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   2018| January-March  | Volume 14 | Issue 2  
    Online since March 8, 2018

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Verruca vulgaris of the buccal mucosa: A case report
Aastha Mattoo, Mohit Bhatia
January-March 2018, 14(2):454-456
DOI:10.4103/jcrt.JCRT_47_17  PMID:29516939
Oral verruca vulgaris is caused by human papillomavirus (HPV) infection. Verruca vulgaris most frequently occurs on the fingers, toes, soles, and dorsal surfaces of hands and is mostly asymptomatic. Varieties of verrucous and papillary lesions affect the skin as well as oral mucosa which may be either benign or reactive. Common wart is one of the most commonly observed skin growths and a lesion of childhood. Intraoral warts can occur at any age with equal incidence in both genders but are most commonly seen in the third to fifth decade. It is found commonly on the palate followed by lip, tongue, buccal mucosa, and rarely seen on gingiva. Surgical excision with adequate margins is the treatment of choice.
  9,824 440 -
Anticancer potential of leaf and leaf-derived callus extracts of Aerva javanica against MCF-7 breast cancer cell line
Desingu Kamalanathan, Devarajan Natarajan
January-March 2018, 14(2):321-327
DOI:10.4103/0973-1482.171210  PMID:29516913
Background: Aerva javanica is an exotic and medicinal plant in India. Aim of the Study: The main goal of this study was to evaluate the antiproliferative properties of leaf and leaf-derived callus extracts against human breast cancer cell line MCF-7. Methods: The plant parts were sequentially extracted with hexane, chloroform, ethyl acetate, acetone, and methanol. The extract was concentrated to yield the crude extract, which was tested for anticancer potentials. The anticancer potential of cytotoxic extracts was determined by 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and DNA fragmentation assays in human breast cancer cell lines (MCF-7). Results: All the tested extracts showed significant antiproliferative activities in a concentration- and time-dependent manner. The inhibitory concentration of extract was tested against target cell line, and the results show in vitro leaf of A. javanica has higher inhibitory effect against the tested cancer cells at lower concentration (about 11.89 and 22.45 μg/ml) followed by other samples extracts. Conclusion: The results of the present study conclude in vitro plant sample having more potent anticancer property and support the need of further studies to isolate potential anticancer drug with cancer cell-specific cytotoxicity.
  4,746 683 -
The effect of mesenchymal stem cell-conditioned medium on proliferation and apoptosis of breast cancer cell line
Leila Farahmand, Rezvan Esmaeili, Leila Eini, Keivan Majidzadeh-A
January-March 2018, 14(2):341-344
DOI:10.4103/0973-1482.177213  PMID:29516916
Purpose: Bone marrow-derived mesenchymal stem cells (MSCs) have the potential ability to differentiate into bone, muscle, fat, and cartilage lineage cells. Furthermore, MSCs are known to migrate into tumor-associated stroma of cancer. This tumor microenvironment consists of a dynamic network of growth factors, immune cells, fibroblasts, extracellular matrix, and MSCs. MSCs as nonhematopoietic stem cells affect tumor, epithelial cells by alteration proliferative capacity, morphology, and aggregation pattern of tumor cells. Materials and Methods: This research aimed to further elucidate the MSCs effects in the progress of proliferation, cell cycle, and apoptosis in breast cancer by gene expression analysis in human breast cancer cell lines exposed to MSCs conditioned media (CM). Expression pattern of two genes, including survivin (Birc5) as anti-apoptotic gene and serine threonine kinase 15 as proliferative gene, were studied. Results: Anti-apoptotic and proliferative genes were up-regulated in co-cultured breast tumor cells with MSCs-CM that correlate with tumor progression and poor prognosis. Conclusion: Our results and other findings indicate the interaction of breast tumor cells with MSCs through paracrine factors. Also, the applications of MSCs as therapeutic tools are facing controversial concerns.
  3,550 294 -
Biological markers as an outcome measure of exercise in cancer rehabilitation: A systematic review
Lauri-Anne McDermott, Marie H Murphy, Andrea M McNeilly, Jane P Rankin, Jackie H Gracey
January-March 2018, 14(2):267-277
DOI:10.4103/0973-1482.191036  PMID:29516906
The number of people living with and beyond cancer is at an all time high. These survivors are not necessarily living well, as adverse side effects from cancer and its treatment can last up to 5 years and leave patients at a higher risk of developing secondary cancers and other chronic illnesses. Exercise has been proven to be a safe and effective method of intervention to decrease mortality and overall improve health outcomes. The biological mechanism through which this occurs is an area of research that is in its infancy and not well defined. A systematic search was conducted of four databases for relevant randomized controlled trials (RCTs) published between January 2004 and December 2014. Studies had to include any blood/urine biological markers as an outcome measure to a physical activity intervention for cancer survivors posttreatment. Fifteen relevant articles were identified (12 RCTs). It was shown that randomized controlled trials of exercise for cancer survivors posttreatment may results in changes to circulating levels of insulin, insulin related pathways (insulin like growth factor II [IGF II], IGF binding protein 3), high density lipoprotein, total cholesterol, leptin, and osteocalcin. Due to small sample sizes, the evidence is still preliminary and therefore more research is warranted in this area in the form of larger, statistically powered RCTs for cancer survivors.
  3,627 188 -
Renal cell carcinoma presenting with heart metastasis without inferior vena caval and right atrial involvement
Suleyman Sahin, Fatih Karatas, Muhammet Bekir Hacioglu, Aydin Aytekin, Ebru Cilbir, Isik Conkbayir
January-March 2018, 14(2):457-458
DOI:10.4103/0973-1482.193111  PMID:29516940
Heart metastasis of renal cell carcinoma (RCC) without vena cava inferior involvement is exceptionally rare. Here, we presented a case of RCC presenting with the right ventricle metastasis without inferior vena caval and right atrial involvement.
  3,242 118 -
The effects of thymoquinone and genistein treatment on telomerase activity, apoptosis, angiogenesis, and survival in thyroid cancer cell lines
Sibel Azizenur Ozturk, Ebru Alp, Atiye Seda Yar Saglam, Ece Konac, Emine Sevda Menevse
January-March 2018, 14(2):328-334
DOI:10.4103/0973-1482.202886  PMID:29516914
Context: Thyroid cancers (TCs) are the most common endocrine malignancies. There were two problems with the current cancer chemotherapy: the ineffectiveness of treatment due to resistance to cancer cell, and the toxic effect on normal cells. Aims: This study was aimed to determine the effects of thymoquinone (TQ) and genistein (Gen) phytotherapeutics on telomerase activity, angiogenesis, and apoptosis in follicular and anaplastic thyroid cancer cells (TCCs). Materials and Methods: Cell viability, caspase-3 (CASP-3) activity, and messenger RNA (mRNA) expression levels of human telomerase reverse transcriptase (hTERT), phosphatase and tensin homolog (PTEN), nuclear factor-kappa B (NF-kB), cyclin-dependent kinase inhibitor 1 (p21), and vascular endothelial growth factor-A (VEGF-A) genes were analyzed. Results: It was found that TQ and Gen treatment on TCCs caused a statistically significant decrease of cell viability, and mRNA expression levels of hTERT, VEGF-A, and NF-kB genes, but a statistically significant increase of PTEN and p21 mRNA expression levels. In addition, TQ and Gen treatment also caused a statistically significant increase active CASP-3 protein level in TCCs. Moreover, our results demonstrated that, when compared with follicular TCCs, anaplastic TCCs were more sensitive to the treatment of TQ and Gen. Conclusions: Based on these results, two agents can be good options as potential phytochemotherapeutics against TCCs.
