Publications by authors named "Behzad Khademi"

18 Publications

  • Page 1 of 1

Mucoepidermoid Carcinoma Ex Pleomorphic Adenoma of Lacrimal Gland: Case Report and Review of Literature.

Ophthalmic Plast Reconstr Surg 2022 Aug 8. Epub 2022 Aug 8.

Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.

Carcinoma ex pleomorphic adenoma (Ca ex PA) is defined as an infiltrative carcinoma arising from a primary or recurrent benign pleomorphic adenoma. Ca ex PA with the histologic subtype mucoepidermoid carcinoma is extremely uncommon. Only 2 previous reports in the lacrimal gland have been documented. We reported a 55-year-old lady with a firm, solid, nontender mass in the supralateral quadrant of the right orbit at the area of the lacrimal gland. After wide excision of mass, pathology revealed high-grade mucoepidermoid carcinoma Ex pleomorphic adenoma. To reduce tumor recurrence 60 Gray radiation was delivered to the orbital cavity. She is still tumor-free 1 year after completion of treatment.
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http://dx.doi.org/10.1097/IOP.0000000000002258DOI Listing
August 2022

Short- and Long-term Patient Satisfaction and Complications in 650 Endoscopic Forehead Lift Procedures.

Ophthalmic Plast Reconstr Surg 2022 Mar-Apr 01;38(2):138-145

Eye and Skull Base Research Centers, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Science, Tehran, Iran.

Purpose: The aims are to compare short- versus long-term patient satisfaction and report temporary versus permanent complications in 650 patients with endoscopic forehead lift procedure (EFL).

Methods: This is a retrospective study on all of the consecutive patients with EFL. Patients with previous trauma and surgery and less than 2 years follow up were excluded. Short- (6 months) and long-term (≥2 years) patient satisfaction (visual analog score [VAS], 0-100) were recorded. Patients' perspectives on temporary versus permanent complications were also documented.

Results: Mean age and follow up were 46.4 and 7.1 (2-13) years, respectively. Long-term satisfaction (79.9) was significantly lower than the short term (96.6). The long-term satisfaction decreased in 95.7%, increased in 2.7%, and remained the same in 1.6% of the patients. Intraoperative skin laceration occurred in 3 patients (0.5%). Mean time of forehead numbness recovery was 2.3 months. Temporary complications were itching (13.7%), headache (6.3%), unilateral facial nerve palsy (5.8%), acne (3.2%), and remained staples (1.7%). Permanent complications included undercorrection (7.1%), alopecia (4.2%), forehead irregularities (2.3%), surprised look (2.2%), incision site complications (2%), and glabellar depression (0.9%). Reoperation (1.2%) was performed for undercorrection and alopecia. While short-term satisfaction was significantly lower in patients with temporary facial nerve paresis, long-term satisfaction was lower in patients with undercorrection and reoperation.

Conclusion: A high satisfaction scores of 96.6 and 80 were observed in the short- and long-term follow up after the EFL. Frequency of temporary and permanent postoperative complications was 30.3% and 15.8%. Reoperation rate was 1.2%.
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http://dx.doi.org/10.1097/IOP.0000000000002003DOI Listing
April 2022

Comparison of the Effectiveness of Onion Extract, Topical Steroid, and Petrolatum Emollient in Cosmetic Appearance of Upper Blepharoplasty Scar.

J Curr Ophthalmol 2020 Oct-Dec;32(4):408-413. Epub 2020 Dec 12.

Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To compare the effectiveness of onion extract, topical steroid, and petrolatum emollient in the prevention of scars in cases who underwent bilateral upper eyelid blepharoplasty.

