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புற்றுநோய் அறிவியல் & சிகிச்சை

ஐ.எஸ்.எஸ்.என்: 1948-5956

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தொகுதி 3, பிரச்சினை 10 (2011)

கட்டுரையை பரிசீலி

A New Era of Liver Transplantation - Radioembolization, a Novel Therapy for Hepatocellular Carcinoma

Hima Bindu A

Liver failure is one of the major causes of death worldwide and a growing health problem. Now-a-days liver transplantation has been an accepted method to treat many liver disorders. Orthotopic liver transplantation (OLT) is a life-saving procedure for end-stage liver failure. Liver transplantation has some complications involved such as immunosuppression, graft rejection and various side effects. Hepatocellular carcinoma (HCC) is one of the most frequently occurring malignancies and orthotopic liver transplantation is not recommended for patients with Hepatocellular carcinoma. Today, transplantation is entering a new era characterized by a growing interest in novel methods for the treatment of disease that do not necessarily require transferring solid organs between patients. Radioembolization (RE) with radiolabeled microspheres, generally Yttrium-90 microspheres is one such novel method. In this review, a brief emphasis on radioembolization has been described.
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A Compendium of Cancer Therapeutic Strategies and their Modality

Lakshmi Prasanna N and Sathish Kumar D

The main objective of cancer therapy is to prop up the death of cancer cells without any damage to surrounding healthy tissue. Our knowledge of molecular changes in cancer cells has enhanced the development of various therapeutic strategies to treat cancer cells. Now we are in an ideal position to utilize our knowledge of cancer cell biology in the designing of novel cancer therapies. This review is to highlight various specific and selective approaches (Chemotherapy, Radiotherapy, Surgery, Biological therapy) to understand its modality and current progress in cancer treatment.

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Risk Factors in Hepatocellular Carcinoma

Naga Anusha P

Hepatocellular carcinoma is the fifth most common cancer in the world. The aim of this study was to identify the possible risk factors causing HCC. Certain metabolic diseases like hepatitis B, Hepatitis C infection lead to liver cancer without causing liver cirrhosis and increases risk of HCC by 27 fold. Cirrhosis itself is an independent risk factor of inducing HCC by 5-fold. Drugs used for the treatment of diabetes have shown to cause HCC. Certain toxins like aflatoxins increase the risk of liver cancer. Anabolic steroids are known to cause HCC by mimicking the action of some hormones. Some of organic and inorganic compounds like vinyl chloride and Arsenic cause HCC. This article summarize the risk factors of Hepato Cellular Carcinoma.

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Vaccine Potentiality and Stem Cells Enhancing Cure to Cancer

Parthasarathi D and Palki D

Vaccine potentiality and stem cell therapy is the new development in curing the Cancer. There are different types of cancer and different curing methods are being discussed by different scientist. The new diagnostic methods using DNA vaccine, adjuvants and target oriented cells methods are used in a descriptive method. The stem cell therapy also enhancing in identifying the site of tumour regenesis and curing the tumour by inducing different target oriented cells like chemokines and interleukin (IL). Beside these mesenchymal stem cells also regenerates the new cell lines for new target oriented cells. Hence no doubt at molecular level, the alteration of stem cell self-renewal pathways has been recognized as an essential step for cancer stem cells transformation. Influencive study and therapy will help to eradicate the disease and vaccines or stem cells will be new era in pharmaceuticals for Cancer.

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A Brief Assessment on Cervical Cancer

Soumya D and Arun Kumar R

The incidence of cervical cancer is most common in underdeveloped countries than developed countries. Cervical cancer is the third most common gynecologic malignancy worldwide. Cervix is the lower part of the uterus, the structure that dilates during childbirth to allow the baby to traverse the birth canal. This cancer is caused by human papilloma virus, a common sexually transmitted virus. Cervical cancers start in the squamous cells on the surface of the cervix. Cervical cancer can be prevented if precancerous lesions are identified early and treated promptly. Pap smears can help detect precancerous changes, which can be treated before they turn into cervical cancer. Treatment of cervical cancer relies upon on the stage of the cancer. Some Complications for the treatment of cervical cancer such as Surgery and radiation can create problems with sexual, bowel, and bladder function. Several preventive measures have been discussed in the present article.

