Prognostic value of systemic hemato-immunological indices in uterine cervical cancer: A systemic review,meta-analysis,and meta-regression of observational studies

ObjectiveTo estimate the prognostic efficacy of several systemic hemato-immunological indices for the treatment of cervical cancer as well as to determine whether the systemic hemato-immunological indices are associated with an increased risk of cervical collision cancer.MethodsA systematic search was conducted to identify studies that evaluated the prognostic impact of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), thrombocyte-to-lymphocyte ratio (TLR), C-reactive protein/albumin ratio (CAR), and systemic immune-inflammation index (SII) in cervical cancer patients. The endpoints were overall survival (OS) or progression-free survival (PFS) and clinicopathologic parameters. A meta-analysis using random-effect models was performed to calculate hazard ratios (HRs) or odds ratios with 95% confidence intervals.ResultsTwenty-two retrospective cohort studies involving 9558 patients were included. Our results show that high NLR, PLR, TLR, and CAR indicated poor prognosis for patients with cervical cancer (HRs = 2.46, 1.88, 3.70, and 3.94, respectively; all P ≤ 0.001). Subgroup analysis suggested that the highest NLR and PLR were more precise biomarkers in patients who were diagnosed with FIGO stage I-III cervical cancer after treatment with chemo-radiotherapy. High TLR and high LMR displayed significant prognostic value in late-FIGO stage III-IV cervical cancer (HRs = 4.33 and 2.032, respectively). Additionally, CAR was associated with poor survival in patients with advanced-FIGO stage cervical cancer and larger tumor size. According to the difference of NLR, the younger (43–51 years old) cervical cancer patients had a tendency of increased collision risk. However, cervical cancer patients in the 52–61 years age group were more vulnerable than their respective counterparts using the pooled estimate for PLR.ConclusionOur findings support a prognostic role for elevated CAR and TLR besides that of NLR and PLR in advanced-FIGO stage cervical cancer.     

P16INK4a Immunostaining but Lack of Human Papilloma Virus Type 16 in Cutaneous Squamous Cell Carcinoma and Basal Cell Carcinoma: a Report from West Iran

The tumor suppressor p16 is a biomarker for transforming human papilloma virus (HPV) infections that can lead to contradictory results in skin carcinomas. The aim of this study was to evaluate p16 expression and HPV-16 infection in the cutaneous basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). This case-control study was performed on paraffin blocks of BCCs and SCCs and normal skin (53, 36, and 44 cases, respectively), between 2006 to 2015. Initial sections for groups were stained with hematoxylin and eosin (H and E). Immunohistochemistry was performed for p16 expression and human papilloma virus type 16 (HPV-16) infection. Normal group was skin of mammoplasty specimens and normal skin tissue in the periphery of tumors. The mean age at diagnosis was 42.1, 61.7 and 71.4 years for normal, BCC and SCC groups, respectively. P16 positivity was more in SCC and BCC groups compared to normal group (P<0.05) and HPV was negative in all patients in three groups. Also, the mean age at diagnosis and P16-positivity were higher for the SCC group than the BCC group (P<0.005). In conclusion, in non-melanoma skin cancers (SCC and BCC), p16-positivity can be a prognostic factor but there is no correlation between HPV-16 and p16 in these tumors.     

Study of the normal internal organ weights in Tehran’s population

ObjectiveExamine the normal adult internal organ weight and its relationship with body height, body weight, body mass index and age.Materials and methodsProspective analysis of data from 1222 autopsies in Legal Medicine Organization of Iran from 1st January, 2007 to 1st September, 2008. All the subjects were adult residents of Tehran died from external causes and showed no pathological changes.ResultsThe weight of the brain, heart, lungs, liver, spleen, pancreas, kidneys, thyroid gland, the pituitary gland, the suprarenal glands, testes, prostate, ovaries and the uterus were collected from 914 males and 308 females between 15 and 88 years. The weight of all the organs was correlated statistically with at least one external parameter with the exception of the pancreas in men, the uterus, the spleen and the thyroid in women. Organ weights decreased with age except for the heart and the prostate, and increased in relation to body height and/or BMI. Except for the brain, the organ weight showed a better statistical correlation with the BMI than the body height.ConclusionThese results can be used as standard organ weights to determine abnormal evidences in Forensic and Pathologic corpses. However such results have to be regularly updated by pathologists in order to keep organ weight as a good criterion used in postmortem diagnosis.     

Report of two cases of myxoinflammatory fibroblastic sarcomas with preceding hematolymphoid neoplasms: Is there any association?

Myxoinflammatory fibroblastic sarcoma (MIFS) is an uncommon soft tissue sarcoma. We present two cases of MIFS: A known case of Hodgkin‘s lymphoma presented with hand mass; a recurrence of MIFS with a history of chronic lymphocytic leukemia.     

Suicide by firearm, a unique pattern from Iran.

