Publications by authors named "Sharareh Seifi"

20 Publications

  • Page 1 of 1

Clinical Manifestations of Patients with Coronavirus Disease 2019 (COVID-19) in a Referral Center in Iran.

Tanaffos 2020 Nov;19(2):122-128

Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Following the recent epidemic of coronavirus disease 2019 (COVID-19) in Wuhan, China, a novel betacoronavirus was isolated from two patients in Iran on February 19, 2020. In this study, we aimed to determine the clinical manifestations and outcomes of the first confirmed cases of COVID-19 infection (n=127).

Materials And Methods: This prospective study was conducted on all COVID-19-suspected cases, admitted to Masih Daneshvari Hospital (a designated hospital for COVID-19), Tehran, Iran, since February 19, 2020. All patients were tested for COVID-19, using reverse transcription-polymerase chain reaction (RT-PCR) assay. Data of confirmed cases, including demographic characteristics, clinical features, and outcomes, were collected and compared between three groups of patients, requiring different types of admission (requiring ICU admission, admission to the general ward, and transfer to ICU).

Results: Of 412 suspected cases, with the mean age of 54.1 years (SD=13.4), 127 (31%) were positive for COVID-19. Following the patients' first visit to the clinic, 115 cases were admitted to the general ward, while ten patients required ICU admission. Due to clinical deterioration in the condition of 25 patients (out of 115 patients), ICU admission was essential. Based on the results, the baseline characteristics of the groups were similar. Patients requiring ICU admission were more likely to have multiorgan involvement (liver involvement, P<0.001; renal involvement, P<0.001; and cardiac involvement, P=0.02), low O saturation (P<0.001), and lymphopenia (P=0.05). During hospital admission, 21 (16.5%) patients died, while the rest (83.5%) were discharged and followed-up until March 26, 2020. Also, the survival rate of patients, who received immunoglobulin, was higher than other patients (60.87% vs. 39.13%).

Conclusion: The mortality rate of COVID-19 patients was considerable in our study. Based on the present results, this infection can cause multiorgan damage. Therefore, intensive monitoring of these patients needs to be considered.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680520PMC
November 2020

Sleep Disorders and Mental Health in Menopausal Women in Tehran.

Tanaffos 2020 Jan;19(1):31-37

Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Sleep complaints are common problems in the general population and insomnia and sleep disorders place significant economic and social burdens on the community. Postmenopausal women are 2.6 to 3.5 times more likely to develop obstructive sleep apnea (OSA) compared to non-menopausal women. In this study, we evaluated sleep disorders and mental health in postmenopausal women.

Materials And Methods: This study was a descriptive cross-sectional study and the samples were selected from postmenopausal women above 50 years who had participated in a survey entitled, "Evaluation of Sleep Disorders among Adults in Tehran" in 2017. Cluster sampling method was applied with proportional allocation. A total of 4021 samples were collected, 2075 of which belonged to women. In addition, 174 out of 2075 samples were related to postmenopausal women over the age of 50. The data were analyzed using the statistical package IBM SPSS version 22.0. P-values less than 0.05 were considered significant.

Results: In this study, 118 (67.8%) women had insomnia for less than three months, and 23 (13.2%) women had insomnia for more than three months. The prevalence of STOPBANG parameters in this group of postmenopausal women was 37% and significantly related to Body mass index (BMI) and neck circumference at P < 0.001 and 0.006, respectively. There was no significant relationship between social dysfunction and insomnia. However, anxiety in General Health Questionnaire (GHQ) was significantly associated with insomnia, sleepiness, sadness, and irritability.

Conclusion: Our results indicate that the impact of insomnia symptoms, OSA comorbidity and mental disorders could extend far beyond. The use of urgent health care and quality of life issues is essential for long-term mental and physical well-being; if there is no treatment in the menopause population, there will be serious mental and physical complications.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569498PMC
January 2020

Promising effects of tocilizumab in COVID-19: A non-controlled, prospective clinical trial.

