed to study the effect of prenatal exposure of single-walled carbon nanotubes (SWCNTs) on reproductive and neurobehavioral endpoints in mice. Thirty pregnant female mice were assigned to three groups (n = 10 for each group). The two treated groups were injected intraperitoneally (i.p.) with 1 or 10 mg/kg body weight (b.w.) of SWCNTs suspended in 1 ml of phosphate buffer saline (PBS) on gestational days 0 and 3. The control group was injected i.p. with an equal volume of PBS. The neurobehavioral ontogeny of pups was evaluated using a modified Fox battery. A decrease in litter size on postnatal day 2 was observed in the group treated with 10 mg/kg b.w. of SWCNTs whereas no significant differences between groups were observed in any other parameters. The behavioral development of pups did not show significant differences during growth except for the surface righting reflex, which showed significant delay compared to control in the group treated with 1 mg/kg b.w. SWCNTs. Moreover, exposed offspring (10 mg/kg b.w. SWCNTs) displayed enhanced anxiety in the elevated plus maze; however, other ethological analysis (Morris water maze and open field test) did not show behavioral changes in the experimental groups. In conclusion, the present results demonstrated small changes in offspring sensory and motor development following exposure to SWCNTs and support the idea that SWCNT risk assessment merits further investigation., (© The Author(s) 2014.)

Background: Colorectal cancer (CRC) is a common malignancyworldwide and its outcome is most closely related to the extent of disease at presentation. Early diagnosis of an asymptomatic recurrence increases the likelihood of a complete surgical resection., Objectives: The aim of this study was to evaluate the incidence of colorectal cancer recurrence and survival rate within 5 years, after surgery., Patients and Methods: During the 9-year period since 21st Mar, 2004 to 20th Mar, 2013, patients whose primary colorectal cancer were resected in Taleghani hospital, Tehran, Iran were selected in a historical cohort. The necessary data such as demographic, age, gender, family history of CRC, site and size of tumor, stage of tumor, operation details, histological results, treatment method, histopathologic, etc. were collected. Then the recurrence and survival of colorectal cancer within 5 years after operation and their risk factors were evaluated. P value less than 0.05 were considered significant. All analysis was done using SPSS software., Results: A total of 107 patients underwent resection for colorectal cancer during the study period, with mean age of 53.50 ± 12.68 years (range 24 - 76 years), survival rate of 73.8% (rectum 70.0% and colon 75.9%), and mean survival time of 142.17 ± 21.60 month. The recurrence rate of CRC patients, during five years after surgery was 5.7%. Regional lymph nodes, Distance metastasis and Adjuvant therapy were significant prognosis factors of survival after surgery., Conclusions: The rate of recurrence in Iranian patients was low, which could be due to improvement of exactness and expertise of surgeons or better adjuvant therapy. The significant association between survival and adjuvant therapy clarifies this finding. Early diagnosis and primary detection could increase the rate of survival.

Steadily increased use of silver nanoparticles (Ag-NPs), has increased the amount of its exposure to humans and animals. Current scarce knowledge about the influences of prenatal exposure to Ag-NPs on postnatal outcomes, motivated us to investigate whether being exposed to it during pregnancy has any effects on neurobehavioral development of the adult offspring. Thirty virgin female NMRI mice were mated and treated subcutaneously once every three days from gestation day 3 until delivery, by 0, 0.2 and 2 mg/kg of bodyweight (BW) of Ag-NPs. Behavioral functions of adult offspring including spatial memory, passive avoidance learning, stress, anxiety-like behaviors and locomotor activities were assessed by commonly used neurobehavioral paradigms and the results were compared according to treatment and sex. Prenatal exposure to Ag-NPs significantly impaired their cognitive behavior in the Morris water maze. Although no evidence was observed indicating more anxiety-like behaviors in the treated offspring in the elevated plus maze, the number of defecations and leanings in the open field assay and number of passages in the light-dark box were greater in groups prenatally treated by Ag-NPs. Most of the impairments were more apparent in the offspring which had been prenatally exposed to high doses of Ag-NPs, particularly female ones. The present study indicated that the exposure of pregnant animals to Ag-NPs may lead to various neurobehavioral disorders in their offspring. Thus, more attention should be paid to avoid exposure to Ag-NPs, especially from pregnant females.

Background: Polycystic ovary syndrome (PCO) is recognized as the most common endocrinopathy in female. Chemerin is a novel adipocytokine that is expressed in ovary and upregulated in adipose tissue of obese, PCO patients. To date there is no report about the regulation of ovarian chemerin gene expression after PCO induction and treatment by insulin sensitizing drugs including pioglitazone and metformin. Thirty female rats were divided into six experimental groups with five rats in each group including control group, PCO group (i.m injection of 4 mg estradiol benzoate for 40 days), metformin treated (200 mg/kg/day for 21 days), pioglitazone treated (20 mg/kg/day, for 21 days), PCO + metformin and PCO + pioglitazone. PCO was detected by microscopic observation of vaginal smear and treatment by metformin and pioglitazone was initiated one week after that. Ovarian chemerin expression was analyzed by real time PCR and western blotting., Results: Our results demonstrated that PCO induction resulted in elevation of chemerin mRNA and protein levels in ovary in concomitant with incidence of insulin resistance and increasing androgen and progesterone production. We observed that metformin and pioglitazone attenuated ovarian chemerin expression and improved insulin resistance and abnormal steroid production in PCO rats., Conclusion: Based on data presented here we concluded that alteration of ovarian chemerin expression may has important role in PCO development and manipulation of chemerin expression or signaling by pioglitazone or metformin can be a novel therapeutic mechanism in the treatment of PCO patients by these drugs.