Methods: A prospective, interventional, comparative, double-blinded case series was designed on cases who underwent upper lid blepharoplasty. After suture removal (1 week following the surgery), the eyelids of participants were randomly allocated into the three groups: The first group used onion extract on the right eyelids ( = 18), and the second group used topical steroid on the right eyelids ( = 19). In the third group, the control group, petrolatum emollient was used on the left eyelids ( = 37) of the first and second group's cases. They used drugs for 2 months and were evaluated by the Manchester Scar Scale (MSS) objectively by two graders who were blinded to the type of medication. MSS evaluates five different characteristics of the scar in addition to the Visual Analog Scale (VAS). These characteristics include color, distortion, contour, texture, and transparency. VAS scores the overall scar appearance which ranged among 0-10. The sum of the scores for the five different parameters, and VAS was calculated, analyzed, and compared among the groups.

Results: A total of 37 cases (74 eyelids) who underwent bilateral upper blepharoplasty were included. The mean ± standard deviation (SD) of age was 51.94 ± 9.26 years, 49.40 ± 9.37 years, and 47.00 ± 9.06 years in the onion extract, topical steroid, and petrolatum emollient groups, respectively ( = 0.275). There were no statistically significant differences in the mean ± SD of the sum of the MSS scores among the three groups ( = 0.924) or between the onion extract and topical steroid groups ( = 0.951). Furthermore, the color, distortion, contour, texture, transparency, and VAS scores were not statistically significantly different among the three groups or between the onion extract and topical steroid groups (P > 0.05).

Conclusion: There were no significant differences among these three groups of drugs regarding the appearance of the upper blepharoplasty scar.
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http://dx.doi.org/10.4103/JOCO.JOCO_39_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861112PMC
December 2020

Postoperative Blepharoptosis After Pars Plana Vitrectomy Procedure.

Ophthalmic Plast Reconstr Surg 2021 Sep-Oct 01;37(5):431-434

Eye and Skull Base Research Centers, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Purpose: To describe the frequency of blepharoptosis and factors affecting it after the pars plana vitrectomy (PPV) procedure.

Methods: In a prospective study, patients were recruited consecutively from October 2016 to June 2018. Upper eyelid margin reflex distance 1 and 2 (MRD1 and 2), upper eyelid crease height, and levator function were measured before, 1 and at least 6 months after surgery by the same investigator. Clinical and Clinically significant ptosis were defined as ≥0.5 and ≥2 mm drop of MRD1.

Result: There were 60 eyes from 57 patients. The majority of surgeries were performed by the fellows (63.3%, 38/60) and under general anesthesia (95.0%, 57/60). Clinical and clinically significant ptosis following PPV were 47.2% (25/53) and 11.3% (6/53) at the last follow up (at least 6 months), respectively. MRD2 (p = 0.389) and eyelid crease height (p = 0.057) did not significantly change. Surgeons' level, time of the procedure and other variables were not significantly impacting the frequencies.

Conclusion: Persistent clinically significant ptosis was observed in 11% of patients undergoing PPV. No variable was significantly associated with persistent postoperative ptosis after PPV.
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http://dx.doi.org/10.1097/IOP.0000000000001890DOI Listing
October 2021

Techniques of Eyebrow Lifting: A Narrative Review.

J Ophthalmic Vis Res 2020 Apr-Jun;15(2):218-235. Epub 2020 Apr 6.

Eye and Skull Base Research Centers, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.

None of brow lift techniques are completely satisfactory because of their limited effectiveness, lack of longevity, and potential complications. The aim of this study was to provide a comprehensive review of the literature on the pros and cons of the most popular techniques in brow and forehead lift. Relevant original articles in the PubMed database (English language) were sought using the search terms "eyebrow lift", "forehead lift", "periorbital rejuvenation", "eyebrow ptosis", "blepharoplasty and eyebrow change", "surgical eyebrow lift", and "non-surgical eyebrow lift", No date limitation was considered. Titles and abstracts were scanned to include the most pertinent articles. Subsequently, full texts of included articles (111 articles) were skimmed and finally 56 references were selected for the review. A narrative synthesis of data was finally undertaken with particular attention to the indications, techniques, and common complications of the eyebrow lift procedures. Ten popular techniques including two non-surgical methods (Botulinum toxin A and soft tissue fillers) were reviewed in this article. In general, non-surgical methods of forehead/brow lift are temporary, need less experience and correction would be easier should any complication occur. Surgical methods are divided into three categories: trans-blepharoplasty eyebrow lift, direct eyebrow lift, and trans-forehead eyebrow/forehead lift. Currently, the most popular method is the endoscopic forehead lift approach even though its longevity is limited. Direct brow-lift is particularly useful in patients with facial palsy and those who are more likely to be accepting of the scar (male gender, high forehead hair line).
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http://dx.doi.org/10.18502/jovr.v15i2.6740DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151508PMC
April 2020