Int Immunopharmacol 2020 Nov 4;88:106869. Epub 2020 Aug 4.

Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Background: The clinical presentation of SARS-CoV-2 infection ranges from mild symptoms to severe complications, including acute respiratory distress syndrome. In this syndrome, inflammatory cytokines are released after activation of the inflammatory cascade, with the predominant role of interleukin (IL)-6. The aim of this study was to evaluate the effects of tocilizumab, as an IL-6 antagonist, in patients with severe or critical SARS-CoV-2 infection.

Methods: In this prospective clinical trial, 76 patients with severe or critical SARS-CoV-2 infection were evaluated for eligibility, and ultimately, 42 patients were included. Tocilizumab was administered at a dose of 400 mg as a single dose via intravenous infusion. Primary outcomes included changes in oxygenation support, need for invasive mechanical ventilation, and death. Secondary outcomes included radiological changes in the lungs, IL-6 plasma levels, C-reactive protein levels, and adverse drug reactions. The data were analyzed using SPSS software.

Results: Of the 42 included patients, 20 (48%) patients presented the severe infection stage and 22 (52%) were in the critical stage. The median age of patients was 56 years, and the median IL-6 level was 28.55 pg/mL. After tocilizumab administration, only 6 patients (14%) required invasive ventilation. Additionally, 35 patients (83.33%) showed clinical improvement. By day 28, a total of 7 patients died (6 patients in the critical stage and 1 patient in the severe stage). Neurological adverse effects were observed in 3 patients.

Conclusions: Based on the current results, tocilizumab may be a promising agent for patients with severe or critical SARS-CoV-2 infection, if promptly initiated during the severe stage.
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http://dx.doi.org/10.1016/j.intimp.2020.106869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402206PMC
November 2020

COVID19 Prevention & Care; A Cancer Specific Guideline.

Arch Iran Med 2020 04 1;23(4):255-264. Epub 2020 Apr 1.

National Cancer Control Secretariat, Ministry of Health and Medical Education, Tehran, Iran.

On March 11th 2020, the coronavirus outbreak was declared a pandemic by the WHO. One of the groups that is considered high risk in this pandemic are cancer patients as they are treated with a variety of immune system suppressor treatment modalities and this puts them in a great risk for infectious disease (including COVID-19). Therefore, cancer patients require higher level measures for preventing and treating infectious diseases. furthermore, cancer patients may bear additional risk due to the restriction of access to the routine diagnostic and therapeutic services during such epidemic. Since most of the attention of health systems is towards patients affected with COVID-19, the need for structured and unified approaches to COVID-19 prevention and care specific to cancer patients and cancer centers is felt more than ever. This article provides the recommendations and possible actions that should be considered by patients, their caregivers and families, physician, nurses, managers and staff of medical centers involved in cancer diagnosis and treatment. We pursued two major goals in our recommendations: first, limiting the exposure of cancer patients to medical environments and second, modifying the treatment modalities in a manner that reduces the probability of myelosuppression such as delaying elective diagnostic and therapeutic services, shortening the treatment course, or prolonging the interval between treatment courses.
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http://dx.doi.org/10.34172/aim.2020.07DOI Listing
April 2020

Cell Free Tumoral DNA Versus Paraffin Block Epidermal Growth Factor Receptor Mutation Detection in Patients with Non-Small Cell Lung Cancer.

Asian Pac J Cancer Prev 2019 Dec 1;20(12):3591-3596. Epub 2019 Dec 1.

Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran. Iran.

Increasing knowledge about the molecular profile of tumors has led to personalized treatment for achieving better outcomes in patients with nonsmall cell lung cancer (NSCLC). Currently, finding exact somatic genomic changes of tumor has gained great importance. On the other hand, crescendoing needs to actual tumor tissue at different time points during cancer treatment may produce major discomfort for NSCLC patients. Tumor genomes can be reconstructed by information obtained from circulating cell-free deoxyribonucleic acid (cfDNA) of peripheral blood. cfDNA may be represented as a suitable alternative test  for epidermal growth factor receptor (EGFR) mutation detection in these patients. This study aimed to assess validity of cfDNA in somatic EGFR mutation identification in Iranian NSCLC cases.