Background: Familial adenomatous polyposis (FAP) is a disease inherited in an autosomal dominant fashion. Most FAP patients develop upper gastrointestinal polyps; especially those in the antrum and duodenum are usually neoplastic. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in Iranian FAP patients., Materials and Methods: 28 patients affected by FAP underwent front-view and side-view endoscopy. Papillary biopsies were performed in all patients. Location of polyps, their number and size, pathology study, patient general information (gender, age, family history of FAP or colorectal cancer and gastroduodenal polyps) were analyzed., Results: Gastric polyps were seen in 39.3 % of patients. Some 72.7% of the affected individuals had fundic gland polyps and 36.36% had hyperplastic polyps. Duodenal adenoma was observed in 25% of patients. While 57% of patients had tubular adenoma with low grade dysplasia, 42.8% showed tubulovillous adenoma with low grade dysplasia., Conclusions: Findings of this study indicated that the prevalence of gastroduodenal polyps in FAP patients is high and dysplasia may be evident in duodenal polyps. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.

Retroperitoneal pseudotumor is an extremely rare presentation of extrapulmonary tuberculosis. The diagnosis of this paucibacillary disease is difficult which is usually misdiagnosed as a malignant tumor. High index of suspicion is required for early diagnosis and treatment of retroperitoneal pseudotumor which can affect prognosis of this disease. Because of its rarity and difficult diagnosis, we report an 18-year-old immunocompetent girl who presented with abdominal pain and vomiting. Upper endoscopy showed an exudative mass between the second and third parts of duodenum. Abdominal computed tomography (CT) revealed a large retroperitoneal mass with extension into small bowel. Exploratory laparotomy and histopathological examination of tissue showed calcified granuloma. Ziehl-Neelsen staining and PCR confirmed the tuberculosis. The patient was successfully treated with standard antituberculosis therapy.

Aim: To evaluate the possible long-term effects of Helicobacter pylori infection on Hemoglobin A1c and fasting blood sugar levels in patients with type 2 diabetes., Background: Helicobacter pylori causes the gastrointestinal tract inflammation, which it plays an important role in distortion of glucose and lipids absorption that altered lipid metabolism and energy harvesting and develops type 2 diabetes, insulin resistance and has been linked to impaired blood glucose., Patients and Methods: In this clinical trial, patients with type 2 diabetes and confirmed Helicobacter pylori infection were recruited from the endocrinology clinic of the Shahid Beheshti University Tehran, Iran. Before and after 3 months of eradication therapy fasting blood samples were taken and glycalated hemoglobin levels and fasting blood sugar levels were measured., Results: 85 (27 male 31.8%, 58 female 68.2%) patients with the mean age of 52.±4.7 years were recruited. 52 (62%) had successful Helicobacter pylori eradication (16 male, 30.8% and 36 female, 69.2%). The mean glycalated haemoglobin levels before successful treatment was 8.7±1.1 and after treatment was 8.3±0.9 and difference was significant (p<0.001). Mean IgG level of serology was 3.3±1.1 and the correlation with glycalated haemoglobin was significant (p=0.02) (r=0.4)., Conclusion: Our results indicate that the Helicobacter pylori treatment can improve the mean glycalated haemoglobin in patients with type 2 diabetes. More investigations will be required to evaluate the effects of Helicobacter pylori eradication among different age groups and in relation to obesity status, diabetes and other disease, and it may be beneficial for patients at risk of diabetes to be checked for the presence of Helicobacter pylori infection.

Purpose: The purpose of the present study was to investigate the effect of sesame oil on the reproductive parameters of diabetic male Wistar rats., Materials and Methods: The adult male rats in a split plot design were divided into normal (n=10), normal 5% (n=5; 5% sesame oil enriched diet), diabetic (Streptozocin induced diabetes; n=9), diabetic 5% (n=9; 5% sesame oil enriched diet), and diabetic 10% (n=9; 10% sesame oil enriched diet) groups. Diet supplementation continued for 56 days., Results: Sesame oil supplementation did not reduce the plasma glucose concentration of rats in the diabetic groups (p>0.05). The total spermatogonia, spermatocytes, Leydig cells/tubule, and the germ cell to Sertoli cell ratio were lower in the diabetic rats than the normal ones (p<0.05), and with the exception of spermatogonia counts, these values improved by the addition of sesame oil to the diet (p<0.05). The sperm progressive motility and viability were lower in the diabetic rats (p<0.05) and sesame oil supplementation did not improve them. Incorporation of sesame oil into the diet improved the plasma testosterone concentration of the diabetic rats in a dose-dependent manner (p<0.05)., Conclusions: In summary, sesame oil supplementation improved the reproductive parameters of diabetic rats at the levels of the testicular microstructure and function, but was not effective in protecting the epididymal sperm.

Aim: The purpose of this study was to determine the relationship of rs4444903 (EGF+61A/G) SNP genotype with colorectal cancer and tumor stage in an Iranian population., Background: Epidermal growth factor (EGF) is one of the important proteins that determine survival of cells. EGF binds to its receptor on the cell surface and then activates some of the cell signaling pathway networks within cells that lead to activation or deactivation of factors which are responsible for growth and apoptosis of cells. In this study we assessed the association in EGF polymorphism rs4444903 with colorectal cancer (CRC) in Iranian population., Patients and Methods: We conducted case-control study to investigate the association of polymorphism rs4444903 in EGF, with colorectal cancer risk in Iranian population. Analyzed Polymorphism of EGF rs4444903 with restriction fragment length polymorphisms (RFLP) among two groups of subjects consisting of including 220 cases with colorectal cancer and 220 healthy individuals as controls. Mutations were confirmed in 10% of the samples by direct sequencing., Results: The frequencies of AA, AG and GG genotypes among cases with colorectal cancer were 28.2, 46.8, and 25.0 % respectively and in controls genotype frequencies were 23.2, 56.4, and 20.5 %, respectively. Frequency of A allele among case group was 51.6% and for control group was 51.4%. The frequency of G allele in case and control was, respectively 48.4% and 48.6% (OR= 1.009, 95% CI= 0.775-1.315; P= 0.946). The percentage of Stage 0, I, II, III, IV were 5%, 9.35%, 38.84%, 30.21% and 16.54%, respectively, among the cases. However, no significant association between this polymorphism and CRC stage was observed (p=0.626)., Conclusion: Our data suggest a SNP rs4444903 may not represent a risk factor in the development and progression of CRC among Iranian population.

