Epidemiology of Different Types of Cancers Reported in Basra, Iraq

Epigenetic frontiers: miRNAs, long non-coding RNAs and nanomaterials are pioneering to cancer therapy

Cancer has arisen from both genetic mutations and epigenetic changes, making epigenetics a crucial area of research for innovative cancer prevention and treatment strategies. This dual perspective has propelled epigenetics into the forefront of cancer research. This review highlights the important roles of DNA methylation, histone modifications and non-coding RNAs (ncRNAs), particularly microRNAs (miRNAs) and long non-coding RNAs, which are key regulators of cancer-related gene expression. It explores the potential of epigenetic-based therapies to revolutionize patient outcomes by selectively modulating specific epigenetic markers involved in tumorigenesis. The review examines promising epigenetic biomarkers for early cancer detection and prognosis. It also highlights recent progress in oligonucleotide-based therapies, including antisense oligonucleotides (ASOs) and antimiRs, to precisely modulate epigenetic processes. Furthermore, the concept of epigenetic editing is discussed, providing insight into the future role of precision medicine for cancer patients. The integration of nanomedicine into cancer therapy has been explored and offers innovative approaches to improve therapeutic efficacy. This comprehensive review of recent advances in epigenetic-based cancer therapy seeks to advance the field of precision oncology, ultimately culminating in improved patient outcomes in the fight against cancer.

Epidemiology of childhood acute leukemias in marginalized populations of the central-south region of Mexico: results from a population-based registry

Introduction

Acute leukemias (AL) are the main types of cancer in children worldwide. In Mexico, they represent one of the main causes of death in children under 20 years of age. Most of the studies on the incidence of AL in Mexico have been developed in the urban context of Greater Mexico City and no previous studies have been conducted in the central-south of the country through a population-based study. The aim of the present work was to identify the general and specific incidence rates of pediatric AL in three states of the south-central region of Mexico considered as some of the marginalized populations of Mexico (Puebla, Tlaxcala, and Oaxaca).

Methods

A population-based study was conducted. Children aged less than 20 years, resident in these states, and newly diagnosed with AL in public/private hospitals during the period 2021-2022 were identified. Crude incidence rates (cIR), standardized incidence rates (ASIRw), and incidence rates by state subregions (ASIRsr) were calculated. Rates were calculated using the direct and indirect method and reported per million children under 20 years of age. In addition, specific rates were calculated by age group, sex, leukemia subtype, and immunophenotype.

Results

A total of 388 cases with AL were registered. In the three states, the ASIRw for AL was 51.5 cases per million (0-14 years); in Puebla, it was 53.2, Tlaxcala 54.7, and Oaxaca de 47.7. In the age group between 0-19 years, the ASIRw were 44.3, 46.4, 48.2, and 49.6, in Puebla, Tlaxcala, and Oaxaca, respectively. B-cell acute lymphoblastic leukemia was the most common subtype across the three states.

Conclusion

The incidence of childhood AL in the central-south region of Mexico is within the range of rates reported in other populations of Latin American origin. Two incidence peaks were identified for lymphoblastic and myeloid leukemias. In addition, differences in the incidence of the disease were observed among state subregions which could be attributed to social factors linked to the ethnic origin of the inhabitants. Nonetheless, this hypothesis requires further investigation.

Al-tameemi Z. In silico comparison between the mutated and wild-type androgen receptors and their influence on the selection of optimum androgenic receptor blockers for the treatment of prostate cancer

Background: Prostate cancer is a disease that occurs in men aged more than 50 years. In Iraq, 8.89 men per 100,000 population suffer from prostate cancer, with the incidence being 14,016 cases and mortality being 6,367 cases. Despite advances in treatment against prostate cancer, it can become resistant to drugs. Therefore, the aim of current study was to search and identify binding sites for the repositioning of drugs by computational methods (docking).  Methods: Based on the protein structure of the wild androgen receptor, the analysis parameters (22x22x22 on the X, Y, and Z axes) were established. Results: The interactions of the natural ligands with androgen receptor were 10.0 (testosterone) and 10.8 (dihydrotestosterone) while mutated androgen receptor (T877A) had a low affinity with testosterone and dihydrotestosterone (-5.3 and -6.7, respectively). In the interactions of both receptors with the reported inhibitors (antagonists), a decrease with Bicalutamide (-8.3 and -4.3, respectively) and an increase in affinity with Flutamide and Nilutamide (-7.7 and 8.6, wild AR; -8.7 and -9.3 AR T877A) were observed. As for Enzalutamide and Apalutamide (second-generation antagonists), the change was minimal between wild androgen receptor and T877A (-7.6 and -7.7; -7.3 and -7.3, respectively). The change in the affinity of the ligands with androgen receptor and androgen receptor T877A shows how a mutation alters the bonds between these molecules. Conclusion: The identification of key sites and potent inhibitors against abnormal androgen receptor functions will enrich prostate cancer treatments.

