Iraqi Journal of Cancer and Medical Genetics

Background: According to World Health Organization publications, cancer arises from the transformation of normal cells into tumor cells in a multi-stage process that generally develops from a precancerous lesion to a malignant tumor. These changes result from the interaction between a person’s genetic factors and three categories of external factors: physical carcinogenic factors, chemical carcinogenic factors, and biological carcinogenic factors. The incidence of cancer increases sharply with age, and the accumulation of cancer risks is associated with the tendency for the effectiveness of cell repair mechanisms to decline as the person ages. This paper highlights the three main cancers that are most common in the world: female breast, prostate, and lung, accompanied by global statistical indicators by region.
Methods: Publications for the year 2024 on the incidence and mortality of the most common cancer diseases in global regions were used. A comparison was made by types of cancer by regions and finding their indicators, illustrated with graphs, for the three cancers.
Results: The data analysis indicated that the mortality-to-incidence ratio (MIR) was lowest for female breast cancer (0.29), intermediate for prostate cancer (0.27), and highest for lung cancer (0.73). While Asia had the highest incidence of the three cancers, Africa demonstrated the highest mortality in relation to incidence.
Conclusion: Analysis of data on the three most prevalent cancers showed that in the developed countries, despite the high number of cancer cases, mortality was lowest due to well-developed healthcare systems and the availability of diagnostic and treatment factors, unlike the continent of Africa, their death rate was the highest among other continents, despite the low prevalence.

Breast cancer is a significant health issue that affects patients› physical, emotional, and financial well-being as well as the health of their families. This study aimed to assess the physical, emotional, and fear of women with breast cancer. A descriptive cross-sectional study was carried out from November 2023 until July 2024. Ninety patients were selected from a purposive sample taken from the Nuclear Medicine Oncology Hospital in Mosul City. The study instrument includes questions about demographic and clinical data, physical and emotional health, and fear. Three response alternatives for each item (always, sometimes, never). Both descriptive and inferential statistics, such as chi-square tests, were used to examine the data, and the reliability estimate of the questionnaire was 0.89 breast cancer in women between the ages of 40 and 49 years. The affected women›s physical and emotional states were moderately impacted (46.7% and 51.5%, respectively). The responses from the participants indicated that their level of fear was between moderate and high. Additionally, there are worries about the disease›s potential to manifest and spread throughout the body. The study recommends that cancer patients benefit from good physical and emotional support to enhance their health, reduce their worry and fear through the use of coping strategies.

Tumor-associated macrophages (TAMs) are important immunological components that influence the tumor microenvironment by inhibiting immune responses and encouraging tumor development and cellular proliferation. This study sought to assess the functional, morphological, and molecular functions of TAMs in solid tumor patients. This study used a number of methods, such as flow cytometry, quantitative polymerase chain reaction (qPCR), and immunohistochemistry. Blood samples were taken from 50 patients clinically diagnosed with solid tumors, as well as from 30 healthy individuals who served as controls. Cytological investigations revealed a considerable increase in the percentage of macrophages bearing the CD163 and CD204 markers, as well as a decrease in HLA-DR expression, indicating that the cells polarized toward the M2 immunophenotype with immunosuppressive features. Additional genetic analyses revealed elevated expression of IL-10, TGF-β, ARG1, CSF-1R, and MMP9, genes linked to the immunosuppressive tumor microenvironment (TME). Histological evaluations revealed distinct infiltration of macrophages toward tumor peripheral zones and increased PD-L1 expression by macrophages, suggesting that macrophages may participate in the regulation of immunological checkpoints in addition to the suppression of effector T lymphocytes. Statistical analyses showed an inverse correlation between PD-L1 and HLA-DR and a positive correlation with IL-10, supporting the notion of the pleiotropic immunosuppressive function of macrophages. These data underscore the importance of TAMs for tumor progression and suppression, thereby rendering them suitable targets for contemporary immunotherapeutic approaches. Research suggests that additional investigations on the potential for reprogramming or targeting these cells therapeutically to enhance the immunotherapy response in solid tumors are needed.

Pediatric cancer patients face increased susceptibility to hepatitis B and C virus infection owing to immunosuppression resulting from the disease and its treatment, the frequent need for blood transfusions, and invasive procedures. This study sought to determine the prevalence of HBV and HCV infection within this community and identify correlated risk variables. Cohort research was performed in the oncology unit of Alhadbaa Teaching Hospital in Mosul from December 1, 2014, to December 1, 2024. The study included 153 children (under 15 years) with cancer selected randomly for routine checkup at the outpatient clinic who were initially negative for HBV and HCV at diagnosis, and screening was performed every 3 months for HBV and HCV. Demographic data, cancer type, vaccination status (both routine and postdiagnosis), and blood transfusion history were collected.
Results: Over a follow-up duration of 10 years, all the children remained in follow-up, largely because of their families’ strong commitment to monitoring their health status, given the diagnosis of cancer. Twelve patients (7.8%) seroconverted to HBV-positive, and 2 patients (1.3%) acquired hepatitis C virus (HCV), culminating in a total incidence of hepatotropic viruses of 9.1%. Although higher proportions of HBV infection were observed among children who underwent blood transfusions and those who were unvaccinated or inadequately vaccinated, these associations did not reach statistical significance. The infection rate decreased relative to that reported in prior trials conducted in other countries. These results strongly support the stringent enforcement of universal blood product screening and meticulous aseptic procedures, importantly, at the time of cancer diagnosis for unvaccinated children.
Conclusion: This study revealed that the prevalence of hepatitis B infection among pediatric cancer patients in Mosul was not significantly associated with frequent blood transfusions and insufficient immunization coverage.