Endoscopic-Assisted Lateral Orbitotomy for Large Orbital Roof Dermoid Cysts With Dural Invasion.

Ophthalmic Plast Reconstr Surg 2020 Sep/Oct;36(5):508-511

Eye Department, Eye and Skull Base Research Center, The Five Senses Institute, Iran University of Medical Science, Tehran, Iran.

Purpose: To demonstrate the technique and report the results of endoscopic-assisted lateral orbitotomy for 6 patients with huge intraorbital dermoid cyst causing orbital roof bone erosion and dural invasion.

Methods: Patients had unilateral cystic tumor with proptosis and hypoglobus for more than 6 months. There was no compressive optic neuropathy. Lateral orbitotomy procedure was performed from 2004 to 2016 by 1 surgeon. Cysts were dissected, and fluid content was aspirated to reduce the size. Solid contents were then suctioned, its cavity was repeatedly irrigated, and orbital part of epithelial lining was removed. The remained epithelial lining and keratinized content at the orbital roof (abutting the dura) were removed using the rigid endoscope lenses (4 mm, 0° and 30°) and curettage. Orbital tissue was pulled away from the roof (inferior) by an assistant surgeon to make a space for introducing the lens and curette. The surgical field was frequently irrigated. No orbital drain was used, and all the patients were discharged on the same day after 8-10 hours of observation. Skin sutures were removed 1 week later.

Results: They were 4 men and 2 women with age range of 19-48 years. A large superolateral orbital tumor with roof erosion and dural invasion was observed on imaging. Procedures were performed uneventfully. Dermoid was the pathological diagnosis. While one patient lost to follow up after 1 week, others had 6-18 months follow-up time with no recurrence.

Conclusions: Endoscopic-assisted lateral orbitotomy approach provided a good field of view, illumination, and magnification to totally remove all the content and epithelial lining of very large orbital roof dermoid cysts with dural invasion.
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http://dx.doi.org/10.1097/IOP.0000000000001661DOI Listing
March 2021

Diabetic versus non-diabetic rhino-orbito-cerebral mucormycosis.

Mycoses 2020 Jun 18;63(6):573-578. Epub 2020 Apr 18.

Eye and skull base Research Centers, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Objective: To compare the characteristics and outcomes of rhino-orbito-cerebral mucormycosis (ROCM) in diabetic versus non-diabetic patients.

Method: It is a retrospective comparative case series on consecutive patients with biopsy-proven ROCM. Systemic and ophthalmic manifestations, imaging, management and final outcomes were compared between diabetic versus non-diabetic ROCMs referred the eye clinic of a university-based hospital (2008-2016).

Results: Forty-three diabetics (55 eyes) with mean age of 54.6 (SD:12.5) years and 20 non-diabetics (24 eyes) with mean age of 57.5 (SD:13.8) years were enrolled. Patients' survival was observed in 51% of diabetics and 70% of non-diabetics (P = .1). The mortality rate was 7.4 times (CI95%: 1.85-29.96) higher in diabetic ROCM treated with non-liposomal amphotericin (P = .01). Exenteration did not significantly change the mortality rate in either group. Globe survival was 40% and 50% in diabetics and non-diabetics (P = 1), respectively. Vision survival was observed in 20% of diabetics and 37% of non-diabetics (P = .2).