Methods: Somatic mutation of EGFR gene was studied in both tissue specimens and plasma. Then, mutations were detected by polymerase chain reaction(PCR) and sequencing.

Results: We observed a high concordance (90%) between tissue samples and cfDNA for EGFR gene mutation.  The sensitivity, accuracy, and positive precision value were 90%, 90% and 100%, respectively. A false negative rate of 10% was also demonstrated in this study.

Conclusion: We established sensitive methods for detecting EGFR gene mutation which may be very useful in clinical practice.
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http://dx.doi.org/10.31557/APJCP.2019.20.12.3591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173361PMC
December 2019

Circulating free DNA concentration as a marker of disease recurrence and metastatic potential in lung cancer.

Clin Transl Med 2019 Apr 18;8(1):14. Epub 2019 Apr 18.

Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: Plasma circulating cell-free (cf) DNA is regarded as a source of tumor DNA. Based on availability of blood tissue for the purposes of early detection of cancer and patients' follow-up, several studies have evaluated concentration of cf DNA in cancer patients in association with tumor features. In the present study, we assessed concentration of cf DNA in lung cancer patients with two commercial kits (MN and QIAGEN) to find whether it can be used as a prognostic biomarker.

Results: Primary cf DNA concentrations as measured by QIAGEN kit was significantly higher in patients who died in the follow-up period compared with alive patients (P = 0.007). Moreover, the concentrations as measured by both methods were higher in patients who experienced recurrence in the follow-up period compared with patients without recurrence (P = 0.008 and 0.007 for MN and QIAGEN kits respectively). Significant associations were also found between cf DNA concentrations and tumor stage (P = 0.005 and 0.02 for MN and QIAGEN kits respectively). Notably, cf DNA concentration was higher in metastatic tumors compared with non-metastatic tumors in association with number of involved organs. Based on the AUC values, both kits could differentiate metastatic cancers from non-metastatic ones with accuracy of 98%.

Conclusions: The current study highlights the accuracy of cf DNA concentrations for prediction of disease course in lung cancer patients.
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http://dx.doi.org/10.1186/s40169-019-0229-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473013PMC
April 2019

Thymoma Recurrence and its Predisposing Factors in Iranian Population: a Single Center Study.

Tanaffos 2019 Apr;18(4):355-364

Lung Transplantation Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Thymoma is relatively rare tumor. Prognosis and patients' outcome vary across different studies. We aimed to study the predisposing factors causing tumor recurrence in thymoma patients.

Materials And Methods: A total of 43 thymoma or thymic carcinoma patients treated at the National Institute of Tuberculosis and Lung Disease (NRITLD), Masih Daneshvari Hospital from September 2005 to January 2017 were evaluated. The primary endpoint was the progression free survival (PFS). The relation of predisposing factors to PFS was studied.

Results: Median age was 55 years old. The mean of follow-up duration was 22.9 months. The most prevalent pathology was thymoma unspecified. Pure red cell aplasia (n=3, 6.9%) was the most prevalent Para neoplastic syndrome. Most of the patients (n=23, 54%) were in stage III and IV Masaoka-Koga staging system. Disease progression was observed in 17 patients (39. 5%). Most recurrences occurred locally. None of demographic characteristics differed between patients who experienced disease recurrence and those who did not. After univariate and multivariate analysis, predisposing factor for disease progression was only Masaoka-Koga stage (P-value=0.015 and 0.031 respectively).

Conclusion: In this study, among different probable predisposing factors, only Masaoka-Koga stage had significant effect on disease recurrence. Large case-control studies may be required for better evaluation of risk factors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309889PMC
April 2019

A preliminary study to propose a diagnostic algorithm for PET/CT-detected incidental breast lesions: application of BI-RADS lexicon for US in combination with SUVmax.