Aim: This study investigated the role of CD86 +237 G/C polymorphism in intensifying the risk of CRC development., Background: Colorectal cancer (CRC) is a multi-factorial diseases. Genetic background could affect the susceptibility of individuals to CRC development. CD86 is a co-stimulatory factor on antigen-presenting cells that plays key roles in several cancer related mechanisms such as autoimmunity, transplantation and tumor immunity., Patients and Methods: A total of 300 individuals, 150 known CRC patients and 150 healthy control individuals, were subjected for the study. CD86 rs17281995 single nucleotide polymorphism (SNP) was genotyped using Allelic Discrimination method., Results: A statistically significant difference was found among CD86 gene polymorphism (rs17281995) and risk of CRC development. The frequency of GG, GC and CC in control subjects was determined as 38%, 57.3% and 4.7% respectively and in CRC subjects were determined as 42%, 85% and 23% respectively. The data shows a significant association between CC genotype (P = 0.007) and C allele (P = 0.017) of the studied polymorphism and risk of CRC. CC genotype and C allele are also more frequent in female patients when the data is stratified according to gender status., Conclusion: Our results suggest that CD86 gene alteration could affect the individual's risk for developing CRC among Iranian population and could be used as an important prognostic factor associated with risk of CRC.

MicroRNAs (miRNAs) are agents of post-transcriptional gene expression, and they can affect many functions of an individual cell or tissue from extracellular matrix production to inflammatory processes and tumor development. We aimed to determine the possible role of miRNA-binding site polymorphisms located in five cancer-related genes: IL-16, CDKN2A (p16), RAF1, PTGER4, and ITGB4 in colorectal cancer (CRC) risk modification in an Iranian population. This study was performed on 643 individuals (249 CRC cases and 394 healthy controls). We selected five cancer-related genes (IL-16, CDKN2A (p16), RAF1, PTGER4, and ITGB4) and investigated the genotypes of the 3' untranslated region miRNA-binding site polymorphisms in these genes in our study population. The restriction fragment length polymorphism results were confirmed by a direct sequencing method. We found a statistically significant difference between the rs1131445 polymorphism of the IL-16 gene and CRC. The frequencies of the genotypes TT, CT, and CC in controls were 51%, 40.4%, and 8.6%, respectively, and in cases were 41.4%, 44.1%, and 14.5%, respectively, which shows a significant association between the CC genotype of the rs1131445 polymorphism and CRC (P = 0.004). The frequency of the C allele in the CRC group was higher than in the controls, and the C allele of the rs1131445 polymorphism was found to be in association with CRC (P = 0.009). These associations remained significant after Bonferroni's correction for multiple testing. We found that the AA genotype of the rs743554 polymorphism in the ITGB4 gene and the T allele of the rs1051208 polymorphism of the RAF1 gene were associated with the risk of CRC in females; however, after Bonferroni's correction we found that they were non-significant. Finally, we can conclude that a significant relationship exists between the miRNA-binding site polymorphism of the IL-16 gene and CRC risk in the Iranian population., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objectives: Since diabetes mellitus is accompanied by cognitive impairment in diabetic patient and animal models and since lipids play important roles in neuronal membrane composition, structure and function; we intended to evaluate the effect of dietary butter oil on passive avoidance memory of streptoztosin (STZ)-induced diabetic rats in this study., Materials and Methods: THIRTY SIX ADULT MALE RATS WERE RANDOMLY ALLOCATED TO FOUR EQUAL GROUPS: normal (N) and diabetic control (D) groups with free access to regular rat diet; but the diet of normal butter oil (NB) and diabetic butter oil (DB) groups was supplemented with 10% butter oil. Diabetes in D and DB groups was induced by intravenous (i.v.) injection of 50 mg/kg.bw of STZ. Passive avoidance memory and cholesterol of brain and hippocampal tissues has been measured six weeks after diabetes confirmation., Results: Diabetes, especially in diabetic butter oil group decreased the abilities of learning and memory. The level of cholesterol in hippocampus was higher in NB (P< 0.05) and DB (P< 0.01) groups., Conclusion: We suggest consumption of butter oil may worsen cognitive impairment of diabetic animal. This may be related to the higher elevation of cholesterol in the hippocampus of diabetic animals.

Aim: This study was designed to evaluate the frequency of antibody against these viruses in individuals attending the endoscopy ward of Taleghani hospital Tehran, Iran., Background: Blood-borne viruses such as hepatitis B and hepatitis C virus and HTLV-1 virus are among the world's public health problems. Hepatitis viruses cause liver problems and HTLV-1 infection can lead to adult T-Cell lymphoma (ATL)., Patients and Methods: Blood samples of 219 individuals attending the endoscopy ward of Taleghani hospital between years 2009-2011 were collected. A questionnaire containing demographic data was completed for each subject. Blood samples were tested for antibody against HTLV-1, HCV and HBc by ELISA (Dia.pro Italy). In case of positive results for anti-HBc, samples were also tested for HBs Ag antigen., Results: Ninety two subjects were male and 127 were female. Mean age of the population was 39.87 ± 16.47. None of the subjects had anti-HCV antibody, while 4 of them had anti-HTLV-1 antibody and 26 anti-HBc antibody; which only two of these individuals had HBs Antibody., Conclusion: The results of this study show that frequency of anti-HCV and anti-HTLV-1 antibodies are very low, while the frequency of anti-HBc was higher in the population. Since HTLV-1 is the causative agent of a type of blood cancer, it seems that screening of donated bloods in this region should be considered.