Conclusion: Patients', globe and vision survivals were not different between diabetic and non-diabetic patients with ROCM. They were 51%, 40% and 20% in diabetic and 70%, 50% and 37% in non-diabetic ROCM.
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http://dx.doi.org/10.1111/myc.13078DOI Listing
June 2020

Pressure ulcer following circumferential head dressing.

Orbit 2020 Oct 30;39(5):350-356. Epub 2020 Jan 30.

Eye Research Center, The Five Senses Institute, Iran University of Medical Sciences , Tehran, Iran.

Purpose: To report four patients with forehead pressure ulcer (PU) following encircling head dressing and review the literature.

Methods: Uneventful endoscopic forehead lift procedure was performed with moderate skin elevation in three patients. Left upper eyelid crease incision was made to remove the sub-brow dermoid cyst uneventfully in one patient. All procedures were performed under general anesthesia. Mixed topical antibiotic and steroid ointments were placed on the incision sites before putting the encircling forehead dressing (using gauze and elastic bandage). The dressing was then removed on the first postoperative examination.

Results: Forehead and eyebrow PUs were observed on the first follow-up visit (16-72 h) after removing the dressing. Patients were otherwise healthy. They did not have significant pain or burning postoperatively. Management included pressure release, wound debridement, daily dressing, topical antibiotic and steroid, and silicone-based anti-scar cream. None had infected ulcer and all except one ended up with atrophic scar in the last follow-up (2-14 months). External pressure and shearing forces were assumed to be the main causative factors, even though reperfusion injury could contribute in the development of PU.

Conclusion: Encircling head dressing can cause PU and result in scar formation in healthy immunocompetent patients. If there is a low risk of postoperative hematoma, encircling dressing should be avoided. Early loosening of the dressing and frequent examination of the skin are the best preventive and diagnostic measures. Treatment includes pressure removal, daily debridement, and topical medications.
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http://dx.doi.org/10.1080/01676830.2020.1719521DOI Listing
October 2020

Surgical management of congenital nasolacrimal duct obstruction; one procedure for all versus all procedures for one.

Curr Opin Ophthalmol 2019 Sep;30(5):364-371

Eye Department, Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Purpose Of Review: After failed conservative management, most clinicians treat congenital nasolacrimal duct obstruction (CNLDO) in a conventional stepwise fashion: starting with probing, then repeat probing, next silicone intubation and/or balloon dilatation, and finally dacryocystorhinostomy. This approach is based on the patient's age and previously failed procedures and recruits 'one procedure for all' CNLDO. A newly introduced approach is based on the type of obstruction and recruits 'all procedures for one' CNLDO. The aim of this review is to examine the best available evidence regarding CNLDO management.

Recent Findings: Recent articles support the concept that through intraoperative evaluation of obstruction in CNLDO, clinicians may predict probing failure and instantaneously employ more appropriate treatment modalities. This review addresses whether an age-based approach should be changed into a one-stage obstruction-based approach.

Summary: An age-based approach treats CNLDO as a homogeneous disease and thus treats all patients with one predetermined procedure. A one-stage obstruction-based approach, however, considers CNLDO to be a heterogeneous disease, and therefore allows recruitment of all procedures simultaneously and selects the best intraoperatively. It may allow replacement of the conventional stepwise approach to CNLDO treatment provided that randomized trials verify its efficacy, safety, and cost-effectiveness.Video abstract http://links.lww.com/COOP/A30.
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http://dx.doi.org/10.1097/ICU.0000000000000584DOI Listing
September 2019

Supine Test: A New Test for Detecting Lacrimal Gland Prolapse Before Upper Blepharoplasty.

Ophthalmic Plast Reconstr Surg 2019 Nov/Dec;35(6):581-585

Eye Department, Eye Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Purpose: To introduce a new (Supine) test and assess the values of lateral eyelid bulging for diagnosis of lacrimal gland (LG) prolapse before upper blepharoplasty.