Background: Chordomas are rare tumors originating from residual chordate tissues, predominantly affecting the base of the skull and the axial skeleton.
Aim: This systematic review investigates the anatomical aspects and neurosurgical treatment modalities of skull base and spinal chordomas.
Methods: We conducted a systematic literature review, adhering to PRISMA guidelines, by searching Databases including PubMed/Medline, Scopus, ScienceDirect, and EBSCO. Data was managed using Microsoft Excel and analysis was performed using SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). PROSPERO Registration Number; CRD420261322007.
Results: In this study, we conducted a systematic review and metaanalysis, including a total of N=2,083 patients with clinical and neurological manifestations, as outlined between Table I and Table IV. The analysis results are summarized in Table 1. N=1,485, (71.5%) patients, N=636, Gross total resection (GTR), N=640, subtotal resection (STR), N=568, Radiotherapy, as detailed in Tables I and II and Figures 1, 2, and 3. Heterogeneity was assessed as follows: I² = [23%, 24%, 32%]. P = 0.21.
Conclusion: The aggressive nature of chordomas necessitates personalized treatment strategies. Surgical approaches, particularly for elderly patients, proved promising in chordoma excision. Despite advancements, further research into disease management and etiopathogenesis is crucial for improved prevention, detection, and treatment strategies. Adjuvant therapies exhibited enhanced survival rates, highlighting their significance in prolonging patients› lives post-surgery.

Introduction: Breast carcinoma is one of the most prevalent cancers in women, with its progression influenced by a complex interplay of genetic and environmental factors. This study aimed to investigate the association between resistin, mammaglobin, MUC1, CA153-, CEA, and AKT pathway activation in breast cancer development.
Methods: A cross-sectional study design was performed in Iraq/ Medical City at Baghdad/ Oncology Teaching Hospital. All samples (105 samples of blood) were classified into 3 groups; each one contains 35 samples.
Results: A serological analysis was conducted using ELISA to measure serum levels of key biomarkers. Malignant samples exhibited elevated concentrations of mammaglobin (mean: 3.74 ng/ml), resistin (mean: 4.195 ng/ml), CA153 (mean: 36.15 ng/ml), CEA (mean: 41.983 ng/ml), mucin1 (mean: 33.45 ng/ml), and AKT (mean: 3.174 ng/ml).
Conclusion: The findings suggest that a combined assessment of these tumor markers could enhance the prognosis, diagnosis, detection, and monitoring of breast cancer. Notably, CEA and MUC1 demonstrated superior sensitivity and specificity, positioning them as highly reliable biomarkers for clinical application.

Background:This research aimed to evaluate the toxic effects of chloroquine alone and in combination with camptothecin on two human cancer cell lines, namely, MCF-7 breast cancer cells and A549 lung cancer cells.
Objective: To determine the percentage inhibition of breast and lung cancer cells after 72 h of exposure to treatments utilizing (originally against C. trachomatis), chloroquine and camptothecin alone and in combination and to calculate the respective half-maximal inhibitory concentration (IC50) values.
Methods: Exposure to varying amounts of chloroquine, camptothecin, and a mixture of these drugs was performed for 72 hours. The percentages of growth inhibition and IC₅₀ were obtained to investigate the cytotoxic effects.
Results: Single treatment with chloroquine strongly reduced cell viability in both models; however, it moderately inhibited (57 - 63%) MCF-7 cells and strongly inhibited (72 - 77%) A549 cells, suggesting that lung cancer cells are more sensitive to chloroquine. Dual treatment with chloroquine and camptothecin resulted in dose-related cytotoxic activity. The inhibition was 17 - 35% at lower doses, whereas a greater percentage of cell death occurred (52 - 67%) at higher doses. Analysis using the IC₅₀ further confirmed the presence of an interaction between the two drugs.
Conclusion: These findings indicate that chloroquine potentiates the antitumor effects of CPT, especially in A549 cells.

Matrix metalloproteinases (MMPs) are tightly regulated enzymes that play a significant role in tissue remodeling. They are produced by normal and tumor cells and participate in extracellular matrix remodeling and degradation of basement membrane barriers. During tumor progression, cancer cells invade surrounding tissues, accompanied by numerous alterations, leading to microenvironmental stress and breakdown of the extracellular matrix, including loss of basement membrane integrity caused by dysfunction of metalloproteinase activity. This review summarizes the significant roles of MMP-3, -9, and prolidase in different stages of breast cancer progression to offer a comprehensive understanding of the main contributions of these enzymes in breast tumors. Studies have indicated that elevated expression and enzymatic activity correlate with tumor progression through the modulation of transcription factor activity and metastasis mechanisms. MMP-3 is involved in angiogenesis; inhibition of MMP-3 activity is considered a potential therapeutic strategy. In contrast, MMP-9 plays a restrictive role in angiogenesis. Numerous studies have shown that targeting tissue inhibitors of MMPs or silencing these enzymes represents a promising therapeutic strategy to suppress tumor growth and enhance apoptosis. MMP-3, MMP-9, and prolidase should not be considered independent regulators of extracellular matrix remodeling; they function through interconnected mechanisms that govern the dynamic remodeling of cancer progression. Few studies have investigated prolidase activity and its role in pathological processes, and its precise association with MMP-3 and MMP-9 in breast cancer remains poorly understood. Currently, no studies have directly discussed the relationship between MMP-3 and prolidase; however, few mechanistic studies have indicated that prolidase acts as an upstream regulator of MMP-3 and MMP-9 in breast cancer. Further experimental investigations are needed to clarify the interplay of these enzymes in extracellular matrix remodeling within the breast tumor microenvironment to support the development of a prospective therapeutic approach.