Tehran University Medical Journal

Background: Wilm’s tumor is the most frequent primary renal neoplasma in pediatric age group. Classically it is composed of three histologic parts: Blastemal, Epithelial and stromal. Different factors are implicated as prognostic determinants. Nowadays special attention is paid to proliferation markers for determining the biologic behavior of tumors. In this study we tried to ascertain the proliferative index of 22 cases of Wilm’s tumor in our center who have had rather good follow up (at least two years).

Materials and Methods: After reviewing the H and E slides, we stained sections with PCNA and ki67 and scanned them by image cytomertry. Then the proliferative indices for each histological part was determined.

Results: We resuted that proliferative indices of blastemal and epithelial parts have significant (P< 0.0002) difference (increment) from that of stromal part. Also the patients were divided into those with recurrence (within two ys of primary surgery) and recurrence. The profileration indices of PCNA for those recurring tumors was significantly higher (PCNA= 22.3%) (P= 0.0015).

Conclusion: Finally we concluded that using proliferative markers in Wilm’s tumor is useful as an effective prognostic factor.

Background: Despite major diagnostic and industrial progresses in the technology and use of Ionizing radiations, they have been found to be harmful to the health of the radiology and nuclear medicine staffs. Since Ionizing radiations have the potential to produce free radicals, therefore, it is likely that the total plasma level of anti-oxidant in medical and nuclear medicine staffs could be reduced.

Methods: In this case-control study the relationship of total anti oxidant level of plasma and the function of immune cells such as lymphocyte proliferating response using MTT method, Neutrophil chemotaxi, Intensity of respiratory burst (NBT) and evaluation of IL-2 and IL-4 (ELISA) were investigated. 101 samples were collected for this study and they were assigned as two groups: 61 samples cases from radiology and nuclear medicine staffs of Tehran University Of Medical Science hospitals (Shariaty, Imam Khomeyni, Ghalb-e-Tehran) were assigned as the exposed group, whereas, 40 samples from Pediatric, Orthopedic, Infirmary and Emergencies wards were assigned as control group. Using heparinized syringes, 8 to 10 ml of blood samples were collected from each person with age between 25 to 50, averaging 36.4±7.2, and several assays including Anii Oxidant Capacity of Total Plasma (FRAP Method), T cell proliferative response to PHA mitogen (MTT Method), Chemotaxi of neutrophils and Magnitude of respiratory burst were carried out on these samples. The results were analyzed using spirman correlation analysis.

Results: The results showed that exposure to ionizing radiation chronically with low dosed had no effect on chemotaxis of neutorophils and intensity of respiratory burst, but could have effect on lymphocyte function specially in cytokines secretion like IL-2 which are essential in the immune responses.

Conclusion: This study indicates that long term low dose ionizing radiation may have effect in some parts of the immune function.

Background: Metformin has been suggested as anti-cancer in retrospective studies. We design a prospective controlled study about metformin efficacy in the window time between biopsy and definite surgery with changes of Ki-67 as the primary endpoint.

Methods: The primary cohort had composed of 50 pathologically diagnosed invasive breast cancers, accrued in Medical Oncology Department of Iran Cancer Institute from February to November 2014. Patients neither had indication of neoadjuvant chemotherapy, nor involved with diabetes mellitus. They followed during the time period of biopsy and definitive surgery with taking tests on pathology specimens for ER, PgR, HER-2/neu and Ki-67 index. We checked fasting insulin and glucose level as well as quality of life and adverse effects in both times in the intervention group. Metformin (1500 mg/day) was prescribed to intervention group from pathology report to the night before surgery.

Results: From 45 patients, 25 had been received metformin for median time of 2.8 weeks. Controlled group included 20 patients who followed in the window time. There were no statistically significant differences between two groups regarding baseline clinical and tumor characteristics such as age, stage, grade, ER, PgR, HER2 status, time and type of surgery. However, immunohistochemistry study showed decrease of median Ki-67 from 35.14 to 29.6% in the intervention group and increase from 24.5 to 30.6 in the control group. Both of these results were statistically significant. Patients tolerated metformin very well, but mild gastrointestinal symptoms were seen in 30% of cases. There was a correlation between metabolic factor of HOMA score (fasting insulin level fasting blood sugar/405) and changes in Ki-67.

Conclusion: In the present study metformin prescription in the short period of time between Biopsy and definite surgery had shown inhibition of breast cancer cell growth. We found relationship between metformin anti-proliferative effect and glucose and insulin metabolism. To find direct apoptotic stimulation of metformin and long-term results of this drug further studies in the adjuvant settings with cooperation of pharmacokinetic groups are recommended.