Eur Radiol 2019 Oct 18;29(10):5507-5516. Epub 2019 Mar 18.

Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Department of Radiology, Shahid Beheshti University of Medical Sciences, Daar-Abad, Niavaran Ave., 19575-154, Tehran, 1956944413, Iran.

Objectives: To develop a diagnostic algorithm for positron emission tomography (PET)-detected incidental breast lesions using both breast imaging reporting and data system (BI-RADS) and maximum standardized uptake value (SUVmax) criteria.

Methods: Fifty-six PET-detected incidental breast lesions from 51 patients, which were subsequently investigated by breast ultrasound within 1 month of the PET study, constituted the study cohort and they were finally verified by tissue diagnosis or a 2-year follow-up. Based on the maximum specificity with sensitivity > 60.0% and maximum sensitivity with specificity > 60.0%, two SUVmax cutoff values were calculated at 2 and 3.7. BI-RADS ≥ 4 was considered as highly suspicious for malignancy. The diagnostic accuracies were estimated for SUVmax levels above or below the cutoff points combined with the BI-RADS suspicion level.

Results: Overall, 46 benign and 10 malignant lesions were studied. The diagnostic characteristics of SUVmax ≥ 2, SUVmax ≥ 3.7, and BI-RADS ≥ 4 were 80.0%, 60.0%, and 80.0% for sensitivity, 73.9%, 95.7%, and 92.7% for specificity, and 75.0%, 89.3%, and 90.2% for accuracy, respectively. When the SUVmax threshold was set at 2, combined with BI-RADS suspicion level, the sensitivity, specificity, and accuracy were 100.0%, 69.6%, and 75.0%, respectively. The results for SUVmax threshold set at 3.7 combined with BI-RADS were 90.0%, 91.3%, and 91.1% for the sensitivity, specificity, and accuracy, respectively. A diagnostic algorithm was accordingly generated.

Conclusion: The need for biopsy should be justified in low BI-RADS lesions presenting with high SUVmax at 3.7 or higher. The biopsy of patients with high B-IRADS and low SUVmax could be preserved.

Key Points: • A diagnostic algorithm was developed for PET-detected incidental breast lesions using both BI-RADS and SUVmax criteria. • Diagnostic performance was calculated separately and conjunctively for SUVmax ≥ 2, SUVmax ≥ 3.7, and BI-RADS ≥ 4. • The need for biopsy can be justified in BI-RADS < 4 lesions with SUVmax ≥ 3.7. Lesions with BI-RADS < 4 and indeterminate SUVmax (2 < SUVmax < 3.7) benefit from a short-interval follow-up. BI-RADS < 4 lesions with SUVmax < 2 may confidently be scheduled for routine screening.
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http://dx.doi.org/10.1007/s00330-019-06106-xDOI Listing
October 2019

Renal Disorders in Pulmonary Sarcoidosis Patients.

Iran J Kidney Dis 2019 Jan;13(1):21-26

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: The frequency of kidney disorders varies in pulmonary sarcoidosis patients. Since the prevalence of kidney disorders among Iranian sarcoidosis patients is uncertain, this study aimed to evaluate kidney disorders and associated manifestations in Iranian pulmonary sarcoidosis patients.

Materials And Methods: One hundred patients with confirmed granuloma as pulmonary sarcoidosis were studied for renal disorders. Size of urinary tract and the presence of renal stones were checked via clinical examination and urinary organ ultrasonography. Patients' 24-hour urine sample was examined for pH, calcium, protein (over 250 mg) and creatinine (over 1.4 mg).

Results: Thirty-three percent of the patients expressed renal disorders simultaneously.Uric acid in pulmonary sarcoidosis patients could be correlated with the probability of developing renal stone. In addition, 1,25-dihydroxyvitamin D levels above 30 ng/mL and uric acid levels above 7 mg/dL in urine were directly correlated with renal disorders in sarcoidosis patients.

