Iraqi Journal of Cancer and Medical Genetics

Cancer is a deadly malignancy of high clinical importance and remains one of the leading causes of death worldwide. Current conventional treatments for cancer include surgery, anticancer drugs, and radiation therapy. Resection surgery is the main treatment method but has a high recurrence rate. The human gut microbiome plays a crucial role in regulating various host processes, such as metabolism, inflammation, and immune and cellular responses. Moreover, it is becoming increasingly clear that the microbiome may also impact cancer development. The gut microbiota is a key component of the human microbial community, characterized by the highest number of bacteria and the greatest diversity compared to microbiomes in other parts of the body. The gastrointestinal tract (GI) extends through our natural environment, providing a suitable habitat and abundant nutrition for the microbiota. Gastrointestinal cancer encompasses a complex group of disorders and heterogeneous diseases. Both environmental and genetic risk factors can convert normal tissue into precancerous lesions, leading to the development of malignant cells. Despite advances in cancer treatment, resistance to chemotherapy and radiation therapy continues to pose a significant challenge. This is particularly relevant in light of new diagnostic and therapeutic methods for gastrointestinal tumors, which increasingly involve various strains of probiotics used as dietary supplements. As proposed treatments, probiotics may significantly benefit cancer prevention and therapy. They can enhance the metabolism of the gut microbiota during chemotherapy, potentially reducing its toxic side effects. Consequently, the potential use of probiotics as an anticancer therapy has received considerable attention in recent years. Conclusion: Current review article concentrates on the ability of probiotics to inhibit antibiotic-resistant Helicobacter pylori. However, there is a lack of studies exploring inhibitory resistance in other contexts. Despite these gaps, probiotics show considerable promise in cancer treatment and in enhancing tumor immunity.

Breast cancer is a significant health concern, necessitating innovative therapeutic approaches beyond traditional treatments. This study investigates the synergistic effects of combining virotherapy and chemotherapy using the mouse mammary adenocarcinoma model. Combination cytotoxicity assays were performed using NDV at different hemagglutination units (HAU) and chemotherapy drugs, including Cisplatin, Methotrexate, Etoposide, Mitomycin C, Vindesine, and Cyclophosphamide, at different concentrations. Cell viability was assessed using the MTT assay, and synergistic interactions were determined through isobologram analysis. The AMN3 cell line, representing mammary adenocarcinoma, was cultured under standard conditions. NDV was propagated, purified, and quantified using embryonated chicken eggs and a hemagglutination assay. Our findings demonstrate that the combined application of NDV and chemotherapy significantly enhances the therapeutic outcomes compared to either modality alone. Mitochondrial permeability transition assays confirmed enhanced apoptosis rates in combination treatments, particularly with NDV plus Cisplatin, Methotrexate, Vindesine, and Cyclophosphamide. Additionally, NDV replication remained stable across all treatment conditions, suggesting that chemotherapy agents did not significantly impact NDV’s oncolytic activity. In conclusion, the findings highlight the potential of NDV as an adjunct to chemotherapy, enhancing cytotoxicity and apoptosis in mammary adenocarcinoma. The observed dose-dependent synergy suggests that optimal dosing strategies should be considered to maximize therapeutic efficacy while minimizing antagonistic effects. Further in vivo studies are warranted to explore the translational potential of NDV-chemotherapy combinations in breast cancer treatment.