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Organ Specific Cancers - Recent Advances in Diagnosis and Treatment

Shalini G, Remya RS, Gayathri G, Vishalakshi V and Phaneendra M

Cancer is one of the leading causes of death all over the world. Organ Specific Cancers are cancers named baseing on the location of cancer in the body organ. Its incidence is showing an increasing trend in various parts of the earth and has been a significant public health problem despite advances in the understanding of the molecular and cellular events that underlie. This review aims to update the current related information about organ specific cancers and provide a further understanding about their diagnosis and treatment.

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Functional Similarity of Anticancer Drugs by MTT Bioassay

Takaki Hiwasa,Takanobu Utsumi, Mari Yasuraoka, Nana Hanamura, Hideaki Shimada, Hiroshi Nakajima, Motoo Kitagawa, Yasuo Iwadate, Ken-ichiro Goto, Atsushi Takeda, Kenzo Ohtsuka, Hiroyoshi Ariga and Masaki Takiguchi

We prepared normal or Ha-ras-transformed NIH3T3 cells transfected stably or transiently with various tumorrelated genes. The chemosensitivity of the transfected clones to 16 anticancer drugs was compared to the parental control cells using the MTT assay. The chemosensitivity changes induced by transfected genes were calculated and expressed numerically as the Drug Chemosensitivity Index (DCI). High DCI values (indicating resistance) were frequently observed in cells expressing C/EBP?, C/EBP?, p53, p21, PTEN, dominant-negative MDM2, caspases, HSP90, COUP-TF1 and decorin. In contrast, transfectants expressing ras, src, erbB2 and calpastatin had low DCI values, indicating increased sensitivity. Thus, it may be possible to predict the sensitivity of cancer cells toward anticancer drugs based on the expression levels of these genes. We then performed a regression analysis of DCI values between anticancer drugs. The correlation coefficients (r) were relatively high between cisplatin, camptothecin, mitomycin C and etoposide, suggesting that the mechanisms of action of these drugs are similar. The r values of aclarubicin, vincristine, taxol and cytarabine were low, suggesting that each of these drugs has a different and unique effect. This analysis may provide a rationale for design of combination chemotherapy regimens.

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Differential Gene Expression Pattern of Transforming Growth Factor Beta-1 in Early and Advanced Breast Cancers

Heena V Dave, Manoj J Shah, Shilin N Shukla and Sunil N Trivedi

Background: Transforming Growth Factor Bs (TGF-?s) are pluripotent polypeptides that switch function from growth suppressor to promoter during breast tumorigenesis. This integral function in tumor progression offers it as an attractive target of cancer therapy. Amongst the three mammalian isoforms, TGF-?1 is the most potent, abundant and is considered to be the representative of TGF-? pathway. Higher circulating TGF-?1 is known to affect prognosis, increase relative risk of recurrence and reduced survival in breast cancer. Altered gene expression is determined in breast cancer cell lines; however it is less explored in clinical breast cancer. Methods: We investigated expression of TGF-?1 with an aim to explore its utility as biomarker. TGF-?1 gene expression was determined from breast cancer patients (N=118) using Real-Time PCR. The relative quantitation was determined by ddct method and differences were expressed as mean fold change (MFC) using GAPDH as endogenous control and adjacent normal tissue of each patient as calibrator. TGF-?1 gene expression was correlated with clinicopathologic prognosticators. Relapse-free and overall survival were assessed by Kaplan-Meier Survival analysis with log-rank test. Results: TGF-?1 mRNA was downregulated in early stage tumors (1.46 fold) whereas it was upregulated in advanced stage tumors (1.60 fold; p=0.05). Higher downregulation was seen in perimenopausal- than postmenopausal- patients (p=0.022). Node positive and node negative patients exhibited differences in early and advanced tumors (p=0.00001). Ductal carcinoma showed highest downregulation however, linear correlation was seen with grade+++ stromal involvement. Reduced disease-free survival (DFS) was noted in tumors with downregulation and advanced stage than early stage patients. Conclusion: We conclude that downregulation of TGF-?1 is associated with poor disease-free survival. TGF-?1 may play a significant role in the invasiveness and metastatic potential of breast cancer. The magnitude of downregulation is believed to be responsible for disease progression and can be used as predictive and prognostic marker.