Methods: In a prospective case series (2011-2017), lateral eyelid bulging and Supine Test were recorded, preoperatively. Lacrimal gland prolapse was graded as mild (<4 mm), moderate (4-7 mm), and severe (>7 mm). A few spots of cautery on LG capsule was performed in patients with bilateral mild and suture repositioning in unilateral or bilateral moderate and severe LG prolapse. Patients with asymmetric LG prolapse were treated based on more severe grade, bilaterally.

Results: Included were 1,207 patients. Frequency of positive Supine Test (11.8%, 142/1,207) increased from almost 10% in patients less than 41 years of age to 15% in more than 60 years of age. Their mean age was significantly older, and 53.2% showed asymmetric LG prolapse. Septum was just opened in patients with positive Supine Test, and all had LG prolapse of ≥3 mm (mean: 5.6 mm, range: 3-14 mm). Mild LG prolapse, moderate LG prolapse, and severe LG prolapse were observed in 22.5%, 62.6%, and 14.7% of the patients, respectively. Mean follow-up time was 22 months (12-60 months). Recurrence was observed in 1 patient (bilateral) after suture repositioning. Lateral eyelid bulging had a high negative (96.2%) and low positive (30.6%) predictive value when compared with the Supine Test.

Conclusions: Positive Supine Test means LG prolapse of ≥3 mm (100% positive predictive value). Negative lateral eyelid bulging was highly predictive of no LG prolapse.
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http://dx.doi.org/10.1097/IOP.0000000000001397DOI Listing
January 2020

Effectiveness of Topical Onion Extract Gel in the Cosmetic Appearance of Blepharoplasty Scar.

J Clin Aesthet Dermatol 2018 10 1;11(10):31-35. Epub 2018 Oct 1.

Drs. Owji, Khademi, and Khalili are with the Poostchi Ophthalmology Research Center at the Shiraz University of Medical Sciences in Shiraz, Iran.

Topical onion extract gel is commonly used in commercial anti-scar medications. The purpose of this study was to evaluate the effectiveness of topical onion extract gel on the appearance of blepharoplasty scars and to compare the results of its use to those of petroleum jelly. The participants enrolled in this prospective, double-blind study were randomly treated with either topical onion extract gel or petroleum jelly. The products were applied twice daily for two months following suture removal. Patients were evaluated objectively using the Manchester Scar Scale at the end of treatment. Six months after surgery, a follow-up phone interview was conducted. The study was carried out in the Khalili and Dastghaib Hospitals in Shiraz, Iran. Out of 43 participants who had upper blepharoplasty, 26 patients completed the follow up. The Manchester Scar Scale evaluates five different characteristics of scar: color (score: 1-4), distortion (score: 1-4), contour (score: 1-4), texture (score: 1-4), and transparency (score: 1-2). A visual analogue scale (VAS) was also used to quantify the overall scar appearance on a range of 0 to 10 (with the highest number indicating the worst appearance). The scores for the five different parameters and the VAS were calculated and compared. There was no statistically significant difference in overall cosmetic appearance objectively and/or subjectively between the two sides ( value: 0.25). Topical onion extract gel was ineffective in improving overall blepharoplasty scar appearance when compared with a petroleum-based ointment.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6239165PMC
October 2018

The Relationship between Primary Acquired Nasolacrimal Duct Obstruction and Gastroesophageal Reflux.

Curr Eye Res 2018 10 11;43(10):1239-1243. Epub 2018 Jul 11.

a Department of Ophthalmology , Shiraz University of Medical Sciences , Shiraz , Fars , Iran.

Purpose/Aim of the study: To evaluate if there is any relationship or coincidence between gastroesophageal reflux disease (GERD) and primary acquired nasolacrimal duct obstruction (PANDO).