Background and purpose: Early-stage laryngeal cancer represents a large proportion of cancer patients treated with definitive radiotherapy (RT). This study aimed to evaluate the outcomes of radical RT for patients with T1-T2 cN0 laryngeal cancer at an institution in a developing country without adequate infrastructure and to address overall survival and voice preservation. Research has shown that radical RT should be performed as soon as possible after the diagnosis of early-stage laryngeal cancer if RT is selected as the main treatment. We evaluated the efficacy of this type of treatment despite the delay in its initiation.
Methods: We reviewed the medical records of patients who had cT1-cT2/cN0 squamous cell carcinoma of the larynx treated with definitive RT from June 2009 to June 2020 and who had not undergone previous surgical treatment or chemotherapy.
Results: The median age of the study population was 63 years, with a male predominance (94%). Histologically, all laryngeal cancers were confirmed to be squamous cell carcinomas, and 86% were glottic squamous cell carcinomas. The mean time from diagnosis until initiation of RT was 120 days (4 months). The median follow-up period was six years. Among the 53 patients enrolled, the 2-, 3- and 5-year survival rates were 83%, 71% and 66%, respectively, during the follow-up period. The majority of the surviving population (97%) had good voice preservation.
Conclusion: Despite these challenges, the results are promising. Definitive RT achieved an acceptable cure rate and voice preservation in patients with cT1-2 laryngeal carcinomas.

Background: Leukemia is a malignant disease of the blood and bone marrow that leads to cancer and accounts for 2.5% of all other cancers, with a small mortality rate (3.1) among the deaths of other cancers. Objective: This paper discusses the global data on leukemia-related cancer, its analysis and comparison by region, and a discussion of children’s cancer cases of this type, in addition to an Iraqi leukemia patient analysis of white blood cell (WBC) count and hemoglobin (HB) levels before and after cancer collection from laboratories in medical city hospitals. Materials & Methods: Publications collected from the WHO for the year 2022 on the prevalence and mortality of leukemia-related diseases by region were used, with comparisons made and their indicators identified, as illustrated with graphs for each country. The blood parameters (WBC and Hb) of 25 leukemia patients before and after cancer were analyzed via paired sample t tests. Results: The data analysis shows that this type of cancer has the lowest incidence and mortality compared to other cancer types; Oceania has the lowest incidence and mortality, whereas Asia and Europe have the highest. Rates and deaths among children younger than nine years. In childhood deaths, there are two types of leukemia: acute lymphoblastic leukemia, precursor cell lymphoblastic leukemia, and NOS leukemia. The two types are equally likely. Two types, acute and precursor cell lymphoblastic leukemia, were present in a lower percentage of girls than boys, whereas other types were present in higher percentages. prevalence. In 2022, the number of cases of leukemia increased, particularly among Asian men. Conclusion: This paper offers a comprehensive explanation of leukemia by analyzing mortality and prevalence data and providing information on the frequency of this disease in children under ten years of age. The findings of the analysis revealed that, particularly in developed countries, the death rate is extremely low.

Objective: This study aimed to assess the inhibitory effect of a methanolic extract of Iraqi Ephedra transitoria on the proliferation of cervical cancer cells.
Materials and methods: To assess the anticancer properties of Ephedra transitoria, a HeLa cell line (derived from cervical cancer) was utilized. The concentration of the evaluated agent was varied between 0.1 and 1000 μg/ml, and the cells were incubated for 24 and 72 hours. The IC50 value was used to identify the potency of the examined substance.
Results: The study results demonstrated that the extraction ratio of E. transitoria was 8%. Additionally, a cytotoxicity study revealed that the plant extract can potentially inhibit the proliferation of human cervical cancer cells in a concentration- and time-dependent manner. The extract at a concentration of 1000 μg/ml inhibited growth by 88% after 72 hours. The comparison between the cytotoxicity of a plant extract and traditional anticancer chemotherapy (cisplatin) revealed that the plant extract exhibited higher cytotoxicity than cisplatin in the HeLa cancer cell line after two incubation periods. Additionally, the IC50 value of the extract was lower than that of cisplatin.
Conclusion: Ephedra transitoria inhibits the proliferation of cervical cancer cells via cell cycle-specific and cell cyclenonspecific mechanisms, thus demonstrating its anticancer properties. The study also revealed that, compared with cisplatin, the plant extract exhibited superior efficacy and potency in cancer treatment.