Conclusions: Urinalysis is an easy and reliable method for assessing renal disorders in sarcoidosis patients. The current study proposes inclusion of urinalysis in routine checkups of sarcoidosis individuals.
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January 2019

Serum Interleukin-27 Level in Different Clinical Stages of Lung Cancer.

Open Access Maced J Med Sci 2019 Jan 5;7(1):45-49. Epub 2019 Jan 5.

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Advanced lung cancer is indicated with rapid disease development. Interleukin 27 (IL-27) is regarded as a cytokine with anti-tumour activities.

Aim: Since, the impact of type of lung cancer on the level of IL-27 in patient's serum has not yet been investigated; current study evaluated the clinical stages according to American Joint Committee on Cancer (AJCC) criteria, Tumor-Node-Metastasis (TNM) stage and the lung cancer spread (localized or widespread) and it's correlation with serum IL-27.MATERIAL AND METHODS: Thirty patients with confirmed histopathological lung cancer and 30 cancer-free healthy individuals as the control group were included in the current study. Patients group were assigned to either small cell lung cancer group (SCLC) or non-small cell lung cancer (NSCLC) according to the clinical features and the results of lung biopsy specimens. Level of IL-27 was quantified with enzyme-linked immunosorbent assay (ELISA) test in serum samples.

Results: A significant increase in serum IL-27 level was noticed in individuals with lung cancer in comparison with the control group. The level of serum IL-27 in the NSCL squamous carcinoma (NSCLC-Sc) type was significantly greater than in the NSCLC adenocarcinoma (NSCLC-Ad) type, and in both groups, this variable was more than the control group. The serum IL-27 content level was greater in stage III versus stage IV.

Conclusion: The current research confirmed the existence of the anti-tumour components in patients with NSCLC. IL-27 can be utilised in diagnosis and screening in early stages of lung cancer along with the management of patients. Different levels of IL-27 in different types of lung cancers in the current study can lead to design more comprehensive studies in the future.
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http://dx.doi.org/10.3889/oamjms.2019.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352477PMC
January 2019

A Phase IV Efficacy Study of Formeta Plus Carboplatin as First-Line Treatment of Advanced Non-Squamous, Non-Small Cell Lung Cancer in Iran: An Affordable Price with Clinical Benefit

Asian Pac J Cancer Prev 2018 Oct 26;19(10):2973-2978. Epub 2018 Oct 26.

Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Email:

Background: This study performed to assess the efficacy and safety of Formeta (generic form of Pemetrexed) plus Carboplatin as first-line chemotherapy in advanced stage, non- squamous, non small cell lung cancer ( NSCLC) in Iran. Methods: This was a post marketing single-arm phase IV efficacy study of Formeta (manufactured by Oncomed.,Czech Republic ) and Carboplatin in chemo-naive advanced non-squamous NSCLC Iranian patients. Patients received up to six cycles of Formeta (500 mg/m2) combined with Carboplatin (area under the curve: AUC 5) every 3 weeks. The primary endpoint was the progression free survival (PFS) and secondary endpoints were safety and overall survival (OS). Results: Fifty-two patients were enrolled between June 2014 to January 2016, and 44 patients were evaluable for both safety and efficacy. Partial and complete responses were achieved in 19 (36.5 %) and 2 (3.8%) patients, respectively as well as stable disease in 8 patients (15.3 %). Median of PFS and OS were 7.9 ± 1.1 months and 12.43±0.6 months, respectively. Anemia was the most prevalent adverse events of this regimen. Grades 3 or 4 of adverse events were not observed in any patients. Non-hematologic and other grades of hematologic toxicities were generally mild, and there were no treatment-related deaths. Conclusion: The combination of Formeta and Carboplatin was effective in advanced non-squamous NSCLC and can be a suitable candidate as first-line treatment in these patient’s population.
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http://dx.doi.org/10.22034/APJCP.2018.19.10.2973DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291026PMC
October 2018

A Rare Report of Lung Metastasis of the Common Non-Melanotic Skin Cancer.