Characterization, risk assessment, and source estimation of PM10-bound polycyclic aromatic hydrocarbons during wintertime in the ambient air of Basrah City, Iraq

In this study, the concentration and structure of polycyclic aromatic hydrocarbons (PAHs) associated with the ambient PM₁₀ in Basrah City, Iraq have been investigated for the first time. From December 2021 to February 2022, PM₁₀ samples were collected on quartz fiber filters, extracted using an optimized extraction protocol, and analyzed for the sixteen US EPA priority PAHs. The results indicated that 4- and 5-ring PAHs represent 52% of the total detected PAHs. The most abundant PAHs over the study period were chrysene (1.2 ± 1.5 ng m^-3), fluorene (0.9 ± 1.4 ng m^-3), and benzo[b]fluoranthene (0.7 ± 0.9 ng m^-3). Source identification suggested that PM₁₀-bound PAHs primarily originated from pyrogenic and petrogenic activities in Basrah City. In addition, the cancer risk associated to PAH exposure was assessed based on benzo[a]pyrene equivalent concentration and was found ranging from 0.07 to 6.32 ng m^-3; hence, it exceeded the threshold limit of 1.0 ng m^-3 established by the European legislation (EU, 2014). Benzo[a]pyrene was determined to be main contributor to total carcinogenic power of the detected PAHs, accounting for 50.3%, followed by dibenz[a,h]anthracene (22.3%). Similarly, benzo[a]pyrene represented a major contributor to PAH associated mutagenicity, accounting for 43.5% of the total.

Survival Analysis of Oncological Patients Using Machine Learning Method

Currently, a considerable volume of information is collected and stored by large health institutions. These data come from medical records and hospital records, and the Hospital Cancer Registry is a database for integrating data from hospitals throughout Iraq. The data mining (DM) technique provides knowledge previously not visible in the database and can be used to predict trends or describe characteristics of the past. DM methods can include classification, generalisation, characterisation, clustering, association, evolution, pattern discovery, data visualisation, and rule-guided mining techniques to perform survival analyses that take into account all the patient's medical record variables. For four of the eleven groups examined, this accuracy was relatively high. The database of patients treated by the Baghdad Teaching Hospital between 2018 and 2021 was examined using a classification of the most crucial variables for event prediction, and a distinctive pattern was found. Machine learning techniques allow a global assessment of the data that is available and produce results that can be interpreted as significant information for epidemiological studies, even in cases where the sample is small and there is a lack of information on several variables.

Effect of Serum Level of Human Epididymis Protein 4 and Interleukin-6 as Biomarkers in Patients with Adnexal Mass

Ovarian carcinoma is one of the most common types of neoplasms in women and the fifth leading cause of cancer death among women worldwide. Adnexal masses are classified as simple or complicated and can be benign or malignant. No single biomarker has demonstrated high sensitivity and specificity for detecting early ovarian cancer. Therefore, the current study was designed to investigate the influence of using two biomarkers as a tool for diagnosis in patients with an adnexal mass. This prospective case-control study was carried out on female patients diagnosed by ultrasound and magnetic resonance imaging with adnexal masses and scheduled for surgery and healthy women as a control group (n=50 each). The patients were in the age range of 16-80 years old and had attended the surgical rooms of Basrah hospitals, Basrah, Iraq, from January to July 2021. The levels of serum biomarkers were quantitatively assessed using the enzyme-linked immunosorbent assay. The serum concentration of the human epididymis protein 4 (HE4) biomarker exhibited significant differences between females with adnexal mass and healthy women. There was no significant association between neither the patient's age nor the menopausal state and the serum level of HE4. The serum level of HE4 had a sensitivity of 92% and a specificity of 66% as a serum marker for the presence of adnexal mass with a positive predictive value of 73% and a negative predictive value of 89%. In this study, serum interleukin-6 (IL-6) had a sensitivity of 30% and specificity of 64% in determining patients with adnexal mass pathology. It was found that the level of IL-6 was similar in all patients, compared to that in the control group. The median levels of serum HE4 showed high value in patients in the age groups of 21-40, 41-50, and >50 than in the control group; however, it was not statistically different (P=0.413). Human epididymis protein 4 was the top biomarker representing a higher concentration in adnexal mass; moreover, it demonstrated the highest performance in all samples with Adnexal mass. The results of our study showed that combining more than one marker measurement increased both the sensitivity and specificity of distinguishing patients with adnexal mass pathology.

