Iraqi Journal of Cancer and Medical Genetics

Medical ethics principles have been the basis of medical practice since early human civilization. The well-accepted principles are autonomy, beneficence, non-maleficence, and justice. With the advancement of academia, industry, medicine, and technology, there is a need to empower ethics-guided radiation therapy (EGRT). A PubMed search was done on Oct. 22, 2023, using the words: (“Radiotherapy”[Mesh]) AND “Ethics, Clinical”[Mesh]) and the results were a total of 58. Among these, 17 titles seem to be in relation, but only a handful were of intimate relation to ethics and radiotherapy. An additional handful of non-PubMed references were found. EGRT, in my opinion, is a new acronym for an old concept that needs further elaboration and experts’ consensus in the modern radiation oncology literature. In parallel with the technological advances in radiotherapy, like intensity-modulated radiation therapy “IMRT” and image-guided radiation therapy “IGRT,” we are aiming to create an initiative to establish EGRT to be like a model that every radiation oncologist can follow in the daily radiotherapy practice. The coming work will be composed of an extensive literature review, international survey, and expert consensus, and it is intended to be a base for further efforts in this aspect.

Breast cancer, as is commonly assumed, one of the most diagnosed kind of cancer is a multifactorial disease, its exact cause is still unknown. It is considered the second killer cancer among women. The present study participants were Iraqi women patients in pre-malignant and malignant (n=59) women with breast tumors as well as age matched healthy Iraqi women (n=27). This study aimed to evaluate the redox status upon transformation from premalignant (benign) to malignant stage of breast cancer by evaluating the saliva-blood correlation to look for the possibility using saliva as alternative fluid for diagnosis of the tumor stages. This was achieved by measuring the [total oxidant status level (TOS), total antioxidant status level (TAS), and oxidative stress index level(OSI). (TOS) and (TAS) were determined in saliva and serum fluid samples from all participants using colorimetric methods, while the oxidative stress index (OSI) was calculated. The results obtained from the study showed that the P value ≤ 0.01 significantly increased the measured [TOS] level and the calculated [OSI] level in saliva and serum fluid samples in contrast significantly decreased the P value ≤ 0.01 in the [TAS] level in both types of fluids of the patient groups compared to that of the healthy control group. Similar results were obtained when the values of these parameters were compared in both samples (serum and saliva) samples were compared between the patient groups in both breast tumors (Premalignant & malignant).

Background: Innate immune checkpoints have been one of the most studied and promising approaches in cancer immune therapy. Therefore, it is considered valuable when investigating these checkpoints at the gene expression and protein levels. However, this approach still has variations from study to study due to various types of cancer. Therefore, it is hypothesized that CD47 could be one of those checkpoints that affect the survival of cancer cells. CD47 is an integrin like marker that has been identified for its role as “do not eat me signal” which enhances the ability of cancer cells to escape from being phagocytized by macrophages. Aim of the study: This study aims to investigate CD47 expression in ten solid tumors and five blood cancers at the gene level and at the protein level. Methods: Clinical specimens were collected from patients with different cancers attending Kirkuk oncology center. The patients were categorized into two main groups: solid tumor group and blood-derived cancer group together with their control counterparts. CD47 gene expression was investigated using q RT-PCR techniques while its protein levels were investigated using ELISA techniques. Results: The results showed a significant up-regulation of CD47 gene expression in gastric cancer, cholangiocarcinoma; CCA (bile duct), chronic myeloid leukemia (CML), and breast cancer, respectively. These results were also confirmed at the protein level, suggesting that those types of malignancy are more susceptible to an increase in CD47 expression than other types of cancer that were involved in this study. Conclusion: CD47 tends to be over expressed in solid tumors and blood cancers, and could be used as diagnostic and prognostic markers, especially for solid tumors.

Background: According to the Iraqi Cancer Registry, renal carcinoma is the 13th most common carcinoma, with 798 registered cases in 2020 and 418 deaths. Methods: This is a cross sectional retrospective study that includes the analysis of 116 randomly selected sample of pediatric patients (74 nephrectomies and 42 biopsies) sent to the Teaching Laboratories of AL-Emamain AL-Kadhmain city (AS), Baghdad medical city, and private laboratories from January 2019 to January 2023. Results: Histopathological diagnosis revealed a ratio from malignant to benign of 7.4:1. Wilm’s tumor was the most common malignant tumor (65.5%), while multicystic renal dysplasia was the most common benign tumor (7.8%). Abdominal pain was the most common clinical feature (67.2%), followed by abdominal mass (20.7%). Regarding malignant cases, Pathological stage I was the most common (39.0%). As for the histopathological subtype, triphasic type was the most common (57.1%), followed by the biphasic type (10.5%). Conclusions, Malignant tumors make up the vast majority of renal tumors. Wilm tumor is the predominant malignant tumor. Fortunately, most cases of Wilm tumors exhibited an early stage and favorable histology. Neuroblastoma was the second most common malignant tumor. The abdominal lump is the most common presentation of pediatric renal tumor.