  3,055 187 -
Effect of staining procedures on the results of micronucleus assay in the exfoliated buccal mucosal cells of smokers and nonsmokers: A pilot study
Rashmi Metgud, Bhardwaj Tina Neelesh
January-March 2018, 14(2):372-376
DOI:10.4103/0973-1482.157351  PMID:29516922
Background: Tobacco consumption in smoke form causes severe health problems such as cancer. Micronuclei are structures that present after genomic damage in buccal mucosal cells which could be a good indicator of chromosomal alterations in cytological samples. The nuclear anomalies that are consequences of cell injury are also found in these cells. Aim: The present study was aimed at evaluating the effectiveness of deoxyribonucleic acid (DNA)-specific stain over DNA-nonspecific stain in exfoliated buccal mucosa cells in smokers and nonsmokers for assessment of micronuclei and nuclear anomalies. Materials and Methods: Thirty subjects were divided into three groups; Group 1 (control) nonsmokers (n = 10), Group 2 individuals with history of smoking for less than 10 years (n = 10), and Group 3 individuals with history of smoking for more than 10 years (n = 10). The exfoliated buccal mucosal cells were scrapped using wooden spatula, smeared over the glass slide, and stained with DNA-nonspecific stain, Giemsa; and DNA-specific stains, Feulgen and acridine orange. Results: We found that the mean micronuclei score with DNA-nonspecific stain, Giemsa, was significantly higher in smokers group when compared to nonsmokers group. No such significant differences were observed with DNA-specific stains. Also, in the smokers groups, mean micronuclei were higher in Group 3 when compared to Group 2. Conclusion: The score of MN assay and nuclear anomalies in exfoliated buccal mucosal cells of smokers and nonsmokers strongly depended on staining procedures and duration of smoking. Hence, these should be interpreted with caution to avoid false-positive results.
  2,969 219 -
The effects of gilaburu (Viburnum opulus) juice on experimentally induced Ehrlich ascites tumor in mice
Dilek Ceylan, Ahmet Aksoy, Tolga Ertekin, Arzu Hanım Yay, Mehtap Nisari, Gökçe Şeker Karatoprak, Harun Ülger
January-March 2018, 14(2):314-320
DOI:10.4103/0973-1482.181173  PMID:29516912
Objective: The aim of study was to investigate anticancer effect of Viburnum opulus (VO) on Ehrlich ascites carcinoma (EAC) bearing mice that treated with different concentrations of VO. Materials and Methods: For tumor transplantation; mice were inoculated with 1 × 106 EAC cells intraperitoneally and than divided into five groups (n = 9). Two hours after inoculation; experimental groups were treated daily with VO extract at doses of 1000 mg/kg, 2000 mg/kg, 4000 mg/kg. Results: Extracts obtained from gilaburu juice can have hinder effect on tumor cell growth. Conclusion: As far as we known, this is the first study about in vivo antitumoral activity of VOon Ehrlich ascites tumor model, and consequently VO extract exhibited anticancer activity against EAC-bearing mice.
  2,840 330 -
Comparison of full width at half maximum and penumbra of different Gamma Knife models
Sepideh Asgari, Nooshin Banaee, Hassan Ali Nedaie
January-March 2018, 14(2):260-266
DOI:10.4103/0973-1482.189248  PMID:29516905
As a radiosurgical tool, Gamma Knife has the best and widespread name recognition. Gamma Knife is a noninvasive intracranial technique invented and developed by Swedish neurosurgeon Lars Leksell. The first commercial Leksell Gamma Knife entered the therapeutic armamentarium at the University of Pittsburgh in the United States on August 1987. Since that time, different generation of Gamma Knife developed. In this study, the technical points and dosimetric parameters including full width at half maximum and penumbra on different generation of Gamma Knife will be reviewed and compared. The results of this review study show that the rotating gamma system provides a better dose conformity.
  2,959 136 -
Giant cells in soft tissue tumors! Is it a clue to diagnosis or cytologists mystery??? An unusual case report
HL Kishanprasad, Lancelot Lobo, Jayaprakash K Shetty, BD Impana
January-March 2018, 14(2):444-446
DOI:10.4103/0973-1482.199433  PMID:29516936
Giant cells in soft tissue (ST) tumors are rare, pose great challenges to treating clinicians, and diagnosing pathologists. Common lesion with giant cells includes benign conditions such as nodular fasciitis to highly malignant lesions such as giant cell variant of malignant fibrous histiocytoma and extraskeletal osteosarcoma. Giant cell tumors of ST, extension of bony lesion to the ST are also rare possibilities. Recently, giant cell fibroblastoma and dermatofibrosarcoma protuberans have also been added to this list. These tumors show unpredictable behavior; some patients are cured by simple surgical excision whereas others develop metastasis. Diagnosing these in cytology is still more challenging. We report here a rare case of a giant cell-rich dermatofibrosarcoma protuberans in a 23-year-old male who presented with ST lesion in left forearm since 6 months. The lesion was predicted in fine-needle aspiration cytology and confirmed later with histopathology. When evaluated along with clinical features, the cytological features are very useful to distinguish between these tumors with giant cell morphology.
  2,761 134 -
Parosteal osteosarcoma of mandible: A rare case report
Swati Gupta, Shilpa Parikh, Sumit Goel
January-March 2018, 14(2):471-474
DOI:10.4103/0973-1482.176420  PMID:29516945
With the exception of multiple myelomas, osteosarcoma is the most frequently occurring primary malignant bone tumor with an overall incidence of 1:100,000/year. It has greatest predilection for the metaphyses, most frequently femur and tibia. However, osteosarcomas affecting the craniofacial bones are infrequent. Two main types: intramedullary and juxtacortical varieties are seen. Juxtacortical variety is further subdivided into periosteal and parosteal variants. Due to its rarity, only 13 cases of parosteal osteosarcoma have been reported till date. A 35-year-old male patient with affected postirradiated mandible is being reported as the 14th case of this kind with its unique benign presentation and less aggressive nature.
  2,560 279 -
Sonographic imaging of fibrosis of oral mucosa and its correlation with clinical staging in oral submucous fibrosis
Lakshmi Kavitha Nadendla, Venkat Kishan Tatikonda, Balaji Babu Bangi, Harsha Bhayya, Revath Vyas Devulapally, Archana Pokala
January-March 2018, 14(2):394-397
DOI:10.4103/0973-1482.183194  PMID:29516926
Background and Objectives: To evaluate the efficacy of ultrasonography (USG) as a noninvasive tool in assessing the severity of oral submucous fibrosis (OSMF) by measuring the submucosal thickness and also to correlate the sonographic changes with clinical staging. Materials and Methods: The submucosal thickness of the upper and lower labial mucosa, anterior and posterior portions of the right and left buccal mucosa were measured using ultrasound in 64 patients comprising of 32 OSMF patients and 32 controls. Among the controls, 16 were with a habit of chewing gutkha and 16 were without any habit history. Results: In OSMF group, four patients were with Stage I, 13 were with Stage II, 11 were with Stage III, and four with Stage IV. Results were analyzed by one-way analysis of variance for the significance of difference among the groups in submucosal thickness. As the stages of OSMF advanced, there was an increase in submucosal thickness of the buccal mucosa in the study group when compared with controls (P< 0.005). Conclusion: USG is an effective noninvasive zero radiation tool for assessing the progression of OSMF.
  2,575 259 -
Treatment of breast cancer in a patient of Alport syndrome-induced chronic renal failure: A triumph story
Gaurang Modi, Irappa Madabhavi, Apurva Patel, Asha Anand
January-March 2018, 14(2):462-464
DOI:10.4103/0973-1482.180680  PMID:29516942
Alport syndrome is a hereditary disease of the glomerular basement membrane, characterized by the familial occurrence of progressive, hematuric nephropathy with sensorineural deafness. We are reporting here a young adult female, suffering from Alport syndrome with significant family history and on maintenance twice-weekly hemodialysis (HD), had been diagnosed with triple negative earlystage right-sided breast cancer. The patient was managed successfully with surgery and adjuvant chemotherapy with 3 cycles of 5-flurouracil, doxorubicin, and cyclophosphamide and 3 cycles of docetaxel. In this case, our clinical challenge was dose reduction of chemotherapeutic agents according to creatinine clearance and timing of HD in each cycle of chemotherapy. We confronted this by dose reduction of cyclophosphamide and timing of chemotherapy was at least 12 h after HD for each and every cycle. Patient is in regular follow-up in our department since 20 months without any recurrence of the disease.