Persistently high incidence rates of childhood acute leukemias from 2010 to 2017 in Mexico City: A population study from the MIGICCL

Introduction

Over the years, the Hispanic population living in the United States has consistently shown high incidence rates of childhood acute leukemias (AL). Similarly, high AL incidence was previously observed in Mexico City (MC). Here, we estimated the AL incidence rates among children under 15 years of age in MC during the period 2010-2017.

Methods

The Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia conducted a study gathering clinical and epidemiological information regarding children newly diagnosed with AL at public health institutions of MC. Crude age incidence rates (cAIR) were obtained. Age-standardized incidence rates worldwide (ASIRw) and by municipalities (ASIRm) were calculated by the direct and indirect methods, respectively. These were reported per million population <15 years of age; stratified by age group, sex, AL subtypes, immunophenotype and gene rearrangements.

Results

A total of 903 AL cases were registered. The ASIRw was 63.3 (cases per million) for AL, 53.1 for acute lymphoblastic leukemia (ALL), and 9.4 for acute myeloblastic leukemia. The highest cAIR for AL was observed in the age group between 1 and 4 years (male: 102.34 and female: 82.73). By immunophenotype, the ASIRw was 47.3 for B-cell and 3.7 for T-cell. The incidence did not show any significant trends during the study period. The ASIRm for ALL were 68.6, 66.6 and 62.8 at Iztacalco, Venustiano Carranza and Benito Juárez, respectively, whereas, other municipalities exhibited null values mainly for AML.

Conclusion

The ASIRw for childhood AL in MC is among the highest reported worldwide. We observed spatial heterogeneity of rates by municipalities. The elevated AL incidence observed in Mexican children may be explained by a combination of genetic background and exposure to environmental risk factors.

Immunohistochemical expression of CD 14 in transitional cell carcinoma of the urinary bladder

CD14 is a co-receptor for bacterial lipolysaccharide (LPS) detection. It is found on myelomonocytic cells such as monocytes, macrophages, and Langerhans cells, CD14 expression in bladder cells is necessary for cytokine secretion and increased tumor growth. The goal of this study was to use immunohistochemistry (IHC) to assess CD14 expression in patients with transitional cell carcinoma of the urinary bladder in order to see if there was a link between CD14 marker expression in bladder cancer and cystitis. The immunoexpression of CD14 in paraffin sections from 30 bladder biopsy samples was separated into three groups: cystitis, low grade bladder cancer (L.G), and high grade bladder cancer (H.G), and studied using immunohistochemical assays (IHC). For bladder cancer (L.G & H.G), the percentage of samples that gave positive results for IHC/CD14 expression was 70% and 80%, respectively, compared to 30% for cystitis. The incidence of study samples appear in both sexes.

Geographic Distribution and Estimating the Childhood Cancer Incidence in Iran: Three-Source Capture-Recapture Analysis on National Registries Data

BACKGROUND

Cancers seldom happen in childhood age and awareness of accurate cancer incidence is essential in order to preventive programs. This study aimed to estimate the childhood cancer incidence in Iran using the three-source capture -recapture method.

METHODS

Total new cases of childhood cancer reported by three national data sources of MAHAK charity database, pathology reports and clinical records in Iran were enrolled in this study. The common cases among three sources were determined using data linkage method. The childhood incidence rate per 1 million populations was estimated based on three-source capture-recapture method. We used BIC, G2 and AIC statistics to select the best-fit model. Arch GIS was used to determine geographic distribution.

RESULTS

Overall, 2567 childhood cancer was included by three sources of registries. The total estimated number of childhood cancer was 5388 (95% CI: 4742.15-6228,14). The higher estimated incidence rate was Leukemia, Lymphoma by 94.91 and 24.80 per 1 million populations and the lower incidence was liver and retinoblastoma with 2.35 and 7.01 per 1 million populations. Provinces of Ardabil and Kohgiluyeh with an incidence rate of 420.01 and 404.61 per 1 million populations had a higher incidence rate and Mazandaran and Ilam with an incidence rate of 60.87 and 66.88 per 1 million populations had the lowest incidence. The overall completeness of the childhood cancer registry based on three-source was 48%.

CONCLUSION

The low-quality childhood cancer registration system highlights the needs for urgent screening programs for early detection in the high prevalent area in Iran.