Introduction: Esophageal cancer is the 6th most common cause of cancer death in the world. During the past two decades some changes have occurred in histologic type and primary tumor location in some parts of the world but there is a little information about histopathological aspect of disease in Iran. The purpose of the present study was to clarify the features of histopathological of esophageal cancer in Iran., Methods: This study designed as a cross sectional study. Data analysis was performed with descriptive and univariate methods. Information required for this study extracted from cancer registry forms. The cases were all patients who received a histopathological diagnosis of EC that were referred to this center from January 2003 to October 2008., Results: A total of 264 EC cases were recruited in the study the lower third of the esophagus was the most frequent site of origin of these tumors. Squamus cell carcinoma was commonest histologic type of tumor. In 15.2% of cases tumor was metastasis to other organs. In 46.6% were in advanced stage at diagnosis., Discussion: Based on result of present study, esophageal cancer in our country more presented in Squamus cell carcinoma histology type, in advanced stage. Since Squamus cell carcinoma have a poorer prognosis and given that these patients have vague symptomatology for approximately several months, therefore, early diagnosis and treatment led to better prognosis.

Multiwalled carbon nanotubes (MWCNTs) with unique chemical and electromechanical properties are ideal candidates for the development of drug delivery platforms. The scarce knowledge for the effects of exposure to MWCNTs during pregnancy on postnatal outcomes motivated us to investigate whether intraperitoneal injections (i.p.) of MWCNTs during mating and early pregnancy affect on reproductive and neurobehavioral endpoints and psychobiological status of pups. Thirty virgin female mice were divided to three groups (n = 10 for each); two treated groups injected i.p. with 1 and 10 mg of MWCNTs suspended in 1 ml of phosphate buffered saline solution (PBS) in both mating day and gestation day 3, respectively. The control group was injected i.p. with an equal volume of PBS as a vehicle. MWCNT-treated dams did not exhibit considerable changes in their reproductive performance in gestation and lactation periods. MWCNT-treated pups exhibited similar ontogenetic expressions of neurobehavioral and physical endpoints as compared with control group. Most notably, exposure to MWCNTs was increased depressive and anxious behaviors of treated pups in parallel to adverse effect on their internal organ weights. The absolute thymus weight was declined in MWCNT-treated groups while absolute weights of liver and spleen decreased in group treated by 1 mg of MWCNT as compared to control group. Relative organ weights in MWCNT-treated groups were almost similar to control group.

Introduction: Design and implementation of screening programs in each country must be based on epidemiological data. Despite the relatively high incidence of CRC, there is no nationwide comprehensive program for screening in Iran. This study was designed to investigate national CRC data and help to determine guidelines for screening., Methods: Incidence data used in this study were obtained from Iranian annual of National Cancer Registration report. Age standardized rates (ASR)were calculated using world standard population and were categorized by age, sex, anatomic subsite and morphology of tumor. Data were analyzed using SPSS.V.13 and Open Source Epidemiologic Statistics for Public Health software (OpenEpi v.2.3.1)., Results: A quarter of cases were less than 50 years of age. The majority of tumors were detected in the colon. The overall ASR in the four years period was 38.0 per 100000 and was higher for men compared women (P<0.05). Incidence rate of colorectal cancer increased with age., Conclusion: Results of present study indicated that incidence of colorectal cancer is relatively high in Iran. Incidence of CRC in people under 50 years and in rectum were reported higher than other countries that related etiologic factors should be investigate in further studies. According to the increasing of ASR after age 50 years, it seems that onset of screening at age 50 would be appropriate.

Background and Aims: A number of theories have been put forward to clarify the etiology of colorectal cancer (CRC), such as genetic alterations and cytokine production. A combination of inflammatory cytokines has an important role in cancer development. The aim of our study was to screen for alterations located in promoter and exons of IL-16 gene sequence, to determine the distribution of genotypes in individuals with CRC and healthy controls in a sample of Iranian population., Methods: The case group consisted of 260 individuals with colorectal cancer and the control group included 405 healthy individuals. Three IL-16 gene polymorphisms (rs4072111, rs11556218, rs4778889) were genotyped using PCR-RFLP method. RFLP results were confirmed by direct sequencing., Results: A significant association between rs11556218 SNP in the IL-16 gene and the risk of CRC was found. The TG genotype of rs11556218 T/G polymorphism showed significant association with a 1.75 fold increased risk of CRC (P=0.005; adjusted OR: 1.759; 95% CI: 1.191-2.598). In addition a significant association between CC genotype of rs4778889 T/C polymorphism and decreased risk of CRC in male subjects (P=0.045; adjusted OR: 0.192; 95% CI: 0.038-0.967) was determined., Conclusion: This study is the first report of IL-16 gene polymorphisms among CRC patients from Iran. Our results suggest an influence of rs11556218 T > G and rs4778889 T/C polymorphisms on the altered risk of CRC.

Epidemiological evidence suggests the protective effect of vitamin D against colorectal cancer (CRC) and the polymorphisms in vitamin D receptor (VDR) gene may influence the development of CRC. In this study the possible association of VDR FokI and BsmI gene polymorphisms with CRC risk was examined. A total of 904 subjects, including 452 cases with CRC and 452 controls were enrolled in this study. All 904 subjects were genotyped for VDR FokI and BsmI gene polymorphisms by PCR-RFLP method. We observed no significant difference in genotype and allele frequencies between the cases with CRC and controls for the both FokI and BsmI polymorphisms either before or after adjustment for confounding factors including age, BMI, sex, and smoking status. Furthermore, no evidence for effect modification of the association VDR gene FokI and BsmI variants and CRC by BMI, sex, or tumor site was observed. In addition, there was no significant difference in genotype and allele frequencies between the normal weight (BMI <25 kg/m(2)) cases with CRC and overweight/obese (BMI ≥25 kg/m(2)) cases with CRC for the two SNPs. Our results do not lend support to the hypothesis that VDR gene FokI and BsmI polymorphisms are associated with the risk of CRC. However, further studies are required to confirm this finding.