  2,731 100 -
A study of clinicopathological characteristics of thyroid carcinoma at a Tertiary Care Center
Ankit A Shah, Preeti P Jain, Anjaney S Dubey, Ghanish N Panjwani, Hiral A Shah
January-March 2018, 14(2):357-360
DOI:10.4103/0973-1482.180611  PMID:29516919
Context: To share clinicopathological data of thyroid carcinoma from a high volume Tertiary Care Centre in East India. Aim: To share the epidemiology and clinicopathological presentation of thyroid cancer at a high volume Tertiary Care Center in East India. Settings and Design: Retrospective observational study. Subjects and Methods: Forty-two consecutive patients of thyroid neoplasm diagnosed by fine needle aspiration cytology (FNAC) and primarily underwent surgical treatment from July 2005 to June 2012 were included. Retrospective data analyses of patient's records were done. Statistical Analysis Used: The statistical analysis was performed using Epi Info version 3.5.3. Results: Forty-two patients underwent surgery for thyroid neoplasm. Median age of diagnosis was 39 years. It was 6 times more common in females (female:male - 6:1). Papillary carcinoma consists of 63.15%, follicular carcinoma consists of 23.68%, and medullary carcinoma and anaplastic carcinoma each consist of 5.26% of malignant cases. Out of them, lymph node metastases were seen in 17 patients (44.73%). FNAC shows positive predictive value of 89.74%. Conclusions: In our study, differentiated thyroid cancers were found to be more common in younger age group. Cervical lymph node metastases occur in a large number of patients. Central compartment lymph node dissection with exploration of lateral neck and modified neck dissection whenever needed is helpful in all cases of thyroid carcinoma for proper pathological staging. FNAC is rapid and efficient procedure with high positive predictive value in diagnosing thyroid neoplastic lesions.
  2,623 154 -
Comparison of immunohistochemical expression of vascular endothelial growth factor and CD105 in oral squamous cell carcinoma: Its correlation with prognosis
BR Patil, Kishore Bhat, Pradeep Somannavar, Jagadish Hosmani, Vijayalakshmi Kotrashetti, Ramakant Nayak
January-March 2018, 14(2):421-427
DOI:10.4103/0973-1482.160908  PMID:29516931
Objectives: Compare and correlate immunoexpression of vascular endothelial growth factor (VEGF) and CD105 in oral squamous cell carcinoma (OSCC), and correlate its expression with the prognosis of the patient. Materials and Methods: A retrospective study was carried out on total of 49 cases of OSCC. Detailed demographic and clinical data were obtained, and tissue sections were stained with hematoxylin and eosin to grade the tumor. Later each case was subjected for immunohistochemical analysis of CD105 and VEGF. Results: All the cases showed positivity for both CD105 and VEGF but high expression was noted with CD105 compared to VEGF. Average microvascular density for CD105 was higher (69.5) in moderately differentiated squamous cell carcinoma (MDSCC) when compared to well differentiated squamous cell carcinoma (WDSCC) (52.16). When expression of CD105 and VEGF was compared in WDSCC and MDSCC, it was statistically insignificant. However when expression of CD105 and VEGF was compared with survival of the patient, survival rate was <2 years in CD105 and was statistically significant, but VEGF did not show any significant difference with survival rate. Conclusion: CD105 immunoexpression in OSCC predicts a poor outcome than VEGF. So it can be postulated that endoglin may have a particular role in the development of cancer and might be relatively more specific than commonly used endothelial markers for squamous cell carcinoma of the oral cavity.
  2,540 156 -
Pattern of invasion as a factor in determining lymph node metastasis in oral squamous cell carcinoma
Tahura Khwaja, Amsavardani S Tayaar, Swetha Acharya, Jayadey Bhushan, MV Muddapur
January-March 2018, 14(2):382-387
DOI:10.4103/0973-1482.187281  PMID:29516924
Context: Lymph node metastasis (LNM) influences survival of oral squamous cell carcinoma (OSCC). Evidence supports the value of prognostic information provided by most aggressive cells that lie in the tumor invasive front. Aims: This study evaluated the clinical and histological parameters (C and HP) that would best associate with LNM in OSCC. Settings and Design: A review of records and histological examination of nonrecurrent surgically treated 182 cases. Subjects and Methods: A review of records and histological examination according to the Bryne's invasive front grading system of nonrecurrent surgically treated 182 cases (pN− =100; pN+ =82) was undertaken. The data were subjected to suitable statistical analysis to check the agreement between observers, association of the parameters to LNM, and to identify the best among all of them. Statistical Analysis Used: Kappa statistics, Pearson's Chi-square, Fisher's exact test, multiple logistic regression analysis. Results: None of the C and HP, with the exception of pattern of invasion (PI) (P = 0.000), modified degree of keratinization and nuclear polymorphism (P = 0.041, 0.022), and total malignancy score for survival (P = 0.013) showed a significant association with nodal status. PI was identified as the most influencing parameter of all. Conclusions: Factor that is primarily the manifestation of tumor and its microenvironment has taken the prime seat followed by the ones that are dictated by the tumor. The factors that are basically quantified were not able to show association. Site influences the nodal status alongside PI.
  2,478 211 -
Immunohistochemical evaluation of prime molecules in cervical lesions towards assessment of malignant potentiality
Lopamudra Das, Sukla Naskar, Tandra Sarkar, Ashok Kumar Maiti, Soumen Das, Jyotirmoy Chatterjee
January-March 2018, 14(2):377-381
DOI:10.4103/0973-1482.158029  PMID:29516923
Objective: A comparative immunohistochemical evaluation of p63, CD105, and E-cadherin expression pattern in histopathologically confirmed normal cervical epithelium (NCM), dysplastic cervical epithelium (DYS) and squamous cell carcinoma (SCC) of uterine cervix towards assessing malignant potentiality of the precancerous condition. Materials and Methods: The biopsies from cervical mucosa (normal, dysplasia, and cancer) were studied by routine hematoxylin and eosin (H and E) and by immunohistochemistry for p63, E-cadherin, and CD105 expression. The expressions of these molecules were assessed in a semiquantitative way by (i) counting p63 cell population and distribution, (ii) intensity scoring of E-cadherin along the expression path, and (iii) measuring CD105 expression density. Result: p63+ cells were highest in carcinomas followed by dysplasia and normal. An abrupt increase in CD105 expression was observed through change of normal to dysplasia and cancer. A decrease in membranous E-cadherin expression was noticed in the transformation from normal to precancer and cancers. Conclusion: The malignant potential of the dysplastic conditions is likely to be correlated with upregulation in p63 and CD105 expression and a simultaneous downregulation of membranous E-cadherin.
  2,327 110 -
Bone metastases without primary tumor: A well-differentiated follicular thyroid carcinoma case
Adil Boz, Gokhan Tazegul, Humeyra Bozoglan, Ozlem Dogan, Ramazan Sari, Hasan Ali Altunbas, Cumhur Arici, Guzide Ayse Ocak, Mustafa Kemal Balci
January-March 2018, 14(2):447-450
DOI:10.4103/0973-1482.199391  PMID:29516937
Metastases to the bone are the most common malignant bone tumors. Prostate, breast, and lung carcinomas are the most common primaries of bone metastases. Bone metastases show poor prognosis in means of median survival; however, some patients with highly curable tumors such as thyroid carcinoma may benefit from treatment. We report and discuss a unique case of a 70-year-old female patient presenting with arm pain, diagnosed with metastatic well-differentiated follicular carcinoma without a primary tumor in the thyroid.
  2,269 147 -
Dosimetric properties of new formulation of PRESAGE® with tin organometal catalyst: Development of sensitivity and stability to megavoltage energy
Davood Khezerloo, Hassan Ali Nedaie, Abbas Takavar, Alireza Zirak, Bagher Farhood, Nooshin Banaee, Eisa Alidokht
January-March 2018, 14(2):308-313
DOI:10.4103/0973-1482.183550  PMID:29516911
Aim: Tin-base catalyst is one of the widely used organometallic catalysts in polyurethane technology. The purpose of this study was to evaluate the effect of tin organometallic catalyst in the radiation response and radiological properties of a new formula of PRESAGE®. Materials and Methods: In the study, two types of PRESAGE were fabricated. A very little amount of dibutyltindillaurate (DBTDL) (0.07% weight) was used as a catalyst in the fabrication of new PRESAGE (i.e., PRESAGE with catalyst), which components were: 93.93% weight polyurethane, 5% weight tetrachloride, and 1% weight leucomalachite green (LMG). For PRESAGE without catalyst, 94% weight polyurethane, 4% weight tetrachloride, and 2% weight LMG were used. Radiochromic response and postirradiation stability of PRESAGEs were determined. Also, radiological characteristics of PRESAGEs, such as mass density, electron density, mass attenuation coefficient, and mass stopping power in different photon energies were assessed and compared with water. Results: The absorption peak of new PRESAGE compared to PRESAGE without catalyst was observed without change. Sensitivity of new PRESAGE was higher than PRESAGE without catalyst and its stability after the first 1 h was relatively constant. Also, Mass attenuation coefficient of new PRESAGE in energy ranges <0.1 MeV was 10% more than water, whereas the maximum difference of mass stopping power was only 3%. Conclusions: Tin organometallic catalyst in very low concentration can be used in fabrication of radiochromic polymer gel to achieve high sensitivity and stability as well as good radiological properties in the megavoltage photon beam.