Tanaffos 2018 Jan;17(1):62-65

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Basal cell carcinoma is a common non-melanotic skin cancer with a prevalence of 74.5%-82.6% in the Iranian population. BCC rarely metastasizes. However, metastasis can cause significant morbidity. The prevalence of metastatic basal cell carcinoma varies between 0.0028% and 0.55% of all cases. We describe a case of lung metastasis of basal cell carcinoma of the scalp.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087531PMC
January 2018

Prospective Randomized Phase II Parallel Study of Vinorelbine Maintenance Therapy versus Best Supportive Care in Advanced Non-Small Cell Lung Cancer.

Tanaffos 2017 ;16(3):207-216

Dalhousie University, Cape Breton Cancer Centre, Sydney, Nova Scotia, Canada.

Background: Maintenance strategy has been used to improve survival in non-small cell lung cancer (NSCLC). We investigated whether switch maintenance therapy with vinorelbine improved progression free survival (PFS) after first-line chemotherapy with gemcitabine plus carboplatin.

Materials And Methods: In this single blind, parallel, phase 2, randomized trial, patients with NSCLC pathology, age >18 years, Eastern Cooperative Oncology Group (ECOG) performance status (PS) score of 0-2, and advanced stage (IIIB and IV) were treated with up to 6 cycles of gemcitabine 1250 mg/m (day 1 and 8) plus carboplatin AUC 5 (day 1) every 3 weeks. Patients who did not show progression after first-line chemotherapy were randomly assigned to receive switch maintenance with vinorelbine (25 mg/m, day 1, 15) or the best supportive care until disease progression.

Results: A total of 100 patients were registered, of whom 34 had a non-progressive response to first-line chemotherapy and randomly received maintenance vinorelbine (n=19) or best supportive care (n=15). The hazard ratio of PFS in the vinorelbine group relative to the best supportive care group was 1.097 (95% confidence interval = 0.479-2.510; P-value =0.827). There was no significant difference between the overall survival for the two groups (P=0.068).

Conclusion: Switch maintenance strategies are beneficial, but defining the right candidates for treatment is a problem. Moreover, the trial designs do not always reflect the real-world considerations. Switch maintenance therapy with vinorelbine, though had tolerable toxicity, did not improve PFS in patients with NSCLC. Therefore, other agents should be considered in this setting.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960225PMC
January 2017

Prognostic value of rare and complex mutations in EGFR and serum levels of soluble EGFR and its ligands in non-small cell lung carcinoma patients.

Clin Biochem 2017 Apr 5;50(6):293-300. Epub 2016 Dec 5.

Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Electronic address:

Background: A number of complex and rare mutations in epidermal growth factor receptor (EGFR) gene have been identified and the clinical implication of serum EGFR ligands has also been reported. However, the prognostic significance of these mutations and also the serum EGFR and its ligands in Non-Small Cell Lung Carcinoma (NSCLC) has remained a challenging issue. This study is aimed at finding the prognostic importance of EGFR rare mutations and serum EGFR, amphiregulin (AR), and TGF-α (Transforming Growth Factor-alpha) in NSCLC.

Materials And Method: NSCLC patients (n=98) with mean age of 59±10.5 were enrolled (M/F: 75/23). DNA was extracted from formalin fixed paraffin embedded tissues. Exons 19 and 21 were amplified using polymerase chain reaction followed by direct sequencing for identification of mutations. Serum EGFR, AR, and TGF-α were measured by ELISA.

Results: EGFR mutation rate in patients was 37% (exon 19 deletions: 72.2%, exon 21 substitutions: 27.8%). The E872K in exon 21 mutation-positive cases was the most frequent rare mutation detected (90%; 9/10 samples). A significant relationship was found between EGFR exon 21mutations and serum EGFR and TGF-α (P<0.05). Increased serum AR (>3pg/ml) and TGF-α (>10.5pg/ml) were associated with shorter overall survival (P<0.05).