Aim: Leptin is a 16 kDa polypeptide hormone which secreted by adipose tissue and has an important role in energy balance, insulin pathway and inflammation, because of that it may play an important role in colorectal cancer (CRC). Leptin exerts its effect through the leptin receptor (LEPR) a member of the class I cytokine receptor family., Background: We have investigated whether glutamine to arginine substitution (Gln223Arg) in exon 6 of the leptin receptor gene, has implications for susceptibility to CRC., Patients and Methods: Polymerase chain reaction (PCR) and restriction enzyme digestion (RFLP) was performed to evaluate the association between the Gln223Arg polymorphism of the LEPR and CRC risk in a case-control study in 346 subjects involving 173 cases with CRC and 173 controls., Results: There was no statistically evidence of significant difference in genotype and allele frequencies between the cases with CRC and controls for the Gln223Arg polymorphism of LEPR, before or after adjusting for confounders (age, BMI, sex, and smoking status). Furthermore, no significant difference was observed between the CRC cases and controls by BMI, sex and smoking status., Conclusion: Our findings suggest that the LEPR Gln223Arg polymorphism is not associated with the risk of CRC in Iranian population.

Aim: The aim of this study was to compare prognostic factors between colon and rectal cancers., Background: Prognosis of Colorectal Cancer (CRC) may depend on the anatomical site., Patients and Methods: A total of 1219 patients with CRC diagnosis according to the pathology report of RCGLD cancer registry, from 1 January 2002 to 1 October 2007, were entered into the study. Demographic and clinico-pathological factors were analyzed using survival analysis., Results: From age at diagnosis, colon cancer had significantly better survival than rectal cancer (Multivariate Hazard Ratio (MVHR)=0.24; 95% Confidence Interval (CI) =(0.074-0.77)). Other factors, including marital status (MVHR =1.78; 95% CI =(0.33-9.62)), body mass index (BMI) (MVHR =1.21 and 1.54; 95% CI =(.30-4.85) and (.44-5.4) respectively for < 18.5 and >30 BMI groups), pathologic stage (MVHR =.64; 95% CI =(.21-1.98)) and alcohol history (MVHR =4.86; 95% CI =(.67-35.14)) were not significantly different between the two patient group but suggested a possible effect upon prognosis. Overall survival in rectum was better than that of colon., Conclusion: Our findings support this hypothesis that prognosis of CRC varies with tumor site.

Aim: The aim of the current investigation was to examine the profile of Kras mutations accompanied with MSI (microsattelite instability) status in polyps and colorectal carcinoma tissues in an Iranian population., Background: Kras mutations in colorectal cancer cause resistance to anti-Epidermal Growth Factor Receptor (EGFR). So it can be considered as a true indicator of EGFR pathway activation status. Kras mutations can be detected in approximately 30% to 40% of all patients with colorectal cancer. The most hot spot of the gene is located in exons 2 and 3., Patients and Methods: In this study we examined exons 2 and 3 Kras gene using polymerase chain reactions and subsequent sequencing of the exons in 95 patients with sporadic colorectal cancer including 48 tumors and 47 polyps. This study was performed using biopsy samples from the patients. We sequenced the Kras gene in a panel of human colorectal tumors and polyps in addition to detecting MSI status using fluorescent technique., Results: We could detect 6 mutations in tumors including 5 mutations in codon 12 and one mutation in codon 13. Moreover, in polyps 2 mutations were determined in codon 13 and one in codon 12. Microsatellite instability assay revealed the presence of 5 and 6 MSI in tumors and polyps, respectively. Among the MSI mononucleotide markers, NR-21 marker demonstrated the most frequency (60%) in the both groups., Conclusion: Our findings showed that probably the profile of mutations in tumors is not entirely compatible with the pattern of mutations in polyps. However, just one of the mutations, Gly12Asp, was similar in both groups.

Background: It has been frequently shown that p53 alterations have an important role in the development of gastric cancers but there is no data on p53 alteration in gastric cancer and its precancerous lesions from Iran although this country experiences one of the highest gastric cancer incidence and mortality rates in the world. The purpose of this study was to do a comprehensive assessment of p53 alterations in the Iranian population of gastritis patients and to evaluate the association between p53 alterations, microsatellite status and clinicopathological aspects., Methods: After DNA extraction, PCR sequencing was done for exons 2-7. Also microsatellite status was evaluated using five microsatellite markers: NR-27, NR-21, NR-24, BAT-25 and BAT-26., Results: The highest rate of alteration was seen in codons 72 (85.6%, SNP) and 248 (30.9%, mutation). Also, we found 2 new mutations in codons 9 and 146. In contrast with previous work, transition at the CpG codons was relatively rare. Nucleotide alterations were more prevalent in the Helicobacter pylori-positive group but not significantly. Neither nuclear staining for p53 protein nor microsatellite instability was seen in gastritis lesions., Conclusion: p53 alterations might contribute to the pathogenesis of gastritis and perhaps gastric cancer in Iran. However, the different spectrum seen here implies other mechanism(s) in gastritis and gastric cancer development in the Iranian population., (Copyright © 2010 S. Karger AG, Basel.)