  2,276 122 -
Prevalence, knowledge, and attitude of gutkha chewing among school children of Arsikere, India
Rashmi Metgud, CJ Murugesh, BN Shiva Kumar, NK Priya, P Rashmi, Smitha Naik, Aniruddh Tak
January-March 2018, 14(2):368-371
DOI:10.4103/0973-1482.174532  PMID:29516921
Aims: To assess the prevalence, knowledge, and attitude of gutkha chewing among school children of Arsikere, India. Materials and Methods: Two thousand school children aged between 10 and 15 years were examined with individual interviews along with a questionnaire to evaluate the presence of betel nut and paan chewing habit in various forms. Children of both sexes were included in the study. Responses of all study population and the association between dependent and explanatory variables were assessed using Chi-square test. Results: Twenty-eight percent of children had the habit of gutkha chewing, more among boys than girls at the ratio of 4:1 which was statistically significant (P < 0.05). The habit was more common in government school children than private school children; over 70% of children believed that it is a bad habit, but half the study population was not aware of side effects; 30% of children believed that it is not a bad habit and has no side effects. Conclusion: There is a higher prevalence of gutkha chewing habit in school children who are not aware of the side effects. Children themselves purchase the gutkha and betel nut sachets, hence the Government should ban the sale and purchase by children.
  2,211 171 -
MicroRNA-associated carcinogenesis in lung carcinoma
Pushpendra Pratap, Syed Tasleem Raza, Shania Abbas, Farzana Mahdi
January-March 2018, 14(2):249-254
DOI:10.4103/0973-1482.187283  PMID:29516903
Lung carcinoma is the leading cause of cancer-related death worldwide; it has been regarded as the origin of death by melanoma universally. Frequently, lung carcinomas identified in progressive phase and have lowermost roots of existence in any category of the cancer. MicroRNAs (miRNAs) are small having 18–25 nucleotides extended noncoding RNAs regulating gene expression and elaborate in a wide assortment of cellular progressions also. Cumulative indications propose that, miRNA plays imperative and multifarious roles in cases of human lung cancer genetics. Collective studies concern with research related to lung sarcoma by using biomarkers which determine phenotypic signatures on behalf of diagnostic, prognostic, as well as therapeutic rationale. Furthermore, a number of aspects are indispensable to be deliberated while opting for miRNAs as clinical biomarkers in lung cancers, which have been recognized as imperative targets for therapeutic interventions in recent times. This review focuses inclusive information over the biogenesis of miRNA and considerable risk dynamics associated with the genetics of human lung cancer.
  2,150 170 -
Translational research in oral cancer: “A challenging key step in moving from bench to bedside”
Neha Sharma, Rajeshwari G Annigeri
January-March 2018, 14(2):245-248
DOI:10.4103/0973-1482.183556  PMID:29516902
This review summarizes and interprets the rate of improvement in cancer treatments which have remained frustratingly slow despite considerable investment in oncological research. Hence, this review emphasizes on minimizing exposure of patients to ineffective investigational therapies by decreasing the number of poorly designed clinical trials through stronger collaboration between industry and academia which can be done by multidisciplinary teams who are essential to facilitate future cancer outcome studies focused on improving clinical care of cancer patients and implementing effective interventions to ultimately improve the quality and duration of survival. Hence, it is recommended to explore all these factors which contribute toward translational lag between implementation of discoveries from basic research into clinical use.
  2,115 170 -
Expression of p53, epidermal growth factor receptor, c-erbB2 in oral leukoplakias and oral squamous cell carcinomas
Swati Singla, Gaurav Singla, Sufian Zaheer, Dushyant Singh Rawat, Ashish Kumar Mandal
January-March 2018, 14(2):388-393
DOI:10.4103/0973-1482.191027  PMID:29516925
Background: Oral cancer is a leading cause of cancer in India and contributes to 12% deaths worldwide. The identification of high-risk oral premalignant lesions such as leukoplakia and intervention at premalignant stages could result in significant loss of mortality and morbidity among these patients. The most frequently observed genetic aberrations in these lesions are of mutations in p53, c-erbB2, and epidermal growth factor receptor (EGFR). No specific tumor markers have been identified consistently in oral leukoplakias and the available studies show wide variations in their expression. Materials and Methods: A total of eighty cases were taken up for study which included forty cases of leukoplakia and forty cases of squamous cell carcinomas (SCCs). Results: There was a significant correlation between the expression of markers p53 and EGFR in leukoplakia and SCC. The expression of p53 was correlated between leukoplakia, SCC, and control and was found to be significant (P ≤ 0.001). Similarly, EGFR expression was significant (P ≤ 0.001) between cases of leukoplakia, SCCs, and controls. c-erbB2 was found to be negative though cytoplasmic positivity was observed in a few cases. Similarly, in SCCs, it was observed that lesser the differentiation, more is the expression of both p53 and EGFR. Similarly, a definite correlation was observed between p53 and EGFR (P ≤ 0.001) but not with c-erbB2 (P ≤ 1.000). Conclusion: Thus, the author concludes that p53 and EGFR are useful biomarkers for the diagnosis of leukoplakia and their risk of malignant transformation.
  1,841 203 -
Adjuvant therapy for intra oral surgical oncological defect with ancillary prosthesis: A literature review
SC Ahila, SK Jagdish
January-March 2018, 14(2):255-259
DOI:10.4103/0973-1482.172118  PMID:29516904
The role of a maxillofacial prosthodontist in the treatment of facial defects cannot be underestimated. A multidisciplinary approach is required during the rehabilitation procedure to bring out effective results. Ancillary maxillofacial prostheses limit the patient's disability and improve function. These prostheses are inevitable in restoring the function, esthetics, general, and psychological health of the patients. This article reviews the various ancillary-maxillofacial prostheses and throws light on their historical development.
  1,854 141 -
Correlation between fasting blood sugar and cytomorphometric values of diabetic patient's buccal mucosa exfoliative cytology
Rahul Agrawal, Naresh Kumar, Kanupriya Gupta, Tej Bali Singh
January-March 2018, 14(2):398-402
DOI:10.4103/jcrt.JCRT_1211_16  PMID:29516927
Objectives: Type-2 diabetes mellitus (DM) has considerable prevalence in India. A noninvasive diagnostic tool will be more appropriate in conditions like DM. In this study, we intend to find a difference in cytomophometric values, and glycogen accumulation (if any) in buccal mucosa exfoliated cells of type-2 DM patients when compared to nondiabetic healthy individuals, and establish its diagnostic role. Methodology: In the present study, 36 known DM patients with at least 1-year history (case group) and 36 healthy, age- (5 year interval) -matched patients (control group) were included in the study. Patients with any other systemic disease were excluded from the study. Buccal mucosa exfoliative cytology smears were prepared from all 72 patients and stained with Papanicolaou (PAP) stain. The cytomorphometric analysis was performed to evaluate nuclear area (NA), cytoplasmic area (CA), and cytoplasm to nuclear area ratio (CNR) of cells in the smear. The data were tabulated and statistically analyzed using Chi-square test, Student's t-test, Karl Pearson's correlation coefficient and significance (two tailed) test. Results: Statistically significant difference was found in NA and CNR in exfoliative cytology of DM patient group when compared to control group. Fasting blood sugar of DM patients was significantly correlated with NA and CNR of buccal mucosa exfoliated cells. Conclusion: The cytomorphometric changes in exfoliated buccal mucosa cells of type-2 DM patients can have a diagnostic value which needs to be explored further.