Breast cancer (BC) is the most commonly diagnosed cancer and the main cause of mortality among women worldwide. Cancer stem cells are subpopulations of cancer cells characterized by self-renewal, tumorigenesis, maintenance of cancer heterogeneity, and metastasis. The current study was designed to identify the presence of cancer stem cells (CSCs) within tumor tissue and their role in metastasis and to determine the relationships between the expression of these markers and the grade and subtype of invasive ductal carcinoma (IDC). Sixty paraffin blocks from patients with IDC, where 49 blocks were from patients without metastasis (M- group), and 11 blocks from patients with distant metastasis (M+ group), were used. All cases were subjected to histopathological and immunohistochemistry investigations to determine the tumor grade and BC subtypes, as well as to identify the presence of CSCs on the basis of the expression of CD44 and CD133. IHC revealed that the subtype (luminal A/B) had the highest percentage (90.9%), triple-negative subtype (9.1%) and no HER2-enriched subtype (0%) in the M+ group compared with the M- group, and this difference was significant. Furthermore, IHC revealed the presence of CSCs within the tumors of both groups, but the odds ratios (ORs) of CD44 and CD133 revealed that these markers are 3.1 and 1.29 times more likely to be expressed in metastatic cases than in other cases without metastasis. There was no significant correlation between the expression of stem cell (CD) markers and tumor grade, but the expression of CD44 and CD133 was significantly lower in the triple-negative IDC subtype than in the luminal IDC subtype (r=-0.3424, P=0.007; and r=-0.2787, P=0.031, respectively). Female patients with the luminal A subtype and positive expression of CD44 and CD133 are more likely to experience metastasis. Therefore, along with IHC investigations of ER, PR, and HER2, the expression of these markers, especially CD44, is recommended as a predictor marker for metastasis.

The skin of humans is thought to be the primary immune barrier, and repeated exposure to various carcinogens and mutagens can have an impact on it. The ability of these dangerous substances to cause skin cancer (melanoma) depends on a number of underlying factors, including the individual’s genetic predisposition, the amount and duration of exposure, their overall health, their age, sex, and race, and their nutritional and lifestyle choices. The elements as mentioned above have the potential to activate oncogenes linked to specific forms of skin cancer. Carcinogens may be chemical substances such as those that alter DNA and cause dimers, a common DNA abnormality, or physical particles such as radiation and prolonged sun exposure. When the body does not eliminate these melanoma-related dimers through proofreading activity, physiological function will continue, and cancer will develop as a result of unchecked cellular proliferation. This review aims to provide an overview of the mechanism(s) underlying the development of cancer (ideally, skin malignancies in general and melanoma in particular), as well as its diagnosis, therapy, and variables contributing to its occurrence in the human body.

Background: Nephrocalcinosis refers to medulla calcium phosphate deposition in the kidney. It can occur as a result of some diseases, drugs, or physiological or genetic effects. Genetic effects can involve either genes or chromosomal disorders. Nephrocalcinosis was thought to be not inherited condition. Objective: A family of six members who were suffering from nephrocalcinosis were referred to the Iraqi Center for Cancer and Medical Genetics for chromosomal analysis. Methods: G-banding chromosomal analysis was performed according to the ICCMGR protocol, karyotype analysis was performed via CytoVision (Leica Microsystems Crop), and chromosomal nomenclature was designated according to ISCN 2020. The aim of this study was to report the role of the deletion of region 7p22 associated with nephrocalcinosis. Results: The relatives exhibited breaks at the common fragile site 7p22, some of which were chromatid breaks and others chromosomal deletions. Few cells within adult samples presented chromosomal abnormalities extending to the 7p21 band. To our knowledge, the correlation between fragile site 7p22 and nephrocalcinosis has not been previously reported, as we have shown in our present study. Only two previous studies mentioned the role of the association between aldosterone and 7p22, and the other study mentioned the association between aldosterone and nephrocalcinosis; thus, our current study clarifies a new relationship between 7p22 and nephrocalcinosis, especially when we know that the region holds some genes involved in renal genesis and kidney function. Our conclusion is that the region 7p22-ter holds effective genes involved in kidney function, and its deletion may lead to the appearance of nephrocalcinosis, and the fragile site 7p22 may play a role in nephrocalcinosis.