Background: Colorectal cancers (CRCs) tumors are diagnosed by microsatellite instability (MSI) due to accumulation of insertion/deletion mutations in tandem repeats of short DNA motifs (1-6 bp) called microsatellites. Microsatellite instability (MSI) is not only a hallmark marker for screening of hereditary nonpolyposis colorectal cancer (HNPCC), but also a prognostic and predictive marker for sporadic colorectal cancer. Our objective was to determine and study of five mononucleotide microsatellite markers status among Iranian patients with HNPCC and sporadic colorectal cancer., Materials and Methods: In the current investigation 80 sporadic CRC and 80 HNPCC patients were evaluated for MSI. The pentaplex panel including 5 quasimonomorphic mononucleotide repeats (NR-21, BAT-26, BAT-25, NR-27 and NR-24) was used., Results: Our findings showed that the NR-21 was the most frequent instable marker among the other markers. 53% and 25.6% specimens had instability in sporadic CRC and HNPCC, respectively. Furthermore, the frequencies of instability BAT-25 was determined in 20% sporadic CRC and 23% HNPCC samples. Interestingly our results demonstrated that the frequency of instability NR-24 was similar 20% sporadic CRC and 20.5% HNPCC. Moreover, percentage of NR-27 in HNPCC was 19.2 and 0% in sporadic CRC. Finally, BAT-26 was instable in 21.8% HNPCC patients while we could find 6.6% instability for BAT-26 in sporadic cases., Conclusion: It seems that among 5 mononucleotides markers NR-21 was the most useful marker for diagnosis HNPCC and sporadic cancer. Following NR-21, BAT-25 and NR-24 are the most reliable markers. Therefore using a triplex panel including 3 aforementioned MSI markers should be more promising markers for identifying MSI status in both patients with HNPCC and/or sporadic colorectal cancer.

Background and Objectives: Gastric cancer is the second leading cause of cancer death worldwide and is the most common type of cancer in Iran. The objective of this research was to apply additive hazards models to the study of survival of patients with gastric cancer and to compare with results obtained using the Cox model., Methods: We retrospectively studied 213 patients with gastric cancer who were registered in one referral cancer registry center in Tehran, Iran. Age at diagnosis, sex, presence of metastasis, tumor size, histology type, lymph node metastasis, and pathologic stages were entered into analysis using the Cox model and additive hazard models. To visualize a covariate effect over time, the estimated cumulative regression function by the Aalen's model was examined., Results: The five-year survival rate and the median life expectancy in the studied patients were 14.6% and 29.6 months, respectively. Multivariate Cox and Additive hazards models analysis identified age at diagnosis, tumor size and pathologic stage as independent prognostic factors for the survival of patients with gastric cancer. Moreover, pathologic stage had a late or delayed effect according to the Aalen's plot. Other clinicopathological characteristics were not statistically significant., Conclusion: Since Cox and Aalen models give different aspects of the association between risk factors and the study outcome, it seems desirable to use then together to give a more comprehensive understanding of data. Our results also suggest that early detection of patients at younger age and in primary stages is important to increase survival of patients with gastric cancer.

Background: With a background of disparities in colorectal cancer (CRC) incidences/mortality across countries due to differences in exposure to various prognostic factors, this study aimed to evaluate the site-specific pattern for the survival of colon and rectal patients., Methods: A total of 1,283 patients with CRC diagnosis according to the pathology report of cancer registry of RCGLD from 1 January 2002 to 1 October 2007, were entered into the study. Data were analyzed using univariate and multivariate competing risk survival analysis., Results: Survival proportion of patients showed a significant trend for 1, 3 and 5 year survival in colon cancer (P< 0.001) but this wasn't significant for rectal cancer (P=0.078). Tumor grade and pathologic stage were the most important factors predicting the survival in colon and rectal cancers with stronger hazard in the rectal site for grade and stronger hazard in the colon site for stage. For colon site, in the well and moderate categories of tumor grade, shifting from early to advance stage and also shifting in tumor grade from well and moderate categories to poor tumor grade had a considerable effect in hazard ratios. For rectum site, well to moderate shifting in tumor grade increased the hazard of death and shifting from early to advance stage increased the hazard equal to 2.54 and 4.36 times within the well and moderate tumor differentiation, respectively. In shifting to advance CRC, colon site had generally worse hazard than the rectum., Conclusion: Due to the worse conditions of CRC patients as shifting to advance cancer, to improve the effectiveness of treatment and hence the survival of Iranian patients, we should pay more attention to early detection, in particular by implementing population based screening programmes.

Introduction: Gastric cancer is one of the major causes of cancer related death in the world. A number of risk factors are now known to be related to the development of the disease. Previous reports indicated that a family history is a serious risk, but there is a little information about this in Iran. The aim of this study was to explore the relation between family history of cancer in first and second degree relatives and the risk of GC in Iran., Methods: The present study was designed as unmatched case control study. Cases were 746 patients with histologically confirmed GC and the 746 controls were randomly selected among the healthy participants in a health survey. Family history was extracted from a standard history form completed by the patient or from records created by a health care provider. Mantel-Heanszel odds ratios were computed for removing the confounding effect of age and sex., Results: Overall, 9.7% of cases versus 5.6% of controls reported a family history of GC. Risk increased over twofold for this group. There was no significant association among family history of other cancers and GC (P>0.05)., Conclusion: In conclusion, this study showed that family history of GC, especially in first-degree relatives, increases the risk of development of the disease. Further studies are needed to better understand the roles of genetic and environmental factors and their interaction in gastric cancer development in the Iranian community.

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.

Background: The significance of expression of different mucins in succession of malignant transformation of colorectal polyps is not determined yet. The aim of the present study was to determine the pattern of expression of MUC1, MUC2, MUC5AC and MUC6 in colorectal polyps and to evaluate the applicability of using mucin expression in predicting the extent of malignant transformation in colorectal polyps., Methods: A total of 454 polyp specimens comprising 36 hyperplastic polyps, 15 serrated adenomas, 258 tubular adenomas, 114 tubulovillous adenomas, and 31 villous adenomas were included in this study, and were immunostained for MUC1, MUC2, MUC5AC and MUC6 by using mucin specific antibodies., Results: MUC1 and MUC6 were absent in all hyperplastic polyps and their expression was higher in serrated and traditional adenomas. Only 5 cases including 2 serrated adenomas, 1 tubulovillous adenoma, and 2 villous adenomas stained negative for MUC2. The highest expression of MUC5AC was observed in serrated adenomas followed by tubular adenomas. Binary logistic regression analysis indicated that positive staining for MUC1, and MUC6, and negative staining for MUC2 would increase the risk of invasion to mucosa or the muscularis mucosae in colorectal polyps. Ordinal regression analysis demonstrated a positive association between the level of staining for MUC1 and risk of being of high configuration/grade in colorectal polyps., Conclusions: MUC1, MUC2, MUC5AC, and MUC6 have the potential to be used as predictors of malignant transformation and invasion to mucosa or the muscularis mucosae in colorectal polyps. The most reliable predictions can be achieved by determining the level of expression of MUC1.