Purpose: The rate of tonsil oropharyngeal cancers is increasing. MicroRNAs (miRNAs) are identified as small, noncoding, endogenously expressed RNAs that target mRNAs and regulate the post-transcriptional levels of protein expression. MiRNA- 21(miR-21) is significantly increased in patients with oral carcinoma and has oncogenic roles in oral carcinogenesis. Therefore, miRNAs have been recommended to be used in the early diagnosis of HNC. Methods - rt-qPCR was utilized to evaluate the expression levels of human salivary miR-21. Samples were collected from individuals diagnosed with tonsil squamous cell carcinoma (TSCC) (n = 45) in both whole saliva and supernatant saliva. Then these levels were compared to those of a control cohort consisting of healthy individuals (n = 45) to determine differential expression patterns. Results- Salivary miR-21 displayed a notable elevation in all stages of tonsil squamous cell carcinoma (TSCC), including cases involving small tumors. The initial analysis revealed a significant up-regulation of both whole saliva and salivary miR- 21 of the supernatant in patients with TSCC compared to controls (P= 0.01, 0.02 respectively). Furthermore, miR-21 showed a higher abundance in whole saliva in contrast to its levels in supernatant saliva. These observations confirm the potential of salivary miR-21 for the detection of tonsil malignancies. Conclusions This investigation underscores the ability of salivary miR-21 for the detection and ongoing prognostic monitoring of tonsil squamous cell carcinoma (TSCC), both in whole saliva and in supernatant saliva samples.

Atherosclerosis is a progressive inflammatory disorder of the arterial wall and can affect any artery in the body. When it occurs in the heart (Coronary atherosclerosis), it can cause MI, angina, and even sudden death; in the brain, stroke, and transient ischemic attack; and in the limbs causing claudication and critical limb ischemia. CETP plays a role in transferring the cholesterol from peripheral tissues to the liver through the collection of triglycerides of VLDL and LDL for exchange by the cholesteryl ester of HDL. Therefore, it has a role in HDL metabolism by converting it to LDL and increasing the risk of incident atherosclerosis. Aim of the study: To investigate the rs5883 genotypes and their association with the coronary atherosclerosis and to study the impact of this SNP on the CETP gene with the lipid profile including the OX-LDL in patients and controls. Patients and method: All patients underwent angiography to confirm diagnosis in a case- control study, comparing 60 volunteers as the control group. The lipid profile test was measured by colorimetric method, Ox-LDL was measured by ELISA technique and the CETP SNP genotypes by RT-PCR technique. Results: There was a significant difference in genotypes in the rs5883 SNP, the heterozygous genotype (TC) was much more frequent in patients (20%) than controls (3.7%) with a significant difference (OR= 6.5, 95%CI=1.38-30.55). There was no association of this SNP with lipid profile, there was a significant impact of rs5883 with Ox-LDL, the medians of CT carriers significantly higher than CC genotypes.

Background and aim: Typhoid fever is one of the major health problems facing humanity of all ages. This study was conducted to investigate the relative contribution of genetic factors to the severity of typhoid fever in a sample of the Iraqi population. Materials and Methods: Blood samples were collected from 52 patients suffering from typhoid fever that was previously diagnosed using conventional and genetic methods at Ibn Al-Baladi Hospital in Baghdad and 52 apparently healthy volunteers as a control group. DNA was extracted from peripheral blood and genotyped for NRAMP1 Intron 4 (469+14 G/C) / rs3731865 and NOD2 Exon 8 (2722 G/C) / rs2066845 single nucleotide polymorphism (SNP) using the Nested T-ARMS PCR method. Results: explained that patients with at least one copy of the NOD2 (C) allele, whether (homozygote or heterozygote) had a high risk of severity of Typhoid fever with highly significant (P≤0.01), as well as results found that there was no association between the occurrence of NRAMP1 rs3731865 Intron 4 (469+14 G/C) with severity of Typhoid fever. Conclusion: The incidence of NOD2 Exon 8 (2722 G/C) rs2066845 SNP plus the C allele could be related to the severity of Typhoid fever in this particular Iraqi population.