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Extracts of Five Medicinal Herbs Induced Cytotoxicity in Both Hepatoma and Myeloma Cell Lines

Hanaa I. Hassanein, Eman G. El-ahwany, Faten M. Salah, Olfat A. Hammam, Laila Refai and Manal Hamed

The aim of this study is to assess the effect of the crude methanol extracts of five herbs (Pelargonium zonale, Terminalia bellerica, Philodendron selloum, Ulmus pumila and Ulmus parvifolia) on human hepatoma and murine myeloma cell lines. Assessment included in vitro neutral red cytotoxicity assay and cytopathological diagnosis. IC50 values obtained in both cell lines using neutral red assay showed that the plant extracts of both Terminalia bellerica and Philodendron selloum, were the most effective in inducing cytotoxicity in HepG2, IC50 (16.25±0.20 μg/ ml, 17.51±0.70 μg/ml respectively). The result showed that there was no significant difference in the IC50 between the different plants extract in Myeloma cell line. However, in hepatoma cell line, the IC50 of both Terminalia bellerica and Philodendron selloum were significantly lower (p< 0.01) than the IC50 of Ulmus pumila, Ulmus parvifolia and Pelorgonium zonale. The results indicated that the in vitro NR assay of cytotoxic activities induced by plant methanol extracts were supported by the cytopathological changes on the same population of cells. Conclusions: Neutral red cytotoxicity assay is a suitable test for screening anti-cancer potential of natural products materials. The present results showed that Terminalia bellerica and Philodendron selloum methanol extracts induced cytotoxicity on HepG2 cells. The identification of the effect of individual constituents of each plant methanol extract recommended. In vivo study on experimental level is needed to verify the mechanism of action.

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Intra-arterial Combination Chemotherapy with Maximum Transurethral Resection of Bladder Tumour for T1 Grade 3 and T2--3N0M0 Bladder Cancers

Kaoru Nemoto, Narumi Tsuboi, Takafumi Miura, Go Shioji, Hiroshi Kawamata, Susumu Okada, Yoshiharu Ohaki, Ryoji Kimata and Yukihiro Kondo

Purpose: We evaluated the clinical outcomes following intra-arterial chemotherapy with maximum transurethral resection of bladder tumour (TURBT) for patients with T1 grade 3 (G3) and T2--3N0M0 bladder cancers. Material and methods: Patients were 27 males and 7 females with a median age of 63.6 years. With the cooperation of an interventional radiologist, cisplatin (100 mg/m2), methotrexate (30 mg/m2) and adriamycin (20 mg/ body) were administered via a catheter in 2 cycles every 4 weeks. Results: The 5-year cancer-specific survival rate in T1 G3, T2 and T3 was 100.0%, 57.3% and 50.0%, respectively. In T2--3N0M0 cases, complete response (CR) and non-CR were seen in 13 (46.4%) and 15 cases (53.6%), respectively. Response to treatment proved to be the most significant prognostic predictor of cancerspecific survival by multivariate analysis in T2--3N0M0 cases. T2--3N0M0 cases with ?2 prognostic predictors at staging TURBT (age >70 years, male, size >3 cm and the presence of hydronephrosis) had an unfavourable outcome. There was a statistical association between the number of prognostic predictors at staging TURBT and response to treatment. Conclusion: These results suggest that our protocol prevents disease progression in T1 G3 cases, but that it is not suitable for T2--3N0M0 cases with ?2 prognostic predictors at staging TURBT.

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