Background and Aim: One candidate gene for colorectal cancer (CRC) susceptibility is exonuclease 1 (EXO1). It is a member of RAD2 nuclease family, which plays a major role in mismatch repair, DNA replication, and recombination. Single-nucleotide polymorphisms are shown to be related with cancer incidence. The aim of the present study was to examine the association between the L757P polymorphism at exon 13 of the EXO1 gene and the risk of CRC in Iranian patients., Methods: In this case-control study, 90 cases and 98 healthy control samples were analyzed genetically. The EXO1 polymorphism, P757L, was analyzed by polymerase chain reaction-restriction fragment length polymorphism. The obtained polymorphisms were examined for the relationship with CRC risk and also clinicopathological characteristics., Results: Our findings showed that patients with the Leu/Leu genotype have a reduced risk of CRC (adjusted odds ratio [OR] = 0.192, 95% confidence interval [CI]: 0.040-0.921) when the Pro/Leu and Pro/Pro genotypes were blended and they were considered as the reference. The Leu/Leu genotype also showed a reduced risk (adjusted OR = 0.168, 95% CI: 0.034-0.816) when the Pro/Pro genotype was a reference; nevertheless, the Pro/Leu genotype did not reveal a significant association with CRC at the same status (adjusted OR = 0.686, 95% CI: 0.367-1.284)., Conclusions: Our results provide evidence diagnosing that the Leu/Leu genotype of EXO1 showed an inverse association with CRC. In addition, despite other investigations, we could define a significant association between the Leu allele and CRC (p = 0.001).

Objectives: The purpose of this study was to investigate vitamin D receptor (VDR) gene ApaI and TaqI polymorphisms in relation to the risk of colorectal cancer (CRC) in the Iranian population., Methods: Two single nucleotide polymorphisms in intron 8 (ApaI) and exon 9 (TaqI) of the VDR gene were genotyped in 160 subjects with CRC and 180 controls by use of the PCR-RFLP method., Results: The VDR ApaI genotype distribution differed significantly between subjects with CRC and controls. The ApaI "aa" genotype compared with "AA" genotype was associated with a 2.3-fold increased risk of CRC (P = 0.014; OR = 2.25, 95% CI = 1.18-4.28) and the difference remained significant after adjustment for age, BMI, sex, and smoking status (P = 0.014; OR = 2.32, 95% CI = 1.19-4.54). Furthermore, the ApaI "a" allele was significantly overrepresented in subjects with CRC than controls (P = 0.014; OR = 1.48, 95% CI = 1.08-2.02)., Conclusions: These findings suggest that VDR ApaI genotype "aa" is associated with increased risk of CRC in the Iranian population. However, these data remain to be confirmed in larger studies and in other populations.

Aims and Background: The objective of the study was to assess the impact of prognostic factors on survival of patients with gastric cancer in the presence of interval censoring using parametric models., Methods and Study Design: In a retrospective cohort study, 178 patients with gastric cancer were studied from February 2003 to January 2008. Gender, age at diagnosis, distant metastasis, tumor size, histology type, tumor grade, lymph node metastasis and pathologic stage were selected as prognostic and entered in the models. Weibull, exponential, log-logistic and log-normal analyses with interval censoring were performed as parametric models, and Akaike Information Criterion (AIC) was used to compare the efficiency of models., Results: The risk of death for patients at an older age, with tumor size greater than 35 mm, distant metastasis and advanced stage of disease was statistically higher. Other clinical and demographic factors were not significant. According to AIC, the log logistic model is the most efficient of all the models in multivariable analysis., Conclusions: The results indicated that the early detection of a cancer at a young patient age and in primary stages is important to increase survival from gastric cancer. According to statistical criteria, a parametric model can also be a useful statistical model to find prognostic factors in the presence of interval censoring. Although it seems that all models in this analysis fit well, AIC supported the log logistic regression as the best option.

Aims and Background: Mucinous adenocarcinoma (MA) colorectal cancer accounts for 10 to 15% of colorectal carcinoma. It is generally thought that patients with MA present at a more advanced stage of disease and have a poorer prognosis than those with other types of carcinoma. The purpose of the present study was to clarify the clinicopathological characteristics of mucinous colorectal carcinoma in the Iranian population., Methods: Between January 2002 and March 2008, Of the 1283 colorectal cancer patients, 110 patients were considered to have mucinous tumors according to pathology report. Patients evaluated on the basis of sex, age, location of tumor, stage, differentiation of tumor and family history of cancer. Kaplan-Meier curves and log-rank tests were used for survival analysis., Results: The median age of these patients at diagnosis was 50.07 years. More than 50% of patients were younger than aged 50 years. 34.5% of patients had a family history of colorectal cancer in their first-degree relatives. Most tumors were presented in right colon. 54.3% of MA patients had advanced stage lesions. The Kaplan-Meier method indicated that, the 1, 3 and 5 year survival rates are 92.6, 80.1 and 41.3 percent, respectively. Survival of the patients was related to disease stage (P = 0.023)., Conclusion: Our suggests that genetic factors may be play an important role in the development of this disease in our country and screening programs, especially genetic screening programs, should be considered as a main measure for prevention and control of colorectal cancer in Iran.

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.

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.