  1,838 116 -
Upregulation of CXC chemokine receptor 4-CXC chemokine ligand 12 axis ininvasive breast carcinoma: A potent biomarker predicting lymph node metastasis
Reza Dayer, Sadegh Babashah, Shirin Jamshidi, Majid Sadeghizadeh
January-March 2018, 14(2):345-350
DOI:10.4103/0973-1482.177221  PMID:29516917
Objective: Breast cancer is considered as a heterogeneous disease, characterized by different biological and phenotypic features which make its diagnosis and treatment challenging. The CXC chemokine receptor 4 (CXCR4) expression was found to be correlated with poor overall survival in invasive breast carcinoma patients. Here, we sought to investigate the expression levels of the CXCR4-CXC chemokine ligand 12 (CXCL12) chemokine axis and their association with clinicopathologic features and lymph node metastasis in invasive breast carcinoma. Materials and Methods: The expression of the CXCR4-CXCL12 chemokine axis and metastasis-related genes (E-cadherin and matrix metalloproteinase 2 [MMP2]) was measured by quantitative real-time-polymerase chain reaction. The correlation with various clinicopathologic parameters was analyzed. Results: We found upregulation of the CXCR4-CXCL12 chemokine axis in invasive breast carcinoma samples compared with normal adjacent tissues. Moreover, we observed that upregulation of this chemokine axis was correlated with tumor stages and lymph node metastasis of breast tumors. Interestingly, this correlation was affected by the expression of human epidermal growth factor receptor 2/neu. There is also a significant correlation between the expression levels of CXCR4-CXCL12 axis and metastasis-related genes (E-cadherin and MMP2) in tumor samples with advanced stages of metastasis. Conclusion: These results suggest a key role for the CXCR4-CXCL12 chemokine axis in breast cancer progression and highlight the prognostic importance of this chemokine axis for breast cancer survival.
  1,791 115 -
Candidate biomarkers predictive of anthracycline and taxane efficacy against breast cancer
Shoko Norimura, Keiichi Kontani, Takako Kubo, Shin-ichiro Hashimoto, Chisa Murazawa, Koichiro Kenzaki, Dage Liu, Masafumi Tamaki, Fuminori Aki, Kazumasa Miura, Kiyoshi Yoshizawa, Akira Tangoku, Hiroyasu Yokomise
January-March 2018, 14(2):409-415
DOI:10.4103/jcrt.JCRT_1053_16  PMID:29516929
Background: Since breast cancer shows diversity in clinical behaviors, a standard therapy does not always lead to favorable outcomes. Materials and Methods: The expression statuses of candidate markers, including topoisomerase-II alpha (TOP2A), beta-tubulin (B-tub), and tissue inhibitor of metalloprotease-1 (TIMP-1), were immunohistochemically evaluated in 70 breast cancer tissues from 68 patients with advanced breast cancers receiving chemotherapy. Results: The response rates to anthracycline and taxane were 70.5% and 67.2%, respectively. Overall, 25.1% ± 29.7%, 8.32% ± 10.1%, and 16.37% ±17.5% of cancer cells in the tumors studied were positive for B-tub, TOP2A, and TIMP-1 expressions, respectively. However, positive molecule expression did not differ between patients who did and did not exhibit clinical responses to treatment. The proportion of TOP2A-positive cancer cells was significantly higher among anthracycline responders than among nonresponders in HR-negative cancer (15.4% ±17.5% vs. 2.0% ± 2.4%, respectively, P = 0.048), whereas TOP2A and TIMP-1 expression statuses did not differ in HR-positive cancer. When patients were stratified according to B-tub, TOP2A, or TIMP-1 expression statuses (B-tub ≥10% vs. <10%, TOP2A ≥5% vs. <5%, TIMP-1 ≤20% vs. >20%, respectively), the proportion of patients with ≥10% B-tub-positive cancer cells was significantly higher in taxane responders than in nonresponders (72.4% vs. 37.5%, respectively, P = 0.016). Anthracycline responders showed a trend to have a higher proportion of patients with either ≥5% TOP2A-positive cancer cells or ≤20% TIMP-1-positive cancer cells compared to nonresponders (86.7% vs. 61.5%, respectively, P = 0.066). Conclusion: Immunohistochemical TOP2A, TIMP-1, and B-tub expression analyses are expected to be useful for predicting tumor responses to chemotherapy.
  1,819 78 -
Cytological and histological correlation of granular cell tumor in a series of three cases
Soutrik Das, Ram Narayan Das, Anway Sen, Uttara Chatterjee, Chhanda Datta, Manoj Choudhuri
January-March 2018, 14(2):459-461
DOI:10.4103/jcrt.JCRT_876_14  PMID:29516941
Granular cell tumor (GCT) is an uncommon soft tissue tumor characterized by proliferation of cells with granular eosinophilic cytoplasm. We came across three such tumors, one in the tongue, one in the chest wall, and one in the right deltoid region, which were referred for fine-needle aspiration cytology. On cytological examination, the first two cases were diagnosed as GCT, and the mass in deltoid region was suggestive of proliferative myositis. The cytological details of these cases are discussed. The excision biopsies of the first two cases and Tru-cut biopsy of the deltoid mass confirmed the diagnosis of GCT.
  1,813 76 -
Cyclin D1 overexpression associated with activation of STAT3 in oral carcinoma patients from South India
VG Deepak Roshan, MS Sinto, Shaji Thomas, S. Kannan
January-March 2018, 14(2):403-408
DOI:10.4103/0973-1482.188295  PMID:29516928
Background: Our previous study showed that overexpression of cyclin D1 protein is associated with poor prognosis in oral squamous cell carcinoma (OSCC) patients. Regarding the alteration in the transactivating pathway regulating cyclin D1 expression is still unclear in OSCC from our population. Objectives: The major objective of this study is to understand the alteration associated with the transactivation pathway regulating the cyclin D1 overexpression in OSCC patients from our population. Materials and Methods: Alteration in the transactivation pathway regulating cyclin D1 expression was evaluated in tumor sample from OSCC patients. The findings were further validated using in vitro knockdown model in OSCC cell line. Results: Results from the patients' samples showed that the Phospho-STAT3 has a significant association with cyclin D1 overexpression in OSCC tumor samples. Further knockdown in vitro studies using SCC66 showed a significant correlation between STAT3 and cyclin D1 in OSCC. Conclusion: The results from this study showed that in our population the cyclin D1 overexpression is associated with hyperactivation of STAT3 pathway. Our previous result has shown that the cyclin D1 protein overexpression is associated with poor prognosis in OSCC patients. Hence, STAT3 pathway will be better target for the patients with increased cyclin D1 in OSCC patients from our population.
  1,762 125 -
Evaluation of serum levels of oxidized and reduced glutathione and total antioxidant capacity in patients with head and neck squamous cell carcinoma
Atessa Pakfetrat, Zohreh Dalirsani, Seyed Issac Hashemy, Ala Ghazi, Leyla Vazifeh Mostaan, Kazem Anvari, Atekeh Movaghari Pour
January-March 2018, 14(2):428-431
DOI:10.4103/0973-1482.189229  PMID:29516932
Background and Aim: Squamous cell carcinoma (SCC) is the most common type of oral cancer, and it is important for it to be diagnosed in early stages. Researchers are interested in exploring the possibility of using biomarkers in the diagnosis of SCC in early stages. One of the detectable biomarkers in the serum is glutathione. Glutathione includes two forms: reduced form (or GSH) and oxidized form (or GSSG). The GSH/GSSG ratio tends to decrease in severe oxidative stress. The aim of this study was to assess the serum levels of GSH and GSSG as well as GSH/GSSG as total antioxidant capacity in patients with head and neck SCC (HNSCC) and to subsequently compare them with healthy controls. Materials and Methods: Twenty HNSCC patients as well as twenty healthy controls were included in the study. A blood sample of 5 ml was obtained from both the case and control groups. GSH, GSSG, and total antioxidant capacity were measured spectrophotometrically. Results: No significant difference in the level of GSSG was observed in the patients from the case and control groups (P = 0.796), whereas the level of GSH and GSH/GSSG was significantly lower in the case group (P = 0.002, P = 0.011, respectively). There was no significant relationship between the level of GSH, GSSG, and total antioxidant capacity, on the one hand, and the stage and grade of the tumor, on the other hand. Conclusion: Since the levels of GSH and GSH/GSSG were significantly lower in the case group, GSH/GSSG could be used as a prognostic factor for the early diagnosis of HNSCC.