Throughout the one-year period from March 21, 2002 to March 21, 2003, the Legal Medicine Organization of Iran in Tehran investigated 27 firearms suicides. The crude mortality rate from firearms suicides was about 0.21 per 100,000 (the rate of suicide in Tehran is around 9.8 per 100,000).All of the victims were young males. Military rifles were responsible for the majority of the suicides. The most common sites of entrance wounds were the submentum (37%) and chest (25.9%). In 84.6% of the cases gunshots were fired from contact or near contact range. With the exception of 1 of the suicides, all were committed at either garrisons or police stations. The unique pattern of suicides found in this series is discussed in the context of availability of method.     

A Dermal Equivalent Engineered with TGF‐β3 Expressing Bone Marrow Stromal Cells and Amniotic Membrane: Cosmetic Healing of Full‐Thickness Skin Wounds in Rats

Transforming growth factor beta‐3 (TGF‐β3) has been shown to decrease scar formation after scheduled topical applications to the cutaneous wounds. This study aimed to continuously deliver TGF‐β3, during the early phase of wound healing, by engineering a dermal equivalent (DE) using TGF‐β3 expressing bone marrow stromal cells (BM‐SCs) and human dehydrated amniotic membrane (hDAM). To engineer a DE, rat BM‐SCs were seeded on the hDAM and TGF‐β3 was transiently transfected into the BM‐SCs using a plasmid vector. Pieces of the dermal equivalent were transplanted onto the full‐thickness excisional skin wounds in rats. The process of wound healing was assessed by image analysis, Manchester Scar Scale (MSS), and histopathological studies 7, 14, 21, and 85 days after the excision. The results confirmed accurate construction of recombinant pcDNA3.1‐TGF‐β3 expression system and showed that the transfected BM‐SCs seeded on hDAM expressed TGF‐β3 mRNA and protein from day 3 through day 7 after transfection. After implantation of the DE, contraction of the wounds was measured from day 7 through 21 and analyzed by linear regression, which revealed that the rate of wound contraction in all experimental groups was similar. Histologic evaluation demonstrated that transfected BM‐SCs decreased retention and recruitment of the cells during the early stage of wound healing, decreased the formation of vascular structures and led to formation of uniformly parallel collagen bundles. MSS scores showed that TGF‐β3 secreting cells significantly improved the cosmetic appearance of the healed skin and decreased the scar formation. From these results, it could be concluded that transient secretion of TGF‐β3, during the early phase of healing, by BM‐SCs seeded on hDAM can improve the cosmetic appearance of the scar in cutaneous wounds without negatively affecting the process of wound repair.     

Bone marker status in mothers and their newborns in Iran

Objectives. The contribution of maternal skeletal calcium metabolism in pregnancy is evidenced in changes in the markers of bone formation and bone resorption. Changes in maternal bone markers could affect fetal bone mineralization. The aim of this study was to determine the association between maternal and cord blood bone markers.

Methods. Five hundred and fifty-two pregnant women were recruited from Tehran University educating hospitals in the winter of 2002. Maternal and cord blood samples were taken at delivery. The serum was assayed for osteocalcin and crosslaps, calcium, and parathyroid hormone.

Results. There was significant correlation between maternal and cord blood serum osteocalcin and crosslaps levels, and the mean cord blood levels of osteocalcin and crosslaps were significantly higher at about 1.59- and 1.62-fold maternal levels, respectively. Serum calcium levels strongly correlated with osteocalcin and crosslaps in mothers (r = 0.21, p = 0.001 and r = 0.25, p = 0.001, respectively).

Conclusions. Skeletal calcium release may play a major role in calcium homeostasis during pregnancy. Because of this, calcium supplements could have an important role in pregnant women in decreasing the risk of subsequent complications such as osteoporosis.     

Incidence of hepatitis B and HIV virus at cadaver of IV drug abusers in Tehran

Injection drug use has been the most growing rout of drug abuse in Iran in the past decade and it has been responsible for the transmission of HIV virus in more than two third of cases. The aim of the present study was to determine the prevalence of HIV and hepatitis B in a group of IDU cadavers and to compare the results to a group of cadavers of the normal population. In a case-control study the blood samples of the cadavers of 400 randomly chosen IDUS and 400 other cadavers as control group were checked for HBS antigen and Anti HIV antibody in the forensic medicine center of Tehran. The prevalence of HIV and HBV infection was compared in two groups according to their demographic characteristics. The number of HIV and HBV positive cadavers was significantly higher in the IDU group than the controls (6.25% vs 0.5%, P<0.001, 27.5% vs 3%, P<0.001). The risk of getting infected by HIV virus was 13.27 times greater in the IDU group and the risk of HBV infection was 12.26 times greater in this group as compared to the control group. The age distribution of IDU cadavers indicated that the percentage of IDU cadavers in the reproductive (21-40 years old) age was 80%. The greater prevalence of the HIV and HBV infection especially in the reproductive age of IDUS indicates a greater concern to the authorities for more attention to prevention and harm reduction programs.