Background: In around 10 to 15% of all colorectal cancer (CRC) cases, a positive family history of colorectal cancer is observed . Although increased risk of colorectal cancer in individuals with a family history of the disease has been observed consistently in the past studies, limited information is available on colorectal cancer associated with family history in Iran., Aims: The purpose of this study is to define the risk of colorectal cancer associated with a family history of cancer., Setting and Design: The present study was designed as an unmatched case control study. The cases were 393 patients with histologically confirmed colorectal carcinomas and there were 393 controls, randomly selected from among the healthy participants in a health survey., Methods: The family history was extracted from a standard history form completed by the patient or from the record created by a health care provider., Statistical Analysis: Mantel-Heanszel Odds Ratio was computed for removing the confounding effect of age and sex., Results: A positive family history of cancer was reported by 36.4 and 24.4% among the cases and controls, respectively. Colorectal cancer risk increased two-fold in subjects who reported having first degree relatives with cancer. The adjusted odds ratio was 4.76, indicating that having a positive family history of colorectal cancer among relatives increased one's risk of colorectal cancer about 4.5-fold., Conclusion: According to our findings, a family history of cancer increased the risk of CRC. Due to this fact that there is no current colorectal cancer screening program in Iran, it is recommended that first degree relatives of patients with colorectal cancer should be considered as a priority group for screening programs.

Background: Failure in the DNA mismatch repair system is commonly accompanied by microsatellite instability and leads to colorectal cancer. The aim of this study was to find the most frequent of five mononucleotide markers in order to devise the simplest diagnostic strategy for identification of patients with hereditary nonpolyposis colorectal cancer (HNPCC) who were defined by defects in mismatch repair system., Materials and Methods: 78 patients with colorectal cancer were recruited for this investigation. Five mononucleotide markers, NR-27, NR-21, NR-24, BAT-25 and BAT-26, were used as a pentaplex panel to determine MSI status., Results: Two out of five mononucleotide markers, NR-21 (25.6%) and BAT-25 (23.1%) showed more instability than the others., Conclusion: In defining individuals with colorectal cancer, BAT25 and NR-21 may provide diagnostic assistance.

Background: Hereditary non polyposis colorectal cancer (HNPCC) appears to have a better prognosis than sporadic cancer. In the present study we evaluated the clinical outcomes of HNPCC patients with their sporadic colorectal cancer counterparts arising from the general population recorded in a population-based cancer registry in Iran., Patients and Methods: The population studied consisted of 121 individuals including 61 patients with sporadic colorectal cancer and 60 with HNPCC who were followed-up between 2003 and 2008 in Taleghani Hospital Tehran. The subjects with HNPCC were screened according to Amsterdam criteria II and Bethesda Guidelines. Subjects with sporadic cancer had no familial history of colorectal cancer. Observed survival was estimated using the Kaplan-Meier method and compared with the log rank test. Multivariate analysis was performed using Cox' regression analysis., Results: In the HNPCC group, 85.0% showed tumors in the colon, vs. 68.9% in the sporadic cancer group. The 5-year survival was 82.5% in the HNPCC study group compared with only 56.4% in the sporadic colorectal cancer group (P= 0.044). The age distribution at diagnosis of sporadic patients was significantly higher than HNPCC patients (mean 50.1 years vs 44.3 years P= 0.008). The hazard ratio for sporadic cases was 2.93 (95% CI 1.06-8.11) compared with the HNPCC group (P= 0.038)., Conclusion: Our findings corroborate the results of previous studies which showed overall survival of colorectal cancer in patients with HNPCC is better than with sporadic CRC patients.

Background and Objectives: Gastric cancer is one of the most common cancers in the world. The aim of this study was to evaluate prognostic factors using Bayesian interval censoring analysis., Methods: This is a historical cohort study of 178 patients from February 2003 through January 2008, admitted with gastric cancer to one referral hospital in Tehran. Age at diagnosis, sex, histology type, tumor grade, tumor size, pathologic stage, lymph node metastasis and distant of metastasis were entered into the analysis using Bayesian Weibull and Exponential models. The term DIC was employed to find best model., Results: The results showed that as age increased, the risk of death slightly increased significantly in both Weibull and Exponential models with similar results. Patients with grater tumor size were also in higher risk of death followed by advanced pathologic stage. Neither the Weibull nor the Exponential models found sex, distant metastasis, histology type, tumor grade and lymph node metastasis to be prognostic factors. Based on DIC, Bayesian analysis of the Weibull model performed better than the Exponential model., Conclusion: According to these results the early detection of patients at lower ages and in primary stages is important to increase the survival in cases with gastric cancer.

Background: Colorectal cancer (CRC) is one of the most malignant cancers, but prognosis varies in different parts of the world. Knowing the prognostic factors of the cancer is clinically important for prognosis and treatment application objectives. However, evaluation of these factors overall does not provide thorough understanding of the cancer. Therefore, this study aimed to evaluate prognostic factors of colon and rectal cancers site-specifically, via a competing risks survival analysis with colon and rectum as competing causes of death., Methods: A total of 1,219 patients with CRC diagnosis according to the pathology reports of our cancer registry, from 1 January 2002 to 1 October 2007, were entered into the study. Demographic and clinicopathological factors with regard to survival of patients were analyzed using univariate and multivariate competing risks survival analysis, utilizing STATA statistical software., Results: The results of univariate analysis showed that gender, body mass index (BMI), alcohol history, inflammatory bowel disease (IBD), tumor size, tumor grade and pathologic stage were significantly associated with colon cancer and BMI, personal history of cancer, pathologic stage and the kind of first treatment used were significantly related to rectal cancer. In the multivariate analysis, BMI, IBD, tumor grade and pathologic stage of the cancer were significant prognostic factors for colon cancer and BMI and the kind of first treatment used were significant prognostic factors of rectal cancer. Also 1, 2, 3, 4 and 5 year and overall adjusted survival of patients with rectal cancer was better than those of colon cancer., Conclusion: Based on our findings, CRC is not a single entity and its sub-sites should be evaluated separately to reveal hidden associations which may not be revealed under general modeling.