  1,735 151 -
Dosimetric verification of small fields in the lung using lung-equivalent polymer gel and Monte Carlo simulation
Nahideh Gharehaghaji, Habib Alah Dadgar
January-March 2018, 14(2):278-286
DOI:10.4103/0973-1482.191040  PMID:29516907
Purpose: The main purpose of this study was evaluate a polymer-gel-dosimeter (PGD) for three-dimensional verification of dose distributions in the lung that is called lung-equivalent gel (LEG) and then to compare its result with Monte Carlo (MC) method. Materials and Methods: In the present study, to achieve a lung density for PGD, gel is beaten until foam is obtained, and then sodium dodecyl sulfate is added as a surfactant to increase the surface tension of the gel. The foam gel was irradiated with 1 cm × 1 cm field size in the 6 MV photon beams of ONCOR SIEMENS LINAC, along the central axis of the gel. The LEG was then scanned on a 1.5 Tesla magnetic resonance imaging scanner after irradiation using a multiple-spin echo sequence. Least-square fitting the pixel values from 32 consecutive images using a single exponential decay function derived the R2 relaxation rates. Moreover, 6 and 18 MV photon beams of ONCOR SIEMENS LINAC are simulated using MCNPX MC Code. The MC model is used to calculate the depth dose water and low-density water resembling the soft tissue and lung, respectively. Results: Percentages of dose reduction in the lung region relative to homogeneous phantom for 6 MV photon beam were 44.6%, 39%, 13%, and 7% for 0.5 cm × 0.5 cm, 1 cm × 1 cm, 2 cm × 2 cm, and 3 cm × 3 cm fields, respectively. For 18 MV photon beam, the results were found to be 82%, 69%, 46%, and 25.8% for the same field sizes, respectively. Preliminary results show good agreement between depth dose measured with the LEG and the depth dose calculated using MCNP code. Conclusion: Our study showed that the dose reduction with small fields in the lung was very high. Thus, inaccurate prediction of absorbed dose inside the lung and also lung/soft-tissue interfaces with small photon beams may lead to critical consequences for treatment outcome.
  1,761 113 -
Morphometric computer-assisted image analysis of epithelial cells in different grades of oral squamous cell carcinoma
Chatterjee Ananjan, Mahadesh Jyothi, BL Laxmidevi, Pillai Arun Gopinathan, Salroo Humaira Nazir, L Pradeep
January-March 2018, 14(2):361-367
DOI:10.4103/0973-1482.189423  PMID:29516920
Introduction: Oral squamous cell carcinoma (OSCC) accounts 94% of all malignant lesions in the oral cavity. In the assessment of OSCC, nowadays the WHO grading system has been followed widely but due to its subjectivity, investigators applied the sophisticated technique of computer-assisted image analysis in the grading of carcinoma in larynx, lungs, esophagus, and cervix to make it more objective. Aims and Objectives: Access, analyze, and compare the cellular area (CA); cytoplasmic area (Cyt A); nuclear area (NA); nuclear perimeter (NP); nuclear form factor (NF); and nuclear-cytoplasmic ratio (N/C) of the cells in different grades of OSCC. Materials and Methods: Fifty OSCC cases were obtained and stained with hematoxylin and eosin which were graded according to the WHO classification. The sections were subjected to morphometric analysis to analyze all the morphometric parameters in different grades of OSCC and subjected to one-way ANOVA statistical analysis. Results: CA and Cyt A decreased from normal mucosa with dedifferentiation of OSCC. The NA and NP increased in carcinoma group when compared to normal mucosa but decreased with dedifferentiation of OSCC (P < 0.05). NF had no significance with normal mucosa and different grades of OSCC (P > 0.05), while N/C ratio increased from normal mucosa through increasing grades of OSCC, reaching the highest value in poorly differentiated squamous cell carcinoma (P < 0.05). Conclusion: Both cellular and nuclear variables provide a more accurate indication of tumor aggressiveness than any single parameter. Morphometric analysis can be a reliable tool to determine objectively the degree of malignancy at the invasive tumor front.
  1,610 153 -
Aggressive laryngeal fibromatosis: A case report and brief review
Enam Murshed Khan, Arpita Sutradhar, Sougata Bandopadhay
January-March 2018, 14(2):465-467
DOI:10.4103/0973-1482.183554  PMID:29516943
We describe a rare case of aggressive fibromatosis of the larynx occurring in a 72-year-old man. The lesion manifested with complaints of dyspnea and stridor. A computerized tomographic scan of the neck revealed irregular polypoidal growth invading right vocal cord, crossing midline. A malignant tumor was suspected. Although several laryngoscopy-driven biopsies were negative for malignancy, total laryngectomy was done since the lesion was not deemed amenable to conservative therapy. Tissue sections featured a moderately cellular lesion composed of spindle cells with bland, elongated nuclei, enmeshed in a variably collagenized ground substance. The spindle cells were immunopositive for vimentin and negative for cytokeratins, PGP-9.5, smooth muscle antigen, CD68, desmin, and S-100 protein and Ki-67 of 4%. No further therapy was administered. Based on the available literature, our data confirm that aggressive laryngeal fibromatosis in adult patients is a locally infiltrating disease. Total laryngectomy with clear margins is needed as to avoid the high risk of local recurrence.
  1,675 75 -
Circulating miR-21 as novel biomarker in gastric cancer: Diagnostic and prognostic biomarker
Miganoosh Simonian, Meysam Mosallayi, Hamed Mirzaei
January-March 2018, 14(2):475-475
DOI:10.4103/0973-1482.175428  PMID:29516946
  1,636 108 -
Evaluating factors affecting survival in colon and rectum cancer: A prospective cohort study with 161 patients
Suleyman Kalcan, Abdullah Sisik, Fatih Basak, Mustafa Hasbahceci, Ali Kilic, Koray Kosmaz, Ali Ediz Kivanc, Ilyas Kudas, Gurhan Bas, Orhan Alimoglu
January-March 2018, 14(2):416-420
DOI:10.4103/0973-1482.199390  PMID:29516930
Context: Colorectal cancers are frequent among cancers of gastrointestinal system. Whether there are any differences between survival in rectum and colon cancer patients is controversial. Aims: In this study, we aimed to compare survival in surgically treated rectum and colon cancers and determine the factors affecting survival. Subjects and Methods: The patients with colon and rectum cancer operated between 2009 and 2013 were examined retrospectively using prospective database. Patients were categorized as colon and rectum according to the tumor's location. Survival was identified as the primary outcome. Kaplan–Meier survival analysis and log-rank tests in survival assessment were used. Results: One hundred and sixty-one patients with a mean age of 62.8 ± 12.7 years were included in the study. Male/female ratio was 1.6. Colon and rectum patients were counted as 92 (%57.1) and 69 (%42.9), respectively. Both groups were similar in demographic data (P > 0.05). It was observed that in 46 months (mean) of follow-up, 39.7% (n: 64) died, and 60.3% (n: 97) survived. Median survival time was 79 months, and 5-year cumulative survival rate was 60.8%. Five-year cumulative survival rates in stages for 1, 2, 3 and 4 were 88.2%, 64.7%, 48.5%, and 37.0%, respectively. It was noted that median survival time for colon cancer was 78 months and for rectum cancer was 79 months. Five-year cumulative survival rates for colon and rectum cancers were calculated as 56.7% and 63.4%, respectively. There were no significant differences in colon and rectum cancers in the means of survival rate (P: 0.459). Conclusions: While location of colorectal cancers shows no significant effect on survival, treatment in the early stages increases survival rate.