Conclusions: The data clearly show that elevation of serum TGF-α and AR are associated with poor prognosis of NSCLC. In addition to the close relationship between EGFR mutations and serum EGFR, serum TGF-α changes was associated with the gene mutations. These findings could be implicated in clinical decision making related to EGFR-TKIs.
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http://dx.doi.org/10.1016/j.clinbiochem.2016.11.033DOI Listing
April 2017

Bilateral Lymphoblastic Lymphoma of Breast Mimicking Inflammatory Breast Cancer: A Case Report and Review of Literature.

Tanaffos 2015 ;14(1):63-6

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

We report a 45 year-old woman who had bilateral breast masses with extradural involvement. Pathologic report revealed malignant high-grade lymphoblastic lymphoma. Systemic chemotherapy was performed but 3 months later, lesions indicating relapse in bone and breast re-appeared. She received salvage chemotherapy, but 4 months after that she was expired.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515332PMC
July 2015

No evidence for a role of Merkel cell polyomavirus in small cell lung cancer among Iranian subjects.

Pathol Res Pract 2014 Dec 2;210(12):836-9. Epub 2014 Sep 2.

Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Merkel cell polyomavirus (MCPyV), as a new member of polyomaviruses, has recently been discovered as a possible etiologic factor for human cancer. It was first detected in Merkel cell carcinoma (MCC). Small cell lung cancer (SCLC) is a malignant lung tumor which shares histopathological and genetic features with MCC, as both are of neuroendocrine origin. In this study, we investigated the presence of MCPyV DNA in SCLC specimens by real-time PCR. Our null hypothesis was that MCPyV is an etiologic factor in SCLC, as previously seen in MCC. Formalin-fixed and paraffin-embedded (FFPE) specimens were obtained from 50 patients, who underwent bronchoscopic biopsy and were diagnosed with SCLC between March 2010 and March 2012. Similarly, we obtained bronchoscopic biopsy specimens from 29 patients, who were diagnosed with non-small cell lung cancer (NSCLC). All samples were obtained at a single center (Masih Daneshvari Hospital, Tehran, Iran). Real-time PCR was done to detect the presence of MCPyV DNA. After excluding one specimen from the SCLC group due to loss of tumor tissue, we did not detect MCPyV DNA in samples from patients with either SCLC (the mean age 58.9 years, male/female ratio: 7.3/1) or NSCLC. Our results suggest that MCPyV does not play a role in the pathogenesis of SCLC, which is in accord with the results from other prior investigations.
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http://dx.doi.org/10.1016/j.prp.2014.08.011DOI Listing
December 2014

Prevalence of oral human papilloma virus in healthy individuals in East azerbaijan province of iran.

Iran J Public Health 2013 1;42(1):79-85. Epub 2013 Jan 1.

Medical Oncology Department, National Research Institute of TB and Lung Disease, Masih Daneshvari Hospital, Tehran, Iran.

Background: Human papilloma virus causes benign and malignant abnormalities in different part of the body. The link between high risk types of HPV and some anogenital and aerodigestive tract cancer is well established. Oral HPV infection plays a role in developing oropharyngeal squamous cell carcinoma. We studied the prevalence of oral HPV in healthy individuals and its relative risk factors.

Methods: Saliva samples of 114 healthy subjects were collected for HPV DNA analysis. Volunteers completed questionnaires and signed a written consent. For data analysis descriptive statistic, chi square test and odds ratio was used.

Results: The frequency of oral HPV in healthy individuals was 6.1 %(seven participant).The most frequent type was HPV-18 in five of them. HPV-6 and HPV-66 each was detected in one case. Relation of oral HPV positivity to demographic features and risk factors was not statistically significant.

Conclusions: The prevalence of oral HPV infection in our community is the same as many other communities of developing countries, stressing that HPV-18 were the dominant type.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3595626PMC
March 2013

Vincristine-induced seizure potentiated by itraconazole following RCHOP chemotherapy for diffuse large B-cell lymphoma.

Curr Drug Saf 2012 Nov;7(5):372-4

Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Iran.

Objectives: To report the case of a patient with diffuse large B-cell lymphoma (DLBCL) who developed vincristine (VCR)-induced seizure after R-CHOP chemotherapy.