Material And Methods: We enrolled 180 patients with PANDO, confirmed by positive regurgitation on sac squeezing or by irrigation test. In the control group, any patient with lacrimal drainage obstruction was excluded. For diagnosis of gastroesophageal reflux we used a (Gerd Q) questionnaire by R. Jones.

Results: According to Gerd Q, prevalence of gastroesophageal reflux in patients with PANDO was 20% (36 out of 180 patients) and in the control group, it was 10.6% (19 out of 180 patients), which was significantly higher in the presence of PANDO (p valve = 0.013). In women, 28 patients (23.5%) in the case group versus 13 patients (10.9%) in the control group has gastroesophageal reflux (p value = 0.01), which was not significant among men (p value = 0.870). When we considered age as an independent variable, results reveled significant value only for patients over 60 years old (p value = 0.008).

Conclusion: The prevalence of gastroesophageal reflux disease was significantly higher in patients with PANDO. This statistical relationship was greater among women and patients over 60 years old. In this study, we found an association between GERD and PANDO.
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http://dx.doi.org/10.1080/02713683.2018.1485948DOI Listing
October 2018

Teratogenic Effects of Intravitreal Injection of Bevacizumab in a Pregnant Rat Model.

Iran J Pharm Res 2017 ;16(2):670-676

Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.

In this research study, to investigate teratogenic effect of intravitreal injection of bevacizumab in pregnant rat model, twenty seven female Wistar rats were inseminated. Pregnant rats were divided into 6 groups (three groups as case and three as control groups). Each case and control groups were divided according to the day of intravitreal injections (day 2, 10 and 18). Rats in the case groups received 4 µL intravitreal injection of bevacizumab and the control groups received the same volume of distilled water. The tail and umbilical cord length in case groups 1, 2, and 3 did not display any significant differences compared to their control groups. The fetal weight was significantly lower in the case groups 1 (p>0.001) and 2 (p>0.001) compared to their control groups. Furthermore, the placental weight was only lower in the case group 1 (p>0.001). Case group 2 had a shorter crown rump length in comparison with its control group (p=0.029). Morphological investigations showed two abnormal cases of gastroschisis in group 1 and a case of a cleft in the skull in one of the rats in case group 2. The results show that intravitreal bevacizumab has developmental effect when administered in the early stages of pregnancy; but it is safe when administered in the last week of pregnancy in rats.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603876PMC
January 2017

Stromal cell derived factor-1, CXCR4 and CXCR7 gene transcripts in pterygia.

J Curr Ophthalmol 2017 Mar 27;29(1):28-32. Epub 2016 Dec 27.

Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: Pterygium is a pathologic process with angiogenic and tumor cell like characteristics. Chemokine and chemokine receptors may contribute to the formation and growth of pterygia. The aim of this study was to assess the expression of stromal cell derived factor (SDF)-1, as an angiogenic chemokine, and its receptors, CXCR4 and CXCR7, gene transcripts in pterygia.

Methods: RNA was extracted from tissue samples of 33 patients with primary pterygium and 35 volunteers with conjunctiva as the control group. Then the mRNA expression of SDF-1, CXCR4, and CXCR7 was assessed through quantitative Real Time PCR method using appropriate primers.

Results: SDF-1 and both receptors transcripts had significantly higher expression in pterygia samples compared to the control group ( < 0.05). The ratio of CXCR7 transcript expression to CXCR4 was 26.4 in patients while it was 11 in controls.

Conclusion: As SDF-1 and its receptors, CXCR4 and CXCR7, were up-regulated in pterygia, SDF-1/CXCR4/CXCR7 axis may contribute to pterygium formation which can be possibly restrained by down-regulating this signaling pathway.
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http://dx.doi.org/10.1016/j.joco.2016.10.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362384PMC
March 2017

The orbital mass.

Int J Rheum Dis 2014 Mar 14;17(3):333-5. Epub 2014 Feb 14.

Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1111/1756-185X.12294DOI Listing
March 2014

Early Detection of Serum Levels of HER-2 in Patients with Head and Neck Squamous Cell Carcinoma.