  1,596 116 -
Carcinoma esophagus with xeroderma pigmentosa: Case report on a rare association
P Guru Sai Ratna Priya, MG Janaki
January-March 2018, 14(2):451-453
DOI:10.4103/jcrt.JCRT_1264_16  PMID:29516938
Radiation in patients with diseases such as xeroderma pigmentosa (XP), systemic lupus erythematosus, and other connective diseases is a matter of concern because of higher incidence of toxicities. Here with, we are reporting a case of carcinoma esophagus with XP, who tolerated the treatment well with sufficiently prolonged palliation of symptoms, after treatment with external beam radiotherapy. This might be attributed to the different mechanisms of DNA damage and repair mechanisms for ultraviolet (UV) rays and X-rays. UV rays cause DNA damage by dimer formation whereas X-rays will cause single- or double-stranded breaks in DNA. The repair mechanisms for UV rays are nucleotide excision repair and translesion synthesis while for X-rays, they are base excision repair, homologous recombination, and nonhomologous end joining, and these repair mechanisms for X-rays are intact in a XP patient. Hence, they can be been treated with high dose of radiation, and they do tolerate the treatment well.
  1,629 67 -
Pleomorphic adenoma of palate with predominant chondroid tissue: A rarity
Treville Pereira, Subraj Shetty
January-March 2018, 14(2):476-477
DOI:10.4103/0973-1482.202898  PMID:29516947
  1,562 103 -
Patterns of tobacco use in patients with upper aero digestive tract cancers: A hospital-based study
Amal Chandra Kataki, Jagannath Dev Sharma, Manigreeva Krishnatreya, Nizara Baishya, Manoj Kalita
January-March 2018, 14(2):437-440
DOI:10.4103/0973-1482.199459  PMID:29516934
Background: Tobacco use is a major risk factor for increasing the burden of upper aero digestive tract (UADT) cancer in the population of Northeast India. Objective: The objective of this study was to investigate the pattern of tobacco use in different UADT cancer. Materials and Methods: This was a retrospective study of electronically recorded data of the Hospital Cancer Registry for the period of May 2014 to December 2014. The UADT cancers were evaluated for gender and age-group distribution, their relative proportion, and association with tobacco use and tobacco-associated risk in males to develop UADT cancers. The type of tobacco usage was clustered as chewable, smoking, and both. Relative risk (RR) of UADT with tobacco usage was identified for males. Results: A total of 1965 (n) UADT cancer patients were identified, male:female was 2.9, tobacco habits was in 1608 (81.8%) patients, both forms of tobacco use in 705 (43.8%), chewable tobacco use in 588 (36.6%) and smoking in 315 (19.6%) patients, tobacco habits in males ranges from 67.3% to 94.3% and in females range from 5.7% to 32.7%, RR of UADT cancer in males for tongue cancer was 1.5 (confidence interval [CI] =1.2–1.9), oropharynx was 1.4 (CI = 1.0–1.8), hypopharynx 1.4 (CI = 1.1–1.7), esophageal cancer was 1.4 (CI = 1.3–1.7), and for laryngeal cancer RR was 1.7 (CI = 1.0–3.0). Conclusion: Consumption of chewable tobacco is the major form of tobacco use alone or in combination in UADT cancer patients of our population.
  1,471 167 -
Calculation of the contrast of the calcification in digital mammography system: Gate validation
Dooman Arefan, Alireza Talebpour, Nasrin Ahmadinejhad, Alireza Kamali Asl
January-March 2018, 14(2):335-340
DOI:10.4103/0973-1482.168967  PMID:29516915
Purpose: Validation of the Gate tool in digital mammography image simulation from the viewpoint of image quality (contrast of calcifications). Materials and Methods: The polymethyl methacrylate (PMMA) phantom containing aluminum foils in different thicknesses is used for measuring the contrast of calcifications in a real system. In this research, the phantom and mammography system have been simulated by the Gate tool with the maximum possible details. The contrast of the aluminum foil in simulations and practical method has been compared with each other and the standard errors in the mean (SEM) for various voltages of X-ray tube, aluminum foil, and PMMA thicknesses have been reported. Results: Based on the obtained results, by increasing the X-ray tube voltage from 20 to 39 kVp, the image contrast has been decreased in both simulation and practical methods. The minimum and maximum average SEM of the contrast of the aluminum foils among various voltages between two simulations and practical methods for different PMMA thicknesses of 2, 4, and 6 cm have been reported as 0.0105 and 0.0117, 0.0049 and 0.0154, and 0.0037 and 0.0072, respectively. Discussion: According to the SEM rate reported in this research for calculating the contrast of the aluminum foils in the mammography system based on simulation and practical methods, the capability of the Gate tool for simulating digital mammography system and the images created in it from the viewpoint of image contrast can be confirmed.
  1,512 94 -
A novel quantification method for low-density gel dosimeter
Hasan Ali Nedaie, Farideh Pak, Vahid Vaezzadeh, Ehsan Eqlimi, Abas Takavar, Hamid Reza Saligheh Rad, Mohammad Amin Mosleh Shirazi, Mona Mirheydari
January-March 2018, 14(2):292-299
DOI:10.4103/jcrt.JCRT_1_17  PMID:29516909
Aim: Low signal-to-noise ratio (SNR) images of lung-like (low-density [LD]) gel dosimeters, compared to unit-density (UD) gels, necessitate the use of different quantification methods. Setting and Design: In this study, a new method is introduced based on noise correction and exponential (NCEXP) fitting. The feasibility of NCEXP method for quantifying dose absorption in LD gels is evaluated. Materials and Methods: Sensitivity, dose resolution, detectable dynamic range, and correlation of the calibration curve for both UD and LD gel dosimeters are the parameters, which we analyze to investigate the consequences of new method. Results of NCEXP method are compared to maximum likelihood estimation of rician distribution (MLE-R) and variable echo number (VAREC) quantification methods. Results: Dose response of LD gel dosimeter shows wider detectable dynamic range as compared to UD gel. Using NCEXP method for both LD and UD dosimeter gels, a more sensitive calibration curve with a superior dose resolution is obtained. The advantage of new quantification method is more significant for LD dosimeter gel analysis, where SNR decreases as a result of higher absorbed doses (≥10 Gy). Despite the inverse effect of the VAREC method on detectable dose range of UD gel, no specific changes are observed in dynamic dose range of LD gel dosimeter with different quantification methods. The correlations obtained with different methods were approximately of the same order for UD and LD gels. Conclusion: NCEXP method seems to be more effective than the MLE-R and VAREC methods for quantification of LD dosimeter gel, especially where high-dose absorption and steep-dose gradients exist such as those in intensity-modulated radiation therapy and stereotactic radiosurgery.
  1,517 66 -
Underdosing of the maxillary sinus for small fields used in newer radiotherapy techniques: Comparison of thermoluminescent dosimeter and Monte Carlo data
Navin Singh, Sunil Dutt Sharma, Nirmal Kumar Painuly, Abhijit Mandal, Lalit Mohan Agarwal, Ashutosh Sinha
January-March 2018, 14(2):351-356
DOI:10.4103/0973-1482.183195  PMID:29516918
Aims: To evaluate the underdosing of the maxillary sinus at its distal end produced by air cavity in the path of the 6 MV photon beam. Materials and Methods: A cubic solid water slab phantom of dimensions 18 cm × 18 cm × 18 cm with 4 cm × 4 cm × 4 cm air cavity 3 cm away from its anterior surface was used in this study. The percentage depth dose (PDD) for 6 MV X-rays along the central axis of the cubical air cavity was measured using thermoluminescent dosimeter-100 chips. The EGSnrc/DOSXYZnrc Monte Carlo (MC) code was used to estimate the PDD values in both homogeneous and inhomogeneous conditions. The dose data were generated for 1 cm × 1 cm, 2 cm × 2 cm, 3 cm × 3 cm, and 5 cm × 5 cm field sizes. Results: Average percentage dose reductions at 1 mm beyond the distal surface of the maxillary sinus for the field sizes 1 × 1, 2 × 2, and 3 × 3 cm2 are 42.4%, 39.5%, and 29.4%, respectively. However, for 5 cm × 5 cm field size, there is a dose enhancement (i.e., overdosing) at 1 mm from the distal surface of the maxillary sinus and the average percentage dose enhancement is 5.9%. Also, beyond 1 cm from the air-water interface, there is dose enhancement for all the field sizes. Conclusion: This study showed that the significant dose reduction occurs near the air-water interface for the treatment techniques using small photon fields such as intensity-modulated radiotherapy or other newer techniques. MC-based treatment planning calculation predicts realistic dose distribution while using small photon fields in the treatment of maxillary sinus.