Case Summary: A 22-year-old boy with DLBCL developed generalized tonic clonic seizures following R-CHOP chemotherapy. After receiving the third cycle of chemotherapy, he developed Aspergillus pneumonia; therefore, itraconazole was started 18 days before the administration of cycle 4 of chemotherapy. Seven days after the administration of the fifth doses of vincristine, the patient reported symptoms of gastrointestinal toxicity (abdominal cramps and constipation). Subsequently, he developed three episodes of generalized tonic-clonic seizure which lasted for 2-3 minutes during one day and became unconsciousness. His serum electrolytes were normal with the exception of low serum sodium (128mEq/L). Blood glucose, blood urea nitrogen, the complete blood count, and a cerebrospinal fluid study were also normal. A computed tomography scan of the brain did not show any abnormalities. He had no previous history of convulsion. Occurrence of seizure due to central nervous system invasion of DLBCL was ruled out with a normal cerebrospinal fluid examination, computed tomography scan, and magnetic resonance imaging of the head. Therefore, the patient's neurotoxicity has been attributed to vincristine, the effects of which were likely potentiated by itraconazole therapy.

Discussion: Vincristine is a naturally occurring vinca alkaloid used in various chemotherapy regimens. Neurotoxicity is a known and commonly encountered side effect of vincristine. Peripheral neuropathy is the most common form of vincristine neuropathy whereas central effects are rarer. Enhanced VCR neurotoxicities from drug interactions with several azole antifungals such as itraconazole and voriconazole have been reported. Our case represents a drug possible adverse drug effect based on the Naranjo ADR Probability Scale.

Conclusion: Administration of vincristine in conjunction with azole antifungals should be with caution and after carefully considering the risks and benefits. Also, it is important to rule out other causes of seizure in these patients.
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http://dx.doi.org/10.2174/157488612805076633DOI Listing
November 2012

Association of serum level of 25 hydroxy-vitamin D with prognostic factors for breast cancer.

Asian Pac J Cancer Prev 2011 ;12(6):1381-4

Hematology and Oncology Research Center, Shahid Ghazi Tabatabai Hospital, and Physiology Department, Tabriz Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Background And Aim: In recent years, there has been considerable interest in whether vitamin D inhibits breast cancer development. Experimental studies have shown that vitamin D promotes cell differentiation and retards or terminates proliferation of breast cancer cells. However, there is little evidence supporting the association of vitamin D and prognosis of breast cancer.

Methods And Materials: In this analytic-descriptive study, 119 female patients with histological proven breast cancer were recruited in Tabriz oncology clinics in a 15-month period of time. History of chemotherapy, radiotherapy or receiving vitamin D/Ca supplements and presence of other malignancies were exclusion criteria. Serum level of 25 hydroxy vitamin D (25(OH)D) was measured in all patients.

Results: One hundred and nineteen patients with a mean age of 50.4∓12.6 (26-76) years were enrolled in the study. Metastasis was present in 21.8% of the cases. Stage of tumor was I, II, III and IV in 11, 56, 26 and 26 patients, respectively. The Tumor grade was low in 37 cases, intermediate in 46 cases, and high in 36 cases. The P53, Ki-67, HER2, ER and PR were positive in 30.3%, 49.6%, 17.6%, 61.2% and 55.5% of the patients, respectively. The mean serum level of 25(OH)D was 15.7∓17.8 (4-122) ng/ml, deficient in 66 cases, insufficient in 36 cases and normal level in 17 cases. The median level of 25(OH)D was lower in the P53+ group in a borderline trend (17.3 vs. 13.6 ng/ml; p=0.07). The median level of 25(OH)D was significantly higher in the patients with metastasis, as well (27.7 vs. 12.0 ng/ml; p=0.03). There was no significant association between the serum level of 25(OH)D and other studied parameters.

Conclusion: Based on our findings, there may be an association between the serum level of 25(OH)D and prognosis of breast cancer.
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July 2012