Iran J Otorhinolaryngol 2013 Jun;25(72):161-8

Department of Otorhinolaryngology, Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shira, Iran.

Introduction: The presence of HER-2 has been shown to be a prognostic factor in many kinds of cancers, but its role in head and neck squamous cell carcinoma (HNSCC) is not still defined. The purpose of the current study is to investigate the role of HER-2 in HNSCC and its correlation with various clinicopathologic parameters.

Materials And Methods: Peripheral blood samples were obtained from 17 healthy volunteers and 69 patients with HNSCC before curative surgery. The HER-2 level was determined in each sample sandwich by ELISA. Statistical analysis was performed using an independent t-test, one-way ANOVA, and the Duncan procedure.

Results: Mean HER-2 serum levels were higher in patients with HNSCC compared with healthy controls, although the difference was not statistically significant (3.85ng/ml vs. 3.75ng/ml; P>0.05). The mean serum level of HER-2 in patients with was higher in patients with lymph node involvement, metastasis, invasion, tumor size ≥2 cm, and stage>1, although the differences were not statistically significant (P>0.05).

Discussion: Mean HER-2 serum levels in patients with tumor size T3 and higher were higher than those from patients in stage T1 and T2.over expression of these receptor translate into disease progression, growth and invasiveness, with the increase serum HER-2 levels in such patients offering some support for this theory.

Conclusion: In this study the mean HER-2 serum level in patients with HNSCC was found to be greater in comparison with the healthy control group, although the difference was statistically insignificant. From the analysis of the results of the current study we have come to the conclusion that by increasing sample size the rising of the serum HER-2 level in patients with HNSCC can be meaningful. Apart from this, the role of HER-2 as a tumor marker in patients with HNSCC is still controversial and needs further studies to clarify the significance of this biomarker for early detection or screening for HNSCC.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846229PMC
June 2013

Intracellular CTLA4 and regulatory T cells in patients with laryngeal squamous cell carcinoma.

Immunol Invest 2013 19;42(2):81-90. Epub 2012 Dec 19.

Cancer Immunology Group, Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

To explore if the increased percentages of Regulatory T (Treg) cells, as well as, overexpression of Cytotoxic T-Lymphocyte Antigen-4 (CTLA-4) are involved in laryngeal-squamous cell carcinoma (SCC), 45 patients with laryngeal-SCC and 27 healthy controls were enrolled. Flow cytometry was performed to investigate, in the peripheral blood, the prevalence of CD4+CD25+FoxP3+ Treg cells, as well as, surface and intracellular expression of CTLA-4 by the main lymphocyte subsets (CD4+, CD8+ and CD19+). The results indicated intracellular (In)CTLA4 with considerable higher expression in the CD8+ lymphocytes among patients with laryngeal-SCC compared with the control group (8.2 ± 8.7 versus 2.3 ± 3.5, P = 0.001). The mean percentage of InCTLA4+CD4+ and InCTLA4+CD19+ lymphocytes was also significantly higher in patients (8.7 ± 7.8 versus 4.4 ± 4.2, P = 0.018 and 0.6 ± 0.8 versus 0.2 ± 0.2, P = 0.024, respectively). With respect to surface (Sur)CTLA4, the difference between patients and controls was, however, significant only in the case of CD8+ lymphocytes (0.7 ± 0.6 versus 0.3 ± 0.3, P = 0.003, respectively). The percentage of Treg cells was observed to be significantly higher in patients (7.5 ± 6.3 and 3.2 ± 1.9, P < 0.0001). Furthermore, association analysis revealed the association of Treg cell increase with the higher tumor-size and lymphnode stage (P < 0.005). These data collectively suggest that patients with laryngeal-SCC may benefit from immunotherapy targeting CTLA4 and Treg cells.
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http://dx.doi.org/10.3109/08820139.2012.708376DOI Listing
July 2013
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