  1,395 102 -
Disseminated cystic nodal metastasis in renal cell carcinoma mimicking systemic hydatidosis on imaging
Amit Nandan Dhar Dwivedi, Chandan Mourya
January-March 2018, 14(2):441-443
DOI:10.4103/0973-1482.174526  PMID:29516935
Cystic metastases in renal cell carcinoma (RCC) are very rare. Very few case reports can be found in literature. Retroperitoneal cystic nodal metastases have been reported in head and neck tumors. We present a very interesting case of RCC that had disseminated intraperitoneal and retroperitoneal cystic metastases that mimicked systemic hydatidosis. A detailed color Doppler sonography was followed by plain and contrast-enhanced computed tomography on a 64-slice multi-detector scanner. Imaging features were more in favor of right RCC with cystic lymph nodal metastasis. However, rare possibility of incidental hydatid disease with RCC could not be ruled out. Biopsy from left inguinal lymph nodes was taken, which confirmed metastatic deposits from RCC.
  1,381 79 -
In vivo dose estimations through transit signal measured with thimble chamber positioned along the central axis at electronic portal imaging device level in medical linear accelerator in carcinoma of the middle-third esophagus patients undergoing three-dimensional conformal radiotherapy
Putha Suman Kumar, S Banerjee, ES Arun Kumar, Challapalli Srinivas, BM Vadhiraja, PU Saxena, Ramamoorthy Ravichandran, Dinesh Pai Kasturi
January-March 2018, 14(2):300-307
DOI:10.4103/jcrt.JCRT_278_17  PMID:29516910
Objective: This study presents a method to estimate midplane dose (Diso, transit) in vivo from transit signal (St) measured with thimble ionization chamber in cancer of the middle-third esophagus patients treated with three-dimensional radiotherapy (RT). This detector is positioned at the level of electronic portal imaging device in the gantry of a medical linear accelerator. Materials and Methods: Efficacy of inhomogeneity corrections of three dose calculation algorithms available in XiO treatment planning system (TPS) for planned dose (for open fields) (Diso, TPS) was studied with three heterogeneous phantoms. Diso, transit represents measured signal at transit point (St) far away correlating to dose at isocenter. A locally fabricated thorax phantom was used to measure the in vivo midplane dose (Diso, mid) which was also estimated through St. Thirteen patients with carcinoma of the middle-third esophagus treated with three-dimensional conformal RT were studied. St was recorded (three times, with a gap of 5–6 fractions during the treatment) to estimate Diso, transit, which was compared with the doses calculated by TPS. Results: The dose predictions by superposition algorithm were superior compared to the other algorithms. Percentage deviation of Diso, transit, Diso, mid with Diso, TPS combined all fields was 2.7 and –2.6%, respectively, with the thorax phantom. The mean percentage deviation with standard deviation of estimated Diso, transit with Diso, TPS observed in patients was within standard deviation –0.73% ±2.09% (n = 39). Conclusions: Midplane dose estimates in vivo using this method provide accurate determination of delivered dose in the middle-third esophagus RT treatments. This method could be useful in similar clinical circumstances for dose confirmation and documentation.
  1,370 86 -
Dose rate and energy dependence study of methacrylic acid gelatin tetrakis (hydroxymethyl) phosphonium chloride gel with flattened and unflattened photon beams
P Sathiyaraj, James Jebaseelan Samuel
January-March 2018, 14(2):287-291
DOI:10.4103/0973-1482.191033  PMID:29516908
Aims: The aim of this study is to evaluate the dose rate and energy dependency of methacrylic acid gelatin tetrakis (hydroxymethyl) phosphonium chloride (MAGAT) gel in unflattened photon beam using X-ray computed tomography (CT) and ultraviolet (UV)-visible spectroscopy. Materials and Methods: MAGAT gel was prepared and it was exposed to 6 MV flattened and unflattened beams. The dose selected for irradiation was ranging from 3 to 15 Gy with an increment of 3 Gy. The dose rate dependency of the gel was investigated by exposing the gel to three different dose rates of 250, 500, and 1500 cGy/min for flattening filter free (FFF). To verify the energy dependency of the gel, it was exposed by both FFF and flattening filter (FF) for constant dose rate (250 cGy/min) and different energy (6 and 10 MV X-ray photons). The exposed gels were scanned by X-ray CT and UV-visible spectrophotometer. Results: The change in dose sensitivity observed over the dose rate from 250 cGy/min to 1500 cGy/min was 58.00% and 57.89% using a UV-visible spectrophotometer and X-ray CT analysis method. Energy dependency was evaluated with respect to dose sensitivity and the variation between 6 MV FF and FFF photon beams was found to be 2.20% and 2.21% using UV-visible spectrophotometer analysis and X-ray CT, respectively. Similarly, the variation noticed with 10 MV FF and FFF was 2.30% using UV-visible spectrophotometer analysis and 2.22% using X-ray CT analysis. Conclusions: The results clearly show that the MAGAT gel was highly dose rate-dependent and less dependent on energy. The beam quality variation between FF and FFF was less. The similar results obtained using X-ray CT scanner and UV-visible spectrophotometer indicate that this study can be recommended for polymer gel scanning procedure.
  1,233 111 -
Clear cell adenocarcinoma of the urethra with inguinal lymph node metastases: A rare case report and review of literature
Varuna Mallya, Ashwin Mallya, J Gayathri
January-March 2018, 14(2):468-470
DOI:10.4103/0973-1482.226734  PMID:29516944
Urethral cancer is a rare malignancy with urothelial subtype being the most common followed by adenocarcinoma. In women, the usual presentation is urinary retention and hematuria. Clear cell variety of adenocarcinoma is a rarer entity which usually has a better prognosis than other variants. Lymph node metastasis is seen in about 30% of urethral cancers. Histopathological differential diagnosis includes Skene gland carcinoma and nephrogenic adenoma. Herein, we present a 58-year-old female patient who presented for evaluation of lymph node mass in the inguinal region. The detailed evaluation revealed clear cell adenocarcinoma of the urethra as the primary with lymph node metastasis.
  1,133 69 -
Does preoperative neutrophil/lymphocyte rate have an effect on survival of the bladder cancer patients who received radical cystectomy?
Sıtkı Ün, Hakan Türk, Ahmet Selçuk Dindar, Ferruh Zorlu
January-March 2018, 14(2):432-436
DOI:10.4103/0973-1482.183555  PMID:29516933
Introduction: Radical cystectomy (RC) is the standard treatment model in invasive bladder cancer patients. Risk definitions before RC is mainly based on pathological results. Neutrophil/lymphocyte (N/L) rate is one of the inflammation markers. Some other studies reported negative prognostic results with increased N/L rates. In our study, we reviewed the relationship between preoperative N/L rate and clinicopathological results following RC. Materials and Methods: Data gathered from 296 bladder cancer patients that received RC between 2002 and 2012 were retrospectively reviewed. All patients received preoperative routine hematological and biochemical tests and metastasis screening. All patients were treated with radical cystoprostatectomy and standard pelvic lymph node dissection. The cutoff value for N/L rate was calculated using a web-based “cutoff finder” software. Results: Patient mean age was calculated as 65.7 years. Mean follow-up period was 24.5 (2–84) months. Cancer-related death was seen in 132 (44.6%) patients. Multivariate analysis showed age, lymph node metastasis, and low N/L rate as significant in cancer-specific survival. Conclusion: In our study, age, lymph node metastasis presence, and preoperative low N/L rates were detected as independent risk factors in RC cases. N/L rate, which is relatively easy to assess during preoperative period, could be beneficial in planning postoperative adjuvant treatments in those patients.
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Erratum: Comparison of full width at half maximum and penumbra of different Gamma Knife models

January-March 2018, 14(2):479-479
DOI:10.4103/0973-1482.226735  PMID:29516949
  455 33 -
Erratum: Dosimetric properties of new formulation of PRESAGE® with tin organometal catalyst: Development of sensitivity and stability to megavoltage energy

January-March 2018, 14(2):478-478
DOI:10.4103/0973-1482.226733  PMID:29516948
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